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Chen Y, Künzel RG, Sanchez SE, Rondon MB, Pinto NI, Sanchez E, Kirschbaum C, Valeri L, Koenen KC, Gelaye B. The Association Between Pre-Pregnancy and First-Trimester Hair Cortisol and Preterm Birth: A Causal Inference Model. RESEARCH SQUARE 2024:rs.3.rs-4095921. [PMID: 38746291 PMCID: PMC11092793 DOI: 10.21203/rs.3.rs-4095921/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/16/2024]
Abstract
Background Adverse life events and chronic psychological distress before and during pregnancy have frequently been associated with preterm birth (PTB) but the biological underpinnings remain unclear. We investigated the association between corticosteroid levels in pre-pregnancy and first-trimester hair and the risk of PTB. Methods We followed 1,808 pregnant women from a prospective pre-birth cohort study in Lima, Perú. Hair samples were taken at the end of the first pregnancy trimester. The two most proximal 3cm segments to the scalp (representing pre-pregnancy and first-trimester) were analyzed to obtain hair cortisol and cortisone concentrations (HCC and HCNC). PTB was defined as birth < 37 completed gestational weeks. We constructed four generalized propensity scores for pre-pregnancy and first-trimester HCC and HCNC to create corresponding inverse probability weights before fitting marginal structural models for estimating the effect of HCC and HCNC on PTB risk. Results Pre-pregnancy Log HCC was not independently associated with PTB risk (RR = 0.97; 95%CI: 0.79, 1.19). In contrast, one SD increase from the mean first-trimester Log HCC was independently associated with a 37% (95%CI: 1.11, 1.69) increased risk of PTB. Although imprecise, pre-pregnancy Log HCNC was negatively associated with PTB risk (RR = 0.84; 95%CI: 0.58, 1.20), whereas the association between first-trimester Log HCNC and PTB risk was positive (RR = 1.20; 95%CI: 0.87, 1.65). Conclusions Our findings show that chronic corticosteroid levels in early pregnancy are causally linked to PTB risk in pregnant Peruvian women. This finding contributes to understanding the biological underpinnings of PTB better to enhance PTB prevention.
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Garvik OS, Jølving LR, Lund K, Friedman S, Nørgård BM. Paternal use of selective serotonin reuptake inhibitors and adverse health outcomes: A nationwide cohort study on 13,547 exposed children. Andrology 2024. [PMID: 38639021 DOI: 10.1111/andr.13646] [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: 01/11/2024] [Revised: 02/29/2024] [Accepted: 03/27/2024] [Indexed: 04/20/2024]
Abstract
BACKGROUND The use of selective serotonin reuptake inhibitors (SSRIs) has increased over time. Several studies indicate that paternal use of medication may adversely affect the developing fetus. Only a few studies have investigated the association between preconceptional paternal exposure to SSRIs and the risks of adverse health outcomes in children. OBJECTIVES This study aimed to assess adverse birth outcomes and adverse early life events in children fathered by men using SSRIs prior to conception. MATERIALS AND METHODS All live-born singleton children born in Denmark from 1997 until 2019 and their parents were included. The exposed cohort comprised all children fathered by men using SSRIs 3 months prior to conception and the unexposed cohort comprised all other children. We estimated the odds ratios for adverse birth outcomes: small for gestational age (SGA), preterm birth, low Apgar score, and major congenital malformations. Furthermore, we estimated the hazard ratios for adverse early life events of infections and hospitalizations within 1 year from birth. We also examined adverse birth outcomes and the adverse early life events according to SSRI subgroups. RESULTS There was a statistically significantly increased odds ratio 1.15 (confidence interval, CI: 1.06-1.23) for preterm birth. No significant results were found for SGA, low Apgar score, and major congenital malformations. The adjusted hazard ratios for hospitalizations and infections were 1.06 (CI: 1.02-1.11) and 1.02 (CI: 0.97-1.07), respectively. There was a statistically significantly increased odds ratio for preterm birth with respect to the SSRI subgroups citalopram and escitalopram, and for hospitalizations with respect to citalopram. DISCUSSION AND CONCLUSION Although the risks of certain adverse birth and adverse early life outcomes were statistically significantly increased, the ratios were small and may have limited clinical importance. Paternal use of SSRI was in general safe in the preconceptual period.
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Affiliation(s)
| | - Line Riis Jølving
- Center for Clinical Epidemiology, Odense University Hospital, Odense, Denmark
- Research Unit of Clinical Epidemiology, Department of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - Ken Lund
- Center for Clinical Epidemiology, Odense University Hospital, Odense, Denmark
- Research Unit of Clinical Epidemiology, Department of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - Sonia Friedman
- Center for Clinical Epidemiology, Odense University Hospital, Odense, Denmark
- Gastroenterology Division, Tufts Medical Center, Tufts University School of Medicine, Boston, Massachusetts, USA
| | - Bente Mertz Nørgård
- Center for Clinical Epidemiology, Odense University Hospital, Odense, Denmark
- Research Unit of Clinical Epidemiology, Department of Clinical Research, University of Southern Denmark, Odense, Denmark
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3
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Roy U, Swain D. A prospective cohort study to assess the prevalence and risk factors of antepartum depression and its effect on maternal and fetal outcome. Asian J Psychiatr 2024; 91:103873. [PMID: 38154353 DOI: 10.1016/j.ajp.2023.103873] [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: 10/11/2023] [Revised: 12/11/2023] [Accepted: 12/13/2023] [Indexed: 12/30/2023]
Abstract
Antepartum depression (APD) is a public health issue has negative repercussions on the health of the mother, child, and family. Early screening for APD will help in early detection and further prevention of postpartum depression and adverse maternal and fetal outcomes. This study was designed to determine i) the prevalence rate of APD in the Indian population and its associated risk factors, ii) the impact of APD on maternal and fetal outcomes. A retrospective cohort study was conducted among antenatal women in the third trimester and screened for antepartum depression between October 2021 and March 2022 by adopting the Edinburgh Postnatal Depression Scale (EPDS). In the study population, 36.6 % had mild to moderate level of depressive symptoms (EPDS score of 8-12) and 28 % had high levels of depressive symptoms (EPDS score of ≥13). An unplanned pregnancy, a history of abortion, and a history of any pregnancy complications were the likely maternal risk factors for developing antepartum depression. The APD risk was also likely to be increased by sociodemographic and personal factors such as insufficient family support, a history of domestic violence, marital dissatisfaction, and a partner with a poor level of education (P < 0.05). Women screened with antepartum depression had 58.34 times the likelihood of developing postpartum depression and a threefold greater risk of having premature delivery. These findings may help to improve pregnancy outcomes by early identification, referral for early treatment of antepartum depression, also inform maternal mental health service development and utilization for boosting women's mental wellbeing.
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Affiliation(s)
- Ushma Roy
- College of Nursing, AIIMS Bhubaneswar, Odisha, India
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Drzymalla E, Crider KS, Wang A, Marta G, Khoury MJ, Rasooly D. Epigenome-wide association studies of prenatal maternal mental health and infant epigenetic profiles: a systematic review. Transl Psychiatry 2023; 13:377. [PMID: 38062042 PMCID: PMC10703876 DOI: 10.1038/s41398-023-02620-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Revised: 10/01/2023] [Accepted: 10/06/2023] [Indexed: 12/18/2023] Open
Abstract
Prenatal stress and poor maternal mental health are associated with adverse offspring outcomes; however, the biological mechanisms are unknown. Epigenetic modification has linked maternal health with offspring development. Epigenome-wide association studies (EWAS) have examined offspring DNA methylation profiles for association with prenatal maternal mental health to elucidate mechanisms of these complex relationships. The objective of this study is to provide a comprehensive, systematic review of EWASs of infant epigenetic profiles and prenatal maternal anxiety, depression, or depression treatment. We conducted a systematic literature search following PRISMA guidelines for EWAS studies between prenatal maternal mental health and infant epigenetics through May 22, 2023. Of 645 identified articles, 20 fulfilled inclusion criteria. We assessed replication of CpG sites among studies, conducted gene enrichment analysis, and evaluated the articles for quality and risk of bias. We found one repeated CpG site among the maternal depression studies; however, nine pairs of overlapping differentially methylatd regions were reported in at least two maternal depression studies. Gene enrichment analysis found significant pathways for maternal depression but not for any other maternal mental health category. We found evidence that these EWAS present a medium to high risk of bias. Exposure to prenatal maternal depression and anxiety or treatment for such was not consistently associated with epigenetic changes in infants in this systematic review and meta-analysis. Small sample size, potential bias due to exposure misclassification and statistical challenges are critical to address in future efforts to explore epigenetic modification as a potential mechanism by which prenatal exposure to maternal mental health disorders leads to adverse infant outcomes.
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Affiliation(s)
- Emily Drzymalla
- Division of Blood Disorders and Public Health Genomics, National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA, USA.
| | - Krista S Crider
- Infant Outcomes Research and Prevention Branch, Division of Birth Defects and Infant Disorders, National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Arick Wang
- Infant Outcomes Research and Prevention Branch, Division of Birth Defects and Infant Disorders, National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | | | - Muin J Khoury
- Division of Blood Disorders and Public Health Genomics, National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Danielle Rasooly
- Division of Blood Disorders and Public Health Genomics, National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA, USA
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Sigmund D, Loew V, Pawils S. Engaging Parents Affected by Mental Health Problems in Pediatric and Gynecologic Practices-Implications of the KID-PROTEKT Study. CHILDREN (BASEL, SWITZERLAND) 2023; 10:1853. [PMID: 38136055 PMCID: PMC10741721 DOI: 10.3390/children10121853] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Revised: 11/08/2023] [Accepted: 11/23/2023] [Indexed: 12/24/2023]
Abstract
Children of parents with mental illness are at higher risk of developing cognitive, mental health or physical health difficulties. Previous studies have described several barriers for reaching parents with mental health problems (MHPs) and their utilization of psychosocial services. We conducted a cluster randomized controlled study in 24 pediatric and gynecologic practices to evaluate KID-PROTEKT, a psychosocial healthcare intervention that comprises a psychosocial assessment to identify families with psychosocial needs and refer them to support services. In this paper, we analyzed whether psychosocially distressed parents with additional MHPs (identified by the PHQ-9 and GAD-7) had higher support needs, could be referred to support and utilized it in comparison to parents with psychosocial burden only. In total, 178 pregnant women and mothers with psychosocial burden were included, of whom 55 had MHPs. Participants with MHPs were distressed in their relationships more often and medical staff rated their level of support needs higher compared to parents without MHPs. There were no significant differences between the groups regarding whether they were referred to support services or utilized the recommended services. All participants were most frequently referred to family or parent counseling/care or childcare assistance. The results indicate that despite existing barriers, parents with MHPs could be reached and identified by the KID-PROTEKT psychosocial assessment. A psychosocial intervention like KID-PROTEKT can help to provide support for mentally ill parents.
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Affiliation(s)
| | | | - Silke Pawils
- Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20246 Hamburg, Germany; (D.S.); (V.L.)
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Bartashevskyy M, Pan X, Senthil Kumar V, Wen X. Partner-Support and Gestational Duration Among Pregnant Women Who Smoke. Matern Child Health J 2023; 27:1713-1718. [PMID: 37306820 DOI: 10.1007/s10995-023-03729-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: 05/22/2023] [Indexed: 06/13/2023]
Abstract
INTRODUCTION Pregnant women who smoke are at a high risk of preterm birth (PTB) and have low partner-support. In a prospective cohort study, we aimed to examine the role of partner-support in gestational duration and PTB among pregnant women who smoke as well as the interaction with race/ethnicity. METHODS We analyzed secondary data of 53 participants from the University at Buffalo Pregnancy and Smoking Cessation Study. Partner-support was measured with Turner's support scale where women reported how much they agreed with five statements about how supportive their partner was. Total partner-support was calculated and split into emotional support and accountability. We fit multivariable linear regression models and log-binomial regression models for gestational duration and PTB, respectively. RESULTS Gestational duration significantly increased with partner-support (0.22 weeks longer per unit increment in partner-support score), emotional support (0.52 weeks), and accountability (0.35 weeks). This association tended to be stronger among Hispanics and women of other races than non-Hispanic Caucasians and African Americans. Women with a bed partner had 1.48 weeks longer gestational duration than women without a bed partner. DISCUSSION Partner-support may increase gestational duration and reduce PTB risk among pregnant women who smoke, especially among Hispanic women. Sharing a bed with a partner was associated with a longer gestational duration. Our findings may be interpreted with caution due to limitations such as small sample size, recruitment within a single metropolitan area, and partner-support measurement via maternal reports only. A partner-support intervention to increase gestational duration is warranted.
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Affiliation(s)
- Maksym Bartashevskyy
- Division of Behavioral Medicine, Department of Pediatrics, Jacobs School of Medicine and Biomedical Sciences, State University of New York at Buffalo, Buffalo, NY, 14214, USA
| | - Xin Pan
- Division of Behavioral Medicine, Department of Pediatrics, Jacobs School of Medicine and Biomedical Sciences, State University of New York at Buffalo, Buffalo, NY, 14214, USA
| | - Vaishnavi Senthil Kumar
- Division of Behavioral Medicine, Department of Pediatrics, Jacobs School of Medicine and Biomedical Sciences, State University of New York at Buffalo, Buffalo, NY, 14214, USA
- Department of Biology, Canisius College, Buffalo, NY, 14208, USA
| | - Xiaozhong Wen
- Division of Behavioral Medicine, Department of Pediatrics, Jacobs School of Medicine and Biomedical Sciences, State University of New York at Buffalo, Buffalo, NY, 14214, USA.
- Division of Behavioral Medicine, Department of Pediatrics, Jacobs School of Medicine and Biomedical Sciences, State University of New York at Buffalo, 3435 Main St., G56 Farber Hall, Buffalo, NY, 14214-3000, USA.
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Noroña-Zhou AN, Ashby BD, Richardson G, Ehmer A, Scott SM, Dardar S, Marshall L, Talmi A. Rates of Preterm Birth and Low Birth Weight in an Adolescent Obstetric Clinic: Achieving Health Equity Through Trauma-Informed Care. Health Equity 2023; 7:562-569. [PMID: 37731783 PMCID: PMC10507928 DOI: 10.1089/heq.2023.0075] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/06/2023] [Indexed: 09/22/2023] Open
Abstract
Objectives Adolescents who are pregnant and identify as Black are exposed to more societal harms that increase their and their offspring's risk for poor health outcomes. The Colorado Adolescent Maternity Program (CAMP) offers comprehensive, multidisciplinary (medical, behavioral health, nutrition, case management), trauma-informed obstetric care to pregnant adolescents to ensure the healthiest pregnancy and birth possible and pursue health equity. The present study aimed to examine ethnic and racial disparities in preterm birth and low birth weight before and after implementation of a trauma-informed model of care. Methods Participants were 847 pregnant adolescents (ages 12-22 years; 41% self-identified as Hispanic, 32% as non-Hispanic Black, 21% as non-Hispanic white) who received prenatal treatment-as-usual (TAU) or trauma-informed treatment. Demographic information, mental health symptoms, and birth outcomes were abstracted from medical records. Results Overall, findings provided support that implementation of a trauma-informed model of prenatal care led to equitable birth outcomes across racial and ethnic groups. Specifically, Black adolescents in the TAU group were more than twice as likely to deliver preterm or low birth weight infants compared with white and Hispanic adolescents. In the trauma-informed group, however, there were no statistical differences in birth outcomes across racial/ethnic groups, indicating an elimination of disparities in both preterm birth and low birth weight in this population. These more equitable birth outcomes occurred even in the context of adolescents of color having reported more severe depression symptoms postimplementation. Conclusions These findings provide evidence that a health system-level intervention, herein trauma-informed obstetric care for adolescents, can play a meaningful role in the reduction of racial disparities in birth outcomes.
