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Maxwell D, Leat SR, Gallegos T, Praetorius RT. Sacred space: a qualitative interpretive meta-synthesis of women's experiences of supportive birthing environments. BMC Pregnancy Childbirth 2024; 24:372. [PMID: 38750419 PMCID: PMC11097458 DOI: 10.1186/s12884-024-06544-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2023] [Accepted: 04/25/2024] [Indexed: 05/18/2024] Open
Abstract
BACKGROUND In the United States there are roughly three million births a year, ranging from cesarean to natural births. A major aspect of the birthing process is related to the healing environment, and how that helps or harms healing for the mother and child. Using the theoretical framework, Theory of Supportive Care Settings (TSCS), this study aimed to explore what is necessary to have a safe and sacred healing environment for mothers. METHOD This study utilized an updated Qualitative Interpretive Meta-synthesis (QIMS) design called QIMS-DTT [deductive theory testing] to answer the research question, What are mother's experiences of environmental factors contributing to a supportive birthing environment within healthcare settings? RESULTS Key terms were run through multiple databases, which resulted in 5,688 articles. After title and abstract screening, 43 were left for full-text, 12 were excluded, leaving 31 to be included in the final QIMS. Five main themes emerged from analysis: 1) Service in the environment, 2) Recognizing oneself within the birthing space, 3) Creating connections with support systems, 4) Being welcomed into the birthing space, and 5) Feeling safe within the birthing environment. CONCLUSIONS Providing a warm and welcoming birth space is crucial for people who give birth to have positive experiences. Providing spaces where the person can feel safe and supported allows them to find empowerment in the situation where they have limited control.
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Affiliation(s)
| | | | - Toni Gallegos
- The University of Texas at Arlington, Arlington, TX, USA
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Marr K, Maguet C, Scarlett H, Dray-Spira R, Dubertret C, Gressier F, Sutter-Dallay AL, Melchior M, van der Waerden J. Social determinants in prenatal antidepressant use and continuation: Systematic review and meta-analysis. Acta Psychiatr Scand 2023. [PMID: 38145902 DOI: 10.1111/acps.13647] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Revised: 11/15/2023] [Accepted: 11/29/2023] [Indexed: 12/27/2023]
Abstract
INTRODUCTION Depression is one of the most common co-morbidities during pregnancy; with severe symptoms, antidepressants are sometimes recommended. Social determinants are often linked with antidepressant use in the general population, and it is not known if this is the case for pregnant populations. Our objective was to determine if social determinants are associated with prenatal antidepressant intake via a systematic review and meta-analysis. METHODS A systematic search of five databases was conducted to identify publications from inception to October 2022 that reported associations with prenatal antidepressant intake (use/continuation) and one or more social determinants: education, race, immigration status, relationship, income, or employment. Eligible studies were included in random effects meta-analyses. RESULTS A total of 23 articles describing 22 studies were included. Education was significantly and positively associated with prenatal antidepressant continuation and heterogeneity was moderate. (Odds ratio = 0.83; 95% CI, 0.78 to 0.89; p < 0.00001; I2 = 53%). Meta-analyses of antidepressant use and education, race, and relationship status, and antidepressant continuation and income were not significant with high levels of heterogeneity. DISCUSSION While most social determinants in this review were not linked with prenatal antidepressant intake, lower maternal education level does seem to be associated with lower rates of prenatal antidepressant continuation. CONCLUSIONS Education appears to be linked with prenatal antidepressant intake. The low number of included studies precludes conclusive evidence for other social determinants.
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Affiliation(s)
- Ketevan Marr
- Institut Pierre Louis d'Epidémiologie et de Santé Publique, Équipe de Recherche en Épidémiologie Sociale, Paris, France
| | - Charlotte Maguet
- Institut Pierre Louis d'Epidémiologie et de Santé Publique, Équipe de Recherche en Épidémiologie Sociale, Paris, France
| | - Honor Scarlett
- Institut Pierre Louis d'Epidémiologie et de Santé Publique, Équipe de Recherche en Épidémiologie Sociale, Paris, France
| | - Rosemary Dray-Spira
- Institut Pierre Louis d'Epidémiologie et de Santé Publique, Équipe de Recherche en Épidémiologie Sociale, Paris, France
- EPI-PHARE Scientific Interest Group in Epidemiology of Health Products, French National Agency for Medicines and Health Products Safety, French National Health Insurance, Saint-Denis, France
| | - Caroline Dubertret
- AP-HP, Groupe Hospital-Universitaire AP-HP Nord, DMU ESPRIT, Service de Psychiatrie et Addictologie, Hôpital Louis Mourier, Colombes, France
- Faculté de Médecine, Université de Paris, Paris, France
| | - Florence Gressier
- CESP, Inserm UMR1178, Department of Psychiatry, Assistance Publique-Hôpitaux de Paris, Bicêtre University Hospital, Le Kremlin Bicêtre, France
| | - Anne-Laure Sutter-Dallay
- Inserm, Bordeaux Population Health Research Center, U1219, Bordeaux University, Bordeaux, France
- University Department of Child and Adolescent Psychiatry, Charles Perrens Hospital, Bordeaux, France
| | - Maria Melchior
- Institut Pierre Louis d'Epidémiologie et de Santé Publique, Équipe de Recherche en Épidémiologie Sociale, Paris, France
| | - Judith van der Waerden
- Institut Pierre Louis d'Epidémiologie et de Santé Publique, Équipe de Recherche en Épidémiologie Sociale, Paris, France
