1
|
Harrison JM. Integrating Mental Health In Perinatal Care: Perspectives Of Interprofessional Clinicians. Health Aff (Millwood) 2024; 43:540-547. [PMID: 38560808 DOI: 10.1377/hlthaff.2023.01427] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/04/2024]
Abstract
Despite the prevalence of perinatal mental health issues in the United States, gaps in care persist. To address this, perinatal health care settings are asked to focus on patients' mental health by administering standardized screening and, increasingly, by integrating mental health teams in their clinics. Using in-depth interviews and ethnographic observations, I investigated these emerging practices, exploring the experiences of certified nurse-midwives, obstetricians, and mental health clinicians. I found that certified nurse-midwives and obstetricians lack time, resources, and expertise, restricting their ability to address patients' mental health. Integrated mental health clinicians are constrained by the stratified organization of health care and structural deprioritization of mental health. Redesigning perinatal health care and de-siloing mental health training are necessary to increase clinicians' effectiveness and to improve perinatal health outcomes.
Collapse
Affiliation(s)
- Jessica M Harrison
- Jessica M. Harrison , University of California San Francisco, San Francisco, California
| |
Collapse
|
2
|
Brooks KM, Charlot-Swilley D, Robertson HA, Bodrick N, Danielson AL, Genovez M, Boogaard C, Morris S, Deshmukh S, Kiker L, Green O, Le HN. "A Judgment-Free Zone": Adaptation and Pilot Study of a Virtual Wellness Group for African American Mothers with Young Children. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2024; 21:390. [PMID: 38673302 PMCID: PMC11049826 DOI: 10.3390/ijerph21040390] [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: 12/22/2023] [Revised: 03/09/2024] [Accepted: 03/20/2024] [Indexed: 04/28/2024]
Abstract
The COVID-19 pandemic has been particularly challenging for the mental health of African American (AA) birthing people. The pandemic necessitated shifting mental health care to online interventions. The goals of this study were to (1) describe an adapted evidence-based group preventive intervention for AA mothers with young children within a pediatric setting and (2) evaluate the feasibility, acceptability, and preliminary effectiveness of this virtual intervention. Phase 1 describes the adaptation of the HealthySteps Mom's Virtual Wellness Group, including eight weekly sessions based on the Mothers and Babies Course. Phase 2 was a mixed-methods, pre-post intervention design. Six AA mothers with young children completed questionnaires related to depression, anxiety, and parenting competence at three time points: pre-intervention (T1), post-intervention (T2), and 3 months post-intervention (T3). The participants also completed a focus group post-T2 to gather qualitative feedback regarding the intervention. The median scores for depression were lower at T2 and increased at T3, and for anxiety, they increased at T2 and decreased at T3. The median scores for parenting competence increased across the three time points. The participants attended a mean of 7.2 sessions (SD = 0.74). The qualitative results indicate that the participants gained a sense of empowerment, enjoyed connecting with other mothers, and acquired information. This pilot study suggests that a virtual intervention is feasible, acceptable, and can increase parenting competence and support among AA mothers with young children.
Collapse
Affiliation(s)
- Kimberly M. Brooks
- Children’s National Hospital, 1 Inventa Place 5th Floor, Silver Spring, MD 20910, USA; (N.B.); (M.G.); (C.B.); (S.D.)
| | - Dominique Charlot-Swilley
- Department of Psychiatry, Medstar Georgetown University Hospital, Washington, DC 20007, USA; (D.C.-S.); (H.A.R.); (A.L.D.)
| | - Hillary A. Robertson
- Department of Psychiatry, Medstar Georgetown University Hospital, Washington, DC 20007, USA; (D.C.-S.); (H.A.R.); (A.L.D.)
| | - Nia Bodrick
- Children’s National Hospital, 1 Inventa Place 5th Floor, Silver Spring, MD 20910, USA; (N.B.); (M.G.); (C.B.); (S.D.)
| | - Aimee L. Danielson
- Department of Psychiatry, Medstar Georgetown University Hospital, Washington, DC 20007, USA; (D.C.-S.); (H.A.R.); (A.L.D.)
| | - Marta Genovez
- Children’s National Hospital, 1 Inventa Place 5th Floor, Silver Spring, MD 20910, USA; (N.B.); (M.G.); (C.B.); (S.D.)
| | - Claire Boogaard
- Children’s National Hospital, 1 Inventa Place 5th Floor, Silver Spring, MD 20910, USA; (N.B.); (M.G.); (C.B.); (S.D.)
| | - Sydney Morris
- Department of Psychology, Palo Alto University, Palo Alto, CA 94308, USA;
| | - Sanyukta Deshmukh
- Children’s National Hospital, 1 Inventa Place 5th Floor, Silver Spring, MD 20910, USA; (N.B.); (M.G.); (C.B.); (S.D.)
| | - Lauren Kiker
- Department of Psychological and Brain Sciences, George Washington University, Washington, DC 20013, USA; (L.K.); (O.G.); (H.-N.L.)
| | - Olukemi Green
- Department of Psychological and Brain Sciences, George Washington University, Washington, DC 20013, USA; (L.K.); (O.G.); (H.-N.L.)
| | - Huynh-Nhu Le
- Department of Psychological and Brain Sciences, George Washington University, Washington, DC 20013, USA; (L.K.); (O.G.); (H.-N.L.)
| |
Collapse
|
3
|
Sadat BN, Zahra M, Fatemeh T. Identifying effective factors to alleviate postnatal distress and coronavirus anxiety in mothers of hospitalized preterm neonates. BMC Pregnancy Childbirth 2023; 23:838. [PMID: 38057744 DOI: 10.1186/s12884-023-06131-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2023] [Accepted: 11/15/2023] [Indexed: 12/08/2023] Open
Abstract
BACKGROUND Given the critical importance of mental health in mothers of preterm neonates during the postpartum period for Population Youth Programs, our research aims to ascertain the correlation between postnatal distress and corona-induced anxiety in women who have hospitalized preterm neonates. METHODS This descriptive-analytical study was conducted with a sample of 275 mothers of preterm neonates, were hospitalized in Gorgan city in 2020. Data collection was facilitated through the Corona Anxiety (CA) and Postnatal Distress Measured Scale (PDM). For data analysis, Spearman's correlation and univariate and multiple linear regression were employed. RESULTS The average age of the participating mothers was 28.61 ± 6.173 years, and the average gestational age of the neonates was 32.8 ± 2.89 weeks. The study found a significant, positive correlation between CA and PDM. Controlling for other variables through multiple regression analysis, the factors that significantly influenced PDM were employment status (β = 3.88, p < 0.01), education level (β = 1.96, p = 0.032), and gestational age (β=-0.60, p < 0.001). Furthermore, number of living children (β=-4.77, p = 0.01), education (β=-2.37, p = 0.01), and gestational age (β=-0.91, p < 0.001) were the factors that were significantly associated with CA scores. CONCLUSIONS The correlation between CA and PDM suggests that preterm neonate's mothers experienced increased anxiety during the pandemic. Considering the factors influencing these anxieties, targeted programs should be developed to enhance the mental health of these mothers in future pandemics. The finding that women with more children experienced less CA could serve as evidence of the positive impact of having children on the mental health of women with premature infants during a pandemic.
Collapse
Affiliation(s)
- Borghei Narjes Sadat
- Reproductive Health, Counseling and Reproductive Health Research Center, School of Nursing and Midwifery, Golestan University of Medical Sciences, Gorgan, Iran
| | - Mehrbakhsh Zahra
- Department of Biostatistics, School of Public Health, Hamadan University of Medical Sciences, Hamadan, Iran.
- Department of Biostatistics and Epidemiology, School of Health, Golestan University of Medical sciences, Gorgan, Iran.
| | - Torklalebaq Fatemeh
- Faculty of Nursing and Midwifery, Pregnancy Health Research Center, Zahedan University of Medical Sciences, Zahedan, Iran
| |
Collapse
|
4
|
Sayahi M, Nikbina M, Jahangirimehr A, Barati B. Mental health status of pregnant women during COVID-19 in healthcare centers of Iran: A cross-sectional study. PLoS One 2023; 18:e0294850. [PMID: 38015922 PMCID: PMC10683986 DOI: 10.1371/journal.pone.0294850] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2023] [Accepted: 11/08/2023] [Indexed: 11/30/2023] Open
Abstract
BACKGROUND AND OBJECTIVE The COVID-19 pandemic impacted every single aspect of life. In addition to being a public health emergency, the COVID-19 outbreak impacted the mental health of individuals, especially pregnant women. This study aimed to examine the mental health status of pregnant women and also the effect of sociodemographic factors on their mental health status during COVID-19 in healthcare centers of Iran. METHODS This cross-sectional, analytical-descriptive study was conducted among pregnant women referring to healthcare centers in Shoushtar, Iran, in 2021. Multistage cluster sampling was used to select participants. Data were collected using the General Health Questionnaire-28 (GHQ-28). Data were analyzed using SPSS software version 22. The Pearson correlation coefficient was used to examine the association between quantitative variables. A generalized linear model (GLM) was applied to estimate the effect of independent variables on the dependent variable (mental health). RESULTS A total of 197 participants with a mean ± SD age of 27.85 ± 6.37 years took part in this study. The total mean score of mental health was estimated at 17.47±8.20. The highest mean ± SD score was, respectively, related to social dysfunction (6.63 ± 2.86), anxiety and insomnia (5.28 ± 3.53), and somatic symptoms (4.17 ± 3.27). Mental health disorder was significantly correlated with participants' age (R = .223, P = .00), number of pregnancy (gravida) (R = .272, P = .00), number of births (para) (R = 0.272, P = .00), and number of abortions (R = .172, P = .015). About 80% of pregnant women did not reveal impaired mental health conditions or psychological distress, while 19.3% showed scores that indicate probable mental health conditions. CONCLUSION Social dysfunction was the most common mental health problem among pregnant women. It is necessary to pay more attention to the mental health status of pregnant women during a pandemic. Interventions such as practical strategies to promote social support and improve pregnant women's mental health during pregnancy are highly important.
