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Ssegujja E, Mulumba Y, Guttmacher S, Andipatin M. The role and attributes of social networks in the provision of support to women after stillbirth: experiences from Uganda. BMC Womens Health 2021; 21:352. [PMID: 34615502 PMCID: PMC8496046 DOI: 10.1186/s12905-021-01498-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2021] [Accepted: 09/17/2021] [Indexed: 11/12/2022] Open
Abstract
INTRODUCTION Communities exert stigma on mothers after stillbirth despite their potential to offer social support to the grieving family. Maternal healthcare-seeking behaviors are socially reinforced rendering a social network approach vital in understanding support dynamics which when utilized can improve community response to mothers experiencing stillbirth. However, the form and direction of social support for women when in need is not clear. The study explored the role and attributes of women's social networks in the provision of support to mothers who have experienced a stillbirth in Uganda. METHODS An exploratory cross-sectional study design adopting a social network approach was conducted. Data collection following established procedures was conducted on a convenient sample of 17 mothers who had experienced a stillbirth six months before the study. Frequencies and bivariate analysis were conducted to determine the factors influencing the provision of social support from 293 network members elicited during the alter generation. We then performed a Poisson regression on each of the social support forms and the explanatory variables. Network structure variables were calculated using UCINET version 6 while Netdraw facilitated the visualization of networks. RESULTS Overall, social support was available from all network relations mentioned by the respondents. No major variations were observed between the two time periods during pregnancy and following a stillbirth. The most common support received was in form of intangible support such as emotional and information support, mainly from females who were married and from the naturally occurring networks such as family and friends. We also observed that social support followed patterns of network relational characteristics including trust, frequency of contact and alters counted on for support more likely to provide the same. CONCLUSIONS A great potential for social support exists within women's social networks to help address stillbirth risk factors during pregnancy and cope after experiencing the same. Alter characteristics like being female, married, and from naturally occurring networks together with relational characteristics such as trust, frequency of contact, and count on alter for support were predictors of eventual social support. Interventions aiming at addressing stillbirth risks at the community level ought to harness these network characteristics for benefits to the mothers.
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Affiliation(s)
- Eric Ssegujja
- Makerere University School of Public Health, Kampala, Uganda.
- School of Public Health, University of the Western Cape, Cape Town, South Africa.
| | - Yusuf Mulumba
- Uganda Cancer Institute, Mulago National Referral Hospital, Kampala, Uganda
| | - Sally Guttmacher
- School of Global Public Health, New York University, New York, NY, USA
| | - Michelle Andipatin
- Department of Psychology, University of the Western Cape, Cape Town, South Africa
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Battulga B, Benjamin MR, Chen H, Bat-Enkh E. The Impact of Social Support and Pregnancy on Subjective Well-Being: A Systematic Review. Front Psychol 2021; 12:710858. [PMID: 34566789 PMCID: PMC8459714 DOI: 10.3389/fpsyg.2021.710858] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2021] [Accepted: 07/13/2021] [Indexed: 12/21/2022] Open
Abstract
Background: Subjective well-being (SWB) has a protective role in mental health maintenance and is prone to change during short stressful moments, such as pregnancy. Longstanding research suggests that social support (SS) from the partner and family members of pregnant women directly or indirectly acts as a buffer against negative mental outcomes. For happier pregnancies, it is important to understand how SS and pregnancy affect the SWB. Objective: This review aims to examine the extended association of being pregnant and SS on the SWB of pregnant women. Methods: A systematic review was conducted in PubMed, ScienceDirect, and Google Scholar. Articles published in peer-reviewed journals were included regardless of the year and if they had assessed the impact of at least one SWB or SS outcome among healthy pregnant women. The tools of the National Heart, Lung, and Blood Institute were used for quality assessment. Results: Thirty-four studies that assessed the domains of SWB measurements, such as happiness, quality of life (QoL), life satisfaction, positive and negative effects, and well-being, were included and its association with either pregnancy or SS was summarized. Variable results, such as life satisfaction, happiness, and mental component of QoL, were found to be high during pregnancy, but positive emotion and physical components of QoL had decreased. Almost universally, SS during pregnancy was found to have a positive association with all measurements of SWB. Conclusion: This study had found that, despite some arising trends, pregnancy itself does not necessarily have similar impacts on SWB across healthy pregnant women. However, SS had a significant effect on SWB.
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Affiliation(s)
- Buyantungalag Battulga
- Department of Psychology, Southwest University, Chongqing, China
- Department of Agricultural and Applied Economics, Mongolian University of Life Science, Ulaanbaatar, Mongolia
| | | | - Hong Chen
- Department of Psychology, Southwest University, Chongqing, China
| | - Enkhmandakh Bat-Enkh
- School of Politics and Public Administration, Southwest University, Chongqing, China
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Drysdale RE, Slemming W, Makusha T, Richter LM. Father involvement, maternal depression and child nutritional outcomes in Soweto, South Africa. MATERNAL & CHILD NUTRITION 2021; 17 Suppl 1:e13177. [PMID: 34241955 PMCID: PMC8269140 DOI: 10.1111/mcn.13177] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/15/2020] [Revised: 02/12/2021] [Accepted: 02/16/2021] [Indexed: 11/27/2022]
Abstract
Father involvement in South Africa is low, despite evidence that it can improve maternal and child health and wellbeing. Within a larger randomised controlled trial, we assessed whether father involvement during and after pregnancy increased birth weight and exclusive breastfeeding through improved maternal mental health. At 6-week postnatal, mothers completed questionnaires on birth, feeding practices, social support, father involvement and postnatal depression. Father involvement during pregnancy was measured by their attendance at antenatal care and the study intervention, whereas postnatal involvement was measured by attendance at antenatal care and type of paternal support provided. Structural equation modelling was used to identify associations between father involvement, maternal depression, low birth weight and exclusive breastfeeding. Among the 212 mother-baby pairs, father involvement was very low with only 43%, 33% and 1% of partners attending early ultrasound, antenatal care and the birth of the child, respectively. Twenty-nine percent of the mothers showed signs of depression during pregnancy, compared with 7% after birth. Eighteen percent of the infants were born low birth weight, and 57% of mothers reported exclusively breastfeeding at 6 weeks. Father involvement was directly associated with postnatal depression, but it did not directly or indirectly impact exclusive breastfeeding or low birth weight. We conclude that postnatal father involvement can improve postnatal maternal depression and that men would benefit from specific guidance on how they can support mothers during and after pregnancy.
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Affiliation(s)
- Roisin E. Drysdale
- DSI‐NRF Centre of Excellence in Human DevelopmentUniversity of the WitwatersrandJohannesburgSouth Africa
| | - Wiedaad Slemming
- Division of Community Paediatrics, Department of Paediatrics and Child Health, Faculty of Health SciencesUniversity of the WitwatersrandJohannesburgSouth Africa
| | - Tawanda Makusha
- DSI‐NRF Centre of Excellence in Human DevelopmentUniversity of the WitwatersrandJohannesburgSouth Africa
- Human Sciences Research CouncilPretoriaSouth Africa
- Wits/MRC Developmental Pathways for Research UnitJohannesburgSouth Africa
| | - Linda M. Richter
- DSI‐NRF Centre of Excellence in Human DevelopmentUniversity of the WitwatersrandJohannesburgSouth Africa
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Stampini V, Monzani A, Caristia S, Ferrante G, Gerbino M, De Pedrini A, Amadori R, Rabbone I, Surico D. The perception of Italian pregnant women and new mothers about their psychological wellbeing, lifestyle, delivery, and neonatal management experience during the COVID-19 pandemic lockdown: a web-based survey. BMC Pregnancy Childbirth 2021; 21:473. [PMID: 34210276 PMCID: PMC8246432 DOI: 10.1186/s12884-021-03904-4] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2020] [Accepted: 05/27/2021] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND In response to the COVID-19 pandemic, drastic measures for social distancing have been introduced also in Italy, likely with a substantial impact in delicate conditions like pregnancy and puerperium. The study aimed to investigate the changes in lifestyle, access to health services, and mental wellbeing during the first Italian lockdown in a sample of Italian pregnant women and new mothers. METHODS We carried out a web-based survey to evaluate how pregnant women and new mothers were coping with the lockdown. We collected data about healthy habits (physical exercise and dietary habits), access to health services (care access, delivery and obstetric care, neonatal care, and breastfeeding), and mental wellbeing (psychological well-being and emotive support). Descriptive analysis was performed for both groups of participants, whereas a Poisson analysis was used to measure the association between some structural variables (age, education, socio-economic data, partner support, contact, free time, previous children, and pregnancy trimester) and anxiety or depression, difficulties in healthy eating and reduction in physical activity after lockdown started. Chi2 and Adjusted Prevalence Ratios were estimated only for pregnant women. RESULTS We included 739 respondents (response rate 85.8 %), 600 were pregnant (81.2 %), and 139 (18.8 %) had delivered during lockdown (new mothers). We found a high score for anxiety and depression in 62.8 % of pregnant women and 61.9 % of new mothers. During the lockdown, 61.8 % of pregnant women reduced their physical exercise, and 44.3 % reported eating in a healthier way. 94.0 % of new mothers reported to have breastfed their babies during the hospital stay. Regarding the perceived impact of restrictive measures on breastfeeding, no impact was reported by 56.1 % of new mothers, whereas a negative one by 36.7 %. CONCLUSIONS The high prevalence of anxiety and depressive symptoms in pregnant women and new mothers should be a public health issue. Clinicians might also recommend and encourage "home" physical exercise. On the other hand, about half of the sample improved their approach towards healthy eating and a very high breastfeeding rate was reported soon after birth: these data are an interesting starting point to develop new strategies for public health.
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Affiliation(s)
- Viviana Stampini
- Obstetrics and Gynecology Unit, Department of Translational Medicine, University of Eastern Piedmont, Via Solaroli 17, 28100, Novara, Italy.
| | - Alice Monzani
- Division of Pediatric, Department of Health Sciences, University of Eastern Piedmont, Novara, Italy
| | - Silvia Caristia
- Department of Translational Medicine, University of Eastern Piedmont, Novara, Italy
| | | | - Martina Gerbino
- Obstetrics and Gynecology Unit, Department of Translational Medicine, University of Eastern Piedmont, Via Solaroli 17, 28100, Novara, Italy
| | - Alberto De Pedrini
- Obstetrics and Gynecology Unit, Maggiore della Carità Hospital, Novara, Italy
| | - Roberta Amadori
- Obstetrics and Gynecology Unit, Maggiore della Carità Hospital, Novara, Italy
| | - Ivana Rabbone
- Division of Pediatric, Department of Health Sciences, University of Eastern Piedmont, Novara, Italy
| | - Daniela Surico
- Obstetrics and Gynecology Unit, Department of Translational Medicine, University of Eastern Piedmont, Via Solaroli 17, 28100, Novara, Italy
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Kroll-Desrosiers A, Holzhauer CG, Russo L, DeRycke EC, Kinney RL, Bastian LA, Mattocks KM. Factors Associated With Quitting Smoking During Pregnancy Among Women Veterans. Womens Health Issues 2021; 31:408-413. [PMID: 34049763 DOI: 10.1016/j.whi.2021.04.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2020] [Revised: 04/20/2021] [Accepted: 04/21/2021] [Indexed: 11/20/2022]
Abstract
INTRODUCTION Little is known about the rates of smoking among pregnant veterans. Our objective was to examine rates of smoking during pregnancy and factors associated with quitting smoking during pregnancy. METHODS We used data from a cohort study of pregnant veterans from 15 Veterans Health Administration facilities nationwide. Veterans who reported smoking during pregnancy were included in this analysis. Poisson regression models were used to estimate the relative risk (RR) of quitting smoking during pregnancy. RESULTS Overall, 133 veterans reported smoking during pregnancy. Among this group of women who smoked, the average age was 31.6 years, 20% were Black, and 14% were Hispanic/Latino. More than one-half of women (65%) who reported smoking at the start of pregnancy quit smoking during pregnancy. Multivariable models, adjusted for history of deployment and age, indicated that prenatal care initiation at 12 or fewer weeks compared with more than 13 weeks (relative risk [RR], 2.06; 95% confidence interval [CI], 1.18-3.58), living without household smokers compared with any household smokers (RR, 1.58; 95% CI, 1.14-2.17), and first pregnancy (RR, 1.51; 95% CI, 1.17-1.95) were significant predictors of quitting versus persistent smoking during pregnancy. CONCLUSIONS Women veterans who quit smoking may be different than those who continue to smoke during pregnancy. Establishing prenatal care early in pregnancy, which likely includes counseling about smoking cessation, seems to be an important factor in quitting. Those for whom it is not a first pregnancy and who live with other smokers may especially benefit from such counseling.
