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Gallego-Gómez C, Rodríguez-Gutiérrez E, Torres-Costoso A, Martínez-Vizcaíno V, Martínez-Bustelo S, Quezada-Bascuñán CA, Ferri-Morales A. Urinary incontinence increases risk of postpartum depression: systematic review and meta-analysis. Am J Obstet Gynecol 2024; 231:296-307.e11. [PMID: 38437894 DOI: 10.1016/j.ajog.2024.02.307] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2023] [Revised: 02/22/2024] [Accepted: 02/27/2024] [Indexed: 03/06/2024]
Abstract
OBJECTIVE Postpartum depression is one of the most common complications after childbearing. Urinary incontinence is a frequent symptom during pregnancy and the postnatal period, often being the first time that women experience it. This systematic review and meta-analysis aimed to synthesize the evidence on the association between urinary incontinence and postpartum depression and to assess whether this association becomes weaker at 6 months after childbirth. DATA SOURCES MEDLINE, Embase, Cochrane Library, Web of Science, and PsycINFO were searched from inception to December 26, 2023. STUDY ELIGIBILITY CRITERIA Cross-sectional and cohort studies addressing the association between urinary incontinence and postpartum depression were included. METHODS Pooled odds ratios and their 95% confidence intervals, and 95% prediction intervals were estimated using a DerSimonian and Laird random-effects model for the association between urinary incontinence and postpartum depression. Subgroup analyses were conducted on the basis of time after delivery (<6 or ≥6 months). The risk of bias was assessed with the National Institutes of Health Quality Assessment Tool for Observational Cohort Studies. RESULTS Eleven published studies were included in the systematic review and meta-analysis. Overall, the odds ratio for the association between urinary incontinence and postpartum depression was 1.45 (95% confidence interval, 1.11-1.79; 95% prediction interval, 0.49-2.40; I2=65.9%; P=.001). For the 7 cohort studies, the odds ratio was 1.63 (95% confidence interval, 1.35-1.91; 95% prediction interval, 1.14-2.13; I2=11.1%; P=.345). For the 4 cross-sectional studies, the odds ratio was 1.05 (95% confidence interval, 1.04-1.05; 95% prediction interval, 1.04-1.06; I2=0.0%; P=.413). According to the time after delivery, the odds ratio estimates for cohort studies with a postpartum period <6 months were 1.44 (95% confidence interval, 1.07-1.81; prediction interval, 0.63-2.25; I2=0.0%; P=.603) and 1.53 (95% confidence interval, 1.16-1.89; prediction interval, 0.41-2.65; I2=50.7%; P=.087) for those with a postpartum period ≥6 months. CONCLUSION This systematic review and meta-analysis suggests that urinary incontinence may be a potential predictor of postpartum depression. Thus, it is important that health care professionals offer support and treatment options to women who experience these conditions.
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Affiliation(s)
- Cristina Gallego-Gómez
- Faculty of Physiotherapy and Nursing, University of Castilla-La Mancha, Toledo, Spain; Physiotherapy Unit, Health Center of Camarena, Toledo, Spain; Toledo Physiotherapy Research Group (GIFTO), University of Castilla-La Mancha, Toledo, Spain
| | | | - Ana Torres-Costoso
- Faculty of Physiotherapy and Nursing, University of Castilla-La Mancha, Toledo, Spain; Health and Social Research Center, University of Castilla-La Mancha, Cuenca, Spain
| | - Vicente Martínez-Vizcaíno
- Health and Social Research Center, University of Castilla-La Mancha, Cuenca, Spain; Facultad de Ciencias de la Salud, Universidad Autónoma de Chile, Talca, Chile
| | - Sandra Martínez-Bustelo
- Psychosocial Intervention and Functional Rehabilitation Research Group, Faculty of Physiotherapy, University of A Coruña, A Coruña, Spain
| | | | - Asunción Ferri-Morales
- Faculty of Physiotherapy and Nursing, University of Castilla-La Mancha, Toledo, Spain; Health and Social Research Center, University of Castilla-La Mancha, Cuenca, Spain
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Lee LC, Hung CH, Wu WR. Trajectory and Determinants of Quality of Life Among Postpartum Women. West J Nurs Res 2024; 46:563-570. [PMID: 38824397 DOI: 10.1177/01939459241257869] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2024]
Abstract
BACKGROUND The postpartum period is a critical phase in which postpartum women experience dynamic changes in their physiology, psychology, and family status. OBJECTIVE This study investigated the changes in women's quality of life (QoL) during the first, third, and sixth months of the postpartum period and their associated factors. METHODS A single-group repeated-measure design was used to collect data from 282 postpartum women recruited from a regional hospital in Taiwan. We used the brief World Health Organization Quality of Life scale, Social Support Scale, and Edinburgh Postnatal Depression Scale to assess postpartum women's quality of life, social support, and postpartum depressive symptoms, respectively. The data were analyzed using trajectory analysis and generalized estimating equations. RESULTS The trajectory analysis indicated that postpartum women could be categorized into low, medium, and high QoL groups. Although the medium and high QoL groups maintained stable QoL levels, the low QoL group experienced a linear decrease in QoL over time. Moreover, the determinants of postpartum women's QoL were immigrant status, employment status, family type, social support, and postpartum depression. CONCLUSIONS Health care providers should assess these determinants of postpartum QoL in perinatal women to identify those at risk of low postpartum quality of life. Early assessment and intervention by health care providers could significantly improve the health status of women after childbirth.
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Affiliation(s)
- Li-Chun Lee
- Department of Nursing, Asia University, Taichung, Taiwan
| | | | - Wan-Ru Wu
- Department of Nursing, Tzu Chi University, Hualien, Taiwan
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Piernicka M, Ossowski Z, Kortas J, Bojar D, Labun J, Szumilewicz A. Can We Improve the Technique of Pelvic Floor Muscle Exercises in Postmenopausal Women Using a Single Electromyography Biofeedback Session? An Experimental Study. J Clin Med 2024; 13:3062. [PMID: 38892773 PMCID: PMC11172777 DOI: 10.3390/jcm13113062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2024] [Revised: 05/13/2024] [Accepted: 05/21/2024] [Indexed: 06/21/2024] Open
Abstract
Background: The aim of this study was to assess the effect of a single session of EMG biofeedback in a group of postmenopausal women on improving technique in pelvic floor muscle (PFM) contractions (exercises). Methods: Sixty-two women aged 60 to 85 years (69 ± 4; mean ± SD) participated in the study. We assessed the technique of PFM exercises via surface electromyography (EMG) using a vaginal probe. A single assessment sequence consisted of 11 exercises involving the conscious contraction of the PFM, during which the order of activation for selected muscles was determined. We then awarded scores for exercise technique on a scale from 0 to 4, where 4 represented the best technique and 0 represented no activation of PFMs. In the second assessment, we used a biofeedback method to teach PFM exercise technique. Results: In total, 32% (n = 20) of the participants were unable to correctly perform the first PFM contraction, scoring 0.9 ± 0.79. After a single EMG biofeedback session, these women received 1.7 ± 1.08 scores (p = 0.003). In the tenth exercise, there was also a statistically significant improvement between the first (baseline) and second assessment (1.7 ± 1.34 and 2.15 ± 1.09, respectively; p = 0.037). For the remaining exercises, the results were not statistically significant, but we observed a positive trend of change. Conclusions: The use of a single EMG biofeedback session is an effective method of improving technique in PFM exercises in a group of women who initially performed them incorrectly.
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Affiliation(s)
- Magdalena Piernicka
- Faculty of Physical Culture, Gdansk University of Physical Education and Sport, 80-336 Gdansk, Poland; (Z.O.); (J.K.); (D.B.); (J.L.); (A.S.)
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Liga AD, Jabir YN, Assefa S, Debelew GT, Worku BT. Identifying associated factors in relation to health-related quality of life among postpartum women in Jimma town: A community-based cross-sectional study. Heliyon 2024; 10:e29328. [PMID: 38644852 PMCID: PMC11033102 DOI: 10.1016/j.heliyon.2024.e29328] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Revised: 04/05/2024] [Accepted: 04/05/2024] [Indexed: 04/23/2024] Open
Abstract
Background The quality of life (QoL) of women during the postpartum period is affected by their living circumstances, reproductive history, exposure to and use of antenatal care, etc. The quality of life (QoL) issues associated to postpartum health among Ethiopian women have not been adequately examined in studies. Therefore, this study identified associated factors in relation to the health-related quality of life (QOL) among postpartum women in Jimma Town, Ethiopia. Methods A structured face-to-face interview and a self-administered questionnaire were utilized in a community-based cross-sectional study to obtain data from 397 postpartum women from May 15 to June 14, 2022, using a multistage sampling strategy. The data analysis utilized several descriptive statistics. Multiple logistic models were run on factors that were significant at the 25 % level in univariate analysis. Adjusted odds ratios and 95 % confidence intervals were computed to identify associated factors. Results The majority (51.2 %) of postpartum women had a low health-related quality of life, with a mean score of 50.58. Women poor health-related quality of life (QoL) was associated with age (AOR = 10.09; CI: 3.45-29.51), non-formal education of partners (AOR = 3.67; CI: 1.25-10.72), multiparousness (AOR = 2.21; CI: 1.14-4.29), unplanned pregnancy (AOR = 7.36; CI: 1.98-27.37), giving birth to a dead baby (AOR = 3.15; CI: 1.54-6.42), and not admitted to the hospital while pregnant (AOR = 5.50; CI: 3.86-26.30). Conclusion The finding revealed that the majority of postpartum women reported poorer health-related QoL. Thus, stakeholders should give attention to significant factors to set up measures to prevent and improve women's postpartum health-related QoL, and should be aware of women about the risk associated with poor health-related QoL.
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Affiliation(s)
- Abebe Debu Liga
- Department of Statistics, College of Natural and Computational Sciences,
Wolkite University, Wolkite, Ethiopia
| | - Yasin Negash Jabir
- Department of Statistics, College of Natural Science, Jimma University,
Jimma, Ethiopia
| | - Seble Assefa
- Department of Nursing, Faculty of Health Sciences, Jimma University,
Jimma, Ethiopia
| | - Gurmesa Tura Debelew
- Department of Population and Family Health, Faculty of Public Health,
Jimma University, Jimma, Ethiopia
| | - Bekalu Teka Worku
- Department of Population and Family Health, Faculty of Public Health,
Jimma University, Jimma, Ethiopia
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Brekke M, Småstuen MC, Glavin K, Amro A, Solberg B, Øygarden AMU, Sæther KM, Haugland T. The impact of New Families home visiting program on first-time mothers' quality of life and its association with social support: a non-randomized controlled study. BMC Public Health 2023; 23:2457. [PMID: 38066502 PMCID: PMC10704737 DOI: 10.1186/s12889-023-17285-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Accepted: 11/21/2023] [Indexed: 12/18/2023] Open
Abstract
BACKGROUND The transition to motherhood is characterized by physical, psychological, social, and relational changes. Quality of life (QoL) changes substantially during this transition. Higher QoL is associated with social support, essential for coping with the challenges and changes of becoming a mother. An early universal home visiting program (New Families) is developed to strengthen and support families. The study aims to evaluate the impact of New Families on first-time mothers' QoL and to investigate the association between their QoL, social support, and selected possible predictive factors. METHODS A prospective non-randomized controlled study with parallel group design. Child Health Services in five city districts of Oslo were matched in intervention and control groups. First-time mothers were allocated based on the residential area and assessed at pregnancy week 28 (N = 228), six weeks postpartum (N = 184), and three months postpartum (N = 167). Measures of the World Health Organization Quality of Life brief, Perinatal Infant Care Social Support Scale, and background variables were collected from October 2018 to June 2020. Multivariate linear regression models were applied to examine intervention impact and assess associations. RESULTS Our data did not reveal a significant association between New Families intervention and the QoL levels of first-time mothers at three months postpartum. Thus, we analyzed the whole sample together. Emotional support was significantly associated with higher QoL levels in the physical health (B = 0.19, 95%CI [0.04 to 0.34]) and social relationships (B = 0.40, 95%CI [0.20 to 0.60]) domains. Appraisal support was significantly associated with higher QoL levels in the psychological (B = 0.34, 95%CI [0.18 to 0.50]) and environment (B = 0.33, 95%CI [0.19 to 0.48]) domains. QoL levels in pregnancy were significantly associated with QoL levels postpartum, showing small to medium effect size (ES = 0.30 to 0.55), depending on the domain. CONCLUSIONS Further research, including qualitative interviews, could provide more insights into the impact of New Families on QoL. A positive association between QoL levels in pregnancy and postpartum suggests that postnatal interventions targeting improved QoL could potentially improve postpartum QoL. Emotional and appraisal support seems beneficial for first-time mothers' QoL and could be provided and facilitated by public health nurses. TRIAL REGISTRATION clinicaltrial.gov NCT04162626.
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Affiliation(s)
- Malene Brekke
- Centre of Diaconia and Professional Practice, VID Specialized University, Oslo, Norway.
- Faculty of Health Sciences, VID Specialized University, Postboks 184 Vinderen, Oslo, 0319, Norway.
| | - Milada Cvancarova Småstuen
- Faculty of Health Sciences, VID Specialized University, Postboks 184 Vinderen, Oslo, 0319, Norway
- Oslo Metropolitan University, Oslo, Norway
| | - Kari Glavin
- Faculty of Health Sciences, VID Specialized University, Postboks 184 Vinderen, Oslo, 0319, Norway
| | - Amin Amro
- Faculty of Health Sciences, VID Specialized University, Postboks 184 Vinderen, Oslo, 0319, Norway
| | - Beate Solberg
- Centre of Diaconia and Professional Practice, VID Specialized University, Oslo, Norway
| | | | - Kristin Marie Sæther
- Centre of Diaconia and Professional Practice, VID Specialized University, Oslo, Norway
- Faculty of Health Sciences, VID Specialized University, Postboks 184 Vinderen, Oslo, 0319, Norway
| | - Trude Haugland
- Faculty of Health Sciences, VID Specialized University, Postboks 184 Vinderen, Oslo, 0319, Norway
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Benhammou V, Marchand-Martin L, Pierrat V, Charkaluk ML, Romito P, Kaminski M, Ancel PY, Saurel-Cubizolles MJ. Maternal health-related quality of life at 1 year after a preterm birth: role of socioeconomic status at birth. J Epidemiol Community Health 2023; 78:25-32. [PMID: 37752012 DOI: 10.1136/jech-2023-220591] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2023] [Accepted: 09/01/2023] [Indexed: 09/28/2023]
Abstract
BACKGROUND Maternal problems in the postpartum period may lead to suboptimal long-term health for women and could affect mother-child attachment. Social disadvantage is a risk factor for preterm birth, which carries its own burden of health issues and stress. The main aim of this study was to investigate the role for social factors in mothers' physical and emotional health-related quality of life (HRQoL) at 1 year after a preterm birth. METHODS EPIPAGE-2 is a French nationwide, prospective, population-based cohort of preterm children born before 35 weeks' gestation (N=3614 women). At birth, detailed data on the family's social status were collected. At 1 year after birth, mothers completed a mailed questionnaire to report information on their HRQoL, assessed by the Medical Outcomes Study 12-item Short Form. We used multivariate linear regression models to assess the association between social factors and maternal HRQoL. RESULTS At 1 year after childbirth, the emotional HRQoL of mothers of preterm children was worse than their physical HRQoL, even in women without any previous signs of psychological distress at the infant's discharge from hospital. Baseline social characteristics were the most important factors influencing the physical component of HRQoL. None of the studied social factors had any clear association with the mental component of HRQoL. CONCLUSION Our study underlines the importance of social disadvantage during pregnancy as risk factors for poor physical HRQoL at 1 year after a preterm birth.
