Introduction: Research has shown that Postpartum Depression (PPD) occurs in 10-20% of new mothers. Symptoms of PPD include excessive sadness, increased anxiety, guilt, and possible suicidal ideation. PPD can increase a mother’s risk for health and psychological dysfunction including future psychiatric illnesses, substance abuse, and decrease her adaptive functioning. PDD can also have negative implications on child safety practices and a child’s psychosocial and developmental wellbeing. Treatments for PPD, such as medication and psychotherapy, have been shown to be effective at reducing the number and severity of a mother’s symptoms, and generally improving their lives and the lives of their families. Unfortunately, many mothers do not receive treatment due to fears of stigma, inadequate screening practices and an inability to access care. Thus, early detection and improved access to care is critical and literature suggests formal screening practices increases the rate of detection. Pediatrician’s offices serve as ideal locations to screen mothers and connect them to appropriate services because of frequent contact with the mother. Methods: Recognizing this public health concern, the American Academy of Pediatrics developed PPD screening guidelines. ETSU Pediatrics, a local pediatric primary care clinic, adhered to these guidelines, assembled an interdisciplinary health care team, and developed a stepped care protocol to not only screen all new mothers but connect them with immediate, onsite behavioral health services. The protocol consisted of four distinct phases: 1) distribution of the Edinburgh Postnatal Depression Scale (EPDS), an evidence- based tool screening for depression in new mothers, to every mother of infants 0 to 6 months at their well- child visit; 2) appropriate documentation of the EPDS score and plan of action noted within the electronic medical record (EHR); 3) brief behavioral health intervention conducted by the on-site behavioral health consultant, and/or referral to outside provider; 4) phone call follow up with mother and referred provider. The aim of the study is to evaluate components of intervention feasibility based upon the RE-AIM framework (Reach, Effectiveness, Adoption, Implementation, and Maintenance), which stems from the Dissemination and Implementation Science field. This particular project extends past previous pilot studies to include EHR chart review from an entire year and evaluates the protocol’s feasibility by examining Adoption and Maintenance domains. Results: Results were collected from EHR and billing records of all patients, 0 to 6 months of age, seen at the clinic from February 26, 2014 to February 25, 2015 (n = 755) for their well-child visit (n = 2,459). Adoption will examine feasibility by noting the percentage of mothers who were administered the EPDS as well as the general trend in administration across the year. Maintenance will examine feasibility from a financial perspective and reveal the amount of reimbursement accrued by billing for the EPDS. Conclusions: The anticipated results will have implications on the

Bakgrund: Den psykiska ohälsan i samhället ökar. Omkring 10-15 % av alla kvinnor blir deprimerade i samband med graviditeten. Det finns idag en bristande kunskap kring förlossningsdepression både hos vårdpersonal och samhället i stort. För att kunna bemöta dessa kvinnor på bästa sätt är det därför viktigt att ha kunskap om deras upplevelser av hur det är att drabbas av en förlossningsdepression. Syfte: Att belysa kvinnors upplevelser av att drabbas av en förlossningsdepression. Metod: Kvalitativ innehållsanalys med induktiv ansats. Elva bloggar har valts ut och analyserats. Resultat: Analysen resulterade i tre kategorier: Utmaningar i samband med graviditeten och det inledande moderskapet, Upplevelser av misslyckande och Stödets betydelse på vägen mot tillfrisknande. Dessa beskrivs i nio underkategorier. Konklusion: Kvinnor upplever känslor som misslyckande och skam relaterat till okunskap och stigma som finns kring förlossningsdepression. Professionellt stöd och stöd från närstående har visat sig vara en central del i tillfrisknandet. Utbildning och kunskap om förlossningsdepression är viktigt för att kunna arbeta personcentrerat och individanpassat utifrån kvinnans behov. / Background: Mental illness in society is increasing. About 10-15 % of all women become depressed during pregnancy. There is a lack of knowledge about postpartum depression among healthcare professionals and in society. In order to be able to treat these women in the best way, it is important to have knowledge of women's experiences of what it’s like to suffer from postpartum depression. Purpose: To illuminate women's experiences of suffering from postpartum depression. Method: Qualitative content analysis with an inductive approach. Eleven blogs have been selected and analyzed. Results: The analysis resulted in three main categories: Challenges during pregnancy and the initial maternity, The experiences of failure and The importance of support on the way to recovery. These are described in nine subcategories. Conclusion: Women experienced feelings of failure and shame related to ignorance and stigma that exists around postpartum depression. Professional support and support from relatives has proven to be a central part of recovery. Education and knowledge about postpartum depression are important to be able to work personcentered and individualized based on the women's needs.

