The risk of attention deficit hyperactivity disorder symptoms in offspring of mothers with perinatal depression: A systematic review and meta-analysis.

BACKGROUND: The existing epidemiological evidence on the link between maternal depression and the risk of attention deficit and hyperactivity disorder (ADHD) symptoms in children lacks consistency. This systematic review and meta-analysis aimed to comprehensively synthesise the existing evidence on the relationship between maternal depression during the antenatal and postnatal periods and the risk of ADHD symptoms in offspring. METHODS: We systematically searched PubMed, Medline, Embase, Scopus, CINAHL, and PsychINFO to identify relevant articles. Random-effects meta-analysis models were employed to estimate the pooled odds ratio (OR) along with 95 % confidence intervals (CI). Statistical heterogeneity was assessed using Cochrane's Q-test and I2-test. Subgroup analysis was conducted to explore potential sources of variation within the included studies. Publication bias was assessed using a funnel plot and Egger's test for regression asymmetry. RESULTS: Twenty-one observational studies, comprising 796,157 mother-offspring pairs, were included in the final analysis. Our meta-analysis found a 67 % (OR = 1.67, 95 % CI = 1.35-2.00) and a 53 % (OR = 1.53, 95 % CI = 1.27-1.78) increased risk of ADHD symptoms in the offspring of mothers experiencing antenatal and postnatal depression, respectively. CONCLUSION: Our systematic review and meta-analysis identified an elevated risk of ADHD symptoms in the offspring of mothers who experienced both antenatal and postnatal depression. These findings underscore the importance of early screening and targeted intervention programs for at-risk children and adolescents.

Ten-year trajectories of postpartum depression of Japanese mothers and fathers.

BACKGROUND: Perinatal depression is a significant concern affecting both women and men during pregnancy and postpartum periods. While maternal postpartum depression has been extensively studied, paternal depression remains under-researched despite its prevalence and impact on family well-being. This study aimed to estimate the trajectories of perinatal and postpartum depression in Japanese parents over ten years and to determine the details of the symptoms of postpartum depression for each trajectory group, considering reciprocal effects between maternal and paternal depression. METHODS: A total of 789 couples used the Edinburgh Postnatal Depression Scale to rate their depressive symptoms prenatally; at 5 weeks, 3 months, 6 months, and 1 year postpartum; and then yearly thereafter until the 10th year. Parallel-process latent class growth analysis was used to group participants according to their longitudinal patterns of depressive symptoms. RESULTS: For both mothers and fathers, four depressive symptom trajectories fit the data best and were most informative (escalating: 6.5 %; mothers low and fathers moderate: 17.2 %; mothers high and fathers low: 17.9 %; low: 58.4 %). A variance analysis showed significant class-parent interactions across anhedonia, anxiety, and depression subscales, indicating distinct patterns of depressive symptomatology. DISCUSSION: Tailored mental health programs and universal screening using the Edinburgh Postnatal Depression Scale are recommended to address the specific needs of each trajectory class. This study contributes to the understanding of long-term depressive symptom trajectories in parents and emphasizes the necessity of comprehensive support strategies to enhance family well-being and resilience.

Assessment of the validity and reliability of edinburgh postpartum depression scale in Turkish men.

OBJECTIVES: Perinatal depression (PD) affects individuals during pregnancy and early parenthood, resembling major depression. Recent research highlights paternal perinatal depression (PPD) in fathers. PPD has adverse effects on fathers and their children. This study assesses the Turkish version of the Edinburgh Postnatal Depression Scale (EPDS) for Turkish fathers, aiming to provide a tool for PPD identification. METHODS: This methodological study validates the EPDS for Turkish fathers and explores associations with demographic and psychosocial factors. The study involved 295 fathers with infants aged 2 weeks to 12 months. The EPDS, originally designed for perinatal depression and validated in Turkish women, was used. Fathers completed a participant information questionnaire, the EPDS, and the Beck Depression Inventory (BDI) during clinic visits. Data on sociodemographic factors, paternal roles, and pregnancy and postpartum support were collected. Mothers also completed the EPDS. Descriptive statistics, exploratory factor analysis, confirmatory factor analysis, and correlation tests were used. RESULTS: The study included fathers with an average age of 30.5 years, mostly with a high school education or higher. The EPDS had a mean total score of 3.1. Factor analysis suggested a three-factor structure for the EPDS in Turkish fathers, including anhedonia, anxiety, and depression. Confirmatory factor analysis validated the three-factor structure, with acceptable model fit indices. Positive correlations were found between fathers' EPDS scores, maternal EPDS scores, and paternal BDI scores. The EPDS effectively discriminated between different levels of depression severity. Various factors, such as education level and lack of support during pregnancy and after childbirth, were associated with higher EPDS scores. CONCLUSIONS: These findings emphasize the significance of assessing and addressing PPD in fathers, supporting the use of the EPDS as a valid tool in the Turkish context. The three-factor structure aligns with international research, highlighting the importance of a multi-dimensional approach to PPD assessment. Early intervention can mitigate PPD's impact on fathers, mothers, and children, benefiting mental health and well-being.

