#PAGE_PARAMS# #ADS_HEAD_SCRIPTS# #MICRODATA#

Postpartum blues – a Czech adaptation of the Maternity Blues Questionnaire


Authors: L. Takács 1;  F. Smolík 2;  J. Mlíková Seidlerová 3;  P. Čepický 4;  S. Hoskovcová 1
Authors‘ workplace: Katedra psychologie FF UK, Praha, vedoucí katedry doc. PhDr. I. Gillernová, CSc. 1;  Psychologický ústav AV ČR, Praha, ředitel prof. PhDr. M. Blatný, CSc. 2;  II. interní klinika, LF UK, Plzeň, přednosta prof. MUDr. J. Filipovský, CSc. 3;  Levret s. r. o. 4
Published in: Ceska Gynekol 2016; 81(5): 355-368

Overview

Objective:
To validate the Kennerley and Gath’s Maternity Blues Questionnaire (MBQ) for the Czech postpartum population, to present the psychometric properties of the Czech version of that screening method, and to assess its predictive power for the risk of postpartum depression.

Design:
Original study.

Setting:
Department of Psychology, Faculty of Arts and Philosophy, Charles University, Prague.

Methods:
The Czech version of the MBQ was validated on a sample of 1093 women. The data were collected from October 2013 to September 2014 at all maternity hospitals in Vysočina region. The MBQ was administered on a one-time basis during women’s postpartal stay at maternity hospital. After six weeks post partum, a screening for postpartum depression was performed using the Edinburgh Postnatal Depression Scale (EPDS). The cut-off point was set at 10/11 for MBQ and 12/13 for EPDS as such were the respective levels achieved by the 90th percentile in the MBQ and EPDS scores. The sociodemografic data were collected at the time of completing the MBQ. A logistic regression was performed to identify the predictors of severe blues. Cronbach’s alpha was calculated to assess the internal consistency of the MBQ as a whole and its component scales. In order to assess the validity of the MBQ, a logistic regression was used to analyze the association between the MBQ and EPDS scores. The norms for the Czech version of MBQ are presented as percentiles.

Results:
The MBQ scores showed a gradual rise over the days following the delivery (day 0 to day 4). The percentage of women with severe blues (MBQ score > 10) increased from 7.3% to 14.55% between day 0 and day 4. The most frequent feelings and mood states experienced by women in the first postpartum days included tiredness (61%), decreased self-confidence (30%), over-sensitivity (26%) and tension (19%), while 6,5% of women felt low spirited and 7% felt depressed. The women suffering from severe blues reported most frequently the same states of mood as did the women in the whole sample, but the rates of those states were higher: 83% for tiredness, 81% for decreased self-confidence, 79% for over-sensitivity, 71% for tension, while 46% of women with severe blues felt low spirited and 51% felt depressed. The significant risk factors for severe blues included parity (multipara, OR = 0.42; p < 0,001), mode of delivery (reference category unassisted vaginal delivery: emergency sectio caesarea, OR = 2.188, p = 0.004; planned sectio caesarea, OR = 1.843, p = 0.03; assisted vaginal delivery, OR = 6.136; p < 0.001), and previous depression (OR = 4.71, p = 0.003). Cronbach’s alpha of the individual scales ranged from 0.34 to 0.76, Cronbach’s alpha for the MBQ as a whole was 0.88. The severe blues were found to be a predictive factor for postpartum depression as assessed with EPDS (OR = 5.90; p < 0.001).

Conclusion:
With its high reliability and validity, the MBQ appears to be a useful tool for clinical practice and research. The MBQ can be used to identify the women with severe blues and with an increased risk of postpartum depression.

Keywords:
Maternity Blues Questionnaire, postpartum blues, postpartum depression, postnatal depression, EPDS, postpartum mood


Sources

1. Adewuya, AO. The maternity blues in Western Nigerian women: prevalence and risk factors. Am J Obstet Gynecol, 2005, 193, p. 1522–1525.

2. Ballinger, CB., Buckley, DE., Naylor, GJ., Stansfield, DA. Emotional disturbance following childbirth: clinical findings and urinary excretion of cyclic AMP (adenosine 3‘5‘cyclic monophosphate). Psychol Med, 1979, 9, p. 293–300.

3. Bergant, AM., Heim, K., Ulmer, H., Illmensee, K. Early postnatal depressive mood: associations with obstetric and psychosocial factors. J Psychosom Res, 1999, 46, p. 391–394.

