1
|
Wilczyńska D, Walczak-Kozłowska T, Santos-Rocha R, Laskowski R, Szumilewicz A. Stress is not so bad-cortisol level and psychological functioning after 8-week HIIT program during pregnancy: a randomized controlled trial. Front Public Health 2024; 11:1307998. [PMID: 38259751 PMCID: PMC10800893 DOI: 10.3389/fpubh.2023.1307998] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2023] [Accepted: 12/22/2023] [Indexed: 01/24/2024] Open
Abstract
Background Amid extensive pregnancy exercise research, the impact of High Intensity Interval Training (HIIT) on pregnant women's mental health is underexplored. Despite exercise benefits, it can trigger stress responses like elevated cortisol. This study fills the gap by investigating correlations between hair cortisol levels, mental health, and HIIT effects in pregnant women. Methods We conducted a randomized control trial among 38 Caucasian women in uncomplicated, singleton pregnancy (age 31.11 ± 4.03 years, 21.82 ± 4.30 week of gestation; mean ± SD). The experimental group comprised 22 women engaged in an 8-week high-intensity interval training program (HIIT). The comparative group consisted of 16 pregnant women undergoing an 8-week educational program (EDU). Before and after the interventions, all women were evaluated using the following tools: Hair cortisol level measurements, Beck Depression Inventory - II for depressive symptoms assessment, Childbirth Attitudes Questionnaire for childbirth fear measurement, 12-item Short Form Health Survey to gage health-related quality of life, International Physical Activity Questionnaire for physical activity level estimation, and a Progressive maximal exercise test to evaluate maternal exercise capacity. Results The key finding of our study reveals that women engaged in the HIIT intervention exhibited a distinct cortisol production pattern in contrast to the EDU group practicing standard moderate intensity physical activity. In the HIIT group, there was an increase in hair cortisol levels, while the EDU group showed a notable decrease. Remarkably, HIIT stimulated cortisol production without adversely impacting fear of childbirth and psychophysical condition during pregnancy. In fact, only the HIIT group showed a significant enhancement in mental health. Conclusion No links were discovered between hair cortisol levels and the severity of depressive symptoms, psychophysical well-being, or fear of childbirth. Hence, based on our research, employing cortisol levels during pregnancy as an indicator of negative stress or depression risk appears unwarranted.
Collapse
Affiliation(s)
- Dominika Wilczyńska
- Department of Physical Culture, Gdańsk University of Physical Education and Sport, Gdańsk, Poland
| | | | - Rita Santos-Rocha
- ESDRM Department of Physical Activity and Health, Sport Sciences School of Rio Maior, Polytechnic Institute of Santarém, Santarém, Portugal
- CIPER Interdisciplinary Centre for the Study of Human Performance, Faculty of Human Kinetics (FMH), University of Lisbon, Lisbon, Portugal
| | - Radosław Laskowski
- Department of Physical Culture, Gdańsk University of Physical Education and Sport, Gdańsk, Poland
| | - Anna Szumilewicz
- Department of Physical Culture, Gdańsk University of Physical Education and Sport, Gdańsk, Poland
| |
Collapse
|
2
|
Bakhteh A, Jaberghaderi N, Rezaei M, Naghibzadeh ZAS, Kolivand M, Motaghi Z. The effect of interventions in alleviating fear of childbirth in pregnant women: a systematic review. J Reprod Infant Psychol 2024; 42:5-21. [PMID: 35435061 DOI: 10.1080/02646838.2022.2059458] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2021] [Accepted: 03/22/2022] [Indexed: 10/18/2022]
Abstract
BACKGROUND The Fear of Childbirth (FOC) is regarded as a general problem, which affects women's health and well-being, justifying demanding caesarean section. Several primary studies have been performed in relation to the interventions performed to reduce the fear of childbirth, which show contradictions between the results of these studies. OBJECTIVE This review aims to provide a comprehensive review of the different types of interventions used to reduce the fear of childbirth in pregnant mothers. METHODS In this study, systematic review of study information related to the effect of different therapies on reducing the fear of childbirth using subject-related keywords and validated with MeSH in SID, MagIran, IranMedex, IranDoc, Embase, ProQuest, Scopus, PubMed, Web of Science (ISI) databases and Google Scholar Search Engine were extracted without any time limit until February 2021. RESULTS After removing duplicates and irrelevant works from among the 5396 articles found, 63 articles remained in the study. The participants in these 63 articles were 5415 cases and 5770 controls. In addition, three studies were on epidural anesthesia, 33 on the effects of psychotherapy, 19 on the effects of education, and eight on the influence of other interventions on alleviating FOC. As shown by the results, psychotherapy intervention and education decreased FOC significantly. CONCLUSION According to the results of this study, to prevent the fear of childbirth, pregnancy training and prenatal preparation courses are recommended to empower pregnant women. It also seems beneficial to use psychotherapy approaches for women who are afraid of childbirth.
Collapse
Affiliation(s)
- Azam Bakhteh
- Student Research Center, School of Nursing and Midwifery, Shahroud University of Medical Sciences, Shahroud, Iran
| | - Nasrin Jaberghaderi
- Department of Clinical Psychology, School of Medicine, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Mansour Rezaei
- Department of Biostatistics, School of Health & Social Development and Health Promotion Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | | | - Mitra Kolivand
- Department of Reproductive Health, School of Nursing and Midwifery, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Zahra Motaghi
- Reproductive Health Department, School of Nursing and Midwifery, Shahroud University of Medical Sciences, Shahroud, Iran
| |
Collapse
|
3
|
Ayala NK, Fain AC, Cersonsky TEK, Werner EF, Miller ES, Clark MA, Lewkowitz AK. Early pregnancy dispositional optimism and pregnancy outcomes among nulliparous people. Am J Obstet Gynecol MFM 2023; 5:101155. [PMID: 37734660 PMCID: PMC10841240 DOI: 10.1016/j.ajogmf.2023.101155] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Revised: 09/07/2023] [Accepted: 09/07/2023] [Indexed: 09/23/2023]
Abstract
BACKGROUND Dispositional optimism, the expectation of positive outcomes after personal challenges, is a resilience factor associated with widespread health benefits. However, the data on pregnancy-related outcomes are more limited. OBJECTIVE This study aimed to assess the association of early pregnancy dispositional optimism with adverse perinatal outcomes. STUDY DESIGN This was a prospective cohort study completed between May 2019 and February 2022 at a single, large tertiary medical center. Nulliparous pregnant people were recruited from outpatient obstetrical care sites. Participants completed a validated assessment of dispositional optimism at <20 weeks of gestation and were followed up until delivery. The primary outcome was an adverse maternal outcome composite that included gestational diabetes mellitus, hypertensive disorders of pregnancy, and/or cesarean delivery. The secondary outcomes included individual composite components and a neonatal morbidity composite. Bivariate analyses compared characteristics and primary and secondary outcomes by dispositional optimism score quartile. Multivariable logistic regression compared outcomes by dispositional optimism score quartile with the highest quartile serving as the referent, controlling for confounders determined a priori. RESULTS Overall, 491 pregnant people were approached for participation, and 135 pregnant people (27.5%) declined participation. Among the 284 individuals who enrolled and had complete outcome data, the median dispositional optimism score was 16.0 (interquartile range, 14-18), and 47.9% of individuals experienced at least 1 adverse maternal outcome 135 (47.9%). After adjusting for confounders, the odds of adverse maternal outcomes were significantly higher in the lowest 2 optimism quartiles: quartile 1 (adjusted odds ratio, 3.33; 95% confidence interval, 1.57-7.36) and quartile 2 (adjusted odds ratio, 2.22; 95% confidence interval, 1.05-4.79) than the highest quartile. This was driven by significantly higher rates of hypertension (quartile 1: adjusted odds ratio, 2.62; 95% confidence interval, 1.12-6.29) and cesarean delivery (quartile 1: adjusted odds ratio, 2.75; 95% confidence interval, 1.20-6.55). There was no difference noted when quartile 3 was compared with quartile 4. CONCLUSION Lower early pregnancy dispositional optimism was associated with significantly higher odds of adverse maternal outcomes. Interventions targeting improvements in optimism may be a novel mechanism for reducing perinatal morbidity.
