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Background Prenatal symptoms of depression (PND) and anxiety affect up to every third pregnancy. Children of mothers with mental health problems are at higher risk of developmental problems, possibly through epigenetic mechanisms together with other factors such as genetic and environmental. We investigated DNA methylation in cord blood in relation to PND, taking into consideration a history of depression, co-morbidity with anxiety and selective serotonin reuptake inhibitors (SSRI) use, and stratified by sex of the child. Mothers ( N  = 373) prospectively filled out web-based questionnaires regarding mood symptoms and SSRI use throughout pregnancy. Cord blood was collected at birth and DNA methylation was measured using Illumina MethylationEPIC array at 850 000 CpG sites throughout the genome. Differentially methylated regions were identified using Kruskal–Wallis test, and Benjamini-Hochberg adjusted p -values < 0.05 were considered significant. Results No differential DNA methylation was associated with PND alone; however, differential DNA methylation was observed in children exposed to comorbid PND with anxiety symptoms compared with healthy controls in ABCF1 (log twofold change − 0.2), but not after stratification by sex of the child. DNA methylation in children exposed to PND without SSRI treatment and healthy controls both differed in comparison with SSRI exposed children at several sites and regions, among which hypomethylation was observed in CpGs in the promoter region of CRBN ( log2 fold change − 0.57), involved in brain development, and hypermethylation in MDFIC (log2 fold change 0.45), associated with the glucocorticoid stress response. Conclusion Although it is not possible to assess if these methylation differences are due to SSRI treatment itself or to more severe depression, our findings add on to existing knowledge that there might be different biological consequences for the child depending on whether maternal PND was treated with SSRIs or not.

Adverse childhood experiences (ACEs) have been associated with increased vulnerability to depressive symptoms during pregnancy and may also be related to emerging prenatal relational processes. This cross-sectional study examined whether prenatal depressive symptoms statistically accounted for the association between ACEs and maternal-fetal attachment (MFA), and whether this indirect association varied as a function of perceived social support from partners, family, and friends. The sample included 149 Romanian women in the first trimester of their first pregnancy. Participants completed self-report measures assessing ACEs, prenatal depressive symptoms, MFA, and perceived social support. Conditional process analyses were conducted using PROCESS Model 7, controlling for maternal age and perceived socioeconomic status. Higher ACEs were significantly associated with increased prenatal depressive symptoms (b = 0.43, = 0.001), which in turn were associated with lower MFA (b = -0.03, = 0.023). The indirect association between ACEs and MFA via prenatal depressive symptoms was statistically significant (b = -0.01, 95% CI [-0.028, -0.0009]). However, perceived social support from partners, family, and friends did not significantly moderate this indirect association. These findings provide preliminary evidence that prenatal depressive symptoms represent an important psychological correlate linking early-life adversity with lower MFA in early pregnancy. Given the cross-sectional design, findings should be interpreted as indirect associations rather than causal mediation.

Purpose: The aim of this research was to study the association between the mother-firstborn relationship and second-time mothers’ prenatal depressive symptoms before the birth of a second child and the mediation role of parenting burnout on this relationship. Methods: Empirical study was adopted in this research. Using a convenient sampling method, we recruited 110 second-time mothers who were in their third trimester of pregnancy. Child-parent relationship questionnaire, parenting burnout scale, and Beck Depression Instrument were used to measure the relationship between firstborn and second-time mothers, mothers’ parenting burnout, and prenatal depressive symptoms, respectively. Regression analysis was conducted to test the relationship between variables, and the mediation effect was tested using PROCESS. Results: Regression results showed that the parent-child relationship is negatively associated with second-time mothers’ prenatal depressive symptoms. The parent-child relationship is negatively associated with parenting burnout which is positively related to prenatal depressive symptoms. When considering the mediation variable of parenting burnout, the direct effect is not statistically significant. Conclusions: Parent-child relationship has a significant impact on second-time mothers’ prenatal depressive symptoms, and this relationship is mediated by parenting burnout.

Greater exposure to racial/ethnic discrimination among pregnant Black American women is associated with elevated prenatal depressive symptomatology, poorer prenatal sleep quality, and poorer child health outcomes. Given the transdiagnostic importance of early childhood sleep health, we examined associations between pregnant women’s lifetime exposure to racial/ethnic discrimination and their two-year-old children’s sleep health. We also examined women’s gendered racial stress as a predictor variable. In exploratory analyses, we examined prenatal sleep quality and prenatal depressive symptoms as potential mediators of the prior associations. We utilized data from a sample of Black American women and children (n = 205). Women self-reported their lifetime experiences of discrimination during early pregnancy, their sleep quality and depressive symptoms during mid-pregnancy, and their children’s sleep health at age two. Hierarchical linear multiple regression models were fit to examine direct associations between women’s experiences of discrimination and children’s sleep health. We tested our mediation hypotheses using a parallel mediator model. Higher levels of gendered racial stress, but not racial/ethnic discrimination, were directly associated with poorer sleep health in children. Higher levels of racial/ethnic discrimination were indirectly associated with poorer sleep health in children, via women’s prenatal depressive symptomatology, but not prenatal sleep quality. Clinical efforts to mitigate the effects of discrimination on Black American women may benefit women’s prenatal mental health and their children’s sleep health.

