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University participation rates are significantly lower in low socioeconomic status (SES) areas in Australia. Specifically, rates differ between-schools and within-schools, where inequalities in opportunities to access university pathway programs exist. The aim of this study was to test whether academic encouragement supported students' school satisfaction and increased their desire for, expectation of and belief in the possibility of university study and whether differences were evident depending on pathway of study: the ATAR pathway versus a Year 12 access enabling pathway program called TLC110. A sample of 257 high school students (58% female) from 18 high schools, within a low-SES area of outer metropolitan Perth, Western Australia, were surveyed. Teacher encouragement was found to be positively associated with school satisfaction and, in turn, supported university desire, expectation and belief for ATAR students but not for TLC110 students. Qualitative data were collected (n = 9) to contextualise the inclusivity of TLC110 for high school students from low-SES backgrounds to support aspirations for university.

Emphasis on continuous infant sleep overnight may be driven by parental concern of risk to child mental health outcomes. The Mercy Pregnancy and Emotional Wellbeing Study (MPEWS) examined whether infant sleep at 6 and 12 months postpartum predicts anxiety disorders at 2–4 years, and whether this is moderated by maternal depression, active physical comforting (APC) or maternal cognitions about infant sleep. Data included 349 women and infants. Infant sleep was measured using the Brief Infant Sleep Questionnaire and child anxiety disorders by the Preschool Age Psychiatric Assessment. The risk of developing generalised anxiety or social phobia disorders at 3–4 years was reduced by 42% (p = 0.001) and 31% (p = 0.001), respectively, for a one standard deviation increase in total sleep at 12 months. No other infant sleep outcomes were associated. Maternal depression, APC and cognitions about infant sleep did not significantly moderate these relationships. Focus may need to be on total infant sleep, rather than when sleep is achieved. Highlights: To assess whether infant sleep outcomes (i.e., frequency of nocturnal wakes; nocturnal wakefulness and total sleep per day) at 6 and 12 months predict early childhood anxiety disorders at 3–4 years of age.Maternally reported infant sleep outcomes were not associated with the risk of developing early childhood anxiety disorders at 3–4 years.It may be total infant sleep, irrespective of when sleep occurs or night waking and, independently, active physical comforting that requires further investigation. [ABSTRACT FROM AUTHOR]

Background: Predicting the course and complications of perinatal depression through the identification of clinical subtypes has been previously undertaken using the Edinburgh Postnatal Depression Scale and has the potential to improve the precision of care and improve outcomes for women and their children. Methods: Edinburgh Postnatal Depression Scale scores were collected twice in pregnancy and twice in the postpartum in a sample of 360 women who met diagnostic criteria for perinatal depression using the Structured Clinical Interview for DSM disorder. These data were used to compare with previous, though conflicting, evidence from cross-sectional studies and extend this by undertaking longitudinal measurement invariance modelling to test the structural validity across the perinatal period. Latent profile and transition modelling was used to identify distinct subtypes of women and assess the utility of these subtypes and transition profiles to predict clinically meaningful outcomes. Results: Although our data supported one of the previously reported three-factor Edinburgh Postnatal Depression Scale structures used to compute subfactor totals for depressed mood, anxiety and anhedonia at both early pregnancy and 6 months postpartum, there was little value in using these Edinburgh Postnatal Depression Scale subfactor scores to identify subtypes predictive of clinically meaningful postpartum symptom subtypes, or of general health, pregnancy and neonatal outcomes. Conclusion: Our study does not support the use of the Edinburgh Postnatal Depression Scale to distinguish perinatal depressive subtypes for the purposes of predicting course and complications associated with perinatal depression. However, the results give guidance on alternative ways to study the value of personalised management in improved outcomes for women living with or at risk for perinatal depression. [ABSTRACT FROM AUTHOR]

Childhood anxiety disorders (CAD) are a common childhood mental disorder and understanding early developmental pathways is key to prevention and early intervention. What is not understood is whether early life stress predictors of CAD might be both mediated by infant cortisol reactivity and moderated by infant attachment status. To address this question, this exploratory study draws on 190 women recruited in early pregnancy and followed together with their children until 4 years of age. Early life stress is operationalized as maternal depression measured using the Structured Clinical Interview for the DSM, Childhood Trauma Questionnaire, Parenting Stress Index, and antenatal maternal hair cortisol concentrations. Infant cortisol reactivity was measured at 12 months together with the Strange Situation Procedure and CAD assessed at 4 years of age using the Preschool Age Psychiatric Assessment. There was no direct association between attachment classification and CAD. Furthermore, infant cortisol reactivity neither mediated nor attachment moderated the association of early life stress predictors and CAD. However, only for infants with organized attachment classifications, higher maternal antenatal depression, and hair cortisol were associated with a higher risk of CAD. [ABSTRACT FROM AUTHOR]

