Women’s Health and Perinatal Mood and Anxiety Disorders

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Mental Health".

Deadline for manuscript submissions: closed (31 January 2022) | Viewed by 41200

Special Issue Editor


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Guest Editor
1. Spitzer Dept Social Work, Ben Gurion University, Beer Sheva, Israel
2. The Center for Women’s Health Studies and Promotion, Beer Sheva, Israel
Interests: social epidemiology; women's health; immigrants and socio-cultural patterns in health and illness; new mothers and parenting; fathers and parenting; prevention and treatment of perinatal mood and anxiety disorders; mixed method research design; mother–daughter relationships; stress; coping and health; midwifery and traumatic birth experiences; cognitive-behavioral techniques and stress reduction; machine learning (MI), artificial intelligence (AI), and natural language processing (NLP) methods to refine diagnostic and treatment planning for diverse groups of persons in distress or in illness; long COVID

Special Issue Information

Dear Colleagues,

The tumultuous events of 2020–2021 have far-reaching implications for women’s health and gender-based medicine. One area where current health, political, social, and economic trends are playing out is in the expression of maternal mental health, specifically in the area of perinatal mood and anxiety disorders (PMADs), which is the current broader term for post-partum depression (PPD). The term PMAD represents new understandings of the etiology of maternal mental and physical health risks, given that many women suffer from mood and anxiety disorders while pregnant, and depression is a frequent co-morbidity along with other psychiatric disorders such as generalized anxiety, PTSD, OCD, bi-polar affective disorders, and puerperal psychosis. COVID-19 has been associated with an increase in anxiety and depression in international studies among women of reproductive age who are considering pregnancy, pregnant, or post-partum; yet, the effects of these patterns of distress on other aspects of women’s health have scarcely been reported in the medical literature. I call on my colleagues from around the world to contribute to this Special Issue, which will explore the intersection between PMAD and women’s health before and during the pandemic era.

Prof. Julie Cwikel
Guest Editor

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Keywords

  • reproductive health
  • pregnancy
  • perinatal health
  • post-partum depression
  • COVID-19
  • psychiatric disorders
  • prevention
  • diagnosis
  • treatment
  • cross-cultural
  • pandemic

Published Papers (8 papers)

