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BackgroundPostpartum depression has a prevalence rate of up to 17%. As there are many negative consequences of postpartum depressive symptoms, it is important to examine possible protective factors, such as trait mindfulness. Since postpartum depressive symptoms are variable over time between and within individuals, this study focused on the possible association between facets of trait mindfulness and trajectories of postpartum depressive symptoms throughout the first postpartum year. MethodsA subsample of 713 women that participated in the HAPPY study completed the Three Facet Mindfulness Questionnaire-Short Form at 22 weeks of pregnancy and the Edinburgh Postnatal Depression Scale (EPDS) at six weeks, four months, eight months, and twelve months postpartum. Possible different EPDS trajectories were obtained by means of growth mixture modeling. ResultsTwo EPDS trajectories (classes) were found: a low stable symptom class (N = 647, 90.7%) and an increasing-decreasing symptom class (N = 66, 9.3%). Women in the low stable class showed higher ‘acting with awareness’ and ‘non-judging’ scores. A higher score on the ‘non-judging’ facet of trait mindfulness was associated with a higher likelihood of belonging to the low stable class (OR = 0.79, 95% CI [0.72, 0.87], p < 0.001), adjusted for confounders and the other mindfulness facets. ConclusionsThe non-judging facet of trait mindfulness was associated with low stable levels of depressive symptoms during the first postpartum year. Mindfulness-based programs, focusing on enhancing non-judging may be of benefit for pregnant women to possibly decrease the risk of developing postpartum depressive symptoms after childbirth

Mental disorders during pregnancy are common, with long-lasting negative effects on mother and child. Treatment of these women is challenging, because of the high incidence of additional psychosocial problems and barriers on population and healthcare level. Collaborative care, collaboration between mental health and obstetric care professionals, may help to overcome these problems. The aim of this review is to review antenatal mental health interventions and analyse the impact of collaborative care. Two independent reviewers searched for RCT’s in PubMed, Embase and PsycINFO. Trials studying the effect of psychological or pharmacological interventions on the mental health of pregnant women with psychiatric symptoms (and psychosocial problems) were eligible for inclusion. Two reviewers independently abstracted data and assessed study quality and risk of bias. Each study was scored on collaborative care criteria: multi-professional approach to patient care, structured management plan, scheduled patient follow-ups and enhanced interprofessional communication. Thirty-five studies were included. Most trials studied the effect of cognitive behavioural therapy and interpersonal psychotherapy on antenatal depression. Almost all interventions met at least one collaborative care criteria. Interventions were mostly provided by multiple professionals, but interprofessional communication rarely took place. Interventions that met more criteria did not more often show a positive effect on maternal mental health. There is lack of research on antenatal psychiatric disorders other than depressive and on long-term treatment outcomes. Collaborative care is partly implemented in most current interventions, but more trials (including interprofessional communication) are needed to be conclusive whether collaborative care is a key component in antenatal mental healthcare.

Background: Oxytocin (OT) is a neuropeptide hormone that has anxiolytic and antidepressant effects, and positive effects on social affiliation and behaviour, particularly in parenting and attachment relationships. In women with postnatal depression (PND), each of these are reduced. This study investigated if OT administration reduces low mood in new mothers with PND and across the low mood spectrum. Design: A double-blind, placebo-controlled, randomised controlled-trial, within-subjects, cross-over design was conducted. Participants: Mothers (N = 58) between 3-9 months postpartum. Participants were screened for traits of PND on the Edinburgh Postnatal Depression Scale (EPDS) and assigned into 2 groups: probable PND cases (N = 26, scoring ≥9) and controls (N = 32, scoring ≤9). Method: Participants rated their current mood on the Positive and Negative Affect Scale (PANAS) at Baseline (before nasal administration), Condition 1 (after first OT/Placebo administration) and Condition 2 (after second OT/Placebo administration). Results: OT administration did not affect mood in women with PND scores above the cut-off point but significantly reduced negative mood in those scoring below the cut-off point. To explore if a subgroup was driving this, we compared participants with mild, moderate and severe scores on the EPDS. OT administration significantly reduced negative mood in women with moderate low mood scores on the EPDS. Limitations: PND was assessed by the EPDS, rather than a clinical diagnosis. Conclusion: These results illustrate individual differences in response to OT administration and suggest that OT administration may offer treatment benefit to new mothers who report moderate sub-clinical levels of depression.

Perinatal depression is common, affecting approximately 7–13% of women. Studies have shown an association between unplanned pregnancy and perinatal depressive symptoms, but many used a cross-sectional design and limited postnatal follow-up. The current study investigated the association of unplanned pregnancy with perinatal depressive symptoms using a longitudinal cohort study that followed women from the first trimester until 12 months postpartum. Pregnant women (N = 1928) provided demographic and clinical data and information about pregnancy intention at the first trimester. Depressive symptoms were assessed during each trimester of pregnancy and five times postpartum using the Edinburgh Postnatal Depression Scale (EPDS) until 12 months postpartum. Mixed model analyses were used to investigate the association between an unplanned pregnancy and the level of depressive symptoms. Women with an unplanned pregnancy (N = 111, 5.8%) reported persistently higher levels of depressive symptoms during the entire perinatal period compared to women with a planned pregnancy, after adjustment for confounders (p course of depressive symptom scores over time in women with an unplanned pregnancy was similar to that of women with a planned pregnancy. Lower age (p = 0.006), unemployment (p = 0.004), and history of depression (p

Dissertação de mestrado integrado em Psychology, A interação face a face é um contexto chave para entender a qualidade da interação mãe-bebé, sendo que pode ser influenciada por fatores externos que estão bastante presentes na atualidade. Desta forma, este estudo tem como objetivo (1) analisar diferenças na interação face-a-face mãe-bebé entre mães deprimidas e mães não deprimidas no pós-parto, e (2) analisar diferenças na interação face-a-face mãe-bebé entre o sexo do bebé (raparigas vs rapazes). A amostra foi composta por 63 mulheres recrutadas no 3º trimestre da gestação, maioritariamente portuguesas (92%). Os instrumentos utilizados neste estudo foram: Questionário Sociodemográfico, Escala de Depressão Pós-Natal de Edimburgo e Escala de Avaliação da Interação. Os resultados revelaram que (1) a depressão influencia alguns comportamentos maternos, como a reduzida atividade física significativa e o aumento da presença de expressões faciais de tensão e raiva. Bem como revelaram que (2) o sexo do bebé influencia o modo como este interage com a mãe, sendo que os rapazes têm comportamentos mais direcionados para a mãe do que as raparigas. Em suma, é importante implementar programas educativos para grávidas e mães recentes, de forma que estas consigam responder adequadamente a possíveis comportamentos que possam existir durante a interação face a face., Face-to-face interaction is a key context for understanding the quality of mother-infant interaction and can be influenced by external factors that are strongly present nowadays. Thus, this study aims to analyze (1) differences in face-to-face mother-infant interaction between depressed mothers and non-depressed mothers in the postpartum period, and (2) to analyze differences in face-to-face mother-infant interaction between the sex of the infant (females vs males). The sample was composed of 63 women recruited in their third trimester of pregnancy, mostly Portuguese (92%). The instruments used in this study were: Sociodemographic Questionnaire, Edinburgh Postnatal Depression Scale, and Interaction Rating Scale. The results revealed that (1) depression influences certain maternal behaviors, such as reduced significant physical activity and increased presence of facial expressions of tension and anger. They also revealed that (2) the sex of the infant influences the way they interact with their mother, with males having more mother oriented behaviors than females. In summary, it is important to implement educational programs for pregnant women and recent mothers so that they can respond appropriately to possible behaviors that may exist during face-to-face interaction.

Limited research exists on dyadic spillover and crossover processes in parenting when depressive symptoms occur. This study examined both direct actor and partner effects from parents’ prenatal depressive symptoms to parenting 19 months postpartum and effects mediated via the parent’s own depressive symptoms 10 months postpartum. The Actor–Partner Interdependence Mediation Model was applied to a sample of 534 couples participating in a randomized controlled trial of a universal parenting support program. For both parents, direct and mediated actor effects were found from depressive symptoms to own parental stress and attachment at 19 months postpartum. For fathers, but not mothers, direct and mediated actor effects were also seen for own postnatal childcare involvement although in mixed directions. Direct partner effects were not indicated across gender, however mediated partner effects appeared from mothers’ depressive symptoms to fathers’ later parental stress and attachment-related feelings, but not vice versa. Findings highlight the importance of a dyadic approach to examine depressive symptoms and parenting processes during the transition to parenthood .

Bakgrund: Graviditet och förlossning innebär en fysisk och mental påfrestning. Efter förlossning kan det vara svårt att återgå till den nivå av fysisk aktivitet som innan en graviditet. Med fluktuerande hormoner visar att vissa kvinnor kan vara mer utsatt för upplevd stress och ångest vilket kan leda till depression. Det finns ej några nationella riktlinjer för fysisk aktivitet och träning postpartum. Det finns endast ett fåtal studier som studerar sambandet mellan fysisk aktivitetsnivå och stress hos kvinnor postpartum. Syfte: Syftet är att undersöka fysisk aktivitet och upplevd stress, samt sambandet mellan fysisk aktivitet och upplevd stress hos kvinnor i Sverige 3 – 6 månader efter vaginal förlossning. Metod: En korrelerande och deskriptiv kvantitativ icke experimentell design användes i denna tvärsnittsstudie. Urvalet skedde via riktade svenska Facebookgrupper och självskattningsenkäter rörande fysisk aktivitetsnivå (Socialstyrelsens indikatorfrågor om fysisk aktivitet) och upplevd stress (The Perceived stress scale - 10) samlades in vid ett tillfälle från 26 kvinnor. Totalt 19 enkäter användes i undersökningen. Resultat: Studiedeltagarna skattade sin vardagsmotion till 225 minuter/vecka (IQR = 180), sin fysiska träning till 15 min/vecka (IQR = 75), samt totala aktivitetsminuter till 300 minuter/vecka (IQR = 225). Den upplevda stressnivån skattades till 16 (IQR = 10). En svag, icke signifikant negativ korrelation förelåg mellan totala aktivitetsminuter och upplevd stress (r = -0,25). Slutsats: Denna studie är den enda studien som studerat samband mellan fysisk aktivitetsnivå och stress hos kvinnor 3–6 månader postpartum. Ingen korrelation förelåg men kvinnorna hade en relativt hög fysisk aktivitetsnivå totalt. Undersökningen har gjorts på en liten grupp individer på 19 personer och därför är slutsatser svåra att dra. Background: Pregnancy and childbirth involve physical and mental strain. After giving birth, it can be difficult to return to the level of physical activity within a pregnancy. Having fluctuating hormones shows that some women may be more vulnerable to perceived stress and anxiety which can lead to depression. There are no national guidelines for physical activity and exercise postpartum. Only few studies study the relationship between physical activity level and stress in postpartum women. Objective: The aim is to investigate physical activity and perceived stress, as well as the relationship between physical activity and perceived stress in women in Sweden 3 – 6 months after giving vaginal birth. Method: A correlational and descriptive quantitative non-experimental design was used in this cross-sectional study. The selection took place via targeted Swedish Facebook groups and self-assessment questionnaires regarding physical activity level (The National Board of Health and Welfare's indicator questions on physical activity) and perceived stress (The Perceived stress scale-10) were collected on one occasion from 26 women. A total of 19 questionnaires were used in the survey. Results: The study participants estimated their daily exercise to be 225 minutes/week (IQR = 180), their physical training to be 15 minutes/week (IQR = 75), and a total activity level to 300 minutes/week (IQR = 225). The perceived stress level was estimated at 16 (IQR = 10). A weak, non-significant negative correlation existed between total activity minutes and perceived stress (r = -0.25). Conclusion: This study is the only study that studied the relationship between physical activity level and stress in women 3–6 months postpartum. There was no correlation, but the women had a relatively high level of physical activity overall. The study has been done on a small group of individuals of 19 people, which is why conclusions are difficult to draw.

