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Choobdarnezhad M, Amiri-Farahani L, Pezaro S. Maternal performance after childbirth and its predictors: a cross sectional study. BMC Pregnancy Childbirth 2024; 24:215. [PMID: 38519910 PMCID: PMC10960374 DOI: 10.1186/s12884-024-06412-3] [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: 08/24/2023] [Accepted: 03/12/2024] [Indexed: 03/25/2024] Open
Abstract
BACKGROUND AND OBJECTIVES Birthing parents need to use specialized skills as the first caregiver of the newborn. Several factors may affect performance. Yet there is a paucity of research in this area, and evidence remains inconsistent. Consequently, this study aimed to determine maternal performance after childbirth and its predictors. METHODS This cross-sectional study was conducted with those (n = 450) who had given birth (< two months) and been referred for the vaccination of their newborn. The multi-stage sampling method was carried out from April 2022 to February 2023. Participants who met the inclusion criteria completed a demographic and obstetric information questionnaire, along with the childbirth experience 2 (CEQ2), Barkin maternal performance and maternal self-efficacy scales. Multiple linear regression was used to investigate the predictive effect of the independent variables of childbirth experience, maternal self-efficacy, demographic and obstetric variables on the dependent variable of maternal performance. RESULTS The mean age of the participants was 26.78 and the mean total score of maternal performance was 91.04 (0-120). The highest and lowest scores related to the 'maternal competence' and the 'maternal needs' domains, with mean score calculated at 77.51 and 72.81 respectively. 'Childbirth experience' and 'maternal self-efficacy' domains had a statistically significant relationship with maternal performance (P < 0.05). Among the predictive factors of maternal performance, the results of our linear regression demonstrated the variables of birth experience (B = 0.63), maternal self-efficacy (B = 1.53), spouse's employment status (B = 5.78 for worker level, B = 3.99 for employee level), the number of previous childbirth experiences (B = -8.46), frequency of receiving antenatal care (B = -6.68), length of stay in the birth suite (B = -2.22) and length of stay in the hospital (B = 2.84) remained in the model. 53.2% of changes in maternal performance can be explained by these independent variables. CONCLUSION The promotion of evidence-based, person-centered, and respectful perinatal care during pregnancy and childbirth are of paramount importance. Strategies to improve the experience of childbirth and self-efficacy are especially required to improve maternal performance in the postpartum period. Prenatal care aimed at improving maternal function after childbirth will be important in achieving this overall.
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Affiliation(s)
- Masoumeh Choobdarnezhad
- Department of Reproductive Health and Midwifery, School of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, Iran
| | - Leila Amiri-Farahani
- Department of Reproductive Health and Midwifery, Nursing and Midwifery Care Research Center, School of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, 1996713883, Iran.
| | - Sally Pezaro
- The Research Centre for Healthcare and Communities, Coventry University, Coventry, UK
- The University of Notre Dame, Notre Dame, Fremantle, Australia
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Wang Y, Gu J, Zhang F, Xu X. Path analysis of influencing factors for maternal antenatal depression in the third trimester. Sci Rep 2024; 14:4742. [PMID: 38413698 PMCID: PMC10899182 DOI: 10.1038/s41598-024-55355-4] [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: 11/13/2023] [Accepted: 02/22/2024] [Indexed: 02/29/2024] Open
Abstract
Maternal antenatal depression (AD) is a nonpsychotic depressive episode during pregnancy that can harm both the pregnant woman and the fetus. This study aimed to investigate the intrinsic interrelationships between AD and its influencing factors by constructing a path model. This survey-based cross-sectional study included 1071 pregnant women who underwent pregnancy examinations in three hospitals in Nantong City, China, between February and June 2023. General information and information regarding maternal AD, pregnancy stress, prenatal anxiety, social support, marital satisfaction, sleep quality, and resilience were collected. Multiple linear regression analysis using SPSS 25.0 was employed to determine the factors influencing pregnancy depression, and Amos25.0 was used to construct a structural equation model. AD incidence was 19.4% (208/1071). The independent risk factors affecting AD in pregnant women have been integrated into the established path analysis model. The model demonstrated a good fit (χ2/DF = 1.238, comparative fit index = 0.999, goodness-of-fit index = 0.998, normed fit index = 0.996, adjusted goodness-of-fit index = 0.990, incremental fit index = 0.999, and root mean square error of approximation = 0.015). While prenatal anxiety (0.230) and hyperthyroidism (0.048) only had direct effects on AD, mental resilience was the biggest factor affecting AD, followed by pregnancy stress, marital satisfaction, prenatal anxiety, sleep quality, social support, and hyperthyroidism. Improved mental resilience, social support, sleep quality, and marital satisfaction; reduced pregnancy stress and prenatal anxiety; and effective hyperthyroidism treatment might reduce AD. This study underscored the significance of delivering actionable strategies and tangible assistance to pregnant women to reduce AD.
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Affiliation(s)
- Yanchi Wang
- Affiliated Nantong Hospital of Shanghai University (The Sixth People's Hospital of Nantong), Nantong, Jiangsu, China
- Medical School of Nantong University, Nantong, Jiangsu, China
- Department of Nursing, Affiliated Hospital of Nantong University, Nantong, 226001, Jiangsu, China
| | - Jian Gu
- Department of Epidemiology and Medical Statistics, School of Public Health, Nantong University, Nantong, Jiangsu, China
| | - Feng Zhang
- Medical School of Nantong University, Nantong, Jiangsu, China.
- Medical School (School of Nursing), Nantong University, Nantong, 226001, Jiangsu, China.
| | - Xujuan Xu
- Department of Nursing, Affiliated Hospital of Nantong University, Nantong, 226001, Jiangsu, China.
