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Blair A, Tan A, Homer CSE, Vogel JP. How do postnatal care guidelines in Australia compare to international standards? A scoping review and comparative analysis. BMC Pregnancy Childbirth 2024; 24:121. [PMID: 38336632 PMCID: PMC10854083 DOI: 10.1186/s12884-024-06295-4] [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: 07/31/2023] [Accepted: 01/27/2024] [Indexed: 02/12/2024] Open
Abstract
BACKGROUND There is no single national guideline in Australia on the provision of postnatal care, which means there is potential for significant variation in the standard and quality of care. This review aimed to systematically identify, synthesise, and assess the quality of postnatal care guidelines produced for use in Australia. A second aim was to compare postnatal care recommendations in Australian guidelines to the National Institute for Health and Care Excellence's (NICE) and the World Health Organization's (WHO) postnatal care recommendations, to identify gaps and areas of disagreement. We focussed on recommendations regarding postnatal assessment of the woman or newborn, infant feeding, discharge planning, or community-based care. METHODS A scoping review was undertaken informed by the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for scoping reviews. A database search and a manual search of state and national government health departments, professional associations and research institute websites was performed to identify relevant guidelines and recommendations. Guideline quality was assessed using the AGREE II tool. Guideline recommendations from Australia were mapped to 67 NICE/WHO recommendations. Recommendations that partially agreed, were modified, or in disagreement underwent further analysis. RESULTS A total of 31 Australian postnatal guidelines were identified and overall, these were of moderate- to high-quality. Of the 67 NICE/WHO recommendations, most agreed with the recommendations contained in Australian guidelines. There were five NICE/WHO recommendations with which corresponding Australian recommendations disagreed. There were 12 NICE/WHO recommendations that were commonly modified within Australia's guidelines. There were three NICE/WHO recommendations that did not appear in any Australian guideline. CONCLUSIONS Recommendations from postnatal guidelines in Australia have a high level of agreement with corresponding NICE/WHO recommendations. The few disagreements and modifications found in guideline recommendations - both across Australia's guidelines and between Australia's and the NICE/WHO guidelines - are worrying and warrant further examination, as they may result in different standards of care across Australia. Identified gaps in guidance should be prioritised for inclusion in new or updated guidelines where appropriate.
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Affiliation(s)
- Amanda Blair
- Maternal, Child and Adolescent Health Program, Burnet Institute, 85 Commercial Road, Melbourne, VIC, 3004, Australia.
- Melbourne School of Population and Global Health, The University of Melbourne, 207 Bouverie Street, Carlton, VIC, 3053, Australia.
| | - Annie Tan
- Maternal, Child and Adolescent Health Program, Burnet Institute, 85 Commercial Road, Melbourne, VIC, 3004, Australia
| | - Caroline S E Homer
- Maternal, Child and Adolescent Health Program, Burnet Institute, 85 Commercial Road, Melbourne, VIC, 3004, Australia
- Melbourne School of Population and Global Health, The University of Melbourne, 207 Bouverie Street, Carlton, VIC, 3053, Australia
| | - Joshua P Vogel
- Maternal, Child and Adolescent Health Program, Burnet Institute, 85 Commercial Road, Melbourne, VIC, 3004, Australia
- Melbourne School of Population and Global Health, The University of Melbourne, 207 Bouverie Street, Carlton, VIC, 3053, Australia
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Zhao Y, Yuan M, Wu J, Wang Z, Jia F, Ma L, Yang Y, Zhou J, Zhang M. A postpartum functional assessment tool for women based on the international classification of functioning, disability and health. BMC Womens Health 2024; 24:27. [PMID: 38184568 PMCID: PMC10771640 DOI: 10.1186/s12905-024-02880-z] [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: 04/13/2023] [Accepted: 01/03/2024] [Indexed: 01/08/2024] Open
Abstract
BACKGROUND Postpartum dysfunctions and complications can occur in women. However, functional assessment should be conducted to make treatment plans before any intervention is implemented. In this context, the International Classification of Functioning, Disability and Health (ICF) may be a useful tool for women postpartum to document functional data and set rehabilitation goals. The purpose of this study was to determine the corresponding domains that should be considered in the evaluation of women's postpartum functioning based on the International Classification of Functioning, Disability and Health (ICF) model using the Delphi method. METHODS Fifteen domestic experts were invited to conduct two rounds of expert consensus survey on the ICF-based postpartum functional assessment category pool obtained through literature retrieval, clinical investigation, and reference to relevant literature. The sample was medical staff with professional knowledge of women's health. The opinions of experts were summarized, and the positive coefficient, authority coefficient and coordination degree of experts were calculated. RESULTS A total of 15 domestic experts participated in this expert consensus. Through two rounds of a questionnaire survey, 69 items were finally selected to form the ICF-based postpartum functional assessment tool for women. The items included 32 items of body function, 12 items of body structure, 17 items of activity and participation, and 8 items of environmental factors. In addition, we identified 8 items of personal factors. The expert positive coefficients of the two rounds of expert consensus were both 100%, the authority coefficient was 0.789, and the coefficient of variation was between 0.09 to 0.31. CONCLUSION A postpartum functional assessment tool for women based on the ICF model was constructed based on the Delphi method, which can provide more comprehensive health management and life intervention for postpartum women. TRIAL REGISTRATION The Registration number of the Chinese Clinical Trial Registry is ChiCTR2200066163, 25/11/2022.
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Affiliation(s)
- Ying Zhao
- The Affiliated Xuzhou Rehabilitation Hospital of Xuzhou Medical University, Xuzhou, 221003, China
- The Xuzhou Clinical College of Xuzhou Medical University, Xuzhou Central Hospital, Xuzhou, 221009, China
| | - Meng Yuan
- The Affiliated Xuzhou Rehabilitation Hospital of Xuzhou Medical University, Xuzhou, 221003, China
| | - Jie Wu
- The Affiliated Xuzhou Rehabilitation Hospital of Xuzhou Medical University, Xuzhou, 221003, China
| | - Zhao Wang
- The Affiliated Xuzhou Rehabilitation Hospital of Xuzhou Medical University, Xuzhou, 221003, China
- The Xuzhou Clinical College of Xuzhou Medical University, Xuzhou Central Hospital, Xuzhou, 221009, China
| | - Fan Jia
- The Affiliated Xuzhou Rehabilitation Hospital of Xuzhou Medical University, Xuzhou, 221003, China
- The Xuzhou Clinical College of Xuzhou Medical University, Xuzhou Central Hospital, Xuzhou, 221009, China
| | - Lili Ma
- The Xuzhou Clinical College of Xuzhou Medical University, Xuzhou Central Hospital, Xuzhou, 221009, China
| | - Yang Yang
- The Xuzhou Clinical College of Xuzhou Medical University, Xuzhou Central Hospital, Xuzhou, 221009, China
| | - Jingjie Zhou
- The Xuzhou Clinical College of Xuzhou Medical University, Xuzhou Central Hospital, Xuzhou, 221009, China
| | - Ming Zhang
- The Affiliated Xuzhou Rehabilitation Hospital of Xuzhou Medical University, Xuzhou, 221003, China.
- The Xuzhou Clinical College of Xuzhou Medical University, Xuzhou Central Hospital, Xuzhou, 221009, China.
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Lau EYH, Li JB, Siu CTS. Postnatal depressive symptoms mediate the relation between prenatal role overload and responsiveness among first-time mothers. J Reprod Infant Psychol 2024; 42:95-109. [PMID: 35499554 DOI: 10.1080/02646838.2022.2070609] [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: 12/31/2021] [Accepted: 04/20/2022] [Indexed: 10/18/2022]
Abstract
BACKGROUND This study examined the association between prenatal role overload and maternal responsiveness, with postnatal depressive symptoms as a mediator. METHODS Participants were 127 first-time mothers in Hong Kong (M = 32.8, SD = 4.0). Participants completed data collection for self-report on prenatal role overload (Time 1) in the third trimester of pregnancy, postnatal depressive symptoms (Time 2) at 4-month postpartum and maternal responsiveness (Time 3) at 9-month postpartum. The hypothesised mediation model was tested with the Hayes PROCESS macro (model 4). RESULTS Time 1 prenatal role overload was not directly predictive of later responsiveness (B = -0.06, p = .270). However, the indirect effect of Time 2 postnatal depressive symptoms in the association between Time 1 prenatal role overload and Time 3 responsiveness was significant (unstandardised effect = -0.03, 95% Bootstrapping CI = [-0.081, -0.001]; standardised effect = -0.06, 95% Bootstrapping CI = [-0.152, -0.002]). CONCLUSION Findings highlighted that more attention is required to the support provided to first-time expectant mothers to prevent role overload, and that intervention for postnatal depressive symptoms may focus on role overload. The findings also highlighted that postnatal depressive symptoms could be a promising way to increase maternal responsiveness.
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Affiliation(s)
- Eva Yi Hung Lau
- Department of Early Childhood Education, The Education University of Hong Kong, Hong Kong
| | - Jian-Bin Li
- Department of Early Childhood Education, The Education University of Hong Kong, Hong Kong
| | - Carrey Tik-Sze Siu
- Department of Early Childhood Education, The Education University of Hong Kong, Hong Kong
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Meyling MMG, Frieling ME, Vervoort JPM, Feijen-de Jong EI, Jansen DEMC. Health problems experienced by women during the first year postpartum: A systematic review. Eur J Midwifery 2023; 7:42. [PMID: 38111746 PMCID: PMC10726257 DOI: 10.18332/ejm/173417] [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: 06/02/2023] [Revised: 10/05/2023] [Accepted: 11/15/2023] [Indexed: 12/20/2023] Open
Abstract
INTRODUCTION During pregnancy and childbirth, health issues can arise that can negatively influence women's postpartum health. Although it is imperative to identify these health problems in order to tailor care to women's needs, they often remain unrecognized. A comprehensive overview of postpartum health problems does not exist in the current literature. This systematic review aimed to explore the health problems experienced by women residing in high-income countries during the first year postpartum. METHODS Scientific databases were searched for articles on health problems experienced by women during the first year postpartum, published between January 2000 and 2 July 2021. Studies investigating the experiences of healthy women from the age of 18 years, residing in high-income countries, who gave birth to a healthy neonate, were included. Identified health issues were divided into five categories and presented in an overview. RESULTS A total of 25 articles were eligible for inclusion. In all, 83 health problems were identified and divided into five different categories (physical health problems, mental health problems, social health problems, problems related to feeding the infant, and other challenges). Common health issues postpartum were exhaustion, urinary incontinence, painful breasts, depressive symptoms, problems related to sexuality and sleep, lack of social support, and problems with breastfeeding. CONCLUSIONS This systematic review contributes to a wider understanding of postpartum health problems and can be used to adapt healthcare to women's needs. It distinguishes itself from previous studies by the wide variety of identified health problems and its specific focus on women's experiences in the postpartum period.
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Affiliation(s)
| | | | - Johanna P. M. Vervoort
- Department of Health Sciences, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | - Esther I. Feijen-de Jong
- Department of Primary and Long-term Care, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
- Department of Midwifery Science, Amsterdam University Medical Centers, Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, Amsterdam, the Netherlands
- Midwifery Academy Amsterdam Groningen, Inholland, Groningen, the Netherlands
| | - Danielle E. M. C. Jansen
- Department of Primary and Long-term Care, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
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Nabulsi M, Smaili H, Abou Khalil N. Validation of the Arabic Maternal postpartum quality of life questionnaire among Lebanese women: A cohort study. PLoS One 2023; 18:e0291826. [PMID: 37768902 PMCID: PMC10538779 DOI: 10.1371/journal.pone.0291826] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2023] [Accepted: 09/06/2023] [Indexed: 09/30/2023] Open
Abstract
BACKGROUND The postpartum period is an important phase in a woman's life. Yet, there is a paucity of validated instruments that assess maternal postpartum quality of life issues. The aim of this study is to describe the adaptation and validation of the Arabic version of the Maternal Postpartum Quality of Life (MAPP-QOL) questionnaire. METHODS This instrument validation cohort study tested an adapted Arabic version of the MAPP-QOL questionnaire on a convenience sample of 485 healthy Lebanese postpartum women. The MAPP-QOL reliability and validity were investigated by conducting Exploratory Factor Analysis using Principal Component Analysis, and by correlating the participants' MAPP-QOL scores with their scores on the Arabic Maternal Breastfeeding Evaluation Scale (MBFES-A), age, and education. Confirmatory Factor Analysis was conducted to examine how well the original factor structure of MAPP-QOL fits with our observed data using STATA 14. All other statistical analyses were done using SPSS version 23. RESULTS The Cronbach's alpha reliability coefficient of the Arabic MAPP-QOL was 0.90. Exploratory factor analysis revealed the following five components: Functioning (11 items, Cronbach's alpha of 0.82), Socioeconomic (9 items, Cronbach's alpha of 0.81), Relational (9 items, Cronbach's alpha of 0.75), Psychological (4 items, Cronbach's alpha of 0.74), and Health (6 items, Cronbach's alpha of 0.59). The overall Arabic MAPP-QOL score was positively but weakly correlated with the MBFES-A score (r = 0.177, p < 0.001), its Maternal Enjoyment/Role Attainment subscale score (r = 0.108, p = 0.023), and Lifestyle/Body Image subscale score (r = 0.286, p < 0.001). There was no significant association between the type of infant feeding at one month and the Arabic MAPP-QOL score (p = 0.932). Similarly, the Arabic MAPP-QOL score was not correlated with the participant's age (r = 0.043, p = 0.362) or education (p = 0.451). After modification of indices, Confirmatory Factor Analysis revealed that the goodness of fit indices corresponding to the 5-factor model in the original questionnaire indicate a reasonable fit with RMSEA = 0.052, CFI = 0.847 and SRMR = 0.062. CONCLUSIONS The Arabic MAPP-QOL has good psychometric properties and may be a useful tool for clinicians and researchers interested in measuring maternal postpartum quality of life. Further replication of our findings in other Arab contexts is needed.
