Abstract
Objective
The aim of the study was to characterize the depressive tendency and stress-coping ability of pregnant and postpartum women who conceived through assisted reproductive technology (ART) and conventional infertility treatment, in terms of their serial changes, association, and influencing factors, to explore an effective approach to support these women.
Subjects and Methods
The survey was conducted from March to October 2011 at a hospital in Kyoto Prefecture, Japan. A total of 95 pregnant women (36 conceived spontaneously, 13 with conventional infertility treatment, and 46 with ART; valid response rate, 95%) who provided consent for participation were assessed longitudinally at 3 time-points (late pregnancy, early postpartum period [2-7 days postpartum], and 1 month postpartum) regarding their past history, depressive tendency (Edinburgh Postnatal Depression Scale, EPDS), and stress-coping ability (Sense of Coherence Scale, SOC). Data were compared among the three conception groups.
Results
The conventional infertility treatment group tended to have higher EPDS and lower SOC scores at the 3 time-points, with no significant differences among the groups. With respect to the relationship between EPDS and SOC scores, a significant negative correlation was observed in the ART group at all 3 time-points (r=-0.500 to 0.592, p<0.01) and in the conventional infertility treatment group at 2 time-points other than late pregnancy (r=-0.563, -0.640, p <0.05), and a relatively strong negative correlation was noted in the participants at late pregnancy (r=-0.466, p<0.01), early postpartum (r=-0.592, p<0.01), and 1 month postpartum (r=-0.623, p<0.01), demonstrating that the higher the EPDS total score, the lower the SOC total score. Regarding the influencing factors, the EPDS score at 1 month postpartum tended to be higher in older primipara (p=0.056), and SOC scores at late pregnancy and 1 month postpartum tended to be lower in older pregnant/postpartum women (p=0.057 and 0.052, respectively).
Conclusion
Depression in pregnant and postpartum women who conceive after ART is currently attracting increasing attention. However, the present finding that pregnant and postpartum women who conceived through conventional infertility treatment had the highest score on the scale for a depressive tendency suggests the need to support pregnant and postpartum women who conceive after infertility treatment, regardless of the type of treatment, from the early stages of pregnancy. Furthermore, the results showed that the depressive tendency and stress-coping ability changed over the peripartum period, and that the EPDS and SOC scores were closely correlated, highlighting the need to provide support for pregnant/postpartum women with high EPDS scores, namely "those who conceive after conventional infertility treatment" and "older primipara", so that they can improve their stress-coping skills.
