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Gusak N, Kendall S, Nizalova O. Understanding of perinatal mental health and its psychosocial determinants through Ukrainian women's experience. Eur J Midwifery 2024; 8:EJM-8-29. [PMID: 38841270 PMCID: PMC11151686 DOI: 10.18332/ejm/188194] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2023] [Revised: 04/29/2024] [Accepted: 05/11/2024] [Indexed: 06/07/2024] Open
Abstract
INTRODUCTION Perinatal mental health defines new mothers, their families, and the social, emotional, and cognitive development of their children. The factors contributing to Ukrainian mothers' mental health are not well-defined in the literature. This study aims to explore how Ukrainian women understand mental health and its psychosocial determinants through their perinatal experience. METHODS This qualitative analysis is part of a larger mixed-methods study exploring perinatal mental health in Ukraine. Five online focus groups (n=30) with Ukrainian mothers of children aged 0-5 years were conducted in June-July 2020. The participants were selected from a pool of 1634 women who completed an online questionnaire and agreed to participate in further research. Informed consent was obtained. The data collected from the focus groups were transcribed verbatim and analyzed thematically using Dedoose software. RESULTS The study identified two themes. The first theme was: 'Understanding perinatal mental health through women's experience', which covers five subthemes. The second theme was 'Psychosocial determinants of maternal mental health', which includes six subthemes. Overall, women's feelings of guilt, blame, and shame during their perinatal journey are influenced by socio-cultural factors and can lead to mental health problems and reluctance to seek proper help. CONCLUSIONS The study has identified some factors that can contribute to the enhancement of mental health and well-being of mothers in Ukraine during their perinatal journey. Negative emotions such as guilt, blame, and shame can have a significant impact on their ability to seek the necessary support, and should be addressed by midwives and other healthcare professionals.
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Affiliation(s)
- Nataliia Gusak
- Department of Social Work, National University of KyivMohyla Academy, Kyiv, Ukraine
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Puertas-Gonzalez JA, Romero-Gonzalez B, Mariño-Narvaez C, Gonzalez-Perez R, Sosa-Sanchez IO, Peralta-Ramirez MI. Can we influence the neurological development and hair cortisol concentration of offspring by reducing the stress of the mother during pregnancy? A randomized controlled trial. Stress Health 2023; 39:753-765. [PMID: 36638545 DOI: 10.1002/smi.3222] [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: 05/13/2022] [Revised: 09/23/2022] [Accepted: 01/09/2023] [Indexed: 01/15/2023]
Abstract
The objective was to evaluate the effects of a stress management cognitive behavioural therapy followed during pregnancy on subsequent childhood on hair cortisol at birth and on neurodevelopment and Hair Cortisol Concentrations (HCC) at 6 months of age. The study sample included 48 pregnant women, divided into two groups: 24 women in the Therapy Group (TG) and 24 women who received standard pregnancy care (control group (CG); CG). To test the therapy efficacy, an evaluation of the HCC and psychological stress, psychopathological symptomatology and resilience was conducted before and after the treatment. The level of cortisol in their hair was obtained during pregnancy and that of their babies at birth. Six months after birth, a cortisol sample was taken from the hair and the babies' neurodevelopment was evaluated based on a Bayley-III test. The TG presented reductions in psychological stress and psychopathological symptomatology after treatment. On the other hand, the CG increased their cortisol concentrations between the pre and post intervention, remaining stable in the TG. Moreover, results showed that TG babies had lower cortisol concentrations at birth and obtained significantly higher cognitive and motor development scores at 6 months. These findings support that providing psychological care to pregnant women may not only have a benefit on these women's mental state, but may also benefit the neurodevelopment of their offspring.
