***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
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    ***EXAMPLES*** 
    Input: Despite negative outcomes for depressed mothers and their children , no treatment specifically design ed to address maternal depression in the context of home visitation has emerged . In-Home Cognitive Behavioral Therapy ( IH-CBT ) is an adapted treatment that is delivered in the home , focuses on the needs of new mothers , and leverages ongoing home visiting to optimize engagement and outcomes . This study examined the efficacy of IH-CBT using a r and omized clinical trial . Subjects were 93 new mothers in a home visiting program . Mothers with major depressive disorder identified at 3months postpartum were r and omized into IH-CBT and ongoing home visitation ( n=47 ) or st and ard home visitation ( SHV ; n=46 ) in which they received home visitation alone and could obtain treatment in the community . Depression was measured at pre- and posttreatment , and 3-month follow-up using interviews , clinician ratings , and self-report . Mothers receiving IH-CBT showed improvements in all indicators of depression relative to the SHV condition and these gains were maintained at follow-up . For example , 70.7 % of mothers receiving IH-CBT were no longer depressed at posttreatment in terms of meeting criteria for major depressive disorder compared to 30.2 % in the SHV group . These findings suggest that IH-CBT is an efficacious treatment for depressed mothers in home visitation programs Abstract STUDY QUESTION How does the psychological well-being and prenatal bonding of Indian surrogates differ from a comparison group of mothers ? SUMMARY ANSWER Surrogates had higher levels of depression during pregnancy and post-birth , displayed lower emotional connection with the unborn baby , and greater care towards the healthy growth of the foetus , than the comparison group of mothers . WHAT IS ALREADY KNOWN Studies in the West have found that surrogates do not suffer long-term psychological harm . One study has shown that surrogates bond less with the foetus than expectant mothers . STUDY , DESIGN , SIZE , DURATION This study uses a prospect i ve , longitudinal and cross-sectional design .  Surrogates  and a matched group of expectant mothers were seen twice , during 4–9 months of pregnancy and 4–6 months after the birth . PARTICIPANTS / MATERIAL S , SETTING , METHODS Semi-structured interviews and st and ardized question naires were administered to 50 surrogates and 69 expectant mothers during pregnancy and 45 surrogates and 49 expectant mothers post-birth . All gestational surrogates were hosting pregnancies for international intended parents . MAIN RESULTS AND THE ROLE OF CHANCE Surrogates had higher levels of depression compared to the comparison group of mothers , during pregnancy and post-birth ( P < 0.02 ) . Low social support during pregnancy , hiding surrogacy and criticism from others were found to be predictive of higher depression in surrogates post-birth ( P < 0.05 ) . Regarding prenatal bonding , surrogates interacted less with and thought less about the foetus but adopted better eating habits and were more likely to avoid unhealthy practice s during pregnancy , than expectant mothers ( P < 0.05 ) . No associations were found between greater prenatal bonding and greater psychological distress during pregnancy or after relinquishment . LIMITATIONS , REASONS FOR CAUTION All surrogates were recruited from one clinic in Mumbai , and thus the representativeness of this sample is not known . Also , the possibility of socially desirable responding from surrogates can not be ruled out . WIDER IMPLICATION S OF THE FINDINGS As this is the first study of the psychological well-being of surrogates in low-income countries , the findings have important policy implication s. Providing support and counselling to surrogates , especially during pregnancy , may alleviate some of the psychological problems faced by surrogates . STUDY FUNDING /COMPETING INTEREST(S ) This study was supported by the Wellcome Trust [ 097857/Z/11/Z ] and Nehru Trust , Cambridge . K.K. is the Medical Director of Corion Fertility Clinic . All other authors have no conflict of interest to declare The prevalence of postpartum depression is approximately 13 % . Postpartum depression is associated with a higher maternal morbidity and mortality , and also with pervasive effects on the emotional , cognitive and behavioral development of the child . The aim of our study was to identify socio-demographic , psychosocial and obstetrical risk factors of postpartum depression in a middle class community sample , using a prospect i ve design . We enrolled consecutively 312 pregnant out patients in a single maternity unit . The first assessment was conducted between 32 and 41 weeks gestation , and a second time between 6 and 8 weeks after delivery . Depressive symptoms were measured using the French