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Papapetrou C, Zouridis A, Eleftheriades A, Panoskaltsis T, Panoulis K, Vlahos N, Eleftheriades M. Screening for perinatal depression and stress: a prospective cohort study. Arch Gynecol Obstet 2024; 310:1397-1408. [PMID: 38091055 DOI: 10.1007/s00404-023-07306-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2023] [Accepted: 11/12/2023] [Indexed: 09/03/2024]
Abstract
PURPOSE There is currently a heightened need for perinatal medical services to timely recognize and accurately meet the psychological needs of pregnant women. Psychological disturbances a mother experiences during pregnancy, such as depression and anxiety, can be later associated with inadequate maternal capacity for antenatal care for herself and the baby, and may lead to subsequent mental health problems later in the mother's life. Routine prenatal assessment could significantly benefit from being proactively enriched with early prevention mental health screening tools to assess, appropriately manage vulnerable populations, and subsequently implement preventive actions. METHODS 178 pregnant women, under routine prenatal medical assessment, were measured regarding depressive symptomatology and stress, through the use of two validated psychometric tools (the Edinburgh Postnatal Depression Scale (EPDS) and the Perceived Stress Scale (PSS-14)). RESULTS Heightened perceived stress and depressive symptomatology levels were associated with younger maternal age, an obstetrical record of more than one births and a history of abortion. Results additionally showed a connection between the requirement for a psychiatric referral-based on the levels of symptomatology recorded through the psychometric assessment and a clinical interview-and currently running the earlier stages (weeks) of pregnancy. CONCLUSION Our revised proposed prenatal screening protocol for depression and stress suggests an amplified follow-up assessment including all pregnant women scoring high in both depression and in perceived stress, regardless of previous history of prenatal depression or of suicidality, to detect earlier or less manifest expressions of distress during pregnancy, in vulnerable perinatal populations.
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Affiliation(s)
- Christina Papapetrou
- Second Department of Obstetrics and Gynaecology, Aretaieio Hospital, National and Kapodistrian University of Athens, 115 28, Athens, Greece.
| | - Andreas Zouridis
- Department of Obstetrics and Gynaecology, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | - Anna Eleftheriades
- Department of Obstetrics and Gynaecology, Women's Hospital, University Hospital of Basel, University of Basel, Basel, Switzerland
| | - Theodoros Panoskaltsis
- Second Department of Obstetrics and Gynaecology, Aretaieio Hospital, National and Kapodistrian University of Athens, 115 28, Athens, Greece
| | - Konstantinos Panoulis
- Second Department of Obstetrics and Gynaecology, Aretaieio Hospital, National and Kapodistrian University of Athens, 115 28, Athens, Greece
| | - Nikos Vlahos
- Second Department of Obstetrics and Gynaecology, Aretaieio Hospital, National and Kapodistrian University of Athens, 115 28, Athens, Greece
| | - Makarios Eleftheriades
- Second Department of Obstetrics and Gynaecology, Aretaieio Hospital, National and Kapodistrian University of Athens, 115 28, Athens, Greece
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Harrison A, Gordon-Strachan G, James Bateman C, Trotman H, Olugbuyi O, Lambert M, Ashley D, Griffith A, Samms-Vaughan M. ECD - Pregnancy outcomes of a birth cohort. Are adolescent mothers really at more risk? PSYCHOL HEALTH MED 2024; 29:1142-1154. [PMID: 33840330 DOI: 10.1080/13548506.2021.1909740] [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: 11/04/2020] [Accepted: 03/23/2021] [Indexed: 10/21/2022]
Abstract
This sub-study within the JAKIDS longitudinal cohort study compares medical and psychosocial outcomes of pregnancy in younger adolescent mothers (<16 years), older adolescent mothers (16-19 years) and adult mothers (>19 years) in Jamaica. Participants were recruited from July to September 2011 and included 9521 mother-infant dyads; mean maternal age 26.0 years (SD 6.8). Adolescent mothers represented 19.1% (n = 1822) of the sample - 1704 older adolescent mothers (17.9%) and 118 younger adolescent mothers (1.2%). Participants completed interviewer-administered questionnaires regarding their sexual and reproductive health history, feelings about the current pregnancy, and presence of anxious and depressive symptoms. Data on delivery and perinatal and neonatal outcomes were extracted from hospital charts. Younger adolescent mothers were more likely to deliver preterm (p < 0.001) and low birth weight infants (p < 0.001) than older adolescent and adult mothers. Younger adolescent mothers had lower levels of antenatal anxiety regarding the pregnancy and its outcome (p < 0.001) while prevalence of elevated depressive symptoms antenatally (EPDS ≥11) was similar across age groups. Older adolescent mothers with significant depressive symptoms had increased odds of preterm delivery. These findings call for close antenatal monitoring of younger adolescent mothers and highlight the need for psychological services for all mothers.
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Affiliation(s)
- Abigail Harrison
- Department of Child and Adolescent Health, Faculty of Medical Sciences, UWI, Mona, Jamaica
| | | | - Caryl James Bateman
- Department of Sociology, Psychology and Social Work, Faculty of Social Sciences, UWI, Mona, Jamaica
| | - Helen Trotman
- Department of Child and Adolescent Health, Faculty of Medical Sciences, UWI, Mona, Jamaica
| | - Oluwayomi Olugbuyi
- Department of Child and Adolescent Health, Faculty of Medical Sciences, UWI, Mona, Jamaica
| | | | - Deanna Ashley
- School for Graduate Studies and Research, UWI, Mona, Jamaica
| | - Anona Griffith
- Department of Child and Adolescent Health, Faculty of Medical Sciences, UWI, Mona, Jamaica
| | - Maureen Samms-Vaughan
- Department of Child and Adolescent Health, Faculty of Medical Sciences, UWI, Mona, Jamaica
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Bao S, Chen B, Zhu S, Hu Y, Lee CS, Du M, Zhou M, Fan D, Xie B, Gu H, Liang Z. Psychological status of pregnant women during the omicron pandemic outbreak in China. BMC Womens Health 2024; 24:333. [PMID: 38849811 PMCID: PMC11157863 DOI: 10.1186/s12905-024-03087-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: 05/30/2023] [Accepted: 04/10/2024] [Indexed: 06/09/2024] Open
Abstract
BACKGROUND Pregnant women faced great challenges and psychological and physiological changes of varying degrees during the omicron epidemic outbreak. It is important to recognize the potential impact of these challenges on the mental health of pregnant women and to provide appropriate resources and support to mitigate their effects. METHOD By using the convenience sampling approach, a total of 401 pregnant women from two hospitals of different grades in two cities were included in the survey. The cross-sectional survey was conducted by basic characteristics, Generalized Anxiety Disorder (GAD-7), Patient Health Questionnaire (PHQ-9), Insomnia Severity Index (ISI) and self-made questionnaire. RESULTS Insomnia affected 207 participants (51.6%), depression affected 160 participants (39.9%) and anxiety affected 151 participants (37.7%). Moreover, pregnant women in provincial capital city were more likely to experience anxiety, depression and insomnia than those in county-level city (P < 0.01). Pregnant women's anxiety, depression and insomnia were positively correlated with the severity of COVID-19 infection (P < 0.05). However, COVID-19 infection had no appreciable impact on maternal demand for termination of pregnancy and cesarean section (P > 0.05). CONCLUSION Pregnant women frequently suffer from anxiety disorder, depression and insomnia as a result of the omicron pandemic in China. During this period, the community and medical professionals should provide more psychological counseling, conduct health education and offer virtual prenatal care to pregnant women (particularly in the provincial capital city).
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Affiliation(s)
- Shuting Bao
- Obstetrical Department, School of Medicine, Women's Hospital, Zhejiang University, Hangzhou, 310006, China
| | - Bangwu Chen
- Ninghai Maternal and Child Health Hospital, Ningbo, China
| | - Shuqi Zhu
- Obstetrical Department, School of Medicine, Women's Hospital, Zhejiang University, Hangzhou, 310006, China
| | - Ying Hu
- Obstetrical Department, School of Medicine, Women's Hospital, Zhejiang University, Hangzhou, 310006, China
| | - Chee Shin Lee
- Obstetrical Department, School of Medicine, Women's Hospital, Zhejiang University, Hangzhou, 310006, China
| | - Mengkai Du
- Obstetrical Department, School of Medicine, Women's Hospital, Zhejiang University, Hangzhou, 310006, China
| | - Menglin Zhou
- Obstetrical Department, School of Medicine, Women's Hospital, Zhejiang University, Hangzhou, 310006, China
| | - Danfeng Fan
- Obstetrical Department, School of Medicine, Women's Hospital, Zhejiang University, Hangzhou, 310006, China
| | - Biao Xie
- Ninghai Maternal and Child Health Hospital, Ningbo, China
| | - Huimin Gu
- Obstetrical Department, School of Medicine, Women's Hospital, Zhejiang University, Hangzhou, 310006, China.
| | - Zhaoxia Liang
- Obstetrical Department, School of Medicine, Women's Hospital, Zhejiang University, Hangzhou, 310006, China.
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Qiu S, Liu X, Lei L, Liang H, Li X, Wang Y, Yu C, Li X, Tang Y, Wu J, Wang Y, Zha D, Liu X, Xiao M, Xiu J. Association between the stress-hyperglycemia ratio and all-cause mortality in community-dwelling populations: An analysis of the National Health and Nutrition Examination Survey (NHANES) 1999-2014. J Diabetes 2024; 16:e13567. [PMID: 38769875 PMCID: PMC11106591 DOI: 10.1111/1753-0407.13567] [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: 04/05/2023] [Revised: 02/01/2024] [Accepted: 04/01/2024] [Indexed: 05/22/2024] Open
Abstract
BACKGROUND Reportedly, the stress-hyperglycemia ratio (SHR) is closely associated with poor prognosis in patients with severe acute disease. However, the community-dwelling may also be in a state of stress due to environmental exposure. Our study aimed to explore the association between SHR and all-cause mortality in the community-dwelling population. METHODS A total of 18 480 participants were included out of 82 091 from the NHANES 1999-2014 survey. The Kaplan-Meier survival analyses were used to assess the disparities in survival rates based on SHR, and the log-rank test was employed to investigate the distinctions between groups. The multivariate Cox regression analysis and restricted cubic spline (RCS) analysis were performed to assess the association of SHR with all-cause mortality. A subgroup analysis was also conducted. RESULTS A total of 3188 deaths occurred during a median follow-up period of 11.0 (7.7; 15.4) years. The highest risk for all-cause mortality was observed when SHR≤ 0.843 or SHR ≥0.986 (log-rank p < .001). After adjusting for the confounding factors, compared with subjects in the second SHR quartile (Q2), participants in the highest (Q4, adjusted hazard ratio [HR] 1.49, 95% confidence interval [CI] 1.28-1.73) and lowest quartiles (Q1, adjusted HR 1.37, 95% CI 1.16-1.60) have a higher probability of all-cause death. The RCS observed a dose-response U-shaped association between SHR and all-cause mortality. The U-shaped association between SHR and all-cause mortality was similar across subgroup analysis. CONCLUSIONS The SHR was significantly associated with all-cause mortality in the community-dwelling population, and the relationship was U-shaped.
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Affiliation(s)
- Shifeng Qiu
- Department of CardiologyNanfang Hospital, Southern Medical UniversityGuangzhouChina
- Guangdong Provincial Key Laboratory of Shock and MicrocirculationNanfang Hospital, Southern Medical UniversityGuangzhouChina
- State Key Laboratory of Organ Failure ResearchNanfang Hospital, Southern Medical UniversityGuangzhouChina
| | - Xiaocong Liu
- Department of CardiologyNanfang Hospital, Southern Medical UniversityGuangzhouChina
- Guangdong Provincial Key Laboratory of Shock and MicrocirculationNanfang Hospital, Southern Medical UniversityGuangzhouChina
- State Key Laboratory of Organ Failure ResearchNanfang Hospital, Southern Medical UniversityGuangzhouChina
| | - Li Lei
- Department of CardiologyShenzhen People's Hospital (The Second Clinical Medical College, Jinan University, The First Affiliated Hospital, Southern University of Science and Technology)ShenzhenChina
| | - Hongbin Liang
- Department of CardiologyNanfang Hospital, Southern Medical UniversityGuangzhouChina
- Guangdong Provincial Key Laboratory of Shock and MicrocirculationNanfang Hospital, Southern Medical UniversityGuangzhouChina
- State Key Laboratory of Organ Failure ResearchNanfang Hospital, Southern Medical UniversityGuangzhouChina
| | - Xue Li
- Department of GastroenterologyNanfang Hospital, Southern Medical UniversityGuangzhouChina
| | - Yutian Wang
- Department of CardiologyNanfang Hospital, Southern Medical UniversityGuangzhouChina
- Guangdong Provincial Key Laboratory of Shock and MicrocirculationNanfang Hospital, Southern Medical UniversityGuangzhouChina
- State Key Laboratory of Organ Failure ResearchNanfang Hospital, Southern Medical UniversityGuangzhouChina
| | - Chen Yu
- Department of CardiologyNanfang Hospital, Southern Medical UniversityGuangzhouChina
- Guangdong Provincial Key Laboratory of Shock and MicrocirculationNanfang Hospital, Southern Medical UniversityGuangzhouChina
- State Key Laboratory of Organ Failure ResearchNanfang Hospital, Southern Medical UniversityGuangzhouChina
| | - Xiaobo Li
- Department of CardiologyXiangdong Hospital Affiliated to Hunan Normal UniversityZhuzhouChina
| | - Yongzhen Tang
- Department of CardiologyNanfang Hospital, Southern Medical UniversityGuangzhouChina
- Guangdong Provincial Key Laboratory of Shock and MicrocirculationNanfang Hospital, Southern Medical UniversityGuangzhouChina
- State Key Laboratory of Organ Failure ResearchNanfang Hospital, Southern Medical UniversityGuangzhouChina
| | - Juefei Wu
- Department of CardiologyNanfang Hospital, Southern Medical UniversityGuangzhouChina
- Guangdong Provincial Key Laboratory of Shock and MicrocirculationNanfang Hospital, Southern Medical UniversityGuangzhouChina
- State Key Laboratory of Organ Failure ResearchNanfang Hospital, Southern Medical UniversityGuangzhouChina
| | - Yuegang Wang
- Department of CardiologyNanfang Hospital, Southern Medical UniversityGuangzhouChina
- Guangdong Provincial Key Laboratory of Shock and MicrocirculationNanfang Hospital, Southern Medical UniversityGuangzhouChina
- State Key Laboratory of Organ Failure ResearchNanfang Hospital, Southern Medical UniversityGuangzhouChina
| | - Daogang Zha
- Department of CardiologyNanfang Hospital, Southern Medical UniversityGuangzhouChina
- Guangdong Provincial Key Laboratory of Shock and MicrocirculationNanfang Hospital, Southern Medical UniversityGuangzhouChina
- State Key Laboratory of Organ Failure ResearchNanfang Hospital, Southern Medical UniversityGuangzhouChina
- Department of General PracticeNanfang Hospital, Southern Medical UniversityGuangzhouChina
| | - Xuewei Liu
- Guangdong Provincial Key Laboratory of Shock and MicrocirculationNanfang Hospital, Southern Medical UniversityGuangzhouChina
- The First School of Clinical MedicineSouthern Medical UniversityDongguanChina
| | - Min Xiao
- Department of CardiologyNanfang Hospital, Southern Medical UniversityGuangzhouChina
- Guangdong Provincial Key Laboratory of Shock and MicrocirculationNanfang Hospital, Southern Medical UniversityGuangzhouChina
- State Key Laboratory of Organ Failure ResearchNanfang Hospital, Southern Medical UniversityGuangzhouChina
| | - Jiancheng Xiu
- Department of CardiologyNanfang Hospital, Southern Medical UniversityGuangzhouChina
- Guangdong Provincial Key Laboratory of Shock and MicrocirculationNanfang Hospital, Southern Medical UniversityGuangzhouChina
- State Key Laboratory of Organ Failure ResearchNanfang Hospital, Southern Medical UniversityGuangzhouChina
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Katlaps I, Ghafari-Saravi A, Mandelbaum A, Packer CH, Doshi U, Garg B, Caughey AB, Valent AM. Adverse Perinatal and Neonatal Outcomes among Adolescent Pregnancies in the United States. Am J Perinatol 2024; 41:e2495-e2504. [PMID: 37399846 DOI: 10.1055/a-2121-7698] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/05/2023]
Abstract
OBJECTIVE Despite a downward trend in recent years, adolescent pregnancies in the United States remain higher than any other western country. Adolescent pregnancies have been inconsistently associated with adverse perinatal outcomes. The objective of this study is to investigate the association between adolescent pregnancies and adverse perinatal and neonatal outcomes in the United States. STUDY DESIGN This is a retrospective cohort study of singleton births in the United States from 2014 to 2020 using national vital statistics data. Perinatal outcomes included gestational diabetes, gestational hypertension, preterm delivery <37 weeks (preterm birth [PTB]), cesarean delivery (CD), chorioamnionitis, small for gestational age (SGA), large for gestational age (LGA), and neonatal composite outcome. Chi-square tests were used to compare outcomes among adolescent (13-19 years) versus adult (20-29 years) pregnancies. Multivariable logistic regression models were used to examine association of adolescent pregnancies with perinatal outcomes. For each outcome, we utilized three models: unadjusted logistic regression, adjusted for demographics, and adjusted for demographics and medical comorbidities. Similar analyses were used to compare younger (13-17 years) and older (18-19 years) adolescent pregnancies to adults. RESULTS In a cohort of 14,014,078 pregnancies, we found that adolescents were at an increased risk of PTB (adjusted odds ratio [aOR]: 1.12, 99% confidence interval (CI): 1.12-1.13) and SGA (aOR: 1.02, 99% CI: 1.01-1.03) compared with adult pregnancies. We also found that multiparous adolescents with a prior history of CD were at an increased risk of CD, compared with adults. For all other outcomes, adult pregnancies were at higher risk for adverse outcomes in the adjusted models. When comparing birth outcomes among adolescents, we found that older adolescents are at an increased risk of PTB, whereas younger adolescents are at an increased risk of both PTB and SGA. CONCLUSION After adjusting for confounders, our study demonstrates adolescents have an increased risk of PTB and SGA, compared with adults. KEY POINTS · Adolescents as a whole subgroup have an increased risk of PTB and SGA compared with adults.. · Younger adolescents have a risk of PTB and SGA, whereas older adolescents have a risk of PTB only.. · Adverse birth outcomes in adults are gestational diabetes, chorioamnionitis, LGA, and worse neonatal composite score..
