Search

Background: Ambient air pollution during pregnancy has been linked with postpartum depression up to 12 months, but few studies have investigated its impact on persistent depression beyond 12 months postpartum. This study aimed to evaluate prenatal ambient air pollution exposure and the risk of persistent depression over 3 years after childbirth and to identify windows of susceptibility., Methods: This study included 361 predominantly low-income Hispanic/Latina participants with full-term pregnancies in the Maternal and Developmental Risks from Environmental and Social Stressors (MADRES) cohort. We estimated daily residential PM 2.5 , PM 10 , NO 2 , and O 3 concentrations throughout 37 gestational weeks using inverse-distance squared spatial interpolation from monitoring data and calculated weekly averaged levels. Depression was assessed by the 20-item Center for Epidemiologic Studies-Depression (CES-D) scale at 12, 24, and 36 months postpartum, with persistent postpartum depression defined as a CES-D score ≥16 at any of these timepoints. We performed robust Poisson log-linear distributed lag models (DLM) via generalized estimating equations (GEE) to estimate the adjusted risk ratio (RR)., Results: Depression was observed in 17.8 %, 17.5 %, and 13.4 % of participants at 12, 24, and 36 months, respectively. We found one IQR increase (3.9 ppb) in prenatal exposure to NO 2 during the identified sensitive window of gestational weeks 13-29 was associated with a cumulative risk ratio of 3.86 (95 % CI: 3.24, 4.59) for persistent depression 1-3 years postpartum. We also found one IQR increase (7.4 μg/m 3 ) in prenatal exposure to PM 10 during gestation weeks 12-28 was associated a cumulative risk ratio of 3.88 (95 % CI: 3.04, 4.96) for persistent depression. No clear sensitive windows were identified for PM 2.5 or O 3 ., Conclusions: Mid-pregnancy PM 10 and NO 2 exposures were associated with nearly 4-fold increased risks of persistent depression after pregnancy, which has critical implications for prevention of perinatal mental health outcomes., Competing Interests: Declaration of competing interest We declare no actual or potential competing interests., (Copyright © 2024 Elsevier B.V. All rights reserved.)

Importance: Little is known about differences between Black and White women with respect to the prevalence of postpartum mood disorders or symptom presentations., Objective: To determine the prevalence and characteristics of postpartum major mood disorders in Black and White women at 4-6 weeks after birth., Methods: This is a secondary analysis of a large-scale study designed to screen women for postpartum depression with the Edinburgh Postnatal Depression Scale (EPDS) and collect symptom data. Data were collected at an urban maternity hospital in an academic setting in Pittsburgh, Pennsylvania. Of the 2,019 women who screened positive and accepted a psychiatric diagnostic interview, 163 and 85 Black women had major depressive and bipolar disorders, respectively, and 508 and 177 White women had major depressive and bipolar disorders, respectively. Those with an EPDS score greater than or equal to 10 were offered a psychiatric assessment (in-person at home or by telephone) with the Structured Clinical Interview for DSM IV using the Structured Interview Guide for the Hamilton Rating Scale for Depression, Atypical Depression Version symptom inventory, a questionnaire related to childhood and adulthood physical and sexual abuse, and the Short Form Survey 12. Participants who self-identified as Black or White were included in this analysis., Results: Among screen-positive participants, no significant difference in the rate of major depressive disorder (40% Black and 35% White) was observed. However, bipolar disorder significantly differed between Black (19.2%) and White (11.5%) women. Additionally, symptom profiles differed between Black and White participants with major depressive disorder, and a high rate of traumatic experiences was reported by participants with major depression and bipolar disorder in both racial groups., Conclusion: An understanding of the different presentations of postpartum mood disorders between Black and White women, as well as trauma-informed care, can optimize postpartum health care through supporting advocacy efforts for resource allocation and health care delivery., Trial Registration: Dataset from study at ClinicalTrials.gov identifier: NCT00282776., (© Copyright 2024 Physicians Postgraduate Press, Inc.)

Background: Perinatal depression is a significant public health issue affecting one in four women globally. It occurs at a critical time of a woman's life; affecting her relationships with family, and child's emotional, behavioral, and cognitive development. Considering the burden of the problem to the whole family, this systematic review and meta-analysis was conducted to estimate the pooled prevalence of perinatal depression and its determinants in Ethiopia to provide up-to-date evidence at a national level., Methods: All observational studies conducted on perinatal depression in Ethiopia were included based on the selection criteria. Data was extracted using Microsoft Excel and then exported to STATA version-11 for analysis. The random-effects model was employed to estimate the pooled effect size of perinatal depression and its determinants with 95% confidence intervals. Funnel plots analysis and Egger regression tests were conducted to check the publication bias. Sub-group and sensitivity analyses were also performed., Results: This systematic review and meta-analysis included thirty studies and the pooled prevalence of perinatal depression in Ethiopia was 24.29% (95% CI (21.98, 26.59)). According to the subgroup analysis, the pooled prevalence of antenatal depression and others (postnatal and perinatal depression) was 24.24% and 24.52% respectively. Regarding determinants of perinatal depression, having unplanned pregnancy [OR = 3.04 (2.2, 4.2)], intimate partner violence [OR = 3.09(2.14, 4.46)], poor social support [OR = 3.3(2.38, 4.57)], and a history of depression [OR = 3.68(2.45, 5.52)] were significantly associated with depression., Conclusion and Recommendation: This study showed that the pooled prevalence of perinatal depression in Ethiopia was found to be high. To ensure the mental health of both the mother and child, health professionals should routinely screen perinatal women for depression giving special focus for those with a history of depression and managing them accordingly., Competing Interests: Declarations Ethical approval and consent to participate Not applicable. Consent for publication Not applicable. Competing interests The authors declared that no competing interest exists., (© 2024. The Author(s).)

Purpose: Depressive symptoms during the perinatal period have broad and enduring health implications for birthing parents and their offspring. Rising prevalence rates of perinatal depression highlight the need for research examining factors influencing depressive symptoms during pregnancy, and trajectories during the early postnatal period. Grounded in bioecological systems theory, this longitudinal multimethod study examined whether prenatal bioecological factors predict depressive symptoms from pregnancy to 36 months postpartum., Methods: Participants were 162 pregnant individuals, oversampled for high emotion dysregulation, who completed a life stress interview and physiological assessment during the 3rd trimester and a self-report measure of depression at five time-points (3rd trimester, within 48 h of birth, 7, 18, and 36 months postpartum). Multilevel models were used to test study aims., Results: Participants exhibited the highest levels of depressive symptoms at 3rd trimester, and substantial variability in depressive symptom trajectories over time. Lower resting respiratory sinus arrhythmia (RSA), an index of parasympathetic nervous system functioning, in the 3rd trimester was associated with higher concurrent depressive symptoms. Higher levels of stress related to partner relationships, finances, and health were concurrently associated with more depressive symptoms during pregnancy and decreases in depressive symptoms over time. Specifically, depressive symptoms decreased only for individuals who reported high levels of stress during pregnancy., Limitations: Although grounded in bioecological systems theory, this study did not assess the macrosystem., Conclusions: Results of this study underscore the importance of multilevel predictors of perinatal health and highlights potential targets for preventing depression and promoting well-being during the perinatal transition., Competing Interests: Declaration of competing interest The authors declare they have no conflicts of interest., (Copyright © 2024 Elsevier B.V. All rights reserved.)

Background: Our study delves into postpartum depression (PPD) extending observation up to six months postpartum, addressing the gap in long-term follow-ups and uncover critical intervention points., Method: Through a continuous three-wave cohort study involving 3174 of 10,730 invited postpartum women, we utilized machine learning to predict PPD risk, incorporating self-reported surveys and health records from October 2021 to Jan 2023., Results: PPD prevalence slightly decreased from 30.9 % to 29.1 % over six months. The Random Forest model emerged as the most effective, identifying key predictors of PPD at different stages. The top three factors at first month were newborn's birth weight, maternal weight before delivery and before pregnancy. The EPDS scores of last time, newborn's birth weight and maternal weight before pregnancy and before delivery were main predictors for EPDS scores at third and sixth months postpartum., Limitation: The study faces limitations such as potential selection bias due to the convenience sampling method and the reliance on self-reported measures, which may introduce reporting bias. Furthermore, the high attrition rate could affect the representativeness of the sample and the generalizability of the findings., Conclusion: There is a slight decrease in PPD rates over six months, yet the prevalence remains high. This underscores the need for early and ongoing mental health support for new mothers. Our study highlights the efficacy of machine learning in enhancing PPD risk assessment and tailoring intervention strategies, paving the way for more personalized healthcare approaches in postpartum care., 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 B.V. All rights reserved.)

