{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,26]],"date-time":"2026-09-26T06:42:53Z","timestamp":1790404973976,"version":"4.1.0"},"reference-count":49,"publisher":"Public Library of Science (PLoS)","issue":"9","license":[{"start":{"date-parts":[[2025,9,4]],"date-time":"2025-09-04T00:00:00Z","timestamp":1756944000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/publicdomain\/zero\/1.0\/"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS One"],"abstract":"<jats:sec id=\"sec001\">\n<jats:title>Introduction<\/jats:title>\n<jats:p>Mental disorders during pregnancy are a significant public health problem due to the substantial physiological and psychological changes that occur during this period. This study aims to investigate the risk factors for mental disorders in pregnant women by comparing data from two distinct cohorts in Jundia\u00ed and Araraquara, Brazil.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec002\">\n<jats:title>Methods<\/jats:title>\n<jats:p>This is a prospective cohort study that included pregnant women from two Brazilian cohorts in S\u00e3o Paulo state. The Jundia\u00ed cohort (1997\u20132000) included 865 pregnant women, while the Araraquara cohort (2017\u20132024) included 755 pregnant women. Socioeconomic, demographic, obstetric history, and mental health data were collected and analyzed. Mental health was assessed using standardized questionnaires, including the General Health Questionnaire (GHQ), the State-Trait Anxiety Inventory (STAI), Trait Anxiety Inventory (TAI) and the Perceived Stress Scale (PSS). Statistical analysis included bivariate tests and univariate and multivariate random-effects models for panel data.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec003\">\n<jats:title>Results<\/jats:title>\n<jats:p>Araraquara participants showed significantly higher GHQ scores at baseline (mean\u2009=\u20094.00) than Jundia\u00ed (mean\u2009=\u20092.78; p\u2009&lt;\u20090.001), with similar trends for SAI, TAI, and PSS. Scores decreased across visits in both cohorts (GHQ Visit 3: Coef.\u2009=\u2009\u20131.053, p\u2009&lt;\u20090.001). Being single (GHQ: Coef.\u2009=\u20090.404, p\u2009=\u20090.019), separated\/widowed (SAI: Coef.\u2009=\u20093.961, p\u2009=\u20090.005), lower education (TAI: Coef.\u2009=\u2009\u20131.910, p\u2009=\u20090.006), and higher household density (PSS: Coef.\u2009=\u20090.946, p\u2009=\u20090.012) were significant risk factors. Maternal morbidities such as urinary infections (TAI: Coef.\u2009=\u20090.862, p\u2009=\u20090.031), cervicitis\/vaginitis (GHQ: Coef.\u2009=\u20090.290, p\u2009=\u20090.009), and tuberculosis (TAI: Coef.\u2009=\u20096.989, p\u2009=\u20090.033) were also strongly associated with worse mental health outcomes. Cohort differences remained significant even after adjustment (GHQ: Jundia\u00ed vs Araraquara, Coef.\u2009=\u2009\u20131.357, p\u2009&lt;\u20090.001).<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec004\">\n<jats:title>Conclusions<\/jats:title>\n<jats:p>This study showed that pregnant women in the more recent Araraquara cohort exhibited significantly higher levels of psychological distress symptoms, anxiety, and perceived stress than those in the earlier Jundia\u00ed cohort. These mental health outcomes were strongly associated with lower per capita income, lower education levels, higher household density, and adverse pregnancy conditions such as urinary infection and gestational hypertension. These findings highlight the worsening social vulnerability of pregnant women over time and reinforce the urgency of incorporating systematic mental health screening into prenatal care policies in Brazil.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0330921","type":"journal-article","created":{"date-parts":[[2025,9,4]],"date-time":"2025-09-04T17:49:22Z","timestamp":1757008162000},"page":"e0330921","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":2,"title":["Risk factors for mental disorders in pregnant women in two cities from S\u00e3o Paulo, Brazil: A cohort study"],"prefix":"10.1371","volume":"20","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8161-3639","authenticated-orcid":true,"given":"Aud\u00eancio","family":"Victor","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria Paula de 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