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Affiliation(s)
- Isabel Katlaps
- Department of Obstetrics and Gynecology, Oregon Health and Science University, Portland, Oregon
| | - Afsoon Ghafari-Saravi
- Department of Obstetrics and Gynecology, Oregon Health and Science University, Portland, Oregon
| | - Ava Mandelbaum
- Department of Obstetrics and Gynecology, Oregon Health and Science University, Portland, Oregon
| | - Claire H Packer
- Department of Obstetrics and Gynecology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Uma Doshi
- Department of Obstetrics and Gynecology, Oregon Health and Science University, Portland, Oregon
| | - Bharti Garg
- Department of Obstetrics and Gynecology, Oregon Health and Science University, Portland, Oregon
| | - Aaron B Caughey
- Department of Obstetrics and Gynecology, Oregon Health and Science University, Portland, Oregon
| | - Amy M Valent
- Department of Obstetrics and Gynecology, Oregon Health and Science University, Portland, Oregon
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Bezie MM, Tesema GA, Seifu BL. Multilevel multinomial regression analysis of factors associated with birth weight in sub-Saharan Africa. Sci Rep 2024; 14:9210. [PMID: 38649729 PMCID: PMC11035683 DOI: 10.1038/s41598-024-58517-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Accepted: 03/30/2024] [Indexed: 04/25/2024] Open
Abstract
Birth weight significantly determines newborns immediate and future health. Globally, the incidence of both low birth weight (LBW) and macrosomia have increased dramatically including sub-Saharan African (SSA) countries. However, there is limited study on the magnitude and associated factors of birth weight in SSA. Thus, thus study investigated factors associated factors of birth weight in SSA using multilevel multinomial logistic regression analysis. The latest demographic and health survey (DHS) data of 36 sub-Saharan African (SSA) countries was used for this study. A total of a weighted sample of 207,548 live births for whom birth weight data were available were used. Multilevel multinomial logistic regression model was fitted to identify factors associated with birth weight. Variables with p-value < 0.2 in the bivariable analysis were considered for the multivariable analysis. In the multivariable multilevel multinomial logistic regression analysis, the adjusted Relative Risk Ratio (aRRR) with the 95% confidence interval (CI) was reported to declare the statistical significance and strength of association. The prevalence of LBW and macrosomia in SSA were 10.44% (95% CI 10.31%, 10.57%) and 8.33% (95% CI 8.21%, 8.45%), respectively. Maternal education level, household wealth status, age, and the number of pregnancies were among the individual-level variables associated with both LBW and macrosomia in the final multilevel multinomial logistic regression analysis. The community-level factors that had a significant association with both macrosomia and LBW were the place of residence and the sub-Saharan African region. The study found a significant association between LBW and distance to the health facility, while macrosomia had a significant association with parity, marital status, and desired pregnancy. In SSA, macrosomia and LBW were found to be major public health issues. Maternal education, household wealth status, age, place of residence, number of pregnancies, distance to the health facility, and parity were found to be significant factors of LBW and macrosomia in this study. Reducing the double burden (low birth weight and macrosomia) and its related short- and long-term effects, therefore, calls for improving mothers' socioeconomic status and expanding access to and availability of health care.
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Affiliation(s)
- Meklit Melaku Bezie
- Department of Public Health, Institute of Public Health, College of Medicine and Health Sciences and Comprehensive Specialized Hospital, University of Gondar, Gondar, Ethiopia.
| | - Getayeneh Antehunegn Tesema
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences and comprehensive specialized hospital, University of Gondar, Gondar, Ethiopia
| | - Beminate Lemma Seifu
- Department of Public Health, College of Medicine and Health Sciences, Samara University, Samara, Ethiopia
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Alnasheet AM, Abdulaal NA, Kamal N. The Prevalence and Risk Factors of Pregnancy-Related Anxiety in Bahrain. Cureus 2024; 16:e57404. [PMID: 38694669 PMCID: PMC11062578 DOI: 10.7759/cureus.57404] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/22/2024] [Indexed: 05/04/2024] Open
Abstract
Objectives We aim to estimate the prevalence of anxiety among pregnant women, explore the possible risk factors, and compare the presence of anxiety in each gestational trimester in all pregnant women attending the antenatal care clinics at a tertiary care hospital in Manama, Bahrain. Methods This study followed a cross-sectional research design at the antenatal clinics of Salmaniya Medical Complex in Manama, Bahrain. Direct interviews with 513 participants were conducted using the Pregnancy Anxiety Questionnaire-Revised-2 (PRAQ-R2). Results Most participants (63%) were 25-35 years old. The majority (85.6%) were Bahraini nationals, and 52.2% were university-educated. Almost two-thirds were unemployed, 28.1% had associated chronic comorbidities, 3.1% had associated psychiatric disorders, 15% had a high level of anxiety, and 38% had a moderate level of anxiety. Employed participants had a significantly higher level of anxiety (p=0.022) than housewives/unemployed participants. Participants' levels of anxiety differed significantly according to their gestational age (p=0.043), with the highest anxiety among those in their third trimester (15.7%). Participants' anxiety levels were significantly higher among those with previously complicated pregnancies (p=0.002). Moreover, those with unplanned current pregnancy had significantly higher anxiety levels (p=0.019). Conclusions This study showed that anxiety seems to be a common disorder among pregnant women in Bahrain. It was more prevalent during the third trimester, and its occurrence was associated with the pregnant woman's employment, the occurrence of previously complicated pregnancies, and unplanned current pregnancies.
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Affiliation(s)
| | - Nada A Abdulaal
- Obstetrics and Gynecology, Al Kharj Military Industries Corporation Hospital (AKMICH), Riyadh, SAU
| | - Nahid Kamal
- Obstetrics and Gynecology, Salmaniya Medical Complex, Manama, BHR
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Okui T, Nakashima N. Exploring the association between non-regular employment and adverse birth outcomes: an analysis of national data in Japan. Ann Occup Environ Med 2024; 36:e6. [PMID: 38623263 PMCID: PMC11016784 DOI: 10.35371/aoem.2024.36.e6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Revised: 02/01/2024] [Accepted: 02/26/2024] [Indexed: 04/17/2024] Open
Abstract
Background As few studies have explored the association between non-regular or precarious employment in parents and adverse birth outcomes, this study aimed to investigate this association using national data in Japan. Methods This study utilized the census data from 2020 and birth data from the vital statistics in 2021 and 2022 in the analysis. Adverse birth outcomes, including preterm birth, term low birth weight (TLBW), and small-for-gestational-age, were examined. Data linkage was conducted between birth data and census data to link parental employment statuses and educational attainments with birth data. Rates of adverse birth outcomes were calculated for each parental employment status. Additionally, regression analysis was used to determine adjusted risk ratios (RRs) of parental employment statuses for each birth outcome. Results After data linkage, 334,110 birth records were included in the statistical analysis. Rates for non-regular workers were consistently higher than those for regular workers across all adverse birth outcomes for maternal employment status. Results of regression analyses indicated that the risks of preterm birth for non-regular workers were statistically significantly higher than those for regular workers, both in mothers and fathers with a RR (95% confidence intervals [CIs]) of 1.053 (1.004-1.104) and 1.142 (1.032-1.264), respectively. Furthermore, the risk of TLBW birth for non-regular workers was statistically significantly higher than that for regular workers in fathers (RR [95% CI]: 1.092 [1.043-1.143]). Conclusions Our findings demonstrate that non-regular workers have a higher risk of some adverse birth outcomes compared to regular workers.
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Affiliation(s)
- Tasuku Okui
- Medical Information Center, Kyushu University Hospital, Fukuoka, Japan
| | - Naoki Nakashima
- Medical Information Center, Kyushu University Hospital, Fukuoka, Japan
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Helmikstøl B, Moe V, Smith L, Fredriksen E. Multiple Risk in Pregnancy- Prenatal Risk Constellations and Mother-Infant Interactions, Parenting Stress, and Child Externalizing and Internalizing Behaviors: A Prospective Longitudinal Cohort Study from Pregnancy to 18 Months Postpartum. Res Child Adolesc Psychopathol 2024; 52:399-412. [PMID: 37938409 PMCID: PMC10896821 DOI: 10.1007/s10802-023-01145-x] [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] [Accepted: 10/18/2023] [Indexed: 11/09/2023]
Abstract
Multiple risk is associated with adverse developmental outcomes across domains. However, as risk factors tend to cluster, it is important to investigate formation of risk constellations, and how they relate to child and parental outcomes. By means of latent class analysis patterns of prenatal risk factors were identified, and relations to interactional quality, parenting stress, and child internalizing and externalizing behaviors were investigated. An array of prenatal risk factors was assessed in 1036 Norwegian pregnant women participating in a prospective longitudinal community-based study, Little in Norway. Mother-infant interactions were videotaped and scored with the Early Relational Health Screen (ERHS) at 12 months. The Parenting Stress Index (PSI) and Infant-Toddler Social and Emotional Assessment (ITSEA) were administered at 18 months. First, we analyzed response patterns to prenatal risks to identify number and characteristics of latent classes. Second, we investigated whether latent class membership could predict mother-child interactional quality, parenting stress, and child internalizing and externalizing behavior after the child was born. Results revealed three prenatal risk constellations: broad risk (7.52%), mental health risk (21.62%) and low-risk (70.86%). Membership in the broad risk group predicted lower scores on interactional quality, while membership in the mental health risk group predicted less favorable scores on all outcome measures. Prenatal risks clustered together in specific risk constellations that differentially related to parent, child and interactional outcomes.
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Affiliation(s)
- Beate Helmikstøl
- Department of Psychology, Ansgar University College, Fredrik Fransons Vei 4, 4635, Kristiansand, Norway.
- Department of Psychology, University of Oslo, Forskningsveien 3a, 0373, Oslo, Norway.
| | - Vibeke Moe
- Department of Psychology, University of Oslo, Forskningsveien 3a, 0373, Oslo, Norway
| | - Lars Smith
- Department of Psychology, University of Oslo, Forskningsveien 3a, 0373, Oslo, Norway
| | - Eivor Fredriksen
- Department of Psychology, University of Oslo, Forskningsveien 3a, 0373, Oslo, Norway
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Parisi F, Høifødt RS, Bohne A, Wang CEA, Pfuhl G. Perceived Parenting Stress Is Related to Cardiac Flexibility in Mothers: Data from the NorBaby Study. Behav Sci (Basel) 2024; 14:117. [PMID: 38392470 PMCID: PMC10886085 DOI: 10.3390/bs14020117] [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: 11/30/2023] [Revised: 01/20/2024] [Accepted: 02/02/2024] [Indexed: 02/24/2024] Open
Abstract
Heart rate variability (HRV) is an indicator of autonomic nervous system activity, and high levels of stress and/or depressive symptoms may reduce HRV. Here, we assessed whether (a) parental stress affected HRV in mothers during the perinatal period and whether this is mediated by bonding and (b) whether antenatal maternal mental states, specifically repetitive negative thinking, depressive symptoms, and pregnancy-related anxiety, have an impact on infant HRV, and lastly, we investigated (c) the relationship between maternal HRV and infant HRV. Data are from the Northern Babies Longitudinal Study (NorBaby). In 111 parent-infant pairs, cardiac data were collected 6 months after birth. In the antenatal period, we used the Pregnancy-Related Anxiety Questionnaire-Revised, the Edinburgh Postnatal Depression Scale, and the Perseverative Thinking Questionnaire; in the postnatal period, we used the Parenting Stress Index and the Maternal Postnatal Attachment Scale. Higher levels of perceived parenting stress but not depressive symptoms were associated with lower HRV in mothers (τ = -0.146), and this relationship was not mediated by maternal bonding. Antenatal maternal mental states were not associated with infant HRV. There was no significant correlation between maternal HRV and infant HRV. Our observational data suggest that perceived stress reduces cardiac flexibility. Future studies should measure HRV and parenting stress repeatedly during the perinatal period.
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Affiliation(s)
- Francesca Parisi
- Department of Psychology, Norwegian University of Science and Technology, 7491 Trondheim, Norway
| | | | - Agnes Bohne
- Department of Psychology, UiT the Arctic University of Norway, 9019 Tromsø, Norway
- Division of Child and Adolescent Health, University Hospital of Northern Norway, 9019 Tromsø, Norway
| | | | - Gerit Pfuhl
- Department of Psychology, Norwegian University of Science and Technology, 7491 Trondheim, Norway
- Department of Psychology, UiT the Arctic University of Norway, 9019 Tromsø, Norway
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11
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Mondolin V, Karlsson H, Tuulari JJ, Pelto J, Karlsson L, Nordenswan E, Kataja EL. Childhood maltreatment, trait resilience and prenatal distress among expecting mothers and fathers in the FinnBrain Birth Cohort Study. J Affect Disord 2024; 344:41-47. [PMID: 37820954 DOI: 10.1016/j.jad.2023.10.026] [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: 05/29/2023] [Revised: 09/21/2023] [Accepted: 10/08/2023] [Indexed: 10/13/2023]
Abstract
BACKGROUND In this study we examined the association between childhood maltreatment exposure (CME) and psychological distress, including symptoms of depression and anxiety, during pregnancy. Additionally, we explored the potential moderating effect of trait resilience on these associations. METHODS The study is part of the ongoing FinnBrain Birth Cohort Study. The sample consisted of 3016 mothers and 1934 fathers. The data were collected using self-report questionnaires, including EPDS, SCL-90, CD-RISC-10 and TADS. We conducted ANOVAs and linear logistic regression analyses to examine the associations between depression, anxiety, resilience, and CMEs. RESULTS CMEs were associated with increased psychological distress, including depression symptoms and anxiety, and decreased trait resilience among both mothers and fathers. Additionally, trait resilience had a moderating effect on the association between fathers' CMEs and psychological distress, while no significant moderating effect was found among mothers. Furthermore, among both mothers and fathers, higher trait resilience was associated with decreased anxiety and depressive symptoms. LIMITATIONS Due to cross-sectionality, it is not possible to establish a causal relationship between CMEs, resilience, and parental distress. Additionally, the study does not provide insights into the underlying factors or processes that contribute to the development of trait resilience. CONCLUSIONS Trait resilience may have a positive impact on parents' mental health during pregnancy. This study is the first to investigate the significance of fathers' trait resilience during pregnancy. In clinical settings, it is essential to identify parents with low levels of resilience and provide them with appropriate support, recognizing them as a vulnerable group.
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Affiliation(s)
- Viivi Mondolin
- FinnBrain Birth Cohort Study, Turku Brain and Mind Center, Department of Clinical Medicine, University of Turku, Turku, Finland; Department of Psychiatry, Helsinki University Hospital, University of Helsinki, Finland.
| | - Hasse Karlsson
- FinnBrain Birth Cohort Study, Turku Brain and Mind Center, Department of Clinical Medicine, University of Turku, Turku, Finland; Department of Psychiatry, Turku University Hospital & University of Turku, Turku, Finland; Centre for Population Health Research, Turku University Hospital and University of Turku, Turku, Finland
| | - Jetro J Tuulari
- FinnBrain Birth Cohort Study, Turku Brain and Mind Center, Department of Clinical Medicine, University of Turku, Turku, Finland; Centre for Population Health Research, Turku University Hospital and University of Turku, Turku, Finland; Turku Collegium for Science, Medicine and Technology, University of Turku, Turku, Finland
| | - Juho Pelto
- FinnBrain Birth Cohort Study, Turku Brain and Mind Center, Department of Clinical Medicine, University of Turku, Turku, Finland; Department of Mathematics and Statistics, University of Turku, Turku, Finland
| | - Linnea Karlsson
- FinnBrain Birth Cohort Study, Turku Brain and Mind Center, Department of Clinical Medicine, University of Turku, Turku, Finland; Centre for Population Health Research, Turku University Hospital and University of Turku, Turku, Finland; Department of Clinical Medicine, Pediatrics and Adolescent Medicine, Turku University Hospital and University of Turku, Finland
| | - Elisabeth Nordenswan
- FinnBrain Birth Cohort Study, Turku Brain and Mind Center, Department of Clinical Medicine, University of Turku, Turku, Finland
| | - Eeva-Leena Kataja
- FinnBrain Birth Cohort Study, Turku Brain and Mind Center, Department of Clinical Medicine, University of Turku, Turku, Finland; Centre for Population Health Research, Turku University Hospital and University of Turku, Turku, Finland
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12
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Tuulari JJ, Rajasilta O, Cabral J, Kringelbach ML, Karlsson L, Karlsson H. Maternal prenatal distress exposure negatively associates with the stability of neonatal frontoparietal network. Stress 2024; 27:2275207. [PMID: 37877207 DOI: 10.1080/10253890.2023.2275207] [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: 09/20/2023] [Accepted: 09/28/2023] [Indexed: 10/26/2023] Open
Abstract
Maternal prenatal distress (PD), frequently defined as in utero prenatal stress exposure (PSE) to the developing fetus, influences the developing brain and numerous associations between PSE and brain structure have been described both in neonates and in older children. Previous studies addressing PSE-linked alterations in neonates' brain activity have focused on connectivity analyses from predefined seed regions, but the effects of PSE at the level of distributed functional networks remains unclear. In this study, we investigated the impact of prenatal distress on the spatial and temporal properties of functional networks detected in functional MRI data from 20 naturally sleeping, term-born (age 25.85 ± 7.72 days, 11 males), healthy neonates. First, we performed group level independent component analysis (GICA) to evaluate an association between PD and the identified functional networks. Second, we searched for an association with PD at the level of the stability of functional networks over time using leading eigenvector dynamics analysis (LEiDA). No statistically significant associations were detected at the spatial level for the GICA-derived networks. However, at the dynamic level, LEiDA revealed that maternal PD negatively associated with the stability of a frontoparietal network. These results imply that maternal PD may influence the stability of frontoparietal connections in neonatal brain network dynamics and adds to the cumulating evidence that frontal areas are especially sensitive to PSE. We advocate for early preventive intervention strategies regarding pregnant mothers. Nevertheless, future research venues are required to assess optimal intervention timing and methods for maximum benefit.