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Affiliation(s)
- Mona Nabulsi
- Department of Pediatrics and Adolescent Medicine, American University of Beirut, Beirut, Lebanon
| | - Hanan Smaili
- Department of Pediatrics and Adolescent Medicine, American University of Beirut, Beirut, Lebanon
| | - Nour Abou Khalil
- Faculty of Health Sciences, Department of Epidemiology and Population Health, American University of Beirut, Beirut, Lebanon
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Shi X, Shen Y. Mental health penalties of having a child: findings from the China family panel studies. NPJ MENTAL HEALTH RESEARCH 2023; 2:7. [PMID: 37215521 PMCID: PMC10184102 DOI: 10.1038/s44184-023-00026-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/03/2022] [Accepted: 04/05/2023] [Indexed: 05/24/2023]
Abstract
In recent years, the birth rate in China has rapidly declined. While much research has been done on the penalties in earnings that women incur when they fall behind men in the labor market due to childbirth, there has been little to no research on the mental health effects. This study addresses the gap in current literature by examining the mental health penalties that women experience after having a child in comparison to men. We applied econometric modeling to data collected from China Family Panel Studies (CFPS) and found that women experienced a significant, immediate, and long-run decline (4.3%) in life satisfaction after their first child, while men were unaffected. We also found that women experienced a significant increase in depression after their first child. This suggests mental health penalties since the mental health risk proxied by these two measurements is only significant for women. This is likely related to child penalties in labor market performance and childbirth-related physical health issues. When countries adopt multiple tools to stimulate the birth rate for economic growth, they must consider the implicit burden on women-especially the long-term negative effects on mental health.
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Affiliation(s)
- Xinjie Shi
- China Academy for Rural Development, School of Public Affairs, Zhejiang University, Hangzhou, China
- Research Center for Common Prosperity, Future Regional Development Laboratory, Innovation Center of Yangtze River Delta, Zhejiang University, Jiaxing, China
- Center for Common Prosperity of Zhejiang University & Huzhou City, Hangzhou, China
- Institute for Common Prosperity and Development, Zhejiang University, Hangzhou, China
| | - Yu Shen
- School of Economics, Nanjing University of Finance and Economics, Nanjing, China
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Hannon S, Gartland D, Higgins A, Brown SJ, Carroll M, Begley C, Daly D. Physical health and comorbid anxiety and depression across the first year postpartum in Ireland (MAMMI study): A longitudinal population-based study. J Affect Disord 2023; 328:228-237. [PMID: 36801420 DOI: 10.1016/j.jad.2023.02.056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2022] [Revised: 02/09/2023] [Accepted: 02/12/2023] [Indexed: 02/21/2023]
Abstract
INTRODUCTION Little is known of the associations between physical health issues and mental health issues such as anxiety, depression and comorbid anxiety and depression (CAD) occurring in the perinatal period. METHODS A longitudinal cohort study with 3009 first-time mothers giving birth in Ireland collected physical and mental health data in pregnancy and at 3, 6, 9 and 12 months postpartum. Mental health was measured using the depression and anxiety subscales of the Depression, Anxiety and Stress Scale. Experience of eight common physical health issues (e.g. severe headaches/migraines, back pain) were assessed in pregnancy, with an additional six assessed at each postpartum data collection point. RESULTS 2.4 % of women reported depression alone in pregnancy and 4 % reported depression across the first postpartum year. Anxiety alone was reported by 3.0 % of women in pregnancy, and 2 % in the first year postpartum. Prevalence of comorbid anxiety/depression (CAD) was 1.5 % in pregnancy and almost 2 % postpartum. A higher proportion of women reporting, compared to women not reporting, postpartum CAD were younger, not partnered, not in paid employment in pregnancy, have fewer years of education, and had a caesarean birth. Extreme tiredness/exhaustion and back pain were the most common physical health issues in pregnancy and postpartum. Constipation, haemorrhoids, bowel issues, breast issues, infection and pain in the perineum or caesarean wound, pelvic pain and urinary tract infections were highest at three months postpartum and gradually decreased thereafter. Women reporting depression alone or anxiety alone were equivalent in terms of physical health issues. However, women without mental health symptoms reported significantly fewer physical health issues than women reporting depressive or anxiety symptoms alone or CAD at every time point. Women with CAD reported a significantly higher number of health issues than women reporting depression alone or anxiety alone at 9 and 12 months postpartum. CONCLUSION Reports of mental health symptoms are associated with higher physical health burden demonstrating a need for integrated approaches in mental and physical health care pathways in perinatal services.
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Affiliation(s)
- Susan Hannon
- School of Nursing and Midwifery, Trinity College Dublin, 24 D'Olier Street, Dublin DO2 T283, Ireland; Trinity Centre for Maternity Care Research (TCMCR), School of Nursing and Midwifery, Trinity College Dublin, No. 2 Clare Street, Dublin 2, Ireland.
| | - Deirdre Gartland
- Intergenerational Health, Murdoch Children's Research Institute, Melbourne, Vic, Australia; Department of Paediatrics, University of Melbourne, Melbourne, Vic, Australia.
| | - Agnes Higgins
- School of Nursing and Midwifery, Trinity College Dublin, 24 D'Olier Street, Dublin DO2 T283, Ireland; Trinity Centre for Maternity Care Research (TCMCR), School of Nursing and Midwifery, Trinity College Dublin, No. 2 Clare Street, Dublin 2, Ireland.
| | - Stephanie J Brown
- Intergenerational Health, Murdoch Children's Research Institute, Melbourne, Vic, Australia; Department of General Practice, University of Melbourne, Melbourne, Vic, Australia; Department of Paediatrics, University of Melbourne, Melbourne, Vic, Australia.
| | - Margaret Carroll
- School of Nursing and Midwifery, Trinity College Dublin, 24 D'Olier Street, Dublin DO2 T283, Ireland; Trinity Centre for Maternity Care Research (TCMCR), School of Nursing and Midwifery, Trinity College Dublin, No. 2 Clare Street, Dublin 2, Ireland.
| | - Cecily Begley
- School of Nursing and Midwifery, Trinity College Dublin, 24 D'Olier Street, Dublin DO2 T283, Ireland; Trinity Centre for Maternity Care Research (TCMCR), School of Nursing and Midwifery, Trinity College Dublin, No. 2 Clare Street, Dublin 2, Ireland.
| | - Déirdre Daly
- School of Nursing and Midwifery, Trinity College Dublin, 24 D'Olier Street, Dublin DO2 T283, Ireland; Trinity Centre for Maternity Care Research (TCMCR), School of Nursing and Midwifery, Trinity College Dublin, No. 2 Clare Street, Dublin 2, Ireland.
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Van der Meulen RT, Veringa-Skiba IK, Van Steensel FJA, Bögels SM, De Bruin EI. Mindfulness-based childbirth and parenting for pregnant women with high fear of childbirth and their partners: outcomes of a randomized controlled trial assessing short- and longer-term effects on psychological well-being, birth and pregnancy experience. Midwifery 2023; 116:103545. [PMID: 36375411 DOI: 10.1016/j.midw.2022.103545] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2022] [Revised: 11/01/2022] [Accepted: 11/02/2022] [Indexed: 11/08/2022]
Abstract
OBJECTIVES Mindfulness-Based Childbirth and Parenting (MBCP) reduces mothers' anticipated fear of childbirth (FOC), nonurgent obstetric interventions during childbirth and may improve childbirth outcomes in women with high FOC (Veringa-Skiba et al, 2022). The aim of this study was to examine the short- and longer-term outcomes of MBCP on psychological well-being, pregnancy and birth experience, as compared to enhanced care-as-usual (ECAU), in pregnant women with high FOC and their partners. DESIGN Participants were randomly assigned to MBCP or ECAU and completed questionnaires preintervention (T1), immediately after intervention (T2), two to four weeks after childbirth (T3) and 16-20 weeks after childbirth (T4). Both intention-to-treat and per-protocol analyses were conducted. SETTING The courses were provided by trained midwives. PARTICIPANTS Participants included 141 pregnant women and 120 partners. INTERVENTION MBCP comprised a nine-weekly three-hour session mindfulness group course for pregnant couples; ECAU consisted of two 90-minute individual couple consultation sessions. MEASUREMENTS Measures of psychological well-being included measures like stress, depression, anxiety and fatigue. Measures of pregnancy and birth experience concerned experiencing uplifts during pregnancy, experienced fear of childbirth, labour pain and satisfaction with childbirth. FINDINGS No differences between MBCP and ECAU in the total group of birthing women were found. However, women with (at least an onset of) labour that participated in MBCP reported a better birth experience compared to ECAU at T3. Concerning the total partner group only one difference between MBCP and ECAU was found at T4; MBCP partners reported an increase in fatigue. However, in the partner risk group (i.e., partners with lower psychological well-being before intervention) partners experienced better psychological well-being at T2 and T3 after MBCP than ECAU. KEY CONCLUSIONS MBCP and ECAU demonstrate similar effects on psychological well-being, birth and pregnancy experience. However, MBCP appears superior to ECAU for labouring women in having a better childbirth experience and for partners at risk for psychological complaints in increasing their psychological well-being. IMPLICATIONS FOR PRACTICE MBCP only positively affects the childbirth experience of those who experience (onset of) natural birth. It might be advisable to include partners at risk for psychological complaints in the MBCP.
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Affiliation(s)
- R T Van der Meulen
- University of Amsterdam, Research Institute of Child Development and Education (RICDE), Nieuwe Achtergracht 127, 1018 WS, Amsterdam, the Netherlands; UvA minds, Academic Treatment Center, Banstraat 29, 1071 JW Amsterdam, the Netherlands.
| | - I K Veringa-Skiba
- University of Amsterdam, Research Institute of Child Development and Education (RICDE), Nieuwe Achtergracht 127, 1018 WS, Amsterdam, the Netherlands
| | - F J A Van Steensel
- University of Amsterdam, Research Institute of Child Development and Education (RICDE), Nieuwe Achtergracht 127, 1018 WS, Amsterdam, the Netherlands
| | - S M Bögels
- University of Amsterdam, Research Institute of Child Development and Education (RICDE), Nieuwe Achtergracht 127, 1018 WS, Amsterdam, the Netherlands
| | - E I De Bruin
- University of Amsterdam, Research Institute of Child Development and Education (RICDE), Nieuwe Achtergracht 127, 1018 WS, Amsterdam, the Netherlands; UvA minds, Academic Treatment Center, Banstraat 29, 1071 JW Amsterdam, the Netherlands
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Higurashi S, Tsujimori Y, Nojiri K, Toba Y, Nomura K, Ueno HM. Dietary Patterns Associated with General Health of Breastfeeding Women 1-2 Months Postpartum: Data from the Japanese Human Milk Study Cohort. Curr Dev Nutr 2023; 7:100004. [PMID: 37181129 PMCID: PMC10064480 DOI: 10.1016/j.cdnut.2022.100004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Revised: 11/03/2022] [Accepted: 11/13/2022] [Indexed: 12/24/2022] Open
Abstract
Background The effects of dietary patterns on health outcome of lactating women remain unclear. Objectives To describe the dietary patterns of lactating Japanese women and explore the association between dietary patterns and their general health. Methods This study included 1096 lactating women from the Japanese Human Milk Study Cohort. The maternal diet during lactation 1-2 mo postpartum was determined using a FFQ. Dietary patterns were identified using a factor analysis based on the energy-adjusted intake of 42 food items. Trend associations between maternal and infant variables and quartiles of dietary pattern scores were tested, and logistic regression was performed to estimate the OR and 95% CI of maternal self-reporting anemia, constipation, rough skin, sensitivity to cold, and mastitis. Results Four dietary patterns were identified in this study. The versatile vegetable diet, characterized by a high intake of vegetables, mushrooms, seaweeds, and tofu, was associated with maternal age, BMI prepregnancy and during the lactation periods, education, household income, and anemia. The plain Japanese diet contained a high intake of typical Japanese foods such as rice and miso soup and a low intake of bread and some confectioneries and was associated with maternal BMI during both periods. The salad vegetable diet, characterized by a high intake of raw vegetables and tomatoes with mayonnaise or dressing, was associated with parity and season in which data collection was conducted. The seafood diet, characterized by a high intake of fish, squid, octopus, shrimp, and shellfish, was associated with days postpartum and sensitivity to cold. Conclusions Four dietary patterns were identified and were independently associated with socioeconomic factors. The versatile vegetables diet and seafood diet were associated with anemia and sensitivity to cold, respectively, among the participants. This trial was registered at the Japanese Clinical Trials Registry (https://center6.umin.ac.jp/cgi-open-bin/icdr_e/ctr_view.cgi?recptno=R000017649) as UMIN000015494.
