Psychoneuroimmunology and Postpartum Depression

Oana Denisa Balalau, Cristina Răduță, Nicolae Bacalbașa, Anca Silvia Dumitriu, Stana Paunica, Cristian Balalau

Abstract


Depression is the most common mental illness at the community level. It is estimated that annually 3-15% of the general population has a depressive episode. An increasing number of cases are identified among pregnant patients.


Thus, WHO has been recommending screening for pregnancy and pregnancy depression since 2015.


The causes of depressive pathology are not fully known. The most commonly identified factors are related to biochemical disorders in the brain, psychological or social causes or the administration of drugs with the potential to induce depressive phenomena: antihypertensives, oral contraceptives, hormones, anti-inflammatory drugs.


The association of hypertension with pregnancy can determine an increased risk of depression in pregnancy or childbirth. Hypertensive disorders in pregnancy cause an altered inflammatory response, with several studies identifying significant increased levels of IL-6, IL-8 and TNF-alpha in pregnant women with preeclampsia. Although hypertensive manifestations remit in approx. 6 weeks postpartum, studies have shown that the inflammatory syndrome persists for up to 3.5 months. Serum IL-6 levels are associated with preeclampsia severity and foetal status.


Inflammatory, neuronal and hormonal changes are found in both pathologies, thus explaining the causal links between hypertensive disorders in pregnancy and postpartum depression.


Current researchers have relied on the evaluation of a possible involvement of oxidative stress. Its association with depression is frequently identified, the severity of symptoms being directly proportional to the level of markers of oxidative stress.

Keywords


Clinical Psychology; Gestational hypertension; Psychoneuroimmunology; Postpartum depression.

Full Text:

PDF

References


Alamolhoda, S. H., Kariman, N., & Mirabi, P. (2020). Relationship Between Oxidative Stress Concentration and Postpartum Depression: A Cohort Study. Iranian Journal of Psychiatry and Behavioral Sciences, 14(1). https://doi.org/10.5812/ijpbs.84188

Ananth, C. V., Keyes, K. M., & Wapner, R. J. (2013). Pre-eclampsia rates in the United States, 1980-2010: age-period-cohort analysis. BMJ (Clinical research ed.), 347, f6564. https://doi.org/10.1136/bmj.f6564

Auger, N., Luo, Z. C., Nuyt, A. M., Kaufman, J. S., Naimi, A. I., Platt, R. W., & Fraser, W. D. (2016). Secular Trends in Preeclampsia Incidence and Outcomes in a Large Canada Database: A Longitudinal Study Over 24 Years. The Canadian journal of cardiology, 32(8), 987.e15–987.e9.87E23. https://doi.org/10.1016/j.cjca.2015.12.011

Baecke, M., Spaanderman, M. E., & van der Werf, S. P. (2009). Cognitive function after pre-eclampsia: an explorative study. Journal of psychosomatic obstetrics and gynaecology, 30(1), 58–64. https://doi.org/10.1080/01674820802546212

Balalau, O. D., Bacalbașa, N., Loghin, M., Dimitriu, A. S., Paunica, S., & Balalau, C. (2021). Management of Postpartum Depression in the Covid Pandemic. Mediterranean Journal of Clinical Psychology, 9(2). https://doi.org/10.13129/2282-1619/mjcp-3071

Bălălău, O. D., Bacalbașa, N., Olaru, O. G., Pleș, L., & Stănescu, D. A. (2020a). Vaginal birth after cesarean section–literature review and modern guidelines. Journal of Clinical and Investigative Surgery, 5(1), 13-17. https://doi.org/10.25083/2559.5555/5.1/13.17

Bălălău, O. D., Olaru, O. G., Dumitru, A. V., Păunică, I., & Stănescu, A. D. (2020b). Maternal infections with an increased risk of transmission to the foetus; a literature review. Journal of Clinical and Investigative Surgery, 5(2), 66-72. https://doi.org/10.25083/2559.5555/5.2/66.72

