Edinburgh Depression Scale Research Articles

The effect of curcumax on postpartum women's depression: a randomized controlled trial.

Postpartum depression is a major psychiatric disorder that affects the mother-baby attachment and may impair cognitive development of the child. This study aimed to evaluate the effect of curcumax (including ginger, turmeric, and black pepper) on postpartum depression in reproductive-aged women. This was a randomized controlled trial in which 124 women were recruited and randomly assigned into two groups of curcumax (n=62) and placebo (n=62) who consumed curcumax or placebo for 8 weeks (one capsule each day). Postpartum depression was measured using Edinburgh Depression Scale. Data were analyzed using Chi-square, independent t-test, and GEE. The mean (SD) score of depression score was 15.83 (2.77) and 15.45 (2.97) before intervention, which reduced to 3.48 (4.29) and 7.22 (3.98) in the intervention and control groups, respectively after 4 weeks (p<0.0001). After eight weeks of intervention, these scores reduced to 1.72 (3.30) and 5.85 (3.67) in the intervention and control groups, respectively (p<0.0001). The results of this study showed that curcumax significantly reduced the mean score of postpartum depression among reproductive-aged women. Because it is the first time this herb was used as an anti-depressant, its effective dose was not available. Therefore, further studies with higher doses of this herb are recommended. https://irct.behdasht.gov.ir/search/result?query=IRCT20210822052254N1, identifier IRCT20210822052254N1.

The influence of assisted reproductive technologies-related stressors and social support on perceived stress and depression

BackgroundWhile assisted reproductive technologies (ART) have helped many people experiencing infertility become pregnant, the ART process can take a psychological toll. This study examined whether and how perceived stress- and depression-related symptoms vary among individuals at different stages of the infertility and ART process, and whether ART-specific stressors and emotional support are associated with mental health symptomatology.MethodsData were collected using an online REDCap survey administered between July 2021 and March 2022. The survey was administered to 240 participants who had experienced infertility, including those who had not yet accessed ART, those undergoing ART but who were not yet pregnant, those currently pregnant through ART, and those who had given birth in the last year through ART. Each participant completed the Cohen Perceived Stress Scale (range 0–40) and the Edinburgh Depression Scale (range 0–30). Participants who had undergone ART were asked about their experience of ART-specific stressors and how helpful partner and provider support had been during the ART process. Survey data were analyzed using ANOVA and multivariate linear regressions.Results88% of participants reported medium or high levels of perceived stress, and 43.8% of respondents showed probable indications of depression. Perceived stress and depression symptoms were significantly higher for individuals currently undergoing, but not yet pregnant from, ART treatments. These effect sizes were substantial; for example, depression scores in this group were five points higher than among currently pregnant individuals and nine points higher than among postpartum individuals. For the subset of participants who had used or were currently undergoing ART (N = 221), perceived social stigma and the physical and time demands of ART were significantly associated with higher stress and depression symptoms, while partner emotional support was associated with lower perceived stress.ConclusionsThe ART process exacerbates perceived stress and depression symptoms among individuals experiencing infertility. Given the potential long-term impacts on both parent and child wellbeing, clinicians and policymaking groups, including the American Society for Reproductive Medicine (ASRM), should consider making access to mental health services a standard of care during infertility treatment.

Association between maternal depression symptoms and child telomere length

The biological mechanisms that explain how adverse early life events influence adult disease risk are poorly understood. One proposed mechanism is via the induction of accelerated biological aging, for which telomere length is considered a biomarker. We aimed to determine if maternal depression pre- and post-partum was associated with telomere length in children at 4 years of age (n = 4299). Mothers completed structured questionnaires assessing depression during pregnancy (Edinburgh Depression Scale), at 9 months (Edinburgh Depression Scale), and at 54 months postpartum (Patient Health Questionnaire 9). Regression methods were used to investigate the relationship between telomere length (DNA from saliva) and maternal depression score recorded at each stage. Significant covariates included in the final model were: maternal age at pregnancy; child sex; child ethnicity; gestational age group, and rurality group. Child telomere length was found to be longer if their mother had a higher depression score at both postpartum time points tested (9 months of age; coefficient 0.003, SE = 0.001, P = 0.01, 54 months of age; coefficient 0.003, SE = 0.002, P = 0.02). Although these findings seem paradoxical, increased telomere length may be an adaptive response to early life stressors. We propose several testable hypotheses for these results and to determine if the positive association between depression and telomere length is a developmental adaptation or an indirect consequence of environmental factors.