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Affiliation(s)
- Amanda N. Noroña-Zhou
- Department of Psychiatry and Behavioral Sciences, Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, California, USA
- Department of Pediatrics, University of California, San Francisco, San Francisco, California, USA
- Department of Psychiatry, University of Colorado School of Medicine, Aurora, Colorado, USA
- Children's Hospital Colorado, Aurora, Colorado, USA
| | - Bethany D. Ashby
- Department of Psychiatry, University of Colorado School of Medicine, Aurora, Colorado, USA
- Children's Hospital Colorado, Aurora, Colorado, USA
- Department of Ob/Gyn, University of Colorado School of Medicine, Aurora, Colorado, USA
| | - Georgette Richardson
- Children's Hospital Colorado, Aurora, Colorado, USA
- Department of Psychological Health and Learning Sciences, College of Education, University of Houston, Houston, Texas, USA
| | - Amelia Ehmer
- Department of Psychiatry, University of Colorado School of Medicine, Aurora, Colorado, USA
- Children's Hospital Colorado, Aurora, Colorado, USA
- Department of Ob/Gyn, University of Colorado School of Medicine, Aurora, Colorado, USA
- Department of Pediatrics, University of Colorado School of Medicine, Aurora, Colorado, USA
| | - Stephen M. Scott
- Children's Hospital Colorado, Aurora, Colorado, USA
- Department of Ob/Gyn, University of Colorado School of Medicine, Aurora, Colorado, USA
- Department of Pediatrics, University of Colorado School of Medicine, Aurora, Colorado, USA
| | - Shaleah Dardar
- Department of Pediatrics, University of Colorado School of Medicine, Aurora, Colorado, USA
| | - Ladean Marshall
- Children's Hospital Colorado, Aurora, Colorado, USA
- Department of Ob/Gyn, University of Colorado School of Medicine, Aurora, Colorado, USA
- Department of Pediatrics, University of Colorado School of Medicine, Aurora, Colorado, USA
| | - Ayelet Talmi
- Department of Psychiatry, University of Colorado School of Medicine, Aurora, Colorado, USA
- Children's Hospital Colorado, Aurora, Colorado, USA
- Department of Pediatrics, University of Colorado School of Medicine, Aurora, Colorado, USA
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8
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Yin W, Ludvigsson JF, Åden U, Risnes K, Persson M, Reichenberg A, Silverman ME, Kajantie E, Sandin S. Paternal and maternal psychiatric history and risk of preterm and early term birth: A nationwide study using Swedish registers. PLoS Med 2023; 20:e1004256. [PMID: 37471291 PMCID: PMC10358938 DOI: 10.1371/journal.pmed.1004256] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Accepted: 06/01/2023] [Indexed: 07/22/2023] Open
Abstract
BACKGROUND Women with psychiatric diagnoses are at increased risk of preterm birth (PTB), with potential life-long impact on offspring health. Less is known about the risk of PTB in offspring of fathers with psychiatric diagnoses, and for couples where both parents were diagnosed. In a nationwide birth cohort, we examined the association between psychiatric history in fathers, mothers, and both parents and gestational age. METHODS AND FINDINGS We included all infants live-born to Nordic parents in 1997 to 2016 in Sweden. Psychiatric diagnoses were obtained from the National Patient Register. Data on gestational age were retrieved from the Medical Birth Register. Associations between parental psychiatric history and PTB were quantified by relative risk (RR) and two-sided 95% confidence intervals (CIs) from log-binomial regressions, by psychiatric disorders overall and by diagnostic categories. We extended the analysis beyond PTB by calculating risks over the whole distribution of gestational age, including "early term" (37 to 38 weeks). Among the 1,488,920 infants born throughout the study period, 1,268,507 were born to parents without a psychiatric diagnosis, of whom 73,094 (5.8%) were born preterm. 4,597 of 73,500 (6.3%) infants were born preterm to fathers with a psychiatric diagnosis, 8,917 of 122,611 (7.3%) infants were born preterm to mothers with a pscyhiatric diagnosis, and 2,026 of 24,302 (8.3%) infants were born preterm to both parents with a pscyhiatric diagnosis. We observed a shift towards earlier gestational age in offspring of parents with psychiatric history. The risks of PTB associated with paternal and maternal psychiatric diagnoses were similar for different psychiatric disorders. The risks for PTB were estimated at RR 1.12 (95% CI [1.08, 1.15] p < 0.001) for paternal diagnoses, at RR 1.31 (95% CI [1.28, 1.34] p < 0.001) for maternal diagnoses, and at RR 1.52 (95% CI [1.46, 1.59] p < 0.001) when both parents were diagnosed with any psychiatric disorder, compared to when neither parent had a psychiatric diagnosis. Stress-related disorders were associated with the highest risks of PTB with corresponding RRs estimated at 1.23 (95% CI [1.16, 1.31] p < 0.001) for a psychiatry history in fathers, at 1.47 (95% CI [1.42, 1.53] p < 0.001) for mothers, and at 1.90 (95% CI [1.64, 2.20] p < 0.001) for both parents. The risks for early term were similar to PTB. Co-occurring diagnoses from different diagnostic categories increased risk; for fathers: RR 1.10 (95% CI [1.07, 1.13] p < 0.001), 1.15 (95% CI [1.09, 1.21] p < 0.001), and 1.33 (95% CI [1.23, 1.43] p < 0.001), for diagnoses in 1, 2, and ≥3 categories; for mothers: RR 1.25 (95% CI [1.22, 1.28] p < 0.001), 1.39 (95% CI [1.34, 1.44] p < 0.001) and 1.65 (95% CI [1.56, 1.74] p < 0.001). Despite the large sample size, statistical precision was limited in subgroups, mainly where both parents had specific psychiatric subtypes. Pathophysiology and genetics underlying different psychiatric diagnoses can be heterogeneous. CONCLUSIONS Paternal and maternal psychiatric history were associated with a shift to earlier gestational age and increased risk of births before full term. The risk consistently increased when fathers had a positive history of different psychiatric disorders, increased further when mothers were diagnosed and was highest when both parents were diagnosed.
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Affiliation(s)
- Weiyao Yin
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
- Department of Obstetrics and Gynecology, West China Second University Hospital, Sichuan University, Chengdu, China
| | - Jonas F Ludvigsson
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
- Department of Pediatrics, Örebro University Hospital, Örebro, Sweden
| | - Ulrika Åden
- Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden
- Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden
| | - Kari Risnes
- Department of Clinical and Molecular Medicine, NTNU, Trondheim, Norway
- Children's Clinic, St Olav University Hospital, Trondheim, Norway
| | - Martina Persson
- Department of Medicine, Clinical Epidemiological Unit, Karolinska Institutet, Stockholm, Sweden
- Department of Clinical Science and Education, Division of Pediatrics, Karolinska Institutet, Stockholm, Sweden
- Sachsska Childrens' and Youth Hospital, Stockholm, Sweden
| | - Abraham Reichenberg
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, New York, United States of America
- Seaver Center for Autism Research and Treatment, Icahn School of Medicine at Mount Sinai, New York, New York, United States of America
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, New York, United States of America
| | - Michael E Silverman
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, New York, United States of America
| | - Eero Kajantie
- Department of Clinical and Molecular Medicine, NTNU, Trondheim, Norway
- Population Health Unit, Finnish Institute for Health and Welfare, Helsinki and Oulu, Finland
- Clinical Medicine Research Unit, MRC Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
| | - Sven Sandin
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, New York, United States of America
- Seaver Center for Autism Research and Treatment, Icahn School of Medicine at Mount Sinai, New York, New York, United States of America
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Guillen-Burgos HF, Galvez-Florez JF, Miranda J, Hincapie-Porras C, Perez-Olivo JL, Piraquive-Caicedo JP, Becerra-Mojica CH, Parra-Ardila SX, Parra-Saavedra MA. Pregnancy and mental health outcomes during the COVID-19 pandemic in Colombia: A nationwide cross-sectional study. JOURNAL OF AFFECTIVE DISORDERS REPORTS 2023; 12:100488. [PMID: 36718157 PMCID: PMC9877320 DOI: 10.1016/j.jadr.2023.100488] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2022] [Revised: 01/19/2023] [Accepted: 01/25/2023] [Indexed: 01/27/2023] Open
Affiliation(s)
- Hernan Felipe Guillen-Burgos
- Center for Clinical and Translational Research, La Misericordia Clínica Internacional, Barranquilla, Colombia.,School of Health Sciences, Universidad Simon Bolivar, Barranquilla, Colombia.,Instituto Cardiovascular del Cesar, Valledupar, Atlántico
| | - Juan Francisco Galvez-Florez
- Center for Clinical and Translational Research, La Misericordia Clínica Internacional, Barranquilla, Colombia.,Latin American Society of Consultation-Liaison Psychiatry, Bogota, Colombia
| | - Jezid Miranda
- Department of Obstetrics and Gynecology, School of Medicine, Grupo de Investigación en Cuidado Intensivo y Obstetricia (GRICIO), Universidad de Cartagena, Cartagena de Indias, Bolívar, Colombia.,Department of Maternal-Fetal Medicine, Centro Hospitalario Serena del Mar, Cartagena de Indias, Bolívar, Colombia
| | - Cristian Hincapie-Porras
- Department of Obstetrics and Gynecology, Hospital Universitario San Jorge, Pereira, Risaralda, Colombia
| | - Jose L Perez-Olivo
- Department of Obstetrics and Gynecology, Clínica La Ermita, Cartagena de Indias, Colombia
| | | | - Carlos H Becerra-Mojica
- Centro de Atención Maternofetal INUTERO, Clínica Carlos Ardila Lulle, Bucaramanga, Santander, Colombia.,Department of Obstetrics and Gynecology, School of Medicine, Universidad Industrial de Santander. Bucaramanga, Santander, Colombia
| | - Sonia X Parra-Ardila
- Instituto de Cirugía y Terapia Fetal del Caribe, Barranquilla, Atlántico, Colombia
| | - Miguel A Parra-Saavedra
- School of Health Sciences, Universidad Simon Bolivar, Barranquilla, Colombia.,Instituto de Cirugía y Terapia Fetal del Caribe, Barranquilla, Atlántico, Colombia
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10
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Song IS, Choi ES, Kim ES, Hwang Y, Lee KS, Ahn KH. Associations of Preterm Birth with Dental and Gastrointestinal Diseases: Machine Learning Analysis Using National Health Insurance Data. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:1732. [PMID: 36767099 PMCID: PMC9914760 DOI: 10.3390/ijerph20031732] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/27/2022] [Revised: 01/15/2023] [Accepted: 01/16/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND This study uses machine learning with large-scale population data to assess the associations of preterm birth (PTB) with dental and gastrointestinal diseases. METHODS Population-based retrospective cohort data came from Korea National Health Insurance claims for 124,606 primiparous women aged 25-40 and delivered in 2017. The 186 independent variables included demographic/socioeconomic determinants, disease information, and medication history. Machine learning analysis was used to establish the prediction model of PTB. Random forest variable importance was used for identifying major determinants of PTB and testing its associations with dental and gastrointestinal diseases, medication history, and socioeconomic status. RESULTS The random forest with oversampling data registered an accuracy of 84.03, and the areas under the receiver-operating-characteristic curves with the range of 84.03-84.04. Based on random forest variable importance with oversampling data, PTB has strong associations with socioeconomic status (0.284), age (0.214), year 2014 gastroesophageal reflux disease (GERD) (0.026), year 2015 GERD (0.026), year 2013 GERD (0.024), progesterone (0.024), year 2012 GERD (0.023), year 2011 GERD (0.021), tricyclic antidepressant (0.020) and year 2016 infertility (0.019). For example, the accuracy of the model will decrease by 28.4%, 2.6%, or 1.9% if the values of socioeconomic status, year 2014 GERD, or year 2016 infertility are randomly permutated (or shuffled). CONCLUSION By using machine learning, we established a valid prediction model for PTB. PTB has strong associations with GERD and infertility. Pregnant women need close surveillance for gastrointestinal and obstetric risks at the same time.
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Affiliation(s)
- In-Seok Song
- Department of Oral and Maxillofacial Surgery, Korea University College of Medicine, Korea University Anam Hospital, Seoul 02841, Republic of Korea
| | - Eun-Saem Choi
- Department of Obstetrics and Gynecology, Korea University College of Medicine, Korea University Anam Hospital, Seoul 02841, Republic of Korea
| | - Eun Sun Kim
- Department of Gastroenterology, Korea University College of Medicine, Korea University Anam Hospital, Seoul 02841, Republic of Korea
| | - Yujin Hwang
- Department of Statistics, Korea University College of Political Science & Economics, Korea University Anam Hospital, Seoul 02841, Republic of Korea
| | - Kwang-Sig Lee
- AI Center, Korea University College of Medicine, Korea University Anam Hospital, Seoul 02841, Republic of Korea
| | - Ki Hoon Ahn
- Department of Obstetrics and Gynecology, Korea University College of Medicine, Korea University Anam Hospital, Seoul 02841, Republic of Korea
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Concepcion T, Velloza J, Kemp CG, Bhat A, Bennett IM, Rao D, Polyak CS, Ake JA, Esber A, Dear N, Maswai J, Owuoth J, Sing'oei V, Bahemana E, Iroezindu M, Kibuuka H, Collins PY. Perinatal Depressive Symptoms and Viral Non-suppression Among a Prospective Cohort of Pregnant Women Living with HIV in Nigeria, Kenya, Uganda, and Tanzania. AIDS Behav 2023; 27:783-795. [PMID: 36210392 PMCID: PMC9944362 DOI: 10.1007/s10461-022-03810-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/02/2022] [Indexed: 12/14/2022]
Abstract
Depression is common during pregnancy and is associated with reduced adherence to HIV-related care, though little is known about perinatal trajectories of depression and viral suppression among women living with HIV (WLHV) in sub-Saharan Africa. We sought to assess any association between perinatal depressive symptoms and viral non-suppression among WLWH. Depressive symptomatology and viral load data were collected every 6 months from WLWH enrolled in the African Cohort Study (AFRICOS; January 2013-February 2020). Generalized estimating equations modeled associations between depressive symptoms [Center for Epidemiological Studies Depression (CES-D) ≥ 16] and viral non-suppression. Of 1722 WLWH, 248 (14.4%) had at least one pregnancy (291 total) and for 61 pregnancies (21.0%), women reported depressive symptoms (13.4% pre-conception, 7.6% pregnancy, 5.5% one-year postpartum). Depressive symptomatology was associated with increased odds of viral non-suppression (aOR 2.2; 95% CI 1.2-4.0, p = 0.011). Identification and treatment of depression among women with HIV may improve HIV outcomes for mothers.
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Affiliation(s)
- Tessa Concepcion
- Department of Global Health, University of Washington, Seattle, WA, USA
| | - Jennifer Velloza
- Department of Epidemiology & Biostatistics, University of California San Francisco, San Francisco, CA, USA
| | - Christopher G Kemp
- Department of International Health, Johns Hopkins University, Baltimore, MD, USA
| | - Amritha Bhat
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA, USA
| | - Ian M Bennett
- Department of Global Health, University of Washington, Seattle, WA, USA
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA, USA
- Department of Family Medicine, University of Washington, Seattle, WA, USA
| | - Deepa Rao
- Department of Global Health, University of Washington, Seattle, WA, USA
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA, USA
| | - Christina S Polyak
- U.S. Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, MD, USA
- Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc., Bethesda, MD, USA
| | - Julie A Ake
- U.S. Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, MD, USA
| | - Allahna Esber
- U.S. Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, MD, USA
- Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc., Bethesda, MD, USA
| | - Nicole Dear
- U.S. Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, MD, USA
- Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc., Bethesda, MD, USA
| | - Jonah Maswai
- U.S. Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, MD, USA
- US Army Medical Research Directorate-Africa, Kericho, Kenya
| | - John Owuoth
- U.S. Army Medical Research Directorate-Africa, Kisumu, Kenya
- HJF Medical Research International, Kisumu, Kenya
| | - Valentine Sing'oei
- U.S. Army Medical Research Directorate-Africa, Kisumu, Kenya
- HJF Medical Research International, Kisumu, Kenya
| | - Emmanuel Bahemana
- U.S. Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, MD, USA
- HJF Medical Research International, Mbeya, Tanzania
| | - Michael Iroezindu
- U.S. Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, MD, USA
- HJF Medical Research International, Abuja, Nigeria
| | - Hannah Kibuuka
- Makerere University Walter Reed Project, Kampala, Uganda
| | - Pamela Y Collins
- Department of Global Health, University of Washington, Seattle, WA, USA.
