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Objectives: To assess the feasibility of universal screening of postpartum depression (PPD), using the Edinburgh Postpartum Depression Scale (EPDS) in the general population. To investigate the proportion of women identified as being at risk of PPD and with confirmed PPD or other mental disorders after a psychiatric consultation. Methods: A multicenter prospective cohort study in four French maternities conducted between 2020 and 2023. All women aged over 18 years, who delivered following a singleton pregnancy after 37 weeks of gestation were eligible for inclusion. The exclusion criteria were pre‐existing psychiatric disorders such as depressive syndrome. The EPDS was completed at 8 weeks postpartum via an online self‐administered questionnaire. If the response to the questionnaire suggested a mental disorder, a psychiatric consultation was proposed to the women concerned. The endpoints were the proportion of women completing the EPDS, the EPDS score, the proportion of women at risk of PPD, the proportion of psychiatric consultation, and the subsequent diagnosis. Results: The study included 923 women, of whom 55.0% (508/923) completed the EPDS. Among them, 28.1% (143/508) had an EPDS score of 10 or more, and 11.2% (57/508) received a psychiatric consultation. PPD was confirmed in 8.8% (5/57) of women. Other disorders detected were mood disorders, disorders specifically associated with stress, and anxiety/fear‐related disorders, in 33.3%, 28.1%, and 14.0% of the women, respectively. Conclusions: Screening with self‐administered EPDS is feasible, with a good response rate, making it possible to suspect mental disorders, including PPD, and to offer psychological support when needed. Synopsis: Screening with EPDS self‐administered is feasible with a good response rate, making it possible to suspect mental disorders and to offer psychological support when needed. [ABSTRACT FROM AUTHOR]

This article discusses the progress being made in perinatal mental health research. It emphasizes the importance of addressing perinatal psychiatric and substance use disorders, as they can have negative effects on maternal functioning, obstetrical and neonatal outcomes, and child socioemotional regulation. The special issue highlights the interdisciplinary nature of perinatal psychiatry, which involves various specialties such as obstetrics, neonatology, pediatrics, psychiatry, psychology, epidemiology, and neuroscience. The studies in the issue cover topics such as the risks associated with perinatal psychiatric disorders, the effects of treatments, the role of Mother-Baby units, and the biological aspects of perinatal depression. The research aims to improve treatment strategies, identify risk factors and biomarkers, and understand the underlying pathophysiology of perinatal mental health disorders. [Extracted from the article]

Background: We quantified relative and absolute risks of postpartum psychiatric episodes (PPE) following risk factors: Young age, past personal or family history of psychiatric disorders, and genetic liability. Methods: We conducted a register‐based study using the iPSYCH2012 case‐cohort sample. Exposures were personal history of psychiatric episodes prior to childbirth, being a young mother (giving birth before the age of 21.5 years), having a family history of psychiatric disorders, and a high (highest quartile) polygenic score (PGS) for major depression. PPE was defined within 12 months postpartum by prescription of psychotropic medication or in‐ and outpatient contact to a psychiatric facility. We included primiparous women born 1981–1999, giving birth before January 1st, 2016. We conducted Cox regression to calculate hazard ratios (HRs) of PPE, absolute risks were calculated using cumulative incidence functions. Results: We included 8174 primiparous women, and the estimated baseline PPE risk was 6.9% (95% CI 6.0%–7.8%, number of PPE cases: 2169). For young mothers with a personal and family history of psychiatric disorders, the absolute risk of PPE was 21.6% (95% CI 15.9%–27.8%). Adding information on high genetic liability to depression, the risk increased to 29.2% (95% CI 21.3%–38.4%) for PPE. Conclusions: Information on prior personal and family psychiatric episodes as well as age may assist in estimating a personalized risk of PPE. Furthermore, additional information on genetic liability could add even further to this risk assessment. [ABSTRACT FROM AUTHOR]

Purpose: Perinatal mood disorders affect both parents, impacting their children negatively. Little is known on the association between parental perinatal mood disorders and pediatric outcomes in Japan considering relevant covariates. Our objective was to investigate the association between paternal and maternal perinatal mood disorders and adverse physical and psychological child outcomes by the age of 36 months, adjusting for covariates such as the child's sex, age of parent at child's birth, perinatal mood disorders of the other parent, and perinatal antidepressant use. Methods: We identified parents in the JMDC Claims Database in Japan from 2012 to 2020. Perinatal mood disorders were defined using International Classification of Diseases, 10th codes for mood disorders during the perinatal period combined with psychiatric treatment codes. We evaluated the association between parental perinatal mood disorders and pediatric adverse outcomes by the age of 36 months using Cox proportional hazard models adjusted for the covariates. Results: Of the 116,423 father-mother-child triads, 2.8% of fathers and 2.3% of mothers had perinatal mood disorders. Paternal perinatal mood disorders were not significantly associated with adverse child outcomes. After adjusting for paternal perinatal mood disorders and antidepressant use, maternal perinatal mood disorders were associated with delayed motor development, language development disorders, autism spectrum disorders, and behavioral and emotional disorders (adjusted hazard ratio [95% confidence interval]: 1.65 [1.01–2.69], 2.26 [1.36–3.75], 4.16 [2.64–6.55], and 6.12 [1.35–27.81], respectively). Conclusions: Paternal perinatal mood disorders were not associated with adverse child outcomes in this population. Maternal perinatal mood disorders were associated with multiple child outcomes. [ABSTRACT FROM AUTHOR]

Purpose: To assess Black women's exposure to and appraisal of racism-related stress during the postpartum period and to distinguish its impact on three indicators of postpartum mood and anxiety disorders (PMADs) symptoms. Methods: Data from the Black Mothers' Mental Wellness Study (N = 231) and linear regression models estimated the associations between racism-related stress and the PMAD indicators: 3-item Edinburgh Postnatal Depression Scale (EPDS-3), 8-item Patient Health Questionnaire (PHQ-8), and PHQ-15. Results: The majority of participants (80.5%, N = 186) experienced racism a few times a year or more, of which 37.1% (N = 69) were bothered somewhat and 19.3% (N = 36) a lot. Racism-related stress, income, level of education, and history of mental health diagnosis explained greater variance in PMAD symptoms as measured by the PHQ-8 score (R2 = 0.58, p = < 0.001) compared to the EPDS-3 (R2 = 0.46, p = < 0.001) or the PHQ-15 (R2 = 0.14, p = 0.035). Conclusions: Racism is a stressor for Black women living in Los Angeles County, California. Racism-related stress and emotional expression of PMAD symptoms were salient to the postpartum mental health of the Black women in this study. Findings from this study suggest that the PHQ-8 should be used to assess how racism impacts Black women's postpartum mental health. [ABSTRACT FROM AUTHOR]

This paper considers maternal subjectivity and maternal identity development through our work in an urban clinical setting where women present for treatment during the perinatal period. Drawing on a rich tradition of psychoanalytic observational research and mother-infant communication research, which supported the relational turn, we aim to shift the lens from mothers as important to their baby's development, to maternal experiences as essential. Likewise, noting that a mother cannot exist without a baby, real or imagined, we consider the role of a baby in a mother's own development. Tracing roots of maternal subjectivity in psychoanalytic traditions, while also noting its absence, we hope to offer ways to formulate maternal identity that are clinically useful and grounded in research, and reflective of our contemporary positions. Case examples further illustrate the utility of narrative measures, including the Adult Attachment Interview, in clinical settings. [ABSTRACT FROM AUTHOR]

Perinatal mental and anxiety disorders (PMADs) contribute to adverse health outcomes, though they are underrecognized and undertreated. Inpatient obstetric settings represent a unique opportunity for behavioral health engagement, including screening, brief treatment, and referrals for outpatient care. The proactive consultation-liaison (CL) model has proven effective in general hospital settings but is not well-studied in obstetric settings. This article describes the implementation and evaluation of a proactive CL model in an inpatient obstetric unit within a tertiary medical center. We implemented a multidisciplinary, proactive CL model in an inpatient obstetric unit with the purpose of identifying patients at risk for or experiencing PMADs and providing intervention and/or referral to treatment. Systematic screening of 7322 admitted patients was performed over a 17-month period to identify eligible patients for behavioral health consultation. Consultation data was retrospectively extracted from the electronic medical record. Key implementation outcomes were assessed using a RE-AIM measures (Reach, Effectiveness, Adoption, Implementation, and Maintenance) framework. 1589 initial consults were conducted by the multidisciplinary team, yielding a consult rate of 21.7 %. The majority of consults (94 %) were completed by a social worker or psychologist, with most patients identified for consultation at multidisciplinary rounds (60.7 %). The most common indications for consultation with a psychiatrist included medication management, history of bipolar disorder, and history of anxiety. All invited staff and providers participated in the model. Alternative funding sources agreed to cover the salaries of the multidisciplinary team following conclusion of pilot grant funding. A proactive CL model implemented in an inpatient obstetric unit led to a higher consult rate (21.7 %) than is observed with traditional CL services. A multidisciplinary proactive CL model shows promise in identifying people at-risk for PMADs and providing targeted interventions to prevent PMADs and treat those with active symptoms. • The proactive CL model increases the consult rate in inpatient obstetric settings. • Team presence at interdisciplinary rounds leads to identification of most consults. • Many consults can reasonably be seen by a social worker or psychologist. • An interdisciplinary team facilitates targeted use of a psychiatrist for complex cases. [ABSTRACT FROM AUTHOR]

