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Fulltext Reliability and validity of the malay version of Edinburgh Postpartum Depression Scale (EPDS) when administered to postpartum mothers at two points in time

Nursazila Asikin MA, Siti Norhani S, Nur Arzuar AR, Azam OE

International Medical Journal Malaysia, 2019;18:65-72.

Introduction: Edinburgh Postpartum Depression Scale (EPDS) is a tool used to assess the risk of postpartum depression (PPD). In this study we determined the reliability and validity of the Malay version of EPDS when administered at two different time points in the postpartum period.
Materials and Methods: This cross-sectional study design was carried out between May and September 2017 at three government primary healthcare clinics located in Batang Padang district, a suburban area of Perak state in Peninsular Malaysia. We recruited a total of 89 women; 41 women were in the early postpartum period (1-30 days) and 48 women were in the late postpartum period (31-120 days). Cronbach's alpha coefficient, inter-item correlation, and corrected item-total correlation were used to assess the internal consistency. The concurrent validity was assessed using Spearman's correlation. The data were analyzed using SPSS version 20 and R 3.4.2.
Results: The Cronbach's alpha for the first and second group was 0.78 and 0.62, respectively, which indicated satisfactory reliability. At both time periods, removing Item 2 from the scale resulted in a significant increase in Cronbach's alpha (to 0.847 and 0.709, respectively). As expected, the EPDS scores correlated moderately with the BDI-II scores (1-30 days: Spearman's rho = 0.65, p < 0.01; 31-120 days: Spearman's rho = 0.73, p < 0.01).
Conclusion: The Malay version of the EPDS is a reliable screening instrument for detecting postpartum depression. It showed reasonability and feasibility and can be used in postpartum clinical settings or for assessing intervention effects in research studies. Furthermore, as our results indicated, removing Item 2 from the Malay version would increase the internal consistency of the EPDS. © 2019 Default.
Study site: Klinik Kesihatan, Perak, Malaysia

Matched MeSH terms: Depression, Postpartum
Fulltext The influence of parenting stress on postpartum depression among newly delivered women. [Pengaruh tekanan keibubapaan terhadap kemurungan postpartum dalam kalangan wanita baru bersalin.]

Abdul Latiff R, Wan Sulaiman WS, Hoesni S

Jurnal Psikologi Dan Pembangunan Manusia, 2013;1(1):12-21.

Postpartum depression is one of the major depressions experienced by women during three months after giving birth to their babies. The symptoms of this type of depression cannot be taken lightly as it affects not only the women but also the development of the babies, family harmony and functioning and can in fact harm themselves and other individuals in their surrounding. Thus, this research was conducted to identify the influence of parental stress towards postpartum depression. A total of 181 women participated in this study and they were from two groups namely married and unmarried women who just gave birth. Two instruments were used and they were the Postpartum Depression Screening Scale and the Parental Stress Index Short Form. Results obtained showed that parental stress and its dimensions were significantly correlated with postpartum depression. In addition, maternal stress and difficult child characteristics were significant predictors of postpartum depression. Findings also showed that there were significant differences of parental stress and its dimensions between married and unmarried women who just gave birth. These findings imply the importance of coping with parental stress to prevent women from experiencing postpartum depression.
Keywords Postpartum Depression · Parental Stress · Child Characteristics · Regression

Matched MeSH terms: Depression, Postpartum
Fulltext Review of the prevalence of postnatal depression across cultures

Arifin SRM, Cheyne H, Maxwell M

AIMS Public Health, 2018;5(3):260-295.
PMID: 30280116 DOI: 10.3934/publichealth.2018.3.260