Potentially modifiable risk and protective factors affecting mental and emotional wellness in pregnancy.

Impaired mental and emotional wellness often co-occurs with prenatal substance use, and both affect infant socio-emotional, cognitive, language, motor, and adaptive behavioral outcomes. Guided by the modified biopsychosocial framework, this study examined the role of common substance exposures during pregnancy (i.e., alcohol and cannabis), socio-cultural factors (social support during pregnancy, adverse childhood experiences), and reproductive health factors on maternal mental health (MMH). Data were obtained from a prospective cohort study-Ethanol, Neurodevelopment, Infant, and Child Health (ENRICH-2), and included 202 pregnant persons. Alcohol and cannabis exposures were assessed through repeated prospective interviews and a comprehensive battery of drug and ethanol biomarkers. MMH outcomes were evaluated during the third trimester through the Perceived Stress Scale, Edinburgh Depression Scale, Generalized Anxiety Disorders-7, and Post-traumatic Stress Disorder Checklist for Diagnostic and Statistical Manual of Mental Disorders. Univariate and multivariable linear regression models evaluated significant predictors of MMH. Results of multivariable analysis indicate that both maternal adverse childhood experiences and alcohol exposure, even at low-to-moderate levels, during pregnancy were associated with poorer scores for most MMH measures, while higher level of social support and Spanish as the primary language at home (as a proxy of enculturation) had protective effects (all p's < 0.05). These findings highlight the importance of assessing substance use, including periconceptional alcohol exposure, and mental health in pregnant persons as closely related risk factors which cannot be addressed in isolation. Our findings also emphasize a strong protective effect of socio-cultural factors on maternal mental and emotional wellbeing-a strong precursor to maternal-infant bonding and infant neurodevelopment.

Individual and joint effects of prenatal PM2.5 and maternal stress on child temperament

Prenatal fine particulate matter (PM2.5) and maternal psychological functioning have been associated with child cognitive outcomes, though their independent and joint impacts on earlier behavioral outcomes remains less studied. We used data from 382 mother-child pairs from a prospective birth cohort in Mexico City. Temperament was measured at 24 months using the Carey Toddler Temperament Scale (TTS). Exploratory factor analysis (EFA) was used to update the factor structure of the TTS. During pregnancy, mothers completed the Crisis in Family Systems-Revised, Edinburgh Depression Scale, pregnancy-specific anxiety scale, and the Perceived Stress Scale. Pregnancy PM2.5 was assessed using estimates from a satellite-based exposure model. We assessed the association between prenatal maternal stress and PM2.5 on temperament, in both independent and joint models. Quantile g-computation was used to estimate the joint associations. Models were adjusted for maternal age, SES, education, child sex, and child age. In EFA, we identified three temperament factors related to effortful control, extraversion, and negative affect. Our main results showed that higher levels of PM2.5 and several of the maternal psychological functioning measures were related to both effortful control and negative affect in the child, both individually and as a mixture. For instance, a one quartile increase in the prenatal mixture was associated with higher negative affect scores in the child (0.34, 95% CI: 0.16, 0.53). We observed modification of these associations by maternal SES, with associations seen only among lower SES participants for both effortful control (−0.45, 95% CI: -0.70, −0.20) and negative affect outcomes (0.60, 95% CI: 0.35, 0.85). Prenatal PM2.5 and maternal psychological functioning measures were associated with toddler temperament outcomes, providing evidence for impacts of chemical and non-chemical stressors on early child health.

