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Synnes A, Lam MM, Ricci MF, Church P, Simard MN, Zwicker JG, Luu TM. How to measure patient and family important outcomes in extremely preterm infants: A scoping review. Acta Paediatr 2024. [PMID: 38578009 DOI: 10.1111/apa.17228] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2024] [Revised: 03/15/2024] [Accepted: 03/26/2024] [Indexed: 04/06/2024]
Abstract
AIM Parents of children born preterm have identified outcomes to be measured for audit and research at 18-24 months of age: child well-being, quality of life/function, socio-emotional/behavioural outcomes, respiratory, feeding, sleeping, and caregiver mental health. The aim was to identify the best tools to measure these seven domains. METHODS Seven working groups completed literature reviews and evaluated potential tools to measure these outcomes in children aged 18-24 months. A group of experts and parents voted on the preferred tools in a workshop and by questionnaire. Consensus was 80% agreement. RESULTS Consensus was obtained for seven brief, inexpensive, parent friendly valid measures available in English or French for use in a minimum dataset and potential alternative measures for use in funded research. CONCLUSION Valid questionnaires and tools to measure parent-identified outcomes in young preterm children exist. This study will facilitate research and collection of data important to families.
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Affiliation(s)
- Anne Synnes
- Department of Pediatrics, BC Women's Hospital and BC Children's Hospital Research Institute, University of British Columbia, Vancouver, British Columbia, Canada
| | - Mei Mei Lam
- Department of Pediatrics, University of British Columbia, Vancouver, British Columbia, Canada
| | - M Florencia Ricci
- Department of Pediatrics and Child Health, University of Manitoba, and Children's Hospital Research Institute of Manitoba, Winnipeg, Manitoba, Canada
| | - Paige Church
- Boston Children's Hospital and Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA
| | - Marie-Noelle Simard
- School of rehabilitation, Faculty of Medicine, Université de Montréal, Montreal, Quebec, Canada
| | - Jill G Zwicker
- Department of Pediatrics, BC Women's Hospital and BC Children's Hospital Research Institute, University of British Columbia, Vancouver, British Columbia, Canada
- Department of Occupational Science & Occupational Therapy, University of British Columbia, Vancouver, British Columbia, Canada
| | - Thuy Mai Luu
- Centre Hospitalier Universitaire Sainte-Justine Research Center and Department of Pediatrics, Centre Hospitalier Universitaire Sainte Justine, Montreal, Quebec, Canada
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Silva-Fernandez CS, de la Calle M, Arribas SM, Garrosa E, Ramiro-Cortijo D. Factors Associated with Obstetric Violence Implicated in the Development of Postpartum Depression and Post-Traumatic Stress Disorder: A Systematic Review. NURSING REPORTS 2023; 13:1553-1576. [PMID: 37987409 PMCID: PMC10661273 DOI: 10.3390/nursrep13040130] [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: 09/22/2023] [Revised: 10/19/2023] [Accepted: 10/27/2023] [Indexed: 11/22/2023] Open
Abstract
Postpartum depression (PPD) and post-traumatic stress disorder (PTSD) continue to be prevalent, and disabling women with mental disorders and obstetric violence (OV) may be a trigger for them, particularly during maternity. We aimed to analyze the association between manifestations of OV with the development of PPD and PTSD during pregnancy, childbirth, and postpartum. This systematic review was based on the PRISMA 2020 statement and explored original articles published between 2012 and 2022. A total of 21 articles were included in the analysis, and bias was assessed by the Effective Public Health Practice Project's Quality Assessment Tool. The highest rate of PPD symptoms appeared in women under 20 years old, multiparous, and with low education levels. The higher PTSD ratio was present in women under 35 years, primiparous, and with secondary studies. The mode of labor (instrumental or C-section) was identified as a major risk factor of PPD, being mediator variables of the informal coercion of health professionals and dissatisfaction with newborn healthcare. Instead, partner support during labor and high satisfaction with healthcare during birth were protective factors. Regarding PTSD, the mode of labor, several perineal tears, and the Kristeller technique were risk factors, and loss of autonomy and coercion modulated PTSD symptomatology. The protective factors for PTSD were respect for the labor plan, adequate communication with health professionals, social support during labor, and the skin-to-skin procedure. This systematic review provides evidence that OV contributes to PPD and PTSD, being important in developing standardized tools to prevent it. This study recommends changes in maternal healthcare policies, such as individualized healthcare assistance, humanized pregnancy protocols, and women's mental health follow-up, and improvements in the methodological quality of future research.
