title: Very low birth-weight as a risk factor for postpartum depression four to six weeks postbirth in mothers and fathers: Cross-sectional results from a controlled multicentre cohort study.
abstract: BACKGROUND
  Preterm birth and survival rates of very low birth-weight (VLBW: <1.500g) infants have increased. Although new parents are frequently affected by depressive symptoms, little is known about prevalence, risk, and predictors of parental postpartum depression (PPD) following VLBW birth. Furthermore, most studies assessing PPD in parents of preterm children relied on self-report only.
  
  
  METHODS
  As part of the HaFEn cohort-study, data from the index groups of parents with VLBW infants and the control group of parents with term infants were cross-sectionally analysed. Families were recruited at the three largest centres of perinatal medical care in Hamburg, Germany. PPD was evaluated one month postpartum using standardized questionnaires and clinical interviews. Socioeconomic status, social support, risks during pregnancy, and psychiatric lifetime diagnoses were also assessed. A multiple random coefficient model was used to examine predictors of PPD in both parents simultaneously.
  
  
  RESULTS
  230 mothers and 173 fathers were included. Depending on the measure, the risk of being postnatally depressed was 4 to 18 times higher in mothers and 3 to 9 times higher in fathers from the index group. The most relevant risk factor for PPD was the birth of a VLBW infant, followed by female sex, lifetime psychiatric disorder, and low social support.
  
  
  CONCLUSIONS
  Results presented here, are based on cross sectional data. Therefore no temporal relationships can be established.
  
  
  CONCLUSIONS
  Our findings highlight the importance of early screening for PPD in both parents of VLBW infants. Factors contributing to developing depression should also be considered in neonatal care.
authors.affiliation: Department of Child and Adolescent Psychiatry, University Medical Center Hamburg-Eppendorf, Germany. Electronic address: n.helle@uke.de.
authors.forename: Nadine
authors.initials: N
authors.lastname: Helle
authors.affiliation: Department of Child and Adolescent Psychiatry, University Medical Center Hamburg-Eppendorf, Germany.
authors.forename: Claus
authors.initials: C
authors.lastname: Barkmann
authors.affiliation: Department of Neonatology and Paediatric Critical Care, Neonatal Intensive Care Unit, Altona Children׳s Hospital, Hamburg, Germany.
authors.forename: Jutta
authors.initials: J
authors.lastname: Bartz-Seel
authors.affiliation: Department of Paediatrics, Neonatal Intensive Care Unit, University Medical Center Hamburg-Eppendorf, Germany.
authors.forename: Thilo
authors.initials: T
authors.lastname: Diehl
authors.affiliation: Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
authors.forename: Stephan
authors.initials: S
authors.lastname: Ehrhardt
authors.affiliation: Department of Neonatology, Neonatal Intensive Care Unit, Asklepios Medical Center Barmbek, Hamburg, Germany.
authors.forename: Astrid
authors.initials: A
authors.lastname: Hendel
authors.affiliation: Institute of Psychology, Clinical Psychology and Psychotherapy, Hamburg University, Hamburg, Germany.
authors.forename: Yvonne
authors.initials: Y
authors.lastname: Nestoriuc
authors.affiliation: Department of Child and Adolescent Psychiatry, University Medical Center Hamburg-Eppendorf, Germany.
authors.forename: Michael
authors.initials: M
authors.lastname: Schulte-Markwort
authors.affiliation: Department of Neonatology and Paediatric Critical Care, Neonatal Intensive Care Unit, Altona Children׳s Hospital, Hamburg, Germany.
authors.forename: Axel
authors.initials: A
authors.lastname: von der Wense
authors.affiliation: Department of Child and Adolescent Psychiatry, University Medical Center Hamburg-Eppendorf, Germany.
authors.forename: Carola
authors.initials: C
authors.lastname: Bindt
mesh_terms: D015331:Cohort Studies; D003430:Cross-Sectional Studies; D019052:Depression, Postpartum / Q000453:epidemiology / Q000523:psychology*; D005220:Fathers / Q000523:psychology*; D005260:Female; D005858:Germany; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D019102:Infant, Very Low Birth Weight / Q000523:psychology*; D008297:Male; D009035:Mothers / Q000523:psychology*; D049590:Postpartum Period / Q000523:psychology; D011247:Pregnancy; D047928:Premature Birth / Q000523:psychology*; D015995:Prevalence; D012944:Social Support; D011795:Surveys and Questionnaires
keywords: Maternal/paternal; Postpartum depression; Preterm birth; Risk factors