title: Predictors of depressive symptoms in older Japanese primiparas at 1 month post-partum: A risk-stratified analysis.
abstract: OBJECTIVE
  Older maternal age has become more common in Japan. Studies suggest that older maternal age and primiparity are associated with post-partum depression. The present study aimed to identify predictors of post-partum depression in older Japanese primiparas at 1 month post-partum.
  
  
  METHODS
  Participants were 479 primiparas aged 35 years and over, drawn from a prospective cohort study. Data were collected using self-report questionnaires. Depression was measured with the Japanese version of the Edinburgh Postnatal Depression Scale. Stepwise logistic regression analysis was conducted on binary outcome variables of depression at 1 month post-partum, along with a stratified analysis based on the risk status of depression.
  
  
  RESULTS
  Five predictors were identified: (i) the depression score during hospital stay; (ii) financial burden; (iii) dissatisfaction with appraisal support; (iv) physical burden in daily life; and (v) concerns about infant caretaking. Stratified analysis identified dissatisfaction with instrumental support in the low-risk group, and the Child-care Value Scale score as unique predictors in the high-risk group.
  
  
  CONCLUSIONS
  These results highlight the importance of early assessment of depressive symptoms and the provision of continuous care.
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: Division of Cancer Survivorship Research, National Cancer Center, Tokyo, 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: Graduate School of Medicine, Nagoya University, Nagoya, Japan.
authors.forename: Koji
authors.initials: K
authors.lastname: Tamakoshi
mesh_terms: D000328:Adult; D019052:Depression, Postpartum / Q000453:epidemiology*; D005260:Female; D006801:Humans; D007223:Infant; D007564:Japan; D008875:Middle Aged; D017060:Patient Satisfaction; D049590:Postpartum Period; D011446:Prospective Studies; D012307:Risk Factors; D012944:Social Support
keywords: depression; maternal age; post-partum; primiparas; risk