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Postpartum Depression (PPD) exerts a substantial negative effect on maternal well-being post-delivery, particularly among Cesarean Section (C/S) recipients. In this study, we aimed to review the efficacy of perioperative esketamine, the S-enantiomer of ketamine, in preventing PPD incidence and depressive symptoms as measured with the Edinburgh Postnatal Depression Scale (EPDS) after C/S. A systematic search for relevant articles was conducted in Scopus, PubMed, Web of Sciences, and PsycINFO until April 6, 2024. Meta-analyses were conducted using random-effect models to compare the PPD incidence and EPDS scores via log odds ratio and Hedge's g, respectively, during the first week post-C/S and at 42 days post-C/S in the esketamine and control group. Fourteen studies, including 12 randomized controlled trials and 2 retrospective cohorts, were reviewed. Our meta-analyses found lower PPD incidence during the first week (log odds ratio: −0.956 [95 % confidence interval: −1.420, −0.491]) and at day 42 post-C/S (log odds ratio: −0.989 [95 % confidence interval: −1.707, −0.272]) among patients administered esketamine compared to controls. Additionally, EPDS scores for the esketamine group were significantly lower than controls during the first week (Hedge's g: −0.682 [95 % confidence interval: −1.088, −0.276]) and at day 42 post-C/S (Hedge's g: −0.614 [95 % confidence interval: −1.098, −0.129]). Presence of various concomitant medications and heterogeneous study designs. Our review highlights the potential impact of esketamine in PPD prevention, as well as in alleviating depressive symptoms post-C/S, regardless of PPD occurrence, therefore suggesting the benefits of adding esketamine to peri-C/S analgesic regimen. • Perioperative esketamine administration can reduce PPD incidence following C/S. • Esketamine can also reduce the severity of depressive symptoms post-C/S. • These favorable effects were observed at both short- and long-term assessments. • Limited number of analyzed studies may reduce our findings' generalizability. • More research on esketamine's preventive effects on PPD is essential. [ABSTRACT FROM AUTHOR]

Maternal behaviors displayed in mother-infant interaction set the grounds for relationship formation in early childhood. Meanwhile, maternal postnatal depression represents an atypical context for infant development. The present review aims to systematically analyze previous research on specific maternal behaviors reflecting maternal depression in the first postnatal year, focusing on the definitions and findings regarding these behaviors. The review includes observational studies with mothers of infants up to 12 months. Results show variability in definitions, particularly for sensitivity and responsiveness, and mixed findings on the relationship between depression and maternal behaviors. Positive behaviors and negative behaviors were inconsistently associated with depression across studies, suggesting moderating factors such as maternal age, personality, socioeconomic status, and cultural context. We emphasize the need for standardized definitions and measures of maternal behaviors and call for further research into moderating variables. This review underscores the complexity of the relationship between maternal depression and maternal behaviors, advocating for more comprehensive and consistent future research. [ABSTRACT FROM AUTHOR]

Background: Postpartum psychosis (PP) is a psychological emergency requiring rapid intervention, hospitalization and psychiatric management. However, PP has been neglected in the postpartum literature. Understanding the detrimental consequences of childhood trauma across mother's life span is crucial to prevent this serious condition. The study's objectives were to demonstrate the relationship between childhood trauma and postpartum psychotic experiences (PPEs) and to look over the mediating role of postnatal depression (PD) and anxiety (PA) in this relationship. Methods: This cross-sectional study, which enrolled 438 postpartum females 4–6 weeks after delivery (mean age: 31.23 ± 5.24 years), was carried out from September 2022 to June 2023. The Arabic validated versions of the Postpartum Psychotic Experiences Scale, the Edinburgh Postnatal Depression Scale, the Perinatal Anxiety Screening Scale, and the Child Abuse Self Report Scale were used. Results: Both PD and PA partially mediated the correlation between psychological abuse and PPEs, and fully mediated the association between neglect and PPEs. Higher psychological abuse and neglect were significantly associated with higher PD (Beta = 1.11) and PA (Beta = 3.94), higher PD (Beta = 0.84) and PA (Beta = 0.26) were significantly associated with higher PPEs in both models, whereas greater child psychological abuse (Beta = 1.37) (but not neglect) was directly and strongly correlated with higher PPEs in all models. Conclusion: The significant mediating effect of PA and PD on the association between childhood adversities and PPEs among postpartum females may offer additional therapeutic avenues to help attenuate various postpartum mental health issues and their potential serious risks on both mother and child. [ABSTRACT FROM AUTHOR]

Introduction: Postpartum depression is one of the most common non‐obstetric postnatal complications. As the microbiome (and gut–brain axis) as well as inflammation may be involved in the mechanism, we aimed to assess if antibiotic or gastric acid inhibition use during pregnancy affects the risk of postpartum depression (clinical diagnosis and/or antidepressant use up to 1 year after childbirth). Material and Methods: This population‐based cohort study used first singleton pregnancy resulting in a live birth in Sweden from 2006 to 2016. Women with history of depression were excluded. Multivariable logistic regression models were used to assess the impact of antibiotics and gastric acid inhibitors and other risk factors, presented as odds ratios (ORs) with 95% confidence intervals (CI). Results: Overall, 29% of all 10 666 women with postpartum depression were exposed to antibiotics and 6.2% to gastric acid inhibitors, compared to, respectively, 21% and 3.2% of 613 205 women without postpartum depression. Antibiotic use during pregnancy was associated with postpartum depression (OR 1.43, 95% CI 1.37–1.49), particularly for quinolones and other antibacterials (including nitroimidazole derivatives). Gastric acid inhibition was associated with an even higher risk than antibiotics (OR 2.04, 95% CI 1.88–2.21). Both antibiotics and gastric acid inhibitors suggested higher risk with increased dose in a dose–response analysis. Conclusions: The use of antibiotics and gastric acid inhibition drugs during pregnancy appeared to be associated with a higher risk of postpartum depression. However, it is important to consider that other predisposing factors could contribute to this increased risk, even after excluding individuals with a history of depression. [ABSTRACT FROM AUTHOR]

Abstract Background Postpartum psychosis (PP) is a psychological emergency requiring rapid intervention, hospitalization and psychiatric management. However, PP has been neglected in the postpartum literature. Understanding the detrimental consequences of childhood trauma across mother’s life span is crucial to prevent this serious condition. The study’s objectives were to demonstrate the relationship between childhood trauma and postpartum psychotic experiences (PPEs) and to look over the mediating role of postnatal depression (PD) and anxiety (PA) in this relationship. Methods This cross-sectional study, which enrolled 438 postpartum females 4–6 weeks after delivery (mean age: 31.23 ± 5.24 years), was carried out from September 2022 to June 2023. The Arabic validated versions of the Postpartum Psychotic Experiences Scale, the Edinburgh Postnatal Depression Scale, the Perinatal Anxiety Screening Scale, and the Child Abuse Self Report Scale were used. Results Both PD and PA partially mediated the correlation between psychological abuse and PPEs, and fully mediated the association between neglect and PPEs. Higher psychological abuse and neglect were significantly associated with higher PD (Beta = 1.11) and PA (Beta = 3.94), higher PD (Beta = 0.84) and PA (Beta = 0.26) were significantly associated with higher PPEs in both models, whereas greater child psychological abuse (Beta = 1.37) (but not neglect) was directly and strongly correlated with higher PPEs in all models. Conclusion The significant mediating effect of PA and PD on the association between childhood adversities and PPEs among postpartum females may offer additional therapeutic avenues to help attenuate various postpartum mental health issues and their potential serious risks on both mother and child.

