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Background: Becoming a father is a critical period of life transition. Evidence suggests that a lifetime history of mental health disorder/s and elevated depressive symptoms prior to conception increase risk for men's post-natal depression. Less is understood about the role of positive mental health, or wellbeing, as a protective factor for future depressive outcomes during the transition to fatherhood. The present study investigated whether men's post-natal depressive outcomes were associated with pre-conception levels of wellbeing and whether wellbeing during the post-natal period predicted depressive outcomes post-infancy., Methods: Secondary analysis of data from a national, longitudinal cohort study of men's health, namely, The Ten to Men (TTM) Study, was conducted. Participants in the pre-conception sample were n = 350 men for whom data were available at both a pre-conception baseline and post-natal follow-up period. The post-natal sample were n = 427 men with post-natal baseline data and post-infancy follow-up data. Multivariate negative binomial regressions and logistic regression models were used to determine pre-conception and post-natal predictors of future depressive outcomes., Results: Men's pre-conception depressive symptoms were the best predictor of post-natal depressive symptoms (IRR = 1.089, p < 0.001) and risk of moderate-severe depression (IRR = 1.193, p = 0.005) the latter of which was also predicted by a previous mental health diagnosis (IRR = 3.079, p = 0.029). Similarly, post-natal depressive symptoms were the best predictor of post-infancy depressive symptoms (IRR = 1.089, p < 0.001) and risk of moderate-severe depression (IRR = 1.193, p = 0.005) alongside lifetime prevalence of a mental health disorder (symptoms: IRR = 1.317, p = 0.011; moderate-severe depression: IRR = 2.606, p = 0.023). Pre-conception levels of wellbeing predicted lower post-natal depressive symptoms (IRR = 0.988, p < 0.001) and reduced risk of moderate-severe depression (IRR = 0.940, p = 0.002) after controlling for baseline symptoms and socio-demographic and behavioural confounds; however, wellbeing during the post-natal period did not predict either of the depressive outcomes post-infancy., Limitations: Fatherhood-specific risk factors for mental health outcomes (e.g., conception difficulties, maternal post-natal mental health) were not assessed in the present study, and only one aspect of wellbeing was captured., Conclusions: Screening for history of common mental health disorders and current symptoms is recommended to inform preventative approaches to paternal mental health care during early fatherhood. Inclusion of wellbeing in such screening procedures may be beneficial; however, further research is required to elucidate the prospective associations between wellbeing and depressive symptoms during the transition to fatherhood., Competing Interests: Declaration of competing interest None., (Copyright © 2024. Published by Elsevier B.V.)

Background: Allergic symptoms and depression are prevalent ailments in childbearing age women. This study assessed the risk of maternal postpartum depression (PPD) associated with prenatal allergic disorders., Methods: From 1,017,507 eligible women of 20-49 years old with singleton live births and 20-week or more gestational age in the birth registry of Taiwan, from 2011 to 2020, we identified cohorts with and without allergic disorders matched by propensity score in the size of 457,826. Cumulative incident PPDs in one year after births were assessed from insurance claims data. Odds ratios (OR) of PPD were measured by each allergic type and multiple types, comparing with the controls., Results: With an overall cumulative PPD incidence 1.25-fold higher in the allergic cohort than in the controls (0.69 % versus 0.55 %), the rate was the highest in women with asthma: 0.94 % with an adjusted OR of 1.71 (95 % CI = 1.49-1.95), followed by those with allergic rhinitis, allergic conjunctivitis and atopic dermatitis. The rate increased from 0.65 % for those with one allergic disorder to 1.06 % for those with 4 or 5 disorders, and the corresponding adjusted OR increased from 1.17 (95 % CI = 1.10-1.24) to 1.92 (95 % CI = 1.36-2.69)., Limitation: The claims data lack detailed information on socio-demographic status, lifestyle, laboratory result, physical activity, and family medical history., Conclusions: Women with prenatal allergic disorder(s) are at an increased risk of PPD in addition to the impact of pregnancy. Prompt and efficient intervention for PPD prevention is needed for women with allergic disorders, particularly for those with asthma and multiple disorders., Competing Interests: Declaration of competing interest The authors declare no conflicts of interest., (Copyright © 2024. Published by Elsevier B.V.)

Background: Postpartum depression (PPD) is one of the most common mental disorders in parents after birth. To develop tailored preventive programs, it is necessary to identify risk factors for PPD in parents. This study aimed to examine the impact of parental childhood maltreatment (CM) as a risk factor for PPD., Methods: Data from a German study comprising n = 349 mothers and n = 46 fathers were used. Hierarchical regression models were performed to examine CM, educational background, single parenthood, emotion regulation and attachment style as predictors of symptoms of PPD. In exploratory analyses, potential mediators (i.e., parenting stress and emotion regulation) were investigated via a path model., Results: CM, low level of education, difficulties in emotion regulation, and attachment anxiety were significant predictors for maternal PPD [R 2  = 0.52, F (6, 305) = 57.99, p < .001]. For fathers, difficulties in emotion regulation were identified as a predictor [R 2  = 0.43, F (6, 24) = 4.78, p < .01]. In exploratory analyses, emotion regulation served as a mediator for the link between CM and PPD as well as for the link between CM and parenting stress., Limitations: The study design is cross-sectional and based on self-report questionnaires. Despite our attempts, only few fathers participated in the study, resulting in an underpowered sample for the regression analyses., Conclusions: The study confirmed the assumption that CM experiences represent a risk factor for the development of maternal PPD. Emotion regulation might provide a pivotal target for interventions with parents at-risk., Competing Interests: Declaration of competing interest Authors have no conflict of interest to report., (Copyright © 2024 The Authors. Published by Elsevier B.V. All rights reserved.)

This study aimed to identify trends and factors in postpartum depression after the Fukushima nuclear accident among women who participated in the Fukushima Health Management Survey (FHMS). We analyzed the prevalence of depressive symptoms and concerns about radiation exposure using FHMS data from FY2011-FY2018. We also analyzed the characteristics of women who did not have depressive symptoms in the postpartum period but had developed them at 4 years after childbirth and women with depressive symptoms in the postpartum period but had improved at 4 years after childbirth. In this survey, depressive symptoms were evident in 23.1% of women in the postpartum period. Factors significantly associated with developing depressive symptoms at 4 years after childbirth were younger maternal age, not being healthy, lacking maternal confidence, history of mental illness, and not intending to become pregnant again because of radiation effects. Improvement from initial depressive symptoms at 4 years after childbirth was associated with being very healthy, having maternal confidence, no medical history, no history of mental illness, having received sufficient perinatal care, and intending to become pregnant again. Our results suggest the need for comprehensive assessment of depression risks for prevention and thorough continuous professional care for disaster affected women with postpartum depression., Competing Interests: Declarations. Competing interests: The authors declare no competing interests., (© 2025. The Author(s).)

Background: Detection of perinatal depression by healthcare providers remain an important barrier to receiving treatment. This study reports on the detection of perinatal depression by frontline non-physician primary healthcare workers (PHCWs) as well as the feasibility, effectiveness and acceptability of routine screening using the 2-item patient health questionnaire (PHQ-2) during antenatal care., Method: Twenty-seven primary healthcare facilities were assigned to screening (n = 11) and non-screening (n = 16) arms. All PHCWs in both arms were trained to diagnose and treat perinatal depression using the WHO mental health gap action intervention guide (mhGAP-IG) while those in the screening arm were trained to routinely screen with PHQ-2 first to determine need for further mhGAP-IG assessment. Perceived usefulness, feasibility and acceptability of routine screening for perinatal depression was explored in key informant interviews on a purposive sample of PHCWs (n = 20) and study participants (n = 22)., Results: In the first 6-months following training, the detection rate of perinatal depression was 4.6% at the clinics where PHCW were not routinely screening with the PHQ-2 compared to 11% at the screening clinics. Over the next six months, with refresher training for PHCW in the screening arm and the introduction of monthly supportive supervision for PHCW in both arms, detection rates increased from 4.6 to 7.6% at non-screening clinics and from 11 to 40% at the screening clinics. Over the entire study period only 81 (15.7%) out of the 517 cases of perinatal depression were detected by the PHCWs. Detection of depression by PHCWs was associated with the severity of depression symptoms and routine screening with PHQ-2. The introduction of routine screening was acceptable to both PHCWs and perinatal women. PHCWs reported that the PHQ-2 was useful, easy to administer and feasible for routine use., Conclusions: Improving detection and subsequently the treatment gap for perinatal depression require not just training of frontline healthcare workers but the introduction of additional measures such as universal screening along with supportive supervision., Trial Registration Number: The main study from which the data for this report was extracted was retrospectively registered 03 December 2019., Registration Number: ISRCTN 94,230,307., Competing Interests: Declarations. Ethics approval and consent to participate: Written informed consent was obtained from all participants. All procedures involving human subjects/patients for the SPECTRA study were approved by the University of Ibadan and University College Hospital Ethics Committee (approval number- UI/EC/16/0003). Additional ethics approval was obtained to use the data emanating from the SPECTRA study for a doctorate degree. The protocol: Integrating care for perinatal depression in primary care: an implementation study (adapted from the SPECTRA study protocol) was approved by the University of Stellenbosch Health Research Ethics Committee HREC Reference No: S21/04/074 (PhD). Consent for publication: Not applicable. Competing interests: The authors declare no competing interests., (© 2025. The Author(s).)

Objectives: This study examines the relationship between adolescent mothers' mental health problems (postnatal depression and generalised anxiety) and adherence to COVID-19 public health prevention strategies in rural Malawi. It is part of a larger previously published study investigating the impact of social and cultural factors on the mental health in adolescent mothers., Design: A cross-sectional study was conducted from September 2021 to March 2022. The Edinburgh Postnatal Depression Scale (EPDS) and the Generalised Anxiety Disorder-7 (GAD-7) were used to identify the risk of postnatal depression (PND) and generalised anxiety disorder (GAD), respectively. Participants also responded to questions about their perception of COVID-19 and how they practiced the recommended COVID-19 prevention strategies., Setting: The study was conducted at a rural hospital in Lilongwe, Malawi., Participants: Adolescent postnatal mothers aged 19 years and below, with children aged less than 1 year, who understood the study and could consent., Results: Adolescent mothers (n=395) completed the researcher-administered survey. The mean age was±17 (SD 1.157). Most participants had recently given birth to their first child (91%, n=358). Almost half (45%, n=113) of participants agreed with the COVID-19 prevention strategies recommended by the Malawian government. However, overall adherence to public health COVID-19 prevention strategies, including hand hygiene practices, was low among adolescent mothers. Participants with probable GAD and probable PND were more likely to practice COVID-19 prevention strategies than participants with low GAD-7 or EPDS scores, except for restrictions on religious gatherings., Conclusions: Adolescent perception of the potential threats or risks of COVID-19 was low. However, adolescents with probable PND and probable GAD reported higher adherence to some COVID-19 prevention strategies than adolescents without PND and GAD. The findings support the need for policies that integrate mental health within the public health response due to the potential direct and indirect effects the pandemic might have on perinatal mothers' mental health. Additionally, recommended pandemic responses should be appropriate and relevant to the social environment., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2025. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ Group.)

