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Maternal mental health is a critical component of overall well-being for mothers and their families, yet it is often influenced by a complex array of factors beyond biological and psychological considerations. Among these, sociocultural influences play a significant role in shaping maternal mental health outcomes. This paper explores the impact of sociocultural factors on maternal mental health, with a focus on how cultural values, societal expectations, and access to support systems shape the mental well-being of mothers. By examining these influences, this study aims to better understand the diverse experiences of motherhood and to identify culturally sensitive interventions that can improve maternal mental health outcomes across different populations.

BackgroundPregnant people are vulnerable to new or worsening mental health conditions. This study aims to describe prevalence and course of depression and anxiety symptoms in pregnancy during the pre-vaccine COVID-19 pandemic.MethodsThis is a prospective cohort study of pregnant individuals with known or suspected COVID-19. Participants completed Edinburgh Postnatal Depression Scale (EPDS) and Generalized-Anxiety Disorder-7 (GAD-7) questionnaires, screening tools for depression and anxiety, at 34weeks gestational age, 6-8weeks postpartum, and 6months postpartum. Prevalence of elevated depressive and anxiety symptoms at each visit was described. Univariable logistic regression analysis was used to determine the association between demographic and clinical factors and those with elevated depression or anxiety symptoms.Results317 participants were included. The prevalence of elevated antepartum depression symptoms was 14.6%, 10.3%, and 20.6% at 34weeks gestational age, 6-8weeks postpartum, and 6months postpartum, respectively. The rate of elevated anxiety symptoms was 15.1%, 10.0%, and 17.3% at 34weeks gestational age, 6-8weeks postpartum, and 6months postpartum, respectively. A prior history of depression and/or anxiety (p's

OBJECTIVE: We sought to examine trends in diagnosed behavioral health (BH) conditions [mental health (MH) disorders or substance use disorders (SUD)] among pregnant and postpartum individuals between 2008-2020. We then explored the relationship between BH conditions and race/ethnicity, acknowledging race/ethnicity as a social construct that influences health disparities. METHODS: This study included delivering individuals, aged 15-44 years, and continuously enrolled in a single commercial health insurance plan for 1 year before and 1 year following delivery between 2008-2020. We used BH conditions as our outcome based on relevant ICD 9/10 codes documented during pregnancy or the postpartum year. RESULTS: In adjusted analyses, white individuals experienced the highest rates of BH conditions, followed by Black, Hispanic, and Asian individuals, respectively. Asian individuals had the largest increase in BH rates, increasing 292%. White individuals had the smallest increase of 192%. The trend remained unchanged even after adjusting for age and Bateman comorbidity score, the trend remained unchanged. CONCLUSIONS: The prevalence of diagnosed BH conditions among individuals in the perinatal and postpartum periods increased over time. As national efforts continue to work toward improving perinatal BH, solutions must incorporate the needs of diverse populations to avert preventable morbidity and mortality.

ABSTRACT This systematic review and meta‐analyses aim to synthesise evidence about behavioural interventions to address dysregulated sleeping and cry/fuss behaviour in infants aged up to 12 months and the effects on infant behaviour and maternal mental health. A systematic literature search of English‐language publications was performed in November 2020 and updated in May 2023 using Medline, Embase, PsychInfo and Cinahl Plus. Twenty‐two papers reporting twenty studies met inclusion criteria of these sixteen papers reported both maternal and infant outcomes. Although, there is heterogeneity of the investigations, their results are broadly consistent. Parents who attended a behavioural intervention program for unsettled behaviours in infants reported improvement of their mental health and parenting confidence, and unsettled infant behaviours were improved including a reduction of night waking and cry/fuss behaviour. This review and meta‐analyse provides evidence that behavioural interventions show a mild to moderate improvement in unsettled infant behaviour and maternal mental health. [ABSTRACT FROM AUTHOR]

Low social support has been identified as a risk factor for maternal perinatal mental health problems. However, previous studies have predominantly focused on general social support or support from the partner, often overlooking the roles of grandparents. This mini review discusses recent developments in perinatal health research showing that supportive grandparents may constitute a protective factor against the development of maternal perinatal mental health problems. In addition, we will discuss how grandparental support may promote fetal and child health. The mini review concludes with a call for more research on the role of grandparents in perinatal health. Recognizing grandmothers as collaborators in maternal and child health may afford more effective perinatal health programs and clinical practice, thereby reducing the risk of adaptational and developmental problems. [ABSTRACT FROM AUTHOR]

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

Objective: The English‐language Postpartum Specific Anxiety Scale (PSAS) is a valid, reliable measure for postpartum anxiety (PPA), but its 51‐item length is a limitation. Consequently, the PSAS Working Group developed the PSAS Research Short‐Form (PSAS‐RSF), a statistically robust 16‐item tool that effectively assesses PPA. This study aimed to assess and validate the reliability of an Arabic‐language version of the PSAS‐RSF in Jordan (PSAS‐JO‐RSF). Methods: Using a cross‐sectional methodological design, a sample of Arabic‐speaking mothers (N = 391) with infants aged up to 6 months were recruited via convenience sampling from a prominent tertiary hospital in northern Jordan. Factor analysis, composite reliability (CR), average variance extracted (AVE), McDonald's ω, and inter‐item correlation measures were all examined. Results: Explanatory factor analysis revealed a four‐factor model consistent with the English‐language version of the PSAS‐RSF, explaining a cumulative variance of 61.5%. Confirmatory factor analysis confirmed the good fit of the PSAS‐JO‐RSF (χ2/df = 1.48, CFI = 0.974, TLI = 0.968, RMSEA = 0.039, SRMR = 0.019, p < 0.001). The four factors demonstrated acceptable to good reliability, with McDonald's ω ranging from 0.778 to 0.805, with 0.702 for the overall scale. The CR and AVE results supported the validity and reliability of the PSAS‐JO‐RSF. Conclusion: This study establishes an Arabic‐language version of the PSAS‐JO‐RSF as a valid and reliable scale for screening postpartum anxieties in Jordan. [ABSTRACT FROM AUTHOR]

Depression is associated with alterations in prosody when speaking (e.g., less variation in pitch, slowed speech rate), but less is known about its impact on emotional prosody. This is particularly important to investigate in parent–child contexts, as parental expression of emotion may contribute to the intergenerational transmission of depression risk. The current study asked mothers of preschool-aged children (with and without a history of major depressive disorder during their child's lifetime) to produce child-relevant sentences in neutral, angry, and happy tones of voice. We examined whether groups' portrayals were acoustically or perceptually different, in speech analyses and listener ratings. Mothers with a history of depression expressed happiness with less range in pitch and a slower speech rate (slower, more monotonous voice) than mothers with no history of depression. Across groups, happy exemplars with less range in pitch were rated as less emotionally intense, recognizable, and authentically happy by listeners; slower speech rate was associated with opposite perceptual ratings. However, listeners' ratings did not differ by depression group as a whole. Results suggest that a history of depression may influence maternal vocal expression of happiness, but that its impact on listeners' perceptions may depend on mothers' idiosyncratic use of acoustic cues. [ABSTRACT FROM AUTHOR]

A growing body of research reveals a connection between maternal incarceration and various child development outcomes. Even so, little is known about how the timing of maternal incarceration may shape the social–emotional development of young children and the role of maternal mental health in mediating this association. Using a sample of 1097 mothers (18–52 years old, 47.6% white) and children (aged 12–48 months) receiving home visiting services in Wisconsin, this study examined the intergenerational effect of incarceration before a child's birth on child social–emotional development, and whether this association was mediated by maternal mental health. While incarceration prior to a child's birth was not directly associated with child social–emotional outcomes, path analysis revealed an indirect association between mother's incarceration prior to a child's birth and child social–emotional problems through maternal mental health problems. Findings suggest that formerly incarcerated mothers may experience long-lasting mental health concerns that can undermine child social–emotional development. To optimize outcomes, practitioners may consider services that address the mental health, social support, and instrumental needs of mothers and children who have been impacted by mass incarceration. [ABSTRACT FROM AUTHOR]

