1
|
Kakwangire P, Atukunda P, Ngari M, Westerberg AC, Iversen PO, Muhoozi G. Long-term effects on depressive symptoms among Ugandan mothers - Findings from a follow-up of a cluster-randomized education trial in a rural low-resource setting. J Affect Disord 2024; 351:598-606. [PMID: 38307132 DOI: 10.1016/j.jad.2024.01.263] [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: 06/15/2023] [Revised: 01/26/2024] [Accepted: 01/29/2024] [Indexed: 02/04/2024]
Abstract
INTRODUCTION Depression is increasingly affecting mothers in poor countries such as Uganda. Various interventions have been implemented to tackle this problem, but their sustainability is under-researched. Here we present follow-up data on maternal depression six years after a cluster-randomized controlled maternal education trial in rural Uganda. METHODS The intervention lasted six months and consisted of nutrition, hygiene, sanitation and child stimulation education, delivered to 511 mothers of 6 to 8 months' old children. Six years later we assessed maternal depressive symptoms using two psychometric tools; the Beck Depression Inventory II (BDI-II) and Center for Epidemiologic Studies Depression scale (CESD). RESULTS For this follow-up study, data was available from 307/511 (60 %) mothers. Intention-to-treat analyses adjusting for clustering showed that the intervention mothers had non-significantly less depression symptoms (absolute score difference - 2; 95 % CI -5 to 0; p = 0.07) on BDI-II, and borderline significantly less depression symptoms (absolute score difference - 3; 95 % CI -5 to 0; p = 0.05) on CES-D compared to the controls. For categorized depression scores, the control mothers had significantly higher proportion of women classified in the worse depression categories for both BDI-II and CESD. We did not find any baseline characteristics associated with maternal depression. LIMITATIONS The BDI-II and CES-D tools are both self-reported and we cannot rule out the possibility of social desirability bias in reporting of depression symptoms. CONCLUSION Six years after the maternal education trial, some benefits on maternal mental health were sustained. More studies are warranted on sustainability and scale-up of such interventions.
Collapse
Affiliation(s)
- Paul Kakwangire
- Department of Nutrition, IMB, University of Oslo, Oslo, Norway
| | - Prudence Atukunda
- Center for Crisis Psychology, Faculty of Psychology, University of Bergen, Bergen, Norway
| | - Moses Ngari
- KEMRI Wellcome Trust Research Programme, Kilifi, Kenya and Department of Public Health, School of Health & Human Sciences, Pwani University, Kilifi, Kenya
| | - Ane C Westerberg
- Division of Obstetrics and Gynecology, Department of Obstetrics, Oslo University Hospital - Rikshospitalet, Oslo, Norway; School of Health Sciences, Kristiania University College, Oslo, Norway
| | - Per O Iversen
- Department of Nutrition, IMB, University of Oslo, Oslo, Norway; Department of Haematology, Oslo University Hospital, Oslo, Norway; Division of Human Nutrition, Stellenbosch University, Tygerberg, South Africa
| | - Grace Muhoozi
- Department of Family Life and Consumer Studies (Home Economics), Kyambogo University, Kampala, Uganda.
| |
Collapse
|
2
|
Zhao X, Liu L. Mendelian randomization analyses for the causal relationship between early age at first sexual intercourse, early age at first live birth, and postpartum depression in pregnant women. Front Psychiatry 2024; 15:1287934. [PMID: 38651010 PMCID: PMC11033313 DOI: 10.3389/fpsyt.2024.1287934] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2023] [Accepted: 03/25/2024] [Indexed: 04/25/2024] Open
Abstract
Introduction There are insufficient epidemiological studies on the impact of age at first sexual intercourse (AFS) and age at first live birth (AFB) on postpartum depression (PPD) in pregnant women, and the conclusions of these studies are inconsistent. Methods We performed a Mendelian randomization (MR) study to determine the causal relationship between AFS or AFB and the risk of PPD. The summary data were extracted from genome-wide association study (GWAS) summary datasets. We selected the instrumental variables according to the P value of exposure-related single nucleotide polymorphisms (P<5 ×10-9 for AFS and P<5 ×10-8 for AFB) and estimated the linkage disequilibrium using the clump parameter (10,000 kb, r2 < 0.001). Single nucleotide polymorphisms were considered instrumental variables that were significantly associated with exposure factors without linkage disequilibrium. The F-statistics of the instrumental variables should all be larger than 10. A random-effects model of IVW was constructed as the main method in our study. Results and discussion MR studies based on GWAS data revealed that both AFS (OR = 0.4, P <0.001) and AFB (OR = 0.38, P <0.001) were negatively correlated with the risk of PPD. Early AFS and early AFB should be studied as possible risk factors for PPD in the future. Public health departments should attach importance to sex education for young girls. The results of our TSMR should be verified by high-quality prospective epidemiological studies in the future.
Collapse
Affiliation(s)
- Xuemin Zhao
- Department of Internal Medicine, Chengde Medical University, Chengde, China
| | - Linfei Liu
- Sericultural Research Institute, Chengde Medical University, Chengde, China
| |
Collapse
|
3
|
Neeser NB, Martani A, De Clercq E, De Geyter C, Vulliemoz N, Elger BS, Wangmo T. Building a family at advanced parental age: a systematic review on the risks and opportunities for parents and their offspring. Hum Reprod Open 2023; 2023:hoad042. [PMID: 38045093 PMCID: PMC10692762 DOI: 10.1093/hropen/hoad042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2023] [Revised: 10/26/2023] [Indexed: 12/05/2023] Open
Abstract
STUDY QUESTION What is the existing empirical literature on the psychosocial health and wellbeing of the parents and offspring born at an advanced parental age (APA), defined as 40 years onwards? SUMMARY ANSWER Although the studies show discrepancies in defining who is an APA parent and an imbalance in the empirical evidence for offspring, mothers, and fathers, there is a drive towards finding psychotic disorders and (neuro-)developmental disorders among the offspring; overall, the observed advantages and disadvantages are difficult to compare. WHAT IS KNOWN ALREADY In many societies, children are born to parents at advanced ages and there is rising attention in the literature towards the consequences of this trend. STUDY DESIGN SIZE DURATION The systematic search was conducted in six electronic databases (PubMed including Medline, Embase, Scopus, PsycInfo, CINAHL, and SocINDEX) and was limited to papers published between 2000 and 2021 and to English-language articles. Search terms used across all six electronic databases were: ('advanced parental age' OR 'advanced maternal age' OR 'advanced paternal age' OR 'advanced reproductive age' OR 'late parent*' OR 'late motherhood' OR 'late fatherhood') AND ('IVF' OR 'in vitro fertilization' OR 'in-vitro-fertilization' OR 'fertilization in vitro' OR 'ICSI' OR 'intracytoplasmic sperm injection' OR 'reproductive techn*' OR 'assisted reproductive technolog*' OR 'assisted reproduction' OR 'assisted conception' OR 'reproduction' OR 'conception' OR 'birth*' OR 'pregnan*') AND ('wellbeing' OR 'well-being' OR 'psycho-social' OR 'social' OR 'ethical' OR 'right to reproduce' OR 'justice' OR 'family functioning' OR 'parental competenc*' OR 'ageism' OR 'reproductive autonomy' OR 'outcome' OR 'risk*' OR 'benefit*'). PARTICIPANTS/MATERIALS SETTING METHODS The included papers were empirical studies in English published between 2000 and 2021, where the study either examined the wellbeing and psychosocial health of parents and/or their children, or focused on parental competences of APA parents or on the functioning of families with APA parents. A quality assessment of the identified studies was performed with the QATSDD tool. Additionally, 20% of studies were double-checked at the data extraction and quality assessment stage to avoid bias. The variables sought were: the geographical location, the year of publication, the methodological approach, the definitions of APA used, what study group was at the centre of the research, what research topic was studied, and what advantages and disadvantages of APA were found. MAIN RESULTS AND THE ROLE OF CHANCE A total number of 5403 articles were identified, leading to 2543 articles being included for title and abstract screening after removal of duplicates. This resulted in 98 articles included for a full-text reading by four researchers. Ultimately, 69 studies were included in the final sample. The key results concerned four aspects relevant to the research goals. (i) The studies showed discrepancies in defining who is an APA parent. (ii) There was an imbalance in the empirical evidence produced for different participant groups (mothers, fathers, and offspring), with offspring being the most studied study subjects. (iii) The research topics studied underlined the increased risks of neuro-developmental and psychotic disorders among offspring. (iv) The observed advantages and disadvantages were varied and could not be compared, especially for the offspring of APA parents. LIMITATIONS REASONS FOR CAUTION Only English-language studies, published between 2000 and 2021, found in the above-mentioned databases were considered for this review. WIDER IMPLICATIONS OF THE FINDINGS More research is necessary to understand the risks and benefits of building a family at an APA for the offspring when they reach adulthood. Furthermore, studies that explore the perspective of older fathers and older parents from non-Western societies would be highly informative. STUDY FUNDING/COMPETING INTERESTS The writing of this manuscript was permitted by financial support provided by the Swiss National Science Foundation (Weave/Lead Agency funding program, grant number 10001AL_197415/1, project title 'Family Building at Advanced Parental Age: An Interdisciplinary Approach'). The funder had no role in the drafting of this manuscript and the views expressed therein are those of the authors. The authors have no conflicts of interest. REGISTRATION NUMBER This systematic review is registered in Prospero: CRD42022304564.
Collapse
Affiliation(s)
- Nathalie B Neeser
- Institute for Biomedical Ethics, University of Basel, Basel, Switzerland
| | - Andrea Martani
- Institute for Biomedical Ethics, University of Basel, Basel, Switzerland
| | - Eva De Clercq
- Institute for Biomedical Ethics, University of Basel, Basel, Switzerland
| | - Christian De Geyter
- Reproductive Medicine and Gynaecological Endocrinology (RME), University Hospital, University of Basel, Basel, Switzerland
| | - Nicolas Vulliemoz
- Centre de Procréation Médicalement Assistée (CPMA), Lausanne, Switzerland
| | - Bernice S Elger
- Institute for Biomedical Ethics, University of Basel, Basel, Switzerland
| | - Tenzin Wangmo
- Institute for Biomedical Ethics, University of Basel, Basel, Switzerland
| |
Collapse
|
4
|
Pouranayatihosseinabad M, Taylor M, Hawrelak J, Peterson GM, Veal F, Ling T, Williams M, Whatley M, Ahdieh K, Mirkazemi C. Maternal Antibiotic Exposure and the Risk of Developing Antenatal or Postpartum Depressive Symptoms: The Maternal Experience Study Protocol. Methods Protoc 2023; 6:98. [PMID: 37888030 PMCID: PMC10609134 DOI: 10.3390/mps6050098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2023] [Revised: 10/02/2023] [Accepted: 10/02/2023] [Indexed: 10/28/2023] Open
Abstract
Limited epidemiological evidence suggests a link between antibiotic use and developing depression. This study seeks to investigate this association in depth, using a cohort of pregnant individuals. The primary aim is to explore any association between the use of antibiotics during pregnancy and the development of antenatal depressive symptoms up to the third trimester, as well as the use of antibiotics during pregnancy and within 12 months postpartum and the development of postpartum depressive symptoms. A national prospective, observational, longitudinal cohort study has been designed to examine these relationships. A sample size of 1500 pregnant individuals has been sought for this study, assuming 10 potential predictor variables (including antibiotic use) in the final multiple logistic regression model and allowing for a 30% drop-out rate. The development of depressive symptoms is considered either a diagnosis by a medical doctor and/or a scoring 13 or higher on the Edinburgh Postnatal Depression Scale. Data will be collected during the third trimester and at 6 weeks, 6 months, and 12 months postpartum. These surveys include variables previously identified as associated with antenatal and postpartum depression (e.g., level of social support, experience of intimate partner abuse, and obstetric complications), as well as antibiotic and probiotic use. This study will provide an update on the prevalence of the symptoms of depression during pregnancy and postpartum and its associated risk factors. It will also, for the first time, comprehensively explore the potential association between antibiotic use during pregnancy and up to 12 months postpartum and the development of depressive symptoms.
Collapse
Affiliation(s)
- Mahsa Pouranayatihosseinabad
- School of Pharmacy and Pharmacology, College of Health and Medicine, University of Tasmania, Hobart, TAS 7005, Australia
| | - Maggie Taylor
- School of Pharmacy and Pharmacology, College of Health and Medicine, University of Tasmania, Hobart, TAS 7005, Australia
| | - Jason Hawrelak
- School of Pharmacy and Pharmacology, College of Health and Medicine, University of Tasmania, Hobart, TAS 7005, Australia
| | - Gregory M. Peterson
- School of Pharmacy and Pharmacology, College of Health and Medicine, University of Tasmania, Hobart, TAS 7005, Australia
| | - Felicity Veal
- School of Pharmacy and Pharmacology, College of Health and Medicine, University of Tasmania, Hobart, TAS 7005, Australia
| | - Tristan Ling
- School of Pharmacy and Pharmacology, College of Health and Medicine, University of Tasmania, Hobart, TAS 7005, Australia
| | - Mackenzie Williams
- School of Pharmacy and Pharmacology, College of Health and Medicine, University of Tasmania, Hobart, TAS 7005, Australia
| | - Megan Whatley
- Department of Obstetrics and Gynaecology, Royal Hobart Hospital, Hobart, TAS 7000, Australia
| | - Kyan Ahdieh
- Launceston Medical Centre, Health Hub, Launceston, TAS 7250, Australia
| | - Corinne Mirkazemi
- School of Pharmacy and Pharmacology, College of Health and Medicine, University of Tasmania, Hobart, TAS 7005, Australia
| |
Collapse
|
5
|
Sim CSM, Chen H, Chong SL, Xia OJ, Chew E, Guo X, Ng LP, Ch'ng YC, Ong JLH, Tan J, Ng DCC, Tan NC, Chan YH. Primary health level screening for postpartum depression during well-child visits: Prevalence, associated risk factors, and breastfeeding. Asian J Psychiatr 2023; 87:103701. [PMID: 37517174 DOI: 10.1016/j.ajp.2023.103701] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Revised: 07/14/2023] [Accepted: 07/16/2023] [Indexed: 08/01/2023]
Abstract
Postpartum depression (PPD) is a public health problem that is associated with detrimental effects on the wellbeing of the mother, child and family. Early detection for PPD at the primary health level provides an opportunity for intervention. We aim to examine: (1) the prevalence rate of PPD in the primary care population, (2) acceptance and attendance rates of intervention for women who screened positive for PPD, (3) sociodemographic and maternal risk factors of PPD, and (4) the impact of PPD on breastfeeding. We implemented a mother-child dyadic screening program using the modified Patient Health Questionnaire-2 during routine well-child visits at 2 or 3 months postpartum between July 2019 and December 2021. We performed multivariable logistic regression to identify independent risk factors for PPD and described using adjusted odds ratio (OR) with corresponding 95 % confidence intervals. Among 5561 mothers, the prevalence rate of probable PPD was 2.4 %. About half (54.4 %) of mothers who screened positive accepted intervention and of these, about two-thirds accepted onward referrals to tertiary care and community mental health service, with higher attendance at the latter. In the final adjusted model, mothers who had probable PPD were more likely to be older than age 35 years (OR 1.88, 95 % CI 1.05-3.45; p < 0.05) and not breastfeeding (OR 1.9, 95 % CI 1.06-3.38; p < 0.05). Overall, our findings highlight the importance of early PPD screening and management in primary care. These findings can help inform maternal mental health service development and utilization, thereby optimizing maternal and infant outcomes.
