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Farewell CV, Schmiege SJ, Leiferman J. Racial Differences in Psychosocial Resources and Mental and Physical Health Outcomes during Pregnancy: A structural equation modeling approach. RESEARCH SQUARE 2024:rs.3.rs-4617998. [PMID: 39070611 PMCID: PMC11276014 DOI: 10.21203/rs.3.rs-4617998/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/30/2024]
Abstract
Objectives Poor prenatal health is of particular concern among minoritized individuals who may experience adverse social determinants of health contributing to the intergenerational transmission of health disparities. The purpose of this study was to investigate associations between psychosocial resources, and mental and physical health among a prenatal sample, and to explore if these relationships vary by race. Methods English-speaking pregnant individuals living in the United States were recruited using Centiment (n=340). Participants completed a 121-item cross-sectional survey. We conducted a single- and multi-group structural equation model to test hypothesized relationships, and then investigated differences by pregnant White individuals versus Black, Indigenous, and People of Color (BIPOC). Results Our final single-group model exhibited good model fit (χ2 (43) = 99.07, p<.01, CFI = 0.97, SRMR = 0.04, and RMSEA = 0. 06 (0.05 - 0.08)). After controlling for demographic characteristics and social determinants of health, higher levels of mindfulness were statistically significantly related to lower anxiety and depression scores (both p<.01). Higher levels of social supports were statistically significantly related to lower anxiety scores. Scale measurement invariance was confirmed for the multi-group model and the structural model was statistically significantly different between pregnant White individuals and BIPOC in this sample (Δ χ2 (27) = 116.71, p <.01). Conclusions Identification of core components of psychosocial resource interventions, consideration of upstream structural determinants, mindfulness and valued-living (MVL)-based strategies, cultural adaptation, and an emphasis on resilience rather than psychopathology may result in improved prenatal health among pregnant individuals traditionally underrepresented in research.
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Hoberg MG, Demirci JR, Sereika SM, Levine MD, DeVito Dabbs A. Mixed-Methods Assessment of Maternal Anxiety During the First 8 Weeks After Birth. J Obstet Gynecol Neonatal Nurs 2024; 53:368-382. [PMID: 38325800 PMCID: PMC11246815 DOI: 10.1016/j.jogn.2024.01.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2023] [Revised: 01/05/2024] [Accepted: 01/11/2024] [Indexed: 02/09/2024] Open
Abstract
OBJECTIVE To describe and compare the experiences of postpartum anxiety among women with generalized anxiety and postpartum-specific anxiety. DESIGN Prospective, longitudinal, mixed methods. SETTING Academic tertiary center in the mid-Atlantic United States. Study activities were remote. PARTICIPANTS Women at 1 to 8 weeks after birth (N = 34). METHODS We used mobile surveys to measure daily anxiety ratings and responses to open-ended, theory-driven questions about anxiety. We used the cutoff scores on the State-Trait Anxiety Inventory and Postpartum Specific Anxiety Scale administered 8 weeks after birth to determine the presence of generalized and postpartum-specific anxiety. Participants' responses were analyzed with qualitative description and sorted by anxiety questionnaire scores at 8 weeks after birth. We compared qualitative findings between participants with generalized anxiety and postpartum-specific anxiety. RESULTS Participants with generalized anxiety had high levels of overwhelm and felt ill-equipped to handle daily stressors, whereas those with postpartum-specific anxiety felt adept at coping. Participants with generalized anxiety lacked emotional and physical support, and those with postpartum-specific anxiety reported more physical but variable emotional support. Sources of daily anxiety in participants with postpartum-specific anxiety were infant-centric (e.g., infant health, end of maternity leave, breastfeeding), whereas anxiety sources for participants with generalized anxiety were varied (e.g., self-health, partner concerns). Participants with generalized anxiety versus postpartum-specific anxiety were more likely to be multiparous and have comorbid depression symptoms. CONCLUSION Symptoms, levels of perceived support, and sources of anxiety differed between participants with generalized versus postpartum-specific anxiety. Our findings can inform postpartum anxiety screening strategies and support interventions.
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Alshowkan A, Shdaifat E. Factors influencing postpartum depression in Saudi women: a cross-sectional descriptive study. WOMEN'S HEALTH NURSING (SEOUL, KOREA) 2024; 30:164-173. [PMID: 38987920 PMCID: PMC11237367 DOI: 10.4069/whn.2024.06.18] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/21/2023] [Accepted: 06/18/2024] [Indexed: 07/12/2024]
Abstract
PURPOSE This study aimed to investigate the prevalence of postpartum depression (PPD) and stress, as well as factors influencing PPD, among women in Saudi Arabia. METHODS This study employed a cross-sectional online survey and recruited participants during postpartum visits to the Clinic of Gynecology and Obstetrics in Al-Khobar, Saudi Arabia. Data collection was done using Arabic versions of the Edinburgh Postnatal Depression Scale, Perceived Stress Scale, and a sociodemographics and obstetric history questionnaire. Descriptive and inferential analyses were conducted, including multiple linear regression using a stepwise method. RESULTS Data from the 270 participants showed low levels of postpartum depressive symptoms with a mean score of 2.54±4.5 and low levels of perceived stress with a mean score of 2.49±6.2. While 94.4% of the participants reported low levels of stress and PPD, 5.6% reported elevated levels (≥10 for PPD, ≥14 for stress). The stepwise regression analysis showed significant results (p<.001), accounting for 34% of the variance in PPD. The factors significantly influencing PPD included the type of family, stress, number of abortions, disease during pregnancy, and family income. Importantly, perceived stress emerged as a factor influencing PPD. CONCLUSION Although the majority of participants exhibited low levels of PPD, about 1 in 18 showed elevated levels. The identification of significant influencing factors highlights the need for targeted interventions to effectively address mental health concerns in postpartum women.
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Affiliation(s)
- Amira Alshowkan
- Community Nursing Department, College of Nursing, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Emad Shdaifat
- Community Nursing Department, College of Nursing, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
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Basile-Ibrahim B, Combellick J, Mead TL, Sorensen A, Batten J, Schafer R. The Social Context of Pregnancy, Respectful Maternity Care, Biomarkers of Weathering, and Postpartum Mental Health Inequities: A Scoping Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2024; 21:480. [PMID: 38673391 PMCID: PMC11049830 DOI: 10.3390/ijerph21040480] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/12/2024] [Revised: 04/05/2024] [Accepted: 04/11/2024] [Indexed: 04/28/2024]
Abstract
Background: Mental health disorders are the number one cause of maternal mortality and a significant maternal morbidity. This scoping review sought to understand the associations between social context and experiences during pregnancy and birth, biological indicators of stress and weathering, and perinatal mood and anxiety disorders (PMADs). Methods: A scoping review was performed using PRISMA-ScR guidance and JBI scoping review methodology. The search was conducted in OVID Medline and Embase. Results: This review identified 74 eligible English-language peer-reviewed original research articles. A majority of studies reported significant associations between social context, negative and stressful experiences in the prenatal period, and a higher incidence of diagnosis and symptoms of PMADs. Included studies reported significant associations between postpartum depression and prenatal stressors (n = 17), socioeconomic disadvantage (n = 14), negative birth experiences (n = 9), obstetric violence (n = 3), and mistreatment by maternity care providers (n = 3). Birth-related post-traumatic stress disorder (PTSD) was positively associated with negative birth experiences (n = 11), obstetric violence (n = 1), mistreatment by the maternity care team (n = 1), socioeconomic disadvantage (n = 2), and prenatal stress (n = 1); and inverse association with supportiveness of the maternity care team (n = 5) and presence of a birth companion or doula (n = 4). Postpartum anxiety was significantly associated with negative birth experiences (n = 2) and prenatal stress (n = 3). Findings related to associations between biomarkers of stress and weathering, perinatal exposures, and PMADs (n = 14) had mixed significance. Conclusions: Postpartum mental health outcomes are linked with the prenatal social context and interactions with the maternity care team during pregnancy and birth. Respectful maternity care has the potential to reduce adverse postpartum mental health outcomes, especially for persons affected by systemic oppression.
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Affiliation(s)
| | - Joan Combellick
- School of Nursing, Yale University, Orange, CT 06477, USA; (J.C.)
| | - Thomas L. Mead
- Biomedical Libraries, Dartmouth College, Hanover, NH 03755, USA;
| | - Alee Sorensen
- School of Nursing, Yale University, Orange, CT 06477, USA; (J.C.)
| | - Janene Batten
- Harvey Cushing/John Hay Whitney Medical Library, Yale University, New Haven, CT 06510, USA;
| | - Robyn Schafer
- Division of Advanced Nursing Practice, School of Nursing, Rutgers University, Newark, NJ 07107, USA;
- Department of Obstetrics, Gynecology, and Reproductive Sciences, Robert Wood Johnson Medical School, Rutgers University, New Brunswick, NJ 08901, USA
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Kılıç S, Can R, Yilmaz SD. Spousal support and dyadic adjustment in the early postpartum period. Women Health 2024; 64:121-130. [PMID: 38221674 DOI: 10.1080/03630242.2024.2304891] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2023] [Accepted: 01/09/2024] [Indexed: 01/16/2024]
Abstract
In the study, we aimed to investigate the effects of perceived spousal support and dyadic adjustment on the psychological well-being of women in the early postpartum period. This descriptive and correlational study consisted of 367 women giving birth in the postpartum department between 15th July and 31st October 2022. The data were collected using the Personal Information Form, the Perceived Spousal Support Among Women in Early Postpartum Period (PSSAWEPP), the Revised Dyadic Adjustment Scale (RDAS), and the Psychological Well-Being Scale (PWBS). The average scores of PSSAWEPP, RDAS, and PWBS in the mothers were found as 61.79 ± 7.73, 54.16 ± 6.28, and 45.87 ± 5.74, respectively. The elevated scores of perceived spousal support (β = 0.234, p < .001) and dyadic adjustment (β = 0.270, p < .001) of women led to a significant increase in the level of psychological well-being. In conclusion, the support received by women from spouses and dyadic adjustment affect the psychological well-being of women in the early postpartum period.
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Affiliation(s)
- Sureyya Kılıç
- Department of Obstetrics and Gynecology, Konya City Hospital, Konya, Turkey
| | - Ruveyde Can
- Department of Midwifery, Faculty of Health Sciences, Selcuk University, Konya, Turkey
| | - Sema Dereli Yilmaz
- Department of Midwifery, Faculty of Health Sciences, Selcuk University, Konya, Turkey
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Schalla MA, Stengel A. The role of stress in perinatal depression and anxiety - A systematic review. Front Neuroendocrinol 2024; 72:101117. [PMID: 38176543 DOI: 10.1016/j.yfrne.2023.101117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2023] [Revised: 11/29/2023] [Accepted: 12/31/2023] [Indexed: 01/06/2024]
Abstract
Perinatal depression (PND) and anxiety affect around 20% of women, but available pharmacotherapy is not sufficiently effective in 20-60% of them, indicating a need for better understanding of these diseases. Since stress is a significant risk factor for PND, the aim was to examine the role of biological, environmental and psychological stress in PND and anxiety through a systematic literature search. Overall 210 studies were included, among which numerous rodent studies showed that perinatal stress induced depressive-like and anxious behavior, which was associated with HPA-axis alterations and morphological brain changes. Human studies indicated that the relationship between cortisol and perinatal depression/anxiety was not as clear and with many contradictions, although social and psychological stress were clearly positively associated with PND. Finally, oxytocin, synthetic neuroactive steroid and n-3 PUFA diet have been identified as potentially beneficial in the therapy of PND and anxiety, worth to be investigated in the future.
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Affiliation(s)
- M A Schalla
- Charité Center for Internal Medicine and Dermatology, Department for Psychosomatic Medicine, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, 12203 Berlin, Germany; Department of Psychosomatic Medicine and Psychotherapy, University Hospital Tübingen, Germany; Department of Gynecology and Obstetrics, Helios Clinic, Rottweil, Germany
| | - A Stengel
- Charité Center for Internal Medicine and Dermatology, Department for Psychosomatic Medicine, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, 12203 Berlin, Germany; Department of Psychosomatic Medicine and Psychotherapy, University Hospital Tübingen, Germany; German Center für Mental Health (DZPG), Site Tübingen, Germany.
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Kestler-Peleg M, Greenblatt-Kimron L, Even-Zohar A, Lavenda O. Parental Self-Efficacy Among Israeli Older Adults. Can J Aging 2023; 42:631-641. [PMID: 37272522 DOI: 10.1017/s0714980823000144] [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: 06/06/2023] Open
Abstract
Parental self-efficacy (PSE) is a central aspect of parenting research. Although parenting continues in older ages, few studies have focused on PSE among older adults. In line with the parenting determinant model, the study examined the associations between psychological distress, social support, loneliness, and PSE in older age.The study used a quantitative cross-sectional survey, including 362 Israeli parents age 65 years and above. Participants were asked to complete questionnaires of psychological distress, social support, loneliness, PSE, and background information.Results revealed that higher PSE was associated with lower psychological distress, higher social support, and a lower sense of loneliness in older adults. The research model explained 36.9 per cent of the variance in PSE among older adults.Mental state and social conditions are important for PSE of older adults; therefore, professionals should ensure the availability of diverse solutions to enable, maintain, and promote well-being through social and familial engagement in this population.
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Affiliation(s)
| | | | | | - Osnat Lavenda
- School of Social Work, Ariel University, Ariel, Israel
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Sun Y, Chia SC, Shi Y. How Exposure to Online Parenting Content Relates to Mothers' Self-Discrepancy and Postpartum Mental Health. HEALTH COMMUNICATION 2023; 38:2782-2794. [PMID: 36127777 DOI: 10.1080/10410236.2022.2114769] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Postpartum mental health problems are common and have deleterious effects on new mothers and their babies. This study developed a theoretically informed model of the relationship between exposure to images of motherhood in online parenting content and mothers' postpartum mental health. The model was tested using survey data collected from 509 Chinese mothers during their 12-month postpartum period. The results revealed that greater exposure to online public parenting content was indirectly related to lower levels of shame among new mothers via two mediators: the presumed influence of parenting media content on their partners, and the mothers' perceptions of the discrepancy between their actual selves as mothers and their partners' expectations of an ideal mother (i.e. actual/own - ideal/partner self-discrepancy). In contrast, increased exposure to online private parenting content shared by peers was indirectly related to increased levels of shame among new mothers via the mediation of social comparison with parenting media images, and of the mothers' perceptions of the discrepancy between their actual selves as mothers and their own expectations of an ideal mother (i.e. actual/own - ideal/own self-discrepancy). Additionally, new mothers were more likely to experience depressive symptoms and shame if they felt that they fell short of their partners' expectations of an ideal mother. However, increased social support reduced the anxiety and shame that stemmed from this belief.
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Affiliation(s)
- Yanqing Sun
- School of Journalism and Communication, Hunan University
| | - Stella C Chia
- Department of Media and Communication, City University of Hong Kong
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Canfield SM, Canada KE, Rolbiecki AJ, Petroski GF. Feasibility and acceptability of an online mental health intervention for pregnant women and their partners: a mixed method study with a pilot randomized control trial. BMC Pregnancy Childbirth 2023; 23:739. [PMID: 37853333 PMCID: PMC10585730 DOI: 10.1186/s12884-023-06031-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Accepted: 09/26/2023] [Indexed: 10/20/2023] Open
Abstract
BACKGROUND Untreated perinatal mood and anxiety disorders (PMAD) have short- and long-term health and social consequences; online cognitive behavioral therapy (CBT) interventions can reduce symptoms. Despite partner support being protective online interventions rarely target couples. This study builds on research on an existing CBT-based intervention, the Mothers and Babies Online Course (eMB), by testing its feasibility with prenatal couples. METHODS We conducted a pilot, randomized, controlled feasibility trial using a 1:1 parallel design. To be eligible, participant dyads were pregnant people (between 13-30 weeks gestation and with a score of 10 or greater on either the GAD-7 or PHQ-9 scale indicating elevated symptoms of anxiety or depression) and their cohabitating partners, living in Missouri, with access to the internet; both in the dyad consented to participate. Recruitment occurred via Facebook ads, flyers, and a snowball approach. The intervention group received eMB, and the control group received a list of community resources. We examined retention and adherence data extracted from eMB analytics and study databases. All participants were given depression and anxiety scales at baseline, 4 and 8 weeks to test preliminary efficacy; satisfaction and acceptability were measured at trial end (i.e., eight weeks) and via interview. RESULTS There were 441 people who responded to recruitment materials, 74 pregnant people were screened; 19 partners did not complete enrolment, and 25 dyads were ineligible. There were 15 dyads per group (N = 30) who enrolled; all completed the study. The survey response rate was 90% but partners required nearly twice the number of reminders. No participant completed all lessons. Mean depression and anxiety scores dropped over time for dyads in control (M = -1.99, -1.53) and intervention (M = -4.80, -1.99). Intervention pregnant people's anxiety significantly decreased (M = -4.05; 95% CI [0.82, 7.27]) at time two compared to control. Twelve pregnant people and four partners participated in post-intervention interviews and suggested improvements for eMB. CONCLUSION Online dyadic interventions can potentially reduce PMAD symptoms. However, to feasibly study eMB with couples, strategies to increase program adherence are necessary. Tailoring interventions to overtly include partners may be advantageous. TRIAL REGISTRATION ClinicalTrials.gov NCT05867680, 19/05/2023.