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Affiliation(s)
- Jetro J Tuulari
- FinnBrain Birth Cohort Study, Turku Brain and Mind Center, Department of Clinical Medicine, University of Turku, Turku, Finland
- Department of Clinical Medicine, Psychiatry, University of Turku and Turku University Hospital, Turku, Finland
- Turku Collegium for Science, Medicine and Technology (TCSMT), University of Turku, Turku, Finland
- Centre for Population Health Research, University of Turku and Turku University Hospital, Turku Finland
- Department of Psychiatry, University of Oxford, Oxford, UK
| | - Olli Rajasilta
- FinnBrain Birth Cohort Study, Turku Brain and Mind Center, Department of Clinical Medicine, University of Turku, Turku, Finland
- Neurocenter, Turku University Hospital, Turku, Finland
| | - Joana Cabral
- Centre for Eudaimonia and Human Flourishing, Linacre College, University of Oxford, Oxford, UK
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Braga, Portugal
- ICVS/3B's-PT Government Associate Laboratory, Braga/Guimarães, Portugal
| | - Morten L Kringelbach
- Department of Psychiatry, University of Oxford, Oxford, UK
- Centre for Eudaimonia and Human Flourishing, Linacre College, University of Oxford, Oxford, UK
- Centre for Music in the Brain, Aarhus University, Aarhus, Denmark
| | - Linnea Karlsson
- FinnBrain Birth Cohort Study, Turku Brain and Mind Center, Department of Clinical Medicine, University of Turku, Turku, Finland
- Centre for Population Health Research, University of Turku and Turku University Hospital, Turku Finland
- Department of Clinical Medicine, Paediatrics and Adolescent Medicine, University of Turku and Turku University Hospital, Turku, Finland
| | - Hasse Karlsson
- FinnBrain Birth Cohort Study, Turku Brain and Mind Center, Department of Clinical Medicine, University of Turku, Turku, Finland
- Department of Clinical Medicine, Psychiatry, University of Turku and Turku University Hospital, Turku, Finland
- Centre for Population Health Research, University of Turku and Turku University Hospital, Turku Finland
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13
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Bruinhof N, Sehic E, Hancock GR, Gartstein MA, de Weerth C. Prenatal anticipatory stress: Baby preparation and worry scale-revised in the Dutch context. Compr Psychiatry 2024; 128:152437. [PMID: 38007905 DOI: 10.1016/j.comppsych.2023.152437] [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: 08/16/2023] [Revised: 10/20/2023] [Accepted: 11/07/2023] [Indexed: 11/28/2023] Open
Abstract
BACKGROUND Prenatal distress encompasses a range of different emotions, worries, and experiences of stress. The Baby Preparation and Worry Scale (Baby-PAWS) was recently developed to target anticipatory worries during pregnancy about the postnatal period. However, the Baby-PAWS questionnaire was only examined in the United States of America, limiting the questionnaire's generalizability to different countries. To address this issue, we performed a psychometric evaluation of the questionnaire in a Dutch sample and examined associations between the Baby-PAWS questionnaire and established measures of maternal distress (i.e., EPDS, STAI, PRAQ-R) and infant temperament (i.e., IBQ-R). METHODS Healthy pregnant women (N = 521) completed questionnaires during their third trimester and postnatally, including the Baby-PAWS and distress measures. A subsample of mothers (N = 194) also reported on infant temperament at 12 weeks postpartum. RESULTS Exploratory factor analysis suggested a four-factor structure for the 16-item questionnaire in our Dutch sample, as compared to the expected three-factor structure found in the original psychometric evaluation with the American sample. The total Baby-PAWS score was related to pre-and postnatal depression, anxiety, stress, and specific scales of infant temperament. American women scored higher on the Baby-PAWS items than Dutch women. LIMITATIONS Our participants had higher-than-average socioeconomic status, limiting the generalizability of the findings. CONCLUSION The current analyses indicate good validity of the Baby-PAWS in a Dutch sample. Furthermore, our results highlight cross-cultural differences in perinatal mental health and show the importance of examining instrument structure of context-dependent constructs, such as prenatal worries.
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Affiliation(s)
- Nina Bruinhof
- Radboud University Medical Center, Donders Institute for Brain, Cognition and Behaviour, Department of Cognitive Neuroscience, P.O. Box 9010, 6500, GL, Nijmegen, the Netherlands.
| | - Ela Sehic
- Washington State University, Department of Psychology, Pullman, WA, United States of America.
| | | | - Maria A Gartstein
- Washington State University, Department of Psychology, Pullman, WA, United States of America.
| | - Carolina de Weerth
- Radboud University Medical Center, Donders Institute for Brain, Cognition and Behaviour, Department of Cognitive Neuroscience, P.O. Box 9010, 6500, GL, Nijmegen, the Netherlands.
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14
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Kumpulainen V, Copeland A, Pulli EP, Silver E, Kataja EL, Saukko E, Merisaari H, Lewis JD, Karlsson L, Karlsson H, Tuulari JJ. Prenatal and Postnatal Maternal Depressive Symptoms Are Associated With White Matter Integrity in 5-Year-Olds in a Sex-Specific Manner. Biol Psychiatry 2023; 94:924-935. [PMID: 37220833 DOI: 10.1016/j.biopsych.2023.05.014] [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: 11/30/2022] [Revised: 04/18/2023] [Accepted: 05/14/2023] [Indexed: 05/25/2023]
Abstract
BACKGROUND Prenatal and postnatal maternal psychological distress predicts various detrimental consequences on social, behavioral, and cognitive development of offspring, especially in girls. Maturation of white matter (WM) continues from prenatal development into adulthood and is thus susceptible to exposures both before and after birth. METHODS WM microstructural features of 130 children (mean age, 5.36 years; range, 5.04-5.79 years; 63 girls) and their association with maternal prenatal and postnatal depressive and anxiety symptoms were investigated with diffusion tensor imaging, tract-based spatial statistics, and regression analyses. Maternal questionnaires were collected during first, second, and third trimesters and at 3, 6, and 12 months postpartum with the Edinburgh Postnatal Depression Scale (EPDS) for depressive symptoms and Symptom Checklist-90 for general anxiety. Covariates included child's sex; child's age; maternal prepregnancy body mass index; maternal age; socioeconomic status; and exposures to smoking, selective serotonin reuptake inhibitors, and synthetic glucocorticoids during pregnancy. RESULTS Prenatal second-trimester EPDS scores were positively associated with fractional anisotropy in boys (p < .05, 5000 permutations) after controlling for EPDS scores 3 months postpartum. In contrast, postpartum EPDS scores at 3 months correlated negatively with fractional anisotropy (p < .01, 5000 permutations) in widespread areas only in girls after controlling for prenatal second-trimester EPDS scores. Perinatal anxiety was not associated with WM structure. CONCLUSIONS These results suggest that prenatal and postnatal maternal psychological distress is associated with brain WM tract developmental alterations in a sex- and timing-dependent manner. Future studies including behavioral data are required to consolidate associative outcomes for these alterations.
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Affiliation(s)
- Venla Kumpulainen
- FinnBrain Birth Cohort Study, Turku Brain and Mind Center, Department of Clinical Medicine, University of Turku, Turku, Finland; Centre for Population Health Research, Turku University Hospital and University of Turku, Turku, Finland.
| | - Anni Copeland
- FinnBrain Birth Cohort Study, Turku Brain and Mind Center, Department of Clinical Medicine, University of Turku, Turku, Finland; Centre for Population Health Research, Turku University Hospital and University of Turku, Turku, Finland
| | - Elmo P Pulli
- FinnBrain Birth Cohort Study, Turku Brain and Mind Center, Department of Clinical Medicine, University of Turku, Turku, Finland; Centre for Population Health Research, Turku University Hospital and University of Turku, Turku, Finland
| | - Eero Silver
- FinnBrain Birth Cohort Study, Turku Brain and Mind Center, Department of Clinical Medicine, University of Turku, Turku, Finland; Centre for Population Health Research, Turku University Hospital and University of Turku, Turku, Finland
| | - Eeva-Leena Kataja
- FinnBrain Birth Cohort Study, Turku Brain and Mind Center, Department of Clinical Medicine, University of Turku, Turku, Finland; Centre for Population Health Research, Turku University Hospital and University of Turku, Turku, Finland
| | - Ekaterina Saukko
- Department of Radiology, Turku University Hospital, Turku, Finland
| | - Harri Merisaari
- FinnBrain Birth Cohort Study, Turku Brain and Mind Center, Department of Clinical Medicine, University of Turku, Turku, Finland; Centre for Population Health Research, Turku University Hospital and University of Turku, Turku, Finland; Department of Radiology, Turku University Hospital, Turku, Finland
| | - John D Lewis
- Montreal Neurological Institute, McGill University, Montreal, Canada
| | - Linnea Karlsson
- FinnBrain Birth Cohort Study, Turku Brain and Mind Center, Department of Clinical Medicine, University of Turku, Turku, Finland; Centre for Population Health Research, Turku University Hospital and University of Turku, Turku, Finland; Department of Clinical Medicine, Paediatrics and Adolescent Medicine, Turku University Hospital and University of Turku, Turku, Finland
| | - Hasse Karlsson
- FinnBrain Birth Cohort Study, Turku Brain and Mind Center, Department of Clinical Medicine, University of Turku, Turku, Finland; Centre for Population Health Research, Turku University Hospital and University of Turku, Turku, Finland; Department of Psychiatry, Turku University Hospital and University of Turku, Turku, Finland
| | - Jetro J Tuulari
- FinnBrain Birth Cohort Study, Turku Brain and Mind Center, Department of Clinical Medicine, University of Turku, Turku, Finland; Centre for Population Health Research, Turku University Hospital and University of Turku, Turku, Finland; Department of Psychiatry, Turku University Hospital and University of Turku, Turku, Finland; Turku Collegium for Science, Medicine and Technology, University of Turku, Turku, Finland; Department of Psychiatry, University of Oxford, Oxford, United Kingdom
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15
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Li J, Gao X, Wang S, Yao D, Shao S, Wu H, Xu M, Yi Q, Xie L, Zhu Z, Song D, Li H. The role of m6A methylation in prenatal maternal psychological distress and birth outcome. J Affect Disord 2023; 338:52-59. [PMID: 37269885 DOI: 10.1016/j.jad.2023.05.098] [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: 07/21/2022] [Revised: 05/29/2023] [Accepted: 05/31/2023] [Indexed: 06/05/2023]
Abstract
BACKGROUND Prenatal maternal psychological distress (PMPD) is a known risk factor for adverse birth outcomes. N6-methyladenosine RNA (m6A) methylation is crucial in moderating RNA biology. This study aimed to evaluate the relationships between PMPD, birth outcomes, and placental m6A methylation. METHODS This was a prospective cohort study. PMPD exposure was assessed by questionnaires about prenatal stress, depression, and anxiety. Placental m6A methylation was measured using a colorimetric assay. The relationships between PMPD, m6A methylation, gestational age (GA), and birth weight (BW) were analyzed using structural equation models (SEMs). Maternal weight gain during pregnancy and infant sex were included as covariables. RESULTS The study included 209 mother-infant dyads. In an adjusted SEM, PMPD was associated with BW (B = -26.034; 95 % CI: -47.123, -4.868) and GA (B = -0.603; 95 % CI: -1.102, -0.154). M6A methylation was associated with PMPD (B = 0.055; 95 % CI: 0.040,0.073) and BW (B = -305.799; 95 % CI: -520.164, -86.460) but not GA. The effect of PMPD on BW was partially mediated by m6A methylation (B = -16.817; 95 % CI: -31.348, -4.638) and GA (B = -12.280; 95 % CI: -23.612, -3.079). Maternal weight gain was associated with BW (B = 5.113; 95 % CI: 0.229,10.438). LIMITATIONS The study sample size was small, and the specific mechanism of m6A methylation on birth outcomes needs to be further explored. CONCLUSIONS In this study, PMPD exposure negatively affected BW and GA. Placental m6A methylation was associated with PMPD and BW and partially mediated the effect of PMPD on BW. Our findings highlight the importance of perinatal psychological evaluation and intervention.
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Affiliation(s)
- Jing Li
- Department of Neonatology, The First Affiliated Hospital of Xi'an Jiaotong University, 277 West Yanta Road, Xi'an 710061, Shaanxi, China
| | - Xueyun Gao
- Department of Neonatology, The First Affiliated Hospital of Xi'an Jiaotong University, 277 West Yanta Road, Xi'an 710061, Shaanxi, China
| | - Shan Wang
- Department of Neonatology, The First Affiliated Hospital of Xi'an Jiaotong University, 277 West Yanta Road, Xi'an 710061, Shaanxi, China
| | - Dan Yao
- Department of Neonatology, The First Affiliated Hospital of Xi'an Jiaotong University, 277 West Yanta Road, Xi'an 710061, Shaanxi, China
| | - Shuya Shao
- Department of Neonatology, The First Affiliated Hospital of Xi'an Jiaotong University, 277 West Yanta Road, Xi'an 710061, Shaanxi, China
| | - Haoyue Wu
- Department of Neonatology, The First Affiliated Hospital of Xi'an Jiaotong University, 277 West Yanta Road, Xi'an 710061, Shaanxi, China
| | - Meina Xu
- Department of Neonatology, The First Affiliated Hospital of Xi'an Jiaotong University, 277 West Yanta Road, Xi'an 710061, Shaanxi, China
| | - Qiqi Yi
- Department of Neonatology, The First Affiliated Hospital of Xi'an Jiaotong University, 277 West Yanta Road, Xi'an 710061, Shaanxi, China
| | - Longshan Xie
- Department of Functional Neuroscience, The First People's Hospital of Foshan, North 81 Lingnan Avenue, Foshan 528000, Guangdong, China
| | - Zhongliang Zhu
- Key Laboratory of Resource Biology and Biotechnology in Western China, Maternal and Infant Health Research Institute and Medical College, Northwestern University, 229 Taibai North Road, Xi'an 710069, Shaanxi, China
| | - Dongli Song
- Division of Neonatology, Department of Pediatrics, Santa Clara Valley Medical Center, 751 South Bascom Avenue, San Jose, CA 95128, USA; Division of Neonatal and Developmental Medicine, Department of Pediatrics, Stanford University School of Medicine, 725 Welch Rd 2 West, Palo Alto, CA 94304, USA.
| | - Hui Li
- Department of Neonatology, The First Affiliated Hospital of Xi'an Jiaotong University, 277 West Yanta Road, Xi'an 710061, Shaanxi, China; Department of Neonatology, Affiliated Children's Hospital of Xi'an Jiaotong University, Xi'an 710002, Shaanxi, China.
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16
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Boyer TM, Avula V, Minhas AS, Vaught AJ, Sharma G, Gemmill A. Psychosocial Stressors as a Determinant of Maternal Cardiovascular Health During Pregnancy. Am J Cardiol 2023; 201:302-307. [PMID: 37399594 PMCID: PMC10414759 DOI: 10.1016/j.amjcard.2023.06.046] [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: 02/17/2023] [Revised: 05/27/2023] [Accepted: 06/11/2023] [Indexed: 07/05/2023]
Abstract
Maternal psychosocial stress may be a risk factor for poor cardiovascular health (CVH) during pregnancy. We aimed to identify classes of psychosocial stressors in pregnant women and to evaluate their cross-sectional association with CVH. We performed a secondary analysis of women from the Nulliparous Pregnancy Outcomes Study: Monitoring Mothers-to-be (nuMoM2b) cohort (2010 to 2013). Latent class analysis was used to identify distinct classes of exposure to psychosocial stressors based on psychological (stress, anxiety, resilience, depression) and sociocultural indicators (social support, economic stress, discrimination). Optimal and suboptimal CVH was defined based on the presence of 0 to 1 and ≥2 risk factors (hypertension, diabetes mellitus, smoking, obesity, inadequate physical activity), respectively based on the American Heart Association Life's Essential 8. We used logistic regression to evaluate the association between psychosocial classes and CVH. We included 8,491 women and identified 5 classes reflective of gradations of psychosocial stress. In unadjusted models, women in the most disadvantaged psychosocial stressor class were approximately 3 times more likely to have suboptimal CVH than those in the most advantaged class (odds ratio 2.98, 95% confidence interval: 2.54 to 3.51). Adjusting for demographics minimally attenuated the risk (adjusted odds ratio 2.09, 95% confidence interval: 1.76 to 2.48). We observed variation across psychosocial stressor landscapes in women in the nuMoM2b cohort. Women in the most disadvantaged psychosocial class had a greater risk of suboptimal CVH which was only partially explained by differences in demographic characteristics. In conclusion, our findings highlight the association of maternal psychosocial stressors with CVH during pregnancy.