Im Zeitraum von November 2022 - Dezember 2022 wurden insgesamt 135 Frauen zu ihrer erhaltenen Sozialen Unterstützung nach der Erstgeburt befragt. Gleichzeit wurde mittels der „Edinburgh Postnatal Depressions Skala“ die Befindlichkeit der Frauen nach der Geburt erhoben. Trotz erhaltener Sozialen Unterstützung durch die Familie, Freund*innen, Nachbar*innen wie auch den unterschiedlichsten Beratungsangeboten während der Schwangerschaft und nach der Geburt, weist die Mehrheit der Frauen eine „mäßigen“ oder „hohen“ Wahrscheinlichkeit für eine Postpartale Depression nach der Geburt auf. Im Fokus der vorliegenden Arbeit steht die Bedeutung der Sozialen Unterstützung während der Schwangerschaft und nach der Geburt für werdende Mütter. Gleichzeitig wird anhand der Untersuchungsergebnisse der Versuch unternommen, aufzugzeigen, welche Bedeutung die Klinische Soziale Arbeit in dieser Zeit einnehmen kann und wie eine professionelle Begleitung aussehen kann. Between November 2022 and December 2022, a total of 135 women that had given birth for the first time (first time mothers) were interviewed about the Social Support they received. Concurrently, the women’s state of mind was assessed using the “Edinburgh Postnatal Depression Scale”. Concurrently, an assessment was made of the women’s state of mind based on the Edinburgh Postnatal Depression Scale. Despite having received social support from family, friends, neighbors, and various counseling services during pregnancy and after giving birth, the majority of women had a “moderate” or “high” probability of postpartum depression. The focus of this Paper is to illustrate the importance of Social Support during the pregnancy and postnatal period of expectant mothers. Ultimately, the results of the study demonstrate the significance of Clinical Social Work and which types of professional support are relevant during postnatal care. Abweichender Titel laut Übersetzung der Verfasserin/des Verfassers Masterarbeit Wien, FH Campus Wien 2023

Background: Previous studies showed consistent results for associations between circulating concentrations of vitamin D and risk of antenatal, postnatal depression. Methods: Articles published in English before November 2020 were searched in databases as follows: PubMed, EMBASE, Web of Science, Medline, Google Scholar and Cochrane. These articles explored associations between circulating concentrations of vitamin D and risk of antenatal, postnatal depression.The present meta-analysis was conducted using STATA 12.0 software. Odds ratios (ORs) and 95% confidence intervals (CIs) extracted from included studies were computed using a random effects model or a fixed effects model according to heterogeneities between included studies. Q test and I2 were used to explore heterogeneities between included studies. Results: 7 cohort studies (including 1567 depression cases and 5254 controls) and 3 case-control studies (including 995 depression cases and 1265 controls) were included in the present study. The study showed that low circulating levels of 25-hydroxy (OH) vitamin D is significantly associated with a higher risk of antenatal and postnatal depression (OR = 1.02, 95% CI 1.01 to 1.04, I2 = 90.7%, p < 0.001). Conclusion: Our results have shown that the low level of vitamin D may be an adverse factor of antenatal and postnatal depression.

Introduction: Postpartum blues in 20% of cases develops into postnatal depression if it lasts longer than 14 days, so the condition requires attention. To help Slovenian midwives in screening for postpartum blues, we aimed to translate the Kennerly–Garth Blues Questionnaire (BQ). Methods: The blues questionnaire was translated using a double-blind translation method. The Cathedra for Midwifery at the Faculty Health Sciences Ljubljana reviewed the ethics and research design of the study. The online survey was conducted among Slovenian postpartum women who had to be between the 3rd and 15th day postpartum (inclusion criteria). A snowball sampling was used. The online questionnaire was active from January to March 2020. Women voluntarily participated in the survey and were assured of anonymity. Results: A total of 101 women participated in the study. More than half (58%) scored ≥7 points in the questionnaire, which is the cut-off score, indicating postpartum blues. More single women obtained a high score (66.6%) than those who were married (63.6%) or in an extramarital relationship (50.9%). High questionnaire scores were more common among women who had had their second child. Cronbach alpha for the Slovenian version of the Blues questionnaire was 0.995. Conclusions: The survey instrument can be used easily and quickly and is a good way to open discussion with women about emotional and mental health in the postnatal period. The Slovenian version of the Blues questionnaire showed a satisfactory level of internal consistency, but a larger study should be conducted to evaluate the cut-off score and the content validity

Chin Wen Tan,1,2 Hon Sen Tan,1,2 Rehena Sultana,3 Anne Chui,4 Tze-Ern Chua,5,6 Helen Chen,5,6 Ban Leong Sng1,2 1Department of Women’s Anesthesia, KK Women’s and Children’s Hospital, Singapore; 2Anesthesiology and Perioperative Sciences Academic Clinical Program, Duke-NUS Medical School, Singapore; 3Centre for Quantitative Medicine, Duke-NUS Medical School, Singapore; 4Lee Kong Chian School of Medicine, Singapore; 5Department of Psychological Medicine, KK Women’s and Children’s Hospital, Singapore; 6Pediatrics Academic Clinical Program, Duke-NUS Medical School, SingaporeCorrespondence: Ban Leong Sng Tel +65 6394 1081Fax +65 62912661Email sng.ban.leong@singhealth.com.sgPurpose: There is limited knowledge on the relationship between postnatal depression and childbirth pain characteristics associated with childbirth. We investigated whether the characteristics of childbirth pain, as assessed by Short-form-McGill Pain Questionnaire-2 (SF-MPQ-2), were associated with postnatal anxiety and depressive disorders.Patients and Methods: Nulliparous parturients who received labor epidural analgesia (LEA) and delivered in our institution were invited to have a Mini-International Neuropsychiatric Interview (MINI) assessment following their 5– 9 weeks post-delivery follow-up phone survey of a larger study. Parturients’ demographics, pre-delivery questionnaires on pain and psychological vulnerabilities, LEA data, maternal and neonatal outcomes, postnatal follow-up survey on pain and psychological vulnerabilities, pain and breastfeeding were collected accordingly. The primary outcome was the binary variable (yes/no) of the presence of postnatal depression and/or anxiety disorders based on the post-delivery MINI assessment.Results: Among the 107 parturients who participated in the post-delivery MINI assessment, a total of 40 (42.5%) patients were found to have postnatal anxiety and depressive disorders. A greater pre-delivery SF-MPQ-2 neuropathic pain mean subscale score (adjusted odds ratio (OR) 1.32, 95% CI 1.00– 1.73, p=0.0482) and greater post-delivery Edinburgh Postnatal Depression Scale (EPDS) at 5– 9 weeks post-delivery (adjusted OR 1.30, 95% CI 1.13– 1.50, p=0.0002) were independently associated with the presence of postnatal anxiety and/or depressive disorders (receiver operating characteristic (ROC) = 0.7489).Conclusion: Patients with greater pre-delivery neuropathic pain and higher EPDS scores at 5– 9 weeks post-delivery are more likely to have postnatal depression and/or anxiety disorders, suggesting possible associations between pain and psychological vulnerability in the development of postnatal mental disorders.Keywords: neuropathic pain, postnatal depression, anxiety, pain vulnerability

Background: First-time mothers may experience postnatal depression and a lack of social support, affecting their life satisfaction. However, there is a lack of studies investigating the application of guided antenatal education support programs to deal with such issues.Purpose: The study aimed to evaluate the effects of guided antenatal education support programs on postnatal depression, social support, and life satisfaction among first-time mothers.Methods: This quasi-experimental study involved a total of 72 first-time mothers. Convenience sampling was applied for participant selection, and no randomization was used. The participants were equally divided into the intervention group and the control group. A self-administrated questionnaire was used for data collection during the antenatal period (pretest) and six weeks postpartum (posttest). The risk of postnatal depression was assessed using the Edinburgh Postnatal Depression Scale (EPDS). In addition, the Multidimensional Scale of Perceived Social Support (MSPSS) and the Satisfaction with Life Scale (SWLS) were used to assess social support, and life satisfaction, respectively. The intervention group received a guided antenatal education support program, consisting of antenatal education sessions plus an extra 15-minute discussion and a support guidebook. The data were analyzed using a paired t-test and an independent t-test.Results: There was a significant reduction in the risk of postnatal depression score in the intervention group (p

Postnatal depression had a pre-covid estimated prevalence ranging up to 23% in Europe, 33% in Australia, and 64% in America [1] and is detrimental to both mothers and their children; for instance, it inhibits a mother’s ability to care for herself and her infant [2-3], predisposes mothers to future bouts of depression [4], and is associated with deficits in a range of child cognitive, social, and physical developmental outcomes [5-9]. Low social support is key risk factor for developing postnatal depression [10-11]; from an evolutionary perspective this is perhaps unsurprising, as humans evolved as cooperative childrearers [12-13], inherently reliant on social support to raise children. For most of our history mothers have raised their children in social environments where dense support networks [14], of both kin and non-kin [15-17], help with childcare and promote mother-infant wellbeing [18-21]. The importance of wider support remains in high-income settings: public health literature shows that in developed populations social support is important for a range for postnatal health indices [10-11, 22-25], including maternal mental health. The coronavirus pandemic has created a situation in which support from social networks beyond the nuclear family is likely to be even more important to new mothers, as it poses novel risks and stresses for mothers to contend with; whilst at the same time, social distancing measures designed to limit transmission create unprecedented alterations to their access to such support. On the 23rd March 2020, England entered a period of “national lockdown”, when the government imposed social distancing measures requiring that individuals should stay at home unless exercising, shopping for food, or seeking medical attention, as well as closing many businesses and stopping public gatherings of more than two people. These measures remained in full force until June 14th. These social distancing measures likely changed interactions within the social networks of postnatal mothers in two primary ways: firstly, by limiting in-person contact between social connections beyond the household – particularly significantly this widely included contact between women and their own mothers, a key source of postnatal support, as three-generation households containing young children are rare in the UK [26]. Female social networks also often change in the perinatal period, with new supportive connections built with other women at a similar stage of pregnancy or motherhood [27-28]. As antenatal classes and mother-baby groups were either cancelled or moved online during lockdown, potential interactions between new “mummy friends” were likely prevented, curtailing peer support, particularly for women giving birth after lockdown commenced. Low social support, as noted, is known to increase the risk of postnatal depression and social isolation also has strong links with depressive onset more generally [29]; therefore, it is crucial to understand the impact of social distancing measures on maternal mental health and the degree to which remote methods of communication are able to buffer against the detrimental consequences of reduced face-to-face contact. Here we explore how communication with members of a mother’s social network relates to her experience of postnatal depressive symptoms during lockdown in England.

