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Bloom M, Gjelsvik A, Amanullah S. Stress During Pregnancy Associated with Newborn Low Birth Weight: Experiences from the State of Rhode Island. Matern Child Health J 2024; 28:344-350. [PMID: 37955837 DOI: 10.1007/s10995-023-03845-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/04/2023] [Indexed: 11/14/2023]
Abstract
PURPOSE Prenatal stress is a known risk for poor birth outcomes. This study specifically looked at reported stress during pregnancy and low birth weight (LBW) in Rhode Island. METHODS Pregnancy Risk Assessment Monitoring System (PRAMS) data from 2016 to 2018 for the state of Rhode Island was utilized. Stress during most recent pregnancy was dichotomized as: 'none to minimal' and 'moderate to high.' LBW was defined as less than 2,500 g. Multivariable regression analysis was performed, accounting for complex survey design. RESULTS In this cohort, 24% of pregnant people reported moderate to high stress leading to an adjusted odds of 1.70 (95% CI 1.43-2.03) of having a LBW newborn compared to those with none to minimal stress. Primiparity, previous preterm birth, racism, smoking history, and history of chronic medical problems were also associated with LBW newborns. CONCLUSION We recommend screening and provision of support services for stress in all settings where pregnant people access care.
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Affiliation(s)
- Molly Bloom
- Global Health/Faculty Development Fellow in the department of Family Medicine, Warren Alpert Medical School of Brown University, Providence, RI, USA.
| | - Annie Gjelsvik
- Department of Epidemiology, Director of MPH Program, Brown University School of Public Health, Providence, RI, USA
| | - Siraj Amanullah
- Department of Emergency Medicine, Pediatrics, and Health Services, Policy and Practice, Alpert Medical School of Brown University and Brown School of Public Health, Hasbro Children's Hospital/Rhode Island, Hospital/Providence Rhode Island, Providence, RI, USA
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Barragán M, Cornet-Bartolomé D, Molina N, Vassena R. The expression levels of NOS2, HMOX1, and VEGFC in cumulus cells are markers of oocyte maturation and fertilization rate. Mol Reprod Dev 2023; 90:369-377. [PMID: 37486100 DOI: 10.1002/mrd.23698] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2022] [Revised: 04/30/2023] [Accepted: 07/12/2023] [Indexed: 07/25/2023]
Abstract
Throughout the reproductive life of women, cumulus cells (CC) protect the dormant oocyte from damage, act as sensors of the follicular microenvironment, and act as a gatekeeper for oocyte developmental potential. One such mechanism relies on the hypoxia-tolerance response, which, with age, decreases systematically, including in the ovary. We aimed to evaluate the association between gene expression related to hypoxia and aging in CC and reproductive results in in vitro fertilization cycles. We recruited 94 women undergoing controlled ovarian stimulation. Total RNA was extracted from pooled CCs collected after oocyte pick-up (OPU) and reverse-transcribed to complementary DNA using random hexamers to test 14 genes related to hypoxia response via HIF1α activation, oxidative stress, and angiogenic responses. The expression of CLU, NOS2, and TXNIP had a positive correlation with age (rs = 0.25, rs = 0.24, and rs = 0.35, respectively). Additionally, NOS2 and HMOX1 expression correlated positively with the retrieval of immature oocytes (rs = 0.22 and rs = 0.40, respectively). Moreover, VEGFC levels decreased overall with increasing fertilization rate, independently of age (rs = -0.29). We found that the fertilization potential of a cohort of oocytes is related to the ability of CC to respond to oxidative stress and hypoxia with age, pointing at NOS2, HMOX1, and VEGFC expression as markers for oocyte maturation and fertilization success.
