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Background Variability in parental leave policies across graduate medical education (GME) programs in the United States complicates efforts to support resident wellness and identify best practices for resident well-being. Objective This review aims to assess how formal parental leave policies affect trainees' well-being, professional satisfaction, and performance during training. Methods A systematic review following the Preferred Reporting Items for Systematic Reviews and Meta Analyses (PRISMA) 2020 guidelines was conducted and registered on PROSPERO in May 2023. Databases searched included MEDLINE, Embase, and Cochrane Central. Studies that evaluated parental leave policies of US-based GME programs and their direct impact on residents and/or fellows were included. Studies were screened for inclusion by 2 independent reviewers, and any conflicts were resolved by a third author. Results Of 1068 articles screened, 43 articles met inclusion criteria. These studies highlighted that leave durations of less than 6 weeks were associated with higher rates of burnout and postpartum depression among trainees. There was no evidence that taking parental leave increased program attrition rate; however, 3 studies reported more than one-third of trainees extended training as a result of taking leave. Trainees who had more than 8 weeks of parental leave reported more successful breastfeeding 6 months out from delivery than those with less than 8 weeks of leave. Conclusions Extended parental leave, notably beyond 6 weeks, improved trainee well-being and professional satisfaction. Based on trainees' perspectives, ideal parental leave policies offer a minimum of 6 to 8 weeks of leave, with a formal and clearly written policy available. [ABSTRACT FROM AUTHOR]

Hair cortisol concentration (HCC) is a valuable biomarker for evaluating chronic stress in preschoolers. However, few studies have explored early life HCC and its associated factors. This prospective cohort study analysed the HCC in children aged 6–48 months and its associations with parental HCC as well as positive and negative parental mental health outcomes. We used data from the ongoing Longitudinal Examination Across Prenatal and Postpartum Health in Taiwan (LEAPP‐HIT) project, conducted in Taipei between 2020 and 2024. Hair samples were collected from both parents and children in 177 families (91 samples obtained during pregnancy and 86 during the postpartum period). The parents also completed self‐reported questionnaires. Multiple linear regression was conducted to analyse the data. We observed a significant positive correlation between parents' and preschoolers' HCC. Furthermore, maternal depression (adjusted beta coefficient [aβ] = 0.09, 95% confidence interval [CI] = 0.02, 0.16) and perceived stress (aβ = 0.15, 95% CI = 0.02, 0.26) were positively associated with preschoolers' HCC. By contrast, higher maternal eudaimonia was associated with lower HCC in preschoolers (aβ = −0.11, 95% CI = −0.20, −0.01). For parents, maternal depression, anxiety, and perceived stress were independently associated with an increased HCC during the postnatal period, whereas maternal eudaimonia was negatively associated with HCC. Our results indicate that both mothers and fathers affect children's responses to stress. Assessment of cortisol stress hormone concentrations through hair samples can be a key means of detecting preschoolers' stress levels and enabling early intervention. [ABSTRACT FROM AUTHOR]

Background: Existing evidence regarding the impact of the COVID-19 pandemic on postpartum mental health is mixed, with disparate studies showing increased, stable, or even reduced risk of postpartum depression (PPD) amid the pandemic. Furthermore, although it is plausible that the pandemic impacted the mental health of mothers from vulnerable and underserved communities differentially, few studies have characterized racial and ethnic differences in the impact of the COVID-19 pandemic on PPD. Materials and Methods: Pregnancy Risk Assessment Monitoring System data for 2018–2019 (pre-pandemic period) and 2020 (peri-pandemic period) from 40 sites (n = 110,779, representing 5,485,137 postpartum women) were used to determine whether rates of PPD changed during the first year of the pandemic. Postpartum depressive symptoms were assessed using the Patient Health Questionnaire 2-item. Average marginal effects and contrasts of predictive margins derived from a multivariable logistic regression model were used to compare the risk of PPD before and during the pandemic in the overall sample and across racial/ethnic subgroups. Results: Adjusting for sociodemographic and clinical characteristics, we found that the overall risk for PPD remained stable (0.0 percentage points [pp]; 95% confidence interval [CI]: −0.7, 0.6 pp) in the first year of the pandemic. We detected no statistically significant changes in risk for PPD across seven of eight racial/ethnic groups considered; however, the risk of PPD among non-Hispanic Black women fell by 2.0 pp (95% CI: −3.5, −0.4 pp) relative to the pre-pandemic period. Conclusion: We identified important subgroup differences in pandemic-related changes in risk for PPD. [ABSTRACT FROM AUTHOR]

Purpose: Perinatal depression significantly impacts maternal and child health, with further complexities arising during the COVID-19 pandemic. This review is the first to comprehensively synthesize evidence on the prevalence of perinatal depression and its associated risk factors in Low- and Middle-Income Countries (LMICs) during the pandemic period. Methods: The study protocol was registered in PROSPERO (CRD42022326991). This review followed the Joanna Briggs Institute (JBI) guideline for prevalence studies. A comprehensive literature search was conducted in six databases: PubMed, Scopus, Web of Science, PsycInfo, CINAHL, and ProQuest. Pooled prevalence estimates were computed for both prenatal and postnatal depression. Identified risk factors were summarized narratively. Results: A total of 5169 studies were screened, out of which 58 were included in the narrative review and 48 [prenatal (n = 36) and postnatal (n = 17)] were included in the meta-analysis. The pooled depression prevalence for prenatal women was 23% (95% CI: 19–27%), and for the postnatal women was 23% (95% CI: 18–30%). Maternal age, education, perceived fear of COVID-19 infection, week of pregnancy, pregnancy complications, and social and family support were identified as associated risk factors for depression. Conclusions: Our review demonstrates an increased prevalence of perinatal depression during the COVID-19 pandemic in LMICs. It sheds light on the significant burden faced by pregnant and postnatal women and emphasizes the necessity for targeted interventions during the ongoing and potential future crisis. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this study was to assess the trajectory of women's depressive symptoms during the first six months postpartum, identify risk factors (sociodemographic, obstetric and personality) associated with classes, and examine associations between classes and postpartum PTSD at two months and bonding at six months. Methods: The final sample included 212 women who gave birth in the maternity wards of a large tertiary health center that were approached at 1–3 days, two months, and six months postpartum and completed a demographic questionnaire and measures of neuroticism (BFI) and postpartum depression (EPDS), postpartum PTSD (City Birth Trauma Scale) and bonding (PBQ). Obstetric data were taken from the medical files. Results: Cluster analysis revealed three distinctive clusters: "stable-low" (64.2%), "transient-decreasing" (25.9%), and "stable-high" (9.9%). Neuroticism, general-related PTSD symptoms, and bonding were associated with differences between all trajectories. Birth-related PTSD symptoms were associated with differences between both stable-high and transient-decreasing trajectories and the stable-low trajectory. No obstetric or demographic variables were associated with differences between trajectories. Conclusion: We suggest that screening women for vulnerabilities such as high levels of neuroticism and offering treatment can alleviate the possible deleterious effects of high-symptom depression trajectories that may be associated with their vulnerability. [ABSTRACT FROM AUTHOR]

