{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T02:52:27Z","timestamp":1760151147393,"version":"build-2065373602"},"reference-count":61,"publisher":"MDPI AG","issue":"2","license":[{"start":{"date-parts":[[2022,2,18]],"date-time":"2022-02-18T00:00:00Z","timestamp":1645142400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000050","name":"National Heart Lung and Blood Institute","doi-asserted-by":"publisher","award":["T32HL105324"],"award-info":[{"award-number":["T32HL105324"]}],"id":[{"id":"10.13039\/100000050","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000025","name":"National Institute of Mental Health","doi-asserted-by":"publisher","award":["R01MH116027"],"award-info":[{"award-number":["R01MH116027"]}],"id":[{"id":"10.13039\/100000025","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Behavioral Sciences"],"abstract":"<jats:p>Background: Hypertensive disorders of pregnancy, such as Preeclampsia (PreE) and HELLP (hemolysis, elevated liver enzyme, low platelet) syndrome, affects approximately 5\u201310% of pregnancies and increases the risk of women developing disorders, such as anxiety or depression, in the postpartum period. Using preclinical rodent models, we set out to determine whether rats with a history of PreE or HELLP had evidence of anxiety, depression or cognitive impairment and whether immune suppression during pregnancy prevented these changes in mood and\/or cognition. Methods: Timed-pregnant rats were infused with sFlt-1 and\/or sEng to induce PreE or HELLP beginning on gestational day 12. After delivery, a battery of validated behavioral assays was used to assess post-partum depression, anxiety and learning. Results: There was no negative effect on maternal pup interaction due to PreE or HELLP; however, hypertensive dams spent more time immobile in the forced swim test (p &lt; 0.0001). Hypertensive dams also spent less time in the open area of the open field (p = 0.001). There were no significant changes in recognition memory (p = 0.08); however, spatial learning was impaired in hypertensive dams (p = 0.003). Immobility time in the forced swim test was positively correlated with increased circulating S100B (p = 0.04), while increased time spent in the outer zones of the open field was negatively correlated with BDNF levels (p &lt; 0.0001). Conclusion: The results from this study suggest that hypertensive pregnancy disorders are associated with depression, anxiety and learning impairments in the post-partum period.<\/jats:p>","DOI":"10.3390\/bs12020053","type":"journal-article","created":{"date-parts":[[2022,2,21]],"date-time":"2022-02-21T08:14:46Z","timestamp":1645431286000},"page":"53","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Evidence of Anxiety, Depression and Learning Impairments following Prenatal Hypertension"],"prefix":"10.3390","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4511-0046","authenticated-orcid":false,"given":"Kedra","family":"Wallace","sequence":"first","affiliation":[{"name":"Department of Pharmacology & Toxicology, University of Mississippi Medical Center, Jackson, MS 39216, USA"},{"name":"Department of Obstetrics & Gynecology, University of Mississippi Medical Center, Jackson, MS 39216, USA"},{"name":"Department of Neurobiology & Anatomical Sciences, University of Mississippi Medical Center, Jackson, MS 39216, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Teylor","family":"Bowles","sequence":"additional","affiliation":[{"name":"Department of Obstetrics & Gynecology, University of Mississippi Medical Center, Jackson, MS 39216, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5899-236X","authenticated-orcid":false,"given":"Ashley","family":"Griffin","sequence":"additional","affiliation":[{"name":"Program in Neuroscience, University of Mississippi Medical Center, Jackson, MS 39216, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Reanna","family":"Robinson","sequence":"additional","affiliation":[{"name":"Department of Obstetrics & Gynecology, University of Mississippi Medical Center, Jackson, MS 39216, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lucia","family":"Solis","sequence":"additional","affiliation":[{"name":"Department of Obstetrics & Gynecology, University of Mississippi Medical Center, Jackson, MS 39216, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3233-1299","authenticated-orcid":false,"given":"Teryn","family":"Railey","sequence":"additional","affiliation":[{"name":"Department of Obstetrics & Gynecology, University of Mississippi Medical Center, Jackson, MS 39216, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"James P.","family":"Shaffery","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, University of Mississippi Medical Center, Jackson, MS 