1
|
DuBois D, Sundell J, Thomsen MR, Brown CC. Impact of the 2022 Infant Formula Shortage on Self-Reported Rates of Anxiety and Depression: Evidence from the Household Pulse Survey. J Perinat Neonatal Nurs 2024; 38:326-333. [PMID: 39074328 PMCID: PMC11296491 DOI: 10.1097/jpn.0000000000000839] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/31/2024]
Abstract
PURPOSE To evaluate the impact of the 2022 infant formula shortage on self-reported anxiety and depression. BACKGROUND The US national infant formula shortage of 2022 originated from supply chain disruptions triggered by the COVID-19 pandemic, and the shortage was further compounded by a recall of tainted formula products. METHODS We used survey-weighted data from the Household Pulse Survey (HPS) to measure self-reported anxiety and depression among individuals with formula-fed infants less than 1 year of age. We evaluated the association between 2 formula disruption variables (being impacted by the infant formula shortage or having difficulty obtaining formula in the last 7 days) with 2 mental health outcomes (anxiety and depression) using multivariable logistic regressions. RESULTS We found increased odds of self-reported anxiety (aOR: 3.13; P < .001) and depression (aOR: 3.05; P = .005) for respondents affected by the infant formula shortage. There were no adjusted associations between having difficulty obtaining formula in the last 7 days and anxiety and depression. CONCLUSIONS Individuals affected by the infant formula shortage had increased odds of both anxiety and depression. Continued efforts to improve food security for low-income infants is critical for ensuring equitable nutritional and health outcomes across infant populations. IMPLICATIONS FOR PRACTICE AND RESEARCH Continued efforts to reduce food insecurity for low-income infants are critically needed, as infant nutrition impacts caregiver mental health and infant health. Efforts to improve lactation support and breastfeeding initiation are needed in addition to improvements in access to formula.
Collapse
Affiliation(s)
- Dominique DuBois
- College of Nursing, University of Arkansas for Medical Sciences, Little Rock, Arkansas
| | - Joe Sundell
- College of Public Health, University of Arkansas for Medical Sciences, Little Rock, Arkansas
| | - Michael R. Thomsen
- College of Public Health, University of Arkansas for Medical Sciences, Little Rock, Arkansas
| | - Clare C. Brown
- College of Public Health, University of Arkansas for Medical Sciences, Little Rock, Arkansas
| |
Collapse
|
2
|
Scroggins JK, Reuter-Rice K, Brandon D, Yang Q. Maternal Psychological Symptom Trajectories From 2 to 24 Months Postpartum: A Latent Class Growth Analysis. Nurs Res 2024; 73:178-187. [PMID: 38329993 PMCID: PMC11039373 DOI: 10.1097/nnr.0000000000000713] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/10/2024]
Abstract
BACKGROUND Postpartum women experience an array of psychological symptoms that are associated with adverse health behaviors and outcomes including postpartum suicidal ideation and long-term depression. To provide early management of postpartum psychological symptoms, it is important to understand how the symptom experiences change over time. OBJECTIVE The aim of this study was to examine maternal psychological symptom trajectories over 2, 6, 15, and 24 months postpartum using latent class growth analysis and to examine how each trajectory is associated with maternal depression outcome at 24 months. METHODS We used secondary data from the Family Life Project ( N = 1,122) and performed multitrajectory latent class growth analysis based on four observed symptom variables (depression, anxiety, somatization, and hostility). After the final model was identified, bivariate analyses were conducted to examine the association between each trajectory and (a) individual characteristics and (b) outcome (Center for Epidemiologic Studies Depression Scale [CES-D]) variables. RESULTS A four-class model was selected for the final model because it had better fit indices, entropy, and interpretability. The four symptom trajectories were (a) no symptoms over 24 months, (b) low symptoms over 24 months, (c) moderate symptoms increasing over 15 months, and (d) high symptoms increasing over 24 months. More postpartum women with the trajectory of high symptoms increasing over 24 months (Trajectory 4) were in low economic status (92.16%), unemployed (68.63%), or did not complete 4-year college education (98.04%). Most postpartum women (95.56%) in Trajectory 4 also had higher CES-D cutoff scores, indicating a possible clinical depression at 24 months postpartum. DISCUSSION Postpartum women who experience increasing symptom trajectories over 15-24 months (Trajectories 3 and 4) could benefit from tailored symptom management interventions provided earlier in the postpartum period to prevent persistent and worsening symptom experiences.
Collapse
|
3
|
Basile-Ibrahim B, Combellick J, Mead TL, Sorensen A, Batten J, Schafer R. The Social Context of Pregnancy, Respectful Maternity Care, Biomarkers of Weathering, and Postpartum Mental Health Inequities: A Scoping Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2024; 21:480. [PMID: 38673391 PMCID: PMC11049830 DOI: 10.3390/ijerph21040480] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/12/2024] [Revised: 04/05/2024] [Accepted: 04/11/2024] [Indexed: 04/28/2024]
Abstract
Background: Mental health disorders are the number one cause of maternal mortality and a significant maternal morbidity. This scoping review sought to understand the associations between social context and experiences during pregnancy and birth, biological indicators of stress and weathering, and perinatal mood and anxiety disorders (PMADs). Methods: A scoping review was performed using PRISMA-ScR guidance and JBI scoping review methodology. The search was conducted in OVID Medline and Embase. Results: This review identified 74 eligible English-language peer-reviewed original research articles. A majority of studies reported significant associations between social context, negative and stressful experiences in the prenatal period, and a higher incidence of diagnosis and symptoms of PMADs. Included studies reported significant associations between postpartum depression and prenatal stressors (n = 17), socioeconomic disadvantage (n = 14), negative birth experiences (n = 9), obstetric violence (n = 3), and mistreatment by maternity care providers (n = 3). Birth-related post-traumatic stress disorder (PTSD) was positively associated with negative birth experiences (n = 11), obstetric violence (n = 1), mistreatment by the maternity care team (n = 1), socioeconomic disadvantage (n = 2), and prenatal stress (n = 1); and inverse association with supportiveness of the maternity care team (n = 5) and presence of a birth companion or doula (n = 4). Postpartum anxiety was significantly associated with negative birth experiences (n = 2) and prenatal stress (n = 3). Findings related to associations between biomarkers of stress and weathering, perinatal exposures, and PMADs (n = 14) had mixed significance. Conclusions: Postpartum mental health outcomes are linked with the prenatal social context and interactions with the maternity care team during pregnancy and birth. Respectful maternity care has the potential to reduce adverse postpartum mental health outcomes, especially for persons affected by systemic oppression.