Person-centered models of care built on newborn and family needs and rights, such as nonseparation immediately after birth and during the care process, can address the complex needs of the newborn, family, and health system. This is particularly important in low- and middle-income countries, where cost-effective modalities are highly needed to accelerate the survival of newborn babies. We conducted a systematic review to explore country experiences on implementation and challenges to implement and scale-up family-centered newborn care models of care. MEDLINE, CINAHL, EMBASE, and PsycINFO databases were searched to identify studies on patient-centered care and newborns between 1990 and 2023. Studies meeting our predefined inclusion criteria were quality assessed and relevant data extracted. We utilized the World Health Organization framework on integrated people-centered health services to summarize and analyze findings while highlighting patterns. Forty-one studies were included for review (including approximately 60% from low- and middle-income countries). Different research conducted over time highlighted how immediate and uninterrupted skin-to-skin care facilitates a series of critical processes for newborns, parents, and health system, including breastfeeding initiation and exclusivity rates, reduced incidence of post-partum depression, and prevention of infection and hospitalization. Thanks to the close contact of the kangaroo position or skin-to-skin contact, parents recount becoming more and more attached to and familiar with their baby, easily establishing a relationship. Overall, countries could transform the newborn care service in terms of family center care by adopting three simple rules: (i) minimizing mother–child separation; (ii) involving fathers; (iii) empowering parents from the time of birth. A paradigm shift is required to change the conventional model of provider-centric care to one of person-centered neonatal health care. Such an approach is feasible in diverse country settings and should be facilitated through political commitment and policies enabling early focus on the maternal–infant relationship. This could, in turn, help achieve improved dignity of care and help create a more efficient and responsive health system and society. [ABSTRACT FROM AUTHOR]

Background: Current research separately analyzed the connection between postpartum depression, fatigue, sleep and infant development. However, depression, fatigue and sleep quality often coexisted as adverse symptoms in postpartum women and influenced infant development together. This study explored the maternal postpartum symptoms on infant growth. Methods: Our study included 224 pairs of singleton full‐term mothers and their infants who underwent routine pediatric outpatient clinics. Latent profile analysis was applied to identify the latent classes based on mothers' postpartum depression, fatigue and sleep profile characteristics. We evaluated the maternal adverse symptoms and infant development using multivariable logistic regressions. Results: Totally, 224 pairs of eligible mothers (28.85 ± 4.43 years) and infants (30.93 ± 3.26 days) participated in this study. Latent profile analysis identified 3 latent groups: mild (58.04%), moderate (34.37%), and severe (7.59%) postpartum adverse symptoms. Postpartum adverse symptoms were associated with delayed development in the baby's motor level (χ2 = 6.572, p =.037) and weight‐for‐length (χ2 = 9.652, p =.008). After controlling for mother and infant related factors, postpartum adverse symptoms remained a risk factor for infant motor level (odds ratio [OR]: 4.35; 95% confidence interval [CI]: 1.25–15.08) and weight‐for‐length (OR: 5.53; 95% CI: 1.55–19.74). Conclusions: Maternal postpartum depression, fatigue and sleep quality are associated with infant development. Clinically, mothers with these symptoms should be intervened timely to avoid the aggravation of maternal symptoms, which affect baby's development. [ABSTRACT FROM AUTHOR]

Background: Postpartum depression (PPD) significantly affects the welfare of mothers, infants, families, and communities. Mothers in rural areas often face low incomes, poor social security, low education levels, and inadequate medical services. These specific cultural, social, and economic aspects have led to a worsening of PPD in rural areas. However, the current situation of PPD among women in rural areas of China is still insufficiently explored. Aim: This study aims to explore the prevalence and risk factors of PPD among women in low‐income developing rural areas of China. Methods: A cross‐sectional design was used in this study. Edinburgh Postnatal Depression Scale (EPDS) was applied to evaluate PPD symptoms. General demographic questionnaire, obstetrics‐/pediatrics‐related questionnaire, and psychosocial‐related questionnaire were adopted. Abuse Assessment Screen (AAS) was utilized to assess experienced intimate partner violence during pregnancy and postpartum. Social Support Rating Scale (SSRS) was utilized to measure their levels of social support. Results: Of the 467 participants, the overall prevalence of PPD among women in rural areas of China was 16.5%, and the average EPDS score was 8.35 (SD = 4.50). PPD occurred most frequently at 7–9 months postpartum (33.8%). Six factors associated with PPD were whether the sex of the baby was in line with the family's expectations, monthly income of partners, social support, IPV during pregnancy and childbirth, and negative life events in the last 1 year, as well as physical and mental exhaustion from caring for a baby. Conclusions: This study sheds light on the prevalence and various risk factors associated with PPD among women residing in low‐income developing rural areas of China. The findings highlighted the need for targeted interventions and support systems designed to address the specific socioeconomic and cultural difficulties encountered by rural mothers. [ABSTRACT FROM AUTHOR]

Although numerous factors have been found to influence postpartum depression (PPD), no previous meta-analysis have systematically explored whether it is affected by adverse childhood experiences (ACEs). This study aimed to explore the influence of ACEs and their subtypes on PPD. A systematic literature search was conducted using Web of Science, PubMed, Embase, Wan Fang, China Science and Technology Journal Database, Chinese Biomedical Database, and China National Knowledge Infrastructure, and literature was screened according to inclusion and exclusion criteria. Methodological quality assessment and data extraction were performed on the included studies. A random-effects model was used to pool the effects. In total, 24 studies were included, and 73 independent effects were extracted from them. The meta-analysis revealed that ACE was a risk factor for PPD (odds ratio [OR] = 2.31, 95% confidence interval [CI] [2.04, 2.63]). The subgroup analysis results showed that emotional abuse was the ACE subtype most strongly related to the occurrence of PPD (OR = 2.95, 95% CI [2.08, 4.20]), followed by emotional neglect (OR = 2.87, 95% CI [1.89, 4.36]) and sexual abuse (OR = 2.81, 95% CI [1.93, 4.09]). In addition, family member incarceration (OR = 2.62, 95% CI [1.51, 4.54]), physical abuse (OR = 2.31, 95% CI [1.67, 3.19]), and physical neglect (OR = 2.15, 95% CI [1.36, 3.39]) also have strong effects on PPD. ACE is a risk factor for PPD. Early screening of ACE plays an important role in the prevention and intervention of PPD. [ABSTRACT FROM AUTHOR]