Background: Up to one in five women experience perinatal depression and/or anxiety with profound negative consequences for mothers and families. Peer support interventions have the potential to effectively prevent perinatal mental health conditions. Meanwhile, mobile health has gained popularity and plays a significant role in enhancing maternal health services. However, little is known about the availability of mobile health combined with peer support for supporting perinatal mental health. This scoping review aimed to map the relevant literature and gain insights into the available evidence on mobile health and peer support for perinatal mental health, to identify gaps and inform opportunities for future research. Methods: A scoping review of the literature was conducted. The search strategy included five databases: CIANHL, Scopus, PsycInfo, PubMed, and ScienceDirect for the period from 2007 to 2022. Results: Eight studies met the inclusion criteria, including features of online support strategies, effectiveness, and attitudes of women about peer support with mobile health. The results showed decreased depressive scores and provided a positive experience for women. Strong satisfaction with accessibility and flexibility of mobile health was found when combined with the peer support features. Additional emotional support tools (e.g., mindfulness‐based activities) were likely to be acceptable to women and beneficial to mobile health. Conclusions: Understanding the context of peer support and mobile health informs the potential to support perinatal mental health. Further research in this growing area is needed to test the effectiveness of peer support in combination with mobile health intervention for supporting perinatal mental health. [ABSTRACT FROM AUTHOR]

Background: Perinatal mental health disorders (PMHDs) are associated with a myriad of negative outcomes for women, infants, and the rest of the family unit. Understanding the prevalence of these conditions is important to guide prevention and treatment pathways. Indeed, the burden of PMHDs has been studied in many countries, but for Malta, an island with an annual birth rate of 4500 births, this burden is still to be determined. The main objective of this study was to address this gap, determine the prevalence of PMHDs among postpartum women in Malta, and study associated psychosocial determinants for this population. Methods: A cross‐sectional epidemiological study was conducted between March and April 2022 to determine the point prevalence of postpartum PMHDs in Malta. A representative, random sample of 243 postnatal mothers were recruited and screened for mental health issues using a two stage approach incorporating symptom scales and a diagnostic interview. Results: The point prevalence of postnatal PMHDs in Malta, according to a diagnostic interview, was found to be 21.4%. Anxiety disorders were the most prevalent conditions (16.8%), followed by obsessive‐compulsive disorder (6.1%) and borderline personality disorder (5.6%), respectively. A higher rate of 32.1% was identified with self‐report measures. Conclusions: PMHDs are highly prevalent, affecting approximately 20% of women in Malta across the first postnatal year. The value of this finding accentuates the need for service availability and the implementation of perinatal mental health screening programs. [ABSTRACT FROM AUTHOR]

The article present a case study of a 30-year-old woman who experienced postpartum anxiety and intrusive thoughts following the birth of her first child. Topics discussed include the clinical presentation of postpartum psychiatric disorders; the differential diagnosis; and the management strategies, particularly focusing on postpartum obsessive-compulsive disorder and coexisting major depressive disorder.

Aim: The aim of the present study was to assess the prevalence of psychiatric disorders among the women between 32-week gestation & two week postpartum. Methods: The study was conducted in the Post Graduate Department of Obstetrics and Gynaecology over a period of one year i.e. November 2016 to October 2017, after approval from the Ethical Committee. Subjects included 150 antenatal women from 32-week period of gestation till delivery and 150 postpartum women from delivery till 2 weeks postpartum. Psychiatric disorder was calculated using Mini Neuropsychiatric Inventory. Other sociodemographic, obstetric, and psychiatric variables were recorded. Results: Overall, 150 antenatal and 150 postnatal women were studied, 28 women (18.7%) in antenatal and 21(14%) women in postnatal group had psychiatric disorder. The overall prevalence of psychiatric disorders in the present study was found to be 16.4%. This prevalence in pregnancy ranges from 15- 29% worldwide. Among 28 antenatal patients diagnosed as having Psychiatric Disorder 13 (8.7%) had Depression. One patient (0.7%) had Dysthymia, 2 (1.3%) had panic disorder. 2 (1.3%) had obsessive compulsive disorder. 10 (6.7%) had Generalized Anxiety Disorder. None of the patients had Depression with Melancholic features, Suicidality, Hypomania, Agoraphobia, Social Phobia, Bipolar Disorder, Alcohol Dependence and abuse, Post-Traumatic Stress Disorder, Psychotic Disorder, Anorexia Nervosa, and Bulimia Nervosa. 21 Postnatal patients were diagnosed as having Psychiatric Disorder, out of which 12 (8.0%) had Depression. None had Dysthymia, 3(2%) had panic disorder. 1 (0.7%) had obsessive compulsive disorder. 1 (0.7%) had Post Traumatic Stress Disorder. 1 (0.7) had Psychotic Disorder and Mood disorder with Psychotic features. 3 (2%) had Generalized Anxiety Disorder. None of the patients had Depression with Melancholic features, Suicidality, Hypomania, Agoraphobia, Social Phobia, Bipolar Disorder, Alcohol Dependence and abuse, Anorexia Nervosa, and Bulimia Nervosa. 21.3% antenatal females had antenatal risk questionnaire score ≥23 with mean score 17.5±8.57 and 26.7% postnatal females had postnatal risk questionnaire score ≥24. Conclusion: Pregnancy-related psychiatric disorders are frequent. The outcomes for pregnant women, infants, and women's health are all improved by proper diagnosis and treatment of psychiatric problems. [ABSTRACT FROM AUTHOR]

The article discusses programs and policies addressing perinatal mental health crisis at the national, state, and local levels in the U.S. Initiatives at the population level aimed at improving the quality of care for perinatal individuals and their newborns and infants, the perinatal psychiatry access programs being implemented by states, and the benefits of the behavioral health model called collaborative care model (CoCM).

Purpose: To estimate the societal costs of untreated perinatal mood and anxiety disorders (PMADs) in Vermont for the 2018–2020 average annual birth cohort from conception through five years postpartum. Methods: We developed a cost analysis model to calculate the excess cases of outcomes attributed to PMADs in the state of Vermont. Then, we modeled the associated costs of each outcome incurred by birthing parents and their children, projected five years for birthing parents who do not achieve remission by the end of the first year postpartum. Results: We estimated that the total societal cost of untreated PMADs in Vermont could reach $48 million for an annual birth cohort from conception to five years postpartum, amounting to $35,910 in excess societal costs per birthing parent with an untreated PMAD and their child. Conclusion: Our model provides evidence of the high costs of untreated PMADs for birthing parents and their children in Vermont. Our estimates for Vermont are slightly higher but comparable to national estimates, which are $35,500 per birthing parent–child pair, adjusted to 2021 US dollars. Investing in perinatal mental health prevention and treatment could improve health outcomes and reduce economic burden of PMADs on individuals, families, employers, and the state. [ABSTRACT FROM AUTHOR]

Background: Postpartum hemorrhage (PPH) is the primary cause of maternal mortality globally, with uterine atony being the predominant contributing factor. However, accurate prediction of PPH in the general population remains challenging due to a lack of reliable biomarkers. Methods: Using retrospective cohort data, we quantified 48 cytokines in plasma samples from 40 women diagnosed with PPH caused by uterine atony. We also analyzed previously reported hemogram and coagulation parameters related to inflammatory response. The least absolute shrinkage and selection operator (LASSO) and logistic regression were applied to develop predictive models. Established models were further evaluated and temporally validated in a prospective cohort. Results: Fourteen factors showed significant differences between the two groups, among which IL2Ra, IL9, MIP1b, TNFb, CTACK, prenatal Hb, Lymph%, PLR, and LnSII were selected by LASSO to construct predictive model A. Further, by logistic regression, model B was constructed using prenatal Hb, PLR, IL2Ra, and IL9. The area under the curve (AUC) values of model A in the training set, internal validation set, and temporal validation set were 0.846 (0.757–0.934), 0.846 (0.749–0.930), and 0.875 (0.789–0.961), respectively. And the corresponding AUC values for model B were 0.805 (0.709–0.901), 0.805 (0.701–0.894), and 0.901 (0.824–0.979). Decision curve analysis results showed that both nomograms had a high net benefit for predicting atonic PPH. Conclusion: We identified novel biomarkers and developed predictive models for atonic PPH in women undergoing “low-risk” vaginal delivery, providing immunological insights for further exploration of the mechanism underlying atonic PPH. [ABSTRACT FROM AUTHOR]

