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Frontiers in Perinatal Mental Health
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Frontiers in Perinatal Mental Health

A special issue of International Journal of Environmental Research and Public Health (ISSN 1660-4601). This special issue belongs to the section "Women's Health".

Deadline for manuscript submissions: closed (30 November 2021) | Viewed by 24212

Special Issue Editors

Dr. Ilaria Lega

E-Mail Website
Guest Editor
National Centre for Diseases Prevention and Health Promotion, Italian National Health Institute, Rome 00161, Italy
Interests: perinatal mental health; psychiatric epidemiology; mental health services; maternity services; maternal mortality
Dr. Letizia Sampaolo

E-Mail Website
Guest Editor
National Centre for Diseases Prevention and Health Promotion, Italian National Health Institute, Rome 00161, Italy
Interests: implications for evidence-based health care; evidence-based medicine; clinical epidemiology; health literacy

Special Issue Information

Dear Colleagues,

Perinatal mental health has raised growing interest in recent years. Research in the field has gone beyond the study of specific mental disorders in pregnant women and mothers, moving toward a more comprehensive approach. Maternal mortality surveillance systems have played a pivotal role in recognizing the mortality and morbidity burden of severe perinatal mental disorders, thereby providing evidence that care for women before, during, and after pregnancy requires taking into account both mental and physical health to the same extent. Breaking the barriers between professions, disciplines, and services offers the opportunity to both identify and treat perinatal mental disorders, as well as empower vulnerable groups and enhance protective factors to promote maternal mental health and positive parenting. Findings about how child development can be improved by policies and interventions promoting responsive caregiving have stimulated interest in parental mental health also in a cross-generational public health perspective.

This Special Issue aims to present the latest research in the field of perinatal mental health. We welcome original studies, reviews, and meta-analysis on risk and protective factors for maternal mental health, the efficacy, effectiveness, and implementation of interventions, programs, or services for perinatal mental disorders diagnosis and treatment, perinatal mental health promotion, and caregiving support.

Dr. Ilaria Lega
Dr. Letizia Sampaolo
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. International Journal of Environmental Research and Public Health is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2500 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • Perinatal mental health
  • Pregnancy
  • Social stress
  • Responsive care
  • Public health interventions
  • Perinatal depression
  • Post-partum psychosis
  • Suicide
  • Maternal mortality

Published Papers (7 papers)