Bălălău, O.D., Corbu, A.T., Bălălău, C., Sima, R.M., Pleș, L., Stănescu, A.D. (2019). Ultrasound signs in the diagnosis of placental anomalies: placenta accreta at the level of the uterine scar. Journal of Clinical and Investigative Surgery, 4(2): 77-80. https://doi.org/10.25083/2559.5555/4.2/77.80

Barchetta, S., Martino, G., Craparo, G., Salehinejad, M. A., Nitsche, M. A., & Vicario, C. M. (2021). Alexithymia is linked with a negative bias for past and current events in healthy humans. International Journal of Environmental Research and Public Health, 18(13), 6696. https://doi.org/10.3390/ijerph18136696

Barker, E. D., Jaffee, S. R., Uher, R., & Maughan, B. (2011). The contribution of prenatal and postnatal maternal anxiety and depression to child maladjustment. Depression and anxiety, 28(8), 696–702. https://doi.org/10.1002/da.20856

Bean, C., Spencer, S. K., Bowles, T., Kyle, P. B., Williams, J. M., Gibbens, J., & Wallace, K. (2016). Inhibition of T-cell activation attenuates hypertension, TNFα, IL-17, and blood-brain barrier permeability in pregnant rats with angiogenic imbalance. American journal of reproductive immunology (New York, N.Y. : 1989), 76(4), 272–279. https://doi.org/10.1111/aji.12547

Blom, E. A., Jansen, P. W., Verhulst, F. C., Hofman, A., Raat, H., Jaddoe, V. W., Coolman, M., Steegers, E. A., & Tiemeier, H. (2010). Perinatal complications increase the risk of postpartum depression. The Generation R Study. BJOG: an international journal of obstetrics and gynaecology, 117(11), 1390–1398. https://doi.org/10.1111/j.1471-0528.2010.02660.x

Boufidou, F., Lambrinoudaki, I., Argeitis, J., Zervas, I. M., Pliatsika, P., Leonardou, A. A., Petropoulos, G., Hasiakos, D., Papadias, K., & Nikolaou, C. (2009). CSF and plasma cytokines at delivery and postpartum mood disturbances. Journal of affective disorders, 115(1-2), 287–292. https://doi.org/10.1016/j.jad.2008.07.008

Bränn, E., Fransson, E., White, R. A., Papadopoulos, F. C., Edvinsson, Å., Kamali‐Moghaddam, M., ... & Skalkidou, A. (2020). Inflammatory markers in women with postpartum depressive symptoms. Journal of neuroscience research, 98(7), 1309-1321. https://doi.org/10.1002/jnr.24312

Capuron, L., & Miller, A. H. (2011). Immune system to brain signaling: neuropsychopharmacological implications. Pharmacology & therapeutics, 130(2), 226–238. https://doi.org/10.1016/j.pharmthera.2011.01.014

Caropreso, L., de Azevedo Cardoso, T., Eltayebani, M., & Frey, B. N. (2020). Preeclampsia as a risk factor for postpartum depression and psychosis: a systematic review and meta-analysis. Archives of women's mental health, 23(4), 493–505. https://doi.org/10.1007/s00737-019-01010-1

Chen, L., Wang, X., Ding, Q., Shan, N., & Qi, H. (2019). Development of Postpartum Depression in Pregnant Women with Preeclampsia: A Retrospective Study. BioMed research international, 2019, 9601476. https://doi.org/10.1155/2019/9601476

Conversano, C., & Di Giuseppe, M. (2021). Psychological factors as determinants of chronic conditions: clinical and psychodynamic advance. Frontiers in Psychology, 12, 86. https://doi.org/10.3389/fpsyg.2021.635708