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Affiliation(s)
- Theresa M Boyer
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland.
| | - Vennela Avula
- M.D. Program, Johns Hopkins School of Medicine, Baltimore, Maryland
| | - Anum S Minhas
- Division of Cardiology, Department of Medicine, Johns Hopkins School of Medicine, Baltimore, Maryland
| | - Arthur J Vaught
- Division of Maternal-Fetal Medicine, Department of Gynecology and Obstetrics, Johns Hopkins School of Medicine, Baltimore, Maryland
| | - Garima Sharma
- Division of Cardiology, Department of Medicine, Johns Hopkins School of Medicine, Baltimore, Maryland
| | - Alison Gemmill
- Department of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
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Riquelme-Gallego B, Martínez-Vázquez S, Caparros-Gonzalez RA. Pandemic-related stress in pregnant women during the first COVID-19 lockdown and neonatal development. J Reprod Infant Psychol 2023:1-16. [PMID: 37469194 DOI: 10.1080/02646838.2023.2237527] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2022] [Accepted: 06/26/2023] [Indexed: 07/21/2023]
Abstract
BACKGROUND Maternal stress and psychopathology have a negative effect on mothers and neonates. Maternal stress may affect neonatal growth and development both physically and psychologically. PURPOSE To study the impact of pandemic-related pregnancy stress and maternal psychopathological symptoms during the COVID-19 lockdown in 2020 on neonatal development. METHODS A two-phase prospective study was carried out on a sample of 181 pregnant women ranged from 18 to 40 years old in Spain (Europe). Phase 1: Pandemic-related pregnancy stress (PREPS), Prenatal Distress Questionnaire (PDQ), Perceived Stress Scale (PSS) and the revised version of the Symptom Checklist-90 (SCL-90-R) were used to assess psychological symptoms during the lockdown. In the follow-up (Phase 2), obstetric, birth-related and anthropometric variables were collected from 81 pregnant women-neonates dyads. RESULTS Primiparous women showed higher psychopathological symptoms and higher levels of pandemic-related pregnancy stress than multiparous women. A multiple linear regression model showed that pandemic-related pregnancy stress could predict the length of neonate by adjusting for maternal age and gestational age, especially for primiparous women. IMPLICATIONS FOR RESEARCH Studies assessing neonates development should evaluate the long-term effect of the COVID-19 pandemic on neonates´ length. IMPLICATIONS FOR PRACTICE States the relation between pandemic-related pregnancy stress and neonatal development by being able to track the effects on neonates whose mothers had high levels of stress during the COVID-19 pandemic.
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Affiliation(s)
- Blanca Riquelme-Gallego
- Department of Nursing of the University of Granada, Ceuta Campus, Spain
- Instituto de Investigación Biosanitaria Ibs. GRANADA, Granada, Spain
| | | | - Rafael A Caparros-Gonzalez
- Department of Nursing of the University of Granada, Ceuta Campus, Spain
- Instituto de Investigación Biosanitaria Ibs. GRANADA, Granada, Spain
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18
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Mestermann S, Fasching PA, Beckmann MW, Gerlach J, Kratz O, Moll GH, Kornhuber J, Eichler A. The Benefit of a Retrospective Pregnancy Anamnesis in Child and Adolescent Psychiatry: The Reliability of Maternal Self-Report during Childhood Development. CHILDREN (BASEL, SWITZERLAND) 2023; 10:children10050866. [PMID: 37238414 DOI: 10.3390/children10050866] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Revised: 05/08/2023] [Accepted: 05/10/2023] [Indexed: 05/28/2023]
Abstract
Pregnancy anamnesis is a crucial part of child and adolescent psychiatry diagnostics. In previous works, the reliability of retrospective maternal self-report on perinatal characteristics was heterogeneous. This prospective longitudinal study aimed to evaluate women's recall of prenatal events in a within-subject design. A sample of 241 women gave a self-report on prenatal alcohol, smoking, partnership quality, pregnancy satisfaction, and obstetric complications during the 3rd trimester (t0), childhood (t1, 6-10 y), and adolescence (t2, 12-14 y). The intra-individual agreement was examined. The t0-t1-(t2) agreement was poor to substantial; this was highest for smoking and worst for obstetric complications, followed by alcohol (Fleiss' κ = 0.719 to -0.051). There were significant t0-t1-(t2) differences for all pregnancy variables (p < 0.017), except for 3rd trimester satisfaction (p = 0.256). For alcohol (t0 25.8%, t1 17.4%, t2 41.0%) and smoking (t0 11.9%, t1 16.4%, t2 22.6%), the highest self-reported rates were found during adolescence. During childhood, fewer obstetric complications (t0 84.9%, t1 42.2%) and worse partnerships were reported (t0 M = 8.86, t1 M = 7.89). Thought to be due to social stigmata and memory effects, pregnancy self-reports cannot be precisely reproduced. Creating a respectful and trusting atmosphere is essential for mothers to give honest self-reports that are in the best interest of their children.
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Affiliation(s)
- Stefan Mestermann
- Department of Child and Adolescent Mental Health, University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), 91054 Erlangen, Germany
| | - Peter A Fasching
- Department of Obstetrics and Gynaecology, University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), 91054 Erlangen, Germany
| | - Matthias W Beckmann
- Department of Obstetrics and Gynaecology, University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), 91054 Erlangen, Germany
| | - Jennifer Gerlach
- Department of Child and Adolescent Mental Health, University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), 91054 Erlangen, Germany
| | - Oliver Kratz
- Department of Child and Adolescent Mental Health, University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), 91054 Erlangen, Germany
| | - Gunther H Moll
- Department of Child and Adolescent Mental Health, University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), 91054 Erlangen, Germany
| | - Johannes Kornhuber
- Department of Psychiatry and Psychotherapy, University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), 91054 Erlangen, Germany
| | - Anna Eichler
- Department of Child and Adolescent Mental Health, University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), 91054 Erlangen, Germany
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19
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Wei Q, Zou J, Ma X, Xiao X, Zhang Y, Shi H. Prospective associations between various prenatal exposures to maternal psychological stress and neurodevelopment in children within 24 months after birth. J Affect Disord 2023; 327:101-110. [PMID: 36738998 DOI: 10.1016/j.jad.2023.01.103] [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: 07/26/2022] [Revised: 01/24/2023] [Accepted: 01/27/2023] [Indexed: 02/05/2023]
Abstract
BACKGROUND There is increasing evidence that prenatal exposure to maternal psychological distress may be a factor influencing offspring neurodevelopment, but stress type-dependent effects of maternal psychological distress on offspring neurodevelopment in early childhood have yet to be fully elucidated. Additionally, although positive maternal mental health exerts potential effects in protecting against adverse health outcomes, few investigators have considered the effects of positive maternal mental health on offspring neurodevelopment in early childhood. AIMS To determine the associations between various prenatal exposures to maternal psychological distress and positive life-event experiences and offspring neurodevelopment within 24 months of age. METHODS A total of 4412 mother-child dyads were recruited from the Shanghai Maternal-Child Pairs Cohort (Shanghai MCPC). Maternal perceived stress, negative life-event stress, positive life-event experiences around the time of conception (i.e., three months prior to and after conception) were assessed at 12-16 gestational weeks, and maternal anxiety and depressive symptoms were assessed at 32-36 gestational weeks. We measured children's neurodevelopment using the Ages and Stages Questionnaire, Third Edition (ASQ-3) at two, six, 12, and 24 months postnatally. We then exploited generalized linear models to estimate the associations between prenatal maternal psychological distress and positive life-event experiences and children's neurodevelopment at the above periods, and generalized linear mixed models were applied to assess the associations between maternal psychological distress and positive life-event experiences and suspected developmental delay (SDD) in children within 24 months after birth based on a longitudinal design. RESULTS Maternal perceived stress and negative life-event stress around the time of conception, and anxiety and depressive symptoms during late pregnancy were negatively associated with scores of children's neurodevelopment at two, six, 12, and 24 months of age; while maternal life-event experiences were positively associated with scores of children's neurodevelopment. Longitudinal analysis revealed that higher levels of maternal negative life-event stress and depressive symptoms augmented the risk of SDD in personal-social (OR = 1.435, 1.681). Mothers who experienced higher levels of positive life-event experiences exhibited a reduced risk of SDD in gross motor and personal-social domains (OR = 0.373, 0.350). CONCLUSIONS Prenatal exposure to maternal psychological distress is negatively associated with children's neurodevelopment in early childhood depending upon the type of distress. Maternal positive life-event experiences around the time of conception appeared to present potential benefits for child neurodevelopment.
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Affiliation(s)
- Qian Wei
- Key Laboratory of Public Health Safety, Ministry of Education, School of Public Health, Fudan University, Shanghai 200032, China
| | - Jiaojiao Zou
- Key Laboratory of Public Health Safety, Ministry of Education, School of Public Health, Fudan University, Shanghai 200032, China
| | - Xuemei Ma
- Key Laboratory of Public Health Safety, Ministry of Education, School of Public Health, Fudan University, Shanghai 200032, China
| | - Xirong Xiao
- Obstetrics & Gynecology Hospital, Fudan University, Shanghai 200011, China
| | - Yunhui Zhang
- Key Laboratory of Public Health Safety, Ministry of Education, School of Public Health, Fudan University, Shanghai 200032, China
| | - Huijing Shi
- Key Laboratory of Public Health Safety, Ministry of Education, School of Public Health, Fudan University, Shanghai 200032, China.
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20
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Baltacı N, Doğan Yüksekol Ö, Koç E, Ulucan M. The effects of listening to lullabies and self-selected music at home on prenatal stress and anxiety in nulliparous pregnant women: A randomized-controlled study. Health Care Women Int 2023; 45:562-578. [PMID: 37010820 DOI: 10.1080/07399332.2023.2196510] [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: 07/30/2022] [Accepted: 03/25/2023] [Indexed: 04/04/2023]
Abstract
To compare the effects of nulliparous pregnant women listening to lullabies and self-selected music on reducing the anxiety and antenatal stress. This was a randomized controlled study. Lullaby group (LG) (n = 40) listened to the lullaby chosen by the researcher, mixed music group (MG) (n = 40) listened to self-selected music and control group (CG) (n = 40) received general care. Post-test anxiety and stress levels was lower in two intervention groups versus CG (p < 0.01). Post-test anxiety was lower in the MG versus LG (p < 0.01), however post-test stress levels were similar. Pregnant women listening to self-selected music at home is more effective in reducing anxiety.
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Affiliation(s)
- Nazlı Baltacı
- Department of Nursing, Faculty of Health Sciences, Ondokuz Mayıs University, Samsun, Turkey
| | - Özlem Doğan Yüksekol
- Department of Midwifery, Faculty of Health Sciences, Munzur University, Tunceli, Turkey
| | - Emine Koç
- Department of Midwifery, Faculty of Health Sciences, Ondokuz Mayıs University, Samsun, Turkey
| | - Mihriban Ulucan
- Department of Midwifery, Faculty of Health Sciences, Munzur University, Tunceli, Turkey
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21
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Zimmerman E, Aguiar A, Aung MT, Geiger SD, Hines M, Woodbury ML, Martens A, Huerta-Montanez G, Cordero JF, Meeker JD, Schantz SL, Alshawabkeh AN. Examining the association between prenatal maternal stress and infant non-nutritive suck. Pediatr Res 2023; 93:1285-1293. [PMID: 34916626 PMCID: PMC9200902 DOI: 10.1038/s41390-021-01894-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2021] [Revised: 10/25/2021] [Accepted: 10/28/2021] [Indexed: 11/09/2022]
Abstract
BACKGROUND This study examined the relationship between prenatal maternal stress (PREMS) and non-nutritive suck (NNS) and tested its robustness across 2 demographically diverse populations. METHODS The study involved 2 prospective birth cohorts participating in the national Environmental influences on Child Health Outcomes (ECHO) Program: Illinois Kids Development Study (IKIDS) and ECHO Puerto Rico (ECHO-PROTECT). PREMS was measured during late pregnancy via the 10-item Perceived Stress Scale (PSS-10). NNS was sampled from 1- to 8-week-olds using a custom pacifier for ~5 min. RESULTS Overall, 237 mother-infant dyads completed this study. Despite several significant differences, including race/ethnicity, income, education, and PREMS levels, significant PREMS-NNS associations were found in the 2 cohorts. In adjusted linear regression models, higher PREMS, measured through PSS-10 total scores, related to fewer but longer NNS bursts per minute. CONCLUSIONS A significant association was observed between PREMS and NNS across two diverse cohorts. This finding is important as it may enable the earlier detection of exposure-related deficits and, as a result, earlier intervention, which potentially can optimize outcomes. More research is needed to understand how NNS affects children's neurofunction and development. IMPACT In this double-cohort study, we found that higher maternal perceived stress assessed in late pregnancy was significantly associated with fewer but longer sucking bursts in 1- to 8-week-old infants. This is the first study investigating the association between prenatal maternal stress (PREMS) and infant non-nutritive suck (NNS), an early indicator of central nervous system integrity. Non-nutritive suck is a potential marker of increased prenatal stress in diverse populations. Non-nutritive suck can potentially serve as an early indicator of exposure-related neuropsychological deficits allowing for earlier interventions and thus better prognoses.
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Affiliation(s)
- Emily Zimmerman
- Department of Communication Sciences and Disorders, Northeastern University, Boston, MA, USA.
| | - Andréa Aguiar
- Beckman Institute for Advanced Science and Technology, University of Illinois at Urbana-Champaign, Urbana, IL, USA
- Department of Comparative Biosciences, University of Illinois at Urbana-Champaign, Urbana, IL, USA
| | - Max T Aung
- Program on Reproductive Health and the Environment, Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco, CA, USA
| | - Sarah Dee Geiger
- Beckman Institute for Advanced Science and Technology, University of Illinois at Urbana-Champaign, Urbana, IL, USA
- Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, Champaign, IL, USA
| | - Morgan Hines
- Department of Communication Sciences and Disorders, Northeastern University, Boston, MA, USA
| | - Megan L Woodbury
- Beckman Institute for Advanced Science and Technology, University of Illinois at Urbana-Champaign, Urbana, IL, USA
- Neuroscience Program, University of Illinois at Urbana-Champaign, Urbana, IL, USA
| | - Alaina Martens
- Department of Communication Sciences and Disorders, Northeastern University, Boston, MA, USA
| | | | - José F Cordero
- Department of Epidemiology and Biostatistics, University of Georgia, Athens, Georgia
| | - John D Meeker
- Department of Environmental Health Sciences, University of Michigan School of Public Health, Ann Arbor, MI, USA
| | - Susan L Schantz
- Beckman Institute for Advanced Science and Technology, University of Illinois at Urbana-Champaign, Urbana, IL, USA
- Department of Comparative Biosciences, University of Illinois at Urbana-Champaign, Urbana, IL, USA
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22
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Holaday LW, Tolliver DG, Moore T, Thompson K, Wang EA. Neighborhood Incarceration Rates and Adverse Birth Outcomes in New York City, 2010-2014. JAMA Netw Open 2023; 6:e236173. [PMID: 37000451 PMCID: PMC10066462 DOI: 10.1001/jamanetworkopen.2023.6173] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Accepted: 02/16/2023] [Indexed: 04/01/2023] Open
Abstract
Importance The US has high rates of adverse birth outcomes, with substantial racial disparities augmented by stress and neighborhood disadvantage. Black people are more likely to live in neighborhoods with high rates of incarceration, which is a source of both stress and neighborhood disadvantage and, thus, may contribute to adverse birth outcomes. Objective To determine whether neighborhoods with high incarceration rates also have higher rates of adverse birth outcomes compared with neighborhoods with lower rates. Design, Setting, and Participants This cross-sectional study used publicly available data from the New York City Department of Health (2010-2014). Censored Poisson regression, with the US Census tract as the unit of analysis, was used to examine the association of neighborhood incarceration rate and birth outcomes. Multivariable models included percentage of births aggregated to the Census tract by maternal factors (age, parity, singleton vs multiple birth, insurance, and race) and neighborhood factors (poverty, education, and violent crime). Analyses were performed between May 2021 and October 2022. Exposure Neighborhood incarceration rate, categorized into quintiles. Main Outcomes and Measures The primary outcome was the incidence rate ratio (IRR) of preterm birth and low birth weight. Secondary outcomes were IRRs of very preterm birth, extremely preterm birth, and very low birth weight. Hypotheses were formulated before data collection. Results Among 2061 Census tracts with 562 339 births, incarceration rates varied from 0 to 4545 people incarcerated per 100 000, and high-incarceration neighborhoods had more residents of Black race (54.00% vs 1.90%), living in poverty (32.30% vs 10.00%), and without a general educational development equivalent (28.00% vs 12.00%) compared with low-incarceration neighborhoods. In fully adjusted models, high-incarceration neighborhoods had a 13% higher IRR of preterm birth (IRR, 1.13; 95% CI, 1.08-1.18), 45% higher IRR of very preterm birth (IRR, 1.45; 95% CI, 1.24-1.71), 125% higher IRR of extremely preterm birth (IRR, 2.25; 95% CI, 1.59-3.18), 10% higher IRR of low birth weight (IRR, 1.10; 95% CI, 1.05-1.16), and 52% higher IRR of very low birth weight compared with low-incarceration neighborhoods (IRR, 1.52; 95% CI, 1.28-1.81). Conclusions and Relevance Neighborhood incarceration rate was positively associated with adverse birth outcomes, particularly those associated with infant mortality. Black people were significantly more likely to live in high-incarceration neighborhoods, suggesting that mass incarceration may contribute to racial disparities in birth outcomes.
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Affiliation(s)
- Louisa W. Holaday
- Division of General Internal Medicine, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, New York
- Institute for Health Equity Research, Icahn School of Medicine at Mount Sinai, New York, New York
- SEICHE Center for Health and Justice, Yale University, New Haven, Connecticut
- National Clinician Scholars Program, Yale University, New Haven, Connecticut
| | - Destiny G. Tolliver
- National Clinician Scholars Program, Yale University, New Haven, Connecticut
| | - Tiana Moore
- Center for Vulnerable Populations, University of California, San Francisco
| | - Keitra Thompson
- National Clinician Scholars Program, Yale University, New Haven, Connecticut
- Department of Social and Behavioral Sciences, Yale School of Public Health. Yale University, New Haven, Connecticut
| | - Emily A. Wang
- SEICHE Center for Health and Justice, Yale University, New Haven, Connecticut
- Section of General Medicine, Department of Internal Medicine, Yale School of Medicine, Yale University, New Haven, Connecticut
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23
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Pope J, Redsell S, Houghton C, Matvienko-Sikar K. Healthcare professionals' experiences and perceptions of providing support for mental health during the period from pregnancy to two years postpartum. Midwifery 2023; 118:103581. [PMID: 36608486 DOI: 10.1016/j.midw.2022.103581] [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: 09/23/2022] [Revised: 12/01/2022] [Accepted: 12/20/2022] [Indexed: 12/25/2022]
Abstract
OBJECTIVE Mental health issues in the perinatal period are common, and can have negative consequences for maternal and child health. Healthcare professionals (HCPs) who provide women with perinatal care are well-placed to detect mental health issues and provide support. This study therefore examines HCPs' experiences and perceptions of providing mental health support during the perinatal period, including during the COVID-19 pandemic. DESIGN An exploratory realist qualitative study was conducted. SETTING Republic of Ireland PARTICIPANTS: A purposive sampling strategy was employed to recruit HCPs (e.g., general practitioners, midwives, public health nurses, practice nurses, doulas, and breastfeeding counsellors), via professional bodies in Ireland. An invitation to participate was also circulated via Twitter. A total of 18 HCPs participated in semi-structured interviews conducted between 18/8/2020 and 24/5/2021. MEASUREMENTS AND FINDINGS Semi-structured interviews were conducted according to a topic guide designed by a multidisciplinary team. Data were analysed using thematic analysis. Four themes were developed: 'Supporting women in healthcare settings,' 'Skills and capacity to provide adequate care,' 'Structural barriers to care provision,' and 'The impact of the COVID-19 pandemic on stress support.' KEY CONCLUSIONS HCPs reported providing emotional support and advocacy, but highlighted challenges, including limited capacity to address women's concerns, clinical culture and hierarchy, insufficient organisational investment, and social inequities in support access. Some HCPs felt these barriers could lead to additional psychological harm. HCPs also reported that the pandemic had introduced novel stressors and changed the nature of the mental health support they provided. IMPLICATIONS FOR PRACTICE Interventions incorporating education and physical resources for HCPs, increased investment in specialist perinatal mental health services, increased investment in holistic supports, and changes to address cultural challenges in care environments, may facilitate - or enhance - support for women.