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Research

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11 pages, 396 KiB  
Article
Prevalence and Risk Factors of Postpartum Depression in Romanian Women during Two Periods of COVID-19 Pandemic
by Cosmin Citu, Florin Gorun, Andrei Motoc, Ioan Sas, Bogdan Burlea, Ioana Mihaela Citu, Marius Biris, Marius Forga, Octavian Neagoe and Oana Maria Gorun
J. Clin. Med. 2022, 11(6), 1628; https://doi.org/10.3390/jcm11061628 - 15 Mar 2022
Cited by 10 | Viewed by 3214
Abstract
Postpartum depression is a major mental health disorder that can negatively affect both mother and baby. In addition, the COVID-19 pandemic associated with extreme measures of the lockdown had profound effects on humanity, increasing the rates of anxiety and depression, especially among women [...] Read more.
Postpartum depression is a major mental health disorder that can negatively affect both mother and baby. In addition, the COVID-19 pandemic associated with extreme measures of the lockdown had profound effects on humanity, increasing the rates of anxiety and depression, especially among women in the postpartum period. The aim of this study was threefold: to determine the prevalence of postpartum depression, to compare the prevalence of postpartum depression at two different times during the COVID-19 pandemic, and to assess a possible association between the timing of childbirth in a given period of the pandemic and the risk of postpartum depression. A cross-sectional study involving 154 women who were interviewed immediately postpartum, using the EPDS scale, was conducted at the Timisoara Municipal Hospital, Romania at two different periods during the COVID-19 pandemic (March–April 2020 during the first wave and August–September 2021 during the fourth wave). The overall prevalence of postpartum depression (EPDS score > 13) was 18.8%, with a statistically significantly higher rate among participants surveyed during the fourth wave of the COVID-19 pandemic in Romania; the COVID-19 pandemic represents an impact on women’s mental health in the postpartum period, increasing the risk of developing postpartum depression. Full article
(This article belongs to the Special Issue Women’s Health and Perinatal Mood and Anxiety Disorders)
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13 pages, 579 KiB  
Article
Elevated Perinatal Depression during the COVID-19 Pandemic: A National Study among Jewish and Arab Women in Israel
by Samira Alfayumi-Zeadna, Rena Bina, Drorit Levy, Rachel Merzbach and Atif Zeadna
J. Clin. Med. 2022, 11(2), 349; https://doi.org/10.3390/jcm11020349 - 11 Jan 2022
Cited by 8 | Viewed by 2231
Abstract
This study assessed prevalence of perinatal depression symptoms (PNDS) during the COVID-19 pandemic among Arab and Jewish women in Israel and identified COVID-19-related risk factors for PNDS, while comparing Arab and Jewish women. Sample included 730 perinatal women (604 Jewish and 126 Arab) [...] Read more.
This study assessed prevalence of perinatal depression symptoms (PNDS) during the COVID-19 pandemic among Arab and Jewish women in Israel and identified COVID-19-related risk factors for PNDS, while comparing Arab and Jewish women. Sample included 730 perinatal women (604 Jewish and 126 Arab) aged 19–45 years, who filled out an online self-report questionnaire. The questionnaire assessed several areas: perinatal experiences and exposure to COVID-19, social support, and financial and emotional impact. PNDS was measured by the Edinburgh Postnatal Depression Scale (EPDS). Prevalence of PNDS (EPDS ≥ 10) in the entire study population was 40.0%. Prevalence among Arab women was significantly higher compared to Jewish women (58% vs. 36%, PV < 0.001). Higher PNDS were significantly associated with anxiety symptoms (GAD ≥ 10) (PV < 0.001), stress related to COVID-19 (PV < 0.001), adverse change in delivery of healthcare services (PV = 0.025), and unemployment (PV = 0.002). PNDS has elevated more than twofold during COVID-19 in Israel. Such high rates of PNDS may potentially negatively impact women, and fetal and child health development. This situation requires special attention from public health services and policy makers to provide support and mitigation strategies for pregnant and postpartum women in times of health crises. Full article
(This article belongs to the Special Issue Women’s Health and Perinatal Mood and Anxiety Disorders)
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15 pages, 557 KiB  
Article
Planned Place of Birth—Impact of Psychopathological Risk Factors on the Choice of Birthplace and Its Postpartum Effect on Psychological Adaption: An Exploratory Study
by Clara Winter, Juliane Junge-Hoffmeister, Antje Bittner, Irene Gerstner and Kerstin Weidner
J. Clin. Med. 2022, 11(2), 292; https://doi.org/10.3390/jcm11020292 - 06 Jan 2022
Cited by 5 | Viewed by 1791
Abstract
The choice of birthplace may have an important impact on a woman’s health. In this longitudinal study, we investigated the psychopathological risk factors that drive women’s choice of birthplace, since their influence is currently not well understood. The research was conducted in 2011/12 [...] Read more.
The choice of birthplace may have an important impact on a woman’s health. In this longitudinal study, we investigated the psychopathological risk factors that drive women’s choice of birthplace, since their influence is currently not well understood. The research was conducted in 2011/12 and we analyzed data of 177 women (obstetric unit, n = 121; free standing midwifery unit, n = 42; homebirth, n = 14). We focused antepartally (M  = 34.3 ± 3.3) on sociodemographic and risk factors of psychopathology, such as prenatal distress (Prenatal Distress Questionnaire), depressiveness (Edinburgh Postnatal Depression Scale), birth anxiety (Birth Anxiety Scale), childhood trauma (Childhood Trauma Questionnaire), and postpartally (M = 6.65 ± 2.6) on birth experience (Salmon’s Item List), as well as psychological adaption, such as postpartum depressive symptoms (Edinburgh Postnatal Depression Scale) and birth anxiety felt during birth (modified Birth Anxiety Scale). Women with fear of childbirth and the beginning of birth were likely to plan a hospital birth. In contrast, women with fear of touching and palpation by doctors and midwives, as well as women with childhood trauma, were more likely to plan an out-of-hospital birth. Furthermore, women with planned out-of-hospital births experienced a greater relief of their birth anxiety during the birth process than women with planned hospital birth. Our results especially show that women with previous mental illnesses, as well as traumatic experiences, seem to have special needs during childbirth, such as a safe environment and supportive care. Full article
(This article belongs to the Special Issue Women’s Health and Perinatal Mood and Anxiety Disorders)
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11 pages, 373 KiB  
