title: Trajectories of depressive symptoms and fatigue among postpartum women.
abstract: OBJECTIVE
  To identify and characterize the trajectories of depressive and fatigue symptoms and determine the relationship between these two trajectories and associated predictors.
  
  
  METHODS
  A prospective, follow-up study.
  
  
  METHODS
  A teaching medical center in central Taiwan.
  
  
  METHODS
  A convenience sample of 121 low-risk, childbearing women.
  
  
  METHODS
  Depressive and fatigue symptoms were assessed using the Edinburgh Postnatal Depression Scale and Fatigue Continuum Form respectively during the third trimester (time 1), one day postpartum (time 2), three days postpartum (time 3), and one week postpartum (time 4). Participants also completed structured questionnaires on demographic features, health status, and sleep quality.
  
  
  RESULTS
  The mean age of participants was 31.2 years. We observed four distinctive trajectories of depressive symptoms and three trajectories of fatigue using group-based trajectory modeling. A frequent conoccurrence of similar levels of these symptoms was found; that is, mothers in the high-risk depressive symptoms group were most likely to fall into the high-risk group for fatigue. Joint trajectories were predicted by poor sleep score (odds ratio = 2.96, 95% confidence interval = 1.2, 7.3) using multinomial logistic regression analysis.
  
  
  CONCLUSIONS
  Overlapping but distinct trajectories of depressive symptoms and fatigue were found. These results suggest that differentiation between depressive symptoms and fatigue is possible and important for improving care during the early postpartum period.
authors.affiliation: Department of Nursing, Ching Kuo Institute of Management and Health, Keelung, Taiwan, R.O.C.
authors.forename: Shu-Yu
authors.initials: SY
authors.lastname: Kuo
authors.affiliation: School of Nursing, College of Medicine, National Taiwan University and an adjunct supervisor in the Department of Nursing, National Taiwan University Hospital, Taipei, Taiwan, R.O.C.
authors.forename: Ya-Ling
authors.initials: YL
authors.lastname: Yang
authors.affiliation: College of Nursing, Chung Shan Medical University and a research advisor in the Nursing Department, Chung Shan Medical University Hospital, Taichung, Taiwan, R.O.C.
authors.forename: Pi-Chao
authors.initials: PC
authors.lastname: Kuo
authors.affiliation: Taichung Veterans General Hospital, Taichung, Taiwan, R.O.C.
authors.forename: Chi-Meng
authors.initials: CM
authors.lastname: Tseng
authors.affiliation: School of Nursing, China Medical University and an adjunct supervisor in the Department of Nursing, China Medical University Hospital, Taichung, Taiwan, R.O.C.. Electronic address: tyaling@mail.cmu.edu.tw.
authors.forename: Ya-Ling
authors.initials: YL
authors.lastname: Tzeng
mesh_terms: D000046:Academic Medical Centers / Q000706:statistics & numerical data; D000328:Adult; D017677:Age Distribution; D001499:Bayes Theorem; D015984:Causality; D015331:Cohort Studies; D015897:Comorbidity; D003863:Depression / Q000175:diagnosis / Q000453:epidemiology*; D018450:Disease Progression; D005221:Fatigue / Q000175:diagnosis / Q000453:epidemiology*; D005260:Female; D005500:Follow-Up Studies; D005865:Gestational Age; D006801:Humans; D015994:Incidence; D007231:Infant, Newborn; D016015:Logistic Models; D008429:Maternal Welfare; D015999:Multivariate Analysis; D011237:Predictive Value of Tests; D011247:Pregnancy; D011248:Pregnancy Complications / Q000175:diagnosis / Q000453:epidemiology*; D011446:Prospective Studies; D011569:Psychiatric Status Rating Scales; D011644:Puerperal Disorders / Q000175:diagnosis / Q000453:epidemiology*; D018570:Risk Assessment; D012720:Severity of Illness Index; D012959:Socioeconomic Factors; D013624:Taiwan / Q000453:epidemiology; D013997:Time Factors; D055815:Young Adult