version of the  Edinburgh Postnatal Depression Scale ( EPDS ) . A cut-off score of 12/30 or above was considered as indicative of Major Depression . Of the initial sample of 312 women , 264 ( 84.6 % ) were followed-up between 6 and 8 weeks after delivery and considered for analysis . Depression during pregnancy , migrant status , and physical abuse by the partner were independently associated with postpartum depression when considered together , whereas physical complications were significantly associated with postpartum depression only when adjusting for antenatal depression . Depression during pregnancy , history of physical abuse , migrant status and postpartum physical complications are four major risk factors for postpartum depression BACKGROUND Peripartum anxiety and depressive disorders are associated with adverse consequences for mother and child . Thus , it is important to examine risk factors , correlates and course patterns of anxiety and depressive disorders during pregnancy and after delivery . METHODS In the prospect ive-longitudinal Maternal Anxiety in Relation to Infant Development ( MARI ) Study , n=306 expectant mothers were recruited from gynaecological outpatient setting s in Germany and completed up to seven waves of assessment from early pregnancy until 16 months postpartum . Anxiety and depressive disorders and potential risk factors/correlates were assessed with the Composite International Diagnostic Interview for Women ( CIDI-V ) , medical records and additional question naires . RESULTS Although peripartum anxiety and depressive disorders appeared to be persistent in some women , others reported major changes with heterogeneous courses and shifts between diagnoses and contents . There was a considerable amount of incident disorders . Strongest predictors for peripartum anxiety and depressive disorders were  anxiety and depressive disorders prior to pregnancy , but psychosocial ( e.g. maternal education ) , individual ( e.g. low self-esteem ) , and interpersonal ( e.g. partnership satisfaction , social support ) factors were also related . LIMITATION Knowing the aims of the study , some participants may have been more encouraged to report particular symptoms , but if so , this points to the importance of a comprehensive assessment in perinatal care . CONCLUSION Peripartum time is a sensitive period for a considerable incidence or persistence/recurrence of anxiety and depressive disorders albeit the course may be rather heterogeneous . Interventional studies are needed to examine whether an alteration of associated factors could help to prevent peripartum anxiety and depressive disorders OBJECTIVE To determine whether a correlation exists between prenatal and postnatal attachment . DESIGN Prospect i ve , correlational study with data collected during the second half of pregnancy and again 1 - 2 months after delivery . SETTING / PARTICIPANTS Two hundred twenty-eight women were recruited from childbirth education classes . The women were generally young , white , well educated , married , and employed . MAIN OUTCOME MEASURES The  Prenatal Attachment Inventory ( PAI )  was used to measure attachment before birth . The  Maternal Attachment Inventory ( MAI ) , the How I Feel About my Baby Now Scale  , and the Maternal Separation Anxiety Scale  were used to measure attachment after birth . RESULTS One hundred ninety-six women completed all the measures . A correlation was found between PAI and MAI scores ( r = 0.41 , p < 0.001 ) . CONCLUSIONS A correlation between prenatal and postnatal attachment was found . However , the modest size of the correlation indicated that other factors also influenced postnatal scores . Thus , caution should be exercised when promoting increased prenatal attachment in hopes of improving postnatal attachment Background While the importance of the infant-parent relationship from the child ’s perspective is acknowledged worldwide , there is still a lack of knowledge about predictors and long-term benefits or consequences of the quality of  parent-infant relationships  from the parent ’s perspective . The purpose of this prospect i ve study is to investigate the quality of parent-infant relationships  from parents ’ perspectives , both in the prenatal and postpartum period . This study therefore focuses on prenatal ( risk ) factors that may influence the quality of pre- and postnatal bonding , the transition to parenthood , and bonding as a process within families with young children . In contrast to most research concerning pregnancy and infant development , not only the roles and experiences of mothers during pregnancy and the first two years of infants ’ lives are studied , but also those of fathers . Methods / design The present study is a prospect i ve longitudinal cohort study , in which pregnant women ( N = 466 ) and their partners ( N = 319 ) are followed from 15 weeks gestation until their child is 24 months old . During