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Affiliation(s)
- Satoshi Higurashi
- Research and Development Department, Bean Stalk Snow, Co., Ltd., Kawagoe, Japan
| | - Yuta Tsujimori
- Research and Development Department, Bean Stalk Snow, Co., Ltd., Kawagoe, Japan
| | - Keisuke Nojiri
- Research and Development Department, Bean Stalk Snow, Co., Ltd., Kawagoe, Japan
| | - Yasuhiro Toba
- Research and Development Department, Bean Stalk Snow, Co., Ltd., Kawagoe, Japan
| | - Kyoko Nomura
- Department of Environmental Health Science and Public Health, Akita University Graduate School of Medicine, Akita, Japan
| | - Hiroshi M. Ueno
- Research and Development Department, Bean Stalk Snow, Co., Ltd., Kawagoe, Japan
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Kelley EL, Sheyn D, Hijaz A, Kingsberg SA, Pope RJ. Sexual Function and Help-Seeking Behaviors following Childbirth: A Cross-Sectional Study. JOURNAL OF SEX & MARITAL THERAPY 2022; 49:331-341. [PMID: 36039380 DOI: 10.1080/0092623x.2022.2117747] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
This study examined 573 postpartum women's perceptions of changes in their sexual function and their help-seeking behaviors. Women residing in Ohio, Michigan, or Pennsylvania, USA, completed an online survey. Most women reported decreased postpartum sexual desire and/or arousal. Among women reporting decreased sexual function, most did not seek help from informal sources of support or health care professions (HCPs). Of those who did seek help from an HCP, in each domain of sexual function, only around half received helpful treatment. Women who did not seek help for their decreased sexual desire or arousal reported greater negative perceived impact of pregnancy/childbirth on their sexual function than women who did seek help.
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Affiliation(s)
- E L Kelley
- Department of Obstetrics and Gynecology, University Hospitals Cleveland Medical Center; Cleveland, Ohio, USA
- Urology Insttitue, University Hospitals System, Cleveland, Ohio, USA
- Department of Reproductive Biology, Case Western Reserve University, Cleveland, Ohio, USA
- Department of Urology, Case Western Reserve University, Cleveland, Ohio, USA
| | - D Sheyn
- Urology Insttitue, University Hospitals System, Cleveland, Ohio, USA
- Department of Urology, Case Western Reserve University, Cleveland, Ohio, USA
| | - A Hijaz
- Urology Insttitue, University Hospitals System, Cleveland, Ohio, USA
- Department of Urology, Case Western Reserve University, Cleveland, Ohio, USA
| | - S A Kingsberg
- Department of Obstetrics and Gynecology, University Hospitals Cleveland Medical Center; Cleveland, Ohio, USA
- Urology Insttitue, University Hospitals System, Cleveland, Ohio, USA
- Department of Reproductive Biology, Case Western Reserve University, Cleveland, Ohio, USA
- Department of Urology, Case Western Reserve University, Cleveland, Ohio, USA
- Department of Psychiatry, University Hospitals Cleveland Medical Center, Cleveland, Ohio, USA
- Department of Psychiatry, Case Western Reserve University, Cleveland, Ohio, USA
| | - R J Pope
- Urology Insttitue, University Hospitals System, Cleveland, Ohio, USA
- Department of Urology, Case Western Reserve University, Cleveland, Ohio, USA
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Lee DE, Suh HW, Park HS, Youn I, Park M, Seo J. Mothers' Experiences of Childbirth and Perspectives on Korean Medicine-Based Postpartum Care in Korea: A Qualitative Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19095332. [PMID: 35564730 PMCID: PMC9105879 DOI: 10.3390/ijerph19095332] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/16/2022] [Revised: 04/25/2022] [Accepted: 04/26/2022] [Indexed: 01/25/2023]
Abstract
This study aimed to record the experiences of childbirth and postpartum care of postpartum women and gain an in-depth understanding of their experiences of Korean medicine-based postpartum healthcare. The investigator conducted a 60–90-min interview with the 8 participants (mean age 34 years), and the comments were analyzed using the thematic analysis method. The two major themes emerging from the participants’ comments were: “experience and awareness of childbirth and postpartum care” and “experiences of the Korean medicine-based postpartum program”. The first theme was analyzed in four primary categories: (1) experiences of breakdown of the body and mind; (2) impossibility of postpartum care without help; (3) experiences of relentless effort for recovery; and (4) experiences of body and mind recovery. The second theme was analyzed in four primary categories: (1) participation with vague expectations; (2) experiences of the effects of managing postpartum symptoms; (3) the need for a comprehensive Korean medicine management for postpartum women; and (4) suggested improvements for the Korean medicine-based postpartum program. Mothers recognized the importance of Korean medicine treatment during the postpartum period for the management of Sanhupung symptoms and postpartum care and reported the benefits of body warming, Sanhupung prevention, pain reduction, and sense of psychological stability.
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Affiliation(s)
- Do-Eun Lee
- Department of Neuropsychiatry, College of Korean Medicine, Won Kwang University, Iksan 54538, Korea;
| | - Hyo-Weon Suh
- Department of Korean Medicine, College of Korean Medicine, Kyung Hee University, Seoul 02453, Korea;
| | - Han-Song Park
- Department of Clinical Korean Medicine, Graduate School, Kyung Hee University, Seoul 02447, Korea; (H.-S.P.); (I.Y.)
| | - Inae Youn
- Department of Clinical Korean Medicine, Graduate School, Kyung Hee University, Seoul 02447, Korea; (H.-S.P.); (I.Y.)
| | - Minjung Park
- National Agency for Development of Innovative Technologies in Korean Medicine, National Institute of Korean Medicine Development, 12F Namsan Square Building, 173 Toegyero, Jung-gu, Seoul 04553, Korea; or
| | - Joohee Seo
- Department of Korean Neuropsychiatry, National Medical Center, 245 Euljiro, Jung-gu, Seoul 04564, Korea
- Correspondence: ; Tel.: +82-2-2260-7466
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Evans K, Fraser H, Uthman O, Osokogu O, Johnson S, Al-Khudairy L. The effect of mode of delivery on health-related quality-of-life in mothers: a systematic review and meta-analysis. BMC Pregnancy Childbirth 2022; 22:149. [PMID: 35193505 PMCID: PMC8864819 DOI: 10.1186/s12884-022-04473-w] [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: 08/23/2021] [Accepted: 02/11/2022] [Indexed: 11/10/2022] Open
Abstract
Background Previous research is inconclusive on the effects of mode of delivery on maternal health-related quality-of-life (HRQoL). We conducted a systematic review and meta-analysis to assess the current evidence for associations between mode of delivery and postpartum health-related quality-of-life. Methods Electronic databases MEDLINE ALL (OVID), Web of Science, The Cochrane Library, CINAHL and EMBASE (OVID) were searched for English written articles investigating the relationship between mode of delivery and quality-of-life published form inception to 15th October 2020. Two reviewers independently screened titles and abstracts, assessed full texts, and extracted data. Meta-analysis was conducted where possible. Results Twenty-one studies, including 19,879 women, met the inclusion criteria. A meta-analysis of 18 studies found HRQoL scores were significantly higher for women after vaginal delivery in comparison to caesarean (emergency and elective combined) (Effect Size (ES) 0.17, 95% CI 0.01–0.25, n = 7665) with highest scores after assisted vaginal delivery (ES 0.21, 95% CI 0.13–0.30, n = 2547). Physical functioning (ES 11.18, 95% CI = 2.29–20.06, n = 1746), physical role (ES 13.10, 95% CI = 1.16–25.05, n = 1471), vitality (ES 6.31, 95% CI = 1.14–10.29, n = 1746) and social functioning (ES 5.69, 95% CI = 1.26–10.11, n = 1746) were significantly higher after vaginal delivery compared to caesarean. Conclusions Health-related quality-of-life scores were higher for women after vaginal delivery in comparison to caesarean section. Consequently, women should be encouraged to deliver vaginally where possible. The findings of this research should be available to the relevant population to help support informed choice. Supplementary Information The online version contains supplementary material available at 10.1186/s12884-022-04473-w.
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Affiliation(s)
- Kate Evans
- Warwick Medical School, University of Warwick, Coventry, CV4 7AL, England.
| | - Hannah Fraser
- Warwick Medical School, University of Warwick, Coventry, CV4 7AL, England
| | - Olalekan Uthman
- Warwick Medical School, University of Warwick, Coventry, CV4 7AL, England
| | - Osemeke Osokogu
- Warwick Medical School, University of Warwick, Coventry, CV4 7AL, England
| | - Samantha Johnson
- Warwick Medical School, University of Warwick, Coventry, CV4 7AL, England
| | - Lena Al-Khudairy
- Warwick Medical School, University of Warwick, Coventry, CV4 7AL, England
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HAPPY MAMA Project (Part 2)-Maternal Distress and Self-Efficacy: A Pilot Randomized Controlled Field Trial. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19031461. [PMID: 35162482 PMCID: PMC8835492 DOI: 10.3390/ijerph19031461] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/09/2021] [Revised: 01/21/2022] [Accepted: 01/24/2022] [Indexed: 12/04/2022]
Abstract
Introduction: The aim of the pilot randomized controlled field trial is to assess if a midwifery intervention is able to increase the maternal self-efficacy and reduce the stress level during the first six months after birth. Methods: The study was conducted in two different hospitals in Rome, Italy, involving women delivering at or beyond term, aged >18 years old and with normal APGAR scores of the infant. The participants were randomly divided into two groups: “Individual Intervention Group” (they received home midwifery assistance for one month after birth, I) and the “Control Group” (C). A self-administered questionnaire was administered four times: at the baseline about one week after the hospital delivery (T0), after the intervention about one month after the delivery (T1), and at three months (T2) and at six months after birth (T3). The questionnaire included different validated scales needed to assess maternal perceived self-efficacy (KPCS), parental stress scale stress (PSS) and maternal depressive risk symptoms (EPDS). Results: The study population counted 51 mothers: 28 women in the “C” group and 23 women in the “I” group. The PSS score was statistically higher in the “C” than “I” group at T1 (p = 0.024); whereas the KPCS score was statistically higher in the “I” (p = 0.039) group; EPDS score did not show significant difference between the two groups in the follow-up period. An inverse significant correlation between KPCS and PSS was found during the study window time (p < 0.0001). Conclusions: These results potentially give the opportunity to explore this area of focus further, in order to better address maternal individual needs for the successful transition to motherhood. More research in this area is required.
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Fischer AR, Green SRM, Gunn HE. Social-ecological considerations for the sleep health of rural mothers. J Behav Med 2021; 44:507-518. [PMID: 33083923 PMCID: PMC7574991 DOI: 10.1007/s10865-020-00189-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2020] [Accepted: 09/30/2020] [Indexed: 02/03/2023]
Abstract
Using a social-ecological framework, we identify social determinants that interact to influence sleep health, identify gaps in the literature, and make recommendations for targeting sleep health in rural mothers. Rural mothers experience unique challenges and protective factors in maintaining adequate sleep health during the postpartum and early maternal years. Geographic isolation, barriers to comprehensive behavioral medicine services, and intra-rural ethno-racial disparities are discussed at the societal (e.g., public policy), social (e.g., community) and individual levels (e.g., stress) of the social-ecological model. Research on sleep health would benefit from attention to methodological considerations of factors affecting rural mothers such as including parity in population-level analyses or applying community-based participatory research principles. Future sleep health programs would benefit from using existing social support networks to disseminate sleep health information, integrating behavioral health services into clinical care frameworks, and tailoring culturally-appropriate Telehealth/mHealth programs to enhance the sleep health of rural mothers.
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Affiliation(s)
- Alexandra R Fischer
- Department of Psychology, University of Alabama, Box 87034, Tuscaloosa, AL, 35487, USA
| | | | - Heather E Gunn
- Department of Psychology, University of Alabama, Box 87034, Tuscaloosa, AL, 35487, USA.
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Mannocci A, Massimi A, Scaglietta F, Ciavardini S, Scollo M, Scaglione C, La Torre G. HAPPY MAMA Project (PART 1). Assessing the Reliability of the Italian Karitane Parenting Confidence Scale (KPCS-IT) and Parental Stress Scale (PSS-IT): A Cross-Sectional Study among Mothers Who Gave Birth in the Last 12 Months. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18084066. [PMID: 33921481 PMCID: PMC8070573 DOI: 10.3390/ijerph18084066] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/18/2021] [Revised: 04/07/2021] [Accepted: 04/08/2021] [Indexed: 01/25/2023]
Abstract
The purposes of this study were: (1) to adapt two validated questionnaires used to evaluate maternal confidence (KPCS-IT) and maternal stress (PSS-IT) to the Italian context, in order to (2) measure the stress level and the self-efficacy in an Italian sample of mothers. The validation process has provided the construction of an online questionnaire. It was administered on a convenience mothers sample with at least a child aged 0–12 months, twice (T0 and T1) with a two day interval. Assessment of instrument stability over time was estimated by applying test–retest reliability between T0 and T1, and the Cronbach’s alpha coefficient. A cross-sectional study was carried out to assess the second aim. Italian mothers with at least one child living at home aged between 0–12 months were recruited. Statistical reliability methods were applied to assess the internal validity of the two questionnaires. PSS-IT was analyzed using univariate and multivariate statistical analyses in order to study the association between KPCS-IT, demographic and maternal characteristics. Statistical significance was established as p < 0.05. The Cronbach’s alpha reported a good level of internal consistency of the questionnaires: PSS-IT alpha = 0.862; KPCS-IT alpha = 0.801. 32% of the mothers declared low maternal confidence and the mean value of PSS-IT was 35.4 (SD = 8). The significant inverse correlation was found between the PSS-IT and the KPCS-IT (coeff = −0.353; p < 0.001): this means that a high level of perceived self-efficacy reduces the maternal stress level. The study identifies that interventions on maternal confidence can be useful to support mothers in the first months after delivery in order to prevent stress risk: the perceived self-efficacy is as a modifiable factor and the results of the study indicate that it significantly reduces the PSS-IT and EPDS scores. In future, more field trials are necessary in order to assess the realistic and feasible interventions on maternal confidence and competence to prevent maternal distress.