Abstract Background New mothers and fathers are at risk of developing postnatal depressive problems. To understand how postnatal depressive symptoms unfold over time, analyses at the within-person level are necessary. Inspecting postnatal depressive problems at the symptom level provides a novel perspective, ultimately offering insight into which symptoms contribute to the elevation of other symptoms over time. Methods Panel graphical vector-autoregression (GVAR) models were applied to analyze the within-person temporal and contemporaneous relations between depressive symptoms across the postnatal period in new mothers and fathers (at T1; N mothers = 869, N fathers = 579). Depressive symptoms were assessed at 6-, 12-, and 18-months postpartum, using the Edinburgh Postnatal Depression Scale. Results The results revealed that for mothers, sadness was a key symptom predicting symptom increases in multiple other depressive symptoms and itself (autoregressive effect) over time. Furthermore, anxiousness and feeling scared predicted each other across the postnatal period in mothers. For fathers, the most central predicting symptom in the overall network of symptoms was being anxious, while self-blame and being overwhelmed had strong self-maintaining roles in the fathers’ symptomatology, indicating that these could be key features in fathers experiencing postnatal depressive problems. The pattern of symptoms that mothers and fathers experienced within the same time window (contemporaneous associations), shared many of the same characteristics compared to the temporal structure. Conclusions This study suggests that across the postnatal period, from 6- to 18-months postpartum, depressive symptoms in mothers and fathers contribute differently to the pattern of depressive problems, highlighting sadness as a key feature in maternal symptomatology and anxiousness components in paternal symptomatology.

Background: New mothers and fathers are at risk of developing postnatal depressive problems. To understand how postnatal depressive symptoms unfold over time, analyses at the within-person level are necessary. Inspecting postnatal depressive problems at the symptom level provides a novel perspective, ultimately offering insight into which symptoms contribute to the elevation of other symptoms over time. Methods: Panel graphical vector-autoregression (GVAR) models were applied to analyze the within-person temporal and contemporaneous relations between depressive symptoms across the postnatal period in new mothers and fathers (at T1; Nmothers = 869, Nfathers = 579). Depressive symptoms were assessed at 6-, 12-, and 18-months postpartum, using the Edinburgh Postnatal Depression Scale. Results: The results revealed that for mothers, sadness was a key symptom predicting symptom increases in multiple other depressive symptoms and itself (autoregressive effect) over time. Furthermore, anxiousness and feeling scared predicted each other across the postnatal period in mothers. For fathers, the most central predicting symptom in the overall network of symptoms was being anxious, while self-blame and being overwhelmed had strong self-maintaining roles in the fathers' symptomatology, indicating that these could be key features in fathers experiencing postnatal depressive problems. The pattern of symptoms that mothers and fathers experienced within the same time window (contemporaneous associations), shared many of the same characteristics compared to the temporal structure. Conclusions: This study suggests that across the postnatal period, from 6- to 18-months postpartum, depressive symptoms in mothers and fathers contribute differently to the pattern of depressive problems, highlighting sadness as a key feature in maternal symptomatology and anxiousness components in paternal symptomatology. [ABSTRACT FROM AUTHOR]

Postnatal depression is a common and severe complication of childbirth. It is an important public health problem with significant implications for both mothers and children. The exact mechanisms underlying and the factors influencing the occurrence of postnatal depression remain unclear. The literature suggests that certain dietary deficiencies during pregnancy and the postnatal period may contribute to a greater risk of maternal depression. This review focuses on the role of selenium in postnatal depression. It collects evidence from published interventional and observational studies investigating the relationship between selenium intake during the antenatal and postnatal periods and the mental status of postpartum women and summarises information about biological mechanisms that may underlie the association between selenium status and postnatal depression. The review includes studies identified through electronic searches of Medline (via PubMed) and Google Scholar databases until December 2023. Despite the small number of relevant studies and their potential methodological limitations, the findings suggest that optimizing selenium status may support the prevention and treatment of postnatal depression. Further longitudinal and interventional studies are necessary to confirm the clinical significance of these effects. [ABSTRACT FROM AUTHOR]

Purpose: Postnatal depression (PND) impacts numerous women after childbirth, leading to various impairments in their lives. Mental health interventions, such as cognitive behavioral therapy (CBT), need further evaluation in low- and middle-income countries (LMICs) where resources may be scarce. This study aimed to assess the effectiveness of CBT in treating PND in women from LMICs, comparing it to standard care. Methods: A systematic review and meta-analysis were conducted following the PRISMA Statement 2020 guidelines. Databases such as PubMed, CINAHL Plus, Cochrane Library, and PsycINFO were searched until September 2022. A modified Delphi process was employed to identify relevant studies. The primary outcome was mean depression scores, measured by the Edinburgh postnatal depression scale at baseline and post-intervention. Results: Out of 487 studies identified, five trials were included, totaling 1056 participants (520 in the intervention group and 536 in the comparator group). At baseline, a minor, insignificant positive effect size was found (Cohen's d = 0.1, 95% CI = − 0.15, 0.35). Post-CBT, the intervention group showed significant improvements in depression scores (Cohen's d = − 1.9, 95% CI = − 3.8, 0). When accounting for the influence of one study, (Ngai et al., Psychother Psychosom 84:294–303, 2015), which held substantial weight in the initial analysis, the effect size was adjusted to d = 0.5, highlighting a lesser but still significant difference. Conclusions: CBT appears to be effective in improving PND symptoms among women in LMICs and may be considered a first-line treatment for at-risk mothers, including those who are displaced. However, the significant impact of one study on the results emphasizes the need for more rigorous research. The study also highlights the challenges and limitations of providing psychotherapies across LMICs, emphasizing the need for culturally adapted and contextually appropriate interventions to ensure successful implementation and sustainability of mental health care for postnatal women in these settings. [ABSTRACT FROM AUTHOR]

Why you should read this article: • To understand the importance of recognising postnatal depression in fathers • To identify fathers’ barriers to, and motivators for, seeking support for postnatal depression • To consider how healthcare services could better support fathers experiencing postnatal depression. Background: Many men tend to avoid seeking support for mental health issues and little is known about help-seeking among fathers who experience postnatal depression. Aim: To explore fathers’ help-seeking for postnatal depression, including barriers and motivators, and their experiences of informal support from partners and formal support from healthcare professionals. Method: Data were obtained through individual semi-structured interviews with eight fathers who self-identified as having experienced postnatal depression. Data were analysed using interpretative phenomenological analysis. Findings: Five themes emerged from the data analysis: not recognising postnatal depression; fatherhood expectations restricting postnatal depression disclosure; disappointment at the medicalised response to help-seeking; health visitors as a feared profession which excludes fathers; needing communication, validation and a safe space to talk. Conclusion: Some fathers need professional support for their mental health after the birth of their child. Nurses and health visitors should routinely ask fathers about their mental well-being, validate their feelings and encourage them to discuss their mental health issues with a healthcare professional. [ABSTRACT FROM AUTHOR]