Collapse
Affiliation(s)
- Nina K Ayala
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Women and Infants Hospital of Rhode Island, Providence, RI (Drs Ayala, Miller, and Lewkowitz); Department of Obstetrics and Gynecology, Alpert Medical School of Brown University, Providence, RI (Drs Ayala, Miller, Clark, and Lewkowitz).
| | - Audra C Fain
- Warren Alpert Medical School of Brown University, Providence, RI (Drs Fain and Cersonsky)
| | - Tess E K Cersonsky
- Warren Alpert Medical School of Brown University, Providence, RI (Drs Fain and Cersonsky)
| | - Erika F Werner
- Department of Obstetrics and Gynecology, Tufts University School of Medicine, Boston, MA (Dr Werner)
| | - Emily S Miller
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Women and Infants Hospital of Rhode Island, Providence, RI (Drs Ayala, Miller, and Lewkowitz); Department of Obstetrics and Gynecology, Alpert Medical School of Brown University, Providence, RI (Drs Ayala, Miller, Clark, and Lewkowitz)
| | - Melissa A Clark
- Department of Obstetrics and Gynecology, Alpert Medical School of Brown University, Providence, RI (Drs Ayala, Miller, Clark, and Lewkowitz); Department of Health Services, Policy, and Practice, Brown University School of Public Health, Providence, RI (Dr Clark)
| | - Adam K Lewkowitz
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Women and Infants Hospital of Rhode Island, Providence, RI (Drs Ayala, Miller, and Lewkowitz); Department of Obstetrics and Gynecology, Alpert Medical School of Brown University, Providence, RI (Drs Ayala, Miller, Clark, and Lewkowitz)
| |
Collapse
|
4
|
Šanjug J, Kuna K, Goldštajn MŠ, Dunkić LF, Carek A, Negovetić Vranić D. Relationship between COMT Gene Polymorphism, Anxiety, and Pain Perception during Labour. J Clin Med 2023; 12:6298. [PMID: 37834942 PMCID: PMC10573766 DOI: 10.3390/jcm12196298] [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: 08/23/2023] [Revised: 09/22/2023] [Accepted: 09/26/2023] [Indexed: 10/15/2023] Open
Abstract
BACKGROUND The COMT gene polymorphism is associated with neurological and psychiatric disorders and pain perception. The present study investigates the existence of anxiety and pain perception in relation to the COMT (catechol-O-methyltransferase) gene polymorphism in labouring women (during "natural" childbirth) with or without inhaled analgesia. METHODS A total of 181 women who chose vaginal birth were enrolled in this study. To present the difference in pain perception, the parturients were divided into one group (n = 90) that chose labour analgesia with inhaled nitrous oxide (50% nitrous oxide and 50% oxygen) and one group (n = 91) without analgesia. The blood samples were taken during the pregnancy as a part of routine pregnancy controls in the hospital. The COMT gene polymorphism was detected with the PCR technique. The pain perception of parturients was self-evaluated two times according to the VAS (Visual Analogue Scale), and anxiety as a personality trait was determined with the STAI-T (State Trait Anxiety Inventory). Pain perception as well as anxiety were compared according to COMT genotypes. RESULTS In the 181 pregnant women, there were 40 women (22%) of wild homozygotes (GG) of COMT, 95 women (53%) of mutant heterozygotes (GA), and 46 women (25%) of mutant homozygotes (AA). A negative association of pain perception with the GA (mutant heterozygote) polymorphism of the COMT gene versus the wild-type (GG polymorphism) was observed. The GA polymorphism of the COMT gene was associated with 0.46 units lower pain perception compared to the wild type (GG). The anxiety trait score in group AA was lower than in groups GA and GG. The difference reached statistical significance only when comparing AA versus GA (p > 0.042). Analgesic efficacy of nitrous oxide was noticed in 22% of labouring women who reported moderate pain (VAS score 4-7). CONCLUSIONS The COMT gene polymorphism was associated with pain perception and anxiety among parturients. The COMT gene polymorphism GA was associated with negative pain perception among labouring women. Nitrous oxide showed statistical significance in anxiolytic efficacy during labour in women with mild anxiety as a personality trait. Anxiolytic efficacy of nitrous oxide has shown better efficacy in parturients with the COMT gene polymorphism AA.
Collapse
Affiliation(s)
- Jadranka Šanjug
- Department of Gynaecology and Obstetrics, General Hospital Zabok and War Veterans’ Hospital, Bračak 8, 49210 Zabok, Croatia
| | - Krunoslav Kuna
- Department of Gynaecology and Obstetrics, Sestre Milosrdnice University Hospital Centre, 10000 Zagreb, Croatia;
| | - Marina Šprem Goldštajn
- Department of Obstetrics and Gynecology, Clinical Hospital Center Zagreb, 10000 Zagreb, Croatia
| | - Lidija Fumić Dunkić
- Division of Anesthesiology, Intensive Care and Pain Medicine, Sestre Milosrdnice University Hospital Center, 10000 Zagreb, Croatia;
| | - Andreja Carek
- Department of Fixed Prosthodontics, School of Dental Medicine, University of Zagreb, Gunduliceva 5, 10000 Zagreb, Croatia
| | - Dubravka Negovetić Vranić
- Department of Pediatric Dentistry, School of Dental Medicine, University of Zagreb, Gunduliceva 5, 10000 Zagreb, Croatia
| |
Collapse
|
5
|
Diotaiuti P, Corrado S, Mancone S, Cavicchiolo E, Chirico A, Siqueira TC, Andrade A. A psychometric evaluation of the Italian short version of the Fear of Pain Questionnaire-III: Psychometric properties, measurement invariance across gender, convergent, and discriminant validity. Front Psychol 2023; 13:1087055. [PMID: 36726497 PMCID: PMC9886064 DOI: 10.3389/fpsyg.2022.1087055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Accepted: 12/12/2022] [Indexed: 01/12/2023] Open
Abstract
Introduction The Fear of Pain Questionnaire-III (FPQ-III) is a self-assessment instrument developed specifically to measure fear based on various pain stimuli converging on three factors: severe pain, medical pain, and minor pain. It actually remains the most studied and internationally used tool even in its short versions. The aim of this work was to propose a new validation study oriented to confirm the good psychometric properties of a short model of the FPQ-III for the Italian context. Methods A large sample of participants was recruited (n = 1,064) and Exploratory Factor Analysis (EFA) as well as Confirmatory Factor Analysis (CFA) were performed. Measurement invariance of the FPQ-III across gender was also evaluated. In order to examine convergent validity, a further convenient sample (n = 292) was used and variables related to the individual's pain experience, locus of control and coping orientations were assessed. A final discriminant assessment using experimental manipulation through fear eliciting videos was performed. Results The three factors structure of the 13-item version of the questionnaire was confirmed (χ2 = 148.092, CFI = 0.971, TLI = 0.962, RMSEA = 0.046, RMSEA 90% CI = 0.037-0.056) as well as the measurement invariance across gender. Item internal reliability was satisfactory. The results provided evidence of the good predictive validity of the FPQ-III and the discriminant assessment demonstrated that the instrument is suitable in detecting changes in fear of pain induced by specific situational conditions. Discussion The scale in this short version is suitable for quickly and efficiently gathering information about the perceived intensity of such anticipatory fears that might affect even the healthy person dysfunctionally.