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Affiliation(s)
- Alice Mannocci
- Faculty of Economics, Universitas Mercatorum, 00186 Rome, Italy
- Correspondence:
| | - Azzurra Massimi
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, 00185 Rome, Italy; (A.M.); (F.S.); (S.C.); (M.S.); (C.S.); (G.L.T.)
| | - Franca Scaglietta
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, 00185 Rome, Italy; (A.M.); (F.S.); (S.C.); (M.S.); (C.S.); (G.L.T.)
| | - Sara Ciavardini
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, 00185 Rome, Italy; (A.M.); (F.S.); (S.C.); (M.S.); (C.S.); (G.L.T.)
| | - Michela Scollo
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, 00185 Rome, Italy; (A.M.); (F.S.); (S.C.); (M.S.); (C.S.); (G.L.T.)
| | - Claudia Scaglione
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, 00185 Rome, Italy; (A.M.); (F.S.); (S.C.); (M.S.); (C.S.); (G.L.T.)
| | - Giuseppe La Torre
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, 00185 Rome, Italy; (A.M.); (F.S.); (S.C.); (M.S.); (C.S.); (G.L.T.)
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Wang M, László KD, Svedberg P, Nylén L, Alexanderson K. Childbirth, morbidity, sickness absence and disability pension: a population-based longitudinal cohort study in Sweden. BMJ Open 2020; 10:e037726. [PMID: 33234618 PMCID: PMC7689079 DOI: 10.1136/bmjopen-2020-037726] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVE To investigate associations of morbidity with subsequent sickness absence (SA) and disability pension (DP) among initially nulliparous women with no, one or several childbirths during follow-up. DESIGN Longitudinal register-based cohort study. SETTING Sweden. PARTICIPANTS Nulliparous women, aged 18 to 39 years and living in Sweden on 31 December 2004 and the three preceding years (n=492 504). OUTCOME MEASURES Annual mean DP and SA days (in SA spells >14 days) in the 3 years before and after inclusion date in 2005. METHODS Women were categorised into three groups: no childbirth in 2005 nor during the follow-up, first childbirth in 2005 but not during follow-up, and having first childbirth in 2005 and at least one more during follow-up. Microdata were obtained for 3 years before and 3 years after inclusion regarding SA, DP, mortality and morbidity (ie, hospitalisation and specialised outpatient healthcare, also excluding healthcare for pregnancy, childbirth and puerperium). HRs and 95% CIs for SA and DP in year 2 and 3 after childbirth were estimated by Cox regression; excluding those on DP at inclusion. RESULTS After controlling for study participants' prior morbidity and sociodemographic characteristics, women with one childbirth had a lower risk of SA and DP than those who remained nulliparous, while women with more than one childbirth had the lowest DP risk. Morbidity after inclusion that was not related to pregnancy, childbirth or the puerperium was associated with a higher risk of future SA and DP, regardless of childbirth group. Furthermore, morbidity both before and after childbirth showed a strong association with SA and DP (HR range: 2.54 to 13.12). CONCLUSION We found a strong positive association between morbidity and both SA and DP among women, regardless of childbirth status. Those who gave birth had lower future SA and DP risk than those who did not.
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Affiliation(s)
- Mo Wang
- Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Krisztina D László
- Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
| | - Pia Svedberg
- Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Lotta Nylén
- Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
- Academic Primary Healthcare Centre, Region Stockholm, Stockholm, Sweden
| | - Kristina Alexanderson
- Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
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Pettersson ML, Nedstrand E, Bladh M, Svanberg AS, Lampic C, Sydsjö G. Mothers who have given birth at an advanced age - health status before and after childbirth. Sci Rep 2020; 10:9739. [PMID: 32546715 PMCID: PMC7298035 DOI: 10.1038/s41598-020-66774-4] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2019] [Accepted: 05/19/2020] [Indexed: 11/09/2022] Open
Abstract
Women postpone childbirth to an age when morbidity is higher and fertility has decreased and yet the knowledge of mothers' morbidity related to age remains scarce. Swedish national register data from the Medical Birth Register and National Patient Register was used to investigate the incidence of diseases listed in the International Classification of Diseases, version 10 (ICD-10) in women who gave birth 2007-8. The index group consisted of women 40 years of age or older (n = 8 203) were compared to a control group of women, younger than 40 years (n = 15 569) at childbirth. The period studied was five years before childbirth to five years after. The main outcome measures were incidence of disease diagnosed in specialized hospital care. Demographical data and use of assisted reproduction (ART) were adjusted for. The results showed that older women were more likely to be single; less frequently used tobacco; were educated on a higher level; had a higher BMI and more often had used ART to become pregnant. The older women showed a higher morbidity rate. In the diagnostic groups: Neoplasms, Blood and immune system, Eye and adnexa, Ear and mastoid, Circulatory, Digestive, Skin and subcutaneous tissue, Musculoskeletal and connective tissue, and Genitourinary. The results add to the body of knowledge of a number of specific risks faced by older mothers and may be used to identify preventive actions concerning fertility and morbidity both before and after childbirth.
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Affiliation(s)
- Malin Lindell Pettersson
- Department of Obstetrics and Gynecology, and Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden.
| | - Elizabeth Nedstrand
- Department of Obstetrics and Gynecology, and Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden
| | - Marie Bladh
- Department of Obstetrics and Gynecology, and Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden
| | | | - Claudia Lampic
- Department of Women's and Children's Health, Karolinska Institutet, SE-171 77, Stockholm, Sweden.,Department of Public health and Caring Sciences, Uppsala University, SE-751 22, Uppsala, Sweden
| | - Gunilla Sydsjö
- Department of Obstetrics and Gynecology, and Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden
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Quality of life and the related factors in early postnatal women in Malawi. Midwifery 2020; 85:102700. [PMID: 32179390 DOI: 10.1016/j.midw.2020.102700] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2019] [Revised: 02/27/2020] [Accepted: 03/06/2020] [Indexed: 11/22/2022]
Abstract
OBJECTIVE To explore the quality of life (QOL) and related factors in early postnatal women. DESIGN A descriptive, cross-sectional study. SETTING Liwonde, Malawi. PARTICIPANTS Women who underwent a normal vaginal birth (N = 173) were included from August to September 2018. MEASUREMENTS The QOL of participants was assessed using a World Health Organization QOL instrument. Demographic, obstetric, and health variables were collected using a structured questionnaire. Childbirth fear and depression were respectively assessed using the Wijma Delivery Experience Questionnaire and the Edinburgh Postnatal Depression Scale. A multiple linear regression was used to examine factors associated with the QOL. RESULTS The mean age of participants was 29 (standard deviation 6.7) years. The overall QOL and health were satisfactory. The mean score of the QOL was highest in the psychological health and social relationships domains, followed by the environmental and physical health domains. A higher educational level was negatively related to the physical health of QOL (p ≤ 0.01), with physician care positively related (p = 0.01). The employment status was positively related to psychological health and the environmental QOL (p ≤ 0.01). Furthermore, a higher income, and physician care were positively related to the environmental QOL (p ≤ 0.05). High levels of childbirth fear and depressive symptoms were negatively related to all domains of the QOL (p ≤ 0.05), except for the social relationships domain. CONCLUSION AND IMPLICATIONS FOR PRACTICE The physical health QOL was lower in postnatal mothers in Malawi. Measures to improve physical health aspects and address women's fears and depressive symptoms during postpartum care are warranted. The findings should alert the health providers of the importance of assessing and improving women's physical health and psychological well-being during postpartum care.
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Moran PS, Wuytack F, Turner M, Normand C, Brown S, Begley C, Daly D. Economic burden of maternal morbidity - A systematic review of cost-of-illness studies. PLoS One 2020; 15:e0227377. [PMID: 31945775 PMCID: PMC6964978 DOI: 10.1371/journal.pone.0227377] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2019] [Accepted: 12/17/2019] [Indexed: 02/07/2023] Open
Abstract
Aim To estimate the economic burden of common health problems associated with pregnancy and childbirth, such as incontinence, mental health problems, or gestational diabetes, excluding acute complications of labour or birth, or severe acute adverse maternal outcomes. Methods Searches for relevant studies were carried out to November 2019 in Medline, Embase, CINAHL, PsycINFO and EconLit databases. After initial screening, all results were reviewed for inclusion by two authors. An adapted version of a previously developed checklist for cost-of-illness studies was used for quality appraisal. All costs were converted to 2018 Euro using national consumer price indices and purchasing power parity conversion factors. Results Thirty-eight relevant studies were identified, some of which reported incremental costs for more than one health problem (16 gestational diabetes, 13 overweight/obesity, 8 mental health, 4 hypertensive disorders, 2 nausea and vomiting, 2 epilepsy, 1 intimate partner violence). A high level of heterogeneity was observed in both the methods used, and the incremental cost estimates obtained for each morbidity. Average incremental costs tended to be higher in studies that modelled a hypothetical cohort of women using data from a range of sources (compared to analyses of primary data), and in studies set in the United States. No studies that examined the economic burden of some common pregnancy-related morbidities, such as incontinence, pelvic girdle pain, or sexual health problems, were identified. Conclusion Our findings indicate that maternal morbidity is associated with significant costs to health systems and society, but large gaps remain in the evidence base for the economic burden of some common health problems associated with pregnancy and childbirth. More research is needed to examine the economic burden of a range of common maternal health problems, and future research should adopt consistent methodological approaches to ensure comparability of results.
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Affiliation(s)
- Patrick S. Moran
- School of Nursing and Midwifery, Trinity College, Dublin, Ireland
- * E-mail:
| | | | | | - Charles Normand
- Centre for Health Policy and Management, Trinity College, Dublin, Ireland
- Cicely Saunders Institute, King’s College, London, United Kingdom
| | - Stephanie Brown
- General Practice and Primary Health Care Academic Centre, University of Melbourne, Melbourne, Australia
- Murdoch Children’s Research Institute, Melbourne, Australia
| | - Cecily Begley
- School of Nursing and Midwifery, Trinity College, Dublin, Ireland
| | - Deirdre Daly
- School of Nursing and Midwifery, Trinity College, Dublin, Ireland
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Rouhi M, Stirling CM, Crisp EP. Mothers' views of health problems in the 12 months after childbirth: A concept mapping study. J Adv Nurs 2019; 75:3702-3714. [PMID: 31452233 DOI: 10.1111/jan.14187] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2019] [Revised: 07/22/2019] [Accepted: 08/10/2019] [Indexed: 01/03/2023]
Abstract
AIMS To identify the health problems that women feel require help and subsequent help-seeking behaviour during the 12 months period after childbirth. BACKGROUND Many women experience physical and mental health problems after childbirth, but there is a gap in understanding how they perceive their health after childbirth. Studies suggested they are inhibited in expressing their needs and so seek informal rather than professional help for their health problems. DESIGN A mixed method concept mapping study. METHOD Two groups of Australian women were recruited by an online platform and purposive sampling (N = 81) in 2017-2018, based on an established concept mapping methodology. A first group created 83 brainstorm statements about post-childbirth health problems and help-seeking and a second group sorted and rated the statements based on their perception of the prevalence of the issues and the help-seeking advice they would offer to others. Bradshaw`s Taxonomy of Needs was used to theoretically underpins the explanation of the results of women's felt need after childbirth. RESULTS Multidimensional scaling resulted in six clusters of issues which were categorized into three domains: 'health issues and care', 'support' and 'fitness'. Despite being directly asked, about two-thirds of the women did not report experiencing any health problems. CONCLUSION Our findings showed women had a broader perception of healthcare needs which included support and fitness. There is a potential gap in services for women who do not have good social support. IMPACT Family and friends were a key source of help-seeking. Post-childbirth routine care was focused on infant care and limited to the first 6 weeks after childbirth. The content of current post-childbirth care must be reviewed.
