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Sani L, Laurenti Dimanche AC, Bacqué MF. Angels in the Clouds: Stillbirth and Virtual Cemeteries on 50 YouTube Videos. OMEGA-JOURNAL OF DEATH AND DYING 2019; 82:587-608. [PMID: 30691330 DOI: 10.1177/0030222818824732] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Today every aspect of our life is published and shared online, including grief. The virtual cemeteries and social networks' use could be considered as a new modern mortuary ritual. Starting from the keyword stillbirth, 50 videos published on YouTube since 2008 have been analyzed qualitatively. The videos, 70% published by the mother, with an average length of 5.52 minutes, a mean of 2,429,576 views and 2,563 of comments, follow a sort of script: the second part with black and white photos, background music, and religious references. Could the continuous access to the child's technological grave encourage a complicated grief or be a support, given by the interaction with users, limiting the sense of isolation. The parent shows his or her own conceptions about death and, as a modern baptism, presents the child to the whole society. Videos keep child's memory alive and fuel a process of personalization and tenderness in the user.
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Affiliation(s)
- Livia Sani
- Clinical Psychological Department, University of Strasbourg, France
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Hu L, Du J, Lv H, Zhao J, Chen M, Wang Y, Wu F, Liu F, Chen X, Zhang J, Ma H, Jin G, Shen H, Chen L, Ling X, Hu Z. Influencing factors of pregnancy loss and survival probability of clinical pregnancies conceived through assisted reproductive technology. Reprod Biol Endocrinol 2018; 16:74. [PMID: 30086781 PMCID: PMC6081896 DOI: 10.1186/s12958-018-0390-6] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2018] [Accepted: 07/23/2018] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND Pregnancies following assisted reproductive technology (ART) may have elevated potential risk of pregnancy loss (PL) when compared to natural conception. However, rare studies comprehensively analyzed the IVF/ICSI cycle-dependent factors for loss of clinical pregnancy. Therefore, we aimed to determine the ART subgroup-specific risks of PL throughout pregnancy and explore different risk factors for early miscarriage and late miscarriage among pregnancies conceived through ART. METHODS A retrospective cohort study was launched in two infertility treatment centers in Nanjing and Changzhou including 5485 IVF/ICSI embryo transfer cycles with known outcomes after clinical pregnancy by the end of 2015. Cox proportional hazards regression analysis was performed to estimate the hazard ratios and their 95% confidence intervals. The associations between survival time during pregnancy and demographics and clinical characteristics of clinical pregnancies were estimated using the Kaplan-Meier method and the Log-rank test. RESULTS The overall PL rate in current ART population was 12.5%. Among the 685 pregnancy loss cycles, a total of 460 ended as early miscarriage, 191 as late miscarriage. We found couples in ART pregnancies demonstrated a significantly increased risk of PL as maternal age (HR = 1.31, Ptrend < 0.001) grows. Pregnancies received controlled ovarian hyperstimulation (COH) protocol like GnRH antagonist protocol (HR = 3.49, P < 0.001) and minimal stimulation protocol (HR = 1.83, P < 0.001) had higher risk of PL than GnRH-a long protocol. Notably, in contrast to fresh cycle, women who received frozen cycle embryo had a significant increased risk of early miscarriage (P < 0.001), while frozen cycle was linked with lower risk of late miscarriage (P = 0.045). In addition, four factors (maternal age, COH protocol, cycle type and serum hCG level 14 days after transfer) had independent impact on miscarriage mainly before 12 weeks of gestational age. CONCLUSIONS With these findings in this study, clinicians may make it better to evaluate a patient's risk of PL based on the maternal age at the time of treatment, COH protocol, cycle type and serum hCG level 14 days after transfer and the gestational week of the fetus, and we hope that it contributes to future study on its etiology and guide the clinical prevention and treatment.
