Every week we review the most recent publications in women’s mental health, covering topics related to premenstrual symptoms, perinatal mood and anxiety disorders, use of medications in pregnant and breastfeeding women, perinatal substance use, and menopausal mental health. 

For more detailed descriptions of many of these topics, you can sign up to receive our weekly CWMH NEWSLETTER which comes out every Thursday.  

And don’t forget to visit ESSENTIAL READS – a curated selection of up-to-date and clinically relevant articles in women’s mental health.

Ruta Nonacs, MD PhD


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Kautzky A, Slamanig R, Unger A, Höflich A. Neonatal outcome and adaption after in utero exposure to antidepressants: A systematic review and meta-analysis [published online ahead of print, 2021 Sep 6]. Acta Psychiatr Scand. 2021;10.1111/acps.13367.

Although there is statistically significant evidence for various effects of intrauterine exposure to SRI antidepressants, the clinical relevance remains unresolved because of inherently low data quality in this research domain and insufficiently defined samples and outcomes.



Prevalence, correlates, and network analysis of Internet addiction symptoms among Chinese pregnant and postpartum women.

Yang Y, Zhang DY, Li YL, Zhang M, Wang PH, Liu XH, Ge LN, Lin WX, Xu Y, Zhang YL, Li FJ, Xu XJ, Wu HH, Cheung T, Ng CH, Bo HX, Xiang YT. J Affect Disord. 2021 Oct 26:S0165-0327(21)01177-0.

In this cohort of Chinese women, 30.19%, reported Internet addiction during or after pregnancy. Women with previous adverse pregnancy experiences (OR=1.831, P=0.001) and physical comorbidities (OR=1.724, P=0.004) had a higher likelihood of developing Internet addiction. Internet addiction was significantly associated with poor QOL in all domains.

Aubry C, Rider A, Russell S, Moyer S, Kinser PA. “I’m Not the Only One With Depression”: Women’s Perceptions of In-Person Group Formats of Depressive Symptom Interventions. J Perinat Neonatal Nurs. 2021;35(1):37-45.

Women taking part in-person group-based intervention; four main themes emerged regarding the group format: shared experiences enhanced the feeling of safety and impact of the group interventions; group instructors played a key role in fostering a safe environment; participants wished for more group interactions; and participants preferred a synchronous group-based intervention over a technology-based or asynchronous alternative for depressive symptom management.

Bedaso A, Adams J, Peng W, Sibbritt D. The association between social support and antenatal depressive and anxiety symptoms among Australian women. BMC Pregnancy Childbirth. 2021;21(1):708. Published 2021 Oct 22.

A considerable proportion of pregnant Australian women had depressive symptoms and/or anxiety symptoms. Low emotional/informational support and low affectionate support/positive social interaction have a significant association with antenatal depressive and anxiety symptoms respectively.

Marín-Jiménez N BsC, Castro-Piñero J PhD, Rodríguez-Ayllón M PhD, Rubio-Marchán A BsC, Delgado-Fernández M PhD, Aparicio VA PhD. The favourable association of self-reported physical fitness with depression and anxiety during pregnancy. The GESTAFIT project [published online ahead of print, 2021 Sep 24]. Eur J Sport Sci. 2021;1-21.

Greater self-reported physical fitness was associated with lower psychological ill-being during pregnancy. Specifically, at the 16 weeks, greater self-reported overall physical fitness was associated with fewer depressive symptoms, greater self-reported muscular strength with lower anxiety levels; greater self-reported overall physical fitness and speed-agility with lower anxiety levels at the 34 weeks.


Examining the association between subjective childbirth experience and maternal mental health at six months postpartum.

Coo S, García MI, Mira A. J Reprod Infant Psychol. 2021; 1-14.

Negative subjective experience of childbirth contributes to maternal depression and anxiety up to 6 months after childbirth, controlling for mental health during pregnancy and at 3 months postpartum. Quality of care from health professionals made the largest, statistically significant contribution to the global perception of childbirth.

Herbert D, Young K, Pietrusi?ska M, MacBeth A. The mental health impact of perinatal loss: A systematic review and meta-analysis J Affect Disord. 2021;297:118-129.

Compared to controls, perinatal loss was associated with increased risk of depression (RR = 2.14, 95% CI = 1.73-2.66, p < 0.001) and anxiety disorders (RR = 1.75, 95% CI = 1.27-2.42, p < 0.001).

Landoni M, Missaglia S, Tavian D, Ionio C, Di Blasio P. Influence of 5-HTTLPR polymorphism on postpartum depressive and posttraumatic symptoms [published online ahead of print, 2021 Oct 22]. Psychiatr Genet. 2021;10.1097.

Lower expression of serotonin transporter gene, associated with SS genotype, seems to render women more vulnerable to depressive and PTSD symptoms after childbirth.

Rokicki S, McGovern M, Von Jaglinsky A, Reichman NE. Depression in the Postpartum Year and Life Course Economic Trajectories [published online ahead of print, 2021 Oct 22]. Am J Prev Med. 2021;S0749-3797(21)00486-4.

In total, 12.2% of the sample met the criteria for a major depressive episode 1 year after delivery. Maternal depression had a strong and sustained positive association with material hardship and not working for pay in Years 3, 5, 9, and 15 after delivery.

Ross CM, Hammond C, Ralph JA, Balmert LC, Wisner KL, Kiley JW. A prospective pilot study to assess the impact of the etonogestrel implant on postpartum depression. Eur J Contracept Reprod Health Care. 2021;26(2):98-104.

Comparing women who received the ENG-implant versus those who used non-hormonal contraception, the rates of positive PHQ-9 screens at 6 weeks postpartum were similar between groups. These preliminary data suggest that immediate postpartum placement of the ENG-implant does not negatively impact the risk for a positive depression screen.

Thiel F, Hochkeppel H, Kress V, Kopp M, Baumann S, Garthus-Niegel S. Prospective associations between prepartum physical activity, birth experience, and maternal depressive symptoms in the postpartum period: Insights from the population-based DREAM cohort study [published online ahead of print, 2021 Oct 26]. J Affect Disord. 2021;S0165-0327(21)01138-1. doi:10.1016/j.jad.2021.10.060

A negative birth experience was linked to postpartum depressive symptoms. Physical activity did not positively or negatively affect the birth experience. Having a positive birth experience is crucial in the prevention of postpartum depressive symptoms.



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Nidey NL, Momany AM, Strathearn L, et al. Association between perinatal depression and risk of attention deficit hyperactivity disorder among children: a retrospective cohort study. Ann Epidemiol. 2021;63:1-6.

Children born to mothers with perinatal depression were found to be at increased risk of ADHD (HR 3.16 (95% CI 2.35, 4.23)).

Roth MC, Humphreys KL, King LS, Mondal S, Gotlib IH, Robakis T. Attachment Security in Pregnancy Mediates the Association Between Maternal Childhood Maltreatment and Emotional and Behavioral Problems in Offspring. Child Psychiatry Hum Dev. 2021;52(5):966-977.

Maternal childhood maltreatment severity was associated with less secure, and more avoidant and anxious attachment. Mediation analyses revealed further that less secure maternal attachment, but not avoidant or anxious attachment, mediated the associations between maternal childhood maltreatment and offspring emotional and behavioral problems. These findings suggest that improving maternal attachment security, which can be identified even prior to the child’s birth, is an important target to consider for intervention efforts aimed at minimizing adverse intergenerational effects of early life adversity.



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