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A psychiatric epidemiological study of postpartum Chinese women

A psychiatric epidemiological study of postpartum Chinese women 82 MONDAY, SEPTEMBER Conclusions: The results suggest that in 85 million childbirths, of low depressed mood (1.2%) were also detected. About 0.4% of participants risk gestation born in one year period in developing countries, when the suffered generalized anxiety disorder (of less than 6 months duration), mother adopts the horizontal outcome(NGAC) resulted in 5,3% of and one participant was diagnosed as a double depression at three depressed new-born (Apgar less than 6) that is to say 4,505,OOO babies, months postpartum. All together, 13.5% (95% CI 8.0% 19.0%) of and 1,5% of very depressed new born (Apgar less than 3) that is to say participants suffered one or more forms of psychiatric disorders in the 1,275,OOO babies. When the mother is in the squatting position (GAC) first three months postpartum. result suggest 1,5% of depressed new-born (Apgar less than 6) that is to Conclusions: This is the first large scale methodologically sound say 1,275,OOO babies and 0,2% of very depressed newborn (Apgar less epidemiological study completed on the prevalence of major than 3). This shows us that we could save 3,230,OOO newborn from the psychological morbidity in a postnatal Chinese population. reanimation possibility and from the neonatal depression consequences in the first minute of life. We could also avoid nearly 1,105,OOO very depressed newbornsThese results encouraged us to begin a P1.02.09 collaborative, prospective and randomized study in several maternity SCREENING POSTNATAL DEPRESSION USING DOUBLE TESTS wards with childbirth’ s assisted with in squatting and litotomy position T. Chug, Dept. OBIGYN, Chinese University of Hong Kong, HK SAR, coord. by Univ. UNICAMP. China. Objectives: Postnatal depression affects 10 to 20 percent of women after P1.02.07 childbirth. To facilitate early detection, self-reporting psychological DESIGNING A NEW SCALE NAMED “DESCENTMETER” (DM) questionnaires have been validated and applied to women following FOR MEASURING THE PROGRESSIVE DESCENT OF FETUS IN confinement. We hypothesize that by applying two complementary LABOUR screening tests simultaneously (a double test), the positive predictive A.Debdas. Telco Maternity Hospital, Telco Colony, Jamshedpur, Bihar, value of the screening instrument can be significantly enhanced. India, 831004. Study Method: Prospective cohort study was conducted at the postnatal clinic of a university teaching hospital. One hundred and forty-five Objective: Introduction of a hard objective method (no clinical guess) to Chinese women completed the Edinburgh Postnatal Depression Scale asses fetal descent in labour because none exist today. Current method (EPDS) and 12.item General Health Questionnaire (GHQ), and were of correlating descent with ischial spines have problems like -a) spines then interviewed by a psychiatrist using the Structured Clinical not easy to locate, b) needs a lot of skill and experience, c) have wide Interview for DSM-III-R (SCID). The SCID interview established the individual variation and d) is painful for the patients. gold standard diagnosis for validation. Method & result Results: The positive predictive value of the EPDS and GHQ, when I. Finding a superficial alternative to ischial spines - Of the 3 choices applied independently, was 44% and 52% at their respective optimal cut- namely ischial tuberosity, tip of sacrum and lower border of symphysis off scores. When the EPDS and GHQ were used simultaneously to (LBS) -the LBS was found to be the best choice because of the define high scorer (EPDS-GHQ double test), the positive predictive following reasons it is easily visible (lcm) above external urthral value was increased to 78%. meatus), easily palpable, is a bony fixed point, is a single point and Conclusions: Simultaneous application of the EPDS and GHQ can hence allows easier relating, is a midline structure hence amenable to substantially improve prediction in screening for postnatal depression. more direct relating and, most importantly, it is the final exit point of the head/breech from pelvis. II. Designing the Descentmeter (DM) - One end of a 30 cm rounded P1.02.10 Taflon rod was calibrated