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Affiliation(s)
- Claudia Susana Silva-Fernandez
- Department of Biological & Health Psychology, Faculty of Psychology, Universidad Autónoma de Madrid, C/Ivan Pavlov 6, 28049 Madrid, Spain (E.G.)
| | - Maria de la Calle
- Obstetric and Gynecology Service, Hospital Universitario La Paz, Universidad Autónoma de Madrid, Paseo de la Castellana 261, 28046 Madrid, Spain
| | - Silvia M. Arribas
- Department of Physiology, Faculty of Medicine, Universidad Autónoma de Madrid, C/Arzobispo Morcillo 2, 28029 Madrid, Spain
- Instituto Universitario de Estudios de la Mujer (IUEM), Universidad Autónoma de Madrid, C/Francisco Tomás y Valiente 5, 28049 Madrid, Spain
| | - Eva Garrosa
- Department of Biological & Health Psychology, Faculty of Psychology, Universidad Autónoma de Madrid, C/Ivan Pavlov 6, 28049 Madrid, Spain (E.G.)
- Instituto Universitario de Estudios de la Mujer (IUEM), Universidad Autónoma de Madrid, C/Francisco Tomás y Valiente 5, 28049 Madrid, Spain
| | - David Ramiro-Cortijo
- Department of Physiology, Faculty of Medicine, Universidad Autónoma de Madrid, C/Arzobispo Morcillo 2, 28029 Madrid, Spain
- Instituto Universitario de Estudios de la Mujer (IUEM), Universidad Autónoma de Madrid, C/Francisco Tomás y Valiente 5, 28049 Madrid, Spain
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Gutiérrez Hermoso L, Catalá Mesón P, Écija Gallardo C, Marín Morales D, Peñacoba Puente C. Mother-Child Bond through Feeding: A Prospective Study including Neuroticism, Pregnancy Worries and Post-Traumatic Symptomatology. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:2115. [PMID: 36767481 PMCID: PMC9915468 DOI: 10.3390/ijerph20032115] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Revised: 01/16/2023] [Accepted: 01/20/2023] [Indexed: 06/18/2023]
Abstract
Post-traumatic stress disorder (PTSD) is a common postpartum problem and influences maternal bonding with the infant. However, the relationship between this disorder, maternal personality, and the infant's emotional state during feeding is not clear. The aim of the present study was to explore the contribution of neuroticism on the infant's emotional state during feeding, by attending to the mediating role of postpartum PTSD (P-PTSD) symptoms and the moderating role of worries during pregnancy. A prospective design study was developed with 120 women with a low pregnancy risk. They responded to a questionnaire assessing maternal personality (first trimester), worries during pregnancy (third trimester), P-PTSD symptoms, and mother-baby bonding (4 months postpartum). The results showed a positive association among neuroticism, infant irritability during feeding, and P-PTSD symptoms, suggesting the latter plays a mediating role in the relationship between neuroticism and infant irritability (B = 0.102, standard error (SE) = 0.03, 95% coefficient interval (CI) [0.038, 0.176]). Excessive worries, related to coping with infant care, played a moderating role between neuroticism and P-PTSD symptoms (B = 0.413, SE = 0.084, p = 0.006, 95% CI [0.245, 0.581]). This relationship was interfered with by depressive symptoms in the first trimester (covariate) (B = 1.820, SE = 0.420, p = 0.016, ci [2.314, 0.251]). This study contributes to a better understanding of the role of neuroticism as an influential factor in the occurrence of P-PTSD symptoms, and in the impairment of infant bonding during feeding. Paying attention to these factors may favor the development of psychological support programs for mothers, with the aim of strengthening the bond with their child.