Background: The perinatal period is a time of 'high risk' for new and recurrent episodes of mental illness with 0.1-0.2% of birthing parents requiring admission to specialist mental health units in the months after birth. The prevalence and role of trauma in the lives of birthing parents (most commonly mothers) experiencing severe perinatal mental illness is not well known. Method: In a new perinatal mental health unit in Sydney Australia, a retrospective audit of trauma prevalence was undertaken using patient completed questionnaires and electronic medical record data. Descriptive analysis was undertaken. Results: Prevalence of trauma in the lives of mothers with severe mental illness was found to be higher than that reported in general or community mental health settings, with 76% of mothers reporting lifetime trauma exposure and 24% meeting criteria for complex PTSD. The majority reported trauma experiences likely to impact attachment and also reported difficulties in responding to their infants' cues and needs. Discussion: The findings suggest a need for more research, awareness, and consideration of the role of trauma in experiences of perinatal mental illness, with implications for developing trauma informed models for responding to parental mental illness. [ABSTRACT FROM AUTHOR]

Maternal behavior research in laboratory rats has revealed important behavioral and neurobiological mechanisms governing the onset, maintenance and decline of maternal behavior. However, the extent to which these mechanisms are evolutionarily conserved across species is less clear. This manuscript proposes that examining these mechanisms in dogs may be a viable approach to test their generality and help bridge the gap between rodent and human research, as domestic dogs show greater individual differences and exhibit more human-like maternal characteristics than rodents. These aspects represent advantages over rodent models, which in turn allow systems biological approaches not available in rodents. Additionally, domestic dogs share similar social environments with humans, suffer from the same mental disorders as humans, and can be treated with the same medications. This paper begins with a summary of key findings and theoretical developments from decades of rat maternal behavior research, followed by a literature review of the extant maternal behavior research on dogs and related methodology, highlighting the unique behavioral characteristics of dog maternal behavior and similarities and differences from rat maternal behavior. Finally, several knowledge gaps in dog maternal behavior research, as well as the future research in this area is discussed. It concludes that research on dog maternal behavior will not only advance our understanding of the universality of the neurobiological and behavioral mechanisms in maternal behavior, but also improve our understanding of risk factors associated with postpartum mental disorders. [ABSTRACT FROM AUTHOR]

To examine, in depth, the perspectives of facilitators of a videoconference-delivered group Acceptance Commitment Therapy (ACT) intervention for perinatal women with moderate-severe mood and/or anxiety disorders. Qualitative study. Thematic analysis was used to analyse semi-structured interviews with seven facilitators and post-session reflections with six facilitators. Four themes were generated. First, there are barriers to accessing psychological therapies during the perinatal period and improvements are required. Second, COVID-19 has accelerated the provision of remote therapies, including videoconference-delivered group therapy, enabling a continuity of service, and facilitating diversification of treatment access and choice. Third, there are benefits of videoconference-delivered group ACT in the perinatal period, with reservations. Attending a group via videoconference is perceived to be less exposing, and offers normalisation, social support, empowerment, and flexibility. Facilitators also shared reservations including whether service users would prioritise videoconference-delivered group therapy, concerns about limited non-verbal cues and the therapeutic alliance, reporting a lack of an evidence base, and technology challenges when working online. Finally, facilitators offered recommendations for videoconference-delivered group therapy best practice in the perinatal period, including the provision of equipment and data, contracts for attendance and suggestions to maximise engagement and group cohesion. This study raises important considerations regarding the use of videoconference-delivered group ACT in the perinatal context. There are opportunities afforded by videoconference-delivered group therapies, which is important and timely given the increased drive towards improving access to perinatal services and psychological therapies, and the need for 'COVID-proof' therapies. Recommendations for best practice are offered. [ABSTRACT FROM AUTHOR]

Postpartum depression (PPD) is a common condition that affects mothers and can have negative effects on their mental health and family. It is caused by a combination of hormonal changes, obstetric circumstances, and social and psychological factors. The prevalence of PPD varies across different regions due to cultural differences and stigma surrounding mental health. Genetic factors, hormonal changes, immune function, sleep problems, and neurobiological pathways are all involved in the development of PPD, but more research is needed to fully understand the complex neurobiology. Changes in the female brain during pregnancy and the postpartum period may contribute to the development of mental disorders like depression. Hormone therapy and antidepressant treatment have shown promise in treating PPD, but more awareness, screening tools, and guidelines are needed, especially in Indian settings. Further research is necessary to understand the neurobiological changes and develop early interventions for those at risk. [Extracted from the article]

Attention-deficit/hyperactivity disorder is a childhood-onset neurodevelopmental disorder that frequently persists into adulthood with 3% of adult women having a diagnosis of attention-deficit/hyperactivity disorder. Many women are diagnosed and treated during their reproductive years, which leads to management implications during pregnancy and the postpartum period. We know from clinical practice that attention-deficit/hyperactivity disorder symptoms frequently become challenging to manage during the perinatal period and require additional support and attention. There is often uncertainty among healthcare providers about the management of attention-deficit/hyperactivity disorder in the perinatal period, particularly the safety of pharmacotherapy for the developing fetus. This guideline is focused on best practices in managing attention-deficit/hyperactivity disorder in the perinatal period. We recommend (1) mitigating the risks associated with attention-deficit/hyperactivity disorder that worsen during the perinatal period via individualized treatment planning; (2) providing psychoeducation, self-management strategies or coaching, and psychotherapies; and, for those with moderate or severe attention-deficit/hyperactivity disorder, (3) considering pharmacotherapy for attention-deficit/hyperactivity disorder, which largely has reassuring safety data. Specifically, providers should work collaboratively with patients and their support networks to balance the risks of perinatal attention-deficit/hyperactivity disorder medication with the risks of inadequately treated attention-deficit/hyperactivity disorder during pregnancy. The risks and impacts of attention-deficit/hyperactivity disorder in pregnancy can be successfully managed through preconception counselling and appropriate perinatal planning, management, and support. [Display omitted] [ABSTRACT FROM AUTHOR]

Introduction: The constellation of pre and perinatal predictors are introduced as predictor for autism spectrum disorders (ASD), however, the information about the direction and strength of these predictors are lacking in Western, Iran. The current study aimed to determine the pre and perinatal predictors of ASD among children in this region. Methods: This case-control study was conducted in Hamadan, Western Iran during January to March 2022. The study included 100 children with ASD who referred to the autism center as case group. Hundred children without ASD from registration system of health service centers were selected as control group and were matched (1:1) to cases by age and place of residency. A structured questionnaire about pre and perinatal predictors of ASD was developed by an expert panel. The questionnaire was administered by interviewing the mothers of children. Results: Boy gender (OR: 3.51, 95% CI: 1.74–7.10, p-value < 0.001), small for gestational age (SGA) (3.92, 1.64–9.39, 0.002), maternal diabetes (3.51, 1.03–24.95, 0.04) and family history of mental disorders (3.64, 1.18–11.27, 0.04) were identified as significant predictors in a multivariable analysis. Conclusion: Our study emphasizes on the importance of screening and monitoring for ASD in the boys, those with history of SGA, from mothers with history of diabetes and with family history of mental disorders. Proposing the replication of findings emphasizes the necessity of conducting studies with larger sample sizes. [ABSTRACT FROM AUTHOR]

The concept of matrescence, akin to adolescence but for mothers, has gained increasing attention in perinatal psychiatry, marking a paradigm shift towards understanding the holistic development of mothers. Matrescence encompasses the myriad psychological, social, cultural, and existential changes which occur as women transition intomotherhood. Despite advances inmaternalmental health, a bias towards pathologizing maternal experiences persists in research and practice. This commentary advocates for the integration of matrescence into perinatal psychiatry, drawing fromthework of Dana Raphael and contemporary scholarship. Matrescence offers a strengths-based framework that acknowledges both the challenges and opportunities of motherhood, emphasizing the normative aspects of a mother's self-development. By adopting matrescence terminology and nosology, clinicians and researchers can enhance traditional psychiatric classifications. Additionally, matrescence underscores the importance of considering ecological systems and historical factors in maternal well-being, highlighting the need for comprehensive and compassionate healthcare services. Embracing matrescence as a fundamental concept in perinatal psychiatry holds promise for improving maternal mental health outcomes and promoting the flourishing of mothers worldwide. [ABSTRACT FROM AUTHOR]