Background: Postpartum depression (PPD) is categorized by the Disorders-Fifth Edition as depression that begins during pregnancy or within the first month after giving birth. Ketamine and esketamine have shown promising results in the treatment of several depressive disorders, which suggests that they may have a role in the prevention of PPD. This systematic review and meta-analysis aim to update evidence about the efficacy and safety of using ketamine and esketamine to reduce PPD incidence., Methods: We searched four databases, PubMed, Scopus, Web of Science, and Cochrane, to collect relevant studies. We included studies which investigated the preventive effect of ketamine or esketamine on PPD among women after giving birth through caesarean or vaginal delivery. We extracted PPD occurrence rate, PPD score, pain score and side effects. Finally, a meta-analysis was conducted using RevMan software., Results: Twenty-one eligible studies were incorporated in the current systematic review and meta-analysis involving 4,389 pregnant women. Esketamine was the intervention in 14 studies, and ketamine was used in 7 studies. In subgroup analysis, both ketamine and esketamine were significantly effective in reducing the incidence of short-term PPD (ketamine: RR = 0.72, 95% CI [0.56, 0.93], P = 0.01; esketamine: RR = 0.43, P < 0.0001). Esketamine only significantly reduced the incidence of long-term PPD (RR = 0.44, P < 0.00001). Low doses and high doses were effective in reducing the incidence of both short-term (high dose: RR = 0.48, P = 0.0005; low dose: RR = 0.46, P = 0.002) and long-term PPD (high dose: RR = 0.54, P < 0.0001; low dose: RR = 0.61, P = 0.009). Regarding the risk of side effects, patients in the Ketamine/esketamine group showed statistically significant higher rates of developing dizziness (P = 0.0007), blurred vision (P = 0.02), vomiting (P = 0.004) and hallucinations (P = 0,002) than women in the control group., Conclusion: Both ketamine and esketamine are effective in lowering the incidence of short-term PPD. On the other hand, only esketamine is effective in reducing the incidence of long-term PPD. It is recommended to use smaller doses for a more tolerable treatment period since doses less than 0.5 mg are significantly effective. Temporary side effects such as dizziness, blurred vision, vomiting and hallucinations were reported., Competing Interests: Declarations. Ethics approval and consent to participate: Not applicable. Consent for publication: Not applicable. Competing interests: The authors declare no competing interests., (© 2025. The Author(s).)

Background: Postpartum maternal depression and socioeconomic factors are established risk factors for the mental health of offspring. It has been consistently unclear as to whether female or male offspring are more vulnerable to the effects of postpartum maternal depression at different stages of the child's life course. To determine whether the characteristics of postpartum maternal depression with a history of prenatal depression influence sex differences in offspring internalizing symptoms across childhood and adolescence, socioeconomic factors should be considered., Methods: We systematically searched PubMed, Embase, PsycINFO, CNKI, and SinoMed databases from inception to November 28, 2023, and selected longitudinal cohort studies that quantified sex differences in internalizing symptoms of children and adolescents. Pooled standardized mean differences (SMDs) were calculated using random-effects models. ROBINS-E tool was used to rate the quality of evidence., Results: Twenty-eight studies were eligible between 1997 and 2023, including 24,022 mother-child dyads. Sex-difference trajectories of offspring internalizing symptoms were identified after exposure to postpartum maternal depression, ranging from a lack of significant sex differences in childhood to a higher prevalence observed among girls than boys in adolescence (SMD, 0.25, 95% CI, 0.13-0.38). Economic income and maternal education affected the associations between the magnitude and concurrent recurrence of postpartum depression and significant sex differences in adolescent internalizing symptoms, respectively. After adjusting for socioeconomic factors, early nonconcurrent recurrence of postpartum depression was associated with greater odds of internalizing symptoms among adolescent girls than among boys (β = 0.03, 95% CI, 0.01-0.06); however, there was no statistical significance after adjusting for prenatal depression., Conclusions: Socioeconomic factors differentially impacted the association between postpartum maternal depression and significant sex differences in adolescent internalizing symptoms. Independent of socioeconomic factors and prenatal depression, postpartum maternal depression was not associated with significant sex differences in adolescent internalizing symptoms. Therefore, the significant sex effects of postpartum maternal depression are more likely due to complex interactions between maternal depression and the intrauterine and postpartum environments that shape offspring sex-difference trajectories, with consequences occurring for later internalizing symptoms in adolescence., Trial Registration: PROSPERO, CRD42022301445., Competing Interests: Declarations. Ethics approval and consent to participate: Not applicable. Consent for publication: Not applicable. Competing interests: The authors declare no competing interests., (© 2025. The Author(s).)

Importance: Esketamine has been found to reduce the incidence of postpartum depression (PPD) in randomized clinical trials. However, current evidence from randomized clinical trials does not reflect esketamine's efficacy in clinical settings., Objective: To assess the clinical efficacy of intraoperative esketamine administration for preventing PPD among women who underwent cesarean delivery., Design, Setting, and Participants: This randomized clinical trial was conducted at The First Affiliated Hospital of Chongqing Medical University in Chongqing, China, from March 2023 to February 2024. Pregnant patients admitted for cesarean delivery were included, while those with intellectual dysfunction or contraindications to esketamine were excluded. All participants were assigned randomly to either the esketamine group or control group in a 1:1 ratio. Data analysis was based on the intention-to-treat principle., Interventions: Patients in the esketamine group received an infusion of 0.25 mg/kg esketamine in 20 mL of saline over 20 minutes, whereas patients in the control group received 20 mL saline over 20 minutes., Main Outcomes and Measures: The primary outcome was the incidence of PPD at 6 weeks post partum. PPD was assessed using the Edinburgh Postnatal Depression Scale., Results: A total of 308 pregnant women were randomly assigned to 1 of 2 groups: esketamine (n = 154; mean [SD] patient age, 31.57 [4.26] years) and control (n = 154; mean [SD] patient age, 32.53 [7.74] years). Incidence of PPD was significantly lower in the esketamine group compared with the control group at 6 weeks post partum (10.4% [16] vs 19.5% [30]; relative risk, 0.53; 95% CI, 0.30-0.93; P = .02)., Conclusions and Relevance: This randomized clinical trial demonstrated esketamine's advantage in reducing the incidence of PPD at 6 weeks post partum in patients who underwent cesarean delivery. The efficacy and safety of esketamine in preventing PPD warrant further investigation in clinical practice., Trial Registration: Chinese Clinical Trial Registry Identifier: ChiCTR2200065494.

Many studies have explored the relationships between demographic variables and postpartum major depressive disorder. However, there is no clear conclusion on the impact of different marital statuses and quality on postpartum major depressive disorder. This systematic review and meta-analysis examined the combined effects of different marital status and quality on postpartum major depressive disorder with cohort studies. Two authors independently searched 6 English databases (PubMed, Medline, Web of Science, PsycARTICLES, EBSCOhost and Scopus) and 3 Chinese databases (China Knowledge Resource Integrated Database (CNKI), Weipu database and Wanfang database) from the beginning of database construction to October 25, 2024. Studies that met the inclusion criteria included maternal diagnosis of postpartum major depressive disorder by clinical diagnostic criteria, inclusion of marital status, and reporting risk estimate. There were no language limitations in this study. The quality of the included studies was assessed using the Newcastle-Ottawa scale (NOS). Publication bias was assessed using a funnel plot and Egger's test. Finally, nineteen cohort studies were included in this meta-analysis. Low marital satisfaction was the most significant predictor of postpartum major depressive disorder (pooled RR = 3.47, 95% CI: 1.96, 6.12) followed by being single/divorced/separated/widowed/unmarried (pooled RR = 1.19, 95% CI: 1.02, 1.39). However, there was not a significant relationship between "worsening relationship/dissatisfaction with partner/problems in marital relationship" and postpartum major depressive disorder (pooled RR = 2.30, 95% CI:0.69, 7.62) yet. Marital status and marriage quality impacted heavily on maternal postpartum major depressive disorder. There is an urgent need to focus on family therapy and marital intervention for pregnant women and to enhance the sense of involvement of the husband or partner., Competing Interests: Declaration of competing interest There is no conflict of interest or competition between authors., (Copyright © 2025 Elsevier Ltd. All rights reserved.)

Objective: Development of postpartum depressive symptoms (PDS) is influenced by many social determinants of health, including income, discrimination, and other stressful life experiences. Early recognition of PDS is essential to reduce its long-term impact on mothers and their children, but postpartum checkups are highly underutilized. This study examined how stressful life experiences and race-based discrimination influence PDS development and whether or not a women has a postpartum checkup., Methods: Pregnancy Risk Assessment Monitoring System (2016-2022) was used for secondary data analysis of mothers from 9 sites (n = 8,851). Stressful life experiences prior to birth, race-based discrimination, PDS, and postpartum checkup data were collected using the PRAMS questionnaire. Covariates were collected using primarily birth certificate data., Results: Women of multiple races and ethnicities were significantly more likely to experience PDS if they reported a greater number of stressful life experiences. Women of multiple races and ethnicities were more likely to experience PDS if they reported experiencing race-based discrimination, with Asian women having nearly 8 times greater odds. Black and Hispanic women were less likely to have a postpartum checkup if they reported a greater number of stressors. Black women were less likely to have a postpartum checkup if they had previously experienced race-based discrimination., Conclusion: The influence of race-based discrimination was seen across a diverse group of races and ethnicities. Findings highlight the need to expand questionnaires focused on social determinants of health, specifically discrimination, in PRAMS to all 50 states to better assess their significant consequences for maternal wellbeing., Competing Interests: Declarations. Ethics Approval: Not applicable. Consent to Participate: Not applicable. Consent for Publication: Not applicable. Conflict of Interest: Authors have no conflicts of interest to disclose., (© 2025. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

Purpose: Postpartum mood disorders affect many women following childbirth. Prescribing medication for depression and anxiety is one strategy for the effective treatment of postpartum mood disorders. Left untreated, mothers experiencing these disorders and their infants face increased risks of adverse health outcomes. Little is known about how diagnosis and treatment of postpartum mood disorders changed during COVID-19., Methods: We used a retrospective pooled cross-sectional design in a sample of privately-insured postpartum women in U.S. claims data from January 1, 2016 to December 31, 2020. We measured changes in diagnoses of anxiety and depression and changes in prescription fills and days supplied of classes of medications used to treat these conditions (antidepressants, benzodiazepines, and z-drugs). We used ordinary least squares (OLS) regression for each outcome variable during the pre-pandemic period and forecast expected outcomes the observation period. Forecasted and actual values of the outcomes were then compared., Results: Following the onset of the COVID-19 pandemic in March 2020, diagnoses of depression and anxiety were not significantly higher among privately insured postpartum women in the United States. The proportion of privately-insured postpartum women filling a benzodiazepine prescription increased by 15.2%., Conclusions: We find diagnosis of postpartum mood disorders did not increase after the onset of the COVID-19 pandemic, however, fills of benzodiazepines increased among privately-insured postpartum women. Given prior evidence of increased depressive and anxiety symptoms among postpartum women during COVID-19, this suggests increased barriers to appropriate diagnoses and treatment for depression during this period., Competing Interests: Declarations. Competing interest: The authors have no competing interests to declare., (© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Austria, part of Springer Nature.)

