Impact of the Covid-19 pandemic on perinatal mental health (Riseup-PPD-COVID-19): protocol for an international prospective cohort study

Background: Corona Virus Disease 19 (COVID-19) is a new pandemic, declared a public health emergency by the World Health Organization, which could have negative consequences for pregnant and postpartum women. The scarce evidence published to date suggests that perinatal mental health has deteriorated since the COVID-19 outbreak. However, the few studies published so far have some limitations, such as a cross-sectional design and the omission of important factors for the understanding of perinatal mental health, including governmental restriction measures and healthcare practices implemented at the maternity hospitals. Within the Riseup-PPD COST Action, a study is underway to assess the impact of COVID-19 in perinatal mental health. The primary objectives are to (1) evaluate changes in perinatal mental health outcomes; and (2) determine the risk and protective factors for perinatal mental health during the COVID-19 pandemic. Additionally, we will compare the results between the countries participating in the study. Methods: This is an international prospective cohort study, with a baseline and three follow-up assessments over a six-month period. It is being carried out in 11 European countries (Albania, Bulgaria, Cyprus, France, Greece, Israel, Malta, Portugal, Spain, Turkey, and the United Kingdom), Argentina, Brazil and Chile. The sample consists of adult pregnant and postpartum women (with infants up to 6 months of age). The assessment includes measures on COVID-19 epidemiology and public health measures (Oxford COVID-19 Government Response Tracker dataset), Coronavirus Perinatal Experiences (COPE questionnaires), psychological distress (BSI-18), depression (EPDS), anxiety (GAD-7) and post-traumatic stress symptoms (PTSD checklist for DSM-V). Discussion: This study will provide important information for understanding the impact of the COVID-19 pandemic on perinatal mental health and well-being, including the identification of potential risk and protective factors by implementing predictive models using machine learning techniques. The findings will help policymakers develop suitable guidelines and prevention strategies for perinatal mental health and contribute to designing tailored mental health interventions. Trial registration: ClinicalTrials.gov Identifier: NCT04595123.The project is part of the COST Action Riseup-PPD CA 18138 and was supported by COST under COST Action Riseup-PPD CA18138; also, by the Spanish Ministry of Health, the Institute of Health Carlos III, and the European Regional Development Fund «Una manera de hacer Europa» by the Prevention and Health Promotion Research Network ‘redIAPP’ (RD16/0007). Raquel Costa is supported by the FSE and FCT under an individual Post-Doctoral Grant SFRH/BPD/117597/2016. Rena Bina and Drorit Levy received funding from the Bar-Ilan Dangoor Centre for Personalized Medicine, Israel. Ana Mesquita is supported from the Portuguese Foundation for Science and Technology (FCT) and from EU through the European Social Fund and from the Human Potential Operational Program - IF/00750/2015. Ana Osório received financial support from CAPES/Proex no. 0653/2018 and CAPES/PrInt grant no. 88887.310343/2018-00.The funders of the study had no role in the study design or the writing the protocol. The corresponding author had final responsibility for the decision to submit for publication

The impact of education, country, race and ethnicity on the self-report of postpartum depression using the Edinburgh Postnatal Depression Scale

Universal screening for postpartum depression is recommended in many countries. Knowledge of whether the disclosure of depressive symptoms in the postpartum period differs across cultures could improve detection and provide new insights into the pathogenesis. Moreover, it is a necessary step to evaluate the universal use of screening instruments in research and clinical practice. In the current study we sought to assess whether the Edinburgh Postnatal Depression Scale (EPDS), the most widely used screening tool for postpartum depression, measures the same underlying construct across cultural groups in a large international dataset. Ordinal regression and measurement invariance were used to explore the association between culture, operationalized as education, ethnicity/race and continent, and endorsement of depressive symptoms using the EPDS on 8209 new mothers from Europe and the USA. Education, but not ethnicity/race, influenced the reporting of postpartum depression [difference between robust comparative fit indexes (∆*CFI) 0.01), but not between European countries (∆*CFI < 0.01). Investigators and clinicians should be aware of the potential differences in expression of phenotype of postpartum depression that women of different educational backgrounds may manifest. The increasing cultural heterogeneity of societies together with the tendency towards globalization requires a culturally sensitive approach to patients, research and policies, that takes into account, beyond rhetoric, the context of a person's experiences and the context in which the research is conducted

Assess mother-infant interactive difficulties at 3 months postpartum with the GRMII elaborated by Fiori-Cowley et Murray [Zapotitlánvaluer les difficultZapotitláns interactives entre une mZapotitlánre dZapotitlánprimZapotitláne et son bZapotitlánbZapotitlán de 3mois au moyen de l'Zapotitlánchelle GRMII de Fiori-Cowley et Murray]

Background and aim: Early detection of postnatal depression and mother-infant interactive difficulties are major issues not only for the emotional and cognitive development of the infant, but also for the implementation of early prevention of interactive disorders. This study examined the characteristics of mother-infant interactions in a free play situation, when infants were 3 months old, in case of maternal postnatal depression, and in a control group. The quality of interactions was assessed using the Global Ratings of Mother-Infant Interactions by Fiori-Cowley and Murray (GRMII). Methods: The sample was composed of 90 mothers with their infants, including 39 mothers with postnatal depression and 51 without mood disorders. Affective disorder was assessed by the Montgomery and Asberg Depression Rating Scale (MADRS). Mothers and their 3-month-old infants were invited to play freely, in a room dedicated to parent-infant observation in the laboratory. Free play sequences were video recorded and a posteriori coded by two trained clinicians blind to maternal affective status, with the GRMII. Results and conclusion: Analyses show that for all items of the GRMII, non-depressed mothers and their infant obtained higher scores i.e. better scores than depressed mothers and their infant. However, significance was evidenced only for 8 items of the grid: 3 on the maternal sensitivity scale, 2 on signs of depression, and 3 on the interactive dimension. Results thus show that at 3 months postpartum, depression appeared to have already affected interaction with the infant. Main differences were observed in mother's active engagement, acceptation, sensitivity and ability to provide adjusted responses to her infant. Analysis of maternal intrusiveness and remoteness did not yield significant findings, but conversely maternal sensitivity was negatively impacted. The GRMII appeared as an easy-to-use and objective tool to detect specificities of early depressed mother-infant interactions, adapted to a clinical setting. Early detection of interactive distortion gives a window of opportunity for a clinical intervention focused not only on maternal depressive symptoms, but also on the dyad itself. Zapotitlán 2013 Elsevier Masson SAS

Le nouveau-né, un partenaire pour sa mère. Analyse du discours maternel

International audienc

Kangaroo supported diagonal flexion positioning: New insights into skin-to-skin contact for communication between mothers and very preterm infants

International audienc