Collapse
Affiliation(s)
| | - Joan Combellick
- School of Nursing, Yale University, Orange, CT 06477, USA; (J.C.)
| | - Thomas L. Mead
- Biomedical Libraries, Dartmouth College, Hanover, NH 03755, USA;
| | - Alee Sorensen
- School of Nursing, Yale University, Orange, CT 06477, USA; (J.C.)
| | - Janene Batten
- Harvey Cushing/John Hay Whitney Medical Library, Yale University, New Haven, CT 06510, USA;
| | - Robyn Schafer
- Division of Advanced Nursing Practice, School of Nursing, Rutgers University, Newark, NJ 07107, USA;
- Department of Obstetrics, Gynecology, and Reproductive Sciences, Robert Wood Johnson Medical School, Rutgers University, New Brunswick, NJ 08901, USA
| |
Collapse
|
4
|
Scroggins JK, Brandon D, Reuter-Rice K, Min SH, Yang Q. Changes in maternal psychological symptom profiles from 2 to 6 months postpartum: an application of latent transition analysis. Arch Womens Ment Health 2024; 27:309-316. [PMID: 38044340 DOI: 10.1007/s00737-023-01407-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Accepted: 11/28/2023] [Indexed: 12/05/2023]
Abstract
To identify subgroups of postpartum women with different psychological symptom profiles at 2 and 6 months postpartum and to examine how they transition between symptom profiles over time using latent transition analysis (LTA). We used secondary data from the Family Life Project (N = 1,117) and performed LTA based on observed variables (depression, anxiety, somatization, and hostility). We examined transition probabilities and changes in latent status prevalence from 2 to 6 months postpartum. Considering the known influences of social determinants of health on psychological symptoms, bivariate analyses were conducted to describe the characteristics of different transition patterns. A 3-class model with better fit indices, entropy, and interpretability was selected. Based on symptom severity, the identified profiles were Profile 1: Low, Profile 2: Moderate, and Profile 3: High. From 2 to 6 months postpartum, the prevalence of low symptom profile decreased (82 to 78.2%) while the prevalence increased for moderate (15.8 to 17.5%) and high symptom profiles (2.2 to 4.4%). For all profiles, it was most likely for postpartum women to stay in the same profile from 2 to 6 months (low to low, moderate to moderate, and high to high). Those in persistent or worsening transition patterns were significantly younger or had less social support or education. Postpartum women in moderate or high symptom profiles at 2 months were most likely to stay in the same profile at 6 months postpartum, indicating persistent symptom burden. Clinicians should consider providing early, targeted support to prevent persistent symptom burden.
Collapse
Affiliation(s)
- Jihye Kim Scroggins
- School of Nursing, Duke University, Durham, NC, USA.
- School of Nursing, Columbia University, 560 W 168th Street, New York, NY, 10032, USA.
| | - Debra Brandon
- School of Nursing, Duke University, Durham, NC, USA
- School of Medicine, Duke University, Durham, NC, USA
| | - Karin Reuter-Rice
- School of Nursing, Duke University, Durham, NC, USA
- School of Medicine, Duke University, Durham, NC, USA
| | - Se Hee Min
- School of Nursing, Columbia University, 560 W 168th Street, New York, NY, 10032, USA
| | - Qing Yang
- School of Nursing, Duke University, Durham, NC, USA
| |
Collapse
|
5
|
Scroggins JK, Yang Q, Tully KP, Reuter-Rice K, Brandon D. Examination of Social Determinants of Health Characteristics Influencing Maternal Postpartum Symptom Experiences. J Racial Ethn Health Disparities 2024:10.1007/s40615-023-01901-1. [PMID: 38180636 PMCID: PMC11224138 DOI: 10.1007/s40615-023-01901-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2023] [Revised: 12/05/2023] [Accepted: 12/20/2023] [Indexed: 01/06/2024]
Abstract
Postpartum women experience multiple, co-occurring postpartum symptoms. It is unknown if social determinants of health (SDOH) influence postpartum symptom typologies. This secondary analysis used the Community and Child Health Network study data. Participants included for analysis varied depending on the availability of the SDOH data (N = 851 to 1784). Bivariate and multiple regression analyses were conducted to examine the association between SDOH and previously identified postpartum symptom typologies. Area under the receiver operating characteristics curve (AUROC) was calculated to examine if adding SDOH variables contributes to predicting postpartum symptom typologies. The adjusted odds (aOR) of being in high symptom severity or occurrence typologies were greater for participants who had less than high school education (aOR = 2.29), experienced healthcare discrimination (aOR = 2.21), used governmental aid (aOR = 2.11), or were food insecure (aOR = 2.04). AUROC improved after adding SDOH. Considering experiences of different social-economic hardships influence postpartum symptom typologies, future practice and research should address SDOH to improve postpartum symptom experiences.
Collapse
Affiliation(s)
- Jihye Kim Scroggins
- School of Nursing, Columbia University, 560 W 168thStreet, New York, NY, 10032, USA.