Article
A Cognitive—Behavioral Intervention for Postpartum Anxiety and Depression: Individual Phone vs. Group Format
by Meital Simhi, Orly Sarid, Heather Rowe, Jane Fisher and Julie Cwikel
J. Clin. Med. 2021, 10(24), 5952; https://doi.org/10.3390/jcm10245952 - 18 Dec 2021
Cited by 5 | Viewed by 3749
Abstract
Cognitive–behavioral interventions can effectively treat symptoms of perinatal mood and anxiety disorders (PMADs). We assessed the acceptability and effectiveness of a workbook-based intervention (What Am I Worried About? (WAWA)) comprising of cognitive–behavioral and mindfulness techniques and weekly professional guidance to address symptoms of [...] Read more.
Cognitive–behavioral interventions can effectively treat symptoms of perinatal mood and anxiety disorders (PMADs). We assessed the acceptability and effectiveness of a workbook-based intervention (What Am I Worried About? (WAWA)) comprising of cognitive–behavioral and mindfulness techniques and weekly professional guidance to address symptoms of depression, anxiety, and stress among postpartum mothers. We compared the efficacy of group versus individual telephone consultation using a pre-and post-test single group, open trial, research design in replication pilot study. A convenience sample of community-residing postpartum women (n = 34) chose between group intervention (n = 24) or individual phone consultation with a mental health professional (n = 10). Outcome measures were anxiety (GAD-7), depression, anxiety, and stress (DASS21), and postpartum depression (PPD-EPDS). After four weeks intervention, significant reductions were observed in postpartum depression, anxiety, and stress scales. Cohen’s d statistics showed medium effect sizes (0.35–0.56). A small but significantly larger change in PPD-EPDS and DASS stress scores was reported among participants who opted for the phone intervention compared to those in the group intervention. Most participants felt that the intervention was highly beneficial and would recommend it to other postpartum women. In conclusion, the WAWA intervention showed efficacy for reducing postpartum anxiety, distress, and depressive symptoms among postpartum women, with a slightly greater reduction in PPD-EPDS and stress symptoms found among those who opted for individual phone consultation. Definitive evaluation of the intervention requires a larger sample and a RCT research design with two treatment arms: telephone and group intervention. Full article
(This article belongs to the Special Issue Women’s Health and Perinatal Mood and Anxiety Disorders)
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10 pages, 625 KiB  
Article
Prenatal and Postnatal Anxiety and Depression in Mothers during the COVID-19 Pandemic
by Joanna Baran, Justyna Leszczak, Rafał Baran, Anna Biesiadecka, Aneta Weres, Ewelina Czenczek-Lewandowska and Katarzyna Kalandyk-Osinko
J. Clin. Med. 2021, 10(14), 3193; https://doi.org/10.3390/jcm10143193 - 20 Jul 2021
Cited by 19 | Viewed by 4139
Abstract
The aim of this study was to assess the changes in the occurrence of prenatal and postnatal anxiety and depression symptoms, and to assess what factors significantly affect the appearance of symptoms of depression and anxiety in young mothers. The study group consisted [...] Read more.
The aim of this study was to assess the changes in the occurrence of prenatal and postnatal anxiety and depression symptoms, and to assess what factors significantly affect the appearance of symptoms of depression and anxiety in young mothers. The study group consisted of 130 women after childbirth. Due to the ongoing restrictions caused by the COVID-19 pandemic, the survey was prepared online. The questionnaire was fully anonymous, and it contained the authors’ own questions and two standardized questionnaires: the Edinburgh Postnatal Depression Scale (EPDS) and Generalized Anxiety Disorders GAD-7. The conducted analysis clearly indicated that the level of postpartum depression, in as many as 52 of the mothers, had increased significantly compared to the time before delivery, when symptoms of depression were shown by 22 women (p = 0.009). However, there was no statistically significant change between prenatal and postnatal anxiety. There are many factors associated with postnatal depression. The strongest predictors turned out to be average socioeconomic status, history of anxiety disorders, past neurosis or depression, lack of or inadequate level of assistance from healthcare professionals, as well as lactation problems and postpartum pain. Full article
(This article belongs to the Special Issue Women’s Health and Perinatal Mood and Anxiety Disorders)
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17 pages, 246 KiB  
Article
Mums Alone: Exploring the Role of Isolation and Loneliness in the Narratives of Women Diagnosed with Perinatal Depression
by Billie Lever Taylor, Louise M. Howard, Katherine Jackson, Sonia Johnson, Nadia Mantovani, Selina Nath, Antoaneta Y. Sokolova and Angela Sweeney
J. Clin. Med. 2021, 10(11), 2271; https://doi.org/10.3390/jcm10112271 - 24 May 2021
Cited by 15 | Viewed by 7538
Abstract
In this study, we explore the role that isolation and loneliness play in the narratives of women diagnosed with perinatal depression. Isolation and loneliness are increasingly seen as risk factors for depression, including in the perinatal period, but little is known about whether, [...] Read more.
In this study, we explore the role that isolation and loneliness play in the narratives of women diagnosed with perinatal depression. Isolation and loneliness are increasingly seen as risk factors for depression, including in the perinatal period, but little is known about whether, and in what ways, women themselves associate isolation or loneliness with perinatal distress. Based on the thematic analysis of semi-structured interviews with fourteen mothers in England, we found that women often connected feelings of depression during and after pregnancy to feeling dislocated from their previous identities and relationships. Women felt lost, confined to their homes, and often unsupported by their partners and families. However, fears of being judged to be inadequate mothers made it difficult for women to make authentic connections with others or to express negative feelings, increasing isolation and depression. We drew on the intersectionality theory to illustrate how the intersect between motherhood and other aspects of women’s identities (being young, single, deprived and/or from an ethnic minority) could leave some women particularly isolated and marginalised. Our conclusions emphasise the need to challenge social constructions of the good/bad mother, advocate for social change to lessen pressures on mothers, and develop support that addresses women’s interpersonal contexts and social networks. Full article
(This article belongs to the Special Issue Women’s Health and Perinatal Mood and Anxiety Disorders)

