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Peterson L, Bridle L, Dasgupta T, Easter A, Ghobrial S, Ishlek I, Magee LA, Mansfield A, Panayotidis I, Rosen O'Sullivan H, Shangaris P, Banerjee A, Silverio SA. Oscillating autonomy: a grounded theory study of women's experiences of COVID-19 infection during pregnancy, labour and birth, and the early postnatal period. BMC Pregnancy Childbirth 2024; 24:511. [PMID: 39075436 PMCID: PMC11285433 DOI: 10.1186/s12884-024-06685-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2024] [Accepted: 07/08/2024] [Indexed: 07/31/2024] Open
Abstract
BACKGROUND Testing positive for COVID-19 was associated with higher rates of detrimental psycho-social and physical health outcomes. The COVID-19 pandemic caused unprecedented disruption to everyday life. This included major reconfiguration of maternal, child, and perinatal mental health and care services and provision. This study aimed to investigate the experiences of those who tested positive for COVID-19 during pregnancy, labour and birth, or the early postnatal period. METHODS National on-line recruitment from across the United Kingdom resulted in sixteen mothers being invited to qualitative semi-structured interviews to understand the experiences of mothers who had been infected by COVID-19 during pregnancy, labour and birth, or the early postnatal period. Interviews were conducted, recorded, and transcribed using video-conferencing software. A Grounded Theory approach was used to analyse the data gathered pertaining to women's experiences of their positive COVID-19 diagnosis during pregnancy, labour and birth, or the early postnatal period. RESULTS The theory of 'Oscillating Autonomy - Losing and Seeking to Regain Control by Striving for Agency' was developed, comprising three main themes: 'Anxious Anticipation: The fear of infection was worse than COVID-19 itself'; 'Fluctuating Agency: What changed when COVID-19 took control'; and 'Reclaiming Control: Seeking reassurance during COVID-19 positivity'. Testing positive for COVID-19 whilst pregnant, during labour or birth, or in the early postnatal period was associated with a perceived loss of control. Those who were able to regain that control felt more secure in their situation. CONCLUSIONS Support was paramount to manage increased vulnerability, as was reassurance achieved by information seeking and positive action including increased health monitoring and COVID-19 vaccination.
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Affiliation(s)
- Lili Peterson
- Department of Population Health Sciences, School of Life Course & Population Sciences, King's College London, London, UK
| | - Laura Bridle
- HELIX Service, Maternal Mental Health Services, King's College Hospital NHS Foundation Trust, London, UK
| | - Tisha Dasgupta
- Department of Women & Children's Health, School of Life Course & Population Sciences, King's College London, London, UK
| | - Abigail Easter
- Department of Women & Children's Health, School of Life Course & Population Sciences, King's College London, London, UK
| | - Stephanos Ghobrial
- General Internal Medicine, Royal Cornwall Hospital, Royal Cornwall Hospitals NHS Trust, Cornwall, UK
| | - Irem Ishlek
- Paediatric Services, Kingston Hospital, Kingston Hospital NHS Foundation Trust, London, UK
| | - Laura A Magee
- Department of Women & Children's Health, School of Life Course & Population Sciences, King's College London, London, UK
- Institute of Women and Children's Health, King's Health Partners, London, UK
| | | | - Ismini Panayotidis
- Maternity Services, Queen's Hospital, Havering and Redbridge University Hospitals NHS Trust, Barking, UK
| | - Hannah Rosen O'Sullivan
- Department of Women & Children's Health, School of Life Course & Population Sciences, King's College London, London, UK
- Maternity Services, St. Thomas' Hospital, Guy's and St, Thomas' NHS Foundation Trust, London, UK
| | - Panicos Shangaris
- Department of Women & Children's Health, School of Life Course & Population Sciences, King's College London, London, UK
- Maternity Services, St. Thomas' Hospital, Guy's and St, Thomas' NHS Foundation Trust, London, UK
| | - Anita Banerjee
- Department of Women & Children's Health, School of Life Course & Population Sciences, King's College London, London, UK
- Maternity Services, St. Thomas' Hospital, Guy's and St, Thomas' NHS Foundation Trust, London, UK
| | - Sergio A Silverio
- Department of Women & Children's Health, School of Life Course & Population Sciences, King's College London, London, UK.
- Institute of Women and Children's Health, King's Health Partners, London, UK.
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Sahebi A, Kheiry M, Abdi K, Qomi M, Golitaleb M. Postpartum depression during the COVID-19 pandemic: an umbrella review and meta-analyses. Front Psychiatry 2024; 15:1393737. [PMID: 39050914 PMCID: PMC11266160 DOI: 10.3389/fpsyt.2024.1393737] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2024] [Accepted: 06/18/2024] [Indexed: 07/27/2024] Open
Abstract
Introduction The COVID-19 pandemic has significantly increased anxiety, stress, and depression, which could have harmful consequences for pregnant women. Therefore, this study aimed to investigate the prevalence of postpartum depression during COVID-19 using an umbrella review and meta-analysis. Methods The current study followed the PRISMA guideline and utilized data from various sources such as PubMed, Scopus, Web of Science, and Google Scholar. The searches were conducted without a time limit until the end of May 2023. Meta-analysis was performed using the random effects model, heterogeneity was assessed using the I2 index, and publication bias was evaluated using Begg's test. Data analysis was carried out using STATA software (version 15). Results In this study, 243 articles were initially identified. Only meta-analysis studies that reported PPD during COVID-19 were included. After quality assessment, nine papers were selected for the meta-analysis stage. The study found that the prevalence postpartum depression (PPD) was 25.27% (95% CI = 23.66-27.86, I2 = 0.0%, p = 0.549). Conclusion The findings of this study revealed that the incidence of PPD during the COVID-19 pandemic was relatively high. To decrease mental health issues among pregnant and postpartum women, healthcare professionals should implement community programs aimed at preventing, promptly identifying, and providing appropriate intervention for pregnant women. This is crucial as pregnant women are particularly vulnerable to psychological distress during infectious disease outbreaks.
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Affiliation(s)
- Ali Sahebi
- Department of Medical Emergencies and Health in Disasters and Emergencies, Ilam University of Medical Sciences, Ilam, Iran
- Non-Communicable Diseases Research Center, Ilam University of Medical Sciences, Ilam, Iraq
| | - Maryam Kheiry
- Non-Communicable Diseases Research Center, Ilam University of Medical Sciences, Ilam, Iraq
| | - Kame Abdi
- Nursing Department, Faculty of Medicine, Komar University of Science and Technology, Sulimaniya, Kurdistan Region, Iraq
| | - Mahla Qomi
- Department of Nursing, Shazand School of Nursing, Arak University of Medical Sciences, Arak, Iran
| | - Mohamad Golitaleb
- Department of Critical Care Nursing, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran
- Department of Nursing, School of Nursing, Arak University of Medical Sciences, Arak, Iran
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Lockett M, Mash RJ. Lived experiences of women with spontaneous abortion at a district hospital, South Africa. S Afr Fam Pract (2004) 2024; 66:e1-e9. [PMID: 38708752 PMCID: PMC11079354 DOI: 10.4102/safp.v66i1.5917] [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: 01/29/2024] [Revised: 02/23/2024] [Accepted: 02/25/2024] [Indexed: 05/07/2024] Open
Abstract
BACKGROUND Spontaneous abortions occur in 12.5% of pregnancies and have a significant impact on the well-being of women. Dissatisfaction with health services is well-documented, but no studies have been conducted in district health services of the Western Cape. The aim was to explore the lived experiences of women presenting with spontaneous abortions to the emergency department at Helderberg Hospital. METHODS A descriptive phenomenological qualitative study used criterion-based purposive sampling to identify suitable participants. Data were collected through semi-structured individual interviews. Atlas-ti (version 22) software assisted with data analysis using the framework method. RESULTS A total of nine participants were interviewed. There were four main themes: a supportive environment, staff attitudes and behaviour, the impact of time, and sharing of information. The comfort, cleanliness and privacy of the environment were important. COVID-19 had also impacted on this. Showing interest, demonstrating empathy and being nonjudgemental were important, as well as the waiting time for definitive treatment and the time needed to assimilate and accept the diagnosis. In addition, the ability to give relevant information, explain the diagnosis and help patients share in decision-making were key issues. CONCLUSION This study highlighted the need for a more person-centred approach and managers should focus on changes to organisational culture through training and clinical governance activities. Attention should be paid to the physical environment, availability of patient information materials and sequential coordination of care with primary care services.Contribution: This study identifies issues that can improve person-centredness and women's satisfaction with care for spontaneous abortion.
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Affiliation(s)
- Marshall Lockett
- Division of Family Medicine and Primary Care, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town.
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Liepinaitienė A, Čirbaitė G, Stepanova J, Jotautis V, Dėdelė A. Women's experiences of childbirth during the COVID-19 pandemic in Lithuania. Eur J Midwifery 2024; 8:EJM-8-17. [PMID: 38660618 PMCID: PMC11040597 DOI: 10.18332/ejm/185750] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2023] [Revised: 12/23/2023] [Accepted: 03/07/2024] [Indexed: 04/26/2024] Open
Abstract
INTRODUCTION Childbirth experiences depend on environmental factors, the provision of qualified medical and non-medical care, and the woman's psychological well-being. Stress experienced during pregnancy and childbirth affects a woman's psychological well-being. The aim of this study was to determine the care of women who gave birth during the COVID-19 pandemic in Lithuania. METHODS This qualitative study used an interview method to reveal women's childbirth experiences during and before the pandemic in Lithuania. The data obtained during the interview were analyzed using qualitative content analysis. Interviews were taken from 15 women who gave birth at least twice, i.e. the first time until March 2020 (but not earlier than March 2019) and gave birth again during the COVID-19 pandemic (March 2020 - January 2021). RESULTS A total of 15 women participanted in the interviews. The experience of childbirth before the COVID-19 pandemic was seen as largely positive by women, but childbirth during the COVID-19 pandemic was mentioned as more complex and negative because of the challenges posed by the pandemic, but easier for other reasons not affected by the pandemic. The results of our study show that a higher proportion of women were satisfied with delivery care in hospitals, were happy, and praised the work of midwives and other staff, which mainly contributed to a positive experience. CONCLUSIONS The COVID-19 pandemic posed particular challenges to women's childbirth experiences, and not enough attention was paid to mental health. The stress that was exacerbated during the pandemic period had a profound impact on the pregnant woman in Lithuania.
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Affiliation(s)
- Alina Liepinaitienė
- Department of Environmental Sciences, Faculty of Natural Sciences, Vytautas Magnus University, Kaunas, Lithuania
- Faculty of Medicine, Kauno Kolegija Higher Education Institution, Kaunas, Lithuania
| | - Gabija Čirbaitė
- Faculty of Medicine, Kauno Kolegija Higher Education Institution, Kaunas, Lithuania
| | - Julijana Stepanova
- Faculty of Medicine, Kauno Kolegija Higher Education Institution, Kaunas, Lithuania
| | - Vaidas Jotautis
- Faculty of Medicine, Kauno Kolegija Higher Education Institution, Kaunas, Lithuania
| | - Audrius Dėdelė
- Department of Environmental Sciences, Faculty of Natural Sciences, Vytautas Magnus University, Kaunas, Lithuania
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Johnson MS, Skjerdingstad N, Ebrahimi OV, Hoffart A, Johnson SU. Fear of giving birth alone: Experiences of psychological distress, symptoms of anxiety and depression, and coping- strategies of childbearing women during COVID-19. Midwifery 2024; 131:103951. [PMID: 38402661 DOI: 10.1016/j.midw.2024.103951] [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: 02/10/2023] [Revised: 12/23/2023] [Accepted: 02/09/2024] [Indexed: 02/27/2024]
Abstract
BACKGROUND Psychological distress during pregnancy is a well-documented risk factor for adverse maternal outcomes. Distress related to the COVID-19 pandemic may further increase the vulnerability of pregnant women to negative mental health outcomes. AIM To explore the mental health experiences of pregnant women, focusing on mental health outcomes, challenges related to the pandemic, coping strategies, and factors buffering mental health factors during the restricted COVID-19 lockdown period. METHODS A mixed-methods survey study was conducted, examining symptoms of anxiety, depression, and burnout among 21 pregnant women. Qualitative data were gathered through open-ended questions about participants' experiences of challenges, coping strategies and buffering factors amid the pandemic. Symptoms of anxiety, depression and burnout were calculated, and qualitative data was thematically analyzed. RESULTS Approximately one-third (24 %) of the respondents reported clinically significant levels of depression, 19 % reported clinically significant levels of anxiety, and 43 % reported experiencing burnout. All participants reported distress and emotional burden, including fear, worry, stress and anxiety related to the pandemic. Specific concerns such as fear of giving birth alone, fear of the consequences due to lockdown restrictions, insufficient information, disruption of prenatal healthcare services, and fear of miscarriage were prevalent among the participants. Social support, financial stability, stable relationships, adherence to daily routines, reduced stress and social demands, a calmer daily life, physical activity, and less work-related stress including working from home, emerges as buffering factors that aided women in coping with pandemic-related distress. CONCLUSION Healthcare providers should prioritize stability, predictability, and minimizing disruptions to prenatal care. Broad-based screening is crucial to identify women at risk of depression, anxiety, and burnout. Recommendations for clinical pathways aimed at pregnant women are discussed.
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Affiliation(s)
- Miriam S Johnson
- Department of Behavioural Sciences, Oslo Metropolitan University, Oslo, Norway.
| | | | - Omid V Ebrahimi
- Department of Psychology, University of Oslo, Oslo, Norway; Modum Bad Psychiatric Hospital, Vikersund, Norway
| | - Asle Hoffart
- Department of Psychology, University of Oslo, Oslo, Norway; Modum Bad Psychiatric Hospital, Vikersund, Norway
| | - Sverre Urnes Johnson
- Department of Psychology, University of Oslo, Oslo, Norway; Modum Bad Psychiatric Hospital, Vikersund, Norway
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Sacchi C, Girardi P, Buri A, De Carli P, Simonelli A. The perinatal health secondary to pandemic: association between women's delivery concerns and infant's behavioral problems. J Reprod Infant Psychol 2024:1-16. [PMID: 38493474 DOI: 10.1080/02646838.2024.2330662] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Accepted: 03/09/2024] [Indexed: 03/19/2024]
Abstract
BACKGROUND COVID-19 pandemic characterised a unique and vulnerable social, emotional, and health environment for pregnancy, with potential long-lasting risks to maternal and child health outcomes. In women who were pregnant at the peak of COVID-19 pandemic, we investigated the association between pandemic-related concerns about pregnancy and delivery and both the parent's (i.e. maternal parenting stress) and the infant's (i.e. emotional-behavioral problems) outcomes 12 months after birth. METHODS A sample of 352 Italian pregnant women completed a web-based survey from 8 April to 4 May 2020 and a follow-up at 12 months after delivery. Maternal assessment in pregnancy covered prenatal measures for: pandemic-related concerns about pregnancy and childbirth, COVID-19 stressful events exposure, pandemic psychological stress, and mental-health symptoms (i.e. depression, anxiety). The 12 months' assessment covered post-partum measures of social support, parenting stress and maternal reports of infants' behavioral problems. RESULTS The results of the Quasi-Poisson regression models on the association between COVID-19 related influencing factors and parenting stress and infant's behavioral problems showed that the presence of higher pandemic-related concerns about pregnancy and childbirth scores was associated with greater total and internalising behavioral problems but not with parenting stress levels. CONCLUSION Perinatal mother-infant health has been sensitively threatened by pandemic consequences with maternal concerns about childbirth in pregnancy being associated with 12 months' children's behavioral outcomes. There is a need to invest in psychological support for perinatal women throughout the transition to parenthood to protect risk conditions before they get chronic or severe and influence offspring development.
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Affiliation(s)
- Chiara Sacchi
- Department of Developmental and Social Psychology, University of Padova, Padova, Italy
| | - Paolo Girardi
- Department of Environmental Sciences, Informatics and Statistics, Ca' Foscari University of Venice, Venezia, Italy
| | - Alice Buri
- Department of Developmental and Social Psychology, University of Padova, Padova, Italy
| | - Pietro De Carli
- Department of Psychology, University of Milano Bicocca, Milano, Italy
| | - Alessandra Simonelli
- Department of Developmental and Social Psychology, University of Padova, Padova, Italy
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Kusi Amponsah A, Boateng EA, Armah J, Dompim JK, Gyamfi D, Lomotey A, Annobil FA, Amankrah AE, Youshah RA, Beauty EU, Diji F, Bam V. The psychosocial experiences of pregnant women in the early stages of the COVID-19 pandemic: A retrospective qualitative study. PLoS One 2024; 19:e0299219. [PMID: 38416742 PMCID: PMC10901345 DOI: 10.1371/journal.pone.0299219] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Accepted: 02/05/2024] [Indexed: 03/01/2024] Open
Abstract
BACKGROUND Pregnant women are among the most vulnerable and suffer the most during pandemics, according to earlier studies. Pregnant women had to seek healthcare for both themselves and their unborn child(ren) in the wake of the COVID-19 pandemic, which was unprecedented. Pregnant women's psychosocial experiences during pandemics are crucial since they both directly and indirectly affect the course of pregnancy and childbirth. The study therefore sought to explore the psychosocial experiences of pregnant women during the COVID-19 pandemic. METHODS In this retrospective qualitative study, 15 nursing mothers who were attending a postnatal clinic at the Kwame Nkrumah University of Science and Technology (KNUST) hospital in Ghana were recruited. Individual interviews were conducted with mothers who were pregnant between March and December 2020. The audio-recorded interviews were transcribed verbatim and inductively analysed into themes. RESULTS Nursing mothers were aged 25-30 years and had infants ranging from 5 months to 15 months. Thirteen (13) were married and two were single. Two (2) major themes and five (5) subthemes emerged from the study. The unpleasant feelings connected to the potential for contracting COVID-19 and experiencing stress were described by the theme, "Fear and Stress". Participants' social experiences (support from significant others), alterations in daily routine and the economic impact because of the pandemic were presented as the "Socioeconomic impact". CONCLUSION Pregnant women go through several challenges during pregnancy such as perceived stress and anxiety. These are likely to heighten during a pandemic, as presented in the study. They therefore need emotional and psychosocial support in such uncertain times to improve outcomes of pregnancy.