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Affiliation(s)
- Jose A Puertas-Gonzalez
- Mind, Brain and Behaviour Research Center (CIMCYC), Granada, Spain
- Personality, Assessment and Psychological Treatment Department, Faculty of Psychology, University of Granada, Granada, Spain
| | - Borja Romero-Gonzalez
- Psychology Department, Faculty of Education, Campus Duques de Soria, University of Valladolid, Soria, Spain
| | | | - Raquel Gonzalez-Perez
- Department of Pharmacology, CIBERehd, Faculty of Pharmacy, University of Granada, Granada, Spain
| | | | - Maria Isabel Peralta-Ramirez
- Mind, Brain and Behaviour Research Center (CIMCYC), Granada, Spain
- Personality, Assessment and Psychological Treatment Department, Faculty of Psychology, University of Granada, Granada, Spain
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Montazeri M, Shabani F, Rezaie R, Mirghafourvand M. Relationship between health practices with attitudes towards pregnancy and motherhood and pregnancy symptoms in Iranian pregnant women: a cross-sectional study. BMJ Open 2023; 13:e074048. [PMID: 37751951 PMCID: PMC10533709 DOI: 10.1136/bmjopen-2023-074048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Accepted: 09/08/2023] [Indexed: 09/30/2023] Open
Abstract
OBJECTIVES Pregnancy is a vulnerable period for women's health, and health practices play an essential role in this period. This study aimed to determine the relationship between health practices with attitudes toward pregnancy and motherhood and pregnancy symptoms. DESIGN It was a cross-sectional study using cluster sampling conducted on 351 pregnant women in 2021-2022. Data were collected using questionnaires of socio-demographic characteristics, health practices in pregnancy (Health Practices Questionnaire-II), attitude towards motherhood and pregnancy (Prenatal Attitudes Towards motherhood and Pregnancy) and pregnancy symptoms (Pregnancy Symptoms Inventory). The general linear model (GLM), with the adjustment of socio-demographic characteristics, was used to determine the relationship of the health practices with attitudes towards motherhood and pregnancy and pregnancy symptoms. SETTING Health centres in Tabriz city, Iran. PARTICIPANTS Women were eligible if living in the Tabriz city, Iran, were pregnant and had a personal health record at the health centre. RESULTS The mean (SD) of the total health practices score was 117.9 (20.5) out of 34-170. The mean (SD) of the attitudes towards motherhood and pregnancy was 33.4 (4.5) out of 11-44. The mean (SD) of the pregnancy symptoms was 28.0 (12.1) out of 0-123. According to the Pearson correlation test, there was a significant direct correlation between health practices with attitudes towards motherhood and pregnancy (r=0.39; p<0.001) and a significant inverse correlation with pregnancy symptoms (r=-0.29; p<0.001). Based on the GLM with an increase in the score of health practices, the mean score of the attitude towards motherhood and pregnancy increased (B=0.07; 95% CI: 0.05 to 0.1), and the mean score of pregnancy symptoms decreased (B=-0.1; 95% CI: -0.2 to -0.05). CONCLUSION Considering the relationship between health practices with the attitude towards motherhood and pregnancy symptoms, healthcare providers better use educational and counselling strategies to promote health practices in pregnant women.
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Affiliation(s)
| | - Fatemeh Shabani
- Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Ronya Rezaie
- Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mojgan Mirghafourvand
- Social determinants of Health Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
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Kinney RL, Copeland LA, Kroll-Desrosiers AR, Walker L, Marteeny V, Mattocks KM. Newborn Outcomes Among Veterans Utilizing VHA Maternity Benefits, 2016-2020. Mil Med 2023; 188:e1252-e1259. [PMID: 34718702 DOI: 10.1093/milmed/usab457] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2021] [Revised: 10/18/2021] [Accepted: 10/20/2021] [Indexed: 11/14/2022] Open
Abstract
INTRODUCTION Public Law 111-163 Section 206 of the Caregivers and Veteran Omnibus Health Services Act amended the Veterans Health Administration's (VHA) medical benefits package to include 7 days of medical care for newborns delivered by Veterans. We examined the newborn outcomes among a cohort of women Veterans receiving VHA maternity benefits and care coordination. MATERIALS AND METHODS We conducted a secondary analysis of phone interview data from Veterans enrolled in the COMFORT (Center for Maternal and Infant Outcomes Research in Translation) study 2016-2020. Multivariable regression estimated associations with newborn outcomes (preterm birth; low birthweight). RESULTS During the study period, 829 infants were born to 811 Veterans. Mothers reported "excellent health" for 94% of infants. The prevalence of preterm birth was slightly higher in our cohort (11% vs. 10%), as were low birthweight (9%) deliveries, compared to the general population (8.28%). Additionally, 42% of infants in our cohort required follow-up care for non-routine health conditions; 11% were uninsured at 2 months of age. Adverse newborn outcomes were more common for mothers who were older in age, self-identified as non-white in race and/or of Hispanic ethnicity, had a diagnosis of posttraumatic stress disorder, or had gestational comorbidities. CONCLUSIONS The current VHA maternity coverage appears to be an effective policy for ensuring the well-being and health care coverage for the majority of Veterans and their newborns in the first days of life, thereby reducing the risk of inadequate prenatal and neonatal care. Future research should examine costs associated with extending coverage to 14 days or longer, comparing those to the projected excess costs of neonatal health problems. VHA policy should continue to support expanding care and resources through the Maternity Care Coordinator model.
