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Malouf R, Harrison S, Pilkington V, Opondo C, Gale C, Stein A, Franck LS, Alderdice F. Factors associated with posttraumatic stress and anxiety among the parents of babies admitted to neonatal care: a systematic review. BMC Pregnancy Childbirth 2024; 24:352. [PMID: 38724899 PMCID: PMC11084127 DOI: 10.1186/s12884-024-06383-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2023] [Accepted: 03/01/2024] [Indexed: 05/12/2024] Open
Abstract
BACKGROUND Posttraumatic stress (PTS) and anxiety are common mental health problems among parents of babies admitted to a neonatal unit (NNU). This review aimed to identify sociodemographic, pregnancy and birth, and psychological factors associated with PTS and anxiety in this population. METHOD Studies published up to December 2022 were retrieved by searching Medline, Embase, PsychoINFO, Cumulative Index to Nursing and Allied Health electronic databases. The modified Newcastle-Ottawa Scale for cohort and cross-sectional studies was used to assess the methodological quality of included studies. This review was pre-registered in PROSPERO (CRD42021270526). RESULTS Forty-nine studies involving 8,447 parents were included; 18 studies examined factors for PTS, 24 for anxiety and 7 for both. Only one study of anxiety factors was deemed to be of good quality. Studies generally included a small sample size and were methodologically heterogeneous. Pooling of data was not feasible. Previous history of mental health problems (four studies) and parental perception of more severe infant illness (five studies) were associated with increased risk of PTS, and had the strongest evidence. Shorter gestational age (≤ 33 weeks) was associated with an increased risk of anxiety (three studies) and very low birth weight (< 1000g) was associated with an increased risk of both PTS and anxiety (one study). Stress related to the NNU environment was associated with both PTS (one study) and anxiety (two studies), and limited data suggested that early engagement in infant's care (one study), efficient parent-staff communication (one study), adequate social support (two studies) and positive coping mechanisms (one study) may be protective factors for both PTS and anxiety. Perinatal anxiety, depression and PTS were all highly comorbid conditions (as with the general population) and the existence of one mental health condition was a risk factor for others. CONCLUSION Heterogeneity limits the interpretation of findings. Until clearer evidence is available on which parents are most at risk, good communication with parents and universal screening of PTS and anxiety for all parents whose babies are admitted to NNU is needed to identify those parents who may benefit most from mental health interventions.
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Affiliation(s)
- Reem Malouf
- NIHR Policy Research Unit in Maternal and Neonatal Health and Care National Perinatal Epidemiology Unit Nuffield Department of Population Health, University of Oxford Old Road Campus Headington, Oxford, OX3 7LF, UK
| | - Sian Harrison
- NIHR Policy Research Unit in Maternal and Neonatal Health and Care National Perinatal Epidemiology Unit Nuffield Department of Population Health, University of Oxford Old Road Campus Headington, Oxford, OX3 7LF, UK
| | - Victoria Pilkington
- NIHR Policy Research Unit in Maternal and Neonatal Health and Care National Perinatal Epidemiology Unit Nuffield Department of Population Health, University of Oxford Old Road Campus Headington, Oxford, OX3 7LF, UK
| | - Charles Opondo
- Department of Medical Statistics, London School of Hygiene and Tropical Medicine, London, UK
| | - Chris Gale
- School of Public Health, Faculty of Medicine, Neonatal Medicine, Imperial College London, Chelsea and Westminster Campus, 369 Fulham Road, London, SW10 9NH, UK
| | - Alan Stein
- Department of Psychiatry, Medical Sciences Division, University of Oxford, Oxford, UK
- Medical Research Council/Wits University Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand Honorary Professor, African Health Research Institute, Johannesburg, KwaZulu Natal, South Africa
- African Health Research Institute, Durban, KwaZulu-Natal, South Africa
| | - Linda S Franck
- Department of Family Health Care Nursing, School of Nursing, University of California San Francisco, 2 Koret Way, San Francisco, CA, 94143, USA
| | - Fiona Alderdice
- NIHR Policy Research Unit in Maternal and Neonatal Health and Care National Perinatal Epidemiology Unit Nuffield Department of Population Health, University of Oxford Old Road Campus Headington, Oxford, OX3 7LF, UK.