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Affiliation(s)
- Abigail Kusi Amponsah
- Department of Nursing, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
- Department of Nursing Sciences, University of Turku, Turku, Finland
| | - Edward Appiah Boateng
- Department of Nursing, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Jerry Armah
- Department of Nursing, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Joana Kyei Dompim
- Department of Nursing, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Douglas Gyamfi
- Department of Nursing, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Alberta Lomotey
- Department of Nursing, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Faithful Adwoa Annobil
- Department of Nursing, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Amena Ekua Amankrah
- Department of Nursing, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Rifka Abdallah Youshah
- Department of Nursing, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Elizabeth Uzoka Beauty
- Department of Nursing, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Francis Diji
- Department of Obstetrics and Gynaecology, Komfo Anokye Teaching Hospital, Kumasi, Ghana
- St. Martins Catholic Hospital, Kumasi, Ghana
| | - Victoria Bam
- Department of Nursing, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
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Grech AM, Sharma S, Kizirian N, Gordon A. Impact of the COVID-19 pandemic on new parents enrolled in the 'BABY1000' birth cohort study in Sydney, Australia: A mixed-methods study. Aust N Z J Public Health 2024; 48:100127. [PMID: 38354625 DOI: 10.1016/j.anzjph.2024.100127] [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: 06/10/2023] [Revised: 12/12/2023] [Accepted: 12/20/2023] [Indexed: 02/16/2024] Open
Abstract
OBJECTIVE The COVID-19 pandemic was, and continues to be, uniquely experienced by women in the perinatal period and their families. Whilst long-term impacts of the pandemic are unknown, exposures in pregnancy and early life have impacts across the life-course and future generations. The objective of this manuscript was to explore how the pregnancy, postpartum and parenting experiences of a subset of participants from the 'BABY1000' cohort in Sydney, Australia, were affected by the COVID-19 pandemic, and explore associations between these experiences and state anxiety. METHODS Mixed methods were used. Participants were requested to complete an online survey including the State-Trait Anxiety Inventory short form (STAI-6), followed by an invitation to participate in focus group discussions (FGDs). RESULTS From September to November 2021, 88 parents completed the survey (mean age 33.5 years, 60% born in Australia, 58% primiparous). Twenty-two parents participated in FGDs. Six themes were identified regarding the experience of parents: (1) Maternal support, (2) Family relationships, (3) Stress and mental health, (4) Healthcare, (5) Family lifestyle and routine, and (6) Long-term impacts. The mean STAI-6 score was 40 (SD 12.3), representing high anxiety. High anxiety was significantly associated with concern regarding COVID-19 and feeling overburdened and lonely. CONCLUSIONS The COVID-19 pandemic and associated public health orders significantly impacted participants' pregnancy, postpartum and parenting experiences. Whilst these experiences included some unexpected positives, for many, these were outweighed by negative impacts on mental health, social support, health behaviours, and family relationships. IMPLICATIONS FOR PUBLIC HEALTH Ongoing longitudinal research is imperative to identify potential long-term effects of the pandemic across the life-course, better support families in the short and long-term, and plan for public health crises in the future.
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Affiliation(s)
- Allison Marie Grech
- The University of Sydney, Faculty of Medicine and Health, Central Clinical School, Sydney, Australia; Charles Perkins Centre, The University of Sydney, Sydney, Australia.
| | - Sweekriti Sharma
- The University of Sydney, Faculty of Medicine and Health, School of Public Health, Sydney Health Literacy Lab, Sydney, Australia; Institute for Musculoskeletal Health, The University of Sydney and Sydney Local Health District, Sydney, Australia
| | - Nathalie Kizirian
- The University of Sydney, Faculty of Medicine and Health, Central Clinical School, Sydney, Australia; Charles Perkins Centre, The University of Sydney, Sydney, Australia
| | - Adrienne Gordon
- The University of Sydney, Faculty of Medicine and Health, Central Clinical School, Sydney, Australia; Charles Perkins Centre, The University of Sydney, Sydney, Australia
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Yee S, Lindsay EA, Laszlo TL, Fine JL, Swanberg L, Librach CL. A qualitative analysis of gestational surrogates' healthcare experiences during the COVID-19 pandemic. Midwifery 2024; 128:103888. [PMID: 37995548 DOI: 10.1016/j.midw.2023.103888] [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: 01/19/2023] [Revised: 11/15/2023] [Accepted: 11/17/2023] [Indexed: 11/25/2023]
Abstract
OBJECTIVE No empirical data are available on the healthcare experiences of surrogates during the COVID-19 pandemic. This study aimed to examine the impact of pandemic-control measures on surrogates' fertility, pregnancy and birthing experiences. METHODS Sampling frame included eligible surrogates who were actively involved in a surrogacy process at an academic IVF centre during the pandemic (03/2020 to 02/2022). Data were collected between 29/04/2022 and 31/07/2022 using an anonymous 85-item online survey that included twelve open-ended questions. Free-text comments were analysed by thematic analysis. FINDINGS The response rate was 50.7% (338/667). Of the 320 completed surveys used for analysis, 609 comments were collected from 206 respondents. Twelve main themes and thirty-six sub-themes grouped under 'vaccination', 'fertility treatment', 'pregnancy care', and 'surrogacy birth' were identified. Three in five surrogates found the control measures highly or moderately affected their surrogacy experiences. Themes involving loneliness and isolation frequently emerged when essential surrogacy support was restricted by the visitor protocols implemented at healthcare facilities. DISCUSSION Our findings show that restricting or limiting intended parents' in-person involvement increased surrogates' feelings of isolation and made the overall surrogacy experience less rewarding and fulfilling. Furthermore, the childbirth experiences of surrogates were mostly negative, suggesting that hospitals were ill-equipped to manage all births, including surrogacy births, during the pandemic. IMPLICATIONS FOR PRACTICE Our findings highlight the needs to rethink how surrogacy care and maternity services could be strengthened to better serve the needs of surrogates during times of public health crises, such as COVID-19, while still allowing for risk mitigation and maximising patient safety.
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Affiliation(s)
- Samantha Yee
- CReATe Fertility Centre, 790 Bay Street, Suite 1100, Toronto, Ontario M5G 1N8, Canada.
| | - Emma A Lindsay
- CReATe Fertility Centre, 790 Bay Street, Suite 1100, Toronto, Ontario M5G 1N8, Canada; Department of Biomedical Sciences, University of Guelph, Guelph, Ontario, Canada
| | - Tali L Laszlo
- CReATe Fertility Centre, 790 Bay Street, Suite 1100, Toronto, Ontario M5G 1N8, Canada; Department of Health Sciences, Wilfrid Laurier University, Waterloo, Ontario, Canada
| | - Jacob L Fine
- CReATe Fertility Centre, 790 Bay Street, Suite 1100, Toronto, Ontario M5G 1N8, Canada; Department of Molecular Genetics, University of Toronto, Toronto, Ontario, Canada
| | - Leia Swanberg
- Canadian Fertility Consulting, Cobourg, Ontario, Canada
| | - Clifford L Librach
- CReATe Fertility Centre, 790 Bay Street, Suite 1100, Toronto, Ontario M5G 1N8, Canada; Faculty of Medicine, University of Toronto, Ontario, Canada; Department of Obstetrics and Gynecology, University of Toronto, Toronto, Ontario, Canada; Department of Obstetrics and Reproductive Endocrinology, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada; Department of Gynecology, Women's College Hospital, Toronto, Ontario, Canada
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Nieto-Tous M, Diaz-Martinez A, De-Arriba-García M, Roca-Prats A, Monfort-Beltrán S, Ivañez-Muñoz M, Alberola-Rubio J, Perales A, Monfort-Ortiz R. GESTACOVID Project: Psychological and Perinatal Effects in Spanish Pregnant Women Subjected to Strict Confinement Due to the COVID-19 Pandemic and Their Evolution during De-Escalation. J Clin Med 2023; 13:248. [PMID: 38202254 PMCID: PMC10779534 DOI: 10.3390/jcm13010248] [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: 11/27/2023] [Revised: 12/14/2023] [Accepted: 12/18/2023] [Indexed: 01/12/2024] Open
Abstract
The lockdown and de-escalation process following the COVID-19 pandemic led to a period of new normality. This study aimed to assess the confinement impact on the mental health of peripartum women, as their psychological well-being may be particularly vulnerable and thus affect their offspring's development. A cross-sectional epidemiological study was conducted among women who gave birth during strict confinement (G0) and the new normality period (G1), in which a self-administered paper-based questionnaire assessed 15 contextual factors and the General Health Questionnaire-12 (GHQ-12). For each item, it was verified whether the positive screening rate differed in each confinement phase, and a risk factor study was conducted. For G0, significantly higher positive screening and preterm birth rates were observed in the positive screening group. In the case of G1, maternal age (>35 years), decreased physical activity, and normal weight were found to be protective factors against distress. This study underscores the heightened mental health risk for postpartum women during major psychosocial upheavals (war, economic crisis, natural disasters, or pandemics), along with their resilience as the positive screening rate decreases with the new normality. Findings encourage adopting strategies to identify high-risk women and promote effective measures, such as promoting physical activity.
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Affiliation(s)
- Mar Nieto-Tous
- Departmento de Obstetricia y Ginecología, Hospital Universitari i Politècnic La Fe, 46026 Valencia, Spain (R.M.-O.)
| | - Alba Diaz-Martinez
- Centro de Investigación e Innovación en Bioingeniería, Universitat Politècnica de València, 46022 Valencia, Spain
| | | | - Alba Roca-Prats
- Departmento de Obstetricia y Ginecología, Hospital Universitari i Politècnic La Fe, 46026 Valencia, Spain (R.M.-O.)
| | - Sara Monfort-Beltrán
- Departmento de Obstetricia y Ginecología, Hospital Universitari i Politècnic La Fe, 46026 Valencia, Spain (R.M.-O.)
| | - María Ivañez-Muñoz
- Departmento de Obstetricia y Ginecología, Hospital Universitari i Politècnic La Fe, 46026 Valencia, Spain (R.M.-O.)
| | - José Alberola-Rubio
- Instituto de Investigación Sanitaria La Fe de Valencia, Hospital Universitari i Politècnic La Fe, 46026 Valencia, Spain
| | - Alfredo Perales
- Departmento de Obstetricia y Ginecología, Hospital Universitari i Politècnic La Fe, 46026 Valencia, Spain (R.M.-O.)
- Departamento de Pediatría, Obstetricia y Ginecología, Facultad de Medicina, Universitat de València, 46010 Valencia, Spain
| | - Rogelio Monfort-Ortiz
- Departmento de Obstetricia y Ginecología, Hospital Universitari i Politècnic La Fe, 46026 Valencia, Spain (R.M.-O.)
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11
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Fors M, González P, Jacho S, Mena-Tudela D, Falcón K. Unveiling the intersection: exploring obstetric violence in the Era of COVID-19 in Ecuador. BMC Public Health 2023; 23:2554. [PMID: 38129818 PMCID: PMC10734149 DOI: 10.1186/s12889-023-17300-4] [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: 07/31/2023] [Accepted: 11/22/2023] [Indexed: 12/23/2023] Open
Abstract
INTRODUCTION Changes to healthcare delivery organization that have occurred to protect people from the virus COVID-19 may have led to harmful consequences to pregnant women intensifying obstetric violence. Prevalence of obstetric violence in Ecuador is high with a range between 30 and 70% approximately. METHODS This cross-sectional study was performed with the participation of 1298 women who answered EPREVO questionnaire from June 2021 to January 2022. Obstetrics characteristics' relationship before and during COVID-19 were examined using Fisher exact test. RESULTS From 1598 respondents, 1284 (80.4%) gave birth before March 2020 Most of the participants (73.6%; CI:73.59-73.61) experienced obstetric violence during childbirth. Vaginal examination, enemas and genital shaving, episiotomy and cesarean section decreased significantly as well as rooming with the baby during the pandemic. Half of the women did not breastfeed the baby in the first hour but there were not statistically significant differences between giving birth before or during the infection from COVID-19. CONCLUSIONS Levels of obstetric violence in Ecuador remains high but without major differences due to the COVID-19 pandemic, however some harmful medical practices considered as obstetric violence decreased but maybe to the fear to be infected by the virus.
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Affiliation(s)
- Martha Fors
- One Health Group, Universidad de Las Américas, Avenida de los Granados, Vía a Nayón, Quito, Ecuador.
| | | | | | - Desirée Mena-Tudela
- Departamento de Enfermería, Instituto Feminista. Universitat Jaume I, Castelló de la Plana, Spain
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12
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Meister S, Dreyer EM, Hahn L, Thomann M, Keilmann L, Beyer S, Mayer C, Prins G, Hasbargen U, Mahner S, Jeschke U, Kolben T, Burges A. Risk of postpartum depressive symptoms is influenced by psychological burden related to the COVID-19 pandemic and dependent of individual stress coping. Arch Gynecol Obstet 2023; 308:1737-1748. [PMID: 36482113 PMCID: PMC9735014 DOI: 10.1007/s00404-022-06854-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2022] [Accepted: 11/06/2022] [Indexed: 12/13/2022]
Abstract
PURPOSE There are different studies worldwide, which have shown a higher risk of mental disorders due to the COVID-19 pandemic. One aim of this study was to identify influencing factors of the psychological burden related to the COVID-19 pandemic and the impact on the development of postpartum depression. Further, the role of individual stress and coping strategies was analyzed in this context. MATERIALS AND METHODS Between March and October 2020, 131 women in obstetric care at the LMU Clinic Munich completed a questionnaire at consecutive stages during their perinatal period. The times set for the questionnaire were before birth, 1 month, 2 months, and 6 months after birth. The questionnaire was designed to evaluate the psychological burden related to the COVID-19 pandemic. For this a modified version of the Stress and coping inventory (SCI) and the Edinburgh Postnatal Depression Scale (EPDS) was used. RESULTS We could show that the psychological burden related to the COVID-19 pandemic influenced the EPDS score 1, 2 and 6 months after birth. In addition, the prenatal stress and individual coping strategies affected the EPDS and the burden related to the COVID-19 pandemic before and after birth significantly. CONCLUSION An association of the psychological burden related to the COVID-19 pandemic with the risk of developing postpartum depressive symptoms could be shown in this study. In this context, the separation of the partner and the family was recognized as an important factor. Furthermore, the SCI was identified as an effective screening instrument for identifying mothers with an increased risk of postpartum depression. Hereby allowing primary prevention by early intervention or secondary prevention by early diagnosis.
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Affiliation(s)
- Sarah Meister
- Department of Obstetrics and Gynecology, University Hospital, LMU Munich, Marchioninistr. 15, 81377 Munich, Germany
| | - Eva-Maria Dreyer
- Department of Obstetrics and Gynecology, University Hospital, LMU Munich, Marchioninistr. 15, 81377 Munich, Germany
| | - Laura Hahn
- Department of Obstetrics and Gynecology, University Hospital, LMU Munich, Marchioninistr. 15, 81377 Munich, Germany
| | - Marilena Thomann
- Department of Obstetrics and Gynecology, University Hospital, LMU Munich, Marchioninistr. 15, 81377 Munich, Germany
| | - Lucia Keilmann
- Department of Obstetrics and Gynecology, University Hospital, LMU Munich, Marchioninistr. 15, 81377 Munich, Germany
| | - Susanne Beyer
- Department of Obstetrics and Gynecology, University Hospital, LMU Munich, Marchioninistr. 15, 81377 Munich, Germany
| | - Clarissa Mayer
- Faculty of Psychology, University Würzburg, Würzburg, Germany
| | - Gwendolin Prins
- Faculty of Humanities and Social Sciences, University of Augsburg, Augsburg, Germany
| | - Uwe Hasbargen
- Department of Obstetrics and Gynecology, University Hospital, LMU Munich, Marchioninistr. 15, 81377 Munich, Germany
| | - Sven Mahner
- Department of Obstetrics and Gynecology, University Hospital, LMU Munich, Marchioninistr. 15, 81377 Munich, Germany
| | - Udo Jeschke
- Department of Obstetrics and Gynecology, University Hospital, LMU Munich, Marchioninistr. 15, 81377 Munich, Germany
- Department of Gynecology and Obstetrics, University Hospital Augsburg, 86156 Augsburg, Germany
| | - Thomas Kolben
- Department of Obstetrics and Gynecology, University Hospital, LMU Munich, Marchioninistr. 15, 81377 Munich, Germany
| | - Alexander Burges
- Department of Obstetrics and Gynecology, University Hospital, LMU Munich, Marchioninistr. 15, 81377 Munich, Germany
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Brandibur TE, Kundnani NR, Boia M, Nistor D, Velimirovici DM, Mada L, Manea AM, Boia ER, Neagu MN, Popoiu CM. Does COVID-19 Infection during Pregnancy Increase the Appearance of Congenital Gastrointestinal Malformations in Neonates? Biomedicines 2023; 11:3105. [PMID: 38137326 PMCID: PMC10740856 DOI: 10.3390/biomedicines11123105] [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: 10/21/2023] [Revised: 11/14/2023] [Accepted: 11/16/2023] [Indexed: 12/24/2023] Open
Abstract
BACKGROUND COVID-19 was an infection that was capable of bringing the entire world to a standstill position within a period of days to months. Despite the advancements in the medical sector, the contagion was difficult to control and costed the lives of millions of people worldwide. Many short- and long-term effects are witnessed even to date in people that contracted the disease. Pregnant females had to suffer not only the devastating effects of the virus, but also the psycho-social impact of the lockdown. The impact of COVID-19 infection during pregnancy causing decreased antenatal care or hypoxemic episodes due to severe respiratory distress and whether it could lead to the appearance of congenital gastrointestinal malformation in neonates is still unclear. The aim of our study was to analyze if COVID-19 infection during pregnancy could increase the incidence of gastric malformations in neonates born from these women. MATERIALS AND METHODS We sifted the files of all neonates admitted into our hospital between January 2022 and December 2022, and based on inclusion and exclusion criteria, we included the cases having gastrointestinal congenital malformations during the COVID-19 pandemic. We performed a single-center, retrospective, observational descriptive study. We further divided the patients based on the anatomical location of the malformation. We also took down details of the evolution of pregnancy and whether the mother had contracted a SARS-CoV-2 infection during the pregnancy. Details regarding the Apgar score, days of intensive care admission, sex, and nutrition were the key findings studied. RESULTS A total of 47 neonates were found to have digestive anomalies, among which, based on the anatomical locations, the number of malformation cases found at the level of the esophagus were 15, while 16 occurred at the level of the pylorus; we found 12 cases of malformation of the duodenum, and four cases had malformation of the rectum. Out of these 47 neonates, 38.3% were females and 61.7% were males. A total of 58% were preemies, among which 9% had intra-uterine growth retardation (IUGR), and 42% were full-term newborns, among which 4% had intra-uterine growth retardation (IUGR). A total of 45% of the births were primiparous pregnancies and 55% were from multiparous females. A total of 14 mothers were found to have tested positive for COVID-19 during the course of pregnancy (p-value = 0.23); many had mild symptoms but were not tested. CONCLUSIONS COVID-19 can affect the wellbeing of the pregnant female and their fetus. Larger studies can help gain extensive knowledge as to whether COVID-19 also has the potential to result in congenital gastrointestinal anomalies in children born from COVID-19 positive mothers. In our study, only a few infants born with this pathology were found to be born from COVID-19 positive mothers. Hence, it is difficult to conclude or exclude a direct correlation between the infection and the congenital malformations.