39216, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sarah","family":"Araji","sequence":"additional","affiliation":[{"name":"Department of Obstetrics & Gynecology, University of Mississippi Medical Center, Jackson, MS 39216, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shauna-Kay","family":"Spencer","sequence":"additional","affiliation":[{"name":"Department of Pharmacology & Toxicology, University of Mississippi Medical Center, Jackson, MS 39216, USA"},{"name":"Department of Obstetrics & Gynecology, University of Mississippi Medical Center, Jackson, MS 39216, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2022,2,18]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"391","DOI":"10.1016\/j.bpobgyn.2011.01.006","article-title":"Epidemiology of pre-eclampsia and the other hypertensive disorders of pregnancy","volume":"25","author":"Hutcheon","year":"2011","journal-title":"Best Pract. Res. Clin. Obstet. Gynaecol."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"e760","DOI":"10.1542\/neo.22-11-e760","article-title":"Hypertensive Disorders of Pregnancy","volume":"22","author":"Young","year":"2021","journal-title":"Neoreviews"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"260","DOI":"10.1016\/S0163-8343(02)00189-5","article-title":"Posttraumatic stress disorder after pre-eclampsia: An exploratory study","volume":"24","author":"Engelhard","year":"2002","journal-title":"Gen. Hosp. Psychiatry"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"58","DOI":"10.1080\/01674820802546212","article-title":"Cognitive function after pre-eclampsia: An explorative study","volume":"30","author":"Baecke","year":"2009","journal-title":"J. Psychosom. Obstet. Gynaecol."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"645","DOI":"10.1177\/1933719110395402","article-title":"Posttraumatic stress disorder following preeclampsia and PPROM: A prospective study with 15 months follow-up","volume":"18","author":"Stramrood","year":"2011","journal-title":"Reprod. Sci."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"6641510","DOI":"10.1155\/2021\/6641510","article-title":"Preeclampsia and its complications exacerabate development of postpartum depression: A Retrospective Cohort Study","volume":"2021","author":"Ye","year":"2021","journal-title":"BioMed Res. Int."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"408","DOI":"10.1080\/00016340801915127","article-title":"Impaired maternal cognitive functioning after pregnancies complicated by severe pre-eclampsia: A pilot case-control study","volume":"87","author":"Brusse","year":"2008","journal-title":"Acta Obstet. Gynecol. Scand."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"89","DOI":"10.1016\/j.jad.2021.09.049","article-title":"Psychological factors and coping strategies in pregnancies complicated by hypertension: A cluster-analytic approach","volume":"296","author":"Irigaray","year":"2022","journal-title":"J. Affect. Disord."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"74.e1","DOI":"10.1016\/j.ajog.2017.03.008","article-title":"Preeclampsia and cognitive impairment later in life","volume":"217","author":"Fields","year":"2017","journal-title":"Am. J. Obstet. Gynecol."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"93","DOI":"10.1007\/s11906-019-0997-9","article-title":"Pregnancy History, Hypertension, and Cognitive Impairment in Postmenopausal Women","volume":"21","author":"Miller","year":"2019","journal-title":"Curr. Hypertens. Rep."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"e381","DOI":"10.1016\/j.ajog.2009.06.033","article-title":"Long-term maternal and subsequent pregnancy outcomes 5 years after hemolysis, elevated liver enzymes, and low platelets (HELLP) syndrome","volume":"201","author":"Habli","year":"2009","journal-title":"Am. J. Obstet. Gynecol."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"101","DOI":"10.3109\/0167482X.2016.1168396","article-title":"Long-term follow-up of psychosocial distress after early onset preeclampsia: The Preeclampsia Risk Evaluation in FEMales cohort study","volume":"37","author":"Mommersteeg","year":"2016","journal-title":"J. Psychosom. Obstet. Gynaecol."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"1535","DOI":"10.1089\/jwh.2010.2584","article-title":"Postpartum depression after mild and severe preeclampsia","volume":"20","author":"Hoedjes","year":"2011","journal-title":"J. Womens Health"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"1390","DOI":"10.1111\/j.1471-0528.2010.02660.x","article-title":"Perinatal complications increase the risk of postpartum depression. The Generation R Study","volume":"117","author":"Blom","year":"2010","journal-title":"Br. J. Obstet. Gynaecol."