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Pan Y, Chen Z, Chen L, Ning L, Wan H, Chen T, Zhang H, Jiang Y, Luo Q. Fungibility, accessibility and clinical utility of remote electronic fetal monitoring in improving maternal emotional status compared with traditional method: A multicenter prospective cohort analysis. Int J Gynaecol Obstet 2024. [PMID: 39324494 DOI: 10.1002/ijgo.15917] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Revised: 08/03/2024] [Accepted: 09/05/2024] [Indexed: 09/27/2024]
Abstract
OBJECTIVE Supported by remote signal processing techniques and wireless communication technology, remote electronic fetal monitoring (REFM) has emerged as a promising alternative to traditional electronic fetal monitoring (TEFM) in clinical practice. The aim of this study was to evaluate the comparability, accessibility, and clinical utility of REFM in contrast to TEFM. METHODS This was a multicenter prospective cohort study. A cohort of 2900 pregnant women were enrolled from three medical centers between June 1, 2021 and June 31, 2022. Among them, 800 utilized REFM, with 760 of them completing the self-rating anxiety scale (SAS) and self-rating depression scale (SDS) assessments using the devices for 1 month. The control group comprised 2100 pregnant women who did not use REFM. Additionally, 80 pregnant women concurrently employed both REFM and TEFM, and their respective curve coincidence rates were determined through curve fitting. Primary outcomes encompassed pregnancy outcomes in both groups, average curve coincidence rates between REFM and TEFM, as well as SDS and SAS scores. RESULTS Among the 760 pregnant women who completed SAS and SDS assessments, their average SAS scores before and after 1 month of REFM usage were 43.09 ± 8.04 and 41.58 ± 6.59, respectively. Concurrently, the average SDS scores before and after 1 month of REFM usage were 45.45 ± 9.60 and 44.80 ± 9.17, respectively. A statistically significant decrease was observed in SAS scores (P = 0.005), whereas no significant difference was noted in SDS scores (P = 0.340). Furthermore, a statistically significant difference in the rate of adverse pregnancy outcomes (neonatal asphyxia) emerged between the two groups, those who employed REFM and those who did not (P = 0.021). In the subset of 80 pregnant women employing both REFM and TEFM, all 80 results showed precise congruence between the two methods. The average coincidence rate was determined to be 79.45% ± 12.64%. CONCLUSION REFM contributes to improved pregnancy outcomes and exhibits a high level of concordance with TEFM, thereby accurately reflecting the quality of fetal heart monitoring. Additionally, REFM effectively mitigates pregnant women's anxiety. Thus, REFM demonstrates comparability, accessibility, and clinical utility.
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Affiliation(s)
- Yu Pan
- Department of Obstetrics, Women's Hospital, Zhejiang University, School of Medicine, HangZhou, China
| | - Zi Chen
- Department of Obstetrics, Women's Hospital, Zhejiang University, School of Medicine, HangZhou, China
| | - Lujiao Chen
- Department of Gynecology and Obstetrics, The Fourth Affiliated Hospital, Zhejiang University School of Medicine, Yiwu, China
| | - Lingli Ning
- Hangzhou Fuyang Women and Children Hospital, HangZhou, China
| | - Huimin Wan
- Department of Obstetrics, Women's Hospital, Zhejiang University, School of Medicine, HangZhou, China
| | - Ting Chen
- Hangzhou Women's Hospital, HangZhou, China
| | | | - Ying Jiang
- Department of Obstetrics, Women's Hospital, Zhejiang University, School of Medicine, HangZhou, China
| | - Qiong Luo
- Department of Obstetrics, Women's Hospital, Zhejiang University, School of Medicine, HangZhou, China
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Yeşil Y, Gündüz Ü, Dönmez A, Paşa S. Evaluation of Prenatal Comfort, Sleep, and Quality of Life in Pregnant Women with Cholestasis: A Cross-Sectional Study. Healthcare (Basel) 2024; 12:1399. [PMID: 39057542 PMCID: PMC11276272 DOI: 10.3390/healthcare12141399] [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: 06/13/2024] [Revised: 07/08/2024] [Accepted: 07/11/2024] [Indexed: 07/28/2024] Open
Abstract
BACKGROUND Associated with adverse pregnancy outcomes, intrahepatic cholestasis of pregnancy is the most prevalent liver disease that women typically experience during pregnancy. This study aimed to evaluate prenatal comfort, sleep, and quality of life in pregnant women with cholestasis. METHODS This cross-sectional study was implemented between November 2022 and June 2023 at Mardin Training and Research Hospital with 150 pregnant women who received a diagnosis of pregnancy-induced intrahepatic cholestasis and agreed to participate. The following tools were utilized to collect data: A personal information form exploring socio-demographic and obstetric characteristics of participants, the Prenatal Comfort Scale (PCS), the Pittsburgh Sleep Quality Index (PSQI), and the World Health Organization Quality of Life-Brief Form (WHOQOL-BREF). RESULTS The mean age of participants was 27.79 ± 6.33 years. The mean PCS and PSQI scores were 61.20 ± 5.84 and 9.52 ± 3.02, respectively. The mean scores of "physical health, psychological health, social relationships, and environmental health" sub-dimensions in WHOQOL-BREF were 10.63 ± 2.18, 10.48 ± 2.10, 11.31 ± 3.28, and 11.27 ± 2.10, respectively. A significant difference was found for PSQI regarding hospitalization status and change in sleep quality variables (p = 0.025 and p = 0.035, respectively). CONCLUSIONS Cholestasis of pregnancy creates problems such as pruritus, body image changes, hospitalization, and poor sleep quality in women. This study showed that pregnant women with cholestasis had low levels of sleep quality and quality of life, implying that cholestasis affects their sleep quality, prenatal comfort levels, and quality of life in general. In addition, it is seen that women with this problem do not want to fall pregnant again.
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Affiliation(s)
- Yeşim Yeşil
- Department of Midwifery, Faculty of Health Sciences, Mardin Artuklu University, 47100 Mardin, Turkey;
| | - Ülkin Gündüz
- Department of Midwifery, Faculty of Health Sciences, Mardin Artuklu University, 47100 Mardin, Turkey;
| | - Ayşegül Dönmez
- Department of Midwifery, Faculty of Health Sciences, İzmir Tınaztepe University, 35400 İzmir, Turkey;
| | - Semir Paşa
- Medikal Park Çanakkale Hospital, 17020 Çanakkale, Turkey;
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Kwitowski MA, Lebin LG, Kelleher J, Zsemlye M, Nagle-Yang S. Behavioral Health Integration on Inpatient Obstetric Units: Program Development, Strategies for Implementation, and Lessons Learned. Clin Obstet Gynecol 2024; 67:169-185. [PMID: 38281174 DOI: 10.1097/grf.0000000000000842] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2024]
Abstract
Perinatal mood and anxiety disorders and substance use disorders are the primary causes of maternal mortality in the postpartum period and represent major public health concerns. Despite this, these conditions remain undertreated. Behavioral health integration in outpatient obstetric settings is necessary but insufficient to meet the needs of all patients. Inpatient behavioral health integration represents a promising avenue for addressing gaps in care. Results from recent program development indicate that needs assessment, stakeholder backing, collaboration with existing programs, and adaptability are key factors in successful implementation.
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Affiliation(s)
| | | | | | - Meggan Zsemlye
- Department of Obstetrics,University of Colorado School of Medicine, Aurora, Colorado
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Scabia A, Donati MA, Primi C, Lunardi C, Lino G, Dettore D, Vannuccini S, Mecacci F. Depression, anxiety, self-efficacy, and self-esteem in high-risk pregnancy. Minerva Obstet Gynecol 2024; 76:14-20. [PMID: 35829625 DOI: 10.23736/s2724-606x.22.05116-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
BACKGROUND The aim of the study was to evaluate the levels of depression, state and trait anxiety, self-efficacy, and self-esteem among women with high-risk pregnancy due to previous adverse pregnancy outcomes (PAPOs) or prepregnancy diseases (PPD), before and after delivery, compared to controls. METHODS An observational longitudinal study on psychological dimensions was conducted on 86 women attending a university referral center for high-risk pregnancy, by administering the Edinburgh Postnatal Depression Scale, the State and Trait Anxiety Inventory, the General Self-Efficacy Scale, and the Self-esteem Scale. A pretest (in the third trimester of pregnancy) and a follow-up measurement session (one month after the delivery) were applied. PAPOs group, PPD group and controls were compared. RESULTS The PAPOs group had higher levels of depression compared to the other groups, with above-threshold levels. However, a more relevant decrease in depression was found in the PAPOs group after delivery. Levels of self-efficacy and self-esteem were unexpectedly high during and after pregnancy in all the groups. CONCLUSIONS A PAPO represents a risk factor for depression development during pregnancy, whereas a PPD seems to be less relevant in influencing affective dimensions. Surprisingly, all pregnant women, independently of the obstetric risk, showed high levels of self-efficacy and self-esteem.
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Affiliation(s)
| | - Maria A Donati
- Department of Developmental and Social Psychology, Sapienza University, Rome, Italy
| | - Caterina Primi
- Department of Health and Science, University of Florence, Florence, Italy
| | - Clara Lunardi
- Section of Psychology, Department of Neuroscience, Psychology, Pharmacology and Child Health (NEUROFARBA), University of Florence, Florence, Italy
| | | | - Davide Dettore
- Department of Health and Science, University of Florence, Florence, Italy
| | - Silvia Vannuccini
- Department of Clinical and Experimental Biomedical Sciences, Careggi University Hospital, University of Florence, Florence, Italy
- Department of Molecular and Developmental Medicine, University of Siena, Siena, Italy
| | - Federico Mecacci
- Department of Molecular and Developmental Medicine, University of Siena, Siena, Italy
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5
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Barat S, Ghanbarpour A, Mirtabar SM, Kheirkhah F, Basirat Z, Shirafkan H, Hamidia A, Khorshidian F, Hosseini Talari D, Pahlavan Z, Esmaelzadeh S, Buzari Z, Zeynalzadeh M, Charati SY, Shafizade F, Adnani M, Amirkhanloo F, Mollaalipour M, Kani AC, Amiri M, Khazaei R, Mehdinia SS, Basirat F, Asadollahi S, Khodami A, Azizi A, Nasiri-Amiri F, Fatery N, Shahrokhi S, Zarinkamar B, Aligoltabar S, Faramarzi M. Psychological distress in pregnancy and postpartum: a cross-sectional study of Babol pregnancy mental health registry. BMC Pregnancy Childbirth 2023; 23:793. [PMID: 37964209 PMCID: PMC10648632 DOI: 10.1186/s12884-023-06024-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Accepted: 09/23/2023] [Indexed: 11/16/2023] Open
Abstract
BACKGROUND Psychological distress (PD) is a significant issue during pregnancy and postpartum, adversely affecting both children and mothers. This study aims to determine PD's prevalence and risk factors in a large Iranian population sample during pregnancy and postpartum. METHODS A cross-sectional study was conducted using data from the Babol Pregnancy Mental Health Registry (located in the north of Iran) between June 2020 and March 2021. A total of 2305 women were included, with 1639 during pregnancy and 666 during postpartum. Psychological distress was assessed using the Brief Symptoms Inventory (BSI-18), and data were analyzed using independent t-tests and multiple logistic regressions. RESULTS The prevalence of psychological distress, defined by a cut-off score of BSI ≥ 13, was 19% during pregnancy and 15% during postpartum. Multivariate logistic analysis revealed that high-risk pregnancy was the leading risk factor for psychological distress during the antenatal period (β = 1.776, P < 0.001), as well as its three subscales: somatization (β = 1.355, P = 0.019), anxiety symptoms (β = 2.249, P < 0.001), and depressive symptoms (β = 1.381, P = 0.028). Additionally, women with a gestational age < 20 weeks had a higher risk of psychological distress (β = 1.344, P = 0.038) and the somatization subscale (β = 1.641, P < 0.001). During the postpartum period, women residing in urban areas were at higher risk of psychological distress (β = 1.949, P = 0.012), as well as two subscales: anxiety symptoms (β = 1.998, P = 0.012) and depressive symptoms (β = 1.949, P = 0.020). CONCLUSION The high prevalence of psychological distress emphasizes detecting and treating PD during pregnancy and postpartum, particularly in women with high-risk pregnancies. This study suggests that obstetricians and midwives should implement programs to identify women experiencing psychological distress during early pregnancy through postpartum visits.
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Affiliation(s)
- Shahnaz Barat
- Department of Obstetrics and Gynecology, Infertility and Reproductive Health Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
| | - Azita Ghanbarpour
- Department of Obstetrics and Gynecology, Health Research Institute, Rouhani Hospital, Babol University of Medical Sciences, Babol, Iran
| | - Seyyedeh Mahboubeh Mirtabar
- Research Clinical Psychology, Student Research Committee, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
| | - Farzan Kheirkhah
- Department of Psychiatry, Social Determinants of Health Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
| | - Zahra Basirat
- Department of Obstetrics and Gynecology, Infertility and Reproductive Health Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
| | - Hoda Shirafkan
- Social Determinants of Health Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
| | - Angela Hamidia
- Department of Psychiatry, Social Determinants of Health Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
| | - Faezeh Khorshidian
- Department of Psychiatry, Social Determinants of Health Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
| | - Davood Hosseini Talari
- Department of Psychiatry, Social Determinants of Health Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
| | - Zeynab Pahlavan
- Department of Midwifery, School of Nursing and Midwifery,Infertility and Reproductive Health Research Center, Reproductive Health, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
| | - Sedigheh Esmaelzadeh
- Department of Obstetrics and Gynecology, Infertility and Reproductive Health Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
| | - Zinatosadat Buzari
- Department of Obstetrics and Gynecology, Infertility and Reproductive Health Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
| | - Mahtab Zeynalzadeh
- Department of Obstetrics and Gynecology, Infertility and Reproductive Health Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
| | - Shahla Yazdani Charati
- Department of Obstetrics and Gynecology, Infertility and Reproductive Health Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
| | - Fatemeh Shafizade
- Department of Obstetrics and Gynecology, Health Research Institute, Rouhani Hospital, Babol University of Medical Sciences, Babol, Iran
| | - Mahsima Adnani
- Department of Obstetrics and Gynecology, Health Research Institute, Rouhani Hospital, Babol University of Medical Sciences, Babol, Iran
| | - Fatemeh Amirkhanloo
- Department of Obstetrics and Gynecology, Health Research Institute, Rouhani Hospital, Babol University of Medical Sciences, Babol, Iran
| | - Maedeh Mollaalipour
- Department of Obstetrics and Gynecology, Health Research Institute, Rouhani Hospital, Babol University of Medical Sciences, Babol, Iran
| | - Atieh Chale Kani
- Department of Obstetrics and Gynecology, Health Research Institute, Rouhani Hospital, Babol University of Medical Sciences, Babol, Iran
| | - Mania Amiri
- Department of Obstetrics and Gynecology, Health Research Institute, Rouhani Hospital, Babol University of Medical Sciences, Babol, Iran
| | - Razieh Khazaei
- Department of Obstetrics and Gynecology, Health Research Institute, Rouhani Hospital, Babol University of Medical Sciences, Babol, Iran
| | - Seyedeh Shabnam Mehdinia
- Department of Obstetrics and Gynecology, Health Research Institute, Rouhani Hospital, Babol University of Medical Sciences, Babol, Iran
| | - Fatemeh Basirat
- Department of Obstetrics and Gynecology, Health Research Institute, Rouhani Hospital, Babol University of Medical Sciences, Babol, Iran
| | - Simin Asadollahi
- Department of Obstetrics and Gynecology, Health Research Institute, Rouhani Hospital, Babol University of Medical Sciences, Babol, Iran
| | - Asieh Khodami
- Department of Obstetrics and Gynecology, Health Research Institute, Rouhani Hospital, Babol University of Medical Sciences, Babol, Iran
| | - Alireza Azizi
- Department of Psychiatry, Social Determinants of Health Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
| | - Fatemeh Nasiri-Amiri
- Department of Midwifery, School of Nursing and Midwifery,Infertility and Reproductive Health Research Center, Reproductive Health, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
| | - Nooshin Fatery
- Midwifery, Clinical Research Development Unit of Rohani Hospital, Health Research, Institute, Babol University of Medical Sciences, Babol, Iran
| | - Shirin Shahrokhi
- Clinical Psychology, Student Reasearch Committee, Behshahr Azad University, Behshahr, Iran.
| | - Banafshe Zarinkamar
- Clinical Psychology, Clinical Research Development Unit of Shahid Yahya Nejad, Health Research Institute, Babol University of Medical Sciences, HospitalBabol, Iran
| | - Sajedeh Aligoltabar
- Midwifery, Student Reasearch Committee, Babol University of Medical Sciences, Babol, Iran
| | - Mahbobeh Faramarzi
- Department of General Courses, Social Determinants of Health Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran.
