Longitudinal, Indigenous-led research integrated with community-controlled continuity of care can improve and support perinatal outcomes for Aboriginal and Torres Strait Islander families in Australia. Across the past 35 years, seven cohorts have contributed complementary insights from pregnancy through early childhood with varying geographic reach and appropriate Indigenous governance. This paper discusses each of these cohorts and how these studies across pregnancy, birth and some continuing through early childhood, have substantially added to the body of knowledge related to perinatal health needs for women. Early cohorts (e.g., MUSP; Raine) advanced life‑course epidemiology but had low Indigenous representation, limiting perinatal inference for these communities. The Aboriginal Birth Cohort achieved exceptional long‑term retention and partnerships and from the late 2000s, Gomeroi gaaynggal enabled causation analyses using biomarkers. Finally, systems initiatives such as PANDORA and BiOC demonstrate successes with culturally safe pathways and Indigenous‑governed continuity models. Evidence suggests the approaches undertaken in the perinatal period must ensure the voices of Indigenous people are paramount particularly when care and research is being delivered to communities. Lessons learned from these cohorts highlight that Indigenous governance and workforce, co‑design and community‑embedded engagement enhance retention, relevance and translation; registries and continuity models deliver measurable outcome gains. The depth of knowledge identified in life-course research for Indigenous women can significantly add to the standard data collection tools used by state and national services.

In this facility-based cross-sectional survey in primary health care centres in southern Ethiopia, women attending for antenatal care (ANC) were screened for depression (PHQ-9; score ≥ 5 and functionally impaired), anxiety symptoms (GAD-7; score ≥ 10), post-traumatic stress disorder (PCL-5 score ≥ 31), intimate partner violence (IPV; non-graphic language screening test) and risky substance use (ASSIST). Clinical notes were reviewed post-consultation for evidence of health worker recognition of psychosocial concerns and actions taken. Of the 2,079 interviewed women, 24.9% had at least one psychosocial problem, and 7.3% had two or more. The most common psychosocial problem was probable IPV (n = 289; 13.9%, 95% CI: [12.57–15.25]), followed by risky khat use (n = 134; 6.5%, 95% CI: [3.72–10.94]) and depression (n = 110; 5.3%, 95% CI: [3.98–7.00]). Identification by ANC professionals was low: 2.7% of women with probable depression, none with probable IPV had it recorded. A history of mental health problems was not documented in 99.7% and only 47.3% (n = 938) reported being asked how they were feeling emotionally. Systemic changes to provider training and procedures are required to promote person-centred maternal care and improve identification of psychosocial problems in ANC in rural Ethiopia.

Perinatal depression and anxiety are major contributors to maternal morbidity, with a disproportionate burden in low- and middle-income countries. In Pakistan, common and modifiable biological risks, including anemia and vitamin D deficiency, may interact with psychosocial factors to influence perinatal mental health. This cohort study enrolled 152 pregnant women from a public hospital in Islamabad; 147 completed baseline assessments (12–32 weeks gestation) and 100 were followed at 6–8 weeks postpartum. Validated Urdu versions of the EPDS, GAD-7, and MSPSS were used alongside hemoglobin and vitamin D assessments at both time points. Longitudinal analyses were conducted using generalized linear mixed models, supplemented by cross-sectional and mediation analyses.Depression was prevalent antenatally (41.5%) and increased postpartum (57.0%), while anxiety declined from 25.2% to 12.0%. Higher hemoglobin was protective against antenatal depression (OR = 0.66) and anxiety (OR = 0.65), but not in longitudinal models. Vitamin D deficiency predicted postnatal depression (OR = 3.15), while sufficiency was associated with remission. Social support showed a strong protective effect (OR = 0.24) and mediated 40% of the hemoglobin–depression association. Baseline symptom severity was the strongest predictor of postpartum outcomes. These findings highlight a substantial burden and point to modifiable nutritional and psychosocial targets for intervention.

Perinatal mental health disorders are prevalent in Ecuador and Peru. Despite national health policies supporting maternal mental health care, service provision remains fragmented, relying on a mix of public, private, and nongovernmental actors. This study examined professional interest holders’ perceptions of barriers to perinatal mental health care and the solutions they propose. We employed a mixed-methods approach. First, a systematic review of publicly available data was conducted to identify organizations engaged in maternal and mental health care in Ecuador and Peru. Following this, in-depth, semistructured interviews were conducted with 17 key informants representing research institutions, nongovernmental organizations (NGOs), government agencies, and private sector entities. Thematic analysis was applied to identify structural barriers, institutional challenges, and proposed solutions. Findings revealed multilevel barriers to perinatal mental health care, including stigma, financial constraints, limited provider training, fragmented health services, and bureaucratic inefficiencies. Community-based interventions, task-shifting strategies, and increased public education were identified as effective approaches to addressing these challenges. Participants also emphasized the need for intersectoral collaboration, increased governmental investment, and policy reforms to strengthen maternal mental health services. Efforts to improve perinatal mental health care in Ecuador and Peru require a combination of culturally sensitive, community-driven interventions, as well as sustainable government investment and commitment.