Collapse
Affiliation(s)
- Masoumeh Sayahi
- Department of Midwifery, Shoushtar Faculty of Medical Sciences, Shoushtar, Iran
| | - Maryam Nikbina
- Department of Midwifery, Shoushtar Faculty of Medical Sciences, Shoushtar, Iran
| | - Azam Jahangirimehr
- Department of Public Health, Shoushtar Faculty of Medical Sciences, Shoushtar, Iran
| | - Barat Barati
- Department of Radiologic Technology, Shoushtar Faculty of Medical Sciences, Shoushtar, Iran
| |
Collapse
|
5
|
Howard A, Wang S, Adachi J, Yadama A, Bhat A. Facilitators of and barriers to perinatal telepsychiatry care: a qualitative study. BMJ Open 2023; 13:e071084. [PMID: 37802623 PMCID: PMC10565296 DOI: 10.1136/bmjopen-2022-071084] [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: 12/14/2022] [Accepted: 09/04/2023] [Indexed: 10/10/2023] Open
Abstract
OBJECTIVES Perinatal mental health disorders such as anxiety, depression and bipolar disorder can negatively impact the health of women and their children without appropriate detection and treatment. Due to increases in mental health symptoms and transmission risks associated with in-person appointments, many clinics transitioned to providing telepsychiatry care during the COVID-19 pandemic. This study sought to identify the facilitators and barriers to receiving perinatal telepsychiatry care from the perspective of patients, clinic staff and psychiatrists. DESIGN Qualitative study based on analysis of in depth semistructured interviews. SETTING The study was conducted in a virtual specialty mental health clinic in an academic setting. PARTICIPANTS Eight patients who had been scheduled for an appointment with the perinatal telepsychiatry clinic between 14 May 2021 and 1 August 2021, seven of whom had attended their scheduled appointment with the clinic and one of whom had not, and five staff members including psychiatrists, navigators and clinic managers, participated in in-depth interviews. RESULTS Telepsychiatry was perceived by most as preferable to in-person care and easy to attend and navigate. Alternatively, technological difficulties, personal preference for in-person care and scheduling conflicts related to the perinatal period were identified as barriers by some. Participants identified communication between care staff and patients, online patient portals, and appointment reminders as important for facilitating appointment preparedness and attendance. CONCLUSIONS The findings from this study suggest that telepsychiatry services are perceived positively by patients and care staff and have the potential to improve access to mental healthcare for perinatal patients.
Collapse
Affiliation(s)
- Anna Howard
- Department of Epidemiology, University of Washington, Seattle, Washington, USA
| | - Sunny Wang
- Department of Health Systems and Population Health, University of Washington, Seattle, Washington, USA
| | - Jamie Adachi
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, Washington, USA
| | - Alexa Yadama
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, Washington, USA
| | - Amritha Bhat
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, Washington, USA
| |
Collapse
|
6
|
Wagner E, Bień K, Łomża A, Grunwald A, Kimber-Trojnar Ż, Libera A, Leszczyńska-Gorzelak B. Stress of Prematurity in the Experience of the COVID-19 Pandemic-Current State of Knowledge. Life (Basel) 2023; 13:1757. [PMID: 37629614 PMCID: PMC10455823 DOI: 10.3390/life13081757] [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: 07/09/2023] [Revised: 08/10/2023] [Accepted: 08/15/2023] [Indexed: 08/27/2023] Open
Abstract
Stress is a process that triggers various physiological, hormonal and psychological mechanisms in response to a threat, which significantly affects the health of an individual. The COVID-19 pandemic introduced a lot of social changes that required constant adaptation to unfavorable conditions. The aim of the study was to assess the impact of stress related to this pandemic on pregnant women, mothers of premature infants and their families, and on obstetric complications, particularly preterm birth. A comprehensive literature review was performed using electronic databases such as Pubmed, Science Direct and Google Scholar. Keywords such as: "prematurity"; "pregnancy"; "stress"; "COVID-19" and various combinations of the above were used. Maternal stress and anxiety increase the levels of corticotropin-releasing hormone (CRH) in the placenta, which in turn affects the incidence of preterm birth and many other related maternal and neonatal complications. In addition, it was found that SARS-CoV-2 infection may increase the risk of this phenomenon. The COVID-19 pandemic has adversely affected preterm birth rates and the mental health of mothers of preterm infants, exacerbating their negative experience of having a premature baby. More research is needed to demonstrate the long-term effects of COVID-19 stress on prematurity.
Collapse
Affiliation(s)
| | | | | | | | - Żaneta Kimber-Trojnar
- Chair and Department of Obstetrics and Perinatology, Medical University of Lublin, 20-090 Lublin, Poland; (E.W.); (K.B.); (A.Ł.); (A.G.); (A.L.); (B.L.-G.)
| | | | | |
Collapse
|
7
|
Krupelnytska L, Morozova-Larina O. Perinatal experiences of Ukrainian women at the beginning of the war. J Reprod Infant Psychol 2023:1-18. [PMID: 37485953 DOI: 10.1080/02646838.2023.2240827] [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: 02/14/2023] [Accepted: 07/18/2023] [Indexed: 07/25/2023]
Abstract
OBJECTIVE Pregnancy and childbirth are related to the experience of distress at their core. However, this distress is significantly increased under war conditions. The study aims to examine the perinatal experience of women during the war in Ukraine. METHODS 12 Ukrainian women who were pregnant and lived in Kyiv or the suburbs of Kyiv from February to May 2022 took part in the study. In-depth interviews were conducted online in the form of semi-structured interviews, and the thematic analysis technique was used. RESULTS The perinatal experiences of women during the war in Ukraine were divided into 2 basic groups: negative perinatal experiences and positive perinatal experiences during the war. The negative perinatal experiences were grouped into three main themes: 1) negative emotions experienced in association with war, 2) dissatisfaction with medical support during the war, 3) suffering associated with separation from a husband and relatives. The positive perinatal experiences include 6 main themes: 1) the joy of returning or/and staying home, 2) satisfaction with medical support during the war, 3) coping with stress during the war, 4) family relationships and support during the war, 5) positive attitudes towards the child (or unborn child), 6) patriotic sentiments. CONCLUSION The study revealed negative and positive aspects of the perinatal experience of Ukrainian women during the war. Providing access to medical advice, facilitating uncertainty reduction, and communication between women and their families contribute to positive perinatal experiences of pregnant women and new mothers during the war.
Collapse
|
8
|
Calpbinici P, Uzunkaya Öztoprak P. The Effect of Fear of COVID-19 on Women's Attitudes toward Cancer Screening and Healthy Lifestyle Behaviors: A Cross-Sectional Study. INDIAN JOURNAL OF GYNECOLOGIC ONCOLOGY 2023; 21:45. [PMID: 37214638 PMCID: PMC10186287 DOI: 10.1007/s40944-023-00719-3] [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: 01/23/2023] [Revised: 04/04/2023] [Accepted: 04/30/2023] [Indexed: 05/24/2023]
Abstract
Purpose The study was conducted to evaluate the effect of fear of COVID-19 on women's attitudes toward cancer screening and healthy lifestyle behaviors. Method The study is of descriptive and cross-sectional type. The sample of the study consisted of 221 women living in Turkey. Research data were collected using Introductory Information Form, Attitude Scale for Cancer Screening, The Fear of COVID-19 Scale and Healthy Lifestyle Behaviors Scale II (HLBS-II). Results It was found out that 92.3% of the women did not have cancer screening during the pandemic period, 33.0% of the women who did not have it because they were afraid of the contamination, 33.0% thought they were healthy, 13.1% did not have screening tests because they thought that screening tests were not easy and accessible during the pandemic period. While no significant relationship was found between women's attitudes toward cancer screenings and fear of COVID-19 (P > 0.05), a positive significant relationship was found between women's attitudes toward cancer screenings and spiritual growth, health responsibility and interpersonal relations scores, which are sub-dimensions of the HLBS-II scale (P > 0.05). In addition, it was found out that women's fear of COVID-19 affected interpersonal relations and stress management (P < 0.05). Conclusion In our study, it was concluded that most of the women did not have cancer screening during the pandemic, and that the fear of COVID-19 affected such healthy lifestyle behaviors as interpersonal relations and stress management.
Collapse
Affiliation(s)
- Pelin Calpbinici
- Department of Obstetrics and Gynecology Nursing, Semra and Vefa Küçük Faculty of Health Sciences, Nevşehir Hacı Bektaş Veli University, Nevşehir, Turkey
| | - Pınar Uzunkaya Öztoprak
- Department of Obstetrics and Gynecology Nursing, Faculty of Nursing, Hacettepe University, Ankara, Turkey
| |
Collapse
|
9
|
Tsai Z, Shah N, Tahir U, Mortaji N, Owais S, Perreault M, Van Lieshout RJ. Dietary interventions for perinatal depression and anxiety: a systematic review and meta-analysis of randomized controlled trials. Am J Clin Nutr 2023:S0002-9165(23)46315-0. [PMID: 37019362 DOI: 10.1016/j.ajcnut.2023.03.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Revised: 03/23/2023] [Accepted: 03/29/2023] [Indexed: 04/05/2023] Open
Abstract
BACKGROUND Dietary interventions are a widely available intervention for depression and anxiety among pregnant and/or postpartum (i.e., perinatal) persons but their effectiveness is not well known. OBJECTIVE We performed a systematic review and meta-analysis to assess the effectiveness of dietary interventions for the treatment of perinatal depression and/or anxiety. DESIGN We searched Medline, EMBASE, PsycINFO, CINAHL, and Web of Science from their inception to November 2, 2022. Studies were included if they were available in English and examined the effectiveness of a dietary intervention for perinatal depression and/or anxiety in a randomized controlled trial. RESULTS Our search identified 4,246 articles, 36 of which were included and 28 were eligible for meta-analysis. Random effects meta-analyses were performed. Polyunsaturated fatty acids (PUFAs) were not found to improve symptoms of perinatal depression compared to control conditions (SMD -0.11; 95% CI -0.26 to 0.04). These results did not change when examined during pregnancy or the postpartum period separately, nor did they vary according to fatty acid ratio. Elemental metals (iron, zinc, and magnesium) were also not found to be superior to placebo (SMD, -0.42; 95% CI, -1.05 to 0.21), though, vitamin D yielded a small to medium effect size improvements (SMD, -0.52; 95% CI, -0.84 to -0.20) in postpartum depression. Iron may help in those with confirmed iron deficiency. Narrative synthesis was performed for studies ineligible for meta-analyses. CONCLUSIONS Despite their widespread popularity, PUFAs and elemental metals do not appear to effectively reduce perinatal depression. Vitamin D taken in doses of 1800 to 3500 International Units (IU) per day may have some promise. Additional high-quality, large-scale randomized controlled trials (RCTs) are needed to determine the true effectiveness of dietary interventions on perinatal depression and/or anxiety. PROSPERO REGISTRATION DATE AND NUMBER July 5th 2020, CRD42020208830.
