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Berbres M, Hesselman S, Ternström E, Schytt E. Women's use of Swedish health care during the postpartum period in relation to maternal country of birth-A population-based study. Acta Obstet Gynecol Scand 2024; 103:2101-2111. [PMID: 39113351 PMCID: PMC11426225 DOI: 10.1111/aogs.14935] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2024] [Revised: 07/05/2024] [Accepted: 07/11/2024] [Indexed: 09/27/2024]
Abstract
INTRODUCTION Migrant women are a heterogenous group with both higher and lower risk for pregnancy complications and adverse birth outcomes compared with women in the receiving countries. This study aimed to investigate women's use of Swedish healthcare postpartum, in terms of hospital stay >48 h, readmission to hospital, and specialized out-patient clinic visits, in relation to maternal country of birth. MATERIAL AND METHODS A population-based register study including 278 219 primiparous and 367 776 multiparous women in Sweden (2014-2019) using data from Swedish Pregnancy Register, National Patient Register and Statistics Sweden. Multivariable logistic regression analyses were used to estimate associations between maternal country of birth and outcomes, adjusting for year of birth, maternal age, education, pre-gestational hypertension and diabetes, and healthcare region, presented as crude and adjusted odds ratios (aOR) with 95% confidence interval (CI) with Swedish-born women as reference. RESULTS Subgroups of migrant women had higher odds of postpartum hospital stays > 48 h, particularly women from Eritrea (primiparous aOR 2.80, CI 2.49-3.15; multiparous aOR 2.78, CI 2.59-2.98), Somalia (primiparous aOR 2.61, CI 2.34-2.92; multiparous aOR 1.87, CI 1.79-1.97), and India (primiparous aOR 2.52, CI 2.14-2.97; multiparous aOR 2.61, CI 2.33-2.93), compared to Swedish-born women. Primiparous women from Afghanistan (aOR 1.32, CI 1.08-1.6), Iraq (aOR 1.30, CI 1.16-1.46), and Iran (aOR 1.23, CI 1.04-1.45) had slightly higher odds of hospital readmission, along with multiparous women from India (aOR 1.34, CI 1.02-1.76) and Somalia (aOR 1.24, CI 1.11-1.38). Specialized out-patient clinic visits were most common in primiparous women from Somalia (aOR 1.47, CI 1.35-1.59), Iran (aOR 1.31, CI 1.22-1.42) and Afghanistan (aOR 1.31, CI 1.18-1.46), and in multiparous women from Iran (aOR 1.30, CI 1.20-1.41) and Iraq (aOR 1.15, CI 1.11-1.20), however less common in women from some other countries. CONCLUSIONS The use of Swedish health care during the postpartum period varied among women, depending on their country of birth. Women from certain countries had particularly high odds of postpartum hospital stays exceeding 48 h, compared to Swedish-born women, regardless of parity and pre-gestational medical disorders. Further studies are needed to determine whether the individual needs of migrant women are being met during the postpartum period or not.
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Affiliation(s)
- Malin Berbres
- Department of Women's and Children's HealthUppsala UniversityUppsalaSweden
- Center for Research and DevelopmentUppsala UniversityGävleSweden
| | - Susanne Hesselman
- Department of Women's and Children's HealthUppsala UniversityUppsalaSweden
- Center for Clinical Research DalarnaUppsala UniversityFalunSweden
| | - Elin Ternström
- Department of Women's and Children's HealthUppsala UniversityUppsalaSweden
- School of Health and WelfareDalarna UniversityFalunSweden
| | - Erica Schytt
- Center for Clinical Research DalarnaUppsala UniversityFalunSweden
- Faculty of Health and Social SciencesWestern Norway University of Applied SciencesBergenNorway
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Persson C, Ericson J, Eriksson M, Salari R, Flacking R. Quality of couple relationship and associated factors in parents of NICU-cared infants during the first year after birth. J Perinatol 2024:10.1038/s41372-024-02076-1. [PMID: 39097668 DOI: 10.1038/s41372-024-02076-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2023] [Revised: 07/17/2024] [Accepted: 07/23/2024] [Indexed: 08/05/2024]
Abstract
OBJECTIVE To describe factors associated with quality of couple relationships among parents of infants cared for in neonatal intensive care units (NICUs) 1 year after birth and examine the trajectory of the relationship quality compared to parents from maternity units (MUs). STUDY DESIGN Longitudinally comparative cohort design. Parents answered surveys during the first year after discharge about the couple relationship, social support, and depressive symptoms. RESULTS Better social support and a hospital stay of 7-14 days were positively associated with the couple relationship in NICU mothers, whereas not having slept together with the partner and infant during hospitalization were negatively associated. Depressive symptoms were negatively associated with the relationship among NICU fathers. There were no differences in trajectory of the relationship quality between NICU and MU parents. CONCLUSION To strengthen couple relationships, it could be important to improve social support, facilitate space and time for support, and enable togetherness during hospitalization.
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Affiliation(s)
- Christine Persson
- School of Health and Welfare, Dalarna University, Falun, Sweden.
- Centre for Clinical Research Dalarna, Uppsala University, Uppsala, Sweden.
| | - Jenny Ericson
- School of Health and Welfare, Dalarna University, Falun, Sweden
- Centre for Clinical Research Dalarna, Uppsala University, Uppsala, Sweden
| | - Mats Eriksson
- Faculty of Medicine and Health, School of Health Sciences, Örebro University, Örebro, Sweden
| | - Raziye Salari
- Department of Clinical Psychology and Psychotherapy, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
- Child Health and Parenting (CHAP), Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden
| | - Renée Flacking
- School of Health and Welfare, Dalarna University, Falun, Sweden
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Jin Y, Mazrekaj D. The association between parenthood and health: A comparison of people in same-sex and different-sex relationships. SSM Popul Health 2024; 26:101685. [PMID: 38881819 PMCID: PMC11179624 DOI: 10.1016/j.ssmph.2024.101685] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2023] [Revised: 04/25/2024] [Accepted: 05/27/2024] [Indexed: 06/18/2024] Open
Abstract
Understanding social inequalities in parental health is crucial for family functioning and child development. Theoretically, the double burden of parenting and minority stress may lead to the negative association between parenthood and health outcomes being stronger for people in same-sex relationships. Moreover, drawn from the social control process and the compensation mechanism, the negative association between parenthood and health risk behaviors may become stronger for people in same-sex relationships. Yet, empirical evidence on parental health disparities between parents in same- and different-sex relationships is limited. Using linear and logistic regression models, coarsened exact matching, and entropy balancing on Dutch data between 2008 and 2021 (196 people in same-sex relationships and 6948 people in different-sex relationships), we investigate the relationship between parenthood and three health outcomes (self-rated health, physical health, and mental health) and two health risk behaviors (smoking and heavy episodic drinking). We find that parents on average are less likely to experience heavy episodic drinking than non-parents. The association between parenthood and health does not differ between people in same-sex and different-sex relationships.
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Affiliation(s)
- Yuxuan Jin
- Netherlands Interdisciplinary Demographic Institute (NIDI) - KNAW/University of Groningen, Lange Houtstraat 19, 2511 CV, Den Haag, the Netherlands
- Department of Sociology, Utrecht University, Padualaan 14, 3584 CH, Utrecht, the Netherlands
| | - Deni Mazrekaj
- Department of Sociology, Utrecht University, Padualaan 14, 3584 CH, Utrecht, the Netherlands
- Nuffield College, University of Oxford, New Road, OX1 1NF, Oxford, UK
- Leuven Economics of Education Research, KU Leuven, Naamsestraat 69, 3000, Leuven, Belgium
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Liu XY, Deng YL, Chen PP, Liu C, Miao Y, Zhang M, Cui FP, Zeng JY, Wu Y, Li CR, Liu CJ, Zeng Q. Self-Rated Health and Semen Quality in Men Undergoing Assisted Reproductive Technology. JAMA Netw Open 2024; 7:e2353877. [PMID: 38289600 PMCID: PMC10828918 DOI: 10.1001/jamanetworkopen.2023.53877] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Accepted: 12/07/2023] [Indexed: 02/01/2024] Open
Abstract
Importance Numerous studies have documented the association of self-rated health (SRH) with chronic diseases. However, few studies have investigated its association with semen quality. Objective To examine the association of SRH with semen quality among men undergoing assisted reproductive technology (ART) in China. Design, Setting, and Participants This cross-sectional study recruited male partners in couples undergoing ART treatment at the Center for Reproductive Medicine, Tongji Hospital, Wuhan, China. A total of 1262 men underwent 2 semen examinations and completed a questionnaire on SRH between December 2018 and January 2020. Data analysis was performed from November 20, 2022, to March 24, 2023. Exposure SRH, including overall physical and mental health, as well as reproductive-related physical and mental health specifically, were reported at baseline recruitment. Main Outcomes and Measures Sperm concentration, sperm progressive motility, sperm motility, and sperm count as semen quality parameters. Results The study included 1262 men with a mean (SD) age of 32.79 (5.25) years and body mass index of 24.37 (3.68). Men with poorer SRH had lower semen quality (eg, sperm concentration among poor vs very good overall physical health: percentage variation, -14.67%; 95% CI, -23.62% to -4.66%). Among 4 components of SRH, a greater reduction in semen quality was estimated for reproductive-related SRH compared with overall SRH, whereas the greatest reduction was observed for reproductive-related physical SRH. In comparison with men with very good reproductive-related physical SRH, men with poor reproductive-related physical SRH had differences of -24.78% (95% CI, -32.71% to -15.93%) and -25.61% (95% CI, -33.95% to -16.22%) in sperm count and concentration, respectively, and regression coefficients of -9.38 (95% CI, -12.01 to -6.76) and -9.24 (95% CI, -11.82 to -6.66) for sperm motility and sperm progressive motility, respectively. Conclusions and Relevance In this cross-sectional study of Chinese men, poorer SRH was associated with lower semen quality, and reproductive-related physical SRH was the most pronounced indicator. Our findings suggest that SRH, especially reproductive-related physical SRH, was a good indicator of semen quality, which should inform public and clinical regulatory decisions.
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Affiliation(s)
- Xiao-Ying Liu
- Department of Occupational and Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, PR China
- Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health (incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, PR China
| | - Yan-Ling Deng
- Department of Occupational and Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, PR China
- Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health (incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, PR China
| | - Pan-Pan Chen
- Department of Occupational and Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, PR China
- Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health (incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, PR China
| | - Chong Liu
- Department of Occupational and Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, PR China
- Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health (incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, PR China
| | - Yu Miao
- Department of Occupational and Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, PR China
- Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health (incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, PR China
| | - Min Zhang
- Department of Occupational and Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, PR China
- Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health (incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, PR China
| | - Fei-Peng Cui
- Department of Occupational and Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, PR China
- Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health (incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, PR China
| | - Jia-Yue Zeng
- Department of Occupational and Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, PR China
- Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health (incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, PR China
| | - Yang Wu
- Department of Occupational and Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, PR China
- Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health (incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, PR China
| | - Cheng-Ru Li
- Department of Occupational and Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, PR China
- Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health (incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, PR China
| | - Chang-Jiang Liu
- NHC Key Laboratory of Birth Defects and Reproductive Health, Chongqing Population and Family Planning Science and Technology Research Institute, Chongqing, PR China
| | - Qiang Zeng
- Department of Occupational and Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, PR China
- Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health (incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, PR China
- NHC Key Laboratory of Birth Defects and Reproductive Health, Chongqing Population and Family Planning Science and Technology Research Institute, Chongqing, PR China
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Benhammou V, Marchand-Martin L, Pierrat V, Charkaluk ML, Romito P, Kaminski M, Ancel PY, Saurel-Cubizolles MJ. Maternal health-related quality of life at 1 year after a preterm birth: role of socioeconomic status at birth. J Epidemiol Community Health 2023; 78:25-32. [PMID: 37752012 DOI: 10.1136/jech-2023-220591] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2023] [Accepted: 09/01/2023] [Indexed: 09/28/2023]
Abstract
BACKGROUND Maternal problems in the postpartum period may lead to suboptimal long-term health for women and could affect mother-child attachment. Social disadvantage is a risk factor for preterm birth, which carries its own burden of health issues and stress. The main aim of this study was to investigate the role for social factors in mothers' physical and emotional health-related quality of life (HRQoL) at 1 year after a preterm birth. METHODS EPIPAGE-2 is a French nationwide, prospective, population-based cohort of preterm children born before 35 weeks' gestation (N=3614 women). At birth, detailed data on the family's social status were collected. At 1 year after birth, mothers completed a mailed questionnaire to report information on their HRQoL, assessed by the Medical Outcomes Study 12-item Short Form. We used multivariate linear regression models to assess the association between social factors and maternal HRQoL. RESULTS At 1 year after childbirth, the emotional HRQoL of mothers of preterm children was worse than their physical HRQoL, even in women without any previous signs of psychological distress at the infant's discharge from hospital. Baseline social characteristics were the most important factors influencing the physical component of HRQoL. None of the studied social factors had any clear association with the mental component of HRQoL. CONCLUSION Our study underlines the importance of social disadvantage during pregnancy as risk factors for poor physical HRQoL at 1 year after a preterm birth.
