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Balle SR, Nothelfer C, Mergl R, Quaatz SM, Hoffmann S, Hoffmann H, Allgaier AK, Eichhorn K. Depression after pregnancy loss: the role of the presence of living children, the type of loss, multiple losses, the relationship quality, and coping strategies. Eur J Psychotraumatol 2024; 15:2386827. [PMID: 39140607 PMCID: PMC11328791 DOI: 10.1080/20008066.2024.2386827] [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: 06/20/2023] [Revised: 05/15/2024] [Accepted: 05/28/2024] [Indexed: 08/15/2024] Open
Abstract
Background: Pregnancy loss (PL) is a common, yet rarely examined public health issue associated with an increased risk of impaired mental health, particularly depression.Objective: Previous research shows childlessness to be a correlate of depression after PL. First studies also indicate associations of the type of loss, multiple losses, relationship quality, and coping strategies with depression after the loss of a pregnancy. However, results are inconsistent and the few existing studies show methodological deficits. Therefore, we expect higher depression scores for women without living children, and we exploratively examine the associations between the type of loss, the number of losses, relationship quality, and coping strategies with depression scores for women who suffered a PL.Method: In an online setting, N = 172 women with miscarriage (n = 137) or stillbirth (n = 35) throughout the last 12 months completed the Patient Health Questionnaire (PHQ-D), Brief-COPE, and Partnerschaftsfragebogen (PFB), a German questionnaire measuring relationship quality.Results: In a multiple hierarchical regression analysis, stillbirth, β = 0.15, p = .035, presence of living children, β = -0.17, p = .022, and self-blame/emotional avoidance, β = 0.34, p < .001, are predictors of depression scores. However, there was no association between depression symptoms and other coping strategies, relationship quality, and multiple losses.Conclusions: Especially with regard to women who have no living children, have suffered a stillbirth, or are affected by self-blame/emotional avoidance, health care providers should monitor the presence of depressive symptoms. Our results indicate the need for specific instruments measuring coping style and relationship quality after PL, since the standard items of the PFB and the Brief-COPE seem inappropriate for this setting.
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Affiliation(s)
- Stefanie Rita Balle
- Institute of Psychology, University of the Bundeswehr Munich, Neubiberg, Germany
| | - Christine Nothelfer
- Institute of Psychology, University of the Bundeswehr Munich, Neubiberg, Germany
| | - Roland Mergl
- Institute of Psychology, University of the Bundeswehr Munich, Neubiberg, Germany
| | - Sarah Miriam Quaatz
- Institute of Psychology, University of the Bundeswehr Munich, Neubiberg, Germany
| | - Svenja Hoffmann
- Institute of Psychology, University of the Bundeswehr Munich, Neubiberg, Germany
| | - Helena Hoffmann
- Institute of Psychology, University of the Bundeswehr Munich, Neubiberg, Germany
| | | | - Kathryn Eichhorn
- Institute of Psychology, University of the Bundeswehr Munich, Neubiberg, Germany
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Mergl R, Quaatz SM, Lemke V, Allgaier AK. Prevalence of depression and depressive symptoms in women with previous miscarriages or stillbirths - A systematic review. J Psychiatr Res 2024; 169:84-96. [PMID: 38006823 DOI: 10.1016/j.jpsychires.2023.11.021] [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: 12/15/2022] [Revised: 08/16/2023] [Accepted: 11/15/2023] [Indexed: 11/27/2023]
Abstract
Women who have had miscarriages or stillbirths are known to have an elevated risk for depression. However, the prevalence of depressive disorders and/or symptoms in this group is unclear. Therefore, our aim was to estimate the corresponding prevalence of depression and depressive symptoms. A systematic literature search of the databases MEDLINE, psycINFO and PSYNDEX was conducted to consider all studies published between 2000 and 2022 in English or German on the prevalence of depression or depressive symptoms in women following miscarriages or stillbirths. Studies using valid psychiatric diagnoses or validated assessment methods regarding depression were included in the systematic review. The PRISMA guidelines were followed. Data concerning depressive symptoms were extracted from 14 studies. The range regarding prevalence of depressive symptoms in women with previous miscarriages or stillbirths was very wide (5%-91.2%). All longitudinal studies demonstrate a reduction of depressive symptoms over time. The prevalence of depressive disorders had a range of 5.4 (only for minor depression according to DSM-IV) - 18.6% (for depressive disorders according to ICD-10). The included studies are very heterogeneous considering the investigated groups, the length of pregnancies and time passed since the occurrence of miscarriages or stillbirths. Women with miscarriages or stillbirths have an elevated risk for depressive symptoms and disorders. In most affected women, depressive symptoms are most pronounced in the first months after the pregnancy loss and diminish over time.