Background: In sub-Saharan Africa the birth rate among teenage mothers is the highest in the world. In 2021, there would be 6,114,000 births for 15-19-yearolds in this part of the world. In Cameroon, the fertility rate among adolescents aged 15-19 is 24%. However, there is a significant lack of data on the mental health of teenage mothers. Given the biopsychosocial conditions of the perinatal period and adolescence, we hypothesise that the prevalence of mental disorders and the risk of suicide is very high in Cameroon. The aim is therefore to determine the prevalence of perinatal mental disorders and suicide risk among adolescent mothers in urban areas of Cameroon. Methods: Following ethical approval of the submitted protocol, we recruited adolescent mothers and data were collected using diagnostic interviews based on the DSM-5, PDM-2 andMINI guidelines. The types of sampling usedwere typical and incidental. Data were tabulated with Epidata 3.1 and processed with SPSS 25. Results: 66.4% of adolescent mothers were diagnosed with a mental disorder and 27.4% with suicidal risk. It was found that there was a link between mental disorders and suicidal risk (p<0.001), with mothers at suicidal risk having an 8.4 times greater risk of having a mental disorder (OR=8.423). Linear regression confirmed the statistically significant relationship between perinatal mental disorders and suicidal risk. 31.1% of the total variance in suicidal risk was explained by mental disorders. The regression coefficients for mental disorders with a p<0.05 value is: perinatal depression (-0.279), post-partum psychosis (-0.133), trauma disorder (-0.034), generalised anxiety disorder (-0.008) and conduct disorder (-0.020). Conclusions: Our hypothesis is confirmed, because the prevalence of 66.4% of mental disorders and 27.4% of suicidal risk are significantly high in Cameroon. In some way, the disorders predict suicidal risk, because the less an adolescent mother has one of these pathologies during the perinatal period, the less she will be at risk of suicide. More research of this kind is needed to contribute in providing more data, including solutions to address the morbidity and mortality problems associated with the mental health of teenage mothers. [ABSTRACT FROM AUTHOR]

Background: We aimed to examine the hypothesized negative associations between childbirth post-traumatic stress disorder (PTSD) symptoms (using the two-factor model of birth-related and general symptoms), social support, and a couple's relationship quality at 8-12 weeks postpartum. This analysis considered the longitudinal positive shared variance with acute stress disorder (ASD) symptoms measured shortly after birth, while accounting for obstetric and demographic variables. Methods: Participants included 246 mothers who gave birth at the maternity ward of a tertiary healthcare center. Self-report questionnaires were used 1-4 days postpartum (T1): Demographic information, the Birth Satisfaction Scale-Revised (BSS-R), and the National Stressful Events Survey Acute Stress Disorder Short Scale (NSESSS). At T2 (8-12 weeks postpartum), the Multidimensional Scale of Perceived Social Support (MSPSS), the Dyadic Adjustment Scale (DAS-7), and the City Birth Trauma Scale (BiTS). Results: In partial support of our hypotheses, three hierarchical regression analyses revealed a significant positive contribution of ASD symptoms to childbirth PTSD general symptoms (β = .33, p <.001) and the total score (β = .29, p <.001), but not to birth-related symptoms. Social support (β = -.21, p = .003) and the quality of the couple's relationship (β=-.20, p = .003) showed negative associations with the BiTS general symptoms. Conclusion: Our study enhances understanding of the shared variance between childbirth ASD and PTSD, supporting the factor structure of general and birthrelated symptoms as different aspects of childbirth PTSD and highlighting the negative association of social support and the quality of a couple's relationship with PTSD general symptoms, suggesting potential avenues for targeted interventions. [ABSTRACT FROM AUTHOR]

Abortion behaviors among individuals with mental disorders presented major obstacles to women's health. However, few studies reported the prevalence and associated factors of abortion among women with severe mental disorders in China. Consequently, this study aims to investigate the prevalence of abortion among female patients in rural communities and identify potential health risks. This was a cross-sectional study of 276 women aged 18 years and older with severe mental disorders in rural areas of Shandong Province, China. The pregnancy history, abortion history and socio-demographic characteristics of women were investigated by questionnaire. Logistic regression analysis was employed to examine the associated factors for different abortion behaviors. The study showed that 82.61 % (228/276) of patients had a pregnancy history. Among the patients with a pregnancy history, 43.42 % (99/228) reported having had at least one abortion, and 15.79 % (36/228) had more than one. In the other side, 31.58 % (72/228) of them experienced spontaneous abortion, while 12.72 % (29/228) experienced induced abortion. Age at first gestation (aOR 0.80, 95 % CI 0.70–0.90) and age at last gestation (aOR 1.17, 95 % CI 1.07–1.27) were both associated with abortion. Anxiety was related to spontaneous (aOR 1.08, 95 % CI 1.02–1.15) and repeat abortions (aOR 1.10, 95 % CI 1.01–1.19). In addition, religion (aOR 10.47, 95 % CI 2.81–39.01), number of children≥2 (aOR 0.18, 95 % CI 0.04–0.77), and family functioning (aOR 1.31, 95 % CI 1.06–1.63) were associated with induced abortion. Women with severe mental disorders in rural regions have notably higher rates of abortion compared to the general female population, particularly for spontaneous abortions. Gestational age and anxiety of pregnant patients deserve attention and preventive measures to avoid the outcomes of abortion. • The prevalence of spontaneous abortion in SMDs patients was 31.58%, and the prevalence of induced abortion was 12.72%. • There were 15.79% of women with SMDs who reported having two or more abortions. • Patients with better family functioning were more likely to have an induced abortion than those with poorer. • Gestational age and anxiety symptoms were significantly associated with abortion. [ABSTRACT FROM AUTHOR]

Background: Although the association between mental disorder and metabolic syndrome as a bidirectional relationship has been demonstrated, there is little knowledge of the cumulative and individual effect of these conditions on peripartum mental health. This study aims to investigate the association between metabolic syndrome conditions (MetS-C) and maternal mental illness in the perinatal period, while exploring time to incident mental disorder diagnosis in postpartum women. Methods: This observational study identified perinatal women continuously enrolled 1 year prior to and 1 year post-delivery using Optum's de-identified Clinformatics® Data Mart Database (CDM) from 2014 to 2019 with MetS-C i.e. obesity, diabetes, high blood pressure, high triglycerides, or low HDL (1-year prior to delivery); perinatal comorbidities (9-months prior to and 4-month postpartum); and mental disorder (1-year prior to and 1-year post-delivery). Additionally, demographics and the number of days until mental disorder diagnosis were evaluated in this cohort. The analysis included descriptive statistics and multivariable logistic regression. MetS-C, perinatal comorbidities, and mental disorder were assessed using the International Classification of Diseases, Ninth, and Tenth Revision diagnosis codes. Results: 372,895 deliveries met inclusion/exclusion criteria. The prevalence of MetS-C was 13.43%. Multivariable logistic regression revealed prenatal prevalence (1.64, CI = 1.59–1.70) and postpartum incident (1.30, CI = 1.25–1.34) diagnosis of mental health disorder were significantly higher in those with at least one MetS-C. Further, the adjusted odds of having postpartum incident mental illness were 1.51 times higher (CI = 1.39–1.66) in those with 2 MetS-C and 2.12 times higher (CI = 1.21–4.01) in those with 3 or more MetS-C. Young women (under the age of 18 years) were more likely to have an incident mental health diagnosis as opposed to other age groups. Lastly, time from hospital discharge to incident mental disorder diagnosis revealed an average of 157 days (SD = 103 days). Conclusion: The risk of mental disorder (both prenatal and incident) has a significant association with MetS-C. An incremental relationship between incident mental illness diagnosis and the number of MetS-C, a significant association with younger mothers along with a relatively long period of diagnosis mental illness highlights the need for more screening and treatment during pregnancy and postpartum. [ABSTRACT FROM AUTHOR]

Background: Genitopelvic pain following childbirth is common and likely to challenge the psychological, relational, and sexual well-being of new mothers. While genitopelvic pain generally decreases during the postpartum period, personal and interpersonal characteristics may explain why genitopelvic pain persists beyond the period of physical recovery in some mothers. Body image concerns, increased stress, and relationship challenges would be particularly salient during pregnancy and the postpartum period, which could put new mothers at greater risk of sexual difficulties. Also, mothers may display a negative appraisal regarding genitopelvic pain and doubt their ability to cope with it, which may contribute to the pain. Aim: The current study aimed to examine the role of perfectionism, body image concerns, and perceived intimacy in the occurrence and change in genitopelvic pain in new mothers in postpartum. Methods: A total of 211 new mothers and their partners were recruited for a larger prospective dyadic study on the transition to parenthood. Outcomes: Mothers completed a single item assessing genitopelvic pain, in addition to brief validated questionnaires measuring perfectionism, body image concerns, and perceived couple intimacy during pregnancy and at 4, 8, and 12 months postpartum. Results: Five multilevel modeling analyses revealed that adaptive perfectionism, maladaptive perfectionism, and body image concerns were associated with a higher occurrence of genitopelvic pain from 4 to 12 months postpartum. Mothers' and partners' perceived intimacy was not significantly related to new mothers' genitopelvic pain. None of the predictors modified the trajectory of genitopelvic pain over time. Clinical Implications: Raising awareness among health care professionals regarding the role of perfectionism and body image concerns in genitopelvic pain may help them identify new mothers at risk of chronic genitopelvic pain, while offering a new avenue of intervention. Strengths and Limitations: There has been little research examining the role of perfectionism, body image concerns, and intimacy in postpartum genitopelvic pain. Based on a longitudinal prospective approach, this study identified perfectionism and body image concerns as significant predictors of postpartum genitopelvic pain. However, prepregnancy genitopelvic pain, genitopelvic pain intensity, and sexual distress were not measured. Conclusion: Adaptive and maladaptive perfectionism and body image concerns are associated with new mothers' genitopelvic pain up to 12 months postpartum. [ABSTRACT FROM AUTHOR]

