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ObjectivesThe purpose of this article was to describe the findings from a systematic review, quality review, and meta-analysis of risk factors for postpartum depression among adult Latinas in the United States.MethodsDatabases were searched from inception to May 2020 for studies published in English related to Latina/Hispanic mothers and risk factors of postpartum depression. Of 115 abstracts screened, 10 met the inclusion criteria for the review and meta-analysis. Eleven risk factors from these studies were included: acculturation, age, economic stress, education, marital status, number of children, prenatal depression, recent and remote intimate partner violence (IPV), general social support, and partner/father’s social support.ResultsPartner/father’s social support had a large effect size. Prenatal depression and recent IPV had medium effect sizes, while education, economic stress, general social support and remote IPV had small effect sizes. Negligible effect sizes were found for age, marital status, number of children, and acculturation.ConclusionsPrenatal depression, IPV, social support (general and from partner/father), economic stress and education are risk factors that should be screened for when working with perinatal Latinas. Future directions for clinical practice and research are discussed.

Parents of premature infants in the Neonatal Intensive Care Unit (NICU) are at elevated risk of anxiety, depression, stress, and trauma, which may impair bonding and infant development. This scoping review synthesized preventive and treatment interventions designed to reduce parental psychological distress in the United States. Guided by PRISMA-ScR, systematic searches were conducted in PubMed, Scopus, MEDLINE, and PsycINFO. Eligible studies were those that examined interventions for parents of preterm infants (<37 weeks’ gestation) initiated before, during, or within one year after NICU discharge. Excluded were studies limited to abstracts or qualitative designs; those not addressing parental depression, anxiety, post-traumatic stress disorder, or stress; and those involving congenital anomalies or conducted outside the United States. Eighteen studies met the inclusion criteria, including ten prevention-focused and seven treatment-focused studies. Eight reported significant reductions in distress, with cognitive behavioral therapy (CBT) and the Creating Opportunities for Parent Empowerment (COPE) program showing the strongest evidence. However, most interventions targeted mothers, highlighting underrepresentation of fathers. Overall, findings underscore the need for interventions that address both parents, include diverse populations, and evaluate participant engagement to improve clinical applicability.

This manuscript is based on a keynote address presented at the 2020 Marcé Society’s Conference celebrating the Society’s 40th anniversary. The address described a 50-year perspective on prevention research, current evidence that perinatal depression can be prevented, and how digital tools could be used to disseminate perinatal depression prevention interventions throughout the world. We utilized the Mothers and Babies Course as a case study to illustrate these goals. The article reviews the gradual progress of depression prevention research, from the time when the state of the science was such that it was believed that the onset of major depressive episodes could not be prevented until the present day. In addition, the article recounts the three consensus reports on prevention of mental disorders published by the National Academies of Science, Engineering, and Medicine, culminating in the 2019 report, which calls on the field to implement known interventions for the prevention of depression and other mental disorders, and to scale up their administration to reduce the prevalence of these disorders in the general population. The paper presents the 2019 recommendations of the US Preventive Services Task Force, which instructs the health system to provide routine referrals to perinatal depression prevention interventions (e.g., the Mothers and Babies Course) to perinatal persons at risk for depression. We now have the knowledge to prevent approximately half of episodes of perinatal depression. It is time to implement this knowledge and begin to do research on how to prevent the remaining half.

The article presents a lexical study that investigates the lexical demands of academic written texts at different levels of writing. By employing the British National Corpus/ Corpus of Contemporary American English (BNC/COCA) word list and the Academic Word List (AWL), the present study analyzed data from the British Academic Written English (BAWE) corpus, which contained 2,761 student assignments, and the Public Library of Science One (PLOS ONE) corpus which included 4,000 scholarly articles. Results from the analyses demonstrated significant differences in lexical difficulty between students’ assignments and scholarly publications. The proportion of academic vocabulary in written texts was also found to increase as the writers’ levels went up. Cross-discipline comparisons highlighted the difference in lexical difficulties between scientific disciplines. Plain Language Summary Lexical demands of Academic Written English The present study was designed to find an answer to the question concerning the number of words needed to understand academic writing. Two corpora of students’ assignments and research articles which contained papers from a range of disciplines were analyzed. The results from the analyses showed the number of words needed to gain acceptable and optimal comprehension of academic written texts for different scientific disciplines and levels of writing. The findings also provided evidence for the differences in lexical difficulty between academic texts at various levels and of different disciplines.

