First-time fathers show longitudinal gray matter cortical volume reductions: evidence from two international samples.

Emerging evidence points to the transition to parenthood as a critical window for adult neural plasticity. Studying fathers offers a unique opportunity to explore how parenting experience can shape the human brain when pregnancy is not directly experienced. Yet very few studies have examined the neuroanatomic adaptations of men transitioning into fatherhood. The present study reports on an international collaboration between two laboratories, one in Spain and the other in California (United States), that have prospectively collected structural neuroimaging data in 20 expectant fathers before and after the birth of their first child. The Spanish sample also included a control group of 17 childless men. We tested whether the transition into fatherhood entailed anatomical changes in brain cortical volume, thickness, and area, and subcortical volumes. We found overlapping trends of cortical volume reductions within the default mode network and visual networks and preservation of subcortical structures across both samples of first-time fathers, which persisted after controlling for fathers' and children's age at the postnatal scan. This study provides convergent evidence for cortical structural changes in fathers, supporting the possibility that the transition to fatherhood may represent a meaningful window of experience-induced structural neuroplasticity in males.

Prenatal testosterone synchrony in first-time parents predicts fathers' postpartum relationship quality.

There is evidence that men's testosterone levels decline across the transition to fatherhood and that this decline may reflect fathers' investment in the new family. There is also emerging evidence that cohabiting couples show synchrony or within-couple associations in testosterone levels during the perinatal period. Hormonal synchrony may act as a mechanism that supports fathers' biological preparation for parenthood, perhaps by facilitating perinatal declines in paternal testosterone. However, few studies have examined testosterone synchrony and change within couples. A sample of 97 U.S. couples expecting their first child provided testosterone samples during pregnancy, and of those couples, 78 couples also provided testosterone at seven months postpartum. Couples reported on relationship satisfaction both at prenatal and postpartum visits. Bayesian multilevel modeling revealed within-couple testosterone synchrony both during pregnancy and postpartum. Testosterone synchrony during pregnancy predicted a greater drop in fathers' testosterone levels from prenatal to postpartum and higher paternal postpartum relationship quality. Fathers' lower prenatal testosterone levels also subsequently predicted higher self-reported postpartum relationship quality for both parents. In sum, this study finds that couples' testosterone levels show synchrony across the transition to parenthood in ways that are associated with couple relationship quality and men's neuroendocrine preparation for fatherhood.

Differences in infant negative affectivity during the COVID-19 pandemic.

This longitudinal study compared infant temperament rated at 3 months postpartum by 263 United-States-based women who gave birth during the COVID-19 pandemic and 72 who gave birth prior to the pandemic. All women completed questionnaires assessing perinatal mental health, social contact, and infant temperament. Mothers whose infants were born during the pandemic reported higher levels of infant negative affectivity as compared with mothers whose infants were born earlier (F(1, 324) = 18.28, p < .001), but did not differ in their ratings of surgency or effortful control. Maternal prenatal depressive symptoms, prenatal stress, and postpartum stress mediated differences in infant negative affectivity  between pandemic and pre-pandemic groups. Within the pandemic group, decreased postpartum social contact was associated with higher ratings of infant negative affectivity. These findings suggest that the pandemic has affected maternal perceptions of infant temperament, perinatal mental health, and social contact.

Este estudio longitudinal comparó el temperamento del infante evaluado a los tres meses después del parto por 263 mujeres con base en Estados Unidos, las cuales dieron a luz durante la pandemia del COVID-19 y 72 que dieron a luz antes de la pandemia. Todas las mujeres completaron cuestionarios para evaluar la salud mental perinatal, el contacto social y el temperamento del infante. Las madres cuyos infantes nacieron durante la pandemia reportaron más altos niveles de afectividad negativa del infante tal como se les comparó con madres cuyos infantes nacieron antes (F(1,324) = 18.28, p<.001), pero no difirieron en sus puntajes de rapidez y astucia o control esforzado. Los síntomas depresivos maternos mediaron la asociación entre la condición de pandemia y la afectividad negativa del infante. Dentro del grupo de pandemia, la baja en el contacto social posterior al parto fue asociada con más altos puntajes en la afectividad negativa del infante. Estos resultados proponen que la pandemia ha afectado las percepciones mentales de la salud mental y el contacto social del temperamento perinatal del infante.