- School of Nursing and Midwifery, Queens University Belfast, Belfast, UK.
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Maggioni E, Pigoni A, Fontana E, Delvecchio G, Bonivento C, Bianchi V, Mauri M, Bellina M, Girometti R, Agarwal N, Nobile M, Brambilla P. Right frontal cingulate cortex mediates the effect of prenatal complications on youth internalizing behaviors. Mol Psychiatry 2024:10.1038/s41380-024-02475-y. [PMID: 38378927 DOI: 10.1038/s41380-024-02475-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Revised: 01/26/2024] [Accepted: 01/31/2024] [Indexed: 02/22/2024]
Abstract
Prenatal and perinatal complications represent well-known risk factors for the future development of psychiatric disorders. Such influence might become manifested during childhood and adolescence, as key periods for brain and behavioral changes. Internalizing and externalizing behaviors in adolescence have been associated with the risk of psychiatric onset later in life. Both brain morphology and behavior seem to be affected by obstetric complications, but a clear link among these three aspects is missing. Here, we aimed at analyzing the association between prenatal and perinatal complications, behavioral issues, and brain volumes in a group of children and adolescents. Eighty-two children and adolescents with emotional-behavioral problems underwent clinical and 3 T brain magnetic resonance imaging (MRI) assessments. The former included information on behavior, through the Child Behavior Checklist/6-18 (CBCL/6-18), and on the occurrence of obstetric complications. The relationships between clinical and gray matter volume (GMV) measures were investigated through multiple generalized linear models and mediation models. We found a mutual link between prenatal complications, GMV alterations in the frontal gyrus, and withdrawn problems. Specifically, complications during pregnancy were associated with higher CBCL/6-18 withdrawn scores and GMV reductions in the right superior frontal gyrus and anterior cingulate cortex. Finally, a mediation effect of these GMV measures on the association between prenatal complications and the withdrawn dimension was identified. Our findings suggest a key role of obstetric complications in affecting brain structure and behavior. For the first time, a mediator role of frontal GMV in the relationship between prenatal complications and internalizing symptoms was suggested. Once replicated on independent cohorts, this evidence will have relevant implications for planning preventive interventions.
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Affiliation(s)
- Eleonora Maggioni
- Department of Electronics Information and Bioengineering, Politecnico di Milano, Milano, Italy
| | - Alessandro Pigoni
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
- Social and Affective Neuroscience Group, MoMiLab, IMT School for Advanced Studies Lucca, Lucca, Italy
| | - Elisa Fontana
- Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
| | - Giuseppe Delvecchio
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | | | - Valentina Bianchi
- Child and Adolescent Psychiatry Unit, Scientific Institute IRCCS "Eugenio Medea", Bosisio Parini (Lc), Italy
| | - Maddalena Mauri
- Child and Adolescent Psychiatry Unit, Scientific Institute IRCCS "Eugenio Medea", Bosisio Parini (Lc), Italy
| | - Monica Bellina
- Child and Adolescent Psychiatry Unit, Scientific Institute IRCCS "Eugenio Medea", Bosisio Parini (Lc), Italy
| | - Rossano Girometti
- Institute of Radiology, Department of Medicine (DMED), University of Udine, Udine, Italy
- University Hospital S. Maria Della Misericordia, Azienda Sanitaria Universitaria Friuli Centrale (ASUFC), Udine, Italy
| | - Nivedita Agarwal
- Neuroimaging Unit, Scientific Institute IRCCS "Eugenio Medea", Bosisio Parini (Lc), Italy
| | - Maria Nobile
- Child and Adolescent Psychiatry Unit, Scientific Institute IRCCS "Eugenio Medea", Bosisio Parini (Lc), Italy
| | - Paolo Brambilla
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.
- Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy.
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Chaibekava KV, Scheenen AJC, Lettink A, Smits LJM, Langenveld J, Laar RVD, Peeters B, Joosten S, Verstappen ML, Dirksen CD, Nieuwenhuijze MJ, Scheepers HCJ. Continuous care during labor by maternity care assistants in the Netherlands vs care-as-usual: a randomized controlled trial. Am J Obstet Gynecol MFM 2023; 5:101168. [PMID: 37742999 DOI: 10.1016/j.ajogmf.2023.101168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Accepted: 09/20/2023] [Indexed: 09/26/2023]
Abstract
BACKGROUND Continuous support during labor has many benefits including lower use of obstetrical interventions. However, implementation remains limited. Insights into birth outcomes and peripartum costs are essential to assess whether continuous care by a maternity care assistant is a potentially (cost) effective program to provide for all women. OBJECTIVE Continuous care during labor, provided by maternity care assistants, will reduce the use of epidural analgesia and peripartum costs owing to a reduction in interventions. STUDY DESIGN This was a randomized controlled trial comparing continuous support during labor (intervention group) with care-as-usual (control group) with prespecified intention-to-treat and per-protocol analyses. The primary outcome was epidural analgesia use. The secondary outcomes were use of other analgesia, referrals from midwife- to obstetrician-led care, modes of birth, hospital stay, sense of control (evaluated with the Labor Agentry Scale), maternal and neonatal adverse outcomes and peripartum costs. Data were collected using questionnaires. Anticipating incomplete adherence to providing continuous care, both intention-to-treat and per-protocol analyses were planned. Peripartum costs were estimated using a healthcare perspective. Mean costs per woman and cost differences between the intervention and control group were calculated. RESULTS The population consisted of 1076 women with 54 exclusions and 30 discontinuations, leaving 992 women to be analyzed (515 continuous care and 477 care-as-usual). Intention-to-treat analyses showed statistically nonsignificant differences between the intervention and control group for epidural use (relative risk, 0.88; 95% confidence interval, 0.74-1.04; P=.14) and peripartum costs (mean difference, € 185.83; 95% confidence interval, -€ 204.22 to € 624.54). Per-protocol analyses showed statistically significant decreases in epidural analgesia (relative risk, 0.64; 95% confidence interval, 0.48-0.84; P=.001), other analgesia (relative risk, 0.59; 95% confidence interval, 0.37-0.94; P=.02), cesarean deliveries (relative risk, 0.53; 95% confidence interval, 0.29-0.95; P=.03) and increase in spontaneous vaginal births (relative risk, 1.09; 95% confidence interval, 1.01-1.18; P=.001) in the intervention group, but difference in total peripartum costs remained statistically nonsignificant (mean difference, € 246.55; 95% confidence interval, -€ 539.14 to € 13.50). CONCLUSION If the provision of continuous care given by maternity care assistants during labor can be secured, continuous care leads to more vaginal births and less epidural use, pain medication, and cesarean deliveries while not leading to a difference in peripartum costs compared with care-as-usual.
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Affiliation(s)
- Karina V Chaibekava
- Department of Obstetrics & Gynecology, Maastricht University Medical Center, Maastricht, The Netherlands (Mses Chaibekava and Scheenan and Dr Scheepers); GROW-School for Oncology and Developmental Biology, Maastricht University, Maastricht, The Netherlands (Ms Chaibekava and Dr Scheepers).
