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Asefa A, Gebremedhin S, Delamou A, Marchal B, Benová L. Is MIStreatment of women during facility-based childbirth an independent risk factor for POstpartum Depression in Ethiopia and Guinea? A mixed methods prospective study protocol-MISPOD study. Reprod Health 2024; 21:129. [PMID: 39232855 PMCID: PMC11375852 DOI: 10.1186/s12978-024-01850-w] [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: 07/01/2024] [Accepted: 07/10/2024] [Indexed: 09/06/2024] Open
Abstract
BACKGROUND Worldwide, 10% of postpartum women experience postpartum depression, which can lead to diverse sequalae at individual, family, and societal levels. In sub-Saharan Africa, it is estimated that 17% of women experience depression in the postpartum period, which could be an underestimate as 48% of women in the region do not receive postnatal care (81% in Ethiopia and 51% in Guinea) and a large share of postpartum depression remains undiagnosed and untreated as a result. Globally, despite a critical evidence gap, there are growing reports of postpartum depression among women mistreated (disrespected and abused) during childbirth in health facilities, making a strong case to examine the association between mistreatment and postpartum depression. This study in Addis Ababa (Ethiopia) and Conakry (Guinea) uses a mixed methods design to 1) examine the link between mistreatment and postpartum depression, 2) explore the health system capacity to provide respectful maternity care and maternal mental health services, and 3) explore the experiences of women in accessing care and support for postpartum depression. METHODS We will conduct a prospective longitudinal survey of women (434 in Addis Ababa and 408 in Conakry) from the third trimester of pregnancy to eight weeks postpartum and carry out in-depth interviews with key health system informants (20-25 in each city) and women who recovered from a clinically confirmed episode of postpartum depression (15-25 in each city). Quantitative data from the women's survey will be analysed using a multilevel mixed-effects model; qualitative data from key-informants will be analysed by using a hybrid thematic analysis approach, whereas data from women's in-depth interviews will be analysed using the phenomenological approach. The inclusion of two different settings in our study (Addis Ababa and Conakry) will enable us to apply a comparative health systems lens to explore the dynamics of respectful maternity care and maternal mental health services within the broader health systems of the two countries (Ethiopia and Guinea). DISCUSSION The findings from this study will inform actions aimed at mitigating the mistreatment of women in maternity settings and improving promotive, preventive, and treatment interventions for postpartum depression in Ethiopia and Guinea. The findings can also be extrapolated to other low-resource settings.
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Affiliation(s)
- Anteneh Asefa
- Department of Public Health, Institute of Tropical Medicine, Antwerp, Belgium.
| | | | - Alexandre Delamou
- Centre National de Formation Et de Recherche en Santé Rurale, Maférinyah, Forécariah, Guinea
- Centre d'Excellence d'Afrique Pour la Prévention et le Contrôle des Maladies Transmissibles (CEA-PCMT), Université Gamal Abdel Nasser de Conakry, Conakry, Guinea
- Centre National de Formation et de Recherche en Santé Rurale de Maferinyah, Forecariah, Guinea
| | - Bruno Marchal
- Africa Center of Excellence, University Gamal Abdel Nasser, Conakry, Guinea
| | - Lenka Benová
- Department of Public Health, Institute of Tropical Medicine, Antwerp, Belgium
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Tetema MD, Fikadu K, Ayele G, Jima GB, Kebede BN, Yimer AA, Abza LF, Demissie M, Mossa KA, Mohammed SJ, Abdo AS, Abera M. Prevalence of insomnia and associated factors among postpartum mothers in Southern Ethiopia, a community-based cross-sectional study. PLoS One 2024; 19:e0307104. [PMID: 39042615 PMCID: PMC11265656 DOI: 10.1371/journal.pone.0307104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Accepted: 06/28/2024] [Indexed: 07/25/2024] Open
Abstract
Insomnia has become a global public health concern, particularly among postpartum women. Minimal sleep interruption related to newborn care is normally expected, insomnia, however has negative impact during the postpartum period. Although its causes and contributing factors are poorly understood, it has a wide-ranging impact on the mother and her infant. So far, studies in Ethiopia have focused on the general community, neglecting mothers in the postpartum period. Thus, this study aimed to assess the prevalence of insomnia and the factors associated with it. A community-based cross-sectional study included 451 study participants who were chosen using a simple random sampling technique. A structured, pretested, and interviewer-administered questionnaire was used to collect data. After entering the data into EpiData version 3.1, it was exported to the Statistical Package for Social Sciences version 26 for analysis. Bivariable and multivariable binary logistic regression analyses were carried out. Variables with a P-value of 0.2 in the bivariable analysis were included in the multivariable analyses. Those with a P-value of 0.05 were declared statistically significant in the final model. The current study included 444 mothers in total. Insomnia was prevalent among 23.2% (95% CI: 19.3%, 27.4%) of mothers who had given birth within the previous 12 months. Insomnia was associated with unplanned index pregnancy [AOR = 4.4, 95% CI (2.2, 8.7)], alcohol consumption [AOR = 3.0, 95% CI (1.4, 6.5), low social support [AOR = 9.7, 95% CI (4.4, 21.1)], medium social support [AOR = 2.2, 95% CI (1.1, 4.3)] and depression [AOR = 10.7, 95% CI (5.7, 20.0). A planned index pregnancy, abstaining from alcohol, and recognizing and treating postpartum depression were all advised.
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Affiliation(s)
- Mesfin Difer Tetema
- Department of Midwifery, College of Medicine & health Sciences, Wolkite University, Wolkite, Ethiopia
| | - Kassahun Fikadu
- Department of Midwifery, College of Medicine & health sciences, Arba Minch University, Arba Minch, Ethiopia
| | - Gistane Ayele
- School of Public health, College of Medicine & health sciences, Arba Minch University, Arba Minch, Ethiopia
| | - Gudeta Beriso Jima
- Department of Midwifery, College of Medicine & health Sciences, Wolkite University, Wolkite, Ethiopia
| | - Berhanu Negesse Kebede
- Department of Midwifery, College of Medicine & health sciences, Arba Minch University, Arba Minch, Ethiopia
| | - Awol Arega Yimer
- Department of Midwifery, College of Medicine & health sciences, Arba Minch University, Arba Minch, Ethiopia
| | - Legese Fekede Abza
- Department of Nursing, College of Medicine & health sciences, Wolkite University, Wolkite, Ethiopia
| | - Mebratu Demissie
- Department of Midwifery, College of Medicine & health Sciences, Wolkite University, Wolkite, Ethiopia
| | - Kenzudin Assfa Mossa
- Department of Public health, College of medicine & health sciences, Wolkite University, Wolkite, Ethiopia
| | - Seid Jemal Mohammed
- Department of Midwifery, College of Medicine & health Sciences, Wolkite University, Wolkite, Ethiopia
| | - Ayele Sahile Abdo
- Department of Midwifery, College of Medicine & health Sciences, Wolkite University, Wolkite, Ethiopia
| | - Mangistu Abera
- Department of Midwifery, College of Medicine & health Sciences, Wolkite University, Wolkite, Ethiopia
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Schuijers M, Greenwood CJ, McIntosh JE, Youssef G, Letcher P, Macdonald JA, Spry E, Le Bas G, Teague S, Biden E, Elliott E, Allsop S, Burns L, Olsson CA, Hutchinson DM. Maternal perinatal social support and infant social-emotional problems and competencies: a longitudinal cross-cohort replication study. Arch Womens Ment Health 2024:10.1007/s00737-024-01473-x. [PMID: 38819645 DOI: 10.1007/s00737-024-01473-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2023] [Accepted: 05/10/2024] [Indexed: 06/01/2024]
Abstract
PURPOSE Maternal perinatal social support is theorised to promote offspring social-emotional development, yet few studies have prospectively examined this relationship. Findings may inform preventative intervention efforts, to support a healthy start to emotional life. METHODS This study examined whether maternal social support perinatally predicts infant social-emotional development at 12 months of age in two longitudinal cohort studies: The Australian Temperament Project (ATP) (n = 1,052 mother-infant dyads [653 mothers, M age_at_birth = 32.03, 88% Australian-born; 1,052 infants, 52% girls]) and The Triple B Pregnancy Cohort Study (Triple B) (n = 1,537 dyads [1,498 mothers, M age_at_birth = 32.53, 56% Australian-born; 1,537 infants, 49% girls]). Social support was assessed at pregnancy (third trimester) and eight-weeks post-birth. Infant social-emotional competencies (ATP: Brief Infant and Toddler Social and Emotional Assessment (BITSEA), Competencies Scale; Triple B: Bayley Scales of Infant and Toddler Development-Social Emotional Scale) and problems (ATP: BITSEA, Problems Scale; Triple B: Ages and Stages Questionnaires: Social-Emotional Scale), were assessed at 12-months of age. RESULTS In ATP, social support was associated with lower offspring problems (pregnancy: β = -0.15; post-birth: β = -0.12) and greater competencies (pregnancy: β = 0.12; post-birth: β = 0.16) at 12 months. In Triple B, social support also predicted lower offspring problems (pregnancy: β = -0.11; post-birth: β = -0.07) and greater competencies (pregnancy: β = 0.07) at 12 months. Findings did not indicate an association between support at eight-weeks post-birth and subsequent competencies (β = 0.06). CONCLUSIONS Evidence suggests that perinatal social support promotes healthy infant social and emotional development. These results underscore the critical importance of social support for mothers transitioning into parenthood.
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Affiliation(s)
- Melanie Schuijers
- Centre for Social and Early Emotional Development, Deakin University, Burwood, Australia
| | | | - Jennifer E McIntosh
- Centre for Social and Early Emotional Development, Deakin University, Burwood, Australia
- The Bouverie Centre, La Trobe University, Bundoora, Australia
- Murdoch Children's Research Institute, Royal Children's Hospital, Melbourne, Australia
- Department of Paediatrics, University of Melbourne, Melbourne, Australia
| | - George Youssef
- Centre for Social and Early Emotional Development, Deakin University, Burwood, Australia
| | - Primrose Letcher
- Centre for Social and Early Emotional Development, Deakin University, Burwood, Australia
- Murdoch Children's Research Institute, Royal Children's Hospital, Melbourne, Australia
- Department of Paediatrics, University of Melbourne, Melbourne, Australia
| | - Jacqui A Macdonald
- Centre for Social and Early Emotional Development, Deakin University, Burwood, Australia
- Murdoch Children's Research Institute, Royal Children's Hospital, Melbourne, Australia
- Department of Paediatrics, University of Melbourne, Melbourne, Australia
| | - Elizabeth Spry
- Centre for Social and Early Emotional Development, Deakin University, Burwood, Australia
- Murdoch Children's Research Institute, Royal Children's Hospital, Melbourne, Australia
| | - Genevieve Le Bas
- Centre for Social and Early Emotional Development, Deakin University, Burwood, Australia
| | - Samantha Teague
- Centre for Social and Early Emotional Development, Deakin University, Burwood, Australia
- Department of Psychology, College of Healthcare Sciences, James Cook University, Queensland, Australia
| | - Ebony Biden
- Centre for Social and Early Emotional Development, Deakin University, Burwood, Australia
- Murdoch Children's Research Institute, Royal Children's Hospital, Melbourne, Australia
| | - Elizabeth Elliott
- Discipline of Child and Adolescent Health, University of Sydney, Sydney, Australia
- The Children's Hospital at Westmead, Sydney, Australia
| | - Steve Allsop
- National Drug Research Institute, Curtin University, Perth, Australia
| | - Lucinda Burns
- National Drug and Alcohol Research Centre, University New South Wales, Sydney, Australia
| | - Craig A Olsson
- Centre for Social and Early Emotional Development, Deakin University, Burwood, Australia
- Murdoch Children's Research Institute, Royal Children's Hospital, Melbourne, Australia
- Department of Paediatrics, University of Melbourne, Melbourne, Australia
| | - Delyse M Hutchinson
- Centre for Social and Early Emotional Development, Deakin University, Burwood, Australia.
- Murdoch Children's Research Institute, Royal Children's Hospital, Melbourne, Australia.
- Department of Paediatrics, University of Melbourne, Melbourne, Australia.
- National Drug and Alcohol Research Centre, University New South Wales, Sydney, Australia.
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Kassa G, Batchelder A, Gross D. Prevalence and determinants of postpartum depression among adolescent and adult mothers in Northwest Ethiopia. Res Nurs Health 2024; 47:125-140. [PMID: 38095115 DOI: 10.1002/nur.22362] [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: 05/29/2023] [Revised: 10/25/2023] [Accepted: 12/03/2023] [Indexed: 03/25/2024]
Abstract
Postpartum depression (PPD) is a common mental health issue in resource-limited settings that negatively affects the well-being of mothers and children. However, PPD often remains untreated, leading to long-term consequences for families. Therefore, we examined the prevalence and determinants of PPD among adolescent and adult mothers in northwest Ethiopia. Data were collected from 374 adolescent (10-19 years) and 760 adult (20-34 years) mothers 6 weeks after childbirth. Data were analyzed using binary and multiple logistic regression. Adolescent mothers had a significantly higher proportion of PPD (37.4%) than adult mothers (20.1%) and were more likely to report low self-esteem (13.1% vs. 8.2%) and low social support (28.3% vs. 23.3%). Factors associated with PPD differed between adolescent and adult mothers. Adolescent mothers with PPD were more likely to report household food insecurity, low self-esteem, low knowledge of postpartum complications, and working in agriculture or professional/technical occupations. For adult mothers, factors associated with PPD included distance to the nearest health facility, medium social support, inadequate dietary diversity, and food insecurity. Results suggest that targeted interventions by age group are needed to reduce the burden of PPD in Ethiopia.
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Affiliation(s)
- Getachew Kassa
- School of Nursing, Johns Hopkins University, Baltimore, Maryland, USA
| | - Anne Batchelder
- School of Nursing, Johns Hopkins University, Baltimore, Maryland, USA
| | - Deborah Gross
- School of Nursing, Johns Hopkins University, Baltimore, Maryland, USA
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Uwase A, Nsereko E, Pillay N, Levin J. Dietary diversity and associated factors among pregnant women in the Southern Province of Rwanda: A facility-based cross-sectional study. PLoS One 2024; 19:e0297112. [PMID: 38394158 PMCID: PMC10889653 DOI: 10.1371/journal.pone.0297112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Accepted: 12/28/2023] [Indexed: 02/25/2024] Open
Abstract
The inadequate dietary diversity of pregnant women in low- and middle-income countries, including Rwanda, is rising and leading to macro and micronutrient deficiencies. The extent of dietary diversity and the factors contributing to it are unknown in Rwanda. This cross-sectional study, with 612 women who attended antenatal care services in Rwanda's Southern Province, identified determinants of dietary diversity among pregnant women. A multistage sampling scheme was used in which four districts were sampled, thereafter one urban and one rural health centre was sampled in each district and finally, a systematic sample of pregnant women was selected in each sampled health centre. Dietary diversity was measured using Minimum Dietary Diversity for Women (MDD-W), and multiple logistic regression models were fitted to identify factors associated with dietary diversity. Only 44.1% (95% confidence interval (CI) of [40.1%, 48.0%]) of participants had adequate dietary diversity. Approximately 95.4% of participants consumed grains, white roots, and tubers. The food groups that were the least consumed consisted of eggs (n = 99, 16.4%), as well as those consisting of milk and milk products (n = 112, 18.5%). The factors which were positively associated with dietary diversity were owning a radio (adjusted odds ratio [aOR] = 1.90 [95% CI 1.27, 2.85]), maternal education (aOR = 1.85 [95% CI 1.28, 2.65]), having a kitchen garden (aOR = 1.69 [95% CI 1.11, 2.57]) and nutrition knowledge score (aOR = 1.45 [95% CI 1.21, 1.74]) for a five-point increase in nutrition knowledge score. The factors negatively associated with dietary diversity include food insecurity, which reduced the odds of dietary diversity (aOR = 0.19 [0.07, 0.50]) per five-unit increase in food insecurity. Furthermore, the odds of adequate dietary diversity were lower among urban residents than rural residents (aOR = 0.69 [0.47, 1.03]). The household size was associated with dietary diversity with the odds of dietary diversity decreasing by 12% for a five-unit increase in household size (aOR = 0.88 [0.79; 0.99]). 23% had poor nutritional status, indicated by their mid-upper arm circumference (MUAC; < 23 cm). Enhanced nutritional education is needed to improve the nutritional knowledge of this population with particular emphasis on the consumption of animal-source foods. Sensitisation activities promoting ownership of kitchen gardens and radios could improve dietary diversity among Rwanda's pregnant women.
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Affiliation(s)
- Aline Uwase
- University of Rwanda College of Medicine and Health Sciences, Kigali, Rwanda
| | - Etienne Nsereko
- University of Rwanda College of Medicine and Health Sciences, Kigali, Rwanda
| | - Nirvana Pillay
- University of Witwatersrand School of Public Health, Johannesburg, South Africa
| | - Jonathan Levin
- University of Witwatersrand School of Public Health, Pretoria, South Africa
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6
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Al-Abri K, Edge D, Armitage CJ. Prospective analysis of factors associated with perinatal depression. Midwifery 2024; 128:103871. [PMID: 37967499 DOI: 10.1016/j.midw.2023.103871] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2023] [Revised: 09/13/2023] [Accepted: 11/01/2023] [Indexed: 11/17/2023]
Abstract
BACKGROUND Perinatal depression is a significant public health problem that has adverse effects on both mothers and infants. Little research has been conducted on how depressive symptoms change throughout the perinatal period, especially in the Middle East. This study examines changes in depressive symptoms from pregnancy to the postnatal period, and what explains these changes. METHODS This prospective study recruited 306 Omani women in the third trimester of pregnancy and followed them up two to eight weeks after delivery. The Edinburgh Postnatal Depression Scale (EPDS), with a cut-off of ≥12, was used to assess depressive symptoms in both the antenatal and postnatal periods. Independent t-tests, one-way ANOVA, Tukey's honestly significant difference test and Chi-square tests were used to analyse the data. RESULTS The prevalence of depressive symptoms was 27.12 % (n = 83) during late pregnancy and 29.30 % (n = 81) during the postnatal period. Four groups of women were identified based on the EPDS scores: 1) antenatal depression group (8.82 %; n = 27); 2) ante- and postnatal depression group (14.38 %; n = 44); 3) postnatal depression group (12.09 %; n = 37); and 4) non-depression group (54.90 %; n = 168). Depressive symptoms were associated with low birth weight babies (d = 0.50), which confirms the negative effects of depression on perinatal health outcomes. When compared to the non-depression group, the three depressed groups had higher antenatal Perceived Stress Scale (PSS) scores (ds > 0.52), while the non-depression group had higher antenatal and postnatal Maternity Social Support Scale (MSSS) scores (ds > 0.63), and better relationships with the mother-in-law antenatally (d= 0.57). CONCLUSION The present study of this Middle Eastern cohort shows that there were distinct groups of women experiencing perinatal depressive symptoms, influenced by various psychosocial and obstetric factors, which were comparable to those identified in more regularly studied populations. However, this study also identified other novel factors, such as the quality of family relationships. There is a need for additional research into the factors associated with these groups in order to develop appropriate interventions.