Physical Activity in Work and Leisure Time during Pregnancy, and Its Influence on Maternal Health and Perinatal Outcomes

Background: Physical inactivity during pregnancy has been shown to be linked to an increased risk of complications. However, during pregnancy, doubts arise about what type, intensity and frequency of physical activity are most recommended. Objective: Our main objective was to know the level of physical activity (PA) and sedentary lifestyle in a representative sample of pregnant women in Málaga, one of the most populated cities in Spain. Also, we aimed to find out the effects of PA on obstetric and perinatal outcomes and on the mental health of pregnant women, differentiated according to PA intensity and domain. Methods: Five hundred and forty full-term pregnant women who had their obstetric checks in the maternity ward of the Regional University Hospital of Málaga were recruited through consecutive sampling. Participants answered a questionnaire that included the WHO Global Physical Activity Questionnaire (GPAQ), the Edinburgh Depression Scale (EDS), the Generalized Anxiety Disorder Scale (GAD-7) and some other sociodemographic and health-related questions. Subsequently, information about perinatal outcomes was obtained after birth. Results: Only 50.8% of women followed the WHO recommendations on activity. We found a high proportion of obese pregnant women and a direct effect of a sedentary lifestyle on the rate of cesarean sections and vulvovaginal tears in spontaneous births, as well as on the mental health of future mothers. Women’s age, the number of children, BMI at the beginning of pregnancy and leisure time physical activity (LTPA) explained anxiety scores, and age, LTPA, BMI at the end of pregnancy and intense work-related physical activity (WTPA) predicted depression scores. Conclusions: LTPA improves obstetric outcomes, helping to reduce the rate of cesarean sections and vulvovaginal tears, as well as reducing prenatal anxiety and depression.

Maternal depressive symptoms during pregnancy and infant wheezing up to 2 years of age

To determine whether maternal depressive symptoms at multiple time points during pregnancy are associated with infant wheezing in the first 2 years of life to assess etiologically relevant time windows. We included Dutch women participating in the PRIDE Study with delivery in 2013-2019. Maternal depressive symptoms were assessed with the Hospital Anxiety and Depression Scale and Edinburgh Depression Scale at enrollment and in gestational weeks 17 and 34. The International Study of Asthma and Allergies in Childhood questionnaire was used to assess infant wheezing biannually postpartum. Adjusted risk ratios (RRs) and 95% confidence intervals (CIs) were estimated with modified Poisson regression. Among 5294 pregnancies included, maternal depressive symptoms in gestational weeks 15-22 was associated with any wheezing in the first 2 years of life (RR 1.36, 95% CI 1.04-1.78) and with current wheezing at 12 (RR 1.29, 95% CI 1.03-1.61) and 18 months (RR 1.33, 1.04-1.69). Depressive symptoms in gestational weeks 32-35 seemed to be associated with any wheezing reported at two years (RR 1.27, 95% CI 0.96-1.69) and current wheezing at 12 months (RR 1.28, 95% CI 1.02-1.60). Four trajectories of depressive symptoms were identified. Only the trajectory with increasing symptoms throughout pregnancy seemed to be associated with infant wheezing (RR 1.36, 95% CI 0.97-1.89). Maternal depressive symptoms in mid- and late pregnancy may be associated with development of infant wheezing, particularly those with onset in the second half of pregnancy. Research is needed to identify biological pathways and associations with more objective, long-term respiratory morbidity.