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

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

Introduction: Prenatal mental health problems are associated with morbidity for the pregnant person, and their infants are at long-term risk for poor health outcomes. We aim to explore how the SARS-CoV-2 pandemic affected the mental health of pregnant people in the United Kingdom (UK), and to further identify resilience factors which may have contributed to varying mental health outcomes. We also aim to examine the quality of antenatal care provided during the pandemic in the UK and to identify potential inadequacies to enhance preparedness for future events. Methods: During June-November 2020, we recruited 3666 individuals in the UK for the EPPOCH pregnancy cohort (Maternal mental health during the COVID-19 pandemic: Effect of the Pandemic on Pregnancy Outcomes and Childhood Health). Participants were assessed for depression, anxiety, anger and pregnancy-related anxiety using validated scales. Additionally, physical activity, social support, individualized support and personal coping ability of the respondents were assessed as potential resilience factors. Results: Participants reported high levels of depression (57.05%), anxiety (58.04%) and anger (58.05%). Higher levels of social and individualized support and personal coping ability were associated with lower mental health challenges. Additionally, pregnant individuals in the UK experienced higher depression during the pandemic than that reported in Canada. Finally, qualitative analysis revealed that restrictions for partners and support persons during medical appointments as well as poor public health communication led to increased mental health adversities and hindered ability to make medical decisions. Discussion: This study revealed increased mental health challenges among pregnant individuals in the UK during the SARS-CoV-2 pandemic. These results highlight the need for reassessing the mental health support measures available to pregnant people in the UK, both during times of crisis and in general. [ABSTRACT FROM AUTHOR]

Introduction: The United States is the only high-income country without a comprehensive national maternity leave policy guaranteeing paid, job-projected leave. The current study examined associations between maternity leave characteristics (duration of leave, payment status of leave) and postpartum depressive symptoms. Methods: This study used a sample of 3,515 postpartum women from the New York City and New York State Pregnancy Risk Assessment Monitoring System (PRAMS) from 2016 to 2019. We used logistic regression to examine the association of leave duration and payment status with self-reported postpartum depressive symptoms between 2 and 6 months postpartum. Results: Compared to having at least some paid leave, having unpaid leave was associated with an increased odds of postpartum depressive symptoms, adjusting for leave duration and selected covariates (adjusted odds ratio [aOR] = 1.41, 95% confidence interval [CI]: 1.04–1.93). There was no significant difference in postpartum depressive symptoms between those with partially and those with fully paid leave. In contrast to prior literature, leave duration was not significantly associated with postpartum depressive symptoms (aOR = 0.99, 95% CI: 0.97–1.02 for each additional week of leave). Discussion: This study suggests that unpaid leave is associated with increased risk of postpartum depression, which can have long-term health effects for both mothers and children. Future studies can help to identify which communities could most benefit from paid leave and help to inform paid leave policies. Significance: What is already known on this subject?: Postpartum depression can have long-term consequences for maternal and child health. Longer maternity leave duration and paid maternity leave have been linked with better maternal mental health, though more recent studies in the U.S. context are needed. What this study adds?: This study is one of the few investigations of postpartum mental health to examine leave duration and paid leave individually and in combination. We found that mothers with unpaid leave were 40% more likely to experience depression than those with paid leave and that payment status was more important than leave duration. [ABSTRACT FROM AUTHOR]

There is evidence of an overall decline in women's mental health, particularly those with young children, in the wake of the COVID-19 pandemic. However, research has also found heterogeneity in women's mental health responses. This longitudinal study sampled low-income women with young children by recruiting from the government's child care financial subsidy waitlist. To examine heterogeneity in women's mental health responses to COVID-19, a latent transition analysis was employed to identify profiles of anxiety, depression, and stress among 289 low-income mothers. Using these identified profiles, we examined the transitional patterns between profiles before and during COVID-19 and the sociodemographic and familial factors related to these profiles. A three-profile solution was identified prior to COVID-19 and a four-profile solution during COVID-19, with some profiles exhibiting qualitatively different defining characteristics. Latent transition analyses found diverse patterns of mental health changes after the onset of COVID-19. Mothers with better mental health prior to COVID-19 tended to have the most stable mental health during COVID-19. In contrast, mothers who were highly stressed prior to COVID-19 were equally likely to improve or decline after the onset of the pandemic. In addition, the relationships between race, parenting practices, child temperament, and child mental health were significantly related to mothers' mental health profiles. These findings describe mothers' experiences and areas where policymakers and practitioners can tailor support to low-income women with young children. Significance: What is already known on this subject?: There is a bidirectional relationship between maternal and child mental health. Child and maternal mental health challenges increased, on average, during the COVID-19 pandemic. What this study adds?: A person-centred longitudinal approach is an effective tool for identifying maternal mental health profiles over time. It provides a more nuanced understanding of how mothers' mental health is impacted. Low-income mothers' responses to the pandemic were heterogeneous and did not uniformly decline as previously (majorly) reported. In addition, poor maternal and child mental health and difficult child temperament pre-COVID-19 were risk factors for poor mental health trajectories in mothers from low-income families. [ABSTRACT FROM AUTHOR]

Inpatient parent–infant psychiatric units (PIUs) are considered "gold standard" for treating maternal mental illness, with well‐documented positive outcomes for mothers. However, little research addresses outcomes for infants in these units, who often face significant developmental and socio‐emotional adversity. This pilot study aimed to evaluate the characteristics and progress of an Australian PIU population, focusing on the impact of PIU admission on infant outcomes. Over 3 months, 31 consecutively admitted mother–infant pairs (dyads) were assessed through interviews, observations, and standardized measures to evaluate maternal and infant characteristics and progress from admission to discharge. Maternal well‐being and the mother–infant relationship improved. Infants exhibited high levels of physical (29%) and developmental concerns (80.6%). 22.6% receiving an Axis I infant mental health diagnosis. Infant socio‐emotional responsiveness improved significantly, as measured by the modified Alarm‐Distress Baby Scale, indicating a positive impact of PIU admission. The small sample size and reliance on clinician‐observed measures limit the generalizability of the findings. PIU infants are particularly vulnerable, and PIU admission may ameliorate socio‐emotional responsiveness. Further research with larger samples and extended follow‐up is needed to determine the most effective intervention strategies during and after PIU admission to maximize benefits for these infants. [ABSTRACT FROM AUTHOR]

Aim: To clarify the concept of fear of childbirth among pregnant women and to examine its current measure tools. Background: Fear of childbirth is a psychological symptom, prevalent among pregnant women, which negatively impacts women's health and well‐being. It has become an increasingly concerning issue in perinatal mental health. However, due to its poor conceptualization, it presents difficulty in conducting reliable assessments and identifying risk factors. Methods: The Walker and Avant approach to concept analysis guided this review. Six bibliographic databases were systematically searched for published research from their inception date to May 2023. Additional records were identified by manually searching the reference lists of relevant studies. Quantitative and qualitative studies investigating fear of childbirth in pregnant women were included. Results: Three critical attributes have been identified: cognitive impairments, affective disorders and somatic symptoms. Antecedents include perceived a real or anticipated threat of pregnancy or its outcomes, low perceived self‐coping ability and unmet social support needs. Consequences include processing and avoiding behaviours. This study also identified the dimensions of fear of childbirth, including 6 primary categories and 14 subcategories. The content of five scales was analysed and none covered all domains. Conclusions: The current analysis provides healthcare providers with a more comprehensive framework to assess and identify fear of childbirth. Further research is needed to develop a suitable instrument that covers all the attributes and dimensions of this concept and assesses its severity. Impact: This conceptual analysis provides a comprehensive insight into the phenomenon of fear of childbirth. This will help family members, healthcare providers and policymakers to identify the psychological needs of pregnant women and improve the quality of antenatal care. Patient or Public Contribution: Not applicable as no new data were generated. [ABSTRACT FROM AUTHOR]

