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Clark SM, Zhang X, Goncharov DA. Inpatient Management of Hyperemesis Gravidarum. Obstet Gynecol 2024; 143:745-758. [PMID: 38301258 DOI: 10.1097/aog.0000000000005518] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2023] [Accepted: 11/16/2023] [Indexed: 02/03/2024]
Abstract
Hyperemesis gravidarum has a reported incidence of approximately 0.3-3% of pregnancies. Without treatment, refractory hyperemesis gravidarum can result in dehydration, electrolyte deficiencies, and severe nutritional deficiencies, resulting in significant maternal morbidity. The overall goals of inpatient management of refractory hyperemesis gravidarum are the resumption of oral intake to an adequate level to maintain hydration and nutrition, including the ability to tolerate oral pharmacotherapy. Patients initially are stabilized with rehydration and electrolyte repletion. There are numerous pharmacotherapeutics available that can be administered intravenously to control symptoms when oral intake is not an option. However, despite maximizing typical antiemetics, there will be cases refractory to these medications, and alternative pharmacotherapeutics and nutrition-support modalities must be considered. Mirtazapine, olanzapine, corticosteroids, and gabapentin are examples of alternative pharmacotherapeutics, and enteral and parenteral nutrition are alternative therapies that can be used when oral intake is not tolerated for prolonged time periods with ongoing weight loss. In refractory cases of hyperemesis gravidarum, the risks and benefits of these alternative forms of management must be considered, along with the risks of undertreated hyperemesis gravidarum and the overall effect of hyperemesis gravidarum on patients' quality of life.
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Affiliation(s)
- Shannon M Clark
- University of Texas Medical Branch at Galveston, Galveston, Texas
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2
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Gökbulut N, Aksoy Derya Y. Effects of foot-massage in pregnant women with hyperemesis gravidarum on severity of nausea-vomiting and anxiety. J Reprod Infant Psychol 2023:1-20. [PMID: 38099324 DOI: 10.1080/02646838.2023.2291412] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Accepted: 11/30/2023] [Indexed: 12/22/2023]
Abstract
OBJECTIVE This study was conducted to determine the effects of foot massage performed on pregnant women with hyperemesis gravidarum on the severity of nausea and vomiting and pregnancy-related anxiety. MATERIAL AND METHOD This randomised controlled study was conducted between February and November 2020 with 104 pregnant women hospitalised in the pregnant women follow-up service ward of a public hospital in eastern Turkey with the diagnosis of hyperemesis gravidarum. Data were obtained from the pregnant women who were given a 'Personal Information Form' and before and after each application by using the Pregnancy-Unique Quantification of Emesis and Nausea (PUQE) Test and the Pregnancy-Related Anxiety Scale-Revision 2 (PRAQ-R2). RESULTS Before foot massage, the pre-test mean PUQE total, PRAQR-2 total, and PRAQR2 fear of childbirth and concerns about physical appearance dimension scores of the participants in the experimental and control groups were similar (p > 0.05), It was determined that the PRAQR2 fear of having a disabled child control group had significantly higher pre-test scores compared to the massage group (p < 0.05). After foot massage, the severity of nausea and vomiting was significantly lower in the participants in the experimental group compared to those in the control group (p < 0.001). Additionally, the mean PRAQR2 total and dimension scores of the participants in the experimental group were significantly lower than those in the control group (p < 0.05). CONCLUSION These findings support the use of the foot massage is an effective intervention in reducing the severity of nausea and vomiting and pregnancy-related anxiety.
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Affiliation(s)
- Nilay Gökbulut
- Department of Midwifery, Faculty of Health Sciences, Cankırı Karatekin University, Cankırı, Turkey
| | - Yeşim Aksoy Derya
- Department of Midwifery, Faculty of Health Sciences, Inonu University, Malatya, Turkey
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Standeven LR, Miller KN, Mallow A, Berger R, Little V. Reduction of anxiety symptoms among women within a collaborative care model and women's health settings. Prim Health Care Res Dev 2023; 24:e69. [PMID: 38047371 PMCID: PMC10790713 DOI: 10.1017/s1463423623000440] [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: 07/27/2022] [Revised: 01/23/2023] [Accepted: 07/20/2023] [Indexed: 12/05/2023] Open
Abstract
AIM The purpose of this study is to focus on changes in anxiety symptoms among women treated in women's health practices and under a collaborative care model. BACKGROUND Research on collaborative care has largely focused on improving depressive and anxiety symptoms among adults in primary care settings. The applicability of collaborative care in other healthcare settings is underreported with limited research investigating if collaborative care has advantages in subpopulations treated in both traditional primary care settings and other healthcare settings, such as women's health practices. METHODS This study, completed through secondary data analysis of the electronic record of N = 219 women across three women's healthcare centers, evaluated if instituting a collaborative care model is associated with reduced anxiety symptoms and which factors (eg, primary diagnosis, duration of care, and use of psychotropic medications) are associated with anxiety outcomes. Anxiety symptoms were assessed using the Generalized Anxiety Disorder 7-item scale (GAD-7) at entry into and at termination from collaborative care services. RESULTS Overall, there was a significant reduction in average anxiety scores from baseline to termination of collaborative care (t(218) = 12.41, P < 0.001). There was a main effect for the duration of time receiving collaborative care services on anxiety score reduction (β = -0.28, SE = 0.06, P < 0.001) with a significant reduction in anxiety symptoms at the 90-day mark (t(218) = 10.58, P < 0.001). Therefore, collaborative care can be useful in women's health practices in reducing anxiety symptoms over a 90-day time period.
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Affiliation(s)
- Lindsay R. Standeven
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins Reproductive Mental Health Center, Baltimore, MD, USA
- School of Medicine, Johns Hopkins University, Baltimore, MD, USA
| | - Kristen N. Miller
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins Reproductive Mental Health Center, Baltimore, MD, USA
- School of Medicine, Johns Hopkins University, Baltimore, MD, USA
| | - Alissa Mallow
- School of Social Work, Adelphi University, Poughkeepsie, NY, USA
| | - Roni Berger
- School of Social Work, Adelphi University, Poughkeepsie, NY, USA
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Jia L, Li W, Liu Y, Wang L. Psychologic Sequelae in Early Pregnancy Complications. Int J Womens Health 2023; 15:51-57. [PMID: 36643713 PMCID: PMC9838123 DOI: 10.2147/ijwh.s382677] [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: 08/21/2022] [Accepted: 12/06/2022] [Indexed: 01/11/2023] Open
Abstract
Early pregnancy complications, including miscarriage, ectopic pregnancies, and hyperemesis gravidarum, are common discomforts accounting for about 15% to 20% of all pregnancies. A proportion of women with early pregnancy complications will experience short- and long-term psychologic sequelae in the aftermath of pregnancy complications, including anxiety, depression, and post-traumatic stress disorder (PTSD) which are the most commonly reported psychologic reactions. This review will focus on the course and impact of these psychologic sequelae in early pregnancy complications, and the noninvasive interventions to improve mental health are also briefly discussed.
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Affiliation(s)
- Lili Jia
- Department of Gynaecology and Obstetrics, Binhai County People’s Hospital, Yancheng City, People’s Republic of China
| | - Wenfei Li
- Department of Gynaecology and Obstetrics, Binhai County People’s Hospital, Yancheng City, People’s Republic of China
| | - Yue Liu
- Department of Gynaecology and Obstetrics, Binhai County People’s Hospital, Yancheng City, People’s Republic of China
| | - Longqin Wang
- Department of Emergency, Binhai County People’s Hospital, Yancheng City, People’s Republic of China,Correspondence: Longqin Wang, Department of Emergency, Binhai County People’s Hospital, 248 Fudong Middle Road, Yancheng City, 224599, People’s Republic of China, Email
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Azlan WAW, Ramalingam M, Razali R, Abdullah MF, Rahman FNA. Anxiety, depression and marital satisfaction in women with hyperemesis gravidarum: A comparative cross-sectional study in Hospital Tengku Ampuan Rahimah, Klang, Malaysia. Asia Pac Psychiatry 2022; 14:e12416. [PMID: 32929893 DOI: 10.1111/appy.12416] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2019] [Accepted: 07/30/2020] [Indexed: 12/01/2022]
Abstract
INTRODUCTION Hyperemesis Gravidarum (HG) is a severe form of vomiting that occurs among pregnant mothers. Due to the nature of HG, pregnant mothers may feel fatigued and burdened by it and questions have been raised about the emergence of psychiatric illness during this period of vulnerability. METHODS A comparative cross-sectional study using Hospital Anxiety and Depression Scale (HADS), M.I.N.I (MINI International Neuropsychiatric Interview) and ENRICH- EMS (Evaluation and Nurturing Relationship Issues, Communication and Happiness - Marital Satisfaction Scale) were performed in a group of 112 pregnant women. RESULTS There were no differences in the prevalence rate of any anxiety disorder among the patient with HG vs comparative group (9% vs 3%, P > 0.05) and depressive disorder in women with HG vs comparative group (16% vs 8%, P > 0.05) respectively. There were associations between HG and gravida, past history of miscarriage, and gestational diabetes (P < 0.05). After adjustment, only past history of gestational diabetes was associated with HG as a protective factor (AOR 0.034 95% CI 0.002-0.181; P = 0.0014). We found that women in the HG group tended to score statistically significantly higher than the comparison group for depressive symptoms in the HADS Depression subscale (P = 0.041). DISCUSSION We found no convincing association between HG and anxiety disorder, depressive disorder, and marital satisfaction, but women with HG statistically significantly reported more depressive symptoms than women who were not diagnosed with HG. Psychiatric evaluation should be considered for women with HG.
