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Kaliush PR, Conradt E, Kerig PK, Williams PG, Crowell SE. A multilevel developmental psychopathology model of childbirth and the perinatal transition. Dev Psychopathol 2024; 36:533-544. [PMID: 36700362 PMCID: PMC10368796 DOI: 10.1017/s0954579422001389] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
Despite recent applications of a developmental psychopathology perspective to the perinatal period, these conceptualizations have largely ignored the role that childbirth plays in the perinatal transition. Thus, we present a conceptual model of childbirth as a bridge between prenatal and postnatal health. We argue that biopsychosocial factors during pregnancy influence postnatal health trajectories both directly and indirectly through childbirth experiences, and we focus our review on those indirect effects. In order to frame our model within a developmental psychopathology lens, we first describe "typical" biopsychosocial aspects of pregnancy and childbirth. Then, we explore ways in which these processes may deviate from the norm to result in adverse or traumatic childbirth experiences. We briefly describe early postnatal health trajectories that may follow from these birth experiences, including those which are adaptive despite traumatic childbirth, and we conclude with implications for research and clinical practice. We intend for our model to illuminate the importance of including childbirth in multilevel perinatal research. This advancement is critical for reducing perinatal health disparities and promoting health and well-being among birthing parents and their children.
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Affiliation(s)
- Parisa R. Kaliush
- Department of Psychology, University of Utah, 380 South 1530 East, BEH S 502, Salt Lake City, UT 84112, USA
| | - Elisabeth Conradt
- Department of Psychiatry and Behavioral Sciences, Duke University, Durham, NC 27701, USA
| | - Patricia K. Kerig
- Department of Psychology, University of Utah, 380 South 1530 East, BEH S 502, Salt Lake City, UT 84112, USA
| | - Paula G. Williams
- Department of Psychology, University of Utah, 380 South 1530 East, BEH S 502, Salt Lake City, UT 84112, USA
| | - Sheila E. Crowell
- Department of Psychology, University of Utah, 380 South 1530 East, BEH S 502, Salt Lake City, UT 84112, USA
- Department of Psychiatry, University of Utah, Salt Lake City, UT 84108, USA
- Department of Obstetrics and Gynecology, University of Utah, Salt Lake City, UT 84132, USA
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Kaliush PR, Butner JE, Williams PG, Conradt E, Crowell SE. Dynamic Associations Among Sleep, Emotion Dysregulation, and Desire to Live in a Perinatal Sample. Psychosom Med 2024; 86:272-282. [PMID: 38451838 PMCID: PMC11081831 DOI: 10.1097/psy.0000000000001297] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/09/2024]
Abstract
OBJECTIVE The present study prospectively examined dynamic associations among sleep, emotion dysregulation, and desire to live during the perinatal transition, as it was theorized that these factors may contribute to the emergence of postpartum suicide risk. METHOD Ninety-four women ( Mage = 29.2 years; 23.4% Latina) wore wrist actigraphs and completed twice daily surveys for 7 days during the third trimester of pregnancy, 6 weeks postpartum, and 4 months postpartum. Multilevel, change-as-outcome models were built to examine changes in attractor dynamics among sleep, emotion dysregulation, and desire to live, as well as if sleep-emotion dysregulation dynamics differed based on participants' desires to live. RESULTS From pregnancy to 6 weeks postpartum, emotion dysregulation ( B = -0.09, p = .032) and desire to live ( B = -0.16, p < .001) exhibited more stable temporal patterns around higher emotion dysregulation and lower desire to live. Compared to women who reported consistently high desires to live, those who experienced fluctuations in their desires to live exhibited lower, more stable sleep efficiency during pregnancy ( B = -0.90, p < .001). At 4 months postpartum, those with fluctuating desires to live exhibited a coupling dynamic whereby low sleep efficiency predicted increases in emotion dysregulation ( B = -0.16, p = .020). CONCLUSIONS This study was the first to examine nonlinear dynamics among risk factors for postpartum suicide, which may be evident as early as pregnancy and 6 weeks postpartum. Sleep health, in particular, warrants further exploration as a key susceptibility factor in the emergence of postpartum suicide risk. PREREGISTRATION Open Science Framework ( https://osf.io/qxb75/?view_only=799ffe5c048842dfb89d3ddfebaa420d ).
