1
|
Mkhitaryan M, Avetisyan T, Mkhoyan A, Avetisyan L, Yenkoyan K. A case-control study on pre-, peri-, and neonatal risk factors associated with autism spectrum disorder among Armenian children. Sci Rep 2024; 14:12308. [PMID: 38811666 PMCID: PMC11137108 DOI: 10.1038/s41598-024-63240-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2024] [Accepted: 05/27/2024] [Indexed: 05/31/2024] Open
Abstract
We aimed to investigate the role of pre-, peri- and neonatal risk factors in the development of autism spectrum disorder (ASD) among Armenian children with the goal of detecting and addressing modifiable risk factors to reduce ASD incidence. For this purpose a retrospective case-control study using a random proportional sample of Armenian children with ASD to assess associations between various factors and ASD was conducted. The study was approved by the local ethical committee, and parental written consent was obtained. A total of 168 children with ASD and 329 controls were included in the analysis. Multivariable logistic regression analysis revealed that male gender, maternal weight gain, use of MgB6, self-reported stress during the pregnancy, pregnancy with complications, as well as use of labor-inducing drugs were associated with a significant increase in the odds of ASD, whereas Duphaston use during pregnancy, the longer interpregnancy interval and birth height were associated with decreased odds of ASD. These findings are pertinent as many identified factors may be preventable or modifiable, underscoring the importance of timely and appropriate public health strategies aimed at disease prevention in pregnant women to reduce ASD incidence.
Collapse
Affiliation(s)
- Meri Mkhitaryan
- Neuroscience Laboratory, Cobrain Center, Yerevan State Medical University Named After M. Heratsi, 0025, Yerevan, Armenia
| | - Tamara Avetisyan
- Cobrain Center, Yerevan State Medical University Named After M. Heratsi, 0025, Yerevan, Armenia
- Muratsan University Hospital Complex, Yerevan State Medical University Named After M. Heratsi, 0075, Yerevan, Armenia
| | - Anna Mkhoyan
- Department of Infectious Diseases, Yerevan State Medical University Named After M. Heratsi, 0025, Yerevan, Armenia
| | - Larisa Avetisyan
- Cobrain Center, Yerevan State Medical University Named After M. Heratsi, 0025, Yerevan, Armenia
- Department of Hygiene, Yerevan State Medical University Named After M. Heratsi, 0025, Yerevan, Armenia
| | - Konstantin Yenkoyan
- Neuroscience Laboratory, Cobrain Center, Yerevan State Medical University Named After M. Heratsi, 0025, Yerevan, Armenia.
| |
Collapse
|
2
|
Wei Q, Xiao Y, Yang T, Chen J, Chen L, Wang K, Zhang J, Li L, Jia F, Wu L, Hao Y, Ke X, Yi M, Hong Q, Chen J, Fang S, Wang Y, Wang Q, Jin C, Xu X, Li T. Predicting autism spectrum disorder using maternal risk factors: A multi-center machine learning study. Psychiatry Res 2024; 334:115789. [PMID: 38452495 DOI: 10.1016/j.psychres.2024.115789] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2023] [Revised: 02/02/2024] [Accepted: 02/11/2024] [Indexed: 03/09/2024]
Abstract
Autism spectrum disorder (ASD) is a neurodevelopmental disorder with a complex environmental etiology involving maternal risk factors, which have been combined with machine learning to predict ASD. However, limited studies have considered the factors throughout preconception, perinatal, and postnatal periods, and even fewer have been conducted in multi-center. In this study, five predictive models were developed using 57 maternal risk factors from a cohort across ten cities (ASD:1232, typically developing[TD]: 1090). The extreme gradient boosting model performed best, achieving an accuracy of 66.2 % on the external cohort from three cities (ASD:266, TD:353). The most important risk factors were identified as unstable emotions and lack of multivitamin supplementation using Shapley values. ASD risk scores were calculated based on predicted probabilities from the optimal model and divided into low, medium, and high-risk groups. The logistic analysis indicated that the high-risk group had a significantly increased risk of ASD compared to the low-risk group. Our study demonstrated the potential of machine learning models in predicting the risk for ASD based on maternal factors. The developed model provided insights into the maternal emotion and nutrition factors associated with ASD and highlighted the potential clinical applicability of the developed model in identifying high-risk populations.
Collapse
Affiliation(s)
- Qiuhong Wei
- Children Nutrition Research Center, Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Child Neurodevelopment and Cognitive Disorders, Chongqing, China
| | - Yuanjie Xiao
- Children Nutrition Research Center, Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Child Neurodevelopment and Cognitive Disorders, Chongqing, China
| | - Ting Yang
- Children Nutrition Research Center, Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Child Neurodevelopment and Cognitive Disorders, Chongqing, China
| | - Jie Chen
- Children Nutrition Research Center, Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Child Neurodevelopment and Cognitive Disorders, Chongqing, China
| | - Li Chen
- Department of Children's Healthcare, Children's Hospital of Chongqing Medical University, China
| | - Ke Wang
- Children Nutrition Research Center, Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Child Neurodevelopment and Cognitive Disorders, Chongqing, China; Big Data Center for Children's Medical Care, Children's Hospital of Chongqing Medical University, No. 136. Zhongshan Er Rd, Yuzhong District, Chongqing 400014, China
| | - Jie Zhang
- Xi'an Children's Hospital, Xi'an, China
| | - Ling Li
- Department of Children Rehabilitation, Hainan Women and Children's Medical Center, Haikou, China
| | - Feiyong Jia
- Department of Developmental and Behavioral Pediatric, The First Hospital of Jilin University, Changchun, China
| | - Lijie Wu
- Department of Children's and Adolescent Health, Public Health College of Harbin Medical University, Harbin, China
| | - Yan Hao
- Department of Pediatrics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Xiaoyan Ke
- Child Mental Health Research Center of Nanjing Brain Hospital, Nanjing, China
| | - Mingji Yi
- Department of Child Health Care, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Qi Hong
- Maternal and Child Health Hospital of Baoan, Shenzhen, China
| | - Jinjin Chen
- Department of Child Healthcare, Shanghai Children's Hospital, Shanghai Jiao Tong University, Shanghai, China
| | - Shuanfeng Fang
- Children's Hospital Affiliated to Zhengzhou University, Zhengzhou, China
| | - Yichao Wang
- NHC Key Laboratory of Birth Defect for Research and Prevention, Hunan Provincial Maternal and Child Health Care Hospital, Changsha, China
| | - Qi Wang
- Deyang Maternity & Child Healthcare Hospital, Deyang, China
| | - Chunhua Jin
- Department of Children Health Care, Capital Institute of Pediatrics, Beijing, China
| | - Ximing Xu
- Big Data Center for Children's Medical Care, Children's Hospital of Chongqing Medical University, No. 136. Zhongshan Er Rd, Yuzhong District, Chongqing 400014, China.
| | - Tingyu Li
- Children Nutrition Research Center, Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Child Neurodevelopment and Cognitive Disorders, Chongqing, China.
| |
Collapse
|
3
|
Persson Waye K, Löve J, Lercher P, Dzhambov AM, Klatte M, Schreckenberg D, Belke C, Leist L, Ristovska G, Jeram S, Kanninen KM, Selander J, Arat A, Lachmann T, Clark C, Botteldooren D, White K, Julvez J, Foraster M, Kaprio J, Bolte G, Psyllidis A, Gulliver J, Boshuizen H, Bozzon A, Fels J, Hornikx M, van den Hazel P, Weber M, Brambilla M, Braat-Eggen E, Van Kamp I, Vincens N. Adopting a child perspective for exposome research on mental health and cognitive development - Conceptualisation and opportunities. ENVIRONMENTAL RESEARCH 2023; 239:117279. [PMID: 37778607 DOI: 10.1016/j.envres.2023.117279] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/09/2023] [Revised: 09/27/2023] [Accepted: 09/29/2023] [Indexed: 10/03/2023]
Abstract
Mental disorders among children and adolescents pose a significant global challenge. The exposome framework covering the totality of internal, social and physical exposures over a lifetime provides opportunities to better understand the causes of and processes related to mental health, and cognitive functioning. The paper presents a conceptual framework on exposome, mental health, and cognitive development in children and adolescents, with potential mediating pathways, providing a possibility for interventions along the life course. The paper underscores the significance of adopting a child perspective to the exposome, acknowledging children's specific vulnerability, including differential exposures, susceptibility of effects and capacity to respond; their susceptibility during development and growth, highlighting neurodevelopmental processes from conception to young adulthood that are highly sensitive to external exposures. Further, critical periods when exposures may have significant effects on a child's development and future health are addressed. The paper stresses that children's behaviour, physiology, activity pattern and place for activities make them differently vulnerable to environmental pollutants, and calls for child-specific assessment methods, currently lacking within today's health frameworks. The importance of understanding the interplay between structure and agency is emphasized, where agency is guided by social structures and practices and vice-versa. An intersectional approach that acknowledges the interplay of social and physical exposures as well as a global and rural perspective on exposome is further pointed out. To advance the exposome field, interdisciplinary efforts that involve multiple scientific disciplines are crucial. By adopting a child perspective and incorporating an exposome approach, we can gain a comprehensive understanding of how exposures impact children's mental health and cognitive development leading to better outcomes.