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Affiliation(s)
- Valerie Benhammou
- Université Paris Cité, CRESS, Obstetrical Perinatal and Pediatric Epidemiology Research Team, EPOPé, INSERM, Paris, France
| | - Laetitia Marchand-Martin
- Université Paris Cité, CRESS, Obstetrical Perinatal and Pediatric Epidemiology Research Team, EPOPé, INSERM, Paris, France
| | - Véronique Pierrat
- Université Paris Cité, CRESS, Obstetrical Perinatal and Pediatric Epidemiology Research Team, EPOPé, INSERM, Paris, France
- Department of Neonatal Medicine, CHI Créteil, Créteil, France
| | - Marie-Laure Charkaluk
- Université Paris Cité, CRESS, Obstetrical Perinatal and Pediatric Epidemiology Research Team, EPOPé, INSERM, Paris, France
- Department of Neonatal Medicine, Lille Catholic Institute Hospital Group, Lomme, France
| | - Patrizia Romito
- Department of Human Studies, University of Trieste, Trieste, Italy
| | - Monique Kaminski
- Université Paris Cité, CRESS, Obstetrical Perinatal and Pediatric Epidemiology Research Team, EPOPé, INSERM, Paris, France
| | - Pierre-Yves Ancel
- Université Paris Cité, CRESS, Obstetrical Perinatal and Pediatric Epidemiology Research Team, EPOPé, INSERM, Paris, France
- Center for Clinical Investigation P1419, APHP - Centre Université Paris-Cité, Paris, France
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7
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Suar G, Cevik F, Simal Yavuz N, Ozerdogan N. Urinary incontinence in the postpartum 1-year period: Its prevalence and effect on psychosocial status of women. Low Urin Tract Symptoms 2023; 15:191-199. [PMID: 37365141 DOI: 10.1111/luts.12495] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Revised: 06/12/2023] [Accepted: 06/14/2023] [Indexed: 06/28/2023]
Abstract
OBJECTIVES In this study, it was aimed to determine the prevalence and effect of urinary incontinence in the postpartum 1 year period on psychosocial status of women. METHODS This study with a cross-sectional and descriptive design was conducted between 01.10.2021 and 01.04.2022. There were 406 women in the postpartum 8 weeks to 1 year period who participated in the study. The data were collected through Identifying Information Form, Edinburgh Postnatal Depression Scale, and Nottingham Health Profile. RESULTS In the study, it was determined that 21.9% of the women in the postpartum period experienced urinary incontinence problems, and that the most common type of incontinence experienced was stress incontinence (62.9%). Edinburgh Postnatal Depression Scale mean score of the women who experienced urinary incontinence problems in the postpartum period was found to be significantly higher compared to those who did not experience this problem (P < .05), but no significant difference was found between the rates of those with depression risk according to the cutoff point of the scale (≥13 points). As a result of the regression analysis, it was determined that the increase in depression risk resulted not from urinary incontinence but from age and parity. It was also determined that the mean scores of the women who experienced incontinence problems from the subscales of Nottingham Health profile was significantly high (P < .05). CONCLUSIONS In conclusion, urinary incontinence in the postpartum period is a prevalent problem affecting approximately one-fifth of women. In addition, this problem negatively affects the psychological and social dimensions of women's health.
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Affiliation(s)
- Gulennur Suar
- Birth Unit, Kocaeli Darica Farabi Training and Research Hospital, Kocaeli, Turkey
| | - Feride Cevik
- Department of Midwifery, Eskisehir Osmangazi University Faculty of Health Science, Eskisehir, Turkey
| | - Nurgul Simal Yavuz
- Department of Midwifery, Lokman Hekim University Faculty of Health Sciences, Ankara, Turkey
| | - Nebahat Ozerdogan
- Department of Midwifery, Eskisehir Osmangazi University Faculty of Health Science, Eskisehir, Turkey
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Cox JM, Sánchez-Polán M, Mota P, Barakat R, Nagpal TS. A scoping review exploring stigma associated with postpartum urinary incontinence. Int Urogynecol J 2023; 34:1997-2005. [PMID: 37060372 DOI: 10.1007/s00192-023-05526-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Accepted: 03/19/2023] [Indexed: 04/16/2023]
Abstract
INTRODUCTION AND HYPOTHESIS Postpartum urinary incontinence (UI) is prevalent, yet health-seeking behaviours for prevention and treatment are markedly low. Health-related stigma refers to conditions that may be socially devalued and considered deviating from "expected norms" and is a barrier to equitable health care. It may be plausible that stigma is associated with postpartum UI and leads to avoiding health-seeking behaviours, which this scoping review sought to examine and summarize. METHODS The Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for scoping reviews was followed. The following keywords were used to develop a search strategy: Postpartum, Urinary Incontinence and Stigma. The search was carried out on PubMed, PsycInfo, Scopus, CINAHL, Web of Science and ProQuest Dissertation and Theses Global. All study designs (clinical trials, observational studies, qualitative studies) were eligible for inclusion. Data were extracted and mapped to identify causal factors of postpartum UI stigma and implications for outcomes and behaviours. RESULTS Twelve studies were included. Most studies utilized questionnaires assessing constructs related to quality of life that also captured potential stigma, or interviews. Sources of postpartum UI stigma included community values surrounding UI and self-stigma, whereby participants directed stereotypes associated with urinary leakage towards themselves. Implications of postpartum UI stigma included negative mental emotions such as shame and embarrassment, which led to avoiding situations where they needed to disclose symptoms, including in health care environments. CONCLUSIONS Future research requires a purposeful assessment of postpartum UI stigma to learn from lived experience how to mitigate stigma and improve quality of care.
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Affiliation(s)
- Jordyn M Cox
- Kinesiology, Sport and Recreation, University of Alberta, 116 Street and 85 Avenue, Edmonton, AB, T6G 2R3, Canada
| | - Miguel Sánchez-Polán
- AFIPE Research Group, Faculty of Physical Activity and Sport Sciences-INEF, Universidad Politécnica de Madrid, Madrid, Spain
| | - Patrícia Mota
- H&TRC- Health & Technology Research Center, ESTeSL- Escola Superior de Tecnologia da Saúde, Instituto Politécnico de Lisboa, Lisboa, Portugal
- Univ Lisboa, Fac. Motricidade Humana, CIPER, LBMF, 1499-002, Lisboa, Portugal
| | - Ruben Barakat
- AFIPE Research Group, Faculty of Physical Activity and Sport Sciences-INEF, Universidad Politécnica de Madrid, Madrid, Spain
| | - Taniya S Nagpal
- Kinesiology, Sport and Recreation, University of Alberta, 116 Street and 85 Avenue, Edmonton, AB, T6G 2R3, Canada.
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Saleh EA, Walton L, Said S, Raigangar V, Kim M. The association between Diastasis recti abdominis and pelvic floor
dysfunction, sacroiliac joint dysfunction, and quality of life among postpartum
women after Cesarean delivery. PHYSIKALISCHE MEDIZIN, REHABILITATIONSMEDIZIN, KURORTMEDIZIN 2023. [DOI: 10.1055/a-1962-4221] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/18/2023]
Abstract
Abstract
Purpose The goal of this study is to see if there's a predictive
relationship between diastasis rectus abdominis and pelvic floor dysfunction,
sacroiliac joint dysfunction, and postpartum women's health-related
quality of life.
Method This cross-sectional, correlative study focused on 32 postpartum
mothers aged 18 to 45 years old. Real Ultrasound Sonographic Imaging (RUSI) was
used to determine DRA. The Pelvic Floor Disability Index was used to assess
pelvic floor dysfunction (PFDI). The Active Straight Leg Raise Test (ASLR), the
Long Dorsal Sacral Ligament Test (LDL), and the Posterior Pelvic Provocation
Test (P4) were also investigated. The Short Form-12 (SF-12) Survey was used to
assess health-related quality of life (HRQoL).
Results A negative correlation between DRA and postpartum period was
recorded (ρ=0.0001). The following categories showed a
significant positive correlation between DRA and Pelvic floor dysfunction:
Pelvic Organ Prolapse Distress Inventory-6 (POPDI-6) corelated positively with
DRA (ρ =0.01); Colorectal-Anal Distress Inventory-8 (CRAD-8)
(ρ =0.02); Urinary Distress Inventory-6 (UDI-6) (ρ
=0.00). There was no correlation between DRA and sacroiliac joint
dysfunction (ρ =0.8).
Conclusion DRA was discovered to be a strong predictor of pelvic floor
dysfunction, such as prolapse, colorectal-anal dysfunction, and urine distress.
There was no evidence of a link between DRA and sacroiliac joint dysfunction or
HRQoL.
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Affiliation(s)
- Enas Abu Saleh
- Physiotherapy, University of Sharjah, Sharjah, United Arab
Emirates
| | - Lori Walton
- Department of Physical Therapy, University of Scranton, Scranton,
United States
| | - Sahar Said
- Physical medicine and rehabilitation, Dubai Hospital, Dubai, United
Arab Emirates
| | - Veena Raigangar
- Physiotherapy, University of Sharjah, Sharjah, United Arab
Emirates
| | - Meeyoung Kim
- Physiotherapy, University of Sharjah, Sharjah, United Arab
Emirates
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Ilska M, Kołodziej-Zaleska A, Banaś-Fiebrich E, Brandt-Salmeri A, Janowska-Tyc E, Łyszczarz A, Rzewiczok J, Piela B, Cnota W. Health-Related Quality-of-Life among Pregnant Women after First, Second, and Multiple Cesarean Sections in the Perinatal Period: A Short-Term Longitudinal Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:16747. [PMID: 36554628 PMCID: PMC9779739 DOI: 10.3390/ijerph192416747] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/16/2022] [Revised: 12/04/2022] [Accepted: 12/09/2022] [Indexed: 06/17/2023]
Abstract
The primary objective of this study was to compare assessments of health-related quality-of-life (HRQoL) in women who had a medical qualification for cesarean section (CS), depending on the number of CSs in their medical history. A short longitudinal study was conducted among 115 women on the day before a planned cesarean section (CS)-T1, and on the third day after CS-T2. They were divided into three groups. G1: no CS (n = 17); G2: one CS (n = 34); G3: two or more CSs (n = 64). Participants completed a set of questionnaires concerning sociodemographic aspects and psychological outcomes: the HRQoL questionnaire (EQ-5D-3L). A chi-square test, McNemar's test, and repeated measures ANOVA were used to compare the three groups in T1 and T2. Regardless of the number of CSs, before a CS, women mainly experience health problems with pain and anxiety/depression, and after a CS, mostly problems with pain, usual activity, and mobility. All participants experienced an increase in the amount of health problems with mobility and pain after a CS. Women who have had two or more CSs also had problems with self-care and usual activities. Women who have had one or two CSs experienced a decrease in the general assessment of the HRQoL, which is not observed in the group of women with multiple CSs. However, the HRQoL of women in the group with multiple CSs was lower before the CS than in the other groups. The results indicated the significance of the number of CSs, not only in postoperative, but also in preoperative HRQoL.