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Affiliation(s)
- Wan Asyikin Wan Azlan
- Department of Psychiatry, Universiti Kebangsaan Malaysia Medical Centre, Jalan Yaakob Latif, Kuala Lumpur, Malaysia
| | - Magendra Ramalingam
- Department of Obstetrics and Gynaecology, Hospital Tengku Ampuan Rahimah, Jalan Langat, Klang Selangor, Malaysia
| | - Rosdinom Razali
- Department of Psychiatry, Universiti Kebangsaan Malaysia Medical Centre, Jalan Yaakob Latif, Kuala Lumpur, Malaysia
| | - Mohamad Farouk Abdullah
- Department of Obstetrics and Gynaecology, Hospital Tengku Ampuan Rahimah, Jalan Langat, Klang Selangor, Malaysia
| | - Fairuz Nazri Abdul Rahman
- Department of Psychiatry, Universiti Kebangsaan Malaysia Medical Centre, Jalan Yaakob Latif, Kuala Lumpur, Malaysia
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Muchanga SMJ, Eitoku M, Mbelambela EP, Ninomiya H, Iiyama T, Komori K, Yasumitsu-Lovell K, Mitsuda N, Tozin RR, Maeda N, Fujieda M, Suganuma N. Association between nausea and vomiting of pregnancy and postpartum depression: the Japan Environment and Children's Study. J Psychosom Obstet Gynaecol 2022; 43:2-10. [PMID: 32131648 DOI: 10.1080/0167482x.2020.1734792] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
OBJECTIVE Postpartum depression (PPD) is a global emotional distress that affects women and their offspring regardless of their culture. The association between nausea and vomiting of pregnancy (NVP) and PPD has been widely described only for the severe form of NVP. We aimed to assess the relationship between PPD and NVP with regards to its severity. METHODS Data from the Japan Environment and Children's Study (JECS), a birth cohort study, were analyzed. PPD was assessed using the Edinburgh Postnatal Depression Scale (EPDS). Multiple logistic regression models were performed to assess the association between NVP and PPD. RESULTS Out of the 80,396 women included in the study 14% had PPD. Among them 4,640 (42.1%) had mild NVP; 3,295 (29.9%) had moderate NVP whereas 1,481 (13.4%) had severe NVP. All forms of NVP were associated with PPD and the association gradually increased with the severity of NVP symptoms with odd ratio (OR): 1.26; 95% confidence interval (CI): 1.18-1.35 for mild, OR: 1.28; 95% CI: 1.19-1.38 for moderate and OR: 1.54; 95% CI: 1.42-1.68 for severe NVP. CONCLUSION Japanese women with NVP were more susceptible to develop PPD and the more severe the NVP symptoms were, the greater the risk of PPD. Thus, close monitoring of NVP-affected women is recommended.
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Affiliation(s)
- Sifa Marie Joelle Muchanga
- Department of Environmental Medicine, Kochi Medical School, Kochi University, Kochi, Japan.,Department of Obstetrics and Gynaecology, University of Kinshasa, Kinshasa, Democratic Republic of the Congo.,Department of International Trials, National Center for Global Health and Medicine, Tokyo, Japan
| | - Masamitsu Eitoku
- Department of Environmental Medicine, Kochi Medical School, Kochi University, Kochi, Japan
| | | | - Hitoshi Ninomiya
- Integrated Center for Advanced Medical Technologies, Kochi Medical School, Kochi University, Kochi, Japan
| | - Tatsuo Iiyama
- Department of International Trials, National Center for Global Health and Medicine, Tokyo, Japan
| | - Kaori Komori
- Department of Environmental Medicine, Kochi Medical School, Kochi University, Kochi, Japan
| | - Kahoko Yasumitsu-Lovell
- Department of Environmental Medicine, Kochi Medical School, Kochi University, Kochi, Japan.,Gilbert Neuropsychiatry Centre, University of Gothenburg, Gothenburg, Sweden
| | - Naomi Mitsuda
- Department of Environmental Medicine, Kochi Medical School, Kochi University, Kochi, Japan.,Department of Pediatrics, Kochi Medical School, Kochi University, Kochi, Japan
| | - Rahma Rashid Tozin
- Department of Obstetrics and Gynaecology, University of Kinshasa, Kinshasa, Democratic Republic of the Congo
| | - Nagamasa Maeda
- Department of Obstetrics and Gynaecology, Kochi Medical School, Kochi University, Kochi University, Kochi, Japan
| | - Mikiya Fujieda
- Department of Pediatrics, Kochi Medical School, Kochi University, Kochi, Japan
| | - Narufumi Suganuma
- Department of Environmental Medicine, Kochi Medical School, Kochi University, Kochi, Japan
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Liu C, Zhao G, Qiao D, Wang L, He Y, Zhao M, Fan Y, Jiang E. Emerging Progress in Nausea and Vomiting of Pregnancy and Hyperemesis Gravidarum: Challenges and Opportunities. Front Med (Lausanne) 2022; 8:809270. [PMID: 35083256 PMCID: PMC8785858 DOI: 10.3389/fmed.2021.809270] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Accepted: 12/17/2021] [Indexed: 12/16/2022] Open
Abstract
Nausea and vomiting of pregnancy (NVP) is a common condition that affects up to 70% of pregnant women. Hyperemesis gravidarum (HG) is considered the serious form of NVP, which is reported in 0.3–10.8% of pregnant women. NVP has a relatively benign course, but HG can be linked with some poor maternal, fetal, and offspring outcomes. The exact causes of NVP and HG are unknown, but various factors have been hypothesized to be associated with pathogenesis. With the advance of precision medicine and molecular biology, some genetic factors such as growth/differentiation factor 15 (GDF15) have become therapeutic targets. In our review, we summarize the historical hypotheses of the pathogenesis of NVP and HG including hormonal factors, Helicobacter pylori, gastrointestinal dysmotility, placenta-related factors, psychosocial factors, and new factors identified by genetics. We also highlight some approaches to the management of NVP and HG, including pharmacological treatment, complementary treatment, and some supporting treatments. Looking to the future, progress in understanding NVP and HG may reduce the adverse outcomes and improve the maternal quality of life during pregnancy.
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Affiliation(s)
- Chuan Liu
- School of Medicine, Henan University, Kaifeng, China
| | - Guo Zhao
- School of Medicine, Henan University, Kaifeng, China
| | - Danni Qiao
- School of Medicine, Henan University, Kaifeng, China
| | - Lintao Wang
- Department of Neurology, The First Affiliated Hospital of Henan University, Kaifeng, China
| | - Yeling He
- School of Medicine, Henan University, Kaifeng, China
| | - Mingge Zhao
- School of Life Sciences, Henan University, Kaifeng, China
| | - Yuanyuan Fan
- School of Life Sciences, Henan University, Kaifeng, China
| | - Enshe Jiang
- Institute of Nursing and Health, School of Nursing and Health, Henan University, Kaifeng, China.,Henan International Joint Laboratory for Nuclear Protein Regulation, Henan University, Kaifeng, China
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8
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Depression and Anxiety Disorders in Patients with Hyperemesis Gravidarum and the Effect of This Disease on the Quality of Life. JOURNAL OF CONTEMPORARY MEDICINE 2021. [DOI: 10.16899/jcm.817501] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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9
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Şahin B, Özçetinkaya Erdoğan S, Cura Şahin G, Karlı P, Kara OF, Hatırnaz Ş, Tinelli A. Nausea and vomiting during pregnancy: a possible correlation with obsessive compulsive disorder and alexithymia. J OBSTET GYNAECOL 2021; 42:929-934. [PMID: 34693875 DOI: 10.1080/01443615.2021.1960492] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
The possible correlation between nausea and vomiting during pregnancy (NVP) with obsessive-compulsive disorder (OCD) and alexithymia were examined in this cross-sectional study. A cohort of pregnant women at the first trimester of pregnancy experiencing NVP were divided into three groups, according to severity (mild, moderate and severe) with the Pregnancy Unique Quantification of Emesis and Nausea (PUQE) test. The Maudsley Obsessive Compulsive Disorder Scale (MOCQ) and the Toronto Alexithymia Scale (TAS-20) were applied. Scores of scales were compared in all three groups, and the relationship between NVP severity and OCD and alexithymia was evaluated. On the 110 enrolled pregnant women, 42 had mild, 36 had moderate and 32 had severe NVP. Pregnant women with mild NVP had lower MOCQ scores than those with severe NVP (p = .010). Total scores of TAS-20 were higher among subjects with greater NVP severity (p < .001). PUQE scores were demonstrated significant correlations with MOCQ and total and subsection scores of the TAS-20, regardless of NVP groups. Study results showed that women with more pronounced OCD and/or alexithymia can experience somatic complaints, such as NVP, particularly intense in their first trimester of pregnancies. For this reason, psychotherapy in addition to medical treatments could be recommended to pregnant women with severe NVP.Impact statementWhat is already known on this subject? NVP is a condition experienced by most women, particularly in the first trimester of pregnancy, which can be affected by the psychosomatic condition of the pregnant woman.What do the results of this study add? The severity of nausea and vomiting according to PUQE test were significantly associated with OCD and alexithymia presence in pregnant women during their first trimester period.What are the implications of these findings for clinical practice and/or further research? These findings might demonstrate the symptoms of NVP are correlated to OCD, as well as alexithymia. Longitudinal studies are required to demonstrate the clear causal relationship between NVP and psychiatric symptoms as in OCD and in alexithymia.