The purpose of this review was to examine articles related to recent epidemiological evidence of the prevalence of maternal postnatal depression (PND) across different countries and cultures and to identify specific epidemiological studies that have been carried out exclusively in Malaysia on the prevalence of maternal PND. The review was undertaken in two stages, an initial review and an updated review. At both stages systematic literature searches of online databases were performed to identify articles on the prevalence of maternal PND. A total of 124 articles concerning research conducted in more than 50 countries were included in the final analysis. There were wide variations in the screening instruments and diagnostic tools used although the Edinburgh Postnatal Depression Scale (EPDS) was the most common instrument applied to identify PND. The prevalence of maternal PND ranged from 4.0% to 63.9%, with Japan and America recording the lowest and highest rates, respectively. Within continents, a wide variation in reported prevalence was also found. The reported rates of maternal PND in Malaysia were much higher than that previously documented with a range of 6.8-27.3%. This review indicated that the widely cited prevalence of maternal PND of 10-15% underestimates rates of PND worldwide. The reasons for this variability may not be fully explained by review methods. Future studies should evaluate the nature of women's PND experiences across cultures to explain these wide variations.

Matched MeSH terms: Depression, Postpartum
Perspective of Postpartum Depression Theories: A Narrative Literature Review

Abdollahi F, Lye MS, Zarghami M

N Am J Med Sci, 2016 Jun;8(6):232-6.
PMID: 27500126 DOI: 10.4103/1947-2714.185027

Postpartum depression is the most prevalent emotional problem during a women's lifespan. Untreated postpartum depression may lead to several consequences such as child, infant, fetal, and maternal effects. The main purpose of this article is to briefly describe different theoretical perspectives of postpartum depression. A literature search was conducted in Psych Info, PubMed, and Science Direct between 1950 and 2015. Additional articles and book chapters were referenced from these sources. Different theories were suggested for developing postpartum depression. Three theories, namely, biological, psychosocial, and evolutionary were discussed. One theory or combinations of psychosocial, biological, and evolutionary theories were considered for postpartum depression. The most important factor that makes clinicians' choice of intervention is their theoretical perspectives. Healthcare providers and physicians should help women to make informed choices regarding their treatment based on related theories.

Matched MeSH terms: Depression, Postpartum
Mental health literacy of maternal and paternal postnatal (postpartum) depression in British adults

Swami V, Barron D, Smith L, Furnham A

J Ment Health, 2019 May 09.
PMID: 31070064 DOI: 10.1080/09638237.2019.1608932

BACKGROUND: Postnatal depression affects between 6 and 13% of new parents, but only a small proportion of individuals who meet diagnostic criteria receive optimal treatment. One reason for this is poor mental health literacy of postnatal depression.
AIMS: Studies have examined mental health literacy of maternal postnatal depression, but there are no similar studies of paternal postnatal depression, which we sought to rectify.
METHODS: A sample of 406 British adults was presented with vignettes describing cases of either maternal or paternal postnatal depression. Based on the vignettes, participants were asked to report if they thought anything was wrong with the targets and, if so, to describe what they thought was wrong. Participants also rated the targets on a range of attitudinal dimensions.
RESULTS: Participants were more likely to indicate that something was wrong when the target was female (97.0%) compared to male (75.9%). Of those who believed something was wrong, 90.1% of participants correctly described the female target as experiencing postnatal depression, but only 46.3% did so for the male target. Participants also held more positive attitudes toward the female target than the male target.
CONCLUSIONS: There is a gender binary in symptom recognition of postnatal depression, which highlights the need for greater awareness of paternal postnatal depression.

Matched MeSH terms: Depression, Postpartum
Postpartum depression in Asian cultures: a literature review

Klainin P, Arthur DG

Int J Nurs Stud, 2009 Oct;46(10):1355-73.
PMID: 19327773 DOI: 10.1016/j.ijnurstu.2009.02.012

OBJECTIVES:
Postpartum depression (PPD), a major health concern, produces insidious effects on new mothers, their infant, and family. This literature review aims to explore risk factors for postpartum depression among women in Asian cultures, which has not been fully elaborated.

DATA SOURCES:
A literature search was undertaken by using various electronic research databases. Studies were eligible for this review if they (a) examined risk factors for PPD, (b) were conducted in Asian countries using quantitative or qualitative methodologies, and (c) were published in English in peer-reviewed journals between 1998 and 2008. A total of 64 studies from 17 countries were reviewed, summarised, and synthesised.

