Search Results (111)

Background: Antenatal depression and anxiety contribute significantly to maternal morbidity and adverse pregnancy outcomes. However, structured screening and targeted interventions are largely absent from standard prenatal care in many Eastern European countries, including Bulgaria. This study examines the prevalence and psychosocial predictors of antenatal psychosocial risk using the validated Antenatal Risk Questionnaire–Revised (ANRQ-R) in a nationally underrepresented population. Methods: A cross-sectional survey was conducted among 216 third-trimester pregnant women in Bulgaria. Data on sociodemographic characteristics, health behaviours, and reproductive history were collected. Multivariate logistic regression identified predictors of elevated psychosocial risk. Results: A total of 65.7% of participants met the criteria for elevated psychosocial risk. Significant risk factors included passive smoking exposure during pregnancy (OR = 5.03, p < 0.001), physical activity prior to pregnancy (OR = 1.81, p = 0.004), and a family history of hereditary disease (OR = 42.67, p < 0.001). Protective factors were better self-rated current health (OR = 0.37, p = 0.004), the presence of chronic illness (OR = 0.42, p = 0.049), previous childbirth experience (OR = 0.11, p = 0.032), and residence in Northwestern Bulgaria (OR = 0.31, p = 0.028). Despite the high prevalence of psychosocial vulnerability, only 9.5% of affected women sought professional help. Conclusions: While our findings point to important unmet needs in antenatal mental health, further research is required before national screening policies can be implemented. Pilot programs, cultural validation of tools, and system-level readiness assessments should precede broad adoption. Full article

Pregnant individuals who receive a fetal anomaly diagnosis experience significantly elevated rates of depression, anxiety, and traumatic stress—up to four to six times higher than those for individuals with low-risk pregnancies. In low-risk pregnancies, perinatal mental health conditions are the leading cause of maternal mortality and are associated with adverse birth outcomes, including preterm birth and low birth weight. These risks are likely compounded in pregnancies involving fetal anomalies due to the intersecting psychological and social burdens that complicate maternal well-being and access to care. However, there is a critical gap in understanding how these mental health symptoms translate into diagnoses, treatments, and outcomes due to the absence of a validated screening tool tailored to this population’s unique psychosocial needs. This perspective article reviews evidence, highlights the urgent need for specialized screening, and introduces ongoing research aimed at developing and validating an instrument that integrates both mental health symptoms and broader psychosocial distress. By bridging this gap, structured psychosocial screening has the potential to improve care coordination, facilitate earlier intervention, and mitigate long-term distress for individuals navigating pregnancies affected by fetal anomalies. Full article

Background/Objectives: The Mediterranean diet (MD) is well-studied for its health-promoting effects, while the factors influencing adherence in children remain an important research focus. This study examines the sociodemographic, maternal, perinatal, and lifestyle determinants associated with MD adherence among children aged 6–9 years in an effort to identify key predictors and their impact on long-term nutritional habits. Methods: This study recruited 4851 children from diverse Greek rural and urban regions. The mothers of the enrolled children completed relevant questionnaires on their children’s sociodemographics, perinatal outcomes, anthropometric parameters, breastfeeding practices, and physical activity status. The enrolled children completed the Children’s Depression Inventory (CDI) and the State–Trait Anxiety Inventory for Children—State (STAIC-S) form to assess the presence of depression and anxiety symptoms, respectively. The KIDMED score was used to assess the MD compliance of the enrolled children. Results: The outcomes demonstrated that higher maternal education and family economic status gravitated toward increased MD adherence (p = 0.0071, p ˂ 0.0001), while exclusive breastfeeding (p ˂ 0.0001) and higher physical activity levels (p = 0.0101) were strong predictive factors for MD adherence, highlighting the role of early-life interventions in shaping dietary habits. In contrast, cesarean delivery (p = 0.0173) and higher birth weight (p ˂ 0.0001) were linked to lower MD adherence, indicating potential metabolic and behavioral predispositions. Notably, higher MD adherence correlated with lower prevalence of depressive and anxiety symptoms (p ˂ 0.0001, p = 0.0001), underscoring its potential protective role in mental health. Conclusions: Our findings highlight a complex interplay between early-life and dietary behaviors, while further longitudinal studies are needed to establish causality and optimize evidence-based nutritional strategies and education for childhood health and well-being. Full article