Collapse
Affiliation(s)
- Kerstin Persson Waye
- School of Public Health and Community Medicine, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden.
| | - Jesper Löve
- School of Public Health and Community Medicine, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden
| | - Peter Lercher
- Institute of Highway Engineering and Transport Planning, Graz University of Technology, Graz, Austria
| | - Angel M Dzhambov
- Institute of Highway Engineering and Transport Planning, Graz University of Technology, Graz, Austria; Department of Hygiene, Faculty of Public Health, Medical University of Plovdiv, Plovdiv, Bulgaria; Research Group "Health and Quality of Life in a Green and Sustainable Environment", SRIPD, Medical University of Plovdiv, Plovdiv, Bulgaria; Environmental Health Division, Research Institute at Medical University of Plovdiv, Medical University of Plovdiv, Bulgaria
| | - Maria Klatte
- Cognitive and Developmental Psychology, University of Kaiserslautern-Landau, Kaiserslautern, Germany
| | - Dirk Schreckenberg
- Centre for Applied Psychology, Environmental and Social Research (Zeus GmbH), Hagen, Germany
| | - Christin Belke
- Centre for Applied Psychology, Environmental and Social Research (Zeus GmbH), Hagen, Germany
| | - Larisa Leist
- Cognitive and Developmental Psychology, University of Kaiserslautern-Landau, Kaiserslautern, Germany
| | - Gordana Ristovska
- Institute of Public Health of the Republic of North Macedonia, Skopje, Macedonia
| | - Sonja Jeram
- National Institute of Public Health, Ljubljana, Slovenia
| | - Katja M Kanninen
- A.I. Virtanen Institute for Molecular Sciences, University of Eastern Finland, Kuopio, Finland
| | - Jenny Selander
- Unit of Occupational Medicine, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Arzu Arat
- Unit of Occupational Medicine, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Thomas Lachmann
- Cognitive and Developmental Psychology, University of Kaiserslautern-Landau, Kaiserslautern, Germany; Centro de Investigación Nebrija en Cognición (CINC), Universidad Nebrija, Madrid, Spain
| | - Charlotte Clark
- Population Health Research Institute, St George's, University of London, London, United Kingdom
| | - Dick Botteldooren
- Department of Information Technology, Faculty of Engineering and Architecture, Ghent University, Ghent, Belgium
| | - Kim White
- National Institute for Public Health and the Environment, Netherlands
| | - Jordi Julvez
- Institut D'Investigació Sanitària Pere Virgili (IISPV), Clinical and Epidemiological Neuroscience Group (NeuroÈpia), Reus, Spain
| | | | - Jaakko Kaprio
- Institute for Molecular Medicine Finland and Department of Public Health, University of Helsinki, Helsinki, Finland
| | - Gabriele Bolte
- Institute of Public Health and Nursing Research, University of Bremen, Bremen, Germany
| | - Achilleas Psyllidis
- Department of Sustainable Design Engineering, Delft University of Technology, Delft, the Netherlands
| | - John Gulliver
- Population Health Research Institute, St George's, University of London, London, United Kingdom; Centre for Environmental Health and Sustainability & School of Geography, Geology and the Environment, University of Leicester, Leicester, United Kingdom
| | - Hendriek Boshuizen
- Department for Statistics, Datascience and Mathematical Modelling, National Institute for Public Health and the Environment, Bilthoven, the Netherlands
| | - Alessandro Bozzon
- Department of Sustainable Design Engineering, Delft University of Technology, Delft, the Netherlands
| | - Janina Fels
- Institute for Hearing Technology and Acoustics, RWTH Aachen University, Aachen, Germany
| | - Maarten Hornikx
- Department of the Built Environment, Eindhoven University of Technology, Eindhoven, the Netherlands
| | - Peter van den Hazel
- International Network on Children's Health, Environment and Safety, Ellecom, the Netherlands
| | | | - Marco Brambilla
- Data Science Laboratory, Politecnico di Milano, Milan, Italy
| | | | - Irene Van Kamp
- National Institute for Public Health and the Environment, Netherlands
| | - Natalia Vincens
- School of Public Health and Community Medicine, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden
| |
Collapse
|
4
|
Mariño-Narvaez C, Puertas-Gonzalez JA, Romero-Gonzalez B, Kraneis MC, Peralta-Ramirez MI. Pregnant women's mental health during the COVID-19 pandemic according to the trimester of pregnancy. J Reprod Infant Psychol 2023:1-16. [PMID: 37942780 DOI: 10.1080/02646838.2023.2279039] [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: 04/24/2023] [Accepted: 10/30/2023] [Indexed: 11/10/2023]
Abstract
AIM This study aimed to analyse the psychological impact of the COVID-19 pandemic on pregnant women according to the pregnancy trimester, comparing their psychopathological symptomatology, pregnancy-specific stress, resilience and perceived stress to those of women pregnant before the pandemic. METHODS A total of 797 pregnant women participated in the study, one group of 393 women pregnant before the pandemic and the other of 404 women pregnant during the pandemic. Student-t test was used to analyse continuous data and the Chi-square test was used for categorical data. RESULTS Psychopathological symptomatology was significantly higher in six subscales of the SCL-90-R in pregnant women during COVID-19: somatisation, interpersonal sensitivity, depression, anxiety, phobic anxiety, obsessions-compulsions, mainly on the first two trimesters. There is also a higher level of pregnancy-specific stress in pregnant women during the pandemic on the first two trimesters, most likely due to the hypervigilance and fears related to the COVID-19 disease. Nevertheless, perceived stress, usually elevated during pregnancy, was lower in women pregnant during the pandemic in comparison to those pregnant before, as a positive consequence of being on lockdown and diminishing the exposure to daily stressful situations. CONCLUSIONS Knowing the struggles these women go through during each trimester of pregnancy can be the key to a better health professional-patient relationship, consequently having a positive impact on their mental and physical health.
Collapse
Affiliation(s)
| | - Jose A Puertas-Gonzalez
- Department of Personality, Assessment and Psychological Treatment, Faculty of Psychology, University of Granada, Granada, Spain
| | - Borja Romero-Gonzalez
- Department of Psychology, Faculty of Education, University of Valladolid, Soria, Spain
| | - Marie-Christin Kraneis
- Mind, Brain and Behavior Research Center (CIMCYC), University of Granada, Granada, Spain
| | - Maria Isabel Peralta-Ramirez
- Mind, Brain and Behavior Research Center (CIMCYC), University of Granada, Granada, Spain
- Department of Personality, Assessment and Psychological Treatment, Faculty of Psychology, University of Granada, Granada, Spain
| |
Collapse
|
5
|
Pajek J, Mancini K, Murray M. COVID-19 and children's behavioral health: An overview. Curr Probl Pediatr Adolesc Health Care 2023; 53:101491. [PMID: 38040607 DOI: 10.1016/j.cppeds.2023.101491] [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] [Indexed: 12/03/2023]
Abstract
The paper reviews the impact of the COVID-19 pandemic on children's and adolescents' well-being. A trauma-informed framework is employed to discuss the emerging evidence of notable changes in youth's psychological, developmental, academic, and social well-being since the start of the COVID-19 pandemic. Children and adolescents have been uniquely affected based on their age at the start of the pandemic. Despite multiple resiliency factors, COVID-19 and its ramifications have had an adverse effect on youth in general and have exacerbated preexisting racial and socioeconomic disparities. This review concludes with recommendations for child health clinicians.