Cette étude longitudinale a comparé le tempérament du nourrisson évalué à trois mois postpartum par 263 femmes basées aux Etats-Unis d'Amérique ayant donné naissance durant la pandémie du COVD-19 et 72 femmes ayant donné naissance avant la pandémie. Toutes les femmes ont rempli des questionnaires évaluant la santé mentale périnatale, le contact social et le tempérament du nourrisson. Les mères dont les nourrissons étaient nés durant la pandémie ont fait état de niveaux plus élevés d'affectivité négative du bébé comparées aux mères dont les bébés étaient nés avant (F(1 324) = 18,28, p <,001), mais n'ont pas divergé dans leurs évaluations du dynamisme ou du contrôle efficace. Les symptômes dépressifs maternels ont médiatisé le lien entre le statue pandémique et l'affectivité négative du nourrisson. Au sein du groupe pandémique le contact social postpartum décru était lié à des évaluations plus élevées de l'affectivité négative du nourrisson. Ces résultats suggèrent que la pandémie a affecté les perceptions maternelles du tempérament du bébé, la santé mentale périnatale et le contact social.

Theory of mind processing in expectant fathers: Associations with prenatal oxytocin and parental attunement.

Social cognition may facilitate fathers' sensitive caregiving behavior. We administered the Why-How Task, an fMRI task that elicits theory of mind processing, to expectant fathers (n = 39) who also visited the laboratory during their partner's pregnancy and provided a plasma sample for oxytocin assay. Three months postpartum, fathers reported their beliefs about parenting. When rating "Why" an action was being performed versus "How" the action was being performed (Why > How contrast), participants showed activation in regions theorized to support theory of mind, including the dorsomedial prefrontal cortex and superior temporal sulcus. Fathers' prenatal oxytocin levels predicted greater signal change during the Why > How contrast in the inferior parietal lobule. Both prenatal oxytocin and attunement parenting beliefs were associated with Why > How activation in the dorsolateral prefrontal cortex, a theory of mind region implicated in emotion regulation. Posterior parahippocampal gyrus and dorsolateral prefrontal cortex activation during the Why > How contrast predicted fathers' attunement parenting beliefs. In conclusion, fathers' neural activation when engaging in a theory of mind task was associated with their prenatal oxytocin levels and their postpartum attunement parenting beliefs. Results suggest biological and cognitive components of fathering may track with the theory of mind processing.

Fathers' decline in testosterone and synchrony with partner testosterone during pregnancy predicts greater postpartum relationship investment.

The transition to parenthood has been associated with declines in testosterone among partnered fathers, which may reflect males' motivation to invest in the family. Moreover, preliminary evidence has found that couples show correlations in hormone levels across pregnancy that may also be linked to fathers' preparation for parenthood. The current study used repeated-measures sampling of testosterone across pregnancy to explore whether fathers' change in T, and correlations with mothers' T, were associated with fathers' and mothers' postpartum investment. In a sample of 27 couples (54 individuals) expecting their first child, both parents' salivary testosterone was measured multiple times across pregnancy. At approximately 3.5months postpartum, participants rated their investment, commitment, and satisfaction with their partner. A multilevel model was used to measure change in testosterone over time and associations between mother and father testosterone. Fathers who showed stronger declines in T across pregnancy, and stronger correlations with mothers' testosterone, reported higher postpartum investment, commitment, and satisfaction. Mothers reported more postpartum investment and satisfaction if fathers showed greater prenatal declines in T. These results held even after controlling for paternal investment, commitment, and satisfaction measured prenatally at study entry. Our results suggest that changes in paternal testosterone across pregnancy, and hormonal linkage with the pregnant partner, may underlie fathers' dedication to the partner relationship across the transition to parenthood.

High paternal testosterone may protect against postpartum depressive symptoms in fathers, but confer risk to mothers and children.