Collapse
Affiliation(s)
- Zoe Tsai
- Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada.
| | - Nirmay Shah
- Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada
| | - Umair Tahir
- Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada
| | - Neda Mortaji
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada
| | - Sawayra Owais
- Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada
| | - Maude Perreault
- Faculty of Medicine, University of Montreal, Montreal, Québec, Canada
| | - Ryan J Van Lieshout
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada
| |
Collapse
|
10
|
Moise IK, Ivanova N, Wilson C, Wilson S, Halwindi H, Spika VM. Lessons from digital technology-enabled health interventions implemented during the coronavirus pandemic to improve maternal and birth outcomes: a global scoping review. BMC Pregnancy Childbirth 2023; 23:195. [PMID: 36941565 PMCID: PMC10026210 DOI: 10.1186/s12884-023-05454-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Accepted: 02/17/2023] [Indexed: 03/23/2023] Open
Abstract
BACKGROUND Timely access to essential obstetric and gynecologic healthcare is an effective method for improving maternal and neonatal outcomes; however, the COVID-19 pandemic impacted pregnancy care globally. In this global scoping review, we select and investigate peer-reviewed empirical studies related to mHealth and telehealth implemented during the pandemic to support pregnancy care and to improve birth outcomes. METHODS We searched MEDLINE and PubMed, Scopus, CINAHL and Web of Science for this Review because they include peer-reviewed literature in the disciplines of behavioral sciences, medicine, clinical sciences, health-care systems, and psychology. Because our investigative searches reviewed that there is considerable 'grey literature' in this area; we did not restrict our review to any study design, methods, or place of publication. In this Review, peer-reviewed preprints were comparable to published peer-reviewed articles, with relevant articles screened accordingly. RESULTS The search identified 1851 peer reviewed articles, and after removal of duplicates, using inclusion and exclusion criteria, only 22 studies were eligible for inclusion in the review published from January 2020 to May 2022. mHealth interventions accounted for 72.7% (16 of 22 studies) and only 27.3% (6 of 22 studies) were telehealth studies. There were only 3 example studies that integrated digital technologies into healthcare systems and only 3 studies that developed and evaluated the feasibility of mobile apps. Experimental studies accounted 68.8% of mHealth studies and only 33.3% studies of telehealth studies. Key functionalities of the pregnancy apps and telehealth platforms focused on mental and physical wellness, health promotion, patient tracking, health education, and parenting support. Implemented interventions ranged from breastfeeding and selfcare to behavioral health. Facilitators of uptake included perceived benefits, user satisfaction and convenience. Mobile apps and short messaging services were the primary technologies employed in the implemented mHealth interventions. CONCLUSION Although our Review emphasizes a lack of studies on mHealth interventions and data from pregnant women during the COVID-19 crisis, the review shows that implementation of digital health interventions during emergencies are inevitable given their potential for supporting pregnancy care. There is also a need for more randomized clinical trials and longitudinal studies to better understand the effectiveness and feasibility of implementing such interventions during disease outbreaks and emergencies.
Collapse
Affiliation(s)
- Imelda K Moise
- Department of Geography & Sustainable Development, College of Arts and Sciences, University of Miami, 1300 Campo Sano Ave, Coral Gables, FL, 33124, USA.
| | - Nicole Ivanova
- Global Health Studies Program, College of Arts and Sciences, University of Miami, 1252 Memorial Drive, Coral Gables, FL, 33146, USA
| | - Cyril Wilson
- Department of Geography & Anthropology, University of Wisconsin-Eau Claire, Eau Claire, WI, 54702-4004, USA
| | - Sigmond Wilson
- Department of History & Political Science, Rogers State University, 1701 W. Will Rogers Blvd, Claremore, OK, 74017, USA
| | - Hikabasa Halwindi
- Department of Community and Family Medicine, School of Public Health, University of Zambia, P.O Box 50110, Lusaka, Zambia
| | - Vera M Spika
- University of Miami, 1300 Memorial Drive, Coral Gables, FL, 33124, USA
| |
Collapse
|
11
|
Yang L, Sun J, Nan Y, Waqas A, Nisar A, Wang D, Rahman A, Li X. Prevalence of perinatal anxiety and its determinants in mainland China: A systematic review and meta-analysis. J Affect Disord 2023; 323:193-203. [PMID: 36442655 DOI: 10.1016/j.jad.2022.11.075] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Revised: 10/04/2022] [Accepted: 11/20/2022] [Indexed: 11/26/2022]
Abstract
BACKGROUND Perinatal anxiety is among the most common mental health conditions that have a huge negative impact both on mothers and their children. This study aimed to establish summary estimates of the prevalence of perinatal anxiety and its influencing factors in Mainland China. METHODS A systematic search was carried out from nine major English and Chinese electronic databases to identify studies published up to August 20, 2022 with data on the prevalence of perinatal anxiety. Two reviewers conducted data extraction and quality assessment. Meta-analysis was performed using a random-effects model. Subgroup and meta-regression analyses were performed when possible. RESULTS 271 studies representing 369,477 women were included in the study. Pooled prevalence of perinatal anxiety was 17.4 % (95 % CI: 16.2 % to 18.7 %), with prenatal anxiety 17.4 % (95%CI: 16.1 % to 18.8 %) and postpartum anxiety 17.5 % (95%CI: 13.5 % to 22.4 %). However, the overall estimates presented substantial heterogeneity (I2 = 98.93 %). Qualitative summaries demonstrated some main potential risk factors of perinatal anxiety such as women with abnormal pregnancy-labor history, poor health status, pregnancy complications, and unplanned pregnancies, and some potential protective factors such as high family income, good social support, good interpersonal relationships, and history of multiple deliveries. LIMITATION Very large heterogeneity among studies was observed in meta-synthesis, and all included studies used self-report scales to identify anxiety rather than diagnostic interviews. CONCLUSION Varying degrees of perinatal anxiety is prevalent among Chinese women. Screening and evidence-based interventions are urgent and necessary to address this public concern and promote their health and well-being.
Collapse
Affiliation(s)
- Lei Yang
- School of Nursing, Health Science Center, Xi'an Jiaotong University, 710061, China
| | - Jingwen Sun
- School of Nursing, Health Science Center, Xi'an Jiaotong University, 710061, China
| | - Yiping Nan
- School of Nursing, Health Science Center, Xi'an Jiaotong University, 710061, China
| | - Ahmed Waqas
- Human Development Research Foundation, Rawalpindi, Pakistan
| | - Anum Nisar
- School of Nursing, Health Science Center, Xi'an Jiaotong University, 710061, China
| | - Duolao Wang
- Department of Clinical Sciences, Liverpool School of Tropical Medicine, L3 5QA, United Kingdom
| | - Atif Rahman
- Department of Psychological Sciences, University of Liverpool, L69 3BX, United Kingdom.
| | - Xiaomei Li
- School of Nursing, Health Science Center, Xi'an Jiaotong University, 710061, China.
| |
Collapse
|
12
|
Tambawala ZY, Saquib S, Salman A, Khalid M, Beshtawi H, Akbari EA, Binashoor A, Hubaishi N, Hamza LK, Rayssi MA. Perinatal anxiety and depression amidst the COVID-19 pandemic in Dubai, United Arab Emirates. AJOG GLOBAL REPORTS 2023; 3:100164. [PMID: 36718221 PMCID: PMC9876005 DOI: 10.1016/j.xagr.2023.100164] [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] [Indexed: 01/26/2023] Open
Abstract
BACKGROUND Pregnancy and COVID-19 increase the risk of mental health conditions. The stress of pregnancy, childbirth, and uncertainty about the global pandemic has negatively affected the obstetrical population. OBJECTIVE This study aimed to investigate the effects of the COVID-19 pandemic in terms of anxiety and depression in antenatal and postnatal mothers. STUDY DESIGN This was a cross-sectional observational study conducted at Dubai Hospital, United Arab Emirates, evaluating depression and anxiety (point prevalence) with the Edinburgh Postnatal Depression Scale and Generalized Anxiety Disorder-7 scale. RESULTS Of the 784 women approached, 438 consented to participate in our survey; 43.6% of the women screened positive for depression by the Edinburgh Postnatal Depression Scale (with a cutoff score ≥10), and 42% had a Generalized Anxiety Disorder-7 score of ≥5, indicating anxiety. Both anxiety and depression were found in 32.4% of the women; 7.5% had considered self-harm in the last 14 days, and 15% had COVID-19 during the current pregnancy. The 11.87% who had COVID-19, but before the pregnancy, had higher mean Edinburgh Postnatal Depression Scale and Generalized Anxiety Disorder-7 scores than others. Surprisingly, the women who had COVID-19 during pregnancy had statistically significantly (P<.05) lower Edinburgh Postnatal Depression Scale and Generalized Anxiety Disorder-7 scores. University graduates had significantly (P<.05) higher Edinburgh Postnatal Depression Scale and Generalized Anxiety Disorder-7 scores. Women of Middle Eastern ethnicity (50% positive for depression and 48.5% for anxiety) were more prone to depression and anxiety compared with South Asian (29% positive for depression and 25.2% for anxiety) and African women (39.6% positive for depression and 43.4% for anxiety). There was no statistically significant difference between antenatal and postnatal patients in the prevalence of anxiety or depression. CONCLUSION The COVID-19 pandemic is associated with an increase in depression and anxiety in pregnant and postnatal women. Women who were more concerned about the effects of the pandemic had higher mean Edinburgh Postnatal Depression Scale and Generalized Anxiety Disorder-7 scores. Additional psychological support for women is necessary during the pandemic for maternal perinatal well-being.