| | - Amber J C Scheenen
- Department of Obstetrics & Gynecology, Maastricht University Medical Center, Maastricht, The Netherlands (Mses Chaibekava and Scheenan and Dr Scheepers)
| | - Adrie Lettink
- Department of Obstetrics & Gynecology, Maastricht University Medical Center, Maastricht, The Netherlands (Dr Lettink)
| | - Luc J M Smits
- Department of Epidemiology, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands (Dr Smits)
| | - Josje Langenveld
- Department of Obstetrics & Gynecology, Zuyderland Medical Center, Heerlen, The Netherlands (Dr Langenveld)
| | - Rafli Van De Laar
- Department of Obstetrics & Gynecology, VieCuri Medical Center, Venlo, The Netherlands (Dr Van De Laar)
| | - Babette Peeters
- Cicogna Kraamzorg, Gulpen, The Netherlands (Mses Peeters and Joosten)
| | - Sanne Joosten
- Cicogna Kraamzorg, Gulpen, The Netherlands (Mses Peeters and Joosten)
| | | | - Carmen D Dirksen
- Department Clinical Epidemiology and Medical Technology Assessment, Care And Public Health Research Institute, Maastricht University Medical Center, Maastricht, The Netherlands (Dr Dirksen)
| | - Marianne J Nieuwenhuijze
- Research Center for Midwifery Science, Zuyd University, Maastricht, The Netherlands (Dr Nieuwenhuijze); and Care and Public Health Research Institute, Maastricht University, Maastricht, The Netherlands (Dr Nieuwenhuijze)
| | - Hubertina C J Scheepers
- Department of Obstetrics & Gynecology, Maastricht University Medical Center, Maastricht, The Netherlands (Mses Chaibekava and Scheenan and Dr Scheepers); GROW-School for Oncology and Developmental Biology, Maastricht University, Maastricht, The Netherlands (Ms Chaibekava and Dr Scheepers)
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Miller ML, O'Hara MW. The structure of mood and anxiety disorder symptoms in the perinatal period. J Affect Disord 2023; 325:231-239. [PMID: 36610596 PMCID: PMC11095580 DOI: 10.1016/j.jad.2022.12.111] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2022] [Revised: 09/06/2022] [Accepted: 12/23/2022] [Indexed: 01/05/2023]
Abstract
BACKGROUND The perinatal period is increasingly recognized as a vulnerable time for the development and exacerbation of psychiatric symptoms. Research has often focused on perinatal depression, with much less information on perinatal anxiety. This study examined the psychometric structure of all internalizing (anxiety and mood disorder symptoms) in the perinatal period. METHODS Participants were primarily community adults receiving prenatal care from an academic medical center (N = 246). Participants completed a structured clinical interview using the Interview for Mood and Anxiety Symptoms (IMAS) during pregnancy (28-32 weeks gestation) and the postpartum (6-8 weeks). Clinical interviews dimensionally assessed all current anxiety, mood, and obsessive-compulsive symptoms as well as lifetime psychiatric diagnoses. RESULTS Confirmatory factor analyses identified three latent factors onto which psychiatric symptoms loaded: Distress (depression, generalized anxiety, irritability, and panic symptoms), Fear (social anxiety, agoraphobia, specific phobia, and obsessive-compulsive symptoms), and Bipolar (mania and obsessive-compulsive symptoms) in both pregnancy and the postpartum. The fit statistics of the models indicated adequate to good fit in both models. LIMITATIONS The IMAS is validated against the DSM-IV-TR rather than the DSM-5 and assessments of psychiatric symptoms were focused only on the current pregnancy. CONCLUSIONS A three-factor model consisting of Distress, Fear and Bipolar latent factors was the best-fitting model in pregnancy and the postpartum period and showed stability across time. The structure of internalizing symptoms has important implications for future perinatal research and can be utilized to guide treatment by highlighting which psychiatric symptoms may be most similar during the perinatal period.
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Affiliation(s)
- Michelle L Miller
- University of Iowa, United States of America; Indiana University School of Medicine, United States of America.
