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Objectives: We aimed to analyze whether (1) infant temperament mediates the impact of maternal prenatal depressive symptoms on infant sleep problems and (2) the mediation role of infant temperament was moderated by the infant's sex., Methods: The sample was comprised of 172 mother-infant dyads. Mothers completed self-reported measures of prenatal and postnatal depressive symptoms, infant temperament (negative affectivity, surgency/extraversion, and orienting regulation), and sleep problems., Results: While controlling for maternal postnatal depressive symptoms, our results revealed that (1) infant negative affectivity at two weeks partially mediated the impact of maternal prenatal depressive symptoms on sleep anxiety at six months, and (2) this mediation is independent of the infant's sex., Conclusions: Our findings provided evidence that negative affectivity can be an early specific marker of sleep anxiety and can partially explain the negative impact of maternal prenatal depressive symptoms on further sleep problems in the infant.

Objective: Previous tobacco consumption, and depression and anxiety symptoms are major predictors of women's tobacco consumption during pregnancy and the postpartum period. However, the joint effect of these predictors is still unexplored. This study aimed to analyse the effects of previous tobacco consumption, and depression and anxiety symptoms on women's tobacco consumption status and quantity from the 1st trimester of pregnancy to 7 months postpartum., Method: A sample of 803 Spanish women was assessed at the 1st and the 3rd trimester of pregnancy, and at 2 and 7 months postpartum. Previous tobacco consumption, and depression and anxiety symptoms were self-reported. Pregnancy and postpartum tobacco consumption were confirmed with biochemical tests., Results: Women with more previous tobacco consumption or more anxiety symptoms presented a steeper decrease in the number of cigarettes smoked per week from the 1st trimester of pregnancy to the childbirth, although smoking more cigarettes than women with less previous tobacco consumption or less anxiety symptoms. Women with more depression symptoms showed a higher tendency to relapse smoking during the first 2 months postpartum., Conclusions: Previous tobacco consumption and anxiety symptoms were associated with higher smoking quantity during pregnancy, while depression symptoms were associated with consumption relapse during postpartum period., (Copyright © 2021 The Author(s). Published by Elsevier Ltd.. All rights reserved.)

This study analyzed the possible interaction effects between tobacco consumption and anxiety or depression during pregnancy on maternal and neonatal health. We recruited a sample of 807 pregnant Spanish women from public healthcare services. Women completed a questionnaire on sociodemographic variables, health status and tobacco consumption (continuous, quitting or no consumption) in the first and third trimester of pregnancy and at 2 months postpartum, and self-reported measures of anxiety and depression in the first trimester. Abstinence of tobacco consumption was verified through biochemical measurements. Interaction effects between tobacco consumption and anxiety were found for delivery ( p < 0.001), neonatal health complications ( p = 0.026) and gestational age at birth ( p = 0.029). Interaction effects between tobacco consumption and depression were found for pregnancy ( p = 0.032), delivery complications ( p < 0.001) and weeks of gestation at birth ( p = 0.031). This study suggests that there are different kinds of interaction effects between tobacco consumption and anxiety or depression. Smokers with high anxiety presented more delivery complications compared to quitters and non-smokers with high anxiety. There is a cumulative effect of anxiety on the effects of tobacco consumption on maternal health. The results highlighted the beneficial impact of quitting smoking during pregnancy to reduce the risk of suffering anxiety, depression and health complications.

Background: Depression symptoms may negatively affect the achievement of developmental tasks within the transition to parenthood, increasing the risk of paternal adjustment problems and negative paternal attitudes., Objective: This study analysed the effect of men's depression symptoms on paternal adjustment and paternal attitudes trajectories from the second trimester of pregnancy to six months postpartum., Methods: A sample of 127 men completed measures of depression symptoms and paternal adjustment and paternal attitudes at the second trimester of pregnancy and at six months postpartum., Results: From the second trimester of pregnancy to six months postpartum, men with more depression symptoms revealed a decrease on positive attitudes towards sex (while men with fewer depression symptoms revealed an increase), a steeper decrease in the satisfaction with marital relationship (than men with fewer depression symptoms), and a decrease in positive attitudes towards pregnancy and the baby (while men with fewer depression symptoms revealed an increase)., Conclusion: Depression symptoms early in pregnancy may represent a risk factor to increased paternal adjustment problems and negative paternal attitudes during the transition to parenthood.