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA, USA.
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12
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Kern A, Khoury B, Frederickson A, Langevin R. The associations between childhood maltreatment and pregnancy complications: A systematic review and meta-analysis. J Psychosom Res 2022; 160:110985. [PMID: 35816769 DOI: 10.1016/j.jpsychores.2022.110985] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2022] [Revised: 04/28/2022] [Accepted: 06/28/2022] [Indexed: 11/19/2022]
Abstract
INTRODUCTION Childhood maltreatment is associated with pregnancy complications. This study aimed to systematically review and quantitatively synthesize the strength of the associations between maternal histories of childhood maltreatment and the risk of preterm delivery, low birth weight, and gestational diabetes. METHODS Subject Headings and keywords for childhood maltreatment and the pregnancy outcomes were searched in MEDLINE (Ovid; 1946-Present), PsycINFO (Ovid; 1806-Present), and Web of Science Core Collection. Original studies or dissertations that reported quantitative associations between childhood maltreatment and any of the pregnancy outcomes of interest were included. Two independent reviewers selected the pertinent studies, assessed the risk of bias, and extracted data. Pooled effect sizes were calculated for the three outcomes. RESULTS Twenty-eight studies were reviewed and 22 were meta-analysed. Maternal childhood maltreatment was associated with preterm birth (OR = 1.27 95% CI: 1.06-1.52, p = 0.001), low birth weight (OR = 1.42 95% CI: 1.10-1.83, p = 0.001), and gestational diabetes (RR = 1.37 95% CI: 1.02-1.83, p = 0.030), however high levels of heterogeneity were found. Findings were insignificant for studies examining gestational age and birth weight as continuous variables. DISCUSSION Findings confirm that under certain conditions, childhood maltreatment is associated with pregnancy outcomes. Future research should prioritize mediation and moderation models to clarify the mechanisms underlying these relationships. Trauma-informed care is needed to tailor the appropriate care for expecting mothers.
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Affiliation(s)
- Audrey Kern
- Department of Educational and Counselling Psychology, McGill University, 3700 McTavish St, Montreal, Quebec H3A 1Y2, Canada
| | - Bassam Khoury
- Department of Educational and Counselling Psychology, McGill University, 3700 McTavish St, Montreal, Quebec H3A 1Y2, Canada
| | - Alesha Frederickson
- Department of Educational and Counselling Psychology, McGill University, 3700 McTavish St, Montreal, Quebec H3A 1Y2, Canada
| | - Rachel Langevin
- Department of Educational and Counselling Psychology, McGill University, 3700 McTavish St, Montreal, Quebec H3A 1Y2, Canada.
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Kim EG, Park SK, Nho JH. Associated factors of depression in pregnant women in Korea based on the 2019 Korean Community Health Survey: a cross-sectional study. KOREAN JOURNAL OF WOMEN HEALTH NURSING 2022; 28:38-45. [PMID: 36312040 PMCID: PMC9334204 DOI: 10.4069/kjwhn.2022.02.03.1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2021] [Revised: 01/30/2022] [Accepted: 02/03/2022] [Indexed: 11/22/2022] Open
Abstract
Purpose Various individual and social factors influence depression in pregnant women. The purpose of this study was to identify the influence of socioeconomic status, health behaviors, and health status on depression of pregnant women in Korea. Methods This study analyzed data from the 2019 Korean Community Health Survey conducted from August to October 2019. A structural questionnaire with Patient Health Quetsionnaire-9 (PHQ-9), health behavior, health status, and psychological characteristics was used. The data of 1,096 pregnant women between the ages of 19 and 55 years were analyzed using descriptive statistics, independent-test and chi-square tests, and multiple regression. Results The mean score of prenatal depression as measured by the PHQ-9 during pregnancy was 2.35 points out of 0 to 27 points. Low income (B=0.69, p<.001), low-education level (B=0.70, p<.001), skipping breakfast (B=0.34, p=.001), less than 8 hours of sleeping (B=0.26, p=.009), binge drinking during pregnancy (B=0.46, p=.001), and stress (B=1.89, p<.001) were significantly associated with increased depression scores. In contrast, depression scores significantly decreased as subjective health status (B=-0.59, p<.001) and subjective oral health status (B=-.17, p=.003) increased. Conclusion Findings support the need for healthcare policies and clinical screening to alleviate prenatal depression, especially for pregnant women with low socioeconomic status, poor health behavior, poor health status, and high stress.
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Affiliation(s)
- Eun Gyeong Kim
- Department of Nursing, Kunsan National University, Gunsan, Korea
| | - Sook Kyoung Park
- College of Nursing, Research Institute of Nursing Science, Jeonbuk National University, Jeonju, Korea
| | - Ju-Hee Nho
- College of Nursing, Research Institute of Nursing Science, Jeonbuk National University, Jeonju, Korea
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14
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Eick SM, Goin DE, Cushing L, DeMicco E, Smith S, Park JS, Padula AM, Woodruff TJ, Morello-Frosch R. Joint effects of prenatal exposure to per- and poly-fluoroalkyl substances and psychosocial stressors on corticotropin-releasing hormone during pregnancy. JOURNAL OF EXPOSURE SCIENCE & ENVIRONMENTAL EPIDEMIOLOGY 2022; 32:27-36. [PMID: 33824413 PMCID: PMC8492777 DOI: 10.1038/s41370-021-00322-8] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/03/2020] [Revised: 02/26/2021] [Accepted: 03/18/2021] [Indexed: 05/05/2023]
Abstract
BACKGROUND Prenatal exposure to per- and poly-fluoroalkyl substances (PFAS) and psychosocial stressors has been associated with adverse pregnancy outcomes, including preterm birth. Previous studies have suggested that joint exposure to environmental chemical and social stressors may be contributing to disparities observed in preterm birth. Elevated corticotropin-releasing hormone (CRH) during mid-gestation may represent one biologic mechanism linking chemical and nonchemical stress exposures to preterm birth. METHODS Using data from a prospective birth cohort (N = 497), we examined the cross-sectional associations between five individual PFAS (ng/mL; PFNA, PFOA, PFOS, PFHxS, and Me-PFOSA-AcOH) and CRH (pg/mL) using linear regression. PFAS and CRH were measured during the second trimester in serum and plasma, respectively. Coefficients were standardized to reflect change in CRH associated with an interquartile range (IQR) increase in natural log-transformed PFAS. We additionally examined if the relationship between PFAS and CRH was modified by psychosocial stress using stratified models. Self-reported depression, stressful life events, perceived stress, food insecurity, and financial strain were assessed using validated questionnaires during the second trimester and included as binary indicators of psychosocial stress. RESULTS An IQR increase in PFNA was associated with elevated CRH (β = 5.17, 95% confidence interval [CI] = 1.79, 8.55). Increased concentrations of PFOA were also moderately associated with CRH (β = 3.62, 95% CI = -0.42, 7.66). The relationship between PFNA and CRH was stronger among women who experienced stressful life events, depression, food insecurity, and financial strain compared to women who did not experience these stressors. CONCLUSIONS This cross-sectional study is the first to examine the relationship between PFAS exposure and CRH levels in mid-gestation. We found that these associations were stronger among women who experienced stress, which aligns with previous findings that chemical and nonchemical stressor exposures can have joint effects on health outcomes.
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Affiliation(s)
- Stephanie M Eick
- Program on Reproductive Health and the Environment, Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco, San Francisco, CA, USA.
| | - Dana E Goin
- Program on Reproductive Health and the Environment, Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco, San Francisco, CA, USA
| | - Lara Cushing
- Department of Environmental Health Sciences, Fielding School of Public Health, University of California, Los Angeles, Los Angeles, CA, USA
| | - Erin DeMicco
- Program on Reproductive Health and the Environment, Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco, San Francisco, CA, USA
| | - Sabrina Smith
- Environmental Chemistry Laboratory, Department of Toxic Substances Control, California Environmental Protection Agency, Berkeley, CA, USA
| | - June-Soo Park
- Environmental Chemistry Laboratory, Department of Toxic Substances Control, California Environmental Protection Agency, Berkeley, CA, USA
| | - Amy M Padula
- Program on Reproductive Health and the Environment, Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco, San Francisco, CA, USA
| | - Tracey J Woodruff
- Program on Reproductive Health and the Environment, Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco, San Francisco, CA, USA
| | - Rachel Morello-Frosch
- Program on Reproductive Health and the Environment, Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco, San Francisco, CA, USA.
- Department of Environmental Science, Policy and Management and School of Public Health, University of California, Berkeley, Berkeley, CA, USA.
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15
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Craig F, Gioia MC, Muggeo V, Cajiao J, Aloi A, Martino I, Tenuta F, Cerasa A, Costabile A. Effects of maternal psychological distress and perception of COVID-19 on prenatal attachment in a large sample of Italian pregnant women. J Affect Disord 2021; 295:665-672. [PMID: 34509782 PMCID: PMC8428478 DOI: 10.1016/j.jad.2021.08.102] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2021] [Revised: 07/21/2021] [Accepted: 08/28/2021] [Indexed: 12/23/2022]
Abstract
BACKGROUND Evidence concerning the impact of COVID-19-related stress exposure on prenatal attachment in pregnant women is unknown. In this study we sought to assess the effect of psychological distress and risk perception of COVID-19 on prenatal attachment in a Italian sample of pregnant women. METHODS 1179 pregnant women completed an anonymous online survey and self-report questionnaires measuring socio-demographic and obstetric characteristics, psychological distress (STAI Form Y-1-2 and BDI-II), prenatal attachment (PAI) and risk perception of COVID-19. Data were collected from March 2020 to April 2020 referring to the national lockdown period. RESULTS After adjusting for the socio-demographic and obstetric factors in the multivariable analysis, we found out the state anxiety was shown to be a significant predictor (p < 0001) of prenatal attachment. Moreover, the COVID-19-risk perception positively moderate the relationship between trait anxiety and prenatal attachment (p=0008), indicating that when COVID-19-risk perception is high, the effects of trait anxiety on prenatal attachment is attenuated. The synergistic effect between STAI Form Y-1 and COVID-19-risk perception index on PAI is partially mediated by STAI Form Y-2 score. CONCLUSIONS Findings from this study showed that state anxiety related to COVID-19 outbreak in pregnant women may affect the prenatal attachment process of the expectant mother negatively. However, an adequate and functional perception of COVID-19 could enhance prenatal attachment. These results underline the importance of monitoring the prenatal attachment process and the mother's mental health during pandemics, to safeguard maternal and infant mental health.
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Affiliation(s)
- Francesco Craig
- Department of Cultures, Education and Society, University of Calabria, Cosenza, Italy
| | - Maria Cecilia Gioia
- iGreco Ospedali Riuniti - Sacro Cuore Corso Italia, 50, 87100 Cosenza CS; Associazione di Volontariato Mammachemamme, Cosenza, Italy.
| | - Vito Muggeo
- Department of Economics, Business and Statistics, University of Palermo, Palermo, Italy
| | - Juanita Cajiao
- Faculty of Medicine Universitat de Barcelona, Barcelona, Spain,Grupo de Investigación en Salud, Fundación Universitaria CAFAM, Colombia
| | - Alessia Aloi
- Associazione di Volontariato Mammachemamme, Cosenza, Italy
| | - Iolanda Martino
- Department of Medical and Surgical Sciences, Institutes of Neurology, Magna Græcia University of Catanzaro, Catanzaro, Italy
| | - Flaviana Tenuta
- Department of Cultures, Education and Society, University of Calabria, Cosenza, Italy
| | - Antonio Cerasa
- Institute for Biomedical Research and Innovation, National Research Council (IRIB-CNR), 98164, Messina, Italy,S’Anna Institute, 88900 Crotone, Italy
| | - Angela Costabile
- Department of Cultures, Education and Society, University of Calabria, Cosenza, Italy
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16
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Sommer JL, Shamblaw A, Mota N, Reynolds K, El-Gabalawy R. Mental disorders during the perinatal period: Results from a nationally representative study. Gen Hosp Psychiatry 2021; 73:71-77. [PMID: 34624829 DOI: 10.1016/j.genhosppsych.2021.09.011] [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: 06/25/2021] [Revised: 09/24/2021] [Accepted: 09/27/2021] [Indexed: 02/07/2023]
Abstract
OBJECTIVE This study examined mental health profiles of pregnant and postpartum females, with and without perinatal complications, compared to non-perinatal females of childbearing age. METHODS We analyzed nationally representative data from the 2012-2013 National Epidemiologic Survey on Alcohol and Related Conditions (N = 36,309; 51.9% female). A validated semi-structured interview assessed past-year DSM-5 mental disorders. Multivariable regressions examined associations between perinatal status and mental disorders, controlling for sociodemographic characteristics. RESULTS Using females who were not pregnant in the past year as a reference group, those who were postpartum with complications during pregnancy or delivery had increased odds of any past-year mental disorder (58.7% vs. 46.8%; AOR = 1.56), any depressive/bipolar disorder (26.4% vs. 18.8%; AOR = 1.57), and posttraumatic stress disorder (14.0% vs. 7.3%; AOR = 1.99). In contrast, those who were postpartum without complications did not have increased odds of these disorders. Those who were pregnant without pregnancy complications had reduced odds of any past-year mental disorder (33.7% vs. 46.8%; AOR = 0.55) and any depressive/bipolar disorder (11.7% vs. 18.8%; AOR = 0.60). All perinatal groups had reduced odds of any substance use disorder compared to those who were not pregnant in the past year (18.9-25.7% vs. 29.8% AORs: 0.49-0.78), except those who were postpartum with pregnancy or delivery complications (28.8%). CONCLUSION Results highlight the importance of mental health screening among perinatal females, particularly those who are postpartum and experience perinatal complications. Findings may inform the development of targeted interventions for this subpopulation.
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Affiliation(s)
- Jordana L Sommer
- Department of Anesthesiology, Perioperative and Pain Medicine, University of Manitoba, Winnipeg, Manitoba, Canada; Department of Psychology, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Amanda Shamblaw
- Department of Clinical Health Psychology, University of Manitoba, Winnipeg, Manitoba, Canada; Department of Psychology, University of Toronto Scarborough, Toronto, Ontario, Canada
| | - Natalie Mota
- Department of Clinical Health Psychology, University of Manitoba, Winnipeg, Manitoba, Canada; Department of Psychiatry, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Kristin Reynolds
- Department of Psychology, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Renée El-Gabalawy
- Department of Anesthesiology, Perioperative and Pain Medicine, University of Manitoba, Winnipeg, Manitoba, Canada; Department of Psychology, University of Manitoba, Winnipeg, Manitoba, Canada; Department of Clinical Health Psychology, University of Manitoba, Winnipeg, Manitoba, Canada; Department of Psychiatry, University of Manitoba, Winnipeg, Manitoba, Canada.
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Campesi I, Montella A, Seghieri G, Franconi F. The Person's Care Requires a Sex and Gender Approach. J Clin Med 2021; 10:4770. [PMID: 34682891 PMCID: PMC8541070 DOI: 10.3390/jcm10204770] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2021] [Revised: 10/14/2021] [Accepted: 10/14/2021] [Indexed: 12/15/2022] Open
Abstract
There is an urgent need to optimize pharmacology therapy with a consideration of high interindividual variability and economic costs. A sex-gender approach (which considers men, women, and people of diverse gender identities) and the assessment of differences in sex and gender promote global health, avoiding systematic errors that generate results with low validity. Care for people should consider the single individual and his or her past and present life experiences, as well as his or her relationship with care providers. Therefore, intersectoral and interdisciplinary studies are urgently required. It is desirable to create teams made up of men and women to meet the needs of both. Finally, it is also necessary to build an alliance among regulatory and ethic authorities, statistics, informatics, the healthcare system and providers, researchers, the pharmaceutical and diagnostic industries, decision makers, and patients to overcome the gender gap in medicine and to take real care of a person in an appropriate manner.