RESULTS:
The prevalence of postpartum depression in Asian countries ranged from 3.5% to 63.3% where Malaysia and Pakistan had the lowest and highest, respectively. Risk factors for postpartum depression were clustered into five major groups: biological/physical (e.g., riboflavin consumption), psychological (e.g., antenatal depression), obstetric/paediatric (e.g., unwanted pregnancy), socio-demographic (e.g., poverty), and cultural factors (e.g., preference of infants' gender). Traditional postpartum rituals were not found to provide substantial psychological benefits for the new mothers.

CONCLUSIONS:
This review informs a current state of knowledge regarding risk factors for postpartum depression and has implications for clinical practice. Health care professionals should be aware that the phenomenon is as prevalent in Asian cultures as in European cultures. Women should be screened for potential risk factors and depressive symptoms during pregnancy and postpartum periods so that appropriate interventions, if needed, can be initiated in a timely fashion.

Matched MeSH terms: Depression, Postpartum/diagnosis; Depression, Postpartum/ethnology*; Depression, Postpartum/therapy
Fulltext Prevalence and determinants of antepartum depressive and anxiety symptoms in expectant mothers and fathers: results from a perinatal psychiatric morbidity cohort study in the east and west coasts of Malaysia

Nasreen HE, Rahman JA, Rus RM, Kartiwi M, Sutan R, Edhborg M

BMC Psychiatry, 2018 06 15;18(1):195.
PMID: 29902985 DOI: 10.1186/s12888-018-1781-0

BACKGROUND: Research on antepartum psychiatric morbidities investigating depressive and anxiety symptoms in expectant mothers and fathers is lacking in low- and middle-income countries. This study aimed to estimate the prevalence of antepartum depressive, anxiety and co-occurring significant symptoms and explore the associated factors in a cross-section of Malaysian expectant mothers and fathers.

METHODS: We used cross-sectional data from a prospective cohort study of 911 expectant mothers and 587 expectant fathers during their third trimester of pregnancy, from health clinics of two states in the east and west coasts of Malaysia. The validated Malay version of Edinburgh Postnatal Depression Scale and the anxiety sub-scale of Depression, Anxiety and Stress Scale were used to measure the depressive and anxiety symptoms. Multiple logistic regression analyses identified the determinants of antepartum depressive and anxiety symptoms (ADS and AAS).

RESULTS: Prevalence of ADS was 12.2% in expectant mothers and 8.4% in expectant fathers, while AAS was 28.8% in expectant mothers and 13.3% in expectant fathers, and co-occurring significant symptoms was 8.0% in expectant mothers and 4.0% in expectant fathers. Expectant mothers and fathers having perceived social/family support were less likely to suffer from ADS. Intimate partner violence, poor relationship with husbands, depression in earlier pregnancy and husband's depression in current pregnancy in expectant mothers, and living in rented house, sex preference for the unborn child, stressful life events and wife's depression in current pregnancy in expectant fathers were associated with a greater likelihood of ADS. The determinants for AAS were living in rented house and with parents/in-laws, poor relationship with husbands, restrictions during pregnancy and stressful life events for expectant mothers, and stressful life events and being unsupportive towards wives in household chores for expectant fathers.

CONCLUSION: Both ADS and AAS are prevalent in expectant mothers and fathers, and largely an undetected problem in Malaysia. Administration of couple-based screening and referral program during antenatal check-up should be universal practices to identify and treat the psychiatric morbidities.

