Effects of a psychological nursing intervention on prevention of anxiety and depression in the postpartum period: a randomized controlled trial

Hongling Liu, Yang Yang, Hongling Liu, Yang Yang

Abstract

Background: Anxiety and postpartum depression are the most common psychological problems in women after delivery. Cognitive behavior intervention has been reported to have an effect in the therapy of postpartum depression. This research aimed to investigate whether cognitive behavior intervention could prevent the pathogenesis of postpartum depression in primiparous women.

Methods: In this randomized controlled trial, primiparous women who were prone to postpartum depression were recruited. Participates in the control group received routine postpartum care and those in the intervention group received both routine postpartum care and cognitive behavior intervention. Hamilton Depression Scale (HAMD), Hamilton Anxiety Scale (HAMA), Edinburgh Postpartum Depression Scale (EPDS) and Pittsburgh Sleep Quality Index (PSQI) were evaluated before and after the intervention.

Results: In the intervention group, the post-intervention scores of HAMA, HAMD, EPDS and PSQI were all significantly lower than the baseline scores (p = 0.034, p = 0.038, p = 0.004, p = 0.014, respectively). The proportion of participants with postpartum depression in the intervention group (11.5%) was significantly lower than the control group (24.3%) after the 6-week intervention. Participants in the intervention group were significantly more satisfied with the care than those in the control group (p = 0.032).

Conclusion: This research provided evidence that cognitive behavioral intervention in postpartum period could alleviate anxiety and depression in primiparous women, and inhibit the pathogenesis of postpartum depression. Trial registry This clinical trial was registered in the Chinese Clinical Trial Registry (ChiCTR2000040076).

Keywords: Anxiety; Cognitive behavioral intervention; Postpartum depression.

Conflict of interest statement

The authors declare that they have no conflict of interest.