upto 10 cm in 0.5 cm steps - 10 cm because THE IMPACT OF GESTATIONAL FACTORS ON UMBILICAL both vaginal and sacral length is 10 cm. CORD BLOOD AVAILABLE FOR TRANSPLANTATION III. How to take reading by DM -The calibrated end is introduced D.V.Surbek, U.Aufderhaar, A.Tichelli, A.Wodnar-Filipowicz, inside the vagina under guidance of vaginal fingers and guided to rest A.Gratwohl, W.Holzgreve, Depts. of OBIGYN, Hematology and perpendicularly on the lowest point of the head with its handle directed Research, University Hospital, Schanzenstrasse 46, 4031 Basel, straight towards the feet of the patient. In this position the device rests, Switzerland in fact stretches, the fourchettes posteriorly and lies roughly at the central axis of the outlet which lies approximately 5 cm posterior to LBS Objectives: To determine if gestational and peripartum factors have an (the AP diameter of outlet being 10.5 cm). Now, with DM held in right influence on umbilical cord blood (CB) collected at delivery for the hand the index finger of the left hand is placed vertically over the purpose of hematopoietic stem cell transplantation external urethral meatus with its tip pointing towards the anus till it Study Methods: CB was collected using a closed blood-bag system by touches the DM rod perpendicularly. The cm mark at the touch-point puncturing the umbilical vein after cord clamping. CB volume, constitutes the DM reading which denotes that the presenting part is so nucleated cell (NC) count, relative and absolute number of CD34’ many cm away from LBS - the final exit point. As the fetus would progenitor/stem cells (by FACS), and proliferative capacity of descend the DM reading would decrease. progenitors (by colony-forming assay / methylcellulose cultures) were determined. A total of n=167 CB samples from normal term deliveries (n=94), preterm deliveries (n=45, postdate gestations (n=9), pregnancies P1.02.08 affected by preeclampsia (n=ll) or gestational diabetes (n=8) were A PSYCHIATRIC EPIDEMIOLOGICAL STUDY OF POSTPARTUM compared. Additionally, intrapartum variables such as duration of labor CHINESE WOMEN and ruptured membranes, meconium-stained amniotic fluid, fetal T. Chug, Dept. OBIGYN, Chinese University of Hong Kong, HK SAR, acidemia, and mode of delivery were compared among the normal term China. delivery group. Results: CB volume and total NC count showed a linear correlation with Objective: To determine the prevalence of major psychological gestational age. However, among preterm deliveries, there was no morbidity in Hong Kong women following childbirth. gestational age-dependent difference in the total CD34+ cell count per Study Method: A prospective cohort study of 956 women recruited in CB sample due to an inverse relationship of CD34+ cell frequency the antenatal clinic. At three months postpartum, the participants among NC, and up to 77% of samples would have been suitable for completed General Health Questionnaire (GHQ). Then, all participants transplantation into a recipient <20kg bogy weight. CB samples from who scored high on the GHQ (>=5) were assessed by a psychiatrist postdate pregnancies and preeclamptic patients had a significantly using non-patient version of the Structured Clinical Interview for DSM- smaller volume and NC count, the former in comparison with term III-R (SCID-NP). Ten per cent of the participants who scored below the deliveries, the latter in comparison with gestational-age matched non- 415 cut-off were randomly selected to receive the SCID-NP interview to preeclamptic controls. No statistically significant differences were determine the rate of false negatives. Three-month prevalence rates were detected for gestational diabetes (birth-weight adjusted values) and estimated using reverse weighting intrapartum parameters except a higher CB volume and NC count in Results: The 3-month prevalence rates for major depression and minor deliveries with meconium staining. depression were 6.1% (95% CI 2.1% 10.1%) and 5.1% (95% CI 1.1% Conclusions: Our study shows that gestational factors influence CB 9.1%) respectively. Dysthymia (0.7%) and adjustment disorders with samples obtained for stem cell transplantation. These factors should be http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png International Journal of Gynecology & Obstetrics Wiley