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Affiliation(s)
- Valerie Benhammou
- Université Paris Cité, CRESS, Obstetrical Perinatal and Pediatric Epidemiology Research Team, EPOPé, INSERM, Paris, France
| | - Laetitia Marchand-Martin
- Université Paris Cité, CRESS, Obstetrical Perinatal and Pediatric Epidemiology Research Team, EPOPé, INSERM, Paris, France
| | - Véronique Pierrat
- Université Paris Cité, CRESS, Obstetrical Perinatal and Pediatric Epidemiology Research Team, EPOPé, INSERM, Paris, France
- Department of Neonatal Medicine, CHI Créteil, Créteil, France
| | - Marie-Laure Charkaluk
- Université Paris Cité, CRESS, Obstetrical Perinatal and Pediatric Epidemiology Research Team, EPOPé, INSERM, Paris, France
- Department of Neonatal Medicine, Lille Catholic Institute Hospital Group, Lomme, France
| | - Patrizia Romito
- Department of Human Studies, University of Trieste, Trieste, Italy
| | - Monique Kaminski
- Université Paris Cité, CRESS, Obstetrical Perinatal and Pediatric Epidemiology Research Team, EPOPé, INSERM, Paris, France
| | - Pierre-Yves Ancel
- Université Paris Cité, CRESS, Obstetrical Perinatal and Pediatric Epidemiology Research Team, EPOPé, INSERM, Paris, France
- Center for Clinical Investigation P1419, APHP - Centre Université Paris-Cité, Paris, France
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Ferreira MS, da Silva ZP, de Almeida MF, Alencar GP. Is parenthood associated with self-rated health among women in Brazil? PLoS One 2023; 18:e0293262. [PMID: 37903132 PMCID: PMC10615280 DOI: 10.1371/journal.pone.0293262] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2022] [Accepted: 10/09/2023] [Indexed: 11/01/2023] Open
Abstract
BACKGROUND Previous studies conducted in Europe and North America addressing the relationship between self-rated health and parenthood offer inconsistent results, with effects ranging from nonsignificant to significant and in opposite directions. The aim of the present study was to explore the relationship between parenthood and self-rated health (SRH) among women in Brazil (a country with strong inequalities) considering the time interval from the last delivery in the analyses, as proposed in previous studies set in Sweden. METHODS The study used data from cross-sectional National Health Surveys in Brazil conducted from 2013 to 2014 and 2019 to 2020 with selected groups of 20,046 and 25,100 women for whom complete data were available on the variables of interest. The primary outcome was self-rated health measured on a five-point scale. Partial proportional odds models were employed. RESULTS Compared to women that were not a parent, primiparous women whose delivery was within less than one year had a lower likelihood of worse SRH (OR (95% CI): 0.58-0.84 in 2013, and 0.64-0.94 in 2019), whereas multiparous women whose last delivery was more than one year earlier had greater likelihood of worse SRH (OR (95% CI): 1.08-1.27 in 2013, and 1.21-1.39 in 2019). CONCLUSIONS An association was found between parenthood and SRH among Brazilian women. Considering the epidemiological relevance of SRH, different aspects of parenthood concerning parity and time since the last delivery should be considered in further analyses.
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Affiliation(s)
- Matheus Souza Ferreira
- Department of Epidemiology, University of São Paulo, School of Public Health, São Paulo, Brazil
| | - Zilda Pereira da Silva
- Department of Epidemiology, University of São Paulo, School of Public Health, São Paulo, Brazil
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Mäkelä T, Saisto T, Salmela-Aro K, Miettinen J, Sintonen H, Rouhe H. Prenatal wellbeing of mothers, their partners, and couples: a cross-sectional descriptive study. BMC Pregnancy Childbirth 2023; 23:468. [PMID: 37349712 DOI: 10.1186/s12884-023-05790-4] [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: 11/26/2022] [Accepted: 06/15/2023] [Indexed: 06/24/2023] Open
Abstract
BACKGROUND Prenatal posttraumatic stress symptoms (PTSS), fear of childbirth (FOC), and depressive symptoms have been related to various negative effects during pregnancy, childbirth, and in the postnatal period. This study evaluates the prevalence of PTSS, FOC, depressive symptoms, and health-related quality of life (HRQoL) among pregnant women, their partners, and as couples. METHODS In a cohort of 3853 volunteered, unselected women at the mean of 17th weeks of pregnancy with 3020 partners, PTSS was evaluated by Impact of Event Scale (IES), FOC by Wijma Delivery Expectancy Questionnaire (W-DEQ-A), depressive symptoms by Edinburgh Postnatal Depression Scale (EPDS), and HRQoL by 15D instrument. RESULTS PTSS (IES score ≥ 33) was identified among 20.2% of the women, 13.4% of the partners, and 3.4% of the couples. Altogether, 5.9% of the women, but only 0.3% of the partners, and 0.04% of the couples experienced symptoms suggestive of phobic FOC (W-DEQ A ≥ 100). Respectively, 7.6% of the women, 1.8% of the partners, and 0.4% of the couples reported depressive symptoms (EPDS ≥ 13). Nulliparous women and partners without previous children experienced FOC more often than those with previous children, but there was no difference in PTSS, depressive symptoms, or HRQoL. Women's mean 15D score was lower than partners' and that of age- and gender-standardized general population, while partners' mean 15D score was higher than that of age- and gender-standardized general population. Women whose partners reported PTSS, phobic FOC, or depressive symptoms, often had the same symptoms (22.3%, 14.3%, and 20.4%, respectively). CONCLUSIONS PTSS were common in both women and partners, as well as in couples. FOC and depressive symptoms were common in women but uncommon in partners, thus they rarely occurred simultaneously in couples. However, special attention should be paid to a pregnant woman whose partner experiences any of these symptoms.
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Affiliation(s)
- Tia Mäkelä
- Department of Obstetrics and Gynecology, Helsinki University Hospital, PO BOX 140, Helsinki, 00029 HUS, Finland.
- University of Helsinki, PO BOX 4, Helsinki, 00014, Finland.
| | - Terhi Saisto
- Department of Obstetrics and Gynecology, Helsinki University Hospital, PO BOX 140, Helsinki, 00029 HUS, Finland
- University of Helsinki, PO BOX 4, Helsinki, 00014, Finland
| | - Katariina Salmela-Aro
- Department of Educational Sciences, University of Helsinki, PO BOX 9, Helsinki, 00014, Finland
| | - Jenny Miettinen
- University of Helsinki, PO BOX 4, Helsinki, 00014, Finland
- Espoo Health Care Center, City of Espoo, PO BOX 1, Espoo, 02070, Finland
| | - Harri Sintonen
- Department of Public Health, University of Helsinki, PO BOX 20, Helsinki, 00014, Finland
| | - Hanna Rouhe
- Department of Obstetrics and Gynecology, Helsinki University Hospital, PO BOX 140, Helsinki, 00029 HUS, Finland
- University of Helsinki, PO BOX 4, Helsinki, 00014, Finland
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Lara-Cinisomo S, Loret de Mola JR, Flores-Carter K, Tabb KM, Roloff K. Prenatal Depressive Symptoms, Self-Rated Health, and Diabetes Self-Efficacy: A Moderated Mediation Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph192013603. [PMID: 36294181 PMCID: PMC9602843 DOI: 10.3390/ijerph192013603] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Revised: 10/07/2022] [Accepted: 10/09/2022] [Indexed: 05/31/2023]
Abstract
BACKGROUND Diabetes leads to risk for pregnant persons and their fetuses and requires behavioral changes that can be compromised by poor mental health. Poor self-rated health (SRH), a reliable predictor of morbidity and mortality, has been associated with depressive symptoms and lower self-efficacy in patients with diabetes. However, it is unclear whether SRH mediates the association between depressive symptoms and self-efficacy in pregnant patients with diabetes and whether the healthcare site moderates the mediation. Thus, we sought to test these associations in a racially and ethnically diverse sample of pregnant individuals diagnosed with diabetes from two clinical settings. MATERIALS AND METHODS This was an observational, cross-sectional study of 137 pregnant individuals diagnosed with diabetes at two clinical study sites. Participants self-administered a demographic questionnaire and measures designed to assess depressive symptoms, SRH in pregnancy, and diabetes self-efficacy. A moderated mediation model tested whether these indirect effects were moderated by the site. RESULTS The results show that SRH mediated the association between depressive symptoms and diabetes self-efficacy. The results also showed the site moderated the mediating effect of SRH on depressive symptoms and diabetes self-efficacy. CONCLUSIONS Understanding the role of clinical care settings can help inform when and how SRH mediates that association between prenatal depressive symptoms and self-efficacy in diabetic patients.
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Affiliation(s)
- Sandraluz Lara-Cinisomo
- Department of Kinesiology and Community Health, University of Illinois Urbana-Champaign, 1206 S. Fourth Street, Champaign, IL 61820, USA
| | - Julio Ricardo Loret de Mola
- Department of Obstetrics and Gynecology, Southern Illinois University School of Medicine, 415 N. 9th St. Suite 6W100, Springfield, IL 62794, USA
| | - Kendra Flores-Carter
- Department of Social Work, College of Behavioral and Social Sciences, California Baptist University, 8432 Magnolia Avenue, Riverside, CA 92504, USA
| | - Karen M. Tabb
- School of Social Work, University of Illinois Urbana-Champaign, 1010 W. Nevada St., Urbana, IL 61801, USA
| | - Kristina Roloff
- Department of Women’s Health, Arrowhead Regional Medical Center, 400 N. Pepper Avenue, Colton, CA 92324, USA
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Juarez Padilla J, Singleton CR, Pedersen CA, Lara-Cinisomo S. Associations between Self-Rated Health and Perinatal Depressive and Anxiety Symptoms among Latina Women. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph191911978. [PMID: 36231278 PMCID: PMC9565349 DOI: 10.3390/ijerph191911978] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Revised: 09/13/2022] [Accepted: 09/20/2022] [Indexed: 06/01/2023]
Abstract
PURPOSE The objective of this study was to determine whether decreases in or consistently low preconception to pregnancy self-rated health (SRH) were associated with perinatal depressive and anxiety symptoms among Latinas. METHODS This is a secondary data analysis of 153 perinatal Latinas. Three groups were created to capture SRH from preconception to pregnancy: a decline in ratings, consistently low, and good+ (i.e., good, very good, or excellent). SRH was measured using two questions about their perceived physical health before and during pregnancy. Depressive symptoms and anxiety symptoms were assessed in the third trimester and six weeks postpartum using the Edinburgh Postnatal Depression Scale and State-Trait Anxiety Inventory, respectively. Life stressors were assessed in pregnancy using a modified version of the Life Experiences Survey. Linear regressions tested the associations. RESULTS Women with consistently low (i.e., fair or poor) SRH reported significantly more prenatal depressive symptoms than women who reported consistently good+ SRH. Women who reported a decline in SRH to fair or poor reported more prenatal anxiety symptoms but decreased postpartum anxiety symptoms than women who reported consistently good+ ratings. Life stressors were positively associated with prenatal depressive and anxiety symptoms. CONCLUSIONS Healthcare practitioners should assess changes in SRH ratings to identify risks for prenatal depressive and anxiety symptoms among Latinas, who have elevated rates of depressive and anxiety symptoms compared to non-Hispanic White women. Policymakers should provide healthcare providers with mental health resources to support at-risk Latinas during the prenatal period.
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Affiliation(s)
- Janeth Juarez Padilla
- Division of Scholarship and Research, Columbia University School of Nursing, New York, NY 10032, USA
| | - Chelsea R. Singleton
- Department of Social, Behavioral, and Populations Sciences, Tulane School of Public Health and Tropical Medicine, New Orleans, LA 70112, USA
| | - Cort A. Pedersen
- Department of Psychiatry, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA
| | - Sandraluz Lara-Cinisomo
- Department of Kinesiology and Community Health, College of Applied Health Sciences, University of Illinois Urbana-Champaign, Champaign, IL 61820, USA
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10
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Huber M, Tunón K, Lindqvist M. "From hell to healed" - A qualitative study on women's experience of recovery, relationships and sexuality after severe obstetric perineal injury. SEXUAL & REPRODUCTIVE HEALTHCARE 2022; 33:100736. [PMID: 35640528 DOI: 10.1016/j.srhc.2022.100736] [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: 08/30/2021] [Revised: 05/03/2022] [Accepted: 05/15/2022] [Indexed: 10/18/2022]
Abstract
OBJECTIVE Few studies have investigated women's experiences of daily life after childbirth complicated by obstetric anal sphincter injury (OASI). The aim of the present study was to explore experiences related to recovery, sexual function, relationships and coping strategies among women affected by OASI. METHODS In-depth interviews were conducted using a purposive sample of 11 women affected by OASI. Women were interviewed 1-2 years after their first childbirth. Inductive qualitative content analysis was applied. RESULTS The theme "From hell to healed" illustrates women's experiences of recovery, relationships and sexual function after OASI. Three categories addressing women's perceptions emerged: "Challenged to the core", "At the mercy of the care provider" and "For better or for worse". Support from partners and family and comprehensive care were important elements for the experiences of coping and healing from OASI. Elements that negatively influenced women's experiences were the pain and physical symptoms of pelvic floor dysfunction, normalization of symptoms by heath care providers, and unrealistic expectations about how this period in life should be experienced. CONCLUSION OASI greatly affects women's experiences of their first years with their newborn child, relationships, social context and sexuality. For some women, OASI negatively affects everyday life for a long period after childbirth. However, others heal and cope quite quickly. Health care professionals need to identify and pay attention to women with persisting problems after OASI so that they can be directed to the right level of care.
