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Preis H, Wang W, St. Denis I, Zhu W, Mahaffey B, Lobel M. Anxiety trajectories from pregnancy to one-year postpartum and their contributors during the COVID-19 pandemic. J Reprod Infant Psychol 2023:1-13. [PMID: 38111259 PMCID: PMC11182884 DOI: 10.1080/02646838.2023.2293914] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2023] [Accepted: 12/06/2023] [Indexed: 12/20/2023]
Abstract
BACKGROUND Anxiety in the peripartum period (pregnancy through one-year postpartum) has negative impacts on mothers and infants. During the COVID-19 pandemic, high rates of anxiety were reported worldwide, but trajectories for how these symptoms change longitudinally in the peripartum period remain unknown. METHODS A total of 1,411 women who were pregnant during the second U.S. COVID-19 surge completed four study questionnaires between December 2020 and March 2022, including assessments of anxiety symptoms (GAD-7) and individual and community-level contributors. Latent Class Growth Mixture Models (LCGMM) were used to identify anxiety trajectories, and multinomial logistic regression was used to identify contributors to class membership. RESULTS Three classes of anxiety symptom trajectories were identified. Class 1 (n = 956, 67.8%) experienced minimal/mild anxiety throughout the peripartum period. Class 2 (n = 362, 25.7%) experienced initial moderate anxiety that remained stable. Class 3 (n = 93, 6.6%) experienced initial moderate anxiety that increased to severe in the postpartum period. Stress and history of mental health diagnosis contributed to higher initial levels of anxiety and ongoing social support contributed to lower levels of anxiety. In addition, financial insecurity increased the risk of belonging to Class 3. CONCLUSIONS Screening for anxiety symptoms and psychosocial vulnerabilities in the peripartum period is vital, as is early intervention. This is especially the case among women with limited financial and social resources who may experience chronic or worsening anxiety as they transition to parenthood.
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Affiliation(s)
- Heidi Preis
- Department of Psychology, Stony Brook University
- Department of Obstetrics, Gynecology and Reproductive Medicine, Renaissance School of Medicine, Stony Brook University
| | - Weihao Wang
- Department of Applied Mathematics and Statistics, Stony Brook University
| | | | - Wei Zhu
- Department of Applied Mathematics and Statistics, Stony Brook University
| | - Brittain Mahaffey
- Department of Psychiatry and Behavioral Health, Renaissance School of Medicine, Stony Brook University
| | - Marci Lobel
- Department of Psychology, Stony Brook University
- Department of Obstetrics, Gynecology and Reproductive Medicine, Renaissance School of Medicine, Stony Brook University
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Lee MS, Lee JJ, Park S, Kim S, Lee H. Is social support associated with postpartum depression, anxiety and perceived stress among Korean women within the first year postpartum? J Psychosom Obstet Gynaecol 2023; 44:2231629. [PMID: 37428880 DOI: 10.1080/0167482x.2023.2231629] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Revised: 06/26/2023] [Accepted: 06/26/2023] [Indexed: 07/12/2023] Open
Abstract
PURPOSE This study aimed to examine the association between social support, postpartum depression (PPD), anxiety and perceived stress among women within 12 months of childbirth in South Korea. METHODS A cross-sectional, web-based survey was conducted from 21 to 30 September 2022 and included women within 12 months of childbirth in Chungnam Province, South Korea. A total of 1486 participants were included. Multiple linear regression models were used to evaluate the association between social support and mental health. RESULTS In total, 40.0% of the participants had mild to moderate PPD; 12.0%, anxiety symptoms; and 8.2%, perceived severe stress. Social support (from family and significant others) is significantly associated with PPD, anxiety and perceived severe stress. Current maternal health problems, unplanned pregnancy and low household income were risk factors for PPD, anxiety and perceived stress. The increase in the time elapsed after childbirth showed a positive association with PPD and perceived severe stress. CONCLUSIONS Our findings provide insights to identify at-risk mothers and emphasize the importance of social support in families, early screening and continuous monitoring for postpartum women to prevent PPD, anxiety and stress.