Substance use disorders (SUDs) patients have longer lengths of hospital stay, and more unplanned readmissions than other hospitalized patients. We aim to evaluate SUD-related rehospitalization and length of hospital stay in a major rehabilitation center that serves countries of the Gulf States. In a retrospective cohort study for 16-year data set in Al-Amal Hospital Electronic Health Record in the city of Dammam, Eastern region of Saudi Arabia, patients received services from the SUD treatment programs in the period of January 1, 2005, to December 31, 2021. We used cause-specific Cox proportional hazards regression model to estimate risk of readmission, and general linear model to examine the association between substance use disorders and length of hospital stay. Of the total cohort, 4398 (30.17%) were readmitted within 1 year of discharge date. More than half of the cohort were unemployed patients (52.93%). Patients diagnosed with amphetamine use disorder were 1.36 higher risk of readmission compared to no amphetamine disorder (HR = 1.36; CI (1.04, 1.78) P.02). Patients diagnosed with mental disorder had 7.25 times higher risk of longer hospital stay compared to no mental health disorder (coefficient = 7.25; P <.0001). Amphetamine use disorder increased the risk of readmission. A secondary diagnosis of mental disorders among SUD patients increased length of hospital stay. As a targeted region of amphetamine smuggling in the world, policy and clinical decision-makers in Saudi Arabia and the Gulf States should consider taking proactive steps to minimize the future anticipated high demand for addiction treatment in the region. [ABSTRACT FROM AUTHOR]

Introduction: Understanding the mechanisms underlying maternal postpartum depression (PPD) and its effects on offspring development is crucial. However, research on the association between maternal PPD, gut microbiota, and offspring neurodevelopment remains limited. This study aimed to examine the association of maternal PPD symptoms with early gut microbiome, gut metabolome, and neurodevelopment in infants at 6 months. Methods: Maternal PPD symptoms were assessed using the Edinburgh Postpartum Depression Scale (EPDS) at 42 days postpartum. Infants stool samples collected at 42 days after birth were analyzed using 16S rRNA sequencing and liquid chromatography-mass spectrometry (LC-MS) detection. Infant neurodevelopment was measured at 6 months using the Ages and Stages Questionnaire, Third Edition (ASQ-3). Correlations between gut microbiota, metabolites and neurodevelopment were identified through cooccurrence network analysis. Finally, mediation analyses were conducted to determine potential causal pathways. Results: A total of 101 mother-infant dyads were included in the final analysis. Infants born to mothers with PPD symptoms at 42 days postpartum had lower neurodevelopmental scores at 6 months. These infants also had increased alpha diversity of gut microbiota and were abundant in Veillonella and Finegoldia, while depleted abundance of Bifidobacterium, Dialister, Cronobacter and Megasphaera. Furthermore, alterations were observed in metabolite levels linked to the Alanine, aspartate, and glutamate metabolic pathway, primarily characterized by decreases in N-Acetyl-L-aspartic acid, L-Aspartic acid, and LAsparagine. Co-occurrence network and mediation analyses revealed that NAcetyl-L-aspartic acid and L-Aspartic acid levels mediated the relationship between maternal PPD symptoms and the development of infant problemsolving skills. Conclusions: Maternal PPD symptoms are associated with alterations in the gut microbiota and neurodevelopment in infants. This study provides new insights into potential early intervention for infants whose mother experienced PPD. Further research is warranted to elucidate the biological mechanisms underlying these associations. [ABSTRACT FROM AUTHOR]

The editorial "Women in psychiatry 2023: Perinatal psychiatry" published in Frontiers in Psychiatry highlights the importance of gender equity in mental health research, particularly in the field of perinatal psychiatry. The document emphasizes the need for more research on perinatal mood and anxiety disorders, especially among minorities and disadvantaged populations. Various studies within the research topic explore risk factors for perinatal mental illness, including the impact of nutritional factors, total bilirubin levels, and behavioral factors on conditions like postpartum depression. Additionally, the editorial discusses the role of artificial intelligence and the importance of addressing race/ethnicity in understanding mental health disparities during the perinatal period. [Extracted from the article]

Background: Hypertensive disorders of pregnancy are a main cause of maternal morbidity and mortality in the United States and worldwide, and it is estimated that approximately 60% of maternal deaths in the United States occur during the postpartum period. The utilization of telehealth modalities such as home blood pressure monitoring has shown improvement in blood pressure control and adherence with follow up visits. Our study sought to determine if standardized education improved patient hypertension knowledge and if this when combined with home blood pressure telemonitoring increased participants' postpartum self-blood pressure monitoring and postpartum visit attendance. Methods: This is an Institutional Review Board approved prospective cohort study conducted at the University of Mississippi Medical Center. Women with a hypertensive disorder of pregnancy who met the inclusion criteria and provided written informed consent to participate were enrolled. Participants received a baseline pre-education questionnaire designed to assess their knowledge of their hypertensive diagnosis, hypertension management, and postpartum preeclampsia (PreE). Participants then received standard education, a blood pressure monitor, and were scheduled a follow-up visit during the first 10 days following discharge. Remote home blood pressure monitoring was performed via text messages and voice calls for 6-weeks postpartum. At the conclusion of the study, participants repeated their original questionnaire. Results: 250 women provided informed consent to participate in the study and were included in this analysis. Relative to the baseline survey, there was a significant increase (p = 0.0001) in the percentage of correct responses. There was not an association between study engagement and percentage of correct responses on end of study questionnaire (p = 0.33) or postpartum visit attendance (p = 0.69). Maternal age was found to drive study engagement, even when adjusted for community-level distress (p = 0.03) and maternal race (p = 0.0002). Conclusion: Implementing a standardized postpartum education session was associated with improvement in patient's knowledge. Further studies are needed with more longitudinal follow up to assess if this program would also result in improved long-term outcomes and decreased hospital readmission rates. Trial registration: NCT04570124. [ABSTRACT FROM AUTHOR]

Objectives: Remotely administered mental health care is becoming increasingly common for treatment of a range of psychiatric disorders; however, there is a dearth of literature overviewing direct comparisons between remote and in-person interventions for treatment of Perinatal Mood and Anxiety Disorders (PMADs). The sudden advent of the Covid-19 pandemic in New York City forced an abrupt conversion for an intensive day treatment program for new mothers with PMADs, from an on-site to a remote program. Methods: The current report compares outcomes of 81 women who completed the program in-person to those of 60 women who completed the program remotely. Results: Improvement in depression scores was statistically superior in the remote program, and improvement in mother-infant bonding was statistically equivalent between the on-site and remote programs. Discussion: These findings indicate that specialized partial hospitalization treatment for individuals with moderate to severe psychiatric illness can be effectively provided via telehealth, thus offering improved convenience, accessibility, and safety without compromising care. We conclude that remotely administered group psychotherapy is an effective intervention for women with moderate to severe PMADs. Significance: Resources and treatments remain limited for perinatal women, with approximately 50% of women diagnosed with a perinatal mood and anxiety disorder (PMAD) not receiving adequate mental health treatment (Luca et al., 2020), with accessibility and viability as essential to appropriate treatment of PMADs. While the advantages of remotely administered mental health treatments have been established, there is a dearth of evidence of the utility and benefits of virtual mental health treatment for women with PMADs. Our analyses represent a significant contribution to the literature regarding treatment of women with severe PMADs, especially acute depressive symptoms, in the virtual milieu. Given the acuity and need for specialized treatment for at-risk individuals in the perinatal period, our findings are promising regarding the helpfulness of wrap-around virtual care as a viable alternative to intensive in-person treatment, despite disadvantages including lack of on-site nursery [ABSTRACT FROM AUTHOR]

