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Perinatal Mental Health for Mothers and Their Partners: A Matter for Public Health

A special issue of International Journal of Environmental Research and Public Health (ISSN 1660-4601). This special issue belongs to the section "Mental Health".

Deadline for manuscript submissions: closed (31 March 2023) | Viewed by 57113

Special Issue Editor


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Guest Editor
Department of Psychology, Bournemouth University, Poole BH12 5BB, UK
Interests: perinatal mental health; mental health; psychology

Special Issue Information

Dear Colleagues,

We are pleased to announce the Special Issue entitled “Perinatal Mental Health for Mothers and their Partners: A Matter for Public Health”. This Special Issue aims to discuss new knowledge or new cutting-edge developments in perinatal mental health research (for mothers, fathers and other partners) through selected works, which will provide a great contribution to the community. In addition to adding to the research on maternal mental health, we are keen to include new developments regarding the mental health of fathers and other partners (including same-sex partners), as evidence on these factors remains limited. Given the global events of 2020, we are also keen to encourage contributions that focus on the impact of COVID-19 on perinatal mental health. We feel that the topics raised here have important implications for our global environment and public health.

You are welcome to send a tentative title and a short abstract to our Editorial Office ([email protected]) for evaluation before submission. Please note that the selected full papers will still be subjected to a thorough and rigorous peer-review.

We are looking forward to receiving your excellent work.

Dr. Andrew Mayers
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. International Journal of Environmental Research and Public Health is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2500 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • perinatal mental health
  • maternal mental health
  • fathers’ mental health
  • partners’ mental health
  • covid-19

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Published Papers (12 papers)