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Sun S, Luo C, Zeng X, Wu Q. The relationship between pregnancy stress and mental health of the pregnant women: the bidirectional chain mediation roles of mindfulness and peace of mind. Front Psychol 2024; 14:1295242. [PMID: 38259564 PMCID: PMC10800386 DOI: 10.3389/fpsyg.2023.1295242] [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: 09/15/2023] [Accepted: 12/15/2023] [Indexed: 01/24/2024] Open
Abstract
Objective This study aimed to investigate the relationship between pregnancy stress and mental health of the pregnant women, employing a positive psychology perspective. Specifically, the study sought to explore how the two positive psychological qualities of mindfulness and peace of mind may serve as potential mediators in the association between pregnancy stress and mental health of the pregnant women. Methods Seven hundreds and thirteen pregnant women seeking care at the First Affiliated Hospital of Sun Yat-Sen University were included in this study. The participants completed a self-report demographic questionnaire, as well as several validated scales including the Pregnancy Pressure Scale (PPS), Mindful Attention Awareness Scale (MAAS), Peace of Mind Scale (PoMS), and Chinese Health Questionnaire (CHQ). The Amos 23.0 system was utilized to construct structural equation models. Results A total of 713 participants had an average age of 29.46 ± 4.81 years and an average gestational age of 24.26 ± 22.66 weeks. Out of the pregnant women, 163 (22.9%) experienced moderate or higher levels of pregnancy stress (PPS > 1), while 212 (29.7%) exhibited mental distress (CHQ > 3). Pregnancy stress exhibited a positive association with mental distress, while displaying negative associations with mindfulness and peace of mind. Mindfulness and peace of mind were negatively associated with mental distress. By employing structural equation modeling, the analysis revealed that mindfulness and peace of mind acted as partial mediators in the relationship between pregnancy stress and mental health. Furthermore, the identified models exhibited bidirectional sequential mediating pathways, suggesting that the pathways of mindfulness ↔ peace of mind mitigated the harmful influence of pregnancy stress on the mental health of pregnant women. Conclusion This study adds to the current body of knowledge by investigating the relationships among mindfulness, peace of mind, pregnancy stress, and mental health in pregnant women. From a positive psychology framework, it provides valuable understanding of the intricate dynamics between pregnancy stress and protective factors of mental health. Consequently, interventions aimed at bolstering positive psychological qualities in pregnant women should prioritize the cultivation of mindfulness to foster peace of mind, or alternatively, the cultivation of peace of mind to enhance mindfulness, ultimately leading to improved mental health outcomes.
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Affiliation(s)
- Shasha Sun
- College of Humanities and Social Sciences, Zhongkai University of Agriculture and Engineering, Guangzhou, China
| | - Chunqi Luo
- The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Xun Zeng
- The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Qichang Wu
- The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
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Riquelme-Gallego B, Martínez-Vázquez S, Caparros-Gonzalez RA. Pandemic-related stress in pregnant women during the first COVID-19 lockdown and neonatal development. J Reprod Infant Psychol 2023:1-16. [PMID: 37469194 DOI: 10.1080/02646838.2023.2237527] [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: 07/08/2022] [Accepted: 06/26/2023] [Indexed: 07/21/2023]
Abstract
BACKGROUND Maternal stress and psychopathology have a negative effect on mothers and neonates. Maternal stress may affect neonatal growth and development both physically and psychologically. PURPOSE To study the impact of pandemic-related pregnancy stress and maternal psychopathological symptoms during the COVID-19 lockdown in 2020 on neonatal development. METHODS A two-phase prospective study was carried out on a sample of 181 pregnant women ranged from 18 to 40 years old in Spain (Europe). Phase 1: Pandemic-related pregnancy stress (PREPS), Prenatal Distress Questionnaire (PDQ), Perceived Stress Scale (PSS) and the revised version of the Symptom Checklist-90 (SCL-90-R) were used to assess psychological symptoms during the lockdown. In the follow-up (Phase 2), obstetric, birth-related and anthropometric variables were collected from 81 pregnant women-neonates dyads. RESULTS Primiparous women showed higher psychopathological symptoms and higher levels of pandemic-related pregnancy stress than multiparous women. A multiple linear regression model showed that pandemic-related pregnancy stress could predict the length of neonate by adjusting for maternal age and gestational age, especially for primiparous women. IMPLICATIONS FOR RESEARCH Studies assessing neonates development should evaluate the long-term effect of the COVID-19 pandemic on neonates´ length. IMPLICATIONS FOR PRACTICE States the relation between pandemic-related pregnancy stress and neonatal development by being able to track the effects on neonates whose mothers had high levels of stress during the COVID-19 pandemic.
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Affiliation(s)
- Blanca Riquelme-Gallego
- Department of Nursing of the University of Granada, Ceuta Campus, Spain
- Instituto de Investigación Biosanitaria Ibs. GRANADA, Granada, Spain
| | | | - Rafael A Caparros-Gonzalez
- Department of Nursing of the University of Granada, Ceuta Campus, Spain
- Instituto de Investigación Biosanitaria Ibs. GRANADA, Granada, Spain
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Zimmerman E, Aguiar A, Aung MT, Geiger SD, Hines M, Woodbury ML, Martens A, Huerta-Montanez G, Cordero JF, Meeker JD, Schantz SL, Alshawabkeh AN. Examining the association between prenatal maternal stress and infant non-nutritive suck. Pediatr Res 2023; 93:1285-1293. [PMID: 34916626 PMCID: PMC9200902 DOI: 10.1038/s41390-021-01894-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2021] [Revised: 10/25/2021] [Accepted: 10/28/2021] [Indexed: 11/09/2022]
Abstract
BACKGROUND This study examined the relationship between prenatal maternal stress (PREMS) and non-nutritive suck (NNS) and tested its robustness across 2 demographically diverse populations. METHODS The study involved 2 prospective birth cohorts participating in the national Environmental influences on Child Health Outcomes (ECHO) Program: Illinois Kids Development Study (IKIDS) and ECHO Puerto Rico (ECHO-PROTECT). PREMS was measured during late pregnancy via the 10-item Perceived Stress Scale (PSS-10). NNS was sampled from 1- to 8-week-olds using a custom pacifier for ~5 min. RESULTS Overall, 237 mother-infant dyads completed this study. Despite several significant differences, including race/ethnicity, income, education, and PREMS levels, significant PREMS-NNS associations were found in the 2 cohorts. In adjusted linear regression models, higher PREMS, measured through PSS-10 total scores, related to fewer but longer NNS bursts per minute. CONCLUSIONS A significant association was observed between PREMS and NNS across two diverse cohorts. This finding is important as it may enable the earlier detection of exposure-related deficits and, as a result, earlier intervention, which potentially can optimize outcomes. More research is needed to understand how NNS affects children's neurofunction and development. IMPACT In this double-cohort study, we found that higher maternal perceived stress assessed in late pregnancy was significantly associated with fewer but longer sucking bursts in 1- to 8-week-old infants. This is the first study investigating the association between prenatal maternal stress (PREMS) and infant non-nutritive suck (NNS), an early indicator of central nervous system integrity. Non-nutritive suck is a potential marker of increased prenatal stress in diverse populations. Non-nutritive suck can potentially serve as an early indicator of exposure-related neuropsychological deficits allowing for earlier interventions and thus better prognoses.