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Affiliation(s)
- Shannon M Canfield
- Department of Family and Community Medicine, University of Missouri, Columbia, MO, USA.
| | - Kelli E Canada
- School of Social Work, University of Missouri, Columbia, MO, USA
| | - Abigail J Rolbiecki
- Department of Family and Community Medicine, University of Missouri, Columbia, MO, USA
- Department of Family Medicine and Division of Geriatrics, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Gregory F Petroski
- Department of Family and Community Medicine, University of Missouri, Columbia, MO, USA
- Department of Biomedical Informatics, Biostatistics, and Medical Epidemiology, School of Medicine - University of Missouri, Columbia, MO, USA
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Effati Daryani F, Mohammadi A, Mirghafourvand M. Childbirth self-efficacy and fear of childbirth and their predictors in adolescent and adult pregnant women referring to health centres of Urmia-Iran: a cross-sectional study. BMJ Open 2023; 13:e077043. [PMID: 37848306 PMCID: PMC10582945 DOI: 10.1136/bmjopen-2023-077043] [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: 06/23/2023] [Accepted: 09/29/2023] [Indexed: 10/19/2023] Open
Abstract
OBJECTIVE Adolescent pregnancy as a growing phenomenon in the world has been investigated from different aspects. However, the examination of childbirth fear and self-efficacy has received less attention. Therefore, this study was conducted to compare the self-efficacy and fear of childbirth and to determine their predictors in adolescent and adult pregnant women. DESIGN In this comparative cross-sectional study, participants were selected through two-stage cluster sampling method. Data were collected using the Childbirth Self-Efficacy Inventory and Wijma Delivery Expectancy/Experience Questionnaire. The Pearson correlation test, independent t-test, and general linear model were used for data analysis. SETTING Urmia health centres, Iran in 2020. PARTICIPANTS Three hundred and sixty adults and adolescent pregnant women. RESULTS The mean (SD) of fear of childbirth was 114.7 (14.1) and 108.1 (23.1) in adolescent and adult pregnant women, respectively. The mean (SD) of childbirth self-efficacy in the active phase and the second stage of labour respectively were also obtained 208.8 (28.6) and 203.5 (32.1) for adolescent pregnant women and 213.8 (25.7) and 212.0 (26.5) for adult ones. There was a significant difference between adolescent and adult pregnant women in fear of childbirth (p=0.001), self-efficacy expectancy (p=0.003) and total childbirth self-efficacy (p=0.008) in the second stage of labour. After adjusting the sociodemographic characteristics, the mean score of fear of childbirth was significantly higher in adolescent pregnant women than in adult ones whereas the mean total self-efficacy score in the second stage of labour was significantly lower in adolescent pregnant women than in adult ones. CONCLUSION This study showed that adolescent pregnant women had more fear of childbirth and low self-efficacy than adult mothers, and there was also a relationship between fear of childbirth and self-efficacy. Paying more attention to fear and self-efficacy in childbirth and their predictors by health providers can improve pregnancy and childbirth outcomes.
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Affiliation(s)
- Fatemeh Effati Daryani
- Midwifery Department, Urmia University of Medical Sciences, Urmia, Iran (the Islamic Republic of)
| | - Azam Mohammadi
- Midwifery Department, Tehran University of Medical Sciences, Tehran, Iran (the Islamic Republic of)
| | - Mojgan Mirghafourvand
- Social Determinants of Health Research Center, Tabriz University of Medical Sciences, Tabriz, Iran (the Islamic Republic of)
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Xiong J, Ma H, Ma R, Xu T, Wang Y. The relationship between perceived stress and prolonged grief disorder among Chinese Shidu parents: effects of anxiety and social support. BMC Psychiatry 2023; 23:714. [PMID: 37784043 PMCID: PMC10546787 DOI: 10.1186/s12888-023-05206-9] [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: 01/26/2023] [Accepted: 09/20/2023] [Indexed: 10/04/2023] Open
Abstract
BACKGROUND Shidu parents refer to the couple who have lost their only child and have not given birth or adopted another child in China. The number of Shidu parents is increasing annually. The aim of this research was to examine the mediating role of anxiety and the moderating role of social support between perceived stress and prolonged grief disorder (PGD) among Chinese Shidu parents. METHODS A cross-sectional study was carried out with 505 participants who completed a questionnaire including the Prolonged Grief Questionnair-3 (PG-13), the Perceived Stress Scale-10 (PSS-10), the Self-Rating Anxiety Scale (SAS) and the Duke-UNC Functional Social Support Questionnaire (FSSQ). SPSS PROCESS macro was employed to examine the mediating role of anxiety and the moderating role of social support. RESULTS The mediation analysis showed anxiety partially mediated the link between perceived stress and PGD, and the proportion of mediation of anxiety was 39.22%. The moderated mediation analysis revealed the second stage of mediating effects of anxiety on the link between perceived stress and PGD was moderated by social support. Specifically, compared with Shidu parents with higher social support, the association between anxiety and PGD was closer for those with lower social support. CONCLUSIONS The moderated mediation model can broaden our understanding of how and when perceived stress, anxiety and social support work together to affect PGD. The interventions aimed at improving mental health of Chinese Shidu parents need to work on reducing stress and enhancing social support.
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Affiliation(s)
- Jiexi Xiong
- Department of Social Medicine, College of Health Management, China Medical University, No. 77 Puhe Road, Shenyang North New District, Shenyang, Liaoning, 110122, P.R. China
| | - Hongfei Ma
- Department of Social Medicine, College of Health Management, China Medical University, No. 77 Puhe Road, Shenyang North New District, Shenyang, Liaoning, 110122, P.R. China
| | - Ruiyao Ma
- Department of Social Medicine, College of Health Management, China Medical University, No. 77 Puhe Road, Shenyang North New District, Shenyang, Liaoning, 110122, P.R. China
| | - Tianhui Xu
- Department of Social Medicine, College of Health Management, China Medical University, No. 77 Puhe Road, Shenyang North New District, Shenyang, Liaoning, 110122, P.R. China
| | - Yang Wang
- Department of Social Medicine, College of Health Management, China Medical University, No. 77 Puhe Road, Shenyang North New District, Shenyang, Liaoning, 110122, P.R. China.
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Traino KA, Fisher RS, Basile NL, Dattilo TM, Baskin LS, Buchanan CL, Chan YM, Cheng EY, Coplen DE, Kolon TF, Lakshmanan Y, Palmer BW, Mullins LL, Ciciolla LM, Wisniewski AB. Adverse Birth Experiences and Parent Adjustment Associated With Atypical Genital Appearance Due to Differences of Sex Development. J Pediatr Psychol 2023; 48:759-767. [PMID: 37500595 PMCID: PMC10516460 DOI: 10.1093/jpepsy/jsad042] [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: 03/20/2023] [Revised: 06/22/2023] [Accepted: 06/23/2023] [Indexed: 07/29/2023] Open
Abstract
OBJECTIVE Differences/disorders of sex development (DSDs) are rare, congenital conditions involving discordance between chromosomes, gonads, and phenotypic sex and are often diagnosed in infancy. A key subset of parents of children newly diagnosed with a DSD experience clinically elevated distress. The present study examines the relationship between perinatal factors (i.e., gestational age, delivery method) and trajectories of parental adjustment. METHODS Parent participants (mothers = 37; fathers = 27) completed measures at baseline, 6- and 12-month follow-up. Multilevel linear regression controlled for clustering of the data at three levels (i.e., time point, parent, and family) and examined the relationship between perinatal factors and trajectories of depressive and anxious symptoms. Two-way interactions between perinatal factors and parent type were evaluated. RESULTS Overall depressive and anxious symptoms decreased over time. There were significant interactions between gestational age and parent type for depressive and anxious symptoms, with younger gestational age having a stronger negative effect on mothers vs. fathers. There was a significant interaction between time and gestational age for depressive symptoms, with 36 weeks' gestational age demonstrating a higher overall trajectory of depressive symptoms across time compared to 38 and 40 weeks. Findings for the delivery method were not significant. CONCLUSIONS Findings uniquely demonstrated younger gestational age was associated with increased depressive symptoms, particularly for mothers compared to fathers. Thus, a more premature birth may predispose parents of infants with DSD to distress. Psychosocial providers should contextualize early diagnosis-related discussions within stressful birth experiences when providing support.
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Affiliation(s)
- Katherine A Traino
- Department of Psychology, Center for Pediatric Psychology, Oklahoma State University, USA
| | - Rachel S Fisher
- Department of Psychology, Center for Pediatric Psychology, Oklahoma State University, USA
| | - Nathan L Basile
- Department of Psychology, Center for Pediatric Psychology, Oklahoma State University, USA
| | - Taylor M Dattilo
- Department of Psychology, Center for Pediatric Psychology, Oklahoma State University, USA
| | - Laurence S Baskin
- Department of Urology, University of California San Francisco Medical Center, USA
| | - Cindy L Buchanan
- Department of Psychiatry, University of Colorado Anschutz Medical Campus, USA
| | - Yee-Ming Chan
- Division of Endocrinology, and Harvard Medical School, Boston Children’s Hospital, USA
| | - Earl Y Cheng
- Department of Urology, Ann & Robert H. Lurie Children’s Hospital of Chicago, USA
| | - Douglas E Coplen
- Division of Urologic Surgery, St. Louis Children’s Hospital, USA
| | - Thomas F Kolon
- Division of Urology, Children’s Hospital of Philadelphia, USA
| | | | - Blake W Palmer
- Department of Pediatric Urology, Cook Children’s Medical Center, USA
| | - Larry L Mullins
- Department of Psychology, Center for Pediatric Psychology, Oklahoma State University, USA
| | - Lucia M Ciciolla
- Department of Psychology, Center for Pediatric Psychology, Oklahoma State University, USA
| | - Amy B Wisniewski
- Department of Psychology, Center for Pediatric Psychology, Oklahoma State University, USA
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Türkmen H, Sezer F. The Effect of Fear of Happiness as a Cultural Phenomenon on Anxiety and Self-Efficacy in the Puerperae. J Transcult Nurs 2023; 34:356-364. [PMID: 37554081 DOI: 10.1177/10436596231188361] [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: 08/10/2023] Open
Abstract
INTRODUCTION Individuals who believe that experiencing positive emotions such as happiness could lead to negative results can suppress their authentic positive feelings to prevent undesired consequences. The aim of this study was to determine the levels of fear of happiness as a cultural phenomenon among puerperal women and the effects of fear of happiness on anxiety and self-efficacy in these women. METHOD This cross-sectional study was conducted in the puerperal service of a hospital in Turkey between September 2021 and June 2022 (n = 287). The study data were collected through State-Trait Anxiety Inventory Scale (STAI-I and STAI-II), General Self-Efficacy (GSE) Scale, and Fear of Happiness Scale (FHS). RESULTS There was a significant relationship between STAI-II and GSE and FHS scores, which explained 43.4% (R2 = .434) of the variance (p < .001). Also, a significant relationship of GSE with working at an income-generating job, STAI-I, and STAI-II was found (p = .008, p = .040, p < .001, respectively). It was found that the puerperae who stated that they needed training on the postpartum process and baby care had high levels of fear of happiness (p = .007). DISCUSSION Screening puerperae in terms of fear of happiness is important for determining their psychological well-being. Health care professionals should be aware that fear of happiness as a cultural approach negatively affects anxiety and therefore self-efficacy levels of puerperae. Providing a comprehensive training to the puerperae on parenthood and self-efficacy as well as mental health support is important for them to cope with fear of happiness.
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Leavy E, Cortet M, Huissoud C, Desplanches T, Sormani J, Viaux-Savelon S, Dupont C, Pichon S, Gaucher L. Disrespect during childbirth and postpartum mental health: a French cohort study. BMC Pregnancy Childbirth 2023; 23:241. [PMID: 37046229 PMCID: PMC10091597 DOI: 10.1186/s12884-023-05551-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2022] [Accepted: 03/28/2023] [Indexed: 04/14/2023] Open
Abstract
BACKGROUND While the World Health Organisation (WHO) warned about mistreatment, disrespect and/or abuse during childbirth as early as 2014. This same year a social media movement with #payetonuterus brought to light the problematic of obstetrical violence in French speaking countries, and more specifically on issues of disrespect. The experience of care is an integral part of the quality of care, and perception on inadequate support during labour and loss of control in labour are some of the most frequently reported risk factors for childbirth-related post-traumatic stress disorder (CB-PTSD). Therefore, it seems crucial to study the associations between disrespect during childbirth and the mental well-being of mothers. METHODS We performed a multicentered cohort study using auto-questionnaires within a French perinatal network. The main outcome was women's report of disrespect during childbirth measured by the Behavior of the Mother's Caregivers - Satisfaction Questionnaire (BMC-SQ) 3 days and 2 months after childbirth. CB-PTSD and Postpartum Depression (PPD) were assessed 2 months after childbirth using respectively the Post-Traumatic Checklist Scale (PCLS) and the Edinburgh Postnatal Depression Scale (EPDS). RESULTS This study followed 123 mothers from childbirth to 2 months postpartum. Among them, 8.13% (n = 10/123) reported disrespect during childbirth at 3 days after childbirth. With retrospect, 10.56% (n = 13/123) reported disrespect during childbirth at 2 months postpartum, i.e. an increase of 31%. Some 10.56% (n = 13/123) of mothers suffered from postpartum depression, and 4.06% (n = 5/123) were considered to have CB-PTSD at 2 months after childbirth. Reported disrespect during childbirth 3 days after birth was significantly associated with higher CB-PTSD 2 months after birth (R2 = 0.11, F(1,117) = 15.14, p < 0.001 and β = 9.11, p = 0.006), PPD at 2 months after childbirth was positively associated to reported disrespect in the birth room, 3 days after birth (R2 = 0.04, F(1, 117) = 6.28, p = 0.01 and β = 3.36, p = 0.096). Meanwhile, PPD and CB-PTSD were significantly associated 2 months after childbirth (R2 = 0.41, F=(1,117) = 82.39, p < 0.01 and β = 11.41, p < 0.001). CONCLUSIONS Disrespect during childbirth was associated with poorer mental health during the postpartum period. Given the high prevalence of mental health problems and the increased susceptibility to depression during the postpartum period, these correlational results highlight the importance of gaining a deeper awareness of healthcare professionals about behaviours or attitudes which might be experienced as disrespectful during childbirth.
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Affiliation(s)
- Emma Leavy
- Geneva School of Health Sciences, HES-SO University of Applied Sciences and Arts, Western Switzerland47, av. de Champel, Geneva, CH-1206, Switzerland
| | - Marion Cortet
- Hospices Civils de Lyon, Hôpital de la Croix-Rousse, Lyon, F-69004, France
| | - Cyril Huissoud
- Hospices Civils de Lyon, Hôpital Femme Mère-Enfant, Bron, F-69500, France
| | - Thomas Desplanches
- Geneva School of Health Sciences, HES-SO University of Applied Sciences and Arts, Western Switzerland47, av. de Champel, Geneva, CH-1206, Switzerland
| | - Jessica Sormani
- Geneva School of Health Sciences, HES-SO University of Applied Sciences and Arts, Western Switzerland47, av. de Champel, Geneva, CH-1206, Switzerland
| | | | | | - Swann Pichon
- Geneva School of Health Sciences, HES-SO University of Applied Sciences and Arts, Western Switzerland47, av. de Champel, Geneva, CH-1206, Switzerland
| | - Laurent Gaucher
- Geneva School of Health Sciences, HES-SO University of Applied Sciences and Arts, Western Switzerland47, av. de Champel, Geneva, CH-1206, Switzerland.