Aims: This systematic review aims to summarize the findings of empirical studies conducted in low- and middle-income countries (LMICs) examining the relationship between postpartum depression and anxiety, and child developmental outcomes measured at 24 months of child's age., Methods: The study was performed as per PRISMA guidelines for a systematic review. EBESCO, ProQuest, PubMed, Science Direct, Google Scholar, and BMJ databases were examined, along with a forward and backward examination of the citations published. The New Ottawa scales (NOS) was used to assess the quality of the studies. The findings of the studies were integrated using a narrative synthesis approach., Results: The systematic review revealed that there are 14 studies examining the impact of postpartum depression (n=14) and postpartum anxiety (n=2) across different domains of child development in LMICs. Studies varied regarding the severity and duration of maternal depression, the context and nature of evaluation, and motherinfant characteristics which are important to understand the association between postpartum depression and anxiety and infant development. Maternal depression is negatively associated with language development, socio-emotional and behavioural development while its association with motor and cognitive development is inconsistent. The impact of maternal anxiety on infant development was examined in two studies, and both have identified a negative association. However, the results of the current review need to be interpreted within the scope and limitations of the methodologies adopted by each study details of which are elaborated in the manuscript., Conclusion: Postpartum depression and anxiety can have a wide range of effects on child development. Therefore, periodic infant developmental assessments should become part of routine psychiatric evaluation. There is a need for uniform guidelines for conducting studies and reporting data related to postpartum mental health and child development., Competing Interests: Declaration. The authors received no financial support for this article's research, authorship, and/or publication. Competing interests: The authors have no competing interests to declare., (© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Austria, part of Springer Nature.)

Objectives: Postpartum depression (PPD) is widely acknowledged as a significant mental health problem for postpartum women, and several factors have been associated with PPD. This study aimed to assess the prevalence of PPD and explore the factors and relationships associated with PPD symptoms in postpartum women using path analysis. Furthermore, a new framework for PPD modeling for postpartum women was introduced., Methods: A cross-sectional survey of 406 women at 42 days postpartum was conducted to collect the basic postpartum conditions and the factors associated with PPD. Linear regression was used to identify factors associated with PPD, and path analysis was used to explore the relationship between PPD and related factors., Results: The incidence of PPD symptoms was 18.5% (75/406). Multiple linear regression analysis showed that the independent risk factors associated with PPD symptoms in postpartum women included maternal postpartum stress, postpartum anxiety, social support, marital satisfaction, sleep quality, and maternal postnatal attachment (P < 0.05). The constructed path analysis model had good a fit (χ2/DF = 1.779, CFI = 0.998, GFI = 0.997, AGFI = 0.965, NFI = 0.995, IFI = 0.998, and RMSEA = 0.044). The path analysis revealed that postpartum anxiety exhibited only a direct effect on PPD (effect value: 0.243). Sleep quality was the factor that most affected PPD symptoms, followed by maternal postnatal attachment, postpartum stress, social support, postpartum anxiety, and marital satisfaction., Discussion: Our findings show that interventions targeting enhanced maternal postnatal attachment, improved sleep quality, strengthened social support, better marital relationships, as well as reduced postpartum stress and anxiety, can effectively alleviate PPD symptoms. The direct and indirect effects of these factors on PPD highlight its complexity and the significance of a multifaceted prevention and treatment approach. Our study deepens the understanding of the intricate relationships between psychosocial factors and PPD, providing insights for potential intervention targets., Competing Interests: Declaration of competing interest No potential conflicts of interest relevant to this article were reported., (Copyright © 2025 Elsevier Ltd. All rights reserved.)

The understanding of long-term depression and anxiety trajectories across the perinatal periods is lacking. This longitudinal study investigated the change trajectories of both depressive and anxiety symptoms, as well as the associations of their trajectories over five years. The study included nulliparous participants (N = 163, M age  = 33.47, SD age  = 3.53) with self-reported depressive and anxiety symptoms collected via questionnaires at 30- and 35 weeks' gestation, 1.5, 3, 6, 12, 24, and 60 months postpartum. Data were analysed using structural equation latent growth modelling with and without covariates. Symptoms of depression increased significantly during pregnancy (p < .001), and both depression and anxiety symptoms increased during postpartum (p-values<.001). A previous mental health history was significantly associated with greater depressive symptomology (p = .001), and White individuals (compared to non-White) tended to have greater depression and anxiety symptoms during pregnancy (p-values<.05). At 30- and 35-weeks' gestation, 6 weeks postpartum, 3, 6, 12, 24 months, and 5 years postpartum 2.5 %, 2.0 %, 4.6 %, 4.0 %, 7.3 %, 5.6 %, 3.5 % and 8.0 % of participants had clinically significant depressive symptoms and 6.1 %, 8.5 %, 7.1 %, 12.0 %, 11.9 %, 8.1 %, 7.9 %, and 28 % had clinically significant anxiety symptoms. This study highlights the need to assess both depression and anxiety in perinatal care, and to identify individuals who may require intervention., Competing Interests: Declaration of competing interest None., (Copyright © 2024 The Authors. Published by Elsevier B.V. All rights reserved.)

In Pakistan, a setting with high gender inequality, the relationship between female agency and mental health has not been studied longitudinally or beyond a defined life stage like pregnancy. Using data from the Bachpan cohort of mother-infant dyads in Pakistan, we investigated female agency and depression at two life stages: perinatal (third trimester to 6-months postpartum; n = 1154) and beyond (3- to 4-years postpartum). Modified Poisson models estimated adjusted prevalence ratios (PR) for probable depression (PHQ-9) associated with female agency (freedom of movement and participation in household decision-making) at the two life stages. Among 1154 mothers (average age 26.6 years), female agency was substantially lower during pregnancy than it was at 3-years and depression was more common during postpartum than at 4-years. Low freedom of movement during pregnancy nominally increased the likelihood of postpartum depression (PR: 1.33; 95% CI: 0.98, 1.80). The risk of depression was higher for low- (PR: 1.01; 95% CI: 0.72-1.41) and high- (PR: 1.24; 95% CI: 0.65-2.36) participation in household decision-making compared to moderate, but estimates were imprecise. Results from beyond the perinatal period indicated a stronger relationship between low freedom of movement and subsequent depression (PR: 1.89; 95% CI: 1.12, 3.20; Table 3). Low- (PR: 1.19; 95% CI: 0.67-2.12) and high- (PR: 1.21; 95% CI: 0.67-2.17) decision-making continued to demonstrate a nominal U-shaped relationship with depression, but estimates were imprecise. Overall, restricted freedom of movement beyond the perinatal period, may increase the likelihood of depression. Future research should explore the nuances of participation in decision-making and how it impacts women's mental health., (Copyright © 2025 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Background: Maternal postpartum depression is an important risk factor for internalizing and externalizing problems in children. The role of concurrent paternal depression remains unclear, especially by socioeconomic status. This study examined independent and interactive associations of postpartum maternal and paternal depression with children's internalizing/externalizing symptoms throughout childhood and adolescence (ages 3.5-17 years)., Methods: We used data from the Québec Longitudinal Study of Child Development, a representative birth cohort (1997-1998) in Canada. Data included self-reported maternal and paternal depressive symptoms at 5 months' postpartum using the Center for Epidemiologic Studies Depression Scale. Internalizing and externalizing symptoms in children were reported by parents, teachers and children/adolescents using the Social Behaviour Questionnaire (ages 3.5-13 years) and the Mental Health and Social Inadaptation Assessment for Adolescents (ages 15-17 years). We used three-level mixed effects modelling to test associations after adjusting for confounding factors., Results: With 168 single-parent families excluded, our sample consisted of 1,700 families with useable data. Of these, 275 (16.2%) families reported maternal depression (clinically elevated symptoms), 135 (7.9%) paternal depression and 39 (2.3%) both. In families with high socioeconomic status, maternal depression was associated with greater child internalizing (β = .34; p < .001) and externalizing symptoms (β = .22; p = .002), regardless of the presence/absence of paternal depression. In families with low socioeconomic status, associations with symptoms were stronger with concurrent paternal depression (internalizing, β = .84, p < .001; externalizing, β = .71, p = .003) than without (internalizing, β = .30, p < .001; externalizing, β = .24, p = .002)., Conclusions: Maternal depression increases the risk for children's internalizing/externalizing problems in all socioeconomic contexts. In families with low socioeconomic status, risks were exacerbated by concurrent paternal depression. Postpartum depression, especially in low socioeconomic environments, should be a primary focus to optimize mental health across generations., (© 2024 The Author(s). Journal of Child Psychology and Psychiatry published by John Wiley & Sons Ltd on behalf of Association for Child and Adolescent Mental Health.)

Background: To determine the impact of the COVID-19 pandemic on prenatal and postpartum depressive symptoms in rural versus urban populations., Methods: A retrospective cohort study was conducted among 24,227 cisgender women who gave birth from 2010 to 2021 at an academic medical center located in a rural midwestern state. Exclusion criteria were <18 years old, incarcerated, or without a documented zip code. The Patient Health Questionnaire-9 (PHQ-9) was administered during pregnancy and the Edinburgh Postnatal Depression Scale (EPDS) during postpartum. A sub-cohort also completed a COVID-related questionnaire. Rurality was defined as living in a county with <50,000 people. The COVID-19 era was defined as 1/1/2020 to 9/25/2021. Chi-square and Fisher exact tests were used as appropriate. Significance was set at α < 0.05., Results: Rural participants were more likely (p ≤ 0.001) to exhibit clinical depression symptoms before the pandemic in both the prenatal (8.63 % of rural participants vs. 6.49 % of urban participants) and postpartum periods (11.19 % rural vs. 9.28 % urban). During the pandemic, urban participants had increased postpartum depression. Rural participants endorsed more financial and labor concerns, whereas urban participants expressed support system concerns., Limitations: Study data were gathered from participants who gave birth at a single, midwestern hospital. Results may not be widely generalizable given the homogeneity of participants., Conclusions: Rural women experienced higher rates of prenatal and postpartum depressive symptoms compared to their urban counterparts. The COVID-19 pandemic was a significant stressor, revealing specific mental health vulnerabilities among birthing people., Competing Interests: Declaration of competing interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: Donna Santillan reports financial support was provided by National Institutes of Health. Stephen K. Hunter reports financial support was provided by Health Resources and Services Administration. Stephen K. Hunter reports financial support was provided by Iowa Department of Health and Human Services. Mark K. Santillan reports financial support was provided by National Institutes of Health. If there are other authors, they declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier B.V. All rights reserved.)

Objectives: To determine the association between mothers' persistent maternal depression and their toddlers' behavior., Methods: Online surveys were conducted twice with mothers who gave birth to their first child between March and June 2020. The survey periods were November 2020 and May-June 2022. Measures included baseline characteristics and family environment factors, maternal postpartum depression (Edinburgh Postnatal Depression Scale [EPDS]), maternal lifestyle and mother-reported toddler behaviors, and Internet/media use. Statistical analysis was performed using the χ² test, trend test, and logistic regression., Results: Of the 339 participants, 82 (24.1%) were in the "persistent maternal depression" group with high EPDS scores (≥ 9 points) at both time points, and 178 (52.5%) were in the "no maternal depression" group with low EPDS scores (< 9 points) at both time points. Persistent maternal depression was associated with sleep, eating behavior, physical activity, parenting emotions, and abusive behavior of mothers. Furthermore, persistent maternal depression may be related to undesirable toddler behaviors such as smartphone overuse and hyperactivity-like symptoms., Conclusions for Practice: The persistence of postpartum depression is influenced by factors such as mothers' parenting emotions. Preventing and supporting maternal depression in mothers can foster favorable behaviors in toddlers. In Japan, enhanced individualized, ongoing support for postpartum mothers, tailored in duration and form, could promote both maternal well-being and positive parenting practices., Competing Interests: Declarations. Ethics Approval and Consent to Participate: This study was approved by the Bioethics Review Committee of the Nagoya University Graduate School of Medicine (Approval No. 2020 − 0306, 21–134). Informed consent was obtained from respondents before their participation in the study. Consent for Publication: Not applicable. Conflict of Interest: The authors declare that they have no conflicts of interest., (© 2025. The Author(s).)