This randomised feasibility study investigates whether using an infant carrier leads to reduction in postnatal depression scores, increased wellbeing scores, and changes in parenting experiences. Maternal attachment style is examined as a potential moderator of this effect. Mothers of infants aged 0-6 weeks will be randomised to receive sling training and free sling hire, either immediately, or after a waitlist period of 12 weeks (control group). This study aims to collect information regarding the feasibility of recruitment and administering the intervention for future Randomised Control Trials.

We will explore postnatal depression (PND) symptom trajectories across the COVID-19 pandemic of participants of an ongoing (four waves so far) longitudinal survey of postnatal mental health in the United Kingdom (UK). Edinburgh Postnatal Depression Scale (EPDS) scores (Cox, Holden, and Sagovsky 1987) were high during England’s first national lockdown (Wave 1), with an average score of 10.4 found among a sample of 162 London-based mothers with young infants, 47.5% and 34.6% meeting the ≥11 and ≥13 cut-offs for PND respectively (Myers and Emmott 2021); here we will report on the characteristics of postnatal depressive symptoms across all four waves of the study so far – Wave 1 (May-June 2020), Wave 2 (July 2020), Wave 3 (October-December 2020), Wave 4 (February 2021).

“It takes a village to raise a child” – yet the COVID-19 pandemic and the social distancing measures implemented in England created a situation in which mothers faced barriers in accessing social support. Lockdowns have been an "extreme" form of social distancing measures implemented by government- but the restrictions around lockdowns have varied over time. How have mothers experienced the different lockdowns, particularly in terms of social support? Our original study collected quantitative social network, support, and wellbeing data from 164 mothers living in London (the original epicentre of COVID-19 in the UK) whose youngest child is aged 6 months or under, via online survey in May-June ’20 and August ‘20. Drawing from this sample, we aim to conduct focus groups to collect in-depth qualitative data on maternal experience through the lockdowns. The project is being funded by a UCL Strategic Initiatives Seed-funding Small Grant and The British Academy Special Research Awards – COVID-19 scheme (Ref: COV19\200776).

This is a scoping review aiming to map out current quantitative literature examining the impact of skin-to-skin, or close body, contact between mothers and infants, upon maternal psychological outcomes (mental health/wellbeing/confidence/parenting behaviours).

The social distancing measures enacted in response to the COVID-19 pandemic have both restricted social network access and changed household dynamics, altering the informal support systems of new mothers and elevating postnatal depressive symptoms, potentially influencing mother-to-infant bonding. During the first UK lockdown, we found postnatal mothers experienced both positive and negative impacts on bonding (Myers and Emmott In Press). Some felt it increased “quality time” spent with the baby, leading to perceived better bonding; this was often accompanied by high partner involvement. Others experienced a “constant mothering” burden and resentment towards their children. Here we explore the characteristics of mother-to-infant bonding and maternal confidence in bonding during the pandemic in late 2020 and whether mother-to-infant bonding was predicted by partner support.

“It takes a village to raise a child” – yet mothers in the West now frequently live without the village. Women commonly reside far from extended family and transitioning to motherhood is often socially disruptive. These social changes can have long-term bio-psychological consequences for mothers and children. Public health literature shows that social support is imperative for maternal mental-health and secure mother-infant relationships. However, a biological anthropological perspective highlights how current public health solutions are too narrow, being predicated on nuclear family norms along with medicalisation of maternal support – leaving the wider informal network of potential supporters ‘untapped’. The COVID-19 pandemic creates a situation in which practical, informational, and emotional support are all likely to be more important to new mothers, but it will also be having unprecedented effects on their access to such support. As we currently do not know how long the pandemic will last, it is crucial that public health officials know what forms of social support are most beneficial for protecting emotional wellbeing at this time, so as to best support mothers going forward in this and future crisis situations. A pilot study collected quantitative social network, support, and wellbeing data from 164 mothers living in London, the epicentre of COVID-19 in the UK, whose youngest child is aged 6 months or under, via online survey in May-June ’20 and August ‘20. During November-December ’20 we will be collecting UK-wide data from 1000 mothers and then following their progress over the following year with three further surveys. We will also collect qualitative data from a smaller sub-sample of mothers (n=20), selected to maximise diversity, during four focus groups held via online video conferencing. The project is being funded by a UCL Strategic Initiatives Seed-funding Small Grant and The British Academy Special Research Awards – COVID-19 scheme (Ref: COV19\200776).

ObjectiveTo assess the association between trajectories of comorbid anxiety and depressive (CAD) symptoms assessed in each pregnancy trimester and physiological birth.DesignLarge longitudinal prospective cohort study with recruitment between January 2013 and September 2014.SettingPrimary care, in the Netherlands.PopulationDutch-speaking pregnant women with gestational age at birth ≥37 weeks, and without multiple pregnancy, severe psychiatric disorder or chronic disease history.MethodsPregnancy-specific anxiety and depressive symptoms were measured prospectively in each trimester of pregnancy using the negative affect subscale of the Tilburg Pregnancy Distress Scale and Edinburgh (Postnatal) Depression Scale. Data on physiological birth were obtained from obstetric records. Multivariate growth mixture modelling was performed in MPLUS to determine longitudinal trajectories of CAD symptoms. Multiple logistic regression analysis was used to examine the association between trajectories and physiological birth.Main outcome measuresTrajectories of CAD symptoms and physiological birth.ResultsSeven trajectories (classes) of CAD symptoms were identified in 1682 women and subsequently merged into three groups: group 1—persistently low levels of symptoms (reference class 1; 79.0%), group 2—intermittently high levels of symptoms (classes 3, 6 and 7; 11.2%), and group 3—persistently high levels of symptoms (classes 2, 4 and 5; 9.8%). Persistently high levels of CAD symptoms (group 3) were associated with a lower likelihood of physiological birth (odds ratio 0.67, 95% confidence interval 0.47–0.95, P = 0.027) compared with the reference group (persistently low levels of symptoms), after adjusting for confounders.ConclusionsThis study is the first showing evidence that persistently high CAD levels, assessed in each pregnancy trimester, are associated with a lower likelihood of physiological birth.

Background: Post-Natal Depression (PND) is a mood disorder that affects both the health of mother as the development of her son and has a social-family negative impact. The clinical manifestations of this condition usually appears four weeks after birth, reaching higher values in the first six months, [for full text, please go to the a.m. URL]

BackgroundPostnatal depression (PND) affects 13% of new mothers, with numbers rising during the COVID-19 pandemic. Despite this prevalence, many women have difficulty with or hesitancy towards accessing pharmacological and/or psychological interventions. Group-based mother-baby activities, however, have a good uptake, with singing improving maternal mental health and the mother-infant relationship. The recent lockdowns highlight the importance of adapting activities to an online platform that is wide-reaching and accessible.AimsThe SHAPER-PNDO study will primarily analyse the feasibility of a 6-week online singing intervention, Melodies for Mums (M4M), for mothers with PND who are experiencing barriers to treatment. The secondary aim of the SHAPER-PNDO study will be to analyse the clinical efficacy of the 6-week M4M intervention for symptoms of postnatal depression.MethodsA total of 120 mothers and their babies will be recruited for this single-arm study. All dyads will attend 6 weekly online singing sessions, facilitated by Breathe Arts Health Research. Assessments will be conducted on Zoom at baseline and week 6, with follow-ups at weeks 16 and 32, and will contain interviews for demographics, mental health, and social circumstances, and biological samples will be taken for stress markers. Qualitative interviews will be undertaken to understand the experiences of women attending the sessions and the facilitators delivering them. Finally, data will be collected on recruitment, study uptake and attendance of the programme, participant retention, and acceptability of the intervention.DiscussionThe SHAPER-PNDO study will focus on the feasibility, alongside the clinical efficacy, of an online delivery of M4M, available to all mothers with PND. We hope to provide a more accessible, effective treatment option for mothers with PND that can be available both during and outside of the pandemic for mothers who would otherwise struggle to attend in-person sessions, as well as to prepare for a subsequent hybrid RCT.Trial registrationClinicalTrials.gov Identifier:NCT04857593. Registered retrospectively on 22 April 2021. The first participants were recruited on 27 January 2021, and the trial is ongoing.

Maternal depression symptoms are common in pregnant women and can have negative effects on offspring’s emotional development. This study investigated the association between prenatal maternal depression symptoms (assessed with the Edinburgh Postnatal Depression Scale at 24 weeks of gestation) and auditory perception of emotional stimuli in 3-year-olds (n = 58) from the FinnBrain Birth Cohort Study. Using electroencephalography (EEG), we examined mismatch responses for happy, sad, and angry sounds presented among neutral stimuli. A positive association between maternal depression symptoms and the emotional mismatch responses in an early time window (80–120 ms) was found, indicating that brain responses of children of mothers with depressive symptoms were weaker to happy sounds, though the results did not survive Bonferroni correction. There were no clear associations in the sad and angry emotional categories. Our results tentatively support that the 3-year-old children of mothers with depression symptoms may be less sensitive to automatically detect happy sounds compared to children whose mothers do not display symptoms of depression.

Aims: This systematic review aimed to evaluate randomized controlled trials (RCTs) to examine the effect of maternal and infant sleep intervention during women's pregnancy for the purpose of preventing perinatal depression. Method: A systematic search (from inception to January 28, 2019) for RCTs using five electronic databases—the Cochrane Controlled Register of Trials (CENTRAL), Embase, PubMed, PsycINFO, and Ichushi Web (Japan Medical Abstracts Society)—was conducted. Twelve investigators independently conducted initial screenings based on title and abstract, and then, two researchers performed full-text reviews one by one. A meta-analysis would be conducted if at least three studies were found. However, only two articles that met inclusion criteria, and narrative data synthesis was conducted for these two articles. The study protocol has been registered at PROSPERO (CRD42019119999). Result: A total of 13 654 studies were initially searched. After removing duplicates, 10 547 studies were screened, and finally, two studies met the inclusion criteria. In both studies, the intervention was a one-time face-to-face session during pregnancy to deliver the behavioral knowledge and skills for optimizing sleep hygiene for both infant and mother. Effectiveness of the intervention in improving maternal mood was not significant in one study. In the other, there was a significant difference in maternal mood between the intervention and control group. No mood comparison was made between baseline and postintervention. Conclusion: This study found limited evidence to support the effectiveness of sleep intervention for all pregnant women, which means “universal intervention,” to protect maternal mental health. Further well-designed RCTs are needed to confirm these findings.