- School of Nursing, Duke University, Durham, NC, USA.
| | - Qing Yang
- School of Nursing, Duke University, Durham, NC, USA
| | - Kristin P Tully
- Department of Obstetrics and Gynecology, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Karin Reuter-Rice
- School of Nursing, Duke University, Durham, NC, USA
- School of Medicine, Duke University, Durham, NC, USA
| | - Debra Brandon
- School of Nursing, Duke University, Durham, NC, USA
- School of Medicine, Duke University, Durham, NC, USA
| |
Collapse
|
6
|
Beese S, Postma J, Graves JM. Allostatic Load Measurement: A Systematic Review of Reviews, Database Inventory, and Considerations for Neighborhood Research. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph192417006. [PMID: 36554888 PMCID: PMC9779615 DOI: 10.3390/ijerph192417006] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Revised: 12/13/2022] [Accepted: 12/14/2022] [Indexed: 05/27/2023]
Abstract
BACKGROUND Neighborhoods are critical to understanding how environments influence health outcomes. Prolonged environmental stressors, such as a lack of green spaces and neighborhood socioeconomic disadvantage, have been associated with higher allostatic load levels. Since allostatic load levels experienced earlier in life have stronger associations with mortality risk, neighborhoods may be uniquely suited to monitor and mitigate the impacts of environmental stressors. Researchers often study allostatic load in neighborhoods by utilizing administrative boundaries within publicly accessible databases as proxies for neighborhoods. METHODS This systematic review of reviews aims to identify commonly used biomarkers in the measurement of allostatic load, compare measurement approaches, inventory databases to study allostatic load, and spotlight considerations referenced in the literature where allostatic load is studied in neighborhoods. The review was conducted using the search term "allostatic load" in the MEDLINE, CINAHL, and PsychINFO databases. The search results were filtered to include reviews. RESULTS The search returned 499 articles after deduplication. Overall, 18 synthesis reviews met the inclusion criteria and were retained for extraction. The synthesis reviews analyzed represented 238 studies published from 1995 to 2020. The original ten biomarkers were most often used to measure allostatic load. More recently, body mass index and C-reactive protein have additionally been frequently used to measure allostatic load burden. CONCLUSIONS The scientific contributions of this study are that we have identified a clear gap in geographic considerations when studying allostatic load. The implication of this study is that we have highlighted geographic concepts when conducting neighborhood-level research using administrative databases as a neighborhood proxy and outlined emerging future trends that can enable future study of allostatic load in the neighborhood context.
Collapse
Affiliation(s)
- Shawna Beese
- College of Agricultural, Human, and Natural Resources Sciences, Washington State University, Pullman, WA 99164, USA
- College of Nursing, Washington State University, Spokane, WA 99202, USA
| | - Julie Postma
- College of Nursing, Washington State University, Spokane, WA 99202, USA
| | - Janessa M. Graves
- College of Nursing, Washington State University, Spokane, WA 99202, USA
| |
Collapse
|
7
|
Lueth AJ, Allshouse AA, Blue NM, Grobman WA, Levine LD, Simhan HN, Kim JK, Johnson J, Wilson FA, Murtaugh M, Silver RM. Allostatic Load and Adverse Pregnancy Outcomes. Obstet Gynecol 2022; 140:974-982. [PMID: 36357956 PMCID: PMC9712159 DOI: 10.1097/aog.0000000000004971] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2022] [Accepted: 07/28/2022] [Indexed: 11/13/2022]
Abstract
OBJECTIVE To assess the association between allostatic load, as an estimate of chronic stress, and adverse pregnancy outcomes. METHODS This was a secondary analysis of nuMoM2b (Nulliparous Pregnancy Outcomes Study: Monitoring Mothers-to-Be), a prospective observational cohort study. Our primary exposure was dichotomous high allostatic load in the first trimester, defined as 4 or more of 12 biomarkers in the "worst" quartile. The primary outcome was a composite adverse pregnancy outcome: hypertensive disorders of pregnancy (HDP), preterm birth, small for gestational age (SGA), and stillbirth. Secondary outcomes included components of the composite. Multivariable logistic regression was used to test the association between high allostatic load and adverse pregnancy outcomes, adjusted for potential confounders. Mediation and moderation analyses were conducted to assess the role of allostatic load along the causal pathway between racial disparities and adverse pregnancy outcomes. RESULTS Among 4,266 individuals, 34.7% had a high allostatic load. Composite adverse pregnancy outcome occurred in 1,171 (27.5%): 14.0% HDP, 8.6% preterm birth (48.0% spontaneous and 52.2% indicated), 11.0% SGA, and 0.3% stillbirth. After adjustment for maternal age, gravidity, smoking, bleeding in the first trimester, and health insurance, high allostatic load was significantly associated with a composite adverse pregnancy outcome (adjusted odds ratio [aOR] 1.5, 95% CI 1.3, 1.7) and HDP (aOR 2.5, 95% CI 2.0-2.9), but not preterm birth or SGA. High allostatic load partially mediated the association between self-reported race and adverse pregnancy outcomes. The association between allostatic load and HDP differed by self-reported race, but not for a composite adverse pregnancy outcome, preterm birth, or SGA. CONCLUSION High allostatic load in the first trimester is associated with adverse pregnancy outcomes, particularly HDP. Allostatic load was a partial mediator between race and adverse pregnancy outcomes. The association between allostatic load and HDP differed by self-reported race.
Collapse
Affiliation(s)
- Amir J. Lueth
- Department of Obstetrics and Gynecology, University of Utah Health, Salt Lake City, Utah
| | - Amanda A. Allshouse
- Department of Obstetrics and Gynecology, University of Utah Health, Salt Lake City, Utah
| | - Nathan M. Blue
- Department of Obstetrics and Gynecology, University of Utah Health, Salt Lake City, Utah
| | - William A. Grobman
- Department of Obstetrics and Gynecology, Ohio State University, Columbus, Ohio
| | - Lisa D. Levine
- Department of Obstetrics and Gynecology, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Hyagriv N. Simhan
- Department of Obstetrics and Gynecology, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Jin Kyung Kim
- Department of Obstetrics and Gynecology, University of California Irvine, Irvine, California
| | - Jasmine Johnson
- Department of Obstetrics and Gynecology, School of Medicine, Indiana University
| | - Fernando A. Wilson
- Department of Population Health Sciences, University of Utah Health, Salt Lake City, Utah
| | - Maureen Murtaugh
- Department of Obstetrics and Gynecology, University of Utah Health, Salt Lake City, Utah
| | - Robert M. Silver
- Department of Obstetrics and Gynecology, University of Utah Health, Salt Lake City, Utah
| | | |
Collapse
|
8
|
Cain KS, Meyer SC, Cummer E, Patel KK, Casacchia NJ, Montez K, Palakshappa D, Brown CL. Association of Food Insecurity with Mental Health Outcomes in Parents and Children. Acad Pediatr 2022; 22:1105-1114. [PMID: 35577282 PMCID: PMC10153634 DOI: 10.1016/j.acap.2022.04.010] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Revised: 04/07/2022] [Accepted: 04/30/2022] [Indexed: 01/19/2023]
Abstract
BACKGROUND Food insecurity affects 13.7 million US households and is linked to poor mental health. Families shield children from food insecurity by sacrificing their nutritional needs, suggesting parents and children experience food insecurity differentially. OBJECTIVE To identify the associations of food insecurity and mental health outcomes in parents and children DATA SOURCES: PubMed, Embase, Web of Science, and PsycInfo STUDY ELIGIBILITY CRITERIA: We included original research published in English from January 1990 to June 2020 that examined associations between food insecurity and mental health in children or parents/guardians in the United States. STUDY APPRAISAL AND SYNTHESIS METHODS Two reviewers screened studies for inclusion. Data extraction was completed by one reviewer and checked by a second. Bias and confounding were assessed using the Agency for Healthcare Research and Quality RTI Item Bank. Studies were synthesized qualitatively, grouped by mental health outcome, and patterns were assessed. Meta-analyses were not performed due to high variability between studies. RESULTS We included 108 studies, assessing 250,553 parents and 203,822 children in total. Most studies showed a significant association between food insecurity and parental depression, anxiety, and stress, and between food insecurity and child depression, externalizing/internalizing behaviors, and hyperactivity. LIMITATIONS Most studies were cross-sectional and many were medium- or high-risk for bias or confounding. CONCLUSIONS AND IMPLICATIONS OF KEY FINDINGS Food insecurity is significantly associated with various mental health outcomes in both parents and children. The rising prevalence of food insecurity and mental health problems make it imperative that effective public health and policy interventions address both problems.
