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Reeves N, Benarous X, Decaluwe B, Wendland J. Comparative analysis of general and pregnancy-related prenatal anxiety symptoms: progression throughout pregnancy and influence of maternal attachment. J Psychosom Obstet Gynaecol 2024; 45:2389811. [PMID: 39126231 DOI: 10.1080/0167482x.2024.2389811] [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: 03/21/2024] [Revised: 06/03/2024] [Accepted: 08/02/2024] [Indexed: 08/12/2024] Open
Abstract
Pregnancy-specific anxiety (PSA) has been differentiated from general anxiety (GA) to better account for the heterogeneity of prenatal anxiety and possible measurement bias. A longitudinal study was conducted to determine the evolution of maternal anxiety symptoms during pregnancy, distinguishing PSA and GA, and the influence of maternal attachment A sample of 155 women (mean age 32.5, SD 3.88) were enrolled in their first trimester of pregnancy (T1) in one center and follow throughout their pregnancy. The Relationship Scales Questionnaire (RSQ), the State-Trait Anxiety Inventory (STAI), and the Pregnancy-Related Anxiety Questionnaire (PRAQ) were completed at T1, and, for the last two, at the second (T2) and third trimesters of pregnancy (T3). Multi-level model found significant decreases in the PRAQ total score and the STAI total score between T1 and T3, but only the PRAQ total score decreased from T1 to T2. Preoccupied maternal attachment was independently associated with higher PRAQ and STAI total scores at T1, T2, and T3. Considering the progressive decline of the levels of PSA and GA during pregnancy, interventions should focus on pregnant mothers with risk factors for a persisting course of anxiety such as preoccupied attachment.
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Affiliation(s)
- Nicole Reeves
- Psychopathology and Health Processes Laboratory- LPPS, Université Paris Cité, Paris, France
- Research Centre University of Montréal, Montréal, Canada
| | - Xavier Benarous
- Department of Child and Adolescent Psychiatry, Armand-Trousseau Hospital (APHP), Sorbonne-Université, Paris, France
- INSERM Unit 1136 IPLESP, Research Team in Social Epidemiology (ERES), Paris, France
| | - Béatrice Decaluwe
- Population Health and Optimal Health Practices Research Branch, University Hospital Québec Research Centre, University Laval, Quebec City, Canada
| | - Jaqueline Wendland
- Psychopathology and Health Processes Laboratory- LPPS, Université Paris Cité, Paris, France
- Vivaldi Parent-Infant Mental Health Unit, Department of Child and Adolescent Psychiatry, Pitié-Salpêtrière Hospital, Paris, France
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2
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Çetindağ Karatlı SK, Uğurlu M, Keskin A, Dağcıoğlu BF, Karakaş Uğurlu G, Karatlı S. A Comprehensive and Longitudinal View of Pregnancy from the Perspective of the Couple, Maternal Mental Health and Fetal Growth. Matern Child Health J 2024; 28:1592-1603. [PMID: 38847991 DOI: 10.1007/s10995-024-03953-z] [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] [Accepted: 05/20/2024] [Indexed: 08/29/2024]
Abstract
OBJECTIVE This study investigates the impact of both maternal psychopathological factors and adaptive psychological changes within the couple on fetal growth, emphasizing the importance of evaluating pregnancy from the perspectives of the couple, the mother, and the fetus collectively. A "couple" in this context refers to heterosexual partners engaged in the pregnancy process together, whether married or in a stable relationship. METHODS We included 189 pregnant women in their first trimester, tracking maternal depression, anxiety, body appreciation, prenatal attachment, and the couple's adjustment level across each trimester. Fetal growth parameters measured include biparietal diameter, femur length, humerus length, abdomen circumference, head circumference, β-HCG, and amniotic fluid levels, with relationships between these variables being modeled accordingly. RESULTS Our findings indicate stable levels of maternal depression, anxiety, body appreciation, and couple's adjustment throughout the pregnancy, with a significant increase in prenatal attachment levels in each subsequent trimester. Prenatal attachment in the first trimester and maternal depression levels in the second and third trimesters were found to directly influence fetal growth, while other variables exhibited indirect effects. CONCLUSIONS Fetal growth is influenced by a myriad of biopsychosocial factors. Ensuring healthy pregnancy and fetal development necessitates close monitoring and support of the mother's adaptive psychological changes, early identification and treatment of potential psychopathologies, and maintenance of the psychosocial health of the couple.
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Affiliation(s)
| | - Mustafa Uğurlu
- Faculty of Medicine, Department of Psychiatry, Ankara Yıldırım Beyazıt University, Ankara, Turkey.
| | - Ahmet Keskin
- Faculty of Medicine, Department of Family Medicine, Ankara Yıldırım Beyazıt University, Ankara, Turkey
| | - Basri Furkan Dağcıoğlu
- Faculty of Medicine, Department of Family Medicine, Ankara Yıldırım Beyazıt University, Ankara, Turkey
| | - Görkem Karakaş Uğurlu
- Faculty of Medicine, Department of Psychiatry, Ankara Yıldırım Beyazıt University, Ankara, Turkey
| | - Salih Karatlı
- Karabük Training and Research Hospital, Internal Medicine, Karabük, Turkey
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3
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Ionio C, Ciuffo G, Landoni M, Smorti M, Della Vedova AM, Christiansen P, Fallon V, Silverio SA, Bramante A. The Italian language postpartum specific anxiety scale [PSAS-IT]: translation, psychometric evaluation, and validation. Front Psychiatry 2023; 14:1208613. [PMID: 37621969 PMCID: PMC10445131 DOI: 10.3389/fpsyt.2023.1208613] [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: 04/19/2023] [Accepted: 07/26/2023] [Indexed: 08/26/2023] Open
Abstract
Introduction While often positive, the lifecourse transition to motherhood is susceptible to the risk for developing mood disorders. Postpartum anxiety has often been overshadowed by other perinatal-specific mental health disorders, such as postpartum depression, and therefore has not been at the forefront or center of as much empirical study. This has meant there is a lack of effective and reliable tools with which to measure it, despite growing evidence suggesting its detrimental impact on mothers, their babies, wider family and social contacts, and on healthcare systems. This current study aimed to translate and validate the Postpartum Specific Anxiety Scale [PSAS] into the Italian language, and to validate the tool for its use in detecting anxiety specific to motherhood. Methods The study (N = 457) comprised 4 stages: English-Italian translation and back-translation to obtain the Italian version [PSAS-IT]; a preliminary pilot study to adapt the PSAS to the characteristics of the Italian population; measurement invariance; and internal reliability of subscales. Results The PSAS-IT demonstrates similar psychometric properties as the original English-language PSAS, with acceptable acceptability, construct and convergent validity, and internal consistency. Confirmatory factor analysis for multiple groups (Italy and United Kingdom) showed that the factor structure of the PSAS was valid for both groups [χ2 (2436) = 4679.481, p < 0.001, TLI = 0.969, CFI =0.972, RMSEA = 0.045, SRMR =0.064]. Discussion The resulting findings offer a reliable measure of postpartum anxiety in Italian language up to six months after birth.
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Affiliation(s)
- Chiara Ionio
- CRIdee, Dipartimento di Psicologia, Facoltà di Psicologia, Università Cattolica del Sacro Cuore, Milan, Italy
| | - Giulia Ciuffo
- CRIdee, Dipartimento di Psicologia, Facoltà di Psicologia, Università Cattolica del Sacro Cuore, Milan, Italy
| | - Marta Landoni
- CRIdee, Dipartimento di Psicologia, Facoltà di Psicologia, Università Cattolica del Sacro Cuore, Milan, Italy
| | - Martina Smorti
- Dipartimento di Patologia Chirurgica, Medica, Molecolare e dell'Area Critica, Università di Pisa, Pisa, Italy
| | - Anna Maria Della Vedova
- Dipartimento di Scienze Cliniche e Sperimentali, Facoltà di Medicina e Chirurgia, Università Degli Studi di Brescia, Brescia, Italy
| | - Paul Christiansen
- Department of Psychology, Institute of Population Health, Faculty of Health and Life Sciences, University of Liverpool, Liverpool, United Kingdom
| | - Victoria Fallon
- Department of Psychology, Institute of Population Health, Faculty of Health and Life Sciences, University of Liverpool, Liverpool, United Kingdom
| | - Sergio A. Silverio
- Department of Women & Children’s Health, School of Life Course & Population Sciences, Faculty of Life Sciences & Medicine, King’s College London, London, United Kingdom
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Mashayekh-Amiri S, Jafarabadi MA, Montazeri M, Fallon V, Silverio SA, Mirghafourvand M. Validation of the Iranian version of the Postpartum Specific Anxiety Scale 12-item research short-form for use during global crises (PSAS-IR-RSF-C). BMC Psychiatry 2023; 23:511. [PMID: 37452292 PMCID: PMC10347867 DOI: 10.1186/s12888-023-04998-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/20/2022] [Accepted: 07/04/2023] [Indexed: 07/18/2023] Open
Abstract
BACKGROUND Due to its high pervasiveness and adversarial consequences, postpartum anxiety has been one of the most worrying public health concerns in the last decade. According to previous research, the occurrence of mental disorders among women in the postpartum period upsurges significantly in the course of universal disasters. The Postpartum Specific Anxiety Scale - Research Short Form - for use in global Crises [PSAS-IR-RSF-C] has not been used in Iran for postpartum women during a health system shock. Consequently, this study was conducted to determine the validity and reliability of the Persian version (PSAS-IR-RSF-C) during the COVID-19 pandemic. METHODS This cross-sectional study was performed with 180 women who were between six weeks and six months after delivery, by random sampling method from December 2021 to June 2022. The validity of the PSAS-RSF-C in terms of face, content, was analyzed, and the construct validity was assessed using exploratory and confirmatory factor analyses. Internal consistency and test-retest reliability of the questionnaire were measured using (Cronbach's alpha, McDonald's ω) and intraclass correlation coefficient (ICC), respectively. RESULTS The content validity index and content validity ratio of the Persian version of the PSAS-IR-RSF-C were 0.96 and 0.98, respectively. A three-factor structure was extracted during the exploratory factor analysis process, and model validity was confirmed by the values of fit indices. Cronbach's alpha coefficient, McDonald's ω and intra-cluster correlation coefficient (95% confidence interval) were 0.74, 0.92 (0.78 to 0.93) and 0.97 (0.93 to 0.98), respectively. CONCLUSIONS For the specific assessment of postpartum anxiety among Iranian women during crises, the Persian version of the PSAS-IR-RSF-C is a valid and reliable tool.
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Affiliation(s)
- Sepideh Mashayekh-Amiri
- Students Research Committee, Midwifery Department, Faculty of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mohammad Asghari Jafarabadi
- Cabrini Research, Cabrini Health, Melbourne, VIC 3144 Australia
- School of Public Health and Preventative Medicine, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, VIC 3004 Australia
- Road Traffic Injury Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Maryam Montazeri
- Department of Psychology, Institute of Population Health, University of Liverpool, Liverpool, UK
| | - Victoria Fallon
- Department of Women and Children’s Health, School of Life Course and Population Sciences, King’s College London, London, UK
| | - Sergio A. Silverio
- Social Determinants of Health Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mojgan Mirghafourvand
- Menopause Andropause Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
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Moshki M, Esmailzadeh-Asali F, Rahmani-Bilandi R, Esmaily H, Dehnoalian A, Jafari A. The effect of prenatal education in two ways, face-to-face and virtual, on the fear of natural childbirth in pregnant women. ZEITSCHRIFT FUR GESUNDHEITSWISSENSCHAFTEN = JOURNAL OF PUBLIC HEALTH 2023:1-9. [PMID: 37361301 PMCID: PMC10088583 DOI: 10.1007/s10389-023-01866-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/26/2022] [Accepted: 02/23/2023] [Indexed: 06/28/2023]
Abstract
Aims This study was designed and implemented to compare the effect of prenatal education on the fear of natural birth in pregnant women. Subject and method This research was a semi-experimental study with a control group conducted on 96 pregnant women in Mashhad. People were randomly allocated to face-to-face and virtual groups. The Wijma childbirth experience/expectation questionnaire version A and the midwifery personal information form were used as pre-test and post-test tools. Results In the face-to-face and virtual groups, the average scores before and after the intervention were different, which indicated a decrease in fear of Natural childbirth in pregnant women, which was statistically significant. The changes in fear of natural childbirth score were significantly different between the three groups, and these changes were higher in the face-to-face group than in the other two groups. Conclusion Attendance in natural childbirth preparation classes in face-to-face and virtual training methods positively affects the fear of natural childbirth. Therefore, encouraging and supporting women to participate in training courses increase the women's desire for natural childbirth.