- Hospices Civils de Lyon, Hôpital Femme Mère-Enfant, Bron, F-69500, France.
- Research on Healthcare Performance (RESHAPE), Université Claude Bernard Lyon 1, INSERM U1290, Lyon, F-69008, France.
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Isokääntä S, Koivula K, Kokki H, Palokangas S, Tavast K, Toivonen I, Kokki M. Psychiatric symptoms and couple satisfaction in parents of newborns before and during the COVID-19 pandemic-A comparison of two prospective studies. Nurs Open 2023; 10:2667-2677. [PMID: 36380141 PMCID: PMC10006651 DOI: 10.1002/nop2.1475] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2022] [Revised: 10/21/2022] [Accepted: 10/29/2022] [Indexed: 11/17/2022] Open
Abstract
AIMS To assess anxiety, depression, perceived stress, couple satisfaction and life satisfaction of parents of healthy newborns in two cohorts in 2015 and in 2020 during the COVID-19 pandemic. DESIGN A prospective follow-up study. METHODS We enrolled 60 parents of healthy newborns (n = 30 dyads) in 2015 and 60 parents (n = 30 dyads) in 2020. Both parents completed six valid and reliable questionnaires independently 1-2 days and 12 months after delivery: Beck Anxiety Inventory, Beck Depression Inventory-II, Edinburgh Postnatal Depression Scale, Perceived Stress Scale, Couple Satisfaction Index and Life Satisfaction Scale-4. RESULTS Anxiety was more common but couple satisfaction better in both parents during the COVID-19 pandemic than in 2015. Depressive symptoms and perceived stress were similarly low, and life satisfaction was similarly high in both cohorts, indicating ample parental resilience. There was a moderate positive association between previous mental health disorders and parental anxiety after delivery during the COVID-19 pandemic.
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Affiliation(s)
- Siiri Isokääntä
- Department of Anesthesiology and Intensive Care, Kuopio University Hospital, Kuopio, Finland.,School of Medicine, Faculty of Health Sciences, University of Eastern Finland, Kuopio, Finland
| | - Krista Koivula
- Department of Pediatrics, Kuopio University Hospital, Kuopio, Finland
| | - Hannu Kokki
- Department of Anesthesiology and Intensive Care, Kuopio University Hospital, Kuopio, Finland
| | - Sinivaula Palokangas
- School of Medicine, Faculty of Health Sciences, University of Eastern Finland, Kuopio, Finland
| | - Kati Tavast
- School of Medicine, Faculty of Health Sciences, University of Eastern Finland, Kuopio, Finland
| | - Iines Toivonen
- School of Medicine, Faculty of Health Sciences, University of Eastern Finland, Kuopio, Finland
| | - Merja Kokki
- Department of Anesthesiology and Intensive Care, Kuopio University Hospital, Kuopio, Finland
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Galbally M, Watson SJ, Coleman M, Worley P, Verrier L, Padmanabhan V, Lewis AJ. Rurality as a predictor of perinatal mental health and well-being in an Australian cohort. Aust J Rural Health 2023; 31:182-195. [PMID: 36251362 PMCID: PMC10946854 DOI: 10.1111/ajr.12934] [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: 05/01/2022] [Revised: 09/18/2022] [Accepted: 09/26/2022] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVE Perinatal emotional well-being is more than the presence or absence of depressive and anxiety disorders; it encompasses a wide range of factors that contribute to emotional well-being. This study compares perinatal well-being between women living in metropolitan and rural regions. DESIGN Prospective, longitudinal cohort. PARTICIPANTS/SETTING Eight hundred and six women from Victoria and Western Australia recruited before 20 weeks of pregnancy and followed up to 12 months postpartum. MAIN OUTCOME MEASURES Rurality was assessed using the Modified Monash Model (MM Model) with 578 in metropolitan cities MM1, 185 in regional and large rural towns MM2-MM3 and 43 in rural to remote MM4-MM7. The Structured Clinical Interview for DSM-IV (SCID-IV) was administered at recruitment to assess depression, and symptoms of depression and anxiety were measured using the Edinburgh Post-natal Depression Scale and the State and Trait Anxiety Scale, respectively. Other measures included stressful events, diet, exercise, partner support, parenting and sleep. RESULTS The prevalence of depressive disorders did not differ across rurality. There was also no difference in breastfeeding cessation, exercise, sleep or partner support. Women living in rural communities and who also had depression reported significantly higher parenting stress than metropolitan women and lower access to parenting activities. CONCLUSIONS Our study suggests while many of the challenges of the perinatal period were shared between women in all areas, there were important differences in parenting stress and access to activities. Furthermore, these findings suggest that guidelines and interventions designed for perinatal mental health should consider rurality.
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Affiliation(s)
- Megan Galbally
- School of Clinical SciencesMonash UniversityClaytonVictoriaAustralia
- Health Futures InstituteMurdoch UniversityMurdochWestern AustraliaAustralia
| | - Stuart J. Watson
- School of Clinical SciencesMonash UniversityClaytonVictoriaAustralia
- Health Futures InstituteMurdoch UniversityMurdochWestern AustraliaAustralia
| | - Mathew Coleman
- The Rural Clinical School of WAUniversity of Western AustraliaPerthWestern AustraliaAustralia
- Telethon Kids InstitutePerth's Children HospitalPerthWestern AustraliaAustralia
| | - Paul Worley
- Riverland Academy of Clinical ExcellenceRiverland Mallee Coorong Local Health NetworkMurray BridgeSouth AustraliaAustralia
- College of Medicine and Public HealthFlinders UniversityAdelaideSouth AustraliaAustralia
| | - Leanda Verrier
- Women and Newborn Health ServiceKing Edward Memorial Hospital for WomenSubiacoWestern AustraliaAustralia
| | | | - Andrew J. Lewis
- Institute of Health and Well‐beingFederation UniversityBallaratVictoriaAustralia
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Zhou X, Rao L, Yang D, Wang T, Li H, Liu Z. Effects of maternal pre-pregnancy body mass index and gestational weight gain on antenatal mental disorders in China: a prospective study. BMC Pregnancy Childbirth 2023; 23:188. [PMID: 36934260 PMCID: PMC10024407 DOI: 10.1186/s12884-023-05502-y] [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: 10/10/2022] [Accepted: 03/06/2023] [Indexed: 03/19/2023] Open
Abstract
BACKGROUND Maternal obesity is the most common medical condition among women of reproductive age worldwide. The pre-pregnancy body mass index and gestational weight gain have been suggested to be associated with maternal mental disorders. This study aimed to investigate the effects of the pre-pregnancy body mass index and gestational weight gain on antenatal depression, stress, and anxiety. METHODS In total, 4,890 pregnant women were enrolled in the present study, which is based on an ongoing prospective cohort study. We used self-reported pre-pregnancy weights and the last weights measured prior to delivery (using professional instruments) to calculate the pre-pregnancy body mass index and gestational weight gain. The questionnaires used included the Center for Epidemiologic Studies Depression Scale (CES-D), Self-Rating Anxiety Scale (SAS), and 10-item version of the Perceived Stress Scale (PSS-10). We used Pearson product-moment correlation and multivariable logistic regression models to examine the impact of the pre-pregnancy body mass index and gestational weight gain on different maternal mental disorders. RESULTS After adjusting for conception, annual household income, occupation, education, smoking status, and drinking status, excessive gestational weight gain during pregnancy was associated with a greater chance of anxiety symptoms in the entire sample (adjusted model: odds ratio = 1.479, 95% confidence interval = 1.128, 1.938) and especially in women with a normal body mass index (adjusted model: odds ratio = 1.668, 95% confidence interval = 1.209, 2.302). However, the relationship between the maternal pre-pregnancy body mass index and mental health was not significant. CONCLUSION Pregnant women with a normal pre-pregnancy body mass index had a greater chance of experiencing anxiety symptoms before delivery if gestational weight gain was excessive; however, its effects on depression or stress symptoms were not observed. The maternal pre-pregnancy body mass index may not be independently associated with maternal mental disorders.
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Affiliation(s)
- Xuan Zhou
- School of Medicine, The International Peace Maternity and Child Health Hospital, Shanghai Jiao Tong University, 910 Hengshan Road, Xuhui District, 200030, Shanghai, China
- Shanghai Key Laboratory of Embryo Original Diseases, 200030, Shanghai, China
- Institute of Birth Defects and Rare Diseases, School of Medicine, Shanghai Jiao Tong University, 200030, Shanghai, China
| | - Lin Rao
- School of Medicine, The International Peace Maternity and Child Health Hospital, Shanghai Jiao Tong University, 910 Hengshan Road, Xuhui District, 200030, Shanghai, China
- Shanghai Key Laboratory of Embryo Original Diseases, 200030, Shanghai, China
- Institute of Birth Defects and Rare Diseases, School of Medicine, Shanghai Jiao Tong University, 200030, Shanghai, China
| | - Dongjian Yang
- School of Medicine, The International Peace Maternity and Child Health Hospital, Shanghai Jiao Tong University, 910 Hengshan Road, Xuhui District, 200030, Shanghai, China
- Shanghai Key Laboratory of Embryo Original Diseases, 200030, Shanghai, China
- Institute of Birth Defects and Rare Diseases, School of Medicine, Shanghai Jiao Tong University, 200030, Shanghai, China
| | - Tong Wang
- Shanghai Jiao Tong University School of Medicine, 200030, Shanghai, China
| | - Hong Li
- School of Medicine, The International Peace Maternity and Child Health Hospital, Shanghai Jiao Tong University, 910 Hengshan Road, Xuhui District, 200030, Shanghai, China.
- Shanghai Key Laboratory of Embryo Original Diseases, 200030, Shanghai, China.
- Institute of Birth Defects and Rare Diseases, School of Medicine, Shanghai Jiao Tong University, 200030, Shanghai, China.
| | - Zhiwei Liu
- School of Medicine, The International Peace Maternity and Child Health Hospital, Shanghai Jiao Tong University, 910 Hengshan Road, Xuhui District, 200030, Shanghai, China.
- Shanghai Key Laboratory of Embryo Original Diseases, 200030, Shanghai, China.
- Institute of Birth Defects and Rare Diseases, School of Medicine, Shanghai Jiao Tong University, 200030, Shanghai, China.
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Shorey S, Chong YS, Shi L, Chua JS, Mathews J, Lim SH, Du R, Chan YH, Tan TC, Chee C, Law E. Evaluating the Effects of the Supportive Parenting App on Infant Developmental Outcomes: Longitudinal Study. JMIR Mhealth Uhealth 2023; 11:e43885. [PMID: 36811952 PMCID: PMC9996416 DOI: 10.2196/43885] [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: 10/28/2022] [Revised: 12/04/2022] [Accepted: 01/12/2023] [Indexed: 01/15/2023] Open
Abstract
BACKGROUND Previous studies have investigated the various effects of parenting on infant developmental outcomes. In particular, parental stress and social support have been found to significantly affect the growth of the newborn. Although many parents today use mobile apps to obtain more support in parenting and perinatal care, few studies have examined how these apps could affect infant development. OBJECTIVE This study aimed to examine the effectiveness of the Supportive Parenting App (SPA) in improving infant developmental outcomes during the perinatal period. METHODS This study adopted a 2-group parallel prospective longitudinal design and recruited 200 infants and their parents (N=400 mothers and fathers). The parents were recruited at 24 weeks of gestation for a randomized controlled trial conducted from February 2020 to July 2022. They were randomly allocated to either the intervention or control group. The infant outcome measures included cognition, language, motor skills, and social-emotional development. Data were collected from the infants when they were aged 2, 4, 6, 9, and 12 months. Linear and modified Poisson regressions were used to analyze the data to examine between- and within-group changes. RESULTS At 9 and 12 months post partum, the infants in the intervention group were found to have better communication and language skills than those in the control group. An analysis of motor development revealed that a larger proportion of the infants in the control group fell under the at-risk category, where they scored approximately 2 SDs below the normative scores. The control group infants scored higher on the problem solving domain at 6 months post partum. However, at 12 months postpartum, the infants in the intervention group performed better on cognitive tasks than those in the control group. Despite not being statistically significant, the intervention group infants were found to have consistently scored better on the social components of the questionnaires than the control group infants. CONCLUSIONS Overall, the infants whose parents had received the SPA intervention tended to fare better in most developmental outcome measures than those whose parents had received standard care only. The findings of this study suggest that the SPA intervention exerted positive effects on the communication, cognition, motor, and socioemotional development of the infants. Further research is needed to improve the content and support provided by the intervention to maximize the benefits gained by infants and their parents. TRIAL REGISTRATION ClinicalTrials.gov NCT04706442; https://clinicaltrials.gov/ct2/show/NCT04706442.
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Affiliation(s)
- Shefaly Shorey
- Alice Lee Centre for Nursing Studies, National University of Singapore, Singapore, Singapore
| | - Yap Seng Chong
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Luming Shi
- Singapore Clinical Research Institute, Singapore, Singapore
| | - Jing Shi Chua
- Alice Lee Centre for Nursing Studies, National University of Singapore, Singapore, Singapore
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- Division of Nursing, KK Women's and Children's Hospital, Singapore, Singapore
| | - Jancy Mathews
- National University Polyclinics, Singapore, Singapore
| | | | - Ruochen Du
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Yiong Huak Chan
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Thiam Chye Tan
- Mount Elizabeth Novena Specialist Centre, Singapore, Singapore
| | | | - Evelyn Law
- National University Hospital, Singapore, Singapore
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Hinton L, Dumelow C, Hodgkinson J, Montgomery C, Martin A, Allen C, Tucker K, Green ME, Wilson H, McManus RJ, Chappell LC, Band R. 'Nesting networks': Women's experiences of social network support in high-risk pregnancy. Midwifery 2023; 120:103622. [PMID: 36893551 DOI: 10.1016/j.midw.2023.103622] [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: 07/26/2022] [Revised: 01/27/2023] [Accepted: 02/03/2023] [Indexed: 02/18/2023]
Abstract
OBJECTIVE Social support, an individual's social relationships (both online and offline), may provide protection against adverse mental health outcomes, such as anxiety and depression, which are high in women who have been hospitalised with high-risk pregnancy. This study explored the social support available to women at higher risk of preeclampsia during pregnancy by examining personal social networks. DESIGN Semi-structured interviews were accompanied by social network mapping using the web-based social networking tool GENIE. SETTING England. PARTICIPANTS Twenty-one women were recruited, of whom 18 were interviewed both during pregnancy and postnatally between April 2019 and April 2020. Nineteen women completed maps pre-natally, 17 women completed maps pre-natally and post-natally. Women were taking part in the BUMP study, a randomised clinical trial that included 2441 pregnant individuals at higher risk of preeclampsia and recruited at a mean of 20 weeks' gestation from 15 hospital maternity units in England between November 2018 and October 2019. RESULTS Women's social networks tightened during pregnancy. The inner network changed most dramatically postnatally with women reporting fewer network members. Interviews revealed networks were primarily 'real-life' rather than online social networks, with members providing emotional, informational, and practical support. Women with a high-risk pregnancy valued the relationships they developed with health professionals during pregnancy, and would like their midwife to have a more central role in their networks by providing informational and, where needed, emotional support. The social network mapping data supported the qualitative accounts of changing networks across high-risk pregnancy. CONCLUSION Women with a high-risk pregnancy seek to build "nesting networks" to support them through pregnancy into motherhood. Different types of support are sought from trusted sources. Midwives can play a key role. PRACTICE IMPLICATIONS As well as highlighting other potential needs during pregnancy and the ways in which they can be met, support from midwives has a key role. Through talking to women early in their pregnancy, signposting information and explaining ways to contact health professionals regarding informational or emotional support would fill a gap that currently is met by other aspects of their network.