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Affiliation(s)
- Aimee Kroll-Desrosiers
- Research and Development, VA Central Western Massachusetts Healthcare System, Leeds, Massachusetts; Department of Psychiatry, University of Massachusetts Medical School, Worcester, Massachusetts; Department of Population & Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, Massachusetts.
| | - Cathryn Glanton Holzhauer
- Research and Development, VA Central Western Massachusetts Healthcare System, Leeds, Massachusetts; Department of Psychiatry, University of Massachusetts Medical School, Worcester, Massachusetts
| | - Lindsey Russo
- Department of Biostatistics and Epidemiology, School of Public Health and Health Sciences, University of Massachusetts Amherst, Amherst, Massachusetts
| | - Eric C DeRycke
- Pain Research, Informatics, Multimorbidities, and Education (PRIME) Center, VA Connecticut Healthcare System, West Haven, Connecticut
| | - Rebecca L Kinney
- Research and Development, VA Central Western Massachusetts Healthcare System, Leeds, Massachusetts
| | - Lori A Bastian
- Pain Research, Informatics, Multimorbidities, and Education (PRIME) Center, VA Connecticut Healthcare System, West Haven, Connecticut; Department of Medicine, Yale University School of Medicine, New Haven, Connecticut
| | - Kristin M Mattocks
- Research and Development, VA Central Western Massachusetts Healthcare System, Leeds, Massachusetts; Department of Psychiatry, University of Massachusetts Medical School, Worcester, Massachusetts; Department of Population & Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, Massachusetts
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Fouladi N, Feizi I, Pourfarzi F, Yousefi S, Alimohammadi S, Mehrara E, Rostamnejad M. Factors Affecting Behaviors of Women with Breast Cancer Facing Intimate Partner Violence Based on PRECEDE-PROCEED Model. J Caring Sci 2021; 10:89-95. [PMID: 34222118 PMCID: PMC8242298 DOI: 10.34172/jcs.2021.017] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2019] [Accepted: 11/16/2019] [Indexed: 11/09/2022] Open
Abstract
Introduction: More than half of women in Iran experience intimate partner violence (IPV). This study aimed to explore IPV in women with breast cancer (BC) in Ardabil, Iran. Moreover, the predictors of violence and women’s reactions against violence were examined. Methods: Using a convenient sampling method, the current cross-sectional study was performed on 211 women with BC in northwest of Iran. To collect data, a questionnaire consisting of demographic characteristics and items based on PRECEDE-PROCEED model and women's reaction to violence was used. Data were analyzed using SPSS Ver. 20 and descriptive and inferential statistics. Results: In this study, 190 (90%) subjects reported that they had experienced IPV in the preceding year. Only 27(12.8%) women were familiar with all forms of violence. Moreover, 141 (66.8%) and 160 (75.8%) women had no access to counseling centers and life skill training courses, respectively. Women mostly had adopted emotion-oriented coping strategies when facing IPV. The results of multivariate regression analysis indicated that enabling factors and knowledge were predictors of problem-oriented coping strategies in women. Conclusion: Empowered women, for the most part, were better educated and had more access to social resources than others. Therefore, empowering women can help reduce the amount of violence they might have to encounter. It is essential that supporting and empowering centers for women be established in the society and efficient laws be enacted to fight IPV.
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Affiliation(s)
- Nasrin Fouladi
- Departement of Community Medicine, Social Determinants of Health Research Center, Faculty of Medicine, Ardabil University of Medical Sciences, Ardebil, Iran
| | - Iraj Feizi
- Department of Surgery, Faculty of Medicine, Ardebil University of Medical Sciences, Ardebil, Iran
| | - Farhad Pourfarzi
- Department of Community Medicine, Faculty of Medicine, Ardabil University of Medical Sciences, Ardebil, Iran
| | - Sajjad Yousefi
- Department of Community Medicine, Faculty of Medicine, Ardabil University of Medical Sciences, Ardebil, Iran
| | - Sara Alimohammadi
- Department of Medicine, Faculty of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Elham Mehrara
- Department of English Language, Faculty of Persian and Foreign Language, University of Tabriz, Tabriz, Iran
| | - Masoumeh Rostamnejad
- Department of Midwifery, Faculty of Nursing and Midwifery, Ardebil University of Medical Sciences, Ardebil, Iran
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Fathnezhad-Kazemi A, Aslani A, Hajian S. Association between Perceived Social Support and Health-Promoting lifestyle in Pregnant Women: A Cross-Sectional Study. J Caring Sci 2021; 10:96-102. [PMID: 34222119 PMCID: PMC8242291 DOI: 10.34172/jcs.2021.018] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2019] [Accepted: 01/29/2020] [Indexed: 11/09/2022] Open
Abstract
Introduction: Adopting health-promoting lifestyle might be affected by a variety of factors. The existing evidence suggests that social support can improve health by fulfilling physical and mental needs. This study aimed to investigate the association between social support and health-promoting lifestyle in Pregnancy. Methods: Using multistage cluster sampling method, this cross-sectional study was conducted on 360 pregnant women. Data were collected using three questionnaires, including a self-reported demographic and obstetric, health-promoting lifestyle profile and perceived social support questionnaires. Data were analyzed using a t-test, repeated measures ANOVA, and multivariate linear regression model with SPSS software ver. 21 with. Results: The mean (SD) of health-promoting behaviors was 135.21(20.03). Amongst the different dimensions of health-promoting behaviors, the highest mean was detected in spiritual growth 26.84 (4.90) and nutrition 26.17 (4.22), respectively. Meanwhile, the lowest scores were detected in sub-domains of stress management 19.80 (3.78) and physical activity 16.71(4.14), respectively. The mean (SD) of perceived social support was 60.31 (14.75), and 51.7% of the participants had intermediate social support. Results indicated a significant difference between the mean score of Health-Promoting Lifestyle at different levels of social support. There was a direct and significant association between the scores of social support and health-promoting behavior (r=0.36; P<0.001). Conclusion: Pregnant women with better perception of social support had a better performance in adopting health-promoting Lifestyle. However, the status of health behaviors and social support was not favorable. Thus, there is a need to intervene and design programs to help pregnant women and improve their health.
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Affiliation(s)
| | - Armin Aslani
- Department of Medical Sciences, Student Research Committee, Islamic Azad University, Tabriz Branch, Tabriz, Iran
| | - Sepideh Hajian
- Department of Midwifery & Reproductive Health, Faculty of Nursing & Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Izadirad H, Zareban I, Niknami S, Atashpanjeh A. Factors affecting pregnancy care and birth weight among pregnant women in Baluchestan, Iran: an application of the social cognitive theory. Women Health 2021; 61:510-519. [PMID: 34016032 DOI: 10.1080/03630242.2021.1919282] [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: 10/21/2022]
Abstract
This study aimed to determine the effects of self-efficacy, social support, and health literacy on prenatal care and birth weight among pregnant women. This descriptive-analytical study was conducted on 860 primiparous pregnant women who referred to health care centers for prenatal care in Iranshahr, Iran. Participants were selected through a two-stage cluster sampling. The data were collected from November 2016 to the end of January 2017 using a valid and reliable questionnaire. Data were analyzed using descriptive tests, chi-square and hierarchical regression analyses in SPSS 20. The findings indicated that health literacy, self-efficacy, income, social support, and education level explained for 7.5%, 4.6%, 2.6%, 1%, and 0.6% of the variances in caring prenatal care, respectively. Moreover, income, prenatal care, insurance, health literacy, and social support were the most effective on birth weight outcome (OR = 2.21, OR = 2.12, OR = 2, OR = 0.66, OR = 0.17). The results of the current study indicated that a combination of health literacy, self-efficacy, and social support are necessary to improve prenatal care and birth weight for Iranian low-income pregnant women.
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Affiliation(s)
- Hossien Izadirad
- Zahedan Health Promotion Research Center, Zahedan University of Medical Sciences, Zahedan, Iran
| | - Iraj Zareban
- Zahedan Health Promotion Research Center, Zahedan University of Medical Sciences, Zahedan, Iran
| | - Shamsoddin Niknami
- Department of Health Education, School of Medical Sciences, Tarbiat Modarres University, Tehran, Iran
| | - Alireza Atashpanjeh
- Clinical Immunology Research Center, ELT Department, School of Medicine, Zahedan University of Medical Sciences, Zahedan, Iran
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Greene CA, McCoach DB, Briggs-Gowan MJ, Grasso DJ. Associations among childhood threat and deprivation experiences, emotion dysregulation, and mental health in pregnant women. PSYCHOLOGICAL TRAUMA : THEORY, RESEARCH, PRACTICE AND POLICY 2021; 13:446-456. [PMID: 33475412 PMCID: PMC8217136 DOI: 10.1037/tra0001013] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
OBJECTIVE Women who have experienced childhood maltreatment are at increased risk for experiencing mental health problems. When these occur during pregnancy, they are associated with birth complications and worse developmental outcomes for children. Emotion dysregulation (ED) may be an important, and potentially modifiable, mechanism that links women's maltreatment experiences with their mental health. However, there is limited information about the emotion regulation skills of pregnant women to guide treatment. The current study examines the unique effects of childhood threat (physical, sexual, and emotional abuse and exposure to violence) and deprivation (physical and emotional neglect and separation from primary caregivers) experiences on pregnant women's ED, posttraumatic stress and negative emotional symptoms, and social support. METHOD Two hundred forty-three women were recruited from an urban prenatal care clinic, the majority of whom identified as Latinx (80%) and low-income (90%). The mean age of the women was 27 years (SD = 5.5). RESULTS Structural equation modeling revealed significant indirect pathways from childhood threat experiences to posttraumatic stress and negative emotional symptoms via women's ED. In contrast, childhood deprivation experiences were associated with inattention to one's emotions and low perceived social support. CONCLUSIONS These results underscore the importance of identifying women during pregnancy who may be at risk for ED or emotional inattentiveness due to childhood maltreatment experiences and providing prevention and intervention efforts aimed at enhancing their emotional awareness and regulation. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
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Affiliation(s)
- Carolyn A. Greene
- Department of Psychiatry, University of Connecticut School of Medicine
| | | | | | - Damion J. Grasso
- Department of Psychiatry, University of Connecticut School of Medicine
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Versteegen M, Bozlak CT, Larkin H, Appleton AA. Maternal depression, adverse childhood experiences, and social support in relation to gestational diabetes risk: results from the Albany Infant and Mother Study (AIMS). BMC Pregnancy Childbirth 2021; 21:335. [PMID: 33906618 PMCID: PMC8077784 DOI: 10.1186/s12884-021-03814-5] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2021] [Accepted: 04/20/2021] [Indexed: 11/29/2022] Open
Abstract
Background Psychosocial factors are of increasing interest as potential influencers in disease development. This study explores associations between gestational diabetes mellitus (GDM) and maternal depression, adverse childhood experiences (ACEs), and social support, in response to emerging evidence in these areas. Methods An observational, prospective cohort study (AIMS) served as the source of secondary data for this study. Participants included 300 pregnant women aged 18–40 years at an upstate New York prenatal care clinic, who completed a set of self-report questionnaires assessing exposures and stressors both during and prior to their pregnancy. Data were also abstracted from infant and maternal medical records. Results Logistic regression modeling estimated the odds ratios (ORs) of developing GDM in relation to psychosocial factors. There was a significant association between depression and GDM (OR = 2.85, 95% CI: 1.15, 7.06), which persisted in the model adjusted for age and BMI (aOR = 3.19, 95% CI: 1.25, 8.10). No significant associations were found between ACEs or social support with GDM. Conclusions Study findings support an association between maternal depression and GDM development. This study underscores the need for additional research on psychosocial factors and connections to health risks.
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Affiliation(s)
| | - Christine T Bozlak
- Health Policy, Management, and Behavior, University at Albany School of Public Health, Rensselaer, USA
| | - Heather Larkin
- University at Albany School of Social Welfare, Albany, USA
| | - Allison A Appleton
- Epidemiology and Biostatistics, University at Albany School of Public Health, Rensselaer, USA
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Dule A, Hajure M, Mohammedhussein M, Abdu Z. Health-related quality of life among Ethiopian pregnant women during COVID-19 pandemic. Brain Behav 2021; 11:e02045. [PMID: 33506639 PMCID: PMC7994997 DOI: 10.1002/brb3.2045] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Revised: 01/07/2021] [Accepted: 01/12/2021] [Indexed: 02/01/2023] Open
Abstract
OBJECTIVE To explore the quality of life and its association with perceived social support and pandemic fear among pregnant women. METHODS Cross-sectional study was conducted among 384 pregnant mothers at southwest Ethiopia from August 1, 2020, to August 15, 2020. Participants were included by consecutive sampling. Quality of life was assessed by short version of WHO quality of life. Social support and fear of COVID-19 were evaluated by Multidimensional Scale of Perceived Social Support (MSPSS) and fear of COVID-19 scale (FCoV-19S), respectively. Data were analyzed by SPSS version 23.0. Frequency and percentage for categorical variables, and mean ± SD for continuous variables were calculated. Independent sample t test and ANOVA were employed to compare the groups of normally distributed variables. Multiple regressions were performed, and Pearson correlation (r) was used to explore the relationships. Statistical significance was declared at p < .05, and 95% CI was calculated. RESULTS The mean age of the participants was 31.3 ± 7.7, and 40.4% of them were between the ages of 25-34. The mean scores of participants those living with <5 family members and those living with ≥5 family members were significantly different [t(382) = 3.09, p = .002]. Participants with primary education have significantly high mean score of WHOQOL-BREF from those participants with no formal education (p = .028, MD = -1.9). Moderate negative correlation was observed between the scores of WHOQOL-BREF and FCoV-19S. All the components of MSPSS had positively associated with WHOQOL-BREF score at significant level. On final model, FCoV-19S score has uniquely accounted for 19.4% of variance in WHOQOL-BREF. CONCLUSIONS Perceived social support has positively linked to QOL among pregnant women during COVID-19 pandemic. Pandemic-related fear has negative association with QOL and may be considered independent contributor of decreased quality of life in this population.
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Affiliation(s)
- Aman Dule
- Department of PsychiatryCollege of Health ScienceMettu UniversityMettuEthiopia
| | - Mohammedamin Hajure
- Department of PsychiatryCollege of Health ScienceMettu UniversityMettuEthiopia
| | | | - Zakir Abdu
- Department of PsychiatryCollege of Health ScienceMettu UniversityMettuEthiopia
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Goldstein BL, Briggs-Gowan M, Grasso DJ. The effects of Intimate Partner Violence and a history of Childhood Abuse on Mental Health and Stress during Pregnancy. JOURNAL OF FAMILY VIOLENCE 2021; 36:337-346. [PMID: 34113060 PMCID: PMC8186840 DOI: 10.1007/s10896-020-00149-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
PURPOSE Maternal adverse childhood experiences (ACEs) and intimate partner violence (IPV) are temporally distinct risk factors that negatively impact mothers and their offspring. Risk associated with ACEs and IPV begin during pregnancy, a period of increased physical and psychological demands. The current study examined a person-centered method to empirically identify profiles of pregnant women based on type and severity of ACEs and past-year IPV. Profiles were then differentiated on psychosocial functioning indicators. METHODS A primarily Latinx, low socioeconomic sample of women (n = 225) completed measures assessing ACEs and past-year IPV, perceived and experienced stress, emotion regulation, and trauma-related symptoms during their third trimester. Latent profile analysis (LPA) was used to identify unique profiles of women based on seven dimensional indicators reflecting threat- and deprivation-based ACEs and IPV. RESULTS A 4-class solution best fit the data: (1) low probability of ACEs or IPV (64.9%), (2) childhood neglect-only (20.4%), (3) childhood abuse/neglect (10.2%), and (4) polytrauma characterized by a combination of childhood abuse, neglect, and IPV (4.4%). Women with the "childhood abuse/neglect" or "polytrauma" profiles reported more stress and symptoms than women with the "low exposure" profile. Women in the "childhood neglect-only" profile were generally similar to women in the "low exposure" profile, but did report greater difficulties in emotion regulation. CONCLUSIONS These results suggest that childhood abuse and IPV, exposure types involving threat, are potent correlates of stress, emotion regulation, and mental health difficulties during pregnancy. However, exposure characterized by deprivation alone generally did not increase difficulties.