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Affiliation(s)
- Banuhan Şahin
- Gynecology and Obstetrics Department, Amasya University Sabuncuoglu Serefeddin Training and Research Hospital, Amasya, Turkey
| | - Serap Özçetinkaya Erdoğan
- Psychiatry Department, Amasya University Sabuncuoglu Serefeddin Training and Research Hospital, Amasya, Turkey
| | | | - Pervin Karlı
- Gynecology and Obstetrics Department, Amasya University Sabuncuoglu Serefeddin Training and Research Hospital, Amasya, Turkey
| | - Osman Fadıl Kara
- Gynecology and Obstetrics Department, Amasya University Sabuncuoglu Serefeddin Training and Research Hospital, Amasya, Turkey
| | - Şafak Hatırnaz
- Gynecology and Obstetrics Department, IVF Unit, Medicana International Hospital, Samsun, Turkey
| | - Andrea Tinelli
- Obstetrics and Gynecology Department, Veris delli Ponti Hospital, Scorrano, Lecce, Italy.,Division of Experimental Endoscopic Surgery, Imaging, Technology and Minimally Invasive Therapy, Vito Fazzi Hospital, Lecce, Italy.,Faculty of Biological and Medical Physics, Phystech BioMed School, Moscow Institute of Physics and Technology (State University), Dolgoprudny, Moscow Region, Russia
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Khodabakhsh S, Ramasamy S. Anxiety and coping strategies among women with hyperemesis gravidarum in Malaysia. CENTRAL EUROPEAN JOURNAL OF NURSING AND MIDWIFERY 2021. [DOI: 10.15452/cejnm.2021.12.0017] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
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Elmas B, Vatansever M, Civan Kahve A, Salman Özgü B, Asut G, Çakmak IB, Bestel A, Erkaya S. Evaluation of psychological resilience and anxiety levels of patients with hyperemesis gravidarum diagnosis and comparison with healthy pregnant women. Turk J Obstet Gynecol 2021; 18:115-123. [PMID: 34083634 PMCID: PMC8191320 DOI: 10.4274/tjod.galenos.2021.05994] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
Objective: To compare the psychological resilience and anxiety levels of patients diagnosed with hyperemesis gravidarum (HG) and healthy pregnant women. Materials and Methods: A sociodemographic data form and the Resilience scale for Adults (RSA) and the State-Trait Anxiety Inventory (STAI) were administered. The sociodemographic data form was completed by the physician, and the RSA and STAI were completed by the participant. The sample of the study consisted of 60 pregnant women with HG and hospitalized and 97 healthy voluntary pregnant women with similar characteristics to the research group without any pregnancy complications. Data were evaluated using descriptive statistical analyses, the independent samples t-test, the Mann-Whitney U test and Pearson’s correlation analysis. Results: The age range was 18-42 years for HG group and 20-43 years for control group. The average age of the HG group was 28.17±5.96 years and that of the control group was 29.45±5.83 years. There was no statistically significant difference between the groups in terms of pregnancy week. Regarding the prevalence of state and trait anxiety between the groups, it was found that 66.7% of the HG group had a high level of trait anxiety and 51.7% had a high level of state anxiety. It was found that 61.9% of the control group had a high level of trait anxiety and 38.1% had a high level of state anxiety. There was no difference between the healthy pregnant group and the HG group in terms of anxiety (p=0.125). It was found that there was a significant difference between the groups in terms of only sub-dimensions of RSA, which were perception of self (U=2385.00, p=0.044) and perception of future (U=2350.50, p=0.030). The perception of self and perception of future scores of the healthy control group were higher. Conclusion: There was no difference between the healthy pregnant group and the HG group in terms of anxiety. It was observed that the HG group had a lower perception of self and future. Apart from the usual increase in anxiety levels during pregnancy, HG accompanied by stubborn nausea and vomiting does not create an extra psychological burden, either as a cause or a result.
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Affiliation(s)
- Burak Elmas
- Private Olbamed Hospital, Clinic of Obstetrics and Gynecology, Mersin, Turkey
| | - Merve Vatansever
- Ankara University Institute of Forensic Sciences, Departmant of Forensic Psychology, Ankara, Turkey
| | - Aybeniz Civan Kahve
- Ministry of Health Ankara City Hospital, Clinic of Psychiatry, Ankara, Turkey
| | - Burçin Salman Özgü
- Ministry of Health Ankara City Hospital, Clinic of Obstetrics and Gynecology, Ankara, Turkey
| | - Gonca Asut
- Tekirdağ State Hospital, Clinic of Psychiatry, Tekirdağ, Turkey
| | - Işık Batuhan Çakmak
- Ministry of Health Ankara City Hospital, Clinic of Psychiatry, Ankara, Turkey
| | - Ayşegül Bestel
- University of Health Sciences Turkey, Kanuni Sultan Süleyman Training and Research Hospital, Clinic of Obstetrics and Gynecology, İstanbul, Turkey
| | - Salim Erkaya
- University of Health Sciences Turkey, Ankara Etlik Zübeyde Hanım Women's Health Training and Research Hospital, Clinic of Obstetrics and Gynecology, Ankara, Turkey
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12
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Karakayalı Ay Ç, Aksoy Derya Y. The relationship between birth fear and psychosocial health level of nausea-vomiting severity in pregnancy: An example from Turkey. CURRENT PSYCHOLOGY 2021. [DOI: 10.1007/s12144-021-01907-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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13
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Saadatnia S, Tiznobaik A, Saber A. The effects of psychological counseling and acupressure based on couple therapy procedure for alleviation of vomiting and nausea in pregnant women in Iran country. JOURNAL OF COMPLEMENTARY & INTEGRATIVE MEDICINE 2021; 19:423-427. [PMID: 33962493 DOI: 10.1515/jcim-2020-0308] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Accepted: 02/17/2021] [Indexed: 11/15/2022]
Abstract
OBJECTIVES Nausea and vomiting have psychological negative effects on some pregnant women during gestation. Different strategies have been used for the treatment of nausea and vomiting during pregnancy, such as acupressure and psychological interventions. This study was conducted to evaluate the effects of psychological counseling and acupressure based on couple therapy procedures on vomiting and nausea in pregnant women in Iran. METHODS Two hundred and eight women were divided into four groups (n=52): 1) they did not any intervention (control group), 2) they received the psychological intervention, 3) they received acupressure intervention, and 4) they received a combination of psychological + acupressure interventions. To investigate the effects of interventions on nausea and vomiting, the Rhodes index of nausea, vomiting and retching were used. The counseling period has lasted for 4 weeks. The pressure intervention on the site was conducted in clockwise form for 1 min and anticlockwise form for another 1 min. RESULTS Groups did not have a significant difference for abortion and income (p>0.05). The effects of counseling, and acupressure interventions on severity and period of vomiting and nausea were not significant (p>0.05), but the intervention based on counseling and acupressure decreased severity of vomiting and nausea (p<0.05). CONCLUSIONS The intervention based on counseling and acupressure could not reduce nausea and vomiting during the gestation, but the intervention based on a combination of both decreased nausea and vomiting. It can be suggested to apply an intervention based on a combination of counseling and acupressure in short-time period for decreasing nausea and vomiting in women during pregnancy.
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Affiliation(s)
- Sahar Saadatnia
- Faculty of Nursing and Midwifery, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Azita Tiznobaik
- Department of Midwifery, Maternity and Child Care Research Center, Faculty of Nursing and Midwifery, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Amir Saber
- Department of Nutritional Sciences, School of Nutritional Sciences and Food Technology, Kermanshah University of Medical Sciences, Kermanshah, Iran
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14
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Şimşek Y, Şimşek G, Bayar Muluk N, Arıkan OK. Olfactory dysfunction and oxidative stress in pregnant women with hyperemesis gravidarum. Arch Gynecol Obstet 2021; 304:657-661. [PMID: 33591381 DOI: 10.1007/s00404-021-05998-9] [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: 04/25/2020] [Accepted: 02/02/2021] [Indexed: 11/27/2022]
Abstract
PURPOSE This study aimed to compare the first-trimester pregnancy serum total oxidative status (TOS), total antioxidant status (TAS), and serum estradiol levels as well as the olfactory functions assessed using the brief smell identification test (BSIT) of women with healthy pregnancies and those with hyperemesis gravidarum (HG). METHODS In this prospective study, 60 pregnant women in the first trimester of their pregnancies were divided into two groups: 30 pregnant women with HG (study group) and 30 healthy pregnant women (control group). The following parameters were compared in the HG group and the healthy controls: TOS, TAS, serum levels of estradiol (E2), and olfactory function, which was measured using BSIT. RESULTS Both groups were similar in terms of age, gravida, and parity. The mean total smell score was lower in the HG group than the healthy control group (p < 0.05). TOS was significantly higher in the HG group than the control group. TAS was significantly higher in the control group than the HG group (p < 0.05). CONCLUSION The removal of sharp odors that will trigger the perception of odor in pregnant women with HG can contribute to the effective control of this disease; moreover, adding fetal-safe antioxidants to the treatment can contribute to the effective control of this disease.