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Affiliation(s)
- L Hinton
- The Healthcare Improvement Studies (THIS) Institute, University of Cambridge.
| | - C Dumelow
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, OX2 6GG, UK
| | - J Hodgkinson
- Institute of Applied Health Research, University of Birmingham, Birmingham
| | - C Montgomery
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, OX2 6GG, UK
| | - A Martin
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, OX2 6GG, UK
| | - C Allen
- School of Health Sciences, University of Southampton, Southampton, UK. SO17 1BJ
| | - K Tucker
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, OX2 6GG, UK
| | | | - H Wilson
- Department of Women and Children's Health, King's College London, London
| | - R J McManus
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, OX2 6GG, UK
| | - L C Chappell
- Department of Women and Children's Health, King's College London, London
| | - R Band
- School of Health Sciences, University of Southampton, Southampton, UK. SO17 1BJ
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Perceived social support in solo women seeking treatment with donor gametes and in women in heterosexual couples seeking IVF-treatment with own gametes. Sci Rep 2023; 13:2733. [PMID: 36792663 PMCID: PMC9931690 DOI: 10.1038/s41598-023-29441-y] [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: 12/12/2021] [Accepted: 02/06/2023] [Indexed: 02/17/2023] Open
Abstract
Solo motherhood is a family constellation that is becoming increasingly common in high income countries. The demographic characteristics of solo women entering treatment with donated sperm or embryo have been shown to be different from that of cohabiting women. The general importance of perceived social support is frequently amplified when health and quality of life are concerned, and positively affects mental health status, experienced stress, perceived self-efficacy during the transition to parenthood and during parenthood itself. The objective of the present study was to compare demographic characteristics, social network and perceived social support among solo women and cohabiting women awaiting fertility treatment. This objective was explored with a study-specific demographic and background questionnaire as well as through questions on access to practical support and the Multidimensional Scale of Perceived Social Support (MSPSS) assessing different sources of support. This study is a part of a longitudinal prospective multicenter study of solo women who awaited donation treatment in six Swedish public and private fertility clinics and a comparison group of women who were cohabiting/married to male partner and awaited in vitro fertilization (IVF) treatment with the couple's own gametes. A total of 670 women were invited and 463 accepted participation (69% response rate); 207 solo women (study group) and 256 cohabiting women (comparison group). The results show significant differences in age, education, and employment between the groups. Solo women were on average 3.6 years older, had a higher level of education, a higher-income profession, and were more frequently working full time. Solo women perceived an equally high degree of social support from their families, significantly higher levels of support from friends and significantly lower support from a significant other compared to cohabiting women. Solo women expected their mother to be the most supportive person in future parenthood, while cohabiting women most often stated their cohabiting partner to fill that role. The study adds to the body of knowledge of solo women as a sociodemographic distinct group going at motherhood alone, stating a high degree of currently perceived and expected social support. The previously studied negative impact that lack of a co-parent might have, may be attenuated by the expected and perceived social support from family and friends.
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Bień A, Pieczykolan A, Korżyńska-Piętas M, Grzesik-Gąsior J. Body Esteem and Self-Efficacy of Pregnant Women with Gestational Diabetes Mellitus. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:2171. [PMID: 36767537 PMCID: PMC9915844 DOI: 10.3390/ijerph20032171] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Revised: 01/21/2023] [Accepted: 01/23/2023] [Indexed: 06/18/2023]
Abstract
The diagnosis of gestational diabetes mellitus provokes a change in a pregnant woman's lifestyle, which may affect her well-being and precipitate a sense of loss of self-control over her own body. The perception of "body image" is not only physical appearance and physical attractiveness but also the emotional attitude to the body and beliefs about it. The aim of the study was to analyze the factors affecting body esteem and analyze the relationship between body esteem and self-efficacy in pregnant women with gestational diabetes mellitus. The study was conducted in the period from April 2019 to January 2021 among 287 women with gestational diabetes mellitus with the use of the following research tools: Body Esteem Scale (BES) and Generalized Self-Efficacy Scale (GSES). The explanatory variables for the sexual attractiveness variable were age (β = 0.252; p = 0.006) and education (β = 0.334; p = 0.007), for the weight concern variable were age (β = 0.161; p = 0.005), BMI (β = 0.334; p = 0.005), and education (β = 0.252; p = 0.033), for the physical condition variable, were age (β = 0.096; p = 0.004) and education (β = 0.213; p = 0.006). Positive correlations were found between self-efficacy and body esteem in the aspects of sexual attractiveness (p = 0.350), weight concern (p = 0.296), and physical condition (p = 0.286). Positive correlations were found between self-efficacy and body esteem in the aspects of sexual attractiveness (p = 0.350), weight concern (p = 0.296), and physical condition (p = 0.286). Older women who had better education and a lower BMI rated their bodies better. In women with gestational diabetes mellitus, high self-efficacy determines a better perception of their bodies in all areas: sexual attractiveness, weight concern, and physical condition.
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Affiliation(s)
- Agnieszka Bień
- Chair of Obstetrics Development, Faculty of Health Sciences, Medical University of Lublin, 4/6 Staszica St., 20-081 Lublin, Poland
| | - Agnieszka Pieczykolan
- Chair of Obstetrics Development, Faculty of Health Sciences, Medical University of Lublin, 4/6 Staszica St., 20-081 Lublin, Poland
| | - Magdalena Korżyńska-Piętas
- Chair of Obstetrics Development, Faculty of Health Sciences, Medical University of Lublin, 4/6 Staszica St., 20-081 Lublin, Poland
| | - Joanna Grzesik-Gąsior
- State University of Applied Sciences in Krosno, 6 KazimierzaWielkiego St., 38-400 Krosno, Poland
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Liebana-Presa C, Martínez-Fernández MC, García-Fernández R, Martín-Vázquez C, Fernández-Martínez E, Hidalgo-Lopezosa P. Self perceived health and stress in the pregnancy during the COVID-19 pandemic. Front Psychiatry 2023; 14:1166882. [PMID: 37065878 PMCID: PMC10102544 DOI: 10.3389/fpsyt.2023.1166882] [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: 02/15/2023] [Accepted: 03/14/2023] [Indexed: 04/18/2023] Open
Abstract
Introduction The COVID-19 pandemic has had numerous maternal and neonatal consequences, especially at the mental level. Pregnant women experience a rise in anxiety symptoms and prenatal stress. Aims The aim was to describe self-perceived health status, general stress and prenatal stress and to analyze relations and associations with sociodemographic factors. Methods A quantitative, descriptive and cross-sectional study was conducted using non-probabilistic circumstantial sampling. The sample was recruited during the first trimester of pregnancy during the control obstetrical visit. The Google Forms platform was used. A total of 297 women participated in the study. The Prenatal Distress Questionnaire (PDQ), the Perceived Stress Score (PSS) and the General Health Questionnaire (GHQ-28) were used. Results Primiparas presented higher levels of worry about childbirth and the baby (10.93 ± 4.73) than multiparous women (9.88 ± 3.96). Somatic symptoms were present in 6% of the women. Anxiety-insomnia was scored positively by 18% of the women. In the Spearman correlation analysis, statistically significant values were found between almost all study variables. A positive correlation was observed between self-perceived health and prenatal and general stress levels. Discussion During the first trimester of gestation, prenatal concerns increase when levels of anxiety, insomnia and depression also increase. There is a clear relationship between prenatal worries, anxiety, insomnia and depression with stress. Health education that focuses on mental health of pregnant women would help reduce worries during pregnancy and would improve the pregnant women perception of her health and well-being.
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Affiliation(s)
- Cristina Liebana-Presa
- Department of Nursing and Physiotherapy, Universidad de León, León, Spain
- SALBIS Research Group, Faculty of Health Sciences, Ponferrada, Spain
| | - María Cristina Martínez-Fernández
- Department of Nursing and Physiotherapy, Universidad de León, León, Spain
- SALBIS Research Group, Faculty of Health Sciences, Ponferrada, Spain
| | - Rubén García-Fernández
- Department of Nursing and Physiotherapy, Universidad de León, León, Spain
- SALBIS Research Group, Faculty of Health Sciences, Ponferrada, Spain
- *Correspondence: Rubén García-Fernández,
| | | | - Elena Fernández-Martínez
- Department of Nursing and Physiotherapy, Universidad de León, León, Spain
- SALBIS Reseach Group, Faculty of Health Sciences, León, Spain
| | - Pedro Hidalgo-Lopezosa
- Department of Nursing, Pharmacology and Physiotherapy, Universidad de Córdoba, Córdoba, Spain
- Maimonides Biomedical Research Institute of Cordoba (IMIBIC), Córdoba, Spain
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Galvan T, Hurwich-Reiss E, Watamura SE. Latina mothers' mental health: An examination of its relation to parenting and material resources. FAMILY PROCESS 2022; 61:1646-1662. [PMID: 34913484 DOI: 10.1111/famp.12737] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Revised: 08/24/2021] [Accepted: 10/01/2021] [Indexed: 06/14/2023]
Abstract
The demands and stressors associated with motherhood can increase a mother's risk for mental health concerns. Latina mothers are particularly vulnerable to the relation between motherhood-related stressors and maternal mental health given that they are at an increased risk for mental health concerns, that they are likely to have their mental health needs go unmet, and that traditional Latinx cultural values/gender roles emphasize women assuming the role of primary caregiver of the family's children. In an attempt to better understand how motherhood impacts Latina mother's mental health, this study explored the relations among parental self-efficacy, parenting stress, and maternal mental health. This study also explored how a mother's perception of her material resources influenced these relations. One hundred and thirty-two Latina mothers completed questionnaires to assess parenting stress, parental self-efficacy, and maternal mental health risk. The moderating effect of maternal perception of material resources in the aforementioned relations was assessed through the creation of a composite variable derived from items in the demographic questionnaires. Multiple linear regression analyses were used. Higher levels of parenting stress, but not parental self-efficacy, were related to increased maternal mental health risk. Furthermore, mothers who perceived themselves to have lower material resources were at increased risk for diminished mental health in the context of low parental self-efficacy. Results of this study yielded important information that is necessary for informing healthcare best practices, identifying targets for future interventions, and ultimately improving the health outcomes of Latinx mothers and their families.
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Affiliation(s)
- Thania Galvan
- Department of Psychology, University of Denver, Denver, Colorado, USA
| | - Eliana Hurwich-Reiss
- Department of Psychiatry, University of California San Diego, San Diego, California, USA
| | - Sarah E Watamura
- Department of Psychology, University of Denver, Denver, Colorado, USA
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Wickramaratne PJ, Yangchen T, Lepow L, Patra BG, Glicksburg B, Talati A, Adekkanattu P, Ryu E, Biernacka JM, Charney A, Mann JJ, Pathak J, Olfson M, Weissman MM. Social connectedness as a determinant of mental health: A scoping review. PLoS One 2022; 17:e0275004. [PMID: 36228007 PMCID: PMC9560615 DOI: 10.1371/journal.pone.0275004] [Citation(s) in RCA: 37] [Impact Index Per Article: 18.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Accepted: 09/08/2022] [Indexed: 11/29/2022] Open
Abstract
Public health and epidemiologic research have established that social connectedness promotes overall health. Yet there have been no recent reviews of findings from research examining social connectedness as a determinant of mental health. The goal of this review was to evaluate recent longitudinal research probing the effects of social connectedness on depression and anxiety symptoms and diagnoses in the general population. A scoping review was performed of PubMed and PsychInfo databases from January 2015 to December 2021 following PRISMA-ScR guidelines using a defined search strategy. The search yielded 66 unique studies. In research with other than pregnant women, 83% (19 of 23) studies reported that social support benefited symptoms of depression with the remaining 17% (5 of 23) reporting minimal or no evidence that lower levels of social support predict depression at follow-up. In research with pregnant women, 83% (24 of 29 studies) found that low social support increased postpartum depressive symptoms. Among 8 of 9 studies that focused on loneliness, feeling lonely at baseline was related to adverse outcomes at follow-up including higher risks of major depressive disorder, depressive symptom severity, generalized anxiety disorder, and lower levels of physical activity. In 5 of 8 reports, smaller social network size predicted depressive symptoms or disorder at follow-up. In summary, most recent relevant longitudinal studies have demonstrated that social connectedness protects adults in the general population from depressive symptoms and disorders. The results, which were largely consistent across settings, exposure measures, and populations, support efforts to improve clinical detection of high-risk patients, including adults with low social support and elevated loneliness.
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Affiliation(s)
- Priya J. Wickramaratne
- Department of Psychiatry, Vagelos College of Physicians and Surgeons, Columbia University Irving Medical Center, New York, NY, United States of America
- Division of Translational Epidemiology, New York State Psychiatric Institute, New York, NY, United States of America
| | - Tenzin Yangchen
- Division of Translational Epidemiology, New York State Psychiatric Institute, New York, NY, United States of America
| | - Lauren Lepow
- Departments of Psychiatry and Genetics & Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, United States of America
| | - Braja G. Patra
- Division of Health Informatics, Department of Population Health Sciences, Weill Cornell Medicine, New York, NY, United States of America
| | - Benjamin Glicksburg
- Departments of Psychiatry and Genetics & Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, United States of America
| | - Ardesheer Talati
- Department of Psychiatry, Vagelos College of Physicians and Surgeons, Columbia University Irving Medical Center, New York, NY, United States of America
- Division of Translational Epidemiology, New York State Psychiatric Institute, New York, NY, United States of America
| | - Prakash Adekkanattu
- Department of Information Technologies and Services, Weill Cornell Medicine, New York, NY, United States of America
| | - Euijung Ryu
- Department of Health Sciences Research, Mayo Clinic, Rochester, MN, United States of America
| | - Joanna M. Biernacka
- Department of Health Sciences Research, Mayo Clinic, Rochester, MN, United States of America
| | - Alexander Charney
- Departments of Psychiatry and Genetics & Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, United States of America
| | - J. John Mann
- Division of Molecular Imaging and the Neuropathology, Departments of Psychiatry and Radiology, New York State Psychiatric Institute, Vagelos College of Physicians and Surgeons, Columbia University Irving Medical Center, New York, NY, United States of America
| | - Jyotishman Pathak
- Division of Health Informatics, Department of Population Health Sciences, Weill Cornell Medicine, New York, NY, United States of America
| | - Mark Olfson
- Department of Psychiatry, Vagelos College of Physicians and Surgeons, Columbia University Irving Medical Center, New York, NY, United States of America
| | - Myrna M. Weissman
- Department of Psychiatry, Vagelos College of Physicians and Surgeons, Columbia University Irving Medical Center, New York, NY, United States of America
- Division of Translational Epidemiology, New York State Psychiatric Institute, New York, NY, United States of America
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Liu C, Chen H, Zhou F, Long Q, Wu K, Lo LM, Hung TH, Liu CY, Chiou WK. Positive intervention effect of mobile health application based on mindfulness and social support theory on postpartum depression symptoms of puerperae. BMC Womens Health 2022; 22:413. [PMID: 36217135 PMCID: PMC9549653 DOI: 10.1186/s12905-022-01996-4] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2022] [Accepted: 09/26/2022] [Indexed: 11/10/2022] Open
Abstract
OBJECTIVE This study investigated the effects of mobile health application designed based on mindfulness and social support theory on parenting self-efficacy and postpartum depression symptoms of puerperae. METHODS We recruited 130 puerperae from a hospital in China and randomized them to an App use group (n = 65) and a waiting control group (n = 65). The App group underwent an 8-week app use intervention while the control group underwent no intervention. We measured four main variables (mindfulness, perceived social support, maternal parental self-efficacy and postpartum depressive symptoms) before and after the App use intervention. RESULTS In the App group, perceived social support, maternal parental self-efficacy were significantly higher and postpartum depressive symptoms was significantly lower. In the control group, there were no significant differences in any of the four variables between the pre-test and post-test. CONCLUSIONS Our findings indicated that the mobile health application may help to improve perceived social support, maternal self-efficacy and reduce postpartum depressive symptoms. The finding of the mobile health application's effect extends our understanding of integrative effects of mindfulness and perceived social support on reduction of postpartum depressive symptoms and suggests clinical potentials in the treatment of postpartum depressive symptoms.