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Affiliation(s)
- Johanna Pope
- School of Public Health, University College Cork, Western Road, Mardyke, Cork, Ireland; School of Nursing and Midwifery, Aras Moyola, University of Galway, Upper Newcastle, Gaillimh, Ireland.
| | - Sarah Redsell
- School of Health Sciences, University of Nottingham, Nottingham NG7 2UH, United Kingdom
| | - Catherine Houghton
- School of Nursing and Midwifery, Aras Moyola, University of Galway, Upper Newcastle, Gaillimh, Ireland
| | - Karen Matvienko-Sikar
- School of Public Health, University College Cork, Western Road, Mardyke, Cork, Ireland
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24
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Mason-Jones AJ, Beltrán L, Keding A, Berry V, Blower SL, Whittaker K, Bywater T. Predictors of Mother and Infant Emergency Department Attendance and Admission: A Prospective Observational Study. Matern Child Health J 2023; 27:527-537. [PMID: 36701099 PMCID: PMC9879240 DOI: 10.1007/s10995-022-03581-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/20/2022] [Indexed: 01/27/2023]
Abstract
OBJECTIVE To explore the predictors of emergency department attendance and admission for mothers and their infants. METHODS Self-reported emergency department (ED) attendance and admission, sociodemographic, mental health, and other measures were recorded at baseline and at 12 months at 4 sites in England between May 2017 and March 2020. RESULTS Infants' gestational age (OR 0.73, 95% CI 0.61 to 0.88, p = 0.001), mothers' mental health (OR 2.40, 95% CI 1.30 to 4.41, p = 0.005) and mothers' attendance at ED (OR 2.34, 95% CI 1.13 to 4.84, p = 0.022) predicted infant ED attendance. Frequency of attendance was predicted by ED site (IRR 0.46, 95% CI 0.29 to 0.73, p = 0.001) and mothers' age (IRR 0.96, 95% CI 0.92 to 1.00, p = 0.028). Infant hospital admissions were predominantly for respiratory (40%) and other infectious diseases (21%) and were predicted by previous health problems (OR 3.25, 95% CI 1.76 to 6.01, p < 0.001). Mothers' ED attendance was predicted by mixed or multiple ethnic origin (OR 9.62, 95% CI 2.19 to 42.27, p = 0.003), having a male infant (OR 2.08, 95% CI 1.03 to 4.20, p = 0.042), and previous hospitalisation (OR 4.15, 95% CI 1.81 to 9.56, p = 0.001). Hospital admission was largely for reproductive health issues (61%) with frequency predicted by having attended the ED at least once (IRR 3.39, 95% CI 1.66 to 6.93, p = 0.001), and being anxious or depressed (IRR 3.10, 95% CI 1.14 to 8.45, p = 0.027). CONCLUSIONS FOR PRACTICE Improving the reproductive and mental health of mothers may help to avoid poor maternal and infant health outcomes and reduce emergency service utilisation and hospitalisation.
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Affiliation(s)
- Amanda J Mason-Jones
- Department of Health Sciences, University of York, Heslington, York, YO10 5DD, UK.
| | - Luis Beltrán
- Department of Health Sciences, University of York, Heslington, York, YO10 5DD, UK
| | - Ada Keding
- Department of Health Sciences, University of York, Heslington, York, YO10 5DD, UK
| | - Vashti Berry
- College of Medicine and Health, South Cloisters, University of Exeter, St Luke's Campus, Heavitree Road, Exeter, EX1 2LU, UK
| | - Sarah L Blower
- Department of Health Sciences, University of York, Heslington, York, YO10 5DD, UK
| | - Karen Whittaker
- School of Nursing, University of Central Lancashire, Preston, PR1 2HE, UK
| | - Tracey Bywater
- Department of Health Sciences, University of York, Heslington, York, YO10 5DD, UK
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25
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Gao Y, Tang X, Deng R, Liu J, Zhong X. Latent Trajectories and Risk Factors of Prenatal Stress, Anxiety, and Depression in Southwestern China-A Longitudinal Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:3818. [PMID: 36900833 PMCID: PMC10001100 DOI: 10.3390/ijerph20053818] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/07/2023] [Revised: 02/11/2023] [Accepted: 02/17/2023] [Indexed: 06/18/2023]
Abstract
(1) Background: Few studies have explored the heterogeneity of trajectories of stress, anxiety, and depressive symptoms during pregnancy. This study aimed to explore the trajectory groups of stress, anxiety, and depressive symptoms in women during pregnancy and the risk factors associated with those groups. (2) Methods: Data came from pregnant women recruited from January to September 2018 in four hospitals in Chongqing Province, China. A structured questionnaire was given to pregnant women, which collected basic information, including personal, family, and social information. The growth mixture model was applied to identify potential trajectory groups, and multinomial logistic regression was applied to analyze factors of trajectory groups. (3) Results: We identified three stress trajectory groups, three anxiety trajectory groups, and four depression trajectory groups. Less developed regions, inadequate family care, and inadequate social support were associated with a high risk of stress; residence, use of potentially teratogenic drugs, owning pets, family care, and social support were strongly associated with the anxiety trajectory group; family care and social support were the most critical factors for the depression trajectory group. (4) Conclusions: The trajectories of prenatal stress, anxiety, and depressive symptoms are dynamic and heterogeneous. This study may provide some critical insights into the characteristics of women in the high-risk trajectory groups for early intervention to mitigate worsening symptoms.
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Affiliation(s)
- Yuwen Gao
- Department of Medical Record Management, West China Second University Hospital, Sichuan University, Chengdu 610041, China
- Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu 610041, China
| | - Xian Tang
- School of Public Health, Chongqing Medical University, Chongqing 400016, China
- Research Center for Medicine and Social Development, Chongqing Medical University, Chongqing 400016, China
| | - Ruibin Deng
- Chongqing Shapingba District Center for Disease Control and Prevention, Chongqing 400030, China
| | - Jiaxiu Liu
- College of Medical Informatics, Chongqing Medical University, Chongqing 400016, China
| | - Xiaoni Zhong
- School of Public Health, Chongqing Medical University, Chongqing 400016, China
- Research Center for Medicine and Social Development, Chongqing Medical University, Chongqing 400016, China
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26
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Demirci GM, DeIngeniis D, Wong WM, Shereen AD, Nomura Y, Tsai CL. Superstorm Sandy exposure in utero is associated with neurobehavioral phenotypes and brain structure alterations in childhood: A machine learning approach. Front Neurosci 2023; 17:1113927. [PMID: 36816117 PMCID: PMC9932505 DOI: 10.3389/fnins.2023.1113927] [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: 12/01/2022] [Accepted: 01/12/2023] [Indexed: 02/05/2023] Open
Abstract
Introduction Prenatal maternal stress (PNMS), including exposure to natural disasters, has been shown to serve as a risk factor for future child psychopathology and suboptimal brain development, particularly among brain regions shown to be sensitive to stress and trauma exposure. However, statistical approaches deployed in most studies are usually constrained by a limited number of variables for the sake of statistical power. Explainable machine learning, on the other hand, enables the study of high data dimension and offers novel insights into the prominent subset of behavioral phenotypes and brain regions most susceptible to PNMS. In the present study, we aimed to identify the most important child neurobehavioral and brain features associated with in utero exposure to Superstorm Sandy (SS). Methods By leveraging an explainable machine learning technique, the Shapley additive explanations method, we tested the marginal feature effect on SS exposures and examined the individual variable effects on disaster exposure. Results Results show that certain brain regions are especially sensitive to in utero exposure to SS. Specifically, in utero SS exposure was associated with larger gray matter volume (GMV) in the right caudate, right hippocampus, and left amygdala and smaller GMV in the right parahippocampal gyrus. Additionally, higher aggression scores at age 5 distinctly correlated with SS exposure. Discussion These findings suggest in utero SS exposure may be associated with greater aggression and suboptimal developmental alterations among various limbic and basal ganglia brain regions.
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Affiliation(s)
- Gozde M. Demirci
- The Graduate Center, City University of New York, New York, NY, United States
| | - Donato DeIngeniis
- Queens College, City University of New York, New York, NY, United States
| | - Wai Man Wong
- The Graduate Center, City University of New York, New York, NY, United States
- Queens College, City University of New York, New York, NY, United States
| | - A. Duke Shereen
- The Graduate Center, City University of New York, New York, NY, United States
| | - Yoko Nomura
- The Graduate Center, City University of New York, New York, NY, United States
- Queens College, City University of New York, New York, NY, United States
| | - Chia-Ling Tsai
- The Graduate Center, City University of New York, New York, NY, United States
- Queens College, City University of New York, New York, NY, United States
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27
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Developmental Programming in Animal Models: Critical Evidence of Current Environmental Negative Changes. Reprod Sci 2023; 30:442-463. [PMID: 35697921 PMCID: PMC9191883 DOI: 10.1007/s43032-022-00999-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Accepted: 06/02/2022] [Indexed: 11/23/2022]
Abstract
The Developmental Origins of Health and Disease (DOHaD) approach answers questions surrounding the early events suffered by the mother during reproductive stages that can either partially or permanently influence the developmental programming of children, predisposing them to be either healthy or exhibit negative health outcomes in adulthood. Globally, vulnerable populations tend to present high obesity rates, including among school-age children and women of reproductive age. In addition, adults suffer from high rates of diabetes, hypertension, cardiovascular, and other metabolic diseases. The increase in metabolic outcomes has been associated with the combination of maternal womb conditions and adult lifestyle-related factors such as malnutrition and obesity, smoking habits, and alcoholism. However, to date, "new environmental changes" have recently been considered negative factors of development, such as maternal sedentary lifestyle, lack of maternal attachment during lactation, overcrowding, smog, overurbanization, industrialization, noise pollution, and psychosocial stress experienced during the current SARS-CoV-2 pandemic. Therefore, it is important to recognize how all these factors impact offspring development during pregnancy and lactation, a period in which the subject cannot protect itself from these mechanisms. This review aims to introduce the importance of studying DOHaD, discuss classical programming studies, and address the importance of studying new emerging programming mechanisms, known as actual lifestyle factors, during pregnancy and lactation.
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Clark J, Bulka CM, Martin CL, Roell K, Santos HP, O’Shea TM, Smeester L, Fry R, Dhingra R. Placental epigenetic gestational aging in relation to maternal sociodemographic factors and smoking among infants born extremely preterm: a descriptive study. Epigenetics 2022; 17:2389-2403. [PMID: 36134874 PMCID: PMC9665142 DOI: 10.1080/15592294.2022.2125717] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2022] [Revised: 08/30/2022] [Accepted: 09/05/2022] [Indexed: 11/03/2022] Open
Abstract
Social determinants of health (SDoH) are defined as the conditions in which people are born, grow, live, work, and age. The distribution of these conditions is influenced by underlying structural factors and may be linked to adverse pregnancy outcomes through epigenetic modifications of gestational tissues. A promising modification is epigenetic gestational age (eGA), which captures 'biological' age at birth. Measuring eGA in placenta, an organ critical for foetal development, may provide information about how SDoH 'get under the skin' during pregnancy to influence birth outcomes and ethnic/racial disparities. We examined relationships of placental eGA with sociodemographic factors, smoking, and two key clinical outcomes: Apgar scores and NICU length of stay. Using the Robust Placental Clock, we estimated eGA for placental samples from the Extremely Low Gestational Age Newborns cohort (N = 408). Regression modelling revealed smoking during pregnancy was associated with placental eGA acceleration (i.e., eGA higher than chronologic gestational age). This association differed by maternal race: among infants born to mothers racialized as Black, we observed greater eGA acceleration (+0.89 week, 95% CI: 0.38, 1.40) as compared to those racialized as white (+0.27 week, 95% CI: -0.06, 0.59). Placental eGA acceleration was also correlated with shorter NICU lengths of stay, but only among infants born to mothers racialized as Black (-0.08 d/week-eGA, 95% CI: -0.12, -0.05). Together, these observed associations suggest that interpretations of epigenetic gestational aging may be tissue-specific.
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Affiliation(s)
- Jeliyah Clark
- Department of Environmental Sciences and Engineering, UNC Gillings School of Global Public Health, Chapel Hill, NC, USA
| | - Catherine M. Bulka
- Department of Environmental Sciences and Engineering, UNC Gillings School of Global Public Health, Chapel Hill, NC, USA
| | - Chantel L. Martin
- Department of Epidemiology, UNC Gillings School of Global Public Health, Chapel Hill, NC, USA
| | - Kyle Roell
- Institute for Environmental Health Solutions, University of North Carolina, Chapel Hill, NC, USA
| | - Hudson P. Santos
- Institute for Environmental Health Solutions, University of North Carolina, Chapel Hill, NC, USA
- Biobehavioral Lab, School of Nursing, University of North Carolina, Chapel Hill, North Carolina, USA
| | - T. Michael O’Shea
- Department of Pediatrics, Division of Neonatal-Perinatal Medicine, School of Medicine, University of North Carolina, Chapel Hill, North Carolina, USA
| | - Lisa Smeester
- Department of Environmental Sciences and Engineering, UNC Gillings School of Global Public Health, Chapel Hill, NC, USA
- Institute for Environmental Health Solutions, University of North Carolina, Chapel Hill, NC, USA
| | - Rebecca Fry
- Department of Environmental Sciences and Engineering, UNC Gillings School of Global Public Health, Chapel Hill, NC, USA
- Institute for Environmental Health Solutions, University of North Carolina, Chapel Hill, NC, USA
- Curriculum in Toxicology, School of Medicine, University of North Carolina, Chapel Hill, North Carolina, USA
| | - Radhika Dhingra
- Department of Environmental Sciences and Engineering, UNC Gillings School of Global Public Health, Chapel Hill, NC, USA
- Institute for Environmental Health Solutions, University of North Carolina, Chapel Hill, NC, USA
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Horan H, Cheyney M, Torres EG, Eick G, Bovbjerg M, Snodgrass JJ. Maternal hair cortisol concentrations across pregnancy and the early postpartum period in a Puerto Rican sample. Am J Hum Biol 2022; 34:e23718. [PMID: 35001460 DOI: 10.1002/ajhb.23718] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2021] [Revised: 12/17/2021] [Accepted: 12/21/2021] [Indexed: 01/25/2023] Open
Abstract
OBJECTIVE Hair cortisol is a noninvasive, long-term biomarker of human stress. Strengths and weaknesses of this biomarker as a proxy measure of perinatal stress are not yet well understood. Hair cortisol data were collected from pregnant women in Puerto Rico to investigate maternal cortisol level variance across pregnancy. METHODS In 2017, we recruited 86 pregnant women planning to birth at a large urban hospital. We aimed to collect four hair samples from each participant, one in each trimester and one in the postpartum period. RESULTS Median cortisol in the first trimester (n = 82) was 5.7 picograms/milligram (pg/mg) (range: 1.0-62.4). In the second, third, and postpartum periods, the medians were 6.8 pg/mg (1.0-69.5), (n = 46), 20.1 pg/mg (5.6-89.0), (n = 30), and 14.1 pg/mg (1.7-39.8), (n = 9), respectively. These medians disguise a 10-fold and 50-fold variability for two participants. Our sample sizes declined sharply when Hurricane Maria caused major disruptions in services and participants' lives. CONCLUSION Maternal hair cortisol concentrations were lower in the first and second trimester than the third trimester and early postpartum period. We also observed a wide range of variation in cortisol levels throughout pregnancy and in the postpartum period.
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Affiliation(s)
- Holly Horan
- Department of Anthropology, Oregon State University, Corvallis, Oregon, USA.,Department of Anthropology, The University of Alabama, Tuscaloosa, Alabama, USA
| | - Melissa Cheyney
- Department of Anthropology, Oregon State University, Corvallis, Oregon, USA
| | | | - Geeta Eick
- Department of Anthropology, Global Health Biomarker Laboratory, University of Oregon, Corvallis, Oregon, USA
| | - Marit Bovbjerg
- Epidemiology Program, Oregon State University, Corvallis, Oregon, USA
| | - James Josh Snodgrass
- Department of Anthropology, Global Health Biomarker Laboratory, University of Oregon, Corvallis, Oregon, USA
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Abahussain E, Al-Otaibi M, Al-Humaidi K, Al-Mutairi S, Al-Khatir A, Abualnaja A, Al-Mazidi S. Pregnancy Complications in Pandemics: Is Pregnancy-Related Anxiety a Possible Physiological Risk Factor? INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:12119. [PMID: 36231419 PMCID: PMC9566655 DOI: 10.3390/ijerph191912119] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Revised: 09/07/2022] [Accepted: 09/23/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND Birth and pregnancy complications increased by 10.2% during the 2019 coronavirus (COVID-19) pandemic. Pregnant women are at high risk for anxiety, which might trigger physio-logical stress, leading to pregnancy complications. AIM This study aimed to investigate factors leading to antenatal anxiety during the COVID-19 pandemic. We also aimed to discuss our find-ings with regard to the current literature about pregnancy complications. METHODS This cross-sectional study interviewed 377 pregnant women and assessed anxiety using a validated 7-item general anxiety disorder (GAD-7) scale. Anxiety was related to physiological and demo-graphic parameters. Anxiety was subdivided into pandemic- and pregnancy-related anxiety to minimize results bias. RESULTS Our results showed that 75.3% of pregnant women were anxious. The mean GAD-7 score was 8.28 ± 5. Linear regression analysis showed that for every increase in the number of previous pregnancies, there was a 1.3 increase in anxiety level (p < 0.001). Women with no previous miscarriages were more anxious (p < 0.001). Surprisingly, pregnant women who were previously infected with COVID-19 were 6% less stressed. Pregnant women with comorbid-ities were more stressed (p < 0.001). Low income (p < 0.001) and age (p < 0.05) were the demo-graphic factors most significantly related to increased anxiety. CONCLUSIONS The prevalence of pregnancy-related anxiety increased threefold in Saudi Arabia due to the COVID-19 pandemic. Healthcare support should be available remotely during pandemics; pregnant women (especially those with comorbidities) should be educated about the risks of infection and complications to prevent anxiety-related complications during pregnancy.