Collapse
Affiliation(s)
- Pierluigi Diotaiuti
- Department of Human Sciences, Society and Health, University of Cassino and Lazio, Cassino, Italy,*Correspondence: Pierluigi Diotaiuti,
| | - Stefano Corrado
- Department of Human Sciences, Society and Health, University of Cassino and Lazio, Cassino, Italy
| | - Stefania Mancone
- Department of Human Sciences, Society and Health, University of Cassino and Lazio, Cassino, Italy
| | - Elisa Cavicchiolo
- Department of Systems Medicine, Tor Vergata University of Rome, Rome, Italy
| | - Andrea Chirico
- Department of Psychology of Development and Socialization Processes, Sapienza University of Rome, Rome, Italy
| | - Thais Cristina Siqueira
- Health and Sports Science Center, Department of Physical Education, CEFID, Santa Catarina State University, Florianopolis, Santa Catarina, Brazil
| | - Alexandro Andrade
- Health and Sports Science Center, Department of Physical Education, CEFID, Santa Catarina State University, Florianopolis, Santa Catarina, Brazil
| |
Collapse
|
6
|
Ayala NK, Whelan AR, Recabo O, Cersonsky TE, Bublitz MH, Sharp MC, Lewkowitz AK. Dispositional Optimism, Mode of Delivery, and Perceived Labor Control among Recently Delivered Parturients. Am J Perinatol 2023; 40:122-127. [PMID: 35738357 PMCID: PMC9805476 DOI: 10.1055/a-1882-9940] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
OBJECTIVE Dispositional optimism (DO) is an understudied transdiagnostic resilience factor among peripartum individuals. Low DO is associated with increased fear and pain in labor and increased rates of emergent cesarean delivery, but it is unknown whether DO is associated with perceived control over the labor process. STUDY DESIGN This a planned secondary analysis of a prospective observational cohort of term parturients (n = 164) who were recruited in July and August 2021 during their delivery hospitalization at a single, tertiary medical center. Participants completed a baseline demographic survey prior to delivery and then completed evaluations of DO (Revised Life-Orientation Test [LOT-R]) and control over the labor process (Labor Agentry Scale [LAS]) during their postpartum hospitalization. DO was dichotomized into low and high by score of ≤14 or >14 on LOT-R, respectively, and labor agentry scores were compared between groups. Maternal demographics, pregnancy, and delivery characteristics were compared by DO status. Multivariable regression was performed, adjusting for known confounders (induction, labor analgesia, and mode of delivery). RESULTS Demographic, pregnancy, and neonatal characteristics were similar between those with low compared with high DO. People with low DO had significantly higher rates of cesarean section (44 vs. 24%, p = 0.02) and overall had lower LAS scores (139.4 vs. 159.4, p < 0.001), indicating that they felt less control over their labor process than those with high DO. In the multivariable regression, those with low DO had higher odds of a low LAS score after controlling for induction, labor analgesia, and mode of delivery (adjusted odds ratio = 1.29, 95% confidence interval: 1.20-1.39). CONCLUSION People with low DO had significantly lower perceived control over their labor, even after controlling for differences in mode of delivery. Interventions to alter DO may be an innovative way to improve birth experience and its associated perinatal mental health morbidities. KEY POINTS · It is unknown if there is an association between DO and perceived labor control.. · People with low DO had higher rates of cesarean delivery and lower perceived labor control.. · Altering DO may be a novel mechanism for improving birth experience..
Collapse
Affiliation(s)
- Nina K. Ayala
- Division of Maternal Fetal Medicine, Women and Infants Hospital of Rhode Island
- Department of Obstetrics and Gynecology, Alpert Medical School of Brown University
| | - Anna R. Whelan
- Division of Maternal Fetal Medicine, Women and Infants Hospital of Rhode Island
- Department of Obstetrics and Gynecology, Alpert Medical School of Brown University
| | | | | | - Margaret H. Bublitz
- Women’s Medicine Collaborative at Lifespan Hospital System
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University
| | - Meghan C. Sharp
- Women’s Medicine Collaborative at Lifespan Hospital System
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University
| | - Adam K. Lewkowitz
- Division of Maternal Fetal Medicine, Women and Infants Hospital of Rhode Island
- Department of Obstetrics and Gynecology, Alpert Medical School of Brown University
| |
Collapse
|
7
|
Wilczyńska D, Walczak-Kozłowska T, Radzimiński Ł, Oviedo-Caro MÁ, Santos-Rocha R, Szumilewicz A. Can we hit prenatal depression and anxiety through HIIT? The effectiveness of online high intensity interval training in pregnant women during the COVID-19 pandemic: a randomized controlled trial. BMC Sports Sci Med Rehabil 2022; 14:215. [PMID: 36550564 PMCID: PMC9773485 DOI: 10.1186/s13102-022-00610-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2022] [Accepted: 12/16/2022] [Indexed: 12/24/2022]
Abstract
BACKGROUND In recent years high intensity interval training (HIIT) has grown in popularity. However, it rarely represents training interventions in experimental studies in pregnant populations. Therefore, in this study we aimed to assess changes in depressive symptoms, fear of childbirth, fear of Covid-19 and quality of life after an 8-week supervised online HIIT program, compared to an educational (self-performed physical activity) program. METHODS We conducted a randomized control trial among 54 Caucasian women in uncomplicated, singleton pregnancy (age 32 ± 4 years, 22 ± 4 week of gestation; mean ± SD). There were 34 women in the experimental group, who participated in an 8-week high intensity interval training program (HIIT group). The comparative group was constituted of 20 pregnant women who attended 8-week educational program (EDU group). RESULTS The most important finding was that mental health improved somewhat in both groups after the intervention, but only the HIIT group improved statistically significantly. The positive trends in lowering the severity of depressive symptoms, fear of childbirth, and fear of Covid-19 were observed in both groups. However, the positive response to the intervention was stronger in the EDU group. As a secondary outcome, there was a significant decrease in cardiorespiratory fitness level in the EDU group, while the HIIT group maintained unchanged level of maximal oxygen uptake. CONCLUSIONS HIIT seems to be beneficial for women with uncomplicated pregnancies to maintain adequate quality of life and mental health. However, more research is needed to determine the effectiveness of prenatal HIIT in pregnant women in various psychological conditions. TRIAL REGISTRATION We conducted this study in Poland, in 2021. It was approved by the Bioethics Commission at the District Medical Chamber in Gdansk (KB-8/21). The full study protocol was registered in ClinicalTrials.gov (NCT05009433).
Collapse
Affiliation(s)
- Dominika Wilczyńska
- grid.445131.60000 0001 1359 8636Department of Physical Culture, Gdansk University of Physical Education and Sport, Gdansk, Poland
| | - Tamara Walczak-Kozłowska
- grid.8585.00000 0001 2370 4076Department of Neuropsychology, Institute of Psychology, University of Gdansk, Gdansk, Poland
| | - Łukasz Radzimiński
- grid.445131.60000 0001 1359 8636Department of Physical Culture, Gdansk University of Physical Education and Sport, Gdansk, Poland
| | - Miguel Ángel Oviedo-Caro
- grid.9224.d0000 0001 2168 1229Department of Physical Education and Sport, University of Seville, Seville, Spain
| | - Rita Santos-Rocha
- grid.410927.90000 0001 2171 5310Sport Sciences School of Rio Maior (ESDRM), Polytechnic Institute of Santarém, Rio Maior, Portugal ,grid.9983.b0000 0001 2181 4263Interdisciplinary Centre for the Study of Human Performance (CIPER), Faculty of Human Kinetics (FMH), University of Lisbon, lisboa, Portugal
| | - Anna Szumilewicz
- grid.445131.60000 0001 1359 8636Department of Physical Culture, Gdansk University of Physical Education and Sport, Gdansk, Poland
| |
Collapse
|
8
|
Assessment of In-Hospital Pain Control after Childbirth and Its Correlation with Anxiety in the Postpartum Period: A Cross-Sectional Study at a Single Center in the USA. REPRODUCTIVE MEDICINE 2022. [DOI: 10.3390/reprodmed3040026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Anxiety is common during the antepartum, intrapartum, and postpartum period. While the relationship between obstetric pain and depression is well characterized, there are few publications examining the relationship between obstetric pain and anxiety. Our objective was to characterize the association, if any, between postpartum pain and anxiety. This was a survey-based cross-sectional study. The general anxiety disorder (GAD)-7 and American Pain Society patient outcome questionnaire (APS-POQ) were completed by 64 postpartum participants at hospital discharge. Associations between anxiety and pain control were assessed. Participants with moderate to severe scores (greater or equal to 10) on the GAD-7 had more maximum pain scores (0 to 10 scale) in the severe range (greater or equal to 7) in the first (p = 0.049) and second (p = 0.010) 24 h periods after delivery and were more likely to have spent more time in severe pain within these time frames (p = 0.007 and p = 0.010, respectively). Similar relationships were observed when classifying anxiety ordinally. In conclusion, higher postpartum pain scores were associated with greater anxiety in the postpartum period.