Collapse
Affiliation(s)
- Cherie Sze Min Sim
- Department of Psychological Medicine, KK Women's and Children's Hospital, Singapore
| | - Helen Chen
- Department of Psychological Medicine, KK Women's and Children's Hospital, Singapore; SingHeatlth-Duke NUS Paediatric Medicine Academic Clinical Programme, Singapore.
| | - Shu-Ling Chong
- SingHeatlth-Duke NUS Paediatric Medicine Academic Clinical Programme, Singapore; Paediatric Emergency Medicine Department, KK Women's and Children's Hospital, Singapore
| | | | - Elaine Chew
- SingHeatlth-Duke NUS Paediatric Medicine Academic Clinical Programme, Singapore; Adolescent Medicine Service, KK Women's and Children's Hospital, Singapore
| | - Xiaoxuan Guo
- SingHealth Polyclinics, Singapore; SingHealth-Duke NUS Family Medicine Academic Clinical Programme, Singapore
| | - Lai Peng Ng
- SingHealth Polyclinics, Singapore; SingHealth-Duke NUS Family Medicine Academic Clinical Programme, Singapore
| | - Ying Chia Ch'ng
- Department of Psychological Medicine, KK Women's and Children's Hospital, Singapore
| | | | | | - David Chee Chin Ng
- SingHealth Polyclinics, Singapore; SingHealth-Duke NUS Family Medicine Academic Clinical Programme, Singapore
| | - Ngiap Chuan Tan
- SingHealth Polyclinics, Singapore; SingHealth-Duke NUS Family Medicine Academic Clinical Programme, Singapore
| | - Yoke Hwee Chan
- SingHeatlth-Duke NUS Paediatric Medicine Academic Clinical Programme, Singapore; Division of Medicine, KK Women's and Children's Hospital, Singapore
| |
Collapse
|
6
|
Kosiva A, Xydias EM, Ziogas AC, Tsakos E, Thanasas I, Lykeridou A. Evaluation of Postpartum Midwifery Care in Greece Based on Patient-Reported Outcomes Using the MMAYpostpartum Questionnaire: A Cross-Sectional Study. Cureus 2023; 15:e46129. [PMID: 37779677 PMCID: PMC10537349 DOI: 10.7759/cureus.46129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/19/2023] [Indexed: 10/03/2023] Open
Abstract
Background The midwife's role throughout pregnancy and delivery management is essential, with multiple healthcare systems even following a midwife-led model of care. Of particular interest is the improvement and optimisation of midwifery postpartum care, which in Greece is empirically known to have decreased in quality, both due to the economic crisis and the recent pandemic. Aims To collect patient-reported outcomes with regard to the quality of midwifery services in Greece, ascertain baseline patient characteristics that may affect quality assessment, identify key areas for improvement, and propose patient subgroups who would most benefit from more specialized care. Setting and design A prospective, cross-sectional, questionnaire-based survey using the Measurement of Midwifery quality postpartum (MMAYpostpartum) questionnaire was conducted in public and private postpartum care centers in Greece. Methods The MMAYpostpartum questionnaire was distributed to 316 eligible women who received postpartum midwifery care in a healthcare center in Greece during the past three years. Multivariate linear regression was performed to examine significant correlations between baseline parameters and questionnaire scores. Results Ultimately, 204 answers were collected and analyzed. The patient's mean age was 35.5 years, and the mean body mass index (BMI) was 23.5. Overall, submitted scores were lower than those observed in the literature. A statistically significant correlation between older age, delivery at a public hospital, a history of hospitalization during pregnancy, and a lower midwifery service score was demonstrated. No other factors had a statistically significant effect on the quality score. Conclusions Delivery at public healthcare centers, older maternal age, and a history of hospitalization during pregnancy are significant predictors of a lower perceived quality of midwifery care. Thus, such patient subgroups may constitute potential targets for more meticulous midwifery care when resource setting prohibits the overall improvement of quality. Further research is required to collect additional data on patient insight and to test the present observations in a clinical setting.
Collapse
Affiliation(s)
- Alexandra Kosiva
- Department of Midwifery, School of Health and Care Sciences, University of West Attica, Athens, GRC
| | - Emmanouil M Xydias
- Department of Obstetrics and Gynaecology, EmbryoClinic IVF, Thessaloniki, GRC
- Department of Medicine, University of Thessaly, School of Health Sciences, Larissa, GRC
| | - Apostolos C Ziogas
- Department of Medicine, University of Thessaly, School of Health Sciences, Larissa, GRC
| | - Elias Tsakos
- Department of Obstetrics and Gynaecology, EmbryoClinic IVF, Thessaloniki, GRC
| | - Ioannis Thanasas
- Department of Obstetrics and Gynecology, General Hospital of Trikala, Trikala, GRC
| | - Aikaterini Lykeridou
- Department of Midwifery, School of Health and Care Sciences, University of West Attica, Athens, GRC
| |
Collapse
|
7
|
Yu J, Zhang Z, Deng Y, Zhang L, He C, Wu Y, Xu X, Yang J. Risk factors for the development of postpartum depression in individuals who screened positive for antenatal depression. BMC Psychiatry 2023; 23:557. [PMID: 37528383 PMCID: PMC10394808 DOI: 10.1186/s12888-023-05030-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2022] [Accepted: 07/15/2023] [Indexed: 08/03/2023] Open
Abstract
BACKGROUND Women with antenatal depression often have a higher risk of developing postpartum depression (PPD) after delivery. A number of factors associated with the PDD in those previously reporting antenatal depression have been suggested, but further research is needed. This study aimed to investigate factors associated with developing subsequent postnatal depression in women who had screened positive for antenatal depression. METHODS This study was carried out in Hangzhou women's Hospital. 578 women who experienced antenatal depression from this cohort were enrolled in this study. The sociodemographic and clinical characteristics of the participants were collected and tabulated against the incidence of postnatal depression. Binary logistic regression was used to estimate the effects of the principal underlying variables. The Chinese-version Edinburgh Postnatal Depression Scale (EPDS) was used to screen for PPD. Antenatal screening for depression was conducted at 28-34 weeks during pregnancy and postpartum depressive symptoms were assessed at 6 weeks after childbirth in the women. Path Analysis of Structural Equation Model (SEM) was employed to explore the direct, indirect, and total effects of risk factors of PPD. RESULTS 57.6% (n = 333) of the participants subsequently developed PPD in our study. The results of the logistic analysis indicated that ages ≤ 35 years old (OR = 1.852; 95%CI: 1.002-3.423), non-one-child families (OR = 1.518; 95%CI: 1.047-2.200), and rare care from partner during pregnancy (OR = 2.801; 95%CI: 1.038-7.562), the antenatal EPDS score (OR = 1.128; 95%CI: 1.052-1.209), pyrexia during pregnancy (OR = 2.43; 95%CI: 1.358-4.345), fairly good (OR = 1.836; 95%CI: 1.009-3.340), fairly bad (OR = 3.919; 95%CI:2.072-7.414) and very bad postpartum sleep quality (OR = 9.18; 95%CI: 2.335-36.241) were associated with increased risk of PPD (compared to very good postpartum sleep quality). In path analysis model, antenatal EPDS score (standardized total β = 0.173) and pyrexia during pregnancy (standardized total β = 0.132) had both direct and indirect effects (the impact on outcome variables needs to be determined through other variables) on PPD. Sleep quality after delivery (standardized β = 0.226) and one-child family (standardized β = 0.088) had direct effects only on PPD. CONCLUSION The results from our study indicated that more than 50% of the women who experienced antepartum depression would subsequently develop PPD. Depressive symptoms and pyrexia during pregnancy increase PPD scores, and these effects were in part mediated via poor sleep quality during the postpartum period.
Collapse
Affiliation(s)
- Jingjing Yu
- Department of Nutrition and Toxicology, Hangzhou Normal University School of Public Health, 2318 Yuhangtang Rd, Hangzhou, 311121, Zhejiang, China
| | - Zhiyin Zhang
- Department of Obstetrics, The Affiliated Hangzhou Women's Hospital, Hangzhou Normal University, Hangzhou, China
| | - Yuanyuan Deng
- Department of Nutrition and Toxicology, Hangzhou Normal University School of Public Health, 2318 Yuhangtang Rd, Hangzhou, 311121, Zhejiang, China
| | - Lijun Zhang
- Department of Nutrition and Toxicology, Hangzhou Normal University School of Public Health, 2318 Yuhangtang Rd, Hangzhou, 311121, Zhejiang, China
| | - Chuncao He
- Department of Nutrition and Toxicology, Hangzhou Normal University School of Public Health, 2318 Yuhangtang Rd, Hangzhou, 311121, Zhejiang, China
| | - Yinyin Wu
- Department of Epidemiology and Biostatistics, Hangzhou Normal University School of Public Health, Hangzhou, China
| | - Xianrong Xu
- Department of Nutrition and Toxicology, Hangzhou Normal University School of Public Health, 2318 Yuhangtang Rd, Hangzhou, 311121, Zhejiang, China.
| | - Jun Yang
- Department of Nutrition and Toxicology, Hangzhou Normal University School of Public Health, 2318 Yuhangtang Rd, Hangzhou, 311121, Zhejiang, China.
- Zhejiang Provincial Research Center for the Diagnosis and Treatment of Uterine Cancer, The Affiliated Women's Hospital, Zhejiang University, Hangzhou, China.
| |
Collapse
|
8
|
Chan J, Kirby J, Gardiner KK, Abruzzo V, Bannister S, Bellamy K, Brophy C, Clifford V, Cox L, Elborough H, Freyne BF, Summons F, Morrison C, Wall K, Casalaz DM, Curtis N, Pittet LF. Use of a paediatric advice line for parents of infants recruited to a randomised controlled trial. BMJ Paediatr Open 2023; 7:10.1136/bmjpo-2022-001665. [PMID: 36759016 PMCID: PMC9923309 DOI: 10.1136/bmjpo-2022-001665] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2022] [Accepted: 11/07/2022] [Indexed: 02/11/2023] Open
Abstract
BACKGROUND This study aims to describe the use of a paediatric advice line (PAL) provided to parents whose infants were recruited to a large randomised controlled trial (RCT), including the number and types of medical concerns addressed, seasonal variability and call outcomes. Additionally, sociodemographic characteristics of the parents and children of those parents who used the PAL are compared with those who did not. METHODS Prospective cohort of 1246 children nested in the Melbourne Infant Study: BCG for Allergy and Infection Reduction (MIS BAIR) RCT. All MIS BAIR participants were offered access to the PAL. Data were collected over the initial 2 years of a 5-year follow-up. Data were analysed using χ2 tests, and ORs were calculated using multiple logistic regression. RESULTS The PAL was used by 230 (18.5%) participants, who made a total of 586 calls during the 2-year study period. The reasons for calling the PAL were dermatological (24%); gastrointestinal (18%); disturbances in feeding, sleeping and crying (14%); respiratory (7%); and developmental/neurological (6%). Analysis revealed that those who used the PAL were more likely to be first-time parents (OR 1.4, 95% CI 1.1 to 1.9) and mothers who hold a university degree (OR 3.3, 95% CI 1.3 to 8.4). PAL costs were minimal and comprised 15 clinicians with paediatric experience. CONCLUSIONS A cost-effective PAL service for clinical trial participants was used appropriately by parents for relatively minor concerns and may have a role in trials to promote participant engagement and reduce demand for other health services.
