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Özer E, Güvenç G. Developing the quality of life in pregnancy scale (PREG-QOL). BMC Pregnancy Childbirth 2024; 24:587. [PMID: 39244534 PMCID: PMC11380417 DOI: 10.1186/s12884-024-06771-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2024] [Accepted: 08/20/2024] [Indexed: 09/09/2024] Open
Abstract
AIM This study aims to develop the Quality of Life in Pregnancy Scale (PREG-QOL) as a new instrument to evaluate the quality of life during pregnancy and test its psychometric properties. DESIGN An instrument development study and psychometric testing of the content and construct validity, factor structure and reliability. METHODS The study was conducted in three stages: (1) creating an item pool, (2) preliminary evaluation of items, and (3) refining the scale and evaluating psychometric properties. Instrument development guidelines were used to evaluate content validity, construct validity, internal consistency and stability of the instrument over time. Data to evaluate psychometric properties of the PREG-QOL were collected between April and August 2021. RESULTS Items were developed using in-depth interviews with pregnant women and extensive literature review. Scale-content validity index was 0.98. Exploratory factor analysis revealed a 26-item instrument with 6 factors, which explained % 56.2 of variance. Confirmatory factor analysis (CFA) showed that factors 3 and 5 should be combined into the factor of physical domain since they included items about the same theme. Fit indices obtained by CFA were at sufficient levels. Parallel test method was employed to evaluate the correlation of the PREG-QOL with the SF-36. The findings indicated that the PREG-QOL had high internal inconsistency and stability over time. CONCLUSION The PREG-QOL is a valid and reliable instrument in terms of its psychometric characteristics. The 26-item instrument was composed of the five factors of perception of general satisfaction, emotional domain, physical domain, health support systems and social domain. IMPACT Displaying good psychometric properties, the PREG-QOL may be used to evaluate multiple dimensions of the quality of life during pregnancy.
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Affiliation(s)
- Esra Özer
- Faculty of Health Sciences, Midwifery Department, Ankara Medipol University, Ankara, Turkey.
| | - Gülten Güvenç
- Gulhane Faculty of Nursing, Department of Obstetrics and Gynecology Nursing, University of Health Sciences, Ankara, Turkey
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Calle-Martínez A, Ruiz-Páez R, Gómez-González L, Egea-Ferrer A, López-Bueno JA, Díaz J, Asensio C, Navas MA, Linares C. Short-term effects of tropospheric ozone and other environmental factors on emergency admissions due to pregnancy complications: A time-series analysis in the Madrid Region. ENVIRONMENTAL RESEARCH 2023; 231:116206. [PMID: 37217123 DOI: 10.1016/j.envres.2023.116206] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/03/2023] [Revised: 05/18/2023] [Accepted: 05/19/2023] [Indexed: 05/24/2023]
Abstract
Air pollution has been linked to adverse neonatal outcomes, mainly in the case of prolonged exposures. This study focuses on the short-term effects on maternal health. We conducted a retrospective ecological time-series study in the Madrid Region covering the period 2013-2018. The independent variables were mean daily concentrations of tropospheric ozone (O3), particulate matter (PM10/PM2.5) and nitrogen dioxide (NO2), as well as noise levels. The dependent variables were daily emergency hospital admissions due to complications in pregnancy, childbirth and the puerperium. Poisson generalised linear regression models were fitted to quantify the relative and attributable risks, controlling for trend, seasonality, the autoregressive nature of the series, and a number of meteorological factors. There were 318 069 emergency hospital admissions due to obstetric complications across the 2191 days of study. Of this total: 13 164 (95%CI: 9930-16 398) admissions were attributable to exposure to O3, the only pollutant to show a statistically significant (p < 0.05) association with admissions due to hypertensive disorders; and 10 575 (95%CI: 3573-17 566) admissions were attributable to daytime noise levels, while admissions due to hyperemesis gravidarum and vomiting were related to exposure to night noise. Other pollutants which also displayed statistically significant associations were: NO2 concentrations, with admissions due to vomiting and preterm labour; PM10 concentrations, with premature rupture of membranes: and PM2.5 concentrations, with total complications. Exposure to a range of air pollutants, and ozone in particular, is associated with a higher number of emergency hospital admissions due to gestational complications. Hence, surveillance of environmental effects on maternal health should be intensified, and plans and strategies to minimise these should be drawn up.