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Affiliation(s)
- Khalood Al-Abri
- Division of Psychology and Mental Health, University of Manchester, G35 Coupland 1 Building, Manchester, UK; Department of Community and Mental Health, College of Nursing, Sultan Qaboos University, Oman.
| | - Dawn Edge
- Division of Psychology and Mental Health, University of Manchester, G35 Coupland 1 Building, Manchester, UK; Equality, Diversity & Inclusion Research Unit, Greater Manchester Mental Health NHS Trust, UK
| | - Christopher J Armitage
- Division of Psychology and Mental Health, University of Manchester, G35 Coupland 1 Building, Manchester, UK; Manchester Academic Health Science Centre, Manchester University NHS Foundation Trust, UK; NIHR Greater Manchester Patient Safety Translational Research Centre, University of Manchester, UK
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Bahrami‐Samani S, Omidvar S, Mohsenzadeh‐Ledari F, Azizi A, Ashrafpour M, Kordbagheri M. The relationship between perceived stress and pregnancy distress with self-care of pregnant women: The mediating role of social support-A cross-sectional study. Health Sci Rep 2023; 6:e1730. [PMID: 38028701 PMCID: PMC10663433 DOI: 10.1002/hsr2.1730] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Revised: 10/19/2023] [Accepted: 11/05/2023] [Indexed: 12/01/2023] Open
Abstract
Background and Aims Pregnancy is a stressful experience, which can affect different aspects of a woman's life. Yet, women with a supportive network of friends and family may experience lower stress and improved self-care behavior. The study aimed to investigate the relationship between perceived stress and pregnancy distress with the self-care of pregnant women, as well as the mediating role of social support. Methods This cross-sectional study was conducted from February to May 2022 in Babol, Iran. A total of 157 pregnant women participated in the study. The participants completed five questionnaires, including a demographic and obstetric questionnaire, a Self-care questionnaire, Perceived Social support (PSS), Perceived Stress Inventory (PSI), and Pregnancy Specific Distress. Structural equation modeling was used to test the hypothesis relationships among the variables. Results We found that Perceived stress (β = -0.221, p = 0.012β) and pregnancy distress (β = -0.203, p = 0.002β) had a negative and significant effect on the self-care of pregnant women. Also, perceived stress (β = -0.429, p < 0.001β) and pregnancy distress (β = -0.381, p < 0.001β) had a negative and significant effect on the social support of pregnant women. The results exhibited a significant specific indirect effect between pregnancy distress, perceived stress, and pregnancy self-care, with social support as the mediator: standardized indirect effect = -0.068, -0.076, respectively. Conclusion According to the findings, social support plays a direct and mediating role in improving self-care behaviors among pregnant women. Therefore, providing strategies and measures to improve perceived social support by maternal health professionals may be expected to reduce the impact of stress on pregnant women's self-care. The implementation of policies and social interventions to improve the social support of pregnant women can be one of the applications of the findings.
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Affiliation(s)
| | - Shabnam Omidvar
- Social Determinants of Health Research Center, Health Research InstituteBabol University of Medical SciencesBabolI.R. Iran
| | - Farideh Mohsenzadeh‐Ledari
- Social Determinants of Health Research Center, Health Research InstituteBabol University of Medical SciencesBabolI.R. Iran
| | - Alireza Azizi
- Social Determinants of Health Research Center, Health Research InstituteBabol University of Medical SciencesBabolI.R. Iran
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Wedajo LF, Mamo AM, Alemu SS, Mesfin BA. Extended postpartum intimate partner violence and its associated factors: community-based cross-sectional study design. BMC Womens Health 2023; 23:501. [PMID: 37730570 PMCID: PMC10512573 DOI: 10.1186/s12905-023-02649-w] [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: 10/25/2022] [Accepted: 09/11/2023] [Indexed: 09/22/2023] Open
Abstract
BACKGROUND Intimate partner violence is a global problem that threatens mothers. It has multidimensional consequences but has not gained attention from scholars after childbirth. OBJECTIVE To assess the prevalence of extended postpartum intimate partner violence and its associated factors. METHOD A community-based cross-sectional study design was employed among 570 postpartum mothers in Arba Minch Town, Southern Ethiopia, from May 21st to June 21st, 2022. A pretested, face-to-face interviewer-administered structured questionnaire was used. Bivariable and multivariable logistic regression analyses were used. The level of statistical significance was declared at P < 0.05 with a 95% CI. RESULTS Overall, the prevalence of extended postpartum intimate partner violence was 45% (95% CI: 40.89, 49.20). Participants whose husband has no formal education (AOR = 3.62; 95%CI: 1.32, 9.90) and only secondary education (AOR = 2.96; 95%CI: 1.56, 5.48), husband alcohol consumption (AOR = 1.73; 95%CI: 1.06, 2.80), husband dominance in decision-making (AOR = 1.94; 95%CI: 1.13, 3.33), husband disappointment in the gender of the baby (AOR = 2.13; 95%CI: 1.28, 3.56), previous history of intimate partner violence (AOR = 5.71; 95%CI: 3.59, 9.07), and low social support (AOR = 4.37; 95%CI: 2.53, 7.55) were significantly associated factors. CONCLUSIONS AND RECOMMENDATIONS The prevalence of extended postpartum intimate partner violence was found to be high. Thus, increasing awareness of husbands with no formal education and having lower academic achievement, incorporating maternal social support assessment into maternity and child health care; teaching on alcohol reduction behavior and gender roles; and screening of mothers during the prenatal period should be given.
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Affiliation(s)
- Lema Fikadu Wedajo
- Department of Midwifery, College of medical and Health Sciences, Mettu University, Metu, Ethiopia.
| | - Abera Mersha Mamo
- Departments of Nursing, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, Ethiopia
| | - Solomon Seyife Alemu
- Department of Midwifery, College of medical and Health Sciences, Mettu University, Metu, Ethiopia
| | - Bezawit Afework Mesfin
- Departments of Midwifery, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, Ethiopia
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Fransquet PD, Macdonald JA, Ryan J, Greenwood CJ, Olsson CA. Exploring perinatal biopsychosocial factors and epigenetic age in 1-year-old offspring. Epigenomics 2023; 15:927-939. [PMID: 37905426 DOI: 10.2217/epi-2023-0284] [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: 11/02/2023] Open
Abstract
Background: Little is known about the determinants of epigenetic aging in pediatric populations. Methods: Epigenetic age was estimated from 258 1-year-olds, using pediatric buccal epigenetic and Horvath clocks. We explored associations between epigenetic age and maternal indicators of mental and relational health, substance use and general physical health assessed during trimester three. Results: Higher anxiety and stress, BMI and higher parent-parent relationship quality were associated with pediatric buccal epigenetic clock differences. High blood pressure during pregnancy was associated with Horvath age acceleration. Third-trimester smoking and pre-pregnancy weight were associated with acceleration and deceleration respectively, and concordant across clocks. Conclusion: A broad range of maternal factors may shape epigenetic age in infancy; further research is needed to explore the possible effects on health and development.
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Affiliation(s)
- Peter D Fransquet
- Deakin University, Centre for Social & Early Emotional Development, School of Psychology, Faculty of Health, Geelong, Victoria, Australia
| | - Jacqui A Macdonald
- Deakin University, Centre for Social & Early Emotional Development, School of Psychology, Faculty of Health, Geelong, Victoria, Australia
- Murdoch Children's Research Institute, Population Studies of Adolescents, The Royal Children's Hospital Melbourne, Parkville, Victoria, Australia
- The University of Melbourne, Department of Paediatrics, The Royal Children's Hospital Melbourne, Parkville, Victoria, Australia
| | - Joanne Ryan
- School of Public Health & Preventive Medicine, Monash University, Melbourne, VIC 3004, Australia
| | - Christopher J Greenwood
- Deakin University, Centre for Social & Early Emotional Development, School of Psychology, Faculty of Health, Geelong, Victoria, Australia
- Murdoch Children's Research Institute, Population Studies of Adolescents, The Royal Children's Hospital Melbourne, Parkville, Victoria, Australia
- The University of Melbourne, Department of Paediatrics, The Royal Children's Hospital Melbourne, Parkville, Victoria, Australia
| | - Craig A Olsson
- Deakin University, Centre for Social & Early Emotional Development, School of Psychology, Faculty of Health, Geelong, Victoria, Australia
- Murdoch Children's Research Institute, Population Studies of Adolescents, The Royal Children's Hospital Melbourne, Parkville, Victoria, Australia
- The University of Melbourne, Department of Paediatrics, The Royal Children's Hospital Melbourne, Parkville, Victoria, Australia
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10
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Umuziga PM, Gishoma D, Hynie M, Nyirazinyoye L, Nsereko E. Predicting postnatal depressive symptoms in a prospective cohort study in Rwanda: the impact of poor maternal social support. Front Glob Womens Health 2023; 4:1113483. [PMID: 37547130 PMCID: PMC10402918 DOI: 10.3389/fgwh.2023.1113483] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Accepted: 06/26/2023] [Indexed: 08/08/2023] Open
Abstract
Background Postnatal depression is a significant public health issue that demands attention, and recent evidence indicates that rates are relatively high in low-income countries such as Rwanda. However, lack of social support is recognized as a potential risk factor for postnatal depressive symptoms. This study sought to explore the influence of poor maternal social support on postnatal depressive symptoms in a sample of women in Rwanda. Method A prospective cohort research design was conducted with women recruited from four different health centers in Rwanda's Southern Province. A sample of 396 pregnant women accessing antenatal care services was recruited at the baseline from their late second term or later, then followed up after giving birth. The dropout rate was 21.46%; thus, the data of 311 women were analyzed. The outcome variable was the presence of depressive symptoms (Edinburgh Postnatal Depression Scale (EPDS) (≥12 cut-off score), while predictor variables included maternal social support measured using a modified Maternal Social Support Scale (MSSS), perceived health status, socio-demographic information (marital status, wealth class, age, education, occupation), negative life events, gestational and obstetric information (parity, pregnancy intention, age at birth, children given birth, and mode of delivery). Univariate and multivariate analyses were performed. Results From a sample of 311 participants, over a quarter (20.9%) had elevated postnatal depressive symptoms (EPDS ≥ 12 scores). Elevated scores were predicted by poor perceived health status; respondents reporting neither poor nor good (AOR = 0.28, CI = 0.11; 0.72, p = 0.007) or good health (AOR = 0.14, CI = 0.05; 0.37, p = 0.001) were less likely to be affected. Poor maternal social support was also linked with postnatal depressive symptoms; poor partner support (AOR = 4.22; CI = 1.44; 12.34; p = 0.009) was associated with high risk, while good friend support (AOR = 0.47, CI = 0.23; 0.98, p = 0.04) was a significant protector. Additionally, violence or negative life events were also independent predictors of postnatal depressive symptoms (AOR: 2.94, CI: 1.37-6.29, p = 0.005). Conclusion Postnatal depressive symptoms were found to affect one in five Rwandan women. However, good maternal social support can be a strong protector. Early interventions targeting mothers in the postnatal period and strengthened social support networks for women at risk should be developed.
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Affiliation(s)
- Providence M. Umuziga
- Department of Mental Health Nursing, College of Medicine and Health Sciences, School of Nursing and Midwifery, University of Rwanda, Kigali, Rwanda
| | - Darius Gishoma
- Department of Mental Health Nursing, College of Medicine and Health Sciences, School of Nursing and Midwifery, University of Rwanda, Kigali, Rwanda
| | - Michaela Hynie
- Department of Psychology, York University, Toronto, ON, Canada
| | - Laetitia Nyirazinyoye
- School of Public Health, College of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda
| | - Etienne Nsereko
- School of Health Sciences, College of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda
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Scandurra C, Mezzalira S, Aviani S, Lastra V, Bochicchio V, Zapparella R, Saccone G, Maldonato NM, Locci M. Perinatal depression during the fourth wave of the COVID-19 outbreak in a single prenatal clinic in Southern Italy: The role of loneliness, anxiety, and maternal support. JOURNAL OF AFFECTIVE DISORDERS REPORTS 2023; 13:100585. [PMID: 37152681 PMCID: PMC10141786 DOI: 10.1016/j.jadr.2023.100585] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Revised: 03/15/2023] [Accepted: 04/27/2023] [Indexed: 05/09/2023] Open
Abstract
Background The current study aimed at assessing the levels of perinatal depression (i.e., both antenatal and postnatal) during the fourth wave of the COVID-19 outbreak in a group of Italian women, as well as to evaluate the role of loneliness, anxiety, and lack of maternal support in cumulatively predicting perinatal depression. Methods A cross-sectional study was conducted with 200 Italian women recruited during a peak of the COVID-19 pandemic in Italy (i.e., from September to December 2021) from a single prenatal clinic in Southern Italy. A non-parametric binomial test was conducted to assess whether the perinatal depression frequencies of the current sample differed from those found in a pre-Covid reference group. Additionally, hierarchical multiple linear regression analyses assessing whether loneliness, anxiety, and maternal support affected women's perinatal depression were also conducted. Results The general prevalence of perinatal depression was significantly higher in participants recruited during the fourth wave of the COVID-19 pandemic compared to the pre-Covid reference group (29% vs. 9.2%). However, results showed that, contrary to postnatal depression (18.2% vs. 19.9%), only the prevalence of antenatal depression was significantly higher compared to the pre-Covid reference group (39.6% vs. 6.4%). Furthermore, loneliness and anxiety, but not maternal support, were associated with higher levels of PD. Limitations Limitations concerned the cross-sectional nature of the study and the relatively small sample size. Conclusions This study sheds light on the need to address perinatal mental health of women during major stressful events, such as the COVID-19 pandemic.
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Affiliation(s)
- Cristiano Scandurra
- Department of Neuroscience, Reproductive Sciences and Dentistry, University of Naples Federico II, Via Sergio Pansini 5, Napoli 80133, Italy
| | - Selene Mezzalira
- Department of Humanistic Studies, University of Calabria, Via Ponte Bucci Cubo 18/C, Rende 87036, Italy
| | - Silvia Aviani
- Intradepartmental Program of Clinical Psychology, Federico II University Hospital, Via Sergio Pansini 5, Napoli 80133, Italy
| | - Valeria Lastra
- Department of Neuroscience, Reproductive Sciences and Dentistry, University of Naples Federico II, Via Sergio Pansini 5, Napoli 80133, Italy
| | - Vincenzo Bochicchio
- Department of Humanistic Studies, University of Calabria, Via Ponte Bucci Cubo 18/C, Rende 87036, Italy
| | - Rosanna Zapparella
- Department of Neuroscience, Reproductive Sciences and Dentistry, University of Naples Federico II, Via Sergio Pansini 5, Napoli 80133, Italy
| | - Gabriele Saccone
- Department of Neuroscience, Reproductive Sciences and Dentistry, University of Naples Federico II, Via Sergio Pansini 5, Napoli 80133, Italy
| | - Nelson Mauro Maldonato
- Department of Neuroscience, Reproductive Sciences and Dentistry, University of Naples Federico II, Via Sergio Pansini 5, Napoli 80133, Italy
| | - Mariavittoria Locci
- Department of Neuroscience, Reproductive Sciences and Dentistry, University of Naples Federico II, Via Sergio Pansini 5, Napoli 80133, Italy
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Wedajo LF, Alemu SS, Jarso MH, Golge AM, Dirirsa DE. Late postpartum depression and associated factors: community-based cross-sectional study. BMC Womens Health 2023; 23:280. [PMID: 37221573 DOI: 10.1186/s12905-023-02444-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Accepted: 05/18/2023] [Indexed: 05/25/2023] Open
Abstract
BACKGROUND Late postpartum depression is the presence of depressive symptoms beyond the early postpartum period and is a significant mental health problem that has a devastating impact on mothers, infants, partners, family members, the healthcare system, and the world's economy. However, there is limited information regarding this problem in Ethiopia. OBJECTIVE To assess the prevalence of late postpartum depression and associated factors. METHOD the community-based cross-sectional study was employed among 479 postpartum mothers in Arba Minch town from May 21 to June 21, 2022. The pre-tested face-to-face interviewer administered a structured questionnaire used to collect the data. A bivariate and multivariable analysis was done using a binary logistic regression model to identify factors associated with late postpartum depression. Both crude and adjusted odds ratios with 95% CI were calculated, and a p-value of < 0.05 was used to declare statistically significant factors. RESULT The prevalence of late postpartum depression was 22.98% (95% CI: 19.16, 26.80). Husband Khat use (AOR = 2.64; 95% CI: 1.18, 5.91), partner dissatisfaction with the gender of the baby (AOR = 2.53; 95% CI: 1.22, 5.24), short inter-delivery interval (AOR = 6.80; 95% CI: 3.34, 13.84), difficulty to meet husband sexual need (AOR = 3.21; 95% CI: 1.62, 6.37), postpartum intimate partner violence (AOR = 4.08; 95% CI: 1.95, 8.54), and low social support (AOR = 2.50; 95% CI: 1.25, 4.50) were significantly associated factors at p-value < 0.05. CONCLUSION Overall, 22.98% of mothers suffered from late postpartum depression. Therefore, based on the identified factors, the Ministry of Health, Zonal Health Departments, and other responsible agencies should establish effective strategies to overcome this problem.