Collapse
|
9
|
Souto SPAD, Silva RCGD, Prata AP, Guerra MJ, Couto C, Albuquerque RSD. Midwives' interventions for reducing fear of childbirth in pregnant women: a scoping review. JBI Evid Synth 2022; 20:2867-2935. [PMID: 35976033 DOI: 10.11124/jbies-21-00382] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
OBJECTIVE The objective of this review was to map and analyze midwives' interventions for reducing fear of childbirth in pregnant women. INTRODUCTION Fear of childbirth is a phenomenon negatively affecting women's health and well-being before and during pregnancy. Over the past few decades, there has been growing research interest in interventions for reducing fear of childbirth in pregnant women. One of the challenges in midwifery care is to provide an appropriate model of care for pregnant women with fear of childbirth. Further research efforts are needed to identify midwives' interventions for reducing fear of childbirth in pregnant women and to examine their characteristics. INCLUSION CRITERIA This scoping review considered studies that included midwives' interventions for reducing fear of childbirth in pregnant women. Specifically, interventions were led and/or implemented by midwives during the antenatal period, and integrating all possible midwifery practice settings. Quantitative, qualitative, and mixed methods studies were included. This review also considered systematic reviews, text and opinion papers, and conference abstracts. METHODS The JBI methodology for conducting scoping reviews was used. Published and unpublished literature in English, Portuguese, and Spanish from January 1981 to October 2020 was included. MEDLINE (PubMed), CINAHL Complete, APA PsycINFO, Scopus, Embase, Web of Science, SciELO, MedicLatina, Academic Search Complete, ERIC, Psychology and Behavioral Sciences Collection, and the Cochrane Library databases were searched. Searches for gray literature were also undertaken on the Repositório Científico de Acesso Aberto de Portugal, ProQuest Dissertations and Theses, British Library EThOS, OvidSP Resource Center, Banco de Teses da CAPES, and OpenGrey. A three-step search strategy was followed, and the Preferred Reporting Items for Systematic Reviews and Meta-Analysis extension for Scoping Reviews checklist was used. Two independent reviewers extracted the data using a data extraction tool developed specifically for this scoping review. RESULTS A total of 3704 articles were identified and screened, of which 34 articles were included. The majority of studies had been published in the past 10 years (88%) in Scandinavian countries or Australia (79%). Several midwives' antenatal interventions were found, such as midwife-led team models of care. Midwives played a facilitator role that varied across the included studies. In 20 studies (59%), midwives led and implemented the interventions alone ( n = 13; 38%) or with the participation of other health professionals ( n = 7; 21%). In the remaining 14 studies (41%), midwives were part of a multidisciplinary team that included different health professionals (mainly obstetricians and psychologists) who had been involved in delivering interventions alongside midwives or with minor participation from midwives. Counseling ( n = 12; 35%) and psychoeducation ( n = 8; 24%) were the most common midwife interventions for reducing fear of childbirth in pregnant women. CONCLUSIONS Midwives working across their full scope of practice play a pivotal role in reducing fear of childbirth, which may explain the variety of midwives' antenatal interventions. Reducing fear of childbirth in pregnant women and promoting normal childbirth as a positive experience are key features of midwives' interventions, which should include women's empowerment measures. Evidence-based midwife-led intervention programs for pregnant women with fear of childbirth should be designed and tested to improve clinical practice as well as women's reproductive outcomes and perinatal experiences.
Collapse
Affiliation(s)
- Sandra Patrícia Arantes do Souto
- Centre for Interdisciplinary Research in Health: Institute of Health Sciences, Universidade Católica Portuguesa, Porto, Portugal.,Maternity unit, Hospital Center Póvoa de Varzim/Vila do Conde, Póvoa de Varzim, Portugal
| | - Rosa Carla Gomes da Silva
- Health Sciences Research Unit: Nursing (UICISA: E), Nursing School of Coimbra (ESEnfC).,Portugal Centre for Evidence Based Practice: A JBI Centre of Excellence, Nursing School of Coimbra, Coimbra, Portugal
| | - Ana Paula Prata
- CINTESIS - Center for Health Technology and Services Research, Nursing School of Porto (ESEP), Porto, Portugal
| | - Maria João Guerra
- Centre for Interdisciplinary Research in Health: Institute of Health Sciences, Universidade Católica Portuguesa, Porto, Portugal
| | - Cristina Couto
- Centre for Interdisciplinary Research in Health: Institute of Health Sciences, Universidade Católica Portuguesa, Porto, Portugal.,Maternity unit, Hospital Center Tâmega e Sousa, Penafiel, Portugal
| | | |
Collapse
|
10
|
Heravan MB, Rashki S. The relationship between childbirth self-efficacy and coping styles of problem based and emotive based in nulliparous pregnant women. JOURNAL OF EDUCATION AND HEALTH PROMOTION 2022; 11:213. [PMID: 36177417 PMCID: PMC9514275 DOI: 10.4103/jehp.jehp_987_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/05/2021] [Accepted: 10/16/2021] [Indexed: 06/16/2023]
Abstract
BACKGROUND Vaginal childbirth is the most stressful physical and mental event for most women, which necessitates the use of coping styles. Furthermore, childbirth self-efficacy will be one of the effective factors to cope with this stressful situation and doing compatible behaviors with childbirth pain. Therefore, the aim of this study was to determine the relationship between childbirth self-efficacy and coping styles of problem based and emotive based in nulliparous pregnant women. MATERIALS AND METHODS This study is a descriptive-correlational study that is done over 323 nulliparous pregnant women attending the health centers in the city of Zahedan in 2020-2021. Data were collected by participants' demographic questionnaire, childbirth self-efficacy questionnaire of Lowe, and coping styles questionnaire of Folkman and Lazarus. The data were analyzed using Spearman's correlation coefficient test, linear regressions model, and multiple regression in SPSS software version 22. P < 0.05 was considered statistically significant. RESULTS Results of Spearman's correlation coefficient test showed a significant direct correlation between problem-based coping style and childbirth self-efficacy (P = 0/017, r = 0.13); but, there was no significant direct correlation with emotive-based coping style (P = 0/782, r = 0.01). According to the linear regressions model, just the problem-based coping style is predicted childbirth self-efficacy (P = 0/006). CONCLUSIONS According to the findings, nulliparous pregnant women should be responsible, have a positive reassessment of vaginal childbirth, plan to solve their problems, and look for social support (all of these are part of a problem-based coping style) to increase and improve their childbirth self-efficacy. Furthermore, designing appropriate educational interventions based on problem-based coping style is necessary.
Collapse
Affiliation(s)
- Mahsima Banaei Heravan
- Instructor, Department of Midwifery, Faculty of Nursing and Midwifery, Pregnancy Health Research Center, Zahedan University of Medical Sciences, Zahedan, Iran
| | - Sadaf Rashki
- Midwifery Student, Faculty of Nursing and Midwifery, Zahedan University of Medical Sciences, Zahedan, Iran
| |
Collapse
|
11
|
Liu S, Jin Y, Li H, Zeng T, Zhou G, Yu L, Fan Y, Lei X. Associations of Musical Activities and Positive Affect With Fear of Childbirth: A Structural Equation Modeling Approach. Front Public Health 2022; 10:906996. [PMID: 35784209 PMCID: PMC9247401 DOI: 10.3389/fpubh.2022.906996] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Accepted: 05/16/2022] [Indexed: 11/20/2022] Open
Abstract
Background Fear of childbirth is a prevalent issue among women, with a wide range of interventions to dispel it. Here we explored a novel and beneficial intervention and one possible influence mechanism of it. Methods The cross-sectional study recruited 1,053 pregnant women from one tertiary-grade A class hospital between March to August 2021. The questionnaire included demographic characteristics, a self-made musical activities questionnaire, the Positive affect subscale, and the Childbirth Attitudes Questionnaire. We parceled the eight musical activities into three items by item parceling methodology. The associations of musical activities and positive affect with fear of childbirth were evaluated by a structural equation modeling approach. Results Our analyses demonstrated the effectiveness of musical activities, which was notably correlated with the increase in positive affect (β = 0.309, P < 0.01). On the contrary, positive affect predicted a decrease in fear of childbirth (β = −0.085, P = 0.019). Additionally, positive affect mediated the effect of musical activities on fear of childbirth (β = −0.026, P = 0.030). However, the direct effect of musical activities on fear of childbirth was not found (β = 0.029, P = 0.514). Conclusions Relying on musical activities alone may not be adequate to alleviate the fear of childbirth, and positive affect played a pivotal role between musical activities and fear of childbirth. The results showed that musical activities would be an effective non-pharmaceutical way to alleviate the fear of childbirth and positive affect can not be ignorant in future childbirth fear reduction programs.
