{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T13:24:18Z","timestamp":1786973058464,"version":"build-2736575974"},"reference-count":19,"publisher":"BMJ","issue":"8","license":[{"start":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T00:00:00Z","timestamp":1786924800000},"content-version":"unspecified","delay-in-days":16,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100003743","name":"Adlerbertska Foundations","doi-asserted-by":"crossref","award":["NA"],"award-info":[{"award-number":["NA"]}],"id":[{"id":"10.13039\/501100003743","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/100018442","name":"Carl Bennet","doi-asserted-by":"crossref","award":["NA"],"award-info":[{"award-number":["NA"]}],"id":[{"id":"10.13039\/100018442","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/501100004359","name":"Swedish Research Council","doi-asserted-by":"crossref","award":["VR 2024-03225"],"award-info":[{"award-number":["VR 2024-03225"]}],"id":[{"id":"10.13039\/501100004359","id-type":"DOI","asserted-by":"crossref"}]},{"name":"Wellcome Research Fellowship in Humanities","award":["219744\/Z\/19\/Z"],"award-info":[{"award-number":["219744\/Z\/19\/Z"]}]},{"DOI":"10.13039\/501100003849","name":"IngaBritt och Arne Lundbergs Forskningsstiftelse","doi-asserted-by":"publisher","award":["LU2020-0008"],"award-info":[{"award-number":["LU2020-0008"]}],"id":[{"id":"10.13039\/501100003849","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Vetenskapr\u00e5det","award":["VR 2024-03225"],"award-info":[{"award-number":["VR 2024-03225"]}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2026,8,3]]},"published-print":{"date-parts":[[2026,8]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To examine immigration-related inequities across the perinatal mental healthcare pathway, including differences in case detection, treatment uptake and timeliness of care, among first-time parents in Sweden.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Population-based cohort study using linked administrative register data.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>The three largest Swedish regions (Stockholm, V\u00e4stra G\u00f6taland and Sk\u00e5ne) covering approximately 55% of the national population.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>All first-time parents with a live first birth between 1 January 2008 and 31 December 2018 residing in the study regions (404\u2009043 mothers and 391\u2009068 fathers).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Exposure<\/jats:title>\n                    <jats:p>Individuals\u2019 country of birth (born outside vs inside the Nordic countries).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Main outcome measures<\/jats:title>\n                    <jats:p>We examine immigration-related inequalities across the perinatal mental healthcare pathway, including case detection (issues recorded a year postpartum, with no diagnoses\/treatments in the previous year), treatment uptake (antidepressants and\/or psychotherapy) and timeliness of care (weeks from diagnosis to treatment).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>In the 12 months postpartum, 7.2% of mothers and 4.5% of fathers had common perinatal mental health conditions requiring clinical management. Parents born outside the Nordic countries had substantially lower detection rates: \u22125.3\u2009percentage points for mothers (95% CI \u22125.8 to \u22124.9; 59% below the Nordic-born baseline of 9.0%) and \u22122.5\u2009percentage points for fathers (95% CI \u22122.8 to \u22122.3; 48% below the Nordic-born baseline of 5.2%). Conditional on diagnosis, immigrant mothers and fathers were 12.1 and 7.6\u2009percentage points less likely to receive treatment, respectively. Differences in time from diagnosis to treatment were small.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Immigration-related inequalities were observed across multiple stages of the perinatal mental healthcare pathway. As previous evidence suggests similar or higher levels of perinatal mental health problems among immigrant parents, the observed differences are unlikely to reflect lower need for care. Findings instead point to inequalities in access and use of perinatal mental healthcare and highlight the need for more equitable screening, assessment and follow-up.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2026-122722","type":"journal-article","created":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T12:25:32Z","timestamp":1786969532000},"page":"e122722","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Immigration-related inequalities across the perinatal mental health care pathway among new parents in Sweden: a population-based cohort study"],"prefix":"10.1136","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4631-3227","authenticated-orcid":false,"given":"Roxanne","family":"Kovacs","sequence":"first","affiliation":[{"name":"Department of Economics, University of Gothenburg, Gothenburg, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0556-1483","authenticated-orcid":false,"given":"Nawi","family":"Ng","sequence":"additional","affiliation":[{"name":"School of Public Health and Community Medicine, University of Gothenburg, Gothenburg, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gustav","family":"Kjellsson","sequence":"additional","affiliation":[{"name":"School of Public Health and Community Medicine, University of Gothenburg, Gothenburg, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2026,8,17]]},"reference":[{"key":"2026081705252144000_16.8.e122722.1","doi-asserted-by":"publisher","DOI":"10.1002\/wps.20769"},{"key":"2026081705252144000_16.8.e122722.2","doi-asserted-by":"crossref","first-page":"1800","DOI":"10.1016\/S0140-6736(14)61277-0","article-title":"Effects of perinatal mental disorders on the fetus and child","volume":"384","author":"Stein","year":"2014","journal-title":"The Lancet"},{"key":"2026081705252144000_16.8.e122722.3","unstructured":"Rikshandboken . Screening with EPDS - national handbook in child health care. 2024. Available: https:\/\/www.rikshandboken-bhv.se\/foraldraskapsstod\/individuellt-foraldraskapsstod\/screening-med-epds [Accessed 27 Jan 2026]."},{"key":"2026081705252144000_16.8.e122722.4","doi-asserted-by":"publisher","DOI":"10.1177\/1403494812459610"},{"key":"2026081705252144000_16.8.e122722.5","doi-asserted-by":"crossref","first-page":"262","DOI":"10.1093\/eurpub\/ckad160.262","article-title":"Perinatal common mental health disorders among migrant women: a systematic review and meta-analysis","volume":"33","author":"Stevenson","year":"2023","journal-title":"Eur J Public Health"},{"key":"2026081705252144000_16.8.e122722.6","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpsychires.2015.08.010"},{"key":"2026081705252144000_16.8.e122722.7","doi-asserted-by":"crossref","first-page":"165","DOI":"10.1016\/j.jad.2021.03.013","article-title":"Who do we miss when screening for postpartum depression? A population-based study in a Swedish region","volume":"287","author":"Br\u00e4nn","year":"2021","journal-title":"J Affect Disord"},{"key":"2026081705252144000_16.8.e122722.8","doi-asserted-by":"crossref","DOI":"10.1001\/jamanetworkopen.2023.42398","article-title":"Neighborhood Disadvantage, Race and Ethnicity, and Postpartum Depression","volume":"6","author":"Onyewuenyi","year":"2023","journal-title":"JAMA Netw Open"},{"key":"2026081705252144000_16.8.e122722.9","doi-asserted-by":"crossref","DOI":"10.1136\/bmjopen-2021-049220","article-title":"Is neighbourhood income inequality associated with maternal mental health? 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