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Affiliation(s)
- Yavuz Şimşek
- Faculty of Medicine, Obstetrics and Gynecology Department, Biruni University, Istanbul, Turkey
| | - Gökçe Şimşek
- Faculty of Medicine, ENT Department, Kırıkkale University, Kırıkkale, Turkey
| | - Nuray Bayar Muluk
- Faculty of Medicine, ENT Department, Kırıkkale University, Kırıkkale, Turkey.
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15
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Abstract
Hyperemesis gravidarum (HG) is a debilitating and potentially life-threatening pregnancy disease marked by weight loss, malnutrition, and dehydration attributed to unrelenting nausea and/or vomiting; HG increases the risk of adverse outcomes for the mother and child(ren). The complexity of HG affects every aspect of a woman's life during and after pregnancy. Without methodical intervention by knowledgeable and proactive clinicians, life-threatening complications may develop. Effectively managing HG requires an understanding of both physical and psychosocial stressors, recognition of potential risks and complications, and proactive assessment and treatment strategies using innovative clinical tools.
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16
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Leach LS, Poyser C, Fairweather‐schmidt K. Maternal perinatal anxiety: A review of prevalence and correlates. CLIN PSYCHOL-UK 2020. [DOI: 10.1111/cp.12058] [Citation(s) in RCA: 104] [Impact Index Per Article: 26.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Affiliation(s)
- Liana S. Leach
- Centre for Research on Ageing, Health and Wellbeing, The Australian National University, Canberra, Australian Capital Territory, Australia,
| | - Carmel Poyser
- Centre for Research on Ageing, Health and Wellbeing, The Australian National University, Canberra, Australian Capital Territory, Australia,
| | - Kate Fairweather‐schmidt
- Centre for Research on Ageing, Health and Wellbeing, The Australian National University, Canberra, Australian Capital Territory, Australia,
- School of Psychology, Flinders University, Adelaide, South Australia, Australia,
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17
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Caporaso E, Oliver D, Rusher M. A Pregnant Woman with Hyperemesis Gravidarum Admitted to the Psychiatric Ward. Psychiatr Ann 2020. [DOI: 10.3928/00485713-20200903-01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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18
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Aksu E, Albayrak Y, Beyazyüz E, Potas N, Durankuş F, Tenel B, Beyazyüz M. Distinct temperament and character traits in patients with hyperemesis gravidarum. Gynecol Endocrinol 2020; 36:525-529. [PMID: 31668106 DOI: 10.1080/09513590.2019.1683820] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
Hyperemesis gravidarum (HG) is an extreme form of vomiting during pregnancy and is characterized with excessive vomiting and nausea and ketonuria, electrolyte imbalance, dehydration and severe nurtition deficiency. The etiology of HG is considered as multifactorial. Altough there is a great interest to HG in terms of psychiatric conditions, there have been limited numbers of studies that researched personality traits in patients with HG. In present study, we aimed to compare temperament and character traits between pregnant women with and without HG by Temperament and Character Inventory. 48 pregnant women with HG and 64 healthy pregnant women were included to study. The HG groups and control group were compared in terms of temperament and character traits and anxiety levels. The temperament scores of novelty seeking, harm avoidance and reward dependence were found to be similar between groups while the score of persistence was significantly lower in HG group compared with control group (p = .021). All character scores in HG group as cooperativeness, self-directedness, and self-transcendence were significantly lower compared with control groups (respectively; p = .002, p = .018 and p = .029). The scores of STAI-1 was higher in HG group compared with control group (p = .027) whereas the score of STAI-2 was found to be similar between groups. Present study is the first to demonstrate different temperament and character traits in patients with HG. We argue that our results support the psychiatric background of HG; however further studies are needed to confirm our results.
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Affiliation(s)
- Erson Aksu
- Department of Gynecology and Obstetrics, Vatan Hospital, İstanbul Rumeli University, İstanbul, Turkey
| | - Yakup Albayrak
- Faculty of Medicine, Department of Psychiatry, Tekirdağ Namık Kemal University, Tekirdağ, Turkey
| | - Elmas Beyazyüz
- Faculty of Medicine, Department of Psychiatry, Tekirdağ Namık Kemal University, Tekirdağ, Turkey
| | - Nihan Potas
- Faculty of Economics and Administrative Science, Department of Healthcare Managment, Ankara Hacıbayram Veli University, Ankara, Turkey
| | - Ferit Durankuş
- Department of Pediatrics, Göztepe Education and Research Hospital, İstanbul Medeniyet University, İstanbul, Turkey
| | - Burçak Tenel
- Faculty of Medicine, Department of Psychiatry, Tekirdağ Namık Kemal University, Tekirdağ, Turkey
| | - Murat Beyazyüz
- Faculty of Medicine, Department of Psychiatry, Tekirdağ Namık Kemal University, Tekirdağ, Turkey
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19
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Bahadırlı A, Sönmez MB, Memiş ÇÖ, Bahadırlı NB, Memiş SD, Dogan B, Sevincok L. The association of temperament with nausea and vomiting during early pregnancy. J OBSTET GYNAECOL 2019; 39:969-974. [DOI: 10.1080/01443615.2019.1581745] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Affiliation(s)
- Ali Bahadırlı
- Department of Obstetrics and Gynecology, Mustafakemalpaşa State Hospital, Bursa, Turkey
| | | | - Çağdaş Öykü Memiş
- Department of Psychiatry, Adnan Menderes University School of Medicine, Aydin, Turkey
| | - Nil Banu Bahadırlı
- Department of Psychiatry, Mustafakemalpaşa State Hospital, Bursa, Turkey
| | | | - Bilge Dogan
- Department of Psychiatry, Adnan Menderes University School of Medicine, Aydin, Turkey
| | - Levent Sevincok
- Department of Psychiatry, Adnan Menderes University School of Medicine, Aydin, Turkey
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20
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van de Loo KFE, Vlenterie R, Nikkels SJ, Merkus PJFM, Roukema J, Verhaak CM, Roeleveld N, van Gelder MMHJ. Depression and anxiety during pregnancy: The influence of maternal characteristics. Birth 2018. [PMID: 29517137 DOI: 10.1111/birt.12343] [Citation(s) in RCA: 70] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
BACKGROUND Depression and anxiety during pregnancy are associated with adverse health outcomes for both mother and child. This study aims to investigate the occurrence of symptoms of depression and anxiety in early and late pregnancy, the longitudinal changes from early to late pregnancy, and factors associated with symptoms of depression and anxiety in pregnant women in the Netherlands. METHODS We studied 2897 women participating in the PRegnancy and Infant DEvelopment (PRIDE) Study. To assess symptoms of depression and anxiety, web-based questionnaires including the Hospital Anxiety and Depression Scale (HADS) and multiple questions on maternal characteristics were completed in early and late pregnancy. Cross-sectional and longitudinal multivariable linear regression analyses were conducted. RESULTS The depressive symptoms in our population increased, with a prevalence of probable depression from 5.4% in early pregnancy to 10.0% in late pregnancy (P < .001), whereas the anxiety symptoms decreased, with a prevalence of probable anxiety from 17.9% to 14.2% (P < .001). Characteristics associated with depressive or anxiety symptoms included low level of education, multiparity, a history of depression, severe nausea, extreme fatigue, lack of physical exercise, and negative life events. Being non-Dutch, not living with a partner, and having an unplanned pregnancy or a long time to pregnancy were associated with the depressive and/or anxiety symptoms in early pregnancy only. DISCUSSION Symptoms of depression and anxiety are common in both early and late pregnancy. Screening for risk factors in early pregnancy is important, since prenatal depression and anxiety may be related to adverse maternal and child health outcomes.
