Saralee Glasser1, Lea Hadad2, Rena Bina3, Valentina Boyko1, Racheli Magnezi4. 1. Women and Children's Health Research Unit, Gertner Institute for Epidemiology and Health Policy Research, Sheba Medical Center, Tel Hashomer, Israel. 2. Women Health Clinic, Maccabi Health Services, Elad, Israel. 3. School of Social Work, Bar Ilan University, Ramat Gan, Israel. 4. Public Health and Health Systems Management Program, Department of Management, Bar Ilan University, Ramat Gan, Israel.
Abstract
AIM: To investigate the rate of and risk factors for perinatal depression in an Israeli ultra-orthodox Jewish community and assess the contribution of antenatal nursing intervention to reducing symptoms of postpartum depression. BACKGROUND: Perinatal depression is recognized globally as a common complication of pregnancy and childbirth, with negative effects on the mother, infant and family. Among Jewish ultra-orthodox women both religion and childbearing play major roles. DESIGN: Single-group pretest-posttest intervention study. METHOD: Depressive symptoms were assessed by the Edinburgh Postnatal Depression Scale. One-hundred-sixty women attending a mother-child healthcare clinic during December 2011-January 2013 completed the Edinburgh Postnatal Depression Scale prenatally and 148 (92·5%) repeated the survey 6 weeks postpartum. Nurses were trained to screen and offer non-directive supportive counselling intervention. Risk factors for antenatal depressive symptoms were analysed using multivariable logistic regression and analysis of changes in score was performed by 2-way analysis of variance. RESULTS: Nineteen participants (11·9%) scored ≥10 on the Edinburgh Postnatal Depression Scale antenatally. Nurses provided intervention for 40 women. Postpartum, only one participant scored ≥10. The decrease in Edinburgh score was greater for those whose antenatal score was ≥10. CONCLUSION: Although the rate of antenatal depressive symptoms was similar to that in other studies, postpartum symptoms may have been underreported, possible due to culturally-related reticence. This underscores the importance of understanding the context in which the service is offered and the sensitivities of particular groups. The findings indicate that antenatal nursing intervention is a potentially protective measure for perinatal emotional well-being.
AIM: To investigate the rate of and risk factors for perinatal depression in an Israeli ultra-orthodox Jewish community and assess the contribution of antenatal nursing intervention to reducing symptoms of postpartum depression. BACKGROUND: Perinatal depression is recognized globally as a common complication of pregnancy and childbirth, with negative effects on the mother, infant and family. Among Jewish ultra-orthodox women both religion and childbearing play major roles. DESIGN: Single-group pretest-posttest intervention study. METHOD:Depressive symptoms were assessed by the Edinburgh Postnatal Depression Scale. One-hundred-sixty women attending a mother-child healthcare clinic during December 2011-January 2013 completed the Edinburgh Postnatal Depression Scale prenatally and 148 (92·5%) repeated the survey 6 weeks postpartum. Nurses were trained to screen and offer non-directive supportive counselling intervention. Risk factors for antenatal depressive symptoms were analysed using multivariable logistic regression and analysis of changes in score was performed by 2-way analysis of variance. RESULTS: Nineteen participants (11·9%) scored ≥10 on the Edinburgh Postnatal Depression Scale antenatally. Nurses provided intervention for 40 women. Postpartum, only one participant scored ≥10. The decrease in Edinburgh score was greater for those whose antenatal score was ≥10. CONCLUSION: Although the rate of antenatal depressive symptoms was similar to that in other studies, postpartum symptoms may have been underreported, possible due to culturally-related reticence. This underscores the importance of understanding the context in which the service is offered and the sensitivities of particular groups. The findings indicate that antenatal nursing intervention is a potentially protective measure for perinatal emotional well-being.