1
|
Reimer CJ, Willis MD, Wesselink AK, Hystad P, Campbell EJ, Hatch EE, Kirwa K, Gradus JL, Vinceti M, Wise LA, Jimenez MP. Exposure to residential greenness, perceived stress, and depressive symptoms in a North American preconception cohort. ENVIRONMENTAL RESEARCH 2024; 260:119438. [PMID: 38901815 DOI: 10.1016/j.envres.2024.119438] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/23/2024] [Revised: 05/10/2024] [Accepted: 06/17/2024] [Indexed: 06/22/2024]
Abstract
BACKGROUND Studies suggest that greater exposure to natural vegetation (i.e., greenness) is associated with better mental health. However, there is limited research on greenness and mental health in the preconception period, a critical window of exposure in the life course. We investigated the associations of residential greenness with perceived stress and depressive symptoms using cross-sectional data from a cohort of pregnancy planners. METHODS From 2013 to 2019, we enrolled female-identified participants aged 21-45 years who were trying to conceive without the use of fertility treatment into a North American preconception cohort study (Pregnancy Study Online [PRESTO]). On the baseline questionnaire, participants completed the 10-item Perceived Stress Scale (PSS) and the Major Depression Inventory (MDI). Using geocoded addresses, we estimated residential greenness exposure via satellite imagery (Normalized Difference Vegetation Index [NDVI]) in a 100m buffer. We estimated mean differences and 95% confidence intervals for the association of greenness with perceived stress and depression scores using linear regression models, adjusting for individual and neighborhood sociodemographic characteristics. We also evaluated the extent to which associations were modified by urbanicity and neighborhood socioeconomic status (SES). RESULTS Among 9718 participants, mean age was 29.9 years, 81.5% identified as non-Hispanic White, 25% had household incomes <$50,000, and mean neighborhood income was $61,932. In adjusted models, higher greenness was associated with lower stress and depression scores (mean difference per interquartile range in greenness: -0.20, 95% CI: -0.39, -0.01; and -0.19, 95% CI: -0.48, 0.10, respectively). The association was stronger among residents of lower SES neighborhoods in urban areas (PSS: -0.57, 95% CI: -1.00, -0.15; MDI: -0.72, 95% CI: -1.40, -0.04). CONCLUSIONS Higher greenness exposure was associated with lower stress and depressive symptoms among pregnancy planners, particularly in lower-SES neighborhoods.
Collapse
Affiliation(s)
- Cameron J Reimer
- Department of Epidemiology, Boston University School of Public Health, Boston, MA, USA.
| | - Mary D Willis
- Department of Epidemiology, Boston University School of Public Health, Boston, MA, USA
| | - Amelia K Wesselink
- Department of Epidemiology, Boston University School of Public Health, Boston, MA, USA
| | - Perry Hystad
- School of Nutrition and Public Health, College of Health, Oregon State University, Corvallis, OR, USA
| | - Erin J Campbell
- Department of Epidemiology, Boston University School of Public Health, Boston, MA, USA
| | - Elizabeth E Hatch
- Department of Epidemiology, Boston University School of Public Health, Boston, MA, USA
| | - Kipruto Kirwa
- Department of Environmental Health, Boston University School of Public Health, Boston, MA, USA
| | - Jaimie L Gradus
- Department of Epidemiology, Boston University School of Public Health, Boston, MA, USA
| | - Marco Vinceti
- Department of Epidemiology, Boston University School of Public Health, Boston, MA, USA; Department of Biomedical, Metabolic and Neural Sciences, Medical School, University of Modena and Reggio Emilia, Modena, Italy
| | - Lauren A Wise
- Department of Epidemiology, Boston University School of Public Health, Boston, MA, USA
| | | |
Collapse
|
2
|
Singh S, Goel I, Tripathi S, Ahirwar A, Kumar M, Rana A, Dhar R, Karmakar S. Effect of environmental air pollutants on placental function and pregnancy outcomes: a molecular insight. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2024:10.1007/s11356-024-35016-9. [PMID: 39388084 DOI: 10.1007/s11356-024-35016-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/26/2024] [Accepted: 09/13/2024] [Indexed: 10/15/2024]
Abstract
Air pollution has become a major health concern, particularly for vulnerable populations such as the elderly, children, and pregnant women. Studies have reported a strong association between prenatal exposure to air pollutants and adverse pregnancy outcomes, including lower birth weight, reduced fetal growth, and an increased frequency of preterm births. This review summarizes the harmful effects of air pollutants, such as particulate matter, on pregnancy and outlines the mechanistic details associated with these adverse outcomes. Particulate pollutant matter may be able to cross the placenta barrier, and alterations in placental functions are central to the detrimental effects of these pollutants. In addition to associations with preeclampsia and gestational hypertension, air pollutants also induce oxidative stress, inflammation, and epigenetic alteration in the placenta. These pollutants can also affect placental homeostasis and endocrine function, contributing to pregnancy complications and possible transgenerational effects. Prenatal air pollution exposure has been linked to reduced cognitive and motor function in infants and newborns, increasing the predisposition to autism spectrum disorders and other neuropsychiatric disorders. This review also summarizes the use of various animal models to study the harmful effects of air pollution on pregnancy and postnatal outcomes. These findings provide valuable insight into the molecular events associated with the process and can aid in risk mitigation and adopting safety measures. Implementing effective environmental protocols and taking appropriate steps may reduce the global disease burden, particularly for developing nations with poor regulatory compliance and large populations of pregnant women.
Collapse
Affiliation(s)
- Sunil Singh
- Department of Biochemistry, All India Institute of Medical Sciences, Room 3020, New Delhi, 110029, India
| | - Isha Goel
- Department of Psychiatry, All India Institute of Medical Sciences, New Delhi, India
| | - Smita Tripathi
- Department of Biochemistry, Lady Harding Medical College, New Delhi, India
| | - Ashok Ahirwar
- Department of Lab Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Megha Kumar
- CSIR-Centre for Cellular and Molecular Biology (CSIR-CCMB), Habsiguda, Hyderabad, India
| | - Anubhuti Rana
- Department of Obstetrics and Gynaecology, All India Institute of Medical Sciences, New Delhi, India
| | - Ruby Dhar
- Department of Biochemistry, All India Institute of Medical Sciences, Room 3020, New Delhi, 110029, India
| | - Subhradip Karmakar
- Department of Biochemistry, All India Institute of Medical Sciences, Room 3020, New Delhi, 110029, India.
| |
Collapse
|
3
|
Nguyen BN, Britten-Jones AC, Bui BV, Walker LE, Titter P. Physiological and pathological changes to the eye and vision during and after pregnancy. Clin Exp Optom 2024:1-9. [PMID: 39374945 DOI: 10.1080/08164622.2024.2410031] [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: 03/29/2024] [Revised: 09/02/2024] [Accepted: 09/19/2024] [Indexed: 10/09/2024] Open
Abstract
Pregnancy introduces a multitude of changes in the body, including hormonal fluctuations and metabolic changes, which can lead to atypical ocular signs and symptoms. Ocular manifestations range from fluctuations in vision, to microstructural changes in the retina and choroid, to dry eye disease. This narrative review highlights the range of pregnancy-related effects on the eye and vision that are likely to present in the context of routine eyecare. Specifically, physiological ocular changes and pathological ocular changes that manifest for the first time, or are exacerbated, in uncomplicated pregnancy are discussed. The literature has evolved from simply noting differences in the eye between pregnant and non-pregnant groups, to refining knowledge of the proposed underlying pathophysiology with the advent of newer technologies in eyecare. A particular focus of this review is navigating when pregnancy changes in the eye occur or peak during the gestational period, and whether the changes are short-lived or might extend past pregnancy. While many pregnancy-associated changes are temporary and resolve post-partum, it is also recognised that some changes persist after pregnancy, with a notable absence of literature on ocular changes with loss or termination of pregnancy. Currently or previously pregnant women (or those planning to become pregnant), and other health professionals, should be educated about the importance of seeking eyecare before, during and after pregnancy.
Collapse
Affiliation(s)
- Bao N Nguyen
- Department of Optometry and Vision Sciences, The University of Melbourne, Parkville, Victoria, Australia
| | | | - Bang V Bui
- Department of Optometry and Vision Sciences, The University of Melbourne, Parkville, Victoria, Australia
| | - Lorraine E Walker
- School of Nursing and Midwifery, Monash University, Clayton, Victoria, Australia
| | - Peta Titter
- School of Nursing, University of Tasmania, Hobart, Tasmania, Australia
| |
Collapse
|
4
|
Maryam H, Liaqat R, Rowther AA, Atiq M, Nazir H, Malik A, Rahman A, Surkan PJ, Atif N. "If it has happened once, it can happen again". The impact of previous pregnancy loss on anxious women's ongoing pregnancies: A qualitative study from Pakistan. Midwifery 2024; 137:104087. [PMID: 39003932 PMCID: PMC11365798 DOI: 10.1016/j.midw.2024.104087] [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: 08/25/2023] [Revised: 06/20/2024] [Accepted: 06/28/2024] [Indexed: 07/16/2024]
Abstract
BACKGROUND Pregnancy loss that includes both miscarriage and stillbirth cause significant psychological distress for women including anxiety, depression, and grief that persist long after physical recovery. This study focuses on the experiences of women in Pakistan, where pregnancy loss rates are high. OBJECTIVE To explore how pregnant women with anxiety symptoms and a history of pregnancy loss perceive their past experiences with the loss and how it affects overall well-being in their current pregnancy. DESIGN Qualitative methods were used to explore the impact of previous pregnancy loss on the well-being of pregnant women. SETTING This qualitative research was embedded within a randomized control trial conducted in a tertiary care facility in Rawalpindi, Pakistan. PARTICIPANTS Data were collected through in-depth interviews with 18 pregnant women who had experienced pregnancy loss. Data was analyzed using Framework Analysis. FINDINGS The findings revealed several factors influencing participants' well-being during pregnancies that resulted in a loss, such as unsupportive and abusive environments, unintended pregnancies, certain superstitious beliefs, poor health, and lack of access to quality healthcare. The study also highlighted the adverse impact of previous pregnancy loss on the ongoing pregnancy, including deterioration of physical and mental health and aversion of healthcare services. However, some participants reported positive changes in medical and self-care practices and an enhanced faith and reliance on destiny in their subsequent pregnancies. CONCLUSION Our study highlights the lasting impact of past pregnancy loss on subsequent pregnancies, affecting overall wellbeing and leading to healthcare avoidance. We identified persistent anxiety along with positive outcomes like enhanced medical practices and strengthened faith. Results suggest the need for culturally responsive interventions to support the overall well-being of anxious pregnant women with a history of pregnancy loss in resource-constrained settings.
Collapse
Affiliation(s)
- Hadia Maryam
- Human Development Research Foundation, Gujar Khan, Pakistan
| | | | - Armaan A Rowther
- Department of International Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, United States; Department of Psychiatry, Harbor-UCLA Medical Center, Los Angeles, CA, United States; Programme in Islamic Psychology, Cambridge Muslim College, Cambridge, United Kingdom
| | - Maria Atiq
- Human Development Research Foundation, Gujar Khan, Pakistan
| | - Huma Nazir
- Human Development Research Foundation, Gujar Khan, Pakistan
| | - Abid Malik
- Human Development Research Foundation, Gujar Khan, Pakistan; Public Mental Health Department, Health Services Academy, Islamabad, Pakistan
| | - Atif Rahman
- Human Development Research Foundation, Gujar Khan, Pakistan; Institute of Population Health, University of Liverpool, Liverpool, United Kingdom
| | - Pamela J Surkan
- Department of International Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, United States
| | - Najia Atif
- Human Development Research Foundation, Gujar Khan, Pakistan.
| |
Collapse
|
5
|
Datye S, Smiljanic M, Shetti R, MacRae-Miller A, van Teijlingen E, Vinayakarao L, Peters EMJ, Lebel C, Tomfohr-Madsen L, Giesbrecht G, Khashu M, Conrad ML. Prenatal maternal mental health and resilience in the United Kingdom during the SARS-CoV-2 pandemic: a cross- national comparison. Front Psychiatry 2024; 15:1411761. [PMID: 39391080 PMCID: PMC11466367 DOI: 10.3389/fpsyt.2024.1411761] [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: 04/03/2024] [Accepted: 09/02/2024] [Indexed: 10/12/2024] Open
Abstract
Introduction Prenatal mental health problems are associated with morbidity for the pregnant person, and their infants are at long-term risk for poor health outcomes. We aim to explore how the SARS-CoV-2 pandemic affected the mental health of pregnant people in the United Kingdom (UK), and to further identify resilience factors which may have contributed to varying mental health outcomes. We also aim to examine the quality of antenatal care provided during the pandemic in the UK and to identify potential inadequacies to enhance preparedness for future events. Methods During June-November 2020, we recruited 3666 individuals in the UK for the EPPOCH pregnancy cohort (Maternal mental health during the COVID-19 pandemic: Effect of the Pandemic on Pregnancy Outcomes and Childhood Health). Participants were assessed for depression, anxiety, anger and pregnancy-related anxiety using validated scales. Additionally, physical activity, social support, individualized support and personal coping ability of the respondents were assessed as potential resilience factors. Results Participants reported high levels of depression (57.05%), anxiety (58.04%) and anger (58.05%). Higher levels of social and individualized support and personal coping ability were associated with lower mental health challenges. Additionally, pregnant individuals in the UK experienced higher depression during the pandemic than that reported in Canada. Finally, qualitative analysis revealed that restrictions for partners and support persons during medical appointments as well as poor public health communication led to increased mental health adversities and hindered ability to make medical decisions. Discussion This study revealed increased mental health challenges among pregnant individuals in the UK during the SARS-CoV-2 pandemic. These results highlight the need for reassessing the mental health support measures available to pregnant people in the UK, both during times of crisis and in general.
Collapse
Affiliation(s)
- Swarali Datye
- Institute of Microbiology, Infectious Diseases and Immunology, Charité–Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, Berlin, Germany
- Neonatology and Pediatric Intensive Care, Faculty of Medicine, University of Augsburg, Augsburg, Germany
| | - Marko Smiljanic
- Institute of Botany and Landscape Ecology, University of Greifswald, Greifswald, Germany
| | - Rohan Shetti
- Faculty of Environment, Julius von Payer Institute for Arctic and Subarctic Research, Jan Evangelista Purkyně University, Ústí nad Labem, Czechia
| | - Alison MacRae-Miller
- Department of Family Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Edwin van Teijlingen
- Centre for Midwifery and Women’s Health, Bournemouth University, Bournemouth, United Kingdom
| | - Latha Vinayakarao
- University Hospitals Dorset NHS Foundation Trust, Poole, United Kingdom
| | - Eva M. J. Peters
- Psychoneuroimmunology Laboratory, Department of Psychosomatic Medicine and Psychotherapy, Justus-Liebig University, Gießen, Germany
- Department of Psychosomatic Medicine and Psychotherapy, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - Catherine Lebel
- Department of Radiology, University of Calgary, Calgary, AB, Canada
- Alberta Children's Hospital Research Institute, University of Calgary, Calgary, AB, Canada
| | - Lianne Tomfohr-Madsen
- Alberta Children's Hospital Research Institute, University of Calgary, Calgary, AB, Canada
- Department of Pediatrics, University of Calgary, Calgary, AB, Canada
- Department of Psychology, University of Calgary, Calgary, AB, Canada
| | - Gerald Giesbrecht
- Alberta Children's Hospital Research Institute, University of Calgary, Calgary, AB, Canada
- Department of Pediatrics, University of Calgary, Calgary, AB, Canada
- Department of Psychology, University of Calgary, Calgary, AB, Canada
- Department of Community Health Sciences, University of Calgary, Calgary, AB, Canada
| | - Minesh Khashu
- University Hospitals Dorset NHS Foundation Trust, Poole, United Kingdom
| | - Melanie L. Conrad
- Institute of Microbiology, Infectious Diseases and Immunology, Charité–Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, Berlin, Germany
- Neonatology and Pediatric Intensive Care, Faculty of Medicine, University of Augsburg, Augsburg, Germany
- Institute for Medical Psychology, Charité–Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, Berlin, Germany
| |
Collapse
|
6
|
Marín-Jiménez N, Flor-Alemany M, Baena-García L, Corres P, Molina-Hidalgo C, Aparicio VA. The Role of Physical Fitness in Emotional Well-Being and Distress during Pregnancy: The GESTAFIT Project. Healthcare (Basel) 2024; 12:1692. [PMID: 39273717 PMCID: PMC11395653 DOI: 10.3390/healthcare12171692] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2024] [Revised: 08/18/2024] [Accepted: 08/22/2024] [Indexed: 09/15/2024] Open
Abstract
Pregnancy involves various physiological, physical, and social changes that can impact the mental health of the woman, causing her to have a stressful experience. Physical fitness (PF) is postulated as a powerful marker of health in this population. Therefore, this longitudinal study examined the association of PF with maternal emotional well-being and ill-being outcomes at 16th and 34th gestational weeks (g.w.) in a sample of 158 pregnant women (32.9 ± 4.7 years old). Self-reported PF was assessed with the valid and feasible International Fitness Scale [i.e., overall PF, cardiorespiratory fitness (CRF), muscular strength, speed-agility, and flexibility]; positive and negative affect, emotional intelligence, and resilience were measured using validated questionnaires specifically designed for this purpose. The results showed that women with greater overall PF and its components showed higher positive affect and lower negative affect (all, p < 0.05); greater emotional intelligence (all, p < 0.05); and greater resilience (all, p < 0.05), with similar results both in the 16th and the 34th g.w. These findings underscore the pivotal role of PF in promoting emotional health and resilience during pregnancy, thereby highlighting the need for integrating PF enhancement strategies in prenatal care programs.