Background: Hypertensive disorders of pregnancy are associated with longer term cardiovascular risk. Understanding if depression or antidepressant use in pregnancy is associated with HDP is important in identifying those potentially vulnerable to poorer health in later life. This study examines if depression and antidepressants are associated with HDP. Methods: In all, 815 pregnant women were recruited within an Australian pregnancy cohort study at less than 20 weeks of pregnancy, all undertook the Structured Clinical Interview for the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, and were assigned to four groups for this paper: those with unmedicated depression meeting criteria for current depression (n = 97), those taking selective serotonin reuptake inhibitors in early pregnancy (n = 101), those taking serotonin and noradrenaline reuptake inhibitors in early pregnancy (n = 31), and those without depression or taking antidepressant medication (control; n = 586). Women were then assessed again following birth. Hypertensive disorders of pregnancy were diagnosed according to the Society of Obstetric Medicine in Australia and New Zealand Guidelines. Results: Use of serotonin and noradrenaline reuptake inhibitors (SNRIs) (adjusted risk ratio = 9.10, 95% confidence interval = [3.82, 21.67]) and unmedicated depression (adjusted risk ratio = 3.11, 95% confidence interval = [1.32, 7.35]) were independently associated with significantly higher risk for developing hypertensive disorders of pregnancy compared to controls. Selective serotonin reuptake inhibitors (SSRIs) use did not confer any increased risk. Higher doses of SNRIs, but not selective serotonin reuptake inhibitors, were associated with significantly higher risk for developing HDP (adjusted risk ratio = 4.83, 95% confidence interval = [1.50, 15.58]). Conclusions: Our findings suggest that those with depression in pregnancy and/or on an serotonin and noradrenaline reuptake inhibitor should have closer surveillance for the development of hypertensive disorders of pregnancy. These findings support treatment of depression in pregnancy, however, also the consideration of class of antidepressant. [ABSTRACT FROM AUTHOR]

Objective: Perinatal emotional well‐being is more than the presence or absence of depressive and anxiety disorders; it encompasses a wide range of factors that contribute to emotional well‐being. This study compares perinatal well‐being between women living in metropolitan and rural regions. Design: Prospective, longitudinal cohort. Participants/setting: Eight hundred and six women from Victoria and Western Australia recruited before 20 weeks of pregnancy and followed up to 12 months postpartum. Main outcome measures: Rurality was assessed using the Modified Monash Model (MM Model) with 578 in metropolitan cities MM1, 185 in regional and large rural towns MM2‐MM3 and 43 in rural to remote MM4‐MM7. The Structured Clinical Interview for DSM‐IV (SCID‐IV) was administered at recruitment to assess depression, and symptoms of depression and anxiety were measured using the Edinburgh Post‐natal Depression Scale and the State and Trait Anxiety Scale, respectively. Other measures included stressful events, diet, exercise, partner support, parenting and sleep. Results: The prevalence of depressive disorders did not differ across rurality. There was also no difference in breastfeeding cessation, exercise, sleep or partner support. Women living in rural communities and who also had depression reported significantly higher parenting stress than metropolitan women and lower access to parenting activities. Conclusions: Our study suggests while many of the challenges of the perinatal period were shared between women in all areas, there were important differences in parenting stress and access to activities. Furthermore, these findings suggest that guidelines and interventions designed for perinatal mental health should consider rurality. [ABSTRACT FROM AUTHOR]