Collapse
Affiliation(s)
- Kathryn S Cain
- Department of Pediatrics (KS Cain, SC Meyer, E Cummer, KK Patel, K Montez, D Palakshappa, and CL Brown), Wake Forest School of Medicine, Winston-Salem, NC
| | - Stephanie C Meyer
- Department of Pediatrics (KS Cain, SC Meyer, E Cummer, KK Patel, K Montez, D Palakshappa, and CL Brown), Wake Forest School of Medicine, Winston-Salem, NC
| | - Elaina Cummer
- Department of Pediatrics (KS Cain, SC Meyer, E Cummer, KK Patel, K Montez, D Palakshappa, and CL Brown), Wake Forest School of Medicine, Winston-Salem, NC
| | - Kishan K Patel
- Department of Pediatrics (KS Cain, SC Meyer, E Cummer, KK Patel, K Montez, D Palakshappa, and CL Brown), Wake Forest School of Medicine, Winston-Salem, NC
| | - Nicholas J Casacchia
- Clinical and Translational Science Institute (NJ Casacchia), Wake Forest University, Winston-Salem, NC
| | - Kimberly Montez
- Department of Pediatrics (KS Cain, SC Meyer, E Cummer, KK Patel, K Montez, D Palakshappa, and CL Brown), Wake Forest School of Medicine, Winston-Salem, NC
| | - Deepak Palakshappa
- Department of Pediatrics (KS Cain, SC Meyer, E Cummer, KK Patel, K Montez, D Palakshappa, and CL Brown), Wake Forest School of Medicine, Winston-Salem, NC; Department of Internal Medicine (D Palakshappa), Wake Forest School of Medicine, Winston-Salem, NC; Department of Epidemiology and Prevention (D Palakshappa, CL Brown), Wake Forest School of Medicine, Winston-Salem, NC
| | - Callie L Brown
- Department of Pediatrics (KS Cain, SC Meyer, E Cummer, KK Patel, K Montez, D Palakshappa, and CL Brown), Wake Forest School of Medicine, Winston-Salem, NC; Department of Epidemiology and Prevention (D Palakshappa, CL Brown), Wake Forest School of Medicine, Winston-Salem, NC.
| |
Collapse
|
9
|
Scroggins JK, Ledbetter LS, Jones-Hepler B, Brandon D, Reuter-Rice K. Postpartum symptom clusters in birthing individuals: A systematic review. J Clin Nurs 2022. [PMID: 35995761 DOI: 10.1111/jocn.16494] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2022] [Revised: 07/13/2022] [Accepted: 08/05/2022] [Indexed: 11/27/2022]
Abstract
BACKGROUND Birthing individuals experience various postpartum symptoms which have been associated with adverse health outcomes. Previous systematic reviews have focused on the examination of individual symptoms and their impact on health, which have limited our understanding of postpartum symptom clusters. OBJECTIVE To examine the compositions of symptom clusters, analytic methodologies and predictors of symptom clusters in birthing individuals up to 1 year postpartum. DESIGN Systematic review. METHODS This systematic review was reported following the PRISMA. Five databases were searched: PubMed, Embase, CINAHL Complete, PsycINFO and Scopus. Two reviewers performed title and abstract and full-text screening independently. Standard Quality Assessment Criteria were used to assess the articles' qualities. Key information was extracted into evidence table, which was checked for accuracy and completeness. A narrative synthesis was conducted. RESULTS A total of 30 articles were included. Studies were conducted in 16 countries, mostly in Europe (n = 9) and North America (n = 7). The majority were quantitative (n = 27) and cross-sectional (n = 27). Factor analysis was the most frequently used analytic methodology (n = 21). All three qualitative studies used grounded theory. Taking into consideration the variations among the studies, stress (n = 15, infant or partner-related and from other sources), depression (n = 12), somatic (n = 12) and anxiety clusters (n = 10) were most frequently identified. Symptom cluster predictors were examined in less than half of the included studies (n = 13). Among these, most were focused on how individual postpartum symptoms influence symptom clusters. CONCLUSIONS Stress, depression, somatic and anxiety clusters are the most frequently identified postpartum symptom clusters. Future studies should examine the consistency, stability and clinical meaningfulness of these four symptom clusters. RELEVANCE TO CLINICAL PRACTICE The identification and management of the four symptom clusters should be of particular interest to clinicians and researchers. NO PATIENT OR PUBLIC CONTRIBUTION This systematic review did not directly involve patient or public contribution to the manuscript.