Social media use as a risk factor for depressive symptoms during pregnancy

BackgroundAccumulating research has shown associations between excessive social media use (SMU) with depressive symptoms. Depression is common during pregnancy, but it is not known whether SMU plays a role in the etiology and clinical course of depressive symptoms during pregnancy. MethodsThe current study is a prospective cohort study with Dutch-speaking pregnant women recruited at the first antenatal appointment (N = 697). Depressive symptoms were measured at each trimester of pregnancy using the Edinburgh Depression Scale. Growth mixture modeling was used to determine classes of women based on longitudinal trajectories of depressive symptoms. SMU was assessed at 12 weeks of pregnancy, specifically, intensity (time and frequency) and problematic SMU (Bergen Social Media Addiction Scale). Multinomial logistic regression analyses were used to examine the associations between SMU and trajectories of depressive symptoms. ResultsThree trajectories of depressive symptoms during pregnancy were identified: a low stable (N = 489, 70.2 %), intermediate stable (N = 183, 26.3 %), and high stable (N = 25, 3.6 %) class. SMU Time and Frequency were significantly associated with belonging to the high stable class. Problematic SMU was significantly associated with belonging to the intermediate or high stable class. LimitationsThe study does not allow to draw conclusions about causality. The group sizes of the three trajectories differed considerably. Data were collected during the COVID-19 pandemic which may have influenced the results. SMU was measured by self-report. ConclusionsThese results indicate that both higher intensity of SMU (time and frequency) and problematic SMU may be a risk factor for higher levels of prenatal depressive symptoms during pregnancy.

Urban stress and its association with symptoms of depression, fatigue, and sleep disruption in women in Mexico City

ABSTRACT Women in urban neighborhoods often face disproportionately higher levels of environmental and social stressors; however, the health effects from urban stressors remain poorly understood. We evaluated the association between urban stress and depression, fatigue, and sleep disruption in a cohort of 460 women in Mexico City. To assess urban stress, women were administered the Urban Annoyances scale. Six constructs were summarized to create an overall index. Depressive symptoms were assessed using the Edinburgh Depression Scale; the Patient-Reported Outcomes Information System scales were used to assess sleep disruption and fatigue. Linear regression models were used to estimate the association with continuous symptoms comparing women with high stress to those with lower levels. Models were adjusted for socioeconomic status, education, age, social support, and previous depressive symptoms. High urban stress was associated with greater depressive symptoms (β: 1.77; 95% CI: 0.83, 2.71), fatigue (β: 2.47; 95% CI: 0.87, 4.07), and sleep disruption (β: 2.14; 95% CI: 0.54, 3.73). Urban stress plays an important role in women’s psychological and physical health, highlighting the importance of including these measures in environmental health studies. Urban interventions, such as promoting alternative transport options, should additionally be addressed to improve health of urban populations.

Validation of the Mexican version of the Schedule of Attitudes Toward Hastened Death in patients undergoing palliative care in Mexico.

The Schedule of Attitudes Toward Hastened Death (SAHD) has emerged as a valid and reliable tool to assess the wish to hasten death (WTHD) among patients diagnosed with advanced cancer; however, the instrument has never been culturally adapted and validated for patients in Mexico. This study sought to validate and abbreviate the SAHD tool for use among patients attending the Palliative Care Service of the Instituto Nacional de Cancerología in Mexico. The SAHD was culturally adapted from a previously published validation in patients from Spain. Eligible patients included Spanish literate subjects treated as outpatients in the Palliative Care Service, with an Eastern Cooperative Oncology Group (ECOG) performance status of 0-3. Patients were asked to answer the Mexican version of SAHD (SAHD-Mx) instrument and the Brief Edinburgh Depression Scale (BEDS). A total of 225 patients were included in the study. Median positive response in the SAHD-Mx was 2 (range 0-18). Positive correlation was identified between the SAHD-Mx scale and ECOG performance status (r=0.188, p=0.005), as well as BEDS (r=0.567, p<0.001). SAHD-Mx displayed strong internal consistency (alpha=0.85) and adequate reliability from test-retest phone interviews (r=0.567, p<0.001). Using the confirmatory factor analysis model, a factor was identified and the number of items was reduced to 6, including items 4, 5, 9, 10, 13, and 18. The SAHD-Mx emerges as an adequate tool, with appropriate psychometric characteristics, for assessing WTHD among patients diagnosed with cancer undergoing palliative care in Mexico. .