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Affiliation(s)
- Eman Abahussain
- Department of Neuroscience, Faculty of Medicine, Imam Mohammad Ibn Saud Islamic University, P.O. Box 5701, Riyadh 11432, Saudi Arabia
| | - Manal Al-Otaibi
- Faculty of Medicine, Imam Mohammad Ibn Saud Islamic University, P.O. Box 5701, Riyadh 11432, Saudi Arabia
| | - Khulud Al-Humaidi
- Faculty of Medicine, Imam Mohammad Ibn Saud Islamic University, P.O. Box 5701, Riyadh 11432, Saudi Arabia
| | - Sultanah Al-Mutairi
- Faculty of Medicine, Imam Mohammad Ibn Saud Islamic University, P.O. Box 5701, Riyadh 11432, Saudi Arabia
| | - Alexandra Al-Khatir
- Department of Obstetric and Gynecology, Faculty of Medicine, Imam Mohammad Ibn Saud Islamic University, P.O. Box 5701, Riyadh 11432, Saudi Arabia
| | - Amani Abualnaja
- Faculty of Medicine, Imam Mohammad Ibn Saud Islamic University, P.O. Box 5701, Riyadh 11432, Saudi Arabia
| | - Sarah Al-Mazidi
- Department of Physiology, Faculty of Medicine, Imam Mohammad Ibn Saud Islamic University, P.O. Box 5701, Riyadh 11432, Saudi Arabia
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Cognitive Behavioral Training and Positive Psychology Training for Pregnant Women’s Psychological Health. PSYCHOLOGICAL STUDIES 2022. [DOI: 10.1007/s12646-022-00673-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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Mohapatra S, Ayash Kumar P, Farooq U, Jain P, Khan R, Hassan N, Shamim A, Javed Ansari M, Alalaiwe AS, Aldawsari MF, Aamir Mirza M, Iqbal Z. COVID 19 pandemic challenges and their management: A review of medicines, vaccines, patents and clinical trials with emphasis on psychological health issues. Saudi Pharm J 2022; 30:879-905. [PMID: 35645588 PMCID: PMC9128298 DOI: 10.1016/j.jsps.2022.05.004] [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: 01/11/2022] [Accepted: 05/20/2022] [Indexed: 12/15/2022] Open
Abstract
The SARS-CoV-2 (COVID 19) paroxysm is a dominant health exigency that caused significant distress, affecting physical and mental health. Increased mortality, a stressed healthcare system, financial crisis, isolation, and new living and working styles enhanced societal commiseration leading to poor health outcomes. Though people try to maintain good physical health but unfortunately the mental affliction is still ignored. Poor psychological health has emerged as a burgeoning social issue and demands attention. Henceforth, the fundamental objective of this review article is to collate information about COVID-linked physical and psychological agony in diverse population groups with related symptoms and accessible diagnosis techniques. Recent studies have unraveled the fragile mental states of people who have either contracted COVID 19 or had near and dear ones falling prey to it. The impact of the epidemic on the human mind both in short and long-term, with possible risk and preventive factors together with suggested solutions for maintaining good health have also been discussed here. It also enlists the available medications, vaccines and investigational research in the form of patents and clinical trials. This article can be taken as an updated information sheet for COVID 19, accompanied by its management techniques with special emphasis on coping strategies for mental health. Further, it may also assist the policymakers to devise approaches that could enable the public to overcome the pandemic-driven adversity not only in the given situation but also futuristically.
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Affiliation(s)
- Sradhanjali Mohapatra
- Nanotechnology Lab, School of Pharmaceutics Education and Research (SPER), Jamia Hamdard, New Delhi, India
| | - P. Ayash Kumar
- Sun Pharmaceutical Industry Limited, R& D Centre, Gurugram, India
| | - Uzma Farooq
- Nanotechnology Lab, School of Pharmaceutics Education and Research (SPER), Jamia Hamdard, New Delhi, India
| | - Pooja Jain
- Nanotechnology Lab, School of Pharmaceutics Education and Research (SPER), Jamia Hamdard, New Delhi, India
| | - Rahmuddin Khan
- Nanotechnology Lab, School of Pharmaceutics Education and Research (SPER), Jamia Hamdard, New Delhi, India
| | - Nazia Hassan
- Nanotechnology Lab, School of Pharmaceutics Education and Research (SPER), Jamia Hamdard, New Delhi, India
| | - Athar Shamim
- Nanotechnology Lab, School of Pharmaceutics Education and Research (SPER), Jamia Hamdard, New Delhi, India
| | - Mohammad Javed Ansari
- Department of Pharmaceutics, College of Pharmacy, Prince Sattam Bin Abdulaziz University, Alkharj, Saudi Arabia
| | - Ahmed S. Alalaiwe
- Department of Pharmaceutics, College of Pharmacy, Prince Sattam Bin Abdulaziz University, Alkharj, Saudi Arabia
| | - Mohammed F. Aldawsari
- Department of Pharmaceutics, College of Pharmacy, Prince Sattam Bin Abdulaziz University, Alkharj, Saudi Arabia
| | - Mohd Aamir Mirza
- Nanotechnology Lab, School of Pharmaceutics Education and Research (SPER), Jamia Hamdard, New Delhi, India
| | - Zeenat Iqbal
- Nanotechnology Lab, School of Pharmaceutics Education and Research (SPER), Jamia Hamdard, New Delhi, India
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Monk C, Dimidjian S, Galinsky E, Gregory KD, Hoffman MC, Howell EA, Miller ES, Osborne C, Rogers CE, Saxbe DE, D'Alton ME. The Transition to Parenthood in Obstetrics: Enhancing Prenatal Care for Two Generation Impact. Am J Obstet Gynecol MFM 2022; 4:100678. [PMID: 35728782 DOI: 10.1016/j.ajogmf.2022.100678] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Accepted: 06/15/2022] [Indexed: 11/25/2022]
Abstract
Obstetrics, the specialty overseeing infant and parent health before birth, could be expanded to address the inter-related areas of parents' prenatal impact on children's brain development and their own psychosocial needs during a time of immense change and neuroplasticity. Obstetrics is primed for the shift that is happening in pediatrics, which is moving from its traditional focus on physical health to a coordinated, whole child, two or multi-generation approach. Pediatric care now includes developmental screening, parenting education, parent coaching, access to developmental specialists, brain-building caregiving skills, linkages to community resources, and tiered interventions with psychologists. Drawing on decades of Developmental Origins of Health and Disease research highlighting the prenatal beginnings of future health and new studies on the transition to parenthood describing adult development from pregnancy to early postpartum, we propose that, similar to pediatrics, the integration of education and intervention strategies into the prenatal care ecosystem should be tested for its potential to improve child cognitive and social-emotional development and parental mental health. Pediatric care programs can serve as models of change for the systematic development, testing and, incorporation of new content into prenatal care as universal, first-tier treatment as well as evidenced-based, triaged interventions according to level of need. To promote optimal beginnings for the whole family, we propose an augmented prenatal care ecosystem that aligns with, and could build on, current major efforts to enhance perinatal care individualization through consideration of medical, social, and structural determinants of health.
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Affiliation(s)
- Catherine Monk
- Department of Obstetrics and Gynecology, Columbia University Irving Medical Center, New York, NY; Department of Psychiatry, Columbia University Irving Medical Center, New York, NY.
| | - Sona Dimidjian
- Department of Psychology and Neuroscience, University Colorado, Boulder
| | | | | | - M Camille Hoffman
- Department of Obstetrics and Gynecology, University of Colorado School of Medicine, Aurora; Department of Psychiatry, University of Colorado School of Medicine, Aurora
| | - Elizabeth A Howell
- Department of Obstetrics and Gynecology, Perelman School of Medicine, University of Pennsylvania, Philadelphia
| | - Emily S Miller
- Department of Obstetrics and Gynecology, Northwestern University, Chicago, IL; Department of Psychiatry and Behavioral Health Sciences, Northwestern University, Chicago, IL
| | - Cynthia Osborne
- Department of Leadership, Policy, and Organizations, Peabody College, Vanderbilt University, Nashville, TN
| | - Cynthia E Rogers
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO
| | - Darby E Saxbe
- Department of Psychology, University of Southern California, Los Angeles
| | - Mary E D'Alton
- Department of Obstetrics and Gynecology, Columbia University Irving Medical Center, New York, NY
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Ma J, Wang A, Zhou H. Impact of the COVID-19 Lockdown on Quality of Life in Pregnant Women. Front Public Health 2022; 10:785383. [PMID: 35174122 PMCID: PMC8841653 DOI: 10.3389/fpubh.2022.785383] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Accepted: 01/03/2022] [Indexed: 11/23/2022] Open
Abstract
Background The COVID-19 pandemic has been associated with significant impacts on mental health and well-being of populations worldwide. However, little is known about its significant impact on psychological aspects of vulnerable population groups such as pregnant women. Therefore, the aim of the study was to determine the psychological impact of the COVID-19 pandemic among pregnant women in mainland China. Methods A cross-sectional survey was performed between July and August 2020 using a modified validated 40-item questionnaire which consisted of sociodemographics, attitude, lifestyle changes and the Impact of Event Scale (IES) toward COVID-19 using snowball and convenience samplings. Results A total of 1,078 participants were included in the study. The mean age of participants was 29.4 ± 4.0 years. Overall, the mean IES of participants was 30.6 ± 12.8 (i.e., moderate-to-severe stressful impact) amidst the COVID-19 pandemic, with 63.9% of participants had an IES score ≥26. Despite increased family and social support, more than half of participants also reported increased feeling of being horrified, apprehensive and helpless. Conclusions The COVID-19 pandemic has several psychological impacts on pregnant women. Therefore, based on these valuable data of pregnant women collected, we recommend that a thoughtful planning and time preparation by the government would definitely help to reduce the negative impacts caused by the COVID-19 pandemic and restore the quality of life among pregnant women. Further research is needed to identify vulnerable groups including pregnant women to better adapt and inform mental health interventions and policies by health authorities.
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Affiliation(s)
- Jingjie Ma
- Department of Nutrition, Baoji Maternal and Child Health Hospital, Baoji, China
| | - Ating Wang
- Department of Nutrition, Baoji Maternal and Child Health Hospital, Baoji, China
| | - Hang Zhou
- Clinical Medical College, Yangzhou University, Yangzhou, China
- Department of Clinical Nutrition, Northern Jiangsu People's Hospital, Yangzhou, China
- *Correspondence: Hang Zhou
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Tharwat D, Trousselard M, Fromage D, Belrose C, Balès M, Sutter-Dallay AL, Ezto ML, Hurstel F, Harvey T, Martin S, Vigier C, Spitz E, Duffaud AM. Acceptance Mindfulness-Trait as a Protective Factor for Post-Natal Depression: A Preliminary Research. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:1545. [PMID: 35162565 PMCID: PMC8834924 DOI: 10.3390/ijerph19031545] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Revised: 01/21/2022] [Accepted: 01/24/2022] [Indexed: 02/06/2023]
Abstract
(1) Background: the prevalence of postnatal depression (PND) reaches up to 20%. PND could be based on the interaction between a psychological vulnerability and chronic stress that pregnancy would activate. Vulnerability factors reflect a psychological profile mirroring mindfulness-trait (MT). A high level of MT is associated with an efficient regulation of both physiological and psychological stress, especially negative moods. Interestingly, mindfulness level can be improved by program based on mindfulness meditation. We hypothesize that MT is a protective factor for PND. We also postulate that negative moods increase during the pregnancy for women who develop a PND after delivery (2) Methods: we conducted a multicentric prospective longitudinal study including 85 women during their first trimester of their pregnancy and 72 from the childbirth to the baby's first birthday". At the inclusion, presence and acceptance of MT and various variables of personality and of psychological functioning were assessed. Mood evolution was monitored each month during the pregnancy and a delivery trauma risk was evaluated after delivery. PND detection was carried out at 48 h, 2, 6 and 12 months after the delivery with the Edinburgh Postnatal Depression Scale with a screening cut-off >11. (3) Results: high-acceptance MT is a protective factor for PND (OR: 0.79). Women without PND displayed less negative mood during pregnancy (p < 0.05 for Anxiety, Confusion and Anger). (4) Conclusions: these results suggest the value of deploying programs to enhance the level of mindfulness, especially in its acceptance dimension, before, during and after pregnancy, to reduce the risk of PND.
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Affiliation(s)
- Dahlia Tharwat
- Groupe Hospitalier Diaconesses Croix Saint Simon, 75012 Paris, France; (D.T.); (T.H.)
- Unit of Stress Neurophysiology, French Armed Forces Biomedical Research Institute, BP73, 91223 Brétigny-sur-Orge, France; (M.T.); (C.B.); (C.V.)
- APEMAC/EPSAM, Université de Lorraine, UR 4360, Ile du Saulcy, BP 30309, CEDEX 1, 57006 Metz, France;
| | - Marion Trousselard
- Unit of Stress Neurophysiology, French Armed Forces Biomedical Research Institute, BP73, 91223 Brétigny-sur-Orge, France; (M.T.); (C.B.); (C.V.)
- Réseau ABC des Psychotraumas, CEDEX 5, 34093 Montpellier, France
- French Military Health Service Academy, 1 Place Alphonse Laveran, CEDEX 05, 75230 Paris, France; (D.F.); (S.M.)
| | - Dominique Fromage
- French Military Health Service Academy, 1 Place Alphonse Laveran, CEDEX 05, 75230 Paris, France; (D.F.); (S.M.)
| | - Célia Belrose
- Unit of Stress Neurophysiology, French Armed Forces Biomedical Research Institute, BP73, 91223 Brétigny-sur-Orge, France; (M.T.); (C.B.); (C.V.)
- Réseau ABC des Psychotraumas, CEDEX 5, 34093 Montpellier, France
| | - Mélanie Balès
- Périnatal Psychiatry Network, University Department of Child Psychaitry, CH Charles Perrens, 33076 Bordeaux, France; (M.B.); (A.-L.S.-D.)
| | - Anne-Laure Sutter-Dallay
- Périnatal Psychiatry Network, University Department of Child Psychaitry, CH Charles Perrens, 33076 Bordeaux, France; (M.B.); (A.-L.S.-D.)
- BPHRC, Inserm 1219, Bordeaux University, 33000 Bordeaux, France
| | | | - Françoise Hurstel
- Protection Maternelle et Infantile du Department de la Moselle, 57000 Metz, France;
| | - Thierry Harvey
- Groupe Hospitalier Diaconesses Croix Saint Simon, 75012 Paris, France; (D.T.); (T.H.)
| | - Solenne Martin
- French Military Health Service Academy, 1 Place Alphonse Laveran, CEDEX 05, 75230 Paris, France; (D.F.); (S.M.)
| | - Cécile Vigier
- Unit of Stress Neurophysiology, French Armed Forces Biomedical Research Institute, BP73, 91223 Brétigny-sur-Orge, France; (M.T.); (C.B.); (C.V.)
| | - Elisabeth Spitz
- APEMAC/EPSAM, Université de Lorraine, UR 4360, Ile du Saulcy, BP 30309, CEDEX 1, 57006 Metz, France;
| | - Anaïs M. Duffaud
- Unit of Stress Neurophysiology, French Armed Forces Biomedical Research Institute, BP73, 91223 Brétigny-sur-Orge, France; (M.T.); (C.B.); (C.V.)
- Réseau ABC des Psychotraumas, CEDEX 5, 34093 Montpellier, France
- French Military Health Service Academy, 1 Place Alphonse Laveran, CEDEX 05, 75230 Paris, France; (D.F.); (S.M.)
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Dewi A, Safaria T, Wenang S, Dewanto I, Dhiya An A, Dewi DTK. The COVID-19 Pandemic: How Does it Affect Pregnant Women? Open Access Maced J Med Sci 2022. [DOI: 10.3889/oamjms.2021.7838] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND: The COVID-19 pandemic has a severe impact globally, not limited to general health and mental health. Pregnant women are a vulnerable group. Hormonal changes that occur during pregnancy significantly affect physical and psychological health.
AIM: The purpose of this study was to explore the anxiety felt by pregnant women holistically about their pregnancy during the COVID-19 pandemic.
METHODOLOGY: This study is qualitative phenomenological research with a naturalistic approach. The informants consisted of 20 pregnant women from three different islands and provinces in Indonesia in February 2021. They were selected to obtain heterogeneous data based on education level, gestational age, urban-rural areas, culture, and religion. The collection of information data used semi-structured interview guidelines with 12 questions. Data analysis used qualitative content analysis to explore pregnant women’s anxiety with a similar meaning using software (Nvivo release 12).
RESULTS: Five domains caused anxiety for pregnant women related to the COVID-19 pandemic, such as feeling worried about being infected with COVID-19, the impact on health during pregnancy, the family economy, the circulating information around the community, and unfulfilled spiritual needs in utilizing places of worship.