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Affiliation(s)
- Rebecca L Kinney
- VA Central Western Massachusetts Healthcare System, Leeds, MA 01053, USA
- Department of Population and Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, MA 01655, USA
| | - Laurel A Copeland
- VA Central Western Massachusetts Healthcare System, Leeds, MA 01053, USA
- Department of Population and Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, MA 01655, USA
| | - Aimee R Kroll-Desrosiers
- VA Central Western Massachusetts Healthcare System, Leeds, MA 01053, USA
- Department of Population and Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, MA 01655, USA
| | - Lorrie Walker
- VA Central Western Massachusetts Healthcare System, Leeds, MA 01053, USA
| | - Valerie Marteeny
- VA Central Western Massachusetts Healthcare System, Leeds, MA 01053, USA
| | - Kristin M Mattocks
- VA Central Western Massachusetts Healthcare System, Leeds, MA 01053, USA
- Department of Population and Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, MA 01655, USA
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Phipps JE, Whipps MDM, D'Souza I, LaSalle JM, Simmons LA. Pregnant in a Pandemic: Mental Wellbeing and Associated Healthy Behaviors Among Pregnant People in California During COVID-19. Matern Child Health J 2023:10.1007/s10995-023-03657-w. [PMID: 37029891 PMCID: PMC10083068 DOI: 10.1007/s10995-023-03657-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/16/2023] [Indexed: 04/09/2023]
Abstract
INTRODUCTION Pregnancy is a time of increased vulnerability to mental health disorders. Additionally, the COVID-19 pandemic has increased the incidence of depression and anxiety. Thus, we aimed to assess mental health and associated healthy behaviors of pregnant people in California during the pandemic in order to contextualize prenatal well-being during the first pandemic of the twenty-first century. METHODS We conducted an online cross-sectional study of 433 pregnant people from June 6 through July 29, 2020. We explored 3 hypotheses: (1) mental health would be worse during the pandemic than in general pregnant samples to date; (2) first-time pregnant people would have worse mental health; and (3) healthy behaviors would be positively related to mental health. RESULTS Many of our participants (22%) reported clinically significant depressive symptoms and 31% reported clinically significant anxiety symptoms. Multiparous pregnant people were more likely to express worries about their own health and wellbeing and the process of childbirth than were primiparous pregnant people. Additionally, as pregnancy advanced, sleep and nutrition worsened, while physical activity increased. Lastly, anxious-depressive symptomology was significantly predictive of participant sleep behaviors, nutrition, and physical activity during the past week. DISCUSSION Pregnant people had worse mental health during the pandemic, and this was associated with worse health-promoting behaviors. Given that the COVID-19 pandemic and associated risks are likely to persist due to low vaccination rates and the emergence of variants with high infection rates, care that promotes mental and physical well-being for the pregnant population should be a public health priority.
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Affiliation(s)
- Jennifer E Phipps
- Department of Human Ecology, Perinatal Origins of Disparities Center, University of California, Davis, 1 Shields Ave, Davis, CA, 95616, USA.
| | - Mackenzie D M Whipps
- Department of Human Ecology, Perinatal Origins of Disparities Center, University of California, Davis, 1 Shields Ave, Davis, CA, 95616, USA
| | - Indira D'Souza
- Department of Human Ecology, Perinatal Origins of Disparities Center, University of California, Davis, 1 Shields Ave, Davis, CA, 95616, USA
| | - Janine M LaSalle
- Department of Medical Microbiology and Immunology, Perinatal Origins of Disparities Center, University of California, Davis, 1 Shields Ave, Davis, CA, 95616, USA
| | - Leigh Ann Simmons
- Department of Human Ecology, Perinatal Origins of Disparities Center, University of California, Davis, 1 Shields Ave, Davis, CA, 95616, USA
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Urizar GG, Murillo J, Miller K. Factors Associated with Prenatal Health Behaviors among Low-Income, Ethnic Minority Women. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:1695. [PMID: 36767060 PMCID: PMC9914291 DOI: 10.3390/ijerph20031695] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Revised: 01/10/2023] [Accepted: 01/12/2023] [Indexed: 06/18/2023]
Abstract
Less than one-third of pregnant women in the U.S. meet prenatal nutrition, exercise, and stress management health behavior guidelines. Low rates of these prenatal health behaviors have been especially observed among low-income, ethnic minority women, placing them and their infants at a disproportionally higher risk for health complications. Yet, few studies have identified factors associated with these prenatal health behaviors in this population. This study examined whether certain demographic (e.g., ethnicity) and psychosocial characteristics (i.e., coping, stress, pregnancy-specific stress, and depression) were associated with prenatal nutrition (i.e., high-fat food and fruit and vegetable intake), exercise, and stress management health behaviors in 100 low-income, pregnant women (39% African American, 30% foreign-born Latinas, 15% U.S.-born Latinas, 10% non-Hispanic white, and 6% Asian American/Pacific Islander) in southern California using an embedded, mixed-methods, cross-sectional design. Results demonstrated that ethnic minority women who experienced more stress and used more maladaptive coping strategies (e.g., avoidance) were particularly at risk of consuming more high-fat foods and engaging in less exercise and stress management during pregnancy. Qualitative responses revealed women's experiences with these prenatal health behaviors. These findings highlight the need for interventions and collaborative care models that target psychosocial factors in order to optimize prenatal health behaviors and health outcomes among ethnic minority women.