Antenatal depression risk under the NSW SAFE START Strategic Policy: Who is missing out on universal screening?

To examine antenatal depression risk screening coverage under the NSW SAFE START Strategic Policy and to explore maternal and sociodemographic factors associated with under-screening. Completion rates for the Edinburgh Depression Scale (EDS) were examined in a retrospective dataset of routinely collected antenatal care data including all women who birthed at public health facilities in Sydney Local Health District from 1 October 2019 to 6 August 2020. Potential sociodemographic/clinical factors associated with under-screening were identified using univariate and multivariate logistic regression. Free-text responses regarding reasons for EDS non-completion were examined using qualitative thematic analysis techniques. A total of 4810 women (96.6%) in our sample (N = 4980) completed antenatal EDS screening; only 170 (3.4%) were not screened or lacked data to indicate that screening had occurred. Multivariate logistic regression analyses showed that women under certain models of antenatal care (public hospital care, private midwife/obstetrician or no formal care), non-English speaking women who required an interpreter, and women whose smoking status during pregnancy was unknown had a higher odds of missing screening. The reasons for EDS non-completion indicated in the electronic medical record revealed language and time/practical constraints to be the most commonly-reported barriers. Antenatal EDS screening coverage was high in this sample. Refresher training for staff involved can emphasise the need to ensure appropriate screening for women who access shared care in external services (particularly private obstetric care). Additionally, at the service level, improved access to interpreter services and foreign language resources may help minimise EDS under-screening for culturally and linguistically diverse families.

Online mindfulness-based intervention for women with pregnancy distress: A randomized controlled trial

BackgroundPregnancy distress among childbearing women is common and can negatively affect both mother and infant. Mindfulness-based interventions (MBIs) may have a positive effect on pregnancy distress but randomized controlled trials with sufficient power are lacking. The current study examined the effectiveness of an online self-guided MBI in pregnant women with pregnancy distress. MethodsPregnant women with elevated pregnancy distress levels at 12 weeks of pregnancy, measured with the Edinburgh Depression Scale (EDS) and Tilburg Pregnancy Distress Scale negative affect (TPDS-NA), were randomized into an intervention group (online MBI, N = 109) or control group (care as usual, N = 110). The primary outcome was the change in pregnancy distress post-intervention and at eight-weeks-follow-up. Secondary outcomes were mindfulness skills (Three Facet Mindfulness Questionnaire-Short Form), rumination (Rumination-Reflection Questionnaire), and self-compassion (Self-Compassion Scale-Short Form) at post-intervention and follow-up in the intervention group. ResultsSignificant improvements were found in pregnancy distress scores, but no significant differences between intervention and control group appeared. The MBI group showed improvements in mindfulness skills, rumination, and self-compassion. LimitationsLow adherence to the intervention and assessment of secondary outcome measures in the intervention group only. ConclusionsAn intervention trial with one of the largest samples (N = 219) provided no evidence of a significant effect of an online self-guided MBI in distressed pregnant women. An online MBI may be associated with an improvement in mindfulness skills, rumination, and self-compassion. Future research should address the effectiveness of MBI's with different formats (online and group-based combined) and examine a possible delayed effect. Trial registrationClinicalTrials.gov: NCT03917745, registered on 4 March 2019.

Pregnancy- and Birth-Related Experiences among Postpartum Women during the Third Wave of the COVID-19 Pandemic—A Multinational European Study