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Keten Edis E, Kurtgöz A. Care experiences and care expectations of hospitalized high-risk pregnant women: a qualitative study. Women Health 2023; 63:704-712. [PMID: 37758687 DOI: 10.1080/03630242.2023.2262614] [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: 12/07/2022] [Accepted: 09/19/2023] [Indexed: 09/29/2023]
Abstract
Gaining insight into the prenatal care experiences and expectations of high-risk pregnant women is crucial for offering holistic care that aligns with their individualized needs. This study aimed at determining the care experiences and expectations of women with high-risk pregnancies. We adopted a descriptive qualitative approach in the research. The data were collected through in-depth interviews between March and June 2022. The participants included 27 high-risk pregnant women selected by purposive sampling. We analyzed the data using inductive content analysis. We utilized the Consolidated Criteria for Reporting Qualitative Research (COREQ) checklist to report data. The participants' ages ranged from 22 to 40 years. The participants' gestational ages ranged from 29 to 38 weeks. We identified three themes, namely "Emotions felt in the course of pregnancy", "Care experiences; satisfaction and dissatisfaction", and "Expectations for ideal care". The findings showed that women experienced fear, stress, and anxiety while expecting supportive, attentive, and understanding care during the course of pregnancy. Our results revealed that high-risk pregnant women have some unmet care needs. Healthcare professionals should strive to provide individualized and holistic care for high-risk pregnant women.
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Affiliation(s)
- Elif Keten Edis
- Department of Nursing, Faculty of Health Sciences, Amasya University, Amasya, Turkey
| | - Aslı Kurtgöz
- Sabuncuoglu Serefeddin Health Services Vocational School, Amasya University, Amasya, Turkey
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Pabon S, Guida JP, Lamus MN, Charles CMP, Parpinelli MA, Escobar MF, Cecatti JG, Costa ML. Impacts of childbirth on anxiety, disability, and depression: Results from a Brazilian cohort. Health Care Women Int 2023; 45:1034-1047. [PMID: 37748187 DOI: 10.1080/07399332.2023.2261104] [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: 12/20/2022] [Revised: 09/12/2023] [Accepted: 09/16/2023] [Indexed: 09/27/2023]
Abstract
Conditions such as violence, drug abuse, sexual satisfaction, anxiety, depression, and disability interfere with a healthy pregnancy and can also account for maternal morbidity. The instrument WOICE was built by WHO to measure it. We applied WOICE in a prospective cohort of 125 pregnant women, using a before-after approach, during the third trimester of pregnancy, and after 42 until 90 days of childbirth. 60% had anxiety during pregnancy, decreasing to 48.8% after delivery (p = 0.07), and depression scores decreased from 7.56 to 5.80 (p = 0.014). Disability affected 62.4% and 56, respectively. 9.6% used drugs during pregnancy, reducing to 4.0% after delivery (RR 0.69, IC 0.49 - 0.69).
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Affiliation(s)
- Stephanie Pabon
- Department of Obstetrics and Gynecology, University of Campinas School of Medicine, Campinas, Brazil
- Department of Obstetrics and Gynecology, Icesi University and Fundacion Valle del Lili, Cali, Colombia
| | - José Paulo Guida
- Department of Obstetrics and Gynecology, University of Campinas School of Medicine, Campinas, Brazil
| | - Martha Narvaez Lamus
- Department of Obstetrics and Gynecology, Icesi University and Fundacion Valle del Lili, Cali, Colombia
| | - Charles MPoca Charles
- Department of Obstetrics and Gynecology, University of Campinas School of Medicine, Campinas, Brazil
| | - Mary Angela Parpinelli
- Department of Obstetrics and Gynecology, University of Campinas School of Medicine, Campinas, Brazil
| | - María Fernanda Escobar
- Department of Obstetrics and Gynecology, Icesi University and Fundacion Valle del Lili, Cali, Colombia
| | - José Guilherme Cecatti
- Department of Obstetrics and Gynecology, University of Campinas School of Medicine, Campinas, Brazil
| | - Maria Laura Costa
- Department of Obstetrics and Gynecology, University of Campinas School of Medicine, Campinas, Brazil
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Smorti M, Ponti L, Ghinassi S, Mauri G, Pancetti F, Mannella P. Do prenatal depressive symptoms developed by hospitalized women with high-risk pregnancy persist to post-partum? Psychiatry Res 2023; 325:115224. [PMID: 37148834 DOI: 10.1016/j.psychres.2023.115224] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Revised: 04/19/2023] [Accepted: 04/23/2023] [Indexed: 05/08/2023]
Abstract
This study aims to explore the level of depressive symptoms during pregnancy and after childbirth comparing women hospitalized due to high-risk pregnancy (clinical group) and women with low-risk pregnancy (control group). Seventy pregnant women (26 clinical group and 44 control group) filled in the Edinburgh Postnatal Depression Scale both during pregnancy and three months after childbirth. Results showed that the clinical group reported significant higher levels of prenatal depression than the control group, while no differences were found on postnatal depression. Data highlighted that hospitalization could represents a significant stressor that can exacerbate depression in women with high-risk pregnancy.
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Affiliation(s)
- Martina Smorti
- Department of Surgical, Medical and Molecular Pathology and Critical Care Medicine, University of Pisa, Italy
| | - Lucia Ponti
- Department of Humanities, University of Urbino, Italy.
| | - Simon Ghinassi
- Department of Experimental and Clinical Medicine, University of Florence, Italy
| | - Giulia Mauri
- Department of Surgical, Medical and Molecular Pathology and Critical Care Medicine, University of Pisa, Italy
| | - Federica Pancetti
- Division of Obstetrics and Gynaecology, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Paolo Mannella
- Department of Clinical and Experimental Medicine, University of Pisa, Italy
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Gerges S, Hallit R, Hallit S. Stressors in hospitalized patients and their associations with mental health outcomes: testing perceived social support and spiritual well-being as moderators. BMC Psychiatry 2023; 23:323. [PMID: 37161403 PMCID: PMC10169454 DOI: 10.1186/s12888-023-04833-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2023] [Accepted: 04/30/2023] [Indexed: 05/11/2023] Open
Abstract
BACKGROUND Although hospitalization can be a burdensome experience for all patients, research into the sources of this distress and potential protective factors has so far been scattered, specifically among the broad hospitalized population across all disease types and inpatient units. The present study explores the frequency and nature of the foremost experienced hassles among a sample of Lebanese hospitalized patients, tracing their correlations with depression and anxiety while also investigating positive coping (i.e., perceived social support and spiritual well-being) as potential moderator of these relationships. METHODS A total of 452 Lebanese inpatients from all medical units filled a survey composed of a list of 38 stressors experienced during hospitalization and other measures assessing depression, anxiety, perceived social support, and spiritual well-being. RESULTS Pain was the most common stressor experienced by the patients (88.9%), followed by the feeling of being overwhelmed (80.3%). When conducting a factor analysis, 18 stressors loaded on 4 distinct factors, hence yielding 4 main stressor groups (i.e., Illness Apprehension, Hopelessness/Uselessness, Social Isolation, and Spiritual Concerns). The multivariable analysis showed that increased illness apprehension (Beta = 0.69) and hopelessness (Beta = 1.37), being married (Beta = 1.17) or divorced (Beta = 1.38) compared to single, being admitted in a two-bed room compared to one-bed (Beta = 1.59), higher financial burden (Beta = 0.24), and lower socio-economic status (Beta = 1.60) were significantly associated with higher anxiety. Additionally, increased hopelessness (Beta = 0.82) and being married (Beta = 0.79) compared to single were significantly associated with higher depression. However, among patients experiencing high levels of stressors, those with high spiritual well-being and perceived social support had lower depressive/anxiety symptoms. CONCLUSION Our study characterized the principal stressors encountered during hospitalization, underscoring their associations with Lebanese inpatients' mental health. On the other hand, as perceived social support and spiritual well-being acted as negative moderators of these associations, intervention programs aimed at enhancing such adaptive coping techniques are strongly called upon to palliate the psychological distress of patients in hospital settings.
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Affiliation(s)
- Sarah Gerges
- School of Medicine and Medical Sciences, Holy Spirit University of Kaslik, P.O. Box 446, Jounieh, Lebanon
| | - Rabih Hallit
- School of Medicine and Medical Sciences, Holy Spirit University of Kaslik, P.O. Box 446, Jounieh, Lebanon
- Department of Infectious Disease, Notre Dame, Secours University Hospital Center, Street 93, Postal Code 3, Byblos, Lebanon
- Department of Infectious Disease, Bellevue Medical Center, Mansourieh, Lebanon
| | - Souheil Hallit
- School of Medicine and Medical Sciences, Holy Spirit University of Kaslik, P.O. Box 446, Jounieh, Lebanon.
- Applied Science research Center, Applied Science private university, Amman, Jordan.
- Research Department, Psychiatric Hospital of the Cross, Jal Eddib, Lebanon.
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Zacher M, Wollanka N, Sauer C, Haßtenteufel K, Wallwiener S, Wallwiener M, Maatouk I. Prenatal paternal depression, anxiety, and somatic symptom burden in different risk samples: an explorative study. Arch Gynecol Obstet 2023; 307:1255-1263. [PMID: 35608702 PMCID: PMC10023642 DOI: 10.1007/s00404-022-06612-2] [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: 01/20/2022] [Accepted: 05/04/2022] [Indexed: 11/02/2022]
Abstract
PURPOSE Growing evidence implies that transition to parenthood triggers symptoms of mental burden not only in women but likewise in men, especially in high-risk pregnancies. This is the first study that examined and compared the prevalence rates of depression, anxiety, and somatic symptom burden of expectant fathers who face different risk situations during pregnancy. METHODS Prevalence rates of paternal depression (Edinburgh postnatal depression scale), anxiety (generalized anxiety disorder seven), and somatic symptom burden (somatic symptom scale eight) were examined in two risk samples and one control group in the third trimester of their partners' pregnancy: risk sample I (n = 41) consist of expectant fathers whose partners were prenatally hospitalized due to medical complications; risk sample II (n = 52) are fathers whose partners were prenatally mentally distressed; and control group (n = 70) are those non-risk pregnancies. RESULTS On a purely descriptive level, the data display a trend of higher symptom burden of depression, anxiety, and somatic symptoms in the two risk samples, indicating that expectant fathers, whose pregnant partners were hospitalized or suffered prenatal depression, were more prenatally distressed. Exploratory testing of group differences revealed an almost three times higher prevalence rate of anxiety in fathers whose partner was hospitalized (12.2%) compared to those non-risks (4.3%). CONCLUSION Results underline the need for screening implementations for paternal prenatal psychological distress, as well as specific prevention and treatment programs, especially for fathers in risk situations, such as their pregnant partners' prenatal hospitalization. The study was registered with the German clinical trials register (DRKS00020131) on 2019/12/09.
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Affiliation(s)
- Magdalena Zacher
- Department of General Internal Medicine and Psychosomatics, University of Heidelberg, Heidelberg, Germany
| | - Nele Wollanka
- Department of General Internal Medicine and Psychosomatics, University of Heidelberg, Heidelberg, Germany
| | - Christina Sauer
- Department of General Internal Medicine and Psychosomatics, University of Heidelberg, Heidelberg, Germany
| | - Kathrin Haßtenteufel
- Department of Obstetrics and Gynecology, University of Heidelberg, Heidelberg, Germany
| | - Stephanie Wallwiener
- Department of Obstetrics and Gynecology, University of Heidelberg, Heidelberg, Germany
| | - Markus Wallwiener
- Department of Obstetrics and Gynecology, University of Heidelberg, Heidelberg, Germany
| | - Imad Maatouk
- Section of Psychosomatic Medicine, Psychotherapy and Psychooncology, Department of Internal Medicine II, Julius-Maximilian University Würzburg, Würzburg, Germany.
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11
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Kawamura E, Asano M. Changes, differences, and factors of parenthood in high-risk pregnant women and their partners in Japan. BMC Pregnancy Childbirth 2023; 23:205. [PMID: 36964602 PMCID: PMC10037369 DOI: 10.1186/s12884-023-05519-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Accepted: 03/14/2023] [Indexed: 03/26/2023] Open
Abstract
BACKGROUND Various stressors exists for pregnant women worldwide, especially negative social and environmental influences that can increase the number of high-risk pregnant women. These may cause a difficult transition to parenthood for women and their partners. However, limited studies have focused on and examined parenthood. Therefore, this study aimed to identify the changes in parenthood from pregnancy to post-discharge after childbirth among high-risk pregnant women and their partners, as well as the presence or absence of gender differences and the factors associated with parenthood. METHODS This longitudinal quantitative study used a self-administered anonymous questionnaire distributed among 127 pregnant women and their partners who visited a high-risk pregnant outpatient clinic. The Scale of Early Childrearing Parenthood (SECP; three subareas, 33 items) was administered thrice: during pregnancy (T1), after childbirth (T2), and after discharge (T3). RESULTS The analysis included 85 T1 (37 fathers and 48 mothers), 36 T2 (13 fathers and 23 mothers), and 31 T3 (11 fathers and 20 mothers) responses. There was a significant increase in the SECP scores for both parents from T1 to T3. Mothers had a greater increase in the SECP scores from T1 to T2 than fathers. In addition, fathers' mean SECP scores at T1 and T2 were higher compared with those of the mothers. Mothers' and fathers' SECP scores at each time point showed no significant differences. At all time points, the SECP scores were commonly and significantly associated with infertility treatment, physical and mental condition, postpartum depression at T2, and parenting stress at T3. CONCLUSIONS Because parenthood in the infertility treatment group was significantly higher throughout the series, we need to support such couples so that childbirth does not become their main goal. We suggest interventions for factors that impede parenthood development, understand the various backgrounds of the parents, and support the couple individually while also considering them as a unit.