Matched MeSH terms: Depression, Postpartum/diagnosis; Depression, Postpartum/epidemiology*; Depression, Postpartum/psychology*
Incidence of postnatal depression in Malaysian women

Kit LK, Janet G, Jegasothy R

J Obstet Gynaecol Res, 1997 Feb;23(1):85-9.
PMID: 9094824

OBJECTIVE: To determine the incidence of postnatal depression of Malaysias women at 6 week postpartum and a survey of their sociocultural practices.
METHODS: A hundred and fifty-four women who were 6 weeks postpartum attending the postnatal clinic between May and July 1995 at Maternal and Child Health Clinic, Seremban, Malaysia. Maternal socio-demography, depression by Edinburgh Postnatal Depression Scale (EPDS), postnatal care and practices e.g. pantang larang (prohibited behaviour and practices), diet and partnering were evaluated.
RESULTS: Postnatal depression was 3.9%. Indians had the highest rate at 8.5% as compared to Malays (3.0%) and none in Chinese (p < 0.05). There were no demographic differences in the study groups. Average score of EPDS was 4.05 which ranged from 0 to 20. During the confinement 85.7% of women took special diet; 64.3% followed pantang larang and 78.8% had someone to look after them. The incidence of postnatal depression is low in Malaysia at 3.9%. Majority of Malaysian women still observed the traditional postnatal beliefs and practices.

Matched MeSH terms: Depression, Postpartum/epidemiology*
The Effectiveness of Hypnosis Intervention in Alleviating Postpartum Psychological Symptoms

Beevi Z, Low WY, Hassan J

Am J Clin Hypn, 2019 Apr;61(4):409-425.
PMID: 31017553 DOI: 10.1080/00029157.2018.1538870

Psychological symptoms, particularly postpartum depression, may impair women's well-being after childbirth. Mind-body treatments such as hypnosis are available to help prepare women to maintain or improve their well-being postpartum. The aims of the present study are to determine the effectiveness of a hypnosis intervention in alleviating psychological symptoms (stress, anxiety, and depression) and the symptoms of postpartum depression. A quasi-experimental design was utilized in this study. The experimental group participants (n = 28) received a hypnosis intervention at weeks 16, 20, 28, and 36 of their pregnancies. Participants in the control group (n = 28) received routine prenatal care. The final data collection, occurring at two months postpartum, included 16 women from the experimental group and 11 women from the control group. The Depression Anxiety Stress Scale-21 (DASS-21) was used to measure psychological symptoms, and postpartum depression was assessed using the Edinburgh Postnatal Depression Scale (EPDS). The results at two months postpartum showed that the experimental group had significantly lower postpartum anxiety than the control group (M = 2.88 versus M = 38.36, p = .023). Similarly, the experimental group had significantly lower postpartum depressive symptoms than the control group (M = 1.25 versus M = 6.73, p postpartum stress symptoms were not significant (p = .363). Finally, the results indicated that the experimental group experienced reduced postpartum depression when compared to the control group (M = 5.69 versus M = 10.64, p postpartum.

Matched MeSH terms: Depression, Postpartum/prevention & control
Severe Maternal Morbidity and Postpartum Depressive Symptomatology: A Prospective Double Cohort Comparison Study

Norhayati MN, Nik Hazlina NH, Aniza AA, Asrenee AR

Res Nurs Health, 2016 Dec;39(6):415-425.
PMID: 27367484 DOI: 10.1002/nur.21741

The adverse consequences to mothers of postpartum depression are well-documented, and risk factors are of interest. There is limited evidence on postpartum depression among women with severe maternal morbidity, defined as potentially life-threatening conditions during pregnancy, childbirth, or soon after termination of pregnancy. We compared postpartum depressive symptoms of postpartum women aged 18 and older who delivered in two tertiary referral hospitals in 2014 in Kelantan, Malaysia, and had (n = 145) or had not (n = 187) suffered severe maternal morbidity. A prospective double cohort study design was applied. Postpartum depressive symptoms were assessed at 1 and 6 months postpartum using the Malay version of the Edinburgh Postnatal Depression Scale. There was no significant difference in the mean Edinburgh Postnatal Depression Scale score changes (p = .803) between the two groups of women, after adjusting for age, social support, physical health, occupation, and education. Factors other than severe medical complications should be pursued as predictors of postpartum depressive symptomatology. © 2016 Wiley Periodicals, Inc.

