Archives of Women's Mental Health最新文献

Purpose

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.

Materials and methods

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).

Results

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.

Conclusion

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).

Purpose

Although the relationship between previous pregnancy loss and perinatal depression has been explored, most previous research has been cross-sectional and has not utilized diagnostic evaluation techniques. This study longitudinally examined the relationship using the self-administered web-based World Health Organization Composite International Diagnostic Interview 3.0.

Methods

This study used data from a control group of pregnant women in a randomized controlled trial conducted between November 2019 and March 2020. An accelerated failure time model with Weibull distribution was conducted to evaluate the impact of previous pregnancy loss by number (never, once, and two or more times) on the onset of perinatal depression from 18 ± 2 weeks (baseline) to 3 months postpartum.

Results

The final analysis included 2,347 participants. The risk of developing perinatal depression was significantly higher for those with two or more previous pregnancy losses compared to those with no previous pregnancy loss (adjusted models: time ratio 0.17, 95% CI 0.03–0.86, p = 0.033). No statistically significant difference was found between those with one pregnancy loss and those with no previous pregnancy loss (adjusted models: time ratio 0.99, 95% confidence interval [CI] 0.24–4.04, p = 0.990).

Conclusion

Women who experienced repeated pregnancy loss had an elevated risk of diagnosable perinatal depression. Thus, it is crucial to consider interventions targeting pregnant women who have experienced repeated pregnancy loss to prevent perinatal depression.

Purpose

Oral contraceptives (OCs) are commonly used for the treatment of polycystic ovarian syndrome (PCOS). However, the therapeutic effects of OCs on cognitive function have not been explored extensively. This study aimed to determine the changes in cognitive function in PCOS patients treated with three cycles of combined oral contraceptives (COCs) containing estrogen and progesterone.

Methods

Drug-naive PCOS patients (N = 35), aged 18–35 years, were evaluated at baseline and three months after treatment with COC containing levonorgestrel (0.15 mg) plus ethinyl estradiol (30 µg). Working memory (WM), attention, and executive function domains of cognition were assessed using the auditory and visual digit span test (DST), continuous performance test-identical pair (CPT-IP), and trail-making test (TMT), respectively.

Results

The DST results showed improvements in the maximal digit span (ML) of the auditory (p = 0.0039) and visual (p = 0.0005) WM tasks after treatment. Improvements were also observed in the mean span (MS) of the auditory (Cohen’s d = 0.94, p = 0.0009) and visual (Cohen’s d = 0.90, p < 0.0001) DST after treatment. In CPT-IP test, the mean reaction time (RT) of hit rate (Cohen’s d = 0.64, p = 0.01) and random errors (Cohen’s d = 0.64, p = 0.01) showed a significant decrease after treatment. After treatment, TMT showed a significant decrease in all parameters, except trail 1 errors (p = 0.1079).

Conclusions

This preliminary study suggests that three months of COCs treatment in PCOS patients improves cognitive performance in the domains of WM, attention, and executive function. However, the lack of a control group and short follow-up period limits the strength of our findings.

Purpose

Infant temperament is influenced by environmental factors, such as maternal depression and anxiety. However, the association between maternal sleep and infant temperament is unclear. We examined the associations between maternal postpartum sleep and maternal perception of infant temperament and the moderating effect of maternal depression and anxiety over 6 months following delivery.

Methods

Postpartum women with a history of depression (N = 166) completed the Pittsburgh Sleep Quality Index, Edinburgh Postnatal Depression scale, Generalized Anxiety Disorder Scale-7, and Infant Behavior Questionnaire-Very Short Form once per month for 6 months post-delivery. Associations between maternal sleep and infant temperament and interactions with maternal anxiety and depression were tested via 2-level multilevel models.

Results

At the month-level, shorter sleep duration and greater sleep disturbance were significantly associated with higher infant negative affectivity, and shorter sleep duration, greater sleep disturbance, and lower sleep efficiency were associated with significantly lower infant orienting/regulation (p’s < 0.05). At the person-level, lower sleep efficiency and greater sleep disturbance were significantly associated with higher infant negative affectivity (p’s < 0.05). Both person-level effects were significantly moderated by depression symptoms, whereas only the effect of sleep efficiency was moderated by anxiety symptoms (p’s < 0.05).