Background and Objectives: Evidence regarding how dispositional traits, antenatal anxiety, substance use, and obstetric events converge to shape post-partum depression (PPD) in South-East Europe is limited. We analysed 102 third-trimester women and followed them to six weeks post-partum, and 102 age-matched community controls were used to (i) compare baseline psychological profiles, (ii) chart antenatal-to-post-partum symptom trajectories, and (iii) build an integrated model of clinically relevant PPD (Edinburgh Post-natal Depression Scale, EPDS ≥ 12). Materials and Methods: All 96 raw variables were forward–backward translated from Romanian, reconciled, and harmonized. The principal instruments used were EPDS, State–Trait Anxiety Inventory form Y (STAI-Y), Revised Obsessive–Compulsive Inventory (OCI-R), NEO Five-Factor Inventory (NEO-FFI-60), and the four-item Maternal Worry and Satisfaction Scale (MWSS). Results: Groups were age-matched (31.1 ± 5.4 vs. 30.3 ± 5.1 years, p = 0.268) but differed in urban residence (39% vs. 17%, p = 0.001) and current substance use (smoking 21% vs. 34%, p = 0.041; alcohol 6% vs. 22%, p = 0.002). Of five personality domains, only openness scored lower in peripartum women (26.1 ± 4.6 vs. 29.3 ± 5.2, p < 0.001). State anxiety rose significantly from pregnancy to puerperium (+5.1 ± 8.4 points, p < 0.001). Post-partum EPDS correlated most strongly with state anxiety (r = 0.62) and neuroticism (r = 0.50). A final model (pseudo-R² = 0.30) identified post-partum state anxiety (OR 1.10 per point, 95% CI 1.05–1.15, p < 0.001) as the independent predictor; neuroticism showed a trend (OR 1.08, p = 0.081). Obstetric factors (prematurity, birth weight, caesarean section) were not significant. Conclusions: In this Romanian cohort, heightened state anxiety—in synergy with high neuroticism and lower openness—dominated the risk landscape of early onset PPD, whereas delivery mode and neonatal status were neutral. Routine perinatal mental health screening should therefore incorporate anxiety metrics alongside depression scales and brief trait inventories to refine preventive targeting. Full article

Background/Objectives: The global prevalence of childhood obesity and overweight is steadily increasing, representing a pressing public health concern due to its persistence during adolescence and adulthood and its association with elevated morbidity and mortality risks. This cross-sectional study was designed to examine the potential association between overweight/obesity and the presence of depressive and anxiety symptoms in children aged 6 to 9 years. Methods: A total of 4098 children from various urban and rural regions in Greece were enrolled. Data was collected through maternal questionnaires capturing sociodemographic characteristics, perinatal outcomes, anthropometric measurements, breastfeeding practices, and physical activity levels. Children fulfilled the Children’s Depression Inventory (CDI) and the State-Trait Anxiety Inventory for Children—State form (STAIC-S) to evaluate symptoms of depression and anxiety, respectively. Results: Childhood overweight/obesity was independently and significantly associated with a more than two-fold increased likelihood of presenting depressive and anxiety symptoms. Childhood overweight/obesity was also significantly associated with maternal obesity, gestational weight gain, childbirth weight, mode of delivery, exclusive breastfeeding, and children’s physical activity. Conclusions: Overweight and obesity in children aged 6–9 years are significantly associated with an elevated risk of psychological distress, including depression and anxiety. These findings underscore the need for targeted public health policies and nutritional interventions aimed at promoting healthy lifestyle practices from early childhood. Educational efforts should also support new mothers in adopting and sustaining health-promoting behaviors to mitigate the long-term consequences of childhood obesity. Full article