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Kember AJ, Elangainesan P, Ferraro ZM, Jones C, Hobson SR. Common sleep disorders in pregnancy: a review. Front Med (Lausanne) 2023; 10:1235252. [PMID: 37671402 PMCID: PMC10475609 DOI: 10.3389/fmed.2023.1235252] [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: 06/06/2023] [Accepted: 08/02/2023] [Indexed: 09/07/2023] Open
Abstract
In this review, we provide a comprehensive overview of common sleep disorders during pregnancy, including their characterization, prevalence, risk factors, and possible contribution to maternal and fetal outcomes. We conducted a quasi-systematic literature search of the MEDLINE database and identified 744 studies from 1991 through 2021, inclusive, that met our inclusion criteria. We synthesized the existing literature on sleep disorders during pregnancy and highlighted controversies, research gaps, and needed clinical developments. Our review covers a range of sleep disorders, including insomnia, obstructive sleep apnea, restless legs syndrome, and circadian rhythm disorders. We discuss the prevalence of these disorders in pregnancy and their potential impact on maternal and fetal health outcomes. We also explore the relationship between sleep disorders, pre-pregnancy comorbidities such as obesity, and pregnancy-related conditions such as gestational diabetes mellitus and preeclampsia. In addition to summarizing the existing literature on sleep disorders during pregnancy, we also highlight opportunities for further research in this area. We suggest that future studies should strive to employ validated and objective measurement tools for sleep disorders and prioritize utilization of longitudinal methods with participant follow-up through postpartum, mid-life, menopause, and beyond. We also put forward investigation into the impact of circadian rhythm disruption on reproductive physiology and early pregnancy outcomes as an area of important work. Overall, our review provides valuable insights on sleep and reproduction and into common sleep disorders during pregnancy and their potential impact on maternal and fetal health outcomes.
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Affiliation(s)
- Allan J. Kember
- Department of Obstetrics and Gynaecology, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- Dalla Lana School of Public Health, Institute of Health Policy, Management, and Evaluation, University of Toronto, Toronto, ON, Canada
- Shiphrah Biomedical Inc., Toronto, ON, Canada
| | - Praniya Elangainesan
- Temerty Faculty of Medicine, Medical Education, University of Toronto, Toronto, ON, Canada
| | - Zachary M. Ferraro
- Department of Obstetrics and Gynaecology, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Claire Jones
- Department of Obstetrics and Gynaecology, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- Division of Reproductive Endocrinology and Infertility, Mount Sinai Hospital, Toronto, ON, Canada
| | - Sebastian R. Hobson
- Department of Obstetrics and Gynaecology, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- Dalla Lana School of Public Health, Institute of Health Policy, Management, and Evaluation, University of Toronto, Toronto, ON, Canada
- Temerty Faculty of Medicine, Medical Education, University of Toronto, Toronto, ON, Canada
- Temerty Faculty of Medicine, Institute of Medical Science, University of Toronto, Toronto, ON, Canada
- Maternal-Fetal Medicine Division, Mount Sinai Hospital, Toronto, ON, Canada
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Jamshaid S, Malik NI, Ullah I, Saboor S, Arain F, De Berardis D. Postpartum Depression and Health: Role of Perceived Social Support among Pakistani Women. Diseases 2023; 11:diseases11020053. [PMID: 37092435 PMCID: PMC10123603 DOI: 10.3390/diseases11020053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2022] [Revised: 02/20/2023] [Accepted: 03/07/2023] [Indexed: 04/03/2023] Open
Abstract
Postpartum depression (PPD) can predispose to physical and mental health problems in Pakistani women. However, PPD is associated with health and perceived social support, yet their causal relationship is unclear. Therefore, this study intended to evaluate the association of PPD with insomnia, mental health, and physical health. The convenience sampling technique was used to collect data from 320 (52.8%) young and middle-aged postpartum women, at the outpatient departments of obstetrics and gynecology of the Government Maula Bakhsh Hospital, District Head Quarter in Sargodha, Pakistan. The Edinburgh Postnatal Depression Scale, Pittsburgh Sleep Quality Index, Warwick–Edinburgh Mental Well-being Scale, patient health questionnaire, and Multidimensional Scale of Perceived Social Support were used to measure study variables. The results revealed a significant positive relationship between PPD and physical health (r = 0.45, p = 0.001), negative relationships with insomnia (r = −0.24, p < 0.001), and perceived social support (r = −0.38, p = 0.001). Results further confirmed that perceived social support played a moderating role (β = 0.97, p = 0.01) in the relationship between PPD and mental health among Pakistani women. This study concluded that perceived social support has an important role in PPD and the health of Pakistani women. The study also concluded that poor health is a risk indicator for the identification of aid in the early stages of postpartum among Pakistani women.