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Affiliation(s)
- Ilaria Campesi
- Laboratory of Sex-Gender Medicine, National Institute of Biostructures and Biosystems, 07100 Sassari, Italy;
- Department of Biomedical Sciences, University of Sassari, 07100 Sassari, Italy;
| | - Andrea Montella
- Department of Biomedical Sciences, University of Sassari, 07100 Sassari, Italy;
| | - Giuseppe Seghieri
- Department of Epidemiology, Regional Health Agency of Tuscany, 50124 Florence, Italy;
| | - Flavia Franconi
- Laboratory of Sex-Gender Medicine, National Institute of Biostructures and Biosystems, 07100 Sassari, Italy;
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Cumulative life stressors and stress response to threatened preterm labour as birth date predictors. Arch Gynecol Obstet 2021; 305:1421-1429. [PMID: 34549310 DOI: 10.1007/s00404-021-06251-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2021] [Accepted: 09/01/2021] [Indexed: 02/05/2023]
Abstract
PURPOSE Preterm birth represents one of the main causes of neonatal morbimortality and a risk factor for neurodevelopmental disorders. Appropriate predictive methods for preterm birth outcome, which consequently would facilitate prevention programs, are needed. We aim to predict birth date in women with a threatened preterm labour (TPL) based on stress response to TPL diagnosis, cumulative life stressors, and relevant obstetric variables. METHODS A prospective cohort of 157 pregnant women with TPL diagnosis between 24 and 31 weeks gestation formed the study sample. To estimate the stress response to TPL, maternal salivary cortisol, α-amylase levels, along with anxiety and depression symptoms were measured. To determine cumulative life stressors, previous traumas, social support, and family functioning were registered. Then, linear regression models were used to examine the effect of potential predictors of birth date. RESULTS Lower family adaptation, higher Body Mass Index (BMI), higher cortisol levels and TPL diagnosis week were the main predictors of birth date. Gestational week at TPL diagnosis showed a non-linear interaction with cortisol levels: TPL women with middle- and high-cortisol levels before 29 weeks of gestation went into imminent labour. CONCLUSION A combination of stress response to TPL diagnosis (salivary cortisol) and cumulative life stressors (family adaptation) together with obstetric factors (TPL gestational week and BMI) was the best birth date predictor. Therefore, a psychosocial therapeutic intervention program aimed to increase family adaptation and decrease cortisol levels at TPL diagnosis as well as losing weight, may prevent preterm birth in symptomatic women.
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Braveman P, Dominguez TP, Burke W, Dolan SM, Stevenson DK, Jackson FM, Collins JW, Driscoll DA, Haley T, Acker J, Shaw GM, McCabe ERB, Hay WW, Thornburg K, Acevedo-Garcia D, Cordero JF, Wise PH, Legaz G, Rashied-Henry K, Frost J, Verbiest S, Waddell L. Explaining the Black-White Disparity in Preterm Birth: A Consensus Statement From a Multi-Disciplinary Scientific Work Group Convened by the March of Dimes. FRONTIERS IN REPRODUCTIVE HEALTH 2021; 3:684207. [PMID: 36303973 PMCID: PMC9580804 DOI: 10.3389/frph.2021.684207] [Citation(s) in RCA: 88] [Impact Index Per Article: 29.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Accepted: 07/06/2021] [Indexed: 11/30/2022] Open
Abstract
In 2017–2019, the March of Dimes convened a workgroup with biomedical, clinical, and epidemiologic expertise to review knowledge of the causes of the persistent Black-White disparity in preterm birth (PTB). Multiple databases were searched to identify hypothesized causes examined in peer-reviewed literature, 33 hypothesized causes were reviewed for whether they plausibly affect PTB and either occur more/less frequently and/or have a larger/smaller effect size among Black women vs. White women. While definitive proof is lacking for most potential causes, most are biologically plausible. No single downstream or midstream factor explains the disparity or its social patterning, however, many likely play limited roles, e.g., while genetic factors likely contribute to PTB, they explain at most a small fraction of the disparity. Research links most hypothesized midstream causes, including socioeconomic factors and stress, with the disparity through their influence on the hypothesized downstream factors. Socioeconomic factors alone cannot explain the disparity's social patterning. Chronic stress could affect PTB through neuroendocrine and immune mechanisms leading to inflammation and immune dysfunction, stress could alter a woman's microbiota, immune response to infection, chronic disease risks, and behaviors, and trigger epigenetic changes influencing PTB risk. As an upstream factor, racism in multiple forms has repeatedly been linked with the plausible midstream/downstream factors, including socioeconomic disadvantage, stress, and toxic exposures. Racism is the only factor identified that directly or indirectly could explain the racial disparities in the plausible midstream/downstream causes and the observed social patterning. Historical and contemporary systemic racism can explain the racial disparities in socioeconomic opportunities that differentially expose African Americans to lifelong financial stress and associated health-harming conditions. Segregation places Black women in stressful surroundings and exposes them to environmental hazards. Race-based discriminatory treatment is a pervasive stressor for Black women of all socioeconomic levels, considering both incidents and the constant vigilance needed to prepare oneself for potential incidents. Racism is a highly plausible, major upstream contributor to the Black-White disparity in PTB through multiple pathways and biological mechanisms. While much is unknown, existing knowledge and core values (equity, justice) support addressing racism in efforts to eliminate the racial disparity in PTB.
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Affiliation(s)
- Paula Braveman
- School of Medicine, University of California, San Francisco, San Francisco, CA, United States
- *Correspondence: Paula Braveman
| | - Tyan Parker Dominguez
- USC Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles, CA, United States
| | - Wylie Burke
- University of Washington School of Medicine, Seattle, WA, United States
| | - Siobhan M. Dolan
- Albert Einstein College of Medicine, New York, NY, United States
| | | | | | - James W. Collins
- Northwestern University School of Medicine, Chicago, IL, United States
| | - Deborah A. Driscoll
- University of Pennsylvania School of Medicine, Philadelphia, PA, United States
| | - Terinney Haley
- School of Medicine, University of California, San Francisco, San Francisco, CA, United States
| | - Julia Acker
- School of Medicine, University of California, San Francisco, San Francisco, CA, United States
| | - Gary M. Shaw
- Stanford University School of Medicine, Stanford, CA, United States
| | - Edward R. B. McCabe
- David Geffen School of Medicine at University of California, Los Angeles, CA, United States
| | | | - Kent Thornburg
- School of Medicine, Oregon State University, Portland, OR, United States
| | | | - José F. Cordero
- University of Georgia College of Public Health, Athens, GA, United States
| | - Paul H. Wise
- Stanford University School of Medicine, Stanford, CA, United States
| | - Gina Legaz
- March of Dimes, White Plains, NY, United States
| | | | | | - Sarah Verbiest
- University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
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Sun GQ, Wang Q, Wang SS, Cheng Y. Risk assessment of paternal depression in relation to partner delivery during COVID-19 pandemic in Wuhan, China. BMC Psychiatry 2021; 21:327. [PMID: 34215220 PMCID: PMC8253468 DOI: 10.1186/s12888-021-03325-9] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Accepted: 06/14/2021] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND The COVID-19 pandemic and relevant prevention and control measures may affect the mental health and induce depressive symptoms in fathers with concurrent partner delivery exposure. This study aims to investigate the prevalence of depression in fathers with simultaneous exposure to COVID-19 pandemic and the effects of family functions on paternal perinatal depression (PPD) risk. METHODS A cross-sectional study was conducted among the perinatal fathers recruited in a large tertiary hospital in Wuhan across the whole pandemic period from 31 December 2019 to 11 April 2020. Edinburgh Postnatal Depression Scale (EPDS) and APGAR family function scale were used to evaluate PPD and family function, respectively. Chi-square test and multivariable-adjusted logistic regression model were applied for data analysis. RESULTS Among the 1187 participants, the prevalence of PPD was 13.82% throughout the COVID-19 pandemic. Compared with that in the time period before the announcement of human-to-human transmission on 19 January 2020, the depression risk was significantly lower during the traffic restriction (OR = 0.54, 95% CI: 0.34, 0.86) and public transportation reopening periods (OR = 0.29, 95% CI: 0.14, 0.59). Poor/fair family functions was associated with elevated depression risk (OR = 2.93, 95% CI: 1.90, 4.52). Individuals reporting a low family income and smoking had high depression risks. CONCLUSIONS A declined risk of PPD was observed over the traffic restriction period of the COVID-19 pandemic. An improved family function may help alleviate the risk of PPD during the pandemic. Health authorities are recommended to formulate targeted prevention and control strategies to handle PPD.
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Affiliation(s)
- Guo-qiang Sun
- grid.33199.310000 0004 0368 7223Obstetric Department, Maternal and Child Health Hospital of Hubei Province, Huazhong University of Science and Technology, Wuluo Road No.745, Hongshan District, Wuhan, 430070 China
| | - Qi Wang
- grid.33199.310000 0004 0368 7223Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Hangkong Road No.13, Qiaokou District, Wuhan, 430030 China
| | - Shan-shan Wang
- grid.33199.310000 0004 0368 7223Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Hangkong Road No.13, Qiaokou District, Wuhan, 430030 China
| | - Yao Cheng
- Obstetric Department, Maternal and Child Health Hospital of Hubei Province, Huazhong University of Science and Technology, Wuluo Road No.745, Hongshan District, Wuhan, 430070, China.
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21
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Pellicano GR, Carola V, Bussone S, Cecchini M, Tambelli R, Lai C. Beyond the dyad: the role of mother and father in newborns' global DNA methylation during the first month of life-a pilot study. Dev Psychobiol 2021; 63:1345-1357. [PMID: 33350469 DOI: 10.1002/dev.22072] [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] [Received: 07/28/2020] [Revised: 11/25/2020] [Accepted: 11/29/2020] [Indexed: 12/19/2022]
Abstract
The study aimed to longitudinally explore the effects of parental prenatal attachment and psychopathological symptomatology on neonatal global DNA methylation (5-mC) variation between birth and the first month of life. Eighteen mothers and thirteen fathers were assessed before childbirth (t0) by Perceived Stress Scale (PSS), Prenatal-Attachment Inventory, and Paternal Antenatal Attachment Scale; 48 hr after childbirth (t1) by SCL-90-R; and one month after childbirth (t2) by PSS. At t1 and t2, buccal swabs from parents and newborns were collected. In newborns' 5-mC and single nucleotide polymorphisms (SNPs) of DAT, MAOA, BDNF, and 5-HTTLPR genes were detected, while in parents only SNPs were measured. At t1, newborns' 5-mC was negatively associated with maternal psychopathological symptoms, while at t2, newborns' 5-mC was positively associated with paternal psychopathological symptoms and negatively with paternal prenatal attachment. The variation of newborns' 5-mC from t1 to t2 was predicted by paternal psychopathological symptoms. No significant correlations among parental SNPs and 5-mC levels were found. Results highlight parent-specific influences on newborn's DNA methylation. At birth, maternal psychological symptoms seem to have an effect on newborns' 5-mC, while after one month of life, paternal psychological characteristics could have a specific role in modulating the newborns' epigenetic responses to the environment.
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Affiliation(s)
- Gaia Romana Pellicano
- Department of Clinical and Dynamic Psychology, Sapienza University of Rome, Rome, Italy
| | - Valeria Carola
- Department of Clinical and Dynamic Psychology, Sapienza University of Rome, Rome, Italy.,Santa Lucia Foundation (IRCCS Fondazione Santa Lucia, Rome, Italy
| | - Silvia Bussone
- Department of Clinical and Dynamic Psychology, Sapienza University of Rome, Rome, Italy
| | - Marco Cecchini
- Department of Clinical and Dynamic Psychology, Sapienza University of Rome, Rome, Italy
| | - Renata Tambelli
- Department of Clinical and Dynamic Psychology, Sapienza University of Rome, Rome, Italy
| | - Carlo Lai
- Department of Clinical and Dynamic Psychology, Sapienza University of Rome, Rome, Italy
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22
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Perceived stress may mediate the relationship between antenatal depressive symptoms and preterm birth: A pilot observational cohort study. PLoS One 2021; 16:e0250982. [PMID: 33945579 PMCID: PMC8096039 DOI: 10.1371/journal.pone.0250982] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2020] [Accepted: 04/16/2021] [Indexed: 11/19/2022] Open
Abstract
Background Screening for changes in pregnancy-related anxiety and depressive symptoms during pregnancy may further our understanding of the relationship between these two variables and preterm birth. Objectives To determine whether changes in pregnancy-related anxiety and depressive symptoms during pregnancy influence the risk of preterm birth among Pakistani women; explore whether perceived stress moderates or mediates this relationship, and examine the relationship between the various components of pregnancy-related anxiety and preterm birth. Methods A prospective cohort study design was used to recruit a diverse sample of 300 low-risk pregnant women from four centers of Aga Khan Hospital for Women and Children in Karachi, Pakistan. Changes in pregnancy-related anxiety and depressive symptoms during pregnancy were tested. Multiple logistic regression analysis was used to determine a predictive model for preterm birth. We then determined if the influence of perceived stress could moderate or mediate the effect of depressive symptoms on preterm birth. Results Changes in pregnancy-related anxiety (OR = 1.1, CI 0.97–1.17, p = 0.167) and depressive symptoms (OR = 0.9, CI 0.85–1.03, p = 0.179) were insignificant as predictors of preterm birth after adjusting for the effects of maternal education and family type. When perceived stress was added into the model, we found that changes in depressive symptoms became marginally significant after adjusting for covariates (OR = 0.9, CI 0.82–1.01, p = 0.082). After adjusting for the mediation effect of change in perceived stress, the effect of change in depressive symptoms on preterm birth were marginally significant after adjusting for covariates. Among six different dimensions of pregnancy-related anxiety, mother’s concerns about fetal health showed a trend towards being predictive of preterm birth (OR = 1.3, CI 0.97–1.72, p = 0.078). Conclusions There may be a relationship between perceived stress and antenatal depressive symptoms and preterm birth. This is the first study of its kind to be conducted in Pakistan. Further research is required to validate these results.
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Vargas-Terrones M, Nagpal TS, Perales M, Prapavessis H, Mottola MF, Barakat R. Physical activity and prenatal depression: going beyond statistical significance by assessing the impact of reliable and clinical significant change. Psychol Med 2021; 51:688-693. [PMID: 32102723 DOI: 10.1017/s0033291719003714] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND Previous literature supports exercise as a preventative agent for prenatal depression; however, treatment effects for women at risk for prenatal depression remain unexplored. The purpose of the study was to examine whether exercise can lower depressive symptoms among women who began pregnancy at risk for depression using both a statistical significance and reliable and clinically significant change criteria. METHODS This study is a secondary analysis of two randomized controlled trials that followed the same exercise protocol. Pregnant women were allocated to an exercise intervention group (IG) or control group (CG). All participants completed the Center for Epidemiological Depression (CES-D) scale at gestational week 9-16 and 36-38. Women with a baseline score ⩾16 were included. A clinically reliable cut-off was calculated as a 7-point change in scores from pre- to post-intervention. RESULTS Thirty-six women in the IG and 25 women in the CG scored ⩾16 on the CES-D at baseline. At week 36-38 the IG had a statistically significant lower CES-D score (14.4 ± 8.6) than the CG (19.4 ± 11.1; p < 0.05). Twenty-two women in the IG (61%) had a clinically reliable decrease in their post-intervention score compared to eight women in the CG (32%; p < 0.05). Among the women who met the reliable change criteria, 18 (81%) in the IG and 7 (88%) in the CG had a score <16 post-intervention, with no difference between groups (p > 0.05). CONCLUSIONS A structured exercise program might be a useful treatment option for women at risk for prenatal depression.
