Recent advances in the study of perinatal mental health: Epidemiology, psychopathology and intervention

Perinatal mental health has been increasingly recognized as one of the most prevalent and consequential complications of pregnancy and childbirth. Approximately 1 in 5 women experience depression during or after pregnancy, and up to 1 in 4 encounter difficulties in establishing an emotional bond with their infants - a condition known as mother-to-infant bonding difficulties (MIBD). Pooled global estimates from meta-analyses indicate that these conditions are more prevalent than major obstetric complications such as gestational diabetes and preeclampsia. They also represent the leading cause of maternal mortality, particularly in high-income countries. For example, suicidal ideation (SI) is approx. 16 times more common among women with postpartum depression (PPD) than among those without. Moreover, SI occurring alongside PPD is often associated with prior depressive episodes and a lack of social support, whereas SI in the absence of depression tends to be linked to first-time motherhood, infection during pregnancy, or loneliness. Postpartum depression and MIBD are also closely interconnected, exhibiting a bidirectional relationship and sharing major risk factors such as prenatal depression, limited family support, and adverse childhood experiences. When left untreated, perinatal depression and MIBD can impair maternal functioning and delay infants' emotional, cognitive and social development. Emerging integrative approaches that combine psychotherapy with bonding-focused, lifestyle and psychosocial components show promise in improving outcomes. Future research should focus on developing comprehensive, multimodal interventions that integrate psychotherapy with lifestyle and psychosocial elements within a preventive, family-centered framework, promoting sustained recovery beyond active treatment.