Background: Post-partum depression (PPD) significantly contributes to maternal morbidity and mortality, particularly in developing countries, impacting the well-being of women, their families, and society., Objective(s): This study assessed the prevalence of PPD and its associated factors among parous women in Ibadan SouthWest LGA., Methods: The cross-sectional study utilized a multi-staged sampling technique to select 454 postpartum women from six selected primary health care centres in Ibadan. Data on socio-demographics, obstetric history, patterns of intimate partner violence (IPV), family connectedness, and PPD experiences were elicited using interviewer-administered questionnaires. Data analysis included descriptive statistics, chi-square test and logistic regression with significance level for all test sets at 5%., Results: The mean age of the women was 29.4±5.3, with the majority being married (96.3%) and in monogamous unions (88.8%). About two-fifths (41.4%) had husbands with postsecondary education and the pregnancy of respondents (76.7%) was planned and wanted. Over half (56.2%) of the women experienced emotional violence during pregnancy, and 45.2% were from dysfunctional families. Prevalence of post-partum depression was 44.6%. Husband's education level (p=0.041), family type (p=0.002), pregnancy desire (p=0.037), and family connectedness (p=0.029) were associated with PPD. Independent predictors of postpartum depression included being married (OR=0.242; 95%CI=0.06-0.92) and experiencing emotional or physical abuse (OR=3.960; 95%CI=1.787-8.796 and OR=1.764; 95%CI=1.162-2.680)., Conclusions: PPD was prevalent among women; who experienced IPV, whose spouses had lower education, with unplanned or unwanted pregnancies, and dysfunctional families. Health education and social support for women are advocated to prevent the experience of postpartum depression., Key Message: Postpartum depression is common among urban women in Southwest Nigeria and is significantly influenced by experience of IPV and marital status. Single women had higher odds, with additional factors including educational level, family dynamics, and pregnancy intention affecting PPD. Education, family and societal support are vital to help prevent PPD, Competing Interests: The Authors declare that no competing interest exists, (Copyright © 2024 by West African Journal of Medicine.)

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 < .0001) and maternal complications (OR: 1.145, p < .0001), and more lifestyle risk factors (OR: 1.113, p < .0001). Comorbidity scores were higher for patients with PPD. Controlling for age and clinical factors, living in a disadvantaged neighborhood was associated with an increased incidence of PPD (OR: 1.137, p < .0001)., Limitations: Claims data may include potential inaccurate coding of diagnoses/procedures. Clinical information is limited to conditions and treatments defined by ICD-10-CM codes. Area-based SES measures inevitably misclassify people on both ends of the socioeconomic spectrum (this misclassification is random; direction of bias is known)., Conclusions: The inverse and significant effect of area-based high SES on PPD rates demonstrates that preventive efforts may require interventions focusing on both the patient and the lived environment., (© 2024. The Author(s).)

Importance: Postpartum depression (PPD) poses significant risks to maternal and child health. Understanding temporal trends is crucial for evaluating prevalence and identifying populations at risk., Objective: To evaluate recent trends in PPD and assess how these trends are associated with race, ethnicity, and prepregnancy body mass index (BMI)., Design, Setting, and Participants: A serial, cross-sectional analysis using data from the Kaiser Permanente Southern California (KPSC) electronic health records (EHRs), with live and stillbirths at 20 or more weeks of gestation who were KPSC members at the time of delivery between 2010 and 2021. Data were analyzed from July 2022 to August 2023., Exposures: Self-reported race, ethnicity, and recorded prepregnancy BMI., Main Outcome Measures: PPD cases were identified using validated diagnostic codes and prescription records within 12 months postpartum in the KPSC EHRs. Patients with an Edinburgh Postnatal Depression Scale score of 10 or more within 6 months postpartum were further evaluated by a mental health specialist for formal PPD diagnosis., Results: In this study of 442 308 pregnancies, the median (IQR) maternal age at delivery was 31 (27-34) years. The cohort was racially and ethnically diverse, with 62 860 individuals (14.2%) identifying as Asian/Pacific Islander, 231 837 (52.4%) as Hispanic, 33 207 (7.5%) as non-Hispanic Black, 108 201 (24.5%) as non-Hispanic White, 5903 (1.3%) as multiple or other, and 300 (0.1%) unknown. PPD prevalence doubled over the study period, increasing from 9.4% in 2010 to 19.0% in 2021. The largest increases were observed among Asian and Pacific Islander participants (280% increase) and non-Hispanic Black participants (140% increase). PPD rates increased across all BMI categories, particularly among individuals with obesity (class I) and morbid obesity (class II/III)., Conclusions and Relevance: In this cross-sectional study, PPD diagnosis increased significantly across all racial and ethnic groups and BMI categories over the past decade. While rising PPD may reflect improved screening and diagnosis practices, the persistently high rates highlight the need to develop and implement interventions to prevent the condition while expanding efforts to mitigate the impact of PPD on maternal and child health.

Introduction: The United States is the only high-income country without a comprehensive national maternity leave policy guaranteeing paid, job-projected leave. The current study examined associations between maternity leave characteristics (duration of leave, payment status of leave) and postpartum depressive symptoms., Methods: This study used a sample of 3,515 postpartum women from the New York City and New York State Pregnancy Risk Assessment Monitoring System (PRAMS) from 2016 to 2019. We used logistic regression to examine the association of leave duration and payment status with self-reported postpartum depressive symptoms between 2 and 6 months postpartum., Results: Compared to having at least some paid leave, having unpaid leave was associated with an increased odds of postpartum depressive symptoms, adjusting for leave duration and selected covariates (adjusted odds ratio [aOR] = 1.41, 95% confidence interval [CI]: 1.04-1.93). There was no significant difference in postpartum depressive symptoms between those with partially and those with fully paid leave. In contrast to prior literature, leave duration was not significantly associated with postpartum depressive symptoms (aOR = 0.99, 95% CI: 0.97-1.02 for each additional week of leave)., Discussion: This study suggests that unpaid leave is associated with increased risk of postpartum depression, which can have long-term health effects for both mothers and children. Future studies can help to identify which communities could most benefit from paid leave and help to inform paid leave policies., (© 2024. The Author(s).)

Problem: Women pregnant during the COVID-19 pandemic may be at risk of elevated postpartum mental health problems., Background: Social support protects maternal mental health during a pandemic. It is possible that formal supports, such as continuity maternity models of care, may also support maternal wellbeing., Aim: To investigate whether model of care moderates the association between prenatal maternal stress from the COVID-19 pandemic, and postpartum (a) depression and (b) anxiety., Methods: Women in Australia, pregnant during the COVID-19 pandemic (n = 3048), completed a survey detailing their COVID-19-related objective hardship and subjective distress during pregnancy and completed depression and anxiety measures at birth to six weeks ("Early"), seven to 21 weeks ("Moderate"), and/or 22-30 weeks ("Late") postpartum., Findings: Higher subjective distress was associated with elevated depression and anxiety at all timepoints. Model of care did not moderate the association of objective hardship or subjective distress and depression or anxiety at any timepoint. Compared with Standard Care, women receiving private midwifery care had a 74 % reduction in the odds of elevated anxiety in early postpartum., Discussion: Women receiving private midwifery may have experienced lower anxiety due to a greater duration of postpartum in-home care, fewer changes to service delivery, and the option of homebirth. Women pregnant during a pandemic should be screened for higher subjective distress about the event., Conclusion: These results suggest that continuity of private midwifery care may be beneficial for supporting postpartum mental health during a pandemic, with implications for practice and policy for the current and future pandemics., Competing Interests: Declaration of Competing Interest We have no conflict of interest to declare., (Copyright © 2024 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Introduction: We aimed to (1) identify the prevalence of postpartum depression (PPD) symptoms using the Patient Health Questionnaire-2 (PHQ-2) and the Edinburgh Postnatal Depression Scale (EPDS), and (2) analyze the relationship between PPD symptoms and social determinants of health (SDoH)., Method: We obtained data from 1327 infant/mother dyads at 1 and 6-month well-child checks. We used Chi-square and T-tests to compare social determinants between PPD screening groups and logistical regression to construct predictive models for PPD., Results: The prevalence of positive PPD screens was 5-7%, but only 1.85% screened positive at both periods. Although the EPDS and PHQ-2 were correlated (Pearson 0.66), the PHQ-2 missed 65% of those identified by the EPDS. Positive PPD screens were associated with greater SDoH concerns., Discussion: Our study highlights the importance of repeated PPD screening. The EPDS detected more mothers at risk than the PHQ-2. Multiple SDoH were associated with PPD symptoms., Competing Interests: CONFLICTS OF INTEREST The authors report no financial conflicts or potential conflicts of interest. The authors are submitting this manuscript using the appropriate reporting standards for our work., (Copyright © 2024 National Association of Pediatric Nurse Practitioners. Published by Elsevier Inc. All rights reserved.)