Coskun, H. S., Usta, M. B., Ferhat, S. A. Y., & Yildirim, A. M. Factors affecting post-traumatic stress disorder in children with orthopedic injury. Journal of Clinical and Investigative Surgery, 5(1). https://doi.org/10.25083/2559-5555

de Paula Eduardo, J., de Rezende, M. G., Menezes, P. R., & Del-Ben, C. M. (2019). Preterm birth as a risk factor for postpartum depression: A systematic review and meta-analysis. Journal of affective disorders, 259, 392–403. https://doi.org/10.1016/j.jad.2019.08.069

Dekel, S., Ein-Dor, T., Dishy, G. A., & Mayopoulos, P. A. (2020). Beyond postpartum depression: posttraumatic stress-depressive response following childbirth. Archives of women's mental health, 23(4), 557–564. https://doi.org/10.1007/s00737-019-01006-x

Dekel, S., Ein-Dor, T., Dishy, G. A., & Mayopoulos, P. A. (2020). Beyond postpartum depression: posttraumatic stress-depressive response following childbirth. Archives of women's mental health, 23(4), 557-564. https://doi.org/10.1007/s00737-019-01006-x

Delahaije, D. H., Dirksen, C. D., Peeters, L. L., & Smits, L. J. (2013). Anxiety and depression following preeclampsia or hemolysis, elevated liver enzymes, and low platelets syndrome. A systematic review. Acta obstetricia et gynecologica Scandinavica, 92(7), 746–761. https://doi.org/10.1111/aogs.12175

Dell'Osso, L., Carmassi, C., Rucci, P., Ciapparelli, A., Conversano, C., & Marazziti, D. (2011). Complicated grief and suicidality: the impact of subthreshold mood symptoms. CNS spectrums, 16(1), 1-6. https://doi.org/10.1017/S1092852912000090

DeMuth, G. W., & Ackerman, S. H. (1983). alpha-Methyldopa and depression: a clinical study and review of the literature. The American journal of psychiatry, 140(5), 534–538. https://doi.org/10.1176/ajp.140.5.534

Dennis, C. L., & Chung-Lee, L. (2006). Postpartum depression help-seeking barriers and maternal treatment preferences:A qualitative systematic review. Birth, 33, 323-331. https://doi.org/10.1111/j.1523-536X.2006.00130.x

Dimitriu, M., Stoian, A. M. P., Roșu, G., Dan, A., Caimacan, A., Zygouropoulos, N., ... & Jacotă–Alexe, F. (2020). Postpartum Depression-a serious, dangerous, disabling, extremely frequent condition that is almost completely ignored in Romania. Mediterranean Journal of Clinical Psychology, 8(1). https://doi.org/10.6092/2282-1619/mjcp-2413

Frisone, F., Sicari, F., Settineri, S., & Merlo, E. M. (2021). Clinical Psychological Assessment of Stress: A Narrative Review of the Last 5 Years. Clinical Neuropsychiatry, 18(2). doi.org/10.36131/cnfioritieditore20210203

Furuta, M., Sandall, J., Cooper, D., & Bick, D. (2014). The relationship between severe maternal morbidity and psychological health symptoms at 6-8 weeks postpartum: a prospective cohort study in one English maternity unit. BMC pregnancy and childbirth, 14, 133. https://doi.org/10.1186/1471-2393-14-133

Halligan, S. L., Murray, L., Martins, C., & Cooper, P. J. (2007). Maternal depression and psychiatric outcomes in adolescent offspring: a 13-year longitudinal study. Journal of affective disorders, 97(1-3), 145–154. https://doi.org/10.1016/j.jad.2006.06.010

Hay, D. F., Pawlby, S., Waters, C. S., & Sharp, D. (2008). Antepartum and postpartum exposure to maternal depression: different effects on different adolescent outcomes. Journal of child psychology and psychiatry, and allied disciplines, 49(10), 1079–1088. https://doi.org/10.1111/j.1469-7610.2008.01959.x

Hirose, A., Terauchi, M., Odai, T., Kato, K., & Miyasaka, N. (2020). Depressive symptoms at postpartum are associated with those at the second trimester of pregnancy and the antioxidant activity immediately after delivery. Journal of psychosomatic obstetrics and gynaecology, 1-7. Advance online publication. https://doi.org/10.1080/0167482X.2019.1709817