Background. In European countries, postpartum depression (PPD) occurs in 13–19% of women. The statistics indicate that postpartum depressive disorders affect up to 300,000 women in Russia annually. There is still an extremely acute lack of psychological comfort provided to women during labor in Russia. Objective. To our knowledge, ours is the first study that examines the association between childbirth experience and the risk of PPD in Russia. Design. We collected data from 190 Russian-speaking mothers, ages 19 to 46, (M = 32 +4.3) two months after their delivery. Results. Birth satisfaction and physical well-being two months after delivery were significantly inversely associated with PPD. Birth satisfaction negatively correlated with the perceived severity and unpredictability of labor, and positively correlated with physical well-being two months after delivery. The presence of a partner and a personal midwife or doula at birth was associated with higher birth satisfaction. Conclusion. Our results emphasize the significance of childbirth satisfaction in the context of PPD and suggest the importance of individual professional support during labor.

Background Physical activity (PA) is a modifiable risk factor for postnatal depression (PND) and programs are needed to enhance PA amongst women at risk of PND. Key stakeholder involvement in informing development and implementation of such programs is vital. However, little research demonstrates key stakeholder insights to inform the design and delivery of PA programs for improving PND. The aim of this study was to explore key stakeholder perspectives on the design and delivery of a home-based PA program for mothers with PND symptoms to inform future real-world implementation and scale-up. Methods A descriptive qualitative study was undertaken whereby semi-structured interviews were conducted with representatives from various key stakeholder organisations involved in postnatal PA and/or mental health, public health and policy in Australia (n = 11). Interviews were conducted between September to November 2019 and explored stakeholder perceptions on the design and delivery of a home-based PA program for mothers with PND symptoms. The interview schedule was informed by both the Consolidated Framework for Implementation Research (CFIR) and the PRACTical planning for Implementation and Scale-up (PRACTIS) guide. Data were analysed thematically using both deductive and inductive coding. Results The relative priority of PND and PA was high for most organisations involved, although none implemented PA programs supporting women at risk of PND. Most stakeholders perceived the program as appealing due to addressing barriers to postnatal PA, although identified some feasibility issues regarding funding and delivery mechanisms. Suggestions for program adaptations included an equity focus (e.g. providing socioeconomically disadvantaged women with a greater program dose; translating web-app based content into various languages). Planned components of the program were suggested to align (i.e. relative advantage) with existing initiatives (e.g. equipment hire for nurseries scheme) and screening systems for PND (timing of referral). Perceived barriers to scale-up included logistics/cost of equipment, organisational capacity demands and safety risks/liability. Perceived enablers to scale-up included linking the program with ‘adjunct’ programs and services. Conclusions While the program was appealing and most organisations could see a role in endorsing and/or referring to the program, funding and delivery mechanisms still need to be identified.

Background Studies have shown that breastfeeding self-efficacy constitutes a determinant used to forecast breastfeeding behaviours. Objective The aim of this study was to examine the factors associated to breastfeeding self-efficacy and identify its predictors among Greek women in their immediate postpartum period. Methods A cross-sectional study was conducted at the General Hospital of Volos, Greece. A convenience sample of 120 postpartum women who gave birth at the hospital and met all the inclusion criteria were invited to participate; 100 responded. Questionnaires on socio-demographic, perinatal and breastfeeding-related characteristics, the Edinburgh Postnatal Depression Scale, and the Breastfeeding Self-Efficiency Scale were completed. Univariate and multivariate analyses were performed with the use of the linear regression model. Results Women reported a rather good level of breastfeeding self-efficacy (mean = 3.65; SD = 0.85) in the early postpartum period. 52% of women carried out exclusive breastfeeding in the hospital. The prevalence of postnatal depression was 25%. The best-fit regression analysis revealed four predictors (timing of the mother's decision to breastfeed, infant's feeding pattern, previous breastfeeding experience, levels of postnatal depression) explaining 44.7% of the variance in breastfeeding self-efficacy. Conclusion Acknowledging the determinants which affect breastfeeding self-efficacy of women in the immediate postpartum period is a necessary condition in designing targeted intervention services.

Introduction Screening for developmental delays during critical periods of infant development is essential for early detection and intervention. Among high-risk infants in resource-limited settings, including those who are HIV exposed, there is a greater need for screening. This study expanded on previous analyses of the Bayley Infant Neurodevelopmental Screener (BINS) by providing psychometric properties to evaluate the appropriateness of using the BINS in a sample of HIV-exposed infants in rural South Africa. Method A total of 160 mothers with HIV, their infants, and their male partners were recruited. The BINS was administered to the infants, and their weights were recorded. Mothers completed measures of depression, intimate partner violence, male involvement, and adherence. Male partners reported their own involvement in perinatal care. Results Results demonstrated support for a 5-factor structure consistent with previous transcultural adaptations of the BINS, demonstrating construct validity, and adequate reliability. Convergent validity was partially supported, as shown by associations with intimate partner violence and male involvement as reported by men and women and maternal adherence, although not with birth weight or maternal depression. The BINS showed adequate discriminating power, with only a few low-performing items. Conclusion In rural South Africa, a resource-limited setting, the BINS seems to be an adequate screening tool for developmental delays in children that may be used to identify those in need of intervention. Considering the high prevalence of delays identified in this study, antiretroviral therapy-exposed and HIV-exposed infants may benefit from further assessment to determine a need for intervention in community-based clinics.

This study aimed to record the experiences of childbirth and postpartum care of postpartum women and gain an in-depth understanding of their experiences of Korean medicine-based postpartum healthcare. The investigator conducted a 60–90-min interview with the 8 participants (mean age 34 years), and the comments were analyzed using the thematic analysis method. The two major themes emerging from the participants’ comments were: “experience and awareness of childbirth and postpartum care” and “experiences of the Korean medicine-based postpartum program”. The first theme was analyzed in four primary categories: (1) experiences of breakdown of the body and mind; (2) impossibility of postpartum care without help; (3) experiences of relentless effort for recovery; and (4) experiences of body and mind recovery. The second theme was analyzed in four primary categories: (1) participation with vague expectations; (2) experiences of the effects of managing postpartum symptoms; (3) the need for a comprehensive Korean medicine management for postpartum women; and (4) suggested improvements for the Korean medicine-based postpartum program. Mothers recognized the importance of Korean medicine treatment during the postpartum period for the management of Sanhupung symptoms and postpartum care and reported the benefits of body warming, Sanhupung prevention, pain reduction, and sense of psychological stability.

Background Postpartum depression (PPD) is the most common postpartum psychiatric disorder, affecting 11–15% of new mothers, and initiatives towards early identification and treatment are essential due to detrimental consequences. Family history of psychiatric disorders is a risk factor for developing psychiatric episodes outside the postpartum period, but evidence of the association between familial risk and PPD is not clear. Hence, the objective of this systematic review is to summarize the current literature on the association between family history of psychiatric disorders and PPD. Methods This protocol has been developed and reported according to the PRISMA-P guidelines for systematic reviews. A comprehensive literature search will be conducted in PubMed, Embase, and PsycINFO from inception of the databases, supplemented with citation tracking and reference screening of the included studies. Two independent authors will examine all retrieved articles for inclusion in two steps: title/abstract screening and full-text screening. Eligible studies are case-control and cohort studies reporting a risk estimate for the association between family history of psychiatric disorders and PPD. Studies will be assessed for risk of bias using the Newcastle-Ottawa Scale. The association between family psychiatry and PPD will be combined in a meta-analysis using a restricted maximum likelihood method (REML). Heterogeneity will be quantified using I2 and investigated through meta-regression, subgroup and sensitivity analyses, and publication bias will be evaluated via visual inspection of a funnel plot. The overall strength and quality of the findings will be evaluated using the GRADE (Grading of Recommendations Assessment, Development, and Evaluation) approach. If meta-analysis is not possible, data will be synthesized narratively in text and tables. Discussion This systematic review will be the first to summarize current knowledge and present an overall estimate for the association between family history of psychiatric disorders and PPD. Evaluation of psychiatric family history as a PPD risk factor is essential to assist early identification of women at high risk of PPD in routine perinatal care. Systematic review registration PROSPERO ID: 277998 (registered 10th of September 2021).

Objectives Parental stress has been associated with adverse child outcomes and maternal functioning. Yet, maternal factors during pregnancy that can potentially protect against later parental stress, such as mindfulness, have not been studied. Therefore, we aimed to address the possible associations between prenatal mindfulness and levels of parental stress in mothers raising toddlers. Methods Women in the current study (n = 165) were prospectively followed from pregnancy until 3 years after childbirth, as part of a longitudinal population based cohort (HAPPY study). At 22 weeks of pregnancy, women completed the Three Facet Mindfulness Questionnaire–Short Form (TFMQ-SF) to assess facets of mindfulness (acting with awareness, non-judging, and non-reacting). Women completed the Parenting Stress Questionnaire (PSQ) 3 years after childbirth, reporting on three components of parental stress: (1) parent-child relationship problems, (2) parenting problems, and (3) role restriction. Results Results of multiple linear regression analyses showed that the acting with awareness facet of mindfulness during pregnancy was a significant predictor of fewer parent-child relationship problems and parenting problems, even when adjusted for prenatal and maternal distress and child behavior problems. Higher levels of non-reacting during pregnancy were also significantly associated with fewer parenting problems in mothers raising toddlers. Conclusions The current study emphasizes that mindfulness during pregnancy may be a protective factor for later parental stress. More research is needed to confirm these findings and to evaluate the possible benefit of a mindfulness intervention training during pregnancy on parenting and child outcomes.

Background and Purpose: Postnatal depression （PND） is prevalent in the generalpopulation in Japan. However, there are no data on the actual condition and relatedfactors for PND in Chinese women in Japan, which is the largest group of foreign womenliving in Japan. This study was performed to clarify the tendency of PND and its relatedfactors in Chinese mothers living in Japan. Methods: We carried out a mailed selfadministeredquestionnaire survey among Chinese mothers living in Japan who had givenbirth to a baby in the previous 3-4 months. Survey items included the status of mothersand children, family support, and the Edinburgh Postpartum Depression Scale （EPDS）.Logistic regression analysis was utilized for statistical analysis. Results: The proportion ofhigh-PND-risk respondents among the 80 participants was 36.3%. The results indicatedthat the factors affecting PND risk are parenting loneliness （Odds ratio: 7.416, p=0.003）and support from the husband（ Odds ratio: 0.357, p=0.047）. Conclusion: The loneliness ofchild-rearing and the support status of the husband in the 3rd-4th month after childbirthare DNP risk factors for Chinese mothers in Japan. The presence of support from thehusband will not only be helpful in housework and childcare, but will also support themother’s spirit and alleviate the loneliness of child-rearing. In addition, as the PND riskof Chinese mothers is high in the 3rd- 4th month after childbirth, it is necessary tostrengthen mental support during this period.

