Search Results (22)

Background: Perinatal brain network alterations, including changes in resting-state functional connectivity (rsFC), may increase vulnerability for perinatal mood and anxiety disorders (PMAD). The Fronto-Parietal Network (FPN), the Default-Mode Network (DMN), and the Salience Network (SN) are interconnected networks implicated in mood disorders. However, these networks’ role in perinatal neuroplasticity and PMAD remains unclear. Methods: This pilot study prospectively followed twenty-two women from preconception to postpartum. Participants completed anxiety and depression questionnaires and underwent fMRI scans at preconception and postpartum. The FPN, DMN, and SN were defined and average connectivity of each network was determined. Differences in connectivity from preconception to postpartum within each network and to each network at the whole-brain level were computed. Results: While connectivity within the FPN, DMN, and SN did not show significant changes from preconception to postpartum, we found increased rsFC from the left anterior prefrontal cortex to the DMN, and decreased rsFC from the right ventral posterior cingulate cortex to the FPN, from preconception to postpartum. Bilateral supplementary motor areas (SMAs) showed increased connectivity to the FPN from preconception to postpartum, and this change in connectivity was negatively correlated with anxiety scores during pregnancy. Right SMA connectivity to the FPN at preconception showed positive association with postpartum depression scores (p < 0.05 for all comparisons). Conclusions: RsFC perinatal-related changes were demonstrated in cognitive and motor regions connected to the DMN and FPN. Among women with perinatal depressive and anxiety symptoms, changes in SMA rsFC to the FPN from preconception to postpartum were observed, indicating possible roles in PMAD. Full article

Background/Objectives: Anxiety disorders (ADs) affect up to 20% of mothers in the postpartum period, characterized by psychological symptoms (e.g., emotion dysregulation; ER) and physical symptoms (e.g., disrupted bodily awareness). Although Cognitive Behavioural Therapy effectively reduces anxiety and mood symptoms, it shows limited efficacy in addressing ER difficulties and rarely targets interoceptive dysfunction—both common in postpartum ADs. This study evaluates the effectiveness of a brief mindfulness-based intervention in improving anxiety, ER, and interoception in mothers with postpartum ADs. A secondary aim is to examine changes in brain connectivity associated with these domains. Methods: This protocol describes a proof-of-concept randomized controlled trial involving 50 postpartum mothers with ADs. Participants will be randomized to receive either a 4-week mindfulness intervention plus treatment-as-usual (TAU) or TAU alone. Participants in the mindfulness + TAU group will complete a virtual 4-week group intervention adapted from Mindfulness-Based Cognitive Therapy. The TAU group will receive usual care for 4 weeks and then be offered the mindfulness intervention. Self-report measures of anxiety, ER, and interoception will be collected at baseline, post-intervention, and at a 3-month follow-up. Resting-state functional MRI will be conducted at baseline and post-intervention to assess functional connectivity changes. This trial has been registered on ClinicalTrials.gov (NCT07262801). Results: Improvements in anxiety, ER, and interoception are anticipated, along with decreased default mode network, and increased salience network connectivity post-intervention is hypothesized. Conclusions: This study will be the first to examine the combined psychological and neural effects of mindfulness in postpartum ADs, offering a potentially scalable mind–body treatment. Full article

Background/Objectives: Bipolar II disorder is frequently misdiagnosed as unipolar depression, particularly when depressive symptoms predominate and hypomanic features are subtle or overlooked. This case study describes a patient initially treated for postpartum depression who later developed antidepressant-induced hypomanic symptoms, leading to the correct diagnosis of bipolar II disorder. The objective is to illustrate diagnostic complexities and highlight the value of an integrated treatment approach. Methods: Clinical assessment included standardized mood rating scales, structured interviews, functional evaluations, and monitoring of sleep and physical health indicators. Treatment combined mood-stabilizing pharmacotherapy with cognitive-behavioral therapy (CBT), dialectical behavior therapy (DBT), psychoeducation, and interpersonal and social rhythm therapy (IPSRT). Lifestyle interventions targeted sleep hygiene, physical activity, and stress management. Results: The diagnosis of bipolar II disorder was supported by the emergence of hypomanic symptoms following antidepressant treatment. The integrated therapeutic plan resulted in sustained mood stabilization, normalization of sleep patterns, improved occupational and social functioning, and reductions in depressive and hypomanic symptom scores. Physical health indicators, including body mass index, also improved. Conclusions: This case underscores the importance of comprehensive assessment and careful interpretation of antidepressant response in suspected bipolar presentations. A multimodal treatment approach integrating medication, psychotherapy, and lifestyle modification contributed to significant clinical improvement and may serve as a model for managing complex bipolar II presentations. 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

