Perinatal Mental Health, Reproductive Behavior, Women, Cohort Studies
Conditions
Keywords
perinatal psychology, mental health, reproductive behavior, psychological trauma, PTSD, CB-PTSD, postpartum depression, pregnancy, sexual health, Ukraine, war-affected population
Brief summary
The goal of this observational study is to learn how war affects reproductive decisions and perinatal mental health in Ukrainian women. The main questions it aims to answer are: (1) how are wartime stress and trauma related to women's decisions about pregnancy and childbirth?; (2) what mental health symptoms and psychological difficulties are experienced during the perinatal period under wartime conditions? (3) which demographic, obstetric, and psychological factors are linked to poorer mental health and childbirth experiences? Researchers will survey at least 300 women. Participants will: (1) complete questionnaires about their mental health and psychological well-being; (2) answer questions about their reproductive choices, pregnancy, and/or childbirth experiences; (3) report on the impact of war, social support, maternal care, and postpartum trauma; (4) provide demographic and obstetric information. The findings will be used to develop an evidence-based model of the factors influencing reproductive behavior and perinatal mental health during war.
Interventions
DIAGNOSTIC_TESTPsychological Assessment
A participant-completed questionnaire administered to eligible women and, where applicable, to partners included in the supplementary dyadic component. Question flow will be adapted through programmed routing logic so that participants are presented only with items relevant to their reproductive stage and experiences.
DIAGNOSTIC_TESTRoutine Clinical Data Collection
Clinical data abstracted from routine medical records, including maternal, obstetric, fetal, delivery, and neonatal indicators relevant to the study. Data collection will be limited to information available in routine care and recorded only with participant consent.
Sponsors
Taras Shevchenko National University of Kyiv
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
Yes
Inclusion criteria
* able and willing to provide informed consent; * aged 18 years or older.
Exclusion criteria
* younger than 18 years; * unable to provide informed consent; * do not have sufficient language proficiency to complete the study procedures; * at the time of recruitment, they have an acute medical or psychological condition that would make participation unsafe, inappropriate, or unduly burdensome (e.g., obstetric emergencies, immediate postoperative or critical care status, or severe acute distress requiring urgent clinical care); * participation or the handling of personal data could reasonably pose a risk to the safety of the participant or their family.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| World Health Organization - Five Well-Being Index | Baseline, 3 months, 6 months, and 12 months after enrolment. | Subjective well-being will be measured using the World Health Organization-Five Well-Being Index (World Health Organization, 1998). The total score ranges from 0 to 100, with higher scores reflecting higher levels of well-being. A score of 50 or below will be used as the cut-off for clinically significant decrease in well-being, in accordance with Topp et al. (2015). This measure applies to all study cohorts. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Edinburgh Postnatal Depression Scale | Baseline, 3 months, 6 months, and 12 months after enrolment. | Depressive symptoms will be measured using the Edinburgh Postnatal Depression Scale (Cox et al., 1987). The total score ranges from 0 to 30, with higher scores reflecting greater severity of depressive symptoms. A score of 13 or above will be used as the cut-off for clinically significant depressive symptoms, in accordance with Cox et al. (1987) and Levis et al. (2020). This measure applies to pregnant and postpartum women. |
| The City Birth Trauma Scale | Baseline, 3 months, 6 months, and 12 months after enrolment, where applicable. | Childbirth-related post-traumatic stress symptoms will be measured using the City Birth Trauma Scale (Ayers et al., 2018). The symptom score ranges from 0 to 60, with higher scores reflecting greater severity of childbirth-related post-traumatic stress symptoms. A score of 29 or above will be used as the cut-off for clinically significant symptoms, in accordance with Osório et al. (2020). This measure applies to postpartum women. |
| The City Birth Trauma Scale (Partner version) | Baseline, 3 months, 6 months, and 12 months after enrolment, where applicable. | Childbirth-related post-traumatic stress symptoms among partners will be measured using the City Birth Trauma Scale, Partner Version (Webb et al., 2019). The symptom score ranges from 0 to 60, with higher scores reflecting greater severity of childbirth-related post-traumatic stress symptoms. No predefined cut-off score will be applied. This measure applies to participating partners. |
