Search Results (187)

Background/Objectives: To evaluate diabetes risk perception in women with prior gestational diabetes mellitus (GDM) and prediabetes in early postpartum. Methods: Secondary analysis of a multi-center randomized controlled trial assessing the effectiveness of a mobile-based postpartum lifestyle intervention in women with prediabetes after GDM. Data were collected from the Risk Perception Survey for Developing Diabetes at baseline (6–16 weeks postpartum) and one year post-randomization. Logistic regression was used to analyze the difference between the intervention and control groups on diabetes risk estimation. Results: Among 165 women with prediabetes in early postpartum (mean age: 32.1 years, mean BMI: 27.3 kg/m²), 58.9% (96) adequately estimated their diabetes risk (moderate or high chance) at baseline. These women smoked less often [2.06% (2) vs. 10.3% (7), p = 0.034], reported less anxiety (11.6 ± 3.0 vs. 12.6 ± 3.5, p = 0.040), and reported fewer symptoms of depression [30.9% (21) vs. 15.6% (15), p = 0.023] compared to women who underestimated their risk. At one year, 58.3% (95) of all women adequately estimated their diabetes risk. In the intervention group, 50.6% (41) adequately estimated their risk at baseline, increasing to 56.8% (46) by the end of the intervention after one year (p = 0.638). In the control group, a higher proportion of women adequately estimated their risk at baseline [67.1% (55), (p = 0.039)], which decreased to 59.8% (49) at one year (p = 0.376), with no significant difference in risk perception between the groups at one year (p = 0.638). Conclusions: Almost 60% of this high-risk population adequately estimated their diabetes risk, with no significant impact of the lifestyle intervention on risk perception. Full article

Perinatal depression is one of the most common mental illnesses in women. The aim of this study was to assess the association of life stressors, perceived stress, obstetric and neonatal complications, and depressive symptoms in the early postpartum period and to compare these variables in two groups of women (preterm and term deliveries). Methods: A case–control study was conducted among 300 women who gave birth in 2019 at the University of Szeged. Cases included women with preterm deliveries (<37 weeks, n = 100), and the controls included women with term deliveries (≥37 weeks, n = 200). Data were collected during postpartum hospital stays through a self-administered questionnaire (containing validated questionnaires: the Holmes–Rahe Life Stress Inventory, the Perceived Stress Scale (PSS-14), and the Edinburgh Postnatal Depression Scale (EPDS)) and the medical records of women and newborns. A descriptive statistical analysis and logistic regression were used to identify predictors of high EPDS scores (≥10). Results: Perceived stress levels were significantly higher among cases than controls (p < 0.001). Higher perceived stress was associated with a higher risk of depression in cases (OR: 1.31, 95% CI: 1.17–1.48, p < 0.001) and controls (OR: 1.33, 95% CI: 1.21–1.45, p < 0.001), too. Newborn complications were associated with an increased perinatal depression risk in the controls (OR: 2.48, 95% CI: 1.05–5.91; p = 0.039) but not in the cases (OR: 2.79, 95% CI: 0.79–9.85; p = 0.111). It is supposed that premature birth was stressful itself, and women with preterm babies were less sensitive to any complications occurring in their newborns compared to women with term newborns. Neither maternal age, education, nor obstetric complications predicted depressive symptoms. Conclusions: Our findings highlight the impact of maternal perceived stress and newborns’ health status on the risk of developing depression during the early postpartum period. These results emphasize the need for ongoing screening and follow-up measures, especially for women with higher EPDS scores. 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: Hypothyroidism and thyroid autoimmunity have a negative effect on women’s sexual health, which is only partially reversed by thyroid hormone substitution. Sexual functioning in thyroid disorders after delivery has been poorly researched. The aim of our study was to compare the effect of levothyroxine on sexual response and depressive symptoms in women with postpartum thyroiditis (PPT) and different vitamin D status. Methods: The study population consisted of three matched groups of women with the hypothyroid phase of PPT: two groups with subclinical and one with overt thyroid hypofunction. Each group included similar numbers of women with normal and low vitamin D status. For the following six months, one group of women with subclinical hypothyroidism and all women with overt thyroid hypofunction received levothyroxine. At the beginning and at the end of the study, all participants completed questionnaires evaluating female sexual function (FSFI) and depressive symptoms (BMI-II). The remaining outcomes of interest included thyroid antibody titers, and the serum levels of 25-hydroxyvitamin D, TSH, free thyroid hormones, sex hormones, and prolactin. Results: Before levothyroxine substitution, women with overt and subclinical disease differed in the total FSFI score, all domain scores, and the overall BDI-II score. Within each study group, domain scores for desire were greater in women with vitamin D sufficiency than in those with vitamin D deficiency/insufficiency. Testosterone and estradiol levels were lower in women with overt than in women with subclinical hypothyroidism, while the opposite relationship was found for prolactin. Levothyroxine treatment improved all domains of female sexual function and reduced the total BDI-II score in both patients with overt and subclinical hypothyroidism and normal vitamin D status. In women with vitamin D deficiency/insufficiency, the impact of this agent was limited to arousal, lubrication, and sexual satisfaction. Levothyroxine replacement reduced thyroid antibody titers only in women with normal vitamin D status. The impact on testosterone was limited to women with normal vitamin D status, and was more pronounced in women with overt than subclinical disease. The effect on estradiol and prolactin, observed only in overt disease, was unrelated to vitamin D status. The increase in sexual functioning correlated with the following: 25-hydroxyvitamin D levels (in vitamin D-deficient/insufficient women); the impact on thyroid peroxidase antibodies, free triiodothyronine and testosterone (for desire and arousal); and the changes in the overall BDI-II score. Five years later, the quality of life was better in vitamin D-sufficient women receiving levothyroxine in the postpartum period. Conclusions: Low vitamin D status attenuates the impact of levothyroxine on female sexual function and depressive symptoms in women with the hypothyroid phase of PPT. Full article