4. Bloch, M., Daly, RC., Rubinow, DR. Endocrine factors in the etiology of postpartum depression. Compr Psychiatry, 2003, 44, p. 234–246.

5. Bloch, M., Rotenberg, N., Koren, D., Klein, E. Risk factors for early postpartum depressive symptoms. Gen Hosp Psychiatry, 2006, 28, p. 3–8.

6. Břicháček, V. Edinburghská škála postnatální deprese: ověření v České republice. Praha: Iga MZ ČR; 2000.

7. Boyd, RC., Le, HN., Somberg, R. Review of screening instruments for postpartum depression. Arch Womens Ment Health, 2005, 8, p. 141–153.

8. Buttner, MM., O‘Hara, MW., Watson, D. The structure of women‘s mood in the early postpartum. Assessment, 2012, 19, p. 247–256.

9. Condon, JT., Watson, TL. The maternity blues: exploration of a psychological hypothesis. Acta Psychiatr Scand, 1987, 76, p. 164–171.

10. Cox, JL., Holden, JM., Sagovsky, R. Detection of postnatal depression. Development of the 10-item Edinburgh Postnatal Depression Scale. Br J Psychiatry, 1987, 150, p. 782–786.

11. Davidson, JR. Post-partum mood change in Jamaican women: a description and discussion on its significance. Br J Psychiatry, 1972, 121, p. 659–663.

12. Denis, A., Ponsin, M., Callahan, S. The relationship between maternal self-esteem, maternal competence, infant temperament and post-partum blues. J Reprod Infant Psychology, 2012, 30, p. 388–397.

13. Edhborg, M. Comparisons of different instruments to measure blues and to predict depressive symptoms 2 months postpartum: a study of new mothers and fathers. Scand J Caring Sci, 2008, 22, p. 186–195.

14. Edhborg, M., Matthiesen, AS., Lundh, W., Widstrom, AM. Some early indicators for depressive symptoms and bonding 2 months postpartum – a study of new mothers and fathers. Arch Womens Ment Health, 2005, 8, p. 221–231.

15. Glangeaud-Freudenthal, NMC., Crost, M., Kaminski, MF. Severe post-delivery blues: associated factors. Arch Women Mental Health, 1999, 2, p. 37–44.

16. Glover, V., Kammerer, M. The biology and pathophysiology of peripartum psychiatric disorders. Primary Psychiatry, 2004, 11, p. 37–41.

17. Gonidakis, F., Rabavilas, AD., Varsou, E, et al. Maternity blues in Athens, Greece: a study during the first 3 days after delivery. J Affect Disord, 2007, 99, p. 107–115.

18. Grussu, P., Quatraro, RM. Maternity blues in Italian primipara women: symptoms and mood states in the first fifteen days after childbirth. Health Care Women Int, 2013, 34, p. 556–576.

19. Handley, SL., Dunn, TL., Waldron, G., Baker, JM. Tryptophan, cortisol and puerperal mood. Br J Psychiatry, 1980, 136, p. 498–508.

20. Hannah, P., Adams, D., Lee, A., et al. Links between early post-partum mood and post-natal depression. Br J Psychiatry, 1992, 160, p. 777–780.

21. Harris, B. ‚Maternity blues‘ in East African clinic attenders. Arch Gen Psychiatry, 1981, 38, p. 1293–1295.

22. Hau, FW., Levy, VA. The maternity blues and Hong Kong Chinese women: an exploratory study. J Affect Disord, 2003, 75, p. 197–203.

23. Henshaw, C. Mood disturbance in the early puerperium: a review. Arch Womens Ment Health, 2003, 6 Suppl 2, p. S33–S42.

24. Henshaw, C., Foreman, D., Cox, J. Postnatal blues: a risk factor for postnatal depression. J Psychosom Obstet Gynaecol, 2004, 25, p. 267–272.

25. Ishikawa, N., Goto, S., Murase, S., et al. Prospective study of maternal depressive symptomatology among Japanese women. J Psychosom Res, 2011, 71, p. 264–269.

26. Kendell, RE., McGuire, RJ., Connor, Y., Cox, JL. Mood changes in the first three weeks after childbirth. J Affect Disord, 1981, 3, p. 317–326.

27. Kennerley, H., Gath, D. Maternity blues reassessed. Psychiatr Dev, 1986, 4, p. 1–17.

28. Kennerley, H., Gath, D. Maternity blues. I. Detection and measurement by questionnaire. Br J Psychiatry, 1989, 155, p. 356–362.

