Archives of Women's Mental Health最新文献

{"title":"Depression and antidepressant treatment in growing up in New Zealand: impact on preterm birth and low birth weight","authors":"Stephanie D’Souza,&nbsp;Francesca Anns,&nbsp;Karen E. Waldie,&nbsp;Roger T. Mulder,&nbsp;Julia J. Rucklidge","doi":"10.1007/s00737-026-01692-4","DOIUrl":"10.1007/s00737-026-01692-4","url":null,"abstract":"<div><h3>Purpose</h3><p>To investigate the independent effects of antenatal depression and antidepressant use on birth weight and gestational age in a large, ethnically diverse New Zealand cohort.</p><h3>Methods</h3><p>Data were obtained from 6,759 pregnancies in the <i>Growing Up in New Zealand</i> longitudinal study, of which 5,200 (76.9%) involved neither antidepressant exposure nor unmedicated depression, 197 (2.9%) involved antidepressant exposure, and 715 (10.6%) involved unmedicated depression. Antenatal depression was assessed using the Edinburgh Postnatal Depression Scale (EPDS), and prenatal antidepressant use was self-reported. Birth outcomes were obtained through linked perinatal health records. Multiple regression analyses examined continuous and categorical outcome definitions, adjusting for sociodemographic and antenatal health variables.</p><h3>Results</h3><p>The prevalence of antidepressant use and unmedicated antenatal depression (EDPS <i>≥</i> 13) was 2.9% and 10.6%, respectively. Antidepressant use predicted a 0.40-week reduction in gestational age (95% CI: -0.55 to -0.26), and each one-point increase in EPDS score predicted a 0.02-week reduction (95% CI: -0.03 to -0.01). Higher EPDS scores were also associated with increased odds of preterm birth (OR = 1.04, 95% CI: 1.02 to 1.07) and low birth weight (OR = 1.03, 95% CI: 1.00 to 1.06).</p><h3>Conclusions</h3><p>Antidepressant use and antenatal depression were each associated with slightly earlier births, but only depressive symptoms were associated with increased risk of preterm birth and low birth weight. Effect sizes were small. Antidepressants remain an important, and often most accessible treatment option, for maternal depression. Greater investment in screening and culturally responsive, non-pharmacological options is also needed to support diverse preferences and wellbeing.</p></div>","PeriodicalId":8369,"journal":{"name":"Archives of Women's Mental Health","volume":"29 2","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13005846/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147493508","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Implementing mental health interventions in perinatal home visiting programs: a systematic review of the literature","authors":"Alasia Ledford,&nbsp;Harry Adynski,&nbsp;Linda Beeber,&nbsp;Byron J. Powell,&nbsp;Jada L. Brooks,&nbsp;Anna Matthews,&nbsp;Jennifer Leeman","doi":"10.1007/s00737-026-01685-3","DOIUrl":"10.1007/s00737-026-01685-3","url":null,"abstract":"<div><h3>Purpose</h3><p>Perinatal home visiting programs are well positioned to deliver mental health interventions to those at high risk for adverse mental health outcomes. The purpose of this review was to examine home-based mental health interventions, their effectiveness, and how they have been implemented in perinatal home visiting programs.</p><h3>Methods</h3><p>Following PRISMA guidelines, we searched PubMed, CINAHL, PsycInfo, and Social Work Abstracts for reports of experimental or quasi-experimental studies evaluating outcomes of a mental health intervention delivered in the home setting as part of a perinatal home visiting program in the United States. Data extracted included the study demographics, design, characteristics of the interventions, evidence of intervention effectiveness, implementation strategies, and implementation outcomes and determinants.</p><h3>Results</h3><p>Data abstractors screened 3,500 articles published from January 2010 to January 2024. Of these, 25 articles reporting findings of 12 distinct mental health interventions met the criteria for inclusion. Interventions were based on a variety of therapeutic approaches such as cognitive behavioral therapy, collaborative problem solving, and motivational interviewing. Interventionists ranged from paraprofessionals such as community health workers to professionals such as registered nurses, nurse practitioners and licensed clinical social workers, in addition to others. Recipients of the interventions were predominantly white women; high risk groups including American Indian/Alaskan Native and Asian/Pacific Islander populations were underrepresented in studies. Studies demonstrated evidence of effectiveness in reducing symptoms of depression. Few studies systematically evaluated implementation outcomes or strategies, or followed standard recommendations for reporting implementation outcomes, limiting synthesis.