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Atinafu WT, Tilahun KN, Yilma TM, Mekonnen ZA, Walle AD, Adem JB. Intention to use a mobile phone to receive mental health support and its predicting factors among women attending antenatal care at public health facilities in Ambo town, West Shoa zone, Ethiopia 2022. BMC Health Serv Res 2023; 23:1368. [PMID: 38057856 DOI: 10.1186/s12913-023-10392-z] [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: 12/09/2022] [Accepted: 11/28/2023] [Indexed: 12/08/2023] Open
Abstract
BACKGROUND Mental health problems are the most common morbidities of women during the prenatal period. In LMICs mobile phones have been identified as a good vehicle for monitoring individuals with a high risk of mental health conditions. However, evidence is scarce and the purpose of this study was to assess the intention to use a mobile phone to receive mental health support and its predicting factors among women attending antenatal care at public health facilities in Ambo town, Ethiopia 2022. METHODS AND MATERIALS An institutional-based cross-sectional study design was conducted from May 20th to June 20th, 2022. A total of 715 prenatal women were included and a systematic random sampling technique was employed. An interviewer-administered structured questionnaire was used. Collected data was exported to SPSS version 25 for the descriptive part, and AMOS 26 structural equation modeling was also used to describe and assess the degree and significance of relationships between variables. RESULTS A total of 699 (97.8% response rate) responded to complete all the questionnaires. About 530 (77.3%) 95% CI (74%-80.3%) of women intended to use a mobile phone to receive mental health support. The perceived usefulness has a positive effect on attitude (β = 0.391, p < 0.001) and intention to use (β = 0.253, p < 0.001). The perceived ease of use influences perceived usefulness (β = 0.253, p < 0.001) and attitude β = 0.579, p < 0.001). The intention to use is positively affected by attitude (β = 0.662, p < 0.001).Trust has a positive effect on perceived usefulness (β = 0.580, p < 0.001) and intention to use (β = 0.113, p = 0.005). Subjective norm has a direct positive effect on perceived usefulness (β = 0.248, p < 0.001). Attitude serves as a partial mediator between perceived usefulness and intention to use and a complete mediating role between perceived ease of use and intention to use. CONCLUSION The level of intention to use a mobile phone among prenatal women is relatively high and attitude, perceived usefulness, and trust had direct positive effects on intention to use a mobile phone. Therefore, hospitals and healthcare providers should take proactive measures to implement the strategies and policies for providing mobile phone-based mental health support to prenatal women in remote areas.
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Affiliation(s)
- Wabi Temesgen Atinafu
- Department of Public Health, College of Medicine and Health Sciences, Ambo University, Ambo, Ethiopia.
| | - Kefyalew Naniye Tilahun
- Department of Public Health, College of Medicine and Health Sciences, Ambo University, Ambo, Ethiopia
| | - Tesfahun Melese Yilma
- Department of Health Informatics, Institute of Public Health, University of Gondar, Gondar, Ethiopia
| | - Zeleke Abebaw Mekonnen
- Department of Health Informatics, Institute of Public Health, University of Gondar, Gondar, Ethiopia
| | - Agmasie Damtew Walle
- Department of Health Informatics, College of Health Sciences, Mattu University, Metu, Ethiopia
| | - Jibril Bashir Adem
- Department of Public Health, College of Medicine and Health Sciences, Arsi University, Asella, Ethiopia
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da Fonseca Cumerlato CB, Cademartori MG, Barros FC, Dâmaso AH, da Silveira MF, Hallal PC, Demarco FF, Corrêa MB. Maternal depression in first 1000 days of life and early childhood caries prevalence at 48 months of age. Clin Oral Investig 2023; 27:7625-7634. [PMID: 37897660 DOI: 10.1007/s00784-023-05351-1] [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: 03/22/2023] [Accepted: 10/18/2023] [Indexed: 10/30/2023]
Abstract
OBJECTIVES The aim of this study was to investigate the effect of maternal's depression trajectory in the first 1000 days of the child's life on the prevalence of early childhood dental caries (ECC), in a birth cohort. MATERIALS AND METHODS All infants born in Pelotas in 2015 were identified, and the mothers were invited to participate in the cohort. A total of 3645 children were included in the study. The outcome was ECC at 48 months of age assessed according to ICDAS. Maternal depression was collected using Edinburgh Postnatal Depression Scale (EPDS) antenatally, at 3, 12, and 24 months of age. Maternal depressive symptom trajectory variables were created using group-based trajectory models and adopting two cutoff points. Poisson regression model with robust variance was used to identify the total effect of maternal depressive symptom trajectories on ECC, adjusting by confounders. RESULTS A total of 29.2% of the mothers presented a high trajectory for screening of depression, and 18.8% presented a high trajectory of depression diagnosis. The prevalence of ECC was 26.7%. After adjusted analysis, maternal depression trajectories (screening and diagnosis) from pregnancy to 24 months increased the risk for ECC at 48 months of age (RR = 1.14; 95% CI 1.02-1.28 and RR = 1.19; 95% CI 1.05-1.35). CONCLUSIONS Children from mothers with high depression trajectory had higher risk of having dental caries at 48 months compared to children from mothers with low depression trajectory. CLINICAL RELEVANCE Strategies of early detection and treatment of maternal mental disorders during the Golden Period should be considered of high priority in health services since it could impact positively in children's life.
