Postpartum depression (PPD) is a prevalent psychological condition among birthing women. While several psycho-socio-economic and neurobiological factors influence its development, its relationship with smoking behavior and nicotine addiction remains largely inconclusive. In this combinatorial study, we first evaluate the relationship between smoking and depressive behaviors in postpartum women using data extracted from pertinent primary epidemiological studies. Additionally, to discern the molecular and cellular mechanisms underlying this association, we identified common genetic elements and evaluated their functional attributes using in silico analyses. Meta-analytical assessment of systematically collected data from 38 studies indicated that smoking women are twice as likely to develop PPD, compared to their non-smoking counterparts. While geocultural attributes did not affect this relationship, timing of smoking was a significant moderator, with current and gestational smoking statuses being more strongly linked with PPD outcome, compared to the past smoking habit. Further, depression scores in smoking postpartum women were higher than those in non-smoking controls. Analysis of the common protein-encoding genes underlying the pathophysiology of nicotine addiction and PPD revealed several critical hub proteins (viz., AKT1, JUN, CTNNB1, PTEN, EGFR, ESR1, SRC, STAT3, FN1, IL1B, IL6, TNF, TP53, GAPDH, INS, MYC, and ALB) which were predicted to alter multiple pathophysiological pathways associated with transcriptional expression, intra- and intercellular signaling transduction, metabolism, and immune functions. Our results indicate that smoking is strongly associated with depressive behavior in postpartum women, although this association involve mediation of additional environmental and psychosocial elements. Moreover, network analysis of common genetic elements identified several potentially disrupted neurophysiological pathways in postpartum women with smoking and depressive behaviors which may aid in characterizing the underlying relationship between the two conditions.
Few studies have examined the increased risk for pregnancy complications in women with autism spectrum disorder (ASD) diagnosis. The autism genetic propensity in relation to the complications of pregnancy and birth remains unknown, and is an area critical for informing maternal health and reproductive guidance. Here, we assessed whether maternal genetic liability to ASD is associated with pregnancy complications. The study comprised 28,985 females with at least one pregnancy-related record from the UK Biobank (UKB) cohort. Individual polygenic risk scores (PRS) for ASD were calculated, and pregnancy complications were defined using ICD-10 diagnostic codes. Associations between ASD PRS and pregnancy outcomes were evaluated using logistic regression models adjusted for maternal age at first conception. In the secondary analyses, we used schizophrenia (SCZ) PRS, and analyzed broader, ICD-based clusters of pregnancy outcomes. Maternal ASD PRS showed no nominally significant associations with pregnancy outcomes. Maternal SCZ PRS was nominally associated with a reduced risk of spontaneous delivery (O80) and forceps/vacuum delivery (O81); however, no associations remained significant after FDR correction. Higher genetic liability to ASD was not significantly associated with an increased risk of pregnancy complications in the UKB sample. Findings should be interpreted with caution, given the limitations of PRS, potential selection bias in UKB, and the relatively small sample size of females with pregnancy outcomes in the UKB. Autism PRS enables better understanding of aspects of autism that are otherwise limited by the small sizes of the clinical samples. The genetic liability captured by ASD PRS does not appear to predispose mothers to obstetric complications. The observed increase in obstetric diagnoses among autistic females may instead reflect other genetic influences that are not captured through PRS and/or environmental factors.
Depression is highly prevalent in middle-aged women (MAW), but head-to-head comparisons of first-line interventions in this population are scarce. This systematic review and individual participant data (IPD) meta-analysis examined the comparative efficacy of antidepressant medication (ADM) and interpersonal psychotherapy (IPT) for MAW (aged 40–64) versus other adults (men and non-MAW) on depression, quality of life, and interpersonal problem measures. PubMed, PsycINFO, Embase, and the Cochrane Library were searched January 1, 2025 to identify randomized trials comparing ADM and IPT for adults with depression. IPD were requested and analyzed using mixed-effects models. IPD were obtained from 9 of the 15 (60
Relationship satisfaction is a key factor in women’s mental health and wellbeing outcomes, however, relationship satisfaction may change in times of stress and uncertainty, such as the perinatal period. While positive romantic relationships during the perinatal period may offer benefits, changes in relationship satisfaction and what may contribute to them longitudinally is not currently well understood. One hundred and fifty-seven women in late pregnancy ( 30 weeks gestation) took part in a longitudinal analysis of relationship satisfaction from pregnancy to five years postpartum, across eight timepoints. The study is a secondary analysis of a randomised controlled trial of sleep and diet intervention. Latent growth modelling was used to examine the trajectory of relationship satisfaction change over time and explore predictors of this trajectory. There was a significant decline in relationship satisfaction both during pregnancy and the postpartum. Being of non-White race was associated with overall lower relationship satisfaction (p = 0.004). While being less financially comfortable (p = 0.007), having less than a postgraduate degree (p = 0.049), and older age (p = 0.026) were associated with steeper decrease in relationship satisfaction during the postpartum. This study demonstrates that relationship satisfaction declines from pregnancy to five years postpartum in a sample of Australian mothers. Minority race, financial comfortability, education level and age may influence the magnitude of this trajectory. These findings highlight a need to better support couples during this challenging time, not just through pregnancy and birth, but also through early childhood. Relationship satisfaction declined from late pregnancy to five years postpartum, in a sample of Australian mothers. The decline in relationship satisfaction was more significant for those less financially comfortable, with lower education attainment and older age. Although relationship satisfaction decreased through the perinatal period, it mostly remained within non-distress level.