Background: Maternal prenatal depressive symptoms and abnormal pre-pregnancy BMI have been scarcely reported to play interactive effects on child health. In this prospective cohort, we aimed to examine the interactive effects of maternal prenatal depressive symptoms and pre-pregnancy BMI as well as gestational weight gain (GWG) on offspring emotional and behavioral problems (EPBs). Methods: The study samples comprised 1216 mother–child pairs from Shanghai Maternal–Child Pairs Cohort recruited from 2016 to 2018. Maternal pre-pregnancy BMI and GWG were obtained from medical records, and maternal depressive symptoms were assessed via the Center for Epidemiological Studies Depression Scale (CES-D) at 32–36 gestational weeks. The child completed the behavioral measurement via the Strengths and Difficulties Questionnaire (SDQ) at 24 months postpartum. Results: There were 12.01% and 38.65% women with prenatal depressive symptoms and sub-threshold depressive symptoms during late pregnancy. Both maternal depressive symptoms and prenatal sub-threshold depressive symptoms were associated with higher internalizing (OR = 1.69, 95% CI, 1.05–2.72; OR = 1.48, 95% CI, 1.06–2.07) and externalizing (OR = 2.06, 95% CI, 1.30–3.25; OR = 1.42, 95% CI, 1.02–1.99) problems in children. Maternal pre-pregnancy BMI and GWG modified the association between prenatal depressive symptoms and child externalizing or total difficulties problems (p < 0.10 for interaction). Among the overweight/obese pregnant women, maternal prenatal depressive symptoms were associated with a higher risk of externalizing problems (OR = 2.75, 95% CI, 1.06–7.11) in children. Among the women who gained inadequate GWG, maternal prenatal sub-threshold depressive symptoms were associated with 2.85-fold (95% CI 1.48–5.48) risks for child externalizing problems, and maternal depressive symptoms were associated with higher externalizing and total difficulties problems (OR = 4.87, 95% CI, 2.03–11.70 and OR = 2.94, 95% CI, 1.28–6.74, respectively), but these associations were not significant in the appropriate or excessive GWG group. Conclusions: Both maternal prenatal sub-threshold depressive symptoms and depressive symptoms increased the risks of child internalizing and externalizing problems at 24 months of age, while the effects on child externalizing problems were stronger among overweight/obese or inadequate GWG pregnant women. Our study highlights the importance of simultaneously controlling the weight of pregnant women before and throughout pregnancy and prompting mental health in pregnant women, which might benefit their offspring’s EBPs.

Prenatal depressive symptoms are an important mental health problem during pregnancy. We aimed to explore the moderating role of social support on the association between perceived stress and prenatal depressive symptoms. A cross-sectional study was conducted at an obstetrics clinic. A total of 1846 women completed a self-administered questionnaire, with a response rate of 91.8%. Of the 1846 participants, 28.2% reported prenatal depressive symptoms (Edinburgh postnatal depression scale score ≥ 9). After adjusting for demographic characteristics, gestational age, exercise, and passive smoking, both perceived stress (adjusted odds ratio (AOR): 1.210, 95% confidence interval (CI): 1.178-1.242) and social support (AOR: 0.950, 95% CI: 0.932-0.968) were associated with prenatal depressive symptoms. Moreover, social support had a moderating effect on the association between perceived stress and prenatal depressive symptoms ( < 0.001), and pregnant women with low social support were more likely to be affected by stress and experience prenatal depressive symptoms. Our study suggests that higher social support reduces the impact of stress on pregnant women, which in turn, decreases the risk of prenatal depressive symptoms. Therefore, interventions aimed at improving social support should be considered for the prevention and treatment of prenatal depressive symptoms.

This study examined the associations between intimate partner violence (IPV) during pregnancy, mother-to-infant bonding failure, and postnatal depressive symptoms at 1 month postnatal. This study also examined if these relationships would be mediated by antenatal depressive symptoms. This study was a prospective cohort study that investigated effects between the third trimester of pregnancy and 1 month after childbirth. The Japanese version of the Index of Spouse Abuse (ISA), the Japanese version of the Mother-Infant Bonding Scale (MIBS), and the Japanese version of the Hospital Anxiety and Depression Scale (HADS) were used to measure IPV during pregnancy, bonding failure with infants, and depressive symptoms during pregnancy and the postnatal period respectively. Structural equation modeling (SEM) was used to find the associations between those four variables. The final path model of the SEM showed good fit with the data. IPV during pregnancy was associated with mother-to-infant bonding failure at 1 month postnatal, whereas IPV during pregnancy was not significantly associated with postnatal depressive symptoms at 1 month postnatal. In addition, this study demonstrated that the associations between IPV during pregnancy, mother-to-infant bonding failure, and postnatal depressive symptoms at 1 month postnatal were mediated by antenatal depressive symptoms. The results of this study indicated the need for interventions for IPV and psychological health care for abused pregnant women to prevent antenatal depressive symptoms in prenatal health settings. Those interventions by perinatal health professionals would help to prevent bonding failure with infants and postnatal depressive symptoms after childbirth.