Collapse
Affiliation(s)
- Joyce Chan
- Infectious Diseases Research Group, Murdoch Children's Research Institute, Parkville, Victoria, Australia .,The Royal Melbourne Hospital, Parkville, Victoria, Australia
| | - Jordan Kirby
- Department of Obstetrics and Gynaecology, Mercy Hospital for Women, Heidelberg, Victoria, Australia
| | - Kaya Kareela Gardiner
- Infectious Diseases Research Group, Murdoch Children's Research Institute, Parkville, Victoria, Australia
| | - Veronica Abruzzo
- Infectious Diseases Research Group, Murdoch Children's Research Institute, Parkville, Victoria, Australia
| | - Samantha Bannister
- Infectious Diseases Research Group, Murdoch Children's Research Institute, Parkville, Victoria, Australia.,Infectious Diseases Unit, Royal Children's Hospital Research Institute, Parkville, Victoria, Australia
| | - Karen Bellamy
- Australian Technical Advisory Group on Immunisation (ATAGI), Melbourne, Victoria, Australia.,Vaccine Safety Investigation Group (VSIG), Melbourne, Victoria, Australia
| | - Clare Brophy
- Murdoch Children's Research Institute, Parkville, Victoria, Australia.,The Peter Doherty Institute for Infection and Immunity, Melbourne, Victoria, Australia
| | - Vanessa Clifford
- Infectious Diseases Unit, Royal Children's Hospital Research Institute, Parkville, Victoria, Australia.,Laboratory Services, Royal Children's Hospital Research Institute, Parkville, Victoria, Australia
| | - Lianne Cox
- Murdoch Children's Research Institute, Parkville, Victoria, Australia.,Royal Children's Hospital Research Institute, Parkville, Victoria, Australia
| | - Hannah Elborough
- Murdoch Children's Research Institute, Parkville, Victoria, Australia
| | | | - Freya Summons
- Infectious Diseases Research Group, Murdoch Children's Research Institute, Parkville, Victoria, Australia.,Department of Paediatrics, The University of Melbourne, Parkville, Victoria, Australia
| | - Clare Morrison
- Murdoch Children's Research Institute, Parkville, Victoria, Australia
| | - Kate Wall
- Murdoch Children's Research Institute, Parkville, Victoria, Australia
| | - Daniel M Casalaz
- Department of Paediatrics, Mercy Hospital for Women, Heidelberg, Victoria, Australia
| | - Nigel Curtis
- Infectious Diseases Research Group, Murdoch Children's Research Institute, Parkville, Victoria, Australia.,Department of Paediatrics, The University of Melbourne, Parkville, Victoria, Australia
| | - Laure F Pittet
- Infectious Diseases Research Group, Murdoch Children's Research Institute, Parkville, Victoria, Australia.,Department of Paediatrics, The University of Melbourne, Parkville, Victoria, Australia
| | | |
Collapse
|
9
|
Ensuring Population Health in the Era of Aging in Vietnam: Policy Review and Factors Associated with Intentions of Childbearing before the Age of 30 among Youths. Healthcare (Basel) 2022; 11:healthcare11010102. [PMID: 36611562 PMCID: PMC9818781 DOI: 10.3390/healthcare11010102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Revised: 12/22/2022] [Accepted: 12/23/2022] [Indexed: 12/30/2022] Open
Abstract
Background: Delayed childbearing has become a concern among policymakers across the world. In Vietnam, population policies have been adjusted to cope with this issue. In 2020, Decision 588/QD-TTg was ratified to encourage people to marry and give birth before the age of 30. This study reviewed recent changes in Vietnam's population policies and assessed the intention of giving birth before 30 in young Vietnamese to provide insights into the potential effectiveness of the policy changes among young people. Methods: This study combined two approaches: a desk review and a survey of a group of youths. An online cross-sectional study was conducted on 116 respondents aged 16 to 30 in Vietnam from June to July 2020. The intention of childbearing before 30 and the importance and responsiveness of different social-environmental factors were asked using a structured questionnaire. We used multivariate logistic regression to identify associated factors of such intention. Results: The incentives set out by the Vietnamese government shared similarities with those of other countries. The plan of childbearing before the age of 30 among young adults in Vietnam was demonstrated to correlate with age, socioeconomic and biological characteristics, resources of the local health systems, as well as a clean and safe living environment. Conclusion: This study highlighted the recent crucial shift in Vietnam's population policy. However, the quantitative analysis suggested that measures relating to environmental factors should be incorporated under this policy, implying that further interventions need to be taken into account to cope with delayed childbearing.
Collapse
|
10
|
Borgsted C, Høgh S, Høgsted ES, Fonnesbech‐Sandberg L, Ekelund K, Albrechtsen CK, Wiis JT, Hegaard H, Cvetanovska E, Juul A, Frederiksen H, Pinborg A, Weikop P, Frokjaer V. The role of central serotonergic markers and estradiol changes in perinatal mental health. Acta Psychiatr Scand 2022; 146:357-369. [PMID: 35729864 PMCID: PMC9796905 DOI: 10.1111/acps.13461] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2022] [Revised: 06/09/2022] [Accepted: 06/11/2022] [Indexed: 01/29/2023]
Abstract
OBJECTIVE Women have an increased risk for mental distress and depressive symptoms in relation to pregnancy and birth. The serotonin transporter (SERT) may be involved in the emergence of depressive symptoms postpartum and during other sex-hormone transitions. It may be associated with cerebrospinal fluid (CSF) levels of the main serotonin metabolite 5-hydroxyindolacetic acid (5-HIAA). In 100 healthy pregnant women, who were scheduled to deliver by cesarean section (C-section), we evaluated 5-HIAA and estradiol contributions to mental distress 5 weeks postpartum. METHODS Eighty-two women completed the study. CSF collected at C-section was analyzed for 5-HIAA, with high performance liquid chromatography. Serum estradiol concentrations were quantified by liquid chromatography tandem mass spectrometry before C-section and postpartum. Postpartum mental distress was evaluated with the Edinburgh Postnatal Depression Scale (EPDS). Associations between EPDS, 5-HIAA, and Δestradiol were evaluated in linear regression models adjusted for age, parity and SERT genotype. RESULTS Higher levels of postpartum mental distress symptoms were negatively associated with a large decrease in estradiol concentrations (βΔE2 = 0.73, p = 0.007) and, on a trend level, positively associated with high antepartum 5-HIAA levels (β5-HIAA = 0.002, p = 0.06). CONCLUSION In a cohort of healthy pregnant women, postpartum mental distress was higher in women with high antepartum 5-HIAA (trend) and lower in women with a large perinatal estradiol decrease. We speculate that high antepartum 5-HIAA is a proxy of SERT levels, that carry over to the postpartum period and convey susceptibility to mental distress. In healthy women, the postpartum return to lower estradiol concentrations may promote mental well-being.
Collapse
Affiliation(s)
- Camilla Borgsted
- Neurobiology Research UnitCopenhagen University Hospital ‐ RigshospitaletCopenhagenDenmark,Mental Health Services in the Capital Region of DenmarkCopenhagenDenmark,Department of Clinical Medicine, Faculty of Health and Medical SciencesUniversity of CopenhagenCopenhagenDenmark
| | - Stinne Høgh
- Neurobiology Research UnitCopenhagen University Hospital ‐ RigshospitaletCopenhagenDenmark,Department of Clinical Medicine, Faculty of Health and Medical SciencesUniversity of CopenhagenCopenhagenDenmark,Department of ObstetricsCopenhagen University Hospital ‐ RigshospitaletCopenhagenDenmark
| | - Emma Sofie Høgsted
- Neurobiology Research UnitCopenhagen University Hospital ‐ RigshospitaletCopenhagenDenmark
| | | | - Kim Ekelund
- Department of Anaesthesiology, Juliane Marie CenterCopenhagen University Hospital ‐ RigshospitaletCopenhagenDenmark
| | - Charlotte Krebs Albrechtsen
- Department of Anaesthesiology, Juliane Marie CenterCopenhagen University Hospital ‐ RigshospitaletCopenhagenDenmark
| | - Julie Therese Wiis
- Department of AnaesthesiologyCopenhagen University Hospital ‐ HerlevHerlevDenmark
| | - Hanne Hegaard
- Department of Clinical Medicine, Faculty of Health and Medical SciencesUniversity of CopenhagenCopenhagenDenmark,Department of ObstetricsCopenhagen University Hospital ‐ RigshospitaletCopenhagenDenmark
| | - Eleonora Cvetanovska
- Department of Obstetrics and Gynaecology, Herlev HospitalCopenhagen University HospitalHerlevDenmark
| | - Anders Juul
- Department of Clinical Medicine, Faculty of Health and Medical SciencesUniversity of CopenhagenCopenhagenDenmark,Department of Growth and ReproductionCopenhagen University Hospital ‐ RigshospitaletCopenhagenDenmark
| | - Hanne Frederiksen
- Department of Growth and ReproductionCopenhagen University Hospital ‐ RigshospitaletCopenhagenDenmark
| | - Anja Pinborg
- Department of Clinical Medicine, Faculty of Health and Medical SciencesUniversity of CopenhagenCopenhagenDenmark,Department of FertilityCopenhagen University Hospital ‐ RigshospitaletCopenhagenDenmark
| | - Pia Weikop
- Center for Translational NeuromedicineUniversity of CopenhagenCopenhagenDenmark
| | - Vibe Frokjaer
- Neurobiology Research UnitCopenhagen University Hospital ‐ RigshospitaletCopenhagenDenmark,Mental Health Services in the Capital Region of DenmarkCopenhagenDenmark,Department of Clinical Medicine, Faculty of Health and Medical SciencesUniversity of CopenhagenCopenhagenDenmark
| |
Collapse
|
11
|
Krysko KM, Anderson A, Singh J, McPolin K, Rutatangwa A, Rowles W, Sadovnick AD, Houtchens MK, Bove R. Risk factors for peripartum depression in women with multiple sclerosis. Mult Scler 2022; 28:970-979. [PMID: 34498513 DOI: 10.1177/13524585211041108] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
BACKGROUND Peripartum depression (PPD) is underexplored in multiple sclerosis (MS). OBJECTIVE To evaluate prevalence of and risk factors for PPD in women with MS. METHODS Retrospective single-center analysis of women with MS with a live birth. Prevalence of PPD was estimated with logistic regression with generalized estimating equations (GEE). GEE evaluated predictors of PPD (e.g. age, marital status, parity, pre-pregnancy depression/anxiety, antidepressant discontinuation, sleep disturbance, breastfeeding, relapses, gadolinium-enhancing lesions, and disability). Factors significant in univariable analyses were included in multivariable analysis. RESULTS We identified 143 live births in 111 women (mean age 33.1 ± 4.7 years). PPD was found in 18/143 pregnancies (12.6%, 95% CI = 7.3-17.8). Factors associated with PPD included older age (OR 1.16, 95% CI = 1.03-1.32 for 1-year increase), primiparity (OR 4.02, CI = 1.14-14.23), pre-pregnancy depression (OR 3.70, CI = 1.27-10.01), sleep disturbance (OR 3.23, CI = 1.17-8.91), and breastfeeding difficulty (OR 3.58, CI = 1.27-10.08). Maternal age (OR 1.17, CI = 1.02-1.34), primiparity (OR 8.10, CI = 1.38-47.40), and pre-pregnancy depression (OR 3.89, CI = 1.04-14.60) remained significant in multivariable analyses. Relapses, MRI activity, and disability were not associated with PPD. CONCLUSION The prevalence of PPD in MS appeared similar to the general population, but was likely underestimated due to lack of screening. PPD can affect MS self-management and offspring development, and prospective studies are needed.
Collapse
Affiliation(s)
- Kristen M Krysko
- Department of Neurology, UCSF Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, USA/ Division of Neurology, Department of Medicine, St. Michael's Hospital, University of Toronto, Toronto, ON, Canada/Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, ON, Canada
| | - Annika Anderson
- Department of Neurology, UCSF Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, USA
| | - Jessica Singh
- Department of Neurology, UCSF Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, USA
| | - Kira McPolin
- Department of Neurology, UCSF Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, USA
| | - Alice Rutatangwa
- Department of Neurology, UCSF Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, USA
| | - William Rowles
- Department of Neurology, UCSF Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, USA
| | - A Dessa Sadovnick
- Division of Neurology, Department of Medicine, University of British Columbia, Vancouver, BC, Canada/Department of Medical Genetics, University of British Columbia, Vancouver, BC, Canada
| | - Maria K Houtchens
- Department of Neurology, Partners MS Center, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Riley Bove
- Department of Neurology, UCSF Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, USA
| |
Collapse
|
12
|
Hohman EE, Smyth JM, McNitt KM, Pauley AM, Symons Downs D, Savage JS. Urinary cortisol is lower in pregnant women with higher pre-pregnancy BMI. Front Endocrinol (Lausanne) 2022; 13:1014574. [PMID: 36714602 PMCID: PMC9875043 DOI: 10.3389/fendo.2022.1014574] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Accepted: 12/22/2022] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND/OBJECTIVES Although cortisol levels increase during normal pregnancy, particularly high levels of cortisol or stress have been associated with adverse maternal/child outcomes. Obesity is associated with altered cortisol metabolism, but there is limited information on pregnancy-related changes in cortisol in pregnant women with overweight/obesity. The objective of this study was to examine weekly measures of urinary cortisol and perceived stress throughout ~10-36 weeks gestation, if levels differ by pre-pregnancy BMI categories, and whether concurrent measures of urinary cortisol and perceived stress are associated. METHODS Longitudinal observational data from Healthy Mom Zone, a gestational weight management intervention, and an ancillary fetal growth study were combined. Pregnant women with normal (n=7), overweight (n=11), or obese (n=14) pre-pregnancy BMI were recruited at >8 weeks gestation. Overnight urinary cortisol and Perceived Stress Scale were measured weekly from ~10-36 weeks gestation. RESULTS Higher pre-pregnancy BMI was associated with overall lower urinary cortisol throughout gestation, but rate of increase in urinary cortisol across pregnancy was similar across weight status groups. Women with obesity reported higher levels of overall perceived stress than normal weight women. Regardless of weight status, perceived stress was not associated with gestational age or cortisol. CONCLUSIONS Although women with obesity reported higher perceived stress, they had lower urinary cortisol than women with normal BMI, and gestation-related increases in cortisol were similar across weight groups and unrelated to perceived stress, suggesting that physiological factors that drive increases in cortisol as pregnancy may outweigh effects of stress and adiposity. CLINICAL TRIAL REGISTRATION https://clinicaltrials.gov/ct2/show/NCT03945266, identifier (NCT03945266).