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Affiliation(s)
- Marina Vargas-Terrones
- AFIPE Research Group, Faculty of Sciences for Physical Activity and Sport, INEF, Universidad Politécnica de Madrid (UPM), Madrid, Spain
| | - Taniya S Nagpal
- R. Samuel McLaughlin Foundation-Exercise and Pregnancy Laboratory, School of Kinesiology, The University of Western Ontario, London, Ontario, Canada
- Exercise and Health Psychology Laboratory, School of Kinesiology, The University of Western Ontario, London, Ontario, Canada
| | - Maria Perales
- Camilo José Cela University, Madrid, Spain
- Research Institute of Hospital 12 de Octubre (i+12), Madrid, Spain
| | - Harry Prapavessis
- Exercise and Health Psychology Laboratory, School of Kinesiology, The University of Western Ontario, London, Ontario, Canada
| | - Michelle F Mottola
- R. Samuel McLaughlin Foundation-Exercise and Pregnancy Laboratory, School of Kinesiology, The University of Western Ontario, London, Ontario, Canada
- Department of Anatomy & Cell Biology, Schulich School of Medicine & Dentistry, The University of Western Ontario, London, Ontario, Canada
- Children's Health Research Institute, The University of Western Ontario, London, Ontario, Canada
| | - Ruben Barakat
- AFIPE Research Group, Faculty of Sciences for Physical Activity and Sport, INEF, Universidad Politécnica de Madrid (UPM), Madrid, Spain
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24
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Shenassa ED, Widemann LG, Hunt CD. Antepartum Depression and Preterm Birth: Pathophysiology, Epidemiology, and Disparities due to structural racism. Curr Psychiatry Rep 2021; 23:14. [PMID: 33630175 DOI: 10.1007/s11920-021-01223-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/13/2021] [Indexed: 11/30/2022]
Abstract
PURPOSE OF REVIEW Informed by the evidence of links between physiology of stress and parturition, we review recent epidemiologic evidence (2015-2020) of antenatal depression as a risk factor for preterm birth (PTB). We also explain racial/ethnic disparities in depression and preterm birth as a consequence of structural racism. RECENT FINDINGS Epidemiologic evidence is consistent in linking antepartum depression with an elevated risk of PTB. Antidepressant usage has been linked with an elevated risk of PTB. However, recent evidence suggests that severity of depression is the underlying driver of the elevated risk attributed to antidepressant usage. The number of depressive symptoms, as a proxy for severity of maternal stress, may be a more informative predictor of PTB than criterion based predictors. Across various study designs, measurement modalities, and populations, antenatal depression predicts an elevated risk of delivering preterm. The physiology of stress provides a plausible explanation for this observation. Excessive stress-induced elevations in maternal and then fetal HPA hormones can alter maternal and fetal homeostasis and hasten the timing of parturition. Antenatal depression and exposure to structural racism are two stressors that can trigger the maternal stress response. Chronically elevated levels of stress hormones among women of color in the USA provide a likely physiologic explanation for Black-White disparities in the risk of PTB. Focusing on the number of depressive symptoms as the more informative predictor of PTB raises several questions. We consider these questions as well as directions for future research in the context of recent advances in the field.
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Affiliation(s)
- Edmond D Shenassa
- Maternal & Child Health Program, Department of Family Science; and Department of Epidemiology and Biostatistics, School of Public Health, University of Maryland, College Park, MD, USA. .,Department of Epidemiology, School of Public Health, Brown University, Providence, RI, USA. .,Department of Epidemiology & Biostatistics, School of Medicine, University of Maryland, Baltimore, MD, USA.
| | - Lea G Widemann
- Maternal & Child Health Program, Department of Family Science; and Department of Epidemiology and Biostatistics, School of Public Health, University of Maryland, College Park, MD, USA
| | - Cole D Hunt
- Maternal & Child Health Program, Department of Family Science; and Department of Epidemiology and Biostatistics, School of Public Health, University of Maryland, College Park, MD, USA
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25
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Latendresse G, Bailey E, Iacob E, Murphy H, Pentecost R, Thompson N, Hogue C. A Group Videoconference Intervention for Reducing Perinatal Depressive Symptoms: A Telehealth Pilot Study. J Midwifery Womens Health 2021; 66:70-77. [PMID: 33576146 PMCID: PMC8684833 DOI: 10.1111/jmwh.13209] [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] [Received: 04/14/2020] [Revised: 10/27/2020] [Accepted: 10/29/2020] [Indexed: 11/26/2022]
Abstract
INTRODUCTION Perinatal depression occurs in 12% to 18% of childbearing women. Telehealth is a promising platform for delivering perinatal mental health care, particularly during a pandemic when in-person services have been significantly curtailed. However, there is little research to document the feasibility of telehealth to address perinatal depression. This pilot study evaluated the feasibility and preliminary results of an 8-week facilitated group videoconference intervention. METHODS The study enrolled pregnant and postpartum women into an 8-week group mindfulness-based cognitive behavioral intervention, delivered via videoconference platform. Women receiving care at outpatient clinics who either screened positive for perinatal depression symptoms or had risk factors predictive of perinatal depression were invited to participate. Women attended weekly one-hour group sessions using their own electronic device and completed the Edinburgh Postnatal Depression Scale (EPDS) at several time points. Session attendance and survey completion rates were evaluated. RESULTS A total of 47 women enrolled (8 postpartum; 39 prenatal) into groups of 4 to 6. Twenty-four (51.1%) women were currently experiencing mild to moderate perinatal depression symptoms (EPDS score of 10-20), whereas 23 (48.9%) women had EPDS scores less than 10 but were at high risk for developing perinatal depression due to health history and significant life events. Seventy percent of women attended at least 5 of the 8 sessions. Trajectories of EPDS measures were promising (ie, downward among those with current perinatal depression symptoms and stable among those at high risk for developing perinatal depression). DISCUSSION These observational results are promising, suggesting further study of effectiveness for women with symptoms of perinatal depression, as well as for women at high risk for developing perinatal depression. Randomized trials could evaluate the effectiveness of the intervention, compared with standard of care approaches. Telehealth interventions can be tailored to meet the needs of different communities, and increase access to care, regardless of where women live or inability to receive in-person services.
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Affiliation(s)
| | - ElLois Bailey
- College of Nursing, University of Utah, Salt Lake City, Utah
| | - Eli Iacob
- College of Nursing, University of Utah, Salt Lake City, Utah
| | - Hannah Murphy
- College of Nursing, University of Utah, Salt Lake City, Utah
| | - Ryoko Pentecost
- College of Nursing, University of Utah, Salt Lake City, Utah
| | - Nancy Thompson
- Rollns School of Public Health, Emory University, Atlanta, Georgia
| | - Carol Hogue
- Rollns School of Public Health, Emory University, Atlanta, Georgia
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26
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Lee HJ, Kim SM, Kwon JY. Repetitive transcranial magnetic stimulation treatment for peripartum depression: systematic review & meta-analysis. BMC Pregnancy Childbirth 2021; 21:118. [PMID: 33563220 PMCID: PMC7874443 DOI: 10.1186/s12884-021-03600-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2020] [Accepted: 01/28/2021] [Indexed: 12/29/2022] Open
Abstract
Background Peripartum depression is a common disorder with very high potential hazards for both the patients and their babies. The typical treatment options include antidepressants and electroconvulsive therapy. However, these treatments do not ensure the safety of the fetus. Recently, repetitive transcranial magnetic stimulation has emerged as a promising treatment for neuropathies as well as depression. Nevertheless, many studies excluded pregnant women. This systematic review was conducted to confirm whether repetitive transcranial magnetic stimulation was a suitable treatment option for peripartum depression. Methods We performed a systematic review that followed the PRISMA guidelines. We searched for studies in the MEDLINE, PsycINFO, EMBASE, and Cochrane library databases published until the end of September 2020. Eleven studies were selected for the systematic review, and five studies were selected for quantitative synthesis. Data analysis was conducted using Comprehensive Meta-Analysis 3 software. The effect size was analyzed using the standardized mean difference, and the 95% confidence interval (CI) was determined by the generic inverse variance estimation method. Results The therapeutic effect size of repetitive transcranial magnetic stimulation for peripartum depression was 1.394 (95% CI: 0.944–1.843), and the sensitivity analysis effect size was 1.074 (95% CI: 0.689–1.459), indicating a significant effect. The side effect size of repetitive transcranial magnetic stimulation for peripartum depression was 0.346 (95% CI: 0.214–0.506), a meaningful result. There were no severe side effects to the mothers or fetuses. Conclusions From various perspectives, repetitive transcranial magnetic stimulation can be considered an alternative treatment to treat peripartum depression to avoid exposure of fetuses to drugs and the severe side effects of electroconvulsive therapy. Further research is required to increase confidence in the results. Supplementary Information The online version contains supplementary material available at 10.1186/s12884-021-03600-3.
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Affiliation(s)
- Hyune June Lee
- Department of Medical Devices Industry, Dongguk University, Seoul, South Korea
| | - Sung Min Kim
- Department of Medical Devices Industry, Dongguk University, Seoul, South Korea
| | - Ji Yean Kwon
- Department of Medical Devices Industry, Dongguk University, Seoul, South Korea.
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27
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Zhang L, Wang L, Cui S, Yuan Q, Huang C, Zhou X. Prenatal Depression in Women in the Third Trimester: Prevalence, Predictive Factors, and Relationship With Maternal-Fetal Attachment. Front Public Health 2021; 8:602005. [PMID: 33575242 PMCID: PMC7870992 DOI: 10.3389/fpubh.2020.602005] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2020] [Accepted: 12/23/2020] [Indexed: 12/11/2022] Open
Abstract
Objective: The prevalence of prenatal depression in pregnant women has found to be high, which may adversely affect the intimacy of a mother to her fetus. Few studies have investigated the relationship between prenatal depression and maternal-fetal attachment in pregnant Chinese women. This study is thus designed to evaluate the prevalence rate, predictive factors of prenatal depression in Chinese pregnant women in the third trimester of pregnancy, and the effect of prenatal depression on maternal-fetal attachment. Methods: A total of 340 pregnant women in the third trimester of pregnancy were recruited from a hospital in Anhui Province. The Edinburgh Postpartum Depression Scale (EPDS) was rated to assess the prenatal depression; the Pittsburgh Sleep Quality Index (PSQI) and Zung Self-Rating Anxiety Scale (SAS) were used to assess sleep quality and anxiety level for all participants. The Maternal Antenatal Attachment Scale (MAAS) was used to assess maternal-fetal attachment. Results: The prevalence of prenatal depression in the participants was high (19.1%) in our study. The scores of prenatal anxiety and sleep disorders were higher with prenatal depression than in those without prenatal depression (47.6 ± 9.5 vs. 38.9 ± 6.9; 8.3 ± 3.3 vs. 6.1 ± 2.7, all p < 0.01). MAAS quality was lower in prenatal depression women than those in non-prenatal depression women (43.8 ± 5.6 vs. 46.4 ± 4.5, p < 0.01). Correlation analysis showed that prenatal depression was associated with parity, prenatal education, education level, marital satisfaction, anxiety and sleep disorders (all p < 0.05). Furthermore, binary logistic regression results showed that anxiety and sleep disorders were risk factors for prenatal depression. Prenatal education, higher marriage satisfaction were protective factors for prenatal depression. In addition, correlation analysis also showed that prenatal depression was positively correlated with MAAS intensity, but negatively correlated with MAAS quality. Conclusions: Our results indicated a high prevalence of prenatal depression in women in the third trimester. Prenatal education and higher marital satisfaction were protective factors for prenatal depression; antenatal anxiety and sleep disorders during pregnancy were risk factors for prenatal depression. Prenatal depression was negatively correlated with MAAS quality, but positively correlated with MAAS intensity.
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Affiliation(s)
- Ling Zhang
- College of Mental Health and Psychological Science, Anhui Medical University, Hefei, China.,Chaohu Hospital, Anhui Medical University, Hefei, China
| | - Lei Wang
- College of Mental Health and Psychological Science, Anhui Medical University, Hefei, China.,Chaohu Hospital, Anhui Medical University, Hefei, China
| | - Shu Cui
- College of Mental Health and Psychological Science, Anhui Medical University, Hefei, China.,Chaohu Hospital, Anhui Medical University, Hefei, China
| | - Qiuyu Yuan
- College of Mental Health and Psychological Science, Anhui Medical University, Hefei, China.,Chaohu Hospital, Anhui Medical University, Hefei, China
| | - Cui Huang
- College of Mental Health and Psychological Science, Anhui Medical University, Hefei, China.,Chaohu Hospital, Anhui Medical University, Hefei, China
| | - Xiaoqin Zhou
- College of Mental Health and Psychological Science, Anhui Medical University, Hefei, China.,Chaohu Hospital, Anhui Medical University, Hefei, China
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Dosani A, Arora H, Mazmudar S. mHealth and Perinatal Depression in Low-and Middle-Income Countries: A Scoping Review of the Literature. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17207679. [PMID: 33096738 PMCID: PMC7589927 DOI: 10.3390/ijerph17207679] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/28/2020] [Revised: 10/19/2020] [Accepted: 10/19/2020] [Indexed: 02/07/2023]
Abstract
Women in low- and middle-income countries have high rates of perinatal depression. As smartphones become increasingly accessible around the world, there is an opportunity to explore innovative mHealth tools for the prevention, screening, and management of perinatal depression. We completed a scoping review of the literature pertaining to the use of mobile phone technologies for perinatal depression in low-and middle-income countries. PubMed CINHAL, and Google Scholar databases were searched, generating 423 results. 12 articles met our inclusion criteria. Two of the 12 articles reviewed mobile phone applications. The remaining 9 articles were study protocols or descriptive/intervention studies. Our results reveal that minimal literature is currently available on the use of mobile health for perinatal depression in low- and middle-income countries. We found four articles that present the results of an intervention that were delivered through mobile phones for the treatment of perinatal depressive symptoms and an additional qualitative study describing the perceptions of mothers receiving cognitive behavioral therapy via telephones. These studies demonstrated that depressive symptoms improved after the interventions. There is potential to improve the quality of mHealth interventions, specifically mobile phone applications for perinatal depressive symptoms and depression, through meaningful collaborative work between healthcare professionals and application developers.
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Affiliation(s)
- Aliyah Dosani
- School of Nursing and Midwifery, Faculty of Health, Community and Education, Mount Royal University, Calgary, AB T3E 6K6, Canada
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB T2N 1N4, Canada
- O’Brien Institute for Public Health, Cumming School of Medicine, University of Calgary, Calgary, AB T2N 1N4, Canada
- Correspondence:
| | - Harshmeet Arora
- Department of Computer and Electrical Engineering, Faculty of Applied Science, University of British Columbia, Vancouver, BC V6T 1Z4, Canada; (H.A.); (S.M.)
| | - Sahil Mazmudar
- Department of Computer and Electrical Engineering, Faculty of Applied Science, University of British Columbia, Vancouver, BC V6T 1Z4, Canada; (H.A.); (S.M.)
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Abstract
OBJECTIVE Today, the high prevalence of depression is one of the major health problems of pregnant women. This study aimed to assess the relationship between antenatal depression, pregnancy and neonatal outcomes. METHODS This cohort study involved 394 pregnant women referred to the prenatal care clinic at the Al- Zahra Hospital, affiliated to Guilan University of Medical Sciences, Iran. We used a convenient method for sampling. We collected data using questionnaires on demographic and obstetric characteristics, the CES-D scale for depression evaluation and a checklist for recording pregnancy outcomes. RESULTS According to the results, preeclampsia, premature membrane rupture, preterm delivery, cesarean section, intrauterine fetal death, and intrauterine fetal growth restriction were higher among mothers with depression during their pregnancies, compared to those who did not have depression. In addition, the mean birth weights of depressed mothers' infants were lower than the infants of mothers who did not have depression. CONCLUSION Results from the present study showed that depression during pregnancy is associated with pregnancy and neonatal outcomes. Healthcare planners and mental health counselors should regard screening mothers with risk of depression and following them up and, in the necessary cases, referring to psychiatrists.
