To determine the effect of postpartum care models on the occurrence of postpartum depression.

A prospective case-control study was conducted using EPDS among 419 women who underwent 42-day postpartum checkups between August 2023 and August 2024. The subjects were divided into two groups based on whether they had PPD. The influence of postpartum care models (the modes of receiving care from discharge to 42 days after delivery) on the occurrence of PPD was analyzed, and the independent influence factors on the occurrence of PPD were clarified.

Among the enrolled parturients, 84 had PPD, 11 of whom breastfed, 31 artificially fed, and 42 mixed fed their infants. There were 59 cases of prenatal depression and 25 cases of non-prenatal depression. 31 subjects were satisfied with the gender of the baby, and 53 were not satisfied. PPD occurred in 9 subjects who asked for maternity care at home, 12 who received care in the maternity center, and 63 who were under the care of family members at home. Analysis of the relationship between the occurrence of PPD and various parameters showed that BMI (X2 = 6.111 p = 0.047), feeding methods (X2 = 32.332 p = 0.000), prenatal depression (X2 = 62.988 p = 0.000), satisfied with the gender of the baby (X2 = 39.212 p = 0.000), and puerperal care model (X2 = 11.750 p = 0.003) were significantly correlated with the occurrence of PPD. Furthermore, multivariate logistic regression revealed that mixed feeding (OR 2.922(1.898-4.497) p = 0.000), prenatal depression (OR 0.147(0.079-0.273) p = 0.000), dissatisfaction with the gender of the baby (OR 0.156(0.082-0.297) p = 0.000), and received home care from relatives (OR 2.119(1.371-3.275) p = 0.001) were independent risk factors for the occurrence of PPD. BMI (OR 0.655(0.420-1.021) p = 0.062) was not an independent risk factor.

Parturient received home care with nanny or go to maternity center may reduce the occurrence of PPD. In addition, we recommend strengthened counseling for parturients with prenatal depression, those who use mixed feeding of their infants, and those who were dissatisfied with the gender of the baby in an effort to reduce the occurrence of PPD.

Postpartum psychiatric disorders (PPDs) have been deemed as a significant public health concern, affecting both maternal health and family dynamics. This study aimed to examine the current status of PPDs, identify the potential risk factors of PPDs, and further develop a clinical nomogram model for predicting PPDs in Chinese women.

In this retrospective cohort study, 1418 postpartum women attending the routine postpartum examination at the 42nd day after delivery in Jiangsu Women and Children Health Hospital were recruited as participants from December 2020 to December 2022. The Symptom Checklist-90 (SCL-90) was utilized to assess the status of postpartum psychiatric disorders. A prediction model was constructed by multivariate logistic regression and presented as a nomogram. The performance of nomogram was measured by the receiver operating characteristic (ROC) curve, calibration curve, and decision curve analysis (DCA). The relationships between predictive factors of PPDs and SCL-90 were also evaluated using Pearson correlation analysis. The relationships between predictive factors of PPDs and SCL-90 were evaluated using Pearson correlation analysis.

With the SCL-90 cutoff value of 160, the incidence of postpartum psychiatric disorders was 9.17% among Chinese urban women. The univariate and multivariate logistic regression analyses indicated that age ≤ 25 years old (OR = 10.07, 95%CI = 1.83-55.33), prenatal mood disorder (OR = 4.12, 95%CI = 1.99-8.53), invasive prenatal diagnostic procedures (OR = 4.39, 95%CI = 1.16-16.56), poor relationship with husband (OR = 2.86, 95%CI = 1.58-5.16) and poor relationship with mother-in-law (OR = 5.10, 95%CI = 2.70-9.64) were significantly associated with PPDs. A nomogram prediction model for PPDs was further constructed based on these five independent risk factors, and the area under the receiver operating characteristic curve (AUC) of the nomogram model was 0.823 (95% CI = 0.781-0.865). The calibration curves showed remarkable accuracy of the nomogram and the DCA exhibited high clinical net benefit of the nomogram. Besides, we also explored the relationships between the five risk factors and different symptom dimensions of PPDs and found that the five risk factors were almost associated with increased levels of all symptom dimensions.

Five psychosocial risk factors for PPDs were identified in Chinese women and the nomogram prediction model constructed based on these five risk factors could predict the risk of PPDs intuitively and individually. Systematic screening these risk factors and further conducting psychosocial interventions earlier during the pregnancy period are crucial to prevent PPDs. For future research, we intend to incorporate additional risk factors, including blood biomarkers and facial expression indicators, to refine our risk model.

Genetic variations in oestrogen receptor (ER) genes are associated with inter-individual differences in the sensitivity of ER-α, ER-β and G protein-coupled oestrogen receptor (GPER). These sensitivity differences may modulate susceptibility to mood changes during phases of endogenous oestrogen fluctuations, thereby explaining individual vulnerability. This study examined the association between ER gene variations, oestradiol and perinatal mood disturbances.

A total of 159 women were observed during the perinatal period, providing saliva samples for oestradiol assessment and completing self-report measures of depressive and anxiety symptoms at five time points. Polymorphisms in ER genes were determined from dried blood spots. The associations were analysed using linear mixed models.

The ER-α gene haplotypes were associated with perinatal mood disturbances. The CG haplotype was associated with perinatal depressive (p = 0.0162, F-test) and anxiety symptoms (p = 2.396e-05, F-test), whereas the TA haplotype was associated with perinatal anxiety symptoms (p = 0.004, F-test). The interaction between ER gene variations, oestradiol and perinatal mood disturbances was not significant.

ER-α gene variations are associated with an increased susceptibility to perinatal mood disturbances. Sensitivity differences in ER-α appear to play a more important role for emotional processes than those in ER-β and GPER, independently of oestradiol levels. This might be explained by ER-α's more dominant expression in the hypothalamus and amygdala.

Postpartum depression (PPD) is a common and serious mental health problem that affects many new mothers and their families worldwide. In recent years, there has been an increasing number of studies using magnetic resonance techniques (MRI), particularly functional MRI (fMRI), to explore the neuroimaging biomarker of this disease.

PubMed database was used to search for English literature focusing on resting-state fMRI and PPD published up to June 2024.

After screening, 17 studies were finally identified, among which all 17 studies reported abnormal regions or connectivity compared to health controls (HC), 4 studies reported results considering the differences between PPD and PPD with anxiety (PPD-A), and 2 studies reported biomarkers for the treatment of PPD. The existing studies indicate that PPD is characterized by functional impairments in multiple brain regions, especially the medial prefrontal cortex (MPFC), precentral gyrus and cerebellum. Abnormal functional connectivity has been widely reported in the dorsomedial prefrontal cortex (dmPFC), anterior cingulate cortex (ACC) and the orbitofrontal cortex (OFC). However, none of the four comorbidity studies identified overlapping discriminative biomarkers between PPD and PPD-A. Additionally, the two treatment-related studies consistently reported functional improvements in the amygdala after effective treatment.

The affected brain regions were highly overlapped with major depressive disorder (MDD), suggesting that PPD may be categorized as a potential subtype of MDD. Considering the negative effects of medication on PPD, future efforts should focus on developing non-pharmacological therapies, such as transcranial magnetic stimulation (TMS) and acupuncture, to support women with PPD in overcoming this unique and important phase.

Depression is a prevalent and debilitating condition that has a severe negative impact on a person's life. Chronic stress exposure plays a substantial role in the development of depression. In the present study, rats were exposed to chronic unpredictable mild stress (CUMS) for four weeks. Empagliflozin (EMPA), a Sodium-Glucose Cotransporter-2 (SGLT-2) inhibitor, is an oral antidiabetic agent exhibiting antioxidant, anti-inflammatory, and antiapoptotic effects. This study aimed to examine the antidepressant effect of EMPA in an experimental animal model of depression induced by CUMS in rats and explore the probable underlying mechanisms. Rats were treated with EMPA, per-orally, at a dose of 10 mg/kg/day for four weeks. EMPA treatment counteracted CUMS-induced histopathological, biochemical and behavioral alterations. EMPA suppressed the CUMS-induced increase in the oxidative stress, inflammatory, and apoptotic markers, where levels of MDA, IL-1β, TNF-α, NF-κB, NLRP3 and active caspase 3 were reduced by 29.6 %, 24.8 %, 17.9 %, 36.6 %, 24.5 % and 41.5 %, respectively, compared to the disease group. Furthermore, EMPA decreased the level of the microglial activation marker, iba-1 by 24 % in comparison to the disease group. In addition, EMPA treatment decreased blood glucose levels by 39 %, decreased serum insulin levels by 60.6 %, decreased HOMA-IR by 76.5 % and increased GLUT 4 expression, compared to the CUMS group, all which proves that EMPA has an effect insulin signaling and alleviates insulin resistance. Our results conclude that modulating key factors involved in depression, such as inflammation, oxidative stress, and NLRP3 inflammasome pathway, accounts for the anti-depressant effect of EMPA.

