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Fischer AR, Doudell KR, Cundiff JM, Green SRM, Lavender CA, Gunn HE. Maternal Sleep Health, Social Support, and Distress: A Mixed-Methods Analysis of Mothers of Infants and Young Children in Rural US. Behav Sleep Med 2024; 22:650-673. [PMID: 38600856 DOI: 10.1080/15402002.2024.2339818] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/12/2024]
Abstract
OBJECTIVES The purpose of this study was to explore sleep health in rural maternal populations through a social-ecological framework and identify risk and protective factors for this population. METHODS 39 individuals who are mothers of infants or children under the age of 5 years completed an online survey, 35 of which completed a subsequent semi-structured interview. Recruitment was limited to one rural community and was in partnership with community healthcare providers. Results were integrated using a convergent, parallel mixed-methods design. RESULTS Poor sleep health and high prevalence of insomnia symptoms in rural mothers were evident and associated with social support and maternal distress. Qualitative content from interviews indicated that well-established precipitating and perpetuating factors for insomnia may contribute to poor maternal sleep health. Results also revealed a gap in knowledge and language surrounding sleep health among rural mothers. CONCLUSIONS Sleep health is challenged during the transition to motherhood and rural mothers have less access to specialized perinatal and behavioral health care than their urban counterparts. In this sample, poor sleep was attributable to distress in addition to nocturnal infant and child sleep patterns which has implications for psychoeducation and promotion of sleep health in mothers. Sleep is a modifiable health indicator that is associated with several other maternal health outcomes and should be considered an element of a comprehensive maternal health for prevention and intervention across individual, interpersonal, and societal domains of the social-ecological model of sleep health.
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Affiliation(s)
| | - Kelly R Doudell
- Department of Psychology, University of Alabama, Tuscaloosa, AL, USA
| | - Jenny M Cundiff
- Department of Psychology, University of Alabama, Tuscaloosa, AL, USA
| | | | - Catherine A Lavender
- College of Community Health Sciences, University of Alabama, Tuscaloosa, AL, USA
| | - Heather E Gunn
- Department of Psychology, University of Alabama, Tuscaloosa, AL, USA
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Kuipers YJ, Van de Craen N, Van den Branden L, Mestdagh E. The midwife's support during transition to motherhood: A modified Delphi study among care providers and childbearing women. Scand J Caring Sci 2024; 38:461-475. [PMID: 38450770 DOI: 10.1111/scs.13250] [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: 09/04/2023] [Revised: 01/18/2024] [Accepted: 02/18/2024] [Indexed: 03/08/2024]
Abstract
OBJECTIVE To reach consensus between care providers and childbearing women about the midwife's relevant and appropriate domains and elements to support transition to motherhood. METHODS A modified web-based Delphi study was conducted in Flanders (Belgium). After performing a systematic literature review, searching the grey literature and an online poll, a set of 79 items was generated. In two rounds, the items were presented to an expert panel of (1) care providers from various disciplines providing services to childbearing women and (2) to pregnant women and postpartum women up to 1-year postpartum. Consensus was defined when 70% or more of the experts scored ≥6, 5% or less scored ≤3, and a standard deviation of ≤1.1. FINDINGS In the first Delphi round, 91 experts reached consensus on 24 items. Seventeen round one items that met one or two consensus objectives were included in round two and were scored by 64 panel experts, reaching consensus on three additional items. The final 27 items covered seven domains: attributes, liaison, management of care from a woman-centred perspective, management of care from the midwife's focus, informational support, relational support, and the midwife's competencies. CONCLUSION The shared understanding between childbearing women and care providers shows that the midwife's transitional support is multifaceted. Our findings offer midwives a standard of care, criteria, guidance, and advice on how they can support childbearing women during transition to motherhood, beyond the existing recommendations and current provision of transitional care.
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Affiliation(s)
- Yvonne J Kuipers
- School of Health & Social Care, Edinburgh Napier University, Edinburgh, UK
- Department of Health and Life Science, School of Midwifery, AP University of Applied Sciences, Antwerp, Belgium
| | - Natacha Van de Craen
- Department of Health and Life Science, School of Midwifery, AP University of Applied Sciences, Antwerp, Belgium
| | - Laura Van den Branden
- Department of Health and Life Science, School of Midwifery, AP University of Applied Sciences, Antwerp, Belgium
| | - Eveline Mestdagh
- Department of Health and Life Science, School of Midwifery, AP University of Applied Sciences, Antwerp, Belgium
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Huis in ’t Veld EA, Van Assche IA, Amant F. Long-term outcomes of children after prenatal exposure to maternal cancer and its treatment. Acta Obstet Gynecol Scand 2024; 103:757-760. [PMID: 38419133 PMCID: PMC10993341 DOI: 10.1111/aogs.14811] [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: 11/17/2023] [Revised: 01/12/2024] [Accepted: 02/05/2024] [Indexed: 03/02/2024]
Abstract
The incidence of antenatal cancer is increasing, prompting a medical-ethical evaluation. The International Network on Cancer, Infertility, and Pregnancy (INCIP) was established to study cancer treatment safety during pregnancy and its impact on maternal and child health. Pivotal research has led to a paradigm shift in clinical management, demonstrating the feasibility and safety of most antenatal oncological treatments. Short-term outcomes reveal normal growth and cardiac function in the exposed offspring, but caution is advised against first-trimester chemotherapy. Psychological impact studies highlight the elevated levels of distress in pregnant cancer patients, underscoring the need for personalized information and ongoing psychological support. Long-term follow-up studies address gaps in postnatal impacts, while research into specific chemotherapeutic agents continues. Despite generally reassuring outcomes, continued monitoring is crucial, especially in families, such as those where the child was born premature after cancer (treatment) during pregnancy or where mothers are frequently absent due to continued illness or have died from. The ongoing INCIP child follow-up initiative aims to further elucidate knowledge gaps, emphasizing the importance of large-scale studies and personalized patient care.
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Affiliation(s)
- Evangeline A. Huis in ’t Veld
- Center for Gynecological OncologyNetherlands Cancer InstituteAmsterdamThe Netherlands
- Princess Máxima Center for Pediatric OncologyUtrechtThe Netherlands
| | - Indra A. Van Assche
- Department of Development and RegenerationUnit of Woman and Child, KU LeuvenLeuvenBelgium
| | - Frederic Amant
- Center for Gynecological OncologyNetherlands Cancer InstituteAmsterdamThe Netherlands
- Department of OncologyUnit of Gynecological OncologyKU LeuvenBelgium
- Department of Obstetrics and Gynecology, Division of Gynecological OncologyUZ LeuvenLeuvenBelgium
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Parisi F, Høifødt RS, Bohne A, Wang CEA, Pfuhl G. Perceived Parenting Stress Is Related to Cardiac Flexibility in Mothers: Data from the NorBaby Study. Behav Sci (Basel) 2024; 14:117. [PMID: 38392470 PMCID: PMC10886085 DOI: 10.3390/bs14020117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Revised: 01/20/2024] [Accepted: 02/02/2024] [Indexed: 02/24/2024] Open
Abstract
Heart rate variability (HRV) is an indicator of autonomic nervous system activity, and high levels of stress and/or depressive symptoms may reduce HRV. Here, we assessed whether (a) parental stress affected HRV in mothers during the perinatal period and whether this is mediated by bonding and (b) whether antenatal maternal mental states, specifically repetitive negative thinking, depressive symptoms, and pregnancy-related anxiety, have an impact on infant HRV, and lastly, we investigated (c) the relationship between maternal HRV and infant HRV. Data are from the Northern Babies Longitudinal Study (NorBaby). In 111 parent-infant pairs, cardiac data were collected 6 months after birth. In the antenatal period, we used the Pregnancy-Related Anxiety Questionnaire-Revised, the Edinburgh Postnatal Depression Scale, and the Perseverative Thinking Questionnaire; in the postnatal period, we used the Parenting Stress Index and the Maternal Postnatal Attachment Scale. Higher levels of perceived parenting stress but not depressive symptoms were associated with lower HRV in mothers (τ = -0.146), and this relationship was not mediated by maternal bonding. Antenatal maternal mental states were not associated with infant HRV. There was no significant correlation between maternal HRV and infant HRV. Our observational data suggest that perceived stress reduces cardiac flexibility. Future studies should measure HRV and parenting stress repeatedly during the perinatal period.
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Affiliation(s)
- Francesca Parisi
- Department of Psychology, Norwegian University of Science and Technology, 7491 Trondheim, Norway
| | | | - Agnes Bohne
- Department of Psychology, UiT the Arctic University of Norway, 9019 Tromsø, Norway
- Division of Child and Adolescent Health, University Hospital of Northern Norway, 9019 Tromsø, Norway
| | | | - Gerit Pfuhl
- Department of Psychology, Norwegian University of Science and Technology, 7491 Trondheim, Norway
- Department of Psychology, UiT the Arctic University of Norway, 9019 Tromsø, Norway
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Kuipers YJ, Bleijenbergh R, Rimaux S, Mestdagh E. Evaluation of a web-based intervention to optimize perinatal emotional wellbeing: A nested case-control study. Int J Clin Health Psychol 2024; 24:100422. [PMID: 38023371 PMCID: PMC10654235 DOI: 10.1016/j.ijchp.2023.100422] [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: 10/06/2023] [Accepted: 10/31/2023] [Indexed: 12/01/2023] Open
Abstract
Background/Objective WazzUp Mama© is a remotely delivered web-based tailored intervention to prevent and reduce perinatal emotional distress, originally developed in the Netherlands. The current study aimed to evaluate the adapted WazzUp Mama© intervention in a Flemish (Dutch-speaking part of Belgium) perinatal population. Methods A 1:3 nested case-control study was performed. A data set including 676 participants (169 cases/507 controls) was composed based on core characteristics. Using independent t-test and chi-square, the two groups were compared for mean depression, self and perceived stigma, depression literacy scores, and for positive Whooley items and heightened depression scores. The primary analysis was adjusted for covariates. Results The number of positive Whooley items, the above cut-off depression scores, mean depression, perceived stigma, and depression literacy scores showed statistically significant differences between cases and controls, in favor of the intervention group. When adjusting for the covariates, the statistically significant differences between cases and controls remained for depression, perceived stigma, and depression literacy, for the positive Whooley items and for above cut-off depression scores. Conclusion WazzUp Mama© indicates to have a moderate to large positive effect on optimizing perinatal emotional wellbeing, to positively change perceived stigma and to increase depression literacy.