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Affiliation(s)
- Eriko Kawamura
- Nagoya University Graduate School of Medicine, 1-1-20 Daiko Minami, Higashi-Ku, Nagoya, Aichi, 461-8673, Japan.
| | - Midori Asano
- Nagoya University Graduate School of Medicine, 1-1-20 Daiko Minami, Higashi-Ku, Nagoya, Aichi, 461-8673, Japan
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12
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Collaton J, Dennis CL, Taylor VH, Grigoriadis S, Oberlander TF, Frey BN, Van Lieshout R, Guintivano J, Meltzer-Brody S, Kennedy JL, Vigod SN. The PPD-ACT app in Canada: feasibility and a latent class analysis of participants with postpartum depression recruited to a psychiatric genetics study using a mobile application. BMC Psychiatry 2022; 22:735. [PMID: 36434566 PMCID: PMC9700884 DOI: 10.1186/s12888-022-04363-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/20/2022] [Accepted: 11/02/2022] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND Postpartum depression (PPD) and postpartum psychosis (PPP) are linked to negative consequences for women and families. Virtual applications present a solution to the challenge of recruiting large samples for genetic PPD/PPP research. This study aimed to evaluate the feasibility of a protocol for enrolling Canadian women with PPD and PPP to a large international psychiatric genetics study using a mobile application (PPD-ACT), and identify clinically distinct subtypes of PPD in the recruited sample. METHODS From April 2017-June 2019, Canadian women provided phenotypic data through the PPD-ACT app. Requests for a genetic sample were made from those with a current or past PPD episode based on an Edinburgh Postnatal Depression Scale (EPDS) score > 12 with onset in pregnancy or 0-3 months postpartum, and from those self-reporting lifetime PPP. Latent class analysis (LCA) was used to identify clinically distinct PPD subgroups based on participant responses to the EPDS scale. RESULTS We identified 797 PPD cases, 404 of whom submitted DNA. There were 109 PPP cases, with 66 submitting DNA. PPD cases (86.7% White, mean 4.7 +/- 7.0 years since their episode) came from across Canadian provinces/territories. LCA identified two PPD classes clinically distinct by symptom severity: [1] moderate-severity (mean EPDS = 18.5+/- 2.5; 8.6% with suicidality), and [2] severe (mean EPDS = 24.5+/- 2.1; 52.8% with suicidality). CONCLUSIONS A mobile application rapidly collected data from individuals with moderate and severe symptoms of PPD, an advantage for genetics where specificity is optimal, as well as from women with a history of PPP, supporting future work using this approach.
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Affiliation(s)
- Joanna Collaton
- grid.17063.330000 0001 2157 2938Dalla Lana School of Public Health, University of Toronto, Toronto, ON Canada ,grid.417199.30000 0004 0474 0188Women’s College Hospital and Research Institute, 76 Grenville Street, Toronto, ON Canada
| | - Cindy-Lee Dennis
- grid.417199.30000 0004 0474 0188Women’s College Hospital and Research Institute, 76 Grenville Street, Toronto, ON Canada ,grid.17063.330000 0001 2157 2938Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, ON Canada
| | - Valerie H. Taylor
- grid.417199.30000 0004 0474 0188Women’s College Hospital and Research Institute, 76 Grenville Street, Toronto, ON Canada ,grid.17063.330000 0001 2157 2938Department of Psychiatry, Faculty of Medicine, University of Toronto, Toronto, ON Canada
| | - Sophie Grigoriadis
- grid.17063.330000 0001 2157 2938Department of Psychiatry, Faculty of Medicine, University of Toronto, Toronto, ON Canada ,grid.413104.30000 0000 9743 1587Sunnybrook Health Sciences Centre, Toronto, ON Canada
| | - Tim F. Oberlander
- grid.17091.3e0000 0001 2288 9830BC Women’s Hospital and Health Centre, University of British Columbia, Vancouver, BC Canada
| | - Benicio N. Frey
- grid.25073.330000 0004 1936 8227Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON Canada ,grid.416721.70000 0001 0742 7355Women’s Health Concerns Clinic, St. Joseph’s Healthcare Hamilton ON, Hamilton, ON L8N 4A6 Canada
| | - Ryan Van Lieshout
- grid.25073.330000 0004 1936 8227Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON Canada ,grid.416721.70000 0001 0742 7355Women’s Health Concerns Clinic, St. Joseph’s Healthcare Hamilton ON, Hamilton, ON L8N 4A6 Canada
| | - Jerry Guintivano
- grid.410711.20000 0001 1034 1720University of North Carolina, Chapel Hill, NC USA
| | | | - James L. Kennedy
- grid.17063.330000 0001 2157 2938Department of Psychiatry, Faculty of Medicine, University of Toronto, Toronto, ON Canada ,grid.155956.b0000 0000 8793 5925Centre for Addiction and Mental Health, Toronto, ON Canada
| | - Simone N. Vigod
- grid.417199.30000 0004 0474 0188Women’s College Hospital and Research Institute, 76 Grenville Street, Toronto, ON Canada ,grid.17063.330000 0001 2157 2938Department of Psychiatry, Faculty of Medicine, University of Toronto, Toronto, ON Canada
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Ertmann RK, Nicolaisdottir DR, Kragstrup J, Overbeck G, Kriegbaum M, Siersma V. The predictive value of common symptoms in early pregnancy for complications later in pregnancy and at birth. Acta Obstet Gynecol Scand 2022; 102:33-42. [PMID: 36300886 PMCID: PMC9780714 DOI: 10.1111/aogs.14474] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2022] [Revised: 09/06/2022] [Accepted: 10/03/2022] [Indexed: 12/30/2022]
Abstract
INTRODUCTION The aim was to investigate whether common pregnancy-related symptoms-nausea, vomiting, back pain, pelvic girdle pain, pelvic cavity pain, vaginal bleeding, itching of vulva, pregnancy itching, leg cramps, uterine contractions and varicose veins-in the first trimester of pregnancy add to the identification of women at high risk of future pregnancy and birth complications. MATERIAL AND METHODS Survey data linked to national register data. All women booking an appointment for a first prenatal visit in one of 192 randomly selected General Practices in East Denmark in the period April 2015-August 2016. The General Practices included 1491 women to this prospective study. Two outcomes, pregnancy complications and birth complications, were collected from the Danish Medical Birth Register. RESULTS Among the 1413 included women, 199 (14%) experienced complications in later pregnancy. The most serious complication, miscarriage, was experienced by 65 women (4.6%). Other common pregnancy complications were gestational diabetes mellitus (n = 11, 0.8%), gestational hypertension without proteinuria (n = 34, 2.4%), mild to moderate preeclampsia (n = 34, 2.4%) and gestational itching with effect on liver (n = 17, 1.2%). Women who experienced pelvic girdle pain, pelvic cavity pain or vaginal bleeding in the first trimester of pregnancy had a higher risk of pregnancy complications later on in later pregnancy. None of the other examined symptoms showed associations to pregnancy complications. No associations were found between pregnancy-related physical symptoms in first trimester and birth complications. CONCLUSIONS Symptoms in early pregnancy do not add much information about the risk of pregnancy or birth complications, although pain and bleeding may give reason for some concern. This is an important message to women experiencing these common symptoms and to their caregivers.
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Affiliation(s)
- Ruth Kirk Ertmann
- Research Unit for General Practice and Section for General PracticeInstitute of Public Health, University of CopenhagenCopenhagenDenmark
| | - Dagny Ros Nicolaisdottir
- Research Unit for General Practice and Section for General PracticeInstitute of Public Health, University of CopenhagenCopenhagenDenmark
| | - Jakob Kragstrup
- Research Unit for General Practice and Section for General PracticeInstitute of Public Health, University of CopenhagenCopenhagenDenmark
| | - Gritt Overbeck
- Research Unit for General Practice and Section for General PracticeInstitute of Public Health, University of CopenhagenCopenhagenDenmark
| | - Margit Kriegbaum
- Research Unit for General Practice and Section for General PracticeInstitute of Public Health, University of CopenhagenCopenhagenDenmark
| | - Volkert Siersma
- Research Unit for General Practice and Section for General PracticeInstitute of Public Health, University of CopenhagenCopenhagenDenmark
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Bedaso A, Adams J, Peng W, Xu F, Sibbritt D. An examination of the association between marital status and prenatal mental disorders using linked health administrative data. BMC Pregnancy Childbirth 2022; 22:735. [PMID: 36182904 PMCID: PMC9526285 DOI: 10.1186/s12884-022-05045-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Accepted: 09/08/2022] [Indexed: 11/30/2022] Open
Abstract
Background International research shows marital status impacts the mental health of pregnant women, with prenatal depression and anxiety being higher among non-partnered women. However, there have been few studies examining the relationship between marital status and prenatal mental disorders among Australian women. Methods This is a population-based retrospective cohort study using linked data from the New South Wales (NSW) Perinatal Data Collection (PDC) and Admitted Patients Data Collection (APDC). The cohort consists of a total of 598,599 pregnant women with 865,349 admissions. Identification of pregnant women for mental disorders was conducted using the 10th version International Classification of Diseases and Related Health Problems, Australian Modification (ICD-10-AM). A binary logistic regression model was used to estimate the relationship between marital status and prenatal mental disorder after adjusting for confounders. Results Of the included pregnant women, 241 (0.04%), 107 (0.02%) and 4359 (0.5%) were diagnosed with depressive disorder, anxiety disorder, and self-harm, respectively. Non-partnered pregnant women had a higher likelihood of depressive disorder (Adjusted Odds Ratio (AOR) = 2.75; 95% CI: 2.04, 3.70) and anxiety disorder (AOR = 3.16, 95% CI: 2.03, 4.91), compared with partnered women. Furthermore, the likelihood of experiencing self-harm was two times higher among non-partnered pregnant women (AOR = 2.00; 95% CI: 1.82, 2.20) than partnered pregnant women. Conclusions Non-partnered marital status has a significant positive association with prenatal depressive disorder, anxiety disorder and self-harm. This suggests it would be highly beneficial for maternal health care professionals to screen non-partnered pregnant women for prenatal mental health problems such as depression, anxiety and self-harm. Supplementary Information The online version contains supplementary material available at 10.1186/s12884-022-05045-8.
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Affiliation(s)
- Asres Bedaso
- College of Medicine and Health Sciences, School of Nursing, Hawassa University, Hawassa, Ethiopia. .,Australian Centre for Public and Population Health Research, School of Public Health, Faculty of Health, University of Technology Sydney, Ultimo, NSW, Australia.
| | - Jon Adams
- Australian Centre for Public and Population Health Research, School of Public Health, Faculty of Health, University of Technology Sydney, Ultimo, NSW, Australia
| | - Wenbo Peng
- Australian Centre for Public and Population Health Research, School of Public Health, Faculty of Health, University of Technology Sydney, Ultimo, NSW, Australia
| | - Fenglian Xu
- Data Analysis & Surgical Outcomes Unit, Royal North Shore Hospital, Sydney, NSW, Australia
| | - David Sibbritt
- Australian Centre for Public and Population Health Research, School of Public Health, Faculty of Health, University of Technology Sydney, Ultimo, NSW, Australia
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Polat F, Karasu F, Yıldız M. The Effect of Religious Attitudes on Anxiety and Psychological Well-being in Risky Pregnancies: A Cross-Sectional Study from Turkey. JOURNAL OF RELIGION AND HEALTH 2022; 61:2992-3010. [PMID: 35729300 DOI: 10.1007/s10943-022-01597-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 05/29/2022] [Indexed: 06/15/2023]
Abstract
The aim of this study was to determine how religious attitudes of risky pregnant women affect their anxiety and psychological well-being. This is a cross-sectional study. It was carried out on 137 women diagnosed with risky pregnancy between December 2021 and February 2022 in a state hospital in Osmaniye, located in the southern Turkey. The findings of the study revealed that the participants' religious attitudes affected their trait anxiety and psychological well-being. Being religious in fact, boosted psychological well-being of the participants and lowered their trait anxiety level. They had a moderate religious attitude and a moderate psychological well-being but they also suffered from high trait anxiety levels.
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Affiliation(s)
- Filiz Polat
- Department of Midwifery, Faculty of Health Sciences, Osmaniye Korkut Ata University, 80010, Osmaniye, Turkey.
| | - Fatma Karasu
- Department of Nursing, Yusuf Şerefoğlu Faculty of Health Sciences, Kilis 7 Aralık University, 79000, Kilis, Turkey
| | - Metin Yıldız
- Department of Midwifery, Faculty of Health Sciences, Sakarya University, 54050, Sakarya, Turkey
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Doty MS, Chen HY, Grace R, Ashimi SS, Chauhan SP. Stress, anxiety and depression levels in pregnancy: outpatient versus inpatient. J Matern Fetal Neonatal Med 2022; 35:9608-9613. [PMID: 35477337 DOI: 10.1080/14767058.2022.2049748] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
OBJECTIVE To compare stress, anxiety and depression levels among 3 groups of pregnant women: 1) low-risk outpatient (LRO), 2) high-risk outpatient (HRO), and 3) inpatient (IP). METHODS This was a cross-sectional study using validated instruments. Inclusion criteria were pregnancies 23-37 weeks and maternal age > 18 years. The primary outcome was mean/median scores of Perceived Stress Scale (PSS), State Trait Anxiety Inventory (STAI), and Edinburgh Depression Scale (EDS). Secondary outcome was rate of abnormal scores. RESULTS Among 190 women approached, 180 (95%) participated, with 60 (33%) in each group. Mean PSS scores (range 0-40) significantly increased from LRO (12.0, standard deviation [SD] 7.8) to HRO (14.7, SD 7.9) to IP (15.6, SD 8.2); p = .04. Mean STAI scores (range 20-80) also significantly increased from LRO (32.0, SD 11.1) to HRO (35.8, SD 11.9) to IP (40.9, SD 13.1); p < .01. Abnormal anxiety (STAI ≥ 40) was present in 40% of women and significantly higher among IP compared to LRO (56% vs 25%; RR 2.24, 95% CI 1.36-3.67; aRR 2.24, 95% CI 1.34-3.74). CONCLUSION Stress and anxiety scores significantly differ in LRO, HRO, and IP women. While depression screening is common postpartum, screening for stress, anxiety and depression prenatally may be beneficial.
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Affiliation(s)
- Morgen S Doty
- Mednax, Obstetrix Maternal-Fetal Medicine Specialists of Houston, Houston, TX, USA
| | - Han-Yang Chen
- Department of Obstetrics, Gynecology, and Reproductive Sciences, McGovern Medical School, The University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Rebecca Grace
- Department of Obstetrics and Gynecology, Baylor College of Medicine, Houston, TX, USA
| | - Sunbola S Ashimi
- Department of Obstetrics, Gynecology, and Reproductive Sciences, McGovern Medical School, The University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Suneet P Chauhan
- Department of Obstetrics, Gynecology, and Reproductive Sciences, McGovern Medical School, The University of Texas Health Science Center at Houston, Houston, TX, USA
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Moore Simas TA, Leung K, Nuss E, Marieni M, Marcus B, Rosal MC, Chasan-Taber L. Factors Associated with Risk of Perinatal Depressive Symptoms Among Puerto Rican Women with Hyperglycemia. Matern Child Health J 2022; 26:1741-1751. [PMID: 35386031 DOI: 10.1007/s10995-022-03429-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/17/2022] [Indexed: 10/18/2022]
Abstract
OBJECTIVES Rates of perinatal depression and pregnancy hyperglycemia are higher in Hispanic women as compared to non-Hispanic white women. In turn, depressive symptoms may reduce a woman's ability to engage in lifestyle changes that could reduce their subsequent diabetes risk. METHODS We conducted a secondary analysis using data from Estudio Parto to evaluate sociodemographic, behavioral, psychosocial, and medical factors associated with perinatal depressive symptoms. Estudio Parto was a randomized controlled trial conducted in Western Massachusetts from 2013 to 17. Eligible participants had pregnancy hyperglycemia. The Edinburgh Postnatal Depression Scale (EPDS) was administered at 24-28 weeks gestation and at 6 weeks, 6 months, and 12 months postpartum. An EPDS cutpoint of 10 or greater defined the presence of depressive symptoms. RESULTS In this sample of Puerto Rican women with pregnancy hyperglycemia, 32% and 27% showed prenatal and postpartum depressive symptoms, respectively. Among participants, 35.5% were diagnosed with GDM, 44.3% with isolated hyperglycemia, and 20.2% with impaired glucose tolerance. In multivariable models, being unmarried (OR 3.87; 95% CI 1.51-9.94), prenatal substance use (smoking or alcohol consumption; OR 2.96; 95% CI 1.41-6.18), and maternal age (1.11 for each year; 95% CI 1.04-1.18) were associated with higher odds of prenatal depressive symptoms. None of the risk factors were associated with subsequent postpartum depression in adjusted analyses. CONCLUSIONS Identifying factors associated with prenatal and postpartum depression in Puerto Rican women with pregnancy hyperglycemia can inform targeted lifestyle interventions in this at-risk group, increase the likely adoption of healthy lifestyle behaviors, and thereby work to address health disparities. CLINICALTRIALS gov NCT01679210; date of registration 08/07/2012.
