Search Results (28)

Background/Objectives: Childbirth, although generally a positive life event, can sometimes be experienced as traumatic, leading to postpartum post-traumatic stress disorder. Emergency caesarean section and operative vaginal delivery are associated with elevated psychological distress, while factors such as lifetime trauma, domestic violence, anxiety, and coping strategies may further increase vulnerability. Methods: This prospective cohort study included 113 postpartum women who delivered via emergency caesarean section (73.5%) or operative vaginal delivery (26.5%) in two tertiary hospitals in Athens, Greece (March–July 2023). Data were collected at three time points: the second postpartum day, six weeks postpartum, and three months postpartum. Descriptive statistics were used to summarize sample characteristics. Chi-square tests were performed for categorical variables and independent sample t-tests for continuous variables. Multivariate logistic regression analyses were conducted to identify predictors of postpartum post-traumatic stress disorder, with results expressed as odds ratios (OR) and 95% confidence intervals (CI). Results: At six weeks postpartum, 14.2% of participants met full diagnostic criteria for P-PTSD. Postpartum post-traumatic stress was strongly associated with higher state and trait anxiety, fewer positive coping strategies, and exposure to domestic violence (lifetime, during pregnancy, and in the past year). Women with traumatic childbirth experiences had a 14.7-fold higher risk of developing P-PTSD. Lifetime trauma, particularly physical or sexual abuse and exposure to disasters, further increased vulnerability. Over the last three months, 50% of those initially diagnosed continued to meet the diagnostic criteria. Multivariate analysis identified traumatic childbirth, state anxiety, and domestic violence during pregnancy as significant predictors of postpartum post-traumatic stress. Conclusions: Postpartum post-traumatic stress is a significant and underestimated consequence of high-risk deliveries. Screening for domestic violence and trauma history during pregnancy, assessing perinatal anxiety, and providing trauma-informed psychological support are critical to reducing maternal psychiatric morbidity and promoting maternal-infant well-being. Full article

Objective: This pilot study assessed the psychological and physical impact of the COVID-19 pandemic on postpartum women that gave birth during the pandemic, and evaluated the feasibility of remote monitoring for maternal mental health. The study also proposes a conceptual framework to strengthen remote maternal care in future public health emergencies. Methods: Conducted between 2020 and 2021 in Reggio Emilia, one of Italy’s ten hardest-hit provinces during the early COVID-19 outbreak, this study enrolled 21 pregnant women (10 COVID-19-positive at delivery, 11 COVID-19-negative controls). Psychological and physical health were assessed using validated instruments: the Beck Depression Inventory (BDI) and Edinburgh Postnatal Depression Scale (EPDS) for depression, the State-Trait Anxiety Inventory (STAI) for anxiety, the Impact of Event Scale–Revised (IES-R) for trauma-related stress, and the SF-36 for physical functioning. Additional measures included breastfeeding experience and resilience. Remote assessments were conducted between 6 and 12 months postpartum to evaluate psychological recovery and satisfaction with perinatal care. C test was used to compare the two groups of women. Results: COVID-19-positive women reported significantly higher depressive symptoms (BDI: 13.50 ± 8.14 vs. 6.73 ± 4.73; U = 27, p = 0.048), and elevated state anxiety levels (STAI-S: 41.60 ± 10.23 vs. 33.64 ± 10.15; U = 27, p = 0.048) compared to controls. Post-traumatic stress symptoms were also higher among COVID-positive participants (IES-R total: 41.10 ± 19.33 vs. 30.64 ± 7.99; U = 24.5, p = 0.029). No significant differences emerged in EPDS or trait anxiety scores. Conclusions: Remote data collection proved feasible for postpartum women during the pandemic and highlighted elevated depressive, anxiety, and trauma-related symptoms in COVID-19-positive mothers. These findings support the development of flexible digital care frameworks for maternal well-being in crises. The introduction of the “10 Gold Rules for Remote Maternal Healthcare in Critical Situations” offers a forward-looking, expert-informed conceptual framework to guide the development of scalable, trust-based digital care models that go beyond monitoring to include proactive, patient-centred support. Full article

Late pregnancy represents a critical period for the onset of eating disorder symptoms, particularly in the presence of psychological and relational vulnerabilities. Among these, the quality of the romantic relationship has received limited empirical attention, despite its potential role in shaping women’s psychological adjustment, influencing both mood and body image. The present study examined the association between romantic relationship quality and eating disorder symptoms during the third trimester of pregnancy, considering the mediating roles of depressive symptoms and body dissatisfaction. A sample of 231 Italian pregnant women (Mage = 32.3 years) completed four self-report measures: the Dyadic Adjustment Scale-7, the Edinburgh Postnatal Depression Scale, the Body Image in Pregnancy Scale, and the Eating Disorder Examination Questionnaire-Short. A serial mediation model was tested, including pre-pregnancy body mass index as a covariate. Results indicated that lower romantic relationship quality was associated with greater eating disorder symptoms through higher depressive symptoms and body dissatisfaction, which acted both independently and sequentially. These findings highlight the complex interplay between relational and psychological factors in the development of disordered eating during pregnancy, emphasizing the need for early screening and integrated interventions addressing both interpersonal and intrapersonal domains. Full article