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Affiliation(s)
- Timea Elisabeta Brandibur
- Department of Neonatology and Puericulture, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania
- Department of Neonatology and Puericulture, “Louis Ţurcanu” Children Emergency Hospital, 300011 Timisoara, Romania
| | - Nilima Rajpal Kundnani
- Discipline of Internal Medicine and Ambulatory Care, Prevention and Cardiovascular Recovery, Department of Cardiology, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania;
| | - Marioara Boia
- Department of Neonatology and Puericulture, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania
- Department of Neonatology and Puericulture, “Louis Ţurcanu” Children Emergency Hospital, 300011 Timisoara, Romania
| | - Daciana Nistor
- Discipline of Physiology, Department of Functional Sciences, Physiology, Center of Immuno-Physiology and Biotechnologies (CIFBIOTEH), “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania;
- Centre for Gene and Cellular Therapies in Cancer, 300723 Timisoara, Romania
| | - Daniel Milan Velimirovici
- Doctoral School, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania (L.M.)
| | - Leonard Mada
- Doctoral School, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania (L.M.)
- Syonic SRL, 300254 Timisoara, Romania
| | - Aniko Maria Manea
- Department of Neonatology and Puericulture, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania
- Department of Neonatology and Puericulture, “Louis Ţurcanu” Children Emergency Hospital, 300011 Timisoara, Romania
| | - Eugen Radu Boia
- Department of Oto-Rhino-Laryngology, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania
| | - Marioara Nicula Neagu
- Discipline of Physiology, Faculty of Bioengineering of Animal Resources, University of Life Sciences “King Mihai I”, 300645 Timisoara, Romania
| | - Calin Marius Popoiu
- Department XI of Pediatric Surgery, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania;
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Muñoz-Vela FJ, Fernández-Carrasco FJ, Gómez-Salgado J, Allande-Cussó R, Marques Monteiro Dias Mendes IM, Martins Teixeira-da-Costa EI, Vázquez-Lara JM, Fagundo-Rivera J, Rodríguez-Díaz L. Assessment of Levels of Anxiety and Fear of Covid-19 in a Population of Pregnant Women in Spain. Psychol Res Behav Manag 2023; 16:4665-4676. [PMID: 38024653 PMCID: PMC10660725 DOI: 10.2147/prbm.s432792] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Accepted: 10/14/2023] [Indexed: 12/01/2023] Open
Abstract
Objective The aim of the study was to assess the levels of fear and anxiety in the particularly vulnerable population group of women during pregnancy. Methods Cross-sectional study between March 2022 and July 2022 involving 978 pregnant women aged 16 to 50 years. It was carried out based on the scale for the assessment of fear and anxiety in pregnant women (AMICO_Pregnant) and the collection of sociodemographic data. Normality analysis was performed prior to univariate and bivariate statistical analysis. Results The sample was composed of a total of 978 pregnant women. The mean of the AMICO_Pregnant scale was intermediate (5.04 points; SD=2.36). The bivariate analysis showed a statistically significant relationship between the AMICO_Pregnant scale and the following variables: vaccination schedule status, contact with the disease, weeks of gestation, altered delivery or birth plan. Conclusion Women with pregnancies closer to term, with no contact with the disease, without a complete vaccination schedule, or who had undergone changes in their delivery or birth plans, showed higher levels of fear and anxiety.
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Affiliation(s)
- Francisco Javier Muñoz-Vela
- Department of Nursing, Faculty of Health Sciences, University of Málaga, Málaga, Spain
- Obstetrics and Gynecology Area, Hospital Regional Universitario de Málaga, Málaga, Spain
| | | | - Juan Gómez-Salgado
- Department of Sociology, Social Work and Public Health, Faculty of Labour Sciences, University of Huelva, Huelva, Spain
- Safety and Health Postgraduate Programme, Universidad Espíritu Santo, Guayaquil, Ecuador
| | | | | | - Emilia Isabel Martins Teixeira-da-Costa
- Department of Nursing, Health School, University of Algarve, Faro, Portugal
- Health Sciences Research Unit: Nursing, Escola Superior de Enfermagem de Coimbra, Coimbra, Portugal
| | - Juana María Vázquez-Lara
- Department of Gynaecology and Obstetrics, Ceuta University Hospital, Midwifery Teaching Unit of Ceuta, University of Granada, Ceuta, Spain
| | | | - Luciano Rodríguez-Díaz
- Department of Gynaecology and Obstetrics, Ceuta University Hospital, Midwifery Teaching Unit of Ceuta, University of Granada, Ceuta, Spain
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15
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Barat S, Ghanbarpour A, Mirtabar SM, Kheirkhah F, Basirat Z, Shirafkan H, Hamidia A, Khorshidian F, Hosseini Talari D, Pahlavan Z, Esmaelzadeh S, Buzari Z, Zeynalzadeh M, Charati SY, Shafizade F, Adnani M, Amirkhanloo F, Mollaalipour M, Kani AC, Amiri M, Khazaei R, Mehdinia SS, Basirat F, Asadollahi S, Khodami A, Azizi A, Nasiri-Amiri F, Fatery N, Shahrokhi S, Zarinkamar B, Aligoltabar S, Faramarzi M. Psychological distress in pregnancy and postpartum: a cross-sectional study of Babol pregnancy mental health registry. BMC Pregnancy Childbirth 2023; 23:793. [PMID: 37964209 PMCID: PMC10648632 DOI: 10.1186/s12884-023-06024-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Accepted: 09/23/2023] [Indexed: 11/16/2023] Open
Abstract
BACKGROUND Psychological distress (PD) is a significant issue during pregnancy and postpartum, adversely affecting both children and mothers. This study aims to determine PD's prevalence and risk factors in a large Iranian population sample during pregnancy and postpartum. METHODS A cross-sectional study was conducted using data from the Babol Pregnancy Mental Health Registry (located in the north of Iran) between June 2020 and March 2021. A total of 2305 women were included, with 1639 during pregnancy and 666 during postpartum. Psychological distress was assessed using the Brief Symptoms Inventory (BSI-18), and data were analyzed using independent t-tests and multiple logistic regressions. RESULTS The prevalence of psychological distress, defined by a cut-off score of BSI ≥ 13, was 19% during pregnancy and 15% during postpartum. Multivariate logistic analysis revealed that high-risk pregnancy was the leading risk factor for psychological distress during the antenatal period (β = 1.776, P < 0.001), as well as its three subscales: somatization (β = 1.355, P = 0.019), anxiety symptoms (β = 2.249, P < 0.001), and depressive symptoms (β = 1.381, P = 0.028). Additionally, women with a gestational age < 20 weeks had a higher risk of psychological distress (β = 1.344, P = 0.038) and the somatization subscale (β = 1.641, P < 0.001). During the postpartum period, women residing in urban areas were at higher risk of psychological distress (β = 1.949, P = 0.012), as well as two subscales: anxiety symptoms (β = 1.998, P = 0.012) and depressive symptoms (β = 1.949, P = 0.020). CONCLUSION The high prevalence of psychological distress emphasizes detecting and treating PD during pregnancy and postpartum, particularly in women with high-risk pregnancies. This study suggests that obstetricians and midwives should implement programs to identify women experiencing psychological distress during early pregnancy through postpartum visits.
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Affiliation(s)
- Shahnaz Barat
- Department of Obstetrics and Gynecology, Infertility and Reproductive Health Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
| | - Azita Ghanbarpour
- Department of Obstetrics and Gynecology, Health Research Institute, Rouhani Hospital, Babol University of Medical Sciences, Babol, Iran
| | - Seyyedeh Mahboubeh Mirtabar
- Research Clinical Psychology, Student Research Committee, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
| | - Farzan Kheirkhah
- Department of Psychiatry, Social Determinants of Health Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
| | - Zahra Basirat
- Department of Obstetrics and Gynecology, Infertility and Reproductive Health Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
| | - Hoda Shirafkan
- Social Determinants of Health Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
| | - Angela Hamidia
- Department of Psychiatry, Social Determinants of Health Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
| | - Faezeh Khorshidian
- Department of Psychiatry, Social Determinants of Health Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
| | - Davood Hosseini Talari
- Department of Psychiatry, Social Determinants of Health Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
| | - Zeynab Pahlavan
- Department of Midwifery, School of Nursing and Midwifery,Infertility and Reproductive Health Research Center, Reproductive Health, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
| | - Sedigheh Esmaelzadeh
- Department of Obstetrics and Gynecology, Infertility and Reproductive Health Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
| | - Zinatosadat Buzari
- Department of Obstetrics and Gynecology, Infertility and Reproductive Health Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
| | - Mahtab Zeynalzadeh
- Department of Obstetrics and Gynecology, Infertility and Reproductive Health Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
| | - Shahla Yazdani Charati
- Department of Obstetrics and Gynecology, Infertility and Reproductive Health Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
| | - Fatemeh Shafizade
- Department of Obstetrics and Gynecology, Health Research Institute, Rouhani Hospital, Babol University of Medical Sciences, Babol, Iran
| | - Mahsima Adnani
- Department of Obstetrics and Gynecology, Health Research Institute, Rouhani Hospital, Babol University of Medical Sciences, Babol, Iran
| | - Fatemeh Amirkhanloo
- Department of Obstetrics and Gynecology, Health Research Institute, Rouhani Hospital, Babol University of Medical Sciences, Babol, Iran
| | - Maedeh Mollaalipour
- Department of Obstetrics and Gynecology, Health Research Institute, Rouhani Hospital, Babol University of Medical Sciences, Babol, Iran
| | - Atieh Chale Kani
- Department of Obstetrics and Gynecology, Health Research Institute, Rouhani Hospital, Babol University of Medical Sciences, Babol, Iran
| | - Mania Amiri
- Department of Obstetrics and Gynecology, Health Research Institute, Rouhani Hospital, Babol University of Medical Sciences, Babol, Iran
| | - Razieh Khazaei
- Department of Obstetrics and Gynecology, Health Research Institute, Rouhani Hospital, Babol University of Medical Sciences, Babol, Iran
| | - Seyedeh Shabnam Mehdinia
- Department of Obstetrics and Gynecology, Health Research Institute, Rouhani Hospital, Babol University of Medical Sciences, Babol, Iran
| | - Fatemeh Basirat
- Department of Obstetrics and Gynecology, Health Research Institute, Rouhani Hospital, Babol University of Medical Sciences, Babol, Iran
| | - Simin Asadollahi
- Department of Obstetrics and Gynecology, Health Research Institute, Rouhani Hospital, Babol University of Medical Sciences, Babol, Iran
| | - Asieh Khodami
- Department of Obstetrics and Gynecology, Health Research Institute, Rouhani Hospital, Babol University of Medical Sciences, Babol, Iran
| | - Alireza Azizi
- Department of Psychiatry, Social Determinants of Health Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
| | - Fatemeh Nasiri-Amiri
- Department of Midwifery, School of Nursing and Midwifery,Infertility and Reproductive Health Research Center, Reproductive Health, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
| | - Nooshin Fatery
- Midwifery, Clinical Research Development Unit of Rohani Hospital, Health Research, Institute, Babol University of Medical Sciences, Babol, Iran
| | - Shirin Shahrokhi
- Clinical Psychology, Student Reasearch Committee, Behshahr Azad University, Behshahr, Iran.
| | - Banafshe Zarinkamar
- Clinical Psychology, Clinical Research Development Unit of Shahid Yahya Nejad, Health Research Institute, Babol University of Medical Sciences, HospitalBabol, Iran
| | - Sajedeh Aligoltabar
- Midwifery, Student Reasearch Committee, Babol University of Medical Sciences, Babol, Iran
| | - Mahbobeh Faramarzi
- Department of General Courses, Social Determinants of Health Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran.
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Corno G, Villani D, de Montigny F, Pierce T, Bouchard S, Molgora S. The role of perceived social support on pregnant women's mental health during the COVID-19 pandemic. J Reprod Infant Psychol 2023; 41:488-502. [PMID: 35196188 DOI: 10.1080/02646838.2022.2042799] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2021] [Accepted: 02/09/2022] [Indexed: 02/08/2023]
Abstract
PURPOSE The present study aimed at investigating which sources of social support best account for pregnant women's levels of psychological distress and mental well-being during the COVID-19 pandemic. METHODS 274 Italian and Canadian expectant mothers completed an online-based survey including measures of perceived social support (from family, significant other and friends), state anxiety, depressive symptoms, and satisfaction with life. Correlation analyses and amultivariate analysis of covariance were performed to explore how social support from different sources was related to depressive symptoms, state anxiety and satisfaction with life. RESULTS Different sources of social support contributed to explaining women's psychological distress and mental well-being. Social support both from family and friends was significantly related to women's state anxiety and depressive symptoms. Social support from friends was specifically related to women's satisfaction with life. CONCLUSION Our findings endorse the crucial role of perceived social support as a protective factor for pregnant women's mental health. In the context of the COVID-19 pandemic, our results suggest that support from family seems important in preventing psychological distress, whereas support from friends is also associated with mental well-being. These results may help designing future interventions aimed at improving women's perinatal mental health in life-threatening conditions.
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Affiliation(s)
- Giulia Corno
- Department of Psychoeducation and Psychology, Université du Québec en Outaouais, Gatineau, QC, Canada
| | - Daniela Villani
- Department of Psychology, Catholic University of the Sacred Heart, Milan, Italy
| | - Francine de Montigny
- Department of Nursey Sciences, Université du Québec en Outaouais, Gatineau, QC, Canada
| | - Tamarha Pierce
- School of Psychology, Université Laval, Laval, QC, Canada
| | - Stéphane Bouchard
- Department of Psychoeducation and Psychology, Université du Québec en Outaouais, Gatineau, QC, Canada
| | - Sara Molgora
- Department of Psychology, Catholic University of the Sacred Heart, Milan, Italy
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17
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Mazuchová L, Murínová M, Kelčíková S, Maskálová E, Malinovská N. Predictors Related to Quality of Life in Pregnant Women. IRANIAN JOURNAL OF PUBLIC HEALTH 2023; 52:2109-2116. [PMID: 37899923 PMCID: PMC10612566 DOI: 10.18502/ijph.v52i10.13849] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/10/2022] [Accepted: 09/16/2022] [Indexed: 10/31/2023]
Abstract
Background Assessment of quality of life (QoL) during pregnancy can be a starting point for streamlining and promoting the humanization of evidence-based healthcare. We aimed to determine the life quality in pregnant women and its predictors. Methods A cross-sectional study was conducted on pregnant women from Slovakia from March 2020 to January 2021. A method of purposive sampling was used. The research sample consisted of 393 women (age 29.11±4.65) with physiological pregnancy. Questionnaire method was used. The first part of the questionnaire consisted of a set of questions focused on identification items, which also represented the investigated predictors. The second part was the standardized questionnaire "Quality Of Life-Gravidity Questionnaire"(QOLGRAV), with Cronbach's alpha value of 0.74. The received data were analysed using descriptive and inferential statistics. Results The average life quality score was 18.79±5.04, which oscillates at the level of very good life quality. The lower life quality was recorded in connection with physical changes, satisfaction with social life, concerns about childbirth management failure and a need for physical activity reduction. Education (P=0.008), course of pregnancy (P=0.001), support from healthcare professionals (P=0.003) and concerns about COVID-19 (P=0.001) were the predictors of life quality. Conclusion The proven significant predictors of life quality of pregnant women have shown that healthcare professionals should pay increased attention to the pregnant women with higher education and with problematic pregnancy, positively support and motivate pregnant women and be even more attentivedue to the current COVID-19 pandemic.
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Affiliation(s)
- Lucia Mazuchová
- Department of Midwifery, Jessenius Faculty of Medicine in Martin, Comenius University, Bratislava, Slovakia
| | - Mária Murínová
- Department of Midwifery, Jessenius Faculty of Medicine in Martin, Comenius University, Bratislava, Slovakia
| | - Simona Kelčíková
- Department of Midwifery, Jessenius Faculty of Medicine in Martin, Comenius University, Bratislava, Slovakia
| | - Erika Maskálová
- Department of Midwifery, Jessenius Faculty of Medicine in Martin, Comenius University, Bratislava, Slovakia
| | - Nora Malinovská
- Department of Foreign Languages, Jessenius Faculty of Medicine in Martin, Comenius University, Bratislava, Slovakia
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Obasanya M, Igenoza O, Gupta S, McElroy K, Brannon GE, Brown K. Racial and Ethnic Differences in Maternal and Child COVID-19 Vaccination Intent Among Pregnant and Postpartum Women in the USA (April-June 2020): an Application of Health Belief Model. J Racial Ethn Health Disparities 2023; 10:2540-2551. [PMID: 36352345 PMCID: PMC9645740 DOI: 10.1007/s40615-022-01434-z] [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: 07/06/2022] [Revised: 09/17/2022] [Accepted: 10/21/2022] [Indexed: 11/10/2022]
Abstract
This study investigated racial/ethnic differences in pregnant and postpartum women's intentions to receive the COVID-19 vaccination (maternal COVID-19 vaccination intent) and intentions to vaccinate their children against COVID-19 (child COVID-19 vaccination intent) during the early months of the COVID-19 pandemic (April-June 2020). This study also assessed Health Belief Model constructs to examine their influence on maternal and child COVID-19 vaccination intent by race/ethnicity. This study includes 489 US pregnant and postpartum women (18-49 years) recruited via Prolific Academic to complete a 55-item cross-sectional online survey. Crude and adjusted logistic regression analyses were conducted to determine the associations between race/ethnicity, maternal COVID-19 vaccination intent, and child COVID-19 vaccination intent. Among pregnant women, the odds of maternal COVID-19 vaccination intent (aOR = 2.20, 95% CI: .862, 5.61) and child COVID-19 vaccination intent (aOR = .194, 95% CI: .066, .565) among NH Black women were statistically significantly lower than that of NH White women after adjustment for demographic, health, and health belief model variables. Among postpartum women, although some racial differences in maternal or child COVID-19 vaccination intent were observed, these differences were not statistically significant in unadjusted and adjusted models. The findings have implications for future research and interventions which should adopt a racial health equity lens and identify strategies grounded in institutional trustworthiness and systems perspectives to address racial/ethnic disparities in COVID-19 vaccination intent among pregnant and postpartum women during novel pandemics.