The red blood cell distribution width-to-albumin ratio (RAR) serves as an indicator of systemic inflammation and nutritional status. This study examines the relationship between RAR and depressive disorder in U.S. adults, utilizing data from the National Health and Nutrition Examination Survey (NHANES).

We applied logistic regression to evaluate the link between RAR and depressive risk, with its corresponding odds ratios (OR) and 95 % confidence intervals (CI) calculated. Restricted cubic spline (RCS) was adopted to assess the potential linear association, while the receiver operating characteristic (ROC) curve was used to evaluate the ability of RAR to predict the depressive risk, with the result presented as an area under the curve (AUC).

After adjusting for relevant covariates, a positive association between RAR and clinically relevant depression persisted (OR = 1.33, 95 % CI: 1.18-1.51, P < 0.001). Participants in the highest RAR quartile exhibited a greater risk of clinically relevant depression than those in the lowest quartile (OR = 1.36, 95 % CI: 1.10-1.67, P = 0.005). A linear relationship between RAR and clinically relevant depression was identified (P for non-linear = 0.473), with RAR showing a strong predictive ability for depressive risk (AUC = 0.7467). Stratified analysis showed significant interactions among smoking (P = 0.045), marital status (P < 0.001), and RAR's effect on depression outcome.

Elevated RAR is independently linked to clinically relevant depression, indicating its potential as a novel biomarker for mental health risk assessment. Further longitudinal studies are necessary to establish causality and evaluate its clinical relevance.

Weight stigma is linked to adverse effects, but whether it directly heightens the risk of disordered eating behaviors or psychological factors mediate this connection among postpartum women is uncertain.

To investigate the relationship between perceived weight stigma and disordered eating behaviors (restrained eating, emotional eating, and external eating) and identify the mediating role of weight bias internalization and postpartum depression (PPD).

This cross-sectional study involved 507 postpartum women. Data were collected anonymously using self-reported questionnaires, including the Perceived Weight Stigma Questionnaire, Weight Bias Internalization Scale, Edinburgh Postpartum Depression Scale, and Dutch Eating Behavior Questionnaire. Data were analyzed using descriptive statistics, Pearson's correlation analysis, hierarchical linear regression, and mediation analysis.

The results showed that the relationship between perceived weight stigma and disordered eating behaviors was fully mediated by weight bias internalization and PPD. Specifically, perceived weight stigma was associated with greater weight bias internalization, which was associated with greater PPD, and greater PPD was associated with greater disordered eating behaviors.

This may be the first study to propose a chain mediation model exploring the roles of weight bias internalization and PPD in the relationship between perceived weight stigma and disordered eating behaviors among postpartum women. The findings enhance the understanding of the psychological impacts of perinatal weight stigma and underscore the importance of addressing weight stigma in postpartum care. Comprehensive interventions should be developed to enhance postpartum health and reduce the risk of disordered eating behaviors.

Investigating the bioactivities of zuranolone derivatives as Type-A γ-aminobutyric acid inhibitors which will thereby down-regulate postpartum depression is considered a crucial study.

This study is aimed at investigating the biochemical activities of 1-(2-((3R,5R,8R,9R,10S,13S,14S,17S)-3‑hydroxy-3,13-dimethylhexadecahydro-1H-cyclopenta[a]phenanthren-17-yl)-2-oxoethyl)-1H-pyrazole-4-carbonitrile derivatives against type-A γ-aminobutyric acid (GABA A) which will thereby enhance the activity of γ-aminobutyric acid (GABA) in human central nervous system.

In this work, series of computational tools such as Spartan 14, molecular operating environment software, Gromacs and Admetsar1 were explored and the studied compounds were subjected to this software which resulted to series of results. Vacuum was observed to have highest influence on highest occupied molecular orbital (EH) of compound 1 and water as well as ethanol reduces its ability to donate electron to the nearby molecules. Also, the effect of water and ethanol were investigated on the studied compound via lowest unoccupied molecular orbital (EL) and energy gap and the results were reported appropriately. The molecular docking investigation was carried out on the studied compounds and Type-A γ-aminobutyric acid (pdb id: 4cof) and the compounds 3 with calculated binding affinity value of -7.32433319kcal/mol as well as pi-H as the non-bonding interaction were observed which therefore confirm the potential ability of compound to inhibit the target than other studied compound. Also, compound 1 and reference compound were subjected to molecular dynamic simulation study and the actual binding energy for the selected compounds were obtained and reported.

Our findings from this work may open door for the design of several 1-(2-((3R,5R,8R,9R,10S,13S,14S,17S)-3-(benzyloxy)-3,13-dimethylhexadecahydro-1H-cyclopenta[a]phenanthren-17-yl)-2-oxoethyl)-1H-pyrazole-4-carbonitrile derivatives as potential Type-A γ-aminobutyric acid inhibitors.

This study examines the risk of Attention-Deficit/Hyperactivity Disorder (ADHD) in offspring of mothers with perinatal depressive disorders, considering direct and indirect pathways through adverse birth outcomes.

The study employed a retrospective cohort design, utilising administrative-linked health data from New South Wales. Maternal perinatal depressive disorders and offspring ADHD were identified using the International Classification of Diseases, Tenth Revision, Australian Modification (ICD-10-AM .) codes. A generalised linear model with a binomial distribution and log link function was used to estimate the direct association. Additionally, a mediation analysis was conducted to examine the mediating effects of low birth weight, low Apgar scores, and preterm birth on the association between maternal antenatal depressive disorder and offspring ADHD.

After adjusting for confounders, offspring of mothers with antenatal, postnatal, and perinatal depressive disorders had 2.10 (95 % CI: 1.46-3.03), 1.80 (95 % CI: 1.11-2.92), and 2.16 (95 % CI: 1.57-2.97) times greater risk of ADHD, respectively. Preterm birth minimally mediated the relationship between antenatal depression and ADHD, accounting for only 0.73 % of the total effect, which was about 45 times smaller than the direct effect. Low birth weight and low Apgar scores did not mediate this relationship.

Our study revealed that maternal perinatal depressive disorders are associated with an increased risk of offspring ADHD, with very minimal or no mediating effects from adverse birth outcomes. Therefore, implementing early intervention strategies aimed at improving maternal mental health is crucial to reducing the risk of ADHD in children.

Aims: To examine the association between depressive symptoms and metabolic profile in women with prior gestational diabetes mellitus (GDM) and early postpartum prediabetes, and to explore whether a mobile-based lifestyle intervention affected mental health outcomes. Methods: Secondary, exploratory analysis of a multi-centric randomized controlled trial (MELINDA), evaluating a mobile-based lifestyle intervention versus standard follow-up (control group) in women with prediabetes after GDM. The analysis included 166 participants who completed the Center for Epidemiologic Studies-Depression (CES-D) questionnaire [score of ≥16 being suggestive for (sub)clinical depression] at baseline (6-16 weeks postpartum) and one year post-randomization. Results: At one year, 26.5% of women (n = 44) reported depressive symptoms, with no significant difference between the intervention and control groups (30.5% vs. 22.6%, p = 0.293). Women with depressive symptoms (symptomatic women) were younger (30.9 ± 4.9 vs. 32.5 ± 3.8 years, p = 0.033) and were less often highly educated (61.4% vs. 80.3%, p = 0.028). At baseline, symptomatic women had a higher rate of metabolic syndrome (38.6% vs. 21.9%, p = 0.044), higher LDL-cholesterol [3.2 ± 0.8 vs. 2.8 ± 0.8 mmol/L, p = 0.009], lower quality of life (lower SF-36 scores, p < 0.050) and a higher level of anxiety based on the STAI-6 questionnaire (14.5 ± 3.6 vs. 11.2 ± 2.6, p < 0.001). These differences persisted at one year postpartum with worse metabolic profile, more anxiety and lower quality of life in symptomatic women. Conclusions: Depressive symptoms are common in women with prediabetes in early postpartum after GDM and are associated with a persistent worse metabolic profile, increased anxiety and lower quality of life postpartum. The mobile-based lifestyle intervention did not improve mental health.