Context: Studies have shown nutrition to play a role in etiology of postnatal depression, but few risk markers have been developed for the same. Anthropometric determinants have not been sufficiently researched in relation to suicidality and severity of illness in women with postnatal depression. Aim: The present study assesses the efficacy of anthropometric determinants as risk markers of severity of illness and suicidal ideations in postnatal depression. Methods and Materials: 100 women were screened at 6 weeks postnatal for the presence of postnatal depression and suicidal ideation using the Edinburgh Postnatal Depression Scale. Anthropometric determinants assessed were height, weight, weight gain in pregnancy, weight at first antenatal visit, body mass index and waist-to-hip ratio. Univariate and multivariate analysis were done for risk estimation using Spearman's rank correlation and multiple regression analysis, respectively. Results: In total, 39% of the women showed the presence of postnatal depression. Out of these 39 women, 31% had suicidal ideations. The waist-to-hip ratio was the most significant factor in all the models, having a negative correlation with suicidality and severity of depression (P < 0.05). The multiple regression model using anthropometric determinants could significantly assess risk of both suicidality (P = 0.03, adjusted R2 = 0.08) and postnatal depression (P = 0.04, adjusted R2 = 0.07). Conclusions: The study concludes that anthropometric determinants can be used effectively as risk markers for suicidality and severity of illness in women with postnatal depression. The most significant risk factor was found to be waist-to-hip ratio in both the models.

Background: Finding modifiable predictors of paternal depression symptoms is helpful for developing interventions. The aim is to assess the unidirectional and/or bidirectional associations between paternal postpartum depression symptoms and coparenting among fathers of infants and toddlers. Methods: Longitudinal data were collected prospectively from 429 fathers of infants aged 0–24 months (median = 8 months) in Sweden, with 6- and 18-month follow-ups. All fathers participated in at least two of three waves of data collection, and multiple imputation was used for missing values. The Edinburgh Postnatal Depression Scale was used to detect depression symptoms (≥10 points), while the Brief Coparenting Relationship Scale measured the coparenting relationship. A cross-lagged panel model was used to estimate the associations between paternal depression symptoms and coparenting relationship quality over time, controlling for several known covariates and COVID-19 exposure. Results: Fathers with higher coparenting scores at Time 1 and 2 had less depression symptoms at Time 3, and fathers with more depression symptoms at Time 2 had lower coparenting scores at Time 3. Plotted probabilities of having at least mild depression symptoms revealed a multifold increase in the probability of depression symptoms at Time 3 for fathers with minimal coparenting scores at Times 1 and 2, respectively, compared to fathers with mean coparenting scores at Times 1 and 2, respectively. Limitations: Causal links cannot be determined using the current non-experimental study design. Using the EPDS alone may have missed some fathers with depression symptoms. Conclusions: Clinicians seeking to reduce paternal depression symptoms should help strengthen the coparenting relationship.

(1) Background: the prevalence of postnatal depression (PND) reaches up to 20%. PND could be based on the interaction between a psychological vulnerability and chronic stress that pregnancy would activate. Vulnerability factors reflect a psychological profile mirroring mindfulness-trait (MT). A high level of MT is associated with an efficient regulation of both physiological and psychological stress, especially negative moods. Interestingly, mindfulness level can be improved by program based on mindfulness meditation. We hypothesize that MT is a protective factor for PND. We also postulate that negative moods increase during the pregnancy for women who develop a PND after delivery (2) Methods: we conducted a multicentric prospective longitudinal study including 85 women during their first trimester of their pregnancy and 72 from the childbirth to the baby’s first birthday”. At the inclusion, presence and acceptance of MT and various variables of personality and of psychological functioning were assessed. Mood evolution was monitored each month during the pregnancy and a delivery trauma risk was evaluated after delivery. PND detection was carried out at 48 h, 2, 6 and 12 months after the delivery with the Edinburgh Postnatal Depression Scale with a screening cut-off >11. (3) Results: high-acceptance MT is a protective factor for PND (OR: 0.79). Women without PND displayed less negative mood during pregnancy (p < 0.05 for Anxiety, Confusion and Anger). (4) Conclusions: these results suggest the value of deploying programs to enhance the level of mindfulness, especially in its acceptance dimension, before, during and after pregnancy, to reduce the risk of PND.

Background: There is a lack of information on how maternal stress coping styles during admission of the newborn to the neonatal intensive care unit (NICU) influences the onset of the postpartum depression (PPD). We examined potential risk factors for the emergence of the PPD in mothers whose infants were admitted to the NICU. Methods: A cross-sectional study was conducted on 401 mothers, 125 were mothers whose infants were admitted to the NICU and 276 mothers without NICU care. Newborn illness severity information score was taken throughout NICU admission via the Clinical Risk Index for Babies (CRIB). Six weeks after giving birth, participants from both groups individually completed the Edinburg Postnatal Depression Scale (EPDS), the Postpartum Bonding Questionnaire (PBQ) and the Coping Strategies Inventory (CSI) using an online platform. Results: No differences were found regarding PPD and bonding in either groups. Multivariate analysis provided a final model in which cognitive restructuring, problem avoidance, severity of neonatal health problems during the first 12 hours of life, and problem solving were the best predictors of postpartum depression explaining, 43.7% of the variance in the NICU group. Conclusion: It is necessary to obtain early detailed information on coping styles in the NICU environment to prevent the possible onset of PPD. © 2020 Society for Reproductive and Infant Psychology.

Einleitung: Bis zu 15 % der Wöchnerinnen leiden an einer postpartalen Depression (Riecher-Rössler, 2012). Aufgrund der negativen Folgen für Eltern und Kind ist die Früherkennung wichtig. Der Edinburgh Postnatal Depression Scale (EPDS) gilt als Goldstandard für das Screening. In der Schweiz sind jedoch keine Leitlinien zum Screening auf PPD vorhanden. Ziel: Das Ziel der Arbeit besteht darin, Einflussfaktoren auf das Screening mittels EPDS aus Sicht der Fachpersonen der Wochenbettpflege und Mütter aufzudecken. Methode: Diese Bachelorarbeit ist ein Literaturreview. Anhand von Keywords wurde in verschiedenen Datenbanken eine systematische Literaturrecherche durchgeführt. Es wurden fünf Studien zu Erfahrungen mit dem Screening auf PPD verwendet. Die Ergebnisse wurden mittels der thematischen Analyse nach Braun und Clarke (2006) untersucht. Ergebnisse: Die ermittelten Einflussfaktoren auf die Handhabbarkeit des Screenings mittels EPDS sind Beziehungsaufbau und Vertrauen, Zeitmangel, Arbeitsaufwand und Betreuungskontinuität, Dienste und Versorgungspfade, einheitliche Vorgehensweise, Kenntnisse und Fähigkeiten der Fachpersonen, Schulung der Fachpersonen und verschiedene maternale Faktoren. Schlussfolgerungen: Ein Routinescreening mit dem EPDS durch Fachpersonen des Wochenbettes ist zu empfehlen. Um dieses zu implementieren, müssen in der Schweiz Leitlinien erstellt und etabliert werden. Das Fachwissen muss durch Schulungen gefördert und damit das Kompetenzgefühl der Fachpersonen im Screeningprozess gestärkt werden.

There is little data on the burden of perinatal depression in Pakistan. This research aimed to provide estimates of the prevalence of perinatal depression, identify the risk factors, and understand the experiences and perceptions of perinatal depression in the Pakistani population. A systematic review and meta-analysis, two cross-sectional studies, and a qualitative study were conducted. A systematic review methodology was used to calculate estimates of the prevalence of perinatal depression in Pakistan. For the cross-sectional studies, recent parents completed a questionnaire, including the Edinburgh Postnatal Depression Scale and the Pittsburgh Sleep Quality Index. Qualitative interviews were conducted with recent parents about their experiences of perinatal depression. The meta-analysis estimated a pooled prevalence of maternal depression (30.0%-37.0%). Intimate partner violence, unintended pregnancy, poor relationship with spouse, and low-income were risk factors for perinatal depression. The maternal cross-sectional study reported that 35.2% and 34.3% of participants scored more than 12 on the EPDS during the antenatal and postnatal periods respectively. Intimate partner violence, sleep disturbance, adverse life events, and unplanned pregnancy were predictors of antenatal depression. Antenatal depression, financial hardship, and a lack of support were predictors of postnatal depression. The paternal cross-sectional study found that 23.5% of participants scored more than 10 on the EPDS during the postnatal period. A depressed spouse and own sleep disturbance were predictors of paternal depression. The qualitative study reported that a lack of understanding of perinatal mental health issues, disturbed sleep, emotional stressors, and financial burdens were stressors during the perinatal period. This research concludes that perinatal depression is prevalent in the Pakistani population and there is a need to raise awareness about perinatal depression in Pakistan