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Affiliation(s)
- Guido G. Urizar
- Department of Psychology, California State University, 1250 Bellflower Blvd, Long Beach, CA 90840-0901, USA
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Alhusen JL, Hughes RB, Lyons G, Laughon K. Depressive symptoms during the perinatal period by disability status: Findings from the United States Pregnancy Risk Assessment Monitoring System. J Adv Nurs 2023; 79:223-233. [PMID: 36320150 PMCID: PMC9795828 DOI: 10.1111/jan.15482] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Revised: 09/04/2022] [Accepted: 10/19/2022] [Indexed: 11/05/2022]
Abstract
AIMS The aim of the current study was to compare the prevalence of depressive symptoms during the perinatal period among respondents with a disability as compared to those without a disability. DESIGN We conducted a secondary analysis of nationally representative data from the Pregnancy Risk Assessment Monitoring System data from 24 participating United States between 2018 and 2020. METHODS A cross-sectional sample of 37,989 respondents provided data on disability, including difficulty in vision, hearing, ambulation, cognition, communication and self-care. The outcome of interest was perinatal depressive symptoms, defined as experiencing depressive symptoms during the antenatal period or postpartum period. Regression models were used to calculate odds of depressive symptoms during these two time periods by disability status while controlling for relevant sociodemographic characteristics and depressive symptoms prior to pregnancy. RESULTS Respondents with disabilities experienced a higher prevalence of depressive symptoms in both the antenatal period and postpartum period as compared to those without disabilities. In fully adjusted models, respondents with disabilities had 2.4 times the odds of experiencing depressive symptoms during pregnancy and 2.1 times the odds of experiencing postpartum depressive symptoms as compared to respondents without disabilities. CONCLUSION Respondents with disabilities experience a higher prevalence of depressive symptoms throughout the perinatal period thereby increasing the risk for adverse maternal, neonatal and infant health outcomes. IMPACT Perinatal depression is a significant public health issue globally, and our findings suggest that persons with disability are at an increased risk for depressive symptoms both during pregnancy and in the postpartum period. Our findings represent a call to action to improve clinical and supportive services for women with disabilities during the perinatal period to improve their mental health and the consequent health of their offspring. PATIENT OR PUBLIC CONTRIBUTION We thank our Community Advisory Board members who have been instrumental in the conception of this study.
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Affiliation(s)
- Jeanne L. Alhusen
- University of Virginia School of Nursing, Charlottesville, Virginia, USA
| | - Rosemary B. Hughes
- University of Montana Rural Institute for Inclusive Communities, Missoula, Montana, USA
| | - Genevieve Lyons
- Department of Public Health Sciences, University of Virginia, Charlottesville, Virginia, USA
| | - Kathryn Laughon
- University of Virginia School of Nursing, Charlottesville, Virginia, USA
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8
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Puertas-Gonzalez JA, Mariño-Narvaez C, Romero-Gonzalez B, Sanchez-Perez GM, Peralta-Ramirez MI. Online cognitive behavioural therapy as a psychological vaccine against stress during the COVID-19 pandemic in pregnant women: A randomised controlled trial. J Psychiatr Res 2022; 152:397-405. [PMID: 35830754 PMCID: PMC9259661 DOI: 10.1016/j.jpsychires.2022.07.016] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2021] [Revised: 06/18/2022] [Accepted: 07/04/2022] [Indexed: 12/02/2022]
Abstract
The COVID-19 pandemic has affected the population's levels of stress and anxiety due to its contagious nature and the uncertainties generated by its novelty. One population that is especially vulnerable to these psychological consequences are pregnant women. This is why the objective of this study was to test the efficacy of an online stress management programme of a cognitive behavioural nature on pregnant women during the COVID-19 pandemic, in Spain. The trial was controlled and randomised, with a total of 207 pregnant women divided into three groups: the Online Cognitive Behavioural Therapy group (o-CBT) (N = 70); the Online Psychological Support group (o-PS) (N = 69); and the Usual Care group (UC) (N = 68). To test the therapy's efficacy, the women's resilience, perceived stress, pregnancy-specific stress and psychopathological symptoms were assessed before and after the intervention. The o-CBT and o-PS consisted of a programme of 8 group sessions (one per week). The results showed that pregnant women who participated in the o-CBT group presented lower rates of pregnancy-specific stress and perceived stress, as well as greater resilience and lower anxiety, depression and obsessions-compulsions symptoms. These data show the efficacy of the treatment programme and thus confirm the importance of implementing these types of interventions during a woman's pregnancy, especially over periods of major stress, such as during a pandemic.