Collapse
Affiliation(s)
| | - Leila S Ledbetter
- Duke University Medical Center Library & Archives, Durham, North Carolina, USA
| | | | - Debra Brandon
- Duke University School of Nursing, Durham, North Carolina, USA.,Duke University School of Medicine, Durham, North Carolina, USA
| | - Karin Reuter-Rice
- Duke University School of Nursing, Durham, North Carolina, USA.,Duke University School of Medicine, Durham, North Carolina, USA
| |
Collapse
|
10
|
Paulson JL. Intimate Partner Violence and Perinatal Post-Traumatic Stress and Depression Symptoms: A Systematic Review of Findings in Longitudinal Studies. TRAUMA, VIOLENCE & ABUSE 2022; 23:733-747. [PMID: 33252020 DOI: 10.1177/1524838020976098] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
The link between maternal violence exposure and adverse obstetric outcomes is well-documented, but less is understood about the relationship between intimate partner violence (IPV) exposure and perinatal post-traumatic stress symptoms(PTSS) and depression in women around the world. A systematic review was conducted to synthesize empirical literature on the associations between IPV (e.g., before pregnancy, during pregnancy, postpartum) and post-traumatic stress and depression symptoms in the perinatal period. This review acknowledged the effects of IPV exposure timing, timing of assessment, and IPV subtypes. Forty-seven longitudinal studies met inclusion criteria and were reviewed to determine the effects of IPV exposure on perinatal mental health. Findings suggested a strong relationship between IPV exposure and perinatal mental health. Results were more consistent between perinatal mental health and IPV sustained close to or during the perinatal period than for lifetime IPV exposure. In general, physical, sexual, and psychological IPV were independently associated with perinatal depression and PTSS. Findings underscore the importance of theoretically driven research and the development of treatment protocols for women worldwide.
Collapse
|
11
|
Rankin L, Mendoza NS, Grisham L. Unpacking Perinatal Experiences with Opioid Use Disorder: Relapse Risk Implications. CLINICAL SOCIAL WORK JOURNAL 2022; 51:34-45. [PMID: 35611138 PMCID: PMC9119270 DOI: 10.1007/s10615-022-00847-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 04/27/2022] [Indexed: 06/15/2023]
Abstract
While pregnancy presents a strong motivation to seek and comply with treatment for opioid use disorder (OUD), many women relapse within the first year of childbirth. Addressing relapse risk, we examined the perinatal experiences of mothers with OUD through 6 months postpartum. We recruited mothers (N = 42) with a history of OUD into the Newborn Attachment and Wellness study, all of whom met with a child welfare worker immediately after giving birth. In qualitative interviews, mothers described their social, physical, emotional, and psychological perinatal experiences. Seven themes categorically informed relapse risk (i.e., related to childhood bond, mother-infant attachment, birth support, child protective services, breastfeeding, mental health, and recovery planning). In conclusion, we noted a critical window in which clinical social workers and other health/behavioral health providers have the opportunity to capitalize on mothers' desire not to "ever want to touch it again." We outline specific avenues for directed support in the perinatal and postpartum period associated with reduced risk for relapse, and we make recommendations to enhance risk assessment practices.
Collapse
Affiliation(s)
- Lela Rankin
- School of Social Work, Watts College of Public Service and Community Solutions, Arizona State University, Phoenix, USA
| | - Natasha S. Mendoza
- School of Social Work, Watts College of Public Service and Community Solutions, Arizona State University, Phoenix, USA
| | - Lisa Grisham
- Banner University Medical Center –Tucson, College of Medicine, University of Arizona, Tucson, USA
| |
Collapse
|
12
|
Ankerstjerne LBS, Laizer SN, Andreasen K, Normann AK, Wu C, Linde DS, Rasch V. Landscaping the evidence of intimate partner violence and postpartum depression: a systematic review. BMJ Open 2022; 12:e051426. [PMID: 35584869 PMCID: PMC9119188 DOI: 10.1136/bmjopen-2021-051426] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVE To assess the evidence of the association between exposure to intimate partner violence (IPV) and postpartum depression. IPV during pregnancy can have immediate and long-term physical and mental health consequences for the family. Therefore, it has been hypothesised that IPV may affect the risk of developing postpartum depression. METHODS A systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. PubMed, Embase, Global Health Library, Scopus and Google scholar were searched for published studies without restrictions on language, time or study design (up to May 2020). Studies were included if they assessed postpartum depression using the Edinburg Postnatal Depression Scale (cut-off≥10), among women who had been exposed to IPV (emotional, physical and/or sexual abuse). The quality of studies was judged according to the Newcastle-Ottawa scale. RESULTS A total of 33 studies were included in the review (participants n=131 131). The majority of studies found an association between exposure to IPV and the development of signs of postpartum depression. Overall, studies measured both exposure and outcome in various ways and controlled for a vast number of different confounders. Thirty percent of the studies were set in low-income and lower-middle-income countries while the rest were set in upper-middle-income and high-income countries and the association did not differ across settings. Among the studies reporting adjusted OR (aOR) (n=26), the significant aOR ranged between 1.18 and 6.87 (95% CI 1.12 to 11.78). The majority of the studies were judged as 'good quality' (n=20/33). CONCLUSION We found evidence of an association between exposure to IPV and the development of signs of postpartum depression. Meta-analysis or individual patient data meta-analysis is required to quantify the magnitude of the association between IPV and postpartum depression. PROSPERO REGISTRATION NUMBER CRD42020209435.