Standard models of well-child care may not sufficiently address preventive health needs of immigrant families. To augment standard individual well-child care, we developed a virtual group-based psychoeducational intervention, designed to be delivered in Spanish as a single, stand-alone session to female caregivers of 0–6 month-olds. The intervention included a video testimonial of an individual who experienced perinatal depression followed by a facilitated discussion by the clinic social worker and an orientation to relevant community resources by a community health worker. To assess feasibility and acceptability of the intervention, we conducted an open pilot within an academic pediatric practice serving predominantly Latinx children in immigrant families. Participants included 19 female caregivers of infants attending the practice, of whom 16 completed post-intervention measures and 13 completed post-intervention semi-structured interviews. Quantitative measures of acceptability and satisfaction with the intervention were high. We found preliminary effects of the intervention on postpartum depression knowledge and stigma in the expected direction. In interviews, participants described increases in their familiarity with postpartum depression and about relevant community resources, including primary care for caregivers. Participants reported an appreciation for the opportunity to learn from other caregivers and provided suggestions for additional topics of interest. Trial registration: Registered 6/21/22 as NCT05423093. [ABSTRACT FROM AUTHOR]

Background: Mother-to-infant bonding (MIB) is foundational for nurturing behaviors and an infant's development. Identifying risk factors for difficulties or problems in MIB is vital. However, traditional research often dichotomizes MIB using cutoff thresholds, overlooking its underlying complexities. This research utilizes latent profile analysis (LPA) to discern MIB subtypes in a nationwide Japanese dataset. Methods: We conducted LPA on data from the Mother-to-Infant Bonding Scale (MIBS), collected from 3,877 postpartum women within one year of childbirth. To empirically validate the derived profiles, we examined their associated risk factors, focusing on sociodemographic, health, and perinatal variables. Results: Four distinct MIB profiles emerged. Profile 1 indicated minimal difficulties, while Profile 4 exhibited severe multifaceted difficulties. Profiles 2 and 3 showed moderate difficulties distinguished by lack of positive affection and presence of negative affection (especially indifference), respectively. Compared to Profile 1, women in Profiles 2–4 had a higher likelihood of postpartum depression and low family support. Each profile also presented unique risk factors: medium family support in Profile 2, maternal working status in Profile 3, and pre-pregnancy underweight status in Profile 4. Notably, both Profiles 3 and 4 were also linked to increased feelings of loneliness since the onset of the COVID-19 pandemic. Conclusion: This study represents the first application of LPA to MIB, revealing distinct subtypes and their respective risk profiles. These insights promise to enhance and personalize early interventions for difficulties in MIB, affirming the necessity of acknowledging MIB's heterogeneity. [ABSTRACT FROM AUTHOR]

Purpose: Postpartum depression (PPD) brings adverse and serious consequences to both new parents and newborns. Neuroticism affects PPD, which remains controversial for confounding factors and reverse causality in cross-sectional research. Therefore, mendelian randomization (MR) study has been adopted to investigate their causal relationship. Methods: This study utilized large-scale genome-wide association study genetic pooled data from three major databases: the United Kingdom Biobank, the European Bioinformatics Institute, and the FinnGen databases. The causal analysis methods used inverse variance weighting (IVW). The weighted median, MR-Egger method, MR-PRESSO test, and the leave-one-out sensitivity test have been used to examine the results' robustness, heterogeneity, and horizontal pleiotropy. The fixed effect model yielded the results of meta-analysis. Results: In the IVW model, a meta-analysis of the MR study showed that neuroticism increased the risk of PPD (OR, 1.17; 95% CI, 1.11–1.25, p < 0.01). Reverse analysis showed that PPD could not genetically predict neuroticism. There was no significant heterogeneity or horizontal pleiotropy bias in this result. Conclusion: Our study suggests neuroticism is the risk factor for PPD from a gene perspective and PPD is not the risk factor for neuroticism. This finding may provide new insights into prevention and intervention strategies for PPD according to early detection of neuroticism. [ABSTRACT FROM AUTHOR]

Purpose: To compare the prevalence of emotional and physical intimate partner violence (IPV) across pregnancy and the first year postpartum in those with and without clinical depression and assess the association between maternal childhood trauma, current stressful life events and depression and IPV over the perinatal period. Methods: Data were obtained from 505 pregnant women from the Mercy Pregnancy and Emotional Wellbeing Study (MPEWS), a cohort study with data collected across pregnancy until 12 months postpartum. Maternal antenatal depression was measured using the Structured Clinical Interview for DSM-IV (SCID-IV) with repeat measurement of perinatal depressive symptoms using the Edinburgh Postnatal Depression Scale (EPDS). Trauma was measured using the Childhood Trauma Questionnaire, and experiences of physical and emotional intimate partner violence using items in the Stressful Life Events Scale. Results: Women experiencing IPV across the perinatal period were significantly more likely to score over 13 on the EPDS (p <.001) at each timepoint in pregnancy and the postpartum and physical IPV was associated with clinical depression. Further, a history of childhood trauma and current additional stressful life events were significantly associated with reporting current IPV in the perinatal period. Conclusions: This study confirmed the risk factors of childhood trauma and current stressful life events for reporting experiences of IPV in the perinatal period. Furthermore, women experiencing IPV reported higher depressive symptoms, providing evidence supporting the value of assessing those women who screen higher on the EPDS for IPV. Together these findings also support trauma informed care across pregnancy and the postpartum. [ABSTRACT FROM AUTHOR]

No increased risk of postpartum major depression (PPMD) was reported in women conceiving through assisted reproductive technologies (ART). However, ART may be associated with a higher risk of parenting difficulties in women with PPMD. In 359 women with a PPMD admitted to a Mother-Baby Unit (MBU), ART-women (4.2%) showed a 5-fold higher rate of parenting difficulties than those with spontaneous pregnancy (73.33% vs. 35.17%, multivariate ORa = 5.09 [1.48–17.48] p = 0.01). Specific support for mother-child relationship should be implemented in ART-women with PPMD. [ABSTRACT FROM AUTHOR]

Objective This study aimed to determine the prevalence of partner violence and depression in neonatal intensive care unit (NICU) mothers. Study Design This was a descriptive study. Mothers were screened in a safe room away from their partner with the Edinburgh Postnatal Depression Scale (EPDS) and the Abuse Assessment Screen Tool (AAS) within 2 days of the newborn's admission. The EPDS was administered again 2 weeks later and then at discharge. Results Nearly 20% of mothers reported on the AAS that they had experienced physical abuse since pregnancy. Abuse significantly predicted baseline depression 48 hours after delivery. A significant relationship emerged between depression and past year partner violence, with 100% experiencing abuse in the past year after pregnancy. Regular hospital intake questions underreported NICU mothers' partner violence experience and feelings of depression. Conclusion There was a marked difference between what mothers reported in their health history at admission versus evidence-based surveys in a private setting. These results challenge assumptions that accurate screening happens at hospital admission. It is imperative to use evidence-based scales after delivery to improve outcomes. Key Points Intake questions undermeasure partner violence and depression. Clinical depression emerges by 2 weeks postdelivery. Screening is optimal postdelivery, rather than at admission. [ABSTRACT FROM AUTHOR]

