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Receiver operating characteristic (ROC) curve according to Edinburgh Postnatal Depression Scale using cut-off points of 11, 12 and 13.
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Background: More than one million babies are born with Low birthweight (LBW) in India every year, often afflicting disadvantaged families. Earlier studies on LBW in India have mostly focused on addressing poverty, nutritional status, and obstetric factors for LBW babies, comprising of preterm babies (<37 weeks) or small for gestational age (SGA) or...
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Background : Annually, more than a million Low birthweight (LBW) are born in India, often afflicting disadvantaged families. Several studies have undertaken association of poverty, nutritional status, and obstetric factors with LBW. Through our study, we aimed to examine the possibility of any relation between Edinburgh Postnatal Depression Scale (...
Citations
... However, studies that used questionnaires to assess mental health status during pregnancy found a substantial impact on small for gestational age. 30 Articles evidence on the effect of higher cortisol exposure during pregnancy on an infant's head circumference, skinfold thickness and crown-rump length. This suggests the need for further research to explore more on this relationship as well as clinical expert advice on the probable associations. ...
Background:
The role of maternal stress levels on mothers' mental health and fetal growth has been previously studied. However, the evidence linking cortisol exposure during pregnancy to growth outcomes in infants is sparsely available from lower and middle-income countries. We aim to investigate the association of serum cortisol levels in pregnancy with infant birth outcomes and postpartum depressive symptoms in a public health facility in India.
Methods:
The current study is a part of the maternal antecedents of adiposity and studying the transgenerational role of hyperglycemia and insulin (MAASTHI) prospective cohort. We assessed the relationship between maternal exposure to serum cortisol and adverse neonatal outcomes and postpartum depressive symptoms. Serum cortisol levels in stored blood samples were measured in 230 pregnant women as a biomarker for stress during pregnancy. Pregnant women between 18 and 45 years of age were recruited for the study, presenting at ≥14 weeks of gestation and providing voluntary written informed consent. The Edinburgh Postnatal Depression Scale assessed postpartum depressive symptoms, and detailed infant anthropometric measurements were carried out at birth.
Findings:
We found that higher levels (>17.66 μg/L) are significantly associated with low birth weight (OR = 2.28; 95% CI 1.21-4.32) and lower weight for length (OR = 2.16; 95% CI 1.07-4.35). The odds of developing postpartum depressive symptoms in pregnant women with higher mean cortisol cut-off levels is 2.3-fold [OR: 2.33, 95% CI (1.17, 4.64)] compared than women with lower cortisol levels. No significant association was found between serum cortisol and infants' birth weight for gestational age, head circumference, the sum of skinfold thickness, and crown-rump length.
Interpretation:
Our results support the hypothesis that higher maternal cortisol levels may adversely impact birth weight, weight for length in newborns, and postpartum depressive symptoms in mothers.
Funding:
This study was supported by the India Alliance Senior Fellowship [Grant No. IA/CPHS/20/1/505278] awarded to Giridhara R. Babu.
... Es así como en el caso de los bebés pequeños para la edad gestacional (PEG) se ve una menor interacción y reciprocidad entre ambos, lo cual podría relacionarse a las influencias recíprocas que hay entre las características del bebé con el estado emocional de la madre. Estudios han relacionado la sintomatología depresiva en el embarazo con partos de niños/ as PEG, por lo que estas madres podrían estar enfrentando dificultades emocionales que podrían también impactar la relación con su bebé 49 . Los infantes dentro del grupo PEG son un grupo más vulnerable 50 , por lo que es importante prestar atención a las dificultades que puedan presentar a nivel de interacción con sus cuidadores, dado que un ambiente positivo de crianza puede moderar cierta adversidad en su desarrollo, pero también una crianza negativa puede amplificar el efecto de la adversidad 51 . ...
Objetivo:
evaluar cómo la sintomatología depresiva y la percepción del estrés de las madres de bebés prematuros moderados durante la hospitalización puede afectar la interacción de la díada.
Pacientes y Método:
participa ron 85 diadas. Durante la segunda y tercera semana de hospitalización, las madres completaron un cuestionario sociodemográfico, la escala de estrés parental y la Edinburgh postnatal depression scale (EPDS). La interacción madre-hijo fue evaluada y codificada con la Escala de Observación del Vínculo Madre-Bebé Hospitalizados.