Collapse
|
13
|
Alves SP, Costa T, Ribeiro I, Néné M, Sequeira C. Perinatal mental health counselling programme: A scoping review. PATIENT EDUCATION AND COUNSELING 2023; 106:170-179. [PMID: 36376136 DOI: 10.1016/j.pec.2022.10.347] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Revised: 10/09/2022] [Accepted: 10/22/2022] [Indexed: 06/16/2023]
Abstract
OBJECTIVE To map the evidence on a Perinatal Mental Health Counselling Programme, identifying its characteristics, participants, and outcomes. METHODS This review followed the guidelines of the Joanna Briggs Institute and PRISMA-ScR. Published and unpublished studies, from 2011 to 2021, written in English, Portuguese or Spanish were included. RESULTS Despite the high number of articles identified, only nine articles were included in the final analysis, mainly from Iran, Italy and one Portuguese study. All articles referred to community health care centres and hospitals. The sessions varied between 6 and 16 and lasted 30-90 min. The method used was either individual and/or group, with weekly or monthly sessions or whenever deemed necessary throughout the evaluation. Different techniques were found, but emotional management, problem-solving, relaxation and mindfulness techniques were highlighted. Participants are pregnant women, partners, or family members. All articles suggest a decrease in the levels of stress, anxiety, and depression after the counselling intervention. CONCLUSION Perinatal counselling programme have varied characteristics and mental health nurses are potential facilitators.
Collapse
Affiliation(s)
- Sónia Patricia Alves
- Oporto University - Instituto Ciências Biomédicas Abel Salazar, Portugal; Mental Health Nurse at ACES Porto Ocidental - Northern Regional Health Administration, Portugal; Nursing School of Porto, Portugal; Research Group "NursID:Innovation & Development in Nursing" - Center for Health Technology andServices Research (CINTESIS), 4250-224 Porto, Portugal.
| | - Tiago Costa
- Nursing School of Porto, Portugal; Research Group "NursID:Innovation & Development in Nursing" - Center for Health Technology andServices Research (CINTESIS), 4250-224 Porto, Portugal; Hospital Center of Vila Nova de Gaia/Espinho, Portugal; University of Barcelona, Spain.
| | - Isilda Ribeiro
- Nursing School of Porto, Portugal; Research Group "NursID:Innovation & Development in Nursing" - Center for Health Technology andServices Research (CINTESIS), 4250-224 Porto, Portugal.
| | - Manuela Néné
- Research Group "NursID:Innovation & Development in Nursing" - Center for Health Technology andServices Research (CINTESIS), 4250-224 Porto, Portugal; Higher School of Health of The Portuguese Red Cross in Lisbon, Portugal.
| | - Carlos Sequeira
- Nursing School of Porto, Portugal; Research Group "NursID:Innovation & Development in Nursing" - Center for Health Technology andServices Research (CINTESIS), 4250-224 Porto, Portugal.
| |
Collapse
|
14
|
Grussu P, Quatraro RM, Alderdice F, Jorizzo GJ. Routine E-Screening for Perinatal Mental Health During the COVID-19 Emergency: Beyond the Instrument Cut-Off Points. Matern Child Health J 2022; 26:2357-2361. [PMID: 36198852 PMCID: PMC9534459 DOI: 10.1007/s10995-022-03468-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/18/2022] [Indexed: 12/15/2022]
Abstract
The COVID-19 pandemic represents a significant risk factor for mental distress in perinatal women. Assessment for mental health issues should therefore be an integral part of safeguarding health at every stage of pregnancy and postpartum. Considering the impact of the COVID-19 pandemic on the planning of healthcare services locally, it is important to employ information-gathering techniques such as seeking feedback from both patients and staff. E-screening conforms to stay-at-home COVID restrictions and can improve the efficiency of mental healthcare. The symptomatologic levels indicated by the cut-off points, as well as the real time concerns expressed by perinatal women through open questions, are valuable on many levels. Future studies are needed not only on the sensitivity of the e-screening routines in the context of daily clinical practice, but also on the deeper meaning of the personal concerns reported in e-screening open questions in both positive and negative screening environments.
Collapse
Affiliation(s)
- Pietro Grussu
- Consultorio Familiare, South Padua District, Azienda ULSS 6 Euganea, Via San Fermo 10, 35042, Este, PD, Italy.
| | | | - Fiona Alderdice
- Department of Population Health, National Perinatal Epidemiology Unit, Nuffield, University of Oxford, Oxford, UK.,School of Nursing and Midwifery, Queens University Belfast, Belfast, Northern Ireland, UK
| | - Gianfranco J Jorizzo
- Prenatal Medicine, Azienda ULSS 6 Euganea, Veneto Region, National Health Service, Padua, Italy
| |
Collapse
|
15
|
Singla DR, Savel K, Dennis CL, Kim J, Silver RK, Vigod S, Dalfen A, Meltzer-Brody S. Scaling up Mental Healthcare for Perinatal Populations: Is Telemedicine the Answer? Curr Psychiatry Rep 2022; 24:881-887. [PMID: 36401679 PMCID: PMC9676781 DOI: 10.1007/s11920-022-01389-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/26/2022] [Indexed: 11/20/2022]
Abstract
PURPOSE OF REVIEW Telemedicine has transformed our ability to access and offer mental healthcare. There remain key questions to facilitate scalable, patient-centered solutions for perinatal mental health. We critically evaluate the recent literature and propose potential future directions. RECENT FINDINGS The current literature highlights the promise of telemedicine in the prevention and treatment of perinatal depression, including the preference for and the potential efficacy of telemedicine-delivered mental healthcare when compared to in-person treatments. There remains a need for large, adequately powered randomized controlled trials; integration of trauma into depression and anxiety trials, transdiagnostic treatment of perinatal women, and scaling up these effective treatments into existing health and payer systems. Pragmatic, evidence-based solutions exist to effectively scale-up treatments for perinatal mental health. While research is underway to address the growing treatment gap, questions remain regarding who will deliver and pay for these treatments and how we can leverage telemedicine to treat perinatal mental health transdiagnostically.
Collapse
Affiliation(s)
- Daisy R Singla
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, 60 White Squirrel Way, Rm 313, Toronto, ON, M6J 1H4, Canada.
- Department of Psychiatry, Lunenfeld Tanenbaum Research Institute and Sinai Health, Toronto, Canada.
- Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, Canada.
| | - Katarina Savel
- Department of Psychiatry, Lunenfeld Tanenbaum Research Institute and Sinai Health, Toronto, Canada
| | - Cindy-Lee Dennis
- Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, Canada
- Lawerence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Canada
- Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Canada
| | - Jo Kim
- Department of Obstetrics & Gynecology, NorthShore University HealthSystem and University of Chicago, Chicago, USA
- Department of Obstetrics & Gynecology, University of Chicago Pritzker School of Medicine, Chicago, USA
| | - Richard K Silver
- Department of Obstetrics & Gynecology, NorthShore University HealthSystem and University of Chicago, Chicago, USA
- Department of Obstetrics & Gynecology, University of Chicago Pritzker School of Medicine, Chicago, USA
| | - Simone Vigod
- Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, Canada
- Women's College Hospital, Toronto, Canada
- Women's College Research Institute, Toronto, Canada
| | - Ariel Dalfen
- Department of Psychiatry, Lunenfeld Tanenbaum Research Institute and Sinai Health, Toronto, Canada
- Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, Canada
- Women's College Hospital, Toronto, Canada
| | | |
Collapse
|
16
|
Does the COVID-19 Pandemic Affect Labor-Related Anxiety and Prevalence of Depressive Symptoms in Pregnant Women? J Clin Med 2022; 11:jcm11216522. [DOI: 10.3390/jcm11216522] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2022] [Revised: 10/23/2022] [Accepted: 11/02/2022] [Indexed: 11/06/2022] Open
Abstract
The COVID-19 pandemic undoubtedly had significant effects on women’s health and the course of pregnancy. The aim of this single-center study was to explore the impact of the COVID-19 pandemic on adult pregnant and postpartum women’s mental health, as well as to identify factors associated with depressive symptoms, anxiety and fear of delivery. The 465 women included in this questionnaire-based cohort study were divided into two groups: one (controls) of women who gave birth before (n = 190), and the second who were pregnant and delivered during the pandemic (n = 275). The COVID-19 pandemic affected the severity of self-reported anxiety regarding childbirth (mean scores 2.7 vs. 2.36, p = 0.01). The depression (19.84 ± 13.23) and anxiety (16.71 ± 12.53) scores were higher in pregnant women during the COVID 19 pandemic, compared to women who gave birth before the pandemic (8.21 ± 7.38 and 11.67 ± 9.23, respectively). These findings demonstrate the magnitude of the pandemic’s impact on women’s mental health, and actions to improve the mental health of pregnant women in Poland may be crucial for maternal and fetal well-being.
