Investigating associations of intolerance of uncertainty and inflated responsibility beliefs with postnatal specific anxiety and infant feeding outcomes.

This study evaluated whether exposure to maternal pre- or postnatal depression or anxiety symptoms predicted psychopathology in adolescent offspring. Growth mixture modeling was used to identify trajectories of pre- and postnatal depression and anxiety symptoms in 577 women of low socioeconomic status selected from a prenatal clinic. Logistic regression models indicated that maternal pre- and postnatal depression trajectory exposure was not associated with offspring major depression, anxiety, or conduct disorder, but exposure to the high depression trajectory was associated with lower anxiety symptoms in males. Exposure to medium and high pre- and postnatal anxiety was associated with the risk of conduct disorder among offspring. Male offspring exposed to medium and high pre- and postnatal anxiety had higher odds of conduct disorder than did males with low exposure levels. Females exposed to medium or high pre- and postnatal anxiety were less likely to meet conduct disorder criteria than were females with lower exposure. To the best of our knowledge, this is the first study to examine the effect of pre- and postnatal anxiety trajectories on the risk of conduct disorder in offspring. These results suggest new directions for investigating the etiology of conduct disorder with a novel target for intervention.

PurposeThere is limited knowledge on the relationship between postnatal depression and childbirth pain characteristics associated with childbirth. We investigated whether the characteristics of childbirth pain, as assessed by Short-form-McGill Pain Questionnaire-2 (SF-MPQ-2), were associated with postnatal anxiety and depressive disorders.Patients and MethodsNulliparous parturients who received labor epidural analgesia (LEA) and delivered in our institution were invited to have a Mini-International Neuropsychiatric Interview (MINI) assessment following their 5–9 weeks post-delivery follow-up phone survey of a larger study. Parturients’ demographics, pre-delivery questionnaires on pain and psychological vulnerabilities, LEA data, maternal and neonatal outcomes, postnatal follow-up survey on pain and psychological vulnerabilities, pain and breastfeeding were collected accordingly. The primary outcome was the binary variable (yes/no) of the presence of postnatal depression and/or anxiety disorders based on the post-delivery MINI assessment.ResultsAmong the 107 parturients who participated in the post-delivery MINI assessment, a total of 40 (42.5%) patients were found to have postnatal anxiety and depressive disorders. A greater pre-delivery SF-MPQ-2 neuropathic pain mean subscale score (adjusted odds ratio (OR) 1.32, 95% CI 1.00–1.73, p=0.0482) and greater post-delivery Edinburgh Postnatal Depression Scale (EPDS) at 5–9 weeks post-delivery (adjusted OR 1.30, 95% CI 1.13–1.50, p=0.0002) were independently associated with the presence of postnatal anxiety and/or depressive disorders (receiver operating characteristic (ROC) = 0.7489).ConclusionPatients with greater pre-delivery neuropathic pain and higher EPDS scores at 5–9 weeks post-delivery are more likely to have postnatal depression and/or anxiety disorders, suggesting possible associations between pain and psychological vulnerability in the development of postnatal mental disorders.

The impacts of postnatal psychiatric disorders on different types of mental health problems in offspring are unclear. We investigated the prospective associations of maternal postnatal depression, and anxiety, with offspring depression, anxiety, psychotic-like experiences and Borderline Personality Disorder symptoms, in adolescence, and examined whether these were independent of each other. Data were obtained from the Avon Longitudinal Study of Parents and Children (ALSPAC) birth cohort. Maternal postnatal depression and anxiety at 8 weeks were measured using the Edinburgh Postnatal Depression Scale and Crown-Crisp Index, respectively. Offspring mental health outcomes were measured at 10-13 years old, using a variety of questionnaire-based and interview assessments. Logistic regression analyses were used to assess the associations between maternal postnatal risk factors and offspring mental health, and path analysis was used to investigate the pathways of maternal postnatal factors to adolescent offspring outcomes. Data were available for 14,054 mothers with information reported on postnatal depression and 13,892 on postnatal anxiety. Logistic regression analyses found significant associations between maternal postnatal depression and offspring anxiety at 10 years old (odds ratio = 1.039, 95% confidence interval = [1.005, 1.073], p = 0.022) and between maternal postnatal anxiety and offspring psychotic experiences at 12/13 years old (odds ratio = 1.042, 95% confidence interval = [1.008, 1.077], p = 0.016). These significant associations remained after applying path analyses, when we controlled for potential offspring psychopathological overlay. These findings suggest that mothers with postnatal depression are more likely to have offspring with anxiety at 10 years old, and that mothers with postnatal anxiety are more likely to have offspring with psychotic experiences at 12/13 years old. Our findings suggest specific pathways in the association between postnatal anxiety/depression and offspring mental health and contribute to the importance of identifying mothers and their offspring with increased vulnerability to adverse outcomes resulting from postnatal mental health disorders.

