A lifecourse approach to women's mental health: from fertility to perimenopause
A lifecourse approach to women's mental health: From fertility to perimenopause
Manuscript One
Anxiety and depression symptoms during pregnancy and postpartum among parous women with a history of infertility
Published in Fertility & Sterility. Abstracts were presented at the American Society for Reproductive Medicine (ASRM) Scientific Congress & Expo, New Orleans, Louisiana, October 14-18; The Revitalizing Women’s Healthcare Together, Institute of Restorative Reproductive Medicine of America and FACTS About Fertility, September 29-30, 2023, Minneapolis, Minnesota; and the 6th Annual Sigma Region 15 Nursing Research Conference, Chestnut Hill, MA, October 6, 2023. Results from the first aim of her grant is published in the high impact journal, Fertility & Sterility, and she has submitted two other manuscripts from her other two aims. Melissa’s most significant contribution to the science will be with her dissemination of her third aim, which was to examine associations of infertility with depressive symptoms across subsequent pregnancy, postpartum, and mid-life, and to examine the impact of experiencing both infertility and hardships on symptoms of depression. Using information from a longitudinal cohort of parous women in Project Viva, she found that infertility at index pregnancy was associated with greater depressive symptoms in midlife than in the postpartum period (adjusted 𝛽 1.86, 95% CI 0.06, 3.66). Yet, the experience of infertility was not associated with greater depressive symptomsin pregnancy or postpartum. The impact of experiencing both infertility and hardships, such as ever physical abuse, sexual abuse as a teen and ever history of sexual abuse, and financial hardship on depressive symptoms is greater than the impact of either infertility or above mentioned hardships alone. The study is novel in that it examined depressive symptoms among women with infertility at three distinct time points throughout the lifespan. These findings indicate the value in flagging a women’s past reproductive and obstetric history as she may beat increased risk for depressive symptoms in midlife. The scale of the work for this analysis was impressive, as women completed the Edinburgh Postnatal Depression Scale (EPDS) in mid-pregnancy (median 27.9 weeks’ gestation) and at 6 months postpartum and the Patient Health Questionnaire (PHQ-9) in midlife (2017-2021, 50.9 [5.1] years). To have a common measure, Melissa had to confer scores on both the EPDS and PHQ-9 to externally-standardized PROMIS T-scores. She then performed adjusted linear regression models across the three time points by infertility status (pregnancy/postpartum, postpartum/midlife, and pregnancy/midlife), as well as the interaction between infertility with hardships.
Manuscript Two
Associations of infertility with symptoms of anxiety and depression during midlife in Project Viva
Abstract presented at the Eastern Nursing Research Society, 36th Annual Scientific Session in Boston, MA on April 4, 2024
Manuscript Three
Associations of infertility with depressive symptoms across pregnancy, postpartum, and midlife
Abstract presented at the Eastern Nursing Research Society, 36th Annual Scientific Session in Boston, MA on April 5, 2024