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Affiliation(s)
- Tiffany A Moore Simas
- Departments of Obstetrics & Gynecology, Pediatrics, Psychiatry and Population & Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, MA, USA
| | - Katherine Leung
- Department of Obstetrics & Gynecology, University of Massachusetts Medical School, Worcester, MA, USA
| | - Emily Nuss
- Departments of Obstetrics & Gynecology, Pediatrics, Psychiatry and Population & Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, MA, USA
| | - Michelle Marieni
- Departments of Obstetrics & Gynecology, Pediatrics, Psychiatry and Population & Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, MA, USA
| | - Bess Marcus
- Department of Behavioral and Social Sciences, Brown University School of Public Health, Providence, RI, USA
| | - Milagros C Rosal
- Division of Preventive and Behavioral Medicine, Department of Population & Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, MA, USA
| | - Lisa Chasan-Taber
- Department of Biostatistics & Epidemiology, School of Public Health and Health Sciences, University of Massachusetts, 401 Arnold House, 715 North Pleasant Street, Amherst, MA, 01003-9304, USA.
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Doty MS, Chen HY, Ajishegiri O, Sibai BM, Blackwell SC, Chauhan SP. Daily meditation program for anxiety in individuals admitted to the antepartum unit: a multicenter randomized controlled trial (MEDITATE). Am J Obstet Gynecol MFM 2022; 4:100562. [PMID: 35031521 DOI: 10.1016/j.ajogmf.2022.100562] [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: 09/29/2021] [Revised: 12/26/2021] [Accepted: 01/06/2022] [Indexed: 11/18/2022]
Abstract
BACKGROUND Inpatient antepartum women have higher levels of anxiety than outpatient. Former randomized trials using mindful meditation programs to decrease maternal anxiety have conflicting results; some studies showed a considerable decrease in anxiety levels, whereas others showed no difference. A paucity of trials exist using mindful meditation for maternal anxiety in the inpatient antepartum population; most studies focus on the outpatient clinic population. Because of inpatient acuity and anxiety factors, we conducted a randomized trial to target this population. OBJECTIVE This study aimed to compare anxiety levels on day 4 of either routine care or routine care plus a twice-daily application-based mindful meditation program in women admitted to the antepartum unit. STUDY DESIGN In a multisite randomized trial (ClinicalTrials.gov Identifier: NCT03737279), women admitted to the antepartum units were randomized to either routine care plus educational pamphlets (control arm) or routine care plus a twice-daily application-based mindful meditation program (intervention arm). The inclusion criteria were age of at least 18 years, gestational age of at least 23 weeks, planned inpatient care for >3 days from randomization, and care by our university physician team. The primary outcome was maternal state anxiety level (measured using the validated State-Trait Anxiety Inventory) on day 4 (randomization being day 1). The secondary outcomes included stress (measured using the Perceived Stress Scale) and depression (measured using the Edinburgh Depression Scale) on day 4, latency period from randomization to delivery, patient experience, number of meditation sessions, and total meditation time. A total of 56 women were needed for 90% power to detect a decrease in the primary outcome by 30% in the intervention group, compared with the control group. All women were observed using an intention-to-treat analysis. We compared the continuous variables using the Wilcoxon rank-sum test or t test and the categorical variables using the chi-squared test or the Fisher exact test. RESULTS From March 4, 2019, to December 20, 2019, 412 women were screened for eligibility, 77 women (18.7%) were found eligible, and 56 women (72.7%) were randomized with 28 women in each group. Of note, 96.4% of women completed at least 1 meditation session, and 39.3% of women completed all meditation sessions. The mean score of the anxiety level using the State-Trait Anxiety Inventory on day 4 was not significantly different (P=.24) between the control group (42.0±10.8) and meditation group (37.5±13.1). A decreased anxiety score from day 1 to day 4 was seen in both the control group and meditation group (-4.7 vs -9.4, respectively; P=.12). The rate of abnormal State-Trait Anxiety Inventory scores on day 4 was not significantly different between the control group and meditation group (62% vs 45%, respectively; P=.28). When asked about the experience with the research trial, 88.8% of women in the control group and 89.5% of women in the meditation group reported a positive experience. CONCLUSION Compared with the control group, a twice-daily application-based mindful meditation program for women admitted to the antepartum unit did not considerably decrease the anxiety score on day 4. However, >88% of women in both groups had a positive experience with the nonpharmacologic intervention.
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Affiliation(s)
- Morgen S Doty
- Obstetrix Maternal-Fetal Medicine Specialists of Houston, Houston, TX (Dr Doty).
| | - Han-Yang Chen
- Department of Obstetrics, Gynecology, and Reproductive Sciences, McGovern Medical School, The University of Texas Health Science Center at Houston, Houston, TX (Dr Chen, Ms Ajishegiri, and Drs Sibai, Blackwell, and Chauhan)
| | - Oluwadare Ajishegiri
- Department of Obstetrics, Gynecology, and Reproductive Sciences, McGovern Medical School, The University of Texas Health Science Center at Houston, Houston, TX (Dr Chen, Ms Ajishegiri, and Drs Sibai, Blackwell, and Chauhan)
| | - Baha M Sibai
- Department of Obstetrics, Gynecology, and Reproductive Sciences, McGovern Medical School, The University of Texas Health Science Center at Houston, Houston, TX (Dr Chen, Ms Ajishegiri, and Drs Sibai, Blackwell, and Chauhan)
| | - Sean C Blackwell
- Department of Obstetrics, Gynecology, and Reproductive Sciences, McGovern Medical School, The University of Texas Health Science Center at Houston, Houston, TX (Dr Chen, Ms Ajishegiri, and Drs Sibai, Blackwell, and Chauhan)
| | - Suneet P Chauhan
- Department of Obstetrics, Gynecology, and Reproductive Sciences, McGovern Medical School, The University of Texas Health Science Center at Houston, Houston, TX (Dr Chen, Ms Ajishegiri, and Drs Sibai, Blackwell, and Chauhan)
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Schiele C, Goetz M, Hassdenteufel K, Müller M, Graf J, Zipfel S, Wallwiener S. Acceptance, experiences, and needs of hospitalized pregnant women toward an electronic mindfulness-based intervention: A pilot mixed-methods study. Front Psychiatry 2022; 13:939577. [PMID: 36072461 PMCID: PMC9444059 DOI: 10.3389/fpsyt.2022.939577] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2022] [Accepted: 07/28/2022] [Indexed: 12/05/2022] Open
Abstract
BACKGROUND Anxiety disorders and depression during pregnancy are highly prevalent. Hospitalized pregnant women with high maternal or fetal risk represent a particularly vulnerable population often excluded from research samples. Screening for mental health disorders is not routinely offered for this particular patient group. Electronic mindfulness-based interventions constitute an accessible, convenient, and cost-effective mental health resource but have not yet been evaluated for acceptance in inpatient settings. To date, little is known about the needs and perceptions of this group of women. OBJECTIVE The aim of this study was to examine whether a brief electronic mindfulness-based intervention (eMBI) is accepted among hospitalized high-risk pregnant women. We assessed personal motivation and barriers, experiences, usability requirements, and overall acceptance of the eMBI, as well the specific needs and demands of patients with high-risk pregnancies regarding mental health services. METHODS An exploratory pilot study with a mixed-methods study design was carried out among 30 women hospitalized with a high obstetric risk. The study participants were given access to an eMBI with a 1-week mindfulness program on how to deal with stress, anxiety, and depressive symptoms. Semi-structured interviews were conducted with the 30 participants and analyzed using systematic content analysis. In addition, acceptance and usability were assessed via questionnaires. RESULTS Study findings showed a high level of acceptance of the eMBI. Most of the respondents were satisfied with the usability and considered the eMBI program to be helpful. The greatest barriers to using the eMBI were a general negative attitude toward using apps, preference for personal contact, or no current need for psychotherapy. Participants criticized the lack of awareness of mental health issues during pregnancy and expressed a need for low-threshold treatment offers, especially during hospitalization. CONCLUSIONS There is a strong need for mental health services in pregnancy care, especially for pregnant women with risk profiles. An eMBI offers an acceptable means of providing mental health support for hospitalized women with a severe obstetric risk.
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Affiliation(s)
- Claudia Schiele
- Department of Obstetrics and Gynecology, University of Heidelberg, Heidelberg, Germany
| | - Maren Goetz
- Department of General Pediatrics, University of Heidelberg, Heidelberg, Germany
| | - Kathrin Hassdenteufel
- Department of Obstetrics and Gynecology, University of Heidelberg, Heidelberg, Germany
| | - Mitho Müller
- Department of Psychology, Ludwig Maximilian University, Munich, Germany
| | - Johanna Graf
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital Tübingen, Tübingen, Germany
| | - Stephan Zipfel
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital Tübingen, Tübingen, Germany
| | - Stephanie Wallwiener
- Department of Obstetrics and Gynecology, University of Heidelberg, Heidelberg, Germany
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Bedaso A, Adams J, Peng W, Sibbritt D. The association between social support and antenatal depressive and anxiety symptoms among Australian women. BMC Pregnancy Childbirth 2021; 21:708. [PMID: 34686140 PMCID: PMC8532351 DOI: 10.1186/s12884-021-04188-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Accepted: 10/12/2021] [Indexed: 11/17/2022] Open
Abstract
Background Antenatal depression and antenatal anxiety adversely affect several obstetric and foetal outcomes, and increase the rate of postnatal mental illness. Thus, to tackle these challenges the need for social support during pregnancy is vital. However, an extensive literature search failed to show a published study on the relationship between domains of social support and antenatal depressive, as well as antenatal anxiety symptoms in Australia. This study examined the association between domains of social support and antenatal depressive and anxiety symptoms among Australian women. Methods The current study used data obtained from the 1973–78 cohort of the Australian Longitudinal Study on Women’s Health (ALSWH), focusing upon women who reported being pregnant (n = 493). Depression and anxiety were assessed using the 10 item Center for Epidemiological Studies Depression (CES-D-10) scale, and the 9-item Goldberg Anxiety and Depression scale (GADS) respectively. The 19 item-Medical Outcomes Study Social Support index (MOSS) was used to assess social support. A logistic regression model was used to examine the associations between domains of social support and antenatal depressive and anxiety symptoms after adjusting for potential confounders. Result The current study found 24.7 and 20.9% of pregnant women screened positive for depressive and anxiety symptoms respectively. After adjusting for potential confounders, our study found that the odds of antenatal depressive symptoms was about four and threefold higher among pregnant women who reported low emotional/informational support (AOR = 4.75; 95% CI: 1.45, 15.66; p = 0.010) and low social support (overall support) (AOR = 3.26; 95%CI: 1.05, 10.10, p = 0.040) respectively compared with their counterpart. In addition, the odds of antenatal anxiety symptoms was seven times higher among pregnant women who reported low affectionate support/positive social interaction (AOR = 7.43; 95%CI: 1.75, 31.55; p = 0.006). Conclusion A considerable proportion of pregnant Australian women had depressive symptoms and/or anxiety symptoms, which poses serious health concerns. Low emotional/informational support and low affectionate support/positive social interaction have a significant association with antenatal depressive and anxiety symptoms respectively. As such, targeted screening of expectant women for social support is essential. Supplementary Information The online version contains supplementary material available at 10.1186/s12884-021-04188-4.
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Affiliation(s)
- Asres Bedaso
- Hawassa University, College of Medicine and Health Sciences, School of Nursing, Hawassa, Ethiopia. .,Australian Centre for Public and Population Health Research, School of Public Health, Faculty of Health, University of Technology Sydney, Ultimo, NSW, Australia.
| | - Jon Adams
- Australian Centre for Public and Population Health Research, School of Public Health, Faculty of Health, University of Technology Sydney, Ultimo, NSW, Australia
| | - Wenbo Peng
- Australian Centre for Public and Population Health Research, School of Public Health, Faculty of Health, University of Technology Sydney, Ultimo, NSW, Australia
| | - David Sibbritt
- Australian Centre for Public and Population Health Research, School of Public Health, Faculty of Health, University of Technology Sydney, Ultimo, NSW, Australia
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Sommerlad S, Schermelleh-Engel K, La Rosa VL, Louwen F, Oddo-Sommerfeld S. Trait anxiety and unplanned delivery mode enhance the risk for childbirth-related post-traumatic stress disorder symptoms in women with and without risk of preterm birth: A multi sample path analysis. PLoS One 2021; 16:e0256681. [PMID: 34464408 PMCID: PMC8407573 DOI: 10.1371/journal.pone.0256681] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2021] [Accepted: 08/12/2021] [Indexed: 11/18/2022] Open
Abstract
Childbirth-related post-traumatic stress disorder (CB-PTSD) occurs in 3-7% of all pregnancies and about 35% of women after preterm birth (PTB) meet the criteria for acute stress reaction. Known risk factors are trait anxiety and pain intensity, whereas planned delivery mode, medical support, and positive childbirth experience are protective factors. It has not yet been investigated whether the effects of anxiety and delivery mode are mediated by other factors, and whether a PTB-risk alters these relationships. 284 women were investigated antepartum and six weeks postpartum (risk-group with preterm birth (RG-PB) N = 95, risk-group with term birth (RG-TB) N = 99, and control group (CG) N = 90). CB-PTSD symptoms and anxiety were measured using standardized psychological questionnaires. Pain intensity, medical support, and childbirth experience were assessed by single items. Delivery modes were subdivided into planned vs. unplanned delivery modes. Group differences were examined using MANOVA. To examine direct and indirect effects on CB-PTSD symptoms, a multi-sample path analysis was performed. Rates of PTS were highest in the RG-PB = 11.58% (RG-TB = 7.01%, CG = 1.1%). MANOVA revealed higher values of CB-PTSD symptoms and pain intensity in RG-PB compared to RG-TB and CG. Women with planned delivery mode reported a more positive birth experience. Path modeling revealed a good model fit. Explained variance was highest in RG-PB (R2 = 44.7%). Direct enhancing effects of trait anxiety and indirect reducing effects of planned delivery mode on CB-PTSD symptoms were observed in all groups. In both risk groups, CB-PTSD symptoms were indirectly reduced via support by medical staff and positive childbirth experience, while trait anxiety indirectly enhanced CB-PTSD symptoms via pain intensity in the CG. Especially in the RG-PB, a positive birth experience serves as protective factor against CB-PTSD symptoms. Therefore, our data highlights the importance of involving patients in the decision process even under stressful birth conditions and the need for psychological support antepartum, mainly in patients with PTB-risk and anxious traits. Trial registration number: NCT01974531 (ClinicalTrials.gov identifier).
