Psychosocial health in pregnancy and postpartum among women living with - and without HIV and non-pregnant women living with HIV living in the Nordic countries – Results from a longitudinal survey study

Background The success of antiretroviral therapy has normalized pregnancy among women living with HIV (WWH) with a very low risk of perinatal transmission of HIV. Despite these advances, WWH still face complex medical and psychosocial issues during pregnancy and postpartum. The aim of this study was to assess differences in psychosocial health outcomes between pregnant WWH, non-pregnant WWH, and pregnant women without HIV, and further identify factors associated with probable depression in the third trimester and postpartum. Methods In a longitudinal survey study, participants were included from sites in Denmark, Finland, and Sweden during 2019–2020. Data was collected in the 3rd trimester, 3 and 6 months postpartum using standardized questionnaires assessing depression, perceived stress, loneliness, and social support. Mixed regression models were used to assess changes over time within and between groups. Logistic regression models were used to identify factors associated with depression in pregnancy and postpartum. Results A total of 47 pregnant WWH, 75 non-pregnant WWH, and 147 pregnant women without HIV were included. The prevalence of depression was high among both pregnant and non-pregnant WWH. There was no significant difference between pregnant and non-pregnant WWH in depression scores, perceived stress scores, or social support scores at any time point. Compared to pregnant women without HIV, pregnant WWH reported worse outcomes on all psychosocial scales. Social support and loneliness were associated with an increased odds of depressive symptoms in the adjusted analysis. Conclusions A high burden of adverse psychosocial outcomes was observed in both pregnant and non-pregnant women living with HIV compared to pregnant women without HIV. Loneliness and inadequate social support were associated with increased odds of depression in pregnancy and should be a focus in future support interventions.

Predictors of Antenatal Depression in a Tertiary Hospital in Nigeria

Background: Antenatal depression is very common in pregnant women all over the world. Women in the developing and poor countries are more at risk. Several risk factors have been identified and some of them may lead to unbearable pregnancy situations, that pose a threat to mother and the baby. If pregnancy must be made pleasurable for mothers, then the risk factors which predict depression in pregnancy must be identified and considered in antenatal care. Objective: To identify risk factors which are predictors to antenatal depression in pregnant women. Methods: Within the months of January and February 2021, all the pregnant women who registered for antenatal care in the teaching hospital, who met the study inclusion criteria were assessed for depression using the English version of Edinburgh Postnatal Depression scale (EPDS) and a study designed risk factor questionnaire, which contained socio-demographic variables and other factors. Data obtained were analyzed using the statistical package for social sciences (SPSS) version 23. Variables were compared using chi squared and t-tests and p values < 0. 05 were statistically significant. Results: Five hundred (500) respondents completed the study, 158 (31.6%) were depressed. Risk factors of co-habiting, threats to life, and/or pregnancy, fight with spouse and other forms of abuse, previous abortions and child health challenges, were predictors of antenatal depression. Conclusion: Depression in pregnancy should be part of routine antenatal care by obstetricians noting the predictors.

Mother–infant interaction in women with depression in pregnancy and in women with a history of depression: the Psychiatry Research and Motherhood – Depression (PRAM-D) study

Background Little is known about the effects of depression before birth on the quality of the mother–infant interaction. Aims To understand whether depression, either in pregnancy or in lifetime before pregnancy, disrupts postnatal mother–infant interactions. Method We recruited 131 pregnant women (51 healthy, 52 with major depressive disorder (MDD) in pregnancy, 28 with a history of MDD but healthy pregnancy), at 25 weeks’ gestation. MDD was confirmed with the Structured Clinical Interview for DSM-IV Disorders. Neonatal behaviour was assessed at 6 days with the Neonatal Behavioural Assessment Scale, and mother–infant interaction was assessed at 8 weeks and 12 months with the Crittenden CARE-Index. Results At 8 weeks and 12 months, dyads in the depression and history-only groups displayed a reduced quality of interaction compared with healthy dyads. Specifically, at 8 weeks, 62% in the depression group and 56% in the history-only group scored in the lowest category of dyadic synchrony (suggesting therapeutic interventions are needed), compared with 37% in the healthy group (P = 0.041); 48% and 32%, respectively, scored the same at 12 months, compared with 14% in the healthy group (P = 0.003). At 6 days, neonates in the depression and history-only groups exhibited decreased social-interactive behaviour, which, together with maternal socioeconomic difficulties, was also predictive of interaction quality, whereas postnatal depression was not. Conclusions Both antenatal depression and a lifetime history of depression are associated with a decreased quality of mother–infant interaction, irrespective of postnatal depression. Clinicians should be aware of this, as pregnancy provides an opportunity for identification and intervention to support the developing relationship.

REDUCING DEPRESSION IN PREGNANCY AND POSTPARTUM PERIOD THROUGH ACCEPTANCE AND COMMITMENT THERAPY: A REVIEW OF DEPRESSION REDUCTION AMONG IRANIAN WOMEN

Pregnancy is an important event in the life of every woman that is associated with conflicting emotions. Having a newborn baby can be accompanied by hardships and loss of desire, as well as other stresses in life, all of which can have adverse effects on the mental health of the mother and her family. Depression is a common mental disorder in mothers during and after childbirth, which can have negative consequences for mother and baby. Acceptance and Commitment Therapy (ACT) is one of the new treatments with a positive impact on the reduction of depression during pregnancy and afterward. This form of psychotherapy is significant in increasing the psychological flexibilities of women as well as reducing their distress and depressive symptoms during pregnancy and during the postpartum period. Hence this paper aims to review the literature on the concept of depression, its symptoms, and outcomes during pregnancy and the postpartum period, and subsequently, it reviews how ACT can reduce depression, in terms of relevance to Iranian mothers. The studies were selected and identified through online databases from relevant published articles in psychology, psychotherapy, and mental health journals. The reviews of the literature on the ACT and reducing depression in pregnancy and postpartum period were identified from research studies in Iran from 2015 to the present time. This paper highlights the significance of future research into ACT for reducing depression during pregnancy and the postpartum period among Iranian women.