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Postpartum depression (PPD) can interfere with the establishment of affective bonds between infant and mother, which is important for the cognitive, social-emotional, and physical development of the child. Rates of PPD have increased during the COVID-19 pandemic, likely due to the added stress and limited support available to new parents. The present study examined whether parenting-related stress, perceived bonding impairments, the quality of observed mother-infant interactions, and salivary oxytocin levels differ between depressed and non-depressed mothers, along with differential impacts of COVID-19 on depressed mothers. Participants included 70 mothers (45 depressed, 25 controls) with infants aged 2-6 months. All data were collected remotely to ease participant burden during the pandemic. Depression was associated with experiences of heightened parenting-related stress and bonding difficulties. These differences were not observed during mother-infant interactions or in salivary oxytocin levels. Differences in COVID-19-related experiences were minimal, though depressed mothers rated slightly higher stress associated with returning to work and financial impacts of the pandemic. Findings highlight the importance of early intervention for PPD to mitigate long-term effects on mothers, children, and families. Additionally, they underscore the need for early intervention to support the developing mother-infant dyad relationship during this crucial time.

This cross-sectional study investigated the mental health of Italian women who gave birth during the three years of the COVID-19 pandemic. The study focused on the impact of the partner's presence during childbirth, the time point of birth in relation to pandemic waves, hospital restrictions, and individual attitudes regarding the pandemic. In addition, the study aimed to determine potential risk or protective factors for postpartum depression. 1,636 Italian women who gave birth between 2020 and 2022 in a hospital-restricted setting were surveyed anonymously online. Standardized questionnaires were used to evaluate depression, post-traumatic stress, and psychological well-being. Women who gave birth in 2020 had the highest percentage of unaccompanied births and higher levels of depression and fear of COVID-19. Women who gave birth alone reported higher depression and post-traumatic stress and lower psychological well-being. Furthermore, they were more frightened by COVID-19 and less in agreement with pandemic restrictions than women who gave birth with their partner present. The main risk factors for postpartum depression were childbirth in 2020, high COVID-19 anxiety, discomfort with pandemic restrictions, and the partner's absence during birth. Protective factors were the partner's presence during childbirth and satisfaction with the partner relationship. This study emphasizes the importance of targeted support to women who give birth during crises such as the COVID-19 pandemic to reduce risk factors and enhance protective factors, particularly by strengthening the partner's presence. Future research should focus on children born during these tumultuous periods, assessing potential impacts on their developmental trajectories and relationships with primary caregivers. [ABSTRACT FROM AUTHOR]

ABSTRACT: Background: Postpartum depression (PPD) is a significant public health concern with detrimental effects on maternal and child well-being. Social support, breastfeeding attitudes, and self-efficacy have been identified as potential protective or risk factors for PPD. This study aimed to investigate the associations between PPD, social support, breastfeeding attitudes, and self-efficacy among postpartum women in Gujarat, India. Methods: A cross-sectional study was conducted among 403 postpartum women in Gujarat, India. Data on sociodemographic characteristics, obstetric factors, PPD (assessed using the Edinburgh Postnatal Depression Scale), social support, breastfeeding attitudes, and self-efficacy were collected through structured interviews. Bivariate and multivariate logistic regression analyses were performed to examine the associations between PPD and the independent variables. Results: The prevalence of PPD in the study population was 50.1% (n = 202), with 28.8% (n = 116) experiencing mild depression, 16.6% (n = 67) moderate depression, and 4.7% (n = 19) severe depression. Lower educational level (n = 120, 29.8%; AOR: 1.72, 95% CI: 1.04–2.85), lower socioeconomic status (n = 242, 60%; AOR: 1.84, 95% CI: 1.12–3.02), non-exclusive breastfeeding (n = 167, 41.4%; AOR: 1.68, 95% CI: 1.11–2.54), low social support (n = 101, 25.1%; AOR: 2.51, 95% CI: 1.57–4.02), and a history of depression (n = 93, 23.1%; AOR: 2.94, 95% CI: 1.82–4.75) were significantly associated with higher odds of PPD in the multivariate analysis. In addition, negative breastfeeding attitudes and low self-efficacy levels were associated with increased odds of PPD. Conclusions: The findings highlight the significant associations between PPD and various sociodemographic, obstetric, and psychosocial factors among postpartum women in Gujarat, India. Interventions targeting social support, breastfeeding attitudes, and self-efficacy, as well as targeted support for women with identified risk factors, may help mitigate the burden of PPD and promote maternal well-being. [ABSTRACT FROM AUTHOR]

Introduction: Understanding the incidence and predictors of postpartum depression (PPD) among active-duty service members is critical given the importance of this population and its unique stressors. Methods: We conducted a retrospective cohort study of all active-duty U.S. Army soldiers with a record of at least one live-birth delivery between January 2012 and December 2013. Multivariate logistic regression models were used to estimate associations between demographic, health-related, and military-specific variables and diagnoses of PPD in the total population (N = 4,178) as well as in a subpopulation without a record of depression before delivery (N = 3,615). Results: The overall incidence of PPD diagnoses was 15.9% (N = 664 cases) among the total population and 10.4% (N = 376 cases) among those without prior depression. Statistically significant predictors of PPD in the adjusted model included lower pay grade, a higher number of prior deployments, a higher number of child dependents, tobacco use, and a history of depression or anxiety before or during pregnancy. For soldiers without a history of depression, lower pay grade, and a history of anxiety before or during pregnancy were significantly associated with PPD. Conclusions: Knowing the predictors of overall and novel onset PPD diagnoses in this population could help establish clearer guidelines on PPD prevention, screening, management, and return to duty. [ABSTRACT FROM AUTHOR]

Objective: The purpose of this study was to understand the pharmacotherapy and electroconvulsive therapy (ECT) prescription of women with depression and anxiety admitted to an Australian inpatient psychiatric mother-baby unit (MBU) and compare prescription to national clinical practice guidelines. Method: A retrospective audit was conducted on women diagnosed with depression or anxiety admitted to a public psychiatric inpatient MBU from March 2017 to July 2019. Data was captured at three time points to assess demographic, clinical and pharmacotherapy treatment characteristics. Descriptive statistics were completed. Results: Of the 74 women, 57 women had depression, with 73% prescribed Selective Serotonin Reuptake Inhibitors (SSRIs) and 14% provided ECT during admission. For women with anxiety (n = 17), 23% were prescribed a benzodiazepine with concurrent antidepressant prescription. SSRI prescription increased, with other antidepressant prescription up trending through admission. Atypical antipsychotic prescription was increased initially and trended downwards at discharge. Conclusions: This study explored the therapeutic armamentarium employed for the treatment of mothers admitted to an inpatient psychiatric MBU with depression and anxiety. The results point to the intricate prescribing practices in a naturalistic setting and highlight that prescribing practices were in line with national guidelines. [ABSTRACT FROM AUTHOR]

Summary: This study sought to examine the effects of childhood adversity on the longitudinal associations between perinatal sleep quality and depressive symptoms, and to determine the prospective associations between these constructs over time. A cross‐lagged autoregressive model was used to examine the longitudinal association between sleep quality and depressive symptoms at four points during the perinatal period: 18 and 32 weeks of pregnancy, and 6 and 12 weeks postpartum. Longitudinal mediation models were used to examine whether sleep quality or depressive symptoms mediated the effects of childhood adversity on these symptoms. Most participants (86%) reported poor sleep quality during pregnancy. Significant cross‐lagged effects of depressive symptoms on subsequent sleep quality were observed during pregnancy and postpartum. Depressive symptoms significantly mediated the effects of childhood trauma on sleep quality during pregnancy, but sleep quality did not significantly mediate the effects of childhood trauma on depressive symptoms. While sleep quality and depressive symptoms tend to co‐occur, our analyses indicate that perinatal depressive symptoms work as the primary driver of sleep quality over time. Childhood adversity may have long‐reaching effects in women as it was associated with more depressive symptoms in the perinatal period, which in turn appeared to undermine sleep quality. [ABSTRACT FROM AUTHOR]