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Affiliation(s)
- Yvonne J Kuipers
- Edinburgh Napier University, School of Health and Social Care, Edinburgh EH11 4BN, Scotland, UK
- Department of Health and Life Science, School of Midwifery, AP University of Applied Sciences, Noorderplaats 2 Antwerp 2000, Belgium
| | - Roxanne Bleijenbergh
- Department of Health and Life Science, School of Midwifery, AP University of Applied Sciences, Noorderplaats 2 Antwerp 2000, Belgium
| | - Sophie Rimaux
- Department of Health and Life Science, School of Midwifery, AP University of Applied Sciences, Noorderplaats 2 Antwerp 2000, Belgium
| | - Eveline Mestdagh
- Department of Health and Life Science, School of Midwifery, AP University of Applied Sciences, Noorderplaats 2 Antwerp 2000, Belgium
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Bruinhof N, Sehic E, Hancock GR, Gartstein MA, de Weerth C. Prenatal anticipatory stress: Baby preparation and worry scale-revised in the Dutch context. Compr Psychiatry 2024; 128:152437. [PMID: 38007905 DOI: 10.1016/j.comppsych.2023.152437] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Revised: 10/20/2023] [Accepted: 11/07/2023] [Indexed: 11/28/2023] Open
Abstract
BACKGROUND Prenatal distress encompasses a range of different emotions, worries, and experiences of stress. The Baby Preparation and Worry Scale (Baby-PAWS) was recently developed to target anticipatory worries during pregnancy about the postnatal period. However, the Baby-PAWS questionnaire was only examined in the United States of America, limiting the questionnaire's generalizability to different countries. To address this issue, we performed a psychometric evaluation of the questionnaire in a Dutch sample and examined associations between the Baby-PAWS questionnaire and established measures of maternal distress (i.e., EPDS, STAI, PRAQ-R) and infant temperament (i.e., IBQ-R). METHODS Healthy pregnant women (N = 521) completed questionnaires during their third trimester and postnatally, including the Baby-PAWS and distress measures. A subsample of mothers (N = 194) also reported on infant temperament at 12 weeks postpartum. RESULTS Exploratory factor analysis suggested a four-factor structure for the 16-item questionnaire in our Dutch sample, as compared to the expected three-factor structure found in the original psychometric evaluation with the American sample. The total Baby-PAWS score was related to pre-and postnatal depression, anxiety, stress, and specific scales of infant temperament. American women scored higher on the Baby-PAWS items than Dutch women. LIMITATIONS Our participants had higher-than-average socioeconomic status, limiting the generalizability of the findings. CONCLUSION The current analyses indicate good validity of the Baby-PAWS in a Dutch sample. Furthermore, our results highlight cross-cultural differences in perinatal mental health and show the importance of examining instrument structure of context-dependent constructs, such as prenatal worries.
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Affiliation(s)
- Nina Bruinhof
- Radboud University Medical Center, Donders Institute for Brain, Cognition and Behaviour, Department of Cognitive Neuroscience, P.O. Box 9010, 6500, GL, Nijmegen, the Netherlands.
| | - Ela Sehic
- Washington State University, Department of Psychology, Pullman, WA, United States of America.
| | | | - Maria A Gartstein
- Washington State University, Department of Psychology, Pullman, WA, United States of America.
| | - Carolina de Weerth
- Radboud University Medical Center, Donders Institute for Brain, Cognition and Behaviour, Department of Cognitive Neuroscience, P.O. Box 9010, 6500, GL, Nijmegen, the Netherlands.
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Van den Branden L, Van de Craen N, Van Leugenhaege L, Bleijenbergh R, Mestdagh E, Timmermans O, Van Rompaey B, Kuipers YJ. On cloud nine? Maternal emotional wellbeing six weeks up to one year postpartum - A cross-sectional study. SEXUAL & REPRODUCTIVE HEALTHCARE 2023; 36:100856. [PMID: 37229926 DOI: 10.1016/j.srhc.2023.100856] [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: 09/27/2022] [Revised: 03/31/2023] [Accepted: 05/02/2023] [Indexed: 05/27/2023]
Abstract
BACKGROUND Little is known about the full scope of emotional wellbeing of mothers up to one year postpartum, to adequately support women during transition to motherhood. Reduced emotional wellbeing (REW) affects women's adaption to the changes and challenges in becoming a mother. We aimed to increase the knowledge and understanding of mothers' emotional wellbeing and the influencing factors. METHODS This cross-sectional study includes 385 Flemish mothers up to one year postpartum. Online data were collected with the General Health Questionnaire-12, Postpartum Bonding Questionnaire, Personal Well-Being Index-Adult, The Basic Psychological Needs Scale, Sense of Coherence-13 and Coping Operations Preference Enquiry. RESULTS A total of 63.9% of the participants reported REW. Mothers with REW more often had (a history of) psychological problems compared to mothers with healthy emotional wellbeing (p = 0.007). Multiple linear regression analysis showed negative associations between emotional wellbeing and satisfaction (p = 0.002; p < 0.001), comprehensibility (p = 0.013) and positive associations between emotional wellbeing and bonding (p < 0.001), manageability (p = 0.033), problem solving (p = 0.030) and avoidance (p = 0,011) - with an explained variance of 55.5%. LIMITATIONS Some limitations of our study are the GHQ-12 cut-off value, the nature and implication of (a history of) psychological problems and the self-selected population. CONCLUSION It would be of worth for midwives to discuss with mothers (to be) what to expect. This - to support mothers in making sense of their life as a mother and how various factors might influence their emotional wellbeing. The high prevalence of REW is worrying, but needs to be interpreted with caution.
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Affiliation(s)
- Laura Van den Branden
- AP University of Applied Sciences, Department of Health and Social Care, School of Midwifery, Noorderplaats 2, 2000 Antwerp, Belgium; University of Antwerp, Faculty of Medicine & Health Sciences, Department of Nursing and Midwifery, Universiteitsplein 1, 2610 Wilrijk, Belgium.
| | - Natacha Van de Craen
- AP University of Applied Sciences, Department of Health and Social Care, School of Midwifery, Noorderplaats 2, 2000 Antwerp, Belgium
| | - Luka Van Leugenhaege
- AP University of Applied Sciences, Department of Health and Social Care, School of Midwifery, Noorderplaats 2, 2000 Antwerp, Belgium; University of Antwerp, Faculty of Medicine & Health Sciences, Department of Nursing and Midwifery, Universiteitsplein 1, 2610 Wilrijk, Belgium
| | - Roxanne Bleijenbergh
- AP University of Applied Sciences, Department of Health and Social Care, School of Midwifery, Noorderplaats 2, 2000 Antwerp, Belgium; University of Antwerp, Faculty of Medicine & Health Sciences, Department of Nursing and Midwifery, Universiteitsplein 1, 2610 Wilrijk, Belgium
| | - Eveline Mestdagh
- AP University of Applied Sciences, Department of Health and Social Care, School of Midwifery, Noorderplaats 2, 2000 Antwerp, Belgium; University of Antwerp, Faculty of Medicine & Health Sciences, Department of Nursing and Midwifery, Universiteitsplein 1, 2610 Wilrijk, Belgium
| | - Olaf Timmermans
- University of Antwerp, Faculty of Medicine & Health Sciences, Department of Nursing and Midwifery, Universiteitsplein 1, 2610 Wilrijk, Belgium; Professorship Healthy Region, HZ University of Applied Sciences, Edisonweg 4, 4382 NW Vlissingen, the Netherlands
| | - Bart Van Rompaey
- University of Antwerp, Faculty of Medicine & Health Sciences, Department of Nursing and Midwifery, Universiteitsplein 1, 2610 Wilrijk, Belgium
| | - Yvonne J Kuipers
- AP University of Applied Sciences, Department of Health and Social Care, School of Midwifery, Noorderplaats 2, 2000 Antwerp, Belgium; University of Antwerp, Faculty of Medicine & Health Sciences, Department of Nursing and Midwifery, Universiteitsplein 1, 2610 Wilrijk, Belgium; Edinburgh Napier University, School of Health & Social Care, Sighthill Court, Edinburgh EH11 4BN, Scotland, UK
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van Gils Y, Bleijenbergh R, Brosens C, Van den Branden L, Rimaux S, Kuipers YJ. The validation of the brief COPE in a belgian perinatal population. Matern Child Health J 2022; 26:2050-2059. [PMID: 35934724 DOI: 10.1007/s10995-022-03476-5] [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: 12/13/2020] [Revised: 06/13/2022] [Accepted: 07/17/2022] [Indexed: 11/30/2022]
Abstract
INTRODUCTION The Brief Coping Orientation to Problems Experienced (Brief-COPE) measures individuals' coping strategies. There is limited evidence on the psychometric properties of this measure in a perinatal population. The aim of this study is to explore the psychometric properties of the Brief COPE in pregnant and postpartum women. METHODS The Dutch/Flemish version of the Brief-COPE was administrated in a sample of 754 antenatal (n = 432) and postpartum (n = 322) women living in Belgium. Exploratory factor analyses assessed the factor structure of the Brief-COPE and its convergent validity in an antenatal and postpartum sample. Cronbach's alpha was calculated for internal consistency reliability of the Brief-COPE items. RESULTS Exploratory factor analysis showed a five-factor antenatal model, presented by the subscales: (1) Active coping (α = 0.86), (2) Self-blame and Disengagement (α = 0.70), (3) Alcohol use (α = 0.96), (4) Humour (α = 0.79), and (5) Spirituality (α = 0.81). For the postpartum sample, a three-factor model emerged, presented by the subscales: (1) Active coping (α = 0.85), (2) Self-blame (α = 0.85) and (3) Spirituality (α = 0.74). CONCLUSIONS We observed differences and similarities in coping strategies between antenatal and postpartum women - information to be of merit for clinical practice and research. The Brief-COPE is a promising tool for the use of identifying women's coping strategies during pregnancy and the postpartum period, specifically for women in a similar cultural context as the women in this study, mainly in terms of antenatal alcohol use.