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Affiliation(s)
- Lorena Gutiérrez Hermoso
- Department of Psychology, Universidad Rey Juan Carlos, Avenida de Atenas s/n, 28922 Alcorcón, Spain
| | - Patricia Catalá Mesón
- Department of Psychology, Universidad Rey Juan Carlos, Avenida de Atenas s/n, 28922 Alcorcón, Spain
| | - Carmen Écija Gallardo
- Department of Psychology, Universidad Rey Juan Carlos, Avenida de Atenas s/n, 28922 Alcorcón, Spain
| | - Dolores Marín Morales
- Obstetric Department, Hospital Universitario de Fuenlabrada, Camino del Molino, 2, 28942 Fuenlabrada, Spain
| | - Cecilia Peñacoba Puente
- Department of Psychology, Universidad Rey Juan Carlos, Avenida de Atenas s/n, 28922 Alcorcón, Spain
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O'Byrne LJ, Bodunde EO, Maher GM, Khashan AS, Greene RM, Browne JP, McCarthy FP. Patient-reported outcome measures evaluating postpartum maternal health and well-being: a systematic review and evaluation of measurement properties. Am J Obstet Gynecol MFM 2022; 4:100743. [PMID: 36087713 DOI: 10.1016/j.ajogmf.2022.100743] [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] [Revised: 08/31/2022] [Accepted: 09/01/2022] [Indexed: 11/18/2022]
Abstract
OBJECTIVE This study aimed to systematically review and evaluate postpartum health and well-being using patient-reported outcome measures across all domains of postpartum health using the COnsensus-based Standards for the selection of health Measurement INstruments guidelines. DATA SOURCES Based on a preprepared published protocol, a systematic search of PubMed, Embase, and CINAHL was undertaken to identify patient-reported outcome tools. The protocol was registered with the International Prospective Register of Systematic Reviews (registration number CRD42021283472), and this work followed the COnsensus-based Standards for the selection of health Measurement INstruments guidelines for systematic reviews. STUDY ELIGIBILITY CRITERIA Studies eligible for inclusion included those that assessed a patient-reported outcome measure examining postpartum women's health and well-being with no limitation on the domain. The included studies aimed to evaluate one or more measurement properties of the patient-reported outcome measure. METHODS Data extraction and the methodological assessment of the quality of the patient-reported outcome measure were assessed by 2 reviewers independently based on content validity, structural validity, internal consistency, cross-cultural validity or measurement invariance, reliability, measurement error, hypotheses testing for construct validity, and responsiveness, as defined by the COnsensus-based Standards for the selection of health Measurement INstruments. The standard used for content validity were the domains of importance to women in postpartum health and well-being proposed by the International Consortium for Health Outcomes Measurement. The outcome domains for patient-reported health status include mental health, health-related quality of life, incontinence, pain with intercourse, breastfeeding, and motherhood role transition. The quality of the methods was rated an overall rating of results, awarded a level of evidence, and assessed using the Grading of Recommendations, Assessment, Development, and Evaluations assessment tool, and a level of recommendation was awarded for each tool. RESULTS There were 10,324 studies identified in the initial search, of which 29 tools were identified from 41 eligible studies included in the review. Moreover, 21 tools were awarded an "A" grading of recommendation for use as a patient-reported outcome measure in postpartum women following the COnsensus-based Standards for the selection of health Measurement Instruments standards. Of the "A"-rated tools, 17 (80%) examined the domain of mental health, 5 examined health-related quality of life, 4 examined breastfeeding, and 6 represented role transition. No "A"-recommended tool examined postpartum incontinence or pain with intercourse. Of note, 3 tools did not cover domains as recommended by the International Consortium for Health Outcomes Measurement, and 5 tools were awarded a "B" rating, requiring more research before their recommendation for use. Here, most tools were awarded very low-moderate Recommendations, Assessment, Development, and Evaluations level of evidence. Moreover, the highest quality tool identified that covered multiple domains of postpartum health and well-being was the women's Postpartum Quality-of-Life Questionnaire. CONCLUSION This systematic review identified the best performing patient-reported outcome measures to assess postpartum health and well-being. No individual tool covers all 6 domains of postpartum health and well-being. Here, the highest quality tool found that covered multiple domains of postpartum health and well-being was the Postpartum Quality-of-Life Questionnaire. The Postpartum Quality-of-Life Questionnaire captures 4 of 6 domains of importance to women, with domains of incontinence and sexual health unevaluated. The domain of urinary incontinence was represented by the International Consultation on Incontinence Questionnaire Short Form, which requires further psychometric analysis before its recommended use. Postpartum sexual health, not represented by any tool, necessitates the development of a patient-reported outcome measure. A postpartum patient-reported outcome measure would be best provided by a combination of tools; however, further research is required before its implementation.