• Mental health of women with fetal anomaly diagnoses is understudied. • Emotion regulation and inflammation may predict risk of poor mental health. • Reappraisal and IL-6 predicted resilience and depressive symptoms. • Reappraisal and insurance status predicted anxiety and posttraumatic stress symptoms. Fetal anomalies occur in approximately 3% of pregnancies and receiving the diagnosis may be a potentially traumatic experience for families. The mental health of mothers receiving diagnoses and what predicts resilience or poor mental health is understudied. Emotion regulation is an important, modifiable, transdiagnostic factor of mental health, and may be protective post-diagnosis. Evaluating biomarkers of stress, including IL-6 and Allostatic Load (AL), can also serve as early indicators of risk, indicative of early intervention. This study assessed whether reappraisal, suppression, IL-6, and AL was associated with mental health outcomes and resilience in women after receiving a fetal anomaly diagnosis. Pregnant women (N=108) presenting to a fetal concerns clinic for initial consultation completed measures of emotion regulation (i.e., reappraisal and suppression), depression, anxiety, posttraumatic stress symptoms, and resilience between 2019–2022. A blood draw was used to assess IL-6 and create composite allostatic load measure including: IL-6, blood pressure, heart rate, glucose, cortisol, and body mass index. Linear regressions controlling for age, gestational age, and perceived fetal diagnosis severity, demonstrated that IL-6 was negatively associated with resilience and positively associated with depression. Reappraisal was positively associated to resilience and negatively associated with depression, anxiety, and PTSD, whereas state insurance status was positively associated to anxiety and PTS symptoms. Suppression and allostatic load were not significant. Women experiencing fetal anomaly diagnosis represent an understudied population with unaddressed mental health needs. Reappraisal serves as not only a protective factor, but one that can be enhanced to promote maternal resilience and mental health. Furthermore, elevated IL-6 may be a critical early indicator of potential intervention needs among women who are pregnant, to mitigate negative psychological states and enhance resilience. [ABSTRACT FROM AUTHOR]

Parenting has been found to be highly contextually and culturally determined and there have been calls to research parenting within culture as it is lived. Due to changing social and economic factors, middle-class South African mothers face unique challenges in relation to the navigation of culture and class in child-rearing. Foregrounding the complexity of acculturation, this paper uses social constructionist theory in the analysis of maternal narratives and responses to video-recordings of their interaction with their infants, of a group of middle-class South African mothers from various cultural and racial groups, with an aim to understanding how mothering is changing amongst middle-class South African mothers. The findings suggest that acculturation is complex and influenced by a combination of socioeconomic status, geographical location, contact with other cultural groups and personal emotional experiences of having been parented within a particular culture. [ABSTRACT FROM AUTHOR]

To determine the prevalence of postpartum depression (PPD) and postpartum stress (PPS) and identify associated risk factors among mothers of preterm and low birth weight (LBW) infants. We conducted a secondary analysis of data collected from 255 mothers with preterm and LBW infants admitted to the neonatal intensive care unit (NICU) at Korle‐Bu Teaching Hospital, Accra, Ghana. A standardized interviewer‐administered questionnaire collected data on maternal, pregnancy, birth, and infant characteristics. The questionnaire also included the Patient Health Questionnaire‐9 (PHQ‐9) and the Perceived Stress Scale‐4 (PSS‐4) to assess PPD and PPS, respectively. Simple and multivariable linear regression analyses were performed to identify factors associated with PPD and PPS. The prevalence of moderate to moderately severe PPD was 3.9%, and that of PPS was 43.5%. The multivariable linear regression analysis showed that an increased number of prenatal care visits (β‐estimate = 0.26; 95% confidence interval [CI] 0.08–0.43; P < 0.01) was positively associated with higher scores on the PHQ‐9, whereas gestational age at birth (β = −0.21; 95% CI –0.40 to −0.03; P = 0.02) was inversely associated with PHQ‐9 scores. Moreover, a longer gestational period at the first prenatal care visit (β = 0.25; 95% CI 0.05–0.45; P = 0.01) and following the Islamic religion were associated with elevated scores on the PSS‐4 (β = 0.95; 95% CI 0.11−1.80; P = 0.011). Our findings underscore the presence of moderate PPD levels and high PPS levels among mothers. Active screening, diagnosis, and treatment for mothers at risk of mental health disorders during the peripartum period could enhance coping mechanisms for mothers navigating the challenging NICU environment and transitioning to the home environment. [ABSTRACT FROM AUTHOR]

Background: This study evaluated an online childbirth education course on childbirth self-efficacy and, subsequent birth related posttraumatic stress disorder (PTSD) symptoms and mother-infant relationship quality. Method: Three group (intervention, passive control, active control) parallel randomised controlled trial. Groups were assigned using computer generated random allocation. For the passive control group participants were instructed to carry on with whatever they were currently undertaking with their pregnancy, while the active control group were asked to read a booklet comprised of twelve birth stories. The purpose of the active control was to check if the act of having an activity to complete would influence outcomes. For the online course group (intervention) participants were asked to complete the online version of a birthing course designed by She Births®. One hundred and twenty-five women residing in Australia between 12 and 24 weeks pregnant were recruited online. Participants were asked to complete their required activity between 24 and 36 weeks pregnant. Childbirth self-efficacy scores were tested pre and post intervention (time one and time 2), PTSD symptoms and mother-infant relationship quality were tested at six weeks and six months postnatal. Results: There was no significant interaction by group for childbirth self-efficacy scores. Mean difference scores at time one (pre-intervention) and time two (post-intervention) for each group indicated a trend in the online group towards higher childbirth self-efficacy compared with the two control groups. The main effect of group on birth related PTSD scores was not statically significant at six weeks postnatal or at six months postnatal. The main effect of group on mother-infant relationship scores was not statically significant at six weeks postnatal or six months postnatal. Conclusions: Trends showed childbirth self-efficacy scores to be higher in the intervention group compared with the two control groups, demonstrating effectiveness for the intervention. Paradoxically, PTSD scores were higher in the intervention group compared with the two control groups and therefore also reported poorer mother-infant relationship quality. External factors may be more important than childbirth self-efficacy highlighting the need for a holistic approach that addresses systemic and socio-political influences to improve communication, autonomy, and respectful maternity care. Trial Registration: This trial was retrospectively registered with the Australian New Zealand Clinical Trials Registry number: ACTRN12624000241538 on March 11, 2024. [ABSTRACT FROM AUTHOR]

Background: Pregnancy and childbirth are critical life events which lead to significant changes in family structures and roles, thus having a substantial impact on partner relationship and maternal wellbeing. A dysfunctional partnership during this critical time of life has been associated with maternal depressiveness. However, sub-components of partnership quality and the causal relation with maternal symptoms of depression in the perinatal period have been sparsely studied so far. The current study aims to longitudinally assess the course of relationship quality and its sub-components from pregnancy to postpartum and to test a potential causal association with maternal symptoms of depression in the perinatal period. Methods: Differing from previous studies, partnership quality and symptoms of depression have been assessed prospectively and longitudinally from an early stage of pregnancy (second trimester) until six months postpartum. Cross-lagged panel models were applied to investigate a potential causal relationship between partnership quality and maternal depressive symptoms. Results: Relationship quality decreased significantly during the transition to parenthood (p <.05) with the steepest decline referring to tenderness (p <.001). We also found a substantial association of relationship quality and maternal depressiveness, but no indication for a clear causal direction of this association. Conclusions: Our results suggest that relationship quality and maternal depressiveness are substantially related in the perinatal period, thus pointing to the need of early prevention and intervention programs for peripartum women and their partners to prevent adverse outcome for the couple and the family. [ABSTRACT FROM AUTHOR]

