Background: Social and emotional learning (SEL) is the process through which children acquire skills that support mental health, such as managing emotions and behaviours, and building positive relationships with others. Embedding SEL practices within early childhood education and care (ECEC) service routines presents an important opportunity to promote child mental health at the population level.
Aims: To explore ECEC staff’s perceptions of (1) opportunities to promote child SEL skills during mealtimes and playtimes within ECEC; and (2) enablers and barriers to implementing these practices.
Methods: We conducted four 90-minute online focus groups with educators and supervisors working across 22 ECEC services in New South Wales. Qualitative data on the opportunities to promote SEL skills were analysed using thematic analysis, and the enablers and barriers to implementing practices were mapped to the Theoretical Domains Framework (TDF). Themes and sub-themes were generated, and consensus among the team was reached for all coding and analysis decisions.
Results: Twenty-three female participants (17 classroom educators and six service managers) from urban and regional long daycare services participated, with 35% from culturally and/or linguistically diverse backgrounds. Participants described varied opportunities for children to understand and demonstrate positive SEL skills during both mealtimes and playtimes. Key themes are promoting prosocial skills in sharing plate activities and take-turning games, and regulating behaviours through mealtime expectations and game instructions. Factors influencing participants’ facilitation of these opportunities were mapped across six themes of the TDF, including the capacity to recognise opportunities, staff workload and competing priorities, child-educator relationships, available play-based learning materials and infrastructures, children’s engagement with recognised opportunities, and involvement of leadership and children’s families.
Conclusion: Findings highlighted the implementation experiences, barriers and enablers of ECEC staff, and identified opportunities at the individual, organisational and contextual levels to improve mealtime and playtime routines promoting SEL within everyday ECEC practice.

Abstract
Background: Depression remains a leading cause of global disability, with high rates of antidepressant nonresponse. Glucagon-like peptide-1 receptor agonists (GLP-1RAs) improve metabolic health and may influence mood and addictive behaviours, although existing evidence is inconsistent. We aimed to evaluate the associations between GLP-1RAs and depression severity, psychiatric service utilization, and suicidal outcomes, compared with initiators of SGLT-2 inhibitors, DPP-4 inhibitors, and non-initiators of these agents.

Methods: We used de-identified electronic health records from the NeuroBlu to synthesise a cohort of adults with type 2 diabetes (T2DM) and depression between Jan 2018, and Dec 2024, and were followed until May 2025. Inverse probability treatment weighting (IPTW) was used to balance treatment groups using predefined and high-dimensional covariates. IPTW-adjusted models were used to estimate the risk of each outcome.

Results: The cohort included 133,591 individuals (including 12,696 with bipolar depression) of whom, 24,552 were GLP-1RA initiators, 25,848 SGLT2i initiators, 19,094 DPP-4i initiators, and 64,097 non-initiators. Compared with non-initiators, DPP-4i inhibitors, and SGLT2i inhibitors initiators, GLP-1RA was associated with lower depression severity (risk ratio (RR), 0.80 [95% CI, 0.78–0.81]; 0.79 [95% CI, 0.77–0.81]; and 0.88 [95% CI, 0.85–0.90], respectively) and psychiatric hospitalization or ED presentation (RR, 0.60 [95% CI, 0.59–0.62]; 0.88 [95% CI, 0.85–0.90]; and 0.88 [95% CI, 0.85–0.90], respectively). Findings were consistent for separate analysis of GLP-1 agents, semaglutide and tirzepatide and across unipolar and bipolar depression. No significant associations were observed for suicidal events and length of hospitalization.

Conclusions: GLP-1RA initiation was associated with reduced depressive symptom severity, as well as lower rates of psychiatric service use, without evidence of increased risk for suicidal events. These findings suggest a potential antidepressant effect of GLP-1RAs, which may inform antihyperglycemic choice in individuals with T2DM and depression, and warrant confirmation in large-scale randomized clinical trial.

Background
Mental disorders and cardiovascular diseases are the major global burden of diseases, and chronic stress has been recognised as one of the risk factors. This study examined the effects of Transcendental Meditation (TM), a stress-reduction technique, on mental and cardiometabolic health outcomes, and stress-related physiological markers in working adults.