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Affiliation(s)
- Lingmin Hu
- Department of Reproduction, the Affiliated Changzhou Maternity and Child Health Care, Hospital of Nanjing Medical University, Changzhou, 213003, Jiangsu, China
- State Key Laboratory of Reproductive Medicine, Nanjing Medical University, Nanjing, 211166, China
| | - Jiangbo Du
- Department of Epidemiology, School of Public Health, Nanjing Medical University, Nanjing, 211166, China
- State Key Laboratory of Reproductive Medicine, Nanjing Medical University, Nanjing, 211166, China
| | - Hong Lv
- Department of Epidemiology, School of Public Health, Nanjing Medical University, Nanjing, 211166, China
- State Key Laboratory of Reproductive Medicine, Nanjing Medical University, Nanjing, 211166, China
| | - Jing Zhao
- State Key Laboratory of Reproductive Medicine, Nanjing Medical University, Nanjing, 211166, China
- Department of Reproduction, the Affiliated Nanjing Maternity and Child Health, Hospital of Nanjing Medical University, Nanjing, 210004, China
| | - Mengxi Chen
- State Key Laboratory of Reproductive Medicine, Nanjing Medical University, Nanjing, 211166, China
- Department of Reproduction, the Affiliated Nanjing Maternity and Child Health, Hospital of Nanjing Medical University, Nanjing, 210004, China
| | - Yifeng Wang
- Department of Epidemiology, School of Public Health, Nanjing Medical University, Nanjing, 211166, China
- State Key Laboratory of Reproductive Medicine, Nanjing Medical University, Nanjing, 211166, China
| | - Fang Wu
- Department of Epidemiology, School of Public Health, Nanjing Medical University, Nanjing, 211166, China
- State Key Laboratory of Reproductive Medicine, Nanjing Medical University, Nanjing, 211166, China
| | - Feng Liu
- Department of Epidemiology, School of Public Health, Nanjing Medical University, Nanjing, 211166, China
- State Key Laboratory of Reproductive Medicine, Nanjing Medical University, Nanjing, 211166, China
| | - Xiaojiao Chen
- State Key Laboratory of Reproductive Medicine, Nanjing Medical University, Nanjing, 211166, China
- Department of Reproduction, the Affiliated Nanjing Maternity and Child Health, Hospital of Nanjing Medical University, Nanjing, 210004, China
| | - Junqiang Zhang
- State Key Laboratory of Reproductive Medicine, Nanjing Medical University, Nanjing, 211166, China
- Department of Reproduction, the Affiliated Nanjing Maternity and Child Health, Hospital of Nanjing Medical University, Nanjing, 210004, China
| | - Hongxia Ma
- Department of Epidemiology, School of Public Health, Nanjing Medical University, Nanjing, 211166, China
- State Key Laboratory of Reproductive Medicine, Nanjing Medical University, Nanjing, 211166, China
| | - Guangfu Jin
- Department of Epidemiology, School of Public Health, Nanjing Medical University, Nanjing, 211166, China
- State Key Laboratory of Reproductive Medicine, Nanjing Medical University, Nanjing, 211166, China
| | - Hongbing Shen
- Department of Epidemiology, School of Public Health, Nanjing Medical University, Nanjing, 211166, China
- State Key Laboratory of Reproductive Medicine, Nanjing Medical University, Nanjing, 211166, China
| | - Li Chen
- Department of Reproduction, the Affiliated Changzhou Maternity and Child Health Care, Hospital of Nanjing Medical University, Changzhou, 213003, Jiangsu, China.
- State Key Laboratory of Reproductive Medicine, Nanjing Medical University, Nanjing, 211166, China.
| | - Xiufeng Ling
- State Key Laboratory of Reproductive Medicine, Nanjing Medical University, Nanjing, 211166, China.
- Department of Reproduction, the Affiliated Nanjing Maternity and Child Health, Hospital of Nanjing Medical University, Nanjing, 210004, China.
| | - Zhibin Hu
- Department of Epidemiology, School of Public Health, Nanjing Medical University, Nanjing, 211166, China.
- State Key Laboratory of Reproductive Medicine, Nanjing Medical University, Nanjing, 211166, China.
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Qin X, Liang Y, Guo Y, Liu X, Zeng W, Wu F, Lin Y, Zhang Y. Eukaryotic initiation factor 5A and Ca 2+ /calmodulin-dependent protein kinase 1D modulate trophoblast cell function. Am J Reprod Immunol 2018; 80:e12845. [PMID: 29533498 DOI: 10.1111/aji.12845] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2017] [Accepted: 02/14/2018] [Indexed: 12/19/2022] Open
Abstract
PROBLEM Trophoblast cells regulate embryo implantation and placental development. Eukaryotic initiation factor 5A (eIF5A) is an initiator of translation involved in cellular processes, such as migration, proliferation, and apoptosis. However, the function of eIF5A in trophoblast cells is unknown. METHOD OF STUDY We inhibited eIF5A and Ca2+ /calmodulin-dependent protein kinase 1D (CAMK1D) expression in HTR8 cells using RNA interference. The effects of eIF5A and CAMK1D on HTR8 cells were investigated using real-time polymerase chain reaction, Western blotting, flow cytometry, cell transfection assays, cell migration assays, and terminal deoxynucleotidyl transferase dUTP nick-end labeling. RESULTS eIF5A inhibition decreased CAMK1D expression, proliferation, migration, and invasion, but upregulated apoptosis, in HTR8 cells. CONCLUSION Cross-talk between eIF5A and CAMK1D enhances proliferation, migration, and invasion, but inhibits apoptosis, in trophoblasts.