Exclusive (EBF) and continued breastfeeding (CBF) as defined by the World Health Organization are the optimal feeding practices. Perinatal Mental Health Conditions (PMHCs) such as anxiety and depression may influence breastfeeding practices. We aimed to examine if maternal postpartum anxiety and depression symptoms, individually and combined (comorbid), influence EBF and CBF practices.

A cross-sectional survey was conducted between November 2022 and March 2023 with 326 mothers of children 0-23 months old, all residing in Clark County, Nevada, USA. Descriptive, bivariate, and multivariable logistic regression analyses were conducted to examine the association between self-reported postpartum anxiety and depression symptoms and EBF and CBF in the 24 h prior to the survey.

The prevalence of EBF among infants under 6 months old and CBF among children 6-23 months old was 36.3% (n = 41) and 52.1% (n = 111), respectively. After adjusting for maternal socio-demographic, perinatal, and infant/child characteristics, decreased odds of EBF were associated with the presence of postpartum depressive symptoms (AOR 0.13; 95% CI 0.03,0.55) and the comorbid presence of postpartum anxiety and depression symptoms (AOR 0.16; 95% CI 0.04,0.66). Similarly, decreased odds of CBF were associated with the presence of postpartum anxiety symptoms (AOR 0.36; 95% CI 0.16,0.82).

Postpartum anxiety and depression symptoms decreased the odds of breastfeeding practices among mothers of children under two years old in Clark County, Nevada. However, the relationship may be bidirectional or inverse, requiring further research to clarify. Culturally appropriate interventions to reduce postpartum anxiety and depression are essential to improve breastfeeding practices.

Perinatal insomnia and depression significantly impact maternal-infant health, but their co-developing trajectories are poorly understood. This study examines their heterogeneous progression, interrelationships, and predictive factors across the perinatal period.

This was part of a mother-infant cohort study conducted in the obstetrics outpatient clinic of a tertiary hospital in Wuhan, Hubei Province. Pregnant women were enrolled (N = 1034) at early pregnancy (< 14 weeks) from July 2022 to September 2023. The perinatal depressive symptoms, insomnia severity, anxiety symptoms, and social capital were reassessed at 5-time points from enrollment (T0) to 6 months postpartum using the Edinburgh postnatal depression scale, the Insomnia Severity Index, the Pregnancy-related Anxiety Questionnaire, and the Personal Social Capital Scale 16, respectively. The follow-up time points were 16-20 weeks of gestation (T1), 28-36 weeks of gestation (T2), six weeks postpartum (T3) and six months postpartum (T4), respectively. Group-based trajectory modelling and binary logistic regression modelling were used to analyze the data (n = 436).

We identified three trajectories for perinatal insomnia and depression symptoms. Insomnia: no insomnia (27.7%), subclinical (54.5%), clinical (17.8%). Depression: low-stable (38.7%), moderate-stable (43.9%), high-improving (17.4%). The dual trajectory analysis revealed significant co-occurrence patterns between insomnia and depression trajectories (p < 0.001). Members of the high-improving depression group were more likely to have clinical insomnia trajectories. Baseline ISI ≥ 8, EPDS ≥ 10, and PRAQ ≥ 24 predicted the higher trajectories of perinatal insomnia and depressive symptoms (all p < 0.05).

Perinatal insomnia and depression follow three distinct but interrelated trajectories, identifiable through early screening. Risk-stratified interventions should consider their co-occurrence patterns to optimize outcomes.

Postpartum depression (PPD) is characterized by feelings of sadness, hopelessness, and disinterest in daily activities, leading to detrimental effects on both maternal and child well-being. We aimed to investigate the associations between blood immune-inflammatory biomarkers during pregnancy and the postpartum period and the risk of PPD.

In this study, we included postpartum women who underwent routine blood tests during second and third trimester visits as well as postpartum reviews. Immune-inflammatory biomarkers were assessed at three time points: neutrophil-to-lymphocyte ratio (NLR), lymphocyte-to-monocyte ratio (LMR), platelet-to-lymphocyte ratio (PLR), systemic immune-inflammatory index (SII), systemic inflammatory response index (SIRI), and pan-immune-inflammatory value (PIV). PPD symptoms were assessed at five to eight weeks postpartum using the Edinburgh Postnatal Depression Scale (EPDS). Multivariable logistic regression, restricted cubic spline (RCS) regression, and subgroup and sensitivity analyses were used to examine the relationships between immune-inflammatory biomarkers and PPD symptoms.

Of the 17,500 women eligible for analysis, 2,576 (14.72 %) exhibited PPD symptoms. During the postpartum period, maternal lymphocyte count was associated with decreased odds of PPD symptoms (OR = 0.86, 95 % CI: [0.80, 0.93]), whereas NLR, PLR, and SII were associated with increased odds of PPD symptoms after Bonferroni correction (OR = 1.19, 95 % CI: [1.06, 1.34]; OR = 1.40, 95 % CI: [1.21, 1.61]; OR = 1.18, 95 % CI: [1.07, 1.30], respectively). The relationships showed significant linear trends (all P for nonlinear > 0.05). Subgroup analyses demonstrated that cesarean delivery could modify the association between NLR and PPD symptoms (P for interaction = 0.034). The significant association between NLR and PPD symptoms was observed only in women without cesarean delivery (OR = 1.31, 95 % CI: [1.13, 1.52]). Sensitivity analyses showed that the main findings remained robust.

Our findings suggest that lymphocyte count, NLR, PLR, and SII during the postpartum period are independent risk factors for PPD symptoms. Monitoring these biomarkers could aid in clinical decision-making and the implementation of effective PPD management strategies.

Introduction: Neuropsychiatric symptoms are signs of cognitive decline and associated disorders. The effects of socioeconomic status and social interaction on cognitive decline have already been well documented. Accordingly, the present study aimed to build on the work investigating those factors and cognitive health by examining the relationships between socioeconomic status, sociability, and neuropsychiatric symptoms. Methods: Data from the UK Biobank (N = 301,848) were subjected to logistic regressions to examine the relationship between socioeconomic status, sociability, and neuropsychiatric symptoms and sociability to identify any potential moderator in the socioeconomic status-neuropsychiatric symptoms relationship. Specifically, socioeconomic status was defined by the Townsend deprivation index, while sociability was constructed using a cumulative score of four aspects. Meanwhile, neuropsychiatric symptoms were represented by depression, anxiety, and irritability, each of which had a genetic risk score calculated. Results: Individuals who reported lower socioeconomic status also reported more depression and anxiety, while those with higher sociability reported fewer depression and anxiety. Further, it was found that sociability moderated the relationship between socioeconomic status and two symptoms: depression and anxiety. No significant moderating effects were found regarding irritability. Conclusion: The study results indicate the need for interventions aimed at neuropsychiatric symptoms to reduce possible cognitive disorders. They also demonstrate the need to eliminate economic and social disparities and the importance of improving sociability.

Postpartum depression (PPD) affects numerous women globally, impairing maternal and infant health and contributing to substantial socioeconomic burdens on both families and society. This study aimed to investigate the association between the Dietary Inflammatory Index (DII) and PPD in Chinese women, and explore whether inflammatory cytokines mediate this association.

The study recruited 2038 participants and collected data from them. The Chinese version of the Self-Rating Depression Scale was used to assess postpartum depressive symptoms, and the DII scores were evaluated using semi-quantitative food frequency questionnaires (FFQ). To ensure balanced groups, researchers performed propensity score matching. From the matched participants, 126 blood samples were collected to determine serum levels of C-reactive protein (CRP), tumor necrosis factor-α (TNF-α), interleukin (IL)-1β, and IL-6. Researchers used logistic regression to estimate the odds ratios (OR) and 95 % confidence intervals (CI) between the DII tertiles, inflammatory markers, and PPD. Finally, researchers conducted a mediation analysis using the bootstrap method to examine the relationship between DII, inflammation, and PPD.