Collapse
Affiliation(s)
- Julie Pajek
- MetroHealth Medical Center, Case Western Reserve University School of Medicine, 2500 MetroHealth Drive, Cleveland, OH 44109, USA.
| | - Kathryn Mancini
- MetroHealth Medical Center, Case Western Reserve University School of Medicine, 2500 MetroHealth Drive, Cleveland, OH 44109, USA
| | - Marsheena Murray
- MetroHealth Medical Center, Case Western Reserve University School of Medicine, 2500 MetroHealth Drive, Cleveland, OH 44109, USA
| |
Collapse
|
6
|
Despriee ÅW, Småstuen MC, Glavin K, Lødrup Carlsen KC, Magi CAO, Söderhäll C, Hedlin G, Nordhagen L, Jonassen CM, Rehbinder EM, Nordlund B, Skjerven H. Infant colic and abdominal pain; associations with infant multimorbidity and maternal perceived stress up to 3 months postpartum-A cross-sectional/cohort study in the PreventADALL study. J Clin Nurs 2023; 32:7605-7617. [PMID: 37462350 DOI: 10.1111/jocn.16825] [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: 09/09/2022] [Revised: 05/26/2023] [Accepted: 07/03/2023] [Indexed: 09/21/2023]
Abstract
AIMS AND OBJECTIVES The primary aim was to explore whether infants with pain symptoms (colic, abdominal pain and visit to healthcare provider with pain or other discomforts) had increased multimorbidity (common infections, eczema and food sensitivity) compared with infants without these conditions. Secondarily, we aimed to determine whether infant pain symptoms were associated with maternal perceived stress in pregnancy and 3 months postpartum. BACKGROUND Infant colic and abdominal pain are common concerns in early infancy. Nevertheless, to our knowledge, little research exists on the relationship between infant pain and common infant infections, eczema and food sensitization as comorbidities, and the impact of infant pain on the development of maternal perceived stress from pregnancy to infancy is inconsistent. DESIGN This study was cross-sectional and partly prospective. METHODS The sample consisted of mother-infant pairs (N = 1852); information regarding infant pain and multimorbidity was collected from the 3-month questionnaire and postpartum visits in the PreventADALL prospective cohort study. Chi-square tests and regression analyses were conducted. The STROBE checklist was followed. RESULTS Our results showed a statistically significant higher proportion of respiratory and other infections in infants with pain symptoms. The odds of infant pain were higher for infants with multimorbidity compared to those with no comorbidity. Mothers of infants with colic and of infants visiting healthcare with pain and other discomforts reported statistically significant higher perceived stress by 3 months compared with mothers of infants with no reported pain. CONCLUSION Our results indicate an association between infant pain symptoms and the presence of infections. Mothers of infants with colic and visiting healthcare had higher perceived stress compared to the no pain group. IMPLICATIONS FOR PRACTICE Our study indicates that infant pain is associated with infant multimorbidity and maternal perceived stress, which may be useful when planning diagnostic, treatment and coping strategies in infant and family care. PATIENT OR PUBLIC CONTRIBUTION The PreventADALL is a collaborative study with governmental and patient organisation representation. Selected infants with parents were also contributing during calibrating courses on eczema assessment for the data collectors. TRIAL REGISTRATION The study was approved by the Regional Committee in Norway (2014/518) and Sweden (2014/2242-31/4) and registered at clinicaltrial.gov (NCT02449850). Link for clinical trials: https://clinicaltrials.gov/ct2/show/NCT02449850.
Collapse
Affiliation(s)
- Åshild Wik Despriee
- Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- VID Specialized University, Oslo, Norway
| | | | | | - Karin C Lødrup Carlsen
- Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Division of Paediatric and Adolescent Medicine, Oslo University Hospital, Oslo, Norway
| | - Caroline Aleksi Olsson Magi
- Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden
- Astrid Lindgren Children's Hospital, Karolinska University Hospital, Stockholm, Sweden
| | - Cilla Söderhäll
- Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden
- Astrid Lindgren Children's Hospital, Karolinska University Hospital, Stockholm, Sweden
| | - Gunilla Hedlin
- Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden
- Astrid Lindgren Children's Hospital, Karolinska University Hospital, Stockholm, Sweden
| | | | - Christine M Jonassen
- Center for Laboratory Medicine, Østfold Hospital Trust, Grålum, Norway
- Department of Dermatology, Oslo University Hospital, Oslo, Norway
| | - Eva Maria Rehbinder
- Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Division of Paediatric and Adolescent Medicine, Oslo University Hospital, Oslo, Norway
- Department of Dermatology and Venaerology, Oslo University Hospital, Oslo, Norway
| | - Björn Nordlund
- Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden
- Astrid Lindgren Children's Hospital, Karolinska University Hospital, Stockholm, Sweden
| | - Håvard Skjerven
- Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Division of Paediatric and Adolescent Medicine, Oslo University Hospital, Oslo, Norway
| |
Collapse
|
7
|
Van Haeken S, Braeken MAKA, Horsch A, Oosterman M, Bogaerts A. Development of a resilience-enhancing intervention during and after pregnancy: a systematic process informed by the behaviour change wheel framework. BMC Psychol 2023; 11:267. [PMID: 37670333 PMCID: PMC10481562 DOI: 10.1186/s40359-023-01301-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Accepted: 08/23/2023] [Indexed: 09/07/2023] Open
Abstract
BACKGROUND Pregnancy and the transition to parenthood are accompanied by multiple changes and stress exposure. Resilience has the potential to counteract the negative impact of stress and can be a protective factor against mental health problems. To date, the use of a theoretical framework in the development or application of resilience interventions during pregnancy up to one year postpartum is missing. The aim of this study is to develop an intervention to enhance resilience for pregnant women up to one year postpartum. METHODS A systematic and theory-based approach informed by the Behaviour Change Wheel framework and the theoretical model of perinatal resilience was applied. The development took place in three phases and during the process, the target group, researchers and clinicians were involved. RESULTS A combination of resilience-enhancing exercises, group sessions and an online support platform, including follow-up at six and twelve months after delivery, was designed to enhance resilience during pregnancy and up to one year postpartum. This intervention incorporates 5 intervention functions delivered by 18 behaviour change techniques. CONCLUSIONS This study responds to the need for theory-based intervention programs aiming to enhance resilience to improve the psychological health of pregnant women. We developed a multicomponent resilience-enhancing intervention for pregnant women up to one year postpartum.
Collapse
Affiliation(s)
- Sarah Van Haeken
- Research & Expertise, Resilient People, UC Leuven-Limburg, Wetenschapspark 21, 3590, Diepenbeek, Belgium.
- Faculty of Medicine, department of Development & Regeneration, REALIFE Research Group, Women & Child KU Leuven, Leuven, Belgium.
| | - Marijke A K A Braeken
- Faculty of Rehabilitation Sciences, REVAL-Rehabilitation Research Center, Hasselt University, Diepenbeek, Belgium
| | - Antje Horsch
- Institute of Higher Education and Research in Healthcare, University of Lausanne, Lausanne, Switzerland
- Department Woman-Mother-Child, Faculty of Biology and Medicine, Lausanne University Hospital, Lausanne, Switzerland
| | - Mirjam Oosterman
- Department of Clinical Child and Family Studies, Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - Annick Bogaerts
- Faculty of Medicine, department of Development & Regeneration, REALIFE Research Group, Women & Child KU Leuven, Leuven, Belgium
- Department of Nursing and Midwifery, CRIC Centre for Research & Innovation in Care, University of Antwerp, Antwerp, Belgium
- Faculty of Health, University of Plymouth, Devon, UK
| |
Collapse
|
8
|
Khoury JE, Atkinson L, Jack S, Bennett T, Raha S, Duku E, Gonzalez A. Protocol for the COVID-19 Wellbeing and Stress Study: a longitudinal study of parent distress, biological stress and child biopsychosocial development during the pandemic and beyond. BMJ Open 2023; 13:e071926. [PMID: 37580092 PMCID: PMC10432660 DOI: 10.1136/bmjopen-2023-071926] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2023] [Accepted: 05/22/2023] [Indexed: 08/16/2023] Open
Abstract
INTRODUCTION The COVID-19 pandemic has had a unique impact on the mental health and well-being of pregnant individuals and parents of young children. However, the impact of COVID-19-related stress during pregnancy on early child biopsychosocial development, remains unclear. The COVID-19 Wellbeing and Stress Study will: (1) investigate the impact of different forms of prenatal stress experienced during the pandemic (including objective hardship, perceived psychological distress and biological stress) on child stress biology, (2) examine the association between child stress biology and child developmental outcomes, (3) determine whether child stress biology acts as a mechanism linking prenatal stress to adverse child developmental outcomes and (4) assess whether gestational age at the onset of the COVID-19 pandemic or child sex, moderate these associations. METHODS AND ANALYSES The COVID-19 Wellbeing and Stress Study is a prospective longitudinal study, consisting of six time points, spanning from pregnancy to 3 years postpartum. The study began in June 2020, consisting of 304 pregnant people from Ontario, Canada. This multimethod study is composed of questionnaires, biological samples, behavioural observations and developmental assessments ETHICS AND DISSEMINATION: This study was approved by the Hamilton Integrated Research Ethics Board (#11034) and the Mount Saint Vincent University Research Ethics Board (#2020-187, #2021-075, #2022-008). Findings will be disseminated through peer-reviewed presentations and publications, community presentations, and electronic forums (social media, newsletters and website postings).