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Affiliation(s)
- Sarah Sommerlad
- Department of Gynecology and Obstetrics, University Hospital of Frankfurt, Frankfurt, Germany
| | | | | | - Frank Louwen
- Department of Gynecology and Obstetrics, University Hospital of Frankfurt, Frankfurt, Germany
| | - Silvia Oddo-Sommerfeld
- Department of Gynecology and Obstetrics, University Hospital of Frankfurt, Frankfurt, Germany
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Atuhaire C, Rukundo GZ, Nambozi G, Ngonzi J, Atwine D, Cumber SN, Brennaman L. Prevalence of postpartum depression and associated factors among women in Mbarara and Rwampara districts of south-western Uganda. BMC Pregnancy Childbirth 2021; 21:503. [PMID: 34247576 PMCID: PMC8272966 DOI: 10.1186/s12884-021-03967-3] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2020] [Accepted: 06/25/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Postpartum depression (PPD) is a significant cause of maternal morbidity and has severe consequences on the well-being of mothers, new-borns, families, and communities. PPD reduces the mother's response to the child's needs. In severe cases, mothers suffering from PPD are prone to postpartum psychosis, commit suicide and, in rare cases, infanticide. We aimed to determine the prevalence and understand the factors associated with PPD among mothers in southwestern Uganda. METHODS This was a cross-sectional study between November 2019 and June 2020 among 292 mothers, 6 to 8 weeks' postpartum. Mothers were selected from three health facilities in southwestern Uganda and enrolled using stratified consecutive sampling. Postpartum depression was clinically diagnosed using the Diagnostic and Statistical Manual of Mental Disorders V. The factors associated with PPD were assessed by using a structured interviewer administered questionnaire. The factors were analyzed using bivariate chi square analyses and multivariate logistic regression. RESULTS Overall prevalence of PPD was 27.1% (95% CI: 22.2-32.5). This did not vary by the number of previous births or mode of birth. Five factors associated with PPD were low perceived social support, HIV positive status, rural residence, obstetrical complications and the baby crying excessively. CONCLUSION AND RECOMMENDATIONS Prevalence of PPD in Mbarara and Rwampara districts is higher than what has previously been reported in Uganda indicating an urgent need to identify pregnant women who are at increased risk of PPD to mitigate their risk or implement therapies to manage the condition. Midwives who attend to these mothers need to be empowered with available methods of mitigating prevalence and consequences of PPD. Women who are HIV positive, residing in rural settings, whose babies cry excessively, having low social support systems and who have birth complications may be a particularly important focus for Ugandan intervention strategies to prevent and reduce the prevalence of PPD.
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Affiliation(s)
- Catherine Atuhaire
- Faculty of Medicine, Department of Nursing, Mbarara University of Science and Technology (MUST), Mbarara, Uganda.
| | - Godfrey Zari Rukundo
- Faculty of Medicine, Department of Nursing, Mbarara University of Science and Technology (MUST), Mbarara, Uganda
| | - Grace Nambozi
- Faculty of Medicine, Department of Nursing, Mbarara University of Science and Technology (MUST), Mbarara, Uganda
| | - Joseph Ngonzi
- Faculty of Medicine, Department of Nursing, Mbarara University of Science and Technology (MUST), Mbarara, Uganda
| | - Daniel Atwine
- Faculty of Medicine, Department of Nursing, Mbarara University of Science and Technology (MUST), Mbarara, Uganda
| | - Samuel Nambile Cumber
- Faculty of Medicine, Department of Nursing, Mbarara University of Science and Technology (MUST), Mbarara, Uganda
| | - Laura Brennaman
- Faculty of Medicine, Department of Nursing, Mbarara University of Science and Technology (MUST), Mbarara, Uganda
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Anxiety and depression in women hospitalized due to high-risk pregnancy: An integrative quantitative and qualitative study. CURRENT PSYCHOLOGY 2021. [DOI: 10.1007/s12144-021-01902-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
AbstractLiterature has shown that hospitalized women with high-risk pregnancy tend to develop anxious and depressive symptoms. Research has used quantitative or qualitative methods. By integrating both quantitative and qualitative methods, this study aims to analyze: a) the level of depression, anxiety, and pregnancy-related anxiety in a group of women hospitalized with high-risk pregnancy (hospitalized high-risk) compared with a group of non-hospitalized women with low-risk pregnancy; b) the content of hospitalization-related emotions in a high-risk group. A cross-sectional study was conducted on 30 hospitalized high-risk pregnant women and 32 women with low-risk pregnancy. Participants completed the Edinburgh Postnatal Depression Scale, Hospital Anxiety and Depression Scale (Anxiety), and Pregnancy Related Anxiety Questionnaire. The hospitalized high-risk group also completed open-ended questions about emotions experienced during hospitalization. Univariate Analysis of Covariance showed that the hospitalized high-risk group reported higher general anxiety and depression than the low-risk pregnancy group. Low-risk group reported higher level of concerns about own appearance than high-risk group. Narratives showed that the anxious and depressive symptoms of hospitalized women are related to the loneliness of being away from family. Despite attempts to understand hospitalization, they express concerns about pregnancy. Psychological support for hospitalized pregnant women should be provided to facilitate the communication of emotions that leads women to elaborate the experience of hospitalization to better adapt and cope with the critical condition.
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Rossetti C. Art Therapy as a Support for Women Hospitalized on an Antepartum Unit. ART THERAPY 2021. [DOI: 10.1080/07421656.2021.1919008] [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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Chaharrahifard L, Jashni Motlagh A, Akbari-Kamrani M, Ataee M, Esmaelzadeh-Saeieh S. The Effect of Midwife-led Psycho-Education on Parental Stress, Postpartum Depression and Parental Competency in High Risk Pregnancy Women: A Randomized Controlled Trial. J Caring Sci 2021; 10:70-76. [PMID: 34222115 PMCID: PMC8242294 DOI: 10.34172/jcs.2021.014] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2019] [Accepted: 01/27/2020] [Indexed: 11/21/2022] Open
Abstract
Introduction: Women with high-risk pregnancy are at increased risk of depression and anxiety during pregnancy, as well as a less favorable parent-infant interaction. This study aimed to investigate the effect of midwife-led psycho-education intervention on parental stress, competency, and postpartum depression in nulliparous women hospitalized with high-risk pregnancy. Methods: This randomized controlled trial was carried out on 66 nulliparous women admitted to the high-risk pregnancy ward of Kamali Hospital, Karaj, Iran. Using convenient sampling method, the mothers were randomly assigned to control and intervention groups. In addition to routine care, the intervention group received four sessions of midwife-led psycho-education intervention in two group sessions in pregnancy and two individual sessions immediately after delivery. The parental stress, parental competency, and postpartum depression questionnaires were used for data collection before, after, and one month after the intervention. Data were analyzed using SPSS software ver. 13.0. Repeated-measures ANOVA test was used for comparing the mean scores of parenting stress, parental competency, and depression between and within both study groups before, after, and one month after delivery. Results: While postpartum depression and parental stress decreased in intervention group, parental competency increased. Conclusion: Our findings indicated that midwife-led psycho-education was effective on parental stress, competency, and postpartum depression in high-risk pregnancy mothers. Accordingly, prenatal distress in high-risk pregnancies should be assessed routinely.
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Affiliation(s)
- Leila Chaharrahifard
- Departement of Reproductive Health, Student Research Committee, Faculty of Medicine, Alborz University of Medical Sciences, Karaj, Iran
| | - Alireza Jashni Motlagh
- Department of Pediatrics, Neonatal-Perinatal Medicine, Faculty of Medicine, Alborz University of Medical Sciences, Karaj, Iran
| | - Mahnaz Akbari-Kamrani
- Department of Reproductive Health, Faculty of Medicine, Alborz University of Medical Sciences, Karaj, Iran
| | - Mina Ataee
- Department of Obstetrics and Gynecology, Faculty of Medicine, Alborz University of Medical Sciences, Karaj, Iran
| | - Sara Esmaelzadeh-Saeieh
- Department of Reproductive Health, Social Determinants of Health Research Center, Alborz University of Medical Sciences, Karaj, Iran
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Toscano M, Royzer R, Castillo D, Li D, Poleshuck E. Prevalence of Depression or Anxiety During Antepartum Hospitalizations for Obstetric Complications: A Systematic Review and Meta-analysis. Obstet Gynecol 2021; 137:881-891. [PMID: 33831928 PMCID: PMC8087456 DOI: 10.1097/aog.0000000000004335] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2020] [Accepted: 01/14/2021] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To systematically review the prevalence of antenatal depression and anxiety in women hospitalized in an antepartum unit for obstetric complications. DATA SOURCES We searched PubMed, EMBASE, CINAHL, PsycINFO, and ClinicalTrials.gov for English-language articles published from database inception through March 2020. METHODS OF STUDY SELECTION We included cross-sectional, cohort, case-control, quasi-experimental, and randomized controlled studies from any country that reported the proportion of pregnant women with an elevated depression or anxiety screening scale or diagnostic interview during antepartum hospitalization of any duration and at any gestational age. TABULATION, INTEGRATION, AND RESULTS We identified 8,799 articles and reviewed 79, 39 of which were included in a systematic review and 18 in meta-analysis of the primary outcome. Two raters independently assessed quality of individual studies using a 14-question tool. A random effects meta-analysis model was used to estimate prevalence and 95% CI of depression or anxiety. Heterogeneity was examined with the I2 test, and funnel plots were used to assess publication bias. After meta-analysis, the estimated prevalence of depression was 34% (95% CI 27-41%) and of anxiety 29% (95% CI 16-43%). There was expected substantial clinical and methodologic heterogeneity between studies that persisted even after planned a priori subgroup analyses and meta-regression. Even so, the direction of effect was consistent across studies. No publication bias was found. CONCLUSION The current meta-analysis suggests that one in three women hospitalized during pregnancy for obstetric complications report clinical levels of depression or anxiety symptoms, twice the reported prevalence of antenatal depression or anxiety in the general obstetric population. SYSTEMATIC REVIEW REGISTRATION PROSPERO, CRD42020172111.
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Affiliation(s)
- Marika Toscano
- Division of Maternal-Fetal Medicine, Department of Obstetrics & Gynecology, the Edward G. Miner Library, Institute for Innovative Education, the Department of Public Health Sciences, the Department of Obstetrics & Gynecology, and the Department of Psychiatry, University of Rochester Medical Center, and the School of Medicine and Dentistry, University of Rochester, Rochester, New York
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Ertekin Pinar S, Daglar G, Duran Aksoy O. The effect of stress management training on perceived stress, anxiety and hopelessness levels of women with high-risk pregnancy. J OBSTET GYNAECOL 2021; 42:17-22. [PMID: 33892613 DOI: 10.1080/01443615.2020.1867970] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
The aim of this study was to investigate the effect of stress management training on the perceived stress, anxiety and hopelessness levels of women with high-risk pregnancy. The sample of this experimental study consisted of 206 high-risk pregnant women (intervention = 103; control = 103). Data were collected using a Personal Information Form, the Perceived Stress Scale, the Beck Hopelessness Scale and the State-Trait Anxiety Inventory. In the second follow-up after the training, there was a statistically significant difference amongst the Perceived Stress Scale, Beck Hopelessness Scale and State-Trait Anxiety Inventory mean scores in the intervention and control groups (p < .05). Perceived stress scores of the control group who did not receive training during discharge increased. The state and trait anxiety scores and hopelessness scores of the intervention group received training decreased compared with the control group.IMPACT STATEMENTWhat is already known on this subject? Mental problems such as anxiety and stress are more common in high-risk pregnancies compared with healthy pregnancies.What do the results of this study add? After the training 51.4% of women in the intervention group, 75.7% of women in the control group had stress. The state and trait anxiety and hopelessness scores of the intervention group having training decreased compared to the control group.What are the implications of these findings for clinical practice and/or further research? Health professionals should provide stress management training in high-risk pregnant women to reducing perceived stress, anxiety and hopelessness levels.
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Affiliation(s)
| | - Gulseren Daglar
- Faculty of Health Sciences, Cumhuriyet University, Sivas, Turkey
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Cheng B, Meng Y, Zhou Y, Li J, Zeng J, Tan X, Zhang K, Luo Y, Zhang Y. Cerebral Regional Homogeneity Alternation of Pregnant Women With Antenatal Depression During the Pandemic. Front Psychiatry 2021; 12:627871. [PMID: 33959047 PMCID: PMC8093433 DOI: 10.3389/fpsyt.2021.627871] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Accepted: 03/22/2021] [Indexed: 02/05/2023] Open
Abstract
Purpose: The COVID-19 epidemic has been a threat to the health of people all over the world. Various precautions during COVID-19 in China have kept a large number of people in isolation, and this has inconvenienced and placed enormous stress on pregnant women. Pregnant women are more likely to suffer from antenatal depression (ANDP) with social isolation or low social support. This research aims to investigate the neurobiological mechanisms underlying ANDP, which impedes early detection and intervention in this disorder. Methods: A total of 43 singleton pregnant women who experienced isolation were recruited, including 21 treatment-naïve ANDP patients and 22 healthy pregnant women (HPW). To explore the intrinsic cerebral activity alternations in ANDP using resting-state functional MRI (rsfMRI), we assessed the local regional homogeneity (ReHo) differences in two groups using the voxel-based whole-brain analysis. The correlation between the regional functional abnormalities and clinical variables in ANDP patients was also examined. Results: Compared with HPW, ANDP patients showed decreased ReHo in the left dorsolateral prefrontal cortex, right insular and the cluster coving the right ventral temporal cortex (VTC), amygdala (AMG), and hippocampus (HIP). The Edinburgh Postnatal Depression Scale (EPDS) scores of ANDP patients negatively correlated with the ReHo in the right VTC, AMG, and HIP. Conclusion: Elucidating the neurobiological features of ANDP patients during COVID-19 is crucial for evolving adequate methods for early diagnosis, precaution, and intervention in a future epidemic.
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Affiliation(s)
- Bochao Cheng
- Department of Radiology, West China Second University Hospital, Sichuan University, Chengdu, China
| | - Yajing Meng
- Department of Psychiatry, West China Hospital of Sichuan University, Chengdu, China
| | - Yushan Zhou
- Department of Nuclear Medicine, West China Hospital of Sichuan University, Chengdu, China
| | - Jinrong Li
- Key Laboratory of Birth Defects and Related Diseases of Women and Children, Ministry of Education, Sichuan University, Chengdu, China
| | - Jianguang Zeng
- School of Economics and Business Administration, Chongqing University, Chongqing, China
| | - Xi Tan
- Department of Gynecology and Obstetrics, West China Second University Hospital, Sichuan University, Chengdu, China
| | - Kaiyou Zhang
- Department of Clinical Laboratory, West China Second Hospital, Sichuan University, Chengdu, China
| | - Ya Luo
- Department of Psychiatry, West China Hospital of Sichuan University, Chengdu, China
| | - Yan Zhang
- Department of Gynecology and Obstetrics, Wuxi Maternal and Child Health Hospital, The Affiliated Hospital of Nanjing Medical University, Wuxi, China
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Machado MDSR, Bertagnolli TV, Veiga ECDA, Ferreira CJH, Duarte G, Machado JDSR, Carvalho R. Multiprofessional care promotes of quality of life in pregnant women with preeclampsia: a cross-sectional study. Clinics (Sao Paulo) 2020; 75:e1951. [PMID: 33146357 PMCID: PMC7561055 DOI: 10.6061/clinics/2020/e1951] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/20/2020] [Accepted: 07/14/2020] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVES To assess the quality of life of hospitalized pregnant women with preeclampsia (PE), and compare with a group of healthy pregnant women (HP). METHODS This was an observational cross-sectional study conducted among 58 pregnant women; 28 of them had preeclampsia and 30 were healthy. The WHOQOL-Bref questionnaire, which was divided into four aspects: physical, psychological, social, and environmental, was applied to each subject. RESULTS A statistically significant difference was observed regarding maternal age (PE 27.8±6.2 x HG 23.0±6.6, p<0.01) and gestational age (PE 224±28.1 x HG 253.8±43.7, p<0.01) in relation to the clinical and obstetric data. No significant difference was observed among groups in the physical (PE 57.7±18.9 x HG 65.7±16.6, p=0.19), psychological (PE 68.2±12.8 x HG 73.3±13.30, p=0.16), social (PE 72.0±15.8 x HG 71.7±18.7, p=0.78), or environmental (PE 61.1±11.9 x HG 59.3±15.9, p=0.88) aspects of the WHOQOL-Bref. CONCLUSION There was no difference in quality of life between the groups studied, a result possibly due to the fact that women with PE were hospitalized and received multiprofessional care.