Collapse
Affiliation(s)
- Lea Bo Sønderlund Ankerstjerne
- Department of Gynaecology and Obstetrics, Odense University Hospital, Odense, Denmark
- Institute of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - Sweetness Naftal Laizer
- Kilimanjaro Christian Medical University College, Kilimanjaro Clinical Research Institute, Moshi, United Republic of Tanzania
| | - Karen Andreasen
- Gynaecology and Obstetrics, Odense Universitetshospital, Odense, Denmark
| | - Anne Katrine Normann
- Deparment of Obstetrics and Gynecology, Odense University Hospital, Odense, Denmark
| | - Chunsen Wu
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark
- Obstetrics and Gynaecology, Odense Universitetshospital, Odense, Denmark
| | - Ditte Søndergaard Linde
- Institute of Clinical Research, University of Southern Denmark, Odense, Denmark
- Obstetrics and Gynaecology, Odense Universitetshospital, Odense, Denmark
| | - Vibeke Rasch
- Institute of Clinical Research, University of Southern Denmark, Odense, Denmark
- Department of Gynaecology and Obstetrics, Odense Universitets hospital, Odense, Denmark
| |
Collapse
|
13
|
Docherty A, Stoyles S, Najjar R, Woolley R. Oregon PRAMS 2012–2018: Revealing racial inequity in postpartum depression. Res Nurs Health 2022; 45:163-172. [DOI: 10.1002/nur.22214] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2021] [Revised: 12/21/2021] [Accepted: 01/22/2022] [Indexed: 11/10/2022]
Affiliation(s)
- Angie Docherty
- School of Nursing Oregon Health and Science University Monmouth Oregon USA
| | - Sydnee Stoyles
- School of Nursing Oregon Health and Science University Monmouth Oregon USA
| | - Rana Najjar
- School of Nursing Oregon Health and Science University Monmouth Oregon USA
| | - Rachel Woolley
- School of Nursing Oregon Health and Science University Monmouth Oregon USA
| |
Collapse
|
14
|
Guidi J, Lucente M, Sonino N, Fava GA. Allostatic Load and Its Impact on Health: A Systematic Review. PSYCHOTHERAPY AND PSYCHOSOMATICS 2021; 90:11-27. [PMID: 32799204 DOI: 10.1159/000510696] [Citation(s) in RCA: 397] [Impact Index Per Article: 132.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/17/2020] [Accepted: 08/06/2020] [Indexed: 11/19/2022]
Abstract
INTRODUCTION Allostatic load refers to the cumulative burden of chronic stress and life events. It involves the interaction of different physiological systems at varying degrees of activity. When environmental challenges exceed the individual ability to cope, then allostatic overload ensues. Allostatic load is identified by the use of biomarkers and clinical criteria. OBJECTIVE To summarize the current knowledge on allostatic load and overload and its clinical implications based on a systematic review of the literature. METHODS PubMed, PsycINFO, Web of Science, and the Cochrane Library were searched from inception to December 2019. A manual search of the literature was also performed, and reference lists of the retrieved articles were examined.We considered only studies in which allostatic load or overload were adequately described and assessed in either clinical or non-clinical adult populations. RESULTS A total of 267 original investigations were included. They encompassed general population studies, as well as clinical studies on consequences of allostatic load/overload on both physical and mental health across a variety of settings. CONCLUSIONS The findings indicate that allostatic load and overload are associated with poorer health outcomes. Assessment of allostatic load provides support to the understanding of psychosocial determinants of health and lifestyle medicine. An integrated approach that includes both biological markers and clinimetric criteria is recommended.
Collapse
Affiliation(s)
- Jenny Guidi
- Department of Psychology, University of Bologna, Bologna, Italy,
| | | | - Nicoletta Sonino
- Department of Statistical Sciences, University of Padova, Padova, Italy.,Department of Psychiatry, State University of New York at Buffalo, Buffalo, New York, USA
| | - Giovanni A Fava
- Department of Psychiatry, State University of New York at Buffalo, Buffalo, New York, USA
| |
Collapse
|
15
|
Kim AJH, Servino L, Bircher S, Feist C, Rdesinski RE, Dukhovny S, Shaffer BL, Saxton SN. Depression and socioeconomic stressors in expectant parents with fetal congenital anomalies. J Matern Fetal Neonatal Med 2021; 35:8645-8651. [PMID: 34670457 DOI: 10.1080/14767058.2021.1992379] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
OBJECTIVE Congenital anomalies are increasingly diagnosed before birth, which may lead to psychological distress in expectant parents. While the presence of significant symptoms of depression and stress in these parents is established, understanding their context within parents' other life stressors has not been fully investigated. We sought to characterize the socioeconomic profile and depression symptoms of expectant parents in a quaternary care academic hospital's fetal care clinic. METHODS This prospective observational study enrolled pregnant persons and their partners in our fetal care clinic. The Edinburgh Postpartum Depression Scale (EPDS), Tool Assessing Patient Stress (TAPS), and a sociodemographic survey were utilized to assess parent psychological distress and socioeconomic stressors. Results were analyzed by the severity of the fetal anomaly. EPDS was repeated at two weeks postpartum. RESULTS 21.7% of pregnant subjects and 25.0% of co-parents had a positive screen on the EPDS at enrollment during their pregnancy. Mothers' EPDS scores correlated with the severity of the fetal anomaly. Many parents reported socioeconomic stressors including: living remotely from the medical center, low household income, food insecurity, unemployment, or other employment concerns, and difficulty affording living expenses. Most also reported factors that can mitigate psychological distress including social support and participation in a religion or faith. CONCLUSIONS Expectant parents with fetal anomalies should be screened for depression as well as social and economic risk factors that place them and their infants at higher risk for poor health outcomes. Further work is needed to determine the optimum interventions for addressing their depression symptoms and reducing socioeconomic stressors.
