A psychosocial examination of feelings and thoughts about pregnancy: A qualitative study

The Effects of MBSR Programme on Prenatal Comfort and Fetal Health Anxiety in Pregnant Women

OBJECTIVE

This study was conducted to examine the effect of the online Mindfulness-Based Stress Reduction (MBSR) programme applied to pregnant women on their prenatal comfort and foetal anxiety levels.

MATERIAL AND METHOD

This randomised controlled study was conducted between July and October 2022, with 89 pregnant women registered in a Family Health Centre of Adiyaman, located in the Southeastern Anatolia region of Turkey. In the study, a total of eight sessions of MBSR programme, one session per week for eight weeks, were applied to the pregnant women in the experimental group. Data of the study was collected with the 'Personal Information Form', 'Prenatal Comfort Scale (PCS)', and 'Fetal Health Anxiety Inventory (FHAI)'. Descriptive statistics, chi-square test, and t-test for independent and dependent samples were utilised in the analysis of the data.

RESULTS

It has been determined that the PCS total mean score after the intervention is 58.91 ± 7.18 in the experimental group and 50.56 ± 15.78 in the control group; the post-test FHAI total mean score is 4.52 ± 1.66 in the experimental group and 9.76 ± 5.00 in the control group, and the difference between the groups is statistically significant (p < 0.001).

CONCLUSION

It has been determined that the MBSR programme applied to pregnant women has increased the prenatal comfort levels of pregnant women and has decreased foetal health anxieties. In line with these results, it is recommended that the MBSR programme may be used as an alternative method to relieve pregnant women.

Decision-Making on Contraceptive Use among Women Living with Human Immunodeficiency Virus in Malaysia: A Qualitative Inquiry

BACKGROUND

Malaysia is the first country in the Western Pacific Region to receive the validation certificate for the elimination of mother-to-child transmission of human immunodeficiency virus (HIV). The validation report recommends making sexual and reproductive health and rights of women living with HIV a priority. This article explores and assesses the sexual and reproductive health, rights, and access to healthcare services of Malaysia's women living with HIV (WLHIV).

METHODS

A qualitative secondary analysis conducted on 73 WLHIV from all over Malaysia comprised 11 in-depth interviews and 16 focus group discussions. Data were extracted from the original interview transcripts that emerged from the following questions: (1) "What are your experiences as a woman living with HIV in relation to your sexual and reproductive health and rights?" (2) "What are your experiences in accessing contraception?" (3) "What are your day-to-day experiences as a woman living with HIV?" Data were analyzed using thematic analysis.

RESULTS

Four themes emerged from the study findings: "lack of negotiation," "idealism in pregnancy," "coping with restrictions," and "past and future fears." The four themes are grounded in religion, a patriarchal culture, meaning and expectations of motherhood, taking risks and going against medical advice to pursue fertility desires, fear of HIV transmission, and the side effects of contraceptive use.

CONCLUSION

The complexities involved in decision-making regarding contraceptive use revealed how WLHIV may have unresolved reproductive health needs inconsistent with healthcare providers' focus on HIV management and prevention. Suggestions are made for improving the sexual and reproductive health and rights of WLHIV in Malaysia, which include establishing a reproductive health counseling program.

Revealing the impact of lifestyle stressors on the risk of adverse pregnancy outcomes with multitask machine learning

Psychosocial and stress-related factors (PSFs), defined as internal or external stimuli that induce biological changes, are potentially modifiable factors and accessible targets for interventions that are associated with adverse pregnancy outcomes (APOs). Although individual APOs have been shown to be connected to PSFs, they are biologically interconnected, relatively infrequent, and therefore challenging to model. In this context, multi-task machine learning (MML) is an ideal tool for exploring the interconnectedness of APOs on the one hand and building on joint combinatorial outcomes to increase predictive power on the other hand. Additionally, by integrating single cell immunological profiling of underlying biological processes, the effects of stress-based therapeutics may be measurable, facilitating the development of precision medicine approaches.

Objectives

The primary objectives were to jointly model multiple APOs and their connection to stress early in pregnancy, and to explore the underlying biology to guide development of accessible and measurable interventions.

Materials and Methods

In a prospective cohort study, PSFs were assessed during the first trimester with an extensive self-filled questionnaire for 200 women. We used MML to simultaneously model, and predict APOs (severe preeclampsia, superimposed preeclampsia, gestational diabetes and early gestational age) as well as several risk factors (BMI, diabetes, hypertension) for these patients based on PSFs. Strongly interrelated stressors were categorized to identify potential therapeutic targets. Furthermore, for a subset of 14 women, we modeled the connection of PSFs to the maternal immune system to APOs by building corresponding ML models based on an extensive single cell immune dataset generated by mass cytometry time of flight (CyTOF).

Results

Jointly modeling APOs in a MML setting significantly increased modeling capabilities and yielded a highly predictive integrated model of APOs underscoring their interconnectedness. Most APOs were associated with mental health, life stress, and perceived health risks. Biologically, stressors were associated with specific immune characteristics revolving around CD4/CD8 T cells. Immune characteristics predicted based on stress were in turn found to be associated with APOs.

Conclusions

Elucidating connections among stress, multiple APOs simultaneously, and immune characteristics has the potential to facilitate the implementation of ML-based, individualized, integrative models of pregnancy in clinical decision making. The modifiable nature of stressors may enable the development of accessible interventions, with success tracked through immune characteristics.