Collapse
Affiliation(s)
- Emily E. Hohman
- Center for Childhood Obesity Research, University Park, PA, United States
- *Correspondence: Emily E. Hohman,
| | - Joshua M. Smyth
- Department of Biobehavioral Health, Pennsylvania State University, University Park, PA, United States
| | - Katherine M. McNitt
- Center for Childhood Obesity Research, University Park, PA, United States
- Department of Nutritional Sciences, Pennsylvania State University, University Park, PA, United States
| | - Abigail M. Pauley
- Department of Kinesiology, Pennsylvania State University, University Park, PA, United States
| | - Danielle Symons Downs
- Department of Kinesiology, Pennsylvania State University, University Park, PA, United States
- Department of Obstetrics and Gynecology, Penn State College of Medicine, Hershey, PA, United States
| | - Jennifer S. Savage
- Center for Childhood Obesity Research, University Park, PA, United States
- Department of Nutritional Sciences, Pennsylvania State University, University Park, PA, United States
| |
Collapse
|
13
|
Uslu Yuvaci H, Cinar N, Yalnizoglu Caka S, Topal S, Peksen S, Saglam N, Cevrioglu AS. Effects of antepartum education on worries about labor and mode of delivery. J Psychosom Obstet Gynaecol 2021; 42:228-234. [PMID: 32050831 DOI: 10.1080/0167482x.2020.1725465] [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] [Indexed: 01/12/2023] Open
Abstract
AIM This study evaluated the effects of antenatal education, which was provided in a pregnancy education class, on pregnant women's concerns about labor and the mode of delivery. MATERIALS AND METHODS Primigravid pregnant women (n = 144) were enrolled into the study between May 2017 and November 2018. Pregnant women received standard education on nutrition during pregnancy, exercise, methods of coping with pain, and breastfeeding. The participants completed the "Introductory Information Form" and "Oxford Worries about Labour Scale" to collect data. RESULTS A statistically significant difference was found between the participants' pain, distress, uncertainty, and interventions in the pre-education, post-education, and postpartum periods and mean total score on the Oxford scale (p<.05). However, education had no significant effect on the mode of delivery (p>.05). CONCLUSION Education provided during pregnancy significantly decreased women's worries about labor, but it did not lead to a significant difference in the modes of delivery.
Collapse
Affiliation(s)
- Hilal Uslu Yuvaci
- Department of Obstetrics and Gynecology, University of Sakarya School of Medicine, Sakarya, Turkey
| | - Nursan Cinar
- School of Health Sciences, Sakarya University, Sakarya, Turkey
| | | | - Sumeyra Topal
- School of Health Sciences, Kahramanmaras Sutcu Imam University, Kahramanmaras, Turkey
| | - Sultan Peksen
- Department of Obstetrics and Gynecology, Sakarya Training and Research Hospital, Sakarya, Turkey
| | - Nuran Saglam
- Department of Obstetrics and Gynecology, Sakarya Training and Research Hospital, Sakarya, Turkey
| | - Arif Serhan Cevrioglu
- Department of Obstetrics and Gynecology, University of Sakarya School of Medicine, Sakarya, Turkey
| |
Collapse
|
14
|
The Effects of Maternal Age on Neonatal and Post-neonatal Mortality in India: Roles of Socioeconomic and Biodemographic Factors. CANADIAN STUDIES IN POPULATION 2021. [DOI: 10.1007/s42650-021-00041-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
|
15
|
Sakalli Kani A, Esim Buyukbayrak E, Dural U, Oguz S, Yavuzer Ö, Yanartas Ö, Topcuoglu V. Impact of expectant mother's knowledge level about fetal anomaly scan on their state anxiety prior to antenatal ultrasound screening. J Matern Fetal Neonatal Med 2021; 35:5025-5030. [PMID: 33461355 DOI: 10.1080/14767058.2021.1874905] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
OBJECTIVE We aimed to investigate the role of expectant mothers' background antenatal ultrasound knowledge on their state anxiety when they apply for the ultrasound examination. MATERIALS AND METHODS A cross-sectional study was conducted in perinatology outpatient clinic of a university hospital. Expectant mothers who applied for the first trimester ultrasound scan and second trimester anomaly scan were recruited to the study. A self-report form was applied to participants to assess the sociodemographic characteristics, obstetric history, knowledge and attitudes toward antenatal ultrasound. Expectant mothers' state anxiety prior to ultrasound scan was measured with the state sub-scale of State-Trait Anxiety Inventory. RESULTS A total of 500 expectant mothers (220 in the first trimester and 280 in the second trimester) were included to the study. We found a negative correlation between the participants' age and state anxiety level (r = -0.118, p < .01). Also, participants' education level had a significant effect on their state anxiety level (F (2, 497)=5.91, p < .01). Participant's age significantly predicted lower state anxiety level (β = -0.10, t = -2.09, p < .05). We did not find any significant relationship between the mean knowledge level of mothers and state anxiety levels of mothers (r = -0.07, p > .05). CONCLUSION Age was the only affecting factor on anxiety levels before ultrasound scan in pregnant participants. There was no significant effect of background knowledge on state anxiety.
Collapse
Affiliation(s)
- Ayse Sakalli Kani
- Department of Psychiatry, Pendik Research and Training Hospital, Marmara University, Istanbul, Turkey
| | - Esra Esim Buyukbayrak
- Department of Obstetrics and Gynecology, School of Medicine, Marmara University, Istanbul, Turkey
| | - Uzay Dural
- Department of Psychology, Istanbul Medeniyet University, Istanbul, Turkey
| | - Seren Oguz
- School of Medicine, Marmara University, Istanbul, Turkey
| | - Özlem Yavuzer
- Department of Obstetrics and Gynecology, School of Medicine, Marmara University, Istanbul, Turkey
| | - Ömer Yanartas
- Department of Psychiatry, Pendik Research and Training Hospital, Marmara University, Istanbul, Turkey
| | - Volkan Topcuoglu
- Department of Psychiatry, Pendik Research and Training Hospital, Marmara University, Istanbul, Turkey
| |
Collapse
|
16
|
Ribeiro SG, Aquino CBDQ, Martins ES, Guedes TG, Aquino PDS, Pinheiro AKB. FACTORS THAT INTERFERE IN THE QUALITY OF LIFE RELATED TO THE HEALTH OF WOMEN IN THE POSTPARTUM PERIOD IN NORTHEASTERN BRAZIL. TEXTO & CONTEXTO ENFERMAGEM 2021. [DOI: 10.1590/1980-265x-tce-2019-0009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
ABSTRACT Objective to analyze the sociodemographic, obstetric, type of delivery and professional factors that provided care that can influence the quality of life related to women's health in the immediate puerperium period. Method cross-sectional, correlational study conducted in a reference maternity hospital, with 272 women in the immediate puerperium period hospitalized in the rooming-in accommodation. A sociodemographic, clinical and obstetric questionnaire and the Short Form Health Survey-36 scale were used to assess health-related quality of life. Results regarding age, there was a significant association in the domains functional capacity and general status, with better scores for ages up to 29 years. Regarding education, significance was observed in the functional capacity domain with better scores for 9 to 11 years of schooling. The analysis of obstetric complications showed statistical significance in the general health status domain p<0.05. By correlating the type of delivery and the attending professional, the mean scores showed that the domains limitation due to physical aspects, pain, vitality, social aspects, limitations due emotional aspects and mental health presented higher means for normal delivery performed by nurses, with statistical significance in the domains: pain (p<0.05), vitality (p<0.05) and mental health (p=0.05). Conclusion these analyzed factors interfere in the quality of life of women in the postpartum period. Thus, considering these questions provides complementary information to the use of the Short Form Health Survey-36, highlighting areas that need greater attention and that can be worked on even in prenatal care.
Collapse
|
17
|
Branjerdporn G, Meredith P, Wilson T, Strong J. Prenatal Predictors of Maternal-infant Attachment. The Canadian Journal of Occupational Therapy 2020; 87:265-277. [PMID: 32686467 DOI: 10.1177/0008417420941781] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND. Increasingly, occupational therapists are working with women in the perinatal period, including supporting the developing mother-child relationship. PURPOSE. To examine prenatal predictors of maternal-infant attachment (maternal-fetal attachment, sensory patterns, adult attachment, perinatal loss, and mental health) that may provide possible avenues for assessment and intervention by occupational therapists. METHOD. Women (N = 60) were assessed during pregnancy and within one year postpartum in a cohort study. Independent t-tests, correlations, and multivariate regression models were conducted. FINDINGS. Low threshold maternal sensory patterns, more insecure adult attachment, and poorer quality of maternal-fetal attachment were each correlated with less optimal maternal-infant attachment. Quality of prenatal attachment was the best predictor of overall postnatal attachment in multivariate regression models. IMPLICATIONS. Occupational therapists working in a range of clinical settings (e.g., mental health, substance use, and perinatal care) may work with women during pregnancy to promote their relationship with their developing baby in utero and after birth.
Collapse
|
18
|
Gao LL, Yang JP, Wang DN, Sun K. Health related quality of life in Chinese pregnant women at advanced maternal age: a cross-sectional study. J Reprod Infant Psychol 2020; 40:22-33. [PMID: 32643396 DOI: 10.1080/02646838.2020.1788209] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
OBJECTIVE This study aims to explore the relationship between advanced maternal age (AMA) and health-related quality of life in Chinese pregnant women. METHODS A cross-sectional study was conducted in Guangzhou, China between September 2018 and June 2019. Four hundred and twenty-seven AMA women and the equal number of their younger counterparts completed the 36-Item Short-Form Health Survey (SF-36). RESULTS Compared with younger women, the AMA women were more likely to be employed; have a higher monthly household income and insurance covered; have a satisfied relationship with their husband and mother-in-law; and had a significantly lower level of physical (SF36-PCS) health-related quality of life and a higher level of mental (SF36-MCS) health-related quality of life during the pregnancy. The association of maternal age with health-related quality of life varies according with the trimester of pregnancy. Maternal age was a significant predictor of SF36-PCS and SF36-MCS. The third trimester was the significant predictor of SF36-PCS while the relationship with the mother-in-law was the significant predictor of SF36-MCS. CONCLUSIONS The SF36-PCS in the AMA women decreased with advancing age. However, their SF36-MCS was better over their younger counterparts. Age-related biological disadvantages may be offset by social/psychological advantages in AMA women.
Collapse
Affiliation(s)
- Ling-Ling Gao
- Obstetrics & Gynecology Department, School of Nursing, Sun Yat-sen University, Guangzhou, China
| | - Jing-Ping Yang
- Nursing Department, The First Affiliated Hospital of Fujian Medical University, Fuzhou, China
| | - Dan-Ni Wang
- School of Nursing, Sun Yat-sen University, Guangzhou, China
| | - Ke Sun
- Obstetrics & Gynecology Department, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| |
Collapse
|
19
|
Pettersson ML, Nedstrand E, Bladh M, Svanberg AS, Lampic C, Sydsjö G. Mothers who have given birth at an advanced age - health status before and after childbirth. Sci Rep 2020; 10:9739. [PMID: 32546715 PMCID: PMC7298035 DOI: 10.1038/s41598-020-66774-4] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2019] [Accepted: 05/19/2020] [Indexed: 11/09/2022] Open
Abstract
Women postpone childbirth to an age when morbidity is higher and fertility has decreased and yet the knowledge of mothers' morbidity related to age remains scarce. Swedish national register data from the Medical Birth Register and National Patient Register was used to investigate the incidence of diseases listed in the International Classification of Diseases, version 10 (ICD-10) in women who gave birth 2007-8. The index group consisted of women 40 years of age or older (n = 8 203) were compared to a control group of women, younger than 40 years (n = 15 569) at childbirth. The period studied was five years before childbirth to five years after. The main outcome measures were incidence of disease diagnosed in specialized hospital care. Demographical data and use of assisted reproduction (ART) were adjusted for. The results showed that older women were more likely to be single; less frequently used tobacco; were educated on a higher level; had a higher BMI and more often had used ART to become pregnant. The older women showed a higher morbidity rate. In the diagnostic groups: Neoplasms, Blood and immune system, Eye and adnexa, Ear and mastoid, Circulatory, Digestive, Skin and subcutaneous tissue, Musculoskeletal and connective tissue, and Genitourinary. The results add to the body of knowledge of a number of specific risks faced by older mothers and may be used to identify preventive actions concerning fertility and morbidity both before and after childbirth.
Collapse
Affiliation(s)
- Malin Lindell Pettersson
- Department of Obstetrics and Gynecology, and Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden.
| | - Elizabeth Nedstrand
- Department of Obstetrics and Gynecology, and Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden
| | - Marie Bladh
- Department of Obstetrics and Gynecology, and Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden
| | | | - Claudia Lampic
- Department of Women's and Children's Health, Karolinska Institutet, SE-171 77, Stockholm, Sweden.,Department of Public health and Caring Sciences, Uppsala University, SE-751 22, Uppsala, Sweden
| | - Gunilla Sydsjö
- Department of Obstetrics and Gynecology, and Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden
| |
Collapse
|
20
|
Prenatal tobacco smoking is associated with postpartum depression in Japanese pregnant women: The japan environment and children's study. J Affect Disord 2020; 264:76-81. [PMID: 31846904 DOI: 10.1016/j.jad.2019.11.145] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2019] [Revised: 11/16/2019] [Accepted: 11/30/2019] [Indexed: 12/11/2022]
Abstract
INTRODUCTION Previous studies in Western countries have examined the association between prenatal smoking and risk for Postpartum depression (PPD). However, evidence from Japan is lacking, despite the high prevalence of smoking among pregnant women. Therefore, we examined the association between prenatal smoking and PPD among pregnant Japanese women. METHODS We analyzed data for up to 1 month after childbirth from the Japan Environment and Children's Study (JECS), a nationwide birth cohort study. Among the 103,070 pregnant women recruited, 80,872 eligible participants were included in the analysis. PPD was defined as a score of ≥9 on the Edinburgh Postnatal Depression Scale (EPDS). Prenatal smoking and length of smoking cessation among ex-smokers were obtained using self-administered questionnaires at second/third trimester. RESULTS Among 80,872 pregnant women, 9.0% reported PPD. Multivariable-adjusted odds ratios (OR) (95% confidence intervals) for PPD (reference: never smoked) were 1.24 (1.12-1.37) for women who quit smoking after becoming pregnant, and 1.38 (1.21-1.56) for those who smoked during pregnancy. Compared with women who had never smoked, those who quit smoking ≤5 years before childbirth had a higher occurrence of PPD, with a multivariable-adjusted OR of 1.10 (1.00-1.22). LIMITATIONS Questionnaire data was self-reported by participants, thus smoking status might be under-reported. CONCLUSIONS Women who smoked during pregnancy, quit smoking after becoming pregnant, and quit smoking ≤5 years before childbirth are more likely to experience PPD than those who had never smoked.