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Affiliation(s)
- Lema Fikadu Wedajo
- Department of Midwifery, Mattu University College of medical and Health Sciences, Mattu, Ethiopia.
| | - Solomon Seyife Alemu
- Department of Midwifery, Mattu University College of medical and Health Sciences, Mattu, Ethiopia
- Department of Midwifery, Madda Walabu University College of Medicine and Health Sciences, Sheshemene, Ethiopia
| | - Mohammedamin Hajure Jarso
- Department of Psychiatry, Walabu University College of Medicine and Health Sciences, Sheshemene, Ethiopia
| | - Aman Mamo Golge
- Department of Nursing, Madda Walabu University College of Medicine and Health Sciences, Sheshemene, Ethiopia
| | - Dejene Edosa Dirirsa
- College of Medicine and Health Sciences, Department of Midwifery, Salale University, Salale, Ethiopia
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Mprah A, Haith-Cooper M, Duda-Mikulin E, Meddings F. A systematic review and narrative synthesis of fathers' (including migrant fathers') experiences of pregnancy and childbirth. BMC Pregnancy Childbirth 2023; 23:238. [PMID: 37041486 PMCID: PMC10088224 DOI: 10.1186/s12884-023-05568-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Accepted: 04/01/2023] [Indexed: 04/13/2023] Open
Abstract
OBJECTIVE The purpose of this review was to consider factors that influence the experiences of pregnancy and childbirth by fathers including migrant fathers. METHOD A systematic review and narrative synthesis were conducted as per the PRISMA guidelines. The spider tool was used to build a search strategy which was used to conduct literature search in eight identified electronic databases: ASSIA, CINAHL, EMBASE, MEDLINE, PsycINFO, PUBMED, Sage and Scopus. Grey literature was searched through the King's Fund Library database, Ethos, The North Grey Literature Collection, Social Care Online and other charity websites such as the Refugee Council and Joseph Rowntree Foundation. The search was conducted across all the databases in the week commencing January 7, 2019, and restricted to studies published in the English language. RESULTS The search across all the eight electronic databases identified 2564 records, 13 records through grey literature databases/websites and an additional 23 records identified through hand-searching/forward citation. The number of records after duplicates were removed was 2229. Record screening based on titles and abstracts identified 69 records for full text screening. Dual screening of these full text records identified 12 full records from 12 separate studies, eight of which were qualitative studies, three of which were quantitative studies and one mixed method study. FINDINGS This review has revealed three main themes: influence of society and health professionals; adjustment to a new life of fatherhood; and involvement in maternity care. However, the literature has focused on non-migrant father's experiences of pregnancy and childbirth, with little attention paid to fathers who may be migrants. KEY CONCLUSION AND IMPLICATIONS FOR PRACTICE This review has exposed a dearth of research on migrant fathers' experiences of pregnancy and childbirth in an era of increasing globalisation and migration between countries. Midwives and other health professionals should be alert to the needs of any father when providing maternity care. More research is needed which considers experiences of migrants and how choosing to move to a new country or being forced to move could influence migrant father's experiences and therefore their needs.
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Affiliation(s)
- Andy Mprah
- Faculty of Health Studies, University of Bradford, Richmond Road, Bradford, BD7 1DP, UK.
| | - Melanie Haith-Cooper
- Faculty of Health Studies, University of Bradford, Richmond Road, Bradford, BD7 1DP, UK
| | - Eva Duda-Mikulin
- Centre for Interdisciplinary Research into Health and Illness, University of Wroclaw, Wroclaw, Poland
| | - Fiona Meddings
- Faculty of Health Sciences, University of York, Seebohm Rowntree Building, Heslington, York, YO10 5DD, UK
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Coca KP, Chien LY, Lee EY, Souza ACDP, Hong SA, Chang YS. Factors associated with postpartum depression symptoms among postpartum women in five countries during the COVID-19 pandemic: an online cross-sectional study. BMC Psychiatry 2023; 23:171. [PMID: 36922822 PMCID: PMC10016169 DOI: 10.1186/s12888-023-04607-0] [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] [Received: 10/23/2022] [Accepted: 02/13/2023] [Indexed: 03/17/2023] Open
Abstract
BACKGROUND This study aimed to examine factors associated with postpartum depression (PPD) symptoms during the COVID-19 pandemic among postpartum women in five countries, a subject that has not been investigated thus far. METHODS A multi-country, cross-sectional, online survey was conducted with a convenience sample of 3,523 postpartum women in Brazil, South Korea, Taiwan, Thailand, and the United Kingdom, from July to November 2021. Sociodemographic and obstetric data, food insecurity, COVID-19 positive status, COVID-19 vaccination, infant feeding, breastfeeding belief score, and social support were investigated. PPD and social support were measured using the Edinburgh Postnatal Depression Scale and Maternal Social Support Scale, respectively. Descriptive statistics, chi-squared tests, and t-tests were used to identify associations with PPD symptoms. A binary logistic regression model was used to identify explanatory factors associated with PPD and adjusted odds ratios (OR) and 95% confidence intervals (CIs) were calculated. RESULTS Women in Taiwan (AOR = 0.5; 95%CI 0.34, 0.73) and Thailand (AOR = 0.68; 95%CI 0.46, 0.99) had a lower risk of PPD symptoms than those in Brazil. In addition, women with planned pregnancies had a lower risk of PPD (AOR = 0.74; 95%CI 0.60, 0.91). Younger women (AOR = 1.62; 95%CI 1.05, 2.51), health problems during pregnancy, delivery, or postpartum (AOR = 1.71; 95%CI 1.42, 2.06), and no change or worse food insecurity during COVID-19 (AOR = 1.66; 95%CI 1.21, 1.27 for no change and AOR = 1.68; 95%CI 1.27, 1.23, respectively) presented a higher likelihood of having PPD. Feeding babies with expressed human milk (AOR = 1.25; 95%CI 1.03, 1.50) and/or complementary food (AOR = 1.51; 95%CI 1.17, 1.94) were associated with PPD symptoms. Women who received low (AOR = 7.74; 95%CI 5.43, 11.03) or medium support (AOR = 3.25; 95%CI 2.71, 3.88) had higher likelihoods of PPD. CONCLUSION PPD symptoms during the pandemic were high in young women, particularly Brazilian women, with health problems in the puerperal pregnancy cycle who fed their babies expressed breast milk and/or complementary food. Low social support also impacted PPD symptoms. This study highlights the need for the professional screening for PPD and provision of virtual or personal support.
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Affiliation(s)
- Kelly Pereira Coca
- Escola Paulista de Enfermagem, Universidade Federal de São Paulo, São Paulo, Brazil
| | - Li-Yin Chien
- Institute of Community Health Care, College of Nursing, National Yang Ming Chiao Tung University, Yang-Ming Campus, Taipei, Taiwan
| | - Eun Young Lee
- Department of Nursing, Catholic Kkottongnae University, Cheongju, Republic of Korea
| | | | - Seo Ah Hong
- ASEAN Institute for Health Development, Institute for Health and Society, Mahidol University, Hanyang University, Seoul, Republic of Korea.
- ASEAN Institute for Health Development, Mahidol University, Salaya, Thailand.
| | - Yan-Shing Chang
- Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, King's College London, London, UK
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Psychosocial Risk Factors and Psychopathological Outcomes: Preliminary Findings in Italian Pregnant Women. WOMEN 2023. [DOI: 10.3390/women3010010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/04/2023] Open
Abstract
The perinatal period may represent a particularly challenging time for expecting parents. Previous studies have highlighted an association between several perinatal risk conditions (e.g., childhood maltreatment, poor social support, and stress levels) and the development of psychopathological symptoms in pregnant women, especially depression symptoms. The current study examined the effects of psychosocial risk factors (childhood maltreatment, poor social support, and stressful events) on anxiety, depression, perceived stress, irritability/anger, relationship problems, psychosomatic symptoms, specific physiological problems, and addiction/at-risk behaviors. Sixty-one pregnant women (age range = 24–45) participating in a larger study completed questionnaires about childhood maltreatment (CECA Q.), Maternity Social Support Scale (MSSS), questionnaire on stressful events, and the Perinatal Assessment of Maternal Affectivity (PAMA) during their pregnancy. Results from regression analysis indicated that the presence of childhood maltreatment predicted elevated depressive symptoms, elevated irritability and anger, and elevated relationship problems. Further, stressful events in the year prior to pregnancy predicted elevated psychosomatic symptoms during pregnancy. No other significant associations were found. In this study, traumatic childhood events were strongly associated with mental health symptoms during pregnancy. This is an important finding that suggests the importance of screening and targeting psychotherapeutic interventions for vulnerable women during pregnancy.
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Xia ML, Lin WX, Gao LL, Zhang ML, Li ZY, Zeng LL. Readiness for Hospital Discharge After a Cesarean Section and Associated Factors Among Chinese Mothers: A Single Centre Cross-Sectional Study. Patient Prefer Adherence 2023; 17:1005-1015. [PMID: 37077667 PMCID: PMC10106991 DOI: 10.2147/ppa.s404137] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Accepted: 04/04/2023] [Indexed: 04/21/2023] Open
Abstract
Purpose Knowledge of the readiness for hospital discharge can help health care professionals accurately determine the patients' discharge time. However, few studies were on the readiness for discharge and its related factors among mothers with cesarean sections. Thus, this study aims to examine the readiness for hospital discharge and its associated factors among Chinese mothers with cesarean sections. Patients and Methods A single-centre cross-sectional study was conducted from September 2020 to March 2021 in Guangzhou, China. Three hundred thirty-nine mothers with cesarean sections completed the questionnaires on demographic and obstetric characteristics, readiness for hospital discharge, quality for discharge teaching, parenting sense of competence, family function, and social support. Multiple linear regression analysis was used to identify independent factors influencing readiness for hospital discharge among mothers with cesarean sections. Results The total score of readiness for hospital discharge was 136.47 ± 25.29. The quality of discharge teaching, parenting sense of competence, number of cesareans, family function, and attending antenatal classes were independent factors influencing the readiness for hospital discharge (P < 0.05) among mothers with cesarean sections. Conclusion The readiness for hospital discharge of mothers with cesarean sections need to be improved. Improving the quality of discharge teaching, parenting sense of competence, and family function may help improve the readiness for hospital discharge of mothers with cesarean sections.
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Affiliation(s)
- Mei-Ling Xia
- Reproductive Centre, Guangdong Women and Children Hospital, Guangzhou, People’s Republic of China
| | - Wen-Xuan Lin
- Nursing Department, Guangdong Women and Children Hospital, Guangzhou, People’s Republic of China
| | - Ling-Ling Gao
- School of Nursing, Sun Yat-Sen University, Guangzhou, People’s Republic of China
- Correspondence: Ling-Ling Gao, School of Nursing, Sun Yat-sen University, Guangzhou, People’s Republic of China, Tel +86-20-87335013, Fax +86-20-87333043, Email
| | - Mao-Ling Zhang
- Reproductive Centre, Guangdong Women and Children Hospital, Guangzhou, People’s Republic of China
| | - Zhi-Yun Li
- Obstetric Department, Guangdong Women and Children Hospital, Guangzhou, People’s Republic of China
| | - Li-Ling Zeng
- Obstetric Department, Guangdong Women and Children Hospital, Guangzhou, People’s Republic of China
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Wheeler SM, Massengale KE, Fitzgerald TA, Truong T, Østbye T, Corneli A, Swamy GK. IMPaCT: A Pilot Randomized Trial of an Intervention to Reduce Preterm Birth Among Non-Hispanic Black Patients at High Risk. Health Equity 2022; 6:922-932. [PMID: 36636112 PMCID: PMC9811828 DOI: 10.1089/heq.2022.0089] [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] [Accepted: 11/15/2022] [Indexed: 12/29/2022] Open
Abstract
Introduction Preterm birth is a major cause of neonatal morbidity and mortality rate. Non-Hispanic black patients disproportionately experience preterm birth and nonadherence to evidence-based preventive measures. Interventions tailored to non-Hispanic black birthing individuals (NHBBIs) that address barriers to preterm birth preventions are urgently needed. Methods Together with a community-engaged multidisciplinary stakeholder group, we developed an intervention to improve adherence to preterm birth preventions among black pregnant patients with prior preterm birth. The intervention included the following: (1) preterm birth prevention education, (2) an employment navigation toolkit, and (3) encouragement text messages. We piloted the intervention by recruiting self-identified non-Hispanic black patients at or before 20 weeks of gestation with a prior preterm birth and randomizing them to the intervention or an active control. The primary outcomes were feasibility and acceptability. Our secondary outcomes were preliminary efficacy based on birth outcomes, patient experience, and pregnancy-specific anxiety (PSA). Descriptive statistics, analysis of verbatim survey responses, Wilcoxon signed rank, and Fisher's exact were used to describe and compare quantitative and qualitative data. Results We identified 53 individuals who met the inclusion criteria, 35 were reachable remotely and 30 were enrolled and randomized. More than 80% (n=26) were retained throughout the study, and 100% of participants identified at least one intervention component as helpful. In this small pilot, there were no detectable differences in adherence to preterm birth preventive recommendations. No difference in preterm births, other pregnancy, or patient experience outcomes was detected between the intervention and active control participants. Discussion The intervention is feasible and acceptable. Larger, appropriately powered studies are needed to assess whether the intervention will decrease PSA and reduce preterm birth. This trial was registered with ClinicalTrials.gov (NCT04933812).
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Affiliation(s)
- Sarahn M. Wheeler
- Division of Maternal and Fetal Medicine, Department of Obstetrics and Gynecology, Duke University School of Medicine, Durham, North Carolina, USA
- Address correspondence to: Sarahn M. Wheeler, MD, Division of Maternal and Fetal Medicine, Department of Obstetrics and Gynecology, Duke University School of Medicine, 2608 Erwin Road #210, Durham, NC 27710, USA.
| | | | - Thelma A. Fitzgerald
- Division of Maternal and Fetal Medicine, Department of Obstetrics and Gynecology, Duke University School of Medicine, Durham, North Carolina, USA
| | - Tracy Truong
- Department of Biostatistics and Bioinformatics, Duke University School of Medicine, Durham, North Carolina, USA
| | - Truls Østbye
- Department of Family Medicine and Community Health, Duke University School of Medicine, Durham, North Carolina, USA
| | - Amy Corneli
- Department of Population Health Sciences, Duke University School of Medicine, Durham, North Carolina, USA
| | - Geeta K. Swamy
- Division of Maternal and Fetal Medicine, Department of Obstetrics and Gynecology, Duke University School of Medicine, Durham, North Carolina, USA
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Wheeler SM, Jackson M, Massengale KEC, Ramey-Collier K, Østbye T, Corneli A, Bosworth H, Swamy G. EngagINg the COmmunity to Reduce Preterm birth via Adherence To an Individualized Prematurity Prevention Plan (INCORPorATe IP3): intervention development and future pilot study design. J Matern Fetal Neonatal Med 2022; 35:8559-8565. [PMID: 34663168 PMCID: PMC10509753 DOI: 10.1080/14767058.2021.1988565] [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: 06/17/2021] [Revised: 09/27/2021] [Accepted: 09/29/2021] [Indexed: 10/20/2022]
Abstract
OBJECTIVE Non-Hispanic Black birthing individuals are at increased risk of preterm birth compared to other racial and ethnic groups. In our clinical setting, we offer a tailored package of recommendations to reduce the risk of preterm birth known as an individualized prematurity prevention plan (IP3). Patient-centered, community engaged interventions that address patient-perceived barriers to preterm birth prevention are urgently needed. MATERIALS AND METHODS We engaged a group of stakeholders to develop a mutli-level (patient-centered and community-involved) intervention that will increase adherence to an individualized prematurity prevention plan (IP3) by addressing barriers identified during our prior qualitative studies. RESULTS The intervention includes trained doulas from a community-led, Black owned doula group. The doulas will moderate group prenatal social support sessions. In between the group sessions, participants will be encouraged to continue interacting with one another and the doulas using a private Facebook™ group page. We will pilot test the intervention in a cohort of pregnant, self-identified non-Hispanic Black patients with a history of prior preterm birth. CONCLUSION We present a novel, patient-centered, community engaged intervention to reduce preterm birth in high-risk non-Hispanic Black birthing individuals. If the intervention is feasible based on the pilot study findings, we anticipate conducting an appropriately powered study to determine whether the intervention achieves our goal of reducing preterm birth.
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Affiliation(s)
- Sarahn M. Wheeler
- Department of Obstetrics and Gynecology, Division of Maternal and Fetal Medicine, Duke University School of Medicine, Durham, NC, USA
| | - Maya Jackson
- Mobilizing African American Mothers through Empowerment (MAAME), Inc., Durham, NC, USA
| | | | | | - Truls Østbye
- Department of Family Medicine and Community Health, Duke University School of Medicine, Durham, NC, USA
| | - Amy Corneli
- Department of Population Health Sciences, Duke University School of Medicine, Durham, NC, USA
| | - Hayden Bosworth
- Department of Population Health Sciences, Duke University School of Medicine, Durham, NC, USA
| | - Geeta Swamy
- Department of Obstetrics and Gynecology, Division of Maternal and Fetal Medicine, Duke University School of Medicine, Durham, NC, USA
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Grant D. The "Quiet Revolution" and the cesarean section in the United States. ECONOMICS AND HUMAN BIOLOGY 2022; 47:101192. [PMID: 36351359 DOI: 10.1016/j.ehb.2022.101192] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/20/2022] [Revised: 10/10/2022] [Accepted: 10/11/2022] [Indexed: 06/16/2023]
Abstract
This paper estimates how changes in family structure and women's labor market attachment during the last fifty years have affected the incidence of cesarean delivery in the United States. Both sets of factors are strongly related to cesarean utilization, and have generally changed so as to increase the rate of cesarean delivery over time. Altogether, changes in these factors, complemented by demographic changes, raised the U.S. cesarean section rate by eleven percentage points since the late 1970s, nearly two-thirds of the increase over that period. Today's elevated cesarean section rate is in part a social phenomenon.
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Affiliation(s)
- Darren Grant
- Department of Economics and International Business, Sam Houston State University, Box 2118, Huntsville, TX 77341-2118, USA.
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Worku WZ, Azale T, Ayele TA, Mekonnen DK. HIV is still a major public health problem among pregnant women attending ANC in Referral Hospitals of the Amhara Regional State, Ethiopia: a cross sectional study. BMC Womens Health 2022; 22:468. [PMID: 36434557 PMCID: PMC9701049 DOI: 10.1186/s12905-022-02059-4] [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: 07/28/2022] [Accepted: 11/10/2022] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND The burden of HIV is disproportionately higher among women of reproductive age contributing more than half of the global share. The situation in Ethiopia is not exceptional. The present study was done to determine the proportion of HIV among pregnant women in Amhara Regional State, Ethiopia. METHOD Institutions-based cross-sectional study was conducted from October 2020 to December 2020. Systematic random sampling technique was used to select 538 study participants from pregnant women who had ANC follow-up in Referral Hospitals of the Amhara Regional State. Data on socio-demographic, clinical, obstetric, behavioral as well as psychosocial characteristics were gathered using an interviewer administered structured and standardized instruments. The data was entered into Epi-Data Manager V4.6.0.0 and exported to STATA version 14 for data analyses. Descriptive statics were computed to summarize the participant's characteristics. Bi-variable and multivariable logistic regression analyses were conducted to identify the association between dependent and independent variables. Independent variables with a p-value of less than 0.05 were considered to be statistically significant at 95% confidence level (CI). RESULTS The proportion of HIV infection among pregnant women was 8.68% (95% CI: 6.5, 11.4). Completing secondary school education (Adjusted Odds Ratio (AOR = 0.15; 95% CI: 0.04-0.53), graduated from college (AOR = 0.03; 95% CI: 0.01-0.22), and family monthly income greater than 8001 ETB (1 USD = 56 ETB) (AOR = 0.19; 95% CI: 0.04-0.87) were protective factors associated with maternal HIV. On the other hand, history of previous abortion (AOR = 7.73; 95% CI: 3.33-17.95) and positive syphilis status (AOR = 10.28; 95% CI: 2.80-37.62) were risk factors associated with maternal HIV status. CONCLUSION The proportion of HIV infection among pregnant women was found to be high. Advanced level of education, relatively higher monthly income, history of abortion and previous syphilis status were associated factors with HIV status. Strengthening women's formal education; empowering women in all spheres of life (especially improving their economic standing that prevents women from engaging in risky sexual practices); educating women about HIV transmission methods and HIV prevention and control strategies using behavior change intervention strategy prepared for women to reduce their vulnerability; advocating for the use of family planning to reduce unsafe abortions and syphilis; as well as regular screening and testing for syphilis are recommended.