Purpose: This study tests the hypotheses that lifetime history of depression, and prenatal depression, are associated with a reduced likelihood of breastfeeding initiation (giving the baby any breastmilk during the first week of life) and breastfeeding maintenance (giving the baby breastmilk for at least 6 months), and a greater likelihood of reporting breastfeeding problems., Methods: We analyzed data from the Norwegian Mother, Father, and Child cohort study (MoBa), N = 78,307. Mothers reported a lifetime history of depression during the second trimester of pregnancy, and current symptoms of depression during the third trimester using the Hopkins Symptoms Checklist short version (SCL-8). At six months postpartum, mothers self-reported breastfeeding initiation, maintenance, and difficulties., Results: Using binary logistic regression analyses, we report that a lifetime history of depression is associated with a lower likelihood of breastfeeding initiation (OR = 0.751, 95%CI = 0.650-0.938), breastfeeding maintenance (OR = 0.712, 95%CI = 0.669-0.785), and a greater likelihood of breastfeeding difficulties (OR = 1.86, 95%CI = 1.72-2.06). Similarly, prenatal depression was associated with a lower likelihood of breastfeeding initiation (OR = 0.904, 95%CI = 0.878-0.929), breastfeeding maintenance (OR = 0.929, 95%CI = 0.920-0.938), and a greater likelihood of breastfeeding difficulties (OR = 1.10, 95%CI = 1.09-1.12). Results remained largely unchanged when covaried for several confounding variables, including medication use., Conclusion: We provide novel evidence that pre-conception and prenatal symptoms of depression are associated with breastfeeding outcomes. This information could be used to identify women very early in pregnancy who may need additional support with breastfeeding. There is also a need to fully understand the biopsychosocial mechanisms that mediate the relationship between depression prior to birth and breastfeeding outcomes., Competing Interests: Declarations. Competing interests: All authors declare they have no financial interests to declare., (© 2024. The Author(s).)

Background: Mental health conditions are among the most frequent underlying causes of pregnancy-related death, and antidepressants may have a positive impact. However, adherence is suboptimal, and little is known regarding antidepressant adherence trajectories among postpartum women in the United States., Objective: To describe antidepressant use among postpartum women with Texas Medicaid and determine factors associated with adherence trajectories., Methods: This retrospective analysis of Texas Medicaid claims (January 1, 2018, to June 30, 2022) included women aged 12 to 55 years with at least 1 delivery, who were continuously enrolled 84 days before and 12 months after delivery, and who received an antidepressant within 90 days after delivery. The index date was the first dispensing of an antidepressant after delivery. The dependent variable was antidepressant adherence, defined as the proportion of days covered (PDC) and measured in 30-day increments for 270 days after antidepressant initiation. The independent variables were guided by the Andersen Behavioral Model and included predisposing (age and race and ethnicity), enabling (urbanicity, prenatal care, and postpartum care), and need (baseline depression/anxiety, baseline substance use disorder [SUD], cesarean delivery, preterm birth, and pregnancy complications) factors. Group-based trajectory modeling (GBTM) was used to identify antidepressant adherence trajectory groups. Multinomial logistic regression was used to identify factors associated with adherence trajectory group membership., Results: The included patients (N = 15,667) had a mean ± SD age of 27.4 ± 5.9 years, and 41.7% were White. Most resided in urban counties (78.0%) and had 6.4 ± 3.5 prenatal visits, 3.1 ± 2.8 postpartum visits, and 1.4 ± 0.9 pregnancy complications. Nearly half (49.8%) had baseline depression/anxiety, 17.2% had baseline SUD, 37.4% had cesarean delivery, and 13.9% had preterm birth. At 270 days after antidepressant initiation, mean ± SD adherence was 43.9 ± 29.5, and the adherence rate (PDC ≥ 80) was 15.9%. During the 270 days follow-up, mean ± SD persistence without a 30-day gap was 103 ± 85.2 days, and the persistence rate (proportion persisting 180 days without a 30-day gap) was 22.1%. GBTM revealed 5 membership groups: consistent high (19.0%), fluctuating (22.5%), slowly decreasing (13.3%), and rapidly decreasing (21.8%) adherence and early and consistent nonadherence (23.4%). Patterns emerged with decreasing adherence at 2, 3, and 6 months after initiation. Increasing age, non-Black race, urban residence, increasing postpartum care visits, and baseline depression/anxiety were associated with the consistent high-adherence trajectory compared with most lower-adherence trajectories. However, baseline SUD and preterm birth were associated with membership in the less-adherent compared with the consistently adherent trajectory., Conclusions: Overall adherence and persistence were suboptimal, and GBTM revealed unique patterns of postpartum antidepressant adherence behaviors. To help impact maternal morbidity and mortality, adherence interventions should be tailored to women who are younger, Black, live in rural counties, have SUD, or had a preterm birth.

Purpose: While neuropsychological deficits are commonly observed in affective and psychotic disorders, this remains unexplored in these disorders when they occur during pregnancy and the postpartum period., Methods: A neuropsychological test battery was administered to women defined at risk of postpartum depression (PD, N = 53) because having either a current or past diagnosis of major depressive disorder, women at risk of postpartum psychosis (PP, N = 43) because of a diagnosis of bipolar disorder or schizoaffective disorder and/or a previous episode of PP and women not at risk (NR, N = 48) in the third trimester of pregnancy. Generalized and specific cognitive abilities were compared between groups., Results: Women at risk of PP presented worse executive functions and processing speed compared to NR and worse performance compared to women at risk of PD across all cognitive domains. In addition, women at risk of PP who developed a psychiatric relapse in the first four weeks post-partum showed worse verbal learning and memory, visual memory, executive functions and processing speed in pregnancy compared to NR, whereas women at risk of PP who remained well presented neuropsychological performance that was intermediate between that of the women NR and those at risk of PP who developed symptoms. There were no differences in performance between women at risk of PD and the NR women, even if 31 women at risk of PD presented depressive symptoms at the time of cognitive assessment., Conclusions: Our findings in women at risk of PP align with neuropsychological findings in individuals with, or at risk of psychosis unrelated to pregnancy. In addition, initial evidence that women at risk of PP who develop a psychiatric relapse in the postpartum show a particularly poor neuropsychological performance in pregnancy suggests that this could be considered part of a phenotype for the disease and help guiding future preventive strategies in this clinical population. In women at risk of PD, the presence of depressive symptoms did not influence cognitive performance., Competing Interests: Declarations. Conflict of interest: The authors report no competing interests., (© 2024. The Author(s).)

Background: Pregnancy-related anatomic, physiologic, and hormonal factors can occur at different stages of pregnancy and affect sleep disturbances. The relationship between sleep problems during pregnancy and postpartum depressive symptoms as well as neonatal condition at delivery have not been well described. This study hypothesized that sleep problems are associated with postpartum depressive symptoms and adverse neonatal outcomes at delivery., Methods: This study conducted a prospective study for perinatal women (n = 683, 30.54 ± 5.11 years old) to evaluate sleep problems during pregnancy using the Pittsburgh sleep quality index (PSQI) and Berlin questionnaire, postpartum depressive symptoms using Edinburgh postnatal depression scale (EPDS), and clinical signs of neonatal condition at delivery using the Apgar score., Results: PSQI total score during pregnancy were significantly higher in those with postpartum depressive symptoms than those without 1 month after delivery. PSQI score in the third trimester was significantly associated with postpartum depressive symptoms even after adjustment for relevant confounding factors and self-reported lifetime depression (odds ratio = 1.19, 95% confidence interval = 1.03-1.36, p = 0.015). The Apgar score at 5 min after birth was significantly lower in those with obstructive sleep apnea (OSA) than those without OSA in the second and third trimesters, although mean scores were within the normal range., Conclusion: This study revealed that sleep problems during pregnancy influence postpartum depression 1 month after delivery. OSA during pregnancy may lead to risks of delivery. Attention should be paid to sleep health during pregnancy to ensure the mental health of mothers and a safe delivery., (© 2025 The Author(s). Journal of Obstetrics and Gynaecology Research published by John Wiley & Sons Australia, Ltd on behalf of Japan Society of Obstetrics and Gynecology.)

Background: Cultural variations in pregnancy and childbirth experiences can influence the causes and contributing factors of postpartum depression (PPD). However, research on this issue remains scarce in Arab countries, especially in Lebanon. This study aimed to assess the prevalence of PPD and explore socio-contextual factors affecting it in Lebanon during the COVID-19 pandemic. It also sought to validate the psychometric reliability of the Arabic version of the Edinburgh Postnatal Depression Scale (EPDS) among Lebanese women., Methods: A cross-sectional study was conducted between May 2022 and July 2022, with 402 Lebanese adult postpartum women (mean age 31.46 ± 4.88 years) enrolled from the maternity ward at CHU-Notre Dame des Secours Hospital in Byblos, Lebanon by responding to an online survey after obtaining informed concent. Along with the EPDS, the following measures were administered to participants: The Multidimensional Scale of Perceived Social Support, the Fear of COVID-19 Scale, and the Lebanese Anxiety Scale-10., Results: Our findings demonstrated appropriate psychometric properties of the Arabic one-factor, 10-item EPDS in our sample of Lebanese women. The scale yielded good composite reliability (ω = 0.97), and appropriate patterns of correlations with anxiety and social support measures, thus attesting for its convergent validity. A total of 239 women (59.5%) had potential postpartum depression. Multivariate analysis showed that perceived childbirth experience (as "normal" (Beta= -2.57), "good" (Beta= -3.45) and "very good" (Beta= -4.14)), with worries that the newborn will get hurt/die during labor ("rarely" (Beta = 1.43) and "never" (Beta = 1.24)), a lower financial burden (Beta = - 0.19) and a higher social support (Beta = - 0.02) were significantly associated with lower rates of PPD; while higher levels of anxiety (Beta = 0.32) were associated with increased symptoms of PPD., Conclusion: The study highlights the significant burden of PPD among Lebanese women, with an alarmingly high prevalence. Key factors associated with PPD-such as anxiety, childbirth experience, and social support-are largely preventable and modifiable. Nonetheless, there is an imperative need for future longitudinal and qualitative research, to better understand obstetrical experiences, address PPD and confirm causality of the associations found., Competing Interests: Declarations. Ethics approval and consent to participate: Ethics approval for this study was obtained from the CHU-Notre Dame des Secours Institutional Review Board after careful review of the study proposal on February 22, 2022. (CR: 1/2022). A digital informed consent was obtained from all subjects and/or their legal guardians for study participation and was considered equivalent to receiving a written informed consent. All methods were performed in accordance with the relevant guidelines and regulations. Consent for publication: Not applicable. Competing interests: The authors declare no competing interests., (© 2025. The Author(s).)

