Archives Of Women's Mental Health[JOURNAL]
Sun
200 papers
Mental health after unintended pregnancy: insights from a context with available abortion care.
Beumer WY, Roseboom TJ, van Ditzhuijzen J
Arch Womens Ment Health · 2026 Jul · PMID 42399547 · Full text
PURPOSE: 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-occu...
PURPOSE: 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. METHODS: 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. RESULTS: 26.5% developed MH symptoms one year after their UP, with no significant differences between AB and CT groups. Pregnancy intendedness and -outcome (abortion vs. continuation), as well as their interaction, were not related to MH symptoms one year later. Previous MH was the strongest predictor of MH risks (OR: 3.54), while perceived social support from family/friends was associated with a lower risk (OR: 0.66). CONCLUSIONS: In a context where abortion care is available, pregnancy intendedness and -outcome do not increase people's risks of MH symptoms one year after experiencing an UP. Instead, previous MH and support from family/friends are important for MH after experiencing an UP. Positioning UP as inherently problematic is not warranted. Policy and practice should center people's lived reproductive experiences and care needs.
The evidence base of interventions to treat antenatal depression: a meta-analysis of randomized controlled trials.
Laijawala R, Priestley K, Bind R … +13 more , Hazelgrove K, Rebecchini L, Kirkpatrick M, Mancino F, Sangha S, Biaggi A, Godara M, Buss C, Entringer S, Woods A, Dazzan P, Cattaneo A, M Pariante C
Arch Womens Ment Health · 2026 Jul · PMID 42397557 · Full text
PURPOSE: Antenatal depression (AD) is a mental health condition estimated to affect close to 30% of pregnant people globally. The importance of treating depression in pregnancy is underscored by its downstream impact on...
PURPOSE: Antenatal depression (AD) is a mental health condition estimated to affect close to 30% of pregnant people globally. The importance of treating depression in pregnancy is underscored by its downstream impact on both maternal and infant biopsychosocial outcomes, such as preterm birth, low birthweight, and postnatal depression. Despite these outcomes, only 20% of women experiencing AD receive appropriate and timely support and treatment. This meta-analysis is a comprehensive synthesis of RCTs evaluating psychological and non-psychological interventions to treat antenatal depression, conducted as part of the HappyMums project. METHODS: Studies were sourced from PubMed, Embase Medline and MIDIRS (via OVID), and were included if they were (a) randomized controlled trials, (b) with pregnant people with, or at risk for depression, (c) consisted of an intervention, and (d) published in English. To estimate efficacy, Standardized Mean Differences (SMDS) were calculated with 95% confidence intervals using the post- intervention Ms and SDs of both the intervention and control groups. The I statistic was used as an indicator of variation between studies. Analyses were conducted using the software R Studio. RESULTS: In total, 115 studies were included in the analysis. The pooled effect size of all interventions, compared with all pooled control arms, showed a clear therapeutic effect (SMD = 0.65, 95% CI 0.48; 0.83), although the between-study heterogeneity variance was high (τ = 0.78, 95% CI 0.7;1.3). After accounting for outliers, the pooled effect size across 94 treatment arms was still SMD = 0.5 (95% CI, 0.42, 0.56). No significant subgroup differences were found by intervention type and format, or measure used. CONCLUSION: There are numerous interventions that, on average, are moderately effective in reducing depressive symptomology in pregnancy. Future research should be aimed at addressing how to personalise the choice of treatment and improve treatment outcomes for the individual pregnant person.
Maternal peripartum stress: A new consensus-based definition.
Fort D, Ayers S, Horesh D … +8 more , Garthus-Niegel S, Zietlow AL, Handelzalts J, Caparros-Gonzalez RA, Alderdice F, Rattaz V, Horsch A, WG 1.1 COST Action 22114
Arch Womens Ment Health · 2026 Jul · PMID 42384219 · Full text
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...
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.
Attention-deficit/hyperactivity disorder and snuff use prior to and early in pregnancy.
Andersson A, Oskarsson S, Halkola RK … +4 more , Chang Z, D'Onofrio B, Larsson H, Tuvblad C
Arch Womens Ment Health · 2026 Jul · PMID 42384073 · Full text
BACKGROUND: 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 associatio...