Background: Postpartum women experience an array of psychological symptoms that are associated with adverse health behaviors and outcomes including postpartum suicidal ideation and long-term depression. To provide early management of postpartum psychological symptoms, it is important to understand how the symptom experiences change over time. Objective: The aim of this study was to examine maternal psychological symptom trajectories over 2, 6, 15, and 24 months postpartum using latent class growth analysis and to examine how each trajectory is associated with maternal depression outcome at 24 months. Methods: We used secondary data from the Family Life Project (N = 1,122) and performed multitrajectory latent class growth analysis based on four observed symptom variables (depression, anxiety, somatization, and hostility). After the final model was identified, bivariate analyses were conducted to examine the association between each trajectory and (a) individual characteristics and (b) outcome (Center for Epidemiologic Studies Depression Scale [CES-D]) variables. Results: A four-class model was selected for the final model because it had better fit indices, entropy, and interpretability. The four symptom trajectories were (a) no symptoms over 24 months, (b) low symptoms over 24 months, (c) moderate symptoms increasing over 15 months, and (d) high symptoms increasing over 24 months. More postpartum women with the trajectory of high symptoms increasing over 24 months (Trajectory 4) were in low economic status (92.16%), unemployed (68.63%), or did not complete 4-year college education (98.04%). Most postpartum women (95.56%) in Trajectory 4 also had higher CES-D cutoff scores, indicating a possible clinical depression at 24 months postpartum. Discussion: Postpartum women who experience increasing symptom trajectories over 15–24 months (Trajectories 3 and 4) could benefit from tailored symptom management interventions provided earlier in the postpartum period to prevent persistent and worsening symptom experiences. [ABSTRACT FROM AUTHOR]

The transition to parenthood, or the addition of another child to the family system is a life altering event for both mothers and fathers that can affect both parents individually and their relationship. For some parents, this includes perinatal suicidal ideation. Despite the prevalence of perinatal mood disorders, there are no systemic models designed specifically for couples who are at risk for suicide. This paper reviews the literature on the prevalence of perinatal suicidal ideation and proposes an integrative treatment model using aspects of Collaborative Assessment of Suicidality (CAMS), Attachment based family therapy (ABFT), and Emotionally Focused Therapy (EFT). [ABSTRACT FROM AUTHOR]

This Special Communication reviews data about associations between maternal mortality and perinatal mental conditions, social determinants of health, suicide and addictive disorders, access limitations, and prenatal stress and describes efforts involving cross-disciplinary education and intervention sites and models. Importance: The rate of maternal mortality in the United States is 2-fold to 3-fold greater than that in other high-income countries. While many national initiatives have been developed to combat maternal mortality, these efforts often fail to include mental illness. Objective: To highlight the underrecognized contribution of mental illness to maternal mortality, which is nearly double that of postpartum hemorrhage. Evidence Review: A topic outline was developed to include challenges in measuring perinatal mental conditions and mortality rates; contributions of social determinants of health to mental conditions and mortality; perinatal psychiatric disorder characterization; mechanisms by which maternal mental illness increases mortality, specifically, suicide and addictive disorders; access limitations and care "deserts"; prenatal stress and its impact on reproductive outcomes; increasing clinician expertise through cross-disciplinary education; intervention sites and models; and asserting that mental health is fundamental to maternal health. Publications in the last 3 years were prioritized, particularly those relating to policy. References were selected through consensus. Sources were PubMed, Ovid, direct data published on government websites, and health policy sources such as the Policy Center for Maternal Mental Health. Findings: Priority was given to recent sources. Citations from 2022-2023 numbered 26; within the last 5 years, 14; and historical references, 15. Recommendations to address each topic area serve as concluding statements for each section. To mitigate the contributions of mental illness to the maternal mortality risk, a coordinated effort is required across professional and governmental organizations. Conclusions and Relevance: Concrete programmatic and policy changes are needed to reduce perinatal stress and address trauma, standardize the collection of social determinant of health data among perinatal patients, increase access to reproductive psychiatry curricula among prescribers, reduce perinatal mental health and obstetrical deserts, institute paid parental leave, and support seamless integration of perinatal and behavioral health care. Moreover, instead of focusing on a relatively minor portion of the contributors to health that current medical practice targets, fortifying the social foundation strengthens the prospects for the health of families for our current and future generations. [ABSTRACT FROM AUTHOR]

Background: Common mental disorders describe the physical, mental, and social disturbances that are more prevalent in low and middle-income countries. Mothers are among the more vulnerable groups especially mothers having children with under-nutrition. However, there are limited studies about the magnitude of common mental disorders among mothers of undernourished children in Ethiopia. Therefore, we aimed to assess the magnitude of common mental disorders and associated factors among mothers of children attending severe acute malnutrition treatment in Gedio Zone, Southern Ethiopia. Methods: A cross-sectional study was employed on 405 systematically selected participants. The outcome variable was assessed by a self-reporting questionnaire (SRQ-20) which was applicable and validated in Ethiopia. Data were entered and analyzed by EPi data version 5 software and SPSS version 25 respectively. Model fitness was checked by Hosmer Lemeshow's test. Logistic regression was employed to identify significant determinants. A p-value < 0.05 was used to declare association and expressed by odds ratio with a 95% CI. Result: In this study, the magnitude of common mental disorders was 33.16% (95% CI [28.5–38])). In multivariable analysis, six factors poor social support [AOR: 14.0, 95% CI (5.45, 35.9)], educational status [AOR: 1.95, 95% CI (1.07. 3.55)], cigarette smoking [AOR: 10.9, 95% CI (1.78, 67.01)], mother of a child with another chronic disease [AOR: 3.19, 95% CI (1.13, 8.99)], sexual violence [AOR: 4.14, 95% CI (1.38, 12.4)] and mothers with chronic disease [AOR: 3.44, 95% CI (1.72, 6.86)] were significantly associated with common mental disorders. Conclusion: The magnitude of common mental disorders was high. Six factors were significantly associated with common mental disorders; social support, sexual violence, maternal chronic illness, educational status, smoking, and mother of child with other chronic disease. Community awareness regarding the effect of violence, substance use, and social support on mental health should be created by the local stakeholders. [ABSTRACT FROM AUTHOR]

Perinatal mood and anxiety disorders (PMADs) profoundly impact maternal and infant health, affecting women worldwide during pregnancy and postpartum. This review synthesizes current research on the neurobiological effects of PMADs, particularly their influence on brain structure, function, and corresponding cognitive, behavioral, and mental health outcomes in mothers. A literature search across PubMed, PsycINFO, and Google Scholar yielded studies utilizing neuroimaging (MRI, fMRI) and cognitive assessments to explore brain changes in PMADs. The key findings indicate significant neurobiological alterations in PMADs, such as glutamatergic dysfunction, neuronal damage, and altered neural connectivity, particularly in postpartum depression (PPD). Functional MRI studies reveal distinct patterns of brain function alteration, including amygdala non-responsivity in PPD, differing from traditional major depressive disorder (MDD). These neurobiological changes are connected with cognitive impairments and behavioral modifications, impacting maternal caregiving. Understanding these alterations is fundamental for developing effective treatments. The findings emphasize the importance of focusing on maternal mental health, advocating for early detection, and personalized treatment strategies to improve maternal and child outcomes. [ABSTRACT FROM AUTHOR]

Postpartum depression is a common and serious mental health problem that is affecting an increasing percentage of the world's population. We aimed to evaluate the prevalence of postpartum depressive symptoms in Beijing, China, during the COVID-19 pandemic and identify several potential risk factors. This was a cross-sectional observational study conducted at Peking University First Hospital from 2020 to 2021. Women who delivered and had postpartum reviews at 42 days after delivery were invited to complete the Chinese version of the Edinburgh Postnatal Depression Scale (EPDS) under the guidance of trained nurses. A score of ≥10 was used as the threshold of postpartum depression. t- tests, chi-square tests or Mann–Whitney U tests were applied. A multivariate logistic regression analysis was conducted to assess the risk factors for postpartum depressive symptoms. A total of 2462 mothers were included in this study, 20.2 % of whom were considered to have postpartum depressive symptoms. Multivariate logistic regression analysis showed that formula feeding (OR = 2.219, 95 % CI: 1.300–3.786, P = 0.013), preterm birth (OR = 1.619, 95 % CI: 1.108–2.367, P = 0.013), cervical insufficiency (OR 3.022, 95 % CI: 1.200–7.615, P = 0.019) and history of depression (OR = 6.519, 95 % CI: 1.537–27.659, P = 0.011) were associated with a high prevalence of postpartum depressive symptoms. There is a high prevalence of postpartum depressive symptoms in developed regions of China during the COVID-19 pandemic. More attention should be given to mothers with risk factors for PPD, and follow-up care is needed. • There is a high prevalence of postpartum depressive symptoms in Beijing of China. • History of depression, preterm birth, CI and formula feeding are risk factors for postpartum depressive symptoms. • Routine assessments of PPD at postpartum outpatient visits and a follow-up care for high-risk mothers are necessary. [ABSTRACT FROM AUTHOR]

