Amidst a rapidly growing worldwide literature on non-invasive interventions to optimize parent–child relationships prenatally, the effectiveness of prenatal attachment intervention remains uncertain due to methodologic restrictions of prior systematic reviews. The current systematic review was aimed at capturing the diversity of study designs, intervention targets and methods employed reflective of this burgeoning literature. We then employed meta-regression to evaluate the impact of expected heterogeneity on estimated intervention effects.
We searched MEDLINE/PubMed, Scopus, PsychINFO, Trip database, and Google Scholar for empirical prenatal attachment intervention studies published through August 11, 2025, with titles and abstracts written in English. Articles with main texts written in other languages were translated prior to analysis (PROSPERO ID CRD42021241199).
Prenatal attachment scores increased following intervention when examining all studies (p < . 001), randomized controlled trials only (p < .001), and studies of only male expectant parents (p = .017). Specific intervention methods found to be effective were touch and Leopold’s maneuver (p = .004), fetal movement counting (p < .001), music, lullaby and singing (p = .012), relaxation techniques (p = .014), cognitive therapies (p = .022), meditation (p = .003), breathing exercises (p = .001), and educational interventions (p < .001).
While the prior systematic reviews of prenatal attachment interventions involving a total of 15 randomized controlled trials suggested equivocal effects of prenatal intervention, evidence from the current more inclusive review of non-randomized control trial (RCT) studies testing a wide range of intervention methods was substantially more compelling. More research on prenatal attachment in non-pregnant expectant partners and other caregivers and on promising but understudied interventions involving music and 3D fetal ultrasound images is recommended.
Cannabis use has increased markedly in Iran, emerging as the second most commonly consumed illicit substance, with a notable rise among women. Interpersonal relationships play a critical role in shaping behaviors and patterns of substance use. This study examines how young women who use cannabis interpret their interpersonal relationships.
A thematic narrative analysis was conducted in Karaj and Tehran from 2022 to 2023. Twelve young women who use cannabis were recruited through purposive and snowball sampling methods. Semi-structured interviews were conducted until data saturation was reached. Interview data were analyzed using open coding and thematic analysis to identify key relational dynamics related to cannabis use.
A total of 961 open codes were generated and organized into two overarching themes. The first theme, “A Triad of Dysfunctional Interpersonal Relationships—Father, Mother, and Child,”, comprising 447 codes, illustrated how maladaptive familial interactions contributed to the initiation and persistence of cannabis use. The second theme, “Positive and Negative Qualities of Interpersonal Relationships Across Childhood, Adolescence, and Early Adulthood,”, encompassed 514 codes and five subthemes. While some participants reported receiving emotional support from peers or family members, the prevailing narrative involved experiences of emotional neglect, parent–child conflict, and the absence of secure attachment figures. These relational challenges were frequently cited as key drivers of the initiation and persistence of cannabis use, employed as a coping mechanism in response to unresolved emotional needs and relational distress.
The findings indicate that early experiences of family dysfunction and unresolved relational trauma substantially shape patterns of cannabis use among young women in Iran. Preventive strategies should include parent-focused educational interventions on emotional communication, family cohesion, and support structures. Additionally, increased access to psychosocial support and counseling services for young women is essential to mitigate risk and address underlying relational vulnerabilities.
Women’s risk of mental health conditions fluctuates across the lifespan with hormone-mediated reproductive transitions. Reproductive psychiatry, a relatively new subspecialty, focuses on preventing and treating these conditions throughout various reproductive stages. Multimodal large language models (MLLMs) are advanced artificial intelligence (AI) systems that can process and integrate information across multiple modalities, including text, images, audio, and video. Although MLLMs have shown broad utility in healthcare, their potential in reproductive psychiatry remains largely unexplored.Objective: To explore how MLLMs could advance research and clinical care in women’s reproductive mental health and to outline opportunities, requirements, and barriers for safe, equitable deployment.
This perspective synthesizes the literature and domain expertise using a consistent analytical framework applied to each application domain in women’s reproductive mental health: (1) define gaps in current clinical knowledge and practice; (2) explain why prevailing AI methods are insufficient; and (3) specify the distinctive advantages of MLLMs, including example data modalities and use cases relevant to reproductive psychiatry.