Postpartum depression and depressive symptoms have a major impact on maternal and infant health and well-being, yet to date their aetiology remains unclear. One hypothesis suggests a link between these symptoms and variations in prenatal cortisol levels, but existing evidence is limited and inconclusive. This study aims to provide additional evidence to disentangle the relationship between prenatal cortisol concentrations and subsequent occurrence of postpartum depressive symptoms. Cortisol for all three trimesters of pregnancy was extracted from the hair of 775 women participating in the French ELFE cohort. Depressive symptomatology at two months postpartum was assessed through the Edinburgh Postpartum Depression Scale (EPDS). Associations between prenatal cortisol levels and EPDS scores were tested using propensity-score weighted logistic regression models to control for confounders. An increase in mean cortisol concentrations was observed from the first to the third trimester of pregnancy. No significant differences in hair cortisol concentrations were found during the first and second trimesters between women who experienced postpartum depressive symptoms and those who did not. However, an association was observed between third trimester hair cortisol concentrations and depressive symptoms at two months postpartum. Women whose cortisol concentrations fell within the second quartile had a higher risk of subsequent PPDS (aOR = 2.67, 95%CI [1.01, 7.08]). Using a large sample from the general population, we observed an association between hair cortisol levels during the third trimester of pregnancy and postpartum depressive symptoms. Nevertheless, our results suggest that future studies could benefit from investigating other biomarkers of the reactivity of the corticotropic axis. [ABSTRACT FROM AUTHOR]

In this study, we describe continuing bonds and grief reactions and assess their association in 980 parents bereaved in pregnancy, at or shortly after birth. We found that most parents experienced continuing bonds. However, they differed by type of loss. Parents losing their child due to termination of pregnancy or miscarriage experienced bonds less frequently and had the least intense grief reaction. Parents losing their child postpartum experienced bonds most frequently and had the most intense grief reaction. Continuing bonds were associated with intensified grief in parents losing their child after termination or miscarriage, while this relationship was less obvious after stillbirth or postpartum death. [ABSTRACT FROM AUTHOR]

Insomnia in pregnancy is common and highly comorbid with depression. To investigate if: 1) depressive symptoms decrease after cognitive behavioural therapy for insomnia (CBT I) delivered in pregnancy, and 2) changes in insomnia symptoms represent a mechanism linking CBT-I treatment and reduced symptoms of postpartum depression. A two-arm, single-blind, parallel groups randomized controlled trial (RCT) design was used to evaluate the impact of a 5-week CBT-I intervention adapted for pregnant people with insomnia (N = 62). Participants were eligible if they were pregnant, between 12 and 28 weeks gestation, and met diagnostic criteria for insomnia. Participants completed questionnaires assessing symptoms of insomnia and depression pre-intervention (T1), post-intervention (T2), and six months postpartum (T3). A path analysis model was used to test direct and indirect effects simultaneously. There was a significant direct effect of CBT-I on postpartum depressive symptoms at T3. Additionally, significant indirect treatment effects on depressive symptoms at T3 emerged, through depressive symptoms at T2 and through improvements in insomnia that persisted from T2 to T3. Limitations to the current study include limited generalizability, the non-depressed sample, and variability in treatment and assessment delivery (in-person vs. online). CBT-I treatment in pregnancy may indirectly reduce postpartum depressive symptoms, through sustained improvements in insomnia symptoms. • Research on the effectiveness of CBT-I in pregnancy to alleviate depressive symptoms is mixed. • CBT-I delivered in pregnancy had lasting anti-depressive effects in the postpartum period. • CBT-I reduces postpartum depressive symptoms through sustained improvements in postpartum insomnia symptoms. • CBT-I in pregnancy may indirectly reduce postpartum depressive symptoms. [ABSTRACT FROM AUTHOR]

Empirical investigations have shown an association between gut microbiota and postpartum depression (PPD); nevertheless, the precise cause-and-effect relationship between these two variables remains ambiguous. This research aimed to examine the possible reciprocal causal relationship between the gut microbiota and PPD. In this work, we used Mendelian randomization (MR) to analyze the relationship between the gut microbiota (n = 18,340) and PPD (n = 67,205). We obtained the relevant SNPs from publicly accessible genome-wide association studies (GWAS). The SNP estimations were combined by the inverse-variance weighted (IVW) method, including sensitivity analyses such as weighted median, MR Egger, and MR Pleiotropy Residual Sum and Outlier (PRESSO). We have identified strong correlations between six bacterial characteristics and the likelihood of developing PPD. Our research revealed that the genus Ruminococcaceae UCG010, the family Veillonellaceae, and the class Clostridia had a beneficial effect on preventing PPD. The class Alphaproteobacteria, genus Slackia, and order NB1n were found to have a significant negative impact on PPD. The sensitivity studies conducted on these bacterial features consistently confirmed these finding. It is crucial to acknowledge that our study was conducted just within a European society, which may restrict its applicability to other groups. The findings from our MR investigation indicate a potential causal relationship between certain kinds of gut bacteria and PPD. Additional investigation is required to elucidate the influence of gut microbiota on the advancement of PPD. • Observational studies revealed a correlation between gut microbiota and PPD, but the findings were inconclusive. • Clostridia, Veillonellaceae, and Ruminococcaceae (UCG010) were found to reduce the risk of developing PPD. • In contrast, the presence of Alphaproteobacteria, Slackia, and NB1n increased the risk of PPD. [ABSTRACT FROM AUTHOR]

This short communication explores the interrelationships between depressed mood and sleep disturbances in one-year postpartum period. Utilizing data from the Interaction of Gene and Environment of Depression during PostPartum Cohort (IGEDEPP) involving 3310 French postpartum women, we employed a cross-lagged panel model (CLPM) to analyze the relationships between these two symptoms, across three time points (immediate postpartum [<1 week after delivery], early postpartum [<2 months after delivery], and late postpartum [2 months to 1 years after delivery]). Depressed mood significantly influences sleep disturbances in late postpartum (β = 0.096, z-value = 7.4; p < 0.001) but not in early postpartum (p-value = 0.9). We found no cross-lagged influence of sleep disturbances on depressed mood in early (p = 0.066) or in late postpartum (p = 0.060). Moreover, depressed mood and sleep disturbances in immediate postpartum are predictive of similar symptoms in the two other postpartum periods (between each of the three periods, p = 0.006 and p < 0.001 for depressed mood, and p = 0.039 and p < 0.001 for sleep disturbances), thus demonstrating the stability of these symptoms over time. Although conducted with a prospectively assessed cohort, this study faces limitations due to potential methodological biases. This study is a pioneering analysis of mutual causal interactions between depressed mood and sleep disturbances in the postpartum period, highlighting the need for vigilant monitoring, early detection, prevention of worsen outcomes and intervention on these symptoms. • This study of 3,310 women shows early postpartum depressed mood significantly impacts late postpartum sleep disturbances. • Depressed mood and sleep disturbances at one time predict similar issues at future times. • No evidence was found that sleep disturbances affect depressed mood over time. • Results stress the need for ongoing monitoring and targeted treatment for early detection of mood and sleep issues. [ABSTRACT FROM AUTHOR]