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5
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Dewi A, Safaria T, Supriyatiningsih S, Dewi DTK. Efforts and expectations of pregnant women against the impact of the COVID-19 pandemic: a phenomenological study. BMC Pregnancy Childbirth 2023; 23:53. [PMID: 36681793 PMCID: PMC9862243 DOI: 10.1186/s12884-023-05383-1] [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: 08/12/2022] [Accepted: 01/16/2023] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND COVID-19 is a global threat that directly impacts people's mental health and physical well-being. This study explored the efforts and expectations of pregnant women against the impact of the COVID-19 pandemic. METHODS This study was a qualitative study that used a phenomenological approach. The informants of this study were pregnant women (n = 20). Data analysis used content analysis with software assistance (Nvivo Release 1.5). RESULTS The results of this study identified three themes which were: 1) causative factors of pregnant women's anxiety regarding the impact of COVID-19 including lack of knowledge regarding the impact of the COVID-19 virus and perceived susceptibility; 2) Efforts to reduce anxiety during the COVID-19 pandemic including a spiritual approach, the role of family and COVID-19 prevention; and 3) Expectation regarding healthcare services during COVID-19 including virtual based Antenatal Care (ANC) Services and Private ANC Services. CONCLUSION A spiritual approach, the role of family, and COVID-19 prevention will help pregnant women reduce their anxiety about being infected with the COVID-19 virus. Furthermore, virtual-based ANC Services, and private ANC services, such as home visits and dividing ANC services and general services into two different tracks as a protective mechanism from being infected with the COVID-19 virus, would assist pregnant women feel safer and secure.
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Affiliation(s)
- Arlina Dewi
- grid.444658.f0000 0004 0375 2195Department of Public Health, Master of Hospital Administration, Universitas Muhammadiyah Yogyakarta, Yogyakarta, Indonesia
| | - Triantoro Safaria
- grid.444626.60000 0000 9226 1101Department of Psychology, Faculty of Psychology, Ahmad Dahlan University, Yogyakarta, Indonesia
| | - Supriyatiningsih Supriyatiningsih
- grid.444658.f0000 0004 0375 2195Department of Obstetrics and Gynecology, Faculty of Medicine and Health Sciences, Universitas Muhammadiyah Yogyakarta, Yogyakarta, Indonesia
| | - Dyah Tri Kusuma Dewi
- grid.444658.f0000 0004 0375 2195Department of Public Health, Master of Hospital Administration, Universitas Muhammadiyah Yogyakarta, Yogyakarta, Indonesia ,grid.412896.00000 0000 9337 0481School of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan
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Sherer ML, Voegtline KM, Park HS, Miller KN, Shuffrey LC, Klein SL, Osborne LM. The immune phenotype of perinatal anxiety. Brain Behav Immun 2022; 106:280-288. [PMID: 36115543 DOI: 10.1016/j.bbi.2022.09.005] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/04/2022] [Revised: 08/12/2022] [Accepted: 09/11/2022] [Indexed: 10/31/2022] Open
Abstract
BACKGROUND Immune dysregulation has been linked to both psychiatric illness and pregnancy morbidity, including perinatal depression, but little is known about the immune phenotype of perinatal anxiety. Here, we sought to identify the unique immune profile of antenatal anxiety. MATERIALS AND METHODS Pregnant women (n = 107) were followed prospectively at 2nd and 3rd trimesters (T2, T3) and 6 weeks postpartum (PP6). Each visit included a blood draw and psychological evaluation, with clinical anxiety assessed using the Spielberg State-Trait Anxiety Scale. We enrolled both healthy controls and participants with anxiety alone; those with comorbid depression were excluded. Multiplex cytokine assays and flow cytometry were used to examine the association of anxiety symptoms with secreted immune markers and PBMC-derived immune cells. RESULTS K cluster means revealed three clusters of anxiety symptomatology; due to low numbers in the highest severity anxiety group, these were collapsed into two groups: Non-Anxiety and Anxiety. Principal components analysis revealed two distinct clusters of cytokine secretion including one cluster that consisted of many innate immune cytokines and differed between groups. Compared to women in the Non-Anxiety group, women in the Anxiety group had lower levels of cytokine expression during pregnancy and an increase in levels into the postpartum, whereas Non-Anxiety women experienced a time-dependent decline. Immune cell populations also differed between our two groups, with the Anxiety group showing a decrease in the ratio of B cells to T cells from pregnancy to postpartum, whereas the Non-Anxiety women showed an increase in this ratio over time. Women in the Anxiety group also demonstrated an increased ratio of cytotoxic to helper T cells throughout pregnancy, a modest increase in the Th1:Th2 ratio across pregnancy, and a lower ratio of Th17:TREG cells in the postpartum as compared with Non-Anxiety women. CONCLUSION These data suggest that the immune response throughout the antenatal period differs for women with anxiety symptoms compared to those without, suggestive of a unique immune phenotype of perinatal anxiety.