Among 2038 participants, 742 (36.4 %) participants were identified as having PPD symptoms. The higher DII scores were associated with PPD, and its significance still exists after a series of factors were adjusted (T2 vs T1: OR = 1.24, 95 % CI: 0.99, 1.55, P > 0.05; T3 vs T1: OR = 1.33, 95 % CI: 1.06, 1.66, P < 0.05). In addition, a higher level of CRP was associated with increased odds of PPD (OR = 1.34, 95 % CI: 1.13, 1.59, P < 0.05). The mediation analysis showed that a direct effect of DII on PPD persisted, and CRP mediated the relationship between DII and PPD.

A higher DII was associated with an increased risk of PPD in Chinese women. The present finding reinforces the importance of limiting pro-inflammatory food consumed and adopting an anti-inflammatory diet to decrease the risk of PPD.

Postpartum depression (PPD) is an increasingly prevalent but still poorly characterized disorder. Causal and modulating factors include hormones fluctuations, such as estrogen, progesterone, and allopregnolone, pathways imbalances, such as oxytocin and kynurenine, chronobiological factors, and brain imaging alterations. Treatment may differ from the traditional major depression management, while selective serotonin reuptake inhibitors such as sertraline are commonly used and suggested by guidelines, neurosteroids such as brexanolone and the more convenient zuranolone have been recently approved. Newer neurosteroids such as ganaxolone, valaxanolone, and lysaxanolone are currently under development, but also esketamine and psychedelics are promising potential treatments. Other somatic treatments including brain stimulation techniques and light therapy also showed benefit. PPD is therefore increasingly understood as, at least partially, independent from major depressive disorder. Specific and individualized treatments including pharmacological and non-pharmacological therapies are progressively being introduced in the routine clinical practice.

Postpartum depression is a leading public health issue of current international concern. With the change in the concept of postpartum health care, the adjustment of fertility policies, and government support, new postpartum management methods such as maternity matrons and postpartum management centers are becoming increasingly popular. Therefore, the aim of this study is to explore the correlation between postpartum management approaches and postpartum depression symptoms.

This study recruited 450 postpartum women who gave birth at the Yongkang Women and Children's Health Hospital, and their data were collected using a convenient sampling method. Out of the total, 150 women received care at the postpartum center of the Yongkang Women and Children's Health Hospital between June 2022 and February 2024 and were included in the postpartum management centers group, while the other 300 women underwent traditional postpartum care at home, with routine follow-up at the same hospital, and included in the traditional postpartum management group. General information and Edinburgh Postnatal Depression Scale (EPDS) scores were compared between the two groups at 42 days postpartum. Based on EPDS scores, study participants were divided into a postpartum depression symptom group (n = 92) and a non-postpartum depression symptom group (n = 358). Additionally, univariate and multivariate analyses were used to evaluate the factors influencing postpartum depression symptoms.

There were significant differences in maternal education level, family income, and EPDS scores between the postpartum management centers group and the traditional postpartum management group (p < 0.05). Univariate analysis identified that family income (p < 0.001), employment status (p = 0.020), preterm birth (p = 0.042), adverse pregnancy history (p < 0.001), whether the newborn's gender meets the family expectation (p = 0.005), breast-feeding (p < 0.001), adverse postpartum life events (p < 0.001), and postpartum management (p < 0.001) were associated with postpartum depressive symptoms. Furthermore, lower family income [p = 0.013, Odds ratio (OR) = 2.256, 95% Confidence interval (CI) (1.187, 4.287)], adverse pregnancy history [p < 0.001, OR = 3.786, 95% CI (1.839, 7.796)], adverse postpartum life events [p < 0.001, OR = 11.743, 95% CI (3.669, 37.579)], and traditional postpartum management [p < 0.001, OR = 2.842, 95% CI (1.591, 5.075)] were found as risk factors for postpartum depression symptoms. Additionally, neonatal gender conformity with family's expectations [p = 0.010, OR = 0.442, 95% CI (0.239, 0.819)] and breast-feeding [p < 0.001, OR = 0.318, 95% CI (0.182, 0.555)] were found as protective factors against postpartum depressive symptoms.

Postpartum depression symptoms are affected by a variety of factors, such as family income, preterm birth, and adverse pregnancy history. Furthermore, postpartum management style is crucial, with women who undergo care in postpartum management centers experiencing a lower risk of postpartum depression symptoms.

Postpartum depression (PPD) is a serious mental health problem that affects about 17% of mothers. The aims of the current study were to observe the associations between prenatal stress, self- and expert-rated PPD, and prepartal and postpartal hair cortisol and cortisone concentrations as proxies for altered hypothalamic-pituitary-adrenal axis activity (HPA-AA).

A total of 129 mothers (mean age 33.1 years) completed the Edinburgh Postnatal Depression Scale 3 days (baseline) and 12 weeks (study end) postpartum. At the end of the study, participants reported on prepartum stressful life events, experts rated participants' symptoms of depression, and participants provided 6 cm of hair strands for analysis of hair glucosteroid levels 12 weeks before and 12 weeks after delivery.

Prepartal stress was associated with higher scores for self- and expert-rated PPD and with lower hair cortisone concentrations as a proxy for less adaptive HPA-AA. Higher prepartal and postpartal hair cortisol/cortisone ratios (i.e., higher cortisol/lower cortisone concentrations) were associated with higher PPD symptom scores.

Women with prepartal stress were at increased risk of experiencing PPD 12 weeks after delivery. Altered hair steroid levels (lower cortisone concentrations) as a proxy for altered HPA-AA further substantiated this association. Results suggest that 1) both prepartal stress and the suppression of HPA-AA appear to be involved in the development of PPD; 2) hair steroid analysis can be used to predict PPD; and 3) women with prepartal stressful life events may benefit from timely support and relief to decrease their risk of developing PPD.

Approximately 9 to 50 % of women report a traumatic birth experience and 12 % develop childbirth-related posttraumatic stress disorder symptoms (CB-PTSS). A recent study using a postpartum midwifery-led counselling session showed promising results in reducing CB-PTSS, but more evidence is needed.

The main objective of the study was to evaluate the impact of a midwifery-led counselling session 6 weeks post-partum or later, on depression and CB-PTSS.

The pre-post-intervention study, including 159 women, took place in a Swiss 18 university hospital. It was designed as a healthcare service quality project and therefore was therefore not registered a priori in a clinical trial registry. Ethical approval from the institutional board was obtained (n° 2020-06). A midwifery-led counselling session, six weeks or more after birth, allowed women to discuss their childbirth experience and to receive additional information about childbirth. Women completed the Edinburgh Postnatal Depression Scale (EPDS) and the PTSD Checklist for DSM-5 (PCL-5) two weeks before and three months after the consultation.

Results showed a significant decrease in depression and CB-PTSS, and in cases with probable childbirth-related posttraumatic stress disorder diagnosis (CB-PTSD): 24.7 % (36/146) before counselling versus 6.3 % (5/80) three months after (p < 0.01). The session was rated as extremely/very satisfactory by 91 % of women and extremely/very useful by >87 % of women. No associations were found between depression and CB-PTSD scores and obstetrical or neonatal data.

A midwifery-led single-session offered to women 6 weeks or more after birth seemed to be associated with a decrease of depression and CB-PTSS. However, the attrition rate (49 %) made definitive conclusions difficult. More research is needed with a larger sample, a randomized design, and a wait-list control group to consider the effect of time on depression or CB-PTSS.

Oxytocin (OT) is a key molecule that not only acts as a uterine-contracting hormone during delivery but is also a critical maternal hormone that enables the social transmission of maternal behavior. Postpartum depression (PPD) is a series of depression-like symptoms that occur especially in women in the perinatal period and is accompanied by the failure to adapt to motherhood as well as impaired parent-infant bonding. However, the mechanism by which OT regulates PPD is still unclear. This study aimed to investigate the correlation between OT levels in the paraventricular nucleus (PVN) and PPD and to explore the potential mechanism underlying the involvement of the OT system in the regulation of PPD.

