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Background Postpartum posttraumatic stress disorder (PP-PTSD) is a prevalent, yet often unrecognized mental health problem, particularly in low- and middle-income countries. Moreover, the long-term effects of PP-PTSD symptoms on maternal well-being and child socioemotional development beyond the first year postpartum remain largely unknown. This study focused on the association between PP-PTSD symptoms within one year after childbirth and maternal depressive symptoms and child behavioral problems two years later. Methods Russian women ( n  = 419) completed the City Birth Trauma Scale and the Edinburgh Postnatal Depression Scale evaluating symptoms of PP-PTSD and postpartum depression (PPD) via a web-based survey. Mothers also filled in the Beck Depression Inventory that assessed their depressive symptoms and the Child Behavior Checklist that assessed child’s behavioral problems 2.24 years later. Results The regression analysis showed a significant association between PP-PTSD and elevated depressive symptoms 2 years later even after adjustment for PPD (β = 0.19, 95% Confidence Interval 0.11, 0.26, p  < 0.01). Children of mothers with higher PP-PTSD symptoms had higher internalizing, externalizing, and total behavioral problems, independent of PPD and concurrent depressive symptoms (β > 0.12, p  < 0.01 for all). Conclusions Childbirth-related PTSD presents risk for maternal psychological well-being and child socioemotional development beyond comorbidity with maternal depression. Raising awareness about PP-PTSD among families, communities, healthcare providers, and policymakers is essential in order to decrease stigma of childbirth-related distress, particularly, in low- and middle-income countries like Russia, improve support system during the postpartum period, promote mother–infant bonding in affected women, and, thus, prevent long-term consequences of traumatic childbirth for maternal and child mental health outcomes. Clinical trial number Not applicable.

Background The COVID-19 pandemic has had a profound impact on global mental health, particularly affecting vulnerable groups such as pregnant women. Post-traumatic stress disorder (PTSD) in this population may potentially hinder infant physical development, underscoring the necessity for specific interventions. This study seeks to explore the prevalence of PTSD among pregnant women during the pandemic and its implications for infant physical development, thereby providing evidence to mitigate the adverse effects of the pandemic on maternal and child health. Methods A prospective cohort study was carried out involving 450 pregnant women from December 2022 to February 2023. Data included demographic details, PTSD evaluation using the PTSD Checklist-Civilian version (PCL-C) scale, coping mechanisms, and infant growth indicators at three months postpartum. Statistical methods included descriptive statistics, univariate analysis, and multivariate analysis of covariance (ANCOVA) to control for confounding factors. Results The study enrolled a total of 450 pregnant women. Following exclusions and follow-up attrition, 422 pregnant women were analyzed. There were 72 pregnant women with PTSD and 350 without PTSD. There was no statistically significant difference in birth weight between the two groups of participants. Three months after birth, infants of PTSD-positive mothers exhibited significantly lower weight percentiles at three months ( P  < 0.001), adjusted for birth weight, feeding method, and coping strategies. Multivariate analysis affirmed a 9.44-point reduction in weight percentile among infants in the PTSD-positive group (95% CI: 4.01–14.87, P  = 0.001). Conclusion: Pregnant women suffering from PTSD during the pandemic are at risk of giving birth to infants with impaired physical growth. These findings highlight the critical need for mental health support for pregnant women to foster optimal infant development and to guide public health policies and clinical practices.

