This study aimed to evaluate the convergent validity of the Edinburgh Postnatal Depression Scale (EPDS) and the Patient Health Questionnaire (PHQ-9) in Thai pregnant and postpartum women, using the 12-item WHO Disability Assessment Schedule (WHODAS) as the reference standard. Participants completed the EPDS, PHQ-9, and WHODAS during the third trimester of pregnancy (over 28 weeks in gestational age) and six weeks postpartum. The sample included 186 and 136 participants for the antenatal and postpartum data analyses, respectively. The antenatal and postpartum data showed moderate correlations between both the EPDS and the PHQ-9 scores and the WHODAS scores (Spearman’s correlation coefficients = 0.53–0.66, p < 0.001). The EPDS and PHQ-9 were moderately accurate in distinguishing disability (WHODAS score ≥ 10) from non-disability (WHODAS score < 10) in pregnant and postpartum participants, but the area under the curve of the PHQ-9 receiver operating characteristic curves in postpartum participants was significantly larger than that of the EPDS, with a difference (95% CI; p-value) of 0.08 (0.16, 0.01; p = 0.044). In conclusion, the EPDS and PHQ-9 are valid for assessing PND-related disability in pregnant and postpartum women. The PHQ-9 may perform better than the EPDS in distinguishing disability from non-disability in postpartum women. Full article

Background: Perinatal depression (PND) represents one of the most common mental disorders in the pregnancy and/or postpartum period, with a 5–25% prevalence rate. Our aim was to investigate predictors associated with PND in a cohort of pregnant and puerperal women based in an Italian setting during the COVID-19 pandemic. Methods: We retrospectively recruited 199 (55 pregnant and 144 puerperal) women, afferent to our Perinatal Mental Outpatient Service of Ancona (Italy). Participants were administered an ad hoc case-report form, Whooley Questions (WQ), the General Health Questionnaire-12 (GHQ-12), the Stress Holmes-Rahe scale (HR) and the Edinburgh Postnatal Depression Scale (EPDS). Results: Around 10% of the sample had a confirmed PND. Being a foreigner woman (RR = 3.8), having a positive psychiatric family history (RR = 5.3), a pre-pregnancy medical comorbidity (RR = 1.85) and a comorbid medical illness occurring during the pregnancy (RR = 2) were much likely associated with PND. Multiple linear regression analysis demonstrated that GHQ, medium- and high-risk at the HR, foreign nationality, positive family psychiatric history, and neoplastic disease before conception significantly predicted EPDS [F(1, 197) = 10.086, R² = 0.324, p < 0.001]. Limitations: The sample size, poor heterogeneity in terms of socio-demographic, clinical and gynecological-obstetric characteristics, the cross-sectional design of the study. Conclusions: Our study showed a set of predictors associated with a higher risk for the PND onset, including gestational and pregestational medical disease. Our findings outline the need to screen all fertile women, particularly in gynecological and medical settings, in order to identify at-risk women for PND and promptly suggest a psychiatric consultation. Full article

Perinatal exposure to pollutants, including persistent organic pollutants (POPs) and heavy metals, poses significant risks to both mothers and children, marking this period as highly vulnerable. Despite the well-acknowledged benefits of breastfeeding, there exists a gap in comprehensive understanding regarding the impact of environmental pollutants on breast milk, underscoring the critical need for this study. Our research addresses this gap by exploring the intersection of environmental health and lactation, situated within the broader ‘One Health’ concept, thus contributing a novel perspective to the existing body of knowledge. This scoping review aims to examine recent research on the persistent presence of organic pollutants (POPs) and heavy metals in breast milk, thereby elucidating the environmental setting’s impact on milk quality. We seek to highlight the innovative angle of our study by emphasizing the ‘One Health’ concept, which has not been thoroughly explored in the context of lactation and environmental pollutants. We performed a scoping review, consulting two online databases to identify articles published from 1995 to 2023 that reported on pollutants in breast milk, using the PRISMA checklist. This methodological approach underlines the comprehensive and up-to-date nature of our literature review, ensuring the relevance and timeliness of our findings. From a total of 54 relevant articles, findings indicate that POPs are present in higher concentrations in breast milk the longer the lactation period. These findings highlight the persistent and bioaccumulative nature of such contaminants, offering new insights into their long-term implications for maternal and infant health. This exposure does not appear time-sensitive, suggesting pollutants accumulated in maternal fat compartments can be excreted into human milk years after exposure, a novel finding that underscores the importance of considering long-term environmental exposures in lactation research. The presence of POPs and heavy metals in both infant formula and maternal milk underscores a critical need for further comparative studies to understand the health implications better. Our discussion extends the current dialogue on the safety of breastfeeding in polluted environments, providing a new framework for assessing risks and benefits. While breastfeeding remains the WHO-recommended nutrition for optimal infant growth, the findings emphasize the importance of continued risk reduction policies to protect mothers and infants from environmental contaminants in breast milk. Our conclusion calls for an integrated approach, combining public health, environmental science, and clinical practice to develop effective strategies for reducing exposure to environmental pollutants. This multidisciplinary perspective is a significant contribution to the field, paving the way for future research and policy development. Full article