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Affiliation(s)
- Yannic van Gils
- Department of Health and Social Studies, School of Midwifery, AP University of Applied Sciences, Noorderplaats 2, 2000, Antwerpen, Belgium. .,Faculty of Medicine and Health Sciences, Antwerp University, Universiteitsplein 1, 2600, Wilrijk, Antwerp, Belgium.
| | - Roxanne Bleijenbergh
- Department of Health and Social Studies, School of Midwifery, AP University of Applied Sciences, Noorderplaats 2, 2000, Antwerpen, Belgium.,Faculty of Medicine and Health Sciences, Antwerp University, Universiteitsplein 1, 2600, Wilrijk, Antwerp, Belgium
| | - Charlotte Brosens
- Department of Health and Social Studies, School of Midwifery, AP University of Applied Sciences, Noorderplaats 2, 2000, Antwerpen, Belgium.,Faculty of Medicine and Health Sciences, Antwerp University, Universiteitsplein 1, 2600, Wilrijk, Antwerp, Belgium
| | - Laura Van den Branden
- Department of Health and Social Studies, School of Midwifery, AP University of Applied Sciences, Noorderplaats 2, 2000, Antwerpen, Belgium.,Faculty of Medicine and Health Sciences, Antwerp University, Universiteitsplein 1, 2600, Wilrijk, Antwerp, Belgium
| | - Sophie Rimaux
- Department of Health and Social Studies, School of Midwifery, AP University of Applied Sciences, Noorderplaats 2, 2000, Antwerpen, Belgium
| | - Yvonne J Kuipers
- Department of Health and Social Studies, School of Midwifery, AP University of Applied Sciences, Noorderplaats 2, 2000, Antwerpen, Belgium.,Faculty of Medicine and Health Sciences, Antwerp University, Universiteitsplein 1, 2600, Wilrijk, Antwerp, Belgium.,School of Health and Social Care, Edinburgh Napier University, Sighthill Campus, EH11 4BN, Edinburgh, Scotland
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Kang SJ, Yang MJ. [Factors influencing pregnancy stress in pregnant women in Korea: a cross-sectional study]. KOREAN JOURNAL OF WOMEN HEALTH NURSING 2022; 28:27-37. [PMID: 36312048 PMCID: PMC9334213 DOI: 10.4069/kjwhn.2022.02.03] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2021] [Revised: 02/01/2022] [Accepted: 02/03/2022] [Indexed: 11/24/2022] Open
Abstract
Purpose The purpose of this study was to investigate the association between maternal knowledge and social support on pregnancy stress among pregnant women in Korea. Methods The participants in this study were 148 pregnant women in Korea, recruited from online communities on pregnancy and/or childbirth, from June 2019 to April 2020. The collected data were analyzed using the independent t-test, one-way analysis of variance, Pearson correlation coefficient, and multiple regression. Results Participants were at average 18.25±8.28 weeks gestation, 56% were in the second trimester, 31% had one or more health issues in the current pregnancy (e.g., hyperemesis gravidarum), and 76% were first-time mothers. Participants had moderate levels of pregnancy stress (mean, 23.09±7.11 points out of 48) and maternal knowledge (mean, 14.42±4.67 points out of 21), whereas social support was somewhat high (mean 45.88±7.81 points out of 60). Pregnancy stress was weakly negatively correlated with social support (r=-.37, p<.001). Main source of pregnancy information (β=-.21, p=.011), marital satisfaction (β=-.18, p=.036), and social support (β=-.19, p=.038) were identified as significant factors affecting pregnancy stress, and these variables had an explanatory power of 22.7% for pregnancy stress. Conclusion Based on these findings, nurses should assess pregnancy-related stress during pregnancy and consider main source of pregnancy information and marital satisfaction when providing education or counseling. Moreover, strategies to reduce pregnancy stress through social support are needed to improve the quality of life for pregnant women.
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Evans K, Rennick-Egglestone S, Cox S, Kuipers Y, Spiby H. Remotely Delivered Interventions to Support Women With Symptoms of Anxiety in Pregnancy: Mixed Methods Systematic Review and Meta-analysis. J Med Internet Res 2022; 24:e28093. [PMID: 35166688 PMCID: PMC8889484 DOI: 10.2196/28093] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2021] [Revised: 06/03/2021] [Accepted: 11/19/2021] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Symptoms of anxiety are common in pregnancy, with severe symptoms associated with negative outcomes for women and babies. Low-level psychological therapy is recommended for women with mild to moderate anxiety, with the aim of preventing an escalation of symptoms and providing coping strategies. Remotely delivered interventions have been suggested to improve access to treatment and support and provide a cost-effective, flexible, and timely solution. OBJECTIVE This study identifies and evaluates remotely delivered, digital, or web-based interventions to support women with symptoms of anxiety during pregnancy. METHODS This mixed methods systematic review followed a convergent segregated approach to synthesize qualitative and quantitative data. The ACM Digital Library, Allied and Complementary Medicine Database, Applied Social Sciences Index and Abstracts, Centre for Reviews and Dissemination database, the Cochrane Central Register of Controlled Trials, the Cochrane Library, CINAHL, Embase, Health Technology Assessment Library, IEEE Xplore, Joanna Briggs Institute, Maternity and Infant Care, MEDLINE, PsycINFO, and the Social Science Citation Index were searched in October 2020. Quantitative or qualitative primary research that included pregnant women and evaluated remotely delivered interventions reporting measures of anxiety, fear, stress, distress, women's views, and opinions were included. RESULTS Overall, 3 qualitative studies and 14 quantitative studies were included. Populations included a general antenatal population and pregnant women having anxiety and depression, fear of childbirth, insomnia, and preterm labor. Interventions included cognitive behavioral therapy, problem solving, mindfulness, and educational designs. Most interventions were delivered via web-based platforms, and 62% (8/13) included direct contact from trained therapists or coaches. A meta-analysis of the quantitative data found internet-based cognitive behavioral therapy and facilitated interventions showed a beneficial effect in relation to the reduction of anxiety scores (standardized mean difference -0.49, 95% CI -0.75 to -0.22; standardized mean difference -0.48, 95% CI -0.75 to -0.22). Due to limitations in the amount of available data and study quality, the findings should be interpreted with caution. Synthesized findings found some evidence to suggest that interventions are more effective when women maintain regular participation which may be enhanced by providing regular contact with therapists or peer support, appropriate targeting of interventions involving components of relaxation and cognitive-based skills, and providing sufficient sessions to develop new skills without being too time consuming. CONCLUSIONS There is limited evidence to suggest that women who are pregnant may benefit from remotely delivered interventions. Components of interventions that may improve the effectiveness and acceptability of remotely delivered interventions included providing web-based contact with a therapist, health care professional, or peer community. Women may be more motivated to complete interventions that are perceived as relevant or tailored to their needs. Remote interventions may also provide women with greater anonymity to help them feel more confident in disclosing their symptoms.
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Affiliation(s)
- Kerry Evans
- School of Health Sciences, University of Nottingham, Nottingham, United Kingdom
| | - Stefan Rennick-Egglestone
- Institute of Mental Health, School of Health Sciences, University of Nottingham, Nottingham, United Kingdom
| | - Serena Cox
- School of Health Sciences, University of Nottingham, Nottingham, United Kingdom
| | - Yvonne Kuipers
- School of Health and Social Care, Edinburgh Napier University, Edinburgh, United Kingdom
| | - Helen Spiby
- School of Health Sciences, University of Nottingham, Nottingham, United Kingdom
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Decker AN, Fischer AR, Gunn HE. Socio-Ecological Context of Sleep: Gender Differences and Couples' Relationships as Exemplars. Curr Psychiatry Rep 2022; 24:831-840. [PMID: 36401678 PMCID: PMC9676909 DOI: 10.1007/s11920-022-01393-6] [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] [Accepted: 10/28/2022] [Indexed: 11/21/2022]
Abstract
PURPOSE OF REVIEW We summarized recent findings on insufficient sleep and insomnia, two prominent sleep issues that impact public health. We demonstrate the socio-ecologial impact of sleep health with findings on gender and couples' relationships as exemplars. RECENT FINDINGS Robust gender differences in sleep duration and insomnia are due to biological and socio-ecological factors. Gender differences in insufficient sleep vary by country of origin and age whereas gender differences in insomnia reflect minoritized identities (e.g., sexual, gender). Co-sleeping with a partner is associated with longer sleep and more awakenings. Gender differences and couples' sleep were affected by intersecting social and societal influences, which supports a socio-ecological approach to sleep. Recent and seminal contributions to sleep health highlight the importance of observing individual sleep outcomes in a socio-ecological context. Novel methodology, such as global measures of sleep health, can inform efforts to improve sleep and, ultimately, public health.
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Affiliation(s)
- Andrea N. Decker
- Department of Psychology, The University of Alabama, 505 Hackberry Lane, Tuscaloosa, AL 35401 USA
| | - Alexandra R. Fischer
- Department of Psychology, The University of Alabama, 505 Hackberry Lane, Tuscaloosa, AL 35401 USA
| | - Heather E. Gunn
- Department of Psychology, The University of Alabama, 505 Hackberry Lane, Tuscaloosa, AL 35401 USA
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12
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Kuipers YJ, Beeck EV, Cijsouw A, van Gils Y. The impact of motherhood on the course of women's psychological wellbeing. JOURNAL OF AFFECTIVE DISORDERS REPORTS 2021. [DOI: 10.1016/j.jadr.2021.100216] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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13
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Giovannini N, Cetera GE, Ercolino C, Miozzo MR, Parazzini F, Ferrazzi EM, Manzotti A, Colaceci S. MYNd&CO (Mindfulness, Yoga, Nutrition, development & Coaching, and Osteopathy) randomized controlled trial for a positive psychophysical experience in pregnancy and after birth: a study protocol. ACTA BIO-MEDICA : ATENEI PARMENSIS 2021; 92:e2021032. [PMID: 34328141 PMCID: PMC8383226 DOI: 10.23750/abm.v92is2.11259] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Accepted: 06/28/2021] [Indexed: 11/23/2022]
Abstract
BACKGROUND AND AIM The medicalisation of birth pathway may negatively impact on women's empowerment, enhancing distress even in cases of healthy pregnancies. We have built a program which is comprised of Mindfulness, Yoga, Nutrition, development & Counselling, Coaching, antenatal classes, and Osteopathic treatment (MYNd&CO). METHODS This study is a randomized controlled trial involving low-risk pregnant women. They will be randomized to the experimental (MYNd&CO intervention plus standard care) or control group (standard care). The primary (general health and wellbeing, maternal distress) and secondary outcome measures (urinary incontinence, sexual problems, and physical wellbeing) will be assessed via questionnaires at baseline and 6 months after childbirth. The independent-samples t-test and Chi-square will be used to detect changes in the outcomes between intervention and control group. DISCUSSION The trial is expected to increase knowledge about the effectiveness of a holistic approach in low-risk pregnant women, in terms of obstetrical and psychophysiological outcomes.
