Predictors Of Postpartum Depression

Postpartum depression (PPD) has been reported as a common mood disorder that affects women right after childbirth. Such a condition puts the baby’s care in jeopardy by affecting the mother-child bonding adversely as well as the mother’s welfare. This could lead to delays in infant development. The fact that the disorder lacks a common cause or even a target population does not help at all. To assist in dealing with it, several studies have been conducted such as the predictors of a postpartum depression research article (Katon, Russo, & Gavin, 2014). This research article aims to examine the risk factors of PPD including health risk behaviors, birth outcomes, pregnancy-related illnesses, pre-pregnancy medical and psychiatric illness, pregnancy-associated psychosocial stress and depression, and social demographic factors. This paper purposes to critique the Katon et al.’s research article, a review that will go a long way in assisting the health stakeholders in managing the condition.

This article aims to answer the following research question. Are health risk behaviors, birth outcomes, pregnancy-related illnesses, pre-pregnancy medical and psychiatric illness, social demographic factors, and pregnancy-associated psychosocial stress and depression, risk factors for PPD? Thus the interest here is what makes women vulnerable to PPD. This a good research question as it provides an excellent basis for the research.it was influenced by the lack of sufficient literature on potential risk factors of PPD. Studies that existed before only included factors such as stressful events in life, feelings of anxiety during pregnancy, inadequate life support, a history of depression, and the personality factor of neuroticism. Other factors that had been found to be a lower risk of PPD included complications such as premature labor, preeclampsia among others. Other studies have also included unemployment and other social-economic factors as risks of PPD. All this inadequacy has propelled the need for Katon et al.’s research question. Thie question has also been affected by the need to raise awareness for obstetricians and primary care physicians on the populations that at are at a high risk of PPD.

The study uses a descriptive research design mostly utilizing the use of questionnaires, with a survey methodology applied in sampling. From the data collected, the predictors of PPD were then examined using hierarchical logistic regression analysis. The sample involved 1423 pregnant women of between 4-8 months at the University Obstetrics Clinic. The questionnaire consisted assessment of information regarding the social demographics, mood, medical and behavioral tendencies. The study then involved a follow up to examine PPD prevalence. Some of the strengths of the descriptive research design include the fact that one can obtain primary data instead of relying on secondary sources of information. Also, the sample population was placed in their natural environment hence avoiding introduction of bias in the results, as they were in their normal behavior. Descriptive research acts as a prerequisite for further research due to variables that can be tested. This research design also offers an allowance for collection of both quantitative and qualitative data. Its weaknesses include difficulties in confidentiality. Also, the lack of sufficient variables to facilitate statistical analysis is an issue where the study cannot be used to correlate variables and the fact that variables are not manipulated. It does not also give an opportunity to review the results due to hindrances in repeatability and replication. This design can be subject to bias in cases where the researcher prepares questionnaire questions and records data with subjectivity. The reason why the researchers chose this type of design as opposed to others could have been due to the advantages listed above. This design suited the research due to the need for in-depth information on a personal level.

 

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In the study, the entire sample size was 3039 that were administered with questionnaires. Out of these, 1423 women were selected based on the key information required including demographics and clinical variables. This was accomplished using the Fischer exact tests and t-tests. The sample size appears to be adequate. This is because according to previous reviews, about 7-13% of women experience PPD. From calculations and regarding the sample size, this gives a figure of 100-185 women. This combined with a low margin of error and a high confidence level justifies this sample. However, for the study to be a true representation of the women, this number is too low compared to the billions of women around the world. Furthermore, the sample was from one region, at the University of Washington hospital. This implies that factors such as social demographics were not fully exploited.

Data collection methods included administering of questionnaires to the women, and the medical records complimented the survey combined with observation. The women filled out the questionnaires while the clinic staff was charged with the responsibility of screening the patients with the questionnaires, after which they would link the medical results with the results upon obtained a written and informed consent. Data collection tools included the questionnaires as well as the health records obtained from screening. The researchers did have ethical considerations as they state that all the procedures in the paper were indeed approved by the University of Washington Human Subjects Institutional Review Board. Written and informed consent for linking the results and medical results were required, and those under the age of 15 were not included in the success. Participation was also voluntary. Confidentiality is observed as there are no names mentioned. The data in the research is primary; therefore copyrights have not been breached. The article is well cited where there is a reference to other works.

The research paper contains limitations such as the sample being inadequate for a research of this magnitude. The period of research was also too long (2004-2011). In such a long time, so many variables could be introduced hence reducing the credibility of the results. The authors also cite the issue of the hospital being too busy thus presenting difficulties in getting questionnaires completed. These limitations can be overcome in future research. The sample size can be increased by merely choosing a bigger hospital instead of a clinic. They should also select a hospital with adequate staff to ensure that a busy schedule does not hinder research. The time of the study should also be shortened to provide its credibility. The importance of listing such limitations is to inform the reader on the issues that may have hindered the study, and that might introduce errors in the study.

The findings of the research paper were that unemployment, antenatal depressive symptoms, younger age, taking Ads, psychosocial stressors, smoking and pre-pregnancy chronic illnesses are all predictors of PPD. These findings did answer the research question identifying the risk factors as mentioned in the research question. The results are very credible save for a few limitations as earlier mentioned. The research design applied ensured rich data was obtained with the statistical approach applied, which is the hierarchical logistic regression analyses, being very effective. The authors are as well scholarly experts within their fields.

In summary, the article starts by listing the existing research that has been done by other experts relating to this research. The authors list what is lacking in that research hence justifying this research and establishing its purpose, which is to determine whether several issues are health factors for PPD. The materials and methods of this research are then outlined including those who were the sample population as well as tools used to collect data such as the questionnaires. The study variables and measures are then addressed regarding how they will be obtained, including through questionnaires and health records. Statistical analysis was then done at a 95% confidence interval giving results which are discussed before a conclusion is made. The results are tabulated for effective presentation. From the research, it is clear that the research question is supported by the findings regarding the risk factors of PPD; hence it was a successful research. This is to say that the findings support that health risk behaviors, birth outcomes, pregnancy-related illnesses, pre-pregnancy medical and psychiatric illness, social demographic factors, and pregnancy-associated psychosocial stress and depression are risk factors for PPD. This research will assist in raising awareness among obstetricians and primary care physicians on the likelihood of PPD among a certain population. In conclusion, due to the knowledge of the risk factors of PPD according to the paper Katon et al., now the condition of PPD can be predicted earlier hence make it easier to deal with it (Katon et al. 2014).

 

References

Katon, W., Russo, J., & Gavin, A. (2014). Predictors of postpartum depression. Journal of women’s health23(9), 753-759.

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