OBJECTIVE: Gestational diabetes mellitus (GDM) is a common complication of pregnancy and is associated with considerable psychological burden for women. In qualitative research, women with GDM describe increased awareness about their bonding with their infant, potentially resulting from the highly medicalised nature of the condition. The primary aim is to examine quantitatively whether GDM was associated with lower mother-infant bonding in the postnatal period.
METHODS: Data were analysed from 10,419 women who participated in the Tohoku Medical Megabank Project Birth and Three-Generation Cohort Study from 2013 to 2017 in Japan. GDM status was collected from hospital records and measured using the oral glucose tolerance test. Mother-infant bonding was assessed using the Japanese version of Mother-to-Infant Bonding Scale (MIBS-J) at one-month postpartum, higher scores representing lower bonding. Data were analysed in SAS using multiple regression adjusting for relevant confounders.
RESULTS: GDM did not appear to be associated with worse mother-infant bonding scores at one-month postpartum. There was a non-significant unadjusted trend in the mean mother-infant bonding scores and the proportion with bonding disorder (n = 4 (4.12%) versus n = 969 (9.39%)) in the GDM versus non GDM group respectively, indicating higher self-reported bonding in the GDM group, and this remained not statistically significant in the adjusted analyses.
CONCLUSIONS: We observed the reverse of our hypothesis, that there was a trend for women with GDM to self-report higher bonding compared to non-GDM women. There is need to replicate this finding in cohorts specifically designed to measure GDM-specific psychological distress.

BACKGROUND: Experiential education, particularly through game-based approaches, has gained recognition for effectively addressing the myriad challenges faced by expectant parents.
OBJECTIVE: To consolidate and synthesize the available evidence regarding expectant parents\' experiences of game-based perinatal education.
METHODS: A mixed studies review.
METHODS: Six electronic databases were searched from their inception until March 2024: PubMed, Embase, CINAHL, Web of Science, Scopus, ProQuest Dissertations and Theses Global.
METHODS: This review observed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and was guided by Pluye and Hong\'s (2014) framework for mixed studies review. Quality appraisal of included studies was conducted using the Mixed Methods Appraisal Tool. A convergent qualitative synthesis design for mixed studies review was adopted to analyse all findings and thematic analysis was conducted.
RESULTS: Three themes and 10 subthemes were generated from the eight included studies. The main themes were: (1) Exploring novel frontiers to deliver perinatal education, (2) Empowerment through play: Unveiling key insights and (3) Insights and recommendations.
CONCLUSIONS: The findings suggest that game-based education holds promise as a valuable tool for equipping expectant parents with the necessary knowledge and skills in an engaging and immersive manner to navigate the challenging perinatal period.
UNASSIGNED: The findings suggest that game-based education holds promise as a valuable tool for equipping expectant parents with the necessary knowledge and skills to navigate the challenging perinatal period. Nurses should consider incorporating or developing a game-based curriculum to supplement current educational classes to encourage parental participation and enhance learning for perinatal education.
UNASSIGNED: This study adhered to the PRISMA reporting guidelines.
UNASSIGNED: No Patient or Public Contribution.
UNASSIGNED: A protocol was submitted to PROSPERO (CRD42023447527).

OBJECTIVE: Cognitive impairment and decreased executing functioning represent common symptoms of both ADHD and pregnancy. This study aimed to characterize temporal trends and racial/ethnic disparities in ADHD diagnosis during the perinatal period.
METHODS: In this serial cross-sectional study, we used administrative claims to create a cohort of commercially insured women with a documented live birth between 2008 and 2020 and identified those with an ADHD diagnosis in the year before or after delivery. We applied logistic regression to assess the probability of ADHD diagnosis adjusting for race/ethnicity, age, and comorbid conditions. We used this model to calculate the predicted probability of ADHD diagnosis by racial/ethnic group for each year.
RESULTS: We identified 736,325 deliveries from 2008 to 2020. Overall, 16,801 (2.28 %) of deliveries had an ADHD diagnosis in the year before or after delivery. ADHD rates increased 290 % from 101 (95%CI: 92-111) per 10,000 deliveries in 2008 to 394 (95%CI: 371-419) per 10,000 deliveries in 2020. White women experienced the highest rates followed by Black, Hispanic, and Asian, respectively.
CONCLUSIONS: Increasing ADHD diagnosis rates during the perinatal period may reflect improved detection but racial disparities persist. Additional research is needed to develop equitable outreach strategies to better support women experiencing ADHD during the perinatal period.