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Affiliation(s)
- Atefeh Ghanbari Khanghah
- Social Determinants of Health Research Center, School of Nursing and Midwifery, Guilan University of Medical Sciences, Rasht, Iran
| | - Zahra Bostani Khalesi
- Social Determinants of Health Research Center, School of Nursing and Midwifery, Guilan University of Medical Sciences, Rasht, Iran
| | - Rad Hassanzadeh
- Pediatric Diseases Research Center, Guilan University of Medical Sciences, Rasht, Iran
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Larsson M, Eriksson I, Johansson K, Stigsson AK, Svahn R, Wetterström J, Wilhsson M. Individual parental conversations with non-birthing parents. Prim Health Care Res Dev 2020; 21:e25. [PMID: 32727632 PMCID: PMC7443773 DOI: 10.1017/s1463423620000286] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2019] [Revised: 05/11/2020] [Accepted: 06/25/2020] [Indexed: 11/30/2022] Open
Abstract
AIM The aim of this study was to describe Child Health Service (CHS) nurses' experiences with conducting individual parental conversations (IPCs) with non-birthing parents. BACKGROUND CHS nurses in Sweden mainly focus on monitoring a child's physical and mental development and the mothers' health in order to support their parenthood. The assignment of the CHS includes identifying dysfunctional social relationships in a family and strengthening responsive parenting. An imbalance arises within the family when someone in the family suffers from illness, which could have a negative effect on the whole family's health and well-being. METHODS An inductive, descriptive qualitative study design was used to describe and to gain an understanding of the CHS nurses' experiences. Data were collected in 13 interviews, and a qualitative content analysis was performed. FINDINGS The analysis of interviews with CHS nurses resulted in two main categories, each with three subcategories. The main categories are: working for equality and applying a family focus, and dealing with challenges in the developing assignment. The IPCs stimulate the CHS nurses to work for more equality and to apply a family focus, which can be a way of strengthening the families' health and the children's upbringing. Developing the CHS nurses' assignment can be a challenge that appears to entail positive outcomes for CHS nurses, while also generating the need for CHS nurses to receive supervision to find ways to improve their approach and practice.
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Affiliation(s)
| | - Irene Eriksson
- School of Health Sciences, University of Skövde, Skövde, Sweden
| | | | | | | | | | - Marie Wilhsson
- School of Health Sciences, University of Skövde, Skövde, Sweden
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31
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Montagnoli C, Zanconato G, Cinelli G, Tozzi AE, Bovo C, Bortolus R, Ruggeri S. Maternal mental health and reproductive outcomes: a scoping review of the current literature. Arch Gynecol Obstet 2020; 302:801-819. [PMID: 32671543 DOI: 10.1007/s00404-020-05685-1] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2020] [Accepted: 07/04/2020] [Indexed: 11/26/2022]
Abstract
PURPOSE Current data show that maternal mental conditions affect about 10% of pregnant women worldwide. Assessing timing and patterns of mental health illness, therefore, is critical to ensure the wellbeing of the mother, the new-born and the whole family. The aim of this review is to summarize the latest evidence linking maternal mental disorders and adverse reproductive outcomes. METHODS Following the PRISMA guidelines for systematic reviews, a literature search was conducted to ascertain the possible impact of mental health conditions on reproductive outcomes before and during pregnancy. The comprehensive strategy included cohort studies, randomised controlled trials and literature reviews on women with Primary Maternal Mental Illness (PMMI) and Secondary Maternal Mental Illness (SMMI) considering periconceptional, obstetric and foetal-neonatal outcomes. PubMed, WoS, CINAHL and Google scholar were used for the search. Cross-referencing in bibliographies of the selected papers ensured wider study capture. RESULTS Evidence linking depressive disorders and infertility among PMMI is weak. Given this, women with prior mental conditions experience additional distress when undergoing fertility treatments. Primary mental disorders may also increase the risk of miscarriage and other pregnancy complications (e.g., gestational diabetes). For SMMI, there is more robust evidence correlating Preterm Birth (PTB) and Low Birth Weight (LBW) with common mental disorders which develop during pregnancy. CONCLUSION Prevention and management of maternal mental health diseases and minor mental conditions within the first 1000 days' timeframe, should have a place in the holistic approach to women going through reproductive decisions, infertility treatment and pregnancy.
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Affiliation(s)
- Caterina Montagnoli
- Department of the Hospital Management, Azienda Ospedaliera Universitaria Integrata, Verona, Italy
| | - Giovanni Zanconato
- Department of Surgery, Odonto-Stomatology and Maternal and Child Health, University of Verona, Verona, Italy
| | - Giulia Cinelli
- Predictive and Preventive Medicine Research Unit, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
- School of Specialization in Food Science, University of Rome Tor Vergata, Rome, Italy
| | - Alberto Eugenio Tozzi
- Predictive and Preventive Medicine Research Unit, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy.
| | - Chiara Bovo
- Department of the Hospital Management, Azienda Ospedaliera Universitaria Integrata, Verona, Italy
| | - Renata Bortolus
- Directorate General for Preventive Health - Office 9, Ministry of Health, Rome, Italy
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Huang W, Sundquist K, Sundquist J, Crump C, Ji J. Risk of being born preterm in offspring of survivors with childhood or adolescent central nervous system tumor in Sweden. Int J Cancer 2020; 147:100-106. [PMID: 31595491 DOI: 10.1002/ijc.32722] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2019] [Revised: 09/24/2019] [Accepted: 09/26/2019] [Indexed: 12/30/2022]
Abstract
An increasing number of patients with central nervous system (CNS) tumor could survive to reproductive age. However, it is largely unknown whether the history of CNS tumor might affect pregnancy outcome. We aimed to explore the risk of being born preterm among children of CNS tumor survivors. By linking several nationwide registers in Sweden, we identified 1,369 children whose parents were childhood or adolescent CNS tumor survivors. Children whose parents did not have CNS tumor were matched randomly with a 5:1 ratio to generate the reference group. Conditional logistic regression was used to calculate the odds ratio (OR) and 95% confidence interval (CI). The prevalence of preterm birth (PTB) was 6.9% among children of survivors with CNS tumor and 5.2% among the matched controls. Children of survivors had an increased risk of PTB (adjusted OR = 1.29, 95%CI 1.01-1.65) compared to the matched controls. This risk was increased specifically among offspring of those diagnosed in childhood (adjusted OR = 1.53, 95%CI 1.14-2.06) but not adolescence (adjusted OR = 0.89, 95%CI 0.56-1.41). For families with more than one child, the risk was slightly lower among the second child as compared to the first child. The risk was negatively associated with time interval between parental diagnosis and childbirth. Parental medulloblastoma and ependymoma were most strongly associated with a higher risk of PTB. Children of survivors with CNS tumor experienced an elevated risk of PTB. However, the risk diminishes gradually after parental diagnosis of CNS tumor. Offspring of childhood CNS tumor survivors and medulloblastoma or ependymoma survivors may have the highest risk of PTB.
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Affiliation(s)
- Wuqing Huang
- Center for Primary Health Care Research, Lund University/Region Skåne, Lund, Sweden
| | - Kristina Sundquist
- Center for Primary Health Care Research, Lund University/Region Skåne, Lund, Sweden
- Department of Family Medicine and Community Health, Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, NY
- Center for Community-based Healthcare Research and Education (CoHRE), Department of Functional Pathology, School of Medicine, Shimane University, Shimane, Japan
| | - Jan Sundquist
- Center for Primary Health Care Research, Lund University/Region Skåne, Lund, Sweden
- Department of Family Medicine and Community Health, Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, NY
- Center for Community-based Healthcare Research and Education (CoHRE), Department of Functional Pathology, School of Medicine, Shimane University, Shimane, Japan
| | - Casey Crump
- Department of Family Medicine and Community Health, Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Jianguang Ji
- Center for Primary Health Care Research, Lund University/Region Skåne, Lund, Sweden
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Eick SM, Goin DE, Izano MA, Cushing L, DeMicco E, Padula AM, Woodruff TJ, Morello-Frosch R. Relationships between psychosocial stressors among pregnant women in San Francisco: A path analysis. PLoS One 2020; 15:e0234579. [PMID: 32530956 PMCID: PMC7292353 DOI: 10.1371/journal.pone.0234579] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2020] [Accepted: 05/28/2020] [Indexed: 11/18/2022] Open
Abstract
Pregnant women who experience psychosocial stressors, such as stressful life events, poor neighborhood quality, and financial hardship, are at an increased risk for adverse pregnancy outcomes. Yet, few studies have examined associations between multiple stressors from different sources, which may be helpful to better inform causal pathways leading to adverse birth outcomes. Using path analysis, we examined associations between multiple self-reported stressor exposures during and before pregnancy in the Chemicals in Our Bodies-2 study (N = 510), a demographically diverse cohort of pregnant women in San Francisco. We examined associations between eight self-reported exposures to stressors and three responses to stress which were assessed via interview questionnaire at the 2nd trimester. Stressors included: neighborhood quality, stressful life events, caregiving, discrimination, financial strain, job strain, food insecurity, and unplanned pregnancy. Perceived stress, depression, and perceived community status were included as indicators of self-reported stress response. Our model indicated that women who experienced discrimination and food insecurity had a 3.76 (95% confidence interval [CI] = 1.60, 5.85) and 2.67 (95% CI = 1.31, 4.04) increase in depression scale scores compared to women who did not experience discrimination and food insecurity, respectively. We additionally identified job strain and caregiving for an ill family member as strong predictors of increased depressive symptoms (β = 1.63, 95% CI = 0.29, 3.07; β = 1.48, 95% CI = 0.19, 2.70, respectively). Discrimination, food insecurity, and job strain also influenced depression indirectly through the mediating pathway of increasing perceived stress, although indirect effects were less precise. In our study population, women who experienced discrimination, food insecurity, job strain and caregiving for an ill family member had an increased number of depressive symptoms compared to women who did not experience these stressors. Results from our study highlight the complex relationships between stressors and stress responses and may help to identify possible mediating pathways leading to adverse pregnancy outcomes.
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Affiliation(s)
- Stephanie M. Eick
- Department of Obstetrics, Gynecology and Reproductive Sciences, Program on Reproductive Health and the Environment, University of California, San Francisco, San Francisco, California, United States of America
- * E-mail: (SME); (RM)
| | - Dana E. Goin
- Department of Obstetrics, Gynecology and Reproductive Sciences, Program on Reproductive Health and the Environment, University of California, San Francisco, San Francisco, California, United States of America
| | - Monika A. Izano
- Department of Obstetrics, Gynecology and Reproductive Sciences, Program on Reproductive Health and the Environment, University of California, San Francisco, San Francisco, California, United States of America
| | - Lara Cushing
- Department of Health Education, San Francisco State University, San Francisco, California, United States of America
| | - Erin DeMicco
- Department of Obstetrics, Gynecology and Reproductive Sciences, Program on Reproductive Health and the Environment, University of California, San Francisco, San Francisco, California, United States of America
| | - Amy M. Padula
- Department of Obstetrics, Gynecology and Reproductive Sciences, Program on Reproductive Health and the Environment, University of California, San Francisco, San Francisco, California, United States of America
| | - Tracey J. Woodruff
- Department of Obstetrics, Gynecology and Reproductive Sciences, Program on Reproductive Health and the Environment, University of California, San Francisco, San Francisco, California, United States of America
| | - Rachel Morello-Frosch
- Department of Obstetrics, Gynecology and Reproductive Sciences, Program on Reproductive Health and the Environment, University of California, San Francisco, San Francisco, California, United States of America
- Department of Environmental Science, Policy and Management and School of Public Health, University of California, Berkeley, Berkeley, California, United States of America
- * E-mail: (SME); (RM)
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Abstract
Mothers' genetics as well as their environment, behaviors, and social determinants of health are all important factors influencing short and long term childhood outcomes. There is an emerging body of literature investigating the extent to which fathers also contribute to their offspring's future health. We review fathers' impact on short term birth outcomes, longer term health, and neurodevelopment to emphasize the inter-relatedness of individual paternal traits. Factors that are linked to offspring outcomes include paternal demographics, race, stress, marriage and support, mental health, and the baseline health and behaviors of fathers. Several methodologic issues exist in current research such as maternal report of paternal information. Mechanisms proposed regarding paternal effect on progeny health range from genetic to reduction of stress of mothers through support. These are varied, possibly inter-related, and difficult to isolate as a single etiology. Future initiatives need to support fathers to allow them to support their families.
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Affiliation(s)
- Heather L Brumberg
- Division of Newborn Medicine, Department of Pediatrics, New York Medical College, Maria Fareri Children's Hospital at Westchester Medical Center, 100 Woods Road, Valhalla, NY 10595, United States.
| | - Shetal I Shah
- Division of Newborn Medicine, Department of Pediatrics, New York Medical College, Maria Fareri Children's Hospital at Westchester Medical Center, 100 Woods Road, Valhalla, NY 10595, United States
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Liu C, Långström N, Ekéus C, Frisell T, Cnattingius S, Hjern A. Paternal violent criminality and preterm birth: a Swedish national cohort study. BMC Pregnancy Childbirth 2020; 20:307. [PMID: 32429861 PMCID: PMC7238610 DOI: 10.1186/s12884-020-02964-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2018] [Accepted: 04/22/2020] [Indexed: 12/02/2022] Open
Abstract
Background Fathers may affect expectant mothers’ daily living situations, which in turn might influence pregnancy outcomes. We investigated the association between paternal violent criminality and risk of preterm birth (≤36 weeks). Methods We conducted a register-based study with all live singleton births in the Swedish Medical Birth Register from 1992 to 2012, linked with records of paternal violent crime convictions from the National Crime Register from 1973 to 2012. Results Paternal violent criminality was associated with increased risk of preterm birth and lower gestational age. The association was especially pronounced among infants of reoffenders: men convicted of three or more violent crimes (adjusted odds ratio [aOR] 1.23 [95% CI 1.17, 1.29]). Maternal half sibling-comparisons, an analytic approach controlling for maternal factors stable across pregnancies, also suggested increased risk of preterm birth and lower gestational age when exposed to a violently reoffending father compared to a father without violent criminal convictions (aOR 1.30 [0.99, 1.72], adjusted mean difference − 1.07 [− 1.78, − 0.36]). Conclusions Persistent paternal violent criminality was associated with increased risk of preterm birth, even after controlling for maternal characteristics that did not change between pregnancies.
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Affiliation(s)
- Can Liu
- Centre for Health Equity Studies (CHESS), Karolinska Institutet/Stockholm University, 106 91, Stockholm, Sweden. .,Clinical Epidemiology, Department of Medicine, Karolinska Institutet, 171 77, Stockholm, Sweden.
| | - Niklas Långström
- Department of Neuroscience, Uppsala University, Box 256, 751 05, Uppsala, Sweden.,Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, 171 77, Stockholm, Sweden
| | - Cecilia Ekéus
- Division of Reproductive Health, Department of Women's and Children's Health (KBH), 171 77, Stockholm, Sweden
| | - Thomas Frisell
- Clinical Epidemiology, Department of Medicine, Karolinska Institutet, 171 77, Stockholm, Sweden
| | - Sven Cnattingius
- Clinical Epidemiology, Department of Medicine, Karolinska Institutet, 171 77, Stockholm, Sweden
| | - Anders Hjern
- Centre for Health Equity Studies (CHESS), Karolinska Institutet/Stockholm University, 106 91, Stockholm, Sweden.,Clinical Epidemiology, Department of Medicine, Karolinska Institutet, 171 77, Stockholm, Sweden
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Gallagher A, Kring D, Whitley T. Effects of yoga on anxiety and depression for high risk mothers on hospital bedrest. Complement Ther Clin Pract 2020; 38:101079. [DOI: 10.1016/j.ctcp.2019.101079] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2019] [Revised: 12/10/2019] [Accepted: 12/10/2019] [Indexed: 12/16/2022]
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Yuan Y, Niu W. Maternal pre-pregnancy obesity and preterm birth: more explorations needed. Lancet Diabetes Endocrinol 2019; 7:829. [PMID: 31621590 DOI: 10.1016/s2213-8587(19)30320-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2019] [Accepted: 09/04/2019] [Indexed: 11/27/2022]
Affiliation(s)
- Yuan Yuan
- Graduate School, Beijing University of Chinese Medicine, Beijing, China; Department of Pediatrics, China-Japan Friendship Hospital, Beijing 100029, China
| | - Wenquan Niu
- Institute of Clinical Medical Sciences, China-Japan Friendship Hospital, Beijing 100029, China.