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Affiliation(s)
- Chao Liu
- grid.495500.d0000 0004 1762 5592School of Journalism and Communication, Hua Qiao University, School of Film and Communication, Xiamen University of Technology, Department of Economic and Management, Suzhou Vocational Institute of Industrial Technology, Xiamen, 361021 China ,grid.145695.a0000 0004 1798 0922Director of Business Analytics Research Center, Chang Gung University, Taoyuan, 33302 Taiwan
| | - Hao Chen
- grid.495500.d0000 0004 1762 5592School of Journalism and Communication, Hua Qiao University, School of Film and Communication, Xiamen University of Technology, Department of Economic and Management, Suzhou Vocational Institute of Industrial Technology, Xiamen, 361021 China ,grid.145695.a0000 0004 1798 0922Director of Business Analytics Research Center, Chang Gung University, Taoyuan, 33302 Taiwan
| | - Fang Zhou
- grid.495500.d0000 0004 1762 5592School of Journalism and Communication, Hua Qiao University, School of Film and Communication, Xiamen University of Technology, Department of Economic and Management, Suzhou Vocational Institute of Industrial Technology, Xiamen, 361021 China
| | - Qiqi Long
- grid.8547.e0000 0001 0125 2443Shanghai Obstetrics and Gynecology Hospital, Fudan University, Shanghai, 200090 China
| | - Kan Wu
- grid.145695.a0000 0004 1798 0922Director of Business Analytics Research Center, Chang Gung University, Taoyuan, 33302 Taiwan ,grid.413801.f0000 0001 0711 0593Department of Orthopaedic Surgery, Chang Gung Memorial Hospital, Taoyuan, 33302 Taiwan
| | - Liang-Ming Lo
- grid.145695.a0000 0004 1798 0922Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital, Taipei, College of Medicine, Chang Gung University, Taoyuan City, Taiwan
| | - Tai-Ho Hung
- grid.145695.a0000 0004 1798 0922Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital, Taipei, College of Medicine, Chang Gung University, Taoyuan City, Taiwan
| | - Chia-Yih Liu
- grid.413801.f0000 0001 0711 0593Department of Psychiatry, Chang Gung Memorial Hospital, Taipei, 10507 Taiwan
| | - Wen-Ko Chiou
- grid.413801.f0000 0001 0711 0593Department of Psychiatry, Chang Gung Memorial Hospital, Taipei, 10507 Taiwan ,grid.145695.a0000 0004 1798 0922Department of Industrial Design, Chang Gung University, Taoyuan, 33302 Taiwan ,grid.440372.60000 0004 1798 0973Department of Industrial Engineering and Management, Ming Chi University of Technology, New Taipei, 24301 Taiwan
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26
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Lin R, Lu Y, Luo W, Zhang B, Liu Z, Xu Z. Risk factors for postpartum depression in women undergoing elective cesarean section: A prospective cohort study. Front Med (Lausanne) 2022; 9:1001855. [PMID: 36250100 PMCID: PMC9553994 DOI: 10.3389/fmed.2022.1001855] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2022] [Accepted: 09/13/2022] [Indexed: 11/13/2022] Open
Abstract
BackgroundPostpartum depression (PPD) has adverse effects on maternal and child health. Cesarean section (CS) is suggested to be associated with PPD, but no study has examined the risk factors for PPD in women who underwent CS. Therefore, this study aimed to investigate this association.MethodsA prospective observational study was conducted between December 2020 and September 2021. In total, 590 women who underwent elective CS participated in this study. Data were collected using a questionnaire through a face-to-face interview at three time points: 32nd week of gestation, 2 days postpartum, and 6 weeks postpartum. PPD was defined by an Edinburgh Postnatal Depression Scale (EPDS) score of ≥ 11 at 6 weeks postpartum. Multivariate logistic regression analysis was performed to identify the risk factors for PPD.ResultsAmong the 590 women, 25.4% had PPD (142/590). After adjustment for the confounding factors, high antenatal self-rating anxiety scale score (OR = 1.10, 95% CI = 1.04–1.16), PPD symptoms (EPDS ≥ 11) at 2 days postpartum (OR = 6.17, 95% CI = 1.35–28.31), and pain at 6 weeks postpartum (OR = 2.14, 95% CI = 1.24–3.69) were independently associated with PPD.ConclusionPrenatal anxiety, PPD symptoms occurring at an early postoperative stage, and pain at 6 weeks postpartum may be associated with an increased risk of PPD among women who undergo CS.
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Affiliation(s)
- Rong Lin
- Department of Anesthesiology, Shanghai First Maternity and Infant Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Yan Lu
- Department of Anesthesiology, Shanghai First Maternity and Infant Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Wei Luo
- Department of Anesthesiology, Shanghai First Maternity and Infant Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Bing Zhang
- Clinical and Translational Research Center, Shanghai First Maternity and Infant Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Zhiqiang Liu
- Department of Anesthesiology, Shanghai First Maternity and Infant Hospital, School of Medicine, Tongji University, Shanghai, China
- *Correspondence: Zhiqiang Liu,
| | - Zhendong Xu
- Department of Anesthesiology, Shanghai First Maternity and Infant Hospital, School of Medicine, Tongji University, Shanghai, China
- Zhendong Xu,
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Juarez Padilla J, Singleton CR, Pedersen CA, Lara-Cinisomo S. Associations between Self-Rated Health and Perinatal Depressive and Anxiety Symptoms among Latina Women. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph191911978. [PMID: 36231278 PMCID: PMC9565349 DOI: 10.3390/ijerph191911978] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Revised: 09/13/2022] [Accepted: 09/20/2022] [Indexed: 06/01/2023]
Abstract
PURPOSE The objective of this study was to determine whether decreases in or consistently low preconception to pregnancy self-rated health (SRH) were associated with perinatal depressive and anxiety symptoms among Latinas. METHODS This is a secondary data analysis of 153 perinatal Latinas. Three groups were created to capture SRH from preconception to pregnancy: a decline in ratings, consistently low, and good+ (i.e., good, very good, or excellent). SRH was measured using two questions about their perceived physical health before and during pregnancy. Depressive symptoms and anxiety symptoms were assessed in the third trimester and six weeks postpartum using the Edinburgh Postnatal Depression Scale and State-Trait Anxiety Inventory, respectively. Life stressors were assessed in pregnancy using a modified version of the Life Experiences Survey. Linear regressions tested the associations. RESULTS Women with consistently low (i.e., fair or poor) SRH reported significantly more prenatal depressive symptoms than women who reported consistently good+ SRH. Women who reported a decline in SRH to fair or poor reported more prenatal anxiety symptoms but decreased postpartum anxiety symptoms than women who reported consistently good+ ratings. Life stressors were positively associated with prenatal depressive and anxiety symptoms. CONCLUSIONS Healthcare practitioners should assess changes in SRH ratings to identify risks for prenatal depressive and anxiety symptoms among Latinas, who have elevated rates of depressive and anxiety symptoms compared to non-Hispanic White women. Policymakers should provide healthcare providers with mental health resources to support at-risk Latinas during the prenatal period.
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Affiliation(s)
- Janeth Juarez Padilla
- Division of Scholarship and Research, Columbia University School of Nursing, New York, NY 10032, USA
| | - Chelsea R. Singleton
- Department of Social, Behavioral, and Populations Sciences, Tulane School of Public Health and Tropical Medicine, New Orleans, LA 70112, USA
| | - Cort A. Pedersen
- Department of Psychiatry, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA
| | - Sandraluz Lara-Cinisomo
- Department of Kinesiology and Community Health, College of Applied Health Sciences, University of Illinois Urbana-Champaign, Champaign, IL 61820, USA
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Jiang F, Lin Y, Li S, Peng Y, Huang X, Chen L. A Study of the Nursing Intervention Based on Self-Efficacy Theory for Patients After Mechanical Heart Valve Replacement: A Randomized Controlled Trial. Int J Gen Med 2022; 15:6539-6547. [PMID: 35971525 PMCID: PMC9375546 DOI: 10.2147/ijgm.s353977] [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: 12/14/2021] [Accepted: 03/23/2022] [Indexed: 11/23/2022] Open
Abstract
Aim To explore the practicability and efficiency of self-efficacy intervention on the nursing for patients after mechanical heart valve replacement (MHVR), so as to provide a theoretical and data foundation for the implementation of self-efficacy intervention in clinical practice. Methods This study adopted a randomized controlled trial (RCT). A total of 140 patients undergoing MHVR were randomly divided into the experimental group (normal nursing + self-efficacy intervention) or the control group (normal nursing only) based on a random number table. The primary goal was to evaluate the effect of self-efficacy theory on the self-efficacy of postoperative MHVR patients by General Self-Efficacy Scale (GSES). The secondary goal was to assess the improvement of mental health of postoperative patients as well as their pain through Symptom Checklist 90 (SCL-90) and the visual analogue scale (VAS). The incidence of infection during hospitalization was analyzed, as well as the medication compliance of patients during 3-month follow-up after discharge. Results Finally, 136 patients completed the whole trial. The GSES score of the experimental group was notably superior over the control group (p < 0.001), and the SCL-90 scores were lower over the control group. The VAS score of the experimental group was remarkably lower than that of the control group (p < 0.001). The incidence of infection in the experimental group was lower than that in the control group (p = 0.026). The medication compliance of the experimental group was superior to that of the control group (p = 0.030). Conclusion Self-efficacy intervention for patients after MHVR could mobilize their self-efficacy, enhance their postoperative medication compliance, and improve their postoperative recovery. This study provides evidence-based medicine (EBM) evidence for the application of self-efficacy theory to postoperative nursing for patients receiving MHVR.
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Affiliation(s)
- Fei Jiang
- Heart Medicine Research Center, Fujian Medical University Union Hospital, Fuzhou, 350001, Fujian, People's Republic of China
| | - Yanjuan Lin
- Nursing Department, Fujian Medical University Union Hospital, Fuzhou, 350001, Fujian, People's Republic of China
| | - Sailan Li
- Heart Medicine Research Center, Fujian Medical University Union Hospital, Fuzhou, 350001, Fujian, People's Republic of China
| | - Yanchun Peng
- Heart Medicine Research Center, Fujian Medical University Union Hospital, Fuzhou, 350001, Fujian, People's Republic of China
| | - Xizhen Huang
- Heart Medicine Research Center, Fujian Medical University Union Hospital, Fuzhou, 350001, Fujian, People's Republic of China
| | - Liangwan Chen
- Heart Medicine Research Center, Fujian Medical University Union Hospital, Fuzhou, 350001, Fujian, People's Republic of China
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de Jong PF, Schreurs BG, Zee M. Parent–child conflict during homeschooling in times of the COVID-19 pandemic: A key role for mothers’ self-efficacy in teaching. CONTEMPORARY EDUCATIONAL PSYCHOLOGY 2022; 70:102083. [PMID: 35765576 PMCID: PMC9221406 DOI: 10.1016/j.cedpsych.2022.102083] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
To contain the COVID-19 pandemic schools have been closed in many countries. Children stayed at home and were assisted by their parents with their schoolwork. Evidently, homeschooling puts extra demands on parents. We presumed that parents’ sense of efficacy in teaching would play a key role in how they cope with this extra task of homeschooling. In particular, we hypothesized that parental characteristics (level of parental education and stress) and social contextual factors (household chaos and school support) would contribute to parents’ teaching self-efficacy and that, in turn, a lower efficacy would result in more parent–child conflict during home schooling. Participants were 173 mothers of children in kindergarten or early elementary schools, who provided information for one of their children about interpersonal conflicts around schoolwork before and during school closure. Additionally, they reported on their self-efficacy in teaching, perceived stress during lockdown, home chaos, and school support. Path analyses indicated that mothers’ perceived stress and household chaos were associated with a lower sense of efficacy in teaching, whereas school support, but not level of parental education, was related to a higher level of teaching self-efficacy. Higher levels of self-efficacy beliefs, in turn, were associated with a lower degree of mother–child conflict during schoolwork, even after controlling for prior levels of conflict. We discuss how the results of this study might be used to foster parents’ self-efficacy in teaching and thereby decrease the amount of parent–child conflict during parents’ support with schoolwork.
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Deutsch AR, Vargas MC, Lucchini M, Brink LT, Odendaal HJ, Elliott AJ. Effect of individual or comorbid antenatal depression and anxiety on birth outcomes and moderation by maternal traumatic experiences and resilience. JOURNAL OF AFFECTIVE DISORDERS REPORTS 2022; 9:100365. [PMID: 35966253 PMCID: PMC9373828 DOI: 10.1016/j.jadr.2022.100365] [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] [Indexed: 11/22/2022] Open
Abstract
Background Although antenatal depression and anxiety (e.g., negative antenatal mental health; NAMH) are individually associated with preterm birth (PTB) and infant neurological impairment, few studies account for comorbidity. Understanding how NAMH impacts PTB and infant neurological functioning by either singular (depression or anxiety) or comorbid status, as well as the way in which these effects can be moderated by additional risk or protective factors (traumatic experiences and trait resiliency) can contribute further understanding of NAMH effects on birth outcomes. Methods The sample included 3042 mother-infant dyads from U.S. and South Africa cohorts of the Safe Passage Study (N = 3042). A four-category NAMH variable was created to categorize depression-only, anxiety-only, comorbid, or no NAMH statuses. Results There were no NAMH main effects on PTB, however, anxiety-only and comorbid NAMH increased odds of PTB for mothers with higher rates of traumatic life experiences. Anxiety-only and comorbid NAMH were associated with increased odds of newborn neurological impairment, and the effect of comorbid NAMH was stronger for mothers with higher rates of traumatic experiences. Resiliency decreased odds of neurological impairment for mothers who reported depression-only or anxiety-only NAMH. Limitations Limitations included potential artefacts of two cohorts that differed in rates of almost all variables, a single time point for measuring NAMH, and lack of pregnancy-specific NAMH measures. Conclusions Especially when compared to mothers with no NAMH, comorbidity or singular-condition NAMH statuses associate with negative birth outcomes in nuanced ways, especially when considering additional contexts that may foster or protect against NAMH.
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Affiliation(s)
- Arielle R. Deutsch
- Avera Research Institute
- University of South Dakota School of Medicine, Department of Pediatrics
| | | | - Maristella Lucchini
- Columbia University Irving Medical Center, Department of Psychiatry
- New York State Psychiatric Institute, Division of Developmental Neuroscience
| | - Lucy T. Brink
- Stellenbosch University, School of Medicine and Health Science, Department of Obstetrics and Gynaecology
| | - Hein J. Odendaal
- Stellenbosch University, School of Medicine and Health Science, Department of Obstetrics and Gynaecology
| | - Amy J. Elliott
- Avera Research Institute
- University of South Dakota School of Medicine, Department of Pediatrics
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Deliktas Demirci A, Aydin R, Korukcu O, Kabukcuoglu K. Is marital adjustment a way to increase women's identification with the motherhood role during pregnancy?: A correlational assessment. Health Care Women Int 2022; 43:568-582. [PMID: 33571061 DOI: 10.1080/07399332.2020.1867859] [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: 12/04/2019] [Revised: 12/16/2020] [Accepted: 12/18/2020] [Indexed: 10/22/2022]
Abstract
The researchers sought to determine the correlation level and factors that affect the correlation between pregnant women's marital adjustment and their identification with the motherhood role. A total of 146 healthy, married, and pregnant women were included. There was a negative and significantly low-level correlation between marital adjustment and identification with the motherhood role. The correlation was significant among women who were multiparous, married for six to 10 years, with low level of education, and decided to marry in agreement. The authors of this study suggest promoting marital adjustment may be way to facilitate women's identification with the motherhood role.