We induced perinatal chronic stress in pregnant rats to establish a PPD model. OT levels in the cerebrospinal fluid (CSF) and PVN were measured throughout the perinatal period. We administered the chemogenetic virus hM3Dq into the PVN, intraperitoneally injected N-oxyclozapine to activate OT-secreting neurons, and observed the effects of OT treatment on behaviors related to PPD. Finally, we investigated the potential mechanism underlying PPD regulation by the OT system via transmission electron microscopy, immunofluorescence (IF), and quantitative real-time PCR (qRT-PCR).

Compared with those in the normal group, CSF oxytocin levels in the postpartum depression group decreased from late pregnancy to lactation (p < 0.001). Chemogenetic activation-induced endogenous OT release in the PVN not only alleviated PPD-like symptoms in rats but also enhanced the intracellular production of OT. Transmission electron microscopy revealed an increase in the size of the Golgi apparatus, endoplasmic reticulum, and dense vesicles within OT neurons. IF and qRT-PCR revealed elevated OT levels and increased oxytocin expression within the PVN following chemogenetic activation (p < 0.01).

Lower OT levels are strongly associated with the occurrence of PPD. The release of activated OT has been shown to improve PPD-like behaviors in rats and promote intracellular OT synthesis.

Previous studies on maternal postpartum mental health are limited by non-representative samples, a narrow focus on mental illness, and a lack of systematic examination of predictors for diverse mental health trajectories. We investigated maternal mental health trajectories during eight years postpartum and their socio-demographic, family, and health-related predictors in a large cohort of mothers in Taiwan.

Participants were 17,886 mothers drawn from the Taiwan Birth Cohort Study (TBCS), a cohort study of a nationally representative sample of children born in Taiwan in 2005 and their parents. Maternal mental health was assessed at 6, 18, 36, 66, and 96 months postpartum using the Mental Component Summary (MCS) from the 36-item Short-Form Health Survey (SF-36) Taiwan version. We used group-based trajectory modeling to identify trajectory groups of maternal mental health and examined their predictors using multinomial logistic regression.

Five postpartum mental health trajectories were identified: persistently poor (6.7%), improving (12.1%), deteriorating (14.3%), persistently moderate (46.7%), and persistently good (20.1%), with the first two groups having the poorest mental health at six months postpartum. Immigrant status and higher household income were associated with favorable (i.e., improving, or persistently moderate or good) mental health trajectories, while low family function and poor general health at six months postpartum were associated with less favorable (i.e., deteriorating or persistently poor) trajectories. Among mothers with poor mental health at six months postpartum, being divorced or separated was additionally associated with persistently poor mental health. Among mothers with moderate mental health at six months postpartum, being a first-time mother was additionally associated with deteriorating mental health.

Our findings highlight distinct maternal mental health trajectories over eight years postpartum, with one in five mothers experiencing deteriorating or persistently poor mental health. Socio-demographic factors, family function, and early postpartum health were predictors of these trajectories.

Minority ethnic groups often face ethnocultural barriers in accessing mental health treatments. The ROSHNI-2 trial compared culturally adapted cognitive behavioural therapy (Positive Health Programme [PHP]) with treatment as usual for postnatal depression in British south Asian women. We aimed to assess the cost-effectiveness of the PHP intervention.

The ROSHNI-2 trial was a multicentre, two-arm, assessor-blinded, randomised controlled trial; we conducted an economic evaluation over a 12-month period to assess the cost-effectiveness of PHP plus treatment as usual versus treatment as usual alone from the perspective of the English National Health Service and personal social services. In the trial, British south Asian women aged 16 years or older with a child aged up to 12 months, and meeting DSM-5 criteria for depression, were recruited from northwest England, Yorkshire, the East Midlands, and London. The PHP intervention involved 12 group sessions delivered by two trained bilingual facilitators, held once per week for 2 months and once per fortnight thereafter, each lasting 60-90 min. Questionnaires on depression symptoms, quality of life, and resource use were completed at baseline, 4 months (end of intervention), and 12 months after random assignment. Quality-adjusted life-years (QALYs) were used for the cost-utility analysis, and recovery from depression at 4 months (the primary clinical outcome), assessed using the Hamilton Rating Scale for Depression, informed the cost-effectiveness analysis. After the onset of the COVID-19 pandemic, the intervention was adapted for online delivery for the remaining participants. A stratified analysis compared the cost-effectiveness of online versus in-person delivery. The trial involved researchers with lived experience, and all methods, including health economic measures, were developed in consultation with service users, community members, and faith leaders. This is a preplanned analysis of the ROSHNI-2 trial, registered with ISRCTN (ISRCTN10697380).

From Feb 8, 2017, to March 29, 2020, 732 eligible women were enrolled: 368 participants were randomly assigned to the PHP arm and 364 to the treatment as usual arm. The base-case intention-to-treat analysis showed that PHP significantly increased costs (£712, 95% CI 311 to 1113) and QALYs (0·036, 95% CI 0·006 to 0·067), with an incremental cost-effectiveness ratio of £19 601 (7622 to 83 772). Based on the UK National Institute for Health and Care Excellence (NICE) maximum willingness-to-pay threshold of £30 000 per QALY, the likelihood of PHP being cost-effective was 77% from a health and social care perspective. Cost per remission from depression at the 4-month follow-up was £5509 (2916 to 17 860). In a stratified analysis of 34 participants attending online sessions during the pandemic, incremental QALY effects were 0·125 (0·048 to 0·203), resulting in costs of £202 (-3906 to 10 918) per additional QALY gained.

The average cost of PHP for postpartum women was below the lower end of the NICE threshold of £20 000-30 000 per QALY, excluding benefits to the child or potential gains such as reduced lost productivity from early remission. PHP, a culturally adapted group cognitive behavioural therapy-based intervention, might be a cost-effective intervention for postnatal depression in British south Asian women. Online PHP delivery showed promising clinical and cost-effective results for this group but requires a large-scale study.

UK National Institute for Health and Care Research.

Historically, perinatal depression has predominantly focussed on the mother-baby dyad, often neglecting the crucial role of fathers.

To determine the prevalence and associated factors of depressive symptoms in the immediate puerperium (PDS) in both mothers and fathers, individually and concurrently.

This study employed a cross-sectional design. The presence of PDS was assessed using the Edinburgh Postnatal Depression Scale (EPDS), with a cut-off score of ⩾11 for mothers and ⩾9 for fathers. Logistic regression analyses were conducted to identify factors independently associated with PDS. Robustness of findings was verified through sensitivity analyses among participants without prior psychiatric conditions.

Among 1,502 partnered mothers and fathers aged ⩾18 years who met the inclusion criteria, PDS were present in 13.0% of mothers, 10.5% of fathers and 3.5% of both parents. Mother-baby skin-to-skin contact and the father's pregnancy planning were associated with a lower likelihood of PDS in mothers. For fathers, financial difficulties increased the likelihood of experiencing PDS threefold. The presence of PDS in mothers quadrupled the likelihood of PDS in fathers, and vice versa; their EPDS scores demonstrated a moderate correlation (rs = .38). Among participants without prior psychiatric conditions, the odds of co-occurring PDS nearly tripled if the mother had a history of abortion or miscarriage. Fathers who had increased potentially addictive behaviours showed a six-fold increase in the likelihood of experiencing PDS.

Identifying depressive symptoms in both parents and incorporating fathers into clinical practice, research and health policy could enhance mental health outcomes in vulnerable populations.

In the UK, in addition to the recommended blood pressure check, women with hypertensive disorders of pregnancy are offered a postpartum six-week check (SWC) with either a specialist or general practitioner. We aimed to describe the prevalence and disparities in the provision of SWC, and describe short-term postpartum outcomes among women with hypertensive disorders of pregnancy by SWC status.

Data were from the UK Clinical Practice Research Datalink GOLD for women aged 15-49 years at childbirth in 2000-2018, who were diagnosed with hypertensive disorders of pregnancy, and were registered for ≥12 months postpartum. Trends in SWC prevalence and differences in characteristics and short-term postpartum outcomes of women by SWC status were described. Multivariable modified Poisson regression was used to compute risk ratio of a SWC for severe hypertensive disorders of pregnancy.