Aim: This paper aims to examine the maternal and child mental health and parenting outcomes in the context of COVID‐19 pandemic conditions using a sample from Melbourne, Australia – a city exposed to one of the longest lockdowns world‐wide in response to the pandemic. Methods: This study utilises observational data from a prospective, pregnancy cohort, Mercy Pregnancy Emotional Wellbeing Study and includes 468 women and their children followed up in Melbourne to 3–4 years postpartum pre‐COVID pandemic and compared to those followed up during the COVID‐19 pandemic. Results: When compared to mothers followed up at 3–4 years postpartum pre‐pandemic, those followed up during the COVID‐19 pandemic showed higher depressive symptoms with a steep incline in their symptom trajectory (EMMdifference = 1.72, Bonferroni‐corrected P < 0.01, d = 0.35) and had a three times higher risk of scoring 13 or above on the EPDS (aRR = 3.22, Bonferroni‐corrected P < 0.01). Although this increase was not associated with the variation in the duration of exposure to pandemic conditions, the steep increase in depressive symptoms was more pronounced in those with pre‐existing depressive disorders. There was no difference in parenting stress or adjusted childhood mental health symptoms or disorder. Conclusions: Our findings highlight the vulnerability of those with pre‐existing clinical mental health disorders and the need for adequate clinical care for this vulnerable group. Equally, our study indicates the possibility that parenting and early childhood mental health outcomes, at least in the short term, may be resilient. [ABSTRACT FROM AUTHOR]

Objective: Understanding the relationship between attachment and mental health has an important role in informing management of perinatal mental disorders and for infant mental health. It has been suggested that experiences of attachment are transmitted from one generation to the next. Maternal sensitivity has been proposed as a mediator, although findings have not been as strong as hypothesised. A meta-analysis suggested that this intergenerational transmission of attachment may vary across populations with lower concordance between parent and infant attachment classifications in clinical compared to community samples. However, no previous study has examined major depression and adult attachment in pregnancy as predictors of infant–parent attachment classification at 12 months postpartum. Methods: Data were obtained on 52 first-time mothers recruited in early pregnancy, which included 22 women who met diagnostic criteria for current major depression using the Structured Clinical Interview for the Diagnostic and Statistical Manual of Mental Disorders. The Adult Attachment Interview was also administered before 20 weeks of pregnancy. A history of early trauma was measured using the Childhood Trauma Questionnaire and maternal sensitivity was measured at 6 months postpartum using the observational measure of the Emotional Availability Scales. Infant–parent attachment was measured using the Strange Situation Procedure at 12 months. Results: Overall, we found no significant association between the Adult Attachment Interview and the Strange Situation Procedure classifications. However, a combination of maternal non-autonomous attachment on the Adult Attachment Interview and major depression was a significant predictor of insecure attachment on the Strange Situation Procedure. We did not find that maternal sensitivity mediated parental and infant attachment security in this sample. Conclusion: While previous meta-analyses identified lower concordance in clinical samples, our findings suggest women with major depression and non-autonomous attachment have a greater concordance with insecure attachment on the Strange Situation Procedure. These findings can guide future research and suggest a focus on depression in pregnancy may be important for subsequent infant attachment. [ABSTRACT FROM AUTHOR]

Introduction: Placental dysfunction and inefficiency, is important in understanding fetal growth restriction and low birth weight. Two recent studies have examined the relationship between antidepressant use in pregnancy and placental weight ratios; one found lower placental weight ratio associated with antidepressant use and the other found a higher ratio.Methods: This study examined 342 women recruited in early pregnancy, including 75 taking antidepressants, 29 with current depression and 238 controls. Antidepressant use was measured through self-report in early and late pregnancy, hospital records at delivery and drug concentrations in umbilical cord and maternal blood obtained at delivery. Maternal depression was measured using the Structured Clinical Interview for the DSM IV (SCID) at recruitment. Placentas were collected at delivery and weighed, and infant birth weight recorded. Placental efficiency was measured using standardised placental weight residuals and included as the outcome in general linear models (ANOVA/ANCOVA) to test hypotheses.Results: While placental weight was higher for those on antidepressants compared to controls (z=.30 c.f. Z=-0.08, p=.012), there were no significant differences between the three groups after adjusting for maternal body mass index at recruitment. When comparing antidepressant groups separately there were small-to-moderate positive associations between (SSRI) concentrations and placental weight (rho's > 0.20, p's > 0.05), which did not reach significance.Conclusion: Antidepressant use in pregnancy was not associated with significant changes in placental efficiency after adjustment for confounding variables. Future research should expand on this to examine other aspects of placental function and include a wide range of potential confounding variables to draw clinically meaningful conclusions. [ABSTRACT FROM AUTHOR]

