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Enthoven CA, Labrecque JA, Koopman-Verhoeff ME, Lambregtse-van den Berg MP, Hillegers MHJ, Marroun HE, Jansen PW. Reducing behavior problems in children born after an unintended pregnancy: the generation R study. Soc Psychiatry Psychiatr Epidemiol 2024:10.1007/s00127-024-02693-3. [PMID: 38819520 DOI: 10.1007/s00127-024-02693-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/28/2023] [Accepted: 05/17/2024] [Indexed: 06/01/2024]
Abstract
OBJECTIVES To examine differences in behavior problems between children from intended versus unintended pregnancies, and to estimate how much the difference in problem behavior would be reduced if postnatal depression was eliminated and social support was increased within 6 months after birth. METHODS Data from the Generation R Study were used, a population-based birth cohort in Rotterdam, the Netherlands (N = 9621). Differences in child internalizing and externalizing behavior at ages 1.5, 3, 6, 9 and 13 years between pregnancy intention groups were estimated using linear regression. Associations of postnatal depression and social support with internalizing and externalizing problems were also estimated using linear regression. Child behavior outcomes where compared before and after modelling a situation in which none of the mothers experienced a postnatal depression and all mother experienced high social support. RESULTS Most pregnancies (72.9%) were planned, 14.8% were unplanned and wanted, 10.8% were unplanned with initially ambivalent feelings and 1.5% with prolonged ambivalent feelings. Children from unplanned pregnancies had more internalizing and externalizing problems at all ages as compared to children from a planned pregnancy, especially when ambivalent feelings were present. Hypothetically eliminating on postnatal depression reduced the differences in internalizing and externalizing problems by 0.02 to 0.16 standard deviation. Hypothetically increasing social support did not significantly reduce the difference in internalizing and externalizing problems. CONCLUSIONS Children from an unplanned pregnancy have more behavior problems, in particular when mothers had prolonged ambivalent feelings. Eliminating postnatal depression may help to reduce the inequality in child behavior related to pregnancy intention.
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Affiliation(s)
- Clair A Enthoven
- Department of Psychology, Education and Child Studies, Erasmus School of Social and Behavioral Sciences, Erasmus University, Mandeville Building, Floor T13, Rotterdam, The Netherlands
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus University Medical Center-Sophia Childrens Hospital, Rotterdam, The Netherlands
- The Generation R Study Group, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Jeremy A Labrecque
- Department of Epidemiology, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - M Elisabeth Koopman-Verhoeff
- Simches Division of Child and Adolescent Psychiatry, McLean Hospital and Harvard Medical School, Belmont, MA, USA
| | - Mijke P Lambregtse-van den Berg
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus University Medical Center-Sophia Childrens Hospital, Rotterdam, The Netherlands
- Department of Psychiatry, Erasmus University Medical Center, Rotterdam, Zuid-Holland, The Netherlands
| | - Manon H J Hillegers
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus University Medical Center-Sophia Childrens Hospital, Rotterdam, The Netherlands
| | - Hanan El Marroun
- Department of Psychology, Education and Child Studies, Erasmus School of Social and Behavioral Sciences, Erasmus University, Mandeville Building, Floor T13, Rotterdam, The Netherlands
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus University Medical Center-Sophia Childrens Hospital, Rotterdam, The Netherlands
| | - Pauline W Jansen
- Department of Psychology, Education and Child Studies, Erasmus School of Social and Behavioral Sciences, Erasmus University, Mandeville Building, Floor T13, Rotterdam, The Netherlands.
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus University Medical Center-Sophia Childrens Hospital, Rotterdam, The Netherlands.
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Vega-Sanz M, Rey-Sáez R, Berástegui A, Sánchez-López Á. Difficulties in Pregnancy Adjustment as Predictors of Perinatal Depression: Indirect Effects through the Role of Brooding Rumination and Maternal-Fetal Bonding. Am J Perinatol 2024; 41:e2870-e2877. [PMID: 37848044 PMCID: PMC11150065 DOI: 10.1055/s-0043-1776062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2023]
Abstract
OBJECTIVE The aim of this research was to study the ways in which problems of adaptation to pregnancy influence the development of symptoms of perinatal depression via the presence of brooding and low maternal-fetal bonding, in addition to other risk factors previously established in the literature. STUDY DESIGN Representative sample of pregnant women in the third trimester of gestation (N = 594) completed an online survey that included sociodemographic data and measures of perinatal depression, adjustment to pregnancy, bonding, and brooding. Other risk factors were also assessed as covariates, such as previous history of depression, generalized anxiety, perceived social support, and experience of stressful life events. Descriptive and correlational analyses were performed on the scores obtained by the subjects with the different instruments. A path model was formulated to establish the pathways through which adjustment influences perinatal depression symptomatology. On the one hand, the presence of brooding (worst adjustment to pregnancy → high brooding → perinatal depression symptomatology), and on the other hand, the quality of maternal-fetal bonding (worst adjustment to pregnancy → poor quality fetal-maternal bonding → perinatal depression symptomatology) would act as a mediator. RESULTS The factors proposed by the literature were predictive of perinatal depressive symptomatology and the quality of adjustment to pregnancy. Problems adjusting to changes during pregnancy and experiencing it unsatisfactorily may predict individual differences in perinatal depressive symptoms. Significantly, this relationship was mediated by two key factors, the presence of brooding and low quality of the maternal-fetal bond. CONCLUSION Our results provide evidence in favor of the existence of multiple paths through which difficulties in adapting to pregnancy can favor the occurrence of higher levels of perinatal depressive symptoms and identify new avenues for developing research in this area and preventive interventions empirically informed.
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Affiliation(s)
- Maria Vega-Sanz
- University Institute of Family Studies, Comillas Pontifical University, Madrid, Spain
| | - Ricardo Rey-Sáez
- Department of Personality, Evaluation and Psychological Treatments, Complutense University of Madrid, Madrid, Spain
| | - Ana Berástegui
- University Institute of Family Studies, Comillas Pontifical University, Madrid, Spain
| | - Álvaro Sánchez-López
- Department of Personality, Evaluation and Psychological Treatments, Complutense University of Madrid, Madrid, Spain
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Mollons M, Levasseur-Puhach S, Kaur J, Doyle J, Giesbrecht G, Lebel CA, Woods L, Tomfohr-Madsen L, Roos L. Mixed-methods study exploring health service access and social support linkage to the mental well-being of Canadian Indigenous pregnant persons during the COVID-19 pandemic. BMJ Open 2024; 14:e078388. [PMID: 38553054 PMCID: PMC11005712 DOI: 10.1136/bmjopen-2023-078388] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Accepted: 02/27/2024] [Indexed: 04/02/2024] Open
Abstract
OBJECTIVES This study aimed to explore how the unprecedented stressors associated with the COVID-19 pandemic may have contributed to heightened levels of depression and anxiety among pregnant Indigenous persons, and identify protective individual-level factors. DESIGN The current study used a mixed-methods design including standardised questionnaires and open-ended response questions. Using hierarchical regression models, we examined the extent to which COVID-19-related factors of service disruption (ie, changes to prenatal care, changes to birth plans and social support) were associated with mental well-being. Further, through qualitative analyses of open-ended questions, we examined the coping strategies used by pregnant Indigenous persons in response to the pandemic. SETTING Participants responded to an online questionnaire consisting of standardised measures from 2020 to 2021. PARTICIPANTS The study included 336 self-identifying Indigenous pregnant persons in Canada. RESULTS Descriptive results revealed elevated rates of clinically relevant depression (52.7%) and anxiety (62.5%) symptoms among this population. 76.8% of participants reported prenatal care service disruptions, including appointment cancellations. Thematic analyses identified coping themes of staying informed, social and/or cultural connections and activities, and internal mental well-being strategies. Disruptions to services and decreased quality of prenatal care negatively impacted mental well-being of Indigenous pregnant persons during the COVID-19 pandemic. CONCLUSIONS Given the potential for mental well-being challenges to persist and long-term effects of perinatal distress, it is important to examine the quality of care that pregnant individuals receive. Service providers should advance policies and practices that promote relationship quality and health system engagement as key factors linked to well-being during the perinatal period for Indigenous persons.
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Affiliation(s)
- Meghan Mollons
- Psychology, University of Manitoba, Winnipeg, Manitoba, Canada
| | | | - Jasleen Kaur
- Psychology, University of Regina, Regina, Saskatchewan, Canada
| | - Jennifer Doyle
- Educational and Counselling Psychology, The University of British Columbia, Vancouver, British Columbia, Canada
| | - Gerald Giesbrecht
- Alberta Children's Hospital Research Institute, Calgary, Province of Alberta, Canada
- Department of Community Health Sciences, University of Calgary, Calgary, Province of Alberta, Canada
| | - Catherine A Lebel
- Alberta Children's Hospital Research Institute, Calgary, Province of Alberta, Canada
- Department of Radiology, University of Calgary, Calgary, Province of Alberta, Canada
| | | | - Lianne Tomfohr-Madsen
- Educational and Counselling Psychology, The University of British Columbia, Vancouver, British Columbia, Canada
| | - Leslie Roos
- Psychology, University of Manitoba, Winnipeg, Manitoba, Canada
- University of Manitoba Children's Hospital Research Institute, Winnipeg, Manitoba, Canada
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Okoror TA, Nyamuame BM, Martin-Ikpe C, Gilani Y, Nyamuame SE. "… He's not beating me"-Socio-cultural construction of intimate partner violence and traditional birth attendants: implications for maternal & child health in rural communities in Hohoe, Ghana. Front Glob Womens Health 2024; 5:1352793. [PMID: 38567108 PMCID: PMC10985337 DOI: 10.3389/fgwh.2024.1352793] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2023] [Accepted: 02/29/2024] [Indexed: 04/04/2024] Open
Abstract
Introduction Most research on Intimate Partner Violence (IPV) focuses on the physical, sexual and psychological abuse, with less focus on the financial abuse. This study explores nursing mothers' experiences and perceptions of financial and material support from their significant others and traditional birth attendants' (TBA) observations of support to nursing mothers in their communities. Methods Using purposive sampling, focus groups and interviews were conducted primarily in Ewe language among nursing mothers and TBAs in rural communities in Hohoe, Volta region, Ghana. All discussions were audio-recorded and transcribed for analysis. Thematic analysis guided by the social constructivist framework was used in data analysis. Results Twenty-seven women participated in the study, ranging in ages from 19 to 82 (20 nursing mothers; 7 TBAs). Most participants were married (19) and about 65% reported working outside the home (10 nursing mothers; 7 TBAs). Two themes emerged from the data analysis: Lack of support from partners for housekeeping chores and finances; and TBAs as mediators. Nursing mothers who reported lack of financial support did not perceive it as abuse, rather as hinderance to their efforts to care for their children. TBAs act as mediators interceding on behalf of nursing mothers with their husbands and fathers of their children, while also seeking resources to support them. Discussion Understanding the perceptions and socio-cultural meanings women attached to IPV experience is essential for effective intervention to reduce IPV. In addition, TBAs can be a resource in intervening to alleviate IPV in their communities, thereby improving maternal and child health.
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Affiliation(s)
- Titilayo A. Okoror
- Department of Africana Studies & Global Public Health Program, Binghamton, NY, United States
- Center for Health Equity and Evaluation Research (CHEER), School of Public Health, Texas A&M University, College Station, TX, United States
| | - Bless M. Nyamuame
- Department of Midwifery, Nursing & Midwifery Training College, Hohoe, Ghana
| | - Cordelia Martin-Ikpe
- Department of Africana Studies & Global Public Health Program, Binghamton, NY, United States
- Center for Health Equity and Evaluation Research (CHEER), School of Public Health, Texas A&M University, College Station, TX, United States
| | - Yasmeen Gilani
- Department of Africana Studies & Global Public Health Program, Binghamton, NY, United States
| | - Samuel Elikem Nyamuame
- Department of Africana Studies, Binghamton University (SUNY), Vestal Parkway East, Binghamton, NY, United States
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Gu Y, Waters TEA, Zhu V, Jamieson B, Lim D, Schmitt G, Atkinson L. Attachment expectations moderate links between social support and maternal adjustment from 6 to 18 months postpartum. Dev Psychopathol 2024:1-13. [PMID: 38273665 DOI: 10.1017/s0954579423001657] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2024]
Abstract
Significant links exist between one's perception of available social support and mental health outcomes, including during the transition to motherhood. Yet, attachment theory posits that individuals do not benefit equally from social support. As such, we examined the influence of attachment representations (i.e., secure base script knowledge) as they potentially moderate links between social support and psychological distress in a 1-year longitudinal study of an ethnically diverse (56% White) sample of infant-mother dyads. We hypothesized that higher social support would predict lower maternal psychological distress and this relation would be strongest in those with higher secure base script knowledge. Results indicated that maternal perceptions of social support were significantly negatively correlated with psychological distress. Analyses revealed that secure base script scores significantly moderated these associations. Interestingly, for those high in script knowledge, low social support predicted greater psychological distress. For those low in script knowledge, social support was unrelated to psychological distress. This pattern suggested that those who expect care (i.e., high secure base script knowledge) but receive minimal support (i.e., low perceived social support) find motherhood uniquely dysregulating. Practitioners may do well to examine individuals' attachment expectations in relation to their current social support.
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Affiliation(s)
- Yufei Gu
- Department of Psychology, New York University Abu Dhabi, Abu Dhabi, United Arab Emirates
- Department of Applied Psychology, Steinhardt School of Culture, Education, and Human Development, New York University, New York, NY, USA
| | - Theodore E A Waters
- Department of Psychology, New York University Abu Dhabi, Abu Dhabi, United Arab Emirates
- Department of Applied Psychology, Steinhardt School of Culture, Education, and Human Development, New York University, New York, NY, USA
| | - Victoria Zhu
- Department of Psychology, New York University Abu Dhabi, Abu Dhabi, United Arab Emirates
| | - Brittany Jamieson
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada
| | - Danielle Lim
- Department of Psychology, Toronto Metropolitan University, Toronto, ON, Canada
| | - Gabrielle Schmitt
- Department of Psychology, Toronto Metropolitan University, Toronto, ON, Canada
| | - Leslie Atkinson
- Department of Psychology, Toronto Metropolitan University, Toronto, ON, Canada
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Sands G, Blake H, Carter T, Spiby H. Nature-based interventions to support mental health and well-being of young women in pregnancy: exploratory work for future feasibility RCT. PUBLIC HEALTH RESEARCH 2023:1-23. [PMID: 38140912 DOI: 10.3310/npgr3411] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2023] Open
Abstract
Background The prevalence of mental health and well-being issues among young women is increasing. Pregnancy is a time when new mental health challenges may arise, or existing conditions can be exacerbated. This project presents preparatory work on how nature-based interventions may help to support the mental health and well-being of young pregnant women (aged 16-24 years) in a future study. Methods This project was formed of three main phases conducted from March to August 2022: (1) mapping nature activities available across the East Midlands region and two focus groups with providers of nature activities (n = 6); (2) public participation and involvement work to inform future research. This included four focus groups with young women (n = 11), leading to the formation of a new young women's panel (Research Influencers Group). Networking and stakeholder engagement to support future research. Results The mapping survey identified 68 nature-based organisations/projects operating in the region, many of whom expressed interest in being involved in future research. The young women's focus groups confirmed the importance of the topic and generated a wealth of information to support the intervention design. A Research Influencer Group of five young women was established from the focus group participants. The Research Influencer Group chose the nature-based intervention and had input into all aspects of the study design. This group will continue into future projects. Focus groups with providers of nature activities have further advanced the study design. The project team have developed relationships with relevant stakeholders and networks that will inform the future trial. Conclusion This preparatory co-design work suggested that a nature-based intervention may be acceptable to young women, and providers of such interventions felt it was feasible to offer these activities to young pregnant women. This preparatory work has led to an outline research plan which has been co-produced with public contributors and stakeholders throughout. Limitations This preparatory work is limited by small focus group samples, and the possibility that not all providers were reached through the snowballing approach to the mapping survey. Future work Future research is needed to test the nature-based intervention; this would be in the form of a feasibility randomised controlled trial of nature-based interventions to promote the mental health and well-being of young pregnant women. Funding This article presents independent research funded by the National Institute for Health and Care Research (NIHR) Public Health Research programme as award number NIHR135167.