Collapse
Affiliation(s)
- Jennifer E Khoury
- Department of Psychology, Mount Saint Vincent University, Halifax, Nova Scotia, Canada
| | - Leslie Atkinson
- Department of Psychology, Toronto Metropolitan University, Toronto, Ontario, Canada
| | - Susan Jack
- School of Nursing, McMaster University, Hamilton, Ontario, Canada
| | - Teresa Bennett
- Psychiatry and Behavioural Neuroscience, McMaster University, Hamilton, Ontario, Canada
- Offord Centre for Child Studies, McMaster University, Hamilton, Ontario, Canada
| | - Sandeep Raha
- Department of Biochemistry & Biomedical Sciences, McMaster University, Hamilton, Ontario, Canada
| | - Eric Duku
- Offord Centre for Child Studies, McMaster University, Hamilton, Ontario, Canada
| | - Andrea Gonzalez
- Psychiatry and Behavioural Neuroscience, McMaster University, Hamilton, Ontario, Canada
- Offord Centre for Child Studies, McMaster University, Hamilton, Ontario, Canada
| |
Collapse
|
9
|
Seebeck J, Sznajder KK, Kjerulff KH. The association between prenatal psychosocial factors and autism spectrum disorder in offspring at 3 years: a prospective cohort study. Soc Psychiatry Psychiatr Epidemiol 2023:10.1007/s00127-023-02538-5. [PMID: 37556019 DOI: 10.1007/s00127-023-02538-5] [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: 12/20/2022] [Accepted: 07/30/2023] [Indexed: 08/10/2023]
Abstract
PURPOSE Few studies of risk factors for autism spectrum disorder (ASD) have been prospective in design or investigated the role of psychosocial factors measured during pregnancy. We aimed to investigate associations between prenatal psychosocial factors and risk of ASD in offspring, as part of a multicenter prospective cohort study of more than 2000 mother-child pairs. METHODS Nulliparous women aged 18-35 years, living in Pennsylvania, USA, were interviewed during pregnancy and multiple times postpartum over the course of a 3-year period. There were 2388 mothers who completed the Screen for Social Interaction Toddler Version (SSI-T), a measure of risk of ASD, when their child was 3-years old. Multivariable logistic regression models were used to investigate the associations between prenatal psychosocial factors-including total scores on three scales (social-support, stress and depression), trouble paying for basic needs, mental illness diagnosis and use of antidepressants-and risk of ASD in offspring at the age of 3-years, controlling for relevant confounding variables. RESULTS There were 102 children (4.3%) who were scored as at-risk of ASD at 3-years. Prenatal psychosocial factors that were significantly associated with risk of ASD in the adjusted models were lower social-support (p < 0.001); stress (p = 0.003): depression (< 0.001), trouble paying for basic needs (p = 0.012), mental illness diagnosis (p = 0.016), and use of antidepressants (p < 0.001). CONCLUSION These findings suggest that maternal experience of adverse psychosocial factors during pregnancy may be important intrauterine exposures related to the pathogenesis of ASD.
Collapse
|
10
|
Khoury JE, Jambon M, Giles L, Atkinson L, Gonzalez A. Trajectories of distress from pregnancy to 15-months post-partum during the COVID-19 pandemic. Front Psychol 2023; 14:1104386. [PMID: 37063573 PMCID: PMC10102331 DOI: 10.3389/fpsyg.2023.1104386] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Accepted: 02/15/2023] [Indexed: 04/03/2023] Open
Abstract
BackgroundThe COVID-19 pandemic has particularly burdened pregnant and postpartum women. It remains unclear how distress levels of pregnant and postpartum people have changed (or persisted) as the pandemic continues on and which factors may contribute to these trajectories of distress.MethodsThis longitudinal study included 304 pregnant people, who were followed during pregnancy, 6-weeks, 6-months and 15-months postpartum. At each time point, a latent “distress” factor was estimated using self-reported depressive symptoms, anxiety symptoms, and stress. Reported negative impact of COVID-19 and social support were assessed during pregnancy as risk and protective factors related to distress. Second-order latent growth curve modeling with a piecewise growth function was used to estimate initial levels and changes in distress over time.ResultsMean distress was relatively stable from the pregnancy to 6-weeks postpartum and then declined from 6-weeks to 15-months postpartum. Higher education, greater social support, and lower negative impact of COVID-19 were associated with a lower distress during pregnancy. Unexpectedly, negative impact of COVID-19 was associated with a faster decrease in distress and more social support was associated with a greater increase in distress from pregnancy to 6-weeks postpartum. However, these effects became non-significant after controlling for distress during pregnancy.ConclusionFindings indicate high but declining levels of distress from pregnancy to the postpartum period. Changes in distress are related to social support and the negative impact of the pandemic in pregnancy. Findings highlight the continued impact of COVID-19 on perinatal mental health and the need for support to limit the burden of this pandemic on pregnant people and families.
Collapse
Affiliation(s)
- Jennifer E. Khoury
- Department of Psychology, Mount Saint Vincent University, Halifax, NS, Canada
- *Correspondence: Jennifer E. Khoury,
| | - Marc Jambon
- Department of Psychology, Wilfrid Laurier University, Waterloo, ON, Canada
| | - Lauren Giles
- Department of Psychology, Mount Saint Vincent University, Halifax, NS, Canada
| | - Leslie Atkinson
- Department of Psychology, Metropolitan Toronto University, Toronto ON, Canada
| | - Andrea Gonzalez
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada
- Offord Centre for Child Studies, McMaster University, Hamilton, ON, Canada
| |
Collapse
|
11
|
Comparing prenatal and postpartum stress among women with previous adverse pregnancy outcomes and normal obstetric histories: A longitudinal cohort study. SEXUAL & REPRODUCTIVE HEALTHCARE 2023; 35:100820. [PMID: 36774741 DOI: 10.1016/j.srhc.2023.100820] [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: 10/06/2022] [Revised: 01/24/2023] [Accepted: 02/05/2023] [Indexed: 02/10/2023]
Abstract
OBJECTIVE The aim of this study was to compare subjectively and objectively measured stress during pregnancy and the three months postpartum in women with previous adverse pregnancy outcomes and women with normal obstetric histories. METHODS We recruited two cohorts in southwestern Finland for this longitudinal study: (1) pregnant women (n = 32) with histories of preterm births or late miscarriages January-December 2019 and (2) pregnant women (n = 30) with histories of full-term births October 2019-March 2020. We continuously measured heart rate variability (HRV) using a smartwatch from 12 to 15 weeks of pregnancy until three months postpartum, and subjective stress was assessed with a smartphone application. RESULTS We recruited the women in both cohorts at a median of 14.2 weeks of pregnancy. The women with previous adverse pregnancy outcomes delivered earlier and more often through Caesarean section compared with the women with normal obstetric histories. We found differences in subjective stress between the cohorts in pregnancy weeks 29 and 34. The cohort of women with previous adverse pregnancy outcomes had a higher root mean square of successive differences between normal heartbeats (RMSSD), a well-known HRV parameter, compared with the other cohort in pregnancy weeks 26 (64.9 vs 55.0, p = 0.04) and 32 (63.0 vs 52.3, p = 0.04). Subjective stress did not correlate with HRV parameters. CONCLUSIONS Women with previous adverse pregnancy outcomes do not suffer from stress in subsequent pregnancies more than women with normal obstetric histories. Healthcare professionals need to be aware that interindividual variation in stress during pregnancy is considerable.
Collapse
|
12
|
Benefits and Risks of Antidepressant Drugs During Pregnancy: A Systematic Review of Meta-analyses. Paediatr Drugs 2023; 25:247-265. [PMID: 36853497 DOI: 10.1007/s40272-023-00561-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/06/2023] [Indexed: 03/01/2023]
Abstract
BACKGROUND The prescription of antidepressant drugs during pregnancy has been steadily increasing for several decades. Meta-analyses (MAs), which increase the statistical power and precision of results, have gained interest for assessing the safety of antidepressant drugs during pregnancy. OBJECTIVE We aimed to provide a meta-review of MAs assessing the benefits and risks of antidepressant drug use during pregnancy. METHODS Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, a literature search on PubMed and Web of Science databases was conducted on 25 October, 2021, on MAs assessing the association between antidepressant drug use during pregnancy and health outcomes for the pregnant women, embryo, fetus, newborn, and developing child. Study selection and data extraction were carried out independently and in duplicate by two authors. The methodological quality of included studies was evaluated with the AMSTAR-2 tool. Overlap among MAs was assessed by calculating the corrected covered area. Data were presented in a narrative synthesis, using four levels of evidence. RESULTS Fifty-one MAs were included, all but one assessing risks. These provided evidence for a significant increase in the risks for major congenital malformations (selective serotonin reuptake inhibitors, paroxetine, fluoxetine, no evidence for sertraline; eight MAs), congenital heart defects (paroxetine, fluoxetine, sertraline; 11 MAs), preterm birth (eight MAs), neonatal adaptation symptoms (eight MAs), and persistent pulmonary hypertension of the newborn (three MAs). There was limited evidence (only one MA for each outcome) for a significant increase in the risks for postpartum hemorrhage, and with a high risk of bias, for stillbirth, impaired motor development, and intellectual disability. There was inconclusive evidence, i.e., discrepant results, for an increase in the risks for spontaneous abortion, small for gestational age and low birthweight, respiratory distress, convulsions, feeding problems, and for a subsequent risk for autism with an early antidepressant drug exposure. Finally, MAs provided no evidence for an increase in the risks for gestational hypertension, preeclampsia, and for a subsequent risk for attention-deficit/hyperactivity disorder. Only one MA assessed benefits, providing limited evidence for preventing relapse in severe or recurrent depression. Effect sizes were small, except for neonatal symptoms (small to large). Results were based on MAs in which overall methodological quality was low (AMSTAR-2 score = 54.8% ± 12.9%, [19-81%]), with a high risk of bias, notably indication bias. The corrected covered area was 3.27%, which corresponds to a slight overlap. CONCLUSIONS This meta-review has implications for clinical practice and future research. First, these results suggest that antidepressant drugs should be used as a second-line treatment during pregnancy (after first-line psychotherapy, according to the guidelines). The risk of major congenital malformations could be prevented by observing guidelines that discourage the use of paroxetine and fluoxetine. Second, to decrease heterogeneity and bias, future MAs should adjust for maternal psychiatric disorders and antidepressant drug dosage, and perform analyses by timing of exposure.