Introduction. The study of the quality of life of the population adjusted for health is one of the priority areas of public health for research. The research results make it possible to identify vulnerabilities and make decisions to strengthen them. Health-adjusted quality of life has two components for research: physical and mental health. The study on global AGEing and adult health (SAGE) male older adults reported a better quality of life than female older adults across all of the countries in low- and middle-income countries. Purpose of the work: to assess health-related quality of life and related factors among women in the postpartum period. Search strategy: Two validated questionnaires were used for collection in five primary health care centers located in Semey city: the Edinburgh Postpartum Depression Scale (EPDS) and the short version of SF-36 (SF-12). The sample for the study consisted of 251 women within a year after giving birth. All analyzes were performed using IBM SPSS Statistics 25 and PRO CoRE software. The social-demographic characteristics and obstetric factors of women were assessed by using parametric methods between women with and without postpartum depression. Correlation between EPDS score and scores of QoL dimensions (PHRQoL, MHRQoL) were evaluated by Pearson and Spearman Correlation Coefficient. A p-value less than 0.05 were considered significant. Results: The quality of life assessment using SF-12 ranged from 17 to 47 points (/33.1 ± 0.3 / point). The average level of quality of life was mainly observed - in 57% of cases. According to basic characteristics to health related quality of life, age of mothers (t = –2.97, df = 249, р = 0.003) and satisfaction with living conditions (t = –5.77, df = 249, р = 0.001) showed a significant difference. Conclusions: The results of our study confirmed the existence of a relationship between the quality of life of socio-demographic and obstetric factors. It indicates the need for an integrated approach to providing medical services and individual professional support to women in the postpartum period., Введение.Изучение качества жизни населения с поправкой на здоровье является одним из приоритетных направлений научных исследований общественного здравоохранения. Результаты исследований позволяют выявлять уязвимые места и принимать решения по их усилению. Качество жизни с поправкой на здоровье имеет два компонента для исследования: физическое и психическое здоровье. Исследование глобального старения и здоровья взрослых (SAGE) показало, что мужчины имеют лучшее качество жизни, чем женщины, во всех странах с низким и средним уровнем дохода. Цель работы:оценить качество жизни женщин в послеродовом периоде, связанное со здоровьем и с сопутствующими факторами. Стратегия поиска: Для сбора данных в пяти центрах первичной медико-санитарной помощи, расположенных в городе Семей, были использованы два валидированных вопросника: Эдинбургская шкала послеродовой депрессии (EPDS) и краткая версия опросника SF-36 (SF-12). Выборка для исследования состояла из 251 женщины в течение года после родов. Все анализы проводились с использованием программного обеспечения IBM SPSS Statistics 25 и PRO Core. Социально-демографические характеристики и акушерские факторы оценивались с использованием параметрических методов у женщин с симптомами послеродовой депрессии и без. Корреляция между показателями EPDS и показателями качества жизни (PHRQoL, MHRQoL) оценивалась с помощью коэффициента корреляции Пирсона и Спирмена. Значение p менее 0,05 считалось значимым. Результаты:Оценка качества жизни с использованием SF-12 варьировалась от 17 до 47 баллов (/33,1 ± 0,3/балла). В основном наблюдался средний уровень качества жизни - в 57% случаев. По основным характеристикам качества жизни, связанным со здоровьем, возраст матерей (t = -2,97, df = 249, р = 0,003) и удовлетворенность условиями жизни (t = -5,77, df = 249, р = 0,001) показали статистическую значимость. Выводы:Результаты нашего исследования подтвердили наличие взаимосвязи между качеством жизни социально-демографическими и акушерскими факторами. Это указывает на необходимость комплексного подхода к предоставлению медицинских услуг и индивидуальной профессиональной поддержки женщин в послеродовом периоде., Кіріспе. Денсаулыққа бейімделген халықтың өмір сүру сапасын зерттеу қоғамдық денсаулықты зерттеудің басым бағыттарының бірі болып табылады. Зерттеу нәтижелері осалдықтарды анықтауға және оларды күшейту бойынша шешімдер қабылдауға мүмкіндік береді. Денсаулыққа бейімделген өмір сапасының екі компоненті бар: физикалық және психикалық денсаулық. Ғаламдық қартаю және ересектер денсаулығы зерттеуі (SAGE) барлық төмен және орташа табысы бар елдерде ерлердің әйелдерге қарағанда өмір сүру сапасы жақсырақ екенін көрсетті. Жұмыстың мақсаты: босанғаннан кейінгі кезеңдегі әйелдердің денсаулығына және оған байланысты факторларға байланысты өмір сүру сапасын бағалау. Іздеу стратегиясы: Екі расталған сауалнама, Эдинбург босанғаннан кейінгі депрессия шкаласы (EPDS) және SF-36 (SF-12) сауалнамасының қысқа нұсқасы Семей қаласында орналасқан бес алғашқы медициналық-санитарлық көмек орталығынан деректерді жинау үшін пайдаланылды. Зерттеу үлгісі бір жыл ішінде босанғаннан 251 әйелден тұрды. Барлық талдаулар IBM SPSS Statistics 25 және PRO Core бағдарламалық құралы арқылы орындалды. Босанғаннан кейінгі депрессия симптомдары бар және жоқ әйелдерде параметрлік әдістерді қолдану арқылы әлеуметтік-демографиялық мен акушерлік факторлары бағаланды. EPDS ұпайлары мен өмір сапасы ұпайлары (PHRQoL, MHRQoL) арасындағы корреляция Пирсон және Спирман корреляция коэффициенті арқылы бағаланды. p шамасы 0,05-тен төмен мәні маңызды деп саналды. Нәтижелер: SF-12 сауалнамасы негізінде өмір сапасы 17-ден 47 баллға дейінгі ауытқуын көрсетті (/33,1 ± 0,3/ ұпай). Өмір сапасының орташа деңгейі байқалды – 57% жағдайда. Денсаулыққа байланысты өмір сапасының негізгі сипаттамалары бойынша аналардың жасы (t = -2,97, df = 249, p = 0,003) және өмір сүру жағдайына қанағаттанушылық (t = -5,77, df = 249, p = 0,001) статистикалық маңыздылығын көрсетті. Қорытынды: Біздің зерттеуіміздің нәтижелері әлеуметтік-демографиялық және акушерлік факторлардың өмір сапасы арасындағы байланысты растады. Бұл босанғаннан кейінгі кезеңде әйелдерге медициналық қызмет көрсетуге және жеке кәсіби қолдау көрсетуге кешенді көзқарастың қажеттілігін көрсетеді., Наука и здравоохранение, Выпуск 3 (24) 2022, Pages 48-54

Ongoing disturbances in parental psychological functioning are proposed as one of the mechanisms linking maternal PPD and adverse child development. We examined the effect of maternal PPD on mothers’ and fathers’ parenting stress and depressive symptoms at child age five. Depressive symptoms and parenting stress were assessed using self-report questionnaires at child age five in a sample of nonclinical mothers (n = 31) and mothers previously diagnosed with PPD (n = 12) and their partners. Maternal PPD diagnosis was associated with mothers’ but not fathers’ depressive symptoms at child age five. Maternal PPD diagnosis was associated with more parental distress in mothers and fathers, although, for mothers, this relationship was better explained by own concurrent depressive symptoms. Finally, maternal PPD diagnosis was associated with mothers reporting more difficult parent–child interactions. Overall, the study shows that maternal PPD diagnosis has long-term negative effects on both mothers’ and fathers’ parenting resources.

Objective: The first months after birth is a very difficult period for mothers who are trying to get used to their baby. In particular, it can be even more difficult for mothers with frequent crying babies. The aim of this study is to determine the factors that may cause shaking and shaking of babies aged 1-4 months by their mothers. Material and Methods: A total of 180 mothers were included in our descriptive and cross-sectional study. Research data were compiled using the Edinburgh Postpartum Depression Scale, the Fragile Infant Scale, and the mother and infant descriptive characteristics form. Results: When the variables of mothers and babies and the state of being shaken by their mothers were examined, it was seen that none of the variables were effective. In addition, the frequency of swinging during the day was 5.3±3.2, the frequency of rocking to sleep was 5.7±3.8, the frequency of swinging in the car was 2.9±2.8, and the frequency of playing the game of being thrown into the air was 3.4±3.3. Babies with a high frequency of crying shake about 1.5 times more than babies who do not cry. The mothers' mean depression scores were found to be 12.1±7, and the fragile infant perception mean score was 31.9±5.3. In the correlation analysis, no statistically significant relationship was found between mothers' depression scale score and fragile baby perception scale score and shaking their babies. The first three practices preferred by the mothers when their babies started to cry were shaking (66.6%), breastfeeding/feeding (63.8%) and pacifier (23.3%), respectively. It was determined that the first three practices preferred by the mothers when the babies continued to cry were shaking (61.1%), breastfeeding/ feeding (58.3%), and playing the throwing game (53.8%), respectively. Conclusion: The results of our study showed that the babies of the mothers included in the study had a low risk for shaken baby syndrome, especially in this period when abuse against children increased with the restrictions that came to the fore in the coronavirus disease-2019 epidemic. Copyright © 2022 by Türkiye Klinikleri.

Einleitung: Nach der Entbindung sind Mütter anfälliger auf psychische Erkrankungen. Eines dieser Erkrankungen ist die postpartale Depression, die typischerweise bis zu 4 Wochen nach der Geburt des Kindes auftritt und bis zu 1 Jahr andauern kann. Eine postpartale Depression der Mutter kann viele negative Folgen für die Mutter selbst und auch ihr Umfeld, besonders ihr Säugling und Partner haben. Aus diesem Grund ist die Anwendung einer hilfreichen und evidenzbasierten Intervention notwendig, um diesen Konsequenzen entgegenwirken zu können. Diese Arbeit beschäftigt sich mit den Auswirkungen der Kangaroo Mother Care und Skin-to-Skin Care auf die Entwicklung von Säuglingen. Anschließend wird dargestellt wie diese Interventionen die Mutter-Kind-Beziehung und die Symptome der postpartalen Depression der Mutter beeinflusst. Methodik: Die Literaturrecherche erfolgte in verschiedenen Datenbanken, nämlich PubMed, Cochrane Library, CINAHL und Science Direct. In dieser Arbeit wurden 15 Studien zur Beantwortung der Fragestellungen herangezogen. Ergebnisse: Anhand der Ergebnisse der Studien konnte festgestellt werden, dass die Implementation der Kangaroo Mother Care und Skin-to-Skin Care zu positiven Auswirkungen auf die physiologische und kognitive Entwicklung von Säuglingen führen kann. Ähnlich konnte anhand der Durchführung der Interventionen eine Minimierung von Symptomen postpartaler Depression und auch eine Förderung der Mutter-Kind-Beziehung erzielt werden. Schlussfolgerung: Da die Anwendung der Kangaroo Mother Care und Skin-to-Skin Care zu unterschiedlichen Vorteilen für Mütter und auch ihr Umfeld, wie ihr Säugling und Partner verhilft kann die Anwendung der Interventionen für die Praxis empfohlen werden. Allerdings ist ein weiterer Forschungsbedarf notwendig, um diese gewonnenen Ergebnisse zu festigen. Introduction: After birth women are more susceptible to psychological disorders. One of these diseases is called postpartum depression, which typically occurs up to 4 weeks after birth and normally lasts around 1 year. Maternal postpartum depression has various negative effects, not only for the mother herself but also for her immediate family, such as her infant and partner. Therefore, it is important to find and use helpful and evidence-based interventions to counter or prevent these consequences. This thesis discusses what benefits the implementation of kangaroo mother care and skin-to-skin care cause for the development of infants and how they influence mother-infant relationships and the symptoms of maternal postpartum depression. Methodology: Multiple databases were used to find adequate and suitable literature to be able to examine the topics mentioned above: PubMed, Cochrane Library, CINAHL, and Science Direct. In this literary review, 15 studies were included in the data analysis. Results: The studies conclude that the use of kangaroo mother care and skin-to-skin care brings multiple benefits to infant physiological and cognitive development. Similarly, through the implementation of both KMC, and SSC the symptoms of post-partum depression in the mother can be reduced, as well as facilitate mother-infant interaction, which positively influences maternal attachment, mother-infant relationships, and family dynamics. Conclusion: Since the KMC and SSC cause a variety of positive outcomes, not only for mothers with postpartum depression but also for their surroundings, namely their infants and the whole family, its practice can be recommended for clinical practice. However, there is a need for further research to strengthen the results presented in this thesis.