Collapse
Affiliation(s)
- Shidi Liu
- School of Public Health and Management, Chongqing Medical University, Chongqing, China
- Research Center for Medicine and Social Development, Chongqing Medical University, Chongqing, China
- Collaborative Innovation Center of Social Risks Governance in Health, Chongqing Medical University, Chongqing, China
- Research Center for Public Health Security, Chongqing Medical University, Chongqing, China
| | - Yi Jin
- School of Public Health and Management, Chongqing Medical University, Chongqing, China
- Research Center for Medicine and Social Development, Chongqing Medical University, Chongqing, China
- Collaborative Innovation Center of Social Risks Governance in Health, Chongqing Medical University, Chongqing, China
- Research Center for Public Health Security, Chongqing Medical University, Chongqing, China
| | - Hongmei Li
- Obstetrics and Gynecology Center, The Third Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Tingting Zeng
- Obstetrics and Gynecology Center, The Third Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Ge Zhou
- Obstetrics and Gynecology Center, The Third Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Lili Yu
- Obstetrics and Gynecology Center, The Third Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Yao Fan
- School of Public Health and Management, Chongqing Medical University, Chongqing, China
- Research Center for Medicine and Social Development, Chongqing Medical University, Chongqing, China
- Collaborative Innovation Center of Social Risks Governance in Health, Chongqing Medical University, Chongqing, China
- Research Center for Public Health Security, Chongqing Medical University, Chongqing, China
- Yao Fan
| | - Xun Lei
- School of Public Health and Management, Chongqing Medical University, Chongqing, China
- Research Center for Medicine and Social Development, Chongqing Medical University, Chongqing, China
- Collaborative Innovation Center of Social Risks Governance in Health, Chongqing Medical University, Chongqing, China
- Research Center for Public Health Security, Chongqing Medical University, Chongqing, China
- *Correspondence: Xun Lei
| |
Collapse
|
12
|
Tang LJ, Han J, Feng YJ, Pu CX, Zhang Y. Comparative study of the efficacy of dexmedetomidine and fentanyl on anxiety and pain of parturients with different COMTva1158met genotypes. BMC Anesthesiol 2022; 22:84. [PMID: 35346044 PMCID: PMC8962552 DOI: 10.1186/s12871-022-01628-2] [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: 10/22/2021] [Accepted: 03/22/2022] [Indexed: 11/19/2022] Open
Abstract
Objective This study investigates the effects of COMTval158met gene polymorphism on maternal anxiety and pain during delivery and on the analgesic and anxiety efficacy of dexmedetomidine during delivery. Methods Sixty-one pregnant women, who were hospitalized in our hospital from January to November of 2016 were recruited and randomly divided into two groups, F and D groups. The pregnant women in the F group were given labor analgesia with ropivacaine combined with fentanyl. The pregnant women in the D group were given labor analgesia with ropivacaine combined with dexmedetomidine. Before and after labor analgesia, the genotype of COMT in the blood from two groups was detected, and the situation of labor anxiety and analgesia was analyzed. Then, the relationship between labor anxiety, analgesia, and COMT polymorphism was analyzed. Results In the 61 pregnant women, there were 30 women of wild homozygotes (GG) of COMT, 22 women of mutant heterozygotes (GA), and nine women of mutant homozygotes (AA), the mutation rate of allele A was 23.77%. The anxiety status score, anxiety trait score, and pain score in the AA genotype were significantly higher than those in the GG and GA genotype (p < 0.05). There was a significant difference in the efficacy of GG and AA genotypes between groups D and F for treating labor anxiety (p < 0.05), the efficacy of group D was better than that of group F in treating delivery anxiety, there was no significant difference in anxiety scores between the two groups in GA genotypes (p > 0.05); there was no significant difference in pain between group D and F in GG, GA, and AA genotypes (p > 0.05). There was no significant difference in pain and anxiety scores between the three genotypes in group D (p > 0.05), there was significant difference in pain scores among the three genotypes in group F (p < 0.05), but there was no significant difference in anxiety (p > 0.05). Conclusions The mutation of the COMTval158met gene leads to increased anxiety and pain during childbirth. The effect of dexmedetomidine on the anxiety of GG and AA genotypes is better than that of fentanyl, and the mutation of the COMTval158met gene has no impact on dexmedetomidine effect.
Collapse
Affiliation(s)
- Li-Jia Tang
- Department of Anesthesiology, Hospital (T.C.M) Affiliated to Southwest Medical University, Chunhui Road 182#, Luzhou, Sichuan, 646000, China
| | - Jiang Han
- Department of Anesthesiology, Hospital (T.C.M) Affiliated to Southwest Medical University, Chunhui Road 182#, Luzhou, Sichuan, 646000, China
| | - Yi-Juan Feng
- Department of Anesthesiology, Hospital (T.C.M) Affiliated to Southwest Medical University, Chunhui Road 182#, Luzhou, Sichuan, 646000, China
| | - Cui-Xia Pu
- Department of Anesthesiology, Hospital (T.C.M) Affiliated to Southwest Medical University, Chunhui Road 182#, Luzhou, Sichuan, 646000, China
| | - Ying Zhang
- Department of Anesthesiology, Hospital (T.C.M) Affiliated to Southwest Medical University, Chunhui Road 182#, Luzhou, Sichuan, 646000, China.
| |
Collapse
|
13
|
Abstract
Background Between 5% and 14% of women suffer from fear of childbirth (FOC) which is associated with difficulties during birth and in postnatal psychological adjustment. Therefore, effective interventions are needed to improve outcomes for women. A systematic review and meta-analysis was used to identify effective interventions for treating women with FOC. Methods Literature searches were undertaken on online databases. Hand searches of reference lists were also carried out. Studies were included in the review if they recruited women with FOC and aimed to reduce FOC and/or improve birth outcomes. Data were synthesised qualitatively and quantitatively using meta-analysis. The literature searches provided a total of 4474 citations. Results After removing duplicates and screening through abstracts, titles and full texts, 66 papers from 48 studies were identified for inclusion in the review. Methodological quality was mixed with 30 out of 48 studies having a medium risk of bias. Interventions were categorised into six broad groups: cognitive behavioural therapy, other talking therapies, antenatal education, enhanced midwifery care, alternative interventions and interventions during labour. Results from the meta-analysis showed that most interventions reduced FOC, regardless of the approach (mean effect size = −1.27; z = −4.53, p < 0.0001) and that other talking therapies may reduce caesarean section rates (OR 0.48, 95% CI 0.48–0.90). Conclusions Poor methodological quality of studies limits conclusions that can be drawn; however, evidence suggests that most interventions investigated reduce FOC. Future high-quality randomised controlled trials are needed so that clear conclusions can be made.