Collapse
|
17
|
Orsolini L, Pompili S, Mauro A, Salvi V, Volpe U. Fear and anxiety related to COVID-19 pandemic may predispose to perinatal depression in Italy. Front Psychiatry 2022; 13:977681. [PMID: 35990081 PMCID: PMC9382111 DOI: 10.3389/fpsyt.2022.977681] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/24/2022] [Accepted: 07/07/2022] [Indexed: 12/23/2022] Open
Abstract
The COVID-19 pandemic situation significantly affected the mental health of the general and clinical population. However, few studies investigated which COVID-19-related psychopathological determinants may predispose to perinatal depression. We evaluated the impact of COVID-19 related anxiety and fear on perinatal depression in Italy. We retrospectively screened 184 perinatal outpatients afferent to Perinatal Mental Health outpatient service, during March 2020-March 2021, by administering the Edinburgh Postnatal Depression Scale (EPDS), the Fear of COVID-19 (FCV-19-S) and the Coronavirus Anxiety Scale (CAS). Among these, 85 patients agreed to be recruited in the present study. The mean EPDS score was 9.0, experiencing a clinically relevant perinatal depression in 45.7% of the sample. The mean FCV-19-S score was 15.0 and CAS was 1.7. Linear regression analyses demonstrated that FCV-19-S and CAS scores statistically significantly predicted EPDS total scores. A positive significant correlation was reported between FCV-19-S and EPDS and between CAS and EPDS. During the COVID-19 pandemic, women in their perinatal period, independently of previous psychiatric history, experienced increased levels of anxiety, fear and psychological distress, due to subsequent isolation, quarantine, lockdown and deprivation of their normal social support. Further preventive and screening strategies should be implemented in order to early identify at-risk pregnant and puerperal women during the COVID-19 pandemic.
Collapse
Affiliation(s)
- Laura Orsolini
- Unit of Clinical Psychiatry, Department of Neurosciences/DIMSC, Polytechnic University of Marche, Ancona, Italy
| | | | | | | | | |
Collapse
|
18
|
Collart C, Craighead C, Rose S, Frankel R, Tucker Edmonds B, Perni U, Chien EK, Coleridge M, Ranzini A, Farrell RM. The Impact of Outpatient Prenatal Care Visitor Restrictions on Pregnant Patients and Partners During the COVID-19 Pandemic. WOMEN'S HEALTH REPORTS 2022; 3:718-727. [PMID: 36147830 PMCID: PMC9436262 DOI: 10.1089/whr.2022.0031] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Accepted: 06/30/2022] [Indexed: 11/13/2022]
Abstract
Introduction: Methods: Results: Conclusions:
Collapse
Affiliation(s)
- Christina Collart
- Subspecialty Care for Women's Health, OB/GYN and Women's Health Institute, Cleveland Clinic, Cleveland, Ohio, USA
| | - Caitlin Craighead
- Subspecialty Care for Women's Health, OB/GYN and Women's Health Institute, Cleveland Clinic, Cleveland, Ohio, USA
| | - Susannah Rose
- Center for Patient Experience, Cleveland Clinic, Cleveland, Ohio, USA
| | - Richard Frankel
- Department of the Lerner Research Institute, Cleveland Clinic Lerner College of Medicine, Cleveland, Ohio, USA
| | | | - Uma Perni
- Subspecialty Care for Women's Health, OB/GYN and Women's Health Institute, Cleveland Clinic, Cleveland, Ohio, USA
| | - Edward K. Chien
- Subspecialty Care for Women's Health, OB/GYN and Women's Health Institute, Cleveland Clinic, Cleveland, Ohio, USA
| | - Marissa Coleridge
- Subspecialty Care for Women's Health, OB/GYN and Women's Health Institute, Cleveland Clinic, Cleveland, Ohio, USA
- Center for Personalized Genetic Healthcare, Department of Genomic Medicine Institute, Cleveland Clinic, Cleveland, Ohio, USA
| | - Angela Ranzini
- Department of OB/GYN, MetroHealth Medical Center, Cleveland, Ohio, USA
| | - Ruth M. Farrell
- Subspecialty Care for Women's Health, OB/GYN and Women's Health Institute, Cleveland Clinic, Cleveland, Ohio, USA
- Center for Personalized Genetic Healthcare, Department of Genomic Medicine Institute, Cleveland Clinic, Cleveland, Ohio, USA
- Center for Bioethics, Cleveland Clinic, Cleveland, Ohio, USA
| |
Collapse
|
19
|
Depression in pregnant and postpartum women during COVID-19 pandemic: systematic review and meta-analysis. Obstet Gynecol Sci 2022; 65:287-302. [PMID: 35754363 PMCID: PMC9304439 DOI: 10.5468/ogs.21265] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2021] [Accepted: 05/19/2022] [Indexed: 11/08/2022] Open
Abstract
Coronavirus disease 2019 (COVID-19) emerged as a global pandemic in March 2020 and caused a big crisis, especially the health crisis. Pregnant and postpartum women experienced significant physical, social, and mental changes that put them at higher risk for several conditions during the pandemic. This study aimed to report the prevalence of depression in pregnant and postpartum women during the COVID-19 pandemic. Eligible studies were identified using several databases. Prevalence analysis was conducted using MedCalc ver. 19.5.1. This systematic review and meta-analysis was registered in PROSPERO on July 12, 2021 with registration number CRD42021266976. We included 54 studies with 95.326 participants. The overall prevalence of depression was 32.60% among pregnant and postpartum women during the COVID-19 pandemic. The rate was higher among pregnant women (31.49%) compared to postpartum women (27.64%). The prevalence of depression among pregnant and postpartum women increased during the COVID-19 pandemic.
Collapse
|
20
|
Lelisho ME, Merera AM, Tareke SA, Hassen SS, Jemal SS, Markos kontuab A, Bambo MM. Generalized anxiety disorder among mothers attending perinatal services during COVID-19 pandemic: using ordinal logistic regression model. Heliyon 2022; 8:e09778. [PMID: 35761934 PMCID: PMC9220756 DOI: 10.1016/j.heliyon.2022.e09778] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2022] [Revised: 03/01/2022] [Accepted: 06/20/2022] [Indexed: 11/19/2022] Open
Abstract
Background Generalized anxiety disorder is characterized by excessive and uncontrollable worry about a variety of events. It is critical to ensure a pregnant mother's mental health in order to reduce pregnancy and birth-related problems. The major goal of current study was to identify the factors associated with generalized anxiety disorder among mothers attending perinatal services in the study area during COVID-19 using ordinal logistic regression. Methods The institution-based cross-sectional study was conducted from July 10th, 2020 to August 10th, 2020 at Kembata Tembaro zone, Southern Ethiopia. The current study included 423 mothers. The GAD-7 scale was used to assess the anxiety level among mothers. An Ordered logit model was used to identify the determinants of GAD. Brant test of the parallel line was utilized to check proportionality assumption. The statistical significance was determined using an adjusted proportional odd ratio with a 95%CI, and a p-value <5%. STATA software version 14 was used to analyze statistical data. Results Of all 423 mothers attending perinatal service during COVID-19; 134(31.7%), 171(40.4%), 85(20.1%), and 33 (7.8%) had non/minimal to severe generalized anxiety disorder respectively. The results of multivariable proportional odds model (POM) showed that the variables town residents [aPOR = 1.827; 95% CI:1.233-2.708], having alcohol habit [aPOR = 3.437, 95% CI = 1.397-8.454], having occupation [aPOR = 0.509, 95% CI: 0.303-0.857], being health care worker [aPOR = 0.117, 95% CI = 0.044-0.311], having chronic illness [aPOR = 7.685, 95% CI = 3.045-19.39], having family history of anxiety/mood disorder [aPOR = 7.839, 95% CI = 2.656-23.12], fear of contracting COVID-19 [aPOR = 1.704, 95% CI = 1.152-2.521], having moderate social support [aPOR = 0.648, 95% CI = 0.425-0.989], having strong social support [aPOR = 0.495, 95% CI = 0.272-0.901] were significantly associated with generalized anxiety disorder at 5% level of significance. Conclusion Current findings concluded that the prevalence of GAD among mothers attending perinatal service during COVID-19 was high. The covariates like being town resident, lower-income status, occupation status, having a chronic illness, having a positive family history of anxiety or mood disorder, perceived social support, and fear of the COVID-19 were significantly associated with generalized anxiety disorder among mothers. Mothers who visit perinatal services should be given special consideration to improve health care services and ensure their mental health.
Collapse
|
21
|
Arias MP, Wang E, Leitner K, Sannah T, Keegan M, Delferro J, Iluore C, Arimoro F, Streaty T, Hamm RF. The impact on postpartum care by telehealth: a retrospective cohort study. Am J Obstet Gynecol MFM 2022; 4:100611. [PMID: 35331971 PMCID: PMC10134102 DOI: 10.1016/j.ajogmf.2022.100611] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2022] [Revised: 02/28/2022] [Accepted: 03/02/2022] [Indexed: 11/24/2022]
Abstract
BACKGROUND During the COVID-19 pandemic, our institution turned to telehealth as the primary method of postpartum care delivery. OBJECTIVE We aimed to determine the impact of telehealth on completion of postpartum care goals. STUDY DESIGN In a single-center retrospective cohort study, we compared a 14-week period, March to June 2019, before implementation of telehealth, with the same calendar months after implementation during 2020. Patients with a postpartum visit scheduled at our institution during the study period were included. To demonstrate a 10% difference in attendance to the postpartum visit in the postimplementation compared with the preimplementation group, a power analysis calculation resulted in a requirement of at least 356 subjects per group. Our primary outcome was attendance to the postpartum visit. Secondary outcomes included completion of postpartum depression screening, contraception selection, breastfeeding status at postpartum visit, completion of 2-hour glucose tolerance test postpartum for those with gestational diabetes mellitus, and cardiology follow-up when recommended. Multivariable logistic regression with backward elimination was used to control for confounders. RESULTS Of the 1579 patients meeting inclusion criteria, 780 were in the preimplementation group and 799 in the postimplementation group. Subjects in the postimplementation group were at 90% increased odds of attending a postpartum visit compared with those in the preimplementation group, even when controlling for race, prenatal care provider, parity, gestational age at delivery, and insurance status (82.9% vs 72.4%; P<.001; adjusted odds ratio, 1.90; 95% confidence interval, 1.47-2.46). Patients in the postimplementation group were also more likely to be screened for postpartum depression (86.3% vs 65.1%; P<.001). Although subjects in both groups were equally likely to choose contraception, those in the postimplementation group were less likely to select long-acting reversible contraception or permanent sterilization (26.2% vs 33.2%; P=.03). There was no significant difference in breastfeeding status, postpartum 2-hour glucose tolerance test completion, or cardiology follow-up between groups. CONCLUSION Availability of telehealth during the COVID-19 pandemic is associated with increased postpartum visit attendance and postpartum depression screening. However, telehealth was also associated with a decrease in use of long-acting reversible contraception or permanent sterilization.