Following the birth of an infant, decreases in testosterone and increases in depressive symptoms have been observed in fathers. Paternal testosterone may reflect fathers' investment in pair-bonding and paternal caregiving and, as such, may be associated with maternal and familial well-being. This study tests associations between paternal testosterone, paternal and maternal postpartum depressive symptoms, and subsequent family functioning. Within 149 couples, fathers provided testosterone samples when infants were approximately nine months old and both parents reported on postpartum depressive symptoms at two, nine, and 15months postpartum. Fathers with lower aggregate testosterone reported more depressive symptoms at two and nine months postpartum. Mothers whose partners had higher evening testosterone reported more depressive symptoms at nine and 15months postpartum. Maternal relationship satisfaction mediated this effect, such that mothers with higher testosterone partners reported more relationship dissatisfaction, which in turn predicted more maternal depressive symptoms. Higher paternal testosterone and paternal depressive symptoms at nine months postpartum each independently predicted greater fathering stress at 15months postpartum. Higher paternal testosterone also predicted more mother-reported intimate partner aggression at 15months postpartum. In addition to linear relationships between testosterone and depression, curvilinear relationships emerged such that fathers with both low and high testosterone at nine months postpartum reported more subsequent (15-month) depressive symptoms and fathering stress. In conclusion, whereas higher paternal testosterone may protect against paternal depression, it contributed to maternal distress and suboptimal family outcomes in our sample. Interventions that supplement or alter men's testosterone may have unintended consequences for family well-being.

Prospective and dyadic associations between expectant parents' prenatal hormone changes and postpartum parenting outcomes.

During the transition to parenthood, both men and women experience hormone changes that are thought to promote parental care. Yet very few studies have explicitly tested the hypothesis that prenatal hormone changes are associated with postpartum parenting behavior. In a longitudinal study of 27 first-time expectant couples, we assessed whether prenatal hormone changes were moderated by self- and partner-reported parenting outcomes at 3 months postpartum. Expectant fathers showed prenatal declines in testosterone and estradiol, and larger declines in these hormones were associated with greater contributions to household and infant care tasks postpartum. Women whose partners showed larger testosterone declines also reported receiving more support and more help with household tasks. Expectant mothers showed prenatal increases in testosterone and estradiol, and larger increases in these hormones were associated with lower partner-rated support. Together, our findings provide some of the first evidence that prenatal hormone changes may indeed be functional and that the implications of these changes may be detectable by co-parents.

HPA axis linkage in parent-child dyads: Effects of parent sex, autism spectrum diagnosis, and dyadic relationship behavior.

Families of preschoolers participated in two dyadic home visits, once with mother (56 dyads) and once with father (59 dyads). Each member of the dyad provided three cortisol samples and participated in several interaction tasks that were behaviorally coded. Approximately half of the children had been diagnosed with autism spectrum disorders (ASD), whereas half were typically developing (TD). In a multilevel model, father's cortisol level at each timepoint predicted child cortisol. Father-child linkage was stronger in dyads that showed less reciprocity, in which fathers showed less sensitivity, and in which children showed less self-regulation and more withdrawal. Cortisol levels were not significantly correlated in mother-child dyads, and there was a trend toward moderation by ASD diagnosis, such that linkage was greater in TD children. Mother-child linkage was stronger in dyads that showed less behavioral coordination and less sensitivity. HPA axis linkage may be stronger in less behaviorally attuned dyads.

Sleep Quality Predicts Persistence of Parental Postpartum Depressive Symptoms and Transmission of Depressive Symptoms from Mothers to Fathers.

BACKGROUND: Early parenthood is a time of chronic sleep disturbance and also of heightened depression risk. Poor sleep quality has been identified both as a predictor of postpartum depressive symptoms and as a consequence. PURPOSE: This study sought to clarify causal pathways linking sleep and postpartum depression via longitudinal path modeling. Sleep quality at 6 months postpartum was hypothesized to exacerbate depressive symptoms from 1 month through 1 year postpartum in both mothers and fathers. Within-couple associations between sleep and depression were also tested. METHODS: Data were drawn from a low-income, racially and ethnically diverse sample of 711 couples recruited after the birth of a child. Depressive symptoms were assessed at 1, 6, and 12 months postpartum, and sleep was assessed at 6 months postpartum. RESULTS: For both partnered mothers and fathers and for single mothers, depressive symptoms at 1 month postpartum predicted sleep quality at 6 months, which in turn predicted depressive symptoms at both 6 and 12 months. Results held when infant birth weight, breastfeeding status, and parents' race/ethnicity, poverty, education, and immigration status were controlled. Mothers' and fathers' sleep quality and depressive symptoms were correlated, and maternal sleep quality predicted paternal depressive symptoms both at 6 and at 12 months. CONCLUSIONS: Postpartum sleep difficulties may contribute to a vicious cycle between sleep and the persistence of depression after the birth of a child. Sleep problems may also contribute to the transmission of depression within a couple. Psychoeducation and behavioral treatments to improve sleep may benefit new parents.