Background: Adipokines secreted by the adipose tissue and placenta play a critical role in regulating metabolic functions that are essential for fetoplacental development and embryonic growth. While adipokines are known to impact a wide range of physiological and pathological conditions, their role in affective disorders during pregnancy remains underexplored. In this study, we aimed to assess the serum levels of distinct adipokines and examine their association with anxiety and comorbid depression in pregnant women. Methods: Third-trimester pregnant women with severe anxiety (ANX, n = 45) and anxiety plus depressive symptoms (ANX + DEP, n = 61) were enrolled in the study, along with healthy control subjects (CTRL, n = 33). Participants were classified using the Hamilton Anxiety Rating Scale (HARS) and the Hamilton Depression Rating Scale (HDRS). Serum levels of adiponectin, adipsin, leptin, and resistin were quantified by flow cytometry-based immunoassay. Clinical, biochemical, and demographic parameters were analyzed using ANOVA with a post hoc Tukey test. Pearson bivariate and partial correlations were performed to assess associations between variables. Results: Adipokine serum levels were significantly higher in the symptomatic groups (ANX, ANX + DEP) than in the CTRL group (p < 0.001). Adiponectin, leptin, and resistin levels positively correlated with anxiety symptoms (HARS, p < 0.01). Furthermore, resistin levels showed a strong association with depressive symptoms (HDRS, p = 0.001) in the ANX + DEP group, after adjusting all parameters by clinical confounders. Conclusions: Our findings revealed that both pro- and anti-inflammatory adipokine levels are elevated in women with affective symptoms during late pregnancy. Pro-inflammatory properties of leptin and resistin may contribute to the severity of anxiety symptoms. Notably, resistin emerges as a key adipokine associated with the expression of depressive symptoms. In addition, adiponectin, acting as an anti-inflammatory mediator, may counteract the inflammatory responses induced by leptin and resistin. These results provide new insights into the role of specific adipocytokine in women with affective disorders during late pregnancy. Full article

Pregnancy is a period of great complexity and potential psychological vulnerability which may increase in unfavorable conditions, such as hospitalization. Therefore, early identification of emotional, anxious, or depressive difficulties is important in terms of maternal and fetal well-being. International guidelines recommend the use of brief screening tools to identify perinatal women for further investigation, but which of the measures is optimal remains to be clarified. The objective of this study was to compare the Whooley depression questions used together with the Generalized Anxiety Disorder-2 (GAD-2), versus the Matthey Generic Mood Questionnaire (MGMQ), to evaluate their concordance in screening results and their clinical usefulness in the hospital setting. Hospitalized pregnant women, numbering 228, and 55 male partners completed both questionnaires. The women’s results showed high similar screen positive rates on both measures, but the screen positive concordance between the two instruments was low (around 50%). The Whooley/GAD-2 missed a significant percentage of women who, on the MGMQ, wished to talk with a professional, or who expressed moderate to high distress. The data from male partners were too few to be interpretable. Findings suggest that screening is important in hospitalized women, and clinicians should consider the respective merits and possible weaknesses of different screening tools. Full article

Background: Perinatal depression and anxiety can be experienced simultaneously and change over time. This study aimed to explore the independent and joint developmental trajectories and predictors of perinatal depression and anxiety. Methods: From January 2022 to December 2023, a total of 1062 pregnant women from Affiliated Women’s Hospital of Jiangnan University were surveyed for depression and anxiety symptoms using the Patient Health Questionnaire (PHQ-9) and Generalized Anxiety Disorder Scale (GAD-7) in early pregnancy (T1, 0–13⁺⁶ weeks), mid-term pregnancy (T2, 14–27⁺⁶ weeks), late pregnancy (T3, 28–41 weeks), and 42 days postpartum (T4). Parallel-process latent class growth model (PPLCGM) was performed to identify the joint developmental trajectories of perinatal depression and anxiety, and logistic regression was used to analyze factors of joint trajectories. Results: Perinatal depression and anxiety each showed four heterogeneous developmental trajectories, and three joint developmental trajectories were identified: “high–slightly decreasing depression and high decreasing anxiety group” (3%), “low–stable depression and low–stable anxiety group” (71%), and “moderate–slightly increasing depression and moderate–decreasing anxiety group” (26%). Adverse maternal history, history of anxiety and depression, and work stress were risk factors for the joint developmental trajectory of perinatal depression and anxiety, while regular exercise, paid work and social support were protective factors. Conclusions: Three joint developmental trajectories for perinatal depression and anxiety were identified, demonstrating group heterogeneity. Perinatal healthcare providers should pay attention to the mental health history of pregnant women, conduct multiple assessments of perinatal anxiety and depression, prioritize individuals with risk factors, and advocate for regular exercise, work participation, and provide greater social support. Full article

