UNASSIGNED: Paternal antenatal depression and postpartum depression are associated with adverse health outcomes in mothers and infants; however, their prevalence among Chinese fathers remains controversial. This meta-analysis aimed to summarize the prevalence of antenatal depression and postpartum depression in Chinese fathers.
UNASSIGNED: We conducted a systematic meta-analysis on the prevalence of antenatal depression and postpartum depression among Chinese fathers by searching 11 databases. Pooled estimates and 95 % confidence intervals were calculated. The choice between a random-effects model and a fixed-effects model was based on an assessment of heterogeneity among the studies as well as assumptions regarding the similarity of the studies in terms of clinical characteristics, quality, design, and conduct. Subgroup and meta-regression analyses were conducted based on the scale used to measure antenatal depression and postpartum depression, the region where the study was completed, the time of the study, the study design, the number of children, publication language, the study site, and quality assessment.
UNASSIGNED: This meta-analysis included 28 studies with 8795 participants. The prevalence of antenatal depression among Chinese fathers was 11 % (95 % CI: 5%-17 %, P < 0.01) using a random-effects model. Heterogeneity was I2 = 91 %. Publication language moderated the prevalence of paternal antenatal depression (the amount of heterogeneity accounted for was 92.13 %). The prevalence of postpartum depression among Chinese fathers was 16 % (95 % CI: 13%-18 %, P < 0.01), using a random-effects model. The heterogeneity was I2 = 94 %. The prevalence of paternal postpartum depression was moderated by the scale used to measure postpartum depression (39.17 % heterogeneity) and the region where the study was completed (33.15 % heterogeneity). Moreover, Egger\'s test (t = 4.542, P < 0.001) indicated publication bias in studies on postpartum depression among Chinese fathers. However, after applying the trimming correction, the pooled prevalence of postpartum depression had a P value of <0.05, indicating that despite the publication bias, the results remain reliable and unaffected in terms of effect size.
UNASSIGNED: The prevalence of antenatal depression and postpartum depression among Chinese fathers was similar to those reported in low- and middle-income countries. Fathers should receive regular screening, effective prevention, and appropriate treatment. However, interpreting these results requires consideration of the limitations of the study.

BACKGROUND: The impacts of maternal depression during mid-to-late pregnancy on fetal growth have been extensively investigated. However, the association between maternal depression during early pregnancy and fetal intrauterine growth are less clear.
METHODS: A prospective study comprised 23,465 eligible pregnant women and their offspring was conducted at a hospital-based center in Shanghai. Prenatal depression was assessed used using Patient Health Questionnaire (PHQ-9) before 14 gestational weeks. Differences in fetal growth trajectory of different maternal depressive statuses during three periods (16-23, 24-31, and 32-41 gestational weeks) were compared using a multilevel model with fractional polynomials.
RESULTS: Women with depressive symptoms during early pregnancy had higher longitudinal fetal trajectories, with an estimated increase in fetal weight (β = 0.33; 95 % CI, 0.06-0.61), compared to those without depressive symptoms. Increases in fetal abdominal circumference among women with depressive symptoms were observed before 23 gestational weeks. Offspring born to mothers with early pregnancy depression had a significantly higher birth weight of 14.13 g (95 % CI, 1.33-27.81 g) and an increased risk of severe large size for gestational age (adjusted odds ratio [aOR], 1.64; 95 % CI, 1.32-2.04) and macrosomia (aOR, 1.21; 95 % CI, 1.02-1.43).
CONCLUSIONS: Self-rated scale was used to assess depressive symptoms rather than clinical diagnosis. And Long-term effects of early pregnancy depression on offspring were not explored.
CONCLUSIONS: The study revealed an association between maternal depression during early pregnancy and increased fetal biometrics, higher birth weight, and an elevated risk of severe large size for gestational age and macrosomia.

