title: Predicting early post-partum depressive symptoms among older primiparous Japanese mothers.
abstract: OBJECTIVE
  The number of older primiparas is increasing in Japan. These women have been shown to be more vulnerable to post-partum depression. This study aimed to identify factors for predicting post-partum depressive symptoms during hospitalization after childbirth in Japanese primiparas aged 35 years and over.
  
  
  METHODS
  The present authors used the data of 479 primiparas aged 35 years and over from a prospective cohort study. Data were collected using self-report questionnaires on the day before hospital discharge. The questionnaire consisted of: demographics and background information; depressive symptoms; fatigue; maternal confidence and maternal satisfaction; child-care values; physical symptoms; perceptions of daily life during hospitalization; concerns about child care and daily life; and infant feeding. Additionally, vital records data were obtained from the hospitals. A stepwise logistic regression analysis was performed on the binary outcome variable of depressive symptoms, measured by the Japanese version of the Edinburgh Postnatal Depression Scale. Women who scored 9 or more were considered to be at high risk for post-partum depression. The authors obtained informed consent from all participants and institutional ethics approvals before initiating the study.
  
  
  RESULTS
  The following six variables reliably predicted the risk of post-partum depression: emergency cesarean section, lower satisfaction with birth experience, higher physical burden in daily life, long-term complications with the newborn, more concerns about newborn caretaking after discharge, and more concerns about one's own life after discharge.
  
  
  CONCLUSIONS
  Recognition of women with these factors will help nurses to identify those at risk for developing post-partum depression and to provide appropriate care during hospitalization after childbirth.
authors.affiliation: Graduate School of Nursing, Chiba University, Chiba, Japan.
authors.forename: Hiroko
authors.initials: H
authors.lastname: Iwata
authors.affiliation: Graduate School of Nursing, Chiba University, Chiba, Japan.
authors.forename: Emi
authors.initials: E
authors.lastname: Mori
authors.affiliation: Graduate School of Nursing, Chiba University, Chiba, Japan.
authors.forename: Miyako
authors.initials: M
authors.lastname: Tsuchiya
authors.affiliation: Graduate School of Nursing, Chiba University, Chiba, Japan.
authors.forename: Akiko
authors.initials: A
authors.lastname: Sakajo
authors.affiliation: Graduate School of Nursing, Chiba University, Chiba, Japan.
authors.forename: Kunie
authors.initials: K
authors.lastname: Maehara
authors.affiliation: Graduate School of Nursing, Chiba University, Chiba, Japan.
authors.forename: Harumi
authors.initials: H
authors.lastname: Ozawa
authors.affiliation: Former Graduate School of Nursing, Chiba University, Chiba, Japan.
authors.forename: Akiko
authors.initials: A
authors.lastname: Morita
authors.affiliation: Former Graduate School of Nursing, Chiba University, Chiba, Japan.
authors.forename: Tomoko
authors.initials: T
authors.lastname: Maekawa
authors.affiliation: Graduate School of Nursing, Chiba University, Chiba, Japan.
authors.forename: Kyoko
authors.initials: K
authors.lastname: Aoki
authors.affiliation: School of Nursing, Kitasato University, Sagamihara, Japan.
authors.forename: Miyuki
authors.initials: M
authors.lastname: Makaya
authors.affiliation: Graduate School of Medicine, Nagoya University, Nagoya, Japan.
authors.forename: Koji
authors.initials: K
authors.lastname: Tamakoshi
mesh_terms: D000328:Adult; D019052:Depression, Postpartum / Q000503:physiopathology* / Q000523:psychology; D005260:Female; D006801:Humans; D007564:Japan; D009035:Mothers / Q000523:psychology*
keywords: depression; hospitalization; logistic regression; maternal age; nursing