BACKGROUND: Suicide is a leading global cause of maternal death in the first year after birth. Limited research has explored which factors may support or prevent women from disclosing suicidality. This is important for informing appropriate approaches to identifying perinatal women who may require support.
OBJECTIVE: (i) explore perinatal women\'s views and experiences regarding the barriers, facilitators, and implications of identifying and disclosing suicidality in maternity care settings; and (ii) explore their perspectives on appropriate approaches for healthcare practitioners (HCPs) to take when asking about suicide during pregnancy or after birth.
METHODS: Twenty-one semi-structured interviews with perinatal women in the UK. Of these women, 17 had experienced self-reported perinatal mental health (PMH) problems and/or suicidality. Inductive thematic analysis was used to explore the data and identify themes.
RESULTS: Four themes, comprising 11 subthemes were identified. Barriers that affected women\'s willingness and capacity to disclose suicidality included: stigma, social expectations of motherhood, not recognising symptoms, not being asked about PMH and/or rushed appointments, lack of care continuity, and HCPs interpersonal skills. Important facilitators were the provision of PMH information and peer support. Women also suggested providing more choice in how PMH and suicide-related questions are administered (e.g., via a form and in-person) and for HCPs to frame these discussions sensitively.
CONCLUSIONS: Significant barriers impact perinatal women\'s disclosure of suicidality. Appropriate approaches for identifying suicidality in maternity contexts need to be developed that take account of these barriers and support women to feel safe, comfortable, and able to answer suicide-related questions honestly.

Despite efforts to reduce stillbirths and neonatal deaths, inconsistent definitions and reporting practices continue to hamper global progress. Existing data frequently being limited in terms of quality and comparability across countries. This paper addresses this critical issue by outlining the new International Classification of Disease (ICD-11) recommendations for standardized recording and reporting of perinatal deaths to improve data accuracy and international comparison. Key advancements in ICD-11 include using gestational age as the primary threshold to for reporting, clearer guidance on measurement and recording of gestational age, and reporting mortality rates by gestational age subgroups to enable country comparisons to include similar populations (e.g., all births from 154 days [22+0 weeks] or from 196 days [28+0 weeks]). Furthermore, the revised ICD-11 guidance provides further clarification around the exclusion of terminations of pregnancy (induced abortions) from perinatal mortality statistics. Implementing standardized recording and reporting methods laid out in ICD-11 will be crucial for accurate global data on stillbirths and perinatal deaths. Such high-quality data would both allow appropriate regional and international comparisons to be made and serve as a resource to improve clinical practice and epidemiological and health surveillance, enabling focusing of limited programmatic and research funds towards ending preventable deaths and improving outcomes for every woman and every baby, everywhere.

BACKGROUND: Little is known about the effect of music intervention on perinatal depressive symptoms (PDS), especially the effectiveness of specific aspects of the intervention. This meta-analysis aimed to evaluate the effectiveness of music intervention and explore the role of different intervention features.
METHODS: Six databases were searched from inception to May 21, 2024, to identify randomized controlled trials evaluating the effect of music intervention on PDS. The Cochrane Risk of Bias (RoB) 2.0 tool was used to assess RoB.
RESULTS: The meta-analysis of 10 studies including 988 participants showed that music intervention significantly improved PDS (standardized mean difference (SMD): 0.61, 95% confidence interval (CI): 0.91, -0.32), with statistical heterogeneity among the studies (I2 = 78%). Subgroup analysis showed significant effects on pregnant and postpartum women, and women with or without perinatal complications. Effects were also significant in low- and middle-income countries (SMD: 0.79, 95% CI: 1.16, -0.42), music medicine (SMD: 0.82, 95% CI: 1.17, -0.47), and total intervention length of less than 6 weeks (SMD: 0.85, 95% CI: 1.25, -0.45), but not in high-income countries, music therapy, or total intervention length of 6 weeks or more. Hospital intervention (SMD: 0.86, 95% CI: 1.41, -0.31) showed greater effects compared with home intervention and hospital combined with home intervention. Six studies had a high overall RoB and four had some concerns.
CONCLUSIONS: Music intervention is effective in alleviating PDS. Interventions in low- and middle-income countries, music medicine, total intervention length of less than 6 weeks, and hospital intervention may be advisable.