Background and Objective: Postpartum depression (PPD) is a prevalent psychiatric condition with significant consequences for maternal, paternal, and infant well-being. In Saudi Arabia, some reported prevalence rates exceed global averages. This narrative review synthesizes the current literature on the prevalence, risk factors, awareness, and quality-of-life impact of PPD in Saudi Arabia. The aim is to identify methodological inconsistencies, highlight the risk factors, and guide future research and policy. Method: A comprehensive literature search was conducted using PubMed, Scopus, Web of Science, and Google Scholar. Studies published between 2010 and May 2025 were included if they addressed PPD in Saudi Arabia and the inclusion criteria were met. 38 articles were selected for full-text analysis and incorporation in the study. Results: PPD prevalence in Saudi Arabia ranges from 5.1% to 75.7%, with regional variation attributed to inconsistent methodologies, screening instruments, and diagnostic cutoffs. Risk factors encompass psychiatric history, marital conflict, limited social support, low income, cesarean delivery, unplanned pregnancy, anemia, and sleep disturbance. Nutritional and newborn-related predictors were inconsistently reported. Awareness among the public and healthcare professionals remains limited, and paternal postpartum depression is underrecognized. PPD exerts a pronounced negative impact on maternal quality of life, spanning physical, psychological, and social domains. Conclusions: PPD poses a substantial public health burden in Saudi Arabia. Routine screening with validated tools, integrated perinatal mental health services, and targeted public education campaigns may help address diagnostic delays and stigma. Future studies must adopt standardized diagnostic criteria and longitudinal designs to generate nationally representative prevalence estimates and evaluate preventive strategies. Full article

Background: Since quality of life encompasses social, psychological, and physical well-being, it is a crucial component of overall health and well-being. The quality of life has a significant impact on both the mother and the unborn child throughout the perinatal period. Both parties suffer when a threat, such as an illness, materialises because it lowers the quality of life. Using the SCL-90-R and SF-36, the current study aims to investigate variations in anxiety levels and health-related quality of life (HRQoL) between pregnant women with and without relevant medical conditions. Methods: We carried out a cross-sectional study between April 2023 and December 2024. Eligibility criteria were: (a) pregnant women; (b) at least 18 years old; (c) of Romanian nationality residing in Romania; and (d) who signed informed consent and agreed to participate. A Personal Information Form (PIF), the SF-36 Health Survey, and the SCL-90-R questionnaire were used to collect data. Statistical analyses were performed with SPSS v26, using non-parametric tests (Mann–Whitney U, Spearman correlations). Results: Ninety-five of the 212 patients in the study reported having related medical conditions. There were no statistically significant differences between the groups in the physical or mental components of the SF-36. Nonetheless, the pathological group’s anxiety scores were noticeably higher. Particularly in the pathological group, Spearman correlation revealed an inverse relationship between anxiety and SF-36 physical component scores. Conclusions: The findings highlight the importance of integrating psychological screening into prenatal care, particularly for women with medical comorbidities. Early identification and management of elevated anxiety may help preserve maternal HRQoL and contribute to better perinatal outcomes. Full article