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Affiliation(s)
- Workie Zemene Worku
- grid.59547.3a0000 0000 8539 4635Department of Community Health Nursing, School of Nursing, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Telake Azale
- grid.59547.3a0000 0000 8539 4635Department of Health Education and Behavioral Sciences, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Tadesse Awoke Ayele
- grid.59547.3a0000 0000 8539 4635Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Dawit Kassahun Mekonnen
- grid.59547.3a0000 0000 8539 4635Department of Gynaecology and Obstetrics, School of Medicine, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
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21
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Wemakor A, Awuni V, Issah S. Maternal autonomy but not social support is a predictor of child feeding indicators in the Northern Region, Ghana. BMC Nutr 2022; 8:135. [PMID: 36401277 PMCID: PMC9673434 DOI: 10.1186/s40795-022-00630-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2022] [Accepted: 10/31/2022] [Indexed: 11/19/2022] Open
Abstract
Background Child malnutrition may be mediated by poor infant and young child feeding (IYCF) practices. This study sought to explore if maternal social support or autonomy was related to IYCF indicators in Northern Region, Ghana. Methods An analytical cross-sectional study was conducted with 395 randomly sampled mother–child pairs from 8 health facilities. Data were collected on socio-demographic characteristics, social support and autonomy statuses of mothers, and dietary intake and anthropometry of children. Maternal social support and autonomy statuses were derived and classified into tertiles and IYCF and child growth indicators were derived based on WHO protocol. Logistic regression analysis was used to explore the association of maternal social support and autonomy statuses to IYCF indicators and child nutritional status. Results The mean age of the women was 27 (± 5.10) years and most belonged to the lowest tertile of social support (52.4%), and autonomy (44.1%). About half of the children, 53.2% and 44.6%, received Minimum Dietary Diversity (MDD) and Minimum Acceptable Diet (MAD) respectively but the majority (72.9%) received Minimum Meal Frequency (MMF). About a fifth of the children, 21.0%, 24.1%, and 20.5%, were wasted, stunted, and underweight respectively. Maternal autonomy was associated with IYCF but not growth indicators of young children. Compared to children of mothers of richest autonomy tertile, children of women of middle autonomy tertile were 67% less likely to receive MDD [Adjusted Odds Ratio (AOR): 0.33; 95% Confidence Interval (CI): 0.18–0.59], and 56% less likely to receive MAD (AOR: 0.44; 95% CI: 0.24–0.77). Also, children belonging to mothers of poorest autonomy tertile were 56% less likely to receive MMF compared to children of richest maternal autonomy tertile (AOR: 0.44; 95% CI: 0.23–0.84). Conclusion Maternal autonomy and not social support is associated with IYCF indicators of children in Northern Ghana; child survival programmes should incorporate or strengthen women empowerment interventions to improve child nutrition. Supplementary Information The online version contains supplementary material available at 10.1186/s40795-022-00630-8.
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22
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Chang Y, Li KMC, Chien L, Lee EY, Hong SA, Coca KP. Associations between breastfeeding intention, breastfeeding practices and post-natal depression during the COVID-19 pandemic: A multi-country cross-sectional study. MATERNAL & CHILD NUTRITION 2022; 19:e13450. [PMID: 36349949 PMCID: PMC9749603 DOI: 10.1111/mcn.13450] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/24/2022] [Revised: 09/14/2022] [Accepted: 10/11/2022] [Indexed: 11/11/2022]
Abstract
Associations between breastfeeding intention, duration and post-natal depression (PND) have been shown in pre-COVID-19 studies. However, studies during COVID-19 have not examined the associations between breastfeeding intention, breastfeeding practices, and PND in an international sample of post-natal women, taking into consideration COVID-19 related factors. This is the first study to address this gap as both PND and breastfeeding may be affected by COVID-19, and have important long-term effects on women's and infant's health. A cross-sectional internet-based survey was conducted with 3253 post-natal women from five countries: Brazil, South Korea, Taiwan, Thailand, and the United Kingdom from July to November 2021. The results showed that women who intended to breastfeed during pregnancy had lower odds of having PND than women who did not intend to. Women who had no breastfeeding intention but actually breastfed had greater odds (AOR 1.75) of having PND than women who intended to breastfeed and actually breastfed. While there was no statistical significance in expressed breast milk feeding in multivariable logistic regression models, women who had shorter duration of breastfeeding directly on breast than they planned had greater odds (AOR 1.58) of having PND than those who breastfed longer than they planned even after adjusting for covariates including COVID-19-related variables. These findings suggested the importance of working with women on their breastfeeding intention. Tailored support is required to ensure women's breastfeeding needs are met and at the same time care for maternal mental health during and beyond the pandemic.
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Affiliation(s)
- Yan‐Shing Chang
- Florence Nightingale Faculty of Nursing, Midwifery & Palliative CareKing's College LondonLondonUK
| | - Kan M. C. Li
- Florence Nightingale Faculty of Nursing, Midwifery & Palliative CareKing's College LondonLondonUK,Guy's and St. Thomas' NHS Foundation TrustEvelina London Children's HospitalLondonUK
| | - Li‐Yin Chien
- Institute of Community Health Care, National Yang Ming Chiao Tung UniversityYang‐Ming CampusTaipeiTaiwan
| | - Eun Y. Lee
- Department of NursingCatholic Kkottongnae UniversityCheongjuRepublic of Korea
| | - Seo A. Hong
- ASEAN Institute for Health DevelopmentMahidol UniversityNakhon PathomThailand,Institute for Health and SocietyHanyang UniversitySeoulRepublic of Korea
| | - Kelly P. Coca
- Department of Women's Health Nursing, Escola Paulista de EnfermagemUniversidade Federal de São PauloSão PauloBrazil
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Belay S, Astatkie A, Hinderaker SG. Birth weight was associated with maternal exposure to intimate partner violence during pregnancy in southern Ethiopia: A prospective cohort study. Front Public Health 2022; 10:960443. [PMID: 36407992 PMCID: PMC9667023 DOI: 10.3389/fpubh.2022.960443] [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: 06/02/2022] [Accepted: 10/11/2022] [Indexed: 11/06/2022] Open
Abstract
Introduction Birth weight is defined as the first weight of the newborn, ideally measured soon after birth. A recent Ethiopian survey estimated that 48% of births took place in health facilities. Data for women exposed to intimate partner violence (IPV) may be lacking in official statistics because these women may prefer to deliver at home, where data from non-institutional births, including reporting of birth weights, are not routinely recorded. Objective The aim of this study was to investigate the association between maternal exposure to IPV during pregnancy and birth weight in a community in the Wondo Genet district of southern Ethiopia. Methods We carried out a community-based prospective cohort study from February to December 2017. We followed up with 505 pregnant women and their newborns until after delivery. An interview about partner violence was done during pregnancy at home when enrolled. Field assistants who visited the homes measured the birth weight of each baby in grams. Twins and late birth weight measurements were excluded. Factors associated with birth weight were assessed by multiple linear regression. Results Birth weight was assessed within 48 h for 477 (94.5%) newborns and between 48 and 72 h for an additional 28 (5.5%). There were 365 (72.3%) institutional deliveries. In an adjusted regression analysis (IPV adjusted for socio-economic status), birth weight was 203 g lower (B -203 95% CI -320 to -87) among newborns of women exposed to IPV than among the unexposed. Birth weight was also lower in girls than in boys, in newborns delivered at home rather than in a health facility, and in babies with a younger gestational age. Conclusion Maternal exposure to IPV during pregnancy was associated with lower baby birth weights. Antenatal clinics should consider routinely identifying IPV-exposed women, and identifying babies with lower birth weights at home is an important indicator.
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Affiliation(s)
- Sewhareg Belay
- School of Public Health, College of Medicine and Health Sciences, Hawassa University, Hawassa, Ethiopia,Centre for International Health, University of Bergen, Bergen, Norway,*Correspondence: Sewhareg Belay
| | - Ayalew Astatkie
- School of Public Health, College of Medicine and Health Sciences, Hawassa University, Hawassa, Ethiopia
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24
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Worku WZ, Azale T, Ayele TA, Mekonnen DK. Effects of HIV Infection on Pregnancy Outcomes Among Women Attending Antenatal Care in Referral Hospitals of the Amhara Regional State, Ethiopia: A Prospective Cohort Study. Int J Womens Health 2022; 14:1405-1423. [PMID: 36176965 PMCID: PMC9514786 DOI: 10.2147/ijwh.s382685] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Accepted: 09/15/2022] [Indexed: 11/23/2022] Open
Abstract
Background Human immunodeficiency virus (HIV) has remained to be a significant public health problem worldwide mainly affecting women. Despite a 2 to 3 times higher risk of adverse pregnancy outcomes, around 2 million HIV positive women give birth each year globally. However, there is a dearth of evidences in Ethiopia about the effect of maternal HIV infection on pregnancy outcomes where adverse birth outcomes are still a significant health problem. This study is, therefore, aimed to examine the effect of HIV on the risk of adverse pregnancy outcomes in Amhara Regional State, Ethiopia. Methods A prospective cohort study was conducted among 704 pregnant women (352 women with HIV and 352 women without HIV infection). Systematic random sampling technique was employed to select the study participants. Data on socio-demographic, obstetric, clinical, as well as behavioral and psychosocial characteristics were collected using a validated tool. Data on the outcome variables were also collected following delivery. Modified Poisson regression was employed to estimate the relative risk (RR) of HIV on low birth weight (LBW), preterm birth, and still birth at 95% confidence level. Attributable fraction (AF) was used to report the impact of HIV infection on pregnancy outcomes. Results Of the total 704 pregnant women enrolled for the study, 96.3% (678) completed the study. The mean age of the study participants was 30.8 (SD ± 5.4) for HIV positive and 27 (SD ± 5.4) for HIV negative women. The cumulative incidence of low birth weight, preterm birth, and stillbirth were 21.4%, 9.4%, and 4.1%, respectively. The incidence of LBW was 24.7% among HIV positive and 17.8% among HIV negative women. The incidence of preterm birth was 10.7% among HIV positive and 7.9% among HIV negative women. And the incidence of stillbirth was 3.7% and 4.6% among HIV positive and those HIV negative women. New-borns from women with HIV infection had a higher risk of low birth weight and preterm birth than those HIV negative women (Adjusted Relative Risk (ARR) = 1.47; 95% CI: 1.06-2.03) and (ARR = 1.74; 95% CI: 1.08-2.79), respectively. The attributable risk of HIV on low birth weight was 32% (Attributable Fraction (AF) = 32%, 95% CI: 23-46%), and 43% (AF = 43%, 95% CI: 23-46%) for preterm birth. Conclusion Maternal HIV infection increased the risk of low birth weight and preterm birth. This implies due attention is required while providing maternal health services primarily antenatal care and delivery services. These services should be aimed at reducing adverse pregnancy outcomes with more attention given to women with HIV infection. Moreover, reinforcement of HIV prevention intervention strategies should be considered at all levels.
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Affiliation(s)
- Workie Zemene Worku
- Department of Community Health Nursing, School of Nursing, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Telake Azale
- Department of Health Education and Behavioural Sciences, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Tadesse Awoke Ayele
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Dawit Kassahun Mekonnen
- Department of Gynaecology and Obstetrics, School of Medicine, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
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25
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Olsson CA, Letcher P, Greenwood CJ, McIntosh JE, Barker S, Olsson CM, Macdonald JA, Spry EA, Hutchinson D, Ryan J, Edwards B, McGee R, Patton GC, Sanson AV. The Australian Temperament Project Generation 3 study: a population-based multigenerational prospective cohort study of socioemotional health and development. BMJ Open 2022; 12:e061854. [PMID: 36113945 PMCID: PMC9486332 DOI: 10.1136/bmjopen-2022-061854] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
PURPOSE The Australian Temperament Project Generation 3 Study (ATPG3) was established to examine the extent to which offspring social and emotional development is shaped in the decades prior to conception, in parent and grandparent histories of psychosocial adjustment (eg, emotional regulation, relationship quality and prosociality) and maladjustment (eg, depressive symptoms, substance use and antisociality). PARTICIPANTS The Australian Temperament Project (ATP) commenced in 1983 as a population representative survey of the social and emotional health of 2443 young Australians (Generation 2: 4-8 months old) and their parents (Generation 1). Since then, families have been followed from infancy to young adulthood (16 waves). Between 2012 and 2018, the cohort was screened biannually for pregnancies (Generation 3), with assessments conducted in the third trimester of pregnancy, and at 8 weeks and 1 year postpartum. FINDINGS TO DATE A total of 1167 offspring (607 female) born to 703 Generation 2 parents (400 mothers) were recruited into the ATPG3 Study. Findings to date highlight: (1) strong continuities in depressive symptoms and substance use from adolescence through to becoming a parent; (2) a role for persistent preconception mental health problems in risk for parent-child bonding difficulties, as well as infant emotional reactivity and behaviour problems; (3) the importance of secure attachments in adolescence in reducing long-term risk for postpartum mental health problems; and (4) the protective nature of perceived social support, both preconception and postpartum, in strengthening relationship quality and social support during the COVID-19 pandemic. FUTURE PLANS Assessments of ATPG3 families in preschool and middle childhood are currently funded and underway. We intend to maintain the offspring cohort through childhood, adolescence, young adulthood and into parenthood. Data will be used to map preconception determinants of emotional health, and enhance approaches to population monitoring and targeted intervention over the life course and across generations.
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Affiliation(s)
- Craig A Olsson
- Centre for Social and Early Emotional Development, School of Psychology, Faculty of Health, Deakin University, Geelong, Victoria, Australia
- Centre for Adolescent Health, Murdoch Children's Research Institute, Parkville, Victoria, Australia
- Department of Paediatrics, University of Melbourne, Parkville, Victoria, Australia
| | - Primrose Letcher
- Centre for Social and Early Emotional Development, School of Psychology, Faculty of Health, Deakin University, Geelong, Victoria, Australia
- Centre for Adolescent Health, Murdoch Children's Research Institute, Parkville, Victoria, Australia
- Department of Paediatrics, University of Melbourne, Parkville, Victoria, Australia
| | - Christopher J Greenwood
- Centre for Social and Early Emotional Development, School of Psychology, Faculty of Health, Deakin University, Geelong, Victoria, Australia
- Centre for Adolescent Health, Murdoch Children's Research Institute, Parkville, Victoria, Australia
- Department of Paediatrics, University of Melbourne, Parkville, Victoria, Australia
| | - Jennifer E McIntosh
- Centre for Social and Early Emotional Development, School of Psychology, Faculty of Health, Deakin University, Geelong, Victoria, Australia
- Centre for Adolescent Health, Murdoch Children's Research Institute, Parkville, Victoria, Australia
- Department of Paediatrics, University of Melbourne, Parkville, Victoria, Australia
- The Bouverie Centre, School of Psychology and Public Health, La Trobe University, Bundoora, Victoria, Australia
| | - Sophie Barker
- Department of Paediatrics, University of Melbourne, Parkville, Victoria, Australia
| | - Catherine M Olsson
- Centre for Adolescent Health, Murdoch Children's Research Institute, Parkville, Victoria, Australia
- Department of Paediatrics, University of Melbourne, Parkville, Victoria, Australia
| | - Jacqui A Macdonald
- Centre for Social and Early Emotional Development, School of Psychology, Faculty of Health, Deakin University, Geelong, Victoria, Australia
- Centre for Adolescent Health, Murdoch Children's Research Institute, Parkville, Victoria, Australia
- Department of Paediatrics, University of Melbourne, Parkville, Victoria, Australia
| | - Elizabeth A Spry
- Centre for Social and Early Emotional Development, School of Psychology, Faculty of Health, Deakin University, Geelong, Victoria, Australia
- Centre for Adolescent Health, Murdoch Children's Research Institute, Parkville, Victoria, Australia
- Department of Paediatrics, University of Melbourne, Parkville, Victoria, Australia
| | - Delyse Hutchinson
- Centre for Social and Early Emotional Development, School of Psychology, Faculty of Health, Deakin University, Geelong, Victoria, Australia
- Centre for Adolescent Health, Murdoch Children's Research Institute, Parkville, Victoria, Australia
- Department of Paediatrics, University of Melbourne, Parkville, Victoria, Australia
- National Drug and Alcohol Research Centre, Faculty of Medicine, The University of New South Wales, Sydney, New South Wales, Australia
| | - Joanne Ryan
- Department of Paediatrics, University of Melbourne, Parkville, Victoria, Australia
- Department of Epidemiology and Preventive Medicine, Monash University, Prahran, Victoria, Australia
| | - Benjamin Edwards
- Centre for Social Research and Methods, Australian National University, Canberra, Australian Capital Territory, Australia
| | - Rob McGee
- Department of Preventive and Social Medicine, University of Otago, Dunedin, New Zealand
| | - George C Patton
- Centre for Adolescent Health, Murdoch Children's Research Institute, Parkville, Victoria, Australia
- Department of Paediatrics, University of Melbourne, Parkville, Victoria, Australia
| | - Ann V Sanson
- Department of Paediatrics, University of Melbourne, Parkville, Victoria, Australia
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Wittkowski A, Emsley R, Bee PE, Camacho E, Calam R, Abel KM, Duxbury P, Gomez P, Cartwright K, Reid HE. A Feasibility Randomized Controlled Trial of a Parenting Intervention Offered to Women With Severe Mental Health Problems and Delivered in a Mother and Baby Unit Setting: The IMAgINE Study Outcomes. Front Psychiatry 2022; 13:815018. [PMID: 35651824 PMCID: PMC9149174 DOI: 10.3389/fpsyt.2022.815018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2021] [Accepted: 03/28/2022] [Indexed: 11/13/2022] Open
Abstract
Background Approximately 1-2% of mothers may experience severe mental illness (SMI) requiring admission to an inpatient Mother and Baby Unit (MBU). MBUs aim to provide mental health assessment and treatment and strengthen the mother-infant relationship, essential for infant development. Whilst MBUs offer various interventions, they do not routinely offer structured parenting interventions. The Baby Triple P Positive Parenting Program (BTP) was developed to enhance parenting competence, psychological coping and the quality of partner and other social support. Guided by lived experience consultation, we aimed to determine the feasibility and acceptability of delivering BTP plus Treatment as Usual (TAU) in this setting. Method A multi-site, parallel-group, single-blind pilot randomized controlled trial (registration: ISRCTN12765736) comparing BTP+TAU to TAU in participants, recruited from two MBUs in England. The Baby Triple P intervention consisted of eight parenting sessions, with the final four being delivered over the telephone following MBU discharge. Feasibility outcomes were participant intervention engagement and study retention. Clinical outcomes including maternal parenting competence, bonding and mental health outcomes were assessed at baseline, post-baseline/intervention (10 weeks) and six-month follow-up. Data were analyzed using descriptive statistics and linear regression models. An economic feasibility analysis was also conducted. Results Thirty-seven of the 67 eligible participants consented; 34 were randomized (16 to BTP+TAU and 18 to TAU), of whom 20 were retained at post-intervention data collection and 21 at six-month follow-up. Twelve participants (75%) completed the intervention, which was rated as highly acceptable. Clinical outcomes signaled potential improvements in maternal parenting competence, bonding, mood and mental health symptomatology in participants who received the intervention. Healthcare resource use and EQ-5D-5L questionnaires were well-completed by participants. Delivering BTP in this setting is estimated to cost £443-822 per participant. Conclusions This is the first trial of a parenting intervention in a MBU setting. BTP is feasible and acceptable to mothers with SMI, with a promising signal for treatment efficacy. Although minor modifications may be required for the collection of observer-rated measures post-MBU discharge, the findings indicate that a larger, definitive trial could be conducted, especially if the setting is extended to include perinatal mental health community settings.