Collapse
|
14
|
Budnik-Przybylska D, Laskowski R, Pawlicka P, Anikiej-Wiczenbach P, Łada-Maśko A, Szumilewicz A, Makurat F, Przybylski J, Soya H, Kaźmierczak M. Do Physical Activity and Personality Matter for Hair Cortisol Concentration and Self-Reported Stress in Pregnancy? A Pilot Cross-Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17218050. [PMID: 33139602 PMCID: PMC7663188 DOI: 10.3390/ijerph17218050] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/21/2020] [Revised: 10/20/2020] [Accepted: 10/28/2020] [Indexed: 01/01/2023]
Abstract
Background: Physical activity reduces psychosocial stress in pregnant women. Stress levels might be self-reported (psychosocial) or measured with biomarkers, one of which is hair cortisol concentration (HCC). Additionally, personality has been associated with stress and physical activity. Methods: The first aim of our study was to explore the differences in self-reported stress assessed by the Perceived Stress Scale (PSS) and in HCC with regard to physical activity level in pregnant (N = 29) and non-pregnant (N = 21) women. The second aim was to analyze the correlations among perceived stress, HCC, frequency of exercise and personality in the two groups separately. Results: There was a significant difference in frequency of exercise and self-reported stress between the two groups, with a lower level in pregnant women, but no differences in HCC and in personality were found. In the group of pregnant women, there was a significant negative correlation between HCC and frequency of exercise sessions, with the latter correlating positively with openness to experience. In the group of non-pregnant women, perceived stress negatively correlated with extraversion, agreeableness and emotional stability. HCC correlated negatively with conscientiousness. Conclusions: Our findings indicate the importance of physical activity programs dedicated to pregnant women for their life quality.
Collapse
Affiliation(s)
- Dagmara Budnik-Przybylska
- Department of Sport Psychology, Institute of Psychology, Faculty of Social Sciences, University of Gdańsk, 80-309 Gdańsk, Poland; (D.B.-P.); (F.M.); (J.P.)
| | - Radosław Laskowski
- Department of Physiology and Biochemistry, Faculty of Physical Culture, Gdansk University of Physical Education and Sport; 80-336 Gdańsk, Poland;
| | - Paulina Pawlicka
- Department of Cross-Cultural Psychology and Psychology of Gender, Institute of Psychology, Faculty of Social Sciences, University of Gdańsk, 80-309 Gdańsk, Poland;
| | - Paulina Anikiej-Wiczenbach
- Psychological Counseling for Rare Genetic Diseases Institute of Psychology, Faculty of Social Sciences, University of Gdańsk, 80-309 Gdańsk, Poland;
| | - Ariadna Łada-Maśko
- Department of Developmental Psychology and Psychopathology, Institute of Psychology, Faculty of Social Sciences, University of Gdańsk, 80-309 Gdańsk, Poland;
| | - Anna Szumilewicz
- Department of Fitness, Faculty of Physical Culture, Gdansk University of Physical Education and Sport, 80-309 Gdańsk, Poland;
| | - Franciszek Makurat
- Department of Sport Psychology, Institute of Psychology, Faculty of Social Sciences, University of Gdańsk, 80-309 Gdańsk, Poland; (D.B.-P.); (F.M.); (J.P.)
| | - Jacek Przybylski
- Department of Sport Psychology, Institute of Psychology, Faculty of Social Sciences, University of Gdańsk, 80-309 Gdańsk, Poland; (D.B.-P.); (F.M.); (J.P.)
| | - Hideaki Soya
- Sports Neuroscience Division, Advanced Research Initiative for Human High Performance, Faculty of Health and Sport Sciences, University of Tsukuba, 305-8574 Tsukuba, Japan;
| | - Maria Kaźmierczak
- Department of Family Studies and Quality of Life, Institute of Psychology, Faculty of Social Sciences, University of Gdańsk, 80-309 Gdańsk, Poland
- Correspondence:
| |
Collapse
|
15
|
Bahri N, Hesar FE, Bahri N. Application of the Health Belief Model Educational Program to Reduce the Tendency of Cesarean Birth. INTERNATIONAL JOURNAL OF CHILDBIRTH 2020. [DOI: 10.1891/ijcbirth-d-19-00012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUNDPregnant women are an important population in all health systems and they are responsible for making decisions about their delivery mode.OBJECTIVEThis study aimed to investigate the effects of an educational intervention based on the Health Belief Model (HBM) to reduce the tendency of cesarean section among pregnant women.METHODThis field trial was conducted in Mashhad, Iran. 180 primigravida women who had a healthy and uncomplicated pregnancy with 28–32 weeks of gestational age were recruited in the study by the cluster sampling method and randomly allocated to intervention (90 women) and control (90 women) groups. A 6-hour workshop that was designed based on the HBM about delivery modes was conducted for the intervention group. The control group did not receive any intervention. All the participants filled out demographic and reproductive characteristics, knowledge about mode of delivery, and the HBM constructs questionnaires at the beginning of the study and 1 month after the intervention. Analyses were carried out using SPSS 16 software. The level of significance was set at p less than .05.RESULTSThere was no significant difference between the two groups in terms of knowledge about delivery modes and constructs of the HBM as well as selected delivery mode before the intervention (p > .05), but the results showed a significant difference between the two groups in the mentioned variables 1 month after the intervention (p < .0001). Also, the change of score between 1 month after and before the intervention had a significant difference between the two groups in terms of knowledge about delivery modes (p < .0001) and constructs of the HBM (p < .0001). The two groups were significantly different in terms of selected delivery mode and more participants opted for normal vaginal delivery in the intervention group (p = .025).CONCLUSIONSThe overall results showed that instruction of delivery modes based on the HBM can lead to more selection of normal delivery by pregnant women. Therefore, it is recommended that this model be used in educational programs during pregnancy.
Collapse
|
16
|
Levett KM, Lord SJ, Dahlen HG, Smith CA, Girosi F, Downe S, Finlayson KW, Fleet J, Steen M, Davey MA, Newnham E, Werner A, Arnott L, Sutcliffe K, Seidler AL, Hunter KE, Askie L. The AEDUCATE Collaboration. Comprehensive antenatal education birth preparation programmes to reduce the rates of caesarean section in nulliparous women. Protocol for an individual participant data prospective meta-analysis. BMJ Open 2020; 10:e037175. [PMID: 32967876 PMCID: PMC7513601 DOI: 10.1136/bmjopen-2020-037175] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2020] [Revised: 07/09/2020] [Accepted: 08/14/2020] [Indexed: 01/10/2023] Open
Abstract
INTRODUCTION Rates of medical interventions in normal labour and birth are increasing. This prospective meta-analysis (PMA) proposes to assess whether the addition of a comprehensive multicomponent birth preparation programme reduces caesarean section (CS) in nulliparous women compared with standard hospital care. Additionally, do participant characteristics, intervention components or hospital characteristics modify the effectiveness of the programme? METHODS AND ANALYSIS: Population: women with singleton vertex pregnancies, no planned caesarean section (CS) or epidural.Intervention: in addition to hospital-based standard care, a comprehensive antenatal education programme that includes multiple components for birth preparation, addressing the three objectives: preparing women and their birth partner/support person for childbirth through education on physiological/hormonal birth (knowledge and understanding); building women's confidence through psychological preparation (positive mindset) and support their ability to birth without pain relief using evidence-based tools (tools and techniques). The intervention could occur in a hospital-based or community setting.Comparator: standard care alone in hospital-based maternity units. OUTCOMES Primary: CS.Secondary: epidural analgesia, mode of birth, perineal trauma, postpartum haemorrhage, newborn resuscitation, psychosocial well-being.Subgroup analysis: parity, model of care, maternal risk status, maternal education, maternal socio-economic status, intervention components. STUDY DESIGN An individual participant data (IPD) prospective meta-analysis (PMA) of randomised controlled trials, including cluster design. Each trial is conducted independently but share core protocol elements to contribute data to the PMA. Participating trials are deemed eligible for the PMA if their results are not yet known outside their Data Monitoring Committees. ETHICS AND DISSEMINATION Participants in the individual trials will consent to participation, with respective trials receiving ethical approval by their local Human Research Ethics Committees. Individual datasets remain the property of trialists, and can be published prior to the publication of final PMA results. The overall data for meta-analysis will be held, analysed and published by the collaborative group, led by the Cochrane PMA group. TRIAL REGISTRATION NUMBER CRD42020103857.