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Affiliation(s)
- Roland Mergl
- Institute of Psychology, Universität der Bundeswehr München, Werner-Heisenberg-Weg 39, D-85577, Neubiberg, Germany.
| | - Sarah M Quaatz
- Institute of Psychology, Universität der Bundeswehr München, Werner-Heisenberg-Weg 39, D-85577, Neubiberg, Germany.
| | - Vanessa Lemke
- Institute of Psychology, Universität der Bundeswehr München, Werner-Heisenberg-Weg 39, D-85577, Neubiberg, Germany.
| | - Antje-Kathrin Allgaier
- Institute of Psychology, Universität der Bundeswehr München, Werner-Heisenberg-Weg 39, D-85577, Neubiberg, Germany.
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Andersen KN, Shittu F, Magama A, Ahmed T, Bakare D, Salako J, Burgess RA, King C. Perceptions of child death in Jigawa State, Nigeria: a mixed-methods study on how sociocultural nuances shape paediatric mortality reporting. Glob Health Action 2022; 15:2120251. [PMID: 36326015 PMCID: PMC9639556 DOI: 10.1080/16549716.2022.2120251] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2022] [Accepted: 08/26/2022] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND Vital statistics are critical for effective public health and monitoring progress towards child survival. Nigeria has the highest global under-five mortality rate; however, deaths are often under- or misreported. OBJECTIVE We explored perceptions of child deaths and socio-cultural factors influencing the reporting of child deaths in Jigawa State, Nigeria. METHODS We conducted a triangulation mixed-methods study in Kiyawa local government area, Jigawa, including: four focus group discussions (FGDs) with 8-12 women, six key informant interviews (KII) with Imams, and process data from 42 verbal autopsies (VAs) conducted with caregivers of deceased children. Data was collected between November 2019-April 2021. Purposive sampling was used to recruit FDG and KII participants and two-stage systematic and simple random sampling was employed to recruit VA participants. Qualitative data was analysed using content analysis; VA data was described with proportions. RESULTS Five categories emerged from FGDs: culturally grounded perceptions of child death, etiquette in mourning and offering condolence, formal procedures surrounding child death, the improving relationship between hospital and community, and reporting practices. Women expressed that talking or crying about a death was not culturally accepted, and that prayer is the most acceptable form of coping and offering condolence. Many women expressed that death was God's will. These findings correlated with VAs, in which visible signs of emotional distress were recorded in 31% of the interviews. Three categories emerged from KIIs: religion as part of formal procedures surrounding child death, communities support the bereaved, and multilayered reasons for unreported deaths. Imams serve a key role as community leaders, involved in both the logistical and religious aspects of their community, though they are not involved in mortality reporting. CONCLUSION Religion plays a central role in burial practices, community mourning rituals, and expression of grief, but does not extend to reporting of child deaths. Imams could provide an opportunity for improving vital registration.
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Affiliation(s)
| | - Funmilayo Shittu
- Department of Pediatrics, University of Ibadan, Ibadan, Nigeria and University College Hospital, Ibadan, Nigeria
| | | | | | - Damola Bakare
- Department of Pediatrics, University of Ibadan, Ibadan, Nigeria and University College Hospital, Ibadan, Nigeria
| | - Julius Salako
- Department of Pediatrics, University of Ibadan, Ibadan, Nigeria and University College Hospital, Ibadan, Nigeria
| | | | - Carina King
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
- Institute for Global Health, University College London, London, UK
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Christou A, Alam A, Hofiani SMS, Mubasher A, Rasooly MH, Rashidi MK, Raynes-Greenow C. 'I should have seen her face at least once': parent's and healthcare providers' experiences and practices of care after stillbirth in Kabul province, Afghanistan. J Perinatol 2021; 41:2182-2195. [PMID: 33408332 DOI: 10.1038/s41372-020-00907-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Revised: 11/15/2020] [Accepted: 12/01/2020] [Indexed: 02/05/2023]
Abstract
OBJECTIVE This study aimed to explore bereaved parents' and healthcare providers experiences of care after stillbirth. STUDY DESIGN Qualitative in-depth interviews with 55 women, men, female elders, healthcare providers and key informants in Kabul province, Afghanistan between October and November 2017. RESULTS Inadequate and insensitive communication and practices by healthcare providers, including avoiding or delaying disclosing the stillbirth were recurring concerns. There was a disconnect between parents' desires and healthcare provider's perceptions. The absence of shared decision-making on seeing and holding the baby and memory-making, manifested as profound regret. Health providers' reported hospitals were not equipped to separate women who had a stillbirth and acknowledged that psychological support would be beneficial. However, the absence of trained personnel and resource constraints prevented provision of such support. CONCLUSION Findings can inform future provision of perinatal bereavement care. Given resource constraints, communication training can be considered with longer term goals to develop context-appropriate bereavement care guidelines.