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Research

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15 pages, 366 KiB  
Article
The Psychological Impact of COVID-19 among Women Accessing Family Care Centers during Pregnancy and the Postnatal Period in Italy
by Ilaria Lega, Alessandra Bramante, Laura Lauria, Pietro Grussu, Valeria Dubini, Marcella Falcieri, Maria Carmen Ghiani, Antonia Giordano, Stefania Guidomei, Anna Domenica Mignuoli, Serena Paris, Maria Enrica Bettinelli, Patrizia Proietti, Silvia Andreozzi, Valeria Brenna, Mauro Bucciarelli, Gabriella Martelli, Claudia Ferraro, Melissa Torrisi, Danilo Carrozzino and Serena Donatiadd Show full author list remove Hide full author list
Int. J. Environ. Res. Public Health 2022, 19(4), 1983; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph19041983 - 10 Feb 2022
Cited by 11 | Viewed by 2496
Abstract
There has been concern about the impact of the COVID-19 outbreak on women’s mental health during the perinatal period. We conducted a cross-sectional web-based study aimed at evaluating the psychological impact (BSI-18) of the COVID-19 pandemic on this population and collecting information on [...] Read more.
There has been concern about the impact of the COVID-19 outbreak on women’s mental health during the perinatal period. We conducted a cross-sectional web-based study aimed at evaluating the psychological impact (BSI-18) of the COVID-19 pandemic on this population and collecting information on the perinatal experiences (COPE-IS) during the second Italian wave. Overall, 1168 pregnant women, and 940 within the first six months after childbirth, were recruited in selected Italian Family Care Centers from October 2020 to May 2021. The prevalence of psychological distress symptoms during pregnancy was 12.1% and 9.3% in the postnatal group. Financial difficulties, a previous mood or anxiety disorder and lack of perceived social support and of support provided by health professionals were associated to psychological distress symptoms in both groups. A third of the women felt unsupported by their social network; 61.7% of the pregnant women experienced changes in antenatal care; 21.2% of those in the postnatal period gave birth alone; more than 80% of the participants identified access to medical and mental health care and self-help as important resources in the present context. Health services should assure enhanced support to the most vulnerable women who face the perinatal period during the pandemic. Full article
(This article belongs to the Special Issue Frontiers in Perinatal Mental Health)
14 pages, 650 KiB  
Article
Psychological and Physical Intimate Partner Aggression Are Associated with Broad and Specific Internalizing Symptoms during Pregnancy
by Gabriela R. Perez, Sara M. Stasik-O’Brien, Lauren M. Laifer and Rebecca L. Brock
Int. J. Environ. Res. Public Health 2022, 19(3), 1662; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph19031662 - 31 Jan 2022
Cited by 3 | Viewed by 2714
Abstract
Background: Intimate partner violence (IPV) has serious consequences, particularly during high-risk periods such as pregnancy, which poses a significant risk to maternal mental health. However, it is unclear whether IPV presents a broad risk for psychopathology or is specific to distinct diagnoses or [...] Read more.
Background: Intimate partner violence (IPV) has serious consequences, particularly during high-risk periods such as pregnancy, which poses a significant risk to maternal mental health. However, it is unclear whether IPV presents a broad risk for psychopathology or is specific to distinct diagnoses or symptom dimensions (e.g., panic, social anxiety). Further, the relative impact of physical versus psychological aggression remains unclear. Methods: One hundred and fifty-nine pregnant couples completed surveys assessing psychological and physical intimate partner aggression unfolding in the couple relationship, as well as a range of internalizing symptoms. Results: Psychological and physical aggression were each associated with broad negative affectivity, which underlies mood and anxiety disorders; however, only psychological aggression demonstrated a unique association. Further, for pregnant women, aggression was uniquely associated with several symptom dimensions characteristic of PTSD. In contrast, men demonstrated a relatively heterogeneous symptom presentation in relation to aggression. Conclusion: The present study identifies unique symptom manifestations associated with IPV for couples navigating pregnancy and suggests psychological aggression can be more detrimental to mental health than physical aggression. To promote maternal perinatal mental health, clinicians should screen for covert forms of psychological aggression during pregnancy (e.g., raised voices, insults), trauma-related distress, and symptom elevations in women and their partners. Full article
(This article belongs to the Special Issue Frontiers in Perinatal Mental Health)
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12 pages, 619 KiB  
Article
“Nobody Listened”. Mothers’ Experiences and Needs Regarding Professional Support Prior to Their Admission to an Infant Mental Health Day Clinic
by Tinne Nuyts, Sarah Van Haeken, Neeltje Crombag, Binu Singh, Susan Ayers, Susan Garthus-Niegel, Marijke Anne Katrien Alberta Braeken and Annick Bogaerts
Int. J. Environ. Res. Public Health 2021, 18(20), 10917; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph182010917 - 17 Oct 2021
Cited by 4 | Viewed by 3188
Abstract
Challenges during the perinatal period can lead to maternal distress, negatively affecting mother-infant interaction. This study aims to retrospectively explore the experiences and needs regarding professional support of mothers with difficulties in mother-infant interaction prior to their admission to an infant mental health [...] Read more.
Challenges during the perinatal period can lead to maternal distress, negatively affecting mother-infant interaction. This study aims to retrospectively explore the experiences and needs regarding professional support of mothers with difficulties in mother-infant interaction prior to their admission to an infant mental health day clinic. In-depth semi-structured interviews were conducted with 13 mothers who had accessed an infant mental health day clinic because of persistent severe infant regulatory problems impairing the wellbeing of the infant and the family. Data were transcribed and analyzed using the Qualitative Analysis Guide of Leuven (QUAGOL). Three themes were identified: ‘experience of pregnancy, birth, and parenthood’; ‘difficult care paths’; and ‘needs and their fulfillment’. The first theme consisted of three subthemes: (1) ‘reality does not meet expectations’, (2) ‘resilience under pressure’, and (3) ‘despair’. Mothers experienced negative feelings that were in contradiction to the expected positive emotions associated with childbirth and motherhood. Resilience-related problems affected the mother-child relationship, and infants’ regulatory capacities. Determined to find solutions, different healthcare providers were consulted. Mothers’ search for help was complex and communication between healthcare providers was limited because of a fragmented care provision. This hindered the continuity of care and appropriate referrals. Another pitfall was the lack of a broader approach, with the emphasis on the medical aspects without attention to the mother-child dyad. An integrated care pathway focusing on the early detection of resilience-related problems and sufficient social support can be crucial in the prevention and early detection of perinatal and infant mental health problems. Full article