Collapse
Affiliation(s)
- Maria Paula Arias
- Perelman School of Medicine and the Department of Obstetrics and Gynecology at Penn Medicine, Philadelphia, PA..
| | - Eileen Wang
- Perelman School of Medicine and the Department of Obstetrics and Gynecology at Penn Medicine, Philadelphia, PA
| | - Kristin Leitner
- Perelman School of Medicine and the Department of Obstetrics and Gynecology at Penn Medicine, Philadelphia, PA
| | - Tasneem Sannah
- Perelman School of Medicine and the Department of Obstetrics and Gynecology at Penn Medicine, Philadelphia, PA
| | - Morgan Keegan
- Perelman School of Medicine and the Department of Obstetrics and Gynecology at Penn Medicine, Philadelphia, PA
| | - Joseph Delferro
- Perelman School of Medicine and the Department of Obstetrics and Gynecology at Penn Medicine, Philadelphia, PA
| | - Charissa Iluore
- Perelman School of Medicine and the Department of Obstetrics and Gynecology at Penn Medicine, Philadelphia, PA
| | - Faith Arimoro
- Perelman School of Medicine and the Department of Obstetrics and Gynecology at Penn Medicine, Philadelphia, PA
| | - Taylor Streaty
- Perelman School of Medicine and the Department of Obstetrics and Gynecology at Penn Medicine, Philadelphia, PA
| | - Rebecca F Hamm
- Perelman School of Medicine and the Department of Obstetrics and Gynecology at Penn Medicine, Philadelphia, PA
| |
Collapse
|
22
|
Fernandes DV, Canavarro MC, Moreira H. Self-compassion and mindful parenting among postpartum mothers during the COVID-19 pandemic: The role of depressive and anxious symptoms. CURRENT PSYCHOLOGY 2022; 42:1-13. [PMID: 35283611 PMCID: PMC8905028 DOI: 10.1007/s12144-022-02959-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/25/2022] [Indexed: 11/03/2022]
Abstract
Self-compassion is an important psychological skill that may facilitate the adoption of a mindful way of parenting, especially during the COVID-19 pandemic. However, the association between these constructs may be explained by several variables, such as maternal psychopathological symptoms, with a well-established interference in parenting. This study aimed to compare mothers who experienced and mothers who did not experience a negative emotional impact of the COVID-19 pandemic on self-compassion, mindful parenting, postpartum depressive symptoms (PPDS) and postpartum anxious symptoms (PPAS). We also explored whether mothers' self-compassion was associated with mindful parenting and whether this relationship may be mediated by PPDS and PPAS. A sample of 977 Portuguese mothers of infants aged between zero and six months completed an online survey between December 2020 and January 2021, a period of major pandemic-related restrictions. The survey included several self-report questionnaires that assessed sociodemographic, clinical, and COVID-19 information, self-compassion, mindful parenting, PPDS and PPAS. Mothers who reported having felt that the pandemic had a negative emotional impact during their postpartum period (79.5%) presented lower levels of self-compassion and mindful parenting, and higher levels of PPDS and PPAS. Regarding the mediation model, higher levels of self-compassion were related to higher levels of mindful parenting, and this association was mediated by lower levels of PPAS. These results highlight the relevance of mothers' self-compassion for helping them feel less anxious and to adopt a mindful way of parenting in the postpartum period, particularly during the pandemic. Compassion-based interventions may be particularly important in reducing PPAS and promoting mindful parenting and should be available to postpartum mothers, especially during, but also beyond the pandemic.
Collapse
Affiliation(s)
- Daniela Ventura Fernandes
- Centre for Research in Neuropsychology and Cognitive Behavioural Intervention (CINEICC), Faculty of Psychology and Educational Sciences, University of Coimbra, Rua Do Colégio Novo, 3030-115 Coimbra, Portugal
| | - Maria Cristina Canavarro
- Centre for Research in Neuropsychology and Cognitive Behavioural Intervention (CINEICC), Faculty of Psychology and Educational Sciences, University of Coimbra, Rua Do Colégio Novo, 3030-115 Coimbra, Portugal
| | - Helena Moreira
- Centre for Research in Neuropsychology and Cognitive Behavioural Intervention (CINEICC), Faculty of Psychology and Educational Sciences, University of Coimbra, Rua Do Colégio Novo, 3030-115 Coimbra, Portugal
| |
Collapse
|
23
|
Singla DR, Hossain S, Ravitz P, Schiller CE, Andrejek N, Kim J, La Porte L, Meltzer-Brody SE, Silver R, Vigod SN, Jung JW, Dimidjian S. Adapting behavioral activation for perinatal depression and anxiety in response to the COVID-19 pandemic and racial injustice. J Affect Disord 2022; 299:180-187. [PMID: 34875282 PMCID: PMC8645290 DOI: 10.1016/j.jad.2021.12.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2021] [Revised: 11/06/2021] [Accepted: 12/02/2021] [Indexed: 11/25/2022]
Abstract
BACKGROUND We examined the implementation of a brief, behavioural activation (BA) model, via telemedicine, for perinatal populations during a confluence of significant global events in 2020. We conducted a rigorous qualitative study to identify relevant barriers and facilitators from the perspectives of both perinatal participants and treatment providers. We also present two case studies where BA was used and adapted to provide patient-centered care. METHODS Within the ongoing SUMMIT non-inferiority randomized controlled trial in Canada and USA, we interviewed a random selection of perinatal participants (n = 23) and all treatment providers (n = 28). A content analysis framework was developed to identify relevant barriers and facilitators and frequencies were calculated for each emergent theme within and across respondent groups. RESULTS Key facilitators reported by participants receiving BA were that BA helped with support and social connection (73.9%), creative problem solving (26.1%) and attending to pandemic-related symptoms (21.7%). Key facilitators endorsed by providers delivering BA were the use of telemedicine (35.7%) and loosening of government restrictions (21.4%). Both participant groups reported similar barriers to BA during the pandemic such as a lack of privacy and limited activities due to pandemic restrictions. However, providers were more likely to endorse pandemic-related life stressors as a barrier to treatment delivery compared to participants (64.3% vs. 34.8%). Both participant groups experienced explicit discussion of race and the racial justice movements during sessions as beneficial and reported harms of not doing so to the therapeutic alliance. CONCLUSIONS BA offers a person-centered model to facilitate social connection through creative problem-solving for women with perinatal depressive and anxiety symptoms within the context of the COVID-19 pandemic. Explicit discussion of race and racial injustice during sessions is an important and helpful aspect in psychological treatments.
Collapse
Affiliation(s)
- Daisy R. Singla
- Campbell Family Mental Health Research Institute, Center of Addiction and Mental Health, Toronto, Canada,Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, Canada,Lunenfeld Tanenbaum Research Institute, Toronto, Canada,Corresponding author at: 60 White Squirrel Way, Rm313, Toronto, ON M6J 1H4, Canada
| | | | - Paula Ravitz
- Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, Canada,Lunenfeld Tanenbaum Research Institute, Toronto, Canada,Department of Psychiatry, Sinai Health, Toronto, Canada
| | - Crystal E. Schiller
- Department of Psychiatry, School of Medicine, University of North Carolina, Chapel Hill, United States
| | | | - Jo Kim
- Department of Obstetrics and Gynecology, NorthShore University HealthSystem, Chicago, IL, United States
| | - Laura La Porte
- Department of Obstetrics and Gynecology, NorthShore University HealthSystem, Chicago, IL, United States
| | - Samantha E. Meltzer-Brody
- Department of Psychiatry, School of Medicine, University of North Carolina, Chapel Hill, United States
| | - Richard Silver
- Department of Obstetrics and Gynecology, NorthShore University HealthSystem, Chicago, IL, United States
| | - Simone N. Vigod
- Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, Canada,Department of Psychiatry, Women's College Hospital, Toronto, Canada
| | - James W. Jung
- Department of Psychology, University of Calgary, Calgary, Canada
| | - Sona Dimidjian
- Renee Crown Wellness Institute and Department of Psychology and Neuroscience, University of Colorado, Boulder, United States
| |
Collapse
|
24
|
Efendi D, Hasan F, Natalia R, Utami AR, Sonko I, Asmarini TA, Yuningsih R, Wanda D, Sari D. Nursing care recommendation for pediatric COVID-19 patients in the hospital setting: A brief scoping review. PLoS One 2022; 17:e0263267. [PMID: 35113925 PMCID: PMC8812980 DOI: 10.1371/journal.pone.0263267] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2021] [Accepted: 01/14/2022] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND The hospitalization of children during the COVID-19 pandemic has affected their physical and mental health. Pediatric nurses have faced challenges in providing high-quality nursing care for children and their families. However, the pediatric nursing care recommendations for COVID-19 patients in the hospital setting remain unclear. The current scoping review provides recommendations for nursing interventions for pediatric COVID-19 patients in the hospital setting. METHODS AND FINDINGS The selected articles containing management and nursing recommendations for COVID-19 that have occurred in pediatric patients ages 0-19 years old. A search strategy was developed and implemented in seven databases. We included peer-reviewed articles that reported observational or interventional studies, as well as policy papers, guides or guidelines, letters and editorials, and web articles. A total of 134 articles and other documents relevant to this review were included. We categorized the results based on The Nursing Intervention Classification (NIC) taxonomy which consists of six domains (e.g., Physiological: Basic); eleven classes (e.g., Nutrition Support); and eighteen intervention themes (e.g., Positioning, Family Presence Facilitation, Family Support, and Discharge Planning). CONCLUSION Apart from the intervention of physical problems, there is a need to promote patient- and family-centered care, play therapy, and discharge planning to help children and families cope with their new situation.