Childbirth-related PTSD is a population-level postpartum mental health concern that remains under-recognized due to limited routine PTSD screening and symptom overlap with postpartum depression and anxiety. The condition is associated with impaired mother–infant bonding and is supported by converging biological evidence consistent with PTSD in other trauma-exposed populations. We propose that DSM-6 add a PTSD timing specifier, “with postpartum onset”, defined as the onset of PTSD symptoms within 4 weeks after delivery following a childbirth event that satisfies DSM Criterion A. A full PTSD diagnosis would still require that symptoms persist for more than 1 month, as required by DSM criteria. This targeted update could improve recognition, coding, screening pathways, and research harmonization for childbirth-related PTSD.
To investigate how unintended pregnancy (UP) is associated with the occurrence of mental health (MH) problems one year later among womxn, while also considering pregnancy outcome (abortion/continuation), co-occurring risks and protective factors. We examine this in the Dutch context, given available abortion care up to 24 weeks gestation and high diversity in people’s pregnancy intentions. We hypothesized that MH problems are more prevalent among those whose pregnancy was more unintended. Data from the Dutch BluePrInt study included both womxn who had an abortion (AB, n = 152) and who continued their UP (CT, n = 212). They filled out an online survey shortly after their abortion (AB) or around 14 weeks gestation (CT), and at follow-up one year later. Key variables included pregnancy intendedness (continuously measured), anxiety/depression symptoms (measured with a screening tool based on the CIDI), social- and partner support, abuse experiences, UP-related variables (difficulty deciding, uncertainty, pressure, and negative emotions) and socioeconomic position. 26.5
Antenatal depression (AD) is a mental health condition estimated to affect close to 30
ADHD is a neurodevelopmental disorder linked to impulsivity and self-regulation difficulties. While the association between ADHD and nicotine dependence is well-established, less is known about the association with smokeless tobacco use, such as snuff. Given the adverse health effects of nicotine during pregnancy, this study examines whether women diagnosed with ADHD are more likely to use snuff prior to and early in pregnancy, and whether they persist in use between these periods. This study also explores the associations between ADHD and snuff use in the presence of common psychiatric disorders: depression, anxiety and substance use disorders (SUDs). Using Swedish population-based registers, we identified women who gave birth between 2000 and 2020. ADHD was defined based on clinical diagnoses and/or ADHD medication prescriptions. Snuff use was self-reported during a prenatal care visit. Logistic regression models estimated odds ratios (ORs) with 95
Postpartum Depression (PPD) is the most common mental health complication of childbirth, and has short-term and long-term consequences for mother, child, and the entire family. PPD is a function of several factors. Prenatal exposure to nicotine (PEN) by Active Tobacco Smoking (ATS), Secondhand Smoking (SHS), or Electronic Nicotine Products (ENPs) is a major potential risk factor. This systematic review and meta-analysis aim to summarize and evaluate all evidence regarding the association between PEN and PPD. We searched the following databases, PubMed, Medline, Cochrane, EMBASE, and CINHAL, for studies published between Jan.1st ,2000 Sep.19th ,2024, with the outcome PPD. Studies quality was assessed using the Newcastle–Ottawa Scale. Pooled Prevalence (PP) was calculated using the Freeman-Tukey Double Arcsine Transformation method. Pooled Odds Ratio (pooled-OR) was estimated using a random-effects model. Sensitivity analysis was conducted using the leave-one-out technique. Of 29 studies in the systematic review, 26 included in the meta-analysis. PP of PPD was 0.15,(95
The peripartum period is a time of increased vulnerability to stress for women, yet no consensus definition of maternal peripartum stress exists. This paper reports work from European COST Action 22114 (TREASURE), which identified key concepts related to maternal peripartum stress in the literature and developed a consensus definition via a qualitative Delphi process involving 161 international researchers and clinicians. The resulting definition supports a shared understanding, enabling more targeted research and evidence-based clinical practice to improve perinatal care.