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Koh M, Ahn S, Kim J, Park S, Oh J. Pregnant Women's Antenatal Depression and Influencing Factors. KOREAN JOURNAL OF WOMEN HEALTH NURSING 2019; 25:112-123. [PMID: 37679934 DOI: 10.4069/kjwhn.2019.25.1.112] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2019] [Revised: 03/04/2019] [Accepted: 03/05/2019] [Indexed: 09/09/2023] Open
Abstract
PURPOSE The objective of this study was to investigate the prevalence of antenatal depression in pregnant women and its influencing factors. METHODS With a cross-sectional survey design, a total of 396 pregnant women were recruited from a local obstetrics and gynecology clinic. Measurements included antenatal depression, perceived stress, predictors of depression during pregnancy, and demographic and obstetric characteristics. RESULTS Mean antenatal depression score was 8.20 (standard deviation=4.95) out of 30, falling into its normal range. However, the prevalence of antenatal depression was 35.9% when cut-point of 9/10 was used. The prevalence of antenatal depression among women in the first trimester was 31.4%. It was slightly increased to 34.9% in the second trimester but significantly increased to 40.5% in the third trimester. In multiple logistic regression analysis, experiencing prenatal anxiety (odds ratio [OR], 4.16), having no job (OR, 2.90), lower self-esteem (OR, 1.62), and higher perceived stress (OR, 1.32) were significant factors influencing antenatal depression. CONCLUSION Negative feeling such as feeling anxious, lower self-esteem, and higher perceived stress during pregnancy are key factors affecting antenatal depression. Thus, antenatal nursing intervention focusing on pregnant women's feeling upon their job status is necessary to improve their antenatal psychological well-being.
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Affiliation(s)
- Minseon Koh
- PhD Student, College of Nursing, Chungnam National University, Daejeon, Korea
| | - Sukhee Ahn
- PhD Student, College of Nursing, Chungnam National University, Daejeon, Korea
| | - Jisoon Kim
- PhD Student, College of Nursing, Chungnam National University, Daejeon, Korea
| | - Seyeon Park
- PhD Student, College of Nursing, Chungnam National University, Daejeon, Korea
| | - Jiwon Oh
- PhD Student, College of Nursing, Chungnam National University, Daejeon, Korea
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Laine MK, Masalin S, Rönö K, Kautiainen H, Gissler M, Pennanen P, Eriksson JG. Risk of preterm birth in primiparous women with exposure to antidepressant medication before pregnancy and/or during pregnancy - impact of body mass index. Ann Med 2019; 51:51-57. [PMID: 30299166 PMCID: PMC7857451 DOI: 10.1080/07853890.2018.1534265] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2023] Open
Abstract
INTRODUCTION Preterm birth is a major cause of infant mortality. It is unknown whether body mass index (BMI) influences the risk of preterm birth in women, who prenatally use antidepressants. MATERIALS AND METHODS The study cohort (N = 6920) consists of all primiparous European born women without previously diagnosed diabetes from the city of Vantaa, Finland, who delivered a singleton child between 2009 and 2015. Data on births, pre-pregnancy BMI and purchases of antidepressants from 12 months before conception until delivery were obtained from Finnish National Registers. RESULTS Of the primiparous women, 9.9% used antidepressants. The overall prevalence of preterm birth was 5.2%. In women with a pre-pregnancy BMI <18.5 kg/m2, the Odds Ratio (OR) for preterm birth among antidepressant users compared with those who were non-users was 1.91 (95% confidence intervals [CI] 0.40 to 9.15, adjusted for age, smoking, education, use of fertility treatments and number of previous pregnancies) while in women with a pre-pregnancy BMI ≥30 kg/m2, the OR was 0.53 (95% CI 0.21-1.36), respectively. DISCUSSION Primiparous women using antidepressants, who were underweight before conception should be closely monitored and provided tailored care in a maternity clinic to minimize the risk of preterm birth. Key messages In primiparous women, one in ten used antidepressant medications before pregnancy and/or during pregnancy. In primiparous women, the prevalence of preterm birth was 5%. Underweight primiparous women using antidepressants should be closely monitored and provided tailored care in a maternity clinic.
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Affiliation(s)
- Merja K Laine
- a Department of General Practice and Primary Health Care , University of Helsinki and Helsinki University Hospital , Helsinki , Finland.,b Vantaa Health Centre , Vantaa , Finland
| | - Senja Masalin
- a Department of General Practice and Primary Health Care , University of Helsinki and Helsinki University Hospital , Helsinki , Finland.,c Department of Gynecology and Obstetrics , University of Helsinki and Helsinki University Hospital , Helsinki , Finland
| | - Kristiina Rönö
- c Department of Gynecology and Obstetrics , University of Helsinki and Helsinki University Hospital , Helsinki , Finland
| | - Hannu Kautiainen
- a Department of General Practice and Primary Health Care , University of Helsinki and Helsinki University Hospital , Helsinki , Finland.,d Primary Health Care Unit , Kuopio University Hospital , Kuopio , Finland.,e Folkhälsan Research Center , Helsinki , Finland
| | - Mika Gissler
- f National Institute for Health and Welfare , Helsinki , Finland.,g Karolinska Institute , Stockholm , Sweden
| | | | - Johan G Eriksson
- a Department of General Practice and Primary Health Care , University of Helsinki and Helsinki University Hospital , Helsinki , Finland.,e Folkhälsan Research Center , Helsinki , Finland.,h Department of Chronic Disease Prevention , National Institute for Health and Welfare , Helsinki , Finland
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Giurgescu C, Misra DP. Psychosocial Factors and Preterm Birth Among Black Mothers and Fathers. MCN Am J Matern Child Nurs 2019; 43:245-251. [PMID: 29944478 DOI: 10.1097/nmc.0000000000000458] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
OBJECTIVE Black women are more likely to live in disadvantaged neighborhoods and experience racial discrimination and psychological stress compared with White women. These factors have been related to preterm birth (PTB). However, research is limited on the associations of disadvantaged neighborhoods, racial discrimination, and psychological stress among expectant Black fathers and PTB. This review focuses on what is known about psychosocial factors in relation to PTB among Black parents. METHODS The Scopus database was used to search for studies using keywords of adverse childhood experiences, neighborhood environment, racial discrimination, psychological stress, depressive symptoms/depression, coping, locus of control, social support, and mother-father relationship. Each of these keywords was combined with the term preterm birth. This review focused on the associations of these psychosocial factors collected during the prenatal period and risk for PTB. However, due to lack of data for some of these factors during the prenatal period, studies conducted in the immediate period after birth were included. The focus of this review was on research conducted with Black expectant fathers given the limited data on the association between paternal psychosocial factors and PTB. This review only highlights studies that examined the associations of maternal psychosocial factors and PTB. It does not present a comprehensive review of studies on maternal factors given the extent of the studies that examined these associations. RESULTS Pregnant Black women are more likely to report living in disadvantaged neighborhoods; experiencing racial discrimination, psychological stress, and depressive symptoms; using avoidance coping; and reporting lower levels of social support compared with White women. Limited data suggest that Black expectant fathers experience higher rates of everyday unfair treatment because of race/ethnicity compared with White fathers. Research suggests that these psychosocial factors have been related to PTB among pregnant Black women; however, research is limited on examining these associations among expectant Black fathers. CLINICAL IMPLICATIONS Maternal-child nurses are in the position to assess these psychosocial factors among expectant parents. Nurses should also assess risk factors for PTB for both expectant parents and provide support to couples who are at risk for PTB.
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Affiliation(s)
- Carmen Giurgescu
- Carmen Giurgescu is an Associate Professor, College of Nursing, The Ohio State University, Columbus, OH. The author can be reached via e-mail at Dawn P. Misra is a Professor, Department of Family Medicine & Public Health Sciences, School of Medicine, Wayne State University, Detroit, MI
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Karlsson L, Tolvanen M, Scheinin NM, Uusitupa HM, Korja R, Ekholm E, Tuulari JJ, Pajulo M, Huotilainen M, Paunio T, Karlsson H. Cohort Profile: The FinnBrain Birth Cohort Study (FinnBrain). Int J Epidemiol 2019; 47:15-16j. [PMID: 29025073 DOI: 10.1093/ije/dyx173] [Citation(s) in RCA: 154] [Impact Index Per Article: 30.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/02/2017] [Indexed: 12/29/2022] Open
Affiliation(s)
- Linnea Karlsson
- Institute of Clinical Medicine, Turku Brain and Mind Center, FinnBrain Birth Cohort Study.,Department of Child Psychiatry
| | - Mimmi Tolvanen
- Institute of Clinical Medicine, Turku Brain and Mind Center, FinnBrain Birth Cohort Study.,Department of Community Dentistry
| | - Noora M Scheinin
- Institute of Clinical Medicine, Turku Brain and Mind Center, FinnBrain Birth Cohort Study.,Department of Psychiatry
| | - Henna-Maria Uusitupa
- Institute of Clinical Medicine, Turku Brain and Mind Center, FinnBrain Birth Cohort Study
| | - Riikka Korja
- Institute of Clinical Medicine, Turku Brain and Mind Center, FinnBrain Birth Cohort Study.,Department of Psychology, University of Turku
| | - Eeva Ekholm
- Institute of Clinical Medicine, Turku Brain and Mind Center, FinnBrain Birth Cohort Study.,Department of Obstetrics and Gynecology, University of Turku and Turku University Hospital, Turku, Finland
| | - Jetro J Tuulari
- Institute of Clinical Medicine, Turku Brain and Mind Center, FinnBrain Birth Cohort Study
| | - Marjukka Pajulo
- Institute of Clinical Medicine, Turku Brain and Mind Center, FinnBrain Birth Cohort Study.,Department of Child Psychiatry
| | - Minna Huotilainen
- Institute of Clinical Medicine, Turku Brain and Mind Center, FinnBrain Birth Cohort Study.,University of Helsinki, Cognitive Brain Research Unit and CICERO Learning Network, Helsinki, Finland
| | - Tiina Paunio
- National Institute for Health and Welfare, the Genomics and Biomarkers Unit, Helsinki, Finland.,University of Helsinki and Helsinki University Hospital, Department of Psychiatry, Helsinki, Finland
| | - Hasse Karlsson
- Institute of Clinical Medicine, Turku Brain and Mind Center, FinnBrain Birth Cohort Study.,Department of Psychiatry
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A Leiferman J, Farewell CV, E Lee-Winn A, Jewell J, Ulrickson C, Huberty J, Paulson J. Management of Prenatal Depression: Effectiveness of an Online Training Module Across Health Care Disciplines. THE JOURNAL OF CONTINUING EDUCATION IN THE HEALTH PROFESSIONS 2019; 39:178-184. [PMID: 31464821 DOI: 10.1097/ceh.0000000000000263] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
INTRODUCTION Maternal depression is associated with numerous deleterious maternal and child health outcomes. Although there are several treatment options for prenatal depression, many depressed women remain untreated. This study tested the effects of a low-intensity online training module on providers' attitudes, beliefs, and management practices of prenatal depression across a diverse group of providers. METHODS Health care providers who were providing care to pregnant women completed a 64-item survey consisting of items from the Management of Maternal Depression Inventory. Upon completion of the survey, providers were randomized into the intervention or the active control arm (wait-listed). The intervention consisted of an online training, which targeted knowledge and skills related to providing guidance on prenatal mood disorders. Approximately 6 to 8 weeks after randomization, all providers completed the survey again, and a general linear model framework was used to test change from baseline. RESULTS The final sample was comprised 74 compliant providers (intervention arm: n = 41; control arm: n = 33). Providers in the intervention arm reported significant increases in the sense of responsibility and self-efficacy when compared with their counterparts in the active control arm (all P < .001). Providers in the intervention arm also reported an increase in satisfaction related to communication with mental health specialists when compared with their counterparts in the active control arm (P = .05). DISCUSSION Our findings suggest that a brief, online training improved the attitudes, confidence, and communication of diverse providers related to the management of prenatal depression. Provider online training may help encourage patient-provider dialogue and in turn, enhance the management of prenatal depression.
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Affiliation(s)
- Jenn A Leiferman
- Dr. Leiferman: Associate Professor, Department of Community and Behavioral Health, Colorado School of Public Health, Aurora, CO. Dr. Farewell: Senior Research Instructor, Department of Community and Behavioral Health, Colorado School of Public Health, Aurora, CO. Dr. Lee-Winn: Assistant Professor, Department of Community and Behavioral Health, Colorado School of Public Health, Aurora, CO. Ms. Jewell: DrPH Student, Department of Community and Behavioral Health, Colorado School of Public Health, Aurora, CO. Ms. Ulrickson: Research Coordinator, Denver Health and Hospital Authority, Denver, CO. Dr. Huberty: Associate Professor, Arizona State University, Phoenix, AZ. Dr. Paulson: Associate Professor Old Dominion University, Norfolk, VA
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Korja R, Nolvi S, Kataja EL, Scheinin N, Junttila N, Lahtinen H, Saarni S, Karlsson L, Karlsson H. The courses of maternal and paternal depressive and anxiety symptoms during the prenatal period in the FinnBrain Birth Cohort study. PLoS One 2018; 13:e0207856. [PMID: 30557345 PMCID: PMC6296666 DOI: 10.1371/journal.pone.0207856] [Citation(s) in RCA: 49] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2018] [Accepted: 11/07/2018] [Indexed: 01/09/2023] Open
Abstract
Maternal prenatal symptoms of depression and anxiety have been suggested to impose differential effects on later offspring development, depending on their characteristics, such as timing, intensity and persistence. Paternal symptoms have been less investigated. While knowledge on these trajectory characteristics is essential for improved comprehension of prenatal stress, prospective studies including both expecting parents have been scarce. We aim at identifying and comparing the trajectories of prenatal depressive and anxiety symptoms in both parents in a pregnancy cohort design. The sample included 3202 mothers and 2076 fathers who were recruited to the FinnBrain Birth Cohort study (www.finnbrain.fi). Depressive symptoms were assessed using the Edinburgh Postnatal Depression Scale (EPDS) and general anxiety by the anxiety scale of the Symptom Checklist -90 (SCL-90) repeatedly at 14, 24, and 34 gestational weeks. Five differential depressive and four anxiety symptom trajectories were identified across pregnancy both in mothers and in fathers. The trajectories of consistently low depressive or anxiety symptoms were associated with higher educational level in both parents, and with nulliparity and non-smoking during pregnancy in mothers. Parents with consistently high or increasing levels of symptoms had more often prenatal SSRI medication. The congruences between elevated depressive and anxiety symptoms at any point in pregnancy, as well as parental trajectories within families were low. However, in this population-based sample, the self-reported symptom levels of both parents were generally very low. Variance in timing and persistence of parent-reported prenatal depressive and anxiety symptoms is potentially important, while symptom trajectories are very similar in mothers and fathers. These differential symptom trajectories and the significance of their correlates should be acknowledged when studying prenatal stress exposures and the related outcomes in children.