Hoedjes, M., Berks, D., Vogel, I., Franx, A., Duvekot, J. J., Steegers, E. A., & Raat, H. (2011). Poor health-related quality of life after severe preeclampsia. Birth (Berkeley, Calif.), 38(3), 246–255. https://doi.org/10.1111/j.1523-536X.2011.00477.x

Hsieh, T. T., Chen, S. F., Lo, L. M., Li, M. J., Yeh, Y. L., & Hung, T. H. (2012). The association between maternal oxidative stress at mid-gestation and subsequent pregnancy complications. Reproductive sciences (Thousand Oaks, Calif.), 19(5), 505–512. https://doi.org/10.1177/1933719111426601

Hutchens, B. F., & Kearney, J. (2020). Risk factors for postpartum depression: an umbrella review. Journal of midwifery & women's health, 65(1), 96-108. https://doi.org/10.1111/jmwh.13067

Iasevoli, M., Giantin, V., Voci, A., Valentini, E., Zurlo, A., Maggi, S., ... & Manzato, E. (2012). Discussing end-of-life care issues with terminally ill patients and their relatives: comparisons among physicians, nurses and psychologists. Aging clinical and experimental research, 24(3 Suppl), 35-42.

Janzarik, W. G., Jacob, J., Katagis, E., Markfeld-Erol, F., Sommerlade, L., Wuttke, M., & Reinhard, M. (2019). Preeclampsia postpartum: Impairment of cerebral autoregulation and reversible cerebral hyperperfusion. Pregnancy hypertension, 17, 121–126. https://doi.org/10.1016/j.preghy.2019.05.019

Jonsson, Y., Rubèr, M., Matthiesen, L., Berg, G., Nieminen, K., Sharma, S., Ernerudh, J., & Ekerfelt, C. (2006). Cytokine mapping of sera from women with preeclampsia and normal pregnancies. Journal of reproductive immunology, 70(1-2), 83–91. https://doi.org/10.1016/j.jri.2005.10.007

Jordan, W. J. (2020). Mental Health & Drugs; A Map of the Mind. Journal of Mind and Medical Sciences, 7(2), 133-140. https://doi.org/10.22543/7674.72.P133140

Kaplan, P. S., Danko, C. M., Everhart, K. D., Diaz, A., Asherin, R. M., Vogeli, J. M., & Fekri, S. M. (2014). Maternal depression and expressive communication in one-year-old infants. Infant behavior & development, 37(3), 398–405. https://doi.org/10.1016/j.infbeh.2014.05.008

LaMarca, B., Cornelius, D., & Wallace, K. (2013). Elucidating immune mechanisms causing hypertension during pregnancy. Physiology (Bethesda, Md.), 28(4), 225–233. https://doi.org/10.1152/physiol.00006.2013

Letourneau, N., Duffett-Leger, L., Stewart, M., Hegadoren, K., Dennis, C. L., Rinaldi, C. M., & Stoppard, J. (2007). Canadian mothers' perceived support needs during postpartum depression. Journal of obstetric, gynecologic, and neonatal nursing : JOGNN, 36(5), 441–449. https://doi.org/10.1111/j.1552-6909.2007.00174.x

Lewis, S. J., Araya, R., Leary, S., Smith, G. D., & Ness, A. (2012). Folic acid supplementation during pregnancy may protect against depression 21 months after pregnancy, an effect modified by MTHFR C677T genotype. European journal of clinical nutrition, 66(1), 97–103. https://doi.org/10.1038/ejcn.2011.136

Liu, H., Zhang, Y., Gao, Y., & Zhang, Z. (2016). Elevated levels of Hs-CRP and IL-6 after delivery are associated with depression during the 6 months post partum. Psychiatry research, 243, 43–48. https://doi.org/10.1016/j.psychres.2016.02.022