Objective: To study the effects of playing mother's recorded voice to preterm infants in the NICU on their mothers' mental health as measured by the Depression, Anxiety and Stress Scale −21 (DASS-21) questionnaire. Design/Methods: This was a pilot single center prospective randomized controlled trial done at a level IV NICU. The trial was registered at clinicaltrials.gov (NCT 04559620). Inclusion criteria were mothers of preterm infants with gestational ages between 26wks and 30 weeks. DASS-21 questionnaire was administered to all the enrolled mothers in the first week after birth followed by recording of their voice by the music therapists. In the interventional group, recorded maternal voice was played into the infant incubator between 15 and 21 days of life. A second DASS-21 was administered between 21 and 23 days of life. The Wilcoxon rank-sum test was used to compare DASS-21 scores between the two groups and Wilcoxon signed-rank test was used to compare the pre- and post-intervention DASS-21 scores. Results: Forty eligible mothers were randomized: 20 to the intervention group and 20 to the control group. The baseline maternal and neonatal characteristics were similar between the two groups. There was no significant difference in the DASS-21 scores between the two groups at baseline or after the study intervention. There was no difference in the pre- and post-interventional DASS-21 scores or its individual components in the experimental group. There was a significant decrease in the total DASS-21 score and the anxiety component of DASS-21 between weeks 1 and 4 in the control group. Conclusion: In this pilot randomized control study, recorded maternal voice played into preterm infant's incubator did not have any effect on maternal mental health as measured by the DASS-21 questionnaire. Data obtained in this pilot study are useful in future RCTs (Randomized Controlled Trial) to address this important issue. [ABSTRACT FROM AUTHOR]

Background: Major Depressive Disorder (MDD) during the perinatal period is a significant global health concern, ranking as the fourth-leading contributor to the global burden of disease and the second-leading cause of disability in individuals aged 15–44. This study investigates the association between perinatal MDD, poor nutrition, low prenatal care adherence, substance use and increased suicide risk. Methodology: A comprehensive review of existing research studies examined the prevalence and consequences of perinatal MDD. Studies focusing on symptoms, risk factors, and associated outcomes in mothers and infants were analyzed to provide a comprehensive overview of the multifaceted impact of MDD during the perinatal period. Conclusion: Approximately 10–15% of women experience postpartum depression, with over 60% reporting symptoms within the first 6 weeks postpartum. perinatal MDD increases the likelihood of preterm birth, small-for-gestational-age newborns and developmental delay. These findings underscore the critical need for comprehensive screening, identification and intervention approaches to mitigate the short and long term consequences of perinatal MDD. [ABSTRACT FROM AUTHOR]

An increasing number of women are conceiving through assisted reproductive technology; however, few studies have investigated their mental health after successful conception. This study investigated the changes in depressive symptoms in women using assisted reproductive technology and the association between the mode of conception and perinatal depressive symptoms. A longitudinal observational study was conducted from 2015 to 2019, 542 pregnant women completed questionnaires on depressive symptoms at eight timepoints during the prepregnancy, pregnancy and first-year postpartum periods. Depressive symptoms were assessed using the Center for Epidemiologic Studies Depression Scale. A generalized estimating equation regression model was employed for repeated measures. In the assisted reproductive technology group, depressive symptoms were more prevalent during early pregnancy and at 1 month postpartum than before pregnancy, and more prevalent before pregnancy and at 1 month after childbirth than in the spontaneous conception group. No significant association was identified between the mode of conception and depressive symptoms during the antenatal or postnatal period. The lack of full-time employment and prepregnancy depressive symptoms were associated with antenatal depressive symptoms. Primipara status and depressive symptoms during prepregnancy and pregnancy were associated with depressive symptoms during the first-year postpartum. Assisted reproductive technology was not a risk factor for depressive symptoms during the pregnancy and postpartum periods, whereas primipara status, lack of full-time employment and prepregnancy depressive symptoms were negative predictors. Therefore, targeted mental health interventions should address these specific factors to effectively support maternal mental health. [ABSTRACT FROM AUTHOR]

Purpose: Estrogen levels fall sharply after parturition and have long been considered an etiologic contributor to postpartum depression (PPD); however, no differences have been reported in plasma hormone concentrations in people who develop PPD. We examine the question: What is the current view of estrogen and the neurophysiologic processes it impacts in the development and treatment of PPD? Methods: A literature review of the role of estrogen on candidate hormonal and epigenetic systems in the peripartum period was performed, including landmark historical studies and recent publications on estrogen-related research. The authors reviewed these papers and participated in reaching consensus on a conceptual framework of estrogen activity within the complexity of pregnancy physiology to examine its potential role for driving novel interventions. Results: Estrogen fluctuations must be conceptualized in the context of multiple dramatic and interacting changes inherent in pregnancy and after birth, including progesterone, corticosteroids, inflammation, circadian biology and psychosocial challenges. Individuals who develop PPD have increased sensitivity to epigenetic alteration at estrogen-responsive genes, and these changes are highly predictive of PPD. An effective estrogen-based treatment for PPD has yet to be found, but interventions focused on associated inflammation and circadian rhythms are promising. Conclusions: Our understanding of the biological basis of PPD, one of the most common morbidities of the perinatal period, is expanding beyond changes in gynecologic hormone concentrations to include their impact on other systems. This growing understanding of the many processes influencing PPD will allow for the development of novel prevention and treatment strategies. [ABSTRACT FROM AUTHOR]

Background: The COVID-19 pandemic may have affected the mental health of pregnant and postpartum women, influencing the duration of exclusive breastfeeding and the child's neuropsychomotor development. Research aim: To evaluate the influence of COVID-19 on the mental health of postpartum women, on the protein and antioxidant profile of breast milk, on the duration of exclusive breastfeeding and on the neuropsychomotor development of their infants. Methods: Observational study, prospective cohort, with 180 postpartum women. Psychosocial status was assessed by changes in mood and lifestyle; trait and state anxiety, and postpartum depression. Breastfeeding time and neuropsychomotor development were determined at the three-month well-child consultation based on the child's health record and the WHO Anthro software. 5 ml of mature breast milk were collected from the full breast of the lactating women. Results: There was no difference between the prevalence of anxious traits and states and postpartum depression among seropositive and negative postpartum women for COVID-19. There was no difference in the prevalence of time and type of breastfeeding, and of normal and delayed neuropsychomotor development between seropositive and negative postpartum women for COVID-19. The fact that the baby smiles and raises and keeps his head elevated were associated with lower chances of an anxious state among postpartum women (OR: 0.23; OR: 0.28 and OR: 0.20, respectively). Conclusions: The need for more studies to investigate the influence of the COVID-19 pandemic on the mental health of postpartum women, breastfeeding and the neuropsychomotor development of babies is highlighted, given the importance of breast milk for the growth and development of babies. [ABSTRACT FROM AUTHOR]