Associations between poor subjective prenatal sleep quality and postnatal depression and anxiety symptoms

Due to the harmful effects of prenatal and postnatal anxiety and depression on fathers, the aim of this study was to determine the impact of lifestyle-based training on paternal depression and anxiety (primary outcomes) during the prenatal and postnatal periods. This single-blind randomized controlled clinical trial was conducted on 126 spouses of pregnant women with gestational ages of 24-28weeks. They were followed up until 6weeks after childbirth. Using the block randomization method and stratified based on the number of children, the eligible samples were divided into two groups (one receiving two weekly group lifestyle-based training session (lasting 60-90min) and a control group). Edinburgh Postnatal Depression Scale and Spielberger's State-Trait Anxiety Inventory were filled out by the participants before the intervention, 8weeks after it, and 6weeks after childbirth. The general linear model was used to analyze data. Out of 126 fathers, one individual from the intervention group left the study because he was not willing to cooperate. Compared with the control group, there was a significant decrease in depression (adjusted difference: -1.6; 95% CI -2.8 to -0.5), state anxiety (-5.7; -8.6 to -2.9) and trait anxiety (-5.0; -7.8 to -2.2) scores at 8weeks after intervention as well as postnatal depression (-3.3; -5.0 to -1.5); postnatal state anxiety (-7.5; -11.6 to -3.4), and postnatal trait anxiety (-8.3; -12.2 to -4.4) in the intervention group. The research results indicated the positive impact of training on prenatal and postnatal depression and anxiety in fathers. Given the easy implementation of training interventions during pregnancy, it is suggested that such interventions be paid more attention.

BackgroundNearly 20% of women will be confronted with anxiety or depressive disorders during the perinatal period and this may lead to adverse outcomes for both mother and child. Cognitive behavioural therapy (CBT) is the psychological intervention with the most empirical support for the clinical management of anxiety and depressive disorders. Anxiety and depression frequently occur in women during the perinatal period, and there is growing evidence that internet-delivered CBT (iCBT) could be an acceptable and effective intervention. THIS WAY UP, an Australian digital mental health service, has developed a program for postnatal anxiety and depression. This study protocol aims to examine the acceptability and efficacy of a French-Canadian adaptation of the program.Methods/designThe research team propose to conduct a mixed hybrid type 1 pragmatic randomized clinical trial and implementation study to replicate the findings of the trial conducted in Australia by Loughnan et al. (2019), as well as explore barriers and facilitators to potential large-scale implementation.Treatment and control conditionsa) postnatal anxiety and depression iCBT program with three lessons to complete in a six-week period, added to treatment-as-usual (TAU); b) TAU. Participants will include French-speaking women with probable postnatal depression or anxiety as per the Generalized Anxiety Disorder-7 (GAD-7) or the Edinburgh Postnatal Depression Scale (EPDS). The primary outcome measures will be the GAD-7 and the EPDS. Secondary outcome measures will comprise self-reported instruments to evaluate psychological distress, quality of life, mother–child experience, and treatment experience. Qualitative interviews with participants and health professionals will provide insights on acceptability and delivery of the iCBT program.Statistical analysisStatistical analysis will follow intent-to-treat principles. A mixed model regression approach will be used to account for between- and within-subject variations in the analysis of the effects of iCBT compared to TAU only intervention.DiscussionThe study will generate important data of efficacy and acceptability to patients, clinicians, and decision-makers to inform the scaling-up of the postnatal iCBT intervention in Canada.Trial registrationClinicalTrials.gov: NCT06778096, prospectively registered on 2025/01/16.