Attenuated hypothalamic-pituitary-adrenal axis functioning predicts accelerated pubertal development in girls 1 year later.

Accelerated pubertal development has been linked to adverse early environments and may heighten subsequent mental and physical health risks. Hypothalamic-pituitary-adrenal axis functioning has been posited as a mechanism whereby stress may affect pubertal development, but the literature lacks prospective tests of this mechanism. The current study assessed 277 youth (M = 10.84 years, SD = 1.14), 138 boys and 139 girls, who reported on their pubertal development and underwent the Trier Social Stress Test for Children at baseline and returned to the laboratory approximately 1 year later (M = 1.12 years, range = 0.59-1.98 years). For girls, lower cortisol area under the curve (with respect to ground) at Time 1 predicted more advanced pubertal development at Time 2, controlling for Time 1 pubertal development. This association persisted after additional covariates including age, body mass index, race, and maltreatment history were introduced, and was driven by adrenal rather than gonadal development. Cortisol was not linked to boys' subsequent pubertal development, and no interaction by gender or by maltreatment appeared. These results suggest that attenuated cortisol, reported in other studies of children exposed to early adversity, may contribute to accelerated pubertal tempo in girls.

Childhood maltreatment, pubertal development, HPA axis functioning, and psychosocial outcomes: An integrative biopsychosocial model.

The timing and pace of pubertal development has been associated with psychosocial functioning, with pubertal variables represented both as predictors (e.g., earlier puberty linked with poor outcomes) and as sequelae (e.g., early stress linked with earlier puberty). However, the literature has largely not tested mediational models or prospective mechanisms of associations between puberty and psychosocial variables. In a longitudinal study including 454 youth followed over four timepoints (mean ages 10-18), structural equation modeling tested a hypothesized path from childhood maltreatment to cortisol (Time 1) to pubertal stage (Time 2), and psychosocial outcomes (Times 3 and 4). There was not support for the full hypothesized pathway in either gender. However, for boys, maltreatment was associated with attenuated cortisol, and more pubertal change predicted subsequent delinquency. For girls, cortisol predicted more pubertal change which then predicted substance use. This study demonstrates links between HPA axis function, pubertal development, and risky outcomes.

White matter microstructure organization across the transition to fatherhood.

The transition to parenthood remains an understudied window of potential neuroplasticity in the adult brain. White matter microstructural (WMM) organization, which reflects structural connectivity in the brain, has shown plasticity across the lifespan. No studies have examined how WMM organization changes from the prenatal to postpartum period in men becoming fathers. This study investigates WMM organization in men transitioning to first-time fatherhood. We performed diffusion-weighted imaging to identify differences in WMM organization, as indexed by fractional anisotropy (FA). We also investigated whether FA changes were associated with fathers' postpartum mental health. Associations between mental health and WMM organization have not been rarely examined in parents, who may be vulnerable to mental health problems. Fathers exhibited reduced FA at the whole-brain level, especially in the cingulum, a tract associated with emotional regulation. Fathers also displayed reduced FA in the corpus callosum, especially in the forceps minor, which is implicated in cognitive functioning. Postpartum depressive symptoms were linked with increases and decreases in FA, but FA was not correlated with perceived or parenting stress. Findings provide novel insight into fathers' WMM organization during the transition to parenthood and suggest postpartum depression may be linked with fathers' neuroplasticity during the transition to parenthood.

Neural correlates of inhibitory control in the context of infant cry and paternal postpartum mental health.

BACKGROUND: Inhibitory control, a form of self-regulation, may support sensitive parenting, but has been understudied in new fathers despite their pronounced risk for stress and mental health challenges. METHODS: This study probed the neural correlates of inhibitory control and its associations to first-time fathers' postpartum mental health, focusing on depressive symptoms, state anxiety, and perceived stress. Six months after their child's birth, 38 fathers self-reported on their mood, anxiety, and stress, and performed a Go/No-Go fMRI task while listening to three sets of sounds (infant cry, pink noise, and silence). RESULTS: Fathers' behavioral inhibition accuracy was consistent across the sound conditions, but their patterns of neural activation varied. Compared to the pink noise condition, fathers showed heightened engagement in prefrontal regulatory regions when self-regulating during the infant cry and silent conditions. When examining correct trials only, results in visual motor area and primary somatosensory cortex emerged only for infant cry and not for pink noise and silence. Moreover, fathers reporting higher levels of postpartum depression, state anxiety, and perceived stress showed greater activation in prefrontal regions when inhibiting during infant cry or silence. CONCLUSION: This study is the first to underscore the complex interplay between the neural mechanisms related to inhibitory control and postpartum mental health and stress across varied auditory context, laying the groundwork for future research.