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Affiliation(s)
- A Calle-Martínez
- Preventive Medicine Department, University Hospital of Móstoles, Móstoles, Spain
| | | | - L Gómez-González
- Climate Change, Health and Urban Environment Reference Unit, Carlos III Institute of Health (Instituto de Salud Carlos III/ISCIII), Madrid, Spain
| | - A Egea-Ferrer
- Preventive Medicine Department, Albacete University General Teaching Hospital, Castile-La Mancha, Spain
| | - J A López-Bueno
- Climate Change, Health and Urban Environment Reference Unit, Carlos III Institute of Health (Instituto de Salud Carlos III/ISCIII), Madrid, Spain
| | - J Díaz
- Climate Change, Health and Urban Environment Reference Unit, Carlos III Institute of Health (Instituto de Salud Carlos III/ISCIII), Madrid, Spain.
| | - C Asensio
- Instrumentation and Applied Acoustics Research Group, Madrid Polytechnic University, Campus Sur, Ctra. Valencia Km 7, 28031, Madrid, Spain
| | - M A Navas
- Climate Change, Health and Urban Environment Reference Unit, Carlos III Institute of Health (Instituto de Salud Carlos III/ISCIII), Madrid, Spain
| | - C Linares
- Climate Change, Health and Urban Environment Reference Unit, Carlos III Institute of Health (Instituto de Salud Carlos III/ISCIII), Madrid, Spain
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Boutib A, Chergaoui S, Marfak A, Hilali A, Youlyouz-Marfak I. Quality of Life During Pregnancy from 2011 to 2021: Systematic Review. Int J Womens Health 2022; 14:975-1005. [PMID: 35941917 PMCID: PMC9356752 DOI: 10.2147/ijwh.s361643] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Accepted: 05/24/2022] [Indexed: 11/23/2022] Open
Abstract
Purpose Health-related quality of life (HRQoL) has emerged as a key concern in patient care. It has become one of the major objectives of clinical trials. Our study aims to describe the quality of life (QoL) during uncomplicated pregnancy and to assess its associated factors. Patients and Methods The search of articles was carried out using the online database of PUBMED and Web of Science with a limit of time between 2011 and 2021. Data were retrieved by two independent reviewers. Results 721 publications responding to keywords were identified, of which 73 articles on the topic were selected. The main countries that have published on this subject are Australia (n = 10) and China (n = 7). Twenty-three articles deal with QoL for pathological pregnancies. All the pathologies studied have a negative impact on the HRQoL of pregnant women, and its improvement depends on the type of treatment. Obesity, low back, and pelvic girdle pain, and hyperemesis gravidarum were the frequent pathologies during pregnancy. Socio-demographic characteristics related to improved well-being (favorable economic status, social support). Similarly, better sleep quality and moderate physical exercise were linked to an increased QoL. Physical and psychological factors were associated with a lower QoL. Conclusion The HRQoL refers to patients’ subjective evaluation of physical, mental, and social components of well-being. Optimizing the QoL during pregnancy necessitates a deeper understanding of their issues as well as counseling which provides support wherever needed.
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Affiliation(s)
- Amal Boutib
- Laboratory of Health Sciences and Technologies, Higher Institute of Health Sciences, Hassan First University of Settat, Settat, Morocco
| | - Samia Chergaoui
- Laboratory of Health Sciences and Technologies, Higher Institute of Health Sciences, Hassan First University of Settat, Settat, Morocco
| | - Abdelghafour Marfak
- Laboratory of Health Sciences and Technologies, Higher Institute of Health Sciences, Hassan First University of Settat, Settat, Morocco
- National School of Public Health, Rabat, Morocco
| | - Abderraouf Hilali
- Laboratory of Health Sciences and Technologies, Higher Institute of Health Sciences, Hassan First University of Settat, Settat, Morocco
| | - Ibtissam Youlyouz-Marfak
- Laboratory of Health Sciences and Technologies, Higher Institute of Health Sciences, Hassan First University of Settat, Settat, Morocco
- Correspondence: Ibtissam Youlyouz-Marfak, Hassan First University of Settat, Higher Institute of Health Sciences, Laboratory of Health Sciences and Technologies, Settat, 26000, Morocco, Tel +212 6 61 60 43 58, Fax +212 5 23 40 01 87, Email
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Pobee RA, Setorglo J, Kwashie Klevor M, Murray-Kolb LE. High levels of depressive symptoms and low quality of life are reported during pregnancy in Cape Coast, Ghana; a longitudinal study. BMC Public Health 2022; 22:894. [PMID: 35513825 PMCID: PMC9069749 DOI: 10.1186/s12889-022-13299-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2021] [Accepted: 04/20/2022] [Indexed: 12/04/2022] Open
Abstract