PurposeThe aim of this study is to better understand perinatal mental health research priorities of neurotypical and neurodivergent people.MethodsA co-designed mixed-methods survey was conducted as part of the Wellbeing Across Neurotypes: Depression and Anxiety (WANDA) study. 709 participants in the United Kingdom (UK) quantitatively rated and ranked research topics within perinatal mental health, with 253 also providing qualitative data.ResultsThe top research priorities were (1) interventions and (2) diagnosis for perinatal mental health problems for birthing people and (3) how these impact parent-infant relationships. Qualitative data revealed additional topics of importance including healthcare experiences, trauma, and neurodiversity.ConslusionsThese results suggest complex, multilevel barriers to accessing diagnosis and support in the UK.
To examine associations between the 2024 South Brazilian flood and postpartum obstetric and maternal mental health outcomes. This cross-sectional study recruited 274 postpartum women 8–12 months after the flood at two tertiary hospitals in Porto Alegre, Brazil. We focused on three disaster-related exposures: (1) need for financial assistance due to the flood; (2) housing displacement or damage due to the flood; and (3) delivery within nine months after the flood (already pregnant at the time of the disaster). Financial and housing exposures were associated with higher odds of perinatal posttraumatic stress disorder symptoms (OR = 6.7; 95
PURPOSE:The transition to motherhood is characterized by increased stress and changes in coping behaviors, yet limited research has examined how different dimensions of parenting stress relate to maternal functioning and media use over time. Guided by the ABC-X model of family stress, this study examined longitudinal associations between parenting stress, maternal depressive symptoms, parenting self-efficacy (PSE), and media coping behaviors. METHODS:Longitudinal data were collected from 439 mothers across three yearly waves. Parenting stress was measured at Time 1, maternal depression at Times 1 and 2, and parenting efficacy at Times 1 and 3. Health app use was assessed via passive-sensing data, and mothers reported their use of media for emotion regulation at Time 3. Path analyses tested direct associations and moderation by maternal depressive symptoms, controlling for baseline PSE, depressive symptoms, household income, and frequency of cell phone checking at Time 1. RESULTS:Parental distress at Time 1 predicted lower PSE and greater media emotion regulation at Time 3. Maternal depressive symptoms further moderated these associations in distinct ways across outcomes. For media emotion regulation, difficult-child stress was associated with lower use only at higher levels of depressive symptoms. For PSE, depressive symptoms weakened the negative association between parent-child dysfunctional interaction and PSE, with stronger associations at lower levels of depression. No consistent associations emerged for health app use. CONCLUSIONS:Parental distress is a key predictor of maternal functioning, while other stress dimensions show context-dependent associations. Findings highlight the importance of distinguishing stress types and considering maternal emotional context when examining coping and adjustment.
Tokophobia refers to a clinically significant fear of childbirth that affects women across the reproductive lifespan. Given its prevalence and association with adverse mental health, obstetric, and reproductive decision-making outcomes, valid and reliable measures are essential to identify women at risk of tokophobia. Tokophobia Severity Scale (TSS) psychometric properties were analyzed in nulliparous non-pregnant, pregnant, and women in the postpartum using data from cross-sectional and longitudinal studies conducted in four countries: Australia, Lithuania, Poland, and Portugal. Sample (n = 1,585) comprised nulliparous non-pregnant (Poland, n = 559), pregnant (Lithuania, n = 197, Portugal, n = 353), and women at two months postpartum (Australia, n = 292; Lithuania, n = 184). Participants completed the TSS, and self-reported questionnaires on sociodemographic, obstetric, fetal/neonatal, mental health-related characteristics, depressive and anxiety symptoms, birth trauma perception, and another measure of fear of childbirth (FOC). Results supported a three-factor model: fear, coping, and intrusive thoughts. Invariance was found across childbearing-age periods and countries. Cronbach’s alpha and McDonald’s omega coefficients for the TSS total score were 0.89-0.90. Known-group validity was established with differences in sociodemographic, obstetric, fetal/neonatal, and mental health-related characteristics. Concurrent validity was found with depressive and anxiety symptoms, and birth trauma perception. Convergent validity was found with another FOC measure. TSS scores in pregnancy predicted elective cesarean section, birth trauma perception, and postpartum depressive and anxiety symptoms. TSS discriminates women with or without clinically significant tokophobia symptoms in childbearing-age periods and countries. TSS is a psychometrically strong measure that can be used to screen clinically significant tokophobia symptoms.
This study explored the impact of exposure to nonstandard work on workers' depression and suicidal ideation. Using data from the 12th to 18th waves of the Korea Welfare Panel Study, longitudinal analyses were conducted employing cox regression and survival analysis techniques to examine the relationships between nonstandard employment, depression, and suicidal ideation. The Kaplan-Meier survival analysis revealed that individuals with the longest duration of nonstandard work exhibited a higher prevalence of suicidal ideation. Cox regression analysis confirmed a significant association between nonstandard work and depression levels. However, in the recurrent events Cox model, nonstandard work was not a statistically significant predictor of suicidal ideation; only depression showed a significant effect. Nevertheless, the findings overall indicate heavy connections between these factors, for which relevant policy implications can be proposed.