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Research

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17 pages, 2379 KiB  
Article
Understanding the Barriers Fathers Face to Seeking Help for Paternal Perinatal Depression: Comparing Fathers to Men Outside the Perinatal Period
by Megan Reay, Andrew Mayers, Rebecca Knowles-Bevis and Matthew T. D. Knight
Int. J. Environ. Res. Public Health 2024, 21(1), 16; https://doi.org/10.3390/ijerph21010016 - 21 Dec 2023
Cited by 4 | Viewed by 3945
Abstract
Research has shown that men are less likely than women to seek help for depression at any time of life due to barriers, including stereotypical masculine norms and stigma. The evidence suggests that approximately 10% of fathers experience postnatal depression, yet new and [...] Read more.
Research has shown that men are less likely than women to seek help for depression at any time of life due to barriers, including stereotypical masculine norms and stigma. The evidence suggests that approximately 10% of fathers experience postnatal depression, yet new and expectant fathers are not routinely offered screening or support in the same way as mothers. Therefore, this research explored the barriers fathers face to seeking help for paternal perinatal depression (PPD). Data were collected using an online survey. Initially, fathers with postnatal depression were compared to men experiencing depression at another time of their life in terms of their attitudes to seeking psychological help, conformity to masculine norms, self-stigma, and awareness of services. Secondly, a proposed model of help-seeking amongst fathers with postnatal depression was evaluated. Finally, additional barriers to help-seeking for paternal postnatal depression were explored qualitatively. A total of 125 participants took part in the quantitative comparison, and 50 of the fathers also provided qualitative data. No between-group differences were found, suggesting that the existing literature on barriers to seeking help for male depression is applicable to fathers with postnatal depression. The qualitative results also highlighted the need for better awareness of paternal postnatal depression and better access to services for fathers. Limitations, implications for policy, and directions for future research are discussed. Full article
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13 pages, 348 KiB  
Article
Paternal Leave Entitlement and Workplace Culture: A Key Challenge to Paternal Mental Health
by Ernestine Gheyoh Ndzi and Amy Holmes
Int. J. Environ. Res. Public Health 2023, 20(8), 5454; https://doi.org/10.3390/ijerph20085454 - 10 Apr 2023
Cited by 9 | Viewed by 3238 | Correction
Abstract
Paternal mental health continues to be a health concern in the UK. Paternal leave entitlement and workplace cultures have failed to support fathers in navigating the complexity of fatherhood, which has an impact on fathers’ wellbeing. Interviewing twenty fathers in the York area, [...] Read more.
Paternal mental health continues to be a health concern in the UK. Paternal leave entitlement and workplace cultures have failed to support fathers in navigating the complexity of fatherhood, which has an impact on fathers’ wellbeing. Interviewing twenty fathers in the York area, this study seeks to explore the impact of parental leave entitlements and workplace cultures on fathers’ mental health. The findings demonstrate that the influence of gendered norms and hegemonic masculinity perceptions are ingrained in the current leave entitlement and workplace cultures. While fathers are entitled to take leave, the leave is significantly insufficient to allow them to forge a meaningful bond with a newborn or adapt to the change in routine brought about by the birth of a baby. Furthermore, workplace cultures fail to recognise the responsibilities that come with fatherhood and provide insufficient support for fathers. The COVID-19 lockdown presented fathers with a unique opportunity to be available and take on more family responsibilities. Fathers felt they did not have to navigate gendered and hegemonic perceptions to spend more time with the family. This paper challenges structural and cultural barriers that prevent fathers from taking leave and impacting negatively on fathers’ mental health. The paper suggests a review of the current paternal leave entitlement and cultural change in the workplace. Full article
15 pages, 329 KiB  
Article
“We Should Be Working Together, and It Felt like They Disrupted That”: Pregnant Women and Partners’ Experiences of Maternity Care in the First UK COVID-19 Pandemic Lockdown
by Alice Keely, Mari Greenfield and Zoe Darwin
Int. J. Environ. Res. Public Health 2023, 20(4), 3382; https://doi.org/10.3390/ijerph20043382 - 15 Feb 2023
Cited by 2 | Viewed by 2403
Abstract
Pregnant women were identified as being at elevated risk from COVID-19 early in the pandemic. Certain restrictions were placed upon birth partners accompanying their pregnant partner to in-person maternity consultations and for in-patient maternity care. In the absence of a central directive in [...] Read more.