A psychiatric epidemiological study of postpartum Chinese women

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Wiley
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© International Federation of Gynecology and Obstetrics
ISSN
0020-7292
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1879-3479
DOI
10.1016/S0020-7292(00)82758-7
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Abstract

82 MONDAY, SEPTEMBER Conclusions: The results suggest that in 85 million childbirths, of low depressed mood (1.2%) were also detected. About 0.4% of participants risk gestation born in one year period in developing countries, when the suffered generalized anxiety disorder (of less than 6 months duration), mother adopts the horizontal outcome(NGAC) resulted in 5,3% of and one participant was diagnosed as a double depression at three depressed new-born (Apgar less than 6) that is to say 4,505,OOO babies, months postpartum. All together, 13.5% (95% CI 8.0% 19.0%) of and 1,5% of very depressed new born (Apgar less than 3) that is to say participants suffered one or more forms of psychiatric disorders in the 1,275,OOO babies. When the mother is in the squatting position (GAC) first three months postpartum. result suggest 1,5% of depressed new-born (Apgar less than 6) that is to Conclusions: This is the first large scale methodologically sound say 1,275,OOO babies and 0,2% of very depressed newborn (Apgar less epidemiological study completed on the prevalence of major than 3). This shows us that we could save 3,230,OOO newborn from the psychological morbidity in a postnatal Chinese population. reanimation possibility and from the neonatal depression consequences in the first minute of life. We could also avoid nearly 1,105,OOO very depressed newbornsThese results encouraged us to begin a P1.02.09 collaborative, prospective and randomized study in several maternity SCREENING POSTNATAL DEPRESSION USING DOUBLE TESTS wards with childbirth’ s assisted with in squatting and litotomy position T. Chug, Dept. OBIGYN, Chinese University of Hong Kong, HK SAR, coord. by Univ. UNICAMP. China. Objectives: Postnatal depression affects 10 to 20 percent of women after P1.02.07 childbirth. To facilitate early detection, self-reporting psychological DESIGNING A NEW SCALE NAMED “DESCENTMETER” (DM) questionnaires have been validated and applied to women following FOR MEASURING THE PROGRESSIVE DESCENT OF FETUS IN confinement. We hypothesize that by applying two complementary LABOUR screening tests simultaneously (a double test), the positive predictive A.Debdas. Telco Maternity Hospital, Telco Colony, Jamshedpur, Bihar, value of the screening instrument can be significantly enhanced. India, 831004. Study Method: Prospective cohort study was conducted at the postnatal clinic of a university teaching hospital. One hundred and forty-five Objective: Introduction of a hard objective method (no clinical guess) to Chinese women completed the Edinburgh Postnatal Depression Scale asses fetal descent in labour because none exist today. Current method (EPDS) and 12.item General Health Questionnaire (GHQ), and were of correlating descent with ischial spines have problems like -a) spines then interviewed by a psychiatrist using the Structured Clinical not easy to locate, b) needs a lot of skill and experience, c) have wide Interview for DSM-III-R (SCID). The SCID interview established the individual variation and d) is painful for the patients. gold standard diagnosis for validation. Method & result Results: The positive predictive value of the EPDS and GHQ, when I. Finding a superficial alternative to ischial spines - Of the 3 choices applied independently, was 44% and 52% at their respective optimal cut- namely ischial tuberosity, tip of sacrum and lower border of symphysis off scores. When the EPDS and GHQ were used simultaneously to (LBS) -the LBS was found to be the best choice because of the define high scorer (EPDS-GHQ double test), the positive predictive following reasons it is easily visible (lcm) above external urthral value was increased to 78%. meatus), easily palpable, is a bony fixed point, is a single point and Conclusions: Simultaneous application of the EPDS and GHQ can hence allows easier relating, is a midline structure hence amenable to substantially improve prediction in screening for postnatal depression. more direct relating and, most importantly, it is the final exit point of the head/breech from pelvis. II. Designing the