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Affiliation(s)
- Mahdi Moshki
- Department of Health Education and Health Promotion, School of Health, Social Determinants of Health Research Center, Gonabad University of Medical Sciences, Gonabad, Iran
| | - Farzaneh Esmailzadeh-Asali
- Department of Health Education and Health Promotion, Gonabad University of Medical Sciences, Gonabad, Iran
| | - Roghaieh Rahmani-Bilandi
- Department of Midwifery, Faculty of Medicine, Social Development and Health Promotion Research Center, Gonabad University of Medical Sciences, Gonabad, Iran
| | - Habibollah Esmaily
- Department of Biostatistics, School of Health, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Atefeh Dehnoalian
- Department of Nursing, Neyshabur University of Medical Sciences, Neyshabur, Iran
| | - Alireza Jafari
- Department of Health Education and Health Promotion, School of Health, Social Development and Health Promotion Research Center, Gonabad University of Medical Sciences, Gonabad, Iran
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Smorti M, Mauri G, Carducci A, Andreol A, Bonassi L. Prenatal Mental Representations in Italian First-Time Mothers Before and During the COVID-19 Pandemic: A Study with Interviews on Maternal Representations During Pregnancy. Matern Child Health J 2023; 27:711-718. [PMID: 36720772 PMCID: PMC9888744 DOI: 10.1007/s10995-022-03573-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Revised: 09/30/2022] [Accepted: 12/20/2022] [Indexed: 02/02/2023]
Abstract
INTRODUCTION Psychosocial risks increase the levels of not-integrated/ambivalent and restricted/disengaged representations during pregnancy, but no study has specifically analysed the impact of the COVID-19 pandemic on maternal representation styles. OBJECTIVES (1) to compare maternal representation styles in primiparous women who became pregnant before and during the COVID-19 pandemic and (2) to analyse the content of representation styles during the COVID-19 pandemic. METHODS A total of 37 Italian pregnant women were recruited from 2019 to 2021. The sample was divided into two groups: the pre-COVID-19 group (22 women, mean age = 33.14 years; SD = 3.78) and the COVID-19 group (15 women, mean age = 35.9 years; SD = 4.6). Interviews on maternal representations during pregnancy were administered and analysed for style and content. RESULTS Women during the COVID-19 pandemic reported more restricted/disengaged and less integrated/balanced representation styles than women pre-COVID-19. Content analysis showed that the COVID-19 pandemic led women to focus more on concrete aspects of pregnancy in lieu of emotional aspects, thus leading them to develop more restricted/disengaged representation styles. CONCLUSIONS FOR PRACTICE In future pandemics pregnant women should be supported in focusing their attention to emotions, sensations and fantasies about themselves as mothers and their children.
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Affiliation(s)
- Martina Smorti
- Department of Surgical, Medical and Molecular Pathology and Critical Care Medicine, University of Pisa, Via Savi 10, 56126, Pisa, Italy.
| | - Giulia Mauri
- Department of Surgical, Medical and Molecular Pathology and Critical Care Medicine, University of Pisa, Via Savi 10, 56126, Pisa, Italy
| | - Alessia Carducci
- Department of Surgical, Medical and Molecular Pathology and Critical Care Medicine, University of Pisa, Via Savi 10, 56126, Pisa, Italy
| | | | - Lucia Bonassi
- Department of Mental Health, ASST Bergamo-Est, Seriate, Italy
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7
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Val A, Míguez MC. Prevalence of Antenatal Anxiety in European Women: A Literature Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:1098. [PMID: 36673854 PMCID: PMC9858852 DOI: 10.3390/ijerph20021098] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Revised: 12/29/2022] [Accepted: 01/05/2023] [Indexed: 06/17/2023]
Abstract
The presence of anxiety during pregnancy is associated with adverse consequences for both mothers and their babies. The aim of this study was to review the prevalence of anxiety in European pregnant women in order to find out which countries have published the most studies in respect to the presence of anxiety during pregnancy, which countries are the most and least prevalent in terms of anxiety within pregnant women, and which are the most common tools used to assess anxiety during this stage. As such, a literature review was conducted regarding the studies that were published in the last twenty years in the PsycInfo, Medline, and SCOPUS databases. Thirty-eight studies were selected for the purposes of this review. The prevalence of anxiety in pregnancy and generalized anxiety disorder (GAD) varies considerably between studies. The European countries that have carried out the most research on this issue are Spain, Italy, and the United Kingdom. The most widely used assessment instrument is the State Trait Anxiety Inventory (STAI). The lowest prevalence rate of anxiety, using the STAI-E, was found in Poland, 7.7%, and the highest was found in Italy, 36.5%. The prevalence of GAD ranges from 0.3% to 10.8%. This indicates that anxiety in pregnant women is a very relevant mental health problem. It is therefore important to detect and intervene early in order to promote the well-being of both mothers and children.
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Affiliation(s)
| | - M. Carmen Míguez
- Department of Clinical Psychology and Psychobiology, Faculty of Psychology, University of Santiago de Compostela, Campus Vida, 15782 Santiago de Compostela, Spain
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van Gils Y, Bleijenbergh R, Brosens C, Van den Branden L, Rimaux S, Kuipers YJ. The validation of the brief COPE in a belgian perinatal population. Matern Child Health J 2022; 26:2050-2059. [PMID: 35934724 DOI: 10.1007/s10995-022-03476-5] [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: 12/13/2020] [Revised: 06/13/2022] [Accepted: 07/17/2022] [Indexed: 11/30/2022]
Abstract
INTRODUCTION The Brief Coping Orientation to Problems Experienced (Brief-COPE) measures individuals' coping strategies. There is limited evidence on the psychometric properties of this measure in a perinatal population. The aim of this study is to explore the psychometric properties of the Brief COPE in pregnant and postpartum women. METHODS The Dutch/Flemish version of the Brief-COPE was administrated in a sample of 754 antenatal (n = 432) and postpartum (n = 322) women living in Belgium. Exploratory factor analyses assessed the factor structure of the Brief-COPE and its convergent validity in an antenatal and postpartum sample. Cronbach's alpha was calculated for internal consistency reliability of the Brief-COPE items. RESULTS Exploratory factor analysis showed a five-factor antenatal model, presented by the subscales: (1) Active coping (α = 0.86), (2) Self-blame and Disengagement (α = 0.70), (3) Alcohol use (α = 0.96), (4) Humour (α = 0.79), and (5) Spirituality (α = 0.81). For the postpartum sample, a three-factor model emerged, presented by the subscales: (1) Active coping (α = 0.85), (2) Self-blame (α = 0.85) and (3) Spirituality (α = 0.74). CONCLUSIONS We observed differences and similarities in coping strategies between antenatal and postpartum women - information to be of merit for clinical practice and research. The Brief-COPE is a promising tool for the use of identifying women's coping strategies during pregnancy and the postpartum period, specifically for women in a similar cultural context as the women in this study, mainly in terms of antenatal alcohol use.
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Affiliation(s)
- Yannic van Gils
- Department of Health and Social Studies, School of Midwifery, AP University of Applied Sciences, Noorderplaats 2, 2000, Antwerpen, Belgium. .,Faculty of Medicine and Health Sciences, Antwerp University, Universiteitsplein 1, 2600, Wilrijk, Antwerp, Belgium.
| | - Roxanne Bleijenbergh
- Department of Health and Social Studies, School of Midwifery, AP University of Applied Sciences, Noorderplaats 2, 2000, Antwerpen, Belgium.,Faculty of Medicine and Health Sciences, Antwerp University, Universiteitsplein 1, 2600, Wilrijk, Antwerp, Belgium
| | - Charlotte Brosens
- Department of Health and Social Studies, School of Midwifery, AP University of Applied Sciences, Noorderplaats 2, 2000, Antwerpen, Belgium.,Faculty of Medicine and Health Sciences, Antwerp University, Universiteitsplein 1, 2600, Wilrijk, Antwerp, Belgium
| | - Laura Van den Branden
- Department of Health and Social Studies, School of Midwifery, AP University of Applied Sciences, Noorderplaats 2, 2000, Antwerpen, Belgium.,Faculty of Medicine and Health Sciences, Antwerp University, Universiteitsplein 1, 2600, Wilrijk, Antwerp, Belgium
| | - Sophie Rimaux
- Department of Health and Social Studies, School of Midwifery, AP University of Applied Sciences, Noorderplaats 2, 2000, Antwerpen, Belgium
| | - Yvonne J Kuipers
- Department of Health and Social Studies, School of Midwifery, AP University of Applied Sciences, Noorderplaats 2, 2000, Antwerpen, Belgium.,Faculty of Medicine and Health Sciences, Antwerp University, Universiteitsplein 1, 2600, Wilrijk, Antwerp, Belgium.,School of Health and Social Care, Edinburgh Napier University, Sighthill Campus, EH11 4BN, Edinburgh, Scotland
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Bilbul M, Caccese C, Horsley K, Gauvreau A, Gavanski I, Montreuil T, Konci R, Lai JK, Da Costa D, Zelkowitz P, Shen HC, Gryte KR, Larosa A, Brown RN, Suarthana E, Nguyen TV. Maternal anxiety, depression and vascular function during pregnancy. J Psychosom Res 2022; 154:110722. [PMID: 35114604 DOI: 10.1016/j.jpsychores.2022.110722] [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: 08/21/2020] [Revised: 01/07/2022] [Accepted: 01/08/2022] [Indexed: 11/28/2022]
Abstract
OBJECTIVE We aim to clarify whether type and timing of mental health symptoms in early pregnancy distinctly contribute to maternal-fetal vascular function, independent from the psychotropic medications given to treat these conditions. METHODS Data from a prospective cohort study (n = 1678) were used to test whether self-reported fears about giving birth and depressive symptoms prior to 16 weeks of gestation were associated with vascular outcomes predictive of hypertensive disorders of pregnancy (HDP) i.e., systolic and diastolic blood pressure (BP); uterine artery pulsatility index (UAPI); umbilical artery resistance index (UmbARI); and urine protein creatinine ratio. Multiple linear regressions models and mediation models were used to test for associations between predictors and outcomes, controlling for previously identified risk factors for vascular dysfunction such as maternal age and history of infertility. RESULTS Fears about giving birth in early pregnancy were inversely associated with UmbARI (β = -0.33, p = 0.03, df = 51) mid- to late-pregnancy (≥20 weeks). Depressive symptoms in early pregnancy were also inversely associated with maternal systolic BP (β = -0.13, p = 0.01, df = 387) and diastolic BP (β = -0.10, p = 0.04, df = 387) during the first trimester. CONCLUSIONS While fears about giving birth in early pregnancy were associated with lower vascular resistance in the fetal-placental unit, early depressive symptoms were associated with lower maternal vascular tone. At the very least, our results support the notion that early maternal psychological distress is unlikely to account for the development of HDP later during pregnancy and provide preliminary evidence to support distinct roles of pregnancy-related anxiety and depressive symptoms in maternal-fetal vascular function.
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Affiliation(s)
- Melanie Bilbul
- Department of Psychiatry, Icahn School of Medicine, New York, NY, USA; Department of Psychiatry, McGill University, Montreal, QC, Canada
| | | | - Kristin Horsley
- Department of Psychology, McGill University, Montreal, QC, Canada
| | - Alexandre Gauvreau
- Department of Obstetrics and Gynecology, McGill University, Montreal, QC, Canada
| | | | - Tina Montreuil
- Department of Psychiatry, McGill University, Montreal, QC, Canada; Department of Educational and Counselling Psychology, McGill University, Montreal, QC, Canada; Research Institute of the McGill University Health Centre, Montreal, QC, Canada
| | - Rea Konci
- Department of Medicine, McGill University, Montreal, QC, Canada
| | - Jonathan K Lai
- Department of Pathology, McGill University Health Centre, Montreal, QC, Canada
| | | | - Phyllis Zelkowitz
- Department of Psychiatry, McGill University, Montreal, QC, Canada; Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, QC, Canada
| | - Hao Cheng Shen
- Department of Medicine, Université de Montreal, Montreal, QC, Canada
| | | | - Amanda Larosa
- Integrated Program in Neuroscience, McGill University, Montreal, QC, Canada; Neuroscience Division, Douglas Mental Health University Institute, Montreal, QC, Canada
| | | | - Eva Suarthana
- Department of Obstetrics and Gynecology, McGill University, Montreal, QC, Canada
| | - Tuong-Vi Nguyen
- Reproductive Psychiatry Program, McGill University Health Centre, Departments of Psychiatry and Obstetrics and Gynecology, Montreal, QC, Canada.
