Maternal Mood Research Articles

Parental Depression Screening in Pediatric Health Care Settings: A Scoping Review.

Parental depression affects as many as 1 in 5 US families. Pediatric professionals can play an important role in detecting parental depression, yet most studies on parental depression screening focus only on the postpartum period. The authors performed this scoping review to understand the existing literature on parental depression screening outside the postpartum period (child >12 months old) and to identify knowledge gaps. Sources for this research include PubMed, CINAHL, SCOPUS, Web of Science, and APA Psych Info. We included English language papers concerning screening for maternal and/or paternal depression or mood disorders outside of the postpartum period by pediatric clinicians or in a pediatric health care setting. Extracted variables included publication year, title, author(s), country, geographic setting, clinical setting, child age range (in years), parental focus, sample size, study type, approach, screening instrument(s), and findings. Forty-one papers were included. The proportion of positive parental depression screens was consistently high across the included studies. Relatively few structured screening programs outside of the postpartum period were identified, especially for fathers. The included studies suggest that screening can be accomplished in pediatric settings, but appropriate referral and follow-up of positive screens poses a major challenge. This review was limited to English language papers concerning parental depression outside of the postpartum period. These findings suggest that screening for parental depressive symptoms outside the postpartum period could identify families in need of support. Research is required to identify best practices for referral and follow-up of parents who screen positive.

Prevalence of Perinatal Depression and Anxiety in Both Parents

New and expectant parents experience perinatal mood disorders, with consequences to parenting ability, bonding with the neonate, interpersonal relationships, and health and well-being of parents. Research shows that maternal and paternal perinatal mood disorders are associated, but no recent systematic review has addressed the prevalence of perinatal mood disorders in both mothers and fathers (parental dyad). To examine the prevalence of perinatal mood disorders in parental dyads and identify factors associated with perinatal mood disorders in parental dyads. Ovid (MEDLINE, Embase, and PsycINFO) and Web of Science were searched from January 1, 1990, to June 8, 2021, for observational studies reporting on the prevalence of perinatal depression or anxiety in a parental dyad. Studies reporting the prevalence of anxiety or depression in both members of a parental dyad were included, with diagnosis according to established criteria (Diagnostic and Statistical Manual of Mental Disorders [Fifth Edition], International Classification of Diseases, 11th Revision) or use of validated screening tools. Prevalence data were extracted in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Data were analyzed in subgroups: antenatal depression, early postnatal depression (0-12 weeks), late postnatal depression (3-12 months), and perinatal anxiety. Pooled prevalence was calculated using a random-effects meta-analysis model. Quality assessment was performed using Joanna Briggs Institute Appraisal Checklist for Studies Reporting Prevalence Data. Data were analyzed in June 2021. Prevalence of perinatal anxiety and perinatal depression in parental dyads. Twenty-three studies were included, with data from 29 286 couples. The pooled prevalence of antenatal depression in both parents was 1.72% (95% CI, 0.96%-2.48%; P < .001). The prevalence of early postnatal depression (up to 12 weeks post partum) was 2.37% (95% CI, 1.66%-3.08%; P < .001) and the prevalence of late postnatal depression (3-12 months post partum) was 3.18% (95% CI, 2.3-4.05; P < .001). Only 3 studies reported on perinatal anxiety in both parents, precluding a quantitative analysis. In up to 3.18% of couples, both parents may concurrently experience perinatal depression. Perinatal health care must consider the mental health needs of parents, both as individuals and as a parental dyad. Further research is needed to examine outcomes in families where both parents experience perinatal mood disorders.