Introduction: Prenatal mental health problems are associated with morbidity for the pregnant person, and their infants are at long-term risk for poor health outcomes. We aim to explore how the SARS-CoV-2 pandemic affected the mental health of pregnant people in the United Kingdom (UK), and to further identify resilience factors which may have contributed to varying mental health outcomes. We also aim to examine the quality of antenatal care provided during the pandemic in the UK and to identify potential inadequacies to enhance preparedness for future events. Methods: During June-November 2020, we recruited 3666 individuals in the UK for the EPPOCH pregnancy cohort (Maternal mental health during the COVID-19 pandemic: Effect of the Pandemic on Pregnancy Outcomes and Childhood Health). Participants were assessed for depression, anxiety, anger and pregnancy-related anxiety using validated scales. Additionally, physical activity, social support, individualized support and personal coping ability of the respondents were assessed as potential resilience factors. Results: Participants reported high levels of depression (57.05%), anxiety (58.04%) and anger (58.05%). Higher levels of social and individualized support and personal coping ability were associated with lower mental health challenges. Additionally, pregnant individuals in the UK experienced higher depression during the pandemic than that reported in Canada. Finally, qualitative analysis revealed that restrictions for partners and support persons during medical appointments as well as poor public health communication led to increased mental health adversities and hindered ability to make medical decisions. Discussion: This study revealed increased mental health challenges among pregnant individuals in the UK during the SARS-CoV-2 pandemic. These results highlight the need for reassessing the mental health support measures available to pregnant people in the UK, both during times of crisis and in general. [ABSTRACT FROM AUTHOR]

Background: Postpartum Anxiety [PPA] is a prevalent problem in society, posing a significant burden to women, infant health, and the National Health Service [NHS]. Despite this, it is poorly detected by current maternal mental health practices. Due to the current lack of appropriate psychometric measures, insufficiency in training of healthcare professionals, fragmentation of maternal mental healthcare policy and practice, and the magnitude of the effects of PPA on women and their infants, PPA is a critical research priority. This research aims to develop a clear understanding from key stakeholders, of the current landscape of maternal mental health and gain consensus of the needs associated with clinically identifying, measuring, and targeting intervention for women with PPA, in the NHS. Methods: Four focus groups were conducted with a total of 21 participants, via Zoom. Data were analysed using Template Analysis. Results: Analysis rendered four main themes: (1) Defining Postpartum Anxiety; (2) Postpartum Anxiety in Relation to other Mental Health Disorders; (3) Challenges to Measurement and Identification of Maternal Mental Health; and (4) An Ideal Measure of Postpartum Anxiety. Conclusions: Findings can begin to inform maternal mental healthcare policy as to how to better identify and measure PPA, through the implementation of a postpartum-specific measure within practice, better training and resources for staff, and improved interprofessional communication. [ABSTRACT FROM AUTHOR]

This study examined modifiable caregiver factors influencing child development in Malawi using baseline data from 1,021 mothers and their children <2 years of age participating in a cluster‐randomized controlled trial implemented in rural Malawi (2022–2025). We fit an evidence‐based theoretical model using structural equation modelling examining four caregiver factors: (1) diet diversity (sum of food groups consumed in the past 24 h), (2) empowerment (assessed using the project‐level Women's Empowerment in Agriculture Index), (3) mental health (assessed using the Self‐Reported Questionnaire, SRQ‐20), and (4) stimulation (number of stimulation activities the mother engaged in the past 3 days). Child development was assessed using the Malawi Development Assessment Tool (norm‐referenced aggregate Z‐score). The model controlled for child, caregiver, and household socioeconomic characteristics. Results showed that caregiver dietary diversity was directly associated with higher child development scores (standardized coefficient 0.091 [95% CI 0.027, 0.153]) and lower SRQ‐20 scores −0.058 (−0.111, −0.006). Empowerment was directly associated with higher child development scores (0.071 [0.007, 0.133]), higher stimulation score (0.074 [0.013, 0.140]), higher dietary diversity (0.085 [0.016, 0.145]), and lower SRQ‐20 scores (−0.068 [−0.137, −0.002]). Further, higher empowerment was indirectly associated with improved child development through enhancement of caregiver dietary diversity, with an indirect effect of 0.008 (0.002, 0.018). These findings highlight the important role that caregiver diet and empowerment play in directly influencing child development and other aspects of caregiver well‐being. Interventions aimed at enhancing child development should consider these factors as potential targets to improve outcomes for children and caregivers. Key messages: Caregiver diet and empowerment were associated with child development in children <2 years of age in rural Malawi.Caregiver diet was associated with improved caregiver mental health.Caregiver empowerment was directly associated with improved caregiver diet, mental health, and stimulation practices.Caregiver empowerment was indirectly associated with child development via improved caregiver diet.Interventions aimed at enhancing child development can focus on caregiver diet and empowerment as potential targets to improve outcomes for both children and their caregivers. [ABSTRACT FROM AUTHOR]

Introduction: Pregnancy is an incredibly stressful period due to outcome of delivery, anxious about the well-being of the unborn child, added responsibilities once the child is born, financial obligations, adapting to her postpartum body, interpersonal relationships with her spouse and other family members. Aim & Objectives: 1. To determine whether higher anxiety levels in term patients has significant effects on the duration, progress and complications of labour, 2.To assess whether significant maternal anxiety can lead to an increase in caesarean sections or instrumental deliveries, 3.To assess the difference in anxiety levels between term primigravida and term multigravida. Methodology: The study was a descriptive cross-sectional study conducted in the Department of Obstetrics and Gynecology in IGMC&RI. Antenatal women in the low-risk group with gestational age more than or equal to 37 weeks, who gave consent for participation were included in the study. Antenatal women who refused to give consent or those with known co-morbidities complicating labour like gestational diabetes mellitus, pregnancy induced hypertension, multiple gestation, breech presentation, placental abnormalities like placenta previa or abruption, previous history of caesarean section and cephalo - pelvic disproportion were excluded. Results: The demographic details of the participants are shown in Table 1. Out of the 269 participants analysed for the study, Majority of them were housewives, belonged to the age group of 25-30 years (40%). Majority were graduates (49%) and pregnant for the first time (primi) (56.1%). Conclusion: The significance of this study is that maternal anxiety was found positive in about 105 patients, among which 19 participants had severe anxiety. These anxiety scores if known during the antenatal chechups can help in interventions for the betterment of maternal health including guidance and counselling [ABSTRACT FROM AUTHOR]

(1) Background: Prenatal depression, maternal anxiety, puerperal psychosis, and suicidal thoughts affect child welfare and development and maternal health and mortality. Women in low-income countries suffer maternal mental health issues in 25% of cases during pregnancy and 20% of cases thereafter. However, MMH screening, diagnosis, and reporting are lacking. The primary goals of the present study are twofold, as follows: firstly, to evaluate the importance of screening maternal mental health to alleviate perinatal depression and maternal anxiety, and, secondly, to analyze research patterns and propose novel approaches and procedures to bridge the current research gap and aid practitioners in enhancing the quality of care offered to women exhibiting symptoms of perinatal depression. (2) Methods: We conducted a bibliometric analysis to analyze the research topic, using the bibliometric tools Biblioshiny and VOSviewer, as well as the R statistical programming language. To accomplish our goal, we obtained a total of 243 documents from the Scopus and PubMed databases and conducted an analysis utilizing network, co-occurrence, and multiple correlation approaches. (3) Results: Most of the publications in the field were published between the years 2021 and 2024. The results of this study highlight the significance of shifting from conventional screening methods to digital ones for healthcare professionals to effectively manage the symptoms of maternal mental health associated with postpartum depression. Furthermore, the results of the present study suggest that digital screening can prevent maternal physical morbidity, contribute to psychosocial functioning, and enhance infant physical and cognitive health. (4) Conclusions: The research indicates that it is crucial to adopt and include a computerized screening practice to efficiently and immediately detect and clarify the signs of prenatal to neonatal depression. The introduction of digital screening has led to a decrease in scoring errors, an improvement in screening effectiveness, a decrease in administration times, the creation of clinical and patient reports, and the initiation of referrals for anxiety and depression therapy. [ABSTRACT FROM AUTHOR]