Collapse
|
21
|
de Lijster JM, van den Dries MA, van der Ende J, Utens EMWJ, Jaddoe VW, Dieleman GC, Hillegers MHJ, Tiemeier H, Legerstee JS. Developmental Trajectories of Anxiety and Depression Symptoms from Early to Middle Childhood: a Population-Based Cohort Study in the Netherlands. JOURNAL OF ABNORMAL CHILD PSYCHOLOGY 2019; 47:1785-1798. [PMID: 31069583 PMCID: PMC6805800 DOI: 10.1007/s10802-019-00550-5] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Developmental patterns of anxiety and depression symptoms in early childhood have previously been related to anxiety and mood disorders in middle childhood. In the current study, trajectories of anxiety and depression symptoms (1.5-10 years) were related to children's broader psychosocial and school-related functioning at 10 years. We included a population-based sample of 7499 children, for whom primary caregivers reported anxiety and depression symptoms on the Child Behavior Checklist, at children's ages of 1.5, 3, 6, and 10. Growth Mixture Modeling identified four distinct, gender-invariant, trajectories of anxiety and depression symptoms: low (82.4%), increasing (7.4%), decreasing (6.0%), and increasing symptoms up to age 6 followed by a decrease to age 10 (preschool-limited, 4.2%). Children with a non-Dutch ethnicity had lower odds to be in the increasing trajectory and higher odds to be in the decreasing and pre-school limited trajectory. Also, low maternal education predicted the decreasing and pre-school limited trajectory. Higher levels of psychopathology during pregnancy for both mothers and fathers predicted the increasing, decreasing, and preschool-limited trajectory, compared to the low trajectory. At age 10, children in the increasing and preschool-limited trajectory had diminished psychosocial outcomes (friendship-quality and self-esteem) and worse school-related outcomes (school performance and school problems). This study adds to current knowledge by demonstrating that developmental patterns of anxiety and depression symptoms in early childhood are related to broader negative outcomes in middle childhood. Child and family factors could guide monitoring of anxiety and depression symptoms in the general population and provide targets for prevention programs.
Collapse
Affiliation(s)
- Jasmijn M de Lijster
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus MC - Sophia Children's Hospital, Erasmus University Medical Center, P.O. Box 2060, Wytemaweg 80, 3000, CB, Rotterdam, the Netherlands
| | - Michiel A van den Dries
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus MC - Sophia Children's Hospital, Erasmus University Medical Center, P.O. Box 2060, Wytemaweg 80, 3000, CB, Rotterdam, the Netherlands
- The Generation R Study Group, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Jan van der Ende
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus MC - Sophia Children's Hospital, Erasmus University Medical Center, P.O. Box 2060, Wytemaweg 80, 3000, CB, Rotterdam, the Netherlands
| | - Elisabeth M W J Utens
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus MC - Sophia Children's Hospital, Erasmus University Medical Center, P.O. Box 2060, Wytemaweg 80, 3000, CB, Rotterdam, the Netherlands
- Research Institute of Child Development and Education, University of Amsterdam, Amsterdam, The Netherlands
- Academic Center for Child Psychiatry the Bascule /Department of Child and Adolescent Psychiatry, Academic Medical Center, Amsterdam, The Netherlands
| | - Vincent W Jaddoe
- The Generation R Study Group, Erasmus University Medical Center, Rotterdam, The Netherlands
- Department of Epidemiology, Erasmus University Medical Center, Rotterdam, The Netherlands
- Department of Pediatrics, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Gwendolyn C Dieleman
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus MC - Sophia Children's Hospital, Erasmus University Medical Center, P.O. Box 2060, Wytemaweg 80, 3000, CB, Rotterdam, the Netherlands
| | - Manon H J Hillegers
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus MC - Sophia Children's Hospital, Erasmus University Medical Center, P.O. Box 2060, Wytemaweg 80, 3000, CB, Rotterdam, the Netherlands
| | - Henning Tiemeier
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus MC - Sophia Children's Hospital, Erasmus University Medical Center, P.O. Box 2060, Wytemaweg 80, 3000, CB, Rotterdam, the Netherlands
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Jeroen S Legerstee
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus MC - Sophia Children's Hospital, Erasmus University Medical Center, P.O. Box 2060, Wytemaweg 80, 3000, CB, Rotterdam, the Netherlands.
| |
Collapse
|
22
|
Determinants of Maternal Health-Related Quality of Life after Childbirth: The Generation R Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16183231. [PMID: 31487782 PMCID: PMC6765914 DOI: 10.3390/ijerph16183231] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/01/2019] [Revised: 08/29/2019] [Accepted: 08/30/2019] [Indexed: 12/18/2022]
Abstract
Having good health-related quality of life (HRQoL) is essential, particularly for women after childbirth. However, little is known about its determinants. We aimed to identify the determinants of HRQoL after childbirth in a large community sample in the Netherlands. We have included 4312 women in the present study. HRQOL was assessed by a 12-Item Short Form Survey (SF-12) at around two months after childbirth; Physical and Mental Component Summary scores were calculated. Information on 27 potential determinants of HRQoL was collected through questionnaires and medical records. Multivariate linear regression models were applied to assess significant determinants of physical and mental HRQoL. Our study showed that older maternal age, shorter time since childbirth, elective/emergency cesarean delivery, loss of energy, maternal psychopathology, and the hospital admission of the infant were significantly associated with worse physical HRQoL (p < 0.05); older maternal age, non-western background, low household income, loss of energy, and maternal psychopathology were significantly associated with worse mental HRQoL (p < 0.05). We identified multiple determinants of suboptimal physical and mental HRQoL after childbirth. In particular, maternal psychopathology after childbirth was profoundly associated with mental HRQoL. These women may need support. We therefore call for awareness among health care professionals.
Collapse
|
23
|
Pullmer R, Coelho JS, Zaitsoff SL. Kindness begins with yourself: The role of self-compassion in adolescent body satisfaction and eating pathology. Int J Eat Disord 2019; 52:809-816. [PMID: 30977532 DOI: 10.1002/eat.23081] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2018] [Revised: 03/25/2019] [Accepted: 03/25/2019] [Indexed: 02/04/2023]
Abstract
OBJECTIVE A wealth of evidence indicates that self-compassion is linked with positive psychological outcomes; however, little is known about the process through which self-compassion exerts its effect. The primary purpose of this research was to investigate the direct and indirect impact of self-compassion on body satisfaction and eating pathology in adolescents. METHOD Two hundred and thirty-eight students were recruited from three local high schools (Mage = 16.49, 43.7% boys). All participants completed the Self-Compassion Scale (SCS), Hopkins Symptom Checklist (SCL-5), Body Areas Satisfaction Scale (BASS), and Eating Disorder Examination Questionnaire - Adolescent Version (EDE-Q) at baseline. The SCL-5, BASS, and EDE-Q were completed 4 months later. RESULTS Self-compassion was positively associated with body satisfaction and negatively associated with psychological distress and eating pathology in boys and girls at both time points. Longitudinal conditional process analyses revealed that self-compassion predicted changes in body satisfaction and eating pathology through changes in psychological distress for girls only. Notably, self-compassion was higher in boys than in girls. DISCUSSION Results underscore how self-compassion may be an important factor to target in fostering a positive body image and preventing disordered eating in adolescents.
Collapse
Affiliation(s)
- Rachelle Pullmer
- Department of Psychology, Simon Fraser University, Burnaby, British Columbia, Canada
| | - Jennifer S Coelho
- Provincial Specialized Eating Disorders Program for Children & Adolescents, British Columbia Children's Hospital, Vancouver, British Columbia, Canada.,Department of Psychiatry, University of British Columbia, Vancouver, British Columbia, Canada
| | - Shannon L Zaitsoff
- Department of Psychology, Simon Fraser University, Burnaby, British Columbia, Canada
| |
Collapse
|
24
|
Daly D, Carroll M, Barros M, Begley C. Stop, think, reflect, realize-first-time mothers' views on taking part in longitudinal maternal health research. Health Expect 2019; 22:415-425. [PMID: 30793449 PMCID: PMC6543136 DOI: 10.1111/hex.12861] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2018] [Revised: 11/20/2018] [Accepted: 12/06/2018] [Indexed: 12/23/2022] Open
Abstract
Background Longitudinal cohort studies gather large amounts of data over time, often without direct benefit to participants. A positive experience may encourage retention in the study, and participants may benefit in unanticipated ways. Objective To explore first‐time mothers’ experiences of taking part in a longitudinal cohort study and completing self‐administered surveys during pregnancy and at 3, 6, 9 and 12 months’ postpartum. Design Content analysis of comments written by participants in the Maternal health And Maternal Morbidity in Ireland study's five self‐completion surveys, a multisite cohort study exploring women's health and health problems during and after pregnancy. This paper focuses on what women wrote about taking part in the research. Ethical approval was granted by the site hospitals and university. Setting and participants A total of 2174 women were recruited from two maternity hospitals in Ireland between 2012 and 2015. Findings A total of 1000 comments were made in the five surveys. Antenatally, barriers related to surveys being long and questions being intimate. Postpartum, barriers related to being busy with life as first‐time mothers. Benefits gained included gaining access to information, taking time to reflect, stopping to think and being prompted to seek help. Survey questions alone were described as valuable sources of information. Discussion and conclusions Findings suggest that survey research can “give back” to women by being a source of information and a trigger to seek professional help, even while asking sensitive questions. Understanding this can help researchers construct surveys to maximize benefits, real and potential, for participants.
Collapse
Affiliation(s)
- Deirdre Daly
- School of Nursing and Midwifery, Trinity College Dublin, Dublin, Ireland
| | - Margaret Carroll
- School of Nursing and Midwifery, Trinity College Dublin, Dublin, Ireland
| | - Monalisa Barros
- Departamento de Ciencias Naturais, Universidade Estadual do Sudoeste da Bahia, Vitoria Da Conquista, BA, Brazil
| | - Cecily Begley
- School of Nursing and Midwifery, Trinity College Dublin, Dublin, Ireland.,Sahlgrenska Academy, Institute of Health and Care Sciences, University of Gothenburg, Gothenburg, Sweden
| |
Collapse
|
25
|
‘It's now or never’—nulliparous women's experiences of pregnancy at advanced maternal age: A grounded theory study. Midwifery 2019; 68:1-8. [DOI: 10.1016/j.midw.2018.09.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2018] [Revised: 09/05/2018] [Accepted: 09/10/2018] [Indexed: 10/28/2022]
|
26
|
Lefkovics E, Rigó J, Szita B, Talabér J, Kecskeméti A, Kovács I, Baji I. Relevance of anxiety in the perinatal period: prospective study in a Hungarian sample. J Psychosom Obstet Gynaecol 2018. [PMID: 28631998 DOI: 10.1080/0167482x.2017.1338264] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
Abstract
There is increasing evidence that anxiety occurs frequently during pregnancy and can be one of the most important risk factors and predictors of postpartum depression (PPD). The aim of our study was to investigate whether antenatal anxiety is an independent predictor of PPD. We used the data of 476 women enrolled in a prospective study in a single maternity unit. The first assessment was conducted between 22 and 40 weeks gestation and a second time 8-12 months postpartum. Symptoms were measured using the Edinburgh Postnatal Depression Scale (EPDS) and the State Trait Anxiety Inventory (STAI). Based on our results, antenatal anxiety measured by a subscale of EPDS has predicted better PPD than the antenatal depressive subscale. However, the most relevant predictor of PPD might be the trait anxiety level of a women measured by STAI Trait Scale, whereas a cutoff value of 38 was identified to indicate higher risk of PPD.
Collapse
Affiliation(s)
- Eszter Lefkovics
- a Department of Obstetrics and Gynecology, Faculty of Health Sciences , Semmelweis University , Budapest , Hungary
| | - János Rigó
- a Department of Obstetrics and Gynecology, Faculty of Health Sciences , Semmelweis University , Budapest , Hungary.,b First Department of Obstetrics and Gynecology , Semmelweis University , Budapest , Hungary
| | - Bernadett Szita
- b First Department of Obstetrics and Gynecology , Semmelweis University , Budapest , Hungary
| | - Júlia Talabér
- c Department of Family Care and Methodology, Faculty of Health Sciences, Institute for Health Promotion and Clinical Methodology , Semmelweis University , Budapest , Hungary
| | - András Kecskeméti
- b First Department of Obstetrics and Gynecology , Semmelweis University , Budapest , Hungary
| | - Illés Kovács
- d Department of Opthalmology , Semmelweis University , Budapest , Hungary
| | - Ildikó Baji
- c Department of Family Care and Methodology, Faculty of Health Sciences, Institute for Health Promotion and Clinical Methodology , Semmelweis University , Budapest , Hungary
| |
Collapse
|
27
|
Lefkovics E, Rigó J, Kovács I, Talabér J, Szita B, Kecskeméti A, Szabó L, Somogyvári Z, Baji I. Effect of maternal depression and anxiety on mother's perception of child and the protective role of social support. J Reprod Infant Psychol 2018; 36:434-448. [PMID: 29999404 DOI: 10.1080/02646838.2018.1475726] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
OBJECTIVE The purpose of this study was to investigate the impact of postpartum depressive and anxiety symptoms on maternal perception of the infant and the protective role of social support. BACKGROUND Adverse effects of perinatal depression on mother-child interaction are well documented; however, the role of maternal perception has not been examined. METHODS We used the data of 431 women enrolled in a prospective study in a single maternity unit. Depressive and anxiety symptoms were measured using the Edinburgh Postnatal Depression Scale (EPDS), the State Trait Anxiety Inventory (STAI), and the mother's perception of infant with the Mother's Object Relation Scale (MORS). We used Multidimensional Scale of Perceived Social Support (MSPSS) in order to measure social support. RESULTS Depressive and anxiety symptoms were positively associated to less positive emotions and a more dominant attitude of child as perceived by mothers. This association was even more significant in the case of trait anxiety. Perceived social support has been found to be a protective factor which was able to reduce this tendency. CONCLUSION The findings have potential implications for our understanding of the impact of maternal depressive and anxiety symptoms on the developing mother-infant relationship.