“Hey child, why were you born when the world is almost over?”: An analysis of first-time mothers’ postpartum experiences during the early stages of the COVID-19 pandemic in Coatepec, Veracruz, Mexico

IntroductionIn Coatepec, Mexico, the immediate postpartum is considered a special time, called the cuarentena, when postpartum women receive critical social support and observe diet and activity pre- and proscriptions—all intended to enhance maternal-child health. This study examined how public health mandates aimed at containing COVID-19, which instructed people to socially isolate, affected women’s postpartum experiences, including observing the cuarentena.MethodsWe recruited first-time mothers from the local public health clinic and collected qualitative data via a verbally administered survey that covered knowledge/perceived threat of COVID-19 and its effect on the cuarentena and maternal mood. We used content analysis to analyze the data.ResultsWe conducted 33 telephonic interviews from March to December 2020. Overall, women were knowledgeable about and receptive to public health messaging regarding COVID-19 risks and safety measures. Despite knowledge and receptivity, most followed their original cuarentena plans to observe culturally prescribed postpartum practices, even when doing so contradicted public health mandates. However, the mandates that limited socialization with friends and extended family during the cuarentena negatively affected maternal mood.DiscussionPostpartum women, especially in under-studied low- and middle-income countries, merit research attention. Emergent from this study is that public health messaging should speak to its target audience in a way that makes sense within local contexts, which includes consideration of highly valued health practices. Future studies aimed at understanding how to achieve this goal will facilitate development of stronger programs that address public health needs and protect individual well-being.

Effect of Narrative Nursing Combined with Thinking Map Health Education on Parturient Self-Efficacy and Neonatal Nursing Ability.

The motivation behind this study is to explore the influence of narrative nursing combined with thinking map health education on parturient self-efficacy and neonatal nursing ability. To verify this claim, we have selected 60 parturients who were treated in the hospital from February 2019 to April 2021. Moreover, these patients were randomly assigned to control and study groups. The former received narrative nursing, and the latter received narrative nursing combined with thinking map health education. The nursing satisfaction, maternal and neonatal nursing ability, maternal health knowledge awareness score, maternal self-efficacy, anxiety, and depression scores were compared. Initially, we have compared the nursing satisfaction: in the study group, 22 cases were satisfied, 8 cases were basically satisfied, and 0 cases were dissatisfied, and the satisfaction rate was 100.00%; in the control group, 12 cases were satisfied, 14 cases were basically satisfied, and 4 cases were dissatisfied, and the satisfaction rate was 86.67%. The nursing satisfaction in the study group was higher compared to the control group (P < 0.05). Secondly, we compared the mastery of neonatal nursing ability. The study group mastered the relevant knowledge of neonatal nursing in 23 cases, basically mastered 6 cases, and did not master 1 case, with a mastery rate of 96.67%. The control group mastered the knowledge of neonatal nursing in 12 cases, basically mastered 10 cases, and did not master 8 cases with a mastery rate of 73.33%. In the comparison between the two groups, the mastery of neonatal nursing ability in the study group was higher compared to the control group (P < 0.05). Considering the scores of maternal health knowledge, the scores of neonatal basic nursing, physiological characteristics, breastfeeding methods, environmental nursing knowledge, vaccination, and physical examination requirements in the study group were higher compared to the control group (P < 0.05). In the comparison of maternal self-efficacy, the total scores for promoting development, health care, safety, feeding, and self-efficacy in the study group were significantly higher compared to the control group (P < 0.05). Finally, we compared the scores for anxiety and depression. Before nursing, there exhibited no significant difference (P > 0.05). After nursing, the anxiety and depression scores decreased. Furthermore, the anxiety and depression scores of the study group were lower compared to the control group (P < 0.05). In the health education of primary parturient, the adoption of narrative nursing combined with thought guiding schema can enhance the level of nursing satisfaction and self-efficacy, strengthen the nursing ability of primiparas and the awareness rate of health knowledge, and reduce the occurrence of a maternal bad mood, which is more in line with the requirements of parturient.

Efficacy of Direct or Indirect Use of Probiotics for the Improvement of Maternal Depression during Pregnancy and in the Postnatal Period: A Systematic Review and Meta-Analysis.