Objective: To examine the risk of perinatal depression, parenting stress and infant sleep practices in Australian culturally and linguistically diverse (CaLD) women.Method: Within the Mercy Pregnancy and Emotional Wellbeing Study, we examined 487 pregnant women of whom 52 were CaLD and 435 non-CaLD. Depression was measured using the Structured Clinical Interview for DSM-IV and the Edinburgh Postnatal Depression Scale. In addition, Parenting Stress Index and infant sleep measures were collected.Results: Fewer CaLD women had a depression diagnosis but there were no differences between CaLD and non-CaLD women for perinatal mental health symptoms. More mothers in the CaLD group were bed sharing with their infant during the night at six months; however, bedsharing was only associated with higher parenting stress for non-CaLD mothers.Conclusions: Findings suggest both differences in infant sleep parenting practices and in parenting stress but not general emotional wellbeing. Future research is required to replicate these findings. [ABSTRACT FROM AUTHOR]

Background: The development of childhood anxiety disorders (CADs) is likely to depend on pathways that can be programmed by early-life risk factors. We test the hypothesis that early-life maternal factors can predict this programming effect on CAD. Methods: Data were obtained from 198 women and children from the Mercy Pregnancy and Emotional Wellbeing Study (MPEWS), a cohort study with data collected across pregnancy, postpartum and until 4 years of age. Maternal antenatal depression was measured using the Structured Clinical Interview for DSM-IV (SCID-IV), together with antenatal hair cortisol concentrations, maternal childhood trauma and parenting stress at 6 months postpartum. CAD was assessed with the Preschool Age Psychiatric Assessment and the Child Behaviour Checklist. Results: Antenatal depression, a history of maternal childhood trauma and lower gestational age at birth were each associated with anxiety disorders at 4 years of age in their children. A multivariate binary logistic model with these early predictors explained approximately 9% of variance in CAD outcome at 4 years of age; however, only maternal trauma and gestational age were significant predictors in the model. The effect of early parenting stress on CAD was found to vary by the concentration of maternal antenatal hair cortisol, whereby postpartum parenting stress was associated with CAD only when there were higher maternal antenatal cortisol levels. Conclusions: This study suggests the importance of maternal factors pre-conception, pregnancy and in the postnatal period, which predict CADs and this is consistent with a developmental programming hypothesis for CAD. [ABSTRACT FROM AUTHOR]

Understanding how a mother's traumatic experiences influence her interactions with her infant may have importance for understanding infant development and mental health. Data for this study were drawn from an Australian pregnancy cohort, the Mercy Pregnancy and Emotional Wellbeing Study. Maternal trauma from Childhood, Childbirth Experiences, and Stressful Life Events were examined. At six-months postpartum, 211 predominantly first-time mothers (mean age 31.5 years), and their infants, were video-recorded interacting for 40 minutes. Interactions were assessed with the Emotional Availability (EA) Scales. Using structural equation modelling to test multiple mediation pathways, moderate-to-severe childhood trauma had only a direct effect on reducing maternal EA with the infant (β=−.17, p=.031), as did current stressful life events (β=−.19, p=.019), after controlling for maternal depression, age, and tertiary education. This highlights that proximate trauma specific to the perinatal period may not account for the effect of distal childhood trauma on maternal EA at six-months postpartum. [ABSTRACT FROM AUTHOR]

Caesarean section birth (CS) accounts for 38% of Australian births and is known to negatively impact breastfeeding exclusivity and duration. Comparison of breastfeeding outcomes between elective (ELUSCS) and non-elective lower uterine segment caesarean section (NELUSCS) births is needed to inform clinical care. Secondary analysis was performed on data from Australian women who had birthed by CS within the previous 12 months and completed an anonymous online questionnaire. Women responded to items relating to CS birth type and feeding methods immediately post birth, during the hospital stay and in the first 2 weeks at home. Self-reported pain at those time points was rated using a scale of 0–10 with 0 indicating no pain and 10 indicating severe pain. Associations between CS birth type, pain scores and feeding methods were determined, and breastfeeding prevalence at the time of survey completion examined. Our sample consisted of 851 women at 5 ± 3.5 months postpartum, of which 435 (51.1%) were primiparous and 362 (42%) had a NELUSCS birth. Infants born by NELUSCS were more likely to receive formula (37.1% vs. 28.8% ELUSCS, p = 0.024) and less likely to be breastfed (78.6% vs. 85.9% ELUSCS, p = 0.022) during the hospital stay. During the 2 weeks after discharge, women who birthed by NELUSCS had higher mean pain scores (6.5 vs. 4.6 ELUSCS, p < 0.001). Few women expressed and fed their milk in the weeks after discharge, with higher rates seen after NELUSCS (7.7% vs. 3.5%, p = 0.017). Breastfeeding status at study completion was not associated with CS birth type (19.6% ELUSCS vs. 19% NELUSCS, p = 0.99). The study findings indicate that Australian women who give birth by NELUSCS are more likely to experience breastfeeding challenges, with higher rates of infant formula supplementation and a more painful recovery in the days and weeks after birth. In light of the higher postpartum pain scores and lower rates of exclusive breastfeeding, women who birth by NELUSCS need additional postpartum support. [ABSTRACT FROM AUTHOR]

