Rui-Hong Xue1. 1. International Peace Maternity and Child Health Hospital, School of Medicine, Shanghai Jiao Tong University, No.910 Hengshan Road, Shanghai, 200030, China. wfmcxrh@alumni.sjtu.edu.cn.
Dear Editor,We read with great interest the article by Avir Sarkar et al. entitled “The unheard parental cry of a stillbirth: fathers and mothers” [1]. The prospective cohort study concluded that the couples suffering stillbirths are at higher risk of depression, anxiety, and stress, and suggested that mental health screening should be highlighted, especially for the low-middle income countries. We would like to congratulate and thank for the authors for their excellent work, which has a significant clinical meaning. We would like to address some points that merit more attention.Maternal mental disorders are often overlooked by obstetricians in clinical practice. It had been reported that substantially high prevalence rates of mental disorders were observed during pregnancy which urgently warrant more awareness for validated screening and adequate treatment options [2]. What was worse, when adverse pregnant outcome happened, these conditions might get worse. Similarly with stillbirth, recurrent pregnancy loss patients are more likely to develop depression and anxiety than women with no history of pregnancy loss [3]. Conversely, maternal mental disorders were also associated with adverse birth outcomes, mainly with preterm births [4].During the COVID-19 epidemic, the level of depression of pregnant women was significantly higher than that before the epidemic [5]. We suggest that mental health screening should also be conducted in other adverse pregnancy outcomes, and we appeal for possible psychological interventions when indicated to avoid adverse events during the global pandemic.We congratulate the authors and appreciate the editor for publishing such an interesting article.