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Affiliation(s)
- Morgan L Sherer
- Department of Psychiatry & Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA; W. Harry Feinstone Department of Molecular Microbiology and Immunology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
| | - Kristin M Voegtline
- Division of General Pediatrics, Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Han-Sol Park
- W. Harry Feinstone Department of Molecular Microbiology and Immunology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Kristen N Miller
- Department of Psychiatry & Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Lauren C Shuffrey
- Department of Psychiatry, Columbia University Irving Medical Center, New York, USA
| | - Sabra L Klein
- W. Harry Feinstone Department of Molecular Microbiology and Immunology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Lauren M Osborne
- Department of Psychiatry & Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA; Department of Obstetrics & Gynecology, Weill Cornell Medicine, New York, NY, USA.
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Yu X, Liu Y, Huang Y, Zeng T. The effect of nonpharmacological interventions on the mental health of high-risk pregnant women: A systematic review. Complement Ther Med 2022; 64:102799. [PMID: 34995769 DOI: 10.1016/j.ctim.2022.102799] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Revised: 12/31/2021] [Accepted: 01/03/2022] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVES To evaluate the effect of nonpharmacological interventions on the mental health of high-risk pregnant women. METHODS This review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020 (PRISMA) statement. The Cochrane Library, Embase, CINAHL, PubMed and Web of Science databases were systematically searched for randomized controlled trials and quasi-randomized controlled trials from inception to April 2021. The quality of the studies was assessed using the Cochrane Risk of Bias Tool 2.0. Data were independently extracted and narratively synthesized. RESULTS Fifteen studies involving 1723 pregnant women were selected. Nonpharmacological interventions included cognitive behavioral interventions, yoga, relaxation interventions, psychological and educational support interventions, and acupressure. Cognitive behavioral interventions and yoga for high-risk pregnant women had potential benefits on the symptoms of anxiety, stress and depression. There was insufficient evidence that relaxation interventions, psychological and educational support interventions and acupressure had positive effects on these women's mental health. CONCLUSIONS This review showed that cognitive behavioral interventions and yoga during pregnancy may benefit women with high-risk pregnancies. However, due to methodological limitations of this review, further studies with robust methodological designs are needed to verify the efficacy.
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Affiliation(s)
- Xiaoyan Yu
- Department of Nursing, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, No. 1095 Jiefang Avenue, Wuhan 430030, China
| | - Yu Liu
- Department of Nursing, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, No. 1095 Jiefang Avenue, Wuhan 430030, China.
| | - Yi Huang
- Department of Nursing, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, No. 1095 Jiefang Avenue, Wuhan 430030, China
| | - Tieying Zeng
- Department of Nursing, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, No. 1095 Jiefang Avenue, Wuhan 430030, China
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Dewi A, Safaria T, Wenang S, Dewanto I, Dhiya An A, Dewi DTK. The COVID-19 Pandemic: How Does it Affect Pregnant Women? Open Access Maced J Med Sci 2022. [DOI: 10.3889/oamjms.2021.7838] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND: The COVID-19 pandemic has a severe impact globally, not limited to general health and mental health. Pregnant women are a vulnerable group. Hormonal changes that occur during pregnancy significantly affect physical and psychological health.
