The effectiveness of medical interventions aimed at preventing preterm birth: a literature review

Emotional distress in mothers of early-preterm infants, late-preterm infants, and full-term infants in Malawi

BACKGROUND

Mothers of preterm infants, early or late, report more distress than mothers of full-term infants. Malawi has the highest preterm birth rate in the world, but nothing is known about the relation of preterm birth to maternal mental health.

PURPOSE

To compare emotional distress among mothers of early-preterm, late-preterm, and full-term infants.

METHODS

We recruited 28 mothers of early-preterm, 29 mothers of late-preterm, and 28 mothers of full-term infants. Emotional distress was assessed 24-72 hr following birth. One-way ANOVA and regression analysis were used to compare the three groups.

FINDINGS

Mothers of early-preterm infants reported more distress symptoms than mothers of full-term infants, and scores of mothers of late-preterm infants fell between the other two groups. Having a support person present was associated with lower symptoms and caesarean birth was associated with more symptoms.

DISCUSSION

Promoting maternal mental health is important following preterm birth and health care providers need to support mothers.

The Relationships of Health Behaviour and Psychological Characteristics with Spontaneous Preterm Birth in Nulliparous Women

Objectives Preterm birth is the leading pregnancy outcome associated with perinatal morbidity and mortality and remains difficult to prevent. There is evidence that some modifiable maternal health characteristics may influence the risk of preterm birth. Our aim was to investigate the relationships of self-reported maternal health behaviour and psychological characteristics in nulliparous women with spontaneous preterm birth in prenatal primary care. Methods The data of our prospective study was obtained from the nationwide DELIVER multicentre cohort study (September 2009–March 2011), which was designed to examine perinatal primary care in the Netherlands. In our study, consisting of 2768 nulliparous women, we estimated the relationships of various self-reported health behaviours (smoking, alcohol consumption, folic acid supplementation, daily fruit, daily fresh vegetables, daily hot meal and daily breakfast consumption) and psychological characteristics (anxious/depressed mood and health control beliefs) with spontaneous preterm birth as a dichotomous outcome. Due to the clustering of clients within midwife practices, Generalized Estimating Equations was used for these analyses. Results Low health control beliefs was the sole characteristic significantly associated with spontaneous preterm birth (odds ratio 2.26; 95 % confidence interval 1.51, 3.39) after being adjusted for socio-demographics, anthropometrics and the remaining health behaviour and psychological characteristics. The other characteristics were not significantly associated with spontaneous preterm birth. Conclusions for Practice Maternal low health control beliefs need to be explored further as a possible marker for women at risk for preterm birth, and as a potentially modifiable characteristic to be used in interventions which are designed to reduce the risk of spontaneous preterm birth.

An exploration of connections between a mother and her unborn in preterm labor

The purpose of this special feature is to elaborate on a unique physician-patient interaction between a neonatologist and a pediatrician established during the pediatrician's personal experience with the onset of labor between 22 and 23 weeks' gestation. As the two are both versed in conventional aspects of neonatal care including prenatal counseling, the neonatologist thought that he had more to offer the expectant mother holistically. Thus, he decided against approaching her as an information source and contribute to the customary data-dumping format that can be both frightening and dehumanizing. Instead, he wanted to focus on her individual experience of pregnancy and the healing aspects of care. The most important lesson received from the interaction is the value of being present with another. This sense of 'being with' applied to the neonatologist and the mother from their initial phone conversation to their in person times, and to the mother with her unborn permitting interaction in a meaningful way. Fostering each of those connections in alternative ways was valuable in this prenatal experience.