The mother and infant form a unique bond, with maternal mental health affecting the interactions with the infant and infant behaviours impacting maternal mental health. One of the possible mechanisms influencing maternal mental health is the manipulation of the gut-brain axis by consuming probiotic supplements. Probiotics can also have an indirect influence on maternal mental health via the modulation of the infant microbiome and consequently improving the infant’s health and thus, indirectly leading to an improvement in maternal mood. This systematic review evaluated the efficacy of probiotics on maternal mental health by searching for randomised controlled trials via international databases: Cochrane Library, PubMed, Scopus, ScienceDirect, and Web of Science until January 2022. A meta-analysis was performed using the Cochrane Collaboration methodology where possible. We found seven clinical trials that included the word probiotics and addressed maternal depression and/or anxiety. Of these, five trials investigated the influence of maternal probiotic supplementation on the gut-brain axis. Two trials investigated the indirect influence of probiotics on maternal depression via supplementation of probiotics by infants and subsequent influence on the crying of colicky infants. Meta-analysis of two studies of pregnant and postnatal women and two studies of infants consuming probiotics on the outcome of the Edinburgh Postnatal Depression Scale for mothers showed no statistical difference. The findings indicate that maternal depression is very complex and is influenced by various bidirectional factors. One of the factors that can improve maternal mental health is probiotics, however, careful consideration must be given to correct strain selection as strain-specific effectiveness was observed. Further well-designed, robust clinical studies are warranted.

Poor sleep Quality and Obstructive Sleep Apnea are Associated with Maternal Mood, and Anxiety Disorders in Pregnancy.

Previous studies suggest sleep quality and obstructive sleep apnea (OSA) may be associated with psychiatric symptoms, including depression, anxiety, and posttraumatic stress disorder (PTSD). However, few studies have examined the relationship between sleep quality and OSA with maternal psychiatric symptoms during pregnancy, a state of vulnerability to these disorders. The objective of our study is to examine the association between poor sleep quality and sleep apnea with antepartum depression, anxiety, and PTSD among pregnant women. A cross-sectional study was conducted among women seeking prenatal care in Lima, Peru. Sleep quality was measured using the Pittsburgh Sleep Quality Index, and the Berlin questionnaire was used to identify women at high risk for OSA. Depression, generalized anxiety, and PTSD symptoms were measured using the Patient Health Questionnaire-9, Generalized Anxiety Disorder Assessment, and PTSD Checklist - Civilian Version. Multivariate logistic regression procedures were used to estimate adjusted odds ratios (aOR) and 95% confidence intervals (95% CI). Approximately 29.0X% of women had poor sleep quality, and 6.2% were at high risk for OSA. The prevalence of psychiatric symptoms was high in this cohort with 25.1%, 32.5%, and 30.9% of women reporting symptoms of antepartum depression, antepartum anxiety, and PTSD, respectively. Women with poor sleep quality had higher odds of antepartum depression (aOR = 3.28; 95%CI: 2.64-4.07), generalized anxiety (aOR = 1.94; 95%CI: 1.58-2.38), and PTSD symptoms (aOR = 2.81; 95% CI: 2.28-3.46) as compared with women who reported good sleep quality. Women with a high risk of OSA had higher odds of antepartum depression (aOR = 2.36; 95% CI: 1.57-3.56), generalized anxiety (aOR = 2.02, 95% CI: 1.36-3.00), and PTSD symptoms (aOR = 2.14; 95%CI: 1.43-3.21) as compared with those with a low risk of sleep apnea. Poor sleep quality and high risk of OSA are associated with antepartum depression, generalized anxiety, and PTSD symptoms among pregnant women. Further characterizations of the associations of these prevalent sleep, mood, and anxiety conditions among pregnant women could aid in evaluating and delivering optimal perinatal care to women with these comorbidities.