L'objectif de notre étude est d'explorer les mécanismes à l'œuvre dans les cas de passages à l'acte suicidaires en période de post-partum. Il s'agit ici de souligner l'importance de l'accompagnement pluridisciplinaire, tant psychologique, médical que social, dans la mise en place d'un maillage pluridisciplinaire autour des parents pendant et après la grossesse. Notre méthode consiste en une revue de la littérature sur les enjeux de l'accompagnement de femmes en ante- et post-partum, afin de prévenir ou d'accompagner la dépression du post-partum et les passages à l'acte pouvant en découler. Nous appuierons notre propos sur l'étude d'un cas clinique illustrant les points aveugles du système de soin. Les résultats de notre étude montrent que la dynamique suicidaire en post-partum est multifactorielle, prenant sa source en période anténatale et parfois bien en amont, mêlant des facteurs endogènes et exogènes pour des femmes confrontées aux attendus supposés de la société envers la jeune mère. Il est également à noter que l'accompagnement de la dépression du post-partum se fait de façon inégale sur les différents territoires, par manque de moyens effectifs ou structurels, laisse échapper certains sujets au maillage professionnel et mène parfois un passage à l'acte. Nous observons que l'accompagnement pluridisciplinaire des femmes suicidaires permet de limiter les risques d'aggravation de la symptomatologie et d'un passage à l'acte. Nous encourageons le travail conjoint entre les professionnels institutionnels et les professionnels libéraux du champ psychiatrique, médical et social, pour la constitution du maillage pluridisciplinaire indispensable à l'accompagnement de toute femme dans son devenir mère, il s'agit d'une question de santé publique. The aim of our study is to explore the mechanisms that come into play in cases of suicidal acts during the post-partum period. Our starting point is to emphasize the importance of multidisciplinary support – psychological, medical and social – in establishing a multifaceted network for parents during and after pregnancy. Additionally, the link between post-partum depression and suicidal behavior is discussed, as are the different types of risk factors. Our method consists of a review of the literature on the issues involved in supporting women in the ante- and post-partum periods, to prevent or support post-partum depression, and any resulting acts of aggression. These observations are then supported through the study of a clinical case illustrating the blind spots in the care system, which can leave certain subjects out in the cold. The clinical case illustrates the desire to have a child, the use of drugs during the perinatal period and the consequences of confinement in France during the post-partum period. The results of our study show that the post-partum suicidal trajectory is multifactorial, originating in the antepartum period, combining endogenous and exogenous factors, as well as society's supposed expectations of the mother-to-be. It should also be noted that support for mothers suffering from post-partum depression is often uneven in the different regions of the country, due to a lack of resources in terms of staff or structure, sometimes allowing the patient to slip through the net of care, leading her to act out. Information and training for professionals on the issue of the post-partum period and its possible repercussions on the mother's behavior are essential for better prevention and rapid treatment. Sometimes, depression is diagnosed during pregnancy, which facilitates treatment and speeds up contact with professionals to provide the best possible support for the mother during her perinatal period. We note, however, that multidisciplinary support for suicidal women helps limit the risk of the symptoms worsening and the risk of the patient acting on them. We emphasize and encourage concerted work and cooperation between institutional professionals and independent professionals in the psychiatric, medical, and social fields, to establish the multidisciplinary network needed to support all women, as they become mothers. Multidisciplinary support for mothers is essential during the perinatal period. Of course, we need to consider the importance of the health professional's work, but the family, spouse, and friends are also essential resources for the mother's well-being, and it is important to include them in this support network. [ABSTRACT FROM AUTHOR]

Attention deficit/hyperactivity behaviors in children are often unnoticed until they reach school age; however, evidence suggests that attention deficit hyperactivity disorder (ADHD) tends to develop at an earlier age. Recent studies also indicate that perinatal maternal mental health is associated with ADHD symptoms in offspring. This study examines the association between maternal postpartum depression, early hyperactive/aggressive behavior, and later ADHD symptoms. This longitudinal cohort study used data from health checkups and surveys. Mothers with a postpartum Edinburgh postnatal depression scale score ⩾ 9 were considered as having postpartum depression symptoms. The presence of early hyperactive/aggressive behavior was determined based on 3-year-old children's health checkup data. The ADHD rating scale (ADHD-RS) answered by the caregivers of 182 sixth-grade children was used for the analysis. ADHD-RS scores were significantly higher in children with early hyperactive and/or aggressive behavior (p =.002) and for children of mothers who had postpartum depression symptoms (p <.001). Early hyperactive/aggressive behavior did not mediate the predictive association of maternal postpartum depression symptoms with ADHD symptoms in sixth grade. ADHD symptoms in the sixth grade were independently associated with childhood hyperactive/aggressive behavior at age 3 and maternal postpartum depression symptoms. [ABSTRACT FROM AUTHOR]

Objective: This cross-sectional study aims to examine the prevalence of postpartum depression (PPD) and sleep problems, their relationship, and the characteristics associated with depression/insomnia in Qassim, Saudi Arabia. Methods: An online survey was administered to a convenience sample of 395 mothers who had given birth within the preceding year. The survey comprised demographic characteristics, pregnancy and childbirth characteristics, depression (via the Edinburgh Postnatal Depression Scale; EPDS), and sleep quality (via the Pittsburgh Sleep Quality Index; PSQI). Results: Nearly two-thirds of respondents (62.3%) had PPD, while 92.2% experienced poor sleep quality. Both scales demonstrated a statistically significant positive correlation. Participants with previous PPD, peripartum depression, a personal or family history of other depression, those bottle-feeding their infants, or who had a change in sleep pattern scored significantly higher on the EPDS and had poorer PSQI scores. Respondents with a history of mental illness, pregnancy or delivery complications, those who lacked support, or gave birth to unhealthy newborns also had significantly higher EPDS scores. Conclusions: PPD and poor sleep quality were highly prevalent among mothers living in the Qassim region of Saudi Arabia. Not surprisingly, PPD was strongly correlated with poor sleep quality. Postpartum counseling for mothers during the first year after delivery is necessary to decrease the risk of developing depressive symptoms and poor sleep quality. Screening for sleep-related difficulties and depression in prenatal and postnatal programs may help prevent the development of depressive disorder among postpartum women in this region of Saudi Arabia (or other areas of the Middle East). [ABSTRACT FROM AUTHOR]

BackgroundThis 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.MethodsOut 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.ResultsMore 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).ConclusionThis 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.