BACKGROUND: Prenatal depression, associated with adverse effects on mothers and fetuses, has received little attention. We conducted a large-sample study to investigate the risk factors of, and develop a predictive model for, prenatal depression in the Chinese population.
METHODS: This study enrolled 14,329 pregnant women who delivered at the West China Second University Hospital, Sichuan University from January 2017 to December 2020. Participants were divided into a training or validation cohort. Multiple variables were collected and selected using univariate logistic regression and least absolute shrinkage and selection operator penalty regression. After multivariate logistic analysis, a predictive model was developed and validated internally and externally.
RESULTS: Nine variables (employment, planned pregnancy, pregnancy number, conception methods, gestational diabetes mellitus, twin pregnancy, placenta previa, umbilical cord encirclement, and educational attainment) were identified as independent risk factors for prenatal depression. Receiver operating characteristic curves in both the training and validation cohorts showed excellent discrimination of the predictive model (the area under the curve: 0.746 and 0.732, respectively).
CONCLUSIONS: The results of this retrospective study may be affected by confounding and information bias. Some important variables were excluded, such as family history of mental disorders. The study was conducted in China; its results may not be generalizable to other regions.
CONCLUSIONS: Our study identified nine significant risk factors for prenatal depression and constructed an accurate predictive model. This model could be applied as a clinical decision aid for individualized risk estimates and prevention of prenatal depression.

BACKGROUND: The incidence of perinatal depression is increasing and has become a global public health problem to be addressed.
OBJECTIVE: To explore the prevention and treatment effects of different exercise methods on perinatal depression.
METHODS: A meta-analysis was conducted by searching databases for published \"exercise interventions for perinatal depression \"related randomized controlled trials, up to July 20, 2022.
RESULTS: 48 randomized controlled trials were included, with a total of 5282 pregnant women. (1) Exercise prevention of prenatal depression has a low effective stress intervention effect, ranking from high to low as yoga, aerobic+resistance. (2) Exercise therapy for prenatal depression has a significant intervention effect, followed by gymnastics, pelvic floor muscle training, aerobic exercise, aerobic+resistance, and yoga. (3) Exercise prevention of postpartum depression has a low effective intervention effect, followed by yoga, aerobic exercise, aerobic+resistance, and gymnastics. (4) Exercise has a moderate equivalent stress intervention effect on treating postpartum depression, followed by aerobic exercise, water exercise, yoga, fertility dance, and stroller walking.
CONCLUSIONS: Due to the small number of included literature on single exercise modalities, and maternity is a special population, most of the trial procedures included in the text were not blinded, which has a certain risk of bias and affects the accuracy of the Meta-analysis results.
CONCLUSIONS: The therapeutic effect of exercise in the prevention and treatment of perinatal depression is superior to the preventive effect, and the effect of prenatal prevention and treatment is better than that of postpartum, with a moderate effect.

UNASSIGNED: The gut microbiota may affect mood through the microbiota-gut-brain axis. The purpose of this study was to examine the effect of the gut microbiota and its metabolites, such as short-chain fatty acids (SCFAs), on prenatal depression and to determine the role of 5-hydroxytryptamine (5-HT) on prenatal depression in association with the gut microbiota and its metabolites (i.e. SCFAs).
UNASSIGNED: Eighty-six pregnant women in the third trimester were recruited. Prenatal depression was determined by a score of 10 via the Edinburgh Postpartum Depression Scale. Demographic data, stool, and blood samples were collected. The gut microbiota and its metabolites SCFAs were determined by 16S rRNA gene sequencing and liquid chromatography-mass spectrometry analysis. Plasma 5-HT was determined by gas chromatography-mass spectrometry analysis.
UNASSIGNED: After controlling relevant covariates, our results found the higher the abundance of Candidatus_Soleaferrea, the lower the risk of prenatal depression; the higher the concentration of propanoic acid, the higher risk of prenatal depression. Our results also found the lower the plasma 5-HT, the higher the risk of prenatal depression, and 5-HT was related to unclassified_c_Clostridia and NK4A214_group. However, results of this study did not support the moderating effect of plasma 5-HT on the association of Candidatus_Soleaferrea or propionic acid with prenatal depression.
UNASSIGNED: Results of this study supported that changes in certain gut microbiota, SCFAs, and plasma 5-HT during pregnancy were associated with prenatal depression. This finding provides new ideas for interventions based on diet or probiotics to regulate mood during pregnancy.