We identify seven application domains: (1) menstruation, (2) pregnancy, (3) abortion, miscarriage and recurrent pregnancy loss, (4) the postpartum period, (5) menopause, (6) psychiatric comorbidities in infertility, and (7) gynecologic conditions (e.g., endometriosis, polycystic ovary syndrome). Across these domains, MLLMs could enable multimodal risk stratification, longitudinal symptom trajectory modelling, clinical decision support, and patient-tailored education and self-management resources that adapt to evolving reproductive stages. Realizing these benefits requires addressing bias in training corpora; safeguarding privacy and consent for sensitive reproductive data; ensuring consistent, high-quality longitudinal data collection across life stages; and establishing standardized, well-governed multimodal repositories specific to women’s health.
MLLMs hold promise to foster more personalized and precise care in reproductive psychiatry. By mapping opportunities and constraints and proposing a structured evaluation lens, this perspective aims to inform clinicians and researchers, stimulate cross-disciplinary dialogue, and guide responsible development and integration of MLLMs in women’s mental health.
The pregnancy and postpartum periods represent a time of heightened psychological vulnerability with implications for the offspring. Knowledge of the mental health of perinatal women exposed to armed conflict when their partner is in military deployment is scarce.
This matched-control, survey-based study included a sample of 429 women recruited during the first months of the Israel-Hamas War who were pregnant or within six months postpartum. Women who had a partner in military deployment were matched primarily on demographics, prior mental health, and trauma exposure to women whose partner was no longer deployed.
We found that nearly 44% of pregnant women with a partner deployed endorsed probable depression. This group was more than twice as likely to endorse probable depression than matched pregnant controls. Likewise, postpartum women with a partner deployed reported significantly more maternal-infant attachment problems than the matched postpartum group of partners not deployed. Importantly, analysis showed that partner’s active deployment was related to maternal depression and attachment problems via reduced perceived social support.
Partner military deployment during conditions of war can serve as a major psychological stressor for pregnant and postpartum women. It can heighten psychiatric morbidity and interfere with attachment to the infant in part by diminished social support. Implementation of community-based services for the peripartum population is crucial during times of war and other large-scale traumas.
Depression, anxiety, and mood disorders are common in women. Tibolone, acting as both estrogen and progestin, has shown conflicting effects in hormone therapy. This first meta-analysis of RCTs assesses Tibolone’s impact on these conditions in women.
Two reviewers independently searched Scopus, PubMed/Medline, Web of Science, and Embase up to 22 May 2024. Using the DerSimonian and Laird random-effects model, weighted mean differences (WMD) with 95% confidence intervals (CI) were calculated. Risk of bias was assessed using the Cochrane tool, and evidence certainty was rated using the GRADE approach.
Eight articles were included in the meta-analysis. Tibolone significantly reduced depression scores (WMD = -5.335, 95% CI: -9.144 to -1.525, p = 0.006), with high heterogeneity (I² = 99.8%). Greater effects were observed in trials ≤6 months. Anxiety (WMD =-1.489, CI: -3.271 to 0.294, p = 0.102, I² = 99.1%) and mood (WMD = -0.719, CI:-1.805 to 0.366, p = 0.194, I² = 76.6%) scores showed non-significant reductions.
Tibolone significantly improved depressive symptoms in women, with non-significant trends in anxiety and mood. However, due to high heterogeneity, risk of bias in some studies, and limited number of trials for anxiety and mood outcomes, findings should be interpreted with caution.
During pregnancy, it is unclear whether women with attention deficit hyperactivity disorder (ADHD) should stop prescribed medication – risking relapse – or continue – risking harm to themselves and their baby. We aimed to conduct a systematic review to examine whether ADHD medications should be continued during pregnancy.
We searched MEDLINE, Embase, PsycINFO, PubMed, CINAHL, AMED, CENTRAL, Cochrane Library, NHS Knowledge and Library Hub from 1st July 2019 to 1st July 2024, without any restrictions on language, setting, or study type. We supplemented this with relevant studies identified from the references of retrieved studies. Two authors used the Newcastle-Ottawa Scale (NOS) to independently rate the quality of included studies.