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Affiliation(s)
- Kim F E van de Loo
- Department of Medical Psychology, Radboud Institute for Health Sciences, Radboudumc Amalia Children's Hospital, Radboud university medical center, Nijmegen, The Netherlands
| | - Richelle Vlenterie
- Department for Health Evidence, Radboud Institute for Health Sciences, Radboud university medical center, Nijmegen, The Netherlands
| | - Sylke J Nikkels
- Department of Paediatrics, Radboudumc Amalia Children's Hospital, Radboud university medical center, Nijmegen, The Netherlands
| | - Peter J F M Merkus
- Department of Paediatric Pulmonology, Radboudumc Amalia Children's Hospital, Radboud university medical center, Nijmegen, The Netherlands
| | - Jolt Roukema
- Department of Paediatric Pulmonology, Radboudumc Amalia Children's Hospital, Radboud university medical center, Nijmegen, The Netherlands
| | - Chris M Verhaak
- Department of Medical Psychology, Radboud Institute for Health Sciences, Radboudumc Amalia Children's Hospital, Radboud university medical center, Nijmegen, The Netherlands
| | - Nel Roeleveld
- Department for Health Evidence, Radboud Institute for Health Sciences, Radboud university medical center, Nijmegen, The Netherlands.,Department of Paediatrics, Radboudumc Amalia Children's Hospital, Radboud university medical center, Nijmegen, The Netherlands
| | - Marleen M H J van Gelder
- Department for Health Evidence, Radboud Institute for Health Sciences, Radboud university medical center, Nijmegen, The Netherlands.,Radboud REshape Innovation Center, Radboud university medical center, Nijmegen, The Netherlands
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21
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Sridharan K, Sivaramakrishnan G. Interventions for treating nausea and vomiting in pregnancy: a network meta-analysis and trial sequential analysis of randomized clinical trials. Expert Rev Clin Pharmacol 2018; 11:1143-1150. [PMID: 30261764 DOI: 10.1080/17512433.2018.1530108] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2018] [Accepted: 09/26/2018] [Indexed: 12/26/2022]
Abstract
INTRODUCTION Several drugs were explored for their utility in treating nausea and vomiting in pregnancy (NVP). The present study is a network meta-analysis of such drugs. METHODS Electronic databases were searched for randomized clinical trials that have compared active interventions (with placebo or other active interventions) for treating NVP. Nausea scores were the primary outcome and changes in nausea scores, emetic episodes, adverse events, and vomiting control were the key secondary outcomes. Weighted mean difference was the effect estimate for continuous variable and odds ratio for the numerical variable. Random-effects model was used and the strength of the evidence was graded. RESULTS Fifty studies were included in the systematic review and 42 in the meta-analysis. Acupuncture, chamomile, dimenhydrinate, doxylamine/vitamin B6, ginger, quince, metoclopramide, and vitamin B6 were associated with reduced nausea scores compared to placebo. Of these interventions, ginger and vitamin B6 were also associated with better vomiting control and less incidence of adverse events. Adequate evidence supporting the use exists only for ginger and the quality of evidence for this comparison is moderate. Strength of evidence for all other comparisons is very low. CONCLUSION Present evidence is conclusive on the therapeutic benefits of ginger in treating NVP. Although favorable results were obtained for several other interventions, the strength of evidence is very low. The results of this network meta-analysis should be interpreted with extreme caution as it might change with the advent of data from future head-to-head clinical trials.
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Affiliation(s)
- Kannan Sridharan
- a Department of Pharmacology and Therapeutics, College of Medicine and Medical Sciences , Arabian Gulf University , Manama , Bahrain
| | - Gowri Sivaramakrishnan
- b School of Oral Health, College of Medicine, Nursing and Health Sciences , Fiji National University , Suva , Fiji
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22
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Bayrampour H, Vinturache A, Hetherington E, Lorenzetti DL, Tough S. Risk factors for antenatal anxiety: A systematic review of the literature. J Reprod Infant Psychol 2018; 36:476-503. [PMID: 30293441 DOI: 10.1080/02646838.2018.1492097] [Citation(s) in RCA: 38] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
BACKGROUND Given the prevalence of antenatal anxiety and its consistent associations with adverse pregnancy and child outcomes, early detection and management of anxiety are essential. OBJECTIVE The aim was to identify risk factors for anxiety among pregnant women by systematically reviewing original research. METHODS Cross-sectional, case-control and cohort studies that examined associations between antenatal anxiety and at least one potential risk factor prospectively or retrospectively and measured anxiety independent from other mental health conditions were included. Studies rated strong/moderate in methodological quality appraisal were used to synthesise the evidence. RESULTS Factors associated with greater risk of anxiety included previous pregnancy loss, medical complications, childhood abuse, intimate partner violence, denial/acceptance coping styles, personality traits, inadequate social support, history of mental health problems, high perceived stress and adverse life events. CONCLUSIONS Several risk factors identified in this review are detectable in routine prenatal care visits (e.g. previous pregnancy loss, pregnancy complications), potentially modifiable (e.g. coping styles, social support, partner factors) and can be identified prior to pregnancy (e.g. psychosocial factors), underlining the significance of pre-conception mental health screening.
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Affiliation(s)
- Hamideh Bayrampour
- a Department of Family Practice , University of British Columbia , Vancouver , Canada
| | - Angela Vinturache
- b Department of Pediatrics , University of Calgary , Calgary , Canada
| | - Erin Hetherington
- c Department of Community Health Sciences , University of Calgary , Calgary , Canada
| | - Diane L Lorenzetti
- c Department of Community Health Sciences , University of Calgary , Calgary , Canada
| | - Suzanne Tough
- d Departments of Pediatrics and Community Health Sciences , University of Calgary , Calgary , Canada
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23
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Colodro-Conde L, Cross SM, Lind PA, Painter JN, Gunst A, Jern P, Johansson A, Lund Maegbaek M, Munk-Olsen T, Nyholt DR, Ordoñana JR, Paternoster L, Sánchez-Romera JF, Wright MJ, Medland SE. Cohort Profile: Nausea and vomiting during pregnancy genetics consortium (NVP Genetics Consortium). Int J Epidemiol 2018; 46:e17. [PMID: 26921609 PMCID: PMC5837614 DOI: 10.1093/ije/dyv360] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/16/2015] [Indexed: 12/17/2022] Open
Affiliation(s)
- Lucía Colodro-Conde
- QIMR Berghofer Medical Research Institute, Brisbane, Australia.,Department of Human Anatomy and Psychobiology, University of Murcia, and IMIB-Arrixaca, Murcia, Spain
| | - Simone M Cross
- QIMR Berghofer Medical Research Institute, Brisbane, Australia
| | - Penelope A Lind
- QIMR Berghofer Medical Research Institute, Brisbane, Australia
| | - Jodie N Painter
- QIMR Berghofer Medical Research Institute, Brisbane, Australia
| | - Annika Gunst
- Department of Psychology and Speech-Language Pathology University of Turku, Turku, Finland
| | - Patrick Jern
- Department of Psychology, Åbo Akademi, University, Turku, Finland.,Department of Psychology and Speech-Language Pathology University of Turku, Turku, Finland
| | - Ada Johansson
- QIMR Berghofer Medical Research Institute, Brisbane, Australia.,Department of Psychology, Åbo Akademi, University, Turku, Finland.,Department of Psychology and Speech-Language Pathology University of Turku, Turku, Finland
| | | | - Trine Munk-Olsen
- National Center for Register-based Research, Aarhus University, Aarhus Denmark
| | - Dale R Nyholt
- QIMR Berghofer Medical Research Institute, Brisbane, Australia.,Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Australia
| | - Juan R Ordoñana
- Department of Human Anatomy and Psychobiology, University of Murcia, and IMIB-Arrixaca, Murcia, Spain
| | - Lavinia Paternoster
- MRC Integrative Epidemiology Unit, School of Social & Community Medicine, University of Bristol, Bristol, UK
| | - Juan F Sánchez-Romera
- Department of Developmental and Educational Psychology, University of Murcia and IMIB-Arrixaca, Murcia, Spain and
| | - Margaret J Wright
- QIMR Berghofer Medical Research Institute, Brisbane, Australia.,Queensland Brain Institute, University of Queensland, Brisbane, Australia
| | - Sarah E Medland
- QIMR Berghofer Medical Research Institute, Brisbane, Australia
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24
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Topalahmetoğlu Y, Altay MM, Akdağ Cırık D, Tohma YA, Çolak E, Çoşkun B, Gelişen O. Depression and anxiety disorder in hyperemesis gravidarum: A prospective case-control study. Turk J Obstet Gynecol 2017; 14:214-219. [PMID: 29379663 PMCID: PMC5780564 DOI: 10.4274/tjod.78477] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2017] [Accepted: 10/20/2017] [Indexed: 12/13/2022] Open
Abstract
Objective To assess the anxiety and depression status of women with hyperemesis gravidarum (HG); the risk factors for developing both depression and anxiety in women with HG were evaluated. Materials and Methods A total of 200 women, 100 diagnosed as having HG before the 20th week of gestation at a tertiary referral center and 100 gestational-age-matched controls were enrolled. The socio-demographic data and the depression and anxiety scores, as assessed using the Beck depression and anxiety inventory were compared between the two groups. Results The median depression and anxiety scores were significantly higher in the HG group compared with controls (19.5 vs. 9.0 and 22.0 vs. 10.0). Women with HG have the highest relative risks for moderate depression and severe anxiety [relative risk (RR): 16.88 and RR: 20.50, respectively]. In the univariate analysis, having HG, low education level, low income and poor social relationships were significant predictors of depression and having HG. Moreover, poor social relationships significantly predicted the presence of anxiety disorder. However, having HG and poor social relationships were found as the only independent predictors of both depression and anxiety. Patients with HG were 5.5 and 6.7 times more prone to having depression and anxiety disorder compared with controls, respectively. Conclusion Both depression and anxiety disorder were more frequent in women with HG who have weak family and social relationships, lower education and income levels. Therefore, the determination of the psychological status of women with HG should be an integral part of the evaluation.