Collapse
|
13
|
Martinez-Vazquez S, Riquelme-Gallego B, Lugo-Toro LJ, Lucena-Prieto L, Garrido-Torres N, Lopez-Soto T, Caparros-Gonzalez RA, De la Torre-Luque A. Maternal Psychopathological Profile during Childbirth and Neonatal Development during the COVID-19 Pandemic: A Pre-Posttest Study. Behav Sci (Basel) 2023; 13:80. [PMID: 36829309 PMCID: PMC9952727 DOI: 10.3390/bs13020080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2022] [Revised: 01/12/2023] [Accepted: 01/16/2023] [Indexed: 01/20/2023] Open
Abstract
The coronavirus SARS-CoV-2 generated an alert that became a state of emergency in health issues worldwide, a situation that affected the entire population, including pregnant women. The present study aims to understand the effect of the psychopathological profile of a sample of pregnant women at the time of the COVID-19 pandemic on themselves during childbirth (Phase 1) and after childbirth and the anthropometric measures of the neonate at birth (Phase 2). The total sample comprises 81 pregnant women aged 32.07 years (SD = 5.45) and their neonates. Sociodemographic and obstetric data of the sample were collected. During pregnancy, psychopathology was measured by means of the SCL-90, as well as other psychological measures on stress and social support. Cluster k-means techniques were used to uncover the heterogeneous profiles of psychopathology in Phase 1. Two main psychopathological profiles were found (Cluster 1: High psychopathological symptoms; Cluster 2: Low psychopathological symptoms). The clusters generated show significant differences in all the SCL-90-R subscales used and in the general index at Phase 1. After childbirth, high psychopathology profile membership was associated with a greater probability of having a non-eutocic delivery. On the other hand, the low psychopathological symptoms cluster shows higher levels of depressive symptoms, hostility, paranoid ideation, and psychotic symptoms in Phase 2. In conclusion, there seemed to exist two heterogeneous profiles of psychopathology in pregnant women during the pandemic; the stress related to the pandemic seemed uninfluential on the development of a profile of high psychopathological symptoms and the psychopathology profile may influence delivery and postpartum outcomes.
Collapse
Affiliation(s)
| | | | | | - Lidia Lucena-Prieto
- Department of Obstetrics and Gynecology, Delivery Ward, Hospital Antequera, 29200 Malaga, Spain
| | | | - Teresa Lopez-Soto
- English Language Department, University of Seville, 41004 Seville, Spain
| | - Rafael A. Caparros-Gonzalez
- Instituto de Investigación Biosanitaria (ibs.GRANADA), 18014 Granada, Spain
- Department of Nursing, The University of Granada, 18071 Granada, Spain
| | - Alejandro De la Torre-Luque
- Department of Legal Medicine, Psychiatry and Pathology, Complutense University of Madrid, CIBERSAM ISCIII, 28040 Madrid, Spain
| |
Collapse
|
14
|
Petitfils C, Maurel S, Payros G, Hueber A, Agaiz B, Gazzo G, Marrocco R, Auvray F, Langevin G, Motta JP, Floch P, Tremblay-Franco M, Galano JM, Guy A, Durand T, Lachambre S, Durbec A, Hussein H, Decraecker L, Bertrand-Michel J, Saoudi A, Oswald E, Poisbeau P, Dietrich G, Melchior C, Boeckxstaens G, Serino M, Le Faouder P, Cenac N. Identification of bacterial lipopeptides as key players in IBS. Gut 2022; 72:939-950. [PMID: 36241390 PMCID: PMC10086498 DOI: 10.1136/gutjnl-2022-328084] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2022] [Accepted: 09/27/2022] [Indexed: 12/08/2022]
Abstract
OBJECTIVES Clinical studies revealed that early-life adverse events contribute to the development of IBS in adulthood. The aim of our study was to investigate the relationship between prenatal stress (PS), gut microbiota and visceral hypersensitivity with a focus on bacterial lipopeptides containing γ-aminobutyric acid (GABA). DESIGN We developed a model of PS in mice and evaluated, in adult offspring, visceral hypersensitivity to colorectal distension (CRD), colon inflammation, barrier function and gut microbiota taxonomy. We quantified the production of lipopeptides containing GABA by mass spectrometry in a specific strain of bacteria decreased in PS, in PS mouse colons, and in faeces of patients with IBS and healthy volunteers (HVs). Finally, we assessed their effect on PS-induced visceral hypersensitivity. RESULTS Prenatally stressed mice of both sexes presented visceral hypersensitivity, no overt colon inflammation or barrier dysfunction but a gut microbiota dysbiosis. The dysbiosis was distinguished by a decreased abundance of Ligilactobacillus murinus, in both sexes, inversely correlated with visceral hypersensitivity to CRD in mice. An isolate from this bacterial species produced several lipopeptides containing GABA including C14AsnGABA. Interestingly, intracolonic treatment with C14AsnGABA decreased the visceral sensitivity of PS mice to CRD. The concentration of C16LeuGABA, a lipopeptide which inhibited sensory neurons activation, was decreased in faeces of patients with IBS compared with HVs. CONCLUSION PS impacts the gut microbiota composition and metabolic function in adulthood. The reduced capacity of the gut microbiota to produce GABA lipopeptides could be one of the mechanisms linking PS and visceral hypersensitivity in adulthood.