Background/Objectives: Sleep plays a key role in female fertility. Sleep disturbances (SDis) during pregnancy are common and may negatively affect maternal health, contributing to an increased risk of perinatal depression and anxiety. Aim: The present prospective study aimed to examine the interplay of sleep, anxiety, and depression during the pregnancy and postpartum stages, comparing women who conceived naturally (NC) with those who conceived through assisted reproductive treatment (ART). Methods: The study included five timepoints: pre-pregnancy (t0), the end of each trimester (t1–t3), and the postpartum period (t4). SDis were assessed using the Pittsburgh Sleep Quality Index (PSQI), the Athens Insomnia Scale (AIS), the Epworth Sleepiness Scale (ESS), the Fatigue Severity Scale (FFS); perinatal depressive and anxiety symptoms were assessed using the Edinburgh Postnatal Depression Scale (EPDS). Demographic and clinical characteristics were also collected. Given the imbalance in group size and the dispersion of values, a negative binomial regression model with robust variances and Satterthwaite approximation for the degrees of freedom was applied. Results: Compared to women with NC (N = 37), those undergoing ART (N = 57) were more likely to be older (p < 0.001), married (p < 0.001), unemployed (p < 0.001), and have a history of thyroid disease (p = 0.008). Significant differences between different time points were observed in both NC (N = 37) and successfully conceived ART groups (N = 9) in all sleep, fatigue, and well-being parameters. Notably, at the end of the first trimester (t1), the ART group reported more severe insomnia symptoms (p = 0.02). Conclusions: SDis are common in pregnancy, but more pronounced during the first trimester among women on ART. These findings highlight the need for early screening and targeted psychological support during perinatal care. 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: The perinatal period is a critical phase in a woman’s life, during which cultural and contextual factors significantly influence her physical and emotional well-being, as well as her transition to motherhood. Understanding cultural differences—such as those between Brazil and Spain—is essential for improving tailored perinatal care. Objective: This study explores and compares the perinatal experiences of women in Spain and Brazil, with a focus on their postpartum support needs and mental health implications. Method: A qualitative design was employed, using in-depth interviews with 22 postpartum women—11 from Spain and 11 from Brazil. Interviews were conducted using a semi-structured guide, and the data were analyzed through thematic analysis. Results: Common themes across both cultural contexts included the importance of preparation for childbirth, the need for emotional and psychological support, challenges related to breastfeeding, and adjustments to physical and psychological changes. Cultural differences were also identified: Brazilian women tended to engage in more detailed planning and valued the support of professionals such as doulas and midwives, whereas Spanish women emphasized the importance of having their choices respected during childbirth. Notably, both groups experienced significant emotional challenges, highlighting crucial considerations for maternal mental health. Conclusions: These findings emphasize the need for culturally sensitive perinatal support programs that address the emotional and psychological needs of postpartum women, aiming to improve mental health outcomes. 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

The perinatal period, due to the many physical, psychological, and social changes in future mothers, may represent a critical phase with an increased risk for mental health. Postpartum depression (PPD) is one of the main syndromes that affect around 17 percent of women after pregnancy and in the first months of motherhood. This systematic review, following PRISMA guidelines, aimed to identify the main pre-partum psychiatric risk factors that may influence the occurrence and diagnosis of PPD with a focus on the antenatal and clinical history of depression, bipolar disorders, obsessive–compulsive disorder, and psychosis. From the search in main scientific databases (Web of Science, Pubmed, Psychinfo, and Scopus), 37 articles were included for the critical evaluation. The studies showed that antenatal depression and depressive episodes during pregnancy represent higher risk factors for PPD. Also, a clinical history of major depression, especially if associated with other risk factors (such as poor demographic or social conditions) increases the risk for PPD. From the systematic analysis emerged a paucity of studies considering the other psychiatric syndromes that should be overcome. PPD represents a multisystemic syndrome involving all the aspects of a mother’s life as well as affecting children’s development; for this reason, exploring the role of mental health risk factors for PPD onset, progression, and prognosis is relevant, from a clinical point of view, to find the best way to promote the mother’s psychological well-being from the antenatal period. Full article

Background/Objectives: Perinatal loss is a challenging experience that significantly impacts families and healthcare professionals. This study aimed to explore the perceptions and experiences of the nursing team in the gynecology unit at a Spanish hospital regarding the implementation of a new protocol for perinatal bereavement care. Methods: A qualitative descriptive study was conducted involving a focal group interview with nursing staff from the gynecology unit. Participants were selected through purposive sampling, and data were analyzed using thematic analysis to identify recurring patterns and insights. Results: The findings revealed a disparity in attitudes toward perinatal bereavement care, with some nurses demonstrating empathy and understanding, while others expressed discomfort and avoidance behaviors. Barriers to effective care included a lack of formal training, insufficient emotional support, and practical challenges in implementing the protocol. Participants suggested improvements such as enhanced communication training, the appointment of a bereavement coordinator, and earlier psychological interventions to support both families and staff. Conclusions: The study highlights the need for continuous education and emotional support to facilitate the adoption of perinatal bereavement protocols. Involving nursing staff in protocol development and addressing systemic barriers can improve the quality of care for bereaved families while supporting healthcare professionals’ emotional well-being. Full article

Neuroticism is a personality trait associated with the risk of affective disorders and perinatal depression. We investigated the relationship between different levels of neuroticism, psychological characteristics, and depressive symptoms in a sample of pregnant women (N = 2631) who accessed the gynecology departments in the Puglia Region (Italy) from July 2020 to November 2022. Women were assessed for depressive symptoms and associated risk factors in their third trimester of pregnancy (T0) and after childbirth (T1), and followed-up at 6 months and 1 year after delivery if presenting signs of depression (T2–T3). The Edinburgh Postnatal Depression Scale (EPDS) was used to screen depressive symptoms, and neuroticism was assessed through the subscales of the NEO Five Factor Inventory. Standardized measures of resilience, coping strategies, partner attachment, and quality of life were also employed. Higher levels of neuroticism were significantly associated with: (a) higher scores on the EPDS; (b) higher anxiety in the experience of close relationships; (c) lower psychological wellbeing; (d) lower levels of resilience; (e) lower levels of active coping; and (f) higher levels of self-blame. Our findings may suggest that neuroticism is a specific associated factor of perinatal depression and should be routinely assessed in the clinical screening of pregnant women in order to promote an early referral to psychological or psychiatric support services. Full article