Background/Objectives: While studies in rat pups suggest that early zinc exposure is critical for optimal brain structure and function, associations of prenatal zinc intake with measures of brain development in infants are unknown. This study aimed to assess the associations of maternal zinc intake during pregnancy with MRI measures of brain tissue microstructure and neurodevelopmental outcomes, as well as to determine whether MRI measures of the brain mediated the relationship between maternal zinc intake and neurodevelopmental indices. Methods: Forty-one adolescent mothers were recruited for a longitudinal study during pregnancy. Maternal zinc intake was assessed during the third trimester of pregnancy using a 24 h dietary recall. Infant MRI scans were acquired at 3 weeks postpartum using a 3.0 Tesla scanner to measure fractional anisotropy (FA) and mean diffusivity (MD). Cognitive, language, and motor skills were assessed at 4, 14, and 24 months postpartum using the Bayley Scales of Infant Development. Results: Greater prenatal zinc intake was associated with reduced FA in cortical gray matter, particularly in the frontal lobe [medial superior frontal gyrus; β (95% CI) = −1.0 (−1.5, −0.5)], in developing white matter, and in subcortical gray matter nuclei. Greater prenatal zinc intake was associated with reduced MD in cortical gray matter and developing white matter [superior longitudinal fasciculus; −4.4 (−7.1, −1.7)]. Greater maternal zinc intake also was associated with higher cognitive development scores at 14 [0.1 (0.0, 0.1)] and 24 [0.1 (0.0, 0.2)] months of age; MRI indices of FA and MD did not mediate this relationship. Conclusions: Maternal prenatal zinc intake was associated with more favorable measures of brain tissue microstructural maturation and cognitive development during infancy. Full article

(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. Full article

Background. This study aims to compare the cognitive function of women with T1DM during and after pregnancy, as well as one year post-delivery. Additionally, it aims to investigate the impacts of leptin and body mass index on cognitive function. Methods. A prospective longitudinal cohort study was conducted involving 64 pregnant women with T1DM. Cognitive function was assessed using a cognitive assessment battery during the first trimester, immediately after delivery, and one year postpartum for the final assessment. This program evaluates a wide range of cognitive abilities and provides a comprehensive cognitive well-being score (high–moderate–low), identifying strengths and weaknesses in reasoning, memory, attention, coordination, and perception. Results. The average age of the participants was 30.9 years, with a mean diabetes duration of 14.9 years. Pregnant women with a BMI of 30 kg/m² or higher faced an increased risk of reduced cognitive function, memory, and reasoning. Additionally, mothers with lower overall cognitive function and memory levels had significantly higher concentrations of leptin in their blood. Conclusions. Cognitive functions—particularly reasoning and attention—are adversely affected in women with T1DM during pregnancy and shortly after delivery. Elevated BMI and leptin levels can be linked to worse cognitive outcomes in this population. Full article

Lard is highly appreciated for its flavor. However, it has not been elucidated how to consume lard while at the same time eliminating its adverse effects on postpartum cognitive function. Female mice were divided into three groups (n = 10): soybean oil (SO), lard oil (LO), and a mixture of soybean oil and lard at a ratio of 1:1 (LS). No significant difference was observed between the SO and LS groups in behavioral testing of the maternal mice, but the LO group was significantly worse compared with these two groups. Moreover, the SO and LS supplementation increased docosahexaenoic acid (DHA) and total n-3 polyunsaturated fatty acid (PUFA) levels in the brain and short-chain fatty acid (SCFA)-producing bacteria in feces, thereby mitigating neuroinflammation and lowering the p-ERK(1/2)/ERK(1/2), p-CREB/CREB, and BDNF levels in the brain compared to the LO group. Collectively, the LS group inhibited postpartum cognitive impairment by regulating the brain fatty acid composition, neuroinflammation, gut microbiota, and the SCFA/ERK(1/2)/CREB/BDNF signaling pathway compared to lard. Full article