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Affiliation(s)
- Michalina Ilska
- Institute of Psychology, University of Silesia in Katowice, Grażyńskiego Street 53, 40-126 Katowice, Poland
| | - Anna Kołodziej-Zaleska
- Institute of Psychology, University of Silesia in Katowice, Grażyńskiego Street 53, 40-126 Katowice, Poland
| | - Ewa Banaś-Fiebrich
- Clinical Department of Perinatology, Gynaecology and Obstetrics in Ruda Ślaska, Medical University of Silesia, W. Lipa Street 2, 41-703 Ruda Śląska, Poland
| | - Anna Brandt-Salmeri
- Institute of Psychology, University of Silesia in Katowice, Grażyńskiego Street 53, 40-126 Katowice, Poland
| | - Ewa Janowska-Tyc
- Clinical Department of Perinatology, Gynaecology and Obstetrics in Ruda Ślaska, Medical University of Silesia, W. Lipa Street 2, 41-703 Ruda Śląska, Poland
| | - Anna Łyszczarz
- Clinical Department of Perinatology, Gynaecology and Obstetrics in Ruda Ślaska, Medical University of Silesia, W. Lipa Street 2, 41-703 Ruda Śląska, Poland
| | - Justina Rzewiczok
- Clinical Department of Perinatology, Gynaecology and Obstetrics in Ruda Ślaska, Medical University of Silesia, W. Lipa Street 2, 41-703 Ruda Śląska, Poland
| | - Bogusława Piela
- Clinical Department of Perinatology, Gynaecology and Obstetrics in Ruda Ślaska, Medical University of Silesia, W. Lipa Street 2, 41-703 Ruda Śląska, Poland
| | - Wojciech Cnota
- Clinical Department of Perinatology, Gynaecology and Obstetrics in Ruda Ślaska, Medical University of Silesia, W. Lipa Street 2, 41-703 Ruda Śląska, Poland
- Faculty of Health Sciences in Katowice, Medical University of Silesia, 41-703 Ruda Śląska, Poland
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11
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Health-related quality of life among postpartum women with preeclampsia, southern Ethiopia: a prospective cohort study. Health Qual Life Outcomes 2022; 20:147. [PMID: 36309707 PMCID: PMC9618225 DOI: 10.1186/s12955-022-02061-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2022] [Accepted: 10/14/2022] [Indexed: 11/21/2022] Open
Abstract
Background Preeclampsia affects the health of the mother and the fetus during pregnancy and childbirth. To date, little is known about the impact of preeclampsia on postpartum health-related to quality of life (HRQoL) in the Sidama region of southern Ethiopia. This study aimed to measure the HRQoL and its contributing factors among postpartum women with preeclampsia in the Sidama region. Methods A prospective cohort study was conducted by enrolling pregnant women at ≥20 weeks of gestation up until the 37th week of gestation. We then followed them until 12 weeks after delivery. A locally validated, World Health Organization Quality-of-Life-BREF (WHOQOL-BREF) tool was used to assess participants’ HRQoL at two time points; the 6th and 12th weeks postpartum. Assessment of HRQoL of participants was based on total scores on the WHOQoL-BREF. Higher scores on the WHOQoL-BREF reflected a higher HRQoL. Multiple linear regression analyses were performed to evaluate the contributing factors to HRQoL. The level of significance was determined at a p-value of < 0.05. Results The HRQoL of postpartum women with preeclampsia significantly improved over time from 6 (151 ± 17) to 12 weeks (167 ± 18), p < 0.001). However, the overall HRQoL scores were lower (156 ± 16, p < 0.001) among women with preeclampsia compared to normotensive women (181 ± 21). An experience of early neonatal death was found to have a significant negative effect on the HRQoL of women with preeclampsia [β = − 2.1, 95% CI: − 3.43– − 0.85] compared to normotensive women who did not have early neonatal death. At 6 weeks of the postpartum period, the physical domain was found to have a significantly higher contribution to the lower HRQoL [β = 1.04, 95% CI: 0.88–1.12] compared to normotensive women, while other factors were constant. Conclusions The HRQoL of women with preeclampsia improved over time from 6 to 12 weeks in the postpartum period. Lower HRQoL was observed among postpartum women with preeclampsia, especially among those who experienced preterm birth or early neonatal death. The effects of preeclampsia on the HRQoL of postpartum women should be considered in redesigning postnatal care intervention services. Supplementary Information The online version contains supplementary material available at 10.1186/s12955-022-02061-2.
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Brekke M, Berg RC, Amro A, Glavin K, Haugland T. Quality of Life instruments and their psychometric properties for use in parents during pregnancy and the postpartum period: a systematic scoping review. Health Qual Life Outcomes 2022; 20:107. [PMID: 35810315 PMCID: PMC9271249 DOI: 10.1186/s12955-022-02011-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Accepted: 06/26/2022] [Indexed: 11/23/2022] Open
Abstract
Purpose To identify instruments used to measure parents’ Quality of Life (QoL) during pregnancy and the postpartum period, and to describe their characteristics and psychometric properties. Methods For this scoping review we conducted systematic literature searches in MEDLINE, EMBASE, PsychINFO, CINAHL and HaPI in mid-December 2020, to identify studies evaluating psychometric properties. The COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) were used to define and categorize psychometric properties. Two reviewers screened the studies independently, and customized screening questions were used to assess eligibility against inclusion criteria. Data were systematically extracted into a predesigned data charting matrix, and descriptively analyzed. Results The searches identified 5671 studies, of which 53 studies met the inclusion criteria. In total, there were 19 QoL instruments: 12 generic and seven period specific. The most reported instruments were SF-36, SF-12 and WHOQOL-BREF, and the most evaluated instruments were SF-12, WHOQOL-BREF, QOL-GRAV, and PQOL. We found that none of the identified instruments had been evaluated for all nine psychometric properties recommended by the COSMIN. The most reported psychometric properties were internal consistency and structural validity. The instruments were primarily assessed in parents residing in Asia (50%), and 83% of the studies were conducted from 2010 to 2020. Only three studies included psychometric measures assessed on fathers. Conclusion Our review shows there is extensive evidence on the internal consistency and structural validity of QoL instruments used on parents during pregnancy and the postpartum period, but that the evidence on other psychometric properties is sparse. Validation studies and primary studies are needed to provide evidence on the reliability, validity, responsiveness, and interpretability of QoL instruments for this target group, in particular for fathers and partners. Supplementary Information The online version contains supplementary material available at 10.1186/s12955-022-02011-y.
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Affiliation(s)
| | - Rigmor C Berg
- Norwegian Institute of Public Health, Oslo, Norway.,The University of Tromsø, Tromsö, Norway
| | - Amin Amro
- VID Specialized University, Oslo, Norway
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El-Sherbeeny N, El Tantawy A, Ibrahim O, Elsayed M, El-Okda N, Hassan H. Insomnia and sleep quality among women during the perinatal period. MIDDLE EAST CURRENT PSYCHIATRY 2022. [DOI: 10.1186/s43045-022-00209-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
Insomnia is the most common sleep disorder affecting sleep quality and quality of life among women during the perinatal period. The aim of the study is to study the frequency of insomnia and sleep quality among perinatal women and their effect on quality of life: 131 participants; 64 perinatal and 67 control groups from the outpatient clinics of Suez Canal University Hospital, Ismailia, Egypt. DSM-5 criteria were used to diagnose insomnia. Sleep quality was assessed using PSQI, and SF-36 questionnaire was used for assessment of health-related quality of life.
Results
Insomnia was statistically significant higher among the perinatal group than the control; 28.1% and 10.4%, respectively (P < 0.05). The perinatal women had poor sleep quality as compared with the control group with a higher mean global PSQI score; 8.02 ± 2.97 and 4.97 ± 2.45, respectively (P < 0.05). The quality of life in the perinatal group was lower than the control group with scores of 54.96 ± 14.63 versus 62.34 ± 14.63, respectively.
Conclusions
Insomnia and poor sleep quality are found in higher frequency in perinatal women than their counterpart control. The study also showed a significant impact of these changes on maternal HRQoL.
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Evans K, Fraser H, Uthman O, Osokogu O, Johnson S, Al-Khudairy L. The effect of mode of delivery on health-related quality-of-life in mothers: a systematic review and meta-analysis. BMC Pregnancy Childbirth 2022; 22:149. [PMID: 35193505 PMCID: PMC8864819 DOI: 10.1186/s12884-022-04473-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2021] [Accepted: 02/11/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Previous research is inconclusive on the effects of mode of delivery on maternal health-related quality-of-life (HRQoL). We conducted a systematic review and meta-analysis to assess the current evidence for associations between mode of delivery and postpartum health-related quality-of-life. METHODS Electronic databases MEDLINE ALL (OVID), Web of Science, The Cochrane Library, CINAHL and EMBASE (OVID) were searched for English written articles investigating the relationship between mode of delivery and quality-of-life published form inception to 15th October 2020. Two reviewers independently screened titles and abstracts, assessed full texts, and extracted data. Meta-analysis was conducted where possible. RESULTS Twenty-one studies, including 19,879 women, met the inclusion criteria. A meta-analysis of 18 studies found HRQoL scores were significantly higher for women after vaginal delivery in comparison to caesarean (emergency and elective combined) (Effect Size (ES) 0.17, 95% CI 0.01-0.25, n = 7665) with highest scores after assisted vaginal delivery (ES 0.21, 95% CI 0.13-0.30, n = 2547). Physical functioning (ES 11.18, 95% CI = 2.29-20.06, n = 1746), physical role (ES 13.10, 95% CI = 1.16-25.05, n = 1471), vitality (ES 6.31, 95% CI = 1.14-10.29, n = 1746) and social functioning (ES 5.69, 95% CI = 1.26-10.11, n = 1746) were significantly higher after vaginal delivery compared to caesarean. CONCLUSIONS Health-related quality-of-life scores were higher for women after vaginal delivery in comparison to caesarean section. Consequently, women should be encouraged to deliver vaginally where possible. The findings of this research should be available to the relevant population to help support informed choice.
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Affiliation(s)
- Kate Evans
- Warwick Medical School, University of Warwick, Coventry, CV4 7AL, England.
| | - Hannah Fraser
- Warwick Medical School, University of Warwick, Coventry, CV4 7AL, England
| | - Olalekan Uthman
- Warwick Medical School, University of Warwick, Coventry, CV4 7AL, England
| | - Osemeke Osokogu
- Warwick Medical School, University of Warwick, Coventry, CV4 7AL, England
| | - Samantha Johnson
- Warwick Medical School, University of Warwick, Coventry, CV4 7AL, England
| | - Lena Al-Khudairy
- Warwick Medical School, University of Warwick, Coventry, CV4 7AL, England
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Valla L, Helseth S, Småstuen MC, Misvær N, Andenæs R. Factors associated with maternal overall quality of life six months postpartum: a cross sectional study from The Norwegian Mother, Father and Child Cohort Study. BMC Pregnancy Childbirth 2022; 22:4. [PMID: 34979992 PMCID: PMC8722151 DOI: 10.1186/s12884-021-04303-5] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2021] [Accepted: 11/30/2021] [Indexed: 01/07/2023] Open
Abstract
Background Having good Quality of Life (QoL) is essential, particularly for women after childbirth. However, little is known about the factors associated with maternal QoL after giving birth. We aimed to investigate the relationship between characteristics of the mother (socio-demographic variables), selected symptoms (depression and joy/anger), health perception (perception of birth) and possible characteristics of the environment (infant temperament, colic, sleep, parental relationship), with mothers’ overall quality of life when the child is 6 months of age. Methods This study is based on the Norwegian Mother, Father and Child Cohort Study (MoBa), conducted at the Norwegian Institute of Public Health from June 1999 to December 2008, which included a total of 86,724 children. Maternal QoL was assessed by the Satisfaction With Life Scale. Joy and anger were measured using the Differential Emotional Scale, mothers’ mental health was assessed using the Edinburgh Postnatal Depression Scale and satisfaction with relationship was measured using the Relationship Satisfaction Scale. Child temperament was measured using the Infant Characteristics Questionnaire and colic, sleep duration and feelings related to childbirth were assessed by mothers’ reports. The associations between life satisfaction and selected variables were analysed using stepwise multiple linear regression models, and the results are presented as effect sizes (ES). Results Maternal feelings of joy of having a baby (ES = 0.35), high relationship satisfaction (ES = 0.32), as well as having a baby with normal sleep (ES = 0.31), are factors associated with higher maternal overall QoL. Postnatal depression was negatively associated with mothers’ QoL, and infant colic or child’s temperament (fussiness) showed no such association with mothers’ QoL. Conclusions Health professionals and clinicians should focus on infants sleep but also on supporting joy of motherhood and strengthening relationships of the new parents when they develop health interventions or provide counselling to new mothers and their families.
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Affiliation(s)
- Lisbeth Valla
- Department of Nursing and Health Promotion, Faculty of Health Sciences, Metropolitan University, Oslo, Norway.
| | - Sølvi Helseth
- Department of Nursing and Health Promotion, Faculty of Health Sciences, Metropolitan University, Oslo, Norway
| | - Milada Cvancarova Småstuen
- Department of Nursing and Health Promotion, Faculty of Health Sciences, Metropolitan University, Oslo, Norway
| | - Nina Misvær
- Department of Nursing and Health Promotion, Faculty of Health Sciences, Metropolitan University, Oslo, Norway
| | - Randi Andenæs
- Department of Nursing and Health Promotion, Faculty of Health Sciences, Metropolitan University, Oslo, Norway
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Grundström H, Malmquist A, Ivarsson A, Torbjörnsson E, Walz M, Nieminen K. Fear of childbirth postpartum and its correlation with post-traumatic stress symptoms and quality of life among women with birth complications - a cross-sectional study. Arch Womens Ment Health 2022; 25:485-491. [PMID: 35230529 PMCID: PMC8921122 DOI: 10.1007/s00737-022-01219-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2021] [Accepted: 02/22/2022] [Indexed: 12/03/2022]
Abstract
The primary aim of the study was to analyze differences in post-traumatic stress symptoms (PTSS) and quality of life (QoL) between women with and without severe fear of childbirth postpartum (PP FOC). The secondary aims were to analyze the correlation between PP FOC and PTSS, and PP FOC and QoL, in women undergoing complicated childbirth. This cross-sectional study was conducted in South-East Sweden. Women aged ≥ 18 years who had undergone complicated childbirth (i.e., acute or emergency cesarean section, vacuum extraction, child in need of neonatal care, manual placenta removal, sphincter rupture, shoulder dystocia, or hemorrhage ≥ 1000 ml) were invited. Seventy-six women answered demographic questions and three validated instruments measuring PP FOC, PTSS, and QoL. The study population was divided into two sub groups: severe PP FOC or no severe PP FOC. Statistical analyses were conducted using Mann-Whitney U-test, chi-square test or Fisher's exact test, and Spearman's rank-order correlation. Severe PP FOC was reported by 29% of the women, and 18% reported PTSS indicating post-traumatic stress disorder. Women with severe PP FOC reported significantly higher levels of PTSS, and significantly lower QoL in five dimensions: physical role functioning, emotional role functioning, energy/fatigue, emotional well-being, and social functioning. There was a positive significant correlation between level of PP FOC and PTSS. There were also significant negative correlations between level of PP FOC and most of the QoL dimensions. In conclusion, almost one-third of the women with complicated childbirth reported severe PP FOC, and almost one-fifth reported PTSS indicating post-traumatic stress disorder. PP FOC correlated with PTSS and deteriorated QoL.
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Affiliation(s)
- Hanna Grundström
- Department of Obstetrics and Gynecology in Norrköping, and Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden.
- Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden.
| | - Anna Malmquist
- Department of Behavioral Sciences and Learning, Linköping University, Linköping, Sweden
| | - Alice Ivarsson
- Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
| | - Elin Torbjörnsson
- Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
| | - Malin Walz
- Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
| | - Katri Nieminen
- Department of Obstetrics and Gynecology in Norrköping, and Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden
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Khanum S, Jabeen S, Souza MDLD, Naz N, Andrade ZBD, Nóbrega JFD, Lynn FA, Giacon-Arruda BCC. MENTAL HEALTH OF MOTHERS AFTER NATURAL CHILDBIRTH AND CESAREAN SECTION: A COMPARATIVE STUDY IN KOHAT, KHYBER PAKHTUNKHWA, PAKISTAN. TEXTO & CONTEXTO ENFERMAGEM 2022. [DOI: 10.1590/1980-265x-tce-2022-0140en] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
ABSTRACT Objective: to compare the quality of life of women after natural childbirth and cesarean section from a mental health perspective. Method: this is a causal-comparative study that included 104 women, 52 of whom underwent natural childbirth: and 52 cesarean sections. It was conducted in the gynecology ward of Liaqat Memorial Hospital in Kohat Khyber Pakhtunkhwa, Pakistan using the Quality-of-Life Questionnaire. Pakistani Nurses made direct translation of it in to Urdu language, interview by interview (read in English and told in Urdu). The results related to Emotional Health Problems, Energy, Emotions and Social Activities were analyzed. Results: women after cesarean section reported more problems regarding emotional health variables than women after natural childbirth. The mean quality of life score among the natural childbirth group was 89.94 and 66.02 among the cesarean section group (p<0.001). Conclusion: women who undergo natural childbirth have better quality of life than women who undergo cesarean section (average versus poor quality of life). Mental health is also affected, especially for those who undergo cesarean section. Thus, natural childbirth demonstrates benefits in the puerperium in terms of emotional indicators.
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18
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Roch M, Gaudreault N, Cyr MP, Venne G, Bureau NJ, Morin M. The Female Pelvic Floor Fascia Anatomy: A Systematic Search and Review. Life (Basel) 2021; 11:life11090900. [PMID: 34575049 PMCID: PMC8467746 DOI: 10.3390/life11090900] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2021] [Revised: 08/20/2021] [Accepted: 08/26/2021] [Indexed: 12/20/2022] Open
Abstract
The female pelvis is a complex anatomical region comprising the pelvic organs, muscles, neurovascular supplies, and fasciae. The anatomy of the pelvic floor and its fascial components are currently poorly described and misunderstood. This systematic search and review aimed to explore and summarize the current state of knowledge on the fascial anatomy of the pelvic floor in women. Methods: A systematic search was performed using Medline and Scopus databases. A synthesis of the findings with a critical appraisal was subsequently carried out. The risk of bias was assessed with the Anatomical Quality Assurance Tool. Results: A total of 39 articles, involving 1192 women, were included in the review. Although the perineal membrane, tendinous arch of pelvic fascia, pubourethral ligaments, rectovaginal fascia, and perineal body were the most frequently described structures, uncertainties were identified in micro- and macro-anatomy. The risk of bias was scored as low in 16 studies (41%), unclear in 3 studies (8%), and high in 20 studies (51%). Conclusions: This review provides the best available evidence on the female anatomy of the pelvic floor fasciae. Future studies should be conducted to clarify the discrepancies highlighted and accurately describe the pelvic floor fasciae.
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Affiliation(s)
- Mélanie Roch
- Research Center of the Centre Hospitalier Universitaire de Sherbrooke, Faculty of Medicine and Health Sciences, School of Rehabilitation, Université de Sherbrooke, Sherbrooke, QC J1H 5N4, Canada; (M.R.); (N.G.); (M.-P.C.)
| | - Nathaly Gaudreault
- Research Center of the Centre Hospitalier Universitaire de Sherbrooke, Faculty of Medicine and Health Sciences, School of Rehabilitation, Université de Sherbrooke, Sherbrooke, QC J1H 5N4, Canada; (M.R.); (N.G.); (M.-P.C.)
| | - Marie-Pierre Cyr
- Research Center of the Centre Hospitalier Universitaire de Sherbrooke, Faculty of Medicine and Health Sciences, School of Rehabilitation, Université de Sherbrooke, Sherbrooke, QC J1H 5N4, Canada; (M.R.); (N.G.); (M.-P.C.)
| | - Gabriel Venne
- Anatomy and Cell Biology, Faculty of Medicine and Health Sciences, McGill University, Montreal, QC H3A 0C7, Canada;
| | - Nathalie J. Bureau
- Centre Hospitalier de l’Université de Montréal, Department of Radiology, Radio-Oncology, Nuclear Medicine, Faculty of Medicine, Université de Montréal, Montreal, QC H3T 1J4, Canada;
| | - Mélanie Morin
- Research Center of the Centre Hospitalier Universitaire de Sherbrooke, Faculty of Medicine and Health Sciences, School of Rehabilitation, Université de Sherbrooke, Sherbrooke, QC J1H 5N4, Canada; (M.R.); (N.G.); (M.-P.C.)
- Correspondence:
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19
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Tuzil J, Bartakova J, Watt T, Dolezal T. Health-related quality of life in women with autoimmune thyroid disease during pregnancy and postpartum: systematic review including 321,850 pregnancies. Expert Rev Pharmacoecon Outcomes Res 2021; 21:1179-1193. [PMID: 34120552 DOI: 10.1080/14737167.2021.1941882] [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
BACKGROUND Utilities of the general population or expert estimates have been used for all published cost-effectiveness analyses of screening for thyroid disorders in pregnancy. METHODS A systematic review CRD42019120897 of studies with patient-reported outcomes (PRO) and laboratory evidence of thyroid function/autoimmunity was conducted using PubMed, Cochrane Central, EconLit, SocIndex, DARE, NHS EEDS, Annual Reviews, and CINAHL. Quality was assessed using Joanna Briggs Institute appraisal tool. RESULTS Of 664 abstracts screened, we analyzed 97 full texts. All studies describing the impact of thyroid disease on the generic QoL excluded pregnant and postpartum women. 21 reports of acceptable quality (321,850 pregnancies) determined depression and anxiety with validated tools and/or reported subjective symptoms. During pregnancy, contradictory conclusions were published on the impact of thyroid disease on PRO. Postpartum, antithyroid antibodies coincide with alexithymia and depression, postpartum thyroiditis negatively impacts mood. No conclusion could be drawn on the impact of thyroid hormonal levels. CONCLUSIONS The generic QoL in autoimmune thyroid disease during pregnancy has never been described, which represents an obstacle for the construction of economic models. We found contradictory information on the impact of thyroid disease on depression, anxiety, and specific symptoms.
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Affiliation(s)
- Jan Tuzil
- Department of Biomedical Informatics, First Faculty of Medicine, Charles University, Prague, Czech Republic.,Institute of Health Economics and Technology Assessment o.p.s (iHETA), Prague, Czech Republic
| | - Jana Bartakova
- Department of Biomedical Informatics, First Faculty of Medicine, Charles University, Prague, Czech Republic.,Department Public Health, Faculty of Medicine, University of Basel, Basel, Switzerland
| | - Torquil Watt
- Department of Internal Medicine, Endocrinology, Herlev Gentofte Hospital, Copenhagen, Denmark
| | - Tomas Dolezal
- Institute of Health Economics and Technology Assessment o.p.s (iHETA), Prague, Czech Republic.,Department of Pharmacology, Faculty of Medicine, Masaryk University, Brno, Czech Republic
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Tola Y, Ayele G, Boti N, Yihune M, Gethahun F, Gebru Z. Health-Related Quality-of-Life and Associated Factors Among Post-Partum Women in Arba Minch Town. Int J Womens Health 2021; 13:601-611. [PMID: 34188554 PMCID: PMC8232860 DOI: 10.2147/ijwh.s295325] [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: 12/02/2020] [Accepted: 05/13/2021] [Indexed: 12/03/2022] Open
Abstract
Background It is generally accepted that pregnancy and childbirth are natural physiological processes. However, these significantly affect the quality of mothers’ lives. Little is known about the level of quality-of-life and associated factors among postpartum women in Ethiopia, particularly in the study area. Methods A community-based cross-sectional study was conducted among 409 randomly selected post-partum women who were living in Arba Minch town. Systematic random sampling was employed to select the study participants. The standard quality-of-life assessment tool which is known as the short-form SF 36 tool was used to assess health-related quality-of-life. The logistic regression model was used to identify associated factors. Statistically significant variables at a p-value<0.25 in the bi-variable analysis were candidate variables for multi-variable analysis and statistical significance which was declared at a p-value<0.05. Results Among the study participants, 255 (62.3%) had lower level health-related quality-of-life (HRQoL). About 46.2% of the study participants had lower physical HRQoL and about 79% of the study participants had lower mental HRQoL. The overall mean score of HRQoL was 45.15 (±8.13). Factors associated with lower overall HRQoL were age group 17–24 years (AOR=2.73, 95% CI=1.22–6.10), no formal education [AOR 2.02, 95% CI (1.05–3.89)], and cesarean delivery (AOR=0.49, 95% CI=0.24–0.97). A factor associated with lower physical HRQoL was cesarean delivery (AOR=0.34, 95% CI=0.13–0.88). Factors associated with lower mental HRQoL were age group 17–24 (AOR=3.37, 95% CI=1.60–7.04), not receiving antenatal care (AOR=3.65, 95% CI=1.45–9.16), and having postpartum depression (AOR=2.27, 95% CI=1.30–3.93). Conclusion The results suggest that the majority of post-partum women had a lower HRQoL, particularly women’s mental health was compromised. In this study, a suggestion is made that the respective bodies need to give particular attention to mothers during the post-partum period to prevent poor quality-of-life.
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Affiliation(s)
- Yirgalem Tola
- Arba Minch Health Science College, Department of Midwifery, Arba Minch, Ethiopia
| | - Gistane Ayele
- Arba Minch University, College of Medicine & Health Sciences, School of Public Health, Arba Minch, Ethiopia
| | - Negussie Boti
- Arba Minch University, College of Medicine & Health Sciences, School of Public Health, Arba Minch, Ethiopia
| | - Manaye Yihune
- Arba Minch University, College of Medicine & Health Sciences, School of Public Health, Arba Minch, Ethiopia
| | - Firdawek Gethahun
- Arba Minch University, College of Medicine & Health Sciences, School of Public Health, Arba Minch, Ethiopia
| | - Zeleke Gebru
- Arba Minch University, College of Medicine & Health Sciences, School of Public Health, Arba Minch, Ethiopia
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Woodley SJ, Hay-Smith EJC. Narrative review of pelvic floor muscle training for childbearing women-why, when, what, and how. Int Urogynecol J 2021; 32:1977-1988. [PMID: 33950309 DOI: 10.1007/s00192-021-04804-z] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2021] [Accepted: 04/12/2021] [Indexed: 02/06/2023]
Abstract
INTRODUCTION AND HYPOTHESIS Urinary incontinence (UI) is prevalent during pregnancy and postpartum. UI in pregnancy strongly predicts UI postpartum and later in life. UI reduces women's wellbeing and quality of life and presents a significant burden to healthcare resource. METHODS A narrative review summarizing quantitative and qualitative evidence about pelvic floor muscle training (PFMT) for prevention and treatment of UI for childbearing women. RESULTS There are clinically important reductions in the risk of developing UI in pregnancy and after delivery for pregnant women who start PFMT during pregnancy, and PFMT offers additional benefits preventing prolapse and improving sexual function. If women develop UI during pregnancy or postpartum then PFMT is an appropriate first-line treatment. For novice exercisers, a programme comprising eight contractions, with 8-s holds, three times a day, 3 days a week, for at least 3 months is a reasonable minimum and 'generic' prescription. All women need clear accurate verbal instruction in how to do PFMT. Incontinent women, and women who cannot do a correct contraction, require referral for pelvic floor rehabilitation. Behavioural support from maternity care providers (MCPs)-increasing women's opportunity, capability, and motivation for PFMT-is as important as the exercise prescription. CONCLUSION PFMT is effective to prevent and treat UI in childbearing women. All pregnant and postpartum women, at every contact with a MCP, should be asked if they are continent. Continent women need exercise prescription and behavioural support to do PFMT to prevent UI. Incontinent women require appropriate referral for diagnosis or treatment.
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Affiliation(s)
- Stephanie J Woodley
- Department of Anatomy, School of Biomedical Sciences, University of Otago, Dunedin, New Zealand
| | - E Jean C Hay-Smith
- Rehabilitation Teaching and Research Unit, Department of Medicine, University of Otago, Wellington, New Zealand.
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Jeong YJ, Nho JH, Kim HY, Kim JY. Factors Influencing Quality of Life in Early Postpartum Women. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:2988. [PMID: 33799474 PMCID: PMC8000893 DOI: 10.3390/ijerph18062988] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Revised: 03/05/2021] [Accepted: 03/11/2021] [Indexed: 12/30/2022]
Abstract
Postpartum women experience various changes in their physical and psychological health and in their relationships with their spouse and newborn. This study aimed to identify and evaluate the factors that affect the quality of life (QoL) of women within six weeks after childbirth. A prospective, cross-sectional correlational study was used. A convenience sample of 179 postpartum women was recruited from four postpartum care centers in South Korea. Participants completed structured questionnaires on postpartum fatigue, postpartum depression, marital intimacy, breastfeeding adaptation, and quality of life. Marital intimacy (β = 0.466, p < 0.001) was the most influencing factor on the QoL of women during the postpartum period. In descending order, postpartum fatigue (β = -0.192, p = 0.001), postpartum depression (β = -0.190, p = 0.001), breastfeeding adaptation (β = 0.163, p = 0.002), and occupation (β = 0.163, p = 0.004) all had a significant influence on QoL (F = 32.09, p < 0.001), and the overall explanatory power was 63.6%. It is necessary to assess and consider the physical, psychological, relational, and demographic factors of women during the early postpartum period. Comprehensive interventions need to be developed to improve the QoL of women during the postpartum period.
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Affiliation(s)
- Yu-Jeong Jeong
- Department of Nursing, Presbyterian Medical Center, 365 Seowon-ro, Wansan-gu, Jeonju, Jeollabuk do 54987, Korea;
| | - Ju-Hee Nho
- College of Nursing, Jeonbuk National University, 567 Baekje-daero, Deokjin-gu, Jeonju, Jeollabuk do 54896, Korea; (H.Y.K.); (J.Y.K.)
| | - Hye Young Kim
- College of Nursing, Jeonbuk National University, 567 Baekje-daero, Deokjin-gu, Jeonju, Jeollabuk do 54896, Korea; (H.Y.K.); (J.Y.K.)
| | - Ji Young Kim
- College of Nursing, Jeonbuk National University, 567 Baekje-daero, Deokjin-gu, Jeonju, Jeollabuk do 54896, Korea; (H.Y.K.); (J.Y.K.)
