Background Depression affects both fathers and mothers during the perinatal period; however, preventive interventions targeting paternal perinatal depression remain under-researched. This scoping review aimed to systematically map the literature on preventive interventions for paternal perinatal depression from pregnancy through one year after childbirth. Methods This review followed JBI methodology. We included studies of primary and secondary preventive interventions for paternal perinatal depression from pregnancy through one year after childbirth. Primary preventive interventions promoting mental health were included when paternal depression was reported as an outcome; studies targeting individuals with a diagnosed depression were excluded. MEDLINE, CINAHL, APA PsycINFO, CENTRAL, and Ichushi-Web were searched for published literature, and Google Scholar and ProQuest Health and Medical Collection for grey literature. Two reviewers independently screened titles/abstracts and full texts. Data were extracted using a standardized form and analyzed according to intervention characteristics, including target population, outcomes, aims, content, delivery mode, timing, provider, theoretical basis, and level of intervention. Results Forty-seven studies (2012–2023), primarily from the United States and Australia, were included, with randomized controlled trials as the predominant design. Interventions showed substantial heterogeneity across target populations, aims, outcomes, content, delivery strategies, timing, and providers. Many adopted a couple-based approach and aimed to promote overall mental health rather than focusing solely on fathers or depressive symptoms. Conclusions Given the interdependence of maternal and paternal mental health, couple-based interventions may provide a more comprehensive understanding of their effects on preventing paternal depression and promoting overall mental health.

Introduction The objective of this scoping review is to map the literature describing preventive interventions for paternal perinatal depression. Depression is a common mental disorder experienced by fathers as well as mothers around childbirth. Perinatal depression has negative consequences for men, and suicide is the most serious adverse effect. Impaired father–child relationships can also result from perinatal depression, negatively impacting child health and development. Considering its severe effects, early prevention of perinatal depression is important. However, little is known about preventive interventions for paternal perinatal depression including Asian populations. Methods and analysis This scoping review will consider studies of preventive interventions for perinatal depression in men with a pregnant wife or partner, and new fathers (less than 1 year post partum). Preventive intervention includes any form of intervention intended to prevent perinatal depression. Primary prevention intended to promote mental health will also be included if depression is included as an outcome. Interventions for those with a formal diagnosis of depression will be excluded. MEDLINE (EBSCOhost), CINAHL (EBSCOhost), APA PsycINFO (EBSCOhost), Cochrane Central Register of Controlled Trials and Ichushi-Web (Japan’s medical literature database) will be searched for published studies, and Google Scholar and ProQuest Health and Medical Collection will be searched for grey literature. Beginning in 2012, the search will include the last 10 years of research. Screening and data extraction will be performed by two independent reviewers. Data will be extracted using a standardised data extraction tool and presented in diagrammatic or tabular form, accompanied by a narrative summary. Ethics and dissemination As this study involves no human participants, approval from a human research ethics committee is not required. Findings of the scoping review will be disseminated through conference presentations and publication in a peer-reviewed journal. Trial registration number https://osf.io/fk2qe/ .

OBJECTIVE:This systematic review aims to identify and synthesize available qualitative evidence related to the experiences of transition to motherhood during pregnancy in women who conceived through assisted reproductive technology (ART).INTRODUCTION:Women who conceived through ART experience pregnancy-specific anxiety and paradoxical feelings, and face unique challenges in their identity transition to motherhood. It is important for healthcare professionals working with these women to understand the context and complexity of this special path to parenthood, including the emotional adaptation to pregnancy following ART. A qualitative systematic review can provide the best available evidence to inform development of nursing interventions to meet the needs of pregnant women after ART.INCLUSION CRITERIA:This review will consider any qualitative research data from empirical studies published from 1992-2019 in English or Japanese that described experiences of transition to motherhood during pregnancy in women who conceived with ART.METHODS:This review will follow the JBI approach for qualitative systematic reviews. Databases that will be searched for published and unpublished studies include MEDLINE, CINAHL, PsycINFO, ProQuest Health & Medical Collection, Google Scholar and Open Access Theses and Dissertations (in English), and Ichushi-Web, CiNii and the Institutional Repositories Database (in Japanese). Titles and abstracts will be screened by two independent reviewers in full. The full-text of selected studies will be assessed in detail, and findings and their illustrations will be extracted and aggregated. Any disagreements between the reviewers that arise at each stage will be resolved through discussion, or by a third reviewer.

