Prevalence of Maternal Depression
Maternal depression is one of the common conditions affecting families, women, and society at large. It encompasses extensive conditions that predominantly affect women during pregnancy and up to twelve months postpartum. Some of the depressive disorders attributed to maternal depression include postpartum depression, postpartum psychosis, and prenatal depression. The issue of maternal depression is widely recognized in the entire world as it induces a negative impact on the individual’s life, affecting numerous families, interfering with the development of children, and affecting society at large. As per the current research, maternal depression in countries such as the United Kingdom has been identified a health issue, with approximately 12 to 16% of the women in the country experiencing depression at the time of pregnancy and in the first twelve months of postpartum (Drury et al 2016 p.78). Maternal depression culminates into serious health complications and risks to the women and children, thus increasing the cost during birth, causing health complications to the infants, and inducing a permanent impact on the women and children’s wellbeing (Côté et al 2018 p.121). Therefore, the discussion will include research data collected based on maternal depression concerning the targeted research. The study anticipates getting both primary and secondary information related to risks of maternal depression, how the condition affects society, and some of the appropriate health actions and guidelines that should be followed to halt the whole concept of maternal depression that interferes with health and wellbeing.
The aim and objective of this research are;
- To determine some of the risk factors associated with maternal depression in the entire context of pregnancy and the whole aspect of the postnatal period.
- To evaluate how is maternal depression affects society, that is, children, mothers, fathers, and family members at large.
- To review some of the detection, health prevention, and treatment guidelines that should be emulated to curb maternal depression among pregnant women and mothers.
Based on the above-outlined concepts, the research question(s) will be;
- What are some of the risks associated with maternal depression among pregnant women?
- How is maternal depression affecting pregnant women and society and large?
- What are some of the detection, prevention, and treatment guidelines suitable for maternal depression among pregnant women and mothers?
Various sources have outlined the topic of maternal depression. According to Priel et al (2019 p.32), maternal depression is one of the health complications that risks the health and wellbeing of pregnant women, mothers, fathers, children and the family at large. Different researchers have reported how women from various nations have struggled with maternal depression (Baranov et al 2020 p.34). Maternal depression is one of the most common mental health conditions affecting many mothers and women in the UK and the entire world. The existing evidence has confirmed that depression in both the postnatal and pregnancy period is prevalent in all nations, both low- and high-income countries. As evidenced by Matijasevich et al (2015 p.54) the results articulate that the prevalence rate for maternal depression is approximated to be between 18% to 55%. This confirms that many clinics anticipate at least one in every seven pregnant women to experience maternal health complications, including anxiety and depression. Also, extensive evidence shows that most mental health diseases, including anxiety and depression, are expected to be two to four times more prevalent among mothers and pregnant women in low-income settings than in high-income locations.
Moreover, as highlighted by Weissman et al (2015 p.212) maternal depression results in a wide range of health challenges, thus interfering with the quality of life. It is evidenced that maternal depression is associated with dangerous health consequences such as the low-income reduced functional capacity for the mothers and pregnant women and poor quality of life. One of the main issues to comprehend regarding depression is that the condition remains under-treated and under-detected during prenatal care, with some persisting sequelae far beyond the perinatal duration. In addition, there are different risk factors associated with maternal depression. As cited by Nemoda and Szyf (2017 p.657) some of the common elements supporting this condition include deficiency of social support, low socioeconomic status, adverse life events, disappointments from partners, and the stormy relationship between mother and other family members. In the UK, maternal depression among women increases from one year to another. This has been catalyzed by the negative cognitive style, low levels of self-esteem, history of family abuse, lack of social support, among other risk factors (Conners-Burrow et al 2015 p.43). Currently, the meta-analysis results have found that aspects such as domestic violence, life stress, and low social status are three key elements supporting maternal depression among women and mothers. Maternal depression predicts outcomes such as higher complications of preterm birth, poorer growth of children, higher rates of stunting and under-nutrition children, low weight, and increased diseases such as diarrheal diseases and reduced cognitive development (Garrison et al 2021 p.180). However, despite the overwhelming evidence on the health effects of maternal depression among women and children, the prevention and treatment actions have been delayed. Most of the associated maternal programs have been neglected, thus reducing well-being. The goals of improving mental health among pregnant women and mothers have not been supported for the last three years until early this year when the World Health Organization has incorporated sound guidelines for the treatment and prevention of depression in pregnancy and the whole concept of the postnatal period.
Health Complications and Risks of Maternal Depression
Participants
Both institution and community-based cross-sectional studies will be conducted from April to July 2022 at different antenatal clinics in public health settings in the United Kingdom. The research targets both public and private health institutions and will be selected randomly for this study. The anticipated participants of this study include pregnant women and mothers. We expect to work with a sample size of 1500 pregnant women and mothers, thus collecting adequate data related to the whole subject of maternal depression in the United Kingdom.