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10
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Validation of the Postpartum Bonding Questionnaire: a cross-sectional study among Flemish mothers. Midwifery 2022; 107:103280. [DOI: 10.1016/j.midw.2022.103280] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2020] [Revised: 01/27/2022] [Accepted: 02/06/2022] [Indexed: 11/22/2022]
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11
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Vriend E, Leemhuis A, Flierman M, Schie P, Nollet F, Jeukens‐Visser M. Mental health monitoring in parents after very preterm birth. Acta Paediatr 2021; 110:2984-2993. [PMID: 34375472 PMCID: PMC9291782 DOI: 10.1111/apa.16064] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Revised: 07/09/2021] [Accepted: 08/06/2021] [Indexed: 11/28/2022]
Abstract
AIM To evaluate parental mental health monitoring during follow-up care for very preterm (VPT) infants, describe symptoms of anxiety and depression and risk factors for mothers and fathers at 1 and 12 months of corrected age. METHODS Parents completed the Hospital Anxiety and Depression Scale (HADS). Psychological symptoms and risk factors were analysed within and between mothers and fathers. RESULTS In 4 years, the monitoring reached 1260 (48%) families. Of these, 693 mothers and 340 fathers (300 couples) completed the HADS twice. At 1 month, 22% and 15% of the mothers and 10% and 9% of the fathers, respectively, reported elevated symptoms of anxiety and depression. At 12 months, these rates were significantly reduced to 14% and 9% for mothers and 5% and 4% for fathers respectively. Within couples, anxiety and depression were positively associated. At 12 months, in 20% of the couples, one or both parents reported elevated symptoms. Risk factors were length of hospital stay, migration background, educational level and employment status. CONCLUSION The mental health of parents of VPT infants improved, but elevated symptoms were still observed in 17% of included families after one year. Acknowledging and remediating parental mental health remain essential during follow-up care.
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Affiliation(s)
- Eline Vriend
- Department of Rehabilitation Medicine, Amsterdam Reproduction and Development Amsterdam UMC University of Amsterdam Amsterdam the Netherlands
| | - Aleid Leemhuis
- Department of Neonatology, Amsterdam Reproduction and Development Emma Children's Hospital Amsterdam UMC University of Amsterdam Amsterdam the Netherlands
| | - Monique Flierman
- Department of Rehabilitation Medicine, Amsterdam Reproduction and Development Amsterdam UMC University of Amsterdam Amsterdam the Netherlands
| | - Petra Schie
- Department of Rehabilitation Medicine, Amsterdam Reproduction and Development Amsterdam UMC University of Amsterdam Amsterdam the Netherlands
| | - Frans Nollet
- Department of Rehabilitation Medicine, Amsterdam Movement Sciences Amsterdam UMC University of Amsterdam Amsterdam the Netherlands
| | - Martine Jeukens‐Visser
- Department of Rehabilitation Medicine, Amsterdam Reproduction and Development Amsterdam UMC University of Amsterdam Amsterdam the Netherlands
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12
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Khakbazan Z, Poursharifi H, Farnam F, Hantoushzadeh S, Abdollahi P, Haghani S, Arjmandifar M. Mixed-methods study protocol for explanation of pregnant women's concerns about antenatal anomaly screening process: Designing, implementing and evaluation of intervention. Nurs Open 2021; 8:3655-3665. [PMID: 34328675 PMCID: PMC8510754 DOI: 10.1002/nop2.1012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2021] [Revised: 06/03/2021] [Accepted: 07/19/2021] [Indexed: 11/05/2022] Open
Abstract
AIM This study aims to investigate the concerns of Iranian pregnant women in the antenatal anomaly screening process (AASP) and propose an intervention to reduce these concerns. DESIGN This exploratory sequential mixed-methods study is conducted in three stages (qualitative, intervention design and quantitative), in Tehran. METHODS A qualitative study is carried out to collect pregnant women's concerns during the AASP. Then, a two-step procedure is implemented. In the first step (expert session), the concerns extracted in the qualitative part are prioritized. Next, the interventions used to reduce the concerns of pregnant women in the AASP are reviewed by considering the priority determined in the previous stage. The information obtained from this step is used to design intervention. Ultimately, a randomized controlled trial is used to evaluate the effectiveness of the intervention. DISCUSSION The results can be used for framing policies in health systems to address pregnant women's concerns in the AASP and to promote their mental health.
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Affiliation(s)
- Zohreh Khakbazan
- Department of Reproductive HealthSchool of Nursing and MidwiferyTehran University of Medical SciencesTehranIran
| | - Hamid Poursharifi
- Department of Clinical PsychologyUniversity of Social Welfare and Rehabilitation SciencesTehranIran
| | - Farnaz Farnam
- Department of Reproductive HealthSchool of Nursing and MidwiferyTehran University of Medical SciencesTehranIran
| | - Sedigheh Hantoushzadeh
- School of MedicineVali‐e‐Asr Research CenterTehran University of Medical SciencesTehranIran
| | - Parsa Abdollahi
- School of MedicineTehran Medical SciencesIslamic Azad UniversityTehranIran
| | - Shima Haghani
- Nursing care research centerSchool of Nursing and MidwiferyTehran University of Medical SciencesTehranIran
| | - Mitra Arjmandifar
- Department of Reproductive HealthSchool of Nursing and MidwiferyTehran University of Medical SciencesTehranIran
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13
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Hildingsson I, Nilsson J, Merio E, Larsson B. Anxiety and depressive symptoms in women with fear of birth: A longitudinal cohort study. Eur J Midwifery 2021; 5:32. [PMID: 34396062 PMCID: PMC8328228 DOI: 10.18332/ejm/138941] [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: 04/11/2021] [Revised: 05/28/2021] [Accepted: 06/14/2021] [Indexed: 11/24/2022] Open
Abstract
INTRODUCTION Anxiety and depression during pregnancy could imply difficulties in the attachment to the unborn baby. The objective of this study was to investigate the prevalence and change in anxiety and depressive symptoms in pregnant women with fear of birth. Another aim was to explore associations between symptoms of anxiety and depression on prenatal attachment. METHODS This is a longitudinal cohort study of 77 pregnant women with fear of birth in three hospitals in Sweden. Data were collected by three questionnaires in mid and late pregnancy and two months after birth. RESULTS Anxiety symptoms were more often reported than depressive symptoms, significantly decreasing over time in both conditions. Anxiety symptoms were associated with low education level, negative feelings towards the upcoming birth, and levels of fear of birth. Depressive symptoms were associated with levels of fear of birth. One in five women presented with fear of birth, anxiety, and depressive symptoms, suggesting that co-morbidity was quite common in this sample. Depressive symptoms and co-morbidity were negatively associated with prenatal attachment. CONCLUSIONS This study shows that symptoms of anxiety and depression in women with fear of birth vary over time and that co-morbidity is quite common. Lack of emotional well-being was related to prenatal attachment. Healthcare professionals must identify and support women with anxiety and depressive symptoms and fear of birth so that difficulties in the relationship between the mother and the newborn baby might be reduced.
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Affiliation(s)
- Ingegerd Hildingsson
- Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden.,Department of Nursing, Mid Sweden University, Sundsvall, Sweden
| | - Johanna Nilsson
- Department of Nursing, Mid Sweden University, Sundsvall, Sweden
| | - Elida Merio
- Department of Nursing, Mid Sweden University, Sundsvall, Sweden
| | - Birgitta Larsson
- Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden.,Department of Nursing, Mid Sweden University, Sundsvall, Sweden.,Department of Health Promoting Science, Sophiahemmet University College, Stockholm, Sweden
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14
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Michalik A, Wójcicka L, Zdun-Ryżewska A, Czerwińska-Osipiak A, Krzemiński M, Olszewska J, Klasa-Mazurkiewicz D, Huizink AC. Polish Adaptation of the Pregnancy-Related Anxiety Questionnaire-Revised 2 for All Pregnant Women. Healthcare (Basel) 2021; 9:917. [PMID: 34356295 PMCID: PMC8307515 DOI: 10.3390/healthcare9070917] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Revised: 07/14/2021] [Accepted: 07/16/2021] [Indexed: 11/16/2022] Open
Abstract
Pregnancy-related anxiety (PrA) is a specific type of anxiety characteristic of the perinatal period. PrA can affect pregnancy and birth. However, no validated tool exists to measure PrA in Polish obstetric practice. The aim of this study was to translate the Pregnancy-Related Anxiety Questionnaire-Revised 2 (PRAQ-R2) into Polish and to evaluate its reliability and factorial and construct validity. This study was conducted in Poland as an online questionnaire in April 2020 and included 175 healthy women. To validate the PRAQ-R2, we used standardized tools for the measurement of general anxiety: the modified Visual Analog Scale (VAS), the Ten-Item Personality Inventory (TIPI), and the Hospital Anxiety and Depression Scale (HADS). Scale reliability was assessed using Cronbach's alpha. Concurrent validity was evaluated by calculating Spearman's rho correlation coefficients. Statistical analyses were performed using R ver. 4.0.2. Values for comparative fit index >0.90, Tucker-Lewis index >0.90, and root mean square error of approximation <0.08 indicated acceptable model fit, confirming the reliability of the three-factor structure of the translation. The subscales and total scores had good consistency (α > 0.7), and convergent validity was demonstrated. The PRAQ-R2 as translated into Polish represents the first validated tool in Poland to measure PrA for all pregnant women.
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Affiliation(s)
- Anna Michalik
- Department of Obstetrical and Gynaecological Nursing, Medical University of Gdansk, 80-211 Gdansk, Poland; (A.M.); (L.W.); (A.C.-O.); (J.O.)
| | - Lucyna Wójcicka
- Department of Obstetrical and Gynaecological Nursing, Medical University of Gdansk, 80-211 Gdansk, Poland; (A.M.); (L.W.); (A.C.-O.); (J.O.)
| | - Agata Zdun-Ryżewska
- Department of Quality of Life Research, Medical University of Gdansk, 80-210 Gdansk, Poland;
| | - Agnieszka Czerwińska-Osipiak
- Department of Obstetrical and Gynaecological Nursing, Medical University of Gdansk, 80-211 Gdansk, Poland; (A.M.); (L.W.); (A.C.-O.); (J.O.)
| | - Michał Krzemiński
- Institute of Applied Mathematics, Faculty of Applied Physics and Mathematics, Gdansk University of Technology, 80-233 Gdansk, Poland;
| | - Jolanta Olszewska
- Department of Obstetrical and Gynaecological Nursing, Medical University of Gdansk, 80-211 Gdansk, Poland; (A.M.); (L.W.); (A.C.-O.); (J.O.)
| | - Dagmara Klasa-Mazurkiewicz
- Department of Gynaecology, Oncologic Gynaecology and Gynaecological Endocrinology, Medical University of Gdansk, 80-214 Gdansk, Poland;
| | - Anja C. Huizink
- Department of Clinical Developmental Psychology, Vrije Universiteit Amsterdam, Van der Boechorststraat 1, 1081 BT Amsterdam, The Netherlands
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15
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Silverio SA, Davies SM, Christiansen P, Aparicio-García ME, Bramante A, Chen P, Costas-Ramón N, de Weerth C, Della Vedova AM, Infante Gil L, Lustermans H, Wendland J, Xu J, Halford JCG, Harrold JA, Fallon V. A validation of the Postpartum Specific Anxiety Scale 12-item research short-form for use during global crises with five translations. BMC Pregnancy Childbirth 2021; 21:112. [PMID: 33557764 PMCID: PMC7868877 DOI: 10.1186/s12884-021-03597-9] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2020] [Accepted: 01/20/2021] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Global crises inevitably increase levels of anxiety in postpartum populations. Effective and efficient measurement is therefore essential. This study aimed to create a 12-item research short form of the 51-item Postpartum Specific Anxiety Scale [PSAS] and validate it for use in rapid response research at a time of global crises [PSAS-RSF-C]. We also present the same 12-items, in five other languages (Italian, French, Chinese, Spanish, Dutch) to increase global accessibility of a psychometric tool to assess maternal mental health. METHODS Twelve items from the PSAS were selected on the basis of a review of their factor loadings. An on-line sample of UK mothers (N = 710) of infants up to 12 weeks old completed the PSAS-RSF-C during COVID-19 'lockdown'. RESULTS Principal component analyses on a randomly split sample (n = 344) revealed four factors, identical in nature to the original PSAS, which in combination explained 75% of the total variance. Confirmatory factor analyses (n = 366) demonstrated the four-factor model fit the data well. Reliability of the overall scale and of the underlying factors in both samples proved excellent. CONCLUSIONS Findings suggest the PSAS-RSF-C may prove useful as a clinical screening tool and is the first postpartum-specific psychometric scale to be validated during the COVID-19 pandemic. This offers psychometrically sound assessment of postpartum anxiety. By increasing the accessibility of the PSAS, we aim to enable researchers the opportunity to measure maternal anxiety, rapidly, at times of global crisis.