The objective of this study was to describe pregnancy- and birth-related experiences of postpartum women during the third wave of the COVID-19 pandemic and their association with mental health outcomes. An online questionnaire was distributed in five European countries (Belgium, The Netherlands, Norway, Switzerland, UK) between June and August 2021. Participants were recruited though social media platforms including pregnancy- and motherhood-related websites, pregnancy fora, and apps. Postpartum women were asked eleven specific questions about pregnancy- and birth-related changes and the presence of support during delivery. The Edinburgh Depression Scale was used to assess depressive and anxiety symptoms. Covariates included sociodemographics, health and reproductive characteristics, and COVID-19 status. Associations were estimated with logistic regression. The study included 1730 postpartum women. Frequent changes included the exclusion of the partner from pregnancy care appointments (83.2%), changed prenatal care settings (64.4%), and cancellation of hospital information visits (42.7%). Few women, however, were without support apart from medical staff during delivery (1.4%). The number of pregnancy- and birth-related changes was associated with each woman’s mental health status, as well as the type of change. Experiencing changes related to delivery and cancellation or reduction of prenatal examination was associated with a doubling in the odds of symptoms of major depression and anxiety postpartum. These findings highlight the importance of ensuring adequate maternity care for women’s mental health postpartum, as well as during a pandemic.

Exploring the psychological wellbeing of women with gestational diabetes mellitus (GDM): increased risk of anxiety in women requiring insulin. A Prospective Longitudinal Observational Pilot Study

ABSTRACT Introduction Gestational diabetes mellitus (GDM) complicates ∼16% of pregnancies in Australia and has significant implications for health of both mother and baby. Antenatal anxiety and depression are also associated with adverse pregnancy outcomes. The interaction between GDM and mental health in pregnancy is poorly understood. With the aim of exploring the nuanced interaction between GDM and mental health further, we investigated whether GDM treatment modality (diet versus insulin) influenced psychological wellbeing in women with GDM. Methods Psychological wellbeing was assessed in women with GDM treated with diet (GDM-Diet, n = 20) or insulin (GDM-Insulin, n = 15) and pregnant women without GDM (non-GDM, n = 20) using questionnaires [Edinburgh Depression Scale (EDS), State-Trait Anxiety Inventory (STAI-6), and in women with GDM, Problem Areas in Diabetes (PAID)] at 24–34 weeks gestation and again at ∼36 weeks gestation. Results Women in the GDM-insulin group had significantly higher levels of anxiety than the non-GDM group at both time points. Women in the GDM-Diet group had higher levels of anxiety at 24–34 weeks gestation than the non-GDM group but did not differ at ∼36 weeks gestation. Although depression scores tended to be higher in GDM-Insulin and GDM-Diet groups than in the non-GDM group at both time points, this was not statistically significant. Diabetes-related distress was similar in the GDM-Diet and GDM-Insulin groups at both time points and did not change during pregnancy. A high proportion of the GDM-Insulin group had past/current mental illness (60%). Conclusions In this pilot study GDM was associated with differences in psychological wellbeing, specifically increased anxiety in women treated with insulin. Specialised interventions to support women with GDM should be considered, especially those requiring insulin. Trial registration: Not applicable as this was a purely observational study.

Mental health of pregnant and postpartum women during the third wave of the COVID-19 pandemic: a European cross-sectional study

ObjectiveTo describe the mental health of perinatal women in five European countries during the third pandemic wave and identify risk factors related to depressive and anxiety symptoms.DesignA cross-sectional, online survey-based...

Dấu hiệu trầm cảm và một số yếu tố liên quan ở phụ nữ mang thai tại bệnh viện Phụ sản Hà Nội

Objectives: Evaluated depressive symptoms in pregnant women and identified risk factors during the COVID-19 pandemic. Methods: A cross-sectional study was conducted in Hanoi Obstetrics and Gynecology hospital collecting data from November 2021 to March 2022, using a structured questionnaire among 444 pregnant women. Edinburgh Depression Scale was used to assess antenatal depression. Anxiety and social support were investigated by the PROMIS Anxiety Adult, and Multidimensional Scale of Perceived Social Support, respectively. A multivariate logistic regression model was used to determine related factors for antenatal depression. Main findings: 68.2% of participants reported antenatal depressive symptoms. Risk factors were previous stillbirth, current gynecological diseases, and antenatal anxiety. While higher levels of social support, later trimester, higher educational levels were associated with lower psychological symptoms. Conclusions: We emphasized the importance of implementing formal screening programs to detect antennal depression early and encourage the support from family and friends for expected mother during pregnancy. Keywords: Depression, pregnancy, pregnant women, COVID-19.