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The Effect of Bergamot Essential Oil Aromatherapy on Improving Depressive Mood and Sleep Quality in Postpartum Women: A Randomized Controlled Trial. THE JOURNAL OF NURSING RESEARCH : JNR 2022; 30:e201. [PMID: 34690334 DOI: 10.1097/jnr.0000000000000459] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
BACKGROUND The postpartum period is a physiologically and psychologically crucial transition phase for every woman who gives birth. Aromatherapy may improve mood and alleviate sleep challenges. However, few randomized controlled clinical trials have focused on the effect of aromatherapy in postpartum women. PURPOSE This study was designed to explore the effect of a bergamot essential oil aromatherapy intervention on depressive mood and sleep quality in postpartum women. METHODS This randomized controlled trial used consecutive sampling. The participants were all women in a postpartum care center in eastern Taiwan and were randomly assigned to either the experimental (n = 29) or control (n = 31) group. Bergamot essential oil aroma was used in the experimental group, and pure water aroma was used in the control group. The experimental and control interventions were both performed while the participants were residents at the postpartum care center in the afternoon for 15 minutes each day. Before the aroma intervention, pretests were conducted using the Edinburgh Postnatal Depression Scale and the Postpartum Sleep Quality Scale. The first and second posttests were conducted using the same two scales at 2 and 4 weeks after the intervention, respectively. RESULTS At both the first and second posttests, depressive mood was significantly lower (p < .001) in the experimental group than in the control group, supporting the positive effect of the bergamot essential oil aroma intervention on depressive mood in postpartum women. No significant intergroup difference in sleep quality (p > .05) was observed at either the first or second posttest, indicating an uncertain effect of the bergamot essential oil aroma intervention on sleep quality. CONCLUSIONS/IMPLICATIONS FOR PRACTICE The results of this study support the effectiveness of bergamot essential oil aromatherapy in alleviating depressive mood in postpartum women. In addition, the results provide a practical reference for clinical postpartum nursing care.
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Amegavluie REA, Ani-Amponsah M, Naab F. Women's experiences of surviving severe obstetric complications: a qualitative inquiry in southern Ghana. BMC Pregnancy Childbirth 2022; 22:212. [PMID: 35296276 PMCID: PMC8928636 DOI: 10.1186/s12884-022-04538-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2021] [Accepted: 02/28/2022] [Indexed: 12/04/2022] Open
Abstract
Women who survive severe obstetric complications (SOC) have health and well-being issues even up to 1 year postpartum and have challenges in their quality-of-life (QoL). However, little is known about their predicaments. This study aimed to describe the impact of severe obstetric complications on women’s QoL and well-being after surviving severe obstetric complications. Using the WHO standards for near-miss, twelve (12) women who survived severe obstetric complications were recruited between January and March 2019. The study adopted a qualitative approach with an exploratory descriptive design to explore the experiences of women who survived SOC in Southern Ghana. The participants were purposively sampled and were interviewed face to face in their homes and healthcare facility after discharge from the Hospital. Recorded interviews were transcribed and analyzed. Two (2) major themes and nine (9) sub-themes emerged. The findings revealed that women who suffered SOC are unable to perform functional activities, have financial constraints, residual hypertension, signs and symptoms of anaemia, pain, and mostly have difficulty in sleeping due to fear of death when they fall asleep. Anxiety, sadness, and emotional trauma was a common phenomenon. The study findings offer insights and directions on measures to improve the care and QoL of women who have survived severe obstetric complications in Ghana.
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Affiliation(s)
| | - Mary Ani-Amponsah
- Maternal and Child Health Department, School of Nursing and Midwifery/ College of Health Sciences. University of Ghana, Legon, Ghana
| | - Florence Naab
- Maternal and Child Health Department, School of Nursing and Midwifery/ College of Health Sciences. University of Ghana, Legon, Ghana
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Kalmbach DA, Cheng P, Roth A, Roth T, Swanson LM, O'Brien LM, Fresco DM, Harb NC, Cuamatzi-Castelan AS, Reffi AN, Drake CL. DSM-5 insomnia disorder in pregnancy: associations with depression, suicidal ideation, and cognitive and somatic arousal, and identifying clinical cutoffs for detection. SLEEP ADVANCES : A JOURNAL OF THE SLEEP RESEARCH SOCIETY 2022; 3:zpac006. [PMID: 35391758 PMCID: PMC8981986 DOI: 10.1093/sleepadvances/zpac006] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/29/2021] [Revised: 02/18/2022] [Indexed: 11/23/2022]
Abstract
Study Objectives The study had three primary goals. First, we estimated survey-assessed DSM-5 insomnia disorder rates in pregnancy, and described associated sociodemographics, and sleep-wake and mental health symptoms. Second, we derived cutoffs for detecting DSM-5 insomnia disorder using common self-report measures of sleep symptoms. Third, we identified clinically relevant cut-points on measures of nocturnal cognitive and somatic arousal. Methods Ninety-nine women (85.9% in the 2nd trimester) completed online surveys including DSM-5 insomnia disorder criteria, the Insomnia Severity Index (ISI), Pittsburgh Sleep Quality Index (PSQI), Presleep Arousal Scale's Cognitive (PSASC) and Somatic (PSASS) factors, and Edinburgh Postnatal Depression Scale. Results DSM-5 insomnia disorder rate was 19.2%. Insomnia was associated with depression, suicidality, nocturnal cognitive and somatic arousal, and daytime sleepiness. An ISI scoring method that aligns with DSM-5 criteria yielded excellent metrics for detecting insomnia disorder and good sleep. Regarding quantitative cutoffs, ISI ≥ 10 and ISI ≥ 11 (but not ISI ≥ 15) were supported for detecting DSM-5 insomnia, whereas ISI ≤ 7 and ISI ≤ 9 performed well for detecting good sleep. PSQI cutoff of 5 was supported for detecting insomnia and good sleep. The optimal cutoff for nocturnal cognitive arousal was PSASC ≥ 18, whereas the optimal cutoff for somatic arousal was PSASS ≥ 13. Conclusions Insomnia disorder affects a large segment of pregnant women. Empirically derived cutoffs for insomnia, good sleep, cognitive arousal, and somatic arousal may inform case identification and future perinatal sleep research methodology.