AIM: The purpose of this study was to explore the anxiety felt by pregnant women holistically about their pregnancy during the COVID-19 pandemic.
METHODOLOGY: This study is qualitative phenomenological research with a naturalistic approach. The informants consisted of 20 pregnant women from three different islands and provinces in Indonesia in February 2021. They were selected to obtain heterogeneous data based on education level, gestational age, urban-rural areas, culture, and religion. The collection of information data used semi-structured interview guidelines with 12 questions. Data analysis used qualitative content analysis to explore pregnant women’s anxiety with a similar meaning using software (Nvivo release 12).
RESULTS: Five domains caused anxiety for pregnant women related to the COVID-19 pandemic, such as feeling worried about being infected with COVID-19, the impact on health during pregnancy, the family economy, the circulating information around the community, and unfulfilled spiritual needs in utilizing places of worship.
CONCLUSION: The COVID-19 pandemic influenced pregnant women in a bio-psycho-socio-cultural manner, both about themselves, their fetuses, and their families. Anxiety that mothers feel during the pregnancy process needs proper treatment to protect the mothers’ health and babies’ well-being in the future. Thus, early detection or screening of anxiety during the COVID-19 pandemic in health services is necessary.
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Demers CH, Bagonis MM, Al-Ali K, Garcia SE, Styner MA, Gilmore JH, Hoffman MC, Hankin BL, Davis EP. Exposure to prenatal maternal distress and infant white matter neurodevelopment. Dev Psychopathol 2021; 33:1526-1538. [PMID: 35586027 PMCID: PMC9109943 DOI: 10.1017/s0954579421000742] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
The prenatal period represents a critical time for brain growth and development. These rapid neurological advances render the fetus susceptible to various influences with life-long implications for mental health. Maternal distress signals are a dominant early life influence, contributing to birth outcomes and risk for offspring psychopathology. This prospective longitudinal study evaluated the association between prenatal maternal distress and infant white matter microstructure. Participants included a racially and socioeconomically diverse sample of 85 mother-infant dyads. Prenatal distress was assessed at 17 and 29 weeks' gestational age (GA). Infant structural data were collected via diffusion tensor imaging at 42-45 weeks' postconceptional age. Findings demonstrated that higher prenatal maternal distress at 29 weeks' GA was associated with increased fractional anisotropy (b = .283, t(64) = 2.319, p = .024) and with increased axial diffusivity (b = .254, t(64) = 2.067, p = .043) within the right anterior cingulate white matter tract. No other significant associations were found with prenatal distress exposure and tract fractional anisotropy or axial diffusivity at 29 weeks' GA, nor earlier in gestation.