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Affiliation(s)
- Sergio A Silverio
- Department of Women & Children's Health, School of Life Course Sciences, King's College London, London, UK.
- Department of Psychology, Institute of Population Health, University of Liverpool, Liverpool, UK.
- Elizabeth Garrett Anderson Institute for Women's Health, Faculty of Population Health Sciences, University College London, London, UK.
| | - Siân M Davies
- Department of Psychology, Institute of Population Health, University of Liverpool, Liverpool, UK
- School of Psychology, Faculty of Health, Liverpool John Moores University, Liverpool, UK
- Division of Psychology and Mental Health, School of Health Sciences, The University of Manchester, Manchester, UK
| | - Paul Christiansen
- Department of Psychology, Institute of Population Health, University of Liverpool, Liverpool, UK
| | - Marta E Aparicio-García
- Departamento de Psicología Social, Psicología del Trabajo y Psicología Diferencial, Facultad de Psicología, Universidad Complutense de Madrid, Madrid, Spain
| | | | - Ping Chen
- Collaborative Innovation Center of Assessment for Basic Education Quality, Beijing Normal University, Beijing, China
| | - Natalia Costas-Ramón
- Departamento de Psicología Social, Psicología del Trabajo y Psicología Diferencial, Facultad de Psicología, Universidad Complutense de Madrid, Madrid, Spain
| | - Carolina de Weerth
- Department of Cognitive Neuroscience, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Anna M Della Vedova
- Dipartimento di Scienze Cliniche e Sperimentali, Università degli Studi di Brescia, Brescia, Italy
| | - Lilliam Infante Gil
- Laboratoire Psychopathologie et Processus de Santé, Institut de Psychologie, Université de Paris, Paris, France
| | - Hellen Lustermans
- Department of Cognitive Neuroscience, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Jaqueline Wendland
- Laboratoire Psychopathologie et Processus de Santé, Institut de Psychologie, Université de Paris, Paris, France
| | - Jihong Xu
- National Research Institute for Family Planning, Beijing, China
| | - Jason C G Halford
- Department of Psychology, Institute of Population Health, University of Liverpool, Liverpool, UK
- School of Psychology, Faculty of Medicine and Health, University of Leeds, Leeds, UK
| | - Joanne A Harrold
- Department of Psychology, Institute of Population Health, University of Liverpool, Liverpool, UK
| | - Victoria Fallon
- Department of Psychology, Institute of Population Health, University of Liverpool, Liverpool, UK
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16
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Kim BK, Sung MH. [Influence of self-differentiation, psychological discomfort, and marital dyadic adjustment on maternal-fetal attachment in primigravida]. KOREAN JOURNAL OF WOMEN HEALTH NURSING 2020; 26:318-325. [PMID: 36312303 PMCID: PMC9328610 DOI: 10.4069/kjwhn.2020.11.12] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2020] [Revised: 11/12/2020] [Accepted: 11/12/2020] [Indexed: 11/30/2022] Open
Abstract
Purpose The purpose of this study was to identify the influence of self-differentiation, psychological discomfort, and marital dyadic adjustment on maternal-fetal attachment in primigravida. Methods In total, 108 primigravida participated in this descriptive correlational study. The participants answered self-report questionnaires. Data were collected from January to May, 2020, and were analyzed using descriptive statistics, the t-test, analysis of variance, Pearson correlation coefficients, and hierarchical multiple regression with SPSS for Windows ver. 23.0. Results The mean age of the primigravida was 31.66 years. The mean score for the degree of maternal-fetal attachment was 76.81 out of 96 points. Participants' scores for maternal-fetal attachment differed significantly based on age (t=2.08 p=.039) and marital status (t=2.05, p=.043). Maternal-fetal attachment was significantly negatively correlated with psychological discomfort (r=-.39, p<.001), and significantly positively correlated with self-differentiation (r=.36, p<.001) and marital dyadic adjustment (r=.36, p<.001). Self-differentiation explained 24.1% of variance in participants' maternal-fetal attachment, and its effect was statistically significant (F=7.79, p<.001). Conclusion In primigravida, more self-differentiation was associated with stronger maternal-fetal attachment. To strengthen maternal-fetal attachment in primigravida, educational program that increases the level of self-differentiation and minimizes their psychological discomfort may be helpful for first time pregnant women. Additionally, it is recommended to provide nursing interventions to encourage couples to work together throughout the gestational period.
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Affiliation(s)
| | - Mi-Hae Sung
- Corresponding author: Mi-Hae Sung Institute of Health Science and College of Nursing, Inje University, 75 Bokji-ro, Busanjin-gu, Busan 47392, Korea Tel: +82-51-890-6825 E-mail:
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17
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Anderson CM, Brunton RJ, Dryer R. Pregnancy‐related anxiety: Re‐examining its distinctiveness†. AUSTRALIAN PSYCHOLOGIST 2020. [DOI: 10.1111/ap.12365] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Affiliation(s)
- Carla M. Anderson
- School of Psychology, Charles Sturt University, Bathurst, New South Wales, Australia
| | - Robyn J. Brunton
- School of Psychology, Charles Sturt University, Bathurst, New South Wales, Australia
| | - Rachel Dryer
- School of Psychology, Charles Sturt University, Bathurst, New South Wales, Australia
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18
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Leach LS, Poyser C, Fairweather‐schmidt K. Maternal perinatal anxiety: A review of prevalence and correlates. CLIN PSYCHOL-UK 2020. [DOI: 10.1111/cp.12058] [Citation(s) in RCA: 104] [Impact Index Per Article: 26.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Affiliation(s)
- Liana S. Leach
- Centre for Research on Ageing, Health and Wellbeing, The Australian National University, Canberra, Australian Capital Territory, Australia,
| | - Carmel Poyser
- Centre for Research on Ageing, Health and Wellbeing, The Australian National University, Canberra, Australian Capital Territory, Australia,
| | - Kate Fairweather‐schmidt
- Centre for Research on Ageing, Health and Wellbeing, The Australian National University, Canberra, Australian Capital Territory, Australia,
- School of Psychology, Flinders University, Adelaide, South Australia, Australia,
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19
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Pregnancy-Related Anxiety, Perceived Parental Self-Efficacy and the Influence of Parity and Age. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17186709. [PMID: 32942604 PMCID: PMC7557851 DOI: 10.3390/ijerph17186709] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/10/2020] [Revised: 09/10/2020] [Accepted: 09/11/2020] [Indexed: 12/17/2022]
Abstract
Pregnancy-related anxiety is contextualised by pregnancy and is a health concern for the mother and child. Perceived parental self-efficacy is associated with this anxiety and age and parity are identified as influential factors. This research, therefore, predicted that negative perceptions of parental self-efficacy would predict greater pregnancy-related anxiety, moderated by parity and age. Participants (N = 771) were recruited online and assessed for perceived parental self-efficacy, pregnancy-related anxiety, and demographics. Moderation models showed that the psychosocial and sociodemographic factors combined predicted up to 49% of the variance. Parental self-efficacy predicted anxiety in the areas of body image, worry about themselves, baby concerns, pregnancy acceptance, attitudes towards medical staff and childbirth, and avoidance. Parity predicted pregnancy-related anxiety both overall and in childbirth concerns, worry about self, baby concerns and attitudes towards childbirth. Age predicted baby concerns. There was a significant moderation effect for pregnancy acceptance indicating that primiparous women with low perceptions of parental self-efficacy are less accepting of their pregnancy. Results suggest that parity and parental self-efficacy may be risk factors for first-time mothers for pregnancy-related anxiety.
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20
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Chan CY, Lee AM, Koh YW, Tang CSK. Validation of the Chinese version of the Pregnancy-related Anxiety Questionnaire-Revised (PRAQ-R) and its distinction from general anxiety and depression in pregnant women. J Psychosom Obstet Gynaecol 2020; 41:215-223. [PMID: 31290358 DOI: 10.1080/0167482x.2019.1639042] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
Abstract
Objective: This study aims to evaluate the reliability and validity of the translated Chinese-Cantonese version of the Pregnancy-Related Anxiety Questionnaire-Revised (PRAQ-R) in a sample of pregnant women in Hong Kong, China. It also aims to determine whether pregnancy-related anxiety changes significantly across trimesters and if it is differentiated from general anxiety and depression.Method: This study adopts a prospective longitudinal design with a quantitative approach. A consecutive sample of 186 Chinese pregnant women from hospitals in Hong Kong are assessed using the translated Chinese-Cantonese version of the PRAQ-R and other standardized instruments at three time points during the first to third trimester.Results: A confirmatory factor analysis revealed a three-factor structure of the Chinese-Cantonese version of the PRAQ-R, including fear of giving birth, fear of bearing a physically or mentally handicapped child, and concern about one's appearance. The internal consistency was excellent (α = 0.88 to 0.91) for all of the items in the PRAQ-R across the three trimesters. The average variance extract (AVE) and composite reliability (CR) for each factor were greater than the recommended level of CR > 0.70 and AVE > 0.50. Multiple regression analyses showed that a combination of general anxiety and depression explained a small proportion of the variance (10-29%) in the PRAQ-R subscales during the three trimesters.Conclusions: The Chinese-Cantonese version of the PRAQ-R has good validity and reliability, and the results provide evidence of its relevance for Chinese pregnant women with pregnancy-related anxiety in Hong Kong. The finding also shows that pregnancy-related anxiety is a relatively distinctive form of anxiety that is different from general anxiety and depression.
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Affiliation(s)
- Chui Yi Chan
- Department of Psychiatry, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong, China.,The Felizberta Lo Padilla Tong School of Social Sciences, Caritas Institute of Higher Education, Hong Kong, China
| | - Antoinette Marie Lee
- Department of Psychiatry, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong, China.,Department of Psychology, The University of Hong Kong, Hong Kong, China
| | - Yee Woen Koh
- Department of Psychiatry, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong, China.,Center for Family and Population Research, National University of Singapore, Singapore, Singapore
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21
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Asselmann E, Kunas SL, Wittchen HU, Martini J. Maternal personality, social support, and changes in depressive, anxiety, and stress symptoms during pregnancy and after delivery: A prospective-longitudinal study. PLoS One 2020; 15:e0237609. [PMID: 32833975 PMCID: PMC7446870 DOI: 10.1371/journal.pone.0237609] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2020] [Accepted: 07/29/2020] [Indexed: 11/19/2022] Open
Abstract
Background The role of maternal personality and perceived social support for peripartum changes in psychopathological symptoms remains unresolved. Methods In a regional-epidemiological sample of 306 women, depressive, anxiety, and stress symptoms were assessed three times during pregnancy and three times after delivery with the 21-item version of the Depression Anxiety Stress Scale. In pregnancy, the Big Five personality traits and perceived social support were assessed with the short version of the Big Five Inventory and the Social Support Questionnaire. Results Multilevel analyses revealed that depressive (b = -0.055) and stress (b = -0.047) symptoms decreased from early to late pregnancy. After delivery, anxiety symptoms were lower (two months postpartum: b = -0.193; four/ 16 months postpartum: b = -0.274), but stress symptoms were higher (two months postpartum: b = 0.468; four/ 16 months postpartum: b = 0.320) than during pregnancy. Across the peripartum period, more conscientious and more extraverted women experienced lower depressive and stress symptoms (b = -0.147 to -0.177), and more emotionally stable women experienced lower depressive, anxiety, and stress symptoms (b = -0.294 to -0.415). More emotionally stable women more strongly increased in anxiety during pregnancy (b = 0.019), and more extraverted women less strongly increased in depression after delivery (b = -0.010). Moreover, peripartum depressive, anxiety, and stress symptoms were lower in women with higher perceived social support (b = -0.225 to -0.308). Conclusions Less emotionally stable, less conscientious, and less extraverted women and women with lower perceived social support seem to be at increased risk for peripartum psychopathological symptoms and might thus particularly profit from targeted prevention.
