Paper
Friday, July 13, 2007
Stability and change in physical symptoms and depression at one month and at one year after delivery
Li-Yin Chien, ScD, Institute of Community Health Nursing, National Yang Ming University, Taipei, Taiwan
| Learning Objective #1: recognize the persistence of health problems among postpartum women at one year after delivery. |
| Learning Objective #2: know that overall severity of physical symptoms decreased between one month and one year after delivery. |
A high prevalence of physical symptoms and depression after childbirth was reported worldwide. Relatively few studies examined whether the health problems after delivery persisted with passage of time. The objectives of this study were to examine the stability and change in physical symptoms and depression between one month and one year after delivery. The study participants were 166 women who completed a structured questionnaire at one month and one year after delivery. Depression was measured using the Center for Epidemiologic Studies Depression Scale (CES-D). Postpartum physical symptoms were assessed using an 18-item, 4-point Likert scale, with higher score indicating more severe physical symptoms. There were a significant decrease in mean scores of physical symptoms (one month: 8.48; one year: 5.01; p<0.001) but no differences in mean scores of depression scale (one month: 12.76; one year: 12.10; p=0.35). Prevalence of postnatal depression based on the CES-D cut-off score of 15 was 27.7% and 23.5% at one month and one year after delivery, respectively. Women who were depressed at one month were more likely to be depressed at one year (odds ratio 3.03, 95% CI: 1.42- 6.46). Prevalence of the eighteen physical symptoms decreased significantly between the two time points, except for three symptoms. They were “more colds than usual” (24.1% vs. 26.5%), “cold hands and/or feet” (16.9% vs. 47.6%), and “urinary incontinence” (12.0% vs. 11.4%). Of the eighteen physical symptoms included, ten symptoms were more likely to be reported at one year among those women who reported them at one month. Our study revealed a persistence of physical symptoms and depression among postpartum women at one year after delivery, though overall severity of physical symptoms decreased. Health professionals need to be aware of the persistence of health problems among postpartum women and to provide continuous care for women with health problems.