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Affiliation(s)
- Anja Wittkowski
- Division of Psychology and Mental Health, School of Health Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, United Kingdom
- Department of Clinical Psychology, Laureate House, Wythenshawe Hospital, Greater Manchester Mental Health NHS Foundation Trust, Manchester, United Kingdom
- Manchester Academic Health Science Centre, The University of Manchester, Manchester, United Kingdom
| | - Richard Emsley
- Department of Biostatistics and Health Informatics, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - Penny E. Bee
- Division of Nursing, Midwifery and Social Work, School of Health Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, United Kingdom
| | - Elizabeth Camacho
- Division of Population Health, Health Services Research and Primary Care, Faculty of Biology, Medicine and Health, School of Health Sciences, The University of Manchester, Manchester, United Kingdom
| | - Rachel Calam
- Division of Psychology and Mental Health, School of Health Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, United Kingdom
| | - Kathryn M. Abel
- Division of Psychology and Mental Health, School of Health Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, United Kingdom
- Manchester Academic Health Science Centre, The University of Manchester, Manchester, United Kingdom
| | - Paula Duxbury
- Department of Research and Innovation, Greater Manchester Mental Health NHS Foundation Trust, Manchester, United Kingdom
| | - Paula Gomez
- Department of Clinical Psychology, Laureate House, Wythenshawe Hospital, Greater Manchester Mental Health NHS Foundation Trust, Manchester, United Kingdom
| | - Kim Cartwright
- Department of Research and Innovation, Greater Manchester Mental Health NHS Foundation Trust, Manchester, United Kingdom
| | - Holly E. Reid
- Division of Psychology and Mental Health, School of Health Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, United Kingdom
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Umuziga MP, Gishoma D, Hynie M, Nyirazinyoye L. Antenatal depressive symptoms in rwanda: rates, risk factors, and social support. BMC Pregnancy Childbirth 2022; 22:193. [PMID: 35260093 PMCID: PMC8905742 DOI: 10.1186/s12884-022-04522-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2021] [Accepted: 02/24/2022] [Indexed: 12/15/2022] Open
Abstract
Background Prevalence of perinatal depression is high in Rwanda and has been found to be associated with the quality of relationship with partner. This study extends this work to examine the relationship between antenatal depressive symptoms and social support across several relationships among women attending antenatal care services. Methods Structured survey interviews were conducted with 396 women attending antenatal care services in 4 health centres in the Southern Province of Rwanda. The Edinburgh Postnatal Depression Scale (EPDS) and Maternity Social Support Scale (MSSS) were used to assess antenatal depressive symptoms and the level of support respectively. Socio-demographic and gestational information, pregnancy intentions, perceived general health status, and experience of violence were also collected. Univariate, bivariate analyses and a multivariate logistic regression model were performed to determine the relationship between social support and risk factors for antenatal depressive symptoms. Results More than half of respondents were married (55.1%) or living with a partner in a common-law relationship (28.5%). About a third (35.9%) were in their 6th month of pregnancy; the rest were in their third term. The prevalence of antenatal depressive symptoms was 26.6% (EPDS ≥ 12). Bivariate analyses suggested that partner and friend support negatively predict depression level symptoms. Adjusting for confounding variables such as unwanted pregnancy (AOR: 0.415, CI: 0.221- 0.778), parity (AOR: 0.336, CI: 0.113–1.000) and exposure to extremely stressful life events (AOR: 2.300, CI: 1.263- 4.189), partner support (AOR: 4.458, CI: 1.833- 10.842) was strongly significantly associated with antenatal depressive symptoms; women reporting good support were less likely to report depressive symptoms than those reporting poor support or those with no partner. Friend support was no longer significant. Conclusion The study revealed that social support may be a strong protector against antenatal depressive symptoms but only support from the partner. This suggests that strengthening support to pregnant women may be a successful strategy for reducing the incidence or severity of maternal mental health problems, but more work is required to assess whether support from the broader social network can compensate for absent or unsupportive partners.
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Affiliation(s)
- Marie Providence Umuziga
- School of Nursing, College of Medicine and Health Sciences, University of Rwanda, P.O. Box 3286, Kigali, Rwanda.
| | - Darius Gishoma
- School of Nursing, College of Medicine and Health Sciences, University of Rwanda, P.O. Box 3286, Kigali, Rwanda
| | - Michaela Hynie
- Department of Psychology, York University, 4700 Keele Street, Toronto, ON, M3J 1P3, Canada
| | - Laetitia Nyirazinyoye
- School of Nursing, College of Medicine and Health Sciences, University of Rwanda, P.O. Box 3286, Kigali, Rwanda
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Taylor BL, Nath S, Sokolova AY, Lewis G, Howard LM, Johnson S, Sweeney A. The relationship between social support in pregnancy and postnatal depression. Soc Psychiatry Psychiatr Epidemiol 2022; 57:1435-1444. [PMID: 35451605 PMCID: PMC9246777 DOI: 10.1007/s00127-022-02269-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2021] [Accepted: 03/08/2022] [Indexed: 10/25/2022]
Abstract
PURPOSE Lack of social support is considered a potential risk factor for postnatal depression but limited longitudinal evidence is available. Pregnancy, when women have increased contact with healthcare services, may be an opportune time to intervene and help strengthen women's social networks to prevent feelings of depression postnatally, particularly for those at greatest risk. Our study examined the longitudinal relationship between social support in pregnancy and postnatal depression, and whether this is moderated by age or relationship status. METHODS We analysed data collected from 525 women from a diverse inner-city maternity population in England who were interviewed in pregnancy and again three months postnatally. Women provided sociodemographic information and completed self-report measures of depression (Edinburgh Postnatal Depression Scale) and social support (Social Provisions Scale). RESULTS Less social support in pregnancy was associated with postnatal depression, after adjusting for sociodemographic confounders and antenatal depression (Coef. = - 0.05; 95% CI - 0.10 to - 0.01; p = 0.02). There was weak evidence of a moderating effect of relationship status. Subgroup analysis showed a stronger relationship between social support in pregnancy and postnatal depression for women who were not living with a partner (Coef. = - 0.11; 95% CI - 0.21 to - 0.01; p = 0.03) than for those who were (Coef. = - 0.03; 95% CI - 0.09 to 0.02; p = 0.28). Sensitivity analysis using multiple imputations to account for missing data confirmed the main results. CONCLUSIONS Interventions that target social support in pregnancy have the potential to reduce depression postnatally. Future research should explore in greater detail which women would benefit most from which type of social support.
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Affiliation(s)
- Billie Lever Taylor
- Division of Psychiatry, Faculty of Brain Sciences, University College London, Maple House, 149 Tottenham Court Road, London, W1T 7NF, UK.
| | - Selina Nath
- grid.83440.3b0000000121901201Present Address: Population, Policy and Practice Research and Teaching Department, UCL Great Ormond Street Institute of Child Health, 30 Guilford Street, London, WC1N 1EH UK ,grid.13097.3c0000 0001 2322 6764Health Services and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, Kings College London, De Crespigny Park, London, SE5 8AF UK
| | - Antoaneta Y. Sokolova
- grid.83440.3b0000000121901201Lived Experience Advisory Group, University College London, Maple House, 149 Tottenham Court Road, London, W1T 7NF UK
| | - Gemma Lewis
- grid.83440.3b0000000121901201Division of Psychiatry, Faculty of Brain Sciences, University College London, Maple House, 149 Tottenham Court Road, London, W1T 7NF UK
| | - Louise M. Howard
- grid.13097.3c0000 0001 2322 6764Health Services and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, Kings College London, De Crespigny Park, London, SE5 8AF UK
| | - Sonia Johnson
- grid.83440.3b0000000121901201Division of Psychiatry, Faculty of Brain Sciences, University College London, Maple House, 149 Tottenham Court Road, London, W1T 7NF UK
| | - Angela Sweeney
- Health Services and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, Kings College London, De Crespigny Park, London, SE5 8AF, UK.
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Tani F, Ghinassi S, Ponti L. The Role of Maternal Perceived Social Support on the Relation Between Prenatal Depressive Symptoms and Labor Experience. EUROPEAN JOURNAL OF HEALTH PSYCHOLOGY 2021. [DOI: 10.1027/2512-8442/a000103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Abstract. Background: Depression during pregnancy is a severe risk factor for negative outcomes in women and children. In particular, prenatal symptoms of depression are linked to a more complicated labor experience, characterized by more painful labor and more frequent recourse to epidural analgesia and/or oxytocin. Although this link is evident, less is known about possible mediators of this relationship. Aims: This study investigated the mediating role of perceived maternal social support on the relationship between prenatal maternal depression and labor experience. Methods: Participants were 152 Italian nulliparous women ( Mage = 31.68 years, SD = 4.94). Data were collected at two different times: T1 (at week 30–33 of gestation) women completed the Beck Depression Inventory and the Maternal Social Support Scale; T2 (at childbirth) clinical data regarding labor was registered from hospital records (duration of labor in hours and administration of oxytocin and epidural analgesia in hours). Results: The Structural Equation Modeling showed that prenatal symptoms of depression are linked to a more complicated labor experience (β = .31, p < .001). However, the quality of the maternal social support can mediate this relationship (indirect effect: β = .17, p < .000). Limitations: The complexity of the proposed model, the characteristics of the sample, the variables investigated, and the questionnaires used are discussed. Conclusion: The perception of having a good social network is an important predictor of women’s health in the transition to motherhood, decreasing the negative effect of maternal prenatal depressive symptoms on the quality of women’s labor experience.
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Affiliation(s)
- Franca Tani
- Department of Health Sciences, University of Florence, Italy
| | - Simon Ghinassi
- Department of Health Sciences, University of Florence, Italy
| | - Lucia Ponti
- Department of Humanities, University “Carlo Bo” of Urbino, Italy
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Robson S, McParlin C, Mossop H, Lie M, Fernandez-Garcia C, Howel D, Graham R, Ternent L, Steel A, Goudie N, Nadeem A, Phillipson J, Shehmar M, Simpson N, Tuffnell D, Campbell I, Williams R, O'Hara ME, McColl E, Nelson-Piercy C. Ondansetron and metoclopramide as second-line antiemetics in women with nausea and vomiting in pregnancy: the EMPOWER pilot factorial RCT. Health Technol Assess 2021; 25:1-116. [PMID: 34782054 DOI: 10.3310/hta25630] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Around one-third of pregnant women suffer from moderate to severe nausea and vomiting, causing physical and emotional distress and reducing their quality of life. There is no cure for nausea and vomiting in pregnancy. Management focuses on relieving symptoms and preventing morbidity, and often requires antiemetic therapy. National guidelines make recommendations about first-, second- and third-line antiemetic therapies, although care varies in different hospitals and women report feeling unsupported, dissatisfied and depressed. OBJECTIVES To determine whether or not, in addition to intravenous rehydration, ondansetron compared with no ondansetron and metoclopramide compared with no metoclopramide reduced the rate of treatment failure up to 10 days after drug initiation; improved symptom severity at 2, 5 and 10 days after drug initiation; improved quality of life at 10 days after drug initiation; and had an acceptable side effect and safety profile. To estimate the incremental cost per treatment failure avoided and the net monetary benefits from the perspectives of the NHS and women. DESIGN This was a multicentre, double-dummy, randomised, double-blinded, dummy-controlled 2 × 2 factorial trial (with an internal pilot phase), with qualitative and health economic evaluations. PARTICIPANTS Thirty-three patients (who were < 17 weeks pregnant and who attended hospital with nausea and vomiting after little or no improvement with first-line antiemetic medication) who attended 12 secondary care NHS trusts in England, 22 health-care professionals and 21 women participated in the qualitative evaluation. INTERVENTIONS Participants were randomly allocated to one of four treatment groups (1 : 1 : 1: 1 ratio): (1) metoclopramide and dummy ondansetron; (2) ondansetron and dummy metoclopramide; (3) metoclopramide and ondansetron; or (4) double dummy. Trial medication was initially given intravenously and then continued orally once women were able to tolerate oral fluids for a maximum of 10 days of treatment. MAIN OUTCOME MEASURES The primary end point was the number of participants who experienced treatment failure, which was defined as the need for further treatment because symptoms had worsened between 12 hours and 10 days post treatment. The main economic outcomes were incremental cost per additional successful treatment and incremental net benefit. RESULTS Of the 592 patients screened, 122 were considered eligible and 33 were recruited into the internal pilot (metoclopramide and dummy ondansetron, n = 8; ondansetron and dummy metoclopramide, n = 8; metoclopramide and ondansetron, n = 8; double dummy, n = 9). Owing to slow recruitment, the trial did not progress beyond the pilot. Fifteen out of 30 evaluable participants experienced treatment failure. No statistical analyses were performed. The main reason for ineligibility was prior treatment with trial drugs, reflecting an unpredicted change in prescribing practice at several points along the care pathway. The qualitative evaluation identified the requirements of the study protocol, in relation to guidelines on anti-sickness drugs, and the diversity of pathways to care as key hurdles to recruitment while the role of research staff was a key enabler. No important adverse events or side effects were reported. LIMITATIONS The pilot trial failed to achieve the recruitment target owing to unforeseen changes in the provision of care. CONCLUSIONS The trial was unable to provide evidence to support clinician decisions about the best choice of second-line antiemetic for nausea and vomiting in pregnancy. TRIAL REGISTRATION Current Controlled Trials ISRCTN16924692 and EudraCT 2017-001651-31. FUNDING This project was funded by the National Institute for Health Research (NIHR) Health Technology Assessment programme and will be published in full in Health Technology Assessment; Vol. 25, No. 63. See the NIHR Journals Library website for further project information.
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Affiliation(s)
- Stephen Robson
- Population Health Sciences Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK
| | - Catherine McParlin
- Department of Nursing, Midwifery and Health, Faculty of Health and Life Sciences, Northumbria University, Newcastle upon Tyne, UK
| | - Helen Mossop
- Population Health Sciences Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK
| | - Mabel Lie
- Population Health Sciences Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK
| | - Cristina Fernandez-Garcia
- Population Health Sciences Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK
| | - Denise Howel
- Population Health Sciences Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK
| | - Ruth Graham
- School of Geography, Politics and Sociology, Newcastle University, Newcastle upon Tyne, UK
| | - Laura Ternent
- Population Health Sciences Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK
| | - Alison Steel
- Newcastle Clinical Trials Unit, Newcastle University, Newcastle upon Tyne, UK
| | - Nicola Goudie
- Newcastle Clinical Trials Unit, Newcastle University, Newcastle upon Tyne, UK
| | - Afnan Nadeem
- Newcastle Clinical Trials Unit, Newcastle University, Newcastle upon Tyne, UK
| | - Julia Phillipson
- Newcastle Clinical Trials Unit, Newcastle University, Newcastle upon Tyne, UK
| | - Manjeet Shehmar
- Gynaecology Secretaries Department, Birmingham Women's and Children's NHS Foundation Trust, Birmingham, UK
| | - Nigel Simpson
- Leeds Institute of Medical Research, Department of Women's and Children's Health, School of Medicine, University of Leeds, Leeds, UK
| | - Derek Tuffnell
- Department of Obstetrics, Bradford Teaching Hospitals NHS Foundation Trust, Bradford, UK
| | - Ian Campbell
- Pharmacy Department, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK
| | | | | | - Elaine McColl
- Population Health Sciences Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK
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Weisshaupt K, Weichert A, Henrich W, Walter H, Hägele C, Großbölting R. [Psychiatric Patients in Obstetrics in Germany - The Legal Basis and a Thematic Analysis of Case Reports]. Z Geburtshilfe Neonatol 2021; 226:25-33. [PMID: 34492708 DOI: 10.1055/a-1541-8924] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
The care of adult patients with particularly severe psychiatric illnesses in the daily routine of inpatient obstetrics is rare, but due to its complexity it represents a great challenge for all professions involved. The clinical pictures are very variable. There are a number of interlocking responsibilities in the provision of care. For planning of the birth, the medical-professional cooperation of psychiatry, obstetrics and pediatrics is necessary. Patients are often represented by legal guardians. The Youth Welfare Office is responsible for the welfare of the family and the children. The legal basis is essentially provided by the Civil Code, the Criminal Code and specific state laws, compliance with which is monitored by the courts. Typical psychiatric clinical pictures are presented by means of case reports. Legally defined applications such as accommodation, measures similar to deprivation of liberty, compulsory medical measures and justifiable necessity are explained. In the sense of a thematic analysis, these are applied to the case reports and peripartum management is discussed against the legal background. The precise knowledge of the legal background makes it easier for obstetricians to follow the procedures and interdisciplinary cooperation, especially at perinatalogical centres.