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Affiliation(s)
- Jose A. Puertas-Gonzalez
- Mind, Brain and Behaviour Research Center (CIMCYC), Granada, Spain,Personality, Assessment and Psychological Treatment Department, Faculty of Psychology, University of Granada, Granada, Spain
| | | | - Borja Romero-Gonzalez
- Psychology Department, Faculty of Education, University of Valladolid, Campus Duques de Soria, Soria, Spain.
| | | | - Maria Isabel Peralta-Ramirez
- Mind, Brain and Behaviour Research Center (CIMCYC), Granada, Spain,Personality, Assessment and Psychological Treatment Department, Faculty of Psychology, University of Granada, Granada, Spain
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Koire A, Nong YH, Cain CM, Greeley CS, Puryear LJ, Van Horne BS. Longer wait time after identification of peripartum depression symptoms is associated with increased symptom burden at psychiatric assessment. J Psychiatr Res 2022; 152:360-365. [PMID: 35785579 DOI: 10.1016/j.jpsychires.2022.06.046] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/27/2021] [Revised: 06/07/2022] [Accepted: 06/24/2022] [Indexed: 11/26/2022]
Abstract
Untreated peripartum depression (PD) affects one in seven women and is associated with negative maternal outcomes. This retrospective observational study used health record data from an integrated health system in Texas to assess the extent to which time to access reproductive psychiatry influences the mental health of peripartum women. Women with at least one screening for depression symptoms conducted in obstetric or pediatric settings between May 2014 and October 2019 and subsequently seen by the reproductive psychiatry clinic (n=490) were included. Descriptive and inferential statistics were used to assess timing and factors related to psychiatry follow-up. Findings from this study demonstrated that the average time between a positive screen and a psychiatry assessment was 5 weeks. At psychiatry referral appointments, 85% of women continued to screen positive for PD symptoms. Depression symptom scores at the psychiatry appointment were significantly higher than scores precipitating the referral (p = 0.002). Wait time between initial positive screen and referral appointment was positively correlated with clinically meaningful increases in depression symptom scores (p < 0.001). Each week spent waiting for an appointment produced a 13% increase in odds of clinically meaningful worsening of PD scores and 9% increase in odds of developing new self-harm ideation. Given the findings that a longer period between primary care referral and subspecialty appointment has a negative impact on the mental health of women, this study supports the need for earlier psychiatric assessment to minimize decompensation. Expansion of reproductive psychiatry services are needed to support peripartum women and improve maternal outcomes.
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Affiliation(s)
- Amanda Koire
- Department of Psychiatry, Brigham and Women's Hospital, Boston, MA, USA; Harvard Medical School, Boston, MA, USA
| | - Yen H Nong
- Department of Pediatrics, Baylor College of Medicine, 6621 Fannin Street, MC A2275, Houston, TX, 77030, USA; Division of Public Health Pediatrics, Texas Children's Hospital, 6621 Fannin Street, MC A2275, Houston, TX, USA
| | - Cary M Cain
- Department of Pediatrics, Baylor College of Medicine, 6621 Fannin Street, MC A2275, Houston, TX, 77030, USA; Division of Public Health Pediatrics, Texas Children's Hospital, 6621 Fannin Street, MC A2275, Houston, TX, USA
| | - Christopher S Greeley
- Department of Pediatrics, Baylor College of Medicine, 6621 Fannin Street, MC A2275, Houston, TX, 77030, USA; Division of Public Health Pediatrics, Texas Children's Hospital, 6621 Fannin Street, MC A2275, Houston, TX, USA
| | - Lucy J Puryear
- Obstetrics and Gynecology, Menninger Department of Psychiatry, Baylor College of Medicine, 6651 Main Street, Houston, TX, 77030, USA
| | - Bethanie S Van Horne
- Department of Pediatrics, Baylor College of Medicine, 6621 Fannin Street, MC A2275, Houston, TX, 77030, USA; Division of Public Health Pediatrics, Texas Children's Hospital, 6621 Fannin Street, MC A2275, Houston, TX, USA.