Conclusions

Maternal perception of infant orienting/regulation may be sensitive to acute sleep disruption, whereas maternal perception of infant negative affectivity is linked both acute and trait-like maternal sleep disruption. Lower depression symptoms may buffer trait-like effects of maternal sleep disruption on perception of infant negative affectivity, whereas higher anxiety symptoms may be sensitizing. These findings highlight the importance of maternal sleep health for infant outcomes.

Purpose

While interventions to mitigate and prevent perinatal maternal distress exist, none are personalized based on participants’ daily experiences and intervention response. This study compared maternal distress outcomes (depressive symptoms, anxiety symptoms, perceived stress) between perinatal individuals receiving a personalized mobile health-enhanced cognitive-behavioral intervention and individuals receiving usual prenatal care.

Methods

Pregnant individuals ≤ 22 weeks’ gestation recruited from six prenatal care clinics were randomized to the intervention or usual prenatal care. Intervention participants received a 12-session adaptation of the Mothers and Babies intervention (MB-P), personalized by just-in-time stress reduction and mindfulness content based on elevated physiologic or self-reported stress. Primary outcomes were depressive and anxiety symptoms, and perceived stress. Secondary outcomes were behavioral activation, decentering of thoughts, social support, and mood regulation. Outcomes were measured at baseline, one-week post-intervention, one month postpartum, and three months postpartum. An intent-to-treat approach using mixed-effects models guided analysis.

Results

Forty-nine individuals were randomized to MB-P and fifty-one to usual prenatal care. Participants were 70% White, 33.7 years old on average, and 16.2 weeks gestation. At three months postpartum, intervention participants had lower depressive symptomatology (d = 0.43) and less perceived stress (d = 0.46) than controls. Intervention participants exhibited greater behavioral activation three months postpartum (d = 0.41), greater decentering post-intervention (d = 0.37), and greater mood regulation post-intervention (d = 0.56) and three months postpartum (d = 0.55).

Conclusion

MB-P improved maternal depression and anxiety and mechanisms of behavioral activation, decentering, and mood regulation when compared to usual prenatal care. Future research should examine MB-P impact compared to standard MB without just-in-time content.

Trial registration: Clinical Trials.gov, NCT05052281.

Background

One of the challenges women may face after experiencing severe burns is a shift in their social and marital roles. The process by which they reclaim these roles remains unclear.

Purpose

This study was carried out to explore how women work to restore their marital and social status.

Methods

This qualitative research involved face-to-face, semi-structured interviews using open-ended questions. Sixteen women with severe burn injuries participated in the study. Data collection proceeded until no new information emerged (data saturation), and the analysis was carried out using a conventional content analysis approach. The study was conducted in accordance with the Standards for Reporting Qualitative Research (SRQR).

Results

Two themes and six subthemes emerged: Consistency of self-position in married life (self-sacrifice, continuity of roles, normalization of sexual relations) and social interaction (social isolation, reliance on internal forces in interaction with the community, use of available support).

Conclusion

Following severe burn injuries, women often strive to reestablish their roles within their marital and social relationships. Healthcare professionals, including nurses and physicians, can play a vital role by educating survivors and their families (particularly their spouses) about how to effectively cope with the challenges associated with severe burns. Such educational efforts can support women in reclaiming their position and improving their overall well-being.

Purpose

The discourse around menstrual cycles is often pathologized, potentially reinforcing negative perceptions of menstruation. The extent to which individuals have internalized the idea that bodily and social experiences before menstruation are the manifestation of ill-health, thereby biasing reports of premenstrual experiences towards negative emotions, remains unclear.

Methods

Using an online experimental design, we investigate whether phrasing the premenstrual experience as having both negative and positive dimensions would enable individuals to report more diverse and positive experiences than are reported in the absence of specific emotional prompts. Participants were recruited using a period tracker app and randomly allocated to one of three conditions: control (describe your premenstrual experience); treatment 1 (describe your negative and positive premenstrual experience); treatment 2 (describe your posititive and negative premenstrual experience). Sentiment analysis was used to derive polarity scores, and a two-part Bayesian model assessed the impact of phrasing order.

Results

Among 2,637 participants, responses skewed negatively (mean -0.25). Compared to the control, treatment conditions 1 and 2 reported premenstrual experiences 64% and 62% less negative, respectively. Positive themes, notably ‘sex, libido, and energy’emerged. The absence of positive prompts in questioning led to more negative and less diverse reports.

Conclusions

These findings support existing literature on the predominance of negative premenstrual phases and underline the need to broaden measurements to encompass positive symptoms. The study also pioneers the use of text analysis for investigating premenstrual symptoms.