Collapse
Affiliation(s)
- Nuria Marín-Jiménez
- Department of Physical Education and Sports, Faculty of Sport Sciences, University of Granada, 18071 Granada, Spain
- Sport and Health University Research Institute (iMUDS), University of Granada, 18007 Granada, Spain
- GALENO Research Group, Department of Physical Education, Faculty of Education Sciences, University of Cádiz, 11510 Puerto Real, Spain
- Biomedical Research and Innovation Institute of Cádiz (INiBICA) Research Unit, 11009 Cádiz, Spain
| | - Marta Flor-Alemany
- Sport and Health University Research Institute (iMUDS), University of Granada, 18007 Granada, Spain
- Department of Physiology, University of Granada, 18011 Granada, Spain
- Institute of Nutrition and Food Technology, University of Granada, 18003 Granada, Spain
| | - Laura Baena-García
- Sport and Health University Research Institute (iMUDS), University of Granada, 18007 Granada, Spain
- Institute of Nutrition and Food Technology, University of Granada, 18003 Granada, Spain
- Department of Nursing, Faculty of Health Sciences, University of Granada, 18071 Granada, Spain
- Biosanitary Research Institute, IBS, University of Granada, 18012 Granada, Spain
| | - Pablo Corres
- Department of Physical Education and Sport, Faculty of Education and Sport, Physical Activity and Sport Sciences Section, University of the Basque Country (UPV/EHU), 01006 Vitoria-Gasteiz, Spain
| | - Cristina Molina-Hidalgo
- Sport and Health University Research Institute (iMUDS), University of Granada, 18007 Granada, Spain
- AdventHealth Research Institute, Neuroscience Institute, Orlando, FL 32803, USA
| | - Virginia A Aparicio
- Sport and Health University Research Institute (iMUDS), University of Granada, 18007 Granada, Spain
- Institute of Nutrition and Food Technology, University of Granada, 18003 Granada, Spain
- Department of Physical Education and Sport, Faculty of Education and Sport, Physical Activity and Sport Sciences Section, University of the Basque Country (UPV/EHU), 01006 Vitoria-Gasteiz, Spain
| |
Collapse
|
7
|
Bane SS, Obedin-Maliver J, Ragosta S, Hastings J, Lunn MR, Flentje A, Capriotti MR, Lubensky ME, Tordoff DM, Moseson H. Pathways to parenthood among transgender men and gender diverse people assigned female or intersex at birth in the United States: analysis of a Cross-Sectional 2019 Survey. AJOG GLOBAL REPORTS 2024; 4:100381. [PMID: 39253027 PMCID: PMC11381974 DOI: 10.1016/j.xagr.2024.100381] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/11/2024] Open
Abstract
Objective To assess pathways to parenthood, pregnancy outcomes, future pregnancy desire, and fertility counseling experiences among a cross-sectional sample of transgender men and gender diverse individuals assigned female or intersex at birth in the United States. Methods Participants were recruited from The Population Research in Identity and Disparities for Equality (PRIDE) Study and the general public. Eligible participants for this analysis were able to read and understand English, assigned female or intersex at birth, US residents, 18+ years old, and identified as transgender, nonbinary, or gender diverse. We analyzed responses to close-ended survey questions, overall and stratified by gender identity, race/ethnicity, and testosterone use. We also qualitatively assessed open-text responses on fertility counseling. Results Among the 1694 participants, median age was 27 years (range: 18-72), 12% had ever been pregnant, and 12% were parents. Carrying a pregnancy where the individual was the egg source (36%) was the most common pathway to parenthood. Individuals with an exclusively binary gender identity (ie, transgender man or man) more often reported becoming parents through adoption than individuals with gender diverse identities (19% vs 12%). A third of individuals did not receive fertility counseling prior to initiating testosterone; individuals who exclusively reported nonbinary identities were recommended to investigate fertility preservation options less often (36%) compared to transgender men (50%). Conclusion Transgender men and gender diverse individuals who were assigned female or intersex at birth build their families through a variety of pathways, including pregnancy, stepparenting, and adoption. Clinicians should avoid making assumptions about reproductive desires in these populations based on gender identities or testosterone use and should provide consistent fertility counseling prior to and after hormone initiation.
Collapse
Affiliation(s)
- Shalmali Sunil Bane
- Department of Epidemiology and Population Health, Stanford University School of Medicine, Stanford, California, USA (Shalmali Bane)
| | - Juno Obedin-Maliver
- Department of Obstetrics and Gynecology, Stanford University School of Medicine, Stanford, California, USA (Juno Obedin-Maliver)
- Department of Epidemiology and Population Health, Stanford University School of Medicine, Stanford, CA, USA (Juno Obedin-Maliver and Mitchell R. Lunn)
- The PRIDE Study, Stanford University, Stanford, California, USA (Juno Obedin-Maliver, Mitchell R. Lunn, Annesa Flentje, Matthew R. Capriotti, Micah E. Lubensky and Diana M. Tordoff)
| | - Sachiko Ragosta
- Ibis Reproductive Health, Oakland, California, USA (Sachiko Ragosta and Heidi Moseson)
| | - Jen Hastings
- Department of Family and Community Medicine, University of California San Francisco, San Francisco, California, USA (Jen Hastings)
| | - Mitchell R Lunn
- Department of Epidemiology and Population Health, Stanford University School of Medicine, Stanford, California, USA (Shalmali Bane)
- The PRIDE Study, Stanford University, Stanford, California, USA (Juno Obedin-Maliver, Mitchell R. Lunn, Annesa Flentje, Matthew R. Capriotti, Micah E. Lubensky and Diana M. Tordoff)
- Department of Medicine, Division of Nephrology, Stanford University School of Medicine, Stanford, California, USA (Mitchell R. Lunn and Diana M. Tordoff)
| | - Annesa Flentje
- The PRIDE Study, Stanford University, Stanford, California, USA (Juno Obedin-Maliver, Mitchell R. Lunn, Annesa Flentje, Matthew R. Capriotti, Micah E. Lubensky and Diana M. Tordoff)
- Department of Community Health Systems, University of California San Francisco, San Francisco, California, USA (Annesa Flentje and Micah E. Lubensky)
- Alliance Health Project, Department of Psychiatry, University of California, San Francisco, San Francisco, California, USA (Annesa Flentje)
| | - Matthew R Capriotti
- The PRIDE Study, Stanford University, Stanford, California, USA (Juno Obedin-Maliver, Mitchell R. Lunn, Annesa Flentje, Matthew R. Capriotti, Micah E. Lubensky and Diana M. Tordoff)
- Department of Psychology, San Jose State University, San Jose, California, USA (Matthew R. Capriotti)
| | - Micah E Lubensky
- The PRIDE Study, Stanford University, Stanford, California, USA (Juno Obedin-Maliver, Mitchell R. Lunn, Annesa Flentje, Matthew R. Capriotti, Micah E. Lubensky and Diana M. Tordoff)
- Department of Community Health Systems, University of California San Francisco, San Francisco, California, USA (Annesa Flentje and Micah E. Lubensky)
| | - Diana M Tordoff
- The PRIDE Study, Stanford University, Stanford, California, USA (Juno Obedin-Maliver, Mitchell R. Lunn, Annesa Flentje, Matthew R. Capriotti, Micah E. Lubensky and Diana M. Tordoff)
- Department of Medicine, Division of Nephrology, Stanford University School of Medicine, Stanford, California, USA (Mitchell R. Lunn and Diana M. Tordoff)
| | - Heidi Moseson
- Ibis Reproductive Health, Oakland, California, USA (Sachiko Ragosta and Heidi Moseson)
| |
Collapse
|
8
|
Maul J, Behnam S, Wimberger P, Henrich W, Arabin B. Systematic review on music interventions during pregnancy in favor of the well-being of mothers and eventually their offspring. Am J Obstet Gynecol MFM 2024; 6:101400. [PMID: 38866136 DOI: 10.1016/j.ajogmf.2024.101400] [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: 04/04/2024] [Revised: 05/24/2024] [Accepted: 05/28/2024] [Indexed: 06/14/2024]
Abstract
OBJECTIVE Mental health affects maternal well-being and indirectly affects the development of fetal brain structures and motor and cognitive skills of the offspring up to adulthood. This study aimed to identify specific characteristics of music interventions that improve validated maternal outcomes. DATA SOURCES Randomized controlled trials and systematic reviews investigating music interventions during pregnancy were identified from the start of data sources up to December 2023 using MEDLINE, the Cochrane Central Register of Controlled Trials, or Web of Science. STUDY ELIGIBILITY CRITERIA Using Covidence, 2 reviewers screened for randomized controlled trials with ≥3 music interventions during pregnancy and applied either the Perceived Stress Scale score, State-Trait Anxiety Inventory score, Edinburgh Postnatal Depression Scale score, or blood pressure as outcomes. METHODS The Cochrane risk-of-bias tool 2, the checklist to assess Trustworthiness in RAndomised Clinical Trials, and the reversed Cohen d were applied. This review was registered in the International Prospective Register of Systematic Reviews (registration number: CRD42022299950). RESULTS From 251 detected records, 14 randomized controlled trials and 2375 pregnancies were included. Music interventions varied from 3 to 84 active or passive sessions with either patient-selected or preselected music and a duration of 10 to 60 minutes per session. Thereby, 2 of 4 studies observed a significant decrease in the Perceived Stress Scale, 8 of 9 studies observed a significant decrease in the State-Trait Anxiety Inventory, and 3 of 4 studies observed a significant decrease in the Edinburgh Postnatal Depression Scale. Blood pressure was significantly reduced in 3 of 4 randomized controlled trials. The Cochrane risk-of-bias tool 2 was "high" in 5 of 14 studies or "with concerns" in 9 of 14 studies. Stratifying the Cohen d in 14 intervention arms suggested a big effect in 234 of 469 mothers on blood pressure and in 244 of 489 mothers on maternal anxiety and a medium effect in 284 of 529 mothers on maternal anxiety. Small or very small effects on blood pressure, the Edinburgh Postnatal Depression Scale, and the Perceived Stress Scale were observed in 35 of 70, 136 of 277, and 374 of 784 mothers-to-be, respectively. CONCLUSION Our study found a general positive effect of music interventions on maternal stress resilience. This was independent of the music but was influenced by the frequency and empathy of the performances. How far music interventions may improve postnatal development and skills of the offspring should be increasingly evaluated with follow-ups to interrupt vicious epigenetic circles during global pandemics, violent conflicts, and natural catastrophes. El resumen está disponible en Español al final del artículo.
Collapse
Affiliation(s)
- Johanna Maul
- Clara Angela Foundation, Witten and Berlin, Germany (Maul, Behnam, Henrich, and Arabin); Technische Universtität Dresden, Dresden, Germany (Maul).
| | - Susann Behnam
- Clara Angela Foundation, Witten and Berlin, Germany (Maul, Behnam, Henrich, and Arabin)
| | - Pauline Wimberger
- Department of Obstetrics and Gynecology, Technische Universität Dresden, Dresden, Germany (Wimberger)
| | - Wolfgang Henrich
- Clara Angela Foundation, Witten and Berlin, Germany (Maul, Behnam, Henrich, and Arabin); Department of Obstetrics, University Hospital Charité Berlin, Berlin, Germany (Henrich and Arabin)
| | - Birgit Arabin
- Clara Angela Foundation, Witten and Berlin, Germany (Maul, Behnam, Henrich, and Arabin); Department of Obstetrics, University Hospital Charité Berlin, Berlin, Germany (Henrich and Arabin)
| |
Collapse
|
9
|
Hoirisch-Clapauch S. The Impact of Emotional Responses on Female Reproduction: Fibrinolysis in the Spotlight. Semin Thromb Hemost 2024. [PMID: 39029520 DOI: 10.1055/s-0044-1788324] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/21/2024]
Abstract
Fibrinolytic enzymes modify various substrates required for tissue remodeling, playing a crucial role in mechanisms underlying resilience, reward processing, ovulation, embryo implantation, and placentation. Individuals with low resilience and reduced reward responsiveness, when exposed to chronic stress, are at increased risk of experiencing a range of negative emotions. Chronic anxiety and melancholia are examples of negative emotions associated with hypercortisolism, while fear and atypical depression are characterized by systemic inflammation. Both cortisol and inflammatory cytokines stimulate the production of plasminogen activator inhibitor-1 (PAI-1), a potent fibrinolysis inhibitor. Chronic anxiety, fear, and depression are among the many hypofibrinolytic conditions increasing the risk of oligo-anovulation, miscarriage, fetal growth restriction, and preeclampsia. Although significant, the impact of negative emotions on implantation is not as obvious as on ovulation or placentation. Other hypofibrinolytic conditions that may affect female reproduction through mechanisms dependent or independent of PAI-1 include metabolic disturbances (e.g., due to consumption of highly palatable foods, often used to alleviate negative affect), inflammation, hyperhomocysteinemia, hypothyroidism, hypercortisolism, antiphospholipid antibodies, and the 4G allele of the PAI-1 gene. Benzodiazepines and antidepressants should be used with caution in the first trimester as this combination may cause malformations. Also, selective serotonin reuptake inhibitors have fibrinolytic properties that increase the risk of bleeding after surgical procedures. Psychological interventions, especially group therapy, are effective in the prevention of reproductive disorders. Controlled trials are needed to test the hypothesis that female reproductive health depends on psychological well-being, a balanced diet and physical activity, suppression of inflammation and autoantibodies, and homocysteine and hormonal homeostasis.
Collapse
Affiliation(s)
- Silvia Hoirisch-Clapauch
- Hematology Department, Vascular Medicine, Hospital Federal dos Servidores do Estado, Rio de Janeiro, Brazil
| |
Collapse
|
10
|
Eichenauer H, Fischer S, Gardini E, Onsongo S, Ehlert U. Effects of improved on-farm crop storage on DNA methylation of mothers and their infants: evidence from a randomized controlled trial in Kenya. Clin Epigenetics 2024; 16:90. [PMID: 38978139 PMCID: PMC11232227 DOI: 10.1186/s13148-024-01693-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: 03/11/2024] [Accepted: 06/06/2024] [Indexed: 07/10/2024] Open
Abstract
BACKGROUND Stress during pregnancy can lead to adverse maternal and infant health outcomes through epigenetic changes in the hypothalamic-pituitary-adrenal axis. Among farmers in low-income countries, one important stressor is food insecurity, which can be reduced using hermetic storage bags. This study aimed to determine, for the first time, whether a hermetic storage bag intervention during pregnancy positively affects maternal and infant DNA methylation of the hypothalamic-pituitary-adrenal axis-related genes FKBP5 and NR3C1. We further analyzed whether anthropometrics, stress, and mental health were associated with DNA methylation. METHODS This study was part of a larger matched-pair randomized controlled trial focusing on the impact of improved on-farm storage on food security, poverty, and net income of smallholder farming households. A total of N = 149 mothers were recruited by telephone and invited to attend a study appointment at health facilities in Kakamega County, Western Kenya, with their infants in April or May 2021. During the appointment, anthropometric measurements were taken, questionnaires on stress and mental health were administered, and saliva samples were collected. Logistic and multiple linear regression were used to examine the effect of the intervention and related measures on DNA methylation. RESULTS Mothers in the intervention group showed higher mean NR3C1 methylation levels than those in the control group, corrected for multiple testing. Maternal postpartum body mass index was positively associated with infant NR3C1 CpG3 DNA methylation. The more stressful life events a mother had experienced in the previous 12 months (including during pregnancy), the lower her FKBP5 CpG3 methylation levels. CONCLUSIONS Food insecurity and stressful life events during pregnancy seem to exert significant effects on maternal DNA methylation. While these stressors did not appear to impact infant DNA methylation in the present study, maternal postpartum body mass index was significantly related to infant methylation. These findings suggest that while infants may be protected from excessive maternal glucocorticoids by placental barrier activity, maternal metabolic status is still reflected in their epigenetic make-up. Trial registration This study was part of a larger matched-pair randomized controlled trial on the impact of improved on-farm crop storage on welfare, nutrition, and human health. Registration can be found in the American Economic Association (AEA) RCT Registry, RCT ID: AEARCTR-0005845.
Collapse
Affiliation(s)
- Heike Eichenauer
- Institute of Psychology, Clinical Psychology and Psychotherapy, University of Zurich, Binzmuehlestrasse 14/Box 26, 8050, Zurich, Switzerland
| | - Susanne Fischer
- Institute of Psychology, Clinical Psychology and Psychotherapy, University of Zurich, Binzmuehlestrasse 14/Box 26, 8050, Zurich, Switzerland
| | - Elena Gardini
- Institute of Psychology, Clinical Psychology and Psychotherapy, University of Zurich, Binzmuehlestrasse 14/Box 26, 8050, Zurich, Switzerland
| | | | - Ulrike Ehlert
- Institute of Psychology, Clinical Psychology and Psychotherapy, University of Zurich, Binzmuehlestrasse 14/Box 26, 8050, Zurich, Switzerland.
| |
Collapse
|
11
|
Al-Alami Z, Abu-Huwaij R, Hamadneh S, Taybeh E. Understanding Miscarriage Prevalence and Risk Factors: Insights from Women in Jordan. MEDICINA (KAUNAS, LITHUANIA) 2024; 60:1044. [PMID: 39064473 PMCID: PMC11279235 DOI: 10.3390/medicina60071044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/14/2024] [Revised: 06/18/2024] [Accepted: 06/20/2024] [Indexed: 07/28/2024]
Abstract
Background and Objectives: Miscarriage is a complication that is influenced by many risk factors that have been reported in different studies and that vary among countries. Despite the influence of various known risk factors for miscarriage, 30% to 50% of miscarriages are from unidentified causes. The aim of this study is to determine the prevalence of miscarriages in Jordan and the associated risk factors. Materials and Methods: A cross-sectional online survey was conducted in Jordan among married women to investigate the prevalence of miscarriages and identify potential risk factors. Results: Women (n = 704) were surveyed, and 17.9% reported a history of miscarriage. The identified risk factors were being an active smoker during pregnancy, having more than four children, having a family history of miscarriage, having fertility problems, receiving medical assistance for conception, and traveling by air during pregnancy. Conclusions: The results suggest that there are both modifiable and non-modifiable risk factors for miscarriages in Jordan and that a proportion of these may be preventable. The findings can be used to enhance patient awareness and inform policy development to decrease the incidence of miscarriage in the country.