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Affiliation(s)
- Malin Huber
- Department of Clinical Sciences, Obstetrics and Gynecology, Umeå University, Umeå, Sweden.
| | - Katarina Tunón
- Department of Clinical Sciences, Obstetrics and Gynecology, Umeå University, Umeå, Sweden
| | - Maria Lindqvist
- Department of Clinical Sciences, Obstetrics and Gynecology, Umeå University, Umeå, Sweden
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11
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Mitchell AM, Kowalsky JM, Christian LM, Belury MA, Cole RM. Perceived social support predicts self-reported and objective health and health behaviors among pregnant women. J Behav Med 2022; 45:589-602. [PMID: 35449357 DOI: 10.1007/s10865-022-00306-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2020] [Accepted: 03/07/2022] [Indexed: 02/06/2023]
Abstract
Perinatal health and health behaviors play a crucial role in maternal and neonatal health. Data examining psychosocial factors which predict self-reported health and health behaviors as well as objective indicators downstream of health behaviors among pregnant women are lacking. In this longitudinal study design with 131 pregnant women, perceived social support was examined as a predictor of self-rated health and average levels of sleep quality, health-promoting and health-impairing behaviors, and red blood cell (RBC) polyunsaturated fatty acids across early, mid, and late pregnancy. Participants provided a blood sample and fatty acid methyl esters were analyzed by gas chromatography. Measures included the Multidimensional Scale of Perceived Social Support, Pittsburgh Sleep Quality Index, and Prenatal Health Behavior Scale. Regression models demonstrated that, after adjustment for income, race/ethnicity, age, relationship status, pre-pregnancy body mass index, greater social support was associated with better self-rated health (p = 0.001), greater sleep quality (p = 0.001), fewer health-impairing behaviors (p = 0.02), and higher RBC omega-3 fatty acids (p = 0.003). Associations among social support with health-promoting behaviors, RBC omega-6 fatty acids, or gestational weight gain were not significant. Findings underscore the benefits of perceived social support in the context of pregnancy. Examination of pathways that link social support with these outcomes will be meaningful in determining the ways in which perinatal psychosocial interventions may promote health.
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Affiliation(s)
- Amanda M Mitchell
- Department of Counseling and Human Development, College of Education and Human Development, University of Louisville, Woodford and Harriett Porter Building, 1905 South 1st Street, Louisville, KY, 40292, USA.
| | | | - Lisa M Christian
- Department of Psychiatry &, Behavioral Health, The Ohio State University Wexner Medical Center, Columbus, OH, USA
- The Institute for Behavioral Medicine Research, The Ohio State University Wexner Medical Center, Columbus, OH, USA
| | - Martha A Belury
- Department of Human Nutrition, The Ohio State University, Columbus, OH, USA
| | - Rachel M Cole
- Department of Human Nutrition, The Ohio State University, Columbus, OH, USA
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12
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Dahlgren H, Jansson MH, Franzén K, Hiyoshi A, Nilsson K. Sexual function in primiparous women: a prospective study. Int Urogynecol J 2022; 33:1567-1582. [PMID: 34973088 PMCID: PMC9206602 DOI: 10.1007/s00192-021-05029-w] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2021] [Accepted: 10/19/2021] [Indexed: 11/30/2022]
Abstract
INTRODUCTION AND HYPOTHESIS The aim of this prospective study was to examine the impact of sociodemographic, pregnancy and obstetric characteristics on sexual function 12 months postpartum in primiparous women. We hypothesized that sexual function would decrease after childbirth. METHODS Between 1 October 2014 and 1 October 2017, all nulliparous women in early pregnancy registering for maternity health care in Region Örebro County, Sweden, were invited to participate in this prospective study. A total of 958 women were included. Sexual activity and function were measured at early pregnancy, 8 weeks postpartum and 12 months postpartum using the Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire (PISQ-12). The associations between sociodemographic, pregnancy and obstetric characteristics and sexual activity and function from early pregnancy to 12 months postpartum were examined using linear and logistic models based on generalized estimating equations. RESULTS We found that the prevalence of sexually active women decreased from 98.0% in early pregnancy to 66.7% at 8 weeks postpartum, but increased to 90.0% at 12 months postpartum. Age ≥ 35 years, second-degree perineal tear and current breastfeeding were statistically significant risk factors for sexual inactivity at 12 months postpartum. Poor self-reported health in early pregnancy was statistically significantly associated with decreased sexual function at 12 months postpartum. CONCLUSIONS A majority of women resumed sexual activity at 8 weeks postpartum and most women at 12 months postpartum; the decrease in sexual function at 12 months postpartum was small and few risk factors were observed.
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Affiliation(s)
- Hedda Dahlgren
- Department of Obstetrics and Gynecology, Örebro University Hospital, Region Örebro County, PO Box 1613, SE-701 16, Örebro, Sweden.
| | - Markus H Jansson
- Department of Obstetrics and Gynecology, Örebro University Hospital, Region Örebro County, PO Box 1613, SE-701 16, Örebro, Sweden.,School of Medical Sciences, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
| | - Karin Franzén
- Department of Obstetrics and Gynecology, Örebro University Hospital, Region Örebro County, PO Box 1613, SE-701 16, Örebro, Sweden.,School of Medical Sciences, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
| | - Ayako Hiyoshi
- Clinical Epidemiology and Biostatistics, School of Medical Sciences, Örebro University, Örebro, Sweden
| | - Kerstin Nilsson
- School of Medical Sciences, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
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13
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Self-Rated Health and Pain Problems in Mothers of Healthy Children or Children Requiring Outpatient Observation or Hospitalisation: A Pilot Cross-Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18189543. [PMID: 34574464 PMCID: PMC8466010 DOI: 10.3390/ijerph18189543] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Revised: 08/05/2021] [Accepted: 09/01/2021] [Indexed: 11/17/2022]
Abstract
A child's illness or disability is a considerable stressor for the mother and a risk factor for many psychological problems and somatic diseases. The purpose of the study was to (1) assess the prevalence of poor SRH and pain, (2) compare self-rated health and pain, (3) and identify the determinants of SRH and pain in mothers of healthy children and children requiring ambulatory observation or hospitalization. The study covered 234 mothers of both healthy and unhealthy children who required outpatient observation or treatment at an intensive care unit, neonatal intensive care unit, or oncology department. To analyse the variables obtained, the following tools were used: Self-Rated Health, Numerical Rating, Interpersonal Support Evaluation List, Peritraumatic Distress Inventory, Modified Hospital Anxiety and Depression Scale, and Impact of Effects Scale-Revised. The self-assessment of health in mothers of healthy children and those in need of outpatient observation or hospitalization at units with various specialities differed in a statistically significant way. The severity of the average and maximum pain among mothers of healthy children and those with a history of disease differed statistically significantly. Poor SRH co-occurred with severe maximum pain in all of the examined groups. Both in the control group and the group of mothers of children requiring outpatient observation, poor SRH co-occurred with a high level of anxiety. Only in the control group was a correlation found between the severity of the average and maximum pain and the severity of anxiety and depression symptoms.
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14
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Poulain T, Spielau U, Vogel M, Dathan-Stumpf A, Körner A, Kiess W. Changes in diet from pregnancy to one year after birth: a longitudinal study. BMC Pregnancy Childbirth 2021; 21:600. [PMID: 34481457 PMCID: PMC8418026 DOI: 10.1186/s12884-021-04038-3] [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: 02/12/2021] [Accepted: 08/04/2021] [Indexed: 11/27/2022] Open
Abstract
Background Pregnancy and the first year after giving birth are marked by physiological and psychological changes. While it is well known that energy requirements change during this time, the question of how a woman’s diet actually changes from pregnancy until 1 year postpartum has been left virtually unexplored. The present study employs a longitudinal design to investigate these changes. Methods Data were collected within the framework of the LIFE Child study (Leipzig, Germany). The diet composition and culture of eating of 110 women were assessed at 3 time points: in the 24th week of pregnancy, 3 months after giving birth (breastfeeding period), and 12 months after giving birth (after weaning). We assessed differences in nutritional health (Nutritional Health Score, NHS) and the consumption of different food items at each of these time points. We also investigated associations between nutritional health and age, socio-economic status (SES), BMI before pregnancy, and previous births at all three time points. Results The analyses revealed high correlations in the NHS values between the three time points (rhot0/t1 = .55, rhot0/t2 = .60). On average, nutritional health was lower in the breastfeeding period than during pregnancy. In more detail, women reported less healthy levels of treats and white bread consumption and a higher frequency of snacking in the breastfeeding period than during pregnancy. In contrast, overall nutritional health did not differ significantly between pregnancy and the time after weaning. Increased age was associated with a healthier diet during pregnancy, and a high SES was associated with healthier diet after weaning. Furthermore, the increase in nutritional health from the breastfeeding period to the time after weaning was significantly stronger in women with a higher BMI. We observed no significant associations between dietary nutritional health and previous births. Conclusions The present findings suggest that higher energy requirements in the breastfeeding period are met by consuming high-calorie and unhealthy food products rather than healthy and nutrient-rich food. Young mothers should be supported in taking care of their own nutritional health during the challenging time of breastfeeding and caring for a newborn child. Supplementary Information The online version contains supplementary material available at 10.1186/s12884-021-04038-3.
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Affiliation(s)
- Tanja Poulain
- LIFE Leipzig Research Center for Civilization Diseases, Leipzig University, Philipp-Rosenthal-Strasse 27, 04103, Leipzig, Germany. .,Department of Women and Child Health, University Hospital for Children and Adolescents and Center for Pediatric Research, Leipzig University, Liebigstrasse 20a, 04103, Leipzig, Germany.
| | - Ulrike Spielau
- Department of Women and Child Health, University Hospital for Children and Adolescents and Center for Pediatric Research, Leipzig University, Liebigstrasse 20a, 04103, Leipzig, Germany
| | - Mandy Vogel
- LIFE Leipzig Research Center for Civilization Diseases, Leipzig University, Philipp-Rosenthal-Strasse 27, 04103, Leipzig, Germany.,Department of Women and Child Health, University Hospital for Children and Adolescents and Center for Pediatric Research, Leipzig University, Liebigstrasse 20a, 04103, Leipzig, Germany
| | - Anne Dathan-Stumpf
- Department of Obstetrics and Gynecology, University Hospital Leipzig, Liebigstrasse 20a, 04103, Leipzig, Germany
| | - Antje Körner
- LIFE Leipzig Research Center for Civilization Diseases, Leipzig University, Philipp-Rosenthal-Strasse 27, 04103, Leipzig, Germany.,Department of Women and Child Health, University Hospital for Children and Adolescents and Center for Pediatric Research, Leipzig University, Liebigstrasse 20a, 04103, Leipzig, Germany
| | - Wieland Kiess
- LIFE Leipzig Research Center for Civilization Diseases, Leipzig University, Philipp-Rosenthal-Strasse 27, 04103, Leipzig, Germany.,Department of Women and Child Health, University Hospital for Children and Adolescents and Center for Pediatric Research, Leipzig University, Liebigstrasse 20a, 04103, Leipzig, Germany
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15
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Lee E, Song J. The Effect of Physical and Mental Health and Health Behavior on the Self-Rated Health of Pregnant Women. Healthcare (Basel) 2021; 9:1117. [PMID: 34574890 PMCID: PMC8470925 DOI: 10.3390/healthcare9091117] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2021] [Revised: 08/04/2021] [Accepted: 08/25/2021] [Indexed: 11/20/2022] Open
Abstract
Self-rated health (SRH) is an evaluation tool to assess an individual's level of health, including both general health and personal experience. There have been existing studies on women's SRH; however, few studies have been on pregnant women's SRH and its associated factors. This study investigated the SRH of pregnant women and their factors using the Korea Community Health Survey. The chi-squared test and multivariable logistic regression were used to investigate the effects of demographic, physical, and mental health and health behaviors on the SRH of pregnant women. As a result of the study, 54.0% out of 1032 pregnant women had good SRH. Their SRH score was good when they were young, economically active, and living in cities. Poor SRH was observed with depression, hypertension, and after experiencing a fall. Good SRH was found when they exercised and slept for more than 8 h a day. This study is the first to observe the SRH of pregnant women and its related factors in South Korea.