Background: Perinatal depression has been suggested to adversely impact child neurodevelopment. However, the complexity of the early childhood environment challenges conclusive findings., Objective: To evaluate whether there is an association between perinatal depressive symptoms and child intelligence quotient (IQ) at 5 years of age., Study Design: Secondary analysis of an ancillary study to a multicenter randomized trial of thyroxine therapy for pregnant individuals with subclinical hypothyroidism. Dyads of infants and birthing parent, with completed Center for Epidemiological Studies-Depression (CES-D) screens during pregnancy and postpartum and child neurodevelopment testing completed at five years of age (n=209) were included. CES-D screening was performed at 11-20 weeks, 34-38 weeks, and one-year postpartum. Depressive symptoms were categorized as antenatal (i.e., a positive screen at any point during pregnancy) or postpartum. The primary outcome was child IQ score < 85 at 5 years of age using the Wechsler Preschool and Primary Scale of Intelligence III (WPPSI-III) Full Scale test. Secondary outcomes included other assessments of childhood neurodevelopment. Bivariable analyses and multivariable logistic regressions were utilized., Results: Of the 209 birthing people included, 72 (34%) screened positive for depression during pregnancy and 32 (15%) screened positive one year postpartum. Children born to individuals with a positive antenatal depression screen had a higher odds of IQ < 85 at 5 years of age compared with children born to individuals with a CES-D < 16 (35% vs. 18%, OR 2.4, 95% CI 1.2-4.7). Similar findings were seen for children born to individuals with a positive postpartum depression screen (47% vs. 21%, OR 3.3, 95% CI 1.5-7.3). These associations did not persist in multivariable analyses that controlled for social determinants of health and clinical characteristics (adjusted odd ratio [aOR] 1.4, 95% CI 0.7-3.1; aOR 2.1, 95% CI 0.9-5.1, for antenatal and postpartum depressive symptoms, respectively). Similar findings were observed for other adverse neurodevelopmental outcomes., Conclusions: Having a positive perinatal depression screen was not associated with child cognitive outcomes after controlling for covariates including social determinants of health., (Copyright © 2024 Elsevier Inc. All rights reserved.)

Background: Postpartum depression is a major psychiatric disorder associated with maternal suicide and child developmental disturbances. In this study, we aimed to investigate whether general anesthesia for cesarean delivery is associated with a higher rate of new-onset depression after delivery than neuraxial anesthesia., Methods: This is a nationwide retrospective cohort study using data retrieved from the National Health Insurance Research Database between 2014 and 2018. Women who had cesarean delivery under general or neuraxial anesthesia were enrolled. After 1:4 propensity score matching, there were 4544 and 18,176 women under the general and neuraxial anesthesia groups, respectively. The primary outcome was new-onset depression diagnosed after delivery in a time-to-event analysis setting., Results: After propensity-score matching, the rate of new-onset depression diagnosed within 1 year was 1.10 % (50/4488) and 0.86 % (157/18176) after cesarean delivery under general and neuraxial anesthesia, respectively. For depression diagnosed within 90 days of delivery, significant difference between the two groups was noted (0.51 % vs. 0.30 %, P = 0.031). In the time-to-event analysis with Cox regression model, women who delivered under general anesthesia were associated with significantly higher risk of postpartum depression within 90 days (Hazard ratio [HR], 1.71; 95 % CI, 1.05-2.79) compared with those under neuraxial anesthesia., Limitations: The observational design only allows asserting association, rather than establishing causality between exposure and outcomes., Conclusions: Women who underwent cesarean delivery under general anesthesia had a higher risk of subsequent depression within 90 days than those under neuraxial anesthesia. Early screening for depressive disorders might facilitate timely management., Competing Interests: Declaration of competing interest The authors declare no competing interests., (Copyright © 2024 Elsevier B.V. All rights reserved.)

Objectives: To assess the feasibility of universal screening of postpartum depression (PPD), using the Edinburgh Postpartum Depression Scale (EPDS) in the general population. To investigate the proportion of women identified as being at risk of PPD and with confirmed PPD or other mental disorders after a psychiatric consultation., Methods: A multicenter prospective cohort study in four French maternities conducted between 2020 and 2023. All women aged over 18 years, who delivered following a singleton pregnancy after 37 weeks of gestation were eligible for inclusion. The exclusion criteria were pre-existing psychiatric disorders such as depressive syndrome. The EPDS was completed at 8 weeks postpartum via an online self-administered questionnaire. If the response to the questionnaire suggested a mental disorder, a psychiatric consultation was proposed to the women concerned. The endpoints were the proportion of women completing the EPDS, the EPDS score, the proportion of women at risk of PPD, the proportion of psychiatric consultation, and the subsequent diagnosis., Results: The study included 923 women, of whom 55.0% (508/923) completed the EPDS. Among them, 28.1% (143/508) had an EPDS score of 10 or more, and 11.2% (57/508) received a psychiatric consultation. PPD was confirmed in 8.8% (5/57) of women. Other disorders detected were mood disorders, disorders specifically associated with stress, and anxiety/fear-related disorders, in 33.3%, 28.1%, and 14.0% of the women, respectively., Conclusions: Screening with self-administered EPDS is feasible, with a good response rate, making it possible to suspect mental disorders, including PPD, and to offer psychological support when needed., (© 2024 The Author(s). International Journal of Gynecology & Obstetrics published by John Wiley & Sons Ltd on behalf of International Federation of Gynecology and Obstetrics.)

Aims: The aim of this study was to examine the association between women's migrant status (majority, immigrant, descendant) and use of postpartum mental healthcare and investigate whether migration characteristics are associated with mental healthcare use., Methods: Retrospective cohort study. We included all mothers of children born between 2002 and 2018 in 34 municipalities of Denmark who had an identified mental health need as clinically assessed by a child health visitor (CHV) or by a score of 11 or more on the Edinburgh Postpartum Depression Scale (EPDS). Women were followed until the first mental healthcare received 2 years' postpartum, death or emigration. Using Cox regression models, we estimated the time to mental healthcare by migrant status and explored the role of migration characteristics., Results: A total of 29% of women ( n = 45,573) had a mental health need identified by the CHV, and 7% ( n = 4968) had an EPDS ⩾ 11. Immigrants accounted for 19.5%, and descendants for 4.7% of the sample. Immigrants were at lower risk of using mental healthcare than the majority group (CHV: hazard ratio adjusted (HRa) 0.75 (0.70-0.79), EPDS: HRa 0.67 (0.58-0.78)), as were descendants (CHV: HRa 0.77 (0.70-0.86), EPDS: HRa 0.69 (0.55-0.88)). Among migrants, those not refugees, newly arrived, whose partners were immigrants or descendants, and those originally from Africa showed a lower risk of using postpartum mental healthcare., Conclusions: Our findings emphasize the need to strengthen access to mental healthcare for immigrants and descendants experiencing postpartum mental health concerns and consider migration characteristics as indicators of potential inequalities in access to maternal mental healthcare ., Competing Interests: Declaration of conflicting interestsThe authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Objective: China has a serious burden of Postpartum depression (PPD). In order to improve the current situation of high burden of PPD, this study explores the factors affecting PPD from the multidimensional perspectives with physiology, family support and social support covering the full-time chain of pre-pregnancy-pregnancy-postpartum., Methods: A follow-up survey was conducted in the Qujing First People's Hospital of Yunnan Province from 2020 to 2022, and a total of 4838 pregnant women who underwent antenatal checkups in the hospital were enrolled as study subjects. Mothers were assessed for PPD using the Edinburgh Postnatal Depression Scale (EPDS), and logistic regression was used to analyse the level of mothers' postnatal depression and identify vulnerability characteristics., Results: The prevalence of mothers' PPD was 46.05%, with a higher prevalence among those who had poor pre-pregnancy health, had sleep problems during pregnancy, and only had a single female fetus. In the family support dimension, only family care (OR = 0.52, 95% CI 0.42-0.64) and only other people care(OR = 0.78, 95% CI 0.64-0.96) were the protective factors of PPD. The experience risk of PPD was higher among mothers who did not work or use internet., Conclusion: The PPD level in Yunnan Province was significantly higher than the global and Chinese average levels. Factors affecting mothers' PPD exist in all time stages throughout pregnancy, and the influence of family support and social support on PPD shouldn't be ignored. There is an urgent need to extend the time chain of PPD, move its prevention and treatment forward and broaden the dimensions of its intervention., (© 2024. The Author(s).)