Liu, Y., Kaaya, S., Chai, J., McCoy, D. C., Surkan, P. J., Black, M. M., ... & Smith-Fawzi, M. C. (2017). Maternal depressive symptoms and early childhood cognitive development: a meta-analysis. Psychological medicine, 47(4), 680-689. https://doi.org/10.1017/S003329171600283X

Marchini, F., Langher, V., Napoli, A., Balonan, J. T., Fedele, F., Martino, G., ... & Caputo, A. (2021). Unconscious loss processing in diabetes: associations with medication adherence and quality of care. Psychoanalytic Psychotherapy, 1-19. https://doi.org/10.1080/02668734.2021.1922492

Martino, G., Caputo, A., Vicario, C. M., Feldt-Rasmussen, U., Watt, T., Quattropani, M. C., ... & Vita, R. (2021). Alexithymia, Emotional Distress, and Perceived Quality of Life in Patients With Hashimoto’s Thyroiditis. Frontiers in Psychology, 12, 1295. https://doi.org/10.3389/fpsyg.2021.667237

Merlo, E. M., McNabney, S. M., Frisone, F., Sicari, F., Paunica, M., Motofei, C., & Settineri, S. (2020). Compassion and suppression in caregivers: twin masks of tragedy and joy of caring. Journal of Mind and Medical Sciences, 7(1), 61-68. https://doi.org/10.22543/7674.71.P6168

Mohanty, S., Sahu, P. K., Mandal, M. K., Mohapatra, P. C., & Panda, A. (2006). Evaluation of oxidative stress in pregnancy induced hypertension. Indian journal of clinical biochemistry : IJCB, 21(1), 101–105. https://doi.org/10.1007/BF02913074

Myles, L. A. M., Merlo, E. M., & Obele, A. (2021). Desire for Control Moderates the Relationship between Perceived Control and Depressive Symptomology. Journal of Mind and Medical Sciences, 8(2), 299-305. https://doi.org/10.22543/7674.82.P299305

Nayak, A. S., & Nachane, H. B. (2018). Risk analysis of suicidal ideations and postpartum depression with antenatal alpha methyldopa use. Asian journal of psychiatry, 38, 42–44. https://doi.org/10.1016/j.ajp.2018.10.024

Netsi, E., Pearson, R. M., Murray, L., Cooper, P., Craske, M. G., & Stein, A. (2018). Association of Persistent and Severe Postnatal Depression With Child Outcomes. JAMA psychiatry, 75(3), 247–253. https://doi.org/10.1001/jamapsychiatry.2017.4363

Oren, D. A., Moul, D. E., Schwartz, P. J., Wehr, T. A., & Rosenthal, N. E. (1994). A controlled trial of levodopa plus carbidopa in the treatment of winter seasonal affective disorder: a test of the dopamine hypothesis. Journal of clinical psychopharmacology, 14(3), 196–200. https://doi.org/10.1097/00004714-199406000-00007

Pawlby, S., Sharp, D., Hay, D., & O'Keane, V. (2008). Postnatal depression and child outcome at 11 years: the importance of accurate diagnosis. Journal of affective disorders, 107(1-3), 241–245. https://doi.org/10.1016/j.jad.2007.08.002

Pearson, R. M., Evans, J., Kounali, D., Lewis, G., Heron, J., Ramchandani, P. G., O'Connor, T. G., & Stein, A. (2013). Maternal depression during pregnancy and the postnatal period: risks and possible mechanisms for offspring depression at age 18 years. JAMA psychiatry, 70(12), 1312–1319. https://doi.org/10.1001/jamapsychiatry.2013.2163

Piccinni, A., Origlia, N., Veltri, A., Vizzaccaro, C., Marazziti, D., Catena-Dell'Osso, M., ... & Dell'Osso, L. (2012). Plasma β-amyloid peptides levels: a pilot study in bipolar depressed patients. Journal of affective disorders, 138(1-2), 160-164. https://doi.org/10.1016/j.jad.2011.12.042