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Affiliation(s)
- Aliki Christou
- Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia.
| | - Ashraful Alam
- Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
| | | | | | - Mohammad Hafiz Rasooly
- Afghanistan National Public Health Institute, Ministry of Public Health, Kabul, Afghanistan
| | | | - Camille Raynes-Greenow
- Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
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Ogbonna I, Ikefuna A, Nkpozi M, Okoronkwo N, Bisi-Onyemaechi A, Chikani U. Prevalence and severity of depression among caregivers of HIV-infected children in Enugu, South-East Nigeria. NIGERIAN JOURNAL OF MEDICINE 2020. [DOI: 10.4103/njm.njm_145_20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Bakhtiyar K, Beiranvand R, Ardalan A, Changaee F, Almasian M, Badrizadeh A, Bastami F, Ebrahimzadeh F. An investigation of the effects of infertility on Women's quality of life: a case-control study. BMC Womens Health 2019; 19:114. [PMID: 31484531 PMCID: PMC6727411 DOI: 10.1186/s12905-019-0805-3] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2019] [Accepted: 07/29/2019] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND Human instinctively desire to have offspring. Infertility can cause painful emotional experiences throughout the life mainly known as quality of life impairment. This study aimed to investigate the impact of infertility on a woman's quality of life. METHODS A number of 180 infertile and 540 fertile women participated in this matched case-control study. The cases were selected through a combination of multistage stratified and cluster sampling methods. For each infertile woman three fertile women were randomly selected. The data gathering instrument consisted of demographic variables and the WHOQOL-BREF questionnaire. Data collection was conducted through interview with participants. The multivariate marginal model and SPSS software 21 were used for data analyses with a significance level of 0.05. RESULTS The results of the multivariate modeling show infertility can potentially affect various aspects of women's quality of life such as physical health (p < 0.001), mental health (p < 0.001), social health (p < 0.001) and the total score of quality of life (p < 0.001) significantly. CONCLUSION An infertile woman practice a relatively lower scores in QOL sub-scales of mental, physical and environmental health; while they experience a higher social health score than a fertile woman.
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Affiliation(s)
- Katayoun Bakhtiyar
- Department of Public Health, School of Health and Nutrition, Lorestan University of Medical Sciences, Khorramabad, Iran
| | - Ramin Beiranvand
- Department of Public Health, School of Health and Nutrition, Lorestan University of Medical Sciences, Khorramabad, Iran
| | - Arash Ardalan
- Public Health Center, 563 Hampshire Road, Apt 273, Westlake Village, CA, 91361, USA
| | - Farahnaz Changaee
- Department of midwifery, School of Nursing and midwifery, Lorestan University of Medical Sciences, Khorramabad, Iran
| | - Mohammad Almasian
- Department of the English Language, School of Medicine, Lorestan University of Medical Sciences, Khorramabad, Iran
| | - Afsaneh Badrizadeh
- Department of Psychology, Lorestan University of Medical Sciences, Khorramabad, Iran
| | - Fatemeh Bastami
- Health Education and Promotion, Department of Public Health, School of Health and Nutrition, Lorestan University of Medical Sciences, Khorramabad, Iran
| | - Farzad Ebrahimzadeh
- Department of Biostatistics and Epidemiology, School of Health and Nutrition, Lorestan University of Medical Sciences, Khorramabad, Iran.
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Ghodrati F, Akbarzadeh M. Jurisprudence Study of Muslim Rules and Effects of Ovarian Transplants in Women with Infertility; A Review. CURRENT WOMEN S HEALTH REVIEWS 2019. [DOI: 10.2174/1573404814666181015125406] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Background:
The use of assisted reproductive techniques, in addition to mental and
emotional stress in different stages, made some jurists, as fatwa authorities, to investigate and
evaluate the problems of this type of transplantation.