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Affiliation(s)
- Gina Sands
- School of Health Sciences, University of Nottingham, Nottingham, UK
| | - Holly Blake
- School of Health Sciences, University of Nottingham, Nottingham, UK
- NIHR Nottingham Biomedical Research Centre, Nottingham, UK
| | - Tim Carter
- School of Health Sciences, University of Nottingham, Nottingham, UK
| | - Helen Spiby
- School of Health Sciences, University of Nottingham, Nottingham, UK
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van Lonkhuijzen RM, Rustenhoven H, de Vries JHM, Wagemakers A. The role of the partner in the support of a pregnant woman's healthy diet: an explorative qualitative study. BMC Pregnancy Childbirth 2023; 23:760. [PMID: 37898778 PMCID: PMC10612286 DOI: 10.1186/s12884-023-06072-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Accepted: 10/17/2023] [Indexed: 10/30/2023] Open
Abstract
BACKGROUND Active partner involvement during pregnancy is an effective strategy to enhance both maternal and newborn health outcomes. The presence of a supportive partner equips women with a heightened sense of empowerment to deal with the challenges of pregnancy, including maintaining a healthy diet during pregnancy, which is important for the health of both the mother and child. However, little information exists regarding the partner's role in encouraging a pregnant woman's healthy dietary choices. This study aimed to explore the perspectives of pregnant women and their partners concerning the partner's role in promoting a healthy dietary intake during pregnancy. METHODS Sixteen semi-structured couple interviews were conducted in the Netherlands, involving expecting couples. Based on Berkman's social networks and support theory, we categorized various forms of support as emotional, instrumental, appraisal, and informational. The interviews were accurately recorded, transcribed verbatim, and analysed using an inductive approach. RESULTS In general, pregnant women reported being positive regarding the support they received from their partners. Partners primarily offered instrumental support to pregnant women, such as cooking, grocery shopping, and helping them avoid unsafe foods. Partners provided informational support, mainly about foods considered unsafe during pregnancy. Emotional support was relatively less common. The primary motives for giving support were pregnancy-related symptoms, the importance of the health of the mother and baby, and solidarity with the pregnant woman. Support from the partner was more willingly accepted by pregnant women if the support was perceived as being helpful, showing involvement, and positive. Conversely, partner support was not accepted if it was perceived as judgmental or unwanted. CONCLUSIONS The majority of pregnant women were satisfied with the support received from their partners, although there are opportunities for a partner to provide more support to improve the dietary intake of pregnant women. To optimise this support, partners are advised to tailor their support to the needs and expectations of pregnant women. Personalizing dietary support can be achieved by couples communicating their dietary wishes and expectations regarding support.
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Affiliation(s)
- Renske M van Lonkhuijzen
- Department of Social Sciences, Health and Society, Wageningen University & Research, Hollandseweg 1, bode 60, Wageningen, 6706, KN, The Netherlands.
- Department of Agrotechnology and Food Sciences, Human Nutrition & Health, Wageningen University & Research, Stippeneng 4, bode 62, Wageningen, 6708, WE, The Netherlands.
| | | | - Jeanne H M de Vries
- Department of Agrotechnology and Food Sciences, Human Nutrition & Health, Wageningen University & Research, Stippeneng 4, bode 62, Wageningen, 6708, WE, The Netherlands
| | - Annemarie Wagemakers
- Department of Social Sciences, Health and Society, Wageningen University & Research, Hollandseweg 1, bode 60, Wageningen, 6706, KN, The Netherlands
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Sands G, Blake H, Carter T, Spiby H. Nature-Based Interventions in the UK: A Mixed Methods Study Exploring Green Prescribing for Promoting the Mental Wellbeing of Young Pregnant Women. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:6921. [PMID: 37887659 PMCID: PMC10606054 DOI: 10.3390/ijerph20206921] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Revised: 09/29/2023] [Accepted: 10/12/2023] [Indexed: 10/28/2023]
Abstract
Green prescribing is gaining in popularity internationally for the promotion of mental wellbeing. However, the evidence base is limited, particularly in young pregnant women, a population with known risk factors for anxiety and depression. The aim of this mixed-methods study was to provide insights into the availability, processes, and suitability of nature-based interventions for young pregnant women. First, an online mapping survey of nature-based activities in the East Midlands region of the United Kingdom (UK) was undertaken. Second, focus groups (n = 6) were conducted with nature activity providers and young mothers (n = 11). This study found there were many diverse nature-based activities available to promote mental wellbeing. The organisational challenges highlighted include a lack of sufficient funding for service provision and disappointing experiences with some green prescribing programmes. The young women felt that nature-based activities helped to promote their mental wellbeing, and also offered an opportunity for social support. The facilitators, such as having detailed information and being accompanied to initial sessions to ease anxieties, were found to maximise the women's engagement with nature-based interventions. This study provides new perspectives on nature-based interventions from service providers and young women. Findings on the organisational barriers and facilitators to delivering interventions will inform the design of much needed future experimental research.
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Affiliation(s)
- Gina Sands
- School of Health Sciences, University of Nottingham, Nottingham NG7 2HA, UK; (H.B.); (T.C.); (H.S.)
| | - Holly Blake
- School of Health Sciences, University of Nottingham, Nottingham NG7 2HA, UK; (H.B.); (T.C.); (H.S.)
- NIHR Nottingham Biomedical Research Centre, Nottingham NG7 2UH, UK
| | - Tim Carter
- School of Health Sciences, University of Nottingham, Nottingham NG7 2HA, UK; (H.B.); (T.C.); (H.S.)
| | - Helen Spiby
- School of Health Sciences, University of Nottingham, Nottingham NG7 2HA, UK; (H.B.); (T.C.); (H.S.)
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Yamamoto SS, Premji SS, Saini V, McDonald SW, Jhangri GS. Investigating associations between maternal stress, smoking and adverse birth outcomes: evidence from the All Our Families cohort. BMC Pregnancy Childbirth 2023; 23:710. [PMID: 37794335 PMCID: PMC10548639 DOI: 10.1186/s12884-023-06029-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2022] [Accepted: 09/25/2023] [Indexed: 10/06/2023] Open
Abstract
BACKGROUND Independently, active maternal and environmental tobacco smoke exposure and maternal stress have been linked to an increased risk of preterm birth and low birth weight. An understudied relationship is the potential for interactive effects between these risk factors. METHODS Data was obtained from the All Our Families cohort, a study of 3,388 pregnant women < 25 weeks gestation recruited from those receiving prenatal care in Calgary, Canada between May 2008 and December 2010. We investigated the joint effects of active maternal smoking, total smoke exposure (active maternal smoking plus environmental tobacco smoke) and prenatal stress (Perceived Stress Scale, Spielberger State-Trait Anxiety Inventory), measured at two time points (< 25 weeks and 34-36 weeks gestation), on preterm birth and low birth weight. RESULTS A marginally significant association was observed with the interaction active maternal smoking and Spielberger State-Trait Anxiety Inventory scores in relation to low birth weight, after imputation (aOR = 1.02, 95%CI: 1.00-1.03, p = 0.06). No significant joint effects of maternal stress and either active maternal smoking or total smoke exposure with preterm birth were observed. Active maternal smoking, total smoke exposure, Perceived Stress Scores, and Spielberger State-Trait Anxiety Inventory scores were independently associated with preterm birth and/or low birth weight. CONCLUSIONS Findings indicate the role of independent effects of smoking and stress in terms of preterm birth and low birthweight. However, the etiology of preterm birth and low birth weight is complex and multifactorial. Further investigations of potential interactive effects may be useful in helping to identify women experiencing vulnerability and inform the development of targeted interventions.
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Affiliation(s)
- Shelby S Yamamoto
- School of Public Health, University of Alberta, 11405 87th Ave, Edmonton, AB, T6G 1C9, Canada.
| | - Shahirose S Premji
- School of Nursing, Queen's University, 92 Barrie Street, Kingston, ON, K7L 3N6, Canada
| | - Vineet Saini
- Alberta Health Services, Department of Research and Innovation, Provincial Population and Public Health, 10030 - 107 Street NW, Edmonton, AB, T5J 3E4, Canada
- Cumming School of Medicine, Department of Community Health Sciences, University of Calgary, 3280 Hospital Drive NW, Calgary, AB, T2N 4Z6, Canada
| | - Sheila W McDonald
- Alberta Health Services, Department of Research and Innovation, Provincial Population and Public Health, 10030 - 107 Street NW, Edmonton, AB, T5J 3E4, Canada
- Cumming School of Medicine, Department of Community Health Sciences, University of Calgary, 3280 Hospital Drive NW, Calgary, AB, T2N 4Z6, Canada
| | - Gian S Jhangri
- School of Public Health, University of Alberta, 11405 87th Ave, Edmonton, AB, T6G 1C9, Canada
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Hampton S, Man J, Allison C, Aydin E, Baron-Cohen S, Holt R. A qualitative exploration of autistic mothers' experiences I: Pregnancy experiences. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2023; 27:1271-1282. [PMID: 36325726 PMCID: PMC10291382 DOI: 10.1177/13623613221132435] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/16/2024]
Abstract
Little is known about how autistic people experience pregnancy. We interviewed 24 autistic and 21 non-autistic women during pregnancy to find out about their experiences. Autistic participants had more physical difficulties, such as nausea and pain, during pregnancy than non-autistic participants. They also sometimes felt that healthcare professionals, such as midwives, did not have a good understanding of autism and they did not always feel comfortable telling professionals about their autism diagnosis. Autistic participants told us that they needed professionals to communicate with them clearly and to make changes during appointments such as dimming lights. This research shows that autistic people would benefit from changes to pregnancy appointments and that more training about autism would help maternity care professionals to support autistic people during pregnancy.
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Scandurra C, Mezzalira S, Aviani S, Lastra V, Bochicchio V, Zapparella R, Saccone G, Maldonato NM, Locci M. Perinatal depression during the fourth wave of the COVID-19 outbreak in a single prenatal clinic in Southern Italy: The role of loneliness, anxiety, and maternal support. JOURNAL OF AFFECTIVE DISORDERS REPORTS 2023; 13:100585. [PMID: 37152681 PMCID: PMC10141786 DOI: 10.1016/j.jadr.2023.100585] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Revised: 03/15/2023] [Accepted: 04/27/2023] [Indexed: 05/09/2023] Open
Abstract
Background The current study aimed at assessing the levels of perinatal depression (i.e., both antenatal and postnatal) during the fourth wave of the COVID-19 outbreak in a group of Italian women, as well as to evaluate the role of loneliness, anxiety, and lack of maternal support in cumulatively predicting perinatal depression. Methods A cross-sectional study was conducted with 200 Italian women recruited during a peak of the COVID-19 pandemic in Italy (i.e., from September to December 2021) from a single prenatal clinic in Southern Italy. A non-parametric binomial test was conducted to assess whether the perinatal depression frequencies of the current sample differed from those found in a pre-Covid reference group. Additionally, hierarchical multiple linear regression analyses assessing whether loneliness, anxiety, and maternal support affected women's perinatal depression were also conducted. Results The general prevalence of perinatal depression was significantly higher in participants recruited during the fourth wave of the COVID-19 pandemic compared to the pre-Covid reference group (29% vs. 9.2%). However, results showed that, contrary to postnatal depression (18.2% vs. 19.9%), only the prevalence of antenatal depression was significantly higher compared to the pre-Covid reference group (39.6% vs. 6.4%). Furthermore, loneliness and anxiety, but not maternal support, were associated with higher levels of PD. Limitations Limitations concerned the cross-sectional nature of the study and the relatively small sample size. Conclusions This study sheds light on the need to address perinatal mental health of women during major stressful events, such as the COVID-19 pandemic.
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Affiliation(s)
- Cristiano Scandurra
- Department of Neuroscience, Reproductive Sciences and Dentistry, University of Naples Federico II, Via Sergio Pansini 5, Napoli 80133, Italy
| | - Selene Mezzalira
- Department of Humanistic Studies, University of Calabria, Via Ponte Bucci Cubo 18/C, Rende 87036, Italy
| | - Silvia Aviani
- Intradepartmental Program of Clinical Psychology, Federico II University Hospital, Via Sergio Pansini 5, Napoli 80133, Italy
| | - Valeria Lastra
- Department of Neuroscience, Reproductive Sciences and Dentistry, University of Naples Federico II, Via Sergio Pansini 5, Napoli 80133, Italy
| | - Vincenzo Bochicchio
- Department of Humanistic Studies, University of Calabria, Via Ponte Bucci Cubo 18/C, Rende 87036, Italy
| | - Rosanna Zapparella
- Department of Neuroscience, Reproductive Sciences and Dentistry, University of Naples Federico II, Via Sergio Pansini 5, Napoli 80133, Italy
| | - Gabriele Saccone
- Department of Neuroscience, Reproductive Sciences and Dentistry, University of Naples Federico II, Via Sergio Pansini 5, Napoli 80133, Italy
| | - Nelson Mauro Maldonato
- Department of Neuroscience, Reproductive Sciences and Dentistry, University of Naples Federico II, Via Sergio Pansini 5, Napoli 80133, Italy
| | - Mariavittoria Locci
- Department of Neuroscience, Reproductive Sciences and Dentistry, University of Naples Federico II, Via Sergio Pansini 5, Napoli 80133, Italy
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Fox MM, Knorr DA, Kwon D, Wiley KS, Parrish MH. How prenatal cortisol levels relate to grandmother-mother relationships among a cohort of Latina women. Am J Hum Biol 2023; 35:e23883. [PMID: 36862026 PMCID: PMC10474942 DOI: 10.1002/ajhb.23883] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2022] [Revised: 02/09/2023] [Accepted: 02/10/2023] [Indexed: 03/03/2023] Open
Abstract
INTRODUCTION As part of the human reproductive strategy, mothers receive childcare assistance from others. For kin, allomothers are adaptively incentivized to provide assistance due to inclusive fitness benefits. Previous studies across a broad range of populations identify grandmothers as particularly consistent allomothers. Minimal attention has been paid to the possibility that allomothers may begin investing in offspring quality during the prenatal stage of life. Here, we innovate within the area of grandmother allocare research by examining the prenatal stage of life and biopsychosocial mechanisms by which prenatal grandmother effects may be enacted. METHODS Data derive from the Mothers' Cultural Experiences study, a cohort of 107 pregnant Latina women in Southern California. At <16 weeks' gestation, we administered questionnaires, collected morning urine samples, and measured cortisol by enzyme-linked immunosorbent assay, correcting for specific gravity. We measured the soon-to-be maternal and paternal grandmothers' relationship quality, social support, frequency of seeing each other, communicating, and geographic proximity to pregnant mothers, that is, their daughters and daughters-in-law. These measures were self-reported by the pregnant mothers. We assessed how grandmother constructs related to the pregnant women's depression, stress, anxiety, and cortisol levels. RESULTS We observed benefits conferred by maternal grandmothers for mothers' prenatal mental health and lower cortisol levels. Paternal grandmothers also conferred mental health benefits to pregnant daughters-in-law, but higher cortisol levels. CONCLUSION Our results suggest that grandmothers, especially maternal grandmothers, are able to improve their inclusive fitness by caring for pregnant daughters, and allomother support may positively impact prenatal health. This work extends the traditional cooperative breeding model by identifying a prenatal grandmother effect, and, by examining a maternal biomarker.