Background Significant rates of anxiety, depressive symptoms, and low quality of life (QoL) have been found among pregnant women in developed countries. These psychosocial disturbances have not been adequately assessed during pregnancy in many developing countries. Methods Women were recruited in their first trimester of pregnancy (< 13 weeks; n = 116) and followed through to their 2nd (n = 71) and 3rd (n = 71) trimesters. Questionnaires were used to collect data on anxiety symptoms (Beck Anxiety Inventory; BAI), depressive symptoms (Center for Epidemiological Studies-Depression Inventory; CES-D), and quality of life (RAND SF-36; QoL). Psychometric analyses were used to determine the reliability of the questionnaires in this context. The proportion of pregnant women with psychosocial disturbances at each trimester was determined. Repeated measures ANOVA were used to examine changes in psychosocial outcomes over time; and generalized estimating equation to determine if gestational age predicted the psychosocial outcomes whilst controlling for sociodemographic variables. Results Participants were aged 27.1 ± 5.2 years, on average. Psychometric analyses revealed a 4-factor solution for BAI (18 items), 1-factor solution for CES-D (13 items) and 4-factor solution for RAND SF-36 (26 items). The prevalence estimate of psychosocial disturbances was 34%, 10%, 2% (anxiety), 49%, 31%, 34% (depressive symptoms), and 46%, 37%, 59% (low QoL) for 1st, 2nd and 3rd trimesters, respectively. Gestational age and food insecurity were significant predictors of depressive symptoms, anxiety symptoms and QoL. Conclusions In this population of Ghanaian women, the levels of depressive symptoms and low QoL observed across pregnancy should be recognized as major public health problems and efforts to address these should be put in place. Addressing food insecurity may be a major step to solve not only the physical needs of the pregnant woman but also the psychological needs. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-022-13299-2.
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Affiliation(s)
- Ruth Adisetu Pobee
- Department of Nutritional Sciences, The Pennsylvania State University, University Park, PA, 16802, USA
| | - Jacob Setorglo
- Department of Clinical Nutrition and Dietetics, University of Cape Coast, Cape Coast, Ghana
| | - Moses Kwashie Klevor
- Department of Clinical Nutrition and Dietetics, University of Cape Coast, Cape Coast, Ghana
| | - Laura E Murray-Kolb
- Department of Nutritional Sciences, The Pennsylvania State University, University Park, PA, 16802, USA. .,Department of Nutrition Science, Purdue University, Room 214 Stone Hall, 700 West State Street, West Lafayette, IN, 47907, USA.
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Sullivan MB, Rentz A, Mathura P, Gleddie M, Luthra T, Thiele AT, Kovacs Burns K, Rich R, Sia WW. Establishing an alternative accommodation for stable hospitalised antepartum patients: barriers and challenges. BMJ Open Qual 2022; 11:bmjoq-2021-001625. [PMID: 34992054 PMCID: PMC8739065 DOI: 10.1136/bmjoq-2021-001625] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2021] [Accepted: 12/02/2021] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND Patients in remote communities who risk premature delivery require transfer to a tertiary care centre for obstetric and neonatal care. Following stabilisation, many patients are candidates for outpatient management but cannot be discharged to their home communities due to lack of neonatal intensive care unit (ICU) support. PROBLEM Without outpatient accommodation proximal to neonatal ICU, these patients face prolonged hospitalisation-an expensive option with medical, social and psychological consequences. Therefore, we sought to establish an alternative accommodation for out-of-town stable antepartum patients. METHODS Quality Improvement approaches were used to identify process strengths and opportunities for improvement on the antepartum ward in a tertiary care centre. Physician and patient surveys informed outpatient accommodation programme development by a multidisciplinary team. The intervention was implemented using a plan-do-study-act cycle. Barriers to patient discharge and enrolment in the programme were analysed by completing thematic and strengths-weaknesses-opportunities-threats (SWOT) analysis. RESULTS Physicians broadly supported safe outpatient management, whereas patients were hesitant to leave the hospital even when physicians assured safety. Our alternative accommodation was pre-existing and cost-effective, however, we encountered significant barriers. The physical space limited family visits and social interaction, lacked desired amenities,and the programme proved inconvenient to patients. The thematic and SWOT analysis identified aspects of the intervention which can be optimised to develop future actionable strategies. CONCLUSION The utilisation of acute care beds is costly for the healthcare system and must be allocated judiciously. Patient needs, experience and health system barriers need to be considered when establishing alternative outpatient accommodations and strategies for stable antepartum patients.