Objectives: Schema Therapy, an approach that integrates cognitive-behavioural and attachment principles, helps us understand the impact of early interactions with caregivers on adult mental health. These early interactions can be assessed through Schema Therapy-informed tools; however, these tools have yet to be used with a postnatal population, which represents a period of vulnerability for new mothers. Therefore, the present study aimed to evaluate the impact of positive and negative early parenting interactions on a first-time mother’s mental health and her sense of competence during the postnatal period, using recently revised and newly developed Schema Therapy-informed tools. Design: This is a cross-sectional study. Method: First-time mothers (N = 220) participated in an online survey within 12 months post-birth. Participants completed the Positive Parenting Schema Inventory (PPSI), Young Parenting Inventory—Revised (YPI-R2), Edinburgh Postnatal Depression Scale (EPDS), and Parenting Sense of Competence (PSOC) scale. The data were analysed using hierarchical multiple regression and mediational analysis. Results: Negative early interactions with mothers and fathers led to greater postnatal depressive symptomology, while positive early interactions with mothers led to fewer postnatal depressive symptoms. Mediation analyses revealed that postnatal depressive symptoms mediated early parenting interactions and participants’ sense of parenting competence as a new mother. Conclusions: The protective effects of positive early interactions with caregivers can help first-time mothers’ postnatal emotional adjustment and their sense of competence through diminished postnatal depressive symptoms. However, the enduring effects of negative early interactions with caregivers can contribute to a first-time mother’s risk of developing postnatal depression and negatively affect her sense of parental competence.

Daryl Jian An Tan,1 Rehena Sultana,2 Sheryl Yu Xuan Chow,3 Chin Wen Tan,1,4 Hon Sen Tan,1,4 Helen Yu Chen,5,6 Tze-Ern Chua,5,6 Ban Leong Sng1,4 1Department of Women’s Anesthesia, KK Women’s and Children’s Hospital, Singapore, Singapore; 2Centre for Quantitative Medicine, Duke-NUS Medical School, Singapore, Singapore; 3Duke-NUS Medical School, Singapore, Singapore; 4Anaesthesiology and Perioperative Sciences Academic Clinical Program, Duke-NUS Medical School, Singapore, Singapore; 5Department of Psychological Medicine, KK Women’s and Children’s Hospital, Singapore, Singapore; 6Paediatrics Academic Clinical Program, Duke-NUS Medical School, Singapore, SingaporeCorrespondence: Chin Wen Tan, Department of Women’s Anesthesia, KK Women’s and Children’s Hospital, 100 Bukit Timah Road, Singapore, Singapore, Tel +65 6394 6486, Fax +65 62912661, Email tan.chin.wen@kkh.com.sgPurpose: This study aimed to validate a proposed association model previously published to determine the clinical relevance of pre-operative determinants in the development of PND after Cesarean delivery (CD).Patients and Methods: Parturients undergoing elective CD under neuraxial anesthesia were recruited for a prospective cohort study between Oct 2021 and Oct 2022 at KK Women’s and Children’s Hospital, Singapore. Predelivery pain, psychological and mechanical temporal summation, and demographic data were recorded. A follow-up survey was conducted at 6 to 10 weeks after CD. The primary outcome was the incidence of PND, defined as an Edinburgh Postnatal Depression Scale (EPDS) score ≥ 10.Results: A total of 180 patients were recruited for validation. PND 6 to 10 weeks post-delivery occurred in 18.9% of recruited parturients. Multivariate regression analyses showed that higher pre-operative CSI scores (p=0.0156), higher anxiety levels about upcoming surgery (p=0.0429), increased pre-operative pain scores on movement (p=0.0110), and higher pre-operative HADS subscale scores on anxiety (p=0.0041) were independently associated with the development of PND weeks post-CD. Lower anticipation of pain medication needs (p=0.0038) was independently associated with the development of PND post-CD. The area under curve (AUC) of this multivariable model (training cohort), internal cross validation (training cohort) and external cross validation (validation cohort) were 0.818 (95% CI, 0.746 to 0.889), 0.785 (95% CI, 0.707 to 0.864) and 0.604 (95% CI, 0.497 to 0.710) respectively.Conclusion: The proposed model performed well in a local population. Further refinement is necessary to test the proposed model in populations with social and cultural differences.Keywords: anxiety, obstetrics, pain, postnatal depression

Background: Perinatal mental health issues affect approximately 10% of women in high-income countries and 30% in low- or middle-income countries. This review aims to determine the prevalence of perinatal depression among mothers and fathers in Pakistan and identify associated risk factors.Methods: We conducted a systematic review and meta-analysis following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines. We included quantitative studies on the prevalence or incidence of maternal and paternal perinatal depression, including antenatal or postnatal depression in Pakistan, with or without associated risk factors. We performed an electronic search, dual-title/abstract and full-text screening, and data extraction. Analysis was conducted on Revman and JBI SUMARI software. The quality of the included studies was assessed with the NHLBI tool. This review updated a previously published review that included 43 studies, with the last search date of 31st May 2019, now extended to literature published up to June 30, 2023.Results: Consistent with the previous review, our analysis of 61 studies indicated a pooled prevalence of 37% (95% confidence interval (CI): 30.6–43.6) for maternal antenatal depression. Postnatal depression at different time points, revealed rates of 34.2% (95% CI: 22.7–46.7), 40.9% (95% CI: 0–97.4), and 43.1% (95% CI: 24.4–62.9) at 3, 6 and 12 months, respectively. Paternal postnatal depression was observed at 40.5% (95% CI: 14.9–69) based on two studies. Risk factors for maternal perinatal depression include multiparity, contraceptive failure, inadequate antenatal care, pregnancy-induced hypertension, previous psychiatric illness, passive smoking, drug abuse, low socio-economic status, marital problems, family hardships, recent bereavement, housing difficulties, food insecurity, husband's illiteracy, his unemployment, and being blamed for child disability.Conclusion: The findings reveal a high prevalence of perinatal depression among mothers with very limited evidence of fathers residing in Pakistan, emphasising the need for prospective studies addressing mental health challenges.Registration: This review is registered on PROSPERO (CRD42023442581).

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

AbstractThis prospective study conducted at a single center in 2022 aims to identify risk and protective factors for postpartum depression (PPD) in Polish women and to assess the impact of pregnancy, delivery, the postpartum period, and psychosocial factors on PPD. After delivery and 4 weeks later, 311 women filled out two questionnaires of our design related to risk factors for PPD. Immune Power Personality Questionnaire, Walsh Family Resilience Questionnaire, and Edinburg Postnatal Depression Scale were also applied. The predictors of PPD identified at two time points included: use of antidepressants, previous depressive episodes, family history of depression, risk of preterm delivery, anxiety about child’s health, and breastfeeding and sleep problems. Risk factors for PPD found only after delivery were: suicidal ideation before pregnancy, stressful life events, premature rupture of the membranes, and cesarean section. Inhalation analgesia during labor reduced the PPD frequency. At 4 weeks’ postpartum, regular physical activity was also predictive of PPD, while breastfeeding, financial satisfaction, and sufficient sleep duration were protective factors. PPD after delivery was negatively correlated with capacity to confide, hardiness, assertiveness, self-complexity, and communication. PPD at 4 weeks postpartum decreased belief systems, organization patterns, and communication. Two proposed self-designed questionnaires can be useful for effectively screening PPD in the Polish population.