The Perinatal Multisite Databank (PMD) aims at facilitating research on perinatal mental health by collecting clinical information of patients referred for evaluations at perinatal mental health clinics across the province of Quebec, Canada with the potential to improve patient care and support evidence-based practice. This study provides a detailed description of the first 693 participants concerning psychosocial risk characteristics, the prevalence of psychiatric disorders and comorbidity during the perinatal period, the evolution of perinatal depression and anxiety symptoms over time, and the treatments received. Data were collected using clinical reports and well-validated questionnaires at multiple timepoints (from pregnancy to 6 months postpartum). Results are discussed within the context of improving patient care and disease prevention strategies in the perinatal period. Full article

Postpartum depression (PPD) is a severe mental health condition that affects women following childbirth and is marked by persistent sadness, anxiety, fatigue, and difficulty functioning. Unlike the temporary “baby blues”, PPD is more severe and long-lasting, potentially leading to negative consequences for mother and child. Globally, PPD impacts approximately 10–20% of postpartum women, with prevalence influenced by genetic, hormonal, psychological, and socio-environmental factors. Early detection is crucial, with screening tools such as the Edinburgh Postnatal Depression Scale (EPDS) commonly used in clinical practice. Treatment options include pharmacological interventions such as selective serotonin reuptake inhibitors (SSRIs), psychological therapies like cognitive behavioral therapy (CBT) and interpersonal therapy (IPT), and lifestyle modifications. Despite the growing awareness of PPD, stigma remains a significant barrier to treatment, discouraging many women from seeking help. In low-income countries, where mental health care is often underfunded, accessing professionals trained in perinatal mental health presents an even greater challenge. This gap underscores the urgent need for a collaborative, multidisciplinary approach involving obstetricians, psychiatrists, pediatricians, and midwives to ensure comprehensive support and care for affected individuals. Full article

Objective: The aim of this study was to assess the opinions of pregnant women living with HIV (PWLWHIV) about their positive childbirth experiences and the most important factors contributing to positive or negative experiences. Methods: A cross-sectional study was conducted with 82 PWLWHIV; semi-structured interviews were conducted in a public hospital in Rio de Janeiro. Results: A total of 65 (79.3%) PWLWHIV experienced a positive childbirth experience. Conversely, 14 (17.1%) PWLWHIV had a negative experience. The main reasons given by the PWLWHIV for positive experiences were the good health of the baby, their partner’s presence at the childbirth, and good healthcare professional support. The main reasons for negative childbirth experiences were poor healthcare professional support, excessive pain or medication, and the absence of a companion during childbirth. Conclusions: Our findings indicate that the health of the baby at birth was the main factor in positive childbirth experiences. On the other hand, poor healthcare professional support was the main cause of negative childbirth experiences. Increasing the incidence of positive childbirth experiences could reduce maternal depression and anxiety, and significantly impact neonatal outcomes (mainly low birth weights and preterm birth). Future studies should target reducing depressive symptoms in perinatal HIV-positive women, increasing partner involvement, and decreasing HIV stigma. Full article

Background/Objectives: This study investigates the effects of a high-fat diet (HFD) during pregnancy and lactation on maternal and offspring health, focusing on behavioral, metabolic, and fatty acid composition outcomes in a rat model. Methods: Twelve female Sprague–Dawley rats were fed either a control diet, CD (n = 6), or HFD (n = 6) for 12 weeks, encompassing mating, gestation, and lactation periods (18 weeks). Anxiety-like behavior, maternal behavior, depression-like behavior, and social play were studied. Post mortem, the liver function, hepatic steatosis, and fatty acid composition (erythrocytes, liver, adipose tissue) were evaluated. In regard to desaturase enzymes (Δ-6D and Δ-5D), liver activity, protein mass, and gene expression (RT-PCR) were analyzed. Additionally, gene expression of PPAR-α, ACOX, CPT1-α, SREBP-1c, ACC, and FAS was assessed. Statistical analysis was performed using Student’s t-test, mean ± SD (p < 0.05). Results: The HFD significantly increased maternal weight and anxiety-like behavior while reducing social interactions exclusively in male offspring (p < 0.05). It also led to a significant decrease in the synthesis and content of n-3 PUFAs in the analyzed tissues, induced hepatic steatosis, and upregulated the expression of pro-lipogenic genes in the maternal liver. Conclusions: These findings suggest that long-term HFD consumption alters tissue fatty acid composition, disrupts metabolic homeostasis, and contributes to behavioral changes, increasing anxiety-like behaviors in pregnant dams and reducing social interactions in male offspring. Overall, this study provides further insight into the detrimental effects of HFD consumption during the perinatal period. Full article