#Body goals or #Bopo? Exposure to pregnancy and post-partum related social media images: Effects on the body image and mood of women in the peri-pregnancy period

Women who are pregnant or have recently given birth use social media where they may encounter content promoting appearance ideals or offering more realistic representations of the body during this unique period. To date, little is known regarding the ways in which different social media content may impact the body image and mood of women who are pregnant or postpartum. A sample of 261 participants aged 21–44, mean (SD) age = 31.79 (4.402), were randomly allocated online to view either thin-and-toned ideal or body positive social media content specific to the pregnancy and postpartum period, or a neutral travel condition. Findings revealed that exposure to the body positive images had positive effects on body image relative to the thin-and-toned ideal condition, as well as leading to increases in some indices of positive body image, while the thin-ideal images were harmful. Partial support emerged for the protective roles of body appreciation and low social media-related rumination among women exposed to the thin-and-toned ideal images. Social media content may be harmful or helpful to the body image and mood of pregnant and postpartum women, which is important given the documented relationships between maternal body image, mood, and maternal and infant outcomes.

A Feasibility Randomized Controlled Trial of a Parenting Intervention Offered to Women With Severe Mental Health Problems and Delivered in a Mother and Baby Unit Setting: The IMAgINE Study Outcomes.

BackgroundApproximately 1–2% of mothers may experience severe mental illness (SMI) requiring admission to an inpatient Mother and Baby Unit (MBU). MBUs aim to provide mental health assessment and treatment and strengthen the mother-infant relationship, essential for infant development. Whilst MBUs offer various interventions, they do not routinely offer structured parenting interventions. The Baby Triple P Positive Parenting Program (BTP) was developed to enhance parenting competence, psychological coping and the quality of partner and other social support. Guided by lived experience consultation, we aimed to determine the feasibility and acceptability of delivering BTP plus Treatment as Usual (TAU) in this setting.MethodA multi-site, parallel-group, single-blind pilot randomized controlled trial (registration: ISRCTN12765736) comparing BTP+TAU to TAU in participants, recruited from two MBUs in England. The Baby Triple P intervention consisted of eight parenting sessions, with the final four being delivered over the telephone following MBU discharge. Feasibility outcomes were participant intervention engagement and study retention. Clinical outcomes including maternal parenting competence, bonding and mental health outcomes were assessed at baseline, post-baseline/intervention (10 weeks) and six-month follow-up. Data were analyzed using descriptive statistics and linear regression models. An economic feasibility analysis was also conducted.ResultsThirty-seven of the 67 eligible participants consented; 34 were randomized (16 to BTP+TAU and 18 to TAU), of whom 20 were retained at post-intervention data collection and 21 at six-month follow-up. Twelve participants (75%) completed the intervention, which was rated as highly acceptable. Clinical outcomes signaled potential improvements in maternal parenting competence, bonding, mood and mental health symptomatology in participants who received the intervention. Healthcare resource use and EQ-5D-5L questionnaires were well-completed by participants. Delivering BTP in this setting is estimated to cost £443-822 per participant.ConclusionsThis is the first trial of a parenting intervention in a MBU setting. BTP is feasible and acceptable to mothers with SMI, with a promising signal for treatment efficacy. Although minor modifications may be required for the collection of observer-rated measures post-MBU discharge, the findings indicate that a larger, definitive trial could be conducted, especially if the setting is extended to include perinatal mental health community settings.

Ontogeny of the Dyad: the Relationship Between Maternal and Offspring Neuroendocrine Function.

We review ontogeny of the maternal-offspring neuroendocrine relationship in human pregnancy. We present bidirectional genetic, physiological, and behavioral influences that enhance or disrupt HPA activity and its end product cortisol at the individual level and within the dyad. Consistent evidence supports that maternal mood and caregiving behavior are associated with maternal and offspring cortisol levels. Select studies support the buffering effects of antidepressant use and maternal positive affect on offspring cortisol. Growing research highlights evocative effects of fetalneuroendocrine activity, antenatalgene transfer, andinfantbehavioral distress and risk characteristics on maternal cortisol levels and dyadic attunement. There is potential to advance our understanding of the mother-offspring neuroendocrine relationship by consideration of other neuroactivesteroids in addition to cortisol, and to consider developmental timing and measurement source in study design. Future study should emphasize in what context or for whom neuroendocrine attunement is adaptive versus maladaptive for mother and child.