BACKGROUND: 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). METHODS: 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% confidence intervals (CIs) for snuff use prior to and early in pregnancy among women with ADHD, adjusting for sociodemographic factors. We also stratified the analyses by depression, anxiety, and/or SUDs to assess potential differences in associations. RESULTS: Women diagnosed with ADHD were more likely to use snuff prior to pregnancy (adjOR = 1.89, 95% CI: 1.83-1.95), early in pregnancy (adjOR = 2.43, 95% CI: 2.32-2.55), as well as be persistent snuff users (adjOR = 2.39, 95% CI: 2.27-2.52) compared to women without ADHD. Stratification by common psychiatric disorders revealed that the associations between ADHD and snuff use prior to and early in pregnancy were strongest among women diagnosed with ADHD without depression, anxiety, and/or SUDs. CONCLUSIONS: ADHD is an important risk factor for snuff use prior to and early in pregnancy, underscoring the need for targeted interventions to prevent nicotine use in young women with ADHD as part of integrated care. TRIAL REGISTRATION: Retrospectively registered.
Prenatal exposure to nicotine and postpartum depression: a systematic review and meta-analysis.
Sharaf-Alddin R, Salama M, McKinney D … +2 more , Saade G, Zhang Q
Arch Womens Ment Health · 2026 Jul · PMID 42384052 · Full text
PURPOSE: 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 facto...
PURPOSE: 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. METHODS: 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. RESULTS: Of 29 studies in the systematic review, 26 included in the meta-analysis. PP of PPD was 0.15,(95% CI[0.12-0.17]; I = 99.80%,p < 0.001). Pooled-OR for ATS 1.96,(95%CI[1.59-2.41]; Z = 6.46,p < 0.001), 1.22,(95%CI[0.69-2.18], Z = 0.69,p = 0.49) for SHS, and 1.14,(95%CI[0.82-1.58,Z = 0.78,p = 0.43) for ENPs. While the overall Pooled-OR for all PEN was 1.74,(95%CI[1.44-2.12]; Z = 5.59,p < 0.001), funnel plots and Egger test showed no evidence of publication bias. Sensitivity analysis confirmed the robustness of the findings. CONCLUSION: This meta-analysis reveals that the accumulated evidence shows a significant association between prenatal PEN and PPD; though this final finding should be interpreted cautiously due to the high heterogeneity. Therefore, the exposure-stratified estimates represent the principal findings of this meta-analysis. The findings indicates a significant association between prenatal ATS and PPD, but no clear conclusion could be drawn about prenatal SHS or ENPs use due to the limited number of studies. There is a need for future studies that prospectively assess the impact of SHS and ENP on PPD.
Perinatal mental health research: priorities from a neurodiverse sample in the United Kingdom.
Lautarescu A, Heraty S, Johnson C … +11 more , Ruigrok A, Eaton E, Bazelmans T, Sigurdardottir J, Ratti V, Stone H, Anderson J, Javed A, Mahtani S, Lau-Zhu A, Smith DM
Arch Womens Ment Health · 2026 Jun · PMID 42329297 · Full text
PURPOSE: The aim of this study is to better understand perinatal mental health research priorities of neurotypical and neurodivergent people. METHODS: A co-designed mixed-methods survey was conducted as part of the Wellb...
PURPOSE: The aim of this study is to better understand perinatal mental health research priorities of neurotypical and neurodivergent people. METHODS: A 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. RESULTS: The 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. CONSLUSIONS: These results suggest complex, multilevel barriers to accessing diagnosis and support in the UK.
Impact of the 2024 South Brazilian flood on obstetric and mental health outcomes in pregnant women.
Skonieski LP, Giuberti P, Garcia MG … +8 more , Baldi BB, Turra Berlaver S, Lodi MA, Machado GC, Motyczka E, Grassi-Oliveira R, Schreiner L, Viola TW
Arch Womens Ment Health · 2026 Jun · PMID 42322363 · Full text
OBJECTIVE: To examine associations between the 2024 South Brazilian flood and postpartum obstetric and maternal mental health outcomes. METHODS: This cross-sectional study recruited 274 postpartum women 8-12 months after...