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Affiliation(s)
- Molly M. Fox
- Department of Anthropology, University of California, Los Angeles, Los Angeles, CA, 90095 USA
- Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, Los Angeles, CA, 90095 USA
| | - Delaney A. Knorr
- Department of Anthropology, University of California, Los Angeles, Los Angeles, CA, 90095 USA
| | - Dayoon Kwon
- Department of Epidemiology, UCLA Fielding School of Public Health, University of California, Los Angeles, Los Angeles, CA, 90095 USA
| | - Kyle S. Wiley
- Department of Anthropology, University of California, Los Angeles, Los Angeles, CA, 90095 USA
| | - Michael H. Parrish
- Department of Psychology, University of California, Los Angeles, CA 90095 USA
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Harriett LE, Eary RL, Prickett SA, Romero J, Maddrell RG, Keenan-Devlin LS, Borders AEB. Adaptation of Screening Tools for Social Determinants of Health in Pregnancy: A Pilot Project. Matern Child Health J 2023:10.1007/s10995-023-03732-2. [PMID: 37316688 DOI: 10.1007/s10995-023-03732-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/22/2023] [Indexed: 06/16/2023]
Abstract
OBJECTIVES Social determinants of health (SDOH) and stress during pregnancy may contribute to adverse pregnancy outcomes. The objective of this in the field pilot project was to develop a comprehensive screening tool by combining existing validated screeners. Additionally, implement use of this tool within routine prenatal visits and assess feasibility. METHODS Pregnant patients accessing prenatal care at a single site of an urban Federally Qualified Health Center were recruited during prenatal visits to complete a Social Determinants of Health in Pregnancy Tool (SIPT). SIPT combines a series of questions from existing and well-validated tools and consists of five domains: (1) perceived stress, (2) relationship and family stress, (3) domestic violence, (4) substance abuse, and (5) financial stress. RESULTS Between April 2018 and March 2019, 135 pregnant participants completed SIPT. Ninety-one percent of patients scored positive on at least one screener, 54% to three or more screeners. CONCLUSIONS Despite guidelines to screen for SDOH during pregnancy there is no universal tool. Our pilot project demonstrated the concurrent use of adapted screening tools where participants reported at least one area of potential stress, and that linking to resources at the time of a visit is plausible. Future work should examine if screening and point of care linkages of services improves maternal child outcomes.
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Affiliation(s)
- Lauren E Harriett
- PCC Community Wellness Center, 115 North Parkside Avenue, Chicago, IL, 60644, USA
| | - Rebecca L Eary
- Department of Family and Community Medicine, UT Southwestern Medical Center, 5323 Harry Hines Blvd., K Building, 2nd Floor, Suite 400F, Dallas, TX, 75390, USA.
| | - Sarah A Prickett
- Department of Family and Community Medicine, UT Southwestern Medical Center, 5323 Harry Hines Blvd., K Building, 2nd Floor, Suite 400F, Dallas, TX, 75390, USA
| | - Janedelie Romero
- Department of Obstetrics and Gynecology, NorthShore University Health System, Chicago, IL, USA
| | - Rebecca G Maddrell
- A.L. Burdick Family Medicine Center, 3 Erie Court Suite 6160, Oak Park, IL, 60302, USA
| | - Lauren S Keenan-Devlin
- Department of Obstetrics and Gynecology, NorthShore University Health System and Pritzker School of Medicine, University of Chicago, Chicago, IL, USA
| | - Ann E B Borders
- Department of Obstetrics and Gynecology, NorthShore University Health System and Pritzker School of Medicine, University of Chicago, Chicago, IL, USA
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Bedaso A, Adams J, Peng W, Sibbritt D. The direct and mediating effect of social support on health-related quality of life during pregnancy among Australian women. BMC Pregnancy Childbirth 2023; 23:372. [PMID: 37217842 DOI: 10.1186/s12884-023-05708-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Accepted: 05/16/2023] [Indexed: 05/24/2023] Open
Abstract
BACKGROUND Prenatal stress can have a negative effect on the quality of life (QoL) of pregnant women. Social support plays a vital role in improving the psychological well-being of pregnant women by enhancing their stress-coping ability. The current study assessed the association between social support and health-related quality of life (HRQoL) as well as the mediating role of social support in the linkage between perceived stress and HRQoL among pregnant Australian women. METHODS Secondary data was obtained from 493 women who reported being pregnant in survey six of the 1973-78 cohort of the Australian Longitudinal Study on Women's Health (ALSWH). Social support and perceived stress were assessed using the Medical Outcomes Study Social Support Index (MOS-SSS-19) and the Perceived Stress Scale, respectively. The Mental Component Scale (MCS) and Physical Component Scale (PCS) of the SF-36 were used to examine the mental and physical HRQoL. A mediation model was used to examine the mediating effect of social support in the relationship between perceived stress and HRQoL. A multivariate quantile regression (QR) model was used to assess the association between social support and HRQoL after adjusting for potential confounders. RESULT The mean age of the pregnant women was 35.8 years. The mediational analysis revealed that emotional/informational support (β= -1.53; 95% CI: -2.36, -0.78), tangible support (β= -0.64; 95% CI: -1.29, -0.09), and affectionate support/positive social interaction (β= -1.33; 95% CI: -2.25, -0.48), played a significant mediating role in the relationship between perceived stress and mental health-related QoL. In addition, perceived stress had a significant indirect effect on mental health-related QoL through overall social support (β = -1.38; 95% CI: -2.28, -0.56), and the mediator accounted for approximately 14.3% of the total effect. The multivariate QR analysis indicated that all the domains of social support and overall social support scores were positively associated with higher MCS scores (p < 0.05). However, social support was found to have no significant association with PCS (p > 0.05). CONCLUSION Social support plays a direct and mediating role in improving the HRQoL of pregnant Australian women. Maternal health professionals need to consider social support as an essential tool to improve the HRQoL of pregnant women. Further, as part of routine antenatal care activity, assessing pregnant women's level of social support is beneficial.
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Affiliation(s)
- Asres Bedaso
- College of Medicine and Health Sciences, School of Nursing, Hawassa University, Hawassa, Ethiopia.
- School of Public Health, Faculty of Health, University of Technology Sydney, Ultimo, NSW, Australia.
| | - Jon Adams
- School of Public Health, Faculty of Health, University of Technology Sydney, Ultimo, NSW, Australia
| | - Wenbo Peng
- School of Public Health, Faculty of Health, University of Technology Sydney, Ultimo, NSW, Australia
| | - David Sibbritt
- School of Public Health, Faculty of Health, University of Technology Sydney, Ultimo, NSW, Australia
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15
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Ruiz-Algueró M, Izquierdo R, Suárez-García I, Moreno C, Alejos B, Rava M, Moreno S, Montero Alonso M, Gutiérrez F, Gutierrez Cuellar I, Curran A, Hernando V, Jarrín I. Unplanned pregnancies and social and partner support during pregnancy in Spanish women living with HIV. HIV Med 2023. [PMID: 36810955 DOI: 10.1111/hiv.13469] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2022] [Accepted: 02/01/2023] [Indexed: 02/23/2023]
Abstract
OBJECTIVES To describe prevalence and factors associated with unplanned pregnancies, and social and partner support during pregnancy among women from the Cohort of the Spanish HIV/AIDS Research Network (CoRIS). METHODS We included all women recruited in CoRIS from 2004 to 2019, aged 18-50 years at recruitment who were pregnant during 2020. We designed a questionnaire, organized into the following domains: sociodemographic characteristics, tobacco and alcohol consumption, pregnancy and reproductive health, and social and partner support. The information was gathered via telephone interviews conducted from June to December 2021. We calculated prevalence of unplanned pregnancies as well as odds ratios (ORs) of association and 95% confidence intervals (CIs) according to sociodemographic, clinical and reproductive characteristics. RESULTS Among 53 women who were pregnant during 2020, 38 (71.7%) answered the questionnaire. Median age at pregnancy was 36 years [interquartile range (IQR) 31-39], 27 (71.1%) women were born outside of Spain, mainly in sub-Saharan Africa (39.5%) and 17 (44.7%) were employed. Thirty-four (89.5%) women had been through previous pregnancies and 32 (84.2%) had experienced previous abortions/miscarriages. Seventeen (44.7%) women had shared with their clinician their desire to get pregnant. Thirty-four (89.5%) pregnancies were natural and four used assisted reproductive techniques (in vitro fertilizations; one additionally used oocyte donation). Of 34 women with natural pregnancies, pregnancy was unplanned in 21 (61.8%) and 25 (73.5%) had information on how to become pregnant avoiding HIV transmission to the baby and partner. Women who did not seek advice from their physician about becoming pregnant had a significantly increased risk of unplanned pregnancy (OR = 71.25, 95% CI: 8.96-566.67). Overall, 14 (36.8%) women reported having low social support during pregnancy and 27 (71.0%) had good/very good support by their partner. CONCLUSIONS Most pregnancies were natural and unplanned and very few women had talked with their clinician about their desire to become pregnant. A high proportion of women reported low social support during pregnancy.
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Affiliation(s)
- Marta Ruiz-Algueró
- National Centre for Epidemiology, Institute of Health Carlos III, Madrid, Spain.,CIBER de Enfermedades Infecciosas (CIBERINFEC), Madrid, Spain
| | - Rebeca Izquierdo
- National Centre for Epidemiology, Institute of Health Carlos III, Madrid, Spain.,CIBER de Enfermedades Infecciosas (CIBERINFEC), Madrid, Spain
| | - Ines Suárez-García
- CIBER de Enfermedades Infecciosas (CIBERINFEC), Madrid, Spain.,Infectious Diseases Unit, Department of Internal Medicine, Hospital Universitario Infanta Sofía, Madrid, Spain.,Universidad Europea de Madrid, Madrid, Spain
| | - Cristina Moreno
- National Centre for Epidemiology, Institute of Health Carlos III, Madrid, Spain.,CIBER de Enfermedades Infecciosas (CIBERINFEC), Madrid, Spain
| | - Belen Alejos
- National Centre for Epidemiology, Institute of Health Carlos III, Madrid, Spain
| | - Marta Rava
- National Centre for Epidemiology, Institute of Health Carlos III, Madrid, Spain.,CIBER de Enfermedades Infecciosas (CIBERINFEC), Madrid, Spain
| | - Santiago Moreno
- CIBER de Enfermedades Infecciosas (CIBERINFEC), Madrid, Spain.,Infectious Diseases Unit, Hospital Universitario Ramón y Cajal, Madrid, Spain
| | - Marta Montero Alonso
- Infectious Diseases Unit, Hospital Universitario y Politécnico de La Fe, Valencia, Spain
| | - Felix Gutiérrez
- CIBER de Enfermedades Infecciosas (CIBERINFEC), Madrid, Spain.,Infectious Diseases Unit, Hospital General Universitario De Elche, Alicante, Spain.,University Miguel Hernandez, Alicante, Spain
| | | | - Adrián Curran
- Infectious Diseases Unit, Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | - Victoria Hernando
- National Centre for Epidemiology, Institute of Health Carlos III, Madrid, Spain.,CIBER de Enfermedades Infecciosas (CIBERINFEC), Madrid, Spain
| | - Inma Jarrín
- National Centre for Epidemiology, Institute of Health Carlos III, Madrid, Spain.,CIBER de Enfermedades Infecciosas (CIBERINFEC), Madrid, Spain
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Hinton L, Dumelow C, Hodgkinson J, Montgomery C, Martin A, Allen C, Tucker K, Green ME, Wilson H, McManus RJ, Chappell LC, Band R. 'Nesting networks': Women's experiences of social network support in high-risk pregnancy. Midwifery 2023; 120:103622. [PMID: 36893551 DOI: 10.1016/j.midw.2023.103622] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Revised: 01/27/2023] [Accepted: 02/03/2023] [Indexed: 02/18/2023]
Abstract
OBJECTIVE Social support, an individual's social relationships (both online and offline), may provide protection against adverse mental health outcomes, such as anxiety and depression, which are high in women who have been hospitalised with high-risk pregnancy. This study explored the social support available to women at higher risk of preeclampsia during pregnancy by examining personal social networks. DESIGN Semi-structured interviews were accompanied by social network mapping using the web-based social networking tool GENIE. SETTING England. PARTICIPANTS Twenty-one women were recruited, of whom 18 were interviewed both during pregnancy and postnatally between April 2019 and April 2020. Nineteen women completed maps pre-natally, 17 women completed maps pre-natally and post-natally. Women were taking part in the BUMP study, a randomised clinical trial that included 2441 pregnant individuals at higher risk of preeclampsia and recruited at a mean of 20 weeks' gestation from 15 hospital maternity units in England between November 2018 and October 2019. RESULTS Women's social networks tightened during pregnancy. The inner network changed most dramatically postnatally with women reporting fewer network members. Interviews revealed networks were primarily 'real-life' rather than online social networks, with members providing emotional, informational, and practical support. Women with a high-risk pregnancy valued the relationships they developed with health professionals during pregnancy, and would like their midwife to have a more central role in their networks by providing informational and, where needed, emotional support. The social network mapping data supported the qualitative accounts of changing networks across high-risk pregnancy. CONCLUSION Women with a high-risk pregnancy seek to build "nesting networks" to support them through pregnancy into motherhood. Different types of support are sought from trusted sources. Midwives can play a key role. PRACTICE IMPLICATIONS As well as highlighting other potential needs during pregnancy and the ways in which they can be met, support from midwives has a key role. Through talking to women early in their pregnancy, signposting information and explaining ways to contact health professionals regarding informational or emotional support would fill a gap that currently is met by other aspects of their network.
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Affiliation(s)
- L Hinton
- The Healthcare Improvement Studies (THIS) Institute, University of Cambridge.
| | - C Dumelow
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, OX2 6GG, UK
| | - J Hodgkinson
- Institute of Applied Health Research, University of Birmingham, Birmingham
| | - C Montgomery
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, OX2 6GG, UK
| | - A Martin
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, OX2 6GG, UK
| | - C Allen
- School of Health Sciences, University of Southampton, Southampton, UK. SO17 1BJ
| | - K Tucker
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, OX2 6GG, UK
| | | | - H Wilson
- Department of Women and Children's Health, King's College London, London
| | - R J McManus
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, OX2 6GG, UK
| | - L C Chappell
- Department of Women and Children's Health, King's College London, London
| | - R Band
- School of Health Sciences, University of Southampton, Southampton, UK. SO17 1BJ
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17
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Community health workers as change agents in improving equity in birth outcomes in Detroit. PLoS One 2023; 18:e0281450. [PMID: 36787290 PMCID: PMC9928129 DOI: 10.1371/journal.pone.0281450] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Accepted: 01/23/2023] [Indexed: 02/15/2023] Open
Abstract
We examined whether pairing pregnant women with community health workers improved pregnancy outcomes among 254 Black women with singleton pregnancies participating in the Women-Inspired Neighborhood (WIN) Network: Detroit using a case-control design. A subset (N = 63) of women were recontacted and asked about program satisfaction, opportunities, and health behaviors. Michigan Vital Statistics records were used to ascertain controls (N = 12,030) and pregnancy and infant health outcomes. Logistic and linear regression were used to examine the association between WIN Network participation and pregnancy and infant health outcomes. The WIN Network participants were less likely than controls to be admitted to the neonatal intensive care unit (odds ratio = 0.55, 95% CI 0.33-0.93) and had a longer gestational length (mean difference = 0.42, 95% CI 0.02-0.81). Community health workers also shaped participants' view of opportunities to thrive. This study demonstrates that community health workers can improve pregnancy outcomes for Black women.
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Nar M, Ozcirpan CY. Exploring psychosocial adaptation to pregnancy in women with gestational diabetes. Contemp Nurse 2023:1-11. [PMID: 36734366 DOI: 10.1080/10376178.2023.2175699] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Background: Gestational diabetes mellitus (GDM) is one of the most common medical complications of pregnancy. Diagnosis of GDM, that could be unexpected, may cause women to feel negative emotions such as fear, guilt, sadness, and loss of control and experience difficulties adapting to pregnancy.Objective: This study aimed to explore psychosocial adaptation to pregnancy in women with GDM.Methods: This observational cross-sectional study was conducted with women with GDM and healthy pregnant women who applied to the pregnancy and perinatology outpatient clinic of a university hospital. Groups were matched according to age, education level, and gestational week. The Prenatal Self-Evaluation Questionnaire (PSEQ) was used to collect data. Simple linear regression was performed to determine factors influenced psychosocial adaptation to pregnancy using average scores from the PSEQ.Results: Regression analysis indicated, GDM status (beta = -48.8, p ≤ 0.001) and smoking status during pregnancy (beta = 11.0, p = 0.032) influenced the total score of the PSEQ.Conclusions: Nurses are encouraged to develop a multifaceted nursing care model that considers the physical and psychosocial problems and to provide care to increase the psychosocial adaptation of women with GDM to pregnancy.