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Affiliation(s)
- Eva Asselmann
- Department of Psychology, Faculty of Life Sciences, Humboldt-Universität zu Berlin, Berlin, Germany
- * E-mail:
| | - Stefanie L. Kunas
- Department of Psychiatry and Psychotherapy, Campus Charité Mitte, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - Hans-Ulrich Wittchen
- Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany
- Department of Psychiatry and Psychotherapy, Ludwig Maximilians Universität, Munich, Germany
| | - Julia Martini
- Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany
- Department of Psychiatry & Psychotherapy, Faculty of Medicine, Carl Gustav Carus University Hospital, Technische Universität Dresden, Dresden, Germany
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22
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Degrie L, Dierckx de Casterlé B, Gastmans C, Denier Y. 'Can you please hold my hand too, not only my breast?' The experiences of Muslim women from Turkish and Moroccan descent giving birth in maternity wards in Belgium. PLoS One 2020; 15:e0236008. [PMID: 32726359 PMCID: PMC7390407 DOI: 10.1371/journal.pone.0236008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2019] [Accepted: 06/26/2020] [Indexed: 11/30/2022] Open
Abstract
Objectives To reach nuanced understanding of the perinatal experiences of ethnic minority women from Turkish and Moroccan descent giving birth in maternity wards in Belgium thereby gaining insight into the underlying challenges of providing intercultural care for ethnic minority persons in a hospital setting. Methods A qualitative study design was used by conducting In-depth interviews with 24 women from Turkish and Moroccan descent who gave birth during the past three years in maternity wards in Flanders, Belgium. The interviews were analysed using a Grounded Theory Approach. Results This study shows that the women’s care experiences were shaped by the care interactions with their caregivers, more specifically on the attention that was given by the caregivers towards two essential dimensions of the care relationship, viz. Ereignis (attention to what happens) and Erlebnis (attention to how it happens). These two dimensions were interrelated in four different ways, which defined the women’s care experiences as being either ‘uncaring’, ‘protocolized’, ‘embraced’ or ‘ambiguous’. Moreover, these experiences were fundamentally embedded within the women’s cultural context, which has to be understood as a relational process in which an emotional and moral meaning was given to the women’s care expectations, interactions and interpretations of care. Conclusions The findings reveal that the quality of intercultural care depends on the nature and quality of care interactions between ethnic minority patients and caregivers much more than on the way in which cultural questions and tensions are being handled or dealt with in a practical way. As such, the importance of establishing a meaningful care relationship should be the priority when providing intercultural care. In this, a shift in perspective on ‘culture’ from being an ‘individual culture-in-isolation’ towards an understanding of culture as being inter-relational and emerging from within these care relationships is necessary.
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Affiliation(s)
- Liesbet Degrie
- Department of Public Health and Primary Care, Centre for Biomedical Ethics and Law, University of Leuven, Leuven, Belgium
| | - Bernadette Dierckx de Casterlé
- Department of Public Health and Primary Care, Academic Centre for Nursing and Midwifery, University of Leuven, Leuven, Belgium
| | - Chris Gastmans
- Department of Public Health and Primary Care, Centre for Biomedical Ethics and Law, University of Leuven, Leuven, Belgium
| | - Yvonne Denier
- Department of Public Health and Primary Care, Centre for Biomedical Ethics and Law, University of Leuven, Leuven, Belgium
- * E-mail:
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23
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Durgun Ozan Y, Alp Yilmaz F. Is there a relationship between basic birth beliefs and pregnancy-related anxiety in Turkey. J Obstet Gynaecol Res 2020; 46:2036-2042. [PMID: 32643257 DOI: 10.1111/jog.14375] [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: 12/29/2019] [Revised: 06/02/2020] [Accepted: 06/12/2020] [Indexed: 11/26/2022]
Abstract
AIM It is important to investigate the relationship between the beliefs about birth as a natural or medical process and the pregnancy-related anxiety that has a powerful impact on the negative outcomes of labor. This study was aimed at investigating the relationship between basic birth beliefs and pregnancy-related anxiety in Turkey. METHODS This descriptive, cross-sectional and correlational study was conducted in a University hospital located in eastern Turkey. The study sample included 473 primiparae having completed 14 weeks of pregnancy. The Birth Belief Scale and Pregnancy-Related Anxiety Questionnaire/PRAQ-R2 were used to collect the data. RESULTS A relationship was found between birth beliefs and pregnancy-related anxiety. Strong beliefs about birth as a medical process or weak beliefs about birth as a natural process were found to be related with fear of giving birth and worries about bearing a handicapped child. CONCLUSION A relationship was detected between beliefs of pregnant women about birth as a medical and natural process and fear of giving birth, worries about bearing a handicapped child., concern about own appearance. It is highly important to detect the birth beliefs in order to help women have a healthy pregnancy period and to decrease their anxiety levels. Pregnancy-related anxieties of women must be detected, and their birth beliefs that result in anxiety must not be overlooked during the provision of prenatal healthcare services.
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Affiliation(s)
- Yeter Durgun Ozan
- Nursing Department, Atatürk School of Health, Dıcle University, Dıyarbakır, Turkey
| | - Figen Alp Yilmaz
- Health Sciences Faculty, Yozgat Bozok University, Yozgat, Turkey
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Faccio F, Mascheroni E, Ionio C, Pravettoni G, Alessandro Peccatori F, Pisoni C, Cassani C, Zambelli S, Zilioli A, Nastasi G, Giuntini N, Bonassi L. Motherhood during or after breast cancer diagnosis: A qualitative study. Eur J Cancer Care (Engl) 2020; 29:e13214. [PMID: 31904906 DOI: 10.1111/ecc.13214] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2018] [Revised: 10/25/2019] [Accepted: 12/10/2019] [Indexed: 10/25/2022]
Abstract
OBJECTIVE Little is known about the process of becoming a mother in women who experienced a breast cancer diagnosis (BC). In this qualitative study, we investigated maternal representations in pregnant women with experience of BC and those with no oncological history. METHODS A total of 38 women were recruited, 19 women who experienced a BC diagnosis and 19 who had not. To explore maternal representations, semi-structured interviews were conducted and analysed through thematic analysis. RESULTS Four main themes were identified: fears and worries, meaning of motherhood, mother-foetus relationship and partner support. Across themes, differences between primiparous and multiparous are reported. Women with gestational breast cancer (GBC) described fear for their own and their child's survival. Women with previous BC recall contrasting emotions. All women with experience of BC perceived breastfeeding as fundamental and inability to do so provoked worry. Relationship with the partner was considered central, while healthy women were projected towards the future triadic relationship. CONCLUSIONS Finding a mental space during pregnancy for the representation of the future child could be hard for women with GBC. Dissimilarities in the experience of motherhood in cancer patients provide insight into psychological aspects that should be taken into account in clinical practice.
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Affiliation(s)
- Flavia Faccio
- Applied Research Division for Cognitive and Psychological Science, European Institute of Oncology IRCCS, Milan, Italy.,Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy
| | - Eleonora Mascheroni
- CRIdee, Department of Psychology, Catholic University of Milan, Milan, Italy
| | - Chiara Ionio
- CRIdee, Department of Psychology, Catholic University of Milan, Milan, Italy
| | - Gabriella Pravettoni
- Applied Research Division for Cognitive and Psychological Science, European Institute of Oncology IRCCS, Milan, Italy.,Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy
| | - Fedro Alessandro Peccatori
- Fertility and Procreation Unit, Gynecologic Oncology Division, European Institute of Oncology IRCCS, Milan, Italy
| | - Camilla Pisoni
- Neonatal Intensive Care Unit, IRCCS Foundation Policlinico San Matteo, Pavia, Italy
| | - Chiara Cassani
- Department of Obstetrics and Gynecology, IRCCS Foundation Policlinico San Matteo, Pavia, Italy
| | - Sara Zambelli
- Department of Mental Health, ASST Bergamo Est, Seriate, Italy
| | - Anna Zilioli
- Department of Mental Health, ASST Bergamo Est, Seriate, Italy
| | | | | | - Lucia Bonassi
- Department of Mental Health, ASST Bergamo Est, Seriate, Italy
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25
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Ranjbar F, Warmelink JC, Gharacheh M. Prenatal attachment in pregnancy following assisted reproductive technology: a literature review. J Reprod Infant Psychol 2019; 38:86-108. [PMID: 31852259 DOI: 10.1080/02646838.2019.1705261] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Objective: To summarise the literature on prenatal attachment in pregnancies following Assisted Reproductive Technology (ART).Background: Prenatal attachment can predict the quality of the postpartum parent-infant relationship and is linked to perinatal mental health of the parents and their adjustment to the parental role. It might be expected prenatal attachment will be influenced by fertility treatment such as ART, but there are contradictory results.Methods: In this review, studies with a cross-sectional and longitudinal design, published in 1990-2019 were included. A search was conducted in MEDLINE/PubMed, EMbase, Web of Science and Scopus, and using the Google Scholar search engine. A total of 17 articles were found which met the inclusion criteria and after these articles were reviewed using the STROBE-checklist, 15 articles were included in the study.Results: In most couples who conceived following ART, the level of prenatal attachment was either similar to or higher than in couples who conceive without ART.Conclusions: The findings challenge the idea that infertility problems affect attachment in pregnancies following ART. However, ART- couples may be more susceptible to anxiety due to pregnancy loss and support may be better focused on the pregnancy-related anxiety in these couples rather than any attachment intervention.
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Affiliation(s)
- Fahimeh Ranjbar
- Nursing Care Research Centre, Iran University of Medical Sciences, Tehran, Iran
| | - J Catja Warmelink
- Department of Midwifery Science, Amsterdam Public Health Research Institute, VU University Medical Center, Amsterdam, The Netherlands.,Department of General Practice & Elderly Medicine, University Medical Centre Groningen, University of Groningen, Groningen, The Netherlands.,AVAG (Amsterdam/Groningen Midwifery Academy), Groningen, The Netherlands
| | - Maryam Gharacheh
- Nursing Care Research Centre, Iran University of Medical Sciences, Tehran, Iran
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26
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Roman M, Bostan CM, Diaconu-Gherasim LR, Constantin T. Personality Traits and Postnatal Depression: The Mediated Role of Postnatal Anxiety and Moderated Role of Type of Birth. Front Psychol 2019; 10:1625. [PMID: 31354598 PMCID: PMC6639766 DOI: 10.3389/fpsyg.2019.01625] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2019] [Accepted: 06/27/2019] [Indexed: 11/13/2022] Open
Abstract
This study investigated how personality traits are related to postnatal depression 2 weeks after giving birth and whether these relations are mediated by postnatal anxiety, measured after 3–4 days after giving birth and moderated by the type of birth. New mothers (N = 672, Mage = 29.33) completed scales assessing their personality traits, postnatal anxiety, and postnatal depression 3 or 4 days after giving birth (T1). They also reported postnatal depression 2 weeks after giving birth (T2). Path analysis indicated that postnatal anxiety explained the link between personality traits (i.e., neuroticism) and postnatal depression 2 weeks after childbirth. The type of birth moderated the relation among, personality traits, postnatal anxiety and depression. Neuroticism and consciousness, in the natural birth’s group, and neuroticism and agreeableness, in the cesarean birth’s group, were associated with postnatal depression. Further, anxiety explained the relation between neuroticism and postnatal depression in both natural and cesarean birth groups. In addition, postnatal anxiety mediated the relation between extraversion and postnatal depression in the cesarean birth group. Our findings highlight that postnatal anxiety is a potential mechanism explaining how personality traits (i.e., neuroticism, extraversion) are related to postnatal depression, and that these relations may depend on the type of childbirth.