Objective:
The aim of this study was the jurisprudence investigation of the rules and effects of ovarian
transplants in women with infertility.
Methods:
This study was conducted through review and library studies using the keywords ovarian
transplants, infertility, jurists’ opinions and religious rules as to ovarian transplantation.
Results:
Permission for transplanting one’s own ovarian tissue was issued through the consent of
most scholars of Islamic schools and according to some verses, traditions, legal rules, and logical
reasons. Although some of the Ancient religious scholars have dissenting opinions about transplantation,
for some jurists, ovarian transplant from a woman to an infertile woman has no legal problem
and the infant belongs to the recipient. However, some other jurists oppose this fatwa. They
believe that there is a problem in the oocytes and ovarian transplantation due to mixed parentage
and the holy legislator does not agree with this transplantation. So, they had opposing fatwa in this
regard.
Conclusion:
According to the consensus of some Muslim jurists on ovarian transplant from one’s
own ovary or from another woman, there is a new hope for infertile couples to use this method
which is done from a woman to another woman.</P>
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Affiliation(s)
- Fatemeh Ghodrati
- Department of Theology, Faculty of Humanities Science College, Yasouj University, Yasouj, Iran
| | - Marzieh Akbarzadeh
- Department of Midwifery, Maternal-Fetal Medicine Research Center, School of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz, Iran
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Adebayo A, Liu M, Cheah W. Sociocultural Understanding of Miscarriages, Stillbirths, and Infant Loss: A Study of Nigerian Women. ACTA ACUST UNITED AC 2018. [DOI: 10.1080/17475759.2018.1557731] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- Adebanke Adebayo
- Department of Communication, George Mason University, Fairfax, VA, USA
| | - Min Liu
- Department of Applied Communication Studies, Southern Illinois University Edwardsville, Edwardsville, IL, USA
| | - Wai Cheah
- Department of Applied Communication Studies, Southern Illinois University Edwardsville, Edwardsville, IL, USA
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Shakespeare C, Merriel A, Bakhbakhi D, Baneszova R, Barnard K, Lynch M, Storey C, Blencowe H, Boyle F, Flenady V, Gold K, Horey D, Mills T, Siassakos D. Parents' and healthcare professionals' experiences of care after stillbirth in low- and middle-income countries: a systematic review and meta-summary. BJOG 2018; 126:12-21. [PMID: 30099831 DOI: 10.1111/1471-0528.15430] [Citation(s) in RCA: 42] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/29/2018] [Indexed: 11/29/2022]
Abstract
BACKGROUND Stillbirth has a profound impact on women, families, and healthcare workers. The burden is highest in low- and middle-income countries (LMICs). There is need for respectful and supportive care for women, partners, and families after bereavement. OBJECTIVE To perform a qualitative meta-summary of parents' and healthcare professionals' experiences of care after stillbirth in LMICs. SEARCH STRATEGY Search terms were formulated by identifying all synonyms, thesaurus terms, and variations for stillbirth. Databases searched were AMED, EMBASE, MEDLINE, PsychINFO, BNI, CINAHL. SELECTION CRITERIA Qualitative, quantitative, and mixed method studies that addressed parents' or healthcare professionals' experience of care after stillbirth in LMICs. DATA COLLECTION AND ANALYSIS Studies were screened, and data extracted in duplicate. Data were analysed using the Sandelowski meta-summary technique that calculates frequency and intensity effect sizes (FES/IES). MAIN RESULTS In all, 118 full texts were screened, and 34 studies from 17 countries were included. FES range was 15-68%. Most studies had IES 1.5-4.5. Women experience a broad range of manifestations of grief following stillbirth, which may not be recognised by healthcare workers or in their communities. Lack of recognition exacerbates negative experiences of stigmatisation, blame, devaluation, and loss of social status. Adequately developed health systems, with trained and supported staff, are best equipped to provide the support and information that women want after stillbirth. CONCLUSIONS Basic interventions could have an immediate impact on the experiences of women and their families after stillbirth. Examples include public education to reduce stigma, promoting the respectful maternity care agenda, and investigating stillbirth appropriately. TWEETABLE ABSTRACT Reducing stigma, promoting respectful care and investigating stillbirth have a positive impact after stillbirth for women and families in LMICs.