Matched MeSH terms: Depression, Postpartum/epidemiology*
Fulltext A review of depression research in Malaysia

Ng CG

Med J Malaysia, 2014 Aug;69 Suppl A:42-5.
PMID: 25417950 MyJurnal

Depression is a debilitating illness and has become a leading cause of morbidity globally. We aim to summarise the evidence available in regard to the prevalence, type of assessment tools used and treatment options for depression in Malaysia. Two hundred and forty seven articles related to depression were found in a search through a database dedicated to indexing all original data relevant to medicine published in Malaysia between the years 2000-2013. Fifty seven articles were selected and reviewed on the basis of clinical relevance and future research implications. Findings were summarised, categorised and presented according to prevalence of depression, depression in women, depression in clinical condition, assessment tools, and treatment of depression. The prevalence of depression in Malaysia was estimated to be between 8 and 12%. The figures were higher among women of low socio-economic background or those with comorbid medical condition. The common assessment tools used in Malaysia include Beck Depression Inventory (BDI), Depression, Anxiety and Stress Scale (DASS), Patient Health Questionnaire 9 (PHQ-9) and Hospital Anxiety and Depression Scale (HADS). They were translated into the Malay language and their psychometric properties were established. Both pharmacological treatment and psychotherapy were commonly used in Malaysia, and were highly recommended in local clinical practice guidelines. There are discrepancies in the reported rates of depression in Malaysia and this needs to be addressed. There were lack of studies looking into the depression among subgroups in Malaysia especially in the male population. There were several instruments available for assessment of depression in Malaysia but their suitability for the local setting need further research. Both pharmacotherapy and psychotherapy were recommended in the local treatment guideline in Malaysia. With the emergence of generic medication, we need to compare their clinical efficacy and tolerability with original products.

Matched MeSH terms: Depression, Postpartum
Fulltext Antidepressant-like effects of omega-3 fatty acids in postpartum model of depression in rats

Arbabi L, Baharuldin MT, Moklas MA, Fakurazi S, Muhammad SI

Behav Brain Res, 2014 Sep 1;271:65-71.
PMID: 24867329 DOI: 10.1016/j.bbr.2014.05.036

Postpartum depression (PPD) is a psychiatric disorder that occurs in 10-15% of childbearing women. It is hypothesized that omega-3 fatty acids, which are components of fish oil, may attenuate depression symptoms. In order to examine this hypothesis, the animal model of postpartum depression was established in the present study. Ovariectomized female rats underwent hormone-simulated pregnancy (HSP) regimen and received progesterone and estradiol benzoate or vehicle for 23 days, mimicking the actual rat's pregnancy. The days after hormone termination were considered as the postpartum period. Forced feeding of menhaden fish oil, as a source of omega-3, with three doses of 1, 3, and 9g/kg/d, fluoxetine 15mg/kg/d, and distilled water 2ml/d per rat started in five postpartum-induced and one vehicle group on postpartum day 1 and continued for 15 consecutive days. On postpartum day 15, all groups were tested in the forced swimming test (FST) and open field test (OFT), followed by a biochemical assay. Results showed that the postpartum-induced rats not treated with menhaden fish oil, exhibited an increase in immobility time seen in FST, hippocampal concentration of corticosterone and plasmatic level of corticosterone, and pro-inflammatory cytokines. These depression-related effects were attenuated by supplementation of menhaden fish oil with doses of 3 and 9g/kg. Moreover, results of rats supplemented with menhaden fish oil were comparable to rats treated with the clinically effective antidepressant, fluoxetine. Taken together, these results suggest that menhaden fish oil, rich in omega-3, exerts beneficial effect on postpartum depression and decreases the biomarkers related to depression such as corticosterone and pro-inflammatory cytokines.