Collapse
Affiliation(s)
- Zina Al-Alami
- Department of Basic Medical Sciences, Faculty of Allied Medical Sciences, Al-Ahliyya Amman University, Amman P.O. Box 19328, Jordan
| | - Rana Abu-Huwaij
- College of Pharmacy, Amman Arab University, P.O. Box 2234, Amman 11953, Jordan;
| | - Shereen Hamadneh
- Department of Maternal and Child Health, Princess Salma Faculty of Nursing, Al al-Bayt University, Mafraq P.O. Box 130040, Jordan;
| | - Esra’ Taybeh
- Department of Applied Pharmaceutical Sciences and Clinical Pharmacy, Faculty of Pharmacy, Isra University, P.O. Box 22, Amman 11622, Jordan;
| |
Collapse
|
12
|
Mu F, Huo H, Wang C, Hu N, Wang F. A new prognostic model for recurrent pregnancy loss: assessment of thyroid and thromboelastograph parameters. Front Endocrinol (Lausanne) 2024; 15:1415786. [PMID: 38883610 PMCID: PMC11177760 DOI: 10.3389/fendo.2024.1415786] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2024] [Accepted: 05/16/2024] [Indexed: 06/18/2024] Open
Abstract
Objective This study aimed to identify predictors associated with thyroid function and thromboelastograph (TEG) examination parameters and establish a nomogram for predicting the risk of subsequent pregnancy loss in recurrent pregnancy loss (RPL). Methods In this retrospective study, we analyzed the medical records of 575 RPL patients treated at Lanzhou University Second Hospital, China, between September 2020 and December 2022, as a training cohort. We also included 272 RPL patients from Ruian People's Hospital between January 2020 and July 2022 as external validation cohort. Predictors included pre-pregnancy thyroid function and TEG examination parameters. The study outcome was pregnancy loss before 24 weeks of gestation. Variable selection was performed using least absolute shrinkage and selection operator regression and stepwise regression analyses, and the prediction model was developed using multivariable logistic regression. The study evaluated the model's performance using the area under the curve (AUC), calibration curve, and decision curve analysis. Additionally, dynamic and static nomograms were constructed to provide a visual representation of the models. Results The predictors used to develop the model were body mass index, previous pregnancy losses, triiodothyronine, free thyroxine, thyroid stimulating hormone, lysis at 30 minutes, and estimated percent lysis which were determined by the multivariable logistic regression with the minimum Akaike information criterion of 605.1. The model demonstrated good discrimination with an AUC of 0.767 (95%CI 0.725-0.808), and the Hosmer-Lemeshow test indicated good fitness of the predicting variables with a P value of 0.491. Identically, external validation confirmed that the model exhibited good performance with an AUC of 0.738. Moreover, the clinical decision curve showed a positive net benefit in the prediction model. Meanwhile, the web version we created was easy to use. The risk stratification indicated that high-risk patients with a risk score >147.9 had a higher chance of pregnancy loss (OR=6.05, 95%CI 4.09-8.97). Conclusions This nomogram well-predicted the risk of future pregnancy loss in RPL and can be used by clinicians to identify high-risk patients and provide a reference for pregnancy management of RPL.
Collapse
Affiliation(s)
| | | | | | | | - Fang Wang
- Department of Reproductive Medicine, Lanzhou University Second Hospital, Lanzhou, China
| |
Collapse
|
13
|
Eleje GU, Oguejiofor CB, Oriji SO, Ekwuazi KE, Ugwu EO, Igbodike EP, Malachy DE, Nwankwo EU, Onah CE, Ugboaja JO, Ikechebelu JI, Nwagha UI. Depression, anxiety, and stress and adverse pregnancy outcomes in pregnant women with history of recurrent pregnancy loss in Nigeria. Int J Psychiatry Med 2024; 59:303-324. [PMID: 37641892 DOI: 10.1177/00912174231199215] [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] [Indexed: 08/31/2023]
Abstract
OBJECTIVE The primary purpose of this study was to examine whether pregnant women with a history of recurrent pregnancy loss (RPL) are more likely to experience moderate-to-severe depression, anxiety, or stress symptoms than pregnant women without a history of RPL. The secondary purpose was to determine whether women with prior RPL experienced more unfavorable pregnancy outcomes if they had depression, anxiety, or stress. METHODS A prospective case-control study was conducted that included 47 pregnant women with a history of RPL and 94 pregnant women without prior RPL. Participants 20 weeks of gestation or earlier were included. Both groups completed the Depression, Anxiety, and Stress Scale (DASS-21), and were followed up until delivery to determine the pregnancy outcomes. Multivariate logistic regression was used to compare adverse pregnancy outcomes. RESULT Among the 47 women with prior RPL, 10 had primary RPL (two or more miscarriages without a successful pregnancy) and 37 secondary RPL (two or more miscarriages with a history of successful pregnancy). RPL was significantly associated with moderate-to-severe levels of depression (P < .001), anxiety (P < .001), and stress (P < .001). Among the RPL group, high stress level was significantly associated with repeat miscarriage (adjusted odds ratio (AOR) = 5.28, 95%CI = 1.25-100.0, P = .03) and preterm labor (AOR = 6.07, 95%CI = 1.61-100.0, P = .04). Depression and anxiety were not associated with adverse pregnancy outcomes. CONCLUSION Pregnant women with a history of RPL had considerably higher rates of moderate-to-severe depression, anxiety, and stress. Repeat miscarriage and preterm labor were considerably higher among pregnant women with RPL who were experiencing high stress levels at baseline.
Collapse
Affiliation(s)
- George U Eleje
- Effective Care Research Unit, Department of Obstetrics and Gynaecology, Nnamdi Azikiwe University, Awka, Nigeria
- Institute of Maternal and Child Health, College of Medicine, University of Nigeria Ituku-Ozalla Campus, Nsukka, Nigeria
- Department of Obstetrics and Gynaecology, Nnamdi Azikiwe University Teaching Hospital Nnewi, Nnewi, Nigeria
| | - Charlotte B Oguejiofor
- Department of Obstetrics and Gynaecology, Nnamdi Azikiwe University Teaching Hospital Nnewi, Nnewi, Nigeria
| | - Sunday O Oriji
- Department of Mental Health, Nnamdi Azikiwe University, Awka, Nigeria
| | - Kingsley E Ekwuazi
- Department of Obstetrics and Gynaecology, College of Medicine, University of Nigeria Ituku-Ozalla, Nsukka, Nigeria
| | - Emmanuel O Ugwu
- Institute of Maternal and Child Health, College of Medicine, University of Nigeria Ituku-Ozalla Campus, Nsukka, Nigeria
- Department of Obstetrics and Gynaecology, College of Medicine, University of Nigeria Ituku-Ozalla, Nsukka, Nigeria
| | - Emeka P Igbodike
- Department of Obstetrics and Gynecology, Havana Specialist Hospital, Lagos, Nigeria
| | - Divinefavour E Malachy
- Effective Care Research Unit, Department of Obstetrics and Gynaecology, Nnamdi Azikiwe University, Awka, Nigeria
| | - Ekeuda U Nwankwo
- Rural Community Clinical School, School of Medicine, Deakin University, Burwood, VIC, Australia
| | - Christian E Onah
- Department of Medical Laboratory Science, Faculty of Health Sciences and Technology, Nnamdi Azikiwe University, Nnewi, Nigeria
| | - Joseph O Ugboaja
- Department of Obstetrics and Gynaecology, Nnamdi Azikiwe University Teaching Hospital Nnewi, Nnewi, Nigeria
| | - Joseph I Ikechebelu
- Effective Care Research Unit, Department of Obstetrics and Gynaecology, Nnamdi Azikiwe University, Awka, Nigeria
- Institute of Maternal and Child Health, College of Medicine, University of Nigeria Ituku-Ozalla Campus, Nsukka, Nigeria
- Department of Obstetrics and Gynaecology, Nnamdi Azikiwe University Teaching Hospital Nnewi, Nnewi, Nigeria
| | - Uchenna I Nwagha
- Institute of Maternal and Child Health, College of Medicine, University of Nigeria Ituku-Ozalla Campus, Nsukka, Nigeria
- Department of Obstetrics and Gynaecology, College of Medicine, University of Nigeria Ituku-Ozalla, Nsukka, Nigeria
| |
Collapse
|
14
|
Andre KE, Hood RB, Gaskins AJ, Kawwass JF, Almquist RG, Kramer MR, Hipp HS. Neighborhood deprivation and racial differences in in vitro fertilization outcomes. Am J Obstet Gynecol 2024; 230:352.e1-352.e18. [PMID: 37939983 DOI: 10.1016/j.ajog.2023.11.003] [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: 06/14/2023] [Revised: 10/30/2023] [Accepted: 11/02/2023] [Indexed: 11/10/2023]
Abstract
BACKGROUND There are significant racial disparities in in vitro fertilization outcomes, which are poorly explained by individual-level characteristics. Environmental factors such as neighborhood-level socioeconomic factors may contribute to these disparities. However, few studies have directly addressed this research question in a large, racially diverse cohort. OBJECTIVE This study aimed to investigate whether neighborhood deprivation is associated with differences in in vitro fertilization outcomes. STUDY DESIGN Our retrospective cohort study included 1110 patients who underwent 2254 autologous in vitro fertilization cycles between 2014 and 2019 at an academic fertility center in the Southeastern United States. Neighborhood deprivation was estimated using the Neighborhood Deprivation Index, a composite variable measuring community levels of material capital based on poverty, occupation, housing, and education domains. Using multivariable log-binomial generalized estimating equations with cluster weighting, risk ratios and 95% confidence intervals were estimated for cycle cancellation, miscarriage (defined as spontaneous pregnancy loss before 20 weeks after a confirmed intrauterine gestation), and live birth according to patient Neighborhood Deprivation Index. RESULTS There were positive associations between increasing Neighborhood Deprivation Index (indicating worsening neighborhood deprivation) and body mass index, as well as increasing prevalence of tubal and uterine factor infertility diagnoses. The crude probability of live birth per cycle was lower among Black (24%) than among White patients (32%), and the crude probability of miscarriage per clinical pregnancy was higher among Black (22%) than among White patients (12%). After adjustment, the Neighborhood Deprivation Index was not significantly associated with risk of cycle cancellation or live birth. Results were consistent when analyses were stratified by race. CONCLUSION Our research demonstrates racial disparities between Black and White women in the incidence of miscarriage and live birth following in vitro fertilization. Although the level of neighborhood deprivation was closely related to race, it did not have strong associations with in vitro fertilization outcomes in our population as a whole or within strata of race.
Collapse
Affiliation(s)
- Kerri E Andre
- Department of Gynecology and Obstetrics, Emory University School of Medicine, Atlanta, GA.
| | - Robert B Hood
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA
| | - Audrey J Gaskins
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA
| | - Jennifer F Kawwass
- Division of Reproductive Endocrinology, Department of Gynecology and Obstetrics, Emory University School of Medicine, Atlanta, GA
| | - R Garland Almquist
- Department of Gynecology and Obstetrics, Emory University School of Medicine, Atlanta, GA
| | - Michael R Kramer
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA
| | - Heather S Hipp
- Division of Reproductive Endocrinology, Department of Gynecology and Obstetrics, Emory University School of Medicine, Atlanta, GA
| |
Collapse
|
15
|
Mínguez-Alarcón L, Williams PL, Souter I, Ford JB, Hauser R, Chavarro JE. Women's preconception psychological stress and birth outcomes in a fertility clinic: the EARTH study. Front Glob Womens Health 2024; 5:1293255. [PMID: 38379838 PMCID: PMC10877713 DOI: 10.3389/fgwh.2024.1293255] [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: 10/10/2023] [Accepted: 01/19/2024] [Indexed: 02/22/2024] Open
Abstract
Background The epidemiologic literature on women's perceived stress in relation to perinatal outcomes has been inconclusive and does not consider the preconception window of exposure. Objective To evaluate whether women's preconception perceived stress is related to live birth, gestational age, and birthweight in a cohort receiving fertility treatment. Methods This observational study included women seeking fertility care at the Massachusetts General Hospital (2004-2019). During preconception, women provided information on their psychological stress using the short version of the validated Perceived Stress Scale 4 (PSS-4). We used regression models to evaluate the associations of stress with live birth (N = 768 attempting to conceive) and perinatal outcomes (N = 413 live births) while adjusting for confounders. Stratified analyses by mode of conception [natural, intrauterine insemination (IUI), and IVF (in vitro fertilization)] and selected socioeconomic factors (race, education, and income) were also conducted. Results Higher psychological stress was negatively associated with the overall probability of live birth (adjusted RR = 0.95, 95% CI: 0.92, 0.98), particularly among women conceiving using IVF. However, we found no association between women's psychological stress and gestational age and birth weight in the overall analyses and also stratified by mode of conception. Similarly, we observed no differences in women's psychological stress with any of the measured outcomes by socioeconomic factors. Discussion These results highlight the importance of considering the preconception window and mode of conception when evaluating the relationship between women's preconception stress and live birth.
Collapse
Affiliation(s)
- Lidia Mínguez-Alarcón
- Channing Division of Network Medicine, Harvard Medical School & Brigham and Women’s Hospital, Boston, MA, United States
- Departments of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, United States
| | - Paige L. Williams
- Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, United States
- Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA, United States
| | - Irene Souter
- Vincent Obstetrics and Gynecology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, United States
| | - Jennifer B. Ford
- Departments of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, United States
| | - Russ Hauser
- Departments of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, United States
- Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, United States
- Department of Obstetrics, Gynecology and Reproductive Biology, Harvard Medical School, Boston, MA, United States
| | - Jorge E. Chavarro
- Channing Division of Network Medicine, Harvard Medical School & Brigham and Women’s Hospital, Boston, MA, United States
- Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, United States
- Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, United States
| |
Collapse
|
16
|
Raziani Y, Hasheminasab L, Gheshlagh RG, Dalvand P, Baghi V, Aslani M. The prevalence of intimate partner violence among Iranian pregnant women: a systematic review and meta-analysis. Scand J Public Health 2024; 52:108-118. [PMID: 36207824 DOI: 10.1177/14034948221119641] [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] [Indexed: 11/16/2022]
Abstract
BACKGROUND Intimate partner violence against pregnant women is an important public health concern and human rights issue. According to the various findings of previous studies, this study was conducted to assess the pooled prevalence of intimate partner violence against Iranian women. METHODS In this systematic review and meta-analysis, a literature search was conducted in databases such as PubMed, Scopus, Web of Science, MagIran, and Scientific Information Database without a time limit. Heterogeneity was assessed by Cochrane Q test statistics and the I2 test, and the results were incorporated into a random effects model to estimate the prevalence of intimate partner violence. Data analysis was performed using R software version 4.3.2. RESULTS The overall prevalence of intimate partner violence was reported to be 51.5% (95% confidence interval (CI) 45.0-58.1), and the prevalence rate of physical, sexual, and psychological intimate partner violence was 18.0% (95% CI 15.1-20.9), 22.1% (95% CI 17.7-26.60) and 43.2% (95% CI 36.6-49.8), respectively. The lowest level of physical, sexual, and emotional intimate partner violence rate was observed in district 1 of Iran (includes Tehran, the capital of Iran and the surrounding provinces). The rate of physical and sexual intimate partner violence prevalence decreased with the increased mean age of the husband (P=0.005) and the mean age of the wife (P=0.035), respectively. CONCLUSIONS Studies included in this review report that more than half of Iranian women experience violence during pregnancy. In order to prevent adverse maternal and neonatal consequences, it is necessary to identify these women and introduce them to support centres.
Collapse
Affiliation(s)
- Yosra Raziani
- Nursing Department, Komar University of Science and Technology, Sulimaniya, Iraq
| | - Leila Hasheminasab
- Clinical Care Research Center, Kurdistan University of Medical Sciences, Sanandaj, Iran
| | - Reza Ghanei Gheshlagh
- Social Determinants of Health Research Center, Kurdistan University of Medical Sciences, Sanandaj, Iran
| | - Pegah Dalvand
- Department of Mathematics, Shahrood University of Technology, Shahrood, Iran
| | - Vajiheh Baghi
- Be'sat Hospital, Kurdistan University of Medical Sciences, Sanandaj, Iran
| | - Marzieh Aslani
- Department of Nursing, Asadabad School of Medical Sciences, Asadabad, Iran
| |
Collapse
|
17
|
Yland JJ, Wesselink AK, Regan AK, Hatch EE, Rothman KJ, Savitz DA, Wang TR, Huybrechts KF, Hernández-Díaz S, Eisenberg ML, Wise LA. A prospective cohort study of preconception COVID-19 vaccination and miscarriage. Hum Reprod 2023; 38:2362-2372. [PMID: 37864485 PMCID: PMC10694406 DOI: 10.1093/humrep/dead211] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2023] [Revised: 08/04/2023] [Indexed: 10/23/2023] Open
Abstract
STUDY QUESTION To what extent is preconception maternal or paternal coronavirus disease 2019 (COVID-19) vaccination associated with miscarriage incidence? SUMMARY ANSWER COVID-19 vaccination in either partner at any time before conception is not associated with an increased rate of miscarriage. WHAT IS KNOWN ALREADY Several observational studies have evaluated the safety of COVID-19 vaccination during pregnancy and found no association with miscarriage, though no study prospectively evaluated the risk of early miscarriage (gestational weeks [GW] <8) in relation to COVID-19 vaccination. Moreover, no study has evaluated the role of preconception vaccination in both male and female partners. STUDY DESIGN, SIZE, DURATION An Internet-based, prospective preconception cohort study of couples residing in the USA and Canada. We analyzed data from 1815 female participants who conceived during December 2020-November 2022, including 1570 couples with data on male partner vaccination. PARTICIPANTS/MATERIALS, SETTING, METHODS Eligible female participants were aged 21-45 years and were trying to conceive without use of fertility treatment at enrollment. Female participants completed questionnaires at baseline, every 8 weeks until pregnancy, and during early and late pregnancy; they could also invite their male partners to complete a baseline questionnaire. We collected data on COVID-19 vaccination (brand and date of doses), history of SARS-CoV-2 infection (yes/no and date of positive test), potential confounders (demographic, reproductive, and lifestyle characteristics), and pregnancy status on all questionnaires. Vaccination status was categorized as never (0 doses before conception), ever (≥1 dose before conception), having a full primary sequence before conception, and completing the full primary sequence ≤3 months before conception. These categories were not mutually exclusive. Participants were followed up from their first positive pregnancy test until miscarriage or a censoring event (induced abortion, ectopic pregnancy, loss to follow-up, 20 weeks' gestation), whichever occurred first. We estimated incidence rate ratios (IRRs) for miscarriage and corresponding 95% CIs using Cox proportional hazards models with GW as the time scale. We used propensity score fine stratification weights to adjust for confounding. MAIN RESULTS AND THE ROLE OF CHANCE Among 1815 eligible female participants, 75% had received at least one dose of a COVID-19 vaccine by the time of conception. Almost one-quarter of pregnancies resulted in miscarriage, and 75% of miscarriages occurred <8 weeks' gestation. The propensity score-weighted IRR comparing female participants who received at least one dose any time before conception versus those who had not been vaccinated was 0.85 (95% CI: 0.63, 1.14). COVID-19 vaccination was not associated with increased risk of either early miscarriage (GW: <8) or late miscarriage (GW: 8-19). There was no indication of an increased risk of miscarriage associated with male partner vaccination (IRR = 0.90; 95% CI: 0.56, 1.44). LIMITATIONS, REASONS FOR CAUTION The present study relied on self-reported vaccination status and infection history. Thus, there may be some non-differential misclassification of exposure status. While misclassification of miscarriage is also possible, the preconception cohort design and high prevalence of home pregnancy testing in this cohort reduced the potential for under-ascertainment of miscarriage. As in all observational studies, residual or unmeasured confounding is possible. WIDER IMPLICATIONS OF THE FINDINGS This is the first study to evaluate prospectively the relation between preconception COVID-19 vaccination in both partners and miscarriage, with more complete ascertainment of early miscarriages than earlier studies of vaccination. The findings are informative for individuals planning a pregnancy and their healthcare providers. STUDY FUNDING/COMPETING INTEREST(S) This work was supported by the Eunice Kennedy Shriver National Institute of Child Health and Human Development, the National Institute of Health [R01-HD086742 (PI: L.A.W.); R01-HD105863S1 (PI: L.A.W. and M.L.E.)], the National Institute of Allergy and Infectious Diseases (R03-AI154544; PI: A.K.R.), and the National Science Foundation (NSF-1914792; PI: L.A.W.). The funders had no role in the study design, data collection, analysis and interpretation of data, writing of the report, or the decision to submit the paper for publication. L.A.W. is a fibroid consultant for AbbVie, Inc. She also receives in-kind donations from Swiss Precision Diagnostics (Clearblue home pregnancy tests) and Kindara.com (fertility apps). M.L.E. received consulting fees from Ro, Hannah, Dadi, VSeat, and Underdog, holds stock in Ro, Hannah, Dadi, and Underdog, is a past president of SSMR, and is a board member of SMRU. K.F.H. reports being an investigator on grants to her institution from UCB and Takeda, unrelated to this study. S.H.-D. reports being an investigator on grants to her institution from Takeda, unrelated to this study, and a methods consultant for UCB and Roche for unrelated drugs. The authors report no other relationships or activities that could appear to have influenced the submitted work. TRIAL REGISTRATION NUMBER N/A.