Background: Globally, adolescent mothers are at increased risk for postpartum depression (PPD). In Kenya, 15% of adolescent girls become mothers before the age of 18. While social support can buffer a mother's risk of PPD, there are gaps in knowledge as to whether-and which types-of social support are protective for adolescent mothers in Kenya. Understanding the associations between support and postpartum depression symptoms among adolescent mothers can inform mental health interventions., Methods: Cross-sectional data of adolescent mothers ≤ 1 year postpartum (aged 14-19 years old) in an informal settlement in Nairobi, Kenya (N = 193) were used in analyses. Participants with scores ≥ 10 on the Patient Health Questionnaire-9 were classified as having postpartum depressive symptoms. To fully examine the different ways that social support might matter for adolescent mothers, we examined several domains of social support: child's father support during pregnancy, parental support during pregnancy, parental support of girl's education, membership in a social club, having a good female friend and having a supportive female adult one can turn to for help. We used bivariate and adjusted modified Poisson regression with robust standard errors to examine the associations between support measures and depressive symptoms, controlling for relevant covariates., Results: One-quarter of participants experienced postpartum depressive symptoms (24.9%). Adolescent mothers who reported their mothers or their fathers as being very supportive of girls' education had a lower risk of depressive symptoms (ARR 0.35, 95% CI 0.20-0.61; ARR:0.34, 95% CI 0.13-0.90, respectively) than those whose mothers or fathers were less supportive. Adolescent mothers who had a good female friend to confide in had decreased risk of depressive symptoms (ARR 0.61; 95% CI 0.37-0.99)., Conclusions: Having a mother or father being very supportive of girls' education and having a good female friend reduced risk of depressive symptoms. With the unique challenges of early childbearing and high adolescent birth rates in Kenya, interventions which increase parental and peer support during pregnancy and the postpartum period could improve adolescent mothers' mental health., Competing Interests: Declarations. Ethics approval and consent to participate: The Amref Health Africa Ethics and Scientific Review Committee (ESRC) approved the study (ESRC P1175-2022; September 19, 2022). The National Commission for Science, Technology and Innovation authorized the study (License No: NACOSTI/P/222116). Written and verbal consent were obtained from parents of minors and adolescent mothers aged 18 and over. For adolescent mothers under 18 years of age, verbal and written assent were obtained. Prior to soliciting consent and/or assent, field assistants informed participants of their rights to privacy, confidentiality, respect, anonymity, and voluntary participation. Consent for publication: Not applicable. Competing interests: The authors declare no competing interests., (© 2025. The Author(s).)

Objectives: Postpartum depression (PPD) is a prevalent complication of childbearing, with numerous risk factors associated with its onset. Although the risk factors for PPD among postpartum women have been studied, the mechanisms underlying these factors remain inadequately understood. This study aimed to investigate the direct and mediating roles of different coping styles in the relationship between dyadic adjustment status and PPD among women 6 weeks postdelivery., Design: Single-centre, cross-sectional study., Setting: A tertiary care setting in Chengdu City, Sichuan Province, China, from July 2022 to January 2023., Participants: The study involved 626 women 6 weeks post-delivery., Outcome Measures: The Dyadic Adjustment Scale, the Simplified Coping Style Questionnaire and the Edinburgh Postnatal Depression Scale (EPDS) were used to evaluate the dyadic adjustment status, coping styles and the depressive condition of postpartum women, respectively. Data analysis encompassed correlation and mediation analyses based on structural equation modelling., Results: EPDS scores were significantly correlated with all four dimensions of dyadic adjustments status as well as with both positive and negative coping styles. Dyadic consensus ( β = -0.16, p=0.005), affectional expression ( β = -0.14, p=0.008) and dyadic cohesion ( β = -0.10, p=0.037) directly correlated with PPD after adjusting for covariates. For dyadic satisfaction, the mediating effects of positive and negative coping styles on PPD were -0.04 (95% CI: -0.08 to -0.01) and -0.07 (95% CI: -0.11 to -0.03), respectively. Moreover, both positive and negative coping styles were identified as mediators in the relationship between dyadic cohesion and PPD, with mediating effects of -0.01 (95% CI: -0.03 to -0.00) and -0.09 (95% CI: -0.14 to -0.04), respectively. No mediation was found in the association between affectional expression and PPD., Conclusion: Our findings suggest that both positive and negative coping styles mediate the relationship between dyadic adjustment status and PPD, especially concerning dyadic satisfaction and dyadic cohesion., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2025. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ Group.)

Background: Maternal short-term outcomes of postpartum depression (PPD) were widely examined, but little is known about its long-term association with multiple chronic diseases (multimorbidity) in women's later life. This study aims to assess the association of PPD with chronic diseases and multimorbidity in women's mid-late life., Methods: This prospective cohort study included female participants in UK Biobank who attended online follow-up assessment and reported their history of PPD. A total of 36 chronic diseases were assessed and multimorbidity was defined as the co-existence of two or more of these diseases. Participants were followed from the baseline recruitment to the onset of two or more chronic diseases, death, or the end of follow-up (2023). Logistic regression models, Cox proportional hazard models, quasi-Poisson mixed effects models, and linear mixed models were conducted to examine the association of PPD with chronic diseases and multimorbidity at baseline and during follow-up., Results: Among all 54,885 participants, 5106 (9.3%) participants experienced PPD, 13,928 (25.4%) participants had multimorbidity at baseline, and 14,135 (25.8%) participants developed two or more diseases during a median follow-up of 15 years. Women with a PPD history had higher odds of having multimorbidity at baseline (odds ratio = 1.35, 95% confidence interval [CI] = 1.27-1.44) and higher risk of developing multimorbidity during follow-up (hazard ratio = 1.13, 95% CI = 1.08-1.20). PPD was associated with increased number of chronic diseases, with the relatively new-onset number of diseases during follow-up being 8% higher for those with PPD (relative risk = 1.08, 95% CI = 1.05-1.12). Chronic diseases also accumulated at a faster annual rate for women with a history of PPD (b = 0.009, 95% CI = 0.007-0.011), compared to those without. We observed no interaction or mediation effects of physical activity, smoking, alcohol drinking, and dietary factors on the association between PPD and multimorbidity; however, women's body mass index at baseline contributed to the association, with the mediation proportion of 6.38% (2.56-10.20%)., Conclusions: PPD was associated with higher risks of chronic diseases and multimorbidity in women's mid-late life. This finding supports the importance of perinatal and postpartum mental health care, and its role in the prevention of chronic diseases and multimorbidity throughout women's life course., Competing Interests: Declarations. Ethics approval and consent to participate: The UK Biobank has ethical approval from the North West Multi-centre Research Ethics Committee (reference number 06/MRE08/65). All participants provided informed consent. Institutional review board approval was exempted for this study because of the publicly available and deidentified data. Competing interests: The authors declare no competing interests., (© 2025. The Author(s).)

Background: Postpartum depression (PPD) is a prevalent mental health issue with significant impacts on mothers and families. Exploring reliable predictors is crucial for the early and accurate prediction of PPD, which remains challenging., Objective: This study aimed to comprehensively collect variables from multiple aspects, develop and validate machine learning models to achieve precise prediction of PPD, and interpret the model to reveal clinical implications., Methods: This study recruited pregnant women who delivered at the West China Second University Hospital, Sichuan University. Various variables were collected from electronic medical record data and screened using least absolute shrinkage and selection operator penalty regression. Participants were divided into training (1358/2055, 66.1%) and validation (697/2055, 33.9%) sets by random sampling. Machine learning-based predictive models were developed in the training cohort. Models were validated in the validation cohort with receiver operating curve and decision curve analysis. Multiple model interpretation methods were implemented to explain the optimal model., Results: We recruited 2055 participants in this study. The extreme gradient boosting model was the optimal predictive model with the area under the receiver operating curve of 0.849. Shapley Additive Explanation indicated that the most influential predictors of PPD were antepartum depression, lower fetal weight, elevated thyroid-stimulating hormone, declined thyroid peroxidase antibodies, elevated serum ferritin, and older age., Conclusions: This study developed and validated a machine learning-based predictive model for PPD. Several significant risk factors and how they impact the prediction of PPD were revealed. These findings provide new insights into the early screening of individuals with high risk for PPD, emphasizing the need for comprehensive screening approaches that include both physiological and psychological factors., (© Ren Zhang, Yi Liu, Zhiwei Zhang, Rui Luo, Bin Lv. Originally published in JMIR Medical Informatics (https://medinform.jmir.org).)

Background: Panic disorder (PD) is highly prevalent during the peripartum period. The aim of this systematic review was to summarize evidence on risk factors and course patterns of peripartum PD as well as maternal, infant or dyadic outcomes during the first three years after delivery., Methods: A literature search was conducted according to PRISMA guidelines. Inclusion criteria were: (1) a diagnosis of PD or panic attacks during pregnancy, (2) risk factors and course as well as maternal, infant or dyadic outcomes measured in pregnancy and/or up to 3 years postpartum (3) peer-reviewed articles in English or German published between 1980 and April 2024. After screening of n = 2,740 records, n = 75 records based on n = 64 projects were eligible for this systematic review., Results: Overall, n = 47 studies investigated the course of PD during the peripartum period, n = 23 studies examined the associations of PD and obstetric, neonatal or infant outcomes, and n = 5 studies focused on the associations of PD and characteristics of the mother-infant dyad. We found (1) no common trajectory, but heterogeneous courses of maternal PD in the peripartum period, (2) associations of maternal PD with birth complications and subsequent postpartum depression, and (3) evidence for associations of PD with infant and dyadic outcomes., Limitations: Diverse outcome measures in recent original publications did not allow for a meta-analytic approach., Conclusion: Heterogenous courses and outcomes of peripartum PD require comprehensive monitoring of affected mothers and their infants. There is a need for further longitudinal investigations into familial transmission of anxiety disorders., Competing Interests: Declarations. Ethics approval and consent to participate: Not applicable. Consent for publication: Not applicable. Competing interests: The authors declare no competing interests., (© 2025. The Author(s).)

Background: Perinatal depression is a significant concern affecting both women and men during pregnancy and postpartum periods. While maternal postpartum depression has been extensively studied, paternal depression remains under-researched despite its prevalence and impact on family well-being. This study aimed to estimate the trajectories of perinatal and postpartum depression in Japanese parents over ten years and to determine the details of the symptoms of postpartum depression for each trajectory group, considering reciprocal effects between maternal and paternal depression., Methods: A total of 789 couples used the Edinburgh Postnatal Depression Scale to rate their depressive symptoms prenatally; at 5 weeks, 3 months, 6 months, and 1 year postpartum; and then yearly thereafter until the 10th year. Parallel-process latent class growth analysis was used to group participants according to their longitudinal patterns of depressive symptoms., Results: For both mothers and fathers, four depressive symptom trajectories fit the data best and were most informative (escalating: 6.5 %; mothers low and fathers moderate: 17.2 %; mothers high and fathers low: 17.9 %; low: 58.4 %). A variance analysis showed significant class-parent interactions across anhedonia, anxiety, and depression subscales, indicating distinct patterns of depressive symptomatology., Discussion: Tailored mental health programs and universal screening using the Edinburgh Postnatal Depression Scale are recommended to address the specific needs of each trajectory class. This study contributes to the understanding of long-term depressive symptom trajectories in parents and emphasizes the necessity of comprehensive support strategies to enhance family well-being and resilience., Competing Interests: Declaration of competing interest While the dataset analyzed in this study partially overlaps with a cross-lag analysis study by Jikihara et al. (2023) examining behavioral problem scores in children's aged 3–10 years, we deemed it suitable for publication because of the distinct research objectives. The authors declare no conflict of interest. During the preparation of this work the authors used ChatGPT in order to enhance the language and ensure that the paper conforms to the standards of scholarly journals. After using this tool/service, the authors reviewed and edited the content as needed and take(s) full responsibility for the content of the publication. The data that support the findings of this study are available from the corresponding author upon reasonable request., (Copyright © 2024 The Authors. Published by Elsevier B.V. All rights reserved.)