Aims: The aims of this study were to analyse the changes in anxiety and depression symptoms from early pregnancy to 30 months postpartum according to gender and parity., Method: 129 couples (N = 258) recruited from an obstetrics unit completed self-report measures of anxiety and depression at each pregnancy trimester, childbirth, 3 and 30 months postpartum. Using multilevel modelling, piecewise dyadic growth curve models were performed, assessing time, gender and parity as predictors of anxiety and depression symptoms., Results: Anxiety and depression symptoms decreased from the first trimester to 3 months postpartum and increased from 3 to 30 months postpartum, returning to the baseline levels in the overall sample. The symptoms were positively correlated within-dyad; in a given time point when a partner reported more symptoms, the other reported more symptoms as well. Changes in anxiety and depression symptoms over time were different according to gender and parity, especially from 3 to 30 months postpartum. Primiparous women revealed low stable symptoms, whereas multiparous women revealed the steepest symptoms increase (in comparison to primiparous men and women and multiparous men)., Conclusions: This study corroborates the literature considering that the transition to parenthood can last until the child's age of 2 or 3 years. Results point out that the risk for anxiety and depression symptoms increasing over the postpartum period is greater for multiparous and lesser for primiparous women. Future studies should explore the factors that contribute to the high risk of symptoms increase over the postpartum period for multiparous women. Screening and intervention should target couples and not only women.

Objective: Maternal depression and anxiety have been found to negatively affect fetal and neonatal growth. However, the independent effects of maternal depression and anxiety on fetal-neonatal growth outcomes and trajectories remain unclear. This study aimed to analyze simultaneously the effects of maternal prenatal depression and anxiety on (1) neonatal growth outcomes, and (2), on fetal-neonatal growth trajectories, from the 2nd trimester of pregnancy to childbirth., Methods: A sample of 172 women was recruited and completed self-reported measures of depression and anxiety during the 2nd and 3rd trimesters of pregnancy, and at childbirth. Fetal and neonatal biometrical data were collected from clinical reports at the same assessment moments., Results: Neonates of prenatally anxious mothers showed lower weight (p=0.006), length (p=0.025), and ponderal index (p=0.049) at birth than neonates of prenatally non-anxious mothers. Moreover, fetuses-neonates of high-anxiety mothers showed a lower increase of weight from the 2nd trimester of pregnancy to childbirth than fetuses-neonates of low-anxiety mothers (p<0.001). Considering maternal depression and anxiety simultaneously, only the effect of maternal anxiety was found on these markers of fetal-neonatal growth outcomes and trajectories., Conclusion: This study demonstrates the independent longitudinal effect of maternal anxiety on major markers of fetal-neonatal growth outcomes and trajectories, simultaneously considering the effect of maternal depression and anxiety., (Copyright © 2017 Sociedade Brasileira de Pediatria. Published by Elsevier Editora Ltda. All rights reserved.)

Background: Both depressive and somatic symptoms are significant predictors of parenting and coparenting problems. However, despite clear evidence of their co-occurrence, no study to date has examined the association between depressive-somatic symptoms clusters and parenting and coparenting. The current research sought to identify and cross-validate clusters of cognitive-affective depressive symptoms and nonspecific somatic symptoms, as well as to test whether clusters would differ on parenting and coparenting problems across three independent samples of mothers., Method: Participants in Studies 1 and 3 consisted of 409 and 652 community mothers, respectively. Participants in Study 2 consisted of 162 mothers exposed to intimate partner violence. All participants prospectively completed self-report measures of depressive and nonspecific somatic symptoms and parenting (Studies 1 and 2) or coparenting (Study 3)., Results: Across studies, three depression-somatic symptoms clusters were identified: no symptoms, high depression and low nonspecific somatic symptoms, and high depression and nonspecific somatic symptoms. The high depression-somatic symptoms cluster was associated with the highest levels of child physical maltreatment risk (Study 1) and overt-conflict coparenting (Study 3). No differences in perceived maternal competence (Study 2) and cooperative and undermining coparenting (Study 3) were found between the high depression and low somatic symptoms cluster and the high depression-somatic symptoms cluster., Conclusions: The results provide novel evidence for the strong associations between clusters of depression and nonspecific somatic symptoms and specific parenting and coparenting problems. Cluster stability across three independent samples suggest that they may be generalizable. The results inform preventive approaches and evidence-based psychotherapeutic treatments., (Copyright © 2017 Elsevier B.V. All rights reserved.)