Collapse
Affiliation(s)
- Kate M Levett
- School of Medicine Sydney, University of Notre Dame Australia, Darlinghurst, New South Wales, Australia
- NICM Health Research Institute, University of Western Sydney, Penrith South, New South Wales, Australia
| | - Sarah J Lord
- School of Medicine Sydney, University of Notre Dame Australia, Darlinghurst, New South Wales, Australia
- NHMRC Clinical Trials Centre, Camperdown, New South Wales, Australia
| | - Hannah G Dahlen
- School of Nursing and Midwifery, University of Western Sydney, Parramatta, New South Wales, Australia
| | - Caroline A Smith
- NICM Health Research Institute, University of Western Sydney, Penrith South, New South Wales, Australia
- Graduate Research School, University of Western Sydney, Kingswood, New South Wales, Australia
| | - Federico Girosi
- Translational Health Research Institute, Western Sydney University, Penrith, New South Wales, Australia
- Capital Markets CRC, New South Wales, Australia, Sydney, New South Wales, Australia
| | - Soo Downe
- School of Midwifery and Community Health, University of Central Lancashire, Preston, Lancashire, UK
| | | | - Julie Fleet
- School of Nursing and Midwifery, University of South Australia, Adelaide, South Australia, Australia
| | - Mary Steen
- School of Nursing and Midwifery, University of South Australia, Adelaide, South Australia, Australia
| | - Mary-Ann Davey
- Obstetrics & Gynaecology, Monash Health, Monash University Central Clinical School, Melbourne, Victoria, Australia
| | - Elizabeth Newnham
- School of Nursing & Midwifery, Griffith University, Medowbrook, Queensland, Australia
| | - Anette Werner
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - Leslie Arnott
- The B.E.A.R. Program, Lamaze Australia, Melbourne, Victoria, Australia
| | - Kerry Sutcliffe
- School of Medicine Sydney, University of Notre Dame Australia, Darlinghurst, New South Wales, Australia
| | - Anna Lene Seidler
- NHMRC Clinical Trials Centre, The University of Sydney, Camperdown, New South Wales, Australia
| | - Kylie Elizabeth Hunter
- NHMRC Clinical Trials Centre, The University of Sydney, Camperdown, New South Wales, Australia
| | - Lisa Askie
- NHMRC Clinical Trials Centre, The University of Sydney, Camperdown, New South Wales, Australia
| |
Collapse
|
17
|
Badaoui A, Kassm SA, Naja W. Fear and Anxiety Disorders Related to Childbirth: Epidemiological and Therapeutic Issues. Curr Psychiatry Rep 2019; 21:27. [PMID: 30868272 DOI: 10.1007/s11920-019-1010-7] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
PURPOSE OF REVIEW This paper seeks to identify the risk factors of fear of childbirth (FOC) and posttraumatic stress disorder (PTSD) related to birth and reviews the efficacy of their respective screening tools and therapeutic interventions. RECENT FINDINGS Biofeedback, hypnosis, internet-based cognitive behavioral therapy, and antenatal education are promising treatments for FOC. Training midwives to address traumatic birth experiences could help in preventing PTSD. A shorter more pragmatic screening tool for FOC than the Wijma Delivery Expectancy/Experience Questionnaire (WDEQ) is needed. Women with PTSD attributed a mismatch between the expected mode of delivery (MOD) and the actual MOD as the cause of their trauma. A history of mental health disorders, lack of social support, previous negative birth experiences, and MOD are correlated to FOC and postpartum PTSD. Psycho-education and CBT-based treatments have been found to reduce levels of FOC and PTSD.
Collapse
Affiliation(s)
- Alexandra Badaoui
- Faculty of Medical Sciences, Department of Psychiatry, Lebanese University, Beirut, Lebanon.
| | - Sandra Abou Kassm
- Faculty of Medical Sciences, Department of Psychiatry, Lebanese University, Beirut, Lebanon
| | - Wadih Naja
- Faculty of Medical Sciences, Department of Psychiatry, Lebanese University, Beirut, Lebanon
| |
Collapse
|
18
|
Romero-Gonzalez B, Peralta-Ramirez MI, Caparros-Gonzalez RA, Cambil-Ledesma A, Hollins Martin CJ, Martin CR. Spanish validation and factor structure of the Birth Satisfaction Scale-Revised (BSS-R). Midwifery 2019; 70:31-37. [DOI: 10.1016/j.midw.2018.12.009] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2018] [Revised: 12/08/2018] [Accepted: 12/11/2018] [Indexed: 10/27/2022]
|
19
|
Ren X, Zhang L, Xiao Q, Huang D, Liu Q, Zhang Y. Association between COMT polymorphism, labor anxiety, and analgesia in pregnant women. J Pain Res 2019; 12:779-785. [PMID: 30881091 PMCID: PMC6398968 DOI: 10.2147/jpr.s192719] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
Background COMT gene polymorphism is associated with mental disorders and sensitivity to pain. In this study, we investigated the association between the COMT gene polymorphism and labor anxiety and analgesia in pregnant women. Subjects and methods A total of 425 pregnant women undergoing labor analgesia were selected from May 2016 to February 2018. The COMT gene polymorphism was detected through the PCR with restriction fragment length polymorphism technique before childbirth. According to a COMT genotype, the enrolled pregnant women were subdivided into the Val/Val (allele GG) group, the Met/Met (allele AA) group, and the Val/Met (allele GA) group. Then, the intervertebral space of all pregnant women was injected with 3 mL of 2% lidocaine +6 mL of 0.08% ropivacaine and 6 µg of fentanyl. Labor analgesia was administered as follows: 80 mg of 0.08% ropivacaine +100 µg of fentanyl + normal saline to 100 mL. The general characteristics of the women were examined and recorded. In addition, the State Anxiety Inventory (SAI), VAS, Ramsay sedation score, and epinephrine and norepinephrine levels were compared and analyzed. Results A total of 391 pregnant women were enrolled in this study; among these pregnant women, there were 180 pregnant women in the GG group, 132 in the GA group, and 99 in the AA group. The minor allele frequency of COMT polymorphism among these pregnant women was 32.8%. Compared with the GG group, the SAI and VAS scores were higher, the Ramsay sedation score was lower, and the epinephrine and norepinephrine levels were higher in AA and GA groups (P<0.05). Nonetheless, there was no statistically significant difference in the SAI, VAS, Ramsay sedation score, and epinephrine and norepinephrine levels between the groups AA and GA (P>0.05). Conclusion The COMT gene polymorphism was associated with labor anxiety and analgesia among pregnant women, and the Val158Met mutation in the COMT gene could lead to worse labor anxiety and less-effective labor analgesia in pregnant women.
Collapse
Affiliation(s)
- Xiaohui Ren
- Department of Anesthesiology, Neijiang City Central Maternal and Child Health Care Hospital, Neijiang 641000, Sichuan, China.,Department of Anesthesiology and Pain Management, Affiliated Traditional Chinese Medicine Hospital of Southwest Medical University, Luzhou 646000, Sichuan, China, ;
| | - Le Zhang
- Department of Anesthesiology, Sichuan Provincial Armed Police Corps Hospital, Leshan 614000, Sichuan, China
| | - Qiuxia Xiao
- Department of Anesthesiology and Pain Management, Affiliated Traditional Chinese Medicine Hospital of Southwest Medical University, Luzhou 646000, Sichuan, China, ;
| | - Daxue Huang
- Department of Anesthesiology, Neijiang City Central Maternal and Child Health Care Hospital, Neijiang 641000, Sichuan, China
| | - Qing Liu
- Department of Anesthesiology and Pain Management, Affiliated Traditional Chinese Medicine Hospital of Southwest Medical University, Luzhou 646000, Sichuan, China, ;
| | - Ying Zhang
- Department of Anesthesiology and Pain Management, Affiliated Traditional Chinese Medicine Hospital of Southwest Medical University, Luzhou 646000, Sichuan, China, ;
| |
Collapse
|
20
|
Prenatal stress and the development of psychopathology: Lifestyle behaviors as a fundamental part of the puzzle. Dev Psychopathol 2018; 30:1129-1144. [PMID: 30068418 DOI: 10.1017/s0954579418000494] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Maternal psychological stress, depression, and anxiety during pregnancy (prenatal stress; PNS) are thought to impact fetal development with long-term effects on offspring outcome. These effects would include physical and mental health, including psychopathology. Maternal sleep, diet, and exercise during pregnancy are lifestyle behaviors that are understudied and often solely included in PNS studies as confounders. However, there are indications that these lifestyle behaviors may actually constitute essential mediators between PNS and fetal programming processes. The goal of this theoretical review was to investigate this idea by looking at the evidence for associations between PNS and sleep, diet, and exercise, and by piecing together the information on potential underlying mechanisms and causal pathways through which these factors may affect the offspring. The analysis of the literature led to the conclusion that sleep, diet, and exercise during pregnancy, may have fundamental roles as mediators between PNS and maternal pregnancy physiology. By integrating these lifestyle behaviors into models of prenatal programming of development, a qualitatively higher and more comprehensive understanding of the prenatal origins of psychopathology can be obtained. The review finalizes by discussing some of the present challenges facing the field of PNS and offspring programming, and offering solutions for future research.