Background: Early relational health (ERH) interventions can buffer toxic stress and improve the developmental trajectories of neonatal intensive care unit (NICU) infants. Purpose: The purpose was to examine the current state of the science related to multimodal, dyadic ERH interventions implemented in the NICU setting in the United States and identify gaps in the current literature. Data Sources: PubMed, Scopus, Cumulative Index to Nursing and Allied Health Literature (CINAHL), and PsycInfo were searched in November 2022 and November 2023 for original studies and conference proceedings from 1970 to present in the English language. Gray literature searches were performed in February 2023 and December 2023. Study Selection: English language, original research, with a focus on multimodal, dyadic ERH interventions that took place primarily in a NICU in the United States were included. Outcome measures could be related to implementation, relational health, or physical and/or mental health outcomes of parent and/or infant. Eighteen of 2021 reviewed articles met the inclusion criteria. Data Extraction: Data were extracted for author, year, intervention, purpose, methods, sample, paternal inclusion, dyadic components, non-dyadic components, and major outcomes/results and distilled for study characteristics, multimodal, dyadic intervention characteristics, and outcome measures. Results: Several multimodal dyadic interventions exist to aid ERH in the NICU, providing evidence of improved outcomes for infants and families. More research is required using higher sample sizes and replication studies. Implications for Practice and Research: ERH interventions show promise in improving neurodevelopmental, behavioral, and maternal mental health outcomes and should be considered for implementation into NICU services. [ABSTRACT FROM AUTHOR]

Abstract Background Postpartum Anxiety [PPA] is a prevalent problem in society, posing a significant burden to women, infant health, and the National Health Service [NHS]. Despite this, it is poorly detected by current maternal mental health practices. Due to the current lack of appropriate psychometric measures, insufficiency in training of healthcare professionals, fragmentation of maternal mental healthcare policy and practice, and the magnitude of the effects of PPA on women and their infants, PPA is a critical research priority. This research aims to develop a clear understanding from key stakeholders, of the current landscape of maternal mental health and gain consensus of the needs associated with clinically identifying, measuring, and targeting intervention for women with PPA, in the NHS. Methods Four focus groups were conducted with a total of 21 participants, via Zoom. Data were analysed using Template Analysis. Results Analysis rendered four main themes: (1) Defining Postpartum Anxiety; (2) Postpartum Anxiety in Relation to other Mental Health Disorders; (3) Challenges to Measurement and Identification of Maternal Mental Health; and (4) An Ideal Measure of Postpartum Anxiety. Conclusions Findings can begin to inform maternal mental healthcare policy as to how to better identify and measure PPA, through the implementation of a postpartum-specific measure within practice, better training and resources for staff, and improved interprofessional communication.

Abstract Background This study evaluated an online childbirth education course on childbirth self-efficacy and, subsequent birth related posttraumatic stress disorder (PTSD) symptoms and mother-infant relationship quality. Method Three group (intervention, passive control, active control) parallel randomised controlled trial. Groups were assigned using computer generated random allocation. For the passive control group participants were instructed to carry on with whatever they were currently undertaking with their pregnancy, while the active control group were asked to read a booklet comprised of twelve birth stories. The purpose of the active control was to check if the act of having an activity to complete would influence outcomes. For the online course group (intervention) participants were asked to complete the online version of a birthing course designed by She Births®. One hundred and twenty-five women residing in Australia between 12 and 24 weeks pregnant were recruited online. Participants were asked to complete their required activity between 24 and 36 weeks pregnant. Childbirth self-efficacy scores were tested pre and post intervention (time one and time 2), PTSD symptoms and mother-infant relationship quality were tested at six weeks and six months postnatal. Results There was no significant interaction by group for childbirth self-efficacy scores. Mean difference scores at time one (pre-intervention) and time two (post-intervention) for each group indicated a trend in the online group towards higher childbirth self-efficacy compared with the two control groups. The main effect of group on birth related PTSD scores was not statically significant at six weeks postnatal or at six months postnatal. The main effect of group on mother-infant relationship scores was not statically significant at six weeks postnatal or six months postnatal. Conclusions Trends showed childbirth self-efficacy scores to be higher in the intervention group compared with the two control groups, demonstrating effectiveness for the intervention. Paradoxically, PTSD scores were higher in the intervention group compared with the two control groups and therefore also reported poorer mother-infant relationship quality. External factors may be more important than childbirth self-efficacy highlighting the need for a holistic approach that addresses systemic and socio-political influences to improve communication, autonomy, and respectful maternity care. Trial Registration This trial was retrospectively registered with the Australian New Zealand Clinical Trials Registry number: ACTRN12624000241538 on March 11, 2024.

Abstract Background Pregnancy and childbirth are critical life events which lead to significant changes in family structures and roles, thus having a substantial impact on partner relationship and maternal wellbeing. A dysfunctional partnership during this critical time of life has been associated with maternal depressiveness. However, sub-components of partnership quality and the causal relation with maternal symptoms of depression in the perinatal period have been sparsely studied so far. The current study aims to longitudinally assess the course of relationship quality and its sub-components from pregnancy to postpartum and to test a potential causal association with maternal symptoms of depression in the perinatal period. Methods Differing from previous studies, partnership quality and symptoms of depression have been assessed prospectively and longitudinally from an early stage of pregnancy (second trimester) until six months postpartum. Cross-lagged panel models were applied to investigate a potential causal relationship between partnership quality and maternal depressive symptoms. Results Relationship quality decreased significantly during the transition to parenthood (p

Early life adversity is a potent risk factor for poor mental health outcomes across the lifespan, including offspring vulnerability to psychopathology. Developmentally, the prenatal period is a sensitive window in which maternal early life experiences may influence offspring outcomes and demarcates a time when expectant mothers and offspring are more susceptible to stressful and salutary influences. This prenatal plasticity constituted the focus of the current study where we tested the association of maternal early life adversity with infant stress regulation through maternal prenatal internalizing symptoms and moderation by prenatal social support. Mother-infant dyads (n = 162) were followed prospectively and mothers completed assessments of social support and depressive and anxiety symptoms across pregnancy. Infants completed standardized stress paradigms at one month and six months. There were several key findings. First, maternal prenatal depressive symptoms significantly mediated predictions of infant cortisol reactivity to the heel stick at one month from maternal early life adversity: specifically, maternal early life adversity positively predicted depressive symptoms in pregnancy, which in turn predicted dampened infant cortisol reactivity. Second, prenatal social support did not significantly moderate predictions of depressive or anxiety symptoms in pregnancy from maternal early life adversity nor did it alter the associations of maternal depressive or anxiety symptoms with infant stress regulation. These results suggest that maternal prenatal mental health is a key mechanism by which maternal early life adverse experiences affect offspring risk for psychopathology. We discuss potential clinical and health implications of dysregulated infant cortisol reactivity with respect to lifespan development.

Background: Few studies have examined the associations between pregnancy and birth complications and long‐term (>12 months) maternal mental health outcomes. Objectives: To review the published literature on pregnancy and birth complications and long‐term maternal mental health outcomes. Search strategy: Systematic search of Cumulative Index to Nursing and Allied Health Literature (CINAHL), Excerpta Medica Database (Embase), PsycInfo®, PubMed® and Web of Science from inception until August 2022. Selection criteria: Three reviewers independently reviewed titles, abstracts and full texts. Data collection and analysis: Two reviewers independently extracted data and appraised study quality. Random‐effects meta‐analyses were used to calculate pooled estimates. The Meta‐analyses of Observational Studies in Epidemiology (MOOSE) guidelines were followed. The protocol was prospectively registered on the International Prospective Register of Systematic Reviews (PROSPERO: CRD42022359017). Main results: Of the 16 310 articles identified, 33 studies were included (3 973 631 participants). Termination of pregnancy was associated with depression (pooled adjusted odds ratio, aOR 1.49, 95% CI 1.20–1.83) and anxiety disorder (pooled aOR 1.43, 95% CI 1.20–1.71). Miscarriage was associated with depression (pooled aOR 1.97, 95% CI 1.38–2.82) and anxiety disorder (pooled aOR 1.24, 95% CI 1.11–1.39). Sensitivity analyses excluding early pregnancy loss and termination reported similar results. Preterm birth was associated with depression (pooled aOR 1.37, 95% CI 1.32–1.42), anxiety disorder (pooled aOR 0.97, 95% CI 0.41–2.27) and post‐traumatic stress disorder (PTSD) (pooled aOR 1.75, 95% CI 0.52–5.89). Caesarean section was not significantly associated with PTSD (pooled aOR 2.51, 95% CI 0.75–8.37). There were few studies on other mental disorders and therefore it was not possible to perform meta‐analyses. Conclusions: Exposure to complications during pregnancy and birth increases the odds of long‐term depression, anxiety disorder and PTSD. [ABSTRACT FROM AUTHOR]