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Affiliation(s)
- C Shakespeare
- School of Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK.,Department of Women and Children's Health, The Chilterns, Southmead Hospital, Bristol, UK
| | - A Merriel
- School of Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK.,Department of Women and Children's Health, The Chilterns, Southmead Hospital, Bristol, UK
| | - D Bakhbakhi
- School of Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK.,Department of Women and Children's Health, The Chilterns, Southmead Hospital, Bristol, UK
| | - R Baneszova
- 2nd Department of Obstetrics and Gynaecology, Faculty of Medicine, University Hospital Bratislava, Comenius University, Bratislava, Slovakia
| | - K Barnard
- Library and Knowledge Service, Southmead Hospital, North Bristol NHS Trust, Bristol, UK
| | - M Lynch
- Department of Women and Children's Health, The Chilterns, Southmead Hospital, Bristol, UK
| | - C Storey
- International Stillbirth Alliance, Bristol, UK
| | - H Blencowe
- London School of Hygiene and Tropical Medicine, London, UK
| | - F Boyle
- Centre of Research Excellence in Stillbirth, Mater Research Institute, University of Queensland, South Brisbane, Qld, Australia
| | - V Flenady
- Centre of Research Excellence in Stillbirth, Mater Research Institute, University of Queensland, South Brisbane, Qld, Australia
| | - K Gold
- Department of Medicine, Department of Obstetrics and Gynecology, University of Michigan, Ann Arbor, MI, USA
| | - D Horey
- La Trobe University, Bundoora, Vic., Australia
| | - T Mills
- School of Nursing, Midwifery and Social Work, University of Manchester, Manchester, UK
| | - D Siassakos
- School of Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK.,Department of Women and Children's Health, The Chilterns, Southmead Hospital, Bristol, UK
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Mutiso SK, Murage A, Mukaindo AM. Prevalence of positive depression screen among post miscarriage women- A cross sectional study. BMC Psychiatry 2018; 18:32. [PMID: 29402255 PMCID: PMC5799918 DOI: 10.1186/s12888-018-1619-9] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2017] [Accepted: 01/25/2018] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Miscarriages are a common pregnancy complication affecting about 10-15% of pregnancies. Miscarriages may be associated with a myriad of psychiatric morbidity at various timelines after the event. Depression has been shown to affect about 10-20% of all women following a miscarriage. However, no data exists in the local setting informing on the prevalence of post-miscarriage depression. We set out to determine the prevalence of positive depression screen among women who have experienced a miscarriage at the Aga Khan University hospital, Nairobi. METHODS The study was cross-sectional in design. Patients who had a miscarriage were recruited at the post-miscarriage clinic review at the gynecology clinics at Aga Khan University Hospital, Nairobi. The Edinburgh postpartum depression scale was used to screen for depression in the patients. Prevalence was calculated from the percentage of patients achieving the cut -off score of 13 over the total number of patients. RESULTS A total of 182 patients were recruited for the study. The prevalence of positive depression screen was 34.1% since 62 of the 182 patients had a positive depression screen. Moreover, of the patients who had a positive depression screen, 21(33.1%) had thoughts of self-harm. CONCLUSION A positive depression screen is present in 34.1% of women in our population two weeks after a miscarriage. Thoughts of self-harm are present in about a third of these women (33.1%) hence pointing out the importance of screening these women using the EPDS after a miscarriage.
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Affiliation(s)
- Steve Kyende Mutiso
- Department of Obstetrics and Gynaecology, Aga Khan University hospital, Nairobi, Kenya.
| | - Alfred Murage
- 0000 0004 1756 6158grid.411192.eDepartment of Obstetrics and Gynaecology, Aga Khan University hospital, Nairobi, Kenya
| | - Abraham Mwaniki Mukaindo
- 0000 0004 1756 6158grid.411192.eDepartment of Obstetrics and Gynaecology, Aga Khan University hospital, Nairobi, Kenya
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Abdullahi ZG, Abdul MA, Aminu SM, Musa BOP, Amadu L, Jibril EBM. Antiphospholipid antibodies among pregnant women with recurrent fetal wastage in a tertiary hospital in Northern Nigeria. Ann Afr Med 2017; 15:133-7. [PMID: 27549418 PMCID: PMC5402808 DOI: 10.4103/1596-3519.188894] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Context: The association between antiphospholipid antibodies (APAs) and pregnancy loss has been established and now considered as a treatable cause of pregnancy loss. Data on the prevalence of APA in patients with recurrent pregnancy loss are scarce in our environment. Aims: To determine the prevalence of APA in pregnant women with and without recurrent fetal wastage. Settings and Design: Antenatal clinic of Ahmadu Bello University Teaching Hospital, Zaria, Nigeria. A cross-section analytical study. Subjects and Methods: Eighty-five antenatal patients with recurrent fetal loss (cases) and an equal number of antenatal patients without recurrent fetal loss (control) matched for age were studied. Their sociodemographic data obtained and blood samples analyzed for lupus anticoagulant (LA) using activated partial thromboplastin time, direct Russel's viper venom time, hexagonal phospholipids, and IgG anticardiolipin antibody (ACA) using enzyme-linked immunosorbent assay. Statistical Analysis Used: Data were analyzed with Statistical Package for Social Sciences (version 17) by univariate analysis and Chi-square test. Results: The age range of the patients was 18–42 years with a median of 30 years. The prevalence of APA was 14.1% and 4.7% among the cases and controls, respectively. The prevalence of LA was 7.1% and 1.2% among the cases and controls, respectively, whereas ACA was 8.2% and 3.5%, respectively. However, one of the cases was positive for both APA and ACA, giving a prevalence of 1.2%. Conclusions: The prevalence of APA among antenatal patients with recurrent pregnancy loss was, at least, 3 times higher than that of normal antenatal clients. APA should be included in the investigation protocol of women with recurrent fetal wastages in our setting.