Women's Participation in a Savings Group and Depression: a Community-Based Financial Capability Intervention in Mozambique.

As one of the fastest growing community-based financial capability approaches, village savings and loan group (VSLG) is an organized group and formal entity that creates opportunities for participants to save and access financial assets. VSLG has potentially positive impacts on increasing women's financial resources and social support and further improves their mental health. Participation in a VSLG not only increases women's opportunities for asset-building and income generation, but also facilitates trust and promotes social capital development. However, few studies have examined the association between the VSLG participation and women's depression status. To fill the knowledge gap, we examined the association between the VSLG participation and depressive symptoms among low-income women in Mozambique. The data was collected as part of the VSLG program evaluation. The study applied a posttest-only comparison group quasi-experimental design and sampled female VSLG participants and non-participants from three sub-villages in the Sofala province, Mozambique. A multi-stage sampling technique was employed, and a total of 205 women were randomly selected, including 105 VSLG participants and 100 non-participants. Depressive symptoms were measured using the short version of the Edinburgh Depression Scale (EDS) with a summative score ranging from 7 to 28. Using the cutoff value at a score of 14, we created a dichotomous depression indicator. Linear and logit models were used to examine the associations of the VSLG participation and the participation duration with the depression score and the presence of depression controlling for demographic variables. The VSLG participants had a statistically lower mean depression score of 12.2 (SD = 4.4) compared to non-participants (15.0, SD = 4.0, p < .001). The regression analysis suggested that the VSLG participants had a mean depression score of 2.7 lower than the non-participants (p < .001). Nearly 60% of the non-participants reported the presence of depression; however, this percentage is 31% for participants (p < .001). The multivariate logit model indicated the odds of the presence of depression for participants are .34 of that for non-participants. Similar results were obtained when the VSLG program duration was used as an independent variable. Study findings showed a positive association between the VSLG participation and women's mental health. Future research should further explore the intervention mechanisms and assess how the VSLG participation affects women's mental health. Findings also provided important insights into developing community-based financial capability interventions to improve low-income women's mental health.

Antenatal diet quality and perinatal depression: the Microbiome Understanding in Maternity Study (MUMS) cohort.

Previous findings from research investigating the role of antenatal nutrition in preventing postpartum depression (PPD) are inconsistent. Our primary aim was to investigate the association between pregnancy diet quality and PPD. Our secondary aim was to investigate associations between (a) diet quality and depression during pregnancy and (b) depression during pregnancy and PPD. This analysis represents data from 73 women participating in the Microbiome Understanding in Maternity Study (MUMS) cohort in Sydney, Australia, which followed women from Trimester 1 of pregnancy to 1-year postpartum (PP). Participants' diet quality was assessed using the Australian Eating Survey at Trimester 1 and 3 to calculate diet quality, known as the Australian Recommended Food Score (lower diet quality defined as score <39; higher diet quality ≥39). Depression was assessed using the Edinburgh Depression Scale at Trimesters 1, 2, 3 and 6 weeks PP (defined as score ≥11). Depression scores during pregnancy were significantly associated with depression score 6 weeks PP (Trimester 1: r = 0.66, Trimester 2: r = 0.69, Trimester 3: r = 0.67; all p < 0.001). Diet quality during pregnancy was not significantly correlated with 6-week PPD score. In unadjusted analysis, diet quality during pregnancy was not associated with pregnancy depression scores. When adjusted for age, parity and Trimester 1 body mass index, Trimester 1 physical activity levels and gestational weight gain, higher Trimester 3 diet quality was associated with reduced Trimester 3 depression only. Depression scores during pregnancy were positively associated with PPD, highlighting the importance of screening for depression during pregnancy and postnatally. Larger longitudinal prospective studies may elucidate the association between diet quality and PPD.