This study analyzed the mediating role of fetal heart rate variability (FHR) on prenatal depression and neonatal neurobehavioral maturity. A sample of 104 pregnant women was recruited and divided into two groups according to their Edinburgh Postnatal Depression Scale (EPDS) scores (depressed/non-depressed). FHR variability in response to speech stimuli was assessed at term (between 37 and 39 weeks gestation). The neonates were then assessed on the Neonatal Behavioral Assessment Scale (NBAS) during the first 5days after birth. The fetuses of non-depressed pregnant women showed higher HR variability than the fetuses of depressed pregnant women in response to speech stimuli, and later as neonates they performed more optimally on the NBAS (on autonomic stability and total scores). FHR variability mediated the relationship between the mother's prenatal depression and the neonatés NBAS performance. Prenatal depression effects on neonatal behavior may be partially explained by its adverse effects on fetal neurobehavioral maturity., (Copyright © 2016 Elsevier B.V. All rights reserved.)

Study Question: Does mode of conception [spontaneous/after infertility treatment (IT)], type of pregnancy (singleton/twin) and parent gender have an effect on anxiety and depression levels and trajectories during pregnancy and the post-partum period?, Summary Answer: Conception after IT was associated with a transitory increase in anxiety during the perinatal period for parents of singletons, while for IT parents of twins higher levels of psychopathological symptoms tended to persist during pregnancy and the post-partum period., What Is Known Already: Most previous studies have shown that successful IT is not associated with poor psychological well-being during pregnancy and the post-partum period, but there is also some evidence for heightened pregnancy-related anxiety, lower self-esteem and lower self-efficacy. Parents of twins experience increased postnatal anxiety and depression., Study Design, Size, Duration: This prospective longitudinal study assessed 267 couples (N = 534) at each trimester of pregnancy, after childbirth and at 3 months post-partum., Participants/materials, Setting, Method: The sample comprised 36 couples who had conceived after IT (19 twin pairs and 17 singletons) and 231 couples who had conceived spontaneously (SC; 28 twin pairs and 203 singletons). Couples were recruited at four public hospitals in Portugal, and self-report measures of anxiety and depression symptoms were administered., Main Results and the Role of Chance: IT parents reported higher anxiety after childbirth than parents who SC, regardless of pregnancy type. IT parents of twins showed higher anxiety at mid-pregnancy, as well as higher anxiety and depression at 3 months post-partum than IT parents of singletons. Among IT mothers, those who had twins exhibited higher depression after childbirth than those who had singletons. Differences according to mode of conception, pregnancy type and parents gender over time were also noted. During pregnancy, IT parents of twins showed no significant change in depression scores, while the other groups depression scores statistically significantly decreased over time. From pregnancy to the post-partum period, (i) IT parents showed an increase in anxiety scores, whereas SC parents exhibited no changes in anxiety scores; (ii) IT women exhibited an increase in depression scores, while SC women depression scores decreased. During the post-partum period, IT and SC parents of twins showed no changes in anxiety scores, while IT and SC parents of singletons anxiety scores declined., Limitations, Reasons for Caution: Due to the small number of IT couples, the interpretation and generalization of the results should be done with caution., Wider Implications of the Findings: The adverse impact of IT on psychopathological symptoms depends mostly on time and type of pregnancy, and is greater for twin pregnancies. These findings are important for tailoring interventions that address parents' specific needs at different moments., Study Funding/competing Interests: This work was supported by a grant (SFRH/BD/40146/2007) to the first author from the FCT, Foundation for Science and Technology (Portuguese Ministry of Education and Science), by the Operational Program Science and Innovation 2010 (POCI 2010) of the Community Support Board III, by FEDER Funds through the Operational Competitiveness Programme, COMPETE, and through national funding from the FCT under the projects: POCI/SAU-ESP/ 56397/2004 and PTDC/SAU/SAP/116738/2010. The authors have no conflicts of interest., (© The Author 2016. Published by Oxford University Press on behalf of the European Society of Human Reproduction and Embryology. All rights reserved. For Permissions, please email: journals.permissions@oup.com.)