Of 30 483 women, 61.4% had a SWC. The proportion of women who received a SWC check was highest in 2007 (66.8%) but subsequently decreased. Women were less likely to have a SWC record if they were younger, of a minoritised ethnicity, living in more deprived areas, were multiparous, had severe hypertensive disorders of pregnancy, preterm birth, caesarean birth, or had a low birthweight baby. Compared to women who did not have a SWC, a higher proportion of women with SWC had their blood pressure recorded (SWC 47.4%, no SWC 39.9%), and had a diagnosis of postpartum depression (SWC 13.6%, no SWC 11.1%). There were no substantial differences in other short-term postpartum outcomes by SWC status.

There may be missed opportunities in postpartum care among women with hypertensive disorders of pregnancy. Our findings highlight the need to ensure that general postpartum care is not overlooked in women with specific morbidities in pregnancy.

Pregnancy brings numerous physiological and psychosocial changes and conditions that may include gestational diabetes mellitus (GDM) and anxiety and mood disorders. Household food insecurity (HFI)-not having access to food that meets dietary needs and preferences-may put pregnant people at risk for developing pregnancy complications like GDM. This study used qualitative and quantitative methods to understand, from a syndemic perspective, the intersections among these conditions in Canada. Using the Canadian Community Health Survey cycles from 2009 to 2018, we fit multivariable and multivariate logistic regressions to these data to understand interactions among food insecurity, anxiety and mood disorders, and GDM. We also conducted four focus group discussions (FGDs) and six one-on-one interviews with pregnant and postpartum people living in Hamilton, Ontario. Analyses of the survey data show that pregnant individuals who reported an anxiety and/or mood disorder were more likely to experience HFI. Those who experienced HFI were also more likely to be diagnosed with GDM during pregnancy or report an anxiety and/or mood disorder. Major themes identified from interviews and FGDs revealed that structural variables impact access to food, that a GDM diagnosis increased anxiety, and that experiencing HFI exacerbates the management of these conditions during pregnancy. The potential interactions among HFI, GDM, and anxiety and/or mood disorders indicate that addressing rising HFI alongside prevention and treatment of GDM and anxiety and mood disorders are critical to improving the health and well-being of pregnant people in Canada.

The postpartum period is a crucial yet often neglected stage of childbirth in Ghana. Cultural expectations and societal norms often lead some women-especially first-time mothers with no prior experience-to focus more on childbirth as a significant life event, while their postpartum well-being remains overlooked. However, childbirth often brings physical, emotional, social, and psychological changes that need to be carefully managed for the greater well-being of the mother and child.

This study investigates the postpartum experiences of first-time mothers in the Oti Region of Ghana with the Biopsychosocial Model as its theoretical foundation.

Achored on qualitative methods, semi-structured interviews were conducted with 25 first-time mothers to explore themes such as physical health challenges, psychological distress, and social support during postpartum.

Diverse postpartum experiences were established among the first-time mothers, which highlight the pivotal roles of spousal, familial, and healthcare support in shaping maternal well-being during this critical post-childbirth period. Specifically, these supportive resources helped these first-time mothers through physical health, psychological, emotional, neurological, and sensory issues. However, these social support systems were uneven, thereby creating differential postpartum experiences.

Our findings highlight the need for policy and interventions to enhance comprehensive access to postpartum care, address healthcare delivery gaps, and promote culturally sensitive maternal health services. Healthcare providers must therefore adopt holistic care strategies that covers the physical, emotional, and social dimensions of postpartum health. These should include follow-ups, mental health screenings, and personalized postpartum education, and care. Finally, future research should prioritize postpartum care and long-term health outcomes in addition to mechanisms that strengthen social support systems and advance maternal health nationwide.

Postpartum pelvic girdle pain (PGP), experienced by approximately 10% of women, is typically refractory to conservative management. Customised dynamic elastomeric fabric orthoses (DEFOs) are one novel option to address this. We assessed the feasibility and acceptability of a randomised controlled trial comparing a DEFO plus standardised advice/exercises (intervention) versus standardised advice/exercise alone (control).

A multicentre randomised controlled feasibility trial with embedded qualitative study and economic evaluation. Participants were randomised to either intervention or control group. All received two remote physiotherapy sessions via videoconferencing separated by 14 days. Primary feasibility outcomes were related to the feasibility and acceptability of methods and interventions, recruitment, intervention fidelity, outcome measure performance and completion. The proposed primary outcome measure for the definitive trial was the Numerical Pain Rating Scale (NPRS) which assessed pain intensity fortnightly over 24 weeks. Secondary outcome measures assessed kinesiophobia, continence, function, health-related quality of life, depression and health/care resource use at baseline, 12 and 24 weeks. Adverse events were recorded. Pre-defined progression criteria were set to decide whether, and how, to proceed with a future definitive trial: (1) Target sample size (60 from 3 centres over a 7-month recruitment period), (2) outcome measure completion (> 60% at 24 weeks), (3) orthosis wear-time compliance (> 70% for 6 h/day) as measured by the Orthotimer, and (4) evidence suggesting efficacy.

Of 180 participants sent information sheets, 40 were screened and 24 randomised. At 24 weeks, 95% completed NPRS and 89-95% the secondary outcome measures. Wear-time adherence appeared below the set target of 42 h per week. Outcomes were broadly comparable between groups. Recruitment was insufficient to estimate a signal of efficacy with confidence. Two intervention participants experienced Candida infections, considered possibly due to the DEFO.

Trial procedures and interventions were acceptable to participants. Technical Orthotimer issues are resolvable through modification of recording parameters. Recruitment of participants was a major challenge. Work to understand how best to engage women in this research is needed before moving to a definitive trial.

ISCRTN, ISRCTN67232113. Registered 08/05/2021, https://www.isrctn.com/ISRCTN67232113 .

Postpartum depression and anxiety are significant public health concerns that have serious well documented negative effects on mothers and their families. However, they often remain under-recognized because of limited in-person interactions, time restrictions, lack of adequate support, and pervasive stigmatization. This study investigated the effectiveness of the Smart Mama application on postpartum depression, anxiety levels, and maternal-infant bonding at 12 weeks postpartum.

This prospective parallel-group randomized controlled trial included 148 participants from March 1, 2023, to March 31, 2024. Those who agreed to participate were randomly assigned to receive the Smart Mama intervention (n = 74) or routine care (n = 74), using permuted stratified block randomization. The primary outcome was assessed using the Edinburgh Postnatal Depression Scale (EPDS). The secondary outcomes were evaluated using the State-Trait Anxiety Inventory (STAI) and Maternal-Infant Bonding Scale (MIBS) at baseline and the 12-week follow-up using validated standardized tools.

Compared with the control group, the Smart Mama intervention group showed a significant reduction in postpartum depressive symptoms (P for time × group interaction = 0.04), with a reduction in the EPDS mean score from 9.03 (standard deviation, 2.47) to 5.61 (3.3), whereas the control group showed a change from 9.01 (2.75) to 7.16 (3.1) at 12 weeks post-intervention. Similarly, the Smart Mama intervention led to a significantly greater decrease in both state and trait anxiety levels (both P for time × group interaction < 0.05) compared to the control group. No statistically significant effect on maternal-infant bonding was observed between the intervention and control group (P for time × group interaction = 0.25).

The Smart Mama intervention significantly reduced postpartum depressive symptoms and anxiety. This study provides empirical evidence and novel insights into the effectiveness of mobile device applications. By integrating a holistic approach, Smart Mama represents a promising and innovative solution for enhancing maternal health outcomes, empowering self-care activities, and overcoming barriers to accessibility.

The study was registered in the University Hospital Medical Information Network (UMIN) Clinical Trial Registry (ID: (UMIN000050065) on January 19, 2023 ( https://center6.umin.ac.jp/cgi-open-bin/ctr/ctr_view.cgi?recptno=R000056562 ).