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Affiliation(s)
- Xiaoli Qin
- International Peace Maternity and Child Health Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Yan Liang
- International Peace Maternity and Child Health Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Yuna Guo
- International Peace Maternity and Child Health Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Xiaorui Liu
- International Peace Maternity and Child Health Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Weihong Zeng
- International Peace Maternity and Child Health Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Fan Wu
- International Peace Maternity and Child Health Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Yi Lin
- International Peace Maternity and Child Health Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Yan Zhang
- Department of Obstetrics and Gynecology, Renmin Hospital of Wuhan University, Wuhan, China
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Seeber BE. Alpha-fetoprotein in vaginal blood: a promising novel marker for early pregnancy failure that needs further validation. Fertil Steril 2018; 109:1006-1007. [DOI: 10.1016/j.fertnstert.2018.03.037] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2018] [Accepted: 03/26/2018] [Indexed: 11/26/2022]
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Weathering the storm; a review of pre-pregnancy stress and risk of spontaneous abortion. Psychoneuroendocrinology 2018; 92:142-154. [PMID: 29628283 DOI: 10.1016/j.psyneuen.2018.03.001] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2017] [Revised: 02/01/2018] [Accepted: 03/01/2018] [Indexed: 01/01/2023]
Abstract
The Weathering Effect is a theory that links stress exposure, over the life-course, with racial disparities in reproductive outcomes, through the effects of social adversity on a woman's body. The concept of maternal "weathering" captures cumulative somatic and psychological adversities that can exacerbate the effects of aging. Much of the evidence for weathering comes from observational studies linking self-report measures with reproductive outcomes. The purpose of this review is to explore biological mechanisms that underlie these observations. We focus on spontaneous abortion because this event is understudied despite evidence of racial disparities in this outcome. Spontaneous abortion is the most common pregnancy failure, and it happens early in pregnancy. Early pregnancy is a time most susceptible to the harmful effects of immune dysregulation that may, in part, result from adversities experienced before pregnancy begins. In exploring these mechanisms, we draw on well-defined signaling processes observed in the stressor-depression relationship. Pro-inflammatory dysregulation, for example, has particular relevance to immunological control occurring early in pregnancy. Early pregnancy immunologic changes affect the trajectories of pregnancy via control of trophoblastic invasion. Within the first few weeks of pregnancy, uterine derived cytokines operate within cytokine networks and play a critical role in this invasion. Programming for pro-inflammatory dysregulation can occur before conception. This dysregulation, brought into early pregnancy, has implications for viability and success of the index pregnancy. These patterns suggest early pregnancy health is susceptible to stress processing pathways that influence this immunologic control in the first six to eight weeks of pregnancy. In this review, we discuss the known mediating role of immune factors in the stressor-depression relationship. We also discuss how adversity experienced before the index pregnancy, or "pre-pregnancy" may influence these pathways, and subsequently influence early pregnancy health. There is a need to understand adversity, experienced before pregnancy, and mechanisms driving the effects of these experiences on pregnancy outcomes. This approach is a useful entry point for understanding racial inequities in pregnancy health through an understanding of differences in exposures to adversity. We hypothesize that spontaneous abortion involves cyclical changes within a woman's reproductive tract in response to stressors that are established well before a woman enters into pregnancy. Furthermore, we propose mechanisms that potentially drive weathering processes relevant to reproductive disparities. We also examine what is known about pre-pregnancy stress exposures associated with race, inequity, and adversity, and their potential impact on neuroendocrine and immune changes affecting early pregnancy risk.