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Affiliation(s)
- Eunwon Lee
- Department of Nursing, Gwangju University, Jinwol-dong, Gwangju-si 61743, Korea;
| | - Jiyoung Song
- College of Nursing, Korea University, Anam-dong, Seongbuk-Gu, Seoul 02841, Korea
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16
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Ben-Yaakov O, Ben-Ari OT. COVID-19-Related anxieties and parenting stress among first-time mothers and fathers in their first year of parenthood. Psychol Health 2021; 37:1327-1341. [PMID: 34180318 DOI: 10.1080/08870446.2021.1942875] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
INTRODUCTION The changes accompanying the transition to parenthood, joined by the fears aroused by the COVID-19 pandemic, may lead to high levels of parental anxieties and stress, particularly among parents of young infants. This study, conducted in the midst of the crisis, explores the level of COVID-19-related anxieties and parenting stress of Israeli parents in their first year of parenthood. METHODS First-time mothers (n = 469) and fathers (n = 137), aged 21-50, completed self-report questionnaires in April, 2020. They were divided into two groups: parents of younger infants (aged 3-6 months); parents of older infants (aged 7-12 months). RESULTS The levels of all COVID-19-related anxieties were quite high, with the greatest concern aroused by public transportation and public places, followed by concerns over the possible infection of family members and the infant, going for infant check-ups, getting the virus themselves, and the health of the infant. In both groups, mothers reported higher COVID-19-related anxieties than fathers. Fathers of older infants reported higher parenting stress than mothers. DISCUSSION The results highlight the need to be attentive to the double stress of new parents in the first year of parenthood in a time of crisis, and to the potentially greater vulnerability of fathers of older infants.
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Affiliation(s)
- Ofir Ben-Yaakov
- The Louis and Gabi Weisfeld School of Social Work, Bar-Ilan University, Ramat Gan, Israel
| | - Orit Taubman Ben-Ari
- The Louis and Gabi Weisfeld School of Social Work, Bar-Ilan University, Ramat Gan, Israel
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17
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Kazemi A, Ghaedrahmati M, Kheirabadi G. Partner's emotional reaction to pregnancy mediates the relationship between pregnancy planning and prenatal mental health. BMC Pregnancy Childbirth 2021; 21:168. [PMID: 33639876 PMCID: PMC7913387 DOI: 10.1186/s12884-021-03644-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Accepted: 02/16/2021] [Indexed: 12/13/2022] Open
Abstract
Background An unplanned pregnancy may be followed by increased depression and anxiety. The aim of the present study was to evaluate the mediating role of partner’s emotional reaction to pregnancy (PERP) on the relationship between pregnancy planning and prenatal mental health. Methods This cross-sectional study was conducted on 303 healthy Iranian pregnant women during their third trimester. The levels of depression and anxiety were measured using the Edinburgh Postnatal Depression Scale and the State-Trait Anxiety Inventory. The PERP score was also measured using a researcher-made questionnaire. The data were analyzed using the plug-in application PROCESS macro. Results The results showed that PERP score was reversely related to pregnancy planning and prenatal depression and anxiety. The direct effect of the pregnancy planning on depression (c = −.05) and anxiety levels (c = −.02) were not significant; but the indirect effect of pregnancy planning on depression (Point Estimate = −.379, CI: −.523 to −.250) and anxiety levels (Point Estimate = −.560, CI: −.741 to −.385) with the mediating role of PERP were significant. Conclusions The results indicated that the effect of pregnancy planning on prenatal mental health is mediated by PERP, and in unplanned pregnancy women need to receive positive reaction of their partners toward pregnancy so that they can preserve their mental health.
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Affiliation(s)
- Ashraf Kazemi
- Reproductive Health Department, School of Nursing and Midwifery, Isfahan University of Medical Sciences, Hezarjerib Av., Isfahan, Iran.
| | - Maryam Ghaedrahmati
- Reproductive Health Department, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Gholamreza Kheirabadi
- Behavioral Sciences Research center, Department of psychiatry, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
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18
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Moran E, Bradshaw C, Tuohy T, Noonan M. The Paternal Experience of Fear of Childbirth: An Integrative Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:1231. [PMID: 33573071 PMCID: PMC7908162 DOI: 10.3390/ijerph18031231] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/29/2020] [Revised: 12/17/2020] [Accepted: 01/23/2021] [Indexed: 11/24/2022]
Abstract
BACKGROUND It is estimated that approximately 13% of expectant fathers experience a pathological and debilitating fear of childbirth. OBJECTIVE The aim of this integrative review was to examine and synthesise the current body of research relating to paternal experience of fear of childbirth. METHODS A systematic literature search of five databases-CINAHL, Cochrane Library, MEDLINE, PsycArticles and PsycInfo-identified seventeen papers. Methodological quality of studies was assessed using the Crowe Critical Appraisal Tool. RESULTS Thematic data analysis identified three themes: the focus of fathers' childbirth-related fears, the impact of fear of childbirth on health and wellbeing, and fear of childbirth as a private burden. DISCUSSION Fear of childbirth is a significant and distressing experience for expectant fathers who may benefit from an opportunity to express their childbirth-related fears in an environment where they feel validated and supported. Antenatal education is recommended to enhance fathers' childbirth-related self-efficacy to reduce fear of childbirth. CONCLUSIONS Fear of childbirth may negatively impact the lives of men and consequently their families. Further investigation into methods and models for identifying and supporting men at risk of or experiencing fear of childbirth is required to improve outcomes for this population of men.
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Affiliation(s)
- Emma Moran
- St. Patrick’s Mental Health Services, D08K7YW Dublin, Ireland
| | - Carmel Bradshaw
- Department of Nursing and Midwifery, University of Limerick, V94X5K6 Limerick, Ireland; (C.B.); (T.T.); (M.N.)
| | - Teresa Tuohy
- Department of Nursing and Midwifery, University of Limerick, V94X5K6 Limerick, Ireland; (C.B.); (T.T.); (M.N.)
| | - Maria Noonan
- Department of Nursing and Midwifery, University of Limerick, V94X5K6 Limerick, Ireland; (C.B.); (T.T.); (M.N.)
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Adler K, Rahkonen L, Kruit H. Maternal childbirth experience in induced and spontaneous labour measured in a visual analog scale and the factors influencing it; a two-year cohort study. BMC Pregnancy Childbirth 2020; 20:415. [PMID: 32693773 PMCID: PMC7372821 DOI: 10.1186/s12884-020-03106-4] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2020] [Accepted: 07/09/2020] [Indexed: 12/21/2022] Open
Abstract
Background Poor maternal childbirth experience plays a role in family planning and subsequent pregnancies. The aim of this study was to compare childbirth experiences in induced and spontaneous labor and to investigate the factors influencing the childbirth experience. Methods This two-year cohort study included all women with term singleton pregnancies in cephalic presentation aiming for vaginal delivery at Helsinki University Hospital between January 2017 and December 2018. Maternal satisfaction in the childbirth experience was measured after delivery using a Visual Analog Scale (VAS) score. A low childbirth experience score was defined as VAS < 5. The characteristics and delivery outcomes of the study population were collected in the hospital database and analyzed by SPSS. Results A total of 18,396 deliveries were included in the study, of which 28.9% (n = 5322) were induced and 71.1% (n = 13 074) were of spontaneous onset. The total caesarean delivery rate was 9.3% (n = 1727). Overall, 4.5% (n = 819) of the women had a low childbirth experience VAS score. The women who underwent labor induction were less satisfied with their birth experience compared to women with spontaneous onset of labor [7.5% (n = 399) vs. 3.2% (n = 420); p < 0.001]. Poor childbirth experience was associated with primiparity [OR 2.0 (95% CI 1.6–2.4)], labor induction [OR 1.6 (95% CI 1.4–1.9)], caesarean delivery [OR 4.5 (95% CI 3.7–5.5)], operative vaginal delivery [OR 3.3 (95% CI 2.7-4.0)], post-partum hemorrhage [OR 1.3 (95% CI 1.1–1.6)], and maternal infections [OR 1.7 (95% CI 1.3–2.4)]. Conclusions Poor childbirth experience was associated with labor induction, primiparity, operative delivery, and labor complications, such as post-partum hemorrhage and maternal infections. These results highlight the aspects of care for which patient experience may be improved by additional support and counselling.
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Affiliation(s)
- Katti Adler
- Department of Obstetrics and Gynecology, University of Helsinki and Helsinki University Hospital, Haartmaninkatu 2, 00029 HUS, Helsinki, Finland
| | - Leena Rahkonen
- Department of Obstetrics and Gynecology, University of Helsinki and Helsinki University Hospital, Haartmaninkatu 2, 00029 HUS, Helsinki, Finland
| | - Heidi Kruit
- Department of Obstetrics and Gynecology, University of Helsinki and Helsinki University Hospital, Haartmaninkatu 2, 00029 HUS, Helsinki, Finland.
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20
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Self-Rated Health in Migrant and Non-Migrant Women before, during and after Pregnancy: A Population-Based Study of 0.5 Million Pregnancies from the Swedish Pregnancy Register. J Clin Med 2020; 9:jcm9061764. [PMID: 32517225 PMCID: PMC7356601 DOI: 10.3390/jcm9061764] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2020] [Revised: 05/31/2020] [Accepted: 06/03/2020] [Indexed: 11/17/2022] Open
Abstract
Self-rated health is a strong health marker. Migrants have been suggested to have poorer self-rated health than non-migrants (i.e., native-born). However, little is known about whether there are disparities in self-reported health in relation to pregnancy. Therefore, the aim of the current study was to examine the odds of poor self-rated health before, during and after pregnancy in migrant women as compared to women born in Sweden. We utilized population-based data from the Swedish Pregnancy Register containing 0.5 million women born in Sweden (i.e., non-migrant women) and migrant women between 2010 and 2018. Self-rated health was reported on a 5-point scale (from very poor to very good). Very poor and poor health were categorized as poor self-rated health. Logistic regression was utilized to calculate odds ratios (ORs) that were unadjusted and adjusted for covariates (age, parity, educational attainment and body mass index). The results demonstrate disparities in self-rated health across birth regions. In comparison to women born in Sweden, women born in Latin America and the Caribbean, South Asia as well as North Africa and the Middle East had consistently higher odds of poor self-rated health before, during and after pregnancy (ORs ranging from 1.14 to 1.96 in both unadjusted and adjusted models). Although women born in Sub-Saharan Africa did have comparable self-rated health as to women born in Sweden before pregnancy, after accounting for covariates, they had lower odds of poor self-rated health during and after pregnancy (ORs: 0.71 and 0.80 respectively). Therefore, additional measures and support may be needed to tackle disparities in health between migrant and non-migrant women before, during and after pregnancy.
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21
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Schwank SE, Andersson E, Wickberg B, Fu SC, Ding Y, Lindgren H. Care-seeking behavior and disclosure on self-reported mental health among young women in urban Shanghai, China. Health Psychol Open 2020; 7:2055102919897382. [PMID: 32082605 PMCID: PMC7005976 DOI: 10.1177/2055102919897382] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Mental health is a major public health concern in China. Help-seeking behavior
typically does not involve professionals. Aim of the study was to assess
Shanghai women’s care-seeking behavior for common mental health disorders. Using
an online survey, fielding questions regarding perinatal mental health status
and help-seeking behavior. A total of 487 women participated. One fifth of
participants reporting badwell-being did not seek help for mental distress. A
total of 82.2 percent seek online support. A majority entrusted in family and
avoided professional contact. Mother-in-laws were the least trusted source of
support. Shanghai women avoid seeking professional help for mental health
issues. Friends, spouses, and online resources are preferred venues.
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22
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Aftyka A, Rosa W, Taczała J. Self-rated health in mothers of children hospitalised for severe illnesses and mothers of healthy children: cross-sectional study. Scand J Caring Sci 2019; 34:698-709. [PMID: 31657048 DOI: 10.1111/scs.12774] [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: 02/14/2019] [Revised: 09/12/2019] [Accepted: 09/15/2019] [Indexed: 11/30/2022]
Abstract
INTRODUCTION Self-rated health (SRH) is a recognised tool for predicting morbidity and mortality. AIM The aim of the study was to investigate and compare SRH in a group of mothers of hospitalised children and mothers of healthy children and to indicate the variables associated with poor SRH in both groups. METHODS We conducted questionnaire-based cross-sectional research in a group of 184 women. Half of the respondents (n = 92) were the mothers of children hospitalised for a severe illnesses (Group H). The control group (n = 92) comprised mothers of healthy children (Group C). Self-Rated Health (SRH), Numerical Rating Scale (NRS), Hospital Anxiety and Depression Scale (HADS), Impact of Event Scale-Revised (IES-R) and Interpersonal Support Evaluation List (ISEL-40 v. GP) were used. In order to facilitate critical appraisal and interpretation of results, STROBE recommendations were used. RESULTS The prevalence of poor SRH was greater in mothers of children hospitalised for a severe illness than in those of healthy children (35 and 19%, respectively). In both groups, the risk of poor SRH was statistically significantly higher in those mothers who for the past 7 days reported at least moderate pain and in mothers who manifested anxiety symptoms. In both groups, the prevalence of poor SRH was statistically significantly lower if the respondents' children were in good health. The risk of poor SRH was associated with poor financial status in group H and with depression and at least moderate pain for the past 7 days in group C. RELEVANCE TO CLINICAL PRACTICE In order to provide mothers of severely ill children with high-quality health care including preventive measures, it is recommended that their health is assessed by healthcare professionals.