Opioid use disorder (OUD) among pregnant people has increased dramatically during the opioid epidemic, affecting a significant number of families with young children. Parents with OUD commonly face significant challenges as they are often balancing the stress of caring for young children with maintaining recovery and co-occurring psychosocial challenges (e.g., mental health, low social support). Toward designing interventions to address parenting needs among parents with OUD, we conducted a mixed-methods study to understand the acceptability of receiving parenting support prenatally among pregnant people with OUD residing in the United States. Semi-structured interviews were conducted among 18 pregnant and early postpartum people recruited from a substance use treatment program specializing in the care of pregnant and parenting populations. Among all participants, a prenatal parenting program that comprehensively addresses recovery, parenting, and wellbeing was found to be widely acceptable. Regarding content most desirable within a parenting intervention, participants indicated an interest in breastfeeding, caring for newborns with in-utero opioid exposure, parent-infant bonding, infant soothing techniques, their own wellbeing/mental health, and parenting skills. We introduce a prenatal adaptation of the well-established Family Check-up parenting intervention as a novel, prenatal intervention to prevent negative outcomes for caregivers in recovery and their children.
El trastorno de uso de Opioides (OUD) entre personas embarazadas ha aumentado dramáticamente durante la epidemia de opioides, lo cual afecta a un número significativo de familias con niños pequeños. Los progenitores con OUD comúnmente enfrentan retos significativos ya que ellos a menudo buscan equilibrar el estrés de cuidar a niños pequeños con mantener la recuperación y retos sicosociales concurrentes (v.g. salud mental, bajo apoyo social). Con miras al diseño de intervenciones que se ocupen de las necesidades de crianza entre progenitores con OUD, llevamos a cabo un estudio con métodos combinados para comprender el nivel de aceptación de recibir apoyo de crianza prenatalmente entre personas embarazadas con OUD residentes en Estados Unidos. Se llevaron a cabo entrevistas semiestructuradas con 18 personas embarazadas y en el estado temprano del postparto reclutadas de un programa de tratamiento por uso de sustancias que se especializa en el cuidado de grupos de población en estado de embarazo y de crianza. Entre todos los participantes, se notó la amplia aceptación de un programa prenatal de crianza que de manera comprensiva se ocupa de la recuperación. Con respecto al contenido más adecuado dentro de una intervención de crianza, los participantes indicaron su interés en amamantar, cuidar de los recién nacidos expuestos a opioides en el útero, la unión afectiva entre progenitor e infante, técnicas para calmar al infante, su propio bienestar/salud mental, así como las habilidades de crianza. Introdujimos una adaptación prenatal de la bien establecida intervención de crianza Family Check‐Up (El Chequeo de Familia) como una novedosa intervención prenatal para prevenir resultados negativos para cuidadores en proceso de recuperación y sus niños.