[Review about smoking in pregnancy: prevalence, sociodemographic profile, perinatal depression, psychological variables involved and treatment]. / Revisión del tabaquismo en el embarazo: prevalencia, perfil sociodemográfico, depresión perinatal, variables psicológicas implicadas y tratamiento.

OBJECTIVE: Smoking is a Public Health problem. Half of all women smokers continue to smoke during pregnancy, putting their health and that of their foetus at risk. The aim of this review was to synthesise the main studies on the prevalence and sociodemographic, psychological and obstetric profile of women who smoke during pregnancy, the relationship of stress, personality and depression with smoking during pregnancy and the most effective treatments. METHODS: We conducted a literature review in the MEDLINE and PsycInfo databases from 2013 to 2023 on the most relevant aspects of smoking in pregnancy, including thirty studies. RESULTS: The prevalence of smoking in pregnancy is 15.7% in Spain. The socio-demographic profile of women who smoke during pregnancy is that of women with a low socioeconomic and educational level, generally without a partner or with partners who smoke and are unemployed. A relationship had been found between smoking in pregnancy and a higher probability of suffering from perinatal depression. High self-perceived stress may be a predictor variable for continued smoking in pregnancy. Personality traits such as high neuroticism appear to be related to smoking in pregnancy. Intervention to help pregnant women quit smoking must be tailored to the profile of the pregnant woman to be effective. Cognitive behavioural interventions show efficacy, especially in the long term. CONCLUSIONS: In order to design effective prevention and intervention programmes to help pregnant women quit smoking, not only the socio-demographic profile of the pregnant women should be taken into account, but also psychological variables such as personality and stress. These programmes should include cognitive behavioural interventions that teach adaptive stress management strategies to maximise their effectiveness. Special emphasis should be placed on reaching those women with the most disadvantaged profiles.

OBJETIVO: El tabaquismo es un problema de Salud Pública. La mitad de las mujeres fumadoras continúan haciéndolo en el embarazo, poniendo en riesgo su salud y la del feto. El objetivo de esta revisión fue sintetizar los principales estudios sobre la prevalencia y el perfil sociodemográfico, psicológico y obstétrico de la mujer fumadora en el embarazo, la relación del estrés, la personalidad y la depresión con el tabaquismo durante el embarazo y los tratamientos más eficaces. METODOS: Se llevó a cabo una revisión bibliográfica en las bases de datos MEDLINE y PsycInfo desde el año 2013 al 2023 sobre los aspectos más relevantes del tabaquismo en el embarazo, incluyéndose treinta estudios. RESULTADOS: La prevalencia del tabaquismo en el embarazo se sitúa en un 15,7% en España. El perfil sociodemográfico de la mujer fumadora en el embarazo es de aquella con bajo nivel socioeconómico y educativo, generalmente sin pareja o con parejas fumadoras, y sin trabajo. Se encontró relación entre fumar en el embarazo y mayor probabilidad de padecer depresión perinatal. Un alto estrés autopercibido es posible que sea una variable predictora de continuar fumando en el embarazo. Algunos rasgos de personalidad como elevado neuroticismo parecen estar relacionados con el tabaquismo en el embarazo. La intervención para ayudar a dejar de fumar a las embarazadas debe adaptarse al perfil de la misma para que sea eficaz. Las intervenciones cognitivo-conductuales muestran su eficacia, especialmente a largo plazo. CONCLUSIONES: Para diseñar programas de prevención e intervención eficaces que ayuden a las gestantes a dejar de fumar se debe tener en cuenta no solo el perfil sociodemográfico de las mismas, sino variables psicológicas como la personalidad y el estrés. Estos programas deben incluir intervenciones cognitivo-conductuales que enseñen estrategias adaptativas de gestión del estrés para maximizar su eficacia. Se debe poner especial énfasis en que estos programas lleguen a aquellas mujeres con perfil más desfavorecido.