</p><h3>Conclusions</h3><p>Mental health interventions delivered through perinatal home visiting programs show effectiveness at reducing depressive symptoms, and in a subset of studies, anxiety symptoms, though evidence for reduction in anxiety is more limited. Variations in how implementation measures were reported limited synthesis demonstrating that further research is needed in implementation.</p></div>","PeriodicalId":8369,"journal":{"name":"Archives of Women's Mental Health","volume":"29 2","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147493543","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Traumatic birth experiences and maternal caregiving behaviors and attitudes in black and white women","authors":"Sara L. Kornfield,&nbsp;Nicole M. Henry,&nbsp;Rebecca Waller,&nbsp;Lauren White,&nbsp;Raquel Gur,&nbsp;Deiriai Myers,&nbsp;Kate Wisniewski,&nbsp;Florence Momplaisir,&nbsp;Wanjikũ F. M. Njoroge","doi":"10.1007/s00737-026-01682-6","DOIUrl":"10.1007/s00737-026-01682-6","url":null,"abstract":"<div><h3>Purpose</h3><p>This longitudinal investigation examined the association between traumatic birth experiences (measured via self-report and clinician-report) and caregiving behaviors and attitudes and any race-related differences in these associations.</p><h3>Methods</h3><p>Subjective childbirth trauma was measured via a three-item questionnaire at 12 weeks postpartum. Medical childbirth factors were extracted from the electronic health record. Maternal caregiving behaviors and attitudes were assessed via comprehensive questionnaires (i.e., mother-infant bonding and parenting stress) and observation ratings (i.e., positive parenting and mother-infant interactions) at 12 weeks, 12 months, and 24 months postpartum. Multiple linear regressions were run to analyze these relationships.</p><h3>Results</h3><p>A total of 255 mothers (106 Black and 149 White) who gave birth from April to December 2020 were examined. More traumatic childbirth experiences were significantly associated with higher-rated observed positive parenting scores (<i>β</i> = 0.21, <i>p</i>_<i>FDR</i>&lt;0.05) when controlling for demographic factors. There were no significant relationships at 12 weeks or 24 months postpartum. Additionally, there were no effects of race on the relationship between childbirth trauma and caregiving.</p><h3>Conclusions</h3><p>Subjective reports of childbirth trauma were not significantly associated with poorer maternal caregiving behaviors and attitudes. This study adds to the literature by examining Black women, as they are underrepresented in this body of research and more at risk of experiencing traumatic childbirths.</p></div>","PeriodicalId":8369,"journal":{"name":"Archives of Women's Mental Health","volume":"29 2","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12999831/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147479883","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correction to: Is anybody out there? Tackling intimate partner violence as a hidden pandemic during COVID times and beyond: factors, impact, and recommendations, a systematic review and meta-analyses","authors":"Petra Heidler,&nbsp;Lisa Dam,&nbsp;Isabel King,&nbsp;Nouran Hamza,&nbsp;Marwa Muhammed Abdeljawad,&nbsp;Dina Alaraby,&nbsp;Mochammad Fahlevi,&nbsp;Temoor Anjum,&nbsp;Roy Rillera Marzo,&nbsp;Michael Wagner,&nbsp;Sudip Bhattacharya,&nbsp;Priyanka Chahal","doi":"10.1007/s00737-026-01681-7","DOIUrl":"10.1007/s00737-026-01681-7","url":null,"abstract":"","PeriodicalId":8369,"journal":{"name":"Archives of Women's Mental Health","volume":"29 2","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147430397","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Continuation and discontinuation of antidepressant treatment before, during and after pregnancy: a cohort study","authors":"Ella J. Marson,&nbsp;Irene Petersen,&nbsp;Sonia Saxena,&nbsp;Patricia Schartau,&nbsp;Holly Christina Smith","doi":"10.1007/s00737-026-01683-5","DOIUrl":"10.1007/s00737-026-01683-5","url":null,"abstract":"<div><h3>Objective</h3><p>To assess the relationship between antidepressant treatment before, during and after childbirth.</p><h3>Design</h3><p>Cohort study.</p><h3>Setting</h3><p>Primary care in the United Kingdom (UK).</p><h3>Participants</h3><p>Women aged 15–49 with a single live birth (2006–2015), stratified by antidepressant history:</p><ul>\u0000 <li>\u0000 <p><b>Cohort A</b>: Prescribed antidepressants ≥ 2 years before childbirth.</p>\u0000 </li>\u0000 <li>\u0000 <p><b>Cohort B</b>: Prescribed 1–2 years before childbirth.</p>\u0000 </li>\u0000 <li>\u0000 <p><b>Cohort C</b>: Prescribed within 1 year before childbirth.</p>\u0000 </li>\u0000 <li>\u0000 <p><b>Cohort D</b>: No antidepressants prescribed before childbirth.