Background: Many studies have used machine learning techniques to construct predictive models of postpartum depression, but few such models are simple enough to use in community maternal health settings with pen and paper. Here, we use a decision tree to construct a prediction model for chronic postpartum depression., Methods: Participants were 84,091 mothers. Chronic postpartum depression was identified as an Edinburgh Postnatal Depression Scale score of ≥9 at both 1 and 6 months postpartum. The training dataset included 84 diverse variables measured during pregnancy, including health status and biomarkers. In learning, the branching depth was constrained to 3, the number of branches per branch to 4, and the minimum number of n in a branch was 100. The training to validation data ratio was set to 7:3., Results: A decision tree with 35 branches and an area under the receiver operating characteristic of 0.84 was created. Ten of 84 variables were extracted, and the most effective in classification was "feeling worthless." At training (n = 58,635), the most and least prevalent branches were 73.2 % and 0.84 % (mean = 6.29 %), respectively; at validation (n = 25,456), they were 60.4 % and 0.72 % (mean = 6.52 %), respectively., Limitations: Chronic postpartum depression was identified using self-administered questionnaires., Conclusions: This study created a simple and relatively high-performing prediction model. Because the model can be easily understood and used without expertise in machine learning, it is expected to be useful in maternal health settings, including grassroots community health., Competing Interests: Declaration of competing interest None., (Copyright © 2024 The Authors. Published by Elsevier B.V. All rights reserved.)

Objective: There is a lack of research on epidural esketamine for labor analgesia. The purpose of this research is to compare the efficacy of epidural esketamine and sufentanil on labor analgesia and postpartum depression., Methods: A total of 187 cephalic full-term parturients with single-fetus vaginal delivery were collected in this retrospective study from Jan 2022 to Jan 2023. Parturients were categorized into two groups according to anesthetics: the esketamine group (Group KR, n = 97) with patient-controlled epidural analgesia with 0.3 mg/ml esketamine and 0.083% ropivacaine in 240 ml of normal saline and the Sufentanil group (Group SR, n = 90) with 0.3 µg/ml sufentanil and 0.083% ropivacaine in 240 ml of normal saline. The Visual Analogue Scale, Ramsay Sedation Scale, and Modified Bromage Score were recorded before, 5, 10, and 30 min after analgesia, when the uterine orifice was fully opened, and after delivery. The Edinburgh Postnatal Depression Scale(EPDS) scores at 3 and 42 days after delivery were recorded. The maternal and infant outcomes and occurrence of maternal adverse reactions were recorded., Results: The VAS scores after analgesia at 5,10,30 min and when the cervix was fully opened were higher in Group KR than Group SR (all P < 0.05). RSS scores at 5,10,30 min after analgesia in group KR were lower in Group KR than Group SR (all P < 0.05). Compared with group SR, significant decreases were shown in the EPDS and the incidence of postpartum depression at 42 days after delivery in Group KR (all P < 0.05). Group KR has considerably decreased rates of pruritus compared to Group SR (P < 0.05). The other adverse effects showed no significant difference (all P > 0.05). The maternal and neonatal outcomes were not significantly different between the two groups (all P > 0.05)., Conclusions: In comparison to sufentanil, epidural esketamine for labor analgesia may exhibit a better sedative effect, and a low incidence of pruritus, but a limited analgesic effect. It may be associated with a lower risk of postpartum depression. Further exploration of the optimal regimen and dosage of esketamine for epidural labor analgesia would be necessary., Competing Interests: Declarations. Ethics approval and consent to participate: This study was authorized by the Ethics Committee of the Third Affiliated Hospital of Zhengzhou University (No. 2022-089-01), and all parturients signed informed consent forms. The study followed the principles of the Helsinki Declaration. Consent for publication: Not applicable. Competing interests: The authors declare no competing interests., (© 2025. The Author(s).)

Aim: Perinatal depression (PND) is a global health concern, affecting millions of childbearing women. Emerging data suggest that inflammation may play a role in the development of PND. Peripheral blood inflammatory biomarkers before pregnancy are widely tested in clinical practice at minimum cost, yet their potential role in PND risk remains unknown., Methods: We conducted a prospective cohort study of 4483 birthing women during 2009-2021 within the LifeGene study with linkage to Swedish registers. Peripheral blood inflammatory biomarkers were profiled at baseline. Cases of PND were identified using validated tools or clinical diagnosis from subsequent pregnancies and postpartum periods. Logistic regression models were employed to assess the associations of each inflammatory biomarker (z scored) with PND., Results: We identified 495 (11.0 %) PND cases with an average age of 29.2 years. Pre-pregnancy platelet-to-lymphocyte ratio (PLR) was positively associated [OR, 95 % CI:1.14(1.01,1.27)], while lymphocyte count was inversely associated [OR, 95 % CI: 0.89(0.80,0.98)] with PND. A dose-response relationship was indicated for both PLR and lymphocytes when analyzed in categories based on tertile distribution. These associations appeared more pronounced for postpartum depression than antepartum depression and were independent of psychiatric comorbidities., Conclusion: With implications for future mechanistic research, these findings suggest that blood levels of lymphocytes and PLR before pregnancy are associated with subsequent risk of PND in a dose-response manner., Competing Interests: Declaration of competing interest None., (Copyright © 2024 The Authors. Published by Elsevier B.V. All rights reserved.)

Aims/background: This research aimed to identify the sources of social support and its relationship with perinatal depression (PPD) during the coronavirus (COVID-19) pandemic., Design/methods: We carried out a cross-sectional study with a sample of 3,356 women during perinatal period living in Spain. We used five items from the Spanish version of the Coronavirus Perinatal Experiences - Impact Survey to assess the impact of COVID-19 on social support and, the Edinburgh Postnatal Depression Scale was used to assess depressive symptomatology., Results: The results obtained identified a possible relationship between seeking in-person support (OR = 0.51; 0.67, during pregnancy and after delivery respectively) and degree of feeling social support (OR = 0.77; 0.77) during the COVID-19 pandemic with a lower prevalence of depression. Otherwise, requiring the help of a mental health professional (OR = 2.92; 2.41) and weeks of confinement (OR = 1.03; 1.01) appeared to be associated with a higher prevalence of depression. During pregnancy, a possible association was found between the degree of concern about future changes in support and involvement of family and friends (OR = 1.75) with a higher prevalence of depression. On the other hand, in the postpartum period, there seems to be a relationship between seeking social support through social media (OR = 1.32) with a higher prevalence of depression and receiving support from friends (OR = 0.70) and health professionals (OR = 0.53) with a lower prevalence of depression., Conclusion: These results highlighted the importance of protecting perinatal mental health during the COVID-19 pandemic by protecting and developing social support networks.

Objectives: This study aimed to investigate the impact of having a companion during vaginal birth on postpartum depression and birth satisfaction., Methods: This prospective cohort study included 220 postpartum women aged 18-45 who delivered vaginally at Ankara Etlik City Hospital between August 2023 and February 2024. During labor, each woman had the option to be accompanied by a companion person (such as a mother, partner or spouse, sibling, or friend) of her choice; those who opted not to have a relative present received the standard support provided by the hospital's routine birth protocol. Participants were divided into three groups based on the type of support received during childbirth: spousal support, support from others (non-spousal support), and no support. Data were collected within six weeks postpartum using the Edinburgh Postnatal Depression Scale (EPDS) and the Birth Satisfaction Scale-Revised (BSS-R)., Results: Women supported by their spouses during childbirth had significantly higher BSS-QC (Quality of care provision), BSS-SL (Stress experienced during labor), and BSS-R total scores compared to those without support. BSS-SL scores were particularly higher for those with spousal support versus support from others or no support. Non-spousal support also resulted in higher BSS-QC scores than no support at all. BSS-WA (Women's personal attributes) scores and EPDS scores were similar between the groups. Additionally, no significant differences in BSS-QC, BSS-SL, BSS-WA, and BSS-R total scores were observed between women with high (≥13) and low (<13) EPDS scores, but a negative correlation between EPDS and BSS-R total scores was noted ( r =-0.203, p  = 0.003)., Conclusion: Women receiving spousal support during childbirth reported significantly higher birth satisfaction, particularly in care quality (BSS-QC) and stress management (BSS-SL). The presence of a companion, whether spousal or non-spousal, positively influenced birth satisfaction, though it did not significantly affect postpartum EPDS scores.

Introduction: The diagnosis of cystic fibrosis (CF) can impact the mental health of caregivers. This study aimed to explore prevalence of postpartum depression (PPD) symptoms in caregivers of infants with CF or CFTR-related metabolic syndrome (CRMS)., Methods: This prospective, observational study was conducted in a CF clinic at a tertiary hospital over 4 years. Caregivers of infants with CF/CRMS completed serial surveys over the first year of life. Surveys included the Edinburgh Postnatal Depression Scale (EPDS), Patient Health Questionnaire-9 (PHQ-9) and the General Anxiety Disorder-7 (GAD-7). A control group of healthy infant caregivers was used for comparative analysis of EPDS scores., Results: Analyses were conducted on 55 caregivers of 42 infants with CF/CRMS and 915 caregivers of healthy infants. Caregivers of infants with CF/CRMS had a significantly higher prevalence of elevated EPDS scores and higher mean EPDS scores for visit 1 (age 1-2mo) and visit 3 (age 6-9mo) compared to healthy controls (p < 0.001 for both). There was a higher prevalence of caregivers identifying thoughts of self-harm in the CF/CRMS cohort (8.3%) compared to caregivers of healthy controls (1.2%) at visit 1 (p = 0.015) and at visit 3 (CF/CRMS 8.8%; control 1.7%; p = 0.030). EPDS scores correlated with PHQ-9 and GAD-7 scores, particularly earlier in the infant's life., Conclusions: Caregivers of infants with CF/CRMS may be at higher risk of PPD and thoughts of self-harm when compared to healthy controls. Given what is known about the impact of PPD on mental and physical health of children, early identification is vital for this population., (© 2024 The Author(s). Pediatric Pulmonology published by Wiley Periodicals LLC.)