Bibliometric Analysis on of the Impact of Screening to Minimize Maternal Mental Health on Neonatal Outcomes: A Systematic Review.

(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.

Prolonged transcranial magnetic stimulation in a pregnant patient with treatment-resistant depression: a case report.

INTRODUCTION: Perinatal depression is a serious and highly prevalent medical condition in the USA. Nearly 85% of individuals with perinatal depression go untreated, leading to significant morbidity and mortality. There is an urgent need to develop and advance safe and effective treatments for perinatal depression. Transcranial magnetic stimulation is an established intervention for depression in non-pregnant individuals yet is not well studied in perinatal depression. CASE PRESENTATION: A 33-year-old pregnant Latina female presented with severe, recurrent, treatment-resistant depression and suicidal ideation. The patient had previously trialed psychotherapy, multiple antidepressants, and mood stabilizers and had achieved remission with lithium prior to pregnancy. Due to pregnancy and fetal safety concerns, the patient discontinued lithium and consequently suffered progressive worsening of perinatal depression. At 24 weeks gestation and after additional failed medication trials, a prolonged course of transcranial magnetic stimulation was initiated. Following 46 transcranial magnetic stimulation treatments over 9 weeks using two protocol types (repetitive transcranial magnetic stimulation and intermittent theta burst stimulation), she achieved near-remission of perinatal depression and resolution of suicidal ideation. There were no identified maternal or fetal adverse events at 6 weeks post-delivery. CONCLUSION: To our knowledge, this is the first published case of a pregnant individual with perinatal depression who received and tolerated a prolonged transcranial magnetic stimulation course with two distinct protocols (repetitive transcranial magnetic stimulation and intermittent theta burst stimulation) with clinically significant response. Transcranial magnetic stimulation is a well-tolerated and effective intervention that warrants further investigation for use in treatment-resistant perinatal depression.

Predicting Prenatal Depression and Assessing Model Bias Using Machine Learning Models.

Background: Perinatal depression is one of the most common medical complications during pregnancy and postpartum period, affecting 10% to 20% of pregnant individuals, with higher rates among Black and Latina women who are also less likely to be diagnosed and treated. Machine learning (ML) models based on electronic medical records (EMRs) have effectively predicted postpartum depression in middle-class White women but have rarely included sufficient proportions of racial/ethnic minorities, which has contributed to biases in ML models. Our goal is to determine whether ML models could predict depression in early pregnancy in racial/ethnic minority women by leveraging EMR data. Methods: We extracted EMRs from a large U.S. urban hospital serving mostly low-income Black and Hispanic women (n = 5875). Depressive symptom severity was assessed using the Patient Health Questionnaire-9 self-report questionnaire. We investigated multiple ML classifiers using Shapley additive explanations for model interpretation and determined prediction bias with 4 metrics: disparate impact, equal opportunity difference, and equalized odds (standard deviations of true positives and false positives). Results: Although the best-performing ML model's (elastic net) performance was low (area under the receiver operating characteristic curve = 0.61), we identified known perinatal depression risk factors such as unplanned pregnancy and being single and underexplored factors such as self-reported pain, lower prenatal vitamin intake, asthma, carrying a male fetus, and lower platelet levels. Despite the sample comprising mostly low-income minority women (54% Black, 27% Latina), the model performed worse for these communities (area under the receiver operating characteristic curve: 57% Black, 59% Latina women vs. 64% White women). Conclusions: EMR-based ML models could moderately predict early pregnancy depression but exhibited biased performance against low-income minority women.

Perinatal depression affects 10% to 20% of pregnant individuals, with higher rates among racial/ethnic minorities who are underdiagnosed and undertreated. This study used machine learning models on electronic medical record data from a hospital serving mostly low-income Black and Hispanic women to predict early pregnancy depression. While the best model performed moderately well, it exhibited bias, predicting depression less accurately for Black and Latina women compared with White women. The study identified some known risk factors such as unplanned pregnancy and underexplored factors such as self-reported pain, lower prenatal vitamin intake, and carrying a male fetus that may contribute to perinatal depression.