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Alesci A, Pergolizzi S, Fumia A, Miller A, Cernigliaro C, Zaccone M, Salamone V, Mastrantonio E, Gangemi S, Pioggia G, Cicero N. Immune System and Psychological State of Pregnant Women during COVID-19 Pandemic: Are Micronutrients Able to Support Pregnancy? Nutrients 2022; 14:nu14122534. [PMID: 35745263 PMCID: PMC9227584 DOI: 10.3390/nu14122534] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Revised: 06/04/2022] [Accepted: 06/16/2022] [Indexed: 02/04/2023] Open
Abstract
The immune system is highly dynamic and susceptible to many alterations throughout pregnancy. Since December 2019, a pandemic caused by coronavirus disease 19 (COVID-19) has swept the globe. To contain the spread of COVID-19, immediate measures such as quarantine and isolation were implemented. These containment measures have contributed to exacerbate situations of anxiety and stress, especially in pregnant women, who are already particularly anxious about their condition. Alterations in the psychological state of pregnant women are related to alterations in the immune system, which is more vulnerable under stress. COVID-19 could therefore find fertile soil in these individuals and risk more severe forms. Normally a controlled dietary regimen is followed during pregnancy, but the use of particular vitamins and micronutrients can help counteract depressive-anxiety states and stress, can improve the immune system, and provide an additional weapon in the defense against COVID-19 to bring the pregnancy to fruition. This review aims to gather data on the impact of COVID-19 on the immune system and psychological condition of pregnant women and to assess whether some micronutrients can improve their psychophysical symptoms.
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Affiliation(s)
- Alessio Alesci
- Department of Chemical, Biological, Pharmaceutical and Environmental Sciences, University of Messina, 98166 Messina, Italy;
- Correspondence: (A.A.); (A.F.); (N.C.)
| | - Simona Pergolizzi
- Department of Chemical, Biological, Pharmaceutical and Environmental Sciences, University of Messina, 98166 Messina, Italy;
| | - Angelo Fumia
- Department of Clinical and Experimental Medicine, University of Messina, 98147 Messina, Italy;
- Correspondence: (A.A.); (A.F.); (N.C.)
| | - Anthea Miller
- Department of Veterinary Sciences, University of Messina, 98168 Messina, Italy;
| | - Caterina Cernigliaro
- Azienda Sanitaria Provinciale 5 Messina, 98124 Messina, Italy; (C.C.); (M.Z.); (V.S.); (E.M.)
| | - Maria Zaccone
- Azienda Sanitaria Provinciale 5 Messina, 98124 Messina, Italy; (C.C.); (M.Z.); (V.S.); (E.M.)
| | - Vanessa Salamone
- Azienda Sanitaria Provinciale 5 Messina, 98124 Messina, Italy; (C.C.); (M.Z.); (V.S.); (E.M.)
| | - Enza Mastrantonio
- Azienda Sanitaria Provinciale 5 Messina, 98124 Messina, Italy; (C.C.); (M.Z.); (V.S.); (E.M.)
| | - Sebastiano Gangemi
- Department of Clinical and Experimental Medicine, University of Messina, 98147 Messina, Italy;
| | - Giovanni Pioggia
- Institute for Biomedical Research and Innovation (IRIB), National Research Council of Italy (CNR), 98125 Messina, Italy;
| | - Nicola Cicero
- Department of Biomedical and Dental Science and Morphofunctional Imaging, University of Messina, 98125 Messina, Italy
- Correspondence: (A.A.); (A.F.); (N.C.)