ZUSAMMENFASSUNGHintergrund: Die postpartale Depression (PPD) ist die häufigste Form des psychischen Syndroms in der Zeit nach der Geburt und als psychische Störung eine ernst zu nehmende Erkrankung. Allein in Österreich leiden bis zu 21% der Frauen an einer PPD, welche mit erhöhtem persönlichen Leidensdruck, beeinträchtigten sozialen Beziehungen, schlechter gesundheitsbezogener Lebensqualität (HRQOL) sowie sozialen, emotionalen und kognitiven Störungen bei den betroffenen Kindern einhergeht. Wirksame Behandlungen sind von entscheidender Bedeutung. Viele Frauen mit PPD bevorzugen komplementäre Therapien, da der Einsatz pharmakologischer Methoden auf Ablehnung stößt, insbesondere bei stillenden Müttern. Es besteht daher ein wachsendes Interesse an komplementären Therapien für Frauen mit PPD. Ziel dieser Arbeit ist es, die Wirksamkeit von Yoga als ergänzende Maßnahme bei postpartaler Depression zu untersuchen.Methode: Zur Beantwortung der Forschungsfrage wurde sowohl eine selektive als auch eine strukturierte Literaturrecherche durchgeführt. Im Rahmen der selektiven Recherche wurden die Grundlagen des Themas erläutert und darauf aufbauend alle wesentlichen theoretischen Aspekte untersucht. Ziel der strukturierten Suche war es, insbesondere qualitativ hochwertige Studien (Reviews, systemische Reviews und Meta-Analysen) zu analysieren und zu sammeln, in denen die Forschungsfrage näher erläutert werden konnte. Dazu wurden elektronische Datenbanken wie PubMed, Science Direct, Springer Link und Researchgate verwendet.Ergebnisse: Zu den wichtigsten Auslösefaktoren einer PPD gehören soziale, psychologische und biologische Aspekte. Es hat sich gezeigt, dass Yoga verschiedene physiologische Parameter positiv beeinflusst, zu einer Steigerung der körperlichen Leistungsfähigkeit und einer Verringerung von Schmerzen führen kann, sowie sich positiv auf das emotionale Wohlbefinden auswirkt. Darüber hinaus werden ein höheres Maß an Zufriedenheit, Selbstvertrauen und eine verbesserte Selbstkontrolle nach Yoga mit einem geringeren Stressempfinden in Verbindung gebracht. Zudem ergaben Studien signifikante Verbesserungen bei Yoga-Interventionen zur Behandlung von postpartalen Depressionen, mit Verbesserungen der depressiven Symptome, der Angstzustände und einer Steigerung der gesundheitsbezogenen Lebensqualität.Diskussion: Die vorliegenden Studienergebnisse legen nahe, dass Yoga eine wirksame Behandlung für PPD ist und die gesundheitsbezogene Lebensqualität verbessert. Das Interesse an der Rolle von Yoga als alternative Therapie für die emotionale und körperliche Gesundheit nimmt stetig zu, denn als komplementäre Intervention ist die Yogatherapie eine praktikable, akzeptable und leicht zugängliche Alternative und Ergänzung zu konventionellen Therapien. Darüber hinaus stellt Yoga eine niedrigschwellige, weithin akzeptierte und ganzheitlich ressourcenorientierte Therapie dar, die zudem stigmatisierungsfrei, relativ kostengünstig und kaum Nebenwirkungen aufweist. Trotz der zahlreichen Studien über Yoga im Zusammenhang mit psychischen Erkrankungen im Allgemeinen sind weitere hochwertige Forschungsarbeiten erforderlich, um die spezifischen Auswirkungen von Yoga besser zu verstehen, insbesondere in Bezug auf die postpartale Depression. ABSTRACTBackground: Postpartum depression (PPD) is the most common form of mental syndrome in the postpartum period and, as a mental disorder, is an illness to be taken seriously. In Austria alone, up to 21% of women suffer from PPD, which is associated with increased personal distress, impaired social relationships, poor health-related quality of life (HRQOL), and social, emotional and cognitive disorders in the affected children. Effective treatments are essential. Many women with PPD prefer complementary therapies as the use of pharmacological methods is met with rejection, especially among breastfeeding mothers. Therefore, there is a growing interest in complementary therapies for women with PPD. The aim of this work is to investigate the effectiveness of yoga as a complementary intervention for postpartum depression.Method: To answer the research question, both a selective and a structured literature search were conducted. In the course of the selective search, the basics of the topic were explained and, building on this, all essential theoretical aspects were examined. The aim of the structured search was to analyse and collect high-quality studies (reviews, systemic reviews and meta-analyses) in which the research question can be explained in more detail. Electronic databases such as PubMed, Science Direct, Springer Link and Researchgate were used for this purpose.Results: The main triggers of PPD include social, psychological and biological aspects. It has been shown that yoga influences various physiological parameters positively, can lead to an increase in physical performance and a reduction in pain, as well as having a positive effect on emotional well-being. In addition, higher levels of satisfaction, self-confidence and improved self-control after yoga are associated with lower feelings of stress. In addition, studies found significant improvements in yoga interventions for the treatment of postpartum depression, with improvements in depressive symptoms, anxiety and an increase in health-related quality of life.Discussion: The available study results suggest that yoga is an effective treatment for PPD and improves health-related quality of life. The interest in the role of yoga as an alternative therapy for emotional and physical health is continuously growing because, as a complementary intervention, yoga therapy is a practicable, acceptable and easily accessible alternative and addition to conventional therapies. Moreover, yoga represents a low-threshold, widely accepted and holistic resource-oriented therapy that is also stigma-free, comparatively inexpensive and has nearly no side effects. Despite the numerous studies on yoga in relation to mental illness in general, more high-quality research is needed to better understand the specific effects of yoga, especially in relation to postpartum depression. eingereicht von: Stephanie Holzer Abweichender Titel laut Übersetzung der Verfasserin/des Verfassers Bachelorarbeit FH JOANNEUM 2022

Einleitung: Die postpartale Depression ist die häufigste Komplikation bei der Frau nach der Geburt ihres Kindes und eine der relevantesten perinatalen psychiatrischen Erkran-kungen. Postpartale Depression ist ein bereits lang bestehendes, aber auch aktuelles Gesundheitsproblem der Gesellschaft. Obwohl es effektive medikamentöse Behand-lungsmöglichkeiten gibt, entscheiden sich Frauen mit dieser affektiven Störung dreimal häufiger für eine Psychotherapie. Diese Arbeit behandelt, aufgrund der hohen Prä-valenz der postpartalen Depression, spezielle Interventionen, um die Pflege dieser Frauen zu verbessern. Methodik: Anhand festgestellter Ein- und Ausschlusskriterien wurde nach passender Literatur gesucht. Für die Recherche wurden elektronischen Datenbanken wie PubMed, CINAHL und Cochrane verwendet. Insgesamt wurden neun Studien in der Arbeit darge-stellt. Ergebnisse: Verschiedene nichtmedikamentöse Pflegeinterventionen waren in den letz-ten Jahren Gegenstand zahlreichen Studien. Die meisten Pflegeinterventionen, die in dieser Arbeit beschrieben wurden, bewiesen eine signifikante therapeutische Wirkung auf die Symptome der postpartalen Depression. Die technologie-basierten Pflegehand-lungen zeigten keinen therapeutischen Effekt. Es ist noch weitere Forschung in diesem Bereich notwendig, um passende Pflegeinterventionen zu entwickeln. Schlussfolgerung: Die speziellen Pflegeinterventionen, die auf der Theorie der inter-personalen Beziehungen von Hildegard Peplau basieren, zeigen klinisch signifikante Er-gebnisse bei der Behandlung von postpartaler Depression. Eine erfolgreiche nicht medi-kamentöse Behandlung der Frauen mit postpartaler Depression ist grundsätzlich abhän-gig von einer guten Kommunikation zwischen den Patientinnen und Gesundheitsleisten-den. Introduction: Postpartum depression is the most common complication in women af-ter the birth of their child and one of the most relevant perinatal psychiatric disorders. Postpartum depression is a long-standing, but also current health issue in society. Alt-hough there are effective drug treatment options, women with this affective disorder are three times more likely to choose psychotherapy. Due to the high prevalence of postpartum depression, this paper discusses specific interventions to improve the quali-ty of care outcomes. Methodology: Suitable literature was searched based on the chosen inclusion and ex-clusion criteria. Electronic databases such as PubMed, CINAHL and Cochrane were used for the research. A total of nine studies were presented in this paper. Results: Various non-medical nursing interventions have been the subject of numerous trials in recent years. Most of the nursing interventions described in this paper demon-strated the significant therapeutic effect on the the symptoms of postpartum depres-sion. The technology-based care treatments showed no therapeutic effect. Further re-search is needed, to improve caring interventions. Conclusion: The special care interventions, which are based on the Peplau´s Interper-sonal Relations Theory, showed clinically significant results in the treatment of postpar-tum depression. Successful non-medical treatment of women with postpartum depres-sion is dependent on good communication between patients and health care providers. Keywords: postpartum depression, postnatal depression, nursing interventions

BACKGROUND: Perinatal depression causes significant burden to women and their families during the perinatal period. However, there is no reliable national prevalence data on perinatal depression in Malawi. AIM: This systematic review aimed at establishing the pooled prevalence of perinatal depression. SETTING: The study setting is Malawi. METHODS: Two reviewers conducted the search, selection, quality evaluation and data abstraction. Appropriate terms were used to search the CINAHL, PsychINFO, PubMed and ScienceDirect databases. The relevance and the quality of the studies were assessed. The prevalence of prenatal depression was pooled using a random-effects model, which was used to synthesise the data. RESULTS: The review included a total of eight articles of fair and good quality. This review found a pooled prevalence of antenatal depression of 17.1% (95.0% confidence interval [CI]: 12.5-22.2) and postnatal depression of 19.8% (95.0% CI: 4.6-42.1) with an overall pooled prevalence of perinatal depression of 18.9% (95.0% CI: 14.5-23.8). CONCLUSION: This systematic review provided a pooled prevalence of perinatal depression which may be used in the absence of national prevalence data on perinatal depression. CONTRIBUTION: This systematic review found a high a pooled prevalence of perinatal depression in Malawi suggesting that mental health should be a key component of maternal health programmes, policies and activities in the local setting.