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Bulhões ÉRFN, Dantas THDM, Dantas JH, Souza ÍND, Castaneda L, Dantas DDS. Functioning of women in the postpartum period: an International Classification of Functioning, Disability and Health-based consensus of physical therapists. Braz J Phys Ther 2020; 25:450-459. [PMID: 33386254 DOI: 10.1016/j.bjpt.2020.12.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2019] [Revised: 11/23/2020] [Accepted: 12/01/2020] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Physical therapists provide treatment for pain and other common complaints for women in the postpartum period, thereby contributing to the improvement of their functioning. However, before applying any interventions, physical therapists should assess their patients to identify the desired therapeutic goals. In this context, the International Classification of Functioning, Disability and Health (ICF) may be a useful tool for documenting functioning data and operationalizing collaborative goal setting. OBJECTIVE To identify ICF categories and the respective domains that should be considered in the evaluation of women postpartum. METHODS A consensus-building, three-round e-mail survey was conducted using the Delphi method. The sample included Brazilian physical therapists with expertise in women's health. Meaningful content was analyzed in accordance to the ICF linking rules. The kappa coefficient and content validity index (CVI) were calculated. RESULTS The panel consisted of 45 participants with a median age of 33 years and more than 10 years of experience in women's health. A total of 1261 meaningful contents were identified from the responses in the first round. After consensus was achieved, a final list of 62 items was prepared, including 53 categories (11 were on structures; 15 on body functions; 12 on activities and participation; 15 on environmental factors) and nine personal factors (CVI=0.89). CONCLUSION From the perception of physical therapists, an ICF-based postpartum assessment to describe functioning and disability must comprise 53 ICF categories and nine personal factors.
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Affiliation(s)
| | - Thaissa Hamana De Macedo Dantas
- Programa de Pós-graduação em Ciências da Reabilitação, Universidade Federal do Rio Grande do Norte (UFRN), Santa Cruz, RN, Brazil
| | - Jardelina Hermecina Dantas
- Programa de Pós-graduação em Ciências da Reabilitação, Universidade Federal do Rio Grande do Norte (UFRN), Santa Cruz, RN, Brazil
| | - Íris Nascimento De Souza
- Federal Institute of Education, Sciences and Technology of Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| | - Luciana Castaneda
- Federal Institute of Education, Sciences and Technology of Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| | - Diego De Sousa Dantas
- Programa de Pós-graduação em Ciências da Reabilitação, Universidade Federal do Rio Grande do Norte (UFRN), Santa Cruz, RN, Brazil; Programa de pós-graduação em Fisioterapia, Universidade Federal de Pernambuco, Recife, PE, Brazil.
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Ozcan S, Eryilmaz G. Using Levine's conservation model in postpartum care: a randomized controlled trial. Health Care Women Int 2020; 42:794-814. [PMID: 32744924 DOI: 10.1080/07399332.2020.1797038] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
This randomized controlled trial was conducted with 117 puerperae who were assigned into 2 groups: the intervention group and the control group. While the participants in the intervention group participated in a full program based on the module trainings, the participants in the control group received routine care. There was a significant difference between the women in the intervention and control groups in terms of the variables such as fatigue, sleep, and quality of life. The women in the intervention group experienced less fatigue, and their quality of sleep and quality of life improved considerably. Levine's conservation model enables the provision of the integrative care to women in their postpartum period.
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Affiliation(s)
- Sadiye Ozcan
- Faculty of Health Science, Yalova University, Yalova, Turkey
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Slavin V, Creedy DK, Gamble J. Benchmarking outcomes in maternity care: Peripartum incontinence - a framework for standardised reporting. Midwifery 2020; 83:102628. [DOI: 10.1016/j.midw.2020.102628] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2019] [Revised: 12/13/2019] [Accepted: 01/12/2020] [Indexed: 01/17/2023]
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Quality of life and the related factors in early postnatal women in Malawi. Midwifery 2020; 85:102700. [PMID: 32179390 DOI: 10.1016/j.midw.2020.102700] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2019] [Revised: 02/27/2020] [Accepted: 03/06/2020] [Indexed: 11/22/2022]
Abstract
OBJECTIVE To explore the quality of life (QOL) and related factors in early postnatal women. DESIGN A descriptive, cross-sectional study. SETTING Liwonde, Malawi. PARTICIPANTS Women who underwent a normal vaginal birth (N = 173) were included from August to September 2018. MEASUREMENTS The QOL of participants was assessed using a World Health Organization QOL instrument. Demographic, obstetric, and health variables were collected using a structured questionnaire. Childbirth fear and depression were respectively assessed using the Wijma Delivery Experience Questionnaire and the Edinburgh Postnatal Depression Scale. A multiple linear regression was used to examine factors associated with the QOL. RESULTS The mean age of participants was 29 (standard deviation 6.7) years. The overall QOL and health were satisfactory. The mean score of the QOL was highest in the psychological health and social relationships domains, followed by the environmental and physical health domains. A higher educational level was negatively related to the physical health of QOL (p ≤ 0.01), with physician care positively related (p = 0.01). The employment status was positively related to psychological health and the environmental QOL (p ≤ 0.01). Furthermore, a higher income, and physician care were positively related to the environmental QOL (p ≤ 0.05). High levels of childbirth fear and depressive symptoms were negatively related to all domains of the QOL (p ≤ 0.05), except for the social relationships domain. CONCLUSION AND IMPLICATIONS FOR PRACTICE The physical health QOL was lower in postnatal mothers in Malawi. Measures to improve physical health aspects and address women's fears and depressive symptoms during postpartum care are warranted. The findings should alert the health providers of the importance of assessing and improving women's physical health and psychological well-being during postpartum care.
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Changes in quality of life and sleep across the perinatal period in women with mood disorders. Qual Life Res 2020; 29:1767-1774. [PMID: 32016680 DOI: 10.1007/s11136-020-02437-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/29/2020] [Indexed: 10/25/2022]
Abstract
INTRODUCTION The perinatal period represents a time of significant life changes associated with increases in sleep difficulties, depression, and potentially impaired quality of life (QoL). Associations between QoL and sleep among women with perinatal depression are poorly understood, and changes in QoL across the perinatal period have received little attention. METHODS Participants were the treatment-as-usual group (n = 23) from a clinical trial testing an intervention for perinatal mood disorders. They completed the WHOQOL-Bref, had depression assessed with the HAM-D-17, and wore wrist actigraphs to estimate sleep for 1 week during third trimester and at 6 weeks postpartum. RESULTS Higher education level was associated with better environmental QoL during pregnancy (p = .044) and presence of older children was associated with worse social QoL postpartum (p = .045). Psychological health QoL worsened (p = .014) across the perinatal period. Total sleep time (p = .001) and sleep efficiency (p = .008) decreased from third trimester to postpartum week 6, but sleep measures were not associated with QoL at either time point. Depressive symptoms decreased from pregnancy to postpartum week 6 and were inversely associated with postpartum physical and social QoL (p = .031 and .048). DISCUSSION Factors contributing to self-rated QoL are variable across multiple domains during the perinatal period. QoL among our participants was lower than population norms. In our sample of women with depression and/or anxiety, QoL was related to postpartum depressive symptoms, but not to objectively measured sleep quality, quantity, or timing. Links between QoL and sleep may be inherently complex in perinatal women.
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Handelzalts JE, Stringer MK, Menke RA, Muzik M. The Association of Religion and Spirituality with Postpartum Mental Health in Women with Childhood Maltreatment Histories. JOURNAL OF CHILD AND FAMILY STUDIES 2020; 29:502-513. [PMID: 33311967 PMCID: PMC7728403 DOI: 10.1007/s10826-019-01595-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
OBJECTIVES Although the associations between religion and spirituality and mental health and trauma have been studied extensively across various populations, relatively few studies have focused on the postpartum period. This study aimed to shed light on specific domains of religiosity and spirituality that may be resiliency factors for positive postpartum adjustment defined as low depression and high quality of life in mothers oversampled for childhood trauma histories. METHODS We examined several religion and spirituality variables among 108 women at 6 months postpartum as well as prospective relations from religion and spirituality to postpartum depression and quality of life at 12 and 15 months postpartum. RESULTS We found that the personal aspects of self-forgiveness and forgiveness for others were most relevant as resiliency factors predicting lower postpartum depression and better quality of life even when controlling for other risks (trauma and demographics). Surprisingly, no other religion and spirituality domain had associations with postpartum depression or quality of life, with the exception of a significant negative association for organizational religiousness with quality of life at 12 months postpartum. CONCLUSIONS Our findings suggest that forgiveness, especially to self and to others, in women who have been physically and mentally hurt as children may be associated with mental wellness and quality of life in the late postpartum period. Further, our results point to the need to study specific religion and spirituality aspects in the context of specific populations and conditions instead of generally studying religion and spirituality as a common marker for coping.
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Affiliation(s)
| | | | - Rena A Menke
- Department of Psychiatry, University of Michigan, Ann Arbor, MI
| | - Maria Muzik
- Departments of Psychiatry, Obstetrics & Gynecology, University of Michigan - Michigan Medicine, Ann Arbor, MI
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Salmon VE, Hay-Smith EJC, Jarvie R, Dean S, Terry R, Frawley H, Oborn E, Bayliss SE, Bick D, Davenport C, MacArthur C, Pearson M. Implementing pelvic floor muscle training in women's childbearing years: A critical interpretive synthesis of individual, professional, and service issues. Neurourol Urodyn 2019; 39:863-870. [PMID: 31845393 PMCID: PMC7079154 DOI: 10.1002/nau.24256] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2019] [Accepted: 12/02/2019] [Indexed: 11/06/2022]
Abstract
AIMS Antenatal pelvic floor muscle training (PFMT) may be effective for the prevention and treatment of urinary and fecal incontinence both in pregnancy and postnatally, but it is not routinely implemented in practice despite guideline recommendations. This review synthesizes evidence that exposes challenges, opportunities, and concerns regarding the implementation of PFMT during the childbearing years, from the perspective of individuals, healthcare professionals (HCPs), and organizations. METHODS Critical interpretive synthesis of systematically identified primary quantitative or qualitative studies or research syntheses of women's and HCPs attitudes, beliefs, or experiences of implementing PFMT. RESULTS Fifty sources were included. These focused on experiences of postnatal urinary incontinence (UI) and perspectives of individual postnatal women, with limited evidence exploring the views of antenatal women and HCP or wider organizational and environmental issues. The concept of agency (people's ability to effect change through their interaction with other people, processes, and systems) provides an over-arching explanation of how PFMT can be implemented during childbearing years. This requires both individual and collective action of women, HCPs, maternity services and organizations, funders and policymakers. CONCLUSION Numerous factors constrain women's and HCPs capacity to implement PFMT. It is unrealistic to expect women and HCPs to implement PFMT without reforming policy and service delivery. The implementation of PFMT during pregnancy, as recommended by antenatal care and UI management guidelines, requires policymakers, organizations, HCPs, and women to value the prevention of incontinence throughout women's lives by using low-risk, low-cost, and proven strategies as part of women's reproductive health.
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Affiliation(s)
| | - E J C Hay-Smith
- Department of Women's and Children's Health, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand
| | - Rachel Jarvie
- College of Medicine and Health, University of Exeter, Exeter, UK
| | - Sarah Dean
- College of Medicine and Health, University of Exeter, Exeter, UK
| | - Rohini Terry
- College of Medicine and Health, University of Exeter, Exeter, UK
| | - Helena Frawley
- Department of Physiotherapy, School of Primary and Allied Health Care, Monash University, Melbourne, Australia
| | - Eivor Oborn
- Warwick Business School, University of Warwick, Coventry, UK
| | - Susan E Bayliss
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| | - Debra Bick
- Warwick Clinical Trials Unit, University of Warwick, Coventry, UK
| | - Clare Davenport
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| | - Christine MacArthur
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| | - Mark Pearson
- Wolfson Palliative Care Research Centre, Institute for Clinical & Applied Health Research, Hull York Medical School, University of Hull, Heslington, UK
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Hagaman A, Gallis JA, Bhalotra S, Baranov V, Turner EL, Sikander S, Maselko J. Psychosocial determinants of sustained maternal functional impairment: Longitudinal findings from a pregnancy-birth cohort study in rural Pakistan. PLoS One 2019; 14:e0225163. [PMID: 31743374 PMCID: PMC6863521 DOI: 10.1371/journal.pone.0225163] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2019] [Accepted: 10/30/2019] [Indexed: 11/22/2022] Open
Abstract
Function is an important marker of health throughout the life course, however, in low-and-middle-income-countries, little is known about the burden of functional impairment as women transition from pregnancy to the first year post-partum. Leveraging longitudinal data from 960 women participating in the Share Child Cohort in Pakistan, this study sought to (1) characterize functional trajectories over time among women in their perinatal period and (2) assess predictors of chronic poor functioning following childbirth. We used a group-based trajectory modeling approach to examine maternal patterns of function from the third trimester of pregnancy through 12 months post-partum. Three trajectory groups were found: persistently well-functioning (51% of women), poor functioning with recovery (39% of women), and chronically poor functioning (10% of women). When compared to mothers in the highest functioning group, psychosocial characteristics (e.g., depression, stress, and serious life events) were significantly associated with sustained poor functioning one-year following child-birth. Mothers living in nuclear households were more likely to experience chronic poor functioning. Higher education independently predicted maternal function recovery, even when controlling for psychosocial characteristics. Education, above and beyond socio-economic assets, appears to play an important protective role in maternal functional trajectories following childbirth. Public health implications related to maternal function and perinatal mental health are discussed.