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Affiliation(s)
- Mercy Obasanya
- Department of Kinesiology, College of Nursing and Health Innovation, University of Texas at Arlington, 500 W. Nedderman Drive, Arlington, TX, 76019, USA
| | | | | | - Kristin McElroy
- Maternal and Child Health Epidemiologist, Division of Epidemiology and Health Information, Tarrant County Public Health, 1101 S. Main Street, Fort Worth, TX, 76104, USA
| | - Grace E Brannon
- Department of Communication, College of Liberal Arts, University of Texas at Arlington, 700 W. Greek Row Drive, Arlington, TX, 76019, USA
| | - Kyrah Brown
- Department of Kinesiology, College of Nursing and Health Innovation, University of Texas at Arlington, 500 W. Nedderman Drive, Arlington, TX, 76019, USA.
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Ravaldi C, Mosconi L, Bonaiuti R, Vannacci A. The Emotional Landscape of Pregnancy and Postpartum during the COVID-19 Pandemic in Italy: A Mixed-Method Analysis Using Artificial Intelligence. J Clin Med 2023; 12:6140. [PMID: 37834784 PMCID: PMC10573687 DOI: 10.3390/jcm12196140] [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: 09/05/2023] [Revised: 09/19/2023] [Accepted: 09/21/2023] [Indexed: 10/15/2023] Open
Abstract
The COVID-19 pandemic affected the perinatal emotional landscape in Italy, a country that had high mortality and implemented a strict lockdown during the pandemic. This study explores the emotions and challenges of pregnant and postpartum women during the pandemic, using AI-based mixed methods. The study analyzed 1774 women from the national survey COVID-ASSESS: 1136 pregnant and 638 postpartum women. The survey had qualitative questions on emotions and feelings related to birth, communication with healthcare professionals, media, and peers and family. We used natural language processing and machine learning to classify emotions, identify themes, and extract citations from the data. Fear and anxiety replaced joy as dominant emotions during the pandemic: trust and joy decreased by 49.3% and 36.4%, respectively, while sadness and fear increased by 52.3% and 49.3%, respectively. The pandemic also induced loneliness, isolation, frustration, and anger. Women faced challenges related to birth, communication with HCPs, media, and peers and family. They also used coping strategies such as self-care, news limitation, and trying to cultivate gratitude and hope. This study provides a comprehensive exploration of the perinatal emotional landscape of Italian women during the pandemic. The findings underscore the significant psychological impact of the pandemic and also highlight women's resilience and coping strategies.
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Affiliation(s)
| | | | | | - Alfredo Vannacci
- PeaRL—Perinatal Research Laboratory, CiaoLapo Foundation, Department of Neurosciences, Psychology, Drug Research and Child Health, University of Florence, 50121 Florence, Italy; (C.R.); (L.M.); (R.B.)
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20
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Muñoz-Vela FJ, Rodríguez-Díaz L, Fernández-Carrasco FJ, Allande-Cussó R, Vázquez-Lara JM, Fagundo-Rivera J, Gómez-Salgado J. Adaptation and psychometric study of the scale for the measurement of fear and anxiety of COVID-19 disease in pregnant women (AMICO_Pregnant). Front Public Health 2023; 11:1225822. [PMID: 37809001 PMCID: PMC10552539 DOI: 10.3389/fpubh.2023.1225822] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2023] [Accepted: 09/01/2023] [Indexed: 10/10/2023] Open
Abstract
Objective The aim of this research was to adapt and explore the psychometric properties of a specific scale to assess the levels of fear and anxiety of COVID-19 disease in pregnant women. Methods An adaptation phase, by a panel of experts, and a psychometric descriptive cross-sectional study were carried out on the final version of the 16-item, self-administered AMICO_Pregnant scale. Univariate and bivariate analyses were carried out, followed by exploratory factor analysis (EFA) and confirmatory factor analysis (CFA). The consistency of the scale was assessed using the Omega coefficient and Cronbach's Alpha. Results With a sample of 1,013 pregnant women living in Spain and over 18 years of age, the mean age was 33 years. The scale showed a bifactor structure (anxiety and fear) that was confirmed with good fit parameters. Reliability was assessed in terms of internal consistency by calculating Cronbach's Alpha coefficient (0.95) and McDonald's Omega coefficient (0.94) as indicators of robustness of the scale's reliability. Conclusion The AMICO_Pregnant scale of 16 items with scores ranging from 1 to 10 is a valid and reliable tool to assess levels of anxiety and fear of COVID_19 in Spanish pregnant women. Pregnant women have shown moderate levels of anxiety and fear regarding the COVID_19 disease in the final phase of the pandemic.
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Affiliation(s)
- Francisco Javier Muñoz-Vela
- Department of Nursing, Faculty of Health Sciences, University of Malaga, Málaga, Spain
- Regional University Hospital of Malaga, Málaga, Spain
| | - Luciano Rodríguez-Díaz
- Department of Nursing, Faculty of Health Sciences of Ceuta, University of Granada, Ceuta, Spain
| | | | | | | | | | - Juan Gómez-Salgado
- Department of Sociology, Social Work and Public Health, Faculty of Labour Sciences, University of Huelva, Huelva, Spain
- Escuela de Posgrado, Universidad de Especialidades Espíritu Santo, Guayaquil, Ecuador
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21
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Nkweleko Fankam F, Ugarte W, Akilimali P, Ewane Etah J, Åkerman E. COVID-19 pandemic hits differently: examining its consequences for women's livelihoods and healthcare access - a cross-sectional study in Kinshasa DRC. BMJ Open 2023; 13:e072869. [PMID: 37678942 PMCID: PMC10496687 DOI: 10.1136/bmjopen-2023-072869] [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: 02/18/2023] [Accepted: 08/24/2023] [Indexed: 09/09/2023] Open
Abstract
OBJECTIVES The emergence of the COVID-19 pandemic led to multiple preventive actions as primary interventions to contain the spread of the virus. Globally, countries are facing enormous challenges with consequences for use of social, economic and health services. The Democratic Republic of Congo (DRC) was among the African countries implementing strict lockdown at the start of the pandemic, resulting in shortages and decreased access to services. The adverse effects of the pandemic had unpleasant consequences for the country. This study aimed to examine the association between COVID-19 pandemic-related factors, sociodemographic factors, and the need to visit healthcare facilities, including family planning services, among women aged 15-49 years in the DRC. METHODS We conducted a secondary analysis of a performance monitoring for action (PMA) cross-sectional COVID-19 phone survey in Kinshasa, DRC, which had a response rate of 74.7%. In total, 1325 randomly selected women aged 15-49 years from the Kinshasa province who had previously participated in the PMA baseline survey participated in the survey. Bivariate and multivariate logistic regressions were used to assess associations. RESULTS The COVID-19 pandemic and related factors affected 92% of women in the Kinshasa province socioeconomically. A majority were highly economically dependent on their partner or some other sources for their basic needs to be met, and even more worried about the future impact of the pandemic on their household finances. Over 50% of women did not attempt visiting a health service, with some of the top reasons being fear of being infected with COVID-19 and not being able to afford services. We found a significant association between age groups and contraceptive use. The need for and use of contraceptives was higher among women aged 25-34 years than those aged 15-24 or 35-49 years. CONCLUSION Effective social/economic support to women and girls during pandemics and in crises is essential as it can have lasting beneficial effects on many domains of their lives, including their ability to access health services and the contraceptives of their choice.
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Affiliation(s)
| | - William Ugarte
- Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
| | - Pierre Akilimali
- Kinshasa School of Public Health, University of Kinshasa, Kinshasa, Democratic Republic of Congo
| | - Junior Ewane Etah
- Department of Microbiology and Parasitology, Faculty of Science, University of Buea, Buea, Cameroon
| | - Eva Åkerman
- Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden
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Kanellopoulos D, Gourounti K. A Systematic Review of Tocophobia Rate Before and During the COVID-19 Pandemic. MAEDICA 2023; 18:455-462. [PMID: 38023761 PMCID: PMC10674136 DOI: 10.26574/maedica.2023.18.3.455] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/01/2023]
Abstract
Introduction: Childbirth is a phenomenon that causes stress to future mothers. The fear of childbirth is complemented by the fear that prevails all over the world due to the COVID-19 pandemic. Childbirth alone entails many risks; adding to them the COVID-19 outbreaks lead to a considerable amount of uncertainty that affects the psychology of pregnant women. Aim:The present study aims at comparing the rate of tocophobia before and during the COVID-19 pandemic through a systematic review of studies published before and during the COVID-19 pandemic. Methods:The methodology used in this study comprised an advanced search in several scientific databases and the recovery of relevant quantitative studies. Results:The review included a total of 18 research papers published in English from January 2009 to April 2023, which examined the phenomenon of tocophobia before and during the COVID-19 pandemic. Conclusion:This systematic review shows that tocophobia was more prevalent after the outbreak of the COVID-19 pandemic (ranging from 4.8%-20.8% before the COVID-19 pandemic and 10.6%-62% during the COVID-19 pandemic). It seems that the increase in tocophobia rate after the onset of the COVID-19 pandemic ranged from 6.4% to 54.3%. According to our review, tocophobia constitutes a major source of anxiety, especially during the COVID-19 pandemic. Therefore, governments should take appropriate action, especially in times of the COVID-19 pandemic, to ensure a more secure and friendly hospital setting for pregnant women.
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23
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Mazzoli I, O'Malley D. Outpatient versus inpatient cervical ripening with a slow-release dinoprostone vaginal insert in term pregnancies on maternal, neonatal, and birth outcomes: A systematic review. Birth 2023; 50:473-485. [PMID: 36332128 DOI: 10.1111/birt.12687] [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: 12/18/2020] [Accepted: 10/10/2022] [Indexed: 11/06/2022]
Abstract
BACKGROUNDS Outpatient induction of labor (IOL) is an alternative choice offered to pregnant women requiring cervical ripening. Outpatient IOL can provide solutions in terms of women empowerment, but most importantly promotes as normal labor as possible, within the medical context of the IOL. The objectives of this systematic review were to assess safety and effectiveness of cervical ripening performed with a slow-release dinoprostone vaginal insert in term pregnancies in two settings: the outpatient (home) versus the inpatient (hospital). METHODS The electronic databases Cinahl, Embase, Medline and Maternity and Infant Care were searched to detect studies that met the inclusion criteria. Both reviewers collected the data and assessed the quality of the studies and assessed the pooled odds ratio using a 95% confidence interval and a random-effects model. Primary outcomes were linked to maternal and neonatal morbidity. Secondary outcomes were related to birth outcomes. RESULTS No statistical difference was seen between the outpatient and inpatient setting in terms of maternal complications, neonatal morbidity, cesarean section, and labor onset <24 h. Women in the outpatient setting were significantly less likely to experience uterine hyperstimulation, and they were also significantly more likely to require oxytocin to augment or induce their labor than the women in the inpatient setting. Women in the outpatient setting were more satisfied with the cervical ripening experience. CONCLUSIONS Cervical ripening with a slow-release dinoprostone vaginal insert in term pregnancies in the outpatient setting appears as safe as the inpatient setting in terms of maternal, neonatal, and birth outcomes.
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Affiliation(s)
- Ilenia Mazzoli
- Research & Innovation, Homerton Healthcare NHS Foundation Trust, London, UK
| | - Deirdre O'Malley
- Department of Nursing, Midwifery and Early Years, School of Health and Science, Dundalk Institute of Technology, Dundalk, Ireland
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Mokhtari Zanjani P, Tehranian N, Changizi N, Mohammadi E, Farzinrad B, Kazemnejad A. Maternal mental health concerns during the COVID-19 pandemic in Iran: a content analysis study. Reprod Health 2023; 20:102. [PMID: 37434144 DOI: 10.1186/s12978-023-01645-5] [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: 05/01/2023] [Accepted: 07/03/2023] [Indexed: 07/13/2023] Open
Abstract
BACKGROUND As crises occur, attention to physical health usually becomes more than mental health, neglecting mental health, especially in some vulnerable groups such as pregnant women and new mothers, can have adverse consequences. Therefore, it is imperative to recognize and comprehend their mental health needs, particularly during critical situations such as the recent COVID-19 pandemic. The aim of this study was to explain the understanding and experience of mental health concerns faced by pregnant and postpartum women during this pandemic. METHODS This qualitative study was conducted from March 2021 to November 2021 in Iran. Data were collected using semi-structured in-depth interviews to understand mental health concerns in pregnancy and the postpartum period during the COVID-19 pandemic. Twenty-five purposefully retrieved and participated in the study. Due to the prevalence of coronavirus, most of the participants preferred tele interviews. When data saturation was achieved, the data were codified manually and analyzed using Graneheim and Lundman's approach 2004. RESULTS Based on the content analysis of the interviews, 2 main themes, 8 categories 23 subcategories were identified. The identified themes were as follows: (1) Maternal mental health threats and (2) Inadequate access to the required information. CONCLUSION The results of this study showed that the main concern and fear of pregnant and postpartum women in the COVID-19 pandemic was the fear of the possibility of death for themselves and/or their fetus/infant. The knowledge that was obtained from the understanding of pregnant women and new mothers about the mental health concerns during the COVID-19 pandemic can help managers in planning to improve and promote women's mental health, especially in critical situations.
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Affiliation(s)
- Pouran Mokhtari Zanjani
- Department of Reproductive Health and Midwifery, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
| | - Najmeh Tehranian
- Department of Reproductive Health and Midwifery, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran.
| | - Nasrin Changizi
- Maternal, Fetal and Neonatal Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Eesa Mohammadi
- Department of Nursing, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
| | - Banafsheh Farzinrad
- School of Behavioral Sciences and Mental Health, Iran Medical Science University, Tehran, Iran
| | - Anoshirvan Kazemnejad
- Department of Biostatistics, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
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25
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Allegri B, Brenna V, Confalonieri L, Puzzini A, Nichelatti M, Piccinini G, Mazza U, Percudani ME. The impact of the second COVID-19 lockdown on anxiety and depressive symptoms in pregnant women: A case study of pregnant women in northern Italy. Brain Behav Immun Health 2023; 30:100633. [PMID: 37206958 PMCID: PMC10182657 DOI: 10.1016/j.bbih.2023.100633] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2022] [Revised: 04/28/2023] [Accepted: 04/30/2023] [Indexed: 05/21/2023] Open
Abstract
Background the different lockdown phases due to COVID-19 may have negatively impacted pregnant women's mental health. Concerning antenatal stress, most studies focused more on the effect of pandemic onset than on the impact of the following phases and restrictions. Aim the present study aimed to assess levels of anxiety and depression in a group of Italian pregnant women during the second COVID-19 phase and possible risk factors. Method We recruited 156 pregnant women through our Perinatal Psychology Outpatient Clinic. We divided the sample into women recruited before the pandemic (N = 88) through a face-to-face antenatal class and pregnant women recruited during the second lockdown (Covid-19 study group) (November 2020-April 2021) through the same antenatal class via Skype (N = 68). To investigate depressive and anxiety symptoms, we administered the Edinburgh Postnatal Depression Scale (EPDS) and the State and Trait Anxiety Inventory (STAI-Y) scales; women's medical history and obstetric data were collected. Findings women belonging to the Covid-19 study group reported higher depressive and anxious levels than the pre-pandemic group. Moreover, during the second lockdown previous psychopathology and being close to childbirth were related to increased depression; a history of abortion was related to higher levels of trait anxiety instead. Conclusion recurrent restrictive measures due to COVID-19 negatively affected the antenatal mental well-being of pregnant women, particularly worsening depressive and anxious feelings. Pregnant women during the pandemic represented a vulnerable population to be monitored more closely and timely to prevent psychological problems in the postpartum period and their consequences on the child. Keywords anxiety, depression, pregnancy, COVID-19, mental health, lockdown.
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Affiliation(s)
- Beatrice Allegri
- Department of Mental Health and Addiction Services Niguarda Ca' Granda Hospital, Piazza dell'Ospedale Maggiore 3, 20162, Milan, Italy
| | - Valeria Brenna
- Department of Mental Health and Addiction Services Niguarda Ca' Granda Hospital, Piazza dell'Ospedale Maggiore 3, 20162, Milan, Italy
| | - Linda Confalonieri
- Department of Mental Health and Addiction Services Niguarda Ca' Granda Hospital, Piazza dell'Ospedale Maggiore 3, 20162, Milan, Italy
| | - Alessandra Puzzini
- Department of Mental Health and Addiction Services Niguarda Ca' Granda Hospital, Piazza dell'Ospedale Maggiore 3, 20162, Milan, Italy
| | - Michele Nichelatti
- Biostatistics Service, Department of Hematology, Niguarda Ca' Granda Hospital, Piazza dell'Ospedale Maggiore 3, 20162, Milan, Italy
| | - Gianluca Piccinini
- Department of Mental Health and Addiction Services Niguarda Ca' Granda Hospital, Piazza dell'Ospedale Maggiore 3, 20162, Milan, Italy
| | - Umberto Mazza
- Department of Mental Health and Addiction Services Niguarda Ca' Granda Hospital, Piazza dell'Ospedale Maggiore 3, 20162, Milan, Italy
| | - Mauro Emilio Percudani
- Department of Mental Health and Addiction Services Niguarda Ca' Granda Hospital, Piazza dell'Ospedale Maggiore 3, 20162, Milan, Italy
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Zafman KB, Riegel ML, Levine LD, Hamm RF. An interactive childbirth education platform to improve pregnancy-related anxiety: a randomized trial. Am J Obstet Gynecol 2023; 229:67.e1-67.e9. [PMID: 37054807 PMCID: PMC10330277 DOI: 10.1016/j.ajog.2023.04.007] [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: 12/07/2022] [Revised: 03/06/2023] [Accepted: 04/05/2023] [Indexed: 04/15/2023]
Abstract
BACKGROUND Perinatal anxiety is one of the most common conditions during pregnancy and is associated with adverse maternal and neonatal outcomes. Interventions that are focused on childbirth education and health literacy have been shown to help decrease pregnancy-related anxiety. These programs, however, have limitations. Transportation, childcare, and work conflicts pose barriers to patients. In addition, many of these programs have not been studied in high-risk patients, who are most at risk for pregnancy-related anxiety. Thus, it is uncertain whether an online childbirth education course can help to improve outcomes in a high-risk patient population. OBJECTIVE This study aimed to compare an interactive online platform for childbirth education (Birthly) with usual prenatal education on anxiety, emergency healthcare utilization, and delivery outcomes for high-risk pregnancies. STUDY DESIGN We performed a randomized trial comparing an interactive online childbirth education platform combined with usual prenatal education (intervention) with usual prenatal education alone (usual care). Nulliparous, English-speaking patients with internet access and a high-risk pregnancy (medical or mental health disorders) were included. Patients in 2 urban clinics that serve underresourced patients were enrolled at <20 weeks of gestation. The intervention included 3 interactive courses (prenatal bootcamp, breastfeeding, newborn care) and access to a clinician-moderated online community. Pregnancy-related Anxiety Scale questionnaires were administered at randomization and at 34 to 40 weeks. The primary outcome was third-trimester Pregnancy-related Anxiety Scale score. Secondary outcomes included change in Pregnancy-related Anxiety Scale score, unscheduled emergency visits, delivery, and postpartum outcomes. To demonstrate a 15% decrease in Pregnancy-related Anxiety Scale score, 37 patients would be needed per group. Accounting for a 20% loss to follow-up rate, we planned to recruit 90 total patients or 45 per group. RESULTS A total of 90 patients were randomized with no differences in demographics or baseline Pregnancy-related Anxiety Scale scores. Most patients self-identified as Black and were publicly insured. More than 60% of patients (62.2%) in the intervention arm completed at least 1 Birthly course. Patients in the intervention arm had significantly lower third-trimester Pregnancy-related Anxiety Scale scores (indicating lower anxiety) compared with those receiving usual care (44.6±7.3 vs 53.9±13.8; P<.01), with a decrease in score of 8.3 points vs 0.7 for usual care (P<.01). Patients in the intervention arm also had fewer emergency visits (1 [0-2] vs 2 [1-3]; P=.003). There were no differences in delivery outcomes. Patients in the intervention arm were more likely to breastfeed at delivery, although this was not different by the postpartum visit. Finally, patients who received the intervention were more likely to be satisfied with their childbirth education (94.6% vs 64.9%; P<.01). CONCLUSION An interactive online childbirth education platform can reduce pregnancy-related anxiety and emergency healthcare utilization while improving satisfaction in a high-risk patient population.