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Affiliation(s)
- Yusuf Topalahmetoğlu
- University of Health Sciences, Etlik Zübeyde Hanım Women's Health Training and Research Hospital, Clinic of Obstetrics and Gynecology, Ankara, Turkey
| | - Mehmet Metin Altay
- University of Health Sciences, Etlik Zübeyde Hanım Women's Health Training and Research Hospital, Clinic of Obstetrics and Gynecology, Ankara, Turkey
| | - Derya Akdağ Cırık
- University of Health Sciences, Etlik Zübeyde Hanım Women's Health Training and Research Hospital, Clinic of Obstetrics and Gynecology, Ankara, Turkey
| | - Yusuf Aytaç Tohma
- University of Health Sciences, Etlik Zübeyde Hanım Women's Health Training and Research Hospital, Clinic of Obstetrics and Gynecology, Ankara, Turkey
| | - Eser Çolak
- University of Health Sciences, Etlik Zübeyde Hanım Women's Health Training and Research Hospital, Clinic of Obstetrics and Gynecology, Ankara, Turkey
| | - Bora Çoşkun
- University of Health Sciences, Etlik Zübeyde Hanım Women's Health Training and Research Hospital, Clinic of Obstetrics and Gynecology, Ankara, Turkey
| | - Orhan Gelişen
- University of Health Sciences, Etlik Zübeyde Hanım Women's Health Training and Research Hospital, Clinic of Obstetrics and Gynecology, Ankara, Turkey
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25
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Yavuz F, Ulusoy S, Cebeci E, Sen S. What do repetitive thinking styles tell about hyperemesis gravidarum? PSYCHIAT CLIN PSYCH 2017. [DOI: 10.1080/24750573.2017.1407115] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
Affiliation(s)
- Fatih Yavuz
- Bakirkoy Mazhar Osman Mental Health and Neurological Diseases Education and Research Hospital, Istanbul, Turkey
| | - Sevinc Ulusoy
- Bakirkoy Mazhar Osman Mental Health and Neurological Diseases Education and Research Hospital, Istanbul, Turkey
| | - Esra Cebeci
- Kartal Yavuz Selim State Hospital, Istanbul, Turkey
| | - Serhat Sen
- Department of Gynecology and Obstetrics, Diyarbakir Gazi Yasargil Research and Training Hospital, Diyarbakir, Turkey
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26
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Senturk MB, Yıldız G, Yıldız P, Yorguner N, Çakmak Y. The relationship between hyperemesis gravidarum and maternal psychiatric well-being during and after pregnancy: controlled study. J Matern Fetal Neonatal Med 2016; 30:1314-1319. [PMID: 27418012 DOI: 10.1080/14767058.2016.1212331] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
OBJECTIVE Psychiatric symptoms of varying degrees that accompany hyperemesis gravidarum (HG) may continue throughout the pregnancy or after, and these psychological problems may cause morbidity. In this study, we aimed to evaluate the relationship between the HG and psychiatric symptoms in the first trimester and postpartum depression. METHODS Two hundred and seven pregnant who were diagnosed as HG and 177 healthy pregnant women included in this prospective study. All cases were assessed with SCL-90-R in first trimester and with ED in postpartum period. Factors related to postpartum psychiatric symptoms were investigated with bivariate logistic regression analysis. RESULTS SCL-90-R and ED scores were statistically significant at HG group (p < 0.05). In cases who diagnosed as postpartum depression, the rates of HG and SCL-90-R results were higher (p< 0.05). In the bivariate analysis, the high rates of HG and high SCL-90-R scores were determined to be related to postpartum depression (p < 0.05). CONCLUSIONS The results show that mental health is negatively affected by HG at pregnancy, and in this case, psychiatric symptoms may continue even after discontinuation HG.
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Affiliation(s)
- Mehmet B Senturk
- a Departments of Obstetrics and Gynecology , Zeynep Kamil Training and Research Hospital , İstanbul , Turkey
| | - Gazi Yıldız
- b Departments of Obstetrics and Gynecology , Private Mus Sifa Hospital , Mus , Turkey
| | - Pınar Yıldız
- b Departments of Obstetrics and Gynecology , Private Mus Sifa Hospital , Mus , Turkey
| | - Nese Yorguner
- c Departments of Psychiatry , Mus State Hospital , Mus , Turkey , and
| | - Yusuf Çakmak
- d Department of Obstetrics and Gynecology , Batman State Hospital , Batman , Turkey
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27
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Kasap E, Aksu EE, Gur EB, Genc M, Eskicioğlu F, Gökduman A, Güçlü S. Investigation of the relationship between salivary cortisol, dehydroepiandrosterone sulfate, anxiety, and depression in patients with hyperemesis gravidarum. J Matern Fetal Neonatal Med 2016; 29:3686-9. [PMID: 26752270 DOI: 10.3109/14767058.2016.1140741] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND The aim of this study was to determine the relationship of the salivary levels of dehydroepiandrosterone sulfate (DHEA-S) and cortisol with factors related to depression and anxiety in patients with hyperemesis gravidarum (HG). METHODS Forty patients with a diagnosis of HG were selected for the study and matched with 40 control patients according to body mass index, parity, and age. Symptoms of depression and anxiety were investigated using the Beck Depression Inventory and Beck Anxiety Inventory for Adults, respectively. Saliva samples were collected in the morning and at night and subjected to enzyme-linked immunosorbent assay for the determination of DHEA-S and cortisol levels. RESULTS We observed a positive correlation between increased levels of depression and anxiety and increased salivary levels of cortisol and DHEA-S in patients with HG. CONCLUSIONS Salivary cortisol and DHEA-S levels, as well as mood disorders, should be monitored in patients with HG, although further large, prospective studies are needed to confirm our results.
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Affiliation(s)
- Esin Kasap
- a Department of Obstetrics and Gynecology
| | - Ebru Emine Aksu
- b Department of Psychiatry , Sifa University School of Medicine , İzmir , Turkey
| | | | - Mine Genc
- a Department of Obstetrics and Gynecology
| | - Fatma Eskicioğlu
- c Department of Obstetrics and Gynecology , Merkez Efendi State Hospital , Manisa , Turkey , and
| | - Ayşe Gökduman
- d Department of Biochemistry , Sifa University School of Medicine , İzmir , Turkey
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28
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Nausea and Vomiting During Pregnancy is Highly Heritable. Behav Genet 2016; 46:481-91. [PMID: 26801654 DOI: 10.1007/s10519-016-9781-7] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2015] [Accepted: 01/05/2016] [Indexed: 12/27/2022]
Abstract
Nausea and vomiting during pregnancy (NVP) affects about 70 % of all expectant mothers and commonly impacts their physical health and psychosocial functioning. The aim of this study was to estimate the heritability of the presence, duration and severity of NVP. The sample consisted of 1723 women (M age = 41.78, SD = 11.67) including twins in both complete and incomplete pairs and their sisters from two cohorts participating in the NVP Genetics Consortium. The sample comprised 159 monozygotic and 140 dizygotic complete twin pairs, and 69 twin-sister pairs. We applied an extended twin design using OpenMx and Mx for secondary analysis. Individual differences in NVP were best explained by additive genetic and unique environmental effects. Heritability estimates were 73 % (95 % CIs = 57-84 %) for presence, 51 % (95 % CIs = 36-63 %) for duration and 53 % (95 % CIs = 38-65 %) for severity of NVP. The genetic correlation between duration and severity was almost perfect. Our results show that genes play an important role in different aspects of NVP and justify the importance of searching for genetic variants.
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29
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Faramarzi M, Yazdani S, Barat S. A RCT of psychotherapy in women with nausea and vomiting of pregnancy. Hum Reprod 2015; 30:2764-73. [PMID: 26466913 DOI: 10.1093/humrep/dev248] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2015] [Accepted: 08/27/2015] [Indexed: 11/14/2022] Open
Abstract
STUDY QUESTION Does adding psychological intervention to medical therapy improve nausea/vomiting, psychological symptoms, and pregnancy distress in women with moderate nausea and vomiting of pregnancy (NVP)? SUMMARY ANSWER Three weeks of medical therapy plus psychotherapy yielded statistically and clinically significant improvements in NVP-specific symptoms, anxiety/depression symptoms, and pregnancy distress, compared with medical therapy alone. WHAT IS KNOWN ALREADY Pregnancy with nausea/vomiting is associated with psychiatric morbidity. Evidence supports the exploration of psychosocial reactions in addition to biochemical markers related to NVP. STUDY DESIGN, SIZE, DURATION This prospective, open-label, randomized, controlled, parallel-group study was performed at two obstetrics clinics in Iran. A total of 86 women, aged 18-40 years, between 6 and 12 weeks pregnant with moderate NVP, more than 5 years of education, and not currently practicing any relaxation techniques or undergoing any psychotherapy, were enrolled from June 2013 to November 2014. PARTICIPANTS/MATERIALS, SETTING, METHODS A total of 86 moderate NVP women were randomly allocated to either a control (medical therapy alone) or experimental (medical therapy plus psychotherapy) group. Block randomization was achieved using a paper list prepared by an investigator with no clinical involvement in the trial. The experimental group was given pyridoxine hydrochloride (40 mg daily) for 3 weeks, and also received intensive mindfulness-based cognitive therapy (MBCT) in eight individual sessions (50 min each) over 3 weeks. The control group was given pyridoxine hydrochloride (40 mg daily tablet) for 3 weeks alone. All participants completed the Rhodes index of nausea, vomiting and retching (RINVR), the hospital anxiety and depression scale (HADS), and the prenatal distress questionnaire (PDQ) at baseline, 3 weeks after baseline at the end of the study, and at a 1 month post-treatment follow-up. Linear mixed-effects models were used, in an intention-to-treat analysis. MAIN RESULTS AND ROLE OF CHANCE In the psychotherapy plus medical therapy group, the mean relative difference between baseline and post-treatment decreased for RINVR; nausea 8.2 (95% confidence interval (CI) 4.1, 10.2), vomiting 3.5 (95% CI 1.5, 5.8), and total RINVR 11.7 (95% CI 6.5, 16.5), for HADS; anxiety 5.1 (95% CI 3.2, 9.2), depression 3.5 (95% CI 2.4, 7.3), total HADS 7.2 (95% CI 4.4, 12.1), for PDQ; birth concerns 3.3 (95% CI 1.3, 9.1), body concerns 1.5 (95% CI 0.9, 5.1), relationship concerns 2.1 (95% CI 1.2, 5.9), and total PDQ 5.9 (95% CI 3.5, 10.6). At 1 month after treatment, the statistically significant improvement in RINVR, HADS and PDQ, as well as clinical improvement in severity of symptoms, persisted. Medical therapy plus psychotherapy also improved nausea/vomiting symptoms, psychological symptoms, and reduced pregnancy distress more than medical therapy alone, with an effect size of 0.42-0.72 over the trial period. LIMITATIONS, REASONS FOR CAUTION The conclusions were limited to a small number of women with moderate NVP. It is unclear whether the difference between the outcomes in the different groups was related to MBCT alone, or to the extra time and attention paid to patients in the medical therapy plus psychotherapy. The participants in the study did not remain blind to the treatment and the outcome may only be representative of women with moderate NVP who have been referred to obstetrics clinics. WIDER IMPLICATIONS OF THE FINDINGS These findings show that adding 3 weeks of psychological intervention to medical therapy may appear to produce positive therapeutic outcomes upon conclusion of treatment, and 1 month after treatment. This suggests that psychotherapy should be considered as an adjunctive treatment option for women with moderate NVP. In future studies, however, a group of patients who are receiving placebo psychotherapy along with medical treatment should be included. Furthermore, an economic evaluation of the addition of psychological intervention to standard medical therapy would be useful.