Infant self-regulation is shaped by early physiological systems and caregiver-infant co-regulatory interactions. Maternal perinatal (pre- and/or postnatal) depression may affect these processes and infants’ development of this critical construct. However, literature addressing the association between maternal perinatal depression and infant self-regulation has been mixed. We conducted a pre-registered meta-analysis of the association between maternal perinatal depression and several self-regulation constructs (e.g., effortful control, executive function) measured during the first 2 years of life. We included 68 reports comprising 193 effect sizes and 16,722 mother-infant dyads. On average, studies included an equal number of male and female infants, and, for most (68%) studies, most participants were White. Average infant age ranged from 0 – 16 months. Three-level random effects meta-analytic models indicated a small, significant overall association, with higher levels of depression associated with lower self-regulation (r = −.10, 95% CI = −.14, −.06, p < .001). There was substantial heterogeneity in this pooled effect. Subsequent analyses indicated moderation by methodological and conceptual variables. Evidence that maternal perinatal depression is associated with lower infant self-regulation underscores the importance of supporting dyads experiencing perinatal depression. Clarifying this association highlights a critical next step of examining potential causal processes linking maternal and infant well-being.

Early life, or the neonatal period, is perhaps the most challenging time for ruminant livestock, as they adapt to the extra-uterine environment, undergo important physiological maturation, and navigate harsh ambient conditions. Maternal influences during gestation, especially energy and protein nutrition in late pregnancy, can alter many processes that affect the neonatal period. These processes include fetal growth and development, gestation length, difficulty of parturition, and maternal behavior, which interact to affect offspring vigor at birth. Moreover, colostrum and early milk production and composition are affected by gestational nutrition, and these along with the previous factors affect the neonate’s ability to obtain transfer of passive immunity, thermoregulate, perform basal metabolism, and ultimately survive to weaning. Often, the long-term effects of maternal nutrition during gestation on offspring are attributed solely to the prenatal environment, but it is critical to also consider influences of early life on later productivity and health. More research is needed to integrate these neonatal outcomes with prenatal and postnatal mechanisms as well as later ruminant livestock performance. Better understanding of the maternal environment’s effects on the neonatal period provides opportunity for improved management of ruminant livestock dams and offspring.

Women in the perinatal phase are at an increased risk of experiencing mental health problems, but in low and middle-income countries such as India, perinatal mental health (PMH) care provision is often scarce. This situational analysis presents the formative findings of the SMARThealth Pregnancy and Mental Health (PRAMH) project (Votruba et al. 2023). It investigates the nature and availability of maternal mental health policies, legislation, systems and services, as well as relevant context and community in India on a national, state (Haryana and Telangana) and district (Faridabad and Siddipet) level. A desktop, scoping review and informal interviews with mental health experts were conducted. Socio-demographic and maternal health indicators vary between Haryana and Telangana. No specific national PMH policy or plan is available. General mental health services exist at a district level within Siddipet and Faridabad, but no specific PMH services have been identified.

Exposure to adversity during the perinatal period has been associated with cognitive difficulties in children. Given the role of the nucleus accumbens (NAcc) in attention and impulsivity, we examined whether NAcc volume at age six mediates the relations between pre- and postnatal adversity and subsequent attention problems in offspring. 306 pregnant women were recruited as part of the Growing Up in Singapore Towards Healthy Outcomes Study. Psychosocial stress was assessed during pregnancy and across the first 5 years postpartum. At six years of age, children underwent structural MRI and, at age seven years, mothers reported on their children’s attention problems. Separate factor analyses conducted on measures of pre- and postnatal adversity each yielded two latent factors: maternal mental health and socioeconomic status. Both pre- and postnatal maternal mental health predicted children’s attention difficulties. Further, NAcc volume mediated the relation between prenatal, but not postnatal, maternal mental health and children’s attention problems. These findings suggest that the NAcc is particularly vulnerable to prenatal maternal mental health challenges and contributes to offspring attention problems. Characterizing the temporal sensitivity of neurobiological structures to adversity will help to elucidate mechanisms linking environmental exposures and behavior, facilitating the development of neuroscience-informed interventions for childhood difficulties.

The prevalence of co-morbid anxiety and depression varies greatly between research studies, making it difficult to understand and estimate the magnitude of this problem. This systematic review and meta-analysis aim to provide up-to-date information on the global prevalence of co-morbid anxiety and depression in pregnant and postpartum women and to further investigate the sources of heterogeneity. Systematic searches of eight electronic databases were conducted for original studies published from inception to December 10, 2024. We selected studies that directly reported prevalence data on co-morbid anxiety and depression during the perinatal periods. We extracted data from published study reports and calculated the pooled prevalence of symptoms of co-morbid anxiety and depression. There are 122 articles involving 560,736 women from 43 different countries included in this review. The global prevalence of co-morbid anxiety and depression during the perinatal period was about 9% (95%CI 8%–10%), with approximately 9% (95%CI 8%–11%) in pregnant women and 8% (95%CI 7%–10%) in postpartum women. Prevalence varied significantly by the assessment time points, study country, study design, and the assessment tool used for anxiety and depression, while prevalence was not dependent on publication year, country income level, and COVID-19 context. No publication bias was observed for this prevalence rate. These findings suggest that approximately 1 in 10 women experience co-morbid anxiety and depression during pregnancy and postpartum. Targeted action is needed to reduce this burden.