Poterasu, M., Rowland, D. L., Ciobanu, C., & Fica, S. (2020). Anorexia nervosa and reproduction: connecting brain to gonads. Journal of Mind and Medical Sciences, 7(1), 1-8. https://doi.org/10.22543/7674.71.P18

Quevedo, L. A., Silva, R. A., Godoy, R., Jansen, K., Matos, M. B., Tavares Pinheiro, K. A., & Pinheiro, R. T. (2012). The impact of maternal post-partum depression on the language development of children at 12 months. Child: care, health and development, 38(3), 420–424. https://doi.org/10.1111/j.1365-2214.2011.01251.x

Rahman, A., Bunn, J., Lovel, H., & Creed, F. (2007). Maternal depression increases infant risk of diarrhoeal illness: A cohort study. Archives of Disease in Childhood, 92(1), 24–28. https://doi.org/10.1136/adc.2005.086579

Raposa, E., Hammen, C., Brennan, P., & Najman, J. (2014). The long-term effects of maternal depression: early childhood physical health as a pathway to offspring depression. The Journal of adolescent health: official publication of the Society for Adolescent Medicine, 54(1), 88–93. https://doi.org/10.1016/j.jadohealth.2013.07.038

Roberts, L., Davis, G. K., & Homer, C. (2019). Depression, Anxiety, and Post-traumatic Stress Disorder Following a Hypertensive Disorder of Pregnancy: A Narrative Literature Review. Frontiers in cardiovascular medicine, 6, 147. https://doi.org/10.3389/fcvm.2019.00147

Schetsche, C., Jaume, L. C., Gago-Galvagno, L., & Elgier, A. M. (2021). Social support and its associations with Depression and Anxiety: an in-depth Analysis using Structural Equation Modeling. Mediterranean Journal of Clinical Psychology, 9(2). https://doi.org/10.13129/2282-1619/mjcp-3017

Settineri, S., Frisone, F., Alibrandi, A., & Merlo, E. M. (2019a). Vulnerability and physical well-being of caregivers: what relationship?. Journal of Mind and Medical Sciences, 6(1), 95-102. https://doi.org/10.22543/7674.61.P95102

Settineri, S., Merlo, E. M., Alibrandi, A., Sicari, F., Dritto, I. P., Strangis, F., & Frisone, F. (2019b). Personality and phobias in adolescence: age and gender in psychopathological expressions. Journal of Mind and Medical Sciences, 6(2), 304-310. https://doi.org/10.22543/7674.62.P304310

Shahar, G. (2021). Interdisciplinarity and Integration: An Introduction to the Special Issue on Psychopathology in Medical Settings. Journal of clinical psychology in medical settings, 28(1), 1-5. https://doi.org/10.1007/s10880-020-09752-2

Sharma, A., Satyam, A., & Sharma, J. B. (2007). Leptin, IL-10 and inflammatory markers (TNF-alpha, IL-6 and IL-8) in pre-eclamptic, normotensive pregnant and healthy non-pregnant women. American journal of reproductive immunology (New York, N.Y. : 1989), 58(1), 21–30. https://doi.org/10.1111/j.1600-0897.2007.00486.x

Stanescu, A. D., Balalau, D. O., Ples, L., Paunica, S., & Balalau, C. (2018). Postpartum depression: Prevention and multimodal therapy. Journal of Mind and Medical Sciences, 5(2), 163-168. https://doi.org/10.22543/7674.52.P163168

Stein, A., Pearson, R. M., Goodman, S. H., Rapa, E., Rahman, A., McCallum, M., Howard, L. M., & Pariante, C. M. (2014). Effects of perinatal mental disorders on the fetus and child. Lancet (London, England), 384(9956), 1800–1819. https://doi.org/10.1016/S0140-6736(14)61277-0