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Affiliation(s)
- Kelly B Zafman
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA.
| | - Melissa L Riegel
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | - Lisa D Levine
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | - Rebecca F Hamm
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA; Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, PA
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Scandurra C, Mezzalira S, Aviani S, Lastra V, Bochicchio V, Zapparella R, Saccone G, Maldonato NM, Locci M. Perinatal depression during the fourth wave of the COVID-19 outbreak in a single prenatal clinic in Southern Italy: The role of loneliness, anxiety, and maternal support. JOURNAL OF AFFECTIVE DISORDERS REPORTS 2023; 13:100585. [PMID: 37152681 PMCID: PMC10141786 DOI: 10.1016/j.jadr.2023.100585] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Revised: 03/15/2023] [Accepted: 04/27/2023] [Indexed: 05/09/2023] Open
Abstract
Background The current study aimed at assessing the levels of perinatal depression (i.e., both antenatal and postnatal) during the fourth wave of the COVID-19 outbreak in a group of Italian women, as well as to evaluate the role of loneliness, anxiety, and lack of maternal support in cumulatively predicting perinatal depression. Methods A cross-sectional study was conducted with 200 Italian women recruited during a peak of the COVID-19 pandemic in Italy (i.e., from September to December 2021) from a single prenatal clinic in Southern Italy. A non-parametric binomial test was conducted to assess whether the perinatal depression frequencies of the current sample differed from those found in a pre-Covid reference group. Additionally, hierarchical multiple linear regression analyses assessing whether loneliness, anxiety, and maternal support affected women's perinatal depression were also conducted. Results The general prevalence of perinatal depression was significantly higher in participants recruited during the fourth wave of the COVID-19 pandemic compared to the pre-Covid reference group (29% vs. 9.2%). However, results showed that, contrary to postnatal depression (18.2% vs. 19.9%), only the prevalence of antenatal depression was significantly higher compared to the pre-Covid reference group (39.6% vs. 6.4%). Furthermore, loneliness and anxiety, but not maternal support, were associated with higher levels of PD. Limitations Limitations concerned the cross-sectional nature of the study and the relatively small sample size. Conclusions This study sheds light on the need to address perinatal mental health of women during major stressful events, such as the COVID-19 pandemic.
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Affiliation(s)
- Cristiano Scandurra
- Department of Neuroscience, Reproductive Sciences and Dentistry, University of Naples Federico II, Via Sergio Pansini 5, Napoli 80133, Italy
| | - Selene Mezzalira
- Department of Humanistic Studies, University of Calabria, Via Ponte Bucci Cubo 18/C, Rende 87036, Italy
| | - Silvia Aviani
- Intradepartmental Program of Clinical Psychology, Federico II University Hospital, Via Sergio Pansini 5, Napoli 80133, Italy
| | - Valeria Lastra
- Department of Neuroscience, Reproductive Sciences and Dentistry, University of Naples Federico II, Via Sergio Pansini 5, Napoli 80133, Italy
| | - Vincenzo Bochicchio
- Department of Humanistic Studies, University of Calabria, Via Ponte Bucci Cubo 18/C, Rende 87036, Italy
| | - Rosanna Zapparella
- Department of Neuroscience, Reproductive Sciences and Dentistry, University of Naples Federico II, Via Sergio Pansini 5, Napoli 80133, Italy
| | - Gabriele Saccone
- Department of Neuroscience, Reproductive Sciences and Dentistry, University of Naples Federico II, Via Sergio Pansini 5, Napoli 80133, Italy
| | - Nelson Mauro Maldonato
- Department of Neuroscience, Reproductive Sciences and Dentistry, University of Naples Federico II, Via Sergio Pansini 5, Napoli 80133, Italy
| | - Mariavittoria Locci
- Department of Neuroscience, Reproductive Sciences and Dentistry, University of Naples Federico II, Via Sergio Pansini 5, Napoli 80133, Italy
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Poškienė I, Minkauskienė M, Kregždytė R, Jarienė K, Kliučinskas M. Outcomes of low-risk birth care during the Covid-19 pandemic: A cohort study from a tertiary care center in Lithuania. Open Med (Wars) 2023; 18:20230720. [PMID: 37251540 PMCID: PMC10224623 DOI: 10.1515/med-2023-0720] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Revised: 04/03/2023] [Accepted: 04/26/2023] [Indexed: 05/31/2023] Open
Abstract
According to the World Health Organization, midwife-led care is the most appropriate and cost-effective type of perinatal care. As the Covid-19 pandemic with its drastic changes and challenges for the health systems and the medical staff made large adjustments to the healthcare delivery system, midwife-led care became an even more important supportive tool in maintaining unnecessary interventions. This retrospective cohort study aims to compare the outcomes of midwife-led care and team-led care in low-risk births between the Covid-19 pandemic and non-Covid-19 pandemic period. The total studied population was 1,185 singleton births and consisted of 727 births during the non-Covid-19 period and 458 births from the Covid-19 period. The study revealed the safety of low-risk birth care during the first wave of the Covid-19 pandemic in both groups. The maternal and perinatal outcomes remained stable without an increased rate of unsuccessful vaginal births and newborn asphyxia; moreover, birth care of low-risk women provided by midwives preserved autonomy, integrity, and resistance to responding to a disaster. The aforementioned results exhibit that high-quality, safe supervision by midwives in low-risk births can be provided even in high-stress circumstances.
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Affiliation(s)
- Ingrida Poškienė
- Department of Obstetrics and Gynaecology, Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Meilė Minkauskienė
- Department of Obstetrics and Gynaecology, Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Rima Kregždytė
- Department of Preventive Medicine, Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Kristina Jarienė
- Department of Obstetrics and Gynaecology, Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Mindaugas Kliučinskas
- Department of Obstetrics and Gynaecology, Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania
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Silverio SA, De Backer K, Brown JM, Easter A, Khazaezadeh N, Rajasingam D, Sandall J, Magee LA. Reflective, pragmatic, and reactive decision-making by maternity service providers during the SARS-CoV-2 pandemic health system shock: a qualitative, grounded theory analysis. BMC Pregnancy Childbirth 2023; 23:368. [PMID: 37210485 DOI: 10.1186/s12884-023-05641-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Accepted: 04/24/2023] [Indexed: 05/22/2023] Open
Abstract
BACKGROUND Pregnant and postpartum women were identified as having particular vulnerability to severe symptomatology of SARS-CoV-2 infection, so maternity services significantly reconfigured their care provision. We examined the experiences and perceptions of maternity care staff who provided care during the pandemic in South London, United Kingdom - a region of high ethnic diversity with varied levels of social complexity. METHODS We conducted a qualitative interview study, as part of a service evaluation between August and November 2020, using in-depth, semi-structured interviews with a range of staff (N = 29) working in maternity services. Data were analysed using Grounded Theory analysis appropriate to cross-disciplinary health research. ANALYSIS & FINDINGS Maternity healthcare professionals provided their views, experiences, and perceptions of delivering care during the pandemic. Analysis rendered three emergent themes regarding decision-making during reconfigured maternity service provision, organised into pathways: 1) 'Reflective decision-making'; 2) 'Pragmatic decision-making'; and 3) 'Reactive decision-making'. Whilst pragmatic decision-making was found to disrupt care, reactive-decision-making was perceived to devalue the care offered and provided. Alternatively, reflective decision-making, despite the difficult working conditions of the pandemic, was seen to benefit services, with regards to care of high-quality, sustainability of staff, and innovation within the service. CONCLUSIONS Decision-making within maternity care was found to take three forms - where at best changes to services could be innovative, at worst they could cause devaluation in care being delivered, and more often than not, these changes were disruptive. With regard to positive changes, healthcare providers identified staff empowerment, flexible working patterns (both for themselves and collectively as teams), personalised care delivery, and change-making in general, as key areas to capitalise on current and ongoing innovations borne out of the pandemic. Key learnings included a focus on care-related, meaningful listening and engagement of staff at all levels, in order to drive forward high-quality care and avoid care disruption and devaluation.
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Affiliation(s)
- Sergio A Silverio
- Department of Women & Children's Health, School of Life Course & Population Sciences, Faculty of Life Sciences & Medicine, King's College London, 6th Floor Addison House, Great Maze Pond, Southwark, London, SE1 1UL, UK.
| | - Kaat De Backer
- Department of Women & Children's Health, School of Life Course & Population Sciences, Faculty of Life Sciences & Medicine, King's College London, 10th Floor North Wing, St. Thomas' Hospital, Westminster Bridge Road, Lambeth, London, SE1 7EH, UK
| | - Jeremy M Brown
- Health Research Institute, Medical School, Faculty of Health, Social Care & Medicine, Edge Hill University, St. Helen's Road, Ormskirk, L39 4QP, Lancashire, UK
| | - Abigail Easter
- Department of Women & Children's Health, School of Life Course & Population Sciences, Faculty of Life Sciences & Medicine, King's College London, 10th Floor North Wing, St. Thomas' Hospital, Westminster Bridge Road, Lambeth, London, SE1 7EH, UK
| | - Nina Khazaezadeh
- Chief Midwifery Office, NHS England and Improvement, Wellington House, 133-155 Waterloo Road, Southwark, London, SE1 8UG, UK
| | - Daghni Rajasingam
- Maternity Services, St. Thomas' Hospital, Guy's and St. Thomas's NHS Foundation Trust, Westminster Bridge Road, Lambeth, London, SE1 7EH, UK
| | - Jane Sandall
- Department of Women & Children's Health, School of Life Course & Population Sciences, Faculty of Life Sciences & Medicine, King's College London, 10th Floor North Wing, St. Thomas' Hospital, Westminster Bridge Road, Lambeth, London, SE1 7EH, UK
| | - Laura A Magee
- Department of Women & Children's Health, School of Life Course & Population Sciences, Faculty of Life Sciences & Medicine, King's College London, 6th Floor Addison House, Great Maze Pond, Southwark, London, SE1 1UL, UK
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Ataman H, Tuncer M. The effect of COVID-19 fear on prenatal distress and childbirth preference in primipara. REVISTA DA ASSOCIACAO MEDICA BRASILEIRA (1992) 2023; 69:e20221302. [PMID: 37222319 DOI: 10.1590/1806-9282.20221302] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/06/2023] [Accepted: 02/03/2023] [Indexed: 05/25/2023]
Abstract
OBJECTIVE The purpose of this study was to examine the effect of COVID-19 fear on prenatal distress and childbirth preference in primipara. METHODS This descriptive and cross-sectional study was conducted with 206 primipara women in Istanbul between June and December 2021. The data were collected with an information form, "The Fear of COVID-19 Scale" and "The Prenatal Distress Questionnaire." RESULTS The median of the Fear of COVID-19 Scale was 14.00 (7-31) and the median of the Prenatal Distress Questionnaire was 10.00 (0-21). A statistically significant positive and weak correlation was found between "The Fear of COVID-19 Scale" and "The Prenatal Distress Questionnaire" (r=0.21; p=0.00). Overall, 75.2% of pregnant women preferred normal (vaginal) delivery. There was no statistically significant relationship between "The Fear of COVID-19 Scale" and childbirth preference (p>0.05). CONCLUSION It was determined that fear of coronavirus increases prenatal distress. Women should be supported to cope with fear of COVID-19 and prenatal distress, both during the preconceptional and antenatal periods.
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Affiliation(s)
- Hacer Ataman
- İstanbul Medeniyet Üniversitesi, Faculty of Health Sciences, Department of Obstetrics and Gynecology Nursing, Department of Nursing - Istanbul, Turkey
| | - Merve Tuncer
- İstanbul Üniversitesi, Faculty of Nursing, Department of Women Health and Diseases Nursing - İstanbul, Turkey
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Geremia S, Valente EP, Mariani I, Dalena P, Lazzerini M. Women's suggestions on how to improve the quality of maternal and newborn care during the COVID-19 pandemic in Italy: A co-occurrence network analysis. J Glob Health 2023; 13:06013. [PMID: 37144478 PMCID: PMC10161149 DOI: 10.7189/jogh.13.06013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/06/2023] Open
Abstract
Background Recent evidence revealed significant gaps in the quality of maternal and newborn care in the World Health Organization (WHO) European Region (EUR) countries. Collecting and analyzing women's views on their needs and priorities is crucial for developing actions to improve the quality of maternal and newborn care. With this study from the IMAgiNE EURO Project, we aimed to add to previous quantitative studies by analysing emerging themes from women's suggestions on how to improve the quality of maternal and newborn care during facility-based birth in Italy during the COVID-19 pandemic. Methods We collected data from mothers giving birth during the coronavirus 2019 (COVID-19) pandemic using a validated online anonymous WHO standard-based questionnaire consisting of open-ended questions. Using a word co-occurrence network (WCON), we analysed responses in Italian from women who gave birth between March 2020 and March 2022. This approach entails a graphical representation of word pairings that frequently co-occur across sentences and compose clusters. Results The texts, produced by 2010 women participating in the study, consisted of 79 204 words and 3833 sentences. Eight clusters emerged with WCON, the three largest of which were related to companionship during childbirth, breastfeeding support, and physical resources. The term "swab", associated with other terms in the COVID-19 domain, had the highest degree of centrality, thus representing a core topic. Conclusions The key emerging themes from women's suggestions can be used to shape policies to improve the quality of care for mothers and newborns. Our WCON analysis offers a valid approach to quickly screen large textual data on quality of care, providing a first set of major themes identified by clusters. As such, it could be used to improve documentation of service users' suggestions promoting the engagement of both researchers and policymakers. Registration ClinicalTrials.gov: NCT04847336.
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Borrelli SE, Lecis A, Antolini L, Miglietta M, Zanini AA, Nespoli A, Fumagalli S. Pain Intensity, coping and maternal satisfaction in Low-Risk labouring Women: A prospective descriptive correlational study. SEXUAL & REPRODUCTIVE HEALTHCARE 2023; 36:100848. [PMID: 37084524 DOI: 10.1016/j.srhc.2023.100848] [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: 11/14/2022] [Revised: 03/27/2023] [Accepted: 04/10/2023] [Indexed: 04/23/2023]
Abstract
OBJECTIVES The primary aim of the study was to explore pain intensity (PI) and pain coping (PC) scores and the relationship between them. The secondary aim was to explore the correlation between PI and PC scores with labour progress, parity, labour acceleration, labour augmentation and maternal satisfaction. METHODS A prospective descriptive correlational study was conducted in a maternity hospital in Northern Italy. The sample included 54 low-risk women in active labour at term of pregnancy. A data record sheet was used to collect the relevant variables and the Italian Birth Satisfaction Scale Revised (I-BSS-R) was administered to participants at least 24 h after birth. RESULTS In the first labour stage, the average PI score was 6.99 (SD = 1.95) and the average PC score was 6.5 (SD = 2.22). During the second labour stage, the average PI score was 7.75 (SD = 1.74) and the average PC score was 4.97 (SD = 2.76). The average PI score trend increased with labour progress. The average PC score improved between 4 and 7 cm of cervical dilatation. A significant positive correlation between PI scores and oxytocin augmentation (p < 0.001) and labour progression (p < 0.001) was noted. A significant positive correlation between PC scores and oxytocin augmentation (p = 0.02) was also observed. No significant differences were found for maternal satisfaction in regard to PI and PC scores. CONCLUSION coping in labour do not solely depend on PI but also on labour progress and oxytocin augmentation. Additional support to empower women to cope with pain may be required in case of labour augmentation.
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Affiliation(s)
- S E Borrelli
- University of Nottingham, School of Health Sciences, United Kingdom.
| | - A Lecis
- Department of Medicine and Surgery, University of Milano-Bicocca, Milan, Italy
| | - L Antolini
- Department of Medicine and Surgery, University of Milano - Bicocca, Milan, Italy
| | - M Miglietta
- Department of Obstetrics and Gynecology, Sacra Famiglia Hospital, Ordine Ospedaliero Fatebenefratelli, Erba (CO), Italy
| | - A A Zanini
- Department of Obstetrics and Gynecology, Sacra Famiglia Hospital, Ordine Ospedaliero Fatebenefratelli, Erba (CO), Italy
| | - A Nespoli
- University of Milano Bicocca, Dipartimento di Medicina e Chirurgia, Italy.
| | - S Fumagalli
- University of Milano Bicocca, School of Medicine and Surgery, Italy.