Matched MeSH terms: Depression, Postpartum/chemically induced; Depression, Postpartum/drug therapy*; Depression, Postpartum/metabolism
Fulltext Antidepressant-Like Properties of Fish Oil on Postpartum Depression-Like Rats Model: Involvement of Serotonergic System

Abdul Aziz NU, Chiroma SM, Mohd Moklas MA, Adenan MI, Ismail A, Hidayat Baharuldin MT

Brain Sci, 2020 Oct 13;10(10).
PMID: 33066310 DOI: 10.3390/brainsci10100733

Pathophysiology of postpartum depression (PPD) has been associated with many factors, such as neuroendocrine, neuroinflammation and neurotransmitter changes. Fish oil (FO) improves PPD both in humans and animals. However, little is known with regards to its pharmacology on a PPD-like rat model. Hence, the current study aimed at investigating the effects of FO on a PPD-like rat model. Female rats were induced with PPD-like symptoms and then randomly divided into six groups (n = 6) for two experimental protocols. Protocol 1 consisted of PPD-like rats (2 mL distilled water), PPD-like + FO (9 g/kg/d) and PPD-like + Fluoxetine (FLX) (15 mg/kg/d) groups of rats, whereas Protocol 2 consisted of PPD-like rats (2 mL distilled water) + PCPA (p-chlorophenylalanine) 150 mg/kg, PPD-like + FO (9 g/kg/d) + PCPA 150 mg/kg and PPD-like + FLX (15 mg/d) + PCPA 150 mg/kg groups of rats, respectively. All treatments were administered orally for 10 days postpartum, except PCPA, which was given intraperitoneally. Prior to euthanasia, the antidepressant-like effect of the FO was evaluated using the forced swimming test (FST) and open field test (OFT) on day 10 postpartum. Biochemical analysis of serotonin, serotonin metabolite and serotonin turnover from their prefrontal cortex and hippocampus were also measured. The results showed that FO decreased immobility time and increased swimming time significantly, but not climbing time in FST. Further, it also decreased serotonin metabolite and turnover significantly in the hippocampus of the PPD-like rats. In contrast, administration with PCPA reversed all the outcomes. The antidepressant-like effects of FO were found to be similar with that of FLX. Thus, it can be concluded that FO exerts its antidepressant-like effects in PPD-like rats through modulation of serotonergic system.

Matched MeSH terms: Depression, Postpartum
Postnatal depression in mothers attending primary care clinics in Kelantan, Malaysia

Abdul Kadir A, Nordin R, Ismail SB, Yaacob MJ, Wan Mahmud WMR

International Medical Journal (Tokyo), 2005;12:105-109.

Objective: To determine the prevalence of postnatal depression (PND), and associated risk factors among women in Kota Bharu District, Kelantan. Design: A cohort study Methods: A study involving four hundred and twenty one pregnant women attending primary health care facilities in Kota Bharu between February and September 2000 were screened for depression at 36-42 weeks of pregnancy, 1 week postpartum and 4-6 weeks postpartum using validated Malay version of Edinburgh Postnatal Depression Scale (EPDS). Results: Three hundred and seventy seven women successfully completed the EPDS (response rate = 89.8%). The prevalence of PND at 4-6 weeks postpartum, based on an EPDS score of 12 and above, was 20.7%. Depressive symptoms at the end of pregnancy (p<0.05) and one week postnatal (p<0.05) were significantly associated with PND. Conclusions: PND among women in Kota Bharu was 20.7%, which was higher than previously reported studies. Onset of depressive symptoms towards the end of pregnancy and early postnatal period independently predicted postnatal depression. © 2005 Japan International Cultural Exchange Foundation.

Matched MeSH terms: Depression, Postpartum
Fulltext Postpartum depression among Malay women from a rural area in Kedah, north-west of Peninsular Malaysia: prevalence and risk factor

Wan Mahmud WMR, Hayati MR, Bashah B, Amir A, Mahmood NM

Malaysian Journal of Psychiatry, 2005;13:3-19.