Bakgrund: Postpartum depression (PPD) är ett växande folkhälsoproblem, vilken drabbar mellan 10 – 20 % av barnafödande kvinnor globalt. PPD kan negativt påverka moderns funktion, social anpassning och ökar risken för självmord. Därtill kan det störa föräldrarnas välbefinnande och moderns interaktion med barnet, vilket kan medföra negativa effekter på barnets kognitiva och känslomässiga utveckling. Våld, tidigare depression och brist på socialt stöd är starka riskfaktorer för PPD. De exakta orsakerna till PPD är fortfarande oklara, vissa hormonella förändringar såväl som störningar i neurotransmission anses vara möjliga orsaker. För behandling av mild PPD är psykoterapi det första alternativet, därefter rekommenderas selektiva serotoninåterupptagshämmare (SSRI) vid måttlig till svår PPD, där sertralin och paroxetin är säkraste vid amning. Nyligen utvecklades nya läkemedel som innehåller progesteronmetaboliten allopregnanolon, såsom brexanolon och zuranolon för behandling av PPD. Syfte: Syftet med litteraturstudien var att utvärdera effekten av brexanolon, zuranolon, sertralin och paroxetin för behandling av post partum depression. Metod: Denna litteraturstudie baserades på sex randomiserande, dubbelblinda och placebokontrollerade studier framsökta via den vetenskapliga databasen PubMed. Två separata sökningar gjordes för att hitta relevanta artiklar. I den första artikelsökningen användes sökorden " neuroactive steroids in postpartum depression" medan i den andra användes sökorden " antidepressants in post partum depression". Resultat: Brexanolon och zuranolon gav upphov till statistiskt signifikant förbättring av PPD svårghetsgrad samt högre remission- och till viss del responsfrekvens jämfört med placebo efter 60 timmar respektive 15 dagar. Intag av sertralin visade blandat resultat. I en studie gav sertralin signifikant högre remission- och responsfrekven jämfört med placebo, efter sex veckors behandling. Men i den andra studien gav sertralin endast en signifikant förbättring av PPD svårghetsgrad jämfört med placebo och ingen skillnad i remission- och responsfrekvens efter 12 veckors behandling. Paroxetin gav en statistiskt signifikant högre remissionfrekvens jämfört med placebo efter åtta veckors behandling. Slutsats: Resultaten tyder på att brexanolon, zuranolon, sertraline och paroxetin har god effekt mot PPD, med en fördel för brexanolon och zuranolon över sertralin och paroxetin gällande bättre och snabbare effekt. Brexanolon ger en snabbt effekt (efter 60 timmar), men kan orsaka plötslig medvetslöshet och överdriven sedering. Det kan därför vara ett lämpligt val för kvinnor med mycket svår PPD, vilken kräver sjukhusvård. Zuranolondatan är lovande och verkar vara ett bättre val än de andra läkemedlen, men underlaget är begränsat av endast en studie med svår PPD. Framtida större studier med samma skattningskalor, samma utfallsmått och samma baslinjeegenskaper skulle vara användbara för att med säkerhet kunna fastslå vilken av de  läkemedlen som är det bättre valet. / Background: Postpartum depression (PPD) is a growing public health problem, affecting between 10-20% of women giving birth globally. PPD can negatively affect the mothers' function social adjustment and increases the risk of suicide. In addition, it may disturb the parents' well-being and interaction with the child, which can have adverse effects on the child's cognitive and emotional development. Violence, previous depression, and lack of social support are strong risk factors for PPD. The exact causes of PPD remain unclear. Some hormonal changes, as well as disturbances in neurotransmission, are considered possible causes. For the treatment of mild PPD, psychotherapy is used as the first alternative. Selective serotonin reuptake inhibitors (SSRIs) are often recommended at moderate to severe PPD, where sertraline and paroxetine are safest at breastfeeding. Recently, new drugs containing the progesterone metabolite allopregnanolone such as brexanolone and zuranolone were developed to treat PPD. Aim: This study aimed to evaluate the effect of brexanolone, zuranolone, sertraline, and paroxetine in treating postpartum depression. Methods: This study was based on six randomized, double-blind, placebo-controlled studies conducted through the PubMed database. Two separate searches were made to find relevant articles. The keywords "neuroactive steroids in postpartum depression" were used in the first search, while in the second search, "antidepressants in postpartum depression" were used. Results: Brexanolone and zuranolone gave statistically significant better improvement in PPD severity, remission, and partially higher response rates compared to placebo after 60 hours and 15 days, respectively. Intake of sertraline showed mixed results. In one study, sertraline gave significantly higher remission and response rates after six weeks of treatment compared with placebo. However, in the second study, sertralin gave only a significant improvement in PPD severity compared to placebo and no differences in remission and response rates after 12 weeks of treatment. Paroxetine gave a statistically significantly higher remission rate compared to placebo after eight weeks of treatment. Conclusion: The results indicate that brexanolone, zuranolone, sertraline, and paroxetine have effects against PPD, with an advantage for brexanolone and zuranolone over sertraline and paroxetine in terms of impact and onset of action. Brexanolone provides an immediate effect (after 60 hours) but can cause syncope and excessive sedation. Therefore, it may be a suitable choice for women with severe PPD, which requires hospital care. The data of zuranolon is promising and seems to be a better choice than the other drugs, but the evidence is limited by only one study in severe PPD. Future studies using similar scales, outcomes, and baseline characteristics would be helpful to determine which of the drugs is the better choice.

Bakgrund: I Sverige är det är ungefär 13 % av alla nyblivna mammor som drabbas av en postpartumdepression (PPD), och 5 % av dessa mammor drabbas av en svår och djupare PPD. Tillståndet påverkar inte bara mammorna utan kan få konsekvenser även för spädbarnet och övriga familjemedlemmar. Syfte: Syftet med denna litteraturöversikt var att beskriva nyblivna mammors upplevelser av PPD och vilket behov av stöd de önskar från BHV. Metod: Litteraturöversikt med tolv kvalitativa vetenskapliga artiklar som inkluderades efter sökning i databaserna PubMed, Cinahl, SweMed och Psycinfo. Huvudresultat: Mammorna med PPD beskrev att de upplevde att det var svårt att prata om sitt mående. De upplevde rädsla för att bli betraktade som “dåliga mammor” och att inte klara av att ta hand om sitt barn. De önskade regelbundna besök för att kunna ställa frågor, få bekräftelse samt skapa en god relation med BHV-sjuksköterskan. Mammorna upplevde stöd från BHV-sjuksköterskan när hen lyssnade och inte var stressad och när de fick möjlighet att dela sina erfarenheter vilket medförde upplevelser av trygghet. Slutsats: Vårdande samtal kan hjälpa mammor i moderskapet och med deras mående. BHV-sjuksköterskan har unika möjligheter att stödja mammor och deras partners då de träffar mödrarna regelbundet under barnets första år. Stödjande samtal, regelbundna besök och förståelse för mammorna kan leda till ett hälsosamt moderskap. / Background: In Sweden, approximately 13% of all new mothers suffer from postpartum depression (PPD), and 5% of these mothers suffer from severe and deeper PPD. The condition can have consequences not only for the mother herself but also for the infant and other family members. Aim: The aim of this literature overview was to describe new mothers' experiences of PPD and what support they want from BHV. Method: Twelve qualitative scientific articles that were included after searching the databases PubMed, Cinahl, SweMed and Psycinfo. Main results: The mothers experienced that PPD meant it was difficult to talk about their state of mind. They also feared being considered as ‘bad mothers’ and as not being able to take care of their child. They wanted regular visits to the CHS nurse to ask questions, to be confirmed and to create a good relationship with the nurse. The mothers felt support from the CHS nurse when the nurse listened and were not stressed, allowing the mothers to share their experiences, which were perceived as security. Conclusion: Caring conversations can help mothers in motherhood and with PPD. The CHS nurse has unique opportunities to support mothers and partners as they meet the mothers regularly during the child's first year. Supportive conversations, regular visits and understanding for the mothers can lead to a healthy motherhood.