The optimal dosage and method of esketamine for postpartum depressive symptoms (PDS) are unclear. We conducted a randomized controlled trial (RCT) to investigate the effect of different doses of esketamine on PDS in women undergoing cesarean section, with evidence of prenatal depression.
The three groups were high- (2 mg kg-1) and low-dose (1 mg kg-1) esketamine via patient controlled intravenous analgesia (PCIA), following an initial intravenous infusion of 0.25 mg kg-1 esketamine, compared to placebo (0.9 % saline infusion). All groups also received the sufentanil (2.2 μg kg-1). The primary outcome was the incidence of PDS at 7 and 42 days postpartum. The secondary outcomes were: the remission from depression and total EPDS scores at 7 days and 42 days postpartum; mean change from baseline in the EPDS score; postoperative analgesia.
i). 0.25 mg kg-1 of esketamine intravenous infusion combined with 1 mg kg-1 (n = 99) or 2 mg kg-1 (n = 99) esketamine PCIA reduces PDS incidence at 7 days postpartum (p < 0.05), with high-dose esketamine PCIA also reduces PDS incidence 42 days postpartum (p < 0.05), compared to placebo (n = 97). ii). Low- and high-dose esketamine PCIA lowers NRS scores at rest within 48 h postoperatively (p < 0.01), with high-dose esketamine also reducing the NRS score during movement at 48 h postoperatively (p = 0.018). iii). Neither high- nor low-dose esketamine PCIA increased postoperative adverse reactions (p > 0.05).
Esketamine (0.25 mg kg-1) intravenous infusion combined with 1 mg kg-1 or 2 mg kg-1 esketamine PCIA seems safe and with few adverse effects in the management of PDS and pain in women undergoing cesarean section.
The tolerability and safety of esketamine requires further investigation based on more specific scales; the transient side effects of esketamine could have biased the staff and patients.
ChiCTR-ROC-2000039069.

The mechanism of levels of inflammatory cytokines that affects brain function and mood through gut microbiota has not been fully elucidated. This study aimed to investigate the potential mediating role of gut microbiota between maternal inflammatory cytokines levels and prenatal depression.
There were 29 women in the prenatal depression group and 27 women in the control group enrolled in this study. The Edinburgh Postnatal Depression Scale (EPDS) score of 10 was considered the cut-off value for prenatal depression. We collected demographic information, stool and blood samples. The gut microbiota was profiled using V3-V4 gene sequence of 16S rRNA, and the concentration of inflammatory cytokines were analyzed. The mediation model was analyzed by using the model 4 in the process procedure for SPSS.
There were significance differences in the concentration of interleukin-1beta (IL-1β)(Z = -2.383, P = 0.017) and IL-17A (Z = -2.439, P = 0.015) between the prenatal depression group and control group. There was no significant difference in α- diversity and β-diversity between the two groups. Intestinibacter (OR: 0.012; 95% CI, 0.001-0.195) and Escherichia_Shigella (OR: 0.103; 95% CI, 0.014-0.763) were protective factors for prenatal depression, while Tyzzerella (OR: 17.941; 95% CI, 1.764-182.445) and Unclassified_f_Ruminococcaceae (OR: 22.607; 95% CI, 1.242-411.389) were risk factors. And Intestinibacter play a mediation effect between IL-17A and prenatal depression.
Maternal gut microbiota is a significant mediator of the relationship between inflammatory cytokines and prenatal depression. Further research is still needed in exploring the mediating mechanisms of gut microbiota between inflammatory cytokines and depression.