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Affiliation(s)
- Karen Weisshaupt
- Klinik für Geburtsmedizin, Charité - Universitätsmedizin Berlin, Berlin, Deutschland
| | - Alexander Weichert
- Klinik für Geburtsmedizin, Charité - Universitätsmedizin Berlin, Berlin, Deutschland
| | - Wolfgang Henrich
- Klinik für Geburtsmedizin, Charité - Universitätsmedizin Berlin, Berlin, Deutschland
| | - Henrik Walter
- Klinik für Psychiatrie und Psychotherapie, Charité - Universitätsmedizin Berlin, Berlin, Deutschland
| | - Claudia Hägele
- Klinik für Psychiatrie und Psychotherapie, Charité - Universitätsmedizin Berlin, Berlin, Deutschland
| | - Ralf Großbölting
- kwm Berlin - Kanzlei für Wirtschaft und Medizin, Berlin, Deutschland
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Feld H, Barnhart S, Wiggins AT, Ashford K. Social support reduces the risk of unintended pregnancy in a low-income population. Public Health Nurs 2021; 38:801-809. [PMID: 33938034 PMCID: PMC8419072 DOI: 10.1111/phn.12920] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2020] [Revised: 04/06/2021] [Accepted: 04/07/2021] [Indexed: 11/29/2022]
Abstract
Almost half of all pregnancies (45%) in the United States (US) are unintended, with the highest concentration in women with low incomes. Targeted research is warranted to identify risk and protective factors that influence pregnancy intention to improve maternal/child health. PURPOSE To identify individual and interpersonal level associations to pregnancy intention to use as leverage points to build resilience. METHOD A cross-sectional, secondary analysis of Medicaid eligible pregnant women in Kentucky (n = 309). RESULTS Sixty-two percent reported their current pregnancy was unintended. Older age, partnered, negative drug screen, and increased social support were associated with decreased odds of unintended pregnancy. For every 1 unit increase of belonging and tangible social support, women were 13% and 14% (respectively) less likely to have an unintended pregnancy (OR = 0.87, 95% CI = 0.78-0.97, p = .011, OR = 0.86, 95% CI = 0.77-0.95, p = .005). A positive drug screen was associated with an almost three-fold increase in the odds of unintended pregnancy (OR = 2.88, 95% CI = 1.49-5.58, p = .002). CONCLUSION Public health nurses can play a critical role in reducing unintended pregnancy rates by promoting social support, inclusion, and acceptance. There remains a critical need to identify barriers and facilitators to pregnancy planning for persons who use illicit drugs.
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Affiliation(s)
- Hartley Feld
- College of Nursing, University of Kentucky, Lexington, KY, USA
| | - Sheila Barnhart
- College of Social Work, University of Kentucky, Lexington, KY, USA
| | | | - Kristin Ashford
- College of Nursing, University of Kentucky, Lexington, KY, USA
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Addila AE, Azale T, Gete YK, Yitayal M. The effects of maternal alcohol consumption during pregnancy on adverse fetal outcomes among pregnant women attending antenatal care at public health facilities in Gondar town, Northwest Ethiopia: a prospective cohort study. Subst Abuse Treat Prev Policy 2021; 16:64. [PMID: 34446055 PMCID: PMC8390259 DOI: 10.1186/s13011-021-00401-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/05/2021] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND The teratogenic effect of fetal alcohol exposure may lead to actual and potential problems, instantly after birth, at infancy; or even later, and mental impairment in life. This study aimed to investigate the effects of maternal alcohol consumption during pregnancy on adverse fetal outcomes at Gondar town public health facilities, Northwest Ethiopia. METHODS A facility-based prospective cohort study was performed among 1778 pregnant women who were booked for antenatal care in selected public health facilities from 29 October 2019 to 7 May 2020 in Gondar town. We used a two-stage random sampling technique to recruit and include participants in the cohort. Data were collected using the Alcohol Use Disorders Identification Test - Consumption (AUDIT-C) standardized and pre-tested questionnaire. Multivariable analysis was performed to examine the association between reported prenatal alcohol exposure (non-hazardous and hazardous) and interested adverse birth outcomes using log-binomial regression modeling. The burden of outcomes was reported using the adjusted risk ratio and population-attributable risk (PAR). RESULTS A total of 1686 pregnant women were included in the analysis, which revealed that the incidences of low birth weight, preterm, and stillbirth were 12.63% (95% CI: 11.12, 14.31), 6.05% (95% CI: 5.00, 7.29) and 4.27% (95% CI: 3.4, 5.35), respectively. Non-hazardous and hazardous alcohol consumption during pregnancy was significantly associated with low birth weight (ARR = 1.50; 95% CI: 1.31, 1.98) and (ARR = 2.34; 95% CI: 1.66, 3.30), respectively. Hazardous alcohol consumption during pregnancy was also significantly associated with preterm birth (ARR = 2.06; 95% CI: 1.21, 3.52). The adjusted PAR of low birth weight related to non-hazardous and hazardous alcohol drinking during pregnancy was 11.72 and 8.44%, respectively. The adjusted PAR of hazardous alcohol consumption was 6.80% for preterm. CONCLUSIONS Our findings suggest that there is an increasing risk of adverse birth outcomes, particularly preterm delivery and low birth weight, with increasing levels of alcohol intake. This result showed that the prevention of maternal alcohol use during pregnancy has the potential to reduce low birth weight and preterm birth. Hence, screening women for alcohol use during antenatal care visits and providing advice with rigorous follow-up of women who used alcohol may save the fetus from the potential risks of adverse birth outcomes.
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Affiliation(s)
- Alemu Earsido Addila
- Department of Public Health, College of Medicine and Health Sciences, Wachemo University, Hossana, Ethiopia.
- Department of Epidemiology and Biostatistics, College of Medicine and Health Sciences, Institute of Public Health, University of Gondar, Gondar, Ethiopia.
| | - Telake Azale
- Department of Health Education and Behavioral Sciences, College of Medicine and Health Sciences, Institute of Public Health, University of Gondar, Gondar, Ethiopia
| | - Yigzaw Kebede Gete
- Department of Epidemiology and Biostatistics, College of Medicine and Health Sciences, Institute of Public Health, University of Gondar, Gondar, Ethiopia
| | - Mezgebu Yitayal
- Department of Health Systems and Policy, College of Medicine and Health Sciences, Institute of Public Health, University of Gondar, Gondar, Ethiopia
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Anbesaw T, Negash A, Mamaru A, Abebe H, Belete A, Ayano G. Suicidal ideation and associated factors among pregnant women attending antenatal care in Jimma medical center, Ethiopia. PLoS One 2021; 16:e0255746. [PMID: 34432799 PMCID: PMC8386870 DOI: 10.1371/journal.pone.0255746] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2021] [Accepted: 07/22/2021] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND Suicidal ideation (SI) among pregnant women is a major public health concern worldwide and is associated with a higher risk of completed suicide. However, there are limited studies that determined the prevalence and the potential determinants of suicidal ideation in Sub-Saharan Africa, including Ethiopia. Therefore, this study aimed to explore the prevalence of suicidal ideation and associated factors among pregnant women attending antenatal care in Jimma, Ethiopia. METHODS An institutional-based cross-sectional study was conducted among 423 pregnant women attending Jimma medical center in Southwest, Ethiopia. A systematic random sampling technique was used to select the study participants. Suicidal ideation assessed using the Suicidality Module of the World Mental Health survey initiative version of the World Health Organization Composite International Diagnostic Interview (CIDI). Other tools used are EPDS, Abuse Assessment Scale (AAS), DASS -21, PSS, Maternity Social Support Scale (MSSS), and Pittsburgh Sleep Quality Index (PSQI). A multivariable logistic regression analysis was used to explore the potential determinants of suicidal ideation among the participants. RESULT The prevalence of SI among women who are on antenatal care was found to be 13.3% (95% CI (10.1,16.4). In multivariable analysis, marital status with lack of cohabiting partners (AOR = 2.80,95%CI:1.23,6.37), history of abortion (AOR = 2.45,95% CI:1.03,5.93), having depression (AOR = 4.28,95% CI:1.75,10.44),anxiety(AOR = 2.99,95% CI:1.24,7.20), poor sleep quality (AOR = 2.85,95% CI:1.19,6.79), stress (AOR = 2.50, 95% CI:1.01,5.67), and intimate partner violence (AOR = 2.43, 95% CI:1.07,5.47) were found to be significant predictors of suicidal ideation. CONCLUSION The prevalence of SI among pregnant women was found to be huge. Lack of cohabiting partners, previous history of abortion, depression, anxiety, intimate partner violence, poor sleep quality, and stress were variables that are independent predictors of suicidal ideation. Screening and interventions of antenatal SI are needed.
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Affiliation(s)
- Tamrat Anbesaw
- Department of Psychiatry, College of Medicine and Health Science, Wollo University, Dessie, Ethiopia
| | - Alemayehu Negash
- Department of Psychiatry, Institute of Health Sciences, Faculty of Medical Science, Jimma University, Jimma, Ethiopia
| | - Almaz Mamaru
- Department of Psychiatry, Faculty of Medical Science, Institute of Health Sciences, Jimma University, Jimma, Ethiopia
| | - Habtamu Abebe
- Department of Epidemiology and Biostatistics, Faculty of Medical Science, Institute of Health Sciences, Jimma University, Jimma, Ethiopia
| | - Asmare Belete
- Department of Psychiatry, College of Medicine and Health Science, Wollo University, Dessie, Ethiopia
| | - Getinet Ayano
- Research and Training Department, Amanuel Mental Specialized Hospital, Addis Ababa, Ethiopia
- School of Public Health, Curtin University, Bentley, Australia
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Biden EJ, Greenwood CJ, Macdonald JA, Spry EA, Letcher P, Hutchinson D, Youssef GJ, McIntosh JE, Olsson CA. Preparing for Future Adversities: Lessons From the COVID-19 Pandemic in Australia for Promoting Relational Resilience in Families. Front Psychiatry 2021; 12:717811. [PMID: 34421689 PMCID: PMC8371315 DOI: 10.3389/fpsyt.2021.717811] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Accepted: 07/09/2021] [Indexed: 11/13/2022] Open
Abstract
Background: The COVID-19 pandemic has placed considerable pressure on families, testing the quality of relationships and the strength of social support within and beyond the family network. However, little is known about the pre-pandemic factors that predict family relational resilience and social functioning during times of natural disaster or global crisis. Here we use data from one of Australia's longest running studies of social and emotional development to examine the nature and timing of possible relational and social support intervention aimed at preparing families for future adversities. Methods: Data were from the Australian Temperament Project Generation 3 (ATPG3) Study, a population representative three generation cohort study of families established in 1983. A subset of Generation 2 parents completed a COVID-19 specific survey in May-September 2020 (502 parents of 871 children; 60% mothers; 37-38 years). These participants had completed the Quality of Relationships Inventory to assess social support during young adulthood, at 23-24 years (2006) and 27-28 years (2010), before next generation conception. Participants had also completed the Maternity Social Support Scale 1 year postpartum for each child born across the ATPG3 assessment period (2012-2019). In 2020, during the height of the Australian lockdowns, participants rated the quality of their relationships with their partners, children and broader family and friends, in addition to social support within and extended beyond their family. Results: Pre-pandemic partner support was associated with partner relationship quality during the pandemic (β = 0.22). Pre-pandemic support from friends was associated with relationship quality with other family and friends during the pandemic (β = 0.12 - 0.18). Pre-pandemic support (from partner, family and friends) was consistently associated with social support within families during the pandemic (β = 0.11 - 0.21). Pre-pandemic support from friends was also associated with family support extended to others within their local community during the pandemic (β = 0.12 - 0.13). Conclusions: Strengthening supportive relationships during major life transitions, prior to the start of family life and in early parenthood, may have long-term and intergenerational benefits years into the future for both families and communities. This may promote resilience during future crises and other more normative stressful life events.
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Affiliation(s)
- Ebony J. Biden
- Centre for Social and Early Emotional Development, School of Psychology, Faculty of Health, Deakin University, Geelong, VIC, Australia
- Centre for Adolescent Health, Murdoch Children's Research Institute, Parkville, VIC, Australia
| | - Christopher J. Greenwood
- Centre for Social and Early Emotional Development, School of Psychology, Faculty of Health, Deakin University, Geelong, VIC, Australia
- Centre for Adolescent Health, Murdoch Children's Research Institute, Parkville, VIC, Australia
| | - Jacqui A. Macdonald
- Centre for Social and Early Emotional Development, School of Psychology, Faculty of Health, Deakin University, Geelong, VIC, Australia
- Centre for Adolescent Health, Murdoch Children's Research Institute, Parkville, VIC, Australia
- Department of Paediatrics, Royal Children's Hospital, University of Melbourne, Parkville, VIC, Australia
| | - Elizabeth A. Spry
- Centre for Social and Early Emotional Development, School of Psychology, Faculty of Health, Deakin University, Geelong, VIC, Australia
- Centre for Adolescent Health, Murdoch Children's Research Institute, Parkville, VIC, Australia
| | - Primrose Letcher
- Centre for Social and Early Emotional Development, School of Psychology, Faculty of Health, Deakin University, Geelong, VIC, Australia
- Centre for Adolescent Health, Murdoch Children's Research Institute, Parkville, VIC, Australia
- Department of Paediatrics, Royal Children's Hospital, University of Melbourne, Parkville, VIC, Australia
| | - Delyse Hutchinson
- Centre for Social and Early Emotional Development, School of Psychology, Faculty of Health, Deakin University, Geelong, VIC, Australia
- Centre for Adolescent Health, Murdoch Children's Research Institute, Parkville, VIC, Australia
- Department of Paediatrics, Royal Children's Hospital, University of Melbourne, Parkville, VIC, Australia
- National Drug and Alcohol Research Centre, Faculty of Medicine, University of New South Wales, Sydney, NSW, Australia
| | - George J. Youssef
- Centre for Social and Early Emotional Development, School of Psychology, Faculty of Health, Deakin University, Geelong, VIC, Australia
- Centre for Adolescent Health, Murdoch Children's Research Institute, Parkville, VIC, Australia
| | - Jennifer E. McIntosh
- Centre for Social and Early Emotional Development, School of Psychology, Faculty of Health, Deakin University, Geelong, VIC, Australia
- Centre for Adolescent Health, Murdoch Children's Research Institute, Parkville, VIC, Australia
- Department of Paediatrics, Royal Children's Hospital, University of Melbourne, Parkville, VIC, Australia
- The Bouverie Centre, School of Psychology & Public Health, La Trobe University, Melbourne, VIC, Australia
| | - Craig A. Olsson
- Centre for Social and Early Emotional Development, School of Psychology, Faculty of Health, Deakin University, Geelong, VIC, Australia
- Centre for Adolescent Health, Murdoch Children's Research Institute, Parkville, VIC, Australia
- Department of Paediatrics, Royal Children's Hospital, University of Melbourne, Parkville, VIC, Australia
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Atuhaire C, Rukundo GZ, Nambozi G, Ngonzi J, Atwine D, Cumber SN, Brennaman L. Prevalence of postpartum depression and associated factors among women in Mbarara and Rwampara districts of south-western Uganda. BMC Pregnancy Childbirth 2021; 21:503. [PMID: 34247576 PMCID: PMC8272966 DOI: 10.1186/s12884-021-03967-3] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2020] [Accepted: 06/25/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Postpartum depression (PPD) is a significant cause of maternal morbidity and has severe consequences on the well-being of mothers, new-borns, families, and communities. PPD reduces the mother's response to the child's needs. In severe cases, mothers suffering from PPD are prone to postpartum psychosis, commit suicide and, in rare cases, infanticide. We aimed to determine the prevalence and understand the factors associated with PPD among mothers in southwestern Uganda. METHODS This was a cross-sectional study between November 2019 and June 2020 among 292 mothers, 6 to 8 weeks' postpartum. Mothers were selected from three health facilities in southwestern Uganda and enrolled using stratified consecutive sampling. Postpartum depression was clinically diagnosed using the Diagnostic and Statistical Manual of Mental Disorders V. The factors associated with PPD were assessed by using a structured interviewer administered questionnaire. The factors were analyzed using bivariate chi square analyses and multivariate logistic regression. RESULTS Overall prevalence of PPD was 27.1% (95% CI: 22.2-32.5). This did not vary by the number of previous births or mode of birth. Five factors associated with PPD were low perceived social support, HIV positive status, rural residence, obstetrical complications and the baby crying excessively. CONCLUSION AND RECOMMENDATIONS Prevalence of PPD in Mbarara and Rwampara districts is higher than what has previously been reported in Uganda indicating an urgent need to identify pregnant women who are at increased risk of PPD to mitigate their risk or implement therapies to manage the condition. Midwives who attend to these mothers need to be empowered with available methods of mitigating prevalence and consequences of PPD. Women who are HIV positive, residing in rural settings, whose babies cry excessively, having low social support systems and who have birth complications may be a particularly important focus for Ugandan intervention strategies to prevent and reduce the prevalence of PPD.
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Affiliation(s)
- Catherine Atuhaire
- Faculty of Medicine, Department of Nursing, Mbarara University of Science and Technology (MUST), Mbarara, Uganda.
| | - Godfrey Zari Rukundo
- Faculty of Medicine, Department of Nursing, Mbarara University of Science and Technology (MUST), Mbarara, Uganda
| | - Grace Nambozi
- Faculty of Medicine, Department of Nursing, Mbarara University of Science and Technology (MUST), Mbarara, Uganda
| | - Joseph Ngonzi
- Faculty of Medicine, Department of Nursing, Mbarara University of Science and Technology (MUST), Mbarara, Uganda
| | - Daniel Atwine
- Faculty of Medicine, Department of Nursing, Mbarara University of Science and Technology (MUST), Mbarara, Uganda
| | - Samuel Nambile Cumber
- Faculty of Medicine, Department of Nursing, Mbarara University of Science and Technology (MUST), Mbarara, Uganda
| | - Laura Brennaman
- Faculty of Medicine, Department of Nursing, Mbarara University of Science and Technology (MUST), Mbarara, Uganda
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Varga S, Mackert M, Mandell DJ. The prenatal triad: The importance of provider-patient communication with expectant fathers throughout the prenatal care process. PATIENT EDUCATION AND COUNSELING 2021; 104:1826-1830. [PMID: 33229190 DOI: 10.1016/j.pec.2020.11.005] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/06/2020] [Revised: 10/14/2020] [Accepted: 11/03/2020] [Indexed: 06/11/2023]
Abstract
Previous research has primarily focused on the relationship between providers and expectant mothers as a key element of quality prenatal care. Significantly less attention has been directed toward expectant fathers and the importance of their communication with prenatal care providers and involvement in the prenatal care process. Much of this limited existing literature emphasizes the health benefits including fathers would bring for mom and baby, but rarely is the potential benefit to fathers' health included in the conversation. This discussion aims to highlight the value of this line of research for both communication and medical researchers and consider potential avenues for studying and promoting father engagement in prenatal care.