Background Evidence suggests maternal birth experience impacts infant health. Alterations of the infant’s hypothalamus-pituitary-adrenal (HPA) axis are discussed as one possible underlying mechanism. This study aimed to investigate both objective and subjective birth experience as potential predictors of offspring’s hair glucocorticoid concentrations (GCs) and infant development, respectively. Further, we examined the role of hair GCs for prospective infant development in different domains. Methods n  = 263 mothers participating in the prospective cohort study DREAM HAIR completed questionnaires about their objective and subjective birth experience approximately eight weeks after birth. Additionally, hair samples from n  = 286 infants were taken around ten days (neonatal hair GCs) and eight weeks after birth (infant hair GCs) and long-term integrated hair cortisol and cortisone levels were measured in scalp-near 2-cm segments. Infant development (communication, gross motor, fine motor, problem-solving, personal-social) was assessed 14 months after birth using the Ages and Stages Questionnaire − 3 (ASQ-3). Results No significant associations were found between objective or subjective birth experience and most domains of infant development, except that a more negative objective birth experience predicted poorer fine motor skills. Additionally, a more negative objective birth experience was linked to lower infant hair cortisone levels and a higher cortisol/cortisone ratio, while a more negative subjective experience was associated with higher neonatal hair cortisol. Lower neonatal hair cortisone showed a link to poorer personal-social development. However, after correction for multiple testing, only the associations between a more negative objective birth experience and lower hair cortisone and a higher cortisol/cortisone ratio at eight weeks remained significant. Conclusions Objective aspects of the birth experience may have a more enduring impact on infant hair GCs than maternal subjective perceptions, particularly with higher birth complications being linked to lower infant cortisone and a higher infant cortisol/cortisone ratio. Given that this ratio may indicate reduced enzymatic activity in converting cortisol to its inactive form, results suggest that birth complications could affect the infant’s glucocorticoid metabolism. No robust associations were found between birth experiences or hair GCs and infant development. Further research in more diverse, at-risk populations is needed to clarify these complex relationships.

Background A growing body of literature links prenatal mood and substance use to children's cognitive and behavioral development. The relative contribution of these risk factors on children's executive function (EF) in the context of socioeconomic adversities needs further evaluation. To address this gap, we investigated the role of prenatal maternal anxiety and depression on childhood EF, specifically inhibitory control and working memory, within the context of socioeconomic adversities and prenatal substance use. We hypothesized that higher maternal mood symptoms, higher persistent prenatal drinking and smoking, and lower socioeconomic status would be associated with lower EF skills during early childhood. Methods We used data from 334 mother–child dyads followed prospectively through pregnancy and the offspring’s childhood. Prenatal maternal depression and anxiety were assessed via standardized questionnaires. Prenatal alcohol and tobacco consumption were assessed via a timeline follow-back interview. The EF touch battery assessed child inhibitory control and working memory at 3–5 years of age (4.76 ± 0.58 years, 171 females). Separate linear regression models were used to estimate the association of prenatal tobacco, alcohol, anxiety, and depression exposure with our two components of child EF, inhibitory control and working memory, while adjusting for gestational age, sex, and age at assessment. The following variables were also included as covariates: maternal educational achievement, employment status, parity, and household crowding index. Results Children of mothers with high trait anxiety scores had reduced inhibitory control compared to children of mothers without trait anxiety or depression (β = -0.12, 95% CI:-0.22,-0.01). Children of mothers in the moderate to high continuous smoking group showed lower inhibitory control (β = − 0.19, 95% CI:-0.38,-0.01) compared to children of mothers in the none smoking group. Additionally, lower maternal education and higher household crowding were each associated with reduced inhibitory control. We found no significant association between prenatal maternal depression, anxiety, or socioeconomic factors with working memory. Conclusions These results underscore the need for comprehensive context-specific intervention packages, including mental health support for women to promote healthy inhibitory control development in children.