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Volgsten H, Jansson C, Svanberg AS, Darj E, Stavreus-Evers A. Longitudinal study of emotional experiences, grief and depressive symptoms in women and men after miscarriage. Midwifery 2018; 64:23-28. [PMID: 29864578 DOI: 10.1016/j.midw.2018.05.003] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2017] [Revised: 04/10/2018] [Accepted: 05/07/2018] [Indexed: 11/17/2022]
Abstract
OBJECTIVE Although miscarriage is common and affects up to 20% of pregnant women, little is known about these couples' short term and long term experiences after miscarriage. The aim of the present study was to study emotional experience, grief and depressive symptoms in women and men, one week and four months after miscarriage. RESEARCH DESIGN /SETTING Women, (n = 103), and their male partner (n = 78), were recruited at the gynecological clinic after miscarriage. Control women were recruited from the general population. Three validated questionnaires concerning psychological wellbeing and mental health, RIMS, PGS and MADRS-S were answered by the participants one week and four months after the miscarriage. FINDINGS It was shown that for women, the emotional experiences of miscarriage, grief and depressive symptoms were more pronounced than for their male partners. Grief and depressive symptoms were reduced with time, which was not the case for the emotional experiences of miscarriage. Previous children was favorable for emotional experience while previous miscarriage or infertility treatment made the emotional experience worse. CONCLUSION Grief and depressive symptoms is reduced over time while emotional experiences such as isolation, loss of baby and a devastating event persist for longer time than four months. Lack of previous children, previous miscarriage and infertility diagnosis could increase negative emotional experiences after miscarriage, this was especially pronounced for grief reaction. The questionnaires could be used both clinically and in research to understand the emotional experiences after miscarriage.
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Affiliation(s)
- Helena Volgsten
- Department of Women's and Children's Health, Uppsala University, 751 85 Uppsala, Sweden; Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden
| | - Caroline Jansson
- Department of Women's and Children's Health, Uppsala University, 751 85 Uppsala, Sweden
| | - Agneta Skoog Svanberg
- Department of Women's and Children's Health, Uppsala University, 751 85 Uppsala, Sweden
| | - Elisabeth Darj
- Department of Women's and Children's Health, Uppsala University, 751 85 Uppsala, Sweden; Department of Public Health and Nursing, NTNU, Norwegian University of Science and Technology, Trondheim, Norway; Department of Obstetrics and Gynecology, St Olav's Hospital, Trondheim, Norway
| | - Anneli Stavreus-Evers
- Department of Women's and Children's Health, Uppsala University, 751 85 Uppsala, Sweden.
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Veltri F, Kleynen P, Grabczan L, Salajan A, Rozenberg S, Pepersack T, Poppe K. Pregnancy outcomes are not altered by variation in thyroid function within the normal range in women free of thyroid disease. Eur J Endocrinol 2018; 178:189-197. [PMID: 29187511 DOI: 10.1530/eje-17-0628] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2017] [Revised: 10/27/2017] [Accepted: 11/28/2017] [Indexed: 12/12/2022]
Abstract
OBJECTIVE In the recently revised guidelines on the management of thyroid dysfunction during pregnancy, treatment with thyroid hormone (LT4) is not recommended in women without thyroid autoimmunity (TAI) and TSH levels in the range 2.5-4.0 mIU/L, and in a recent study in that particular group of pregnant women, more complications were observed when a treatment with LT4 was given. The objective of the study was therefore to investigate whether variation in thyroid function within the normal (non-pregnant) range in women free of thyroid disease was associated with altered pregnancy outcomes? DESIGN Cross-sectional data analysis of 1321 pregnant women nested within an ongoing prospective collection of pregnant women's data in a single centre in Brussels, Belgium. METHODS Thyroid peroxidase antibodies (TPO-abs), thyroid-stimulating hormone (TSH), free T4 (FT4) and ferritin levels were measured and baseline characteristics were recorded. Women taking LT4, with TAI and thyroid function outside the normal non-pregnant range were excluded. Pregnancy outcomes and baseline characteristics were correlated with all TSH and FT4 levels within the normal range and compared between two groups (TSH cut-off < and ≥2.5 mIU/L). RESULTS Tobacco use was associated with higher serum TSH levels (OR: 1.38; CI 95%: 1.08-1.74); P = 0.009. FT4 levels were inversely correlated with age and BMI (rho = -0.096 and -0.089; P < 0.001 and 0.001 respectively) and positively correlated with ferritin levels (rho = 0.097; P < 0.001). Postpartum haemorrhage (>500 mL) was inversely associated with serum FT4 levels (OR: 0.35; CI 95%: 0.13-0.96); P = 0.040. Also 10% of women free of thyroid disease had serum TSH levels ≥2.5 mIU/L. CONCLUSIONS Variation in thyroid function during the first trimester within the normal (non-pregnant) range in women free of thyroid disease was not associated with altered pregnancy outcomes. These results add evidence to the recommendation against LT4 treatment in pregnant women with high normal TSH levels and without TPO antibodies.