Pregnant women were identified as being at elevated risk from COVID-19 early in the pandemic. Certain restrictions were placed upon birth partners accompanying their pregnant partner to in-person maternity consultations and for in-patient maternity care. In the absence of a central directive in England, the nature of restrictions varied across maternity services. Eleven participants (seven pregnant women and four partners), who were expectant parents during the first UK COVID-19 pandemic lockdown, took part in serial interviews in pregnancy and the postnatal period. Data were subject to a reflexive thematic analysis. Four main themes were identified, with sub-themes: uncertainty and anxiety (uncertainty and anxiety about COVID-19, uncertainty and anxiety about maternity services); disruption of partnering and parenting role; complexity around entering hospital spaces (hospitals offering protection while posing threat, individual health professionals in inflexible systems); and attempting to feel in control. Separating couples may result in disruption to their anticipated roles and significant distress to both partners, with potential impacts for mental health and future family relationships. Trauma-informed perspectives are relevant for understanding parents’ experiences of maternity care in the pandemic and identifying ways to improve care to promote and protect the mental health of all parents. Full article
12 pages, 346 KiB  
Article
The Effect of Dairy Products and Nutrient Intake after Childbirth on the Risk of Postpartum Depression
by Shoug Alashmali, Arwa S. Almasaudi, Haya S. Zedan, Baian A. Baattaiah and Yazed Alashmali
Int. J. Environ. Res. Public Health 2022, 19(24), 16624; https://doi.org/10.3390/ijerph192416624 - 10 Dec 2022
Cited by 2 | Viewed by 1793
Abstract
Previous studies have shown an association between the intake of dairy products during pregnancy and reduced symptoms of postpartum depression (PPD). However, the effect of postpartum intake of dairy products on PPD is not fully understood. This study evaluates the effects of dairy [...] Read more.
Previous studies have shown an association between the intake of dairy products during pregnancy and reduced symptoms of postpartum depression (PPD). However, the effect of postpartum intake of dairy products on PPD is not fully understood. This study evaluates the effects of dairy products and nutrient intake after childbirth on the risk of PPD. A cross-sectional survey-based study was conducted asking participants to fill out a food frequency questionnaire (FFQ) to assess intake of dairy products and other nutrients. The Edinburgh Postnatal Depression Scale (EPDS) was used to screen for PPD symptoms. Out of 530 participants, almost three-quarters subjectively reported PPD (N = 395, 74.11%). The risk of PPD was relatively high for a Q1 level of consumption of all four dairy products and other nutrients, and from Q2 to Q4 there appeared to be an increase in the risk of PPD as consumption increased. However, after adjustment for confounding factors, there was no significant association between postpartum intake of dairy products and other nutrients and PPD. The results indicate that the potential of dairy products and nutrient intake to reduce PPD are minimal. Further longitudinal and intervention studies of dairy products and other (particularly anti-depressants) nutrients are required to draw firm conclusions about their associations with the risk of PPD. Full article
12 pages, 1032 KiB  
Article
Pregnancy-Specific Stress during the First Lockdown of the COVID-19 Pandemic: Assessing Face-to-Face versus Online Recruitment
by Sandra Simó, Juanita Cajiao-Nieto, Natalia V. Awad-Sirhan and Rafael A. Caparros-Gonzalez
Int. J. Environ. Res. Public Health 2022, 19(21), 14102; https://doi.org/10.3390/ijerph192114102 - 28 Oct 2022
Viewed by 2124
Abstract
The study aims to assess pregnancy-specific stress among pregnant women in Spain during the first lockdown of the COVID-19 pandemic. Two samples of pregnant women from the south of Spain (Andalusia) were assessed using the Prenatal Distress Questionnaire (PDQ) and a sociodemographic and [...] Read more.
The study aims to assess pregnancy-specific stress among pregnant women in Spain during the first lockdown of the COVID-19 pandemic. Two samples of pregnant women from the south of Spain (Andalusia) were assessed using the Prenatal Distress Questionnaire (PDQ) and a sociodemographic and obstetric questionnaire. Group 1 (N = 155) was recruited face-to-face, whereas Group 2 (N = 78) was recruited online. Pregnancy-specific stress levels were significantly different in both groups. The face-to-face group (Group 1) had higher pregnancy-specific stress levels than the online group (Group 2). The online sample over-represents young adult pregnant women with high education levels and a high number of previous miscarriages. The face-to-face study seems more accessible to racially and ethnically diverse groups. The main concern among both groups was the risk of having a sick neonate. Research during the COVID-19 pandemic can benefit from using online resources to collect data to screen and identify perinatal mental health problems in a crisis environment. Nevertheless, researchers should be aware of the potential limitations this strategy can have, for example, certain groups of people may have limited access to the internet. Full article
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14 pages, 327 KiB  
Article
Examining the Relationship between Paternal Mental Health and Informal Support Networks: Reflections on the Impact of the COVID-19 Pandemic
by Ernestine Gheyoh Ndzi and Amy Holmes
Int. J. Environ. Res. Public Health 2022, 19(19), 12751; https://doi.org/10.3390/ijerph191912751 - 5 Oct 2022
Cited by 4 | Viewed by 1635
Abstract
Paternal mental health remains an under-researched area in the UK. Consequently, father-focused formal and informal support provisions fail to address the complex emotional and psychological wellbeing needs of fathers. Drawing on data from twenty semi-structured interviews with fathers in the York area, this [...] Read more.