Purpose: Postpartum depression (PPD) and anxiety (PPA) affect nearly one-quarter (23%) of women in Canada. eHealth is a promising solution for increasing access to postpartum mental healthcare. However, a user-centered approach is not routinely taken in the development of web-enabled resources, leaving postpartum women out of critical decision-making processes. This study aimed to evaluate the effectiveness, usability, and user satisfaction of PostpartumCare.ca, a web-enabled psychoeducational resource for PPD and PPA, created in partnership with postpartum women in British Columbia. Methods: Participants were randomized to either an intervention group (n = 52) receiving access to PostpartumCare.ca for four weeks, or to a waitlist control group (n = 51). Measures evaluating PPD (Edinburgh Postnatal Depression Scale) and PPA symptoms (Perinatal Anxiety Screening Scale) were completed at baseline, after four weeks, and after a two-week follow-up. User ratings of website usability and satisfaction and website metrics were also collected. Results: PPD and PPA symptoms were significantly reduced for the intervention group only after four weeks, with improvements maintained after a two-week follow-up, corresponding with small-to-medium effect sizes (PPD: partial η2 = 0.03; PPA: partial η2 = 0.04). Intervention participants were also more likely than waitlist controls to recover from clinical levels of PPD symptoms (χ 2 (1, n = 63) = 4.58, p =.032) and PostpartumCare.ca's usability and satisfaction were rated favourably overall. Conclusion: Findings suggest that a web-enabled psychoeducational resource, created in collaboration with patient partners, can effectively reduce PPD and PPA symptoms, supporting its potential use as a low-barrier option for postpartum women. Trial Registration: Protocol for this trial was preregistered on NIH U.S. National Library of Medicine, ClinicalTrials.gov as of May 2022 (ID No. NCT05382884). [ABSTRACT FROM AUTHOR]

Background: In the United States, 35% of all pregnancy‐related deaths occur between 24 h and 6 weeks after delivery, yet the first outpatient visit is not typically scheduled until 6 weeks postpartum. Thus, the ability to independently navigate this period is critical to maternal well‐being and safety. However, previous research suggests that many women feel unprepared to manage the challenges they encounter during this time, and there is a current need to synthesize the existing evidence. Therefore, the purpose of this integrative review is to describe parent‐identified gaps in preparation for the postpartum period in the United States. Methods: Using the Integrative Review framework by Whittemore and Knafl, a systematic search of Medline, CINAHL, PsychInfo, Web of Science, and a hand‐search was conducted for peer‐reviewed articles published in English between 1995 and 2023. Results were reported according to PRISMA 2020 guidelines. Studies that met eligibility criteria were synthesized in a literature matrix. Results: Twenty‐two studies met inclusion criteria. Four themes were identified: Mental Health Concerns, Physical Concerns, Infant Feeding and Care Concerns, and General Concerns and Recommendations. Many women, regardless of parity, reported feeling unprepared for numerous postpartum experiences, including depression, anxiety, physical recovery, breastfeeding, and infant care. Parents reported difficulty differentiating normal postpartum symptoms from complications. Hospital discharge teaching was viewed as simultaneously overwhelming and inadequate. Parent recommendations included the need for earlier and more comprehensive postpartum preparation during pregnancy, delivered in multiple formats and settings. Parents also reported the need for earlier postpartum visits and improved outpatient support. Conclusions: Our findings indicate that many parents in the United States feel unprepared to navigate a wide variety of emotional, physical, breastfeeding, and infant‐care experiences. Future research should explore innovative educational approaches to postpartum preparation during pregnancy as well as outpatient programs to bridge the current gaps in postpartum care. [ABSTRACT FROM AUTHOR]

Rationale: Psycho‐education application is effective in reducing the risk of postpartum depression (PPD) and increasing the level of social support. The quality of care increases with the implementation of Watson's Theory of Human Caring Model (WTHCM)‐based care programs to reduce the risk of PPD. Aims: This study aimed to evaluate the impact of a psycho‐educational intervention based on the Watson model on pregnant women in preventing PPD. Additionally, the effect of the psycho‐educational intervention on women's perceptions of social support in relation to PPD was evaluated. Methods: A randomized‐controlled pretest–posttest control group intervention study design was used. The sample consisted of 91 women (intervention:45, control:46) in their 20th to 32nd gestational week. While all women received routine care at the family health centre the intervention group was additionally applied a psycho‐educational intervention based on the WTHCM. Chi‐square and t‐test analysis methods were performed to determine the homogeneity of the intervention and control groups. The t‐test method was used to compare group scores. Multiple regression analysis was employed to compare multiple variables. Results: Following the psycho‐educational intervention, the total Edinburgh Postpartum Depression Scale of the intervention group was found significantly lower than that of the control group, but the total and friend subscale scores on the Multidimensional Scale of Perceived Social Support (MSPSS) were higher (p < 0.05). The regression analysis results indicate that friend and family support, which are sub‐dimensions of the MSPSS, exhibited a significant decrease in both groups. Furthermore, this decline had a greater impact on reducing the PPD level in the intervention group compared to the control group. It was found that while the support of the significant other sub‐dimension reduced the PPD level in the intervention group, it did not make a significant difference in the control group. Conclusions: The Watson's Theory of Human Caring Model‐based psycho‐educational intervention program decreased women's risk of PPD and increased their social support levels. It is recommended to use approaches that include psycho‐educational intervention in postpartum midwifery care. [ABSTRACT FROM AUTHOR]

Background: Zuranolone is an oral, once-daily, 14-day treatment course approved for adults with postpartum depression in the United States. Aims: To assess cognitive effects, pharmacokinetics, and safety of zuranolone, alone or with alprazolam/ethanol. Methods: This was a phase 1, two-part, two-period, randomized, double-blind, placebo-controlled crossover trial. Participants received zuranolone 50 mg or placebo once daily for 9 days, and additionally received alprazolam (1 mg, Part A), ethanol (males: 0.7 g/kg; females: 0.6 g/kg, Part B), or corresponding placebo on days 1, 5, and 9. Within each part, participants received all treatment combinations. Cognition was assessed using a computerized test battery; pharmacokinetics and safety were also evaluated. Results: All participants (Part A, N = 24; Part B, N = 25) received ⩾1 dose of zuranolone/placebo. Compared to placebo, zuranolone produced small-to-moderate cognitive decline (Cohen's | d | = 0.126–0.76); effects were larger with alprazolam (Cohen's | d | = 0.523–0.93) and ethanol (Cohen's | d | = 0.345–0.88). Zuranolone coadministration with alprazolam (Cohen's | d | = 0.6–1.227) or ethanol (Cohen's | d | = 0.054–0.5) generally worsened cognitive decline when compared with zuranolone alone. Maximal pharmacodynamic effects occurred at approximately 5 h and were resolved by 12 h postbaseline. No pharmacokinetic interactions were observed. Incidence of adverse events was similar between groups; most events were mild or moderate in severity. Conclusion: A general small-to-moderate magnitude decline in cognition occurred with zuranolone alone. Coadministration with alprazolam/ethanol increased the magnitude, but not the duration, of effects compared with single-agent administration. Zuranolone prescribers and patients should be aware of the potential for increased central nervous system-depressant effects if coadministered with GABAergic active compounds such as alprazolam and ethanol. [ABSTRACT FROM AUTHOR]

Accessible Summary: What is known on the subject?: 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. What does this paper add to existing knowledge?: 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. What are the implications for practice?: 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. Introduction: 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. Aim: 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. Methods: The author utilises a first‐person approach to share and reflect on her lived experience. Findings: 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. Discussion: 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]