OBJECTIVE: To examine associations between the 2024 South Brazilian flood and postpartum obstetric and maternal mental health outcomes. METHODS: 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). RESULTS: Financial and housing exposures were associated with higher odds of perinatal posttraumatic stress disorder symptoms (OR = 6.7; 95% CI: 2.4-18.4 and OR = 3.6; 95% CI: 1.2-10.2, respectively) and receipt of mental health care due to the flood (OR = 6.5; 95% CI: 2.3-18.6 and OR = 5.8; 95% CI: 2.1-15.9), whereas only financial exposure was associated with perinatal depression symptoms (OR = 2.6; 95% CI: 1.03-6.6). Delivery within nine months after the disaster was associated with low birth weight (OR = 2.7; 95% CI: 1.03-7.4), gestational preeclampsia (OR = 3.4; 95% CI: 1.32-8.88), and missed prenatal appointments due to the flood (OR = 9.9; 95% CI: 2.4-39.8). Women exposed to financial or housing losses reported greater material and infrastructural disruptions, while those who delivered within nine months of the flood more frequently reported involvement in rescue/aid activities and related emotional distress. CONCLUSION: Disaster-related financial and housing stressors were associated with adverse maternal mental health outcomes, and delivery within nine months after the flood was associated with higher odds of adverse obstetric outcomes.
The effect of emotional freedom technique on premenstrual syndrome, menstrual symptoms and quality of life experienced by nursing students: a randomized controlled trial.
Yakıcı T, Yağcan H
Arch Womens Ment Health · 2026 Jun · PMID 42319509 · Full text
PURPOSE: This randomized controlled trial aimed to investigate the effect of Emotional Freedom Technique (EFT) on premenstrual syndrome, menstrual symptoms, and quality of life among nursing students. METHODS: The study...
PURPOSE: This randomized controlled trial aimed to investigate the effect of Emotional Freedom Technique (EFT) on premenstrual syndrome, menstrual symptoms, and quality of life among nursing students. METHODS: The study was conducted with 80 nursing students enrolled at XXX University, who were randomly assigned to an experimental group (n = 40) and a control group (n = 40) using a pretest-posttest design. Data were collected using the Personal Information Form, Premenstrual Syndrome Scale, Menstrual Symptom Scale, Subjective Units of Distress Scale, and the SF-12 Health Survey. The experimental group received EFT interventions, while the control group received no intervention during the study period. Pre- and post-intervention measurements were obtained for both groups. RESULTS: Following the intervention, statistically significant differences were found between the experimental and control groups in Premenstrual Syndrome Scale, Menstrual Symptom Scale, and Subjective Units of Distress Scale and their subdimensions (p < 0.05). The experimental group also demonstrated significant improvements from pretest to posttest across these measures (p < 0.05). Regarding quality of life, the Mental Component Summary score of the SF-12 increased significantly in the experimental group (p < 0.05), whereas the Physical Component Summary score showed an increase that did not reach statistical significance (p > 0.05). CONCLUSIONS: The findings suggest that EFT may be an effective complementary intervention for reducing premenstrual and menstrual symptoms and improving mental aspects of quality of life among nursing students. EFT may be considered a potentially supportive, non-pharmacological approach in the management of menstrual-related symptoms. TRIAL REGISTRATION: Clinical Trials.gov, NCT06557070.
The effect of mindfulness-based stress reduction training on fear of childbirth and psychological well-being in women experiencing premenstrual syndrome: a randomized controlled trial.
Akbeniz A, Sabancı Baransel E
Arch Womens Ment Health · 2026 Jun · PMID 42319498 · Full text
AIM: This study aimed to evaluate the effects of a Mindfulness-Based Stress Reduction (MBSR) program on premenstrual symptom severity, pre-pregnancy fear of childbirth, and psychological well-being in women experiencing...