Paternal mental health remains an under-researched area in the UK. Consequently, father-focused formal and informal support provisions fail to address the complex emotional and psychological wellbeing needs of fathers. Drawing on data from twenty semi-structured interviews with fathers in the York area, this study seeks to better understand how access to and participation in informal support networks is influenced by gendered perceptions and the impact hegemonic perceptions of masculinity have on fathers’ access to support prior and during the COVID-19 pandemic. The findings demonstrate that fathers internalise stereotypical masculine tropes, such as stoicism, which prevent them from actively seeking support. While fathers value informal support network, they generally struggle to engage in mental health talks. The COVID-19 lockdown exacerbated fathers’ struggles to access informal support or prioritise their mental health. Fathers felt the pandemic presented a unique challenge that only people that became parents at the time understood. This meant that fathers could not rely on their parents or other parents who did not have similar experiences of the COVID-19 pandemic. This paper aims at challenging structural and cultural barriers that inhibit fathers’ participation in informal support networks, and to promote more meaningful, supportive engagement with peer groups. Full article
10 pages, 362 KiB  
Article
Quality of Life and Conformity to Gender Norms in Women Receiving Assisted Reproductive Technologies as a Potential Indicator of Mental Health
by Lidia Bueno-Sánchez, Tamara Alhambra-Borrás, Alfonso Gallego-Valadés and Jorge Garcés-Ferrer
Int. J. Environ. Res. Public Health 2022, 19(16), 10031; https://doi.org/10.3390/ijerph191610031 - 14 Aug 2022
Cited by 1 | Viewed by 2076
Abstract
The prevalence of depression, stress, or anxiety in people receiving assisted reproductive technologies (ART) has been demonstrated. However, knowledge about the influence of gender norms on quality of life (QofL) during infertility treatment is limited. The main objective of this study was to [...] Read more.
The prevalence of depression, stress, or anxiety in people receiving assisted reproductive technologies (ART) has been demonstrated. However, knowledge about the influence of gender norms on quality of life (QofL) during infertility treatment is limited. The main objective of this study was to confirm that patients undergoing ART present a vulnerable mental state, which may be an indicator of risk. For this purpose, a quasi-experimental cross-sectional study was carried out in the Assisted Reproduction Unit of the Hospital Politécnico Universitario de la Fe (Spain) in which a total of 438 women participated: 256 in pre-treatment and 182 in treatment. Two questionnaires were administered, FertiQol and CFNI-23, assessing self-perceived QofL and conformity to gender norms, respectively. The results showed significant differences between the pre-treatment and treatment groups on the FertiQol and its subscales. Significant associations were also found between the CFNI-23 factors and the FertiQol subscales. The results suggest that gender norms and ART interfere with women’s mental health and QofL and should be considered as possible risk indicators by professionals preventively before the prenatal or perinatal stages. Future research should design prospective studies aimed at estimating the impact of clinical and sociodemographic variables on women and other groups receiving ART. Full article
14 pages, 2450 KiB  
Article
Current Issues within the Perinatal Mental Health Care System in Aichi Prefecture, Japan: A Cross-Sectional Questionnaire Survey
by Kei Fujita, Tomomi Kotani, Yoshinori Moriyama, Takafumi Ushida, Kenji Imai, Tomoko Kobayashi-Nakano, Noriko Kato, Takeo Kano, Fumitaka Kikkawa and Hiroaki Kajiyama
Int. J. Environ. Res. Public Health 2021, 18(17), 9122; https://doi.org/10.3390/ijerph18179122 - 29 Aug 2021
Cited by 1 | Viewed by 3027
Abstract
Mental illnesses commonly occur in the reproductive age. This study aimed to identify the issues that exist within the perinatal mental health care system. A cross-sectional survey was conducted in Aichi Prefecture in central Japan. Questionnaires on the situation between 2016 and 2018 [...] Read more.
Mental illnesses commonly occur in the reproductive age. This study aimed to identify the issues that exist within the perinatal mental health care system. A cross-sectional survey was conducted in Aichi Prefecture in central Japan. Questionnaires on the situation between 2016 and 2018 were mailed to the head physicians of 128 maternity care units, 21 neonatal intensive care units (NICUs), and 40 assisted reproductive technology (ART) units. A total of 82 (52.6 per 100,000 births) women were admitted to mental health care units during the perinatal period, and 158 (1.0 per 1000 births) neonates born to mothers with mental illness were admitted to NICUs. Approximately 40% of patients were hospitalized in psychiatric hospitals without maternity care units. Eighty-four (71.1%) and 76 (64.4%) maternity care units did not have psychiatrists or social workers, respectively. Moreover, 20–35% of the head physicians in private clinics, general hospitals, and ART units endorsed the discontinuation of psychotropic drug use during pregnancy. However, the corresponding figures were only 5% among those in maternal-fetal centers. Resources for perinatal mental illness might be limited. Perspectives on psychotropic drug use differed based on the type of facilities where the doctors were working. Full article
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Review