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Affiliation(s)
- Maryam Rouhi
- School of Nursing, College of Health and Medicine, University of Tasmania, Hobart, TAS, Australia
| | - Christine M Stirling
- School of Nursing, College of Health and Medicine, University of Tasmania, Hobart, TAS, Australia
| | - Elaine P Crisp
- School of Nursing, College of Health and Medicine, University of Tasmania, Launceston, TAS, Australia
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Rouhi M, Stirling C, Ayton J, Crisp EP. Women's help-seeking behaviours within the first twelve months after childbirth: A systematic qualitative meta-aggregation review✰. Midwifery 2019; 72:39-49. [PMID: 30772692 DOI: 10.1016/j.midw.2019.02.005] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2018] [Revised: 01/11/2019] [Accepted: 02/06/2019] [Indexed: 10/27/2022]
Abstract
INTRODUCTION Women within the first 12 months after birth often do not seek professional help for post-childbirth morbidities. This systematic review uses the Behavioural Model of Health Services Use (BMSHU) to assess the barriers and facilitators to women's help-seeking from health professionals during the first twelve months after childbirth. METHOD A qualitative meta-aggregation was used for the review. Systematic searching of Medline via Ovid, CINAHL, EMBASE and Web of Science revealed an initial 691 papers, of which 48 were reviewed. Nine qualitative papers, peer-reviewed, English papers and published from 2000 to 2017, were identified. Studies selected according to the pre-defined protocol were assessed using The Joanna Briggs Institute Critical Appraisal Tools (JBIQARI). RESULTS Seventy-five findings were identified from the approved articles and aggregated into seven categories. Key themes that emerged were that women did not seek help because they accepted problems as a part of the motherhood role or because they feared being judged negatively. Women shared their issues with family and friends as trusted people. Low health literacy was a barrier to seeking help, as was lack of access to proper care and poor advice from families. The women's cultural context was an essential influence in whether or not they sought help. According to BMSHU, a model of key influences on women's help-seeking for maternal morbidities introduced.
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Affiliation(s)
- Maryam Rouhi
- School of Nursing, College of Health and Medicine, University of Tasmania, Advocate House, 9 Liverpool St, Hobart TAS 7001, Australia.
| | - Christine Stirling
- School of Nursing, College of Health and Medicine, University of Tasmania, Private Bag 135, Hobart TAS 7001, Australia.
| | - Jenifer Ayton
- Lecturer in Public Health School of Medicine, College of Health and Medicine, University of Tasmania, Private Bag 34, Hobart, TAS 7001, Australia.
| | - Elaine Peta Crisp
- School of Health Sciences, College of Health and Medicine, University of Tasmania, Locked Bag 1322, Launceston 7250, Australia.
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Mirghafourvand M, Bagherinia M. Relationship between maternal self-efficacy and functional status four months after delivery in Iranian primiparous women. J Psychosom Obstet Gynaecol 2018; 39:321-328. [PMID: 29094655 DOI: 10.1080/0167482x.2017.1394290] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
Abstract
INTRODUCTION Postpartum women experience changes in their physiological and psychological functions as they adapt to their parenting role. The objective of this study was to examine the association between maternal self-efficacy and functional status in postpartum period. METHODS In this cross-sectional study, 305 Iranian women were selected randomly via a two-stage cluster sampling method at the end of the fourth month postpartum in 25 healthcare centers of Tabriz-Iran, 2016. Data were collected using the socio-demographic characteristics questionnaire, self-efficacy scale and inventory of functional status after childbirth. The statistical tests including Pearson correlation, Independent sample t-test, one-way ANOVA and General linear model were used for data analysis. RESULTS A significant positive relationship was observed between functional status and self-efficacy (p < 0.001, r = 0.359). According to the adjusted general linear model, self-efficacy, mother's age, income status and planned pregnancy have statistically significant relationships with functional status and explain 33.5% of the variance in the functional status score. CONCLUSION The findings of the present study showed that increased postpartum maternal self-efficacy is associated with improved functional status, which requires health providers to evaluate postpartum maternal self-efficacy and make the necessary interventions if it is low.
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Affiliation(s)
- Mojgan Mirghafourvand
- a Nursing and Midwifery Faculty, Midwifery Department , Tabriz University of Medical Sciences , Tabriz , Iran
| | - Marzieh Bagherinia
- b Department of Midwifery, Students Research Committee, Faculty of Nursing and Midwifery , Tabriz University of Medical Sciences , Tabriz , Iran
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Martins CA. Transition to parenthood: consequences on health and well-being. A qualitative study. ENFERMERIA CLINICA 2018; 29:225-233. [PMID: 29914790 DOI: 10.1016/j.enfcli.2018.04.005] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2017] [Revised: 04/08/2018] [Accepted: 04/18/2018] [Indexed: 11/19/2022]
Abstract
OBJECTIVE Parenthood is one of the most dramatic developmental transitions in the family life cycle. It requires profound changes in lifestyle, roles and relationships, can increase stress levels and affects both men and women's quality of life. This study aimed to explore the effects on the health and well-being of parents during the first six months of transition to the parental role. METHOD A qualitative study using the grounded theory approach. Data collection was from semi-structured interviews (total of 60 interviews). The constant comparative method was used and theoretical sampling in the process of data collection and analysis, and the study was undertaken in a simultaneous and cyclical way. Five fathers and five mothers (couples) participated. RESULTS The category "living on the edge of one's capacities" was described, which is composed of the subcategories "feeling exhaustion", "perceiving exhaustion in the mother", "overflowing emotions" and "feeling less exhaustion", to explain the impact that the birth of a child had on the parents' lives, when taking on all the tasks and responsibilities of parenthood. CONCLUSIONS Adapting to parenthood is not easy, linear or fast. It involves numerous situations that generate stress and emotional disturbance, linked to tiredness, sleep disturbance, work overload and readjustments of the dynamics of life, which especially affect the mother. Antenatal and postnatal preparation for this impact should, therefore, be encouraged and effective, as a focus of nursing intervention.
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Rezaei N, Tavalaee Z, Sayehmiri K, Sharifi N, Daliri S. The relationship between quality of life and methods of delivery: A systematic review and meta-analysis. Electron Physician 2018; 10:6596-6607. [PMID: 29881521 PMCID: PMC5984013 DOI: 10.19082/6596] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2016] [Accepted: 09/15/2017] [Indexed: 01/01/2023] Open
Abstract
Background and aim Some physical, emotional and social changes arise in mothers during the postpartum periods which can affect the quality of life (QOL) of the mother and family. Given the importance of the quality of life in the postpartum period and its influencing factors such as method of delivery, the present study aimed at investigating the relationship between the quality of life and methods of delivery in the world, using a systematic review and meta-analysis method. Methods The present study is a systematic review and meta-analysis on the relationship between aspects of quality of life and method of delivery in the world conducted in Persian and English language articles published by the end of 2015. For this purpose, the databases of Medlib, SID, Scopus, ISI Web of Science, PubMed, Google scholar, Irandoc, Magiran and Iranmedex were searched using key words and their compounds. The results of studies were combined using the random effects model in the meta-analysis. Heterogeneity of studies was assessed using I2 index and Cochran test and data were analyzed using STATA Version 11.1 and SPSS Version 16. Results Based on the results of the meta-analysis of studies, the aspect of physical functioning had the highest quality of life mean score in women with vaginal delivery: 74.37 (95% CI: 67.7–81) and mental health had the highest QOL mean score in women with cesarean delivery: 65.8 (95% CI: 62.7–69). Also, based on the time elapsed since delivery, mental health had the highest mean score in less than 1 month, 2 months and 4 months’ postpartum. Physical pain had the highest mean score 6 months after giving birth, and mental functioning in 8 months after giving birth. Conclusions The results of the present meta-analysis showed that the mean scores for most dimensions of quality of life in women with vaginal delivery were higher than in women with cesarean delivery.
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Affiliation(s)
- Nazanin Rezaei
- Department of Midwifery, Faculty of Nursing and Midwifery, Ilam University of Medical sciences, Ilam, Iran
| | - Zahra Tavalaee
- Department of Midwifery, Faculty of Nursing and Midwifery, Ilam University of Medical Sciences, Ilam, Iran
| | - Kourosh Sayehmiri
- Psychosocial Injuries Research Center, Ilam University of Medical Sciences, Ilam, Iran
| | - Nasibeh Sharifi
- Ph.D. of Reproductive Health, Assistant Professor, Department of Midwifery, Faculty of Nursing and Midwifery, Ilam University of Medical Sciences, Ilam, Iran
| | - Salman Daliri
- M.Sc. of Epidemiology, School of Health, Ilam University of Medical sciences, Ilam, Iran
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Schaffir J, Kunkler A, Lynch CD, Benedict J, Soma L, Doering A. Association between postpartum physical symptoms and mood. J Psychosom Res 2018; 107:33-37. [PMID: 29502761 DOI: 10.1016/j.jpsychores.2018.02.003] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2017] [Revised: 02/02/2018] [Accepted: 02/03/2018] [Indexed: 02/06/2023]
Abstract
OBJECTIVE Postpartum depression may be associated with higher levels of postpartum pain, but the association with discomfort in general is unclear. We sought to describe an association between postpartum mood disturbances and quantitatively measured physical symptoms at the time of the routine postpartum encounter. METHODS We designed a novel quantitative measurement of postpartum symptoms, the Postpartum Symptom Inventory (PSI), to allow comparison to scores of postpartum mood. Women presenting for a routine postpartum visit were asked to complete a brief questionnaire about their delivery, the 20-item PSI, and an Edinburgh Postnatal Depression Scale (EPDS). Depression scores were compared with symptom inventory scores and demographic data. RESULTS Two hundred six women responded, of whom 77% had a vaginal delivery. The most common physical symptoms experienced to a bothersome degree were fatigue (35.3%), back/hip pain (22.4%), and headache (13.2%). Twenty-nine women (14.3%) had an EPDS score of 10 or more, thereby screening positive for possible depression. Women screening positive had significantly greater total PSI scores than women who did not screen positive (20.2 vs 12.2, p < 0.001). After adjustment for history of depression and age, the odds of screening positive for depression were 3.6 times higher in women with PSI scores over 10 compared to women with lower scores [95% CI: (1.1, 11.4); p = 0.03]. CONCLUSION Data suggest that a high level of physical symptomatology as measured by a PSI score >10 at six weeks post-delivery is associated with increased odds of screening positive for postpartum depression.
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Affiliation(s)
- Jonathan Schaffir
- Department of Obstetrics & Gynecology, The Ohio State University College of Medicine, United States.
| | - Anne Kunkler
- Department of Obstetrics & Gynecology, The Ohio State University College of Medicine, United States
| | - Courtney D Lynch
- Department of Obstetrics & Gynecology, The Ohio State University College of Medicine, United States
| | - Jason Benedict
- Center for Biostatistics, The Ohio State University College of Medicine, United States
| | - Loriana Soma
- Department of Obstetrics & Gynecology, The Ohio State University College of Medicine, United States
| | - Andrew Doering
- Department of Obstetrics & Gynecology, The Ohio State University College of Medicine, United States
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Investigation of the association between quality of life and depressive symptoms during postpartum period: a correlational study. BMC WOMENS HEALTH 2017; 17:115. [PMID: 29162087 PMCID: PMC5698934 DOI: 10.1186/s12905-017-0473-0] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/01/2016] [Accepted: 11/15/2017] [Indexed: 11/17/2022]
Abstract
Background The onset of a major depressive episode is experienced by a large number of women in the weeks or months following delivery. Postpartum depression may deem those women experiencing it incapable of taking care for themselves, their family and their infants, while at the same time it could negatively affect their quality of life. The present study assessed the quality of life of a sample of mothers in Greece, in order to investigate the association between postpartum depression and quality of life (QoL). Methods 145 women in a Private-General Obstetrics and Pediatric Clinic in Greece completed the Edinburgh Postnatal Depression scale (EPDS) and SF-36 questionnaire on the third and fourth day after delivery (caesarean or normal childbirth). The data were analyzed using SPSS version 17.0. Linear and logistic regression analysis was performed in order to find the independent factors related to the quality of life and postpartum depression symptoms. Results 9.9% of the participants experienced postpartum depression symptoms. Significant associations were found between the place of residence and symptoms of postpartum depression, and more specifically, women outside of Attica indicated higher levels of postpartum depression symptoms (p = 0.008) than women living in Attica. The level of education was also found to be significantly associated with postpartum depression symptoms, since women with Primary and Secondary education experienced higher levels of postpartum depression symptoms (p = 0.005) than those with a tertiary education. Concerning quality of life, women with postpartum depression symptoms scored 24.27 lower in «Role-Physical», 15.60 lower in «Bodily pain», 11.45 lower in «General Health», 14.18 lower in dimension of «Vitality», 38.25 lower in Role – Emotional and 16.82 lower in dimension of mental health, compared to those without depression symptoms. Conclusion Postpartum depression symptoms are associated with the quality of life of women after pregnancy, and therefore constitute a powerful predictor of the quality of life. Health care professionals should provide individualized care for the prevention and treatment of Postpartum Depression symptoms in order to help women improve their quality of life.
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Vikström A, Johansson S, Barimani M. Postnatal
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visits within 30 days—Pattern, risk factors and implications for care. J Clin Nurs 2017; 27:769-776. [DOI: 10.1111/jocn.14090] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/17/2017] [Indexed: 11/27/2022]
Affiliation(s)
- Anna Vikström
- The Division of Family Medicine Department of Neurobiology, Care Sciences and Society Karolinska Institutet Stockholm Sweden
| | - Sven‐Erik Johansson
- The Division of Family Medicine Department of Neurobiology, Care Sciences and Society Karolinska Institutet Stockholm Sweden
| | - Mia Barimani
- Division of Reproductive Health Department of Women′s and Children′s Health Karolinska Institutet Stockholm Sweden
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Cano-Climent A, Oliver-Roig A, Cabrero-García J, de Vries J, Richart-Martínez M. The Spanish version of the Fatigue Assessment Scale: reliability and validity assessment in postpartum women. PeerJ 2017; 5:e3832. [PMID: 28970968 PMCID: PMC5622603 DOI: 10.7717/peerj.3832] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2017] [Accepted: 08/30/2017] [Indexed: 11/20/2022] Open
Abstract
Background Fatigue is the most widely reported symptom by women during pregnancy, labour, the postpartum period, and early parenting. The objective was to translate the Fatigue Assessment Scale (FAS) into Spanish and assess its psychometric properties. Methods Instrumental Design. The FAS was translated into Spanish (FAS-e) using forward and back translation. A convenience sample was constituted with 870 postpartum women recruited at discharge from 17 public hospitals in Eastern Spain. Data was obtained from clinical records and self-administered questionnaires at discharge. Internal consistency, factor structure, comparisons between known groups and correlations with other variables were assessed. Results Cronbach’s alpha coefficient was .80. Findings on the dimensionality of the FAS-e scale indicated that it was sufficiently unidimensional. FAS-e scores were higher among women who had undergone caesarean births (p < .05), had a higher level of postpartum pain (p < .01), experienced difficulties during breastfeeding (p < .01) and had lower levels of self-efficacy for breastfeeding (p < .01). Conclusions An equivalent Spanish version of the FAS was obtained with good reliability and validity properties. FAS-e is an appropriate tool to measure postpartum fatigue.