Objectives: To examine differences in behavior problems between children from intended versus unintended pregnancies, and to estimate how much the difference in problem behavior would be reduced if postnatal depression was eliminated and social support was increased within 6 months after birth. Methods: Data from the Generation R Study were used, a population-based birth cohort in Rotterdam, the Netherlands (N = 9621). Differences in child internalizing and externalizing behavior at ages 1.5, 3, 6, 9 and 13 years between pregnancy intention groups were estimated using linear regression. Associations of postnatal depression and social support with internalizing and externalizing problems were also estimated using linear regression. Child behavior outcomes where compared before and after modelling a situation in which none of the mothers experienced a postnatal depression and all mother experienced high social support. Results: Most pregnancies (72.9%) were planned, 14.8% were unplanned and wanted, 10.8% were unplanned with initially ambivalent feelings and 1.5% with prolonged ambivalent feelings. Children from unplanned pregnancies had more internalizing and externalizing problems at all ages as compared to children from a planned pregnancy, especially when ambivalent feelings were present. Hypothetically eliminating on postnatal depression reduced the differences in internalizing and externalizing problems by 0.02 to 0.16 standard deviation. Hypothetically increasing social support did not significantly reduce the difference in internalizing and externalizing problems. Conclusions: Children from an unplanned pregnancy have more behavior problems, in particular when mothers had prolonged ambivalent feelings. Eliminating postnatal depression may help to reduce the inequality in child behavior related to pregnancy intention. [ABSTRACT FROM AUTHOR]

Little is known about the time trends of postpartum depression (PPD) and whether they differ from time trends of depression among women in general. Using Danish health registers, we identified a postpartum population from all women who had a liveborn child from 2000-2022. We sampled a background population by matching five women for each delivery on age and date of childbirth. Depression and PPD were measured as incident depression diagnosis or redeemed antidepressant prescription within 180 days from childbirth/matching. We described incidence rates from 2000-2022 using Poisson regression with a restricted cubic spline. The study population included 1,133,947 postpartum women (669,101 unique), matched to 5,669,735 women (1,165,505 unique). Overall IR per 10,000 person-years of diagnoses was 34.3 (95% CI: 32.8–35.9) for PPD and 18.9 (95% CI: 18.3–19.4) for depression. Both IRs increased similarly over time in the main analyses, but more pronounced for PPD in primiparous and older mothers. Correspondingly, IR for prescriptions was 135.7 (95% CI: 132.7–138.8) for PPD and 209.8 (95% CI: 208.1–211.5) for depression, and both groups had fluctuating time trends. Depression measures were based on women who actively sought and received treatment, expectedly underestimating true disease incidence. Incidence rates of PPD and depression diagnoses increased over time, especially for PPD among primiparous and older mothers. These findings could suggest either increased vulnerability or increased awareness and detection over time in these groups. Fluctuating trends overserved from prescriptions could likely be driven by external factors and not a reflection of disease trends. • Incidence of postpartum depression diagnoses has increased over the past decades. • Time trends of postpartum depression and depression in women are overall similar. • Postpartum depression has increased particularly in primiparous and older mothers. • Using antidepressants as depression markers may not reflect disease time trends. [ABSTRACT FROM AUTHOR]

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Postpartum Depression (PPD) is a major health challenge with potentially devastating maternal and physical health outcomes. Development of diabetes mellitus has been hypothesized as one of the potential adverse effects of PPD among mothers in the postpartum period, but this association has not been adequately studied especially in low resource settings. This study aimed at determining prevalence of postpartum depression and its association with diabetes mellitus among mothers in Mbarara District, southwestern Uganda. We conducted a facility based cross-sectional study of 309 mothers between 6th week to 6th month after childbirth. Using proportionate stratified consecutive sampling, mothers were enrolled from postnatal clinics of two health facilities, Mbarara Regional Referral Hospital and Bwizibwera Health center IV. PPD was diagnosed using the Mini-International Neuropsychiatric Interview (MINI 7.0.2) for the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5). Diabetes mellitus was diagnosed by measuring Hemoglobin A1c (HbA1c). Logistic regression was used to determine the association of PPD and diabetes mellitus among mothers. The study established that PPD prevalence of PPD among mothers of 6th weeks to 6th months postpartum period in Mbarara was 40.5% (95% CI: 35.1–45.1%) and it was statistically significantly associated with diabetes mellitus in mothers between 6 weeks and 6 months postpartum. The prevalence of diabetes mellitus among mothers with PPD was 28% compared to 13.6% among mothers without PPD. Mothers with PPD had 3 times higher odds of being newly diagnosed with diabetes as compared to those without PPD (aOR = 3.0, 95% CI: 1.62–5.74, p = 0.001). Mothers with PPD between 6 weeks and 6 months postpartum are more likely to have diabetes mellitus as compared to those without PPD. Well-designed prospective analytical studies are needed to conclude on the risk of diabetes mellitus in relation to PPD. Early screening of PPD may be considered in postpartum mothers. [ABSTRACT FROM AUTHOR]

Background: Postpartum posttraumatic stress disorder (PP-PTSD) is a prevalent, yet often unrecognized mental health problem, particularly in low- and middle-income countries. Moreover, the long-term effects of PP-PTSD symptoms on maternal well-being and child socioemotional development beyond the first year postpartum remain largely unknown. This study focused on the association between PP-PTSD symptoms within one year after childbirth and maternal depressive symptoms and child behavioral problems two years later. Methods: Russian women (n = 419) completed the City Birth Trauma Scale and the Edinburgh Postnatal Depression Scale evaluating symptoms of PP-PTSD and postpartum depression (PPD) via a web-based survey. Mothers also filled in the Beck Depression Inventory that assessed their depressive symptoms and the Child Behavior Checklist that assessed child's behavioral problems 2.24 years later. Results: The regression analysis showed a significant association between PP-PTSD and elevated depressive symptoms 2 years later even after adjustment for PPD (β = 0.19, 95% Confidence Interval 0.11, 0.26, p < 0.01). Children of mothers with higher PP-PTSD symptoms had higher internalizing, externalizing, and total behavioral problems, independent of PPD and concurrent depressive symptoms (β > 0.12, p < 0.01 for all). Conclusions: Childbirth-related PTSD presents risk for maternal psychological well-being and child socioemotional development beyond comorbidity with maternal depression. Raising awareness about PP-PTSD among families, communities, healthcare providers, and policymakers is essential in order to decrease stigma of childbirth-related distress, particularly, in low- and middle-income countries like Russia, improve support system during the postpartum period, promote mother–infant bonding in affected women, and, thus, prevent long-term consequences of traumatic childbirth for maternal and child mental health outcomes. Clinical trial number: Not applicable. [ABSTRACT FROM AUTHOR]

Women are twice at risk of developing depression compared to men. This risk is even higher during pregnancy where many physiological, hormonal, social, and psychological changes occur. Prevalence studies show perinatal mental disorders are at least as prevalent in sub-Saharan Africa as they are in high-income and other low- and middle-income sub-regions. The mean weighted prevalence of both antenatal and postpartum depression are 11.3% and 18.3%, respectively, and the mean prevalence of both prenatal and postpartum anxiety is 14.8% and 14%, respectively in both high and low- and middle-income countries. Although maternal mental disorders, including antenatal depression, are widespread and have serious consequences, there remains a lack of understanding and inadequate care provided to pregnant women, by midwives who are their main healthcare providers. Therefore, this study aims to explore the midwives' knowledge of antenatal depression before and after a training session on antenatal depression. The study will follow a qualitative research methodology and will be conducted in a Community Healthcare Center, in South Africa. In-depth individual interviews will be conducted with the midwives who attend to pregnant women at the study site before and after a training session on antenatal depression. Elo and Knygas' content analysis will be used to analyse data. It is hoped that the results of the study may provide support for advocating the integration of mental health services into maternal care programmes. [ABSTRACT FROM AUTHOR]