Abstract Aim We evaluated the effectiveness of a nursing intervention program for Chinese women who are giving birth in Japan to reduce cross‐cultural stressors during the postpartum period and prevent postpartum depressive symptoms. Methods A prospective, before‐and‐after study incorporating a longitudinal mixed‐method design was conducted. Thirty‐eight participants underwent this program from August 2016 to July 2017. The program comprised a maternity class, conversation cards, and a social‐network group. Data collection was initially performed using questionnaires administered in the third trimester (T1)—before the intervention—to obtain participants' basic information, stress levels, depressive symptoms, and cognitive appraisals. Then, stress levels, depressive symptoms, and social support were measured during hospitalization after having given birth (T2) and during the first month postpartum (T3). Finally, through semi‐structured interviews, cognitive appraisal, coping, stress, social support, participants' evaluations of the intervention were determined. Results Post‐intervention, all participants showed positive cognitive appraisals, although eight also showed some negative appraisals. At T3, 36 participants did not report experiencing stress owing to cross‐cultural stressors. Furthermore, post‐intervention, participants who returned scores that were suggestive of depression remained identical to that at pre‐intervention (21.1%). Among the eight participants who showed postpartum depressive symptoms during T3, seven did not report experiencing cross‐cultural stressors, but did report encountering maternity stressors. Conclusion The nursing intervention program may be effective for preventing postpartum depressive symptoms in Chinese women who give birth in Japan. Since this was a pre‐post study in which one group was measured pre‐intervention and again post‐intervention, we did not register in a publicly assessible database.

Objective: This review evaluated the effectiveness of antenatal parenting education versus usual care for maternal confidence, maternal depressive symptoms, and parenting stress among expectant primiparous women in Asia. Introduction: Previous reviews on parenting education have mostly examined practices in non-Asian countries and found that no single parenting education program met the needs of all parents. Given that there may be some common characteristics in Asian cultures, such as grandparents' involvement with child care, this review focused on specific interventions in determining the effects of practices on particular outcomes in these populations, so that providers of antenatal education can tailor interventions that are more culturally appropriate for Asian women. Inclusion criteria: Studies published in English or Japanese that included expectant primiparous women and couples in Asia who received antenatal parenting education were considered. The outcomes were maternal confidence, maternal depressive symptoms, and parenting stress. Methods: The authors searched for English-language articles up to February 2019 using MEDLINE, CINAHL, Cochrane Central Register of Controlled Trials, and PsycINFO. They also searched Ichushi-Web for Japanese articles. A gray literature search was conducted using Google Scholar and ProQuest Health and Medical Collection. Two independent reviewers selected studies, and a critical appraisal was undertaken using appropriate JBI tools. Data were presented in narrative form owing to the heterogeneity of the included studies. Results: Four studies involving 652 pregnant women were included: three were randomized controlled trials, and one was a quasi-experimental study. The studies were conducted in China, Hong Kong, and Taiwan, and included the following antenatal parenting education interventions: interpersonal, psychotherapy-oriented childbirth education; childbirth psychoeducation based on the concept of learned resourcefulness; and Internet newborn-care education based on self-efficacy theory. Overall, the methodological quality of the included studies was moderate. Meta-analysis was not possible owing to the heterogeneity, including small sample sizes and differences in intervention content, populations, and follow-up times. A subsequent narrative synthesis was undertaken for each outcome. Of three studies with maternal confidence as an outcome (n = 496), two showed significantly higher maternal confidence at six weeks' (P = 0.000, Cohen's d = 1.41) and three months' postpartum (P = 0.016, Cohen's d = 0.35) in the intervention groups; however, one study showed no significant group differences. Of three studies with maternal depressive symptoms as an outcome (n = 534), two found significantly fewer depressive symptoms at three months' (P = 0.018, Cohen's d = -0.34) and six months' postpartum (P = 0.005, Cohen's d = -0.42) in the intervention groups; however, one study revealed no significant group differences. Parenting stress was examined in one study (n = 156); it showed significantly lower parenting stress (P = 0.017, Cohen's d = 0.38) immediately after the intervention. Conclusions: There is insufficient evidence to support the effectiveness of a specific type of antenatal parenting education for maternal confidence, maternal depressive symptoms, and parenting stress for expectant primiparous women in Asia. However, the findings suggest that specific theory-oriented antenatal parenting education is potentially effective for those women. Further high-quality studies are needed for antenatal parenting education among expectant primiparous women, especially in Asia.