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Affiliation(s)
| | - Mariana Gonzalez Cademartori
- Graduate Program in Dentistry, Federal University of Pelotas, Rua Gonçalves Chaves, 457, 5th floor, Pelotas, RS, 96015560, Brazil
| | - Fernando Celso Barros
- Catholic University of Pelotas, Gonçalves Chaves, 373, Pelotas, RS, 96015560, Brazil
| | - Andréa Homsi Dâmaso
- Graduate Program in Epidemiology, Federal University of Pelotas, Marechal Deodoro, 1160, 3rd floor, Pelotas, RS, 96020220, Brazil
| | - Mariângela Freitas da Silveira
- Graduate Program in Epidemiology, Federal University of Pelotas, Marechal Deodoro, 1160, 3rd floor, Pelotas, RS, 96020220, Brazil
| | - Pedro Curi Hallal
- Graduate Program in Epidemiology, Federal University of Pelotas, Marechal Deodoro, 1160, 3rd floor, Pelotas, RS, 96020220, Brazil
| | - Flávio Fernando Demarco
- Graduate Program in Dentistry, Federal University of Pelotas, Rua Gonçalves Chaves, 457, 5th floor, Pelotas, RS, 96015560, Brazil
- Graduate Program in Epidemiology, Federal University of Pelotas, Marechal Deodoro, 1160, 3rd floor, Pelotas, RS, 96020220, Brazil
| | - Marcos Britto Corrêa
- Graduate Program in Dentistry, Federal University of Pelotas, Rua Gonçalves Chaves, 457, 5th floor, Pelotas, RS, 96015560, Brazil.
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Baumgartel K, Saint Fleur A, Prescott S, Fanfan D, Elliott A, Yoo JY, Koerner R, Harringon M, Dutra SO, Duffy A, Ji M, Groer MW. Social Determinants of Health Among Pregnant Hispanic Women and Associated Psychological Outcomes. J Racial Ethn Health Disparities 2023:10.1007/s40615-023-01852-7. [PMID: 37973772 PMCID: PMC11186463 DOI: 10.1007/s40615-023-01852-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Revised: 10/17/2023] [Accepted: 10/24/2023] [Indexed: 11/19/2023]
Abstract
BACKGROUND There has been a concerning surge in maternal mortality among Hispanic women in recent years. Compromised mental health is present in nearly half of all maternal deaths, and risk factors include poor social support and depression. OBJECTIVE Among Hispanic women who were born in the USA versus those not born in the USA, we sought to describe and compare social determinants of health and maternal psychological outcomes. METHODS Hispanic pregnant women (n = 579) were recruited from two clinics in Tampa, FL, and completed various questionnaires related to social determinants of health, depression, stress, and social support. STATISTICAL ANALYSIS Descriptive statistics, t-tests, and chi-square analyses were used to compare relationships between maternal nativity and subsequent psychosocial outcomes. Pearson correlations were used to explore associations between variables. RESULTS Hispanic pregnant women who were not born in the USA had lower incomes (χ2 = 5.68, p = 0.018, df = 1), were more likely to be unemployed (χ2 = 8.12, p = 0.004, df = 1), and were more likely to be married (χ2 = 4.79, p = 0.029, df = 1) when compared with those born in the USA. Those not born in the USA reported lower social support (t = 3.92, p<0.001), specifically the tangible (t = 4.18, p < 0.001) and emotional support subscales (t = 4.4, p<0.001). When compared with those born in the USA, foreign-born Hispanic women reported less stress (t = 3.23, p = 0.001) and depression (t = 3.3, p = 0.002). CONCLUSION Pregnant Hispanic women not born in the USA are at increased risk for suboptimal social determinants of health, including less social support. US-born women were more stressed and depressed and had higher BMIs.
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Affiliation(s)
- Kelley Baumgartel
- University of South Florida College of Nursing, 12912 USF Health Dr, Tampa, FL, 33612, USA.