Background: Stressful large-scale events, such as the COVID-19 pandemic and natural disasters, impact birthing individuals' postpartum experiences and their mental health. Resultant changes in government assistance, housing, and employment may further exacerbate these impacts, with differences experienced by varying income levels and races. This study aimed to examine maternal depression and anxiety in postpartum individuals by income and race during a stressful large-scale event, and the mediating role of government assistance, housing, and employment. Methods: An explanatory sequential mixed methods study was conducted (QUANT + QUAL). For aim 1 (quantitative), birthing individuals who delivered during peak pandemic (June 2020 - September 2021) completed questionnaires related to their perinatal experiences and mental health. Macrosystem factors (government assistance, housing, and employment changes) were assessed using the Psychosocial Recommended Measures. The Edinburgh Postnatal Depression Scale (EPDS) and the Generalized Anxiety Disorder-7 (GAD7) assessed depression and anxiety, respectively. Serial linear regression models assessed the relationship between race and income with mental health and macrosystem factors. For aim 2 (qualitative), 40 individuals from the quantitative study balanced by income (low vs. high income) and race (Black vs. White) completed one-on-one semi-structured interviews which were analyzed using thematic analysis. Results: Amongst 1582 birthing individuals, Black individuals had a significantly higher EPDS score compared to White counterparts. Not receiving government assistance, unstable housing, and experiencing various employment changes were all related to worse mental health during stressful large-scale events. In semi-structured interviews, low-income individuals discussed that government assistance helped alleviate a financial and mental burden. Low- and high-income individuals reported varying job changes that impacted their mental health (low-income: job loss, high-income: increased hours). Conclusions: This research spotlights the negative impact of large-scale events most affected both Black and low-income individuals' postpartum mental health, and the role of government assistance, stable housing, and secure employment in helping to alleviate these disparities between income levels. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]

BackgroundMethodsResultsConclusionsPostpartum depression is a major public health issue impacting women’s well-being and infant development. Dispositional mindfulness has been linked to lower severity of postpartum depressive symptoms (PDS), but the mechanisms behind this connection remain unclear. This study examines the serial mediation of psychological flexibility and maternal role satisfaction in the relationship between mindfulness facets and PDS.Participants were recruited using convenience sampling and completed an electronic questionnaire assessing sociodemographic background, dispositional mindfulness, psychological flexibility, maternal role satisfaction, and PDS. The study included mothers over 18, who had given birth within ten months and could complete a Hebrew questionnaire. The final sample consisted of 298 women aged 21 to 47 (M = 31.34, SD = 4.34) with babies up to 10 months old.Mediation analyses showed that the mindfulness facets -describing, acting with awareness, and the overall score of dispositional mindfulness – were indirectly linked to lower severity of PDS through psychological flexibility and maternal role satisfaction. A serial mediation occurred, where higher mindfulness increased psychological flexibility, leading to greater role satisfaction and lower PDS. Additionally, nonjudging of inner experiences was directly associated with lower PDS severity and partially mediated by psychological flexibility and role satisfaction.The findings contribute to our understanding of how dispositional mindfulness relates to postpartum mental health through emotional and cognitive pathways. In practice, encouraging mindfulness, particularly nonjudgment, alongside fostering psychological flexibility and maternal role satisfaction, may help alleviate PDS and promote the well-being of postpartum women. [ABSTRACT FROM AUTHOR]

This study was carried out to examine the spiritual well-being and depression levels of postpartum women following the two major earthquakes that occurred in 2023 with the epicenter Kahramanmaraş in Turkey. This cross-sectional analytical study was conducted with the participation of 345 postpartum women admitted to the maternity ward of a medical faculty hospital in the provincial center of Kahramanmaraş in Turkey between June and September 2023. Data were collected using the Spiritual Well-Being Scale (SWBS) and the Edinburgh Postnatal Depression Scale (EPDS). Independent-samples t-tests, Pearson’s correlation tests, and simple linear regression analysis were used in the analyses. It was determined that 48.7% of the participants were at risk of postpartum depression. The participants whose relatives were lost/injured in the earthquakes and those who experienced financial losses had significantly lower total SWBS scores and significantly higher total EPDS scores (p < 0.05). A negative and statistically significant relationship was found between the total SWBS and total EPDS scores of the participants (p < 0.001). In this study, it was determined that after the Kahramanmaraş earthquakes in 2023, almost one in every two postpartum women was at risk of depression, and their earthquake experience affected their mental health and spiritual well-being negatively. Moreover, as the spiritual well-being of the postpartum women increased, their risk of postpartum depression decreased. [ABSTRACT FROM AUTHOR]

Objective: Postpartum depression (PPD) is a major mental health issue affecting 10%–15% of women globally. This meta-analysis synthesized updated evidence on sub-anesthetic ketamine/esketamine's efficacy in preventing PPD. Methods: Randomized controlled trials (RCTs) comparing ketamine/esketamine to a placebo for PPD prevention were searched without language restriction. Primary outcomes were PPD risk at 1- and 4–6-week postpartum. Secondary outcomes included the difference in depression scores and risk of adverse events. Trial sequential analysis (TSA) was conducted to validate the reliability. Results: A meta-analysis of 22 RCTs (n = 3,463) showed that ketamine/esketamine significantly decreased PPD risk at 1- (risk ratio [RR], 0.41; 95% confidence interval [CI], 0.3–0.57) and 4–6-week (RR, 0.47; 95%CI, 0.35–0.63) follow-ups. Consistently, participants receiving ketamine/esketamine had lower depression-related scores at 1- (standardized mean difference [SMD], −0.94; 95%CI, −1.26 to −0.62) and 4–6-week (SMD, −0.89; 95%CI, −1.25 to −0.53) follow-ups. Despite potential publication bias, TSA confirmed the evidence's reliability. Subgroup analysis showed that ketamine/esketamine's preventive effect on 1-week PPD was consistent, regardless of administration timing, type of agents, or total dosage (<0.5 vs. ≥0.5 mg/kg). For the 4–6-week period, PPD risk was favorably reduced only with postoperative administration or the use of esketamine, with the total dosage having no observed influence. Participants on ketamine/esketamine experienced more frequency of hallucinations (RR, 4.77; 95%CI, 1.39–16.44) and dizziness (RR, 1.36; 95%CI, 1.02–1.81). Conclusion: Our findings advocate for the postoperative administration of low-dose ketamine/esketamine to avert PPD, which needed additional research for confirmation. [ABSTRACT FROM AUTHOR]

The incidence of postpartum depression (PPD) among Chinese women surpasses the global average, and this disparity is closely associated with the level of social support they receive. Using Sensitive Interaction Systems Theory and Family Communication Patterns Theory as guiding frameworks, we conducted a content analysis of 705 posts gathered from the hashtag #PPD (chanhou yiyu) on Zhihu, a popular Chinese social media platform. Our findings reveal that postpartum women primarily seek social support from their husbands and mothers-in-law through indirect nonverbal and direct verbal communication strategies. They tend to receive more problem-focused support than emotion-focused solace. Moreover, the use of direct verbal communication strategies promotes potential support providers' problem-solving behaviors, while the use of indirect nonverbal strategies elicits their avoidance behaviors. In addition, the conversation-oriented family communication pattern strengthens the positive association between direct verbal communication and support-providing behaviors, whereas the conformity-oriented family communication pattern weakens this relationship. This study contributes to the applicability of the abovementioned theories in the Chinese context and provides insights for future interventions aimed at addressing PPD among women. [ABSTRACT FROM AUTHOR]

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. 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. 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. 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. 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. • Extensive follow-up reveals PPD trends up to six months postpartum, emphasizing continuous monitoring necessity. • Machine learning utilized in a three-wave cohort study identifies PPD risk predictors. • Key predictors for PPD include newborn's birth weight and maternal pre-delivery weight, highlighting intervention targets. • PPD prevalence demostrates a slight decline over six months, maintaining a significant impact. [ABSTRACT FROM AUTHOR]