Descentmeter (DM) - One end of a 30 cm rounded P1.02.10 Taflon rod was calibrated upto 10 cm in 0.5 cm steps - 10 cm because THE IMPACT OF GESTATIONAL FACTORS ON UMBILICAL both vaginal and sacral length is 10 cm. CORD BLOOD AVAILABLE FOR TRANSPLANTATION III. How to take reading by DM -The calibrated end is introduced D.V.Surbek, U.Aufderhaar, A.Tichelli, A.Wodnar-Filipowicz, inside the vagina under guidance of vaginal fingers and guided to rest A.Gratwohl, W.Holzgreve, Depts. of OBIGYN, Hematology and perpendicularly on the lowest point of the head with its handle directed Research, University Hospital, Schanzenstrasse 46, 4031 Basel, straight towards the feet of the patient. In this position the device rests, Switzerland in fact stretches, the fourchettes posteriorly and lies roughly at the central axis of the outlet which lies approximately 5 cm posterior to LBS Objectives: To determine if gestational and peripartum factors have an (the AP diameter of outlet being 10.5 cm). Now, with DM held in right influence on umbilical cord blood (CB) collected at delivery for the hand the index finger of the left hand is placed vertically over the purpose of hematopoietic stem cell transplantation external urethral meatus with its tip pointing towards the anus till it Study Methods: CB was collected using a closed blood-bag system by touches the DM rod perpendicularly. The cm mark at the touch-point puncturing the umbilical vein after cord clamping. CB volume, constitutes the DM reading which denotes that the presenting part is so nucleated cell (NC) count, relative and absolute number of CD34’ many cm away from LBS - the final exit point. As the fetus would progenitor/stem cells (by FACS), and proliferative capacity of descend the DM reading would decrease. progenitors (by colony-forming assay / methylcellulose cultures) were determined. A total of n=167 CB samples from normal term deliveries (n=94), preterm deliveries (n=45, postdate gestations (n=9), pregnancies P1.02.08 affected by preeclampsia (n=ll) or gestational diabetes (n=8) were A PSYCHIATRIC EPIDEMIOLOGICAL STUDY OF POSTPARTUM compared. Additionally, intrapartum variables such as duration of labor CHINESE WOMEN and ruptured membranes, meconium-stained amniotic fluid, fetal T. Chug, Dept. OBIGYN, Chinese University of Hong Kong, HK SAR, acidemia, and mode of delivery were compared among the normal term China. delivery group. Results: CB volume and total NC count showed a linear correlation with Objective: To determine the prevalence of major psychological gestational age. However, among preterm deliveries, there was no morbidity in Hong Kong women following childbirth. gestational age-dependent difference in the total CD34+ cell count per Study Method: A prospective cohort study of 956 women recruited in CB sample due to an inverse relationship of CD34+ cell frequency the antenatal clinic. At three months postpartum, the participants among NC, and up to 77% of samples would have been suitable for completed General Health Questionnaire (GHQ). Then, all participants transplantation into a recipient <20kg bogy weight. CB samples from who scored high on the GHQ (>=5) were assessed by a psychiatrist postdate pregnancies and preeclamptic patients had a significantly using non-patient version of the Structured Clinical Interview for DSM- smaller volume and NC count, the former in comparison with term III-R (SCID-NP). Ten per cent of the participants who scored below the deliveries, the latter in comparison with gestational-age matched non- 415 cut-off were randomly selected to receive the SCID-NP interview to preeclamptic controls. No statistically significant differences were determine the rate of false negatives. Three-month prevalence rates were detected for gestational diabetes (birth-weight adjusted values) and estimated using reverse weighting intrapartum parameters except a higher CB volume and NC count in Results: The 3-month prevalence rates for major depression and minor deliveries with meconium staining. depression were 6.1% (95% CI 2.1% 10.1%) and 5.1% (95% CI 1.1% Conclusions: Our study shows that gestational factors influence CB 9.1%) respectively. Dysthymia (0.7%) and adjustment disorders with samples obtained for stem cell transplantation. These factors should be

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International Journal of Gynecology & Obstetrics – Wiley

Published: Jan 1, 2000

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