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Affiliation(s)
- Michelle de Souza Rangel Machado
- Departamento de Ginecologia e Obstetricia, Faculdade de Medicina de Ribeirao Preto da Universidade de Sao Paulo (FMRP-USP), SP, BR
| | - Tawana Vicente Bertagnolli
- Departamento de Ginecologia e Obstetricia, Faculdade de Medicina de Ribeirao Preto da Universidade de Sao Paulo (FMRP-USP), SP, BR
| | - Eduardo Carvalho de Arruda Veiga
- Departamento de Ginecologia e Obstetricia, Faculdade de Medicina de Ribeirao Preto da Universidade de Sao Paulo (FMRP-USP), SP, BR
| | - Cristine Jorge Homsi Ferreira
- Departamento de Biomecanica, Medicina e Reabilitacao do Aparelho Locomotor da Faculdade de Medicina de Ribeirão Preto da Universidade de Sao Paulo (FMRP-USP), SP, BR
| | - Geraldo Duarte
- Departamento de Ginecologia e Obstetricia, Faculdade de Medicina de Ribeirao Preto da Universidade de Sao Paulo (FMRP-USP), SP, BR
| | | | - Ricardo Carvalho
- Departamento de Ginecologia e Obstetricia, Faculdade de Medicina de Ribeirao Preto da Universidade de Sao Paulo (FMRP-USP), SP, BR
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Sinaci S, Ozden Tokalioglu E, Ocal D, Atalay A, Yilmaz G, Keskin HL, Erdinc SO, Sahin D, Moraloglu Tekin O. Does having a high-risk pregnancy influence anxiety level during the COVID-19 pandemic? Eur J Obstet Gynecol Reprod Biol 2020; 255:190-196. [PMID: 33147531 PMCID: PMC7585497 DOI: 10.1016/j.ejogrb.2020.10.055] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2020] [Revised: 10/20/2020] [Accepted: 10/23/2020] [Indexed: 01/18/2023]
Abstract
Objective We aimed to analyze the changing level of anxiety during COVID-19 pandemic in pregnant women, with and without high-risk indicators separately, in a tertiary care center serving also for COVID-19 patients, in the capital of Turkey. Study design We designed a case-control and cross-sectional study using surveys. The Spielberger State-Trait Anxiety Scale questionnaire (STAI-T) and Beck Anxiety Inventory (BAI) which were validated in Turkish were given to outpatient women with high-risk pregnancies as study group and normal pregnancies as control group. A total of 446 women were recruited. Results There was a statistically significant difference between those with and without high-risk pregnancy in terms of Trait-State Anxiety scores with COVID-19 pandemic (p < 0.05). We found an increased prevalence of anxiety during COVID-19 pandemic in high-risk pregnant women comparing to pregnancies with no risk factors (p < 0.05). There was a statistically significant difference between the education level in high-risk pregnant women in terms of anxiety scores (p < 0.05), Beck Anxiety score was highest in high school graduates (42.75). While the level of Trait Anxiety was the highest with pandemic in those with high-risk pregnancy with threatened preterm labor and preterm ruptures of membranes (58.0), those with thrombophilia were the lowest (50.88). The State Anxiety level and Beck Anxiety Score of those with maternal systemic disease were the highest (53.32 and 45.53), while those with thrombophilia were the lowest (46.96 and 40.08). The scores of Trait Anxiety (56.38), State Anxiety (52.14), Beck Anxiety (43.94) were statistically higher during the pandemic in those hospitalized at least once (p < 0.05). Conclusion High-risk pregnant women require routine anxiety and depression screening and psychosocial support during the COVID-19 pandemic. High-risk pregnancy patients have comorbid conditions most of the time, hence they not only at more risk for getting infected, but also have higher anxiety scores because of the stress caused by COVID-19 pandemic.
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Affiliation(s)
- Selcan Sinaci
- Department of Obstetrics and Gynecology, Ministry of Health, Ankara City Hospital, Ankara, Turkey.
| | - Eda Ozden Tokalioglu
- Department of Obstetrics and Gynecology, Ministry of Health, Ankara City Hospital, Ankara, Turkey
| | - Doga Ocal
- Department of Obstetrics and Gynecology, Ministry of Health, Ankara City Hospital, Ankara, Turkey
| | - Aysegul Atalay
- Department of Obstetrics and Gynecology, Ministry of Health, Ankara City Hospital, Ankara, Turkey
| | - Gamze Yilmaz
- Department of Obstetrics and Gynecology, Ministry of Health, Ankara City Hospital, Ankara, Turkey
| | - Huseyin Levent Keskin
- Department of Obstetrics and Gynecology, Ministry of Health, Ankara City Hospital, Ankara, Turkey
| | - Seval Ozgu Erdinc
- Department of Obstetrics and Gynecology, Ministry of Health, Ankara City Hospital, Ankara, Turkey
| | - Dilek Sahin
- University of Health Sciences, Ankara City Hospital, Ankara, Turkey; Department of Obstetrics and Gynecology, Ministry of Health, Ankara City Hospital, Ankara, Turkey
| | - Ozlem Moraloglu Tekin
- University of Health Sciences, Ankara City Hospital, Ankara, Turkey; Department of Obstetrics and Gynecology, Ministry of Health, Ankara City Hospital, Ankara, Turkey
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Goetz M, Schiele C, Müller M, Matthies LM, Deutsch TM, Spano C, Graf J, Zipfel S, Bauer A, Brucker SY, Wallwiener M, Wallwiener S. Effects of a Brief Electronic Mindfulness-Based Intervention on Relieving Prenatal Depression and Anxiety in Hospitalized High-Risk Pregnant Women: Exploratory Pilot Study. J Med Internet Res 2020; 22:e17593. [PMID: 32780023 PMCID: PMC7448174 DOI: 10.2196/17593] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2019] [Revised: 06/03/2020] [Accepted: 06/15/2020] [Indexed: 02/06/2023] Open
Abstract
Background Peripartum depression and anxiety disorders are highly prevalent and are correlated with adverse maternal and neonatal outcomes. Antenatal care in Germany does not yet include structured screening and effective low-threshold treatment options for women facing peripartum depression and anxiety disorders. Mindfulness-based interventions (MBIs) are increasingly becoming a focus of interest for the management of such patients. Studies have shown a decrease in pregnancy-related stress and anxiety in expectant mothers following mindfulness programs. Objective The aim of this study was to explore the clinical effectiveness of a 1-week electronic course of mindfulness on prenatal depression and anxiety in hospitalized, high-risk pregnant women. We hypothesized that participating in a 1-week electronic MBI (eMBI) could alleviate symptoms of depression and anxiety during the hospital stay. Methods A prospective pilot study with an explorative study design was conducted from January to May 2019 in a sample of 68 women hospitalized due to high-risk pregnancies. After enrolling into the study, the participants were given access to an eMBI app on how to deal with stress, anxiety, and symptoms of depression. Psychometric parameters were assessed via electronic questionnaires comprising the Edinburgh Postnatal Depression Scale (EPDS), State-Trait Anxiety Inventory (STAI-S), and abridged version of the Pregnancy-Related Anxiety Questionnaire (PRAQ-R). Results We observed a high prevalence of peripartum depression and anxiety among hospitalized high-risk pregnant women: 39% (26/67) of the study participants in the first assessment and 41% (16/39) of the participants in the second assessment achieved EPDS scores above the cutoff value for minor/major depression. The number of participants with anxiety levels above the cutoff value (66% [45/68] of the participants in the first assessment and 67% [26/39] of the participants in the second assessment) was significantly more than that of the participants with anxiety levels below the cutoff value, as measured with the STAI-S. After completing the 1-week electronic course on mindfulness, the participants showed a significant reduction in the mean state anxiety levels (P<.03). Regarding pregnancy-related anxiety, participants who completed more than 50% of the 1-week course showed lower scores in PRAQ-R in the second assessment (P<.05). No significant changes in the EPDS scores were found after completing the intervention. Conclusions Peripartum anxiety and depression represent a relevant health issue in hospitalized pregnant patients. Short-term eMBIs could have the potential to reduce anxiety levels and pregnancy-related anxiety. However, we observed that compliance to eMBI seems to be related to lower symptoms of pregnancy-related stress among high-risk patients. eMBIs represent accessible mental health resources at reduced costs and can be adapted for hospitalized patients during pregnancy.
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Affiliation(s)
- Maren Goetz
- Department of Obstetrics and Gynecology, University of Heidelberg, Heidelberg, Germany.,Department of General Pediatrics, University Children's Hospital, Heidelberg, Germany
| | - Claudia Schiele
- Department of Obstetrics and Gynecology, University of Heidelberg, Heidelberg, Germany
| | - Mitho Müller
- Department of Psychology, Ludwig Maximilian University, Munich, Germany
| | - Lina M Matthies
- Department of Obstetrics and Gynecology, University of Heidelberg, Heidelberg, Germany
| | - Thomas M Deutsch
- Department of Obstetrics and Gynecology, University of Heidelberg, Heidelberg, Germany
| | - Claudio Spano
- Department of Psychology, Ludwig Maximilian University, Munich, Germany
| | - Johanna Graf
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital Tuebingen, Tuebingen, Germany
| | - Stephan Zipfel
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital Tuebingen, Tuebingen, Germany
| | - Armin Bauer
- Research Institute for Women's Health, Department of Women's Health, University Hospital Tuebingen, Tuebingen, Germany
| | - Sara Y Brucker
- Department of Women's Health, University Hospital Tuebingen, Tuebingen, Germany
| | - Markus Wallwiener
- Department of Obstetrics and Gynecology, University of Heidelberg, Heidelberg, Germany
| | - Stephanie Wallwiener
- Department of Obstetrics and Gynecology, University of Heidelberg, Heidelberg, Germany
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Risk for Depressive Symptoms among Hospitalized Women in High-Risk Pregnancy Units during the COVID-19 Pandemic. J Clin Med 2020; 9:jcm9082449. [PMID: 32751804 PMCID: PMC7464613 DOI: 10.3390/jcm9082449] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2020] [Revised: 07/16/2020] [Accepted: 07/29/2020] [Indexed: 02/07/2023] Open
Abstract
Objective: Higher rates of mental disorders, specifically depression, were found among affected people in previous epidemiological studies taken after disasters. The aim of the current study was to assess risk for depression among pregnant women hospitalized during the “coronavirus disease 2019” (COVID-19) pandemic, as compared to women hospitalized before the COVID-19 pandemic. Study design: A cross-sectional study was performed among women hospitalized in the high-risk pregnancy units of the Soroka University Medical Center (SUMC). All participating women completed the Edinburgh Postnatal Depression Scale (EPDS), and the results were compared between women hospitalized during the COVID-19 strict isolation period (19 March 2020 and 26 May 2020) and women hospitalized before the COVID-19 pandemic. Multivariable logistic regression models were constructed to control for potential confounders. Results: Women hospitalized during the COVID-19 strict isolation period (n = 84) had a comparable risk of having a high (>10) EPDS score as compared to women hospitalized before the COVID-19 pandemic (n = 279; 25.0% vs. 29.0%, p = 0.498). These results remained similar in the multivariable logistic regression model, while controlling for maternal age, ethnicity and known mood disorder (adjusted odds ratio (OR) 1.0, 95% CI 0.52–1.93, p = 0.985). Conclusion: Women hospitalized at the high-risk pregnancy unit during the COVID-19 strict isolation period were not at increased risk for depression, as compared to women hospitalized before the COVID-19 pandemic.
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Coglianese F, Beltrame Vriz G, Soriani N, Piras GN, Comoretto RI, Clemente L, Fasan J, Cristiano L, Schiavinato V, Adamo V, Marchesoni D, Gregori D. Effect of Online Health Information Seeking on Anxiety in Hospitalized Pregnant Women: Cohort Study. JMIR Med Inform 2020; 8:e16793. [PMID: 32374268 PMCID: PMC7240442 DOI: 10.2196/16793] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2019] [Revised: 02/16/2020] [Accepted: 02/20/2020] [Indexed: 11/13/2022] Open
Abstract
Background There are approximately 1,000,000 pregnant women at high risk for obstetric complications per year, more than half of whom require hospitalization. Objective The aim of this study was to determine the relation between online health information seeking and anxiety levels in a sample of hospitalized woman with pregnancy-related complications. Methods A sample of 105 pregnant women hospitalized in northern Italy, all with an obstetric complication diagnosis, completed different questionnaires: Use of Internet Health-information (UIH) questionnaire about use of the internet, EuroQOL 5 dimensions (EQ-5D) questionnaire on quality of life, State-Trait Anxiety Inventory (STAI) questionnaire measuring general anxiety levels, and a questionnaire about critical events occurring during hospitalization. Results Overall, 98/105 (93.3%) of the women used the internet at home to obtain nonspecific information about health in general and 95/105 (90.5%) of the women used the internet to specifically search for information related to their obstetric disease. Online health information-seeking behavior substantially decreased the self-reported anxiety levels (P=.008). Conclusions Web browsing for health information was associated with anxiety reduction, suggesting that the internet can be a useful instrument in supporting professional intervention to control and possibly reduce discomfort and anxiety for women during complicated pregnancies.
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Affiliation(s)
- Fabiana Coglianese
- Unit of Obstetrics and Gynecology, Maternal-Infant Department, Santa Maria degli Angeli Hospital, Pordenone, Italy
| | | | - Nicola Soriani
- Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padua, Padua, Italy
| | - Gianluca Niccolò Piras
- Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padua, Padua, Italy
| | - Rosanna Irene Comoretto
- Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padua, Padua, Italy
| | - Laura Clemente
- Unit of Obstetrics and Gynecology, Maternal-Infant Department, Santa Maria degli Angeli Hospital, Pordenone, Italy
| | - Jessica Fasan
- Unit of Obstetrics and Gynecology, Maternal-Infant Department, Santa Maria degli Angeli Hospital, Pordenone, Italy
| | - Lucia Cristiano
- Unit of Obstetrics and Gynecology, Maternal-Infant Department, Santa Maria degli Angeli Hospital, Pordenone, Italy
| | - Valentina Schiavinato
- Department of Philosophy, Sociology, Education and Applied Psychology, University of Padua, Padua, Italy
| | - Valter Adamo
- Unit of Obstetrics and Gynecology, Maternal-Infant Department, Santa Maria degli Angeli Hospital, Pordenone, Italy
| | - Diego Marchesoni
- Unit of Obstetrics and Gynecology, Maternal-Infant Department, Santa Maria della Misericordia Hospital, Udine, Italy
| | - Dario Gregori
- Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padua, Padua, Italy
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Rosman L, Salmoirago-Blotcher E, Cahill J, Sears SF. Psychosocial Adjustment and Quality of Life in Patients With Peripartum Cardiomyopathy. J Cardiovasc Nurs 2020; 34:20-28. [PMID: 30273257 DOI: 10.1097/jcn.0000000000000518] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
BACKGROUND Psychological distress can adversely affect heart failure prognosis, yet the immediate and ongoing challenges faced by women diagnosed with peripartum cardiomyopathy (PPCM) are not well studied. OBJECTIVE We examined psychological distress and quality of life in a large, national sample of patients with PPCM and evaluated whether these characteristics differ among newly diagnosed (0-1 year), short-term (2-4 years), and long-term (5-10 years) survivors. METHODS One hundred forty-nine patients with PPCM (mean age, 33.9 ± 5.0 years) recruited from a web-based registry completed questionnaires about generalized anxiety (Generalized Anxiety Disorder-7), cardiac anxiety (Cardiac Anxiety Questionnaire [CAQ]), health status (Medical Outcomes Study Short-Form 12 [SF-12] Health Survey), and PPCM-specific quality-of-life concerns. Group differences were evaluated using multivariate statistics with adjustments for disease severity and psychiatric history. RESULTS Generalized anxiety symptoms higher than the clinical cutoff were reported by 53% of patients with PPCM. Mean scores on the CAQ (1.9 ± 0.7) and CAQ subscale scores (cardiac-specific fear [2.1 ± 0.8], avoidance [1.7 ± 0.9], and heart-focused attention [1.6 ± 0.8]) were elevated in the overall sample. Psychological symptoms and quality-of-life concerns were generally similar across patients except for cardiac avoidance, which was significantly higher in newly diagnosed women after adjustments for disease severity (P = .05) and psychiatric history (P = .01). Peripartum cardiomyopathy-specific quality-of-life concerns were also prevalent; however, group differences were nonsignificant (P = .07). CONCLUSIONS Generalized anxiety, cardiac anxiety, and quality-of-life concerns are prevalent among patients with PPCM at all stages of recovery. Psychological issues may be an underrecognized aspect of women's recovery from PPCM.