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Affiliation(s)
- Montserrat Barragán
- EUGIN Group, Research and Development, Parc Científic de Barcelona, Barcelona, Spain
| | - David Cornet-Bartolomé
- EUGIN Group, Research and Development, Parc Científic de Barcelona, Barcelona, Spain
- Department of Genetics, Microbiology and Statistic, CIBERER, IBUB, IRSJD, Universitat de Barcelona, Barcelona, Spain
| | - Natalia Molina
- EUGIN Group, Research and Development, Parc Científic de Barcelona, Barcelona, Spain
- Universitat Pompeu Fabra, Barcelona, Spain
| | - Rita Vassena
- EUGIN Group, Research and Development, Parc Científic de Barcelona, Barcelona, Spain
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Shen Q, Huang CR, Rong L, Ju S, Redding SR, Ouyang YQ, Wang R. Effects of needs-based education for prenatal anxiety in advanced multiparas: a randomized controlled trial. BMC Pregnancy Childbirth 2022; 22:301. [PMID: 35395734 PMCID: PMC8994345 DOI: 10.1186/s12884-022-04620-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2021] [Accepted: 03/22/2022] [Indexed: 11/12/2022] Open
Abstract
Background Prenatal anxiety is a common concern which may have adverse effects on maternal and infant health outcomes. Studies addressing needs-based education interventions for prenatal anxiety are limited. Aim To explore the effects of needs-based education on alleviating prenatal anxiety among advanced multiparas when compared with routine prenatal health education. Methods A total of 86 advanced multiparas were randomized into the intervention group (n = 43) or the control group (n = 43) in this study. The control group received routine prenatal care. The intervention group received five needs-based education programs presented by trained researchers. The Pregnancy-related Anxiety Questionnaire was used to evaluate changes in anxiety level of participants. Concurrent physiological parameters, including blood pressure, heart rate and non-stress test were also measured. Results Scores on the Pregnancy-related Anxiety Questionnaire of the intervention group were significantly lower than those of the control group (t = 4.21, P < 0.05). Systolic blood pressure (t = 3.64, P < 0.05) and heart rate (t = 2.39, P < 0.05) of the intervention group were also significantly lower than the control group whereas no differences were noted in diastolic blood pressure and non-stress test. Conclusion A needs-based education program is an effective intervention strategy to allay prenatal anxiety in advanced multiparas. Trial registration The trial was retrospectively registered in the Chinese Clinical Trial Registry as number ChiCTR2100047552.
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Affiliation(s)
- Quan Shen
- School of Nursing, Wuhan University, No.115, Donghu Road, Wuchang District, Wuhan, 430071, China
| | - Can-Ran Huang
- School of Nursing, Wuhan University, No.115, Donghu Road, Wuchang District, Wuhan, 430071, China
| | - Liu Rong
- School of Nursing, Wuhan University, No.115, Donghu Road, Wuchang District, Wuhan, 430071, China
| | - Shan Ju
- School of Nursing, Wuhan University, No.115, Donghu Road, Wuchang District, Wuhan, 430071, China
| | | | - Yan-Qiong Ouyang
- School of Nursing, Wuhan University, No.115, Donghu Road, Wuchang District, Wuhan, 430071, China.
| | - Rong Wang
- Nursing Department of East Campus, Renming Hospital of Wuhan University, Gaoxin Sixth Road, Jiangxia District, Wuhan, 430071, China.
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Saur AM, Dos Santos MA. Risk factors associated with stress symptoms during pregnancy and postpartum: integrative literature review. Women Health 2021; 61:651-667. [PMID: 34311677 DOI: 10.1080/03630242.2021.1954132] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Stressful events during prenatal and postpartum have been associated with an increase in the susceptibility to the onset of various diseases, threatening mental and physical health of mother and baby. The aim of this study was to synthesize and analyze the literature related to risk factors associated with stress symptoms during pregnancy and immediate postpartum by means of an integrative review. The search was conducted from January 2013 to July 2020, consulting the following databases: PubMed, PsycINFO, CINAHL, Web of Science and LILACS. In total, 1,677 studies were identified, resulting in 38 articles included in this review. The risk factors most associated with stress in pregnancy and postpartum were related to emotional factors (including mental health, traumatic events and obstetric complications); social and economic factors; mother's health conditions and life style behaviors, and social support and partner related stress. The results are discussed under the light of the biopsychosocial model, which proposes that biological, psychological, and social domains should be considered in order to minimize psychosocial risk conditions. It is concluded that strategies to promote psychological care, education, additional social support and health behaviors should be considered to prevent adverse birth outcomes and to increase maternal well-being.
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Affiliation(s)
- Adriana Martins Saur
- Department of Psychology, University of São Paulo, Faculty of Philosophy, Sciences and Letters at Ribeirão Preto, Brazil
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First-time mothers’ experiences of preparing for childbirth at advanced maternal age. Midwifery 2020; 86:102558. [DOI: 10.1016/j.midw.2019.102558] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2019] [Revised: 09/24/2019] [Accepted: 10/18/2019] [Indexed: 11/19/2022]
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‘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]
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Pedro J, Brandão T, Schmidt L, Costa ME, Martins MV. What do people know about fertility? A systematic review on fertility awareness and its associated factors. Ups J Med Sci 2018; 123:71-81. [PMID: 29957086 PMCID: PMC6055749 DOI: 10.1080/03009734.2018.1480186] [Citation(s) in RCA: 108] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2017] [Accepted: 06/01/2017] [Indexed: 01/04/2023] Open
Abstract
INTRODUCTION Recent evidence indicates that reproductive-age people have inadequate fertility awareness (FA) concerning fertility, infertility risk factors, and consequences of delaying childbearing. However, no study has tried to summarize these studies and to clarify the variables associated with FA, namely the role of gender, age, education, and reproductive status on FA. METHODS A literature search up to February 2017 was conducted using the EBSCO, Web of Science, Scielo, and Scopus electronic databases with combinations of keywords and MeSH terms (e.g. 'awareness' OR 'health knowledge, attitudes, practice' AND 'fertility'; 'fertile period'; 'assisted reprod*'). RESULTS Seventy-one articles met the eligibility criteria and were included. The main results showed that participants report low-to-moderate FA. Higher levels of FA were shown by women, highly educated individuals, people who reported difficulties with conceiving, and those who had planned their pregnancies. Having or desiring to have children was not related to FA level. An inconsistent association between study participant age and FA was observed, with some studies indicating that older participants had higher FA, but others found an opposite result or did not find any association. CONCLUSION The current findings suggest that interventions to increase FA are warranted, especially those targeting men, people with low education, and in family planning settings. Interventions and campaigns should be customized to meet individuals' needs regarding FA. Because of the high heterogeneity regarding the assessment of FA, these conclusions must be interpreted with caution.