Periconceptional omega-6 and omega-3 polyunsaturated fatty acid intake plane and postpartum depression: a nationwide birth cohort-the Japan Environment and Children's Study.

Intake of omega-3 polyunsaturated fatty acids (PUFAs) has favorable effects on the prevention of postpartum depression, but fish, the principal source of omega-3 PUFAs, are becoming a depleted resource. We therefore examined whether lower periconceptional intake of omega-6 PUFAs, whose metabolic pathways are antagonistic to those of omega-3 PUFAs, is associated with lower prevalence of postpartum depression while simultaneously considering omega-3 PUFA intake. The participants were 92,595 mothers involved in the ongoing Japan Environment and Children's Study. Periconceptional intakes of omega-6 and -3 PUFA were measured using a food frequency questionnaire. Postpartum depression was assessed using the Edinburgh Postnatal Depression Scale. Generalized additive mixed model analysis was used to draw contour plots of postpartum depression on a plane with omega-6 and omega-3 PUFA intakes on the x- and y-axes, respectively. The adjusted prevalence ranged from 11.0% to 26.3% within the respective 1st to 99th percentile intake ranges and monotonously decreased with decreasing omega-6 PUFA intake. In contrast, the prevalence decreased with increasing omega-3 PUFA intake, but the trend almost disappeared above 2 g/day. Our results highlight the potential importance of focusing on omega-6 PUFAs as well as omega-3 PUFAs prior to conception to reduce postpartum depression.

The role of emotion regulation in perinatal depression and anxiety: a systematic review.

BACKGROUND: Major depressive disorder and anxiety disorders are highly prevalent and comorbid during the perinatal period. Although research and clinicians agree that emotion regulation (ER) is an important transdiagnostic factor underlying both disorders in the general population, ER during the perinatal period has received less research attention. The aim of this systematic review was to assess the literature regarding the role of ten commonly studied ER strategies in the onset and maintenance of perinatal depression and anxiety in pregnant women and young mothers, using the Process Model of Gross (1998) as a theoretical framework. METHODS: We searched four electronic databases with variations of the following key words: women; emotion regulation (i.e., behavioral approach, behavioral avoidance, problem solving, support seeking, distraction, rumination, reappraisal, acceptance, expressive suppression, and expressive engagement); perinatal period; and psychopathology. The aim was to identify peer-reviewed, and quantitative studies published between January 1999 and January 2023. Six articles were selected for analysis. RESULTS: Similar ER strategies emerged as risk and protective factors in perinatal depression and anxiety. Overall, behavioral avoidance, distraction, rumination, and expressive engagement appeared as risk factors, while problem solving, emotional and instrumental support seeking, cognitive reappraisal, and acceptance, emerged as protective factors in the onset and maintenance of perinatal depression and anxiety. These findings align with previous research in perinatal community samples, as well as in non-perinatal clinical samples. CONCLUSIONS: Our results support the role of ER as a transdiagnostic factor underlying both perinatal depression and anxiety. Clinicians are encouraged to implement ER strategies into the screening, prevention, and treatment of perinatal depression and anxiety. Further research is needed to strengthen these findings and to examine the role of emotion regulation during antenatal depression and anxiety more closely.

The effect of music intervention on depression in perinatal women: A systematic review.

Objective: Perinatal depression has become a global public health problem, which not only harms the health of mothers and their offspring, but also increases the socio-economic burden, so early intervention is urgent. Music intervention is a low-cost and safe intervention method. This study endeavored to systematically integrate and quantitatively evaluate the effectiveness of music intervention for perinatal depression. Methods: PubMed, Embase, Web of Science and Cochrane Library were searched systematically. The search period was up to September 1, 2024. The included studies were summarized and analyzed. Results: A total of 1375 articles were obtained through preliminary search, and 13 of them were finally included. The effect of music intervention on perinatal depression was better than that of the control group (SMD = -0.53, 95%CI (-0.81, -0.26), p ＜ 0.05). Music intervention had no significant effect on alleviating anxiety (SMD = -0.47, 95%CI (-0.63, -0.31), p ＞ 0.05). However, the heterogeneity of the included studies was significant. Conclusions: This study indicated that music intervention had a significant effect on alleviating perinatal depression, but the effect on anxiety was not significant. However, the results were highly heterogeneous, and large-scale, multi-center, and long-term studies are needed in the future to confirm this.