To decrease the high rates of mental health-related maternal morbidity and mortality among rural-dwelling women, it is critical to identify those experiencing postpartum depression (PPD) and provide necessary follow-up care. To effectively screen for PPD, clinicians must utilize instruments which account for context-specific factors and maintain validity across diverse populations. The Edinburgh Postnatal Depression Scale (EPDS) is the most commonly used depression screening tool in perinatal settings, but has not been validated for use within rural American settings. The aim of this study was to establish the psychometric properties of the EPDS and assess its validity for clinical use within a rural American context. In regards to construct validity, we found that a single-factor structure representing depression status was psychometrically sound and well explained by the items of the EPDS. The scale demonstrated strong criterion-related validity, where EPDS screening results were significantly correlated with the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) criteria used by providers to make differential depression diagnoses. The EPDS yielded acceptable reliability and internal consistency (Cronbach's alpha = 0.90) in measuring depression status among our rural-dwelling sample. This is the first study establishing validity of a PPD screening tool within a rural U.S. population.

Background: Postpartum depression and suicide are two of the most frequent mental health disorders in the perinatal period and have an increasing trend.. An increasing number of women report receiving inadequate treatment during childbirth care. There are no studies that relate inadequate treatment to any of these mental health disorders; those that exist are very limited and have not used validated instruments. We proposed to determine if there is an association between inadequate treatment and/or abuse during childbirth care with the risk of postpartum depression (PPD) and the risk of suicidality in women during the perinatal stage., Methods: An observational study was carried out with postpartum women in Spain. Information was collected on sociodemographic and obstetric variables, among others. Edinburgh Postnatal Depression Scale was used to determine the risk of postpartum depression and item 10 for the risk of suicide, and the Childbirth Abuse and Respect Evaluation-Maternal Questionnaire (CARE-MQ) was used to determine the women's perception of having been treated inadequately during childbirth. Adjusted ORs and their 95 % CI were calculated., Results: 1579 women participated. Women with CARE-MQ scores above the 90th percentile had a higher probability of risk of suicidal ideation (aOR of 2.89; 95 %CI: 1.60-5.04) and postpartum depression (aOR of 3.17; 95 %CI: 1.94-5.18) compared to those who had scores lower than the 50th percentile. On the contrary, factors associated with a lower probability of suicidal ideation and PPD were: higher economic income and attendance at prenatal education., Conclusion: Women who perceived that they experienced a situation of inadequate treatment during childbirth were more likely to be at risk of postpartum depression and risk of suicide., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Objective: To evaluate the association between postpartum depression (PPD) screening results in pediatric primary care and subsequent infant preventive and acute care utilization., Methods: This was a retrospective cohort analysis of 5341 infants born in 2021 whose mothers were screened for PPD at a well-child visit during the first 6 months. Logistic regression was used to examine the association between a positive PPD screen and 1) adherence to the 12-month well-child visit, and 2) any acute care visits (urgent care or emergency department visits) from 6-15 months. The association between PPD screen and number of acute care visits was examined with negative binomial regression., Results: The incidence of positive PPD screens was 15.6% in the first 6 months. There was no significant difference in 12-month well-child visit adherence based on PPD screening (adjusted odds ratio (aOR): 0.91; 95% confidence interval (CI): 0.77-1.06; P-value: 0.206). The odds of having any acute care visit were higher among infants whose mothers screened positive for PPD (aOR: 1.2; 95% CI: 1.0-1.3; P-value: 0.009). There was a significant difference in the incidence rate of acute care visits based on PPD screening results (incidence rate ratio: 1.1; 95% CI: 1.0-1.2; P-value: 0.005)., Conclusions: Screening positive for PPD was associated with subsequent acute care utilization but not 12-month preventive care. Primary care providers may need to proactively follow-up after acute care visits to ensure both infant health and maternal needs are met, connecting mothers to resources as needed., Competing Interests: Declaration of Competing Interest There was no direct funding given or received for the work described in this submission. None of the authors report a conflict of interest. The views expressed in this article are those of the authors and do not necessarily reflect the position of Nationwide Children's Hospital or The Ohio State University., (Copyright © 2025 Academic Pediatric Association. Published by Elsevier Inc. All rights reserved.)

Background: Postpartum depression (PPD) affects approximately 17% of the women worldwide with nearly half of all cases going undetected. More research on maternal mental health, particularly among healthcare professionals and pregnant mothers, could help identify PPD risks and reduce its prevalence., Objective: Given that awareness of PPD is a crucial preventive factor, we studied PPD awareness among midwives and pregnant women in Arkhangelsk, Arctic Russia., Methods: A qualitative study was conducted using in-depth semi-structured interviews. Midwives and pregnant women were recruited from the women's clinic of the Arkhangelsk municipal polyclinic. Seven midwives and 12 pregnant mothers were interviewed., Results: Midwives described limited time for psychological counselling of pregnant women; they reported that their primary focus was on the physiological well-being of women. Pregnant women have expressed a desire for their families to share responsibilities. The participants considered PPD as a mix of psychological and physiological symptoms, and they also highlighted a discrepancy between the expectations of pregnant women and the reality of motherhood. The present study underscored the limited understanding of PPD identification., Conclusions: The findings suggest that there is a need for increased awareness among midwives and pregnant women regarding PPD. Prevention programs targeting PPD with a specific emphasis on enhancing maternal mental health knowledge are warranted.

Background: Postpartum depression is associated with low socioeconomic status, adverse birthing processes, and life stress. Increasing evidence of mistreatment during childbirth, negative birth experiences, and poor quality of maternal care is of global concern., Objective: To assess the risk of experiencing depressive symptoms among postpartum women exposed to mistreatment during institutional birthing in Nepal., Method: We conducted a prospective cohort study from 29 March to 19 August 2022. Of 1629 women who gave birth in a hospital in Nepal, 1222 were assessed for mistreatment during childbirth and depressive symptoms using the Edinburgh Postnatal Depression Scale. We used binomial generalized linear mixed model to examine the risk ratio of postpartum depressive symptoms in women exposed to mistreatment during childbirth., Results: The prevalence of postpartum depressive symptoms was 4.4%. Women exposed to mistreatment during childbirth were almost fifty percent more likely to have postpartum depressive symptoms (cRR 1.47; 95% CI 1.14, 1.89; p  = 0.003) compared with the unexposed group. Furthermore, adolescent mothers exposed to mistreatment during childbirth had a seventy percent increased risk of depressive symptoms (aRR 1.72; 95% CI 1.23, 2.41; p = 0.002 ). Similarly, women who gave birth to female infants were thirty percent more likely to experience postpartum depressive symptoms (aRR 1.32; 95% CI 1.01-1.74; p = 0.039 )., Conclusion: We observed an association between postpartum depressive symptoms and mistreatment during institutional births in Nepal. The implementation of appropriate respectful maternity care during childbirth and also routine screening for depressive symptoms is critical to improving perinatal mental health and well-being.

The Edinburgh Postnatal Depression Scale (EPDS) is the screening tool for perinatal depression, and its cut-off score varies according to context and population. In Cameroon, no study has yet defined a cut-off score or the prevalence of perinatal depression in adolescent mothers. Our aim is to determine the cut-off for teenage mothers in Cameroon. The study is cross-sectional and analytical in nature. The EPDS was used to screen for symptoms of depression and an interview based on the DSM-5 criteria for depression was conducted to diagnose the depressive syndrome. The data were processed with Epidata 3.1 and was analysed with SPSS 25. Positive and negative predictive values (PPV, NVP) were calculated. The optimal EPDS score was determined by taking into account the importance of false-negative and false-positive test results. 1633 adolescent mothers were recruited. The prevalence of perinatal depression was 60.8% (95% CI = 58.5, 63.2). The cut-off score for this population was ≥ 11. Sensitivity was 92.6% (95% CI = 0.913, 0.939) specificity 53.2% (95% CI = 0.508, 0.556), PPV 75.5% and NPV 80.2%. This score of ≥ 11 is retained because false-negative results have important adverse consequences. This study on the validation of the EPDS and the prevalence of perinatal depression in a population of teenage mothers is new in Cameroon and central Africa., Competing Interests: Declarations. Competing interests: The authors declare no competing interests. Informed consent: Informed consent was obtained from all participants in involved in the study., (© 2024. The Author(s).)

Background: Postpartum anxiety (PPA) symptoms have harmful effects on child development and mother-infant interactions. Accordingly, in-depth knowledge of associated risk factors is crucial for prevention policies. This study aimed to estimate PPA symptom prevalence at 2 months and to identify associated risk factors in a representative sample of all women who gave birth in France in 2021, and in two subgroups: women with no postpartum depression (PPD) symptoms, and those with no history of mental health care., Methods: Among the 12,723 women included in the representative French national perinatal survey 2021ENP, 7,133 completed the Edinburgh Postnatal Depression Scale (EPDS) self-administered questionnaire - including three anxiety-specific items (EPDS-3A) - at 2 months postpartum. We estimated the adjusted prevalence ratios (aPR) of PPA symptoms using Poisson regression models with robust variance., Results: PPA symptom prevalence at 2 months was 27.6% (95% CI [26.5-28.8]). Associated risk factors were: age ≤ 34 years (maximum aPR = 1.38 [1.22-1.58] obtained for persons aged 25-29 years vs. 35-39 years), poorer health literacy (1.15 [1.07-1.23]), a history of medical termination of pregnancy (1.32 [1.05-1.68]), psychological (1.31 [1.17-1.47]) or psychiatric (1.42 [1.24-1.63]) care history since adolescence, nulliparity (1.23 [1.12-1.35]), no weight gain or loss (1.29 [1.03-1.61] vs. 9-15 kg gain) or gain ≥23 kg (1.20 [1.00-1.43]) during pregnancy, ≥3 pregnancy-related emergency consultations (1.16 [1.03-1.31] vs. none), poor/good support during pregnancy, (1.16 [1.00-1.34] and 1.15 [1.05-1.26], respectively, vs. very good), sadness (1.52 [1.36-1.69]), anhedonia (1.48 [1.27-1.72]), or both (1.99 [1.79-2.21]) during pregnancy, not at all/not very satisfied with pain management during childbirth (1.16 [1.01-1.32] vs. quite/very satisfied). Similar risk factors were found in the 'no PPD symptoms' and 'no history of mental health care' subgroups., Conclusions: Estimated PPA symptom prevalence at 2 months in our study sample was 27.6%. The risk factors we identified may guide future prevention policies.

Objectives: This cross-sectional study aimed to explore the frequency of breast refusal (BR), associated factors including postpartum depression and breastfeeding self-efficacy, and investigate the recovery status following BR., Methods: The survey comprised four sections, to investigate the sociodemographic characteristics of mothers and their babies, Breastfeeding Self-Efficacy Scale-Short Form (BSES-SF), the Edinburgh Postnatal Depression Scale (EPDS) of mothers, and features associated with BR. The survey was administered online to those with babies aged 0-24 months. Specific questions related to BR were directed to mothers who experienced it within the first 12 months., Results: The study encompassed 651 mothers, with a mean age of 30.5 ± 3.6 years, and revealed that 35.6% experienced BR. The presence or history of BR was associated with monthly household income, nurse-midwife support during the first breastfeeding, nipple shape, co-sleeping practices, mother-in-law's support in child care, and BSES-SF scores. Notably, mothers facing breastfeeding-related challenges such as engorgement, pressured milk issues, and infants with gas-related concerns, -excluding low milk supply, pacifier or bottle use-, demonstrated higher recovery from BR., Conclusions: Some sociodemographic factors, social support, mothers characteristics were associated with the BR. In addition, several challenges were present in BR recovery. Mothers need to be supported in child care and house work to prevent and improve BR and restore breastfeeding. Additinal cohort studies with the possible related factors for BR are necessary to implement targeted interventions to prolong breastfeeding duration., Competing Interests: Declarations. Ethical approval: This study was performed in line with the principles of the Declaration of Helsinki. The study protocol was approved by Pamukkale University’s Non-Interventional Research Ethics Committee (decision no: E-60116787-020-340822, date: 28.02.2023). Consent to participate: Informed consent was obtained for all participants. Consent to publication: Not applicable. Competing interests: The authors declare no competing interests., (© 2024. The Author(s).)