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Affiliation(s)
- Zubaida Garba Abdullahi
- Department of Obstetrics and Gynecology, Ahmadu Bello University Teaching Hospital, Zaria, Nigeria
| | - Mohammmed A Abdul
- Department of Obstetrics and Gynecology, Ahmadu Bello University Teaching Hospital, Zaria, Nigeria
| | - Sirajo M Aminu
- Department of Hematology and Blood Transfusion, Ahmadu Bello University Teaching Hospital, Zaria, Nigeria
| | - Bolanle O P Musa
- Department of Medicine, Immunology Unit, Ahmadu Bello University Teaching Hospital, Zaria, Nigeria
| | - Lawal Amadu
- Department of Community Medicine, Ahmadu Bello University Teaching Hospital, Zaria, Nigeria
| | - El-Bashir M Jibril
- Department of Chemical Pathology, Ahmadu Bello University Teaching Hospital, Zaria, Nigeria
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Surkan PJ, Sakyi K, Strobino DM, Mehra S, Labrique A, Ali H, Ullah B, Wu L, Klemm R, Rashid M, West KP, Christian P. Depressive symptoms in mothers after perinatal and early infant loss in rural Bangladesh: a population-based study. Ann Epidemiol 2016; 26:467-473. [PMID: 27449568 PMCID: PMC4966902 DOI: 10.1016/j.annepidem.2016.06.001] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2015] [Revised: 05/27/2016] [Accepted: 06/01/2016] [Indexed: 11/30/2022]
Abstract
PURPOSE We examined stillbirth and neonatal death as predictors of depressive symptoms in women experiencing these events during the first 6 months postpartum. METHODS We performed secondary analyses using data from 41,348 married women aged 13-44 years, originally collected for the JiVitA-1 study (2001-2007) in northwest Bangladesh. Adjusted relative risk ratios were estimated to determine the associations between stillbirth and early infant death and women's risk of reported depressive symptoms (trichotomized 0, 1-2, 3-5) up to 6 months after the death. Adjusted risk ratios, comparing 0-2 versus 3-5 depressive symptoms, were used in stratified analyses. RESULTS Women having fetal/infant deaths had elevated risk of experiencing 1-2 postpartum depressive symptoms (adj RRRs between 1.2 and 1.7) and of experiencing 3-5 postpartum depressive symptoms (adj RRRs between 1.9 and 3.3), relative to women without a fetal/infant death. Notably, those whose infants died in the early postneonatal period had over a three-fold risk of 3-5 depressive symptoms (adj relative risk ratio [RRR] = 3.3; 95% confidence interval [CI], 2.6-4.3) compared to a two-fold risk for women experiencing a stillbirth (adj RRR = 1.9; 95% CI, 1.7-2.1). After early postneonatal deaths, women with higher levels of education were more likely to suffer 3-5 depressive symptoms (adj relative risk [RR] = 10.6; 95% CI, 5.2-21.7, ≥10 years of education) compared to women with lower levels of education (adj RR = 2.0; 95% CI, 1.6-2.4, no education; adj RR = 2.2; 95% CI, 1.6-2.9, 1-9 years of education). CONCLUSIONS Women's mental health needs should be prioritized in low-resource settings, where these outcomes are relatively common and few mental health services are available.