Collapse
Affiliation(s)
- Jennifer J Yland
- Department of Epidemiology, Boston University School of Public Health, Boston, MA, USA
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Amelia K Wesselink
- Department of Epidemiology, Boston University School of Public Health, Boston, MA, USA
| | - Annette K Regan
- School of Nursing and Health Professions, University of San Francisco, San Francisco, CA, USA
| | - Elizabeth E Hatch
- Department of Epidemiology, Boston University School of Public Health, Boston, MA, USA
| | - Kenneth J Rothman
- Department of Epidemiology, Boston University School of Public Health, Boston, MA, USA
| | - David A Savitz
- Department of Epidemiology, Brown University School of Public Health, Providence, RI, USA
| | - Tanran R Wang
- Department of Epidemiology, Boston University School of Public Health, Boston, MA, USA
| | - Krista F Huybrechts
- Division of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - Sonia Hernández-Díaz
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Department of Epidemiology, CAUSALab, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | | | - Lauren A Wise
- Department of Epidemiology, Boston University School of Public Health, Boston, MA, USA
| |
Collapse
|
18
|
Weaver EB, Gad L, Zota AR. Climate change as a threat multiplier to environmental reproductive justice. Semin Perinatol 2023; 47:151843. [PMID: 37839904 PMCID: PMC10841484 DOI: 10.1016/j.semperi.2023.151843] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/17/2023]
Abstract
Legacies of racial capitalism and colonialism drive present day racial disparities in perinatal health outcomes. Climate change amplifies existing social inequalities associated with environmental exposures and reproductive health, of which BIPOC (Black, Indigenous, and people of color) communities bear a disproportionate burden. Through case studies, this article summarizes three examples of climate justice issues with reproductive healthcare outcomes: traffic related air pollution exposure, chemical exposures in personal care products and plastics, and natural disaster frequency. We advocate for incorporation of climate justice and environmental health impact into medical school curriculum, increased prenatal screening for environmental toxins, and physician engagement with local environmental issues.
Collapse
Affiliation(s)
- Emily B Weaver
- Department of Environmental Health Sciences Mailman School of Public Health Columbia University New York NY 10032 United States
| | - Laila Gad
- Department of Environmental Health Sciences Mailman School of Public Health Columbia University New York NY 10032 United States
| | - Ami R Zota
- Department of Environmental Health Sciences Mailman School of Public Health Columbia University New York NY 10032 United States.
| |
Collapse
|
19
|
Edwards CM, Miller É, da Silva DF, Puranda JL, Souza SCS, Semeniuk K, Adamo KB. Does a history of childbirth impact injury prevalence and mental health in female military members? Appl Physiol Nutr Metab 2023; 48:841-850. [PMID: 37429041 DOI: 10.1139/apnm-2023-0028] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/12/2023]
Abstract
The effect of parity status on the prevalence and impact of musculoskeletal injury (MSKi) among female Canadian Armed Forces (CAF) members is unknown. This study aims to identify whether a history of childbirth and pregnancy-related complications are associated with MSKi occurrence among female members of the CAF. From September 2020 to February 2021, data were collected via an online questionnaire that assessed MSKi, reproductive health, and barriers to recruitment and retention in the CAF. Actively serving, female members were included in this analysis stratified by parous (n = 313) or nulliparous (n = 435) status. Descriptive analysis and binary logistic regressions were used to identify prevalence and adjusted odds ratios (aOR) of repetitive strain injuries (RSI), acute injuries, and body regions affected. Covariates included in aOR: age, body mass index, and rank. A p value of <0.05 was considered significant and 95% confidence intervals (CI) were reported. Female members with a history of childbirth were more likely to report an RSI (80.9% vs. 69.9%, OR = 1.57, CI: 1.03 to 2.40), and when stratified by body region, were more likely to have an RSI of the wrist (30.0% vs. 20.5%, aOR = 1.62, CI: 1.09 to 2.40), and foot (39.3% vs. 24.1%, aOR = 1.79, CI: 1.24 to 2.59). When compared to the nulliparous group, parity did not influence prevalence of acute injuries. MSKi and mental health perceptions were different for females who experienced postpartum depression, miscarriage, or preterm birth. Childbirth and pregnancy-related complications impact prevalence of some RSI among female CAF members. Thus, specific health and fitness support may be needed for parous female CAF members.
Collapse
Affiliation(s)
- Chris M Edwards
- Faculty of Health Sciences, School of Human Kinetics, University of Ottawa, Ottawa, ON K1N 6N5, Canada
| | - Émilie Miller
- Faculty of Health Sciences, School of Human Kinetics, University of Ottawa, Ottawa, ON K1N 6N5, Canada
| | - Danilo F da Silva
- Faculty of Health Sciences, School of Human Kinetics, University of Ottawa, Ottawa, ON K1N 6N5, Canada
- Faculty of Arts and Science, Sports Studies Department, Bishop's University, Sherbrooke, QC J1M 1Z7, Canada
| | - Jessica L Puranda
- Faculty of Health Sciences, School of Human Kinetics, University of Ottawa, Ottawa, ON K1N 6N5, Canada
| | - Sara C S Souza
- Faculty of Health Sciences, School of Human Kinetics, University of Ottawa, Ottawa, ON K1N 6N5, Canada
| | - Kevin Semeniuk
- Faculty of Health Sciences, School of Human Kinetics, University of Ottawa, Ottawa, ON K1N 6N5, Canada
| | - Kristi B Adamo
- Faculty of Health Sciences, School of Human Kinetics, University of Ottawa, Ottawa, ON K1N 6N5, Canada
| |
Collapse
|
20
|
Wang T, Hou Y, Liu Y, Qiao C. Psychological changes among women with recurrent pregnancy loss during the COVID-19 period in northeastern China: a cross-sectional study. Front Psychol 2023; 14:1265926. [PMID: 37936571 PMCID: PMC10626446 DOI: 10.3389/fpsyg.2023.1265926] [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: 07/24/2023] [Accepted: 10/02/2023] [Indexed: 11/09/2023] Open
Abstract
Background It aimed to investigate the prevalence of anxiety and depression in recurrent pregnancy loss (RPL) women and the related factors in Northeastern China during the Coronavirus disease 2019 (COVID-19) pandemic. Methods From March to June 2021, we conducted an electronic questionnaire survey of 267 RPL women who attended the recurrent pregnancy loss clinic at Shengjing Hospital of China Medical University. The State-Trait Anxiety Inventory (STAI), Beck Depression Inventory-II (BDI-II), Perceived Stress Scale (PSS), and Medical Outcomes Study Social Support Survey (MOS-SSS-C) were used to screen for anxiety, depression, stress, and social support. Logistic regression was used to explore the related factors of anxiety and depression. Results RPL women had severe psychological problems during the pandemic: 56.6% showed state anxiety or trait anxiety, 26.6% showed high levels of stress, and 13.1% showed depression. Economic pressure caused by COVID-19, and high stress were common related factors for anxiety and depression. The interval since last miscarriage <6 months, worse mood changes due to COVID-19, and concerns about COVID-19 were associated with anxiety. A history of pregnancy loss >14 weeks was associated with depression. While adequate social support and actively seeking health help were protective factors for trait anxiety. And identifying the etiology was a protective factor for depression. Conclusion The study revealed the prevalence of anxiety, depression, and the associated factors in RPL women during COVID-19. More attention should be paid to the psychology of RPL women and adequate social support should be provided.
Collapse
Affiliation(s)
- Tingting Wang
- Department of Obstetrics and Gynecology, Shengjing Hospital of China Medical University, Shenyang, China
- Key Laboratory of Obstetrics and Gynecology of Higher Education of Liaoning Province, Shenyang, China
| | - Yue Hou
- Department of Obstetrics and Gynecology, Shengjing Hospital of China Medical University, Shenyang, China
- Key Laboratory of Obstetrics and Gynecology of Higher Education of Liaoning Province, Shenyang, China
| | - Yilin Liu
- Department of Obstetrics and Gynecology, Shengjing Hospital of China Medical University, Shenyang, China
- Key Laboratory of Obstetrics and Gynecology of Higher Education of Liaoning Province, Shenyang, China
| | - Chong Qiao
- Department of Obstetrics and Gynecology, Shengjing Hospital of China Medical University, Shenyang, China
- Key Laboratory of Obstetrics and Gynecology of Higher Education of Liaoning Province, Shenyang, China
| |
Collapse
|
21
|
Spoon K, LaBerge N, Wapman KH, Zhang S, Morgan AC, Galesic M, Fosdick BK, Larremore DB, Clauset A. Gender and retention patterns among U.S. faculty. SCIENCE ADVANCES 2023; 9:eadi2205. [PMID: 37862417 PMCID: PMC10588949 DOI: 10.1126/sciadv.adi2205] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Accepted: 09/14/2023] [Indexed: 10/22/2023]
Abstract
Women remain underrepresented among faculty in nearly all academic fields. Using a census of 245,270 tenure-track and tenured professors at United States-based PhD-granting departments, we show that women leave academia overall at higher rates than men at every career age, in large part because of strongly gendered attrition at lower-prestige institutions, in non-STEM fields, and among tenured faculty. A large-scale survey of the same faculty indicates that the reasons faculty leave are gendered, even for institutions, fields, and career ages in which retention rates are not. Women are more likely than men to feel pushed from their jobs and less likely to feel pulled toward better opportunities, and women leave or consider leaving because of workplace climate more often than work-life balance. These results quantify the systemic nature of gendered faculty retention; contextualize its relationship with career age, institutional prestige, and field; and highlight the importance of understanding the gendered reasons for attrition rather than focusing on rates alone.
Collapse
Affiliation(s)
- Katie Spoon
- Department of Computer Science, University of Colorado, Boulder, CO 80309, USA
| | - Nicholas LaBerge
- Department of Computer Science, University of Colorado, Boulder, CO 80309, USA
| | - K. Hunter Wapman
- Department of Computer Science, University of Colorado, Boulder, CO 80309, USA
| | - Sam Zhang
- Department of Applied Mathematics, University of Colorado, Boulder, CO 80309, USA
| | - Allison C. Morgan
- Department of Computer Science, University of Colorado, Boulder, CO 80309, USA
| | | | - Bailey K. Fosdick
- Department of Biostatistics and Informatics, Colorado School of Public Health, Aurora, CO 80045, USA
| | - Daniel B. Larremore
- Department of Computer Science, University of Colorado, Boulder, CO 80309, USA
- BioFrontiers Institute, University of Colorado, Boulder, CO 80303, USA
| | - Aaron Clauset
- Department of Computer Science, University of Colorado, Boulder, CO 80309, USA
- Santa Fe Institute, Santa Fe, NM 87501, USA
- BioFrontiers Institute, University of Colorado, Boulder, CO 80303, USA
| |
Collapse
|
22
|
Jadgal MS, Alizadeh-Siuki H, Kasiri N, Zareipour M. COVID-19 anxiety and quality of life among adolescent pregnant women: a cross-sectional study. Int J Adolesc Med Health 2023; 35:189-195. [PMID: 36539995 DOI: 10.1515/ijamh-2022-0080] [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: 09/14/2022] [Accepted: 11/28/2022] [Indexed: 04/30/2023]
Abstract
OBJECTIVES To determine the relationship between the COVID-19 anxiety and the quality of life among adolescent pregnant women in Dashtiari city, Iran. METHODS In this cross-sectional study, 216 adolescent pregnant women in Dashtiari city, Iran in 2021 who met the inclusion criteria participated in a multi-stage sampling. Data collection tools included: demographic information, COVID-19 Anxiety Scale and a questionnaire of quality of life. Finally, the obtained data were analyzed in SPSS software version 21 using descriptive, Chi-square, Tukey and logistic regression tests. RESULTS The results showed that 74 (34.3%) adolescent pregnant women had weak COVID-19 anxiety, 23 (10.6%) had moderate COVID-19 anxiety and 119 (55.1%) had severe COVID-19 anxiety. The results also showed that gestational age (OR=2.2, p=0.03), history of COVID-19 infection among adolescent pregnant women (OR=1.6, p=0.02), history of family and friends (OR=1.7) (p=0.04), quality of life (OR=4.3, p=0.001), increases the probability of COVID-19 anxiety. CONCLUSIONS Considering the psychological consequences of the post-COVID-19 era and the psychological events that occur in this period, by identifying and predicting these issues, strategies should be considered for optimal intervention and reduction of injuries in the post-crisis era.
Collapse
Affiliation(s)
- Mohammad Saeed Jadgal
- Tropical and Communicable Diseases Research Center, Iranshahr University of Medical Sciences, Iranshahr, Iran
- Department of Public Health, School of Nursing, Iranshahr University of Medical Sciences, Chabahar, Iran
| | - Hadi Alizadeh-Siuki
- Department of Public Health, School of Health, Torbat Heydariyeh University of Medical Sciences, Torbat Heydariyeh, Iran
| | - Nayyereh Kasiri
- Department of Health in Disasters and Emergencies, School of Management and Medical Information Sciences, Isfahan University of Medical Sciences, Isfahan, Iran
| | - MoradAli Zareipour
- Department of Public Health, Khoy University of Medical Sciences, Khoy, Iran
| |
Collapse
|
23
|
Barbe C, Ouy J, Boiteux-Chabrier M, Bouazzi L, Pham BN, Carrau-Truillet S, Hurtaud A. Exploring the impact of prior spontaneous miscarriage on stress among pregnant women during the first trimester: an observational study. BJGP Open 2023; 7:BJGPO.2022.0100. [PMID: 36517185 DOI: 10.3399/bjgpo.2022.0100] [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: 07/03/2022] [Revised: 10/08/2022] [Accepted: 11/10/2022] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Spontaneous miscarriage (SM) is the most common complication of pregnancy. Its psychological repercussions are widely documented but few studies have investigated its effect on women's experience of a subsequent pregnancy. AIM To evaluate the impact of prior SM on the level of stress experienced by pregnant women during the first trimester of pregnancy. DESIGN AND SETTING Cross-sectional, observational study, which was conducted between June and October 2021 in France. METHOD A self-report questionnaire was distributed to women in the first trimester of pregnancy. Stress was assessed using the Antenatal Perceived Stress Inventory to yield an overall score and a score for three dimensions ('medical and obstetric risks or fetal health'; 'psychosocial changes during pregnancy'; and the 'prospect of childbirth'). Women with a history of prior SM and those without were compared. RESULTS In total, 93 women were included; 63 without and 30 with a history of prior SM. Prior SM was not associated with the overall score. The score for the dimension 'medical and obstetric risks or fetal health' was significantly higher in women with prior SM (3.00±0.86 versus 2.34±0.80; β = 0.61 [95% confidence interval {CI} = 0.25 to 0.96]; P = 0.001). Prior SM was significantly associated with the items 'the baby's health' (P = 0.048) and 'the echography' (P = 0.002). CONCLUSION This study shows a significant impact of prior SM on the level of stress of pregnant women during the first trimester, particularly relating to the medical and obstetric risks or fetal health, underlining the need for appropriate psychological support to be provided to women who experience SM.