We will use a single population proportion formula to calculate the sample size of this study. This will be based on the magnitude of depression in both mothers and pregnant women in the UK with a confidence interval of 95% and a margin error of about 5%, and with a calculated design impact of 2.5. Also, a cluster sampling technique will be employed, thus helping in selecting fie woredas out of the list of 30 targeted. The health extension employees for the woreda targeted will have to list the number of pregnant women and mothers using the non-identifying registration digits or codes. This action will facilitate the registration of expectant mothers in the first, second, and third trimesters of their pregnancy. We will exclude pregnant women and mothers who have impaired communication capacity as they will not be in the best position to participate in this targeted research.
In this study, we target the demographic variables that semi-structured interviews will collect. This will be done after we have obtained the written informed consent from the participants. A participant information sheet will explain the nature and purpose of the study. This will be issued to only those willing to participate in this research. First of all, we will ensure the confidentiality and privacy of this research. Through the interview process, we will design a semi-structured questionnaire that will be provided online. The data will include questions related to participants’ medical history, obstetric history, social-demographic data, marital discord, social support, pregnancy-related depression, and anxiety. We will have to record data related to mental illness induced by current catastrophic events. Specific tools for assessing health conditions will be used to collect other data suitable for analyzing the targeted research aims and objectives.
Secondly, we will have to assess the depressive symptoms incurred by the participants using the Edinburgh Postnatal Depression Scale. This is a ten-item questionnaire consistently scored from level 0 to 3 (with three being the highest score revealing the more maternal depressive signs and symptoms experienced by the targeted population). The tool has been validated, thus helping in detecting depressive behaviors at postpartum and in antepartum periods in various nations worldwide. According to Eberhard?Gran et al (2021 p.76), the Edinburgh Postnatal Depression Scale has been used and validated in different countries such as the United States of America, confirming a specificity score of 76% and sensitivity of 87% at the cut off range of 9/10. As it is explained by Cox et al (2017 p.43) the cut-off score in this tool for the many pregnant women is higher as compared with postpartum women. Thus, considering this study, we anticipate working with a cut-off score of 13 hence helping identify pregnant women experiencing maternal depression. The pregnant women who score more than 13 will be described as depressed women, while those who score less than the anticipated target score in this study will be considered non-depressive.
Risk Factors Associated with Maternal Depression
Additionally, we will have to consider the experience of stressful life actions and events, but this will be based on the six months before the assessment. To have adequate data on this experience, we will have tools such as the List of Threatening Experiences. This is a twelve-item grouped into five different health categories: legal problems, income instability, relationship challenges, loss of life, and health risks. The tools contain twelve types articulating significant life events, for instance, those relating to the loss of relationships, death of a partner, loss of the valued object, and imprisonment. All these 12 categories in this tool will account for two-thirds of all the life events or risk factors that culminate into maternal depression among pregnant women and mothers.
Also, we expect to determine the issue of social support and how it leads to maternal depression among the targeted population. Thus, we will consider the Oslo 3 item Social Support Scale. This is a three-item questionnaire that is always used by researchers when they assess the issue of social support among the targeted participants. The technique includes a sum score scale starting from level three to fourteen, and it has three broad categories, namely poor help, moderate support, and strong support ranging (3 to 8, 9 to 11, and 12 to 14, respectively. This means that social support scores will be grouped into either poor or no social support provided for those responses that are less than 9. Besides, those scores starting from 9 to 14 will be termed as moderate to firm support, and we will have to merge them as “yes” to include social support.
We expect to use various techniques for data processing and analysis. The code data will be checked and then cleaned by entering the dataset in the Epi Info version 7. Afterward, the data will be exported to the Statistical Package for Social Sciences, thus helping analyze. We will also employ descriptive statistics to assist in estimating the prevalence of antenatal mental depression among the targeted participants. Also, the binary logistic regression analysis will be conducted, thus assessing the relationship between the dependent and independent variables in this study. Lastly, the strength association will be measured using odds ratios within the confidence intervals of 95% and with a statistical significance less than 0.05.
Different databases will be used to analyze the most appropriate secondary data relevant to this research topic. According to Oermann et al (2021 p.101) there are various databases related to the field of public health that will be used in collecting secondary data related to maternal depression among pregnant mothers. These databases include Medline, PubMed, CINAHL, Cochrane Controlled Trials Register, and Evidence-Based Medicine. The two databases have unique features that make them top-notch sources for getting peer-reviewed scholarly papers with approved information significant to public health. We will target using the MEDLINE database as it includes a large number of educational materials articulating various topics related to public health and specifically to the subject matter of this study. Secondly, the database consists of a specific format that must be adhered to by each article before it is approved. The sources should have valid and relevant information hammering current information pertinent to public health. Also, each source is arranged in a specific format by including the authors’ name, the topic of the authorities, the year of publication, the journal section, and the publisher’s name. This chronological format makes it easy for the readers to quickly identify and select the source needed from an extensive list of peer-reviewed scholarly sources.
Prevention Strategies for Maternal Depression
We will use various search terms and synonyms to identify the most appropriate literature for this study. This will involve using standard phrases such as postpartum psychosis, postnatal depression, postpartum depress, risk factors, detection and preventive guidelines, and mental depression impact. All these key terms will help in getting only relevant peer-reviewed literature.