Resultados:
las madres de bebés prematuros moderados hospitalizados en una unidad de neonatología pueden presentar una importante sintomatología depresiva y ésta se correlaciona con el estrés experimentado por la madre. El estrés parental y el ser pequeño para la edad gestacional evidenciaron una asociación negativa con las interacciones de las diadas.
Conclusiones:
El tener un bebé prematuro moderado puede impactar la salud mental de las madres y esto a su vez se relaciona con las interacciones que tienen con sus hijos/as. Del mismo modo se detectaron variables relacionadas con los bebés que también pueden disminuir las interacciones y contacto entre la diada.
... Its reliability and validity have been confirmed in 9 different North and sub-Saharan African countries, (9) including validation as a screening instrument in a South African urban community. (10) Previous research has documented an association of high EPDS in pregnant mothers with small-for-gestational age (SGA), (11) low birthweight, (12,13) intrauterine growth restricted (IUGR), (14) and preterm infants. (15) The multicentered prospective Safe Passage Study (SPS), conducted by the NIH-sponsored Prenatal Alcohol and SIDS and Stillbirth (PASS) Network, collected extensive maternal, fetal and infant data in order to investigate the association of drinking and smoking during pregnancy with stillbirths and sudden infant deaths (16). ...
Background:
Depression in the peripartum period is prevalent in low-income-countries. The identification of women needing referral is often lacking and on the other hand, women in need of support and treatment do not make use of existing support.
Objectives:
To identify risk factors for fetal and postnatal consequences of depression in pregnancy and to investigate further management once women at risk have been identified.
Methods:
The Safe Passage Study was a large prospective multicenter international study. Extensive information, including the Edinburgh postnatal depression scale (EPDS), was collected during the study. At risk women were referred to the study's social worker (SW). Women were categorized according to risk on their EPDS results. Risk categories were characterized and investigated for infant outcomes.
Results:
Data from 5,489 women were available for analysis and revealed a 51% prevalence of prenatal depression. Fourteen percent of at-risk women attended SW appointments, while 36% accepted the SW referral but persistently failed to attend. At risk women were significantly younger, had less formal education, had lower monthly income, and lived in more crowded conditions. They used significantly more alcohol and cigarettes. Their infants had shorter gestational ages, lower birth weights and were more growth restricted. Infants of depressed women who missed appointments weighed less and were more growth restricted.
Conclusion:
Women with high EPDSs had less favorable socioeconomic conditions, used more alcohol or tobacco during pregnancy, and their infants weighed less with more growth restriction. Women who repeatedly missed their appointments came from the poorest socioeconomic conditions and their infants had worse birth outcomes.
... A BMI of < 18.5 was classified as underweight, 18.5-22.9 as normal, 23-24.9 as overweight, 25-29.9 as pre-obese, 30-40 as obese type 1, and 40.1-50 as obese type 2. Cut off of EPDS scores for defining depressive symptoms were taken as 11 based on our significant findings for the MAASTHI cohort (31). ...
Introduction: Despite national efforts for promoting exclusive breastfeeding (EBF) during the first 6 months of the infants' life, breastfeeding rates are low in India. Evidence on the interference of supplementary food on optimal nourishment and growth of the infant has also been well-established. Our study was undertaken to assess the effect of breastfeeding practices on infant anthropometry and determine the various factors affecting breastfeeding practices.
Methods: A prospective cohort study - Maternal antecedents of adiposity and studying the transgenerational role of hyperglycemia and insulin (MAASTHI) was conducted at a tertiary care public hospital in Bengaluru, South India. From the consenting women, data such as obstetric history, infant feeding practices, anthropometry of mother and child, the psychosocial status of the women using the Edinburgh Postnatal Depression Scale (EPDS), was collected at baseline and subsequent follow-up: post-delivery and 14 weeks after birth. In this study, we analyzed data collected from April 2016 to April 2018, with descriptive statistics presented in mean and standard deviation, and logistic regression adjusting for confounders.
Results: Among the 240 women enrolled in the study, 33% (n= 80) were using supplementary food for their infants at 14 weeks of infants age. Infants who received supplementary feeding at age 14 weeks had nearly 2.5 times higher odds of being wasted (OR: 2.449, p-value: 0.002) as compared to exclusively breastfed infants.