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Affiliation(s)
- Pamela J Surkan
- Social and Behavioral Interventions Program, Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD; Center for Human Nutrition, Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD.
| | - Kwame Sakyi
- Social and Behavioral Interventions Program, Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
| | - Donna M Strobino
- Department of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
| | - Sucheta Mehra
- Center for Human Nutrition, Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
| | - Alain Labrique
- Center for Human Nutrition, Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
| | - Hasmot Ali
- The JiVitA Project, Johns Hopkins University in Bangladesh, Gaibandha, Bangladesh
| | - Barkat Ullah
- The JiVitA Project, Johns Hopkins University in Bangladesh, Gaibandha, Bangladesh
| | - Lee Wu
- Center for Human Nutrition, Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
| | - Rolf Klemm
- Center for Human Nutrition, Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
| | - Mahbubur Rashid
- Center for Human Nutrition, Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
| | - Keith P West
- Center for Human Nutrition, Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
| | - Parul Christian
- Center for Human Nutrition, Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
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13
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Mukherjee B, Bindhani B, Saha H, Sinha D, Ray MR. Platelet hyperactivity, neurobehavioral symptoms and depression among Indian women chronically exposed to low level of arsenic. Neurotoxicology 2014; 45:159-67. [PMID: 25451969 DOI: 10.1016/j.neuro.2014.10.011] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2014] [Revised: 10/21/2014] [Accepted: 10/21/2014] [Indexed: 10/24/2022]
Abstract
The prevalence of neurobehavioral symptoms (NBS) and depression has been investigated in premenopausal rural women of West Bengal, India enrolled from arsenic (As) endemic (groundwater As 11-50 μg/L; n = 342) and control areas (As level ≤ 10 μg/L; n = 312). The subjective symptoms questionnaire and Beck's 21-point depression inventory-II were used for the detection of NBS and depression, respectively. Platelet P-selectin expression was measured by flow cytometry, plasma neurotransmitter activity with high performance liquid chromatography and groundwater As level by atomic absorption spectroscopy. The As level in groundwater was 2.72 ± 1.18 μg/L in control and 28.3 ± 13.51 μg/L in endemic areas (p < 0.0001). Women residing in endemic areas demonstrated a higher prevalence of depressive symptoms (39.8 vs. 19.9%, p < 0.001) and anxiety (43.3 vs. 18.0% in control, p < 0.001), fatigue (68.4 vs. 23.4%, p < 0.0001), reduced sense of taste (15.8 vs. 4.5%, p<0.0001) and smell (14.9 vs. 5.8%, p < 0.001); burning sensation (36.8 vs. 5.4%, p < 0.0001) and tingling or numbness in the extremities (25.1 vs. 5.1%, p < 0.0001); and transient loss of memory (69.9 vs. 28.2%, p < 0.001). As-exposed women had 1.6-times more plasma epinephrine and norepinephrine (p < 0.05), 1.8-times higher level plasma serotonin with 28.9% lower intraplatelet serotonin (p < 0.05 for both), but their plasma dopamine level was not significantly different (p>0.05) from that of controls. Moreover, women from endemic areas had 2.3-times more P-selectin-expressing platelets in their circulation (p < 0.001). After controlling the potential confounders, chronic low level As (11-50 μg/L) exposure showed a positive association with the prevalence of neurobehavioral symptoms and depression among Indian women in their child-bearing age.
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Affiliation(s)
- Bidisha Mukherjee
- Department of Experimental Hematology Unit, Chittaranjan National Cancer Institute, Kolkata-700 026, India
| | - Banani Bindhani
- Department of Experimental Hematology Unit, Chittaranjan National Cancer Institute, Kolkata-700 026, India
| | - Hirak Saha
- Department of Experimental Hematology Unit, Chittaranjan National Cancer Institute, Kolkata-700 026, India
| | - Dona Sinha
- Department of Receptor Biology and Tumor Metastasis, Chittaranjan National Cancer Institute, Kolkata-700 026, India.