The procedures entail searching for the relevant literature supporting the research question and topic. We will start by entering the search terms such as postpartum depression or depression, pregnancy depression, maternal depression, screening maternal depression, prevention or primary prevention, and preventive health services for mental depression. All these key terms are expected to reveal different sources supporting the whole topic of mental depression incurred by pregnant women. We hope to develop 20 peer-reviewed scholarly articles articulating these binding terms related to the research.
To develop appropriate and adequate data, we will employ a concise data selection criterion. We expect to appreciate the element of inclusion and exclusion when collecting the secondary data from the list of the sources obtained from the targeted database in this study. First of all, the selection will start by reviewing the abstract of the anticipated sources. Those with irrelevant abstracts from the research topic will be excluded. Secondly, we will exclude those sources whose information is ten years ago as a term this content to be obsolete. Those research papers articulating on the subject of maternal depression, screening and prevention of maternal conditions, and the effect of maternal depression on pregnant women will be included in the research. Ideally, those sources that have been published from 2011 and have included quality and relevant content related to maternal depression on women will be included to provide adequate data suitable for the research topic.
Data Handling and Analysis
To effectively handle the collected data from the sources, we anticipate writing the findings of each source. All approved secondary materials will be downloaded and saved on our computers to help summarize ideas revealed by the author(s). The summary will be done by analyzing the abstract of each article, reviewing the literature review, and discussing part of each study. The evidence outlined in each material will be recorded, thus providing a comprehensive overview of the whole concept of maternal depression among pregnant women.
The school of public health will approve the research. Also, written consent will be obtained from the targeted pregnant women, and we assure them that the whole aspect of privacy and confidentiality will be observed.
Some of the resources needed for this study include;
Financial resources, computers with installed software for data analysis, audio recording devices, register any relevant material suitable for this study.
References
Baranov, V., Bhalotra, S., Biroli, P. and Maselko, J., 2020. Maternal depression, women’s empowerment, and parental investment: evidence from a randomized controlled trial. American economic review, 110(3), pp.824-59.
Conners-Burrow, N.A., Swindle, T., McKelvey, L. and Bokony, P., 2015. A little bit of the blues: Low-level symptoms of maternal depression and classroom behavior problems in preschool children. Early Education and Development, 26(2), pp.230-244.
Côté, S.M., Ahun, M.N., Herba, C.M., Brendgen, M., Geoffroy, M.C., Orri, M., Liu, X., Vitaro, F., Melchior, M., Boivin, M. and Tremblay, R.E., 2018. Why is maternal depression related to adolescent internalizing problems? A 15-year population-based study. Journal of the American Academy of Child & Adolescent Psychiatry, 57(12), pp.916-924.
Cox, J.L., Holden, J.M. and Sagovsky, R., 2017. Detection of postnatal depression: development of the 10-item Edinburgh Postnatal Depression Scale. The British journal of psychiatry, 150(6), pp.782-786.
Drury, S.S., Scaramella, L. and Zeanah, C.H., 2016. The neurobiological impact of postpartum maternal depression: prevention and intervention approaches. Child and Adolescent Psychiatric Clinics, 25(2), pp.179-200.
Eberhard?Gran, M., Eskild, A., Tambs, K., Opjordsmoen, S. and Ove Samuelsen, S., 2011. Review of validation studies of the Edinburgh Postnatal Depression Scale. Acta Psychiatrica Scandinavica, 104(4), pp.243-249.
Garrison, A., Maselko, J., Saurel-Cubizolles, M.J., Courtin, D., Zoumenou, R., Boivin, M.J., Massougbodji, A., Garcia, A., Alao, M.J., Cot, M. and Maman, S., 2021. The Impact of Maternal Depression and Parent–Child Interactions on Risk of Parasitic Infections in Early Childhood: A Prospective Cohort in Benin. Maternal and child health journal, pp.1-10.
Matijasevich, A., Murray, J., Cooper, P.J., Anselmi, L., Barros, A.J., Barros, F.C. and Santos, I.S., 2015. Trajectories of maternal depression and offspring psychopathology at 6 years: 2004 Pelotas cohort study. Journal of affective disorders, 174, pp.424-431.
Nemoda, Z. and Szyf, M., 2017. Epigenetic alterations and prenatal maternal depression. Birth defects research, 109(12), pp.888-897.
Oermann, M.H., Wrigley, J., Nicoll, L.H., Ledbetter, L.S., Carter-Templeton, H. and Edie, A.H., 2021. Integrity of databases for literature searches in nursing: avoiding predatory journals. ANS. Advances in Nursing Science, 44(2), p.102.
Priel, A., Djalovski, A., Zagoory?Sharon, O. and Feldman, R., 2019. Maternal depression impacts child psychopathology across the first decade of life: Oxytocin and synchrony as markers of resilience. Journal of Child Psychology and Psychiatry, 60(1), pp.30-42.
Weissman, M.M., Wickramaratne, P., Pilowsky, D.J., Poh, E., Batten, L.A., Hernandez, M., Flament, M.F., Stewart, J.A., McGrath, P., Blier, P. and Stewart, J.W., 2015. Treatment of maternal depression in a medication clinical trial and its effect on children. American Journal of Psychiatry, 172(5), pp.450-459.
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