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

AbstractPurposeMaterials and methodsResultsConclusions\nIMPLICATIONS FOR REHABILITATIONRecent diagnostic advantages enable detection of cerebral palsy (CP) in infants before five months of age. Parents of children with CP often face mental health problems, but specific knowledge for infancy is needed. In this study, depressive symptoms in mothers of 16-week-old infants and associations with infant development were investigated.This cross-sectional study involves 56 families, 22 high-risk and 34 infants without risk of CP. High-risk-CP was identified following international clinical guidelines. We assessed infant cognitive and language development using the Bayley-III and motor development using the Alberta Infant Motor Scale. Maternal depressive symptoms were self-reported using the Edinburgh Postnatal Depression Scale.Mothers of CP high-risk infants were 15.6 times more likely to experience risk of postnatal depression compared to mothers of infants without risk. Additionally, linear regression analyses showed that having an infant at high-risk of CP (β = .359, p = .006) and delayed language development (β = −0.510, p < .001) were associated with increased maternal depressive symptoms.We recommend systematic screening of postnatal depressive symptoms following detection of high-risk-CP in infants. Early interventions could include a mother-infant interactional component to support caregivers in interpreting and responding to infant communicative cues.Clinicians should pay attention to the high risk of postnatal depression among parents of infants at high risk of cerebral palsy and offer treatment that supports parental well-being and parent sensitivity.Having an infant with delayed language development places parents at greater risk of depression.Early cerebral palsy-specific interventions should include a parent-infant interaction component to support parents in interpreting and responding to infant communicative signals.Clinicians should pay attention to the high risk of postnatal depression among parents of infants at high risk of cerebral palsy and offer treatment that supports parental well-being and parent sensitivity.Having an infant with delayed language development places parents at greater risk of depression.Early cerebral palsy-specific interventions should include a parent-infant interaction component to support parents in interpreting and responding to infant communicative signals. [ABSTRACT FROM AUTHOR]

Background/Objectives: This study explores the characteristics of the early mother–infant relationship in a sample of 30 mother–preterm infant dyads between 6 and 9 months, using a phenomenological observational tool called "Dance Steps". This tool examines the configuration and reciprocity of mother–infant interactions. The study also investigates how sociodemographic factors and maternal functioning variables, such as postnatal depression and perceived social support, may serve as risk or protective factors in the development of these interaction "Steps". Methods: Observations were conducted through video recordings of face-to-face caregiver–infant interactions during unstructured play sessions at neonatal follow-up visits. The data focused on identifying specific characteristics of reciprocity in the "dance steps". Results: The results reveal certain features of reciprocity are stable over time, demonstrating synchronicity and attunement in many of the "dance steps". Other "steps" evolve in response to the child's developing competence. Sociodemographic factors, particularly the mother's educational level and the infant's sex, significantly influence the "Dance". Postnatal depression negatively affected reciprocity in several steps, especially impacting the infant, whereas perceived social support had a lesser effect. Conclusions: The findings emphasize the importance of supporting mothers of preterm infants to adjust their interactions in ways that promote the child's developmental competence. This support is essential for fostering physical and emotional closeness during critical developmental transitions. [ABSTRACT FROM AUTHOR]

Purpose: To determine the psychological experiences of patients with postpartum depression by systematically reviewing, retrieving, and synthesizing data from qualitative studies. Methods: Nine databases were systematically searched for relevant publications, from database establishment to September 20, 2024. All qualitative studies in English and Chinese that explored the real-life experiences, feelings, etc., of individuals affected by postpartum depression after childbirth were included. The qualitative meta-synthesis was performed following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) recommendations. Two independent reviewers selected these studies and evaluated the quality of each study, conducting a meta-analysis to integrate the results. Results: A total of 28 studies revealed 12 sub-themes and 3 descriptive themes: negative physical and psychological experiences and coping strategies, role transition discomfort and impact, lack of relevant support. Conclusion: The prominence of negative physical and psychological experiences, the discomfort of role transformation, and the lack of relevant support in patients with postpartum depression. In future studies, more attention should be paid to maternal mental health, and full mental health screening during pregnancy and childbirth should be implemented. Psychological counseling services should also be provided to pregnant women. [REGISTRATION: PROSPERO ID: CRD42024504506]. [ABSTRACT FROM AUTHOR]

Background: Few studies have compared the influencing factors of postpartum depression between primiparous and multiparous women. Therefore, this study is aimed to investigate the prevalence and influencing factors of postpartum depression in primiparous and multiparous women, and provide reference suggestions for clinical nursing. Methods: A total of 429 postpartum women who gave birth at a Maternal and Child Health Hospital in Shandong Province, China, from April to June 2024, were recruited by convenience sampling. A Sociodemographic Questionnaire, Edinburgh Postpartum Depression Scale, Pittsburgh Sleep Quality Index, and Perceived Social Support Scale were used for investigation. SPSS 26.0 was used to analyze the data, and multivariate regression was employed to analyze the influencing factors of postpartum depression between primiparous and multiparous women. Results: The total prevalence of postpartum depression among 429 postpartum women (191 primiparas and 238 multiparas) was 22.14%. The prevalence of postpartum depression among primiparous and multiparous women were 21.99% and 22.27%, respectively, with no statistically significant difference [OR=1.016, 95% CI (0.642, 1.608)]. Sleep quality is a common protective factor for postpartum depression in both primiparous and multiparous women, while perceived social support is another protective factor for multiparous women. The risk factors are different in both two group, there is no risk factor found in primiparous women, the newborns health and women's expectation on newborns gender are risk factors for postpartum depression in multiparous women. Conclusions: Both primiparous and multiparous women have a high risk of postpartum depression. In order to promote the mental health of postpartum women, precise nursing measures should be adopted for different parity of postpartum women in clinical practice. [ABSTRACT FROM AUTHOR]

BackgroundMethodsResultsConclusionParents cuddling their babies during intensive care to promote parent-infant bonding is usual practice in the neonatal intensive care unit (NICU). However, babies undergoing cooling therapy and intensive care are not routinely offered parent-infant cuddles due to concerns of impacting the cooling process or intensive care. We developed the CoolCuddle intervention to enable parents to cuddle babies safely during cooling therapy. We investigated whether CoolCuddle impacted parent-infant bonding and parent’s mental health.We conducted parental interviews and compared mental health and bonding measures in two cohorts of parents; one with access to CoolCuddle and the other where CoolCuddle was not available.Ten tertiary NICUs in England and Wales from 2019 to 2023 were involved and 107 families. There were high levels of post-delivery depression amongst all parents. However, at discharge mothers in the CoolCuddle group had significantly less depression, lower EPDS scores, and higher MIBS scores (consistent with better mother-infant bonding) than those where CoolCuddle was not available. All measures appeared similar when re-measured at 8 weeks. Parents reported they were not ready to access psychological support or information whilst on NICU and stressed the need of mental health support following discharge, which was not offered or available.The CoolCuddle intervention was associated with a lower prevalence of depression and enhanced bonding scores for mothers at discharge compared to those who did not cuddle their babies. Parents highlighted increased levels of postnatal depression following the sudden and traumatic admission of their infant to NICU after birth asphyxia. [ABSTRACT FROM AUTHOR]