Copyright of African Journal of Reproductive Health is the property of Women's Health & Action Research Centre and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective: In the present study, the cognitive theory of stress and coping was adopted as a framework and a mediation model was developed to investigate the long‐term effect of fathers' involvement in child care and mothers' appraisal of a supportive coparenting partnership (SCP) on postpartum depressed mood (PDM) and parenting self‐efficacy (PSE) in Taiwanese new mothers. Background: Due to the risk of PDM and low PSE, many new mothers struggle with first‐time motherhood. It is therefore meaningful to investigate the benefits of potential protective factors that can reduce the risk of PDM and enhance PSE, such as fathers' involvement in child care and mothers' appraisal of an SCP, to improve new mothers' postpartum adjustment. Method: Using secondary data from the nationwide longitudinal project Kids in Taiwan, we analyzed data provided by 2,020 Taiwanese new mothers at 3 and 6 months after delivery. We conducted structural equation modeling to test our hypothetical mediation model. Results: Fathers' involvement in child care was significantly positively related to mothers' appraisal of an SCP, which in turn had a significant effect on reducing the risk of PDM and increasing PSE in Taiwanese new mothers both concurrently and 3 months later. Conclusion: This study highlighted the concurrent and long‐term benefits of fathers' involvement in child care for new mothers' postpartum adjustment and the importance of new mothers' appraisal of an SCP as a significant mediator. Implications: These findings warrant the attention and efforts of family life educators, marriage counselors, and other experts in related fields to promote better parenting experiences for new parents. [ABSTRACT FROM AUTHOR]

Background and Aim Postnatal depression (PND) can affect both genders, but the common misconception is that it only affects mothers. Increasing literature reports that 10% of the fathers experience PND after childbirth. This systematic review and meta-analysis aim to determine the pooled estimated prevalence of PND among fathers in the postnatal period and identify its risk factors. Materials and Methods The electronic databases PubMed, ProQuest, BASE, DOAJ, ResearchGate, Semantic Scholar, and BioMed Central were searched for related open-access articles published between January 2010 and March 2021. Finally, 15 articles met inclusion criteria. A random-effects model was used to calculate pooled estimates and 95% confidence intervals. Results The pooled prevalence of PND in fathers was 24.06%. Partner's depression, lack of social support, poor marital relationship, low income, and low education were all shown to raise the risk of PND in fathers. Conclusion PND in fathers is a serious concern. Early identification and treatment decrease the detrimental impact on mother and child while further improving quality of life. [ABSTRACT FROM AUTHOR]

Background: Becoming a mother is a very important process because of the impact it can have on women and their families. Currently, there is no validated questionnaire that evaluates the process of becoming a mother in the Spanish population. Moreover, no consistent results have been obtained to identify significant differences between primiparous and multiparous mothers. Aim: (1) Linguistic and metric validation of the Being a Mother scale (BaM-13) in the Spanish population, (2) analysis of possible differences between primiparous and multiparous mothers' experience of motherhood. Methods: Instrumental design. In 2016–2017, a sample of 579 mothers with children between 6 and 11 months of age completed the Spanish version of BaM-13. The instrument was translated using forward and back translation. Construct validity, internal consistency, and criterion validity were empirically analyzed. Results: Factorial analyses showed that the scale presented two adequate factors. Internal consistency of the global scale (α = 0.818, ω = 0.861), the Postnatal bonding factor (α = 0.773, ω = 0.784), and the Adult's experience factor (α = 0.710, ω = 0.721) was adequate. Significant associations were found with postpartum depression (r = 0.560), parental competence (r = − 0.584) and postnatal bonding (r = − 0.327). In terms of parity, primiparous mothers have greater difficulty in postnatal bonding, compared to multiparous mothers (p = 0.006). Conclusions: The Spanish version of the BaM-13 scale is valid for measuring mothers' experience of motherhood in a wide range of domains. The findings of the study show the importance of considering parity in the experience of becoming a mother, highlighting the approach to postnatal bonding in primiparous mothers. Additionally, we underline that it should not be assumed that multiparous mothers experience fewer difficulties in their motherhood process. [ABSTRACT FROM AUTHOR]

Copyright of Acibadem Saglik Bilimleri Dergisi is the property of Acibadem University Medical School and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The birth of a newborn in a family impacts both the mental health of the couple and the overall family's happiness. Yet, limited studies have examined how to address the mental health impact and improve family happiness following the birth of a newborn. This study aimed to determine the effectiveness of social media-based dance, storytelling, and visual art therapies in reducing symptoms of postpartum depression and strengthening family happiness. The study was a randomised control trial involving 313 families. The result showed that first-time families are more mentally stressed following the birth of a newborn than experienced families. The result also showed the main effect of the three interventions and the symptoms of PPD (p = 0.01) and family happiness (p = 0.02). Further results showed that for men, art therapy contributed more to reducing symptoms of PPD, while for women, storytelling contributed more. Dance therapy contributed more to strengthening family happiness when compared with storytelling and art therapies. However, the difference did not achieve a statistical significance (p = 0.06). The impact of the interventions was sustained even after six months of follow-up evaluation. Information in this study could inform practice on the best ways of addressing PPD and improving family happiness in the social media era. [ABSTRACT FROM AUTHOR]

Peripartum mental health is an underdiagnosed and undertreated entity; obstetricians are in a dilemma when patients present with signs of any mental disturbance. The peripartum period is fraught with triggers that can cause, or exacerbate, mental illness, and obstetricians need to be aware of diagnoses and treatment of blues, depression, psychosis and other problems. Key strategies that can be adopted are discussed in this review, along with the scenario in India. [ABSTRACT FROM AUTHOR]

