Maternal Psychological Symptom Trajectories from 2 to 24 Months Postpartum: A Latent Class Growth Analysis.
Journal
Nursing research
ISSN: 1538-9847
Titre abrégé: Nurs Res
Pays: United States
ID NLM: 0376404
Informations de publication
Date de publication:
06 Feb 2024
06 Feb 2024
Historique:
medline:
8
2
2024
pubmed:
8
2
2024
entrez:
8
2
2024
Statut:
aheadofprint
Résumé
Postpartum women experience an array of psychological symptoms that are associated with adverse health behaviors and outcomes including postpartum suicidal ideation and long-term depression. To provide early management of postpartum psychological symptoms, it is important to understand how the symptom experiences change over time. To examine maternal psychological symptom trajectories over 2, 6, 15, and 24 months postpartum using latent class growth analysis (LCGA) and to examine how each trajectory is associated with maternal depression outcome at 24 months. We used secondary data from the Family Life Project (N = 1,122) and performed multi-trajectory LCGA based on four observed symptom variables (depression, anxiety, somatization, and hostility). After the final model was identified, bivariate analyses were conducted to examine the association between each trajectory and (a) individual characteristics and (b) outcome (Center for Epidemiologic Studies Depression Scale [CES-D]) variables. A 4-class model was selected for the final model because it had better fit indices, entropy, and interpretability. The four symptom trajectories were: (1) No symptoms over 24 months, (2) low symptoms over 24 months, (3) moderate symptoms increasing over 15 months, and (4) high symptoms increasing over 24 months. More postpartum women with the trajectory of high symptoms increasing over 24 months (Trajectory 4) were in low economic status (92.16%), unemployed (68.63%), or did not complete 4-year college education (98.04%). Most postpartum women (95.56%) in trajectory 4 also had higher CES-D cut-off scores, indicating a possible clinical depression at 24 months postpartum. Postpartum women who experience increasing symptom trajectories over 15 to 24 months (Trajectories 3 and 4) could benefit from tailored symptom management interventions provided earlier in the postpartum period to prevent persistent and worsening symptom experiences.
Sections du résumé
BACKGROUND
BACKGROUND
Postpartum women experience an array of psychological symptoms that are associated with adverse health behaviors and outcomes including postpartum suicidal ideation and long-term depression. To provide early management of postpartum psychological symptoms, it is important to understand how the symptom experiences change over time.
OBJECTIVE
OBJECTIVE
To examine maternal psychological symptom trajectories over 2, 6, 15, and 24 months postpartum using latent class growth analysis (LCGA) and to examine how each trajectory is associated with maternal depression outcome at 24 months.
METHODS
METHODS
We used secondary data from the Family Life Project (N = 1,122) and performed multi-trajectory LCGA based on four observed symptom variables (depression, anxiety, somatization, and hostility). After the final model was identified, bivariate analyses were conducted to examine the association between each trajectory and (a) individual characteristics and (b) outcome (Center for Epidemiologic Studies Depression Scale [CES-D]) variables.
RESULTS
RESULTS
A 4-class model was selected for the final model because it had better fit indices, entropy, and interpretability. The four symptom trajectories were: (1) No symptoms over 24 months, (2) low symptoms over 24 months, (3) moderate symptoms increasing over 15 months, and (4) high symptoms increasing over 24 months. More postpartum women with the trajectory of high symptoms increasing over 24 months (Trajectory 4) were in low economic status (92.16%), unemployed (68.63%), or did not complete 4-year college education (98.04%). Most postpartum women (95.56%) in trajectory 4 also had higher CES-D cut-off scores, indicating a possible clinical depression at 24 months postpartum.
DISCUSSION
CONCLUSIONS
Postpartum women who experience increasing symptom trajectories over 15 to 24 months (Trajectories 3 and 4) could benefit from tailored symptom management interventions provided earlier in the postpartum period to prevent persistent and worsening symptom experiences.
Identifiants
pubmed: 38329993
doi: 10.1097/NNR.0000000000000713
pii: 00006199-990000000-00100
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Informations de copyright
Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.
Déclaration de conflit d'intérêts
The authors have no conflicts of interest to report.