</p>\u0000 </li>\u0000 </ul><h3>Outcome measures</h3><p>Changes in antidepressant treatment during the perinatal period.</p><h3>Results</h3><p>Of 202,303 women, 46,479 (23%) had pre-childbirth antidepressant prescriptions (Cohorts A: 37,161; B: 19,627; C: 14,363), while 155,824 (77%) did not (Cohort D). In cohort A, 76% discontinued treatment in the year before childbirth, compared to 48% in cohort B. Postpartum, 22% of those in cohort A and 33% in cohort B restarted treatment. Overall, 26,835/202,303 (13%) received antidepressants in the year after childbirth. Among women without prior treatment, 10,258/155,824 (7%) started antidepressants postpartum, compared to 16,577/46,479 (36%) of those with prior use. Cohort C had the highest postpartum prescription rate (9,232/14,363, 64%).</p><h3>Conclusions</h3><p>Antidepressant treatment after childbirth is common, particularly among women who have received treatment before childbirth. Many women discontinue antidepressants before or during pregnancy. The study highlights the importance of considering history of antidepressant treatment when planning postnatal care and counselling women on continuing or stopping antidepressants during pregnancy. This information can aid healthcare professionals in advising women about antidepressant use before, during, and after pregnancy, considering individual circumstances and risks.</p></div>","PeriodicalId":8369,"journal":{"name":"Archives of Women's Mental Health","volume":"29 2","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12971859/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147388788","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Adverse pregnancy outcomes as predictors of postpartum psychiatric illness: a retrospective cohort study","authors":"Maryline Alhajj,&nbsp;Alok Madan,&nbsp;Pedro Ramirez,&nbsp;Jessica Rohr","doi":"10.1007/s00737-026-01689-z","DOIUrl":"10.1007/s00737-026-01689-z","url":null,"abstract":"<div><h3>Purpose</h3><p>Severe maternal morbidity (SMM as defined by the Centers for Disease Control and Prevention) as well as other adverse pregnancy outcomes (APOs) may confer differential risk for postpartum psychiatric illness (PPI). PPI is often underrecognized, and it can have lasting and harmful effects on both the mother’s and the infant’s well-being. The purpose of this cross-sectional study is to explore whether specific pregnancy complications act as potential predictors for PPI, and how this differs across important social determinants of health (e.g. race/ethnicity).</p><h3>Methods</h3><p>Participant data was obtained from the electronic health record of patients (<i>N</i> = 19,231) who received perinatal care from HOSPITAL, a hospital system serving the most ethnically diverse large city in the United States, between 2020 and 2023. We utilized univariate and multivariate logistic regression models to obtain odds ratios for the associations desired.</p><h3>Results</h3><p>After accounting for premorbid psychiatric status, only APOs act as an independent predictor for the development of PPI within a year postpartum, and certain APOs are more closely associated with PPI depending on the mother’s racial/ethnic background. APOs were found to be strongly linked to PPI (OR = 1.43, CI 11.31–1.57, <i>p</i> &lt; .001), specifically for non-Hispanic White women, Hispanic White women, and non-Hispanic Asian women.</p><h3>Conclusions</h3><p>Our findings highlight the need for a more proactive approach to screening, monitoring, and treatment in maternal mental healthcare, that would encompass both the specific APOs and the racial/ethnic differences associated with them.</p></div>","PeriodicalId":8369,"journal":{"name":"Archives of Women's Mental Health","volume":"29 2","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-03-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147388836","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Personality and cortical architecture in premenstrual dysphoric disorder","authors":"Elise Bücklein-Ehlers,&nbsp;Manon Dubol,&nbsp;Birgit Derntl,&nbsp;Andreas Fallgatter,&nbsp;Inger Sundström-Poromaa,&nbsp;Erika Comasco","doi":"10.1007/s00737-026-01677-3","DOIUrl":"10.1007/s00737-026-01677-3","url":null,"abstract":"<div><h3>Purpose</h3><p>Premenstrual dysphoric disorder (PMDD) has been associated with altered grey matter architecture in a trait-like manner. Personality traits, shaped largely by genetics and linked to depressive disorders, may relate to structural properties of the brain and could represent a potential factor mediating vulnerability for PMDD. However, these possible associations remain largely unexplored.