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Affiliation(s)
- Makbule Nar
- Obstetrics and Gynecology Department, Hacettepe University Adult Hospital, Ankara Turkey
| | - Cigdem Yucel Ozcirpan
- Obstetrics and Gynecology Nursing Department, Hacettepe University, Faculty of Nursing, Ankara, Turkey
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Psychosocial factors associated with anxious depression. J Affect Disord 2023; 322:39-45. [PMID: 36375541 DOI: 10.1016/j.jad.2022.11.028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Revised: 10/06/2022] [Accepted: 11/07/2022] [Indexed: 11/13/2022]
Abstract
BACKGROUND Anxious depression is a common subtype of major depressive disorder (MDD) associated with adverse outcomes and severely impaired social function. The aim of this study was to explore the relationships between child maltreatment, family functioning, social support, interpersonal problems, dysfunctional attitudes, and anxious depression. METHODS Data were collected from 809 MDD patients. The Hamilton Anxiety Scale (HAMA), Hamilton Depression Scale-17 (HAMD-17), Family Assessment Device (FAD), Childhood Trauma Questionnaire (CTQ), Social Support Rating Scale (SSRS), Interpersonal Relationship Integrative Diagnostic Scale (IRIDS), and Dysfunctional Attitudes Scale (DAS) were administered and recorded. Anxious depression was defined as an anxiety/somatization factor score ≥ 7 on the HAMD-17. Chi-squared tests, Mann-Whitney U tests, distance correlations, and structural equation models were used for data analysis. RESULTS Two-fifths of MDD patients had comorbid anxiety, and there were significant differences in child maltreatment, family functioning, social support, interpersonal problems, and dysfunctional attitudes between groups. Of these factors, interpersonal relationships were most related to anxiety in MDD patients, and dysfunctional attitudes mediated the relationship between interpersonal relationships and anxiety in MDD patients. LIMITATIONS This study used cross-sectional data with no further follow-up to assess patient outcomes. This study did not include information about pharmacological treatments. A larger sample size is needed to validate the results. CONCLUSIONS Psychosocial factors were significantly associated with anxious depression. Interpersonal relationships and dysfunctional attitudes have a direct effect on anxious depression, and interpersonal relationships also mediate the effects of anxious depression via dysfunctional attitudes.
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Roche D, Rafferty A, Holden S, Killeen SL, Kennelly M, McAuliffe FM. Maternal Well-Being and Stage of Behaviour Change during Pregnancy: A Secondary Analysis of the PEARS Randomised Controlled Trial. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 20:34. [PMID: 36612357 PMCID: PMC9819687 DOI: 10.3390/ijerph20010034] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/05/2022] [Revised: 12/13/2022] [Accepted: 12/14/2022] [Indexed: 06/17/2023]
Abstract
We aimed to determine whether early pregnancy well-being was associated with the stage of behaviour change during an antenatal lifestyle intervention using a secondary analysis of data from the Pregnancy Exercise and Nutrition Research Study (PEARS). Pregnant women (n = 277) with well-being data in early pregnancy were included. Maternal well-being was measured using the World Health Organisation Five-Item Well-Being Index. The intervention consisted of a mobile health (mHealth) phone application, supported by antenatal education and exercise, to prevent gestational diabetes in a population with overweight. Stage of behaviour change was measured in late pregnancy using a five-stage classification. Ordinal logistic regression was used to examine if well-being, the study group, or their interaction, were related to behaviour change. Maternal well-being (OR 1.03, 95% CI 1.01, 1.04, p < 0.01) and the study group (OR 2.25, 95% CI 1.44, 3.51, p < 0.01) both significantly influenced the positive stage of behaviour change. The probability of being at stage 5 increased from 43 to 92% as well-being increased from 0 to 100% and was higher in the intervention (53%) compared to the control (34%) group (p ≤ 0.01 (8.65, 29.27). This study demonstrates the potential importance of well-being in enabling women to engage with a healthy lifestyle, and the role that mHealth technology has in facilitating beneficial behaviour change.
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Affiliation(s)
- Doireann Roche
- UCD Perinatal Research Centre, School of Medicine, University College Dublin, National Maternity Hospital, D02 YH21 Dublin, Ireland
| | - Anthony Rafferty
- UCD Perinatal Research Centre, School of Medicine, University College Dublin, National Maternity Hospital, D02 YH21 Dublin, Ireland
| | - Sinead Holden
- UCD School of Mathematics and Statistics, University College Dublin, D04 V1W8 Dublin, Ireland
| | - Sarah Louise Killeen
- UCD Perinatal Research Centre, School of Medicine, University College Dublin, National Maternity Hospital, D02 YH21 Dublin, Ireland
| | - Maria Kennelly
- UCD Perinatal Research Centre, School of Medicine, University College Dublin, National Maternity Hospital, D02 YH21 Dublin, Ireland
| | - Fionnuala M. McAuliffe
- UCD Perinatal Research Centre, School of Medicine, University College Dublin, National Maternity Hospital, D02 YH21 Dublin, Ireland
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21
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Grant D. The "Quiet Revolution" and the cesarean section in the United States. ECONOMICS AND HUMAN BIOLOGY 2022; 47:101192. [PMID: 36351359 DOI: 10.1016/j.ehb.2022.101192] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/20/2022] [Revised: 10/10/2022] [Accepted: 10/11/2022] [Indexed: 06/16/2023]
Abstract
This paper estimates how changes in family structure and women's labor market attachment during the last fifty years have affected the incidence of cesarean delivery in the United States. Both sets of factors are strongly related to cesarean utilization, and have generally changed so as to increase the rate of cesarean delivery over time. Altogether, changes in these factors, complemented by demographic changes, raised the U.S. cesarean section rate by eleven percentage points since the late 1970s, nearly two-thirds of the increase over that period. Today's elevated cesarean section rate is in part a social phenomenon.
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Affiliation(s)
- Darren Grant
- Department of Economics and International Business, Sam Houston State University, Box 2118, Huntsville, TX 77341-2118, USA.
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22
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Baharvand P, Anbari K, Hamidi H. Perceived social support in pregnant women with gestational diabetes attending hospitals in western Iran compared to healthy controls and its relationship with perceived anxiety. J Diabetes Metab Disord 2022; 21:1549-1555. [PMID: 36404846 PMCID: PMC9672204 DOI: 10.1007/s40200-022-01100-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2022] [Revised: 07/11/2022] [Accepted: 07/16/2022] [Indexed: 11/27/2022]
Abstract
Background/purpose Due to the importance of social support in pregnant women, especially those with gestational diabetes that cause anxiety and stress in them and requires effective and enough attention, this study aims to assess perceived social support of pregnant women with gestational diabetes in western Iran compared to healthy controls and its relationship with their perceived anxiety. Methods This is a descriptive/analytical study with a cross-sectional design conducted on 180 pregnant women with gestational diabetes (n = 89) and without gestational diabetes (n = 91) referred to the obstetrics and gynecology clinics of two hospitals (Asalian and Shahid Rahimi) in Khorramabad, western Iran. Data collection tools were a demographic checklist, the Multidimensional Scale of Perceived Social Support (MSPSS), and the Beck Anxiety Inventory (BAI). Collected data were analyzed in SPSS v.20 software using chi square test, independent t-test, one-way ANOVA, and Pearson correlation test. Results The difference between the two groups was significant in terms of perceived support from family (p = 0.001), perceived support from friends (p = 0.006), and anxiety (p = 0.047). Pearson correlation test results showed a significant negative relationship between the scores of MSPSS and BAI in patients (r= -0.329, p = 0.001) and controls (r=-0.204, p = 0.006). There was a significant difference in the MSPSS score among diabetic women in terms of having fetal macrosomia (p = 0.005), occupation (p = 0.003), education (p = 0.001), and frequency of pregnancy (p = 0.010). Conclusions The perceived social support level is higher in diabetic pregnant women compared to healthy peers in western Iran. Improvement of social support from family and friends can reduce the anxiety of pregnant women with/without diabetes.
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Affiliation(s)
- Parastoo Baharvand
- Social Determinants of Health Research Center, Department of Social Medicine, School of Medicine, Lorestan University of Medical Sciences, Khorramabad, Iran
| | - Khatereh Anbari
- Social Determinants of Health Research Center, Department of Social Medicine, School of Medicine, Lorestan University of Medical Sciences, Khorramabad, Iran
| | - Hossein Hamidi
- General Physician, School of Medicine, Lorestan University of Medical Sciences, Khorramabad, Iran
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23
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Jihed A, Ben Rejeb M, Said Laatiri H, Zedini C, Mallouli M, Mtiraoui A. Prevalence and associated factors of perinatal depression among working pregnant women: a hospital-based cross-sectional study. Libyan J Med 2022; 17:2114182. [PMID: 36000708 PMCID: PMC9415599 DOI: 10.1080/19932820.2022.2114182] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Perinatal depression is a major public health problem having serious negative impacts on personal, family, and child developmental outcomes. This study aimed to determine the prevalence of major depressive disorder (MDD) and its associated factors in working pregnant women. This descriptive, cross-sectional study was performed on 389 working pregnant women enrolled from four Tunisian public maternity hospitals. Data collection tools were the sociodemographic, obstetric, family relationships, and work environment questionnaire, and the Center for Epidemiologic Studies Depression Scale (CES-D). The mean score of depression was 27.39 ± 6.97 and 76.1% of women had major depressive symptoms using cutoff points on the CES-D ≥ 23. Family income, diagnosis with a chronic illness, history of depression, and employment categories were associated with major depressive symptoms. In multivariate analyses, family income and work posture were significantly associated with MDD. These results suggest an increased burden of MDD during pregnancy in Tunisian women. Prevention, early detection, and interventions are needed to reduce the prevalence of perinatal depression.
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Affiliation(s)
- Abdallah Jihed
- Center for Evidence into Public Health Policy (C4EPH), Faculty of Medicine of Sousse, University of Sousse, Sousse, Tunisia
| | - Mohamed Ben Rejeb
- Center for Evidence into Public Health Policy (C4EPH), Faculty of Medicine of Sousse, University of Sousse, Sousse, Tunisia
| | - Houyem Said Laatiri
- Center for Evidence into Public Health Policy (C4EPH), Faculty of Medicine of Sousse, University of Sousse, Sousse, Tunisia
| | - Chekib Zedini
- Center for Evidence into Public Health Policy (C4EPH), Faculty of Medicine of Sousse, University of Sousse, Sousse, Tunisia.,Laboratory of Research LR12ES03, Department of Community and Family Health, Faculty of Medicine of Sousse, University of Sousse, Sousse, Tunisia
| | - Manel Mallouli
- Center for Evidence into Public Health Policy (C4EPH), Faculty of Medicine of Sousse, University of Sousse, Sousse, Tunisia.,Laboratory of Research LR12ES03, Department of Community and Family Health, Faculty of Medicine of Sousse, University of Sousse, Sousse, Tunisia
| | - Ali Mtiraoui
- Center for Evidence into Public Health Policy (C4EPH), Faculty of Medicine of Sousse, University of Sousse, Sousse, Tunisia.,Laboratory of Research LR12ES03, Department of Community and Family Health, Faculty of Medicine of Sousse, University of Sousse, Sousse, Tunisia
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24
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Sheahan KL, Kroll-Desrosiers A, Goldstein KM, Sheahan MM, Oumarou A, Mattocks K. Sufficiency of Health Information During Pregnancy: What's Missing and for Whom? A Cross-Sectional Analysis Among Veterans. J Womens Health (Larchmt) 2022; 31:1557-1566. [PMID: 35404136 DOI: 10.1089/jwh.2021.0462] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Background: Women Veterans often experience trauma and physical and mental health conditions that increase risk of adverse pregnancy outcomes. Information provision during pregnancy may facilitate improved outcomes. However, little evidence exists about information women Veterans receive during pregnancy, and their perceptions of it. Materials and Methods: We recruited pregnant Veterans from 15 Veterans Affairs medical centers. Through telephone surveys, women (N = 851) provided information about sociodemographic characteristics, military service, health, and pregnancy experiences. We asked postpartum women whether, during pregnancy, they received sufficient information about nine health topics. We calculated a composite score (range: 0-9) that reflected sufficiency of information received. Multivariable logistic regression models identified determinants of perceived sufficiency of information. Results: Mean age was 32.1 years. Most reported being White (56.3%), non-Hispanic (80.3%), married/living with a partner (85.1%), and employed (54.4%). Most (54.6%) had been diagnosed with depression (54.6%); one-quarter reported current depressive symptoms. Mean sufficiency of information score was 6.9. Topics that women most reported they did not receive sufficient information on included, what to expect during delivery (32.3%) and how their spouse/partner might support them during labor (40.3%). History of depression (β = -0.35, p = 0.03), current depressive symptoms (β = -0.66, p = 0.001), military sexual trauma (β = 0.37, p = 0.03), and experience of violence (β = 0.66, p = 0.03) were associated with lower sufficiency of information scores. Conclusion: Results indicate need for enhanced and tailored provision of information for Veterans during pregnancy, particularly among those with experience of trauma, past depression diagnoses, and current depressive symptoms. This may include optimizing care coordination and increasing access to childbirth education classes and doula support.
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Affiliation(s)
- Kate L Sheahan
- Center of Innovation to Accelerate Discovery and Practice Transformation (ADAPT), Health Services Research and Development, Durham VA Health Care System, Durham, North Carolina, USA
| | - Aimee Kroll-Desrosiers
- VA Central Western Massachusetts Healthcare System, Leeds, Massachusetts, USA
- Department of Population and Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, Massachusetts, USA
| | - Karen M Goldstein
- Center of Innovation to Accelerate Discovery and Practice Transformation (ADAPT), Health Services Research and Development, Durham VA Health Care System, Durham, North Carolina, USA
- Division of General Internal Medicine, Duke University School of Medicine, Durham, North Carolina, USA
| | | | - Annie Oumarou
- Center of Innovation to Accelerate Discovery and Practice Transformation (ADAPT), Health Services Research and Development, Durham VA Health Care System, Durham, North Carolina, USA
| | - Kristin Mattocks
- VA Central Western Massachusetts Healthcare System, Leeds, Massachusetts, USA
- Department of Population and Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, Massachusetts, USA
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25
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Nazir H, Rowther AA, Rauf N, Atiq M, Kazi AK, Malik A, Atif N, Surkan PJ. 'Those whom I have to talk to, I can't talk to': Perceived social isolation in the context of anxiety symptoms among pregnant women in Pakistan. HEALTH & SOCIAL CARE IN THE COMMUNITY 2022; 30:e5885-e5896. [PMID: 36121172 PMCID: PMC11075807 DOI: 10.1111/hsc.14019] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/05/2021] [Revised: 07/26/2022] [Accepted: 08/20/2022] [Indexed: 06/15/2023]
Abstract
Anxiety during pregnancy is highly prevalent in low- and middle-income countries. The relative importance of different sources and types of perceived support in the Pakistani context is unknown. We explored social support during pregnancy and the role of social isolation in Pakistani women's experiences of antenatal anxiety. We conducted semi-structured interviews with 19 pregnant women with symptoms of anxiety and 10 female healthcare providers at a public urban hospital. We used inductive and deductive thematic coding to analyse the data. Many pregnant women reported feelings of physical and social isolation, even when living in joint families with larger social networks. Often fearing censure by their in-laws and peers for sharing or seeking help with pregnancy-related anxieties, women reported relying on husbands or natal family members. Normative expectations around pregnancy such as male gender preference, perceived immutability of wives' domestic responsibilities and expectations of accompanied travel by women may serve as sources of disconnectedness in the antenatal period. Providers viewed social isolation and deficits in social support during pregnancy as contributing to worse anxiety symptoms, reduced access to care and poorer health behaviours. One limitation is that the hospital setting for this study may have resulted in underreporting of abuse or neglect and limited inclusion of pregnant women who do not utilise facility-based antenatal care. In conclusion, husbands and natal families were key in reducing social isolation in pregnancy and mitigating anxiety, while in-laws did not always confer support. Targeted strategies should enhance existing support and strengthen in-law family relationships in pregnancy.