Collapse
Affiliation(s)
- Defi Efendi
- Department of Pediatric Nursing, Faculty of Nursing, Universitas Indonesia, Depok, Indonesia
- Neonatal Intensive Care Unit, Universitas Indonesia Hospital, Depok, Indonesia
| | - Faizul Hasan
- School of Nursing, Taipei Medical University, Taipei, Taiwan
| | - Regina Natalia
- School of Nursing, Mitra Bunda Health Institute, Batam, Indonesia
| | - Ayuni Rizka Utami
- Department of Pediatric Nursing, Faculty of Nursing, Universitas Indonesia, Depok, Indonesia
| | - Ismaila Sonko
- School of Nursing, Taipei Medical University, Taipei, Taiwan
- Ministry of Health and Social Welfare, The Quadrangle, Banjul, The Gambia, West Africa
| | - Titik Ambar Asmarini
- Department of Pediatric Nursing, Faculty of Nursing, Universitas Indonesia, Depok, Indonesia
- Neonatal and Pediatric Intensive Care Unit, Gatot Soebroto Indonesian Central of Army Hospital, Jakarta, Indonesia
| | - Risna Yuningsih
- Neonatal Intensive Care Unit, Dr. Dradjat Prawiranegara General Hospital, Banten, Indonesia
| | - Dessie Wanda
- Department of Pediatric Nursing, Faculty of Nursing, Universitas Indonesia, Depok, Indonesia
| | - Dian Sari
- School of Nursing, Prima Nusantara Health Institute, Bukittinggi, Indonesia
| |
Collapse
|
25
|
Saleh L, Canclini S, Greer K, Mathison C, Combs SM, Dickerson B, Collins K. Mothers' Experiences of Pregnancy, Labor and Birth, and Postpartum During COVID-19 in the United States: Preliminary Results of a Mixed-Methods Study. J Perinat Neonatal Nurs 2022; 36:55-67. [PMID: 35089178 DOI: 10.1097/jpn.0000000000000624] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
The purpose of this study was to gain insight into the experiences of women who gave birth in the United States during coronavirus disease-2019 (COVID-19). A mixed-methods study was performed using online surveys and interviews. Data were analyzed using descriptive statistics and interview transcripts were analyzed by thematic analysis resulting in major themes. Participants (n = 32) were women who had given birth on or after March 13, 2020. Of the participants, 34% experienced depression, 46% experienced mild to moderate anxiety, and 28% experienced severe anxiety symptoms. Four major themes emerged: expectations versus reality, early versus late COVID-19 experience, mental distress versus mental health, and healthcare policy versus COVID-19 confusion. Experiences varied based upon geographical location, parity, and proximity to support. Short and long-term effects of COVID-19 on participants and their families were recognized. It is important to acknowledge the confusion experienced in many aspects of the birthing experience due to developing or conflicting pandemic or popular media information. Aligning expectations through providing clear, up-to-date information is helpful in decreasing mental distress. Finally, the impact of COVID-19 highlighted the critical need for professional and focused familial support and follow-up for women experiencing pregnancy-related mental health symptoms.
Collapse
Affiliation(s)
- Lisette Saleh
- Texas Christian University, Fort Worth, Texas (Dr Saleh and Mss Canclini, Greer, Mathison, Dickerson, and Collins); and TCU and UNTHSC School of Medicine, Fort Worth, Texas (Dr Combs)
| | | | | | | | | | | | | |
Collapse
|
26
|
Evaluating the effectiveness and quality of mobile applications for perinatal depression and anxiety: A systematic review and meta-analysis. J Affect Disord 2022; 296:443-453. [PMID: 34624434 DOI: 10.1016/j.jad.2021.09.106] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2021] [Revised: 09/02/2021] [Accepted: 09/26/2021] [Indexed: 11/20/2022]
Abstract
BACKGROUND Our objectives were to assess: (1) the effectiveness of existing mHealth apps for reducing symptoms of maternal depression and/or anxiety during the prenatal period and/or the first year postpartum, and (2) the app quality of commercially available apps targeting perinatal depression and/or anxiety. METHODS To address Objective 1, we searched five electronic databases (MEDLINE, CINAHL, PsycINFO, Web of Science, and Embase) from their inception until May 3rd, 2021. For the second objective, we searched Google Play and Apple App Stores in the United States, United Kingdom, Canada, and Australia until May 3rd, 2021. RESULTS Our search identified 3,897 articles, seven of which were meta-analyzed. mHealth apps did not improve perinatal depression (SMD, -0.39; 95% CI, -0.80 to 0.03) or anxiety (SMD, 0.01; 95% CI, -0.13 to 0.16) within the first 3 months post-intervention or at 6 months post-intervention. Our search of app stores identified 74 commercially available apps, 37 of which were evaluated via MARS tool. Current apps for perinatal anxiety and/or depression were rated to be of moderate quality on the MARS (mean, 3.6/5). LIMITATIONS There is a small number of overall studies in this field and the individual studies have methodological limitations. Furthermore, few apps identified in our app store search have been clinically tested. CONCLUSION Despite their widespread availability, mHealth apps do not appear to effectively reduce perinatal depression or anxiety, and few were subjectively rated to be of high quality. There is a need to develop higher quality mHealth apps and assess their potential to improve perinatal maternal mental health.
Collapse
|
27
|
Bachani S, Sahoo SM, Nagendrappa S, Dabral A, Chandra P. Anxiety and depression among women with COVID-19 infection during childbirth-experience from a tertiary care academic center. AJOG GLOBAL REPORTS 2021; 2:100033. [PMID: 34841377 PMCID: PMC8604795 DOI: 10.1016/j.xagr.2021.100033] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND Pregnancy and postpartum are vulnerable periods for mental health problems and distress. Studies conducted worldwide have highlighted the role of the COVID-19 pandemic in adding to the rates of depression and anxiety in the perinatal period. However, there are very few reports on mothers who were identified as having COVID-19 infection at the time of childbirth. OBJECTIVE Our study aimed to find the prevalence of depression and anxiety among pregnant women who were admitted for labor and tested positive for COVID-19 infection. We also aimed to study the association of various sociodemographic, social support, and obstetrical factors and that of COVID-19-related worries with depression and anxiety. STUDY DESIGN The study was conducted at the obstetrics inpatient setting in a public hospital in New Delhi, which had a separate designated COVID-19 block. Pregnant and postpartum women >18 years of age who were admitted to the COVID-19 maternity ward for delivery were included for this study. The women were interviewed within the first week of admission and after 6 to 8 weeks of childbirth. The sociodemographic and obstetrical details and COVID-19-related worries and concerns were assessed. Depression and anxiety were assessed using the Patient Health Questionnaire version 9 and the Generalized Anxiety Disorder 7-item Scale, respectively. The normally distributed variables are expressed as mean±standard deviation and continuous variables with skewed distribution as median (interquartile range). The categorical data presented as proportions of categorical variables were compared using the chi-square or the Fischer exact test. All the tests are 2-sided, with a significance level of 5%. The data were analyzed using the SPSS software version 24. The rates of depression and anxiety were calculated and univariate analysis was done to identify the factors associated with moderate and severe anxiety and depression using various sociodemographic and obstetrical variables, the total COVID anxiety scale scores, and the social support score. RESULTS The mean age of the women was 26.86 years (±4.31). Of the 243 women assessed using the Patient Health Questionnaire version 9, 168 (69.13%) had mild depressive disorder, and 29 (11.3%) had moderate depressive disorder. Of the 187 women who were assessed at the 6-weeks follow-up, 31 (16.57%) had minimal depression, 131 (70.05%) had mild depression, and 25 (13.36%) had moderate depression. Mild anxiety was seen in 121 cases (49.79%) and 13 (5.34%) had moderate anxiety symptoms. Women reported several worries, especially about the stigma of COVID-19 infection, support for infant care, and access to infant health services. CONCLUSION Screening for common mental illnesses with the timely identification of associated risk factors should be done, with a liaison between obstetricians and mental health professionals. Obstetricians can address and reassure pregnant women regarding concerns about contracting the infection, worries about the possible effects of COVID-19 on the fetus and the newborn, and concerns about future consultations. In case the worries are out of proportion and necessitate intervention by mental health professionals, referral services should be made available. Hence, identifying and addressing the mental health concerns will help provide the optimum perinatal care during the pandemic.
Collapse
Affiliation(s)
- Sumitra Bachani
- Vardhaman Mahavir Medical College and Safdurjung Hospital, New Delhi, India
| | | | | | - Anjali Dabral
- Vardhaman Mahavir Medical College and Safdurjung Hospital, New Delhi, India
| | - Prabha Chandra
- National Institute of Mental Health and Neurosciences, Bengaluru, India
| |
Collapse
|
28
|
Leppers I, Veth CPM, de Waardt DA, Migchels H, Traa MJ. Perinatal mental health around the world: priorities for research and service development in The Netherlands. BJPsych Int 2021. [DOI: 10.1192/bji.2021.47] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
The Netherlands has an unique system of perinatal and postpartum healthcare. Pregnancy care is delivered predominantly by primary care midwives and childbirth services predominantly involve hospital care. The first week postpartum, all women receive daily care from maternity nurses. In addition, hospitals and out-patient clinics offer perinatal mental healthcare. More specifically, ‘POP care’ (psychiatry, obstetrics and paediatrics) was developed to promote multidisciplinary collaboration in this regard. Although clinical practices and government initiatives to improve pregnancy-related mental healthcare work well, they have yet to be fully described and evaluated. The current COVID-19 pandemic has an impact on health services and perinatal mental health.
