Resumen Introducción: El tabaquismo es un problema de salud pública. Existe una asociación entre el tabaquismo y el desarrollo de depresión perinatal. Objetivo: Estimar la prevalencia de la depresión prenatal y analizar los factores de riesgo que predicen el desarrollo de depresión prenatal en un grupo representativo de mujeres españolas gestantes fumadoras. Método: Se llevó a cabo un estudio transversal en una muestra de 1.524 de embarazadas en el primer trimestre de gestación. Se les administró el Cuestionario de salud del paciente (PHQ-9) y el Inventario revisado de predictores de depresión posparto (PDPI-R). Resultados: Se encontró una tasa de depresión antenatal en mujeres fumadoras del 25,6%. Se encontraron como predictores de depresión prenatal en fumadoras el estresor de enfermedad grave de un familiar y la falta de apoyo emocional de la pareja. Conclusiones: La falta de apoyo social y la carencia de estrategias adaptativas de afrontamiento del estrés es posible que hagan más proclive que la mujer continúe fumando en el embarazo y aumentan el riesgo de depresión perinatal.

Abstract Introduction: Smoking is a public health problem. There is an association between smoking and the development of perinatal depression. Objective: Estimate the prevalence of prenatal depression and analyze the risk factors that predict the development of prenatal depression in a representative group of Spanish pregnant women who smoke. Method: A cross-sectional study was carried out in a sample of 1,524 pregnant women in the first trimester of pregnancy. The Patient Health Questionnaire (PHQ-9) and the Revised Postpartum Depression Predictors Inventory (PDPI-R) were administered. Results: A rate of prenatal depression in smoking women was found to be 25.6%. The stressor of a serious illness in a family member and the lack of emotional support from the partner were found as predictors of prenatal depression in smokers. Conclusions: The lack of social support and the lack of adaptive strategies for coping with stress may make it more likely for women to continue smoking during pregnancy and increase the risk of perinatal depression.

ABSTRACT Background: Perinatal depression is a major public health problem, with an estimated prevalence of approximately 15% during the first postpartum year. Despite the high prevalence of postpartum depression, there is no consensus regarding assessment and treatment in the Spanish context. The General Council of Psychology of Spain convened a working group of experts in the field, including both academics and healthcare professionals, to review and propose recommendations based on evidence and best practices that could be applied in the Spanish context. Method: A literature search was completed in various databases (e.g., Medline, PsychInfo) including a combination of terms related to peripartum depression (PPD) assessment and diagnosis, prevention, treatment, and cost-effectiveness. A narrative synthesis of the literature has been conducted together with a critical overview of PPD with a special focus on the Spanish context. Results: In this consensus report, developing questions including prevalence and assessment tools, comparative effectiveness of preventive and treatment interventions, and cost-effectiveness of PPD management have been analyzed. Conclusions: The General Council of Psychology of Spain network advocates the establishment of compulsory screening protocols in all the autonomous regions. Also, it is necessary to promote the inclusion in maternal education of programs for the promotion of mental well-being and selective/indicated prevention carried out by a psychology professional with specialized training in the area. This consensus document also promotes the presence of a psychology professional with specialized training in the area.

RESUMEN Antecedentes. La depresión perinatal es un importante problema de salud pública, con una prevalencia estimada de aproximadamente el 15% durante el primer año posparto. A pesar de la gran prevalencia de depresión posparto (DPP), no existe consenso sobre la evaluación y el tratamiento en el contexto español. El Consejo General de Psicología de España convocó a un grupo de trabajo de expertos en la materia, tanto académicos como profesionales sanitarios, para revisar y proponer recomendaciones basadas en evidencias y mejores prácticas que puedan aplicarse en el contexto español. Método. Se realizó una búsqueda bibliográfica en varias bases de datos (p. ej., Medline, PsychInfo) que incluía una combinación de términos relacionados con la evaluación y el diagnóstico de la DPP, prevención, tratamiento y coste-eficacia. Se ha realizado una síntesis narrativa de la literatura junto con una visión crítica de la DPP con un enfoque especial en el contexto español. Resultados. Las preguntas de desarrollo que incluyen prevalencia y herramientas de evaluación, la eficacia comparativa de las intervenciones preventivas y de tratamiento y la relación coste-efectividad de la gestión de la PPD se han analizado en este informe de consenso. Conclusiones. La red del Consejo General de Psicología de España aboga por el establecimiento de protocolos obligatorios de cribado en todas las Comunidades Autónomas. Asimismo, es necesario promover la inclusión en la educación materna de programas de promoción del bienestar mental y la prevención selectiva indicada llevadas a cabo por un profesional de la psicología con formación especializada en el área.

Abstract Background: Pregnancy is a period when women are particularly vulnerable to suicidal ideation and a great opportunity for suicide risk prevention. Aims: This study aimed to establish a comprehensive understanding of suicidal ideation prevalence, risk factors, screening tools, consequences and management during pregnancy. Method: A literature search was performed in MEDLINE and PsycInfo databases from 2016 to 2021. A narrative synthesis of the literature and a critical overview of the current issues/questions to be addressed within the topic of suicidal ideation during pregnancy was performed. Results: The prevalence of suicidal ideation during pregnancy was between 2.73 and 18% internationally. The risk factors identified were major depressive disorder, anxiety disorder, difficulties with sleep, previous suicide attempts, high rumination, low incomes, being black, being young, low educational level, partner violence, having poor support, food insecurity, history of child abuse, high obstetric risk, multiparity, previous induced abortion and exposure to tobacco or human immunodeficiency virus diagnosis. The screening tools used for suicidal ideation during pregnancy were item 10 of the Edinburgh Postpartum Depression Scale and item 9 of the Patient Health Questionnaire. Results showed that suicidal ideation during pregnancy is associated with poor cognitive development in children and low birth weight. No case management studies on suicidal ideation were found. Limitations: The main limitation of the available studies was the lack of articles with a high degree of methodological rigour on this subject. Conclusions: This narrative review is a state-of-the-art paper about suicidal ideation during pregnancy. Further research is needed, and researchers should carry out systematic reviews and meta-analyses, leading to Clinical Practice Guidelines in this area. This effort would improve our evidence-based practice in Perinatal Psychology and prevent associated suicidal behaviour.