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Affiliation(s)
| | | | - Damion J Grasso
- Department of Psychiatry, University of Connecticut School of Medicine
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Zuccolo PF, Xavier MO, Matijasevich A, Polanczyk G, Fatori D. A smartphone-assisted brief online cognitive-behavioral intervention for pregnant women with depression: a study protocol of a randomized controlled trial. Trials 2021; 22:227. [PMID: 33757591 PMCID: PMC7985923 DOI: 10.1186/s13063-021-05179-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2020] [Accepted: 03/10/2021] [Indexed: 12/28/2022] Open
Abstract
Background Pregnancy is strongly associated with increased risk for depression. Approximately 25% of pregnant women develop depression. Treatment for depression during pregnancy has several complexities: the use of psychiatric medications during pregnancy might result in developmental problems in the child and must be used with caution. Psychosocial interventions are effective, but they require specialized professionals. Low- and middle-income countries (LMIC) such as Brazil do not have enough mental health professionals needed to meet this demand. In this context, smartphone-based interventions show immense potential. We developed Motherly, a smartphone application (app) designed to treat maternal depression. We aim to test the efficacy of Motherly in addition to brief cognitive-behavioral therapies (CBT) to treat maternal depression. Methods We will conduct a 2-arm parallel-randomized controlled clinical trial in which 70 pregnant women aged between 16 and 40 years with depression will be randomized to intervention or active control. The intervention group will have access to Motherly, a smartphone app based on three concepts: psychoeducation, behavior monitoring, and gaming elements. Motherly is composed of a package of interventions composed of modules: mental health, sleep, nutrition, physical activity, social support, prenatal/postnatal support, and educational content. The main focus of Motherly is delivering behavioral activation (BA), a brief and structured psychological treatment. The app allows participants to schedule and engage in, and monitor activities according to a plan to avoid acting exclusively according to their mood. The active control group will have access to a simplified version of the app consisting of educational content about various aspects of pregnancy, maternal physical and mental health, and infant development (BA, activity scheduling, sleep hygiene, among other functionalities, will not be present in this version). Both groups will receive four sessions of brief CBT in 8 weeks. Participants will be evaluated by assessors blind to randomization and allocation status. Assessments will occur at baseline (T0), midpoint (T1, week 4–5), posttreatment (T2, week 8), and follow-up (T3, when the child is 2 months old). Maternal mental health (prenatal anxiety, psychological well-being, perceived stress, depression, depression severity, and sleep quality), quality of life, physical activity levels, and infant developmental milestones and social/emotional problems will be measured. Our primary outcome is the change in maternal prenatal depression from baseline to posttreatment (8 weeks). Discussion The potential of digital technology to deliver mental health interventions has been increasingly recognized worldwide. There is a growing literature on interventions using smartphone applications to promote mental health, both with or without the intermediation of a mental health professional. Our study adds to the literature by testing whether an app providing an intervention package, including CBT, psychoeducation, nutrition, physical activity, and social support, can promote maternal and child health and well-being. In particular, we aim to treat depression, for which the use of digital technologies is still scarce. Smartphone applications designed to treat maternal depression are especially relevant because of the potential to circumvent barriers that prevent pregnant women from accessing mental health care. Trial registration ClinicalTrials.gov NCT04495166. Prospectively registered on July 29, 2020.
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Affiliation(s)
- Pedro Fonseca Zuccolo
- Department of Psychiatry, University of Sao Paulo Medical School, Sao Paulo, Brazil.
| | - Mariana O Xavier
- Department of Social Medicine, Post-Graduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil
| | - Alicia Matijasevich
- Department of Preventive Medicine, University of Sao Paulo Medical School, Sao Paulo, Brazil
| | - Guilherme Polanczyk
- Department of Psychiatry, University of Sao Paulo Medical School, Sao Paulo, Brazil
| | - Daniel Fatori
- Department of Psychiatry, University of Sao Paulo Medical School, Sao Paulo, Brazil
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Derksen ME, Kunst AE, Murugesu L, Jaspers MWM, Fransen MP. Smoking cessation among disadvantaged young women during and after pregnancy: Exploring the role of social networks. Midwifery 2021; 98:102985. [PMID: 33761432 DOI: 10.1016/j.midw.2021.102985] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2020] [Revised: 09/29/2020] [Accepted: 03/07/2021] [Indexed: 10/21/2022]
Abstract
OBJECTIVE Smoking prevalence during and after pregnancy remains high among socioeconomically disadvantaged, European women. This research aims to gain insight into the role of social networks on smoking cessation among disadvantaged young women during and after pregnancy. DESIGN Qualitative interview study. SETTING Dutch preventive care program (VoorZorg). PARTICIPANTS Disadvantaged young women during and after pregnancy (n = 17) who participated in a Dutch preventive care program, and members in their social networks (n = 4). METHODS All qualitative interviews were recorded, transcribed, and analyzed by iterative coding processes. FINDINGS Many women were not intrinsically motivated to quit smoking due to, amongst other factors, difficulties in their lives (e.g. domestic violence, psychosocial problems), limited supportive social networks, and a strong dependence on relatives who smoked. Women seemed to be prompted to smoke by smoking cues in their social networks, while distancing from smokers would lead to feelings of social exclusion. When attempting to stop smoking, women experienced little encouragement from their social networks, which instead often undermined their smoking cessation efforts. KEY CONCLUSIONS AND IMPLICATIONS FOR PRACTICE The social networks of disadvantaged young women mostly had a negative role on their smoking cessation efforts. Our results emphasize the need to look at interventions that involve women's social networks, and explore novel opportunities, such as eHealth and mHealth applications so that these women can build supportive new social networks.
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Affiliation(s)
- Marloes E Derksen
- Amsterdam UMC, University of Amsterdam, Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Meibergdreef 9, 1105 AZ, Amsterdam, Netherlands.
| | - Anton E Kunst
- Amsterdam UMC, University of Amsterdam, Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Meibergdreef 9, 1105 AZ, Amsterdam, Netherlands
| | - Laxsini Murugesu
- Amsterdam UMC, University of Amsterdam, Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Meibergdreef 9, 1105 AZ, Amsterdam, Netherlands
| | - Monique W M Jaspers
- Amsterdam UMC, University of Amsterdam, Department of Medical Informatics, Amsterdam Public Health Research Institute, Meibergdreef 9, 1105 AZ, Amsterdam, Netherlands
| | - Mirjam P Fransen
- Amsterdam UMC, University of Amsterdam, Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Meibergdreef 9, 1105 AZ, Amsterdam, Netherlands
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Iqbal A, Burrin C, Aydin E, Beardsall K, Wong H, Austin T. Generation COVID-19 - Should the foetus be worried? Acta Paediatr 2021; 110:759-764. [PMID: 33253455 PMCID: PMC7753784 DOI: 10.1111/apa.15693] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2020] [Revised: 11/11/2020] [Accepted: 11/25/2020] [Indexed: 12/25/2022]
Abstract
Aim The aim of this narrative review was to evaluate the risks, both direct and indirect, to the foetus from the COVID‐19 pandemic. Methods Direct and indirect risks were defined as (a) vertical infection (congenital or intrapartum), (b) maternal infection and its sequelae, and (c) sources of maternal stress during lockdown, including social isolation and altered healthcare provision. Results Early studies suggest that vertical viral transmission is low; however, there may be an important effect of maternal infection on foetal growth and development. The impact of various degrees of lockdown on prospective mothers’ health, habits and healthcare provision is of concern. In particular, increased maternal stress has been shown to have a significant effect on foetal brain development increasing the risk of mental health, and cognitive and behavioural disorders in later life. Conclusion From the evidence available to date, direct risks to the foetus from the SARS‐CoV‐2 virus are low. Indirect effects of the pandemic, particularly resulting from the effect of maternal stress on the developing brain, can have lifelong detrimental impacts for this generation of children.
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Affiliation(s)
| | - Charlotte Burrin
- School of Clinical Medicine University of Cambridge Cambridge UK
| | - Ezra Aydin
- Department of Psychology University of Cambridge Cambridge UK
| | | | - Hilary Wong
- Department of Paediatrics University of Cambridge Cambridge UK
| | - Topun Austin
- Department of Paediatrics University of Cambridge Cambridge UK
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Fitzgerald E, Parent C, Kee MZL, Meaney MJ. Maternal Distress and Offspring Neurodevelopment: Challenges and Opportunities for Pre-clinical Research Models. Front Hum Neurosci 2021; 15:635304. [PMID: 33643013 PMCID: PMC7907173 DOI: 10.3389/fnhum.2021.635304] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Accepted: 01/21/2021] [Indexed: 12/12/2022] Open
Abstract
Pre-natal exposure to acute maternal trauma or chronic maternal distress can confer increased risk for psychiatric disorders in later life. Acute maternal trauma is the result of unforeseen environmental or personal catastrophes, while chronic maternal distress is associated with anxiety or depression. Animal studies investigating the effects of pre-natal stress have largely used brief stress exposures during pregnancy to identify critical periods of fetal vulnerability, a paradigm which holds face validity to acute maternal trauma in humans. While understanding these effects is undoubtably important, the literature suggests maternal stress in humans is typically chronic and persistent from pre-conception through gestation. In this review, we provide evidence to this effect and suggest a realignment of current animal models to recapitulate this chronicity. We also consider candidate mediators, moderators and mechanisms of maternal distress, and suggest a wider breadth of research is needed, along with the incorporation of advanced -omics technologies, in order to understand the neurodevelopmental etiology of psychiatric risk.
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Affiliation(s)
- Eamon Fitzgerald
- Department of Psychiatry, Faculty of Medicine, Douglas Mental Health University Institute, McGill University, Montreal, QC, Canada
- Ludmer Centre for Neuroinformatics and Mental Health, Douglas Research Centre, McGill University, Montreal, QC, Canada
| | - Carine Parent
- Department of Psychiatry, Faculty of Medicine, Douglas Mental Health University Institute, McGill University, Montreal, QC, Canada
- Ludmer Centre for Neuroinformatics and Mental Health, Douglas Research Centre, McGill University, Montreal, QC, Canada
| | - Michelle Z. L. Kee
- Translational Neuroscience Programme, Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research (ASTAR), Singapore, Singapore
| | - Michael J. Meaney
- Department of Psychiatry, Faculty of Medicine, Douglas Mental Health University Institute, McGill University, Montreal, QC, Canada
- Ludmer Centre for Neuroinformatics and Mental Health, Douglas Research Centre, McGill University, Montreal, QC, Canada
- Translational Neuroscience Programme, Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research (ASTAR), Singapore, Singapore
- Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
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Govender R, Moodley J, Naicker T. The COVID-19 Pandemic: an Appraisal of its Impact on Human Immunodeficiency Virus Infection and Pre-Eclampsia. Curr Hypertens Rep 2021; 23:9. [PMID: 33570681 PMCID: PMC7877335 DOI: 10.1007/s11906-021-01126-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/10/2020] [Indexed: 12/22/2022]
Abstract
PURPOSE OF REVIEW The impact of the coronavirus disease 2019 (COVID-19) pandemic is profound, with distressing consequences on many individuals, especially those with co-morbidities. Pregnant women are one such group of individuals who are at in increased risk of contracting COVID-19, due to their immunocompromised state. In South Africa, HIV infection and pre-eclampsia are the leading causes of maternal morbidity and mortality, with South Africa being the HIV epicentre of the world. The relationship between COVID-19 superimposed on HIV infection and preeclampsia is complex and uncertain due to their different immune responses, and therefore requires further research. RECENT FINDINGS Notably evidence suggests that pregnant women with chronic comorbidities (HIV and pre-eclampsia) may be at a greater risk of contracting or encountering complications from COVID-19. Maternal stress, during a pandemic, as well as home delivery have become potential options for pregnant woman. Nonetheless there is currently a paucity of information on the combined effect of COVID-19 in HIV-associated preeclampsia. Understanding the pathogenesis of COVID-19 could potentially aid in developing effective treatment strategies for COVID-19 in HIV associated preeclampsia. This review article presents a comprehensive analysis of the current data in relation to COVID-19 and its effect on pregnant women, including symptoms, pathogenesis and the possible risk of vertical transmission. This paper also reviews its' interactions and effects on preeclamptic and HIV positive pregnant women with suspected or confirmed COVID-19.
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Affiliation(s)
- Rowen Govender
- Optics & Imaging Centre, Doris Duke Medical Research Institute, College of Health Sciences, Nelson R. Mandela School of Medicine, University of KwaZulu-Natal, Private Bag 7, Congella, Durban, KwaZulu-Natal, 4013, South Africa.
| | - Jagidesa Moodley
- Women's Health and HIV Research Group, Department of Obstetrics & Gynaecology, School of Clinical Medicine, College of Health Sciences, University of KwaZulu-Natal, Durban, South Africa
| | - Thajasvarie Naicker
- Optics & Imaging Centre, Doris Duke Medical Research Institute, College of Health Sciences, Nelson R. Mandela School of Medicine, University of KwaZulu-Natal, Private Bag 7, Congella, Durban, KwaZulu-Natal, 4013, South Africa
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Bush NR, Savitz J, Coccia M, Jones-Mason K, Adler N, Boyce WT, Laraia B, Epel E. Maternal Stress During Pregnancy Predicts Infant Infectious and Noninfectious Illness. J Pediatr 2021; 228:117-125.e2. [PMID: 32827529 PMCID: PMC7752845 DOI: 10.1016/j.jpeds.2020.08.041] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2020] [Revised: 07/31/2020] [Accepted: 08/14/2020] [Indexed: 12/21/2022]
Abstract
OBJECTIVES To examine the association between prenatal stress and infant physical health in the first year of life within an understudied, racially and ethnically diverse, highly stressed community sample. We expected that greater stress exposure would predict higher rates of infant illness. STUDY DESIGN Low-income, racially/ethnically diverse, overweight women with low medical risk pregnancies were recruited (2011-2014) during pregnancy. Pregnancy Stressful Life Events were assessed retrospectively (mean, 11.88 months postpartum). Perceived stress was assessed twice during pregnancy (at a mean of 17.4 weeks and again at a mean of 25.6 weeks) and at 6 months postpartum. Women with live births (n = 202) were invited; 162 consented to the offspring study. Medical records from pediatric clinics and emergency departments for 148 infants were abstracted for counts of total infectious illnesses, total noninfectious illness, and diversity of illnesses over the first year of life. RESULTS The final analytic sample included 109 women (mean age, 28.08 years) and their infants. In covariate-adjusted negative binomial models, maternal perceptions of stress across pregnancy were positively associated with infant illness. Each 1-point increase in average stress was associated with a 38% increase in incidence of infant infections (Incidence rate ratio, 1.38; 95% CI, 1.01-1.88; P < .05), a 73% increase in noninfectious illness (IRR, 1.73; 95% CI, 1.34-2.23; P < .05), and a 53% increase in illness diversity (IRR, 1.53; 95% CI, 1.25, 1.88; P < .01); effect sizes were larger for perceived stress later in pregnancy. Stressful life events count and postnatal stress were not uniquely associated with illness. CONCLUSIONS In line with recommendations from the American Academy of Pediatrics to screen for maternal perinatal depression, screening and support for stress reduction during pregnancy may benefit both maternal and child health.