Objective: Poorer mother–infant interaction quality has been identified among women with major depression; however, there is a dearth of research examining the impact of bipolar disorder. This study sought to compare mother–infant emotional availability at 6 months postpartum among women with perinatal major depressive disorder, bipolar disorder and no disorder (control). Methods: Data were obtained for 127 mother–infant dyads from an Australian pregnancy cohort. The Structured Clinical Interview for the DSM -5 was used to diagnose major depressive disorder (n = 60) and bipolar disorder (n = 12) in early pregnancy (less than 20 weeks) and review diagnosis at 6 months postpartum. Prenatal and postnatal depressive symptoms were measured using the Edinburgh Postnatal Depression Scale, along with self-report psychotropic medication use. Mother and infant's interaction quality was measured using the Emotional Availability Scales when infants reached 6 months of age. Multivariate analyses of covariance examining the effects of major depressive disorder and bipolar disorder on maternal emotional availability (sensitivity, structuring, non-intrusiveness, non-hostility) and child emotional availability (responsiveness, involvement) were conducted. Results: After controlling for maternal age and postpartum depressive symptoms, perinatal disorder (major depressive disorder, bipolar disorder) accounted for 17% of the variance in maternal and child emotional availability combined. Compared to women with major depressive disorder and their infants, women with bipolar disorder and their infants displayed lower ratings across all maternal and child emotional availability qualities, with the greatest mean difference seen in non-intrusiveness scores. Conclusions: Findings suggest that perinatal bipolar disorder may be associated with additional risk, beyond major depressive disorder alone, to a mother and her offspring's emotional availability at 6 months postpartum, particularly in maternal intrusiveness. [ABSTRACT FROM AUTHOR]

Objective: To examine the risk of past and current experiences of intimate partner violence (IPV) in women with severe mental illness (SMI) in pregnancy. Methods: We examined past and current experiences of IPV in women with SMI in pregnancy. The data of 304 women with SMI including schizophrenia and related psychotic disorders and Bipolar Disorder meeting International Statistical Classification of Diseases and Related Health Problems, Tenth Revision, Australian Modification (ICD-10-AM) criteria were extracted from hospital records at King Edward Memorial Hospital, Western Australia. Comparisons were made between our study data and the Australian population data reported by the Australian Bureau of Statistics, which included data on pregnant women in Western Australia. Additional measures included reported demographics, substance use and pregnancy variables. Results: Around 48% of pregnant women with SMI had experienced IPV and were three times the risk when compared with the general pregnant population in Australia. There was no difference in rates of IPV in those women with psychotic disorders when compared with bipolar disorder. Furthermore, the rates of smoking and illicit substance use were significantly higher in pregnant women with SMI who experienced IPV compared with those who have not experienced IPV. Conclusion: These findings suggest women with SMI in pregnancy are at significantly higher risk of having experienced or experiencing IPV. In addition, IPV in pregnant women with SMI may increase the risk of smoking and illicit substance use. Together this suggests that maternity and mental health services should ensure there are both screening and support pathways for IPV that are developed and evaluated specifically for pregnant women with SMI. [ABSTRACT FROM AUTHOR]