Objective: Postpartum depression (PPD) is a common complication after childbirth. Weight misperception can lead to self-esteem issues and mental health problems, especially in women and adolescents. The aim of this study was to investigate the association between weight perception before and during pregnancy and the status of PPD in Southern China., Methods: From October 2021 to November 2023, a multi-stage sampling method was used to recruit 2169 eligible mothers aged 18-49 who had delivered live-born singleton infants within 3 to 180 days postpartum. Anthropometric measurements and face-to-face questionnaire surveys were conducted to collect data. The Kappa test was used to assess the agreement between actual and perceived weight. The generalized linear model incorporating multiplicative interaction analysis was applied to explore the associations among variables., Results: The prevalence of PPD status was 18.0%. Among women, 35.2% perceived their pre-pregnancy weight (PPW) as abnormal, while 33.1% perceived their gestational weight gain (GWG) as inappropriate. There was poor agreement between maternal actual and perceived PPW/GWG (Kappa = 0.366, p < 0.001; Kappa = 0.188, p < 0.001), with 27.8% of women misperceiving their PPW and 52.1% misperceiving their GWG. The results of the general linear model indicated that women who perceived their PPW as underweight ( β = 0.70, p = 0.016) or overweight/obese ( β = 0.86, p < 0.001), as well as those who perceived their GWG as excessive ( β = 0.47, p = 0.028) were more likely to exhibit PPD status. The interaction analysis results showed that those who perceived their PPW as underweight and their GWG as insufficient ( β = 1.75, p = 0.020), as well as those who perceived their PPW as overweight/obese and their GWG as excessive ( β = 0.90, p = 0.001) had a positive interactive effect on the occurrence of PPD status, while underestimating PPW and GWG may be a protective factor against PPD status ( β = -1.03, p = 0.037)., Conclusion: These findings support that maternal weight perception plays a role in the development of PPD status. Further improvement is needed in personalized health education for weight management, both prior to and throughout the pregnancy period. This can help women reduce weight anxiety, better understand their body image, and potentially lower the risk of developing PPD.

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., (© 2024. The Author(s).)

Aims/Background Perinatal obsessive-compulsive symptoms are significant predictors of increased postpartum anxiety, depression, and bipolar disorder. These symptoms have persistent adverse effects on both mothers and children. Currently, there are few reports in the literature on obsessive-compulsive disorder in elderly parturient women in China. This study primarily discusses the clinical characteristics of perinatal obsessive-compulsive symptoms in elderly parturient women and analyzes their influencing factors, aiming to provide references for clinical prevention and treatment. Methods This research employed a cross-sectional design, utilizing a convenience sampling method to select elderly parturients who delivered at Panjin Central Hospital from September 2022 to August 2023. The assessment instruments included a general data questionnaire, the Yale-Brown Obsessive Compulsive Scale (Y-BOCS), the self-rating anxiety scale (SAS), the edinburgh postpartum depression scale (EPDS), and the sense of coherence scale (SOC-13). The relationship between the severity of obsessive-compulsive symptoms and negative emotions and psychological burden was examined through Pearson correlation analysis. Additionally, the influencing factors of perinatal obsessive-compulsive symptoms were analyzed using multivariate logistic regression. Results In this study, a total of 124 questionnaires were distributed, and 122 valid questionnaires were recovered, yielding an effective recovery rate of 98.39%. Among the 122 elderly parturients, 37 were positive for perinatal obsessive-compulsive disorder, accounting for 30.33% (37/122). Among the 37 elderly parturients with perinatal obsessive-compulsive symptoms, 64.86% had both obsessive-compulsive thoughts and behaviors, 21.62% had obsessive-compulsive thoughts as the main symptom (8/37), and 13.51% had obsessive-compulsive behaviors (5/37). Multivariate logistic regression analysis showed that pregnancy history, pregnancy complications, fetal health, SOC-13 score, SAS score, and EPDS score were independent risk factors for positive perinatal obsessive-compulsive symptoms ( p < 0.05). Conclusion The incidence of perinatal obsessive-compulsive symptoms in elderly parturient women is high. Obsessive-compulsive thoughts primarily involve fears of injury and contamination, while obsessive-compulsive behaviors mainly consist of compulsive checking and cleaning. The occurrence of perinatal obsessive-compulsive disorder is associated with factors such as pregnancy and childbirth history, pregnancy complications, fetal health, negative emotions, and stress resistance.

Background: Paternal postpartum depression (PPD) is a significant yet often neglected mental health issue affecting fathers during the postpartum period. While maternal postpartum depression is extensively studied, the psychological challenges faced by new fathers, particularly in resource-limited settings like Ethiopia, receive considerably less attention. Paternal postpartum depression not only impacts fathers' well-being but also affects the health and development of their children and their relationships with partners. Understanding the prevalence of paternal postpartum depression and its underlying causes in Ethiopia is essential for developing effective healthcare policies and tailored support programs for new fathers. The goal of this meta-analysis and systematic review is to compile the information currently available regarding the prevalence of and contributing factors to postpartum depression in Ethiopian fathers., Methods: This study adhered to the PRISMA guidelines and focused on research from Ethiopia. A comprehensive search was performed across multiple databases, including Google, Google Scholar, PubMed, Web of Science, and Medline. Data were systematically collected using a structured checklist and analyzed with STATA version 11. To assess heterogeneity, the Cochrane Q test and I² statistic were applied. Publication bias was also checked using Egger's regression analysis, a funnel plot, and Begg's test., Results: Five studies with a total of 2,055 participants were included in the meta-analysis. The pooled prevalence of paternal postpartum depression in Ethiopia was 20.86% (95% CI: 16.43-25.29). Significant factors associated with paternal postpartum depression included low family income (OR = 3.04, 95% CI: 1.46-6.32), substance use (OR = 2.96, 95% CI: 1.63-5.37), poor social support (OR = 4.28, 95% CI: 2.53-7.23), unplanned pregnancy (OR = 3.42, 95% CI: 2.24-5.24), and infant sleep problems (OR = 4.78, 95% CI: 2.35-9.73). Heterogeneity was high (I² = 97.9%, P < 0.05). A subgroup analysis was conducted to better understand the variations among the primary studies., Conclusion: The study reveals a significant prevalence of paternal postpartum depression in Ethiopia, highlighting key risk factors such as low family income, substance use, poor social support, unplanned pregnancies, and infant sleep difficulties. These findings emphasize the need for routine depression screening for fathers, improved social support programs, education on infant sleep management, and further research to develop targeted prevention and treatment strategies., (© 2024. The Author(s).)

Background/objectives: To collect evidence from studies that explored the associations between serum vitamin D (25[OH]D) concentrations/status and the presence of depressive/anxiety symptoms in the ante- and/or postnatal periods (PROSPERO-CRD42023390895)., Methods: Studies that assessed serum 25[OH]D concentrations in adult women during the ante/postnatal periods and those that used valid instruments to identify the experience/severity of depressive/anxiety symptoms were included. Independent researchers performed the identification/selection of studies, data extraction, risk of bias (RoB) assessment, and bibliometric analysis steps., Results: Of the total of 6769 eligible records, 15 cohort studies [high ( n = 3), moderate ( n = 7), and low ( n = 5) RoB], nine cross-sectional studies [moderate ( n = 3) and low ( n = 6) RoB], and one case-control study [moderate RoB] were included ( n = 25). Depression ( n = 24) and anxiety ( n = 4) symptoms were assessed. A significant difference in antenatal serum 25[OH]D concentrations between the groups of women with and without depression was identified (mean difference: -4.63 ng/mL; 95% confidence interval [95% CI]: -8.88; -0.38). Postnatal serum 25[OH]D concentrations were found to be, on average, -2.36 ng/mL (95% CI: -4.59; -0.14) lower in women with postnatal depression than in those without. Maternal antenatal anxiety was associated with significantly lower concentrations/deficiency of 25[OH]D in only one included study., Conclusions: Based on very low/low-quality evidence, it was observed that reduced serum 25[OH]D concentrations in the ante- and postnatal period are associated with the presence of ante- and postnatal depressive symptoms, respectively. Low/deficient antenatal serum 25[OH]D concentrations may not be related to the presence of anxiety symptoms before childbirth. Well-designed longitudinal studies are needed to explore the estimated pooled effect of these associations.