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Affiliation(s)
- Niccolò Giovannini
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.
| | | | - Carolina Ercolino
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.
| | - Monica Rosa Miozzo
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.
| | - Fabio Parazzini
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.
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14
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Michalik A, Wójcicka L, Zdun-Ryżewska A, Czerwińska-Osipiak A, Krzemiński M, Olszewska J, Klasa-Mazurkiewicz D, Huizink AC. Polish Adaptation of the Pregnancy-Related Anxiety Questionnaire-Revised 2 for All Pregnant Women. Healthcare (Basel) 2021; 9:917. [PMID: 34356295 PMCID: PMC8307515 DOI: 10.3390/healthcare9070917] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Revised: 07/14/2021] [Accepted: 07/16/2021] [Indexed: 11/16/2022] Open
Abstract
Pregnancy-related anxiety (PrA) is a specific type of anxiety characteristic of the perinatal period. PrA can affect pregnancy and birth. However, no validated tool exists to measure PrA in Polish obstetric practice. The aim of this study was to translate the Pregnancy-Related Anxiety Questionnaire-Revised 2 (PRAQ-R2) into Polish and to evaluate its reliability and factorial and construct validity. This study was conducted in Poland as an online questionnaire in April 2020 and included 175 healthy women. To validate the PRAQ-R2, we used standardized tools for the measurement of general anxiety: the modified Visual Analog Scale (VAS), the Ten-Item Personality Inventory (TIPI), and the Hospital Anxiety and Depression Scale (HADS). Scale reliability was assessed using Cronbach's alpha. Concurrent validity was evaluated by calculating Spearman's rho correlation coefficients. Statistical analyses were performed using R ver. 4.0.2. Values for comparative fit index >0.90, Tucker-Lewis index >0.90, and root mean square error of approximation <0.08 indicated acceptable model fit, confirming the reliability of the three-factor structure of the translation. The subscales and total scores had good consistency (α > 0.7), and convergent validity was demonstrated. The PRAQ-R2 as translated into Polish represents the first validated tool in Poland to measure PrA for all pregnant women.
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Affiliation(s)
- Anna Michalik
- Department of Obstetrical and Gynaecological Nursing, Medical University of Gdansk, 80-211 Gdansk, Poland; (A.M.); (L.W.); (A.C.-O.); (J.O.)
| | - Lucyna Wójcicka
- Department of Obstetrical and Gynaecological Nursing, Medical University of Gdansk, 80-211 Gdansk, Poland; (A.M.); (L.W.); (A.C.-O.); (J.O.)
| | - Agata Zdun-Ryżewska
- Department of Quality of Life Research, Medical University of Gdansk, 80-210 Gdansk, Poland;
| | - Agnieszka Czerwińska-Osipiak
- Department of Obstetrical and Gynaecological Nursing, Medical University of Gdansk, 80-211 Gdansk, Poland; (A.M.); (L.W.); (A.C.-O.); (J.O.)
| | - Michał Krzemiński
- Institute of Applied Mathematics, Faculty of Applied Physics and Mathematics, Gdansk University of Technology, 80-233 Gdansk, Poland;
| | - Jolanta Olszewska
- Department of Obstetrical and Gynaecological Nursing, Medical University of Gdansk, 80-211 Gdansk, Poland; (A.M.); (L.W.); (A.C.-O.); (J.O.)
| | - Dagmara Klasa-Mazurkiewicz
- Department of Gynaecology, Oncologic Gynaecology and Gynaecological Endocrinology, Medical University of Gdansk, 80-214 Gdansk, Poland;
| | - Anja C. Huizink
- Department of Clinical Developmental Psychology, Vrije Universiteit Amsterdam, Van der Boechorststraat 1, 1081 BT Amsterdam, The Netherlands
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15
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Michalik A, Wojcicka L, Czerwińska-Osipiak A, Zdun-Ryżewska A, Jakitowicz K, Olszewska J, Krauze M, Jakitowicz M. Preferences of women with low obstetric risk for cesarean or vaginal birth in Poland: Areas for intervention. Birth 2021; 48:265-273. [PMID: 33580575 DOI: 10.1111/birt.12537] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2020] [Revised: 01/20/2021] [Accepted: 01/26/2021] [Indexed: 11/27/2022]
Abstract
BACKGROUND In Poland, the rate of cesarean birth (CB) is 43%, which is much higher than the European average of 27%. Optimizing the CB birth rate is of critical importance, especially among women with low-risk pregnancies. However, the determinants of cesarean preference among low-risk women in Poland have not been well explored. METHODS This cross-sectional study included 1011 pregnant women and aimed to identify associations between selected determinants of women's preferences for CB vs. vaginal birth (VB) in Poland. A descriptive questionnaire was distributed online, and a theoretical model was validated against empirically gathered data. Group comparisons were performed using the Welch t test for continuous data or chi-square test for categorical data. All statistical analyses were performed using R (R Core Team, 2018). RESULTS The mean age of women preferring CB (30.46 years) was 1.25 years higher than that of women preferring VB (29.21 years). Pregnant women who expressed a preference for CB tended to be multigravid, inhabited cities, and were characterized by higher levels of anxiety and depression. Moreover, the majority of women who underwent a previous CB asserted their intention to repeat the procedure for the current pregnancy. CONCLUSIONS The primary factors that were correlated with high CB preference among the low-risk group included age, previous childbirth experiences, and anxiety. The underlying reasons that drive birth preferences remain poorly understood. However, women who have previously undergone difficult childbirth experiences and are afraid of pain require specialized care.
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Affiliation(s)
- Anna Michalik
- Department of Obstetrical and Gynaecological Nursing, Medical University of Gdansk, Gdansk, Poland
| | - Lucyna Wojcicka
- Department of Obstetrical and Gynaecological Nursing, Medical University of Gdansk, Gdansk, Poland
| | | | - Agata Zdun-Ryżewska
- Department of Quality of Life Research, Medical University of Gdansk, Gdansk, Poland
| | - Karolina Jakitowicz
- Department of Clinical Psychology and Neuropsychology, University of Gdansk, Gdansk, Poland
| | - Jolanta Olszewska
- Department of Obstetrical and Gynaecological Nursing, Medical University of Gdansk, Gdansk, Poland
| | - Magdalena Krauze
- Department of Gynecologic and Obstetrical Didactics, Warsaw Medical University, Warsaw, Poland
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16
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Vázquez MB, Míguez MC. Spanish Brief Version of the Pregnancy Related Anxiety Questionnaire: PRAQ-20. CLÍNICA Y SALUD 2021. [DOI: 10.5093/clysa2020a22] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
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17
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Browne PD, Bossenbroek R, Kluft A, van Tetering EMA, de Weerth C. Prenatal Anxiety and Depression: Treatment Uptake, Barriers, and Facilitators in Midwifery Care. J Womens Health (Larchmt) 2020; 30:1116-1126. [PMID: 33275492 DOI: 10.1089/jwh.2019.8198] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023] Open
Abstract
Background: While many women experience prenatal symptoms of anxiety and/or depression (PSAD), treatment uptake rates are relatively low. Left untreated, symptoms can unfavorably affect maternal and infant health. The first aim of this study was to identify the treatment uptake rate and modalities of treatment received in a community sample of Dutch pregnant women. The second aim was to investigate reasons for not engaging in treatment and to describe facilitators for treatment uptake. The third aim was to determine facilitators and barriers for self-disclosure of feelings to midwives. Materials and Methods: Data were collected from a convenience sample of 1439 Dutch women with low-risk mid-term pregnancies in midwifery care. PSAD was assessed with online questionnaires on symptoms. Reasons, facilitators, and barriers were determined with checklists and open questions. Data were analyzed using conventional content analysis and open code quantification. Results: Only 15% of women with PSAD (scoring above cutoffs; 22% of the full sample) received treatment. Psychotherapy was the most commonly received treatment. The main reason for not engaging in treatment was regarding PSAD as a natural part of pregnancy (71%). The main facilitator to engage in treatment was referral by midwives (16%), and for self-disclosure was the midwife asking about PSAD (59%), whereas not asking formed the main barrier for self-disclosure (23%). Conclusions: Relatively few pregnant women received treatment for PSAD. Midwives play an essential role in identifying and referring women for treatment. Routine screening may be a starting point to offer support and, if needed, referral.