Abstract Background Parental psychological distress is a well-known risk factor for developmental psychopathology, with longer term parental distress associated with worse youth mental health. Neurotoxicant exposure during pregnancy is a risk factor for both poor maternal and youth mental health. The impact of one class of pollutant, polycyclic aromatic hydrocarbons (PAH), on long-term trajectories of maternal distress and youth self-reported mental health symptoms in adolescence has been understudied. Methods PAH exposure was measured by DNA adducts in maternal blood sampled during the third trimester of pregnancy. Maternal distress, operationalized as maternal demoralization, was measured at 11 timepoints (prenatal to child age 16). Adolescent mental health symptoms were measured at age 13–15. Follow up analyses examined a subset of measures available at age 15–20 years. Structural equation modeling examined associations between PAH exposure during pregnancy and latent growth metrics of maternal distress, and between maternal distress (intercept and slope) and youth mental health symptoms in a prospective longitudinal birth cohort (N = 564 dyads). Results Higher prenatal PAH exposure was associated with higher concurrent maternal distress. Prenatal maternal distress was associated with adolescent’s self-reported anxiety, depression, and externalizing problems. On average, maternal distress declined over time; a slower decline in mother’s distress across the course of the child’s life was associated with greater self-reported anxiety and externalizing problems in youth. Conclusions Our findings are consistent with an intergenerational framework of environmental effects on mental health: PAH exposure during pregnancy affects maternal mental health, which in turn influences mental health outcomes for youth well into adolescence. Future research is necessary to elucidate the possible social and biological mechanisms (e.g., parenting, epigenetics) underlying the intergenerational transmission of the negative effects of pollution on mental health in caregiver-child dyads.

Abstract Background Empirical evidence has demonstrated associations between pre-pregnancy obesity and perinatal maternal depressive symptoms. Omega-3 is an essential fatty acid derived from dietary sources that is critical for fetal brain development. Pre-pregnancy obesity is associated with higher omega-3 intake, but a weaker association between dietary intake and respective maternal and cord blood omega-3 levels. Further, lower intake of omega-3 during pregnancy has been linked to higher depressive symptoms. Yet, prior studies have not examined the interactive effects of pre-pregnancy overweight or obesity (OWOB) and prenatal maternal mental health symptoms on infant cord blood omega-3 levels. Methods Participants included 394 maternal-infant dyads from the NIH Environmental influences on Child Health Outcomes (ECHO) - Safe Passage Study in South Dakota. A pre-pregnancy body mass index (BMI) > 25 was used to dichotomize participants as OWOB (54%) vs. non-OWOB (46%). Prenatal maternal depressive symptoms were measured using the Edinburgh Postnatal Depression Scale (EPDS) and prenatal maternal anxiety symptoms were measured using the State-Trait Anxiety Inventory (STAI). We implemented linear regression models to examine the interaction term between pre-pregnancy BMI category and prenatal maternal mental health symptoms on cord blood omega-3 levels. Secondary analyses were stratified by pre-pregnancy BMI category. Results We observed a significant interaction between pre-pregnancy BMI category and prenatal maternal depressive symptoms with cord blood omega-3 (F(4,379) = 6.21, p

Abstract Background The postnatal period is an important time for adolescent mothers to regain their health as they adjust to life with their infants. However, it is also a time when mothers are vulnerable to mental health problems. Generalized anxiety disorders (GADs) are among the common mental disorders that can impact mothers. Anxiety disorders can have adverse effects on a child’s cognitive development. However, there is a scarcity of studies pertaining to anxiety disorders among adolescent mothers in Malawi. Methods A cross-sectional survey was conducted among adolescent postnatal mothers aged ≤ 19 years to establish the prevalence of probable GAD and identify cultural and social factors that influence anxiety in this population. Adolescent mothers were recruited from the Mitundu Rural Hospital catchment area in Lilongwe district, Malawi. A two-stage random sampling method was employed: clinics were randomly selected, and participants were recruited via systematic random sampling. The Generalized Anxiety Disorder (GAD-7) scale was used to assess anxiety. Data were analyzed using SPSS version 27. Results Of the 395 adolescent mothers who participated, 34% were aged 14–17. The prevalence of probable GAD (GAD-7 ≥ 10) was 31.9%. Increased social support decreased the odds of probable GAD (aOR 0.95, 95% CI: 0.91–0.98, p

Aims/BackgroundDesign/MethodsResultsConclusionAlthough the Pregnancy-Related Anxiety Scale – also referred to as the Pregnancy-Related Thoughts Scale (PRT) – is one of the most widely utilised measures of pregnancy-related anxiety (PrA), there is limited research exploring its factor structure and psychometric properties. The present study sought to (a) explore the factor structure of the PRT and (b) examine whether specific dimensions of PrA differentially predict postpartum outcomes.A community sample of pregnant women (N = 159) was recruited from a Midwestern city in the United States and completed the PRT alongside other self-report measures of stress and maternal health and mood during pregnancy. Participants also completed measures of maternal health and mood, as well as parenting/infant outcomes, at 1- and 6-months postpartum.Results provided support for a bifactor model with two unique dimensions of the PRT capturing baby- and self-focused concerns, respectively. Maternal self-focused PrA uniquely predicted postpartum internalising problems (β = .22), worse physical health (β = -.27), and impaired mother-infant bonding (β = .19) when controlling for baby-focused and general PrA.Findings highlight the utility of screening for specific dimensions of PrA to promote both maternal and infant wellbeing following childbirth. Specifically, evidence suggests that screening for self-focused PrA, above and beyond baby-focused PrA, might facilitate prevention and intervention efforts and allow researchers to better understand antecedents and consequences of unique facets of PrA. [ABSTRACT FROM AUTHOR]

Background: Parental psychological distress is a well-known risk factor for developmental psychopathology, with longer term parental distress associated with worse youth mental health. Neurotoxicant exposure during pregnancy is a risk factor for both poor maternal and youth mental health. The impact of one class of pollutant, polycyclic aromatic hydrocarbons (PAH), on long-term trajectories of maternal distress and youth self-reported mental health symptoms in adolescence has been understudied. Methods: PAH exposure was measured by DNA adducts in maternal blood sampled during the third trimester of pregnancy. Maternal distress, operationalized as maternal demoralization, was measured at 11 timepoints (prenatal to child age 16). Adolescent mental health symptoms were measured at age 13–15. Follow up analyses examined a subset of measures available at age 15–20 years. Structural equation modeling examined associations between PAH exposure during pregnancy and latent growth metrics of maternal distress, and between maternal distress (intercept and slope) and youth mental health symptoms in a prospective longitudinal birth cohort (N = 564 dyads). Results: Higher prenatal PAH exposure was associated with higher concurrent maternal distress. Prenatal maternal distress was associated with adolescent's self-reported anxiety, depression, and externalizing problems. On average, maternal distress declined over time; a slower decline in mother's distress across the course of the child's life was associated with greater self-reported anxiety and externalizing problems in youth. Conclusions: Our findings are consistent with an intergenerational framework of environmental effects on mental health: PAH exposure during pregnancy affects maternal mental health, which in turn influences mental health outcomes for youth well into adolescence. Future research is necessary to elucidate the possible social and biological mechanisms (e.g., parenting, epigenetics) underlying the intergenerational transmission of the negative effects of pollution on mental health in caregiver-child dyads. [ABSTRACT FROM AUTHOR]