Depression has been associated with sleep disturbances in pregnancy; however, no previous research has controlled the possible confounding effect of anxiety on this association. This study aims to analyze the effect of depression on sleep during the third trimester of pregnancy controlling for anxiety. The sample was composed by 143 depressed (n = 77) and non-depressed (n = 66) pregnant women who completed measures of depression, anxiety, and sleep. Differences between groups in sleep controlling for anxiety were found. Depressed pregnant women present higher number of nocturnal awakenings and spent more hours trying falling asleep during the night and the entire 24 h period. Present findings point out the effect of depression on sleep in late pregnancy, after controlling for anxiety.

Background: This prospective cohort study explored the effects of prenatal and postpartum depression on breastfeeding and the effect of breastfeeding on postpartum depression., Method: The Edinburgh Postpartum Depression Scale (EPDS) was administered to 145 women at the first, second and third trimester, and at the neonatal period and 3 months postpartum. Self-report exclusive breastfeeding since birth was collected at birth and at 3, 6 and 12 months postpartum. Data analyses were performed using repeated-measures ANOVAs and logistic and multiple linear regressions., Results: Depression scores at the third trimester, but not at 3 months postpartum, were the best predictors of exclusive breastfeeding duration (β = -0.30, t = -2.08, p < 0.05). A significant decrease in depression scores was seen from childbirth to 3 months postpartum in women who maintained exclusive breastfeeding for ⩾3 months (F 1,65 = 3.73, p < 0.10, η p 2 = 0.05)., Conclusions: These findings suggest that screening for depression symptoms during pregnancy can help to identify women at risk for early cessation of exclusive breastfeeding, and that exclusive breastfeeding may help to reduce symptoms of depression from childbirth to 3 months postpartum.

To investigate high-anxiety and depression in women and men from early pregnancy to 3-months postpartum, 260 Portuguese couples (N = 520) filled in the State-Anxiety Inventory (STAI-S) and the Edinburgh Post-Natal Depression Scale (EPDS) at the first, second, and third pregnancy trimesters, childbirth, and 3-months postpartum. Rates for high-anxiety (STAI-S ≥ 45) in women (13.1%; 12.2%; 18.2%; 18.6%; 4.7%) and men (10.1%; 8.0%, 7.8%; 8.5%; 4.4%) and for depression (EPDS ≥ 10) in women (20.0%, 19.6%, 17.4%, 17.6%; 11.1%) and men (11.3%; 6.6%; 5.5%; 7.5%; 7.2%) were high. Rates for depression were higher than rates for high-anxiety only in women during early pregnancy and the postpartum, but not at the third pregnancy trimester and childbirth. Rates for high-anxiety and depression were higher in women than in men during pregnancy/childbirth, but not at 3-months postpartum. Rates for high-anxiety but not rates for depression were higher during pregnancy/childbirth compared to 3-months postpartum and only in women. Considering that 15.9% of the parents-to-be were highly anxious and/or depressed during pregnancy-comparing to 9.3% at 3-months postpartum-particular attention should be drawn to both women's and men's mental health early in pregnancy.

This study examines physical activity patterns among women, from pre-pregnancy to the second trimester of pregnancy, and the relationship between physical activity status based on physical activity guidelines and health-related quality of life (HRQoL) and depression over pregnancy. 56 healthy pregnant women self-reported physical activity, HRQoL and depression at 10-15 and 19-24 weeks of pregnancy and physical activity before pregnancy. Whereas vigorous leisure physical activity decreased after conception, moderate leisure physical activity and work related physical activity remained stable over time. The prevalence of recommended physical activity was 39.3% and 12.5% in the 1st and 2nd trimesters of pregnancy respectively, and 14.3% pre-pregnancy. From the 1st to the 2nd pregnancy trimester, most physical HRQoL dimensions scores decreased and only mental component increased, independently of physical activity status. No changes in mean depression scores were observed. These data suggest that physical activity patterns change with pregnancy and that physical and mental components are differentially affected by pregnancy course, independently of physical activity status.