Collapse
Affiliation(s)
- Coralie Barbe
- Comité Universitaire de Ressources pour la Recherche en Santé, Université de Reims Champagne-Ardenne UFR Médecine, Reims, France
- Laboratoire C2S (Cognition, Santé, Société), Université de Reims Champagne Ardenne, Reims, France
| | - Justine Ouy
- Département de Médecine Générale, Université de Reims Champagne-Ardenne, UFR Médecine, Reims, France
| | - Marie Boiteux-Chabrier
- Département de Médecine Générale, Université de Reims Champagne-Ardenne, UFR Médecine, Reims, France
| | - Leïla Bouazzi
- Comité Universitaire de Ressources pour la Recherche en Santé, Université de Reims Champagne-Ardenne UFR Médecine, Reims, France
| | - Bach-Nga Pham
- Comité Universitaire de Ressources pour la Recherche en Santé, Université de Reims Champagne-Ardenne UFR Médecine, Reims, France
| | - Sandra Carrau-Truillet
- Département de Médecine Générale, Université de Reims Champagne-Ardenne, UFR Médecine, Reims, France
| | - Aline Hurtaud
- Département de Médecine Générale, Université de Reims Champagne-Ardenne, UFR Médecine, Reims, France
| |
Collapse
|
24
|
Tetruashvili N, Domar A, Bashiri A. Prevention of Pregnancy Loss: Combining Progestogen Treatment and Psychological Support. J Clin Med 2023; 12:jcm12051827. [PMID: 36902614 PMCID: PMC10003391 DOI: 10.3390/jcm12051827] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Revised: 01/26/2023] [Accepted: 02/19/2023] [Indexed: 03/03/2023] Open
Abstract
Pregnancy loss can be defined as a loss before either 20 or 24 weeks of gestation (based on the first day of the last menstrual period) or the loss of an embryo or fetus less than 400 g in weight if the gestation age is unknown. Approximately 23 million pregnancy losses occur worldwide every year, equating to 15-20% of all clinically recognized pregnancies. A pregnancy loss is usually associated with physical consequences, such as early pregnancy bleeding ranging in severity from spotting to hemorrhage. However, it can also be associated with profound psychological distress, which can be felt by both partners and may include feelings of denial, shock, anxiety, depression, post-traumatic stress disorder, and suicide. Progesterone plays a key part in the maintenance of a pregnancy, and progesterone supplementation has been assessed as a preventative measure in patients at increased risk of experiencing a pregnancy loss. The primary objective of this piece is to assess the evidence for various progestogen formulations in the treatment of threatened and recurrent pregnancy loss, postulating that an optimal treatment plan would preferably include a validated psychological support tool as an adjunct to appropriate pharmacological treatment.
Collapse
Affiliation(s)
- Nana Tetruashvili
- V.I. Kulakov Obstetrics, National Medical Research Center for Obstetrics, Gynecology and Perinatology, Ministry of Healthcare of the Russian Federation, 117977 Moscow, Russia
| | - Alice Domar
- Inception Fertility, Houston, TX 77081, USA
- Obstetrics, Gynecology and Reproductive Biology, Harvard Medical School, Boston, MA 02115, USA
| | - Asher Bashiri
- Faculty of Health Science, Ben-Gurion University of the Negev, Be’er-Sheva 84101, Israel
- Maternity C Ward & Recurrent Pregnancy Loss Prevention Clinic, Maternal Fetal Medicine and Ultrasound, Soroka University Medical Center, Be’er-Sheva 84101, Israel
- Correspondence: ; Tel.: +972-08-6400842
| |
Collapse
|
25
|
AlArab N, Nabulsi D, El Arnaout N, Dimassi H, Harb R, Lahoud J, Nahouli L, Abou Koura A, El Saddik G, Saleh S. Reproductive health of Syrian refugee women in Lebanon: a descriptive analysis of the Sijilli electronic health records database. BMC Womens Health 2023; 23:81. [PMID: 36823589 PMCID: PMC9951425 DOI: 10.1186/s12905-023-02231-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Accepted: 02/16/2023] [Indexed: 02/25/2023] Open
Abstract
BACKGROUND The Syrian conflict has been responsible for the highest exodus of refugees, with Lebanon hosting the greatest number of refugees per capita, which placed a significant strain on an already overburdened healthcare system. Women are the most vulnerable group in times of conflict and displacement, with sexual and reproductive health and rights often neglected. This study focuses on the obstetric characteristics and pregnancy outcomes of Syrian Refugee (SR) women in Lebanon, in Comparison to their pre-displacement data. METHODS This study is a secondary analysis of de-identified data from the Sijilli database. The data reported and analyzed were the refugees' socio-demographics, obstetric history, pregnancy outcomes, experienced maternal and neonatal complications, breastfeeding history and duration, and contraception use and types. Data were reported in both frequencies and means/medians. Chi-square test, t-test, and ANOVA tests were used to compare pregnancies in Syria to those that happened in Lebanon. RESULTS A total of 1065 female records were included in this study, with 634 ever-pregnant women and the total number of pregnancies being 3272. SR women were shown to get pregnant in Lebanon at a younger age compared to cases in Syria. The number of gravidities is equal in women who got pregnant in Syria and those who moved later to Lebanon. The mean spacing between pregnancies has decreased comparing SR women who got pregnant in Syria only versus those who got pregnant in Lebanon only. Among the mixed group, the mean spacing between pregnancies as well as the prevalence of spontaneous abortions significantly increased after displacing to Lebanon. C-section rate was higher among SR women after moving to Lebanon. Also, maternal complications and not breastfeeding have increased after moving to Lebanon. A prior pregnancy was significantly associated with higher contraception use rate. The most common methods of contraception were oral contraceptive pills and intra-uterine devices. CONCLUSION The C-section deliveries, spontaneous abortions and maternal complications have all increased among SR women after being displaced to Lebanon. While the age at first pregnancy, mean spacing between their pregnancies and breastfeeding rates have decreased after moving to Lebanon. SR women are less likely to use contraceptives after their displacement. It is necessary to address access to reproductive healthcare and antenatal care delivery among displaced refugee women living in informal tented settlements.
Collapse
Affiliation(s)
- Natally AlArab
- grid.22903.3a0000 0004 1936 9801Global Health Institute, American University of Beirut, Beirut, Lebanon
| | - Dana Nabulsi
- grid.22903.3a0000 0004 1936 9801Global Health Institute, American University of Beirut, Beirut, Lebanon
| | - Nour El Arnaout
- grid.22903.3a0000 0004 1936 9801Global Health Institute, American University of Beirut, Beirut, Lebanon
| | - Hani Dimassi
- grid.411323.60000 0001 2324 5973School of Pharmacy, Lebanese American University, Beirut, Lebanon
| | - Ranime Harb
- grid.411323.60000 0001 2324 5973School of Pharmacy, Lebanese American University, Beirut, Lebanon
| | - Julien Lahoud
- grid.22903.3a0000 0004 1936 9801Global Health Institute, American University of Beirut, Beirut, Lebanon
| | - Lara Nahouli
- grid.411654.30000 0004 0581 3406Department of Obstetrics and Gynecology, American University of Beirut Medical Center, Beirut, Lebanon
| | - Abdulghani Abou Koura
- grid.411654.30000 0004 0581 3406Department of Surgery, American University of Beirut Medical Center, Beirut, Lebanon
| | - Ghaidaa El Saddik
- grid.18112.3b0000 0000 9884 2169Beirut Arab University, Beirut, Lebanon
| | - Shadi Saleh
- Global Health Institute, American University of Beirut, Beirut, Lebanon. .,Department of Health Management and Policy, Faculty of Health Sciences, American University of Beirut, Riad El Solh, Beirut, 1107 2020, Lebanon.
| |
Collapse
|
26
|
Lazarides C, Moog NK, Verner G, Voelkle MC, Henrich W, Heim CM, Braun T, Wadhwa PD, Buss C, Entringer S. The association between history of prenatal loss and maternal psychological state in a subsequent pregnancy: an ecological momentary assessment (EMA) study. Psychol Med 2023; 53:855-865. [PMID: 34127159 PMCID: PMC9975992 DOI: 10.1017/s0033291721002221] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2021] [Revised: 05/06/2021] [Accepted: 05/17/2021] [Indexed: 01/13/2023]
Abstract
BACKGROUND Prenatal loss which occurs in approximately 20% of pregnancies represents a well-established risk factor for anxiety and affective disorders. In the current study, we examined whether a history of prenatal loss is associated with a subsequent pregnancy with maternal psychological state using ecological momentary assessment (EMA)-based measures of pregnancy-specific distress and mood in everyday life. METHOD This study was conducted in a cohort of N = 155 healthy pregnant women, of which N = 40 had a history of prenatal loss. An EMA protocol was used in early and late pregnancy to collect repeated measures of maternal stress and mood, on average eight times per day over a consecutive 4-day period. The association between a history of prenatal loss and psychological state was estimated using linear mixed models. RESULTS Compared to women who had not experienced a prior prenatal loss, women with a history of prenatal loss reported higher levels of pregnancy-specific distress in early as well as late pregnancy and also were more nervous and tired. Furthermore, in the comparison group pregnancy-specific distress decreased and mood improved from early to late pregnancy, whereas these changes across pregnancy were not evident in women in the prenatal loss group. CONCLUSION Our findings suggest that prenatal loss in a prior pregnancy is associated with a subsequent pregnancy with significantly higher stress and impaired mood levels in everyday life across gestation. These findings have important implications for designing EMA-based ambulatory, personalized interventions to reduce stress during pregnancy in this high-risk group.
Collapse
Affiliation(s)
- Claudia Lazarides
- Institute of Medical Psychology, Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin, Germany
| | - Nora K. Moog
- Institute of Medical Psychology, Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin, Germany
| | - Glenn Verner
- Institute of Medical Psychology, Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin, Germany
| | - Manuel C. Voelkle
- Faculty of Life Science, Department of Psychology, Psychological Research Methods, Humboldt-University of Berlin, Berlin, Germany
| | - Wolfgang Henrich
- Department of Obstetrics, Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin, Germany
| | - Christine M. Heim
- Institute of Medical Psychology, Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin, Germany
| | - Thorsten Braun
- Department of Obstetrics, Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin, Germany
| | - Pathik D. Wadhwa
- Development, Health and Disease Research Program, University of California, Irvine, CA, USA
| | - Claudia Buss
- Institute of Medical Psychology, Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin, Germany
- Development, Health and Disease Research Program, University of California, Irvine, CA, USA
- Department of Pediatrics, University of California, Irvine, CA, USA
| | - Sonja Entringer
- Institute of Medical Psychology, Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin, Germany
- Development, Health and Disease Research Program, University of California, Irvine, CA, USA
- Department of Pediatrics, University of California, Irvine, CA, USA
| |
Collapse
|
27
|
Koc E, Baltaci N, Bal S. Does telecounseling reduce anxiety and depression during pregnancy? A randomized controlled trial. REVISTA DA ASSOCIACAO MEDICA BRASILEIRA (1992) 2023; 69:e20221213. [PMID: 37194904 DOI: 10.1590/1806-9282.20221213] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Accepted: 03/16/2023] [Indexed: 05/18/2023]
Abstract
OBJECTIVE This study aims to examine the effect of telecounseling in reducing the anxiety and depression experienced by pregnant women. METHOD This randomized control trial was conducted on 100 pregnant women (50 in each intervention and control group). The intervention group received telecounseling with regard to the mother and the fetus as needed between 08:00 h and 20:00 h for 6 weeks at home. The control group received only routine care. Anxiety and depression levels were evaluated at the beginning and end of the study using the Hospital Anxiety Depression Scale. RESULTS Anxiety and depression levels were found to be lower in the intervention group than in the control group (p<0.001). In the control group, the anxiety score increased from 5.62 to 7.16, and the depression score increased from 4.92 to 5.76 without any intervention (p<0.001). CONCLUSION This study shows that telecounseling may have an effect on reducing the level of anxiety and depression of pregnant women.
Collapse
Affiliation(s)
- Emine Koc
- Ondokuz Mayis University, Faculty of Health Sciences, Department of Midwifery - Samsun, Turkey
| | - Nazlı Baltaci
- Ondokuz Mayıs University, Faculty of Health Sciences, Department of Nursing - Samsun, Turkey
| | - Sümeyye Bal
- Ondokuz Mayis University, Faculty of Health Sciences, Department of Midwifery - Samsun, Turkey
| |
Collapse
|
28
|
Tibebu NS, Kassie BA, Anteneh TA, Rade BK. Depression, anxiety and stress among HIV-positive pregnant women in Ethiopia during the COVID-19 pandemic. Trans R Soc Trop Med Hyg 2022; 117:317-325. [PMID: 36579933 DOI: 10.1093/trstmh/trac126] [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: 01/15/2022] [Revised: 09/19/2022] [Accepted: 12/13/2022] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND Assessing the maternal mental health status during the coronavirus disease 2019 (COVID-19) pandemic is necessary to prevent the occurrence of severe mental disorders. Prenatal depression, anxiety and stress disorders are prominent in pregnant women living with human immunodeficiency virus (HIV) and highly associated with poor maternal and neonatal outcomes. Therefore this study aimed to assess the level of depression, anxiety, and stress among HIV-positive pregnant women in Ethiopia during the COVID-19 pandemic. METHODS An institution-based cross-sectional study was conducted in Amhara region referral hospitals from 17 October 2020 to 1 March 2021. A systematic random sampling technique was used to select 423 eligible women. A structured, pretested and interviewer-administered questionnaire was employed to collect the data. A multivariable logistic regression analysis was implemented to identify factors associated with women's depression, anxiety and stress. Statistical association was certain based on the adjusted odds ratio (AOR) with its 95% confidence interval (CI) and p-values ≤0.05. RESULTS Prenatal depression, anxiety and stress among HIV-positive pregnant women were 37.6% (95% CI 33 to 42.3), 42.1 (95% CI 37.7 to 46.7) and 34.8% (95% CI 30.3 to 39.2), respectively. Having an HIV-negative sexual partner (AOR 1.91 [95% CI 1.16 to 3.15]) and being on antiretroviral therapy >1 year (AOR 2.18 [95% CI 1.41 to 3.36]) were found to be statistically significant with women's antenatal depression, while unplanned pregnancy (AOR 1.09 [95% CI 1.02 to 2.33]) and did not discuss with the sexual partner about HIV (AOR 3.21 [95% CI 2.12 to 7.07]) were the factors associated with prenatal anxiety. CONCLUSIONS In this study, more than one in three HIV-positive pregnant women had depression and anxiety. Thus, implementing strategies to prevent unplanned pregnancy and advocating open discussion with sexual partners about HIV will play a large role in reducing pregnancy-related depression and anxiety.
Collapse
Affiliation(s)
- Nebiyu Solomon Tibebu
- Department of Clinical Midwifery, School of Midwifery, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Belayneh Ayanaw Kassie
- Department of Women's and Family Health, School of Midwifery, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Tazeb Alemu Anteneh
- Department of Clinical Midwifery, School of Midwifery, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Bayew Kelkay Rade
- Department of General Midwifery, School of Midwifery, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| |
Collapse
|
29
|
Favre G, Kunz C, Schwank S, Chung HF, Radan AP, Raio L, Fluri M, Winterfeld U, Baud D, Pomar L. Mental health in pregnant individuals during the COVID-19 pandemic based on a Swiss online survey. Sci Rep 2022; 12:18448. [PMID: 36323687 PMCID: PMC9628478 DOI: 10.1038/s41598-022-21881-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Accepted: 10/05/2022] [Indexed: 11/30/2022] Open
Abstract
The aim of our study was to evaluate the mental health of pregnant individuals during the early COVID-19 pandemic and the potential factors associated. A Swiss online survey was proposed to individuals who gave birth during the pandemic period from March 2020. The Edinburgh Postnatal Depression Scale (EPDS), Generalized Anxiety Disorder 7 questions (GAD-7), and Impact Event Scale-Revised (IES-R) were evaluated and used to defined mental health impairment as a composite outcome. From October, 2020 to February, 2021, 736 participants responded. The anxiety GAD-7 score was moderate in 9.6% and severe in 2.0%. The EPDS was moderate in 21.5% and severe in 32.9%. The IES-R was moderate in 10.3% and severe in 3.9%. Mental health impairment was reported in 37.0%. The association between the risk of mental health impairment and foreign nationality was significant (OR = 1.48; 95%CI [1.06-2.05]) as well as fetal and pregnancy worries because of coronavirus (OR = 1.46; 95% CI [1.08-1.98]) and 1.65; 95% CI [1.22-2.24]). Adjusted ORs were significant for foreign nationality (aOR = 1.51; 95%CI [1.07-2.13]) and pregnancy worries because of coronavirus (aOR = 1.62; 95%CI [1.10-2.40]). Pregnant people and especially foreign national have a high risk of mental health impairment during the pandemic.
Collapse
Affiliation(s)
- Guillaume Favre
- Materno-Fetal and Obstetrics Research Unit, Department Woman-Mother-Child, Lausanne University Hospital, Lausanne, Switzerland.