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Affiliation(s)
- Huma Nazir
- Human Development Research Foundation, House No 06, Street No 55, F-7/4, Islamabad 44000, Pakistan
| | - Armaan A Rowther
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe St., Baltimore, MD 21205, USA
| | - Nida Rauf
- Human Development Research Foundation, House No 06, Street No 55, F-7/4, Islamabad 44000, Pakistan
| | - Maria Atiq
- Human Development Research Foundation, House No 06, Street No 55, F-7/4, Islamabad 44000, Pakistan
| | - Asiya K Kazi
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe St., Baltimore, MD 21205, USA
| | - Abid Malik
- Human Development Research Foundation, House No 06, Street No 55, F-7/4, Islamabad 44000, Pakistan
| | - Najia Atif
- Human Development Research Foundation, House No 06, Street No 55, F-7/4, Islamabad 44000, Pakistan
| | - Pamela J. Surkan
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe St., Baltimore, MD 21205, USA
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26
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Knorr DA, Fox M. An evolutionary perspective on the association between grandmother-mother relationships and maternal mental health among a cohort of pregnant Latina women. EVOL HUM BEHAV 2022; 44:30-38. [PMID: 37065817 PMCID: PMC10100916 DOI: 10.1016/j.evolhumbehav.2022.10.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Grandmothers are often critical helpers during a mother's reproductive career. Studies on the developmental origins of health and disease demonstrate how maternal psychological distress can negatively influence fetal development and birth outcomes, highlighting an area in which soon-to-be grandmothers (henceforth "grandmothers") can invest to improve both mother and offspring well-being. Here, we examine if and how a pregnant woman's mental health- specifically, depression, state-anxiety, and pregnancy-related anxiety- is influenced by her relationship with her fetus' maternal and paternal grandmother, controlling for relationship characteristics with her fetus' father. In a cohort of pregnant Latina women in Southern California (N = 216), we assessed social support, geographic proximity, and communication between the fetus' grandmothers and pregnant mother. We assessed maternal mental health with validated questionnaire-based instruments. We find that both social support from and communication with the maternal grandmother were statistically associated with less depression, while no paternal grandmother relationship characteristics were statistically significant in association with any mental health variable. These results align with the idea that maternal grandmothers are more adaptively incentivized to invest in their daughters' well-being during pregnancy than paternal grandmothers are for their daughters-in-law. Results suggest that the positive association of maternal grandmothers with mothers' mental health may not hinge on geographic proximity, but rather, potentially function through emotional support. This work represents a novel perspective describing a psychological and prenatal grandmaternal effect.
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Affiliation(s)
- Delaney A. Knorr
- Department of Anthropology, University of California, Los Angeles, CA 90095, United States of America
- Corresponding author at: 375 Portola Plaza, 341 Haines Hall, University of California, Los Angeles, CA 90095, United States of America. (D.A. Knorr)
| | - Molly Fox
- Department of Anthropology, University of California, Los Angeles, CA 90095, United States of America
- Department of Psychiatry & Biobehavioral Sciences, University of California Los Angeles, Los Angeles, CA 90095, United States of America
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27
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Jiang L, Zhu Z. Maternal mental health and social support from online communities during pregnancy. HEALTH & SOCIAL CARE IN THE COMMUNITY 2022; 30:e6332-e6344. [PMID: 36256486 PMCID: PMC10092248 DOI: 10.1111/hsc.14075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/27/2022] [Revised: 07/29/2022] [Accepted: 10/01/2022] [Indexed: 06/16/2023]
Abstract
Social determinants of public health have gained increasing attention. This paper studied whether social support from online communities related to maternal mental health. We focused on online maternity communities that group users with a similar prenatal status to facilitate their exchange of personal experiences and knowledge about maternal caring during pregnancy. Such online maternity communities are getting increasingly popular and can be found across countries and societies. We invited users-currently pregnant and gave birth within 1 year at the time of the study-from one such community in China to participate in a survey. The survey measured their perceived social support (PSS) exclusively from the peer group in the online community, their mental health and newborns' birth outcomes (N = 500). Users reported high score in PSS from the online peer group which was comparable to the ones from family, significant other and friends in other studies. We used linear regression models to examine the effects of PSS on mental health and birth outcomes. We found that a one-point increase in the PSS score was associated with a 0.19-point (p < 0.1) decrease in the prenatal depression and a 0.26-point (p < 0.01) decrease in the postnatal depression, which was equivalent to 3% and 4.5% of the average respectively. Moreover, a one-point increase in the PSS score was associated with a 14.49-gram increase in a newborn's weight (p < 0.01).
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Affiliation(s)
| | - Zhen Zhu
- Kent Business SchoolUniversity of KentCanterburyUK
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28
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Hübner T, Wolfgang T, Theis AC, Steber M, Wiedenmann L, Wöckel A, Diessner J, Hein G, Gründahl M, Kämmerer U, Kittel-Schneider S, Bartmann C. The impact of the COVID-19 pandemic on stress and other psychological factors in pregnant women giving birth during the first wave of the pandemic. Reprod Health 2022; 19:189. [PMID: 36064560 PMCID: PMC9444078 DOI: 10.1186/s12978-022-01493-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2021] [Accepted: 08/16/2022] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND The onset of mental illness such as depression and anxiety disorders in pregnancy and postpartum period is common. The coronavirus induced disease 2019 (COVID-19) pandemic and the resulting public policy responses represent an exceptional situation worldwide and there are hints for adverse psychosocial impact, hence, the study of psychological effects of the pandemic in women during hospitalization for delivery and in the postpartum period is highly relevant. METHODS Patients who gave birth during the first wave of the COVID-19 pandemic in Germany (March to June 2020) at the Department of Obstetrics and Gynecology, University of Würzburg, Germany, were recruited at hospital admission for delivery. Biosamples were collected for analysis of SARS-CoV-2 infection and various stress hormones and interleukin-6 (IL-6). In addition to sociodemographic and medical obstetric data, survey questionnaires in relation to concerns about and fear of COVID-19, depression, stress, anxiety, loneliness, maternal self-efficacy and the mother-child bonding were administered at T1 (delivery stay) and T2 (3-6 months postpartum). RESULTS In total, all 94 recruited patients had a moderate concern of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) at T1 with a significant rise at T2. This concern correlated with low to low-medium general psychosocial stress levels and stress symptoms, and the women showed a significant increase of active coping from T1 to T2. Anxiety levels were low and the Edinburgh Postnatal Depression Scale showed a medium score of 5 with a significant (T1), but only week correlation with the concerns about SARS-CoV-2. In contrast to the overall good maternal bonding without correlation to SARS-CoV-2 concern, the maternal self-efficiency correlated negatively with the obstetric impairment caused by the COVID-19 pandemic. CONCLUSION Obstetric patients` concerns regarding SARS-CoV-2 and the accompanying pandemic increased during the course of the pandemic correlating positively with stress and depression. Of note is the increase in active coping over time and the overall good mother-child-bonding. Maternal self-efficacy was affected in part by the restrictions of the pandemic. Clinical trial registration DRKS00022506.
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Affiliation(s)
- Theresa Hübner
- Department of Obstetrics and Gynaecology, University Hospital of Würzburg, Josef-Schneider-Str. 4, 97080, Würzburg, Germany.
| | - Tanja Wolfgang
- Department of Obstetrics and Gynaecology, University Hospital of Würzburg, Josef-Schneider-Str. 4, 97080, Würzburg, Germany.,Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital, Margarete-Höppel-Platz 1, 97080, Würzburg, Germany
| | - Ann-Catrin Theis
- Department of Obstetrics and Gynaecology, University Hospital of Würzburg, Josef-Schneider-Str. 4, 97080, Würzburg, Germany
| | - Magdalena Steber
- Department of Obstetrics and Gynaecology, University Hospital of Würzburg, Josef-Schneider-Str. 4, 97080, Würzburg, Germany
| | - Lea Wiedenmann
- Department of Obstetrics and Gynaecology, University Hospital of Würzburg, Josef-Schneider-Str. 4, 97080, Würzburg, Germany
| | - Achim Wöckel
- Department of Obstetrics and Gynaecology, University Hospital of Würzburg, Josef-Schneider-Str. 4, 97080, Würzburg, Germany
| | - Joachim Diessner
- Department of Obstetrics and Gynaecology, University Hospital of Würzburg, Josef-Schneider-Str. 4, 97080, Würzburg, Germany
| | - Grit Hein
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital, Margarete-Höppel-Platz 1, 97080, Würzburg, Germany
| | - Marthe Gründahl
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital, Margarete-Höppel-Platz 1, 97080, Würzburg, Germany
| | - Ulrike Kämmerer
- Department of Obstetrics and Gynaecology, University Hospital of Würzburg, Josef-Schneider-Str. 4, 97080, Würzburg, Germany
| | - Sarah Kittel-Schneider
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital, Margarete-Höppel-Platz 1, 97080, Würzburg, Germany
| | - Catharina Bartmann
- Department of Obstetrics and Gynaecology, University Hospital of Würzburg, Josef-Schneider-Str. 4, 97080, Würzburg, Germany
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29
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Alnuaimi K, Alshraifeen A, Aljaraedah H. Factors influencing quality of life among syrian refugees pregnant women in Jordan: A cross-sectional study. Heliyon 2022; 8:e10685. [PMID: 36193516 PMCID: PMC9526160 DOI: 10.1016/j.heliyon.2022.e10685] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Revised: 02/26/2022] [Accepted: 09/13/2022] [Indexed: 10/25/2022] Open
Abstract
Background Pregnancy is a critical period of transition incorporating important normal physical, emotional, hormonal, and physiological status changes. These changes might affect the quality of life (QOL) of pregnant woman. This study aimed to examine the levels of quality of life and perceived social support of Syrian refugees' pregnant women in Al-Zaatari Refugee Camp in Jordan. Methods A cross-sectional survey design was used. A sample of 319 pregnant women was recruited from two maternal health clinics at Al-Zaatari Refugee Camp. Data were collected from June to August 2020 using the Arabic version of World Health Organization Quality of Life (WHOQOL-BREF), the Multidimensional Perceived Social Support (MSPSS) questionnaires, and two sheets were used to assess sociodemographic and obstetric variables. Results The study reveals that Syrian refugees' pregnant women had good satisfaction with their overall QOL and health status and social support. A significant relationship was found between the socioeconomic index and QOL. Also, age, being in the third trimester, and parity correlated negatively with QOL. In contrast, those who stayed in Jordan as a refugee for a longer period reported better QOL. Conclusion Syrian women in Jordan, in general, have a good QOL and high level of social support. However, women were least satisfied with their physical health domain. Several factors affected QOL including income, employment status, age, number of children, and pregnancy trimester. Social support is an important factor in improving the QOL among Syrian refugees' pregnant women.
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Affiliation(s)
- Karimeh Alnuaimi
- Maternal and Child Health Nursing Department, Faculty of Nursing, Jordan University of Science and Technology Jordan
| | - Ali Alshraifeen
- Adult Health Nursing Department, Faculty of Nursing, The Hashemite University, P.O. Box 330127, Zarqa 13133, Jordan
| | - Hala Aljaraedah
- Faculty of Nursing, Jordan University of Science and Technology, P.O. Box (3030), Irbid, 22110 Jordan
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30
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Willemse E, Walters BH, Springvloet L, Bommelé J, Willemsen MC. “If the social circle is engaged, more pregnant women will successfully quit smoking”: a qualitative study of the experiences of midwives in the Netherlands with smoking cessation care. BMC Health Serv Res 2022; 22:1106. [PMID: 36045362 PMCID: PMC9429426 DOI: 10.1186/s12913-022-08472-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2022] [Accepted: 08/11/2022] [Indexed: 11/10/2022] Open
Abstract
Background If smoking is common within a pregnant woman’s social circle, she is more likely to smoke and her chances of succeeding in quitting smoking are reduced. It is therefore important to encourage smoking cessation in a pregnant woman’s social circle. Midwives are ideally positioned to help pregnant women and members of their social circle quit smoking but there is currently little knowledge about if and how midwives approach smoking cessation with pregnant women’s social circles. Methods In 2017 and 2018, semi-structured interviews were conducted with 14 birth care providers in the Netherlands. Interviews were inductively coded; data were analyzed thematically. Results In the interviews, midwives reported that they don’t commonly provide smoking cessation support to members of pregnant women’s social circles. The respondents noted that they primarily focused on mothers and weren’t always convinced that advising the partners, family, and friends of pregnant women to quit smoking was their responsibility. Data from the interviews revealed that barriers to giving advice to the social circle included a lack of a trusting relationship with the social circle, concerns about raising the topic and giving unwanted advice on cessation to members of the social circle and a lack of opportunity to discuss smoking. Conclusions Midwives in the Netherlands were reluctant to actively provide smoking cessation advice to the social circle of pregnant women. To overcome barriers to addressing cessation to the social circle, educational programs or new modules for existing programs could be used to improve skills related to discussing smoking. Clear guidelines and protocols on the role of midwives in providing cessation support to the social circle could help midwives overcome ambivalence that they might have. Supplementary Information The online version contains supplementary material available at 10.1186/s12913-022-08472-7.
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Nguyen LD, Nguyen LH, Ninh LT, Nguyen HTT, Nguyen AD, Vu LG, Nguyen HSA, Nguyen SH, Doan LP, Vu TMT, Tran BX, Latkin CA, Ho CSH, Ho RCM. Women's holistic self-care behaviors during pregnancy and associations with psychological well-being: implications for maternal care facilities. BMC Pregnancy Childbirth 2022; 22:631. [PMID: 35945522 PMCID: PMC9364562 DOI: 10.1186/s12884-022-04961-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2021] [Accepted: 07/20/2022] [Indexed: 12/12/2022] Open
Abstract
Background Self-care behaviors during pregnancy significantly impacts mother and children's health. This study aimed to explore the self-care behaviors and the associations of these behaviors with the psychological well-being of women during pregnancy, as well as the mediating effects of different social support with these associations. Methods A cross-sectional data of 562 pregnant women at Hanoi Obstetrics & Gynecology Hospital and Ca Mau Obstetrics & Pediatrics in Vietnam were analyzed. Questions about self-care behaviors, pregnancy characteristics, social support, and psychological well-being were asked. Multivariate regression models were performed. Structural Equation Modeling (SEM) was employed to test the mediating effects of different social support with the association between self-care behaviors and psychological well-being. Findings Only 13% of pregnant women often or always did physical exercise at least three times a week, and 40% consumed enough fiber and five servings of vegetables a day. Only 78.7% always avoided alcohol drinking, and 53.9% of pregnant women avoided being exposed to second-hand smoking and 71,7% avoided using traditional medicine without physicians’ prescriptions. Around 66% of pregnant women always or often had prenatal care checkups as scheduled. Information sources, social support and childbirth expectation were major drivers for self-care practices. SEM model showed that social support mediated the relationship between maternal health behaviors and mental well-being. Conclusion This study highlighted the remarkable gaps in self-care practices among our pregnant women, which were significantly associated with their mental well-being. Social support-oriented consultancy and interventions should be warranted for improving behaviors and the mental well-being of pregnant women in Vietnam.
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Affiliation(s)
- Lam Duc Nguyen
- Department of Anaesthesiology, Hanoi Medical University, Hanoi, Vietnam
| | - Long Hoang Nguyen
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
| | - Ly Thi Ninh
- Social Affair Department, Ca Mau Obstetrics & Pediatrics Hospital, Ca Mau, Vietnam
| | | | - Anh Duy Nguyen
- Hanoi Obstetrics and Gynecology Hospital, Hanoi, Vietnam
| | - Linh Gia Vu
- Institute for Global Health Innovations, Duy Tan University, Da Nang, Vietnam.,Faculty of Nursing, Duy Tan University, Da Nang, 550000, Vietnam
| | | | - Son Hoang Nguyen
- Center of Excellence in Evidence-Based Medicine, Nguyen Tat Thanh University, Ho Chi Minh City, Vietnam
| | - Linh Phuong Doan
- Institute for Global Health Innovations, Duy Tan University, Da Nang, Vietnam. .,Faculty of Nursing, Duy Tan University, Da Nang, 550000, Vietnam.
| | | | - Bach Xuan Tran
- Institute for Preventive Medicine and Public Health, Hanoi Medical University, Hanoi, Vietnam.,Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | - Carl A Latkin
- Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | - Cyrus S H Ho
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Roger C M Ho
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.,Institute for Health Innovation and Technology (iHealthtech), National University of Singapore, Singapore, Singapore
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Wright KQ. "It changed the atmosphere surrounding the baby I did have": Making sense of reproduction during the COVID-19 pandemic. JOURNAL OF MARRIAGE AND THE FAMILY 2022; 84:1105-1128. [PMID: 35935914 PMCID: PMC9347647 DOI: 10.1111/jomf.12851] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Revised: 04/13/2022] [Accepted: 05/02/2022] [Indexed: 06/15/2023]
Abstract
OBJECTIVE This study examines the schemas that women employed during the COVID-19 pandemic to make sense of their reproductive desires. BACKGROUND Existing research on reproduction during epidemics suggests that there are variable population responses to periods of long-term social uncertainty. However, less is known about how individuals make sense of maintaining or adapting their reproductive desires during periods of social upheaval. METHOD Twenty-nine women aged 25-35 from a mid-sized Midwestern county in the United States were recruited and interviewed about their experiences during the first 8 months of the COVID-19 pandemic. They were asked about their daily lived experiences and their reproductive desires during in-depth interviews. These interviews were transcribed and analyzed using thematic coding. RESULTS Participants used three normative schemas to describe their reproductive desires during the COVID-19 pandemic. Heteronormative schemas were used by many participants to articulate their commitment to a heteronormative aged-staged timeline of life events. Schemas of social support around being pregnant and giving birth were used by participants, primarily those who were currently or recently pregnant, to express grief and loss over the relational experience of having a new baby. Medicalized schemas were expressed by most participants to describe feelings of fear and risk at real or imagined encounters with medical institutions. CONCLUSION The schemas that participants used to make sense of their reproductive desires demonstrate how sense-making during a profound event that affects everyday realities allows participants to (re)articulate commitments to existing narratives that reinforce heterosexual, social, and medicalized hierarchies in reproduction.