Glee in threes: Positive affect synchrony in parent-infant triads is moderated by maternal hair cortisol and parenting stress.

BACKGROUND: Positive affect synchrony, or the reciprocal exchange of positive affect during free play, can scaffold infants' socioemotional development. However, parental stress may compromise the expression and exchange of positive affect within families. The current study assesses whether parenting stress and hair cortisol are associated with positive affect synchrony during a triadic play interaction. METHOD: Within 70 different-sex dyads consisting of first-time parents and their six-month-old infants who participated in a four-minute laboratory-based free-play task, facial affect of each member of the triad was observationally microcoded at the second-by-second level. Hair samples were collected from mothers and fathers for cortisol assay, and parents completed a self-report measure of parenting stress. RESULTS: Using dynamic structural equation modeling (DSEM), we found positive between-level and within-level affect synchrony across all family members, with one exception: infants' affect did not predict fathers' affect at the following timepoint. Mother-to-infant affect synchrony was greater in mothers with higher hair cortisol. Similarly, mothers with higher parenting stress tended to have greater infant-to-mother affect synchrony, and had infants that displayed less overall positive affect across the interaction. CONCLUSION: We found evidence for bidirectional, time-lagged synchrony in the momentary positive affect of mothers, fathers, and infants. Maternal hair cortisol concentration and parenting stress seem to increase affect synchrony between mothers and infants- suggesting that parental stress may correlate with greater affective attunement, but less overall positive affect in infants.

Maternal prenatal social contact during the COVID-19 pandemic predicts infant birth weight.

BACKGROUND: Social connectedness and mental health have been associated with infant birth weight, and both were compromised by the COVID-19 pandemic. AIMS: We sought to examine whether changes in maternal prenatal social contact due to the COVID-19 pandemic were associated with infant birth weight and if maternal prenatal mental health mediated this association. STUDY DESIGN: A longitudinal study of mothers and their infants born during the first wave of the COVID-19 pandemic. SUBJECTS: The sample consisted of 282 United States-based mother-infant dyads. OUTCOME MEASURES: Depressive symptoms were measured with the Beck Depression Inventory-II, anxiety was measured with the State Anxiety Inventory, and stress was measured using the Perceived Stress Scale 14. We also asked participants about pandemic-related changes in social contact across various domains. Adjusted birth weight was calculated from birth records or participant-report when birth records were unavailable. RESULTS: Decreases in social contact during the pandemic were associated with lower adjusted infant birth weight (B = 76.82, SE = 35.82, p = .035). This association was mediated by maternal prenatal depressive symptoms [Effect = 15.06, 95 % CI (0.19, 35.58)] but not by prenatal anxiety [95 % CI (-0.02, 32.38)] or stress [95 % CI (-0.31, 26.19)]. CONCLUSION: These findings highlight concerns for both mothers and infants in the wake of the COVID-19 pandemic, since birth weight can have long-term health implications and the social restructuring occasioned by the pandemic may lead to lasting changes in social behavior.

Prenatal prolactin predicts postnatal parenting attitudes and brain structure remodeling in first-time fathers.

Despite the important contributions that fathers make to parenting, the neurobiological underpinnings of men's adaptation to parenthood are still not well understood. The current study focuses on prolactin, a hormone that has been extensively linked with reproduction, lactation, and parental behavior in mothers. There is preliminary evidence that prolactin may also reflect the transition to sensitive fatherhood. We sampled prolactin in 91 first-time expectant fathers who participated in a laboratory visit along with their pregnant partners. Fathers' prolactin levels were correlated with their partners' prolactin levels. Men's prolactin levels during their partner's pregnancy were associated with their self-reported antenatal bonding to the unborn infant. Prenatal prolactin levels in fathers also predicted more positive attitudes toward fatherhood at three months postpartum, including lower parenting stress, greater enjoyment of the infant, and a more attunement-oriented parenting style. Within a smaller sample of 32 men who participated in MRI scanning before and after their child's birth, prenatal prolactin also predicted greater reductions in grey matter volume in the left posterior cingulate, left insula, and left nucleus accumbens. In conclusion, men's prenatal prolactin may reflect their perceptions of fatherhood and changes to their perinatal brain structure.