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Affiliation(s)
- Maria Roman
- Department of Psychology, Alexandru Ioan Cuza University, Iaşi, Romania
| | | | | | - Ticu Constantin
- Department of Psychology, Alexandru Ioan Cuza University, Iaşi, Romania
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27
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Matthey S, Souter K. Is pregnancy-specific anxiety more enduring than general anxiety using self-report measures? A short-term longitudinal study. J Reprod Infant Psychol 2019; 37:384-396. [PMID: 30806080 DOI: 10.1080/02646838.2019.1578869] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Objective: To investigate whether the rates of transient and enduring distress differ between general and pregnancy-specific anxiety in antenatal English-speaking women. Background: Evidence indicates that half of women with high levels of general anxiety during pregnancy will no longer be highly anxious after a few weeks, without having received treatment. Pregnancy-specific anxiety, however, may be more enduring, as many worries concerning the forthcoming birth, whether the baby will be healthy and the woman's ability to care for a newborn are likely to continue, or increase, during the pregnancy. Method: Women attending a public hospital antenatal clinic completed several mood questionnaires, including a mix of general anxiety and pregnancy-specific anxiety scales (T1). Between 2 and weeks later (T2), still during pregnancy, participants completed the same measures via a phone interview. Results: Between 76 and 243 women completed the different measures at both time points. For each measure the result was similar: about half of women scoring high at the first assessment (T1) continued to score high at T2 on both the general and pregnancy-specific anxiety measures, despite not receiving any specialist intervention. By contrast, over 90% of women initially scoring low on the various measures continued to score low at T2. Conclusion: Whether women are screened for pregnancy-specific or for general anxiety, around half scoring 'high' on the measure will no longer be in the anxious range a few weeks later. They thus have 'transient' anxiety. This transient/enduring finding was also confirmed for those with high levels of depressive symptomatology.
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Affiliation(s)
- Stephen Matthey
- a School of Psychology, University of Sydney , Sydney , Australia.,b School of Psychiatry, UNSW , Sydney , Australia.,c South West Sydney Local Health District , Sydney , Australia
| | - Kay Souter
- c South West Sydney Local Health District , Sydney , Australia
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28
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Brunton R, Dryer R, Saliba A, Kohlhoff J. Re-examining pregnancy-related anxiety: A replication study. Women Birth 2019; 32:e131-e137. [DOI: 10.1016/j.wombi.2018.04.013] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2018] [Revised: 04/05/2018] [Accepted: 04/16/2018] [Indexed: 10/17/2022]
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Novak Lauš K, Tadinac M, Herman R. Anxiety During Pregnancy and Postpartum: Course, Predictors and Comorbidity with Postpartum Depression. Acta Clin Croat 2019; 57:39-51. [PMID: 30256010 DOI: 10.20471/acc.2017.56.04.05] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Previous findings on peripartum anxiety are inconsistent in respect to the prevalence and course of peripartum anxiety with comorbidity of depression. Our aim was threefold: (1) to examine the course of elevated anxiety during pregnancy, immediately after childbirth, and six weeks postpartum; (2) to establish comorbidity of postpartum anxiety and postpartum depression (PPD); and (3) to examine predictors of anxiety 6 weeks postpartum. A sample of women (N=272) who were below the cut-off score for clinical depression during pregnancy were assessed in the third trimester of pregnancy, then 2 days and 6 weeks postpartum. Questionnaires on anxiety, pregnancy specific distress, stress, coping styles, social support, and depression were administered at each assessment. Obstetric data were collected from the participants' medical records. The estimated rate of high anxiety was 35% during pregnancy, 17% immediately after childbirth, and 20% six weeks postpartum, showing a decrease in anxiety levels after childbirth. Comorbidity of anxiety and PPD was 75%. Trait anxiety and early postpartum state anxiety are significant predictors of postpartum anxiety. Anxiety is a common peripartum psychological disturbance. Anxiety symptoms overlap with PPD, but not com-pletely, indicating that screening for postpartum mental difficulties should include both depression and anxiety.
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Affiliation(s)
| | - Meri Tadinac
- Department of Psychology, Faculty of Humanities and Social Sciences, University of Zagreb, Zagreb, Croatia
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30
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Nakić Radoš S, Tadinac M, Herman R. Anxiety During Pregnancy and Postpartum: Course, Predictors and Comorbidity with Postpartum Depression. Acta Clin Croat 2019. [PMID: 30256010 PMCID: PMC6400346 DOI: 10.20471/acc.2018.57.01.05] [Citation(s) in RCA: 86] [Impact Index Per Article: 17.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Previous findings on peripartum anxiety are inconsistent in respect to the prevalence and course of peripartum anxiety with comorbidity of depression. Our aim was threefold: (1) to examine the course of elevated anxiety during pregnancy, immediately after childbirth, and six weeks postpartum; (2) to establish comorbidity of postpartum anxiety and postpartum depression (PPD); and (3) to examine predictors of anxiety 6 weeks postpartum. A sample of women (N=272) who were below the cut-off score for clinical depression during pregnancy were assessed in the third trimester of pregnancy, then 2 days and 6 weeks postpartum. Questionnaires on anxiety, pregnancy specific distress, stress, coping styles, social support, and depression were administered at each assessment. Obstetric data were collected from the participants' medical records. The estimated rate of high anxiety was 35% during pregnancy, 17% immediately after childbirth, and 20% six weeks postpartum, showing a decrease in anxiety levels after childbirth. Comorbidity of anxiety and PPD was 75%. Trait anxiety and early postpartum state anxiety are significant predictors of postpartum anxiety. Anxiety is a common peripartum psychological disturbance. Anxiety symptoms overlap with PPD, but not com-pletely, indicating that screening for postpartum mental difficulties should include both depression and anxiety.
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Affiliation(s)
| | - Meri Tadinac
- Department of Psychology, Faculty of Humanities and Social Sciences, University of Zagreb, Zagreb, Croatia
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31
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Psychometric Properties of the Spanish Version of the Pregnancy Related Anxiety Questionnaire (PRAQ). SPANISH JOURNAL OF PSYCHOLOGY 2018; 21:E64. [PMID: 30501656 DOI: 10.1017/sjp.2018.67] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Although pregnancy increases the vulnerability to anxiety, no specific assessment instruments are usually used to detect it. The objective of this study was to adapt the Pregnancy Related Anxiety Questionnaire (PRAQ) to Spanish population, as well as analyze its validity and reliability. A sample of 367 nulliparous pregnant women with a normal risk status filled in a socio-demographic and obstetric-gynaecological questionnaire, the PRAQ, the Edinburgh Postnatal Depression Scale (EPDS) and the State-Trait Anxiety Inventory (STAI). After performing a factorial analysis, a five-factor model that explains 53.1% of the variance was obtained. Estimates of internal consistency reliability were adequate (range = .78 to .93) for the five factors included in the final confirmatory factor analysis, and for the total scale (.97). Significant correlation among PRAQ, EPDS, and STAI was found (p < .001). The 85th percentile (score 234 or more) was used as a cut-off point to identify those women with high pregnancy-specific anxiety. In accordance with the results obtained, the PRAQ can be considered a useful screening tool to evaluate pregnancy-related anxiety among the Spanish population.
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32
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van de Loo KFE, Vlenterie R, Nikkels SJ, Merkus PJFM, Roukema J, Verhaak CM, Roeleveld N, van Gelder MMHJ. Depression and anxiety during pregnancy: The influence of maternal characteristics. Birth 2018. [PMID: 29517137 DOI: 10.1111/birt.12343] [Citation(s) in RCA: 70] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
BACKGROUND Depression and anxiety during pregnancy are associated with adverse health outcomes for both mother and child. This study aims to investigate the occurrence of symptoms of depression and anxiety in early and late pregnancy, the longitudinal changes from early to late pregnancy, and factors associated with symptoms of depression and anxiety in pregnant women in the Netherlands. METHODS We studied 2897 women participating in the PRegnancy and Infant DEvelopment (PRIDE) Study. To assess symptoms of depression and anxiety, web-based questionnaires including the Hospital Anxiety and Depression Scale (HADS) and multiple questions on maternal characteristics were completed in early and late pregnancy. Cross-sectional and longitudinal multivariable linear regression analyses were conducted. RESULTS The depressive symptoms in our population increased, with a prevalence of probable depression from 5.4% in early pregnancy to 10.0% in late pregnancy (P < .001), whereas the anxiety symptoms decreased, with a prevalence of probable anxiety from 17.9% to 14.2% (P < .001). Characteristics associated with depressive or anxiety symptoms included low level of education, multiparity, a history of depression, severe nausea, extreme fatigue, lack of physical exercise, and negative life events. Being non-Dutch, not living with a partner, and having an unplanned pregnancy or a long time to pregnancy were associated with the depressive and/or anxiety symptoms in early pregnancy only. DISCUSSION Symptoms of depression and anxiety are common in both early and late pregnancy. Screening for risk factors in early pregnancy is important, since prenatal depression and anxiety may be related to adverse maternal and child health outcomes.
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Affiliation(s)
- Kim F E van de Loo
- Department of Medical Psychology, Radboud Institute for Health Sciences, Radboudumc Amalia Children's Hospital, Radboud university medical center, Nijmegen, The Netherlands
| | - Richelle Vlenterie
- Department for Health Evidence, Radboud Institute for Health Sciences, Radboud university medical center, Nijmegen, The Netherlands
| | - Sylke J Nikkels
- Department of Paediatrics, Radboudumc Amalia Children's Hospital, Radboud university medical center, Nijmegen, The Netherlands
| | - Peter J F M Merkus
- Department of Paediatric Pulmonology, Radboudumc Amalia Children's Hospital, Radboud university medical center, Nijmegen, The Netherlands
| | - Jolt Roukema
- Department of Paediatric Pulmonology, Radboudumc Amalia Children's Hospital, Radboud university medical center, Nijmegen, The Netherlands
| | - Chris M Verhaak
- Department of Medical Psychology, Radboud Institute for Health Sciences, Radboudumc Amalia Children's Hospital, Radboud university medical center, Nijmegen, The Netherlands
| | - Nel Roeleveld
- Department for Health Evidence, Radboud Institute for Health Sciences, Radboud university medical center, Nijmegen, The Netherlands.,Department of Paediatrics, Radboudumc Amalia Children's Hospital, Radboud university medical center, Nijmegen, The Netherlands
| | - Marleen M H J van Gelder
- Department for Health Evidence, Radboud Institute for Health Sciences, Radboud university medical center, Nijmegen, The Netherlands.,Radboud REshape Innovation Center, Radboud university medical center, Nijmegen, The Netherlands
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33
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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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Pakzad M, Dolatian M, Jahangiri Y, Nasiri M, Dargah FA. The Correlation between Islamic Lifestyle and Pregnancy-Specific Stress: A Cross-Sectional, Correlational Study. Open Access Maced J Med Sci 2018; 6:1163-1167. [PMID: 29983821 PMCID: PMC6026416 DOI: 10.3889/oamjms.2018.104] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2018] [Revised: 05/20/2018] [Accepted: 05/31/2018] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND Pregnancy is associated with great psychological, emotional and physical stress. In addition to undergoing hormonal changes, pregnant women experience a change in their attitude toward life and learn to re-assess their skills and lifestyle. Lifestyle, in general, and Islamic lifestyle, in particular, is concerned with the different psychological, social and physical aspects of the individual's life. AIM This study was conducted to evaluate the correlation between Islamic lifestyle and pregnancy-specific stress in pregnant women. MATERIAL AND METHODS This cross-sectional, correlational study was conducted on 300 pregnant women presenting to prenatal care clinics. Data were collected using a demographic, the Islamic lifestyle and the pregnancy-related stress questionnaires. RESULTS The results showed a statistically significant negative correlation (r = -0.284) between Islamic lifestyle and pregnancy-specific stress (P < 0.01). The stepwise regression showed that the mean score obtained in the pregnancy-related stress questionnaire decreased by 0.75 per year of marriage and by 0.14 per point in the Islamic lifestyle questionnaire. CONCLUSION There was a significant negative correlation between Islamic lifestyle and pregnancy-specific stress. Training mothers, raising their awareness and encouraging them to adopt an Islamic lifestyle may play a significant role in controlling pregnancy-specific stress.