Collapse
Affiliation(s)
- Amanda J H Kim
- Pediatrics, Oregon Health & Science University, Portland, OR, USA
| | - Lauren Servino
- Pediatrics, Oregon Health & Science University, Portland, OR, USA.,Department of Obstetrics and Gynecology, Wake Forest University, Winston-Salem, NC, USA
| | - Sam Bircher
- Pediatrics, Oregon Health & Science University, Portland, OR, USA.,Department of Pediatrics, University of Utah, Salt Lake City, UT, USA
| | - Cori Feist
- Oregon Health & Science University, Portland, OR, USA
| | | | - Stephanie Dukhovny
- Obstetrics and Gynecology, Oregon Health & Science University, Portland, OR, USA
| | - Brian L Shaffer
- Obstetrics and Gynecology, Oregon Health & Science University, Portland, OR, USA.,Sutter West Bay Medical Group, San Francisco, CA, USA
| | - Sage N Saxton
- Pediatrics, Oregon Health & Science University, Portland, OR, USA
| |
Collapse
|
16
|
Zhang L, Li YH, Bu YG, Yang FF, Chen YH, Liao PP, Mu TY, Zhang CL. Evaluation of the clinical application of the Postpartum Depression Predictors Inventory-Revised for postpartum women in China. Jpn J Nurs Sci 2021; 18:e12405. [PMID: 34002484 DOI: 10.1111/jjns.12405] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2020] [Revised: 11/05/2020] [Accepted: 12/10/2020] [Indexed: 11/29/2022]
Abstract
AIM This study was designed to assess the clinical applicability of the Postpartum Depression Predictors Inventory-Revised (PDPI-R) during the 1st month following delivery among women in China and to survey the prevalence of postpartum depression (PPD)-related risk factors included in the PDPI-R in this population. METHODS This was a cross-sectional study which recruited 447 women from the People's Liberation Army Hospital in Hefei of Anhui province. All participants completed the Chinese version of the PDPI-R (PDPI-R-C) and the Chinese version of the Edinburgh Postnatal Depression Scale (C-EPDS) within 1 month of delivery. The predictive ability of the PDPI-R was then evaluated through receiver operating characteristic (ROC) curve analyses. RESULTS The PDPI-R-C was able to accurately predict 73.2% of PPD cases (area under the ROC curve = 0.732; 95% CI 0.69-0.78) using a cut-off score of 5.5, as defined by a C-EPDS score of ≥10 (sensitivity = 62.8%; specificity = 73.5%; positive predictive value = 74.5%; negative predictive value = 61.5%). All 13 risk factors in the PDPI-R-C other than socioeconomic status and marital status were associated with the risk of PPD. CONCLUSIONS The PDPI-R-C was found to be an effective and easy-to-implement tool that has promise as a means of screening for PPD in Chinese populations.
Collapse
Affiliation(s)
- Liu Zhang
- School of Nursing, Anhui Medical University, Hefei, China
| | - Yu-Hong Li
- School of Nursing, Anhui Medical University, Hefei, China
| | - Yang-Gao Bu
- Department of Obstetrics and Gynecology, The 901 Hospital of Chinese People's Liberation Army Joint Service Support Unit, Hefei, China
| | - Fang-Fang Yang
- Department of Obstetrics and Gynecology, The 901 Hospital of Chinese People's Liberation Army Joint Service Support Unit, Hefei, China
| | - Yue-Hua Chen
- Department of Obstetrics and Gynecology, The 901 Hospital of Chinese People's Liberation Army Joint Service Support Unit, Hefei, China
| | - Pei-Pei Liao
- School of Nursing, Anhui Medical University, Hefei, China
| | - Ting-Yu Mu
- School of Nursing, Anhui Medical University, Hefei, China
| | - Cheng-Lu Zhang
- School of Nursing, Anhui Medical University, Hefei, China
| |
Collapse
|
17
|
Maternal Prenatal Hair Cortisol Is Associated with Child Wheeze among Mothers and Infants with Tobacco Smoke Exposure and Who Face High Socioeconomic Adversity. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18052764. [PMID: 33803272 PMCID: PMC7967280 DOI: 10.3390/ijerph18052764] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/27/2021] [Revised: 02/25/2021] [Accepted: 02/28/2021] [Indexed: 11/17/2022]
Abstract
The association of co-occurring prenatal stress and tobacco exposures on childhood wheezing and asthma are not well established. In this study, we compared maternal prenatal hair cortisol concentration (HCC) to the maternal report of infant wheezing (y/n) in the first year of life among mother-infant dyads exposed to tobacco smoke and socioeconomic adversity. Data were obtained from the Vitamin C to Decrease Effects of Smoking in Pregnancy on Infant Lung Function study. Maternal adversity was defined by the level of education, household income, and health insurance provider. Hair was collected at delivery, representing average circulating third-trimester cortisol levels. HCC was log transformed and dichotomized into high/low cortisol groups that were placed into a multivariate model predicting wheeze. Subjects (n = 132) were primarily White with ≤high school education and receiving government-provided health insurance. Forty-five percent of infants wheezed. Average HCC was 3.39 pg/mg hair. Women with HCC > 3.55 pg/mg were more than twice as likely to report having a child who wheezed (odds ratio 2.56, 95% confidence interval 1.22-5.40; p = 0.01), adjusting for insurance provider and maternal asthma. Among this sample of dyads with prenatal smoke exposure, elevated maternal HCC was associated with child wheeze that was not diminished after consideration of covariates.
Collapse
|
18
|
Proulx D, Fantasia HC. The Lived Experience of Postpartum Women Attending Outpatient Substance Treatment for Opioid or Heroin Use. J Midwifery Womens Health 2020; 66:211-217. [PMID: 33314604 DOI: 10.1111/jmwh.13165] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2020] [Revised: 07/27/2020] [Accepted: 08/03/2020] [Indexed: 11/27/2022]
Abstract
INTRODUCTION The current opioid crisis and associated heroin epidemic have exhausted the limited community services that are available to substance users, with only about 12% of substance use treatment facilities offering special programs for pregnant women. Little information is known about the lived experience of postpartum women in outpatient substance use treatment programs, who are working toward abstinence and caring for a newborn. The purpose of this phenomenological study was to explore the lived experience of postpartum women attending outpatient substance use treatment for illicit opioid or heroin use. METHODS Individual interviews were conducted between December 2017 and November 2018, with 10 postpartum women with opioid use disorder (OUD) engaged in outpatient substance use treatment programs. A 4-step conceptual framework as suggested by Moustakas was used to understand and synthesize the lived experiences shared by the women. RESULTS Five themes emerged from the raw data: the presence of a stigma in providers of health care services, a fear of being reported to family services, children are primary motivators to remain engaged in treatment, concern for the welfare of the infant, and barriers to treatment. DISCUSSION Postpartum women with OUD and their infants have complex needs that may best be served by treatment programs that offer comprehensive care. The fear of being reported to family services and possible loss of custody influenced all aspects of their decision-making.