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Affiliation(s)
- David A Kalmbach
- Thomas Roth Sleep Disorders & Research Center, Henry Ford Health System, Detroit, MIUSA.,Department of Pulmonary & Critical Care and Sleep Medicine, Wayne State University School of Medicine, Detroit, MIUSA
| | - Philip Cheng
- Thomas Roth Sleep Disorders & Research Center, Henry Ford Health System, Detroit, MIUSA
| | - Andrea Roth
- Pediatric Sleep Medicine, Thriving Minds Behavioral Health, Livonia, MIUSA
| | - Thomas Roth
- Thomas Roth Sleep Disorders & Research Center, Henry Ford Health System, Detroit, MIUSA
| | - Leslie M Swanson
- Department of Psychiatry, University of Michigan, Ann Arbor, MIUSA
| | - Louise M O'Brien
- Departments of Obstetrics & Gynecology and Neurology, University of Michigan, Ann Arbor, MIUSA
| | - David M Fresco
- Department of Psychiatry, University of Michigan, Ann Arbor, MIUSA
| | - Nicholas C Harb
- Thomas Roth Sleep Disorders & Research Center, Henry Ford Health System, Detroit, MIUSA
| | | | - Anthony N Reffi
- Thomas Roth Sleep Disorders & Research Center, Henry Ford Health System, Detroit, MIUSA
| | - Christopher L Drake
- Thomas Roth Sleep Disorders & Research Center, Henry Ford Health System, Detroit, MIUSA
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Horibe K, Isa T, Matsuda N, Murata S, Tsuboi Y, Okumura M, Kawaharada R, Kogaki M, Uchida K, Nakatsuka K, Ono R. Association between sleep disturbance and low back and pelvic pain in 4-month postpartum women: A cross-sectional study. EUROPEAN SPINE JOURNAL : OFFICIAL PUBLICATION OF THE EUROPEAN SPINE SOCIETY, THE EUROPEAN SPINAL DEFORMITY SOCIETY, AND THE EUROPEAN SECTION OF THE CERVICAL SPINE RESEARCH SOCIETY 2021; 30:2983-2988. [PMID: 33977349 DOI: 10.1007/s00586-021-06847-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 04/17/2020] [Revised: 02/20/2021] [Accepted: 04/15/2021] [Indexed: 11/25/2022]
Abstract
PURPOSE Persistent low back and pelvic pain (LBPP) is a postpartum-specific health problem. Sleep disturbances' association with persistent LBPP is not yet clear. We aimed to examine the cross-sectional association between sleep disturbance and persistent LBPP at 4 months postpartum. METHODS We enrolled 120 women with LBPP during pregnancy (mean age, 31.8; standard deviation, 4.9 years). The primary outcome was persistent LBPP. We assessed LBPP severity at 4 months postpartum using the Numerical Rating Scale (NRS), where women with an NRS score of ≥ 4 at 4 months postpartum were allocated to the persistent LBPP group. We assessed sleep disturbance at 4 months postpartum using the Japanese version of the Pittsburgh Sleep Quality Index with a total score of ≥ 6 indicating sleep disturbance. Moreover, we performed univariate and multiple logistic regression analyses to examine the cross-sectional association of sleep disturbance with persistent LBPP. The relevant confounding variables were age, body mass index, parity, and history of LBPP before pregnancy. RESULTS Among the 120 women, 45 women had persistent LBPP (37.5%) with 32 (71.1%) of them reporting sleep disturbance. There was a significant association of sleep disturbance with persistent LBPP (odds ratio [OR], 2.81; 95% confidence interval [95% CI], 1.28-6.19), which remained after adjustments for confounding variables (OR, 2.98; 95% CI, 1.31-6.75). CONCLUSION Our findings indicate that sleep disturbance is associated with persistent LBPP at 4 months postpartum; therefore, it should be taken into consideration in postpartum women with persistent LBPP.