Background/Objectives: The transition to motherhood can be particularly challenging for women with limited socioeconomic resources or mental health concerns. The FAmily Clinic And Municipality (FACAM) intervention was designed to provide additional support through health visitors or family therapists, starting in pregnancy and continuing until the child reached school age. This paper evaluates the effects of the FACAM intervention on the secondary outcomes, maternal mental health and parental functioning during the child’s first year of life. Methods: A total of 331 pregnant women were randomized to either the FACAM intervention (n = 163) or usual care (n = 168). Participants completed questionnaires at baseline and at 3 (N = 284) and 12 (N = 248) months postpartum. Outcomes included maternal mental well-being, satisfaction with motherhood, depressive symptoms, parental stress, parental reflective functioning, worries, and breastfeeding duration. Results: At 12 months postpartum, FACAM mothers reported greater concern about housing issues (b = 0.56, 95% CI [0.06, 1.06], p = 0.03). No other significant differences in the reported outcomes were observed between the groups. Conclusion: The FACAM intervention did not demonstrate superiority over usual care in improving maternal mental health and parental functioning during the first year postpartum. The high-quality and needs-based approach of standard care in Denmark may have limited the potential for additional interventions to yield measurable improvements in maternal outcomes. Full article

Background/Objectives: Postpartum depression (PPD), the most common and prevalent psychiatric disorder after birth, is a prevalent yet underdiagnosed psychiatric condition that remains insufficiently understood, particularly in terms of its biological basis. While epidemiological data are extensive, few studies have systematically investigated their underlying biological mechanisms. The purpose of this study was to explore the potential links between blood biomarker levels and postpartum depressive symptoms, contributing to the development of a unified biological model of PPD. Methods: We conducted a cross-sectional study between 2023 and 2025 at a tertiary academic hospital in Timisoara, Romania, involving 860 postpartum women recruited at hospital discharge (1–2 weeks after childbirth). The participants completed the Edinburgh Postnatal Depression Scale (EPDS) and provided peripheral blood samples, which were analyzed using standardized protocols. The blood levels of pregnancy-related hormones (estrogen and progesterone), vitamin D, biochemical markers of inflammatory response (white blood cell count, C-reactive protein, fibrinogen, neutrophil count, lymphocyte count, and ferritin), anemia indicators (hemoglobin, red blood cell count, hematocrit, and ferritin), thyroid hormones (TSH, FT3, and FT4) and markers of coagulation abnormalities (D-dimer, platelets, fibrinogen, APTT, and INR) were evaluated. The data were analyzed with JASP v0.19.3. The statistical methods included multivariate linear regression, the Kruskal–Wallis and Mann–Whitney U tests, and Spearman correlation, with significance set at p < 0.05. Results: The analysis revealed that postpartum depression (PPD) is associated with distinct biological profiles, reflecting the unique hormonal and physiological changes in the peripartum period. Significant associations were identified between EPDS scores and the levels of estrogen, progesterone, thyroid hormones (TSH, FT3, and FT4), inflammatory markers (CRP and ferritin), vitamin D, and coagulation parameters (APTT and INR). These findings support the notion that PPD has a multifactorial biological basis and highlight the potential of these biomarkers as early predictors of risk. Conclusions: Integrating biochemical assessments into postpartum care may enhance early identification and inform targeted preventive interventions, such as hormone monitoring, vitamin D and iron supplementation, or thyroid function correction. Full article