Association between inflammatory biomarkers before pregnancy and risk of perinatal depression: A prospective cohort study of 4483 women in Sweden.

AIM: Perinatal depression (PND) is a global health concern, affecting millions of childbearing women. Emerging data suggest that inflammation may play a role in the development of PND. Peripheral blood inflammatory biomarkers before pregnancy are widely tested in clinical practice at minimum cost, yet their potential role in PND risk remains unknown. METHODS: We conducted a prospective cohort study of 4483 birthing women during 2009-2021 within the LifeGene study with linkage to Swedish registers. Peripheral blood inflammatory biomarkers were profiled at baseline. Cases of PND were identified using validated tools or clinical diagnosis from subsequent pregnancies and postpartum periods. Logistic regression models were employed to assess the associations of each inflammatory biomarker (z scored) with PND. RESULTS: We identified 495 (11.0 %) PND cases with an average age of 29.2 years. Pre-pregnancy platelet-to-lymphocyte ratio (PLR) was positively associated [OR, 95 % CI:1.14(1.01,1.27)], while lymphocyte count was inversely associated [OR, 95 % CI: 0.89(0.80,0.98)] with PND. A dose-response relationship was indicated for both PLR and lymphocytes when analyzed in categories based on tertile distribution. These associations appeared more pronounced for postpartum depression than antepartum depression and were independent of psychiatric comorbidities. CONCLUSION: With implications for future mechanistic research, these findings suggest that blood levels of lymphocytes and PLR before pregnancy are associated with subsequent risk of PND in a dose-response manner.

Systematic Review of Nature-Based Interventions for Perinatal Depression, Anxiety, and Loneliness.

BACKGROUND: Perinatal mood and anxiety disorders and social isolation are prevalent and associated with adverse maternal and child health outcomes. We conducted a systematic review to assess the evidence for nature-based interventions (NBIs) to address depression, anxiety, and loneliness among pregnant and postpartum women. METHODS: Studies were identified through MEDLINE, Embase, CINAHL, APA PsycINFO, ClinicalTrials.org, Web of Science, and Cochrane Reviews in February 2023. Included studies were original, peer-reviewed studies published in or translated into English that evaluated an intervention which engaged pregnant or postpartum women directly with nature and used a quantitative outcome measure for anxiety, depression, or loneliness. RESULTS: Three studies, including 68 pregnant or postpartum women and their family or friends, met our inclusion criteria. Results were synthesized narratively in text and tables. All studies had early-stage designs and relatively small sample sizes. A variety of intervention content and delivery platforms were utilized. Studies were not adequately powered to test or detect statistically significant changes in depression, anxiety, or loneliness. Measurement of nature engagement varied. Using the Downs and Black checklist, we found study quality varied from good to poor. DISCUSSION: More research is needed to understand the potential benefits of NBIs for perinatal mental health and social wellbeing. Additional study rigor is needed, including the consistent use of validated and well-rationalized measures of nature engagement. Intervention design should consider the varying needs perinatal populations, including barriers to and facilitators of engagement for diverse communities.

Maternal Perinatal Depression, Alexithymia, and Couple Functioning: Which Relationship Exists with Prenatal Attachment.

BACKGROUND: Prenatal attachment refers to the affective investment that parents develop towards their unborn baby during pregnancy. Studies have identified depressive symptoms, affect dysregulation, and poor marital adjustment as potential risk factors for poor prenatal attachment. However, no research has concurrently examined these factors. This study aims to explore the simultaneous impact of depressive symptomatology, alexithymia, and couple functioning on prenatal attachment to develop a more comprehensive understanding of the factors shaping the emotional bond between expectant mothers and their fetuses. METHODS: This cross-sectional study involved 344 women (mean age = 34.1, SD = 4.6) in their last trimester of pregnancy recruited from the National Health System. The participants completed the Edinburgh Postnatal Depression Scale, the Twenty-Item Toronto Alexithymia Scale, the Dyadic Adjustment Scale, and the Maternal Antenatal Attachment Scale. RESULTS: Regression analyses indicated that perinatal depression and alexithymia negatively affected the Quality of Prenatal Attachment, while Dyadic Cohesion served as a protective factor. CONCLUSIONS: The results emphasize the need for early identification of perinatal depression and alexithymia, along with targeted interventions aimed at supporting Dyadic Cohesion during pregnancy. These efforts are crucial for fostering positive prenatal attachment and enhancing maternal mental health.