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Midwives' experiences of providing maternity care to women and families during the COVID-19 pandemic in Northern Italy. Women Birth 2023; 36:e57-e64. [PMID: 35490090 PMCID: PMC9015962 DOI: 10.1016/j.wombi.2022.04.011] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2022] [Revised: 04/13/2022] [Accepted: 04/14/2022] [Indexed: 01/26/2023]
Abstract
PROBLEM The COVID-19 pandemic has significantly challenged maternity provision internationally. Rapid and radical changes were implemented, with midwives facing anxiety and moral distress if not able to provide optimal and woman-centred care in line with professional values. BACKGROUND Healthcare professionals' stress and burnout are commonly reported during other global emergencies, which may eventually contribute to reduced quality of care. There is lack of evidence of the challenges faced by midwives in Italy during the COVID-19 pandemic. AIM To explore midwives' experiences of providing care to women and families during the COVID-19 pandemic. METHODS Qualitative interpretive phenomenological approach, using semi-structured interviews and thematic analysis. The sample included 15 midwives. Ethical approval was obtained. FINDINGS Four themes were identified: 1) adjusting to the ever-evolving organisation of care; 2) physical, psychological and relational challenges; 3) support network; 4) deferred sense of awareness. DISCUSSION Midwives faced professional and personal challenges during the pandemic, displaying feelings of fear, anxiety, uncertainty, discomfort, lack of support and knowledge with potential long-term effects. Adjusting to the continuous, rapid and drastic re-organisation of maternity services was particularly challenging. Factors facilitating a safe, supportive and empowering workplace included support from colleagues and managers, access to appropriate PPE, reliable guidelines, good communication and emotional support. Positive aspects of personal and professional development included communication skills, establishment of trusting relationships, sense of empowerment and teamwork. CONCLUSION In the context of a pandemic, optimisation of midwives' physical, emotional and psychological wellbeing should be considered. Timely and comprehensive guidelines and appropriate resources should be provided to assist midwives in facilitating family-centred respectful maternity care and preserving childbirth as a bio-psychosocial event.
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Pařízek A, Janků P, Kameníková M, Pařízková P, Javornická D, Benešová D, Rogalewicz V, Laštůvka Z, Barták M. Laboring Alone: Perinatal Outcomes during Childbirth without a Birth Partner or Other Companion during the COVID-19 Pandemic. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:2614. [PMID: 36767981 PMCID: PMC9916022 DOI: 10.3390/ijerph20032614] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/04/2023] [Revised: 01/27/2023] [Accepted: 01/30/2023] [Indexed: 06/18/2023]
Abstract
During the first wave of the COVID-19 pandemic in the spring of 2020, the government of the Czech Republic issued a nationwide ban on visitors to maternity wards. We studied whether the absence of a close person during labor due to this ban impacted perinatal indicators. This study was performed using an administrative observational questionnaire focused on absolute frequencies of events sent to maternity facilities across the Czech Republic. Completed answers were received from 33 facilities covering 4805 births during the study period in 2019 and 4514 births in 2020. The differences in individual parameters were tested using Pearson's chi-squared homogeneity test. There were no significant differences between the two periods in spontaneous pre-term births (p = 0.522) or in the number of cesarean sections (p = 0.536). No significant changes were seen in either local or systemic analgesia. Data showed a significantly shorter (p = 0.026) first stage of labor in 2020 compared to 2019, while there was no significant difference (p = 0.673) in the second stage of labor. There was no statistically significant difference found for newborn perinatal adaptation. There were also no significant differences in intrapartum maternal injuries. Overall, we found no significant differences in basic perinatal indicators during the first wave of COVID-19 in 2020 compared to 2019. Although the absence of a close person may cause stress for the laboring women, it does not impair objective clinical outcomes.
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Affiliation(s)
- Antonín Pařízek
- Department of Obstetrics and Gynecology, First Faculty of Medicine, Charles University and General University Hospital, 128 08 Prague, Czech Republic
| | - Petr Janků
- Department of Gynecology and Obstetrics, University Hospital Brno, 602 00 Brno, Czech Republic
| | - Miloslava Kameníková
- Department of Gynecology and Obstetrics, University Hospital Brno, 602 00 Brno, Czech Republic
| | - Petra Pařízková
- Department of Obstetrics and Gynecology, First Faculty of Medicine, Charles University and General University Hospital, 128 08 Prague, Czech Republic
| | - Daniela Javornická
- Department of Midwifery, Faculty of Health Sciences, Palacky University Olomouc, 779 00 Olomouc, Czech Republic
| | - Dana Benešová
- Department of Obstetrics and Gynecology, First Faculty of Medicine, Charles University and General University Hospital, 128 08 Prague, Czech Republic
| | - Vladimír Rogalewicz
- Department of Biomedical Technology, Faculty of Biomedical Engineering, Czech Technical University in Prague, 272 01 Kladno, Czech Republic
| | - Zdeněk Laštůvka
- Department of Obstetrics and Gynecology, First Faculty of Medicine, Charles University and General University Hospital, 128 08 Prague, Czech Republic
| | - Miroslav Barták
- Department of Social Work, Faculty of Social and Economics Studies, J. E. Purkyně University, 400 96 Ústí nad Labem, Czech Republic
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Delanerolle G, McCauley M, Hirsch M, Zeng Y, Cong X, Cavalini H, Sajid S, Shetty A, Rathod S, Shi JQ, Hapangama DK, Phiri P. The prevalence of mental ill-health in women during pregnancy and after childbirth during the Covid-19 pandemic: a systematic review and Meta-analysis. BMC Pregnancy Childbirth 2023; 23:76. [PMID: 36709255 PMCID: PMC9883834 DOI: 10.1186/s12884-022-05243-4] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Accepted: 11/24/2022] [Indexed: 01/29/2023] Open
Abstract
BACKGROUND This systematic review aims to explore the prevalence of the impact of the COVID-19, MERS, and SARS pandemics on the mental health of pregnant women. METHODS All COVID-19, SARS and MERS studies that evaluated the mental health of pregnant women with/without gynaecological conditions that were reported in English between December 2000 - July 2021 were included. The search criteria were developed based upon the research question using PubMed, Science Direct, Ovid PsycINFO and EMBASE databases. A wide search criterion was used to ensure the inclusion of all pregnant women with existing gynaecological conditions. The Newcastle-Ottawa-Scale was used to assess the risk of bias for all included studies. Random effects model with restricted maximum-likelihood estimation method was applied for the meta-analysis and I-square statistic was used to evaluate heterogeneity across studies. The pooled prevalence rates of symptoms of anxiety, depression, PTSD, stress, and sleep disorders with 95% confidence interval (CI) were computed. RESULTS This systematic review identified 217 studies which included 638,889 pregnant women or women who had just given birth. There were no studies reporting the mental health impact due to MERS and SARS. Results showed that women who were pregnant or had just given birth displayed various symptoms of poor mental health including those relating to depression (24.9%), anxiety (32.8%), stress (29.44%), Post Traumatic Stress Disorder (PTSD) (27.93%), and sleep disorders (24.38%) during the COVID-19 pandemic. DISCUSSION It is important to note that studies included in this review used a range of outcome measures which does not allow for direct comparisons between findings. Most studies reported self-reported measure of symptoms without clinical diagnoses so conclusions can be made for symptom prevalence rather than of mental illness. The importance of managing mental health during pregnancy and after-delivery improves the quality of life and wellbeing of mothers hence developing an evidence-based approached as part of pandemic preparedness would improve mental health during challenging times. OTHER The work presented in this manuscript was not funded by any specific grants. A study protocol was developed and published in PROSPERO (CRD42021235356) to explore several key objectives.
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Affiliation(s)
- Gayathri Delanerolle
- Nuffield Department of Primary Health Care Sciences, Uuniversity of Oxford, Oxford, UK
- Southern Health NHS Foundation Trust, Research and Innovation Department, Clinical Trials Facility, Tom Rudd Unit Moorgreen Hospital, Botley Road, West End, Southampton, SO30 3JB, UK
| | - Mary McCauley
- Liverpool Women's NHS Foundation Trust, Liverpool, UK
| | - Martin Hirsch
- University College London, London, UK
- Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | - Yutian Zeng
- Southern University of Science and Technology, Shenzhen, China
| | - Xu Cong
- Southern University of Science and Technology, Shenzhen, China
| | - Heitor Cavalini
- Southern Health NHS Foundation Trust, Research and Innovation Department, Clinical Trials Facility, Tom Rudd Unit Moorgreen Hospital, Botley Road, West End, Southampton, SO30 3JB, UK
| | - Sana Sajid
- Southern Health NHS Foundation Trust, Research and Innovation Department, Clinical Trials Facility, Tom Rudd Unit Moorgreen Hospital, Botley Road, West End, Southampton, SO30 3JB, UK
| | - Ashish Shetty
- University College London, London, UK
- University College London Hospitals NHS Foundation Trust, London, UK
| | - Shanaya Rathod
- Southern Health NHS Foundation Trust, Research and Innovation Department, Clinical Trials Facility, Tom Rudd Unit Moorgreen Hospital, Botley Road, West End, Southampton, SO30 3JB, UK
| | - Jian Qing Shi
- Southern University of Science and Technology, Shenzhen, China
- National Center for Applied Mathematics, Shenzhen, China
| | | | - Peter Phiri
- Southern Health NHS Foundation Trust, Research and Innovation Department, Clinical Trials Facility, Tom Rudd Unit Moorgreen Hospital, Botley Road, West End, Southampton, SO30 3JB, UK.
- School of Psychology, Faculty of Environmental and Life Sciences, University of Southampton, Southampton, UK.
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Kajdy A, Sys D, Pokropek A, Shaw SW, Chang T, Calda P, Acharya G, Ben‐Zion M, Biron‐Shental T, Borowski D, Czuba B, Etchegaray A, Feduniw S, Garcia‐Mandujano R, Santacruz MG, Gil MM, Hassan S, Kwiatkowski S, Martin‐Arias A, Martinez‐Portilla RJ, Prefumo F, Rabijewski M, Salomon LJ, Tiller H, Verlohren S, Voon HY, Yanque‐Robles OF, Yong SL, Poon LC. Risk factors for anxiety and depression among pregnant women during the COVID-19 pandemic: Results of a web-based multinational cross-sectional study. Int J Gynaecol Obstet 2023; 160:167-186. [PMID: 35932096 PMCID: PMC9538861 DOI: 10.1002/ijgo.14388] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Revised: 07/24/2022] [Accepted: 07/28/2022] [Indexed: 12/15/2022]
Abstract
OBJECTIVE To assess risk factors for anxiety and depression among pregnant women during the COVID-19 pandemic using Mind-COVID, a prospective cross-sectional study that compares outcomes in middle-income economies and high-income economies. METHODS A total of 7102 pregnant women from 12 high-income economies and nine middle-income economies were included. The web-based survey used two standardized instruments, General Anxiety Disorder-7 (GAD-7) and Patient Health Questionnaire-9 (PHQ-9). RESULT Pregnant women in high-income economies reported higher PHQ-9 (0.18 standard deviation [SD], P < 0.001) and GAD-7 (0.08 SD, P = 0.005) scores than those living in middle-income economies. Multivariate regression analysis showed that increasing PHQ-9 and GAD-7 scales were associated with mental health problems during pregnancy and the need for psychiatric treatment before pregnancy. PHQ-9 was associated with a feeling of burden related to restrictions in social distancing, and access to leisure activities. GAD-7 scores were associated with a pregnancy-related complication, fear of adverse outcomes in children related to COVID-19, and feeling of burden related to finances. CONCLUSIONS According to this study, the imposed public health measures and hospital restrictions have left pregnant women more vulnerable during these difficult times. Adequate partner and family support during pregnancy and childbirth can be one of the most important protective factors against anxiety and depression, regardless of national economic status.
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Affiliation(s)
- Anna Kajdy
- Department of Reproductive HealthCenter of Postgraduate Medical EducationWarsawPoland
| | - Dorota Sys
- Department of Reproductive HealthCenter of Postgraduate Medical EducationWarsawPoland
| | - Artur Pokropek
- Institute of Philosophy and Sociology of the Polish Academy of SciencesWarsawPoland
| | - Steven W. Shaw
- Department of ObstetricsChang Gung Memorial HospitalTaipeiTaiwan
| | | | - Pavel Calda
- Fetal Medicine CenterFirst Medical Faculty of the Charles University and General Teaching HospitalPragueCzech Republic
| | - Ganesh Acharya
- Division of Obstetrics and GynecologyDepartment of Clinical Science, Intervention and Technology (CLINTEC), Karolinska InstitutetStockholmSweden
- Women's Health and Perinatology Research Group Institute of Clinical Medicine Faculty of Health Sciences UiT‐The Arctic University of NorwayTromsøNorway
| | - Maya Ben‐Zion
- Women's Health and Perinatology Research Group Institute of Clinical Medicine Faculty of Health Sciences UiT‐The Arctic University of NorwayTromsøNorway
- Meir Medical CenterTel Aviv UniversityIsrael
| | - Tal Biron‐Shental
- Women's Health and Perinatology Research Group Institute of Clinical Medicine Faculty of Health Sciences UiT‐The Arctic University of NorwayTromsøNorway
- Meir Medical CenterTel Aviv UniversityIsrael
| | - Dariusz Borowski
- Nicolaus Copernicus University in ToruńCollegium Medicum in Bydgoszcz, The Faculty of Health Sciences, Department of Perinatology, Gynacology and Gynecologic OncologyToruńPoland
| | - Bartosz Czuba
- Chair and Department of Gynecology and ObstetricsFaculty of Health Sciences in Katowice, Medical University of SilesiaPoland
| | | | - Stepan Feduniw
- Department of Reproductive HealthCenter of Postgraduate Medical EducationWarsawPoland
| | | | | | - Maria M. Gil
- Hospital Universitario de TorrejónSchool of Medicine. Universidad Francisco de VitoriaMadridSpain
| | - Sonia Hassan
- Department of Obstetrics and GynecologyWayne State University School of MedicineDetroitMichiganUSA
- Office of Women's HealthIntegrative Biosciences Center, Wayne State UniversityDetroitMichiganUSA
- Department of PhysiologyWayne State University School of MedicineDetroitMichiganUSA
| | | | - Arancha Martin‐Arias
- Hospital Universitario de TorrejónSchool of Medicine. Universidad Francisco de VitoriaMadridSpain
| | | | - Federico Prefumo
- Department of Clinical and Experimental SciencesUniversity of BresciaItaly
| | - Michał Rabijewski
- Department of Reproductive HealthCenter of Postgraduate Medical EducationWarsawPoland
| | - Laurent J. Salomon
- Médecine et Chirurgie FoetalesMaternité—Hôpital Universitaire Necker‐Enfants Malades, Assistance Publique—Hôpitaux de Paris (AP‐HP), Université de ParisFrance
| | - Heidi Tiller
- Women's Health and Perinatology Research GroupInstitute of Clinical medicine, UiT The Arctic University of Norway, Tromsø, Norway; Department of Obstetrics and Gynecology, University Hospital of North NorwayTromsøNorway
| | - Stefan Verlohren
- Department of ObstetricsMedical School – Charité – University Medicine BerlinGermany
| | - Hian Yan Voon
- Maternal Fetal Medicine SpecialistSarawak General HospitalKuchingMalaysia
| | | | - Soon Leong Yong
- Department of Obstetrics & GynaecologyHospital Tengku Ampuan AfzanKuantanMalaysia
| | - Liona C. Poon
- Department of Obstetrics and Gynaecology Prince of Wales HospitalThe Chinese University of Hong KongShatinHong Kong SAR
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Soltani F, Bakht R, Refaei M, Hemmati L, Aghababaei S. Experiences of A Population of Recovered Iranian Pregnant Women from COVID-19: A Qualitative Study. INTERNATIONAL JOURNAL OF FERTILITY & STERILITY 2023; 17:12-21. [PMID: 36617197 PMCID: PMC9807895 DOI: 10.22074/ijfs.2022.543166.1226] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/18/2021] [Indexed: 01/09/2023]
Abstract
BACKGROUND It seems pandemics may have a notable potential adverse effect on the pregnant women. The important biological COVID-19 aspect of the pregnancy has been led to the neglect of its psychological aspect of the pregnant women, especially COVID-19 affected. The present qualitative study aims to explore the experiences of Iranian pregnant women who were recovered from the COVID-19 pandemics. MATERIALS AND METHODS This qualitative study designed based on a semi-structured interview with 9 pregnant women who had developed COVID-19 during pregnancy and had recovered. RESULTS Data analysis revealed five themes including: anxiety and helplessness, stigma, confront disease, apprehension in the heart of desire, and seeking calmness. Rrecovered pregnant women from COVID-19 spoke of their mixed feelings; being happy with their survival and that of their fetus, despite getting the disease, along with anxiety and fear of the future, which had resulted in the continuation of pregnancy in the limbo of ambiguity and expectation. Recovered pregnant women during unknown pandemics, despite being saved from disease, continue to tolerate concerns about their unborn child. CONCLUSION Recovered pregnant women during unknown pandemics, despite being saved from disease, continue to tolerate concerns about their fetus. Therefore, they require comprehensive and complete management approaches that require familiarity with the psychological challenges of this group of patients.
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Affiliation(s)
- Farzaneh Soltani
- Department of Midwifery and Reproductive Health, Mother and Child Care Research Center,
Hamadan University of Medical Sciences, Hamadan, Iran
| | - Rafat Bakht
- Department of Mother and Child Health, Faculty of Nursing and Midwifery, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Mansoureh Refaei
- Department of Mother and Child Health, Faculty of Nursing and Midwifery, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Laya Hemmati
- Students Research Center, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Soodabeh Aghababaei
- Department of Mother and Child Health, Mother and Child Care Research Center, Hamadan University of Medical Sciences, Hamadan, Iran,P.O.Box: 65178-38698Department of Mother and Child
HealthMother and Child Care Research CenterHamadan University of Medical
SciencesHamadanIran
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Caddy C, Cheong M, Lim MSC, Power R, Vogel JP, Bradfield Z, Coghlan B, Homer CSE, Wilson AN. "Tell us what's going on": Exploring the information needs of pregnant and post-partum women in Australia during the pandemic with 'Tweets', 'Threads', and women's views. PLoS One 2023; 18:e0279990. [PMID: 36638130 PMCID: PMC9838848 DOI: 10.1371/journal.pone.0279990] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Accepted: 12/19/2022] [Indexed: 01/14/2023] Open
Abstract
INTRODUCTION The provision of maternity services in Australia has been significantly disrupted in response to the COVID-19 pandemic. Many changes were initiated quickly, often with rapid dissemination of information to women. The aim of this study was to better understand what information and messages were circulating regarding COVID-19 and pregnancy in Australia and potential information gaps. METHODS This study adopted a qualitative approach using social media and interviews. A data analytics tool (TIGER-C19) was used to extract data from social media platforms Reddit and Twitter from June to July 2021 (in the middle of the third COVID-19 wave in Australia). A total of 21 individual semi-structured interviews were conducted with those who were, or had been, pregnant in Australia since March 2020. Social media data were analysis via inductive content analysis and interview data were thematically analysed. RESULTS Social media provided a critical platform for sharing and seeking information, as well as highlighting attitudes of the community towards COVID-19 vaccines in pregnancy. Women interviewed described wanting further information on the risks COVID-19 posed to themselves and their babies, and greater familiarity with the health service during pregnancy, in which they would labour and give birth. Health providers were a trusted source of information. Communication strategies that allowed participants to engage in real-time interactive discussions were preferred. A real or perceived lack of information led participants to turn to informal sources, increasing the potential for exposure to misinformation. CONCLUSION It is vital that health services communicate effectively with pregnant women, early and often throughout public health crises, such as the COVID-19 pandemic. This was particularly important during periods of increased restrictions on accessing hospital services. Information and communication strategies need to be clear, consistent, timely and accessible to reduce reliance on informal and potentially inaccurate sources.