Postpartum depression affects some 10% to 20% of mothers. Its impact on the health and well-being of mothers and their infants is well documented. If not identified and addressed early, it can result in emotional burden, costly hospitalization and treatment, and, at worst, suicide and or infanticide. Empowerment theory was the conceptual framework for this hermeneutic phenomenological study. The purpose was to understand the lived experiences of the screening and treatment processes of 10 women from New York City experiencing postpartum depression and their perceived adequacy of the treatment received. In-depth interviews were used to investigate participants' lived experiences of the screening and treatment processes for their postpartum depression and to explore the extent to which they percieved that their emotional needs were met. From the responses to the interview questions, 6 themes emerged: crying and stress during and after pregnancy, inadequate assessment, feeling bad or unlike oneself, lack of understanding, needing to cope, and prayer was essential for recovery. Participants had tearfulness that began during pregnancy and intensified during the postpartum period, were ineffectively assessed, exhibited bizarre behaviors that could not be explained, had little understanding of what they were experiencing, and were sometimes misunderstood by others. Further, participants at times sought treatment on their own in order to cope. Some reported that prayer was central to the restoration of their mental health. Insights gained through this study can be utilized to foster positive social change by heightening awareness and assisting health care providers in planning appropriate screening and treatment to meet the individual needs of women with postpartum depression.

Childhood overweight and obesity are public health concerns that have negative health consequences and affect many children. Efforts are needed to identify children who are at a higher risk of developing overweight and obesity so that early detection and treatment may be offered. The intent of this study was to investigate the differences in the effects of postpartum depression on infant feeding practices and infant weight gain between Hispanic and African American women. Data were obtained from Infant Feeding Practices Study 11, a longitudinal study involving mothers in their third trimester through infants first year of life. The overall test of model coefficient of complete cases (N = 192, missing = 443) was not statistically significant (x-² = 4.842, df =2, p = 0.089). The result of the overall test after multiple imputation (n = 289) remained insignificant (on average x-² = 4.031, df = 2, p = 0.133). However, results indicated a significant association between excessive infant weight gain and feeding practices (breast feeding vs. formula feeding; r = 0.207, p = 0.01), supporting previous research on the protective effect of breast feeding on excess infant weight gain. Positive social change implications include an understanding of how maternal and infant characteristics may identify early symptoms of maternal depression, through increased awareness and reduced incidents of childhood obesity and maternal postpartum depression.

Background: According to the World Health Organization (WHO), perinatal depression (PD) is the most common childbirth complication. About 10% of pregnant women and about 13% of postpartum women experience a mental health disorder, primarily depression (WHO, 2016). One of the WHO (2015 a) goals for maternal mental health includes providing strategies for the promotion of psychosocial well-being and prevention of mental disorders of mothers during and after delivery. Purpose: The purpose of this performance improvement project was to establish a perinatal depression risk screening protocol and improve nursing knowledge on PD at a community-based hospital in Miami. Theoretical Framework: Beck’s postpartum depression theory Method: The project gained support and buy-in from the administration and management team of the healthcare institution. It included a comprehensive literature review used as a guide to establishing a perinatal depression screening protocol. Finally, staff nurses received education on PD, followed by an assessment for improved knowledge and retention of information. Result: A paired-samples t-test was conducted to compare pretest and posttest results for Registered nurses after receiving education on perinatal depression, N = 70. The results suggested improved knowledge and retention of new information. Conclusion: The perinatal depression screening protocol provided a framework for the assessment and first-line management for perinatal depression. There was evidence of improved nursing knowledge and retention of information on maternal mood disorders, especially perinatal depression.