REVIEW QUESTION:What is the effect of antenatal parenting education on parenting stress, maternal depressive symptoms and maternal confidence, compared to usual care, for expectant primiparous women in Asian countries?

Background: Pregnant and postpartum women with psychosocial problems are prone to face limited or absent perinatal functional support from biological grandmothers due to familial dysfunction. The study aimed to investigate whether the involvement and presence of biological maternal grandmothers providing practical support for their pre/postnatal daughters (ie, pregnant women) during the perinatal period may influence the number of support services provided by multidisciplinary agencies, including child consultation centers and municipal offices. Participants and methods: This is a retrospective cohort study based on the medical records of all pregnant women with psychosocial problems that visited, gave birth, and received intervention from the hospital-based child protection unit at the Chiba University Hospital between February 2018 to March 2019. The primary outcome was to identify whether there was a difference in the number of multidisciplinary agencies providing perinatal support between pregnant women with and without the presence of functional support from biological maternal grandmothers during the perinatal period. Results: We identified 114 pregnant and postpartum women with psychosocial problems. Seventy-six of these participants (66.7/0) had functional support from their biological maternal grandmothers during the perinatal period, and 38 participants (33.3%) did not. The number of agencies involved with participants who lacked functional support was significantly higher than participants with functional support (t(55.14) = 2.98, p < 0.01). This finding was consistent among pregnant and postpartum primipara participants (n = 70) (t(68) = 3.87, p < 0.001), but not multipara (n = 44). Conclusion: The findings indicate that the presence and functional support of biological maternal grandmothers influence the support that is needed from multidisciplinary perinatal support systems by pregnant and postpartum women with psychosocial problems. Primipara mothers without support from their own mothers may need greater multidisciplinary support.

Abstract Purpose To determine whether conventional treatment and assisted reproductive technology for infertility are associated with depressive symptoms and to identify the predictors of depressive symptoms during the first 6 months' post‐partum. Methods A prospective cohort design was used, with the participants being recruited from 13 Japanese hospitals. Using self‐report questionnaires, a total of 2709 women (response rate: 71.9%) provided longitudinal data at five time points: during their hospital stay and at 1, 2, 4, and 6 months' post‐partum. The depressive symptoms were measured by using the Japanese version of the Edinburgh Postnatal Depression Scale (EPDS). A logistic regression analysis was used to examine the association between the mode of conception and depressive symptoms and to identify the predictors of the depressive symptoms. Results There was no significant association between the mode of conception and the depressive symptoms at any time point. Six factors that were associated with the EPDS score were first‐time childbirth, emergency cesarean delivery, infant feeding, financial burden, having a male infant, and dissatisfaction with social support. Conclusion There was no significant relationship between the mode of conception and depressive symptoms. Nursing care should be based on individual assessments that focus on parity, the delivery method, infant feeding method, financial burden, the infant's sex, and social support, rather than on the mode of conception.

AIM:To describe changes in prevalence of shoulder stiffness, back pain, and wrist pain during the first 6 months postpartum, and to examine the association of these symptoms with maternal age and parity.METHODS:Participants were recruited from 13 Japanese hospitals between 2012 and 2013. A total of 2709 (response rate 71.9%) women provided longitudinal data, using self-report questionnaires at 5 time points: during their hospital stay, and at 1, 2, 4, and 6 months postpartum. Shoulder stiffness, back pain, and wrist pain were measured, using checklists with yes-no responses. The effects of age and parity were assessed in 4 groups of younger (<35 years) and older (≥35 years) mothers: 983 younger primiparas, 481 older primiparas, 649 younger multiparas, and 596 older multiparas. Chi-square tests and Cochran's Q tests were used to assess effects of group and time.RESULTS:Prevalence of shoulder stiffness, back pain, and wrist pain during the hospital stay significantly increased up to 1 month postpartum for older primiparas, who were also the most vulnerable to back pain and wrist pain at 1 month postpartum.CONCLUSION:Special attention should be given to older primiparas in assessing and providing nursing care for physical symptoms, especially during the first month postpartum.