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Affiliation(s)
- Antoni Cano-Climent
- Hospital General d'Ontinyent, Conselleria de Sanitat Universal i Salut Pública, Ontinyent, Valencia, Spain
| | - Antonio Oliver-Roig
- Department of Nursing, University of Alicante, San Vicent del Raspeig, Alicante, Spain
| | - Julio Cabrero-García
- Department of Nursing, University of Alicante, San Vicent del Raspeig, Alicante, Spain
| | - Jolanda de Vries
- CoRPS Center of Research on Psychology in Somatic Diseases, Department of Medical and Clinical Psychology, University of Tilburg, Tilburg, Netherlands
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Shon YM, Joung WJ. [Illness Experience of Married Korean Women with Epilepsy]. J Korean Acad Nurs 2017; 47:289-304. [PMID: 28706165 DOI: 10.4040/jkan.2017.47.3.289] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2016] [Revised: 02/23/2017] [Accepted: 03/13/2017] [Indexed: 11/09/2022]
Abstract
PURPOSE The purpose of this study was to understand and describe the illness experience of married Korean women with epilepsy. METHODS Data were collected during 2015~2016 through individual in-depth interviews with 12 married women with epilepsy. Verbatim transcripts were analyzed using Giorgi's phenomenological analysis to uncover the meaning of the illness experience of the participants. RESULTS The study results showed that the illness experience of married Korean women with epilepsy was clustered into a specific description of situated structure and a general description of situated structure. Six themes from 20 meaning units were identified: 1) Undermined self-esteem with stigma of being epileptic; 2) Limited social interaction; 3) Suffering sorrow as a 'disqualified being'; 4) Shuttling back and forth across the boundary between healthy and epileptic; 5) Desperate struggle to meet the expectation of given role; 6) Self-empowering through self-restriction and realization. CONCLUSION The findings from this study show that both the enacted and felt stigma of epilepsy impact on the life of married Korean women with epilepsy. Although the participants face social and interpersonal restriction and prejudices, they try their best to fulfill their role rather than to be cared for as patients. As the stigma and hardships of the participants are related to lack of knowledge, health professionals should focus not just on clinical intervention but also on providing targeted educational programs and counseling for these women to dispel the stigma of the disease and to increase their quality of life.
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Affiliation(s)
- Young Min Shon
- Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Woo Joung Joung
- Research Institute of Nursing Science, Seoul National University, Seoul, Korea.
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Machiyama K, Hirose A, Cresswell JA, Barreix M, Chou D, Kostanjsek N, Say L, Filippi V. Consequences of maternal morbidity on health-related functioning: a systematic scoping review. BMJ Open 2017; 7:e013903. [PMID: 28667198 PMCID: PMC5719332 DOI: 10.1136/bmjopen-2016-013903] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
OBJECTIVES To assess the scope of the published literature on the consequences of maternal morbidity on health-related functioning at the global level and identify key substantive findings as well as research and methodological gaps. METHODS We searched for articles published between 2005 and 2014 using Medline, Embase, Popline, CINAHL Plus and three regional bibliographic databases in January 2015. DESIGN Systematic scoping review PRIMARY OUTCOME: Health-related functioning RESULTS: After screening 17 706 studies, 136 articles were identified for inclusion. While a substantial number of papers have documented mostly negative effects of morbidity on health-related functioning and well-being, the body of evidence is not spread evenly across conditions, domains or geographical regions. Over 60% of the studies focus on indirect conditions such as depression, diabetes and incontinence. Health-related functioning is often assessed by instruments designed for the general population including the 36-item Short Form or disease-specific tools. The functioning domains most frequently documented are physical and mental; studies that examined physical, mental, social, economic and specifically focused on marital, maternal and sexual functioning are rare. Only 16 studies were conducted in Africa. CONCLUSIONS Many assessments have not been comprehensive and have paid little attention to important functioning domains for pregnant and postpartum women. The development of a comprehensive instrument specific to maternal health would greatly advance our understanding of burden of ill health associated with maternal morbidity and help set priorities. The lack of attention to consequences on functioning associated with the main direct obstetric complications is of particular concern. REVIEW REGISTRATION CRD42015017774.
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Affiliation(s)
- Kazuyo Machiyama
- Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK
| | - Atsumi Hirose
- Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden
| | - Jenny A Cresswell
- Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK
| | - Maria Barreix
- Department of Reproductive Health and Research, World Health Organization, UNDP/UNFPA/UNICEF/WHO/World Bank Special Programme of Research, Development and Research Training in Human Reproduction (HRP), Geneva, Switzerland
| | - Doris Chou
- Department of Reproductive Health and Research, World Health Organization, UNDP/UNFPA/UNICEF/WHO/World Bank Special Programme of Research, Development and Research Training in Human Reproduction (HRP), Geneva, Switzerland
| | - Nenad Kostanjsek
- Department of Health Statistics and Informatics, World Health Organization, Classification, Terminology and Standards, Geneva, Switzerland
| | - Lale Say
- Department of Reproductive Health and Research, World Health Organization, UNDP/UNFPA/UNICEF/WHO/World Bank Special Programme of Research, Development and Research Training in Human Reproduction (HRP), Geneva, Switzerland
| | - Véronique Filippi
- Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK
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31
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Kellie FJ. Postpartum health professional contact for improving maternal and infant health outcomes for healthy women and their infants. Hippokratia 2017. [DOI: 10.1002/14651858.cd010855.pub2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Affiliation(s)
- Frances J Kellie
- The University of Liverpool; Cochrane Pregnancy and Childbirth Group, Department of Women's and Children's Health; First Floor, Liverpool Women's NHS Foundation Trust Crown Street Liverpool UK L8 7SS
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Tsuchiya M, Mori E, Sakajo A, Iwata H, Maehara K, Tamakoshi K. Cross-sectional and longitudinal validation of a 13-item fatigue scale among Japanese postpartum mothers. Int J Nurs Pract 2017; 22 Suppl 1:5-13. [PMID: 27184697 DOI: 10.1111/ijn.12434] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
This study examined the psychometric properties of a 13-item fatigue scale for postpartum mothers. Japanese mothers (n = 2026) from a cohort study completed questionnaires (e.g. fatigue scale, Japanese version of the Edinburgh Postnatal Depression Scale, demographics) during their hospital stay after childbirth (baseline) and at 1, 2, 4 and 6 months postpartum. Initial factor analysis of baseline data revealed that the fatigue scale had three factors or subscales (physical, emotional and cognitive). Within-group analysis across each measurement time revealed the same three-factor structure with acceptable fit. Between-group analysis also showed longitudinal factorial invariance across time. The fatigue subscales had acceptable divergent and convergent validities with the depression scale. The subscale scores differed significantly based on participant background. The Japanese Fatigue Scale is a concise and informative tool for assessing aspects of fatigue in clinical settings and in the community.
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Affiliation(s)
- Miyako Tsuchiya
- Division of Cancer Survivorship Research, National Cancer Centre, Tokyo, Japan
| | - Emi Mori
- Graduate School of Nursing, Chiba University, Chiba, Japan
| | - Akiko Sakajo
- Graduate School of Nursing, Chiba University, Chiba, Japan
| | - Hiroko Iwata
- Graduate School of Nursing, Chiba University, Chiba, Japan
| | - Kunie Maehara
- Graduate School of Nursing, Chiba University, Chiba, Japan
| | - Koji Tamakoshi
- Graduate School of Medicine, Nagoya University, Nagoya, Japan
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Ngai FW, Wong PWC, Chung KF, Leung KY. The effect of a telephone-based cognitive behavioral therapy on quality of life: a randomized controlled trial. Arch Womens Ment Health 2017; 20:421-426. [PMID: 28361441 DOI: 10.1007/s00737-017-0722-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2016] [Accepted: 03/22/2017] [Indexed: 10/19/2022]
Abstract
Health-related quality of life (HRQoL) has emerged as a major public health concern in perinatal care. The purpose of this study was to examine the effect of telephone-based cognitive behavioral therapy (T-CBT) on HRQoL among Chinese mothers at risk of postnatal depression at 6 weeks and 6 months postpartum. A multi-center randomized controlled trial was conducted at the postnatal units of three regional hospitals. Three hundred and ninety-seven women at risk of postnatal depression were recruited and were randomly assigned to the T-CBT (n = 197) or usual care (n = 200). Assessment was conducted at baseline, 6 weeks and 6 months postpartum for HRQoL. Women in the T-CBT experienced greater improvement in the physical component of HRQoL from baseline to 6 weeks and 6 months postpartum than the usual care group. At 6 months postpartum, the T-CBT group also experienced better HRQoL in the mental component of HRQoL than the usual care group. The T-CBT appears to be feasible and effective in improving HRQoL in women at risk of postnatal depression in the primary care practice.
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Affiliation(s)
- Fei-Wan Ngai
- School of Nursing, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong SAR.
| | - Paul Wai-Ching Wong
- Department of Social Work and Social Administration, The University of Hong Kong, Pokfulam, Hong Kong SAR
| | - Ka-Fai Chung
- Department of Psychiatry, The University of Hong Kong, Pokfulam, Hong Kong SAR
| | - Kwok-Yin Leung
- Department of Obstetrics and Gynaecology, Queen Elizabeth Hospital, Hospital Authority, 30 Gascoigne Road, Kowloon, Hong Kong SAR
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Abstract
Health problems may occur in mothers and can persist during the postpartum. Life event stress (LES) is a risk factor for poor maternal health. We examined the relations of LES and rise in LES over time to maternal health during the first three years postpartum. We used data from 1,364 mothers obtained between 1991 and 2007 in the U.S. National Institute of Child Health and Human Development Study of Early Child Care and Youth Development. Information on maternal sociodemographics and early postpartum health was collected 1 month after childbirth. Maternal reports on health status and LES were obtained at 6, 15, 24, and 36 months postpartum. Latent growth curve analyses were performed, with maternal sociodemographics and early postpartum health as covariates for which statistical adjustment was made. Maternal health declined steadily in a linear pattern with marked individual differences, whereas maternal LES increased gradually in a linear pattern. Moreover, faster maternal health decline was associated with poorer early health at 1 month postpartum, greater exposure to LES at 6 months postpartum, and faster rise in LES exposure over time. Decline in maternal health may be explained at least in part by the deleterious effects of exposure to stressful life events.
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Affiliation(s)
- Hui-Chin Hsu
- a Department of Human Development and Family Science , University of Georgia , Athens , Georgia , USA
| | - Kandauda A S Wickrama
- a Department of Human Development and Family Science , University of Georgia , Athens , Georgia , USA
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Ghiasvand F, Riazi H, Hajian S, Kazemi E, Firoozi A. The effect of a self-care program based on the teach back method on the postpartum quality of life. Electron Physician 2017; 9:4180-4189. [PMID: 28607653 PMCID: PMC5459290 DOI: 10.19082/4180] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2016] [Accepted: 11/18/2016] [Indexed: 02/07/2023] Open
Abstract
Background The postpartum period is a critical stage of life with major changes in the quality of life. Therefore, special consideration is needed to this issue. Objective To determine the effect of a self-care program based on the Teach Back method on the postpartum quality of life. Methods This experimental study was conducted on eighty postpartum women who had given birth in health centers across Darreh Shahr County, Ilam Province, Iran in 2016. The control group received only routine postpartum care according to the national guidelines. The trial group received the routine care in addition to two sessions of physical and psychological postpartum self-care based on the Teach Back method. The two groups were assessed in terms of their quality of life before and after the intervention using the Postpartum Quality of Life Questionnaire. The data were analyzed using SPSS version 21. Descriptive statistic tests, Chi squared, independent-samples t-test, paired-samples t-test, Wilcoxon and Mann Whitney’s test was used. Results Before the intervention, the postpartum quality of life score was 106.23±11.866 in the trial group and 107.30±13.197 in the control group; after the intervention, the score was 124.73±10.706 and 115.03±12.687 in the two groups respectively, suggesting a significant inter-group difference after the intervention (p<0.001). Significant differences were also observed between the two groups in terms of the mother’s feelings toward herself, toward her child and toward her spouse and others, and physical health before and after the intervention (p<0.001). Conclusions Using the Teach Back model for a self-care program appears to dramatically improve the postpartum quality of life and is therefore recommended as a useful method for postpartum care. Trial registration The trial was registered at the Iranian Registry of Clinical Trials (http://www.irct.ir) with the Irct ID: IRCT2015012820854N1. Funding The authors received no financial support for the research, authorship, and/or publication of this article.