</p><h3>Methods</h3><p>The present study assessed personality traits in participants with PMDD and healthy controls, as well as how personality is related to symptom severity and cortical surface measures in PMDD. Healthy controls and patients completed the Swedish Universities Scale of Personality. Following prospective validation of the PMDD diagnosis, patients had their brain scanned with magnetic resonance imaging (MRI) during the symptomatic luteal phase of the menstrual cycle. Personality of controls and patients was compared using Mann-Whitney U tests. Associations of personality with symptom severity and brain surface parameters were tested through correlation analysis.</p><h3>Results</h3><p> PMDD was associated with higher scores in neuroticism and aggressiveness. Aggressiveness was positively correlated with the severity of irritability/anger, though not significant after correcting for multiple testing. Regarding cortical structural measures, aggressiveness was negatively correlated with cortical complexity of the parahippocampal gyrus.</p><h3>Conclusion</h3><p> Considering neuroticism and aggressiveness during screening for PMDD could contribute to the identification of risk factors and personalized treatment of females suffering from PMDD.</p></div>","PeriodicalId":8369,"journal":{"name":"Archives of Women's Mental Health","volume":"29 2","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-03-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12971799/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147388775","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Patterns of respectful care and mistreatment during childbirth in relation to perinatal mental health: a secondary analysis of listening to mothers in California","authors":"Stacey Iobst,&nbsp;Elise Erickson","doi":"10.1007/s00737-025-01656-0","DOIUrl":"10.1007/s00737-025-01656-0","url":null,"abstract":"<div><h3>Purpose</h3><p>Despite mental health conditions being the leading cause of maternal mortality in the United States, the relationship between perinatal mental health and mistreatment during childbirth has been insufficiently examined. The objective was to identify patterns of respectful care and mistreatment during childbirth and examine associations with perinatal mental health.</p><h3>Methods</h3><p>We conducted a cross-sectional secondary analysis of Listening to Mothers in California (<i>N</i> = 2,539). We conducted latent class analysis of indicator variables describing rough or rude care, discriminatory treatment, support, communication, and encouragement of autonomous decision-making. We conducted multinomial logistic regression to examine symptomatology for antenatal anxiety and antenatal depression in relation to class membership. Logistic regression was used to examine class membership in relation to symptomatology for postpartum anxiety and postpartum depression.</p><h3>Results</h3><p>Four latent classes were identified: Class 1 (84.54%): Respected/Supported, Class 2 (6.69%): Not Supported, Class 3 (5.39%): Rough/Rude, Class 4 (3.38%): Rough/Rude/Discriminated. Women with antenatal depression symptomatology were 3.28 times as likely to be classified in Class 4 versus Class 1 (aRRR 3.28, CI95% 1.88–5.73). Women with antenatal anxiety symptomatology had a higher risk of classification in Class 4 than Class 1 (aRRR 2.04, CI95% 1.21–3.43). Compared to women in Class 1, women in Class 2 had 2.06 higher adjusted risk of postpartum anxiety (aRRR 2.06, CI95% 1.26–3.36).</p><h3>Conclusions</h3><p>Women who were symptomatic for antenatal anxiety or antenatal depression were at increased risk for mistreatment and not receiving support during childbirth. Women who did not feel supported had increased risk of symptomatology for postpartum anxiety.</p></div>","PeriodicalId":8369,"journal":{"name":"Archives of Women's Mental Health","volume":"29 2","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s00737-025-01656-0.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147363095","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Transdiagnostic neuropsychological factors in women with premenstrual dysphoric disorder and premenstrual syndrome: a comparison of the premenstrual and postmenstrual phases","authors":"Rezvan Torabi,&nbsp;Farzad Nasiri,&nbsp;Fateh Rahmani","doi":"10.1007/s00737-026-01684-4","DOIUrl":"10.1007/s00737-026-01684-4","url":null,"abstract":"<div><h3>Purpose</h3><p>This study aimed to compare transdiagnostic neuropsychological factors among women with Premenstrual Syndrome (PMS), Premenstrual Dysphoric Disorder (PMDD), and asymptomatic control groups.</p><h3>Methods</h3><p>Using a causal-comparative design, 150 female university students aged 20 to 35 were selected through purposive sampling. Participants were categorized into PMS, PMDD, and asymptomatic control groups based on a structured clinical interview and a screening questionnaire. Neurocognitive functioning was assessed using the Continuous Performance Test (CPT), the Go/No-Go Task, and the Iowa Gambling Task (IGT).