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Affiliation(s)
- Emily Zimmerman
- Department of Communication Sciences and Disorders, Northeastern University, Boston, MA, USA.
| | - Andréa Aguiar
- Beckman Institute for Advanced Science and Technology, University of Illinois at Urbana-Champaign, Urbana, IL, USA
- Department of Comparative Biosciences, University of Illinois at Urbana-Champaign, Urbana, IL, USA
| | - Max T Aung
- Program on Reproductive Health and the Environment, Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco, CA, USA
| | - Sarah Dee Geiger
- Beckman Institute for Advanced Science and Technology, University of Illinois at Urbana-Champaign, Urbana, IL, USA
- Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, Champaign, IL, USA
| | - Morgan Hines
- Department of Communication Sciences and Disorders, Northeastern University, Boston, MA, USA
| | - Megan L Woodbury
- Beckman Institute for Advanced Science and Technology, University of Illinois at Urbana-Champaign, Urbana, IL, USA
- Neuroscience Program, University of Illinois at Urbana-Champaign, Urbana, IL, USA
| | - Alaina Martens
- Department of Communication Sciences and Disorders, Northeastern University, Boston, MA, USA
| | | | - José F Cordero
- Department of Epidemiology and Biostatistics, University of Georgia, Athens, Georgia
| | - John D Meeker
- Department of Environmental Health Sciences, University of Michigan School of Public Health, Ann Arbor, MI, USA
| | - Susan L Schantz
- Beckman Institute for Advanced Science and Technology, University of Illinois at Urbana-Champaign, Urbana, IL, USA
- Department of Comparative Biosciences, University of Illinois at Urbana-Champaign, Urbana, IL, USA
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Tuxunjiang X, Wumaier G, Zhang W, Sailike B, Wang X, Jiang T. The relationship between positive psychological qualities and prenatal negative emotion in pregnant women: A path analysis. Front Psychol 2023; 13:1067757. [PMID: 36687899 PMCID: PMC9849688 DOI: 10.3389/fpsyg.2022.1067757] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Accepted: 11/29/2022] [Indexed: 01/06/2023] Open
Abstract
Objective The objective of this study was to investigate the relationship between positive psychological qualities and negative emotions of pregnant women. Methods We surveyed 774 pregnant women in a tertiary hospital in Urumqi using the following measures: a self-report general demographic data questionnaire, Generalized Anxiety Disorder scale (GAD-7), Patients Health Questionnaire depression scale (PHQ-9), Pregnancy Pressure Scale (stocktickerPPS), Perceived Social Support Scale (PSSS), General Self-Efficacy Scale (GSES), and Connor-Davidson Resilience scale (CD-RISC). We used the Amos2.03 system to build a structural equation model. Results A total of 774 subjects had an average age of 30 years and an average gestational age of 23 weeks. Among the 774 respondents, 122 (15.8%) had moderate or above pregnancy stress (stocktickerPPS > 1), 376 (48.6%) had mild or above anxiety symptoms (GAD-7 ≥ 5), 456 (58.9%) had mild or above depression symptoms (PHQ-9 ≥ 5), 740 (95.6%) had moderate or above social support scores (PSSS ≥ 37), and 124 (16.0%) had good or above psychological resilience scores (CD-RISC ≥ 60). Notably, 372 (48.1%) people had a self-efficacy score above the overall average (GSES ≥ 2.6). Pregnancy stress had positive correlations with anxiety and depression (β = 0.57, 0.30, P < 0.01) and negative correlations with self-efficacy (β = -0.19, P < 0.01). Anxiety had positive correlations with depression (β = 0.54, P < 0.01) and negative correlations with social support (β = -0.45, P < 0.01). Social support had positive correlations with self-efficacy and resilience (β = 0.37, 0.47, P < 0.01). Resilience had negative correlations with anxiety (β = -0.09, P < 0.01), and self-efficacy had positive correlations with resilience (β = 0.41, P < 0.01). Conclusion Identification of pregnancy stress should be emphasized in pregnant women with negative emotions. Efforts to strengthen the positive psychological qualities of pregnant women should focus on cultivating psychological resilience to reduce the occurrence of anxiety, and improving social support should be a priority because it can enhance psychological resilience and self-efficacy. We provide a reason to intervene in the negative emotions of pregnant women from the perspective of the positive psychology of pregnant women.
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Affiliation(s)
| | - Gulijianati Wumaier
- Xinjiang Production and Construction Corps 13th Division Red Star Hospital, Hami, China
| | - Wei Zhang
- Department of Public Health, Xinjiang Medical University, Ürümqi, China
| | - Bahedana Sailike
- Department of Public Health, Xinjiang Medical University, Ürümqi, China
| | - Xiaoting Wang
- Department of Public Health, Xinjiang Medical University, Ürümqi, China
| | - Ting Jiang
- Department of Public Health, Xinjiang Medical University, Ürümqi, China
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Biresaw MS, Takelle GM, Gebeyehu ET. Perceived stress and associated factors among pregnant women during COVID-19 pandemic period in Northwest Ethiopia, 2020: a cross-sectional study. BMJ Open 2022; 12:e063041. [PMID: 36175090 PMCID: PMC9527741 DOI: 10.1136/bmjopen-2022-063041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
OBJECTIVE This study aimed to determine the prevalence and associated factors of perceived stress among pregnant women during the COVID-19 pandemic period in Northwest Ethiopia. METHOD A cross-sectional study. SETTING University of Gondar Comprehensive Specialized Hospital, Gondar, Ethiopia. PARTICIPANTS A total of 415 pregnant women were recruited by using a systematic random sampling technique from 28 April 2020 to 12 June 2020. MEASUREMENT The required data were collected through face-to-face interviews. The Perceived Stress Scale was used to assess perceived stress. The Edinburgh Postnatal Depression Scale and Oslo Social Support Scale 3 were used for associated factors. The data were analysed by using SPSS V.20. We also included sociodemographic, obstetrical and gynaecology, substance use and intimate partner-related factors. Logistic regression analysis was used to identify associated factors with perceived stress. Bivariate and multivariable logistic regression analyses were used to identify the effect of each independent variable with the outcome variable. A p value of less than 0.05 was considered to be statistically significant. RESULTS A total of 415 pregnant women participated in the study with response rate of 98.57%. The prevalence of perceived stress is found to be 13.7% (95% CI=10.4% to 17.1%). According to the multivariable logistic regression result, being a student (adjusted OR (AOR)=9.67, 95% CI=2.739 to 34.183), being at the first and third trimesters of gestational age (AOR=3.56, 95% CI=1.065 to 11.885; AOR=4.80, 95% CI=1.851 to 14.479, respectively), and having antenatal depression (AOR=3.51, 95% CI=1.628 to 7.563) were factors positively associated with perceived stress. CONCLUSION The prevalence of perceived stress among pregnant people was relatively high. This study recommends that all pregnant people should be screened and treated for perceived stress particularly during the first and third trimesters. Emphasis should be given to early detection and treatment of antenatal depression. Pregnant students must be strongly evaluated and intervened for perceived stress.