Extensive research has been conducted on postpartum depression (PPD) over the past century, and yet no definitive answer regarding its etiopathogenesis, risk factors, genetic predilection, and treatment has been found. The few preclinical and clinical studies propose that maternal brain adaptations to the endocrinological, immunological, and behavioral changes and external sociodemographic risk factors in the perinatal period make women more vulnerable to anxiety and depression. Irrespective of the cause, a dilemma exists regarding the type of help to provide postpartum mothers. With very few treatment options at our disposal, deciding between psychotherapy, pharmacological, and non‐pharmacological therapy on a case‐by‐case basis is unproductive because in developing countries infrastructure is limited and the availability of medications, especially for psychiatric illnesses, is still evolving. Hence, regardless of psychotherapy, antidepressants remain the first line of treatment with selective serotonin reuptake inhibitors (SSRIs); sertraline has the best efficacy and safety profile in breastfeeding women. As endocrine factors play a significant role in etiopathogenesis, hormonal therapy with oxytocin has been shown to be efficacious, and studies investigating the role of testosterone in treating PPD are also under way. In 2019, the US Food and Drug Administration (FDA) approved the first and only drug for the sole purpose of treating PPD, brexanolone. Zuranolone, a drug recently approved by the FDA, has a similar mechanism of action to brexanolone. For breastfeeding mothers reluctant to use pharmacotherapy, somatic therapy has been studied, including bright light therapy, vagal nerve stimulation, and newer noninvasive interventions. This article encompasses a short note on PPD, including its etiopathogenesis and clinical characteristics, and recapitulates the various available and evolving pharmacological and nonpharmacological therapies. [ABSTRACT FROM AUTHOR]

Depression during the perinatal period is associated with negative outcomes for both mothers and children, including higher rates of chronic depression in mothers and physical, emotional, and cognitive issues in children. This study aimed to determine how the stressors of the COVID-19 pandemic contributed to prenatal and postpartum depressive symptoms among a sample of peripartum mothers who gave birth during the pandemic. This study also examined risk factors for postpartum depression, including prenatal depressive symptoms, demographic characteristics, timing of birth during the pandemic, pregnancy intention, birth expectations and experiences, and pandemic-related concerns. This mixed methods study included data from online surveys using a convenience sample of 284 expectant mothers with due dates from April 2020 to September 2021, and qualitative interviews with a subset of participants. Depressive symptoms and risk for clinical depression were assessed using the Edinburgh Postnatal Depression Scale during the third trimester of pregnancy and again within 8 weeks postpartum. Multiple regression models examined potential risk factors to determine which variables most predicted participants' postpartum depressive symptoms and risk of clinical depression. Among this nonrepresentative, mostly white, and highly resourced sample, one-third of participants (33.8%) met the criteria for risk of clinical depression during the prenatal period, and 32.7% met this threshold in the postpartum period. Participants who reported higher levels of prenatal depressive symptoms, gave birth earlier in the pandemic, reported lower income, or had more pandemic-related concerns tended to report more postpartum depressive symptoms, adjusting for demographic characteristics and other variables of interest. Peripartum mothers who reported symptoms consistent with risk of clinical depression prenatally were almost four times more likely to screen positive for depression in the postpartum period, even after adjusting for other variables. In interviews, participants attributed negative emotions in pregnancy to uncertainty related to pandemic-related changes in care and expressed grief about missed pregnancy and postpartum experiences. In the postpartum period, some participants reported that their births were ultimately less stressful than anticipated. Findings highlight the need for consistent and frequent depression screenings across the perinatal period, especially among participants who report depressive symptoms prenatally. Participants who gave birth early in the pandemic were at the highest risk of postpartum depression and may continue to need additional supports. [ABSTRACT FROM AUTHOR]

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. 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. 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. 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. [ABSTRACT FROM AUTHOR]

Background: Screening for perinatal depression can lower its prevalence and ensure that mothers receive adequate treatment and support. Yet, few practitioners screen for it. The present article is a brief review of barriers to screening, and two screening scales are validated for perinatal women. Findings: Even though health organizations recommend screening, most new mothers are not screened. Providers cite a lack of time, opening "Pandora's box," and a lack of resources for mothers who screen positive as the reasons why they do not screen for this condition. The Edinburgh Postnatal Depression Scale and the Patient Health Questionnaires are brief screening scales validated for new mothers and widely available. Conclusions: Screening is necessary to identify depression in pregnant and postpartum women. Practitioners who screen for this condition need a clear plan and knowledge of how to access available community resources so that they know what to do when a mother screens positive. [ABSTRACT FROM AUTHOR]

Background: The risk of depression during pregnancy and postpartum is high and has intensified during the COVID-19 pandemic. The aim of this study was to estimate the risk of depressive disorders and self-harm thoughts in the third trimester of pregnancy and the first week postpartum in the pandemic period. Methods: This study involved a total of 317 pregnant and postpartum women. The risk and severity of depressive disorders and the prevalence of self-harm thoughts in women during the perinatal period were assessed using EPDS. Results: Pregnant women were significantly more likely to have higher EPDS scores compared to postpartum women. Mild depressive symptoms were reported by 22.08% of pregnant women and 17.18% of postpartum women, and severe symptoms were observed in 25.97% of pregnant women and 16.56% of postpartum women. Thoughts of self-harm were reported by 11.69% of pregnant women and 17.79% of postpartum women. Self-harm thoughts were significantly more common among pregnant women: multiparous women, pregnant women who received psychiatric treatment before pregnancy, those diagnosed with depressive disorders, those who suffered from prolonged periods of anxiety and sadness, and those lacking a supportive person. Among postpartum women, there were statistically significant differences in the prevalence of self-harm thoughts for place of residence, education, type of occupation, number of pregnancies, course of pregnancy, and presence of a supportive person. Conclusions: The increased prevalence of depressive symptoms and self-harm thoughts related to the COVID-19 pandemic highlights the urgent need for screening among pregnant women and the implementation of clinical interventions. [ABSTRACT FROM AUTHOR]

Background: Although risk factors associated with maternal postpartum depression (PPD) have been recognized, it is still unknown how some newborn characteristics could influence the appearance of PPD. Aim: Our research aimed to unravel the impact of a newborn's features on women with PPD. Methods: The study was conducted in the Obstetrics and Gynecology Department at our University Emergency County Hospital, between August 2019 and April 2021. We included 904 women from the second day of the postpartum period, divided into two groups: women with PPD (n = 236) and control (i.e., women without PPD, n = 668), by using the Edinburg Postpartum Depression Scale. Characteristic information on the newborns (i.e., the months in which they were born, premature delivery, birth weight, or sex) was evaluated. Results: Our results suggest that the winter season (i.e., December and January months, p = 0.01) births and male newborns (p = 0.02) were strongly related with the appearance of depressive symptoms during the postpartum period. Conclusions: Therefore, our study sustains that women who give birth to male newborns in the winter season are more prone to developing PPD. This should be analyzed by all public health care systems in order to prevent such a condition earlier in certain groups of women. [ABSTRACT FROM AUTHOR]

The aim of this study is to determine the association of the risk of postpartum sexual dysfunction (SD) with posttraumatic stress disorder (PTSD) and depression symptoms. This cross-sectional study was conducted by collecting data from eight different family health centers (n = 147). Data were collected with 'Descriptive Information Form', 'City Birth Trauma Scale (CityBiTS)', 'Edinburg Postpartum Depression Scale (EPDS)' and 'Female Sexual Function Index (FSFI)'. Data were evaluated with Chi-square test, Fisher's exact test, Student's t-test, Spearman's correlation and logistic regression analysis. The risk of SD in women between 6 and 12 months postpartum was 53.1%, and the risk of depression was 19%. Based on self-report data, 16.3% of women met all Diagnostic and Statistical Manual of Mental Disorders (DSM-5) criteria for PTSD in relation to birth-specific events. There was a negative correlation between the FSFI and the CityBiTS (r=-0.208) and EPDS total scores (r=-0.335). It was found that CityBiTS scores were not a significant factor affecting the risk of SD (p > 0.05), but an increase in EDPS scores increased the likelihood of SD (OR:1.22, p < 0.05). Half of the women are at risk of SD in the first postpartum year. As postpartum depression and PTSD symptoms increase, sexual function decreases. [ABSTRACT FROM AUTHOR]