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Affiliation(s)
- Riikka Korja
- University of Turku, Institute of Clinical Medicine, Turku Brain and Mind Center, FinnBrain Birth Cohort Study, Turku, Finland
- University of Turku, Department of Psychology, Turku, Finland
| | - Saara Nolvi
- University of Turku, Institute of Clinical Medicine, Turku Brain and Mind Center, FinnBrain Birth Cohort Study, Turku, Finland
| | - Eeva-Leena Kataja
- University of Turku, Institute of Clinical Medicine, Turku Brain and Mind Center, FinnBrain Birth Cohort Study, Turku, Finland
- University of Turku, Department of Psychology, Turku, Finland
| | - Noora Scheinin
- University of Turku, Institute of Clinical Medicine, Turku Brain and Mind Center, FinnBrain Birth Cohort Study, Turku, Finland
- University of Turku and Turku University Hospital, Department of Psychiatry, Turku, Finland
| | - Niina Junttila
- University of Turku, Department of Teacher Education, Turku, Finland
| | - Henna Lahtinen
- University of Turku, Department of Psychology, Turku, Finland
| | - Suoma Saarni
- University of Turku, Institute of Clinical Medicine, Turku Brain and Mind Center, FinnBrain Birth Cohort Study, Turku, Finland
- University of Turku and Turku University Hospital, Department of Psychiatry, Turku, Finland
- Helsinki University Hospital, Department of Psychiatry, Helsinki, Finland
| | - Linnea Karlsson
- University of Turku, Institute of Clinical Medicine, Turku Brain and Mind Center, FinnBrain Birth Cohort Study, Turku, Finland
- University of Turku and Turku University Hospital, Institute of Clinical Medicine, Department of Child Psychiatry, Turku, Finland
| | - Hasse Karlsson
- University of Turku, Institute of Clinical Medicine, Turku Brain and Mind Center, FinnBrain Birth Cohort Study, Turku, Finland
- University of Turku and Turku University Hospital, Department of Psychiatry, Turku, Finland
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Van Ngo T, Gammeltoft T, Nguyen HTT, Meyrowitsch DW, Rasch V. Antenatal depressive symptoms and adverse birth outcomes in Hanoi, Vietnam. PLoS One 2018; 13:e0206650. [PMID: 30388162 PMCID: PMC6214542 DOI: 10.1371/journal.pone.0206650] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2017] [Accepted: 10/17/2018] [Indexed: 01/06/2023] Open
Abstract
BACKGROUND Antenatal depression is a significant health problem in low and middle- income countries. Although the condition is associated with severe adverse consequences for the mother and newborn, it remains a neglected problem. The purpose of this study was to describe the association between antenatal depressive symptoms and preterm birth (PTB), low birth weight (LBW), and small for gestation age (SGA). METHODS The study was conducted in Dong Anh District, Hanoi, Vietnam, among pregnant women of less than 24 weeks of gestation. Information on socioeconomic characteristics and reproductive history was collected at enrollment and ADS and experiences of intimate partner violence were assessed at week 32. Birth outcomes were determined at delivery. Bivariate and logistic regression analyses were applied to assess the associations between ADS and PTB, LBW, and SGA. RESULTS ADS was significantly associated with an increased risk of PTB (crude OR = 2.4; 95%; CI: 1.01-5.4 and adjusted OR = 2.4; 95% CI: 1.1-5.2, respectively) and a significantly increased risk for giving birth to an LBW infant (crude OR = 3.1; 95% CI: 1.4-7.0 and adjusted OR = 3.5; 95% CI: 1.6-7.6, respectively). In contrast, ADS was not statistically associated with small for gestation age. CONCLUSION ADS is associated with an increased risk of PTB and LBW but not associated with SGA.
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Affiliation(s)
- Toan Van Ngo
- Institute for Preventive Medicine and Public Health, Hanoi Medical University, Hanoi, Vietnam
| | - Tine Gammeltoft
- Department of Anthropology, University of Copenhagen, Copenhagen, Denmark
| | - Hanh Thuy Thi Nguyen
- Institute for Preventive Medicine and Public Health, Hanoi Medical University, Hanoi, Vietnam
| | - Dan W. Meyrowitsch
- Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Vibeke Rasch
- Department of Obstetrics and Gynecology, Odense University Hospital, Odense, Denmark
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark
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Nilsen RM, Vik ES, Rasmussen SA, Small R, Moster D, Schytt E, Aasheim V. Preeclampsia by maternal reasons for immigration: a population-based study. BMC Pregnancy Childbirth 2018; 18:423. [PMID: 30367607 PMCID: PMC6204029 DOI: 10.1186/s12884-018-2034-4] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2018] [Accepted: 09/27/2018] [Indexed: 02/04/2023] Open
Abstract
Background To investigate whether the occurrence of preeclampsia varied by maternal reasons for immigration. Methods We included 1,287,270 singleton pregnancies (163,508 to immigrant women) in Norway during 1990–2013. Individual data were obtained through record linkage between the Medical Birth Registry of Norway and Statistics Norway. Analyses were performed for preeclampsia overall and in combination with preterm birth < 37 and < 34 weeks of gestation, referred to as preterm and very preterm preeclampsia. Odds ratios (ORs) with 95% confidence intervals (CIs) were estimated using logistic regression with robust standard errors, adjusted for relevant covariates, including maternal income and education. Results Preeclampsia was reported in 3.5% of Norwegian women and 2.5% of immigrants. Compared with Norwegian women, the adjusted OR for preeclampsia was lowest in labour immigrants (adjusted OR 0.55 [95% CI 0.49–0.62]), followed by family immigrants (0.62 [0.59–0.65]), immigrant students (0.75 [0.65–0.86]), refugees (0.81 [0.75–0.88]), and immigrants from other Nordic countries (0.87 [0.80–0.94]). Compared with Norwegian women, labour immigrants also had lower adjusted odds of preterm and very preterm preeclampsia, whereas refugees had increased adjusted odds of preterm and very preterm preeclampsia (< 37 weeks: 1.18 [1.02–1.36], and < 34 weeks: 1.41 [1.15–1.72]). Conclusions The occurrence of preeclampsia was lower overall in immigrants than in non-immigrants, but associations varied by maternal reasons for immigration. Maternity caregivers should pay increased attention to pregnant women with refugee backgrounds due to their excess odds of preterm preeclampsia. Electronic supplementary material The online version of this article (10.1186/s12884-018-2034-4) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Roy M Nilsen
- Faculty of Health and Social Sciences, Western Norway University of Applied Sciences, Inndalsveien 28, 5063, Bergen, Norway.
| | - Eline S Vik
- Faculty of Health and Social Sciences, Western Norway University of Applied Sciences, Inndalsveien 28, 5063, Bergen, Norway
| | - Svein A Rasmussen
- Department of Clinical Science, University of Bergen, Bergen, Norway
| | - Rhonda Small
- Judith Lumley Centre, School of Nursing & Midwifery, La Trobe University, Melbourne, Australia.,Reproductive Health, Department of Women's and Children's Health, Karolinska Institute, Stockholm, Sweden
| | - Dag Moster
- Department of Paediatrics, Haukeland University Hospital, Bergen, Norway.,Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
| | - Erica Schytt
- Reproductive Health, Department of Women's and Children's Health, Karolinska Institute, Stockholm, Sweden.,Centre for Clinical Research Dalarna, Uppsala University, Falun, Sweden
| | - Vigdis Aasheim
- Faculty of Health and Social Sciences, Western Norway University of Applied Sciences, Inndalsveien 28, 5063, Bergen, Norway
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Nasreen HE, Rahman JA, Rus RM, Kartiwi M, Sutan R, Edhborg M. Prevalence and determinants of antepartum depressive and anxiety symptoms in expectant mothers and fathers: results from a perinatal psychiatric morbidity cohort study in the east and west coasts of Malaysia. BMC Psychiatry 2018; 18:195. [PMID: 29902985 PMCID: PMC6002988 DOI: 10.1186/s12888-018-1781-0] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2018] [Accepted: 06/07/2018] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Research on antepartum psychiatric morbidities investigating depressive and anxiety symptoms in expectant mothers and fathers is lacking in low- and middle-income countries. This study aimed to estimate the prevalence of antepartum depressive, anxiety and co-occurring significant symptoms and explore the associated factors in a cross-section of Malaysian expectant mothers and fathers. METHODS We used cross-sectional data from a prospective cohort study of 911 expectant mothers and 587 expectant fathers during their third trimester of pregnancy, from health clinics of two states in the east and west coasts of Malaysia. The validated Malay version of Edinburgh Postnatal Depression Scale and the anxiety sub-scale of Depression, Anxiety and Stress Scale were used to measure the depressive and anxiety symptoms. Multiple logistic regression analyses identified the determinants of antepartum depressive and anxiety symptoms (ADS and AAS). RESULTS Prevalence of ADS was 12.2% in expectant mothers and 8.4% in expectant fathers, while AAS was 28.8% in expectant mothers and 13.3% in expectant fathers, and co-occurring significant symptoms was 8.0% in expectant mothers and 4.0% in expectant fathers. Expectant mothers and fathers having perceived social/family support were less likely to suffer from ADS. Intimate partner violence, poor relationship with husbands, depression in earlier pregnancy and husband's depression in current pregnancy in expectant mothers, and living in rented house, sex preference for the unborn child, stressful life events and wife's depression in current pregnancy in expectant fathers were associated with a greater likelihood of ADS. The determinants for AAS were living in rented house and with parents/in-laws, poor relationship with husbands, restrictions during pregnancy and stressful life events for expectant mothers, and stressful life events and being unsupportive towards wives in household chores for expectant fathers. CONCLUSION Both ADS and AAS are prevalent in expectant mothers and fathers, and largely an undetected problem in Malaysia. Administration of couple-based screening and referral program during antenatal check-up should be universal practices to identify and treat the psychiatric morbidities.
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Affiliation(s)
- Hashima E. Nasreen
- Faculty of Medicine, International Islamic University Malaysia, Jalan Sultan Ahmad Shah, 25200 Kuantan, Pahang Malaysia
| | - Jamalludin Ab Rahman
- Faculty of Medicine, International Islamic University Malaysia, Jalan Sultan Ahmad Shah, 25200 Kuantan, Pahang Malaysia
| | - Razman Mohd Rus
- Faculty of Medicine, International Islamic University Malaysia, Jalan Sultan Ahmad Shah, 25200 Kuantan, Pahang Malaysia
| | - Mira Kartiwi
- Faculty of Information and Communication Technology, International Islamic University Malaysia, Jalan Gombak, 53100 Kuala Lumpur, Malaysia
| | - Rosnah Sutan
- Community Health Department, Universiti Kebangsaan Malaysia, Bandar Tun Razak Cheras, 56000 Kuala Lumpur, Malaysia
| | - Maigun Edhborg
- Department of Neurobiology, Care Sciences and Society, Karolinska Institute, SE-141 83 Huddinge, Stockholm, Sweden
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Quantitative assessment of physical activity in pregnant women with sonographic short cervix and the risk for preterm delivery: A prospective pilot study. PLoS One 2018; 13:e0198949. [PMID: 29889906 PMCID: PMC5995449 DOI: 10.1371/journal.pone.0198949] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2017] [Accepted: 05/29/2018] [Indexed: 11/30/2022] Open
Abstract
Objective Bed rest or activity restriction is a common obstetrical practice, despite a paucity of data to support its efficacy. The aim of this study was to determine whether physical activity, as assessed by a smart band activity tracker, is associated with preterm birth in pregnant women at high risk for preterm delivery. Methods This was a pilot prospective cohort study including pregnant women at high risk for preterm delivery between 24 and 32 weeks-of-gestation. Physical activity level was assessed by smart band activity. Patients with sonographic short cervical length (≤ 20 mm) were asked to wear the smart band activity tracker continuously for at least one week, including one weekend. Both physicians and patients were blinded to the data stored in the smart band activity tracker. No specific recommendations were given to participants as to the level or intensity of physical activity. The primary outcome was the rate of preterm birth (< 37 weeks-of-gestation). Secondary outcomes included the rate of delivery before 34 weeks of gestation and neonatal outcome. Parametric and nonparametric statistics were used for analysis. Results Study population included 49 pregnant women: 37 women (75.7%) delivered preterm and 12 (24.5%) delivered at or after 37 weeks-of-gestation. The median steps per day was significantly lower in patients who delivered preterm (3576, IQR: 2478–4775 vs. 4554, IQR: 3632–6337, p = 0.02). Regression analysis revealed that the median number of steps per day was independently inversely associated with preterm birth, after adjustment for maternal age, body mass index, gestational age at recruitment, cervical length, cervical dilatation and plurality. Conclusion This pilot study represents the first quantitative assessment of the association between physical activity and preterm birth. The results of this pilot study do not support the efficacy of decreased physical activity in the prevention of preterm birth in patients with sonographic short cervical length.
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Abstract
Objective To determine the contribution of paternal factors to the risk of adverse birth outcomes. Methods This is a retrospective cross-sectional analysis using birth certificate data from 2004 to 2015 retrieved from the Finger Lakes Regional Perinatal Data System. Primiparous women with singleton pregnancies were analyzed in the study. Two multivariate logistic regression models were conducted to assess potential paternal risk factors including age, race/ethnicity, and education on four birth outcomes, including preterm birth (PTB), low birthweight (LBW), high birthweight (HBW), and small for gestational age (SGA). Results A total of 36,731 singleton births were included in the analysis. Less paternal education was significantly related to an elevated risk of PTB, LBW, and SGA, even after adjustment for maternal demographic, medical, and lifestyle factors (P < 0.05). Paternal race/ethnicity was also significantly associated with all four birth outcomes (P < 0.05) while controlling for maternal factors. Older paternal age was associated with increased odds (OR 1.012, 95% CI 1.003-1.022) of LBW. Maternal race/ethnicity partially mediated the association of paternal race/ethnicity with HBW and SGA. Maternal education partially mediated the relationship between paternal education and SGA. Conclusion Paternal factors were important predictors of adverse birth outcomes. Our results support the inclusion of fathers in future studies and clinical programs aimed at reducing adverse birth outcomes.
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Affiliation(s)
- Ying Meng
- Clinical and Translational Science Institute, University of Rochester, 601 Elmwood Avenue, Rochester, NY, 14642, USA.
- School of Nursing, University of Rochester, 601 Elmwood Avenue, Rochester, NY, 14642, USA.
| | - Susan W Groth
- School of Nursing, University of Rochester, 601 Elmwood Avenue, Rochester, NY, 14642, USA
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Racial/Ethnic Differences in the Modifying Effect of Community Violence on the Association between Paternity Status and Preterm Birth. JOURNAL OF ENVIRONMENTAL AND PUBLIC HEALTH 2017; 2017:3479421. [PMID: 29279715 PMCID: PMC5723942 DOI: 10.1155/2017/3479421] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/02/2017] [Revised: 10/12/2017] [Accepted: 10/29/2017] [Indexed: 11/30/2022]
Abstract
Preterm birth (PTB) is a major public health concern in the US. Lack of established paternity has been linked with increased risk of PTB. Community violence (CV) may modify the association, and racial/ethnic differences may exist. Using a geographically defined cohort of women in Richmond, Virginia (N = 27,518), we examined racial/ethnic differences in the modifying effect of CV on the association between paternity status and PTB. Results showed that lack of established paternity was associated with incremental greater odds of PTB across CV quartiles in NH-Whites (quartile-1: AOR = 1.42, 95% CI = 0.95–2.12; quartile-2: AOR = 1.45, 95% CI = 0.57–3.71; quartile-3: AOR = 3.12, 95% CI = 2.67–6.32), NH-Blacks (quartile-1: AOR = 1.16, 95% CI = 0.85–1.58; quartile-2: AOR = 1.32, 95% CI = 0.82–2.12; quartile-3: AOR = 1.64, 95% CI = 1.24–2.16), and Hispanics (quartile-1: AOR = 1.29, 95% CI = 0.65–2.55; quartile-2: AOR = 1.34, 95% CI = 0.67–2.69). Odds of PTB were highest among NH-White women. Public health practitioners should be aware of the negative effect of lack of paternal presence on PTB in women resident in high violence rate communities and racial/ethnic differences that exist.
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