Fathers' subjective childbirth stress predicts depressive symptoms at six months postpartum.

BACKGROUND: Childbirth is a seminal experience in parents' lives. However, little research has investigated the link between fathers' birth experiences and their postpartum mental health. We hypothesized that a more subjectively stressful birth will predict greater self-reported depressive symptoms in fathers at six months postpartum. We also investigated the association between mode of delivery and paternal subjective stress. METHODS: Seventy-seven heterosexual fathers expecting their first child and cohabiting with their pregnant partners participated in the study. Depressive symptoms were assessed in pregnancy and again at six months postpartum. Subjective birth stress was measured within the first few days of the birth, and birth charts were collected to examine mode of delivery. RESULTS: Fathers' ratings of subjective birth stress significantly predicted postpartum depressive symptoms at six months postpartum. Subjective birth stress ratings varied significantly for fathers whose partners delivered via emergency cesarean section compared to those whose partners gave birth via both medicated and the unmedicated vaginal delivery. LIMITATIONS: The study was limited by its small community (non-clinical) sample, which was restricted to heterosexual, cohabitating couples. Additionally, births were mostly uncomplicated and only 14 mothers underwent emergency cesarean section. CONCLUSION: These findings highlight that the days immediately following childbirth are a window of opportunity for early intervention in new fathers at risk for postpartum depression.

Does dampened physiological reactivity protect youth in aggressive family environments?

Is an attenuated physiological response to family conflict, seen in some youth exposed to early adversity, protective or problematic? A longitudinal study including 54 youth (average age 15.2 years) found that those with higher cumulative family aggression exposure showed lower cortisol output during a laboratory-based conflict discussion with their parents, and were less likely to show the normative pattern of increased cortisol reactivity to a discussion they rated as more conflictual. Family aggression interacted with cortisol reactivity in predicting youth adjustment: Adolescents from more aggressive homes who were also more reactive to the discussion reported more posttraumatic stress symptoms and more antisocial behavior. These results suggest that attenuated reactivity may protect youth from the negative consequences associated with aggressive family environments.

Recent Neuroscience Advances in Human Parenting.

The transition to parenthood entails brain adaptations to the demands of caring for a newborn. This chapter reviews recent neuroscience findings on human parenting, focusing on neuroimaging studies. First, we describe the brain circuits underlying human maternal behavior, which comprise ancient subcortical circuits and more sophisticated cortical regions. Then, we present the short-term and long-term functional and structural brain adaptations that characterize the transition to motherhood, discuss the long-term effects of parenthood on the brain, and propose several underlying neural mechanisms. We also review neuroimaging findings in biological fathers and alloparents (such as other relatives or adoptive parents), who engage in parenting without directly experiencing pregnancy or childbirth. Finally, we describe perinatal mental illnesses and discuss the neural responses associated with such disorders. To date, studies indicate that parenthood is a period of enhanced brain plasticity within brain areas critical for cognitive and social processing and that both parenting experience and gestational-related factors can prime such plasticity.

Delivering alone in a pandemic: Anticipated changes to partner presence at birth are associated with prenatal distress.

INTRODUCTION: The COVID-19 pandemic has impacted individuals across the world, and in particular, dramatically affected the experience of pregnancy and childbirth for many expectant mothers. The transition to parenthood is a time of increased risk for mental health problems, and maternal prenatal stress is associated with long-term maternal and infant health implications. The current study explored whether COVID-19 related changes to mothers' childbirth plans and prenatal health care experiences during the first wave of pandemic lockdowns in the U.S. were associated with self-reported depression, anxiety, and stress. METHOD: In spring 2020; we surveyed 641 pregnant women on their pregnancy and birth plans, as well as their mental health, during the COVID-19 pandemic. RESULTS: Women anticipating changes to the presence of their partner at birth also reported heightened symptoms of depression, anxiety, and stress. Additionally, women who anticipated changes to the timing of delivery reported both higher anxiety and higher perceived stress. DISCUSSION: These findings extend initial work suggesting increased risk for mental health problems in pregnant women during the COVID-19 pandemic by highlighting specific pandemic-related disruptions to pregnancy and birth that may have contributed to prenatal distress. Monitoring and intervention for these mothers and their infants are warranted. (PsycInfo Database Record (c) 2022 APA, all rights reserved).