Methods
A two-arm open-level randomised controlled trial (RCT) was conducted among staff at an Australian university, comparing TM (n = 65) with a control (usual wellbeing resources, n = 64). The primary outcome of the study was the change in perceived stress over six months. Secondary outcomes included burnout, anxiety and depression symptoms, wellbeing, work-impairment, blood pressure (BP), glucose metabolism (fasting blood glucose, insulin resistance), lipid profile, cardiometabolic composite score, C-reactive protein and cortisol, autonomic regulation, and quality of life (QoL). Exploratory analyses examined heart rate variability (HRV), diurnal cortisol slope, and insulin resistance for potential effect modification by burnout, gender, and metabolic risk, respectively. Primary analyses followed intention-to-treat; exploratory analyses used complete cases.

Results
TM significantly improved perceived stress, symptoms of burnout, anxiety, and depression, well-being, QoL, diastolic BP, and cardiometabolic composite score (all p<0.05). Other cardiometabolic outcomes and stress-related physiology were not improved (all p>0.05). There was a significant intervention x burnout interaction (p=0.032), with greater improvement in HRV among participants with higher burnout. TM shows a trend toward a steeper diurnal cortisol slope among men (p=0.023) and improved insulin resistance among participants with higher metabolic risk (p=0.029). A dose-response relationship was observed for perceived stress, QoL, well-being, depression, and burnout (p < 0.05) with twice-daily TM practice.

Conclusion
TM can improve the mental and cardiometabolic health of working adults. The TM may alter autonomic and neuroendocrine markers of stress regulation, with greater responsiveness among individuals with higher psychological or metabolic risk.
Keywords: Meditation, Sympathetic Arousal, Homeostatic Model Assessment (HOMA), Cardiometabolic Health (CMH)

 
Abstract
Background: Depression, hypertensive disorders of pregnancy (HDP), and gestational diabetes mellitus (GDM) are common pregnancy complications that often co-occur, but their combined effects remain underexplored. In this study, we aimed to assess the joint impact of antenatal depressive symptoms comorbid with either HDP or GDM on adverse birth outcomes.
Methods: In this population-based retrospective cohort study, we analysed 149,025 mother–child pairs in Queensland, Australia. Eligible participants were all women who gave birth between July 2015 and December 2021 and had recorded scores on the Edinburgh Postnatal Depression Scale (EPDS). Logistic regression models estimated adjusted odds ratios (AORs) for adverse outcomes, including preterm birth, low birthweight (LBW), neonatal resuscitation, congenital anomalies, low Apgar scores, and admission to intensive or special care nurseries (ICN/SCN), associated with prenatal depressive symptoms alone or in combination with HDP or GDM. We also assessed potential interaction effects.
Results: Depression, HDP, and GDM were each independently associated with increased risks of adverse birth outcomes. Risks were greatest when depression co-occurred with either HDP or GDM. Depression with HDP was strongly associated with preterm birth (AOR 3·08, 95% CI 2·70–3·53), LBW (AOR 3·05, 95% CI 2·62–3·53), neonatal resuscitation (AOR 1·55, 95% CI 1·40–1·73), congenital anomalies (AOR 1·24, 95% CI 1·05–1·46), low Apgar score (AOR 1·80, 95% CI 1·41–2·28), and ICN/SCN admission (AOR 1·85, 95% CI 1·67–2·06), with risks consistently exceeding those for either condition alone. Similarly, depression with GDM was associated with increased risks of preterm birth (AOR 2·60, 95% CI 2·27–2·98), LBW (AOR 2·44, 95% CI 2·10–2·83), neonatal resuscitation (AOR 1·51, 95% CI 1·36–1·68), congenital anomalies (AOR 1·28, 95% CI 1·09–1·51), low Apgar score (AOR 1·64, 95% CI 1·29–2·08), and ICN/SCN admission (AOR 1·94, 95% CI 1·75–2·16).
Conclusions: Antenatal depression comorbid with HDP or GDM is associated with an increased risk of adverse birth outcomes, exceeding the independent additive effects of each condition, underscoring the need for integrated care. Incorporating mental health into routine obstetric practice and evaluating targeted interventions for high-risk women remain key priorities.
Keywords: Depression, Diabetes, Hypertension, Comorbidity, Neonatal Outcomes