Opioidkonsumstörungen (OUD) bei Schwangeren haben im Zuge der Opioidkrise in den USA dramatisch zugenommen und betreffen eine große Zahl von Familien mit kleinen Kindern. Eltern mit OUD stehen häufig vor großen Herausforderungen, da sie den Stress der Betreuung kleiner Kinder mit der Aufrechterhaltung der Genesung und gleichzeitigen psychosozialen Herausforderungen (z. B. psychische Gesundheit, geringe soziale Unterstützung) in Einklang bringen müssen. Im Hinblick auf die Entwicklung von Maßnahmen, die auf die Bedürfnisse von Eltern mit OUD eingehen, haben wir eine mixed‐methods‐Studie durchgeführt, um die Akzeptanz der Inanspruchnahme von pränataler Erziehungshilfe bei schwangeren Frauen mit OUD in den USA zu untersuchen. Es wurden halbstrukturierte Interviews mit 18 schwangeren Frauen und Frauen in der frühen postpartalen Phase durchgeführt, die aus einem Programm zur Behandlung von OUD rekrutiert wurden, das auf die Betreuung von schwangeren Frauen und Eltern spezialisiert ist. Bei allen Teilnehmerinnen erfuhr eine pränatale Elternintervention, die sich umfassend mit Genesung, Elternschaft und Wohlbefinden befasst, breiten Zuspruch. Hinsichtlich der am stärksten gewünschten Inhalte einer Elternintervention gaben die Teilnehmerinnen das größte Interesse für die Themen Stillen, Pflege von Neugeborenen mit Opioidexposition in der Gebärmutter, Eltern‐Kind‐Bindung, Beruhigungstechniken für Säuglinge, ihr eigenes Wohlbefinden/ihre seelische Gesundheit und elterliche Fähigkeiten an. Wir stellen eine pränatale Adaptation der gut etablierten Family Check‐Up Elternintervention als neuartige, pränatale Intervention vor, um negativen Folgen für betreuende Personen in der Genesung von OUD sowie für ihre Kinder vorzubeugen.
妊婦のオピオイド使用障害 (OUD) はオピオイドの流行で顕著に増加しており、幼い子どものいるかなりの数の家族に影響を及ぼしている。OUDの親は、回復の維持や、併発する心理社会的課題 (メンタルヘルス、社会的支援の低さなど) と幼い子どもの世話のストレスのバランスをとることが多いため、一般的に大きな課題に直面している。OUDの親の子育てニーズに対処するための介入策を設計するため、われわれは米国に住むOUDの妊婦が、出産前に子育て支援を受けることの受容性を理解するための混合方法研究を実施した。妊婦および子育て中の人々のケアに特化した薬物使用治療プログラムから募集した妊婦および産後間もない18人を対象に、半構造化面接を実施した。参加者全員において、回復、子育て、幸福度を包括的に扱う出産前の子育てプログラムが広く受け入れられることがわかった。子育て介入で最も望ましい内容については、参加者は母乳育児、子宮内オピオイド曝露を受けた新生児のケア、親と乳児の絆、乳児をなだめる方法、自分自身の幸福度/メンタルヘルス、子育てスキルに関心を示した。回復期にある養育者とその子どもの否定的な転帰を予防するための新しい出生前介入として、確立された家族健診子育て介入の出生前適応を紹介する。.
在阿片类药物泛滥期间, 孕妇中阿片类药物使用障碍 (OUD) 的发病率急剧上升, 影响了大量有幼儿的家庭。患有OUD的父母通常面临巨大的挑战, 因为他们常常需要在照顾幼儿的压力和维持康复以及共同出现的社会心理挑战 (如心理健康、社会支持不足) 之间取得平衡。为了设计干预措施来解决患有OUD的父母的育儿需求, 我们进行了一项混合方法研究, 以了解居住在美国的OUD孕妇对开展产前育儿支持的可接受性。我们从专门为孕妇和育儿人群提供护理的药物使用治疗计划中招募了18名孕妇和产后早期人群, 对他们进行了半结构化访谈。在所有参与者中, 综合解决康复、育儿和健康的产前育儿计划被认为是广泛可接受的。关于育儿干预中最受欢迎的内容, 参与者表示对母乳喂养、照顾在子宫内暴露于阿片类药物的新生儿、亲子关系、婴儿安抚技巧、自己的健康或心理健康以及育儿技巧感兴趣。我们引入了一种新颖的产前干预方法, 即对广受认可的“家庭检查”育儿干预进行产前改编, 以预防对康复中的照顾者及其子女的负面影响。.
لقد ازداد اضطراب تعاطي المواد الأفيونية بين الحوامل بشكل كبير خلال وباء المواد الأفيونية ، مما أثر على عدد كبير من الأسر التي لديها أطفال صغار. وعادة ما يواجه الآباء والأمهات الذين يعانون من اضطراب تعاطي المواد الأفيونية (OUD) تحديات كبيرة لأنهم غالباً ما يوازنون بين ضغوط رعاية الأطفال الصغار والحفاظ على التعافي والتحديات النفسية والاجتماعية المتزامنة (مثل الصحة النفسية وانخفاض الدعم الاجتماعي). من أجل تصميم تدخلات لتلبية احتياجات التربية بين الآباء والأمهات الذين يعانون من اضطراب تعاطي الأفيون ، أجرينا دراسة مختلطة الأساليب لفهم مدى قبول تلقي دعم الرعاية الوالدية قبل الولادة بين الحوامل المصابات باضطراب تعاطي الأفيون المقيمات في الولايات المتحدة. وأجريت مقابلات شبه منظمة بين 18 من الحوامل في مرحلة مبكرة بعد الولادة حيث تم إشراكهن في الدراسة من خلال برنامج للعلاج من تعاطي المخدرات متخصص في رعاية الحوامل والأمهات. ومن بين جميع المشاركين، وُجد أن برنامج الرعاية الوالدية قبل الولادة الذي يعالج بشكل شامل التعافي والتربية والرفاهية مقبول على نطاق واسع. وفيما يتعلق بالمحتوى المرغوب فيه أكثر من غيره في تدخل الرعاية الوالدية، أشار المشاركون إلى الاهتمام بالرضاعة الطبيعية، ورعاية الأطفال حديثي الولادة الذين تعرضوا للمواد الأفيونية داخل الرحم، والترابط بين الوالدين والرضيع، وتقنيات تهدئة الرضع، ورفاههم/صحتهم النفسية، ومهارات الأبوة والأمومة. في هذه الدراسة نقدم تطويعاً لفحص ما قبل الولادة كتدخل جديد قبل الولادة لتجنب النتائج السلبية لمقدمي الرعاية في مرحلة التعافي وأطفالهم.