CONCLUSION: The COVID-19 pandemic influenced pregnant women in a bio-psycho-socio-cultural manner, both about themselves, their fetuses, and their families. Anxiety that mothers feel during the pregnancy process needs proper treatment to protect the mothers’ health and babies’ well-being in the future. Thus, early detection or screening of anxiety during the COVID-19 pandemic in health services is necessary.
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Jones H, Seaborne M, Cowley L, Odd D, Paranjothy S, Akbari A, Brophy S. Population birth outcomes in 2020 and experiences of expectant mothers during the COVID-19 pandemic: A 'born in Wales' mixed methods study using routine data. PLoS One 2022; 17:e0267176. [PMID: 35609019 PMCID: PMC9129046 DOI: 10.1371/journal.pone.0267176] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Accepted: 04/05/2022] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Pregnancy can be a stressful time and the COVID-19 pandemic has affected all aspects of life. This study aims to investigate the pandemic impact on pregnancy experience, rates of primary childhood immunisations and the differences in birth outcomes in during 2020 to those of previous years. METHODS Self-reported pregnancy experience: 215 expectant mothers (aged 16+) in Wales completed an online survey about their experiences of pregnancy during the pandemic. The qualitative survey data was analysed using codebook thematic analysis. Population-level birth outcomes in Wales: Stillbirths, prematurity, birth weight and Caesarean section births before (2016-2019) and during (2020) the pandemic were compared using anonymised individual-level, population-scale routine data held in the Secure Anonymised Information Linkage (SAIL) Databank. Uptake of the first three scheduled primary childhood immunisations were compared between 2019 and 2020. FINDINGS The pandemic had a negative impact on the mental health of 71% of survey respondents, who reported anxiety, stress and loneliness; this was associated with attending scans without their partner, giving birth alone, and minimal contact with midwives. There was no significant difference in annual outcomes including gestation and birth weight, stillbirths, and Caesarean sections for infants born in 2020 compared to 2016-2019. There was an increase in late term births (≥42 weeks gestation) during the first lockdown (OR: 1.28, p = 0.019) and a decrease in moderate to late preterm births (32-36 weeks gestation) during the second lockdown (OR: 0.74, p = 0.001). Fewer babies were born in 2020 (N = 29,031) compared to 2016-2019 (average N = 32,582). All babies received their immunisations in 2020, but there were minor delays in the timings of immunisations. Those due at 8-weeks were 8% less likely to be on time (within 28-days) and at 16-weeks, they were 19% less likely to be on time. INTERPRETATION Whilst the pandemic had a negative impact on mothers' experiences of pregnancy. Population-level data suggests that this did not translate to adverse birth outcomes for babies born during the pandemic.
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Affiliation(s)
- Hope Jones
- National Centre for Population Health and Wellbeing Research, Swansea University Medical School, Swansea, Wales, United Kingdom
- * E-mail:
| | - Mike Seaborne
- National Centre for Population Health and Wellbeing Research, Swansea University Medical School, Swansea, Wales, United Kingdom
| | - Laura Cowley
- National Centre for Population Health and Wellbeing Research, Swansea University Medical School, Swansea, Wales, United Kingdom
- Research and Evaluation Division, Knowledge Directorate, Public Health Wales, Cardiff, Wales, United Kingdom
| | - David Odd
- Division of Population Medicine, School of Medicine, Cardiff University, Cardiff, Wales, United Kingdom
| | - Shantini Paranjothy
- Centre for Health Data Science, University of Aberdeen, Aberdeen, Scotland, United Kingdom
| | - Ashley Akbari
- Population Data Science, Health Data Research UK, Swansea University Medical School, Swansea, Wales, United Kingdom
| | - Sinead Brophy
- National Centre for Population Health and Wellbeing Research, Swansea University Medical School, Swansea, Wales, United Kingdom
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Zou H, Tao Z, Zhou Y, Zhang Z, Zhang C, Li L, Yang J, Wang Y, Huang W, Wang J. Perceived Stress Positively Relates to Insomnia Symptoms: The Moderation of Resilience in Chinese Pregnant Women During COVID-19. Front Psychiatry 2022; 13:856627. [PMID: 35573361 PMCID: PMC9092980 DOI: 10.3389/fpsyt.2022.856627] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Accepted: 03/24/2022] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND The government's COVID-19 pandemic response lockdown strategy had a negative psychological and physical impact on individuals, which necessitated special care to pregnant women's mental health. There has been no large-scale research on the underlying relationship between perceived stress and insomnia symptoms in pregnant Chinese women up to this point. During the COVID-19 pandemic, we wanted to see if there was an association between perceived stress and insomnia symptoms, as well as the moderating impact of resilience for Chinese pregnant women. METHODS This cross-sectional study examined 2115 pregnant women from central and western China using multi-stage sampling methodologies. A systematic questionnaire was used to collect information on sleep quality, perceived stress, and resilience using the Insomnia Severity Index, Perceptual Stress Scale, and Connor and Davidson Resilience Scale. To assess the moderating influence of resilience, hierarchical regressions were used. RESULTS During the COVID-19 pandemic, 18.53% of respondents (N = 2115) reported experiencing sleeplessness. In pregnant women, perceived stress was positively linked with insomnia symptoms (p < 0.001). Furthermore, resilience significantly attenuated the influence of perceived stress on insomnia symptoms in Chinese expectant mother (βinteraction = -0.0126, p < 0.001). CONCLUSION Pregnant women with strong resilience were less influenced by perceived stress than those with poor resilience. The findings of this study might give empirical proof that health care professionals should identify the relevance of reducing perceived stress in pregnant women with poor resilience and provide better treatment and support when necessary.
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Affiliation(s)
- Hongyu Zou
- Shenzhen Mental Health Center/Shenzhen Kangning Hospital, Shenzhen, China.,School of Psychology, South China Normal University, Guangzhou, China
| | - Zhen Tao
- Shenzhen Mental Health Center/Shenzhen Kangning Hospital, Shenzhen, China
| | - Yongjie Zhou
- Shenzhen Mental Health Center/Shenzhen Kangning Hospital, Shenzhen, China
| | - Zhiguo Zhang
- School of Biomedical Engineering, Health Science Center, Shenzhen University, Shenzhen, China
| | - Chunyan Zhang
- Shenzhen Mental Health Center/Shenzhen Kangning Hospital, Shenzhen, China
| | - Linling Li
- School of Biomedical Engineering, Health Science Center, Shenzhen University, Shenzhen, China
| | - Jiezhi Yang
- Shenzhen Health Development Research Center, Shenzhen, China
| | - Yanni Wang
- Department of Maternal, Child and Adolescent Health, School of Public Health, Lanzhou University, Lanzhou, China
| | - Wei Huang
- Shenzhen Mental Health Center/Shenzhen Kangning Hospital, Shenzhen, China
| | - Jianhong Wang
- Shenzhen Mental Health Center/Shenzhen Kangning Hospital, Shenzhen, China
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Bekkhus M, Lee Y, Brandlistuen RE, Samuelsen SO, Magnus P. Maternal Anxiety and Infants Birthweight and Length of Gestation. A sibling design. BMC Psychiatry 2021; 21:609. [PMID: 34876072 PMCID: PMC8650251 DOI: 10.1186/s12888-021-03620-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Accepted: 11/23/2021] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND The overall aim of this study is to examine the effect of prenatal maternal anxiety on birthweight and gestational age, controlling for shared family confounding using a sibling comparison design. METHODS The data on 77,970 mothers and their 91,165 children from the population-based Mother, Father and Child Cohort Study and data on 12,480 pairs of siblings were used in this study. The mothers filled out questionnaires for each unique pregnancy, at 17th and 30th week in pregnancy. Gestational age and birth weight was extracted from the Medical Birth Registry of Norway (MBRN). Associations between prenatal maternal anxiety (measured across the 17th and 30th weeks) and birth outcomes (birthweight and gestational age) were examined using linear regression with adjustment for shared-family confounding in a sibling comparison design. RESULTS In the population level analysis the maternal anxiety score during pregnancy was inversely associated with new-born's birthweight (Beta = -63.8 95% CI: -92.6, -35.0) and gestational age (Beta = -1.52, 95% CI: -2.15, -0.89) after adjustment for several covariates. The association of the maternal anxiety score with birthweight was no longer significant, but remained for maternal anxiety at 30th week with gestational age (Beta = -1.11, 95% CI: -1.82, -0.4) after further adjusting for the shared-family confounding in the sibling comparison design. CONCLUSION No association was found for maternal prenatal anxiety with birth weight after multiple covariates and family environment were controlled. However, there was an association between prenatal maternal anxiety at 30th week only with gestational age, suggesting a timing effect for maternal anxiety in third trimester.
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Affiliation(s)
- Mona Bekkhus
- Promenta Research Centre, Department of Psychology, University of Oslo, PB 1094 Blindern, 0317, Oslo, Norway.
| | - Yunsung Lee
- grid.418193.60000 0001 1541 4204Centre for Fertility and Health, Norwegian Institute of Public Health, Oslo, Norway ,grid.418193.60000 0001 1541 4204Department of Genetics and Bioinformatics, Norwegian Institute of Public Health, Oslo, Norway
| | - Ragnhild Eek Brandlistuen
- grid.418193.60000 0001 1541 4204Department of Child Health and Development, Norwegian Institute of Public Health, Oslo, Norway
| | - Sven Ove Samuelsen
- grid.418193.60000 0001 1541 4204Department of Genetics and Bioinformatics, Norwegian Institute of Public Health, Oslo, Norway ,grid.5510.10000 0004 1936 8921Department of Mathematics, University of Oslo, Oslo, Norway
| | - Per Magnus
- grid.418193.60000 0001 1541 4204Centre for Fertility and Health, Norwegian Institute of Public Health, Oslo, Norway
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Juliebø-Jones P, Pietropaolo A, Spinoit AF, Bergesen AK, Guðbrandsdottir G, Beisland C, von Ostau N, Harke NN, Ribal MJ, Zerva M, Bres-Niewada E, Zondervan P, McLornan L, Ferretti S, Tonnhofer U, Necknig UH, Skolarikos A, Somani BK. Rules and regulations for a pregnant endourologist: the European perspective. World J Urol 2021; 40:857-864. [PMID: 34874462 PMCID: PMC8650738 DOI: 10.1007/s00345-021-03896-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2021] [Accepted: 11/16/2021] [Indexed: 11/30/2022] Open
Abstract
Introduction Working in surgery while pregnant is challenging. Navigating this period safely is of paramount importance. Anecdotal observation suggests that there exists great variation among European nations in regard to maternity leave and radiation safety. The aim of this article was to gain insight into policy patterns and variations across Europe regarding these issues. Methods A series of core question items was distributed to representatives across 12 nations Austria, Belgium, Germany, Greece, Iceland, Italy, Netherlands, Norway, Poland, Republic of Ireland, Spain and the United Kingdom). Results The total number of weeks with full pay ranged from as little as 4 weeks in Belgium to 32 and Iceland. All countries included in this study give the option of additional weeks beyond the initial period, however at reduced pay. Some offer unpaid leave beyond this. Only 5/12 countries had a specific policy on when the pregnant surgeon should come off the on-call rota. Only Austria, Italy and Poland stipulate a requirement for the pregnant clinician to be replaced or be completely exempt in cases involving radiation. Only Germany, Iceland, Norway and Poland highlight the need to limit radiation dose in the first trimester. Beyond this, Germany alone provides written guidance for reduction in gown weight and along with Poland, display arguably the most forward-thinking approach to resting. Conclusion There is a marked range in maternal leave policies across Europe. There also exists a lack of universal guidance on radiation safety for the pregnant urologist. There is urgent need for this void to be addressed.
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Affiliation(s)
- Patrick Juliebø-Jones
- Department of Urology, Haukeland University Hospital, Bergen, Norway. .,Department of Clinical Medicine, University of Bergen, Bergen, Norway. .,Young Academic Urologists (YAU), Urolithiasis & Endourology Working Party, Arnhem, The Netherlands.
| | - Amelia Pietropaolo
- Department of Urology, Ghent University Hospital, Ghent, Belgium.,Young Academic Urologists (YAU), Urolithiasis & Endourology Working Party, Arnhem, The Netherlands
| | | | - Anne K Bergesen
- Department of Urology, Haukeland University Hospital, Bergen, Norway
| | - Gigja Guðbrandsdottir
- Department of Urology, Haukeland University Hospital, Bergen, Norway.,Department of Clinical Medicine, University of Bergen, Bergen, Norway
| | - Christian Beisland
- Department of Urology, Haukeland University Hospital, Bergen, Norway.,Department of Clinical Medicine, University of Bergen, Bergen, Norway
| | - Nicola von Ostau
- Department of Urology, Universitätsklinikum Essen, Essen, Germany
| | - Nina N Harke
- Department of Urology, Universitätsklinikum Essen, Essen, Germany
| | - Maria J Ribal
- Department of Urology, Hospital Clinic, University of Barcelona, Barcelona, Spain
| | - Maria Zerva
- Department of Urology, Red Cross Hospital, Athens, Greece
| | - Ewa Bres-Niewada
- Department of Urology, Roefler Memorial Hospital, Pruszkow, Poland
| | - Patricia Zondervan
- Department of Urology, Amsterdam Medical Centers, Amsterdam, The Netherlands
| | - Liza McLornan
- Department of Urology, Beaumont and Connolly Hospitals, Dublin, Republic of Ireland
| | | | - Ursula Tonnhofer
- Department of Paediatric Surgery, Medical University of Vienna, Vienna, Austria
| | | | - Andreas Skolarikos
- Department of Urology, National and Kapodistrian University of Athens, Athens, Greece
| | - Bhaskar K Somani
- Department of Urology, University Hospital Southampton, Southampton, UK
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Prenatal maternal transdiagnostic, RDoC-informed predictors of newborn neurobehavior: Differences by sex. Dev Psychopathol 2021; 33:1554-1565. [PMID: 33779535 PMCID: PMC8478962 DOI: 10.1017/s0954579420002266] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
We examined whether Research Domain Criteria (RDoC)-informed measures of prenatal stress predicted newborn neurobehavior and whether these effects differed by newborn sex. Multilevel, prenatal markers of prenatal stress were obtained from 162 pregnant women. Markers of the Negative Valence System included physiological functioning (respiratory sinus arrhythmia [RSA] and electrodermal [EDA] reactivity to a speech task, hair cortisol), self-reported stress (state anxiety, pregnancy-specific anxiety, daily stress, childhood trauma, economic hardship, and family resources), and interviewer-rated stress (episodic stress, chronic stress). Markers of the Arousal/Regulatory System included physiological functioning (baseline RSA, RSA, and EDA responses to infant cries) and self-reported affect intensity, urgency, emotion regulation strategies, and dispositional mindfulness. Newborns' arousal and attention were assessed via the Neonatal Intensive Care Unit (NICU) Network Neurobehavioral Scale. Path analyses showed that high maternal episodic and daily stress, low economic hardship, few emotion regulation strategies, and high baseline RSA predicted female newborns' low attention; maternal mindfulness predicted female newborns' high arousal. As for male newborns, high episodic stress predicted low arousal, and high pregnancy-specific anxiety predicted high attention. Findings suggest that RDoC-informed markers of prenatal stress could aid detection of variance in newborn neurobehavioral outcomes within hours after birth. Implications for intergenerational transmission of risk for psychopathology are discussed.
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Bayat A, Amiri-Farahani L, Soleimani M, Eshraghi N, Haghani S. Effect of short-term psychological intervention on anxiety of pregnant women with positive screening results for chromosomal disorders: a randomized controlled trial. BMC Pregnancy Childbirth 2021; 21:757. [PMID: 34753431 PMCID: PMC8576873 DOI: 10.1186/s12884-021-04206-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2021] [Accepted: 10/18/2021] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND AND AIM Prenatal diagnosis of fetal abnormalities is a critical and stressful event for women. Most pregnant women are concerned about fetal abnormalities and screening tests. Due to the importance of anxiety reduction in pregnant women, this study was conducted to determine the effect of short-term psychological intervention on the anxiety of pregnant women with positive screening results for chromosomal disorders. METHODS A randomized clinical trial was performed on women referred to Akbarabadi Hospital in Tehran, Iran, who had positive screening results for chromosomal abnormalities. Participants were selected from eligible individuals by a continuous method and were assigned to two groups of cognitive-behavioral training (n = 46) and control (n = 46), using the block balanced randomization method. Participants in the cognitive-behavioral training group received 4 sessions of individual counseling. The control group received routine pregnancy visits. The Spielberger State-Trait Anxiety Inventory was completed before the intervention and immediately at the end of the intervention (before receiving the amniocentesis result). The analysis of intervention effects was performed as intention-to-treat and per-protocol analysis. RESULTS There was a statistically significant difference in post-intervention state anxiety scores and trait anxiety scores (p < 0.001) between the intervention and control groups, when their means were adjusted for pre-intervention scores for both intention-to-treat and per-protocol analysis. Also, there was a large effect size between the groups in terms of state (ITT: ηp2 = 0.63, PP: ηp2 = 0.71) and trait (ITT: ηp2 = 0.72, PP: ηp2 = 0.75) anxiety scores clinically for both intention-to-treat and per-protocol analysis. The intervention group had a statistically significant and large decrease in state and trait anxiety scores from pretrial to post-trial. In contrast, the control group had a statistically significant and medium increase in state and trait anxiety scores from pretrial to post-trial. CONCLUSION The results showed that cognitive-behavioral training reduced the anxiety of pregnant women with positive screening results for chromosomal disorders. According to the results, it is recommended to hold cognitive-behavioral training classes to reduce the anxiety of pregnant women with a positive screening result for chromosomal disorders. TRIAL REGISTRATION IRCT.ir: IRCT20180427039436N7 ; date of registration: 24/08/2020 2020-08-24.