| | - Angeline Saint Fleur
- University of South Florida College of Nursing, 12912 USF Health Dr, Tampa, FL, 33612, USA
| | - Stephanie Prescott
- University of South Florida College of Nursing, 12912 USF Health Dr, Tampa, FL, 33612, USA
| | - Dany Fanfan
- University of Florida College of Nursing, 1225 Center Drive, Gainesville, FL, 32619, USA
| | - Amanda Elliott
- University of Florida College of Medicine Psychiatry and Behavioral Neurosciences, 3515 Ave Tampa, Fletcher, FL, 33613, USA
| | - Ji Youn Yoo
- University of Tennessee Knoxville College of Nursing, 1412 Circle Dr, Knoxville, TN, 37996, USA
| | - Rebecca Koerner
- University of South Florida College of Nursing, 12912 USF Health Dr, Tampa, FL, 33612, USA
| | - Monalisa Harringon
- University of South Florida College of Nursing, 12912 USF Health Dr, Tampa, FL, 33612, USA
| | - Samia Ozorio Dutra
- University of Hawaii at Manoa Nancy Atmospera-Walch School of Nursing, 2528 McCarthy Mall, Webster Hall 440, Honolulu, HI, 96822, USA
| | - Allyson Duffy
- University of South Florida College of Nursing, 12912 USF Health Dr, Tampa, FL, 33612, USA
| | - Ming Ji
- University of New Mexico Health Sciences, 2500 Marble Ave NE, Albuquerque, NM, 87106, USA
| | - Maureen W Groer
- University of Tennessee Knoxville College of Nursing, 1412 Circle Dr, Knoxville, TN, 37996, USA
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Glassgow AE, Wagner-Schuman M, Knepper A, Holicky A, Angulo M, Handler A, Harris B, Hickey E, Manrique Y, Mauro A, Rodriguez A, Schulte J, Scott S, Wainwright S, Caskey R. Addressing Maternal Health Disparities: Building a Novel Two-Generation Approach to Comprehensive Postpartum Care. Popul Health Manag 2023; 26:275-282. [PMID: 37677001 DOI: 10.1089/pop.2023.0059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/09/2023] Open
Abstract
The United States is facing a maternal health crisis with increasing rates of severe maternal morbidity and mortality. To improve maternal health and promote health equity, the authors developed a novel 2-generation model of postpartum and pediatric care. This article describes the Two-Generation Clinic (Two-Gen) and model of care. The model combines a dyadic strategy for simultaneous maternal and pediatric care with the collaborative care model in which seamless primary and behavioral health care are delivered to address the physical health, behavioral health, and social service needs of families. The transdisciplinary team includes primary care physicians, nurse practitioners, psychiatrists, obstetrician-gynecologists, social workers, care navigators, and lactation specialists. Dyad clinic visits are coscheduled (at the same time) and colocated (in the same examination room) with the same primary care provider. In the Two-Gen, the majority (89%) of the mothers self-identify as racial and ethnic minorities. More than 40% have a mental health diagnosis. Almost all mothers (97.8%) completed mental health screenings, >50.0% have received counseling from a social worker, 17.2% had a visit with a psychiatrist, and 50.0% received lactation counseling. Over 80% of the children were up to date with their well-child visits and immunizations. The Two-Gen is a promising model of care that has the potential to inform the design of postpartum care models and promote health equity in communities with the highest maternal health disparities.
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Affiliation(s)
- Anne Elizabeth Glassgow
- Department of Medicine, College of Medicine, University of Illinois at Chicago, Chicago, Illinois, USA
- Department of Pediatrics, and College of Medicine, University of Illinois at Chicago, Chicago, Illinois, USA
| | - Melissa Wagner-Schuman
- Department of Medicine, College of Medicine, University of Illinois at Chicago, Chicago, Illinois, USA
- Department of Psychiatry, College of Medicine, University of Illinois at Chicago, Chicago, Illinois, USA
| | - Amanda Knepper
- Department of Medicine, College of Medicine, University of Illinois at Chicago, Chicago, Illinois, USA
| | - Abigail Holicky
- Department of Medicine, College of Medicine, University of Illinois at Chicago, Chicago, Illinois, USA
| | - Maria Angulo
- Department of Medicine, College of Medicine, University of Illinois at Chicago, Chicago, Illinois, USA
| | - Arden Handler
- Division of Community Health Sciences, School of Public Health, University of Illinois at Chicago, Chicago, Illinois, USA
| | - Bianca Harris
- Department of Medicine, College of Medicine, University of Illinois at Chicago, Chicago, Illinois, USA
| | - Erin Hickey
- Department of Medicine, College of Medicine, University of Illinois at Chicago, Chicago, Illinois, USA
| | - Yolanda Manrique
- Department of Medicine, College of Medicine, University of Illinois at Chicago, Chicago, Illinois, USA
| | - Ana Mauro
- Department of Medicine, College of Medicine, University of Illinois at Chicago, Chicago, Illinois, USA
| | - Aida Rodriguez
- Department of Medicine, College of Medicine, University of Illinois at Chicago, Chicago, Illinois, USA
| | - Jennifer Schulte
- Department of Medicine, College of Medicine, University of Illinois at Chicago, Chicago, Illinois, USA
| | - Shirley Scott
- Department of Medicine, College of Medicine, University of Illinois at Chicago, Chicago, Illinois, USA
| | - Samuel Wainwright
- Department of Medicine, College of Medicine, University of Illinois at Chicago, Chicago, Illinois, USA
| | - Rachel Caskey
- Department of Medicine, College of Medicine, University of Illinois at Chicago, Chicago, Illinois, USA
- Department of Pediatrics, and College of Medicine, University of Illinois at Chicago, Chicago, Illinois, USA
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Surace T, Quitadamo C, Caldiroli A, Capuzzi E, Colmegna F, Nosari G, Borroni E, Fedrizzi L, Bollati V, Pesatori AC, Carugno M, Clerici M, Buoli M. Air Pollution and Perinatal Mental Health: A Comprehensive Overview. J Clin Med 2023; 12:jcm12093146. [PMID: 37176587 PMCID: PMC10179699 DOI: 10.3390/jcm12093146] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Revised: 03/21/2023] [Accepted: 04/25/2023] [Indexed: 05/15/2023] Open
Abstract
BACKGROUND The aim of the present study was to summarise the available data about the link between air pollution exposure and the new-onset and severity of psychiatric disorders in pregnant women during the perinatal period. MATERIALS AND METHODS We selected articles published until June 2022 on PubMed and the Web of Science. Pollutants included were PM2.5 (particulate matter 2.5 micrometres and smaller), PM10 (particulate matter 10 micrometres and smaller), NO2 (nitrogen dioxide), O3 (ozone), SO2 (sulphur dioxide), CO (carbon monoxide), PBDEs (polybrominated diphenyl ethers), PFAS (per- and polyfluoroalkyl substances), lead, and cadmium. The perinatal period was considered as the time of pregnancy until one year after childbirth. RESULTS Nine studies were included; most of them evaluated the association between exposure to air pollutants and the onset of Postpartum Depression (PPD). Two studies showed an association between, respectively, only PM2.5 and both PM2.5 and NO2 exposure and PPD onset 12 months after childbirth, while another study found a significant association between NO2 exposure and PPD occurrence 6 months after childbirth. PBDE blood levels were associated with more severe depressive symptoms. Lastly, one study observed a link between stressful symptoms and exposure to PM2.5, PM10 during pregnancy. CONCLUSION More comprehensive and uniform studies are required to make a roadmap for future interventions, given the growing relevance of issues such pollution and mental health, particularly during the perinatal period.