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9 pages, 835 KiB  
Review
Paternal Experiences of Perinatal Loss—A Scoping Review
by Cecilia Mota, Claudia Sánchez, Jorge Carreño and María Eugenia Gómez
Int. J. Environ. Res. Public Health 2023, 20(6), 4886; https://doi.org/10.3390/ijerph20064886 - 10 Mar 2023
Cited by 5 | Viewed by 2336
Abstract
Background: Perinatal grief is one of the most complex and devastating types of mourning for both mothers and fathers; however, there is still little research on the psychological impact on men who experience it. Therefore, the objective of this study was to summarize [...] Read more.
Background: Perinatal grief is one of the most complex and devastating types of mourning for both mothers and fathers; however, there is still little research on the psychological impact on men who experience it. Therefore, the objective of this study was to summarize and synthetize the existing literature on the way men’s grief is experienced. Methods: A search was carried out to examine three databases for articles published in the last four years; 56 articles were obtained, and 12 were retained for analysis. Results: Four common themes were found: the men’s experience of grief, their role as fathers, the impact of the death, and their needs regarding grief and how to face it. Conclusions: There is also a need for discussion of the importance of validating perinatal grief in men and studies that examine it without social gender stigmas in order to provide them with effective emotional support. Full article
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11 pages, 1233 KiB  
Review
Prevalence and Risk Factors Associated with Postpartum Depression during the COVID-19 Pandemic: A Literature Review and Meta-Analysis
by Qianqian Chen, Wenjie Li, Juan Xiong and Xujuan Zheng
Int. J. Environ. Res. Public Health 2022, 19(4), 2219; https://doi.org/10.3390/ijerph19042219 - 16 Feb 2022
Cited by 75 | Viewed by 12287
Abstract
Background: Owing to the high prevalence and detrimental consequences, postpartum depression (PPD) has been identified as one of the severe global public health issues in the last decade. Prior research found that during disasters or events, the prevalence rates of mental disorders among [...] Read more.
Background: Owing to the high prevalence and detrimental consequences, postpartum depression (PPD) has been identified as one of the severe global public health issues in the last decade. Prior research found that during disasters or events, the prevalence rates of mental disorders among postpartum women are significantly high. However, the effect of the coronavirus disease 2019 (COVID-19) pandemic on PPD and its risk factors remained unclear for postpartum women. Therefore, the present systematic review and meta-analysis aimed to estimate the influence of the COVID-19 pandemic on the prevalence of PPD and to summarize risk factors for PPD during the COVID-19 pandemic. Methods: Three electronic databases of MEDLINE, EMBASE, and Cochrane library databases were systematically searched for articles from their commencements until 1 November 2021. Quality assessment of included studies, random-effects meta-analysis, and sensitivity analysis were performed. Results: A total of eight studies with 6480 postpartum women during the COVID-19 pandemic were included, and most studies were conducted in developed countries. The pooled prevalence of PPD was 34% (95% CI: 21–46%) during the COVID-19 pandemic, much higher than the incident of previous research during the non-pandemic period. Risk factors for PPD during the COVID-19 pandemic were defined as socio-demographic and clinical characteristics, stress and anxiety, lack of various supports, and the COVID-19 related factors. Conclusion: The research findings indicated that the COVID-19 pandemic could make detrimental effects on maternal mental wellbeing among women after childbirth. Investigating the prevalence and risk factors of PPD among postpartum women could shed some light on their mental and emotional states; so that support measures and tailored interventions from health professionals and policymakers could be offered to improve the maternal and infant outcomes, especially during the COVID-19 pandemic. Much more research on maternal psychological wellbeing during the COVID-19 pandemic was strongly recommended to undertake in the middle and low-income countries. Full article
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12 pages, 1212 KiB  
Review
Supporting Perinatal Mental Health and Wellbeing during COVID-19
by Laura Bridle, Laura Walton, Tessa van der Vord, Olawunmi Adebayo, Suzy Hall, Emma Finlayson, Abigail Easter and Sergio A. Silverio