AIM: This study aimed to evaluate the effects of a Mindfulness-Based Stress Reduction (MBSR) program on premenstrual symptom severity, pre-pregnancy fear of childbirth, and psychological well-being in women experiencing Premenstrual Syndrome (PMS). MATERIALS AND METHODS: This randomized controlled trial was conducted with 126 women experiencing PMS between June 2023 and November 2025 (MBSR group: n = 63; control group: n = 63). The intervention group participated in an 8-session online MBSR program, delivered twice weekly (40 min per session), while the control group received no intervention. Data were collected using the Premenstrual Syndrome Scale (PMSS), the Childbirth Fear - Prior to Pregnancy Scale (CF-PPS), and the Psychological Well-being Scale (PWBS). Between-group differences were analyzed using analysis of covariance (ANCOVA) adjusting for baseline values, and effect sizes were reported using partial eta-squared (η²). The trial was retrospectively registered (ClinicalTrials.gov, NCT06942169). RESULTS: The MBSR intervention was associated with statistically significant improvements in all outcomes compared to the control group. Adjusted analyses indicated a significant reduction in premenstrual symptom severity (p < 0.001, η²=0.117) and fear of childbirth (p < 0.001, η²=0.125), as well as a significant increase in psychological well-being (p < 0.001, η²=0.285). These findings correspond to moderate effect sizes for PMSS and CF-PPS and a relatively large effect size for PWBS. CONCLUSION: The findings suggest that MBSR may be an effective non-pharmacological intervention for reducing premenstrual symptoms, decreasing pre-pregnancy fear of childbirth, and improving psychological well-being in women experiencing PMS. However, the results should be interpreted with caution due to the short-term nature of the assessment and the absence of long-term follow-up data.
Mothers' parenting stress and depression during infancy predicts parenting self-efficacy and media emotion regulation two years later.
Holmgren HG, Fraser AM, Porter CL … +3 more , Gale M, Stockdale L, Evans-Stout C
Arch Womens Ment Health · 2026 Jun · PMID 42313269 · Publisher ↗
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 an...
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.
The tokophobia severity scale: a psychometric multicountry study with childbearing-age women.
Fidalgo D, Sousa M, Sousa C … +11 more , Jomeen J, Pawlicka P, Riklikienė O, Lamela D, Baird K, Baranowska B, Jarašiūnaitė-Fedosejeva G, Mistelska P, Jongenelen I, Pinto TM, Costa R
Arch Womens Ment Health · 2026 Jun · PMID 42313240 · Full text
PURPOSE: 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...
PURPOSE: 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. METHODS: 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: 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. CONCLUSIONS: TSS is a psychometrically strong measure that can be used to screen clinically significant tokophobia symptoms.
Infanticide: forms, causes and jurisprudential solutions.
Brockington I
Arch Womens Ment Health · 2026 Jun · PMID 42287484 · Publisher ↗
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 ex...
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.
Perinatal depression and breastfeeding: a longitudinal investigation of the bidirectional relationship in Pakistan.
Haight SC, Bates LM, Chung EO … +6 more , Collins A, Frost A, Kachoria AG, Shartle K, Sikander S, Maselko J
Arch Womens Ment Health · 2026 Jun · PMID 42287457 · Full text
PURPOSE: The relationship between perinatal depression and breastfeeding is complicated and reciprocal. While breastfeeding may protect against postpartum depression, perinatal depression can also reduce the likelihood o...
PURPOSE: The 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. METHODS: Data 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). RESULTS: Among 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. CONCLUSIONS: Results 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.
Global, regional, and national burden of depression among women of childbearing age from 1990 to 2021: insights from the Global Burden of Disease Study 2021.
Sun J, Xu W, Zhang G … +1 more , Li P
Arch Womens Ment Health · 2026 Jun · PMID 42240674 · Publisher ↗
PURPOSE: 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 depressi...
PURPOSE: 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. METHODS: 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. RESULTS: Globally, from 1990 to 2021, the incidence rate increased by 17.65% (95% UI, 13.51 to 21.84), prevalence rate by 15.00% (95% UI, 11.53 to 18.39), and YLDs rate by 16.03% (95% UI, 12.39 to 19.86). Among the five SDI regions, the highest EAPCs were observed in the high SDI regions for incidence rate (0.49; 95% UI, 0.26 to 0.72), prevalence rate (0.33; 95% UI,0.15 to0.50), and YLDs rate (0.40; 95% CI, 0.20 to 0.60). Regionally, a U-shaped association was found between the SDI and rate of incidence, prevalence, and YLDs. Nationally, Greenland reported the highest rates of three indicators in 2021, whereas Mexico exhibited the largest growth over time. This study found that the 15-19 age group showed a particularly severe new burden of depression among WCBA in 2021, especially in high SDI. The highest burden of depression among WCBA was reported in the older age groups such as 40-44 and 45-49 age groups. Population growth and epidemiological change were the primary drivers of this change except in low SDI which aging was the primary driver. Our study predictions suggested that the burden of depression among WCBA will continue to grow in the future. CONCLUSIONS: Overall, the burden of depression among WCBA has significantly increased globally over the past 32 years, particularly in high SDI regions and among the 15-19 age group. The findings underscore the need for tailored interventions to control the projected rise burden of depression among WCBA.