Background: Community based epidemiological data on postpartum depression in Malaysia is scarce. Aim: To determine the prevalence and risk factors for developing postpartum depression among Malay women from a rural area in Kedah, North West of Peninsular Malaysia. Method: We screened 185 women at 4-12 weeks postpartum attending the selected health centers using the Malay versions of Edinburgh Postnatal Depression Scale (EPDS) and Beck Depression Inventory II (BDI-11). Those scoring 12 and / or 9/10 on BDI-11 were interviewed using the Composite International Diagnostic Interview (CIDI) and the 17-items Hamilton Rating Scale for Depression (HDRS-17). All diagnoses were based on the Tenth Edition of the International Classification for Disease: Diagnostic Criteria for Research (ICD-I0: DCR-10). Results: The prevalence of postpartum depression was 21.08%. The condition was found to be significantly linked to polygamous marriages, high number of life events and financial problems over the last one year prior to delivery, and low scores on the Malay version of the MOS Social Support Survey and all its components (overall support index, informational support, affectionate support/ positive social interactions and instrumental support). Conclusions: Postpartum depression is indeed a reality among Malay women in rural areas In Kedah, North West of Peninsular Malaysia. These findings have implications for policies regarding maternal and childcare programs.

Matched MeSH terms: Depression, Postpartum
Fulltext Relationship between obstetric risk factors and postnatal depression in Malaysian women

Abdul Kadir A, Mohammad Daud MN, Yaacob MJ, Nik Hussain NH

International Medical Journal (Tokyo), 2009;16:101-6.

Objective: To determine the prevalence of depressive symptomatology in early postnatal period and its relationship with obstetric risk factors. Material and Methodology: This is a cross sectional study involving 293 women from postnatal ward Hospital Universiti Sains Malaysia (HUSM), Malaysia. They were screened for depression at day 1 to day 5 postpartum and 4 to 6 weeks postpartum using the Edinburgh Postnatal Depression Scale (EPDS). At the first visit, the women completed questionnaires on socio-demography and obstetric risk factors and Brief Patient Health Questionnaire (BPHQ-9). At the second visit which is 4-6 weeks postpartum, they only completed EPDS. Results: Two hundred and ninety-three women successfully completed the study (100% response rates). The prevalence of PND at 4-6 weeks postpartum using the EPDS score of 12 or more was 27.3%. Women with the history of abortion (p < 0.05) and early postnatal depression (p < 0.05) was significantly associated with PND. Conclusion: Postnatal depression among women in Hospital USM was more common compared to previously reported series in Malaysia. Women with the history of abortion and early postnatal depression were significantly associated with PND. © 2009 Japan International Cultural Exchange Foundation.

Matched MeSH terms: Depression, Postpartum
Fulltext The influence of hospital practices and family support on breastfeeding duration, adverse events, and postnatal depression among first-time mothers

Sarah Dib, Jonathan CK Wells, Nurul Husna M Shukri

Malaysian Journal of Medicine and Health Sciences, 2020;16(106):90-98.
MyJurnal

Introduction: Baby-friendly hospital practices and family support are recognised to improve the chances of success- ful breastfeeding. The associations between support and maternal psychological state and breastfeeding problems are less explored. This study aimed to assess the influence of professional and family support on breastfeeding ad- verse events and postpartum depression at 2 weeks and exclusive breastfeeding (EBF) status at 12 weeks postpartum, and to identify predictors of positive outcomes. Methods: 64 primiparous Malaysian mothers were interviewed face-to-face, at 2, 6 and 12 weeks post-delivery, to collect data regarding family support, hospital and infant feeding practices, breastfeeding problems and pain, maternal perceptions and depression. Logistic regression and correlation were used to ascertain associations between support and EBF, adverse events and postpartum depression. Results: Neither professional nor family support predicted EBF at 12 weeks. Eighty-five percent of the mothers received high family support, which was associated with lower depression scores (r=-0.36, p=0.005); higher depression scores were associated with more breastfeeding problems. EBF discontinuation before 12 weeks was predicted by maternal perception of insufficient milk supply (OR=8.96, CI=1.78, 45.18). Earlier breastfeeding initiation (r=0.26, p=0.04) and skin-to-skin contact (r=0.25, p=0.048) were associated with lower breastfeeding pain. EBF in hospital was cor- related with fewer breastfeeding problems (r=0.31, p=0.01). Conclusion: Mothers with greater family support suf- fered from less depressive symptoms, which could lower the incidence of breastfeeding problems and prolong EBF duration. Skin-to-skin contact, early breastfeeding initiation and EBF in hospital were associated with less adverse events, thus better compliance with these Baby-Friendly practices is recommended.