This study aimed to investigate factors associated with birth-related PTSD symptoms and the subsequent impact on mother–infant relationship quality, exploring what women felt they needed to be different about their birth process to further understand the problem. Participants were recruited using social media advertising. A multi-method approach, using qualitative and quantitative analyses, was employed. The study included 142 pregnant women residing in Australia aged between 19 and 42 years (M = 31.24; SD = 4.70). High extraversion significantly predicted greater birth-related PTSD symptoms. There was a significant relationship between birth-related PTSD symptoms and poorer mother–infant relationship quality. The content analysis of the responses from women who reported a desire for a different or improved birth experience generated four themes: (1) less intrusive intervention, (2) better communication, (3) access to more supportive intervention, and (4) better post-birth care. The findings highlight the importance of supporting women's choices during birth by promoting informed and respectful woman-centred care. Postnatally, the screening and assessment of women should go beyond mood screening and include an assessment of the woman's response to her birth experience. [ABSTRACT FROM AUTHOR]

The concept of matrescence, akin to adolescence, has renewed our theoretical understanding of maternal subjectivity. Over the past two decades, there has been increased attention given to addressing reproductive psychological issues and maternal mental health, acknowledging the profound changes mothers undergo. This special issue explores matrescence as an important yet overlooked developmental phase, rich with opportunities for personal growth and societal transformation. Maternal subjectivity continues to require thorough documentation, investigation, and innovative theoretical frameworks. This discussion reviews recent efforts in psychoanalysis to shed light on the complexities of maternal subjectivity in the modern era and to point toward future research and action. [ABSTRACT FROM AUTHOR]

BackgroundAimMethodsResultsConclusionsThe mother-child bond may be related to maternal health, especially postpartum depression (PPD). Existing studies show the need for further in-depth research on the subject.To determine the relationship between bonding and the probability of the development and presence of PPD in women with a biological child between 6 weeks and 18 months of age.A cross-sectional study was conducted. A questionnaire containing sociodemographic, psychosocial, and health variables referring to the mother and the newborn, a questionnaire measuring the mother-child bond (VAMF-bond), and the Edinburgh Postpartum Depression Scale (EDPS) were administered.1114 women participated. The association between the items of the VAMF-bond subscale and the risk of PPD was statistically significant for all items (p < 0.05), except items 4 and 10. The multivariate analysis showed that the risk of PPD (EPDS scale) was lower in women with higher scores on bond (Adjusted Odds Ratio: aOR = 0.85; 95%CI: 0.81, 0.88), whose birth experience was good or very good (aOR = 0.57; 95%CI: 0.36, 0.89), who received high or very high support from their partner (aOR = 0.34; 95%CI: 0.18, 0.66), and family (aOR = 0.53; 95%CI: 0.32, 0.86). The presence of PPD was less frequent in women who presented higher scores for bond (aOR = 0.90; 95%CI: 0.84, 0.97), who had skin-to-skin contact (aOR = 0.39; 95%CI: 0.17, 0.93) and who received high or very high support from the family (aOR = 0.36; 95%CI: 0.12, 1.04).High scores on the subscale VAMF-bond were associated with a lower risk of PPD. [ABSTRACT FROM AUTHOR]

Aim: To explore whether and how expressing breast milk is perceived as helpful in coping with negative emotions due to premature birth by mothers of very low birth weight (VLBW) infants. Methods: Qualitative interviews and a retrospective cross‐sectional questionnaire with mothers of VLBW infants were conducted and analysed using an exploratory sequential mixed‐method design. Hypotheses were built using qualitative content analysis and quantitatively tested using multivariate regression analysis. Results: Interviews with 12 mothers and questionnaires of 518 mothers were analysed. Coping with prematurity by expressing milk was seen as a way to maintain the caregiving role for the mothers, where three relevant factors arouse: making up for what happened, providing the best for their infant and fear of low milk supply. Quantitative analysis showed that mothers with a high milk supply (Coef. = 1.1, p < 0.000) and more feelings of guilt due to premature birth (Coef. = −0.1; p = 0.015) perceived expressing breast milk significantly more as a resource for coping. Conclusion: This study adds knowledge on how expressing breast milk for their VLBW infant may support mothers in coping with premature birth, by revealing the association with milk supply and feelings of guilt due to premature birth. [ABSTRACT FROM AUTHOR]

Background: Empirical evidence has demonstrated associations between pre-pregnancy obesity and perinatal maternal depressive symptoms. Omega-3 is an essential fatty acid derived from dietary sources that is critical for fetal brain development. Pre-pregnancy obesity is associated with higher omega-3 intake, but a weaker association between dietary intake and respective maternal and cord blood omega-3 levels. Further, lower intake of omega-3 during pregnancy has been linked to higher depressive symptoms. Yet, prior studies have not examined the interactive effects of pre-pregnancy overweight or obesity (OWOB) and prenatal maternal mental health symptoms on infant cord blood omega-3 levels. Methods: Participants included 394 maternal-infant dyads from the NIH Environmental influences on Child Health Outcomes (ECHO) - Safe Passage Study in South Dakota. A pre-pregnancy body mass index (BMI) > 25 was used to dichotomize participants as OWOB (54%) vs. non-OWOB (46%). Prenatal maternal depressive symptoms were measured using the Edinburgh Postnatal Depression Scale (EPDS) and prenatal maternal anxiety symptoms were measured using the State-Trait Anxiety Inventory (STAI). We implemented linear regression models to examine the interaction term between pre-pregnancy BMI category and prenatal maternal mental health symptoms on cord blood omega-3 levels. Secondary analyses were stratified by pre-pregnancy BMI category. Results: We observed a significant interaction between pre-pregnancy BMI category and prenatal maternal depressive symptoms with cord blood omega-3 (F(4,379) = 6.21, p <.0001, adj. R2 = 0.05). Stratified models revealed an association between prenatal maternal depressive symptoms with lower cord blood omega-3 levels only among individuals with pre-pregnancy OWOB (β = -0.06, 95% CI = -0.11, -0.02; F (2,208) = 4.00, p <.05, adj R2 = 0.03). No associations were observed among non-OWOB participants. Conclusions: Findings suggest maternal-placental transfer of omega-3 may represent one pathway by which maternal metabolic and mental health impacts infant development. [ABSTRACT FROM AUTHOR]

Background: The postnatal period is an important time for adolescent mothers to regain their health as they adjust to life with their infants. However, it is also a time when mothers are vulnerable to mental health problems. Generalized anxiety disorders (GADs) are among the common mental disorders that can impact mothers. Anxiety disorders can have adverse effects on a child's cognitive development. However, there is a scarcity of studies pertaining to anxiety disorders among adolescent mothers in Malawi. Methods: A cross-sectional survey was conducted among adolescent postnatal mothers aged ≤ 19 years to establish the prevalence of probable GAD and identify cultural and social factors that influence anxiety in this population. Adolescent mothers were recruited from the Mitundu Rural Hospital catchment area in Lilongwe district, Malawi. A two-stage random sampling method was employed: clinics were randomly selected, and participants were recruited via systematic random sampling. The Generalized Anxiety Disorder (GAD-7) scale was used to assess anxiety. Data were analyzed using SPSS version 27. Results: Of the 395 adolescent mothers who participated, 34% were aged 14–17. The prevalence of probable GAD (GAD-7 ≥ 10) was 31.9%. Increased social support decreased the odds of probable GAD (aOR 0.95, 95% CI: 0.91–0.98, p < 0.001). Experiencing intimate partner violence (IPV) increased the likelihood of probable GAD (aOR 4.80, 95% CI: 1.23–18.82, p = 0.02), while those who had contact with a health worker postnatally (aOR 0.38, 95% CI: 0.17–0.83, p = 0.02) and those who were "not prayerful" (aOR, 0.43, 95% CI: 0.21–0.87, p = 0.02) were less likely to report probable GAD. Conclusions: Given that the prevalence of probable GAD among adolescent mothers in Malawi is higher compared to the global estimates of their peers, policies and guidelines that prioritize the maternal mental health of adolescent mothers in Malawi are required. The findings also highlight the importance of enhancing social support among family and community. Co-designed mental health promotion, prevention, and early interventions to involve health workers and religious leaders are recommended. [ABSTRACT FROM AUTHOR]