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Affiliation(s)
- Juliana Pedro
- Faculty of Psychology and Education Sciences, University of Porto, Porto, Portugal
- Centre for Psychology, University of Porto, Porto, Portugal
| | - Tânia Brandão
- Centre for Research in Psychology (CIP-UAL), Universidade Autónoma de Lisboa, Lisboa, Portugal
| | - Lone Schmidt
- Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Maria E. Costa
- Faculty of Psychology and Education Sciences, University of Porto, Porto, Portugal
- Centre for Psychology, University of Porto, Porto, Portugal
| | - Mariana V. Martins
- Faculty of Psychology and Education Sciences, University of Porto, Porto, Portugal
- Centre for Psychology, University of Porto, Porto, Portugal
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Cheng BH, Chen JH, Wang GH. Psychological factors influencing choice of prenatal diagnosis in Chinese multiparous women with advanced maternal age. J Matern Fetal Neonatal Med 2018; 32:2295-2301. [PMID: 29402153 DOI: 10.1080/14767058.2018.1432038] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Bi-Heng Cheng
- Department of Obstetrics, Renmin Hospital of Wuhan University, Wuhan, China
- Postdoctoral Circulation Station of Clinical Medicine, Wuhan University, Wuhan, China
| | - Jian-Hua Chen
- Department of Obstetrics, Renmin Hospital of Wuhan University, Wuhan, China
| | - Gao-Hua Wang
- Department of Psychiatry, Renmin Hospital of Wuhan University, Wuhan, China
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Sheinis M, Carpe N, Gold S, Selk A. Ignorance is bliss: women's knowledge regarding age-related pregnancy risks. J OBSTET GYNAECOL 2017; 38:344-351. [PMID: 29022426 DOI: 10.1080/01443615.2017.1357685] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Pregnancy risks rise with age and the average age of first time mothers is rising. This study aimed to assess women's actual knowledge and their perceived knowledge of pregnancy complications relating to advanced maternal age. A cross-sectional survey was administered to primiparous women measuring demographics, knowledge of age-related pregnancy risks, previous counselling and health literacy. Of the 218 women surveyed, the mean knowledge score was not significantly different for women <35 years of age compared to women ≥35 years of age (p = .09). Although there was no difference in knowledge between the two groups, women ≥35 years of age perceived themselves to be more knowledgeable than those under 35 (p < .01). The majority of women (67%) wanted further counselling on this topic and indicated a preference for their doctor to counsel them (76%). Women require counselling informing them of their increased risk of complications if they begin childbearing at older ages. Impact statement What is already known on this subject: The average age of first time mothers is rising worldwide. Pregnancy risks rise with age, especially in first time mothers. Previous studies have shown that knowledge of age-related pregnancy risks correlate with educational level and health literacy. What the results of this study add: This study supports those findings and also demonstrates that perceived knowledge does not correlate with measured knowledge of age-related pregnancy risks. Women ≥35 years of age (higher-risk women) are no more knowledgeable than their younger counterparts though they perceive themselves to be better informed. Greater education regarding these risks may allow women to mitigate some of these risks through lifestyle and diet alteration and will prepare women for what to expect if these risks and complications occur. The majority of women in this study seek pregnancy information on the internet, but desire further counselling from their doctors regarding age-related pregnancy risks. What the implications are of these findings for clinical practice and/or further research: Given these results, physicians must consider making greater efforts to counsel women about pregnancy risks in advanced maternal age and tailor these conversations to suit the educational level and health literacy of each individual patient.
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Affiliation(s)
- Michal Sheinis
- a Faculty of Medicine , University of Toronto , Toronto , Canada
| | - Nicole Carpe
- a Faculty of Medicine , University of Toronto , Toronto , Canada
| | - Shira Gold
- a Faculty of Medicine , University of Toronto , Toronto , Canada
| | - Amanda Selk
- b Department of Obstetrics and Gynaecology , Mount Sinai Hospital , Toronto , Canada.,c Department of Obstetrics and Gynaecology , University of Toronto , Toronto , Canada
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