(This article belongs to the Special Issue Frontiers in Perinatal Mental Health)
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11 pages, 1272 KiB  
Article
Obstetricians’ Attitude towards Childbirth
by Ernesto González-Mesa, Jesús Jiménez-López, Marta Blasco-Alonso and Daniel Lubián-López
Int. J. Environ. Res. Public Health 2021, 18(20), 10650; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph182010650 - 11 Oct 2021
Cited by 1 | Viewed by 1908
Abstract
(1) Background: In Spain, as in other countries, there is an increase in policies and practices focused on the humanization of perinatal care. In this regard, the quality of interpersonal interactions between women and health professionals is one of the main factors, and, [...] Read more.
(1) Background: In Spain, as in other countries, there is an increase in policies and practices focused on the humanization of perinatal care. In this regard, the quality of interpersonal interactions between women and health professionals is one of the main factors, and, apart from other factors, it is influenced by health professionals´ attitudes towards childbirth. The main objective of this study was to determine the attitudes of obstetricians towards the humanization of childbirth and the promotion of a positive childbirth experience. (2) Methods: The psychosocial task force of the Spanish Society of Obstetrics and Gynecology designed a nationwide online survey. The questionnaire on attitudes towards childbirth (CAVE, acronym for “cuestionario de actitudes sobre vivencias y experiencias en el parto”) was used for the assessment. Exploratory and confirmatory factor analyses of the scale were also performed. (3) Results: A total of 384 participants completed the survey. Obstetricians showed a high-quality clinical obstetric performance, but some difficulties in identifying birth-related psychological-trauma risk factors. Some differences according to practice and gender were found in the final score and in areas regarding psychosocial risk, pain, accompaniment, and women´s expectations. (4) Conclusions: In light of the results, it is advisable to launch education initiatives aimed to improve interaction with pregnant women. Full article
(This article belongs to the Special Issue Frontiers in Perinatal Mental Health)
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8 pages, 623 KiB  
Article
Childbirth Care among SARS-CoV-2 Positive Women in Italy
by Serena Donati, Edoardo Corsi, Michele Antonio Salvatore, Alice Maraschini, Silvia Bonassisa, Paola Casucci, Ilaria Cataneo, Irene Cetin, Paola D’Aloja, Gabriella Dardanoni, Elena De Ambrosi, Enrico Ferrazzi, Stefania Fieni, Massimo Piergiuseppe Franchi, Gianluigi Gargantini, Enrico Iurlaro, Livio Leo, Marco Liberati, Stefania Livio, Mariavittoria Locci, Luca Marozio, Claudio Martini, Gianpaolo Maso, Federico Mecacci, Alessandra Meloni, Anna Domenica Mignuoli, Luisa Patanè, Edda Pellegrini, Francesca Perotti, Enrica Perrone, Federico Prefumo, Luca Ramenghi, Raffaella Rusciani, Valeria Savasi, Sergio Crescenzo Antonio Schettini, Daniela Simeone, Serena Simeone, Arsenio Spinillo, Martin Steinkasserer, Saverio Tateo, Giliana Ternelli, Roberta Tironi, Vito Trojano, Patrizia Vergani and Sara Zullinoadd Show full author list remove Hide full author list
Int. J. Environ. Res. Public Health 2021, 18(8), 4244; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph18084244 - 16 Apr 2021
Cited by 20 | Viewed by 4473
Abstract
The new coronavirus emergency spread to Italy when little was known about the infection’s impact on mothers and newborns. This study aims to describe the extent to which clinical practice has protected childbirth physiology and preserved the mother–child bond during the first wave [...] Read more.
The new coronavirus emergency spread to Italy when little was known about the infection’s impact on mothers and newborns. This study aims to describe the extent to which clinical practice has protected childbirth physiology and preserved the mother–child bond during the first wave of the pandemic in Italy. A national population-based prospective cohort study was performed enrolling women with confirmed SARS-CoV-2 infection admitted for childbirth to any Italian hospital from 25 February to 31 July 2020. All cases were prospectively notified, and information on peripartum care (mother–newborn separation, skin-to-skin contact, breastfeeding, and rooming-in) and maternal and perinatal outcomes were collected in a structured form and entered in a web-based secure system. The paper describes a cohort of 525 SARS-CoV-2 positive women who gave birth. At hospital admission, 44.8% of the cohort was asymptomatic. At delivery, 51.9% of the mothers had a birth support person in the delivery room; the average caesarean section rate of 33.7% remained stable compared to the national figure. On average, 39.0% of mothers were separated from their newborns at birth, 26.6% practised skin-to-skin, 72.1% roomed in with their babies, and 79.6% of the infants received their mother’s milk. The infants separated and not separated from their SARS-CoV-2 positive mothers both had good outcomes. At the beginning of the pandemic, childbirth raised awareness and concern due to limited available evidence and led to “better safe than sorry” care choices. An improvement of the peripartum care indicators was observed over time. Full article
(This article belongs to the Special Issue Frontiers in Perinatal Mental Health)
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6 pages, 327 KiB  
Article
Perinatal Grief and Post-Traumatic Stress Disorder in Pregnancy after Perinatal Loss: A Longitudinal Study Protocol
by Eloisa Fernández-Ordoñez, María González-Cano-Caballero, Cristina Guerra-Marmolejo, Eloísa Fernández-Fernández and Marina García-Gámez
Int. J. Environ. Res. Public Health 2021, 18(6), 2874; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph18062874 - 11 Mar 2021
Cited by 8 | Viewed by 3789
Abstract
Background: Pregnancies that follow perinatal loss are often associated with mental health disorders, which are not usually treated or even identified. Objectives: The main study aim is to identify the prevalence of symptoms of post-traumatic stress disorder and complicated perinatal grief at different [...] Read more.
Background: Pregnancies that follow perinatal loss are often associated with mental health disorders, which are not usually treated or even identified. Objectives: The main study aim is to identify the prevalence of symptoms of post-traumatic stress disorder and complicated perinatal grief at different stages of pregnancy following a prior gestational loss. Methods: This descriptive longitudinal study will be conducted with a twelve-month follow-up. The study variables addressed will include sociodemographic data (age, sex, education, marital status, employment status and obstetric history) together with clinical data on complicated perinatal grief and post-traumatic stress disorder scores. Results: The results obtained are expected to provide a new perspective on the healthcare approach to perinatal loss and subsequent pregnancy. Conclusions: We seek to optimise comprehensive healthcare in cases of pregnancy following previous perinatal loss and to evaluate options to minimise possible risks. Full article
(This article belongs to the Special Issue Frontiers in Perinatal Mental Health)