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Affiliation(s)
- Mengesha Srahbzu Biresaw
- Department of Psychiatry, University of Gondar College of Medicine and Health Sciences, Gondar, Ethiopia
| | - Girmaw Medfu Takelle
- Department of Psychiatry, University of Gondar College of Medicine and Health Sciences, Gondar, Ethiopia
| | - Enguday Tirfeneh Gebeyehu
- Department of Psychiatry, University of Gondar College of Medicine and Health Sciences, Gondar, Ethiopia
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Roshan-Milani S, Seyyedabadi B, Saboory E, Parsamanesh N, Mehranfard N. Prenatal stress and increased susceptibility to anxiety-like behaviors: role of neuroinflammation and balance between GABAergic and glutamatergic transmission. Stress 2021; 24:481-495. [PMID: 34180763 DOI: 10.1080/10253890.2021.1942828] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
Abstract
Neuroplasticity during the prenatal period allows neurons to regenerate anatomically and functionally for re-programming the brain development. During this critical period of fetal programming, the fetus phenotype can change in accordance with environmental stimuli such as stress exposure. Prenatal stress (PS) can exert important effects on brain development and result in permanent alterations with long-lasting consequences on the physiology and behavior of the offspring later in life. Neuroinflammation, as well as GABAergic and glutamatergic dysfunctions, has been implicated as potential mediators of behavioral consequences of PS. Hyperexcitation, due to enhanced excitatory transmission or reduced inhibitory transmission, can promote anxiety. Alterations of the GABAergic and/or glutamatergic signaling during fetal development lead to a severe excitatory/inhibitory imbalance in neuronal circuits, a condition that may account for PS-precipitated anxiety-like behaviors. This review summarizes experimental evidence linking PS to an elevated risk to anxiety-like behaviors and interprets the role of the neuroinflammation and alterations of the brain GABAergic and glutamatergic transmission in this phenomenon. We hypothesize this is an imbalance in GABAergic and glutamatergic circuits (as a direct or indirect consequence of neuroinflammation), which at least partially contributes to PS-precipitated anxiety-like behaviors and primes the brain to be vulnerable to anxiety disorders. Therefore, pharmacological interventions with anti-inflammatory activities and with regulatory effects on the excitatory/inhibitory balance can be attributed to the novel therapeutic target for anxiety disorders.
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Affiliation(s)
- Shiva Roshan-Milani
- Department of Physiology, Faculty of Medicine, Urmia University of Medical Sciences, Urmia, Iran
- Neurophysiology Research Center, Cellular and Molecular Medicine Institute, Urmia University of Medical Sciences, Urmia, Iran
| | | | - Ehsan Saboory
- Zanjan Metabolic Diseases Research Center, Zanjan University of Medical Sciences, Zanjan, Iran
| | - Negin Parsamanesh
- Zanjan Metabolic Diseases Research Center, Zanjan University of Medical Sciences, Zanjan, Iran
| | - Nasrin Mehranfard
- Neurophysiology Research Center, Cellular and Molecular Medicine Institute, Urmia University of Medical Sciences, Urmia, Iran
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Saur AM, Dos Santos MA. Risk factors associated with stress symptoms during pregnancy and postpartum: integrative literature review. Women Health 2021; 61:651-667. [PMID: 34311677 DOI: 10.1080/03630242.2021.1954132] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Stressful events during prenatal and postpartum have been associated with an increase in the susceptibility to the onset of various diseases, threatening mental and physical health of mother and baby. The aim of this study was to synthesize and analyze the literature related to risk factors associated with stress symptoms during pregnancy and immediate postpartum by means of an integrative review. The search was conducted from January 2013 to July 2020, consulting the following databases: PubMed, PsycINFO, CINAHL, Web of Science and LILACS. In total, 1,677 studies were identified, resulting in 38 articles included in this review. The risk factors most associated with stress in pregnancy and postpartum were related to emotional factors (including mental health, traumatic events and obstetric complications); social and economic factors; mother's health conditions and life style behaviors, and social support and partner related stress. The results are discussed under the light of the biopsychosocial model, which proposes that biological, psychological, and social domains should be considered in order to minimize psychosocial risk conditions. It is concluded that strategies to promote psychological care, education, additional social support and health behaviors should be considered to prevent adverse birth outcomes and to increase maternal well-being.
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Affiliation(s)
- Adriana Martins Saur
- Department of Psychology, University of São Paulo, Faculty of Philosophy, Sciences and Letters at Ribeirão Preto, Brazil
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10
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Ma R, Yang F, Zhang L, Sznajder KK, Zou C, Jia Y, Cui C, Zhang W, Zhang W, Zou N, Yang X. Resilience mediates the effect of self-efficacy on symptoms of prenatal anxiety among pregnant women: a nationwide smartphone cross-sectional study in China. BMC Pregnancy Childbirth 2021; 21:430. [PMID: 34140012 PMCID: PMC8212491 DOI: 10.1186/s12884-021-03911-5] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2020] [Accepted: 05/24/2021] [Indexed: 11/24/2022] Open
Abstract
Background Prenatal anxiety is one of the most prevalent mental disorders during pregnancy. This study assessed the prevalence of prenatal anxiety and examined whether resilience could play the mediating role in the association between self-efficacy and symptoms of prenatal anxiety among pregnant women in China. Methods A nationwide smartphone cross-sectional study was carried out in three cities (Shenyang of Liaoning Province, Zhengzhou of Henan Province and Chongqing Municipality) in China from July 2018 to July 2019. The questionnaire consisted of questions on demographic characteristics, the Generalized Anxiety Disorder Scale (GAD-7), the Chinese version of General Self-efficacy Scale (GSES), and the 14-item Wagnild and Young Resilience Scale (RS-14). A total of 665 pregnant women were recruited in this study. A hierarchical multiple regression model was employed to explore the associate factors and mediators of symptoms of prenatal anxiety. A structural equation model was employed to test the hypothesis that resilience mediates the association between self-efficacy and symptoms of prenatal anxiety. Results The prevalence of symptoms of prenatal anxiety was 36.4% in this study. Self-efficacy was negatively correlated with symptoms of prenatal anxiety (r = -0.366, P < 0.01). Resilience had a significant positive correlation with self-efficacy (r = 0.612, P < 0.01) and had a negative correlation with symptoms of prenatal anxiety (r = -0.427, P < 0.01). The hierarchical multiple regression model indicated that self-efficacy and resilience were the main factors associated with symptoms of prenatal anxiety and contributed to 11.9% and 6.3% to the variance of symptoms of prenatal anxiety, respectively. Resilience served as a mediator between self-efficacy and symptoms of prenatal anxiety (a*b = -0.198, Bias-corrected and accelerated bootstrap 95% Confidence interval: -0.270, -0.126). Conclusions Self-efficacy was a negative predictor of symptoms of prenatal anxiety among pregnant women. Moreover, resilience mediated the relation between self-efficacy and symptoms of prenatal anxiety among pregnant women in China. It was observed in this study that psychological interventions might be beneficial for pregnant women to relieve symptoms of prenatal anxiety through improved self-efficacy and resilience. Supplementary Information The online version contains supplementary material available at 10.1186/s12884-021-03911-5.