Introduction: Adiponectin and leptin play important roles in the central nervous system. During the postpartum period, there is a need for a better understanding of the relationship between these cytokines and the neurological development of the infant, as well as their influence on preventing maternal depressive symptoms., Objectives: To assess the correlation between adiponectin and leptin in maternal plasma and breast milk and their association with: infant neurodevelopment at 6 and 12 months of age; and maternal mental health over the first year postpartum., Methods: Prospective cohort study with four follow-up. Mothers and their newborns are recruited within the first 15 days postpartum (baseline). Follow-up visits occur at 2, 6, and 12 months postpartum. Visits include blood and breast milk collection, application of the Edinburgh Postnatal Depression Scale and Beck Depression Inventory to assess maternal mental health, application of the Bayley-III scale for infant developmental assessment, maternal and infant anthropometry and body composition, evaluation of reproductive history, mother-infant bonding, breastfeeding, consumption of ultra-processed foods, sleep quality, and socio-economic and demographic data., Results: The research received funds in August 2022, and participant recruitment began in September 2022. The sample size will consist of 95 mother-child pairs. As of September 2023, 68 participants have been recruited., Conclusion: The project will provide insights into the association between adiponectin and leptin with postpartum depression and infant neurodevelopment, ultimately promoting improved care and quality of life for these groups. Additionally, it will provide data on the type of delivery, infant physical growth, maternal and infant body composition changes, sleep quality, consumption of ultra-processed foods, and maternal metabolic health, including vitamin D metabolites, oxidized polyunsaturated fatty acid metabolites, phospholipid species and triacylglycerols, which are of significant relevance to public health and, when interconnected, may yield important results and contribute to the existing literature., Trial Registration: Name of the registry: Brazilian Clinical Trials Registry (ReBec). Registration number: RBR-9hcby8c., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2024 Rebelo et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

The widespread adoption of mobile phones in daily life has raised concerns regarding their impact on mental health, including among postpartum women. Considering the rising prevalence of postpartum depression (PPD) and the pervasive use of mobile phones in modern society, this study aimed to rigorously investigate the causal relationship between mobile phone use duration and the risk of developing PPD. Data were collected through an online survey assessing mobile phone usage and mental health among postpartum women. The survey's reliability and validity were evaluated using Statistical Package for the Social Sciences software. In total, 2015 participants completed the survey. To explore causal relationships, genetic data were sourced from open-access databases, and two-sample Mendelian randomization (MR) techniques were employed. Statistical analysis, including chi-square tests, revealed a significant association between higher mobile phone use and lower incidence of PPD. MR analysis supported these findings, indicating a protective effect of mobile phone use against PPD (P < .05 based on inverse variance weighting and the weighted median method). This MR-based study provides evidence that increased mobile phone use is associated with a decreased risk of PPD, suggesting that mobile phones could serve as an effective tool for PPD prevention. These findings highlight the importance of evidence-based evaluations of lifestyle factors in mental health research., Competing Interests: The authors have no conflicts of interest to disclose., (Copyright © 2024 the Author(s). Published by Wolters Kluwer Health, Inc.)

Background: Intimate partner violence (IPV) in pregnancy is a physical, sexual, psychological or economic harm by a current or former partner or spouse on a pregnant woman. It is a global public health problem that is common but underreported. Women are at increased risk of psychiatric illness in pregnancy and after delivery with the risk of major depressive disorder being highest during the postpartum period. Intimate partner violence in pregnancy may worsen this problem., Objectives: The objectives of the study were to determine the prevalence of intimate partner violence (IPV) in pregnancy, incidence of postpartum depression and the relationship between intimate partner violence, delivery outcomes and postpartum depression among booked pregnant women at Alex Ekwueme Federal University Teaching Hospital Abakaliki, Ebonyi state, Nigeria (AEFUTHA)., Study Design: This study was a prospective cohort study., Setting: The antenatal clinic, antenatal ward, labour ward, postpartum clinic and under five clinic of Alex Ekwueme Federal University Teaching Hospital Abakaliki, Ebonyi state, Nigeria were used for the study., Method: One hundred and thirty-seven booked pregnant women that received antenatal care at AEFUTHA who met the inclusion criteria and consented to the study, were recruited from 37 weeks to 41 weeks gestation and screened for intimate partner violence and depression. Those with depression were referred for treatment while those that met the inclusion criteria were followed up to delivery and the delivery outcomes documented. They were also followed up to six weeks postpartum when they were screened for postpartum depression. Data were collated, tabulated and then statistically analysed using Statistical Package for Social Science (SPSS) software (version 25, Chicago II, USA). Numerical variables including participant's age, parity and gestational age were presented as mean, median, frequencies and standard deviation (Mean ± S.D), while categorical variables including occupation, level of education, social class and family type were presented as numbers and percentages. Chi-square test (X 2 ) and relative risk was used for comparison between groups for categorical variables while Fisher's exact test was used when Chi-square test (X 2 ) was not suitable. Binary regression analysis was used to determine the relationship between intimate partner violence and postpartum depression. A P value of ˂0.05 is considered statistically significant., Results: The prevalence of intimate partner violence was 52.6%, as 72 out of the 137 women recruited endured intimate partner violence. The major risk factors for intimate partner violence in the study were low level of education, low social class, polygamy and unemployment. The general incidence of postpartum depression was 29.93% while the incidence among women with intimate partner violence was 56.94%. Women with emotional violence and verbal abuse had a five-fold increase in the incidence of postpartum depression. Sexual violence and physical violence were not statistically significant risk factors for postpartum depression., Conclusion: Intimate partner violence is common as seen from the study. It is a significant risk factor for postpartum depression. Women that are emotionally and verbal abused are more likely to have postpartum depression. Screening pregnant women for intimate violence may identify those at risk and allow for proper interventions., (© 2024. The Author(s).)

Objectives: Perinatal depression (PD) affects individuals during pregnancy and early parenthood, resembling major depression. Recent research highlights paternal perinatal depression (PPD) in fathers. PPD has adverse effects on fathers and their children. This study assesses the Turkish version of the Edinburgh Postnatal Depression Scale (EPDS) for Turkish fathers, aiming to provide a tool for PPD identification., Methods: This methodological study validates the EPDS for Turkish fathers and explores associations with demographic and psychosocial factors. The study involved 295 fathers with infants aged 2 weeks to 12 months. The EPDS, originally designed for perinatal depression and validated in Turkish women, was used. Fathers completed a participant information questionnaire, the EPDS, and the Beck Depression Inventory (BDI) during clinic visits. Data on sociodemographic factors, paternal roles, and pregnancy and postpartum support were collected. Mothers also completed the EPDS. Descriptive statistics, exploratory factor analysis, confirmatory factor analysis, and correlation tests were used., Results: The study included fathers with an average age of 30.5 years, mostly with a high school education or higher. The EPDS had a mean total score of 3.1. Factor analysis suggested a three-factor structure for the EPDS in Turkish fathers, including anhedonia, anxiety, and depression. Confirmatory factor analysis validated the three-factor structure, with acceptable model fit indices. Positive correlations were found between fathers' EPDS scores, maternal EPDS scores, and paternal BDI scores. The EPDS effectively discriminated between different levels of depression severity. Various factors, such as education level and lack of support during pregnancy and after childbirth, were associated with higher EPDS scores., Conclusions: These findings emphasize the significance of assessing and addressing PPD in fathers, supporting the use of the EPDS as a valid tool in the Turkish context. The three-factor structure aligns with international research, highlighting the importance of a multi-dimensional approach to PPD assessment. Early intervention can mitigate PPD's impact on fathers, mothers, and children, benefiting mental health and well-being., (© 2024 Walter de Gruyter GmbH, Berlin/Boston.)

Objective: Generalized Anxiety Disorder is an international mental health problem. Prevalence for anxiety disorders reported in perinatal period is high and related with adverse parental and child outcomes. Thus, the objective of this study was to investigate the psychometric properties and factorial validity of General Anxiety Disorder-7 questionnaire (GAD-7) in the context of postpartum mothers., Methods: In this cross-sectional study, 278 mothers (mean age 31.09; SD = 4.42) were recruited at the Neonatology, Gynecology, and Obstetrics Ward. Generalized Anxiety Disorder was assessed with GAD-7, stress with Parental Stress Scale (PSS), while risk of depression with Edinburgh Postpartum Depression Scale (EPDS). Confirmatory factor analysis (CFA) was used to verify factor structure of GAD-7 and the internal consistency was evaluated using reliability coefficients: Cronbach's Alpha and McDonald's Omega., Results: The internal consistency of the GAD-7 was high (Cronbach's Alpha = 0.90 and MacDonald's Omega = 0.91). GAD-7 had significant correlations with the variables examined for construct validity, stress (PSS; r = 0.35, p < 0.01) and risk of depression (EPDS; r = 0.76, p < 0.01). The Confirmatory Factor Analysis results supported a good fit of the data to the model: χ²(df) = 14.19 (14), p = 0.44; Comparative Fit Index (CFI) = 0.99; Tucker-Lewis Index (TLI) = 0.99; Root Mean Square Error of Approximation (RMSEA) = 0.007 (90% C.I. 0.000; 0.059)., Conclusion: GAD-7 has satisfactory psychometric properties. GAD-7 had significant correlations with the variables examined for construct validity with PSS and EPDS. GAD-7 is a reliable instrument for screening anxiety symptoms in perinatal period in research and clinical setting., (© 2024. The Author(s).)