Background/Objectives: It would be helpful for primary healthcare professionals to have access to a brief, general screening tool allowing them to detect patients suffering from major mental illness. This also holds for organizations and institutions at which pregnant women ask for support during the perinatal period. An evaluation of the psychometric properties, validity, and reliability of the Fainareti mental health screening tool was carried out in Greek women in this study. Methods: The study participants consisted of 518 women retrospectively followed from pregnancy to their first year postpartum as part of a health intervention at the Day Center for Women’s Mental Health Care (Perinatal Mental Health Disorders), operated by the non-profit organization Fainareti. Alongside the newly developed screening tool, this study utilized the Perinatal Anxiety Screening Scale (PASS), the Patient Health Questionnaire (PHQ-9), and the Edinburgh Postnatal Depression Scale (EPDS). Results: The assessment of the tool’s internal reliability included computing two separate internal consistency indices, with both indicating its significant level of reliability. The correlation analysis between the tool and the scales included in this study demonstrated the tool’s strong convergent validity, while factor analyses confirmed its satisfactory construct validity. Conclusions: Overall, these findings suggest that the one-factor Fainareti mental health screening tool is suitable for initial assessments of the mental health of Greek women. Full article

Background: Postpartum Post-Traumatic Stress Disorder (P-PTSD) symptoms develop after experiencing childbirth as traumatic. Several individual and environmental factors influence the childbirth experience. However, in Italy, this phenomenon remains unexplored due to the lack of screening tools. This project aims to validate the Italian version of the Perinatal PTSD Questionnaire (PPQ-II) and to identify maternal, pregnancy, childbirth, and postpartum risk and protective factors associated with P-PTSD. Methods: A total of 702 women (6–24 months postpartum) participated in an online cross-sectional study. They completed the PPQ-II, Depression Anxiety Stress Scales-21 (DASS-21), Big Five Inventory-10 (BFI-10), and a questionnaire to assess sociodemographic and perinatal factors. Factor structure was estimated with an exploratory (EFA) and confirmatory factor analysis (CFA). Internal consistency of the scale, convergent and divergent analyses were computed. Associations between perinatal factors and P-PTSD were also investigated. Results: The EFA revealed a two-factor structure: “Arousal and Mood alteration” and “Avoidance and Intrusion”. CFA supported the factor structure, showing a good fit of the data. The validity was confirmed by a significant association between the PPQ-II and the DASS-21 and a lower correlation with the BFI-10. Significant associations were found between P-PTSD symptoms and factors across the maternal, pregnancy, childbirth, and postpartum periods. Conclusions: The Italian PPQ-II is a valid screening tool to include in maternity care protocols for the early identification of P-PTSD. This study also contributes to identifying perinatal factors for symptom detection and the promotion of maternal well-being. Full article

Objectives: This study examined how self-compassion and emotional regulation strategies have influenced perinatal anxiety, depression, and social anxiety during COVID-19. Methods: A probabilistic sample, determined by convenience criteria of 265 Australian perinatal women completed an online survey containing measures of depression, anxiety, social anxiety, COVID-19 experiences, self-compassion, and emotional regulation strategies. Results: As hypothesised, correlation analyses showed that self-compassion and adaptive emotional regulation strategies were negatively related to anxiety, depression and social anxiety, and maladaptive strategies were positively related. Contrary to predictions, COVID-19-related experiences showed little relationship with mental health outcomes. Parallel mediation analyses showed that self-compassion negatively predicted depression and anxiety and was partially mediated by specific emotional regulation strategies. For social anxiety, self-compassion was fully mediated by emotional regulation strategies. Different emotional regulation strategies were significant mediators of the relationship between self-compassion and each mental health outcome. Conclusions: The findings suggest that reinforcing self-compassion and addressing certain emotional regulation deficits is important in alleviating mental health symptoms among perinatal women. Full article