Objectives: The objective of this overview of systematic reviews with meta-analysis was to summarize the evidence on the possible effectiveness of interventions focused on physical activity in improving and preventing postpartum depression symptoms. Methods: CINAHL (via EBSCOhost), Embase, Epistemonikos, PsycINFO, PubMed, Scopus, SPORTDiscus (via EBSCOhost), and the Cochrane library were searched from inception to 19 February 2025. The methodological quality of the included reviews was assessed with AMSTAR 2. The degree of overlap between meta-analyses was calculated. Results: A total of eight systematic reviews were included. Overall, the included meta-analyses showed favorable results regarding the effects of physical activity on postpartum depression symptoms. Considering specific physical activity modalities, the largest number of meta-analyses focused on aerobic exercise, yoga, or multimodal exercise. In all three cases, most meta-analyses found that aerobic exercise, yoga, and multimodal exercise could be beneficial in reducing postpartum depression symptoms. Furthermore, several meta-analyses explored the effectiveness of walking, finding positive results in favor of this intervention in reducing postpartum depression symptoms. Finally, movement in water was only explored in one meta-analysis, and no differences were found between these interventions and control groups. Conclusions: Aerobic exercise, walking, yoga, and multimodal exercise programs may improve postpartum depression symptoms. Movement in water was not more effective than control groups for reducing this outcome. However, the results of our overview should be considered with caution, since important methodological and clinical implications have been discussed (e.g., lack of subgroups by prevention and treatment) and should guide the development of future systematic reviews on this topic. Full article

Background/Objectives: In the context of maternal mental health, this cross-sectional study investigates a moderated mediation model to explore how prenatal planning is associated with postpartum depression. Specifically, we examined whether planned pregnancy (X) is associated with fewer postpartum depression symptoms (Y) through greater positive affect (M), and whether the indirect association is moderated by breastfeeding duration (W). Methods: Data were collected from 117 postpartum mothers via self-report questionnaires that measured the degree of pregnancy planning, positive affect, postpartum depression symptoms, and breastfeeding duration. Bootstrap analyses were performed to assess the conditional indirect effects across two levels of breastfeeding duration. Results: The findings suggest an indirect association between pregnancy planning and postpartum depressive symptoms through positive affect, moderated by breastfeeding duration. This association was statistically significant only among mothers who breastfed for less than six months, indicating that the protective emotional effect of pregnancy planning may be more evident in this group. No significant indirect effects were observed in mothers who breastfed beyond this duration. Conclusions: These exploratory findings suggest that positive affect may be a pathway through which prenatal planning relates to maternal well-being, particularly in the context of breastfeeding practices. Given the cross-sectional design, causal inferences cannot be drawn. Future longitudinal research is needed to confirm these associations. 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