Iron supplementation is commonly recommended for the prevention and treatment of maternal iron deficiency (ID) or iron deficiency anemia (IDA). However, the impacts of prophylactic of therapeutic prenatal iron supplementation on child neurodevelopment in upper middle-income (UMI) and high-income countries (HICs), where broad nutritional deficiencies are less common, are unclear. To investigate this, we conducted a systematic review, searching four databases (Medline, CINAHL, EMBASE, Cochrane Library) through 1 May 2023. Randomized controlled trials (RCTs) assessing oral or intravenous iron supplementation in pregnant women reporting on child neurodevelopment (primary outcome: age-standardized cognitive scores) were eligible. We included three RCTs (five publications) from two HICs (Spain and Australia) (N = 935 children; N = 1397 mothers). Due to clinical heterogeneity of the RCTs, meta-analyses were not appropriate; findings were narratively synthesized. In non-anemic pregnant women, prenatal iron for prevention of IDA resulted in little to no difference in cognition at 40 days post-partum (1 RCT, 503 infants; very low certainty evidence). Similarly, the effect on the intelligence quotient at four years was very uncertain (2 RCTs, 509 children, very low certainty evidence). No RCTs for treatment of ID assessed offspring cognition. The effects on secondary outcomes related to language and motor development, or other measures of cognitive function, were unclear, except for one prevention-focused RCT (302 children), which reported possible harm for children’s behavioral and emotional functioning at four years. There is no evidence from UMI countries and insufficient evidence from HICs to support or refute benefits or harms of prophylactic or therapeutic prenatal iron supplementation on child neurodevelopment. Full article

Background and Objective: Pregnancy in mothers with multiple sclerosis (MS) commonly results in significant changes in disease activity and changes in clinical care, including the discontinuation of disease modifying therapy (DMT). This study aimed at understanding the clinical and patient-reported outcomes (PROs) before, during and 1-year after delivery. Materials and Methods: A total of 30 pregnant mothers with MS were recruited as part of the study. Clinical (relapse activity and disability changes), PRO information and MRI outcomes were collected on four separate visits: one baseline visit—0–30 days post-delivery; and 3 follow-up visits at week 24, week 36 and week 52 from the baseline. PRO was assessed using a validated questionnaire called the Fatigue Scale for Motor and Cognitive Function (FSMC). The MRI scans were analyzed, and the count of new T2 lesions and/or contrast-enhancing lesions was determined. Results: The average time between delivery and the start of DMT was 142.5 days. Relapse activity before the pregnancy was numerically linked with the activity during the pregnancy, where up to 57.1% of the activity during pregnancy occurred in pwMS with previously active disease before conception (statistically trending with p = 0.073). The relapse activity after the pregnancy occurred twice as often in pwMS whose MS was clinically active before conception. All five pwMS who experienced a relapse prior to the pregnancy experienced worsening in their physical PRO domain. Conclusions: Pre-pregnancy activity is crucial in the screening of mothers with MS at risk for post-partum relapses, worsening of clinical disability and/or PRO measures. A post-partum MS period may benefit from the routine PRO utilization and screening for its worsening. The inflammatory activity during pregnancy was not associated with short-term disease progression. Full article

Background: During the period from pregnancy through the first year postpartum, vulnerable individuals are at elevated risk for the onset or worsening of psychological distress, and accessible (e.g., virtually delivered) mental health interventions are needed. Research suggests that Mindfulness-Based Cognitive Therapy (MBCT) can effectively mitigate psychological distress, although few studies have evaluated MBCT in the perinatal period, and samples have been clinically homogenous. Thus, we have designed and are conducting a pilot trial of virtually delivered MBCT with pregnant individuals experiencing a range of psychological symptoms to assess its feasibility and preliminarily explore its effectiveness. Here, we present the study protocol. Methods: Eligible participants (target N = 70) are ≥18 years with pregnancies between 12 and 30 weeks of gestation. Participants complete a diagnostic interview, self-report symptom ratings, and a computerized cognitive battery assessing self-regulation at the baseline. Participants are then randomized to either MBCT or care as usual. The MBCT intervention involves eight weekly group sessions delivered virtually, with each session focusing on a mindfulness practice followed by group discussion and skill development. Participants in the intervention group are also encouraged to practice mindfulness skills between sessions. Participants in the control condition are provided with information about mindfulness and treatment resources. Baseline measures are repeated following the eight-week intervention period and at three months postpartum. Conclusions: This pilot study is designed to evaluate the feasibility of virtually delivered MBCT and explore group differences in psychological symptoms during the perinatal period, and will lay the foundation for a larger clinical trial focused on optimizing this intervention to improve psychological functioning among diverse pregnant individuals. Full article

More research is needed to understand how the maternal consumption of fish and fish-borne toxicants impacts infant neurodevelopment. The present analysis was conducted over 460 mother–infant pairs within the ECLIPSES study. Dietary intake of metals and persistent organic pollutants from fish (including white fish, blue fish, and seafood) was estimated in pregnant women. The infants underwent cognitive, language, and motor function assessments using the Bayley Scales of Infant Development-III at the 40-day postpartum. Associations between dietary toxicants and outcomes were assessed using multivariable linear regression models. Estimated prenatal exposure to fish-borne toxicants, such as arsenic, inorganic arsenic, methylmercury, dioxin-like polychlorinated biphenyls (DL-PCBs), and non-DL-PCBs, was associated with poorer language functions in infants, whereas no significant associations were found with motor or cognitive functions. Maternal fish consumption exceeding the Spanish recommendation of no more than 71 g per day was linked to these adverse effects on language abilities without affecting motor or cognitive development. This highlights the importance of vigilant monitoring of environmental toxicants and the provision of dietary guidance for pregnant women, with potential implications for public health and child development. Full article