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Affiliation(s)
- Ruqing Ma
- Department of Social Medicine, School of Public Health, China Medical University, No.77 Puhe Road, Shenyang North New Area, Shenyang, Liaoning Province, China
| | - Fengzhi Yang
- Department of Social Medicine, School of Public Health, China Medical University, No.77 Puhe Road, Shenyang North New Area, Shenyang, Liaoning Province, China
| | - Lijuan Zhang
- Department of Obstetrics and Gynecology, Shengjing Hospital of China Medical University, Shenyang, Liaoning Province, China
| | - Kristin K Sznajder
- Department of Public Health Sciences, College of Medicine, Pennsylvania State University, Hershey, PA, USA
| | - Changqing Zou
- Department of Humanities and Social Sciences, China Medical University, Shenyang, Liaoning Province, China
| | - Yajing Jia
- Department of Social Medicine, School of Public Health, China Medical University, No.77 Puhe Road, Shenyang North New Area, Shenyang, Liaoning Province, China
| | - Can Cui
- Department of Social Medicine, School of Public Health, China Medical University, No.77 Puhe Road, Shenyang North New Area, Shenyang, Liaoning Province, China
| | - Weiyu Zhang
- Department of Social Medicine, School of Public Health, China Medical University, No.77 Puhe Road, Shenyang North New Area, Shenyang, Liaoning Province, China
| | - Wenzhu Zhang
- Department of Obstetrics and Gynecology, Shengjing Hospital of China Medical University, Shenyang, Liaoning Province, China
| | - Ning Zou
- Department of Obstetrics and Gynecology, Shengjing Hospital of China Medical University, Shenyang, Liaoning Province, China
| | - Xiaoshi Yang
- Department of Social Medicine, School of Public Health, China Medical University, No.77 Puhe Road, Shenyang North New Area, Shenyang, Liaoning Province, China.
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11
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Dachew BA, Ayano G, Betts K, Alati R. The impact of pre-pregnancy BMI on maternal depressive and anxiety symptoms during pregnancy and the postpartum period: A systematic review and meta-analysis. J Affect Disord 2021; 281:321-330. [PMID: 33341015 DOI: 10.1016/j.jad.2020.12.010] [Citation(s) in RCA: 33] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2020] [Revised: 11/13/2020] [Accepted: 12/05/2020] [Indexed: 11/15/2022]
Abstract
BACKGROUND Studies have reported conflicting results on the association between maternal pre-pregnancy weight and adverse mental health outcomes during pregnancy and the postpartum period. This systematic review and meta-analysis aim to provide the current state of evidence concerning the association between maternal pre-pregnancy BMI and the risk of antenatal and postnatal depressive and anxiety symptoms. METHODS PubMed, EMBASE, Web of Science and Scopus databases were searched from their inception through August 31, 2020. Observational studies assessing the association between maternal pre-pregnancy BMI and risk of depression and/anxiety during pregnancy and the postpartum period were included. We used random-and quality-effects meta-analyses to estimate risks. Subgroup, sensitivity and meta-regression analyses were performed. RESULTS Pre-pregnancy obesity was associated with a 33% increased risk of antenatal depressive symptoms (pooled OR = 1.33 [95% CI; 1.20-1.48]). The pooled ORs for the association between underweight, overweight and obesity and postnatal depressive symptoms were 1.71 [95% CI; 1.27 - 2.31], 1.14 [95% CI; 1.0 - 1.30] and 1.39 [95% CI; 1.23 - 1.57], respectively. Low to moderate level of between-study heterogeneity was noted. The association between pre-pregnancy BMI and perinatal anxiety symptoms remain uncertain. CONCLUSIONS Pre-pregnancy obesity was associated with an increased risk of maternal depressive symptoms both in pregnancy and the postpartum period. The findings suggest that women with both high and low pre-pregnancy weight may benefit from receiving mental health screening and interventions during prenatal care.
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Affiliation(s)
- Berihun Assefa Dachew
- School of Public health, Curtin University, Perth, Australia; Department of Epidemiology and Biostatistics, Institute of Public Health, University of Gondar, Gondar, Ethiopia.
| | - Getinet Ayano
- School of Public health, Curtin University, Perth, Australia; Research and Training Department, Amanuel Mental Specialized Hospital, Addis Ababa, Ethiopia
| | - Kim Betts
- School of Public health, Curtin University, Perth, Australia
| | - Rosa Alati
- School of Public health, Curtin University, Perth, Australia; Institute for Social Science Research, The University of Queensland, Brisbane, Australia
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12
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Rahme C, Haddad C, Akel M, Khoury C, Obeid H, Obeid S, Hallit S. Factors associated with violence against women in a representative sample of the Lebanese population: results of a cross-sectional study. Arch Womens Ment Health 2021; 24:63-72. [PMID: 32008070 DOI: 10.1007/s00737-020-01022-2] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2019] [Accepted: 01/21/2020] [Indexed: 02/07/2023]
Abstract
To evaluate the prevalence of violence against women (VAW) and assess factors associated with VAW among a representative sample of the Lebanese population. This cross-sectional study was carried out between September and December 2018. Participants from all Lebanese governorates were enrolled in this study using a proportionate random sample. The percentages of women who were exposed to physical and non-physical abuse were 37.1% and 49.4% respectively. Factors associated with physical abuse were being divorced, having a partner addicted to substances and alcohol, or with a history of threats, violence, assaults, and crimes, higher stressful life experiences, and abuse reported from childhood (physical, sexual, or psychological). Non-physical abuse was associated with abuse reported from childhood (physical, sexual, or psychological), higher stressful life experiences, and the fact that the partner is addicted to substances and alcohol, or has a history of threats. Our results suggest that being divorced, illiterate, and unemployed, having an addicted partner, and having experienced child abuse are all factors that are associated with more violence against women.
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Affiliation(s)
- Clara Rahme
- Faculty of Science, Lebanese University, Fanar, Lebanon
| | - Chadia Haddad
- Research Department, Psychiatric Hospital of the Cross, P.O. Box 60096, Jal Eddib, Lebanon.,UMR 1094, Neuroépidémiologie Tropicale, Institut d'Epidémiologie et de Neurologie Tropicale, GEIST, University Limoges, 87000, Limoges, France
| | - Marwan Akel
- INSPECT-LB: Institut National de Sante Publique, Epidemiologie Clinique et Toxicologie, Beirut, Lebanon.,School of Pharmacy, Lebanese International University, Beirut, Lebanon
| | - Chloe Khoury
- Faculty of Science, Lebanese University, Fanar, Lebanon
| | - Hala Obeid
- Université Paris 1 Panthéon Sorbonne, Paris, France
| | - Sahar Obeid
- Research Department, Psychiatric Hospital of the Cross, P.O. Box 60096, Jal Eddib, Lebanon. .,INSPECT-LB: Institut National de Sante Publique, Epidemiologie Clinique et Toxicologie, Beirut, Lebanon. .,Faculty of Arts and Sciences, Holy Spirit University of Kaslik (USEK), Jounieh, Lebanon.
| | - Souheil Hallit
- INSPECT-LB: Institut National de Sante Publique, Epidemiologie Clinique et Toxicologie, Beirut, Lebanon. .,Faculty of Medicine and Medical Sciences, Holy Spirit University of Kaslik (USEK), Jounieh, Lebanon.