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Affiliation(s)
- Kana Horibe
- Department of Public Health, Kobe University Graduate School of Health Sciences, 7-10-2 Tomogaoka, Suma-ku, Kobe, Japan
| | - Tsunenori Isa
- Department of Public Health, Kobe University Graduate School of Health Sciences, 7-10-2 Tomogaoka, Suma-ku, Kobe, Japan
| | - Naoka Matsuda
- Division of Rehabilitation Medicine, Kobe Mariners Hospital, Kobe, Japan
| | - Shunsuke Murata
- Department of Preventive Medicine and Epidemiology, National Cerebral and Cardiovascular Center Research Institute, Suita, Osaka, Japan
| | - Yamato Tsuboi
- Department of Public Health, Kobe University Graduate School of Health Sciences, 7-10-2 Tomogaoka, Suma-ku, Kobe, Japan.,Japan Society for the Promotion of Science, Chiyoda, Tokyo, Japan
| | - Maho Okumura
- Division of Rehabilitation Medicine, Kobe University Hospital, Kobe, Japan
| | - Rika Kawaharada
- Department of Public Health, Kobe University Graduate School of Health Sciences, 7-10-2 Tomogaoka, Suma-ku, Kobe, Japan
| | - Masahumi Kogaki
- Takumi Day-Care Facility in Children, Nishinomiya, Hyogo, Japan
| | - Kazuaki Uchida
- Department of Public Health, Kobe University Graduate School of Health Sciences, 7-10-2 Tomogaoka, Suma-ku, Kobe, Japan
| | - Kiyomasa Nakatsuka
- Department of Public Health, Kobe University Graduate School of Health Sciences, 7-10-2 Tomogaoka, Suma-ku, Kobe, Japan
| | - Rei Ono
- Department of Public Health, Kobe University Graduate School of Health Sciences, 7-10-2 Tomogaoka, Suma-ku, Kobe, Japan.
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Lucena L, Frange C, Pinto ACA, Andersen ML, Tufik S, Hachul H. Mindfulness interventions during pregnancy: A narrative review. JOURNAL OF INTEGRATIVE MEDICINE-JIM 2020; 18:470-477. [PMID: 32798196 DOI: 10.1016/j.joim.2020.07.007] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/18/2020] [Accepted: 07/10/2020] [Indexed: 12/14/2022]
Abstract
Pregnancy is a period of major transformations in a woman's life; increased stress, and mood and sleep disorders are frequent. This review evaluates mindfulness interventions during pregnancy and their ability to help manage stress, anxiety, depression, emotional regulation, level of mindfulness and sleep quality. A search of English language scientific literature relevant to mindfulness interventions for pregnant women was conducted using PubMed, Scopus and Web of Science, without restriction on publication date. Inclusion criteria were randomized clinical trials with pregnant women, using mindfulness as an intervention for at least three weeks, in one of our main areas of interest, and using only validated scales to measure outcomes. Two hundred and thirty studies were identified in our searches of research databases, and thirteen were included in our analysis. We found a large diversity of mindfulness programs, heterogeneity among the instruments used to evaluate outcomes, and inconsistency in the gestational periods used in the studies. Mindfulness interventions were beneficial for stress, anxiety and depression. Mindfulness was also effective when applied in pregnant women with a history of depression or experiencing depression. Considering emotional regulation and the level of mindfulness, there were signs of improvement, but more studies are needed. None of the studies evaluated sleep quality. Our review provides information about current mindfulness programs, an overview of the effects of mindfulness interventions, a description of the measurements used so far, and recommendations for developing high-quality mindfulness protocols for pregnant women.
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Affiliation(s)
- Leandro Lucena
- Department of Psychobiology, Universidade Federal de São Paulo (UNIFESP), São Paulo 04023062, Brazil
| | - Cristina Frange
- Department of Neurology and Neurosurgery, Universidade Federal de São Paulo (UNIFESP), São Paulo 04039002, Brazil
| | - Ana Claudia Amorim Pinto
- Department of Psychobiology, Universidade Federal de São Paulo (UNIFESP), São Paulo 04023062, Brazil
| | - Monica Levy Andersen
- Department of Psychobiology, Universidade Federal de São Paulo (UNIFESP), São Paulo 04023062, Brazil
| | - Sergio Tufik
- Department of Psychobiology, Universidade Federal de São Paulo (UNIFESP), São Paulo 04023062, Brazil
| | - Helena Hachul
- Department of Psychobiology, Universidade Federal de São Paulo (UNIFESP), São Paulo 04023062, Brazil; Department of Gynecology, Universidade Federal de São Paulo (UNIFESP), São Paulo 04024002, Brazil.