Aims: To examine the association between depressive symptoms and metabolic profile in women with prior gestational diabetes mellitus (GDM) and early postpartum prediabetes, and to explore whether a mobile-based lifestyle intervention affected mental health outcomes. Methods: Secondary, exploratory analysis of a multi-centric randomized controlled trial (MELINDA), evaluating a mobile-based lifestyle intervention versus standard follow-up (control group) in women with prediabetes after GDM. The analysis included 166 participants who completed the Center for Epidemiologic Studies–Depression (CES-D) questionnaire [score of ≥16 being suggestive for (sub)clinical depression] at baseline (6–16 weeks postpartum) and one year post-randomization. Results: At one year, 26.5% of women (n = 44) reported depressive symptoms, with no significant difference between the intervention and control groups (30.5% vs. 22.6%, p = 0.293). Women with depressive symptoms (symptomatic women) were younger (30.9 ± 4.9 vs. 32.5 ± 3.8 years, p = 0.033) and were less often highly educated (61.4% vs. 80.3%, p = 0.028). At baseline, symptomatic women had a higher rate of metabolic syndrome (38.6% vs. 21.9%, p = 0.044), higher LDL-cholesterol [3.2 ± 0.8 vs. 2.8 ± 0.8 mmol/L, p = 0.009], lower quality of life (lower SF-36 scores, p < 0.050) and a higher level of anxiety based on the STAI-6 questionnaire (14.5 ± 3.6 vs. 11.2 ± 2.6, p < 0.001). These differences persisted at one year postpartum with worse metabolic profile, more anxiety and lower quality of life in symptomatic women. Conclusions: Depressive symptoms are common in women with prediabetes in early postpartum after GDM and are associated with a persistent worse metabolic profile, increased anxiety and lower quality of life postpartum. The mobile-based lifestyle intervention did not improve mental health. Full article

This study examined the mediating role of prenatal cortisol on the relationship between gestational weight or adiposity and postpartum depression (PPD), while considering the moderating roles of breastfeeding (BF) or socioeconomic resources. We hypothesized that women with a higher pre-pregnancy body mass index (PPBMI) or a larger abdominal circumference would have elevated diurnal cortisol levels in late pregnancy, which would predict more PPD symptoms. Additionally, we hypothesized that BF and access to more socioeconomic resources would buffer the positive relationship between prenatal diurnal cortisol and PPD symptoms. We used longitudinal data from the Infant Development and Health Outcomes in Mothers Study, in which women self-reported PPBMI, BF frequency at 6 months, familial education, occupation, and income and completed the Edinburgh Postnatal Depression Scale. The abdominal circumference, cortisol area under the curve with respect to ground (AUC_G), and cortisol awakening response (CAR) were measured. Higher breastfeeding frequency and greater socioeconomic resources were associated with fewer PPD symptoms. There were main and interactive associations of AUC_G with BF frequency with PPD. Notably, higher cortisol levels were linked to more PPD symptoms among women with less frequent BF. Thus, BF may mitigate the relationship between prenatal stress and PPD, highlighting the importance of BF support in PPD prevention. Full article

Background/Objectives: The presence of autoimmune thyroiditis was found to be associated with an increased prevalence of sexual dysfunction. Women’s sexual health was not investigated in postpartum disorders of the thyroid gland. The aim of this study was to assess female sexual functioning and depressive symptoms in postpartum thyroiditis. Methods: This study compared four groups of non-lactating women who gave birth within 12 months before the beginning of the study: women with postpartum thyroiditis and overt hypothyroidism (group A), women with postpartum thyroiditis and subclinical hypothyroidism (group B), euthyroid females with postpartum thyroiditis (group C) and healthy euthyroid females without thyroid disease (group D). All patients completed questionnaires assessing female sexual function (FSFI), and the presence and severity of depressive symptoms (BDI-II). Moreover, we assessed thyroid peroxidase and thyroglobulin antibodies, as well as serum levels of thyroid-stimulating hormone (TSH), free thyroid hormones, testosterone, dehydroepiandrosterone sulfate (DHEAS), estradiol and prolactin. Results: The mean total FSFI score was lower in women with overt hypothyroidism (22.74 ± 4.12) than in the remaining groups of women, lower in groups B (25.71 ± 3.84) and C (29.67 ± 4.00) than in group D (32.15 ± 2.98), as well as lower in group B than in group C. Compared to healthy controls, both groups of women with postpartum thyroiditis and thyroid hypofunction had lower scores for all domains, while euthyroid patients with postpartum thyroiditis had lower scores for sexual desire, sexual arousal and lubrication. The total BDI-II score was highest in group A (15.6 ± 3.2) and lowest in group D (7.8 ± 3.2). Serum testosterone and DHEAS levels were lower while serum prolactin levels were higher in women with postpartum thyroiditis than in healthy subjects. The lowest testosterone levels (1.02 ± 0.35 nmol/L) and estradiol levels (190 ± 80 pmol/L) and the highest prolactin concentration (39.9 ± 13.9 ng/mL) were found in group A. Conclusions: The obtained results show that postpartum thyroiditis is complicated by multidimensional impairment of female sexual functioning, which is accompanied by mood deterioration. Severity of sexual dysfunction and depressive symptoms in this clinical entity depends on the degree of thyroid autoimmunity and hypothyroidism. It seems that assessment of sexual functioning and mood should be recommended to all women with postpartum thyroiditis. Full article