Background: There have been conflicting findings for severe mental illnesses and the risk for gestational diabetes mellitus (GDM). Outside of pregnancy, both severe mental illnesses and specific antipsychotic medications have been associated with an elevated risk for metabolic disorders, including type 2 diabetes mellitus. Aim: This study examined the risk of developing GDM in relation to mental disorder, psychotropic treatment and comorbid risk factors. Materials and Methods: A retrospective study of 539 pregnant women with mental disorders was carried out. Measures included GDM diagnosis, mental health diagnosis, psychotropic medication, body mass index, age, smoking, alcohol and illicit substance use. Results: This study found that women with psychotic disorders had a significantly elevated risk for GDM (20.9%) compared with women with non‐psychotic severe mental illnesses during pregnancy (P = 0.023), and nearly threefold the expected population rate (8.3%). Furthermore, women using specific antipsychotic agents – risperidone (P = 0.016), clozapine (P < 0.001) and higher‐dose quetiapine (P = 0.029) – also had a higher risk of developing GDM. After adjusting for maternal age and body mass index, women taking these specific agents continued to have a fourfold risk of having GDM compared with women not taking these agents. Smoking, alcohol consumption and illicit drug use were not associated with elevated GDM rate in women with mental disorders. Conclusions: These findings support the need for early screening and closer surveillance of metabolic risk in pregnancy for women with psychotic disorders and those taking specific atypical antipsychotic agents. [ABSTRACT FROM AUTHOR]

Confronted with an imminent bushfire threat, Australian householders can respond by evacuating, waiting to see what the bushfire does before deciding, or remaining to defend property from the fire. This decision-making is central to householders' survival because late evacuation has been associated with fatalities. North Americans who seek alternatives to mandatory evacuation from wildfires are confronted with similar choices. Lindell and Perry's Protective Action Decision Model (PADM) has been extensively used to analyse the behaviour and decision-making of people subject to threat from a wide range of hazards and has acquired the status of a theory of hazard decision-making. It has not been widely used for the study of hazards in Australia. This paper addresses the question of how the PADM can be applied to the analysis of behaviour in Australian bushfires and North American wildfire, and whether the model requires adjusting for effective use in a context where householders choose their protective response rather than having decisions made for them. The paper addresses Australian bushfire policy, which emphasises the dangers of staying to defend during extreme fire weather conditions and promotes leaving early as the safer option but allows householders to decide whether to 'stay or go' during a bushfire. This Australian policy approach impacts key elements of the PADM, most importantly how long-run hazard adjustments, preparatory, mitigating and equipping actions, effect the perception of evacuating or remaining. The paper concludes that the PADM should be modified to reflect the complexity of choice confronting Australian bushfire prone householders and North Americans considering alternatives to mandatory evacuation. [ABSTRACT FROM AUTHOR]

Background: There is an established relationship between depression and sexual functioning in women. However, there is limited research examining the relationship between perinatal depression and sexual functioning. Methods: This study draws on the Mercy Pregnancy and Emotional Wellbeing Study and reports on 211 women recruited in early pregnancy and followed to 12 months postpartum. Women were assessed for depression using the Structured Clinical Interview for the DSM-IV, repeated measurement of depressive symptoms using the Edinburgh Postnatal Depression Scale and sexual functioning using the Female Sexual Functioning Inventory. Data were also collected on antidepressant use, mode of delivery, history of childhood trauma, breastfeeding and partner support. Results: Women showed a decline in sexual functioning over pregnancy and the first 6 months postpartum, which recovered by 12 months. For women with depression, sexual functioning was lower throughout pregnancy and continued to be lower at 6 months postpartum than those without depression. Ongoing depressive symptoms at 12 months were also associated with lower sexual functioning. Sexual functioning was not predicted by mode of delivery, antidepressant use or childhood trauma. Breastfeeding predicted lower sexual functioning only at 6 months. Higher partner support predicted higher female sexual functioning. Conclusions: Pregnancy and the postpartum are a time of reduced sexual functioning for women; however, women with depression are more likely to have lower levels of sexual functioning and this was not predicted by antidepressant use. In women with perinatal depression, consideration of the impact on sexual functioning should be an integral part of care. [ABSTRACT FROM AUTHOR]