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Affiliation(s)
- Kelsey Q. Wright
- Department of Sociology, Center for Demography and EcologyUniversity of Wisconsin‐MadisonMadisonWisconsinUSA
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Simanek AM, Manansala R, Woo JMP, Meier HCS, Needham BL, Auer PL. Prenatal Socioeconomic Disadvantage and Epigenetic Alterations at Birth Among Children Born to White British and Pakistani Mothers in the Born in Bradford Study. Epigenetics 2022; 17:1976-1990. [PMID: 35837690 DOI: 10.1080/15592294.2022.2098569] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
Prenatal socioeconomic disadvantage (SD) has been linked to DNA methylation (DNAm) in adulthood, but whether such epigenetic alterations are present at birth remains unclear. We carried out an epigenome-wide analysis of the association between several measures of individual- and area-level prenatal SD and DNAm assessed in neonatal cord blood via the Infinium EpicBeadChip among offspring born to mothers of White British (N = 455) and Pakistani (N = 493) origin in the Born in Bradford Study. Models were adjusted for mother's age, ethnicity, and education level as well as cell-type fractions and then for maternal health behaviours and neonate characteristics, and last, stratified by mother's ethnicity. P-values were corrected for multiple testing and a permutation-based approach was used to account for small cell sizes. Among all children, housing tenure (owning versus renting) as well as father's occupation (manual versus non-manual) were each associated with DNAm of one CpG site and index of multiple deprivation (IMD) was associated with DNAm of 11 CpG sites. Among children born to White British mothers, father's occupation (student or unemployed versus non-manual) was associated with DNAm of 1 CpG site and IMD with DNAm of 3 CpG sites. Among children born to Pakistani mothers, IMD was associated with DNAm of 1 CpG site. Associations were largely unchanged after further adjustment for maternal health behaviours or neonate characteristics and remained statistically significant. Our findings suggest that individual- and area-level prenatal SD may shape alterations to the neonatal epigenome, but associations vary across ethnic groups.
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Affiliation(s)
- Amanda M Simanek
- University of Wisconsin-Milwaukee Joseph J. Zilber School of Public Health, Milwaukee, WI, USA
| | - Regina Manansala
- Centre for Health Economics Research & Modelling Infectious Diseases (CHERMID), Vaccine & Infectious Disease Institute (VAXINFECTIO) WHO Collaborating Centre, University of Antwerp, Antwerp, Belgium
| | - Jennifer M P Woo
- University of Wisconsin-Milwaukee Joseph J. Zilber School of Public Health, Milwaukee, WI, USA.,Epidemiology Branch, National Institute of Environmental Health Sciences, Research Triangle Park, North Carolina, USA
| | - Helen C S Meier
- Survey Research Center, Institute for Social Research, University of Michigan, Ann Arbor, MI, USA
| | - Belinda L Needham
- Department of Epidemiology, University of Michigan-School of Public Health, Ann Arbor, MI, USA
| | - Paul L Auer
- Division of Biostatistics and Cancer Center, Medical College of Wisconsin, Milwaukee, WI, USA
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Health Behaviors and Behavior Change during Pregnancy: Theory-Based Investigation of Predictors and Interrelations. SEXES 2022. [DOI: 10.3390/sexes3030027] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
(1) Background: Preventing pregnancy complications and maternal deaths and helping women stay healthy before, during, and after pregnancy by means of sexual health and behavior is imperative. Previous research demonstrated that a lack of social support and perceived discrimination have adverse effects on pregnancy outcomes. These determinants may impact health behavior as an important mediator of pregnancy outcomes. To better understand this relation, the Compensatory Carry-Over Action Model (CCAM) was applied. The research question was: how do predictors of health behavior, specifically intention, planning, self-efficacy, social support, and discrimination, interrelate with different health behaviors during pregnancy? (2) Methods: By means of qualitative interviews with ten pregnant women (20–39 years, mean = 28.6) from different cultural backgrounds, the predictors of health behaviors and experiences with pregnancy, including racial discrimination, were investigated. (3) Results: Not all women changed their unhealthy behaviors even though their higher-level goal was to ensure their baby’s and their own health. This appeared partially due to lack of social support, racial discrimination, and unexpected pregnancy side effects. The women who previously performed health behaviors revealed a healthier pattern with maintaining or even expanding their health behaviors, while those performing no health behavior in the past reported more obstacles with a healthy lifestyle. (4) Conclusions: Pregnant women appear to be having difficulties translating good intentions into behavior. The reasons include lack of support, fear, and insecurity, which impact self-efficacy and planning. Improvements in health behaviors were facilitated by specific circumstances, such as working from home. Policy and practice should take these aspects into account and help mobilize support and overcome discrimination by means of more rights and support for pregnant women while also empowering the individuals.
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Choi R, Nagappan A, Kopyto D, Wexler A. Pregnant at the start of the pandemic: a content analysis of COVID-19-related posts on online pregnancy discussion boards. BMC Pregnancy Childbirth 2022; 22:493. [PMID: 35710387 PMCID: PMC9201795 DOI: 10.1186/s12884-022-04802-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2021] [Accepted: 05/24/2022] [Indexed: 11/25/2022] Open
Abstract
Background A growing body of evidence indicates that the COVID-19 pandemic has had detrimental mental health effects for pregnant women. However, little is known about the specific stressors that increased anxiety for pregnant women at the start of the pandemic. The present study aimed to better understand the concerns of pregnant women during the beginning COVID-19 pandemic by analyzing content posted during the month of March 2020 on online pregnancy message boards hosted on WhatToExpect.com. Methods All posts published between March 1–31, 2020 on nine different due-date specific WhatToExpect.com message boards were reviewed for COVID-19 relevance. Posts mentioning COVID-19 or its direct effects (e.g., “quarantine” or “stay-at-home order”) were included in our final sample. Data were coded by three authors according to a codebook developed inductively by all four authors. Posts were analyzed by overall frequency of appearance, by trimester, and temporally across the month of March 2020. Results Across the 5,541 posts included in our final sample, the most common topics were fear of COVID-19 exposure, concerns with labor and delivery, navigating social interactions, and disruptions to prenatal care. The most dominant topics by trimester were disruptions to prenatal care (first trimester), fear of COVID-19 exposure (second trimester), and concerns about labor and delivery (third trimester). Conclusion Our findings add to prior literature by demonstrating the salience of social concerns, which was the third largest COVID-19 topic in our sample. Emotional distress was most salient with regard to restrictions on birthing partners, but was apparent in everything from disruptions to pregnancy announcements, to cancelled baby showers, and limitations on newborn visitors. Given that anxiety during pregnancy is associated with worse maternal–fetal health outcomes, in the early stages of future pandemics healthcare providers should focus not only on strictly health-related concerns expressed by pregnant women, but also more broadly on other sources of anxiety that may be impacting the well-being and mental health of their patients. Supplementary information The online version contains supplementary material available at 10.1186/s12884-022-04802-z.
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Affiliation(s)
- Rebekah Choi
- Department of Medical Ethics and Health Policy, University of Pennsylvania, Blockley Hall, 423 Guardian Drive, Philadelphia, PA, 19104, USA
| | - Ashwini Nagappan
- Department of Medical Ethics and Health Policy, University of Pennsylvania, Blockley Hall, 423 Guardian Drive, Philadelphia, PA, 19104, USA
| | - Deena Kopyto
- Department of Medical Ethics and Health Policy, University of Pennsylvania, Blockley Hall, 423 Guardian Drive, Philadelphia, PA, 19104, USA
| | - Anna Wexler
- Department of Medical Ethics and Health Policy, University of Pennsylvania, Blockley Hall, 423 Guardian Drive, Philadelphia, PA, 19104, USA.
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Almeida R, Barbosa C, Pereira B, Diniz M, Baena A, Conde A. Tobacco Smoking during Pregnancy: Women's Perception about the Usefulness of Smoking Cessation Interventions. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:6595. [PMID: 35682178 PMCID: PMC9180849 DOI: 10.3390/ijerph19116595] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/07/2022] [Revised: 05/24/2022] [Accepted: 05/25/2022] [Indexed: 12/10/2022]
Abstract
Tobacco consumption during pregnancy is a serious public health problem due to its negative effects on fetal development and on pregnant women's health and well-being. Thus, it is of utmost importance to plan and implement smoking cessation interventions, to prevent the negative impact of this risk factor, namely on children's health and development. This cross-sectional study aimed at exploring the perceptions and beliefs about the usefulness of smoking cessation interventions during pregnancy, in a sample of pregnant Portuguese women. The smoking use by pregnant women, as well as the risk factors associated with tobacco smoking during pregnancy, were also analyzed. The sample included 247 pregnant Portuguese women aged between 18-43-years-old (M = 30.30, SD = 5.02): 42.5% never smoked, 18.3% quit smoking before pregnancy, 19.0% quit smoking after getting pregnant and 20.2% were current smokers. The pregnant Portuguese women who smoked during pregnancy (current smokers or who quit smoking after getting pregnant) were mostly single or divorced, with lower education levels, showed a higher prevalence of clinically significant anxiety symptoms, and perceived smoking cessation interventions during pregnancy as less useful when compared to women who never smoked or quit smoking prior pregnancy. Daily or weekly smoking cessation interventions, implemented by health professionals such as doctors, nurses, or psychologists are the ones perceived as the most useful for pregnant women. These findings provide important clues for the planning of smoking cessation interventions during pregnancy, highlighting the domains that should be carefully monitored by health professionals. Specific strategies should also be used by health professionals to promote smoking cessation considering the demands of pregnancy and postpartum.
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Affiliation(s)
- Rita Almeida
- Portucalense Institute for Human Development (INPP), Portucalense University, 4200-072 Porto, Portugal; (R.A.); (C.B.); (B.P.); (M.D.)
| | - Carolina Barbosa
- Portucalense Institute for Human Development (INPP), Portucalense University, 4200-072 Porto, Portugal; (R.A.); (C.B.); (B.P.); (M.D.)
| | - Bruno Pereira
- Portucalense Institute for Human Development (INPP), Portucalense University, 4200-072 Porto, Portugal; (R.A.); (C.B.); (B.P.); (M.D.)
| | - Mateus Diniz
- Portucalense Institute for Human Development (INPP), Portucalense University, 4200-072 Porto, Portugal; (R.A.); (C.B.); (B.P.); (M.D.)
| | - Antoni Baena
- eHealth Center, Faculty of Health Sciences, Universitat Oberta de Catalunya, 08018 Barcelona, Spain;
- Tobacco Control Research Group, Bellvitge Biomedical Research Institute (IDIBELL), L’Hospitalet de Llobregat, 08908 Barcelona, Spain
| | - Ana Conde
- Portucalense Institute for Human Development (INPP), Portucalense University, 4200-072 Porto, Portugal; (R.A.); (C.B.); (B.P.); (M.D.)
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Xayyabouapha A, Sychareun V, Quyen BTT, Thikeo M, Durham J. Prevalence and Risk Factors Associated With Postpartum Depressive Symptoms Among Women in Vientiane Capital, Lao PDR. Front Public Health 2022; 10:791385. [PMID: 35592080 PMCID: PMC9110677 DOI: 10.3389/fpubh.2022.791385] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2021] [Accepted: 04/04/2022] [Indexed: 11/19/2022] Open
Abstract
Postpartum depression (PPD), the onset of depressive episodes after childbirth, is the most common psychological condition following childbirth, and a global public health concern. If undiagnosed and/or untreated, postpartum depression can have negative effects on maternal and child health, however, there are few studies on the prevalence of postpartum depression in low- and middle-income countries. To contribute to filling this gap, this study examined the prevalence and risk factors associated with postpartum depressive symptoms among women after delivery in Vientiane Capital, Lao PDR. The study was a cross-sectional design, with multistage sampling used to identify women between 4 and 24 weeks after giving birth (N = 521). The Edinburgh Postnatal Depression Scale was used to identify women with postpartum depressive symptoms. Univariate and multivariate logistic regressions identified risk factors associated with postpartum depressive symptoms. The prevalence of postpartum depressive symptoms among participants was 21.3%. Associated factors were having at least 2-3 living children (AOR: 1.9, 95% CI: 1.1-3.0), experiencing mental health problems during pregnancy (AOR: 3.3, 95% CI: 1.4-7.6), experiencing conflicts with family members (AOR: 2.5, 95% CI: 1.5-4.0), the experience of intimate partner violence (AOR: 2.6, 95% CI: 1.3-5.5), and receiving moderate social support (AOR: 5.6, 95% CI: 3.2-10.0). In contexts where access to mental health specialists has severely constrained maternal and child healthcare providers at primary health care must be supported to develop the necessary skills to identify risk factors and symptoms and offer basic essential services for postpartum depressive symptom (PDS). The study identified a high proportion of mothers with postnatal depressive symptoms, highlighting the need to screen and treat mothers who present with PDS, as not doing so exposes mother and their children to a range of negative health and social outcomes. Addressing the stigma associated with mental health illness and mental health illness and domestic violence that prevents women from seeking healthcare, must also be developed, implemented, and evaluated.
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Affiliation(s)
- Amkha Xayyabouapha
- Faculty of Public Health, University of Health Sciences and Hanoi University of Public Health, Vientiane, Laos
| | | | - Bui Thi Tu Quyen
- Biostatistics Department, Faculty of Fundamental Sciences, Hanoi University of Public Health, Vietnam, Laos
| | - Manivone Thikeo
- Faculty of Public Health, University of Health Sciences, Vientiane, Laos
| | - Jo Durham
- School of Public Health and Social Work, Queensland University of Technology, Brisbane, QLD, Australia
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Mitchell AM, Kowalsky JM, Christian LM, Belury MA, Cole RM. Perceived social support predicts self-reported and objective health and health behaviors among pregnant women. J Behav Med 2022; 45:589-602. [PMID: 35449357 DOI: 10.1007/s10865-022-00306-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2020] [Accepted: 03/07/2022] [Indexed: 02/06/2023]
Abstract
Perinatal health and health behaviors play a crucial role in maternal and neonatal health. Data examining psychosocial factors which predict self-reported health and health behaviors as well as objective indicators downstream of health behaviors among pregnant women are lacking. In this longitudinal study design with 131 pregnant women, perceived social support was examined as a predictor of self-rated health and average levels of sleep quality, health-promoting and health-impairing behaviors, and red blood cell (RBC) polyunsaturated fatty acids across early, mid, and late pregnancy. Participants provided a blood sample and fatty acid methyl esters were analyzed by gas chromatography. Measures included the Multidimensional Scale of Perceived Social Support, Pittsburgh Sleep Quality Index, and Prenatal Health Behavior Scale. Regression models demonstrated that, after adjustment for income, race/ethnicity, age, relationship status, pre-pregnancy body mass index, greater social support was associated with better self-rated health (p = 0.001), greater sleep quality (p = 0.001), fewer health-impairing behaviors (p = 0.02), and higher RBC omega-3 fatty acids (p = 0.003). Associations among social support with health-promoting behaviors, RBC omega-6 fatty acids, or gestational weight gain were not significant. Findings underscore the benefits of perceived social support in the context of pregnancy. Examination of pathways that link social support with these outcomes will be meaningful in determining the ways in which perinatal psychosocial interventions may promote health.