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Affiliation(s)
| | - Marc Cheong
- Burnet Institute, Melbourne, VIC, Australia
- School of Computing and Information Systems, University of Melbourne, Parkville, VIC, Australia
| | | | | | - Joshua P. Vogel
- Burnet Institute, Melbourne, VIC, Australia
- School of Population and Global Health, University of Melbourne, Parkville, VIC, Australia
| | - Zoe Bradfield
- Burnet Institute, Melbourne, VIC, Australia
- Curtin University, Bentley, WA, Australia
- King Edward Memorial Hospital, Subiaco, WA, Australia
| | | | - Caroline S. E. Homer
- Burnet Institute, Melbourne, VIC, Australia
- School of Population and Global Health, University of Melbourne, Parkville, VIC, Australia
| | - Alyce N. Wilson
- Burnet Institute, Melbourne, VIC, Australia
- School of Population and Global Health, University of Melbourne, Parkville, VIC, Australia
- * E-mail:
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Xavier S, Branquinho M, Pires R, Moreira H, Coelho M, Araújo-Pedrosa A. Dysfunctional Attitudes Toward Motherhood and Depressive Symptoms in Portuguese Pregnant Women During COVID-19 Pandemic: the Mediating Roles of Self-Compassion and Mindful Self-Care. Mindfulness (N Y) 2023; 14:418-428. [PMID: 36597485 PMCID: PMC9798940 DOI: 10.1007/s12671-022-02049-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/13/2022] [Indexed: 12/31/2022]
Abstract
Objectives There is evidence that the coronavirus disease 2019 (COVID-19) pandemic had a negative impact on the mental health of pregnant women, such as an increase in the prevalence of depression. Given the negative consequences that depressive symptoms can pose for pregnant women, it is crucial to understand how cognitive processes influence women's depressive symptoms during the COVID-19 pandemic among this specific vulnerable population. The present study aimed to examine the relationship between pregnant women's dysfunctional attitudes toward motherhood and their depressive symptoms, considering the mediating roles of self-compassion and mindful self-care. Method A cross-sectional online survey was conducted in Portugal between October 2020 and April 2021. A sample of 244 pregnant women answered a set of questionnaires to assess dysfunctional attitudes toward motherhood, depressive symptoms, self-compassion, and mindful self-care. Results More dysfunctional attitudes toward motherhood were associated with higher levels of depressive symptoms, and this relation was mediated through self-compassion and mindful self-care. Conclusions These results highlight that self-compassion and mindful self-care are important psychological mechanisms and the importance of considering them in psychological interventions to prevent and/or treat depressive symptoms in pregnant women with dysfunctional attitudes toward motherhood during stressful events such as a pandemic.
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Affiliation(s)
- Sandra Xavier
- grid.8051.c0000 0000 9511 4342Center for Research in Neuropsychology and Cognitive and Behavioral Intervention, Faculty of Psychology and Education Sciences, University of Coimbra, Coimbra, Portugal
| | - Mariana Branquinho
- grid.8051.c0000 0000 9511 4342Center for Research in Neuropsychology and Cognitive and Behavioral Intervention, Faculty of Psychology and Education Sciences, University of Coimbra, Coimbra, Portugal
| | - Raquel Pires
- grid.8051.c0000 0000 9511 4342Center for Research in Neuropsychology and Cognitive and Behavioral Intervention, Faculty of Psychology and Education Sciences, University of Coimbra, Coimbra, Portugal
| | - Helena Moreira
- grid.8051.c0000 0000 9511 4342Center for Research in Neuropsychology and Cognitive and Behavioral Intervention, Faculty of Psychology and Education Sciences, University of Coimbra, Coimbra, Portugal
| | - Maria Coelho
- grid.8051.c0000 0000 9511 4342Center for Research in Neuropsychology and Cognitive and Behavioral Intervention, Faculty of Psychology and Education Sciences, University of Coimbra, Coimbra, Portugal
| | - Anabela Araújo-Pedrosa
- grid.8051.c0000 0000 9511 4342Center for Research in Neuropsychology and Cognitive and Behavioral Intervention, Faculty of Psychology and Education Sciences, University of Coimbra, Coimbra, Portugal
- grid.28911.330000000106861985Clinical Psychology Service & Department of Gynecology, Obstetrics, Reproduction and Neonatology, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
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Taubman–Ben-Ari O, Chasson M, Erel-Brodsky H, Abu-Sharkia S, Skvirsky V, Horowitz E. Contributors to COVID-19-Related Childbirth Anxiety among Pregnant Women in Two Pandemic Waves. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 20:110. [PMID: 36612432 PMCID: PMC9828941 DOI: 10.3390/ijerph20010110] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/12/2022] [Revised: 12/09/2022] [Accepted: 12/13/2022] [Indexed: 06/17/2023]
Abstract
COVID-19 has impacted all levels of daily life for people everywhere, with particularly serious implications for pregnant women. This paper examines the COVID-19-related childbirth anxiety (CCA) of Israeli women in the first two waves of the pandemic. We first present two psychotherapeutic case studies with pregnant women in the two waves. This is followed by an empirical study that compared the contribution of background variables, psychological distress, economic concerns, and personal resources to CCA in two samples, Wave 1, March-April 2020 (n = 403) and Wave 2, September-October 2020 (n = 1401), and two subpopulations, Jewish and Arab women. Findings reveal that CCA was significantly lower in Wave 2 than in Wave 1. Furthermore, poorer health, higher education, being an Arab, later gestational week, at-risk pregnancy, wave, higher psychological distress, greater economic concerns, and lower self-compassion contributed to higher childbirth anxiety. Wave moderated the association between optimism and anxiety. The findings of the empirical study, together with insights from the case studies, provide evidence of a decrease in CCA later in the crisis, and indicate the significance of resources for coping with the psychological implications of the pandemic. Moreover, they suggest the importance of empowering self-reliance techniques, such as self-compassion, which was significantly associated with lower anxiety, above and beyond the background and psychological variables. Clinical Impact Statement: Using both psychotherapeutic cases and empirical findings, this study points to the risk and resilience factors that contributed to pregnant women's COVID-19-related childbirth anxiety (CCA) in the first two waves of the pandemic. The study suggests that CCA was higher in the first wave, as well as among women from a minority group. At the same time, the research shows that resilience resources of optimism and self-compassion contributed to the reduction of anxiety. These findings may guide interventions for the vulnerable group of pregnant women in times of crisis.
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Affiliation(s)
- Orit Taubman–Ben-Ari
- The Louis and Gabi Weisfeld School of Social Work, Bar Ilan University, Ramat Gan 5290001, Israel
| | - Miriam Chasson
- The Louis and Gabi Weisfeld School of Social Work, Bar Ilan University, Ramat Gan 5290001, Israel
| | - Hilit Erel-Brodsky
- The Louis and Gabi Weisfeld School of Social Work, Bar Ilan University, Ramat Gan 5290001, Israel
| | - Salam Abu-Sharkia
- The Louis and Gabi Weisfeld School of Social Work, Bar Ilan University, Ramat Gan 5290001, Israel
| | - Vera Skvirsky
- The Louis and Gabi Weisfeld School of Social Work, Bar Ilan University, Ramat Gan 5290001, Israel
| | - Eran Horowitz
- The Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv 6997801, Israel
- Maccabi Healthcare Services, Tel Aviv 6812509, Israel
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van den Berg LMM, Akooji N, Thomson G, de Jonge A, Balaam MC, Topalidou A, Downe S. Making maternity and neonatal care personalised in the COVID-19 pandemic: Results from the Babies Born Better survey in the UK and the Netherlands. PLoS One 2022; 17:e0267415. [PMID: 36449488 PMCID: PMC9710753 DOI: 10.1371/journal.pone.0267415] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Accepted: 09/24/2022] [Indexed: 12/05/2022] Open
Abstract
BACKGROUND The COVID-19 pandemic had a severe impact on women's birth experiences. To date, there are no studies that use both quantitative and qualitative data to compare women's birth experiences before and during the pandemic, across more than one country. AIM To examine women's birth experiences during the COVID-19 pandemic and to compare the experiences of women who gave birth in the United Kingdom (UK) or the Netherlands (NL) either before or during the pandemic. METHOD This study is based on analyses of quantitative and qualitative data from the online Babies Born Better survey. Responses recorded by women giving birth in the UK and the NL between June and December 2020 have been used, encompassing women who gave birth between 2017 and 2020. Quantitative data were analysed descriptively, and chi-squared tests were performed to compare women who gave birth pre- versus during pandemic and separately by country. Qualitative data was analysed by inductive thematic analysis. FINDINGS Respondents in both the UK and the NL who gave birth during the pandemic were as likely, or, if they had a self-reported above average standard of life, more likely to rate their labour and birth experience positively when compared to women who gave birth pre-pandemic. This was despite the fact that those labouring in the pandemic reported a lack of support and limits placed on freedom of choice. Two potential explanatory themes were identified in the qualitative data: respondents had lower expectations of care during the pandemic, and they appreciated the efforts of staff to give individualised care, despite the rules. CONCLUSION Our study implies that many women labouring during the COVID-19 pandemic experienced restrictions, but their experience was mitigated by staff actions. However, personalised care should not be maintained by the good will of care providers, but should be a priority in maternity care policy to benefit all service users equitably.
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Affiliation(s)
- Lauri M. M. van den Berg
- Department of Midwifery Science, Amsterdam UMC location Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Midwifery Academy Amsterdam Groningen, InHolland, Amsterdam, The Netherlands
- Amsterdam Public Health, Quality of Care, Amsterdam, The Netherlands
- Department of General Practice & Elderly Care Medicine, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Naseerah Akooji
- Lancashire Clinical Trials Units, University of Central Lancashire, Preston, United Kingdom
| | - Gill Thomson
- Faculty of Health and Care, School of Community Health & Midwifery, University of Central Lancashire, Preston, United Kingdom
| | - Ank de Jonge
- Department of Midwifery Science, Amsterdam UMC location Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Midwifery Academy Amsterdam Groningen, InHolland, Amsterdam, The Netherlands
- Department of General Practice & Elderly Care Medicine, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
- Amsterdam Reproduction and Development, Quality of Care, Amsterdam, The Netherlands
| | - Marie-Clare Balaam
- Faculty of Health and Care, School of Community Health & Midwifery, University of Central Lancashire, Preston, United Kingdom
| | - Anastasia Topalidou
- Faculty of Health and Care, School of Community Health & Midwifery, University of Central Lancashire, Preston, United Kingdom
| | - Soo Downe
- Faculty of Health and Care, School of Community Health & Midwifery, University of Central Lancashire, Preston, United Kingdom
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von Rieben MA, Boyd L, Sheen J. Care in the time of COVID: An interpretative phenomenological analysis of the impact of COVID-19 control measures on post-partum mothers' experiences of pregnancy, birth and the health system. Front Psychol 2022; 13:986472. [PMID: 36211889 PMCID: PMC9537098 DOI: 10.3389/fpsyg.2022.986472] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2022] [Accepted: 08/26/2022] [Indexed: 11/13/2022] Open
Abstract
Background Findings suggest pandemic control measures have modified maternal health practices, compromising the quality of care provided to new and expectant mothers and interfering with their birthing experiences. For this reason, this study explored the lived experiences of post-partum Victorian mothers during the pandemic as well as the potential influence of control measures over their perceptions regarding the health system. Methods This study used a qualitative approach. Recruitment was conducted between May and June 2021, using both the Australian Breastfeeding Association's social media pages and snowball recruitment. Interviews were semi-structured using open-ended questions relating to key themes. Seven Victorian post-partum mothers were identified and their transcripts analysed using Interpretative Phenomenological Analysis. Results Mothers described how unexpected changes to maternal care exacerbated feelings of uncertainty regarding pregnancy and birth. Mothers also differentiated between impacts by the health system and the role healthcare professionals played in moderating these effects. Whilst visitor restrictions provided some benefit, restrictions to familial and social support left many of the mothers feeling alone during their pregnancy and interfered with their immediate post-partum experience. Conclusion This study illustrates the importance of evidence-based practice in maternal care and provides insights for both health professionals and policy analysts in developing new or modifying existing guidelines that better balance the needs of expectant and post-partum mothers with pandemic control measures.
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Affiliation(s)
| | - Leanne Boyd
- Monash University, Eastern Health, Melbourne, VIC, Australia
| | - Jade Sheen
- School of Psychology, Deakin University, Burwood, VIC, Australia
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Arzamani N, Soraya S, Hadi F, Nooraeen S, Saeidi M. The COVID-19 pandemic and mental health in pregnant women: A review article. Front Psychiatry 2022; 13:949239. [PMID: 36203829 PMCID: PMC9531726 DOI: 10.3389/fpsyt.2022.949239] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2022] [Accepted: 08/08/2022] [Indexed: 11/13/2022] Open
Abstract
A rapid spreading of the COVID-19 virus in recent years had a great impact on every single aspect of live and the world faced with unexpected and unpredictable crisis in both physical and mental condition. As with any crisis, vulnerable individuals like pregnant women were the concern of societies. Several physiological and psychological changes occur during pregnancy which put individuals in a risk of mental health problems. During the outbreak of the COVID-19, pregnant women have experienced more psychological stresses, fear, anxiety, and depression. The prenatal mental distresses and psychiatric disorders may cause poor compliance, reduce help-seeking behaviors, and neglect to take the follow up screening visits and risk of harm for mother and others. Addressing the mental health in pregnant women is crucial to prevent the consequences. The purpose of this narrative review was to investigate the available literature on the impact of the COVID-19 pandemic on mental health in pregnant women and provide some recommendations to improve mental health in them. It also shed some light on providing mental health services for women during pregnancy and can be used by health professionals and policymakers.
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Affiliation(s)
- Niloufar Arzamani
- Mental Health Research Center, School of Behavioral Sciences and Mental Health, Iran University of Medical Sciences, Tehran, Iran
| | - Shiva Soraya
- Research Center of Addiction and Risky Behaviors, Department of Psychiatry, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Fatemeh Hadi
- Mental Health Research Center, School of Behavioral Sciences and Mental Health, Iran University of Medical Sciences, Tehran, Iran
| | - Sara Nooraeen
- Mental Health Research Center, School of Behavioral Sciences and Mental Health, Iran University of Medical Sciences, Tehran, Iran
| | - Mahdieh Saeidi
- Research Center of Addiction and Risky Behaviors, Department of Psychiatry, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
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Uludağ E, Serçekuş P, Vardar O, Özkan S, Alataş SE. Effects of online antenatal education on worries about labour, fear of childbirth, preparedness for labour and fear of covid-19 during the covid-19 pandemic: A single-blind randomised controlled study. Midwifery 2022; 115:103484. [PMID: 36155390 PMCID: PMC9461235 DOI: 10.1016/j.midw.2022.103484] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Revised: 06/01/2022] [Accepted: 09/08/2022] [Indexed: 11/19/2022]
Abstract
Objective To examine the effects of online antenatal education on worries about labour, fear of childbirth, preparedness for labour and fear of COVID-19 during the COVID-19 pandemic. Design A single-blind randomised controlled trial comparing two groups: an antenatal education group and a control group. Participants The sample consisted of 44 pregnant women. Measurements A demographic data form, The Oxford Worries on Labour Scale, The Fear of Birth Scale, The Prenatal Self Evaluation Questionnaire and The Fear of COVID-19 Scale were used for data collection. Findings Online antenatal education decreased worries about labour, fear of childbirth and fear of COVID-19 and improved preparedness for labour. Key conclusions Online antenatal education offered during the COVID-19 pandemic is effective in preparedness for labour. Implications for practice As an alternative, online antenatal education should be offered to pregnant women unable to attend face to face education programs due to fear of transmission of infection.
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Affiliation(s)
- Elif Uludağ
- Pamukkale University, Faculty of Health Sciences, Denizli, Turkey
| | - Pınar Serçekuş
- Pamukkale University, Faculty of Health Sciences, Denizli, Turkey.
| | - Okan Vardar
- Pamukkale University, Faculty of Health Sciences, Denizli, Turkey
| | - Sevgi Özkan
- Pamukkale University, Faculty of Health Sciences, Denizli, Turkey
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Hadjigeorgiou E, Vogazianos P, Christofi MD, Motrico E, Domínguez-Salas S, Mesquita AR, Christoforou A. Experiences, concerns, and needs of pregnant and postpartum women during the Covid-19 pandemic in Cyprus: a cross-sectional study. BMC Pregnancy Childbirth 2022; 22:685. [PMID: 36064519 PMCID: PMC9442558 DOI: 10.1186/s12884-022-05017-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2021] [Accepted: 08/24/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The current COVID-19 pandemic is a unique stressor with potentially challenging and negative consequences on the experiences of pregnant and postpartum women. International literature highlights the pandemic's negative impact on women's perinatal experiences. This is the first study in the scientific literature reporting on the impact of the COVID-19 pandemic, on the perinatal experiences of a large sample of women living in Cyprus. AIM To examine the impact of the COVID-19 pandemic on the experiences, concerns and needs of pregnant and postpartum women in Cyprus. METHOD The cross-sectional study was conducted from July 2020 to January 2021. A total of 695 women, 355 pregnant and 340 postpartum women (with infants up to 6 months of age), residing in Cyprus were surveyed. RESULTS The great majority of the participants (80.9%) perceived the impact of the COVID-19 pandemic on their life as negative. The greatest sources of stress were identified and quantified for their impact on the participants. Our findings indicate that 74.1% of the pregnant women were concerned about changes due to COVID-19 measures impacting the presence of their family at the time of delivery, 57.2% about their newborn's health, and 43.1% about changes related to perinatal care. Postpartum women's concerns were mainly related to the welfare and health of their child (70.3%), whilst half of them (49.1%) expressed concerns about how they were going to care for their baby because of pandemic-related changes. Qualitative data revealed emerging themes as the basis of the pregnant and postpartum women's concerns and needs. CONCLUSIONS The COVID-19 pandemic and the associated imposed measures and restrictions had adverse effects on pregnant and postpartum women's perinatal experiences in Cyprus. The women's concerns emphasized the need for the development of specialized, evidenced-based support systems which are essential particularly in pandemic-like situations, when pregnant and postpartum women are more vulnerable to isolation.
