Weekly Roundup for MAY 5, 2023: Recent Publications in Women’s Mental Health

Prenatal depression moderates the relationship between maternal trauma exposure and cortisol production and predicts breastfeeding behavior.

Bengtson L, Aubuchon-Endsley NL.  Women Health. 2023 Apr 5:1-12. 

In this study of 96 women, increased prenatal depressive symptoms were related to elevated prenatal cortisol awakening response, as well as moderated the relationship between interpersonal trauma exposure and greater prenatal cortisol awakening response. A significant positive correlation was also found between trauma and prenatal depressive symptoms, as well as a significant negative correlation between prenatal depressive symptoms and breastfeeding frequency. 

Dietary interventions for perinatal depression and anxiety: a systematic review and meta-analysis of randomized controlled trials.

Tsai Z, Shah N, Tahir U, Mortaji N, Owais S, Perreault M, Van Lieshout RJ.  Am J Clin Nutr. 2023 Apr 3:S0002-9165(23)46315-0.

Despite their widespread popularity, PUFAs and elemental metals do not appear to effectively reduce perinatal depression. Vitamin D taken in doses of 1800 to 3500 International Units (IU) per day may have some promise. Additional high-quality, large-scale randomized controlled trials (RCTs) are needed.

The role of perinatal psychiatry access programs in advancing mental health equity.

Deichen Hansen ME, Londoño Tobón A, Kamal Haider U, Moore Simas TA, Newsome M, Finelli J, Boama-Nyarko E, Mittal L, Tabb KM, Nápoles AM, Schaefer AJ, Davis WN, Mackie TI, Flynn HA, Byatt N.  Gen Hosp Psychiatry. 2023 May-Jun;82:75-85.

Racial-Ethnic Differences in Treatment Initiation for New Diagnoses of Perinatal Depression.

Avalos LA, Nance N, Iturralde E, Badon SE, Quesenberry CP, Sterling S, Li DK, Flanagan T.  Psychiatr Serv. 2023 Apr 1;74(4):341-348.

In total, 13,637 women with a new depression diagnosis (prenatal: N=7,041, 51.6%; postpartum: N=6,596, 48.4%) were identified. Of the pregnant women, 31.4% initiated treatment, and of the postpartum women, 73.1% initiated treatment. Latina and Asian women were less likely than White women to initiate treatment postpartum. During pregnancy and postpartum, non-White women were more likely to initiate psychotherapy. White women were more likely to initiate antidepressant medication during pregnancy and postpartum or a combination of antidepressant medication and psychotherapy during the postpartum period.

Risk of hospital admission after discharge from postpartum psychiatric emergency department visits: A focus on the social determinants of health.

Barker LC, Fung K, Zaheer J, Brown HK, Bronskill SE, Kurdyak P, Vigod SN.  Gen Hosp Psychiatry. 2023 Apr 5;83:27-34. 

Psychiatric admission occurred for 9.5% (n = 1242) within 365 days of a psychiatric emergency department visit. Risk was lower among adolescents (vs. ?35 years aRR 0.80, 95%CI 0.65-0.97) and immigrants (<5 years in Canada vs. Canadian-born/long-term residents 0.70, 0.51-0.96; ?5 years in Canada 0.79, 0.65-0.95). Among four identified subgroups, compared to the “older/urban/high-income” subgroup (11.1% admission), the “urban/immigrant/low-income” (7.6%; 0.68, 0.55-0.82) and “young/rural/low-income” subgroups (9.7%; 0.78, 0.63-0.96), but not the “semi-urban/middle-income” subgroup (9.5%; 0.86, 0.73-1.01), were at lower admission risk.

Follow-up after postpartum psychiatric emergency department visits: an equity-focused population-based study in Canada.

Barker LC, Brown HK, Bronskill SE, Kurdyak P, Austin PC, Hussain-Shamsy N, Fung K, Vigod SN.  Lancet Psychiatry. 2022 May;9(5):389-401.

Fewer than half of emergency department visits for a psychiatric reason in the post-partum period were followed by timely outpatient care, with social-determinants-of-health-based disparities in access to care. 

Co-occurrence of depression, anxiety, and perinatal posttraumatic stress in postpartum persons.

Howard S, Witt C, Martin K, Bhatt A, Venable E, Buzhardt S, Chapple AG, Sutton EF.

BMC Pregnancy Childbirth. 2023 Apr 5;23(1):232.