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Affiliation(s)
- Ashley Hagaman
- Department of Social Behavioral Sciences, Yale School of Public Health, New Haven, Connecticut, United States of America
- Center for Methods in Implementation and Prevention Sciences, Yale University, New Haven, Connecticut, United States of America
- * E-mail:
| | - John A. Gallis
- Duke Global Health Institute, Duke University, Durham, North Carolina, United States of America
- Department of Biostatistics and Bioinformatics, Duke University, Durham, North Carolina, United States of America
| | - Sonia Bhalotra
- Department of Economics, University of Essex, Essex, England, United Kingdom
| | - Victoria Baranov
- Department of Economics, The University of Melbourne, Melbourne, Australia
| | - Elizabeth L. Turner
- Duke Global Health Institute, Duke University, Durham, North Carolina, United States of America
- Department of Biostatistics and Bioinformatics, Duke University, Durham, North Carolina, United States of America
| | - Siham Sikander
- Maternal and Neonatal Child Health Department, Health Services Academy, Islamabad, Pakistan
- Human Development Research Foundation, Islamabad, Pakistan
| | - Joanna Maselko
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America
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Rouhi M, Stirling CM, Crisp EP. Mothers' views of health problems in the 12 months after childbirth: A concept mapping study. J Adv Nurs 2019; 75:3702-3714. [PMID: 31452233 DOI: 10.1111/jan.14187] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2019] [Revised: 07/22/2019] [Accepted: 08/10/2019] [Indexed: 01/03/2023]
Abstract
AIMS To identify the health problems that women feel require help and subsequent help-seeking behaviour during the 12 months period after childbirth. BACKGROUND Many women experience physical and mental health problems after childbirth, but there is a gap in understanding how they perceive their health after childbirth. Studies suggested they are inhibited in expressing their needs and so seek informal rather than professional help for their health problems. DESIGN A mixed method concept mapping study. METHOD Two groups of Australian women were recruited by an online platform and purposive sampling (N = 81) in 2017-2018, based on an established concept mapping methodology. A first group created 83 brainstorm statements about post-childbirth health problems and help-seeking and a second group sorted and rated the statements based on their perception of the prevalence of the issues and the help-seeking advice they would offer to others. Bradshaw`s Taxonomy of Needs was used to theoretically underpins the explanation of the results of women's felt need after childbirth. RESULTS Multidimensional scaling resulted in six clusters of issues which were categorized into three domains: 'health issues and care', 'support' and 'fitness'. Despite being directly asked, about two-thirds of the women did not report experiencing any health problems. CONCLUSION Our findings showed women had a broader perception of healthcare needs which included support and fitness. There is a potential gap in services for women who do not have good social support. IMPACT Family and friends were a key source of help-seeking. Post-childbirth routine care was focused on infant care and limited to the first 6 weeks after childbirth. The content of current post-childbirth care must be reviewed.
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Affiliation(s)
- Maryam Rouhi
- School of Nursing, College of Health and Medicine, University of Tasmania, Hobart, TAS, Australia
| | - Christine M Stirling
- School of Nursing, College of Health and Medicine, University of Tasmania, Hobart, TAS, Australia
| | - Elaine P Crisp
- School of Nursing, College of Health and Medicine, University of Tasmania, Launceston, TAS, Australia
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Gualdrón LMV, Villalobos MMDD. Effect of infant stimulation on the adaptation to birth: a randomized trial. Rev Lat Am Enfermagem 2019; 27:e3176. [PMID: 31596411 PMCID: PMC6781411 DOI: 10.1590/1518-8345.2896.3176] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2018] [Accepted: 04/03/2019] [Indexed: 11/21/2022] Open
Abstract
Objective: to measure the effect of an infant stimulation therapy (auditory, tactile, visual and vestibular) on the adaptation to postnatal life of the mother-child dyad. Method: an experimental and blind study composed of 120 dyads of first-time mothers and full-term newborns, who practiced breastfeeding. The follow-up was conducted during the first five weeks of life and the evaluation was carried at two different times. Results: the adaptive capacity was measured in two modes. The physiological adaptive mode (activity and exercise and neonatal nutrition) and the interdependence adaptive mode (appropriate affection and proper development); and statistically significant differences were found in favor of the experimental group. Regression models that show the collaborative relationship between mother and child, and their reciprocity in the process of adaptation were proposed. Conclusion: the early stimulation is a therapy with bidirectional effect, because it has favorable effects on the person who administers it; promotes health and prevents illness in the process of adaptation to birth; especially in contexts of vulnerability. It is recommended its teaching to mothers and its application in the home environment. This study was registered in the Australian New Zealand Clinical Trial Registry (ANZCTR) under protocol number: ACTRN12617000449336.
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Nur N. Identifying variables in relation to health-related quality of life among married women of reproductive age in Sivas Turkey. Women Health 2019; 60:534-546. [PMID: 31587615 DOI: 10.1080/03630242.2019.1674441] [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: 10/25/2022]
Abstract
A cross-sectional study was performed to identify the factors associated with health-related quality of life (HRQoL) among 1,236 married Turkish women aged 15-49 years, in the urban area of Sivas, between January and July 2017. Multiple logistic regression analyzes showed that being unemployed [adjusted odds ratio (AOR) = 1.73, 95% confidence interval (CI) = 1.18-2.25], and having an unsatisfying sexual life (AOR = 1.54, 95% CI = 1.17-2.03), a chronic illness (AOR = 1.66, 95% CI = 1.27-2.17), more than three children (AOR = 1.38, 95% CI = 1.03-1.86), and experienced domestic violence (AOR = 2.15, 95% CI = 1.55-2.98) were associated with worse mental HRQoL. Having less than a high school education (AOR = 2.00, 95% CI = 1.33-3.02), a chronic illness (AOR = 2.49, 95% CI = 1.88-3.30), a history of abortion (AOR = 1.59, CI = 1.09-2.31), and experienced domestic violence (AOR = 1.71, 95% CI = 1.21-2.40) were associated with worse physical HRQoL. These findings suggest that health care providers or policy makers should pay special attention to unemployed women who are less educated, have more than three children and those having unsatisfied sexual lives, chronic illness, domestic violence experience and abortion history to enhance their HRQoL.
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Affiliation(s)
- Naim Nur
- Department of Public Health, Faculty of Medicine, Sivas Cumhuriyet University, Sivas, Turkey
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Determinants of Maternal Health-Related Quality of Life after Childbirth: The Generation R Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16183231. [PMID: 31487782 PMCID: PMC6765914 DOI: 10.3390/ijerph16183231] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/01/2019] [Revised: 08/29/2019] [Accepted: 08/30/2019] [Indexed: 12/18/2022]
Abstract
Having good health-related quality of life (HRQoL) is essential, particularly for women after childbirth. However, little is known about its determinants. We aimed to identify the determinants of HRQoL after childbirth in a large community sample in the Netherlands. We have included 4312 women in the present study. HRQOL was assessed by a 12-Item Short Form Survey (SF-12) at around two months after childbirth; Physical and Mental Component Summary scores were calculated. Information on 27 potential determinants of HRQoL was collected through questionnaires and medical records. Multivariate linear regression models were applied to assess significant determinants of physical and mental HRQoL. Our study showed that older maternal age, shorter time since childbirth, elective/emergency cesarean delivery, loss of energy, maternal psychopathology, and the hospital admission of the infant were significantly associated with worse physical HRQoL (p < 0.05); older maternal age, non-western background, low household income, loss of energy, and maternal psychopathology were significantly associated with worse mental HRQoL (p < 0.05). We identified multiple determinants of suboptimal physical and mental HRQoL after childbirth. In particular, maternal psychopathology after childbirth was profoundly associated with mental HRQoL. These women may need support. We therefore call for awareness among health care professionals.
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Niu L, Luo D, Chen X, Wang M, Zhou W, Zhang D, Xiao S. Longitudinal trajectories of emotional problems and unmet mental health needs among people newly diagnosed with HIV in China. J Int AIDS Soc 2019; 22:e25332. [PMID: 31424617 PMCID: PMC6699581 DOI: 10.1002/jia2.25332] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2018] [Accepted: 06/05/2019] [Indexed: 12/17/2022] Open
Abstract
INTRODUCTION Concern over mental health morbidity affecting people living with HIV is increasing worldwide. The objective of this study was to describe the longitudinal trajectories of depression and anxiety, and mental health service utilization among people newly diagnosed with HIV. METHODS This was an observational cohort study that enrolled people newly diagnosed with HIV consecutively and followed them for one year in Changsha, China. Socio-demographic, clinical and psychological data were collected at the baseline and at one-year follow-up. Participants were recruited between March 1, 2013 and September 30, 2014. The final follow-up was in September 30, 2015. RESULTS Among 557 people newly diagnosed with HIV enrolled at the baseline, 410 (73.6%) completed the one-year follow-up survey (median (interquartile range) age at follow-up: 29 (25, 39) years; 376 men (91.7%)), and were included in the analysis. 39.3% and 30.2% of the 410 participants were screened with significant symptoms of depression and anxiety at baseline respectively. An overall drop in the prevalence of each condition was found at follow-up, however, 10.5% and 6.1% of participants were found to have persistent depression and anxiety. The results of mixed-effect models showed that bisexuality, homosexual transmission, other clinical symptoms (for example, not on antiretroviral therapy (ART)), non-disclosure, higher levels of HIV/AIDS-related stress, and lack of social support were associated with significant symptoms of depression and anxiety. One year after diagnosis, 8.3% had visited healthcare providers for emotional or psychological problems. CONCLUSIONS Despite the obvious need people newly diagnosed with HIV in China rarely seek professional help. Integrating depression and anxiety screening and referral into HIV care settings is warranted.
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Affiliation(s)
- Lu Niu
- Department of Social Medicine and Health ManagementXiangya School of Public HealthCentral South UniversityChangshaChina
- The Affiliated Brain Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital)GuangzhouChina
| | - Dan Luo
- Department of Social Medicine and Health ManagementXiangya School of Public HealthCentral South UniversityChangshaChina
| | - Xi Chen
- Hunan Provincial Center for Disease Prevention and ControlChangshaChina
| | - Min Wang
- HIV/AIDS Research InstituteThe First Hospital of ChangshaChangshaChina
| | - Wei Zhou
- Hospital Administration InstituteXiangya HospitalCentral South UniversityChangshaChina
| | - Dexing Zhang
- The Jockey Club School of Public Health and Primary CareFaculty of MedicineThe Chinese University of Hong KongHong KongChina
| | - Shuiyuan Xiao
- Department of Social Medicine and Health ManagementXiangya School of Public HealthCentral South UniversityChangshaChina
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Fealy S, Chan S, Wynne O, Dowse E, Ebert L, Ho R, Zhang MWB, Jones D. The Support for New Mums Project: A protocol for a pilot randomized controlled trial designed to test a postnatal psychoeducation smartphone application. J Adv Nurs 2019; 75:1347-1359. [PMID: 30740767 DOI: 10.1111/jan.13971] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2018] [Revised: 11/13/2018] [Accepted: 12/06/2018] [Indexed: 11/30/2022]
Abstract
AIM To report a pilot trial protocol for testing the effectiveness of the Support for New Mums smartphone application in a cohort of first-time mothers. DESIGN A pilot/feasibility randomized controlled trial using a two-group pre-test and repeated post-test design. METHOD This protocol follows the Standard Protocol Items: Recommendations for Intervention Trials (SPIRIT) guidelines. The Intervention group will receive access to the smartphone application for 6 weeks post birth. Both Intervention and control groups will receive standardized institutional postnatal care services. Trial funding was gained from respective grant sponsors in May and November 2016. DISCUSSION The Support for New Mums smartphone application could be a novel method for addressing the gap in provision of postpartum care services providing psychoeducation and improving maternal parental self-efficacy for Australian childbearing women. TRIAL REGISTRATION Australian New Zealand Clinical Trials Registry ACTRN12618001580268.
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Affiliation(s)
- Shanna Fealy
- School of Nursing and Midwifery, The University of Newcastle Australia, Callaghan, NSW, Australia.,School of Medicine and Public Health, The University of Newcastle Australia, Callaghan, NSW, Australia.,Priority Research Centre for Health Behaviour, The University of Newcastle Australia, Callaghan, NSW, Australia
| | - Sally Chan
- School of Nursing and Midwifery, The University of Newcastle Australia, Callaghan, NSW, Australia.,Priority Research Centre for Brain & Mental Health, The University of Newcastle Australia, Callaghan, NSW, Australia
| | - Olivia Wynne
- School of Medicine and Public Health, The University of Newcastle Australia, Callaghan, NSW, Australia.,Priority Research Centre for Reproductive Science: Mothers and Babies, University of Newcastle Australia, Callaghan, NSW, Australia
| | - Eileen Dowse
- School of Nursing and Midwifery, The University of Newcastle Australia, Callaghan, NSW, Australia
| | - Lyn Ebert
- School of Nursing and Midwifery, The University of Newcastle Australia, Callaghan, NSW, Australia
| | - Roger Ho
- Department of Psychological Medicine, National University of Singapore, Singapore
| | - Melvyn W B Zhang
- Institute of Mental Health Singapore, National Addictions Management Service, Singapore
| | - Donovan Jones
- School of Nursing and Midwifery, The University of Newcastle Australia, Callaghan, NSW, Australia.,Priority Research Centre for Health Behaviour, The University of Newcastle Australia, Callaghan, NSW, Australia.,Priority Research Centre for Brain & Mental Health, The University of Newcastle Australia, Callaghan, NSW, Australia
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An investigation of prepregnancy body mass index, ethnicity and health-related quality of life as predictors of breastfeeding exclusivity during early postpartum period: Cross sectional survey. Int J Nurs Stud 2019; 93:55-63. [PMID: 30861454 DOI: 10.1016/j.ijnurstu.2019.02.009] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2018] [Revised: 02/11/2019] [Accepted: 02/13/2019] [Indexed: 01/04/2023]
Abstract
BACKGROUND Identifying and understanding the determinants of breastfeeding exclusivity during early postpartum period are crucial for sustainable breastfeeding. Few researchers have examined the association among prepregnancy body mass index, ethnicity and exclusive breastfeeding. As a result, whether or not these factors exhibit different relationship patterns across body mass index groups remains unclear. OBJECTIVES This study was performed to: (1) test the relationships among prepregnancy body mass index, ethnicity, health-related quality of life, maternal and obstetric characteristics and exclusive breastfeeding; and (2) compare the relationships among these study variables for two body mass index groups. DESIGN Exploratory cross-sectional research design. SETTING Two postnatal wards of a university-affiliated hospital. PARTICIPANTS A total of 715 postpartum multi-ethnic women in Singapore. METHODS We used structural equation modelling with multigroup analysis to examine our hypothetical model, which integrated the concepts of breastfeeding initiation and health-related quality of life conceptual models. A 12-item short form health survey was used to assess the health-related quality of life. RESULTS The structural equation modelling showed that women with following factors were significantly less likely to initiate exclusive breastfeeding: being Chinese (β = -0.10, p < 0.05), having high body mass index (β = -0.11, p < 0.01), living with low household income (β = -0.08, p < 0.05) and exhibiting poor health-related quality of life scores (β = 0.17, p < 0.001). Multigroup analysis showed no difference (critical ratio = 0.061) between the parameter estimates of health-related quality of life on exclusive breastfeeding in the two body mass index groups. Health-related quality of life (β = 0.17, p < 0.001) and monthly household incomes (β = -0.11, p < 0.05) were the only significant factors in the normal body mass index group. All structural equation modelling values satisfactorily fitted the data (Goodness of Fit Index = 0.937-0.954, Incremental Fit Index = 0.937-0.945, Tucker-Lewis Index = 0.906-0.917, Comparative Fit Index = 0.936-0.942 and Root Means Square Error of Approximation = 0.027-0.040). CONCLUSIONS Enhancing postpartum health-related quality of life and prepregnancy weight management are crucial to initiate exclusive breastfeeding. Our findings can guide the development of promising health promotion strategies among Chinese women with low household income.
