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Postpartum Mental Health

Perinatal mental health and reproductive behavior among women in wartime Ukraine: a cohort study protocol

Krupelnytska L, Yatsenko N, Molotokas A, Morozova-Larina O, Vavilova A, Baratiuk A, Kazakov S, Artyomenko V

Published July 6, 2026 Frontiers in psychiatry
DOI 10.3389/fpsyt.2026.1874060 PMID 42519206 PMC PMC13383117

RRM Academy Synopsis

Ukraine protocol plans to track war stress and women's well-being

A planned cohort will track mental health in at least 328 women in wartime Ukraine. The women come from reproductive and perinatal care in three groups: not pregnant, pregnant, or within a year after childbirth. Partners are also invited where feasible. The main test asks whether more war-related stressors go with less favorable well-being trajectories.

Key Findings

  • The protocol plans a prospective observational cohort of at least 328 women recruited through reproductive and perinatal care in Ukraine: non-pregnant, pregnant, and within 12 months after childbirth.
  • Participants will complete web-based questionnaires at baseline and at 3, 6 and 12 months. Routine clinical record data will be extracted where participants give specific consent and records are available.
  • The lead outcome is well-being on the WHO-5, a short World Health Organization questionnaire. The main test compares trajectories by the number of war-related stressor domains endorsed at baseline.
  • Secondary outcomes cover reproductive intentions, pregnancy planning and transitions in reproductive status. Partners may complete separate questionnaires, matched to the woman's by a self-generated code, for exploratory analyses.
  • The planned 328 women are expected to give adequate power for the WHO-5 analysis under main retention assumptions. Under conservative attrition, power is about 70%, and about 416 women would give 80%.

Interpretation

This study protocol describes a planned cohort that has not yet collected results. Women will join during routine reproductive and perinatal care in Ukraine. They will answer web-based surveys at the start and again at 3, 6 and 12 months. No treatment is given. The surveys will be translated and tested before the main study begins. The finished study will show how wartime stress relates to well-being in women and partners getting reproductive and perinatal care.

RRM Context

Restorative Reproductive Medicine (RRM) treats reproductive health as a whole-person matter for couples. Mental health is part of that care. This protocol enrolls women who are planning pregnancy or having a fertility check. The protocol also tracks pregnancy plans alongside well-being, and invites partners to answer their own surveys. The cohort will look at how wartime stress relates to pregnancy plans and mental health around birth.

Our editorial summary of this paper, not the article's abstract.

Abstract

Background

War reshapes the conditions under which reproductive decisions are made and pregnancy is experienced. Prolonged insecurity, displacement, economic instability, disruption of healthcare, and reduced social support may lead women and families to postpone pregnancy or face pregnancy and childbirth under constrained conditions. These challenges highlight the need for research on how war-related stress and trauma affect women's reproductive behavior and perinatal mental health.

Method

This prospective cohort study will recruit at least 328 women through healthcare institutions providing reproductive and perinatal care. Eligible participants will include non-pregnant women, pregnant women, and women within the first year postpartum. Where feasible, partners of enrolled women will also be included to provide complementary dyadic data. Participants will be followed from baseline to 3, 6, and 12 months. Data will be collected through web-based questionnaires and routine clinical records. No experimental intervention will be delivered, and participation in the study will not modify standard clinical care. Repeated measures will capture mental health, reproductive intentions and behavior, war-related and perinatal experiences, and key sociodemographic and obstetric characteristics. Primary analyses will use mixed-effects models to examine mental-health trajectories, with reproductive status modeled both as a baseline cohort characteristic and, where participants change status during follow-up, as a time-varying covariate; reproductive transitions will also be examined as secondary longitudinal outcomes.

Discussion

This protocol addresses an important gap by using a longitudinal design to examine women's experiences in a wartime setting. By situating mental health within disrupted reproductive plans, insecurity, healthcare strain, and family-level experiences, the study may help identify how armed conflicts shape both psychological vulnerability and reproductive decision-making. The findings may inform more responsive care for women affected by war.

Trial Registration

ClinicalTrials.gov; identifier: NCT07551934.

Topics

By this author

Related research

Postpartum › Mental Health › Postpartum Depression · Mental Health and Psychosocial Care › Psychosocial Support › Peer and Community Support
Liudmyla Krupelnytska, Nazar Yatsenko, Antonina Molotokas, Olha Morozova-Larina, Alona Vavilova, Artem Baratiuk, Stanislav Kazakov, Volodymyr Artyomenko
L Krupelnytska, N Yatsenko, A Molotokas, O Morozova-Larina, A Vavilova, A Baratiuk, S Kazakov, V Artyomenko
PMID 42519206 42519206 DOI 10.3389/fpsyt.2026.1874060 10.3389/fpsyt.2026.1874060 Krupelnytska et al. 2026, Krupelnytska 2026

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