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Affiliation(s)
- Anna Aftyka
- Department of Anaesthesiological and Intensive Care Nursing, Faculty of Health Sciences, Medical University of Lublin, Lublin, Poland
| | - Wojciech Rosa
- Department of Applied Mathematics, Faculty of Technology Fundamentals, Lublin University of Technology, Lublin, Poland
| | - Jolanta Taczała
- Department of Rehabilitation and Physiotherapy, Faculty of Health Sciences, Medical University of Lublin, Lublin, Poland
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Obregon E, Litt JS, Patel P, Ziyeh T, McCormick MC. Health related quality of life (HRQoL) in mothers of premature infants at NICU discharge. J Perinatol 2019; 39:1356-1361. [PMID: 31417142 DOI: 10.1038/s41372-019-0463-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2018] [Revised: 06/21/2019] [Accepted: 07/01/2019] [Indexed: 11/09/2022]
Abstract
BACKGROUND Premature delivery and a potential Neonatal Intensive Care Unit admission may be associated with the risk of poor maternal health. We aimed to examine the mothers' health-related quality of life (HRQoL) at the time of infant discharge. STUDY DESIGN Fifty mothers completed the Medical Outcomes Study-Short Form 12. It has a Physical Component Score (PCS) and Mental Component Score (MCS), both with a mean of 50 and standard deviation of 10. Analysis included infant, maternal, and pregnancy-related characteristics. RESULTS In multivariable analyses, a household income of <150K lowered the PCS by 10 points (p = 0.003) compared to those with higher incomes. Marginal significance was noted in GA, for every week gained the PCS score was lower by 1.5 points. CONCLUSION Several risk factors are associated with lower physical health ratings in mothers of preterm infants at discharge. This information can be used to inform providers in their anticipatory guidance to the family and follow-up plans.
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Affiliation(s)
- Evelyn Obregon
- Department of Neonatology, Beth Israel Deaconess Medical Center, Boston, MA, USA
| | - Jonathan S Litt
- Department of Neonatology, Beth Israel Deaconess Medical Center, Boston, MA, USA.,Division of Newborn Medicine Harvard Medical School, Boston, MA, USA
| | - Palak Patel
- Rutgers Robert Wood Johnson Medical School, Piscataway, NJ, USA
| | | | - Marie C McCormick
- Department of Neonatology, Beth Israel Deaconess Medical Center, Boston, MA, USA. .,Division of Newborn Medicine Harvard Medical School, Boston, MA, USA. .,Department of Social Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
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Maternal stress and placental function, a study using questionnaires and biomarkers at birth. PLoS One 2018; 13:e0207184. [PMID: 30439989 PMCID: PMC6237336 DOI: 10.1371/journal.pone.0207184] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2018] [Accepted: 10/26/2018] [Indexed: 12/29/2022] Open
Abstract
Background Prenatal stress affects the health of the pregnant woman and the fetus. Cortisol blood levels are elevated in pregnancy, and fetal exposure to cortisol is regulated by the placenta enzyme 11β-HSD2. A decrease in enzyme activity allows more maternal cortisol to pass through the placental barrier. Combining the fetal and maternal cortisol to cortisone ratio into the adjusted fetal cortisol exposure (AFCE) represents the activity of the enzyme 11β-HSD2 in the placenta. Aim To investigate the effect of prenatal maternal stress on the ratio of cortisol and cortisone in maternal and fetal blood at birth in a normal population. Method Maternal self-reported stress was assessed at one time-point, as late in the pregnancy as convenient for the participant, using the Depression Anxiety Stress Scales (DASS-42), Pregnancy Related Anxiety (PRA), and Major Life Events during pregnancy. The study included 273 participants from Copenhagen University Hospital. Maternal and umbilical cord blood was sampled directly after birth and cortisol and cortisone concentrations were quantified using UPLC chromatography. Data were analyzed in a five-step regression model with addition of possible confounders. The primary outcome was AFCE, and plasma concentrations of maternal and fetal cortisol and cortisone were secondary outcomes. Results Significant associations were seen for the primary outcome AFCE and the plasma concentrations of maternal cortisol and fetal cortisone with exposure to Pregnancy Related Anxiety (PRA), though the associations were reduced when adjusting for birth related variables, especially delivery mode. The weight of the placenta affected the associations of exposures on AFCE, but not plasma concentrations of cortisol and cortisone in mother and fetus. Moreover, the study demonstrated the importance of delivery mode and birth strain on cortisol levels right after delivery. Conclusion Our main finding was associations between PRA and AFCE, which shows the effect of maternal stress on placental cortisol metabolism.
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Rao N, Esber A, Turner A, Mopiwa G, Banda J, Norris A. Infertility and self-rated health among Malawian women. Women Health 2018; 58:1081-1093. [PMID: 29240537 DOI: 10.1080/03630242.2017.1414098] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2016] [Revised: 10/29/2017] [Accepted: 10/31/2017] [Indexed: 10/18/2022]
Abstract
Infertility is prevalent and stigmatized in sub-Saharan Africa. Self-rated health, a subjective indicator that has been consistently related to objectively measured health, may be useful in evaluating the relationship between women's infertility and health. Data were from surveys conducted from July 2014 to January 2015 with women aged 15-39 years (n = 915) as part of the initial assessment in a cohort study in Lilongwe district, Malawi. We first assessed correlates of self-reported infertility among women in rural Malawi. We then used multiple logistic regression to examine associations between infertility and self-rated health. Of women surveyed, 20 percent had a history of infertility. Compared to women who had not experienced infertility, women with a history of infertility were older (p = 0.05), less educated (p = 0.01), and more likely to report depressive symptoms (p = 0.02) and forced first intercourse (p = 0.02) and to have been previously diagnosed with a sexually transmitted infection (p = 0.05). However, women with a history of infertility were not significantly more likely to report poor self-rated health (adjusted odds ratio: 1.69; 95 percent confidence interval: 0.70-4.07). Infertility was prevalent in our sample of Malawian women but was not significantly related to self-rated health, an instrument widely used in public-health research.
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Affiliation(s)
- Nisha Rao
- a The Ohio State University College of Medicine , Columbus , Ohio , USA
- b Department of Medicine , Columbia University Medical Center , New York , New York , USA
| | - Allahna Esber
- c The Ohio State University College of Public Health , Columbus , Ohio, USA
| | - Abigail Turner
- a The Ohio State University College of Medicine , Columbus , Ohio , USA
- c The Ohio State University College of Public Health , Columbus , Ohio, USA
| | | | - Joana Banda
- d Child Legacy International , Lilongwe , Malawi
| | - Alison Norris
- a The Ohio State University College of Medicine , Columbus , Ohio , USA
- c The Ohio State University College of Public Health , Columbus , Ohio, USA
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Women's experiences of self-reporting health online prior to their first midwifery visit: A qualitative study. Women Birth 2018; 31:e105-e114. [DOI: 10.1016/j.wombi.2017.07.013] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2016] [Revised: 07/25/2017] [Accepted: 07/28/2017] [Indexed: 11/22/2022]
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Engberg E, Stach-Lempinen B, Rönö K, Kautiainen H, Eriksson JG, Koivusalo SB. A randomized lifestyle intervention preventing gestational diabetes: effects on self-rated health from pregnancy to postpartum. J Psychosom Obstet Gynaecol 2018. [PMID: 28635526 DOI: 10.1080/0167482x.2017.1286642] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
Abstract
INTRODUCTION The purpose was to examine the effects of a randomized lifestyle intervention on self-rated health from pregnancy to postpartum in participants at high risk for gestational diabetes mellitus. METHODS We included 266 women with a history of gestational diabetes and/or prepregnancy BMI ≥30 kg/m2. The intervention group (n = 144) received individualized counseling on diet, physical activity, and weight management from trained nurses at six timepoints between the first trimester of pregnancy and 12 months postpartum, and met three times with a dietitian. The control group (n = 122) received standard antenatal care. We assessed self-rated health at the six timepoints by means of a single question with five response options ranging from good (1) to poor (5). Baseline-adjusted mean changes in self-rated health level were assessed with a mixed model for repeated measure methods. RESULTS The mean (SD) for self-rated health at baseline was 1.8 (0.8) in the intervention group and 2.1 (0.9) in the control group (p = 0.006). Self-rated health varied over time (time effect p < 0.001) and was the poorest in the third trimester. The sample indicated that self-rated health improved in the intervention group and deteriorated in the control group from the first trimester to 12 months postpartum, but the difference between the groups did not reach statistical significance (group effect p = 0.064). DISCUSSION The self-rated health level varied over time from the first trimester of pregnancy to 12 months postpartum in women at risk for gestational diabetes. Improving self-rated health among high-risk pregnant women through lifestyle intervention calls for further research.
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Affiliation(s)
- Elina Engberg
- a Department of Sports and Exercise Medicine, Clinicum , University of Helsinki , Helsinki , Finland.,b Foundation for Sports and Exercise Medicine , Clinic for Sports and Exercise Medicine , Helsinki , Finland
| | - Beata Stach-Lempinen
- c Department of Obstetrics and Gynecology , South-Karelia Central Hospital , Lappeenranta , Finland
| | - Kristiina Rönö
- d Department of Obstetrics and Gynecology , University of Helsinki and Helsinki University Hospital , Helsinki , Finland
| | - Hannu Kautiainen
- e Department of General Practice and Primary Health Care , University of Helsinki and Helsinki University Hospital , Helsinki , Finland.,f Department of General Practice and Primary Health Care , University of Eastern Finland , Joensuu , Finland
| | - Johan G Eriksson
- e Department of General Practice and Primary Health Care , University of Helsinki and Helsinki University Hospital , Helsinki , Finland.,g Department of Chronic Disease Prevention , National Institute for Health and Welfare , Helsinki , Finland.,h Folkhälsan Research Center , Helsinki , Finland
| | - Saila B Koivusalo
- d Department of Obstetrics and Gynecology , University of Helsinki and Helsinki University Hospital , Helsinki , Finland
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Care and self-reported outcomes of care experienced by women with mental health problems in pregnancy: Findings from a national survey. Midwifery 2017; 56:171-178. [PMID: 29145155 PMCID: PMC5735036 DOI: 10.1016/j.midw.2017.10.020] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2017] [Revised: 10/23/2017] [Accepted: 10/26/2017] [Indexed: 11/23/2022]
Abstract
BACKGROUND mental health problems in pregnancy and the postnatal period are relatively common and, in pregnancy, are associated with an increase in adverse outcome. It is recommended that all women are asked about their emotional and mental health and offered treatment if appropriate. OBJECTIVES to describe the care received by women self-identifying with mental health problems in pregnancy, and to describe the effects of support, advice and treatment on outcomes in the postnatal period. DESIGN this study used cross-sectional survey data collected in 2014 which described women's experience of maternity care. SETTING England PARTICIPANTS: a random sample of women who had a live birth in January 2014. MEASUREMENTS the questionnaire asked about sociodemographic characteristics, whether women were asked about emotional and mental health in pregnancy, support and treatment offered, about postnatal wellbeing, and questions relating to attachment to their baby. Descriptive statistics and logistic regression were used to examine the associations between mental health and outcomes taking account of sociodemographic characteristics. FINDINGS the survey response rate was 47%. Women with antenatal mental health problems were significantly more worried at the prospect of labour and birth, had lower satisfaction with the experience of birth, worse postnatal mental health, and indications of poorer attachment to their baby. They received substantially more care than other women but they did not always view this positively. Support, advice and treatment for mental health problems had mixed effects. CONCLUSIONS this study describes the significant additional care provided to women self-identifying with mental health problems in pregnancy, the mixed effects of support, advice and treatment, and the poor perception of staff interaction among women with mental health problems. IMPLICATIONS FOR PRACTICE health care professionals may need additional training to effectively support women with mental health problems during the perinatal period.