- Materno-Fetal & Obstetrics Research Unit, Department of Obstetrics and Gynecology, Centre Hospitalier Universitaire Vaudois (CHUV), 1011, Lausanne, Switzerland.
| | - Cléa Kunz
- Materno-Fetal and Obstetrics Research Unit, Department Woman-Mother-Child, Lausanne University Hospital, Lausanne, Switzerland
| | - Simone Schwank
- Department of Clinical Science, Intervention and Technology (CLINTEC), Karolinska Institutet, Stockholm, Sweden
- Columbia University, College of Physicians and Surgeons, Center for Psychoanalytic Training and Research, New York, USA
| | - Ho-Fung Chung
- Department of Psychology, The University of Hong Kong, Hong Kong, China
- Department of Anthropology, The Chinese University of Hong Kong, Hong Kong, China
| | - Anda Petronela Radan
- Department of Obstetrics and Gynecology, University Hospital of Bern and University of Bern, Bern, Switzerland
| | - Luigi Raio
- Department of Obstetrics and Gynecology, University Hospital of Bern and University of Bern, Bern, Switzerland
| | - Mihaela Fluri
- Department of Obstetrics and Gynecology, University Hospital of Bern and University of Bern, Bern, Switzerland
| | - Ursula Winterfeld
- Swiss Teratogen Information Service, Clinical Pharmacology Service, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - David Baud
- Materno-Fetal and Obstetrics Research Unit, Department Woman-Mother-Child, Lausanne University Hospital, Lausanne, Switzerland
| | - Léo Pomar
- Materno-Fetal and Obstetrics Research Unit, Department Woman-Mother-Child, Lausanne University Hospital, Lausanne, Switzerland
- School of Health Sciences (HESAV), University of Applied Sciences and Arts Western Switzerland, Lausanne, Switzerland
| |
Collapse
|
30
|
Peuranpää P, Gissler M, Peltopuro P, Tiitinen A, Hautamäki H. The effect of paternal and maternal factors on the prognosis of live birth in couples with recurrent pregnancy loss. Acta Obstet Gynecol Scand 2022; 101:1374-1385. [PMID: 36210542 PMCID: PMC9812203 DOI: 10.1111/aogs.14469] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2022] [Revised: 08/25/2022] [Accepted: 09/19/2022] [Indexed: 01/07/2023]
Abstract
INTRODUCTION Currently, recurrent pregnancy loss (RPL) examinations focus on the woman, although paternal factors are also involved. Men in couples with RPL have higher sperm DNA fragmentation levels than fertile men, but the effect of sperm DNA damage on couple's later prognosis is unknown. Advanced maternal age and obesity are associated with RPL, but paternal lifestyle factors are less studied. Therefore, we aimed to study the associations of couples' lifestyle factors, causes of RPL, and sperm DNA fragmentation with their prognosis of future live birth. MATERIAL AND METHODS This descriptive cohort study comprised 506 couples investigated for RPL at Helsinki University Hospital, Finland, between 2007 and 2016, linked with national health and population registers. The primary outcome was couple's live birth after RPL investigations. Data on couple's background factors, including age, body mass index, smoking, and alcohol use, were collected from medical records. Sperm DNA fragmentation index was analyzed from 211 men using the sperm chromatin dispersion test. The associations between background factors, sperm DNA fragmentation, and cumulative probability of live birth over time were analyzed using cross-tabulations and age-adjusted Cox regression. RESULTS In all, 352 of 506 couples (69.6%) achieved live birth. Maternal age, unexplained RPL, prolonged pregnancy attempts before investigations, paternal obesity, and maternal smoking were associated with prognosis: unadjusted hazard ratio for couple's live birth for women aged 35-39 vs younger than 30 years was 0.63 (95% confidence interval [CI] 0.47-0.84), and for 40 years or older was 0.36 (95% CI 0.22-0.58). Age-adjusted hazard ratio for unexplained vs explained RPL was 1.39 (95% CI 1.12-1.72), for couple's pregnancy attempt at least 4 years vs less than 2 years was 0.50 (95% CI 0.33-0.76), for paternal body mass index at least 30 kg/m2 vs less than 25 kg/m2 was 0.67 (95% CI 0.46-0.98), and for maternal smoking was 0.71 (95% CI 0.51-0.99). Altogether, 96/135 (71.1%) couples with normal (<15%), 38/60 (63.3%) with intermediate (15-30%), and 11/16 (68.8%) with high sperm DNA fragmentation index achieved live birth (p = 0.56). CONCLUSIONS In couples with RPL, prolonged pregnancy attempts, a cause found in RPL examinations, lifestyle factors, and maternal age are negatively associated with their prognosis of future live birth. Sperm DNA fragmentation was not associated, but the number of men with damaged spermatozoa was small. We suggest that clinicians include women and men in RPL counseling because couple's joint lifestyle seems to determine their later prognosis.
Collapse
Affiliation(s)
- Pirkko‐Liisa Peuranpää
- The Department of Obstetrics and GynecologyUniversity of Helsinki and Helsinki University HospitalHelsinkiFinland
| | - Mika Gissler
- Finnish Institute for Health and WelfareHelsinkiFinland,Academic Primary Health Care Center, Region Stockholm & Department of Molecular Medicine and SurgeryKarolinska InstituteStockholmSweden
| | - Paula Peltopuro
- The Department of Obstetrics and GynecologyUniversity of Helsinki and Helsinki University HospitalHelsinkiFinland
| | - Aila Tiitinen
- The Department of Obstetrics and GynecologyUniversity of Helsinki and Helsinki University HospitalHelsinkiFinland
| | - Hanna Hautamäki
- The Department of Obstetrics and GynecologyUniversity of Helsinki and Helsinki University HospitalHelsinkiFinland
| |
Collapse
|
31
|
Burke KL, Raley RK. Declines in Non-marital Births Among Black Women Between 2004 and 2014: Are Recent Trends the Result of Increases in Contraception? POPULATION RESEARCH AND POLICY REVIEW 2022; 41:2267-2288. [PMID: 39006865 PMCID: PMC11244848 DOI: 10.1007/s11113-022-09724-4] [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: 03/11/2021] [Accepted: 05/05/2022] [Indexed: 11/27/2022]
Abstract
Non-marital birth rates for women in their twenties began declining in 2008, but the mechanisms driving this decline are not yet well understood. Using a proximate determinants of fertility framework and decomposition techniques, we consider the importance of changes in relationship status, contraceptive use, and other dimensions of deliberate fertility control in understanding trends in the non-marital fertile pregnancy rate between 2004 and 2014. We use data from several cycles of the National Survey of Family Growth to identify relationship and contraceptive use status at the time of conception for pregnancies that resulted or were likely to result in live births (i.e., fertile pregnancies), and focus our analysis on non-Hispanic Black women in their twenties. We find that changes in relationship status and sexual activity did not contribute to the decline in fertile pregnancy rates, nor did changes in the distribution of contraceptive method use. Instead, changing fertile pregnancy rates within contraceptive use categories, including among those who report using no method of contraception, account for the observed trend. Though contraceptive method mix is an insufficient explanation for recent trends, our results suggest that considering the sources of within-method variation in fertile pregnancy rates over time is key to understanding declines in non-marital births, and that some women not using contraception likely engaged in a form of deliberate fertility control not captured by the National Survey of Family Growth.
Collapse
Affiliation(s)
- Kristen Lagasse Burke
- Department of Sociology & Population Research Center, University of Texas at Austin, Austin, TX, USA
| | - R Kelly Raley
- Department of Sociology & Population Research Center, University of Texas at Austin, Austin, TX, USA
| |
Collapse
|
32
|
Jigeer G, Tao W, Zhu Q, Xu X, Zhao Y, Kan H, Cai J, Xu Z. Association of residential noise exposure with maternal anxiety and depression in late pregnancy. ENVIRONMENT INTERNATIONAL 2022; 168:107473. [PMID: 35994797 DOI: 10.1016/j.envint.2022.107473] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/18/2022] [Revised: 08/05/2022] [Accepted: 08/11/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND Noise is one of the most important environmental risk factors that adversely affects human health. Residential noise exposure has been associated with increased risk of anxiety and depression in the general population. However, limited study has been conducted in pregnant women. OBJECTIVE To examine the associations of residential noise exposure with prenatal anxiety and depression. METHODS Self-Rating Anxiety Scale (SAS) and Center for Epidemiological Survey Scale (CES-D) were used to assess the status of prenatal anxiety and depression for 2,018 pregnant women in Shanghai, China. Residential noise exposure was represented by a land use regression model. Multivariate logistic regression model was used to estimate the associations of noise exposure with prenatal anxiety and depression. RESULTS The prevalence rates of prenatal anxiety and depression were 7.5 % and 8.1 %, respectively. The mean (±standard deviation) residential noise exposure during the whole pregnancy was 60.69 (±3.31) dB (A). Higher residential noise exposure was associated with increased odds of both prenatal anxiety and depression. Compared with low level of noise exposure group (<65 dB(A)), the odds of prenatal anxiety and depression increased 69 % (OR = 1.69, 95 % CI, 1.01-2.82) and 71 % (OR = 1.71, 95 % CI, 1.05-2.80) in higher noise exposure group (≥65 dB(A)), respectively. Stratified analyses showed that the associations were stronger among pregnant women with lower socioeconomic status. CONCLUSION Residential noise exposure during pregnancy might be a risk factor for prenatal anxiety and depression.
Collapse
Affiliation(s)
- Guliyeerke Jigeer
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and NHC Key Laboratory of Health Technology Assessment, Fudan University, Shanghai, China
| | - Weimin Tao
- Department of Anesthesiology, Shanghai First Maternity and Infant Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Qingqing Zhu
- The Maternal and Child Healthcare Institute of Songjiang District, Shanghai, China
| | - Xueyi Xu
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and NHC Key Laboratory of Health Technology Assessment, Fudan University, Shanghai, China
| | - Yan Zhao
- Shanghai Key Laboratory of Maternal Fetal Medicine, Shanghai First Maternity and Infant Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Haidong Kan
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and NHC Key Laboratory of Health Technology Assessment, Fudan University, Shanghai, China; Shanghai Typhoon Institute/CMA, Shanghai Key Laboratory of Meteorology and Health, Shanghai, China.
| | - Jing Cai
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and NHC Key Laboratory of Health Technology Assessment, Fudan University, Shanghai, China; Shanghai Typhoon Institute/CMA, Shanghai Key Laboratory of Meteorology and Health, Shanghai, China.
| | - Zhendong Xu
- Department of Anesthesiology, Shanghai First Maternity and Infant Hospital, School of Medicine, Tongji University, Shanghai, China.
| |
Collapse
|
33
|
Li LJ, Du R, Loy SL, Chong YS, Chan JKY, Wong TY, Eriksson JG, Huang Z, Zhang C. Retinal microvasculature and risk of spontaneous abortion in multiethnic Southeast Asian women. Fertil Steril 2022; 118:748-757. [PMID: 35981917 DOI: 10.1016/j.fertnstert.2022.06.033] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2022] [Revised: 06/14/2022] [Accepted: 06/28/2022] [Indexed: 01/13/2023]
Abstract
OBJECTIVE To better understand the underlying pathogenesis of spontaneous abortion that affects 10%-20% of recognized pregnancies. We used retinal imaging to study the role of systemic microvasculature and the risk of spontaneous abortion. DESIGN A prospective multiethnic preconception cohort study conducted in Singapore. SETTING Hospital-based. PATIENT(S) A total of 1,032 Southeast Asian women who intended to conceive naturally were screened at study entry, among which 480 women spontaneously conceived within the 12-month observation period. After excluding 24 women who were lost to follow-up, we calculated the spontaneous abortion rate among 456 women. Further, we included 379 women for the final association analysis because 63 women did not undergo preconception retinal imaging examination and 14 had other types of pregnancy loss instead of spontaneous abortion. INTERVENTION(S) Trained photographers performed retinal examination using a 45-degree nonmydriatic retinal camera at study entry during the preconception screening. Using a semiautomated, computer-based program, we assessed quantitative retinal microvascular measurements, including caliber, fractal dimension, curvature tortuosity, and branching angle. Clinical research coordinators collected information on sociodemographic status, menstrual characteristics, and lifestyle, and assessed blood pressure and anthropometry at study entry. MAIN OUTCOME MEASURE(S) We performed a modified Poisson regression model to estimate the relative risk (RR) and 95% confidence interval (CI) for each retinal microvascular feature and its association with spontaneous abortion after adjusting for major confounders such as maternal prepregnancy, body mass index, and previous pregnancy loss history. RESULT(S) We reported a spontaneous abortion rate of 13.4% (61 out of 456). Among all retinal microvascular features, retinal arteriolar caliber, retinal arteriolar, and venular curvature tortuosity were associated with a high risk of incident spontaneous abortion. In the regression model, per SD increase in retinal curvature tortuosity was associated with a 25%-34% increased risk of incident spontaneous abortion (arteriolar: unadjusted RR, 1.29 [95% CI, 1.06-1.56] and adjusted RR, 1.26 [1.04-1.53]; venule: unadjusted RR, 1.30 [1.08-1.55] and adjusted RR, 1.34 [1.09-1.64]). CONCLUSION(S) Our prospective cohort observed an increased risk of spontaneous abortion among Asian women with more tortuous retinal vessels assessed during the preconception phase. Our results indicate a role of vascular inflammatory and oxidative stress in the pathogenesis of spontaneous abortion. CLINICAL TRIAL REGISTRATION NUMBER ClinicalTrials.gov, NCT03531658.
Collapse
Affiliation(s)
- Ling-Jun Li
- Department of Obstetrics & Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore; NUS Bia-Echo Asia Centre for Reproductive Longevity and Equality (ACRLE), Yong Loo Lin School of Medicine, National University of Singapore, Singapore; Human Potential Translational Research Programme, Yong Loo Lin School of Medicine, National University of Singapore, Singapore; Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Singapore.
| | - Ruochen Du
- Biostatics Unit, Yong Loo Lin School of Medicine, National University of Singapore
| | - See Ling Loy
- Duke-NUS Medical School, Singapore, Singapore; Department of Reproductive Medicine, KK Women's and Children's Hospital, Singapore, Singapore
| | - Yap Seng Chong
- Department of Obstetrics & Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore; NUS Bia-Echo Asia Centre for Reproductive Longevity and Equality (ACRLE), Yong Loo Lin School of Medicine, National University of Singapore, Singapore; Human Potential Translational Research Programme, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Jerry Kok Yen Chan
- Duke-NUS Medical School, Singapore, Singapore; Department of Reproductive Medicine, KK Women's and Children's Hospital, Singapore, Singapore
| | - Tien Yin Wong
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Singapore
| | - Johan G Eriksson
- Department of Obstetrics & Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore; Human Potential Translational Research Programme, Yong Loo Lin School of Medicine, National University of Singapore, Singapore; Department of General Practice and Primary Health Care, University of Helsinki and Helsinki University Hospital, Helsinki, Finland; Folkhälsan Research Center, Helsinki, Finland; Singapore Institute for Clinical Sciences (SICS), Agency for Science, Technology and Research (A∗STAR), Singapore
| | - Zhongwei Huang
- Department of Obstetrics & Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore; NUS Bia-Echo Asia Centre for Reproductive Longevity and Equality (ACRLE), Yong Loo Lin School of Medicine, National University of Singapore, Singapore; Institute of Molecular and Cell Biology, Agency of Science, Technology & Research, Singapore, Singapore
| | - Cuilin Zhang
- Department of Obstetrics & Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore; NUS Bia-Echo Asia Centre for Reproductive Longevity and Equality (ACRLE), Yong Loo Lin School of Medicine, National University of Singapore, Singapore; Human Potential Translational Research Programme, Yong Loo Lin School of Medicine, National University of Singapore, Singapore; Epidemiology Branch, Division of Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, Maryland
| |
Collapse
|
34
|
Puscheck EE, Ruden X, Singh A, Abdulhasan M, Ruden DM, Awonuga AO, Rappolee DA. Using high throughput screens to predict miscarriages with placental stem cells and long-term stress effects with embryonic stem cells. Birth Defects Res 2022; 114:1014-1036. [PMID: 35979652 PMCID: PMC10108263 DOI: 10.1002/bdr2.2079] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Revised: 07/25/2022] [Accepted: 07/26/2022] [Indexed: 11/10/2022]
Abstract
A problem in developmental toxicology is the massive loss of life from fertilization through gastrulation, and the surprising lack of knowledge of causes of miscarriage. Half to two-thirds of embryos are lost, and environmental and genetic causes are nearly equal. Simply put, it can be inferred that this is a difficult period for normal embryos, but that environmental stresses may cause homeostatic responses that move from adaptive to maladaptive with increasing exposures. At the lower 50% estimate, miscarriage causes greater loss-of-life than all cancers combined or of all cardio- and cerebral-vascular accidents combined. Surprisingly, we do not know if miscarriage rates are increasing or decreasing. Overshadowed by the magnitude of miscarriages, are insufficient data on teratogenic or epigenetic imbalances in surviving embryos and their stem cells. Superimposed on the difficult normal trajectory for peri-gastrulation embryos are added malnutrition, hormonal, and environmental stresses. An overarching hypothesis is that high throughput screens (HTS) using cultured viable reporter embryonic and placental stem cells (e.g., embryonic stem cells [ESC] and trophoblast stem cells [TSC] that report status using fluorescent reporters in living cells) from the pre-gastrulation embryo will most rapidly test a range of hormonal, environmental, nutritional, drug, and diet supplement stresses that decrease stem cell proliferation and imbalance stemness/differentiation. A second hypothesis is that TSC respond with greater sensitivity in magnitude to stress that would cause miscarriage, but ESC are stress-resistant to irreversible stemness loss and are best used to predict long-term health defects. DevTox testing needs more ESC and TSC HTS to model environmental stresses leading to miscarriage or teratogenesis and more research on epidemiology of stress and miscarriage. This endeavor also requires a shift in emphasis on pre- and early gastrulation events during the difficult period of maximum loss by miscarriage.
Collapse
Affiliation(s)
- Elizabeth E Puscheck
- CS Mott Center for Human Growth and Development, Department of Ob/Gyn, Reproductive Endocrinology and Infertility, Wayne State University School of Medicine, Detroit, Michigan, USA
- Reproductive Stress 3M Inc, Grosse Pointe Farms, Michigan, USA
- Invia Fertility Clinics, Hoffman Estates, Illinois, USA
| | - Ximena Ruden
- CS Mott Center for Human Growth and Development, Department of Ob/Gyn, Reproductive Endocrinology and Infertility, Wayne State University School of Medicine, Detroit, Michigan, USA
| | - Aditi Singh
- CS Mott Center for Human Growth and Development, Department of Ob/Gyn, Reproductive Endocrinology and Infertility, Wayne State University School of Medicine, Detroit, Michigan, USA
- Center for Molecular Medicine and Genetics, Wayne State University School of Medicine, Detroit, Michigan, USA
| | - Mohammed Abdulhasan
- CS Mott Center for Human Growth and Development, Department of Ob/Gyn, Reproductive Endocrinology and Infertility, Wayne State University School of Medicine, Detroit, Michigan, USA
- Reproductive Stress 3M Inc, Grosse Pointe Farms, Michigan, USA
| | - Douglas M Ruden
- CS Mott Center for Human Growth and Development, Department of Ob/Gyn, Reproductive Endocrinology and Infertility, Wayne State University School of Medicine, Detroit, Michigan, USA
- Invia Fertility Clinics, Hoffman Estates, Illinois, USA
- Institute for Environmental Health Science, Wayne State University School of Medicine, Detroit, Michigan, USA
| | - Awoniyi O Awonuga
- CS Mott Center for Human Growth and Development, Department of Ob/Gyn, Reproductive Endocrinology and Infertility, Wayne State University School of Medicine, Detroit, Michigan, USA
| | - Daniel A Rappolee
- CS Mott Center for Human Growth and Development, Department of Ob/Gyn, Reproductive Endocrinology and Infertility, Wayne State University School of Medicine, Detroit, Michigan, USA
- Reproductive Stress 3M Inc, Grosse Pointe Farms, Michigan, USA
- Invia Fertility Clinics, Hoffman Estates, Illinois, USA
- Institute for Environmental Health Science, Wayne State University School of Medicine, Detroit, Michigan, USA
- Program for Reproductive Sciences and Department of Physiology, Wayne State University School of Medicine, Detroit, Michigan, USA
- Department of Biology, University of Windsor, Windsor, Ontario, Canada
| |
Collapse
|
35
|
Shahamabadi MG, Farajkhoda T, Mahmoodabadi HZ. Online versus face-to-face metacognitive educational counseling program on anxiety and meta-worry in women with a history of miscarriage: A randomized clinical trial. JOURNAL OF EDUCATION AND HEALTH PROMOTION 2022; 11:264. [PMID: 36325205 PMCID: PMC9621353 DOI: 10.4103/jehp.jehp_1292_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Accepted: 12/27/2021] [Indexed: 06/16/2023]
Abstract
BACKGROUND In the COVID-19 outbreak, women with a history of miscarriage need more mental health. Anxiety and meta-worry as consequences of miscarriage, besides concerns due to pregnancy during coronavirus, show the necessity of appropriate online and face-to-face educational counseling. This study aimed to evaluate the effectiveness of online metacognitive educational counseling versus face-to-face method on anxiety and meta-worry in these women. MATERIALS AND METHODS In this randomized clinical trial, 80 women with a history of miscarriage, anxiety, and meta-worry referred to Imam Jafar Sadegh hospital (labor, women ward and women clinic), Meybod, Iran, were selected conveniently and randomly assigned into two groups (n = 20/each). The participants received 8-session metacognitive educational counseling package online or face-to-face. Data were collected by Beck Anxiety Inventory, Wellz meta-worry questionnaire at baseline, week eight, and follow up as primary outcomes and analyzed via SPSS software (Anova and Repeated measure statistic tests). RESULTS Anxiety in the 12th week (online group 13.75 ± 3.59 vs. face to face 18.25 ± 5.91, P = 0.04) was statistical significantly less than baseline (respectively 22.15 ± 5.67 vs. 22.35 ± 4.93, P = 0.56); with fewer anxiety scores in the online group. Meta-worry in the 12th week (online group 11.90 ± 2.59 vs. face to face 15.70 ± 4.06, P = 0.03) was statistically significant compared to baseline (respectively 17.15 ± 2.70 vs. 18.50 ± 3.47, P = 0.36); with fewer meta-worry scores in the online group. Belief about worry in 12th week (online group 66.50 ± 14.60 vs. face to face 78.45 ± 9.27, P = 0.01) was statistical significantly less than baseline (respectively 85.50 ± 8.87 vs. 86.05 ± 8.85, P = 0.96); with less score of belief about worry in the online group. CONCLUSION Online and face-to-face metacognitive educational counseling methods decreased anxiety, meta-worry, and belief about worry in women with miscarriage. But online educational counseling was more effective. Distance online counseling in COVID-19 can help the mental health of women with miscarriage.