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Affiliation(s)
| | - Abby Rentz
- University of Alberta, Edmonton, Alberta, Canada
| | | | | | - Tania Luthra
- University of Alberta, Edmonton, Alberta, Canada
| | | | - Katharina Kovacs Burns
- University of Alberta, Edmonton, Alberta, Canada.,Alberta Health Services, Edmonton, Alberta, Canada
| | - Rebecca Rich
- University of Alberta, Edmonton, Alberta, Canada
| | - Winnie W Sia
- University of Alberta, Edmonton, Alberta, Canada
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Jalali A, Heydarpour S, Tohidinejad F, Salari N. Cognitive-behavioral counseling and mental health of pregnant women. Heliyon 2020; 6:e03463. [PMID: 32140586 PMCID: PMC7049634 DOI: 10.1016/j.heliyon.2020.e03463] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2019] [Revised: 12/03/2019] [Accepted: 02/19/2020] [Indexed: 01/04/2023] Open
Abstract
Background Pregnancy is characterized with several physical and mental changes in women. These changes cause mental health problems in pregnant women and especially in nulliparous women. Objective To determine the effects of cognitive-behavioral counseling on mental health of pregnant women. Method The study was carried out as a quality of life clinical trial with a control group. The participants were 60 pregnant women (less than 20 weeks) who visited Kamyaran-based health centers (Iran) in 2018. The participants were allocated randomly to experiment and control groups (n = 30 each). The experiment group attended eight group behavioral cognitive counseling sessions (70-90min) on weekly basis. Pre-intervention data was collected using a demographics checklist and Goldberg's General Health Questionnaire. One month after the last counseling session, the questionnaires were filled out once more by all the participants. The data was analyzed using Mann-Whitney, independent t-test, Friedman, and Chi Squared tests using SPSS (23). Results The results showed that the difference between the control and experiment groups in terms of mental health score was not significant before the intervention (p = 0.169). However, the difference between the two groups was significant immediately (p = 0.001) and one month (p = 0.001) after the group behavioral cognitive counseling. Conclusion The group behavioral cognitive counseling sessions improved mental health in nulliparous women. Further studies with longer follow-up terms to ensure resilience of the effects of such interventions are recommended.
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Affiliation(s)
- Amir Jalali
- Substance Abuse prevention research center, Research Institute for Health, Kermanshah University of Medical Sciences, Kermanshah, Islamic Republic of Iran
| | - Sousan Heydarpour
- Department of Reproductive Health, Faculty of Nursing and Midwifery, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Fatemeh Tohidinejad
- Student Research Committee, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Nader Salari
- Department of Biostatistics, Faculty of Public Health, Kermanshah University of Medical Sciences, Kermanshah, Iran
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Abrar A, Fairbrother N, Smith AP, Skoll A, Albert AYK. Anxiety among women experiencing medically complicated pregnancy: A systematic review and meta-analysis. Birth 2020; 47:13-20. [PMID: 31222840 DOI: 10.1111/birt.12443] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2019] [Revised: 05/22/2019] [Accepted: 05/22/2019] [Indexed: 12/24/2022]
Abstract
BACKGROUND Symptoms of anxiety are common among pregnant and postpartum women, and 15%-20% of pregnancies are affected by medical complications. Despite this, little is known about the relationship of medical complications in pregnancy and women's experience of anxiety. The purpose of this research was to conduct a systematic review and meta-analysis of differences in anxiety symptom severity among women experiencing a medically complicated versus a medically uncomplicated pregnancy. METHODS This work was guided by the PRISMA reporting process. Electronic databases MEDLINE and PsycINFO were searched to identify studies that met the inclusion criteria. An adaptation of the Newcastle-Ottawa Quality Assessment Scale for case-control studies was used to perform a quality assessment review. A random-effects meta-analysis was used to calculate the estimated average standardized mean differences. RESULTS Based on the five studies which met our inclusion criteria, findings provide evidence of higher levels of anxiety symptoms among pregnant women experiencing a medically complicated versus a medically uncomplicated pregnancy. Despite considerable heterogeneity, all mean difference estimates are in the direction of greater anxiety in the high-risk groups. CONCLUSIONS Women experiencing a medically complex pregnancy report higher levels of anxiety symptoms compared to women experiencing a medically uncomplicated pregnancy.