Objectives:Women carrying a fetus diagnosed with congenital heart disease often experience significant distress because of their medical diagnosis. Given the well-documented impact associated with elevated prenatal stress and critical importance of developing targeted interventions, this study aims to examine stressors, coping and resilience resources, and mental health treatment preferences in pregnant women receiving a congenital heart disease diagnosis to inform the development of a psychological intervention to reduce maternal distress prenatally.Methods:Three groups of participants were included consisting of two pregnant women carrying a fetus with congenital heart disease, five women of children (4−16 months) with congenital heart disease, and five paediatric cardiology medical providers. Responses were gathered via semi-structured interviews and analysed using qualitative thematic analysis.Results:Information regarding four broad areas were analysed of emotional distress during pregnancy; experience of initial diagnosis; coping and resilience; and perspectives on a mental health intervention in pregnancy. Anxiety regarding baby’s future, guilt following diagnosis, and various coping strategies emerged as primary themes among the participant sample. Medical staff corroborated mothers’ heightened anxiety and viewed a psychotherapeutic intervention during the prenatal period as essential and complimentary to standard of care.Conclusion:We identified salient themes and preferred components for a future psychological intervention delivered prenatally.Practice Implications:Patients’ and providers’ perspectives regarding the nature of maternal distress, resilience and treatment preferences can inform the development of interventions to support the emotional well-being of pregnant women carrying a fetus with congenital heart disease to optimise care and potentially improve outcomes for fetal brain development.

The prevalence and risk factors associated with prenatal depression among Spanish-speaking women in Spain and Mexico are examined and compared through a cross-cultural study. The study utilizes secondary data from 563 participants who received prenatal care in Madrid (N = 283) and in Mexico City (N = 280), assessed with the PHQ-9 and the PDPI-R. Spanish women reported a lower prevalence of depressive symptoms (10.0%) than Mexican women (20.3%). Regression analyses showed that previous prenatal anxiety and lack of family emotional support were common risk factors to the two countries. Within each country, significant risk factors included: (a) previous depression history (β = 0.224; p < 0.001) in Spain; and (b) unplanned pregnancy (β = − 0.116; p < 0.027), lack of emotional support from others (β = 0.129; p < 0.032), marital dissatisfaction (β = 0.186; p < 0.009), and life stress due to financial problems (β = 0.117; p < 0.026), and life stress due to marital problems (β = 0.114; p < 0.040) in Mexico. Health professionals can tailor interventions to their particular risk factors to reduce the adverse effects on mothers and infants.

A growing research literature highlights the public health need for preventive interventions to reduce symptoms and incidence of perinatal depression among vulnerable populations. The Mothers and Babies (MB) course is a cognitive–behavioral intervention designed to teach mood regulation skills to English- and Spanish-speaking low-income women at high risk for perinatal depression. We describe the development of the MB course and evaluate the extent to which research findings support efficacy, effectiveness, and dissemination based on the Society for Prevention Research Standards Committee’s standards of evidence. Our review of research and implementation activities suggests that the MB intervention demonstrates promising evidence for efficacy in reducing depressive symptoms; empirical support for prevention of major depressive episodes is still preliminary. Work is in progress to evaluate program effectiveness and prepare for broad dissemination and implementation. The MB course shows promise as an intervention for low-income women at risk for perinatal mood issues. Spanish and English intervention materials have been developed that can be delivered in different settings (hospitals, home visiting), in different dosages (6, 8, or 12 sessions), and via different modalities (group, individual). Evaluating the MB course against current standards is intended to inform other prevention intervention development research.

Perinatal depression is a prevalent and detrimental condition. Determining modifiable factors associated with it would identify opportunities for prevention. This paper: 1) identifies depressive symptom trajectories and heterogeneity in those trajectories during pregnancy through the first-year postpartum, and 2) examines the association between unintended pregnancy and depressive symptoms. Depressive symptoms (BDI-II) were collected from low-income Hispanic immigrants ( n =215) five times from early pregnancy to 12-months postpartum. The sample was at high-risk for perinatal depression and recruited from two prenatal care settings. Growth mixture modeling (GMM) was used to identify distinct trajectories of depressive symptoms over the perinatal period. Multinomial logistic regression was then conducted to examine the association between unintended pregnancy (reported at baseline) and the depression trajectory patterns. Three distinct trajectory patterns of depressive symptoms were identified: high during pregnancy, but low postpartum (“Pregnancy High”: 9.8%); borderline during pregnancy, with a postpartum increase (“Postpartum High”: 10.2%); and low throughout pregnancy and postpartum (“Perinatal Low”: 80.0%). Unintended pregnancy was not associated with the “Pregnancy High” pattern, but was associated with a marginally significant nearly four fold increase in risk of the “Postpartum High” pattern in depressive symptoms (RRR=3.95, p <0.10). Family planning is a potential strategy for the prevention of postpartum depression. Women who report unintended pregnancies during prenatal care must be educated of their increased risk, even if they do not exhibit antenatal depressive symptoms. Routine depression screening should occur postpartum, and referral to culturally appropriate treatment should follow positive screening results.