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Affiliation(s)
- Sarah Varga
- Department of Communication Studies, Moody College of Communication, The University of Texas at Austin, Austin, USA.
| | - Michael Mackert
- Center for Health Communication, Stan Richards School of Advertising & Public Relations, and Department of Population Health, The University of Texas at Austin, Austin, USA
| | - Dorothy J Mandell
- School of Community and Rural Health, The University of Texas Health Science Center at Tyler, and Population Health University of Texas, System Administration, Austin, USA
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Addila AE, Azale T, Gete YK, Yitayal M. Determinants of hazardous alcohol use among pregnant women attending antenatal care at public health facilities in Gondar town, Northwest Ethiopia: A nested case-control study. PLoS One 2021; 16:e0253162. [PMID: 34197507 PMCID: PMC8248645 DOI: 10.1371/journal.pone.0253162] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2020] [Accepted: 05/31/2021] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Alcohol use during pregnancy has a potential negative impact on the health of women and children. Binge or hazardous drinking may do greater alcohol-related damage to the developing fetus than drinking a comparable amount spread over several days or weeks. This study aimed to identify determinants of hazardous alcohol use among pregnant women attending antenatal care at Gondar town public health facilities, Northwest Ethiopia. METHODS An unmatched facility-based nested case-control study was carried out to identify the determinants of hazardous alcohol use among pregnant women within a prospective cohort study from 29 October 2019 to 7 May 2020. A two-stage random sampling technique was used to select 455 (113 cases and 342 controls) pregnant women. Data collection was performed using the AUDIT-C standardized and pretested questionnaire. Bivariable and multivariable logistic regression analyses were computed to identify the predictors of alcohol consumption using the odds ratio, 95% CI, and p-value < 0.05. RESULTS Multivariable logistic regression model revealed that no formal education of the husbands [AOR = 2.79; 95%CI: 1.24, 6.29], being housewife[AOR = 2.43; 95%CI: 1.12, 5.26], poor household wealth index[AOR = 2.65; 95%CI: 1.07, 6.54], unplanned pregnancy [AOR = 4.36;95%CI: 2.44, 7.79], poor social support [AOR = 4.9;95%CI: 2.4, 10.04], depression[AOR = 3.84;95%CI: 2.16, 6.82], and not ever heard the risk of alcohol drinking during pregnancy [AOR = 1.97; 95%CI: 1.08, 3.58] were significantly associated with hazardous alcohol use. CONCLUSIONS Routine alcohol screening during ANC visits creates an appropriate referral system for clinical management and provides an opportunity for healthcare workers to offer information on the potential risks associated with alcohol use in pregnancy. Antenatal care providers have a special role to play in assuring that women receive adequate advice about alcohol use and care to manage the problems especially for pregnant women with depression, poor social support, unplanned pregnancy, low socioeconomic status, and for housewives during the antenatal visits. The warning marks on alcoholic beverages including an ongoing message about the risks of alcohol use during pregnancy could be public health good strategies to minimize preventable harms attributed to alcohol consumption during pregnancy.
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Affiliation(s)
- Alemu Earsido Addila
- Department of Public Health, College of Medicine and Health Sciences, Wachemo University, Hossana, Ethiopia
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Telake Azale
- Department of Health Education and Behavioral Sciences, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Yigzaw Kebede Gete
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Mezgebu Yitayal
- Department of Health Systems and Policy, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
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Spry EA, Moreno-Betancur M, Middleton M, Howard LM, Brown SJ, Molyneaux E, Greenwood CJ, Letcher P, Macdonald JA, Thomson KC, Biden EJ, Olsson CA, Patton GC. Preventing postnatal depression: a causal mediation analysis of a 20-year preconception cohort. Philos Trans R Soc Lond B Biol Sci 2021; 376:20200028. [PMID: 33938272 PMCID: PMC8090815 DOI: 10.1098/rstb.2020.0028] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/03/2020] [Indexed: 12/18/2022] Open
Abstract
Postnatal depression (PND) is common and predicts a range of adverse maternal and offspring outcomes. PND rates are highest among women with persistent mental health problems before pregnancy, and antenatal healthcare provides ideal opportunity to intervene. We examined antenatal perceived social support as a potential intervention target in preventing PND symptoms among women with prior mental health problems. A total of 398 Australian women (600 pregnancies) were assessed repeatedly for mental health problems before pregnancy (ages 14-29 years, 1992-2006), and again during pregnancy, two months postpartum and one year postpartum (2006-2014). Causal mediation analysis found that intervention on perceived antenatal social support has the potential to reduce rates of PND symptoms by up to 3% (from 15 to 12%) in women with persistent preconception symptoms. Supplementary analyses found that the role of low antenatal social support was independent of concurrent antenatal depressive symptoms. Combined, these two factors mediated up to more than half of the association between preconception mental health problems and PND symptoms. Trialling dual interventions on antenatal depressive symptoms and perceived social support represents one promising strategy to prevent PND in women with persistent preconception symptoms. Interventions promoting mental health before pregnancy may yield an even greater reduction in PND symptoms by disrupting a developmental cascade of risks via these and other pathways. This article is part of the theme issue 'Multidisciplinary perspectives on social support and maternal-child health'.
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Affiliation(s)
- Elizabeth A. Spry
- Centre for Social and Early Emotional Development, School of Psychology, Faculty of Health, Deakin University, Geelong, Victoria 3220, Australia
- Murdoch Children's Research Institute, Royal Children's Hospital, Melbourne, Victoria 3052, Australia
| | - Margarita Moreno-Betancur
- Murdoch Children's Research Institute, Royal Children's Hospital, Melbourne, Victoria 3052, Australia
- University of Melbourne, Melbourne, Victoria 3052, Australia
| | - Melissa Middleton
- Murdoch Children's Research Institute, Royal Children's Hospital, Melbourne, Victoria 3052, Australia
- University of Melbourne, Melbourne, Victoria 3052, Australia
| | - Louise M. Howard
- Section of Women's Mental Health, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London SE5 8AF, UK
- South London and Maudsley NHS Foundation Trust, London SE5 8AZ, UK
| | - Stephanie J. Brown
- Murdoch Children's Research Institute, Royal Children's Hospital, Melbourne, Victoria 3052, Australia
- University of Melbourne, Melbourne, Victoria 3052, Australia
| | - Emma Molyneaux
- Section of Women's Mental Health, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London SE5 8AF, UK
| | - Christopher J. Greenwood
- Centre for Social and Early Emotional Development, School of Psychology, Faculty of Health, Deakin University, Geelong, Victoria 3220, Australia
- Murdoch Children's Research Institute, Royal Children's Hospital, Melbourne, Victoria 3052, Australia
| | - Primrose Letcher
- Murdoch Children's Research Institute, Royal Children's Hospital, Melbourne, Victoria 3052, Australia
- University of Melbourne, Melbourne, Victoria 3052, Australia
| | - Jacqui A. Macdonald
- Centre for Social and Early Emotional Development, School of Psychology, Faculty of Health, Deakin University, Geelong, Victoria 3220, Australia
- Murdoch Children's Research Institute, Royal Children's Hospital, Melbourne, Victoria 3052, Australia
- University of Melbourne, Melbourne, Victoria 3052, Australia
| | - Kimberly C. Thomson
- Centre for Social and Early Emotional Development, School of Psychology, Faculty of Health, Deakin University, Geelong, Victoria 3220, Australia
- University of Melbourne, Melbourne, Victoria 3052, Australia
- Human Early Learning Partnership, School of Population and Public Health, Faculty of Medicine, University of British Columbia, Vancouver, Canada V6T 1Z3
- Centre for Health Evaluation and Outcome Sciences, Providence Health Care Research Institute, Vancouver, Canada V6Z 1Y6
| | - Ebony J. Biden
- Centre for Social and Early Emotional Development, School of Psychology, Faculty of Health, Deakin University, Geelong, Victoria 3220, Australia
- Murdoch Children's Research Institute, Royal Children's Hospital, Melbourne, Victoria 3052, Australia
| | - Craig A. Olsson
- Centre for Social and Early Emotional Development, School of Psychology, Faculty of Health, Deakin University, Geelong, Victoria 3220, Australia
- Murdoch Children's Research Institute, Royal Children's Hospital, Melbourne, Victoria 3052, Australia
- University of Melbourne, Melbourne, Victoria 3052, Australia
| | - George C. Patton
- Murdoch Children's Research Institute, Royal Children's Hospital, Melbourne, Victoria 3052, Australia
- University of Melbourne, Melbourne, Victoria 3052, Australia
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Individual and community-level predictors of maternal alcohol consumption during pregnancy in Gondar town, Northwest Ethiopia: a multilevel logistic regression analysis. BMC Pregnancy Childbirth 2021; 21:419. [PMID: 34090373 PMCID: PMC8180107 DOI: 10.1186/s12884-021-03885-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2020] [Accepted: 05/19/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Prenatal alcohol consumption is a serious public health concern that is considered as one of the preventable risk factors for neonatal and childhood morbidity and several adverse pregnancy outcomes. This study aimed to determine the individual- and community-level predictors of maternal alcohol consumption during pregnancy in Gondar town, Northwest Ethiopia. METHODS A community-based cross-sectional study was conducted among pregnant women in Gondar town from 13 June to 24 August 2019. A cluster random sampling technique was used to select 1237 pregnant women. Data collection was carried out using the AUDIT-C pretested standard questionnaire. Bivariable and multivariable multilevel logistic regression analyses were computed to identify predictors of alcohol consumption using the odds ratio, 95% CI, and p-value < 0.05. RESULTS The prevalence of alcohol consumption during pregnancy was found to be 30.26% (95% CI: 27.74%, 32.91%). The study revealed that pregnant women who have a low knowledge level on harmful effect of alcohol consumption (AOR = 3.2; 95% CI: 1.9, 5.4), positive attitude towards alcohol consumption (AOR = 7.5; 95% 5, 11), history of pre-pregnancy alcohol consumption (AOR = 4.8; 95% CI: 3.4, 6.9), whose partner consume alcohol (AOR = 3.9; 95% CI: 2.5, 6), a perception that alcohol consumption is culturally or socially acceptable (AOR = 3.6; 95% CI: 2.4, 5.3), who were encouraged by their partners to consume alcohol (AOR = 4; 95% CI: 1.9, 8) were significantly associated with pregnancy alcohol consumption. Concerning the community-level characteristics, who had not ever heard/media exposure about the risk of alcohol drinking during pregnancy (AOR = 3; 95% CI: 1.7, 5.5), and who were from low community women's education attainment (AOR = 4; 95% CI: 2.2, 7.7) were statistically significant predictors of alcohol consumption during pregnancy. CONCLUSIONS The study revealed that alcohol consumption during pregnancy is prevalent in Gondar town. Both individual- and community-level predictors were found to be associated with alcohol consumption during pregnancy. Policymakers may take into account these predictors for individual and community-based interventions to which our results appear to point.
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Mohammad KI, Sabbah H, Aldalaykeh M, ALBashtawy M, Z Abuobead K, Creedy D, Gamble J. Informative title: Effects of social support, parenting stress and self-efficacy on postpartum depression among adolescent mothers in Jordan. J Clin Nurs 2021; 30:3456-3465. [PMID: 33988270 DOI: 10.1111/jocn.15846] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Revised: 04/08/2021] [Accepted: 04/19/2021] [Indexed: 12/28/2022]
Abstract
AIM AND OBJECTIVE This study investigated the effects of social support, parenting stress and maternal self-efficacy on postpartum depression among adolescent mothers in Jordan. BACKGROUND Adolescent pregnancy may have serious health, social and economic consequences for young women, families and communities. In Jordan, the incidence of adolescent pregnancy has increased from 5% in 2012 to 15% in 2018. Little attention has been given to postpartum depression among adolescent mothers in Arab and Middle Eastern countries. METHOD In a cross-sectional design using convenience sampling, 200 women aged less than 20 years, six to eight weeks postpartum and who could speak and read Arabic were interviewed in a participating health clinic. The interview occurred before or after a woman's scheduled clinic appointment and included socio-demographic data, Edinburgh Postnatal Depression Scale (EPDS), Maternity Social Support Scale (MSSS), Parenting Stress Scale (PSS) and Perceived Self-efficacy Scale (PSES). Data collection took place between December of 2018 and April of 2019. Reporting followed the STROBE guidelines. RESULTS Results revealed that 28.5% of adolescent mothers had probable postpartum depression. Mothers who reported high social support, high parenting stress, low self-efficacy, financial stress and marital conflict had significantly higher EPDS scores than those who did not report these stressors. CONCLUSION Prevalence of postpartum depression reported in this study warrants immediate action on early assessment, detection and intervention. High levels of social support may feel overwhelming for young mothers and contribute to high parenting stress, low maternal self-efficacy and marital conflict. RELEVANCE TO CLINICAL PRACTICE Adolescent mothers are at increased risk of PPD compared to mothers over 20 years of age. Perceived quality rather than availability of social support needs to be considered. Young mothers require education and early intervention prevention strategies to better prepared them for motherhood and manage stressors associated with their changing social role.
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Affiliation(s)
- Khitam I Mohammad
- Midwifery Department, Faculty of Nursing/WHO Collaborating Center, Jordan University of Science & Technology, Irbid, Jordan
| | - Hanan Sabbah
- Maternal and Child Health Nursing Department, Faculty of Nursing/ WHO Collaborating Center, Jordan University of Science & Technology, Irbid, Jordan
| | - Mohammed Aldalaykeh
- Community and Mental Health Nursing Department, Faculty of Nursing/ WHO Collaborating Center, Jordan University of Science & Technology, Irbid, Jordan
| | - Mohammed ALBashtawy
- Community Health Nursing Department, Princess Salma -Faculty of Nursing, Al Al-Bayt University, Mafraq, Jordan
| | - Kholoud Z Abuobead
- Adult Health Nursing Department, Faculty of Nursing/ WHO Collaborating Center, Jordan University of Science & Technology, Irbid, Jordan
| | - Debra Creedy
- Maternal, Newborn and Families Research Collaborative, Menzies Institute of Health Queensland, Griffith University, Brisbane, Australia
| | - Jenny Gamble
- Maternal, Newborn and Families Research Collaborative, Menzies Institute of Health Queensland, Griffith University, Brisbane, Australia
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Akinsulore A, Temidayo AM, Oloniniyi IO, Olalekan BO, Yetunde OB. Pregnancy-related anxiety symptoms and associated factors amongst pregnant women attending a tertiary hospital in south-west Nigeria. S Afr J Psychiatr 2021; 27:1616. [PMID: 33824759 PMCID: PMC8007988 DOI: 10.4102/sajpsychiatry.v27i0.1616] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2020] [Accepted: 10/19/2020] [Indexed: 11/21/2022] Open
Abstract
Background Pregnancy can be associated with anxiety symptoms because of anticipated uncertainty. Aim This study investigated pregnancy-related anxiety symptoms (PRASs) and their associated factors amongst pregnant women. Setting Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Nigeria. Methods This cross-sectional survey involved 230 pregnant women attending antenatal clinic at a tertiary teaching hospital in Nigeria. Pregnancy-related anxiety symptoms, maternal worries, personality traits and social support were measured by using Perinatal Anxiety Screening Scale (PASS), Cambridge Worry Scale (CWS), Big Five Personality Inventory (BFI-10) and Maternal Social Support Scale (MSSS) respectively. Socio-demographic and obstetric details were also obtained. The Chi-square, t-test and logistic regression were used. Results Respondents’ mean age was 28.2 ± 5.4 years, whilst 192 (83.5%) were of Yoruba ethnicity. Twenty-four respondents (10.4%) were in the first trimester, 85 (37.0%) in the second and 121 (52.6%) in the third trimester. Some 154 (67.0%) were parous. The prevalence of PRAS and major maternal worries were 43.5% and 55.7% respectively. The socio-demographic factors significantly associated with PRAS were age (p = 0.004), ethnicity (p = 0.001), educational level (p = 0.011) and living arrangement (p = 0.029). Associated obstetric factors include trimester (p = 0.01), hypertension (p = 0.006), past miscarriage(s) (p = 0.013) and past pregnancy complication (p = 0.030). Significant psychosocial factors were partner social support (p = 0.038), maternal worries (p < 0.001) and extraversion (p = 0.016). Factors that contributed significantly to regression models were older maternal age and socio-medical worries. Conclusion High level of PRAS and major maternal worries were common amongst antenatal clinic attendees of a tertiary teaching hospital in Nigeria. Older maternal age and socio-medical maternal worries are important predictors of PRAS.
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Affiliation(s)
- Adesanmi Akinsulore
- Department of Mental Health, Faculty of Clinical Sciences, Obafemi Awolowo University, Ife-Ife, Osun State, Nigeria
| | - Akinfenwa M Temidayo
- Department of Mental Health, Faculty of Clinical Sciences, Obafemi Awolowo University, Ife-Ife, Osun State, Nigeria
| | - Ibidunni O Oloniniyi
- Department of Mental Health, Faculty of Clinical Sciences, Obafemi Awolowo University, Ife-Ife, Osun State, Nigeria
| | - Badejoko O Olalekan
- Department of Obstetrics, Gynaecology and Perimatology, Faculty of Clinical Sciences, Obafemi Awolowo University, Ife-Ife, Osun State, Nigeria
| | - Oladimeji B Yetunde
- Department of Mental Health, Faculty of Clinical Sciences, Obafemi Awolowo University, Ife-Ife, Osun State, Nigeria
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Desta M, Memiah P, Kassie B, Ketema DB, Amha H, Getaneh T, Sintayehu M. Postpartum depression and its association with intimate partner violence and inadequate social support in Ethiopia: a systematic review and meta-analysis. J Affect Disord 2021; 279:737-748. [PMID: 33234282 DOI: 10.1016/j.jad.2020.11.053] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2020] [Revised: 09/16/2020] [Accepted: 11/08/2020] [Indexed: 11/28/2022]
Abstract
BACKGROUNDS Despite remarkable progress in the reduction of maternal mortality, postpartum depression remains a major public health problem among vulnerable populations. In Ethiopia, study findings regarding postpartum depression and its association with intimate partner violence and social support have been inconsistent. Therefore, this systematic review and meta-analysis estimate the pooled prevalence of postpartum depression and its association with intimate partner violence and inadequate social support in Ethiopia. METHODS We systematically searched international databases like PubMed, Web of Science, SCOPUS, CINAHL, PsycINFO, Google Scholar, Science Direct, and the Cochrane Library. All identified observational studies reporting the postpartum depression and or its predictors in Ethiopia were included. Two authors independently extracted all necessary data using a standardized data extraction format. The I2 statistics were used to assess the heterogeneity of the studies. A random-effects model was computed to estimate the pooled prevalence of postpartum depression and its associations with the selected predictors. RESULTS The random effect meta-analysis of thirteen studies showed a pooled prevalence of postpartum depression was 21.55% (95% CI: 17.89, 25.94). The highest prevalence of postpartum depression occurred in Addis Ababa, 23.3% and the lowest was in Harar, 13.11%. Our meta-analysis indicated a 5.46 folds increased risk of postpartum depression among women exposed to intimate partner violence (POR = 5.46 (95%CI: 3.94, 7.56, I2=38.8%) and 6.27 folds increased risk postpartum depression among women who had inadequate social support (POR = 6.27 (95%CI: 4.83, 8.13, I2=0) relative to those who had adequate social support. The meta-analysis further revealed that marital dissatisfaction (POR = 2.6%; 95%CI: 1.48-4.65), previous postpartum depression (POR = 2.03%; 95%CI: 1.72-2.4), and substance abuse (POR = 2.03%; 95%CI: 1.72-2.4) were associated with postpartum depression. CONCLUSIONS Our study indicates that two in every ten postpartum women in Ethiopia are suffering from postpartum depression. Intimate partner violence and social support should be a major focus to improve women's mental health during postpartum period with the reduction of substance abuse. There is an urgent need for concerted efforts in the reduction of postpartum depression through prevention efforts of intimate partner violence and substance abuse.