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Affiliation(s)
- Nicole R. Bush
- Weill Institute for Neurosciences, Center for Health and Community, Department of Psychiatry,Department of Pediatrics, Division of Developmental Medicine, University of California, San Francisco
| | - Jennifer Savitz
- Departments of Medicine and Clinical Pharmacy, University of California, San Francisco, CA,University of Washington and Seattle Children's Hospital, Seattle, WA
| | - Michael Coccia
- Weill Institute for Neurosciences, Center for Health and Community, Department of Psychiatry
| | - Karen Jones-Mason
- Weill Institute for Neurosciences, Center for Health and Community, Department of Psychiatry
| | - Nancy Adler
- Weill Institute for Neurosciences, Center for Health and Community, Department of Psychiatry
| | - W. Thomas Boyce
- Weill Institute for Neurosciences, Center for Health and Community, Department of Psychiatry,Department of Pediatrics, Division of Developmental Medicine, University of California, San Francisco
| | - Barbara Laraia
- School of Public Health, University of California, Berkeley, CA
| | - Elissa Epel
- Weill Institute for Neurosciences, Center for Health and Community, Department of Psychiatry
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Abstract
Perinatal maternal symptoms of depression and anxiety compromise psychosocial function and influence developmental outcomes in the offspring. The onset of symptoms remains unclear with findings that suggest a preconceptual origin. We addressed this issue with a prospective analysis of anxiety and depressive symptom profiles from preconception through to parturition. Women were recruited into a preconception study to assess (a) variation in symptom levels of depression and anxiety from pre- to post-conception and (b) if the symptom network profiles of depression and anxiety change from pre-conception to post-conception. A within-subject intraclass correlation analyses revealed that symptoms of depression or anxiety in the preconception phase strongly predicted those across pregnancy and into the early postnatal period. The symptom network analysis revealed that the symptom profiles remained largely unchanged from preconception into the second trimester. Our findings suggest that for a significant portion of women, maternal mental health remains stable from preconception into pregnancy. This finding highlights the need for early intervention studies on women's mental health to be targeted during the preconception period and to be extended across the population.
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Değirmenci F, Vefikuluçay Yılmaz D. The relationship between psychosocial health status and social support of pregnant women. J Psychosom Obstet Gynaecol 2020; 41:290-297. [PMID: 31619093 DOI: 10.1080/0167482x.2019.1678021] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
Abstract
PURPOSE The aim of this study was to determine the relationship between psychosocial health status and social support, which has important effects on pregnancy, and to determine the factors related to both psychosocial health and social support. METHOD The research was planned to be a descriptive study. The sample of the study consisted of 393 pregnant women. 'Personal Information Form', 'Pregnancy Psychosocial Health Assessment Scale (PPHAS)', and 'Multidimensional Scale of Perceived Social Support (MSPSS)' were used to collect data, and Student's t-test, ANOVA and Tukey's HSD tests were used for the data analysis. The relationship between the two continuous variables was evaluated according to the Pearson correlation coefficient. RESULTS Psychosocial health conditions and perceived social supports of pregnant women whose spouses were working were determined to be significantly higher (p < .05), and at a lower level (p < .05) in pregnant women with two or more children. As MSPSS total mean scores of the pregnant women increased, their PPHAS total mean scores were weakly affected in the positive direction (r = 0.393, p < .01). CONCLUSIONS It is recommended that health care needs of pregnant women should be evaluated not only in terms of physical health but also together with their psychosocial health and social supports. Furthermore, this assessment should be done in their own home environment with their spouses and other family members.
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Affiliation(s)
- Filiz Değirmenci
- Department of Obstetrics and Gynecology Nursing, Faculty of Nursing, Mersin University, Mersin, Turkey
| | - Duygu Vefikuluçay Yılmaz
- Department of Obstetrics and Gynecology Nursing, Faculty of Nursing, Mersin University, Mersin, Turkey
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van Lee L, Chia A, Phua D, Colega M, Padmapriya N, Bernard JY, Cai S, Tham EKH, Teoh OH, Goh D, Gooley JJ, Gluckman PD, Yap F, Shek LPC, Godfrey KM, Tan KH, Chong YS, Müller-Riemenschneider F, Broekman B, Meaney M, Chen H, Chong MFF. Multiple modifiable lifestyle factors and the risk of perinatal depression during pregnancy: Findings from the GUSTO cohort. Compr Psychiatry 2020; 103:152210. [PMID: 33045668 DOI: 10.1016/j.comppsych.2020.152210] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2020] [Revised: 09/24/2020] [Accepted: 09/24/2020] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Studies have identified lifestyle risk factors for perinatal depression, but none have examined the cumulative effect of these risk factors in pregnant women. METHODS We considered the following six factors during pregnancy: poor diet quality (Healthy eating index for Singapore pregnant women<median), poor sleep quality (global Pittsburgh sleep quality index score > 5), physical inactivity (<600 MET-minutes/week), vitamin D insufficiency (<50 nmol/l), smoking before or during pregnancy, and the perceived need for social support. Probable depression was assessed using the Edinburgh postnatal depression scale during pregnancy (>15) and at three months postpartum (≥13). Prevalence risk ratios were calculated with Poisson regressions while adjusting for potential confounders. RESULTS Of 535 pregnant women, 207 (39%) had zero or one risk factor, 146 (27%) had two, 119 (22%) had three, 48 (9%) had four, and 15 (3%) had ≥5 risk factors at 26-28 weeks' gestation. These six lifestyle habits contributed to 32% of the variance in depressive symptoms during pregnancy. The prevalence of being probably depressed was 6.4 (95% CI 2.1, 19.8; ptrend < 0.001) for expecting women who had ≥4 risk factors compared to women who had ≤1 risk factor. No association was observed between the number of risk factors and depressive symptoms at 3 months postpartum (ptrend = 0.746). CONCLUSION Pregnant women with ≥4 lifestyle risk factors showed a higher prevalence of depression during pregnancy, while no associations were observed for postpartum depression. CLINICAL TRIAL REGISTRATION This cohort is registered under the Clinical Trials identifier NCT01174875; http://www.clinicaltrials.gov/ct2/show/NCT01174875?term=GUSTO&rank=2.
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Affiliation(s)
- Linde van Lee
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, Singapore
| | - Airu Chia
- Department of Obstetrics and Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore; Saw Swee Hock School of Public Health, National University of Singapore, Singapore; Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, Singapore
| | - Desiree Phua
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, Singapore
| | - Marjorelee Colega
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, Singapore
| | - Natarajan Padmapriya
- Department of Obstetrics and Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Jonathan Y Bernard
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, Singapore; Early Life Research On Later Health Unit, Centre for Research in Epidemiology and Statistics Sorbonne Paris Cité (CRESS), National Institute of Health and Medical Research (Inserm), Villejuif, France
| | - Shirong Cai
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, Singapore; Department of Obstetrics and Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Elaine K H Tham
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, Singapore
| | - Oon Hoe Teoh
- Department of Paediatrics, KK Women's and Children's Hospital, Singapore
| | - Daniel Goh
- Department of Pediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Joshua J Gooley
- Center for Cognitive Neuroscience, Program in Neuroscience and behavioural disorders, Duke-NUS Medical School, Singapore
| | - Peter D Gluckman
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, Singapore; Liggins Institute, University of Auckland, Auckland, New Zealand
| | - Fabian Yap
- Department of Paediatrics, KK Women's and Children's Hospital, Singapore; Duke-NUS Medical School, Singapore, Singapore; Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore
| | - Lynette P C Shek
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, Singapore; Department of Pediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Keith M Godfrey
- MRC Lifecourse Epidemiology Unit and NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - Kok Hian Tan
- Duke-NUS Medical School, Singapore, Singapore; Department of Maternal Fetal Medicine, KK Women's and Children's Hospital, Singapore
| | - Yap-Seng Chong
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, Singapore; Department of Obstetrics and Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Falk Müller-Riemenschneider
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore; Institute for Social Medicine, Epidemiology and Health Economics, Charite University Medical Centre, Berlin, Germany
| | - Birit Broekman
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, Singapore; Department of Psychiatry, Amsterdam UMC, location VUmc, VU University, Amsterdam, the Netherlands; Department of Psychiatry, Onze Lieve Vrouwe Gasthuis, Amsterdam, the Netherlands
| | - Michael Meaney
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, Singapore; Departments of Psychiatry and Neurology and Neurosurgery, McGill University, Montreal, Canada
| | - Helen Chen
- Department of Psychological Medicine, KK Women's and Children's hospital, Singapore
| | - Mary F F Chong
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, Singapore; Saw Swee Hock School of Public Health, National University of Singapore, Singapore; Clinical Nutrition Research Centre, Agency for Science, Technology and Research, Singapore.
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Hirose M, Tamakoshi K, Takahashi Y, Mizuno T, Yamada A, Kato N. The effects of nausea, vomiting, and social support on health-related quality of life during early pregnancy: A prospective cohort study. J Psychosom Res 2020; 136:110168. [PMID: 32593093 DOI: 10.1016/j.jpsychores.2020.110168] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/16/2020] [Revised: 06/02/2020] [Accepted: 06/04/2020] [Indexed: 11/30/2022]
Abstract
OBJECTIVE To date, no previous study has examined the independent association between nausea, vomiting, and social support and health-related quality of life among early pregnant women. METHODS To fill this gap, we investigated these associations within this group using repeated-measurement data. METHODS A prospective cohort design was conducted from August 2018 to February 2019 with perinatal outpatients in a general hospital. Participants were 153 pregnant women aged 20 years or older and under 20 weeks of gestation at their first prenatal visit. Along with reporting their sociodemographic data, participants completed the Index of Nausea, Vomiting, and Retching (INVR), the 12-item Short Form Health Survey (SF-12), and the Multidimensional Scale of Perceived Social Support (MSPSS) and re-completed INVR, and SF-12 at follow-up checkups a maximum of three times. RESULTS After controlling for internal correlations and confounding factors, INVR was found to be significantly negatively associated with the physical component summary scale score of SF-12; however, MSPSS showed no association with the physical component summary scale score. Conversely, the scores for both INVR and MSPSS were negatively and positively, respectively, significantly associated with the mental component summary scale score of SF-12. CONCLUSION The severity of nausea and vomiting significantly impacts physical quality of life during early pregnancy. Both nausea and vomiting and social support significantly and independently affect mental quality of life. Health professionals should recognize these impacts and be aware that social support contributes to improving mental quality of life.
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Affiliation(s)
- Masami Hirose
- Department of Nursing, Nagoya University Graduate School of Medicine, 1-1-20 Daiko-Minami, Higashi-ku, Nagoya City, Aichi 461-8673, Japan.
| | - Koji Tamakoshi
- Department of Nursing, Nagoya University Graduate School of Medicine, 1-1-20 Daiko-Minami, Higashi-ku, Nagoya City, Aichi 461-8673, Japan.
| | - Yuki Takahashi
- Department of Nursing, Nagoya University Graduate School of Medicine, 1-1-20 Daiko-Minami, Higashi-ku, Nagoya City, Aichi 461-8673, Japan.
| | - Taeko Mizuno
- Department of Nursing, NIHON FUKUSHI University, 229 KawaMinamishinden, Ota-Machi, Tokai-City, Aichi 477-3295, Japan.
| | - Akiko Yamada
- Department of Nursing, Nagoya University Graduate School of Medicine, 1-1-20 Daiko-Minami, Higashi-ku, Nagoya City, Aichi 461-8673, Japan.
| | - Noriko Kato
- Department of Obstetrics and Gynecology, Japanese Red Cross Nagoya Daini Hospital, 2-9 Myokencho, Showa-ku, Nagoya City, Aichi 466-8650, Japan.
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Lundsberg LS, Cutler AS, Stanwood NL, Yonkers KA, Gariepy AM. Association of Pregnancy Contexts with Depression and Low Social Support in Early Pregnancy. PERSPECTIVES ON SEXUAL AND REPRODUCTIVE HEALTH 2020; 52:161-170. [PMID: 33047499 DOI: 10.1363/psrh.12155] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/27/2019] [Revised: 04/29/2020] [Accepted: 07/11/2020] [Indexed: 06/11/2023]
Abstract
CONTEXT Research into the relationship between pregnancy intention and perinatal depression or low social support is limited. Women's perspectives on pregnancy and their associations with perinatal depression could help in developing targeted efforts for screening and intervention. METHODS In 2014-2015, 161 women seeking pregnancy testing or abortion care at clinics in New Haven, Connecticut, were surveyed. They were asked about pregnancy context (intentions, planning, wantedness, desirability, timing and happiness), and the Edinburgh Depression Screen (EDS) and the Modified Kendler Social Support Index (MKSSI) were used to identify possible antenatal depression and low social support, respectively. Multivariable logistic regression analysis was employed to examine associations between pregnancy context and these outcomes. RESULTS On average, participants were 27 years old and at nine weeks' gestation. One-fifth reported a previous diagnosis of depression or anxiety, and 22% and 33% screened positive for depression (EDS scores of 13 or higher and 10 or higher, respectively); 52% received low social support (MKSSI score of 3.2 or less). Regression analysis found that pregnancies described as unintended, poorly timed or undesired were associated with depression at the higher cutoff (odds ratios, 3.2-4.5); all unfavorable pregnancy measures were associated with depression at the lower cutoff. Ambivalence regarding pregnancy timing, intention, wantedness and desirability was associated with increased odds of depression by either EDS score. Unplanned pregnancies and those about which the woman was ambivalent were associated with low social support. CONCLUSIONS Findings support the need to screen women for depression early in pregnancy and to integrate assessments of pregnancy context into the evaluation of potential risk factors.