Collapse
Affiliation(s)
- Eszter Lefkovics
- a Department of Obstetrics and Gynaecology, Faculty of Health Sciences , Semmelweis University , Budapest , Hungary
| | - János Rigó
- a Department of Obstetrics and Gynaecology, Faculty of Health Sciences , Semmelweis University , Budapest , Hungary.,b First Department of Obstetrics and Gynaecology , Semmelweis University , Budapest , Hungary
| | - Illés Kovács
- c Department of Ophthalmology , Semmelweis University , Budapest , Hungary
| | - Júlia Talabér
- d Department of Family Care and Methodology , Faculty of Health Sciences, Semmelweis University, Institute for Health Promotion and Clinical Methodology , Budapest , Hungary
| | - Bernadett Szita
- b First Department of Obstetrics and Gynaecology , Semmelweis University , Budapest , Hungary
| | - András Kecskeméti
- b First Department of Obstetrics and Gynaecology , Semmelweis University , Budapest , Hungary
| | - László Szabó
- d Department of Family Care and Methodology , Faculty of Health Sciences, Semmelweis University, Institute for Health Promotion and Clinical Methodology , Budapest , Hungary.,e Department of Internal Medicine , Heim Pál Children Hospital , Budapest , Hungary
| | - Zsolt Somogyvári
- d Department of Family Care and Methodology , Faculty of Health Sciences, Semmelweis University, Institute for Health Promotion and Clinical Methodology , Budapest , Hungary
| | - Ildikó Baji
- d Department of Family Care and Methodology , Faculty of Health Sciences, Semmelweis University, Institute for Health Promotion and Clinical Methodology , Budapest , Hungary
| |
Collapse
|
28
|
Denckla CA, Mancini AD, Consedine NS, Milanovic SM, Basu A, Seedat S, Spies G, Henderson DC, Bonanno GA, Koenen KC. Distinguishing postpartum and antepartum depressive trajectories in a large population-based cohort: the impact of exposure to adversity and offspring gender. Psychol Med 2018; 48:1139-1147. [PMID: 28889814 PMCID: PMC5845817 DOI: 10.1017/s0033291717002549] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
BACKGROUND Distinguishing temporal patterns of depressive symptoms during pregnancy and after childbirth has important clinical implications for diagnosis, treatment, and maternal and child outcomes. The primary aim of the present study was to distinguish patterns of chronically elevated levels of depressive symptoms v. trajectories that are either elevated during pregnancy but then remit after childbirth, v. patterns that increase after childbirth. METHODS The report uses latent growth mixture modeling in a large, population-based cohort (N = 12 121) to investigate temporal patterns of depressive symptoms. We examined theoretically relevant sociodemographic factors, exposure to adversity, and offspring gender as predictors. RESULTS Four distinct trajectories emerged, including resilient (74.3%), improving (9.2%), emergent (4.0%), and chronic (11.5%). Lower maternal and paternal education distinguished chronic from resilient depressive trajectories, whereas higher maternal and partner education, and female offspring gender, distinguished the emergent trajectory from the chronic trajectory. Younger maternal age distinguished the improving group from the resilient group. Exposure to medical, interpersonal, financial, and housing adversity predicted membership in the chronic, emergent, and improving trajectories compared with the resilient trajectory. Finally, exposure to medical, interpersonal, and financial adversity was associated with the chronic v. improving group, and inversely related to the emergent class relative to the improving group. CONCLUSIONS There are distinct temporal patterns of depressive symptoms during pregnancy, after childbirth, and beyond. Most women show stable low levels of depressive symptoms, while emergent and chronic depression patterns are separable with distinct correlates, most notably maternal age, education levels, adversity exposure, and child gender.
Collapse
Affiliation(s)
- C. A. Denckla
- Harvard T. H. Chan School of Public Health, Cambridge, MA, USA
| | | | | | | | - A. Basu
- Harvard T. H. Chan School of Public Health, Cambridge, MA, USA
| | - S. Seedat
- Stellenbosch University, Cape Town, South Africa
| | - G. Spies
- Stellenbosch University, Cape Town, South Africa
| | | | - G. A. Bonanno
- Teacher’s College, Columbia University, New York City, USA
| | - K. C. Koenen
- Harvard T. H. Chan School of Public Health, Cambridge, MA, USA
| |
Collapse
|
29
|
|
30
|
De Luca SM, Yueqi Y, Daley D, Padilla Y. A longitudinal study of Latino and non-Hispanic mothers' and fathers' depressive symptoms and its association with parent-child communication. J Affect Disord 2018; 227:580-587. [PMID: 29172050 PMCID: PMC5805639 DOI: 10.1016/j.jad.2017.10.046] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2017] [Revised: 10/21/2017] [Accepted: 10/27/2017] [Indexed: 11/28/2022]
Abstract
BACKGROUND Roughly 8% of the U.S. population report moderate or severe depression for two or more weeks and Latinos (3.7%) report higher rates of severe depression compared to non-Hispanic whites (2.6%) (Pratt and Brody, 2014). As the Latino population continues to grow in the U.S., there is little research on the manifestations for depression, and how this affects the family system longitudinally. METHODS Based on data from the Fragile Families and Child Wellbeing Study, a 3-step latent class analysis examined the association of self-reported parental depressive symptoms and their children's perceived levels of closeness and openness to communicate with their parents over 9 years (N=3956 families). RESULTS Latino parents reported four different depressive patterns, while non-Hispanic parents were more diversified and had six patterns in terms of latent class analysis. Latinos reported episodic symptoms, while NH parents were more likely to report chronic depressive symptoms over time. Regardless of race/ethnicity, parental depressive symptoms negatively affected their children's reported level of parental closeness and openness to communicate with mothers and fathers. LIMITATIONS As with any self-report data, the risk of social desirability bias is likely still present. Additionally, these results cannot be generalized to the broader U.S. CONCLUSIONS Due to the different mental health presentations over 9 years, and following the federal initiatives (National Institute of Mental Health, 2015) of early and consistent surveillance, we advise that clinicians and primary care physicians screen for depressive symptoms at least yearly.
Collapse
Affiliation(s)
- Susan M. De Luca
- School of Social Work & Population Research Center, University of Texas at Austin, 1925 San Jacinto Blvd, School of Social Work, Austin, Texas
| | | | | | | |
Collapse
|
31
|
Hallgrimsdottir H, Shumka L, Althaus C, Benoit C. Fear, Risk, and the Responsible Choice: Risk Narratives and Lowering the Rate of Caesarean Sections in High-income Countries. AIMS Public Health 2017; 4:615-632. [PMID: 30155505 PMCID: PMC6111264 DOI: 10.3934/publichealth.2017.6.615] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2017] [Accepted: 11/11/2017] [Indexed: 11/18/2022] Open
Abstract
In Canada, as elsewhere in the world, caesarean sections are the most common surgical procedure performed in hospitals annually. Recent national statistics indicate 28% of infants in Canada are born by c-section while in the United States that number rises to 33%. This is despite World Health Organization recommendations that at a population level only 10-15% of births warrant this form of medical intervention. This trend has become cause for concern in recent decades due to the short and long-term health risks to pregnant women and infants, as well as the financial burden it places on public health care systems. Others warn this trend may result in a collective loss of cultural knowledge of a normal physiological process and, in the process, establish a new "normal" childbirth. Despite a range of interventions to curb c-section rates-enhanced prenatal care and innovation in pregnancy monitoring, change in hospital level policies, procedures and protocols, as well as public education campaigns-they remain stubbornly resistant to stabilization, let alone, reduction in high-income countries. We explore-through a review of the academic and grey literature-the role of cultural and social narratives around risk, and the responsibilization of the pregnant woman and the medical practitioner in creating this kind of resistance to intervention today.
Collapse
Affiliation(s)
| | - Leah Shumka
- Department of Gender Studies, University of Victoria, Victoria BC, Canada
| | - Catherine Althaus
- School of Social and Political Sciences, University of Melbourne and Australia and New Zealand School of Government
| | - Cecilia Benoit
- Department of Sociology and the Canadian Institute of Substance Use Research, University of Victoria, Victoria BC, Canada
| |
Collapse
|
32
|
Pullmer R, Zaitsoff S, Cobb R. Body Satisfaction During Pregnancy: The Role of Health-Related Habit Strength. Matern Child Health J 2017; 22:391-400. [PMID: 29190007 DOI: 10.1007/s10995-017-2406-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Objectives Body satisfaction during pregnancy is an important determinant of maternal and fetal health outcomes. It is therefore critical to investigate factors related to changes in body satisfaction and to elucidate how body satisfaction changes over time in pregnant women. The purpose of this study was to examine the relation between two novel factors (i.e., healthy eating habit strength and physical activity habit strength) and body satisfaction during pregnancy. Methods Participants (n = 67 pregnant North American women) completed online questionnaires at the beginning of their second trimester (Time 1) and at the end of pregnancy. Maternal characteristics, relationship satisfaction, self-esteem, and psychological distress were assessed at Time 1 and habit strength, body satisfaction, and weight were assessed at both time points. Results Strength of healthy eating and physical activity habits remained stable over time and body satisfaction decreased over time. Healthy eating habit strength at Time 1 predicted increases in body satisfaction from the second trimester to the end of pregnancy, even when controlling for gestational weight gain. Conclusions This study suggests that health-related habit strength in women of reproductive age may offer protection against low levels of body satisfaction during pregnancy.
Collapse
Affiliation(s)
- Rachelle Pullmer
- Department of Psychology, Simon Fraser University, Burnaby, BC, Canada. .,Weight and Eating Laboratory, Simon Fraser University, Rcb 5305, 8888 University Drive, Burnaby, BC, V5A 1S6, Canada.
| | - Shannon Zaitsoff
- Department of Psychology, Simon Fraser University, Burnaby, BC, Canada
| | - Rebecca Cobb
- Department of Psychology, Simon Fraser University, Burnaby, BC, Canada
| |
Collapse
|
33
|
Pekel Uludağlı N. Psikolojik Sağlık Açısından Yetişkin Olma. PSIKIYATRIDE GUNCEL YAKLASIMLAR - CURRENT APPROACHES IN PSYCHIATRY 2017. [DOI: 10.18863/pgy.285949] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
|
34
|
McCall SJ, Nair M, Knight M. Factors associated with maternal mortality at advanced maternal age: a population-based case-control study. BJOG 2017; 124:1225-1233. [PMID: 27412153 PMCID: PMC5484371 DOI: 10.1111/1471-0528.14216] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/17/2016] [Indexed: 11/27/2022]
Abstract
OBJECTIVE This study aimed to examine the factors associated with maternal mortality among women aged ≥35 years. DESIGN Unmatched population based case-control study. SETTING United Kingdom. POPULATION Between 2009 and 2012, 105 cases of maternal deaths aged ≥35 years were extracted from the surveillance database of the MBRRACE-UK confidential enquiries into maternal deaths in the UK. In addition, 766 controls aged ≥35 years were identified from the UK Obstetric Surveillance System (2005-2012). METHODS Risk factors known to be associated with maternal mortality and morbidity and for which data were available were examined for their association with maternal mortality among women ≥35 years using logistic regression analysis. MAIN OUTCOME MEASURES Odds ratios and 95% confidence intervals associated with maternal death. RESULTS Five factors were found to be significantly associated with increased odds of death among women aged ≥35 years: smoking during pregnancy (adjusted odds ratio (aOR) 2.06, 95% CI 1.13-3.75), inadequate use of antenatal care (aOR 23.62, 95% CI 8.79-63.45), medical co-morbidities (aOR 5.92, 95% CI 3.56-9.86) and previous pregnancy problems (aOR 2.06, 95% CI 1.23-3.45). The odds associated with death increased by 12% per year increase in age (aOR 1.12, 95% CI 1.02-1.22). CONCLUSION Age was associated with maternal mortality even after adjusting for other known risk factors. Importantly, this study showed an association between maternal mortality and smoking among women aged 35 years or older. It emphasises the importance of public health action to reduce smoking levels and address trends in rising maternal age. TWEETABLE ABSTRACT Smoking is a risk factor for maternal death for those aged over 35 years.
Collapse
Affiliation(s)
- SJ McCall
- Policy Research Unit in Maternal Health and CareNational Perinatal Epidemiology Unit (NPEU)Nuffield Department of Population HealthUniversity of OxfordOxfordUK
| | - M Nair
- Policy Research Unit in Maternal Health and CareNational Perinatal Epidemiology Unit (NPEU)Nuffield Department of Population HealthUniversity of OxfordOxfordUK
| | - M Knight
- Policy Research Unit in Maternal Health and CareNational Perinatal Epidemiology Unit (NPEU)Nuffield Department of Population HealthUniversity of OxfordOxfordUK
| |
Collapse
|
35
|
Rendtorff R, Hinkson L, Kiver V, Dröge LA, Henrich W. Pregnancies in Women Aged 45 Years and Older - a 10-Year Retrospective Analysis in Berlin. Geburtshilfe Frauenheilkd 2017; 77:268-275. [PMID: 28392580 DOI: 10.1055/s-0043-100105] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023] Open
Abstract
Introduction Improved fertility treatment options and a change in the socio-cultural concept of family planning, especially in industrialized regions, has led to an increasing number of births by women of advanced maternal age, which is associated with a higher rate of complications. The aim of this study was to analyze pregnancy outcomes in women aged ≥ 45 years in an inner-city German hospital and to compare these results to those of a younger cohort. Materials and Methods Over a 10-year period from January 2004 to May 2015, the pregnancy outcomes of all 186 women aged ≥ 45 years who delivered in our hospital were compared in a 1 : 1 ratio to those of a cohort of 29-year old women. Results The rates of assisted reproduction (34 vs. 3 %), multiple pregnancies (16 vs. 5 %) and cesarean section (59 vs. 29 %) were significantly increased in the study group. There was an increased risk of preterm delivery (28 vs. 11 %), preeclampsia, gestational diabetes and premature rupture of membranes in the advanced maternal age group. Conclusion Advanced maternal age leads to higher rates of fetal and maternal complications. These findings should be taken into account when planning assisted reproduction and obstetrical care in women with advanced maternal age.