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Affiliation(s)
- Amanda M Mitchell
- Department of Counseling and Human Development, College of Education and Human Development, University of Louisville, Woodford and Harriett Porter Building, 1905 South 1st Street, Louisville, KY, 40292, USA.
| | | | - Lisa M Christian
- Department of Psychiatry &, Behavioral Health, The Ohio State University Wexner Medical Center, Columbus, OH, USA
- The Institute for Behavioral Medicine Research, The Ohio State University Wexner Medical Center, Columbus, OH, USA
| | - Martha A Belury
- Department of Human Nutrition, The Ohio State University, Columbus, OH, USA
| | - Rachel M Cole
- Department of Human Nutrition, The Ohio State University, Columbus, OH, USA
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Saridi M, Toska A, Latsou D, Chondropoulou MA, Matsioula A, Sarafis P. Assessment of quality of life and psycho-emotional burden in pregnant women in Greece. Eur J Midwifery 2022; 6:13. [PMID: 35415465 PMCID: PMC8939182 DOI: 10.18332/ejm/145963] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2021] [Revised: 04/14/2021] [Accepted: 01/19/2022] [Indexed: 11/24/2022] Open
Abstract
INTRODUCTION Many changes occur in a woman’s body during pregnancy. These changes (biological, chemical, hormonal, anatomical) can make a pregnant woman both physically and mentally vulnerable. Thus, the aim of this study is to evaluate the quality of life (QoL) in association with depression symptoms in pregnancy. METHODS A cross-sectional study was conducted in 123 pregnant women who visited one of the largest obstetrics and gynecology centers in Greece. The Edinburgh Postnatal Depression Scale (EPDS) was used to measure depression symptoms and World Health Organization Quality of Life instrument to evaluate quality of life. The collected data were organized with the SPSS software, version 25. RESULTS The results showed that 15.5% of pregnant women were at an increased risk of developing depression symptoms; 91% of the women declared that their QoL was good/very good, whereas 92.7% was very satisfied with their health status. Depression symptoms seem to be positively correlated with the low household income, unpleasant event during pregnancy, and the trimester of pregnancy. Additionally, unmarried women, an unpleasant event during pregnancy and the second trimester of pregnancy proved to be negatively associated with the quality of life. Women without a risk of depression had better QοL than women who were at risk of depression symptoms. CONCLUSIONS It is important to evaluate the QοL of women during pregnancy with the aim of good prenatal health. The organization of the necessary interventions for mothers’ health and their newborns are also of vital importance.
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Affiliation(s)
- Maria Saridi
- School of Social Sciences, Hellenic Open University, Patras, Greece
| | - Aikaterini Toska
- School of Social Sciences, Hellenic Open University, Patras, Greece
| | - Dimitra Latsou
- Department of Social and Educational Policy, University of Peloponnese, Corinth, Greece
| | | | | | - Pavlos Sarafis
- Department of Nursing, Faculty of Health Sciences, Cyprus University of Technology, Limassol, Cyprus
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Oboro OF, Ebulue V, Oboro VO, Ohenhen V, Oyewole A, Akindele R, Ala O, Oyeniran O, Isawumi A, Afolabi B. The magnitude and determinants of depressive symptoms amongst women in early pregnancy in Southern Nigeria: A cross-sectional study. S Afr J Psychiatr 2022; 28:1691. [PMID: 35747343 PMCID: PMC9210182 DOI: 10.4102/sajpsychiatry.v28i0.1691] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2021] [Accepted: 05/27/2021] [Indexed: 11/16/2022] Open
Abstract
Background Antenatal depression (AD) is prevalent and associated with adverse pregnancy, maternal and child outcomes, yet no study has addressed its magnitude and predictors in early pregnancy in Nigeria. Aim To determine the prevalence and factors associated with AD in first half of pregnancy. Setting Multicentric health facilities in Southern Nigeria. Methods A multicentric health-facilities-based cross-sectional study was conducted from January to July 2018. Using pretested structure interviewer-administered questionnaires, antenatal depressive symptoms were assessed amongst 511 pregnant mothers with the Edinburg Postnatal Depressive Scale tool. Socio-demographic, socio-economic, clinical, family and social factors were also measured. Descriptive statistics, bivariate and multivariable logistic regression analyses were employed to describe and identify factors associated with AD. Results The prevalence of antenatal depressive symptoms in early pregnancy in this study was 29.4% (95% confidence interval [CI] 26.6–32.9). Factors independently associated with AD were intimate partner violence (adjusted odds ratios [AOR] = 8.10, 95% CI 5.00–13.14), marital dissatisfaction (AOR 5.48, 95% CI 3.48–8.38), poor social support (AOR 4.70; 95% CI 2.99–7.38), past history of depression (AOR 4.67; 95% CI 2.47–8.80), previous pregnancy complication (AOR 2.50, 95% CI 1.57–3.89), low socio-economic status (AOR 2.41, 95% CI 1.61–3.66) and unplanned pregnancy (AOR 2.35, 95% CI 1.47–3.64). Conclusions The prevalence of antenatal depression is high with modifiable risk factors requiring context-specific policies such as provision of family, social and economic support for mothers at the earliest possible contact in the antenatal period.
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Affiliation(s)
- Omolola F. Oboro
- Perinatal Mental Health Unit, OMVIAL Medical Group, Benin-City, Nigeria
| | - Vincent Ebulue
- Perinatal Mental Health Unit, OMVIAL Medical Group, Benin-City, Nigeria
| | - Victor O. Oboro
- Perinatal Mental Health Unit, OMVIAL Medical Group, Benin-City, Nigeria
| | - Victor Ohenhen
- Department of Obstetrics and Gynaecology, Central Hospital Benin, Benin-City, Nigeria
| | - Adeoye Oyewole
- Department of Psychiatry, Faculty of Clinical Sciences, Ladoke Akintola University, Ogbomoso, Nigeria
| | - Rasaq Akindele
- Department of Obstetrics and Gynaecology, LAUTECH Teaching Hospital, Osogbo, Nigeria
| | - Olufemi Ala
- Department of Obstetrics and Gynaecology, LAUTECH Teaching Hospital, Osogbo, Nigeria
| | - Olaolu Oyeniran
- Department of Obstetrics and Gynaecology, LAUTECH Teaching Hospital, Osogbo, Nigeria
| | - Adegboye Isawumi
- Department of Obstetrics and Gynaecology, LAUTECH Teaching Hospital, Osogbo, Nigeria
| | - Babatunde Afolabi
- Department of General Practice, LAUTECH Teaching Hospital, Osogbo, Nigeria
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Zhang CXW, Okeke JC, Levitan RD, Murphy KE, Foshay K, Lye SJ, Knight JA, Matthews SG. Evaluating depression and anxiety throughout pregnancy and after birth: impact of the COVID-19 pandemic. Am J Obstet Gynecol MFM 2022; 4:100605. [PMID: 35257937 PMCID: PMC8895717 DOI: 10.1016/j.ajogmf.2022.100605] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2021] [Revised: 02/09/2022] [Accepted: 02/28/2022] [Indexed: 12/12/2022]
Abstract
BACKGROUND The COVID-19 pandemic presents unique social, economic, and psychological challenges for individuals globally. Thus, women who are pregnant face unprecedented mental health challenges. OBJECTIVE We sought to determine the impact of the pandemic on perinatal depression and anxiety in a longitudinal pregnancy cohort. We hypothesized increased depression and anxiety scores in women during pregnancy and after birth in the pandemic at all time points. STUDY DESIGN Participants were enrolled in the Ontario Birth Study, a pregnancy cohort embedded in clinical care at Mount Sinai Hospital, Toronto, Canada. Perinatal depression and anxiety were assessed using the 2-Item Patient Health Questionnaire and 2-Item Generalized Anxiety Disorder Questionnaire in early pregnancy, whereas the Edinburgh Postnatal Depression Scale and 2-Item Generalized Anxiety Disorder Questionnaire were used in late pregnancy and after birth. Logistic regression models were created to examine the association of the pandemic with clinically elevated mental health scores in the prepandemic group vs pandemic group while adjusting for covariates. RESULTS A total of 1159 survey responses from 649 participants between March 1, 2019, and February 28, 2021, were used to conduct this study. Participants were assessed in early pregnancy (n=416), in late pregnancy (n=373), and after birth (n=370). Responses received on or before February 29, 2020, were considered the “prepandemic” responses, whereas responses after the aforementioned date were considered the “pandemic” responses. Mean rank scores of depression and anxiety were significantly higher in the pandemic group (P=.02 and P=.003, respectively) in the postpartum period. There was no significant association between pandemic time and antenatal scores. However, postnatally, mothers were 2.6 times more likely to score ≥13 on the Edinburgh Postnatal Depression Scale during the pandemic than before the pandemic (95% confidence interval, 1.2–5.7; P=.02). Adjustment for ethnicity and income strengthened this association as the odds ratio increased to 3.3 (95% confidence interval, 1.4–8.0; P=.007). CONCLUSION Pandemic-associated increases in depression and anxiety scores were confined to the postpartum period, highlighting a need for increased screening and interventions for perinatal mood and anxiety disorders postnatally as this pandemic continues.
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Affiliation(s)
- Cindy X W Zhang
- Department of Physiology, University of Toronto, Mount Sinai Hospital, Toronto, Ontario, Canada (Ms Zhang, Dr Murphy, Ms Foshay, and Drs Lye and Matthews).
| | - Justin C Okeke
- Department of Obstetrics and Gynecology, Sinai Health System, New York City, NY (Mr Okeke and Drs Murphy, Lye, and Matthews)
| | - Robert D Levitan
- Mood and Anxiety Disorders Program, Centre for Addiction and Mental Health, Mount Sinai Hospital, Toronto, Ontario, Canada (Dr Levitan); Department of Psychiatry, University of Toronto, Mount Sinai Hospital, Toronto, Ontario, Canada (Dr Levitan)
| | - Kellie E Murphy
- Department of Physiology, University of Toronto, Mount Sinai Hospital, Toronto, Ontario, Canada (Ms Zhang, Dr Murphy, Ms Foshay, and Drs Lye and Matthews); Department of Obstetrics and Gynecology, Sinai Health System, New York City, NY (Mr Okeke and Drs Murphy, Lye, and Matthews)
| | - Kim Foshay
- Department of Physiology, University of Toronto, Mount Sinai Hospital, Toronto, Ontario, Canada (Ms Zhang, Dr Murphy, Ms Foshay, and Drs Lye and Matthews)
| | - Stephen J Lye
- Department of Physiology, University of Toronto, Mount Sinai Hospital, Toronto, Ontario, Canada (Ms Zhang, Dr Murphy, Ms Foshay, and Drs Lye and Matthews); Department of Obstetrics and Gynecology, Sinai Health System, New York City, NY (Mr Okeke and Drs Murphy, Lye, and Matthews); Lunenfeld-Tanenbaum Research Institute, Sinai Health System, Toronto, Mount Sinai Hospital, Ontario, Canada (Drs Lye, Knight, and Matthews); and Department of Obstetrics and Gynaecology, University of Toronto, Mount Sinai Hospital, Toronto, Ontario, Canada
| | - Julia A Knight
- Lunenfeld-Tanenbaum Research Institute, Sinai Health System, Toronto, Mount Sinai Hospital, Ontario, Canada (Drs Lye, Knight, and Matthews); Dalla Lana School of Public Health, University of Toronto, Mount Sinai Hospital, Toronto, Ontario, Canada (Dr Knight)
| | - Stephen G Matthews
- Department of Physiology, University of Toronto, Mount Sinai Hospital, Toronto, Ontario, Canada (Ms Zhang, Dr Murphy, Ms Foshay, and Drs Lye and Matthews); Department of Obstetrics and Gynecology, Sinai Health System, New York City, NY (Mr Okeke and Drs Murphy, Lye, and Matthews); Lunenfeld-Tanenbaum Research Institute, Sinai Health System, Toronto, Mount Sinai Hospital, Ontario, Canada (Drs Lye, Knight, and Matthews); and Department of Obstetrics and Gynaecology, University of Toronto, Mount Sinai Hospital, Toronto, Ontario, Canada
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Li H. Affective Instability, Depression, and Anxiety Symptoms in a Community Sample of Pregnant and Postpartum Women: A Cross-Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19063171. [PMID: 35328868 PMCID: PMC8951286 DOI: 10.3390/ijerph19063171] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/08/2021] [Revised: 02/18/2022] [Accepted: 02/24/2022] [Indexed: 11/16/2022]
Abstract
BACKGROUND Although perinatal women experience an elevated level of affective instability (AI), limited research has been conducted to examine perinatal AI and its relation to depression and anxiety. The current study investigated correlations between AI and depression, between AI and anxiety during the perinatal period, and between current depression and anxiety and the latent factors of the Affective Lability Scale-18 (ALS-18). METHODS 202 Canadian perinatal women participated in this cross-sectional study. The ALS-18 was used to assess AI, while the Depression, Anxiety, and Stress Scale-21 measured depression, anxiety, and stress. Multiple logistic regression was performed to investigate the relationship between AI and depression and anxiety, and multiple linear regression was conducted to examine the association between current depression and anxiety and the three latent factors of ALS-18. RESULTS The findings revealed a significant association between AI and depression and between AI and anxiety. Current depression and anxiety were correlated with ALS-18 factors of depression/anxiety shift and depression/elation shift, while current depression was linked to ALS-18 factor of anger. CONCLUSIONS The study findings have important implications for early detection and intervention of maternal anxiety and depression. In order to improve maternal mental health, AI should be included in routine perinatal check-ups.
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Affiliation(s)
- Hua Li
- College of Nursing, University of Saskatchewan, Health Sciences Building, E-Wing, Room 4248, 104 Clinic Place, Saskatoon, SK S7N 2Z4, Canada
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Abstract
BACKGROUND The magnitude of postpartum depression in Jordan is under documented, and little is known about its potential sociodemographic and clinical correlates. PURPOSE The aim of this study was to explore the prevalence and risk factors associated with postpartum depression among Jordanian mothers in the first 18 months after delivery. METHOD This descriptive cross-sectional study was carried out from April to June 2020 in Jordan. A web-based survey was used for recruiting eligible participants. An Arabic version of the validated self-administered Edinburgh Postnatal Depression Scale questionnaire was used to measure postpartum depression with a cut-off score of ⩾12 which indicates probable depression. RESULTS A total of 1,071 Jordanian women participated in the study. Of those, 567 women had postpartum depression (52.9%). Multivariate logistic regression analysis revealed that postpartum depression was significantly associated with marital conflict (OR: 4.91; 95% CI: 2.36-10.20), negative attitude from the pregnancy (OR: 0.67; 95% CI: 0.45-0.99), unplanned pregnancies (OR: 1.73; 95% CI: 1.16-2.60), lack of social support (OR: 1.93; 95% CI: 1.12-3.32), time from last delivery (OR: 0.99; 95% CI: 0.98-1.00), insomnia (OR: 0.53; 95% CI: 0.35-0.82), and depression during the pregnancy (OR: 0.51; 95% CI: 0.33-0.78). Most of the participants (65.7%) sought social support to avoid, reduce, or treat postpartum depression. CONCLUSIONS Postpartum depression among Jordanian women was the highest in comparison to that of women in other countries in the region. Therefore, screening for the presence of depressive symptoms should be implemented during regular pregnancy care visits. Social support should be encouraged in order to avoid, reduce, or treat postpartum depression.