Int. J. Environ. Res. Public Health 2022, 19(3), 1777; https://doi.org/10.3390/ijerph19031777 - 4 Feb 2022
Cited by 21 | Viewed by 5673
Abstract
Mental health is especially important as women transition into parenthood. The COVID-19 pandemic has necessitated the rapid reconfiguration of maternity services, including perinatal mental healthcare, as offered by Specialist Perinatal Mental Health Midwives, in NHS Trusts in the United Kingdom. This article represents [...] Read more.
Mental health is especially important as women transition into parenthood. The COVID-19 pandemic has necessitated the rapid reconfiguration of maternity services, including perinatal mental healthcare, as offered by Specialist Perinatal Mental Health Midwives, in NHS Trusts in the United Kingdom. This article represents work undertaken in rapid response to the COVID-19 pandemic and aims to document the findings from March 2020 up until May 2021 in literature published on perinatal mental health through the pandemic, as well as to engage in a knowledge mapping exercise across five NHS Trusts in London. In this research, we utilised a critical review methodology which purposefully selects and synthesises materials after extensive literature searching to provide a broad and informed narrative around an issue. For our knowledge mapping exercise, we utilised an inclusive stance to gather, pool, and synthesise data from five NHS Trusts regarding the provisions and reconfigurations of their perinatal mental health services, creating a comparable and translatable snapshot in time. Our rapid, critical review highlighted two themes: ‘Increased Perinatal Distress’ and ‘Inaccessible Services and Support’. Our knowledge mapping exercise produced four themes: ‘Retention of Existing Service Provision’; ‘Additional Services Provided’; ‘Reconfiguration of Service Provision’; ‘Additional Provision to Support Staff Wellbeing’. We conclude by offering best practice guidance in order to provide shared learning to aid the transition through para-pandemic circumstances to service delivery in a post-pandemic ‘new normal’. Full article
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15 pages, 1806 KiB  
Review
The Psychological Impact of COVID-19 Pandemic on Women’s Mental Health during Pregnancy: A Rapid Evidence Review
by Monica Ahmad and Laura Vismara
Int. J. Environ. Res. Public Health 2021, 18(13), 7112; https://doi.org/10.3390/ijerph18137112 - 2 Jul 2021
Cited by 93 | Viewed by 10900
Abstract
Background: The perinatal period is a particularly vulnerable period in women’s lives that implies significant physiological and psychological changes that can place women at higher risk for depression and anxiety symptoms. In addition, the ongoing pandemic of coronavirus disease 2019 (COVID-19) is likely [...] Read more.
Background: The perinatal period is a particularly vulnerable period in women’s lives that implies significant physiological and psychological changes that can place women at higher risk for depression and anxiety symptoms. In addition, the ongoing pandemic of coronavirus disease 2019 (COVID-19) is likely to increase this vulnerability and the prevalence of mental health problems. This review aimed to investigate the existing literature on the psychological impact of the COVID-19 pandemic on women during pregnancy and the first year postpartum. Method: The literature search was conducted using the following databases: Pubmed, Scopus, WOS—web of science, PsycInfo and Google Scholar. Out of the total of 116 initially selected papers, 17 have been included in the final work, according to the inclusion criteria. Results: The reviewed contributions report a moderate to severe impact of the COVID-19 outbreak on the mental health of pregnant women, mainly in the form of a significant increase in depression—up to 58% in Spain—and anxiety symptoms—up to 72% in Canada. In addition to the common psychological symptoms, COVID-19-specific worries emerged with respect to its potential effects on pregnancy and the well-being of the unborn child. Social support and being engaged in regular physical activities appear to be protective factors able to buffer against the effects of the pandemic on maternal mental health. Conclusions: Despite the limitations of the study design, the evidence suggests that it is essential to provide appropriate psychological support to pregnant women during the emergency in order to protect their mental health and to minimize the risks of long-term effects on child development. Full article
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