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Affiliation(s)
- Ambar Abrar
- Social Dimensions of Health Program, The University of Victoria, Victoria, British Columbia, Canada
| | - Nichole Fairbrother
- Department of Psychiatry and Island Medical Program, The University of British Columbia, Vancouver, British Columbia, Canada
| | - André P Smith
- Department of Sociology, The University of Victoria, Victoria, British Columbia, Canada
| | - Amanda Skoll
- Department of Obstetrics and Gynaecology, The University of British Columbia, Vancouver, British Columbia, Canada
| | - Arianne Y K Albert
- Women's Health Research Institute, British Columbia's Women's Hospital and Health Centre and Department of Obstetrics and Gynaecology, The University of British Columbia, Vancouver, British Columbia, Canada
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Morin M, Claris O, Dussart C, Frelat A, de Place A, Molinier L, Matillon Y, Elhinger V, Vayssiere C. Health-related quality of life during pregnancy: A repeated measures study of changes from the first trimester to birth. Acta Obstet Gynecol Scand 2019; 98:1282-1291. [PMID: 30985917 DOI: 10.1111/aogs.13624] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2018] [Revised: 04/04/2019] [Accepted: 04/08/2019] [Indexed: 12/15/2022]
Abstract
INTRODUCTION The objective was to evaluate the quality of life of pregnant women with a full-term birth from the first trimester to the 9th month using the EQ5D-3L questionnaire, comparing physiological, simple pathological, or complex pathological pregnancies. MATERIAL AND METHODS A prospective cohort of 500 pregnant women over the age of 18 was monitored between 2015 and 2017 at the Toulouse University Hospital (France). The data were collected monthly with an online report. Given that the decrease in quality of life was not linear during pregnancy, unadjusted and adjusted piecewise linear regression models were performed, considering 3 periods of time during pregnancy: 3-4, 4-8, and 8-9 months. The 5 dimensions of the EQ5D-Index and perceived health status were also analyzed. RESULTS In total, 1847 questionnaires were collected. Between the 4th and 8th months, the quality of life was lower for pathological pregnancies (P < 0.001) than for physiological ones and decreased over time for each type of pregnancy (physiological: -0.08 points per month, P < 0.001; simple pathological: -0.12 points per month, P < 0.001; complex pathological: -0.11 points per month, P < 0.001). Interestingly, the perceived health status was lower at the 9th month than at the 3rd month of pregnancy, for physiological pregnancies (mean difference = -10.5 points, P < 0.001), pathological pregnancies (mean difference = -10.0 points, P < 0.002), and for complex pathological pregnancies (mean difference = -7.8 points, P = 0.058). CONCLUSIONS In our population, the quality of life decreased between the 4th and 8th months, and decreased to a greater degree in a pathological pregnancy.
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Affiliation(s)
- Mathieu Morin
- Department of Obstetrics and Gynecology, Paule de Viguier Hospital, CHU Toulouse, Toulouse, France.,Department of Pathways to Systemic Health-P2S-EA 4129, University Claude Bernard of Lyon I, Lyon, France
| | - Olivier Claris
- Department of Pathways to Systemic Health-P2S-EA 4129, University Claude Bernard of Lyon I, Lyon, France.,Department of Neonatology and Neonatal Intensive Care, Lyon University Hospital, Lyon, France
| | - Claude Dussart
- Department of Pathways to Systemic Health-P2S-EA 4129, University Claude Bernard of Lyon I, Lyon, France
| | - Alais Frelat
- Department of Obstetrics and Gynecology, Paule de Viguier Hospital, CHU Toulouse, Toulouse, France
| | - Alice de Place
- Department of Obstetrics and Gynecology, Paule de Viguier Hospital, CHU Toulouse, Toulouse, France
| | - Laurent Molinier
- Department of Medical Information, CHU Toulouse, Toulouse III University, Toulouse, France.,UMR 1027 INSERM, Team 5-Cancer and Chronic Disease: Social Inequalities in Health, Primary and Secondary Access to Care, Toulouse III University, Toulouse, France
| | - Yves Matillon
- Department of Pathways to Systemic Health-P2S-EA 4129, University Claude Bernard of Lyon I, Lyon, France
| | - Virginie Elhinger