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Affiliation(s)
- Lisbet S Lundsberg
- Department of Obstetrics, Gynecology and Reproductive Sciences, Yale University School of Medicine, New Haven, CT
| | - Abigail S Cutler
- Department of Obstetrics, Gynecology and Reproductive Sciences, Yale University School of Medicine, New Haven, CT
| | - Nancy L Stanwood
- Department of Obstetrics, Gynecology and Reproductive Sciences, Yale University School of Medicine, New Haven, CT
| | - Kimberly A Yonkers
- Department of Psychiatry and Department of Obstetrics, Gynecology and Reproductive Sciences, Yale University School of Medicine, New Haven, CT
| | - Aileen M Gariepy
- Department of Obstetrics, Gynecology and Reproductive Sciences, Yale University School of Medicine, New Haven, CT
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Alenko A, Dejene S, Girma S. Sociodemographic and Obstetric Determinants of Antenatal Depression in Jimma Medical Center, Southwest Ethiopia: Facility Based Case-Control Study. Int J Womens Health 2020; 12:557-565. [PMID: 32801933 PMCID: PMC7394501 DOI: 10.2147/ijwh.s252385] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2020] [Accepted: 06/18/2020] [Indexed: 11/23/2022] Open
Abstract
Background Worldwide, 10–20% of women experience depression during pregnancy. In sub-Saharan countries, depression during pregnancy is estimated to be 15–57%. Even though there is a high burden of depression during pregnancy, little attention has been given to identify sociodemographic and obstetric determinants in diverse populations like Ethiopia. Objective To identify sociodemographic and obstetric determinants of antenatal depression among women attending an antenatal clinic at Jimma Medical Center, southwest Ethiopia. Patients and Methods A case–control study was conducted among 246 pregnant mothers (82 cases and 164 controls) attending an antenatal clinic in Jimma Medical Center from June 1 to August 30, 2019. Antenatal depression was assessed using the Beck Depression Inventory-II. Epidata 3.1 and SPSS v24 were used for data entry and analysis, respectively. Adjusted odds ratios (AOR) and 95%CIs were estimated using logistic regression models. Statistical significance was set at P<0.05. Results Married mothers were 67% (AOR=0.33, 95%CI: 0.15–0.75), housewives were 97% (AOR=0.03, 95%CI: 0.01–0.14), private workers were 87% (AOR=0.13, 95%CI: 0.04–0.44), and government employees were 84% (AOR=0.16, 95%CI: 0.05–0.46), less likely to develop antenatal depression. Multigravida were 88% (AOR=0.12, 95%CI: 0.04–0.37) less likely to develop antenatal depression. Third trimester pregnancy was four times (AOR=4.04, 95%CI: 1.51–10.81) more likely to have depression. Mothers who having wanted pregnancy were 83% (AOR=0.17, 95%CI: 0.04–0.81) less likely to develop antenatal depression compared with mothers having unwanted pregnancy. Conclusion and Recommendation Being married, multigravida, having wanted pregnancy and occupation status (housewives, private workers and government employees) can protect mothers from developing antenatal depression. Mothers with third trimester pregnancy were four times more likely to have depression. Designing a screening and intervention strategy for antenatal depression must consider the aforementioned protective and risk factors.
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Affiliation(s)
- Arefayne Alenko
- Department of Psychiatry, Faculty of Medical Science, Institute of Health, Jimma University, Jimma, Ethiopia
| | - Sisay Dejene
- Department of Health Service Management, College of Medicine and Health Sciences, Hawassa University, Hawassa, Ethiopia
| | - Shimelis Girma
- Department of Psychiatry, Faculty of Medical Science, Institute of Health, Jimma University, Jimma, Ethiopia
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75
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Amygdala-Prefrontal Structural Connectivity Mediates the Relationship between Prenatal Depression and Behavior in Preschool Boys. J Neurosci 2020; 40:6969-6977. [PMID: 32788182 DOI: 10.1523/jneurosci.0481-20.2020] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2020] [Revised: 06/11/2020] [Accepted: 06/18/2020] [Indexed: 01/18/2023] Open
Abstract
Prenatal depression is common, underrecognized, and undertreated. It has negative consequences on child behavior and brain development, yet the relationships among prenatal depression, child behavior, and children's brain structure remain unclear. The aim of this study was to determine whether altered brain connectivity mediates relationships between prenatal maternal depressive symptoms and child behavior. This study included 54 human mother-child pairs. Mothers completed the Edinburgh Postnatal Depression Scale during the second and third trimesters of pregnancy and 3 months postpartum. Their children had diffusion MRI at age 4.1 ± 0.8 years, and children's behavior was assessed using the Child Behavior Checklist within 6 months of their MRI scan. Structural brain connectivity of the amygdala, fornix, uncinate fasciculus, and cingulum was assessed using fractional anisotropy and mean diffusivity and analyzed with maternal prenatal depressive symptoms as well as child behavior. Third trimester maternal Edinburgh Postnatal Depression Scale scores were positively associated with mean diffusivity in the amygdala-frontal tract and the cingulum, controlling for postpartum depression. Externalizing behavior had a sex interaction in the amygdala-frontal pathway; weaker connectivity (lower fractional anisotropy, higher mean diffusivity) was associated with worse behavior in boys. Amygdala-frontal connectivity mediated the relationship between third trimester depressive symptoms and child externalizing behavior in males. These findings suggest that altered brain structure is a mechanism via which prenatal depressive symptoms can impact child behavior, highlighting the importance of both recognition and intervention in prenatal depression.SIGNIFICANCE STATEMENT Understanding how prenatal maternal depression impacts child behavior is critical for appropriately treating prenatal maternal mental health problems and improving child outcomes. Here, we show white matter changes in young children exposed to maternal prenatal depressive symptoms. Children of mothers with worse depressive symptoms had weaker white matter connectivity between areas related to emotional processing. Furthermore, connectivity between the amygdala and prefrontal cortex mediated the relationship between maternal depressive symptoms and externalizing behavior in boys, showing that altered brain structure is a possible mechanism via which maternal prenatal depression impacts children's behavior. This provides important information for understanding why children of depressed mothers may be more vulnerable to depression themselves and may help shape future guidelines on maternal prenatal care.
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Morozumi R, Matsumura K, Hamazaki K, Tsuchida A, Takamori A, Inadera H. Impact of individual and neighborhood social capital on the physical and mental health of pregnant women: the Japan Environment and Children's Study (JECS). BMC Pregnancy Childbirth 2020; 20:450. [PMID: 32762739 PMCID: PMC7409696 DOI: 10.1186/s12884-020-03131-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2020] [Accepted: 07/23/2020] [Indexed: 11/10/2022] Open
Abstract
Background Previous studies revealed positive, negative, and no influence of social capital on the health outcomes of pregnant women. It was considered that such differences were caused by the disparities of outcome measures and sample sizes between studies. Our chief aim was to verify the positive influence of social capital on the health condition of pregnant women using established health outcome measures and large-scale nationwide survey data. Methods We employed questionnaire survey data from 79,210 respondents to the Japan Environment and Children’s Study, and physical and mental component summary scores from the 8-Item Short-Form Health Survey as outcome measures. We estimated the effect of individual and neighborhood social capitals on physical and mental component summary scores. To consider the property that the richness of social capital would be generally determined by individual characteristics, and to estimate the causal influence of social capital on health without bias caused by said property, we adopted average treatment effect estimation with inverse probability weighting. Generally, average treatment effects are based on the difference of average outcomes between treated and untreated groups in an intervention. In this research, we reckoned individuals’ different levels of social capital as a kind of non-randomized treatment for respective individuals, and we applied average treatment effect estimation. The analysis regarded pregnant women with the lowest level of social capital as untreated samples and women with other levels of social capitals as treated samples. Results For mental component summary score, the maximum average treatment effects in the comparison between the lowest and highest levels of social capital were approximately 4.4 and 1.6 for individual and neighborhood social capital, respectively. The average treatment effects for the physical component summary score were negligible for both social capital types. Conclusions Social capital particularly contributes to improving mental component summary score in pregnant women. The likelihood of a mentally healthy pregnancy may be increased by enhancing social capital.
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Affiliation(s)
- Ryoko Morozumi
- Faculty of Social Sciences, University of Toyama, 3190 Gofuku, Toyama-shi, Toyama, 930-8555, Japan.
| | - Kenta Matsumura
- Toyama Regional Center for JECS, University of Toyama, Toyama, Japan
| | - Kei Hamazaki
- Toyama Regional Center for JECS, University of Toyama, Toyama, Japan.,Department of Public Health, Faculty of Medicine, University of Toyama, Toyama, Japan
| | - Akiko Tsuchida
- Toyama Regional Center for JECS, University of Toyama, Toyama, Japan.,Department of Public Health, Faculty of Medicine, University of Toyama, Toyama, Japan
| | - Ayako Takamori
- Toyama Regional Center for JECS, University of Toyama, Toyama, Japan
| | - Hidekuni Inadera
- Toyama Regional Center for JECS, University of Toyama, Toyama, Japan.,Department of Public Health, Faculty of Medicine, University of Toyama, Toyama, Japan
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Yu M, Qiu T, Liu C, Cui Q, Wu H. The mediating role of perceived social support between anxiety symptoms and life satisfaction in pregnant women: a cross-sectional study. Health Qual Life Outcomes 2020; 18:223. [PMID: 32650793 PMCID: PMC7348126 DOI: 10.1186/s12955-020-01479-w] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2020] [Accepted: 07/03/2020] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Pregnancy can be stressful for women and families, so the life satisfaction of pregnant women may face significant challenges. This study aimed to identify the relationship among anxiety symptoms, perceived social support and life satisfaction, and to further explore whether perceived social support can play a mediating role. METHODS This cross-sectional study was conducted from June to September in Shenyang City, China in 2019. 290 effective questionnaires were collected. The Satisfaction with Life Scale (SWLS), the Zung's Self-Rating Anxiety Scale (SAS), the Multi-Dimensional Scale of Perceived Social Support (MSPSS) as well as demographic variables were included in each questionnaire. Hierarchical multiple regression was conducted to explore the mediating role of perceived social support in the relationship between anxiety symptoms and life satisfaction. Then the mediation model was examined by the PROCESS macro for SPSS. RESULTS After adjusting control variables, anxiety symptoms were negatively associated with life satisfaction and explained 14.7% of the variance. Higher level of perceived social support was related to higher level of life satisfaction, explaining 21.0% of the variance. Perceived social support partly mediated the relationship between anxiety symptoms and life satisfaction for pregnant women. CONCLUSIONS Perceived social support played a mediating role between anxiety symptoms and life satisfaction among pregnant women. Strategies and measures to improve perceived social support may be expected to buffer the impact of anxiety symptoms on pregnant women's life satisfaction.
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Affiliation(s)
- Mingli Yu
- Department of Social Medicine, School of Public Health, China Medical University, Shenyang, 110122, China
| | - Tian Qiu
- Department of Social Medicine, School of Public Health, China Medical University, Shenyang, 110122, China
| | - Chunli Liu
- Library, China Medical University, Shenyang, 110122, China
| | - Qi Cui
- Department of Social Medicine, School of Public Health, China Medical University, Shenyang, 110122, China
| | - Hui Wu
- Department of Social Medicine, School of Public Health, China Medical University, Shenyang, 110122, China.
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Coronavirus Disease 2019 (COVID-19) and Pregnancy: Combating Isolation to Improve Outcomes. Obstet Gynecol 2020; 136:33-36. [PMID: 32384386 DOI: 10.1097/aog.0000000000003946] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
With the current global coronavirus disease 2019 (COVID-19) pandemic, new challenges arise as social distancing and isolation have become the standard for safety. Evidence supports the protective benefits of social connections and support during pregnancy and labor; there are increased maternal, fetal, and pregnancy risks when pregnant and laboring women lack support. As health care professionals take appropriate precautions to protect patients and themselves from infection, there must be a balance to ensure that we do not neglect the importance of social and emotional support during important milestones such as pregnancy and childbirth. Resources are available to help pregnant women, and technology represents an opportunity for innovation in providing care.
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Agampodi TC, Wickramasinghe ND, Prasanna RIR, Irangani MKL, Banda JMS, Jayathilake PMB, Hettiarachchi A, Amarasinghe G, Jayasinghe I, Koralagedara I, Gunarathne SP, Wickramage S, Warnasekara J, Lokunarangoda N, Mendis V, Dissanayaka AK, Premadasa J, Hettigama N, Koralagedara D, Weerasinghe M, Malawanage K, Jayakodi H, Wickramasinghe A, Agampodi SB. The Rajarata Pregnancy Cohort (RaPCo): study protocol. BMC Pregnancy Childbirth 2020; 20:374. [PMID: 32586287 PMCID: PMC7318435 DOI: 10.1186/s12884-020-03056-x] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2019] [Accepted: 06/15/2020] [Indexed: 01/14/2023] Open
Abstract
Background Ending preventable maternal deaths remains a global priority and in the later stages of obstetric transition, identifying the social determinants of maternal health outcomes is essential to address stagnating maternal mortality rates. Countries would hardly achieve the Sustainable Development Goal (SGD) targets on maternal health, unless the complex and context-specific socio-economic aetiologies associated with maternal mental health and suicide are identified. The Rajarata Pregnancy Cohort (RaPCo) is a prospective cohort study, designed to explore the interactions between social determinants and maternal mental health in determining pregnancy and new-born outcomes. Methods The study will recruit all eligible pregnant women in the maternal care programme of Anuradhapura district, Sri Lanka from July to September 2019. The estimated sample size is 2400. We will assess the socio-demographic and economic status, social capital, gender-based violence and mental health, including a clinical examination and biochemical investigations during the first trimester. Participants will undergo four follow-ups at 2nd and 3rd trimesters, at delivery and in early postpartum. The new-borns will be followed up at birth, neonatal period, at 6 six months and at 1 year. Pregnancy and child outcome data will be collected using direct contact. Qualitative studies will be carried out to understand the complex social factors and behavioural dimensions related to abortion, antenatal depression, maternal deaths and near misses. Discussion This is the first reported maternal cohort in Sri Lanka focusing on social determinants and mental health. As a country in stage four of obstetric transition, these findings will provide generalizable evidence on achieving SGD targets in low- and middle-income countries. The study will be conducted in a district with multi-cultural, multi-ethnic and diverse community characteristics; thus, will enable the evidence generated to be applied in many different contexts. The study also possesses the strength of using direct participant contact, data collection, measurement, examination and biochemical testing to minimise errors in routinely collected data. The RaPCo study will be able to generate evidence to strengthen policies to further reduce maternal deaths in the local, regional and global contexts particularly focusing on social factors and mental health, which are not optimally addressed in the global agenda.