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Affiliation(s)
- Mahbobeh Faramarzi
- Infertility and Reproductive Health Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
| | - Shala Yazdani
- Infertility and Reproductive Health Research Center, Health Research Institute, Obstetrics & Gynecology Department, Babol University of Medical Science, Babol, Iran
| | - Shahnaz Barat
- Infertility and Reproductive Health Research Center, Health Research Institute, Obstetrics & Gynecology Department, Babol University of Medical Science, Babol, Iran
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Balık G, Tekin YB, Kağıtcı M. Is there relationship between social support, psychological distress, mood disorders and emesis gravidarum? J OBSTET GYNAECOL 2015; 35:737-40. [PMID: 25692766 DOI: 10.3109/01443615.2015.1004529] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- G Balık
- a Department of Obstetrics and Gynecology , Recep Tayyip Erdogan University Medicine School , Rize , Turkey
| | - Y B Tekin
- a Department of Obstetrics and Gynecology , Recep Tayyip Erdogan University Medicine School , Rize , Turkey
| | - M Kağıtcı
- a Department of Obstetrics and Gynecology , Recep Tayyip Erdogan University Medicine School , Rize , Turkey
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Aksoy H, Aksoy Ü, Karadağ Öİ, Hacimusalar Y, Açmaz G, Aykut G, Çağlı F, Yücel B, Aydın T, Babayiğit MA. Depression levels in patients with hyperemesis gravidarum: a prospective case-control study. SPRINGERPLUS 2015; 4:34. [PMID: 25646155 PMCID: PMC4308584 DOI: 10.1186/s40064-015-0820-2] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/15/2014] [Accepted: 01/14/2015] [Indexed: 12/30/2022]
Abstract
Hyperemesis gravidarum (HG) is a condition characterized by severe, intractable nausea and vomiting in early pregnancy. It affects about 0.3–2% of all pregnancies and is thought that HG is a multifactorial disease resulting from the combination of various unrelated conditions such as genetic, hormonal and psychiatric. Although there are studies investigating the relationship between anxiety, depression and HG; however, none have sufficiently clarified this link. The aim of this prospective case–control study was to investigate the possible relationship between depression and HG and compare the prevalence of depression disorders in pregnant women with and without HG. A prospective case–control study was performed at our tertiary referral centre between December 2013 and July 2014. The study group consisted of 78 pregnant women with HG and the control group consisted of 82 healthy pregnant women who never had experienced any nausea and vomiting. No study participants had any pre-pregnancy history of any psychiatric disorder including depression. Structured Clinical Interview for Diagnostic (SCID-I) and Statistical Manual of Mental Disorders Fourth Edition (DSM-IV) was used to evaluate symptoms of depression. Beck Depression Inventory (BDI) was administered to patients during the psychiatric interview and was evaluated by the same psychiatrist. The mean BDI scores in HG study and healthy control groups were 18.97 ± 9.85 and 6.36 ± 5.61, respectively (p < 0.001). Among the 78 women in the HG study population, 42 (53.9%) of patients had moderate or severe depression disorder. Only 6.1% of patients in the control group had moderate or severe depression. In conclusion, the findings of this study indicated that psychological distress associated with HG was a direct consequence rather than a cause of HG. Therefore, patients with HG during pregnancy should be evaluated with respect to mood disorders as much as their medical conditions.
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Affiliation(s)
- Hüseyin Aksoy
- Department of Obstetrics and Gynecology, Kayseri Military Hospital, Kayseri, Turkey
| | - Ülkü Aksoy
- Department of Obstetrics and Gynecology, Kayseri Memorial Hospital, Kayseri, Turkey
| | - Özge İdem Karadağ
- Department of Obstetrics and Gynecology, Kayseri Acıbadem Hospital, Kayseri, Turkey
| | - Yunus Hacimusalar
- Department of Psychiatry, Kayseri Education and Research Hospital of Medicine, Kayseri, Turkey
| | - Gökhan Açmaz
- Department of Obstetrics and Gynecology, Kayseri Education and Research Hospital of Medicine, Kayseri, Turkey
| | - Gülsüm Aykut
- Department of Obstetrics and Gynecology, Kayseri Education and Research Hospital of Medicine, Kayseri, Turkey
| | - Fulya Çağlı
- Department of Obstetrics and Gynecology, Kayseri Education and Research Hospital of Medicine, Kayseri, Turkey
| | - Burak Yücel
- Department of Obstetrics and Gynecology, Kayseri Acıbadem Hospital, Kayseri, Turkey
| | - Turgut Aydın
- Department of Obstetrics and Gynecology, Kayseri Acıbadem Hospital, Kayseri, Turkey
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Chraïbi Z, Ouldamer L, Body G, Bacq Y. Hyperemesis gravidarum : étude de cohorte rétrospective française (109 patientes). Presse Med 2015; 44:e13-22. [DOI: 10.1016/j.lpm.2014.04.028] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/25/2013] [Revised: 04/09/2014] [Accepted: 04/16/2014] [Indexed: 12/27/2022] Open
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Paschetta E, Berrisford G, Coccia F, Whitmore J, Wood AG, Pretlove S, Ismail KMK. Perinatal psychiatric disorders: an overview. Am J Obstet Gynecol 2014; 210:501-509.e6. [PMID: 24113256 DOI: 10.1016/j.ajog.2013.10.009] [Citation(s) in RCA: 67] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2013] [Revised: 10/02/2013] [Accepted: 10/04/2013] [Indexed: 01/10/2023]
Abstract
Perinatal mental illness has a significant implication on maternal health, birth outcomes, and the offspring's development. Prevalence estimates of perinatal psychiatric illnesses range widely, with substantial heterogeneity in different population studies, with a lower prevalence rate in high- rather than low- or middle-income countries. Because of the potential negative impact on maternal and child outcomes and the potential lability of these disorders, the perinatal period is a critical time to identify psychiatric illnesses. Thus, obstetricians and midwives play a crucial role in assessing women's mental health needs and to refer identified women promptly for multidisciplinary specialist assessment. However, there is still limited evidence on best practice assessment and management policies during pregnancy and postpartum. This review focuses on the prevalence of common perinatal mental disorders and antenatal screening policies to identify women at risk. The effect of these conditions and their management on pregnancy, fetal outcomes, and child development are discussed.
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Affiliation(s)
- Elena Paschetta
- Birmingham Women's National Health Service Foundation Trust, Birmingham, UK
| | - Giles Berrisford
- Perinatal Mental Health Service, Birmingham and Solihull Mental Health Foundation Trust, Birmingham, UK
| | - Floriana Coccia
- Perinatal Mental Health Service, Birmingham and Solihull Mental Health Foundation Trust, Birmingham, UK
| | - Jennifer Whitmore
- Perinatal Mental Health Service, Birmingham and Solihull Mental Health Foundation Trust, Birmingham, UK
| | - Amanda G Wood
- School of Psychology, College of Life and Environmental Sciences, University of Birmingham, Birmingham, UK
| | - Sam Pretlove
- Birmingham Women's National Health Service Foundation Trust, Birmingham, UK
| | - Khaled M K Ismail
- Birmingham Women's National Health Service Foundation Trust, Birmingham, UK; School of Clinical and Experimental Medicine, College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK.