UNASSIGNED: Suicide is a leading cause of death in males aged 25-44 years, an age which often coincides with becoming a father. This review aims to synthesise the evidence of the prevalence of suicidal and self-harm ideation in fathers during the perinatal, postnatal and early parenting period.
UNASSIGNED: Five databases were searched (PsycINFO, Medline, Web of Science, PubMed and the Cochrane Database of Systematic Reviews) to identify papers published between 1 January 2000 and 9 March 2023. A meta-analysis was conducted to estimate the prevalence of suicidality and self-harm ideation across the included studies. Subgroup and sensitivity analyses were conducted to explore potential sources of heterogeneity.
UNASSIGNED: A total of 4215 articles were identified, with 14 studies included in the review. The combined pooled prevalence of suicidal and self-harm ideation was 4.2% (95% CI [2.6%, 6.2%]). Prevalence estimates were higher for self-harm ideation at 5.1% (95% CI [2.6%, 6.2%]) than for suicidality at 3% (95% CI [0.9%, 6.1%]).
UNASSIGNED: This review found that a considerable proportion of fathers experience suicidal and self-harm ideation during the early years of parenting. However, the paucity of rigorous prevalence studies indicates that further research in this area is needed urgently.

BACKGROUND: Perinatal depression affects a significant number of women during pregnancy and after birth, and early identification is imperative for timely interventions and improved prognosis. Mobile apps offer the potential to overcome barriers to health care provision and facilitate clinical research. However, little is known about users\' perceptions and acceptability of these apps, particularly digital phenotyping and ecological momentary assessment apps, a relatively novel category of apps and approach to data collection. Understanding user\'s concerns and the challenges they experience using the app will facilitate adoption and continued engagement.
OBJECTIVE: This qualitative study explores the experiences and attitudes of users of the Mom2B mobile health (mHealth) research app (Uppsala University) during the perinatal period. In particular, we aimed to determine the acceptability of the app and any concerns about providing data through a mobile app.
METHODS: Semistructured focus group interviews were conducted digitally in Swedish with 13 groups and a total of 41 participants. Participants had been active users of the Mom2B app for at least 6 weeks and included pregnant and postpartum women, both with and without depression symptomatology apparent in their last screening test. Interviews were recorded, transcribed verbatim, translated to English, and evaluated using inductive thematic analysis.
RESULTS: Four themes were elicited: acceptability of sharing data, motivators and incentives, barriers to task completion, and user experience. Participants also gave suggestions for the improvement of features and user experience.
CONCLUSIONS: The study findings suggest that app-based digital phenotyping is a feasible and acceptable method of conducting research and health care delivery among perinatal women. The Mom2B app was perceived as an efficient and practical tool that facilitates engagement in research as well as allows users to monitor their well-being and receive general and personalized information related to the perinatal period. However, this study also highlights the importance of trustworthiness, accessibility, and prompt technical issue resolution in the development of future research apps in cooperation with end users. The study contributes to the growing body of literature on the usability and acceptability of mobile apps for research and ecological momentary assessment and underscores the need for continued research in this area.

UNASSIGNED: Adolescents with perinatal HIV (APHIV) experience emotional turmoil, which is worsened by real or perceived negative impacts on the adolescents\' relationships, aspirations for their careers, and aspirations for their families.
UNASSIGNED: To explore the experiences of APHIV with regard to social support on their mental health and general well-being in the Vhembe District of Limpopo province.
UNASSIGNED: A mixed-methods sequential exploratory design was employed to conduct in-depth one-on-one interviews in the Vhembe District of the Limpopo province of South Africa. The interviews were conducted in selected community health centres and clinics over a period of four months (April 2019 - July 2019). This study included APHIV between the ages of 10 years and 19 years who had been initiated on antiretroviral therapy before the age of 10 years.
UNASSIGNED: Two major themes emerged. Theme 1 - Experiences within the family - included the sub-themes experience of positive social support within the family, and lack of support in the family. Theme 2 - Experiences outside the family - included the sub-themes experiences at the clinic, experiences at community level, and experiences at school and with friends.
UNASSIGNED: Adolescents with perinatal HIV are in need of social support from their loved ones as well as the community. Expansion of household programmes and intervention through integration of services by the multidisciplinary team might assist with alleviating the social support needs which will improve their mental health and adherence to treatment.