Figures

Fig. 1
Fig. 1
Research framework of this study

References

    1. Korja R, Savonlahti E, Haataja L, Lapinleimu H, Manninen H, Piha J, Lehtonen L. Attachment representations in mothers of preterm infants. Infant Behav Dev. 2009;32(3):305–311. doi: 10.1016/j.infbeh.2009.04.003.
    1. Gamble J, Creedy D, Moyle W, Webster J, McAllister M, Dickson P. Effectiveness of a counseling intervention after a traumatic childbirth: a randomized controlled trial. Birth. 2005;32(1):11–19. doi: 10.1111/j.0730-7659.2005.00340.x.
    1. Soltani N, Abedian Z, Mokhber N, Esmaily H. The Association of family support after childbirth with posttraumatic stress disorder in women with preeclampsia. Iran Red Crescent Med J. 2015;17(10):e17865. doi: 10.5812/ircmj.17865.
    1. Olieman RM, Siemonsma F, Bartens MA, Garthus-Niegel S, Scheele F, Honig A. The effect of an elective cesarean section on maternal request on peripartum anxiety and depression in women with childbirth fear: a systematic review. BMC Pregnancy Childbirth. 2017;17(1):195. doi: 10.1186/s12884-017-1371-z.
    1. Shorey S, Chee CYI, Ng ED, Chan YH, Tam WWS, Chong YS. Prevalence and incidence of postpartum depression among healthy mothers: a systematic review and meta-analysis. J Psychiatr Res. 2018;104:235–248. doi: 10.1016/j.jpsychires.2018.08.001.
    1. Bei B, Coo S, Trinder J. Sleep and mood during pregnancy and the postpartum period. Sleep Med Clin. 2015;10(1):25–33. doi: 10.1016/j.jsmc.2014.11.011.
    1. Zanardo V, Giliberti L, Giliberti E, Volpe F, Straface G, Greco P. The role of elective and emergency cesarean delivery in maternal postpartum anhedonia, anxiety, and depression. Int J Gynaecol Obstet. 2018;143(3):374–378. doi: 10.1002/ijgo.12657.
    1. Pawluski JL, Lonstein JS, Fleming AS. The neurobiology of postpartum anxiety and depression. Trends Neurosci. 2017;40(2):106–120. doi: 10.1016/j.tins.2016.11.009.
    1. Nishioka E, Haruna M, Ota E, Matsuzaki M, Murayama R, Yoshimura K, Murashima S. A prospective study of the relationship between breastfeeding and postpartum depressive symptoms appearing at 1–5 months after delivery. J Affect Disord. 2011;133(3):553–559. doi: 10.1016/j.jad.2011.04.027.
    1. Dekel S, Stuebe C, Dishy G. Childbirth induced posttraumatic stress syndrome: a systematic review of prevalence and risk factors. Front Psychol. 2017;8:560. doi: 10.3389/fphys.2017.00560.
    1. Santos IS, Matijasevich A, Tavares BF, da Cruz Lima AC, Riegel RE, Lopes BC. Comparing validity of Edinburgh scale and SRQ20 in screening for post-partum depression. Clin Pract Epidemiol Ment Health. 2007;3:18. doi: 10.1186/1745-0179-3-18.
    1. Becker M, Weinberger T, Chandy A, Schmukler S. Depression during pregnancy and postpartum. Curr Psychiatry Rep. 2016;18(3):32. doi: 10.1007/s11920-016-0664-7.
    1. Sockol LE, Epperson CN, Barber JP. Preventing postpartum depression: a meta-analytic review. Clin Psychol Rev. 2013;33(8):1205–1217. doi: 10.1016/j.cpr.2013.10.004.
    1. Chen H, Wang J, Ch'ng YC, Mingoo R, Lee T, Ong J. Identifying mothers with postpartum depression early: integrating perinatal mental health care into the obstetric setting. ISRN Obstet Gynecol. 2011;2011:309189.
    1. Milgrom J, Danaher BG, Gemmill AW, Holt C, Holt CJ, Seeley JR, Tyler MS, Ross J, Ericksen J. Internet cognitive behavioral therapy for women with postnatal depression: a randomized controlled trial of mummoodbooster. J Med Internet Res. 2016;18(3):e54. doi: 10.2196/jmir.4993.
    1. Rusner M, Berg M, Begley C. Bipolar disorder in pregnancy and childbirth: a systematic review of outcomes. BMC Pregnancy Childbirth. 2016;16(1):331. doi: 10.1186/s12884-016-1127-1.
    1. Lucas G, Olander EK, Ayers S, Salmon D. No straight lines-young women's perceptions of their mental health and wellbeing during and after pregnancy: a systematic review and meta-ethnography. BMC Womens Health. 2019;19(1):152. doi: 10.1186/s12905-019-0848-5.
    1. Xu H, Ding Y, Ma Y, Xin X, Zhang D. Cesarean section and risk of postpartum depression: a meta-analysis. J Psychosom Res. 2017;97:118–126. doi: 10.1016/j.jpsychores.2017.04.016.
    1. Tang L, Zhu R, Zhang X. Postpartum depression and social support in china: a cultural perspective. J Health Commun. 2016;21(9):1055–1061. doi: 10.1080/10810730.2016.1204384.
    1. Pearlstein T, Howard M, Salisbury A, Zlotnick C. Postpartum depression. Am J Obstet Gynecol. 2009;200(4):357–364. doi: 10.1016/j.ajog.2008.11.033.
    1. Sebela A, Hanka J, Mohr P. Etiology, risk factors, and methods of postpartum depression prevention. Ceska Gynekol. 2018;83(6):468–473.
    1. Liu S, Yan Y, Gao X, Xiang S, Sha T, Zeng G, He Q. Risk factors for postpartum depression among Chinese women: path model analysis. BMC Pregnancy Childbirth. 2017;17(1):133. doi: 10.1186/s12884-017-1320-x.
    1. Borza L. Cognitive-behavioral therapy for generalized anxiety. Dialogues Clin Neurosci. 2017;19(2):203–208. doi: 10.31887/DCNS.2017.19.2/lborza.
    1. Iniesta-Sepulveda M, Storch EA. Cognitive-behavioral therapy as an effective, safe, and acceptable intervention for OCD during pregnancy. Braz J Psychiatry. 2017;39(1):84. doi: 10.1590/1516-4446-2016-1952.
    1. van Beek MH, Oude Voshaar RC, Beek AM, van Zijderveld GA, Visser S, Speckens AE, Batelaan N, van Balkom AJ. A brief cognitive-behavioral intervention for treating depression and panic disorder in patients with noncardiac chest pain: a 24-week randomized controlled trial. Depress Anxiety. 2013;30(7):670–678. doi: 10.1002/da.22106.
    1. Jesse DE, Gaynes BN, Feldhousen EB, Newton ER, Bunch S, Hollon SD. Performance of a culturally tailored cognitive-behavioral intervention integrated in a public health setting to reduce risk of antepartum depression: a randomized controlled trial. J Midwifery Womens Health. 2015;60(5):578–592. doi: 10.1111/jmwh.12308.
    1. Okun ML. Disturbed sleep and postpartum depression. Curr Psychiatry Rep. 2016;18(7):66. doi: 10.1007/s11920-016-0705-2.
    1. Matsumura Kenta, Hamazaki Kei, Tsuchida Akiko, Kasamatsu Haruka, Inadera Hidekuni. Education level and risk of postpartum depression: results from the Japan Environment and Children’s Study (JECS) BMC Psychiatry. 2019;19(1):419. doi: 10.1186/s12888-019-2401-3.
    1. Lewis Beth A, Billing Lauren, Schuver Katie, Gjerdingen Dwenda, Avery Melissa, Marcus Bess H. The relationship between employment status and depression symptomatology among women at risk for postpartum depression. Women's Health. 2017;13(1):3–9. doi: 10.1177/1745505717708475.

Source: PubMed

Sponzoři a spolupracovníci

Zdravotní podmínky

Drogové intervence

3
Předplatit