Conclusion: Infants between 14 to 16 weeks of age who received supplementary feeding were at risk of wasting as compared to exclusively breastfed infants. Despite strong evidence in support of the benefits of exclusive breastfeeding, awareness in urban women in India is low. Increased focus on promoting exclusive breastfeeding is necessary to ensure proper nutritional intake and healthy growth of infants.
... [10] Another study which was conducted at a tertiary care hospital of northern India, the distribution study subjects of based on gravida was as follows, 39.8% were primi gravidas and the remaining 60.2% were multigravida, which is almost similar to the present study findings In an article which considered the birth cohort of India, showed that 35.8% were primigravida and 64.2% were multigravida. [11] In the present study among the 286 Antenatal Mothers, 136 i.e.47.5% antenatal mothers had high risk pregnancy. Most of the mothers i.e. 44.9% had anaemia as risk factor followed by hyperemesis gravidarm which was seen in 35.3% mothers, miscarriage was seen in 5.1%, multiple pregnancy in 2.9%, pregnancy induced hypertension in 2.2%, gestational diabetes mellitus and illness was seen with equal percentage of 1.5% and 0.7% accounted for hypothyroidism. ...
Background:
While hypertensive disorders of pregnancy (HDP) coexist with maternal anxiety and depression, it is unclear how these conditions affect neonatal outcomes. We evaluated the prevalence as well as associations and potential mechanisms between HDP, maternal anxiety and depression, preterm birth (PTB), and small for gestational age (SGA).
Methods:
We conducted a retrospective population-based study using the Healthcare Cost and Utilization Project (HCUP) database from 2004 to 2014. Preterm birth (<37 weeks), SGA (<10th percentile for gestational age and sex), HDP, and mental disorders (anxiety and depression) were extracted using the International Classification of Diseases, Ninth Revision (ICD-9). Mediation and moderation models were constructed separately to evaluate potential mechanisms between maternal anxiety and depression, HDP, and adverse neonatal outcomes. Multivariate logistic regressions were used to determine their associations.
Results:
Of 9,097,355 pregnant women, the prevalence of HDP was 6.9 %, anxiety 0.91 %, depression 0.36 %, preterm birth 7.2 %, and SGA 2.1 %. Anxiety increased the probability of having HDP (OR = 1.242, 95 % CI 1.235-1.250), and HDP mediated the association between anxiety and preterm birth (mediation effect = 0.048, p-value<0.001). Depression significantly moderated the effect of HDP on preterm birth (moderation effect = -0.126, p-value = 0.027). HDP also mediated the association between anxiety and SGA (mediation effect = 0.042, p-value<0.001), but depression did not moderate the association between HDP and SGA (p-value = 0.29).
Conclusion:
Our study suggests that women with anxiety are more likely to have HDP, and HDP mediates the associations between anxiety and adverse neonatal outcomes. Depression moderates associations between HDP and preterm birth but not between HDP and SGA.
BACKGROUND: Depression during pregnancy is often found and ignored even though depression has a negative impact not only on the mother but also on the fetus to adulthood. Stunting is a problem of lack of nutritional status that begins during pregnancy. AIM: The purpose of this article is to systematically identify the description and relationship between depression during pregnancy and stunting in children. METHOD: The approach used is the systematic review method to search articles. Articles were identified from 2010-2020 by conducting a literature search with the keywords "antenatal depression" OR "prenatal depression" OR "depression during pregnancy" and "stunting" in the electronic databases dataset by Sciencedirect, Pubmed Research Gate, and Google Scholar. RESULTS: The search results found 1875 articles selected into 20 journal articles that match the inclusion criteria. CONCLUSION: The results found that depression during pregnancy correlated with risk factors for stunting. As a preventive measure, health workers, especially midwives, can provide psychological care in antenatal care by considering these factors.
Background : Exposure to air pollution (IAP) from the combustion of solid fuels is a significant cause of morbidity and mortality in developing countries. Pregnant women exposed to higher pollutant levels are at higher risk of delivering a low-birth-weight (LBW) baby. There is a lack of standardized data regarding the levels and types of specific pollutants and how they impact LBW. We aim to prospectively assess the association between ambient and indoor air pollution levels in pregnancy and low birth weight and understand the subsequent risk of adiposity in these infants.