Background: The integration of patient-centered care (PCC) and value-based healthcare (VBHC) principles, emphasizing personalized, responsive care and cost efficiency, is crucial in modern healthcare. Despite advocation from the International Consortium for Health Outcomes Measurement (ICHOM) for the global adoption of these principles through patient-reported measures (PRMs), their implementation, especially the pregnancy and childbirth (PCB) set, remains limited in maternity care. This study focuses on understanding the optimal organizational entity for integrating standard ICHOM-PCB-PRMs into routine maternity care in Finland. It aims to clarify the distribution of tasks among stakeholders and gather Finnish maternity healthcare professionals' perspectives on organizational responsibility in PRM collection. The emphasis was on identifying the optimal organizational framework for managing PRMs in maternity care. Results: A total of 66 maternity healthcare professionals participated in the study, reaching a consensus that public maternity care centers in Finland should be the primary entity responsible for managing PRMs in the maternity sector. Key aspects such as confidence with the role as a mother, maternal confidence with breastfeeding, and satisfaction with the result of care were identified as crucial and should be inquired about in both public maternity care centers and hospital maternity wards. The findings highlight the importance of comprehensive and consistent attention to these PRMs across public maternity care centers and hospital maternity settings to ensure holistic and effective maternal care. Conclusions: The study highlights the central role of public maternity care centers in the collection and management of PRMs within Finnish maternity care, as agreed upon by the professional consensus. It underscores the importance of a consistent and holistic approach to PRM inquiry across different care settings to enhance the quality and effectiveness of maternity care. This finding is crucial for policymakers and healthcare practitioners, suggesting that reinforcing the collaborative efforts between public maternity care centers and hospital maternity wards is vital for a patient-centric, efficient healthcare system. Aligning with PCC and VBHC principles, this approach aims to improve healthcare outcomes for pregnant and postpartum women in Finland, emphasizing the need for a unified strategy in managing maternity care. [ABSTRACT FROM AUTHOR]

Purpose. The study aimed to promote, foster, and cultivate psychological well-being among women during their postpartum phase and devise yoga-based interventions that enhance the psychological well-being of postpartum women. Material and Method. A 'mood and self-esteem measure' was employed to evaluate 50 participants who had recently given birth at Annamalai University Hospitals in Chidambaram, Tamil Nadu, India. In the yoga sessions, these individuals were randomly assigned to either a yoga group (N = 25) or a control group (N = 25) comprising 16 instructional units conducted over eight weeks. Those who completed the postpartum therapy and participated in the study received continuous supervision. The yoga sessions took place in a public setting, and the duration gradually increased from 25 minutes, including setup and conclusion, in the initial four weeks to 35 minutes from the fifth week to the eighth week. Result. The group participating in yoga demonstrated significantly more pronounced improvements in depression, anger, and tension compared to the control group, indicating moderate to substantial benefits. Yoga therapy groups and control of anger (t=44.10 and.338) and the depression (t =74.789 and 1.653). Tension (t =24.608 and .428). The yoga therapy groups exhibited significant alterations. Conclusion. The results endorse yoga as a potential complementary therapy for women in the postpartum phase.

Abstract Background Postpartum posttraumatic stress disorder (PP-PTSD) is a prevalent, yet often unrecognized mental health problem, particularly in low- and middle-income countries. Moreover, the long-term effects of PP-PTSD symptoms on maternal well-being and child socioemotional development beyond the first year postpartum remain largely unknown. This study focused on the association between PP-PTSD symptoms within one year after childbirth and maternal depressive symptoms and child behavioral problems two years later. Methods Russian women (n = 419) completed the City Birth Trauma Scale and the Edinburgh Postnatal Depression Scale evaluating symptoms of PP-PTSD and postpartum depression (PPD) via a web-based survey. Mothers also filled in the Beck Depression Inventory that assessed their depressive symptoms and the Child Behavior Checklist that assessed child’s behavioral problems 2.24 years later. Results The regression analysis showed a significant association between PP-PTSD and elevated depressive symptoms 2 years later even after adjustment for PPD (β = 0.19, 95% Confidence Interval 0.11, 0.26, p 0.12, p

Introduction: Postpartum depression, a form of depression, is a relatively common but serious medical condition that occurs following the birth of a baby. This study aimed to determine the relationship between the carbohydrate diet and the occurrence of anxiety and postpartum depression symptoms in women participating in the initial phase of the Maternal and Child Health Cohort Study, Yazd, Iran. Methods: This study was conducted on the data of 1028 pregnant women from the Yazd Maternal and Child Health Cohort Study. The study tools were food frequency questionnaire (FFQ) and postpartum depression questionnaire. Data related to dietary intake at the beginning of the study were collected in the first visit after pregnancy diagnosis and data related to depression in the second month after delivery. Carbohydrate intake score was calculated for each person according to summing up assigned scores to deciles of percentages of energy from macronutrients. Multivariable logistic regression models were used to estimate the odds ratio (ORs) and 95% confidence interval (CI) of postpartum depression and anxiety across quartiles of low carbohydrate diet scores. Results: Based on the multivariable-adjusted model, there was no significant association between low carbohydrate diet score and odds of postpartum depression (P=0.08). However, multivariable-adjusted model significantly indicated an association between low carbohydrate diet score in second tertile and the odds of postpartum anxiety (P=0.02) (OR: 0.36, 95% CI: 0.15-0.86). Conclusion: After adjusting the confounders, women in the second tertile of low carbohydrate diet score might have 64% lower chance of depression versus those in the first quartile. While low or high carbohydrate intake does not affect postpartum anxiety and depression, moderate carbohydrate intake might be anxiety protective.

Abstract Maternal and Child Health (MCH) programs have long been integral to global public health initiatives, aiming to safeguard the well-being of both mothers and their offspring. However, amidst the comprehensive approach to physical health, the mental well-being of mothers has often been overlooked, representing a critical gap in these programs. This paper examines the importance of addressing maternal mental health within the framework of MCH programs, highlighting its significance and the repercussions of its neglect. Despite its profound impact on maternal and child outcomes, issues such as postpartum depression, anxiety, and maternal stress are frequently disregarded in MCH interventions. This oversight not only undermines the holistic nature of maternal health but also perpetuates cycles of poor mental health within families and communities. Herewith, an effort was made to highlight the importance of maternal mental health and the need to focus and strengthen awareness about it through policy and programs.

Abstract Background Postpartum depression (PPD) is a prevalent psychological condition. Although the effect of obstetrical and maternal complications on PPD are well described, the impact of neighborhood socioeconomic status (SES) on PPD is relatively unexplored. Objectives This study examined the relationship between neighborhood SES score and PPD. Methods A summary SES measure for each U.S. zip code was constructed using income, education, and occupational 2021 Census data and linked to national commercial claims for 2017–2023. PPD status using diagnosis codes at outpatient and inpatient visits, and prescription drug use 3, 6, 9, and 12 months postpartum, were determined. Multivariate analysis controlled for potential confounders. Results PPD prevalence in commercial claims was 11.48%. Patients with PPD had higher rates of obstetrical (OR: 1.555, p