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Birth weight and preterm birth in babies of pregnant women with major depression in relation to treatment with antidepressants. J Clin Psychopharmacol 2014; 34:226-9. [PMID: 24525643 DOI: 10.1097/jcp.0000000000000077] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE It is unclear whether antidepressant treatment has a preventive effect on negative neonatal outcomes due to major depression in pregnant women. The objective of the present study was to compare women with major depression treated with antidepressants, untreated women with major depression, and healthy women during pregnancy with respect to birth weight and preterm birth. METHODS The study sample included a total of 23 women taking antidepressant medication, 36 women who were not taking antidepressant medication for major depression during pregnancy, and 30 healthy women. Major depression was diagnosed via the Structured Clinical Interview for the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition. RESULTS The study groups were similar with respect to sociodemographic characteristics. Compared with infants of healthy control subjects, infants of untreated major depressed women had significantly lower birth weight and shorter gestational age at delivery. There is no significant difference between infants of major depressed women treated with antidepressants and infants of healthy subjects for these variables. CONCLUSIONS Our results suggest that antidepressants may have beneficial effects on the risk of low birth weight and preterm birth in the infants of depressed women.
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Tan PC, Zaidi SN, Azmi N, Omar SZ, Khong SY. Depression, anxiety, stress and hyperemesis gravidarum: temporal and case controlled correlates. PLoS One 2014; 9:e92036. [PMID: 24637791 PMCID: PMC3956867 DOI: 10.1371/journal.pone.0092036] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2013] [Accepted: 02/19/2014] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVE To evaluate the temporal and case-controlled correlations of anxiety, depression and stress with hyperemesis gravidarum. STUDY DESIGN We performed a longitudinal cohort study of women with hyperemesis gravidarum using the Depression, Anxiety and Stress Scale (DASS-21) to evaluate psychological distress at hospitalization and in the third trimester of pregnancy (from 28 weeks gestation). Third pregnancy trimester controls were recruited from routine antenatal clinic attendees who were matched to gestational age at the second DASS-21 assessment in the HG cohort. RESULTS The prevalences of nausea and vomiting, depression, anxiety and stress caseness in newly hospitalised hyperemesis gravidarum women were 100% and 100%, 19%, 69% and 21% which by the third trimester had fallen to 15.7% and 9.9%, 4%, 19% and 3% and in third trimester controls were 15.9% and 14.2%, 14%, 61% and 20% respectively. Within the hyperemesis gravidarum cohort, nausea, vomiting depression, anxiety and stress reduced significantly by an absolute 84.3% (95% CI 76.2%-89.8%), 90.1% (82.8%-94.2%), 14.9% (7.2%-23.0%), 49.6% (38.6%-58.7%) and 18.2% (10.4%-26.4%) respectively between hospitalization for hyperemesis gravidarum and at the third trimester. In the third trimester, when comparing the hyperemesis gravidarum cohort to controls, the risk of nausea or vomiting was similar but depression, anxiety and stress were significantly lower: adjusted odds ratio AOR 0.10 (95% CI 0.03-0.5), 0.11 (0.05-0.23) and 0.08 (0.02-0.33) respectively. CONCLUSION Our study revealed a reassuring pattern of a strong rebound from depression, anxiety and stress in women with hyperemesis gravidarum such that by the third pregnancy trimester the level of psychological distress was even lower than in controls. This observation imply that much of the psychological distress in acute hyperemesis gravidarum is self-limiting and probably in the causal pathway of hyperemesis gravidarum. Care in women with hyperemesis gravidarum should focus on the relief of nausea and vomiting.
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Affiliation(s)
- Peng Chiong Tan
- Department of Obstetrics and Gynaecology, University of Malaya, Lembah Pantai, Kuala Lumpur, Malaysia
- * E-mail:
| | - Syeda Nureena Zaidi
- Department of Obstetrics and Gynaecology, University of Malaya, Lembah Pantai, Kuala Lumpur, Malaysia
| | - Noor Azmi
- Department of Obstetrics and Gynaecology, University of Malaya, Lembah Pantai, Kuala Lumpur, Malaysia
| | - Siti Zawiah Omar
- Department of Obstetrics and Gynaecology, University of Malaya, Lembah Pantai, Kuala Lumpur, Malaysia
| | - Su Yen Khong
- Department of Obstetrics and Gynaecology, University of Malaya, Lembah Pantai, Kuala Lumpur, Malaysia
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Uguz F. Low-dose mirtazapine in treatment of major depression developed following severe nausea and vomiting during pregnancy: two cases. Gen Hosp Psychiatry 2014; 36:125.e5-6. [PMID: 24034854 DOI: 10.1016/j.genhosppsych.2013.07.016] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2013] [Revised: 07/31/2013] [Accepted: 07/31/2013] [Indexed: 12/17/2022]
Abstract
This report presents the successful use of low-dose mirtazapine in the treatment of major depression that developed following severe nausea and vomiting symptoms during the early gestational weeks in two cases. The psychiatric diagnosis was determined with the Structured Clinical Interview for the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition. Assessments were performed with the Clinical Global Impression-Improvement Scale and the 17-item Hamilton Rating Scale for Depression. Further large-scale studies should be carried out to confirm the useful effects observed in these cases.
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Affiliation(s)
- Faruk Uguz
- Department of Psychiatry, Meram Faculty of Medicine, Necmettin Erbakan University, Konya, Turkey.
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Annagür BB, Kerimoğlu ÖS, Gündüz Ş, Tazegül A. Are there any differences in psychiatric symptoms and eating attitudes between pregnant women with hyperemesis gravidarum and healthy pregnant women? J Obstet Gynaecol Res 2013; 40:1009-14. [PMID: 24320704 DOI: 10.1111/jog.12274] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2013] [Accepted: 08/12/2013] [Indexed: 11/30/2022]
Affiliation(s)
| | | | - Şule Gündüz
- Department of Psychiatry; Faculty of Medicine; Selçuk University; Konya Turkey
| | - Aybike Tazegül
- Department of Obstetrics and Gynecology; Faculty of Medicine; Selçuk University; Konya Turkey
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Annagür BB, Tazegül A, Gündüz S. Do psychiatric disorders continue during pregnancy in women with hyperemesis gravidarum: a prospective study. Gen Hosp Psychiatry 2013; 35:492-6. [PMID: 23810464 DOI: 10.1016/j.genhosppsych.2013.05.008] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2013] [Revised: 05/23/2013] [Accepted: 05/28/2013] [Indexed: 10/26/2022]
Abstract
OBJECTIVE We aimed to determine Axis I psychiatric disorders in women with hyperemesis gravidarum (HG) and to follow up the course of psychiatric disorder and its association with nausea and vomiting (NV) during pregnancy. METHODS The study sample was composed of 47 patients with HG. Psychiatric interviews were conducted using the Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (SCID-I). Other psychiatric interviews were performed in the second and third trimesters. On each visit, the subjects completed the Beck Depression Inventory and the Beck Anxiety Inventory. RESULTS The prevalence of any anxiety disorder was 25.5%, and the prevalence of any mood disorder was 14.9% in women with HG in the first trimester. Psychiatric disorders continued throughout the pregnancy in two thirds of the women who had HG and a psychiatric diagnosis. Any SCID diagnosis in the first trimester was higher in women whose NV had partially resolved than in women whose NV had fully resolved (P<.05). CONCLUSION The present studies suggest that psychiatric disorders may play a significant role in the etiology of HG. Our findings presented a potential connection between HG and anxiety disorders and major depressive disorder. Additionally, the NV symptoms in women with HG and a psychiatric disorder may persist during pregnancy.
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Affiliation(s)
- Bilge Burçak Annagür
- Department of Psychiatry, Faculty of Medicine, Selcuk University, Konya 42131, Turkey.
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Disability and psychiatric symptoms in hyperemesis gravidarum patients. Arch Gynecol Obstet 2013; 289:55-60. [DOI: 10.1007/s00404-013-2934-5] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2013] [Accepted: 06/17/2013] [Indexed: 11/26/2022]
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Goker A, Yanikkerem E, Demet MM, Dikayak S, Yildirim Y, Koyuncu FM. Postpartum depression: is mode of delivery a risk factor? ISRN OBSTETRICS AND GYNECOLOGY 2012; 2012:616759. [PMID: 23304542 PMCID: PMC3530850 DOI: 10.5402/2012/616759] [Citation(s) in RCA: 61] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/12/2012] [Accepted: 12/03/2012] [Indexed: 11/23/2022]
Abstract
There are various factors related to postpartum depression. In this study we have aimed to determine the effect of mode of delivery on the risk of postpartum depression. A total of 318 women who applied for delivery were included in the study. Previously diagnosed fetal anomalies, preterm deliveries, stillbirths, and patients with need of intensive care unit were excluded from the study. Data about the patients were obtained during hospital stay. During the postpartum sixth week visit Edinburgh postnatal depression scale (EPDS) was applied. There was no significant difference between EPDS scores when compared according to age, education, gravidity, wanting the pregnancy, fear about birth, gender, family type, and income level (P > 0.05). Those who had experienced emesis during their pregnancy, had a history of depression, and were housewives had significantly higher EPDS scores (P < 0.05). Delivering by spontaneous vaginal birth, elective Cesarean section, or emergency Cesarean section had no effect on EPDS scores. In conclusion healthcare providers should be aware of postpartum depression risk in nonworking women with a history of emesis and depression and apply the EPDS to them for early detection of postpartum depression.
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Affiliation(s)
- Asli Goker
- Department of Obstetrics and Gynecology, University of Celal Bayar, 45030 Manisa, Turkey
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