Prenatal vitamin D deficiency is widely reported and may affect perinatal outcomes. In this secondary analysis of the UK Pregnancies Better Eating and Activity Trial, we examined vitamin D status and its relationship with selected pregnancy outcomes in women with obesity (BMI ≥ 30 kg/m2) from multi-ethnic inner-city settings in the UK. Determinants of vitamin D status at a mean of 17 ± 1 weeks’ gestation were assessed using multivariable linear regression and reported as percent differences in serum 25-hydroxyvitamin D (25(OH)D). Associations between 25(OH)D and clinical outcomes were examined using logistic regression. Among 1089 participants, 67 % had 25(OH)D < 50 nmol/l and 26 % had concentrations < 25 nmol/l. In fully adjusted models accounting for socio-demographic and anthropometric characteristics, 25(OH)D was lower among women of Black (% difference = −33; 95 % CI: −39, −27), Asian (% difference = −43; 95 % CI: −51, −35) and other non-White (% difference = −26; 95 % CI: −35, −14) ethnicity compared with women of White ethnicity (n 1086; P < 0·001 for all). In unadjusted analysis, risk of gestational diabetes was greater in women with 25(OH)D < 25 nmol/l compared with ≥ 50 nmol/l (OR = 1·58; 95 % CI: 1·09, 2·31), but the magnitude of effect estimates was attenuated in the multivariable model (OR = 1·33; 95 % CI: 0·88, 2·00). There were no associations between 25(OH)D and risk of preeclampsia, preterm birth or small for gestational age or large-for-gestational-age delivery. These findings demonstrate low 25(OH)D among pregnant women with obesity and highlight ethnic disparities in vitamin D status in the UK. However, evidence for a greater risk of adverse perinatal outcomes among women with vitamin D deficiency was limited.

Significant progress is being made in strengthening perinatal mental health support systems and in several related areas of women’s mental health. Mental health support for women and families during pregnancy and the first year after birth – the perinatal period – remains a priority in most parts of the world. Mental disorders are among the most common perinatal health problems, with over 25% of women in many scarce resource countries and 10% in wealthy countries experiencing a disorder. There is growing recognition of feasible and effective ways to reduce the harm to women and children and their families through societal as well as health system initiatives. Successful initiatives including training and support for health workers and cross-sectoral work to prevent violence in families are operating in a number of countries. The presentation will consider how psychiatrists and other mental health professionals can contribute to the spread, scope and sustainability of this work, and other related contributions to women’s mental health including the prevention of violence in the family.

To analyze the mediation effect of perinatal health on the association between prenatal depressive symptoms and postpartum depressive symptoms 180 women filled the Edinburgh Postnatal Depressive Scale (EPDS) at 35 weeks of gestation and two months after childbirth. Perinatal health data was collected during the first 4 days after childbirth, using the Optimality Index. 25.6% of the mothers-to-be presented clinically significant depressive symptoms, and of these, 80.4% still show clinically significant depressive symptoms at 2-months postpartum. Prenatal depressive symptoms predict higher postpartum depressive symptoms. Additionally, results also showed that the effect of prenatal depressive symptoms on postnatal depressive symptoms is not mediated by perinatal health. Mothers-to-be with prenatal depressive symptoms seem to be at risk for postnatal depression, even when perinatal health is not compromised. This highlights the importance of early screening of prenatal depressive symptoms in order to promote an early intervention on women’s mental health, leading to a better transition to parenthood and to a decrease of the burden of this public health problem on children and families.

Male twin gestations exhibit higher incidence of fetal morbidity and mortality than singleton gestations. From an evolutionary perspective, the relatively high rates of infant and child mortality among male twins born into threatening environments reduce the fitness of these gestations, making them more vulnerable to fetal loss. Women do not perceive choosing to spontaneously abort gestations although the outcome may result from estimates, made without awareness, of the risks of continuing a pregnancy. Here, we examine whether the non-conscious decisional biology of gestation can be linked to conscious risk aversion. We test this speculation by measuring the association between household surveys in Sweden that gauge financial risk aversion in the population and the frequency of twins among live male births. We used time-series regression methods to estimate our suspected associations and Box–Jenkins modeling to ensure that autocorrelation did not confound the estimation or reduce its efficiency. We found, consistent with theory, that financial risk aversion in the population correlates inversely with the odds of a twin among Swedish males born two months later. The odds of a twin among males fell by approximately 3.5% two months after unexpectedly great risk aversion in the population. This work implies that shocks that affect population risk aversion carry implications for fetal loss in vulnerable twin pregnancies.