The association between perinatal depressive symptoms and child neurodevelopment.

BACKGROUND: Perinatal depression has been suggested to adversely impact child neurodevelopment. However, the complexity of the early childhood environment challenges conclusive findings. OBJECTIVE: To evaluate whether there is an association between perinatal depressive symptoms and child intelligence quotient (IQ) at 5 years of age. STUDY DESIGN: Secondary analysis of an ancillary study to a multicenter randomized trial of thyroxine therapy for pregnant individuals with subclinical hypothyroidism. Dyads of infants and birthing parent, with completed Center for Epidemiological Studies-Depression (CES-D) screens during pregnancy and postpartum and child neurodevelopment testing completed at five years of age (n=209) were included. CES-D screening was performed at 11-20 weeks, 34-38 weeks, and one-year postpartum. Depressive symptoms were categorized as antenatal (i.e., a positive screen at any point during pregnancy) or postpartum. The primary outcome was child IQ score < 85 at 5 years of age using the Wechsler Preschool and Primary Scale of Intelligence III (WPPSI-III) Full Scale test. Secondary outcomes included other assessments of childhood neurodevelopment. Bivariable analyses and multivariable logistic regressions were utilized. RESULTS: Of the 209 birthing people included, 72 (34%) screened positive for depression during pregnancy and 32 (15%) screened positive one year postpartum. Children born to individuals with a positive antenatal depression screen had a higher odds of IQ < 85 at 5 years of age compared with children born to individuals with a CES-D < 16 (35% vs. 18%, OR 2.4, 95% CI 1.2-4.7). Similar findings were seen for children born to individuals with a positive postpartum depression screen (47% vs. 21%, OR 3.3, 95% CI 1.5-7.3). These associations did not persist in multivariable analyses that controlled for social determinants of health and clinical characteristics (adjusted odd ratio [aOR] 1.4, 95% CI 0.7-3.1; aOR 2.1, 95% CI 0.9-5.1, for antenatal and postpartum depressive symptoms, respectively). Similar findings were observed for other adverse neurodevelopmental outcomes. CONCLUSIONS: Having a positive perinatal depression screen was not associated with child cognitive outcomes after controlling for covariates including social determinants of health.

Unveiling perinatal depression: A dual-network EEG analysis for diagnosis and severity assessment.

Perinatal depression (PD), which affects about 10-20 percent of women, often goes unnoticed because related symptoms frequently overlap with those commonly experienced during pregnancy. Moreover, identifying PD currently depends heavily on the use of questionnaires, and objective biological indicators for diagnosis has yet to be identified. This research proposes a safe and non-invasive method for diagnosing PD and aims to delve deeper into its underlying mechanism. Considering the non-invasiveness and clinical convenience of electroencephalogram (EEG) for mothers-to-be and fetuses, we collected the resting-state scalp EEG of pregnant women (with PD/healthy) at the 38th week of gestation. To compensate for the low spatial resolution of scalp EEG, source analysis was first applied to project the scalp EEG to the cortical-space. Afterwards, cortical-space networks and large-scale networks were constructed to investigate the mechanism of PD from two different level. Herein, differences in the two distinct types of networks between PD patients and healthy mothers-to-be were explored, respectively. We found that the PD patients illustrated decreased network connectivity in the cortical-space, while the large-scale networks revealed weaker connections at cerebellar area. Further, related spatial topological features derived from the two different networks were combined to promote the recognition of pregnant women with PD from those healthy ones. Meanwhile, the depression severity at patient level was effectively predicted based on the combined spatial topological features as well. These findings consistently validated that the two kinds of networks indeed played off each other, which thus helped explore the underlying mechanism of PD; and further verified the superiority of the combination strategy, revealing its reliability and potential in diagnosis and depression severity evaluation.

