Our study delves into postpartum depression (PPD) extending observation up to six months postpartum, addressing the gap in long-term follow-ups and uncover critical intervention points. Through a continuous three-wave cohort study involving 3174 of 10,730 invited postpartum women, we utilized machine learning to predict PPD risk, incorporating self-reported surveys and health records from October 2021 to Jan 2023. PPD prevalence slightly decreased from 30.9 % to 29.1 % over six months. The Random Forest model emerged as the most effective, identifying key predictors of PPD at different stages. The top three factors at first month were newborn's birth weight, maternal weight before delivery and before pregnancy. The EPDS scores of last time, newborn's birth weight and maternal weight before pregnancy and before delivery were main predictors for EPDS scores at third and sixth months postpartum. The study faces limitations such as potential selection bias due to the convenience sampling method and the reliance on self-reported measures, which may introduce reporting bias. Furthermore, the high attrition rate could affect the representativeness of the sample and the generalizability of the findings. There is a slight decrease in PPD rates over six months, yet the prevalence remains high. This underscores the need for early and ongoing mental health support for new mothers. Our study highlights the efficacy of machine learning in enhancing PPD risk assessment and tailoring intervention strategies, paving the way for more personalized healthcare approaches in postpartum care.

Midwives assume the roles in protecting perinatal women and newborns, meanwhile defending their own safety during the epidemic of COVID-19. Since there is currently no specific treatment available that targets the disease, strictly compliance with various infection prevention and control measures appears utmost important to achieve their occupational safety. We then explored the status quo and influencing factors of the knowledge, attitude and practice (KAP) of occupational protection against the COVID-19 among midwives in China. This online cross-sectional survey was conducted on 2663 midwives across the China during the early stages of the pandemic with a self-reported structured questionnaire. 97.4% and 92.9% of them were identified with positive attitude and appropriate practice, respectively, whereas only 6.4% showed good level of knowledge about the occupational protection toward the COVID-19. Midwives with older age, keeping on working during the breakout period, completing the training programs, caring the confirmed COVID-19 cases and having family members with cold-like symptoms were significantly associated with their KAP status. This study could provide valuable information not only for policy makers and administrators to optimize resource allocation and design education programs on targeted midwives, but also serve as a baseline for measuring changes in subsequent, post-intervention KAP studies.

The evolving COVID-19 pandemic is placing unprecedented pressures on health systems. Accumulative studies suggest that nurses were more likely to develop negative psychiatric outcomes following a public health disaster than other medical staffs, due to their more frequent and closer contact with patients. We examined the psychological status of nurses working in the tertiary women's and children's hospitals in Sichuan, China, in order to explore the possible effect of the COVID-19. The cross-sectional survey was conducted at the peak period of COVID-19 among 1971 nurses. Their anxiety, depression and self-efficacy were assessed by the seven-item anxiety scale (GAD-7), the nine-item Patient Health Questionnaire (PHQ-9), and the General Self-efficacy Scale (GSES), respectively. 1934 valid questionnaires were returned with a response rate of 98.1%. We found that 29.3% and 22.7% of the nurses were identified with anxiety and depressive symptoms, respectively. The median score of GSES was 30, which was at the upper middle level among all populations. Nurses having longer working years and cold-like symptoms, those who were at work during breakout period and working in pediatric ward were significantly associated with the presence of anxiety and depression. Findings suggest that the epidemic of COVID-19 does not necessarily affect the psychological health of nurses working in women's and children's hospitals in Sichuan. The results of this study could serve as valuable suggestions to direct the promotion of psychological well-being among targeted nurses.

Objectives: The objective was to assess the prevalence of perinatal depressive symptoms and determine the trajectories of marital adjustment and depressive symptoms and their reciprocal relationships among Chinese perinatal women. Design: This was a prospective, longitudinal cross-lagged study. Setting: The study was conducted at the outpatient department of the largest women’s and children’s hospital in China, which is located in Chengdu, Sichuan Province. Participants: Four hundred and sixty-three mothers were conveniently sampled. Main outcome measures: The Dyadic Adjustment Scale and the Chinese version of the Edinburgh Postnatal Depression Scale were used to evaluate marital adjustment and depressive symptoms, respectively, at three time points: the first trimester of pregnancy (T1), the third trimester of pregnancy (T2) and 6 weeks after childbirth (T3). Descriptive statistics were used to assess the prevalence of perinatal depressive symptoms, and repeated-measures analysis of variance (ANOVA) was used to determine the trajectories of marital adjustment and depressive symptoms among the participants. A cross-lagged model was used to explore the reciprocal relationship between marital adjustment and depressive symptoms. Results: The prevalence of perinatal depressive symptoms among our participants ranged from 21.2% to 24.0%. Repeated-measures ANOVA showed that during the perinatal period there was a significant tendency towards worse marital adjustment ( F =33.031, p=0.000) and a slight but not significant reduction in depressive symptoms ( F =1.883, p=0.153) among the participants. The cross-lagged model showed that maternal marital adjustment at T1 significantly and negatively predicted depressive symptoms at T2 (β=−0.165, p<0.001), and that depressive symptoms at T2 significantly and negatively predicted marital adjustment at T3 (β=−0.135, p<0.001). However, the predictive effects of depressive symptoms at T1 on marital adjustment at T2 and that of marital adjustment at T2 on depressive symptoms at T3 were not significant. Conclusion: The prevalence of perinatal depressive symptoms ranged from 21.2% to 24.0% among the participants. During the perinatal period, the marital adjustment of women tended to be worse; however, there was no significant change in depressive symptoms. This study showed that better marital adjustment at T1 was a protective factor against maternal depressive symptoms at T2, and a higher level of depressive symptoms at T2 was a risk factor for worse marital adjustment at T3.