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Lee Y, Choi S, Jung H. Self-Care Mobile Application for South Korean Pregnant Women at Work: Development and Usability Study. Risk Manag Healthc Policy 2022; 15:997-1009. [PMID: 35585874 PMCID: PMC9109729 DOI: 10.2147/rmhp.s360407] [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] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Accepted: 04/21/2022] [Indexed: 11/29/2022] Open
Abstract
Background Pregnant women at work often encounter barriers to participating in prenatal education or conducting appropriate self-care practices due to their working conditions. Purpose We aimed at developing a mobile-based intervention application (SPWW) for Korean pregnant women at work and testing its usability and preliminary effects to enhance their self-care practices. Patients and Methods The application was developed and tested with thirty-one pregnant women at work and thirteen women's healthcare providers. The instruments used in this study were a modified Health Practices in Pregnancy Questionnaire II and a System Usability Scale. Descriptive analyses and t-tests were performed using SPSS 25.0. The participants' open-ended answers were analyzed using ATLAS. ti 8. Results We developed the application focusing on four self-care topics: healthy diet, physical activity, sufficient rest, and stress management. After using the application for two weeks, participants' levels of exercise (p = 0.006), adequate fluid intake (p = 0.002), and limiting daily caffeine intake (p = 0.048) significantly improved. In addition to good usability scores, the suggestions for improvement made by the participants included diversifying the educational materials and adding individually customizable functions to the application. Conclusion The application developed in this study enhanced self-care practices of pregnant women at work and showed adequate levels of usability. We expect the developmental process and details of the application provided in this study to serve as a sample guide for future studies.
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Affiliation(s)
- Yaelim Lee
- College of Nursing, Catholic University of Korea, Seoul, Republic of Korea
- Redcross College of Nursing, Chung-Ang University, Seoul, Republic of Korea
| | - Soeun Choi
- Department of Nursing, Yeouido St. Mary’s Hospital, Seoul, Republic of Korea
| | - Heejae Jung
- Department of Nursing, Seoul National University Hospital, Seoul, Republic of Korea
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12
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Prevalence of depression during pregnancy and postpartum periods in low-income women in developed countries. J Public Health (Oxf) 2022. [DOI: 10.1007/s10389-021-01662-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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13
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Ronen K, Choo EM, Wandika B, Udren JI, Osborn L, Kithao P, Hedstrom AB, Masinde M, Kumar M, Wamalwa DC, Richardson BA, Kinuthia J, Unger JA. Evaluation of a two-way SMS messaging strategy to reduce neonatal mortality: rationale, design and methods of the Mobile WACh NEO randomised controlled trial in Kenya. BMJ Open 2021; 11:e056062. [PMID: 34949631 PMCID: PMC9066367 DOI: 10.1136/bmjopen-2021-056062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
INTRODUCTION Globally, approximately half of the estimated 6.3 million under-5 deaths occur in the neonatal period (within the first 28 days of life). Kenya ranks among countries with the highest number of neonatal deaths, at 20 per 1000 live births. Improved identification and management of neonates with potentially life-threatening illness is critical to meet the WHO's target of ≤12 neonatal deaths per 1000 live births by 2035. We developed an interactive (two-way) short messaging service (SMS) communication intervention, Mobile Solutions for Neonatal Health (Mobile women's and children's health (WACh) NEO), focused on the perinatal period. Mobile WACh NEO sends automated tailored SMS messages to mothers during pregnancy and up to 6 weeks post partum. Messages employ the Information-Motivation-Behaviour Skills framework to promote (1) maternal implementation of essential newborn care (ENC, including early, exclusive breast feeding, cord care and thermal care), (2) maternal identification of neonatal danger signs and care-seeking, and (3) maternal social support and self-efficacy. Participants can also send SMS to the study nurse, enabling on-demand remote support. METHODS AND ANALYSIS We describe a two-arm unblinded randomised controlled trial of the Mobile WACh NEO intervention. We will enrol 5000 pregnant women in the third trimester of pregnancy at 4 facilities in Kenya and randomise them 1:1 to receive interactive SMS or no SMS (control), and conduct follow-up visits at 2 and 6 weeks post partum. Neonatal mortality will be compared between arms as the primary outcome. Secondary outcomes include care-seeking, practice of ENC and psychosocial health. Exploratory analysis will investigate associations between maternal mental health, practice of ENC, care-seeking and SMS engagement. ETHICS AND DISSEMINATION This study received ethical approval from the University of Washington (STUDY00006395), Women and Infants Hospital (1755292-1) and Kenyatta National Hospital/University of Nairobi (P310/04/2019). All participants will provide written informed consent. Findings will be published in peer-reviewed journals and international conferences. TRIAL REGISTRATION NUMBER NCT04598165.