The impact of shared governance on the adverse mood of parturients with gestational hypertension and perinatal indicators of newborns

This study aimed to investigate the effect of shared governance on the adverse mood of parturients with gestational hypertension and perinatal indicators of newborns. A total of 318 patients with gestational hypertension treated in our hospital were enrolled as study subjects and were divided into a study group (200 cases) and a control group (118 cases) using double-blind, controlled and randomised methods. Before intervention, the systolic blood pressure (SBP), diastolic blood pressure (DBP), Hamilton Anxiety Rating Scale (HAMA), Hamilton Depression Rating Scale (HAMD) and Quality of Life Scale (SF-36) scores did not differ significantly between the two groups (p>.05). After intervention, the study group had lower SBP, DBP, HAMA and HAMD scores and higher SF-36 scores than the control group (p<.05). The neonates in the study group experienced a lower incidence of adverse outcomes than those in the control group (p<.05). Shared governance can regulate blood pressure and improve mood and quality of life in parturients with gestational hypertension. It can also reduce the incidence of adverse events in newborns during the perinatal period. Impact Statement What is already known on this subject? Gestational hypertension is the development of hypertension in pregnant women after 2 or 20 weeks of gestation and is characterised by headache, dizziness, nausea and swelling of the lower legs. Early intervention is key to improving maternal and neonatal prognosis. Shared governance is an emerging model of participatory decision-making in which nurses are empowered to make decisions about clinical practice standards, quality improvement, staff and professional development, and research, aiming to cultivate the patients' sense of responsibility for their health. What do the results of this study add? This study demonstrated that shared governance can regulate maternal blood pressure and improve maternal adverse mood, maternal quality of life and reduce the incidence of perinatal adverse events in the newborn, indicating the potential of shared governance and may promote the clinical application of shared governance. What are the implications of these findings for clinical practice and/or further research? This study starts with adverse mood of parturients and perinatal outcomes of newborns, and demonstrates in detail the impact of shared governance in nursing interventions on parturients with gestational hypertension and neonates. The data are detailed and reliable, providing certain clinical references for follow-up research.

Negative emotionality as a candidate mediating mechanism linking prenatal maternal mood problems and offspring internalizing behaviour.

Negative emotionality (NE) was evaluated as a candidate mechanism linking prenatal maternal affective symptoms and offspring internalizing problems during the preschool/early school age period. The participants were 335 mother-infant dyads from the Maternal Adversity, Vulnerability and Neurodevelopment project. A Confirmatory Bifactor Analysis (CFA) based on self-report measures of prenatal depression and pregnancy-specific anxiety generated a general factor representing overlapping symptoms of prenatal maternal psychopathology and four distinct symptom factors representing pregnancy-specific anxiety, negative affect, anhedonia and somatization. NE was rated by the mother at 18 and 36 months. CFA based on measures of father, mother, child-rated measures and a semistructured interview generated a general internalizing factor representing overlapping symptoms of child internalizing psychopathology accounting for the unique contribution of each informant. Path analyses revealed significant relationships among the general maternal affective psychopathology, the pregnancy- specific anxiety, and the child internalizing factors. Child NE mediated only the relationship between pregnancy-specific anxiety and the child internalizing factors. We highlighted the conditions in which prenatal maternal affective symptoms predicts child internalizing problems emerging early in development, including consideration of different mechanistic pathways for different maternal prenatal symptom presentations and child temperament.

A pilot feasibility study of Conexiones, a telephone-delivered cancer parenting education program for Hispanic mothers

Objective To test the short-term impact of Conexiones, a culturally adapted cancer parenting education program for diagnosed child-rearing Hispanic mothers. Design Single group, pre-post-test design. Sample 18 U.S. Hispanic mothers diagnosed within 2 years with early-stage cancer (0–III) raising a child (5–17 years). Methods Participants completed consent, baseline measures, and five telephone-delivered Conexiones sessions at 2-week intervals from trained patient educators in English or Spanish. Outcomes were assessed at baseline and at 3 months. Results Maternal depressed mood, parenting self-efficacy, and parenting quality significantly improved. Children’s anxious/depressed mood tended to significantly improve. Outcomes did not co-vary with mothers’ level of acculturation. Conclusions Conexiones appears to positively improve Hispanic mothers’ distress and parenting competencies; efficacy testing is warranted within a larger randomized control trial. Implications for Psychosocial Providers A brief, culturally adapted cancer parenting education program has potential to enhance Hispanic mothers’ and children’s behavioral-emotional adjustment to a mother’s cancer.