Intimate-partner violence and poor mental health are common, harmful issues for women of childbearing age. Although the prevalence and correlates of postpartum depression are well established, far less is known about postpartum anxiety. We aimed to investigate the association between postnatal depression and anxiety, and intimate-partner violence among women attending Victorian Maternal and Child Health services, using data from a randomised control trial: Improving Maternal and Child Health care for Vulnerable Mothers (MOVE). These data included postnatal women who had given birth between May and December 2010. Multiple logistic regression was used to estimate the association between intimate partner violence (using the Composite Abuse Scale) and postnatal depression and anxiety (Depression, Anxiety and Stress Scale), controlling for participant socio-demographic characteristics. Findings showed that abused women were more likely to report postnatal depressive and anxiety symptoms. There was an almost two-fold (odds ratio (OR) 1.76, 95% CI 1.03-3.01) and three-fold (OR 2.6, 95% CI 1.58-4.28) increase in the odds of reporting depressive and anxiety symptoms respectively, among abused compared with non-abused women. Abused women are at a higher risk of mental health problems. This study validated findings that intimate-partner violence is strongly associated with an increased risk of postnatal depression and highlighted the previously under-reported relationship with postnatal anxiety.

The adverse effect of both pre- and post-natal maternal anxiety and depression on the development of offspring is shown by a large body of research. No published studies, however, have simultaneously: (i) controlled for co-occurring prenatal risks that may influence maternal prenatal anxiety and depression; (ii) compared the relative contributions of prenatal and postnatal maternal anxiety and depression on child functioning; and (iii) assessed a full range of child psychopathology and functioning to determine the relative effects of prenatal and postnatal anxiety and depression in the mother. Using 3,298 mother-offspring pairs, the authors examined these factors in a single-path analytic model. Measurements of maternal anxiety and depression were collected at two time points: 32 weeks prenatal and 1.5 years postnatal. Other prenatal risks were assessed between 8 and 32 weeks of gestation. Child outcomes included (a) ordered-categorical measures of DSM-IV externalizing and internalizing disorders, and (b) an assessment of verbal IQ. In both the prenatal and postnatal periods, maternal depression had a wider impact on different types of child maladjustment than maternal anxiety, which appeared more specific to internalizing difficulties in the child. Of note, prenatal risks were prospectively associated with child externalizing difficulties and verbal IQ, beyond the effects of prenatal and postnatal maternal anxiety and depression. The present results suggest that addressing both maternal anxiety and depression, in the prenatal and postnatal periods-as well as associated risk factors-may be the most effective approach to prevent adverse outcomes in the offspring.

Maternal psychological distress during pregnancy is known to elevate the risk of offspring asthma, but the impact of the timing of the distress remains poorly understood. To assess the individual and combined effects of maternal prenatal and postnatal depressive and anxiety disorders, both separately and longitudinally, on offspring asthma and its phenotypes. Healthcare register data on 310,701 children born 2001-2006 and their 232,240 mothers were collected. Maternal depressive disorder was defined by diagnoses F30, F31, F32-F34 and F38 and anxiety disorder as F40-F42, F44-F45 and F48. Timing of disorder was defined as prenatal (from one year before until labor) and postnatal periods (from birth until three years postpartum). Child outcomes were overall asthma diagnosis J45-J46 at 7-12years, further separated into allergic J45.0 and non-allergic J45.1 asthma phenotypes. Altogether, 19,000 (6.1%) children had asthma, 6517 (2.8%) mothers had depression, and 4189 (1.8%) had anxiety disorder. Child overall asthma was associated with maternal prenatal depression (adjusted odds ratio 1.28; 95% confidence interval 1.08-1.53) and anxiety disorders (1.30; 1.07-1.57), and with postnatal anxiety disorders (1.33; 1.15-1.54). Both maternal postnatal depression (1.36; 1.06-1.74) and anxiety disorders (1.45; 1.06-2.00) were associated with non-atopic asthma, and postnatal anxiety was associated with atopic asthma (1.34; 1.07-1.67). The comorbidity or longitudinality of maternal depressive and anxiety disorders didn't affect the associations. Maternal depressive and anxiety disorders were associated with offspring asthma, varying by phenotype and timing. The postnatal effect was significant, suggesting independent associations and possibly distinct pathways in child respiratory morbidity.