Introduction:
Transitioning from military to civilian life can be challenging for veterans, who may experience a loss of a sense identity and structure as conferred by military life, fragmentation of social networks, detachment disconnection from civilian society and employment and financial stressors. Key intervention priorities to improve military veterans’ long-term mental and physical health and wellbeing include promoting physical activity and reducing social isolation. parkrun is a free, weekly, timed, community-based 5km walk/run event. Our qualitative study explored parkrun engagement experiences and perceived impacts among veterans and non-veterans attending a parkrun in an area with a high veteran population.
Methods:
We conducted semi-structured interviews with 16 (10 veteran; 6 non-veteran) participants (including volunteers, runners and walkers). We used an interpretivist approach and generated two themes that help explain the value and impact of the selected parkrun and parkrun more broadly.
Results:
The first theme “Aligned but distinct from military” (with two subthemes “Health, teamwork and purpose” and “Casual, self-directed and equalizing”) illustrates how parkrun affords some of the positive aspects of being in the military such as structure, physical challenge and a unifying identity, but without commitment, obligation or performance pressure. A second theme “Implicit, unconditional support” conveys the tacit and passive support parkrun affords to veterans’ well-being through broadening social connection, camaraderie and knowledge sharing. Importantly though, neither the appeal nor value of parkrun is contingent on military affiliation.
Discussion:
The features of parkrun attractive to veterans and non-veterans are the same, but the value for veterans is both as echoing military life (structure, physical challenge, team work) but also being different to it. Our findings suggest that a non-targeted and highly replicable service model, when locally driven, can successfully engage veterans and enhance their social connection and well-being.

We know young people will encounter mental health challenges, drugs, and alcohol, so why don’t we prepare them for when they do, with their mental health at the centre? Party Ready is a preventative education approach that reframes drug, alcohol and mental health education as a resilience and preparedness issue, supporting wellbeing and positive mental health alongside safer decision-making.

Rather than relying on fear-based or abstinence-focused messaging, Party Ready equips young people with practical skills to navigate real-world social environments. Grounded in community education practice, youth engagement, and harm reduction evidence, the model focuses on 3 core elements: (1) scenario-based learning in real contexts such as parties, festivals, and peer settings; (2) building resilience and preparedness for high-pressure and uncertain situations; and (3) strengthening wellbeing and positive mental health through practical, skills-based strategies.

Mental health is embedded throughout, recognising its role in decision-making, social connection, and risk. Participants build confidence in setting boundaries, recognising and responding to peers, supporting others, and seeking help when needed. This shifts the focus from simply knowing the risks to feeling capable and prepared to respond.

In school and community-based delivery, Party Ready has demonstrated strong engagement, particularly where young people see themselves reflected in the scenarios and discussions. Feedback highlights increased confidence, relevance, and willingness to engage compared to traditional approaches.

Through a fast-paced, scenario-driven demonstration, this presentation will show how Party Ready translates into practice and how it can be adapted across education and community settings.

This is a call to reframe preventative drug and alcohol education as well as mental health first aid for teenagers.
Not if, but when young people encounter these challenges, they deserve preparation that strengthens their resilience, supports their wellbeing, and meets them where they are.

Abstract
Introduction: Paracetamol (acetaminophen) is one of the most widely available over the counter analgesics globally. While safe at therapeutic doses, overdose can cause severe hepatotoxicity and acute liver failure. Its accessibility and perceived safety make it a common agent in intentional self poisoning, particularly among adolescents and young adults. In early 2025, a tertiary government hospital in the Philippines noted an increase in paracetamol intoxication cases, underscoring the intersection of medication access, youth mental health vulnerabilities, and socio cultural stressors in urban settings. This study aimed to describe the epidemiologic and psychosocial characteristics of paracetamol intoxication cases and identify trauma informed, culturally responsive upstream prevention opportunities that strengthen resilience and reduce economic burden.
Methods: A descriptive retrospective review of emergency and laboratory records from January to June 2025 was conducted. Cases included individuals reporting ingestion of ≥10,000 mg or with serum paracetamol levels >200 mg/L at consultation. Demographic, clinical, and psychosocial data were analyzed using descriptive statistics.
Results: Sixteen cases were identified, with the highest frequency in January (n=5). Patients were predominantly female (88%), aged 12–31 years (median 20). Reported ingested doses ranged from 4,000–23,000 mg. Common triggers included romantic conflicts, family disputes, and academic stress. Most patients resided in urban areas within the National Capital Region. All survived following medical management, with no progression to acute liver failure.
The findings highlight the psychosocial drivers of overdose and the resilience challenges faced by Filipino youth. Emergency care successfully prevented fatalities, but the reliance on acute interventions reflects a reactive system with significant economic implications. Each case required costly laboratory monitoring, antidote administration, and extended observation, straining limited public hospital resources. Preventable overdoses thus represent both a public health and economic burden. Upstream prevention—through school based mental health programs, family engagement, psychosocial screening, and strengthened regulation of over the counter medication access—offers a cost effective alternative. Trauma informed, culturally responsive interventions can reduce recurrence, enhance societal resilience, and alleviate the financial strain on health systems. Integrating mental health preparedness into broader One Health resilience frameworks ensures that non communicable crises, such as self poisoning, are addressed alongside infectious threats.
Conclusion: Paracetamol intoxication among young Filipinos is closely linked to socio cultural stressors and highlights gaps in resilience and preparedness. Strengthening upstream prevention through youth centered mental health initiatives and regulatory measures not only protects vulnerable populations but also reduces the economic burden of emergency care. Embedding these strategies within integrated preparedness and resilience frameworks advances sustainable health systems capable of responding to both communicable and non communicable crises.