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"e709","DOI":"10.1212\/WNL.0000000000011363","article-title":"Hypertensive Disorders of Pregnancy and Cognitive Impairment: A Prospective Cohort Study","volume":"96","author":"Adank","year":"2021","journal-title":"Neurology"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"637574","DOI":"10.3389\/fnagi.2021.637574","article-title":"Cognition and cerebrovascular reactivity in midlife women with history of preeclampsia and placental evidence of maternal vascular malperfusion","volume":"13","author":"Shaaban","year":"2021","journal-title":"Front. Aging Neurosci."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"61","DOI":"10.1007\/s11906-017-0757-7","article-title":"Pathophysiology and Current Clinical Management of Preeclampsia","volume":"19","author":"Amaral","year":"2017","journal-title":"Curr. Hypertens. Rep."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"816","DOI":"10.2174\/1389201019666180712115215","article-title":"HELLP Syndrome: Pathophysiology and Current Therapies","volume":"19","author":"Wallace","year":"2018","journal-title":"Curr. Pharm. Biotechnol."},{"key":"ref_19","first-page":"479","article-title":"The role of endoglin and its soluble form in pathogenesis of preeclampsia","volume":"477","author":"Petousis","year":"2021","journal-title":"Mol. Cell. Biochem."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"33","DOI":"10.1016\/j.semnephrol.2010.10.004","article-title":"Angiogenic factors and preeclampsia","volume":"31","author":"Maynard","year":"2011","journal-title":"Semin. Nephrol."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"41","DOI":"10.3109\/10641955.2013.835820","article-title":"Hypertension, inflammation and T lymphocytes are increased in a rat model of HELLP syndrome","volume":"33","author":"Wallace","year":"2014","journal-title":"Hypertens. Pregnancy"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"e1","DOI":"10.1016\/j.ajog.2013.01.049","article-title":"Seeking the Mechanisms of Action for Corticosteroids in HELLP Syndrome: SMASH Study","volume":"208","author":"Wallace","year":"2013","journal-title":"Am. J. Obstet. Gynecol."},{"key":"ref_23","unstructured":"Rana, S., Burke, S., and Karumanchi, S. (2020). Imbalances in circulating angiogenic factors in the pathophysiology of preeclampsia and related disorders. Am. J. Obstet. Gynecol., in press."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"1003","DOI":"10.1161\/HYPERTENSIONAHA.110.158931","article-title":"Plasma from preeclamptic women increases blood-brain barrier permeability","volume":"56","author":"Amburgey","year":"2010","journal-title":"Hypertension"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"278","DOI":"10.1177\/1933719114549844","article-title":"Plasma from patients with HELLP Syndrome Increases Blood-brain barrier permeability","volume":"22","author":"Wallace","year":"2015","journal-title":"Reprod. Sci."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"254","DOI":"10.1113\/expphysiol.2007.039966","article-title":"Magnesium sulphate treatment decreases blood-brain barrier permeability during acute hypertension in pregnant rats","volume":"93","author":"Euser","year":"2008","journal-title":"Exp. Physiol."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"272","DOI":"10.1111\/aji.12547","article-title":"Inhibition of T cell-activation attenuates hypertension, TNF-alpha, IL-17 and blood-brain barrier permeability in pregnant rats with angiogenic imbalance","volume":"76","author":"Bean","year":"2016","journal-title":"Am. J. Reprod. Immunol."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"946","DOI":"10.1161\/HYPERTENSIONAHA.118.11770","article-title":"Hypertension, Anxiety, and Blood-Brain Barrier Permeability are Increased in post-partum rats with a history of Severe Preeclampsia\/Hemolysis, Elevated Liver Enzymes and Low Platelet Syndrome","volume":"72","author":"Wallace","year":"2018","journal-title":"Hypertension"},{"key":"ref_29","first-page":"14873","article-title":"CD4+ T cells play a critical role in mediating hypertension in response to placental ischemia","volume":"2","author":"Novotny","year":"2013","journal-title":"J. Hypertens."},{"key":"ref_30","doi-asserted-by":"crossref","unstructured":"Chourbaji, S., Hoyer, C., Richter, S., Brandwein, C., Pfeiffer, N., Vogt, M., Vollmayr, B., and Gass, P. (2011). Differences in mouse maternal care behavior\u2014Is there a genetic impact of the glucocorticoid receptor?. PLoS ONE, 6.","DOI":"10.1371\/journal.pone.0019218"},{"key":"ref_31","first-page":"5","article-title":"Rodent models of depression: Forced swim and tail suspension behavioral despair tests in rats and mice","volume":"49","author":"Castagne","year":"2011","journal-title":"Curr. Protoc. Neurosci."