Accessible Summary What is known on the subject? What does this paper add to existing knowledge? What are the implications for practice? Introduction Aim Methods Findings Discussion New parents who have previously experienced psychosis outside and/or following childbirth have an increased likelihood of experiencing an episode during the postpartum period. The decision to try to conceive can be agonising. Receiving care from a specialist perinatal community mental health team can improve outcomes. This article offers a first‐person insight into the steps the author took to minimise the impact of an episode of postpartum psychosis and/or postnatal depression whilst navigating new motherhood. This lived experience narrative aligns with the evidence base that demonstrates specialist perinatal community mental health services improve outcomes. It highlights the importance of maternity care providers asking about mental health history to identify any previous episodes or family history and offering referral to a specialist perinatal mental health service if available. Postpartum psychosis is a life‐changing but treatable condition that usually occurs in the first few days to weeks after childbirth affecting 1–2 in 1000 pregnancies. Those who have experienced psychosis before, either as a single episode, related or unrelated to childbirth or as part of a long‐term mental health condition have a higher likelihood of experiencing an episode in the postnatal period.In this lived experience narrative the author shares personal experience of planning and navigating pregnancy with a higher likelihood of experiencing postpartum psychosis and postnatal depression around this major life transition due to previous episodes.The author utilises a first‐person approach to share and reflect on her lived experience.The author shares her experience of receiving care and some of the steps she took to try to manage the impact of pregnancy and birth on her mental health during this major life transition. She describes how care from a specialist perinatal community mental health team and peer support contributed significantly to her family's well‐being.Specialist perinatal community mental health services can improve outcomes for those with a higher likelihood of experiencing postpartum psychosis and postnatal depression by facilitating planning and mitigating some of the risks that could lead to relapse in the perinatal period. [ABSTRACT FROM AUTHOR]

Issue Addressed: Supporting healthy behaviours (quality diet, physical activity, sleep) through home‐based interventions is feasible to improve postnatal mental health. Involving stakeholders in developing interventions is essential for maximising accessibility, implementation and scale‐up. This study aimed to identify factors affecting the sustainable implementation and scalability of the Food, Move, Sleep (FOMOS) for Postnatal Mental Health program, including strategies to enhance research‐practice translation. Methods: Stakeholders (n = 13) involved in promoting physical activity, healthy eating, postnatal and mental health, public health and/or policy participated in semi‐structured interviews. Interviews, based on PRACTIS Guide recommendations for implementation and scale‐up, explored perceptions of program design, implementation and scalability. Reflexive thematic analysis was undertaken. Identified implementation and scale‐up strategies were mapped against the Expert Recommendations for Implementing Change compendium and PRACTIS Guide. Results: Individual‐level: Targeting multiple systems (primary, tertiary, community‐based care) and entry points (early, mid‐postpartum) for uptake was important. For equity, screening women in public hospitals, engaging with community agencies and targeting most at‐risk women, was suggested. Provider‐level: Stakeholders identified strategies to enhance future roll‐out (organisations assisting with recruitment). Factors impacting sustainability included high demand for the FOMOS program, and governance around screening and funding; online delivery, connecting with partners and providers and integration into existing services may enhance sustainability. Systems‐level: Political support and community champions were perceived important for program dissemination. Nine strategies addressing program uptake, reach, implementation, potential scalability and sustainability were identified. Conclusions: For sustainable implementation and potential scalability of a home‐based multi‐behaviour postnatal intervention, multi‐level implementation and scale‐up strategies, aligned with existing health systems, policies and initiatives to support postnatal mental health should be considered. So What?: This paper provides a comprehensive list of strategies that can be used to enhance sustainable implementation and scalability of healthy behaviour programs targeting postnatal mental health. Further, the interview schedule, systematically developed and aligned with the PRACTIS Guide, may serve as a useful resource for researchers conducting similar studies in future. [ABSTRACT FROM AUTHOR]

Summary: There is conflicting evidence regarding the association between epidural labour analgesia and risk of postpartum depression. Most previous studies were observational trials with limited ability to account for confounders. We aimed to determine if epidural analgesia was associated with a significant change in the incidence of postpartum depression in this randomised controlled trial. We enrolled women aged 21–50 years old with a singleton fetus ≥ 36 weeks gestation. Patients were advised regarding available labour analgesic modalities during enrolment (epidural block; intramuscular pethidine; nitrous oxide; or intravenous remifentanil). On request for analgesia, patients were offered the modality that they had been allocated randomly to first. Blinded investigators recorded patient and obstetric characteristics within 24 h of delivery and assessed for postpartum depression at 6–10 weeks following delivery using the Edinburgh Postnatal Depression Scale (score ≥ 13 considered positive for postpartum depression). The modified intention‐to‐treat population consisted of all patients who received any form of labour analgesia, while per‐protocol consisted of patients who received their randomised modality as their first form of labour analgesia. Of 881 parturients allocated randomly (epidural n = 441, non‐epidural n = 440), we analysed 773 (epidural n = 389, non‐epidural n = 384); 62 (15.9%) of women allocated to epidural group developed postpartum depression compared with 65 (16.9%) women allocate to the non‐epidural group. There were no significant differences in the incidence of postpartum depression between the two groups (adjusted risk difference (95%CI) 1.6 (‐3.0–6.3%), p = 0.49). Similar results were obtained with per‐protocol analysis (adjusted risk difference (95%CI) ‐1.0 (‐8.3–6.3%), p = 0.79). We found no significant difference in the risk of postpartum depression between patients who received epidural labour analgesia and those who utilised non‐epidural analgesic modalities. [ABSTRACT FROM AUTHOR]

Objectives: Schema Therapy, an approach that integrates cognitive-behavioural and attachment principles, helps us understand the impact of early interactions with caregivers on adult mental health. These early interactions can be assessed through Schema Therapy-informed tools; however, these tools have yet to be used with a postnatal population, which represents a period of vulnerability for new mothers. Therefore, the present study aimed to evaluate the impact of positive and negative early parenting interactions on a first-time mother's mental health and her sense of competence during the postnatal period, using recently revised and newly developed Schema Therapy-informed tools. Design: This is a cross-sectional study. Method: First-time mothers (N = 220) participated in an online survey within 12 months post-birth. Participants completed the Positive Parenting Schema Inventory (PPSI), Young Parenting Inventory—Revised (YPI-R2), Edinburgh Postnatal Depression Scale (EPDS), and Parenting Sense of Competence (PSOC) scale. The data were analysed using hierarchical multiple regression and mediational analysis. Results: Negative early interactions with mothers and fathers led to greater postnatal depressive symptomology, while positive early interactions with mothers led to fewer postnatal depressive symptoms. Mediation analyses revealed that postnatal depressive symptoms mediated early parenting interactions and participants' sense of parenting competence as a new mother. Conclusions: The protective effects of positive early interactions with caregivers can help first-time mothers' postnatal emotional adjustment and their sense of competence through diminished postnatal depressive symptoms. However, the enduring effects of negative early interactions with caregivers can contribute to a first-time mother's risk of developing postnatal depression and negatively affect her sense of parental competence. [ABSTRACT FROM AUTHOR]