Importance: Selective serotonin reuptake inhibitors (SSRIs) and serotonin-norepinephrine reuptake inhibitors (SNRIs) are consistently reported to be discontinued by approximately half of pregnant women. Little is known about how this may be associated with postpartum psychiatric health., Objective: To investigate associations of SSRI or SNRI discontinuation in pregnant women with depression or anxiety and psychiatric health and sick leave absence after childbirth., Design, Setting, and Participants: This population-based cohort study was conducted between 2006 and 2019 using data from Swedish population-based registers. Pregnant women with a filled prescription of an SSRI or SNRI in the 90 days before pregnancy without recorded comorbid or severe psychiatric conditions were included. Analyses were performed in November 2023., Exposures: K-means for longitudinal data was used to cluster trajectories of SSRI and SNRI use during pregnancy, resulting in 2 trajectory groups based on the number of days covered, defined as continued and discontinued use groups., Main Outcomes and Measures: The primary outcome was psychiatric-related hospitalizations by 90 days after childbirth. Secondary outcomes included psychiatric-related outpatient visits, self-harm and suicide, and any-cause mortality by 90 days after childbirth and all outcomes plus sick leave absence by 1.5 years after childbirth., Results: Among 27 773 pregnant women (17 241 aged ≥30 years [62.1%] at childbirth), 13 184 women (47.5%) had discontinued SSRI or SNRI use and 14 589 individuals (52.5%) had continued use. Individuals in the discontinued compared with continued use group were younger (5588 women [42.4%] vs 4944 women [33.9%] aged <30 years), less educated (4281 women [32.5%] vs 5821 women [39.9%] who completed postsecondary education or above), and more likely to have smoked in early pregnancy (1445 individuals [11.0%] vs 1180 individuals [8.1%]), been born in a non-Nordic country (1641 individuals [12.4%] vs 975 individuals [6.7%]), and used anxiolytics (1301 individuals [9.9%] vs 1119 individuals [7.7%]) and hypnotics and sedatives (1609 individuals [12.2%] vs 1510 individuals [10.4%]). Psychiatric-related hospitalizations occurred in 49 individuals (0.4%) in the discontinued vs 59 individuals (0.5%) in the continued use group in the 90 days after childbirth, with an adjusted hazard ratio (aHR) of 1.28 (95% CI, 0.85-1.91), while at 1.5 years after childbirth, the aHR was 0.81 (95% CI, 0.66-1.00). Lower hazard rates for psychiatric-related outpatient visits in the discontinued vs continued use group at 90 days (aHR, 0.59; 95% CI, 0.53-0.66) and 1.5 years (aHR, 0.60; 95% CI, 0.57-0.64) after childbirth were found. No difference in sick leave absence was found; however, individuals who discontinued had fewer days of sick leave by 1.5 years after childbirth than those who continued (mean [SD], 44.6 [70.6] days vs 53.1 [82.3] days)., Conclusions and Relevance: In this study, approximately half of pregnant women discontinued SSRIs or SNRIs, and discontinuation during pregnancy was not associated with adverse psychiatric-related outcomes, including hospitalizations, outpatient visits, suicidal behavior, or sick leave absence in the 90 days or 1.5 years after childbirth.

Background: Personal and family history of psychiatric disorders are key risk factors for postpartum depression (PPD), yet their combined contribution has been understudied., Objective: To examine personal and family psychiatric history, alone and combined, and their effect on absolute risk and relative risk (RR) of mild/moderate or severe PPD., Methods: In this cohort study, we used data from 142 064 childbirths with PPD screenings from 2015 to 2021 merged with population registers. Exposures were personal and family psychiatric history defined as a psychiatric hospital contact or psychotropic prescription fills by index mothers and their parents prior to delivery. Outcomes were mild/moderate PPD (Edinburgh Postnatal Depression Scale, cut-off: ≥11 within 12 weeks post partum) and severe PPD (antidepressant fill or depression diagnosis within 6 months post partum). We calculated absolute risks and RRs using Poisson regression models adjusted for parity, education, maternal age, and calendar year., Findings: Of the 142 064 participants, 23.4% had no psychiatric history, 47.4% had only family history, 6.0% had only personal history, and 23.2% had both. The latter group had the highest risk of PPD: absolute risk of mild/moderate PPD was 11.7% (95% CI 11.5%; 11.8%), and adjusted RR: 2.35 (95% CI 2.22; 2.49). Alone, personal psychiatric history was the most potent risk factor. Dose-response relationship based on severity of personal and family psychiatric history was found., Discussion: Our study documents a substantial association between personal and family psychiatric history and PPD risk., Clinical Implications: Evaluating combinations of risk factors is important to improve risk assessment., Competing Interests: Competing interests: KBM has received a speaker fee from Medice Nordic within the last 3 years. TM-O has received a speaker fee from Lundbeck within the last 3 years., (© Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY-NC. Published by BMJ.)

Pregnancy-related stress affects not only the woman but also her partner. The issue of postpartum depression in women is increasingly discussed, apart from its occurrence in men, which can develop up to 12 months after giving birth. Risk factors for depression in young fathers are numerous and include hormonal fluctuations, socioeconomic conditions, and co-occurrence of other diseases. Emerging depressive symptoms are nonspecific and can be missed even by experienced medical personnel. Currently, screening tests use questionnaires that do not consider male risk factors. Perhaps the development of more personalized diagnostic methods would enable early identification of men at risk and include preventive measures. The proposed treatment methods of postpartum depression, such as sertraline or cognitive-behavioral therapy, enable patients to recover and provide appropriate support. The disease can cause long-term consequences that negatively affect the development and functioning of the child's psyche. Behavioral disorders and emotional problems are observed in children whose fathers had postpartum depression. Moreover, partner relationships deteriorate and the father-child bond is impaired. Further research should focus on identifying risk factors in men from different social classes, considering environmental, personal, and ethnic characteristics, and on the effectiveness of postpartum depression treatment in men. This article aims to review the incidence, causes, diagnosis, and management of male postpartum depression.

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., (© 2024. The Author(s).)

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., (© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Austria, part of Springer Nature.)

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., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Objectives: This study investigated the predictors of postpartum insurance loss (PPIL), assessed its association with postpartum healthcare receipt, and explored the potential buffering role of Medicaid expansion., Methods: Data from the 2016-2020 Pregnancy Risk Assessment Monitoring System (PRAMS) were analyzed, covering 197,820 individuals with live births. PPIL was determined via self-reported insurance status before and after pregnancy. Postpartum visits and depression screening served as key health service receipt indicators. The association between PPIL and maternal characteristics was examined using bivariate analysis. The association of PPIL with health service receipt was assessed through odds ratios derived from multivariate logistic regression models. The role of Medicaid expansion was explored by interacting ACA Medicaid expansion status with the dichotomous PPIL indicator., Results: PPIL was experienced by 7.8% of postpartum people, with higher rates in Medicaid non-expansion states (13.6%) compared to 6.1% in expansion states (p < 0.05). Racial and ethnic disparities were observed, with 16.5% of Hispanic and 4.6% of white people experiencing PPIL. Individuals who experienced PPIL had decreased odds of attending postpartum visits (adjusted odds ratio (aOR) = 0.81, 95% CI = 0.73-0.90) and receiving screening for postpartum depression (aOR = 0.86, 95% CI = 0.78-0.96) compared to those who maintained insurance coverage. People in expansion states with no PPIL had higher odds of postpartum depression screening (aOR = 1.33, 95% CI = 1.08-1.62). No differences in postpartum visits in expansion versus non-expansion were noted (aOR = 1.13, 95% CI = 0.93-1.36)., Conclusions for Practice: Ensuring consistent postpartum insurance coverage offers policymakers a chance to enhance healthcare access and outcomes, particularly for vulnerable groups., (© 2024. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

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., (© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany.)

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.

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., (© 2024. Crown.)

Importance: The ability to pursue family planning goals is integral to gender equity in any field. Procedural specialties pose occupational risks to pregnancy. As the largest procedural specialty, general surgery provides an opportunity to understand family planning, workplace support for parenthood, obstetric outcomes, and the impact of these factors on workforce well-being, gender equity, and attrition., Objective: To examine pregnancy and parenthood experiences, including mistreatment and obstetric outcomes, among a cohort of US general surgical residents., Design, Setting, and Participants: This cohort study involved a cross-sectional national survey of general surgery residents in all programs accredited by the Accreditation Council for Graduate Medical Education after the 2021 American Board of Surgery In-Training Examination. Female respondents who reported a pregnancy and male respondents whose partners were pregnant during clinical training were queried about pregnancy- and parenthood-based mistreatment, obstetric outcomes, and current well-being (burnout, thoughts of attrition, suicidality)., Main Outcomes and Measures: Primary outcomes included obstetric complications and postpartum depression compared between female residents and partners of male residents. Secondary outcomes included perceptions about support for family planning, pregnancy, or parenthood; assisted reproductive technology use; pregnancy/parenthood-based mistreatment; neonatal complications; and well-being, compared between female and male residents., Results: A total of 5692 residents from 325 US general surgery programs participated (81.2% response rate). Among them, 957 residents (16.8%) reported a pregnancy during clinical training (692/3097 [22.3%] male vs 265/2595 [10.2%] female; P < .001). Compared with male residents, female residents more frequently delayed having children because of training (1201/2568 [46.8%] females vs 1006/3072 [32.7%] males; P < .001) and experienced pregnancy/parenthood-based mistreatment (132 [58.1%] females vs 179 [30.5%] males; P < .001). Compared with partners of male residents, female residents were more likely to experience obstetric complications (odds ratio [OR], 1.42; 95% CI, 1.04-1.96) and postpartum depression (OR, 1.63; 95% CI, 1.11-2.40). Pregnancy/parenthood-based mistreatment was associated with increased burnout (OR, 2.03; 95% CI, 1.48-2.78) and thoughts of attrition (OR, 2.50; 95% CI, 1.61-3.88). Postpartum depression, whether in female residents or partners of male residents, was associated with resident burnout (OR, 1.93; 95% CI, 1.27-2.92), thoughts of attrition (OR, 2.32; 95% CI, 1.36-3.96), and suicidality (OR, 5.58; 95% CI, 2.59-11.99)., Conclusions and Relevance: This study found that pregnancy/parenthood-based mistreatment, obstetric complications, and postpartum depression were associated with female gender, likely driving gendered attrition. Systematic change is needed to protect maternal-fetal health and advance gender equity in procedural fields.