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Lindgren P, Stadin M, Blomberg I, Nordin K, Sahlgren H, Ingvoldstad Malmgren C. Information about first-trimester screening and self-reported distress among pregnant women and partners - comparing two methods of information giving in Sweden. Acta Obstet Gynecol Scand 2017; 96:1243-1250. [PMID: 28742930 DOI: 10.1111/aogs.13195] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2017] [Accepted: 07/17/2017] [Indexed: 01/06/2023]
Abstract
INTRODUCTION Balanced information before prenatal diagnosis (PND) aims to help expectant parents to make an informed choice. However, it is important that the information does not increase the expectant parents' psychological distress. The aim was to examine psychological distress among expectant parents, before and after receiving information about PND, to evaluate the possible differences between two different procedures of information giving, and to evaluate the association between satisfaction with the information and psychological distress. MATERIAL AND METHODS A longitudinal design, based on questionnaire data from 380 expectant parents from four counties in Sweden. The measurement points; T1, before the information about PND was given and T2, 2 weeks after the prenatal screening or 15 weeks of gestation. The Hospital Anxiety and Depression Scale (HADS) and the Swedish version of the Cambridge Worrying Scale (CWS) measured psychological distress. The Satisfaction with Genetic Counseling Scale (SCS) measured satisfaction with information about PND. RESULTS The rate of psychological distress was stable among the pregnant women, but decreased among their partners, after the information was received. General anxiety and the social-medical dimension of pregnancy-related worry decreased among the participants who received information, using the more distinct two-stage process (group A), but was unchanged in group B (less distinct two-stage process). Health-related worry decreased in both groups, whereas relational worry and level of depressive symptoms were unchanged in both groups. CONCLUSION Information about PND does not increase the psychological distress among expectant parents. A more distinct two-stage process of information giving might even decrease their anxiety.
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Affiliation(s)
- Peter Lindgren
- Department of Clinical Science, Intervention and Technology, Karolinska Institutet and Center for Fetal Medicine, Karolinska University Hospital, Stockholm, Sweden
| | - Magdalena Stadin
- School of Health Sciences, Jönköping University, Jönköping, Sweden
| | - Inger Blomberg
- Department of Obstetrics and Gynecology, Gävle Hospital, Gävle, Sweden
| | - Karin Nordin
- Department of Public Health and Caring Science, Uppsala University, Uppsala, Sweden
| | - Hanna Sahlgren
- Department of Women's Health, Falun Hospital, Falun, Sweden
| | - Charlotta Ingvoldstad Malmgren
- Department of Clinical Science, Intervention and Technology, Karolinska Institutet and Center for Fetal Medicine, Karolinska University Hospital, Stockholm, Sweden.,Department of Public Health and Caring Science, Uppsala University, Uppsala, Sweden.,Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
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Margareta W, Eva N, John Ö, Birgitta K. Parental stress and depressive symptoms increase the risk of separation among parents with children less than 11 years of age in Sweden. Scand J Public Health 2017; 47:207-214. [PMID: 28803506 DOI: 10.1177/1403494817724312] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
AIMS Parental separations have become more frequent in recent decades. In Western countries, about 25% of children experience parental separation. There is a need to explore the risk factors for separation to give children an optimal childhood. The objective of the present study was to examine parental stress and depressive symptoms during early parenthood and their association with parental separation. METHODS Four hundred and seven couples completed questionnaires on depressive symptoms for 3 months and parental stress for 18 months after childbirth. Total parental stress and five sub-areas were investigated. To study the separation rate, parents' addresses were recorded 9 to 11 years after childbirth. RESULTS Twenty-nine percent of the parents were separated 9 to 11 years after childbirth. Separation was associated with depressive symptoms at 3 months (mothers p = .002, fathers p = .025) and total parental stress at 18 months after childbirth (mothers p = .010, fathers p = .005). The sub-areas of parental stress, Spouse relationship problems (mothers p = <.001, fathers p = .001) and fathers' Social isolation ( p = .005), were associated with separation. In multivariable regression analyses of the parents' separation rate 9 to 11 years after childbirth, the only significant predictor was mothers' Spouse relationship problems ( p < .001). CONCLUSIONS The knowledge that parental stress and depressive symptoms are risk factors for separation may simplify professional support for parents in early parenting. Courses for new and expectant parents can use this knowledge to increase parents' awareness.
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Affiliation(s)
| | - Nohlert Eva
- 2 Centre for Clinical Research, Uppsala University Västmanland County Hospital, Sweden
| | - Öhrvik John
- 2 Centre for Clinical Research, Uppsala University Västmanland County Hospital, Sweden.,3 Department of Medicine, Karolinska Institutet, Sweden
| | - Kerstis Birgitta
- 1 School of Health, Care and Social Welfare, Mälardalen University, Sweden
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Öst E, Nisell M, Frenckner B, Mesas Burgos C, Öjmyr-Joelsson M. Parenting stress among parents of children with congenital diaphragmatic hernia. Pediatr Surg Int 2017; 33:761-769. [PMID: 28527042 PMCID: PMC5486636 DOI: 10.1007/s00383-017-4093-4] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/10/2017] [Indexed: 01/14/2023]
Abstract
PURPOSE The aim of this study was to examine parental stress among parents of children with congenital diaphragmatic hernia (CDH). METHODS Between 2005 and 2009, a total of 51 children with CDH were treated at Astrid Lindgren Children's Hospital. The survival rate at discharge was 86% and long-term survival rate 80%. One parent each of the long-term survivors (41 children) was included in the present study, and 34 parents (83%) agreed to participate. Participants received the Swedish Parenthood Stress Questionnaire (SPSQ). The questionnaire was supplemented by data from case records. RESULTS Parents of children with CDH, who had been supported by ECMO or had a long hospital stay, showed significantly higher overall parental stress. Mothers scored an overall higher parental stress compared with fathers. A prenatal diagnosis of CDH or lower parental educational level resulted in significantly higher parental stress in some of the factors. CONCLUSIONS Parental stress in parents of children with CDH seems to increase with the severity of the child's malformation. Mothers tend to score higher parental stress than fathers.
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Affiliation(s)
- Elin Öst
- Karolinska Institutet, Department of Women’s and Children’s Health, 171 76 Stockholm, Sweden ,Pediatric Surgery Unit, Karolinska University Hospital, Astrid Lindgren Children’s Hospital, 171 76 Stockholm, Sweden
| | | | - Björn Frenckner
- Karolinska Institutet, Department of Women’s and Children’s Health, 171 76 Stockholm, Sweden ,Pediatric Surgery Unit, Karolinska University Hospital, Astrid Lindgren Children’s Hospital, 171 76 Stockholm, Sweden
| | - Carmen Mesas Burgos
- Karolinska Institutet, Department of Women’s and Children’s Health, 171 76 Stockholm, Sweden ,Pediatric Surgery Unit, Karolinska University Hospital, Astrid Lindgren Children’s Hospital, 171 76 Stockholm, Sweden
| | - Maria Öjmyr-Joelsson
- Karolinska Institutet, Department of Women’s and Children’s Health, 171 76 Stockholm, Sweden ,Pediatric Surgery Unit, Karolinska University Hospital, Astrid Lindgren Children’s Hospital, 171 76 Stockholm, Sweden
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Köhler M, Emmelin M, Rosvall M. Parental health and psychosomatic symptoms in preschool children: A cross-sectional study in Scania, Sweden. Scand J Public Health 2017; 45:846-853. [DOI: 10.1177/1403494817705561] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Aim: The aim of the study was to assess the association between parental self-rated health and recurrent abdominal pain (RAP) in preschool children. Methods: A questionnaire, including questions about sociodemographic and psychosocial factors, lifestyle, parental and child health, was sent to parents of all 4-year-old children in Scania, Sweden. The response rate was 43.6%. The outcome was RAP and the main exposure was parental self-rated health (SRH). Covariates included sociodemographic, lifestyle and psychosocial factors. Logistic regression analyses were used in a five-step model to estimate the odds ratio (OR) and 95% confidence interval (CI) of parental SRH in relation to child RAP. Results: Logistic regression analysis showed higher odds of RAP among children whose parents reported domestic violence, economic worries and poor SRH (mothers OR = 2.1 (95% CI: 1.6, 2.7) and fathers OR = 1.5 (95% CI: 1.1, 2.0)). Adjustment for sociodemographic, lifestyle and psychosocial factors reduced the OR for RAP in the children of mothers with poor SRH (OR = 1.6 (95% CI: 1.2, 2.2)) and fathers with poor SRH (OR = 1.2 (CI 95%: 0.8, 1.7)). Poor SRH was associated with less reading to the child as well as parental perceptions of insufficiency in the interaction with the child. Conclusions: Health professionals have a key position to prevent psychosomatic symptoms in childhood by identifying the living conditions of children with RAP and particularly, to pay attention to parental poor health to identify if support to the family and/or child protection interventions are needed. Health professionals meeting adult patients with poor health should identify whether they are parents and have children who might need information, support and/or protection.
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Affiliation(s)
- Marie Köhler
- Department of Clinical Sciences, Lund University, Malmö, Sweden
| | - Maria Emmelin
- Department of Clinical Sciences, Social Medicine and Global Health, Lund University, Malmö, Sweden
| | - Maria Rosvall
- Department of Clinical Sciences, Lund University, Malmö, Sweden
- Institute of Medicine, University of Gothenburg, Gothenburg, Sweden
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Sahrakorpi N, Koivusalo SB, Eriksson JG, Kautiainen H, Stach-Lempinen B, Roine RP. Perceived Financial Satisfaction, Health Related Quality of Life and depressive Symptoms in Early Pregnancy. Matern Child Health J 2017; 21:1493-1499. [DOI: 10.1007/s10995-017-2271-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Aksu S, Varol FG, Hotun Sahin N. Long-term postpartum health problems in Turkish women: prevalence and associations with self-rated health. Contemp Nurse 2016; 53:167-181. [DOI: 10.1080/10376178.2016.1258315] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Sevde Aksu
- Department of Midwifery, Balıkesir Health High School, Balıkesir University, Balıkesir, Turkey
| | - Füsun G. Varol
- Medical Faculty Hospital, Department of Obstetrics and Gynecology, Trakya University, Edirne, Turkey
| | - Nevin Hotun Sahin
- Department of Obstetrical and Gynecological Nursing, Florence Nightingale School of Nursing, Istanbul University, Istanbul, Turkey
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Semasaka JPS, Krantz G, Nzayirambaho M, Munyanshongore C, Edvardsson K, Mogren I. Self-reported pregnancy-related health problems and self-rated health status in Rwandan women postpartum: a population-based cross-sectional study. BMC Pregnancy Childbirth 2016; 16:340. [PMID: 27821082 PMCID: PMC5100328 DOI: 10.1186/s12884-016-1138-y] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2016] [Accepted: 10/30/2016] [Indexed: 11/28/2022] Open
Abstract
Background Self-rated health status (SRH) can be used as a predictor of morbidity and mortality. Postpartum self-rated health has been used to estimate maternal morbidity and postpartum problems. Reproductive history factors are associated with poor self-rated health postpartum. This study investigated prevalence of self-reported health problems during first, second, and third trimesters of pregnancy, delivery, and postpartum. In addition, this study investigated SRH in Rwandan women up to 13 months from partus. Methods This population-based, cross-sectional study collected data in 2014 using structured interviews (N = 921). Univariable analysis was used to identify variables that were associated with poor self-rated health status (poor-SRH). Logistic regression analyses were performed to identify factors associated with poor-SRH at one day, one week, and one month postpartum and at the time of the interview. Results Mean time between latest delivery and the time of interview was 7.1 months. Prevalence of anaemia, hypertension, diabetes mellitus during pregnancy, and severe bleeding during pregnancy and labour were 15.0, 4.9, 2.4, and 3.7 %, respectively. The prevalence of poor-SRH was 32.2 % at one day postpartum, 7.8 % at one month, and 11.7 % at time of the interview. Hypertension during pregnancy and significant postpartum haemorrhage were associated with poor-SRH at one day and one week postpartum. Severe bleeding during pregnancy and labour were associated with poor-SRH at one week and one month postpartum. Infection and anaemia during pregnancy were associated with poor-SRH at one month postpartum and at the time of interview. The Kaplan-Meier curves illustrate restitution of health for most women during the study period. Conclusions This population-based study reports a high prevalence of poor SRH status among Rwandan women in the early postpartum period. Identified factors associated with poor-SRH were severe bleeding, hypertension, infection, and anaemia during pregnancy and postpartum haemorrhage. These factors may be prevented or reduced by providing more frequent and specific attention during pregnancy and by providing timely measures that address complications during delivery, including adequate postpartum care.