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. Significance: What is already known on this subject?: Postpartum depression can have long-term consequences for maternal and child health. Longer maternity leave duration and paid maternity leave have been linked with better maternal mental health, though more recent studies in the U.S. context are needed. What this study adds?: This study is one of the few investigations of postpartum mental health to examine leave duration and paid leave individually and in combination. We found that mothers with unpaid leave were 40% more likely to experience depression than those with paid leave and that payment status was more important than leave duration. [ABSTRACT FROM AUTHOR]

Background: Perinatal mood and anxiety disorders and social isolation are prevalent and associated with adverse maternal and child health outcomes. We conducted a systematic review to assess the evidence for nature-based interventions (NBIs) to address depression, anxiety, and loneliness among pregnant and postpartum women. Methods: Studies were identified through MEDLINE, Embase, CINAHL, APA PsycINFO, ClinicalTrials.org, Web of Science, and Cochrane Reviews in February 2023. Included studies were original, peer-reviewed studies published in or translated into English that evaluated an intervention which engaged pregnant or postpartum women directly with nature and used a quantitative outcome measure for anxiety, depression, or loneliness. Results: Three studies, including 68 pregnant or postpartum women and their family or friends, met our inclusion criteria. Results were synthesized narratively in text and tables. All studies had early-stage designs and relatively small sample sizes. A variety of intervention content and delivery platforms were utilized. Studies were not adequately powered to test or detect statistically significant changes in depression, anxiety, or loneliness. Measurement of nature engagement varied. Using the Downs and Black checklist, we found study quality varied from good to poor. Discussion: More research is needed to understand the potential benefits of NBIs for perinatal mental health and social wellbeing. Additional study rigor is needed, including the consistent use of validated and well-rationalized measures of nature engagement. Intervention design should consider the varying needs perinatal populations, including barriers to and facilitators of engagement for diverse communities. Significance: What is Already Known on this Subject?: Nature exposure has been shown to have protective effects on mental health among adults and perinatal populations. Nature-based interventions (NBIs) aim to improve physical, mental, and social wellbeing through structured engagement in nature-based experiences that facilitate behavior change and social cohesion. There is substantial evidence that demonstrates the mental and social benefits of NBI among general adult populations. What this Study adds: We found research on NBIs that address depression, anxiety, and loneliness among pregnant and postpartum populations to be very limited. Given the need for innovative and complementary strategies to address poor mental health and social isolation among perinatal populations, there is opportunity for further rigorous research to determine if and how NBI can benefit pregnant and postpartum individuals. [ABSTRACT FROM AUTHOR]

Aim: Genome‐wide association studies (GWAS) of postpartum depression (PPD) based on accumulated cohorts with multiple ethnic backgrounds have failed to identify significantly associated loci. Herein, we conducted a GWAS of Japanese perinatal women along with detailed confounding information to uncover PPD‐associated loci. Methods: The first and second cohorts (n = 9260 and n = 8582 perinatal women enrolled in the Tohoku Medical Megabank Project) and the third cohort (n = 997), recruited at Nagoya University, underwent genotyping. Of them, 1421, 1264, and 225 were classified as PPD based on the Edinburgh Postnatal Depression Scale 1 month after delivery. The most influential confounding factors of genetic liability to PPD were selected, and logistic regression analyses were performed to evaluate genetic associations with PPD after adjusting for confounders. Results: A meta‐analysis of GWAS results from the three cohorts identified significant associations between PPD and the following loci (P < 5 × 10−8) by integrating the number of deliveries and the number of family members living together as the most influential confounders: rs377546683 at DAB1, rs11940752 near UGT8, rs141172317, rs117928019, rs76631412, rs118131805 at DOCK2, rs188907279 near ZNF572, rs504378, rs690150, rs491868, rs689917, rs474978, rs690118, rs690253 near DIRAS2, rs1435984417 at ZNF618, rs57705782 near PTPRM, and rs185293917 near PDGFB. Pathway analyses indicated that SNPs suggestively associated with PPD were mostly over‐represented in categories including long‐term depression, GnRH signaling, glutamatergic synapse, oxytocin signaling, and Rap1 signaling. Conclusion: The current GWAS study identified eight loci significantly associated with PPD, which may clarify the genetic structure underlying its pathogenesis. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]

Postpartum depression is a prevalent condition, and preliminary data suggest that the COVID-19 pandemic further increased its incidence. Building on scholarship that has shown the value of exploring patients' narratives for diagnosis and treatment, this study examines narratives of recovery in an online support forum, using theories of narrative identity. An online forum with 64 participants suffering from postpartum depression was analyzed according to grounded theory. A thematic analysis uncovered two dominant narratives: the full recovery or inevitable progress narrative, and the cyclical recovery or struggle as norm narrative. This study illustrates the complicated interaction between medical institutions, recovery narratives, and identity. [ABSTRACT FROM AUTHOR]

Background: Here, we (a) examined the trajectories of night‐time sleep duration, bedtime and midpoint of night‐time sleep (MPS) from infancy to adolescence, and (b) explored perinatal risk factors for persistent poor sleep health. Methods: This study used data from 12,962 participants in the Avon Longitudinal Study of Parents and Children (ALSPAC). Parent or self‐reported night‐time sleep duration, bedtime and wake‐up time were collected from questionnaires at 6, 18 and 30 months, and at 3.5, 4–5, 5–6, 6–7, 9, 11 and 15–16 years. Child's sex, birth weight, gestational age, health and temperament, together with mother's family adversity index (FAI), age at birth, prenatal socioeconomic status and postnatal anxiety and depression, were included as risk factors for persistent poor sleep health. Latent class growth analyses were applied first to detect trajectories of night‐time sleep duration, bedtime and MPS, and we then applied logistic regressions for the longitudinal associations between risk factors and persistent poor sleep health domains. Results: We obtained four trajectories for each of the three sleep domains. In particular, we identified a trajectory characterized by persistent shorter sleep, a trajectory of persistent later bedtime and a trajectory of persistent later MPS. Two risk factors were associated with the three poor sleep health domains: higher FAI with increased risk of persistent shorter sleep (OR = 1.20, 95% CI = 1.11–1.30, p <.001), persistent later bedtime (OR = 1.28, 95% CI = 1.19–1.39, p <.001) and persistent later MPS (OR = 1.30, 95% CI = 1.22–1.38, p <.001); and higher maternal socioeconomic status with reduced risk of persistent shorter sleep (OR = 0.99, 95% CI = 0.98–1.00, p =.048), persistent later bedtime (OR = 0.98, 95% CI = 0.97–0.99, p <.001) and persistent later MPS (OR = 0.99, 95% CI = 0.98–0.99, p <.001). Conclusions: We detected trajectories of persistent poor sleep health (i.e. shorter sleep duration, later bedtime and later MPS) from infancy to adolescence, and specific perinatal risk factors linked to persistent poor sleep health domains. [ABSTRACT FROM AUTHOR]

The prevalence of postpartum depression (PPD) exceeds 20% in China. In this article, we unpack the coping strategies and involuntary responses to PPD among Chinese women and how such patterns are shaped by family communication dynamics and reflect distinct social, structural, and cultural contexts. Drawing upon the communication accommodation theory and the generic stress and coping model, we analyzed 661 posts collected under the hashtag #PPD (chanhou yiyuzheng) on Zhihu using the phronetic iterative approach. The analysis reveals that women self-identifying as having PPD often find themselves situated within a family environment marked by non-adaptive communication, culminating in insufficient support from their social circles. Furthermore, a significant number of these women lack effective coping mechanisms to manage PPD. Instead, they tend to stifle their expressions and needs through automatic responses, dedicating themselves to constant self-monitoring without practicing self-care. Our findings contribute to informed policymaking for postpartum support, addressing nuanced challenges encountered by new mothers in China. [ABSTRACT FROM AUTHOR]