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Affiliation(s)
- Teresa Surace
- Department of Mental Health and Addiction, Fondazione IRCCS San Gerardo dei Tintori, Via G.B. Pergolesi 33, 20900 Monza, Italy
| | - Cecilia Quitadamo
- Department of Medicine and Surgery, University of Milan Bicocca, Via Cadore 38, 20900 Monza, Italy
| | - Alice Caldiroli
- Department of Mental Health and Addiction, Fondazione IRCCS San Gerardo dei Tintori, Via G.B. Pergolesi 33, 20900 Monza, Italy
| | - Enrico Capuzzi
- Department of Mental Health and Addiction, Fondazione IRCCS San Gerardo dei Tintori, Via G.B. Pergolesi 33, 20900 Monza, Italy
| | - Fabrizia Colmegna
- Department of Mental Health and Addiction, Fondazione IRCCS San Gerardo dei Tintori, Via G.B. Pergolesi 33, 20900 Monza, Italy
| | - Guido Nosari
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Via F. Sforza 35, 20122 Milan, Italy
| | - Elisa Borroni
- EPIGET Lab, Department of Clinical Sciences and Community Health, University of Milan, 20122 Milan, Italy
| | - Luca Fedrizzi
- Epidemiology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Via San Barnaba 8, 20122 Milan, Italy
| | - Valentina Bollati
- EPIGET Lab, Department of Clinical Sciences and Community Health, University of Milan, 20122 Milan, Italy
| | - Angela Cecilia Pesatori
- EPIGET Lab, Department of Clinical Sciences and Community Health, University of Milan, 20122 Milan, Italy
- Epidemiology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Via San Barnaba 8, 20122 Milan, Italy
| | - Michele Carugno
- EPIGET Lab, Department of Clinical Sciences and Community Health, University of Milan, 20122 Milan, Italy
- Epidemiology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Via San Barnaba 8, 20122 Milan, Italy
| | - Massimo Clerici
- Department of Mental Health and Addiction, Fondazione IRCCS San Gerardo dei Tintori, Via G.B. Pergolesi 33, 20900 Monza, Italy
- Department of Medicine and Surgery, University of Milan Bicocca, Via Cadore 38, 20900 Monza, Italy
| | - Massimiliano Buoli
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Via F. Sforza 35, 20122 Milan, Italy
- Department of Pathophysiology and Transplantation, University of Milan, 20122 Milan, Italy
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Psychological impact of hypnosis for pregnancy and childbirth: A systematic review. Complement Ther Clin Pract 2023; 50:101713. [PMID: 36509031 DOI: 10.1016/j.ctcp.2022.101713] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2022] [Revised: 11/26/2022] [Accepted: 12/03/2022] [Indexed: 12/12/2022]
Abstract
BACKGROUND The use of hypnosis as a complementary therapy in the perinatal field is expanding, however, there is little research for its impact on perinatal mental health. Here, we review studies that evaluate the effect of hypnosis on women's mental health and subjective experiences. METHODS A systematic review was conducted according to the PRISMA protocol for articles with experimental designs of hypnosis that measured their impact on several psychological variables, such as the presence of symptoms of anxiety, depression or fear of childbirth. Studies were evaluated according to the Critical Appraisal Skills Program Checklists (CASP), and analyzed for their designs and intervention themes. RESULTS Seven studies were included and six themes emerged: preparation for birth and unexpected events; change in the perception and experience of pain; pregnant body as a natural process; connection with the baby during pregnancy; development of inner resources; and progressive relaxation and guided imagery. Although results were partly mitigated, most studies found positive effects of hypnosis in alleviating anxiety, depression, and fear towards birth, empowering women with a higher sense of confidence and improving the overall emotional experience. Two studies also indicate encouraging outcomes in postnatal wellbeing. CONCLUSION While it is still argued as to what extent hypnosis has positive effects on physical aspects of labor, the empowerment and the increase in confidence associated with hypnosis seem to bring a significant contribution to a more positive subjective experience of pregnancy and childbirth, and on women's overall wellbeing in the perinatal period.