Background: Presentations of young people to Emergency Departments for acute mental health (MH) issues have increased globally and in Australia. The Safeguards Teams Program (STP) was implemented to provide acute, rapid response, recovery-focused, trauma-informed brief intervention. This study aims to explore clinicians’ perspectives and experiences in implementing the STP, including barriers, facilitators, and suggestions for program improvement. Methods: This study used a qualitative approach by employing in-depth interviews. The interview transcripts were coded and analysed thematically. Results: The key study themes included perceived barriers to implementation, program enablers, and suggestions for improvement. Enablers of successful implementation included structures that supported staff buy-in and service accessibility, a centralised and flexible referral model that facilitated timely care, and opportunities for staff capacity building and collaboration. Additionally, findings highlighted that the STP model of care (MoC) effectively met essential service needs, reinforcing its value in the MH system. Perceived barriers included high demand leading to increased workload and challenges associated with the MoC in its early stages of implementation. Suggestions for program improvement emphasised the need for greater contextualised services through co-design, a more flexible MoC as part of STP service delivery, and a structured and formalised referral process. Participants also recommended including staff with specific skills and cultural awareness, enhancing community awareness, and strengthening integration efforts. Discussion/Conclusions: STP meets a gap in the service system for those who need rapid outreach specialist MH crisis response, with ED attendance and hospitalisation potentially prevented via early and timely assessment and support.

Introduction
Aboriginal Community Controlled Health Services (ACCHS) deliver holistic, culturally safe primary care and are associated with improved health outcomes and positive experiences for Aboriginal and Torres Strait Islander people. Despite these strengths, ACCHSs face challenges recruiting and retaining healthcare workers (HCW). The HCWs experience high levels of distress and burnout; for Aboriginal and Torres Strait Islander HCWs this is compounded by cultural and community responsibilities. The current study aims to: (1) identify social and emotional wellbeing (SEWB) support needs of HCWs in ACCHSs, and (2) co-develop a culturally responsive SEWB support framework and implementation plan, in partnership with ACCHSs, guided by HCW experiences.

Method
Clinical and non‑clinical HCWs from two partner ACCHSs will participate in Yarning Circles or one‑on‑one Yarns to identify SEWB support needs and factors influencing help‑seeking. These findings will inform the co‑development of a SEWB support framework and contextualisation guide, with Yarning also used to engage HCWs and organisational leaders in refining and contextualising the framework. A Local Implementation Plan will then be collaboratively developed. All qualitative data will be analysed in partnership with Aboriginal researchers.

Results
Preliminary data collection has been completed, with Yarning sessions conducted with 35 HCWs across partner ACCHSs. Data analysis is currently underway; the results will describe HCWs’ SEWB support needs and the co‑designed SEWB framework developed with ACCHS HCWs and leadership. The complete findings, including co-design process will be presented at the conference.

Implications
The study will generate evidence for a scalable, culturally informed SEWB support framework tailored to the professional and cultural contexts of ACCHS HCWs, with potential to reduce burnout, distress, and workforce turnover. It aligns with national health‑workforce priorities and will provide the first empirical evidence on the SEWB support needs of non‑Indigenous health workers within ACCHSs.