Collapse
Affiliation(s)
- Donna Proulx
- Division of Nursing & Health Professions, Rivier University, Nashua, New Hampshire
| | - Heidi Collins Fantasia
- Susan and Alan Solomont School of Nursing, Zuckerberg College of Health Sciences, University of Massachusetts Lowell, Lowell, Massachusetts
| |
Collapse
|
19
|
Kerr P, Kheloui S, Rossi M, Désilets M, Juster RP. Allostatic load and women's brain health: A systematic review. Front Neuroendocrinol 2020; 59:100858. [PMID: 32758482 DOI: 10.1016/j.yfrne.2020.100858] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2020] [Revised: 07/29/2020] [Accepted: 07/30/2020] [Indexed: 01/11/2023]
Abstract
Allostatic load represents the 'wear and tear' of chronic stress on the brain and body that may differ between men and women. A small but growing number of studies are assessing allostatic load in relation to mental health. The objective of this systematic review was to (1) assess sex differences in allostatic load and (2) identify allostatic load associations that are specific to women. We systematically searched for allostatic load studies that included psychosocial causes and/or psychiatric consequences. Our search focused on allostatic load studies that disaggregated by sex and that include women. Sixty-two studies were included in this systematic review. First, men appear to have higher allostatic load than women. Second, women show gender-specific variation for numerous factors such as age, race/ethnicity, adversities, social support, and health behaviors that influence associations between allostatic load and mental health. Recommendations are made to guide researchers advance sex and gender approaches.
Collapse
Affiliation(s)
- Philippe Kerr
- Center on Sex*Gender, Allostasis and Resilience, Canada; Center for Studies on Human Stress, Canada; Research Center of the Montreal Mental Health University Institute, Canada; Department of Psychiatry and Addiction, Faculty of Medicine, University of Montreal, Canada
| | - Sarah Kheloui
- Center on Sex*Gender, Allostasis and Resilience, Canada; Research Center of the Montreal Mental Health University Institute, Canada; Department of Psychiatry and Addiction, Faculty of Medicine, University of Montreal, Canada
| | - Mathias Rossi
- Center on Sex*Gender, Allostasis and Resilience, Canada; Research Center of the Montreal Mental Health University Institute, Canada; Department of Psychiatry and Addiction, Faculty of Medicine, University of Montreal, Canada
| | - Marie Désilets
- Research Center of the Montreal Mental Health University Institute, Canada
| | - Robert-Paul Juster
- Center on Sex*Gender, Allostasis and Resilience, Canada; Research Center of the Montreal Mental Health University Institute, Canada; Department of Psychiatry and Addiction, Faculty of Medicine, University of Montreal, Canada.
| |
Collapse
|
20
|
Ogawa M, Hashimoto T, Tanaka M, Tachibana M, Seki R, Sato A, Okayama J, Endo M, Saito N, Sato Y, Watanabe H, Nakazato M, Mori E, Shozu M, Iyo M. The Effect of Grandmothers' Presence on the Provision of Multidisciplinary Perinatal Support for Pregnant and Postpartum Women with Psychosocial Problems. J Multidiscip Healthc 2019; 12:1033-1041. [PMID: 31853181 PMCID: PMC6914659 DOI: 10.2147/jmdh.s228320] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2019] [Accepted: 11/27/2019] [Indexed: 12/24/2022] Open
Abstract
Background Pregnant and postpartum women with psychosocial problems are prone to face limited or absent perinatal functional support from biological grandmothers due to familial dysfunction. The study aimed to investigate whether the involvement and presence of biological maternal grandmothers providing practical support for their pre/postnatal daughters (ie, pregnant women) during the perinatal period may influence the number of support services provided by multidisciplinary agencies, including child consultation centers and municipal offices. Participants and methods This is a retrospective cohort study based on the medical records of all pregnant women with psychosocial problems that visited, gave birth, and received intervention from the hospital-based child protection unit at the Chiba University Hospital between February 2018 to March 2019. The primary outcome was to identify whether there was a difference in the number of multidisciplinary agencies providing perinatal support between pregnant women with and without the presence of functional support from biological maternal grandmothers during the perinatal period. Results We identified 114 pregnant and postpartum women with psychosocial problems. Seventy-six of these participants (66.7%) had functional support from their biological maternal grandmothers during the perinatal period, and 38 participants (33.3%) did not. The number of agencies involved with participants who lacked functional support was significantly higher than participants with functional support (t(55.14) = 2.98, p < 0.01). This finding was consistent among pregnant and postpartum primipara participants (n = 70) (t(68) = 3.87, p < 0.001), but not multipara (n = 44). Conclusion The findings indicate that the presence and functional support of biological maternal grandmothers influence the support that is needed from multidisciplinary perinatal support systems by pregnant and postpartum women with psychosocial problems. Primipara mothers without support from their own mothers may need greater multidisciplinary support.
Collapse
Affiliation(s)
- Michi Ogawa
- Department of Psychiatry, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Tasuku Hashimoto
- Department of Psychiatry, Graduate School of Medicine, Chiba University, Chiba, Japan.,Department of Psychiatry, Satsuki-kai Sodegaura-Satsukidai Hospital, Chiba, Japan
| | - Mami Tanaka
- Center for Forensic Mental Health, Chiba University, Chiba, Japan
| | - Masumi Tachibana
- Department of Psychiatry, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Ryota Seki
- Department of Psychiatry, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Aiko Sato
- Department of Psychiatry, Chiba University Hospital, Chiba, Japan
| | - Jun Okayama
- Department of Maternal-Fetal Medicine, Chiba University Hospital, Chiba, Japan
| | - Mamiko Endo
- Department of Pediatrics, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Naoki Saito
- Department of Legal Medicine, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Yasunori Sato
- Department of Preventive Medicine and Public Health, School of Medicine, Keio University, Tokyo, Japan
| | - Hiroyuki Watanabe
- Division of Medical Treatment and Rehabilitation, Center for Forensic Mental Health, Chiba University, Chiba, Japan.,Department of Psychiatry, Gakuji-kai Kimura Hospital, Chiba, Japan
| | - Michiko Nakazato
- Department of Psychiatry, Graduate School of Medicine, Chiba University, Chiba, Japan.,Department of Psychiatry, International University of Health and Welfare Atami Hospital, Atami, Japan
| | - Emi Mori
- Department of Health Promotion Nursing, Graduate School of Nursing, Chiba University, Chiba, Japan
| | - Makio Shozu
- Department of Reproductive Medicine, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Masaomi Iyo
- Department of Psychiatry, Graduate School of Medicine, Chiba University, Chiba, Japan
| |
Collapse
|