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Negussie A, Girma E, Kaba M. A phenomenological study of the lived experiences of partner relationship breakup during pregnancy: Psychosocial effects, coping mechanisms, and the healthcare providers' role. Front Glob Womens Health 2023; 4:1048366. [PMID: 37139172 PMCID: PMC10150961 DOI: 10.3389/fgwh.2023.1048366] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2022] [Accepted: 03/27/2023] [Indexed: 05/05/2023] Open
Abstract
Background Pregnancy is a state of continuous changes in feelings and emotions, and highly stressful experiences such as a relationship breakup during this period may result in additional stress for the woman, making pregnancy and motherhood challenging. This study aimed to investigate pregnant women's lived experiences of partner relationship breakup during pregnancy, their coping mechanisms, and the role of healthcare providers in breakup cases during their Antenatal care visits. Methods A phenomenological study approach was followed to seek an understanding of the lived experiences of pregnant women who encountered partner relationship breakup. The study was carried out in Hawassa, Ethiopia, and eight pregnant women were involved in in-depth interviews. The data meanings found from participants' experiences were described in a meaningful text and organized into themes. Key themes were developed in reference to the research objectives, and thematic analysis was used to analyze the data. Results Pregnant women in such situations faced serious psychological and emotional distress, feelings of shame/embarrassment, prejudice and discrimination, and severe economic struggles. To cope with this multifaceted situation, pregnant women sought social support from family/relatives or close friends, and if they had no other options, from supporting organizations. The participants also revealed that they received no counseling from healthcare providers during their Antenatal care visits, and there was no further discussion to address their psychosocial problems. Conclusions Community-level information, education, and communication should be initiated to aware communities about the psychosocial consequences of relationship breakup during pregnancy, address cultural norms and discrimination, and promote supportive environments. Women's empowerment activities and psychosocial support services should also be strengthened. In addition, the need for more comprehensive Antenatal care to address such unique risk conditions is indicated.
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Affiliation(s)
- Abel Negussie
- Department of Social and Population Health, Yirgalem Hospital Medical College, Yirgalem, Ethiopia
- School of Public Health, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
- Correspondence: Abel Negussie
| | - Eshetu Girma
- School of Public Health, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Mirgissa Kaba
- School of Public Health, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
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Brown S, Sprague C, Lindsay AC. Understanding perinatal mental illness as a governance concern in South Africa through health provider perspectives. Glob Public Health 2022; 17:3519-3532. [PMID: 36735659 DOI: 10.1080/17441692.2022.2129727] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Women in South Africa experience a disproportionately high prevalence of common perinatal mental disorders (CPMDs). These disorders often remain a silent burden and a complex health, social, and policy concern, both nationally and globally. Moreover, policy efforts to address this concern have been fragmented. Greater understanding of the governance of perinatal mental illness is needed to address this complex issue. No research to date has focused explicitly on the importance of 'issue framing' to advance governance for perinatal mental health. We sought to achieve a more nuanced understanding of clinical governance and issue framing for perinatal mental health in South Africa by interviewing 24 key informants with expertise in perinatal mental illness. Dominant themes encompassed: framing of perinatal mental health determines its priority; perinatal mental health is not prioritised due to competition from other health concerns; and, screening policy responses are shaped by the framing. We found that understanding the varying views influencing perinatal mental illness provides insights into how experts frame the problem. Findings suggest that a better understanding of policy implementation and responses in South Africa is important in guiding research, policy, and practice, while improving the governance of perinatal mental illness.
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Affiliation(s)
- Shelley Brown
- Department of Conflict Resolution, Human Security, and Global Governance, McCormack Graduate School, University of Massachusetts Boston, Boston, MA, USA.,Department of Health Sciences, Boston University, Boston, MA, USA
| | - Courtenay Sprague
- Department of Conflict Resolution, Human Security, and Global Governance, McCormack Graduate School, University of Massachusetts Boston, Boston, MA, USA.,Department of Nursing, College of Nursing and Health Sciences, University of Massachusetts Boston, Boston, MA, USA
| | - Ana Cristina Lindsay
- Department of Exercise and Health Sciences, Robert and Donna Manning College of Nursing and Health Sciences, University of Massachusetts Boston, Boston, MA, USA
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Existential aspects as an inevitable part of salutogenesis in maternity care – A discussion paper. Women Birth 2022; 35:532-535. [DOI: 10.1016/j.wombi.2022.02.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Revised: 01/28/2022] [Accepted: 02/01/2022] [Indexed: 11/20/2022]
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Jiang Q, Guo Y, Zhang E, Cohen N, Ohtori M, Sun A, Dill SE, Singh MK, She X, Medina A, Rozelle SD. Perinatal Mental Health Problems in Rural China: The Role of Social Factors. Front Psychiatry 2021; 12:636875. [PMID: 34950062 PMCID: PMC8688533 DOI: 10.3389/fpsyt.2021.636875] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2020] [Accepted: 11/08/2021] [Indexed: 01/22/2023] Open
Abstract