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13
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Prevalence and Associated Factors of Postpartum Anxiety and Depression Symptoms Among Women in Shanghai, China. J Affect Disord 2020; 274:848-856. [PMID: 32664024 DOI: 10.1016/j.jad.2020.05.028] [Citation(s) in RCA: 39] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2019] [Revised: 04/02/2020] [Accepted: 05/10/2020] [Indexed: 01/11/2023]
Abstract
BACKGROUND Postpartum anxiety (PPA) and postpartum depression (PPD) are associated with immediate and long-term health risks for both mothers and babies. The purpose of this paper was to evaluate relationships between sociodemographic, perinatal variables, and PPA and PPD symptoms of parturients 6 weeks postpartum. METHODS A cross-sectional survey with 1204 women who had a healthy and term birth in a baby-friendly hospital, Shanghai, China. PPA and PPD symptoms were measured by using the Self-Rating Anxiety Scale (SAS) and the Edinburgh Postnatal Depression Scale (EPDS). RESULTS The mean score of SAS and EPDS was 40.79 ± 8.48 and 8.18 ± 5.80, respectively. The estimated prevalence of PPA and PPD symptoms was 15.2% and 23.2%, respectively. Multivariable logistic regression analysis showed that the presence of fatigue and PPD symptoms were risk factors for PPA symptoms, whereas having support from family and being satisfied with labor experience were protective factors. In terms of PPD symptoms, its risk factors included smoking before pregnancy, maternal separation from baby, fatigue, encountering difficulties in breastfeeding, and the presence of PPA symptoms. In contrast, the protective factors for PPD symptoms were having support from family and having support from colleagues or friends. LIMITATIONS Convenience sampling and voluntary participation may have led to a selection bias. CONCLUSION PPA and PPD symptoms occur commonly among parturients in Shanghai, China. The findings from this research provide a better understanding of factors associated with PPA and PPD symptoms and will help guide personalized approaches to the management of postpartum anxiety and depression.
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14
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Leff-Gelman P, Flores-Ramos M, Carrasco AEÁ, Martínez ML, Takashima MFS, Coronel FMC, Labonne BF, Dosal JAZ, Chávez-Peón PB, Morales SG, Camacho-Arroyo I. Cortisol and DHEA-S levels in pregnant women with severe anxiety. BMC Psychiatry 2020; 20:393. [PMID: 32758184 PMCID: PMC7409431 DOI: 10.1186/s12888-020-02788-6] [Citation(s) in RCA: 37] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2020] [Accepted: 07/17/2020] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND A complex interaction between cortisol and dehydroepiandrosterone-sulphate (DHEA-S) is crucial in the stress system balance; several studies have reported increased cortisol levels during chronic stress and a weak counter-regulation by DHEA-S. During pregnancy, scarce information about this system is available, although cortisol and DHEA-S play an important role in the initiation and acceleration of labor. We conducted the present study in order to determine both cortisol and DHEA-S levels during the last trimester of pregnancy in patients exhibiting severe anxiety. METHODS Pregnant women during the 3rd trimester of pregnancy were evaluated by using the self-reported version of the Hamilton Anxiety Rating Scale (HARS). According to the scores obtained from the psychometric scale, participants were divided into two groups: 1) patients exhibiting a cutoff score > 15 were considered with severe anxiety (ANX) (n = 101), and control pregnant subjects (CTRL) (n = 44) with a cutoff score < 5. Morning cortisol, DHEA-S and Cortisol/DHEA-S index were measured in all participants. Comparisons between groups were performed; additionally, correlations between clinical variables, biochemical data and HARS were calculated. RESULTS Cortisol levels were significantly higher in the ANX group (p < 0.001), whereas those of DHEA-S were significantly lower in the same group (p < 0.01) when compared to healthy pregnant subjects. An increased cortisol/DHEA-S index was observed in the ANX group (p < 0.05). A significant association between cortisol and HARS scores (p = 0.03), was observed even after adjusting by gestational weeks (p = 0.004). CONCLUSIONS Our data support that the cortisol/DHEA-S index is higher in pregnant women with high anxiety levels as compared with healthy pregnant women.
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Affiliation(s)
| | - Mónica Flores-Ramos
- grid.419154.c0000 0004 1776 9908Instituto Nacional de Psiquiatría, 14370 CDMX Mexico City, Mexico ,grid.418270.80000 0004 0428 7635Consejo Nacional de Ciencia y Tecnología/CONACyT, 03940 CDMX Mexico City, Mexico
| | | | - Margarita López Martínez
- grid.419218.70000 0004 1773 5302Instituto Nacional de Perinatología, 11000 CDMX Mexico City, Mexico
| | | | - Fausto Manuel Cruz Coronel
- grid.414716.10000 0001 2221 3638Hospital General de México, Dr. Eduardo Liceaga, 06720 CDMX Mexico City, Mexico
| | - Blanca Farfán Labonne
- grid.419218.70000 0004 1773 5302Instituto Nacional de Perinatología, 11000 CDMX Mexico City, Mexico
| | | | | | - Saul Garza Morales
- grid.419218.70000 0004 1773 5302Instituto Nacional de Perinatología, 11000 CDMX Mexico City, Mexico
| | - Ignacio Camacho-Arroyo
- grid.9486.30000 0001 2159 0001Unidad de Investigación en Reproducción Humana, Instituto Nacional de Perinatología-Facultad de Química, Universidad Nacional Autónoma de México, 04510 CDMX Mexico City, Mexico
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15
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Cheung HN, Chan SWY, Williams JM. Validation of Chinese Multidimensional Depression Assessment Scale (MDAS) in Inner Mongolia pregnant women and risk factors of antenatal depression in Inner Mongolia in the era of one-child policy. PLoS One 2020; 15:e0227944. [PMID: 32196492 PMCID: PMC7083312 DOI: 10.1371/journal.pone.0227944] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2018] [Accepted: 01/04/2020] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Pregnancy involves physiological changes in reproductive and endocrine systems, and social role changes that can increase the risk of mental health problems. In China, greater emphasis has been given to postpartum depression and its negative impact on infant development. This study examined depression in pregnant women in Inner Mongolia, who are under the influence of cultural values of collectivism and social factors specific to China. Chinese society adheres firmly to traditional values, while market reform, birth-control policy, together with high parental investment in childcare and rearing construct a unique and sometimes unfavorable environment for Chinese women that may influence their depression expression. THE AIMS OF THIS STUDY ARE TWOFOLD First, it validated the Chinese Multidimensional Depression Assessment Scale (MDAS), a holistic self-report questionnaire measuring depression severity in four domains of depression-emotional, somatic, cognitive and interpersonal in pregnant women in Inner Mongolia; second, it examined the influences of demographic characteristics (including age, education and employment), pregnancy characteristics (week of gestation, first pregnancy), self-esteem, social support, social activity, work stress, and work-family balance on depression. METHODS A total of 234 pregnant women, mostly in their third trimester, were recruited in an antenatal hospital in Inner Mongolia and self-reported questionnaires were completed. RESULTS Using Confirmatory factor analysis (CFA), MDAS gave rise to a best-fit four-factor model corresponding to each subscale when it was first developed. MDAS also reported high Cronbach's alpha (0.96) and good convergent validity. Using hierarchical multiple linear regressions with significant demographic variables controlled for, self-esteem, work-family conflict, and social support were found to be significant predictors for depression. CONCLUSIONS MDAS is a valid scale to be used with Chinese pregnant women, especially in more collectivistic geographical areas. Risk factors specific to the Chinese context add insights to the experience of antenatal depression in China and contribute to understanding depression in from a global mental health perspective.