Postnatal maternal mood provides evidence for the psychic pain hypothesis.

Postnatal maternal mood provides evidence for the psychic pain hypothesis.

Pregnant women with bipolar disorder who have a history of childhood maltreatment: Intergenerational effects of trauma on fetal neurodevelopment and birth outcomes.

Intergenerational transmission of trauma occurs when the effects of childhood maltreatment (CM) influence the next generation's development and health; prenatal programming via maternal mood symptoms is a potential pathway. CM is a risk factor for bipolar disorder which is present in 1.8% of pregnant women. Mood symptoms are likely to increase during pregnancy, particularly for those with a history of CM. We examined whether there was evidence for intergenerational transmission of trauma in utero in this population, and whether maternal mood was a transmission pathway. CM and maternal mood were self-reported by N=82 pregnant women in treatment for bipolar disorder. Fetal heart rate variability (FHRV) was measured at 24, 30, and 36 weeks' gestation. Gestational age at birth and birth weight were obtained from medical charts. A cluster analysis yielded two groups, Symptom+ (18.29%) and Euthymic (81.71%), who differed on severe mood symptoms (p < 0.001) but not on medication use. The Symptom+ group had more CM exposures (p < 0.001), a trend of lower FHRV (p=0.077), and greater birth complications (33.3% vs. 6.07% born preterm p < 0.01). Maternal prenatal mood mediated the association between maternal CM and birth weight in both sexes and at trend level for gestational age at birth in females. This is the first study to identify intergenerational effects of maternal CM prior to postnatal influences in a sample of pregnant women with bipolar disorder. These findings underscore the potential enduring impact of CM for women with severe psychiatric illness and their children.

Associations Between Prenatal Exposure to Serotonergic Medications and Biobehavioral Stress Regulation: Protocol for a Systematic Review and Meta-analysis.

BackgroundUp to 20% of mothers experience antenatal depression and approximately 30% of these women are treated with serotonergic psychotropic pharmacological therapy during pregnancy. Serotonergic antidepressants readily cross the placenta and the fetal blood-brain barrier, altering central synaptic serotonin signaling and potentially altering serotonin levels in the developing fetal brain.ObjectiveThe aim of this study is to assess the impact of prenatal exposure to serotonergic antidepressants, accounting for maternal mood disturbances, on markers of stress regulation during childhood.MethodsWe will follow PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines and will search MEDLINE, Embase, CINAHL, PsycINFO, and ClinicalTrials.gov for full-length studies that assessed physiological (eg, cortisol level, heart rate variability, salivary amylase, pupillary size, C-reactive protein) indices of stress regulation in children of pregnant people who were treated with a serotonergic antidepressant at any point during pregnancy. We will assess the quality of observational studies using the Newcastle-Ottawa Scale and the quality of experimental studies using the Cochrane risk-of-bias tool. When possible, we will conduct a random-effects meta-analysis. If meta-analysis is not possible, we will conduct a narrative review. If a sufficient number of studies are found, we will perform subgroup analysis and assess outcomes measured by drug class, dose, trimester of exposure, and child’s age and gender.ResultsWe registered our review protocol with PROSPERO (International Prospective Register of Systematic Reviews; CRD42021275750), completed the literature search, and initiated title and abstract review in August 2021. We expect to finalize this review by April 2022.ConclusionsFindings should identify the impact of prenatal antidepressant effects on stress regulation and distinguish it from the impact of prenatal exposure to maternal mood disturbances. This review should inform decisions about serotonergic antidepressant use during pregnancy.Trial RegistrationPROSPERO CRD42021275750; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=275750International Registered Report Identifier (IRRID)PRR1-10.2196/33363

Maternal Mood and Perception of Infant Temperament at Three Months Predict Depressive Symptoms Scores in Mothers of Preterm Infants at Six Months.