Collapse
|
29
|
Nagendrappa S, Vinod P, Pai NM, Ganjekar S, Desai G, Kishore MT, Thippeswamy H, Vaiphei K, Chandra PS. Perinatal Mental Health Care for Women With Severe Mental Illness During the COVID-19 Pandemic in India-Challenges and Potential Solutions Based on Two Case Reports. Front Glob Womens Health 2021; 2:648429. [PMID: 34816204 PMCID: PMC8593993 DOI: 10.3389/fgwh.2021.648429] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2020] [Accepted: 06/22/2021] [Indexed: 01/09/2023] Open
Abstract
The ongoing COVID-19 pandemic in India has created several challenges in the care of women with perinatal mental illness. Access to healthcare has been disrupted by lockdowns, travel restrictions, and the unavailability of outpatient services. This report aims to discuss the challenges faced by women with severe mental illnesses during the perinatal period with the help of two case reports. Accordingly, we have highlighted the role of COVID-19 infection as a traumatic event during childbirth and its role in triggering a psychotic episode in women with vulnerabilities; difficulties faced by women with postpartum psychosis in accessing perinatal psychiatry services; and the challenges of admission into an inpatient Mother-Baby Unit (MBU). Further, we have discussed potential solutions from the perspectives of Lower and Middle-income (LAMI) countries that need to be extended beyond the pandemic. They include offering video consultations, reviewing hospital policies, and evolving strategies to mitigate traumatic experiences for pregnant and postpartum women with severe mental illnesses in both obstetric and psychiatric care.
Collapse
Affiliation(s)
- Sachin Nagendrappa
- Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bangalore, India
| | - Pratibha Vinod
- Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bangalore, India
| | - Naveen Manohar Pai
- Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bangalore, India
| | - Sundarnag Ganjekar
- Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bangalore, India
| | - Geetha Desai
- Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bangalore, India
| | - M. Thomas Kishore
- Department of Clinical Psychology, National Institute of Mental Health and Neurosciences, Bangalore, India
| | - Harish Thippeswamy
- Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bangalore, India
| | - Kimneihat Vaiphei
- Department of Psychiatric Social Work, National Institute of Mental Health and Neurosciences, Bangalore, India
| | - Prabha S. Chandra
- Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bangalore, India,*Correspondence: Prabha S. Chandra
| |
Collapse
|
30
|
The Indirect Effect of Parental Intolerance of Uncertainty on Perinatal Mental Health via Mindfulness During COVID-19. Mindfulness (N Y) 2021; 12:1999-2008. [PMID: 34093889 PMCID: PMC8171361 DOI: 10.1007/s12671-021-01657-x] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/17/2021] [Indexed: 01/15/2023]
Abstract
Objectives The COVID-19 pandemic is associated with mental health difficulties, especially during pregnancy and early postpartum. Intolerance of uncertainty (IU) and reduced capacity for mindfulness-a protective factor for child-bearers-may be particularly relevant factors driving mental health problems given the unpredictable nature of the pandemic. The current study aims to shed light on modifiable paths to perinatal psychological distress by testing whether there is an indirect effect of IU on psychological symptoms through a perceived reduction in mindfulness during the pandemic. Methods Pregnant individuals (67%, n = 133) and new mothers within 6 months postpartum (33%, n = 66) participated in a cross-sectional online survey assessing IU, current and retrospective pre-pandemic mindfulness (FFMQ), and psychological symptoms (anxiety, depression, somatization; BSI). Perceived change in mindfulness was captured by including retrospective mindfulness as a covariate in the PROCESS macro used for analyses. Results Tests of the direct association between mindfulness, IU, and psychological symptoms showed significant effects of IU (b = 0.46, SE = 0.064; p < .001) and perceived decrease in mindfulness during the pandemic (b = - 0.72, SE = 0.08, p < .001) on psychological symptoms (R 2 = .21-.34; F[2, 197] = 51.13-52.81, p < .001). The indirect effect of IU on symptoms via perceived decrease in mindfulness during the pandemic (b = 0.13, SE = 0.043, 95%CI [.060, .226]) was significant (R 2 = .41, F[3, 195] = 45.08, p < .001). Conclusions Results suggest that mothers who are less able to tolerate uncertainty experience more psychological symptoms, in part due to perceived reduction in mindfulness during the pandemic. Future research should examine whether IU is a screening risk marker and target for mindfulness-based interventions to improve maternal well-being and family outcomes.
Collapse
|
31
|
Wdowiak A, Makara-Studzińska M, Raczkiewicz D, Janczyk P, Słabuszewska-Jóźwiak A, Wdowiak-Filip A, Studzińska N. Effect of Excessive Body Weight and Emotional Disorders on the Course of Pregnancy and Well-Being of a Newborn before and during COVID-19 Pandemic. J Clin Med 2021; 10:jcm10040656. [PMID: 33572044 PMCID: PMC7916002 DOI: 10.3390/jcm10040656] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2020] [Revised: 02/01/2021] [Accepted: 02/04/2021] [Indexed: 12/18/2022] Open
Abstract
This study aimed to evaluate whether excessive body weight and the COVID-19 pandemic affect depression, and subsequently whether depression, excessive body weight, and the COVID-19 pandemic affect the course of pregnancy, as well as the well-being of a newborn. The research material included data retrieved from the medical records of 280 pregnant women who were provided with care by medical facilities in Lublin (100 women with normal weight, 100 overweight women, 50 with Class I and 30 with Class II obesity). They completed a Beck depression inventory (BDI) in pregnancy twice, in order to assess the risk of occurrence of postpartum depression. Pre-pregnancy BMI positively correlated with the severity of depression, both at 10–13 weeks of pregnancy (p < 0.001), and at 32 weeks of pregnancy (p < 0.001). The higher the pre-pregnancy BMI, on average the higher the severity of depression. The severity of depression was significantly higher during the pandemic than before it in women with normal body weight before pregnancy (p < 0.001), as well as in those overweight (p < 0.001) and with Class II obesity (p = 0.015). Excessive body weight before pregnancy leads to depressive disorders during pregnancy, increases the risk of preterm delivery, and exerts a negative effect on the state of a newborn. Depressive symptoms among pregnant, overweight and obese women intensified during the COVID-19 pandemic.
Collapse
Affiliation(s)
- Artur Wdowiak
- Diagnostic Techniques Unit, Medical University of Lublin, ul. Staszica 4/6, 20-081 Lublin, Poland;
| | - Marta Makara-Studzińska
- Department of Health Psychology, Jagiellonian University Medical College, ul. Kopernika 25, 31-501 Kraków, Poland;
| | - Dorota Raczkiewicz
- Department of Medical Statistics, Center of Postgraduate Medical Education, School of Public Health, Kleczewska 61/63, 01-826 Warsaw, Poland;
| | - Paula Janczyk
- Nursing and Midwifery Institute, Jagiellonian University Medical College, Kopernika 25, 31-501 Kraków, Poland;
| | - Aneta Słabuszewska-Jóźwiak
- First Department of Obstetrics and Gynecology, Center of Postgraduate Medical Education, Żelazna 90, 01-813 Warsaw, Poland
- Correspondence: ; Tel.: +48-504187297
| | - Anita Wdowiak-Filip
- Department of Dermatology, Venerology and Pediatric Dermatology, Medical University of Lublin, Radziwiłłowska 13, 20-080 Lublin, Poland;
| | | |
Collapse
|
32
|
Thompson KA, Bardone-Cone AM. 2019-nCOV distress and depressive, anxiety and OCD-type, and eating disorder symptoms among postpartum and control women. Arch Womens Ment Health 2021; 24:671-680. [PMID: 33738572 PMCID: PMC7972814 DOI: 10.1007/s00737-021-01120-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/17/2020] [Accepted: 03/04/2021] [Indexed: 12/21/2022]
Abstract
This study compared postpartum and control women on depressive, anxiety, and OCD-type symptoms, and eating disorder symptoms during the 2019-nCOV pandemic and evaluated if associations between 2019-nCOV distress and these mental health symptoms differed for postpartum compared to control women. A community sample of women, ages 18-39, who had either given birth in the past 12 months (n = 232) or had no pregnancy history (n = 137; controls), was recruited to complete an online survey about their depressive, anxiety, OCD, and eating disorder symptoms. Postpartum women reported greater OCD-type symptoms related to concerns about both contamination and responsibility for harm (ps < .05) compared to controls. After controlling for general stress and mental health history, the association between 2019-nCOV distress and OCD-type symptoms related to concerns about contamination was stronger among postpartum compared to control women (ps < .002). For all women, 2019-nCOV distress was positively related to general anxiety symptoms, total OCD-type symptoms, and OCD-type symptoms related to concerns about responsibility for harm after controlling for general stress and mental health history (ps < .03). Data are first to suggest postpartum women may be at elevated risk for OCD-type symptoms during 2019-nCOV pandemic, and pandemic distress is associated with anxiety and OCD-type symptoms among postpartum women more so than control women.
Collapse
Affiliation(s)
- Katherine A Thompson
- Department of Psychology and Neuroscience, University of North Carolina At Chapel Hill, CB #3270 Davie Hall, Chapel Hill, NC, 27599, USA.
| | - Anna M Bardone-Cone
- Department of Psychology and Neuroscience, University of North Carolina At Chapel Hill, CB #3270 Davie Hall, Chapel Hill, NC, 27599, USA
| |
Collapse
|