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Affiliation(s)
- Eleni Hadjigeorgiou
- Nursing Department, School of Health Sciences, Cyprus University of Technology, Limassol, Cyprus.
| | - Paris Vogazianos
- Department of Social and Behavioral Sciences, School of Humanities, Social and Education Sciences, European University Cyprus, Nicosia, Cyprus
| | - Maria-Dolores Christofi
- Nursing Department, School of Health Sciences, Cyprus University of Technology, Limassol, Cyprus
| | - Emma Motrico
- Psychology Department, Universidad Loyola Andalucia, Dos Hermanas Seville, Spain
| | - Sara Domínguez-Salas
- Psychology Department, Universidad Loyola Andalucia, Dos Hermanas Seville, Spain
| | - Ana R Mesquita
- School of Psychology, University of Minho, Campus de Gualtar, Braga, Portugal
| | - Andri Christoforou
- Department of Social and Behavioral Sciences, School of Humanities, Social and Education Sciences, European University Cyprus, Nicosia, Cyprus
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Loughnan SA, Gautam R, Silverio SA, Boyle FM, Cassidy J, Ellwood D, Homer C, Horey D, Leisher SH, de Montigny F, Murphy M, O'Donoghue K, Quigley P, Ravaldi C, Sandall J, Storey C, Vannacci A, Wilson AN, Flenady V. Multicountry study protocol of COCOON: COntinuing Care in COVID-19 Outbreak global survey of New, expectant, and bereaved parent experiences. BMJ Open 2022; 12:e061550. [PMID: 36691138 PMCID: PMC9445233 DOI: 10.1136/bmjopen-2022-061550] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Accepted: 07/25/2022] [Indexed: 01/27/2023] Open
Abstract
INTRODUCTION Globally, the COVID-19 pandemic has significantly disrupted the provision of healthcare and efficiency of healthcare systems and is likely to have profound implications for pregnant and postpartum women and their families including those who experience the tragedy of stillbirth or neonatal death. This study aims to understand the psychosocial impact of COVID-19 and the experiences of parents who have accessed maternity, neonatal and bereavement care services during this time. METHODS AND ANALYSIS An international, cross-sectional, online and/or telephone-based/face-to-face survey is being administered across 15 countries and available in 11 languages. New, expectant and bereaved parents during the COVID-19 pandemic will be recruited. Validated psychometric scales will be used to measure psychosocial well-being. Data will be analysed descriptively and by assessing multivariable associations of the outcomes with explanatory factors. In seven of these countries, bereaved parents will be recruited to a nested, qualitative interview study. The data will be analysed using a grounded theory analysis (for each country) and thematic framework analysis (for intercountry comparison) to gain further insights into their experiences. ETHICS AND DISSEMINATION Ethics approval for the multicountry online survey, COCOON, has been granted by the Mater Misericordiae Human Research Ethics Committee in Australia (reference number: AM/MML/63526). Ethics approval for the nested qualitative interview study, PUDDLES, has been granted by the King's College London Biomedical & Health Sciences, Dentistry, Medicine and Natural & Mathematical Sciences Research Ethics Subcommittee (reference number: HR-19/20-19455) in the UK. Local ethics committee approvals were granted in participating countries where required. Results of the study will be published in international peer-reviewed journals and through parent support organisations. Findings will contribute to our understanding of delivering maternity care services, particularly bereavement care, in high-income, lower middle-income and low-income countries during this or future health crises.
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Affiliation(s)
- Siobhan A Loughnan
- NHMRC Centre of Research Excellence in Stillbirth, Mater Research Institute-The University of Queensland, Brisbane, QLD, Australia
| | - Rupesh Gautam
- NHMRC Centre of Research Excellence in Stillbirth, Mater Research Institute-The University of Queensland, Brisbane, QLD, Australia
| | - Sergio A Silverio
- Department of Women & Children's Health, School of Life Course Sciences, King's College London, London, UK
| | - Frances M Boyle
- NHMRC Centre of Research Excellence in Stillbirth, Mater Research Institute-The University of Queensland, Brisbane, QLD, Australia
- Institute for Social Science Research, The University of Queensland, Brisbane, Queensland, Australia
| | | | - David Ellwood
- NHMRC Centre of Research Excellence in Stillbirth, Mater Research Institute-The University of Queensland, Brisbane, QLD, Australia
- School of Medicine and Dentistry, Griffith University, Gold Coast, Queensland, Australia
| | - Caroline Homer
- Maternal, Child and Adolescent Health Program, Burnet Institute, Melbourne, Victoria, Australia
| | - Dell Horey
- NHMRC Centre of Research Excellence in Stillbirth, Mater Research Institute-The University of Queensland, Brisbane, QLD, Australia
- Department of Psychology and Public Health, La Trobe University, Melbourne, Victoria, Australia
| | | | - Francine de Montigny
- Département des Sciences Infirmières, Université du Québec en Outaouais, Gatineau, Quebec, Canada
| | - Margaret Murphy
- Nursing and Midwifery, University College Cork-National University of Ireland, Cork, Ireland
| | - Keelin O'Donoghue
- Department of Obstetrics and Gynaecology, Cork University Maternity Hospital, University College Cork, Cork, Ireland
| | - Paula Quigley
- International Stillbirth Alliance, Millburn, New Jersey, USA
- DAI Global Health, London, UK
| | - Claudia Ravaldi
- CiaoLapo Foundation for Perinatal Health, Prato, Italy
- PeaRL - Perinatal Research Laboratory, Department of Neurosciences, Psychology, Drug Research and Child Health (NEUROFARBA), University of Florence, Firenze, Italy
| | - Jane Sandall
- Department of Women & Children's Health, School of Life Course Sciences, King's College London, London, UK
| | - Claire Storey
- International Stillbirth Alliance, Millburn, New Jersey, USA
| | - Alfredo Vannacci
- CiaoLapo Foundation for Perinatal Health, Prato, Italy
- PeaRL - Perinatal Research Laboratory, Department of Neurosciences, Psychology, Drug Research and Child Health (NEUROFARBA), University of Florence, Firenze, Italy
| | - Alyce N Wilson
- Maternal, Child and Adolescent Health Program, Burnet Institute, Melbourne, Victoria, Australia
| | - Vicki Flenady
- NHMRC Centre of Research Excellence in Stillbirth, Mater Research Institute-The University of Queensland, Brisbane, QLD, Australia
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Ravaldi C, Mosconi L, Wilson AN, Amir LH, Bonaiuti R, Ricca V, Vannacci A. Exclusive breastfeeding and women's psychological well-being during the first wave of COVID-19 pandemic in Italy. Front Public Health 2022; 10:965306. [PMID: 36081482 PMCID: PMC9445494 DOI: 10.3389/fpubh.2022.965306] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Accepted: 08/08/2022] [Indexed: 01/24/2023] Open
Abstract
Background At the onset of the COVID-19 pandemic, support for breastfeeding was disrupted in many countries. Italy was severely impacted by the pandemic and is known to have the lowest exclusive breastfeeding rate of all European countries. Considering the inverse association between anxiety and breastfeeding, maternal concerns about the COVID-19 emergency could reduce breastfeeding rates. The aim of the study is to explore the association between infant feeding practices and maternal COVID-19 concerns. Methods This paper is a secondary analysis of the cross-sectional study COVID-ASSESS conducted in Italy in 2020. The original survey was administered in two phases: during the first lockdown and during the reopening. The survey included five sections: socio-demographic, medical history, concerns about the COVID-19 pandemic, infant feeding practices and psychometric evaluation. Participants were considered eligible for the post-hoc analyses if they were exclusively breastfeeding or they were feeding with infant formula (either alone or with breastfeeding) at the time of the interview. Results Between phase 1 and phase 2 there was a decrease in anxiety and concerns about the danger of COVID-19 to general health, except for concerns about their baby's health. Women using formula were more concerned about all the health topics investigated. Moreover, they showed higher levels of stress, state anxiety, somatization and PTSD symptoms. Conclusion Breastfeeding during the first pandemic lockdown in Italy seems to have been an independent factor associated with lower anxiety about COVID-19, fewer psychopathological symptoms, and a positive experience of infant feeding.
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Affiliation(s)
- Claudia Ravaldi
- Perinatal Research Laboratory, PeaRL, CiaoLapo Foundation for Perinatal Health, Department of Neurosciences, Psychology, Drug Research and Child Health, University of Florence, Florence, Italy
| | - Laura Mosconi
- Perinatal Research Laboratory, PeaRL, CiaoLapo Foundation for Perinatal Health, Department of Neurosciences, Psychology, Drug Research and Child Health, University of Florence, Florence, Italy
| | - Alyce N. Wilson
- Maternal, Child and Adolescent Health Program, Burnet Institute, Melbourne, VIC, Australia
| | - Lisa H. Amir
- Judith Lumley Centre, School of Nursing and Midwifery, La Trobe University, Bundoora, VIC, Australia,Breastfeeding Service, Royal Women's Hospital, Parkville, VIC, Australia
| | - Roberto Bonaiuti
- Perinatal Research Laboratory, PeaRL, CiaoLapo Foundation for Perinatal Health, Department of Neurosciences, Psychology, Drug Research and Child Health, University of Florence, Florence, Italy
| | - Valdo Ricca
- Psychiatry Unit, Department of Health Sciences, University of Florence, Florence, Italy
| | - Alfredo Vannacci
- Perinatal Research Laboratory, PeaRL, CiaoLapo Foundation for Perinatal Health, Department of Neurosciences, Psychology, Drug Research and Child Health, University of Florence, Florence, Italy,*Correspondence: Alfredo Vannacci
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Akgün M, Turgut Y, Güdül Öz H, Yangin H, Boz İ. Examining the relationship between perinatal anxiety, COVID-19 phobia and birth type preferences: A cross-sectional study. J Clin Nurs 2022. [PMID: 35949166 PMCID: PMC9538442 DOI: 10.1111/jocn.16486] [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: 05/15/2022] [Revised: 06/21/2022] [Accepted: 07/21/2022] [Indexed: 01/02/2023]
Abstract
AIM To examine the relationship between the COVID-19 phobia and perinatal anxiety levels and birth type preferences of pregnant women in the third trimester. DESIGN This was designed a cross-sectional study using the non-random convenience sampling method following the STROBE checklist. METHODS The research was conducted with 315 pregnant women from April to May 2021. Data were collected using a personal information form, the COVID-19 Phobia Scale, and the Perinatal Anxiety Screening Scale (PASS). RESULTS We found a positive and moderate correlation between the total scores for perinatal anxiety and COVID-19 phobia. During the COVID-19 pandemic, 4.1% of the participants changed their birth type preferences and this change was statistically significant according to McNemar's test. During the COVID-19 pandemic, the women changed their birth type preferences in favour of caesarean section. However, there was no statistically significant difference between those who changed their birth type preferences and those who did not in terms of perinatal anxiety or COVID-19 phobia levels. Women with no access to prenatal follow-up visits due to the COVID-19 pandemic had higher mean PASS scores and higher mean scores for the perfectionism, control and trauma subscale. The scores for general worry and specific fears were lower among individuals who had obtained information about birth types in prenatal follow-up visits. Also, perinatal anxiety and COVID-19 phobia levels were higher among pregnant women who were worried about giving birth in hospital compared to those who were not worried. CONCLUSION We conclude that COVID-19 phobia has increased women's perinatal anxiety, causing them to change their birth type preferences in favour of caesarean section. RELEVANCE TO CLINICAL PRACTICE We recommended that healthcare professionals take COVID-19 phobia and perinatal anxiety into account when counselling pregnant women about birth types to improve prenatal care. NO PATIENT OR PUBLIC CONTRIBUTION No patient or public contribution was required to design, to outcome measures or undertake this research. Patients/members of the public contributed only to the data collection. Data were obtained from pregnant women in the third trimester, who came to a regional hospital-affiliated obstetrics polyclinic for routine prenatal follow-up visits.
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Affiliation(s)
- Mehtap Akgün
- Department of Maternity and Gynecological Nursing, Nursing Faculty, Akdeniz University, Antalya, Turkey
| | - Yasemin Turgut
- Department of Anesthesia, Vocational School of Health Services, Antalya Science University, Antalya, Turkey
| | - Hatice Güdül Öz
- Department of Maternity and Gynecological Nursing, Nursing Faculty, Çukurova University, Adana, Turkey
| | - Hatice Yangin
- Department of Maternity and Gynecological Nursing, Nursing Faculty, Akdeniz University, Antalya, Turkey
| | - İlkay Boz
- Department of Maternity and Gynecological Nursing, Nursing Faculty, Akdeniz University, Antalya, Turkey
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Cena L, Trainini A, Tralli N, Nodari LS, Iacona E, Ronconi L, Testoni I. The Impact of the COVID-19 Pandemic on Perinatal Loss Experienced by the Parental Couple: Protocol for a Mixed Methods Study in Italy. JMIR Res Protoc 2022; 11:e38866. [PMID: 36044641 PMCID: PMC9472504 DOI: 10.2196/38866] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2022] [Revised: 06/10/2022] [Accepted: 08/06/2022] [Indexed: 12/21/2022] Open
Abstract
Background At the beginning of 2020, mothers and fathers who experienced perinatal events (from conception to pregnancy and postpartum period) found themselves facing problems related to the emergency caused by the COVID-19 pandemic and the associated difficulties for health care centers in providing care. In the unexpected and negative event of perinatal loss (ie, miscarriage, stillbirth, and neonatal death) more complications occurred. Perinatal loss is a painful and traumatic life experience that causes grief and can cause affective disorders in the parental couple—the baby dies and the couple’s plans for a family are abruptly interrupted. During the COVID-19 pandemic, limited access to perinatal bereavement care, due to the lockdown measures imposed on medical health care centers and the social distancing rules to prevent contagion, was an additional risk factor for parental mental health, such as facing a prolonged and complicated grief. Objective The main aims of this study are as follows: to investigate the impact of COVID-19 on mothers and fathers who experienced perinatal loss during the pandemic, comparing their perceptions; to evaluate their change over time between the first survey administration after bereavement and the second survey after 6 months; to examine the correlations between bereavement and anxiety, depression, couple satisfaction, spirituality, and sociodemographic variables; to investigate which psychosocial factors may negatively affect the mourning process; and to identify the potential predictors of the development of complicated grief. Methods This longitudinal observational multicenter study is structured according to a mixed methods design, with a quantitative and qualitative section. It will include a sample of parents (mothers and fathers) who experienced perinatal loss during the COVID-19 pandemic from March 2020. There are two phases—a baseline and a follow-up after 6 months. Results This protocol was approved by the Ethics Committee of Psychological Research, University of Padova, and by the Institutional Ethics Board of the Spedali Civili of Brescia, Italy. We expect to collect data from 34 or more couples, as determined by our sample size calculation. Conclusions This study will contribute to the understanding of the psychological processes related to perinatal loss and bereavement care during the COVID-19 pandemic. It will provide information useful to prevent the risk of complicated grief and psychopathologies among bereaved parents and to promote perinatal mental health. International Registered Report Identifier (IRRID) DERR1-10.2196/38866
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Affiliation(s)
- Loredana Cena
- Observatory of Perinatal Clinical Psychology, Department of Clinical and Experimental Science, University of Brescia, viale Europa 11 Brescia 25123, Brescia, IT
| | - Alice Trainini
- Observatory of Perinatal Clinical Psychology, Department of Clinical and Experimental Science, University of Brescia, viale Europa 11 Brescia 25123, Brescia, IT
| | - Nella Tralli
- Observatory of Perinatal Clinical Psychology, Department of Clinical and Experimental Science, University of Brescia, viale Europa 11 Brescia 25123, Brescia, IT
| | - Luisa Silvia Nodari
- Observatory of Perinatal Clinical Psychology, Department of Clinical and Experimental Science, University of Brescia, viale Europa 11 Brescia 25123, Brescia, IT
| | - Erika Iacona
- Department of Philosophy, Sociology, Education and Applied Psychology, University of Padova, Padova, IT
| | - Lucia Ronconi
- IT and Statistical Services, Multifunctional Centre of Psychology, University of Padova, Padova, IT
| | - Ines Testoni
- Department of Philosophy, Sociology, Education and Applied Psychology, University of Padova, Padova, IT
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Orsolini L, Pompili S, Mauro A, Salvi V, Volpe U. Fear and anxiety related to COVID-19 pandemic may predispose to perinatal depression in Italy. Front Psychiatry 2022; 13:977681. [PMID: 35990081 PMCID: PMC9382111 DOI: 10.3389/fpsyt.2022.977681] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/24/2022] [Accepted: 07/07/2022] [Indexed: 12/23/2022] Open
Abstract
The COVID-19 pandemic situation significantly affected the mental health of the general and clinical population. However, few studies investigated which COVID-19-related psychopathological determinants may predispose to perinatal depression. We evaluated the impact of COVID-19 related anxiety and fear on perinatal depression in Italy. We retrospectively screened 184 perinatal outpatients afferent to Perinatal Mental Health outpatient service, during March 2020-March 2021, by administering the Edinburgh Postnatal Depression Scale (EPDS), the Fear of COVID-19 (FCV-19-S) and the Coronavirus Anxiety Scale (CAS). Among these, 85 patients agreed to be recruited in the present study. The mean EPDS score was 9.0, experiencing a clinically relevant perinatal depression in 45.7% of the sample. The mean FCV-19-S score was 15.0 and CAS was 1.7. Linear regression analyses demonstrated that FCV-19-S and CAS scores statistically significantly predicted EPDS total scores. A positive significant correlation was reported between FCV-19-S and EPDS and between CAS and EPDS. During the COVID-19 pandemic, women in their perinatal period, independently of previous psychiatric history, experienced increased levels of anxiety, fear and psychological distress, due to subsequent isolation, quarantine, lockdown and deprivation of their normal social support. Further preventive and screening strategies should be implemented in order to early identify at-risk pregnant and puerperal women during the COVID-19 pandemic.
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Affiliation(s)
- Laura Orsolini
- Unit of Clinical Psychiatry, Department of Neurosciences/DIMSC, Polytechnic University of Marche, Ancona, Italy
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