Collapse
|
21
|
Stoll K, Swift EM, Fairbrother N, Nethery E, Janssen P. A systematic review of nonpharmacological prenatal interventions for pregnancy-specific anxiety and fear of childbirth. Birth 2018; 45:7-18. [PMID: 29057487 DOI: 10.1111/birt.12316] [Citation(s) in RCA: 56] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2017] [Revised: 09/14/2017] [Accepted: 09/14/2017] [Indexed: 12/19/2022]
Abstract
BACKGROUND Despite a sharp increase in the number of publications that report on treatment options for pregnancy-specific anxiety and fear of childbirth (PSA/FoB), no systematic review of nonpharmacological prenatal interventions for PSA/FoB has been published. Our team addressed this gap, as an important first step in developing guidelines and recommendations for the treatment of women with PSA/FoB. METHODS Two databases (PubMed and Mendeley) were searched, using a combination of 42 search terms. After removing duplicates, two authors independently assessed 208 abstracts. Sixteen studies met eligibility criteria, ie, the article reported on an intervention, educational component, or treatment regime for PSA/FoB during pregnancy, and included a control group. Independent quality assessments resulted in the retention of seven studies. RESULTS Six of seven included studies were randomized controlled trials (RCTs) and one a quasi-experimental study. Five studies received moderate quality ratings and two strong ratings. Five of seven studies reported significant changes in PSA/FoB, as a result of the intervention. Short individual psychotherapeutic interventions (1.5-5 hours) delivered by midwives or obstetricians were effective for women with elevated childbirth fear. Interventions that were effective for pregnant women with a range of different fear/anxiety levels were childbirth education at the hospital (2 hours), prenatal Hatha yoga (8 weeks), and an 8-week prenatal education course (16 hours). CONCLUSIONS Findings from this review can inform the development of treatment approaches to support pregnant women with PSA/FoB.
Collapse
Affiliation(s)
- Kathrin Stoll
- School of Population & Public Health, University of British Columbia, Vancouver, Canada
| | - Emma Marie Swift
- Department of Nursing, University of Iceland, Reykjavík, Iceland
| | - Nichole Fairbrother
- Department of Psychiatry, University of British Columbia, Island Medical Program, Victoria, Canada
| | - Elizabeth Nethery
- School of Population & Public Health, University of British Columbia, Vancouver, Canada
| | - Patricia Janssen
- School of Population & Public Health, University of British Columbia, Vancouver, Canada
| |
Collapse
|
22
|
Sarpkaya Güder D, Yalvaç M, Vural G. The effect of pregnancy Pilates-assisted childbirth preparation training on childbirth fear and neonatal outcomes: a quasi-experimental/quantitative research. ACTA ACUST UNITED AC 2018. [DOI: 10.1007/s11135-018-0682-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
|
23
|
Hamama-Raz Y, Sommerfeld E, Ken-Dror D, Lacher R, Ben-Ezra M. The Role of Intra-personal and Inter-personal Factors in Fear of Childbirth: A Preliminary Study. Psychiatr Q 2017; 88:385-396. [PMID: 27401494 DOI: 10.1007/s11126-016-9455-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Childbirth is a major life event, but for some women, the fear of childbirth goes beyond trepidation towards full-blown anxiety and panic, known as fear of childbirth (FOC) or tokophobia. In the present study the authors investigated and compared the intrapersonal and interpersonal factors that might be associated with FOC among women who previously gave birth (parous) and women who did not. A cross sectional survey was conducted among 529 women (parous women (n = 365) and women who had never given birth (n = 173). All participants completed self-report measures using an online survey system. The questionnaires assessed intrapersonal factors including attitudes toward pregnancy and birth, body image, self-esteem and life satisfaction as well as interpersonal factors namely relationship satisfaction. Multiple regression analyses revealed that among parous women age and attitudes toward pregnancy and birth, especially those that relate to body image and delivery were significantly associated with FOC. Among women who had never given birth, only attitudes toward pregnancy and birth, especially those that relate to body image, importance of pregnancy and delivery, and preference of caesarean section (CS), were significantly associated with FOC. In both groups, satisfaction with spousal relationship was not found to be associated with FOC. The results indicate that regarding FOC, intra-personal factors are more dominant than inter-personal factors. When assessing this medico-psychological fear, cognitive aspects should also be addressed.
Collapse
Affiliation(s)
| | | | | | - Rina Lacher
- School of Social Work, Ariel University, Ariel, Israel
| | | |
Collapse
|
24
|
|
25
|
Validation of the Childbirth Attitudes Questionnaire in Greek and psychosocial characteristics of pregnant women with fear of childbirth. Women Birth 2015; 28:e44-51. [DOI: 10.1016/j.wombi.2015.02.004] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2014] [Revised: 02/11/2015] [Accepted: 02/12/2015] [Indexed: 11/19/2022]
|
26
|
Miquelutti MA, Cecatti JG, Makuch MY. Developing strategies to be added to the protocol for antenatal care: an exercise and birth preparation program. Clinics (Sao Paulo) 2015; 70:231-6. [PMID: 26017787 PMCID: PMC4418303 DOI: 10.6061/clinics/2015(04)02] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/03/2014] [Accepted: 01/07/2015] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVES To describe the implementation process of a birth preparation program, the activities in the protocol for physical and birth preparation exercises, and the educational activities that have been evaluated regarding effectiveness and women's satisfaction. The birth preparation program described was developed with the following objectives: to prevent lumbopelvic pain, urinary incontinence and anxiety; to encourage the practice of physical activity during pregnancy and of positions and exercises for non-pharmacological pain relief during labor; and to discuss information that would help women to have autonomy during labor. METHODS The program comprised the following activities: supervised physical exercise, relaxation exercises, and educational activities (explanations of lumbopelvic pain prevention, pelvic floor function, labor and delivery, and which non-pharmacological pain relief to use during labor) provided regularly after prenatal consultations. These activities were held monthly, starting when the women joined the program at 18-24 weeks of pregnancy and continuing until 30 weeks of pregnancy, fortnightly thereafter from 31 to 36 weeks of pregnancy, and then weekly from the 37th week until delivery. Information and printed materials regarding the physical exercises to be performed at home were provided. Clinicaltrials.gov: NCT01155804. RESULTS The program was an innovative type of intervention that systematized birth preparation activities that were organized to encompass aspects related both to pregnancy and to labor and that included physical, educational and home-based activities. CONCLUSIONS The detailed description of the protocol used may serve as a basis for further studies and also for the implementation of birth preparation programs within the healthcare system in different settings.
Collapse
Affiliation(s)
- Maria Amélia Miquelutti
- Department of Obstetrics and Gynecology, School of Medical Sciences, Universidade de Campinas, Campinas, SP, Brazil
| | - José Guilherme Cecatti
- Department of Obstetrics and Gynecology, School of Medical Sciences, Universidade de Campinas, Campinas, SP, Brazil
| | - Maria Yolanda Makuch
- Department of Obstetrics and Gynecology, School of Medical Sciences, Universidade de Campinas, Campinas, SP, Brazil
| |
Collapse
|