| The Birth Satisfaction Scale - Revised | Baseline, 3 months, 6 months, and 12 months after enrolment. | Satisfaction with the childbirth experience will be assessed using the Birth Satisfaction Scale - Revised (Martin \& Martin, 2014). The total score ranges from 0 to 40, with higher scores reflecting greater satisfaction with childbirth. No predefined cut-off score will be applied. This measure applies to postpartum women. |
| Desire to Avoid Pregnancy Scale | Baseline, 3 months, 6 months, and 12 months after enrolment. | Attitudes toward pregnancy avoidance will be measured using the Desire to Avoid Pregnancy Scale (Rocca et al., 2019). The total score ranges from 0 to 4, with higher scores reflecting a stronger desire to avoid pregnancy. A cut-point below 2 will be used for pregnancy prediction, in accordance with Hall et al. (2023). This measure applies to non-pregnant women. |
| London Measure of Unplanned Pregnancy | Baseline, 3 months, and 12 months after enrolment. | Pregnancy intention will be measured using the London Measure of Unplanned Pregnancy (Barrett et al., 2004). The total score ranges from 0 to 12, with higher scores reflecting greater pregnancy intention. No predefined cut-off score will be applied. This measure applies to pregnant and postpartum women. |
| Maternal and Partner Sex During Pregnancy Scales | Baseline, 3 months, 6 months, and 12 months after enrolment. | Pregnancy-related sexual attitudes will be measured using the Maternal and Partner Sex During Pregnancy Scales (Jawed-Wessel et al., 2016). The global attitude score ranges from 1 to 6, with higher scores reflecting more positive attitudes toward sex during pregnancy. No predefined cut-off score will be applied. This measure applies to pregnant women and their partners. |
| Motivations Against Sex Questionnaire | Baseline, 3 months, 6 months, and 12 months after enrolment. | Motivations for sexual avoidance will be measured using the Motivations Against Sex Questionnaire (Patrick et al., 2011). Subscale mean scores range from 1 to 5, with higher scores reflecting stronger endorsement of the respective motivation for not engaging in sexual behavior. No predefined cut-off score will be applied. This measure applies to all study cohorts. |
| Domestic Violence Myth Acceptance Scale | Baseline and 12 months after enrolment. | Attitudes toward domestic violence will be measured using the Domestic Violence Myth Acceptance Scale (Peters et al., 2008). The total mean score ranges from 1 to 7, with higher scores reflecting stronger endorsement of domestic violence myths. No predefined cut-off score will be applied. This measure applies to all study cohorts. |
| General Anxiety Disorder - 7 | Baseline, 3 months, 6 months, and 12 months after enrolment. | Anxiety symptoms will be measured using the Generalized Anxiety Disorder - 7 (Spitzer et al., 2006). The total score ranges from 0 to 21, with higher scores reflecting greater anxiety symptom severity. A score of 7 or above will be used as the cut-off for clinically significant anxiety symptoms in the perinatal population, according to Gong et al. (2021) and Zhong et al. (2015); a score of 10 or above will be used for partners (Spitzer et al., 2006). This measure applies to all study cohorts. |
| Impact of Events Scale - Revised | Baseline, 3 months, 6 months, and 12 months after enrolment. | Trauma-related distress will be measured using the Impact of Event Scale-Revised (Weiss \& Marmar, 1997). The total score ranges from 0 to 88, with higher scores reflecting greater severity of trauma-related symptoms. A score of 30 or above will be used to indicate a high probability of trauma-related disorder (Krupelnytska et al., 2025). This measure applies to all study cohorts. |
| Suicide Crisis Inventory - 2 Short Form | Baseline, 3 months, 6 months, and 12 months after enrolment. | Suicidal crisis symptoms will be measured using the Suicide Crisis Inventory - 2 Short Form (De Luca et al., 2024). The total score ranges from 0 to 36, with higher scores reflecting greater severity of suicide crisis syndrome. No predefined cut-off score will be applied. This measure applies to all study cohorts. |
| Adverse Childhood Experiences Questionnaire | Baseline, 3 months, 6 months, and 12 months after enrolment. | Exposure to childhood adversity will be measured using the Adverse Childhood Experiences Questionnaire (Felitti et al., 1998). The cumulative score ranges from 0 to 10, with higher scores reflecting exposure to a greater number of adverse childhood experiences before age 18. This measure applies to all study cohorts. |
Countries
Ukraine
Contacts
CONTACTNazar Yatsenko, MSc
Outcome results
None listed