The COVID-19 (Coronavirus Disease 2019) pandemic has led to several mandatory prevention regulations, changes in healthcare services, unprecedented unemployment rates, financial stress, and emotional worries. Given the increasing cases of COVID-19, coupled with the drastic physical and psychological changes within postpartum mothers during the postpartum period, this paper aims to present an overview of the postpartum depression (PPD) among postpartum women during the COVID-19 pandemic. The postpartum period is characterized by drastic physical changes and substantial demands on parental role adjustment, and it places enormous stress on the mothers and makes them vulnerable to mental health problems. A literature search was conducted in four electronic databases (ScienceDirect, Scopus, Wiley, and SAGE) with different combinations of keywords were used. As the result, 25 articles that involved 10,515 postpartum women from 14 countries were extracted. Results have recorded PPD prevalence ranged from 6.4% to 56.9% during the COVID-19 pandemic. Limited social support, social isolation, fear of COVID-19 exposure, or infection for themselves, newborns, have worsening PPD symptoms among postpartum women. In brief, early detection, appropriate and timely intervention is needed to prevent and identify PPD among postpartum women during the COVID-19 pandemic. [ABSTRACT FROM AUTHOR]

In December 1973, the BBC aired Nemone Lethbridge’s auto-fictional play Baby Blues as one of their influential ‘Play for Today’ (PfT) series (1970–1984). This article explores the impact of Lethbridge’s controversial television play, which drew attention to taboo topics, such as infertility, caesarean section childbirth, infanticide, suicide, and, separately, motherhood ageism and dismissive medical professionals. It will illustrate how Lethbridge’s play Baby Blues was part of a broader change in discussing maternal mental illness and creating support for women experiencing postnatal depression and psychosis, instigated by the Women’s Liberation Movement (WLM). The article situates Baby Blues within the wider history of the PfT series, with its focus on socio-political issues, and highlights the challenges Lethbridge faced in bringing the play to production. It analyses the mixed responses to the play, many of which were critical, and how this led to Lethbridge’s launching of a grass-roots self-help group, Depressives Anonymous (DA), in 1974, which was—and still is—a long-lasting legacy of Baby Blues. The article builds on the history of maternal mental illness as explored in women’s narratives and its association with stigma, support and feminism, alongside the British Broadcasting Corporation’s television series PfT, in 1970s Britain. [ABSTRACT FROM AUTHOR]

Although controversy exists around labels for postpartum depression (PPD), focusing efforts on terms distracts the research community from better understanding the impact of depression on parent–infant relationships. The purpose of this article is to provide a narrative review of research related to how depression experienced in the postpartum period impacts parent–infant relationships. Our review indicates that PPD is pervasive, symptoms often appear during pregnancy, and it has the potential to negatively impact parent–infant relationships. Based on the recent review of literature, intervention efforts should focus on identification and treatment of PPD as early as possible to mitigate detrimental long-term impacts on parent–child relationships. [ABSTRACT FROM AUTHOR]

The perinatal period is a known time of increased vulnerability to mental health illnesses, which are associated with significant morbidity and mortality. The COVID-19 pandemic saw rates of perinatal mental illness increase, remaining elevated ever since. In this article, postnatal depression is considered a specific perinatal mental health illness, which demonstrates the unique challenges in defining and diagnosing perinatal mental illness, and mitigating the long-term consequences to the infant. As public health practitioners, midwives are effective in preventing postnatal depression, yet may be limited in their ability to support women because of service constraints. Key drivers in the UK are mandating the parity of esteem of mental health and the improved provision of perinatal services, with the recruitment and retention of a sufficient midwifery service highlighted as priority. [ABSTRACT FROM AUTHOR]

Objective: This meta‐analysis of observational studies aimed to derive a more precise estimation of the relationship between postpartum pain and postpartum depression (PPD). Methods: A systematic literature search was completed in the following databases from inception to September 26, 2022: PubMed, Embase, and Web of Science. Quality evaluation of each study was achieved through Newcastle‐Ottawa scale (NOS) assessment. Heterogeneity across studies was evaluated by Cochran's Q test and I2 test. Pooled estimates of odds ratios (ORs) and corresponding 95% confidence intervals (CIs) were analyzed using fixed‐effects model or random‐effects model, according to heterogeneity. Subgroup analysis, sensitivity analysis, and Egger's test were also performed. Results: From the identified 1884 articles, a total of 8 studies involving 3973 participants were included in the final meta‐analysis. Seven of the 8 studies were evaluated as high‐quality, with NOS scores ≥7. A significant heterogeneity was observed (I2 = 66.5%, p = 0.004) among eight studies. Therefore, the performed random‐effect model suggested a significant association between postpartum pain and PPD risk (OR 1.29, 95% CI 1.10–1.52, p = 0.002). However, the subgroup analyses did not define the source of heterogeneity. Moreover, the sensitivity analysis showed the stability of the pooled results, but the significant publication bias was identified (p = 0.009). The trim and fill method was performed and resulted in an OR of 1.14 (95% CI 0.95–1.37, p = 0.162). Conclusions: This meta‐analysis found a potential association between postpartum pain and PPD. Further researches are needed to provide more robust evidences. [ABSTRACT FROM AUTHOR]

Introduction: It is a proven fact that women are affected by poor mental health predominantly in the postnatal period. This is authenticated by the use of a validated and tested Edinburg Postnatal Depression scale (EPNS), which is a simple tool to measure depression among women after delivery by posing 10 questions and this is also validated in Odia language. Odisha has made laudable progress in delivering Maternal and Child Health care to women even in tribal-dominated districts through its robust Comprehensive Obstetrics care network restricting home delivery almost to a mere 4%-5% and reducing maternal deaths by 60%-70% as per the National Family Health Survey (NFHS-5). As a part of an Indian Council of Medical Research (ICMR) extramural project to enhance contraceptive acceptance among males in districts that had a total fertility rate (TFR) higher than 3, a qualitative objective to measure mean postnatal depression in the early postpartum period (who are also the target to advocate contraceptive acceptance) was undertaken. A secondary objective was to compare family care vs. facility care as greater attributing factors for higher EPNS scores. Materials and Methods: Due to time constraints, the study was done on a fast-track mode wherein two villages each from the sampled blocks of Koraput and Boudh (with one of the highest birth rates) were selected. All women in villages who had a baby aged between 1 and 6 months, were the sampling frame and only those were selected who consented. A questionnaire was used that elicited information on familial sociodemographic details and also facility-based antenatal care (ANC) and postdelivery services that were availed for the last-born child. General Health Questionnaire-12 (GHQ-12) scores were used as an independent variable and a proxy measure of cumulative familial stress. Descriptives and log regression were used to measure the odds of family vs. facility-based services. Results: A total of 98 women, 50 from Boudh and 48 from Koraput, participated in the study. Koraput's mean EPNS scores were 6 points higher than Boudh indicating much higher postnatal poor mental health. Log models showed that there was no difference between facility-based care in both districts as both reported 96%-97.3% institutional delivery, with out-of-pocket expenditure (OOP) being less than 520 Indian rupees on average and nearly 100% reported receipt of iron folic acid and calcium as well as streamlined Janani Suraksha Yojana (JSY) services. However, the odds of men's participation in Family planning was 2.77 times less in Koraput (SD = 2.582), fourth birth order 1.33 odds, and female gender 5.66 odds higher for the district as a result of which GHQ 12 score mean was 21.00 (CI: 19.18-22.82) hinting very high psychological stress as compared with Boudh where the mean was 17 (CI: 14.59-19.41). Conclusion: This clearly indicates that a robust healthcare delivery alone will not be able to address the holistic health of women in the childbearing age group. Familial stressors compound poor mental health and hence counseling of the family as a whole is necessary to achieve sound mental health in women in the postnatal period. The spousal role is emerging as a strong determinant, especially in terms of nonacceptance or casual approach to contraceptive use. Interestingly, a skewed gender bias is noted for the female child, which is also a contributor to postnatal depression (PND) in both districts, though a bigger sample would be needed to statistically prove it. [ABSTRACT FROM AUTHOR]