Key Points: Question: Are potentially traumatic events associated with a subsequent risk of psychiatric disorders independent of familial factors? Findings: In this Swedish nationwide cohort study using a sibling-comparison design to adjust for familial factors, physical and sexual assault (n = 49 957), injury (n = 555 314), and bereavement (n = 321 263) were associated with an increased risk of subsequent psychiatric disorders for more than 2 decades of observation and in particular during the first year following the event. Meaning: These findings suggest that early clinical surveillance and targeted mental health services may be advisable among individuals who experience assault, injury, or bereavement. This cohort study evaluates risk of psychiatric disorders following the potentially traumatic events of assault, injury, and bereavement apart from familial factors. Importance: Traumatic events have been associated with elevated risks of psychiatric disorders, while the contributions of familial factors to these associations remain less clear. Objective: To determine the contribution of familial factors to long-term incidence trajectories of psychiatric disorders following potentially traumatic events. Design, Setting, and Participants: This cohort study evaluated 3 separate cohorts of individuals residing in Sweden who were free of previous diagnosed psychiatric disorders when first exposed to assault (n = 49 957), injury (n = 555 314), or bereavement (n = 321 263) from January 1987 to December 2013, together with their unexposed full siblings, and 10 age-, sex-, and birthplace-matched unexposed individuals (per exposed individual). Cohorts were created from the Swedish Total Population Register linked to health and population registers. Data were analyzed from March 2022 to April 2023. Exposures: Potentially traumatic events, including various types of assault, injuries, and bereavement (death of a child or of a spouse or partner), were ascertained from the Swedish national registers. Main Outcomes and Measures: Incident psychiatric disorders were ascertained from the Swedish Patient Register. Flexible parametric and Cox models were used to estimate associations of potentially traumatic events with incident psychiatric disorders after multivariable adjustment. Results: The median (IQR) age at exposure to assault, injury, and bereavement was 22 (18-31), 19 (8-40), and 60 (51-68) years, respectively. During a median (IQR) follow-up of 4.9 (2.2-8.2), 9.1 (4.1-15.6), and 8.1 (3.4-14.8) years, the incidence rates of any psychiatric disorder were 38.1, 13.9, and 9.0 per 1000 person-years for the exposed groups of the 3 cohorts, respectively. Elevated risk of any psychiatric disorder was observed during the first year after exposure to any assault (hazard ratio [HR], 4.55; 95% CI, 4.34-4.77), injury (HR, 3.31; 95% CI,3.23-3.38), or bereavement (HR, 2.81; 95% CI, 2.72-2.91) and thereafter (assault HR, 2.50; 95% CI, 2.43-2.56; injury HR, 1.69; 95% CI, 1.68-1.70; bereavement HR, 1.42; 95% CI, 1.40-1.44). Comparable associations were obtained in sibling comparison (first year: assault HR, 3.70; 95% CI, 3.37-4.05; injury HR, 2.98; 95% CI, 2.85-3.12; bereavement HR, 2.72; 95% CI, 2.54-2.91; thereafter: assault HR, 1.93; 95% CI, 1.84-2.02; injury HR, 1.51; 95% CI, 1.48-1.53; bereavement HR, 1.35; 95% CI, 1.31-1.38). The risk elevation varied somewhat by type of traumatic events and psychiatric disorders, with the greatest HR noted for posttraumatic stress disorder after sexual assault (sibling comparison HR, 4.52; 95% CI, 3.56-5.73 during entire follow-up period). Conclusions and Relevance: In this study, the long-term risk elevation of psychiatric disorders after potentially traumatic events was largely independent of familial factors. The risk elevation observed immediately after these events motivates early clinical surveillance and mental health services for these vulnerable populations. [ABSTRACT FROM AUTHOR]

Background: There is a paucity of data on the presence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in feces of lactating women with coronavirus disease 2019 (COVID-19) and their breastfed infants as well as associations between fecal shedding and symptomatology. Objective: We examined whether and to what extent SARS-CoV-2 is detectable in the feces of lactating women and their breastfed infants following maternal COVID-19 diagnosis. Methods: This was a longitudinal study carried out from April 2020 to December 2021 involving 57 breastfeeding maternal-infant dyads: 33 dyads were enrolled within 7 d of maternal COVID-19 diagnosis, and 24 healthy dyads served as controls. Maternal/infant fecal samples were collected by participants, and surveys were administered via telephone over an 8-wk period. Feces were analyzed for SARS-CoV-2 RNA. Results: Signs/symptoms related to ears, eyes, nose, and throat (EENT); general fatigue/malaise; and cardiopulmonary signs/symptoms were commonly reported among mothers with COVID-19. In infants of mothers with COVID-19, EENT, immunologic, and cardiopulmonary signs/symptoms were most common, but prevalence did not differ from that of infants of control mothers. SARS-CoV-2 RNA was detected in feces of 7 (25%) women with COVID-19 and 10 (30%) of their infants. Duration of fecal shedding ranged from 1-4 wk for both mothers and infants. SARS-CoV-2 RNA was sparsely detected in feces of healthy dyads, with only one mother's and two infants' fecal samples testing positive. There was no relationship between frequencies of maternal and infant SARS-CoV-2 fecal shedding (P=0.36), although presence of maternal or infant fever was related to increased likelihood (7-9 times greater, P<0.04) of fecal shedding in infants of mothers with COVID-19. [ABSTRACT FROM AUTHOR]

Background: The rates of suicide and opioid use disorder (OUD) among pregnant and postpartum women continue to increase. This research characterized OUD and suicide attempts among Medicaid-enrolled perinatal women and examined prenatal OUD diagnosis as a marker for postpartum suicide attempts. Methods: Data from Oregon birth certificates, Medicaid eligibility and claims files, and hospital discharge records were linked and analyzed. The sample included Oregon Medicaid women aged 15–44 who became pregnant and gave live births between January 2008 and January 2016 (N = 61,481). Key measures included indicators of suicide attempts (separately for any means and opioid poisoning) and OUD diagnosis, separately assessed during pregnancy and the one-year postpartum period. Probit regression was used to examine the overall relationship between prenatal OUD diagnosis and postpartum suicide attempts. A simultaneous equations model was employed to explore the link between prenatal OUD diagnosis and postpartum suicide attempts, mediated by postpartum OUD diagnosis. Results: Thirty-three prenatal suicide attempts by any means were identified. Postpartum suicide attempts were more frequent with 58 attempts, corresponding to a rate of 94.3 attempts per 100,000. Of these attempts, 79% (46 attempts) involved opioid poisoning. A total of 1,799 unique women (4.6% of the sample) were diagnosed with OUD either during pregnancy or one-year postpartum with 53% receiving the diagnosis postpartum. Postpartum suicide attempts by opioid poisoning increased from 55.5 per 100,000 in 2009 to 105.1 per 100,000 in 2016. The rate of prenatal OUD also almost doubled over the same period. Prenatal OUD diagnosis was associated with a 0.15%-point increase in the probability of suicide attempts by opioid poisoning within the first year postpartum. This increase reflects a three-fold increase compared to the rate for women without a prenatal OUD diagnosis. A prenatal OUD diagnosis was significantly associated with an elevated risk of postpartum suicide attempts by opioid poisoning via a postpartum OUD diagnosis. Conclusions: The risk of suicide attempt by opioid poisoning is elevated for Medicaid-enrolled reproductive-age women during pregnancy and postpartum. Women diagnosed with prenatal OUD may face an increased risk of postpartum suicides attempts involving opioid poisoning. [ABSTRACT FROM AUTHOR]

Background: Although pregnancy complicated by liver cirrhosis is rare, women with cirrhosis experience increased adverse pregnancy outcomes. This study aimed to evaluate pregnancy outcomes in women with liver cirrhosis and develop a predictive model using maternal factors for preterm birth in such pregnancies. Methods: A retrospective analysis was conducted on pregnancy outcomes of a cirrhosis group (n = 43) and a non-cirrhosis group (n = 172) in a university hospital between 2010 and 2022. Logistic regression evaluated pregnancy outcomes, and a forward stepwise logistic regression model was designed to predict preterm birth in pregnant women with cirrhosis. The model's predictive performance was evaluated using the receiver operating characteristic (ROC) curve and the area under the ROC curve (AUC). Results: The incidence of cirrhosis during pregnancy was 0.06% (50/81,554). Pregnant women with cirrhosis faced increased risks of cesarean section, preterm birth, intrahepatic cholestasis of pregnancy, thrombocytopenia, and postpartum hemorrhage. In pregnant women with cirrhosis, preterm birth risk significantly increased at an incidence rate of 46.51% (20/43). According to the prediction model, the key predictors of preterm birth in pregnant women with cirrhosis were intrahepatic cholestasis of pregnancy and total bilirubin. The model demonstrated accurate prediction, with an AUC of 0.847, yielding a model accuracy of 81.4%. Conclusions: Pregnant women with cirrhosis face a heightened risk of adverse obstetric outcomes, particularly an increased incidence of preterm birth. The preliminary evidence shows that the regression model established in our study can use the identified key predictors to predict preterm birth in pregnant women with cirrhosis, with high accuracy. [ABSTRACT FROM AUTHOR]