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Quality of sleep and quality of life measured monthly in pregnant women in South Korea. Sleep Breath 2020; 24:1219-1222. [PMID: 32157477 DOI: 10.1007/s11325-020-02041-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2020] [Revised: 02/21/2020] [Accepted: 02/24/2020] [Indexed: 10/24/2022]
Abstract
PURPOSE The change in sleep patterns across the duration of pregnancy is an item of interest. The aim of this study is to provide data on pregnant women's quality of sleep (QoS) and quality of life (QoL) to determine appropriate times to screen for potential problems. METHODS This is a multicenter, prospective, longitudinal observational study. Primigravidae, with no previous illness, completed questionnaires once a month. Strict exclusion criteria were applied in order to evaluate QoS and QoL in "normal" pregnant women. RESULTS A total of 83 normal primigravidae completed this study. The mean age was 33.1 ± 4.0. During pregnancy, body mass index gradually increased, and QoS worsened to a significant degree between the fifth and ninth months (Pittsburgh Sleep Quality Index 6.8 ± 2.8 vs. 8.9 ± 3.6, p < 0.001). There was a statistically significant difference in QoL between the fifth and seventh months (Short Form-36 70.8 ± 18.3 vs. 67.3 ± 15.1, p = 0.009). There was no evidence of significant depression or suspicion of sleep-disordered breathing. CONCLUSIONS Pregnant women in South Korea have gradual worsening of QoS which becomes clinically significant by full term. QoL changes significantly between the fifth and seventh months. The results of this observational study suggest that it would be fruitful to evaluate QoS and QoL in pregnant women between the second and third trimesters.
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Komatsu R, Ando K, Flood PD. Factors associated with persistent pain after childbirth: a narrative review. Br J Anaesth 2020; 124:e117-e130. [PMID: 31955857 PMCID: PMC7187795 DOI: 10.1016/j.bja.2019.12.037] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2018] [Revised: 12/26/2019] [Accepted: 12/28/2019] [Indexed: 12/12/2022] Open
Abstract
A systematic literature search was performed to identify studies that reported risk factors for persistent pain after childbirth. Many studies have sought to identify risk factors for post-delivery pain in different populations, using different methodologies and different outcome variables. Studies of several different but interrelated post-partum pain syndromes have been conducted. Factors strongly and specifically associated with persistent incisional scar pain after Caesarean delivery include a coexisting persistent pain problem in another part of the body and severe acute postoperative pain. For persistent vaginal and perineal pain, operative vaginal delivery and the magnitude of perineal trauma have been consistently linked. History of pregnancy-related and pre-pregnancy back pain and heavier body weight are robust risk factors for persistent back pain after pregnancy. Unfortunately, limitations, particularly small samples and lack of a priori sample size calculation designed to detect specific effect sizes for risk of persistent pain outcomes, preclude definitive conclusions about many other predictors and the strength of outcome associations. In future studies, assessments of specific phenotypes using a rigorous analysis with appropriate predetermined sample sizes and validated instruments are needed to allow elucidation of stronger and reliable associations. Interventional studies targeting the most robustly associated, modifiable risk factors, such as acute post-partum pain, may lead to solutions for the prevention and treatment of these common problems that impact a large population.
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Affiliation(s)
- Ryu Komatsu
- Department of Anaesthesiology and Pain Medicine, University of Washington, Seattle, WA, USA.