Evidence shows that behavioral activation (BA), a simple form of psychological therapy, is as effective as the more complex psychological therapy—cognitive behavioral therapy (CBT)—in treating general depression. However, it remains unclear whether BA when compared with treatment-as-usual (TAU) has greater contributions in reducing postnatal depression. This systematic review compared the effect of BA versus TAU in reducing depression symptoms among postnatal women. Five databases (MEDLINE, Embase, Emcare, Cochrane Library, and PsycINFO) were searched. Risk of bias was assessed using the Cochrane Collaboration's 'risk-of-bias 2 tool'. A random-effects meta-analysis was conducted to examine the effect of BA on postnatal depression. Of 2844 initial studies, only two randomized control trials (RCTs) met the inclusion criteria. The overall quality of evidence of these two RCTs was low. When compared to TAU, meta-analysis showed that BA was associated with reduced depression symptoms in postnatal women (standard mean difference −0.56; 95% confidence interval −0.76 to −0.37). This review suggests that BA might be more effective than TAU for alleviating postnatal depression. However, due to concerns about evidence quality, these findings should be interpreted cautiously. [ABSTRACT FROM AUTHOR]

This article offers a sociological study of postnatal depression recovery blogs. Such media render 'failing' and 'ailing' publicly accountable in response to the performative demands of motherhood and the health role. Drawing from nine Anglophone blogs and classic and contemporary scholarship (e.g. on cycles of redemption, the medicalisation of cyberspace), it explores three main themes: (1) guilt, (2) purification and (3) redemption. Analysing these themes provides virtual ethnographic insights on the public drama of medicalised maternal distress. Critically, the limitations of medicalised rhetoric are also considered in a postfeminist context of stigma, deviance, shame and mother blame. Finally, the limitations of this study plus possibilities for future research, policy and social change are highlighted. [ABSTRACT FROM AUTHOR]

Background: Previous research shows that 61% of children younger than 6 months in low- and middle-income countries (LMICs) are not exclusively breastfed. Although data on the role of pre- and postnatal depression on breastfeeding exclusivity is mixed, fetomaternal attachment might foster breastfeeding exclusivity. Thus, we tested the potential mediating role of fetomaternal attachment and postnatal depression in the relationship between maternal prenatal depression and exclusive breastfeeding. Materials and Methods: Data were collected as part of a prospective, cross-cultural project, Evidence for Better Lives Study, which enrolled 1208 expectant mothers, in their third trimester of pregnancy across eight sites, from LMICs. Of the whole sample, 1185 women (mean age = 28.32, standard deviation [SD] = 5.77) completed Computer-Aided Personal Interviews on prenatal depressive symptoms, fetomaternal attachment, and socioeconomic status. A total of 1054 women provided follow-up data at 3–6 months after birth, about postnatal depressive symptoms, exclusive breastfeeding, and infant health indicators. Path analysis was used to assess parallel mediation. Results: In the whole sample, the effect of prenatal depression on breastfeeding exclusivity was completely mediated by postnatal depression, whereas fetomaternal attachment did not mediate the relationship. The full mediation effect was replicated individually in Pakistan and Sri Lanka. Conclusions: The study results indicate that prenatal depression symptoms contributed to the development of depressive symptoms after birth, negatively affecting the probability of exclusive breastfeeding. Future research should explore this in early prevention interventions, increasing the chances of healthy child development in LMICs. Considering the mixed results around the sites, it is important to better understand the relationship between maternal depression, fetomaternal attachment and breastfeeding behavior in each site's socio-cultural context. [ABSTRACT FROM AUTHOR]

Background: Perinatal depression, characterized by the presence of depressive symptoms during pregnancy and/or within the first 12 months postpartum, poses a significant global public health concern. It contributes to a multitude of health risks for mothers, their infants, and their families. Understanding of perinatal depression and its associated factors is crucial for effective prevention and intervention strategies. However, there is a lack of comprehensive research on this topic in Ethiopia. Therefore, this study aims to determine the prevalence and factors contributing to perinatal depression among Ethiopian women. Methods: An institutional-based cross-sectional study was conducted, involving 552 women receiving perinatal services at Kutaber district health institution and Boru Meda General Hospital. Study participants were selected through systematic random sampling techniques. Perinatal depression was assessed using the Depression, Anxiety, and Stress Scale-21 (DASS-21). The associations between various determinants and perinatal depression were examined using binary logistic regression, and factors with a p-value of less than 0.2 were included in the multiple logistic regression analysis. A p-value less than 0.05 was considered statistically significant. Results: The prevalence of perinatal depression was found to be 32.2%. The prevalence of perinatal depression was found to be 32.2%. Factors significantly associated with perinatal depression included being a student [adjusted odds ratio (AOR) = 4.364, 95% confidence interval (CI): 1.386, 13.744], experiencing excessive pregnancy-related concerns (AOR = 1.886, 95% CI: 1.176, 3.041), past substance use (AOR = 2.203, 95% CI: 1.149, 4.225), the presence of anxiety symptoms (AOR = 3.671, 95% CI: 2.122, 6.352), experiencing stress symptoms (AOR = 6.397, 95% CI: 3.394-12.055), and daytime sleepiness (AOR = 2.593, 95% CI: 1.558, 4.316). Conclusion: The findings of this study indicate a relatively high prevalence and valuable factors associated with perinatal depression. It highlights the need for a comprehensive approach to perinatal mental health that takes into account not only the biological aspects of pregnancy but also the psychological, social, and lifestyle factors that can impact a person's mental well-being during this critical period. [ABSTRACT FROM AUTHOR]

