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Maternal depressive symptoms could start in early pregnancy, study finds

Maternal depression can negatively affect a child’s nutrition, physical health, cognitive functions and socioemotional development

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Maternal depressive symptoms could begin from early pregnancy and last up to two years after childbirth, a large-scale international study has shown.

While health professionals often emphasise the postpartum stage after childbirth as a high-risk period for the onset of depression, this latest research has found that maternal depressive symptoms can appear from early pregnancy.

The study, led by researchers from A*STAR’s Translational Neuroscience Programme of the Singapore Institute for Clinical Sciences (SICS) in Singapore, involved seven prospective observational cohorts across the UK, Canada and Singapore.

The researchers analysed the maternal depressive symptom trajectories of 11,563 pregnant women, spanning multiple decades in the largest such analysis to date. Each cohort included depressive symptoms measured at multiple perinatal time points and analysed independently.

The data was based on prospective maternal self-reports of depressive symptoms, eliminating the potential bias collected from retrospective reports.

The study showed three distinct clusters of mothers with stable low, mild, and high symptom levels over the perinatal period – the period from the beginning of pregnancy up to two years post-birth. The trajectories of depressive symptoms were present for all mothers.

This was true even in the case of those who met clinical cut-offs for probable depression indicating that more serious instances of depression in women begin prior to the birth of the child.

“Several recent studies, including one conducted locally suggest that maternal depressive symptoms may begin before conception, which is why interventions, guidelines for care, and public health policies aimed at alleviating maternal depressive symptoms should target as early as preconception, at least during pregnancy, in addition to the postnatal period, for more effective outcomes,” explained Dr Michelle Kee, research scientist at A*STAR’s SICS and first author of the paper.

Professor Michael Meaney, the director of the translational neuroscience programme at SICS, said: “The medical media continues to refer to maternal depression as ‘postnatal depression’, implying that the onset of symptoms occurs following the birth of the child.

“This extensive analysis shows that the onset of symptoms is in the prenatal period and remains largely stable thereafter. This is true for women in the community as well as for those experiencing more severe symptom levels.”

He added: “The results of this study point to the early antenatal period as a crucial time point for the identification of stable trajectories of maternal depressive symptoms and emphasises the critical importance of prenatal intervention.”

Associate Professor Helen Chen, senior consultant, department of psychological medicine at the KK Women’s and Children’s Hospital, said: “This study provides strong evidence across populations that it is crucial to address depression during pregnancy so that mothers are well and ready to receive their babies, rather than to wait until the postnatal period, for postnatal depression has traditionally been the focus.

“Given what we know about the impact of perinatal depression on child development and health outcomes, the paper will help to inform healthcare systems to direct resources upstream to the antenatal period.

“This will benefit our mothers and their children, and population health of future generations.”

Previous findings from the Growing Up in Singapore Towards healthy Outcomes (GUSTO) project showed that prenatal maternal mental health plays a significant role in the brain development and health of babies.

Research found that maternal depressive symptoms can negatively affect a child’s nutrition, physical health, cognitive functions, socioemotional development and academic achievement, in some cases increasing the risk of ADHD and depression.

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Apricity Fertility launches new Freeze and Share programme

The Freeze and Share programme offers a solution for women who wish to preserve their fertility

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In response to the growing demand for affordable fertility options and the pressing need for egg donors, the UK virtual fertility clinic Apricity has launched an innovative Freeze and Share programme.

The initiative is designed to make egg freezing more accessible and cost-effective while simultaneously addressing the shortage of donor eggs in the UK.

In recent years, there has been a significant increase in the number of women choosing to freeze their eggs. According to the Human Fertilisation and Embryology Authority (HFEA), the number of egg freezing cycles in the UK has surged by 81 per cent to 2022. Despite this growing trend, the high costs associated with the procedure—typically upwards of £5000—have made it unaffordable for many.

The Freeze and Share programme offers a solution for women who wish to preserve their fertility; by opting to share their eggs, they can substantially reduce the cost of egg freezing.

This act not only makes the procedure more affordable but also provides much longer for donor eggs for those that need them.

Addressing the egg donor shortage

The UK faces a shortage of egg donors, with many patients experiencing long waiting times for a donor. Current statistics reveal that one in six IVF cycles are donation cycles in the UK, yet demand far outstrips supply.

Prospective parents can wait up to two years to find a suitable donor, and for many they decide to travel abroad to places like Spain and Cyprus. This brings different considerations for patients as egg donation in other countries is regulated differently to the UK, with most egg donation being completely anonymous. 

Apricity’s new programme directly addresses this gap by encouraging egg sharing. Participants in the Freeze and Share programme can donate a portion of their eggs to be used by individuals or couples in need, thereby reducing waiting times and helping more people achieve their dreams of parenthood.

“We are incredibly proud to launch our Freeze and Share Programme, which represents a significant advancement in our fertility services,” said Mel Chacksfield, CEO of Apricity Fertility.

“This new service will not only make egg freezing more accessible and affordable to the many women who may not usually have the chance to preserve their fertility, but will also mean we can better support our families and parents that rely on donor eggs to start their families.

“Our commitment to providing personalised care through innovation in the sector continues to drive us forward, ensuring we meet the evolving needs of all our patients”

To be eligible for egg sharing, women will need to meet specific criteria such as BMI, age and ovarian reserve. They will have unlimited counselling throughout the process to ensure they are fully informed and supported from the start.