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Affiliation(s)
- Mi-Sun Lee
- Department of Preventive Medicine, College of Medicine, The Catholic University of Korea, Seoul, South Korea
| | - Jung Jae Lee
- Department of Psychiatry, Dankook University Hospital, Cheonan, South Korea
- Department of Psychiatry, College of Medicine, Dankook University, Cheonan, South Korea
- Chungcheongnam-do Mental Health Welfare Center, Hongseong, South Korea
| | - Soyeon Park
- Korea Human Resource Development Institute for Health & Welfare, Seoul, South Korea
| | - Seongju Kim
- Department of Preventive Medicine, College of Medicine, The Catholic University of Korea, Seoul, South Korea
- Department of Public Health and Healthcare Management, Graduate School, The Catholic University of Korea, Seoul, South Korea
| | - Hooyeon Lee
- Department of Preventive Medicine, College of Medicine, The Catholic University of Korea, Seoul, South Korea
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Chandra N, Smitha MV. Functional status, social support, and anxiety among postnatal women of Eastern India. Eur J Obstet Gynecol Reprod Biol X 2023; 20:100238. [PMID: 37720888 PMCID: PMC10502358 DOI: 10.1016/j.eurox.2023.100238] [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: 06/30/2023] [Revised: 08/31/2023] [Accepted: 09/02/2023] [Indexed: 09/19/2023] Open
Abstract
Introduction Though becoming a mother is a joyous experience, the postpartum time can be difficult and stressful for women as they deal with significant physical alterations and adjustments to their daily routines. However, very few studies have focused on the functional well-being of the woman after childbirth. This study aims to find the level of functional status, social support, and anxiety among women attending immunization clinics. Methods A descriptive cross-sectional research design was adopted to recruit 220 women in this study from two immunization clinic centers in Bhubaneswar, Odisha. Data were collected using a self-reported sociodemographic profile, functional level scale after childbirth, modified multidimensional scale of perceived social support, and postnatal anxiety scale. Descriptive and inferential statistical tests were used for data analysis, including mean, percentage, and Fisher exact. Results 59.5 % of women returned to a moderate level of functional status after six weeks postpartum. The majority of women, 98.6 % and 83.6 %, reported high levels of return to personal care and baby care, respectively, whereas 34.7 % had moderate levels of return to home activities and 90 % had low levels of return to community and social tasks. Also, 70 % of women had high perceived social support, and 87.7 % had no anxiety. In this study, normal delivery women had better functional status than their cesarean delivery counterparts. Moreover, functional status was significantly associated with anxiety at six postpartum weeks. Conclusion After six weeks of childbirth, most women only partially resumed their pre-pregnancy functional state. So, much more time, rest, and support from family members were needed to recover to a fully functional level. Nurses, midwives, and the family members of women should be aware of the critical role that social support plays in enhancing a woman's functional and psychological status during the postpartum period.
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Affiliation(s)
- Nabanita Chandra
- Obstetrical and Gynecological Nursing, College of Nursing, AIIMS Bhubaneswar, Odisha, India
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Salera-Vieira J. Gaps in Postnatal Support for Intended Parents. MCN Am J Matern Child Nurs 2023; 48:238-243. [PMID: 37335549 DOI: 10.1097/nmc.0000000000000919] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/21/2023]
Abstract
PURPOSE To identify gaps in postnatal depression screening and support services for intended parents (parents who are intended to receive the baby from a gestational surrogacy pregnancy), also known as commissioned parents. STUDY DESIGN AND METHODS This descriptive study used quantitative and free-text survey questions designed to assess postnatal depression screening and postnatal services available for all parents and, more specifically, for intended parents. SAMPLE The survey was sent to 2,000 randomly selected postpartum nurses in the United States who are members of the Association of Women's Health, Obstetric and Neonatal Nurses. RESULTS Completion of the survey was offered to the 125 nurses who responded that they provided care for intended parents. Thirty-seven percent of respondents indicated that postpartum support services are available for both parents. Free-text responses describe a gap in postnatal services for intended parents. Although 85% of survey respondents reported that postpartum depression screening occurs in their setting, nurses reported neither fathers nor intended parents are screened for postnatal depression. CLINICAL IMPLICATIONS This study expands the known gap in postnatal support services for intended parents, including postnatal depression screening. Recommendations for nurses working in the perinatal setting include providing consistent support for all parents as they transition to parenthood. Creating standardized policies and practices reflecting the diverse needs and cultures of intended parents can help direct all clinicians toward providing more significant support. Adapting current postnatal screening and support systems could provide a continuum of support for all families.