Objective:The purpose of this case report was to evaluate the effect of telehealth and postpartum care provided to a mother with maternal depression according to Watson's Theory of Human Caring during the pandemic on the improvement in the mother's emotional state and to evaluate the applicability of the model. Methods:Edinburgh Postnatal Depression Scale was administered to eight women who responded to the announcement made on social media, and verbal and written permission was obtained from the mother with the highest scale score. A total of six video calls were made with the mother via WhatsApp, twice a week in the first week after postnatal discharge and once a week in the next 4 weeks, in accordance with the form drawn up according to Watson's Theory of Human Caring. Results:In this study, it was observed that home-based telehealth and postpartum care provided using Watson's Theory of Human Caring, which includes a holistic approach, was very useful, and the care provided according to the model provided a positive improvement in the emotional state of the mother with depression. Conclusions:It was concluded that telehealth and postpartum care is useful in home-based care in extraordinary situations/quarantine conditions such as pandemic; care can also be provided in the form of telehealth service according to Watson's Theory of Human Caring to mothers with depression; and care provides positive improvement in the emotional state of mothers. [ABSTRACT FROM AUTHOR]

Objectives: Perinatal psychopathology can be damaging. This study examined the strength of the associations between risk factors and all perinatal mood and anxiety disorder symptoms while assessing the mediating effect of experiential avoidance. Method: Participants (N = 246) completed assessments during pregnancy (28–32 weeks) and the postpartum (6–8 weeks). Structural equation modeling (SEM) was used to examine associations between risk factors and latent factors: distress (composed of depression, generalized anxiety, irritability, and panic symptoms); fear (social anxiety, agoraphobia, specific phobia, and obsessive‐compulsive); and bipolar (mania and obsessive‐compulsive). Results: During pregnancy, past psychiatric history, anxiety sensitivity, maladaptive coping, and age were significant risk factors. In the postpartum, negative maternal attitudes and past psychiatric history were only risk factors for symptoms that composed distress. Experiential avoidance mediated the relation between maladaptive coping and symptoms that composed fear. Conclusion: It is important to assess for psychological risk factors starting in pregnancy. This study identified critical risk factors that are associated with the underlying commonality among perinatal mood and anxiety symptoms. Some of the risk factors as well as the mediator are malleable (negative maternal attitudes, experiential avoidance), creating new possibilities for prevention and treatment of perinatal mood and anxiety disorder symptoms. [ABSTRACT FROM AUTHOR]

Postpartum psychosis (PP) is a severe psychiatric illness that occurs in about 1 to 2 per 1000 people in the perinatal period. To date, qualitative research investigating PP has focused on specific topics, such as treatment experiences or the impact of the illness on patients' lives and families. These studies have included small samples of women with histories of PP, often limited to certain geographical areas or treatment centers. Given the heterogeneity in presentations of PP and access to care, larger and geographically diverse samples are needed to broadly understand this complex illness. Initiated in 2018, the Massachusetts General Hospital Postpartum Psychosis Project (MGHP3) consists of a large, international sample of those who have experienced PP. In addition to the specific aims of MGHP3, which include to better understand the phenomenology and potential genetic underpinnings of PP, this investigation invites participants to qualitatively describe their narratives of postpartum psychosis. This analysis included 130 participants who reported on 133 episodes of PP. Participants' responses to the PP narrative prompt fell under several overarching categories: 1) broad psychosocial experiences surrounding postpartum psychosis, 2) impact on the mother-baby dyad, 3) treatment experiences, and 4) recovery experiences. Our findings shed light on a range of ways in which individuals' lives are impacted by this illness, and point to areas for future research and clinical directions to improve the support and care for individuals with PP and their families. • This study highlights qualitative findings from the Massachusetts General Hospital Postpartum Psychosis Project (MGHP3). • MGHP3 consists of a large international sample of women who have experienced and described their narratives of PP. • Their responses fell under themes: broad psychosocial experience, mother-baby dyad, and treatment and recovery experiences. • These qualitative findings point to future work to improve support and care for individuals with PP and their families. [ABSTRACT FROM AUTHOR]

Introduction: Concurrent diagnosis of gestational diabetes mellitus and mental disorders is associated with adverse outcomes for mother and child, but there is limited information about prevalence or which women are at risk. Material and methods: This study was a prospective cohort study of women with gestational diabetes from 10 hospitals in New Zealand who reported anxiety (6‐item Spielberger State–Trait Anxiety Inventory), depression (Edinburgh Postnatal Depression Scale) and health‐related quality of life (36‐Item Short‐Form General Health Survey) at time of gestational diabetes diagnosis (baseline), 36 weeks' gestation, and 6 months postpartum. Potential predictors were assessed using multivariable logistic regression. Results: Among 414 respondents, 17% reported anxiety, 16% vulnerability to depression and 27% poor mental health‐related quality of life at time of gestational diabetes diagnosis. At 36 weeks' gestation, prevalence decreased for vulnerability to depression (8%) and poor mental health‐related quality of life (20%). Younger maternal age, Pacific ethnicity, previous history of gestational diabetes, and older gestational age at time of gestational diabetes diagnosis were associated with poorer mental health outcomes. At 6 months postpartum the prevalence of mental disorders did not differ from in late pregnancy and they were associated with later gestational age at time of gestational diabetes diagnosis and elevated 2‐hour postprandial glucose concentrations. Conclusions: Perinatal mental disorders are common at time of diagnosis among women with gestational diabetes in New Zealand and had decreased by late pregnancy and at 6 months after birth. These disorders are more common among women with specific risk factors who may therefore benefit from additional support. [ABSTRACT FROM AUTHOR]

Objective: Cognitive disengagement syndrome, formerly known as sluggish cognitive tempo, is defined as mental fogginess, daydreaming, and sluggishness. This study aimed to determine the prevalence and sociodemographic characteristics of children with cognitive disengagement syndrome and to examine the relationship between cognitive disengagement syndrome and psychiatric disorders. Methods: About 268 randomly chosen Turkish primary school children aged 7-11 years from 4 different cities were included in this study. Both teachers and parents completed the cognitive disengagement syndrome scanning scale of the Child Behavior Checklist and the Barkley Child Attention Survey. Psychiatric diagnoses in children were assessed using a semi-structured clinical interview. Four separate cognitive disengagement syndrome measurements were performed, matching informants with scales. Results: The prevalence of cognitive disengagement syndrome was estimated with a range of 4.9%-10.9%, depending on the way of measurement. Logistic regression analyses revealed that paternal psychopathology (odds ratio = 6.7) and low maternal education (odds ratio = 3.1) increased while advanced maternal age (odds ratio = 0.7) decreased the risk of cognitive disengagement syndrome. Although cognitive disengagement syndrome was found to be more prevalent in children with chronic diseases, this association no longer remained in the full logistic regression model. Attention deficit/hyperactivity disorder was the most observed disorder and accompanied 42.9%-75% of the cases with higher cognitive disengagement syndrome. However, there was no strong support in favor of associations between cognitive disengagement syndrome and depression and anxiety as a whole. Conclusion: This study provides the first estimates regarding the prevalence and the sociodemographic characteristics of Turkish children with cognitive disengagement syndrome. Cognitive disengagement syndrome seems to be relatively more prevalent in Turkey than in Western cultures. Children whose fathers had a psychiatric disorder, whose mothers had low education, and who were at younger ages should be scrutinized for cognitive disengagement syndrome. [ABSTRACT FROM AUTHOR]

Perinatal mood and anxiety disorders and substance use disorders are the primary causes of maternal mortality in the postpartum period and represent major public health concerns. Despite this, these conditions remain undertreated. Behavioral health integration in outpatient obstetric settings is necessary but insufficient to meet the needs of all patients. Inpatient behavioral health integration represents a promising avenue for addressing gaps in care. Results from recent program development indicate that needs assessment, stakeholder backing, collaboration with existing programs, and adaptability are key factors in successful implementation. [ABSTRACT FROM AUTHOR]

Perinatal mood and anxiety disorders (PMADs) are common, yet obstetricians receive little training prior to independent practice on screening, assessing, diagnosing, and treating patients with depression and anxiety. Untreated PMADs lead to adverse pregnancy and fetal outcomes. Obstetricians are in a unique position to address PMADs. The following serves as a resource for addressing PMADs in obstetric practice. [ABSTRACT FROM AUTHOR]

Mental health and substance use conditions are prevalent among perinatal individuals. These conditions have a negative impact on the health of perinatal individuals, their infants, and families, yet are underdiagnosed and undertreated. Populations that have been marginalized disproportionately face barriers to accessing care. Integrating mental health into obstetric care could address the perinatal mental health crisis. We review perinatal mental health conditions and substance use, outline the impact associated with these conditions, and describe the promise and potential of integrating mental health into obstetric settings to improve outcomes for patients receiving obstetric and gynecologic care. [ABSTRACT FROM AUTHOR]