Collapse
Affiliation(s)
- Camille Petitfils
- IRSD, Université de Toulouse-Paul Sabatier, INSERM, INRAe, ENVT, UPS, Toulouse, France
| | - Sarah Maurel
- IRSD, Université de Toulouse-Paul Sabatier, INSERM, INRAe, ENVT, UPS, Toulouse, France
| | - Gaelle Payros
- IRSD, Université de Toulouse-Paul Sabatier, INSERM, INRAe, ENVT, UPS, Toulouse, France
| | - Amandine Hueber
- Lipidomic, MetaboHUB-MetaToul, National Infrastructure of Metabolomics and Fluxomics, Toulouse, France.,I2MC, Université de Toulouse, Inserm, Université Toulouse III - Paul Sabatier (UPS), Toulouse, France
| | - Bahija Agaiz
- IRSD, Université de Toulouse-Paul Sabatier, INSERM, INRAe, ENVT, UPS, Toulouse, France
| | - Géraldine Gazzo
- Institut des Neurosciences Cellulaire et Integrative (INCI), Centre National de la Recherche Scientifique, Université de Strasbourg, Strasbourg, France
| | - Rémi Marrocco
- INFINITY, Université de Toulouse-Paul Sabatier, INSERM, CNRS, UPS, Toulouse, France
| | - Frédéric Auvray
- IRSD, Université de Toulouse-Paul Sabatier, INSERM, INRAe, ENVT, UPS, Toulouse, France
| | - Geoffrey Langevin
- Institut des Biomolécules Max Mousseron (IBMM), UMR 5247, CNRS, Université de Montpellier, ENSCM, Montpellier, France
| | - Jean-Paul Motta
- IRSD, Université de Toulouse-Paul Sabatier, INSERM, INRAe, ENVT, UPS, Toulouse, France
| | - Pauline Floch
- IRSD, Université de Toulouse-Paul Sabatier, INSERM, INRAe, ENVT, UPS, Toulouse, France.,Service de bactériologie-hygiène, CHU Toulouse, Hôpital Purpan, Toulouse, France
| | - Marie Tremblay-Franco
- Toxalim (Research Center in Food Toxicology), Toulouse University, INRAE, ENVT, INP-Purpan, UPS, Toulouse, France.,Metatoul-AXIOM Platform, MetaboHUB, Toxalim, INRAE, Toulouse, France
| | - Jean-Marie Galano
- Institut des Biomolécules Max Mousseron (IBMM), UMR 5247, CNRS, Université de Montpellier, ENSCM, Montpellier, France
| | - Alexandre Guy
- Institut des Biomolécules Max Mousseron (IBMM), UMR 5247, CNRS, Université de Montpellier, ENSCM, Montpellier, France
| | - Thierry Durand
- Institut des Biomolécules Max Mousseron (IBMM), UMR 5247, CNRS, Université de Montpellier, ENSCM, Montpellier, France
| | - Simon Lachambre
- INFINITY, Université de Toulouse-Paul Sabatier, INSERM, CNRS, UPS, Toulouse, France
| | - Anaëlle Durbec
- Lipidomic, MetaboHUB-MetaToul, National Infrastructure of Metabolomics and Fluxomics, Toulouse, France.,I2MC, Université de Toulouse, Inserm, Université Toulouse III - Paul Sabatier (UPS), Toulouse, France
| | - Hind Hussein
- Laboratory of Intestinal Neuro-immune Interaction, Translational Research Center for Gastrointestinal Disorders, Department of Chronic Diseases, Metabolism and Ageing, KU Leuven, Leuven, Belgium
| | - Lisse Decraecker
- Laboratory of Intestinal Neuro-immune Interaction, Translational Research Center for Gastrointestinal Disorders, Department of Chronic Diseases, Metabolism and Ageing, KU Leuven, Leuven, Belgium
| | - Justine Bertrand-Michel
- Lipidomic, MetaboHUB-MetaToul, National Infrastructure of Metabolomics and Fluxomics, Toulouse, France.,I2MC, Université de Toulouse, Inserm, Université Toulouse III - Paul Sabatier (UPS), Toulouse, France
| | - Abdelhadi Saoudi
- INFINITY, Université de Toulouse-Paul Sabatier, INSERM, CNRS, UPS, Toulouse, France
| | - Eric Oswald
- IRSD, Université de Toulouse-Paul Sabatier, INSERM, INRAe, ENVT, UPS, Toulouse, France.,Service de bactériologie-hygiène, CHU Toulouse, Hôpital Purpan, Toulouse, France
| | - Pierrick Poisbeau
- Institut des Neurosciences Cellulaire et Integrative (INCI), Centre National de la Recherche Scientifique, Université de Strasbourg, Strasbourg, France
| | - Gilles Dietrich
- IRSD, Université de Toulouse-Paul Sabatier, INSERM, INRAe, ENVT, UPS, Toulouse, France
| | - Chloe Melchior
- Gastroenterology Department, Rouen University Hospital, Rouen, France.,Institute for Research and Innovation in Biomedicine, INSERM CIC-CRB 1404, INSERM UMR 1073, Normandy University, Rouen, France.,Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Guy Boeckxstaens
- Laboratory of Intestinal Neuro-immune Interaction, Translational Research Center for Gastrointestinal Disorders, Department of Chronic Diseases, Metabolism and Ageing, KU Leuven, Leuven, Belgium
| | - Matteo Serino
- IRSD, Université de Toulouse-Paul Sabatier, INSERM, INRAe, ENVT, UPS, Toulouse, France
| | - Pauline Le Faouder
- Lipidomic, MetaboHUB-MetaToul, National Infrastructure of Metabolomics and Fluxomics, Toulouse, France.,I2MC, Université de Toulouse, Inserm, Université Toulouse III - Paul Sabatier (UPS), Toulouse, France
| | - Nicolas Cenac
- IRSD, Université de Toulouse-Paul Sabatier, INSERM, INRAe, ENVT, UPS, Toulouse, France
| |
Collapse
|
15
|
"I would never be able to forgive myself if it ended up having consequences for the child": A qualitative study of perceptions of stress and worries among healthy first-time pregnant Danish women. Midwifery 2022; 112:103421. [DOI: 10.1016/j.midw.2022.103421] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Revised: 06/10/2022] [Accepted: 07/01/2022] [Indexed: 11/23/2022]
|
16
|
Parayiwa C, Harley D, Clark R, Behie A, Lal A. Association between severe cyclone events and birth outcomes in Queensland, Australia, 2008-2018: a population based retrospective cohort study. Aust N Z J Public Health 2022; 46:835-841. [PMID: 35735907 DOI: 10.1111/1753-6405.13273] [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: 08/01/2021] [Revised: 03/01/2022] [Accepted: 05/01/2022] [Indexed: 11/28/2022] Open
Abstract
OBJECTIVE Investigate an association between severe tropical cyclones (TCs) and birth outcomes in an Australian population. METHODS We analysed over 600,000 singleton livebirths collected through the Queensland Perinatal Data Collection between 2008 and 2018. We estimated the odds ratios (ORs) of adverse birth outcomes using logistic multi-level modelling. RESULTS Exposure to TCs in early pregnancy was associated with significantly higher odds of preterm births in affected compared to unaffected areas during the TC year [OR=1.28, 95%CI=1.11, 1.49, p=0.001] and slightly significant higher odds in affected areas during TC years compared to non-TC years. Significantly higher odds of low birthweight births were associated with mid-pregnancy exposure to cyclone Marcia [OR=1.62, 95%CI=1.00, 2.40, p=0.016] . CONCLUSIONS Findings aligned with studies demonstrating an association between exposure to environmental stressors in early to mid-pregnancy and adverse birth outcomes. IMPLICATIONS FOR PUBLIC HEALTH There is limited research into TCs and perinatal health in Australia despite most of the population residing along coastlines and TCs presenting one of the nation's most devastating weather events. This study will inform public health practice and contribute to further research into mitigating environmental risks faced by pregnant women.
Collapse
Affiliation(s)
- Cynthia Parayiwa
- School of Archaeology and Anthropology, The Australian National University, Australian Capital Territory
| | - David Harley
- UQ Centre for Clinical Research, Faculty of Medicine, University of Queensland (UQ)
| | - Robert Clark
- Research School of Finance, Actuarial Studies and Statistics, College of Business & Economics, Australian National University, Australian Capital Territory
| | - Alison Behie
- School of Archaeology and Anthropology, The Australian National University, Australian Capital Territory
| | - Aparna Lal
- Research School of Population Health, National Centre for Epidemiology and Population Health (NCEPH), Australian National University, Australian Capital Territory
| |
Collapse
|
17
|
Shuffrey LC, Firestein MR, Kyle MH, Fields A, Alcántara C, Amso D, Austin J, Bain JM, Barbosa J, Bence M, Bianco C, Fernández CR, Goldman S, Gyamfi-Bannerman C, Hott V, Hu Y, Hussain M, Factor-Litvak P, Lucchini M, Mandel A, Marsh R, McBrian D, Mourad M, Muhle R, Noble KG, Penn AA, Rodriguez C, Sania A, Silver WG, O’Reilly KC, Stockwell M, Tottenham N, Welch MG, Zork N, Fifer WP, Monk C, Dumitriu D. Association of Birth During the COVID-19 Pandemic With Neurodevelopmental Status at 6 Months in Infants With and Without In Utero Exposure to Maternal SARS-CoV-2 Infection. JAMA Pediatr 2022; 176:e215563. [PMID: 34982107 PMCID: PMC8728661 DOI: 10.1001/jamapediatrics.2021.5563] [Citation(s) in RCA: 117] [Impact Index Per Article: 58.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
IMPORTANCE Associations between in utero exposure to maternal SARS-CoV-2 infection and neurodevelopment are speculated, but currently unknown. OBJECTIVE To examine the associations between maternal SARS-CoV-2 infection during pregnancy, being born during the COVID-19 pandemic regardless of maternal SARS-CoV-2 status, and neurodevelopment at age 6 months. DESIGN, SETTING, AND PARTICIPANTS A cohort of infants exposed to maternal SARS-CoV-2 infection during pregnancy and unexposed controls was enrolled in the COVID-19 Mother Baby Outcomes Initiative at Columbia University Irving Medical Center in New York City. All women who delivered at Columbia University Irving Medical Center with a SARS-CoV-2 infection during pregnancy were approached. Women with unexposed infants were approached based on similar gestational age at birth, date of birth, sex, and mode of delivery. Neurodevelopment was assessed using the Ages & Stages Questionnaire, 3rd Edition (ASQ-3) at age 6 months. A historical cohort of infants born before the pandemic who had completed the 6-month ASQ-3 were included in secondary analyses. EXPOSURES Maternal SARS-CoV-2 infection during pregnancy and birth during the COVID-19 pandemic. MAIN OUTCOMES AND MEASURES Outcomes were scores on the 5 ASQ-3 subdomains, with the hypothesis that maternal SARS-CoV-2 infection during pregnancy would be associated with decrements in social and motor development at age 6 months. RESULTS Of 1706 women approached, 596 enrolled; 385 women were invited to a 6-month assessment, of whom 272 (70.6%) completed the ASQ-3. Data were available for 255 infants enrolled in the COVID-19 Mother Baby Outcomes Initiative (114 in utero exposed, 141 unexposed to SARS-CoV-2; median maternal age at delivery, 32.0 [IQR, 19.0-45.0] years). Data were also available from a historical cohort of 62 infants born before the pandemic. In utero exposure to maternal SARS-CoV-2 infection was not associated with significant differences on any ASQ-3 subdomain, regardless of infection timing or severity. However, compared with the historical cohort, infants born during the pandemic had significantly lower scores on gross motor (mean difference, -5.63; 95% CI, -8.75 to -2.51; F1,267 = 12.63; P<.005), fine motor (mean difference, -6.61; 95% CI, -10.00 to -3.21; F1,267 = 14.71; P < .005), and personal-social (mean difference, -3.71; 95% CI, -6.61 to -0.82; F1,267 = 6.37; P<.05) subdomains in fully adjusted models. CONCLUSIONS AND RELEVANCE In this study, birth during the pandemic, but not in utero exposure to maternal SARS-CoV-2 infection, was associated with differences in neurodevelopment at age 6 months. These early findings support the need for long-term monitoring of children born during the COVID-19 pandemic.