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Affiliation(s)
- Fatemeh Ghiasvand
- Student Research Committee, School of Nursing & Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Hedyeh Riazi
- Ph.D., Assistant Professor, Department of Midwifery and Reproductive Health, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Sepideh Hajian
- Ph.D., Assistant Professor, Department of Midwifery and Reproductive Health, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Elahe Kazemi
- Ph.D. Student, Department of Biostatistics, School of Paramedical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Armin Firoozi
- MS, Clinical Psychologist, Researcher, Department of Psychology, Khwarizmi University, Karaj, Iran
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36
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Hewitt B, Strazdins L, Martin B. The benefits of paid maternity leave for mothers' post-partum health and wellbeing: Evidence from an Australian evaluation. Soc Sci Med 2017; 182:97-105. [PMID: 28437694 DOI: 10.1016/j.socscimed.2017.04.022] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2017] [Revised: 04/01/2017] [Accepted: 04/09/2017] [Indexed: 11/28/2022]
Abstract
This paper investigates the health effects of the introduction of a near universal paid parental leave (PPL) scheme in Australia, representing a natural social policy experiment. Along with gender equity and workforce engagement, a goal of the scheme (18 weeks leave at the minimum wage rate) was to enhance the health and wellbeing of mothers and babies. Although there is evidence that leave, especially paid leave, can benefit mothers' health post-partum, the potential health benefits of implementing a nationwide scheme have rarely been investigated. The data come from two cross-sectional surveys of mothers (matched on their eligibility for paid parental leave), 2347 mother's surveyed pre-PPL and 3268 post-PPL. We investigated the scheme's health benefits for mothers, and the extent this varied by pre-birth employment conditions and job characteristics. Overall, we observed better mental and physical health among mothers after the introduction of PPL, although the effects were small. Post-PPL mothers on casual (insecure) contracts before birth had significantly better mental health than their pre-PPL counterparts, suggesting that the scheme delivered health benefits to mothers who were relatively disadvantaged. However, mothers on permanent contracts and in managerial or professional occupations also had significantly better mental and physical health in the post-PPL group. These mothers were more likely to combine the Government sponsored leave with additional, paid, employer benefits, enabling a longer paid leave package post-partum. Overall, the study provides evidence that introducing paid maternity leave universally delivers health benefits to mothers. However the modest 18 week PPL provision did little to redress health inequalities.
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Affiliation(s)
- Belinda Hewitt
- School of Social and Political Sciences, The University of Melbourne, Parkville, VIC 3010, Australia.
| | - Lyndall Strazdins
- National Centre for Epidemiology and Population Health, Australian National University, Australia
| | - Bill Martin
- Institute for Social Science Research, The University of Queensland, Australia
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Positive predictors of quality of life for postpartum mothers with a history of childhood maltreatment. Arch Womens Ment Health 2016; 19:1041-1050. [PMID: 27518635 DOI: 10.1007/s00737-016-0653-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2016] [Accepted: 07/30/2016] [Indexed: 12/26/2022]
Abstract
The postpartum period brings a host of biopsychosocial, familial, and economic changes, which may be challenging for new mothers, especially those with trauma histories. Trauma-exposed women are at heightened risk for psychiatric symptomatology and reduced quality of life. The current study sought to evaluate whether a set of hypothesized promotive factors assessed during the first 18 months postpartum (positive parenting, family cohesion, and maternal resilience) are associated with life satisfaction in this population, after controlling for income and postpartum psychiatric symptoms. Analyses were based on data collected for 266 mother-infant dyads from a longitudinal cohort study, Maternal Anxiety during the Childbearing Years (MACY), of women oversampled for childhood maltreatment history. Hierarchical linear regression was used to evaluate the study hypotheses. Consistent with prior work, greater postpartum psychiatric symptoms and less income predicted poor perceptions of life quality. In hierarchical regressions controlling for income and psychiatric symptoms, positive parenting and family cohesion predicted unique variance in mothers' positive perceptions of life quality, and resilience was predictive beyond all other factors. Factors from multiple levels of analysis (maternal, dyadic, and familial) may serve as promotive factors predicting positive perceptions of life quality among women with childhood trauma histories, even those struggling with high levels of psychiatric or economic distress.
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Moura MRS, Araújo CGA, Prado MM, Paro HBMS, Pinto RMC, Abdallah VOS, Mendonça TMS, Silva CHM. Factors associated with the quality of life of mothers of preterm infants with very low birth weight: a 3-year follow-up study. Qual Life Res 2016; 26:1349-1360. [DOI: 10.1007/s11136-016-1456-6] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/10/2016] [Indexed: 10/20/2022]
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Norhayati MN, Nik Hazlina NH, Aniza AA. Immediate and long-term relationship between severe maternal morbidity and health-related quality of life: a prospective double cohort comparison study. BMC Public Health 2016; 16:818. [PMID: 27538506 PMCID: PMC4990872 DOI: 10.1186/s12889-016-3524-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2015] [Accepted: 06/15/2016] [Indexed: 01/13/2023] Open
Abstract
BACKGROUND Given the growing interest in severe maternal morbidity (SMM), the need to assess its effects on quality of life is pressing. The objective of this study was to compare the quality of life scores between women with and without SMM at 1-month and 6-month postpartum in Kelantan, Malaysia. METHODS A prospective double cohort study design was applied at two tertiary referral hospitals over a 6-month period. The study population included all postpartum women who delivered in 2014. Postpartum women with and without SMM were selected as the exposed and non-exposed groups, respectively. For each exposed case identified, a non-exposed case with a similar mode of delivery was selected. The main outcome measures used were scores from the Short Form-12 Health Survey (SF-12). RESULTS The study measured 145 exposed and 187 non-exposed women. The group-time interaction of the repeated measure analysis of variance (RM ANOVA) showed no significant difference in the mean overall SF-12 physical component summary score changes (P = 0.534) between women with and without SMM. Similarly, the group-time interaction of the RM ANOVA showed no significant difference in the mean overall SF-12 mental component summary score changes (P = 0.674) between women with and without SMM. However, women with SMM scored significantly lower on a general health perceptions subscale at 1-month (P = 0.031), role limitations due to physical health subscale at 6-month (P = 0.019), vitality subscale at 1-month (P = 0.007) and 6-month (P = 0.008), and role limitations due to emotional problems subscales at 6-month (P = 0.008). CONCLUSIONS Women with severe maternal morbidity demonstrated comparable quality of life during the 6-month postpartum period compared to women without severe maternal morbidity.
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Affiliation(s)
- Mohd Noor Norhayati
- Department of Family Medicine, School of Medical Sciences, Health Campus, Universiti Sains Malaysia, 16150, Kota Bharu, Kelantan, Malaysia.
| | - Nik Hussain Nik Hazlina
- Women's Health Development Unit, School of Medical Sciences, Health Campus, Universiti Sains Malaysia, 16150, Kota Bharu, Kelantan, Malaysia
| | - Abd Aziz Aniza
- Faculty of Medicine, Universiti Sultan Zainal Abidin, 20400, Kuala Terengganu, Terengganu, Malaysia
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Chang SR, Chen KH, Lee CN, Shyu MK, Lin MI, Lin WA. Relationships between perineal pain and postpartum depressive symptoms: A prospective cohort study. Int J Nurs Stud 2016; 59:68-78. [DOI: 10.1016/j.ijnurstu.2016.02.012] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2015] [Revised: 02/13/2016] [Accepted: 02/17/2016] [Indexed: 12/27/2022]
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Wan SX, Li HL, Wang W, Shen Q, Li CH, Lyon ME, Kelly BC, Wang J. Psychometric properties of the Postpartum Women Health Quotient Scale among Chinese post partum women. Midwifery 2016; 39:63-70. [PMID: 27321722 DOI: 10.1016/j.midw.2016.04.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2015] [Revised: 03/19/2016] [Accepted: 04/09/2016] [Indexed: 11/30/2022]
Abstract
OBJECTIVE to examine the psychometric properties of a newly developed Postpartum Women's Health Quotient Scale (PWHQS) for Chinese post partum women. DESIGN a cross-sectional survey of post partum women was conducted.Categorical confirmatory factor analysis (CCFA) models were applied to examine the factorial structure of the PWHQS; test information function (TIF) was used to examine reliability of PWHQS subscales; and measurement invariance was examined by testing differential item functioning (DIF) using a multiple indicators multiple causes (MIMIC) model. SETTING two large hospitals with a level 3A designation in Suzhou, Jiangsu Province, China. PARTICIPANTS a convenience sample of 395 post partum women was recruited from April to September 2014. MEASUREMENT the PWHQS consists of 31 items with 5 subscales: health consciousness (HC, 6 items), maternal health knowledge (MHK, 8 items), infant health knowledge (IHK, 6 items), maternal health care ability (MHCA, 5 items), and infant health care ability (IHCA, 6 items). FINDINGS PWHQS has a valid factorial structure with five dimensions as theoretically designed. Each of its subscales has adequate reliability that is particularly high over the lower-moderate range of the factor score scale. Measurement non-invariance in PWHQS is very limited as only two of the 31 items displayed DIF related to one grouping variable (Age). KEY CONCLUSION PWHQS is a valid and reliable instrument that can be readily used as a screening tool to assess health quotient (HQ) among Chinese post partum women. PWHQS will also be useful for the development of interventions to help post partum women maintain and improve maternal and infant health. Further research to confirm the findings of the present study is desirable.
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Affiliation(s)
- Shen-Xian Wan
- The First Affiliated Hospital of Soochow University, No.188 Shizi Street, Suzhou 215006, China; School of Nursing, Soochow University, No.1 Shizi Street, Suzhou 215006, China
| | - Hui-Ling Li
- The First Affiliated Hospital of Soochow University, No.188 Shizi Street, Suzhou 215006, China; School of Nursing, Soochow University, No.1 Shizi Street, Suzhou 215006, China.
| | - Wei Wang
- The First Affiliated Hospital of Soochow University, No.188 Shizi Street, Suzhou 215006, China
| | - Qian Shen
- The First Affiliated Hospital of Soochow University, No.188 Shizi Street, Suzhou 215006, China
| | - Chun-Hui Li
- School of Nursing, Soochow University, No.1 Shizi Street, Suzhou 215006, China
| | - Maureen E Lyon
- Center for Transitional Sciences, Children's National Health System, 111 Michigan Ave., N.W., Washington, DC 20010, USA; School of Medicine and Health Sciences, George Washington University, 2121 I Street, N.W., Washington, DC 20052, USA
| | - Brian C Kelly
- Department of Sociology and Anthropology, Purdue University, 101 N. Grant St., West Lafayette, IN 47907, USA
| | - Jichuan Wang
- Center for Transitional Sciences, Children's National Health System, 111 Michigan Ave., N.W., Washington, DC 20010, USA; Epidemiology and Biostatistics Department, George Washington University, 2121 I Street, N.W., Washington, DC 20052, USA
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McBean AL, Kinsey SG, Montgomery-Downs HE. Effects of a single night of postpartum sleep on childless women's daytime functioning. Physiol Behav 2016; 156:137-47. [PMID: 26776447 DOI: 10.1016/j.physbeh.2016.01.014] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2015] [Revised: 12/16/2015] [Accepted: 01/12/2016] [Indexed: 11/30/2022]
Abstract
STUDY OBJECTIVES The maternal postpartum period is characterized by sleep fragmentation, which is associated with daytime impairment, mental health disturbances, and changes in melatonin patterns. In addition to sleep fragmentation, women undergo a complex set of physiological and environmental changes upon entering the postpartum period, confounding our understanding of effects of postpartum sleep disturbance. The primary study aim was to understand the basic impact of a single night of postpartum-like sleep fragmentation on sleep architecture, nocturnal melatonin levels, mood, daytime sleepiness, and neurobehavioral performance. MEASUREMENTS AND RESULTS For one week prior to entry into the laboratory, eleven healthy nulliparous women kept a stable sleep-wake schedule (verified via actigraphy). Participants contributed three consecutive nights of laboratory overnight polysomnography: (1) a habituation/sleep disorder screening night; (2) a baseline night; and (3) a sleep fragmentation night, when participants were awakened three times for ~30min each. Self-reported sleep quality and mood (Profile of Mood States survey) both decreased significantly after sleep fragmentation compared to baseline measurements. Unexpectedly, daytime sleepiness (Multiple Sleep Latency Test) decreased significantly after sleep fragmentation. Experimental fragmentation had no significant effect on time spent in nocturnal sleep stages, urinary 6-sulfatoxymelatonin concentration, or psychomotor vigilance test performance. Participants continued to provide actigraphy data, and daily PVTs and self-reported sleep quality assessments at home for one week following sleep fragmentation; these assessments did not differ from baseline values. CONCLUSIONS While there were no changes in measured physiological components of a single night of postpartum-like experimental sleep fragmentation, there were decreases in self-reported measures of mood and sleep quality. Future research should examine the effects of multiple nights of modeling postpartum-like sleep fragmentation on objective measures of sleep and daytime functioning.