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Affiliation(s)
- Ayse Deliktas Demirci
- Faculty of Nursing, Department of Obstetrics & Gynecological Nursing, Akdeniz University, Antalya, Turkey
| | - Ruveyde Aydin
- Faculty of Nursing, Department of Obstetrics & Gynecological Nursing, Akdeniz University, Antalya, Turkey
| | - Oznur Korukcu
- Faculty of Nursing, Department of Obstetrics & Gynecological Nursing, Akdeniz University, Antalya, Turkey
| | - Kamile Kabukcuoglu
- Faculty of Nursing, Department of Obstetrics & Gynecological Nursing, Akdeniz University, Antalya, Turkey
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Testing Models of Associations Between Depression and Parenting Self-efficacy in Mothers: A Meta-analytic Review. Clin Child Fam Psychol Rev 2022; 25:471-499. [PMID: 35556193 DOI: 10.1007/s10567-022-00398-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/08/2022] [Indexed: 11/03/2022]
Abstract
Numerous cross-sectional studies confirm the long-theorized association between mothers' depression and lower parenting self-efficacy (PSE) beliefs. However, cross-sectional studies leave unanswered the direction of this association: Does depression predict PSE? Does PSE predict depression? Are both true? Does the strength of the association between depression and PSE, regardless of the direction, generalize across participant characteristics and study design features? How stable is PSE over time? And how effective are interventions at enhancing PSE? To answer these questions, we conducted a meta-analytic review of longitudinal studies. With 35 eligible studies (22,698 participants), we found support for both models: there was a significant pooled effect of both depression on PSE and of PSE on depression, with nearly identical effect sizes (d = - 0.21 and - 0.22, respectively). The association was stronger in samples with mothers' younger average age and studies that measured PSE among mothers relative to during pregnancy. We found a medium degree of stability in the index of PSE, d = 0.60. Finally, the estimated pooled effect size between being in an intervention group versus control group and PSE was 0.505. Overall, we found support for (1) bidirectional associations between depression and PSE in mothers, (2) the stability of PSE over time, and (3) the strength of the relationship between PSE and depression with intervention. These results suggest the importance of continuing to develop, test, and disseminate interventions to enhance PSE. We interpret these findings in the context of both depression and low PSE having serious consequences for child outcomes and maladaptive parenting.
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Farewell CV, Thayer Z, Paulson J, Nicklas J, Walker C, Waldie K, Morton S, Leiferman JA. Fostering Resilience Among Mothers Early (FRAME): using growth mixture modeling to identify resources that mitigate perinatal depression. Arch Womens Ment Health 2022; 25:451-461. [PMID: 35137331 DOI: 10.1007/s00737-022-01211-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Accepted: 01/31/2022] [Indexed: 11/02/2022]
Abstract
The primary objective of this study was to delineate classes of individuals based on depression trajectories from the antenatal period through 54-month postpartum and internal and external resources that are associated with low depression risk. Participants came from the Growing Up in New Zealand (GUiNZ) study (n = 5664), which is a pregnancy cohort study and is nationally representative of the ethnic and socioeconomic diversity of contemporary New Zealand births. Growth curve mixture modeling was used to identify distinct subgroups based on depression scores from the antenatal period through 54-month postpartum. Logistic regression models were run to investigate socioeconomic factors and internal and external resources that were associated with depression class membership. A two-class model, "low risk" and "high risk," resulted in the best model fit. Most of the sample (n = 5110, 90%) fell into the "low-risk" class defined by no-to-mild depression symptoms during pregnancy and decreasing depressive symptoms over time (bintercept = - .05, bslope = - .05). Approximately 10% of the sample fell into the "high-risk" class (n = 554, 10%) defined by mild-to-moderate depressive symptoms during pregnancy and increasing depressive symptomology over time (bintercept = .39, bslope = .57). More positive parenting-related attitudes, better pre-pregnancy self-reported health, informal social supports, and community belonging were significantly associated with greater odds of being in the "low-risk" class, after controlling for socioeconomic factors. These findings suggest that targeting internal and external resources for individuals across the perinatal and early childhood periods is important to mitigating maternal depression.
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Affiliation(s)
- Charlotte V Farewell
- Department of Community and Behavioral Health, School of Public Health, University of Colorado-Anschutz Medical Campus, Mail Stop B119, East 17Aurora, CO, 1300180045, USA.
| | | | - James Paulson
- Old Dominion University, Norfolk University, Norfolk, USA
| | - Jacinda Nicklas
- Department of Community and Behavioral Health, School of Public Health, University of Colorado-Anschutz Medical Campus, Mail Stop B119, East 17Aurora, CO, 1300180045, USA
| | | | | | | | - Jenn A Leiferman
- Department of Community and Behavioral Health, School of Public Health, University of Colorado-Anschutz Medical Campus, Mail Stop B119, East 17Aurora, CO, 1300180045, USA
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Lin HC, Zehnah PL, Koire A, Mittal L, Erdei C, Liu CH. Maternal Self-Efficacy Buffers the Effects of COVID-19-Related Experiences on Postpartum Parenting Stress. J Obstet Gynecol Neonatal Nurs 2022; 51:177-194. [PMID: 35114164 PMCID: PMC8709937 DOI: 10.1016/j.jogn.2021.12.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/15/2021] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVE To examine the associations of maternal self-efficacy (MSE) and perceived social support with parenting stress during the postpartum period during the COVID-19 pandemic and whether these two psychosocial factors account for variance in parenting stress in addition to the effects of COVID-19-related experiences and sociodemographic factors. DESIGN Cross-sectional survey. SETTING Online survey, the Perinatal Experiences and COVID-19 Effects (PEACE) study, launched in May 2020. PARTICIPANTS Participants included 310 women who gave birth in the past 24 weeks. METHODS The survey included self-report quantitative measures of MSE, social support, COVID-19-related experiences, parenting stress, symptoms of depression and anxiety, and a range of sociodemographic factors. RESULTS Hierarchical multiple regression analysis indicated that MSE and social support were negatively associated with postpartum parenting stress in addition to the effects of COVID-19-related experiences, maternal symptoms of depression and anxiety, and a range of demographic factors. Furthermore, MSE interacted with COVID-19-related experiences such that higher levels of MSE mitigated the effects of COVID-19-related experiences on parenting stress. CONCLUSION Our findings underscore the importance of protective factors at the individual and interpersonal levels and provide insights for prevention and intervention programs aimed at mitigating postpartum parenting stress during a wide-scale disaster such as the COVID-19 pandemic.
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Li P, Wang H, Feng J, Chen G, Zhou Z, Gou X, Ye S, Fan D, Liu Z, Guo X. Association Between Perceived Stress and Prenatal Depressive Symptoms: Moderating Effect of Social Support. J Multidiscip Healthc 2021; 14:3195-3204. [PMID: 34819730 PMCID: PMC8606966 DOI: 10.2147/jmdh.s341090] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2021] [Accepted: 11/04/2021] [Indexed: 12/19/2022] Open
Abstract
Purpose Prenatal depressive symptoms are an important mental health problem during pregnancy. We aimed to explore the moderating role of social support on the association between perceived stress and prenatal depressive symptoms. Materials and Methods A cross-sectional study was conducted at an obstetrics clinic. A total of 1846 women completed a self-administered questionnaire, with a response rate of 91.8%. Results Of the 1846 participants, 28.2% reported prenatal depressive symptoms (Edinburgh postnatal depression scale score ≥ 9). After adjusting for demographic characteristics, gestational age, exercise, and passive smoking, both perceived stress (adjusted odds ratio (AOR): 1.210, 95% confidence interval (CI): 1.178–1.242) and social support (AOR: 0.950, 95% CI: 0.932–0.968) were associated with prenatal depressive symptoms. Moreover, social support had a moderating effect on the association between perceived stress and prenatal depressive symptoms (p < 0.001), and pregnant women with low social support were more likely to be affected by stress and experience prenatal depressive symptoms. Conclusion Our study suggests that higher social support reduces the impact of stress on pregnant women, which in turn, decreases the risk of prenatal depressive symptoms. Therefore, interventions aimed at improving social support should be considered for the prevention and treatment of prenatal depressive symptoms.
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Affiliation(s)
- Pengsheng Li
- Foshan Fetal Medicine Research Institute, Affiliated Foshan Maternity & Child Healthcare Hospital, Southern Medical University, Foshan, People's Republic of China.,Department of Obstetrics, Affiliated Foshan Maternity & Child Healthcare Hospital, Southern Medical University, Foshan, People's Republic of China
| | - Haiyan Wang
- Department of Obstetrics, Affiliated Foshan Maternity & Child Healthcare Hospital, Southern Medical University, Foshan, People's Republic of China.,Biobank, Foshan Fetal Medicine Research Institute, Affiliated Foshan Maternity & Child Healthcare Hospital, Southern Medical University, Foshan, People's Republic of China
| | - Jinping Feng
- Department of Obstetrics, Affiliated Foshan Maternity & Child Healthcare Hospital, Southern Medical University, Foshan, People's Republic of China
| | - Gengdong Chen
- Foshan Fetal Medicine Research Institute, Affiliated Foshan Maternity & Child Healthcare Hospital, Southern Medical University, Foshan, People's Republic of China.,Department of Obstetrics, Affiliated Foshan Maternity & Child Healthcare Hospital, Southern Medical University, Foshan, People's Republic of China
| | - Zixing Zhou
- Foshan Fetal Medicine Research Institute, Affiliated Foshan Maternity & Child Healthcare Hospital, Southern Medical University, Foshan, People's Republic of China.,Department of Obstetrics, Affiliated Foshan Maternity & Child Healthcare Hospital, Southern Medical University, Foshan, People's Republic of China
| | - Xiaoyan Gou
- Department of Obstetrics, Affiliated Foshan Maternity & Child Healthcare Hospital, Southern Medical University, Foshan, People's Republic of China.,Biobank, Foshan Fetal Medicine Research Institute, Affiliated Foshan Maternity & Child Healthcare Hospital, Southern Medical University, Foshan, People's Republic of China
| | - Shaoxin Ye
- Foshan Fetal Medicine Research Institute, Affiliated Foshan Maternity & Child Healthcare Hospital, Southern Medical University, Foshan, People's Republic of China.,Department of Obstetrics, Affiliated Foshan Maternity & Child Healthcare Hospital, Southern Medical University, Foshan, People's Republic of China
| | - Dazhi Fan
- Foshan Fetal Medicine Research Institute, Affiliated Foshan Maternity & Child Healthcare Hospital, Southern Medical University, Foshan, People's Republic of China.,Department of Obstetrics, Affiliated Foshan Maternity & Child Healthcare Hospital, Southern Medical University, Foshan, People's Republic of China
| | - Zhengping Liu
- Foshan Fetal Medicine Research Institute, Affiliated Foshan Maternity & Child Healthcare Hospital, Southern Medical University, Foshan, People's Republic of China.,Department of Obstetrics, Affiliated Foshan Maternity & Child Healthcare Hospital, Southern Medical University, Foshan, People's Republic of China
| | - Xiaoling Guo
- Department of Obstetrics, Affiliated Foshan Maternity & Child Healthcare Hospital, Southern Medical University, Foshan, People's Republic of China
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Lewis BA, Schuver K, Dunsiger S, Samson L, Frayeh AL, Terrell CA, Ciccolo JT, Fischer J, Avery MD. Randomized trial examining the effect of exercise and wellness interventions on preventing postpartum depression and perceived stress. BMC Pregnancy Childbirth 2021; 21:785. [PMID: 34802425 PMCID: PMC8607568 DOI: 10.1186/s12884-021-04257-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2020] [Accepted: 11/03/2021] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Approximately 13-19% of postpartum women experience postpartum depression and a majority report at least some stress during the postpartum phase. Traditional interventions such as psychotherapy and antidepressant medications are often not feasible or desirable. The purpose of this study was to examine two low cost, brief, accessible interventions designed to prevent postpartum depression and perceived stress among women at high risk. METHODS Participants (n = 450) who were on average four weeks postpartum, had a history of depression before pregnancy, and exercised less than 60 min per week were randomly assigned to one of the following three conditions: (1) 6-month telephone-based exercise intervention; (2) 6-month telephone-based wellness/support intervention (e.g., healthy eating, sleep, and perceived stress); or (3) usual care. RESULTS Overall, 2.4% of participants met criteria for depression at 6 months and 3.6% at 9 months with no differences between groups. At 6 months following randomization, median symptoms of depression were significantly lower among wellness participants compared to usual care participants (b = - 1.00, SE = 0.46, p = .03). Perceived stress at 6 months post-randomization was significantly lower among exercise vs. usual care participants (b = - 2.00, SE = .98, p = .04) and exercise vs. wellness participants (b = - 2.20, SE = 1.11, p = .04). CONCLUSIONS The wellness intervention was efficacious for preventing symptoms of depression; however, postpartum depression that met the diagnostic criteria was surprisingly low in all conditions among this at risk sample of postpartum women. Exercise interventions may have a protective effect on perceived stress among women at risk for postpartum depression. Practitioners should consider integrating exercise and wellness interventions into postpartum care. TRIAL REGISTRATION Clinical Trials Number: NCT01883479 (06/21/2013).
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Affiliation(s)
- Beth A Lewis
- University of Minnesota, School of Kinesiology, 1900 University Ave SE, Minneapolis, MN, 55455, USA.
| | - Katie Schuver
- University of Minnesota, School of Kinesiology, 1900 University Ave SE, Minneapolis, MN, 55455, USA
| | - Shira Dunsiger
- Center for Health Promotion and Health Equity in the Department of Behavioral and Social Sciences, Brown University, Box G-S121-4, Providence, RI, 02912, USA
| | - Lauren Samson
- University of Minnesota, School of Kinesiology, 1900 University Ave SE, Minneapolis, MN, 55455, USA
| | - Amanda L Frayeh
- University of Minnesota, School of Kinesiology, 1900 University Ave SE, Minneapolis, MN, 55455, USA
| | - Carrie A Terrell
- Department of Obstetrics, Gynecology and Women's Health, University of Minnesota, 604 24th Ave S, Ste 300, Minneapolis, MN, 55454, USA
| | - Joseph T Ciccolo
- Department of Biobehavioral Sciences, Teachers College Columbia University, 525 West 120th St., New York, NY, USA
| | - John Fischer
- Department of Obstetrics, Gynecology and Women's Health, University of Minnesota, 604 24th Ave S, Ste 300, Minneapolis, MN, 55454, USA
| | - Melissa D Avery
- University of Minnesota, School of Nursing, 308 Harvard St. SE, Minneapolis, MN, 55455, USA
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Bień A, Rzońca E, Grzesik-Gąsior J, Pieczykolan A, Humeniuk E, Michalak M, Iwanowicz-Palus G, Wdowiak A. Determinants of Psychosocial Resilience Resources in Obese Pregnant Women with Threatened Preterm Labor-A Cross-Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182010590. [PMID: 34682337 PMCID: PMC8535596 DOI: 10.3390/ijerph182010590] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/26/2021] [Revised: 10/02/2021] [Accepted: 10/05/2021] [Indexed: 12/20/2022]
Abstract
Background: The purpose of the study was to assess the level of such psychosocial resilience resources as self-efficacy, dispositional optimism, and health locus of control in pregnant women with obesity with threatened premature labor. Methods: The study was performed in the years 2017-2020 in a group of 328 pregnant women hospitalized due to threatened preterm labor and diagnosed with obesity before the pregnancy. The following instruments were applied: the Life Orientation Test, the Generalized Self-Efficacy Scale, and the Multidimensional Health Locus of Control Scale. Results: Obese pregnant women with threatened premature labor have a moderate level of generalized self-efficacy (28.02) and a moderate level of dispositional optimism (16.20). Out of the three health locus of control dimensions, the highest scores were recorded in the "internal control" subscale (26.08). Statistically significant predictors for the self-efficacy variable model included: satisfactory socio-economic standing (ß = 0.156; p = 0.004), being nulliparous (ß = -0.191; p = 0.002), and the absence of comorbidities (ß = -0.145; p = 0.008). Higher levels of dispositional optimism were found in women who were married (ß = 0.381; p = 0.000), reported a satisfactory socio-economic standing (ß = 0.137; p = 0.005), were between 23 and 27 weeks pregnant (ß = -0.231; p = 0.000), and had no comorbidities (ß = -0.129; p = 0.009). Conclusions: Generalized self-efficacy in obese women with threatened preterm labor is associated with satisfactory socio-economic standing, being nulliparous, and the absence of chronic disease. Dispositional optimism in obese pregnant women with threatened preterm labor is determined by their marital status, socio-economic standing, gestational age, and the absence of comorbidities.