Abstract Background Postpartum depression (PPD) is widely recognized as the most prevalent mental health crisis following childbirth and has been linked to sleep disturbances. However, the potential causal relationships between various sleep traits and PPD remain unclear. This study employs a bidirectional two-sample Mendelian randomization (MR) approach to investigate these associations. Methods The inverse-variance-weighted method was used to evaluate the causally linked sleep traits on postpartum depression. The weighted median, weighted mode, and MR-Egger were used to estimate the robustness of the inverse-variance-weighted method. The leave-one-out method estimated the sensitivity of the result. Cochran’s Q method was used for the heterogeneous test. The MR-Egger intercept and MR-PRESSO methods detected the horizontal pleiotropy. Results We examined the genetic causal relationships between nine sleep traits and postpartum depression. Sleep apnea syndrome (OR: 1.122; 95%CI: 1.063–1.185; p = 0.000), sleeplessness/insomnia (OR: 1.465; 95%CI: 1.104–1.943; p = 0.008), and frequency of tiredness/lethargy in last 2 weeks (OR: 1.725; 95%CI: 1.345–2.213; p = 0.000) genetically predicted the increased risk of postpartum depression. The reverse Mendelian randomization analysis showed PPD caused sleeplessness/insomnia (β: 0.006; 95%CI: 0.001–0.010; p = 0.016) and frequency of tiredness/lethargy in last 2 weeks (β: 0.007; 95%CI: 0.002–0.011; p = 0.004). The remaining six sleep traits showed no significant association with PPD. There was no heterogeneity or horizontal pleiotropy. Conclusions Genetic evidence reveals causal relationships between specific sleep traits and PPD, including sleep apnea syndrome, sleeplessness/insomnia, and tiredness. Whether certain sleep health indicators suggest a risk of postpartum depression or sleep issues that are caused by PPD, both may offer insights into the prevention and treatment of PPD.

Abstract Background Postpartum Depression (PPD) is a severe mental health condition that adversely affects mothers and their infants. The influence of PPD on maternal-infant bonding and breastfeeding practices has been scarcely reported in Nigeria. Therefore, we examined the prevalence of PPD, the associated factors, and the relationship with maternal-infant bonding and breastfeeding practices in Abeokuta, Nigeria. Method A descriptive cross-sectional survey was conducted among 600 mothers within the extended postpartum period (≤ 1 year) from three government-owned immunisation clinics at primary, secondary, and tertiary health facilities in Abeokuta, Ogun State. PPD was assessed using the Edinburgh postnatal depression Scale (EPDS ≥ 13), and maternal-infant bonding was evaluated using the Postpartum Bonding Questionnaire (PBQ ≥ 50). We also examined breastfeeding practices (i.e. the time to initiation by 30 min, exclusive breastfeeding for 6 months and early commencement of complementary feeding by 2 months). Data was analysed using chi-square and logistics regression models at a 5% significance level. Results The prevalence of PPD was 21.8%, 95% CI (18.7–25.3). Factors associated with PPD were maternal age: 25–34 years [AOR = 0.52; 95% CI (0.29–0.90)]; ≥ 35 years [AOR = 0.44; 95% CI (0.20–0.96)], being married [AOR = 0.43; 95% CI (0.21–0.85)], perceived stress increased the odds of PPD: moderate stress level [AOR = 8.38; 95% CI (3.50–19.9)]; high-stress level [AOR = 47.8; 95% CI (8.65–263.7)] and self-reported history of emotional problems [AOR = 3.25; 95% CI (1.43–7.38)]. There was a significant direct association between PPD and poor maternal-infant bonding [AOR = 3.91; 95% CI (1.04–4.60)]. PPD reduces the odds of early breastfeeding initiation [AOR = 0.43; 95% CI (0.28–0.68)], but no association was found between PPD and exclusive breastfeeding [AOR = 1.07; 95% CI (0.07–1.67)]. Conclusion The prevalence of PPD was high in our study population and associated with poor maternal-infant bonding and late breastfeeding initiation but not with exclusive breastfeeding. Promoting maternal mental health to foster stronger mother-infant relationships and better breastfeeding practices has become crucial.

Abstract Background Pregnancy and childbirth are critical life events which lead to significant changes in family structures and roles, thus having a substantial impact on partner relationship and maternal wellbeing. A dysfunctional partnership during this critical time of life has been associated with maternal depressiveness. However, sub-components of partnership quality and the causal relation with maternal symptoms of depression in the perinatal period have been sparsely studied so far. The current study aims to longitudinally assess the course of relationship quality and its sub-components from pregnancy to postpartum and to test a potential causal association with maternal symptoms of depression in the perinatal period. Methods Differing from previous studies, partnership quality and symptoms of depression have been assessed prospectively and longitudinally from an early stage of pregnancy (second trimester) until six months postpartum. Cross-lagged panel models were applied to investigate a potential causal relationship between partnership quality and maternal depressive symptoms. Results Relationship quality decreased significantly during the transition to parenthood (p

Introduction: This is a case of a 32-year-old woman who developed postpartum depression (PPD). She became anxious and depressive about caring for her child, and the Edinburgh Postnatal Depression Scale (EPDS) test showed a score of 9 at 2 weeks after delivery, and at 7 months postpartum, she presented with major melancholic depression followed by mild cognitive decline without any neurological symptoms except cluttering speech. Case Presentation: Cerebral magnetic resonance imaging showed confluent fluid-attenuated inversion recovery hyperintensities in the periventricular and frontal deep white matter, with multiple spotty calcifications in the frontal white matter by cerebral CT. Genetic testing revealed a mutation in the colony-stimulating factor 1 receptor (CSF1R). Conclusion: This case report is consistent with evidence that PPD may have organic causes in some cases, including CSF1R mutations. Atypical findings such as mild cognitive decline combined with PPD in psychiatric interview may justify brain imaging to avoid misdiagnosis, since CSF1R-related leukoencephalopathy is probably an under-recognized disease in medical psychiatry. Further investigations are needed to clarify a pathophysiological correlation between CSF1R signaling abnormality and PPD as well as major depression.

Background: Breastfeeding is very beneficial to both mothers and infants. However, perinatal depression, encompassing both antenatal and postnatal depression, can significantly impact breastfeeding. Prior research suggests a link between postpartum depression and breastfeeding difficulties. This systematic review focuses on the duration of breastfeeding, the duration of exclusive breastfeeding (EBF), initiation, as well as the early cessation of breastfeeding among mothers in South Asian countries with unique sociocultural practices and mental health experiences. Methodology: The searched databases were PubMed, Ovid MEDLINE, ProQuest PsycINFO, EBSCOhost CINAHL, and Bielefeld Academic Search Engine (gray literature) for relevant records till February 2024. Studies conducted in South Asian countries with cross-sectional, cohort, or case–control designs were included, and all interventional studies, qualitative studies, case reports, and case series were excluded. The review examined breastfeeding duration among mothers with perinatal depression. Two reviewers independently screened and selected studies, extracted data, and used the Newcastle–Ottawa Scale for quality assessment. Results: This systematic review identified 109 records, of which 14 were eligible. Ten studies were cross-sectional and 4 were cohort studies. It involved 11,944 perinatal women, with sample sizes ranging from 100 to 8189 participants. Conclusion: Perinatal depression was associated with shorter breastfeeding duration, especially EBF and early cessation of all breastfeeding. However, any association between perinatal depression and the initiation of breastfeeding was unclear. Overall, supporting mothers suffering from perinatal depression is crucial for successful breastfeeding practice. Certain limitations of the review were data heterogeneity, risk of recall bias in breastfeeding practices, and different data collection time points. Future research could study the various sociocultural and economic factors and biological mechanisms in breastfeeding and maternal depression.