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Affiliation(s)
- Pamela D Browne
- Department of Cognitive Neuroscience, Donders Institute for Brain, Cognition, and Behavior, Radboud University Medical Center, Nijmegen, The Netherlands.,Faculty of Earth & Life Sciences, Athena Institute, VU University, Amsterdam, The Netherlands
| | - Rineke Bossenbroek
- Behavioral Science Institute, Radboud University, Nijmegen, The Netherlands
| | - Arne Kluft
- Behavioral Science Institute, Radboud University, Nijmegen, The Netherlands
| | | | - Carolina de Weerth
- Department of Cognitive Neuroscience, Donders Institute for Brain, Cognition, and Behavior, Radboud University Medical Center, Nijmegen, The Netherlands
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18
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Schramm K, Nees J, Hoffmann J, Bruckner T, Haun MW, Maatouk I, Stepan H, Schott S. Emergency consultations in obstetrics: identification of decisive, contributing and associated factors. Arch Gynecol Obstet 2020; 302:821-828. [PMID: 32607806 DOI: 10.1007/s00404-020-05662-8] [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: 04/22/2020] [Accepted: 06/18/2020] [Indexed: 12/01/2022]
Abstract
PURPOSE Psychosocial and biological factors influence the perception of physical changes during pregnancy. Some pregnant women present to the obstetric emergency department (ED) with diverse symptoms not requiring urgent medical action. These visits result in over-consultation, tying up resources and inflating health care expenses. This study outlines factors associated with multiple ED visits during pregnancy, measures the prevalence of anxiety and depression, and explores the choice of maternity clinic for delivery aiming to elucidate options for care strategies. METHODS This prospective, cross-sectional, questionnaire-based bicentric study was performed in the obstetric outpatient departments of two university hospitals in Germany and recruited pregnant women between 12/2016 and 11/2017. The questionnaire included socio-demographics, obstetric history, anxiety (GAD-7), depression (PHQ-9), and health status (WHO-5, SF-12). RESULTS This analysis included 496 women and showed that women with numerous ED visits were significantly younger (p < 0.0001), less educated (p = 0.0002), and more likely to be unemployed and single. Different prevalences for anxiety and depression were detected correlating with the number of ED visits although each showing only low effect sizes (0.024 resp. 0.015). CONCLUSIONS Pregnant women attending the ED more often might benefit from health education, psychosomatic interventions, and social support to overcome their depression and anxiety to avoid non-urgent ED consultations. Further prospective studies are needed to support these findings.
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Affiliation(s)
- Katharina Schramm
- Department of Gynecology and Obstetrics, University Hospital Heidelberg, Im Neuenheimer Feld 440, 69120, Heidelberg, Germany.,Children's Hospital Heilbronn, SLK-Klinikum am Gesundbrunnen, Heilbronn, Germany
| | - Juliane Nees
- Department of Gynecology and Obstetrics, University Hospital Heidelberg, Im Neuenheimer Feld 440, 69120, Heidelberg, Germany.
| | - Janine Hoffmann
- Department of Obstetrics, University Hospital Halle (Saale), Halle (Saale), Germany
| | - Thomas Bruckner
- Institute of Medical Biometry and Informatics, University of Heidelberg, Heidelberg, Germany
| | - Markus W Haun
- Department of General Internal Medicine and Psychosomatics, University Hospital Heidelberg, Heidelberg, Germany
| | - Imad Maatouk
- Department of General Internal Medicine and Psychosomatics, University Hospital Heidelberg, Heidelberg, Germany
| | - Holger Stepan
- Department of Obstetrics, University Hospital Leipzig, Leipzig, Germany
| | - Sarah Schott
- Department of Gynecology and Obstetrics, University Hospital Heidelberg, Im Neuenheimer Feld 440, 69120, Heidelberg, Germany
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19
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Keulen JKJ, Nieuwkerk PT, Kortekaas JC, van Dillen J, Mol BW, van der Post JAM, de Miranda E. What women want and why. Women's preferences for induction of labour or expectant management in late-term pregnancy. Women Birth 2020; 34:250-256. [PMID: 32444268 DOI: 10.1016/j.wombi.2020.03.010] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2019] [Revised: 03/03/2020] [Accepted: 03/23/2020] [Indexed: 01/25/2023]
Abstract
BACKGROUND Both induction of labour at 41 weeks and expectant management until 42 weeks are common management strategies in low-risk pregnancy since there is no consensus on the optimal timing of induction in late-term pregnancy for the prevention of adverse outcomes. Our aim was to explore maternal preference for either strategy and the influence on quality of life and maternal anxiety on this preference. METHODS Obstetrical low-risk women with an uncomplicated pregnancy were eligible when they reached a gestational age of 41 weeks. They were asked to fill in questionnaires on quality of life (EQ6D) and anxiety (STAI-state). Reasons of women's preferences for either induction or expectant management were explored in a semi-structured questionnaire containing open ended questions. RESULTS Of 782 invited women 604 (77.2%) responded. Induction at 41 weeks was preferred by 44.7% (270/604) women, 42.1% (254/604) preferred expectant management until 42 weeks, while 12.2% (74/604) of women did not have a preference. Women preferring induction reported significantly more problems regarding quality of life and were more anxious than women preferring expectant management (p<0.001). Main reasons for preferring induction of labour were: "safe feeling" (41.2%), "pregnancy taking too long" (35.4%) and "knowing what to expect" (18.6%). For women preferring expectant management, the main reason was "wish to give birth as natural as possible" (80.3%). CONCLUSION Women's preference for induction of labour or a policy of expectant management in late-term pregnancy is influenced by anxiety, quality of life problems (induction), the presence of a wish for natural birth (expectant management), and a variety of additional reasons. This variation in preferences and motivations suggests that there is room for shared decision making in the management of late-term pregnancy.
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Affiliation(s)
- J K J Keulen
- Department of Obstetrics and Gynaecology, Amsterdam UMC, University of Amsterdam, The Netherlands; Amsterdam Reproduction & Development Research Institute, Amsterdam UMC, University of Amsterdam, The Netherlands.
| | - P T Nieuwkerk
- Department of Medical Psychology, Amsterdam UMC, University of Amsterdam, The Netherlands
| | - J C Kortekaas
- Department of Obstetrics and Gynaecology, Radboud UMC, Nijmegen, The Netherlands
| | - J van Dillen
- Department of Obstetrics and Gynaecology, Radboud UMC, Nijmegen, The Netherlands
| | - B W Mol
- Department of Obstetrics and Gynaecology, Monash University, Melbourne, Australia
| | - J A M van der Post
- Department of Obstetrics and Gynaecology, Amsterdam UMC, University of Amsterdam, The Netherlands
| | - E de Miranda
- Department of Obstetrics and Gynaecology, Amsterdam UMC, University of Amsterdam, The Netherlands
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20
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Kuipers J, Henrichs J, Evans K. A comparison of the Fear of Childbirth Scale with the Tilburg Pregnancy Distress Scale to identify childbirth-related fear in a sample of Dutch pregnant women: a diagnostic accuracy comparative cross-sectional study. Int J Nurs Stud 2020; 109:103615. [PMID: 32553993 DOI: 10.1016/j.ijnurstu.2020.103615] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2019] [Revised: 04/14/2020] [Accepted: 04/15/2020] [Indexed: 01/07/2023]
Abstract
BACKGROUND Because of the considerable negative effects of women's childbirth-related anxiety, fear and worries, and the time constraints that midwives perceive to assess women's antenatal emotional wellbeing, it is important that midwives can identify women with a more severe fear of birth with an easy to administer, validated tool. OBJECTIVE To investigate the ability of the two-item Fear of Childbirth Scale (FOBS) to discriminate between pregnant women with and without birth-related fear, compared with the 16-item Tilburg Pregnancy Distress Scale (TPDS). METHODS A diagnostic accuracy comparative cross-sectional study was performed, comparing two screening tests. Sensitivity, specificity, positive and negative predictive values and accuracy and discriminant property of the FOBS were determined and compared with the TPDS and with the negative affect 11-items TPDS (TPDS-NA) subscale. The TPDS and TPDS-NA were treated as reference standard to establish the discriminative potential of the FOBS for the presence or absence of antenatal birth-related fear. PARTICIPANTS A sample of 396 Dutch women with uncomplicated pregnancies. RESULTS When compared with the 16-items TPDS, the FOBS showed a higher specificity (95%) than sensitivity (70%) to detect fear of childbirth. The FOBS items had a good predictive ability for fear and worries about the forthcoming birth (79%) and a conclusive ability for negative case-finding (92%). The FOBS showed good accuracy (89%). The FOBS discriminated women who were or were not classified as being fearful according to the TPDS (AUC .86). When compared with the 11 items TPDS-NA subscale, the FOBS validity and accuracy decreased: sensitivity: 51%; specificity 92%; positive predictive ability 65%; negative predictive ability 88%; accuracy 83%; AUC .82. CONCLUSION When compared with the 16-items TPDS, the two-item FOBS shows to be an accurate tool for identifying the presence of antenatal birth-related fear in a sample of Dutch women with uncomplicated pregnancies.
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Affiliation(s)
- Jacoba Kuipers
- Antwerp University, Faculty of Medicine and Health Sciences - Nursing & Midwifery, Campus Drie Eiken, Universiteitsplein 1, 2610 Wilrijk, Belgium.
| | - Jens Henrichs
- Amsterdam University Medical Center, Vrije Universiteit Amsterdam, Department of Midwifery Science AVAG-Amsterdam Public Health research institute, van der Boechhorststraat 7, 1091 BT Amsterdam, the Netherlands.
| | - Kerry Evans
- University of Nottingham, School of Health Sciences, University Park, Nottingham NG7 2RD, United Kingdom.
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21
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Koster D, Romijn C, Sakko E, Stam C, Steenhuis N, de Vries D, van Willigen I, Fontein-Kuipers Y. Traumatic childbirth experiences: practice-based implications for maternity care professionals from the woman's perspective. Scand J Caring Sci 2019; 34:792-799. [PMID: 31657049 DOI: 10.1111/scs.12786] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2019] [Accepted: 10/02/2019] [Indexed: 12/17/2022]
Abstract
OBJECTIVE To explore women's traumatic childbirth experiences in order to make maternity care professionals more aware of women's intrapartum care needs. METHOD A qualitative exploratory study with a constant comparison/grounded theory design was performed. Thirty-six interviews were conducted with women who had given birth in a Dutch birth setting. FINDINGS Three themes, playing a profound role in the occurrence of traumatic birth experiences, emerged: (i) lack of information and consent - maternity care professionals' unilateral decision making during intrapartum care, lacking informed-consent. (ii) feeling excluded - women's mal-adaptive response to the healthcare professionals's one-sided decision making, leaving women feeling distant and estranged from the childbirth event and the experience. (iii) discrepancies - inconsistency between women's expectations and the reality of labour and birth - on an intrapersonal level. CONCLUSION Women's intrapartum care needs cohere with the concept of woman-centred care, including personalised care and reflecting humanising values. Care should include informed consent and shared decision-making. Maternity care professionals need to continuously evaluate whether the woman is consistently part of her own childbearing process. Maternity care professionals should maintain an ongoing dialogue with the woman, including women's internalised ideas of birth.