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Affiliation(s)
- Jean Paul S Semasaka
- Department of Clinical Sciences, Obstetrics and Gynecology, Umeå University, Umeå, Sweden. .,University of Rwanda College of Medicine and Health Sciences School of Public Health, Kigali, Rwanda.
| | - Gunilla Krantz
- Department of Community Medicine and Public Health, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Manasse Nzayirambaho
- University of Rwanda College of Medicine and Health Sciences School of Public Health, Kigali, Rwanda
| | - Cyprien Munyanshongore
- University of Rwanda College of Medicine and Health Sciences School of Public Health, Kigali, Rwanda
| | - Kristina Edvardsson
- Department of Clinical Sciences, Obstetrics and Gynecology, Umeå University, Umeå, Sweden.,Judith Lumley Centre, La Trobe University, Melbourne, Australia
| | - Ingrid Mogren
- Department of Clinical Sciences, Obstetrics and Gynecology, Umeå University, Umeå, Sweden
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Reiter SF, Bjørk MH, Daltveit AK, Veiby G, Kolstad E, Engelsen BA, Gilhus NE. Life satisfaction in women with epilepsy during and after pregnancy. Epilepsy Behav 2016; 62:251-7. [PMID: 27513352 DOI: 10.1016/j.yebeh.2016.06.025] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2016] [Revised: 06/15/2016] [Accepted: 06/16/2016] [Indexed: 11/25/2022]
Abstract
OBJECTIVE The aim of this study was to investigate life satisfaction in women with epilepsy during and after pregnancy. METHODS The study was based on the Norwegian Mother and Child Cohort Study, including 102,265 women with and without epilepsy from the general population. Investigation took place at pregnancy weeks 15-19 and 6 and 18months postpartum. Women with epilepsy were compared with a reference group without epilepsy. RESULTS The proportion of women with epilepsy was 0.6-0.7% at all three time points. Women with epilepsy reported lower life satisfaction and self-esteem both during and after pregnancy compared with the references. Single parenting correlated negatively with life satisfaction in epilepsy during the whole study period. Epilepsy was associated with lower levels of relationship satisfaction and higher levels of work strain during pregnancy and lower levels of self-efficacy and satisfactory somatic health 18months postpartum. Adverse life events, such as divorce, were more common in women with epilepsy compared with the references, and fewer women with epilepsy had a paid job 18months postpartum. SIGNIFICANCE Reduced life satisfaction associated with epilepsy during and after pregnancy showed that, even in a highly developed welfare society, women with epilepsy struggle. Mothers with epilepsy and their partners should be examined for emotional complaints and partnership satisfaction during and after pregnancy. Validated screening tools are available for such measures.
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Affiliation(s)
- Simone Frizell Reiter
- Department of Clinical Medicine, Section for Neurology, University of Bergen, Norway.
| | - Marte Helene Bjørk
- Department of Clinical Medicine, Section for Neurology, University of Bergen, Norway; Department of Neurology, Haukeland University Hospital, Bergen, Norway
| | - Anne Kjersti Daltveit
- Department of Public Health and Primary Health Care, University of Bergen, Norway; Medical Birth Registry of Norway, Division of Epidemiology, Norwegian Institute of Public Health, Bergen, Norway
| | - Gyri Veiby
- Department of Neurology, Haukeland University Hospital, Bergen, Norway
| | - Eivind Kolstad
- Department of Clinical Medicine, Section for Neurology, University of Bergen, Norway; Department of Neurology, Haukeland University Hospital, Bergen, Norway
| | - Bernt A Engelsen
- Department of Clinical Medicine, Section for Neurology, University of Bergen, Norway; Department of Neurology, Haukeland University Hospital, Bergen, Norway
| | - Nils Erik Gilhus
- Department of Clinical Medicine, Section for Neurology, University of Bergen, Norway; Department of Neurology, Haukeland University Hospital, Bergen, Norway
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Kerstis B, Nohlert E, Öhrvik J, Widarsson M. Association between depressive symptoms and parental stress among mothers and fathers in early parenthood: A Swedish cohort study. Ups J Med Sci 2016; 121:60-4. [PMID: 26947219 PMCID: PMC4812059 DOI: 10.3109/03009734.2016.1143540] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Aim To determine whether there is an association between depressive symptoms and parental stress among mothers and fathers during early parenthood in Sweden. Methods In this study, 401 mothers and 396 fathers (393 couples) were included; the Edinburgh Postnatal Depression Scale and the Sense of Coherence Scale were measured 3 months after childbirth, and the Swedish Parenthood Stress Questionnaire and the Sense of Coherence Scale after 18 months. Complete data for multivariable analysis were available for 264 mothers and 252 fathers. Results The mothers estimated greater total depressive symptoms and parental stress than the fathers did. Both the mothers and the fathers had the greatest level of stress in the sub-area 'Role restriction'. The mothers had the lowest level of stress in the sub-area 'Social isolation' and the fathers in the sub-area 'Incompetence'. The mothers perceived greater levels of stress than the fathers did in all sub-areas except for 'Social isolation', where the fathers perceived higher stress. There was an association between the parents' depressive symptoms and parental stress. The parents' own depressive symptoms at 3 months and sense of coherence and the partners' parental stress at 18 months were positively associated with the parental stress at 18 months in univariable and multivariable analyses. Conclusions Understanding the relationship between depressive symptoms and parental stress is important for health professionals so they can offer parents adequate support in early parenthood to optimize the conditions for raising a child. This knowledge should also be communicated to the parents.
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Affiliation(s)
- Birgitta Kerstis
- a School of Health, Care and Social Welfare , Mälardalen University , Västerås , Sweden
- b Centre for Clinical Research , Uppsala University Västmanland County Hospital , Västerås , Sweden
| | - Eva Nohlert
- b Centre for Clinical Research , Uppsala University Västmanland County Hospital , Västerås , Sweden
| | - John Öhrvik
- b Centre for Clinical Research , Uppsala University Västmanland County Hospital , Västerås , Sweden
- c Department of Medicine , Karolinska Institutet , Stockholm , Sweden
| | - Margareta Widarsson
- b Centre for Clinical Research , Uppsala University Västmanland County Hospital , Västerås , Sweden
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Reiter SF, Veiby G, Bjørk MH, Engelsen BA, Daltveit AK, Gilhus NE. Psychiatric Comorbidity, Social Aspects and Quality of Life in a Population-Based Cohort of Expecting Fathers with Epilepsy. PLoS One 2015; 10:e0144159. [PMID: 26637130 PMCID: PMC4670115 DOI: 10.1371/journal.pone.0144159] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2015] [Accepted: 11/14/2015] [Indexed: 01/27/2023] Open
Abstract
OBJECTIVES To investigate psychiatric disorders, adverse social aspects and quality of life in men with epilepsy during partner's pregnancy. METHOD We used data from the Norwegian Mother and Child Cohort Study, including 76,335 men with pregnant partners. Men with epilepsy were compared to men without epilepsy, and to men with non-neurological chronic diseases. RESULTS Expecting fathers in 658 pregnancies (mean age 31.8 years) reported a history of epilepsy, 36.9% using antiepileptic drugs (AEDs) at the onset of pregnancy. Symptoms of anxiety or depression were increased in epilepsy (7.0% and 3.9%, respectively) vs. non-epilepsy (4.6% and 2.5%, respectively, p = 0.004 and 0.023), and so were new onset symptoms of depression (2.0% vs. 1.0%, p < 0.031) and anxiety (4.3% vs. 2.3%, p = 0.023). Low self-esteem (2.5%) and low satisfaction with life (1.7%) were more frequent among fathers with epilepsy compared to fathers without epilepsy (1.3% and 0.7%, respectively, p = 0.01 and 0.010). Adverse social aspects and life events were associated with epilepsy vs. both reference groups. Self-reported diagnoses of ADHD (2.2%) and bipolar disorder (1.8%) were more common in epilepsy vs. non-epilepsy (0.4% and 0.3%, respectively, p = 0.002 and 0.003) and non-neurological chronic disorders (0.5% and 0.5%, respectively, p = 0.004 and 0.018). A screening tool for ADHD symptoms revealed a higher rate compared to self-reported ADHD (9.5% vs. 2.2%, p < 0.001). CONCLUSION Expecting fathers with epilepsy are at high risk of depression and anxiety, adverse socioeconomic aspects, low self-esteem, and low satisfaction with life. Focus on mental health in fathers with epilepsy during and after pregnancy is important. The use of screening tools can be particularly useful to identify those at risk.
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Affiliation(s)
| | - Gyri Veiby
- Department of Clinical Medicine, University of Bergen, Bergen, Norway
- Department of Neurology, Haukeland University Hospital, Bergen, Norway
| | - Marte Helene Bjørk
- Department of Clinical Medicine, University of Bergen, Bergen, Norway
- Department of Neurology, Haukeland University Hospital, Bergen, Norway
| | - Bernt A. Engelsen
- Department of Clinical Medicine, University of Bergen, Bergen, Norway
- Department of Neurology, Haukeland University Hospital, Bergen, Norway
| | - Anne-Kjersti Daltveit
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
- Medical Birth Registry of Norway, Division of Epidemiology, Norwegian Institute of Public Health, Bergen, Norway
| | - Nils Erik Gilhus
- Department of Clinical Medicine, University of Bergen, Bergen, Norway
- Department of Neurology, Haukeland University Hospital, Bergen, Norway
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How happy are pregnant women?: A socio-demographic analysis. CLINICAL EPIDEMIOLOGY AND GLOBAL HEALTH 2015. [DOI: 10.1016/j.cegh.2014.09.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
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Carlander AKK, Andolf E, Edman G, Wiklund I. Health-related quality of life five years after birth of the first child. SEXUAL & REPRODUCTIVE HEALTHCARE 2015; 6:101-7. [PMID: 25998878 DOI: 10.1016/j.srhc.2015.01.005] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2014] [Revised: 01/14/2015] [Accepted: 01/16/2015] [Indexed: 10/24/2022]
Abstract
OBJECTIVES The aim of this study was to describe the overall health-related quality of life (HRQoL) in women five years after the birth of their first child as well as the HRQoL in relation to mode of delivery. METHODS 545 first-time pregnant women, drawn from a hospital situated in Sweden, consented to be included in a cohort. Five years after the birth of the first child, 372 (68%) women agreed to participate in a follow-up study. HRQoL was measured using the Swedish Health-Related Quality of Life Survey (SWED-QUAL) questionnaire. Socio-demographic background and variables related to pregnancy and childbirth were collected using a self-report questionnaire. RESULTS Overall, the HRQoL was perceived to be good. Suboptimal scores were obtained for the three variables: Sleeping problems, Emotional well-being - negative affect and Family functioning - sexual functioning. Women having a vaginal birth, an instrumental vaginal birth or women who underwent caesarean section on maternal request were more likely to report better perceived HRQoL than women who had undergone an emergency caesarean section or caesarean section due to medical indication. CONCLUSION This study demonstrates that the overall HRQoL of the women in the cohort was reported as good. Mode of delivery was associated with differences in HRQoL five years after birth of the first child. Our result suggests that some differences in perceived HRQoL persist in the long term.
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Affiliation(s)
- Anna-Karin Klint Carlander
- Department of Clinical Sciences, Division of Obstetrics and Gynaecology, Danderyd Hospital, Karolinska Institute, Stockholm, Sweden.
| | - Ellika Andolf
- Department of Clinical Sciences, Division of Obstetrics and Gynaecology, Danderyd Hospital, Karolinska Institute, Stockholm, Sweden
| | - Gunnar Edman
- Department of Psychiatry, Tiohundra AB, Norrtälje, Sweden; Department of Neurobiology, Care Sciences and Society, Centre of Family Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Ingela Wiklund
- Department of Clinical Sciences, Division of Obstetrics and Gynaecology, Danderyd Hospital, Karolinska Institute, Stockholm, Sweden
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Björkenstam E, Alexanderson K, Narusyte J, Kjeldgård L, Ropponen A, Svedberg P. Childbirth, hospitalisation and sickness absence: a study of female twins. BMJ Open 2015; 5:e006033. [PMID: 25573523 PMCID: PMC4289737 DOI: 10.1136/bmjopen-2014-006033] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVE To investigate associations of giving birth with morbidity in terms of hospitalisation and social consequences of morbidity in terms of sickness absence (SA), while taking familial (genetics and shared environmental) factors into account. DESIGN Prospective register-based cohort study. Estimates of risk of hospitalisation and SA were calculated as HRs with 95% CIs. SETTING All female twins, that is, women with a twin sister, born in Sweden. PARTICIPANTS 5118 Swedish female twins (women with a twin sister), born during 1959-1990, where at least one in the twin pair had their first childbirth (T0) during 1994-2009 and none gave birth before 1994. MAIN OUTCOME MEASURES Hospitalisation and SA during year 3-5 after first delivery or equivalent. RESULTS Preceding the first childbirth, the mean annual number of SA days increased for mothers, and then decreased again. Hospitalisation after T0 was associated with higher HRs of short-term and long-term SA (HR for short-term SA 3.0; 95% CI 2.5 to 3.6 and for long-term SA 2.3; 95% CI 1.6 to 3.2). Hospitalisation both before and after first childbirth was associated with a higher risk of future SA (HR for long-term SA 4.2; 95% CI 2.7 to 6.4). Familial factors influenced the association between hospitalisation and long-term SA, regardless of childbirth status. CONCLUSIONS Women giving birth did not have a higher risk for SA than those not giving birth and results indicate a positive health selection into giving birth. Mothers hospitalised before and/or after giving birth had higher risks for future SA, that is, there was a strong association between morbidity and future SA.