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Rouhi M, Stirling C, Ayton J, Crisp EP. Women's help-seeking behaviours within the first twelve months after childbirth: A systematic qualitative meta-aggregation review✰. Midwifery 2019; 72:39-49. [PMID: 30772692 DOI: 10.1016/j.midw.2019.02.005] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2018] [Revised: 01/11/2019] [Accepted: 02/06/2019] [Indexed: 10/27/2022]
Abstract
INTRODUCTION Women within the first 12 months after birth often do not seek professional help for post-childbirth morbidities. This systematic review uses the Behavioural Model of Health Services Use (BMSHU) to assess the barriers and facilitators to women's help-seeking from health professionals during the first twelve months after childbirth. METHOD A qualitative meta-aggregation was used for the review. Systematic searching of Medline via Ovid, CINAHL, EMBASE and Web of Science revealed an initial 691 papers, of which 48 were reviewed. Nine qualitative papers, peer-reviewed, English papers and published from 2000 to 2017, were identified. Studies selected according to the pre-defined protocol were assessed using The Joanna Briggs Institute Critical Appraisal Tools (JBIQARI). RESULTS Seventy-five findings were identified from the approved articles and aggregated into seven categories. Key themes that emerged were that women did not seek help because they accepted problems as a part of the motherhood role or because they feared being judged negatively. Women shared their issues with family and friends as trusted people. Low health literacy was a barrier to seeking help, as was lack of access to proper care and poor advice from families. The women's cultural context was an essential influence in whether or not they sought help. According to BMSHU, a model of key influences on women's help-seeking for maternal morbidities introduced.
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Affiliation(s)
- Maryam Rouhi
- School of Nursing, College of Health and Medicine, University of Tasmania, Advocate House, 9 Liverpool St, Hobart TAS 7001, Australia.
| | - Christine Stirling
- School of Nursing, College of Health and Medicine, University of Tasmania, Private Bag 135, Hobart TAS 7001, Australia.
| | - Jenifer Ayton
- Lecturer in Public Health School of Medicine, College of Health and Medicine, University of Tasmania, Private Bag 34, Hobart, TAS 7001, Australia.
| | - Elaine Peta Crisp
- School of Health Sciences, College of Health and Medicine, University of Tasmania, Locked Bag 1322, Launceston 7250, Australia.
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Madokoro S, Miaki H. Relationship between transversus abdominis muscle thickness and urinary incontinence in females at 2 months postpartum. J Phys Ther Sci 2019; 31:108-111. [PMID: 30774216 PMCID: PMC6348182 DOI: 10.1589/jpts.31.108] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2018] [Accepted: 10/24/2018] [Indexed: 11/24/2022] Open
Abstract
[Purpose] Urinary incontinence is a frequent postpartum complication. Thus, this study aimed to examine the associations of transversus abdominis muscle thicknesses at rest and during an abdominal drawing-in maneuver with urinary incontinence in females at 2 months postpartum. [Participants and Methods] The participants included 18 females at 2 months postpartum with or without urinary incontinence, and 10 nulliparous females as controls. Transversus abdominis thickness was measured at rest and during the abdominal drawing-in maneuver using diagnostic ultrasonography. The Japanese version of the International Consultation on Incontinence Questionnaire-Short Form was used to evaluate urinary incontinence. [Results] Females at 2 months postpartum were divided into groups with and without urinary incontinence according to questionnaire scores. The muscle thickness during the abdominal drawing-in maneuver contraction was significantly lower in those with urinary incontinence than in those without urinary incontinence and controls. [Conclusion] The results showed significantly reduced transversus abdominis thickness during contraction, which suggested reduced transversus abdominis strength in females with postpartum urinary incontinence. Thus, promoting synergistic contraction of the inner unit, including the transversus abdominis, in exercise therapy may be more effective for postpartum urinary incontinence.
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Affiliation(s)
- Sachiko Madokoro
- Division of Health Sciences, Graduate School of Medical Science, Kanazawa University: 5-11-80 Kodatsuno, Kanazawa, lshikawa 920-0942, Japan
| | - Hiroichi Miaki
- Division of Health Sciences, Graduate School of Medical Science, Kanazawa University: 5-11-80 Kodatsuno, Kanazawa, lshikawa 920-0942, Japan
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Martínez-Galiano JM, Hernández-Martínez A, Rodríguez-Almagro J, Delgado-Rodríguez M, Rubio-Alvarez A, Gómez-Salgado J. Women's Quality of Life at 6 Weeks Postpartum: Influence of the Discomfort Present in the Puerperium. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16020253. [PMID: 30658406 PMCID: PMC6351916 DOI: 10.3390/ijerph16020253] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/22/2018] [Revised: 12/30/2018] [Accepted: 01/14/2019] [Indexed: 01/25/2023]
Abstract
Background: Discomfort during the puerperium period is very frequent in the lives of women but the influence of this discomfort on the women’s quality of life has been little studied. The objective of this study is to establish the association between discomfort and frequent problems of women in the puerperium and their quality of life score. Methods: A cross-sectional study on postpartum Spanish women was performed. Women older than 18 years and who had had a live birth were included. Less than 1% of women refused to participate in the study. Data were collected on socio-demographic, obstetric and newborn variables, on maternal problems/ discomfort in the postnatal period and on parameters that are quality of life indicators. An ad hoc online questionnaire which included the SF-36 Health Survey was used. Crude mean difference (cMD) and adjusted mean difference (aMD) were calculated through multiple linear regression. Results: 2990 women participated in the study. The greater problems causing quality of life loss were depressive symptoms (aMD = −12.40, CI 95%: −10.79, −14.01), lactation problems (aMD = −4.30, CI 95%: −2.97, −5.63), problems for sexual intercourse after childbirth (aMD = −6.34, CI 95%: −5.07, −7.60) and urinary incontinence (aMD = −4.97, CI 95%: −6.30, −3.65), among others. These have been detected as risk factors that affect the quality of life of the postpartum woman. Conclusions: The discomfort and problems manifested in the 6 weeks after childbirth have an influence that deeply affects the quality of life of postpartum women.
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Affiliation(s)
- Juan Miguel Martínez-Galiano
- Department of Nursing, University of Jaen, 23071 Jaen, Spain.
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), 28029 Madrid, Spain.
| | - Antonio Hernández-Martínez
- Mancha-Centro Hospital, Alcázar de San Juan, 13600 Ciudad Real, Spain.
- Department of Nursing, University of Castilla la Mancha, 13071 Ciudad Real, Spain.
| | | | - Miguel Delgado-Rodríguez
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), 28029 Madrid, Spain.
- Department of Health Sciences, University of Jaen, 23071 Jaen, Spain.
| | - Ana Rubio-Alvarez
- Obstetrics Service, University Hospital of Torrejon de Ardoz, 28850 Madrid, Spain.
| | - Juan Gómez-Salgado
- Department of Nursing, University of Huelva, 21007 Huelva, Spain.
- Safety and Health Posgrade Program, Universidad Espíritu Santo, Guayaquil 091650, Ecuador.
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41
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Sun Y, Yoshitake N, Sugawara M, Matsumoto S, Sakai A, Takaoka J, Goto N. Quality of life in Japanese couples during the transition to parenthood. J Reprod Infant Psychol 2018; 37:161-175. [PMID: 30481063 DOI: 10.1080/02646838.2018.1540862] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [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 quality of life (QOL) in Japanese couples during the transition to parenthood with their first child. BACKGROUND Relevant literature suggests that the health status of women drop during pregnancy and the postpartum period. However, less is known about their partner's well-being during the transition to parenthood and little research has addressed the relationship between couples' QOL across multiple domains. METHOD Participants included 9216 married Japanese men and women, including 3729 couples, who were expecting or raising their first child under the age of three. They independently completed questionnaires on baseline demographics and on WHOQOL-BREF. RESULTS Men showed higher scores for psychological QOL, while women had higher scores for social and environment QOL. A significant interaction between gender and stage of transition to parenthood was found. The moderating effect of age between the stage and QOL was found for men on the physical and psychological domains. Couples' QOL scores were weakly to moderately correlated. CONCLUSION Findings suggest that both men and women had lower QOL, with the exception of women's physical QOL, after childbirth, but they showed different trends during the transition to parenthood across different domains of QOL.
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Affiliation(s)
- Yi Sun
- a Ritsumeikan Global Innovation Research Organization , Osaka , Japan
| | | | | | | | | | - Junko Takaoka
- e Benesse Education Research and Development Institute , Tokyo , Japan
| | - Noriko Goto
- e Benesse Education Research and Development Institute , Tokyo , Japan
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Lee K. Activation of Pelvic Floor Muscle During Ankle Posture Change on the Basis of a Three-Dimensional Motion Analysis System. Med Sci Monit 2018; 24:7223-7230. [PMID: 30301876 PMCID: PMC6192454 DOI: 10.12659/msm.912689] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND Weak pelvic floor muscles (PFMs) is an important cause of stress urinary incontinence. Effective strengthening of PFMs is very helpful in improving lower urinary tract disease. The purpose of this study was to determine the activation of PFMs in accordance with movement of the pelvis and ankle. MATERIAL AND METHODS Fifty healthy adults who underwent PFM contraction in ankle posture change (dorsiflexion, neutral, and plantar flexion) while standing were simultaneously measured using electromyography and motion capture systems. Muscle activity at the tibialis anterior and gastrocnemius muscles was measured by surface electromyography electrodes and PFMs was measured using anal/vaginal probe. Motion analysis was captured by 3-dimensional motion trajectories of the retro-reflective markers. RESULTS At the ankle dorsiflexion, pelvic tilted anteriorly and PFMs were activated, but there was no pelvic movement in ankle plantar flexion. Significantly greater PFM activities were seen in ankle dorsiflexion. CONCLUSIONS PFM exercises performed in active ankle dorsiflexion positions while standing may increase the effectiveness of these exercises. For an effective pelvic floor enhancement in patients with weak PFMs, we recommend a dorsiflexion of the ankle in the standing position.
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Affiliation(s)
- Kyeongjin Lee
- Department of Physical Therapy, Kyungdong University, Gangwon, South Korea
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Angelini CR, Pacagnella RC, Parpinelli MA, Silveira C, Andreucci CB, Ferreira EC, Santos JP, Zanardi DM, Souza RT, Sousa MH, Cecatti JG. Quality of Life after an Episode of Severe Maternal Morbidity: Evidence from a Cohort Study in Brazil. BIOMED RESEARCH INTERNATIONAL 2018; 2018:9348647. [PMID: 30105265 PMCID: PMC6076926 DOI: 10.1155/2018/9348647] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/18/2018] [Revised: 06/19/2018] [Accepted: 07/02/2018] [Indexed: 01/22/2023]
Abstract
OBJECTIVE To assess quality of life (QOL) in women who experienced a severe maternal morbidity (SMM) event and associated factors, in comparison to those who did not. STUDY DESIGN Retrospective cohort study performed at the maternity of the University of Campinas in Brazil, including 801 women with or without SMM, within 6 months to 5 years after delivery. Women were interviewed by phone and data were electronically stored, using the Brazilian version of the SF36 to assess women's self-perception of quality of life. To analyze a possible relationship between SMM and perceived impairment in quality of life, χ2 and Fisher's Exact tests were used. Multiple analysis using Generalized Linear Models was applied to identify factors independently associated with the general health score. The main outcome measures were general and domain-specific SF36 scores on quality of life. RESULTS Maternal morbidity conditions were associated with lower scores of patient perceptions of quality of life in the following domains: physical functioning, role-limiting physical, pain, and general health status. A lower level of school education, not having a partner, caesarean section, and history of previous clinical conditions were associated with a worse perception of general health and quality of life. CONCLUSION Health professionals should know the association between life conditions, previous chronic health conditions, and SMM for women during prenatal care to beyond 42 weeks postpartum. Longitudinal and interdisciplinary actions should be put into practice to provide healthcare for these women, with special emphasis on the effective reduction in health inequities.