Collapse
Affiliation(s)
- Rosa Rendtorff
- Charité Universitätsmedizin Berlin, Klinik für Geburtsmedizin, Berlin, Germany
| | - Larry Hinkson
- Charité Universitätsmedizin Berlin, Klinik für Geburtsmedizin, Berlin, Germany
| | - Verena Kiver
- Charité Universitätsmedizin Berlin, Klinik für Geburtsmedizin, Berlin, Germany
| | - Lisa Antonia Dröge
- Charité Universitätsmedizin Berlin, Klinik für Geburtsmedizin, Berlin, Germany
| | - Wolfgang Henrich
- Charité Universitätsmedizin Berlin, Klinik für Geburtsmedizin, Berlin, Germany
| |
Collapse
|
36
|
Yamamoto N, Naruse T, Sakai M, Nagata S. Relationship between maternal mindfulness and anxiety 1 month after childbirth. Jpn J Nurs Sci 2016; 14:267-276. [PMID: 28004492 DOI: 10.1111/jjns.12157] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2016] [Revised: 06/09/2016] [Accepted: 09/16/2016] [Indexed: 11/29/2022]
Affiliation(s)
- Natsuki Yamamoto
- Division of Health Sciences and Nursing, Department of Community Health Nursing, Graduate School of Medicine; The University of Tokyo; Tokyo Japan
| | - Takashi Naruse
- Division of Health Sciences and Nursing, Department of Community Health Nursing, Graduate School of Medicine; The University of Tokyo; Tokyo Japan
| | - Mahiro Sakai
- Division of Health Sciences and Nursing, Department of Community Health Nursing, Graduate School of Medicine; The University of Tokyo; Tokyo Japan
| | - Satoko Nagata
- Division of Health Sciences and Nursing, Department of Community Health Nursing, Graduate School of Medicine; The University of Tokyo; Tokyo Japan
| |
Collapse
|
37
|
Witteveen AB, De Cock P, Huizink AC, De Jonge A, Klomp T, Westerneng M, Geerts CC. Pregnancy related anxiety and general anxious or depressed mood and the choice for birth setting: a secondary data-analysis of the DELIVER study. BMC Pregnancy Childbirth 2016; 16:363. [PMID: 27871257 PMCID: PMC5118894 DOI: 10.1186/s12884-016-1158-7] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2016] [Accepted: 11/14/2016] [Indexed: 11/10/2022] Open
Abstract
Background In several developed countries women with a low risk of complications during pregnancy and childbirth can make choices regarding place of birth. In the Netherlands, these women receive midwife-led care and can choose between a home or hospital birth. The declining rate of midwife-led home births alongside the recent debate on safety of home births in the Netherlands, however, suggest an association of choice of birth place with psychological factors related to safety and risk perception. In this study associations of pregnancy related anxiety and general anxious or depressed mood with (changes in) planned place of birth were explored in low risk women in midwife-led care until the start of labour. Methods Data (n = 2854 low risk women in midwife-led care at the onset of labour) were selected from the prospective multicenter DELIVER study. Women completed the Pregnancy Related Anxiety Questionnaire-Revised (PRAQ-R) to assess pregnancy related anxiety and the EuroQol-6D (EQ-6D) for an anxious and/or depressed mood. Results A high PRAQ-R score was associated with planned hospital birth in nulliparous (aOR 1.92; 95% CI 1.32–2.81) and parous women (aOR 2.08; 95% CI 1.55–2.80). An anxious or depressed mood was associated with planned hospital birth (aOR 1.58; 95% CI 1.20–2.08) and with being undecided (aOR 1.99; 95% CI 1.23–2.99) in parous women only. The majority of women did not change their planned place of birth. Changing from an initially planned home birth to a hospital birth later in pregnancy was, however, associated with becoming anxious or depressed after 35 weeks gestation in nulliparous women (aOR 4.17; 95% CI 1.35–12.89) and with pregnancy related anxiety at 20 weeks gestation in parous women (aOR 3.91; 95% CI 1.32–11.61). Conclusion Low risk women who planned hospital birth (or who were undecided) more often reported pregnancy related anxiety or an anxious or depressed mood. Women who changed from home to hospital birth during pregnancy more often reported pregnancy related anxiety or an anxious or depressed mood in late pregnancy. Anxiety should be adequately addressed in the process of informed decision-making regarding planned place of birth in low risk women.
Collapse
Affiliation(s)
- A B Witteveen
- Department of Midwifery Science, AVAG and the EMGO Institute for Health and Care Research, VU University Medical Center, Van der Boechorststraat 7, 1081 BT, Amsterdam, The Netherlands.
| | - P De Cock
- Department of Midwifery Science, AVAG and the EMGO Institute for Health and Care Research, VU University Medical Center, Van der Boechorststraat 7, 1081 BT, Amsterdam, The Netherlands
| | - A C Huizink
- Department of Developmental Psychology, VU University Amsterdam, Amsterdam, The Netherlands.,EMGO+ Institute for Health and Care Research, VU Medical Center, Amsterdam, The Netherlands.,Department of Clinical Child and Family Studies, VU University Amsterdam, Amsterdam, The Netherlands
| | - A De Jonge
- Department of Midwifery Science, AVAG and the EMGO Institute for Health and Care Research, VU University Medical Center, Van der Boechorststraat 7, 1081 BT, Amsterdam, The Netherlands
| | - T Klomp
- Department of Midwifery Science, AVAG and the EMGO Institute for Health and Care Research, VU University Medical Center, Van der Boechorststraat 7, 1081 BT, Amsterdam, The Netherlands
| | - M Westerneng
- Department of Midwifery Science, AVAG and the EMGO Institute for Health and Care Research, VU University Medical Center, Van der Boechorststraat 7, 1081 BT, Amsterdam, The Netherlands
| | - C C Geerts
- Department of Midwifery Science, AVAG and the EMGO Institute for Health and Care Research, VU University Medical Center, Van der Boechorststraat 7, 1081 BT, Amsterdam, The Netherlands
| |
Collapse
|
38
|
Abstract
The aim of the Postponing Parenthood project was to investigate several aspects of the delaying of childbearing phenomenon in Sweden and Norway, such as medical risks and parental experiences. Data were retrieved from the Swedish and Norwegian Medical Birth Registers and three different cohorts: the Swedish Young Adult Panel Study, the Norwegian Mother and Child Cohort, and the Swedish Women's Experiences of Childbirth cohort. Postponing childbirth to age 35 years and later increased the risk of rare but serious pregnancy outcomes, such as stillbirth and very preterm birth. Older first-time parents were slightly more anxious during pregnancy, and childbirth overall was experienced as more difficult, compared with younger age groups. First-time mothers' satisfaction with life decreased from about age 28 years, both when measured during pregnancy and early parenthood. Delaying parenthood to mid-30 or later was more related to lifestyle than socioeconomic factors, suggesting that much could be done in terms of informing young persons about the limitations of fertility and assisted reproductive techniques, and the risks associated with advanced parental age.
Collapse
Affiliation(s)
- Ulla Waldenström
- CONTACT Ulla Waldenström Bastugatan 42, 118 25 Stockholm, Sweden
| |
Collapse
|
39
|
Lodge F, Haith-Cooper M. The effect of maternal position at birth on perineal trauma: A systematic review. ACTA ACUST UNITED AC 2016. [DOI: 10.12968/bjom.2016.24.3.172] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Fay Lodge
- Community Midwife, Calderdale and Huddersfield NHS Foundation Trust
| | - Melanie Haith-Cooper
- Director of Post Graduate Research/Senior Lecturer in Midwifery and Reproductive Health, University of Bradford
| |
Collapse
|
40
|
Woolhouse H, Gartland D, Mensah F, Giallo R, Brown S. Maternal depression from pregnancy to 4 years postpartum and emotional/behavioural difficulties in children: results from a prospective pregnancy cohort study. Arch Womens Ment Health 2016; 19:141-51. [PMID: 26271281 DOI: 10.1007/s00737-015-0562-8] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2014] [Accepted: 07/30/2015] [Indexed: 12/14/2022]
Abstract
Considerable attention has been focused on women's mental health in the perinatal period and the subsequent impacts on children. Comparatively, we know much less about maternal depression at later time points and the potential implications for child mental health. The objective of this paper was to explore the association between maternal depression and child emotional/behavioural difficulties at 4 years postpartum, taking into account earlier episodes of perinatal depression. The Maternal Health Study is a prospective cohort study of 1,507 nulliparous women. Maternal depressive symptoms were assessed using the Edinburgh Postnatal Depression Scale (EPDS) in early pregnancy and at 3, 6 and 12 months postpartum and again at 4 years postpartum. Maternal depressive symptoms at 4 years postpartum were associated with significantly increased odds of child emotional/behavioural difficulties (odds ratio (OR) = 3.46, 95 % confidence interval (CI) = 2.21-5.43). This remained significant after adjusting for earlier episodes of perinatal depression and socio-demographic characteristics (OR = 2.07, 95 % CI = 1.18-3.63). We also observed a robust association between child difficulties at age 4 and measures of socio-economic disadvantage. Our findings suggest a pressing need to rethink current paradigms of maternal health surveillance and extend mental health surveillance and support to at least 4 years postpartum.
Collapse
Affiliation(s)
- Hannah Woolhouse
- Healthy Mothers Healthy Families Research Group, Murdoch Childrens Research Institute, WL5 Royal Childrens Hospital, Flemington Road Parkville, Victoria, 3052, Australia.
| | - Deirdre Gartland
- Healthy Mothers Healthy Families Research Group, Murdoch Childrens Research Institute, WL5 Royal Childrens Hospital, Flemington Road Parkville, Victoria, 3052, Australia
| | - Fiona Mensah
- Clinical Epidemiology and Biostatistics Unit, Murdoch Childrens Research Institute, Royal Children's Hospital, Victoria, Australia.,Department of Pediatrics, University of Melbourne, Melbourne, Australia
| | - Rebecca Giallo
- Healthy Mothers Healthy Families Research Group, Murdoch Childrens Research Institute, WL5 Royal Childrens Hospital, Flemington Road Parkville, Victoria, 3052, Australia
| | - Stephanie Brown
- Healthy Mothers Healthy Families Research Group, Murdoch Childrens Research Institute, WL5 Royal Childrens Hospital, Flemington Road Parkville, Victoria, 3052, Australia.,General Practice and Primary Health Care Academic Centre, University of Melbourne, Melbourne, Australia
| |
Collapse
|
41
|
Min HY, Jeong GH. Advanced Aged Women's Needs for Pregnancy and Childbirth Care. KOREAN JOURNAL OF WOMEN HEALTH NURSING 2015; 21:332-341. [PMID: 37684836 DOI: 10.4069/kjwhn.2015.21.4.332] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2015] [Revised: 12/11/2015] [Accepted: 12/11/2015] [Indexed: 09/10/2023] Open
Abstract
PURPOSE Advanced aged pregnancy may be related with health problems so that more aggressive health care is necessary for these women. This study aimed to provide the basic data for developing nursing intervention programs to enhance the health of pregnant women and their new-born babies and by identifying the advanced aged women's need for pregnancy and childbirth. METHODS It is the cross-sectional descriptive study to identify the advanced aged women's need on pregnancy and childbirth. Subjects were pregnant women 35 years or older and postpartum women. Total number of subjects was 95. Measurement tool is self-reporting survey that consisted of 67 items with four-point Likert scale, which was completed during October to November 2014. RESULTS Average score was 3.44 out of maximum 4 on the care need on pregnancy and childbirth. Average scores according to category were as follows: baby rearing and parental role, 3.55; preconception care, 3.49; delivery care, 3.47; postpartum care 3.42; and prenatal pregnancy, 3.39. The degree of needs on pregnancy and childbirth was different according to delivery experience (t=-2.49, p=.014). CONCLUSION Prenatal and postpartum nursing interventions were completed regardless of pregnant women's age until now; however, new nursing intervention programs are necessary to prevent the risk of advanced aged pregnancy, to provide the preconception care, and to increase the infant care and family support.
Collapse
Affiliation(s)
- Hye Young Min
- Department of Nursing, Dongyang University, Yeongju, Korea
| | - Geum Hee Jeong
- Department of Nursing, Dongyang University, Yeongju, Korea
| |
Collapse
|
42
|
Dietl A, Cupisti S, Beckmann MW, Schwab M, Zollner U. Pregnancy and Obstetrical Outcomes in Women Over 40 Years of Age. Geburtshilfe Frauenheilkd 2015; 75:827-832. [PMID: 26366002 DOI: 10.1055/s-0035-1546109] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2014] [Revised: 04/28/2015] [Accepted: 04/29/2015] [Indexed: 12/20/2022] Open
Abstract
Introduction: Delayed childbearing is increasing, and advanced maternal age has been associated with an increased risk of obstetrical complications. The purpose of this study was to evaluate pregnancy outcomes in women with advanced maternal age (≥ 40 years). Methods: Maternal and obstetrical data were collected from the Department of Obstetrics and Gynecology of the University of Wuerzburg for the period from 2006 to 2011. In this retrospective analysis we compared the outcomes for women aged ≥ 40 years (n = 405) with those of three younger subgroups (I: < 30 y; II: 30-34 y; III: 35-39 y). Results: Pregnant women older than 40 years had more chronic diseases such as hypertension, needed medical treatment more frequently and had a higher thrombosis risk. Pregnancy-induced diseases such as gestational diabetes, preeclampsia and pregnancy-associated hypertension occurred more often in women ≥ 40 years of age. Compared to mothers who were younger than 30 years, primiparous women ≥ 40 years had a more than four times higher overall cesarean section rate and four times higher elective cesarean section rate. Furthermore, they required longer hospital stays, both after cesarean section and after vaginal delivery. The preterm birth rate (≤ 32 weeks of gestation) was similar across the different age groups. Conclusions: The outcomes of pregnancy and childbirth and for newborns born to women ≥ 40 years did not vary significantly from those of younger women if the following conditions were met: a) pre-existing chronic diseases were treated medically and dietetically; b) pregnancy-induced morbidity was monitored regularly and controlled medically; c) women attended regular prenatal check-ups; d) a healthy lifestyle was adhered to during pregnancy, and e) delivery occurred in a perinatal center.