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Affiliation(s)
- Mona Pakzad
- Department of Midwifery and Reproductive Health, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mahrokh Dolatian
- Department of Midwifery and Reproductive Health, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Yahia Jahangiri
- International Section of the Islamic Madhahib University, Tehran, Iran
| | - Malihe Nasiri
- Department of Biostatistics, School of Paramedical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Farzaneh Alidoust Dargah
- Department of Midwifery and Reproductive Health, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Hamzehgardeshi Z, Shahhosseini Z, Malari M, Pourasghar M, Yazdani charati J, Amerian M, Amirkhanzadeh Barandouzi Z. Communication skills and anxiety during pregnancy in nulliparous women: A cross-sectional study in an Iranian setting. PREVENTIVE CARE IN NURSING AND MIDWIFERY JOURNAL 2018. [DOI: 10.29252/pcnm.8.1.36] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022] Open
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36
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Park M, Lee S. Effects of an Experience-focused Prenatal Program on Stress, Anxiety, Childbirth Confidence, and Maternal-Fetal Attachment on Women in Their First Pregnancy. KOREAN JOURNAL OF WOMEN HEALTH NURSING 2018; 24:126-137. [PMID: 37684919 DOI: 10.4069/kjwhn.2018.24.2.126] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2018] [Revised: 04/30/2018] [Accepted: 05/26/2018] [Indexed: 09/10/2023] Open
Abstract
PURPOSE To evaluate the effectiveness of an experience-focused prenatal program on stress, anxiety, childbirth confidence, and maternal-fetal attachment for women in their first pregnancy. METHODS The participants were 57 pregnant women at 32 weeks or more of a first pregnancy who agreed to participate in this study. The data were analyzed with descriptive statistics, t-test, χ2 test, and Fisher's exact test using the SPSS 21.0 program. RESULTS The experimental group showed significant differences in stress, anxiety, childbirth confidence, and maternal-fetal attachment from the control group. CONCLUSION The four-week experience-focused prenatal program can be used for women in their first pregnancy to reduce their stress and anxiety and to increase their childbirth confidence and maternal- fetal attachment.
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Affiliation(s)
- Mira Park
- Department of Nursing, Mirero Woman's Hospital, Busan, Korea.
| | - Sunok Lee
- Department of Nursing, Mirero Woman's Hospital, Busan, Korea.
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Aksoy Derya Y, Timur Taşhan S, Duman M, Durgun Ozan Y. Turkish adaptation of the pregnancy-related anxiety questionnaire-revised 2: Validity and reliability study in multiparous and primiparous pregnancy. Midwifery 2018; 62:61-68. [PMID: 29655006 DOI: 10.1016/j.midw.2018.03.006] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2017] [Revised: 02/14/2018] [Accepted: 03/11/2018] [Indexed: 11/25/2022]
Abstract
OBJECTIVE The purpose of this study was to create a Turkish version of the Pregnancy-Related Anxiety Questionnaire-Revised 2 (PRAQR2), which was revised for application to multiparous and primiparous pregnancy, and to explore its psychometric characteristics in multiparous and primiparous pregnancy. DESIGN This study was methodologically designed to assess the reliability and validity of the PRAQ-R2. SETTING The study was carried out in the obstetrics clinic of a training and research hospital in Malatya. PARTICIPANTS A total of 616 healthy pregnant women (399 multiparous and 217 primiparous) constituted the sample of the study. METHODS The cultural adaptation process of the questionnaire was conducted in three phases: language validity, content validity, and pilot application. Exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) were used to test the construct validity of the questionnaire. The reliability of the PRAQ-R2 was evaluated with Cronbach's alpha internal consistency coefficient, item-total correlation, test-retest analysis, and parallel forms reliability. FINDINGS The EFA revealed that the PRAQ-R2 consists of 10 items for the multiparous group and 11 for the primiparous group after adding the item ``I am anxious about the delivery because I have never experienced one before.'' The CFA for both groups supported the three-factor questionnaire yielded by the EFA. Good fit index values were obtained in both groups. Cronbach's alpha internal consistency coefficient ranged from 0.81 to 0.93 for the multiparous group and 0.87 to 0.94 for the primiparous group for the complete PRAQ-R2 and each of its subdimensions. In addition, the item-total correlation, test-retest analysis, and parallel forms reliability of the questionnaire were highly correlated. CONCLUSION The PRAQ-R2 is a valid and reliable instrument that can be used to evaluate the level of anxiety in Turkish pregnant women irrespective of parity. IMPLICATIONS FOR PRACTICE The use of the PRAQ-R2 in prenatal healthcare services will contribute to the early diagnosis, treatment, and management of pregnancy-related anxiety.
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Affiliation(s)
- Yeşim Aksoy Derya
- Department of Midwifery, Faculty of Health Sciences Inonu University, Malatya, Turkey.
| | - Sermin Timur Taşhan
- Department of Nursing, Faculty of Nursing Inonu University, Malatya, Turkey.
| | - Mesude Duman
- Department of Nursing, School of Health Dicle University, Diyarbakır, Turkey.
| | - Yeter Durgun Ozan
- Department of Nursing, School of Health Dicle University, Diyarbakır, Turkey
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Maternal Experience of Neonatal Intensive Care Unit Hospitalization: Trauma Exposure and Psychosocial Responses. MOTHERHOOD IN THE FACE OF TRAUMA 2018. [DOI: 10.1007/978-3-319-65724-0_15] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
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39
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Canário C, Figueiredo B. Anxiety and depressive symptoms in women and men from early pregnancy to 30 months postpartum. J Reprod Infant Psychol 2017. [DOI: 10.1080/02646838.2017.1368464] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
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40
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Sheydaei H, Ghasemzadeh A, Lashkari A, Kajani PG. The effectiveness of mindfulness training on reducing the symptoms of postpartum depression. Electron Physician 2017; 9:4753-4758. [PMID: 28894531 PMCID: PMC5586989 DOI: 10.19082/4753] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2016] [Accepted: 03/08/2017] [Indexed: 01/17/2023] Open
Abstract
Background and Aim Postpartum depression is one of the prevalent disorders among new mothers. The present research aimed to examine the effectiveness of mindfulness training on reducing the symptoms of postpartum depression. Method The present quasi-experimental research was conducted on 410 new mothers in Shahid Chamran Hospital, Tehran in 2014. Using the Beck Depression Inventory (BDI), Structured Clinical Interview and Psychological Clinical Diagnosis, 67 mothers were selected and then randomly divided into experimental and control groups, each of which with 32 applicants. Afterwards, the experimental group received mindfulness training for 8 sessions, each lasting for two hours while the control group received no training. The data were analyzed through descriptive statistics and Analysis of Covariance (ANCOVA) in SPSS, version 20. Results Results showed that based on Beck Inventory, the scores for the experimental group in post-test were significant (p<0.001), compared to those for the control group. Also, it was revealed that pre- and posttest mean scores for postpartum depression in the control group were 25.81 and 25.12 respectively while the scores for the experimental group were 24.75 and 18.5 respectively. Since the posttest mean score in the experimental group was lower than that in the pretest, it can be said that the treatment, i.e., mindfulness training, was effective in reducing depression symptoms in mothers. Conclusion Findings proved that mindfulness training was effective in reducing the symptoms of postpartum depression in new mothers.
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Affiliation(s)
- Hajieh Sheydaei
- MA Graduate in Clinical Psychology, Maragheh University of Medical Sciences, Maragheh, Iran
| | - Azizreza Ghasemzadeh
- Lecturer in Rehabilitation Science, Sun Face Medical Aesthetic Center, Dubai, UAE
| | - Amir Lashkari
- MA Graduate in Clinical Psychology, Azad Islamic University of Roudehen, Roudehen, Iran
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The Correlation of Sexual Dysfunction with Prenatal Stress and Quality of Life: A Path Analysis. IRANIAN RED CRESCENT MEDICAL JOURNAL 2017. [DOI: 10.5812/ircmj.55686] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Croce Nanni R, Troisi A. Maternal attachment style and psychiatric history as independent predictors of mood symptoms in the immediate postpartum period. J Affect Disord 2017; 212:73-77. [PMID: 28152450 DOI: 10.1016/j.jad.2017.01.039] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2016] [Revised: 11/18/2016] [Accepted: 01/23/2017] [Indexed: 10/20/2022]
Abstract
BACKGROUND There is evidence that both a past history of psychiatric illness and insecure attachment put women at risk for mood disturbances in the postpartum period. The aim of this study was to ascertain whether maternal insecure attachment is a risk factor for mood symptoms in the immediate postpartum period independently of the confounding effect of maternal psychiatric history. METHODS A convenience sample of 120 mothers was assessed prenatally with the Maternal History of Mood Disturbances (MHMD), the Relationship Questionnaire (RQ), and in the first week after delivery with the Profile of Mood States (POMS). RESULTS Mothers with higher scores on the preoccupied and fearful attachment scales had more severe postpartum anxiety and depression symptoms but only fearful attachment remained a significant predictor of postpartum anxiety when the significant effect of maternal history of mood disturbances was included in the model. LIMITATIONS Our diagnostic assessment focused on mood symptoms, not disorders, and we limited psychometric assessment to the immediate postpartum period and did not collect longitudinal data to ascertain whether the relationship between maternal insecure attachment and postpartum mood disturbances changed over time. CONCLUSIONS Our results show the necessity to assess prior psychiatric symptoms in studies of maternal attachment style and postpartum mood disturbances. The finding that a mother's recall of her own psychiatric history emerged as significant predictor of postpartum mood symptoms suggests that antenatal assessment based on maternal self-report can be used in those settings where structured diagnostic interviews are not feasible.
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Affiliation(s)
- Roberta Croce Nanni
- U.O.C. Psichiatria, Policlinico Tor Vergata, viale Oxford 81, 00133 Roma, Italy
| | - Alfonso Troisi
- Department of Systems Medicine, University of Rome Tor Vergata, Viale Montpellier 1, 00133 Rome, Italy.
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43
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Arfaie K, Nahidi F, Simbar M, Bakhtiari M. The role of fear of childbirth in pregnancy related anxiety in Iranian women: a qualitative research. Electron Physician 2017; 9:3733-3740. [PMID: 28465800 PMCID: PMC5410899 DOI: 10.19082/3733] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2016] [Accepted: 10/08/2016] [Indexed: 01/10/2023] Open
Abstract
Introduction Anxiety disorders have severe complications for a mother and her developing baby. A few studies have focused on pregnancy related anxiety and its risk factors including fear of childbirth. Therefore, the current study aimed to explore components and dimensions of this kind of anxiety. Methods This qualitative study (conventional content analysis) was conducted with mothers who referred to health care centers from May to December, 2015. In order to collect data, purposive sampling and face-to-face semi-structured in-depth interviews were used. Data analysis was conducted using MAXQDA software. Results Twenty eight pregnant women from different social backgrounds, educational levels and ethnicities aged 18–41 years old participated in this study and after analysis, fear of childbirth was classified into four categories including the process of delivery (fear of pain, prolonged labor, loss of control, being left alone during delivery, fear of her own incompetency), time of delivery (fear of preterm labor, fear of unknown delivery time, fear of late arrival to hospital), delivery complications (fear of bleeding, fear of death, postpartum depression, delivery accidents, genitalia injuries and fetal health problems) and healthcare quality (hospital facilities, lack of trust in maternity staff and lack of trust in obstetricians). Conclusions The results suggest that supporting, reassuring and educating pregnant mothers and giving information about delivery room, labor and strategies for coping with fear of pain and childbirth are critical. Changes in maternity care policies are recommended to promote positive attitudes toward normal delivery.