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Affiliation(s)
- Amanda L McBean
- Department of Psychology, West Virginia University, Morgantown, WV, USA
| | - Steven G Kinsey
- Department of Psychology, West Virginia University, Morgantown, WV, USA
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Narusyte J, Björkenstam E, Alexanderson K, Ropponen A, Kjeldgård L, Svedberg P. Occurrence of sickness absence and disability pension in relation to childbirth: A 16-year follow-up study of 6323 Swedish twins. Scand J Public Health 2015; 44:98-105. [PMID: 26459495 DOI: 10.1177/1403494815610051] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/11/2015] [Indexed: 11/15/2022]
Abstract
BACKGROUND Pregnancy, delivery, and the postpartum period may imply morbidity leading to work incapacity; however, this is seldom studied. This study aimed to compare twin sisters giving or not giving birth regarding occurrence of sickness absence (SA) and disability pension (DP). METHODS This population-based cohort study included all 6323 female twins born in Sweden 1959-1990, using register data for 1994-2010 about SA and DP. Average number of SA/DP days/year was calculated in relation to the year of the first delivery, or, if not giving birth, the year when the twin sister gave birth. Twin pairs discordant for delivery were used to investigate the importance of genetic and environmental factors for occurrence of SA and DP. RESULTS In all, 52% had a first delivery during 1994-2010. Except for the year of delivery, the average number of SA days/year was similar when comparing women who gave birth to those who did not, while number of DP days was significantly higher in women who did not give birth. Differences between the groups seem attributable to genetic factors. Women who delivered once had higher levels of SA and DP than those who had several deliveries. DP with mental diagnoses was more common among women who had not delivered whereas DP with musculoskeletal diagnoses occurred more often among women who delivered. CONCLUSIONS Levels of SA were similar among women who gave birth and who did not. Women not giving birth had significantly higher levels of DP, indicating health selections into childbirth.
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Affiliation(s)
- Jurgita Narusyte
- Department of Clinical Neuroscience, Division of Insurance Medicine, Karolinska Institutet, Sweden
| | - Emma Björkenstam
- Department of Clinical Neuroscience, Division of Insurance Medicine, Karolinska Institutet, Sweden Department of Community Health Sciences, Fielding School of Public Health and California Center for Population Research, University of California Los Angeles, USA
| | - Kristina Alexanderson
- Department of Clinical Neuroscience, Division of Insurance Medicine, Karolinska Institutet, Sweden
| | | | - Linnea Kjeldgård
- Department of Clinical Neuroscience, Division of Insurance Medicine, Karolinska Institutet, Sweden
| | - Pia Svedberg
- Department of Clinical Neuroscience, Division of Insurance Medicine, Karolinska Institutet, Sweden
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Cooklin AR, Amir LH, Jarman J, Cullinane M, Donath SM. Maternal Physical Health Symptoms in the First 8 Weeks Postpartum Among Primiparous Australian Women. Birth 2015; 42:254-60. [PMID: 26088503 DOI: 10.1111/birt.12168] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/20/2015] [Indexed: 11/26/2022]
Abstract
BACKGROUND To describe prospectively the extent, onset, and persistence of maternal physical health symptoms (cesarean delivery pain, perineal pain, back pain, constipation, hemorrhoids, urinary incontinence, bowel incontinence, and fatigue) in the first 8 weeks postpartum. METHODS A prospective cohort of 229 primiparous women was recruited antenatally from a public and a private maternity hospital, Melbourne, Australia, between 2009 and 2011. Data were collected by self-report questionnaires at weeks 1, 2, 3, 4, and 8. Main outcome measures were a checklist of maternal health symptoms and a standardized assessment of fatigue symptoms. RESULTS Birth-related pain was common at week 1 (n = 80/88, 91% cesarean delivery pain; n = 92/125, 74% perineal pain), and still present for one in five women who had a cesarean birth (n = 17, 18%) at week 8. Back pain was reported by approximately half the sample at each study interval, with 25 percent (n = 48) reporting a later onset at week 2 or beyond. Fatigue was not relieved between 4 and 8 weeks. CONCLUSIONS Women experience significant morbidity in the early weeks postpartum, the extent of which may have been underestimated in previous research relying on retrospective recall. Findings contribute to the growing body of evidence that supports early identification, treatment, and support for women's physical health problems in the postpartum.
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Affiliation(s)
- Amanda R Cooklin
- Judith Lumley Centre, La Trobe University, Melbourne, Vic., Australia
| | - Lisa H Amir
- Judith Lumley Centre, La Trobe University, Melbourne, Vic., Australia
| | - Jennifer Jarman
- Judith Lumley Centre, La Trobe University, Melbourne, Vic., Australia
| | - Meabh Cullinane
- Judith Lumley Centre, La Trobe University, Melbourne, Vic., Australia
| | - Susan M Donath
- Murdoch Childrens Research Institute, Melbourne, Vic., Australia.,Department of Paediatrics, University of Melbourne, Melbourne, Vic., Australia
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Lee JY, Hwang JY. A study on postpartum symptoms and their related factors in Korea. Taiwan J Obstet Gynecol 2015; 54:355-63. [DOI: 10.1016/j.tjog.2014.04.030] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/28/2014] [Indexed: 11/24/2022] Open
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Mannion CA, Vinturache AE, McDonald SW, Tough SC. The Influence of Back Pain and Urinary Incontinence on Daily Tasks of Mothers at 12 Months Postpartum. PLoS One 2015; 10:e0129615. [PMID: 26083252 PMCID: PMC4471341 DOI: 10.1371/journal.pone.0129615] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2014] [Accepted: 05/11/2015] [Indexed: 11/24/2022] Open
Abstract
Objective The present study examined back pain (BP) and/or urinary incontinence (UI) impact on the ability to perform daily tasks at 12 months after childbirth in healthy reproductive women who sought maternity care in community based family practice clinics. Methods This study is a secondary analysis from the All Our Babies Study, a prospective, community-based pregnancy cohort in Calgary, Alberta. Maternal self-reported information on demographics, lifestyle, experiences with pregnancy and childbirth, occurrence of BP, UI and consequent impairment of daily tasks were collected by questionnaires administered before 25 weeks, at 34-36 weeks gestation and at 4 and 12 months postpartum. The occurrence and severity of BP and UI at one year after childbirth was assessed using descriptive and bivariate analyses. Logistic regression models examined the association between demographic and obstetrical variables and the severity of functional impairment due to UI and BP. Results From 1574 women with singleton pregnancies included in the study, 1212 (77%) experienced BP, 773 (49%) UI, and 620 (40%) both BP and UI. From the 821 women reporting impairment of daily tasks due to BP, 199 (24 %) were moderately and 90 (11%) severely affected with the remainder, 532 (64%) being mildly affected. From 267 women with functional impairment due to UI, 52 (19%) reported moderately to severe impairment in their ability to perform daily tasks. Obesity and parity were risk factors for impairment of daily functioning due to BP, whereas obesity and vaginal delivery increased the risk of moderate to severe impairment due to UI. Conclusions BP and UI are common occurrences 1 year after childbirth. Maternal performance of daily tasks and women’s health and quality of life are more often impaired due to BP than UI. Our study brings new evidence of the risk factors that predict severity and impact of these conditions on women functioning at 12 months postpartum.
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Affiliation(s)
| | - Angela E. Vinturache
- Department of Paediatrics, Faculty of Medicine, University of Calgary, Calgary, Alberta, Canada
- * E-mail:
| | - Sheila W. McDonald
- Department of Paediatrics, Faculty of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Suzanne C. Tough
- Department of Paediatrics, Faculty of Medicine, University of Calgary, Calgary, Alberta, Canada
- Department of Community Health Sciences, Faculty of Medicine, University of Calgary, Calgary, Alberta, Canada
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Lee LC, Hung CH. Predictors of post-partum stress in Vietnamese immigrant women in Taiwan. Jpn J Nurs Sci 2015; 13:38-45. [DOI: 10.1111/jjns.12084] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2014] [Accepted: 03/31/2015] [Indexed: 11/28/2022]
Affiliation(s)
- Li-Chun Lee
- School of Nursing; Kaohsiung Medical University; Kaohsiung Taiwan
- Department of Nursing; I-Shou University; Kaohsiung Taiwan
| | - Chich-Hsiu Hung
- School of Nursing; Kaohsiung Medical University; Kaohsiung Taiwan
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Brown A, Harries V. Infant sleep and night feeding patterns during later infancy: association with breastfeeding frequency, daytime complementary food intake, and infant weight. Breastfeed Med 2015; 10:246-52. [PMID: 25973527 DOI: 10.1089/bfm.2014.0153] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Infant sleep is a common concern for new parents. Although many expect a newborn infant to wake frequently, encouraging a baby to sleep through the night by a few months of age is seen as both a developmental aim and a parenting success. Many new mothers believe that their infants' diet is related to their sleep; formula milk or increased levels of solid food are often given in an attempt to promote sleep. However, the impact of these in later infancy is not understood. In the current study 715 mothers with an infant 6-12 months of age reported their infants' typical night wakings and night feeds alongside any breastfeeding and frequency of solid meals. Of infants in this age range, 78.6% still regularly woke at least once a night, with 61.4% receiving one or more milk feeds. Both night wakings and night feeds decreased with age. No difference in night wakings or night feeds was found between mothers who were currently breastfeeding or formula feeding. However, infants who received more milk or solid feeds during the day were less likely to feed at night but not less likely to wake. The findings have important implications for health professionals who support new mothers with infant sleep and diet in the first year. Increasing infant calories during the day may therefore reduce the likelihood of night feeding but will not reduce the need for parents to attend to the infant in the night. Breastfeeding has no impact on infant sleep in the second 6 months postpartum.
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Affiliation(s)
- Amy Brown
- Department of Public Health, Policy, and Social Sciences, Swansea University , Swansea, United Kingdom
| | - Victoria Harries
- Department of Public Health, Policy, and Social Sciences, Swansea University , Swansea, United Kingdom
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Chang SR, Chen KH, Ho HN, Lai YH, Lin MI, Lee CN, Lin WA. Depressive symptoms, pain, and sexual dysfunction over the first year following vaginal or cesarean delivery: A prospective longitudinal study. Int J Nurs Stud 2015; 52:1433-44. [PMID: 26008134 DOI: 10.1016/j.ijnurstu.2015.04.019] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2014] [Revised: 04/13/2015] [Accepted: 04/28/2015] [Indexed: 12/14/2022]
Abstract
BACKGROUND Childbirth has a significant impact on maternal health, and the high rate of cesarean delivery is a global health concern. Few studies have used validated measures to explore depression, pain, and sexual dysfunction following vaginal or cesarean delivery over a prolonged time period. OBJECTIVE We examined the associations between vaginal and cesarean delivery and depressive symptoms, pain, and sexual function during the 1-year postpartum period. DESIGN A prospective, five-time-point longitudinal study. SETTING Maternity unit at a medical center. PARTICIPANTS A total of 351 of 736 women completed a questionnaire that described demographic characteristics, depressive symptoms, and pain levels at 3-5 days postpartum, and updated personal data, depressive symptoms, pain levels, and sexual function at 4-6 weeks and at 3, 6, and 12 months after delivery. METHODS Differences between the vaginal and cesarean groups in depressive symptoms, pain, and sexual function and trends of changes in these factors over the first postpartum year were examined. RESULTS Compared with the vaginal birth group, the cesarean birth group had a significantly higher prevalence of depressive symptoms at 3 months (p=0.03); higher scores for non-localized pain at 3-5 days (p<0.001), 4-6 weeks (p=0.03), and 3 months (p=0.046); higher scores for abdominal pain at 3-5 days (p<0.001), 4-6 weeks (p<0.001), and 6 months (p=0.01); lower perineal pain scores at 3-5 days (p <0.001); and higher sexual desire scores (p=0.04) but lower sexual satisfaction scores (p=0.02) at 4-6 weeks. Differences between the vaginal and cesarean groups were significant (p=0.01, p=0.049, respectively) in terms of the decrease in non-localized pain from 3-5 days to 4-6 weeks postpartum and the increase in sexual desire from 4-6 weeks to 3 months postpartum. CONCLUSIONS Cesarean delivery was associated with an increased prevalence of depressive symptoms at 3 months and higher pain levels that persisted at 6 months postpartum in Taiwan. We found no difference in sexual function between vaginal and cesarean delivery after 6 weeks postpartum, and no differences in the trends related to depressive symptoms or in sexual functioning (except for desire) within 1 year postpartum.
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Affiliation(s)
- Shiow-Ru Chang
- School of Nursing, College of Medicine and Hospital, National Taiwan University, Taipei, Taiwan.
| | - Kuang-Ho Chen
- Central Taiwan University of Science and Technology, Taichung, Taiwan
| | - Hong-Nerng Ho
- Department of Obstetrics and Gynecology, College of Medicine and Hospital, National Taiwan University, Taipei, Taiwan
| | - Yeur-Hur Lai
- School of Nursing, College of Medicine and Hospital, National Taiwan University, Taipei, Taiwan
| | - Ming-I Lin
- Shin Kong Wu Ho-Su Memorial Hospital, Taipei, Taiwan
| | - Chien-Nan Lee
- Department of Obstetrics and Gynecology, College of Medicine and Hospital, National Taiwan University, Taipei, Taiwan
| | - Wei-An Lin
- Department of Environmental and Occupational Medicine, National Taiwan University Hospital, Taipei, Taiwan
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Song J, Kim T, Ahn J. A Systematic Review of Psychosocial Interventions for Women with Postpartum Stress. J Obstet Gynecol Neonatal Nurs 2015; 44:183-92. [DOI: 10.1111/1552-6909.12541] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
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