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Affiliation(s)
- Thilini Chanchala Agampodi
- Department of Community Medicine, Faculty of Medicine and Allied Sciences, Rajarata University of Sri Lanka, Anuradhapura, Sri Lanka.
| | - Nuwan Darshana Wickramasinghe
- Department of Community Medicine, Faculty of Medicine and Allied Sciences, Rajarata University of Sri Lanka, Anuradhapura, Sri Lanka
| | - Rampathige Indika Ruwan Prasanna
- Department of Social Sciences, Faculty of Social Sciences and humanities, Rajarata University of Sri Lanka, Anuradhapura, Sri Lanka
| | | | | | | | - Ayesh Hettiarachchi
- Department of Community Medicine, Faculty of Medicine and Allied Sciences, Rajarata University of Sri Lanka, Anuradhapura, Sri Lanka
| | - Gayani Amarasinghe
- Department of Community Medicine, Faculty of Medicine and Allied Sciences, Rajarata University of Sri Lanka, Anuradhapura, Sri Lanka
| | - Imasha Jayasinghe
- Department of Community Medicine, Faculty of Medicine and Allied Sciences, Rajarata University of Sri Lanka, Anuradhapura, Sri Lanka
| | - Iresha Koralagedara
- Department of Anatomy, Faculty of Medicine and Allied Sciences, Rajarata University of Sri Lanka, Anuradhapura, Sri Lanka
| | - Sajaan Praveena Gunarathne
- Department of Community Medicine, Faculty of Medicine and Allied Sciences, Rajarata University of Sri Lanka, Anuradhapura, Sri Lanka
| | - Sujanthi Wickramage
- Department of Physiology, Faculty of Medicine and Allied Sciences, Rajarata University of Sri Lanka, Anuradhapura, Sri Lanka
| | - Janith Warnasekara
- Department of Community Medicine, Faculty of Medicine and Allied Sciences, Rajarata University of Sri Lanka, Anuradhapura, Sri Lanka
| | - Niroshan Lokunarangoda
- Department of Medicine, Faculty of Medicine and Allied Sciences, Rajarata University of Sri Lanka, Anuradhapura, Sri Lanka
| | - Vasana Mendis
- Department of Pathology, Faculty of Medicine and Allied Sciences, Rajarata University of Sri Lanka, Anuradhapura, Sri Lanka
| | - Ajith Kumara Dissanayaka
- Department of Obstetrics and Gynaecology, Faculty of Medicine and Allied Sciences, Rajarata University of Sri Lanka, Anuradhapura, Sri Lanka
| | | | - Nandana Hettigama
- Department of Obstetrics and Gynaecology, Faculty of Medicine and Allied Sciences, Rajarata University of Sri Lanka, Anuradhapura, Sri Lanka
| | | | - Manjula Weerasinghe
- Department of Community Medicine, Faculty of Medicine and Allied Sciences, Rajarata University of Sri Lanka, Anuradhapura, Sri Lanka
| | | | - Hemali Jayakodi
- Provincial Director of Health Services Office, Anuradhapura, Sri Lanka
| | - Anuprabha Wickramasinghe
- Department of Psychiatry, Faculty of Medicine and Allied Sciences, Rajarata University of Sri Lanka, Anuradhapura, Sri Lanka
| | - Suneth Buddhika Agampodi
- Department of Community Medicine, Faculty of Medicine and Allied Sciences, Rajarata University of Sri Lanka, Anuradhapura, Sri Lanka
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Dadi AF, Wolde HF, Baraki AG, Akalu TY. Epidemiology of antenatal depression in Africa: a systematic review and meta-analysis. BMC Pregnancy Childbirth 2020; 20:251. [PMID: 32345263 PMCID: PMC7189721 DOI: 10.1186/s12884-020-02929-5] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2019] [Accepted: 04/07/2020] [Indexed: 01/13/2023] Open
Abstract
BACKGROUND Antenatal depression is a serious problem worldwide that has devastating consequences not only for the mother but also for the child and family. The pooled evidence regarding the prevalence and associated factors of antenatal depression is rare in Africa. Hence this review aimed to investigate the prevalence and associated factors of antenatal depression in Africa. METHODS We searched CINHAL, MEDLINE, PsycINFO, Psychiatry online, PubMed, SCOPES, and Emcare databases for English written observational studies conducted in Africa from 2007 to 2018.Quality of studies was assessed using the Newcastle Ottawa Scale (NOS), and studies with good quality were included in the final review. Heterogeneity across studies was assessed using the I2 and Higgins test. Publication bias was checked using Funnel plot symmetry, and Egger's regression test and adjustment was made by using Duval and Tweedie's Trim and Fill analysis. A random effect Meta-analysis was employed to determine the pooled estimates with 95% confidence interval (CI). Stata 14 was used for analysis. The review protocol has been registered in PROSPERO number CRD42018106717. RESULT Of the 175 studies identified, 28 studies with an overall sample size of 17,938 were included. According to the random effect model following trim and fill analysis, the pooled prevalence of antenatal depression in Africa was 26.3% (95%CI: 22.2, 30.4%). Economic difficulties [POR = 1.87;95%CI:1.25,2.78,I2 = 88.1%], unfavorable marital condition [POR = 4.17;95% CI:1.75, 9.94, I2 = 81.2%], poor support from relatives [POR = 1.36;95% CI:1.18, 1.56, I2 = 78.0%], bad obstetric history [POR = 2.30;95% CI:1.81, 2.92), I2 = 81.7%], and history of mental health problem [POR = 2.97; 95% CI:1.74, 5.06, I2 = 92.0%]were the factors associated with antenatal depression. CONCLUSION The prevalence of antenatal depression is high in Africa, which showed that one in four pregnant women had depression. Pregnant mothers who had economic difficulties, bad obstetric history, poor support from relatives, previous mental health problems, and unfavorable marital conditions were at higher risk of antenatal depression. Therefore these factors should be considered while designing mental health care services for pregnant mothers.
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Affiliation(s)
- Abel Fekadu Dadi
- University of Gondar, College of Medicine and Health Sciences, Institute of Public Health, Department of Epidemiology and Biostatistics, Gondar, Ethiopia.,School of Public Health, College of Medicine and Public Health, Flinders University, Adelaide, Australia
| | - Haileab Fekadu Wolde
- University of Gondar, College of Medicine and Health Sciences, Institute of Public Health, Department of Epidemiology and Biostatistics, Gondar, Ethiopia.
| | - Adhanom Gebreegziabher Baraki
- University of Gondar, College of Medicine and Health Sciences, Institute of Public Health, Department of Epidemiology and Biostatistics, Gondar, Ethiopia
| | - Temesgen Yihunie Akalu
- University of Gondar, College of Medicine and Health Sciences, Institute of Public Health, Department of Epidemiology and Biostatistics, Gondar, Ethiopia
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Rincón-Cortés M, Grace AA. Adaptations in reward-related behaviors and mesolimbic dopamine function during motherhood and the postpartum period. Front Neuroendocrinol 2020; 57:100839. [PMID: 32305528 PMCID: PMC7531575 DOI: 10.1016/j.yfrne.2020.100839] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2020] [Revised: 03/15/2020] [Accepted: 04/10/2020] [Indexed: 02/07/2023]
Abstract
Initiation and maintenance of maternal behavior is driven by a complex interaction between the physiology of parturition and offspring stimulation, causing functional changes in maternal brain and behavior. Maternal behaviors are among the most robust and rewarding motivated behaviors. Mesolimbic dopamine (DA) system alterations during pregnancy and the postpartum enable enhanced reward-related responses to offspring stimuli. Here, we review behavioral evidence demonstrating postpartum rodents exhibit a bias towards pups and pup-related stimuli in reward-related tasks. Next, we provide an overview of normative adaptations in the mesolimbic DA system induced by parturition and the postpartum, which likely mediate shifts in offspring valence. We also discuss a causal link between dopaminergic dysfunction and disrupted maternal behaviors, which are recapitulated in postpartum depression (PPD) and relevant rodent models. In sum, mesolimbic DA system activation drives infant-seeking behavior and strengthens the mother-infant bond, potentially representing a therapeutic target for reward-related deficits in PPD.
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Affiliation(s)
- Millie Rincón-Cortés
- Departments of Neuroscience, Psychiatry and Psychology, University of Pittsburgh, Pittsburgh, PA 15217, United States.
| | - Anthony A Grace
- Departments of Neuroscience, Psychiatry and Psychology, University of Pittsburgh, Pittsburgh, PA 15217, United States
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Schechter J, Do EK, Zhang J(J, Hoyo C, Murphy SK, Kollins SH, Fuemmeler B. Effect of Prenatal Smoke Exposure on Birth Weight: The Moderating Role of Maternal Depressive Symptoms. Nicotine Tob Res 2020; 22:40-47. [PMID: 30590728 PMCID: PMC7297019 DOI: 10.1093/ntr/nty267] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2018] [Accepted: 12/19/2018] [Indexed: 02/06/2023]
Abstract
INTRODUCTION Both prenatal smoke exposure and depression have been linked to lower birth weight, a risk factor for morbidity and mortality. Few studies have looked at the interaction between these risk factors and none have used a biomarker to objectively measure prenatal smoke exposure. The current study sought to examine independent and interactive effects of cotinine and depression on birth weight. The effect of race was also explored. METHOD Data were drawn from a prospective study of pregnant women (N = 568) in the southeastern United States. Maternal demographic, health information, depressive symptoms, and birth data were collected via self-report and medical record abstraction. Prenatal blood samples were assayed for cotinine. RESULTS Controlling for covariates, multiple regression analyses indicated that both cotinine and depressive symptoms independently predicted lower birth weight and a significant interaction was also observed. Upon probing the interaction, a negative association between cotinine levels and birth weight was found in the context of higher depression but not lower depression scores. Similarly, logistic regression analyses revealed a significant interaction between cotinine and depression, such that cotinine predicted having a baby less than 2500 g among women who fell above the indicated cutoff score. African American women had the highest levels of cotinine and lowest weight babies; however, race was not a significant moderator. CONCLUSIONS Results suggest prenatal smoke exposure has a greater negative effect on birth weight for women endorsing co-occurring depressive symptoms. Findings can inform targeted interventions and assist medical providers with identifying women at increased risk for poor perinatal outcomes. IMPLICATIONS Despite the common occurrence of smoking during pregnancy and prenatal depression, the interaction between these risk factors on birth weight has rarely been examined. Further, the extant results have been mixed, likely due in part to difficulties in measurement. The current study was the first to use prenatal cotinine to assess bias-free, continuous levels of prenatal smoke exposure. Results indicate that prenatal cotinine was a significant predictor of birth weight only in the context of maternal depressive symptoms. These findings have important implications for mitigating negative perinatal outcomes for pregnant women and their children.
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Affiliation(s)
- Julia Schechter
- Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC
| | - Elizabeth K Do
- Department of Health Behavior and Policy, Virginia Commonwealth University, Richmond, VA
| | - Junfeng (Jim) Zhang
- Nicholas School of the Environment and Duke Global Health Institute, Duke University, Durham, NC
| | - Cathrine Hoyo
- Department of Biological Sciences, North Carolina State University, Raleigh, NC
| | - Susan K Murphy
- Department of Obstetrics and Gynecology, Duke University Medical Center, Durham, NC
| | - Scott H Kollins
- Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC
| | - Bernard Fuemmeler
- Department of Health Behavior and Policy, Virginia Commonwealth University, Richmond, VA
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Rabiepoor S, Abedi M, Saboory E, Khalkhali HR. Stress during pregnancy affected neonatal outcomes and changed cortisol and leptin levels both in mothers and newborns. J Neonatal Perinatal Med 2020; 12:209-219. [PMID: 30741697 DOI: 10.3233/npm-1818] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND The present study aimed to determine the effect of perceived stress during pregnancy on neonatal outcomes and cortisol and leptin levels in mothers and their newborns. METHODS This longitudinal study was carried out on 110 pregnant women in Miandoab city, Iran. Mothers, who had singleton pregnancies and gestational age of 24 to 28 weeks, were included in the study. The participants were asked to fill out Cohen's Perceived Stress Scale (PSS). The mothers were then tracked in gestational ages of 28-32 weeks, 32-36 weeks, and the time of delivery. The maternal and umbilical cord blood samples were obtained during labor in order to measure leptin and cortisol levels. RESULTS Umbilical cortisol level was significantly higher in newborns who had meconium stained amniotic fluid than those who did not. Maternal blood leptin levels at delivery were significantly higher in the mothers whose neonates had respiratory distress, low birth weight, low head circumference, low Apgar score, and were premature than those whose neonates did not have such problems. The level of leptin in umbilical cord blood was significantly higher in neonates who had respiratory distress than those who did not. The results also showed a significant correlation between maternal cortisol levels and PSS during weeks 24-28 and the entire pregnancy. A significant relationship was observed between umbilical leptin and maternal leptin levels. CONCLUSIONS It can be concluded that stress during pregnancy is accompanied by fetal distress. The probable reason for newborns distress may be related to increased maternal leptin levels.