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Affiliation(s)
- Ho Nam Cheung
- Department of Social Sciences, School of Arts and Social Sciences, The Open University of Hong Kong, Hong Kong, China
| | - Stella W. Y. Chan
- Department of Clinical Psychology, School of Health in Social Science, The University of Edinburgh, Edinburgh, Scotland, United Kingdom
| | - Joanne M. Williams
- Department of Clinical Psychology, School of Health in Social Science, The University of Edinburgh, Edinburgh, Scotland, United Kingdom
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16
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Bleker LS, de Rooij SR, Roseboom TJ. Prenatal Psychological Stress Exposure and Neurodevelopment and Health of Children. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16193657. [PMID: 31569453 PMCID: PMC6801715 DOI: 10.3390/ijerph16193657] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/16/2019] [Accepted: 09/16/2019] [Indexed: 12/19/2022]
Affiliation(s)
- Laura S Bleker
- Department of Obstetrics and Gynaecology, Department of Clinical Epidemiology, Biostatistics and Bioinformatics, Amsterdam University Medical Centers, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands.
| | - Susanne R de Rooij
- Department of Obstetrics and Gynaecology, Department of Clinical Epidemiology, Biostatistics and Bioinformatics, Amsterdam University Medical Centers, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands.
| | - Tessa J Roseboom
- Department of Obstetrics and Gynaecology, Department of Clinical Epidemiology, Biostatistics and Bioinformatics, Amsterdam University Medical Centers, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands.
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17
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Hou Q, Huang L, Ge X, Yang A, Luo X, Huang S, Xiao Y, Jiang C, Li L, Pan Z, Teng T, Zhang H, Li M, Mo Z, Yang X. Associations between multiple serum metal exposures and low birth weight infants in Chinese pregnant women: A nested case-control study. CHEMOSPHERE 2019; 231:225-232. [PMID: 31129403 DOI: 10.1016/j.chemosphere.2019.05.103] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/11/2019] [Revised: 04/28/2019] [Accepted: 05/13/2019] [Indexed: 06/09/2023]
Abstract
To investigate the associations between prenatal exposure to single metal and multiple metals and the risk of low birth weight (LBW), we conducted a nested case-control study of 246 LBW and 406 NBW mother-infant pairs based on a prospective birth cohort study. 22 serum metals were detected by inductively coupled plasma quadruple mass spectrometry (ICP-MS). Categorical analyses showed serum Co and Ti were associated with LBW (Co: 3rd vs 4th. quartile: OR = 1.83, 95%CI: 1.14-2.92, Ptrend = 0.043; Ti: 2nd vs. 4th quartile: OR = 0.51, 95% CI: 0.32-0.81, P trend = 0.051), especially gestational age >13 weeks (Co: 3rd vs. 4th quartile: OR = 1.94, 95% CI: 1.13 - 3.32, Ptrend = 0.043; Ti: 2nd vs. 4th quartile: OR = 0.50, 95% CI: 0.30 - 0.84, P trend= 0.073). Cubic spline analyses showed serum Co and serum Ti had non-linearity associations with LBW (Co: P for overall = 0.048, P-nonlinearity = 0.014; Ti: P for overall = 0.015, P- nonlinearity = 0.008). In multi-metal compound exposure model, 15 metals selected by elastic net model were significantly associated with the increased risk of LBW and OR (95%CI) was 5.14 (2.81-9.40). Our study suggested that lower level serum Co was positively associated with LBW and lower level serum Ti was negatively associated with LBW, especially gestational age >13 weeks, and both of them had non-linearity dose-relationships with LBW. And multi-metal compound model was significantly associated with LBW compared with single metal model.