Background Mothers and Babies (MB) is a cognitive-behavioral intervention with demonstrated efficacy in reducing depressive symptoms and preventing depressive episodes among perinatal women when delivered in a group format by mental health professionals. Study aims were to describe the adaptation of MB into a 1-on-1 modality (MB 1-on-1) and provide data on the adapted intervention’s acceptability and feasibility. Methods Seventy-five home visitors trained on MB 1-on-1 delivered the 15-session intervention to 1–2 clients. Client acceptability data assessed intervention enjoyment, comprehension, and usefulness. Home visitor feasibility and acceptability data measured amount of intervention material delivered, client comprehension, and client engagement. Results Home visitors were all female with 8.8 years of experience on average. 117 clients completed acceptability surveys. Average client age was 21.9 years and 41% were pregnant. Home visitors completely covered 87.9% of sessions and reported clients totally understood MB material 82.5% of the time across sessions, although variability was found in comprehension across modules. 82.0% of clients found MB 1-on-1 enjoyable and 91.6% said they totally understood sessions, when averaged across sessions. Clients enjoyed content on noticing one’s mood and pleasant activities. Implementation challenges were client engagement, facilitating completion of personal projects, and difficulty shifting between didactic and interactive activities. Conclusions Clients found MB 1-on-1 to be enjoyable, easily understood, and useful. Home visitors reported excellent implementation fidelity and felt clients understood MB material. A refined 12-session version of MB 1-on-1 should be examined for its effectiveness in reducing depressive symptoms, given encouraging feasibility and acceptability data.

Postnatal depression and caregiving difficulties adversely affect mothers, infants, and later childhood development. In many countries, resources to help mothers and infants are limited. Online group-based nurse-led interventions have the potential to help address this problem by providing large numbers of mothers with access to professional and peer support during the postnatal period. This study tested the effectiveness of a 4-month online group-based nurse-led intervention delivered when infants were aged 2 to 6 months as compared with standard care outcomes. The study was a block randomized control trial. Mothers were recruited at the time they were contacted for the postnatal health check offered to all mothers in South Australia. Those who agreed to participate were randomly assigned to the intervention or standard care. The overall response rate was 63.3% (133/210). Primary outcomes were the level of maternal depressive symptoms assessed with the Edinburgh Postnatal Depression Scale (EPDS) and quality of maternal caregiving assessed using the Parenting Stress Index (PSI; competence and attachment subscales), the Parenting Sense of Competence Scale (PSCS), and the Nursing Child Assessment Satellite Training Scale. Assessments were completed at baseline (mean child age 4.9 weeks [SD 1.4]) and again when infants were aged 8 and 12 months. Outcomes were evaluated using linear generalized estimating equations adjusting for postrandomization group differences in demographic characteristics and the outcome score at baseline. There were no significant differences in the intervention and standard care groups in scores on the PSI competence subscale (P=.69) nor in the PSCS (P=.11). Although the group by time interaction suggested there were differences over time between the EPDS and PSI attachment subscale scores in the intervention and standard care groups (P=.001 and P=.04, respectively), these arose largely because the intervention group had stable scores over time whereas the standard care group showed some improvements between baseline and 12 months. Mothers engaged well with the intervention with at least 60% (43/72) of mothers logging-in once per week during the first 11 weeks of the intervention. The majority of mothers also rated the intervention as helpful and user-friendly. Mothers reported that the intervention was helpful, and the app was described as easy to use. As such, it appears that support for mothers during the postnatal period, provided using mobile phone technology, has the potential to be an important addition to existing services. Possible explanations for the lack of differences in outcomes for the 2 groups in this study are the failure of many mothers to use key components of the intervention and residual differences between the intervention and standard care groups post randomization. Australian New Zealand Clinical Trials Registry ACTRN12616001732471; http://www.ANZCTR.org.au/ACTRN12616001732471.aspx (archived on WebCite as http://www.webcitation.org/77zo30GDw).