Postpartum depression is more prevalent in mothers and fathers of preterm infants compared to parents of full-term infants and may have long-term detrimental consequences for parental mental health and child development. The temperamental profile of an infant has been postulated as one of the important factors associated with parental depressiveness in the first months postpartum. This study aimed to examine the longitudinal relationship between depressive symptoms and perceived infant temperament at 3 months corrected age, and depressive symptoms at 6 months corrected age among mothers and fathers of infants born preterm. We assessed 59 families with infants born before the 34th gestational week using the Edinburgh Postnatal Depression Scale (EDPS) and the Infant Behavior Questionnaire-Revised. We found that mothers’ scores on EPDS and infants’ Orienting/regulation at 3 months corrected age predicted mothers’ EPDS scores at 6 months corrected age. In particular, higher depressive scores were related to higher depressive symptoms at 6 months corrected age, whereas higher infant Orienting/regulation was related to lower depressive symptoms at 6 months corrected age. Due to the low internal consistency of EPDS at 6 months for fathers, we were unable to conduct similar analyses for fathers. Our results point to the importance of considering both early indices of maternal mood as well as mother-reported measures of preterm infant temperament in the attempts to predict levels of maternal depressiveness in later months of an infant’s life. Further studies are urgently needed in order to better understand the associations between depressiveness and infant temperament in fathers, and with more consideration for the severity of the effects of infant prematurity.

The enduring impact of birth: Women's birth perceptions, postpartum depressive symptoms, and postpartum depression risk.

Postpartum depression (PPD) and related maternal mood disorders affect anywhere from 7% to 19% of postpartum women. Although historically a neglected issue, there has been a strong impetus in the past few decades to implement routine, universal screening and to address PPD as a major public health concern. Still, there has been relatively little analysis of how the quality of the birth experience influences subsequent maternal mental health. We examine the relationship between perceived birth experience and two PPD screeners (Edinburgh Postnatal Depression Scale and Postpartum Depression Screening Scale). Data came from waves I and II of the Listening to Mothers data set. This is the only national survey of US women's childbirth and postpartum experiences. In logistic and linear regression models, we used a 12-item "feeling" index (perceived birth experience) to predict (a) overall PPD screener scores, and (b) likelihood of meeting the clinical cutoff for depression risk. We also controlled for other known socio-demographic and obstetric risk factors. Perceived birth experience strongly and consistently predicted both PPD screener measures, and in both forms-raw scores and clinical cutoffs. By contrast, other known risk factors had inconsistent results across the two screeners. Perceived birth experience should be considered more central in assessing PPD. It may also be more robust than the PPD screeners used in practice, and therefore, could be a more reliable predictor of PPD. Providers should consider how the improved social-psychological quality of women's birth experience can act as a buffer to PPD and other postpartum concerns.

In support of the placental programming hypothesis: Placental endocrine insufficiency programs atypical behaviour in mothers and their offspring