Background: This study investigated the pathways through which various psychological problems occurring across the perinatal period influence mother–child bonding within the first 18 months postpartum, with a particular focus on the relationship between perinatal and postpartum depression and childbirth-related posttraumatic stress symptomatology. Methods: A multi-stage longitudinal design included three assessment points: recruitment and initial assessment in the third trimester of pregnancy (T1), a second assessment at 8 months postpartum (T2), and a final assessment at 18 months postpartum (T3). A total of N = 51 mothers completed all three waves (total follow-up period per participant: approximately 21 months). Sociodemographic data were collected, and all assessments were completed online. Results: Our findings revealed significant indirect effects, linking higher levels of perinatal depressive symptoms in the third trimester with mother–child bonding difficulties at 18 months postpartum. This association was mediated by both greater childbirth-related posttraumatic stress symptoms and elevated postpartum depressive symptoms at 8 months. Conclusions: These preliminary results highlight how complex perinatal factors at different stages (i.e., during pregnancy and early postpartum) influence mother–child bonding at 18 months postpartum. Understanding these pathways is essential in order to inform targeted interventions and to promote optimal maternal mental health and bonding outcomes. Full article

Psychiatric disorders are a major cause of illness in the world. Unfortunately, many patients are resistant to treatment and present serious complications. Schizophrenia is refractory to treatment in about one-third of patients. Antidepressants are effective in about half of patients. Suicidal ideation is an increasing issue in patients with mixed features in bipolar disorder (BD). Therefore, there is a need to develop and test new drugs or new indications of available medications for the treatment of psychiatric disorders through evidence-based investigations. This narrative review aims to present the molecules approved by the main drug agencies, the Food and Drug Administration (FDA) and the European Medicines Agency (EMA), from 2018 to date, along with new indications and new formulations of existing medications. We searched PubMed for new drugs approved for schizophrenia, BD, major depressive disorder (MDD), anxiety disorders, and obsessive-compulsive disorder (OCD). We evaluated their clinical benefits, safety, and tolerability profiles. Finally, we considered studies on the main molecules that have shown initial evidence of efficacy and are in the process of obtaining approval. Our search suggested that a new antipsychotic, lumateperone, and two drug combinations, olanzapine/samidorphan (OLZ/SAM) and xanomeline/trospium (KarXT), were approved for schizophrenia. In addition, some new methods of administration—monthly risperidone administration, subcutaneous risperidone administration, and transdermal asenapine administration—obtained approval from the main drug agencies. Lumateperone and OLZ/SAM were also approved in BD. Esketamine, a compound that modulates glutamatergic transmission, was approved to treat treatment-resistant depression and acute suicidal ideation. The dextromethorphan/bupropion combination was approved for MDD. Two new agents, brexanolone and zuranolone, were approved for treatment of postpartum depression. On the other hand, no new drugs received approval for anxiety disorders or OCD. In summary, some new psychotropic medications have been developed, in particular with the aim to improve the symptoms of resistant patients and to decrease the incidence of adverse effects. It is necessary to continue testing the effectiveness of new compounds in methodologically rigorous studies. 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