Factors associated with mother-to-infant bonding difficulties without prior postnatal depression at 1 and 6 months after childbirth: the Japan Environment and Children's Study (JECS).
Inano H, Matsumura K, Tsuchida A … +4 more , Inadera H, Shimada K, Hasegawa T, Japan Environment and Children’s Study (JECS) Group
Arch Womens Ment Health · 2026 Jun · PMID 42234192 · Full text
PURPOSE: To identify factors associated with mother-to-infant bonding difficulties (MIBD) in mothers without prior postnatal depression and to elucidate the prevalence. METHODS: A total of 64,938 mother-child pairs who h...
PURPOSE: To identify factors associated with mother-to-infant bonding difficulties (MIBD) in mothers without prior postnatal depression and to elucidate the prevalence. METHODS: A total of 64,938 mother-child pairs who had registered between 2011 and 2014 in a nationwide birth cohort study called the Japan Environment and Children's Study (JECS) were analysed. MIBD was assessed using the Mother-to-Infant Bonding Scale Japanese version (MIBS-J). Prior postnatal depression was defined as an Edinburgh Postnatal Depression Scale score ≥ 9 at both 1 month and 6 months postpartum, and mothers who met this criterion were excluded. Mothers with a MIBS-J score ≥ 5 were considered to have MIBD. Cut-offs of ≥ 3 were set for MIBS-J subscale scores for lack of affection (LA)and anger/rejection (AR). We set 30 factors as exposures, and data were subjected to logistic regression analysis. RESULTS: The prevalence of MIBD, LA, and AR among those without prior postpartum depression was 7.7%, 3.9%, and 11.7%, respectively. The most strongly associated factors were 'feeling difficulty in holding the baby when they were cranky or arching their back' (AOR: 3.45 [2.96-4.03]) and 'negative feelings towards the pregnancy' (AOR: 2.42 [2.20-2.65]). 'High social support' (AOR: 0.45 [0.41-0.49]) was strongly associated with the absence of MIBD without prior postnatal depression. CONCLUSIONS: In this study, the prevalence of MIBD among women without prior postnatal depression was 7.7%. MIBD without prior postnatal depression was strongly associated with 'difficulty holding the baby when they were cranky or arching their back', 'low social support', and 'negative feelings towards the pregnancy'.
ADHD and the female reproductive stages: menstruation, perinatal and menopause.
Boyd C, Wrigley M, Kilbride K … +2 more , Mulligan A, Bramham J
Arch Womens Ment Health · 2026 May · PMID 42207323 · Full text
PURPOSE: Gender differences in the presentation of Attention-Deficit/Hyperactivity Disorder (ADHD) are well-documented, yet the interaction between ADHD and female reproductive stages remains underexplored. This study in...
PURPOSE: Gender differences in the presentation of Attention-Deficit/Hyperactivity Disorder (ADHD) are well-documented, yet the interaction between ADHD and female reproductive stages remains underexplored. This study investigates how ADHD impacts menstruation, perinatal experiences, and menopausal symptoms in females. METHODS: A cross-sectional study was conducted with 602 females (mean age = 39.52; SD = 10.21), including 377 with self-reported ADHD and 225 without, recruited through ADHD support groups, social media, Volunteer Ireland, and Prolific. Participants reported their menstrual regularity and completed the Premenstrual Symptoms Screening Tool (PSST). Retrospective postpartum depression levels were measured using the Edinburgh Postnatal Depression Scale (EPDS), and peri- and post-menopausal symptoms were evaluated using the Greene Climacteric Scale (GCS). RESULTS: Females with ADHD exhibited significantly higher rates of menstrual irregularity (χ2 = 14.2, p < .001), more severe premenstrual symptoms (χ2 = 204.7, p < .001), elevated postpartum depression levels (t = 7.89, p < .001) with increased risk of unplanned pregnancies and pregnancy-related complications, and greater menopausal symptom severity (t = 9.61, p < .001) compared to their non-ADHD counterparts. CONCLUSIONS: These findings highlight a higher prevalence of reproductive-related challenges in females with ADHD, underscoring the need for further research in this area and more in-depth analysis. They emphasise the importance of integrating ADHD considerations into female health research and clinical practice.