Collapse
Affiliation(s)
- Lauren C. Shuffrey
- Department of Psychiatry, Columbia University Irving Medical Center, New York, New York
| | - Morgan R. Firestein
- Department of Psychiatry, Columbia University Irving Medical Center, New York, New York
| | - Margaret H. Kyle
- Department of Pediatrics, Columbia University Irving Medical Center, New York, New York
| | - Andrea Fields
- Department of Psychology, Columbia University, New York, New York
| | | | - Dima Amso
- Department of Psychology, Columbia University, New York, New York
| | - Judy Austin
- Heilbrunn Department of Population and Family Health, Columbia University Irving Medical Center, New York, New York
| | - Jennifer M. Bain
- Department of Neurology, Division of Child Neurology, Columbia University Irving Medical Center, New York, New York
| | - Jennifer Barbosa
- Department of Psychiatry, Columbia University Irving Medical Center, New York, New York
| | - Mary Bence
- Department of Pediatrics, Columbia University Irving Medical Center, New York, New York
| | - Catherine Bianco
- Department of Psychology, Columbia University, New York, New York
| | - Cristina R. Fernández
- Department of Pediatrics, Columbia University Irving Medical Center, New York, New York
| | - Sylvie Goldman
- Department of Neurology, Division of Child Neurology, Columbia University Irving Medical Center, New York, New York
| | - Cynthia Gyamfi-Bannerman
- Department of Obstetrics, Gynecology and Reproductive Sciences, University of California San Diego, La Jolla
| | - Violet Hott
- Department of Pediatrics, Columbia University Irving Medical Center, New York, New York
| | - Yunzhe Hu
- Department of Psychiatry, Columbia University Irving Medical Center, New York, New York
| | - Maha Hussain
- Department of Pediatrics, Columbia University Irving Medical Center, New York, New York
| | - Pam Factor-Litvak
- Department of Epidemiology, Mailman School of Public Health, Columbia University Irving Medical Center, New York, New York
| | - Maristella Lucchini
- Department of Psychiatry, Columbia University Irving Medical Center, New York, New York
| | - Arthur Mandel
- Department of Neurology, Division of Child Neurology, Columbia University Irving Medical Center, New York, New York
| | - Rachel Marsh
- Department of Psychiatry, Columbia University Irving Medical Center, New York, New York
| | - Danielle McBrian
- Department of Neurology, Division of Child Neurology, Columbia University Irving Medical Center, New York, New York
| | - Mirella Mourad
- Department of Obstetrics and Gynecology, Columbia University Irving Medical Center New York, New York
| | - Rebecca Muhle
- Department of Psychiatry, Columbia University Irving Medical Center, New York, New York
| | - Kimberly G. Noble
- Department of Neuroscience and Education, Teachers College, Columbia University, New York, New York
| | - Anna A. Penn
- Department of Pediatrics, Columbia University Irving Medical Center, New York, New York
| | | | - Ayesha Sania
- Department of Psychiatry, Columbia University Irving Medical Center, New York, New York
| | - Wendy G. Silver
- Department of Neurology, Division of Child Neurology, Columbia University Irving Medical Center, New York, New York
| | - Kally C. O’Reilly
- Department of Psychiatry, Columbia University Irving Medical Center, New York, New York,New York State Psychiatric Institute, New York
| | - Melissa Stockwell
- Department of Pediatrics, Columbia University Irving Medical Center, New York, New York
| | - Nim Tottenham
- Department of Psychology, Columbia University, New York, New York
| | - Martha G. Welch
- Department of Psychiatry, Columbia University Irving Medical Center, New York, New York,Department of Pediatrics, Columbia University Irving Medical Center, New York, New York,Department of Pathology and Cell Biology, Columbia University Irving Medical Center, New York, New York
| | - Noelia Zork
- Department of Obstetrics and Gynecology, Columbia University Irving Medical Center New York, New York
| | - William P. Fifer
- Department of Psychiatry, Columbia University Irving Medical Center, New York, New York,Department of Pediatrics, Columbia University Irving Medical Center, New York, New York
| | - Catherine Monk
- Department of Psychiatry, Columbia University Irving Medical Center, New York, New York,Department of Obstetrics and Gynecology, Columbia University Irving Medical Center New York, New York
| | - Dani Dumitriu
- Department of Psychiatry, Columbia University Irving Medical Center, New York, New York,Department of Pediatrics, Columbia University Irving Medical Center, New York, New York
| |
Collapse
|
18
|
Factors associated with prenatal stress and anxiety in pregnant women during COVID-19 in Spain. ENFERMERIA CLINICA (ENGLISH EDITION) 2022; 32 Suppl 1:S5-S13. [PMID: 35183488 PMCID: PMC8824223 DOI: 10.1016/j.enfcle.2021.10.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/18/2021] [Accepted: 10/04/2021] [Indexed: 01/12/2023]
Abstract
AIM OF THE STUDY To describe prenatal stress and state anxiety levels in pregnant women living in Spain during the lockdown of the first wave of COVID-19 and its relation with obstetric factors, perception of health care, and concerns about the socio-sanitary situation. METHODS The present study is an observational, correlational, and cross-sectional quantitative study. The participants in the study were pregnant women recruited through non-probabilistic convenience and snowball sampling during the lockdown. A web link was provided to an online questionnaire designed for this research, which collected socio-demographic and obstetric variables, perceptions of health care received during the pandemic and preoccupations associated with COVID-19. It also included the Prenatal Stress Questionnaire (PDQ) and the State Anxiety Inventory (STAI-S). RESULTS Based on the responses of 695 pregnant women, the results showed a mean of 16.98 (SD = 25.20) of prenatal stress and elevated levels of anxiety (M = 25.20/SD = 11.07) in the first wave of the pandemic. Risk factors for prenatal stress and anxiety were the level of preoccupation associated with COVID-19 and previous mental health issues. A specific risk factor for anxiety was having more than one child and a protective factor were perceiving accessibility and availability of health care, with clear and consistent pregnancy care and follow-up protocols. CONCLUSIONS The lockdown period for COVID-19 was a stressful experience for pregnant women, highlighting the need to address their psychological well-being through clear and coherent protocols in terms of maternal-foetal health control and follow-up.
Collapse
|
19
|
Awad-Sirhan N, Simó-Teufel S, Molina-Muñoz Y, Cajiao-Nieto J, Izquierdo-Puchol MT. [Factors associated with prenatal stress and anxiety in pregnant women during COVID-19 in Spain]. ENFERMERIA CLINICA 2022; 32:S5-S13. [PMID: 34697530 PMCID: PMC8529258 DOI: 10.1016/j.enfcli.2021.10.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2021] [Accepted: 10/04/2021] [Indexed: 11/20/2022]
Abstract
Aim of the study To describe prenatal stress and state anxiety levels in pregnant women living in Spain during the lockdown of the first wave of COVID-19 and its relation with obstetric factors, perception of health care, and concerns about the socio-sanitary situation. Methods The present study is an observational, correlational, and cross-sectional quantitative study. The participants in the study were pregnant women recruited through non-probabilistic convenience and snowball sampling during the lockdown. A web link was provided to an online questionnaire designed for this research, which collected socio-demographic and obstetric variables, perceptions of health care received during the pandemic and preoccupations associated with COVID-19. It also included the Prenatal Stress Questionnaire (PDQ) and the State Anxiety Inventory (STAI-S). Results Based on the responses of 695 pregnant women, the results showed a mean of 16.98 (SD = 25.20) of prenatal stress and elevated levels of anxiety (M = 25.20/SD = 11.07) in the first wave of the pandemic. Risk factors for prenatal stress and anxiety were the level of preoccupation associated with COVID-19 and previous mental health issues. A specific risk factor for anxiety was having more than one child and a protective factor were perceiving accessibility and availability of health care, with clear and consistent pregnancy care and follow-up protocols. Conclusions The lockdown period for COVID-19 was a stressful experience for pregnant women, highlighting the need to address their psychological well-being through clear and coherent protocols in terms of maternal-foetal health control and follow-up.