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Affiliation(s)
- Flora Veltri
- Endocrine Unit, Centre Hospitalier Universitaire Saint Pierre, Université Libre de Bruxelles (ULB), Brussels, Belgium
| | - Pierre Kleynen
- Endocrine Unit, Centre Hospitalier Universitaire Saint Pierre, Université Libre de Bruxelles (ULB), Brussels, Belgium
| | - Lidia Grabczan
- Endocrine Unit, Centre Hospitalier Universitaire Saint Pierre, Université Libre de Bruxelles (ULB), Brussels, Belgium
| | - Alexandra Salajan
- Departement of Gynecology and Obstetrics, Centre Hospitalier Universitaire Saint Pierre, Université Libre de Bruxelles (ULB), Brussels, Belgium
| | - Serge Rozenberg
- Departement of Gynecology and Obstetrics, Centre Hospitalier Universitaire Saint Pierre, Université Libre de Bruxelles (ULB), Brussels, Belgium
| | - Thierry Pepersack
- Geriatric Unit, Centre Hospitalier Universitaire Saint Pierre, Université Libre de Bruxelles (ULB), Brussels, Belgium
| | - Kris Poppe
- Endocrine Unit, Centre Hospitalier Universitaire Saint Pierre, Université Libre de Bruxelles (ULB), Brussels, Belgium
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Zhang H, Huang Z, Xiao L, Jiang X, Chen D, Wei Y. Meta-analysis of the effect of the maternal vitamin D level on the risk of spontaneous pregnancy loss. Int J Gynaecol Obstet 2017; 138:242-249. [PMID: 28500757 DOI: 10.1002/ijgo.12209] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2016] [Revised: 03/26/2017] [Accepted: 05/10/2017] [Indexed: 12/20/2022]
Abstract
BACKGROUND The association between vitamin D deficiency and early spontaneous pregnancy loss (SPL) is unclear. OBJECTIVES To assess the association of serum 25-hydroxyvitamin D (25(OH)D) and SPL. SEARCH STRATEGY Embase, PubMed, and Web of Science were searched for relevant papers published before February 20, 2016, using search terms including "vitamin D" and "pregnancy loss." SELECTION CRITERIA Case-control and cohort studies investigating the relationship of maternal serum 25(OH)D and SPL were included. DATA COLLECTION AND ANALYSIS Two authors independently extracted original data from the selected papers. The DerSimonian-Laird random-effects model was used to perform the meta-analysis. Heterogeneity was assessed by calculating I2 . MAIN RESULTS Five studies, including 10 630 pregnant women, met the inclusion criteria. There was no significant association between a low 25(OH)D level and an increased risk of SPL. In a subgroup analysis, an extremely low 25(OH)D level (<20 ng/mL) was significantly associated with an increased risk of SPL in the first trimester (relative risk 2.24, 95% confidence interval 1.15-4.37); the heterogeneity across studies was not significant (I2 =0.0%, P=0.355). CONCLUSIONS Severe Vitamin D deficiency could be detrimental to early embryonic development and increase the risk of early SPL.
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Affiliation(s)
- Heng Zhang
- Wuxi Hospital for Maternal and Child Health Care, The Affiliated Hospital of Nanjing Medical University, Wuxi, China
| | - Zhaohui Huang
- Anhui Provincial Family Planning Institute of Science and Technology, Hefei, China
| | - Limin Xiao
- Second Hospital of Anhui Medical University, Hefei, China
| | - Xinye Jiang
- Wuxi Hospital for Maternal and Child Health Care, The Affiliated Hospital of Nanjing Medical University, Wuxi, China
| | - Daozhen Chen
- Wuxi Hospital for Maternal and Child Health Care, The Affiliated Hospital of Nanjing Medical University, Wuxi, China
| | - Yarong Wei
- Wuxi Hospital for Maternal and Child Health Care, The Affiliated Hospital of Nanjing Medical University, Wuxi, China
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Kanavi JV, G S, G K. Incidence and Risk Factors for Intrauterine Foetal Demise: a Retrospective Study in a Tertiary Care Centre in India. ACTA ACUST UNITED AC 2017. [DOI: 10.15406/ipcb.2017.02.00013] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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Petracchi F, Paez C, Igarzabal L. Cost-effectiveness of cytogenetic evaluation of products of conception by chorionic villus sampling in recurrent miscarriage. Prenat Diagn 2017; 37:282-288. [DOI: 10.1002/pd.5005] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2016] [Revised: 12/23/2016] [Accepted: 01/03/2017] [Indexed: 02/05/2023]
Affiliation(s)
- Florencia Petracchi
- Centro de Educación Médica en Investigaciones Clínicas (CEMIC); Instituto Universitario - Department of Obstetrics and Gynecology; Genetic Unit, Galvan 4102, Buenos Aires Buenos Aires 1425 Argentina
| | - Cecilia Paez
- Centro de Educación Médica en Investigaciones Clínicas (CEMIC); Instituto Universitario - Department of Obstetrics and Gynecology; Genetic Unit, Galvan 4102, Buenos Aires Buenos Aires 1425 Argentina
| | - Laura Igarzabal
- Centro de Educación Médica en Investigaciones Clínicas (CEMIC); Instituto Universitario - Department of Obstetrics and Gynecology; Genetic Unit, Galvan 4102, Buenos Aires Buenos Aires 1425 Argentina