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"117","DOI":"10.1016\/j.bbr.2006.10.029","article-title":"Influence of gender on working and spatial memory in the novel object recogntion task in the rat","volume":"177","author":"Sutcliffe","year":"2007","journal-title":"Behav. Brain Res."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"74","DOI":"10.1037\/h0077579","article-title":"Memory deficits associated with senescence: A Neurophysiological and behavioral study in the rat","volume":"93","author":"Barnes","year":"1979","journal-title":"J. Comp. Physiol. Psychol."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"354","DOI":"10.1016\/j.bbr.2016.05.062","article-title":"Fluoxetine normalizes the effects of prenatal maternal stress on depression- and anxiety-like behaviors in mouse dams and male offspring","volume":"311","author":"Salari","year":"2016","journal-title":"Behav. Brain Res."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"1257","DOI":"10.1097\/01.jom.0000100000.70011.bb","article-title":"Comorbid mental disorders account for the role impairment of commonly occurring chronic physical disorders: Results from the National Comorbidity Survey","volume":"45","author":"Kessler","year":"2003","journal-title":"J. Occup. Environ. Med."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"349","DOI":"10.2147\/VHRM.S147173","article-title":"Anxiety and depression in patients with pulmonary hypertension: Impact and management challenges","volume":"14","author":"Bussotti","year":"2018","journal-title":"Vasc. Health Risk Manag."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"157","DOI":"10.1080\/13651500510029138","article-title":"The relationship between depression and cardiovascular disease","volume":"9","author":"McConnell","year":"2005","journal-title":"Int. J. Psychiatry Clin. Pract."},{"key":"ref_38","first-page":"229","article-title":"Modeling postpartum depression in rats: Theoretic and methodological issues","volume":"37","author":"Li","year":"2016","journal-title":"Dongwuxue Yanjiu"},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"4539","DOI":"10.1111\/bph.12640","article-title":"Using animal models to study post-partum psychiatric disorders","volume":"171","author":"Perani","year":"2014","journal-title":"Br. J. Pharm."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.bbr.2019.02.005","article-title":"Coping with the forced swim stressor: Current state-of-the-art","volume":"364","author":"Molendijk","year":"2019","journal-title":"Behav. Brain Res."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"59","DOI":"10.1016\/j.physbeh.2009.10.011","article-title":"Anhedonia in postpartum rats","volume":"99","author":"Navarre","year":"2010","journal-title":"Physiol. Behav."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"47","DOI":"10.29245\/2578-2959\/2020\/4.1221","article-title":"An Overview of Maternal Anxiety During Pregnancy and the Post-partum Period","volume":"4","author":"Araji","year":"2020","journal-title":"J. Ment. Health Clin. Psychol."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"200","DOI":"10.1016\/j.preghy.2020.06.006","article-title":"Differences in hair cortisol concentrations and reported anxiety in women with preeclampsia versus uncomplicated pregnancies","volume":"21","author":"Bolte","year":"2020","journal-title":"Pregnancy Hypertens."},{"key":"ref_44","doi-asserted-by":"crossref","unstructured":"Papousek, I., Weiss, E., Moertl, M., Schmid-Zaludek, K., Krenn, E., Lessiak, V., and Lackner, H. (2021). Unaffected memory and inhibitory functioning several weeks postpartum in women with pregnancy complicated by preeclamspia. Behav. Sci., 11.","DOI":"10.3390\/bs11040055"},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"355","DOI":"10.1097\/AOG.0000000000002686","article-title":"Long-term cognitive impairment after preeclampsia: A systematic review and meta-analysis","volume":"132","author":"Elharram","year":"2018","journal-title":"Obstet. Gynecol."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"1280","DOI":"10.1111\/aogs.14100","article-title":"Cognitive impairment in preeclampsia complicated by eclampsia and pulmonary edema after delivery","volume":"100","author":"Bergman","year":"2021","journal-title":"Acta Obstet. Gynecol. Scand."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"49","DOI":"10.1016\/j.arr.2018.06.006","article-title":"Changes in the structure and function of the brain years after pre-eclampsia","volume":"47","author":"Ijomone","year":"2018","journal-title":"Ageing Res. Rev."},{"key":"ref_48","doi-asserted-by":"crossref","unstructured":"Wu, J., Sheng, X., Zhou, S., Fang, C., Song, Y., Wang, H., Jia, Z., Jia, X., and You, Y. (2021). Clinical significance of S100B protein in pregnant woman with early- onset severe preeclampsia. Ginekol. Pol.","DOI":"10.5603\/GP.a2021.0126"},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"97","DOI":"10.1007\/s00404-014-3610-0","article-title":"Maternal serum S100-B, PAPP-A and IL-6 levels in severe preeclampsia","volume":"292","author":"Guvnec","year":"2015","journal-title":"Arch. Gynecol. Obstet."