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Affiliation(s)
- Lindsey Rosman
- Lindsey Rosman, PhD Research Fellow, Department of Internal Medicine, Yale School of Medicine, New Haven, Connecticut. Elena Salmoirago-Blotcher, MD, PhD Assistant Professor, Department of Medicine, Brown University Medical School & The Miriam Hospital, Providence, Rhode Island. John Cahill, MD Associate Professor, Department of Cardiovascular Sciences, East Carolina University, Greenville, North Carolina. Samuel F. Sears, PhD Professor, Departments of Cardiovascular Sciences and Psychology, East Carolina University, Greenville, North Carolina
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van den Heuvel JFM, Teunis CJ, Franx A, Crombag NMTH, Bekker MN. Home-based telemonitoring versus hospital admission in high risk pregnancies: a qualitative study on women's experiences. BMC Pregnancy Childbirth 2020; 20:77. [PMID: 32019499 PMCID: PMC7001237 DOI: 10.1186/s12884-020-2779-4] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2018] [Accepted: 01/29/2020] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Hospital admission during pregnancy complications is considered to be an event of significant impact. Besides conventional in-clinic maternal and fetal monitoring, recent technologies enable home-based telemonitoring with self-measurements in high risk pregnancy. This study is part of a feasibility pilot to explore the usability and acceptability of telemonitoring and aims to gain insight in the experiences and preferences of high risk pregnant women concerning the novel strategy of telemonitoring, opposed to women who were hospitalized in pregnancy. METHODS Using secured Facebook Groups, we conducted four online focus groups: two focus groups with women who were admitted during pregnancy (n = 11) and two with women who received home telemonitoring in the pilot phase (n = 11). The qualitative data were analyzed thematically. RESULTS Four major themes emerged from both participant groups: [1] care experience, [2] emotions regarding pregnancy, [3] privacy and [4] impact on daily life. Different views were reported on all four themes, resulting in a direct comparison of experiences during hospitalization and telemonitoring. Most admitted patients reported a growing sense of boredom and anxiety during their clinical admission. Lack of privacy on ward was a great concern, as it affected their contact with hospital staff and family. This issue was not reported amongst telemonitored women. These participants still felt like a patient at times but responded that the comfort of their own home and bed was pleasant. Only a minority of telemonitored participants reported being anxious at times at home, while not having a physician or nurse nearby. Being at home resulted in less travel time for partners or family for hospital visits, which had its positive effects on family life. CONCLUSIONS Telemonitoring of a high-risk pregnancy provides an innovative manner to monitor fetal and maternal condition from home. Compared to the experiences of hospital admission in high risk pregnancy, it allows women to be in a comforting and private environment during an anxious time in their lives. As future studies should further investigate the safety and cost effectiveness of this novel strategy, women's views on the preference of telemonitoring need to be taken into consideration.
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Affiliation(s)
- J F M van den Heuvel
- Department of Obstetrics, University Medical Center Utrecht, Utrecht University, Ref: KE 04.123.1 Heidelberglaan 100, 3584, CX, Utrecht, The Netherlands
| | - C J Teunis
- Department of Obstetrics, University Medical Center Utrecht, Utrecht University, Ref: KE 04.123.1 Heidelberglaan 100, 3584, CX, Utrecht, The Netherlands
| | - A Franx
- Department of Obstetrics, University Medical Center Utrecht, Utrecht University, Ref: KE 04.123.1 Heidelberglaan 100, 3584, CX, Utrecht, The Netherlands
| | - N M T H Crombag
- Department of Obstetrics, University Medical Center Utrecht, Utrecht University, Ref: KE 04.123.1 Heidelberglaan 100, 3584, CX, Utrecht, The Netherlands.,Department of Development and Regeneration, Leuven, KU, Belgium
| | - M N Bekker
- Department of Obstetrics, University Medical Center Utrecht, Utrecht University, Ref: KE 04.123.1 Heidelberglaan 100, 3584, CX, Utrecht, The Netherlands.
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Evcili F, Daglar G. How do personality characteristics of risky pregnant women affect their prenatal distress levels? JOURNAL OF HEALTH RESEARCH 2019. [DOI: 10.1108/jhr-07-2019-0143] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Purpose
The prenatal distress level of the pregnant woman is influenced by many variables. Personality characteristics are one of the most important of these variables. Knowing personality characteristics of pregnant women contributes to the personalization of care. The purpose of this paper is to identify the effect of personality characteristics of pregnant women at risk on the prenatal distress level.
Design/methodology/approach
A total of 438 women who were hospitalized based on a medical diagnosis associated with pregnancy were included in the study. The participants were administered the Personal Information Form, Cervantes Personality Scale and Revised Prenatal Distress Questionnaire. Data were evaluated using the SPSS 22.0 software program.
Findings
Of the pregnant women, 27.4 percent found their ability to cope with stress insufficient, and one-fifth of them found their social support insufficient. The pregnant women at risk with introverted, neurotic and inconsistent personality were found to have high levels of prenatal distress.
Research limitations/implications
This study was conducted on a group of Turkish pregnant women and cannot be generalized to other cultures. The data obtained from the research cannot be used to evaluate the psychological and physical disorders of the pregnant woman.
Practical implications
All health care professionals should evaluate women not only physically but also mentally and emotionally, beginning with the preconceptional period. They should determine the conditions that create distress and identify the personality characteristics that prevent from coping with stress. By using cognitive and behavioral techniques, pregnant women should be trained to gain skills on subjects such as risk perception and stress management, personality characteristics and coping, problem solving, psychological endurance and optimism. Caring initiatives should be personalized in line with personality characteristics of pregnant women. The care offered within this framework will contribute to the strengthening and development of the health of not only the women but also the family and society, and to the reduction of health care costs.
Social implications
Researchers have determined that pregnant women at risk with introverted, neurotic and inconsistent personality characteristics have higher distress levels. They have determined that these pregnant women find their ability to cope with stress more inadequate. It is vital to cope with stress during pregnancy due to its adverse effects on maternal/fetal/neonatal health.
Originality/value
The prenatal distress level of the pregnant woman is influenced by many demographic (age, marital status and socioeconomic level), social (marital dissatisfaction, and lack of social support), personal (self-esteem, neuroticism and negative life experiences) and pregnancy-related (experiencing risky pregnancy, and previous pregnancy experiences) variables. Personality characteristics are one of the most important of these variables. This research is original because there are limited number of studies examining the effect of personality characteristics on prenatal distress level in the literature. And knowing the relationship between personality characteristics and distress by health professionals enables individualization of care. The care offered within this framework will contribute to the strengthening and development of the health of not only the women, but also the family and society, and to the decrease of health care costs.
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Hanko C, Bittner A, Junge-Hoffmeister J, Mogwitz S, Nitzsche K, Weidner K. Course of mental health and mother-infant bonding in hospitalized women with threatened preterm birth. Arch Gynecol Obstet 2019; 301:119-128. [PMID: 31828434 DOI: 10.1007/s00404-019-05406-3] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2019] [Accepted: 12/02/2019] [Indexed: 10/25/2022]
Abstract
PURPOSE Pregnancy complications (PC) with signs of threatened preterm birth are often associated with lengthy hospital stays, which have been shown to be accompanied by anxiety, depressive symptoms, and increased stress level. It remains unclear, whether the perinatal course of mental health of these women differs from women without PC and whether there may be differences in the postpartum mother-infant bonding. METHODS In a naturalistic longitudinal study with two measurements (24-36th weeks of gestation and 6 weeks postpartum), we investigated depression (EPDS), anxiety (STAI-T), stress (PSS), and postpartum mother-infant bonding (PBQ) in women with threatened preterm birth (N = 75) and women without PC (N = 70). For data evaluation, we used means of frequency analysis, analysis of variance with repeated measurements, and t-tests for independent samples. RESULTS The patient group showed significantly higher rates of depression, anxiety, and stress during inpatient treatment in pregnancy, as well as 6 weeks postpartum compared to the control group. While depression and anxiety decreased over time in both groups, stress remained at the same level 6 weeks postpartum as in pregnancy. We found no significant differences in mother-infant bonding between the two groups at all considered PBQ scales. CONCLUSION It is recommended to pay attention to the psychological burden of all obstetric patients as a routine to capture a psychosomatic treatment indication. A general bonding problem in women with threatened preterm birth was not found. Nevertheless, increased maternal stress, anxiety, and depressiveness levels during pregnancy may have a negative impact on the development of the fetus.
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Affiliation(s)
- Cornelia Hanko
- Department of Psychotherapy and Psychosomatic Medicine, University Hospital Carl Gustav Carus, Technische Universitaet Dresden, Fetscherstraße 74, 01307, Dresden, Germany.
| | - Antje Bittner
- Department of Psychotherapy and Psychosomatic Medicine, University Hospital Carl Gustav Carus, Technische Universitaet Dresden, Fetscherstraße 74, 01307, Dresden, Germany
| | - Juliane Junge-Hoffmeister
- Department of Psychotherapy and Psychosomatic Medicine, University Hospital Carl Gustav Carus, Technische Universitaet Dresden, Fetscherstraße 74, 01307, Dresden, Germany
| | - Sabine Mogwitz
- Department of Psychotherapy and Psychosomatic Medicine, University Hospital Carl Gustav Carus, Technische Universitaet Dresden, Fetscherstraße 74, 01307, Dresden, Germany
| | - Katharina Nitzsche
- Department of Gynecology and Obstetrics, University Hospital Carl Gustav Carus, Technische Universitaet Dresden, Fetscherstraße 74, 01307, Dresden, Germany
| | - Kerstin Weidner
- Department of Psychotherapy and Psychosomatic Medicine, University Hospital Carl Gustav Carus, Technische Universitaet Dresden, Fetscherstraße 74, 01307, Dresden, Germany
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Nagle-Yang S, Phillips M, Albaugh A, Zhao L, Amin J, Ahmad E, Hatters Friedman S. Depression, anxiety, and attachment among women hospitalized on an antepartum unit. Int J Psychiatry Med 2019; 54:395-407. [PMID: 30924701 DOI: 10.1177/0091217419837071] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Objective To examine the prevalence of depression, anxiety, attachment issues, and associated factors among pregnant women hospitalized on an antepartum unit. Method Ninety-eight women hospitalized on an antepartum unit reported demographic and social information and were evaluated with screening tools for depression, anxiety, and maternal–fetal attachment. Data were analyzed using descriptive statistics and logistical regression analysis. Results Over one third (36%) of participants screened at risk for depression. Almost half (47%) reported elevated state anxiety and over one third (37%) reported elevated trait anxiety. Depression and anxiety were frequently comorbid. Positive screens for depression and anxiety were associated with decreased maternal-fetal attachment. Those who screened at risk for depression and anxiety in this sample often had a personal or family history of depression or anxiety or a history of intimate partner victimization. Substance use was common among those with elevated anxiety. Only a minority (15%) of at-risk participants had been referred to mental health treatment. Conclusions Women hospitalized on antepartum units had an elevated risk of depression and anxiety. Depression and anxiety were strongly comorbid in this population. Screening efforts to increase detection of perinatal depression and anxiety are recommended on obstetrical antepartum units.
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Affiliation(s)
- Sarah Nagle-Yang
- University Hospitals Cleveland Medical Center, Case Western Reserve University, Cleveland, OH, USA
| | - MacKenzie Phillips
- University Hospitals Cleveland Medical Center, Cleveland Regional Perinatal Network, Cleveland, OH, USA
| | - Avril Albaugh
- University Hospitals Cleveland Medical Center, Cleveland Regional Perinatal Network, Cleveland, OH, USA
| | - Lulu Zhao
- University Hospitals Cleveland Medical Center, Case Western Reserve University, Cleveland, OH, USA
| | - Jaina Amin
- University Hospitals Cleveland Medical Center, Case Western Reserve University, Cleveland, OH, USA
| | - Erum Ahmad
- University Hospitals Cleveland Medical Center, Case Western Reserve University, Cleveland, OH, USA
| | - Susan Hatters Friedman
- University Hospitals Cleveland Medical Center, Case Western Reserve University, Cleveland, OH, USA.,Department of Psychological Medicine, University of Auckland, Auckland, New Zealand
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State anxiety in pregnancies affected by obstetric complications: A systematic review. J Affect Disord 2019; 257:214-240. [PMID: 31301626 DOI: 10.1016/j.jad.2019.07.007] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2019] [Revised: 07/02/2019] [Accepted: 07/03/2019] [Indexed: 01/15/2023]
Abstract
BACKGROUND Maternal mental health status remains an important area of study due to its influence on maternal health outcomes. Past reviews on anxiety in pregnancy have included multiple mental health diagnoses and pre-existing conditions. A systematic review was performed to understand maternal state anxiety during pregnancies affected by obstetrical complications. METHODS A systematic search of electronic databases was performed including quantitative, primary studies in the English language. The population of interest was women whose pregnancies were affected by maternal and/or fetal obstetric (not pre-existing) complications with state anxiety as the outcome. Twenty-six studies met the inclusion and methodological criteria and were included in the review. RESULTS The review revealed that 20% to 100% of women experiencing pregnancies affected by obstetric complications had high levels of state anxiety, and these rates are negatively influenced by complication type and severity, demographic characteristics, and maternal perceptions and expectations. Overall, antenatal state anxiety was shown to improve over the course of the pregnancy, though levels remained above clinical thresholds. LIMITATIONS This review was based only on English peer-reviewed articles, many of which used convenience sampling with homogenous samples, limiting generalizability. Additional limitations include how anxiety prevalence was aggregated due to differences in measurement across studies. CONCLUSIONS Anxiety is prevalent among women experiencing pregnancies affected by obstetric complications. Based on this review, we recommend that all women treated for obstetric complications are screened for anxiety; facilitating detection, referral, and treatment, ultimately contributing to optimal maternal outcomes.
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Pulliainen H, Niela-Vilén H, Ekholm E, Ahlqvist-Björkroth S. Experiences of interactive ultrasound examination among women at risk of preterm birth: a qualitative study. BMC Pregnancy Childbirth 2019; 19:338. [PMID: 31533655 PMCID: PMC6751623 DOI: 10.1186/s12884-019-2493-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2018] [Accepted: 09/05/2019] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND Pregnant women who are at risk of preterm birth are often stressed, anxious and depressed because of worries and fears related to the health of the unborn baby, their own health and uncertainty about the future. Only a few studies have assessed the types of psychological support that would relieve these stress symptoms among women with high-risk pregnancies. The aim of this study was to describe 1) how women at risk of preterm birth experienced an interactive 3/4-dimensional (3/4D) ultrasound examination, and 2) their need for psychological support during the antenatal period. METHODS This qualitative study was conducted at one university hospital in Finland in 2017. Women with a singleton pregnancy of 26-32 gestational weeks (gwks) were included in the study. The interactive 3/4D ultrasound included a joint observation of the baby, based on the mother's wishes, with an obstetrician and psychologist. After the examination, the experiences were explored with a semi-structured interview. The data was analyzed using inductive thematic analysis. RESULTS The women enjoyed the fact that the staff were focused on her fetus and genuinely present during the session and also enabled the women to actively participate. Watching the baby and her/his activities made the baby more concrete and relieved their concerns. The need for additional psychological support varied individually. CONCLUSIONS Interactive ultrasound examination is an interesting way to awaken mental images, increase attachment, and reduce stress. The results imply that an interactive way of jointly looking at the fetus supports pregnant women at risk of preterm birth and may be useful in clinical practice.