Stewart, D. E., & Vigod, S. N. (2019). Postpartum depression: pathophysiology, treatment, and emerging therapeutics. Annual review of medicine, 70, 183-196. https://doi.org/10.1146/annurev-med-041217-011106

Stramrood, C. A., Wessel, I., Doornbos, B., Aarnoudse, J. G., van den Berg, P. P., Schultz, W. C., & van Pampus, M. G. (2011). Posttraumatic stress disorder following preeclampsia and PPROM: a prospective study with 15 months follow-up. Reproductive sciences (Thousand Oaks, Calif.), 18(7), 645–653. https://doi.org/10.1177/1933719110395402

Suárez-Rico, B. V., Estrada-Gutierrez, G., Sánchez-Martínez, M., Perichart-Perera, O., Rodríguez-Hernández, C., González-Leyva, C., ... & Reyes-Muñoz, E. (2021). Prevalence of depression, anxiety, and perceived stress in postpartum Mexican women during the COVID-19 lockdown. International journal of environmental research and public health, 18(9), 4627. https://doi.org/10.3390/ijerph18094627

The American College of Obstetricians and Gynecologists Committee Opinion no. 630. Screening for perinatal depression. (2015). Obstetrics and gynecology, 125(5), 1268–1271. https://doi.org/10.1097/01.AOG.0000465192.34779.dc

van Rijn, B. B., Bruinse, H. W., Veerbeek, J. H., Post Uiterweer, E. D., Koenen, S. V., van der Bom, J. G., Rijkers, G. T., Roest, M., & Franx, A. (2016). Postpartum Circulating Markers of Inflammation and the Systemic Acute-Phase Response After Early-Onset Preeclampsia. Hypertension (Dallas, Tex.: 1979), 67(2), 404–414. https://doi.org/10.1161/HYPERTENSIONAHA.115.06455

van Veen, T. R., Panerai, R. B., Haeri, S., Singh, J., Adusumalli, J. A., Zeeman, G. G., & Belfort, M. A. (2015). Cerebral autoregulation in different hypertensive disorders of pregnancy. American journal of obstetrics and gynecology, 212(4), 513.e1–513.e5137. https://doi.org/10.1016/j.ajog.2014.11.003

Wang, W., Xie, X., Yuan, T., Wang, Y., Zhao, F., Zhou, Z., & Zhang, H. (2021). Epidemiological trends of maternal hypertensive disorders of pregnancy at the global, regional, and national levels: a population-based study. BMC pregnancy and childbirth, 21(1), 364. https://doi.org/10.1186/s12884-021-03809-2

Webber, E., & Benedict, J. (2019). Postpartum depression: a multi-disciplinary approach to screening, management and breastfeeding support. Archives of psychiatric nursing, 33(3), 284-289. https://doi.org/10.1016/j.apnu.2019.01.008

Wiciński, M., Malinowski, B., Puk, O., Socha, M., & Słupski, M. (2020). Methyldopa as an inductor of postpartum depression and maternal blues: A review. Biomedicine & pharmacotherapy = Biomedecine & pharmacotherapie, 127, 110196. https://doi.org/10.1016/j.biopha.2020.110196

Wu, X., Yang, K., Tang, X., Sa, Y., Zhou, R., Liu, J., Luo, Y., & Tang, W. (2015). Folate metabolism gene polymorphisms MTHFR C677T and A1298C and risk for preeclampsia: a meta-analysis. Journal of assisted reproduction and genetics, 32(5), 797–805. https://doi.org/10.1007/s10815-014-0408-8

Yang, S. T., Yang, S. Q., Duan, K. M., Tang, Y. Z., Ping, A. Q., Bai, Z. H., ... & Wang, S. Y. (2022). The development and application of a prediction model for postpartum depression: optimizing risk assessment and prevention in the clinic. Journal of Affective Disorders, 296, 434-442. https://doi.org/10.1016/j.jad.2021.09.099




DOI: https://doi.org/10.13129/2282-1619/mjcp-3230

Refbacks

  • There are currently no refbacks.