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Affiliation(s)
- Agnieszka Bień
- Chair of Obstetrics Development, Faculty of Health Sciences, Medical University of Lublin, 4-6 Staszica St., 20-081 Lublin, Poland; (A.B.); (G.I.-P.)
| | - Ewa Rzońca
- Department of Obstetrics and Gynecology Didactics, Faculty of Health Sciences, Medical University of Warsaw, 14/16 Litewska St., 00-575 Warsaw, Poland;
| | - Joanna Grzesik-Gąsior
- Department of Midwifery, Carpathian State College in Krosno, 6 Kazimierza Wielkiego St., 38-400 Krosno, Poland;
| | - Agnieszka Pieczykolan
- Faculty of Health Sciences, Students’ Scientific Association at the Chair of Obstetrics Development, Medical University of Lublin, 4-6 Staszica St., 20-081 Lublin, Poland
- Correspondence:
| | - Ewa Humeniuk
- Chair and Department of Psychology, Medical University of Lublin, 7 Chodźki St., 20-093 Lublin, Poland;
| | - Małgorzata Michalak
- Department of Gynecology, Independent Public Teaching Hospital No. 4 in Lublin, 8 Jaczewskiego St., 20-954 Lublin, Poland;
| | - Grażyna Iwanowicz-Palus
- Chair of Obstetrics Development, Faculty of Health Sciences, Medical University of Lublin, 4-6 Staszica St., 20-081 Lublin, Poland; (A.B.); (G.I.-P.)
| | - Artur Wdowiak
- Chair of Obstetrics and Gynaecology, Faculty of Health Sciences, Medical University of Lublin, 4-6 Staszica St., 20-081 Lublin, Poland;
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Hagaman A, LeMasters K, Zivich PN, Sikander S, Bates LM, Bhalotra S, Chung EO, Zaidi A, Maselko J. Longitudinal effects of perinatal social support on maternal depression: a marginal structural modelling approach. J Epidemiol Community Health 2021; 75:936-943. [PMID: 33712512 PMCID: PMC8434957 DOI: 10.1136/jech-2020-215836] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2020] [Revised: 02/22/2021] [Accepted: 03/02/2021] [Indexed: 12/18/2022]
Abstract
BACKGROUND Depression in the perinatal period, during pregnancy or within 1 year of childbirth, imposes a high burden on women with rippling effects through her and her child's life course. Social support may be an important protective factor, but the complex bidirectional relationship with depression, alongside a paucity of longitudinal explorations, leaves much unknown about critical windows of social support exposure across the perinatal period and causal impacts on future depressive episodes. METHODS This study leverages marginal structural models to evaluate associations between longitudinal patterns of perinatal social support and subsequent maternal depression at 6 and 12 months postpartum. In a cohort of women in rural Pakistan (n=780), recruited in the third trimester of pregnancy and followed up at 3, 6 and 12 months postpartum, we assessed social support using two well-validated measures: the Multidimensional Scale of Perceived Social Support (MSPSS) and the Maternal Social Support Index (MSSI). Major depressive disorder was assessed with the Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders (DSM IV). RESULTS High and sustained scores on the MSPSS through the perinatal period were associated with a decreased risk of depression at 12 months postpartum (0.35, 95% CI: 0.19 to 0.63). Evidence suggests the recency of support also matters, but estimates are imprecise. We did not find evidence of a protective effect for support based on the MSSI. CONCLUSIONS This study highlights the protective effect of sustained social support, particularly emotional support, on perinatal depression. Interventions targeting, leveraging and maintaining this type of support may be particularly important for reducing postpartum depression.
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Affiliation(s)
- Ashley Hagaman
- Social Behavioral Sciences, Yale University School of Public Health, New Haven, Connecticut, USA
- Center for Methods in Implementation and Prevention Science, Yale University, New Haven, Connecticut, USA
| | - Katherine LeMasters
- Department of Epidemiology, Gillings School of Global Public Health, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
- Carolina Population Center, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Paul N Zivich
- Department of Epidemiology, Gillings School of Global Public Health, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
- Carolina Population Center, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Siham Sikander
- Human Development Research Foundation, Islamabad, Pakistan
- Global Health Department, Health Services Academy, Islamabad, Pakistan
| | - Lisa M Bates
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York, USA
| | - Sonia Bhalotra
- Department of Economics, University of Warwick, UK, Coventry, Warwickshire, UK
| | - Esther O Chung
- Department of Epidemiology, Gillings School of Global Public Health, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
- Carolina Population Center, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Ahmed Zaidi
- Human Development Research Foundation, Islamabad, Pakistan
| | - Joanna Maselko
- Department of Epidemiology, Gillings School of Global Public Health, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
- Carolina Population Center, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
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Manrique Millones DL, Millones Rivalles R, Dominguez Lara S, Pineda Marín C, Manrique Pino O. Social Support in Higher Education: Evidence of Validity and Reliability in the Peruvian Context. UNIVERSITAS PSYCHOLOGICA 2021. [DOI: 10.11144/javeriana.upsy19.sshe] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Social support is a useful cornerstone concept that describes how positive human relationships and social networks allow people to overcome stressful events they face during their lives and to find themselves in a state of relative well-being. This study aims to assess the psychometric properties of the Social Support Appraisals Scale (SS-A) in a Peruvian sample. Participants were 417 undergraduate’s students in Metropolitan Lima (Mage = 21.78, SD = 4.09). Cross-sectional data was collected after approval by the ethical committee and authorization of all parties involved. A theoretical three-factor model was tested using confirmatory factor analysis. Results showed good fit indexes and revealed that the SS-A’s three-dimensional structure was invariant across gender and presented adequate reliability. Likewise, social support showed significant correlations to academic stress. Although the results’ generalizability due to the non-random nature of the data presents a caveat, the current findings reveal preliminary evidence that the adapted version of the Social Support Appraisals Scale is a reliable and valid instrument for the assessment of perceived social support in this sample of Peruvian college students.
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Trends of Perinatal Stress, Anxiety, and Depression and Their Prediction on Postpartum Depression. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18179307. [PMID: 34501906 PMCID: PMC8431252 DOI: 10.3390/ijerph18179307] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/28/2021] [Revised: 08/25/2021] [Accepted: 08/30/2021] [Indexed: 01/22/2023]
Abstract
Perinatal stress, anxiety, and depression impacts not only women but also their child(ren). The purpose of this longitudinal study is to explore trends of stress, anxiety, and depressive symptoms from pregnancy to postpartum and understand predictions of stress and anxiety on postpartum depression. One-hundred-fifty-six women at 23-28 weeks gestation (T1), 147 at 32-36 weeks gestation (T2), 129 at over 36 weeks gestation (T3), and 83 at postpartum (T4) completed study surveys. The Perceived Stress Scale, Center for Epidemiologic Studies Depression scale, and State-Trait Anxiety Inventory were used to measure stress, depressive symptoms, and anxiety. Descriptive statistics, Pearson and Spearman's correlation, and Generalized Estimating Equation were applied to analyze the data. Results showed that levels of anxiety and depressive symptoms increased from 24 weeks gestation to postpartum, whereas stress levels decreased during pregnancy but increased in postpartum. Over half of women experienced anxiety symptoms, especially during late pregnancy and postpartum. Stress, anxiety, and depressive symptoms were inter-correlated. Notably, women at late pregnancy and postpartum were prone to stress, anxiety, and depression. Prenatal anxiety could predict postpartum depressive symptoms. Active assessment and management of stress, anxiety, and depression is needed and should begin from early pregnancy and continue until postpartum.
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MacMillan KK, Lewis AJ, Watson SJ, Bourke D, Galbally M. Maternal social support, depression and emotional availability in early mother-infant interaction: Findings from a pregnancy cohort. J Affect Disord 2021; 292:757-765. [PMID: 34167025 DOI: 10.1016/j.jad.2021.05.048] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2020] [Revised: 05/11/2021] [Accepted: 05/23/2021] [Indexed: 12/01/2022]
Abstract
BACKGROUND Social support theory suggests that parental social support may influence the nature of early parenting behaviours and specifically the mother-infant relationship. This study examines whether support from a partner, friends or family is associated with differences in quality of mother-infant interactions in the context of maternal depression. METHODS 210 women were followed from early pregnancy to six months postpartum within Australian pregnancy cohort, the Mercy Pregnancy and Emotional Wellbeing Study (MPEWS). Mother-infant interactions within a standardised observation at six months postpartum were measured by the Emotional Availability (EA) Scales using total scores of the parental scales. In early and late pregnancy and at six months postpartum, mothers rated perceived maternal social support from a partner, family and friends using subscales of the Multidimensional Scale of Perceived Social Support. Depression was measured in early pregnancy and at six months postpartum using the Structured Clinical Interview for the DSM-IV-TR, with repeated measurement of depressive symptoms by the Edinburgh Postnatal Depression Scale (EPDS). Data was analysed using structural equation models. RESULTS There were significant interactions between depressive symptoms in early pregnancy and perceived maternal support from a partner (B = .18, 95% CI = 03, .31) and separately from family (B = .12, 95% CI = .03, .32) in predicting maternal emotional availability. No such interaction was found for support from friends. While partner and family support moderated the association between early depressive symptoms and emotional availability, there were no direct associations between maternal depressive disorder in early pregnancy and perceived support, and further, maternal depression was not a significant predictor of emotional availability. LIMITATIONS Future studies should consider extending measurement of the mother-infant relationship beyond the EA Scales, inclusion of a measure of maternal childhood trauma, and replicating our findings. CONCLUSION Maternal perception of partner and family support in the postpartum is a predictor of the association between early pregnancy depressive symptoms and maternal emotional availability.
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Affiliation(s)
- Kelli K MacMillan
- School of Medicine, University of Notre Dame, Fremantle, Australia; Psychology, Murdoch University, Perth, Australia; Women's Health, Genetics and Mental Health Directorate, King Edward Memorial Hospital for Women, Subiaco, Australia
| | | | - Stuart J Watson
- School of Medicine, University of Notre Dame, Fremantle, Australia; Psychology, Murdoch University, Perth, Australia
| | | | - Megan Galbally
- School of Medicine, University of Notre Dame, Fremantle, Australia; Psychology, Murdoch University, Perth, Australia; Women's Health, Genetics and Mental Health Directorate, King Edward Memorial Hospital for Women, Subiaco, Australia; Faculty of Health and Medicine Sciences, University of Western Australia, Perth, Australia.
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Tan HS, Agarthesh T, Tan CW, Sultana R, Chen HY, Chua TE, Sng BL. Perceived stress during labor and its association with depressive symptomatology, anxiety, and pain catastrophizing. Sci Rep 2021; 11:17005. [PMID: 34417541 PMCID: PMC8379208 DOI: 10.1038/s41598-021-96620-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2021] [Accepted: 08/13/2021] [Indexed: 12/24/2022] Open
Abstract
Perceived stress is a dimension of the maternal stress response, however little data is available on perceived stress levels and its associated psychological risk factors during labor. In this secondary data analysis from a prospective study evaluating epidural regimens, we investigated the potential associations between depressive symptomatology, anxiety, and pain catastrophizing with perceived stress during labor. Healthy nulliparous adult women with term singleton pregnancies requesting for epidural analgesia in early labor were included. Assessments were administered after epidural analgesia and adequate pain relief were achieved. Perceived stress (Perceived Stress Scale, PSS, high PSS ≥ 16), depressive symptomatology (Edinburgh Postnatal Depression Scale, EPDS, high EPDS ≥ 10), and pain catastrophizing (Pain Catastrophizing Scale, PCS, high total PCS ≥ 25) were assessed as categorical variables. Additionally, anxiety (State-trait Anxiety Inventory, STAI), PCS total and its subscales (rumination, magnification and helplessness) were analyzed as continuous variables. Univariate and multivariable logistic regression models were used to identify factors associated with high PSS. Of 801 women included, 411 (51.9%) had high PSS. High EPDS (OR 2.16, 95%CI 1.36–3.44), increasing trait anxiety (OR 1.17, 95%CI 1.14–1.20), and increasing pain magnification (OR 1.12, 95%CI 1.05–1.19) were independently associated with high PSS. Depressive symptomatology, trait anxiety, and pain magnification were associated with perceived stress during labor, providing impetus for future research aimed at detecting and alleviating stress and its psychological or pain association factors.
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Affiliation(s)
- Hon Sen Tan
- Department of Women's Anesthesia, KK Women's and Children's Hospital, Singapore, Singapore
| | - T Agarthesh
- Anesthesiology and Perioperative Sciences Academic Clinical Program, Duke-NUS Medical School, Singapore, Singapore
| | - Chin Wen Tan
- Department of Women's Anesthesia, KK Women's and Children's Hospital, Singapore, Singapore.,Anesthesiology and Perioperative Sciences Academic Clinical Program, Duke-NUS Medical School, Singapore, Singapore
| | - Rehena Sultana
- Centre for Quantitative Medicine, Duke-NUS Medical School, Singapore, Singapore
| | - Helen Yu Chen
- Department of Psychological Medicine, KK Women's and Children's Hospital, Singapore, Singapore.,Pediatrics Academic Clinical Program, Duke-NUS Medical School, 100 Bukit Timah Road, Singapore, 229899, Singapore
| | - Tze-Ern Chua
- Department of Psychological Medicine, KK Women's and Children's Hospital, Singapore, Singapore.,Pediatrics Academic Clinical Program, Duke-NUS Medical School, 100 Bukit Timah Road, Singapore, 229899, Singapore
| | - Ban Leong Sng
- Department of Women's Anesthesia, KK Women's and Children's Hospital, Singapore, Singapore. .,Anesthesiology and Perioperative Sciences Academic Clinical Program, Duke-NUS Medical School, Singapore, Singapore.
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Ando H, Shen J, Morishige KI, Suto S, Nakashima T, Furui T, Kawasaki Y, Watanabe H, Saijo T. Association between postpartum depression and social support satisfaction levels at four months after childbirth. Arch Psychiatr Nurs 2021; 35:341-346. [PMID: 34176574 DOI: 10.1016/j.apnu.2021.03.010] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2020] [Revised: 03/09/2021] [Accepted: 03/28/2021] [Indexed: 02/01/2023]
Abstract
This study clarifies the association between postpartum depression (PPD) and satisfaction with social support after childbirth through an anonymous survey of 427 postpartum mothers. Mothers' PPD was found to be significantly associated with satisfaction levels regarding formal-instrumental support (OR: 0.32, 95% CI: 0.162-0.632), informal-instrumental support (OR: 0.547, 95% CI: 0.313-0.955), and informal-psychological support (OR: 0.591, 95% CI: 0.384-0.912) in a multivariate logistic regression analysis. To prevent PPD, specialists as formal support providers must provide qualified care based on comprehensive judgments, and families as informal support providers should help with childcare, housework, and mental support.
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Affiliation(s)
- Hitomi Ando
- Department of Human Nursing, Faculty of Human Health, Sonoda Women's University, Japan; Division of Health Sciences, Graduate School of Medicine, Osaka University, Japan.
| | - Junyi Shen
- Research Institute for Economics and Business Administration, Kobe University, Japan
| | - Ken-Ichirou Morishige
- Department of Obstetrics and Gynecology, Graduate School of Medicine, Gifu University, Japan
| | - Shunji Suto
- Department of Community Medicine, Nara Medical University, Japan
| | - Takako Nakashima
- Faculty of Economics, University of Marketing and Distribution Sciences, Japan
| | - Tatsuro Furui
- Department of Obstetrics and Gynecology, Graduate School of Medicine, Gifu University, Japan
| | - Yuki Kawasaki
- Faculty of Nursing, Graduate School of Nursing, Kansai Medical University, Japan
| | - Hiroko Watanabe
- Division of Health Sciences, Graduate School of Medicine, Osaka University, Japan
| | - Tatsuyoshi Saijo
- Research Institute for Humanity and Nature, Research Institute for Future Design at Kochitech, Japan
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Yu M, Sampson M, Liu Y, Rubin A. A longitudinal study of the stress-buffering effect of social support on postpartum depression: a structural equation modeling approach. ANXIETY STRESS AND COPING 2021; 34:751-765. [PMID: 33938786 DOI: 10.1080/10615806.2021.1921160] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
PURPOSE Postpartum depression (PPD) impacts about one out of eight new mothers. Research has demonstrated that social support is a protector of PPD. Nevertheless, there has been disagreement on how social support influences depression. The objective is to test two theories - main-effect theory and stress-buffering theory of social support on PPD with different definitions of stress and two types of social support. METHODS Secondary longitudinal data from the National Data Archive on Child Abuse and Neglect were used. Parenting stress and difficult life circumstances (DLC) measured at six-month postpartum was used to predict the changes in depression from six- to 12-month postpartum; social support at six-month postpartum was conceptualized as a moderator between stress and PPD. Structural Equation Modeling was adopted for the longitudinal analyses. RESULTS DLC and parental distress both showed long-lasting impacts on PPD. Social support was not found to have a direct or indirect effect on PPD. Neither the stress-buffering theory nor the main-effect model was endorsed by this study. CONCLUSION Interventions that are accessible to new mothers and aim to improve self-efficacy are recommended. Measures with higher psychometric quality should be used in moderation research. More longitudinal studies with shorter lags between measurement occasions are warranted.