The Edinburgh Postnatal Depression Scale (EPDS) is effective and cost-effective for identifying postnatal depression. Postnatal anxiety is also common and can be identified by three questions on the EPDS (anxiety sub-scale). We aimed to compare EPDS score alone with EPDS score and sub-scale score together (EPDS+) to identify common mental illness (depression or anxiety) in postnatal women. The sensitivity and specificity of the EPDS and sub-scale were explored. We developed a decision tree to compare costs and health outcomes associated with case-finding for postnatal depression or anxiety over one year. Model parameters were derived from secondary data analysis, published literature, and expert consultation. Costs included case-finding and treatment. Health benefit was measured as quality-adjusted life years (QALYs). We explored the cost-effectiveness of using EPDS alone and EPDS+ (versus no case-finding). The greatest number of true positive outcomes and smallest number of false negative outcomes were seen with EPDS+. However, the number of false positives is also higher for EPDS+. Compared with no case-finding, EPDS alone costs £3365/QALY gained and EPDS+ costs £6405/QALY gained. The additional health gain from EPDS+ (versus EPDS alone) costs £22,104/QALY. The model does not include long-term impacts of maternal mental illness or impacts on other family members. Case-finding for common mental illness in the postnatal period is cost-effective. Compared to no case-finding, EPDS alone is more cost-effective than EPDS+. If decision-makers want to maximise identification of cases, EPDS+ could be cost-effective depending on how much they are willing to pay.

BackgroundMany studies have identified associations between qualities of maternal–child relationships and childhood asthma, but few have examined associations with childhood atopic dermatitis (AD), a common precursor to asthma. Moreover, maternal psychological distress, including prenatal and postnatal depression, anxiety and stress, may increase risk, while social support from partners may reduce risk for childhood AD. We sought to uncover the association between maternal–infant relationship qualities (maternal sensitivity towards infant behavioral signals, controlling behavior, and unresponsiveness) and child AD after accounting for risk (i.e., prenatal and postnatal maternal depression, anxiety and stress) and protective (i.e., social support) factors.MethodsWe conducted a secondary analysis of data collected on a subsample of 242 women and their infants enrolled during pregnancy in the ongoing Alberta Pregnancy Outcomes and Nutrition cohort study. Inclusion criteria required mothers to be >16 years of age, English speaking and <22 weeks gestational age at enrollment. Data on depression, anxiety and stress in the prenatal and postnatal periods and physician diagnosis of childhood AD at 18 months were gathered via maternal report. Maternal sensitivity, unresponsiveness and controlling behaviours were assessed via videotaped observations using the Child-Adult Relationship Experimental (CARE)-Index at 6 months of infant age.ResultsHigher maternal sensitivity, or the inability of the mother to appropriately understand and respond to infant needs based on behavioral signals, predicted reduced odds of AD independent of and in combination with low prenatal and postnatal anxiety and high paternal support. After adjustment, higher maternal controlling behaviours and unresponsiveness also predicted greater odds of AD.ConclusionsLow maternal sensitivity is a risk factor for childhood AD, independently and in combination with perinatal anxiety and low social support. Thus, interventions that improve maternal–infant relationship quality, especially sensitivity, reduce anxiety and improve social support from partners could reduce odds of childhood AD.

Postnatal maternal depression is associated with poorer child emotional and behavioral functioning, but it is unclear whether this occurs following brief episodes or only with persistent depression. Little research has examined the relation between postnatal anxiety and child outcomes. The present study examined the role of postnatal major depressive disorder (MDD) and generalized anxiety disorder (GAD) symptom chronicity on children’s emotional and behavioral functioning at 24 months. Following postnatal screening mothers (n = 296) were identified as having MDD, GAD, MDD and GAD, or no disorder at 3 months postnatal; the average age was 32.3 (SD = 5.0), 91.9% self-identified as Caucasian, and 62.2% were married. Maternal disorder symptom severity was assessed by questionnaires and structured interview at 3, 6, 10, 14, and 24 months postpartum. At 24 months, child emotional negativity and behavior were assessed using questionnaires and by direct observation. Latent trait–state-occasion modeling was used to represent maternal disorder symptom chronicity; both stable trait and time-specific occasion portions of maternal symptomatology were examined in relation to child outcomes. Only the stable trait portion of maternal MDD and GAD symptom severity were related to maternal report of child behavior problems and higher levels of emotional negativity. Persistent maternal MDD, but not GAD, symptom severity was related to higher levels of child emotional negativity as measured observationally. These data suggest that children’s behavior problems and emotional negativity are adversely affected by persistent maternal depression, and possibly anxiety. This has implications for interventions to prevent negative effects of postnatal psychopathology on children.