Background: Improving our understanding of the relationship between maternal depression and parenting stress is likely to lie in the range of additional factors that are associated with vulnerability to depression and also to parenting stress. Objectives: To examine the role of trauma and partner support, in understanding the relationship between perinatal depression and parenting stress. Methods: This study utilises data from 246 women in a pregnancy cohort study that followed women from early pregnancy until their infant was 12 months. Included were both women with a diagnosis of depression and those without depression. The measures included Structured Clinical Interview for the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Edinburgh Postnatal Depression Scale, Childhood Trauma Questionnaire, Social Support Effectiveness Questionnaire and the Parenting Stress Index. Results: We found women with depression were more likely to report a history of childhood trauma. Depressive symptoms were positively associated with parenting stress while partner support was negatively associated with parenting stress. The protective role of partner support for parenting distress was observed in those with no history of childhood abuse and low depressive symptoms, but not in those with a trauma history and high depressive symptoms. Conclusions: These findings highlight the importance of early trauma in understanding the protective role of support on the relationship between parenting and depression. These findings can inform future studies and the refinement of future interventions aimed at both perinatal depression and parenting. [ABSTRACT FROM AUTHOR]

Background: Depression is consistently shown to predict lower rates of breastfeeding. In a handful of studies, breastfeeding has predicted lower depression symptoms. However, studies demonstrating the latter are limited in their measurement of both depression and breastfeeding and have not followed participants from pregnancy across the postpartum period. Research Aim: The primary aim of this study was to describe breastfeeding intentions and behaviors for the first 12 months postpartum among nonmedicated depressed, antidepressant-exposed, and control participants. The secondary aim was to examine group differences in the association between depressive symptoms and breastfeeding duration up to 12 months postpartum. Methods: First-trimester women (N = 212) were recruited into a prospective longitudinal study. Depressive disorders at baseline were diagnosed using the Structured Clinical Interview for DSM-IV Axis I Disorders, and depressive symptoms were measured at the first and second trimesters and 6 and 12 months postpartum using the Edinburgh Postnatal Depression Scale. Breastfeeding duration, support from family and employers, and perceptions of participants' experience were measured. Results: Depressed women and antidepressant-exposed women reported a trend toward lower rates of intention, initiation, and duration, but this did not reach statistical significance. There was a statistically significant difference on depressive symptoms for women taking antidepressants during pregnancy, compared with controls, when they continued to breastfeed for 12 months postpartum. Conclusions: This study did not find a strong association between depression or antidepressant use and intention to breastfeed, partner breastfeeding support, or initiation or duration of breastfeeding. However, for women who took antidepressants, there was evidence that breastfeeding for 12 months was associated with lower depressive symptoms. [ABSTRACT FROM AUTHOR]

Objective: Since the potential mental health benefits of exercise during pregnancy remain unclear, this study examined longitudinally the bidirectional relationship between exercise and maternal mental health symptoms during the perinatal period, and included adjustment for both depression and antidepressant treatment.Methods: Data were collected across pregnancy (first and third trimesters) and the postpartum (six and 12 months) for 258 women drawn from an Australian pregnancy cohort, the Mercy Pregnancy and Emotional Wellbeing Study (MPEWS). The women were assessed for depression using the EPDS, anxiety using the STAI and a clinical diagnostic interview (SCID-IV), and self-reported use of antidepressants. Exercise was measured using self-reported weekly frequency of 30-min bouts of moderate to vigorous exercise, and data were analyzed using parallel process growth curve modelling.Results: On average, women's weekly exercise frequency declined during pregnancy, returning to first trimester levels by 12 months postpartum. Women with depression and taking antidepressants reported lower first trimester exercise compared to control women. However, where non-medicated depressed women remained lower and continued to decline to 12 months, women taking antidepressants reported increasing levels of exercise during the perinatal period. Notably, a steeper decline in exercise frequency during the perinatal period was associated with a faster rate of increase in depressive and anxiety symptoms.Conclusions: This study is the first to examine the longitudinal interaction between exercise and mental health symptoms across the perinatal period. These preliminary findings demonstrate potential benefits for depressive and anxious symptoms when maintaining levels of early-pregnancy exercise throughout pregnancy and the postpartum. [ABSTRACT FROM AUTHOR]