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.., Competing Interests: None declared., (Thieme. All rights reserved.)

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., (© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Austria, part of Springer Nature.)

Introduction: The period from pregnancy to postpartum is a vulnerable time with an increased risk of mental illness. The COVID-19 pandemic led to restrictions in peripartum care, such as infection control measures, or restrictions regarding accompanying persons., Material and Methods: Effects of COVID-19-related restrictions on the psyche and well-being during the peripartum period in Austria were retrospectively assessed using a partially standardized online questionnaire. In addition to closed questions on restrictions and psychological stress, this also contained the Edinburgh Postnatal Depression Scale (EPDS)., Results: Data from 850 women who had given birth during the pandemic were included in the analysis. In 8.5% of cases, appointments were canceled during prenatal care, 10.7% had to wear a face mask during the birth. One in 10 women had to cope with the birth and one in 5 with the puerperium without a companion. Unaccompanied women were significantly less likely to feel well cared for during the birth, more likely to feel alone in the puerperium and, according to the EPDS score, were more likely (39% vs. 20%; p<0.001) to have a high probability of postpartum depression., Conclusions: The pandemic-related restrictions led to anxiety, worry, loneliness and an increased risk of depression during the peripartum period. The balance of mental health was negatively affected by measures and restrictions. Even in times of pandemic, more attention needs to be paid to the vulnerable peripartum period., Competing Interests: Die Autorinnen/Autoren geben an, dass kein Interessenkonflikt besteht., (Thieme. All rights reserved.)

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 (χ 2  = 6.572, p = .037) and weight-for-length (χ 2  = 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., (© 2024 Japan Academy of Nursing Science.)

Background: Postpartum depression (PPD) is a common mental health condition that affects women in a silent and covert way and is not clearly visible to the community or to health care providers. Untreated PPD has significant and long-term consequences on the mother and their child. This study aims to assess the risk of postpartum depression among women in the Emirate of Abu Dhabi and its determinants., Method: This is a questionnaire-based cross-sectional study conducted at primary healthcare centers in the Emirate of Abu Dhabi. The target population is women visiting the well-child vaccination clinics for their infants' vaccination. The questionnaire used consisted of socio-demographic characteristics, important histories such as obstetric, medical, and social histories, and the Edinburgh Post Partum depression scale EPPS. EPPS is a validated tool used to evaluate the probability of postpartum depression., Results: The probability of postpartum depression for women visiting the well child care clinics in the Emirate of Abu Dhabi during the study period was 35%, One-third. 10% had high risk, 7% had moderate risk, and 18% had mild risk. Using logistic and linear regression, there was an association identified between postpartum depression risk and the presence of weight concern and employment status OR 5.499(2.618-11.548) and OR 0.483 (0.246-0.951), respectively (P < 0.005). From the total sample, 3.7% responded quite often or sometimes to the question of having the intention to harm themselves., Conclusion: EPDS is recommended to be used routinely to screen women in the postnatal period. This high prevalence of risk of postpartum depression in the UAE (One in three women) calls for a well-prepared healthcare system and community. Healthcare providers need to be prepared with better knowledge, practice, and management strategies to care for these women, for early identification and management. Further studies should be undertaken to achieve effective strategies to reduce the incidence of this condition., (© 2024. The Author(s).)

Background: Violence against women is a critical public health issue that adversely affects physical and mental health, contributing to injuries, chronic conditions, and mental health disorders. This study addresses the gap in understanding the relationship between spousal violence with maternal functioning and mental health in postpartum mothers., Methods: This Prospective study was conducted on 316 postpartum women who gave birth in Al-Zahra and Taleghani Educational Treatment Centers in Tabriz, Iran, from June 2023 to October 2023. Participants were selected using convenience sampling and followed up for 6-8 weeks. The data were collected using the Revised Conflict Tactics Scale (CTS2), the Edinburgh Postnatal Depression Scale (EPDS), the Postpartum Specific Anxiety Scale (PSAS), and the Barkin Index of Maternal Functioning (BIMF). A general linear model, adjusted for individual, social, and obstetric variables, was used to determine the relationship between domestic violence, maternal functioning, depression and anxiety., Results: Most women (84%) experienced one or more types of intimate partner violence (IPV), including psychological, physical, or sexual abuse. About one-third (32.9%) reported psychological abuse, 21.2% physical violence, 49.4% sexual coercion, and 6.3% reported injuries. The adjusted general linear model showed that the mean depression score was lower in individuals without any experience of violence compared to those who had experienced any violence (β: -1.75; 95% CI: -3.40 to -0.10; p = 0.038). The mean depression score was significantly higher in homemakers compared to employed individuals (β = 3.53; 95% CI = 1.22 to 5.84, p = 0.003). The mean maternal functioning score was significantly higher in those who had not experienced mild physical violence compared to those who had (β = 2.94; 95% CI = 0.34 to 5.55, p = 0.027). The mean anxiety score was lower in individuals with high income (β: -3.38; 95% CI: -5.73 to -1.04; p = 0.005) and moderate income (β: -2.21; 95% CI: -4.35 to -0.07; p = 0.043) compared to those with low income., Conclusion: The findings reveal a high prevalence of violence, particularly sexual coercion, significantly affecting maternal functioning and mental health. Socioeconomic factors also play a crucial role in postpartum mental health. These results highlight the urgent need for enhanced prevention efforts and targeted interventions that consider the socio-economic context and specific forms of violence., (© 2024. The Author(s).)

Background: The relationship between the quality of inpatient versus outpatient obstetric postpartum recovery is under-explored. We examined the association between inpatient reported quality of recovery with outpatient global recovery, pain severity, pain interference, anxiety, and depression screening scores postpartum., Methods: We conducted a multicenter observational cohort study of women in labor who underwent vaginal, operative vaginal, or intrapartum cesarean birth. Subjects completed baseline assessments of pain, social support, anxiety, and depression in early labor. We assessed the Obstetric Quality of Recovery-10 (ObsQoR-10) on the day of discharge and the ObsQoR-10, Global Health Scale (GHVAS; 0-100), Brief Pain Inventory (BPI), and the Edinburgh Postnatal Depression Scale (EPDS) on postpartum day seven. We hypothesized that the ObsQoR-10 scores at discharge would be useful in predicting postpartum day seven measures of recovery and postpartum depression screening scores., Results: We consented 558 subjects, 551/558(98%) completed baseline assessments, 400/551(72%) completed the ObsQoR-10 tool, and 344/551(62%) completed an EPDS assessment. Median (1st, 3rd quartile) ObsQoR-10 scores were 78 (63, 90) at discharge and 85 (68,93) on postpartum day seven, (difference of 7 [99% CI 2 to 13], P < 0.001). GHVAS on postpartum day seven identified 204/344 (59%) of subjects with good recovery. An ObsQoR-10 score of > 86 at discharge had a RR of 1.5 [95% CI 1.2 to 1.8], P < 0.001 for good recovery at postpartum day seven, the EPDS identified 20/344 (5.8%) respondents with a score ≥ 13 on postpartum day seven. The area under the curve between the ObsQoR-10 at discharge with an EPDS ≥ 13 was 0.74 (99% CI 0.61 to 0.86, P < 0.001). The RR for an EPDS ≥ 13 on postpartum day seven with an ObsQoR-10 < 77 on the day of discharge was 7.8 (95% CI 1.8 to 33.8; P = 0.001)., Conclusions: ObsQoR-10 scores at discharge and postpartum day seven demonstrated increased obstetric recovery in the post-discharge period. The observed association between the ObsQoR-10 and the EPDS, suggests that the ObsQoR-10 might facilitate identification of women at increased risk of postpartum anxiety or depression. Identification of high-risk women at discharge may allow early interventions to reduce morbidity secondary to postpartum depression., (© 2024. The Author(s).)