Collapse
Affiliation(s)
- Mina Ghiasi Shahamabadi
- Counseling in Midwifery (MSc), Student Research Committee, Midwifery Department, School of Nursing and Midwifery, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Tahmineh Farajkhoda
- Reproductive Health (Ph.D.) and Clinical Psycologist, Research Center for Nursing and Midwifery Care, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | | |
Collapse
|
36
|
Schliep KC, Hinkle SN, Kim K, Sjaarda LA, Silver RM, Stanford JB, Purdue-Smithe A, Plowden TC, Schisterman EF, Mumford SL. Prospectively assessed perceived stress associated with early pregnancy losses among women with history of pregnancy loss. Hum Reprod 2022; 37:2264-2274. [PMID: 35972454 PMCID: PMC9802052 DOI: 10.1093/humrep/deac172] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2021] [Revised: 07/06/2022] [Indexed: 01/05/2023] Open
Abstract
STUDY QUESTION What is the association between perceived stress during peri-conception and early pregnancy and pregnancy loss among women who have experienced a prior pregnancy loss? SUMMARY ANSWER Daily perceived stress above the median is associated with over a 2-fold risk of early pregnancy loss among women who have experienced a prior loss. WHAT IS KNOWN ALREADY? Women who have experienced a pregnancy loss may be more vulnerable to stress while trying to become pregnant again. While prior research has indicated a link between psychological stress and clinically confirmed miscarriages, research is lacking among a pre-conceptional cohort followed prospectively for the effects of perceived stress during early critical windows of pregnancy establishment on risk of both hCG-detected pregnancy losses and confirmed losses, while considering important time-varying confounders. STUDY DESIGN, SIZE, DURATION Secondary data analysis of the EAGeR trial (2007-2011) among women with an hCG-detected pregnancy (n = 797 women). PARTICIPANTS/MATERIALS, SETTING, METHODS Women from four US clinical centers enrolled pre-conceptionally and were followed ≤6 cycles while attempting pregnancy and, as applicable, throughout pregnancy. Perceived stress was captured via daily diaries and end-of-month questionnaires. Main outcome measures include hCG-detected and clinically recognized pregnancy losses. MAIN RESULTS AND THE ROLE OF CHANCE Among women who had an hCG-confirmed pregnancy, 188 pregnancies (23.6%) ended in loss. Women with high (>50th percentile) versus low (≤50th percentile) peri-implantation or early pregnancy weekly perceived stress had an elevated risk of experiencing any pregnancy loss (hazard ratio (HR): 1.69, 95% CI: 1.13, 2.54) or clinical loss (HR: 1.58, 95% CI: 0.96, 2.60), with higher risks observed for women experiencing an hCG-detected loss (HR: 2.16, 95% CI: 1.04, 4.46). Models accounted for women's age, BMI, employment, marital status, income, education, race, parity, prior losses, exercise and time-varying nausea/vomiting, caffeine, alcohol and smoking. LIMITATIONS, REASONS FOR CAUTION We were limited in our ability to clearly identify the mechanisms of stress on pregnancy loss due to our sole reliance on self-reported perceived stress, and the lack of biomarkers of different pathways of stress. WIDER IMPLICATIONS OF THE FINDINGS This study provides new insight on early pregnancy perceived stress and risk of pregnancy loss, most notably hCG-detected losses, among women with a history of a prior loss. Our study is an improvement over past studies in its ability to account for time-varying early pregnancy symptoms, such as nausea/vomiting, and lifestyle factors, such as caffeine, alcohol and smoking, which are also risk factors for psychological stress and pregnancy loss. STUDY FUNDING/COMPETING INTEREST(S) This work was supported by the Intramural Research Program of the Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, Maryland (Contract numbers: HHSN267200603423, HHSN267200603424, HHSN267200603426, HHSN275201300023I). Additionally, K.C.S. was supported by the National Institute on Aging of the National Institutes of Health under Award Number K01AG058781. The authors have no conflicts of interest to disclose. TRIAL REGISTRATION NUMBER #NCT00467363.
Collapse
Affiliation(s)
- Karen C Schliep
- Correspondence address. Department of Family and Preventive Medicine, University of Utah Health, 375 Chipeta Way, Suite A, Salt Lake City, UT, USA. Tel: +1-801-587-7271; E-mail:
| | - Stefanie N Hinkle
- Department of Biostatistics, Epidemiology and Informatics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Keewan Kim
- Epidemiology Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, MD, USA
| | - Lindsey A Sjaarda
- Epidemiology Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, MD, USA
| | - Robert M Silver
- Department of Obstetrics and Gynecology, University of Utah Health, Salt Lake City, UT, USA
| | - Joseph B Stanford
- Division of Public Health, Department of Family and Preventive Medicine, University of Utah Health, Salt Lake City, UT, USA
| | - Alexandra Purdue-Smithe
- Department of Medicine, Division of Women’s Health at Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA
| | - Torie Comeaux Plowden
- Department of Obstetrics and Gynecology, Womack Army Medical Center, Fort Bragg, NC, USA
| | - Enrique F Schisterman
- Department of Biostatistics, Epidemiology and Informatics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Sunni L Mumford
- Department of Biostatistics, Epidemiology and Informatics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA,Epidemiology Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, MD, USA
| |
Collapse
|
37
|
Kalla A, Loucif L, Yahia M. Miscarriage Risk Factors for Pregnant Women: A Cohort Study in Eastern Algeria’s Population. J Obstet Gynaecol India 2022; 72:109-120. [PMID: 35928069 PMCID: PMC9343518 DOI: 10.1007/s13224-021-01564-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2021] [Accepted: 08/31/2021] [Indexed: 10/20/2022] Open
Abstract
Background Miscarriage is defined as an adverse and unexpected termination of pregnancy; it is the most frequent pregnancy complication. Here, we aimed to identify the factors predisposing to miscarriage in pregnant women in Eastern Algeria and the effect of the combination of several factors, including maternal Body Mass Index (BMI), maternal age, concomitant pathologies, and nutrients, and to predict the occurrence of miscarriage. Methods A total of 786 pregnant women from Eastern Algeria were interviewed between 2011 and 2015. Association between miscarriage exposure and identified risk factors was assessed using a Generalized Linear Model (GLM), ANOVA test, Multiple Correspondence Analysis (MCA), and Hierarchical Clustering Analysis (HCA). Throughout this study, we sought to find answers, discuss this association, and predict the occurrence of miscarriage. Results We developed a predictive model for miscarriage, and we found that miscarriage was significantly higher for pregnant women aged over 35 years (1.75; 95% CI: 0.75-4.37; p = 0.208), with a high BMI (> 25 kg/m2), (1.88; 95% CI:1.28-2.78; p = 0.001). We have highlighted that miscarriage is strongly associated with hypertension (1.67; 95% CI: 1.16-2.39; p = 0.006), diet rich in meat (0.60; 95% CI: 0.33-1.04; p = 0.075), and moderate in fish (2.32; 95% CI: 1.18-4.58; p = 0.015). Conclusion Our study proved that knowing these risk factors helps to establish predictive models and strategies to prevent tragic pregnancy outcomes and highlights the link between miscarriage and several risk factors; and thus, will allow protecting mother and fetus health.
Collapse
|
38
|
Puertas-Gonzalez JA, Mariño-Narvaez C, Romero-Gonzalez B, Vilar-López R, Peralta-Ramirez MI. Resilience, stress and anxiety in pregnancy before and throughout the pandemic: a structural equation modelling approach. CURRENT PSYCHOLOGY 2022; 42:1-11. [PMID: 35698485 PMCID: PMC9178340 DOI: 10.1007/s12144-022-03305-6] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/02/2022] [Indexed: 11/17/2022]
Abstract
The present study explored and compared the link between resilience and pregnancy-related stress, perceived stress, and anxiety, employing two structural equation models. One model focused on pregnant women before the outbreak of the pandemic, and the other on pregnancies throughout the pandemic. For this purpose, a total sample of 690 women during their pregnancy were collected: the Pre-Pandemic Group (P-PG) was composed of 341 pregnant women evaluated prior to the pandemic; and 349 pregnant women assessed at the time of the pandemic constituted the Pandemic Group (PG). The resilience, pregnancy-related stress, perceived stress, and anxiety symptomatology of the women were assessed. For both samples, resilience was found to lower levels of pregnancy-specific stress, as well as general perceived stress, and anxiety symptomatology. Furthermore, pregnancy-specific stress and perceived stress showed a covariance relationship and, that these, in turn, increased the anxiety. Moreover, the PG showed greater levels of pregnancy-specific stress, anxiety, somatisations, and obsessions-compulsions, while the P-PG presented higher perceived stress levels.
Collapse
Affiliation(s)
- Jose A. Puertas-Gonzalez
- Mind, Brain and Behaviour Research Center (CIMCYC), Granada, Spain
- Personality, Assessment and Psychological Treatment Department, Faculty of Psychology, University of Granada, Granada, Spain
| | | | - Borja Romero-Gonzalez
- Psychology Department, Faculty of Education, University of Valladolid, Campus Duques de Soria, Soria, Spain
| | - Raquel Vilar-López
- Mind, Brain and Behaviour Research Center (CIMCYC), Granada, Spain
- Personality, Assessment and Psychological Treatment Department, Faculty of Psychology, University of Granada, Granada, Spain
| | - Maria Isabel Peralta-Ramirez
- Mind, Brain and Behaviour Research Center (CIMCYC), Granada, Spain
- Personality, Assessment and Psychological Treatment Department, Faculty of Psychology, University of Granada, Granada, Spain
| |
Collapse
|
39
|
Khadra MM, Suradi HH, Amarin JZ, El-Bassel N, Kaushal N, Jaber RM, Al-Qutob R, Dasgupta A. Risk factors for miscarriage in Syrian refugee women living in non-camp settings in Jordan: results from the Women ASPIRE cross-sectional study. Confl Health 2022; 16:32. [PMID: 35672855 PMCID: PMC9171994 DOI: 10.1186/s13031-022-00464-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: 11/12/2021] [Accepted: 05/28/2022] [Indexed: 11/12/2022] Open
Abstract
Background Syrian refugee women face health care disparities and experience worse pregnancy outcomes, including miscarriage. We investigated risk factors for miscarriage in Syrian refugee women living in non-camp settings in Jordan to identify targets for interventions. Methods We analyzed data from Women ASPIRE, a cross-sectional study of gendered physical and mental health concerns of 507 Syrian refugee women (≥ 18 years old) living in non-camp settings in Jordan. We recruited women using systematic clinic-based sampling from four clinics. We limited our analyses to women who had a history of pregnancy and whose most recent pregnancy was single, took place in Jordan, and ended in term live birth or miscarriage (N = 307). We grouped the women by the primary outcome (term live birth or miscarriage) and compared the sociodemographic and clinical characteristics of the two groups. We used Pearson’s χ2 test or the Mann–Whitney U test to obtain unadjusted estimates and multivariable binomial logistic regression to obtain adjusted estimates. Results The most recent pregnancies of 262 women (85%) ended in term live birth and another 45 (15%) ended in miscarriage. Since crossing into Jordan, 11 women (4%) had not received reproductive health services. Of 35 women who were ≥ 35 years old, not pregnant, and did not want a (or another) child, nine (26%) did not use contraception. Of nine women who were ≥ 35 years old and pregnant, seven (78%) did not plan the pregnancy. The adjusted odds of miscarriage were higher in women who had been diagnosed with thyroid disease (aOR, 5.54; 95% CI, 1.56–19.07), had been of advanced maternal age (aOR, 5.83; 95% CI, 2.02–16.91), and had not received prenatal care (aOR, 36.33; 95% CI, 12.04–129.71). Each additional previous miscarriage predicted an increase in the adjusted odds of miscarriage by a factor of 1.94 (1.22–3.09). Conclusions We identified several risk factors for miscarriage in Syrian refugee women living in non-camp settings in Jordan. The risk factors may be amenable to preconception and prenatal care.
Collapse
Affiliation(s)
- Maysa M Khadra
- Department of Obstetrics and Gynecology, The University of Jordan School of Medicine, Queen Rania Street, Amman, 11942, Jordan.
| | - Haya H Suradi
- The University of Jordan School of Medicine, Amman, Jordan
| | | | - Nabila El-Bassel
- Columbia University School of Social Work, New York City, NY, USA
| | - Neeraj Kaushal
- Columbia University School of Social Work, New York City, NY, USA
| | - Ruba M Jaber
- Department of Family and Community Medicine, The University of Jordan School of Medicine, Amman, Jordan
| | - Raeda Al-Qutob
- Department of Family and Community Medicine, The University of Jordan School of Medicine, Amman, Jordan
| | | |
Collapse
|
40
|
Swift A, Reis P, Swanson M. Infertility-related stress and quality of life in women experiencing concurrent reproductive trauma. J Psychosom Obstet Gynaecol 2022; 43:171-176. [PMID: 34907847 DOI: 10.1080/0167482x.2021.2008901] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
Abstract
PURPOSE To compare differences in infertility-related stress and quality of life (QOL) among women with infertility and concurrent reproductive trauma, defined as pregnancy loss during the infertility experience. MATERIALS AND METHODS We used a descriptive, cross-sectional study design to recruit 205 women who underwent infertility treatments from infertility-related Facebook support groups and pages. Participants completed the Copenhagen Multi-center Psychosocial Infertility Fertility Problem Stress Scale, the Fertility Quality of Life tool, and a supplemental infertility demographic form. Statistical analyses included descriptive statistics, Pearson correlations, multivariate analysis of variance (MANOVA), univariate ANOVA, and eta squared. Statistical significance was evaluated using a Bonferroni adjusted alpha = .05/7 = .007. RESULTS Participants with concurrent reproductive trauma had significantly higher social stress (p < .001), and significantly lower emotional QOL (p = .003) than women with infertility alone. Although not statistically significant, participants with concurrent reproductive trauma reported higher personal and marital stress scores and lower mind/body, relational, and social QOL scores than women with infertility alone. CONCLUSIONS Women with concurrent reproductive trauma may need psychological support to combat the emotional distress of pregnancy loss during infertility treatment.
Collapse
Affiliation(s)
- Alison Swift
- Department of Advanced Nursing Practice and Education, East Carolina University College of Nursing, Greenville, NC, USA
| | - Pamela Reis
- Department of Nursing Science, East Carolina University College of Nursing, Greenville, NC, USA
| | - Melvin Swanson
- Department of Nursing Science, East Carolina University College of Nursing, Greenville, NC, USA
| |
Collapse
|
41
|
Sarkesh A, Sorkhabi AD, Ahmadi H, Abdolmohammadi-Vahid S, Parhizkar F, Yousefi M, Aghebati-Maleki L. Allogeneic lymphocytes immunotherapy in female infertility: Lessons learned and the road ahead. Life Sci 2022; 299:120503. [PMID: 35381221 DOI: 10.1016/j.lfs.2022.120503] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2021] [Revised: 03/12/2022] [Accepted: 03/22/2022] [Indexed: 02/07/2023]
Abstract
The endometrium is an essential tissue in the normal immunologic dialogue between the mother and the conceptus, which is necessary for the proper establishment and maintenance of a successful pregnancy. It's become evident that the maternal immune system plays a key role in the normal pregnancy's initiation, maintenance, and termination. In this perspective, the immune system contributes to regulating all stages of pregnancy, thus immunological dysregulation is thought to be one of the major etiologies of implantation failures. Many researchers believe that immune therapies are useful tactics for improving the live births rate in certain situations. Lymphocyte immunotherapy (LIT) is an active form of immunotherapy that, when used on the relevant subgroups of patients, has been shown in multiple trials to dramatically enhance maternal immunological balance and pregnancy outcome. The primary goal of LIT is to regulate the immune system in order to create a favorable tolerogenic immune milieu and tolerance for embryo implantation. However, there are a plethora of influential factors influencing its therapeutic benefits that merit to be addressed. The objective of our study is to discuss the mechanisms and challenges of allogeneic LIT.