The Emotional Availability Scales (EAS) are the most widely reported observational assessment measure of parent–child relationships and has been of particular interest in understanding differences between samples of depressed and nondepressed mothers and their offspring. Despite its widespread use, psychometric validation of the factor structure in normative samples and the measurement of invariance within clinical samples has not been published. We evaluated the internal structure (dimensionality, reliability, convergent, and discriminant validity) of the EAS fourth edition using a nondepressed sample of 157 Australian women and their infants aged 6 months, including testing the measurement invariance of the EAS between the same nondepressed sample (n = 157), and a depressed group (n = 185) of mother–infant dyads, using MPlus. Participants were recruited from tertiary hospitals, and depression status was established using a diagnostic measure. Higher-order confirmatory factor analyses on the EAS' six dimensions supported a unidimensional factor solution in our data. Full measurement invariance was not demonstrated due to metric noninvariance of the maternal nonintrusiveness and child responsiveness dimensions. Full scalar invariance supported mean comparisons, and a medium effect of.78SD lower mean emotional availability for the depressed group was found; Cohen's d =.63, 95% CI [.41,.85]. While arguments exist for the clinical utility of differentiating between multiple dimensions of emotional availability, the current findings do not support a multidimensional factor structure or full multigroup measurement invariance of the EAS. Similar psychometric investigations of the EAS in clinical and nonclinical samples are needed. Public Significance Statement: This study reports new validity evidence relating to the Emotional Availability Scales, the most popular observational measure of parent–child relationships. Results challenged the emotional availability theory, underscoring the importance of empirical validations of assessment measures. [ABSTRACT FROM AUTHOR]

Background: Social support theory suggests that parental social support may influence the nature of early parenting behaviours and specifically the mother-infant relationship. This study examines whether support from a partner, friends or family is associated with differences in quality of mother-infant interactions in the context of maternal depression.Methods: 210 women were followed from early pregnancy to six months postpartum within Australian pregnancy cohort, the Mercy Pregnancy and Emotional Wellbeing Study (MPEWS). Mother-infant interactions within a standardised observation at six months postpartum were measured by the Emotional Availability (EA) Scales using total scores of the parental scales. In early and late pregnancy and at six months postpartum, mothers rated perceived maternal social support from a partner, family and friends using subscales of the Multidimensional Scale of Perceived Social Support. Depression was measured in early pregnancy and at six months postpartum using the Structured Clinical Interview for the DSM-IV-TR, with repeated measurement of depressive symptoms by the Edinburgh Postnatal Depression Scale (EPDS). Data was analysed using structural equation models.Results: There were significant interactions between depressive symptoms in early pregnancy and perceived maternal support from a partner (B = .18, 95% CI = 03, .31) and separately from family (B = .12, 95% CI = .03, .32) in predicting maternal emotional availability. No such interaction was found for support from friends. While partner and family support moderated the association between early depressive symptoms and emotional availability, there were no direct associations between maternal depressive disorder in early pregnancy and perceived support, and further, maternal depression was not a significant predictor of emotional availability.Limitations: Future studies should consider extending measurement of the mother-infant relationship beyond the EA Scales, inclusion of a measure of maternal childhood trauma, and replicating our findings.Conclusion: Maternal perception of partner and family support in the postpartum is a predictor of the association between early pregnancy depressive symptoms and maternal emotional availability. [ABSTRACT FROM AUTHOR]

Background: There is an established relationship between depression and sexual functioning in women. However, there is limited research examining the relationship between perinatal depression and sexual functioning., Methods: This study draws on the Mercy Pregnancy and Emotional Wellbeing Study and reports on 211 women recruited in early pregnancy and followed to 12 months postpartum. Women were assessed for depression using the Structured Clinical Interview for the DSM-IV, repeated measurement of depressive symptoms using the Edinburgh Postnatal Depression Scale and sexual functioning using the Female Sexual Functioning Inventory. Data were also collected on antidepressant use, mode of delivery, history of childhood trauma, breastfeeding and partner support., Results: Women showed a decline in sexual functioning over pregnancy and the first 6 months postpartum, which recovered by 12 months. For women with depression, sexual functioning was lower throughout pregnancy and continued to be lower at 6 months postpartum than those without depression. Ongoing depressive symptoms at 12 months were also associated with lower sexual functioning. Sexual functioning was not predicted by mode of delivery, antidepressant use or childhood trauma. Breastfeeding predicted lower sexual functioning only at 6 months. Higher partner support predicted higher female sexual functioning., Conclusions: Pregnancy and the postpartum are a time of reduced sexual functioning for women; however, women with depression are more likely to have lower levels of sexual functioning and this was not predicted by antidepressant use. In women with perinatal depression, consideration of the impact on sexual functioning should be an integral part of care.