Methods: We will conduct a prospective cohort study of 516 pregnant women recruited before 18 weeks of gestation in the urban slums of Bangalore, who have voluntarily consented to participate. We will estimate the level of air pollutants including coarse particulate matter 10 ug/m3 (PM10 ), fine particulate matter 2.5 ug/m3(PM2.5) and carbon monoxide (CO) parts per million (ppm) levels in both indoor and ambient environment. The follow-up of the delivered children will be done at delivery until the infant is two years old. The association between pollutants and LBW will be evaluated using logistic regression adjusting for potential confounders.Further, we will explore the mediation role of LBW in the hypothesized causal chain of air pollution and adiposity. Nested within a larger Maternal Antecedents of Adiposity and Studying the Transgenerational role of Hyperglycemia and Insulin (MAASTHI) cohort, we can estimate the absolute risk of having low birth weight caused by air pollution and other variables.
Discussion: Understanding the association between exposures to ambient and indoor air pollution and low birth weight is essential in India. LBW babies have a higher risk of developing obesity and Non-Communicable Diseases (NCDs) during adulthood. The results from this study can inform the efforts for controlling the air pollution-related chronic diseases in India.
Background : Exposure to air pollution (IAP) from the combustion of solid fuels is a significant cause of morbidity and mortality in developing countries. Pregnant women exposed to higher pollutant levels are at higher risk of delivering a low-birth-weight (LBW) baby. There is a lack of standardized data regarding the levels and types of specific pollutants and how they impact LBW. We aim to prospectively assess the association between ambient and indoor air pollution levels in pregnancy and low birth weight and understand the subsequent risk of adiposity in these infants.
Methods: We will conduct a prospective cohort study of 516 pregnant women recruited before 18 weeks of gestation in the urban slums of Bangalore, who have voluntarily consented to participate. We will estimate the level of air pollutants including particulate matter (<10 μm, <2.5 μm) and carbon monoxide (CO) parts per million (ppm) levels in both indoor and ambient environment. The follow-up of the delivered children will be done at delivery until the infant is one year old. The association between pollutants and LBW will be evaluated using logistic regression adjusting for potential confounders.Further, we will explore the mediation role of LBW in the hypothesized causal chain of air pollution and adiposity. Nested within a large cohort titled "Maternal Antecedents of Adiposity and Studying the Transgenerational role of Hyperglycemia and Insulin (MAASTHI)", we can estimate the absolute risk of having low birth weight caused by air pollution and other variables.
Discussion: Understanding the association between exposures to ambient and indoor air pollution and low birth weight is essential in India. LBW babies have a higher risk of developing obesity and Non-Communicable Diseases (NCDs) during adulthood. The results from this study can inform the efforts for controlling the air pollution-related chronic diseases in India.
Purpose
Neonates born to mothers with obesity or gestational diabetes mellitus (GDM) have an increased chance of various metabolic disorders later in life. In India, it is unclear whether maternal obesity or GDM is related to offspring adiposity. We aimed to understand the independent effect of maternal obesity and GDM with neonatal adiposity and whether GDM has a mediating effect between maternal obesity and neonatal adiposity.
Methods
We recruited a cohort of 1120 women (between April 2016 and February 2019) from the public hospitals in Bangalore, India, who voluntarily agreed to participate and provided written informed consent. The primary outcome was neonatal adiposity, defined as the sum of skinfold thickness >85th percentile. Exposure included maternal obesity, defined as >90th percentile of skinfold thickness. GDM, the potential mediator, was classified using the World Health Organization criteria by oral glucose tolerance test. Binary logistic regression was applied to test the effect of maternal obesity and GDM on neonatal adiposity, adjusting for potential confounders. We used Paramed command in STATA version 14 for analyzing mediating effects.
Results
We found that maternal obesity (odds ratio (OR)=2.16, 95% CI 1.46, 3.18) and GDM (OR=2.21, 95% CI1.38, 3.52) have an independent effect on neonatal adiposity. GDM significantly mediates 25.2% of the total effect between maternal obesity and neonatal adiposity, (natural direct effect OR = 1.16 95% CI 1.04, 1.30) with significant direct effect of maternal obesity (natural direct effect OR = 1.90 95% CI 1.16, 3.10) and significant total effect (OR=2.20 95% CI 1.35, 3.58).
Conclusion
We showed that maternal obesity and GDM are independently associated with offspring adiposity. Also, GDM mediates the association of maternal obesity on adiposity in children. Interventions focused on obesity prevention in women, and effective screening and management of GDM may contribute to reducing childhood obesity in India.