During the 1970s, the National Childbirth Trust (NCT) began to provide information and support to women experiencing postnatal mental illness, building on its promotion of natural childbirth and emphasis on the emotional wellbeing of women around birth, which had occupied the organisation since its establishment in 1956. This article argues that, alongside emotional, social and medical factors, the NCT attributed postnatal depression to the shift to hospital deliveries, involving high levels of intervention and frustrating women's choice and agency. While sharing ambitions to improve care in childbirth and giving women a voice in describing their experiences, it is suggested that the NCT's relationship with the feminist health movement remained ambiguous. The article also explores the NCT's collaboration with a variety of experts and advisors, some of whom emphasised the risk of postnatal depression to the bonding process and infant's development, potentially exacerbating the mental distress of new mothers. [ABSTRACT FROM AUTHOR]

Abstract Background In the case of preterm birth, the idealized postnatal period is replaced by an anxious and even traumatic experience for parents. Higher prevalence of parental anxiety, postnatal depression, and posttraumatic stress disorder has been observed in mothers of preterm infants up to 18 months after childbirth. There is increasing evidence that proprioceptive stimulation has a beneficial effect on preterms’ short-term outcomes. Could this care also have an impact on parental anxiety and depressive symptoms? We reviewed recent publications on the impact on parents’ anxiety and depressive symptoms of delivering tactile and/or kinesthetic stimulation to their premature newborn. Methods We conducted a systematic review by searching the PubMed, PsycInfo, Scopus, ScienceDirect and Google Scholar databases for English-language publications from the past 10 years. We focused on the mothers or fathers of infants born preterm (before 37 weeks of gestation) who provided tactile and/or kinesthetic stimulation to their premature newborn in the neonatal intensive care unit. Relevant outcomes were the parents’ anxiety, stress, depressive symptoms, and symptoms of posttraumatic stress disorder, assessed with reliable standardized inventories. Results Eleven articles were included in the systematic review. Results suggested a beneficial effect of parents’ early tactile and kinesthetic stimulation of their preterm infants. Conclusions These interventions may act as protective factors against the occurrence of anxiety and depressive symptoms in parents and deserve to be studied further in this population.

Introduction: It is a proven fact that women are affected by poor mental health predominantly in the postnatal period. This is authenticated by the use of a validated and tested Edinburg Postnatal Depression scale (EPNS), which is a simple tool to measure depression among women after delivery by posing 10 questions and this is also validated in Odia language. Odisha has made laudable progress in delivering Maternal and Child Health care to women even in tribal-dominated districts through its robust Comprehensive Obstetrics care network restricting home delivery almost to a mere 4%–5% and reducing maternal deaths by 60%–70% as per the National Family Health Survey (NFHS-5). As a part of an Indian Council of Medical Research (ICMR) extramural project to enhance contraceptive acceptance among males in districts that had a total fertility rate (TFR) higher than 3, a qualitative objective to measure mean postnatal depression in the early postpartum period (who are also the target to advocate contraceptive acceptance) was undertaken. A secondary objective was to compare family care vs. facility care as greater attributing factors for higher EPNS scores. Materials and Methods: Due to time constraints, the study was done on a fast-track mode wherein two villages each from the sampled blocks of Koraput and Boudh (with one of the highest birth rates) were selected. All women in villages who had a baby aged between 1 and 6 months, were the sampling frame and only those were selected who consented. A questionnaire was used that elicited information on familial sociodemographic details and also facility-based antenatal care (ANC) and postdelivery services that were availed for the last-born child. General Health Questionnaire-12 (GHQ-12) scores were used as an independent variable and a proxy measure of cumulative familial stress. Descriptives and log regression were used to measure the odds of family vs. facility-based services. Results: A total of 98 women, 50 from Boudh and 48 from Koraput, participated in the study. Koraput's mean EPNS scores were 6 points higher than Boudh indicating much higher postnatal poor mental health. Log models showed that there was no difference between facility-based care in both districts as both reported 96%–97.3% institutional delivery, with out-of-pocket expenditure (OOP) being less than 520 Indian rupees on average and nearly 100% reported receipt of iron folic acid and calcium as well as streamlined Janani Suraksha Yojana (JSY) services. However, the odds of men's participation in Family planning was 2.77 times less in Koraput (SD = 2.582), fourth birth order 1.33 odds, and female gender 5.66 odds higher for the district as a result of which GHQ 12 score mean was 21.00 (CI: 19.18–22.82) hinting very high psychological stress as compared with Boudh where the mean was 17 (CI: 14.59–19.41). Conclusion: This clearly indicates that a robust healthcare delivery alone will not be able to address the holistic health of women in the childbearing age group. Familial stressors compound poor mental health and hence counseling of the family as a whole is necessary to achieve sound mental health in women in the postnatal period. The spousal role is emerging as a strong determinant, especially in terms of nonacceptance or casual approach to contraceptive use. Interestingly, a skewed gender bias is noted for the female child, which is also a contributor to postnatal depression (PND) in both districts, though a bigger sample would be needed to statistically prove it.

Evidence shows that behavioral activation (BA), a simple form of psychological therapy, is as effective as the more complex psychological therapy—cognitive behavioral therapy (CBT)—in treating general depression. However, it remains unclear whether BA when compared with treatment-as-usual (TAU) has greater contributions in reducing postnatal depression. This systematic review compared the effect of BA versus TAU in reducing depression symptoms among postnatal women. Five databases (MEDLINE, Embase, Emcare, Cochrane Library, and PsycINFO) were searched. Risk of bias was assessed using the Cochrane Collaboration’s ‘risk-of-bias 2 tool’. A random-effects meta-analysis was conducted to examine the effect of BA on postnatal depression. Of 2844 initial studies, only two randomized control trials (RCTs) met the inclusion criteria. The overall quality of evidence of these two RCTs was low. When compared to TAU, meta-analysis showed that BA was associated with reduced depression symptoms in postnatal women (standard mean difference −0.56; 95% confidence interval −0.76 to −0.37). This review suggests that BA might be more effective than TAU for alleviating postnatal depression. However, due to concerns about evidence quality, these findings should be interpreted cautiously.

Abstract Background To provide a comprehensive, systematic evaluation of the literature on experiences of psychological interventions for postpartum depression (PPD) in women. Depression is one of the most common postpartum mental disorders. Studies have identified that psychological interventions reduce depressive symptoms. However, less is known about the experiences of women who have received such treatments. Methods A systematic review of the literature was conducted by searching five databases (CINAHL, Cochrane Library, EMBASE, Medline, PsycINFO), in August 2022. Studies with qualitative methodology examining women’s experiences of professional treatment for PPD were included and checked for methodological quality. Eight studies (total N = 255) contributed to the findings, which were synthesized using thematic synthesis. Confidence in the synthesized evidence was assessed with GRADE CERQual. Findings The women had received cognitive behavioral therapy (5 studies) or supportive home visits (3 studies). Treatments were individual or group-based. Two main themes were identified: Circumstances and expectations, and Experiences of treatment, with six descriptive themes. Establishing a good relationship to their health professional was important for the women, regardless of treatment model. They also expressed that they wanted to be able to choose the type and format of treatment. The women were satisfied with the support and treatment received and expressed that their emotional well-being had been improved as well as the relationship to their infant. Conclusion The findings can be helpful to develop and tailor patient-centered care for women who are experiencing postnatal depression.