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Affiliation(s)
| | | | - Eeva Ekholm
- Department of Obstetrics and Gynecology, Turku University Hospital and University of Turku, Turku, Finland
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Epidemiology of antenatal depression among women with high-risk pregnancies due to obstetric complications: a scoping review. Arch Gynecol Obstet 2019; 300:849-859. [DOI: 10.1007/s00404-019-05270-1] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2019] [Accepted: 08/06/2019] [Indexed: 02/07/2023]
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Walker T, Coursey C, Duffus ALJ. Low Dose of Abilify (Aripiprazole) in Combination With Effexor XR (Venlafaxine HCl) Resulted in Cessation of Lactation. CLINICAL LACTATION 2019. [DOI: 10.1891/2158-0782.10.2.56] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Postpartum depression (PPD) is a relatively common experience for women, especially those who have a history of preconception and/or prenatal depression. In some cases, pharmaceutical treatment is required to treat the symptoms of PPD. Unfortunately, the use of some of these treatments may have unintended consequences that affect both the newborn and the new mother. Here we report a case where Abilify (aripiprazole) at a low dose (2 mg/day) was prescribed in conjunction with Effexor XR (venlafaxine HCl) at a high dose (225 mg/day), which resulted in the cessation of lactation.
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Ertmann RK, Nicolaisdottir DR, Kragstrup J, Siersma V, Lutterodt MC, Bech P. Physical discomfort in early pregnancy and postpartum depressive symptoms. Nord J Psychiatry 2019; 73:200-206. [PMID: 30848973 DOI: 10.1080/08039488.2019.1579861] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
PURPOSE Pregnancy examinations conducted in general practice focus mainly on identifying high-risk pregnancies and pregnancy complications. The pregnancy health record has a biomedical focus, and consequently the woman's mental well-being may receive less attention. The aim of this study was to evaluate the extent to which early pregnancy-related symptoms should be considered as indicators of an increased risk of postpartum depression. MATERIALS AND METHODS For a prospective cohort of 1508 pregnant women, the presence of 11 pregnancy-related symptoms was recorded at the first prenatal care consultation together with background information about socio-demography and health. Depression was assessed 8 weeks postpartum with the major depression inventory (MDI) and depression was considered present if MDI > 20. Multivariable logistic regression was used to assess the association between pregnancy-related symptoms and postpartum depressive symptoms, and to adjust for potential confounders. RESULTS A high depression score (MDI score >20) 8 weeks postpartum was found among 6.6% of the women and showed apparent associations with physical discomfort in early pregnancy, such as back pain and pelvic cavity pain. Analysis of confounding revealed, however, that signs of vulnerable mental health, present in early pregnancy, explained most of these associations. CONCLUSIONS Indicators of an increased risk of postpartum depressive symptoms may be found in early pregnancy. Pregnancy-related pain in the first trimester may be a sign of psychological vulnerability or an aspect of an existing depressive state that calls for attention.
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Affiliation(s)
- Ruth K Ertmann
- a Research Unit for General Practice and Section for General Practice, Institute of Public Health , University of Copenhagen, Psychiatric Research Unit Mental Health Centre North Zealand, University of Copenhagen , Copenhagen , Denmark
| | - Dagny R Nicolaisdottir
- a Research Unit for General Practice and Section for General Practice, Institute of Public Health , University of Copenhagen, Psychiatric Research Unit Mental Health Centre North Zealand, University of Copenhagen , Copenhagen , Denmark
| | - Jakob Kragstrup
- a Research Unit for General Practice and Section for General Practice, Institute of Public Health , University of Copenhagen, Psychiatric Research Unit Mental Health Centre North Zealand, University of Copenhagen , Copenhagen , Denmark
| | - Volkert Siersma
- a Research Unit for General Practice and Section for General Practice, Institute of Public Health , University of Copenhagen, Psychiatric Research Unit Mental Health Centre North Zealand, University of Copenhagen , Copenhagen , Denmark
| | - Melissa C Lutterodt
- a Research Unit for General Practice and Section for General Practice, Institute of Public Health , University of Copenhagen, Psychiatric Research Unit Mental Health Centre North Zealand, University of Copenhagen , Copenhagen , Denmark
| | - Per Bech
- a Research Unit for General Practice and Section for General Practice, Institute of Public Health , University of Copenhagen, Psychiatric Research Unit Mental Health Centre North Zealand, University of Copenhagen , Copenhagen , Denmark
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Hermon N, Wainstock T, Sheiner E, Golan A, Walfisch A. Impact of maternal depression on perinatal outcomes in hospitalized women-a prospective study. Arch Womens Ment Health 2019; 22:85-91. [PMID: 29968130 DOI: 10.1007/s00737-018-0883-5] [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: 01/29/2018] [Accepted: 06/22/2018] [Indexed: 11/24/2022]
Abstract
Scarce data exists regarding the prevalence of antenatal depression in hospitalized pregnant women, and its effect on perinatal outcome. We aimed to estimate the risk of maternal depression among women hospitalized in a high-risk pregnancy department, and to evaluate its potential association with adverse perinatal outcome. A depression screening self-questionnaire-based prospective study was performed, in which hospitalized pregnant women who screened positive for depression were compared to those who screened negative. The Edinburgh Postnatal Depression Scale (EPDS) was used for antenatal depression screening. Pregnancy course and perinatal outcome were compared between the groups. A multivariate logistic regression model was constructed to control for clinically relevant confounders. During the study period, 279 women met the inclusion criteria. Among them, 28.3% (n = 79) screened positive for depression (≥ 10 points on the EPDS). In the univariate analysis, a significantly higher incidence of preterm delivery (< 37 weeks), low birthweight (< 2500 g), low Apgar scores (at 1 and 5 min), and neonatal intensive care unit (NICU) admissions were noted among the screen positive group. In the multivariate regression model, controlled for maternal age, ethnicity, gestational diabetes mellitus, preeclampsia, past preterm delivery, and gestational age upon admission, maternal antenatal depression during hospitalization was noted as an independent risk factor for preterm delivery (adjusted OR 3.32, 95%CI 1.16-9.52, p = 0.026). Maternal antenatal depression during hospitalization is very common and appears to play a significant and independent role in the prediction of preterm delivery.
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Affiliation(s)
- Narkis Hermon
- Joyce and Irving Goldman Medical School, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel.
| | - Tamar Wainstock
- The Department of Public Health, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Eyal Sheiner
- Department of Obstetrics and Gynecology, Soroka University Medical Center, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Agneta Golan
- Neonatal Intensive Care Unit, Soroka University Medical Center, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Asnat Walfisch
- Department of Obstetrics and Gynecology, Soroka University Medical Center, Ben-Gurion University of the Negev, Beer-Sheva, Israel
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Madsen C, Søgaard K, Zingenberg H, Jørgensen FS, Rosbach H, Hoseth E, Pedersen LH, Petersen OB. Outcomes of monoamniotic twin pregnancies managed primarily in outpatient care-a Danish multicenter study. Acta Obstet Gynecol Scand 2018; 98:479-486. [PMID: 30472726 DOI: 10.1111/aogs.13509] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2018] [Accepted: 11/20/2018] [Indexed: 11/29/2022]
Abstract
INTRODUCTION Monoamniotic twin pregnancies are high-risk pregnancies, and management by inpatient or frequent outpatient care is recommended. We report the outcomes of a national cohort of monoamniotic twin pregnancies managed primarily as outpatients. MATERIAL AND METHODS We prospectively analyzed the recorded data from the Danish Fetal Medicine Database, local databases, and medical records of all monoamniotic twin pregnancies diagnosed at the first trimester scan or later, and managed at the six major fetal medicine centers in Denmark over a 10-year period. RESULTS Sixty-one monoamniotic twin pregnancies were included. Thirteen pregnancies were terminated early. Of the remaining 48 pregnancies with a normal first trimester scan, there were 36 fetal losses (25 spontaneous miscarriages <22+0 weeks, 3 late terminations and 8 intrauterine deaths >22 weeks) and 60 liveborn children (62.5%), all of whom were delivered by cesarean delivery at a median gestational age of 33+0 weeks. Three children had minor malformations and there was 1 pregnancy with twin-to-twin transfusion syndrome. After 26+0 weeks, 78.8% were managed as outpatients. Intrauterine death occurred in 3.8% of outpatients and in 28.6% of inpatients (admitted due to complications). At weeks 32, 33 and 34, the prospective risk of intrauterine death was 6.9%, 4.2% and 5.9%, respectively. CONCLUSION In this nationwide, unselected population, only 62.5% of fetuses with a normal first trimester scan were born alive. In contrast, the mortality was 3.8% after 26 weeks among the 78.8% of the cohort that was managed as outpatients. More knowledge is still needed to predict which pregnancies are at the highest risk of intrauterine death.
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Affiliation(s)
- Caroline Madsen
- Department of Obstetrics and Gynecology, Aarhus University Hospital, Aarhus, Denmark
| | - Kirsten Søgaard
- Department of Obstetrics and Gynecology, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark
| | - Helle Zingenberg
- Department of Obstetrics and Gynecology, Copenhagen University Hospital Herlev, Herlev, Denmark
| | - Finn S Jørgensen
- Department of Obstetrics and Gynecology, Copenhagen University Hospital Hvidovre, Hvidovre, Denmark
| | - Hanne Rosbach
- Department of Obstetrics and Gynecology, Odense University Hospital, Odense, Denmark
| | - Eva Hoseth
- Department of Obstetrics and Gynecology, Aalborg University Hospital, Aalborg, Denmark
| | - Lars H Pedersen
- Department of Obstetrics and Gynecology, Aarhus University Hospital, Aarhus, Denmark.,Department of Clinical Medicine, Aarhus University, Aarhus, Denmark.,Department of Clinical Pharmacology, Aarhus University Hospital, Aarhus, Denmark
| | - Olav B Petersen
- Department of Obstetrics and Gynecology, Aarhus University Hospital, Aarhus, Denmark.,Department of Clinical Pharmacology, Aarhus University Hospital, Aarhus, Denmark.,Center for Fetal Diagnostics, Aarhus University/Aarhus University Hospital, Aarhus, Denmark
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Giménez Peñalba Y, Fatjó Hurios F, González Plaza E, Arranz Betegón Á. New care challenges: detection of anxiety in pregnant women at risk. ENFERMERIA CLINICA 2018; 29:248-253. [PMID: 30385105 DOI: 10.1016/j.enfcli.2018.09.002] [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: 09/26/2017] [Revised: 08/12/2018] [Accepted: 09/02/2018] [Indexed: 12/01/2022]
Abstract
Pregnancy is considered a period of well-being and happiness in a woman's life. However, these expectations are occasionally disrupted by maternal and/or foetal problems, and situations of vulnerability develop. The evidence suggests that pregnancy-related anxiety is strongly associated with adverse maternal and child outcomes such as pospartum depression, premature birth, low birth weight, and health and mental development problems in childhood. On the other hand, it is evident that obstetric and perinatal complications increase the risk of pospartum anxiety and depression while anxiety levels increase as the gestational risk increases. Current recommendations about the care and treatment of mental health problems in women during pregnancy and up to one year after delivery are aimed at recognition, evaluation, care and treatment, ensuring continuity of care. The aim of this study was to recognise anxiety in pregnant women at risk, from the definition of model cases, in order to enhance critical thinking in both health professionals and pregnant women and thus improve the care of these patients.
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Affiliation(s)
| | - Francesc Fatjó Hurios
- Medicina interna, SCIAS-Hospital de Barcelona, Universitat de Barcelona, Barcelona, España
| | | | - Ángela Arranz Betegón
- BCN Natal Hospital Clínic_Hospital Sant Joan de Déu, Universitat de Barcelona, Barcelona, España
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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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Montejano SR, Mauri JFC, Soriano MIB, Bixquert LG. Terapia de aceptación y compromiso (ACT) en un caso de inflexibilidad psicológica durante el embarazo. CLÍNICA CONTEMPORÁNEA 2018. [DOI: 10.5093/cc2018a13] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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Prevatt BS, Lowder EM, Desmarais SL. Peer-support intervention for postpartum depression: Participant satisfaction and program effectiveness. Midwifery 2018; 64:38-47. [PMID: 29908406 DOI: 10.1016/j.midw.2018.05.009] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2018] [Revised: 04/12/2018] [Accepted: 05/23/2018] [Indexed: 01/18/2023]
Abstract
OBJECTIVE Postpartum mood disorders represent a serious problem affecting 10-20% of women and support groups offer a promising intervention modality. The current study examined participant satisfaction with and effectiveness of a peer-facilitated postpartum support group. INTERVENTION The program consists of a free, peer-support group, developed to increase social support and destigmatise postpartum mood symptoms. The weekly group is co-facilitated by former group attendees and maternal health professionals. SETTING The peer-support program is offered in an urban city in the southeastern United States. DESIGN To address study aims, a community-based participatory research approach was implemented. Participant satisfaction was assessed via mixed methods analyses. Differences in depression scores at follow-up between program attendees and a community sample were examined via weighted linear regression analysis following propensity score analysis. Finally, within-group change in depression scores for program attendees was examined using a repeated measures ANOVA. PARTICIPANTS Intake program data were provided by the sponsoring organisation (n = 73) and follow-up data were collected via an online survey from program attendees (n = 45). A community sample was recruited to establish a comparison group (n = 152). MEASUREMENTS AND FINDINGS Participant satisfaction was high with overwhelmingly positive perceptions of the program. Postparticipation depression scores were similar to those of the community sample at follow-up (p = .447). Among attendees, pre-post analyses revealed reductions in depression symptoms with significant interactions for time × complications (p ≤ .001) and time × delivery method (p ≤ .017). KEY CONCLUSIONS Overall, findings indicate this peer-support program is not only acceptable to program attendees but also they provide a potential mechanism for improving mental health outcomes; however, further evaluation is needed. Findings also emphasise the importance of integrating evaluation procedures into community-based mental health programming to support effectiveness. IMPLICATIONS FOR PRACTICE Peer-support groups are an acceptable form of intervention for women experiencing postpartum depression.
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Affiliation(s)
- Betty-Shannon Prevatt
- Department of Psychology, North Carolina State University, Campus Box 7650, Raleigh, NC 27695-7650, United States.
| | - Evan M Lowder
- Department of Psychology, North Carolina State University, Campus Box 7650, Raleigh, NC 27695-7650, United States.
| | - Sarah L Desmarais
- Department of Psychology, North Carolina State University, Campus Box 7650, Raleigh, NC 27695-7650, United States.
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Vitorino LM, Chiaradia R, Low G, Cruz JP, Pargament KI, Lucchetti ALG, Lucchetti G. Association of spiritual/religious coping with depressive symptoms in high‐ and low‐risk pregnant women. J Clin Nurs 2017; 27:e635-e642. [DOI: 10.1111/jocn.14113] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/06/2017] [Indexed: 11/24/2022]
Affiliation(s)
- Luciano M Vitorino
- Faculty of Medicine Federal University of Juiz de Fora Juiz de Fora Brazil
| | | | - Gail Low
- Faculty of Nursing University of Alberta Edmonton AB Canada
| | - Jonas Preposi Cruz
- Nursing Department College of Applied Medical Sciences Shaqra University Al Dawadmi, Riyadh Saudi Arabia
- Graduate School Union Christian College San Fernando City La Union Philippines
| | - Kenneth I Pargament
- Department of Psychology Bowling Green State University Bowling Green OH USA
- Menninger Department of Psychiatry and Behavioral Sciences Baylor College of Medicine Bowling Green State University Bowling Green OH USA
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