- UMR 1027 INSERM, Team SPHERE-Study of Perinatal, Pediatric and Adolescent Health: Epidemiological Research and Evaluation, Toulouse III University, Toulouse, France
| | - Christophe Vayssiere
- Department of Obstetrics and Gynecology, Paule de Viguier Hospital, CHU Toulouse, Toulouse, France.,UMR 1027 INSERM, Team SPHERE-Study of Perinatal, Pediatric and Adolescent Health: Epidemiological Research and Evaluation, Toulouse III University, Toulouse, France
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Lagadec N, Steinecker M, Kapassi A, Magnier AM, Chastang J, Robert S, Gaouaou N, Ibanez G. Factors influencing the quality of life of pregnant women: a systematic review. BMC Pregnancy Childbirth 2018; 18:455. [PMID: 30470200 PMCID: PMC6251086 DOI: 10.1186/s12884-018-2087-4] [Citation(s) in RCA: 132] [Impact Index Per Article: 22.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2018] [Accepted: 11/13/2018] [Indexed: 12/31/2022] Open
Abstract
Background Pregnancy is a period of transition with important physical and emotional changes. Even in uncomplicated pregnancies, these changes can affect the quality of life (QOL) of pregnant women, affecting both maternal and infant health. The objectives of this study were to describe the quality of life during uncomplicated pregnancy and to assess its associated socio-demographic, physical and psychological factors in developed countries. Methods A systematic review was performed according to the PRISMA guidelines. Searches were made in PubMed, EMBASE and BDSP (Public Health Database). Two independent reviewers extracted the data. Countries with a human development index over 0.7 were selected. The quality of the articles was evaluated on the basis of the STROBE criteria. Results In total, thirty-seven articles were included. While the physical component of QOL decreased throughout pregnancy, the mental component was stable and even showed an improvement during pregnancy. Main factors associated with better QOL were mean maternal age, primiparity, early gestational age, the absence of social and economic problems, having family and friends, doing physical exercise, feeling happiness at being pregnant and being optimistic. Main factors associated with poorer QOL were medically assisted reproduction, complications before or during pregnancy, obesity, nausea and vomiting, epigastralgia, back pain, smoking during the months prior to conception, a history of alcohol dependence, sleep difficulties, stress, anxiety, depression during pregnancy and sexual or domestic violence. Conclusions Health-related quality of life refers to the subjective assessment of patients regarding the physical, mental and social dimensions of well-being. Improving the quality of life of pregnant women requires better identification of their difficulties and guidance which offers assistance whenever possible.
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Affiliation(s)
- Nolwenn Lagadec
- Department of Education and Research in General Medicine, Faculty of Medicine Pierre et Marie Curie, 27, rue Chaligny - 75571, cedex 12, Paris, France
| | - Magali Steinecker
- Department of Education and Research in General Medicine, Faculty of Medicine Pierre et Marie Curie, 27, rue Chaligny - 75571, cedex 12, Paris, France
| | - Amar Kapassi
- Department of Education and Research in General Medicine, Faculty of Medicine Pierre et Marie Curie, 27, rue Chaligny - 75571, cedex 12, Paris, France
| | - Anne Marie Magnier
- Department of Education and Research in General Medicine, Faculty of Medicine Pierre et Marie Curie, 27, rue Chaligny - 75571, cedex 12, Paris, France
| | - Julie Chastang
- Department of Education and Research in General Medicine, Faculty of Medicine Pierre et Marie Curie, 27, rue Chaligny - 75571, cedex 12, Paris, France
| | - Sarah Robert
- Sorbonne Universités, UPMC Univ Paris 06, INSERM, Institut Pierre Louis d'épidémiologie et de Santé Publique (IPLESP UMRS 1136), F75012, Paris, France
| | - Nadia Gaouaou
- Department of Education and Research in General Medicine, Faculty of Medicine Pierre et Marie Curie, 27, rue Chaligny - 75571, cedex 12, Paris, France
| | - Gladys Ibanez
- Sorbonne Universités, UPMC Univ Paris 06, INSERM, Institut Pierre Louis d'épidémiologie et de Santé Publique (IPLESP UMRS 1136), F75012, Paris, France.