Background Depressive symptoms in the perinatal period as well as difficulties developing an emotional bond towards the child have been described as potential risk factors for poor child development. Few studies have investigated the mediating role of parent-child bonding for the association between prenatal depressive symptoms and child outcomes. Research on this association is especially scarce regarding the paternal perspective. This study investigated the prospective association between both parents’ prenatal depressive symptoms and child development, taking the mediating role of parent-child bonding into account. Methods Data of 1,178 mothers and 743 fathers were drawn from the prospective longitudinal cohort study “Dresden Study on Parenting, Work, and Mental Health” (DREAM). To investigate the prospective association between depressive symptoms during pregnancy and eight weeks postpartum (self-report, Edinburgh Postnatal Depression Scale), parent-child bonding at eight weeks postpartum (self-report, Postpartum Bonding Questionnaire), and child development at 14 months postpartum (parent-report, Ages and Stages Questionnaire-3), multiple regression and mediation analyses were conducted individually for both parents, including the confounders parental age, education, child’s sex assigned at birth, prematurity, and perceived social support. Results In both parents, a statistically significant small-sized mediating effect of parent-child bonding for the association between prenatal depressive symptoms and child development was found, with higher depressive symptoms being associated with more parent-child bonding impairment, which was associated with poorer child development. Paternal depressive symptoms were not directly associated with child development, whereas higher levels of maternal prenatal depressive symptoms were directly associated with better child development at 14 months postpartum. After additionally controlling for postpartum depressive symptoms, the association between prenatal depressive symptoms and parent-child bonding was no longer significant, and a positive association between paternal prenatal depressive symptoms and child development emerged. Conclusions Our results underline the importance of addressing depressive symptoms in the context of perinatal care to support parents experiencing mental health problems or struggles with the adjustment to parenthood early on. Future research on the complex dynamics of mental health, parent-child bonding, and child development is needed to replicate our findings. Our study highlights the relevance of including the perspective of both parents into research and clinical practice.

This paper studies how in utero exposure to maternal stress from family ruptures affects later mental health. We find that prenatal exposure to the death of a maternal relative increases take-up of ADHD medications during childhood and anti-anxiety and depression medications in adulthood. Further, family ruptures during pregnancy depress birth outcomes and raise the risk of perinatal complications necessitating hospitalization. Our results suggest large welfare gains from preventing fetal stress from family ruptures and possibly from economically induced stressors such as unemployment. They further suggest that greater stress exposure among the poor may partially explain the intergenerational persistence of poverty.

Background Breastfeeding has long been associated with numerous benefits for both mothers and infants. While some observational studies have explored the relationship between breastfeeding and mental health outcomes in mothers and children, a systematic review of the available evidence is lacking. The purpose of this study is to systematically evaluate the association between breastfeeding and mental health disorders in mothers and children. Methods We systematically searched MEDLINE and EMBASE from inception to June 2, 2023. The inclusion criteria consisted of all studies evaluating links between breastfeeding and development of mental health disorders in children and mothers. Risk of bias was assessed using the Newcastle–Ottawa Scale (NOS) while grading of Recommendations Assessment, Development and Evaluation (GRADE) was used to assess the certainty of evidence. A random-effects meta-analysis was used if possible, to estimate the odds ratio for the association between breastfeeding and mental health outcomes. The Mantel–Haenszel method was utilised for pooling ORs across studies. Study heterogeneity was assessed using the I 2 statistic. Results Our review identified twenty-one original study. Of these, 18 focused on the association between breastfeeding and child health, assessing depressive disorders, schizophrenia, anxiety disorders, eating disorders and borderline personality disorder. Three studies evaluated the associations between breastfeeding and maternal mental health disorders. Three studies looking at outcomes in children showed no significant association between breastfeeding and occurrence of schizophrenia later in life (OR 0.98; 95% CI 0.57–1.71; I 2  = 29%). For depressive disorders (5 studies) and anxiety disorders (3 studies), we found conflicting evidence with some studies showing a small protective effect while others found no effect. The GRADE certainty for all these findings was very low due to multiple limitations. Three studies looking at association between breastfeeding and maternal mental health, were too heterogeneous to draw any firm conclusions. Conclusions We found limited evidence to support a protective association between breastfeeding and the development of mental health disorders in children later in life. The data regarding the association between breastfeeding and maternal mental health beyond the postnatal period is also limited. The methodological limitations of the published literature prevent definitive conclusions, and further research is needed to better understand the relationship between breastfeeding and mental health in mothers and children.