Poporodna depresija v veliki meri zaznamuje materinstvo, odraža pa se tudi v intimnih partnerskih odnosih, kar mnoge pare privede tudi do iskanja pomoči zakonskega in družinskega terapevta. V doktorski disertaciji smo želeli raziskati intimne partnerske odnose in funkcioniranje v izvirni družini v povezavi s poporodno depresivno simptomatiko pri partnerki. V raziskavo smo vključili tudi proces relacijske družinske terapije pri parih, kjer partnerka izraža simptome poporodne depresije. Poporodna depresija in relacijska družinska terapija, kot je pričujoča doktorska disertacija tudi naslovljena, se v osnovi členi na na dva dela: teoretični in empirični del. V teoretičnem delu smo najprej izpostavili problematiko duševnih motenj in dosedanjih spoznanj o depresiji. Sledila je predstavitev poporodnih duševnih motenj s poudarkom na poporodni depresiji. Slednjo smo razčlenili tako z vidika preventive in kurative, kot tudi z vidika materinstva in razvoja otroka. Dotaknili smo se tudi poporodne depresije pri očetih in njenega vpliva na očetovsko vlogo. V nadaljevanju smo se posvetili intimnim partnerskim odnosom in odkrivali, kako intenzivno lahko vplivajo na razvoj poporodne depresije, ki smo jo razdelali tudi z vidika starševske vloge in razvoja otroka v najzgodnejšem obdobju. Zadnji poglavji v teoretičnem delu smo posvetili predstavitvi relacijske družinske terapije v povezavi s poporodno depresijo, in sicer ob spremljavi duhovnosti oz. v kontekstu biblično-teološkega vidika. Tudi empirični del smo razdelili na dva dela: na kvantitativni in kvalitativni del. V kvantitativnem delu so nas zanimale razlike v zadovoljstvu znotraj partnerskega odnosa in funkcioniranju v izvirni družini pri partnerkah, ki izražajo simptome poporodne depresije, in tistimi, ki jih ne izražajo. V raziskavo je bilo vključenih 245 prostovoljnih udeleženk, od katerih je polovica izražala simptome poporodne depresije. Na podlagi rezultatov analize smo ugotovili, da med ženskami s poporodno depresivno simptomatiko obstaja statistično pomembna razlika v zadovoljstvu s partnerskim odnosom, prav tako obstaja statistično pomembna razlika v avtonomiji in intimnosti v izvirni družini. V pretežno kvalitativnem delu smo želeli raziskati, ali z relacijsko družinsko terapijo lahko odpravimo simptome poporodne depresije. V raziskavo smo vključili pet parov (10 udeležencev), pri katerih partnerka na podlagi vprašalnika EPDS izraža simptome poporodne depresije. Podatke smo zbirali skozi vseh 12 srečanj, ki obsegajo en terapevtski cikel. Zanimalo nas je, kako bodo pari po terapevtskem procesu doživljali spremembe na intrapsihičnem, interpersonalnem in sistemskem nivoju, ter, ali se bodo zmanjšali oz. odpravili tudi simptomi poporodne depresije.Ugotovili smo, da so vse udeleženke identificirale vsaj en ključni trenutek spremembe, do katerega je prišlo zunaj ali znotraj terapevtskega procesa. Pri udeleženkah je prišlo do pomembnih sprememb na različnih področjih življenja, poleg tega se je pri nekaterih parih zvišalo zadovoljstvo v odnosu. Simptomi poporodne depresije so se pri vseh udeleženkah zmanjšali oz. odpravili. Izsledke celotne raziskave je potrebno razumeti z upoštevanjem nekaterih omejitev. Te se kažejo kot nereprezentativen vzorec in odsotnost kontrolne skupine. Prav tako je potrebno upoštevati pogosto izostajanje partnerjev, kar je vplivalo na potek terapije in končne rezultate zadovoljstva v odnosu. Omeniti je potrebno tudi alternativne metode pomoči v obliki podpornih skupin za mame po porodu, na podlagi katerih lahko sklepamo, da so zelo verjetno pripomogle k boljšemu počutju in zmanjšanju oz. odpravi depresivnih simptomov. Upoštevati pa bi bilo vredno tudi druge dejavnike, ki se lahko izkažejo kot pomemben faktor pri pojavu depresivnih simptomov (npr. genetske in hormonalne). Smiselno bi bilo izvesti še en ciklus terapij, tokrat v polni prisotnosti obeh partnerjev ter ponoviti meritve. Izsledki naše raziskave se ujemajo z ugotovitvami predhodnih raziskav, obenem pa prinašajo pomemben prispevek k razumevanju poporodne depresije v povezavi z intimnim partnerskim odnosom in izvirno družino, ter odstirajo nova spoznanja o značilnostih terapevtskega procesa in partnerskega odnosa, kjer je prisotna poporodna depresija. Raziskava izpostavlja tudi spoznanja o ključnih trenutkih terapevtske spremembe ter z njimi povezanih pozitivnih spremembah na številnih področjih življenja udeleženk. Vse to pa omogoča bolj celovito razumevanje obravnave parov v procesu relacijske družinske terapije pri predelavi simptomov poporodne depresije. Postnatal depression significantly influences motherhood, yet it simultaneously affects the intimate relationship between two partners, which can result in many couples seeking help of a marriage and family therapist. This doctoral dissertation endeavoured to study intimate relationships and the functioning in a family of origin in relation to the symptoms of postnatal depression present with a female partner. The study also encompassed the process of relational family therapy with the couples in which a female partner exhibits symptoms of postnatal depression. The doctoral dissertation called Postnatal Depression and the Process of Relational Family Therapy is divided into two parts: the theoretical and the empirical one. The theoretical part first emphasised the problem of mental disorders and the findings about the postnatal depression presented so far. Afterwards followed the presentation of postnatal mental disorders with the focus on postnatal depression, which is further elaborated on from the point of view of prevention and curative, as well as from the point of view of motherhood and child development. What is more, postnatal depression with fathers and its effect on the role of a father is also touched upon. In the following chapters, the attention was drawn to intimate relationships and their impact on the development of postnatal depression, which is studied with respect to the role of a parent and from a point of view of child development in the earliest period. The last two chapters of the theoretical part presented a process of relational family therapy with reference to postnatal depression, which is discussed from a spiritual perspective or biblically theological perspective. The empirical part is subdivided into a quantitative and a qualitative part. The emphasis of the quantitative part was on differences in satisfaction within a relationship and its functioning in a family of origin with female partners who suffer from symptoms of postnatal depression and those who do not. Two hundred and forty-five female volunteers were included in the research and a half of them experienced symptoms of postnatal depression. On the basis of the analysis’ results, it was ascertained that there is a statistically significant difference in satisfaction with a relationship amongst females displaying symptoms of postnatal depression and that there is also a statistically significant difference in autonomy and intimacy in a family of origin. The predominantly qualitative part tended to examine whether symptoms of postnatal depression can be suppressed through relational family therapy. Five couples (ten participants), in which a female partner exhibited symptoms of postnatal depression based on the EPDS (Edinburgh postnatal depression scale) questionnaire, were included in the study the data was obtained during twelve sessions, which represent one therapeutic cycle. The primary interest in this part of the study was whether the female participants can identify the key moments of therapeutic change, how they experience changes on an intrapsychic, interpersonal and system level and whether the symptoms of postnatal depression will be reduced or suppressed. It was discovered that all female participants identified at least one key moment of therapeutic change which occurred inside or outside of the therapy process. The female participants experienced salient changes in various domains of their life, what is more, some couples observed an increase in satisfaction in their relationship. All the female participants were subjected to the reduction or suppression of the symptoms of postnatal depression. To correctly understand the results of the entire study, some restrictions need to be taken into account, such as an unrepresentative sample and the absence of a control group. Moreover, the fact that male partners were often not present needs to be considered as well since this affected the course of the therapy and the final results concerning satisfaction in a relationship. In addition, alternative methods of help, such as birth mother support groups, need a special mention since they are liable to have ameliorated the well-being of a mother and reduced or suppressed the symptoms of depression. Other factors that are of great significance for the emergence of the symptoms of postnatal depression would also be worth considering (for instance: genetic and hormonal symptoms). It would be thus reasonable to undergo an additional therapy cycle, this time with both partners present all the time in order to reobtain the measurements. The research’s results, proved to match the findings of previous studies in this domain, significantly contribute to the understanding of postnatal depression with regard to an intimate relationship and a family of origin, and they simultaneously reveal new discoveries concerning the characteristics of a therapeutic process and an intimate relationship where postnatal depression is present. The research also emphasises the findings concerning key moments of therapeutic change and the correlated positive changes observed in various spheres of the female participants’ lives. The study, therefore, allows a more wholesome understanding of couples’ treatment in the process of relational family therapy aimed at relieving the symptoms of postnatal depression.

Perinatal mental health is a vital component of public mental health. The perinatal period represents the time in a woman’s life when she is at the highest risk of developing new-onset psychiatric disorders or relapse of an existing mental illness. Optimisation of maternal mental health in the perinatal period is associated with both short- and long-term benefits not only for the mother, but also for her infant and family. However, perinatal mental health service provision remains variable across the world. At present in Northern Ireland, 80% of women do not have access to specialist community perinatal mental health services, and without access to a mother and baby unit, mothers who require a psychiatric admission in the postnatal period are separated from their baby. However, following successful campaigns, funding for development of specialist perinatal mental health community teams has recently been approved. In this article, we discuss the importance of perinatal mental health from a public health perspective and explore challenges and opportunities in the ongoing journey of specialist service development in Northern Ireland.

Background There is good evidence that female infants are particularly vulnerable to poor emotional outcomes following in utero glucocorticoid exposure. It is currently unclear whether such effects might persist into the postnatal period for breastfed infants, as maternal cortisol is expressed in breastmilk and is influenced by maternal psychological distress. We pre-registered hypotheses that maternal postnatal depression would be associated with infant negative emotionality, and that this effect would be moderated by breastfeeding status and infant sex. Methods We analysed data from the Wirral Child Health and Development Study (WCHADS), a prospective epidemiological study starting in pregnancy. Nine weeks after birth mothers self-reported depressive symptoms and breastfeeding status, and reported infant negative emotionality using the distress to limits subscale of the infant behaviour questionnaire (IBQ-R) when their infant was aged 9 weeks and 14 months. Maximum likelihood estimations made use of data from 857 mother-infant pairs. Results At 9 weeks of age, maternal postnatal depressive symptoms were positively associated with infant distress to limits; however, this effect was not moderated by infant sex or breastfeeding. At age 14 months, the association between postnatal depression symptoms and distress to limits was greatest in the breastfed females, whereas the association was smaller, but still significant, in the non-breastfed females. For males, the association was non-significant in both the breastfed and non-breastfed groups. A test of sex difference between breastfed males and females was significant. Conclusions We provide evidence that effects of maternal postnatal depression on child emotional outcomes are moderated by breastfeeding status and differ by infant sex. Female vulnerability to elevated maternal breastmilk glucocorticoids may, at least in part, explain these effects., Highlights Female infants breastfed by mothers with high depressive symptoms showed the highest levels of negative emotionality at age 14 months. Conversely, female infants breastfed by mothers with very low depressive symptoms showed the lowest negative emotionality. Negative emotionality of males was unrelated to maternal postnatal depression and breastfeeding at 14 months of age. We provide novel evidence that effects of maternal postnatal depression on infant emotional outcomes is moderated by breastfeeding status and differs by infant sex.

BackgroundPostnatal depression (PND) is one of the most frequent complications in women of childbearing age in the developed world. The onset of PND is influenced by several risk factors. In an attempt to avoid unnecessary long maternity stays, the Short Stay Maternity programme was launched, shifting care from the hospital environment to the outpatient setting.AimIn order to develop an efficient programme to trace vulnerable women after childbirth and to provide support within primary care, the aim was to create an inventory of the risk factors for PND within the population of women participating in the short-stay programme.Design & settingThis study is a cross-sectional study without follow-up. Women in Belgium were invited by email to participate in the Short Stay Maternity programme within 3 months of delivery.MethodThe questionnaire addressed background features and feelings during the maternity period, supplemented with the validated Dutch version of the Edinburgh Postnatal Depression Scale (EPDS). The primary outcome measure of the questionnaire was the score on the EPDS.ResultsA total of 131 (27.46%) of the invited women participated. Sixteen participants (12.21%) presented with a positive score on the EPDS. The odds ratio (OR) for a positive score on the EPDS when experiencing negative feelings was 13.5 (95% confidence interval [CI] = 4.14 to 44.01). If only material support was provided, the OR for a positive EPDS score was OR 11.2 (95% CI = 2.72 to 55.5).ConclusionIn this study, two risk factors were identified for PND: negative feelings during pregnancy and the provision of only material support by the partner.