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Affiliation(s)
- Diana Koster
- Women's Counselling & Theray Services, The Hague, the Netherlands
| | - Chantal Romijn
- Research Centre Innovations in Care, Rotterdam University of Applied Sciences, Rotterdam, the Netherlands
| | - Elvira Sakko
- Research Centre Innovations in Care, Rotterdam University of Applied Sciences, Rotterdam, the Netherlands
| | - Catelijne Stam
- Research Centre Innovations in Care, Rotterdam University of Applied Sciences, Rotterdam, the Netherlands
| | - Nienke Steenhuis
- Research Centre Innovations in Care, Rotterdam University of Applied Sciences, Rotterdam, the Netherlands
| | - Daniëlle de Vries
- Research Centre Innovations in Care, Rotterdam University of Applied Sciences, Rotterdam, the Netherlands
| | - Ilze van Willigen
- Research Centre Innovations in Care, Rotterdam University of Applied Sciences, Rotterdam, the Netherlands
| | - Yvonne Fontein-Kuipers
- Research Centre Innovations in Care, Rotterdam University of Applied Sciences, Rotterdam, the Netherlands.,School of Midwifery, Rotterdam University of Applied Sciences, Rotterdam, the Netherlands
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Yilmaz EB. Socio-demographic and pregnancy-related characteristics associated with prenatal distress: a Turkish study. CENTRAL EUROPEAN JOURNAL OF NURSING AND MIDWIFERY 2019. [DOI: 10.15452/cejnm.2019.10.0016] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
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Perinatal maternal mental health and infant socio-emotional development: A growth curve analysis using the MPEWS cohort. Infant Behav Dev 2019; 57:101336. [PMID: 31404801 DOI: 10.1016/j.infbeh.2019.101336] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2019] [Revised: 06/21/2019] [Accepted: 06/24/2019] [Indexed: 12/17/2022]
Abstract
Pregnancy and the early post partum period are widely understood as a critical period for the infant's emotional development and the earliest influence shaping social interaction. The present study aims to understand the potential influence of both antenatal and postnatal maternal anxiety and depressive symptoms on socio-emotional outcomes in offspring aged 12 months. The study used longitudinal data from a prospective cohort study on Australian pregnant women and their children. Data were available for 282 mothers and their children. Maternal depressive and anxiety symptoms were measured in early pregnancy, trimester three of pregnancy, six and 12 months postpartum. Social and emotional development in children was measured using the Brief Infant and Toddler Social Emotional Assessment (BITSEA) at 12 months. Using growth curve analysis of 4 waves of repeated measurement to examine intercept and slope, we found that both initial maternal depression and anxiety symptom levels, and the growth of these symptoms over time, predicted more problems with children's social and emotional development. In the final model anxiety accounted for 19% of the variance in child socio-emotional problems and depression 23% of variance. The results emphasise the importance of perinatal maternal mental health as a potential risk factor for child development. This carries important implications for policy development, such as the need to build early identification and early intervention models in to the current clinical practice for perinatal care, specifically, to develop targeted screening, assessment and interventions to address maternal mental health issues for at-risk parents during pregnancy, and continuing monitoring of young children whose mothers have experienced perinatal mental health difficulties.
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McNamara J, Townsend ML, Herbert JS. A systemic review of maternal wellbeing and its relationship with maternal fetal attachment and early postpartum bonding. PLoS One 2019; 14:e0220032. [PMID: 31344070 PMCID: PMC6657859 DOI: 10.1371/journal.pone.0220032] [Citation(s) in RCA: 89] [Impact Index Per Article: 17.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2018] [Accepted: 07/08/2019] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND An emerging body of literature suggests there is a relationship between a pregnant woman's psychological wellbeing and the development of maternal-fetal attachment (MFA) and early postpartum bonding. The nature of this relationship is not well understood because of the limited theoretical framework surrounding the construct of MFA and variations in study methods and data collection points. In this systematic review, we synthesize the published literature to determine the nature of the relationship from the antenatal to early postnatal period and to provide recommendations for future research and clinical practice. METHOD Using the preferred reporting items for systematic reviews and meta-analyses (PRISMA) approach, four electronic databases were searched for peer-reviewed empirical studies, published in English. Articles were considered for inclusion if data was collected on at least one domain of maternal wellbeing/mental health and MFA during pregnancy or MFA during pregnancy and the mother-infant relationship during the early postpartum period (up to 12 weeks). No date parameters were applied to the search strategy. The review was registered with PROPSERO (registration number: CRD42018096174). RESULTS 25 studies examining maternal mental health and MFA/postpartum bonding were selected for inclusion in this review. Key findings identified from the review were: a need to validate existing mental health measures or develop new measures specific for use in antenatal populations; inconsistencies in data collection points throughout pregnancy and postpartum; a lack of consensus about the construct of MFA and the way it is assessed; and a continued focus on postpartum outcomes. CONCLUSION Scientific gaps remain in our understanding of the relationship between maternal mental health and both MFA and postpartum bonding which limit our theoretical understanding of the MFA construct. Recommendations for future research are to employ prospective longitudinal designs that span the full pregnancy and postpartum period, and for consistency in the terminology and methodology used when considering MFA. A re-focus of research attention on the theory behind MFA will allow a richer and more holistic account of the emerging relationship between mother and baby.
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Affiliation(s)
- Josephine McNamara
- School of Psychology and Early Start, University of Wollongong, Wollongong, New South Wales, Australia
| | - Michelle L. Townsend
- Illawarra Health and Medical Research Institute, University of Wollongong, Wollongong, New South Wales, Australia
| | - Jane S. Herbert
- School of Psychology and Early Start, University of Wollongong, Wollongong, New South Wales, Australia
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25
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Probiotics in pregnancy: protocol of a double-blind randomized controlled pilot trial for pregnant women with depression and anxiety (PIP pilot trial). Trials 2019; 20:440. [PMID: 31315657 PMCID: PMC6637581 DOI: 10.1186/s13063-019-3389-1] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2018] [Accepted: 05/02/2019] [Indexed: 12/28/2022] Open
Abstract
Background Maternal prenatal depressive or anxiety symptoms are associated with adverse maternal and infant health outcomes. With prevalence rates of maternal prenatal depression and anxiety ranging between 10 and 20%, attempts to identify effective interventions to reduce symptoms are priority. There are indications that probiotics can reduce symptoms of maternal depression or anxiety. Probiotics ingested by the mother may thus offer a promising and accessible intervention to complement existing treatments. Methods The Probiotics in Pregnancy (PIP) pilot trial is a double-blind, placebo-controlled, randomized pilot trial. While one group orally consumes a probiotic mixture (Ecologic® Barrier; 2,5 × 109 colony forming units/g; 2 g; daily), the other group consumes a placebo, from between 26 and 30 weeks gestation until delivery. Subjects are randomly allocated (1:1) to the intervention or placebo group. Forty healthy pregnant women with symptoms of depression or anxiety and uncomplicated pregnancies at randomization will be included. The primary aim is to determine the feasibility and acceptability of a probiotic trial to reduce symptoms of maternal depression or anxiety in pregnancy. The secondary aim is to exploratorily compare the potential effect of probiotics, compared to placebo, on depressive and/or anxiety symptoms, maternal stress (i.e. reported/hair cortisol), maternal vaginal and intestinal microbiota, and by possibly affecting maternal mood and microbiota, maternal bonding to offspring, infant microbiota and infant crying. Discussion Results of this pilot trial will help determine whether or not to proceed with a full trial after the pilot trial, and if so, whether revisions should be made to the study protocol and procedures before conducting a full randomized controlled trial. Additionally, they are expected to provide insights into whether changes in psychological, behavioral and biological parameters can be attributed to the probiotic intervention. Trial registration Netherlands Trial Register, NTR6219. Registered on 28 February 2017. Electronic supplementary material The online version of this article (10.1186/s13063-019-3389-1) contains supplementary material, which is available to authorized users.
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26
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Mudra S, Göbel A, Barthel D, Hecher K, Schulte-Markwort M, Goletzke J, Arck P, Diemert A. Psychometric properties of the German version of the pregnancy-related anxiety questionnaire-revised 2 (PRAQ-R2) in the third trimester of pregnancy. BMC Pregnancy Childbirth 2019; 19:242. [PMID: 31296168 PMCID: PMC6625049 DOI: 10.1186/s12884-019-2368-6] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2018] [Accepted: 06/17/2019] [Indexed: 11/10/2022] Open
Abstract
Background Pregnancy-related anxiety (PrA) has been identified as a construct distinct from general stress and anxiety with a negative impact on birth and child outcomes. Validated instruments with good psychometric properties to assess pregnancy-related anxiety in German-speaking expectant mothers are still lacking. The Pregnancy-Related Anxiety Questionnaire revised for its use independent of parity (PRAQ-R2) assesses fear of giving birth (FoGB), worries of bearing a physically or mentally handicapped child (WaHC) and concerns about own appearance (CoA). The aim of this study was to investigate the psychometric properties of the PRAQ-R2 in a German sample of pregnant women in their third pregnancy trimester. Methods The PRAQ-R2 and several questionnaires measuring different forms of anxiety as well as depressive symptoms and perceived general self-efficacy were administered cross-sectionally in a sample of nulliparous and parous women (N = 360) in the third trimester of pregnancy. Results Reliability was satisfactory to excellent for the PRAQ-R2 total scale (Cronbach’s α = .85) and the subscales (α = .77 to .90). Confirmatory and exploratory factor analysis confirmed the three-factorial structure of the instrument. The three factors together explained 68% of variance. Construct validity was confirmed by positive low- to moderate-sized correlations of the PRAQ-R2 total score and the subscales with measurements of anxiety and depression and by negative low correlations with general self-efficacy. Conclusions The German version of the PRAQ-R2 is a valid and feasible measurement for pregnancy-related anxiety for research and clinical practice.