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Nakamura Y, Sato M, Watanabe I. Positive Emotion and its Changes during Pregnancy: Adjunct Study of Japan Environment and Children's Study in Miyagi Prefecture. TOHOKU J EXP MED 2018; 245:223-230. [PMID: 30058596 DOI: 10.1620/tjem.245.223] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
During pregnancy, women experience various emotional changes. Previous research has investigated positive emotion influenced childbirth outcomes positively. This study explored the extent of positive emotion which pregnant women aware of their own pregnancy life subjectively and variables related to the changes thereof. This was an adjunct study of the Japan Environment and Children's Study which is a nationwide epidemiological study to identify the impact of environmental factors on health and development of children in Miyagi Prefecture. Data were collected at 12 weeks (T1) and 24-28 weeks (T2) of gestation. Participants were 3,513 pregnant women. Women's degree of positive emotion was assessed through a numeric rating scale. We also measured related variables, including obstetric factors, physical health status, mental health status, and social situation, using the 8-Item Short Form Health Survey, Kessler-6, and family APGAR score, along with demographic data. Analyses included correlations among variables related to the change in positive emotion. The extent of positive emotion was significantly related with health-related quality of life and satisfaction with family relationships during pregnancy. The women whose positive emotion decreased from T1 to T2 tended to have lower morning sickness symptoms, be unemployed, lower physical and mental health status, and a higher risk of psychological distress in middle pregnancy. Importantly, even discomfort like morning sickness, physical symptoms that indicate being pregnant, might make women to confirm pregnancy. Moreover, employment and satisfaction with family relationships are especially crucial for pregnant women to spend comfortable maternity life.
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Affiliation(s)
- Yasuka Nakamura
- Nursing Course, Tohoku University Graduate School of Medicine
| | - Mari Sato
- Nursing Course, Tohoku University Graduate School of Medicine
| | - Ikue Watanabe
- Department of Nursing, Faculty of Health Sciences, Tohoku Fukushi University
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Evaluation of the quality of life of pregnant women from 2005 to 2015. Eur J Obstet Gynecol Reprod Biol 2017; 214:115-130. [PMID: 28525824 DOI: 10.1016/j.ejogrb.2017.04.045] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2017] [Revised: 04/07/2017] [Accepted: 04/27/2017] [Indexed: 11/21/2022]
Abstract
Over the past two decades, quality of life has become an essential preoccupation in the care of patients. Many measuring instruments are available to assess physical, psychological and social quality of life. These tools allow healthcare professionals to determine the best quality of their patients. However, the quality of life for the pregnant woman seems to be little studied. This article presents the results of a bibliographic review of publications between 2005 and 2015 - referenced in PUBMED and COCHRANE - on the quality of life of pregnant women giving birth after the 22nd week of amenorrhea. The articles were selected by a reading committee. 195 publications responding to keywords were identified. 75 articles on the problem were selected. The main countries that have published on this subject are Iran (n=11) and Brazil (n=9). France ranks 17th with only one publication. 74% of articles deal with quality of life for pathological pregnancies (gestational or pre-existing pathologies). 23 pathologies were identified, mainly depression (20% of items). This review reveals a growing global interest in quality of life in pregnant women. However, few studies evaluate the impact of care in terms of quality of life in pregnant women, contrary to the recommendations of different health authorities. Finally, the analysis of the various articles shows that, in general, few measurements are made to evaluate the quality of life, not requiring a standardized curve of quality of life during pregnancy. There is thus a significant lack of data to establish a standardized curve for the quality of life of pregnant women, which allows a simple comparison of quality of life measures according to the different clinical management.