Review

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17 pages, 1017 KiB  
Review
Effects, Side Effects and Contraindications of Relaxation Massage during Pregnancy: A Systematic Review of Randomized Controlled Trials
by Stephanie M. Mueller and Martin Grunwald
J. Clin. Med. 2021, 10(16), 3485; https://doi.org/10.3390/jcm10163485 - 06 Aug 2021
Cited by 10 | Viewed by 11452
Abstract
Healthcare professionals and expecting mothers frequently voice concerns that massages during pregnancy might cause complications or premature labor. This PRISMA review outlines current results on effects, side effects and contraindications of relaxation massage during pregnancy. Inclusion criteria: all randomized controlled trials (RCT) comparing [...] Read more.
Healthcare professionals and expecting mothers frequently voice concerns that massages during pregnancy might cause complications or premature labor. This PRISMA review outlines current results on effects, side effects and contraindications of relaxation massage during pregnancy. Inclusion criteria: all randomized controlled trials (RCT) comparing relaxation massage during pregnancy with standard care or standard care plus another intervention (i.e., progressive muscle relaxation). Restrictions were full text availability and English language. Results: 12 RCT were included. Trials had good methodological quality but unknown risk of bias. All women were at least 12 weeks gestation at the start of the study. The main benefits of massage during pregnancy were: reduced stress, back and leg pain, depression and anxiety; increased immune response; increased serotonin and dopamine levels; higher fetal birth weight and reduced risk of preterm delivery. Only 2 RCT reported potential side effects of massage, which were minor and transient. Seven RCT excluded women with difficult pregnancies or preexisting complications, five studies did not report preexisting conditions. Those obstetric or postnatal complications that occurred were most likely unrelated to massage treatments. In healthy pregnant women without complications, relaxation massage has positive effects throughout pregnancy. Precautions for massage during pregnancy (i.e., to prevent pulmonary embolism) are discussed. Full article
(This article belongs to the Special Issue Women’s Health and Perinatal Mood and Anxiety Disorders)
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16 pages, 555 KiB  
Review
Perinatal Mental Health during COVID-19 Pandemic: An Integrative Review and Implications for Clinical Practice
by Julia Suwalska, Maria Napierała, Paweł Bogdański, Dorota Łojko, Katarzyna Wszołek, Sara Suchowiak and Aleksandra Suwalska
J. Clin. Med. 2021, 10(11), 2406; https://doi.org/10.3390/jcm10112406 - 29 May 2021
Cited by 48 | Viewed by 5830
Abstract
The COVID-19 pandemic and measures implemented to decelerate its spread have consequences for mental health of societies. The aim of our review was to analyze depressive and anxiety symptoms in perinatal women. The search used PubMed and Web of Science databases. Most studies [...] Read more.
The COVID-19 pandemic and measures implemented to decelerate its spread have consequences for mental health of societies. The aim of our review was to analyze depressive and anxiety symptoms in perinatal women. The search used PubMed and Web of Science databases. Most studies showed an increase in the prevalence of depression and/or anxiety symptoms. Risk factors identified in our study were mainly related to the possibility of COVID-19 infection, changes in the organization of perinatal care, social isolation and financial problems. Protective factors included social support, the woman’s own activity and knowledge about COVID-19. The results of our study point to the importance of the mental health screening including suicide risk assessment in perinatal women. Much of the mental health needs of perinatal women can be met in primary or perinatal care services; however, women with mental health issues should be offered psychiatric consultations and psychological support, and sometimes urgent psychiatric hospitalization is necessary. Healthcare professionals should provide information addressing uncertainty about COVID-19, organization of midwifery and medical care as well as mental health problems and how to get help. Mental health interventions in pregnant women may involve planning physical activity and encouraging to engage in online social activities. Full article
(This article belongs to the Special Issue Women’s Health and Perinatal Mood and Anxiety Disorders)
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