The study aimed to examine effect of prenatal anxiety and depression on the prediction of postnatal anxiety and depression among pregnant women. In addition, to find out mean differences in prenatal and postnatal anxiety and depression among primary and multigravida pregnant women. This study was conducted at Sargodha Pakistan, on a total number of 100 pregnant women as participants. The sample size was calculated by using sampling adequacy test which confirmed that the sample of 100 was sufficient to carry out the statistical analysis for the present study. Data was collected by administering Edinburgh Postnatal Depression Scale. SPSS-23 was used for data analysis. The study has been completed in one year, from October, 2017 to November, 2018. Results indicated prenatal anxiety has significant positive correlation with prenatal depression (p< .001), postnatal anxiety (p< .001) and postnatal depression (p< .001). The prenatal depression has significant positive correlation with postnatal anxiety (p< .001) and postnatal depression (p< .001). Results also indicated that postnatal anxiety has significant positive correlation with postnatal depression (p< .001). In this study, findings suggested that there is significant relationship between prenatal and postnatal psychiatric symptoms.

This study investigated how personality traits are related to postnatal depression 2 weeks after giving birth and whether these relations are mediated by postnatal anxiety, measured after 3–4 days after giving birth and moderated by the type of birth. New mothers (N = 672, Mage = 29.33) completed scales assessing their personality traits, postnatal anxiety, and postnatal depression 3 or 4 days after giving birth (T1). They also reported postnatal depression 2 weeks after giving birth (T2). Path analysis indicated that postnatal anxiety explained the link between personality traits (i.e., neuroticism) and postnatal depression 2 weeks after childbirth. The type of birth moderated the relation among, personality traits, postnatal anxiety and depression. Neuroticism and consciousness, in the natural birth’s group, and neuroticism and agreeableness, in the cesarean birth’s group, were associated with postnatal depression. Further, anxiety explained the relation between neuroticism and postnatal depression in both natural and cesarean birth groups. In addition, postnatal anxiety mediated the relation between extraversion and postnatal depression in the cesarean birth group. Our findings highlight that postnatal anxiety is a potential mechanism explaining how personality traits (i.e., neuroticism, extraversion) are related to postnatal depression, and that these relations may depend on the type of childbirth.

IntroductionExisting evidence regarding the association between hypertensive disorders of pregnancy (HDP) and the risk of maternal mental illness is inconclusive.ObjectivesThis study aimed (i) to investigate the relationship between HDP (pre-eclampsia and gestational hypertension) and the risk of depressive and anxiety symptoms during pregnancy and in the postpartum period and (ii) to test whether parity moderates the association between HDP and antenatal and postnatal anxiety and depressive symptoms.MethodsThe study cohort consisted of more than 8500 mothers who participated in the Avon Longitudinal Study of Parents and Children (ALSPAC), UK. Maternal antenatal and postnatal depressive and anxiety symptoms were assessed using the Edinburgh Postnatal Depression Scale (EPDS) and the Crown-Crisp Experiential Index (CCEI), respectively. Univariable and multivariable logistic and linear regression analyses were used to examine the associations.ResultsMothers with pre-eclampsia had a 53% (aOR= 1.53; 95% CI, 1.06-2.23) increased risk of antenatal depressive symptoms compared with those without pre-eclampsia. Having pre-eclampsia and being a nulliparous woman resulted in a 2.75 fold increased risk of antenatal depressive symptoms (p-value for interaction = 0.03). Gestational hypertension was associated with antenatal depressive and anxiety symptoms. We found no associations between pre-eclampsia and/or gestational hypertension and postnatal anxiety and depressive symptoms.ConclusionsOur study showed that mothers with HDP were at higher risk of antenatal depressive and anxiety symptoms. Nulliparous women with pre-eclampsia are a higher risk group for depression during pregnancy.DisclosureNo significant relationships.