Collapse
Affiliation(s)
- Aila Sarkesh
- Student's Research Committee, Tabriz University of Medical Sciences, Tabriz, Iran; Immunology Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Amin Daei Sorkhabi
- Student's Research Committee, Tabriz University of Medical Sciences, Tabriz, Iran; Immunology Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Hamid Ahmadi
- Department of Medical Biology and Central Electron Microscope Laboratory, Medical School, Pécs University, Pécs, Hungary
| | | | - Forough Parhizkar
- Student's Research Committee, Tabriz University of Medical Sciences, Tabriz, Iran; Stem Cell Research Center, Tabriz University of Medical Science, Tabriz, Iran
| | - Mehdi Yousefi
- Stem Cell Research Center, Tabriz University of Medical Science, Tabriz, Iran; Department of Immunology, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Leili Aghebati-Maleki
- Immunology Research Center, Tabriz University of Medical Sciences, Tabriz, Iran; Department of Immunology, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran.
| |
Collapse
|
42
|
Morris JR, Jaswa E, Kaing A, Hariton E, Andrusier M, Aliaga K, Davis M, Cedars MI, Huddleston HG. Early pregnancy anxiety during the COVID-19 pandemic: preliminary findings from the UCSF ASPIRE study. BMC Pregnancy Childbirth 2022; 22:272. [PMID: 35361137 PMCID: PMC8969813 DOI: 10.1186/s12884-022-04595-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Accepted: 03/17/2022] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND Antenatal anxiety has been linked to adverse obstetric outcomes, including miscarriage and preterm birth. However, most studies investigating anxiety during pregnancy, particularly during the COVID-19 pandemic, have focused on symptoms during the second and third trimester. This study aims to describe the prevalence of anxiety symptoms early in pregnancy and identify predictors of early pregnancy anxiety during the COVID-19 pandemic. METHODS We assessed baseline moderate-to-severe anxiety symptoms after enrollment in the UCSF ASPIRE (Assessing the Safety of Pregnancy in the Coronavirus Pandemic) Prospective Cohort from May 2020 through February 2021. Pregnant persons < 10 weeks' gestation completed questions regarding sociodemographic characteristics, obstetric/medical history, and pandemic-related experiences. Univariate and multivariate hierarchical logistic regression analyses determined predictors of moderate or severe anxiety symptoms (Generalized Anxiety Disorder-7 questionnaire score ≥ 10). All analyses performed with Statistical Analysis Software (SAS®) version 9.4. RESULTS A total of 4,303 persons completed the questionnaire. The mean age of this nationwide sample was 33 years of age and 25.7% of participants received care through a fertility clinic. Over twelve percent of pregnant persons reported moderate-to-severe anxiety symptoms. In univariate analysis, less than a college education (p < 0.0001), a pre-existing history of anxiety (p < 0.0001), and a history of prior miscarriage (p = 0.0143) were strong predictors of moderate-to-severe anxiety symptoms. Conversely, having received care at a fertility center was protective (26.6% vs. 25.7%, p = 0.0009). COVID-19 related stressors including job loss, reduced work hours during the pandemic, inability to pay rent, very or extreme worry about COVID-19, and perceived stress were strongly predictive of anxiety in pregnancy (p < 0.0001). In the hierarchical logistic regression model, pre-existing history of anxiety remained associated with anxiety during pregnancy, while the significance of the effect of education was attenuated. CONCLUSION(S) Pre-existing history of anxiety and socioeconomic factors likely exacerbated the impact of pandemic-related stressors on early pregnancy anxiety symptoms during the COVID-19 pandemic. Despite on-going limitations for in-person prenatal care administration, continued emotional health support should remain an important focus for providers, particularly when caring for less privileged pregnant persons or those with a pre-existing history of anxiety.
Collapse
Affiliation(s)
- Jerrine R Morris
- Department of Obstetrics, Gynecology, & Reproductive Sciences, University of California- San Francisco, 499 Illinois Street Sixth Floor, San Francisco, CA, 94158, USA.
| | - Eleni Jaswa
- Department of Obstetrics, Gynecology, & Reproductive Sciences, University of California- San Francisco, 499 Illinois Street Sixth Floor, San Francisco, CA, 94158, USA
| | - Amy Kaing
- Department of Obstetrics, Gynecology, & Reproductive Sciences, University of California- San Francisco, 499 Illinois Street Sixth Floor, San Francisco, CA, 94158, USA
| | - Eduardo Hariton
- Department of Obstetrics, Gynecology, & Reproductive Sciences, University of California- San Francisco, 499 Illinois Street Sixth Floor, San Francisco, CA, 94158, USA
| | - Miriam Andrusier
- College of Medicine, SUNY Downstate Health Sciences University, Brooklyn, NY, USA, 11203
| | - Katie Aliaga
- Saint James School of Medicine, Park Ridge, Illinois, USA, 60068
| | - Maya Davis
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA, 02284
| | - Marcelle I Cedars
- Department of Obstetrics, Gynecology, & Reproductive Sciences, University of California- San Francisco, 499 Illinois Street Sixth Floor, San Francisco, CA, 94158, USA
| | - Heather G Huddleston
- Department of Obstetrics, Gynecology, & Reproductive Sciences, University of California- San Francisco, 499 Illinois Street Sixth Floor, San Francisco, CA, 94158, USA
| |
Collapse
|
43
|
Psychischer Stress – Implikationen für Schwangerschaftseintritt und -verlauf. GYNAKOLOGISCHE ENDOKRINOLOGIE 2022. [DOI: 10.1007/s10304-022-00443-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
44
|
Alhasani M, Mulchandani D, Oyebode O, Baghaei N, Orji R. A Systematic and Comparative Review of Behavior Change Strategies in Stress Management Apps: Opportunities for Improvement. Front Public Health 2022; 10:777567. [PMID: 35284368 PMCID: PMC8907579 DOI: 10.3389/fpubh.2022.777567] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2021] [Accepted: 01/03/2022] [Indexed: 12/03/2022] Open
Abstract
Stress is one of the significant triggers of several physiological and psychological illnesses. Mobile health apps have been used to deliver various stress management interventions and coping strategies over the years. However, little work exists on persuasive strategies employed in stress management apps to promote behavior change. To address this gap, we review 150 stress management apps on both Google Play and Apple's App Store in three stages. First, we deconstruct and compare the persuasive/behavior change strategies operationalized in the apps using the Persuasive Systems Design (PSD) framework and Cialdini's Principles of Persuasion. Our results show that the most frequently employed strategies are personalization, followed by self-monitoring, and trustworthiness, while social support strategies such as competition, cooperation and social comparison are the least employed. Second, we compare our findings within the stress management domain with those from other mental health domains to uncover further insights. Finally, we reflect on our findings and offer eight design recommendations to improve the effectiveness of stress management apps and foster future research.
Collapse
Affiliation(s)
- Mona Alhasani
- Faculty of Computer Science, Dalhousie University, Halifax, NS, Canada
- *Correspondence: Mona Alhasani
| | | | - Oladapo Oyebode
- Faculty of Computer Science, Dalhousie University, Halifax, NS, Canada
| | - Nilufar Baghaei
- Games and Extended Reality Lab, Massey University, Auckland, New Zealand
| | - Rita Orji
- Faculty of Computer Science, Dalhousie University, Halifax, NS, Canada
| |
Collapse
|
45
|
Silang KA, Sohal PR, Bright KS, Leason J, Roos L, Lebel C, Giesbrecht GF, Tomfohr-Madsen LM. eHealth Interventions for Treatment and Prevention of Depression, Anxiety, and Insomnia During Pregnancy: Systematic Review and Meta-analysis. JMIR Ment Health 2022; 9:e31116. [PMID: 35188471 PMCID: PMC8902665 DOI: 10.2196/31116] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Revised: 10/08/2021] [Accepted: 11/05/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Pregnancy is associated with an increased risk for depression, anxiety, and insomnia. eHealth interventions provide a promising and accessible treatment alternative to face-to-face interventions. OBJECTIVE The objective of this systematic review and meta-analysis is to determine the effectiveness of eHealth interventions in preventing and treating depression, anxiety, and insomnia during pregnancy. Secondary aims are to identify demographic and intervention moderators of effectiveness. METHODS A total of 5 databases (PsycINFO, Medline, CINAHL, Embase, and Cochrane) were searched from inception to May 2021. Terms related to eHealth, pregnancy, randomized controlled trials (RCTs), depression, anxiety, and insomnia were included. RCTs and pilot RCTs were included if they reported an eHealth intervention for the prevention or treatment of depression, anxiety, or insomnia in pregnant women. Study screening, data extractions, and quality assessment were conducted independently by 2 reviewers from an 8-member research team (KAS, PRS, Hangsel Sanguino, Roshni Sohail, Jasleen Kaur, Songyang (Mark) Jin, Makayla Freeman, and Beatrice Valmana). Random-effects meta-analyses of pooled effect sizes were conducted to determine the effect of eHealth interventions on prenatal mental health. Meta-regression analyses were conducted to identify potential moderators. RESULTS In total, 17 studies were included in this review that assessed changes in depression (11/17, 65%), anxiety (10/17, 59%), and insomnia (3/17, 18%). Several studies included both depression and anxiety symptoms as outcomes (7/17, 41%). The results indicated that during pregnancy, eHealth interventions showed small effect sizes for preventing and treating symptoms of anxiety and depression and a moderate effect size for treating symptoms of insomnia. With the exception of intervention type for the outcome of depressive symptoms, where mindfulness interventions outperformed other intervention types, no significant moderators were detected. CONCLUSIONS eHealth interventions are an accessible and promising resource for treating symptoms of anxiety, depression, and insomnia during pregnancy. However, more research is necessary to identify ways to increase the efficacy of eHealth interventions for this population. TRIAL REGISTRATION PROSPERO (International Prospective Register of Systematic Reviews) CRD42020205954; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=205954.
Collapse
Affiliation(s)
| | - Pooja R Sohal
- Department of Psychology, University of Calgary, Calgary, AB, Canada
| | - Katherine S Bright
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.,Women's Mental Health Clinic, Foothills Medical Centre, Alberta Health Services, Calgary, AB, Canada
| | - Jennifer Leason
- Department of Anthropology and Archaeology, University of Calgary, Calgary, AB, Canada
| | - Leslie Roos
- Department of Psychology and Pediatrics, University of Manitoba, Winnipeg, MB, Canada.,Children's Hospital Research Institute of Manitoba, Winnipeg, MB, Canada
| | - Catherine Lebel
- Department of Radiology, Alberta Children's Hospital Research Institute, Hotchkiss Brain Institute, Calgary, AB, Canada
| | - Gerald F Giesbrecht
- Department of Psychology, University of Calgary, Calgary, AB, Canada.,Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.,Alberta Children's Hospital Research Institute, Calgary, AB, Canada.,Department of Pediatrics, University of Calgary, Calgary, AB, Canada
| | - Lianne M Tomfohr-Madsen
- Department of Psychology, University of Calgary, Calgary, AB, Canada.,Department of Radiology, Alberta Children's Hospital Research Institute, Hotchkiss Brain Institute, Calgary, AB, Canada.,Alberta Children's Hospital Research Institute, Calgary, AB, Canada
| |
Collapse
|
46
|
Perceived Partner's Self-Control and Social Support Effects on Relationship Satisfaction in Couples Experiencing Infertility or Miscarriage: Dyadic Analyses. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19041970. [PMID: 35206157 PMCID: PMC8872363 DOI: 10.3390/ijerph19041970] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/12/2021] [Revised: 01/31/2022] [Accepted: 02/02/2022] [Indexed: 02/04/2023]
Abstract
The process that infertile couples and those after a miscarriage go through is unpredictable and difficult to control; therefore, it is associated with a lowered sense of control for both partners. Uncontrolled stress creates a higher level of anxiety, which is associated not only with a lower quality of life but also with worse results from infertility treatment and higher risks of miscarriage. The aim of this study was to analyze the relationship between the partner’s perceived self-control and marital satisfaction in the context of the partners’ coping strategies. The actor-partner interdependence model was applied to 90 heterosexual married couples. Our results show that men who perceive their wives as being more self-controlled and women who are perceived by their husbands as being more self-controlled feel more satisfied in their relationships. The effect of a partner’s perceived self-control on satisfaction with the relationship was weaker when controlled for the length of marriage. It also appeared to be moderated through the spouses’ use of social support. We conclude that the effects of the partner’s perceived self-control and social support are strong for marital satisfaction in the context of infertility and miscarriage.
Collapse
|
47
|
A comparative prospective study with depression, anxiety and quality of life scales in women with induced abortion and miscarriage before pregnancy termination. JOURNAL OF CONTEMPORARY MEDICINE 2022. [DOI: 10.16899/jcm.1024203] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
|
48
|
Savona Venture C, Grech V. Stressor Effects on Sex Ratios and Births in the Maltese Population during the First Half of the 20th Century. ACTA MEDICA (HRADEC KRALOVE, CZECH REPUBLIC) 2022; 65:66-70. [DOI: 10.14712/18059694.2022.20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/04/2022]
Abstract
Background: The sex ratio at birth (male/total = M/F) is expected to approximate 0.515. Stress is known to reduce livebirth M/F. In the first half of the 20th century, Malta was stressed by two World Wars. Objectives: This study was carried out in order to analyse changes in reproductive performance and M/F of stillbirths and livebirths in Malta during this period. Methods: Livebirth and stillbirth data (1910–1951) were obtained from official published Maltese government reports. Stillbirths were defined as any antenatal loss after 28 weeks of gestation. Results: This analysis studied 347,562 live and 11,662 stillbirths. For 1919–1951, M/F at birth was 0.517, stillbirth M/F was 0.664, implying 28/40 M/F = 0.522. Assuming conceptional M/F = 0.5, estimated M/F for fetal wastage before 28 weeks was approximately 0.434. There was a decrease in the overall birth rate starting after 1911 to 1921, more marked for 1941–1943 followed by an overshoot in 1943–48. There was a statistically significant drop in M/F livebirths during the periods 1916–21 and 1934–45. Stillbirths decreased significantly after 1935 (M>F). A stillbirth M/F drop in 1937–45 and rise in 1946–51 were statistically significant. Conclusions: Birth rate drops in both wars were ascribed to conscription, adverse living conditions and decreased fertility from nutritional restrictions. Both conflicts resulted in short post-war baby booms. The decrease in stillbirths is attributed to increase in antenatal attendances, hospital births and special food rations for pregnant women. The M/F observations suggest that the selective survival of both healthier female and male foetuses is favoured during times of stress.
Collapse
|
49
|
Keskin DD, Keskin S, Bostan S. Mental disorders among pregnant women during the COVID-19 pandemic. A cross-sectional study. SAO PAULO MED J 2022; 140:87-93. [PMID: 34468634 PMCID: PMC9623833 DOI: 10.1590/1516-3180.2021.0356.27052021] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2021] [Accepted: 05/27/2021] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Pregnancy is the most important event in women's lives and can lead to psychological lability. Several risk factors (such as disasters, events and pandemics) have been correlated with greater prevalence of mental disorders during pregnancy. OBJECTIVES To research how pregnant women have been affected by the coronavirus disease-19 (COVID-19) pandemic process, in order to contribute to the limited literature. DESIGN AND SETTING Cross-sectional survey study conducted at the Training and Research Hospital of the Faculty of Medicine, University of Ordu, Ordu, Turkey, from February 1 to March 1, 2021. METHODS In total, 356 pregnant women were enrolled and completed the survey. Intention of going to hospital and the Beck anxiety, Beck depression, Beck hopelessness and Epworth sleepiness scales were applied to detect mental disorders. RESULTS Among the participants, the anxiety, depression, hopelessness and sleepiness scores were 29.2%, 36.2%, 58.1% and 11.8%, respectively. The pregnant women stated that they avoided going to hospital in unnecessary situations by obeying the 'stay at home' calls, but also stated that they were afraid of the potential harmful effects of inadequate physician control. However, most of them stated that they would go to the hospital in emergencies. CONCLUSIONS This paper illustrated the effect of the COVID-19 pandemic on the mental health of pregnant women and emphasized their high rates of anxiety, depression, hopelessness and sleepiness. Since presence of mental disorders is indirectly related to poor pregnancy outcomes, preventive strategies should be developed, especially during this pandemic process.
Collapse
Affiliation(s)
- Deha Denizhan Keskin
- MD. Assistant Professor, Department of Obstetrics and Gynecology, Faculty of Medicine, Ordu University, Ordu, Turkey.
| | - Seda Keskin
- MD. Assistant Professor, Department of Obstetrics and Gynecology, Faculty of Medicine, Ordu University, Ordu, Turkey.
| | - Sedat Bostan
- MD. Professor, Department of Health Management, Faculty of Health Sciences, Ordu University, Ordu, Turkey.
| |
Collapse
|
50
|
Mappa I, Distefano FA, Rizzo G. Effects of COVID-19 on maternal anxiety and depressive disease: a literature review. SECHENOV MEDICAL JOURNAL 2021. [DOI: 10.47093/2218-7332.2021.12.2.35-43] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
The coronavirus SARS-CoV-2 (COVID-19) infection is a public health emergency of international concern. Pandemics pose a challenge to psychological resilience and can have an adverse impact on mental health. The impact of the ensuing social isolation and loneliness imposed by quarantine along with the worries about the risks of the infection and its economic fallout would appear likely to affect the mental health of the population. It has been reported that women are more likely to experience anxiety and depression symptoms during COVID-19 than men. COVID-19 pandemic had a profound impact on the level of anxiety and depression of pregnant women according to their basal level and pregnancy characteristics. Antenatal mental disorders may be a risk factor for maternal mental health problems such as an increased likelihood of postnatal depression and adverse obstetric and developmental outcomes. Effective coping strategies are associated with better psychological wellbeing during the COVID-19 pandemic, including reduced anxiety and depression. The increased risk of mental disorders due to COVID-19 requires policies to be developed to address prenatal and postpartum care to promote maternal-child wellbeing outcomes.
Collapse
Affiliation(s)
- I. Mappa
- University of Rome Tor Vergata, Fondazione Policlinico Tor Vergata, Division of Maternal Fetal Medicine, Ospedale Cristo Re
| | - F. A. Distefano
- University of Rome Tor Vergata, Fondazione Policlinico Tor Vergata, Division of Maternal Fetal Medicine, Ospedale Cristo Re
| | - G. Rizzo
- University of Rome Tor Vergata, Fondazione Policlinico Tor Vergata, Division of Maternal Fetal Medicine, Ospedale Cristo Re
| |
Collapse
|