Faced with the crime of infanticide, all nations seek justice for both mothers and their infants. The psychopathology of childbirth and infanticide are among the most complex in human experience. This review takes the example of English law, and traces its evolution during four epochs, as knowledge increased and public attitudes changed. The combination of the 1922 Infanticide Act, recognizing the special circumstances of parturition, and the 1957 Homicide Act, with its concept of diminished responsibility, offer a solution worthy of consideration by other nations.
PurposeThe relationship between perinatal depression and breastfeeding is complicated and reciprocal. While breastfeeding may protect against postpartum depression, perinatal depression can also reduce the likelihood of breastfeeding. Using longitudinal data from Pakistan, we examine the effect of (1) breastfeeding on postpartum depression, stratified by prenatal depression and (2) perinatal depression on breastfeeding.MethodsData were drawn from the Bachpan study in Pakistan at five timepoints: pregnancy, delivery, 3-, 6-, and 12-months postpartum. Breastfeeding (any and exclusive [EBF]) was assessed using 24-hour recall; depression was measured with the Structured Clinical Interview for DSM-5 (SCID). Marginal structural models accounted for the time-varying relationship between depression and breastfeeding to estimate risk ratios (RR) and 95% confidence intervals (CI).ResultsAmong 1,014 postpartum individuals, weighted prevalence of any breastfeeding was 73.6% at delivery, 93.1% at 3-months, 86.1% at 6-months, and 73.0% at 12-months. EBF at 6-months was low (8.7%). Depression prevalence was 25.1% during the third trimester, 13.1% at 3-months, 10.8% at 6-months, and 15.7% at 12-months. Any breastfeeding was associated with a lower risk of postpartum depression (RR: 0.77; 95% CI: 0.51-1.03), though the CI included the null. In turn, perinatal depression reduced the likelihood of any breastfeeding (RR: 0.92; 95% CI: 0.84-0.99). EBF was similarly associated with a lower risk of postpartum depression (RR: 0.94; 95% CI: 0.68-1.20), though the CI also included the null. When stratified by prenatal depression, point estimates suggest that EBF may have a stronger association with lower depression risk among those without prenatal depression compared to those with prenatal depression (RR: 0.77 vs. RR: 1.03), though both CIs included the null.ConclusionsResults support a complex bidirectional relationship between breastfeeding and perinatal depression, where depression reduces breastfeeding likelihood and any breastfeeding shows possible protective associations with depression, though the benefits of EBF may differ by prenatal depression status.
Occupational noise exposure remains a critical but under-prioritized hazard in the global mining industry, contributing significantly to noise-induced hearing loss (NIHL). Workers in drilling, blasting, crushing, and haulage operations routinely face sound levels exceeding 85 dB(A) thresholds, often without adequate protective measures. Despite technological advances, systematic gaps persist in occupational noise hazards (ONH) research and prevention strategies. This study of systematic literature review and metadata analysis consolidate five decades of global research on occupational noise hazards in mining to evaluate methodological approaches, identify underrepresented regions and worker groups, and assess thematic trends for future occupational health strategies. The initial search yielded 69 articles, of which 65 were included for the present study. The review confirmed that most mining activities expose workers to noise levels exceeding 85 dB(A), with NIHL highly prevalent among long-tenured employees. Shift toward data-driven, interdisciplinary frameworks is needed to transform hearing protection from a compliance obligation to a health-preserving imperative.
Depression is a common mental disorder, particularly among women of childbearing age (WCBA). There is a lack of comprehensive epidemiological analysis on the longitudinal trends and changing patterns of depression in WCBA. The study utilized data obtained from the Global Burden of Disease (GBD) 2021 database to analyze incidence, prevalence, and years lived with disability (YLDs) of depression among WCBA across regions, age groups, and sociodemographic index (SDI). We also examined temporal trends, driving factors, age patterns, and projections up to 2035. Globally, from 1990 to 2021, the incidence rate increased by 17.65
In September 2023, a series of heatstroke cases across diverse exposure settings was observed at the University Hospital of Guadeloupe, a tropical region where published data on heatstroke are limited. The aim of this study was to describe the clinical features, environmental conditions, and outcomes of these cases. We conducted a retrospective single-center study including all adult patients admitted with heatstroke between September 1 and 30, 2023. Nine cases were identified over an 18-day period; all patients were male and local residents. Five (55.6%) had exertional heatstroke and four (44.4%) had classic heatstroke. Six patients (66.7%) developed multi-organ failure, of whom five died, with a median time to death of 2 days [1-3]. The median wet bulb globe temperature and heat index at the time of each case were 26.6°C [25.9-26.7] and 33.6°C [31.4-34.4], respectively.