Bakgrund Att bli mamma kan uppfattas som en omtumlande händelse i en kvinnas liv. Kvinnor som inte varit deprimerade under graviditeten kan utveckla en depression efter förlossning, en så kallad postpartumdepression. Det krävs mod hos sjuksköterskan för att kunna bedriva god omvårdnad där sjuksköterskan i mötet med patienten tar hänsyn till relationen och möjliggör partnerskap. I denna studie kommer därför faktorer som påverkar sjuksköterskans vårdrelation med kvinnor som lider av postpartumdepression att belysas. Syfte Syftet var att beskriva faktorer som påverkar sjuksköterskans vårdrelation med kvinnor som lider av postpartumdepression. Metod Designen som valdes för studien var litteraturöversikt som omfattar vetenskapliga artiklar. Dessa har tagits fram genom databassökningar i PubMed, CINAHL och PsycINFO. Resultatet baserades på 17 vetenskapliga artiklar som kvalitetsgranskades och analyserades. Resultat Resultatet utgjordes av tre kategorier. Kunskap och information, Vårdrelation samt Stöd och uppmuntran. Resultatet visade att sjuksköterskan ska ha kunskap kring ämnet postpartumdepression för att kunna identifiera sjukdomen och kunna informera patienten. Sjuksköterskans förmåga att skapa vårdrelationer är grundläggande för om kvinnan kommer att vilja ta emot vården eller inte och därmed avgörande för kvinnans tillfrisknande. Stöd och uppmuntran är betydande i omvårdnaden som bör ske på ett familjefokuserat sätt. Slutsats Sjuksköterskan spelar en central roll i omvårdnaden av kvinnor som lider av postpartumdepression. Trots att studier visar att sjuksköterskor i de flesta fall är de första som tar emot kvinnorna som söker vård för depressiva symtom efter graviditet, så är kunskapen om denna sjukdom begränsad. Mer forskning krävs för att förbättra identifieringen och behandlingen av kvinnor med postpartumdepression inom sjukvårdsområdet. / Background Becoming a mother may be a tumultuous event in a woman’s life. It is common that women who have not been depressed during pregnancy may develop postnatal depression, also known as postpartum depression. In order to facilitate a good working relationship between the nurse and a new mother suffering from postpartum depression, courage and consideration of the circumstances on behalf of the nurse are necessary. This study aims to highlight the nurse’s significance in the care of women with postpartum depression. Aim The aim of this study was to describe factors that affect the alliance between the nurse and the woman suffering from postpartum depression. Method The design of the study is that of a literature review. A search of the databases PubMed, CINAHL and PsycINFO resulted in 17 articles. These articles were reviewed and analysed. Results The review resulted in three major categories; Knowledge and information, The relationship between the nurse and the patient, and Support and encouragement. The results implicated that the nurse needs be knowledgeable about postpartum depression in order to identify the disorder and provide the patient with relevant information. The results showed that women with a good working alliance with the nurse were far more likely to accept care, and thus more likely to recover from postpartum depression. The role of the nurse is therefore crucial to the woman’s recovery. Support and encouragement was found important to be delivered to the entire family. Conclusions The role of the nurse when providing care for women suffering from postpartum depression was found to be of great significance. Even though nurses often are the first in contact with women seeking care for depressive symptoms after pregnancy, the knowledge about postpartum depression is limited. Further research is needed to improve the identification and treatment of women with postpartum depression in the nursing field.

Bakgrund   Förlossningsdepression är en sjukdom som drabbar 8 till 15 procent av alla kvinnor efter förlossningen. Detta kan leda till långvariga konsekvenser för både kvinnan och barnet. För många kvinnor kan hjälpsökandeprocessen vara svår, vilket leder till att flertalet inte får den vård de behöver. Förlossningsdepression är en komplex sjukdom med flera allvarliga symtom. Därför är det viktigt för sjuksköterskor och annan vårdpersonal att ha kunskap om sjukdomen för att kunna ge adekvat vård.  Syfte Syftet var att belysa kvinnors erfarenheter av vården vid förlossningsdepression.  Metod Designen för detta arbete var en litteraturöversikt. Författarna för arbetet har genomfört sökningar i databaserna PubMed samt CINAHL för att hitta relevanta forskningsstudier som besvarade syftet. Totalt 16 vetenskapliga artiklar inkluderades och analyserades samt granskades av författarna. De vetenskapliga artiklarna var främst baserade på kvalitativ forskning med inslag av kvantitativa delar. Data analyserades med hjälp av en integrerad analys. Resultat Resultatet av litteraturöversikten visade att många kvinnor med förlossningsdepression är missnöjda med den vård som erbjuds och hur de blir bemötta av vården. Vidare visade resultatet att information om var kvinnor kan söka hjälp var bristfällig. Flertalet kvinnor uppgav att de inte blivit tagna på allvar samt att de upplevt att stigmatiseringen i samhället som så stor att de inte vågat söka hjälp trots symtom. Ett annat resultat är att kvinnor upplevde att sjukvården inte tagit hänsyn till deras åsikter om önskad behandling.   