29. Kennerley, H., Gath, D. Maternity blues. III. Associations with obstetric, psychological, and psychiatric factors. Br J Psychiatry, 1989, 155, p. 367–373.

30. Kumar, R. Postnatal mental illness: a transcultural perspective. Soc Psychiatry Psychiatr Epidemiol, 1994, 29, p. 250–264.

31. Kuscu, MK., Akman, I., Karabekiroglu, A., et al. Early adverse emotional response to childbirth in Turkey: the impact of maternal attachment styles and family support. J Psychosom Obstet Gynaecol, 2008, 29, p. 33–38.

32. Lane, A., Keville, R., Morris, M., et al. Postnatal depression and elation among mothers and their partners: prevalence and predictors. Br J Psychiatry, 1997, 171, p. 550–555.

33. Manjunath, NG., Venkatesh, G., Rajanna. Postpartum blue is common in socially and economically insecure mothers. Indian J Community Med, 2011, 36, p. 231–233.

34. Moslemi, L., Tadayon, M., Montazeri, S., Tabari, M. Prevalence and several effective factors on maternity blues. HealthMed, 2012, 6, p. 2299–2303.

35. Murata, A., Nadaoka, T., Morioka, Y., et al. Prevalence and background factors of maternity blues. Gynecol Obstet Invest, 1998, 46, p. 99–104.

36. O‘Hara, MW., Schlechte, JA., Lewis, DA., Wright, EJ. Prospective study of postpartum blues. Biologic and psychosocial factors. Arch Gen Psychiatry, 1991, 48, p. 801–806.

37. Oakley, A., Chamberlain, G. Medical and social factors in postpartum depression. J Obstet Gynaecol, 1981, 1, p. 182–187.

38. Okano, T., Nomura, J. Endocrine study of the maternity blues. Prog Neuropsychopharmacol Biol Psychiatry, 1992, 16, p. 921–932.

39. Pitt, B. ‚Maternity blues‘. Br J Psychiatry, 1973, 122, p. 431–433.

40. Revelle, W. Procedures for personality and psychological research, Northwestern University, Evanston, Illinois, USA, 2015, http://CRAN.R-project.org/package=psych Version = 1.5.8.

41. Rohde, LA., Busnello, E., Wolf, A., et al. Maternity blues in Brazilian women. Acta Psychiatr Scand, 1997, 95, p. 231–235.

42. Sakumoto, K., Masamoto, H., Kanazawa, K. Post-partum maternity ‚blues‘ as a reflection of newborn nursing care in Japan. Int J Gynaecol Obstet, 2002, 78, p. 25–30.

43. Séjourné, N., Denis, A., Theux, G., Chabrol, H. The role of some psychological, psychosocial and obstetrical factors in the intensity of postpartum blues. Encephale, 2008, 34, p. 179–182.

44. Stein, GS. The pattern of mental change and body weight change in the first post-partum week. J Psychosom Res, 1980, 24, p. 165–171.

45. Sutter, AL., Leroy, V., Dallay, D., et al. Post-partum blues and mild depressive symptomatology at days three and five after delivery, A French cross sectional study. J Affect Disord, 1997, 44, p. 1–4.

46. Sylven, SM., Papadopoulos, FC., Mpazakidis, V., et al. Newborn gender as a predictor of postpartum mood disturbances in a sample of Swedish women. Arch Womens Ment Health, 2011, 14, p. 195–201.

47. Takahashi, Y., Tamakoshi, K. Factors associated with early postpartum maternity blues and depression tendency among Japanese mothers with full-term healthy infants. Nagoya J Med Sci, 2014, 76, p. 129–138.

48. Watanabe, M., Wada, K., Sakata, Y., et al. Maternity blues as predictor of postpartum depression: a prospective cohort study among Japanese women. J Psychosom Obstet Gynaecol, 2008, 29, p. 206–212.

49. Yalom, ID., Lunde, DT., Moos, RH., Hamburg, DA. „Postpartum blues“ syndrome. A description and related variables. Arch Gen Psychiatry, 1968, 18, p. 16–27.

Labels
Paediatric gynaecology Gynaecology and obstetrics Reproduction medicine
Topics Journals
Login
Forgotten password

Enter the email address that you registered with. We will send you instructions on how to set a new password.

Login

Don‘t have an account?  Create new account

#ADS_BOTTOM_SCRIPTS#