Relationship between hypertensive disorders of pregnancy and postpartum mood and anxiety symptoms: P4 study.
Scott A, Harris K, Roberts LM … +2 more , Graham B, Henry A
Arch Womens Ment Health · 2026 May · PMID 42176084 · Publisher ↗
PURPOSE: Evaluate the relationship between hypertensive disorders of pregnancy (HDP) and long-term mood and anxiety symptoms by (a) investigating prevalence at 5-years after HDP versus normotensive pregnancy (b) comparin...
PURPOSE: Evaluate the relationship between hypertensive disorders of pregnancy (HDP) and long-term mood and anxiety symptoms by (a) investigating prevalence at 5-years after HDP versus normotensive pregnancy (b) comparing longitudinal data 6-months, 2-years and 5-years postpartum. METHODS: Women were recruited 2013-2018 following singleton birth into an observational cohort and categorised into groups: normal blood pressure (NBP), gestational hypertension (GH) and preeclampsia (PE). Surveys measured prevalence and severity of symptoms using the following screening tools: Edinburgh Postnatal Depression Scale (EPDS > 12), 7-item Generalized Anxiety Disorder Scale (GAD-7 ≥ 10), and Posttraumatic Stress Diagnostic Scale (PDS/PDS-5 ≥ 28). RESULTS: 5-years postpartum, 314 participants were surveyed (normotensive n = 238(76%), gestational hypertension n = 17(5%), Preeclampsia n = 59(19%)). Mood and anxiety symptoms (EPDS > 12, GAD-7 ≥ 10, or PDS-5 ≥ 28) were present in 10.8%. Women following preeclampsia had similar prevalence of mood and anxiety symptoms at 5-years compared to NBP (normotensive 10.1% vs. preeclampsia 10.2%, p = 0.20). More women recalled childbirth as traumatic after preeclampsia (normotensive 0.4% vs. preeclampsia 5.5%, p = 0.01). Significant predictors for mood and anxiety symptoms 5-years postpartum were mental illness history and significant stress in the preceding 12-months (p < 0.001 and p = 0.01). Longitudinal analysis found higher rates of mood and anxiety symptoms 5-years (10.8%) than at 2-years and 6-months (5.4% and 4.5% respectively, p < 0.001). CONCLUSION: Prevalence of mood and anxiety symptoms increased over time, hypertensive disorders of pregnancy were not a contributing factor. Prior mental illness and recent life stressors were key predictors.
Changes in facial emotion processing and depression and anxiety symptoms with polycystic ovary syndrome treatment: a longitudinal, naturalistic study.
Douglas KM, Sukhapure M, Porter RJ … +2 more , Fenton A, Eggleston K
Arch Womens Ment Health · 2026 May · PMID 42176072 · Full text
PURPOSE: Changes in facial emotion processing were examined over the course of anti-androgen treatment in women with PCOS. We also explored whether these changes in emotion processing correlated with changes in mood and...
PURPOSE: Changes in facial emotion processing were examined over the course of anti-androgen treatment in women with PCOS. We also explored whether these changes in emotion processing correlated with changes in mood and anxiety symptoms over treatment. METHODS: Thirty-three women with PCOS received 12 weeks of naturalistic treatment based on clinical presentation. Facial emotion processing was assessed at baseline and 12-weeks on the Reading the Mind in the Eyes Test, and a computerised Facial Expression Recognition (FER) Task, which measured accuracy and response time in recognising facial expressions (happiness, sadness, fear, disgust, anger, neutral), and neutral misinterpretation bias. The Hospital Anxiety and Depression Scale was completed at the same time-points. Outcomes were compared with a control group of 40 healthy women. RESULTS: Women with PCOS (mean age = 29 years) were treated with a variety of medications, mainly spironolactone (n = 22) and oral contraceptives (n = 16). Within the PCOS group, significant improvement was found for 10 of 19 FER variables over treatment, and in depression and anxiety symptoms. When comparing the PCOS and control groups over time, the PCOS group became significantly faster in responding to disgusted and neutral expressions, and reduced in their tendency to misinterpret neutral faces as angry. Improved depression and anxiety symptoms correlated significantly with improved accuracy in recognising fearful expressions, but not with any other FER variables. CONCLUSIONS: In this preliminary study, anti-androgen treatment improved some aspects of facial emotion processing in women with PCOS, which has implications for understanding the mental health aspects of PCOS.