Background: Perinatal mental health is important for the well-being of the mother and child, so the relatively high prevalence of perinatal mental health problems in developing settings poses a pressing concern. However, most studies in these settings focus on the demographic factors associated with mental health problems, with very few examing social factors. Hence, this study examines the prevalence of the depressive, anxiety and stress symptoms among pregnant women and new mothers in rural China, and the associations between these mental health problems and social factors, including decision-making power, family conflicts, and social support. Methods: Cross-sectional data were collected from 1,027 women in their second trimester of pregnancy to 6 months postpartum in four low-income rural counties in Sichuan Province, China. Women were surveyed on symptoms of mental health problems using the Depression, Anxiety, and Stress Scale (DASS-21) and social risk factors. Multivariate logistic regression analyses were conducted to examine social risk factors associated with maternal mental health problems, with results reported as odds ratios (OR) and 95% confidence intervals (CI). Results: Among all respondents, 13% showed symptoms of depression, 18% showed symptoms of anxiety, 9% showed symptoms of stress, and 23% showed symptoms of any mental health problem. Decision-making power was negatively associated with showing symptoms of depression (OR = 0.71, CI: 0.60-0.83, p < 0.001) and stress (OR = 0.76, CI: 0.63-0.90, p = 0.002). Family conflict was positively associated with depression (OR = 1.53, CI: 1.30-1.81, p < 0.001), anxiety (OR = 1.34, CI: 1.15-1.56, p < 0.001), and stress (OR = 1.68, CI: 1.41-2.00, p < 0.001). In addition, social support was negatively associated with depression (OR = 0.56, CI: 0.46-0.69, p < 0.001), anxiety (OR = 0.76, CI: 0.63-0.91, p = 0.002), and stress (OR = 0.66, CI: 0.53-0.84, p < 0.001). Subgroup analyses revealed that more social risk factors were associated with symptoms of anxiety and stress among new mothers compared to pregnant women. Conclusion: Perinatal mental health problems are relatively prevalent among rural women in China and are strongly associated with social risk factors. Policies and programs should therefore promote individual coping methods, as well as target family and community members to improve the social conditions contributing to mental health problems among rural women.
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Affiliation(s)
- Qi Jiang
- Stanford Center on China's Economy and Institutions, Freeman Spogli Institute for International Studies, Stanford University, Stanford, CA, United States
| | - Yian Guo
- Stanford Center on China's Economy and Institutions, Freeman Spogli Institute for International Studies, Stanford University, Stanford, CA, United States
| | - Evelyn Zhang
- Stanford Center on China's Economy and Institutions, Freeman Spogli Institute for International Studies, Stanford University, Stanford, CA, United States
| | - Nourya Cohen
- Stanford Center on China's Economy and Institutions, Freeman Spogli Institute for International Studies, Stanford University, Stanford, CA, United States
| | - Mika Ohtori
- Stanford Center on China's Economy and Institutions, Freeman Spogli Institute for International Studies, Stanford University, Stanford, CA, United States
| | - Adrian Sun
- Stanford Center on China's Economy and Institutions, Freeman Spogli Institute for International Studies, Stanford University, Stanford, CA, United States
| | - Sarah-Eve Dill
- Stanford Center on China's Economy and Institutions, Freeman Spogli Institute for International Studies, Stanford University, Stanford, CA, United States
| | - Manpreet Kaur Singh
- Stanford Pediatric Mood Disorders Program, Stanford University, Stanford, CA, United States
| | - Xinshu She
- School of Medicine, Stanford University, Stanford, CA, United States
| | - Alexis Medina
- Stanford Center on China's Economy and Institutions, Freeman Spogli Institute for International Studies, Stanford University, Stanford, CA, United States
| | - Scott D. Rozelle
- Stanford Center on China's Economy and Institutions, Freeman Spogli Institute for International Studies, Stanford University, Stanford, CA, United States
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"Nobody Listened". Mothers' Experiences and Needs Regarding Professional Support Prior to Their Admission to an Infant Mental Health Day Clinic. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182010917. [PMID: 34682666 PMCID: PMC8535578 DOI: 10.3390/ijerph182010917] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/27/2021] [Revised: 10/08/2021] [Accepted: 10/13/2021] [Indexed: 01/09/2023]
Abstract
Challenges during the perinatal period can lead to maternal distress, negatively affecting mother-infant interaction. This study aims to retrospectively explore the experiences and needs regarding professional support of mothers with difficulties in mother-infant interaction prior to their admission to an infant mental health day clinic. In-depth semi-structured interviews were conducted with 13 mothers who had accessed an infant mental health day clinic because of persistent severe infant regulatory problems impairing the wellbeing of the infant and the family. Data were transcribed and analyzed using the Qualitative Analysis Guide of Leuven (QUAGOL). Three themes were identified: 'experience of pregnancy, birth, and parenthood'; 'difficult care paths'; and 'needs and their fulfillment'. The first theme consisted of three subthemes: (1) 'reality does not meet expectations', (2) 'resilience under pressure', and (3) 'despair'. Mothers experienced negative feelings that were in contradiction to the expected positive emotions associated with childbirth and motherhood. Resilience-related problems affected the mother-child relationship, and infants' regulatory capacities. Determined to find solutions, different healthcare providers were consulted. Mothers' search for help was complex and communication between healthcare providers was limited because of a fragmented care provision. This hindered the continuity of care and appropriate referrals. Another pitfall was the lack of a broader approach, with the emphasis on the medical aspects without attention to the mother-child dyad. An integrated care pathway focusing on the early detection of resilience-related problems and sufficient social support can be crucial in the prevention and early detection of perinatal and infant mental health problems.