Attachment classification and early adversity predict perinatal partial hospital treatment response.

BACKGROUND: Depression and anxiety are common in the perinatal period. While most of those affected respond well to treatment, a subpopulation is more resistant. Understanding more about individuals who do not respond well to available treatments may improve care for this group. METHODS: We administered entry and exit self-report measures to 178 women who participated in a specialized partial hospitalization program for perinatal individuals. Baseline measures of anxiety, obsessive symptoms, sleep quality, early life adversity, and adult attachment security were examined as potential predictors of response to treatment. RESULTS: While no individual baseline survey predicted treatment response, clustering patients on the basis of a combination of self-report adult attachment styles and early life adversity yielded four distinct groups. A cluster with high attachment anxiety, high attachment avoidance, and childhood history of verbal and emotional abuse was less responsive to treatment than the other groups. CONCLUSIONS: Combining detailed information about self-report adult attachment style and early life adversity may improve prediction of treatment response in individuals with perinatal mood and anxiety disorders.

Prevalence of Perinatal Depression and Its Associated Risk Factors among Nepalese Women in Kathmandu, Nepal.

Perinatal mental health is a major public health issue that arises during pregnancy and/or after birth, with substantial implications for social, parental, and maternal functioning, as well as overall quality of life. The study aimed to determine the prevalence of perinatal depression and its associated risk factors among women who visited a maternity hospital in Kathmandu, Nepal. A cross-sectional study was conducted at the Paropakar Maternity and Women's Hospital in Kathmandu. A total of 300 women in their perinatal period were interviewed. The Edinburgh Perinatal Depression Scale (EPDS) was used to measure perinatal depression. The Poisson regression model was used to determine risk factors associated with perinatal depression. The mean age of respondents was 25.5 (SD 4.5) years; average age during their first pregnancy was 23.5 (SD 3.7) years; and 53.7% of respondents were in the antenatal period. The prevalence of depressive symptoms (EPDS ≥ 10) was 40% (95% CI 31.4% to 45.8%). Unsupportive family members (adjusted prevalence ratio [aPR] 2.23; 95% CI 1.75-2.86), postnatal period (aPR 2.64; 95% CI 1.97-3.53), complications faced during delivery (aPR 1.76; 95%CI 1.30-2.39), history of intimate partner violence (aPR 0.48; 95% CI 0.36-0.64), and first pregnancy at the age of ≤25 years (aPR 0.61; 95% CI 0.42-0.88) were identified as key risk factors of perinatal depression. Strong family support and the active involvement of partners in counselling can contribute to alleviating perinatal depression symptoms. Targeted interventions in health and well-being services should be implemented to address mental health burden during both pregnancy and postpartum periods.

Early detection of perinatal depression in couples: a single-center prospective study.

OBJECTIVE: This prospective study aimed to assess couples' psychological status during the perinatal period to identify those at risk for postpartum depression. METHODS: Conducted at Lyon University Hospital from March to July 2022, the study enrolled pregnant women without progressive psychiatric disorders or obstetric risk factors, and their partners. Participants completed the Edinburgh Postnatal Depression Scale (EPDS) at three points: during the 9th month of pregnancy, immediate postpartum, and 6-8 weeks after delivery. A score ≥10 on the EPDS indicated depression risk. A score ≥10 on the EPDS indicate depression risk. The primary endpoint was EPDS scores throughout the perinatal period. RESULTS: Ninety-five couples participated; 96% of patients and 68% of partners completed pre-delivery questionnaires, 81% and 71% during maternity stay, and 64% and 46% postpartum, respectively. Overall, 15% of patients and 1% of partners had EPDS scores >10 in the postpartum period. Psychiatric history and emergency cesarean sections were associated with higher immediate postpartum EPDS scores in patients [Beta 3.7 points, 95% CI 0.91; 6.4 and Beta 5.2 points, 2.2; 8.1, respectively]. Episiotomy was associated with higher EPDS scores in partners. No significant association between the different factors studied and the EPDS score was found at 6-8 weeks postpartum in patients nor their partners. CONCLUSIONS: While specific risk factors for persistent perinatal depression in couples were not identified, a notable proportion of patients exhibited high EPDS scores. Screening all couples during prepartum and postpartum periods is crucial, regardless of identified risk factors.