New Findings What is the topic of this review? More than half of all pregnancies in the UK are exposed to adversity linked to increased problems in pregnancy for mothers and adverse outcomes for their children, but we do not know the mechanism(s) underpinning these relationships. What advances does it highlight? Studies in mice prove that placental endocrine insufficiency driven by genetic manipulation of imprinted genes in the offspring can concurrently drive fetal growth restriction, alterations in maternal caregiving and aberrant behaviour in wild‐type offspring exposed to an adverse environment. This suggests that placental endocrine insufficiency might contribute to the co‐morbidity of low birth weight, maternal depression and neurodevelopmental disorders observed in human populations. Prenatal adversity, which is estimated to impact more than half of all pregnancies in the UK, compromises fetal growth and increases the chances of stillbirth, prematurity and infant mortality. Beyond these immediate and highly visible problems, infants that survive carry the invisible burden of increased risk of some of the most common and pervasive diseases that impact human populations. In utero exposure to depression and anxiety is one adversity that has been linked to these poorer outcomes, suggesting that maternal mood disorders drive the outcomes. However, recent studies in animal models suggest that both the maternal mood disorders and the detrimental outcomes for children could be the result of the same underlying placental pathology. In these studies, genetically wild‐type rodent mothers exposed to placental endocrine insufficiency engaged in less pup‐focused behaviours and less self‐care. Genetically wild‐type rodent offspring raised in this abnormal environment exhibited increased anxiety‐like behaviours, with male offspring additionally exhibiting deficits in cognition and atypical social behaviour, with some evidence of depressive‐like symptoms. This work establishes experimentally that placental endocrine insufficiency alone is sufficient to drive atypical behaviour in both mothers and their offspring. Although there are some data to suggest that this phenomenon is relevant to human pregnancy, considerably more work is required.

Maternal mood moderates the trajectory of emotional and behavioural problems from pre- to during the COVID-19 lockdown in preschool children.

The COVID-19 outbreak and subsequent lockdown have dramatically impacted families’ life, raising serious concerns about children’s emotional wellbeing. However, few studies have investigated whether the impact of the COVID-19 lockdown on psychological adjustment in youngest can be moderated by maternal mood and, to our knowledge, none of them has adopted a longitudinal design. The main aim of the current study was to explore if the intensity and directionality of maternal mood symptoms moderated the trajectory of emotional and behavioural problems in Italian pre-schoolers from pre- to during the lockdown adopting a longitudinal design. To assess maternal anxiety and depression symptoms, the EPDS and the STAI-Y were filled in by 94 and 88 women before the lockdown, when their children were 1 (Wave P1) and 3 years old (Wave P2), respectively, and by 74 women during the lockdown, when their children were 4 years old (Wave L). Mothers also filled in the CBCL/1 ½–5 to assess their children’s emotional and behavioural problems at each assessment wave. As a whole, children’s emotional and behavioural problems significantly increased from pre- to during the lockdown. Furthermore, maternal mood moderated this trajectory. In particular, greater maternal mood symptoms were significantly associated with a greater increase in emotional reactive, anxious-depressed, withdrawn and aggressive symptoms during the lockdown. These results contribute to shed light on the role played by maternal emotional wellbeing in buffering the impact of the COVID-19 lockdown on children’s behavioural development. Albeit preliminary, the current findings highlight the need to provide timely psychological interventions to distressed mothers to help their children to better cope with the effects of the pandemic.Supplementary InformationThe online version contains supplementary material available at 10.1007/s00787-021-01925-0.

Impact of mothers' distress and emotional eating on calories served to themselves and their young children: An experimental study.

Parents play a significant role in children's eating behaviours and food environment. Emotional eating (i.e., eating due to/to cope with emotions regardless of hunger) can contribute to excess energy consumption and subsequent weight gain. Yet, there is a paucity of research examining mothers' feeding and eating behaviours in the presence of their young children during times of acute distress. The current study examined whether manipulated maternal mood impacted subsequent eating and parental-feeding in mothers with overweight or obesity with their preschool aged children in a laboratory-based experiment. Mothers (n=47) with overweight or obesity and their preschool aged children were randomized to either an acute distress or control group. After completing a task which manipulated mothers' moods, respectively, dyads were offered a buffet of snack foods. Measures of mothers' reported emotional eating and distress were collected, and calories served and consumed were objectively measured. There were no between-group differences regarding calories served or consumed. Mothers across both groups who reported higher emotional eating served themselves (p=0.014) and their children (p=0.007) less food, and mothers consumed less food (p=0.045). Mothers who reported higher emotional eating and increased acute distress fed their children less food (p = 0.02) and both children and mothers ate less food (p < 0.05). Results suggest that mothers who report emotional eating tendencies may feed their children less food during periods of acute distress.