Deaf mental health has historically been neglected in public health research and service design globally. Recent work has documented widespread experiences of exclusion, stigma, limited opportunities to express emotions, and a lack of accessible mental health support among Deaf communities in Bangladesh, alongside the co-development of the first digitally delivered Bangla Mental Health Sign Language Bank. Building on this foundational work, the present study adopted a co-design approach to collaboratively develop accessible digital mental health resources with sign language users. Across five co-design stages and multiple workshops, the study engaged a total of 28 Deaf participants (16 male, 12 female), seven caregivers (2 male, 5 female), eight mental health professionals (5 male, 3 female), and three sign language interpreters (1 male, 2 female). Stage 1 comprised two exploratory workshops focused on identifying user needs, accessibility requirements, and priority mental health topics with Deaf participants and caregivers. Stage 2 involved collaborative co-creation sessions in which Deaf participants, and mental health professionals developed initial digital prototypes with interpreter support. Stage 3 workshop centred on community review, with Deaf participants and caregivers providing structured feedback on the prototypes. Stage 4 re-engaged co-design participants from Stage 2 to refine and expand the prototypes based on earlier feedback. Stage 5 evaluated the finalised digital mental health tools through community feedback involving Deaf users, caregivers, mental health professionals, and disability-sector stakeholders. This iterative co-design process resulted in a suite of inclusive digital mental health resources, including sign language–based videos (n=5) and accessible e-flyers (n=5 packs), designed to support foundational mental health literacy among Deaf individuals in Bangladesh. The study demonstrates the value of designing ‘with’, rather than ‘for’, sign language users and offers transferable insights for developing equitable digital mental health interventions to address mental health people with Deafness in similar low-resource settings.

Background: Aboriginal families in Australia face health and wellbeing disparities driven by systemic inequity. Community-led programs have shown promise in promoting health and wellbeing, yet evaluations centering Aboriginal community's voices remain limited. The Ngala Nanga Mai (NNM) PARenTing Program is a weekly, three-hour community-based program for caregivers and preschool children held at the La Perouse Aboriginal Community Health Centre and run by the Sydney Children's Hospitals Network. Art is central to the program, alongside informal conversation and childcare. It also runs alongside a community paediatrics clinic, with embedded health education and professionals regularly providing health promotion to program participants.

Methods: This study aimed to evaluate caregiver perceptions of the NNM Program, exploring facilitators, barriers, and perceived wellbeing outcomes. Yarning (Indigenous Methodology) was conducted with 13 carergivers (both Aboriginal and non-Aboriginal) between October and December 2025. All participants had Aboriginal children. The project was overseen by a local Aboriginal Governance Group (AGG) from beginning to end. Transcripts were coded in NVivo and analysed using Braun and Clarke's thematic analysis framework.

Results: Six themes were identified: 1) culturally safe and inclusive environment; 2) social connection and trust; 3) health and wellbeing outcomes; 4) accessibility and program design; 5) social barriers to engagement; and 6) access to opportunities. Participants described improvements in health, reduced isolation, and increased confidence and trust in the medical system. Key barriers included shame, interpersonal tensions, and age-based eligibility criteria disrupting continuity of care.

Implications: Findings underscore the need for sustained funding of holistic and community-led programs, infrastructure investment and revised eligibility criteria to better reflect the ongoing needs and continuity of care for Aboriginal children and their families.

------------------------------
Aboriginal Governance: This study was guided by Aboriginal governance structures to ensure that data sovereignty principles were upheld and that all research processes were culturally appropriate. Aboriginal leadership was embedded throughout the project, as the first author (BW) and co-authors SW and LR are Aboriginal people. LR, an Aboriginal Elder and the founder of the program, provided cultural guidance and oversight throughout the study.

The project was also guided by an Aboriginal Governance Group, which provided strategic oversight and ensured that the research remained aligned with Aboriginal priorities, values, and ways of knowing. The Governance Group contributed to key decisions regarding study design, implementation, interpretation of findings, and dissemination of results.

Aboriginal researchers and governance group members guided all decisions. Findings were also reviewed through an Aboriginal lens to ensure that results were contextualised appropriately, reflected community strengths, and avoided deficit-based narratives.

The study was conducted in accordance with principles of respect, reciprocity, responsibility, and self-determination. Aboriginal leadership throughout the research process helped ensure that the project was culturally safe, community-informed, and responsive to Aboriginal perspectives. These governance arrangements supported meaningful Aboriginal involvement in the generation and interpretation of knowledge and ultimately strengthens the relevance of the research for Aboriginal communities.

Background: Racism is a recognised social determinant of poorer mental health among Indigenous children and adolescents, yet the mechanisms underlying this relationship remain poorly understood. This study examined whether school bullying mediates the longitudinal association between family racism and later mental health outcomes among Aboriginal and Torres Strait Islander adolescents.