Collapse
Affiliation(s)
- A Dietl
- Department of Obstetrics and Gynecology, University of Freiburg i. Br., Freiburg i. Br
| | - S Cupisti
- Department of Obstetrics and Gynecology, University of Erlangen, Erlangen
| | - M W Beckmann
- Department of Obstetrics and Gynecology, University of Erlangen, Erlangen
| | - M Schwab
- Department of Obstetrics and Gynecology, University of Würzburg, Würzburg
| | - U Zollner
- Department of Obstetrics and Gynecology, University of Würzburg, Würzburg
| |
Collapse
|
43
|
Nilsen ABV, Waldenström U, Espehaug B, Schytt E. Still childless at the age of 32: An investigation of predictors in 22-year-old women and men. Scand J Public Health 2015; 43:481-9. [DOI: 10.1177/1403494815576269] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/13/2015] [Indexed: 11/16/2022]
Abstract
Aim: The aim of this study was to investigate if family background and attitudes in early adulthood contribute to postponement of parenthood. Postponement of parenthood is associated with increased need for artificial reproductive techniques, increased risk for adverse pregnancy outcomes and reduced fertility rates. Methods: This was a cohort study including 1000 women and men aged 22 years from the Swedish Young Adult Panel Study. Questionnaire data were linked to information from the Swedish Total Population Register 10 years later. Logistic regression analyses were conducted. Results: Background factors associated with being childless were: being second-generation Polish or Turkish (odds ratio [OR] 1.5; 95% confidence intervals [CI] 1.2–2.0), growing up in a large city (OR 1.5; 95% CI 1.1–2.0), well-educated mother (OR 1.5; 95% CI 1.1–1.9) or father (OR 1.4; 95% CI 1.1–1.9), no siblings (OR 1.9; 95% CI 1.1–3.2), living in parental home (OR 2.2; 95% CI 1.6–3.1), less than good assessment of own mother (OR 1.8; 95% CI 1.2–2.7) or father (OR 1.4; 95% CI 1.0–1.9) as a parent, and less than satisfactory relationship with own mother (OR 1.5; 95% CI 1.1–2.1). Attitudes associated with being childless were: not enjoying children (OR 2.7; 95% CI 2.0–3.6), finding that one could be satisfied in life without being a good parent (OR 2.3; 95% CI 1.7–3.0) and not assuming that one will have children in the future (OR 2.9; 95% CI 2.1–3.9). Conclusions: The findings suggest that postponement of parenthood to the age of 32 could partly be explained by family background and negative or ambivalent attitudes to children and parenthood in early adulthood.
Collapse
Affiliation(s)
- Anne Britt Vika Nilsen
- Department of Women’s and Children’s Health, Karolinska Institutet, Sweden
- Centre for Evidence-Based Practice, Bergen University College, Norway
| | - Ulla Waldenström
- Department of Women’s and Children’s Health, Karolinska Institutet, Sweden
| | - Birgitte Espehaug
- Centre for Evidence-Based Practice, Bergen University College, Norway
| | - Erica Schytt
- Department of Women’s and Children’s Health, Karolinska Institutet, Sweden
- Centre for Clinical Research Dalarna, Sweden
| |
Collapse
|
44
|
Muraca GM, Joseph KS. The association between maternal age and depression. JOURNAL OF OBSTETRICS AND GYNAECOLOGY CANADA 2015; 36:803-810. [PMID: 25222359 DOI: 10.1016/s1701-2163(15)30482-5] [Citation(s) in RCA: 56] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
OBJECTIVE Postpartum depression is a relatively common and potentially debilitating condition but its relationship with advanced maternal age has not been adequately studied. We evaluated the relationship between age and depression in a population-based sample of Canadian women. METHODS Data on women aged 20 to 44 years were obtained from the Canadian Community Health Survey, 2007 to 2008. Depression was defined using the Short-Form score from the Composite International Diagnostic Interview (depression defined as a score of ≥ 5). Women were stratified according to whether they had a live birth within five years preceding the interview. Logistic regression was used to compare the prevalence of depression among women of advanced maternal age versus younger women after adjusting for education, marital status, and chronic disease. RESULTS Among women who had delivered recently, 8.0% (207 of 2326) were depressed compared with 10% (597 of 5610) of women who had not recently delivered. The prevalence of depression in women who had recently delivered was significantly higher in women aged 40 to 44 years than in women aged 30 to 35 years (adjusted OR 3.72; 95% CI 2.15 to 6.41). Depression rates were not higher among older women who had not had a recent delivery (adjusted OR among women 40 to 44 years 0.75; 95% CI 0.56 to 1.01). CONCLUSION Women of advanced maternal age have significantly higher rates of depression than younger women. Research is required to determine if a program of targeted depression screening and prevention will help reduce the burden of illness among older mothers.
Collapse
Affiliation(s)
- Giulia M Muraca
- School of Population and Public Health, and the Department of Obstetrics and Gynaecology University of British Columbia, Vancouver, BC; Children's and Women's Hospital and Health Centre of British Columbia, Vancouver, BC
| | - K S Joseph
- School of Population and Public Health, and the Department of Obstetrics and Gynaecology University of British Columbia, Vancouver, BC; Children's and Women's Hospital and Health Centre of British Columbia, Vancouver, BC
| |
Collapse
|
45
|
Luoma I, Korhonen M, Salmelin RK, Helminen M, Tamminen T. Long-term trajectories of maternal depressive symptoms and their antenatal predictors. J Affect Disord 2015; 170:30-8. [PMID: 25218734 DOI: 10.1016/j.jad.2014.08.017] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2013] [Revised: 08/04/2014] [Accepted: 08/11/2014] [Indexed: 11/17/2022]
Abstract
BACKGROUND Depressive symptoms, often long-term or recurrent, are common among mothers of young children and a well-known risk for child well-being. We aimed to explore the antecedents of the long-term trajectories of maternal depressive symptoms and to define the antenatal factors predicting the high-symptom trajectories. METHODS The sample comprised 329 mothers from maternity centers. Maternal depressive symptoms were assessed with the Edinburgh Postnatal Depression Scale (EPDS) antenatally and at two months, six months, 4-5 years, 8-9 years and 16-17 years after delivery. Maternal expectations concerning the baby were assessed with the Neonatal Perception Inventory (NPI). Background information was gathered with questionnaires. RESULTS A model including four symptom trajectories (very low, low-stable, high-stable and intermittent) was selected to describe the symptom patterns over time. The high-stable and the intermittent trajectory were both predicted pairwise by a high antenatal EPDS sum score as well as high EPDS anxiety and depression subscores but the other predictors were specific for each trajectory. In multivariate analyses, the high-stable trajectory was predicted by a high antenatal EPDS sum score, a high EPDS anxiety subscore, diminished life satisfaction, loneliness and more negative expectations of babies on average. The intermittent trajectory was predicted by a high antenatal EPDS sum score, a poor relationship with own mother and urgent desire to conceive. LIMITATIONS Only self-report questionnaires were used. The sample size was rather small. CONCLUSIONS The results suggest a heterogeneous course and background of maternal depressive symptoms. This should be considered in intervention planning.
Collapse
Affiliation(s)
- Ilona Luoma
- University of Tampere, School of Medicine, University of Tampere, FI-33014, Finland; Tampere University Hospital, Department of Child Psychiatry, PO Box 2000, FI-33521 Tampere, Finland.
| | - Marie Korhonen
- University of Tampere, School of Medicine, University of Tampere, FI-33014, Finland
| | - Raili K Salmelin
- Tampere University Hospital, Department of Child Psychiatry, PO Box 2000, FI-33521 Tampere, Finland; University of Tampere, School of Health Sciences, University of Tampere, FI-33014, Finland
| | - Mika Helminen
- University of Tampere, School of Health Sciences, University of Tampere, FI-33014, Finland; Pirkanmaa Hospital District, Science Center, PO Box 2000, FI-33521 Tampere, Finland
| | - Tuula Tamminen
- University of Tampere, School of Medicine, University of Tampere, FI-33014, Finland; Tampere University Hospital, Department of Child Psychiatry, PO Box 2000, FI-33521 Tampere, Finland
| |
Collapse
|
46
|
Guedes M, Canavarro MC. Psychosocial adjustment of couples to first-time parenthood at advanced maternal age: an exploratory longitudinal study. J Reprod Infant Psychol 2014. [DOI: 10.1080/02646838.2014.962015] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
|
47
|
Guedes M, Canavarro MC. Risk Knowledge and Psychological Distress During Pregnancy Among Primiparous Women of Advanced Age and Their Partners. J Midwifery Womens Health 2014; 59:483-93. [PMID: 25196229 DOI: 10.1111/jmwh.12205] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
INTRODUCTION First childbirth at advanced maternal age has become a growing public health concern due to its increased risks for maternal-fetal health. The present study aimed to characterize the risk knowledge of primiparous women of advanced age and their partners and to examine interindividual variability on risk knowledge depending on sociodemographic and reproductive characteristics. The study also examined the influence of one partner's risk knowledge on both partners' psychological distress. METHODS The present study is part of an ongoing longitudinal project focusing on 2 timings of assessment: the prenatal diagnosis visit (time 1) and the third trimester of pregnancy (time 2). A total of 95 primiparous women of advanced age and their partners were consecutively recruited in a Portuguese referral urban hospital. Participants completed a questionnaire on knowledge of maternal age-related risks of childbearing at time 1 as well as the Brief Symptom Inventory-18 at time 2. RESULTS Both partners showed incomplete risk knowledge, with the exception of the impact of maternal age on fertility, the probability to request medical help to conceive, and increased risk of Down syndrome. Women's risk knowledge did not vary depending on sociodemographic and reproductive characteristics. Male partners with prior infertility and medically assisted reproduction treatments reported higher risk knowledge. Higher risk knowledge in male partners increased psychological distress during pregnancy in both members of the couples. DISCUSSION The findings indicated that first childbirth at advanced maternal age is rarely an informed reproductive decision, emphasizing the need to develop preventive interventions that may enhance couples' knowledge of maternal age-related risks. Given the influence of the risk knowledge of male partners on women's psychological distress, antenatal interventions should be couple-focused. Interventions should inform couples about maternal age-related risks, enhance their perceived control, and promote effective dyadic communication and coping strategies to address risk.
Collapse
|
48
|
Woolhouse H, Gartland D, Mensah F, Brown SJ. Maternal depression from early pregnancy to 4 years postpartum in a prospective pregnancy cohort study: implications for primary health care. BJOG 2014; 122:312-21. [DOI: 10.1111/1471-0528.12837] [Citation(s) in RCA: 100] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/10/2014] [Indexed: 11/29/2022]
Affiliation(s)
- H Woolhouse
- Healthy Mothers Healthy Families; Murdoch Childrens Research Institute and Royal Children's Hospital; Parkville Vic. Australia
| | - D Gartland
- Healthy Mothers Healthy Families; Murdoch Childrens Research Institute and Royal Children's Hospital; Parkville Vic. Australia
| | - F Mensah
- Clinical Epidemiology and Biostatistics Unit; Murdoch Childrens Research Institute and Royal Children's Hospital; Parkville Vic. Australia
- Department of Paediatrics; University of Melbourne; Melbourne Vic. Australia
| | - SJ Brown
- Healthy Mothers Healthy Families; Murdoch Childrens Research Institute and Royal Children's Hospital; Parkville Vic. Australia
- General Practice and Primary Health Care Academic Centre; University of Melbourne; Melbourne Vic. Australia
| |
Collapse
|
49
|
Aasheim V, Waldenström U, Rasmussen S, Espehaug B, Schytt E. Satisfaction with life during pregnancy and early motherhood in first-time mothers of advanced age: a population-based longitudinal study. BMC Pregnancy Childbirth 2014; 14:86. [PMID: 24564871 PMCID: PMC3975966 DOI: 10.1186/1471-2393-14-86] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2013] [Accepted: 02/18/2014] [Indexed: 12/11/2022] Open
Abstract
Background The trend to delay motherhood to the age of 30 and beyond is established in most high-income countries but relatively little is known about potential effects on maternal emotional well-being. This study investigates satisfaction with life during pregnancy and the first three years of motherhood in women expecting their first baby at an advanced and very advanced age. Methods The study was based on the National Norwegian Mother and Child Cohort Study (MoBa) conducted by the Norwegian Institute of Public Health. Data on 18 565 nulliparous women recruited in the second trimester 1999–2008 were used. Four questionnaires were completed: at around gestational weeks 17 and 30, and at six months and three years after the birth. Medical data were retrieved from the national Medical Birth Register. Advanced age was defined as 32–37 years, very advanced age as ≥38 years and the reference group as 25–31 years. The distribution of satisfaction with life from age 25 to ≥40 years was investigated, and the mean satisfaction with life at the four time points was estimated. Logistic regression analyses based on generalised estimation equations were used to investigate associations between advanced and very advanced age and satisfaction with life when controlling for socio-demographic factors. Results Satisfaction with life decreased from around age 28 to age 40 and beyond, when measured in gestational weeks 17 and 30, and at six months and three years after the birth. When comparing women of advanced and very advanced age with the reference group, satisfaction with life was slightly reduced in the two older age groups and most of all in women of very advanced age. Women of very advanced age had the lowest scores at all time points and this was most pronounced at three years after the birth. Conclusion First-time mothers of advanced and very advanced age reported a slightly lower degree of satisfaction with life compared with the reference group of younger women, and the age-related effect was greatest when the child was three years of age.
Collapse
Affiliation(s)
- Vigdis Aasheim
- Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden.
| | | | | | | | | |
Collapse
|
50
|
Was hält Schwangere gesund? Protektive Faktoren für postpartale Depression. ZEITSCHRIFT FUR PSYCHOSOMATISCHE MEDIZIN UND PSYCHOTHERAPIE 2013. [DOI: 10.13109/zptm.2013.59.4.391] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
|