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Affiliation(s)
- Katayoun Arfaie
- Department of Midwifery & Reproductive Health, School of Nursing and Midwifery, International Branch, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Fatemeh Nahidi
- Ph.D. of Reproductive Health, Assistant Professor, Department of Midwifery & Reproductive Health, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Masoumeh Simbar
- Ph.D. of Reproductive Health, Assistant Professor, Department of Midwifery & Reproductive Health, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Maryam Bakhtiari
- Ph.D. of Psychology, Assistant Professor, Departments of Clinical Psychology, School of Medicine, Shahid Beheshti University of Medical Sciences
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Staneva AA, Morawska A, Bogossian F, Wittkowski A. Maternal psychological distress during pregnancy does not increase the risk for adverse birth outcomes. Women Health 2017; 58:92-111. [DOI: 10.1080/03630242.2017.1282395] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Aleksandra A. Staneva
- The School of Psychology, The University of Queensland, Brisbane, Queensland, Australia
| | - Alina Morawska
- The School of Psychology, The University of Queensland, Brisbane, Queensland, Australia
| | - Fiona Bogossian
- The School of Nursing, Midwifery and Social Work, The University of Queensland, Brisbane, Queensland, Australia
| | - Anja Wittkowski
- Department of Psychology, University of Manchester, Manchester, UK
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45
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Blackmore ER, Gustafsson H, Gilchrist M, Wyman C, O’Connor TG. Pregnancy-related anxiety: Evidence of distinct clinical significance from a prospective longitudinal study. J Affect Disord 2016; 197:251-8. [PMID: 26999549 PMCID: PMC4837058 DOI: 10.1016/j.jad.2016.03.008] [Citation(s) in RCA: 109] [Impact Index Per Article: 13.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/20/2015] [Revised: 02/20/2016] [Accepted: 03/06/2016] [Indexed: 01/16/2023]
Abstract
BACKGROUND Pregnancy-related anxiety (PrA) has attracted considerable research attention, but questions remain about its distinctiveness from conventional constructs and measures. In a high psychosocial risk, ethnically diverse sample, we examine the degree to which PrA is distinct from continuous and diagnostic measures of anxiety and worry in terms of longitudinal course, associations with psychosocial and perinatal risk, and prediction of postnatal mood disturbance. METHODS 345 women oversampled for prenatal anxiety and depression were selected from an urban obstetrics clinic serving a predominantly low-income, ethnically diverse population. PrA was assessed at 20 and 32 weeks gestation; anxiety and depression symptoms were assessed from questionnaire and from clinical interview at 20 and 32 weeks gestation and again at 2 and 6 months postnatally. Data relevant to psychosocial and obstetric risks were ascertained from interview, medical exam, and chart review. RESULTS Two distinct factors of PrA were identified, indexing specific concerns about the child's health and about the birth; these two PrA factors showed distinct longitudinal patterns in the prenatal period, and modest associations with general measures of anxiety and depression from questionnaire and clinical interview. PrA was also distinguished from conventional symptom measures in its associated features and prediction of birth weight and postnatal mood. LIMITATIONS The sample was at high psychosocial risk and ethnically diverse; findings may not generalize to other samples. CONCLUSIONS PrA can be distinguished from general measures of anxiety in pregnancy in terms of longitudinal course, associated features, and prediction to postnatal mood disturbance, and may warrant specific clinical attention.
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Affiliation(s)
| | | | | | - Claire Wyman
- Department of Pediatrics, University of Rochester Medical Center
| | - Thomas G O’Connor
- Wynne Center for Family Research, Department of Psychiatry, University of Rochester Medical Center,Correspondence to: Thomas O’Connor, Wynne Center for Family Research, Department of Psychiatry, University of Rochester Medical Center, 300 Crittenden Blvd, Rochester, NY 14642;
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46
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Akiki S, Avison WR, Speechley KN, Campbell MK. Determinants of maternal antenatal state-anxiety in mid-pregnancy: Role of maternal feelings about the pregnancy. J Affect Disord 2016; 196:260-7. [PMID: 26945124 DOI: 10.1016/j.jad.2016.02.016] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2015] [Revised: 01/22/2016] [Accepted: 02/06/2016] [Indexed: 11/30/2022]
Abstract
BACKGROUND The current state of research into antenatal anxiety is lacking in a comprehensive understanding of determinants. This study aims to expand knowledge in this area, with the main objective being to determine potential determinants of maternal antenatal state-anxiety. METHODS Data used for this cross-sectional study were obtained from the Prenatal Health Project: a population cohort study of 2357 women in London, Ontario. 1992 women in their second trimester met inclusion criteria for this study. The primary hypothesis was that "feelings about the pregnancy" would be a determinant of antenatal state-anxiety after controlling for other potential covariates. The abbreviated version of the Spielberger State and Trait Anxiety Inventory (STAI) was used to measure state-anxiety. Univariate analyses and multiple linear regression were performed to identify variables predictive of state-anxiety. RESULTS Stress, feeling unsure/unhappy about the pregnancy and having low self-esteem, low mastery and low social support from one's partner and family were statistically significant determinants of state-anxiety during the second trimester. In addition, anxiety was found to be inversely related to gestational age. LIMITATIONS The two main limitations of the study were the use of a self-report screening tool (STAI) as the measure of anxious symptoms rather than a clinical diagnosis, and possible recall bias of feelings about the pregnancy. CONCLUSIONS We concluded that how a woman feels about her pregnancy was a determinant of state-anxiety. This study contributes knowledge aiming to help women improve their mental health during pregnancy by identifying important determinants of state-anxiety.
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Affiliation(s)
- Salwa Akiki
- Department of Epidemiology and Biostatistics, University of Western Ontario, London, Ontario, Canada
| | - William R Avison
- Department of Epidemiology and Biostatistics, University of Western Ontario, London, Ontario, Canada; Department of Paediatrics, University of Western Ontario, London, Ontario, Canada; Children's Health Research Institute, London, Ontario, Canada; Department of Sociology, University of Western Ontario, London, Ontario, Canada; Lawson Health Research Institute, London, Ontario, Canada
| | - Kathy N Speechley
- Department of Epidemiology and Biostatistics, University of Western Ontario, London, Ontario, Canada; Department of Paediatrics, University of Western Ontario, London, Ontario, Canada; Children's Health Research Institute, London, Ontario, Canada; Lawson Health Research Institute, London, Ontario, Canada
| | - M Karen Campbell
- Department of Epidemiology and Biostatistics, University of Western Ontario, London, Ontario, Canada; Department of Paediatrics, University of Western Ontario, London, Ontario, Canada; Department of Obstetrics and Gynecology, University of Western Ontario, London, Ontario, Canada; Children's Health Research Institute, London, Ontario, Canada; Lawson Health Research Institute, London, Ontario, Canada.
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47
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Winter C, Van Acker F, Bonduelle M, Van Berkel K, Belva F, Liebaers I, Nekkebroeck J. Depression, pregnancy-related anxiety and parental-antenatal attachment in couples using preimplantation genetic diagnosis. Hum Reprod 2016; 31:1288-99. [DOI: 10.1093/humrep/dew074] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2015] [Accepted: 03/14/2016] [Indexed: 11/13/2022] Open
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Abstract
This article is part of a Special Issue "Parental Care". The postpartum period involves some truly transformational changes in females' socioemotional behaviors. For most female laboratory rodents and women, these changes include an improvement in their affective state, which has positive consequences for their ability to sensitively care for their offspring. There is heterogeneity among females in the likelihood of this positive affective change, though, and some women experience elevated anxiety or depression (or in rodents anxiety- or depression-related behaviors) after giving birth. We aim to contribute to the understanding of this heterogeneity in maternal affectivity by reviewing selected components of the scientific literatures on laboratory rodents and humans examining how mothers' physical contact with her infants, genetics, history of anxiety and depression and early-life and recent-life experiences contribute to individual differences in postpartum affective states. These studies together indicate that multiple biological and environmental factors beyond female maternal state shape affective responses during the postpartum period, and probably do so in an interactive manner. Furthermore, the similar capacity of some of these factors to modulate anxiety and depression in human and rodent mothers suggests cross-species conservation of mechanisms regulating postpartum affectivity.
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Affiliation(s)
- Daniella Agrati
- Department of Physiology and Nutrition, Facultad de Ciencias, Universidad de la Republica, Montevideo, Uruguay.
| | - Joseph S Lonstein
- Neuroscience Program & Department of Psychology, Michigan State University, East Lansing, MI 48824, USA
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Staneva A, Morawska A, Bogossian F, Wittkowski A. Pregnancy-specific distress: the role of maternal sense of coherence and antenatal mothering orientations. J Ment Health 2015; 25:387-394. [PMID: 26652295 DOI: 10.3109/09638237.2015.1101425] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND Maternal mental health during pregnancy has been identified as a key factor in the future physiological, emotional and social development of both the mother and her baby. Yet little is known about the factors that contribute to increased levels of pregnancy-specific distress. The present study investigated the role of two psychosocial and personality-based constructs, namely women's sense of coherence (SoC) and their mothering orientations, on their pregnancy-specific distress. DESIGN During their second trimester of pregnancy, 293 Australian and New Zealand women participated in an online study. Hierarchical multiple regression analysis was used to determine the unique contribution of women's SoC (Sense of Coherence Scale, SoC 13) and their antenatal mothering orientation (Antenatal Mothering Orientation Measure-Revised, AMOM-R) to pregnancy-specific distress (Revised Prenatal Distress Questionnaire, NuPDQ). RESULTS Low SoC was the best determinant of women's pregnancy-specific distress, accounting for over 45% of the variance (β = -0.33, p < 0.001, 95% CI [-0.43, -0.23]). A Regulator mothering orientation was correlated with distress but did not have a unique contribution in the final model. CONCLUSIONS This study further highlights the importance of better understanding women's perceptions of emotional health and their mothering role while taking into consideration their wider social context.
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Affiliation(s)
| | - Alina Morawska
- a The School of Psychology, The University of Queensland , Australia
| | - Fiona Bogossian
- b The School of Nursing, Midwifery and Social Work, The University of Queensland , Brisbane , Australia , and
| | - Anja Wittkowski
- c Department of Psychology, Division of Clinical Psychology , University of Manchester , Manchester , UK
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50
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Malary M, Shahhosseini Z, Pourasghar M, Hamzehgardeshi Z. Couples Communication Skills and Anxiety of Pregnancy: A Narrative Review. Mater Sociomed 2015; 27:286-90. [PMID: 26543425 PMCID: PMC4610665 DOI: 10.5455/msm.2015.27.286-290] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
Background: physical problems during pregnancy including Anxiety disorders form a large share of health problems. On the other hand, healthy relationship and communication skills are vital to raise a family. For couples who enjoy communication skills, parenthood will be the best and most pleasant experiences in their lives. High levels of positive communication will lead to couples and their children’s mental health and couples’ good relationship can have a protective effect against stressors including anxiety of pregnancy. The current study reviewed the studies on the relationship between communication skills and the anxiety of pregnancy. Methods: The current study is a review where the researcher browsed the available databases like Google Scholar, Pubmed, Magiran, SID, and Science Direct and using key words of Communication skills, marital satisfaction, and the anxiety of pregnancy, & the researcher has searched the articles of 2000-2014 & read 150 abstracts & 93 full papers and ultimately, chose 50 to write this study. Results: By reviewing the findings literature in three general categories as Communication Skills as the Significant Component to Get Marital Satisfaction, Improving Marital Satisfaction as Pregnancy Anxiety Reducing Factor, and Communication Skills Quality as Component Influencing Pregnancy Anxiety. Conclusions: Having communication skills will lead to promotion of marital satisfaction and increased mental health in life. It is, therefore, recommended that communication skills be trained in routine programs for pre-marriage counseling, pre-pregnancy cares and pregnancy so that the mental health of community can be improved.
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Affiliation(s)
- Mina Malary
- Department of Reproductive Health and Midwifery, School of Nursing and Midwifery, Mazandaran University of Medical Sciences, Sari, Iran ; Student Research Committee, Mazandaran University of Medical Sciences, Sari, Iran
| | - Zohreh Shahhosseini
- Department of Reproductive Health and Midwifery, School of Nursing and Midwifery, Mazandaran University of Medical Sciences, Sari, Iran
| | - Mehdi Pourasghar
- Department of Psychiatry and Research Center for Psychiatry and Behavioral Sciences, Mazandaran University of Medical Sciences, Sari, Iran
| | - Zeinab Hamzehgardeshi
- Department of Reproductive Health and Midwifery, School of Nursing and Midwifery, Mazandaran University of Medical Sciences, Sari, Iran ; Traditional and Complementary Medicine Research Centre, Mazandaran University of Medical Sciences, Sari, Iran
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