Background Antenatal depressive symptoms affect around 12.3% of women in in low and middle income countries (LMICs) and data are accumulating about associations with adverse outcomes for mother and child. Studies from rural, low-income country community samples are limited. This paper aims to investigate whether antenatal depressive symptoms predict perinatal complications in a rural Ethiopia setting. Methods A population-based prospective study was conducted in Sodo district, southern Ethiopia. A total of 1240 women recruited in the second and third trimesters of pregnancy were followed up until 4 to 12 weeks postpartum. Antenatal depressive symptoms were assessed using a locally validated version of the Patient Health Questionnaire (PHQ-9) that at a cut-off score of five or more indicates probable depression. Self-report of perinatal complications, categorised as maternal and neonatal were collected by using structured interviewer administered questionnaires at a median of eight weeks post-partum. Multivariate analysis was conducted to examine the association between antenatal depressive symptoms and self-reported perinatal complications. Result A total of 28.7% of women had antenatal depressive symptoms (PHQ-9 score ≥ 5). Women with antenatal depressive symptoms had more than twice the odds of self-reported complications in pregnancy (OR=2.44, 95% CI: 1.84, 3.23), labour (OR= 1.84 95% CI: 1.34, 2.53) and the postpartum period (OR=1.70, 95% CI: 1.23, 2.35) compared to women without these symptoms. There was no association between antenatal depressive symptoms and pregnancy loss or neonatal death. Conclusion Antenatal depressive symptoms are associated prospectively with self-reports of perinatal complications. Further research is necessary to further confirm these findings in a rural and poor context using objective measures of complications and investigating whether early detection and treatment of depressive symptoms reduces these complications.

Background Psychological interventions for antenatal depression are an integral part of evidence-based care but need to be contextualised for respective sociocultural settings. In this study, we aimed to understand women and healthcare workers’ (HCWs) perspectives of antenatal depression, their treatment preferences and potential acceptability and feasibility of psychological interventions in the rural Ethiopian context. Methods In-depth interviews were conducted with women who had previously scored above the locally validated cut-off (five or more) on the Patient Health Questionnaire during pregnancy ( n  = 8), primary healthcare workers (HCWs; nurses, midwives and health officers) ( n  = 8) and community-based health extension workers ( n  = 7). Translated interview transcripts were analysed using thematic analysis. Results Women expressed their distress largely through somatic complaints, such as a headache and feeling weak. Facility and community-based HCWs suspected antenatal depression when women reported reduced appetite, sleep problems, difficulty bonding with the baby, or if they refused to breast-feed or were poorly engaged with antenatal care. Both women and HCWs perceived depression as a reaction (“thinking too much”) to social adversities such as poverty, marital conflict, perinatal complications and losses. Depressive symptoms and social adversities were often attributed to spiritual causes. Women awaited God’s will in isolation at home or talked to neighbours as coping mechanisms. HCWs’ motivation to provide help, the availability of integrated primary mental health care and a culture among women of seeking advice were potential facilitators for acceptability of a psychological intervention. Fears of being seen publicly during pregnancy, domestic and farm workload and staff shortages in primary healthcare were potential barriers to acceptability of the intervention. Antenatal care providers such as midwives were considered best placed to deliver interventions, given their close interaction with women during pregnancy. Conclusions Women and HCWs in rural Ethiopia linked depressive symptoms in pregnancy with social adversities, suggesting that interventions which help women cope with real-world difficulties may be acceptable. Intervention design should accommodate the identified facilitators and barriers to implementation.

To analyze the mediation effect of perinatal health on the association between prenatal depressive symptoms and postpartum depressive symptoms 180 women filled the Edinburgh Postnatal Depressive Scale (EPDS) at 35 weeks of gestation and two months after childbirth. Perinatal health data was collected during the first 4 days after childbirth, using the Optimality Index. 25.6% of the mothers-to-be presented clinically significant depressive symptoms, and of these, 80.4% still show clinically significant depressive symptoms at 2-months postpartum. Prenatal depressive symptoms predict higher postpartum depressive symptoms. Additionally, results also showed that the effect of prenatal depressive symptoms on postnatal depressive symptoms is not mediated by perinatal health. Mothers-to-be with prenatal depressive symptoms seem to be at risk for postnatal depression, even when perinatal health is not compromised. This highlights the importance of early screening of prenatal depressive symptoms in order to promote an early intervention on women’s mental health, leading to a better transition to parenthood and to a decrease of the burden of this public health problem on children and families.