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Affiliation(s)
- Jean Salera-Vieira
- Jean Salera-Vieira is an Associate Chief Nursing Officer, Professional Development, Women and Infants Hospital, Providence, RI. At the time that this study was conducted, Dr. Salera-Vieira was the Perinatal Clinical Nurse Specialist at Newport Hospital, Newport, RI. Dr. Salera-Vieira can be reached via email at
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Miklowitz DJ, Weintraub MJ, Walshaw PD, Schneck CD, Chang KD, Merranko J, Garrett AS, Singh MK. Early Family Intervention for Youth at Risk for Bipolar Disorder: Psychosocial and Neural Mediators of Outcome. Curr Neuropharmacol 2023; 21:1379-1392. [PMID: 36635932 PMCID: PMC10324335 DOI: 10.2174/1570159x21666230111120817] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2022] [Revised: 05/14/2022] [Accepted: 11/25/2022] [Indexed: 01/14/2023] Open
Abstract
BACKGROUND The impairing neurodevelopmental course of bipolar disorder (BD) suggests the importance of early intervention for youth in the beginning phases of the illness. OBJECTIVE We report the results of a 3-site randomized trial of family-focused therapy for youth at high-risk (FFT-HR) for BD, and explore psychosocial and neuroimaging variables as mediators of treatment effects. METHODS High-risk youth (<18 years) with major depressive disorder or other specified BD, active mood symptoms, and a family history of BD were randomly assigned to 4 months of FFT-HR (psychoeducation, communication and problem-solving skills training) or 4 months of enhanced care psychoeducation. Adjunctive pharmacotherapy was provided by study psychiatrists. Neuroimaging scans were conducted before and after psychosocial treatments in eligible participants. Independent evaluators interviewed participants every 4-6 months over 1-4 years regarding symptomatic outcomes. RESULTS Among 127 youth (mean 13.2 ± 2.6 years) over a median of 98 weeks, FFT-HR was associated with longer intervals prior to new mood episodes and lower levels of suicidal ideation than enhanced care. Reductions in perceived family conflict mediated the effects of psychosocial interventions on the course of mood symptoms. Among 34 participants with pre-/post-treatment fMRI scans, youth in FFT-HR had (a) stronger resting state connectivity between ventrolateral PFC and anterior default mode network, and (b) increased activity of dorsolateral and medial PFC in emotion processing and problem-solving tasks, compared to youth in enhanced care. CONCLUSION FFT-HR may delay new mood episodes in symptomatic youth with familial liability to BD. Putative treatment mechanisms include neural adaptations suggestive of improved emotion regulation.
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Affiliation(s)
- David J. Miklowitz
- Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, Los Angeles, CA, USA
| | - Marc J. Weintraub
- Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, Los Angeles, CA, USA
| | - Patricia D. Walshaw
- Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, Los Angeles, CA, USA
| | | | - Kiki D. Chang
- Private Practice, 2460 Park Blvd, Suite 6 Palo Alto, CA 94306 USA
| | - John Merranko
- Department of Psychiatry, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
| | - Amy S. Garrett
- Department of Psychiatry, University of Texas, Health Science Center at San Antonio, San Antonio, TX, USA
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Howard KJ, Leong C, Chambless S, Grigsby TJ, Cordaro M, Perrotte JK, Howard JT. Major Depression in Postpartum Women during the COVID-19 Pandemic: Can Social Support Buffer Psychosocial Risks and Substance Use? INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:15748. [PMID: 36497822 PMCID: PMC9738345 DOI: 10.3390/ijerph192315748] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/03/2022] [Revised: 11/22/2022] [Accepted: 11/24/2022] [Indexed: 06/17/2023]
Abstract
Rates of mood disorders and substance use increased during the COVID-19 pandemic for postpartum women. The present study's aims were to: (1) examine the prevalence of major depressive disorder (MDD) in postpartum women during the COVID-19 pandemic, and (2) evaluate whether social support can buffer the associations between MDD, psychosocial factors (perceived stress, generalized anxiety, and intimate partner violence) and substance use (alcohol and drug use). A nationwide survey included 593 postpartum mothers (within 12 months from birth). Participants were assessed for a provisional diagnosis of MDD, and provided responses on validated instruments measuring stress, intimate partner violence, suicidal ideation, generalized anxiety, social support, and substance use. A hierarchical logistic regression model assessed the association of psychosocial factors and substance use with MDD. The final model shows that social support attenuates the association of MDD with perceived stress, alcohol use, and drug use, but does not buffer the relationship of MDD with anxiety or intimate partner violence. Social support was shown to significantly attenuate the effects of stress, alcohol use, and drug use on MDD, suggesting that the presence of a strong, supportive social network should be an area of increased focus for public health and healthcare professionals when caring for postpartum women.
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Affiliation(s)
- Krista J. Howard
- Department of Psychology, Texas State University, 601 University Dr., San Marcos, TX 78666, USA
| | - Caleb Leong
- Department of Public Health, University of Texas at San Antonio, One UTSA Circle, San Antonio, TX 78249, USA
- Consequences of Trauma Working Group, The Center for Community-Based and Applied Health Research, University of Texas at San Antonio, One UTSA Circle, San Antonio, TX 78249, USA
| | - Sidney Chambless
- Department of Psychology, Texas State University, 601 University Dr., San Marcos, TX 78666, USA
| | - Timothy J. Grigsby
- Department of Social and Behavioral Health, University of Nevada, Las Vegas, NV 89119, USA
| | - Millie Cordaro
- Department of Psychology, Texas State University, 601 University Dr., San Marcos, TX 78666, USA
| | - Jessica K. Perrotte
- Department of Psychology, Texas State University, 601 University Dr., San Marcos, TX 78666, USA
| | - Jeffrey T. Howard
- Department of Public Health, University of Texas at San Antonio, One UTSA Circle, San Antonio, TX 78249, USA
- Consequences of Trauma Working Group, The Center for Community-Based and Applied Health Research, University of Texas at San Antonio, One UTSA Circle, San Antonio, TX 78249, USA
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