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Devlin CA, Huberty J, Downs DS. Influences of prior miscarriage and weight status on perinatal psychological well-being, exercise motivation and behavior. Midwifery 2016; 43:29-36. [PMID: 27838526 PMCID: PMC5314732 DOI: 10.1016/j.midw.2016.10.010] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2016] [Revised: 09/28/2016] [Accepted: 10/26/2016] [Indexed: 10/20/2022]
Abstract
OBJECTIVES women who have experienced miscarriage may be at increased risk for elevated depressive and anxiety symptoms in subsequent pregnancies. Exercise may be a useful strategy for coping with these symptoms. Little is known about how miscarriage influences prenatal exercise behavior. The study purpose was to examine the influences of miscarriage history and prepregnancy weight status on pregnant women's psychological health, exercise motivation, and behavior using the Theory of Planned Behavior. PARTICIPANTS/SETTING Pregnant women (N=203; 41 with prior miscarriage; 72 overweight/obese; BMI > 25.0) in the northeast United States. DESIGN Women prospectively reported their depressive/anxiety symptoms and exercise motivation/behavior in the 1st, 2nd, and 3rd trimesters via mailed surveys. Group differences in depressive/anxiety symptoms, exercise behavior, and its motivational determinants were examined using Chi Square analyses and Univariate and Multivariate Analyses of Covariance. MEASUREMENTS AND FINDINGS Women with a history of miscarriage had higher 1st and 2nd trimester depressive/anxiety symptoms and lower 1st trimester attitudes about exercise and 1st and 2nd trimester perceived behavior control than women without a history of miscarriage. Overweight/obese women had higher 1st and 2nd trimester pregnancy depressive/anxiety symptoms, engaged in less prepregnancy exercise, and had lower levels of exercise intention, attitude, and perceived behavior control throughout pregnancy than normal weight women. KEY CONCLUSIONS Women with a history of miscarriage and overweight/obese women have poorer psychological health and lower motivation to exercise during pregnancy than women without a history of miscarriage and normal weight women. IMPLICATIONS FOR PRACTITIONERS Interventions and healthcare provider communications aimed at promoting perinatal exercise behavior and psychological health should take into account pre-pregnancy weight status and pregnancy history to identify strategies to help women, particularly overweight/obese women with a history of miscarriage, to overcome exercise barriers.
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Affiliation(s)
- Courtenay A Devlin
- Exercise Psychology Laboratory, Department of Kinesiology, Penn State University, University Park, PA, USA.
| | - Jennifer Huberty
- Department of Exercise Science & Health, School of Nutrition Health and Promotion, Arizona State University, Phoenix, AZ, USA
| | - Danielle Symons Downs
- Exercise Psychology Laboratory, Department of Kinesiology, Penn State University, University Park, PA, USA; Department of OBGYN, Hershey Medical Center, Hershey, PA, USA
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Berhie KA, Gebresilassie HG. Logistic regression analysis on the determinants of stillbirth in Ethiopia. Matern Health Neonatol Perinatol 2016; 2:10. [PMID: 27660718 PMCID: PMC5025573 DOI: 10.1186/s40748-016-0038-5] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/10/2016] [Accepted: 09/08/2016] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND Stillbirth is often defined as fetal death after 24 weeks of gestation, but a fetus greater than any combination of 16, 20, 22, 24, or 28 weeks gestational age and 350 g, 400 g, 500 g, or 1000 g birth weight may be considered stillborn depending on local law. Once the fetus has died, the mother may or may not have contractions and undergo childbirth or in some cases, a Caesarean section. Most stillbirths occur in full-term pregnancies. METHODS This study has intended to model determinants of experiencing stillbirth among women in child bearing age group of Ethiopia using the Ethiopian demographic and health Survey data (EDHS, 2011). First, the bivariate chi-square test of association was fitted to the data and significant variables were considered for further investigation binary logistic regression models were fitted. RESULTS This study revealed that the rate of experiencing stillbirth among women of child bearing age was about 25.5 per 1000 deliveries in Ethiopia. From binary logistic regression, region of residence, maternal age, place of residence, education level, parity, antenatal care utilization, place of delivery, body mass index (BMI) and anemia level were found to be significantly associated with experiencing stillbirth. CONCLUSIONS Researchers should use multilevel models than traditional regression methods when their data structure is hierarchical as like in Ethiopian Demographic and Health Survey data.
