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| ID | Type | Description | Link |
|---|---|---|---|
| 2025.07/0191 | Other Grant/Funding Number | The National Research Foundation of Ukraine |
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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.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Non-pregnant women | Women who are not pregnant at the time of enrollment and who either report an intention to become pregnant or report that they are not currently planning pregnancy. |
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| Pregnant women | Women with an ongoing pregnancy at the time of enrolment, regardless of gestational age. |
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| Postpartum women | Women who have given birth and are within 12 months postpartum at the time of enrolment. |
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| Partners | Partners of enrolled women who provide informed consent and participate in the study as a supplementary dyadic subgroup. |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Psychological Assessment | Diagnostic Test | 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. |
| Measure | Description | Time Frame |
|---|---|---|
| World Health Organization - Five Well-Being Index | 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. | Baseline, 3 months, 6 months, and 12 months after enrolment. |
| Measure | Description | Time Frame |
|---|---|---|
| Edinburgh Postnatal Depression Scale | 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. |
| Measure | Description | Time Frame |
|---|---|---|
| Assessment, Care, and Trust in Pregnant and New Mothers | Demographic, reproductive, background, and war-related information will be collected using the Assessment, Care, and Trust in Pregnant and New Mothers questionnaire, developed by RodrÃguez-Muñoz et al. (2023) for use in a Ukrainian sample. The questionnaire was adapted for use across all study cohorts, including partners and non-pregnant women. This measure is not scored as a scale; therefore, no minimum or maximum total score or better/worse score direction applies. Item-level data will be used to describe the sample and as potential covariates in further analyses. This measure applies to all study cohorts. |
Inclusion Criteria:
Exclusion Criteria:
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Women will be recruited in Ukraine from healthcare settings providing reproductive, gynecological, pregnancy-planning, antenatal, childbirth, and postpartum care. The source population includes women across the reproductive continuum, including those not currently planning pregnancy, those planning pregnancy, those with an ongoing pregnancy, and those within 12 months after childbirth. Where feasible, consenting partners of enrolled women will also be included.
| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Nazar Yatsenko, MSc | Contact | +380733700423 | nazaryatsenko@knu.ua |
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Taras Shevchenko National University of Kyiv | Kyiv | Ukraine |
De-identified individual participant data underlying the results reported in publications from this study will be made available. Shared data may include questionnaire-derived variables, selected longitudinal outcome measures, and other study variables contained in the final anonymized analytic dataset. Direct identifiers will not be shared. Variables that could create a meaningful risk of re-identification, including information used for follow-up administration or dyadic linkage, will be removed, aggregated, or otherwise protected before data sharing. Data shared with external researchers will be limited to the minimum necessary for the approved purpose and in accordance with applicable ethical, legal, and data protection requirements.
De-identified individual participant data and supporting documents will become available after publication of the primary study results and completion of data cleaning and de-identification procedures.
Data may be shared through an open repository for fully anonymised datasets.
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| Routine Clinical Data Collection | Diagnostic Test | 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. |
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| Baseline, 3 months, 6 months, and 12 months after enrolment. |
| The City Birth Trauma Scale | 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. | Baseline, 3 months, 6 months, and 12 months after enrolment, where applicable. |
| The City Birth Trauma Scale (Partner version) | 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. | Baseline, 3 months, 6 months, and 12 months after enrolment, where applicable. |
| The Birth Satisfaction Scale - Revised | 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. | Baseline, 3 months, 6 months, and 12 months after enrolment. |
| Desire to Avoid Pregnancy Scale | 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. | Baseline, 3 months, 6 months, and 12 months after enrolment. |
| London Measure of Unplanned Pregnancy | 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. | Baseline, 3 months, and 12 months after enrolment. |
| Maternal and Partner Sex During Pregnancy Scales | 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. | Baseline, 3 months, 6 months, and 12 months after enrolment. |
| Motivations Against Sex Questionnaire | 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. | Baseline, 3 months, 6 months, and 12 months after enrolment. |
| Domestic Violence Myth Acceptance Scale | 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. | Baseline and 12 months after enrolment. |
| General Anxiety Disorder - 7 | 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. | Baseline, 3 months, 6 months, and 12 months after enrolment. |
| Impact of Events Scale - Revised | 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. | Baseline, 3 months, 6 months, and 12 months after enrolment. |
| Suicide Crisis Inventory - 2 Short Form | 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. | Baseline, 3 months, 6 months, and 12 months after enrolment. |
| Adverse Childhood Experiences Questionnaire | 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. | Baseline, 3 months, 6 months, and 12 months after enrolment. |
| Baseline, 3 months, 6 months, and 12 months after enrolment. |
| ID | Term |
|---|---|
| D043762 | Reproductive Behavior |
| D000092862 | Psychological Well-Being |
| D000067073 | Psychological Trauma |
| D013313 | Stress Disorders, Post-Traumatic |
| D019052 | Depression, Postpartum |
| ID | Term |
|---|---|
| D001519 | Behavior |
| D010549 | Personal Satisfaction |
| D040921 | Stress Disorders, Traumatic |
| D000068099 | Trauma and Stressor Related Disorders |
| D001523 | Mental Disorders |
| D011644 | Puerperal Disorders |
| D011248 | Pregnancy Complications |
| D005261 | Female Urogenital Diseases and Pregnancy Complications |
| D000091642 | Urogenital Diseases |
| D003866 | Depressive Disorder |
| D019964 | Mood Disorders |
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