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van Lee L, Chia A, Phua D, Colega M, Padmapriya N, Bernard JY, Cai S, Tham EKH, Teoh OH, Goh D, Gooley JJ, Gluckman PD, Yap F, Shek LPC, Godfrey KM, Tan KH, Chong YS, Müller-Riemenschneider F, Broekman B, Meaney M, Chen H, Chong MFF. Multiple modifiable lifestyle factors and the risk of perinatal depression during pregnancy: Findings from the GUSTO cohort. Compr Psychiatry 2020; 103:152210. [PMID: 33045668 DOI: 10.1016/j.comppsych.2020.152210] [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] [Received: 03/10/2020] [Revised: 09/24/2020] [Accepted: 09/24/2020] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Studies have identified lifestyle risk factors for perinatal depression, but none have examined the cumulative effect of these risk factors in pregnant women. METHODS We considered the following six factors during pregnancy: poor diet quality (Healthy eating index for Singapore pregnant women<median), poor sleep quality (global Pittsburgh sleep quality index score > 5), physical inactivity (<600 MET-minutes/week), vitamin D insufficiency (<50 nmol/l), smoking before or during pregnancy, and the perceived need for social support. Probable depression was assessed using the Edinburgh postnatal depression scale during pregnancy (>15) and at three months postpartum (≥13). Prevalence risk ratios were calculated with Poisson regressions while adjusting for potential confounders. RESULTS Of 535 pregnant women, 207 (39%) had zero or one risk factor, 146 (27%) had two, 119 (22%) had three, 48 (9%) had four, and 15 (3%) had ≥5 risk factors at 26-28 weeks' gestation. These six lifestyle habits contributed to 32% of the variance in depressive symptoms during pregnancy. The prevalence of being probably depressed was 6.4 (95% CI 2.1, 19.8; ptrend < 0.001) for expecting women who had ≥4 risk factors compared to women who had ≤1 risk factor. No association was observed between the number of risk factors and depressive symptoms at 3 months postpartum (ptrend = 0.746). CONCLUSION Pregnant women with ≥4 lifestyle risk factors showed a higher prevalence of depression during pregnancy, while no associations were observed for postpartum depression. CLINICAL TRIAL REGISTRATION This cohort is registered under the Clinical Trials identifier NCT01174875; http://www.clinicaltrials.gov/ct2/show/NCT01174875?term=GUSTO&rank=2.
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Affiliation(s)
- Linde van Lee
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, Singapore
| | - Airu Chia
- Department of Obstetrics and Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore; Saw Swee Hock School of Public Health, National University of Singapore, Singapore; Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, Singapore
| | - Desiree Phua
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, Singapore
| | - Marjorelee Colega
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, Singapore
| | - Natarajan Padmapriya
- Department of Obstetrics and Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Jonathan Y Bernard
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, Singapore; Early Life Research On Later Health Unit, Centre for Research in Epidemiology and Statistics Sorbonne Paris Cité (CRESS), National Institute of Health and Medical Research (Inserm), Villejuif, France
| | - Shirong Cai
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, Singapore; Department of Obstetrics and Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Elaine K H Tham
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, Singapore
| | - Oon Hoe Teoh
- Department of Paediatrics, KK Women's and Children's Hospital, Singapore
| | - Daniel Goh
- Department of Pediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Joshua J Gooley
- Center for Cognitive Neuroscience, Program in Neuroscience and behavioural disorders, Duke-NUS Medical School, Singapore
| | - Peter D Gluckman
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, Singapore; Liggins Institute, University of Auckland, Auckland, New Zealand
| | - Fabian Yap
- Department of Paediatrics, KK Women's and Children's Hospital, Singapore; Duke-NUS Medical School, Singapore, Singapore; Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore
| | - Lynette P C Shek
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, Singapore; Department of Pediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Keith M Godfrey
- MRC Lifecourse Epidemiology Unit and NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - Kok Hian Tan
- Duke-NUS Medical School, Singapore, Singapore; Department of Maternal Fetal Medicine, KK Women's and Children's Hospital, Singapore
| | - Yap-Seng Chong
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, Singapore; Department of Obstetrics and Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Falk Müller-Riemenschneider
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore; Institute for Social Medicine, Epidemiology and Health Economics, Charite University Medical Centre, Berlin, Germany
| | - Birit Broekman
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, Singapore; Department of Psychiatry, Amsterdam UMC, location VUmc, VU University, Amsterdam, the Netherlands; Department of Psychiatry, Onze Lieve Vrouwe Gasthuis, Amsterdam, the Netherlands
| | - Michael Meaney
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, Singapore; Departments of Psychiatry and Neurology and Neurosurgery, McGill University, Montreal, Canada
| | - Helen Chen
- Department of Psychological Medicine, KK Women's and Children's hospital, Singapore
| | - Mary F F Chong
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, Singapore; Saw Swee Hock School of Public Health, National University of Singapore, Singapore; Clinical Nutrition Research Centre, Agency for Science, Technology and Research, Singapore.
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