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Affiliation(s)
- Kidanemariam Alem Berhie
- Department of Statistics, College of Natural and Computational Sciences, University of Gondar, Gondar, Ethiopia
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Sriarporn P, Turale S, Lordee N, Liamtrirat S, Hanpra W, Kanthino A. Support program for women suffering grief after termination of pregnancy: A pilot study. Nurs Health Sci 2016; 19:75-80. [PMID: 27620532 DOI: 10.1111/nhs.12307] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2015] [Revised: 05/02/2016] [Accepted: 07/14/2016] [Indexed: 11/29/2022]
Abstract
In this study, we preliminarily examined the effects of the Informational and Emotional Support Program for Women after Pregnancy Termination in 30 Thai women. A literature review and House's theory of social support informed the program content, which consisted of the following elements: (i) an evaluation of grief; (ii) an analysis of the problems and needs of each woman; (iii) informational and emotional support tailored to individual problems and needs; (iv) telephone support; and (v) an exit phone interview. The Grief Questionnaire for Women after Pregnancy Termination was used to measure changes in the grief levels of participants. The data were analyzed using descriptive statistics and the contingency coefficient. At the completion of the study, the participants' average grief score had decreased from the prior grief score and was in the moderate to low range. These preliminary findings indicate that the support program can be effective in real-life situations in Thailand to assist women who are grieving after the termination of pregnancy. Our findings highlight the need for nursing and emotional support to be provided to help Thai women after the TOP.
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Affiliation(s)
- Punpilai Sriarporn
- Departments of Obstetric and Gynecological Nursing, Chiang Mai University, Chiang Mai, Thailand
| | - Sue Turale
- Department of Global Health and Nursing, Ewha Womans University, Seoul, Korea
| | - Nuananong Lordee
- Obstetric and Gynecological Nursing Service, Maharaj Nakorn Chiang Mai Hospital, Chiang Mai, Thailand
| | - Sawanee Liamtrirat
- Obstetric and Gynecological Nursing Service, Maharaj Nakorn Chiang Mai Hospital, Chiang Mai, Thailand
| | - Wasana Hanpra
- Obstetric and Gynecological Nursing Service, Maharaj Nakorn Chiang Mai Hospital, Chiang Mai, Thailand
| | - Authid Kanthino
- Obstetric and Gynecological Nursing Service, Maharaj Nakorn Chiang Mai Hospital, Chiang Mai, Thailand
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Soro MAP, Denys A, de Rham M, Baud D. Short & long term adverse outcomes after arterial embolisation for the treatment of postpartum haemorrhage: a systematic review. Eur Radiol 2016; 27:749-762. [PMID: 27229338 DOI: 10.1007/s00330-016-4395-2] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2015] [Revised: 04/25/2016] [Accepted: 05/02/2016] [Indexed: 12/14/2022]
Abstract
OBJECTIVES Arterial embolisation (AE) plays a major role in current practice in the management of postpartum haemorrhage (PPH) that fails to respond to conservative treatment. While its benefit is well known, long-term outcomes of AE have been poorly investigated. The objective of this review is to assess its potential complications and long-term effects on the patients' quality of life. METHODS Using the terms "embolisation" and "postpartum haemorrhage", we searched the Cochrane Central Register of Controlled Trials, Medline and PubMed for published studies. We limited the search to articles in English and French reporting "complications", "fertility", "menstruation" or "menstrual cycle" in humans. To ensure completeness, the references of extracted articles and review articles were also searched. RESULTS The fertility rate in patients attempting another pregnancy reaches 70-80 %. Pregnancies following AE for PPH are not associated with a higher rate of intrauterine growth restriction. Pathological placentation (placenta accreta/increta/percreta) occurs more frequently after AE than in the general population. Psychological wellbeing, post-traumatic stress and sexual dysfunction after a life-threatening PPH requiring AE will require further investigation. CONCLUSION AE does not appear to adversely affect menstrual cycle, fertility and subsequent pregnancies, but may affect placentation. The experience of a life-threatening PPH, however, might prevent couples from pursuing another pregnancy. KEY POINTS • Embolisation for PPH does not adversely affect menstrual cycle and fertility • Experience of life-threatening PPH might prevent couples from pursuing another pregnancy • Pathological placentation seems to occur more frequently after embolisation for PPH.
