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Identifying postnatal depression with mHealth technology
Bettina van Wylich-Muxoll

Identifying postnatal depression with mHealth technology

Baby Blues occur within the first three days after birth and may last until a few weeks later. It is expected that between 60 to 80% of new mothers experience baby blues [1].

However, is estimated that 10 to 15% of new adult mothers develop Postpartum Depression (PPD) within the first year after giving birth, and the percentage increases up to 26% in adolescent mothers [1].

Furthermore, a recent study made with women suffering from bipolar disorder, indicated that 67% of them had a depressive episode after the first child, and they all experienced a relapse with their next birth [1].

According to Dr. Shoshanna Bennett, there are two main ways to differentiate Baby Blues from PPD. Firstly, Baby Blues always begin in the first few days following delivery and should be gone two weeks after childbirth. Besides, the symptoms are mild – frequent tearfulness, feelings of dependence and stress [2].

Unlike Baby Blues, the severity of the postpartum depression disrupts a woman’s ability to function. Therefore, if the symptoms are severe enough and last more than two weeks, it can be considered PPD and she should seek help [2].

While PPD is a major health issue for many women, it often remains undiagnosed. Although several measures have been created to detect depressive symptomatology in women who have recently given birth, the development of a postpartum depression screening program requires careful consideration [3].

Evidence-based decisions need to be made regarding two aspects. Firstly, healthcare systems need to develop an effective screening test that not only has good sensitivity and specificity, but is also quick, easy to interpret, readily incorporated into practice, and culturally sensitive. Second, health care systems should use these tools as a cost-effective, potential harm, and policies for a referral [3].

Fortunately, preliminary research suggests postpartum depression is responsive to treatment interventions thus providing a rationale for the development of a screening program [3].

The Monsenso mHealth solution can help healthcare professionals identify PPD at an early stage. New mothers can be asked to download the app and fill in self-assessments on their smartphones on a daily basis. With the self-assessments, new mothers can rate themselves on relevant parameters such as their levels of stress, anxiety, and tearfulness, as keeping track of the number of hours they slept within a 24-hour period. The system can also collect sensor data such as their level of physical activity, social activity and mobility.

Healthcare professionals can monitor new mothers on a regular basis and contact them if the system indicates any triggers or early warning signs that their Baby Blues is evolving into PPD. It is important to take into consideration that the early intervention of PPD reduces the long-term disadvantages that PPD causes for mother and child.

Current research suggests that postpartum depression has salient but selective effects on the mother/infant relationship, and child growth and development. Young children of mothers with postpartum depression have greater cognitive, behavioural, and interpersonal problems than children of nondepressed mothers. Overall, it is exposure to prolonged episodes of postpartum depression or to recurrent episodes of maternal depression that are most likely to have long-term effects on the child [3].

References:

  1. The Environmental, Cultural, Relational and Physiological Aspects of Postpartum Depression. The Faculty of the Adler Graduate School. Joanne E. Campbell. 2010.
    http://www.alfredadler.edu/sites/default/files/Campbell%20MP%202010.pdf
  2. Do you have Baby Blues or Postpartum Depression? PBS.Org. Dr. Shoshanna Bennett.
    http://www.pbs.org/thisemotionallife/blogs/do-you-have-baby-blues-or-postpartum-depression
  3. Postpartum Depression: Literature review of risk factors and interventions. Toronto Public Health. 2003.
    http://www.who.int/mental_health/prevention/suicide/lit_review_postpartum_depression.pdf