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Affiliation(s)
- S Mudra
- Department of Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany.
| | - A Göbel
- Department of Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany
| | - D Barthel
- Department of Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany
| | - K Hecher
- Department of Obstetrics and Fetal Medicine, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany
| | - M Schulte-Markwort
- Department of Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany
| | - J Goletzke
- Department of Obstetrics and Fetal Medicine, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany
| | - P Arck
- Department of Obstetrics and Fetal Medicine, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany
| | - A Diemert
- Department of Obstetrics and Fetal Medicine, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany
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27
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Copeland DB, Harbaugh BL. "It's Hard Being a Mama": Validation of the Maternal Distress Concept in Becoming a Mother. J Perinat Educ 2019; 28:28-42. [PMID: 31086473 PMCID: PMC6491152 DOI: 10.1891/1058-1243.28.1.28] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
Abstract
New mothers actively adapt to new demands and challenges in the mothering role but some may find this adjustment difficult and distressing, depending on their perceptions and resources. Previous research on maternal distress is primarily concentrated on needs of mothers with depression but nonpathological approaches of viewing difficulties in early parenting should be explored. A secondary analysis of a descriptive, qualitative study was completed on new, low-income mothers in early parenthood to determine how maternal distress influences mothers' transition to becoming a mother and to validate the use of the Maternal Distress Concept in the clinical setting. Findings reveal new mothers experience maternal distress on various levels: stress, adaptation, functioning, and connecting. Implications for practice and education are discussed.
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28
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Lambert C, Jomeen J, McSherry W. Women’s Decision-Making About Birthplace Choices: Booking for Birth Center, Hospital, or Home Birth in the North of England. INTERNATIONAL JOURNAL OF CHILDBIRTH 2018. [DOI: 10.1891/2156-5287.8.2.115] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Aim:This article presents findings from an interpretive phenomenological study that illuminates unique characteristics of the different social representations of antenatal primigravida and multigravida women who book to birth their babies in a birth center, hospital, or at home.Methods:Semi-structured interviews were conducted with 19 women and analyzed by interpretive phenomenological analysis.Findings:Analysis revealed different social representations independent of each other that illustrate how these social groups, determined by women’s collective voices, are uniquely characterized by group views, beliefs, misinterpretations, and preconceptions that establish what influences women in decision-making about choice of birthplace.Conclusion:Women make decisions about what they want for themselves in this birthing experience. These decisions are made long before this impending experience. Recognizing the different social representations of women in pregnancy reveals deeper insight into the complexities of women’s decision-making about birth choices and highlights why some women might opt for certain choices. Knowing that some women may make decisions based on little or misrepresented information confirms midwives are best placed in their interactions with women to provide positive influences, empowering them to make decisions based upon what they want for themselves. This affirms the woman and her midwife should remain partners in the decision-making process.
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29
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Qian K, Feng YG, Zhou JH, Wang RW, Tan QY, Deng B. Anxiety after Sympathectomy in patients with primary palmar hyperhidrosis may prolong the duration of compensatory hyperhidrosis. J Cardiothorac Surg 2018; 13:54. [PMID: 29859106 PMCID: PMC5984730 DOI: 10.1186/s13019-018-0736-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2018] [Accepted: 05/10/2018] [Indexed: 11/24/2022] Open
Abstract
Background Compensatory hyperhidrosis (CH) is a frequent side effect after sympathectomy for the treatment of primary palmar hyperhidrosis. We determined the effects of demographic and clinical factors which may increase the duration of CH (DCH). Methods One hundred twenty-two patients who had undergone sympathectomies from 2014 to 2016 were retrospectively reviewed. Anxiety was evaluated using the State and Trait Anxiety Inventory score. Follow-up evaluations continued until CH remitted. A Cox proportional hazards model was used to determine the association between DCH and variables. Results DCH ranged from 5 to 27 weeks (median, 11.47 weeks). Severe CH (HR = 0.318, 95% CI, 0.136–0.741) and exacerbated anxiety 1 month post-operatively (HR = 0.816, 95% CI, 0.746–0.893) may prolong CH. A positive correlation between post-operative anxiety and DCH was common in patients with moderate or severe CH, and in cases with forearm CH. Conclusions Pre- and post-operative anxiety should be evaluated, and anti-anxiety treatment is offered to patients with moderate-to-severe CH to shorten the DCH. Electronic supplementary material The online version of this article (10.1186/s13019-018-0736-3) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Kai Qian
- Department of Thoracic Surgery, Institute of Surgery Research, Daping Hospital, Army Medical University, Chongqing, 400042, People's Republic of China
| | - Yong-Geng Feng
- Department of Thoracic Surgery, Institute of Surgery Research, Daping Hospital, Army Medical University, Chongqing, 400042, People's Republic of China
| | - Jing-Hai Zhou
- Department of Thoracic Surgery, Institute of Surgery Research, Daping Hospital, Army Medical University, Chongqing, 400042, People's Republic of China
| | - Ru-Wen Wang
- Department of Thoracic Surgery, Institute of Surgery Research, Daping Hospital, Army Medical University, Chongqing, 400042, People's Republic of China
| | - Qun-You Tan
- Department of Thoracic Surgery, Institute of Surgery Research, Daping Hospital, Army Medical University, Chongqing, 400042, People's Republic of China.
| | - Bo Deng
- Department of Thoracic Surgery, Institute of Surgery Research, Daping Hospital, Army Medical University, Chongqing, 400042, People's Republic of China.
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30
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Falah-Hassani K, Shiri R, Dennis CL. The prevalence of antenatal and postnatal co-morbid anxiety and depression: a meta-analysis. Psychol Med 2017; 47:2041-2053. [PMID: 28414017 DOI: 10.1017/s0033291717000617] [Citation(s) in RCA: 186] [Impact Index Per Article: 26.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
To date, the precise prevalence of co-morbidity of anxiety and depression in the perinatal period is not well known. We aimed to estimate the prevalence of co-morbid anxiety and depression in the antenatal and postnatal periods. Systematic searches of multiple electronic databases were conducted for studies published between January 1950 and January 2016. We included 66 (24 published and 42 unpublished) studies incorporating 162 120 women from 30 countries. Prevalence of self-reported antenatal anxiety symptoms and mild to severe depressive symptoms was 9.5% [95% confidence interval (CI) 7.8-11.2, 17 studies, n = 25 592] and of co-morbid anxiety symptoms and moderate/severe depressive symptoms was 6.3% (95% CI 4.8-7.7, 17 studies, n = 27 270). Prevalence of a clinical diagnosis of any antenatal anxiety disorder and depression was 9.3% (95% CI 4.0-14.7, 10 studies, n = 3918) and of co-morbid generalized anxiety disorder and depression was 1.7% (95% CI 0.2-3.1, three studies, n = 3085). Postnatally between 1 and 24 weeks postpartum, the prevalence of co-morbid anxiety symptoms and mild to severe depressive symptoms was 8.2% (95% CI 6.5-9.9, 15 studies, n = 14 731), while co-morbid anxiety symptoms and moderate/severe depressive symptoms was 5.7% (95% CI 4.3-7.1, 13 studies, n = 20 849). The prevalence of a clinical diagnosis of co-morbid anxiety and depression was 4.2% (95% CI 1.9-6.6, eight studies, n = 3251). Prevalence rates did not differ with regard to year of publication, country income, selection bias and attrition bias. The results suggest that co-morbid perinatal anxiety and depression are prevalent and warrant clinical attention given the potential negative child developmental consequences if left untreated. Further research is warranted to develop evidence-based interventions for prevention, identification and treatment of this co-morbidity.
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Affiliation(s)
| | - R Shiri
- Finnish Institute of Occupational Health,Helsinki,Finland
| | - C-L Dennis
- University of Toronto,Toronto, ON,Canada
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31
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Aneja J, Chavan BS, Huria A, Goel P, Kohli N, Chhabra P. Perceived stress and its psychological correlates in pregnant women: an Indian study. ACTA ACUST UNITED AC 2017. [DOI: 10.1080/17542863.2017.1364284] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Jitender Aneja
- Department of Psychiatry, Government Medical College & Hospital, Chandigarh, India
| | - Bir Singh Chavan
- Department of Psychiatry, Government Medical College & Hospital, Chandigarh, India
| | - Anju Huria
- Department of Obstetrics & Gynaecology, Government Medical College & Hospital, Chandigarh, India
| | - Poonam Goel
- Department of Obstetrics & Gynaecology, Government Medical College & Hospital, Chandigarh, India
| | - Navneet Kohli
- Department of Psychiatry, Government Medical College & Hospital, Chandigarh, India
| | - Preeti Chhabra
- Department of Psychiatry, Government Medical College & Hospital, Chandigarh, India
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Cato K, Sylvén SM, Lindbäck J, Skalkidou A, Rubertsson C. Risk factors for exclusive breastfeeding lasting less than two months-Identifying women in need of targeted breastfeeding support. PLoS One 2017; 12:e0179402. [PMID: 28614419 PMCID: PMC5470694 DOI: 10.1371/journal.pone.0179402] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2016] [Accepted: 05/30/2017] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Breastfeeding rates in Sweden are declining, and it is important to identify women at risk for early cessation of exclusive breastfeeding. OBJECTIVE The aim of this study was to investigate factors associated with exclusive breastfeeding lasting less than two months postpartum. METHODS A population-based longitudinal study was conducted at Uppsala University Hospital, Sweden. Six hundred and seventy-nine women were included in this sub-study. Questionnaires were sent at five days, six weeks and six months postpartum, including questions on breastfeeding initiation and duration as well as several other background variables. The main outcome measure was exclusive breastfeeding lasting less than two months postpartum. Multivariable logistic regression analysis was used in order to calculate adjusted Odds Ratios (AOR) and 95% Confidence Intervals (95% CI). RESULTS Seventy-seven percent of the women reported exclusive breastfeeding at two months postpartum. The following variables in the multivariate regression analysis were independently associated with exclusive breastfeeding lasting less than two months postpartum: being a first time mother (AOR 2.15, 95% CI 1.32-3.49), reporting emotional distress during pregnancy (AOR 2.21, 95% CI 1.35-3.62) and giving birth by cesarean section (AOR 2.63, 95% CI 1.34-5.17). CONCLUSIONS Factors associated with shorter exclusive breastfeeding duration were determined. Identification of women experiencing emotional distress during pregnancy, as well as scrutiny of caregiving routines on cesarean section need to be addressed, in order to give individual targeted breastfeeding support and promote longer breastfeeding duration.