Hypothyroid Symptoms Throughout Pregnancy Are Predominantly Associated with Thyroxine and Not with Thyrotropin Concentrations.

Background: It is unclear whether levels of hypothyroid symptoms in pregnant women with (sub)clinical thyroid dysfunction differ from euthyroid controls and whether free thyroxine (fT4)/thyrotropin (TSH) changes throughout pregnancy affect hypothyroid symptom levels. The objective was twofold: (1) To compare hypothyroid symptom levels between thyroid dysfunction subgroups and a carefully defined reference group; (2) to assess the association between fT4/TSH changes throughout pregnancy and hypothyroid symptom levels adjusted for depressive symptoms. Methods: The current study was a longitudinal prospective cohort study in 1800 healthy pregnant women. At each trimester of pregnancy, hypothyroid symptoms were assessed with a 12-item symptom hypothyroidism checklist and depressive symptoms with the Edinburgh Depression Scale. Thyroid dysfunction was defined using the 2.5-97.5th fT4/TSH percentile of thyroid peroxidase antibodies-negative women. Euthyroid controls consisted of women with appropriate fT4 levels within the 10-90th percentile and with a normal TSH level. Hypothyroid symptom mean scores were compared between controls and several thyroid dysfunction subgroups. Growth mixture modeling was performed to evaluate possible longitudinal trajectories of hypothyroid and depressive symptoms. The association between hypothyroid symptom trajectories (adjusted for depression) and fT4/TSH changes was assessed with multivariate logistic regression analysis. Results: Women with overt hypothyroidism (fT4 < 2.5th, TSH >97.5th) and hypothyroxinemia (fT4 < 2.5th, TSH: 2.5-97.5th) showed higher hypothyroid symptom levels compared with the euthyroid controls and women with subclinical hypothyroidism (SCH, fT4: 2.5-97.5th, TSH >97.5th), because 82% of these SCH women had fT4 levels in the euthyroid range. Two groups of hypothyroid and depressive symptoms were defined: a persistently low and persistently high symptom group. fT4 decreased in 98% of the women from the first to third trimester and per unit pmol/L fT4 decrease (not TSH increase), the likelihood to present persistently high hypothyroid symptoms increased with 46%, adjusted for depression. Conclusions: A properly defined euthyroid control group distinguishes women with hypothyroid symptoms. An fT4 decrease toward end term is associated with persistently high hypothyroid symptom levels. Clinicians should be aware of the importance of fT4 stratification in SCH women.

O58 - Symptoms of depression in parents after discharge from NICU associated with family-centred care

In 2018 to 2020, a multicentre cohort study was conducted in 23 NICUs across 15 countries. The aim of this study was to examine the potential association of family-centred care as perceived by parents during a NICU stay with parents’ depressive symptoms at discharge and at 4 months corrected for infant age. Parents ( n = 635 mothers, n = 466, fathers) of infants ( n = 739) born before 35 weeks of gestation and admitted to the participating NICUs were enrolled to the study during the first weeks of their infants’ hospitalisations. Parents’ perception of family-centred care in the NICU was assessed using the Digi-FCC (parent-version) tool with daily text messages and a questionnaire at discharge. Parent’s perception of depressive symptoms was also assessed using the Edinburgh Depression Scale: first at discharge and secondly when infants reached 4-months of corrected age. After controlling for gestational age, multiple birth, parent education and relationship status: an association was found between mothers’ and fathers’ perception of family-centred care, and their depressive symptoms at and after discharge. Parent perceptions of family-centred care was influenced by their ability to participate and make decisions about infant care, by the emotional support provided by staff members, and by other factors such as parental amenities and unlimited access for parents and significant others. Our study shows that family-centred NICU care associates with parents’ depressive symptoms after a NICU stay. Depression is common in parents of preterm infants. The provision of family-centred care may protect the mental well-being of parents of preterm infants.