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Affiliation(s)
- Carina R. Angelini
- Department of Obstetrics and Gynecology, School of Medical Sciences, State University of Campinas, Brazil
| | - Rodolfo C. Pacagnella
- Department of Obstetrics and Gynecology, School of Medical Sciences, State University of Campinas, Brazil
| | - Mary A. Parpinelli
- Department of Obstetrics and Gynecology, School of Medical Sciences, State University of Campinas, Brazil
| | - Carla Silveira
- Department of Obstetrics and Gynecology, School of Medical Sciences, State University of Campinas, Brazil
| | - Carla B. Andreucci
- Department of Obstetrics and Gynecology, School of Medical Sciences, State University of Campinas, Brazil
- Department of Medicine, Federal University of Sao Carlos, Brazil
| | - Elton C. Ferreira
- Department of Obstetrics and Gynecology, School of Medical Sciences, State University of Campinas, Brazil
| | - Juliana P. Santos
- Department of Obstetrics and Gynecology, School of Medical Sciences, State University of Campinas, Brazil
| | - Dulce M. Zanardi
- Department of Obstetrics and Gynecology, School of Medical Sciences, State University of Campinas, Brazil
| | - Renato T. Souza
- Department of Obstetrics and Gynecology, School of Medical Sciences, State University of Campinas, Brazil
| | - Maria H. Sousa
- Department of Public Health, Jundiaí School of Medicine, Jundiaí, SP, Brazil
| | - Jose G. Cecatti
- Department of Obstetrics and Gynecology, School of Medical Sciences, State University of Campinas, Brazil
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Dantas THDM, Castaneda L, Magalhães AG, Dantas DDS. Linking of assessment scales for women with urinary incontinence and the International Classification of Functioning, Disability and Health. Disabil Rehabil 2018; 41:1443-1449. [DOI: 10.1080/09638288.2018.1431695] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
| | - Luciana Castaneda
- Instituto Federal de Educação, Ciência e Tecnologia do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Adriana Gomes Magalhães
- Graduate Program in Rehabilitation Sciences, Universidade Federal do Rio Grande do Norte, Natal, Brazil
| | - Diego de Sousa Dantas
- Graduate Program in Rehabilitation Sciences, Universidade Federal do Rio Grande do Norte, Natal, Brazil
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Vikström A, Johansson S, Barimani M. Postnatal
ER
visits within 30 days—Pattern, risk factors and implications for care. J Clin Nurs 2017; 27:769-776. [DOI: 10.1111/jocn.14090] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/17/2017] [Indexed: 11/27/2022]
Affiliation(s)
- Anna Vikström
- The Division of Family Medicine Department of Neurobiology, Care Sciences and Society Karolinska Institutet Stockholm Sweden
| | - Sven‐Erik Johansson
- The Division of Family Medicine Department of Neurobiology, Care Sciences and Society Karolinska Institutet Stockholm Sweden
| | - Mia Barimani
- Division of Reproductive Health Department of Women′s and Children′s Health Karolinska Institutet Stockholm Sweden
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Seppänen PM, Sund RT, Ala-Kokko TI, Uotila JT, Helminen MT, Suominen TM. Health-related quality of life after obstetric intensive care admission: Comparison with the general population. J Crit Care 2017; 43:276-280. [PMID: 28965036 DOI: 10.1016/j.jcrc.2017.09.034] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2017] [Revised: 08/27/2017] [Accepted: 09/16/2017] [Indexed: 01/13/2023]
Abstract
PURPOSE To examine health-related quality of life (HRQoL) in obstetric patients after intensive care discharge, with comparison to age-appropriate reference values from the general Finnish female population. MATERIAL AND METHODS Retrospective register-based study. Four multidisciplinary intensive care units at Finnish university hospitals participated. RESULTS A total of 291 obstetric patient were admitted to the ICU, of whom 114 (39%) completed follow-up measurements. At baseline (pre-intensive care admission), patients showed lower physical (mobility, self-care, pain/discomfort) and social (usual activities) dimensions compared to reference values. Baseline overall health status (EQsum) was lower than reference values. However EQsum increased over six months (mean, 0.907 to 0.946) such that follow-up values were similar to reference values. At follow-up, 18.4% of patients showed poorer HRQoL (mean, 0.764; range, 0.638-0.885) compared to reference values. Multiparous patients showed lower scores than primiparous patients. EQ VAS scores were lower at baseline, but increased over six months (72.12 to 87.5) such that follow-up values were similar to reference values. CONCLUSIONS The baseline HRQoL of study population was lower than that of the general population, but after six months, the mean values were comparable to reference value. However, one in five patients still experienced impaired QOL at follow-up.
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Affiliation(s)
- Pia M Seppänen
- University of Tampere, School of Health Sciences, Finland.
| | - Reijo T Sund
- Centre for Research Methods, Department of Social Research, University of Helsinki, Helsinki, Finland; Institute of Clinical Medicine, University of Eastern Finland, Kuopio, Finland
| | - Tero I Ala-Kokko
- Division of Intensive Care Medicine, Oulu University Hospital, Medical Research Center Oulu and Research Group of Surgery, Anesthesiology and Intensive Care, University of Oulu, Finland
| | - Jukka T Uotila
- Tampere University; Obstetrics and Gynecology, Tampere University Hospital, Finland
| | - Mika T Helminen
- Science Center, School of Health Sciences, University of Tampere, Pirkanmaa Hospital District, Tampere, Finland
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Machiyama K, Hirose A, Cresswell JA, Barreix M, Chou D, Kostanjsek N, Say L, Filippi V. Consequences of maternal morbidity on health-related functioning: a systematic scoping review. BMJ Open 2017; 7:e013903. [PMID: 28667198 PMCID: PMC5719332 DOI: 10.1136/bmjopen-2016-013903] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
OBJECTIVES To assess the scope of the published literature on the consequences of maternal morbidity on health-related functioning at the global level and identify key substantive findings as well as research and methodological gaps. METHODS We searched for articles published between 2005 and 2014 using Medline, Embase, Popline, CINAHL Plus and three regional bibliographic databases in January 2015. DESIGN Systematic scoping review PRIMARY OUTCOME: Health-related functioning RESULTS: After screening 17 706 studies, 136 articles were identified for inclusion. While a substantial number of papers have documented mostly negative effects of morbidity on health-related functioning and well-being, the body of evidence is not spread evenly across conditions, domains or geographical regions. Over 60% of the studies focus on indirect conditions such as depression, diabetes and incontinence. Health-related functioning is often assessed by instruments designed for the general population including the 36-item Short Form or disease-specific tools. The functioning domains most frequently documented are physical and mental; studies that examined physical, mental, social, economic and specifically focused on marital, maternal and sexual functioning are rare. Only 16 studies were conducted in Africa. CONCLUSIONS Many assessments have not been comprehensive and have paid little attention to important functioning domains for pregnant and postpartum women. The development of a comprehensive instrument specific to maternal health would greatly advance our understanding of burden of ill health associated with maternal morbidity and help set priorities. The lack of attention to consequences on functioning associated with the main direct obstetric complications is of particular concern. REVIEW REGISTRATION CRD42015017774.
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Affiliation(s)
- Kazuyo Machiyama
- Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK
| | - Atsumi Hirose
- Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden
| | - Jenny A Cresswell
- Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK
| | - Maria Barreix
- Department of Reproductive Health and Research, World Health Organization, UNDP/UNFPA/UNICEF/WHO/World Bank Special Programme of Research, Development and Research Training in Human Reproduction (HRP), Geneva, Switzerland
| | - Doris Chou
- Department of Reproductive Health and Research, World Health Organization, UNDP/UNFPA/UNICEF/WHO/World Bank Special Programme of Research, Development and Research Training in Human Reproduction (HRP), Geneva, Switzerland
| | - Nenad Kostanjsek
- Department of Health Statistics and Informatics, World Health Organization, Classification, Terminology and Standards, Geneva, Switzerland
| | - Lale Say
- Department of Reproductive Health and Research, World Health Organization, UNDP/UNFPA/UNICEF/WHO/World Bank Special Programme of Research, Development and Research Training in Human Reproduction (HRP), Geneva, Switzerland
| | - Véronique Filippi
- Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK
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Petrou S, Kim SW, McParland P, Boyle EM. Mode of Delivery and Long-Term Health-Related Quality-of-Life Outcomes: A Prospective Population-Based Study. Birth 2017; 44:110-119. [PMID: 27862265 DOI: 10.1111/birt.12268] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/30/2016] [Indexed: 11/28/2022]
Abstract
BACKGROUND Relatively little is known about the effects of mode of delivery on long-term health-related quality-of-life outcomes. Furthermore, no previous study has expressed these outcomes in preference-based (utility) metrics. METHODS The study population comprised 2,161 mothers recruited from a prospective population-based study in the East Midlands of England encompassing live births and stillbirths between 32+0 and 36+6 weeks' gestation and a sample of term-born controls. Perinatal data were extracted from the mothers' maternity records. Health-related quality-of-life outcomes were assessed at 12 months postpartum, using the EuroQol Five Dimensions (EQ-5D) measure with responses to the EQ-5D descriptive system converted into health utility scores. Descriptive statistics and multivariable analyses were used to estimate the relationship between the mode of delivery and health-related quality-of-life outcomes. RESULTS The overall health-related quality-of-life profile of the women in the study cohort mirrored that of the English adult population as revealed by national health surveys. A significantly higher proportion of women delivering by cesarean delivery reported some, moderate, severe, or extreme pain or discomfort at 12 months postpartum than women undergoing spontaneous vaginal delivery. Multivariable analyses, using the Ordinary Least Squares estimator revealed that, after controlling for maternal sociodemographic characteristics, cesarean delivery without maternal or fetal compromise was associated with a significant EQ-5D utility decrement in comparison to spontaneous vaginal delivery among all women (-0.026; p = 0.038) and among mothers of term-born infants (-0.062; p < 0.001). Among mothers of term-born infants, this result was replicated in models that controlled for all maternal and infant characteristics (utility decrement of -0.061; p < 0.001). The results were confirmed by sensitivity analyses that varied the categorization of the main exposure variable (mode of delivery) and the econometric strategy. CONCLUSIONS Among mothers of term-born infants, cesarean delivery without maternal or fetal compromise is associated with poorer long-term health-related quality of life in comparison to spontaneous vaginal delivery. Further longitudinal studies are needed to understand the magnitude, trajectory, and underpinning mechanisms of health-related quality-of-life outcomes following different modes of delivery.
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49
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Marchetti D, Carrozzino D, Fraticelli F, Fulcheri M, Vitacolonna E. Quality of Life in Women with Gestational Diabetes Mellitus: A Systematic Review. J Diabetes Res 2017; 2017:7058082. [PMID: 28326332 PMCID: PMC5343261 DOI: 10.1155/2017/7058082] [Citation(s) in RCA: 47] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/30/2016] [Accepted: 02/09/2017] [Indexed: 12/16/2022] Open
Abstract
Background and Objective. Diagnosis of Gestational Diabetes Mellitus (GDM) could significantly increase the likelihood of health problems concerning both potential risks for the mother, fetus, and child's development and negative effects on maternal mental health above all in terms of a diminished Quality of Life (QoL). The current systematic review study is aimed at further contributing to an advancement of knowledge about the clinical link between GDM and QoL. Methods. According to PRISMA guidelines, PubMed, Web of Science, Scopus, and Cochrane databases were searched for studies aimed at evaluating and/or improving levels of QoL in women diagnosed with GDM. Results. Fifteen research studies were identified and qualitatively analyzed by summarizing results according to the following two topics: GDM and QoL and interventions on QoL in patients with GDM. Studies showed that, in women with GDM, QoL is significantly worse in both the short term and long term. However, improvements on QoL can be achieved through different intervention programs by enhancing positive diabetes-related self-management behaviors. Conclusion. Future studies are strongly recommended to further examine the impact of integrative programs, including telemedicine and educational interventions, on QoL of GDM patients by promoting their illness acceptance and healthy lifestyle behaviors.
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Affiliation(s)
- Daniela Marchetti
- Department of Psychological Health and Territorial Sciences, “G. d'Annunzio” University of Chieti-Pescara, Chieti, Italy
| | - Danilo Carrozzino
- Department of Psychological Health and Territorial Sciences, “G. d'Annunzio” University of Chieti-Pescara, Chieti, Italy
- Psychiatric Research Unit, Psychiatric Centre North Zealand, Copenhagen University Hospital, Hillerød, Denmark
| | - Federica Fraticelli
- Department of Medicine and Aging, “G. d'Annunzio” University of Chieti-Pescara, Chieti, Italy
| | - Mario Fulcheri
- Department of Psychological Health and Territorial Sciences, “G. d'Annunzio” University of Chieti-Pescara, Chieti, Italy
| | - Ester Vitacolonna
- Department of Medicine and Aging, “G. d'Annunzio” University of Chieti-Pescara, Chieti, Italy
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50
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Salmon VE, Hay-Smith EJC, Jarvie R, Dean S, Oborn E, Bayliss SE, Bick D, Davenport C, Ismail KM, MacArthur C, Pearson M. Opportunities, challenges and concerns for the implementation and uptake of pelvic floor muscle assessment and exercises during the childbearing years: protocol for a critical interpretive synthesis. Syst Rev 2017; 6:18. [PMID: 28122608 PMCID: PMC5267404 DOI: 10.1186/s13643-017-0420-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2016] [Accepted: 01/18/2017] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Pregnancy and childbirth are important risk factors for urinary incontinence (UI) in women. Pelvic floor muscle exercises (PFME) are effective for prevention of UI. Guidelines for the management of UI recommend offering pelvic floor muscle training (PFMT) to women during their first pregnancy as a preventive strategy. The objective of this review is to understand the relationships between individual, professional, inter-professional and organisational opportunities, challenges and concerns that could be essential to maximise the impact of PFMT during childbearing years and to effect the required behaviour change. METHODS Following systematic searches to identify sources for inclusion, we shall use a critical interpretive synthesis (CIS) approach to produce a conceptual model, mapping the relationships between individual, professional, inter-professional and organisational factors and the implementation, acceptability and uptake of PFME education, assessment and training during the childbearing years. Purposive sampling will be used to identify potentially relevant material relating to topics or areas of interest which emerge as the review progresses. A wide range of empirical and non-empirical sources will be eligible for inclusion to encompass the breadth of relevant individual, professional, inter-professional and organisational issues relating to PFME during childbearing years. Data analysis and synthesis will identify key themes, concepts, connections and relationships between these themes. Findings will be interpreted in relation to existing frameworks of implementation, attitudes and beliefs of individuals and behaviour change. We will collate examples to illustrate relationships expressed in the conceptual model and identify potential links between the model and drivers for change. DISCUSSION The CIS review findings and resulting conceptual model will illustrate relationships between factors that might affect the implementation, acceptability and uptake of PFME education, assessment and training during the childbearing years. The model will inform the development and evaluation of a training package to support midwives with implementation and delivery of effective PFME during the antenatal period. The review forms part of the first phase of the United Kingdom National Institute for Health Research funded 'Antenatal Preventative Pelvic floor Exercises And Localisation (APPEAL)' programme (grant number: RP-PG-0514-20002) to prevent poor health linked to pregnancy and childbirth-related UI. SYSTEMATIC REVIEW REGISTRATION PROSPERO: CRD42016042792.
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Affiliation(s)
- Victoria E Salmon
- NIHR Collaboration for Leadership in Applied Health Research & Care South West Peninsula (PenCLAHRC), Institute of Health Research, University of Exeter Medical School, South Cloisters, St. Luke's Campus, Heavitree Road, Exeter, EX1 2LU, UK
| | | | - Rachel Jarvie
- NIHR Collaboration for Leadership in Applied Health Research & Care South West Peninsula (PenCLAHRC), Institute of Health Research, University of Exeter Medical School, South Cloisters, St. Luke's Campus, Heavitree Road, Exeter, EX1 2LU, UK
| | - Sarah Dean
- NIHR Collaboration for Leadership in Applied Health Research & Care South West Peninsula (PenCLAHRC), Institute of Health Research, University of Exeter Medical School, South Cloisters, St. Luke's Campus, Heavitree Road, Exeter, EX1 2LU, UK
| | - Eivor Oborn
- Warwick Business School, University of Warwick, Coventry, UK
| | | | | | | | | | | | - Mark Pearson
- NIHR Collaboration for Leadership in Applied Health Research & Care South West Peninsula (PenCLAHRC), Institute of Health Research, University of Exeter Medical School, South Cloisters, St. Luke's Campus, Heavitree Road, Exeter, EX1 2LU, UK.
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