OBJECTIVE: Pregnancy stress is the psychological confusion or threat caused by various stress events and adverse factors during pregnancy. Pregnant women exposed to many stressors, they will be easy to produce bad mood and prenatal depression if they cannot adapt to their own changes. Prenatal depression is one of the major global public health problems, with a higher incidence in developing countries and a negative impact on the health of pregnant women and fetus. Resilience refers to pregnant women using their own positive psychological capital, can self-emotional adjustment and improve their ability to adapt to the response state. A better level of resilience can enable pregnant women to face various negative and adaptive problems positively. This study aims to investigate the relationship between pregnancy stress, resilience and prenatal depression through a mental health survey of pregnant women.
METHODS: A total of 750 pregnant women in a Grade A tertiary hospital in Urumqi were investigated by self-designed demographic questionnaire, Pregnancy Pressure Scale (PPS) and Patient Health Questionnaire-9 (PHQ-9), Connor-Davidson Resilience Scale (CD-RISC), and the levels of stress during pregnancy, prenatal depression and resilience were analyzed. Pearson correlation analysis was used to explore the correlation between the three. Bootstrap mediation effect test was used to test the mediation effect relationship among the three. If the mediation effect was confirmed, AMOS software was used to establish the mediation effect structural equation model to analyze the mediation effect among the three.
RESULTS: Among 750 respondents, 709 (94.53%) had mild or above pregnancy pressure, 459 (61.20%) had mild or above depressive symptoms and 241 (32.13%) had a good or above level of resilience. Pearson correlation analysis showed that prenatal depression was significantly positively correlated with pregnancy stress (P<0.01), prenatal depression and pregnancy stress were significantly negatively correlated with resilience (all P<0.01). Mediation effect test analysis showed that all the pathways were statistically significant (P<0.01). Mediation effect of resilience between pregnancy stress and prenatal depression was significantly found (95% CI 0.022-0.068, P<0.001). Pregnancy pressure negatively affected resilience (β=-0.38, P<0.01), and resilience negatively affected prenatal depression (β=-0.10, P<0.01). The mediation effect of resilience was 6.5%.
CONCLUSIONS: Pregnant women\'s pregnancy pressure, resilience and prenatal depression are significantly correlated, and the mediation variable resilience plays a partial mediating role in the impact of pregnancy pressure on prenatal depression. Pregnant women can reduce the incidence of prenatal depression and promote their physical and mental health by exercising their resilience.
目的: 妊娠压力是指在孕妇妊娠期间，各种应激事件和不利因素对孕妇心理上造成的困惑或威胁。孕妇暴露在众多压力源下，若不能及时适应自身变化，容易产生不良情绪，发生产前抑郁。产前抑郁是全球主要的公共卫生问题之一，在发展中国家的发病率较高，给孕妇和胎儿的健康带来负面影响。心理弹性是指孕妇利用自身积极的心理资本，能进行自我情绪调整并提高自身适应能力的反应状态。较好的心理弹性水平可以使孕妇积极面对各种负面和适应性问题。本研究旨在通过对孕妇进行心理健康调查来探讨妊娠压力、心理弹性和产前抑郁之间的关系。方法: 采用自编一般人口学资料调查表、妊娠压力量表(Pregnancy Pressure Scale，PPS)、患者健康问卷抑郁量表(Patient Health Questionnaire-9，PHQ-9)、心理弹性量表(Connor-Davidson Resilience Scale，CD-RISC)对乌鲁木齐市某三甲医院750例孕妇进行心理健康调查，分析其妊娠压力、产前抑郁和心理弹性水平；并采用Pearson相关性分析探究三者之间的相关性。采用Bootstrap中介效应检验法检验三者的中介效应关系，若中介效应显示成立，采用AMOS软件建立中介效应结构方程模型对三者的中介效应进行分析。结果: 在750例调查对象中，709例(94.53%)存在轻度及以上的妊娠压力，459例(61.20%)存在轻度及以上的抑郁症状，241例(32.13%)具有较好及以上的心理弹性水平。Pearson相关性分析结果显示：产前抑郁与妊娠压力呈显著正相关 (P<0.01)，产前抑郁、妊娠压力与心理弹性均呈显著负相关(均P<0.01)。经过中介效应检验分析，发现各个路径均具有统计学意义(均P<0.01)，心理弹性在妊娠压力与产前抑郁之间存在中介效应(95% CI 0.022~0.068，P<0.001)。妊娠压力负向预测心理弹性(β=-0.38，P<0.01)，心理弹性负向预测产前抑郁(β=-0.10，P<0.01)。心理弹性的中介效应值为6.5%。结论: 孕妇妊娠压力、心理弹性与产前抑郁都显著相关，中介变量心理弹性在妊娠压力对产前抑郁影响中起部分中介作用。可通过锻炼孕妇心理弹性，降低孕妇产前抑郁发生率，促进孕妇的生理和心理健康。.