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Affiliation(s)
- S Rabiepoor
- Department of Midwifery & Reproductive Health Research Center, Urmia University of Medical Sciences, Urmia, Iran
| | - M Abedi
- Urmia University of Medical Sciences, Urmia, Iran
| | - E Saboory
- Neurophysiology Research Center, Urmia University of Medical Sciences, Urmia, Iran
| | - H R Khalkhali
- Department of Biostatistics & Inpatient's Safety Research Center, Urmia University of Medical Sciences, Urmia, Iran
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84
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Ranjkesh F, Soltanshahi Z, Azh N, Griffiths M. Effect of spouse's participation in childbirth preparation classes in the promotion of social support among pregnant women: A field trial. SOCIAL HEALTH AND BEHAVIOR 2020. [DOI: 10.4103/shb.shb_22_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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85
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Yehia DBM, Malak MZ, Al-Thwabih NN, Awad RR, Al-Ajouri ES, Darwish SS, Hamad AS. Psychosocial factors correlate with fatigue among pregnant women in Jordan. Perspect Psychiatr Care 2020; 56:46-53. [PMID: 30887537 DOI: 10.1111/ppc.12372] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/05/2018] [Revised: 02/17/2019] [Accepted: 03/01/2019] [Indexed: 11/30/2022] Open
Abstract
PURPOSE The study aimed to assess the correlation between fatigue and psychological factors, namely stress, social support, self-esteem, and depression among pregnant women in Jordan. DESIGN AND METHODS A cross-sectional design was suggested. Cluster stratified random sampling technique was adopted. Fatigue assessment scale, Rosenberg Self-Esteem Scale, Perceived Stress Scale, Multidimensional Social Support Scale, and Beck's Depression Inventory were used. FINDINGS A total of 580 pregnant women were included. Overall, 67.4% of the participants experienced fatigue, about 74.0% had moderate to high stress, 56.0% had moderate social support, around 89.0% had normal self-esteem, and 43.1% experienced moderate to extreme depression. Stress, self-esteem, and depression were correlated with fatigue. PRACTICE IMPLICATIONS This study can help develop proper psychosocial care and sustain mental health among women during pregnancy.
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Affiliation(s)
- Dalal Bashir M Yehia
- Gynecology and Maternity Health Nursing, Faculty of Nursing, Al-Zaytoonah University of Jordan, Amman, Jordan
| | - Malakeh Z Malak
- Community Health Nursing, Faculty of Nursing, Al-Zaytoonah University of Jordan, Amman, Jordan
| | - Nancy N Al-Thwabih
- Adult Health Nursing, Marj Al-Hamam Health Center, Ministry of Health, Amman, Jordan
| | - Rawan R Awad
- Adult Health Nursing, Al-jweida Health Center, Ministry of Health, Amman, Jordan
| | - Enas S Al-Ajouri
- Adult Health Nursing, Faculty of Nursing, Al-Zaytoonah University of Jordan, Amman, Jordan
| | - Sarah S Darwish
- Adult Health Nursing, Faculty of Nursing, Al-Zaytoonah University of Jordan, Amman, Jordan
| | - Amnah S Hamad
- Health Education, Faculty of Nursing, Al-Zaytoonah University of Jordan, Amman, Jordan
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86
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Manze MG, Watnick D, Besthoff C, Romero D. Examining Women's and Men's Ideal Criteria Before Forming Families. JOURNAL OF FAMILY STUDIES 2019; 28:239-254. [PMID: 35299887 PMCID: PMC8923530 DOI: 10.1080/13229400.2019.1702079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/05/2017] [Accepted: 12/01/2019] [Indexed: 06/14/2023]
Abstract
In the United States, family formation decision-making is more complex than the predominant models that have been used to capture this phenomenon. Understanding the context in which a pregnancy occurs requires a more nuanced examination. In-depth interviews were conducted with 60 men and women, aged 18-35, who had children or were pregnant. Using grounded theory analysis, themes emerged that revealed participants' ideal criteria desired before pregnancy. We stratified by those who met and did not meet these criteria. Almost universally, participants shared ideal criteria: to graduate, gain financial stability, establish a relationship, and then become pregnant. Many participants did not accomplish these goals. Those who had not met their criteria had experienced traumatic childhoods and suffered economic concerns. For this group, having children prompted positive changes within their control, but financial stability remained limited. Efforts should focus on improving circumstances for all individuals to fulfill their criteria before pregnancy.
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Affiliation(s)
- Meredith G. Manze
- City University of New York (CUNY) Graduate School of Public Health and Health Policy, Department of Community Health and Social Sciences, New York, NY
| | - Dana Watnick
- City University of New York (CUNY) Graduate School of Public Health and Health Policy, Department of Community Health and Social Sciences, New York, NY
- Albert Einstein College of Medicine, Center for AIDS Research, New York, NY
| | | | - Diana Romero
- City University of New York (CUNY) Graduate School of Public Health and Health Policy, Department of Community Health and Social Sciences, New York, NY
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87
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Malina A, Głogiewicz M, Piotrowski J. Supportive Social Interactions in Infertility Treatment Decrease Cortisol Levels: Experimental Study Report. Front Psychol 2019; 10:2779. [PMID: 31920828 PMCID: PMC6927458 DOI: 10.3389/fpsyg.2019.02779] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2019] [Accepted: 11/26/2019] [Indexed: 11/22/2022] Open
Abstract
PURPOSE The aim of the research project was to analyze the importance of supportive social interactions in the process of infertility treatment. The acceptance rates of ART (Assisted Reproductive Technology) in Poland are lower than in western European countries and the social stigma of infertility exists. The research project draws attention to the issue of disclosure of fertility problems and the ability to seek support in Polish couples. METHODS An experimental study was conducted with 51 heterosexual couples who qualified for IVF. The participants were randomly divided into an experimental and control group. The first stage of the research procedure, with all the couples, was to extract a saliva (cortisol) sample as a biomarker for stress. In the second stage the control group viewed an informational (non-emotional) video about human embryology. The experimental group took part in a supportive social interaction process. In the supportive social interaction process, a maximum of five couples, were led through a broad general understanding of their IVF experience by an experienced group psychologist. The third stage of the research involved the second extraction of a saliva (cortisol) sample form all participants. In addition, demographic and medical history related to fertility was collected. RESULTS The statistical analysis indicates a significant decrease in the level of stress experienced after the supportive social interaction. The reported differences between the experimental group and the control group indicated a larger decrease of cortisol level for women and men. CONCLUSION In the current study, the hypothesis that taking part in supportive social interaction significantly lowers stress levels (measured via cortisol) of infertile couples (men and women) was supported. Further the project indicates that a supportive social interaction has a beneficial effect on infertile couple's health and well-being. The results of the study clearly point to the benefits of couples involved in infertility treatment to express and share their experience, and in doing so, provides measurable physiological and psychological benefits.
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Affiliation(s)
- Alicja Malina
- Department of Pedagogy and Psychology, Kazimierz Wielki University in Bydgoszcz, Bydgoszcz, Poland
| | - Małgorzata Głogiewicz
- Department of Obstetrics, Gynecology and Gynecological Oncology, Faculty of Health Sciences, Nicolaus Copernicus University in Toruń, Bydgoszcz, Poland
| | - Jakub Piotrowski
- Department of Immunology, Faculty of Biology and Environment Protection, Nicolaus Copernicus University in Toruń, Torun, Poland
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Agampodi T, Agampodi S, Glozier N, Wms C, Ypjn W, Siribaddana S. How context matters: Demonstrating microgeographical differences in social capital and its implications for mental wellbeing in pregnancy with a novel bubble diagram technique. Health Place 2019; 60:102231. [PMID: 31629193 DOI: 10.1016/j.healthplace.2019.102231] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2018] [Revised: 07/15/2019] [Accepted: 09/25/2019] [Indexed: 11/26/2022]
Abstract
There has been limited exploration of social capital at the contextual level in relation to maternal health, and in particular with the "obstetric transition" and associated mental health problems. In the North Central Province of Sri Lanka, with socio-culturally diverse communities, and a recent history of major conflict, the leading cause of maternal death is suicide. The objective of this study was to identify contextual patterns of social capital constructs that lead to poor maternal mental wellbeing, using a novel bubble visualisation technique, to demonstrate the use of data derived from qualitative approaches. We conducted a qualitative study of pregnant women based on diary entries (n = 41) and interviews (n = 38) in eight different communities of the Anuradhapura district of Sri Lanka. Bubble diagrams were constructed to visualize each context using the frequency and weight of responses given in diaries. Marital, family and neighbourhood cohesion were not homogenous in the district and the bubble diagrams displayed clear microgeographical patterns in which women living in specific communities had poorer mental wellbeing. Such techniques can be used to convey complex social capital implications in digestible way for policy makers and planners to enact locally specific strategies addressing health inequalities.
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Affiliation(s)
- Thilini Agampodi
- Department of Community Medicine, Faculty of Medicine and Allied Sciences, Rajarata University of Sri Lanka, Sri Lanka.
| | - Suneth Agampodi
- Department of Community Medicine, Faculty of Medicine and Allied Sciences, Rajarata University of Sri Lanka, Sri Lanka
| | - Nicholas Glozier
- Central Clinical School, Brain and Mind Centre, Faculty of Medicine and Health, The University of Sydney, Sri Lanka
| | - Chithrani Wms
- Department of Community Medicine, Faculty of Medicine and Allied Sciences, Rajarata University of Sri Lanka, Sri Lanka
| | - Warnasekara Ypjn
- Department of Community Medicine, Faculty of Medicine and Allied Sciences, Rajarata University of Sri Lanka, Sri Lanka
| | - Sisira Siribaddana
- Department of Medicine, Faculty of Medicine and Allied Sciences, Rajarata University of Sri Lanka, Sri Lanka
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Dağlar G, Nur N, Bilgiç D, Aydın Özkan S. Gebelerin stresle başa çıkma tarzları ile yaşam kalitesi arasındaki ilişki. CUKUROVA MEDICAL JOURNAL 2019. [DOI: 10.17826/cumj.491840] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Chiu CM, Fu CY, Lin WY, Chen CF. The central roles of embeddedness and engagement in virtual communities. ONLINE INFORMATION REVIEW 2019. [DOI: 10.1108/oir-10-2017-0304] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Purpose
The purpose of this paper is to develop a deeper understanding of how to promote members’ beneficial behaviors toward other members and toward the virtual community (VC). The authors extend Ray et al.’s (2014) framework by developing a more precise definition of community embeddedness, and determining how such embeddedness relates to social support and community engagement.
Design/methodology/approach
The authors test the proposed research model using data collected from 333 users of online social support communities/groups dedicated to sharing knowledge about pregnancy and child care. Partial least squares is used to analyze the measurement and structural models.
Findings
The study shows that embeddedness and engagement are significant determinants of willingness to help others and willingness to help the community. Embeddedness has a strong, positive effect on engagement. Social support positively affects community identification and embeddedness. However, community identification does not have a significant effect on engagement.
Research limitations/implications
Some of the findings, such as the relative importance of embeddedness in fostering willingness to help the community and the relative importance of engagement in fostering willingness to help others, might not be generalizable to VCs where members join for fun and sharing interests.
Practical implications
Although knowledge contributors could self-derive some drivers of embeddedness and engagement, managers or hosts of VCs should develop strategies and mechanisms to provide or enhance the value they add to knowledge sharing and other beneficial behaviors, even though such added value might be largely intangible.
Social implications
Social support plays an important role in shaping an individual’s embeddedness within a VC. Managers of VCs should develop strategies to stimulate exchanges of support among members.
Originality/value
The authors believe that community embeddedness plays a more important role than engagement in shaping the VC’s success and effectiveness. However, the extant VC literature has indicated a relatively weak understanding of the notion of community embeddedness. This study intends to fill that void.
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Agampodi TC, Agampodi SB, Glozier N, Lelwala TA, Sirisena KDPS, Siribaddana S. Development and validation of the Social Capital Assessment Tool in pregnancy for Maternal Health in Low and middle income countries (LSCAT-MH). BMJ Open 2019; 9:e027781. [PMID: 31289074 PMCID: PMC6629403 DOI: 10.1136/bmjopen-2018-027781] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/14/2023] Open
Abstract
OBJECTIVES Social capital which implies 'features of social organisation, such as trust, norms and networks that can improve the efficiency of society by facilitating coordinated actions' is rarely assessed in relation to maternal health in low/middle-income countries (LMICs). A main reason for this research gap could be the unavailability of a specific tool to measure social capital in pregnancy. The study developed and validated an instrument to measure social capital among pregnant women. SETTING We developed the tool based on World Bank Social Capital Assessment Tool and its adaptations identified as applicable to LMIC from an initial systematic review. The study was conducted in Anuradhapura district in the North Central Province of Sri Lanka. Validation process was conducted in urban, rural and resettled communities. PARTICIPANTS Study participants of the cognitive validation included pregnant women from the three communities, and an expert panel including a social scientist, methodological expert, subject expert, public health officers. The psychometric validation was performed on 439 pregnant women permanently residing in the three communities. RESULTS The 24-item Low and middle income countries Social Capital Assessment Tool for Maternal Health (LSCAT-MH) demonstrated high internal consistency (Cronbach's α=0.94). Factor analytical methods suggested a four-factor model of (1) neighbourhood networks (structural bonding), (2) domestic and neighbourhood cohesion (cognitive bonding), (3) social contribution and (4) social participation (structural bridging). Concurrent validity with antenatal mental ill health was confirmed through a negative correlation with the Edinburgh Postpartum Depression Scale. Test-retest reliability was high with intraclass correlation of 0.71 and a Pearson correlation of 0.83. CONCLUSION The LSCAT-MH is a psychometrically valid and reliable tool to measure social capital in pregnancy. Predictive validity was not tested as the study was not a longitudinal follow-up.