Benzodiazepine exposure during early pregnancy and risk of miscarriage: dose-response, half-life classification, and individual agents.
Ishikawa T, Sakai T, Iwama N … +14 more , Obara R, Morishita K, Adomi M, Kunitoki T, Noda A, Ishikuro M, Kikuchi S, Kobayashi N, Tomita H, Saito M, Nishigori H, Kuriyama S, Mano N, Obara T
Arch Womens Ment Health · 2026 May · PMID 42176056 · Full text
PURPOSE: To evaluate the association between benzodiazepine exposure during early pregnancy and the risk of miscarriage, with a focus on dose-response, half-life, and individual agents. METHODS: This nested case-control...
PURPOSE: To evaluate the association between benzodiazepine exposure during early pregnancy and the risk of miscarriage, with a focus on dose-response, half-life, and individual agents. METHODS: This nested case-control study was conducted using a large Japanese administrative database. Cases were defined as pregnancies ending in miscarriage between 2005 and 2023. Controls were randomly selected through risk-set sampling with replacement and matched in a 3:1 ratio. Conditional logistic regression, adjusted for confounders, was used to assess the associations. RESULTS: Overall, 44,118 cases were matched with 132,317 controls, with a mean age of 33.2 years. The prevalence of benzodiazepine exposure was 1.7% and 1.2% among cases and controls, respectively. Etizolam (0.3%) had the highest prevalence, followed by alprazolam (0.3%) and brotizolam (0.2%) in both groups. Adjusted odds ratio (OR) for benzodiazepine exposure during early pregnancy was 1.241 (95% confidence interval: 1.136-1.357). Adjusted ORs for high-dose (1.212 [1.050-1.400]) and medium-dose (1.189 [1.037-1.363]) exposure were numerically higher than that for low-dose exposure (1.111 [0.934-1.322]). Adjusted OR for long-acting benzodiazepines (1.308 [1.124-1.522]) was numerically higher than those for intermediate- (1.132 [0.999-1.284]) and short-acting (1.157 [1.030-1.300]) agents. Adjusted ORs for etizolam, alprazolam, and brotizolam were 0.929 (0.782-1.103), 0.853 (0.707-1.030), and 1.454 (1.180-1.791), respectively. CONCLUSIONS: Benzodiazepine exposure during early pregnancy was modestly associated with an increased risk of miscarriage. Although associations tended to be stronger with higher dose levels and longer half-life categories, estimates across subgroups lacked precision and should be interpreted with caution.
Moderators, mediators, and components of a standalone smartphone application for postpartum depression: secondary analysis of a randomized controlled trial.
Borja T, Fonseca Zuccolo P, Seda L … +3 more , Matijasevich A, Vanoni Polanczyk G, Fatori D
Arch Womens Ment Health · 2026 May · PMID 42171809 · Full text
PURPOSE: The purpose of this study was to identify potential moderators, mediators, and efficacious components of a standalone app intervention on postpartum depression symptoms and functional impairment. METHODS: A tota...
PURPOSE: The purpose of this study was to identify potential moderators, mediators, and efficacious components of a standalone app intervention on postpartum depression symptoms and functional impairment. METHODS: A total of 264 women were randomized to intervention (Motherly app) or to an active control group. We analyzed depressive symptoms assessed by the Edinburgh Postnatal Depression Scale and functional impairment by the Clinical Global Impression at post-treatment as outcomes. Various potential moderators were assessed at baseline. Potential mediation variables were the level of behavioral activation (BA) measured by the Behavioral Activation for Depression Scale - Short Form and the Response-contingent positive reinforcement (RCPR) by the Reward Probability Index, at post-treatment. Intervention component analysis was evaluated using app engagement data. RESULTS: The results indicate that intervention effects on depressive symptoms were moderated by the number of children and pediatric consultations, with stronger effects observed among mothers with fewer children and higher consultation frequency. Functional impairment was moderated by time spent with the child, with greater improvements among mothers with lower caregiving demands. Mediation analyses showed BA and RCPR mediated the effect of our intervention on depressive symptoms and functional impairment. Total and BA achievements were significantly associated with reduction in depressive symptoms. CONCLUSION: Our findings suggest that our app intervention efficacy is influenced by maternal characteristics and childcare responsibilities. BA and RCPR are key mechanisms, and higher engagement with app components produce greater symptom reduction.
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