Review

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13 pages, 326 KiB  
Review
Caring for Mothers: A Narrative Review on Interpersonal Violence and Peripartum Mental Health
by Marianna Mazza, Emanuele Caroppo, Giuseppe Marano, Daniela Chieffo, Lorenzo Moccia, Delfina Janiri, Lucio Rinaldi, Luigi Janiri and Gabriele Sani
Int. J. Environ. Res. Public Health 2021, 18(10), 5281; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph18105281 - 16 May 2021
Cited by 14 | Viewed by 4210
Abstract
Interpersonal violence in the perinatal period is frequent and should be considered a prominent health issue due to the risk of escalation of violence and the significant impact on mothers’ parenting after childbirth. Domestic violence during pregnancy can be associated with fatal and [...] Read more.
Interpersonal violence in the perinatal period is frequent and should be considered a prominent health issue due to the risk of escalation of violence and the significant impact on mothers’ parenting after childbirth. Domestic violence during pregnancy can be associated with fatal and non-fatal adverse health outcomes due to the direct trauma to a pregnant woman’s body and to the effect of stress on fetal growth and development. Emotional violence is a risk factor for prenatal and/or postpartum depression. Recent studies focusing on abusive situations during peripartum and possible preventive strategies were identified in PubMed/Medline, Scopus, Embase, and ScienceDirect. All of the available literature was retrospectively reviewed with a special attention to peer-reviewed publications from the last ten years. Results of the present narrative review suggest that perinatal health care professionals (general practitioners, gynecologists, obstetricians, psychologists, psychiatrists) should promptly detect interpersonal violence during and after pregnancy and provide health care for pregnant women. It seems pivotal to guarantee psychological care for abused women before, during, and after pregnancy in order to prevent the risk of depressive symptoms, other mental or physical sequelae, and mother-to-infant bonding failure. There is an urgent need for multifaceted interventions: programs should focus on several risk factors and should design tailored care pathways fitted to the specific needs of women and finalized to support them across the lifespan. Full article
(This article belongs to the Special Issue Frontiers in Perinatal Mental Health)
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