Purpose: Pregnancy-related psychophysiological changes are associated with the sleep alterations as the gestational weeks progress. The aim is to evaluate the effectiveness of sleep hygiene education programs during pregnancy. Methods: This prospective randomized controlled study based on pre–post-test after intervention consists of 30 studies and 30 control groups. Pregnant descriptive form, Beck Depression Index (BDI), Pittsburgh Sleep Quality Index (PSQI) and sleep hygiene index (SHI) questionnaires were used. Pregnant women with a score of 15 and above according to BDI were excluded from the study due to depression. Following the application of PSQI and SHI as a pretest, a sleep hygiene training program was applied to the intervention group twice with an interval of 15 days, and PSQI and SHI surveys were repeated as a posttest at the end of 1 month. End points with prespecified hypotheses were changes in sleep quality in different trimesters during antenatal follow-up (primary end point) and changes in sleep quality after the sleep hygiene education intervention from randomization to the end of the intervention period (secondary end point). Results: 90% of all pregnant women had poor sleep quality in the pre-test, and 93.3% in the post-test. In the intervention group, the pre-test PSQI score was 8.10 ± 1.80 and the post-test PSQI score was 8.37 ± 2.05 (p < 0.001). In the control group, the pre-test PSQI score was 8.23 ± 2.54 and the post-test PSQI score was 9.77 ± 2.54, and the worsening of sleep quality became more evident (p < 0.05). While the SHI in intervention group was 16.57 ± 5.64 in the pre-test, it was 10.30 ± 3.78 in the post-test after sleep hygiene training (p < 0.001). In the control group, the pre-test SHI scores increased from 14.50 ± 3.78 to the post-test scores of 16.60 ± 4.36, resulting in a decline in sleep hygiene and sleep quality (p < 0.05). Conclusion: As the gestational week progressed, the deterioration in sleep quality increased. The poor sleep quality improved significantly after sleep hygiene education counseling. It is recommended to add sleep-related screenings to routine pregnancy follow-ups and to provide sleep hygiene education. [ABSTRACT FROM AUTHOR]

Advancements in psychotropic therapy for pregnant women are pivotal for addressing maternal mental health during the perinatal period. Screening for mood and anxiety symptoms during pregnancy is recommended to enable early intervention. Psychotropic medications, including antidepressants, benzodiazepines, antipsychotics, and mood stabilizers, are commonly used, but challenges remain regarding their safety and efficacy during pregnancy. Pregnancy induces significant changes in pharmacokinetics, necessitating personalized dosing strategies and careful monitoring. Real-time monitoring technologies, such as smartphone-integrated platforms and home-based monitoring, enhance accessibility and accuracy. Prospective studies and collaboration among healthcare providers are essential for evidence-based guidelines and optimal treatment strategies. Reducing stigma around mental health during pregnancy is crucial to ensure women seek help and discuss treatment options, promoting understanding and acceptance within the community. [ABSTRACT FROM AUTHOR]

Purpose: To assess the knowledge, clinical experience, and attitudes of Italian midwives toward perinatal depression (PND) and to explore how these factors impact the quality of care. Methods: We conducted a cross-sectional online survey among 152 midwives employed in public hospitals across Italy. The questionnaire covered a range of topics, including demographic data, professional experience, knowledge of PND symptoms, risk factors, and clinical management, as well as communication skills and personal experiences with PND cases. Results: A concerning 76.3% of midwives displayed inadequate knowledge of PND based on current scientific literature. Those with a more comprehensive understanding were notably more confident in their practice, expressing significantly fewer apprehensions about communicating with mothers (25.8% vs 74.2%) and lesser concerns about the mothers' future well-being (38.9% vs 62.95%). The survey results also emphasised the midwives' call for specialised guidelines and formal training in PND management and underscored the value of communication skills, continuity of care, and family engagement in supporting affected mothers. Conclusion: This inaugural study sheds light on the current state of knowledge and attitudes among Italian midwives regarding PND. It pinpoints crucial areas for educational enhancement and practice improvement, suggesting that elevated levels of midwife expertise in PND could significantly elevate the standard of care and expedite early diagnosis and treatment. [ABSTRACT FROM AUTHOR]

Accessible Summary: What is known about the topic?: Mental health‐related problems in pregnancy are now becoming a global health concern. However, most studies have reported that midwives are unable to assess and support maternal mothers due to poor preservice education. The findings of these studies needed to be explored further from the available literature to address the gap. What does the paper add to existing knowledge?: The paper has identified maternal mental health core competencies and innovative clinical teaching strategies that nurse educators can utilize when supporting students theoretically and during clinical practice so that students should be adequately prepared for maternal mental health practice.Challenges and recommendations for clinical teaching were also identified. However, there are still gaps in the literature related to the effectiveness of teaching strategies to promote competence acquisition in maternal mental health. What are the implications for education?: The study results can be used by nurse educators to develop effective clinical teaching practices in maternal mental health care. The findings can be used in the development of best clinical teaching guidelines for maternal or perinatal mental health to be used by nurse educators for the undergraduate midwifery training programmes. Introduction: Maternal mental health problems are commonly experienced by women; however, they are usually not adequately recognized and treated by midwives in Malawi. Evidence suggests poor preservice education by nursing colleges which affects the development of essential maternal mental health competencies. Aim: The aim of the study was to review existing evidence on clinical teaching practices by nurse educators in teaching student midwives maternal mental health care. Method: Integrative review method was used, and various databases were searched. Out of 1768 articles, 27 research articles met the inclusion criteria. The critical appraisal skills programme checklist tools were used to assess data quality. Thematic analysis was done by comparing, grouping and integrating data. Results: Six themes emerged, namely: core maternal mental health competencies, professional regulation, interactive teaching strategies, collaborative partnerships, capacity building and shortage of resources. Discussion: Clinical teaching is an important aspect of midwifery education. Utilizing student‐centred teaching approaches helps students acquire competencies in maternal mental health care. Further research is required to identify the effectiveness of the clinical teaching methods. The Implication to Practice: The study results can assist nurse educators to provide comprehensive clinical teaching practices in maternal mental health care which will aid in the development of maternal mental health competencies among student midwives. [ABSTRACT FROM AUTHOR]

This article provides an innovative perspective of emotional-regulation and human flourishing which acknowledges the fundamental role of early parent-child experiences in shaping brain structure and functioning involved in emotional regulation and the central role of mindful parenting in facilitating emotional regulation in both parent and child (co-regulation). In this perspective paper the author underlines not only the central role of emotions and emotional regulation in human development and flourishing, but also the importance of maternal mental health, mindfulness, and a connected supportive community during pregnancy and postnatally in facilitating emotional regulation in both the caregiver and the infant and thus promoting secure attachment. The role of alloparenting and how we evolved to share childrearing is introduced, and emotional regulation is described not as an individual phenomenon but a relational embodied process. The associations between right brain functioning, mindfulness and secure attachment, all leading to emotional regulation, wellbeing, and resilience are described. Sharing findings and perspectives offer an opportunity for insights and reflection upon what strategies could be created to promote relational emotional regulation and wellbeing in early life, thus human flourishing leading to a peaceful society. [ABSTRACT FROM AUTHOR]

As of April 2021, nine states and the District of Columbia had enacted state-specific paid family leave (PFL) programs, offering partial wage replacement to parents after the birth of a child. The Biden Administration also proposed the development of a national solution through the American Families Plan. Despite these advances, concerns with workforce disruptions and economic costs have hindered wider adoption of PFL. While studies have documented the potential health benefits of PFL for women and babies, less is known about the mechanisms that lead to PFL potentially impacting women's mental health. This mixed-methods study is based on focus groups with over 100 women in four states with operating programs and a secondary analysis of Pregnancy Risk Assessment Monitoring System (PRAMS) data. It presents evidence of how PFL may facilitate longer leave that possibly leads to improved mental health outcomes by providing more time at home. It also demonstrates that PFL may directly support mental health by providing women with increased financial security and work/life boundaries. Implications of PFL design features on access and shortcomings are also discussed. These results aim to inform national or additional state-level PFL programs that may benefit working women, their families, and their employers. [ABSTRACT FROM AUTHOR]