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"142","DOI":"10.1016\/j.cca.2016.11.034","article-title":"Decreased plasma concentrations of brain-derived neurotrophic factor in preeclampsia","volume":"464","author":"Perucci","year":"2017","journal-title":"Clin. Chim. Acta"},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"1151","DOI":"10.1161\/HYPERTENSIONAHA.114.03590","article-title":"CD4+ T cells are important mediators of oxidative stress that cause hypertension in response to placental ischemia","volume":"64","author":"Wallace","year":"2014","journal-title":"Hypertension"},{"key":"ref_52","doi-asserted-by":"crossref","unstructured":"Bean, C., Spencer, S., Pabbidi, M., Szczepanski, J., Araji, S., Dixon, S., and Wallace, K. (2018). Peripheral anti-angiogenic imbalance during pregnancy impairs myogenic tone and increases cerebral edema in a rodent model of HELLP Syndrome. Brain Sci., 8.","DOI":"10.3390\/brainsci8120216"},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"39","DOI":"10.1159\/000343100","article-title":"Imbalance between Th17 and Treg cells may play an important role in the development of chronic unpredictable mild stress-induced depression in mice","volume":"20","author":"Hong","year":"2013","journal-title":"Neuroimmunomodulation"},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"911","DOI":"10.1038\/ajh.2010.70","article-title":"The effect of immune factors, Tumor Necrosis Factor-alpha, and agonistic autoantibodies to the Angiotensin II Type I Receptor on Soluble fms-Like Tyrosine-1 and Soluble Endoglin production in response to hypertension during pregnancy","volume":"23","author":"Parrish","year":"2010","journal-title":"Am. J. Hypertens."},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"642","DOI":"10.1038\/nm1429","article-title":"Soluble endoglin contributes to the pathogenesis of preeclampsia","volume":"12","author":"Venkatesha","year":"2006","journal-title":"Nat. Med."},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"136474","DOI":"10.1016\/j.neulet.2022.136474","article-title":"The antidepressant potential of lactobacillus casei in the postpartum depression rat model mediated by the microbiota-gut-brain axis","volume":"774","author":"Yang","year":"2022","journal-title":"Neurosci. Lett."},{"key":"ref_57","first-page":"170","article-title":"HELLP Syndrome a severe form of preeclampsia: A comparative study of clinical and laboratorial parameters","volume":"3","author":"Campos","year":"2016","journal-title":"Am. J. Exp. Clin. Res."},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"147","DOI":"10.3389\/fcvm.2019.00147","article-title":"Depression, anxiety and post-traumatic stress disorder following a hypertensive disorder of pregnancy: A narrative literature review","volume":"6","author":"Roberts","year":"2019","journal-title":"Front. Cardiovasc. Med."},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"1071","DOI":"10.1097\/01.AOG.0000183597.31630.db","article-title":"Perinatal depression: A systematic review of prevalence and incidence","volume":"106","author":"Gavin","year":"2005","journal-title":"Obstet. Gynecol."},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"97","DOI":"10.1007\/s00737-005-0078-8","article-title":"Depressive symptoms in early pregnancy, two months and one year postpartum\u2014Prevlance and psychosocial risk factors in a national Swedish sample","volume":"8","author":"Rubertsson","year":"2005","journal-title":"Arch. Womens Ment. Health"},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"632","DOI":"10.1016\/j.jad.2021.08.118","article-title":"One-year trajectories of postpartum depressive symptoms and associated psychosocial factors: Findings from the Tohoku Medical Megabank Project Birth and Three-Generation Cohort Study","volume":"295","author":"Kikuchi","year":"2021","journal-title":"J. Affect. Disord."}],"container-title":["Behavioral Sciences"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2076-328X\/12\/2\/53\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T22:22:08Z","timestamp":1760134928000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2076-328X\/12\/2\/53"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,2,18]]},"references-count":61,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2022,2]]}},"alternative-id":["bs12020053"],"URL":"https:\/\/doi.org\/10.3390\/bs12020053","relation":{},"ISSN":["2076-328X"],"issn-type":[{"type":"electronic","value":"2076-328X"}],"subject":[],"published":{"date-parts":[[2022,2,18]]}}}