Background: High-anxiety and depression rates have been reported in women during pregnancy; however men and parity effects have not been studied as extensively. The purpose of this study was to analyze anxiety and depression in women and their partners during pregnancy, namely differences between the 1st, 2nd and 3rd pregnancy trimesters, between women and men, and between primiparous and multiparous., Methods: A sample of 300 women and their partners (n=560) were recruited during the 1st pregnancy trimester and have completed the STAI-S (State Anxiety Inventory) and the EPDS (Edinburgh Postnatal Depression Scale) in the 1st, 2nd and 3rd pregnancy trimesters., Results: Anxiety symptoms follow a U pattern in pregnancy, while depression symptoms decrease throughout pregnancy. Women show higher anxiety and depression values than men, although patterns of time variation are similar. Primiparous women and men display higher anxiety levels in the 1st than in the 3rd trimester, while multiparous register higher values in the 3rd than in the 1st pregnancy trimester., Conclusion: Different time variation in pregnancy was found for anxiety and depression symptoms; however anxiety and depression symptoms are particularly high during the 1st trimester. Intervention needs will be analyzed according to the results.

Prenatally depressed women (N=47) were randomly assigned to a group that received massage twice weekly from their partners from 20 weeks gestation until the end of pregnancy or a control group. Self-reported leg pain, back pain, depression, anxiety and anger decreased more for the massaged pregnant women than for the control group women. In addition, the partners who massaged the pregnant women versus the control group partners reported less depressed mood, anxiety and anger across the course of the massage therapy period. Finally, scores on a relationship questionnaire improved more for both the women and the partners in the massage group. These data suggest that not only mood states but also relationships improve mutually when depressed pregnant women are massaged by their partners.

Three hundred depressed pregnant women were recruited at approximately 20 weeks gestation. They were then divided by a median split into high and low urinary cortisol level groups. The high cortisol group had higher CES-D depression scores and higher inhibition (BIS) scores prenatally. Their fetuses had smaller head circumference, abdominal circumference, biparietal diameter and fetal weight. The high cortisol group neonates were shorter gestational age and lower birthweight and they had lower Brazelton habituation and higher Brazelton reflex scores. Discriminant function analyses suggested that cortisol levels more accurately classified short gestation and low birthweight groups than CES-D depression scores.

Study Question: Do mode of conception [ART versus Natural (NC)] and depression have an interactive effect on antenatal paternal adjustment and paternal attitudes?Summary Answer: Depression increased the negative effect of ART on antenatal paternal adjustment and paternal attitudes, specifically on antenatal marital relationship satisfaction.What Is Known Already: Research on antenatal paternal adjustment and paternal attitudes after ART is scarce and has produced inconsistent results.Study Design, Size, Duration: This cross-sectional study assessed 197 primiparous men (71 ART and 126 NC) during their partner's second trimester of gestation.Participants/materials, Setting, Methods: Participants were derived from three larger longitudinal studies recruited at public Health Services in Northern Portugal. All men, for who this was their first child and had filled in a socio-demographic questionnaire, measures of depression and anxiety, and antenatal paternal adjustment and paternal attitudes were selected.Main Results and the Role Of Chance: An interaction effect of mode of conception and depression was found on antenatal paternal adjustment and paternal attitudes. ART men showing high depressive symptomatology had lower antenatal marital relationship satisfaction than ART men showing low depressive symptomatology and NC men showing high or low depressive symptomatology.Limitations, Reasons For Caution: Due to the cross-sectional design of this study and the small sample size in the depression groups, the findings should be interpreted with caution.Wider Implications Of the Findings: Specialized psychological support should be available for ART men screened with high depressive symptomatology as part of routine prenatal care appointments.Study Funding/competing Interest(s): This study was conducted at Psychology Research Centre (UID/PSI/ 01662/2013), University of Minho, and at the Unidade de Investigação em Epidemiologia-Instituto de Saúde Pública da Universidade do Porto (EPIUnit) (UID/DTP/04750/2013). It was supported by the Foundation for Science and Technology (Portuguese Ministry of Education and Science) through National funds and co-financed by FEDER through COMPETE2020 under the PT2020 Partnership Agreement (POCI-01-0145-FEDER-007653) and through the Operational Programme Factors of Competitiveness-COMPETE within the project 'Health, Governance and Accountability in Embryo Research: Couples' Decisions About the Fates of Embryos' (FCOMP-01-0124-FEDER-014453), the FCT Investigator contract IF/01674/2015 and PhD grants (SFRH/BD/115048/2016, SFRH/BD/75807/2011 and SFRH/BD/40146/2007). The authors have no conflicts of interest. [ABSTRACT FROM AUTHOR]