| | - Kazuo Ando
- Department of Anaesthesiology, Perioperative and Pain Medicine, Stanford University School of Medicine, Stanford, CA, USA
| | - Pamela D Flood
- Department of Anaesthesiology, Perioperative and Pain Medicine, Stanford University School of Medicine, Stanford, CA, USA
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Osnes RS, Roaldset JO, Follestad T, Eberhard-Gran M. Insomnia late in pregnancy is associated with perinatal anxiety: A longitudinal cohort study. J Affect Disord 2019; 248:155-165. [PMID: 30735852 DOI: 10.1016/j.jad.2019.01.027] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2018] [Revised: 01/09/2019] [Accepted: 01/20/2019] [Indexed: 12/18/2022]
Abstract
BACKGROUND Postpartum anxiety (PPA) affects a substantial number of women. Despite increasing recognition of PPA, few studies have focused on perinatal anxiety and potential PPA triggers. Here we aimed to estimate the prevalence of perinatal anxiety disorders, and to explore the association between insomnia during late pregnancy and anxiety before and after childbirth. METHODS This study was part of the large population-based Akershus Birth Cohort. We analyzed data from the hospital's birth records and questionnaire responses from pregnancy weeks 17 and 32 and postpartum week 8 (n = 1563). Perinatal anxiety symptoms were measured using the Hopkins Symptom Check List. Anxiety disorder measurements were based on questions from the Mini-International Neuropsychiatric Interview. Insomnia was measured using the Bergen Insomnia Scale. RESULTS Among perinatal women, 10% reported symptoms of at least one anxiety disorder. The observed prevalence of obsessive-compulsive disorder was higher after delivery (4.2%) than during pregnancy (2.5%). Multiple regression analysis, with adjustment for several psychosocial and reproductive variables, indicated that insomnia during pregnancy was significantly associated with postpartum anxiety symptoms. However, this association was markedly weakened when depression variables were included in the analysis, indicating that gestational insomnia may also be a marker for a mood disorder. LIMITATIONS Immigrant and single women were underrepresented in our sample. CONCLUSIONS Our results suggest that anxiety disorders are prevalent during the perinatal period. Moreover, insomnia during pregnancy is associated with perinatal anxiety. Health professionals should be aware that women with gestational insomnia may have an increased risk of mood and anxiety disorders.
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Affiliation(s)
- Rannveig S Osnes
- Department of Psychiatry, Ålesund Hospital, Møre & Romsdal Health Trust, Ålesund, Norway; Department of Mental Health, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway.
| | - John Olav Roaldset
- Department of Psychiatry, Ålesund Hospital, Møre & Romsdal Health Trust, Ålesund, Norway; Department of Mental Health, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway; Centre for Research and Education in Forensic Psychiatry, Oslo University Hospital, Oslo, Norway
| | - Turid Follestad
- Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway
| | - Malin Eberhard-Gran
- HØKH, Research Unit, Akershus University Hospital, Lørenskog, Norway; Institute of Clinical Medicine, Campus Ahus, University of Oslo, Lørenskog, Norway; Department for Infant Mental Health, Regional Center for Child and Adolescent Mental Health, Eastern and Southern Norway, Oslo, Norway
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Testing the Psychometric Properties of the Postpartum Sleep Quality Scale in Turkish Women. J Nurs Res 2018; 26:385-392. [DOI: 10.1097/jnr.0000000000000253] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Swartz T, Schramm H, Bewley J, Wood C, Leslie K, Petersson-Wolfe C. Meloxicam administration either prior to or after parturition: Effects on behavior, health, and production in dairy cows. J Dairy Sci 2018; 101:10151-10167. [DOI: 10.3168/jds.2018-14657] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2018] [Accepted: 06/29/2018] [Indexed: 01/14/2023]
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Liu XK, Xiao SY, Zhou L, Hu M, Liu HM. Different predictors of pain severity across age and gender of a Chinese rural population: a cross-sectional survey. BMJ Open 2018; 8:e020938. [PMID: 30007928 PMCID: PMC6082477 DOI: 10.1136/bmjopen-2017-020938] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
OBJECTIVES To investigate a 4-week period of pain prevalence and the risk factors of experiencing pain among a rural Chinese population sample. To explore the psychosocial and health condition predictors of pain severity and the interactions of age and gender with these factors in real-life situations among the general adult population in China. METHODS Data were collected from a random multistage sample of 2052 participants (response rate=95%) in the rural areas of Liuyang, China. Visual analogue scale was used to assess participants' pain experienced and a series of internationally validated instruments to assess their sociodemographic characteristics, self-reported health status, depression symptoms, anxiety symptoms, sleep quality, self-efficacy and perceived stress. RESULTS The pain prevalence over the 4-week period in rural China was 66.18% (62.84% for men and 68.82% for women). A logistic regression model revealed that being female (adjusted OR=1.58, 95% CI 1.24 to 2.02), age (adjusted OR=1.03, 95% CI 1.02 to 1.05), depressive symptoms (adjusted OR=1.07, 95% CI 1.02 to 1.13) and medium-quality sleep (adjusted OR=2.14, 95% CI 1.26 to 3.64) were significant risk factors for experiencing pain. General linear model analyses revealed that (1) pain severity of rural Chinese was related to self-rated physical health and social health; (2) the interactions of age, gender with employment status, depression symptoms, perceived stress and physical health were significant. Simple effect testing revealed that in different age groups, gender interacted with employment status, depression symptoms, perceived stress and physical health differently. CONCLUSIONS Improving physical and social health could be effective in reducing the severity of pain and the treatment of pain should be designed specifically for different ages and genders among the general population.