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Affiliation(s)
- Emma Björkenstam
- Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Kristina Alexanderson
- Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Jurgita Narusyte
- Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Linnea Kjeldgård
- Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | | | - Pia Svedberg
- Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
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A comparison of Israeli Jewish and Arab women's birth perceptions. Midwifery 2014; 30:853-61. [DOI: 10.1016/j.midw.2013.11.003] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2013] [Revised: 11/06/2013] [Accepted: 11/10/2013] [Indexed: 10/26/2022]
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First-time fathers' expectations and experiences of childbirth in relation to age. Midwifery 2014; 30:82-8. [DOI: 10.1016/j.midw.2013.01.015] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2012] [Revised: 12/03/2012] [Accepted: 01/31/2013] [Indexed: 11/20/2022]
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Sadat Z, Kafaei Atrian M, Masoudi Alavi N, Abbaszadeh F, Karimian Z, Taherian A. Effect of mode of delivery on postpartum depression in Iranian women. J Obstet Gynaecol Res 2013; 40:172-7. [PMID: 24102708 DOI: 10.1111/jog.12150] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2012] [Accepted: 04/04/2013] [Indexed: 11/30/2022]
Abstract
AIM The aim of this study was to determine the relation between mode of delivery (cesarean section [CS] or unassisted vaginal delivery) and postpartum depression (PPD). MATERIAL AND METHODS In a prospective study, 300 women who had experienced vaginal delivery (VD) or CS were recruited in Kashan, Iran. PPD was measured using the Edinburgh Postnatal Depression Scale (EPDS). A score of 13 or more was defined as PPD. Data collection was conducted at two assessment points: 2 months and 4 months postpartum. Mean scores of EPDS and PPD were compared between the VD and CS groups. RESULTS Differences in mean scores of EPDS between CS (n = 150) and VD (n = 150) groups at the first and the second assessments were not significant. The depression mean scores differences from the first to the second assessment were compared between the two groups; VD group showed more decrease on EPDS score (P = 0.006). Comparing the two assessments, the VD group showed a more decreased EPDS from the first to the second one. PPD prevalence rates (score ≥ 13) among the VD and CS groups were 24% and 20.7% for the first and 14.7% and 16.7% for the second assessment, respectively, which were not significantly different. The logistic regression showed that an unwanted pregnancy and PPD 2 months after delivery were determinants for PPD 4 months after delivery. CONCLUSION There was no relation between delivery mode and PPD at 2 and 4 months after delivery; however, the VD group showed greater decrease in EPDS score from 2 to 4 months after delivery.
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Affiliation(s)
- Zohreh Sadat
- Trauma Nursing Research Center, Kashan University of Medical Sciences, Kashan, Iran
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Wang P, Liou SR, Cheng CY. Prediction of maternal quality of life on preterm birth and low birthweight: a longitudinal study. BMC Pregnancy Childbirth 2013; 13:124. [PMID: 23725558 PMCID: PMC3680160 DOI: 10.1186/1471-2393-13-124] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2012] [Accepted: 05/29/2013] [Indexed: 11/30/2022] Open
Abstract
Background Preterm birth is a significant cause of newborn morbidity and mortality and strains society’s healthcare resources due to its long-term effects on the health of the newborn. Prenatal maternal quality of life (QoL) may be related to the occurrence of preterm birth and low birthweight infants. Few studies, however, have investigated maternal QoL, especially throughout the continuum of pregnancy and the immediate postpartum period. Therefore, the purposes of this longitudinal study were to measure the levels of QoL during and immediately after pregnancy in women with uncomplicated pregnancies, investigate the relationships between the dimensions of QoL, and determine whether prenatal QoL can predict preterm birth and low birthweight. Methods Using convenience sampling in one hospital in Taiwan, we recruited 198 pregnant women without pregnancy complications after 24 gestational weeks and followed up monthly until one-month postpartum. The Duke Health Profile was used to measure QoL. Data were analyzed using descriptive statistics, the Mann–Whitney U test, the Kruskal-Wallis test, generalized estimation equations, Pearson correlations, and hierarchical logistic regression. Results Pregnant women did not perceive that they had a high level of QoL. Women at late pregnancy experienced a significant decrease in their level of physical and general health. After childbirth, although the mothers had better physical health, they had poorer social health. Poor QoL at late pregnancy predicted preterm birth. Employment, parity, educational level, and happiness about pregnancy were related to prenatal maternal QoL; employment was a factor related to postpartum maternal QoL. Conclusions Early assessment of QoL, including its dimensions, of pregnant women may help us to understand women’s health status. Based on this understanding, healthcare professionals can develop interventions to promote pregnant women’s QoL and to lessen the occurrence of preterm birth and low birthweight infants. Further, an emphasis on the positive aspects of pregnancy may increase maternal QoL.
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Affiliation(s)
- Shawn Walker
- Shawn Walker Breech Specialist Midwife James Paget University Hospital NHS Foundation Trust
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Henderson J, Redshaw M. Who is well after childbirth? Factors related to positive outcome. Birth 2013; 40:1-9. [PMID: 24635418 DOI: 10.1111/birt.12022] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/13/2012] [Indexed: 11/27/2022]
Abstract
BACKGROUND Poor outcomes after childbirth are associated with physical ill health and with an absence of a positive sense of well-being. Postnatally poor physical health is thought to be influenced by the care received, the nature of the birth, and associated complications. The aim of this study was to estimate the effects of a range of clinical and other factors on positive outcome and well-being 3 months after childbirth. METHODS This study used data on more than 5,000 women from a 2010 National Maternity Survey about their experiences of maternity care, and health and well-being 3 months after childbirth. Positive outcome was defined as women reporting no problems and feeling "very well" at the time of the survey. RESULTS In the univariate analysis, several variables were significantly associated with positive outcome, including sociodemographic, antenatal, intrapartum, and postnatal factors. In the final logistic regression model, young mothers, those without physical disability and those with no or few antenatal or early postnatal problems, were most likely to have positive outcomes. Other significant factors included a positive initial reaction to the pregnancy, not reporting antenatal depression, fewer worries about the labor and birth, and access to information about choices for care. CONCLUSIONS This study shows how positive outcomes for women after childbirth may be influenced by health, social, and care factors. It is important for caregivers to bear these factors in mind so that extra support may be made available to those women who are likely to be susceptible to poor outcome.
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Affiliation(s)
- Jane Henderson
- Policy Research Unit in Maternal Health and Care, National Perinatal Epidemiology Unit, University of Oxford, Oxford, United Kingdom
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Nilsen ABV, Waldenström U, Rasmussen S, Hjelmstedt A, Schytt E. Characteristics of first-time fathers of advanced age: a Norwegian population-based study. BMC Pregnancy Childbirth 2013; 13:29. [PMID: 23363654 PMCID: PMC3566934 DOI: 10.1186/1471-2393-13-29] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2012] [Accepted: 01/24/2013] [Indexed: 01/02/2023] Open
Abstract
Background The modern phenomenon of delayed parenthood applies not only to women but also to men, but less is known about what characterises men who are expecting their first child at an advanced age. This study investigates the sociodemographic characteristics, health behaviour, health problems, social relationships and timing of pregnancy in older first-time fathers. Methods A cross-sectional study was conducted of 14 832 men who were expecting their first child, based on data from the Norwegian Mother and Child Cohort Study (MoBa) carried out by the Norwegian Institute of Public Health. Data were collected in 2005–2008 by means of a questionnaire in gestational week 17–18 of their partner’s pregnancy, and from the Norwegian Medical Birth Register. The distribution of background variables was investigated across the age span of 25 years and above. Men of advanced age (35–39 years) and very advanced age (40 years or more) were compared with men aged 25–34 years by means of bivariate and multivariate logistic regression analyses. Results The following factors were found to be associated with having the first child at an advanced or very advanced age: being unmarried or non-cohabitant, negative health behaviour (overweight, obesity, smoking, frequent alcohol intake), physical and mental health problems (lower back pain, cardiovascular diseases, high blood pressure, sleeping problems, previous depressive symptoms), few social contacts and dissatisfaction with partner relationship. There were mixed associations for socioeconomic status: several proxy measures of high socioeconomic status (e.g. income >65 000 €, self-employment) were associated with having the first child at an advanced or very advanced age, as were several other proxy measures of low socioeconomic status (e.g. unemployment, low level of education, immigrant background).The odds of the child being conceived after in vitro fertilisation were threefold in men aged 34–39 and fourfold from 40 years and above. Conclusions Men who expect their first baby at an advanced or very advanced age constitute a socioeconomically heterogeneous group with more health problems and more risky health behaviour than younger men. Since older men often have their first child with a woman of advanced age, in whom similar characteristics have been reported, their combined risk of adverse perinatal outcomes needs further attention by clinicians and researchers.
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The association of neighbourhood and individual social capital with consistent self-rated health: a longitudinal study in Brazilian pregnant and postpartum women. BMC Pregnancy Childbirth 2013; 13:1. [PMID: 23324161 PMCID: PMC3556498 DOI: 10.1186/1471-2393-13-1] [Citation(s) in RCA: 96] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2012] [Accepted: 01/11/2013] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Social conditions, social relationships and neighbourhood environment, the components of social capital, are important determinants of health. The objective of this study was to investigate the association of neighbourhood and individual social capital with consistent self-rated health in women between the first trimester of pregnancy and six months postpartum. METHODS A multilevel cohort study in 34 neighbourhoods was performed on 685 Brazilian women recruited at antenatal units in two cities in the State of Rio de Janeiro, Brazil. Self-rated health (SRH) was assessed in the 1st trimester of pregnancy (baseline) and six months after childbirth (follow-up). The participants were divided into two groups: 1. Good SRH--good SRH at baseline and follow-up, and, 2. Poor SRH--poor SRH at baseline and follow-up. Exploratory variables collected at baseline included neighbourhood social capital (neighbourhood-level variable), individual social capital (social support and social networks), demographic and socioeconomic characteristics, health-related behaviours and self-reported diseases. A hierarchical binomial multilevel analysis was performed to test the association between neighbourhood and individual social capital and SRH, adjusted for covariates. RESULTS The Good SRH group reported higher scores of social support and social networks than the Poor SRH group. Although low neighbourhood social capital was associated with poor SRH in crude analysis, the association was not significant when individual socio-demographic variables were included in the model. In the final model, women reporting poor SRH both at baseline and follow-up had lower levels of social support (positive social interaction) [OR 0.82 (95% CI: 0.73-0.90)] and a lower likelihood of friendship social networks [OR 0.61 (95% CI: 0.37-0.99)] than the Good SRH group. The characteristics that remained associated with poor SRH were low level of schooling, Black and Brown ethnicity, more children, urinary infection and water plumbing outside the house. CONCLUSIONS Low individual social capital during pregnancy, considered here as social support and social network, was independently associated with poor SRH in women whereas neighbourhood social capital did not affect women's SRH during pregnancy and the months thereafter. From pregnancy and up to six months postpartum, the effect of individual social capital explained better the consistency of SRH over time than neighbourhood social capital.
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Widarsson M, Engström G, Rosenblad A, Kerstis B, Edlund B, Lundberg P. Parental stress in early parenthood among mothers and fathers in Sweden. Scand J Caring Sci 2012; 27:839-47. [PMID: 23067055 DOI: 10.1111/j.1471-6712.2012.01088.x] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2012] [Accepted: 09/04/2012] [Indexed: 11/29/2022]
Abstract
BACKGROUND Parental stress affects parenting behaviour and the quality of dyadic parent-child interactions. Mothers generally show higher parental stress than fathers. AIMS Our aims were to assess the perceived level of parental stress in early parenthood and examine the differences between mothers and fathers within couples in relation to their levels of education, parental experience, existence of a parental role model and sense of coherence. METHODS In total, 307 mothers and 301 fathers of 18-month-old children answered the Swedish Parenthood Stress Questionnaire (SPSQ); and 318 mothers and 311 fathers answered the Sense of Coherence (SOC-3) scale; 283 couples answered both the SPSQ and SOC-3. RESULTS Mothers perceived higher levels of stress than fathers in the sub-areas incompetence (p < 0.001), role restriction (p < 0.001), spouse relationship problems (p = 0.004) and health problems (p = 0.027), and in total (p = 0.001). In contrast, fathers perceived higher stress than mothers in the sub-area social isolation (p < 0.001). When the data were stratified with respect to education, parental experience, existence of a parental role model and sense of coherence, significant results were observed in some of these sub-areas. CONCLUSIONS Mothers and fathers experience stress in different areas during their early parenthood. Healthcare professionals should be aware of the differences in stress that exist between mothers and fathers, so that parents can be adequately prepared for parenthood and avoid parental stress.
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Affiliation(s)
- Margareta Widarsson
- Centre for Clinical Research, Uppsala University, Västmanland County Hospital, Västerås, Sweden; Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden
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