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Affiliation(s)
- Arezoo Bayat
- Department of Reproductive Health and Midwifery, Shahid Akbarabadi Clinical Research Development Unit (Sh ACRDU), School of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, Iran
| | - Leila Amiri-Farahani
- Department of Reproductive Health and Midwifery, Nursing Care Research Center, School of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, 1996713883 Iran
| | - Mehdi Soleimani
- Department of Psychiatry, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Nooshin Eshraghi
- Department of Obstetrics and Gynecology, Iran University of Medical Sciences, Akbarabadi Teaching Hospital, Tehran, Iran
| | - Shima Haghani
- Department of Biostatistics, Nursing Care Research Center, Iran University of Medical Sciences, Tehran, Iran
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Chehrazi M, Faramarzi M, Abdollahi S, Esfandiari M, Shafie rizi S. Health promotion behaviours of pregnant women and spiritual well-being: Mediatory role of pregnancy stress, anxiety and coping ways. Nurs Open 2021; 8:3558-3565. [PMID: 33938639 PMCID: PMC8510764 DOI: 10.1002/nop2.905] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2020] [Revised: 02/05/2021] [Accepted: 04/14/2021] [Indexed: 11/16/2022] Open
Abstract
AIM Little is known about the link between spiritual well-being and health promotion behaviours in pregnant women. The study aimed to explore the direct and indirect effects of spirituality on health promotion behaviours with the mediatory roles of pregnancy stress, anxiety and coping ways. DESIGN Cross-sectional. METHODS Two hundred women aged above 18 years completed Spiritual Well-Being scale (SWBS), State-Anxiety Inventory (SAI), Promoting Lifestyle Profile (HPLP), Prenatal Coping Inventory (Nu-PCI) and Revised Prenatal Distress Questionnaire (NuPDQ). RESULTS Spirituality directly and negatively affected the state anxiety (β = -.41; p < .001) and NuPDQ (β = -.36; p < .001). Health promotion behaviours were negatively related to state anxiety (β = -.36; p < .001) and positively to planning-preparation coping (β = .23; p = .001). Spirituality had a significant indirect effect on health promotion behaviours (β = .33; p < .001), mediated through its association with state anxiety and planning-preparation coping. Thus, health professionals are proposed to consult pregnant women on the benefits of spirituality for improving healthy behaviours.
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Affiliation(s)
- Mohammad Chehrazi
- Department of Biostatistics and EpidemiologySchool of Public HealthBabol University of Medical SciencesBabolIran
| | - Mahbobeh Faramarzi
- Social Determinants of Health Research CenterHealth Research InstituteBabol University of Medical SciencesBabolIran
| | - Somayeh Abdollahi
- Student Research CommitteeBabol University of Medical SciencesBabolIran
| | - Maria Esfandiari
- Student Research CommitteeBabol University of Medical SciencesBabolIran
| | - Shiva Shafie rizi
- Student Research CommitteeBabol University of Medical SciencesBabolIran
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Fekene DB, Bulto GA, Woldeyes BS, Dina GD, Negash KM. Determinants of adverse birth outcome in the west shewa zone, Oromia, regional state, Ethiopia: Unmatched case-control study. JOURNAL OF MOTHER AND CHILD 2021; 25:9-18. [PMID: 34643348 PMCID: PMC8603841 DOI: 10.34763/jmotherandchild.20212501.d-21-00003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Accepted: 06/17/2021] [Indexed: 11/12/2022]
Abstract
INTRODUCTION Adverse birth outcome (ABO) can lead to higher rates of poor health and infection for newborns, as well as long-term neurological and health problems. Hence, the aim is to identify determinants of ABOs among mothers who gave birth in hospitals in West Shewa zone, Ethiopia. METHODS A hospital-based, unmatched, case-control study was conducted from March 5to July 29, 2020, among 591mothers (171 cases and 420 controls) who had given birth in hospitals found in West Shewa zone. The questionnaire was collected using census and survey processing system (CS-Pro) version7.1.The data were entered into Epi-data version 3.1 and analyzed by SPSS software version 23. Descriptive statistics, bivariate analysis, and multivariate logistic regression analysis were performed. Finally, P-value < 0.05 was used to declare and include variables with statistically significant in predicting the outcome variable. RESULT On multivariate analysis, urban residence(AOR=0.65, 95%, CI=0.43-0.98),lack of family support during child bearing(AOR =5.24, 95% CI=3.16-8.71),pregnancy type(AOR = 4.02, 95% CI: 2.47-6.52,),short inter-pregnancy interval (AOR = 1.43,95% CI= 1.23-4.48),less than four antenatal care (ANC) visits (AOR =1.80,95%CI: 1.17- 2.78),and having current obstetric complication (AOR=2.07, 95% CI =1.18-3.61) were significantly associated with adverse birth outcomes. CONCLUSIONS Residence, lack of family support during childbearing, pregnancy type, short inter-pregnancy interval, having current obstetric complications, and number of ANC visits were identified as determinants of adverse birth outcome. Therefore, improving family support, increasing inter-pregnancy interval through family planning counselling and provision, and having the recommended ANC follow-up were recommended.
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Affiliation(s)
- Daniel Belema Fekene
- Department of Midwifery, College of Medicine and Health Sciences, Ambo University, Ambo, Ethiopia, E-mail:
| | - Gizachew Abdissa Bulto
- Department of Midwifery, College of Medicine and Health Sciences, Ambo University, Ambo, Ethiopia
| | - Benyam Seifu Woldeyes
- Department of Midwifery, College of Medicine and Health Sciences, Ambo University, Ambo, Ethiopia
| | - Gurmesa Daba Dina
- Department of Midwifery, College of Medicine and Health Sciences, Ambo University, Ambo, Ethiopia
| | - Kassa Mamo Negash
- Department of Midwifery, College of Medicine and Health Sciences, Ambo University, Ambo, Ethiopia
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Associations Between Maternal Depression, Antidepressant Use During Pregnancy, and Adverse Pregnancy Outcomes: An Individual Participant Data Meta-analysis. Obstet Gynecol 2021; 138:633-646. [PMID: 34623076 DOI: 10.1097/aog.0000000000004538] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2021] [Accepted: 05/13/2021] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To evaluate the associations of depressive symptoms and antidepressant use during pregnancy with the risks of preterm birth, low birth weight, small for gestational age (SGA), and low Apgar scores. DATA SOURCES MEDLINE, EMBASE, ClinicalTrials.gov, and PsycINFO up to June 2016. METHODS OF STUDY SELECTION Data were sought from studies examining associations of depression, depressive symptoms, or use of antidepressants during pregnancy with gestational age, birth weight, SGA, or Apgar scores. Authors shared the raw data of their studies for incorporation into this individual participant data meta-analysis. TABULATION, INTEGRATION, AND RESULTS We performed one-stage random-effects meta-analyses to estimate odds ratios (ORs) with 95% CIs. The 215 eligible articles resulted in 402,375 women derived from 27 study databases. Increased risks were observed for preterm birth among women with a clinical diagnosis of depression during pregnancy irrespective of antidepressant use (OR 1.6, 95% CI 1.2-2.1) and among women with depression who did not use antidepressants (OR 2.2, 95% CI 1.7-3.0), as well as for low Apgar scores in the former (OR 1.5, 95% CI 1.3-1.7), but not the latter group. Selective serotonin reuptake inhibitor (SSRI) use was associated with preterm birth among women who used antidepressants with or without restriction to women with depressive symptoms or a diagnosis of depression (OR 1.6, 95% CI 1.0-2.5 and OR 1.9, 95% CI 1.2-2.8, respectively), as well as with low Apgar scores among women in the latter group (OR 1.7, 95% CI 1.1-2.8). CONCLUSION Depressive symptoms or a clinical diagnosis of depression during pregnancy are associated with preterm birth and low Apgar scores, even without exposure to antidepressants. However, SSRIs may be independently associated with preterm birth and low Apgar scores. SYSTEMATIC REVIEW REGISTRATION PROSPERO, CRD42016035711.
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Prenatal maternal mental health symptoms predict infant leptin at birth. Brain Behav Immun Health 2021; 16:100317. [PMID: 34589807 PMCID: PMC8474689 DOI: 10.1016/j.bbih.2021.100317] [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: 08/02/2021] [Accepted: 08/03/2021] [Indexed: 01/03/2023] Open
Abstract
Childhood obesity can be predicted by metabolic signaling at birth. Understanding what exposure factors, such as prenatal mental health, predict metabolic signaling at birth are important for understanding the etiology of childhood metabolic dysregulation. Drawing on data from the Born in Bradford (BiB) multi-ethnic birth cohort in the United Kingdom (N = 2962 dyads), this study examined associations between maternal prenatal mental health symptoms and infant leptin and adiponectin. We tested whether total maternal prenatal symptoms as well as specific symptom subscales forecasted infant cord blood levels of leptin and adiponectin. We found that higher total maternal mental health symptoms and somatic symptoms, specifically, predicted lower infant cord blood leptin. We did not find evidence that maternal prenatal mental health symptoms predicted adiponectin. Together, our findings suggest that maternal mental health symptoms may become biologically embedded through infant metabolic changes via leptin. Maternal prenatal mental health symptoms predict infant cord blood leptin at birth. Somatic maternal prenatal mental health symptoms predict infant cord blood leptin at birth. Maternal prenatal mental health symptoms do not predict infant cord blood adiponectin at birth. Maternal prenatal mental health may become biologically embedded in infants via leptin.
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Epigenetic Modifications Associated with Maternal Anxiety during Pregnancy and Children's Behavioral Measures. Cells 2021; 10:cells10092421. [PMID: 34572069 PMCID: PMC8469633 DOI: 10.3390/cells10092421] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2021] [Revised: 09/03/2021] [Accepted: 09/08/2021] [Indexed: 12/15/2022] Open
Abstract
Epigenetic changes are associated with altered behavior and neuropsychiatric disorders and they modify the trajectory of aging. Maternal anxiety during pregnancy is a common environmental challenge for the fetus, causing changes in DNA methylation. Here, we determined the mediating role of DNA methylation and the moderating role of offspring sex on the association between maternal anxiety and children's behavioral measures. In 83 mother-child dyads, maternal anxiety was assessed in each trimester of pregnancy when the child was four years of age. Children's behavioral measures and children's buccal DNA methylation levels (NR3C1, IGF2/H19 ICR, and LINE1) were examined. Higher maternal anxiety during the third trimester was associated with more methylation levels of the NR3C1. Moderating effects of sex on the association between maternal anxiety and methylation were found for IGF2/H19 and LINE1 CpGs. Mediation analysis showed that methylation of NR3C1 could buffer the effects of maternal anxiety on children's behavioral measures, but this effect did not remain significant after controlling for covariates. In conclusion, our data support an association between maternal anxiety during pregnancy and DNA methylation. The results also underscore the importance of sex differences and timing effects. However, DNA methylation as underlying mechanism of the effect of maternal anxiety during pregnancy on offspring's behavioral measures was not supported.
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van Driessche A, van Stel HF, Vink RM, Staal IIE. Assessing Concerns and Care Needs of Expectant Parents: Development and Feasibility of a Structured Interview. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:9585. [PMID: 34574510 PMCID: PMC8467634 DOI: 10.3390/ijerph18189585] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/05/2021] [Revised: 08/30/2021] [Accepted: 09/09/2021] [Indexed: 11/18/2022]
Abstract
Many adverse situations for parenting and healthy child development can be detected before a child's birth. The aim of this project was to develop and test an instrument to use in prenatal home visits, to improve the identification of adverse situations and care needs during pregnancy. The preSPARK is based on a valid and reliable broad-scope structured interview called SPARK (Structured Problem Analysis of Raising Kids). The preSPARK focuses on 12 topics ranging from aspects of the period before pregnancy to future parents' expectations. The preSPARK was tested in daily practice for feasibility and discriminative capacity. User experience was assessed from the perspective of the professional. In total, 64 home visits using the preSPARK were carried out by 21 nurses. About 24% of the expectant parents needed intensive help or immediate action on one or more topics. The risk assessment showed 29% of the participants were at high risk, 40% at increased risk, and 31% at low risk for future parenting and child developmental problems. The nurses indicated that the preSPARK provides a good structure for home visits and gives insight in interrelated factors. The preSPARK is feasible in daily practice and clarifies risks and care needs of expectant parents.
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Affiliation(s)
| | - Henk F. van Stel
- Julius Centre for Health Sciences and Primary Care, Department of Healthcare Innovation and Evaluation, University Medical Centre Utrecht, 3584 CG Utrecht, The Netherlands
| | - Remy M. Vink
- TNO Innovation for Life, 2316 ZL Leiden, The Netherlands;
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Haviland MJ, Nillni YI, Cabral HJ, Fox MP, Wise LA, Burris HH, Hacker MR. Adverse psychosocial factors in pregnancy and preterm delivery. Paediatr Perinat Epidemiol 2021; 35:519-529. [PMID: 33666948 PMCID: PMC8380636 DOI: 10.1111/ppe.12756] [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: 09/07/2020] [Revised: 01/16/2021] [Accepted: 01/26/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND Mental health symptoms, stress, and low psychosocial resources are associated with preterm delivery. It is unknown if there are groups of women who experience similar patterns of these adverse psychosocial factors during pregnancy and if the risk of preterm delivery differs among these groups. OBJECTIVE To identify groups of women with similar patterns of adverse psychosocial factors during pregnancy and determine whether the risk of preterm delivery differs among these groups. METHODS Spontaneous Prematurity and Epigenetics of the Cervix (SPEC) is a prospective cohort study of pregnant women, aged 18 and older. In this analysis, we included women who enrolled after 24 August 2014 and delivered by 20 January 2019. As women could enrol more than once, our cohort included 774 women with 787 pregnancies. We conducted a latent class analysis to identify groups of women with similar patterns of adverse psychosocial factors during pregnancy based on their responses to measures assessing depression, perceived stress, anxiety (pregnancy-related and generalised), stressful life events, resilience, and social support (partner and friend/family). After identifying the latent classes, we used log-binomial regression to compare the incidence of preterm delivery among the classes. RESULTS The median age among participants was 33.2 years (interquartile range 30.3-36.3), and the majority were non-Hispanic white (56.9%). We identified three classes of adverse psychosocial factors (few, some, and many factors). In total, 63 (8.0%) pregnancies resulted in a preterm delivery. Compared to participants with few factors, the risk of preterm delivery was no different among participants with some (RR 1.23, 95% CI 0.68, 2.25) and many adverse factors (RR 1.62, 95% CI 0.73, 3.62). CONCLUSIONS We identified three groups of pregnant women with similar patterns of adverse psychosocial factors. We did not observe a difference in the risk of preterm delivery among the classes.
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Affiliation(s)
- Miriam J. Haviland
- Department of Epidemiology, Boston University School of Public Health, Boston, MA, USA
| | - Yael I. Nillni
- Department of Psychiatry, Boston University School of Medicine, Boston, MA, USA,National Center for PTSD, Women’s Health Sciences Division at VA Boston Healthcare System, Boston, MA, USA
| | - Howard J. Cabral
- Department of Biostatistics, Boston University School of Public Health, Boston, MA, USA
| | - Matthew P. Fox
- Department of Epidemiology, Boston University School of Public Health, Boston, MA, USA
| | - Lauren A. Wise
- Department of Epidemiology, Boston University School of Public Health, Boston, MA, USA
| | - Heather H Burris
- Division of Neonatology, Department of Pediatrics, Children’s Hospital of Philadelphia, and University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - Michele R. Hacker
- Department of Obstetrics and Gynecology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
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Branquinho M, Rodriguez-Muñoz MDLF, Maia BR, Marques M, Matos M, Osma J, Moreno-Peral P, Conejo-Cerón S, Fonseca A, Vousoura E. Effectiveness of psychological interventions in the treatment of perinatal depression: A systematic review of systematic reviews and meta-analyses. J Affect Disord 2021; 291:294-306. [PMID: 34062397 DOI: 10.1016/j.jad.2021.05.010] [Citation(s) in RCA: 35] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Revised: 04/28/2021] [Accepted: 05/05/2021] [Indexed: 11/17/2022]
Abstract
BACKGROUND Perinatal depression is a high prevalent mental health problem with serious consequences. Evidence about effective psychological interventions in treating perinatal depression has been increasing, but it lacks a comprehensive synthesis of findings. METHODS A systematic review of systematic reviews and meta-analyses concerning the effectiveness of psychological interventions in treating perinatal depression (depression during pregnancy and the first 12 months postpartum) in adult women was conducted. The electronic databases MEDLINE (PubMed), PsycINFO, The Cochrane Library, Web of Science and Prospero were searched, on May 2020, using a combination of keywords. Data were independently extracted by two authors and a synthesis of the results was presented. Methodological quality was independently assessed by two authors, using AMSTAR-2. RESULTS Seven systematic reviews were included and reported, overall, the effectiveness of psychological interventions in decreasing depressive symptoms in women in the perinatal period, both short and long-term. CBT was found to be the most effective intervention, regardless of the treatment format. LIMITATIONS Grey literature was not searched, and some studies may overlap among the included systematic reviews. These (the included reviews) were rated with low methodological quality, which weakens the evidence of the reported results. CONCLUSIONS CBT is currently the most evidence-based psychological intervention, provided in different delivery formats (individual, group, face-to-face or Internet-based). Further studies, including systematic reviews, with other types of psychological interventions (e.g., third-wave CBT) and with higher quality are needed.
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Affiliation(s)
- Mariana Branquinho
- University of Coimbra, Center for Research in Neuropsychology and Cognitive and Behavioral Intervention (CINEICC), Coimbra, Portugal
| | | | - Berta Rodrigues Maia
- Universidade Católica Portuguesa, Faculty of Philosophy and Social Sciences, Centre for Philosophical and Humanistic Studies, Portugal
| | - Mariana Marques
- University of Coimbra, Center for Research in Neuropsychology and Cognitive and Behavioral Intervention (CINEICC), Coimbra, Portugal; Coimbra Hospital and Universitary Centre (CHUC), Portugal; Institute of Psychological Medicine (IPM), Coimbra, Portugal
| | - Marcela Matos
- University of Coimbra, Center for Research in Neuropsychology and Cognitive and Behavioral Intervention (CINEICC), Coimbra, Portugal
| | - Jorge Osma
- Universidad de Zaragoza and Instituto de Investigación Sanitaria de Aragón, Spain
| | | | | | - Ana Fonseca
- University of Coimbra, Center for Research in Neuropsychology and Cognitive and Behavioral Intervention (CINEICC), Coimbra, Portugal
| | - Eleni Vousoura
- Department of Psychiatry, Eginition Hospital, University of Athens, Greece
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