</p><h3>Results</h3><p>Significant differences were observed among the three groups in sustained attention, inhibitory control, and risky decision-making. The PMDD group consistently showed lower performance than the PMS and asymptomatic control groups. Within-group phase comparisons revealed a significant decline in sustained attention only in the PMS group during the premenstrual phase, while other cognitive functions remained stable across menstrual cycle phases. No significant menstrual cycle phase changes were observed in the PMDD or asymptomatic control groups.</p><h3>Conclusion</h3><p>These findings indicate that women with PMDD and PMS exhibit difficulties in attention, inhibitory control, and decision-making compared to the asymptomatic control group. Such difficulties appear to be related to symptom burden, highlighting potential targets for assessment and intervention.</p></div>","PeriodicalId":8369,"journal":{"name":"Archives of Women's Mental Health","volume":"29 2","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147347048","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Estimated Impact of Pressure to Conceive on Maternal Depression in Lesotho: A Quasi-experimental Propensity Score Matching using DHS Data","authors":"Melak Jejaw,&nbsp;Jenberu Mekurianew Kelkay,&nbsp;Kaleb Assegid Demissie,&nbsp;Asebe Hagos,&nbsp;Getachew Teshale,&nbsp;Nebebe Demis Baykemagn,&nbsp;Azmeraw Tadele,&nbsp;Tesfahun Zemene Tafere,&nbsp;Andualem Yalew Aschalew,&nbsp;Tirualem Zeleke Yehuala","doi":"10.1007/s00737-026-01687-1","DOIUrl":"10.1007/s00737-026-01687-1","url":null,"abstract":"<div><h3>Background</h3><p>In Southern Africa, Lesotho reports the highest estimated rates of depression, with women disproportionately affected. Cultural, societal, familial, and spousal pressure on women to become pregnant is a substantial public health concern linked with an increased risk of depression. However, there is limited evidence on the impact of pressure to become pregnant on depression in Lesotho using propensity score matching (PSM) analysis. Therefore, this study employed PSM to estimate the effect of pressure to become pregnant on depression among married women in Lesotho.</p><h3>Method</h3><p>A total of 1600 unweighted married women were included in the analysis using the recent 2023/24 Lesotho Demography and Health Survey (LDHS). The analysis used a propensity score matching analysis (PSM) with a logit model using the psmatch2 package in Stata to estimate the average treatment effect on the population (ATE), the treated (ATT), and the untreated (ATU) for the effect of pressure to become pregnant on depression. Kernel matching with a caliper width of 0.01 was used to match individuals in the two groups. The quality of the matches was evaluated statistically and graphically. Sensitivity analysis was performed to test the robustness of the PSM results, using the Mantel-Haenszel test statistics.</p><h3>Result</h3><p>The overall prevalence of depression among married women in Lesotho was 6.83% (95% CI: 5.68%, 8.20%). The PSM analysis showed that experiencing pressure to become pregnant increased the likelihood of depression by 6.3% (ATT = 0.063, 95% CI: 0.0138, 0.1122). The average treatment effect (ATE = 0.058, 95% CI: 0.0443, 0.0721) indicated that pressure to become pregnant significantly increased the risk of depression in the overall population by 5.8%. The average treatment effect for untreated (ATU = 0.0515) underscored that women who had not experienced pressure to become pregnant would have a 5.15% higher risk of developing depression if they had been exposed. Overall, these findings highlight that pressure to become pregnant significantly increases the risk of depression.</p><h3>Conclusion and recommendation</h3><p>This evaluation found that spouse or family pressure to become pregnant significantly increases the risk of depression. These findings underscore pregnancy pressure, pressing attention to reproductive coercion and community-based initiatives to mitigate its mental health consequences. Thus, policymakers and programmers should strengthen reproductive autonomy protection in mental health policies. Additionally, health care providers should screen for reproductive coercion during routine antenatal visits and offer counseling services to decrease the risk of depression. Community-based education campaigns and peer support groups involving men and families are also recommended to help reduce fertility-related pressures.</p></div>","PeriodicalId":8369,"journal":{"name":"Archives of Women's Mental Health","volume":"29 2","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s00737-026-01687-1.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147346992","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}