Women who choose to participate in the Freeze and Share programme will then undergo the standard egg freezing process. A portion of the retrieved eggs will be frozen for their personal use, while the remaining eggs will be donated to Apricity’s frozen egg donor bank.

This mutually beneficial arrangement ensures that participants receive significant financial relief while offering a lifeline to those in need of donor eggs.

For more information on Freeze & Share visit Apricity’s website 

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Endometriosis needs to be taken as seriously as diabetes, says report

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A new report, which called for “urgent” changes in endometriosis care, has said the condition should be taken as seriously as diabetes.

The National Confidential Enquiry into Patient Outcome and Death (NCEPOD) report examined the long-standing issues faced by women with endometriosis in the UK.

The study stated that endometriosis should be treated as a chronic condition and taken as seriously as illnesses such as diabetes and bowel disease.

Currently, endometriosis symptoms are treated as multiple isolated episodes, with symptoms often going unrecognised by healthcare practitioners as potentially being endometriosis.

The report recommended that training for healthcare professionals should be improved to recognise the symptoms of endometriosis and that patients should be asked about how the condition affects them beyond just the physical symptoms.

Professor Andrew Horne, director of the University of Edinburgh’s Centre for Reproductive Health, said: “Endometriosis is frequently treated as a series of acute episodes rather than as a continuous, chronic condition. This fragmented care model overlooks the necessity for ongoing, comprehensive management, which is crucial.

“The NCEPOD report recognises the gaps in our current approach and provides important actionable guidance to drive improvements in endometriosis care.”

Emma Cox, CEO of Endometriosis UK, said: “NCEPOD’s report clearly evidences the issues faced today by those with endometriosis, and the recommendations show how improvements can – and must – be made. Implementing these will not only reduce suffering for those with endometriosis, it will also save the NHS time and resources.

“The report comes at a perfect time; we have a new government who have committed to no longer neglect women’s health, and to prioritise women’s health as the NHS is reformed.”

Dr Katy Vincent, associate professor in the Nuffield Department of Women’s and Reproductive Health, University of Oxford, added: “Endometriosis affects all areas of life and the information collected by this enquiry starkly illustrates the challenges that those with the condition experience.

“I am particularly pleased to see that the report highlights the need for holistic, multi-disciplinary care and for a pathway that takes into account the chronic nature of the disease, as these are areas that I have long considered need improvement.”

She continued: “I hope that those who contributed their experiences to the report feel they were heard and that clinicians and policy makers can now take these findings on board to urgently improve care for this common condition.”

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Daye launches workplace app to plug gaps in female healthcare support

The service helps promote health equity in the workplace by providing vital resources to support women’s health conditions

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The award-winning UK gynaecological health company Daye has launched its new workplace app, Daye for Work.

The app can be offered to employees across the UK as a workplace benefit, providing them with much-needed access to services that are often lacking from the NHS and even private healthcare companies.

Women face a widening gap in healthcare provision, with three-quarters saying they cannot access the services they need and 84 per cent reporting not being listened to by a healthcare professional.

Health issues can have a big impact on women’s careers, with three in five women saying a female health condition has affected them in the workplace.

However, support for women’s health is often lacking in the workplace. According to Benden Health, four in ten women have heard derogatory comments about a female employee’s health in the workplace.

As a result, 42 per cent of females admit that they are uncomfortable discussing health issues with their manager.

In addition, more than two thirds of female employees (70 per cent) have found it difficult to deal with periods at work and 64 per cent have faced challenges when experiencing menopause.

Offering support to employees struggling with female health conditions can help attract and retain staff, with 70 per cent of workers willing to change jobs for women’s health benefits.

Daye for Work provides an accessible and personalised service for women and assigned female at birth (AFAB) individuals.

Through the app, employees of businesses who sign up for Daye for Work can access Daye’s Menstrual Health Programme, which provides access to period pain support, plugging a major gap in healthcare provision as it can take years to diagnose conditions linked to menstrual health, such as endometriosis and adenomyosis.

Currently, menstrual pain support is also not offered by major private healthcare providers. Yet period pain can be so severe that nearly a quarter of women (23 per cent) have taken time off work for menstrual symptoms in the last six months, with nine days of productivity per woman lost every year, according to the British Medical Journal.

In monetary terms, women can lose tens of thousands during their careers as they are forced to take time off work.

Daye for Work also offers a Gynae Health Screening Programme, where users can access specialists for gynaecological-related health issues, such as recurrent vaginal infections, which is another service lacking through the NHS and private healthcare companies.

While users can access help from leading specialists through instant virtual appointments, Daye also offers at-home diagnostic tampon tests that can detect vaginal infections and STIs such as chlamydia and gonorrhoea, and soon they will also be able to detect HPV, which is the biggest cause of cervical cancer.

Users receive clear, actionable results via the platform and have prescriptions delivered to their homes.

Daye also offers educational support programmes, including workshops and webinars covering hot topics in female health, and HR policy and internal comms support. Employees signed up through their company get 20 per cent off products on the Daye website.

Valentina Milanova, founder and CEO of Daye, said: “Gaps in women’s health provision are impacting workplaces all over the UK. Female and AFAB staff are regularly forced to take time off while struggling to access much-needed support, advice and diagnosis, hitting workplace productivity and all too often being detrimental to women’s careers.

“Daye for Work will play a vital role in plugging the gaps in female healthcare, offering services that take years to access on the NHS and aren’t available from private healthcare providers.

“Offering such tailored support is transformational for workplace culture, making staff feel valued and understood, while also helping to attract and retain talent.”

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