Perinatal mood and anxiety disorders (PMADs) profoundly impact maternal and infant health, affecting women worldwide during pregnancy and postpartum. This review synthesizes current research on the neurobiological effects of PMADs, particularly their influence on brain structure, function, and corresponding cognitive, behavioral, and mental health outcomes in mothers. A literature search across PubMed, PsycINFO, and Google Scholar yielded studies utilizing neuroimaging (MRI, fMRI) and cognitive assessments to explore brain changes in PMADs. The key findings indicate significant neurobiological alterations in PMADs, such as glutamatergic dysfunction, neuronal damage, and altered neural connectivity, particularly in postpartum depression (PPD). Functional MRI studies reveal distinct patterns of brain function alteration, including amygdala non-responsivity in PPD, differing from traditional major depressive disorder (MDD). These neurobiological changes are connected with cognitive impairments and behavioral modifications, impacting maternal caregiving. Understanding these alterations is fundamental for developing effective treatments. The findings emphasize the importance of focusing on maternal mental health, advocating for early detection, and personalized treatment strategies to improve maternal and child outcomes. Full article

Background: This study explores family functioning and its associations with adolescent major depressive disorder (MDD), comparing its dynamics with healthy counterparts. Family functioning (cohesion, flexibility, communication, and satisfaction), maternal depressive symptoms, postpartum depression history, parental divorce, parental alcohol abuse, and the adolescents’ cognitive flexibility, are examined. The research incorporates the perspectives of both adolescents and mothers. Methods: The sample includes 63 mother-teenager dyads in the clinical group and 43 in the control group. Instruments encompass the Family Adaptability and Cohesion Evaluation Scales (FACES IV), Children’s Depression Inventory (CDI-2), Beck Depression Inventory (BDI-II), The Brixton Spatial Anticipation Test, and structured interviews. Results: Families of adolescents with MDD exhibit lower flexibility, cohesion, communication, and overall satisfaction. Depressed adolescents display reduced cognitive flexibility. Discrepancies were observed between adolescents’ and mothers’ perspectives as associated with adolescents’ MDD. Teenagers emphasized the severity of maternal depressive symptoms, while mothers highlighted the importance of family cohesion and flexibility. Conclusions: This study emphasizes a holistic strategy in addressing adolescent depression, including family-based assessment and therapy. Screening for maternal depressive symptoms is identified as valuable. Cognitive flexibility also needs to be addressed during therapy for depression in adolescence. Full article

Background: Antenatal depression (AND) and post-partum depression (PPD) are long-term debilitating psychiatric disorders that significantly influence the composition of the gut flora of mothers and infants that starts from the intrauterine life. Not only does bacterial ratio shift impact the immune system, but it also increases the risk of potentially life-threatening disorders. Material and Methods: Therefore, we conducted a narrative mini-review aiming to gather all evidence published between 2018–2022 regarding microflora changes in all three stages of pregnancy. Results: We initially identified 47 potentially eligible studies, from which only 7 strictly report translocations; 3 were conducted on rodent models and 4 on human patients. The remaining studies were divided based on their topic, precisely focused on how probiotics, breastfeeding, diet, antidepressants, exogenous stressors, and plant-derived compounds modulate in a bidirectional way upon behavior and microbiota. Almost imperatively, dysbacteriosis cause cognitive impairments, reflected by abnormal temperament and personality traits that last up until 2 years old. Thankfully, a distinct technique that involves fecal matter transfer between individuals has been perfected over the years and was successfully translated into clinical practice. It proved to be a reliable approach in diminishing functional non- and gastrointestinal deficiencies, but a clear link between depressive women’s gastrointestinal/vaginal microbiota and clinical outcomes following reproductive procedures is yet to be established. Another gut-dysbiosis-driving factor is antibiotics, known for their potential to trigger inflammation. Fortunately, the studies conducted on mice that lack microbiota offer, without a shadow of a doubt, insight. Conclusions: It can be concluded that the microbiota is a powerful organ, and its optimum functionality is crucial, likely being the missing puzzle piece in the etiopathogenesis of psychiatric disorders. Full article