Slutsats Utifrån resultatet kan slutsatsen dras att stigmatiseringen i samhället påverkar kvinnor i deras hjälpsökande, något som bör förändras. Sjukvården behöver utveckla vården vid förlossningsdepression på flera sätt, bland annat genom att göra den mer lättillgänglig. Sjukvårdspersonalen bör även lyssna mer på kvinnorna och anpassa behandlingen utifrån deras behov och önskemål. / Background Postpartum depression is a disease that affects 8-15 percent of all women after childbirth. This can lead to long-term consequences for both the woman and the child. For most women, the help-seeking process can be difficult, leading to the majority not receiving the care they need. Postpartum depression is a complex disease with various serious symptoms. Therefore, it is important for nurses and other healthcare professionals to have knowledge of the disease in order to provide adequate care. The Edinburgh Postnatal Depression Scale (EPDS) screening tool is used to diagnose postpartum depression. Aim The purpose was to shed light on women's experiences of the healthcare in the event of postpartum depression. Method The design for this study was a literature review. The authors have conducted searches in the databases PubMed and CINAHL to find relevant research studies that answered the aim. A total of 16 scientific articles were included and analysed and reviewed by the authors. The scientific articles were mainly based on qualitative research with elements of quantitative parts. The data were analysed using an integrated analysis. Results The results of the literature review showed that the majority of women with postpartum depression are dissatisfied with the care provided and the treatment. Furthermore, the results showed that information on where women can seek help was deficient. The majority of women stated that the healthcare professionals had not taken the women seriously and that the stigma felt so big in society that they did not dare to seek help. The results of the literature review also showed that women felt that the health service did not take into account their views on the desired treatment. Conclusions Based on the results, it can be concluded that the stigma in society affects women in their search for help, something that should change. The healthcare system needs to develop care for postpartum depression in several ways, including by making it more accessible. Healthcare professionals should also listen more to women and adapt treatment based on their needs and wishes. Keywords

Objectives: To investigate the preventive potential of the Developmental Origins of Health and Disease (DOHaD) hypothesis as it pertains to emotion dysregulation and psychopathology by: i) elucidating the impact of modifiable perinatal risk factors, and ii) examining whether a postnatal intervention can improve infant emotion regulation. Methods: Studies 1 and 2 used data from the Canadian Healthy Infant Longitudinal Development (CHILD) cohort and the Maternal-Infant Research on Environmental Chemicals (MIREC) cohort to examine if modifiable perinatal risk factors (including prenatal diet quality) confounded the link between prenatal metabolic complications and offspring psychopathology. Study 3 used MIREC data to examine if prenatal diet quality was linked to a biomarker of emotion regulation in infants (autonomic nervous system (ANS) function). Studies 4 and 5 used data from 40 infants of mothers diagnosed with postpartum depression (PPD) and 40 healthy control infants matched on infant age sex and socioeconomic status. These studies examined if infant emotion regulation (Study 4) and mother-infant physiological synchrony (a marker of dyadic emotion regulation-Study 5) improved following maternal cognitive behavioral therapy (CBT) for PPD. Results: In Studies 1 and 2, prenatal diet quality accounted for significant variance in the links between prenatal metabolic complications and offspring psychopathology. In Study 3, poor prenatal diet quality was associated with adverse ANS development in offspring. In Studies 4 and 5, infants exhibited more adaptive emotion regulation and mother-infant synchrony improved following maternal receipt of CBT for PPD. v Conclusions: Elucidating the impact of modifiable perinatal risk factors on offspring psychopathology provides meaningful targets for intervention, and postnatal interventions may improve offspring emotion regulation and could reduce the risk of psychopathology. This work highlights the importance of the perinatal period as a time during which modifiable risk factors can be identified and intervened upon to reduce mental disorder risk across the lifespan. / Dissertation / Doctor of Philosophy (PhD) / Healthy brain development is important for health and success in life. However, risk factors such as the mother’s poor physical and mental health during pregnancy and in the first postnatal year can increase the risk of emotion and behaviour problems in offspring. Therefore, the objectives of this thesis were to i) identify links between modifiable pre and postnatal risk factors and poorer offspring brain development and ii) determine if intervening on one of these risk factors might improve offspring brain development. Results from this thesis show that an unhealthy maternal diet in pregnancy was linked to more offspring emotion, behaviour, and brain development problems and that treating postpartum depression in mothers may improve offspring brain development. This work suggests that identifying and intervening on modifiable risk factors is important to improve early brain development and may prevent the development of mental disorders later in life.