Twelve cohort studies were included in the qualitative review. All were deemed high quality (NOS ≥ 7). Seven studies found ADHD medication use during pregnancy had no significant negative effect on maternal or offspring outcomes. One study found continuing ADHD medication reduced the risk of various negative outcomes, and another found stopping ADHD medication may increase the risk of threatened abortion. Three studies concluded that ADHD medication use was associated with negative outcomes: pre-eclampsia, gastroschisis, omphalocele, and transverse limb deficiency. Modafinil was identified as significantly increasing the risk of congenital malformations.
Women taking modafinil should consider stopping it prior to pregnancy. Clinicians should discuss the risks, benefits, and uncertainties of other ADHD medications with women who are pregnant, or considering pregnancy, keeping in mind that the benefits of continuing ADHD medications- where it is effective for an individual- are likely to outweigh the risks.
Few robust estimates of perinatal anxiety and/or depression in women who experienced anxiety and/or depression before pregnancy have been reported in the literature. This study calculated rates of perinatal anxiety and depression in women with a history of the disorders using data from the Australian Longitudinal Study on Women’s Health, the Australian Government’s Pharmaceutical Benefits Scheme and the Medicare Benefits Schedule.
The analysis included two cohorts of Australian women. The first comprised 14,247 women born between 1973 and 1978 with nine waves of data collected from 1996 to 2018. The second cohort included 17,010 women born between 1989 and 1995 with data collected from six waves between 2013 and 2019. The proportion of women who reported anxiety and/or depression before having a child and who then reported anxiety and/or depression perinatally (i.e. relapse/recurrence) was calculated for first births and for any birth.
Compared to women who did not report preconception anxiety or depression, rates of perinatal anxiety and depression were higher among women reporting either condition pre-conceptually. For women in the 1973-78 cohort, the rate of perinatal anxiety was 24% (vs. 7%) and the rate of perinatal depression was 26% (vs. 10%). In the 1989-95 cohort, the rate of perinatal anxiety was 43% for women with preconception anxiety (vs. 18%) and the rate of perinatal depression was 41% for women with preconception depression (vs. 12%).
Given the high rates of perinatal relapse or recurrence in women with preconception anxiety and/or depression, as well as the well-established risks to the health and development of their offspring, supporting these women to remain asymptomatic during the perinatal period is a priority.
Suicidal behavior during pregnancy, including ideation, planning, and attempts, represents a significant but under-researched public health concern linked to adverse maternal and fetal outcomes such as preterm labor, low birth weight, and stillbirth. This systematic review and meta-analysis (SRMA) aimed to synthesize evidence on the association between suicidal behavior during pregnancy and feto-maternal outcomes, addressing existing gaps in the literature.
The SRMA, following PRISMA 2020 guidelines, included observational studies that reported maternal and fetal outcomes among pregnant women exhibiting suicidal behaviour (suicidal ideation, planning, or attempts). Four databases (PubMed, Embase, Web of Science, and Cochrane) were searched up to April 30, 2025, and 18 studies were included. Risk of bias assessment was done using the Newcastle-Ottawa scale. Data were analysed using random-effects models to calculate pooled relative risks (RRs) and 95% confidence intervals (CIs).
From the 18 studies included for the SRMA, a total of 30749705 participants were analysed, with 6557 in the suicidal behaviour group. Suicidal behaviour significantly increased the risk of preterm labor (RR = 1.78, 95% CI: 1.7–1.86), preterm birth (RR = 1.40, 95% CI: 1.26–1.55), fetal anomaly (RR = 1.84, 95% CI: 1.22–2.77) and Low Birth Weight (RR = 1.83, 95% CI: 1.67–2.02), with no heterogeneity observed (I² = 0%). Stillbirth risk was markedly elevated (RR = 11.92, 95% CI: 10.32–13.77). Other outcomes, such as placental abruption and postpartum hemorrhage, also demonstrated increased risks. All the outcomes had a low to very low certainty of evidence.
Suicidal behaviour during pregnancy poses significant risks to maternal and fetal health, emphasizing the need for early identification and interventions. Addressing maternal mental health must be prioritized in prenatal care to improve outcomes for both mother and child. Others: The protocol was registered in the PROSPERO (ID: CRD42024539860).
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