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Byatt N, Hicks-Courant K, Davidson A, Levesque R, Mick E, Allison J, Moore Simas TA. Depression and anxiety among high-risk obstetric inpatients. Gen Hosp Psychiatry 2014; 36:644-9. [PMID: 25149040 PMCID: PMC4399814 DOI: 10.1016/j.genhosppsych.2014.07.011] [Citation(s) in RCA: 58] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2014] [Revised: 07/16/2014] [Accepted: 07/21/2014] [Indexed: 10/25/2022]
Abstract
OBJECTIVE To assess the following among women hospitalized antenatally due to high-risk pregnancies: (1) rates of depression symptoms and anxiety symptoms, (2) changes in depression symptoms and anxiety symptoms and, (3) rates of mental health treatment. METHODS Sixty-two participants hospitalized for high-risk obstetrical complications completed the Edinburgh Postnatal Depression Scale (EPDS), Generalized Anxiety Disorder 7-item scale (GAD-7) and Short-Form 12 weekly until delivery or discharge, and once postpartum. RESULTS Average length of total hospital stay was 8.3 ± 7.6 days for women who completed an initial admission survey (n = 62) and 16.3 ± 8.9 (n = 34), 25.4 ± 10.2 (n = 17) and 35 ± 10.9 days (n = 9) for those who completed 2, 3 and 4 surveys, respectively. EPDS was ≥ 10 in 27% (n=17) and GAD-7 was ≥ 10 in 13% (n = 8) of participants at initial survey. Mean anxiety (4.2 ± 6.5 vs. 5.2 ± 5.1, p = .011) and depression (4.4 ± 5.6 vs. 6.9 ± 4.8, p = .011) scores were lower postpartum compared to initial survey. Past mental health diagnosis predicted depression symptoms [odds ratio (OR) = 4.54; 95% confidence interval (CI) 1.91-7.17] and anxiety symptoms (OR = 5.95; 95% CI 3.04-8.86) at initial survey; however, 21% (n = 10) with no diagnostic history had EPDS ≥ 10. Five percent (n = 3) received mental health treatment during pregnancy. CONCLUSION Hospitalized high-risk obstetrical patients may commonly experience depression symptoms and/or anxiety symptoms and not receive treatment. A history of mental health treatment or diagnosis was associated with depression symptoms or anxiety symptoms in pregnancy. Of women with an EPDS ≥ 10, > 50% did not report a past mental health diagnosis.
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Affiliation(s)
- Nancy Byatt
- Department of Psychiatry, University of Massachusetts Medical School, 55 Lake Ave North, Worcester, MA, 01655, USA; Department of Obstetrics and Gynecology, University of Massachusetts Medical School, Worcester, MA, USA.
| | - Katherine Hicks-Courant
- Department of Psychiatry, University of Massachusetts Medical School, 55 Lake Ave North, Worcester, MA, 01655, USA,Department of Obstetrics and Gynecology, University of Massachusetts Medical School, Worcester, MA, USA
| | | | - Ruth Levesque
- Department of Obstetrics and Gynecology, University of Massachusetts Medical School, Worcester, MA, USA
| | - Eric Mick
- Department of Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, MA, USA
| | - Jeroan Allison
- Department of Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, MA, USA
| | - Tiffany A. Moore Simas
- Department of Obstetrics and Gynecology, University of Massachusetts Medical School, Worcester, MA, USA
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Thiagayson P, Krishnaswamy G, Lim ML, Sung SC, Haley CL, Fung DSS, Allen JC, Chen H. Depression and anxiety in Singaporean high-risk pregnancies - prevalence and screening. Gen Hosp Psychiatry 2013; 35:112-6. [PMID: 23265951 DOI: 10.1016/j.genhosppsych.2012.11.006] [Citation(s) in RCA: 56] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2012] [Revised: 11/13/2012] [Accepted: 11/14/2012] [Indexed: 11/19/2022]
Abstract
OBJECTIVE Data on psychiatric morbidity in high-risk pregnant Singaporean women are limited. This study aimed to establish the prevalence of antenatal depression and anxiety in high-risk pregnancies, compare the prevalence of antenatal depression in high-risk pregnancies vs. pregnancies of unspecified obstetric risk and examine the Edinburgh Postnatal Depression Scale (EPDS) and State Trait Anxiety Inventory (STAI) as screening tools for these disorders. METHOD Two hundred high-risk pregnant inpatients at a national public maternity hospital were included. Three psychometric assessment tools were used to evaluate all participants: the diagnostic Mini International Neuropsychiatric Interview and the screening EPDS and STAI. RESULTS Rates of major depression, minor depression, anxiety disorder (agoraphobia, generalized anxiety disorder, panic disorder), and comorbid depression and anxiety were 11%, 7%, 12.5% and 5%, respectively. Major depression was more prevalent in high-risk pregnancies than in the historical cohort of unspecified obstetric risk (11% versus 4.3%). EPDS (cutoff 8/9) screens well for depression and anxiety in high-risk pregnancies (area under the receiver operating characteristic curve=0.82-0.87). CONCLUSION Antenatal depression and anxiety are highly prevalent in a sample of high-risk pregnant Singaporean women. EPDS performs well in screening for depression and anxiety in high-risk pregnant women, with further psychiatric assessment recommended for women with score ≥ 9.
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Affiliation(s)
- Pavaani Thiagayson
- Duke-NUS Graduate Medical School, Duke-NUS Graduate Medical School Singapore, 8 College Road, Singapore 169857, Singapore.
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