pregnancy , midwives register the presence of prenatal risk factors and provide obstetric information after the child ’s birth . Parental characteristics are investigated using self-report question naires at 15 , 26 , and 36 weeks gestational age and at 4 , 6 , 12 , and 24 months postpartum . At 26 weeks of pregnancy and at 6 months postpartum , parents are interviewed concerning their representations of the ( unborn ) child . At 6 months postpartum , the mother-child interaction is observed in several situations within the home setting . When children are 4 , 6 , 12 , and 24 months old , parents also completed question naires concerning the child ’s ( social-emotional ) development and the parent-child relationship . Additionally , at 12 months information about the child ’s physical development and well-being during the first year of life is retrieved from National Health Care Centres . Discussion The results of this study may contribute to early identification of families at risk for adverse parent-infant relationships , infant development , or parenting . Thereby this study will be relevant for the development of policy , practice , and theory concerning infant mental health BACKGROUND Depression is common in low-income pregnant women , and treatments need to be fitted to meet their needs . We conducted a r and omized controlled trial comparing brief Interpersonal Psychotherapy ( brief-IPT ) to enhanced treatment as usual ( ETAU ) for  perinatal depression in low-income women . The brief-IPT model is design ed to better engage low-income women by utilizing an engagement session , providing flexible delivery of sessions , and pragmatic case management . METHODS Pregnant women , aged ≥18 , between 12 and 30 weeks gestation were recruited from an urban prenatal clinic . Women scoring ≥10 on the Edinburgh Depression Scale and meeting depressive disorder criteria were r and omized to either brief-IPT ( n=21 ) or ETAU ( n=21 ) . We assessed treatment outcomes , acceptability , and feasibility of the intervention ( measured by session attendance ) . RESULTS Depression scores significantly decreased in both brief-IPT and ETAU . Brief-IPT participants reported significant improvements in social support satisfaction as compared to ETAU participants , even after controlling for concurrent depressive symptoms . Brief-IPT participants reported high satisfaction with the program . However , many participants did not participate in the full 9-session course of treatment ( average sessions attended = 6 , range 0 - 17 ) . LIMITATIONS Small sample size , use of self-report measures , and lack of an active psychotherapy control group limits interpretation of study results . CONCLUSIONS Brief-IPT for perinatal depression is acceptable to low-income women and is helpful for improving depressive symptoms and social support . However , feasibility of the treatment was limited by relatively low session attendance in spite of efforts to maximize treatment engagement . Additional modifications to meet the needs of low-income women are discussed In this study , we investigated the psychometric qualities of the Dutch version of the Maternal Antenatal Attachment Scale ( MAAS ) . In a monocentric prospect i ve observational cohort study , 403 expectant mothers completed a booklet with question naires in the first ( T1 ) , second ( T2 ) , and third ( T3 ) pregnancy trimesters . In addition to the MAAS ( T1-T3 ) , the following measures were used : the  Marlowe-Crowne Social Desirability Scale ( T1 ) , the  Parental Bonding Inventory ( T1 ) , the  Relationship Question naire ( T1 ) the Facilitator scale and the Regulator scale ( T3 ) , the  Edinburgh Postnatal Depression Scale  ( T1-T3 ) and the  Pregnancy Related Anxiety Question naire  ( T1-T3 ) . In this study , the mean of the MAAS scales increased as the pregnancy progressed . Good internal reliabilities were found for the Total MAAS scale , the Quality subscale and the Preoccupation subscale . Small-to-moderate correlations were found with social desirability , maternal orientation , parental care and adult attachment . Maternal mood was weakly associated with the quality but not with the intensity of the maternal attachment feelings . Overall , our findings suggest that the Dutch version of the Maternal Antenatal Attachment Scale is a reliable and valid measure of the early emotional tie between a pregnant woman and her unborn child OBJECTIVE To investigate the association between the magnitude of foetal movements and level of prenatal attachment within a 24h period among women in the third trimester of pregnancy . DESIGN a prospect i ve population -based survey . SET 
    Output:
    
Specifically , prenatal depressive symptoms were found to be negatively associated with prenatal attachment .
Furthermore , lower levels of prenatal attachment were related to higher postnatal depressive symptoms , although fewer studies assessed this association .