Postpartum patients with mild anxiety or more (i.e. GAD7 > 4) had 26 times higher odds of screening positive for symptoms of depression (PHQ9 > 4) (adjusted odds ratio [aOR] 26.3; 95% confidence interval [CI] 15.29-46.92; p < 0.001). Postpartum persons with a PPQII score indicating symptoms of perinatal PTSD (PPQII [Formula: see text] 19) had 44 times higher odds of screening positive for symptoms of depression (PHQ > 4) (aOR 44.14; 95%CI 5.07-5856.17; p < 0.001).

Dysphoric Milk Ejection Reflex: Report of Two Cases and Postulated Mechanisms and Treatment.

Liu H, Li J, Li X, Lu H.  Breastfeed Med. 2023 Apr 5. 

An investigation into the relationship between community engagement and maternal mental health in Calgary, Alberta using the All Our Families cohort.

Benny C, Pietrosanu M, Lowe SAJ, Yamamoto SS, Kong L, McDonald S, Pabayo R.  Soc Psychiatry Psychiatr Epidemiol. 2023 Apr 5. 

Community engagement has a protective effect against depression and anxiety amongst mothers. The results of this study are in line with existing evidence suggesting that social cohesion, civic participation, and community engagement are protective against adverse mental health outcomes.

Psychodynamic Psychotherapy for Postpartum Depression: A Systematic Review.

Valverde N, Mollejo E, Legarra L, Gómez-Gutiérrez M.  Matern Child Health J. 2023 Apr 8. 

Effectiveness of interventions to prevent perinatal depression: An umbrella review of systematic reviews and meta-analysis.

Motrico E, Bina R, Kassianos AP, Le HN, Mateus V, Oztekin D, Rodriguez-Muñoz MF, Moreno-Peral P, Conejo-Cerón S.  Gen Hosp Psychiatry. 2023 May-Jun;82:47-61.

Exercise/physical activity-based and psychological interventions have a small-to-medium effect on reducing perinatal depressive symptoms. There is insufficient evidence to conclude that dietary supplements and pharmacological interventions are effective in preventing perinatal depression. 

Parental personality traits and emotion regulation: Its relationship with infants’ socioemotional development during the perinatal period.

Muzard A, Olhaberry M, Nuñez C, Vaccarezza S, Franco P, Morán J, Sieverson C, León MJ, Apter G.  Gen Hosp Psychiatry. 2023 Apr 5;83:20-26. 

Differences between maternal and paternal personality traits and emotion regulation difficulties during the perinatal period as well as distinct contributions on infant’s socioemotional development.

Interaction between isolated maternal hypothyroxinemia and pregnancy-related anxiety on preschooler’s internalizing and externalizing problems: A birth cohort study.

Li P, Ru X, Teng Y, Han Y, Liu Z, Tao F, Huang K.

Psychoneuroendocrinology. 2023 Mar 29;152:106102. 

Hypothyroidism during pregnancy and pregnancy-related anxiety during pregnancy may synergistically increase the risk of internalizing and externalizing problems in preschooler children. This interaction is distinct in internalizing problems of preschool girls.

Abortion Restriction and Mental Health.

Wisner KL, Appelbaum PS.  JAMA Psychiatry. 2023 Apr 1;80(4):285-286.

Maternal anxiety, depression and posttraumatic stress disorder (PTSD) after natural disasters: a systematic review.

Futterman ID, Grace H, Weingarten S, Borjian A, Clare CA.  J Matern Fetal Neonatal Med. 2023 Dec;36(1):2199345.

A total of 8357 pregnant or birthing persons in the antepartum and postpartum periods were studied. The prevalence of post-pandemic anxiety, depression and PTSD were calculated to be 48.2%, 27.3%, and 22.9%. Post-earthquake depression and PTSD rates were 38.8% and 22.4%. The prevalence of post-hurricane anxiety, depression and PTSD were 17.4%, 22.5%, and 8.2%. The rates of post-political conflict anxiety, depression and PTSD were 48.8%, 31.6% and 18.5%.

Risk of Global Developmental Delay in Infants Born from Mothers with COVID-19: A Cross-Sectional Study.

Silva PYF, Lima da Cruz MC, Guerra Azevedo I, Moreira RS, Sousa KG, Pereira SA.  Int J Womens Health. 2023 Apr 1;15:467-474. 

In this study including 54 infants, those born to mothers with COVID-19 were at high risk of motor developmental delay and socioemotional alterations. 

High rate of insecure attachment patterns in preterm infants at early school age.

Mehler K, Heine E, Kribs A, Schoemig C, Reimann L, Nonhoff C, Kissgen R.

Acta Paediatr. 2023 May;112(5):977-983. 

Very preterm infants had the highest rate of insecure attachment (81%) compared to moderate or late preterm infants (60%) and full-term infants (47%); (p = 0.013). 

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