To identify the course of maternal fatigue during the first 6 months postpartum and to determine factors associated with it.

AIM:This cross-sectional and longitudinal study explored primiparous mothers' functioning and parenting stress on the basis of infant-feeding method over the first 6 months postpartum.METHODS:Participants were Japanese primiparae who delivered live singleton infants (N = 1120). Questionnaires, completed at 1, 2, 4, and 6 months postpartum, included demographics, feeding method, frequency of feedings, time required from infant's feeding to falling asleep, mother's sleep time, Postnatal Accumulated Fatigue Scale, and the original Japanese version of Parenting Stress Short-Form Scale. Chi-square tests and Welch F tests for one-way analysis of variance were conducted.RESULTS:Exclusively breastfeeding mothers fed their infants more frequently, but required less time from infant's feeding to falling asleep than either mixed or formula-feeding mothers. Mixed feeding mothers required more time for infant feeding and reported more severe fatigue and greater parenting stress than breastfeeding mothers at 1 and 2 months postpartum. Exclusively formula-feeding mothers required more time to get their infant back to sleep and reported greater parenting stress than the other groups at 6 months postpartum. Nearly 25% of mothers continued breastfeeding exclusively through the first 6 months postpartum. Mothers often changed feeding methods, with many exclusively breastfeeding by 6 months.CONCLUSION:Feeding methods may affect maternal functioning and parenting stress across the postpartum period.

The aim of the study was to assess fatigue, depressive symptoms, and maternal confidence or satisfaction among older primiparae during the first month postpartum. The number of older Japanese primiparae has rapidly increased. Older primiparae are believed to be at high risk for puerperal morbidity. A multicentre prospective cohort study design was used. Data were examined from 2854 Japanese women who participated in a 6-month prospective cohort study conducted between May 2012 and September 2013. The women were classified into 4 groups based on maternal age and parity. All participants completed the Postnatal Accumulated Fatigue Scale, Japanese Edinburgh Postnatal Depression Scale, Postpartum Maternal Confidence Scale, and Postpartum Maternal Satisfaction Scale. Primiparae in all age groups were more severely fatigued and had a higher risk of postpartum depression than multiparous mothers during the first month postpartum. Older primiparae had significantly lower scores on maternal confidence and maternal satisfaction than the other 3 groups at 1 month postpartum. These findings suggest that postpartum nursing should focus on promoting adequate sleep, providing emotional support, and fostering the process of maternal role adaptation among older Japanese primiparae, particularly during the first postpartum month.

AIM:To examine the relationship between physical symptoms and depressive symptoms among new mothers during the first 6 months postpartum.METHODS:Prospective cohort study design was used in this study. Participants were recruited in 13 Japanese hospitals between 2012 and 2013. A total of 2709 women (response rate of those invited 71.9%) provided longitudinal data using self-report questionnaires at 5 time points: during the hospital stay and at 1, 2, 4, and 6 months postpartum. Depressive symptoms were measured using the Japanese version of the Edinburgh Postnatal Depression Scale. Also, 37 physical symptoms were measured using a yes-or-no checklist. To examine the association between physical symptoms and depressive symptoms, logistic regression analysis was used.RESULTS:There was a significant positive association between physical symptoms and depressive symptoms during the first 6 months postpartum. Fifteen physical symptoms were associated with significantly increased odds of depression at 1, 2, 4, and 6 months post-partum. These symptoms included: loss of appetite, tiredness/languor, and palpitation/shortness of breath.CONCLUSION:Multiple physical symptoms after childbirth were associated with depressive symptomatology. Health professionals should assess for postpartum depression when puerperal women report multiple physical symptoms as independent complaints.