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Affiliation(s)
- Thilini C Agampodi
- Department of Community Medicine, Faculty of Medicine and Allied Sciences, Rajarata University of Sri Lanka, Saliyapura, Sri Lanka
| | - Suneth B Agampodi
- Department of Community Medicine, Faculty of Medicine and Allied Sciences, Rajarata University of Sri Lanka, Saliyapura, Sri Lanka
| | - Nick Glozier
- Faculty of Medicine and Health, Brain and Mind Centre, Central Clinical School, University of Sydney, Sydney, New South Wales, Australia
| | - T A Lelwala
- Department of Community Medicine, Faculty of Medicine and Allied Sciences, Rajarata University of Sri Lanka, Saliyapura, Sri Lanka
| | - K D P S Sirisena
- Department of Community Medicine, Faculty of Medicine and Allied Sciences, Rajarata University of Sri Lanka, Saliyapura, Sri Lanka
| | - Sisira Siribaddana
- Department of Medicine, Faculty of Medicine and Allied Sciences, Rajarata University of Sri Lanka, Saliyapura, Sri Lanka
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Relación entre la ausencia de soporte social adecuado durante el embarazo y el bajo peso al nacer. ACTA ACUST UNITED AC 2019; 48:140-148. [DOI: 10.1016/j.rcp.2017.11.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2017] [Revised: 10/17/2017] [Accepted: 11/06/2017] [Indexed: 11/22/2022]
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Racine N, Plamondon A, Hentges R, Tough S, Madigan S. Dynamic and bidirectional associations between maternal stress, anxiety, and social support: The critical role of partner and family support. J Affect Disord 2019; 252:19-24. [PMID: 30954841 DOI: 10.1016/j.jad.2019.03.083] [Citation(s) in RCA: 59] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2018] [Revised: 03/26/2019] [Accepted: 03/29/2019] [Indexed: 01/09/2023]
Abstract
BACKGROUND Stress and anxiety in pregnancy and the postpartum period are associated with poor long-term maternal and child health outcomes. Social support has been shown to mitigate the effects of maternal stress and anxiety; however, the directionality and longitudinal associations among these variables are poorly understood. Using a novel multilevel modeling approach called dynamic structural equation modeling (DSEM), we examined within-person (state-level) autoregressive and cross-lagged associations among stress, anxiety, and social support in the perinatal period in order to elucidate directional associations over time. METHODS Mothers from a longitudinal pregnancy cohort (N = 3,388) completed self-report measures of stress, anxiety, and social support across 4 time points from pregnancy to 12 months postpartum. RESULTS Higher than average levels of stress and anxiety led to elevations in anxiety and stress and decreases in social support at subsequent time points. Importantly, earlier individual levels of partner and family support predicted subsequent decreases in stress and anxiety. LIMITATIONS Support was measured via maternal self-report thus extrapolations cannot be made to tangible or instrumental supports and lagged relationships represent average lags over time. CONCLUSIONS Using a novel statistical approach, these results suggest that increases in both partner and family support may be powerful protective factors for decreasing mental health difficulties in pregnancy and the postpartum, highlighting the importance of targeting and increasing this type of support from pregnancy to the postpartum period.
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Affiliation(s)
- Nicole Racine
- Department of Psychology, Faculty of Arts, University of Calgary, 2500 University Dr. NW, Calgary, T2N 1N4 Alberta, Canada.
| | - André Plamondon
- Département des fondements et pratiques en éducation, Université Laval, Pavillon des Sciences de l'éducation, local 954, 2320, rue des Bibliotheques, Quebec, Canada; Department of Applied Psychology and Human Development, University of Toronto, Toronto, Ontario, Canada.
| | - Rochelle Hentges
- Department of Psychology, Faculty of Arts, University of Calgary, 2500 University Dr. NW, Calgary, T2N 1N4 Alberta, Canada.
| | - Suzanne Tough
- Department of Community Health Sciences, University of Calgary, Alberta, Canada; Department of Pediatrics, University of Calgary, 2500 University Dr. NW, Calgary, T2N 1N4 Alberta, Canada.
| | - Sheri Madigan
- Department of Psychology, Faculty of Arts, University of Calgary, Alberta Children's Hospital Research Institute, 2500 University Dr. NW, Calgary, T2N 1N4 Alberta, Canada.
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"…Society is, at the end of the day, still going to stigmatize you no matter which way": A qualitative study of the impact of stigma on social support during unintended pregnancy in early adulthood. PLoS One 2019; 14:e0217308. [PMID: 31120984 PMCID: PMC6532899 DOI: 10.1371/journal.pone.0217308] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2018] [Accepted: 05/08/2019] [Indexed: 11/19/2022] Open
Abstract
Unintended pregnancy in adolescence and early adulthood is stigmatized in the United States because it deviates from social norms that consider young people’s sexuality as a social problem. While limited, prior research has found that this stigma prevents young people from telling people in their lives about their pregnancies, for fear of judgment or negative reactions. We hypothesized that this selective disclosure of unintended pregnancy due to stigma would reduce the social support available to young pregnant people at a particularly vulnerable time—social support that we know is important for optimal physical and mental health of the young person, and the pregnancy (should they choose to carry to term). To explore this hypothesis, we conducted a qualitative study among young people to understand if and how they experienced stigma in relation to an unintended pregnancy, how this stigma shaped patterns of pregnancy disclosure, the implications for received social support, and participant thoughts on how to alleviate the influence of this stigma on their lives. In in-depth interviews with 25 young people in the San Francisco Bay area who had experienced at least one unintended pregnancy, using a thematic analysis approach, we found that the stigma of unintended pregnancy led participants to selectively disclose the pregnancy to limited people, which in turn cut them off from needed sources of social support. Black and Hispanic women disproportionately described this experience. Participants expressed a desire for programs that would connect young people who had experienced unplanned pregnancy to each other–either via the internet, organized groups through clinical care sites, college or high school campuses, or other forums—as a way to alleviate stigma, share perspectives and lessons learned, and otherwise build emotional and informational support networks for themselves where their usual support had fallen away.
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Characteristics of the Family Support Network of Pregnant Adolescents and Its Association with Gestational Weight Gain and Birth Weight of Newborns. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16071222. [PMID: 30959770 PMCID: PMC6479384 DOI: 10.3390/ijerph16071222] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/21/2019] [Revised: 04/02/2019] [Accepted: 04/03/2019] [Indexed: 11/16/2022]
Abstract
It has been proposed that, in the Mexican culture, family support can be a factor that contributes to protect the maternal and child health of pregnant adolescents. There may be complex associations between family support and the circumstances of a pregnancy during adolescence. The aim of the study was to analyze the association between the family support network (FSN) characteristic and the maternal and neonatal outcomes in Mexican adolescents. A cross-sectional study was conducted, and 352 pregnant adolescents participated; their FSN during pregnancy was assessed. The gestational weight gain and birth weight/length of newborns were registered. The size of the FSN was described and divided into quartiles; the main members for each quartile were identified. Then, sociodemographic and clinical variables were compared by FSN quartiles. Logistic regression models were performed to assess the association of FSN size and pregnancy and neonatal outcomes. Our results indicate that the mean age was 15 ± 1 year old. The primary support member in the FSN was the mother of the adolescent in each quartile, except for quartile 3, where the primary support was the mother-in-law. In quartile 3 there was a significantly lower gestational weight gain compared to quartile 4 (11.8 ± 5 vs. 13 ± 5 kg, p = 0.054). According to the regression model, a higher risk of small for gestational age (OR 2.99, CI 95% 1.25–7.15) newborns was found in quartile 3. We conclude that the maternal and neonatal outcomes did not differ between quartiles of FSN size, except for quartile 3. Small for gestational age newborns were observed when a non-blood relative was present in the FSN. The quality rather than the network size might be more important for improving pregnancy outcomes.
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Rabiepoor S, Sadeghi E, Sayyadi H. Spiritual Health and Physical Activity Among Iranian Pregnant Women. JOURNAL OF RELIGION AND HEALTH 2019; 58:506-515. [PMID: 28836086 DOI: 10.1007/s10943-017-0487-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
This study was aimed to investigate the relationship between spiritual health and physical activity among Iranian pregnant women during 2015. A cross-sectional descriptive-analytic design was adopted. A total number of 411 participants were selected by convenience sampling from Iranian women who regularly attended health centers for prenatal care. Data were collected using demographic questionnaire and Health-Promoting Lifestyle Profile questionnaire, 2nd edition. (Spiritual health and physical activity are two components of health-promoting lifestyle.) The data were analyzed, using descriptive statistics, t test, one-way ANOVA, Pearson's correlation coefficient, and regression. p values <0.05 were considered significant. The mean age of pregnant women was 27.90 ± 6.03 years. Spiritual health had the highest score (25.86 ± 4.7) and physical activity had the lowest score (11.31 ± 3.27), among six Health-Promoting Lifestyle Profile subscales. In fact, there was a statistically significant correlation between spiritual health and physical activity (p = 0.000). According to results, pregnant women have higher spiritual health and lower physical activity scores. There was a statistically significant correlation between spiritual health and physical activity. The findings of this study can be used in prenatal care, midwifery education, and maternal health policies.
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Affiliation(s)
- Soheila Rabiepoor
- Reproductive Health Research Centre, Midwifery Department, Urmia University of Medical Sciences, Urmia, Iran
| | - Elham Sadeghi
- Midwifery Department, Urmia University of Medical Sciences, Urmia, Iran.
| | - Hojjat Sayyadi
- Department of Biostatistics and Epidemiology, School of Medicine, Urmia University of Medical Sciences, Urmia, Iran
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97
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Brandão T, Brites R, Hipólito J, Pires M, Nunes O. Dyadic coping, marital adjustment and quality of life in couples during pregnancy: an actor-partner approach. J Reprod Infant Psychol 2019; 38:49-59. [PMID: 30755030 DOI: 10.1080/02646838.2019.1578950] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Objective: This study aimed to examine the impact of dyadic coping on the quality of life of couples during pregnancy and to explore the potential mediating role of marital adjustment on this association.Background: According to the systemic transactional model, pregnancy can be characterised as a situation of dyadic stress because it affects both members of the couple. However, the impact of dyadic coping on couples' quality of life during pregnancy is unexplored. Also, the potential mediating role of marital adjustment on this association remains understudied.Methods: Participants were 320 pregnant women and their partners (N = 640) who completed the Dyadic Coping Inventory, the Dyadic Adjustment Scale and the World Health Organisation Quality of Life instrument. Data were analysed using the actor-partner interdependence mediation model.Results: Results showed that there was an intrapersonal indirect effect of dyadic coping on quality of life through marital adjustment. Moreover, an interpersonal indirect effect was found with fathers' dyadic coping being associated with mothers' quality of life through mothers' marital adjustment.Conclusions: These findings highlight the importance of assessing dyadic coping strategies of couples during pregnancy and targeting them in the psychological support offered to couples as a way of improving their marital adjustment, and consequently, their quality of life.
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Affiliation(s)
- Tânia Brandão
- CIP, Departamento de Psicologia, Universidade Autónoma de Lisboa Luís de Camões, Lisboa, Portugal.,Center for Psychology at University of Porto, Porto, Portugal
| | - Rute Brites
- CIP, Departamento de Psicologia, Universidade Autónoma de Lisboa Luís de Camões, Lisboa, Portugal
| | - João Hipólito
- CIP, Departamento de Psicologia, Universidade Autónoma de Lisboa Luís de Camões, Lisboa, Portugal
| | - Mónica Pires
- CIP, Departamento de Psicologia, Universidade Autónoma de Lisboa Luís de Camões, Lisboa, Portugal
| | - Odete Nunes
- CIP, Departamento de Psicologia, Universidade Autónoma de Lisboa Luís de Camões, Lisboa, Portugal
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98
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Li T, Guo N, Jiang H, Eldadah M, Zhuang W. Social support and second trimester depression. Midwifery 2019; 69:158-162. [DOI: 10.1016/j.midw.2018.11.012] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2018] [Revised: 10/22/2018] [Accepted: 11/22/2018] [Indexed: 12/22/2022]
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99
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Paternal investment and low birth weight - The mediating role of parity. PLoS One 2019; 14:e0210715. [PMID: 30677049 PMCID: PMC6345489 DOI: 10.1371/journal.pone.0210715] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2018] [Accepted: 01/01/2019] [Indexed: 11/19/2022] Open
Abstract
According to life-history theory, paternal investment affects the well-being of offspring. We hypothesized that environmental stress caused by a lack of paternal investment may diminish maternal resource allocation during pregnancy, especially for women who already have dependent children. Our study was conducted on a representative group of more than 80,500 singleton, live-born, full-term infants born in Krakow, Poland in the period 1995-2009. Birth data were obtained from the birth registry. We found that missing data about fathers (a proxy measure of low paternal investment) was associated with higher probability of multiparous mothers giving birth to low-birth-weight infants (1.48; 95% CI 1.05-2.08), but this was not the case with primiparous mothers (1.19; 95% CI 0.89-1.59). The statistically significant synergistic effect between parity and paternal investment was found (Synergy Factor = 2.12; 95% CI 1.47-3.05, p<0.001). These findings suggest that in situations of low paternal investment, multiparous mothers face trade-offs between investing in existing versus unborn children, therefore investment in the latter is lower. Such a strategy may benefit maternal fitness due to investment in older children, who have higher reproductive value.
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100
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Wu WR, Hung CH. Impact of a peer virtual community on pregnant women's well-being: A repeated-measure and quasi-experimental study. J Adv Nurs 2019; 75:1099-1107. [PMID: 30575093 DOI: 10.1111/jan.13938] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2018] [Accepted: 11/22/2018] [Indexed: 12/26/2022]
Abstract
AIM To investigate the effects of a virtual community on pregnant women's well-being. BACKGROUND The virtual social network has been growing rapidly but its effects remain unclear. DESIGN A repeated-measure and quasi-experimental study. METHODS We designed a closed Facebook community for peer-to-peer interaction with no mediator. A total of 121 pregnant women were assigned to either experimental or control group. Data were collected from May 2012-January 2015 using five instruments related to pregnant women's well-being. RESULTS Significant differences on pregnant women's well-being were not found between groups. However, higher adherence to the virtual community was significantly related to first-time pregnant women and women whose pregnancy was assisted by a technology treatment. CONCLUSIONS Nurses and midwifes are recommended to pay more attentions on first-time pregnant women and women whose pregnancy was assisted by a technology treatment regarding their pregnancy-related concerns. TRIAL REGISTRATION NUMBER ClinicalTrials.gov NCT03692923.
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Affiliation(s)
- Wan-Ru Wu
- Department of Nursing, College of Medicine, Tzu Chi University, Hualien, Taiwan
| | - Chich-Hsiu Hung
- School of Nursing, Kaohsiung Medical University, Kaohsiung, Taiwan.,Department of Medical Research, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
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