(1) Background: Mothers of very preterm (VPT) infants may experience psychological symptoms compromising long-term emotional wellbeing. This study describes the emotional wellbeing of mothers of five-year-old children born VPT. We assess the association between sociodemographic, perinatal and neonatal characteristics, and the child’s health and development at five years old and maternal emotional wellbeing. (2) Methods: Data are from the prospective European “Effective Perinatal Intensive Care in Europe” (EPICE) and subsequent “Screening for Health In very Preterm infantS in Europe” (SHIPS) projects including births <32 weeks’ gestational age in 11 countries in 2011/12. Data were abstracted from obstetric and neonatal records. At five years old, 2605 mothers answered a parental questionnaire including the Mental Health Inventory-5 (MHI-5). Associations between sociodemographic and health characteristics and the mother’s MHI-5 score were investigated using multilevel multivariate linear regression analysis with the country modelled as a random effect and inverse probability weighting to correct for attrition bias. (3) Results: The mean MHI-5 score was 71.3 (SD 16.7) out of 100 (highest emotional wellbeing) with a variation among countries from 63.5 (SD 16.8; Poland) to 82.3 (SD 15.8; the Netherlands). MHI-5 scores were significantly lower for mothers whose child had a severe health problem, developmental, or speech delay, for multiparous and single mothers, and when at least one of the parents was unemployed. (4) Conclusions: The emotional wellbeing of mothers of VPT infants differs between European countries. Identifying sociodemographic characteristics and child’s health and developmental conditions that affect maternal emotional wellbeing may help to identify groups of mothers who need special assistance to cope with consequences of the delivery of a VPT child. Full article

Purpose: The COVID-19 pandemic, with its multidimensional consequences, is the most serious threat of the 21st century affecting the mental health of women in the perinatal period around the world. Resilience, which assumes the flexible use of an individual’s resources in facing adversity, is an important, protective factor influencing mental well-being. The presented study aimed to determine to what extent psychological resilience, mitigates the relationship between adverse consequences of the COVID-19 pandemic and symptoms of depression and anxiety in women in the perinatal period. Methods: We recruited pregnant women from 17 February to 13 October 2021, using social media, the parenting portal, and the snowball method. To assess mental well-being, we used: The Edinburgh Postnatal Depression Scale (EPDS), The Beck Depression Inventory (BDI-2), Self-report Labour Anxiety Questionnaire—LAQ and the self-developed COVID-19 Pandemic Anxiety Questionnaire (CRAQ). Resilience was measured usingthe Resilience Measure Questionnaire (KOP26). Multiple Correspondence Analysis (MCA), an independent t-test, and a Pearson correlation analysis were performed. Results: Low resilience was significantly associated with depressive symptoms (r = −0.46; p < 0.05) and anxiety related to childbirth (r = −0.21; p < 0.05). No associations were found for resilience and pandemic-related stress. Very high and high perinatal anxiety along with the lowest level of resilience clustered with EPDS and BDI-2 scores indicating depression. Conclusions: Our study provides evidence that lower levels of resilience during pregnancy may be a significant predictor of increased severity of depressive symptoms and higher levels of anxiety related to childbirth among the perinatal population. Full article

The quality of the early parent–infant relationship is crucial for the child’s optimal development, and parental sensitivity plays a key role in early interactions. The purpose of the study was to evaluate the influence of maternal perinatal depression and anxiety symptoms on dyadic sensitivity at three months post-partum, also considering a large set of maternal and infant variables. At the third trimester of pregnancy (T1) and at three months postpartum (T2), 43 primiparous women filled in a set of questionnaires evaluating symptoms of depression (CES-D) or anxiety (STAI), the woman’s parental bonding experiences (PBI), alexithymia (TAS-20), maternal attachment to the baby (PAI, MPAS) and the perceived social support (MSPSS). At T2 mothers also completed a questionnaire on infant temperament and took part in the CARE-Index videotaped procedure. Dyadic sensitivity was predicted by higher maternal trait anxiety scores in pregnancy. In addition, the mother’s experience of being cared for by her father in childhood was predictive of her infant’s lower compulsivity, while paternal overprotection predicted higher unresponsiveness. The results highlight the influence of perinatal maternal psychological well-being and maternal childhood experiences on the quality of the dyadic relationship. The results may be useful to foster mother–child adjustment during the perinatal period. Full article