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Affiliation(s)
- Xiao-kun Liu
- Mental Health Center, Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Shui-yuan Xiao
- Mental Health Center, Xiangya Hospital, Central South University, Changsha, Hunan, China
- Department of Social Medicine and Health Management, School of Public Health, Central South University, Changsha, Hunan, China
| | - Liang Zhou
- Affiliated Brain Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital), Guangzhou, Guangdong, China
| | - Mi Hu
- Department of Social Medicine and Health Management, School of Public Health, Central South University, Changsha, Hunan, China
| | - Hui-ming Liu
- Shenzhen Kangning Hospital, Shenzhen, Guangdong, China
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Román-Gálvez RM, Amezcua-Prieto C, Salcedo-Bellido I, Martínez-Galiano JM, Khan KS, Bueno-Cavanillas A. Factors associated with insomnia in pregnancy: A prospective Cohort Study. Eur J Obstet Gynecol Reprod Biol 2017; 221:70-75. [PMID: 29304393 DOI: 10.1016/j.ejogrb.2017.12.007] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2017] [Accepted: 12/06/2017] [Indexed: 10/18/2022]
Abstract
OBJECTIVE To quantify insomnia and their components in a longitudinal cohort of pregnant women and factors associated with insomnia. STUDY DESIGN A prospective cohort of 486 healthy singleton pregnancies assembled before the 14th gestational week (February 2013 to March 2016). Insomnia data were collected pre-gestationally, in each trimester and six months post-partum, analysing five different moments. Multiple logistic regression analysis was performed to generate adjusted Odds Ratios (aOR) with 95% confidence intervals (CI) of determinants of insomnia in each trimester, defined using Athens Insomnia Scale (AIS) as score ≥8. RESULTS Insomnia prevalence was 6.1% (3.9-8.9) pre-gestational, 44.2% (39.3-49.6) in first trimester (T1), 46.3% (41.9-51.3) in second (T2) and 63.7% (57.7-67.8) in third trimester (T3). Post-gestational insomnia was 33.2% (28.2-37.9) (p < 0.001 pre-gestational vs T1, T2 vs T3 and T3 vs after pregnancy). There was worsening mean AIS score, from: 2.34 before pregnancy to 9.87 in T3 because the deterioration of nighttime sleep, in absolute terms, but daytime impact was higher in T1. Previous trimester insomnia was associated with insomnia in T2 (aOR = 4.21, 95% CI 2.78-6.37) and T3 (aOR = 4.43, 95% CI 2.77-7.08). Pre-gestational insomnia was determinant of insomnia in T1 (aOR 12.50, 95% CI 3.58-43.60) and obesity was associated with insomnia in T3 (aOR = 2.30, 95% CI 0.99-5.32). On the contrary, moderate physical activity reduced the odds of insomnia in T3 (aOR 0.65, 95% CI 0.40-1.03). CONCLUSIONS Insomnia prevalence was high from the beginning of pregnancy, associated with pre-gestational insomnia. In late pregnancy, two out of three pregnant women suffering insomnia. Insomnia prevention should be targeted particularly to those with high body mass index and pre-gestational insomnia.
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Affiliation(s)
- R M Román-Gálvez
- Unidad de Gestión Clínica Churriana de la Vega, Andalusian Health Service, C/Santa Lucía 1, Churriana de la Vega, 18194, Granada, Spain; Doctoral Program of Clinical Medicine and Public Health, University of Granada, Spain
| | - C Amezcua-Prieto
- Department of Preventive Medicine and Public Health, Faculty of Medicine, University of Granada, Avenida de la Investigación, 11, 18071 Granada, Spain; CIBER de Epidemiología y Salud Pública, CIBERESP, Spain; Instituto de Investigación Biosanitaria ibs.GRANADA.
| | - I Salcedo-Bellido
- Department of Preventive Medicine and Public Health, Faculty of Medicine, University of Granada, Avenida de la Investigación, 11, 18071 Granada, Spain; CIBER de Epidemiología y Salud Pública, CIBERESP, Spain; Instituto de Investigación Biosanitaria ibs.GRANADA
| | - J M Martínez-Galiano
- CIBER de Epidemiología y Salud Pública, CIBERESP, Spain; University of Jaen, Campus de las Lagunillas S/N. Edificio B3, despacho 413, 23071, Jaén, Spain
| | - K S Khan
- Department of Preventive Medicine and Public Health, Faculty of Medicine, University of Granada, Avenida de la Investigación, 11, 18071 Granada, Spain; Women's Health Research Unit, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - A Bueno-Cavanillas
- Department of Preventive Medicine and Public Health, Faculty of Medicine, University of Granada, Avenida de la Investigación, 11, 18071 Granada, Spain; CIBER de Epidemiología y Salud Pública, CIBERESP, Spain; Instituto de Investigación Biosanitaria ibs.GRANADA
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