Matched MeSH terms: Depression, Postpartum
Fulltext Case Study on the effect of Epidural Analgesia on pain management during labour

Ho, S.E., Sumathi, U., Ismail, M.S., Choy, Y.C., Ahmad Zailani, H., Liu, C.Y.

Medicine & Health, 2013;8(1):33-36.
MyJurnal

Child birth is associated with severely painful experience for the parturient, and often exceeds one’s expectations. Even though, severe pain is non life-threatening condition in healthy parturient women, it may lead to undesired neuropsychological consequences. When no analgesia was used, postnatal depression may be more common, and this labour pain leads to the development of post-traumatic stress disorder. Epidural analgesia is now considered gold standard for effective pain relief during labour. We here report a case of a 37-year-old G1 P0 patient at term gestation who successfully used epidural analgesia for labour pain management.

Matched MeSH terms: Depression, Postpartum
Fulltext Depression and coping strategies used by postnatal mothers during the postpartum period

Norliza, J., Siti Khuzaimah, A.S., Emad A.S., Norimah, S.

Malaysian Journal of Psychiatry, 2014;23(2):63-72.
MyJurnal

The objective of this study is to evaluate the depression and coping strategies used by postnatal mothers during the postpartum period.This study used cross-sectional design and was conducted at the University Malaya Medical Centre from November 2013 to January 2014. This study involved 150 respondents (postnatal mothers) and used instrumentation adopted from the Malay version of Edinburgh Postnatal Depression Scale (EPDS) and the Malay version of Brief COPE. The results showed 32 (21.3%) postnatal mothers have had severe depression. Emotional coping strategies were reported to be the most used by postnatal mothers (mean = 4.77 ± 0.70). There was a significant association between problem-focused coping strategies and race (p=0.045) where it was mostly used by Malay participants (mean = 3.39±0.46). There was a mild negative relation between EPDS and problem focus (r=-0.168, p=0.04). On the other hand, there was a mild positive relation between depression level and avoidant emotion (r= 0.162, p= 0.047). The psychological support from nurses and family was needed to improve depression and coping strategies used so that it can improve health outcome among postnatal mothers.

Matched MeSH terms: Depression, Postpartum
Fulltext Postpartum depression: a survey of the incidence and associated risk factors among Malay women in Beris Kubor Besar, Bachok, Kelantan

Wan Mahmud WM, Shariff S, Yaacob MJ

Malays J Med Sci, 2002 Jan;9(1):41-8.
PMID: 22969317 MyJurnal

The aim of this study was to determine the incidence and associated risk factors of postpartum depression among Malay women in Beris Kubor Besar, Bachok, Kelantan The study was conducted between February to August 1998. A two-stage population survey approach was employed. Firstly, all the women who delivered between the months of February and May 1998 in the catchment area were identified. In stage 1, the 30 items GHQ was used as the screening instrument at 6 to 8 weeks postpartum. All the potential cases (scoring above 6 on the questionnaire) were later interviewed using the CIS in stage 2 of the study. Diagnosis of postpartum depression was only made if the women fulfilled required criteria. Of the 174 women who were recruited, 17 of them fulfilled the criteria for postpartum depression yielding an incidence rate of 9.8 %. The condition was found to be significantly linked to low income or socioeconomic status, having marital problems (mainly financial in nature) and not breast - feeding.

Matched MeSH terms: Depression, Postpartum

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