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Affiliation(s)
- Laura J O'Byrne
- National Perinatal Epidemiological Centre (NPEC), University College Cork, Ireland (Drs O'Byrne, Maher and Greene); Department of Obstetrics and Gynaecology, Cork University Maternity Hospital, Ireland (Drs O'Byrne, Greene and McCarthy); INFANT Research Centre, University College Cork, Ireland (Drs O'Byrne, Maher and McCarthy).
| | - Elizabeth O Bodunde
- Department of Public Health, University College Cork, Cork, Ireland (Ms Bodunde Drs Khashan and Browne)
| | - Gillian M Maher
- National Perinatal Epidemiological Centre (NPEC), University College Cork, Ireland (Drs O'Byrne, Maher and Greene); INFANT Research Centre, University College Cork, Ireland (Drs O'Byrne, Maher and McCarthy)
| | - Ali S Khashan
- Department of Public Health, University College Cork, Cork, Ireland (Ms Bodunde Drs Khashan and Browne)
| | - Richard M Greene
- National Perinatal Epidemiological Centre (NPEC), University College Cork, Ireland (Drs O'Byrne, Maher and Greene); Department of Obstetrics and Gynaecology, Cork University Maternity Hospital, Ireland (Drs O'Byrne, Greene and McCarthy)
| | - John P Browne
- Department of Public Health, University College Cork, Cork, Ireland (Ms Bodunde Drs Khashan and Browne)
| | - Fergus P McCarthy
- Department of Obstetrics and Gynaecology, Cork University Maternity Hospital, Ireland (Drs O'Byrne, Greene and McCarthy); INFANT Research Centre, University College Cork, Ireland (Drs O'Byrne, Maher and McCarthy)
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Li X, He W, Zhao Y, Chen B, Zhu Z, Kang Q, Zhang B. Dermal exposure to synthetic musks: Human health risk assessment, mechanism, and control strategy. ECOTOXICOLOGY AND ENVIRONMENTAL SAFETY 2022; 236:113463. [PMID: 35367890 DOI: 10.1016/j.ecoenv.2022.113463] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/29/2022] [Revised: 03/23/2022] [Accepted: 03/25/2022] [Indexed: 06/14/2023]
Abstract
Synthetic musks (SMs) have been widely used as odor additives in personal care products (PCPs). Dermal exposure to SMs is the main pathway of the accumulation of these chemicals in human kerateins and poses potential health risks. In this study, in silico methods were established to reduce the human health risk of SMs from dermal exposure by investigating the risk mechanisms, designing lower bioaccumulation ability SMs and suggesting proper PCP ingredients using molecular docking, molecular dynamics simulation, and quantitative structure-activity relationship (QSAR) models. The binding energy, a parameter reflecting the binding ability of SMs and human keratin protein (4ZRY), was used as the indicator to assess the human health risk of SMs. According to the mechanism analysis, total energy was found as the most influential molecular structural feature influencing the bioaccumulation ability of a SM, and as one of the main factors influencing the function (i.e., odor sensitivity) of an SM. The 3D-QSAR models were constructed to control the human health risk of SMs by designing lower-risk SMs derivatives. The phantolide (PHAN)- 58 was determined to be the optimum SM derivative with lower bioaccumulation ability (reduced 17.25%) and improved odor sensitivity (increased 7.91%). A further reduction of bioaccumulation ability of PHAN-58 was found when adding proper body wash ingredients (i.e., alkyl ethoxylate sulfate (AES), dimethyloldimethyl (DMDM), EDTA-Na4, ethylene glycol distearate (EGDS), hydroxyethyl cellulose (HEC), lemon yellow and octyl glucose), leading to a significant reduction of the bioaccumulation ability (42.27%) compared with that of PHAN. Results demonstrated that the proposed theoretical mechanism and control strategies could effectively reduce the human health risk of SMs from dermal exposure.
