{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,5,23]],"date-time":"2025-05-23T15:27:30Z","timestamp":1748014050170,"version":"3.37.3"},"reference-count":16,"publisher":"Oxford University Press (OUP)","issue":"3-4","funder":[{"name":"Department of Veterans Affairs, Veterans Health Administration, Office of Research and Development (Health Services Research"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,3,20]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>Women veterans using Veterans Health Care Administration maternity benefits have a high prevalence of mental health disorders, including depression, PTSD, and anxiety. Additionally, women with psychiatric histories often experience a relapse or worsening of symptoms during pregnancy and postpartum. Adequate perinatal mental healthcare engagement is critical to optimizing outcomes for mother and child.<\/jats:p><\/jats:sec><jats:sec><jats:title>Materials and Methods<\/jats:title><jats:p>This study evaluated psychiatric symptom severity and predictors of women veteran\u2019s mental health treatment engagement during pregnancy and postpartum at the VA North Texas Health Care System. Seventy women using Veterans Health Administration were assessed longitudinally via chart review and interviews (including the Edinburgh Postnatal Depression Scale) during pregnancy and postpartum. A Friedman test was used to evaluate the change in symptom severity during (1) the 6\u2009months before pregnancy, (2) pregnancy, and (3) postpartum. Multivariate logistic regressions were used to determine predictors of attending outpatient mental health appointments. Potential predictors examined included sociodemographic factors, symptoms of depression, history of military sexual assault, presence of a pre-pregnancy psychiatric diagnosis, and attendance of mental health appointments before pregnancy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Approximately 40% of participants demonstrated at least mild psychiatric symptoms before pregnancy, and symptom severity did not significantly change across the perinatal period (pre-pregnancy, pregnancy, and postpartum) X2 (2, n\u2009=\u200970)\u2009=\u20093.56, P\u2009=\u2009.17. Depressive symptoms during the 2nd or 3rd trimester were a significant predictor for attendance of mental health appointments during both pregnancy (OR\u2009=\u20091.18, 95% CI, 1.04 to 1.34) and postpartum (OR\u2009=\u20091.18, 95% CI, 1.02 to 1.36). An active psychiatric diagnosis during the 6\u00a0months before pregnancy was also a significant predictor of attendance following delivery (OR\u2009=\u200914.63, 95% CI, 1.55 to 138.51).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Our results demonstrate that women with prior histories of mental health conditions will continue to be symptomatic, and this is a good predictor of mental health treatment engagement during the perinatal period.<\/jats:p><\/jats:sec>","DOI":"10.1093\/milmed\/usab278","type":"journal-article","created":{"date-parts":[[2021,7,10]],"date-time":"2021-07-10T07:38:41Z","timestamp":1625902721000},"page":"e468-e472","source":"Crossref","is-referenced-by-count":2,"title":["Perinatal Symptoms and Treatment Engagement in Female Veterans"],"prefix":"10.1093","volume":"188","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0096-9367","authenticated-orcid":false,"given":"Elizabeth H","family":"Anderson","sequence":"first","affiliation":[{"name":"Research Services, VA North Texas Health Care System , Dallas, TX 75216, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Carolyn","family":"Morrow","sequence":"additional","affiliation":[{"name":"Mental Health, VA North Texas Health Care System , Dallas, TX 75216, USA"},{"name":"Department of Psychiatry, UT Southwestern Medical Center , Dallas, TX 75390, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kristin M","family":"Mattocks","sequence":"additional","affiliation":[{"name":"VA Central Western Massachusetts Healthcare System , Leeds, MA 01053, USA"},{"name":"Department of Population and Quantitative Health Sciences, University of Massachusetts Medical School , Worcester, MA 01605, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Geetha","family":"Shivakumar","sequence":"additional","affiliation":[{"name":"Mental Health, VA North Texas Health Care System , Dallas, TX 75216, USA"},{"name":"Department of Psychiatry, UT Southwestern Medical Center , Dallas, TX 75390, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2021,7,9]]},"reference":[{"issue":"12","key":"2023033100392924900_","doi-asserted-by":"crossref","first-page":"2159","DOI":"10.1089\/jwh.2009.1892","article-title":"Pregnancy and mental health among women veterans returning from Iraq and Afghanistan","volume":"19","author":"Mattocks","year":"2010","journal-title":"J Womens Health (Larchmt)"},{"issue":"8","key":"2023033100392924900_","doi-asserted-by":"crossref","first-page":"1598","DOI":"10.1007\/s10995-017-2285-0","article-title":"Improving perinatal mental health care for women veterans: description of a quality improvement program","volume":"21","author":"Katon","year":"2017","journal-title":"Matern Child Health J"},{"issue":"3","key":"2023033100392924900_","doi-asserted-by":"crossref","first-page":"217","DOI":"10.1080\/0954026031000136848","article-title":"Psychiatric disorders during pregnancy","volume":"15","author":"Cott","year":"2003","journal-title":"Int Rev Psychiatry"},{"issue":"1","key":"2023033100392924900_","doi-asserted-by":"crossref","first-page":"56","DOI":"10.1016\/j.whi.2018.10.001","article-title":"Factors impacting perceived access to early prenatal care among pregnant veterans enrolled in the Department of Veterans Affairs","volume":"29","author":"Mattocks","year":"2019","journal-title":"Womens Health Issues"},{"issue":"6","key":"2023033100392924900_","doi-asserted-by":"crossref","first-page":"782","DOI":"10.1192\/bjp.150.6.782","article-title":"Detection of postnatal depression. 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