Background: This research aims to unravel the prevalence of postnatal emotional disorders with a focus on how postnatal anxiety remained under-estimated and often embroiled in postnatal depression., Methods: Out of 600 postnatal women invited to take part in this study from two prominent primary care clinics in Khartoum, 468 women agreed to participate in this study. Three questionnaires were utilized in this study, a Personal Information Questionnaire (PIQ), Hospital Anxiety and Depression Scale (HADS), and Beck depression Inventory (BDI). Multiple linear regression analysis applied to gauge risk factors with postnatal anxiety and depression., Results: More than half (52.50%) of women showed evidence of both anxiety and depression using HADS, while only (20.9%) of cases were detected by BDI, showing evidence of moderate depressive disorder. A substantial proportion (28.4%) showed high levels of comorbidity of anxiety and depression in the category of moderate to severe symptoms. Main risks factors for postnatal disorders were past psychiatric illness (β = 0.25, p = 0.001), a family history of psychiatric illness (β = 0.15, p = 0.002), and stress due to the number of children (β = 0.32, p = 0.001)., Conclusion: This study advances our understanding of postnatal emotional disorders, particularly highlighting the prevalence as well as correlates of postpartum anxiety. More importantly, this study highlights the importance of routine screen for emotional distress in postnatal women., 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 Osman, Osman, Osman and Hagar.)

Purpose: The aim of this study was to investigate the effects of the COVID-19 pandemic on maternal mental health during pregnancy and the postpartum period., Methods: The impact of the COVID-19 pandemic situation during and post pregnancy was addressed on three main factors; maternal mental health, mother-child bonding, and maternal self-confidence. To do this, two different patient cohorts were compared; data from one cohort was collected pre-pandemic, and data was collected from the other cohort at the beginning of the pandemic. Questionnaires were used to collect data regarding depressive symptoms (Edinburgh Postnatal Depression Scale [EPDS]), anxiety (State Trait Anxiety Inventory [STAI]), maternal self-confidence (Lips Maternal Self-Confidence Scale [LMSCS]) and mother-child bonding (Postpartum Bonding Questionnaire [PBQ])., Results: There were no significant differences in depressive symptoms (EPDS with an average median of 4.00-5.00) or anxiety (STAI with an average median of 29.00-33.00) between the cohorts. However, the quality of postpartum maternal bonding was higher at 3-6 months in the pandemic cohort, which was also influenced by education and the mode and number of births. The maternal self-confidence was lower in the pandemic sample, also depending on the mode of birth delivery., Conclusions: In this study, a differential effect of the COVID-19 pandemic on mother-child bonding and maternal self-confidence was observed. The results thereby identified possible protective factors of the pandemic, which could potentially be implemented to improve maternal mental health and bonding to the child under normal circumstances., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2024 Bartmann et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

This study aimed to analyze the relationship between disrespect and abuse during labor and the risk of postpartum depression. This is a cross-sectional study carried out with women from the rural and urban areas of Caxias, Maranhão State, Brazil. Postpartum depression was considered the dependent variable, assessed using the Edinburgh Postnatal Depression Scale. The independent variables were sociodemographic characteristics, mental health history, behavioral aspects, obstetric characteristics and self-perception of disrespect and abuse during labor. Pearson's chi-square test and multiple logistic regression were used to assess the association between postpartum depression and disrespect and abuse during labor. A total of 190 women were interviewed. The prevalence of postpartum depression was 16.3%. The occurrence of at least one type of disrespect and abuse during labor was 97.4%, with health system conditions and restrictions predominating (94.7%). More than half of the women (66.3%) suffered two forms of disrespect and abuse during labor, while three or more forms were reported by 22.6%. Suffering two (adjustedOR = 3.01; 95%CI 1.08-8.33) and three or more forms of disrespect and abuse during labor (adjustedOR = 3.41; 95%CI: 1.68-24.40) increased the chance of postpartum depression. There was a significant association between disrespect and abuse during labor and postpartum depression, and dignified and respectful care for women during childbirth were found to reduce the risk of postpartum depression symptoms.

Background: Mothers with a history of childhood maltreatment (CM) are particularly vulnerable to postpartum mental health changes. Variability in mental health trajectories is present over the first 18-months postpartum. Little is known about the potentially unique impacts of post-traumatic change or resilience on later postpartum mental health., Methods: Participants (N = 97) completed questionnaires over the first 18-months postpartum measuring demographic risk, mental health symptoms, traumatic experiences, and resilience. Mothers also completed an interview measure coded for post-traumatic changes at 6-months postpartum. Multinomial logistic regression models examined post-traumatic change and resilience factors as predictors of mothers' longitudinal latent mental health trajectory., Results: Three classes of latent postpartum mental health emerged: low-symptom, vulnerable, and chronic high-risk. Mothers reporting stronger positive post-traumatic changes were more likely to be in the low-symptom class than the chronic high-risk class (B = -1.082, p = .01). Mothers reporting stronger negative post-traumatic changes were more likely to be in the vulnerable class (B = 0.778, p = .006) or chronic high-risk class (B = 0.906, p = .046) than the low-symptom class. Resilience was not predictive of mental health class., Limitations: Findings are correlational, and causal effects between post-traumatic growth and mental health symptoms cannot be assumed. Mothers who consented to the interview may not be fully representative of all women who have experienced CM, limiting generalizability of findings., Conclusions: Positive post-traumatic change is associated with reduced psychopathology. These findings may assist in identification of mothers at greater risk of adverse postpartum outcomes and futher inform interventions focused on enhancing positive changes in post-traumatic cognitions., Competing Interests: Declaration of competing interest The authors have no disclosures to make., (Copyright © 2024 Elsevier B.V. All rights reserved.)

Background: Perinatal depression is a global public health problem that seriously affects the health of perinatal women. This study evaluated the pooled uptake rate of interventions among women who screened positive for perinatal depression to provide a basis for clinical intervention., Methods: We systematically searched four databases (PubMed, Embase, Cochrane Library and Web of Science) from the establishment of the database to May 1, 2023. All included studies were used to derive the pooled uptake rate. We also performed meta-regression and subgroup analysis to explore the potential sources of heterogeneity using STATA 17.0., Results: Of 15024 retrieved articles, only 41 met the inclusion criteria. The overall uptake rate was 55 % (95 % CI 43-67 %). Meta-regression and subgroup analyses both showed that the uptake rate in high-income countries 57 % (95 % CI 50-65 %) was higher than that in low and middle-income countries 37 % (95 % CI 18-56 %)., Limitations: First, only English publications were included. Therefore, articles in other languages were likely missed. Second, of the 41 studies included, there were only six randomized controlled trials, with limited quality of evidence. Third, we could not adequately explain the source of heterogeneity because there were too many mediating variables, although further subgroup and sensitivity analysis were performed., Conclusions: About a half of women did not receive interventions after screening positive, and the uptake rate of interventions in high-income countries was higher than that in low and middle-income countries., Competing Interests: Declaration of competing interest We declare that we have no financial and personal relationships with other people or organizations that can inappropriately influence our work., (Copyright © 2024 Elsevier B.V. All rights reserved.)

Background: Postpartum depression (PPD) presents a significant public health challenge. While PPD's impact extends from maternal health to child development, cultural stigma and a lack of public awareness, particularly in developing countries, contribute to its underestimation and under diagnosed. This study investigated the non-biological associated factors for PPD in Shenzhen city due to its unique socioeconomic landscape, where rapid urbanization and migrant influx could uniquely impact maternal mental health. By identifying local PPD determinants, the research aimed to contribute to targeted mental health interventions in the region., Method: Data were collected from May to December 2019 at the Luohu Maternal and Child Health Medical Center, Shenzhen. Inclusion criteria were postpartum women without psychiatric histories who live within the locality. The Chinese Edinburgh Postnatal Depression Scale was utilized to confirm PPD diagnosis. Participant information including demographics, economic status and postnatal factors were collected via structured questionnaires. Statistical analyses of t -tests, Wilcoxon rank-sum tests, chi-square tests, and logistic regression, were performed using SPSS 20.0, with significance set at p  ≤ 0.05., Results: The study included 430 healthy mothers and 73 PPD mothers. Several factors were found to significantly influence the onset of PPD ( p  < 0.05): age (OR = 0.921, 95% CI: 0.864-0.981); living with in-laws (OR = 2.133, 95% CI: 1.108-4.106); bottle feeding (OR = 3.757, 95% CI: 1.567-9.006); prenatal depression (OR = 3.515, 95% CI: 1.61-7.675); prenatal anxiety (OR = 6.072, 95% CI: 3.209-11.49); and adverse life events during pregnancy (OR = 3.287, 95% CI: 1.165-9.269). Other factors were not found to have a significant effect., Conclusion: Our study found that in the developed city of Shenzhen in Southern China, living with in-laws, exclusive bottle feeding, prenatal anxiety, depression, and adverse life events are non-biological associated factors for postpartum depression. The findings emphasize the importance of considering a range of factors when addressing maternal mental health within a specific local regions. It calls for targeted interventions or prevention program that take into considering the specific cultural, social, and individual factors., 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 He, Li, Chen and Zhang.)