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Affiliation(s)
- Qingzhi Hou
- Center for Genomic and Personalized Medicine, Guangxi Medical University, Nanning, Guangxi, China; Guangxi Key Laboratory for Genomic and Personalized Medicine, Nanning, Guangxi, China; Guangxi Collaborative Innovation Center for Genomic and Personalized Medicine, Nanning, Guangxi, China; Guangxi Key Laboratory of Colleges and Universities, Nanning, Guangxi, China; Department of Occupational Health and Environmental Health, School of Public Health of Guangxi Medical University, Nanning, Guangxi, China
| | - Lulu Huang
- Center for Genomic and Personalized Medicine, Guangxi Medical University, Nanning, Guangxi, China; Guangxi Key Laboratory for Genomic and Personalized Medicine, Nanning, Guangxi, China; Guangxi Collaborative Innovation Center for Genomic and Personalized Medicine, Nanning, Guangxi, China; Guangxi Key Laboratory of Colleges and Universities, Nanning, Guangxi, China; Department of Occupational Health and Environmental Health, School of Public Health of Guangxi Medical University, Nanning, Guangxi, China
| | - Xiaoting Ge
- Center for Genomic and Personalized Medicine, Guangxi Medical University, Nanning, Guangxi, China; Guangxi Key Laboratory for Genomic and Personalized Medicine, Nanning, Guangxi, China; Guangxi Collaborative Innovation Center for Genomic and Personalized Medicine, Nanning, Guangxi, China; Guangxi Key Laboratory of Colleges and Universities, Nanning, Guangxi, China; Department of Occupational Health and Environmental Health, School of Public Health of Guangxi Medical University, Nanning, Guangxi, China
| | - Aimin Yang
- Hong Kong Institute of Diabetes and Obesity, The Chinese University of Hong Kong, Hong Kong SAR
| | - Xiaoyu Luo
- Center for Genomic and Personalized Medicine, Guangxi Medical University, Nanning, Guangxi, China; Guangxi Key Laboratory for Genomic and Personalized Medicine, Nanning, Guangxi, China; Guangxi Collaborative Innovation Center for Genomic and Personalized Medicine, Nanning, Guangxi, China; Guangxi Key Laboratory of Colleges and Universities, Nanning, Guangxi, China; Department of Occupational Health and Environmental Health, School of Public Health of Guangxi Medical University, Nanning, Guangxi, China
| | - Sifang Huang
- Center for Genomic and Personalized Medicine, Guangxi Medical University, Nanning, Guangxi, China; Guangxi Key Laboratory for Genomic and Personalized Medicine, Nanning, Guangxi, China; Guangxi Collaborative Innovation Center for Genomic and Personalized Medicine, Nanning, Guangxi, China; Guangxi Key Laboratory of Colleges and Universities, Nanning, Guangxi, China; Department of Occupational Health and Environmental Health, School of Public Health of Guangxi Medical University, Nanning, Guangxi, China
| | - Yang Xiao
- Department of Occupational and Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Chao Jiang
- Center for Genomic and Personalized Medicine, Guangxi Medical University, Nanning, Guangxi, China; Guangxi Key Laboratory for Genomic and Personalized Medicine, Nanning, Guangxi, China; Guangxi Collaborative Innovation Center for Genomic and Personalized Medicine, Nanning, Guangxi, China; Guangxi Key Laboratory of Colleges and Universities, Nanning, Guangxi, China; Department of Occupational Health and Environmental Health, School of Public Health of Guangxi Medical University, Nanning, Guangxi, China
| | - Longman Li
- Center for Genomic and Personalized Medicine, Guangxi Medical University, Nanning, Guangxi, China; Guangxi Key Laboratory for Genomic and Personalized Medicine, Nanning, Guangxi, China; Guangxi Collaborative Innovation Center for Genomic and Personalized Medicine, Nanning, Guangxi, China; Guangxi Key Laboratory of Colleges and Universities, Nanning, Guangxi, China; Department of Occupational Health and Environmental Health, School of Public Health of Guangxi Medical University, Nanning, Guangxi, China
| | - Zhijian Pan
- Department of Gynecology and Obstetrics, the Maternal & Child Health Hospital of Qinzhou, Qinzhou, Guangxi, China
| | - Tao Teng
- Department of Antenatal Care, the Maternal & Child Health Hospital of Nanning, Nanning, Guangxi, China
| | - Haiying Zhang
- Center for Genomic and Personalized Medicine, Guangxi Medical University, Nanning, Guangxi, China; Guangxi Key Laboratory for Genomic and Personalized Medicine, Nanning, Guangxi, China; Guangxi Collaborative Innovation Center for Genomic and Personalized Medicine, Nanning, Guangxi, China; Guangxi Key Laboratory of Colleges and Universities, Nanning, Guangxi, China; Department of Occupational Health and Environmental Health, School of Public Health of Guangxi Medical University, Nanning, Guangxi, China
| | - Mujun Li
- Center for Genomic and Personalized Medicine, Guangxi Medical University, Nanning, Guangxi, China; Guangxi Collaborative Innovation Center for Genomic and Personalized Medicine, Nanning, Guangxi, China
| | - Zengnan Mo
- Center for Genomic and Personalized Medicine, Guangxi Medical University, Nanning, Guangxi, China; Guangxi Key Laboratory for Genomic and Personalized Medicine, Nanning, Guangxi, China; Guangxi Collaborative Innovation Center for Genomic and Personalized Medicine, Nanning, Guangxi, China; Guangxi Key Laboratory of Colleges and Universities, Nanning, Guangxi, China
| | - Xiaobo Yang
- Center for Genomic and Personalized Medicine, Guangxi Medical University, Nanning, Guangxi, China; Guangxi Key Laboratory for Genomic and Personalized Medicine, Nanning, Guangxi, China; Guangxi Collaborative Innovation Center for Genomic and Personalized Medicine, Nanning, Guangxi, China; Guangxi Key Laboratory of Colleges and Universities, Nanning, Guangxi, China; Department of Occupational Health and Environmental Health, School of Public Health of Guangxi Medical University, Nanning, Guangxi, China.
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18
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Tang X, Lu Z, Hu D, Zhong X. Influencing factors for prenatal Stress, anxiety and depression in early pregnancy among women in Chongqing, China. J Affect Disord 2019; 253:292-302. [PMID: 31077972 DOI: 10.1016/j.jad.2019.05.003] [Citation(s) in RCA: 97] [Impact Index Per Article: 19.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2019] [Revised: 03/29/2019] [Accepted: 05/01/2019] [Indexed: 12/20/2022]
Abstract
BACKGROUND Prenatal mental disorders are associated with maternal and fetal adverse outcomes, while few studies have been performed in mainland China. This study aimed to investigate the prevalence and influencing factors of maternal stress, anxiety and depression in early pregnancy and provide scientific basis for reducing prenatal mental disorders. METHODS Data were obtained from 1220 women with < 15 weeks gestation in a cohort study conducted in Chongqing, China. Prenatal stress, anxiety and depression were assessed using the pregnancy pressure scale, the Hamilton anxiety scale, and the self-rating depression scale, respectively. RESULTS The prevalence of prenatal stress, anxiety and depression in early pregnancy was 91.86%, 15.04% and 5.19%, respectively. Logistic regression analysis revealed that the risk factors for prenatal stress include housewife/unemployment, presence of anxiety and low- and moderate-level social support, besides, the protective factors were exercise, active smoking and no suggestion from parents. Housewife/unemployment, primiparity, presence of stress and depression and low-level social support were found to be associated with the development of anxiety symptoms, whereas exercise had a protective effect on it. Group-oriented personality, presence of anxiety, no suggestion from husband, low- and moderate-level family care, and low-level social support were risk factors for prenatal depression. LIMITATIONS All participants were recruited from one region of China, and none of them have a history of cesarean section. CONCLUSION Early screening and intervention may have great significance for reducing mental disorders of pregnant women, and the family and society support should be brought into the intervention as well.
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Affiliation(s)
- Xian Tang
- School of Public Health and Management, Chongqing Medical University, 1# yixue Rd., Chongqing 400016, China
| | - Zhuo Lu
- School of Public Health and Management, Chongqing Medical University, 1# yixue Rd., Chongqing 400016, China
| | - Dihui Hu
- School of Public Health and Management, Chongqing Medical University, 1# yixue Rd., Chongqing 400016, China
| | - Xiaoni Zhong
- School of Public Health and Management, Chongqing Medical University, 1# yixue Rd., Chongqing 400016, China.
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