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Pathways between Risk/Protective Factors and Maternal Postnatal Depressive Symptoms: The ELFE Cohort

Objective: The risk factors for postnatal depressive symptoms (PNDS) are numerous, but little is known about the protective factors or the interactions between different exposures. The present study explored the pathways between maternal, infant and parenthood vulnerabilities or risk/protective fact...

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Autores principales: Bales, Mélanie, Pambrun, Elodie, Maguet, Charlotte, van der Waerden, Judith, Glangeaud-Freudenthal, Nine, Charles, Marie-Aline, Bois, Corinne, Melchior, Maria, Milgrom, Jeannette, Falissard, Bruno, Verdoux, Hélène, Sutter-Dallay, Anne-Laure
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10179307/
https://www.ncbi.nlm.nih.gov/pubmed/37176644
http://dx.doi.org/10.3390/jcm12093204
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author Bales, Mélanie
Pambrun, Elodie
Maguet, Charlotte
van der Waerden, Judith
Glangeaud-Freudenthal, Nine
Charles, Marie-Aline
Bois, Corinne
Melchior, Maria
Milgrom, Jeannette
Falissard, Bruno
Verdoux, Hélène
Sutter-Dallay, Anne-Laure
author_facet Bales, Mélanie
Pambrun, Elodie
Maguet, Charlotte
van der Waerden, Judith
Glangeaud-Freudenthal, Nine
Charles, Marie-Aline
Bois, Corinne
Melchior, Maria
Milgrom, Jeannette
Falissard, Bruno
Verdoux, Hélène
Sutter-Dallay, Anne-Laure
author_sort Bales, Mélanie
collection PubMed
description Objective: The risk factors for postnatal depressive symptoms (PNDS) are numerous, but little is known about the protective factors or the interactions between different exposures. The present study explored the pathways between maternal, infant and parenthood vulnerabilities or risk/protective factors and PNDS at 2 months postpartum (PP) in a large sample of women from the general population. Methods: We used data from the French ELFE cohort, a nationally representative cohort of children followed-up from birth. The available information about vulnerabilities or risk/protective factors for PNDS was collected during the maternity ward stay (mother or medical records) and at 2 months PP (mother by phone). PNDS were evaluated with the Edinburgh Postnatal Depression Scale (EPDS) at 2 months. A measurement model was built based on the psychosocial model for PNDS of Milgrom and colleagues using exploratory factor analysis. The Structural Equation Model was used to investigate the pathways between vulnerability, risk/protective factors and PNDS at 2 months PP. Results: In the study sample (n = 11,583), a lack of a partner’s perceived antenatal emotional support, consultation with a mental health specialist before pregnancy, family financial difficulties, prenatal psychological distress and a difficult pregnancy experience were directly associated with the severity of maternal PNDS at 2 months PP, as well as lack of perceived postnatal support. Family financial difficulties and consultation with a mental health specialist before pregnancy were also indirectly associated with the intensity of PNDS through a lack of perceived antenatal emotional support, a difficult pregnancy experience, prenatal psychological distress and a lack of perceived postnatal support. Regarding infant and parenthood characteristics, infant self-regulation difficulties, maternal difficulty in understanding infant crying and infant hospitalisation were directly associated with PNDS severity at 2 months PP, while maternal difficulty in understanding an infant’s cries was also indirectly associated with infant self-regulation difficulties. Conclusions: Perinatal professional support should begin antenatally and target the couple’s prenatal functioning, with particular attention to women presenting a history of psychiatric disorders, especially those of low socioeconomic status. After delivery, addressing infant and parenthood characteristics is also recommended.
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spelling pubmed-101793072023-05-13 Pathways between Risk/Protective Factors and Maternal Postnatal Depressive Symptoms: The ELFE Cohort Bales, Mélanie Pambrun, Elodie Maguet, Charlotte van der Waerden, Judith Glangeaud-Freudenthal, Nine Charles, Marie-Aline Bois, Corinne Melchior, Maria Milgrom, Jeannette Falissard, Bruno Verdoux, Hélène Sutter-Dallay, Anne-Laure J Clin Med Article Objective: The risk factors for postnatal depressive symptoms (PNDS) are numerous, but little is known about the protective factors or the interactions between different exposures. The present study explored the pathways between maternal, infant and parenthood vulnerabilities or risk/protective factors and PNDS at 2 months postpartum (PP) in a large sample of women from the general population. Methods: We used data from the French ELFE cohort, a nationally representative cohort of children followed-up from birth. The available information about vulnerabilities or risk/protective factors for PNDS was collected during the maternity ward stay (mother or medical records) and at 2 months PP (mother by phone). PNDS were evaluated with the Edinburgh Postnatal Depression Scale (EPDS) at 2 months. A measurement model was built based on the psychosocial model for PNDS of Milgrom and colleagues using exploratory factor analysis. The Structural Equation Model was used to investigate the pathways between vulnerability, risk/protective factors and PNDS at 2 months PP. Results: In the study sample (n = 11,583), a lack of a partner’s perceived antenatal emotional support, consultation with a mental health specialist before pregnancy, family financial difficulties, prenatal psychological distress and a difficult pregnancy experience were directly associated with the severity of maternal PNDS at 2 months PP, as well as lack of perceived postnatal support. Family financial difficulties and consultation with a mental health specialist before pregnancy were also indirectly associated with the intensity of PNDS through a lack of perceived antenatal emotional support, a difficult pregnancy experience, prenatal psychological distress and a lack of perceived postnatal support. Regarding infant and parenthood characteristics, infant self-regulation difficulties, maternal difficulty in understanding infant crying and infant hospitalisation were directly associated with PNDS severity at 2 months PP, while maternal difficulty in understanding an infant’s cries was also indirectly associated with infant self-regulation difficulties. Conclusions: Perinatal professional support should begin antenatally and target the couple’s prenatal functioning, with particular attention to women presenting a history of psychiatric disorders, especially those of low socioeconomic status. After delivery, addressing infant and parenthood characteristics is also recommended. MDPI 2023-04-29 /pmc/articles/PMC10179307/ /pubmed/37176644 http://dx.doi.org/10.3390/jcm12093204 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Bales, Mélanie
Pambrun, Elodie
Maguet, Charlotte
van der Waerden, Judith
Glangeaud-Freudenthal, Nine
Charles, Marie-Aline
Bois, Corinne
Melchior, Maria
Milgrom, Jeannette
Falissard, Bruno
Verdoux, Hélène
Sutter-Dallay, Anne-Laure
Pathways between Risk/Protective Factors and Maternal Postnatal Depressive Symptoms: The ELFE Cohort
title Pathways between Risk/Protective Factors and Maternal Postnatal Depressive Symptoms: The ELFE Cohort
title_full Pathways between Risk/Protective Factors and Maternal Postnatal Depressive Symptoms: The ELFE Cohort
title_fullStr Pathways between Risk/Protective Factors and Maternal Postnatal Depressive Symptoms: The ELFE Cohort
title_full_unstemmed Pathways between Risk/Protective Factors and Maternal Postnatal Depressive Symptoms: The ELFE Cohort
title_short Pathways between Risk/Protective Factors and Maternal Postnatal Depressive Symptoms: The ELFE Cohort
title_sort pathways between risk/protective factors and maternal postnatal depressive symptoms: the elfe cohort
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10179307/
https://www.ncbi.nlm.nih.gov/pubmed/37176644
http://dx.doi.org/10.3390/jcm12093204
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