Background Antenatal anxiety and depression are prevalent conditions with significant risks to both maternal and infant health, contributing to preterm birth, low birth weight, and long-term developmental effects. Despite the recognized impact, limited research exists on these disorders in Bulgaria. This study assessed the prevalence of antenatal anxiety and depressive symptoms among pregnant women in Pleven Region and identified sociodemographic and psychosocial risk factors. Methods A cross-sectional survey was conducted from June to October 2024, involving 170 pregnant women in their third trimester at the University Hospital ‘St. Marina’ in Pleven, Bulgaria. Participants completed a self-administered questionnaire that included sociodemographic, behavioral, and psychosocial variables, along with the Antenatal Risk Questionnaire (ANRQ) to assess anxiety and depression. Results Nearly 50% of participants reported mild symptoms of anxiety or depression. Significant associations were found between these symptoms and lower educational attainment (p = 0.03), smoking during pregnancy (p = 0.01), and lack of partner support (p = 0.02). A history of adverse childhood experiences was linked to increased psychological distress (p = 0.01). Logistic regression revealed that higher educational attainment was the strongest protective factor (OR = 0.41, 95% CI: 0.24-0.71, p = 0.02). Conclusions These preliminary results indicate a high prevalence of antenatal anxiety and depression in Pleven Region, with significant predictors such as lower education and lack of partner support. The findings stress the need for integrated psychosocial screening during prenatal care, particularly for vulnerable groups. Further efforts should focus on national guidelines for perinatal mental health and early interventions in maternal care. Key messages • High prevalence of antenatal anxiety and depression in Pleven Region, linked to education and partner support. • Psychosocial screening and early interventions are crucial for improving maternal and infant health outcomes.

ObjectivesIntimate partner violence (IPV) is a global health issue affecting mainly women and is known to escalate during pregnancy and impact negatively on obstetric and perinatal outcomes. The aim of this study is to determine the incidence of IPV in a pregnant multicultural population and to determine the relationship between IPV reported at booking interview and maternal and perinatal outcomes.DesignThis is a retrospective population-based data study. We analysed routinely collected data (2006–2016) from the ObstetriX system on a cohort of pregnant women.Setting and participants33 542 women giving birth in a major health facility in Western Sydney.Primary outcomesIncidence of IPV, association with IPV and other psychosocial variables and maternal and perinatal outcomes.Result4.3% of pregnant women reported a history of IPV when asked during the routine psychosocial assessment. Fifty-four per cent were not born in Australia, and this had increased significantly over the decade. Women born in New Zealand (7.2%) and Sudan (9.1%) were most likely to report IPV at the antenatal booking visit, with women from China and India least likely to report IPV. Women who reported IPV were more likely to report additional psychosocial concerns including Edinburgh Postnatal Depression Scale scores > 13 (7.6%), thoughts of self-harm (2.4%), childhood abuse (23.6%), and a history of anxiety and depression (34.2%). Women who reported IPV were more likely to be Australian born, smoke and be multiparous and to have been admitted for threatened preterm labour (Adjusted Odds Ratio (AOR) 1.8, 95% CI 1.28 to 2.39).ConclusionsA report of IPV at the first antenatal booking visit is associated with a higher level of reporting on all psychosocial risks, higher antenatal admissions, especially for threatened preterm labour. More research is needed regarding the effectiveness of current IPV screening for women from other countries.

The perinatal period may represent a particularly challenging time for expecting parents. Previous studies have highlighted an association between several perinatal risk conditions (e.g., childhood maltreatment, poor social support, and stress levels) and the development of psychopathological symptoms in pregnant women, especially depression symptoms. The current study examined the effects of psychosocial risk factors (childhood maltreatment, poor social support, and stressful events) on anxiety, depression, perceived stress, irritability/anger, relationship problems, psychosomatic symptoms, specific physiological problems, and addiction/at-risk behaviors. Sixty-one pregnant women (age range = 24–45) participating in a larger study completed questionnaires about childhood maltreatment (CECA Q.), Maternity Social Support Scale (MSSS), questionnaire on stressful events, and the Perinatal Assessment of Maternal Affectivity (PAMA) during their pregnancy. Results from regression analysis indicated that the presence of childhood maltreatment predicted elevated depressive symptoms, elevated irritability and anger, and elevated relationship problems. Further, stressful events in the year prior to pregnancy predicted elevated psychosomatic symptoms during pregnancy. No other significant associations were found. In this study, traumatic childhood events were strongly associated with mental health symptoms during pregnancy. This is an important finding that suggests the importance of screening and targeting psychotherapeutic interventions for vulnerable women during pregnancy.