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Affiliation(s)
- Marie-Aimée Päivi Soro
- Materno-Fetal & Obstetrics Research Unit, Department of Obstetrics and Gynecology, University Hospital, Centre Hospitalier Universitaire Vaudois (CHUV), 1011, Lausanne, Switzerland.,Department of Radiology, University Hospital, 1011, Lausanne, Switzerland
| | - Alban Denys
- Department of Radiology, University Hospital, 1011, Lausanne, Switzerland
| | - Maud de Rham
- Materno-Fetal & Obstetrics Research Unit, Department of Obstetrics and Gynecology, University Hospital, Centre Hospitalier Universitaire Vaudois (CHUV), 1011, Lausanne, Switzerland
| | - David Baud
- Materno-Fetal & Obstetrics Research Unit, Department of Obstetrics and Gynecology, University Hospital, Centre Hospitalier Universitaire Vaudois (CHUV), 1011, Lausanne, Switzerland.
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Abstract
Infertility and perinatal loss are common, and associated with lower quality of life, marital discord, complicated grief, major depressive disorder, anxiety disorders, and post-traumatic stress disorder. Young women, who lack social supports, have experienced recurrent pregnancy loss or a history of trauma and / or preexisting psychiatric illness are at a higher risk of experiencing psychiatric illnesses or symptoms after a perinatal loss or during infertility. It is especially important to detect, assess, and treat depression, anxiety, or other psychiatric symptoms because infertility or perinatal loss may be caused or perpetuated by such symptoms. Screening, psychoeducation, provision of resources and referrals, and an opportunity to discuss their loss and plan for future pregnancies can facilitate addressing mental health concerns that arise. Women at risk of or who are currently experiencing psychiatric symptoms should receive a comprehensive treatment plan that includes the following: (1) proactive clinical monitoring, (2) evidence-based approaches to psychotherapy, and (3) discussion of risks, benefits, and alternatives of medication treatment during preconception and pregnancy.
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Affiliation(s)
- Amritha Bhat
- Department of Psychiatry, University of Washington, Box 35650, Seattle, WA, 98195, USA.
| | - Nancy Byatt
- Departments of Psychiatry and Obstetrics and Gynecology, UMass Medical School, Worcester, MA, USA
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Peters MD, Lisy K, Riitano D, Jordan Z, Aromataris E. Caring for families experiencing stillbirth: Evidence-based guidance for maternity care providers. Women Birth 2015; 28:272-8. [DOI: 10.1016/j.wombi.2015.07.003] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2014] [Revised: 06/10/2015] [Accepted: 07/06/2015] [Indexed: 11/28/2022]
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A meta-analysis of risk of pregnancy loss and caffeine and coffee consumption during pregnancy. Int J Gynaecol Obstet 2015; 130:116-22. [PMID: 26026343 DOI: 10.1016/j.ijgo.2015.03.033] [Citation(s) in RCA: 51] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2014] [Revised: 02/25/2015] [Accepted: 04/30/2015] [Indexed: 02/03/2023]
Abstract
BACKGROUND Previous reports of the relationship between pregnancy loss and caffeine/coffee consumption have been inconsistent. OBJECTIVES To evaluate the association between pregnancy loss and caffeine and coffee consumption. SEARCH STRATEGY PubMed was searched for reports published before September 2014, with the keywords "caffeine," "coffee," "beverage," "miscarriage," "spontaneous abortion," and "fetal loss." SELECTION CRITERIA Case-control and cohort studies were included when they had been reported in English, the exposure of interest was caffeine/coffee consumption during pregnancy, the outcome of interest was spontaneous abortion or fetal death, and multivariate-adjusted odds ratios (ORs) or risk ratios were provided or could be calculated. DATA COLLECTION AND ANALYSIS Data were extracted and combined ORs calculated. MAIN RESULTS Overall, 26 studies were included (20 of caffeine and eight of coffee). After adjustment for heterogeneity, caffeine consumption was associated with an increased risk of pregnancy loss (OR 1.32, 95% confidence interval [CI] 1.24-1.40), as was coffee consumption (OR 1.11, 95% CI 1.02-1.21). A dose-response analysis suggested that risk of pregnancy loss rose by 19% for every increase in caffeine intake of 150 mg/day and by 8% for every increase in coffee intake of two cups per day. CONCLUSIONS Consumption of caffeine and coffee during pregnancy seems to increase the risk of pregnancy loss.
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Legendre G, Gicquel M, Lejeune V, Iraola E, Deffieux X, Séjourné N, Bydlowski S, Gillard P, Sentilhes L, Descamps P. Psychologie et perte de grossesse. ACTA ACUST UNITED AC 2014; 43:908-17. [DOI: 10.1016/j.jgyn.2014.09.019] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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