| | - Manas Ranjan Ray
- Department of Experimental Hematology Unit, Chittaranjan National Cancer Institute, Kolkata-700 026, India
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14
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Campbell-Jackson L, Horsch A. The Psychological Impact of Stillbirth on Women: A Systematic Review. ACTA ACUST UNITED AC 2014. [DOI: 10.2190/il.22.3.d] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
This systematic review explored the psychological impact of stillbirth (from 20 weeks gestation) on mothers. A search was conducted in the National Library for Health and Web of Science, Cochrane Review, and Google Scholar. A secondary search based on results from the preliminary search was undertaken. A systematic search identified 26 articles (8 qualitative, 18 quantitative studies), which met criteria and were reviewed according to guidelines. The findings revealed that stillbirth is a distressing experience that can result in high levels of psychological symptoms including anxiety, depression, distress, and negative well-being. Symptoms appear to be highest in the first few months post loss although there is evidence to suggest that for some, symptoms may persist up to 3 years. The long-lasting impact of stillbirth on women was echoed in the qualitative research. Risk factors for higher levels of anxious and depressive symptoms included higher parity at the time of loss and not being married. Social support in particular was identified to be beneficial for women post loss. Longitudinal studies utilizing designs which permit causality to be determined are required to explore the specific experience of stillbirth. Further exploration of risk and protective factors, cultural beliefs, and the impact on partner relationships is needed. Clinical implications of the findings are discussed in light of current guidance.
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15
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Sturrock C, Louw J. Meaning-making after neonatal death: narratives of Xhosa-speaking women in South Africa. DEATH STUDIES 2013; 37:569-588. [PMID: 24520928 DOI: 10.1080/07481187.2012.673534] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
The death of a neonate can be traumatic for mothers, resulting in profound grief which ruptures their sense of coherence and identity. A narrative approach was used to explore how six Xhosa-speaking women tell stories about the death of their baby to help them understand the significance of the loss. They struggled to establish a sense of their baby as a person to be mourned, to redefine their own identity, and to find reasons for the death. Their meaning-making was influenced by the baby's father, older women in their community, and the context of deprivation in which they live.
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Affiliation(s)
- Colleen Sturrock
- Department of Psychology, University of Cape Town, Cape Town, South Africa.
| | - Johann Louw
- Department of Psychology, University of Cape Town, Cape Town, South Africa
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16
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Effectiveness of psychological intervention for treating symptoms of anxiety and depression among pregnant women diagnosed with fetal malformation. Int J Gynaecol Obstet 2013; 121:123-6. [DOI: 10.1016/j.ijgo.2012.12.013] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2012] [Revised: 12/10/2012] [Accepted: 01/25/2013] [Indexed: 01/25/2023]
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17
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Banerjee M, Siddique S, Dutta A, Mukherjee B, Ranjan Ray M. Cooking with biomass increases the risk of depression in pre-menopausal women in India. Soc Sci Med 2012; 75:565-72. [PMID: 22580071 DOI: 10.1016/j.socscimed.2012.03.021] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2011] [Revised: 12/22/2011] [Accepted: 03/01/2012] [Indexed: 10/28/2022]
Abstract
Cooking with biomass fuel, a common practice in rural India, is associated with a high level of indoor air pollution (IAP). The aim of this study was to investigate whether IAP from biomass burning increases the risk of depression. For this cross-sectional study, we enrolled a group of 952 women (median age 37 years) who cooked regularly with biomass and a control group of 804 age-matched women who cooked with cleaner fuel (liquefied petroleum gas). Depression was assessed using the second edition of Beck's depression inventory (BDI-II). Platelet P-selectin expression was assessed by flow cytometry and platelet serotonin was measured by ELISA. Particulate matter having diameter of less than 10 and 2.5 μm (PM(10) and PM(2.5), respectively) in indoor air was measured by real-time aerosol monitor. Carbon monoxide (CO) in exhaled breath was measured by CO monitor. Compared with the control group, women who cooked with biomass had a higher prevalence of depression and depleted platelet serotonin, suggesting altered serotonergic activity in the brain. In addition, P-selectin expression on platelet surface was up-regulated implying platelet hyperactivity and consequent risk of cardiovascular disease. Biomass-using households had increased levels of PM(10) and PM(2.5), and biomass users had elevated levels of CO in expired air. Controlling potential confounders, cooking with biomass was found to be an independent and strong risk factor for depression. IAP from cooking with biomass is a risk for depression among rural women in their child-bearing age.
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Affiliation(s)
- Madhuchhanda Banerjee
- Department of Experimental Hematology, Chittaranjan National Cancer Institute, 37 SP Mukherjee Road, Kolkata 700 026, West Bengal, India
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Sawyer A, Ayers S, Smith H, Sidibeh L, Nyan O, Dale J. Women's experiences of pregnancy, childbirth, and the postnatal period in The Gambia: A qualitative study. Br J Health Psychol 2011; 16:528-41. [DOI: 10.1348/135910710x528710] [Citation(s) in RCA: 73] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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