Background: Studies on the association of exclusive breastfeeding and postpartum depression (PPD) are inconsistent and no prior study has investigated whether this association was influenced by other factors. This study aimed to investigate the correlation between exclusive breastfeeding and PPD in Chinese population, as well as to determine whether other factors influence this association., Methods: A cross-sectional survey was carried out on 7685 postpartum women from a hospital of Shenzhen, China, utilizing the Edinburgh Postnatal Depression Scale (EPDS) to evaluate PPD., Results: A total of 7685 women were included this study, of whom 4549 (59.2%) performed exclusive breastfeeding, and 3136 (40.8%) did not carry out exclusive breastfeeding. Puerperal women who exclusively breastfed were found to have a lower risk of testing positive for PPD (10.5% vs. 13.8%, P < 0.001), in comparison to those who were not exclusively breastfeeding. After controlling for other influencing factors, exclusive breastfeeding was still associated with the lower risk of PPD (OR = 0.80, 95% CI, 0.69-0.94). Moreover, stratified analyses suggested that the association of exclusive breastfeeding with PPD was more pronounced in mothers who gave birth to a girl (P interaction < 0.05)., Conclusions: Our study confirms that the exclusive breastfeeding may reduce the PPD risk, especially among women with a birth of girl. Thus, more tailored preventative approaches should be developed to address PPD in women who were not exclusive breastfeeding., Competing Interests: Declarations. Ethics approval and consent to participate: The research was approved by Ethics Committee of Baoan Maternity and Child Health Hospital. The methodology followed the principles of the Declaration of Helsinki. Written informed consent was obtained from all participants. Consent for publication: Not applicable. Competing interests: The authors declare no competing interests., (© 2024. The Author(s).)

Background: Gestational diabetes mellitus (GDM) and peripartum depression (PPD) are increasing global health issues with potentially long-lasting adverse outcomes. While limited studies suggest a bidirectional relationship between GDM and PPD, most research has been cross-sectional and focused on one direction of the relationship, primarily if GDM predicts postpartum depression. The interplay between antenatal depression and GDM is less explored, with a critical lack of prospective bidirectional studies. This longitudinal study aimed to investigate the bidirectional relationship between GDM and PPD in a total sample and according to different pre-pregnancy body mass index (BMI) categories. Specifically, we examined whether antenatal depression symptoms predict a subsequent GDM diagnosis and whether GDM predicts subsequent postpartum depression symptoms., Methods: A three-wave online longitudinal study included 360 women who were followed from the second trimester (20-28 weeks, T1) through the third trimester (32-42 weeks, T2), and into the postpartum period (6-20 weeks after birth, T3). Participants completed the General Data Questionnaire, one item about the diagnosis of GDM, and the Edinburgh Postnatal Depression Scale (EPDS). The sample was stratified according to pre-pregnancy BMI into normal-weight (N = 247) and overweight/obese (N = 113) subgroups. Women with type I and II diabetes, GDM at T1, and underweight BMI were excluded., Results: In the total sample, antenatal depression symptoms predicted GDM, whereas GDM did not predict postpartum depression symptoms. A bidirectional relationship was observed in normal-weight women, where antenatal depression symptoms predicted subsequent GDM diagnosis, and GDM diagnosis predicted postpartum depression symptoms. In contrast, no associations were found in either direction in the overweight/obese subgroup., Conclusions: This study provides evidence of a bidirectional relationship between GDM and PPD only in women with normal body weight before pregnancy. The results highlight the complexity of the relationship between peripartum mental and metabolic health, that is dependent on pre-pregnancy BMI. Clinicians should be aware that normal-weight women may have a unique sensitivity to the bidirectional interplay between GDM and PPD. Pregnant women should be closely monitored for both mental and metabolic health issues and targeted for prevention programs to reduce the risks and burdens associated with both conditions., Competing Interests: Declarations. Ethics approval and consent to participate: The study was approved by the Ethics Committee of the Catholic University of Croatia (Class: 641-03/21 − 03/21; No: 498 − 16/2-22-04). Consent for publication: Not applicable. Competing interests: The authors declare no competing interests., (© 2024. The Author(s).)

Introduction: Previous studies on the association between recovery from Coronavirus Disease 2019 (COVID-19) infection and postpartum depressive and anxiety symptoms had conflicting results. This study aimed to investigate the psychological burdens among postpartum women who had experienced COVID-19 infection during their pregnancies and those who had not., Methods: This cross-sectional study was conducted at Taichung Veterans General Hospital in Taiwan from April 2022 to January 2023. A total of 113 postpartum women completed self-reported questionnaires, including the Edinburgh Postnatal Depression Scale (EPDS) and General Anxiety Disorder-7 (GAD-7), in the postpartum clinics or wards., Results: Fifty-four individuals (47%) who experienced COVID-19 infection during their pregnancies and 59 uninfected women completed the questionnaires. The mean EPDS scores were 5.00 ± 4.26 vs. 6.46 ± 4.50 ( p = 0.09) and the mean GAD-7 scores were 3.17 ± 2.88 vs. 3.69 ± 2.73 ( p = 0.21). Multivariate linear regression analyses revealed that factors associated with lower EPDS scores included experiencing COVID-19 infection during pregnancy, delivery by expected mode, and neonates not requiring admission to the Intensive Care Nursery (ICN) or Neonatal Intensive Care Unit (NICU). Delivery by expected mode was the only variable associated with a lower GAD-7 score in the multivariate model., Conclusion: Our study demonstrated that COVID-19 infection during pregnancy was associated with fewer postpartum depressive symptoms based on linear regression analysis, with no significant difference in postpartum anxiety symptoms., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Hsieh, Su, Lee, Lin and Chen.)

Background: This study seeks to investigate the relationship between birth experience and risk of developing postpartum depression among Jordanian women. Furthermore, it aims to explore the prevalence and risk factors of postpartum depression and raise awareness of it among Jordanians., Material and Methods: This study was carried out on 214 postpartum Jordanian women at Jordan University Hospital (JUH). A questionnaire was handed to participants which touched on demographics, intrapartum experience, along with the Edinburgh Postnatal Depression Scale (EPDS), and the psychosocial factors affecting them., Results: Among the 214 respondents, 184 women (86%) had postpartum depression according to EPDS, those with high scores and statistically significant p-values include individuals diagnosed with depression (15.89, p = 0.163), those who had previous consultations with a mental health specialist (16.61, p = 0.037), individuals under 18 (18.75, p = 0.028), those who underwent vaginal delivery (15.12, p = 0.008), underwent episiotomy (15.92, p = 0.023), lacked support from the medical team (13.21, p < 0.001), expressed dissatisfaction with childbirth care (17.03, p < 0.001), experienced body image issues during pregnancy (15.74, p = 0.008) and after birth (16.11, p = 0.001), felt anxiety about motherhood (15.88, p < 0.001), reported insufficient emotional support during pregnancy (17.49, p < 0.001), and after childbirth (17.00, p < 0.001)., Conclusion: A significant proportion of Jordanian women are at an increased risk of developing postpartum depression. A maternal age under 18, normal vaginal delivery including episiotomy, and lack of support among others were identified as risk factors for postpartum depression (PPD)., (© 2024 Ayah Fraihat et al., published by Sciendo.)

Background: The aim of this study is to explore the mediation effect of family support on the relationship between SES and postpartum depressive symptoms., Methods: A total of 1887 mothers of newborn babies under 6 months of age in selected community health service centers in Shanghai were included in the analysis. A multi-stage probability sampling method was applied to select the sample. We generated a composite index for measuring each sample household's SES using a categorical principal component analysis approach. The mothers' perceived family support scale was used to reflect family functioning status. Regression models were used to verify the research hypotheses and assess the impact of intermediating variables., Results: 8.90% of participants had postpartum depressive status. The data showed that there was variability in the SES index, ranging from -4.18 to 0.81 (with lower SES being a low index value). According to the findings, the SES index was negative associated with depressive symptoms, the lower the SES level of the household, the higher the probability of the mother being at risk for depressive symptoms. (β = -0. 115, P < 0.001). When examining the analysis that adds family support as a mediator between SES and depressive symptoms, the coefficient of the mediator (family support) was significant (meaning the higher the family support, the lower the risk of depressive symptoms (β = -0.447, P < 0.001) and the coefficient relating the SES index to depressive symptoms became non-significant (β = -0.023, P = 0.280)., Conclusion: The association between SES and depressive symptoms among postpartum women is strongly mediated by family support. The finding suggests that the focus of interventions to prevent or mediate postpartum depression should consider developing strategies to strengthen family support., Competing Interests: Declarations. Ethics approval and consent to participate: This study was reviewed and approved by the Ethics Committee of School of Public Health, Shanghai Jiaotong University. All participants completed an informed consent form. Consent for publication: Not applicable. Competing interests: The authors declare no competing interests., (© 2024. The Author(s).)

Introduction: Around 700,000 children are born in Germany every year. Many mothers are under great pressure and strain due to prevailing role models and social expectations. Up to 15% of mothers in Germany are said to be affected by postpartum depression. The available studies, however, are mainly based on surveys, are older and vary widely in their results. This study brings another data source into play and asks how frequently diagnoses of mental illness are found in mothers after childbirth compared to childless women in the billing data of a large health insurance company., Methods: A retrospective matched cohort study was conducted with health insurance data from 2017-2022, comparing mothers and childless women with the same age and the same medical and socioeconomic characteristics with regard to depression, exhaustion and burnout, and anxiety and stress disorder outcomes. The modelling was carried out using Poisson regression., Results: Mothers were less likely than childless women to receive a diagnosis of a mental disorder within five years after childbirth. In the long run, however, the frequency of diagnoses equalised., Discussion: Becoming a mother does not lead to more diagnoses of mental disorders compared to childless women, at least in the first five years after giving birth. However, the interpretation of the data is difficult. Possible influence of external factors on making the diagnosis is not seen in the data, such as the social expectation of a "happy mother" or a change in the utilisation of medical care due to maternity., Competing Interests: Einhaltung ethischer Richtlinien. Interessenkonflikt: D. Hertle, I. Petrautzki und D. Wende geben an, dass kein Interessenkonflikt besteht. Die Untersuchung erfolgte als retrospektive Auswertung von Routinedaten der gesetzlichen Krankenversicherung BARMER zu Forschungszwecken im Sinne des § 67c SGB X. Es fanden keine Interventionen an Patientinnen, keine Deanonymisierung von Versicherten und keine Übermittlung von Sozialdaten statt. Eine Ethikprüfung war in diesem Zusammenhang nicht erforderlich., (© 2024. Springer-Verlag GmbH Deutschland, ein Teil von Springer Nature.)