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Affiliation(s)
- Miao Yu
- School of Social Work, Social Work Complex, University of Texas at Arlington, Arlington, TX, USA
| | - McClain Sampson
- Graduate College of Social Work, University of Houston, Houston, Texas, USA
| | - Yu Liu
- Department of Psychological, Health and Learning Sciences, College of Education, University of Houston, Houston, Texas, USA
| | - Allen Rubin
- Graduate College of Social Work, University of Houston, Houston, Texas, USA
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Peñacoba Puente C, Suso-Ribera C, Blanco Rico S, Marín D, San Román Montero J, Catalá P. Is the Association between Postpartum Depression and Early Maternal-Infant Relationships Contextually Determined by Avoidant Coping in the Mother? INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:E562. [PMID: 33440857 PMCID: PMC7826648 DOI: 10.3390/ijerph18020562] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/07/2020] [Revised: 12/31/2020] [Accepted: 01/07/2021] [Indexed: 01/04/2023]
Abstract
This study analyzes the moderating role of avoidant coping (in early pregnancy) in the relationship between postpartum depressive (PPD) symptoms and maternal perceptions about mother-baby relations and self-confidence. Participants were 116 low-risk obstetric mothers (mean age = 31.2 years, SD = 3.95, range 23-42) who received care and gave birth at a Spanish public hospital. Measurements were made at two points in time: at first trimester of pregnancy (maternal avoidance coping) and four months after childbirth (PPD and maternal perceptions). Avoidant coping was associated with the perception of the baby as irritable and unstable (p = 0.003), including irritability during lactation (p = 0.041). Interaction effects of avoidant coping and postpartum depression were observed on the perception of the baby as irritable (p = 0.031) and with easy temperament (p = 0.002). Regarding the mother's self-confidence, avoidant coping was related to a lack of security in caring for the baby (p < 0.001) and had a moderating effect between PPD and mother's self-confidence (i.e., lack of security in caring for the baby, p =0.027; general security, p = 0.007). Interaction effects showed that the use of avoidant coping in the mother exacerbated the impact of PPD on the early mother-infant relationship.
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Affiliation(s)
- Cecilia Peñacoba Puente
- Department of Psychology, Rey Juan Carlos University, Avda. de Atenas s/n, 28922 Madrid, Spain; (C.P.P.); (S.B.R.); (J.S.R.M.)
| | - Carlos Suso-Ribera
- Department of Basic and Clinical Psychology and Psychobiology, Jaume I University, 12071 Castellon, Spain;
| | - Sheila Blanco Rico
- Department of Psychology, Rey Juan Carlos University, Avda. de Atenas s/n, 28922 Madrid, Spain; (C.P.P.); (S.B.R.); (J.S.R.M.)
| | - Dolores Marín
- Hospital Universitario de Fuenlabrada, 28944 Madrid, Spain;
| | - Jesús San Román Montero
- Department of Psychology, Rey Juan Carlos University, Avda. de Atenas s/n, 28922 Madrid, Spain; (C.P.P.); (S.B.R.); (J.S.R.M.)
| | - Patricia Catalá
- Department of Psychology, Rey Juan Carlos University, Avda. de Atenas s/n, 28922 Madrid, Spain; (C.P.P.); (S.B.R.); (J.S.R.M.)
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Tan CW, Tan HS, Sultana R, Chui A, Chua TE, Chen H, Sng BL. Association of Childbirth Pain with Postnatal Depressive and Anxiety Disorders in Nulliparous Parturients: A Prospective Study. Neuropsychiatr Dis Treat 2021; 17:2625-2636. [PMID: 34413647 PMCID: PMC8370488 DOI: 10.2147/ndt.s321367] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/22/2021] [Accepted: 08/01/2021] [Indexed: 12/11/2022] Open
Abstract
PURPOSE There is limited knowledge on the relationship between postnatal depression and childbirth pain characteristics associated with childbirth. We investigated whether the characteristics of childbirth pain, as assessed by Short-form-McGill Pain Questionnaire-2 (SF-MPQ-2), were associated with postnatal anxiety and depressive disorders. PATIENTS AND METHODS Nulliparous parturients who received labor epidural analgesia (LEA) and delivered in our institution were invited to have a Mini-International Neuropsychiatric Interview (MINI) assessment following their 5-9 weeks post-delivery follow-up phone survey of a larger study. Parturients' demographics, pre-delivery questionnaires on pain and psychological vulnerabilities, LEA data, maternal and neonatal outcomes, postnatal follow-up survey on pain and psychological vulnerabilities, pain and breastfeeding were collected accordingly. The primary outcome was the binary variable (yes/no) of the presence of postnatal depression and/or anxiety disorders based on the post-delivery MINI assessment. RESULTS Among the 107 parturients who participated in the post-delivery MINI assessment, a total of 40 (42.5%) patients were found to have postnatal anxiety and depressive disorders. A greater pre-delivery SF-MPQ-2 neuropathic pain mean subscale score (adjusted odds ratio (OR) 1.32, 95% CI 1.00-1.73, p=0.0482) and greater post-delivery Edinburgh Postnatal Depression Scale (EPDS) at 5-9 weeks post-delivery (adjusted OR 1.30, 95% CI 1.13-1.50, p=0.0002) were independently associated with the presence of postnatal anxiety and/or depressive disorders (receiver operating characteristic (ROC) = 0.7489). CONCLUSION Patients with greater pre-delivery neuropathic pain and higher EPDS scores at 5-9 weeks post-delivery are more likely to have postnatal depression and/or anxiety disorders, suggesting possible associations between pain and psychological vulnerability in the development of postnatal mental disorders.
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Affiliation(s)
- Chin Wen Tan
- Department of Women's Anesthesia, KK Women's and Children's Hospital, Singapore.,Anesthesiology and Perioperative Sciences Academic Clinical Program, Duke-NUS Medical School, Singapore
| | - Hon Sen Tan
- Department of Women's Anesthesia, KK Women's and Children's Hospital, Singapore.,Anesthesiology and Perioperative Sciences Academic Clinical Program, Duke-NUS Medical School, Singapore
| | - Rehena Sultana
- Centre for Quantitative Medicine, Duke-NUS Medical School, Singapore
| | - Anne Chui
- Lee Kong Chian School of Medicine, Singapore
| | - Tze-Ern Chua
- Department of Psychological Medicine, KK Women's and Children's Hospital, Singapore.,Pediatrics Academic Clinical Program, Duke-NUS Medical School, Singapore
| | - Helen Chen
- Department of Psychological Medicine, KK Women's and Children's Hospital, Singapore.,Pediatrics Academic Clinical Program, Duke-NUS Medical School, Singapore
| | - Ban Leong Sng
- Department of Women's Anesthesia, KK Women's and Children's Hospital, Singapore.,Anesthesiology and Perioperative Sciences Academic Clinical Program, Duke-NUS Medical School, Singapore
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Perinatal Anxiety Symptoms: Rates and Risk Factors in Mexican Women. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 18:ijerph18010082. [PMID: 33374261 PMCID: PMC7795471 DOI: 10.3390/ijerph18010082] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Accepted: 12/18/2020] [Indexed: 02/04/2023]
Abstract
Anxiety during pregnancy and after childbirth can have negative consequences for a woman and her baby. Despite growing interest in the perinatal mental health of Mexican women living in the U.S., perinatal anxiety symptom (PAS) rates and risk factors have yet to be established for women in Mexico. We sought to determine PAS rates and identify risk factors, including the traditional female role (TFR) in a sample of Mexican women. This secondary data analysis is based on 234 Mexican women who participated in a longitudinal study on perinatal depression in Mexico. Anxiety symptoms were assessed in pregnancy and at six weeks postpartum. Rates were determined through frequencies, and multiple logistics regressions were conducted to identify risk factors in the sample. The PAS rate was 21% in pregnancy and 18% postpartum. Stressful life events and depressive symptoms were associated with a higher probability of PAS. Adherence to TFR increased the probability of prenatal anxiety; lower educational attainment and low social support during pregnancy increased the probability of postpartum anxiety. The PAS rates were within the range reported in the literature. The TFR was only associated with anxiety in gestation, highlighting the role of this culturally relevant risk factor. Culturally responsive early interventions are therefore required.
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48
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Gorman G, Toomey E, Flannery C, Redsell S, Hayes C, Huizink A, Kearney PM, Matvienko-Sikar K. Fidelity of Interventions to Reduce or Prevent Stress and/or Anxiety from Pregnancy up to Two Years Postpartum: A Systematic Review. Matern Child Health J 2020; 25:230-256. [PMID: 33237506 DOI: 10.1007/s10995-020-03093-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/07/2020] [Indexed: 10/22/2022]
Abstract
INTRODUCTION Intervention fidelity refers to whether an intervention is delivered as intended and can enhance interpretation of trial outcomes. Fidelity of interventions to reduce or prevent stress and anxiety during pregnancy and postpartum has yet to be examined despite inconsistent findings for intervention effects. This study systematically reviews use and/or reporting of intervention fidelity strategies in trials of interventions, delivered to (expectant) parents during pregnancy and postpartum, to reduce or prevent stress and/or anxiety. METHODS MEDLINE, Embase, CINAHL, PsychINFO, and Maternity and Infant Care were searched from inception to March 2019. Studies were included if they were randomised controlled trials including pregnant women, expectant fathers and/or partners during pregnancy, and/ or parents within the first two years postpartum. The National Institutes of Health Behavior Change Consortium checklist was used to assess fidelity across five domains (study design, provider training, delivery, receipt, enactment). RESULTS Sixteen papers (14 interventions) were identified. Average reported use of fidelity strategies was 'low' (45%), ranging from 17.5 to 76%. Fidelity ratings ranged from 22% for provider training to 54% for study design. CONCLUSIONS Low levels of intervention fidelity may explain previous inconsistent effects of stress and anxiety reduction interventions. Important methodological areas for improvement include intervention provider training, fidelity of comparator conditions, and consideration of non-specific treatment effects. Increased methodological rigour in fidelity enhancement and assessment will improve intervention implementation and enhance examination of stress and anxiety reduction and prevention interventions delivered during pregnancy and the postpartum.
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Affiliation(s)
- Gregory Gorman
- School of Public Health, University College Cork, Western Gateway Building, Western Road, Cork, Ireland
| | - Elaine Toomey
- School of Allied Health, University of Limerick, Limerick, Ireland
| | - Caragh Flannery
- School of Public Health, University College Cork, Western Gateway Building, Western Road, Cork, Ireland
| | - Sarah Redsell
- School of Medicine, University of Nottingham, Nottingham, England
| | | | - Anja Huizink
- Department of Clinical, Neuro- and Developmental Psychology, VU University Amsterdam, Amsterdam, The Netherlands
| | - Patricia M Kearney
- School of Public Health, University College Cork, Western Gateway Building, Western Road, Cork, Ireland
| | - Karen Matvienko-Sikar
- School of Public Health, University College Cork, Western Gateway Building, Western Road, Cork, Ireland. .,School of Public Health, University College Cork, 4th Floor, Western Gateway Building, Western Road, Cork, Ireland.
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Pregnancy-Related Anxiety, Perceived Parental Self-Efficacy and the Influence of Parity and Age. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17186709. [PMID: 32942604 PMCID: PMC7557851 DOI: 10.3390/ijerph17186709] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/10/2020] [Revised: 09/10/2020] [Accepted: 09/11/2020] [Indexed: 12/17/2022]
Abstract
Pregnancy-related anxiety is contextualised by pregnancy and is a health concern for the mother and child. Perceived parental self-efficacy is associated with this anxiety and age and parity are identified as influential factors. This research, therefore, predicted that negative perceptions of parental self-efficacy would predict greater pregnancy-related anxiety, moderated by parity and age. Participants (N = 771) were recruited online and assessed for perceived parental self-efficacy, pregnancy-related anxiety, and demographics. Moderation models showed that the psychosocial and sociodemographic factors combined predicted up to 49% of the variance. Parental self-efficacy predicted anxiety in the areas of body image, worry about themselves, baby concerns, pregnancy acceptance, attitudes towards medical staff and childbirth, and avoidance. Parity predicted pregnancy-related anxiety both overall and in childbirth concerns, worry about self, baby concerns and attitudes towards childbirth. Age predicted baby concerns. There was a significant moderation effect for pregnancy acceptance indicating that primiparous women with low perceptions of parental self-efficacy are less accepting of their pregnancy. Results suggest that parity and parental self-efficacy may be risk factors for first-time mothers for pregnancy-related anxiety.
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50
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Yu Y, Zhu X, Xu H, Hu Z, Zhou W, Zheng B, Yin S. Prevalence of depression symptoms and its influencing factors among pregnant women in late pregnancy in urban areas of Hengyang City, Hunan Province, China: a cross-sectional study. BMJ Open 2020; 10:e038511. [PMID: 32873680 PMCID: PMC7467533 DOI: 10.1136/bmjopen-2020-038511] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2020] [Revised: 06/02/2020] [Accepted: 07/29/2020] [Indexed: 11/03/2022] Open
Abstract
OBJECTIVES To evaluate the prevalence of depressive symptoms and its influencing factors in late pregnancy. DESIGN Cross-sectional study. SETTING Fourteen community in urban areas of Hengyang City. PARTICIPANTS The study conducted from July to October 2019, and surveyed 813 women in late pregnancy who lived in urban areas of Hengyang for more than 6 months, signed an informed consent and were without cognitive disorders, severe mental illnesses or other serious diseases. MEASURES Perinatal depression symptoms were evaluated using the Patient Health Questionnaire-9, and perinatal anxiety symptoms were evaluated using the Generalised Anxiety Disorder-7 Scale. Sociodemographic variables, obstetric characteristics, lifestyle behaviours, family factors, social support, sleep quality and self-efficacy were obtained through structured questionnaires. RESULTS The prevalence of depression symptoms among pregnant women in late pregnancy was 9.2% (95% CI 7.2%-11.2%). Protective factor: age between 25 and 29 years (OR=0.398; 95% CI 0.16-0.991). RISK FACTORS a normal relationship with her mother-in-law (OR=5.309; 95% CI 1.122-4.184), artificial insemination (OR=4.339; 95% CI 1.492-12.623), no exercise during pregnancy (OR=2.666; 95% CI 1.177-6.039), low self-efficacy (OR=4.253; 95% CI 1.518-11.916), low social support (OR=2.371; 95% CI 1.206-4.661), poor sleep quality (OR=2.134; 95% CI 1.131-4.027), existence of anxiety symptoms (OR=17.654; 95% CI 8.494-36.689). CONCLUSION The prevalence of depression symptoms is lower than that in developing countries, but due to the large population base of China, the problem should still be taken seriously. To prevent mental disorders of pregnant women, early screening for mental disorders, promotion of healthy lifestyles, mental healthcare during pregnancy and improved family and social support should be implemented during pregnancy nursing.
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Affiliation(s)
- Yunhan Yu
- Department of Social Medicine and Health Management, Central South University Xiangya School of Public Health, Changsha, Hunan, China
| | - Xidi Zhu
- Department of Social Medicine and Health Management, Central South University Xiangya School of Public Health, Changsha, Hunan, China
| | - Huilan Xu
- Department of Social Medicine and Health Management, Central South University Xiangya School of Public Health, Changsha, Hunan, China
| | - Zhao Hu
- Department of Social Medicine and Health Management, Central South University Xiangya School of Public Health, Changsha, Hunan, China
| | - Wensu Zhou
- Department of Social Medicine and Health Management, Central South University Xiangya School of Public Health, Changsha, Hunan, China
| | - Baohua Zheng
- Department of Social Medicine and Health Management, Central South University Xiangya School of Public Health, Changsha, Hunan, China
| | - Shilin Yin
- Department of Social Medicine and Health Management, Central South University Xiangya School of Public Health, Changsha, Hunan, China
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