Aim: To compare the factors that affect maternal confidence at 1 month post-partum between older (>= 35 years old) and younger (20-34 years old) primiparous Japanese mothers.Methods: A multicenter prospective study of mothers who gave birth to live singleton infants in Japan was conducted. Following ethics approval, the participants completed questionnaires 1 day before discharge and 1 month after childbirth. The questionnaires included the Postpartum Maternal Confidence Scale, demographics and background information, prenatal and obstetric data, situational variables and perceptions of daily life, and social support. The obstetric data were extracted from the hospital medical records. Data from the older primiparae (n = 479) and the younger primiparae (n = 1033) were analyzed by using multiple stepwise regressions, controlling for the delivery mode.Results: Maternal confidence at 1 month post-partum was positively associated with emotional support for the older primiparae and appraisal support and exclusive breastfeeding for younger primiparae. In both groups, feeling overwhelmed by daily life, a lack of communication with their partner about the parenting role, and a lack of prior experience in caring for babies were negatively related to maternal confidence. Family budget instability was negatively related to maternal confidence in the younger group.Conclusion: Providing care that is based on an understanding of the unique support needs of first-time mothers in different age groups could promote more effective parenting.

AIM:Post-partum fatigue is a serious concern for mothers worldwide. The aim of this study was to identify age-specific determinants of self-perceived fatigue after childbirth among Japanese primiparous women.METHODS:A multicenter prospective cohort study was conducted in Japan. The degree of fatigue was assessed using the Postnatal Accumulated Fatigue Scale during the hospital stay after childbirth. Associated factors were stratified into two age groups (<35 or ≥35 years old); data were analyzed using stepwise multiple regression.RESULTS:In the younger group, significant determinants of post-partum fatigue included: anticipated difficulties in child-rearing after discharge; perception of inadequate sleep conditions; dissatisfaction with childbirth; shorter sleep and meal times; longer duration between feeding and infant bedtime; unemployment; and having hyperemesis gravidarum. In the older group, significant determinants of post-partum fatigue included: anticipated difficulties in child-rearing after discharge; perception of inadequate sleep conditions; shorter meal times; formula feeding; and dissatisfaction with childbirth.CONCLUSION:Primiparous mothers who anticipated new life with their infants to be difficult and who had an irregular lifestyle tended to report higher levels of fatigue during the post-partum hospital stay. Nurses and midwives should assess maternal sleep and eating conditions, providing support to ensure adequate maternal rest. Special efforts should be made to reduce anxiety about new life with infants among younger primiparous women who had experienced hyperemesis gravidarum.

Background: Depressive symptoms are common in postpartum women. The present study aimed to describe changes in the prevalence of depressive symptoms during the first 6 months postpartum, and their association with maternal age and parity.Methods: A prospective cohort study was conducted with 3769 women at 13 hospitals in Japan. Depressive symptoms were measured during hospital stay and at 1, 2, 4, and 6 months postpartum, using the Japanese version of the Edinburgh Postnatal Depression Scale (EPDS). The effects of maternal age and parity were assessed by comparing four groups: younger primiparas (aged <35 years); older primiparas (>= 35 years); younger multiparas (<35 years); and older multiparas (>= 35 years). Data were analyzed using a mixed between/within-subjects analysis of variance, Cochran's Q tests, and chi-square tests.Results: Mean EPDS scores significantly decreased from 1 to 2 months postpartum in all groups. The proportion of women with EPDS scores >= 9 significantly decreased during the same period for primiparas but not for multiparas. Primiparas also had significantly higher EPDS scores than multiparas during hospital stay and at 1 month postpartum. Limitations: As we used convenience sampling, our study sample was not fully representative of Japanese mothers. This study was also limited by our focus on the postpartum period.Conclusions: The first month postpartum represented peak prevalence for depressive symptoms. Primiparity was a risk factor for depressive symptoms only during the first month postpartum. Healthcare professionals should be sensitive to postpartum duration and parity when monitoring depressive symptoms. (C) 2016 Elsevier B.V. All rights reserved.

This study examined the psychometric properties of a 13-item fatigue scale for postpartum mothers. Japanese mothers (n = 2026) from a cohort study completed questionnaires (e.g. fatigue scale, Japanese version of the Edinburgh Postnatal Depression Scale, demographics) during their hospital stay after childbirth (baseline) and at 1, 2, 4 and 6 months postpartum. Initial factor analysis of baseline data revealed that the fatigue scale had three factors or subscales (physical, emotional and cognitive). Within-group analysis across each measurement time revealed the same three-factor structure with acceptable fit. Between-group analysis also showed longitudinal factorial invariance across time. The fatigue subscales had acceptable divergent and convergent validities with the depression scale. The subscale scores differed significantly based on participant background. The Japanese Fatigue Scale is a concise and informative tool for assessing aspects of fatigue in clinical settings and in the community.