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Affiliation(s)
- Melaku Desta
- Department of Midwifery, College of Health Sciences, Debre Markos University, Debre Markos, Ethiopia.
| | - Peter Memiah
- Division of Epidemiology and Prevention: Institute of Human Virology, University of Maryland, School of Medicine, Baltimore, Maryland
| | - Bekalu Kassie
- Department of Midwifery, College of Health Sciences, Debre Markos University, Debre Markos, Ethiopia
| | - Daniel Bekele Ketema
- Department of Public health, College of Health Sciences, Debre Markos University, Ethiopia
| | - Haile Amha
- Department of Psychiatry, College of Health Sciences, Debre Markos University, Debre Markos, Ethiopia
| | - Temesgen Getaneh
- Department of Midwifery, College of Health Sciences, Debre Markos University, Debre Markos, Ethiopia
| | - Mezinew Sintayehu
- Department of Psychiatry, College of Health Sciences, Debre Markos University, Debre Markos, Ethiopia
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Spinola O, Liotti M, Speranza AM, Tambelli R. Effects of COVID-19 Epidemic Lockdown on Postpartum Depressive Symptoms in a Sample of Italian Mothers. Front Psychiatry 2020; 11:589916. [PMID: 33312140 PMCID: PMC7704433 DOI: 10.3389/fpsyt.2020.589916] [Citation(s) in RCA: 33] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Accepted: 10/08/2020] [Indexed: 12/31/2022] Open
Abstract
The extraordinary health emergency of the COVID-19 pandemic represents a new challenge for mental health researchers and clinical practitioners. The related containment measures may be a risk factor for psychological distress and mood disorders, especially in at-risk populations. This study aims to explore the impact of COVID-19 on postpartum depressive symptoms in mothers with children below 1 year of age. An online questionnaire survey was therefore conducted in Italy between May and June 2020. The survey consisted of several self-administered questionnaires: besides some ad-hoc questionnaires, the Edinburgh Postnatal Depression Scale (EPDS), the Scale of Perceived Social Support (SPSS) and the Maternity Social Support Scale (MSSS) were used. Two hundred forty-three Italian women were included in the study. The prevalence of postpartum depression symptomatology among mothers was 44%, as measured through the EPDS (cut-off >12). Women who spent the isolation in northern Italy adopted maladaptive coping strategies significantly more than women living in areas at lower risk. The analysis highlighted a significant difference between the group that was not directly affected by the virus and women who have had a direct or indirect contact with it. Besides situational factors specific to the pandemic, the results show that there are some risk factors tied to the personal history of the mother (e.g., having had a previous abortion). These data should inform and enlighten future protocols of intervention.
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Affiliation(s)
| | - Marianna Liotti
- Department of Dynamic and Clinical Psychology, Sapienza University of Rome, Rome, Italy
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Stress and the impact on the outcome of medically assisted reproduction. Eur J Obstet Gynecol Reprod Biol 2020; 248:187-192. [PMID: 32240891 DOI: 10.1016/j.ejogrb.2020.03.006] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2019] [Revised: 03/03/2020] [Accepted: 03/05/2020] [Indexed: 11/24/2022]
Abstract
OBJECTIVES There is evidence to suggest that high perceived stress in early pregnancy is associated with increased rates of miscarriage. Our objective was to determine if psychological stressors have an impact on medically assisted reproduction (MAR) cycle outcomes including miscarriage rates. STUDY DESIGN A survey-based study of women recruited prior to commencing MAR treatment and followed prospectively for treatment outcome (negative/positive pregnancy test, miscarriage) during the study period 2013-2015. The survey focused on perceived stress, emotional well-being, maternal social support and outlook. The women were asked to grade their responses according to a specified scale. RESULTS 320 women responded to the survey (response rate 64 %, 320/498). 290 (90 %, 290/320) women proceeded to MAR of which 58 % (n = 167/290) conceived. Analysis of stressful life events in the preceding 12 months, including job stress or serious financial problems did not reveal significance in terms of conception. A small number had experienced serious illness in the preceding 12 months which demonstrated significance in terms of not achieving pregnancy. Overall, there were high rates of emotional wellbeing, very high rates of maternal support and medium to low levels of perceived stress and this did not differ amongst those who conceived and failed to conceive. The data were further analysed according to livebirth and miscarriage (biochemical pregnancy and miscarriage). Analysis of stressful life events revealed a higher rate of miscarriage amongst those who reported a stressful/demanding job (p < 0.05). A number of women reported non-specified stressful life events and separation/divorce in higher numbers amongst the miscarriage group, reaching statistical significance, however the numbers are small thus limiting interpretation. Psychological factors had no impact on the risk of miscarriage amongst the group. CONCLUSION This study suggests that stressors do not impact greatly on conception rates from MAR but may negatively impact on miscarriage rates. Job-related stress, in particular, is associated with higher risk of miscarriage. This suggests that there may be a role for stress management in early pregnancy.
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Spry E, Olsson CA, Hearps SJC, Aarsman S, Carlin JB, Howard LM, Moreno-Betancur M, Romaniuk H, Doyle LW, Brown S, Borschmann R, Alway Y, Coffey C, Patton GC. The Victorian Intergenerational Health Cohort Study (VIHCS): Study design of a preconception cohort from parent adolescence to offspring childhood. Paediatr Perinat Epidemiol 2020; 34:86-98. [PMID: 31960474 DOI: 10.1111/ppe.12602] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2019] [Revised: 07/27/2019] [Accepted: 09/05/2019] [Indexed: 01/09/2023]
Abstract
BACKGROUND There is increasing evidence that parental determinants of offspring early life development begin well before pregnancy. OBJECTIVES We established the Victorian Intergenerational Health Cohort Study (VIHCS) to examine the contributions of parental mental health, substance use, and socio-economic characteristics before pregnancy to child emotional, physical, social, and cognitive development. POPULATION Men and women were recruited from the Victorian Adolescent Health Cohort (VAHCS), an existing cohort study beginning in 1992 that assessed a representative sample of 1943 secondary school students in Victoria, Australia, repeatedly from adolescence (wave 1, mean age 14 years) to adulthood (wave 10, mean age 35 years). METHODS Victorian Adolescent Health Cohort participants with children born between 2006 and 2013 were recruited to VIHCS and invited to participate during trimester three, at 2 months postpartum, and 1 year postpartum. Parental mental health, substance use and socio-economic characteristics were assessed repeatedly throughout; infant characteristics were assessed postnatally and in infancy. Data will be supplemented by linkage to routine datasets. A further follow-up is underway as children reach 8 years of age. PRELIMINARY RESULTS Of the 1307 infants born to VAHCS participants between 2006 and 2013, 1030 were recruited to VIHCS. At VIHCS study entry, 18% of recruited parents had preconception common mental disorder in adolescence and young adulthood, 18% smoked daily in adolescence and young adulthood, and 6% had not completed high school. Half of VIHCS infants were female (48%), 4% were from multiple births, and 7% were preterm (<37 weeks' gestation). CONCLUSIONS Victorian Intergenerational Health Cohort Study is a prospective cohort of 1030 children with up to nine waves of preconception parental data and three waves of perinatal parental and infant data. These will allow examination of continuities of parental health and health risks from the decades before pregnancy to offspring childhood, and the contributions of exposures before pregnancy to offspring outcomes in childhood.
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Affiliation(s)
- Elizabeth Spry
- Murdoch Children's Research Institute, Centre for Adolescent Health, Melbourne, Victoria, Australia.,Centre for Social and Early Emotional Development, School of Psychology, Faculty of Health, Deakin University Geelong, Geelong, Victoria, Australia
| | - Craig A Olsson
- Murdoch Children's Research Institute, Centre for Adolescent Health, Melbourne, Victoria, Australia.,Centre for Social and Early Emotional Development, School of Psychology, Faculty of Health, Deakin University Geelong, Geelong, Victoria, Australia.,Department of Paediatrics, The University of Melbourne, Melbourne, Victoria, Australia
| | - Stephen J C Hearps
- Murdoch Children's Research Institute, Centre for Adolescent Health, Melbourne, Victoria, Australia.,Clinical Sciences, Murdoch Children's Research Institute, Melbourne, Victoria, Australia
| | - Stephanie Aarsman
- Murdoch Children's Research Institute, Centre for Adolescent Health, Melbourne, Victoria, Australia
| | - John B Carlin
- Department of Paediatrics, The University of Melbourne, Melbourne, Victoria, Australia.,Clinical Epidemiology & Biostatistics Unit, Murdoch Children's Research Institute, Melbourne, Victoria, Australia.,The University of Melbourne, Melbourne School of Population and Global Health, Melbourne, Victoria, Australia
| | - Louise M Howard
- Health Service and Population Research Department, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK.,South London and Maudsley NHS Foundation Trust, London, UK
| | - Margarita Moreno-Betancur
- Department of Paediatrics, The University of Melbourne, Melbourne, Victoria, Australia.,Clinical Epidemiology & Biostatistics Unit, Murdoch Children's Research Institute, Melbourne, Victoria, Australia
| | - Helena Romaniuk
- Biostatistics Unit, Faculty of Health, Deakin University Geelong, Melbourne, Victoria, Australia
| | - Lex W Doyle
- Clinical Sciences, Murdoch Children's Research Institute, Melbourne, Victoria, Australia.,Department of Obstetrics and Gynaecology, The University of Melbourne, Melbourne, Victoria, Australia.,Research Office, The Royal Women's Hospital, Melbourne, Victoria, Australia
| | - Stephanie Brown
- Department of Paediatrics, The University of Melbourne, Melbourne, Victoria, Australia.,Intergenerational Health, Murdoch Children's Research Institute, Melbourne, Victoria, Australia.,Department of General Practice, The University of Melbourne, Melbourne, Victoria, Australia
| | - Rohan Borschmann
- Murdoch Children's Research Institute, Centre for Adolescent Health, Melbourne, Victoria, Australia.,The University of Melbourne, Melbourne School of Population and Global Health, Melbourne, Victoria, Australia.,Health Service and Population Research Department, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK.,The University of Melbourne, Melbourne School of Psychological Sciences, Melbourne, Victoria, Australia
| | - Yvette Alway
- Murdoch Children's Research Institute, Centre for Adolescent Health, Melbourne, Victoria, Australia
| | - Carolyn Coffey
- Murdoch Children's Research Institute, Centre for Adolescent Health, Melbourne, Victoria, Australia
| | - George C Patton
- Murdoch Children's Research Institute, Centre for Adolescent Health, Melbourne, Victoria, Australia.,Department of Paediatrics, The University of Melbourne, Melbourne, Victoria, Australia
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Ruffell B, Smith DM, Wittkowski A. Psychosocial support for male partners of women admitted to Mother and Baby Units. J Reprod Infant Psychol 2019; 38:378-394. [PMID: 31795728 DOI: 10.1080/02646838.2019.1698018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
OBJECTIVE This study explored what support male partners of women admitted to Mother and Baby Units (MBUs) wanted. BACKGROUND Although research has highlighted the need to support male partners of women admitted to specialist MBUs, little is known about the type of support men want and how they wish support to be delivered. METHODS Ten men whose partner was admitted to a MBU in the United Kingdom or Australia participated in semi-structured interviews. Data were analysed using Thematic Analysis. RESULTS Five themes were identified: (1) A smoother journey to and from the MBU, (2) Feeling included, (3) Uncertainty about 'what is going on', (4) Barriers to support and (5) Facilitators of support. CONCLUSION This is the first qualitative study to specifically explore the type of support male partners of MBU patients would like in terms of content, delivery and timing. Participants expressed the need to be involved in care decisions regarding their spouse and infant and to be offered advice from professionals. They highlighted barriers to accessing support and offered solutions to minimise those. In terms of clinical implications, we recommend a support package, which could be developed for MBUs to improve outcomes for male partners and their family.
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Affiliation(s)
- Beth Ruffell
- Division of Psychology and Mental Health, School of Health Sciences, Faculty of Biology, Medicine and Health, The University of Manchester , Manchester, UK
| | - Debbie M Smith
- Division of Psychology and Mental Health, School of Health Sciences, Faculty of Biology, Medicine and Health, The University of Manchester , Manchester, UK.,School of Social and Health Sciences, Leeds Trinity University , Hosforth, UK
| | - Anja Wittkowski
- Division of Psychology and Mental Health, School of Health Sciences, Faculty of Biology, Medicine and Health, The University of Manchester , Manchester, UK.,Department of Clinical Psychology, Greater Manchester Mental Health Foundation NHS Trust , Manchester, UK
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48
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Leahy-Warren P, Mulcahy H, Lehane E. The development and psychometric testing of the Perinatal Infant Care Social Support (PICSS) instrument. J Psychosom Res 2019; 126:109813. [PMID: 31499230 DOI: 10.1016/j.jpsychores.2019.109813] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2019] [Revised: 08/13/2019] [Accepted: 08/14/2019] [Indexed: 11/25/2022]
Abstract
BACKGROUND Social support facilitates a woman's transition to motherhood. This major developmental transition can be stressful as it includes adaptation of self as well as learning new infant care practice skills. Although a number of instruments have been developed to measure social support, none have been developed or underpinned by theory in the context of perinatal infant care practices. AIM To develop a reliable and valid instrument to measure social support for new mothers in the perinatal period. METHODS Phase 1 involved the development of instrument structure and content. Constructs to be measured were defined through an analysis of relevant theoretical and empirical literature. Phase 2 established the psychometric properties of the functional domain of the PICSS. Exploratory factor analyses and principal Component Analyses were undertaken with a sample of first-time mothers (n = 371) from postnatal wards of a large maternity hospital. Item reduction and Cronbach's alpha reliability tests were performed. The structural social support domain was not amenable to psychometric testing. RESULTS Exploratory Factor Analyses and Principal Component Analyses of the functional domain resulted in a logically coherent 19-item, two-factor solution. The first factor 'Supporting Presence' has nine items (Cronbach's alpha = 0.90) and the second factor 'Practical Support' has ten items (Cronbach's alpha = 0.86). CONCLUSIONS The PICSS is a coherent and valid measure of social support for new mothers in the postnatal period in the context of infant care practices.
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Affiliation(s)
| | - Helen Mulcahy
- School of Nursing and Midwifery, University College Cork, Ireland.
| | - Elaine Lehane
- School of Nursing and Midwifery, University College Cork, Ireland.
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Self- screening using the Edinburgh post natal depression scale for mothers and fathers to initiate early help seeking behaviours. Arch Psychiatr Nurs 2019; 33:421-427. [PMID: 31280789 DOI: 10.1016/j.apnu.2019.05.007] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/18/2018] [Accepted: 05/24/2019] [Indexed: 11/23/2022]
Abstract
The forthcoming birth of a new baby and the life changes that occur can present parents with a range of challenges. While recognised in mothers, postnatal depression is not well researched in fathers; especially considering that up to 25% of men report experiencing depression in the ante and postnatal periods. The aim of this study was to test a self-screening tool and referral pathway pamphlet for expectant women and their partners. We used a single blinded randomised controlled study design. The sample, comprised 70 dyads, was randomised to either care as usual or to the self-screening tool and referral pathway pamphlet intervention. The self-screening tool included the Edinburgh Postnatal Depression Scale (EPDS). Other questionnaires used to survey the dyads were the Kessler Psychological Distress (Kessler-10) and the Maternity Social Support Scale (MSSS). The gender differences in the EPDS, Kessler-10 and MSSS scales are represented by differences of 1.0 points on EPDS, 1.0 points on Kessler-10, fathers were reporting less psychological distress than mothers in all cases. No difference was observed in perceived social support. The attrition between time-points was mostly men. Cultural and socio-demographic factors may affect generalisability of the findings. The self-screening tool and referral pathway pamphlet provided to dyads may have some benefit in assisting couples in the perinatal period to detect and seek help for early symptoms of distress.
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Belay S, Astatkie A, Emmelin M, Hinderaker SG. Intimate partner violence and maternal depression during pregnancy: A community-based cross-sectional study in Ethiopia. PLoS One 2019; 14:e0220003. [PMID: 31365566 PMCID: PMC6668805 DOI: 10.1371/journal.pone.0220003] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2019] [Accepted: 07/06/2019] [Indexed: 11/18/2022] Open
Abstract
Introduction Intimate partner violence (IPV) is regarded an important public health and human rights issue, characterized by physical, sexual or emotional abuse. Globally more than one in three women report physical or sexual violence by their intimate partners. Though the association between IPV and depression is known, we found no study investigating depression as a risk factor for IPV and very few studies using standard tools in assessing both IPV and depression among pregnant women. Aim To measure the prevalence of IPV and depression during pregnancy and assess the association between IPV and depression and other determinants. Methods A community-based cross-sectional study was conducted among 589 pregnant women living in Wondo-Genet district, southern Ethiopia. IPV experience was assessed using a structured questionnaire of the World Health Organization (WHO), and maternal depression was measured by the Edinburgh Postnatal Depression Scale (EPDS). Descriptive statistics were computed and multivariable logistic regression was carried out to estimate risk and adjust for confounders. Results The overall prevalence of IPV was 21% (95% confidence interval [CI] = 18.1–24.7). After adjusting for potential confounders, increased risk of IPV remained among rural women (adjusted odds ratio[AOR] = 2.09; 95%CI = 1.06–4.09), women who had parental exposure to IPV (AOR = 14.00; 95%CI = 6.43–30.48), women whose pregnancy was not desired (AOR = 9.64; 95%CI = 3.44–27.03), women whose husbands used alcohol (AOR = 17.08; 95%CI = 3.83–76.19), women with depression (AOR = 4.71; 95%CI = 1.37–16.18) and women with low social support (AOR = 13.93; 95%CI = 6.98–27.77). The prevalence of antenatal depressive symptom (with EPDS score above 13) was 6.8% (95% CI 6.2–11.3). Increased risk of depression was found among women who had been exposed to IPV (AOR = 17.60; 95%CI = 6.18–50.10) and whose husbands use alcohol (AOR = 3.31; 95%CI = 1.33–8.24). Conclusion One in five pregnant women experienced IPV and it was strongly associated with depression. Screening for IPV and depression at antenatal visits with referral to relevant care and service is recommended.
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Affiliation(s)
- Sewhareg Belay
- School of Public Health, College of Medicine and Health Sciences, Hawassa University, Hawassa, Ethiopia
- * E-mail:
| | - Ayalew Astatkie
- School of Public Health, College of Medicine and Health Sciences, Hawassa University, Hawassa, Ethiopia
| | - Maria Emmelin
- Department of Social Medicine and Global Health, Lund University, Lund, Sweden
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