Methods: Data were drawn from three waves of the Longitudinal Study of Indigenous Children (LSIC; Waves 11, 12, and 14), comprising 694 Indigenous adolescents. Family racism was measured at Wave 11, school bullying at Wave 12, and behavioural or psychological conditions at Wave 14. Lagged logistic regression and causal mediation analyses were conducted adjusting for relevant covariates.

Results: Overall, 43.8% of participants reported exposure to family racism at Wave 11, 33.0% experienced school bullying at Wave 12, and 10.2% reported a behavioural or psychological condition at Wave 14. In adjusted lagged logistic regression models, school bullying was strongly associated with later mental health conditions (AOR=3.28, 95% CI: 1.98–5.53, p<0.001). Mediation analysis identified a significant indirect effect through bullying (ACME=0.015, 95% CI: 0.001–0.025, p=0.034), with approximately 28.8% of the association operating through school bullying.

Conclusions: School bullying may represent an important psychosocial pathway linking family racism to later mental health outcomes among Indigenous adolescents. These findings highlight the interconnected impacts of racism, bullying, and mental health, and support the need for culturally safe anti-racism and anti-bullying strategies within schools and communities to strengthen Indigenous adolescent wellbeing.

This study used data from the Longitudinal Study of Indigenous Children (LSIC), a national study developed and conducted with strong Aboriginal and Torres Strait Islander leadership and governance. LSIC is guided by Indigenous data sovereignty principles, including community engagement, cultural respect, and Indigenous oversight throughout data collection and management processes. The present research was conducted using ethically approved LSIC data and aimed to ensure culturally respectful interpretation and reporting of findings related to Indigenous adolescent wellbeing. Findings are presented to support evidence-informed public health strategies aimed at improving mental health outcomes among Aboriginal and Torres Strait Islander young people.

Abstract
Background: Antenatal depressive symptoms commonly co-occur with hypertensive disorders of pregnancy and gestational diabetes mellitus (GDM). While each condition has been independently associated with adverse maternal outcomes, the extent to which their co-occurrence increases the risk of early postpartum psychiatric and physical morbidity requiring hospital readmission remains unclear. This study examined the associations between antenatal depressive symptoms, alone and in combination with HDP and/or GDM, and early postpartum readmissions.
Methods: We analysed population-based linked administrative health data from 149,025 mother–offspring pairs in Queensland, Australia. The cohort included all women who gave birth between July 2015 and December 2021 and had recorded Edinburgh Postnatal Depression Scale (EPDS) scores assessing antenatal depressive symptoms. HDP and GDM were identified using ICD-10-AM codes. Logistic regression models were used to estimate adjusted odds ratios (AORs) for postpartum psychiatric and physical readmissions. Mediation analyses examined the contribution of adverse birth outcomes, and interaction analyses assessed the robustness of combined exposure effects.
Results: Antenatal depressive symptoms were independently associated with markedly increased risks of postpartum psychiatric (AOR 3.07, 95% CI 2.81–3.36) and physical readmission (AOR 3.09, 95% CI 2.85–3.35). In contrast, HDP alone was not associated with either outcome, while GDM alone was modestly associated with psychiatric readmission (AOR 1.15, 95% CI 1.03–1.28). Comorbid antenatal depressive symptoms with HDP or GDM were associated with substantially higher risks of both psychiatric and physical readmission than pregnancy complications alone. Depression co-occurring with HDP was associated with increased odds of psychiatric (AOR 3.17, 95% CI 2.49–4.04) and physical readmission (AOR 3.17, 95% CI 2.56–3.91), while depression co-occurring with GDM was associated with elevated risks of psychiatric (AOR 3.45, 95% CI 2.92–4.07) and physical readmission (AOR 2.53, 95% CI 2.18–2.95). Mediation analyses indicated that these associations were largely driven by direct effects, with adverse birth outcomes accounting for up to 9% of the total effect.
Conclusions: Antenatal depressive symptoms, particularly when co-occurring with gestational diabetes or hypertensive disorders of pregnancy, are associated with a markedly increased risk of early postpartum psychiatric and physical readmission beyond the independent effects of each condition. These associations are largely driven by direct pathways, with adverse birth outcomes contributing only a modest mediating effect. The findings underscore the need for integrated antenatal care that combines routine mental health screening with surveillance for pregnancy complications, as well as targeted, risk-stratified postpartum follow-up to reduce preventable readmission.
Keywords: Depression, Diabetes, Hypertension, Comorbidity, Postpartum readmission