(1) Background: The COVID-19 pandemic caused widespread upheaval, presenting unique challenges for pregnant and postpartum women, who were already in a particularly vulnerable phase. As the COVID-19 pandemic and its public health response unfolded, it became crucial for clinicians and researchers to explore postpartum depression within the context of a global crisis. (2) Methods: We used data from two cross-sectional surveys of postnatal women conducted in our tertiary academic public hospital during the SARS-CoV-2 pandemic and the post-pandemic period, based on the retrospective assessments of two samples of mothers, each including 860 postpartum women. Our research has been conducted with the scope of evaluating postpartum depression disorder during and after the COVID-19 pandemic by using comparable data across time. (3) Results: The prevalence of postpartum depression was significantly higher among women who gave birth during the COVID-19 pandemic (major postpartum depressive disorder: 54.19%, minor depressive disorder: 15.58%), compared to pre-pandemic rates (10% in developed countries and 21-26% in developing countries) and post-pandemic rates (major depressive disorder 10.12%, minor depressive disorder 10.93%). The results of our research indicate that the COVID-19 pandemic had a major negative impact on perinatal mental health and, moreover, might have sped up an existing trend of the increasing prevalence of postpartum depression, despite the fact that the risk factors for postpartum depression disease remained consistent before, during, and after the pandemic. (4) Conclusions: Strengthening support systems during periods of heightened risk, such as during a pandemic, is crucial; therefore, policymakers and health planners should prioritize the mental health of this vulnerable group during global health crises or natural disasters, ensuring the implementation of effective mental health screenings, identification, enhanced support, follow-up, and reassurance measures to better address the challenges faced by susceptible postpartum women in future similar situations.

BackgroundMore than one in five women deal with a psychiatric disorder during the perinatal period. Whereas perinatal depression is well documented, there is still little research on the full range of perinatal psychiatric disorders and their clinical evolution across this whole period. The present study investigated the susceptibility to psychiatric illness during pregnancy and up to one year postpartum. We aimed to identify the most frequent disorders and comorbidities arising in each perinatal period. We outlined the clinical trajectories of these disorders in terms of evolution across past history, pregnancy and postpartum.MethodThrough a retrospective longitudinal design, data were collected in 2019-2020 from the medical records of the cohort of 964 women who required care in a tertiary perinatal psychiatry clinic located in Quebec City (Canada) between 2004 and 2020. Incidence rates of the full range of psychiatric disorders were estimated per period and their evolution across time identified clinical trajectories.ResultsDuring pregnancy, 34 different disorders were newly diagnosed with incidence rates ranging from 0.1% to 15.5% (45.6% of women having had at least one disorder diagnosed during pregnancy) whereas, during postpartum, 36 disorders were newly diagnosed with incidence rates ranging from 0.1% to 31.0% (67.5% of women having had at least one disorder diagnosed during postpartum). For most disorders, rates were significantly higher in postpartum than in pregnancy. A woman could develop multiple disorders during a given perinatal period: this comorbidity involved various combinations of diagnoses in 28% of women during pregnancy and 38% during postpartum. We outlined 52 different clinical trajectories from past history to postpartum, underlining the heterogeneity of the perinatal course.ConclusionsPregnancy is a susceptible period for women with past psychiatric histories whereas postpartum could trigger a new illness in women without a past history or pregnancy-onset psychiatric disorder.

Postpartum mood disorders affect approximately 20 % of postpartum women. This study examines the association between postpartum mood disorders and preeclampsia with severe features (SPE), postpartum hemorrhage (PPH), very/extremely preterm delivery (EPTD), and fetal congenital malformations (FCM).

A retrospective chart review was conducted at a large southeastern quaternary academic hospital using ICD-10 codes for the four high-risk perinatal complications. Medical records included 3,652 cases and 750 normal patient comparisons (NPC). Inclusion criteria: 1) prenatal visit at the institution, 2) live delivery at the institution, 3) postpartum visit at the institution, and 4) completed Edinburgh Postnatal Depression Scale (EPDS) at postpartum visit. EPDS scores≥12 and EPDS-3A scores≥5 were considered positive for depression and anxiety symptoms, respectively.

Five cohorts were analyzed [NPC (n=200), SPE (n=150), PPH (n=153), EPTD (n=102), and FCM (n=200)]. Independent sample t-tests revealed significant differences in mean EPDS scores between NPC and EPTD (p<0.001) and FCM (p=0.014) and in mean EPDS-3A scores between NPC and EPTD (p<0.001) and PPH (p=0.011).

EPTD, FCM, and PPH are diagnoses associated with elevated EPDS and/or EPDS-3A scores. Increased mood surveillance in patients with these complications is warranted. Understanding the association of these conditions with increased depression and anxiety symptoms will allow for earlier identification and treatment of postpartum mood disorders.

Maternal beliefs towards COVID-19 vaccine safety may be associated with infant feeding practice and postpartum depression (PPD). Since there is a paucity of studies, this study aims to identify associations of COVID-19-related cognitive factors (e.g., COVID-19-vaccination-related belief and COVID-19-related knowledge and attitude) with infant feeding practices and their associations with PPD during the COVID-19 pandemic in Thai postpartum mothers.

A cross-sectional online survey was conducted among 840 postpartum mothers whose infants were less than or equal to 6 months old. Mothers with a score ≥ 13 using the Edinburgh Postnatal Depression Scale (EPDS) were considered to have PPD. Student t-tests were used to measure the association between infant feeding practices and COVID-19-related cognitive factors, and Chi-square tests were used to assess their associations with PPD. Significant variables (p < 0.05) from the chi-square test were included in the logistic regression analysis. Multivariable logistic regression analyses were performed to identify factors associated with PPD. The associations were reported in adjusted odds ratio at 95% confidence interval.

This study showed one-third of the participants (32.4%) were at risk of having PPD. Mothers who fed expressed breastmilk had positive beliefs towards COVID-19 vaccination and higher scores on COVID-19 knowledge and attitude, while mothers who fed infant formula or solid, semi-solid, or soft food had negative beliefs towards the vaccination compared to their counterparts. Multivariable logistic regression showed women who fed their infant with solid, semi-solid, and soft foods (AOR = 3.28; 95% CI = 1.35-10.92) had significantly higher odds of PPD. Among COVID-19-related cognitive factors, negative or moderate COVID-19-related attitudes were associated with higher odds of PPD (1.91; 1.19-3.07 and 1.85; 1.20-2.86, respectively). Socio-demographic factors associated with PPD included living in urban areas, residing outside the Southern region, having food insecurity during the pandemic, having unintended pregnancy, and having health problems during the perinatal period.

The association of COVID-19-related cognitive factors and feeding practices with PPD may suggest that proper education on prevention, control, and vaccination of emerging infectious diseases such as COVID-19, as well as support for appropriate infant feeding practices, should be provided to postpartum mothers, which ultimately contributes to improving their mental health.

Postpartum depression is a significant global health challenge that affects mothers, infants, and families. Although various preventive strategies show promise, comprehensive reviews evaluating interventions among pregnant women without a clinical diagnosis of depression remain limited. This scoping review aims to identify and synthesize the existing evidence on proactive postpartum depression prevention programs initiated during pregnancy.

Following PRISMA guidelines for scoping reviews, we systematically searched PubMed and Scopus, supplemented by manual reference reviews. Our search strategy combined terms related to postpartum depression, pregnancy, and preventive interventions. Studies were included if they evaluated interventions conducted during pregnancy, targeting women without a clinical diagnosis of depression, and assessed PPD outcomes using established diagnostic criteria or validated screening tools. Only English-language articles published between 2013 and 2023 were considered.

A total of 49 studies met the inclusion criteria. Interventions were categorized into nine themes: psychoeducation (n = 18), home visits (n = 6), cognitive behavioral therapy (CBT) (n = 6), mindfulness (n = 6), exercise (n = 4), dietary supplements (n = 3), interpersonal therapy (IPT) (n = 4), consultation (n = 1), and inhalation aromatherapy (n = 1). Psychoeducational and mindfulness-based interventions consistently reduce PPD risk, particularly when delivered in structured, theory-driven formats and incorporating family support. Digital CBT interventions demonstrated limited effectiveness due to lower engagement, while home-visit and consultation-based interventions were effective when integrated into existing maternal healthcare despite scalability challenges. Exercise and dietary supplement interventions yielded inconsistent outcomes, indicating that factors such as adherence, duration, and intensity are crucial determinants of effectiveness.