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Affiliation(s)
- Xixi Li
- Northern Region Persistent Organic Pollution Control (NRPOP) Laboratory, Faculty of Engineering and Applied Science, Memorial University, St. John's, NL A1B 3×5, Canada.
| | - Wei He
- MOE Key Laboratory of Resources and Environmental Systems Optimization, North China Electric Power University, Beijing 102206, China.
| | - Yuanyuan Zhao
- MOE Key Laboratory of Resources and Environmental Systems Optimization, North China Electric Power University, Beijing 102206, China.
| | - Bing Chen
- Northern Region Persistent Organic Pollution Control (NRPOP) Laboratory, Faculty of Engineering and Applied Science, Memorial University, St. John's, NL A1B 3×5, Canada.
| | - Zhiwen Zhu
- Northern Region Persistent Organic Pollution Control (NRPOP) Laboratory, Faculty of Engineering and Applied Science, Memorial University, St. John's, NL A1B 3×5, Canada.
| | - Qiao Kang
- Northern Region Persistent Organic Pollution Control (NRPOP) Laboratory, Faculty of Engineering and Applied Science, Memorial University, St. John's, NL A1B 3×5, Canada.
| | - Baiyu Zhang
- Northern Region Persistent Organic Pollution Control (NRPOP) Laboratory, Faculty of Engineering and Applied Science, Memorial University, St. John's, NL A1B 3×5, Canada.
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Martinez-Vázquez S, Rodríguez-Almagro J, Hernández-Martínez A, Delgado-Rodríguez M, Martínez-Galiano JM. Obstetric factors associated with postpartum post-traumatic stress disorder after spontaneous vaginal birth. Birth 2021; 48:406-415. [PMID: 33909303 DOI: 10.1111/birt.12550] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2020] [Revised: 04/03/2021] [Accepted: 04/05/2021] [Indexed: 12/27/2022]
Abstract
BACKGROUND This study aimed to determine whether there is an association between clinical practices carried out during spontaneous vaginal birth (SVB), or clinical situations that arise during vaginal birth, and the incidence of post-traumatic stress disorder (PTSD). METHODS A cross-sectional study with 839 puerperal women in Spain was conducted. The Perinatal Post-traumatic Stress Disorder Questionnaire (PPQ) was administered online. The relationship between the risk of postpartum PTSD and various intrapartum complications was studied in addition to practices or procedures performed during the intrapartum period. RESULTS PTSD (PPQ scores ≥19) was identified in 8.1% (68) of the women who participated. Among the risk factors for PTSD was a concerning intrapartum FHR tracing (adjusted OR: 2.24, 95% CI: 1.07-4.66). Other intrapartum practices also put women at risk of PTSD, including the administration of an enema (aOR: 7.01, 95% CI: 2.14-23.01), being required to stay lying down throughout the labor and birth (aOR: 5.75, 95% CI: 3.25-10.19), artificial amniorrhexis without consent (aOR: 2.28, 95% CI: 1.31-3.97), administration of synthetic oxytocin without consent (aOR: 2.18, 95% CI: 1.26-3.77), fundal pressure during pushing (aOR: 3.14, 95% CI: 1.72-5.73), repeated vaginal examinations performed by different people (aOR: 4.84, 95% CI: 2.77-8.47), and manual removal of the placenta without anesthesia (aOR: 3.45, 95% CI: 1.81-6.58). CONCLUSIONS Various intrapartum clinical practices, all related to dehumanized treatment, and intrapartum complications, were associated with an increased risk of PTSD. There is a need to eradicate obstetric mistreatment and to increase access to evidence-informed, respectful care in Spain. Care practitioners need to better appreciate their roles in preventing PTSD.
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Affiliation(s)
| | - Julián Rodríguez-Almagro
- Department of Nursing, Faculty of Nursing of Ciudad Real, University of Castilla-La Mancha, Ciudad Real, Spain
| | - Antonio Hernández-Martínez
- Department of Nursing, Faculty of Nursing of Ciudad Real, University of Castilla-La Mancha, Ciudad Real, Spain
| | - Miguel Delgado-Rodríguez
- Department of Health Sciences, University of Jaen, Jaén, Spain.,CIBER de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Juan Miguel Martínez-Galiano
- Department of Nursing, University of Jaen, Jaén, Spain.,CIBER de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
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