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Affiliation(s)
- Karin Cato
- Department of Women´s and Children´s Health, Uppsala University, Uppsala, Sweden
- * E-mail:
| | - Sara M. Sylvén
- Department of Neuroscience, Psychiatry, Uppsala University, Uppsala, Sweden
| | - Johan Lindbäck
- Uppsala Clinical Research Center, Uppsala University, Uppsala, Sweden
| | - Alkistis Skalkidou
- Department of Women´s and Children´s Health, Uppsala University, Uppsala, Sweden
| | - Christine Rubertsson
- Department of Women´s and Children´s Health, Uppsala University, Uppsala, Sweden
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33
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Koelewijn JM, Sluijs AM, Vrijkotte TGM. Possible relationship between general and pregnancy-related anxiety during the first half of pregnancy and the birth process: a prospective cohort study. BMJ Open 2017; 7:e013413. [PMID: 28490549 PMCID: PMC5623367 DOI: 10.1136/bmjopen-2016-013413] [Citation(s) in RCA: 51] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVES The rate of interventions during childbirth has increased dramatically during the last decades. Maternal anxiety might play a role in the progress of the labour process and interventions during labour. This study aimed to identify associations between anxiety in the first half of pregnancy and the birth process, including any interventions required during labour. In addition, differences in the associations by parity and ethnicity were explored. DESIGN Prospective cohort study. SETTING Primary care midwifery practices and secondary/tertiary care obstetric practices in Amsterdam, participating in the multiethnic ABCD (Amsterdam Born Children and their Development) study (participation rate 96%; response 8266/12 373 (67%)). PARTICIPANTS Included were women with singletons, alive at labour start, with a gestational age ≥24 weeks (n=6443). INDEPENDENT VARIABLE General anxiety (State-Trait Anxiety Inventory state) and pregnancy-related anxiety (Pregnancy-Related Anxieties Questionnaire (PRAQ)) were self-reported in the first half of pregnancy. OUTCOMES Associations between both forms of anxiety and several indicators of the birth process were analysed. Subgroup analyses were performed for parity and ethnicity. RESULTS The prevalence of high general anxiety (State-Trait Anxiety Inventory score ≥43) and pregnancy-related anxiety (PRAQ score ≥P90) were 30.9% and 11.0%, respectively. After adjustment, in nulliparae, both general anxiety and pregnancy-related anxiety were associated with pain relief and/or sedation (OR for general anxiety 1.23; 95% CI 1.02 to 1.48; OR for pregnancy-related anxiety 1.45; 95% CI 1.14 to 1.85). In multiparae, general anxiety was associated with induction of labour (OR 1.53; 95% CI 1.16 to 2.03) and pregnancy-related anxiety was associated with primary caesarean section (OR 1.66; 95% CI 1.02 to 2.70). Associations were largely similar for all ethnicities. CONCLUSIONS High levels of general and pregnancy-related anxiety in early pregnancy contribute modestly to more interventions during the birth process with similar associations between ethnic groups, but with some differences between nulliparae and multiparae.
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Affiliation(s)
- Johanna Maria Koelewijn
- Sanquin Research and Landsteiner Laboratory, Department of Experimental Immunohematology, University of Amsterdam, Amsterdam, The Netherlands
- Department of Obstetrics and Gynaecology, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - Anne Marie Sluijs
- Department of Obstetrics and Gynecology, Leiden University Medical Center, University of Leiden, Leiden, The Netherlands
| | - Tanja G M Vrijkotte
- Department of Public Health, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
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34
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Vandenbroucke T, Han SN, Van Calsteren K, Wilderjans TF, Van den Bergh BRH, Claes L, Amant F. Psychological distress and cognitive coping in pregnant women diagnosed with cancer and their partners. Psychooncology 2016; 26:1215-1221. [PMID: 27859911 DOI: 10.1002/pon.4301] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2016] [Revised: 09/07/2016] [Accepted: 10/31/2016] [Indexed: 11/05/2022]
Abstract
OBJECTIVE A cancer diagnosis during pregnancy may be considered as an emotional challenge for pregnant women and their partners. We aimed to identify women and partners at risk for high levels of distress based on their coping profile. METHODS Sixty-one pregnant women diagnosed with cancer and their partners filled out the Cognitive Emotion Regulation Questionnaire (CERQ) and the newly constructed Cancer and Pregnancy Questionnaire (CPQ). K-means cluster analysis was performed on the CERQ scales. Scores on the CPQ were compared between the women and their partners and between the CERQ-clusters. RESULTS Comparison of women and partners on the CPQ did not reveal significant differences on distress about the child's health, the cancer disease, and the pregnancy or on information satisfaction (P = .16, P = .44, P = .50, and P = .47, respectively). However, women were more inclined to maintain the pregnancy than their partners (P = .011). Three clusters were retrieved based on the CERQ scales, characterized by positive coping, internalizing coping, and blaming. Women and partners using internalizing strategies had significantly higher scores on concerns about the child's health (P = .039), the disease and treatment (P < .001), and the pregnancy and delivery (P = .009) compared with positive and blaming strategies. No cluster differences were found for information satisfaction (P = .71) and tendency to maintain the pregnancy (P = .35). CONCLUSION Women and partners using internalizing coping strategies deal with the highest levels of distress and may benefit from additional psychosocial support.
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Affiliation(s)
- Tineke Vandenbroucke
- Department of Oncology, KU Leuven-University of Leuven, Leuven, Belgium.,Gynecological Oncology, Department of Obstetrics and Gynecology, University Hospitals Leuven, Leuven, Belgium
| | - Sileny N Han
- Department of Oncology, KU Leuven-University of Leuven, Leuven, Belgium.,Gynecological Oncology, Department of Obstetrics and Gynecology, University Hospitals Leuven, Leuven, Belgium
| | - Kristel Van Calsteren
- Department of Development and Regeneration, KU Leuven-University of Leuven, Leuven, Belgium.,Department of Obstetrics and Gynecology, University Hospitals Leuven, Leuven, Belgium
| | - Tom F Wilderjans
- Methodology and Statistics Research Unit, Institute of Psychology, Faculty of Social and Behavioral Sciences, Leiden University, Leiden, The Netherlands.,Faculty of Psychology and Educational Sciences, KU Leuven-University of Leuven, Leuven, Belgium
| | - Bea R H Van den Bergh
- Faculty of Psychology and Educational Sciences, KU Leuven-University of Leuven, Leuven, Belgium.,Tilburg School of Social and Behavioral Sciences, Tilburg University, Tilburg, The Netherlands
| | - Laurence Claes
- Faculty of Psychology and Educational Sciences, KU Leuven-University of Leuven, Leuven, Belgium.,Faculty of Medicine and Mental Health (CAPRI), University of Antwerp, Antwerp, Belgium
| | - Frédéric Amant
- Department of Oncology, KU Leuven-University of Leuven, Leuven, Belgium.,Gynecological Oncology, Department of Obstetrics and Gynecology, University Hospitals Leuven, Leuven, Belgium.,Antoni van Leeuwenhoek, Netherlands Cancer Institute, Amsterdam, The Netherlands
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35
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Fontein-Kuipers YJ, Ausems M, de Vries R, Nieuwenhuijze MJ. The effect of Wazzup Mama?! An antenatal intervention to prevent or reduce maternal distress in pregnancy. Arch Womens Ment Health 2016; 19:779-88. [PMID: 26965708 DOI: 10.1007/s00737-016-0614-8] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2015] [Accepted: 02/29/2016] [Indexed: 10/22/2022]
Abstract
We evaluated the effect of the intervention WazzUp Mama?! on antenatal maternal distress in a non-randomized pre-post study including healthy women in 17 Dutch midwifery practices. The control group (n = 215) received antenatal care-as-usual. The experimental group (n = 218) received the intervention. Data were collected at the first and third trimester of pregnancy. Maternal distress (MD) was measured with the Edinburgh Depression Scale (EDS), State-Trait Anxiety Inventory (STAI), and Pregnancy-Related Anxiety Questionnaire (PRAQ). We used multivariate repeated-measure analysis to examine the across time changes and ANCOVA was used to examine the differences between the two groups. In the control group, mean EDS, STAI, and MD scores significantly increased from first to third trimester of pregnancy, mean PRAQ scores increased, but not significantly, the proportion of scores above cut-off level of EDS, STAI, and PRAQ significantly increased from first to third trimester, and the proportion of MD scores above cut-off level increased, but not significantly. Within the experimental group, the mean STAI, PRAQ, and MD scores significantly decreased from first to third trimester, the EDS mean scores decreased but not significantly, proportions of scores above cut-off level for PRAQ and MD significantly decreased from first to third trimester of pregnancy, the proportions of EDS and STAI scores above cut-off level decreased but not significantly. There was a moderate significant positive effect of WazzUP Mama?! on the MD scores (F(1.43) = 27.05, p < 0.001, d = 0.5). The results provide support for the effectiveness of the intervention WazzUp Mama?!
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Affiliation(s)
- Yvonne J Fontein-Kuipers
- Midwifery Education & Studies Maastricht-ZUYD, Research Centre for Midwifery Science, PO Box 1256, 6201, Maastricht, The Netherlands.
| | - Marlein Ausems
- Midwifery Education & Studies Maastricht-ZUYD, Research Centre for Midwifery Science, PO Box 1256, 6201, Maastricht, The Netherlands
| | - Raymond de Vries
- Midwifery Education & Studies Maastricht-ZUYD, Research Centre for Midwifery Science, PO Box 1256, 6201, Maastricht, The Netherlands.,Maastricht University Medical Centre/CAPHRI, PO Box 6202, AZ, Maastricht, The Netherlands.,Center for Bioethics and Social Sciences in Medicine, University of Michigan Medical School, 300 North Ingalis Street, Rm 7C27, Ann Arbor, MI, 48109-5429, USA
| | - Marianne J Nieuwenhuijze
- Midwifery Education & Studies Maastricht-ZUYD, Research Centre for Midwifery Science, PO Box 1256, 6201, Maastricht, The Netherlands
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