(1) Background: Few studies have explored the heterogeneity of trajectories of stress, anxiety, and depressive symptoms during pregnancy. This study aimed to explore the trajectory groups of stress, anxiety, and depressive symptoms in women during pregnancy and the risk factors associated with those groups. (2) Methods: Data came from pregnant women recruited from January to September 2018 in four hospitals in Chongqing Province, China. A structured questionnaire was given to pregnant women, which collected basic information, including personal, family, and social information. The growth mixture model was applied to identify potential trajectory groups, and multinomial logistic regression was applied to analyze factors of trajectory groups. (3) Results: We identified three stress trajectory groups, three anxiety trajectory groups, and four depression trajectory groups. Less developed regions, inadequate family care, and inadequate social support were associated with a high risk of stress; residence, use of potentially teratogenic drugs, owning pets, family care, and social support were strongly associated with the anxiety trajectory group; family care and social support were the most critical factors for the depression trajectory group. (4) Conclusions: The trajectories of prenatal stress, anxiety, and depressive symptoms are dynamic and heterogeneous. This study may provide some critical insights into the characteristics of women in the high-risk trajectory groups for early intervention to mitigate worsening symptoms.

UNASSIGNED: The objective of this study was to investigate the relationship between positive psychological qualities and negative emotions of pregnant women.
UNASSIGNED: We surveyed 774 pregnant women in a tertiary hospital in Urumqi using the following measures: a self-report general demographic data questionnaire, Generalized Anxiety Disorder scale (GAD-7), Patients Health Questionnaire depression scale (PHQ-9), Pregnancy Pressure Scale (stocktickerPPS), Perceived Social Support Scale (PSSS), General Self-Efficacy Scale (GSES), and Connor-Davidson Resilience scale (CD-RISC). We used the Amos2.03 system to build a structural equation model.
UNASSIGNED: A total of 774 subjects had an average age of 30 years and an average gestational age of 23 weeks. Among the 774 respondents, 122 (15.8%) had moderate or above pregnancy stress (stocktickerPPS > 1), 376 (48.6%) had mild or above anxiety symptoms (GAD-7 ≥ 5), 456 (58.9%) had mild or above depression symptoms (PHQ-9 ≥ 5), 740 (95.6%) had moderate or above social support scores (PSSS ≥ 37), and 124 (16.0%) had good or above psychological resilience scores (CD-RISC ≥ 60). Notably, 372 (48.1%) people had a self-efficacy score above the overall average (GSES ≥ 2.6). Pregnancy stress had positive correlations with anxiety and depression (β = 0.57, 0.30, P < 0.01) and negative correlations with self-efficacy (β = -0.19, P < 0.01). Anxiety had positive correlations with depression (β = 0.54, P < 0.01) and negative correlations with social support (β = -0.45, P < 0.01). Social support had positive correlations with self-efficacy and resilience (β = 0.37, 0.47, P < 0.01). Resilience had negative correlations with anxiety (β = -0.09, P < 0.01), and self-efficacy had positive correlations with resilience (β = 0.41, P < 0.01).
UNASSIGNED: Identification of pregnancy stress should be emphasized in pregnant women with negative emotions. Efforts to strengthen the positive psychological qualities of pregnant women should focus on cultivating psychological resilience to reduce the occurrence of anxiety, and improving social support should be a priority because it can enhance psychological resilience and self-efficacy. We provide a reason to intervene in the negative emotions of pregnant women from the perspective of the positive psychology of pregnant women.