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Affiliation(s)
- Esra' O Taybeh
- Department of Applied Pharmaceutical Sciences, Faculty of Pharmacy, Isra University, Amman, Jordan
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Pebryatie E, Paek SC, Sherer P, Meemon N. Associations Between Spousal Relationship, Husband Involvement, and Postpartum Depression Among Postpartum Mothers in West Java, Indonesia. J Prim Care Community Health 2022; 13:21501319221088355. [PMID: 35343810 PMCID: PMC8966113 DOI: 10.1177/21501319221088355] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
INTRODUCTION Indonesia is actively promoting husband involvement in maternal health care, since it has been claimed to impact the wellbeing of mothers. This study aims to investigate the extent to which spousal relationship, husband involvement, and maternal health behavior affect postpartum depression among Indonesian mothers. METHOD A survey was carried out among 336 postpartum mothers who received maternal care in 27 independent midwifery clinics in 7 regions of West Java Province, Indonesia. The measurement model of husband involvement comprising 4 dimensions, namely maternity care engagement, instrumental support, emotional support, and informational support were developed and validated using confirmatory factor analysis. The Quality of Marriage Index (QMI) and the Edinburgh Postnatal Depression Scale (EPDS) were also validated and used to measure spousal relationship and postpartum depressive symptoms. A structural equation model was specified to examine the association between spousal relationship, husband involvement, maternal healthy behavior, and postpartum depression. RESULTS The study confirms the assumption that the quality of the spousal relationship could determine husband's involvement during pregnancy, childbirth, and postpartum (γ = .60, P < .001), eventually leading to better maternal healthy behavior (γ = .015, P < .001) and a decrease in postpartum depressive symptoms among mothers (γ = -.21, P < .001). CONCLUSIONS The study results suggest the needs to promote comprehensive husband involvement to enhance the wellbeing of mothers. This can be achieved through couple interventions at the community level and the inclusion of a supportive role for husbands in the maternal and childcare guidebook offered during ANC visits.
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Affiliation(s)
- Elit Pebryatie
- Mahidol University, Salaya, Phutthamonthon, Nakhon Pathom, Thailand.,Poltekkes Kemenkes Tasikmalaya, Indonesia
| | - Seung Chun Paek
- Mahidol University, Salaya, Phutthamonthon, Nakhon Pathom, Thailand
| | - Penchan Sherer
- Mahidol University, Salaya, Phutthamonthon, Nakhon Pathom, Thailand
| | - Natthani Meemon
- Mahidol University, Salaya, Phutthamonthon, Nakhon Pathom, Thailand
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Araji S, Griffin A, Kassahun-Yimer W, Dixon L, Spencer SK, Belk S, Ohaegbulam G, Wallace K. No association between perinatal mood disorders and hypertensive pregnancies. Front Psychiatry 2022; 13:898003. [PMID: 36032225 PMCID: PMC9412728 DOI: 10.3389/fpsyt.2022.898003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2022] [Accepted: 07/25/2022] [Indexed: 01/22/2023] Open
Abstract
Mental health disorders such as anxiety and/or depression are the most common mental health disorders seen among reproductive aged women and can increase during pregnancy. Many sociodemographic risk factors have been associated with anxiety and/or depression in pregnancy, which can lead to adverse maternal and infant outcomes including the risk of a hypertensive pregnancy. The current study prospectively examined self-reported anxiety, depression and stress in pregnant women without a history of fetal loss or mood disorders beginning at 20-26 weeks. At each study visit, circulating immune factors associated with perinatal mood disorders were measured in blood samples that were collected. A total of 65 women were eligible for data analysis, 26 of which had hypertensive pregnancies. There was not a significant difference in self-reported depression, anxiety or stress between hypertensive disorders of pregnancy and normotensive women. Black women were more likely to have a hypertensive pregnancy and develop a perinatal mood disorder compared to non-black women. Both the inflammatory cytokines interleukin-17 and tumor necrosis factor-alpha were increased in patients with perinatal mood disorders. However, additional research is needed in a larger sample to truly understand the relationship between these factors along with the underlying etiologies and the associated outcomes.
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Affiliation(s)
- Sarah Araji
- Department of Obstetrics and Gynecology, University of Mississippi Medical Center, Jackson, MS, United States
| | - Ashley Griffin
- Program in Neuroscience, School of Graduate Studies in Health Sciences, University of Mississippi Medical Center, Jackson, MS, United States
| | - Wondwosen Kassahun-Yimer
- John D. Bower School of Population Health, Department of Data Science, University of Mississippi Medical Center, Jackson, MS, United States
| | - Laura Dixon
- Department of Psychology, University of Mississippi, Oxford, MS, United States
| | - Shauna-Kay Spencer
- Department of Obstetrics and Gynecology, University of Mississippi Medical Center, Jackson, MS, United States.,Department of Pharmacology and Toxicology, University of Mississippi Medical Center, Jackson, MS, United States
| | - Sheila Belk
- Department of Pharmacology and Toxicology, University of Mississippi Medical Center, Jackson, MS, United States
| | - Gail Ohaegbulam
- Department of Obstetrics and Gynecology, University of Mississippi Medical Center, Jackson, MS, United States
| | - Kedra Wallace
- Department of Obstetrics and Gynecology, University of Mississippi Medical Center, Jackson, MS, United States.,Department of Pharmacology and Toxicology, University of Mississippi Medical Center, Jackson, MS, United States.,Myrlie Evers-Williams Institute for the Elimination of Health Disparities, University of Mississippi Medical Center, Jackson, MS, United States
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Green SM, Furtado M, Inness BE, Frey BN, McCabe RE. Characterizing Worry Content and Impact in Pregnant and Postpartum Women with Anxiety Disorders During COVID-19. Clin Psychol Psychother 2021; 29:1144-1157. [PMID: 34931741 DOI: 10.1002/cpp.2703] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2021] [Revised: 11/04/2021] [Accepted: 12/13/2021] [Indexed: 11/08/2022]
Abstract
The novel COVID pandemic has had a substantial impact on global mental health, including those populations that are inherently vulnerable such as pregnant and postpartum (perinatal) women. Anxiety disorders (ADs) are the most common mental health disorders during the perinatal period, affecting up to 1 in 5 women. However, since the onset of the pandemic, up to 60% of perinatal women are experiencing moderate to severe levels of anxiety. Given the substantial increase in perinatal anxiety during COVID, we sought to better understand its phenomenology by characterizing the collective worry content and impact of COVID using a content analysis. Eighty-four treatment-seeking pregnant (n = 35) and postpartum (n = 49) women with a principal AD, participated in this study between April and October 2020. In addition to completing questionnaire measures and a semi-structured diagnostic interview, participants were asked to 1) describe their top excessive and uncontrollable worries; 2) describe additional COVID and non-COVID worries; and 3) describe how the pandemic had affected their lives. All responses were given verbally and transcribed verbatim by assessors. A content analysis led to the emergence of various COVID and non-COVID worry and impact themes. One third of participant's principal worries were specific to COVID, and 40% of COVID worries were specific to the perinatal context. Understanding the worry content and impact of COVID may improve symptom detection and inform the development of targeted treatment strategies to support the mental health needs of perinatal women with ADs throughout the pandemic and thereafter. Understanding pandemic-specific worries is important for perinatal symptom screening and may allow for the development of targeted treatment strategies to address COVID-specific worries and impact.
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Affiliation(s)
- Sheryl M Green
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada.,Women's Health Concerns Clinic, St. Joseph's Healthcare Hamilton, Hamilton, Ontario, Canada
| | - Melissa Furtado
- Department of Psychology, Neuroscience and Behaviour, McMaster University, Hamilton, Ontario
| | - Briar E Inness
- Department of Psychology, Neuroscience and Behaviour, McMaster University, Hamilton, Ontario
| | - Benicio N Frey
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada.,Women's Health Concerns Clinic, St. Joseph's Healthcare Hamilton, Hamilton, Ontario, Canada.,Mood Disorders Program, St. Joseph's Healthcare Hamilton, Hamilton, Ontario, Canada
| | - Randi E McCabe
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada.,Anxiety Treatment and Research Clinic, St. Joseph's Healthcare Hamilton, Hamilton, Ontario, Canada
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Perspectives of Women About Social Support Provided by Men During Pregnancy: A Qualitative Study. Matern Child Health J 2021; 26:1255-1260. [PMID: 34855059 DOI: 10.1007/s10995-021-03303-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/21/2021] [Indexed: 10/19/2022]
Abstract
OBJECTIVES Men have been regarded as critical partners in promoting maternal health and improving pregnancy outcomes, still men have not been able to provide these supports holistically during pregnancy due to the patriarchal nature of many Nigerian societies and dynamics in gender roles. There is a dearth of studies in Nigeria that have investigated the social support spouse provide during pregnancy. This study investigated the perspectives of women about the social support provided by men during pregnancy and factors that could influence or promote these support. METHODS Forty one consenting women who were purposively selected in six primary health centers that offer ANC services in Ibadan participated in the six focus group discussions; participants ranged from 6 to 8 in each group. Transcripts from audio recordings were analyzed using thematic analysis; similar and dissimilar themes within groups and across groups were categorized. RESULTS Discussants highlighted ways of providing social support mainly as assisting with household chores and taking care of other children. None of the discussants stated accompanying to antenatal clinic by their spouses as a way social support was provided during pregnancy. Almost all the women highlighted that social support provided by men changes as pregnancy advances but the changes were dependent on the number of children. CONCLUSIONS Community education and male friendly sessions are encouraged to promote men's participation and engagement during pregnancy.
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Silesh M, Demisse TL, Taye BT, Desta K, Kitaw TM, Mekuria AD, Tafesse TT, Fenta B. Compliance with COVID-19 Preventive Measures and Associated Factors Among Women Attending Antenatal Care at Public Health Facilities of Debre Berhan Town, Ethiopia. Risk Manag Healthc Policy 2021; 14:4561-4569. [PMID: 34795541 PMCID: PMC8592393 DOI: 10.2147/rmhp.s330932] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2021] [Accepted: 10/28/2021] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Coronavirus disease-2019 (COVID-19) is a highly contagious and cause for the death of many people worldwide. Due to physiological immunosuppressive state and mechanical alteration, pregnant women are at a higher risk of severe illness and adverse maternal and fetal outcomes from COVID-19 than non-pregnant women. Compliance with the preventive measures is essential to control COVID-19 related consequences. Therefore, this study aimed to assess compliance with COVID-19 preventive measures among pregnant women attending antenatal care at public facilities of Debre Berhan town, Ethiopia. METHODS A facility-based cross-sectional study was conducted from May 1 to 30, 2021 among 402 pregnant mothers. Data were collected via a face-to-face interviewer-administered questionnaire. Then, entered into Epi-Data version 4.6 and exported to SPSS version 25 for data analysis. In multivariable logistic regression analysis, variables with p < 0.05 were declared as statistically significant and the strength of statistical association was measured by adjusted odds ratio (AOR) and 95% confidence interval (CI). RESULTS Of the total 396 participants, 222 (56.1%) of women had a good compliance with COVID-19 preventive measures. Maternal age (25-34 years) [AOR: 1.926; 95% CI (1.084, 3.421)] and (≥35 years) [AOR: 3.018; 95% CI (1.53, 5.952)], husband educational status [AOR: 3.68; 95% CI (1.55, 8.737)], had current chronic disease [AOR: 2.516; 95% CI (1.297, 4.883)], and knowledge [AOR: 5.484; 95% CI (3.057, 9.838)] were significant predictors to have good compliance with COVID-19 preventive measures. CONCLUSION Although COVID-19 is a global and national agenda, compliance towards its preventive measures was not sufficient enough. Therefore, scale-up the community awareness via media campaign is crucial which will eventually improve compliance. Furthermore, those women who had no pre-existing chronic diseases and those in the young age group should be given special consideration.
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Affiliation(s)
- Mulualem Silesh
- Department of Midwifery, College of Health Science, Debre Berhan University, Debre Berhan, Ethiopia
| | - Tesfanesh Lemma Demisse
- Department of Midwifery, College of Health Science, Debre Berhan University, Debre Berhan, Ethiopia
| | - Birhan Tsegaw Taye
- Department of Midwifery, College of Health Science, Debre Berhan University, Debre Berhan, Ethiopia
| | - Kelem Desta
- Department of Midwifery, College of Health Science, Debre Berhan University, Debre Berhan, Ethiopia
| | - Tebabere Moltot Kitaw
- Department of Midwifery, College of Health Science, Debre Berhan University, Debre Berhan, Ethiopia
| | - Abinet Dagnaw Mekuria
- Department of Public Health, College of Health Science, Debre Berhan University, Debre Berhan, Ethiopia
| | | | - Belete Fenta
- School of Midwifery, Faculty of Health Science, Jimma University, Jimma, Ethiopia
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Reproductive concerns and fear of cancer recurrence: a qualitative study of women's experiences of the perinatal period after cancer. BMC Pregnancy Childbirth 2021; 21:738. [PMID: 34717568 PMCID: PMC8556905 DOI: 10.1186/s12884-021-04208-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2021] [Accepted: 09/27/2021] [Indexed: 11/23/2022] Open
Abstract
Background Young female cancer survivors are at a disproportionate risk of suffering significant psychological distress following treatment, particularly fears of cancer recurrence (FCR). While previous research has established the robust relationship between FCR and family matters (e.g., family planning and motherhood), there is a paucity of information about how a history of cancer affects women’s psychological functioning throughout the perinatal period. The present investigation sought to better understand women’s experiences of pregnancy and the postpartum period following cancer treatment through a qualitative analysis. Methods Ten women participated in a semi-structured, one-on-one interview either over telephone or video conferencing (Zoom). Women were recruited from Sunnybrook Health Sciences Centre in Toronto, as well as through online cancer support platforms, and social media sites. Participants all had a past cancer diagnosis; no active disease; were 45-years of age or younger; currently in the perinatal period; and spoke English fluently. The study employed a grounded theory analysis by which verbatim interview data were analysed using a constant comparison method until data saturation was reached. Results The qualitative analysis yielded I’m So Happy, But Also Terrified, as the core category, indicative of the duality of emotional experience that characterized the perinatal period for these women. Additionally, four higher-order categories emerged revealing how women go through a process of grief related to potential fertility loss; conditional joy during and after pregnancy due to the lingering weight of cancer; frustration with a lack of resources regarding perinatal health after cancer; and hope as they enter into motherhood. Conclusion These results suggest that women in the perinatal period with a history of cancer may be at an increased risk for psychological distress and require additional fertility and reproductive resources both during and after cancer treatment. This research is an important step in further understanding women’s experiences of pregnancy after cancer and may help to inform future research and healthcare practices, in addition to improving perinatal care after cancer. Supplementary Information The online version contains supplementary material available at 10.1186/s12884-021-04208-3.
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Duroux M, Stuijfzand S, Sandoz V, Horsch A. Investigating prenatal perceived support as protective factor against adverse birth outcomes: a community cohort study. J Reprod Infant Psychol 2021:1-12. [PMID: 34644205 DOI: 10.1080/02646838.2021.1991565] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
BACKGROUND Studies show that prenatal maternal anxiety may act as a risk factor for adverse birth outcomes, whilst prenatal social support may rather act as a protective factor. However, studies examining prenatal anxiety symptoms, prenatal perceived support, and neonatal and/or obstetric outcomes are lacking. OBJECTIVE This study investigated whether, in a community sample, prenatal perceived support: (1) had a protective influence on birth outcomes (gestational age (GA), birthweight (BW), 5-minute Apgar score, and mode of delivery); (2) acted as a protective factor, moderating the relationship between anxiety symptoms and the aforementioned birth outcomes. METHOD During their third trimester of pregnancy, 182 nulliparous child-bearers completed standardized questionnaires of anxiety (HADS-A) and perceived support (MOS-SSS). Birth outcomes data was extracted from medical records. RESULTS (1) Perceived support did not significantly predict any birth outcomes. However, perceived tangible support - MOS-SSS subscale assessing perceived material/financial aid - significantly positively predicted the 5-minute Apgar score. (2) Perceived support did not significantly moderate the relationship between anxiety symptoms and birth outcomes. However, perceived tangible support significantly moderated the relationship between anxiety symptoms and the 5-minute Apgar score. CONCLUSION When experienced within non-clinical thresholds, prenatal anxiety symptoms do not increase the risk of adverse neonatal and obstetric outcomes when perceived support is present.
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Affiliation(s)
- Mathilde Duroux
- Department of Psychology, University of Fribourg, Fribourg, Switzerland
| | - Suzannah Stuijfzand
- Faculty of Biology and Medicine, Institute of Higher Education and Research in Healthcare (LUFRS), University of Lausanne, Lausanne, Switzerland
| | - Vania Sandoz
- Faculty of Biology and Medicine, Institute of Higher Education and Research in Healthcare (LUFRS), University of Lausanne, Lausanne, Switzerland
| | - Antje Horsch
- Faculty of Biology and Medicine, Institute of Higher Education and Research in Healthcare (LUFRS), University of Lausanne, Lausanne, Switzerland.,Department Women-Mother-Child, Lausanne University Hospital, Lausanne, Switzerland
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