title: Antenatal Risk Factors of Postpartum Depression at 20 Weeks Gestation in a Japanese Sample: Psychosocial Perspectives from a Cohort Study in Tokyo.
abstract: BACKGROUND
  Prevalence of postnatal depression (PND) is high (Western countries, 10-15%; Japan, 17%). PND can cause parenting impairment and affect family health (e.g. child behaviors, cognitive development and physical health). This study aimed to reveal the risk factors of PND during the pregnancy period in a Japanese sample, and to identify the psychosocial risk factors of PND that should be appended to existing obstetric interview sheets. A cohort study with a Japanese sample was conducted.
  
  
  METHODS
  All 14 obstetrics hospitals in the Setagaya ward, Tokyo, Japan, participated in this study. Pregnant women who booked their delivery between December 2012 and May 2013 were enrolled. Data used for this study were collected at 20 weeks gestation, a few days and one month postnatal. The questionnaires consisted of psychosocial factors and the Edinburgh Postnatal Depression Scale (EPDS). To identify PND risk factors, multivariate analyses were performed.
  
  
  RESULTS
  A total of 1,775 women participated in this study. Eventually, the data of 1,133 women were used for the multivariate analyses. The demonstrated significant risk factors include EPDS score, primipara, "a perceived lack of family cohesion", "current physical illness treatment" and "current psychiatric illness treatment".
  
  
  CONCLUSIONS
  This study highlights the importance of mental health screening using psychological measures during the pregnancy period. In addition, family environment, parity, physical and psychiatric illness should be paid attention by professionals in maternal and child health. The results also suggest that mothers' feelings of developing their families should be supported.
authors.affiliation: Division of Infant and Toddler Mental Health, Department of Psychosocial Medicine, National Center for Child Health and Development, Tokyo, Japan.
authors.forename: Yoshiyuki
authors.initials: Y
authors.lastname: Tachibana
authors.affiliation: National Research Institute for Child Health and Development, Tokyo, Japan.
authors.forename: Tomoe
authors.initials: T
authors.lastname: Koizumi
authors.affiliation: Department of Health Policy, National Research Institute for Child Health and Development, Tokyo, Japan.
authors.forename: Kenji
authors.initials: K
authors.lastname: Takehara
authors.affiliation: Division of Bioethics, National Center for Child Health and Development, Tokyo, Japan.
authors.forename: Naoko
authors.initials: N
authors.lastname: Kakee
authors.affiliation: Department of Psychosocial Medicine, National Center for Child Health and Development, Tokyo, Japan.
authors.forename: Hiromi
authors.initials: H
authors.lastname: Tsujii
authors.affiliation: Department of Health Policy, National Research Institute for Child Health and Development, Tokyo, Japan.
authors.forename: Rintaro
authors.initials: R
authors.lastname: Mori
authors.affiliation: Department of Biostatistics, Clinical Research Center, National Center for Child Health and Development, Tokyo, Japan.
authors.forename: Eisuke
authors.initials: E
authors.lastname: Inoue
authors.affiliation: Department of Health Policy, National Research Institute for Child Health and Development, Tokyo, Japan.
authors.forename: Erika
authors.initials: E
authors.lastname: Ota
authors.affiliation: Department of Child Psychiatry, Kyushu University Hospital, Fukuoka, Japan.
authors.forename: Keiko
authors.initials: K
authors.lastname: Yoshida
authors.affiliation: Japanese Midwives Association, Tokyo, Japan.
authors.forename: Keiko
authors.initials: K
authors.lastname: Kasai
authors.affiliation: Department of Psychosocial Medicine, National Center for Child Health and Development, Tokyo, Japan.
authors.forename: Makiko
authors.initials: M
authors.lastname: Okuyama
authors.affiliation: Shirota Obstetrical and Gynecological Hospital, Tokyo, Japan.
authors.forename: Takahiko
authors.initials: T
authors.lastname: Kubo
mesh_terms: D000328:Adult; D015331:Cohort Studies; D019052:Depression, Postpartum / Q000453:epidemiology / Q000523:psychology*; D005260:Female; D006801:Humans; D008603:Mental Health; D009035:Mothers / Q000523:psychology; D011247:Pregnancy; D015995:Prevalence; D012307:Risk Factors; D014041:Tokyo / Q000453:epidemiology