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. 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. 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. 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. 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. • This study investigated risk factors for postpartum depression in men and women. • Childhood maltreatment increases the risk for postpartum depressive symptoms. • Emotional abuse and neglect are associated with postpartum depressive symptoms. • Emotion regulation provides a promising target for preventing postpartum depression. • Attachment anxiety and educational background are linked with postpartum depression. [ABSTRACT FROM AUTHOR]

Although understanding of maternal hypomania in the postpartum period is gradually improving, the intergenerational pathways of risk associated with hypomania in the context of postpartum depression remain unknown. It is also unclear whether distinct or shared pathways of risk exist for infants exposed to different parental mood characteristics and whether these pathways are mediated by parental reflective functioning. An online survey was administered to 1788 parents (89 % mothers, 50 % White) who were primary caregivers of a child under 2. Structural equation modelling techniques were employed to model direct and indirect associations between parental depressive symptoms, hypomanic traits and infant socio-emotional development, investigating the mediating role of parental reflective functioning. Elevated levels of parental depressive symptoms, in the presence of hypomanic personality traits, were directly associated with infant socio-emotional challenges, without affecting parental reflective functioning. However, higher levels of parental hypomanic traits in the postnatal period displayed a fully mediated pathway of risk transmission to infants' socio-emotional development via their negative association with parental reflective functioning. Results should be interpreted with caution as the reliance on self-and-parent-reported scales may have introduced biases influenced by individual perceptions and situational factors. Additionally, the cross-sectional design of this study inhibits establishing cause-and-effect relationships. Overall, these results highlight the critical role of both parental depressive symptoms and hypomanic traits on infant socio-emotional development, suggesting that supporting parental mood regulation and mentalizing abilities in the postnatal period could reduce the risk of early maladaptive socio-emotional trajectories in children. • Parental depressive symptoms (PPD) directly affect infant socio-emotional development. • Parental hypomanic traits indirectly affect infant socio-emotional development. • Impaired reflective functioning is associated with infant developmental challenges. • In the presence of hypomania, PPD is not associated with reflective functioning. • Hypomanic traits are associated with impaired reflective functioning. [ABSTRACT FROM AUTHOR]

Postpartum depression (PPD), a common and severe mental health problem, affects about 13–20 % of new mothers. Despite the psychological intervention's effectiveness, referral uptake rates among affected women are low. In the article, we aim to characterise those new mothers who adhered to referral advice after a positive PPD screening result. 9161 women had taken part in a midwife-led PPD screening. Those who scored equal to or more than ten points on the Edinburgh Postnatal Depression Scale (EPDS) were referred for psychological consultations (12 %, n = 1109). We used data gathered during the realization of a PPD prevention programme. The following measures were used: EPDS, a sociodemographic and health data survey, and psychological consultation cards. We found that only 85 (8 %) of referred mothers later enrolled in psychological consultations. Those mothers who adhered to the referral advice had higher EPDS (total score) and EPDS – 3A anxiety scores than mothers who did not contact a psychologist. Moreover, they had a higher gestational age at birth and, on average, fewer children. More PPD symptoms, C-section experience, self-assessed good financial situation and a postgraduate higher education degree were predictors of seeking help. A mother's decision to follow the referral advice is crucial in mental health prevention and should be treated as an addition to a separate step 2: referral in a 3-step PDD management process, with identification constituting a step 1, and intervention - a step 3. • Approximately 92% of women with a positive PPD screening result did not take up the referral. • The mother's decision to follow the referral advice is crucial in mental health prevention and should be treated, along with the referral itself, as a separate step 2 in a 3-step PDD management process: screening, a mother's decision to uptake the referral, and the availability of the peripartum mental health services. • Public health professionals should explore what mothers with PPD risk need and how these needs could be met. [ABSTRACT FROM AUTHOR]

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. 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. 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. Chronic postpartum depression was identified using self-administered questionnaires. 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. • A predictive model of chronic postpartum depression was developed. • Machine learning techniques (decision trees) were used to create the model. • Variables measured during pregnancy were used for branching conditions. • The decision tree was simple enough to be implemented using pen and paper. • The decision tree proved to be relatively powerful. [ABSTRACT FROM AUTHOR]

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. 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. 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. 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. • Postnatal depression trajectories were characterized over 10-years. • We compared the EPDS subscales of anhedonia, anxiety, and depression. • Perinatal depression, whether mild or severe, often begins during pregnancy. • Men may be more vulnerable to stress after childbirth as they do not seek help. • Anxiety and depression in mothers remained at high levels for 10 years postpartum. [ABSTRACT FROM AUTHOR]

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. 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. 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. 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. • First study to assess the relationship between inflammatory biomarkers before pregnancy and risk of perinatal depression. • Lower level of lymphocytes associated with elevated risk of perinatal depression • Higher level of platelet-to-lymphocyte ratio associated with elevated risk of perinatal depression • Such associations appeared more pronounced for postpartum depression than antepartum depression. • Inflammation and immune dysregulation may play a role in the mechanism of perinatal depression. [ABSTRACT FROM AUTHOR]

Postpartum depression (PPD) presents a significant mental health challenge for mothers following childbirth. While the precise cause of this condition remains unknown, preventive measures and treatments are available. This study aims to employ ensemble learning techniques, utilizing C4.5 decision tree (DT), gradient boosting tree (GBT), and extreme gradient boosting (XGBoost), to predict the occurrences of PPD in the Banjarmasin, South Kalimantan, Indonesia. The predictive model developed encompasses a dataset comprising 317 records gathered from postpartum mothers in hospitals, community health services, and midwifery clinics (referred to as Model 1). Furthermore, resampling techniques (Model 2) were employed to address class imbalance. Additionally, feature selection including forward selection and backward elimination (Model 3) were implemented to enhance model performance. The findings reveal that XGBoost, combined with resampling methods, achieved the highest accuracy rate at 87.57%. Feature selection identified five crucial factors associated with PPD incidence: marital status, number of living children, history of depression, fear of delivery, and family relationships. The utilization of ensemble learning strategies for PPD prediction yields reliable outcomes that can be applied within clinical settings. Exploring alternative ensemble learning strategies such as random forest and adaptive boosting could further optimize model performance and warrant consideration in future research endeavours. [ABSTRACT FROM AUTHOR]