Collapse
Affiliation(s)
- Natalia Awad-Sirhan
- Facultad de Psicología, Universidad de Valencia, Valencia, España
- Facultad de Psicología, Universidad del Desarrollo, Santiago, Chile
| | | | | | - Juanita Cajiao-Nieto
- Grupo Interdisciplinario de Investigación en Salud, Fundación Universitaria CAFAM, Bogotá, Colombia
| | | |
Collapse
|
20
|
Campos-Garzón C, Riquelme-Gallego B, de la Torre-Luque A, Caparrós-González RA. Psychological Impact of the COVID-19 Pandemic on Pregnant Women: A Scoping Review. Behav Sci (Basel) 2021; 11:181. [PMID: 34940116 PMCID: PMC8698569 DOI: 10.3390/bs11120181] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2021] [Revised: 11/29/2021] [Accepted: 11/30/2021] [Indexed: 12/23/2022] Open
Abstract
During the gestation period, pregnant women experience physical and psychological changes, which represent vulnerability factors that can boost the development of mental health conditions. The COVID-19 pandemic is producing new changes in the routines of the whole society, especially on lifestyle habits. The psychological impact associated with the COVID-19 pandemic and pregnant women remains unclear. A scoping review regarding the psychological impact of the COVID-19 pandemic on pregnant women was conducted. Searchers were conducted using the PubMed, Web of Science and CINAHL databases. Articles in Spanish, English and French were included. The search was conducted between November 2020 and September 2021. We identified 31 studies that evaluated 30,049 expectant mothers during the COVID-19 pandemic. Pregnant women showed high levels of anxiety and depression symptomatology. Fear of contagion and concerns regarding the health of the fetus were identified as the main variables related to psychological distress. An increase of the levels of depression, anxiety and stress during the COVID-19 pandemic amongst pregnant women has been observed. Moreover, an increased vulnerability of the fetus due to placental metabolic alterations is discussed. This review suggests that the COVID-19 pandemic is associated with a negative psychological impact on pregnant women. Thus, high levels of anxiety and depression symptoms suggest the need for a systematic approach.
Collapse
Affiliation(s)
- Celia Campos-Garzón
- Department of Nursing, Faculty of Health Sciences, University of Granada, 18071 Granada, Spain; (C.C.-G.); (R.A.C.-G.)
| | - Blanca Riquelme-Gallego
- Department of Nursing, Faculty of Health Sciences, University of Granada, 18071 Granada, Spain; (C.C.-G.); (R.A.C.-G.)
- Instituto de Investigación Biosanitaria ibs.GRANADA, 18012 Granada, Spain
| | - Alejandro de la Torre-Luque
- Center of Biomedical Research in Mental Health, Department of Legal Medicine, Psychiatry and Pathology, Complutense University of Madrid, CIBERSAM, 28040 Madrid, Spain;
| | - Rafael A. Caparrós-González
- Department of Nursing, Faculty of Health Sciences, University of Granada, 18071 Granada, Spain; (C.C.-G.); (R.A.C.-G.)
- Instituto de Investigación Biosanitaria ibs.GRANADA, 18012 Granada, Spain
| |
Collapse
|
21
|
Takeda T, Yoshimi K, Kai S, Inoue F. Association Between Serious Psychological Distress and Loneliness During the COVID-19 Pandemic: A Cross-Sectional Study with Pregnant Japanese Women. Int J Womens Health 2021; 13:1087-1093. [PMID: 34795535 PMCID: PMC8593838 DOI: 10.2147/ijwh.s338596] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2021] [Accepted: 11/03/2021] [Indexed: 11/30/2022] Open
Abstract
Purpose Pregnant women are vulnerable to stress. The coronavirus disease 2019 (COVID-19) has caused a global pandemic and created significant stress for many people. Social distancing to reduce the spread of COVID-19 has also reduced social interactions, which has increased social isolation and loneliness. Loneliness is thought to increase perceived stress, cause psychological distress, and increase the risk of mental illness, such as depression. This study examined the association between serious psychological distress (SPD) and loneliness during the COVID-19 pandemic in pregnant Japanese women. Patients and Methods An internet survey of 1022 pregnant women in Japan was conducted between June 1 and July 21, 2021. The 6-item Kessler Psychological Distress Scale, 3-item Revised UCLA Loneliness Scale, and Fear of COVID-19 Scale were used as measurement tools. The prevalence of SPD was defined as a K6 score of ≥13. Results The prevalence of SPD was 16.5%. Multivariate analysis revealed that the risk factors for SPD were younger age (odds ratio [OR] 1.05; 95% confidence interval [CI] 1.01 to 1.10; p = 0.020), history of abortion or miscarriages (OR 1.56; 95% CI 1.04 to 2.36; p = 0.034), unemployment (OR 1.67; 95% CI 1.14 to 2.45; p = 0.008), fear of COVID-19 (OR, 1.12; 95% CI, 1.08 to 1.17; p < 0.001), and loneliness (OR 1.53; 95% CI 1.38 to 1.70; p < 0.001). Conclusion Pregnant women in Japan showed a high prevalence of SPD. Younger age, unemployment, history of abortion or miscarriages, fear of COVID-19, and loneliness were independently associated with SPD. Clinicians and health officials should pay particular attention to the psychological health of pregnant women during the COVID-19 pandemic.
Collapse
Affiliation(s)
- Takashi Takeda
- Division of Women's Health, Research Institute of Traditional Asian Medicine, Kindai University, Osaka, 589-8511, Japan
| | - Kana Yoshimi
- Division of Women's Health, Research Institute of Traditional Asian Medicine, Kindai University, Osaka, 589-8511, Japan
| | - Sayaka Kai
- Division of Women's Health, Research Institute of Traditional Asian Medicine, Kindai University, Osaka, 589-8511, Japan
| | - Fumi Inoue
- Division of Women's Health, Research Institute of Traditional Asian Medicine, Kindai University, Osaka, 589-8511, Japan
| |
Collapse
|
22
|
Ölmestig TK, Siersma V, Birkmose AR, Kragstrup J, Ertmann RK. Infant crying problems related to maternal depressive and anxiety symptoms during pregnancy: a prospective cohort study. BMC Pregnancy Childbirth 2021; 21:777. [PMID: 34789174 PMCID: PMC8597256 DOI: 10.1186/s12884-021-04252-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2021] [Accepted: 10/25/2021] [Indexed: 12/24/2022] Open
Abstract
Background Infant crying may cause concerns among new parents and is a frequent reason for seeking help from their general practitioner (GP). The etiology of crying problems in infancy is not fully understood, but recent studies have found associations with maternal mental factors. It is well-established that postpartum depression is related to infant crying problems while the influence of maternal mental problems in pregnancy on infant crying is less investigated. We aimed to explore whether maternal depressive symptoms or maternal anxiety during pregnancy were related to crying problems by the newborn child. Methods In this prospective cohort study, 1290 pregnant women and their newborn children were followed throughout pregnancy until 8 weeks postpartum. Depressive symptoms and anxiety symptoms were assessed three times during pregnancy and again 8 weeks postpartum with the Major Depressive Inventory (MDI) and the Anxiety Symptoms Scale (ASS). Eight weeks postpartum the mothers were also asked whether their child cried in a way they found problematic. Multivariable regression was used to assess the association between depressive and anxiety symptoms during pregnancy and crying problems, and to adjust for potential confounders. Results We found statistically significant associations between high scores of depressive symptoms and anxiety symptoms in pregnancy and infant crying problems. Previously reported strong associations postpartum between depressive symptoms, anxiety symptoms and infant crying problems were also observed in the present data. Conclusion These results indicate that mental problems during pregnancy are associated with having a child with crying problems after birth. If more focus is given to maternal mental problems during pregnancy, the healthcare system might be able to detect and help these women, which would be beneficial for both mother and child.
Collapse
Affiliation(s)
- Tabitha Krogh Ölmestig
- The Research Unit for General Practice and Section of General Practice, Department of Public Health, University of Copenhagen, Øster Farimagsgade 5, 1353 Copenhagen K, Denmark.
| | - Volkert Siersma
- The Research Unit for General Practice and Section of General Practice, Department of Public Health, University of Copenhagen, Øster Farimagsgade 5, 1353 Copenhagen K, Denmark
| | - Anna Rubach Birkmose
- The Research Unit for General Practice and Section of General Practice, Department of Public Health, University of Copenhagen, Øster Farimagsgade 5, 1353 Copenhagen K, Denmark
| | - Jakob Kragstrup
- The Research Unit for General Practice and Section of General Practice, Department of Public Health, University of Copenhagen, Øster Farimagsgade 5, 1353 Copenhagen K, Denmark
| | - Ruth Kirk Ertmann
- The Research Unit for General Practice and Section of General Practice, Department of Public Health, University of Copenhagen, Øster Farimagsgade 5, 1353 Copenhagen K, Denmark
| |
Collapse
|