Various proactive interventions are available to prevent PPD, and this scoping review systematically maps the different strategies used and their outcomes. Proactive, theory-based, and multi-component interventions, particularly psychoeducational and mindfulness programs, demonstrate promising potential. Future research should emphasize evaluating long-term outcomes, optimizing digital engagement strategies, and developing culturally tailored models to enhance scalability and accessibility across diverse populations, including low-resource settings.

Traditionally, postnatal depression (PND) has been considered as depression in the first year after giving birth, although it has been argued that the 12-month cut-off may be somewhat arbitrary. Specialist perinatal mental health services in England have recently been extended to include women in their second year postpartum; however, there is no good estimate for the prevalence of PND beyond the first year. This review aimed to obtain the best estimate of the prevalence of PND in the second postpartum year. Eligible studies were those that assessed PND and provided a point prevalence using a validated screening tool or clinical diagnosis at least once beyond the first 12 months in women over the age of 18 years in any country. Studies were excluded if they only included women who were already depressed or had elevated depression scores at baseline. PubMed, Embase, Web of Science, CINAHL and PsychINFO were searched in January 2021 (and updated in February 2024) for studies that included the prevalence of PND beyond the first 12 postnatal months. Study quality was assessed using Cochrane's ROBINS-I and Risk of Bias 2 tools. Prevalence data were combined in meta-analysis using prediction intervals (PIs). A total of 6340 papers were found, and of these, 32 studies including 57210 participants across 18 countries met the inclusion criteria and were meta-analysed. The prevalence of PND in the second year (13-24 months) was 15% (95% confidence interval [CI] 12%, 17%; 95% PI 4%, 30%) and similar to that in the first year, 16% (95% CI 14%, 19%; 95% PI 6%, 31%). Despite considerable heterogeneity, common in meta-analysis of prevalence studies, findings show that a similar proportion of women experience PND in the second year after birth.

Postpartum depression (PPD) is a severe mental health condition that affects women following childbirth and is marked by persistent sadness, anxiety, fatigue, and difficulty functioning. Unlike the temporary "baby blues", PPD is more severe and long-lasting, potentially leading to negative consequences for mother and child. Globally, PPD impacts approximately 10-20% of postpartum women, with prevalence influenced by genetic, hormonal, psychological, and socio-environmental factors. Early detection is crucial, with screening tools such as the Edinburgh Postnatal Depression Scale (EPDS) commonly used in clinical practice. Treatment options include pharmacological interventions such as selective serotonin reuptake inhibitors (SSRIs), psychological therapies like cognitive behavioral therapy (CBT) and interpersonal therapy (IPT), and lifestyle modifications. Despite the growing awareness of PPD, stigma remains a significant barrier to treatment, discouraging many women from seeking help. In low-income countries, where mental health care is often underfunded, accessing professionals trained in perinatal mental health presents an even greater challenge. This gap underscores the urgent need for a collaborative, multidisciplinary approach involving obstetricians, psychiatrists, pediatricians, and midwives to ensure comprehensive support and care for affected individuals.

The postpartum period can be a wonderful time for women as they embark on motherhood. However, this time is not without its surprises and challenges as new mothers support the life of another and navigate the physical and psychological changes they experience. This transformation period can often negatively impact body image and self-esteem, which can lead to further adverse health outcomes for mothers and children.

This research employs a qualitative design of semi-structured interviews with 20 Australian mothers with at least one child under four.

Using reflexive thematic analysis, our study identified three key themes: (i) navigating expectation vs experience: Physical and psychological transformations in the postpartum, (ii) navigating body image in a socially influenced world, and (iii) navigating well-being in a busy world: Balancing self-care and external demands.

The results highlight the influence of societal thin ideals on mothers' eating attitudes, the crucial role of support networks serving as protective factors against body image concerns, and the need for enhanced education and preparation to guide women through this transformative period. SO WHAT?: The findings shed light on the lived experiences of postpartum women, providing valuable insights into the complex interplay of body image, eating attitudes, and self-care practices, sharing information for healthcare and support interventions, aiming to improve overall health and well-being for mothers.

Women with a history of traumatic experience, particularly adversity encountered during childhood, have an increased risk of developing depression. The authors review the biological mechanisms associating trauma with depression, including the role of the hypothalamic-pituitary-adrenal axis. Additionally, the psychosocial and cultural considerations associating traumatic experience with depression are discussed, and current gaps in knowledge about biological mechanisms, psychosocial factors, and cultural aspects relating trauma to depression that remain to be addressed are described. Women with a history of trauma are also at increased risk for engaging in suicidal behaviors, including suicidal ideation and attempts. Increased suicidality in women with a history of trauma has been observed in various populations, including among victims of intimate partner violence, female veterans, refugees, and individuals who identify as lesbian, gay, bisexual, transgender, queer or questioning, or other. Although associations between trauma and suicidality have been well documented, limited research has examined the impact of age or reproductive stage, an important area for future research. A wide range of biological, psychosocial, and cultural factors that can increase the risk for suicidality across the lifespan in women are described, and how they may be included when completing clinical assessments for women is highlighted. Machine learning, and its use in risk and outcome prediction of depression in women across reproductive stages toward individualized psychiatric services, is introduced, with future directions reviewed.

To inform the development and adaptation of lifestyle programs to prevent type 2 diabetes, we sought to identify factors associated with depressive symptoms in the early postpartum period among women with recent gestational diabetes (GDM).

Participants are from the Balance after Baby Intervention (BABI) study, a two-year randomized clinical trial of a lifestyle program for women with recent GDM conducted in Boston, MA, and Denver, CO between 2016 and 2019. The Edinburgh Postpartum Depression Scale (EPDS) and Perceived Stress Scale (PSS-10) were administered at an average of 8-weeks postpartum. We defined an EPDS score of ≥ 9 as depressive symptoms and reviewed medical records for medical history. We conducted bivariate analyses to identify predictors of postpartum depressive symptoms, then modeled the odds of postpartum depressive symptoms using multivariable logistic regression and selected the best fit model.

Our analysis included 181 women. Thirty-five (19%) scored ≥ 9 on the EPDS. While both perceived stress and whether this was the first pregnancy complicated by GDM were significant in the bivariate analysis, only perceived stress remained a significant predictor of postpartum depressive symptoms in the multivariate regression model (OR 4.34, 95% CI [2.58-7.31]). The effect of first GDM pregnancy was no longer significant in the multivariate model (OR 2.00, 95% CI [0.63-6.33]). Additionally, a mediation model determined that perceived stress fully mediated the effect of first GDM pregnancy on depressive symptoms (Effect ratio, 0.5507/1.5377 = 0.358, p = 0.036).

Perceived stress was predictive of postpartum depressive symptoms in women with recent GDM and was found to mediate the relationship between first pregnancy complicated by GDM and postpartum depressive symptoms. Addressing perceived stress in the early postpartum period may be an important target for future lifestyle programs to maximize diabetes prevention efforts.

Oxytocin (OT) plays pivotal roles in stress regulation, mother-infant bonding, and breastfeeding, all of which are adversely impacted by postnatal depression (PND). In a double-blind, randomized controlled trial, we assessed endogenous OT concentrations first in the breast milk of new mothers at baseline, and second following the administration of exogenous OT compared to a placebo delivered via a nasal spray.

Participants were mothers (N = 62, aged 23-42 years) and their infants (aged 3-9 months). Each mother underwent screening for PND symptoms using the Edinburgh Postnatal Depression Scale (EPDS). N = 26 mothers scored above the cut-off point (≥9) on the EPDS, and N = 36 mothers scored below. Breast milk samples, collected during breastfeeding, were assayed for OT content.

Baseline endogenous OT concentration in breast milk was not associated with maternal low mood. Exogenous OT administration was associated with a significant increase in breast milk OT, but with reduced effect in mothers experiencing symptoms of PND compared to control mothers.

Future studies should test if breast milk OT exhibits a protective role against the developmental disadvantages of maternal PND on children. The current findings may reflect a possible disruption of the interaction between the central and peripheral OT pathways during breastfeeding in mothers experiencing symptoms of PND. These insights shed new light on the potential biological mechanisms involved in the transference of mental health vulnerabilities from mothers to infants.