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Affiliation(s)
- Catherine H. Demers
- Department of Psychology University of Denver, Denver CO,
USA
- Department of Psychiatry, University of Colorado Anschutz
Medical Campus, Aurora CO, USA
| | - Maria M. Bagonis
- Department of Psychiatry, University of North Carolina at
Chapel Hill, Chapel Hill NC, USA
| | - Khalid Al-Ali
- Department of Psychiatry, University of North Carolina at
Chapel Hill, Chapel Hill NC, USA
| | - Sarah E. Garcia
- Department of Psychology University of Denver, Denver CO,
USA
| | - Martin A. Styner
- Department of Psychiatry, University of North Carolina at
Chapel Hill, Chapel Hill NC, USA
- Department of Computer Science, University of North
Carolina at Chapel Hill, Chapel Hill NC, USA
| | - John H. Gilmore
- Department of Psychiatry, University of North Carolina at
Chapel Hill, Chapel Hill NC, USA
| | - M. Camille Hoffman
- Department of Psychiatry, University of Colorado Anschutz
Medical Campus, Aurora CO, USA
- Department of Obstetrics and Gynecology, Division of
Maternal and Fetal Medicine, University of Colorado Denver School of Medicine,
Aurora, Colorado, USA
| | - Benjamin L. Hankin
- Department of Psychology, University of Illinois at
Urbana-Champaign, Champaign IL, USA
| | - Elysia Poggi Davis
- Department of Psychology University of Denver, Denver CO,
USA
- Department of Psychiatry and Human Behavior, University of
California, Irvine, CA, USA
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Hamzehgardeshi Z, Omidvar S, Amoli AA, Firouzbakht M. Pregnancy-related anxiety and its associated factors during COVID-19 pandemic in Iranian pregnant women: a web-based cross-sectional study. BMC Pregnancy Childbirth 2021; 21:208. [PMID: 33722198 PMCID: PMC7957463 DOI: 10.1186/s12884-021-03694-9] [Citation(s) in RCA: 37] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2020] [Accepted: 03/03/2021] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Pregnancy is a risk factor for coronavirus disease 2019 (COVID-19). Pregnant women suffer from varying levels of pregnancy-related anxiety (PRA) which can negatively affect pregnancy outcomes. The aim of this study was to assess PRA and its associated factors during the COVID-19 pandemic. METHODS This web-based cross-sectional study was conducted in 2020 on 318 pregnant women purposively recruited from primary healthcare centers in Sari and Amol, Iran. Data were collected using questionnaires (PRAQ, Edinburg, KAP of COVID-19, CDA-Q and Demographic questionnaire), which were provided to participants through the social media or were completed for them over telephone. Data were analyzed with the linear regression and the logistic regression analysis, at the significance level of 0.05 using the SPSS software (v. 21). RESULTS Around 21% of participants had PRA, 42.1% had depression, and 4.4% had COVID-19 anxiety. The significant predictors of PRA were number of pregnancies (P = 0.008), practice regarding COVID-19 (P < 0.001), COVID-19 anxiety (P < 0.001), depression (P < 0.001), and social support (P = 0.025) which explained 19% of the total variance. Depression and COVID-19 anxiety increased the odds of PRA by respectively four times and 13%, while good practice regarding COVID-19 decreased the odds by 62%. CONCLUSION Around 21% of pregnant women suffer from PRA during the COVID-19 pandemic and the significant predictors of PRA during the pandemic include number of pregnancies, practice regarding COVID-19, COVID-19 anxiety, depression, and social support. These findings can be used to develop appropriate strategies for the management of mental health problems during pregnancy in the COVID-19 pandemic.
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Affiliation(s)
- Zeinab Hamzehgardeshi
- Department of Reproductive Health and Midwifery, Sexual and Reproductive Health Research Center, School of Nursing and Midwifery, Mazandaran University of Medical Sciences, Sari, Iran
| | - Shabnam Omidvar
- Social Determinants of Health Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
| | - Arman Asadi Amoli
- Commette Student Research, Babol University of Medical Sciences, Babol, Iran
| | - Mojgan Firouzbakht
- Department of Nursing- Midwifery, Comprehensive Health Research Center, Babol Branch, Isalamic Azad University, Babol, Iran.
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Bovbjerg ML, Misra D, Snowden JM. Current Resources for Evidence-Based Practice, November 2020. J Obstet Gynecol Neonatal Nurs 2020; 49:605-619. [PMID: 33096044 PMCID: PMC7575432 DOI: 10.1016/j.jogn.2020.10.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
An extensive review of new resources to support the provision of evidence-based care for women and infants. The current column includes a discussion of diversity in the maternity care workforce and commentaries on reviews focused on burnout in midwifery and a cross-national comparison of guidelines for uncomplicated childbirth.
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