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Affiliation(s)
- Keshet Ronen
- Department of Global Health, University of Washington, Seattle, Washington, USA
| | - Esther M Choo
- Department of Global Health, University of Washington, Seattle, Washington, USA
| | - Brenda Wandika
- Department of Research and Programs, Kenyatta National Hospital, Nairobi, Kenya
| | - Jenna I Udren
- Department of Global Health, University of Washington, Seattle, Washington, USA
| | - Lusi Osborn
- Department of Research and Programs, Kenyatta National Hospital, Nairobi, Kenya
| | - Peninah Kithao
- Department of Research and Programs, Kenyatta National Hospital, Nairobi, Kenya
| | - Anna B Hedstrom
- Department of Pediatrics, University of Washington, Seattle, Washington, USA
| | - Millicent Masinde
- Department of Obstetrics and Gynecology, Kenyatta National Hospital, Nairobi, Kenya
| | - Manasi Kumar
- Department of Psychiatry, University of Nairobi, Nairobi, Kenya
| | - Dalton C Wamalwa
- Department of Pediatrics and Child Health, University of Nairobi, Nairobi, Kenya
| | - Barbra A Richardson
- Department of Biostatistics, University of Washington, Seattle, Washington, USA
| | - John Kinuthia
- Department of Research and Programs, Kenyatta National Hospital, Nairobi, Kenya
| | - Jennifer A Unger
- Department of Global Health, University of Washington, Seattle, Washington, USA
- Department of Obstetrics and Gynecology, Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA
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The risk and protective factors of heightened prenatal anxiety and depression during the COVID-19 lockdown. Sci Rep 2021; 11:20261. [PMID: 34642429 PMCID: PMC8511267 DOI: 10.1038/s41598-021-99662-6] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2021] [Accepted: 09/21/2021] [Indexed: 12/22/2022] Open
Abstract
While pregnant women are already at-risk for developing symptoms of anxiety and depression, this is heightened during the COVID-19 pandemic. We compared anxiety and depression symptoms, as indicators of psychological distress, before and during COVID-19, and investigated the role of partner, social network and healthcare support on COVID-19-related worries and consequently on psychological distress. A national survey, conducted during the first lockdown in The Netherlands, assessed COVID-19 experiences and psychological distress (N = 1421), whereas a comparison sample (N = 1439) was screened for psychological distress in 2017-2018. During COVID-19, the percentage of mothers scoring above the questionnaires' clinical cut-offs doubled for depression (6% and 12%) and anxiety (24% and 52%). Women reported increased partner support during COVID-19, compared to pre-pandemic, but decreased social and healthcare support. Higher support resulted in lower COVID-19-related worries, which in turn contributed to less psychological distress. Results suggest that a global pandemic exerts a heavy toll on pregnant women's mental health. Psychological distress was substantially higher during the pandemic than the pre-pandemic years. We identified a protective role of partner, social, and healthcare support, with important implications for the current and future crisis management. Whether increased psychological distress is transient or persistent, and whether and how it affects the future generation remains to be determined.
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15
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Güney E, Ünver H, Bal Z, Uçar T. Psychosocial factors and health practices in pregnancy: A cross-sectional study. Int J Nurs Pract 2021; 28:e13021. [PMID: 34622533 DOI: 10.1111/ijn.13021] [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: 08/01/2020] [Revised: 05/19/2021] [Accepted: 09/17/2021] [Indexed: 11/29/2022]
Abstract
AIM The aim of this study was to investigate psychosocial, demographic and obstetric factors that affect health practices in pregnancy. METHODS This cross-sectional study was conducted with pregnant women selected by using random sampling in a public hospital in Turkey. The pregnant women (n = 383) completed the Health Practices Questionnaire in Pregnancy, the Center for Epidemiologic Studies Depression Scale, the Beck Anxiety Inventory and the Multidimensional Scale of Perceived Social Support. Multiple linear regression was used to examine predictors of participation in health practices. The variables were subjected to multiple linear regression analysis to estimate the effect of each independent variable (depression, anxiety, perceived social support, age, educational level, gestational week and parity) on the dependent variable (health practices). RESULTS Depression and anxiety were not significantly related to gestational health practices. The multiple linear regression model showed that inadequate social support, low education level, early gestational week and high parity were significant predictors of nonengagement in favourable health practices during pregnancy. CONCLUSIONS Pregnant women with inadequate social support and specific demographic and obstetric characteristics are less likely to participate in gestational health practices. This study suggests that more attention should be paid to these groups to improve the health practices of pregnant women.
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Affiliation(s)
- Esra Güney
- Department of Midwifery, Faculty of Health Sciences, İnönü University, Malatya, Turkey
| | - Hacer Ünver
- Department of Midwifery, Faculty of Health Sciences, İnönü University, Malatya, Turkey
| | - Zeynep Bal
- Department of Midwifery, Faculty of Health Sciences, İnönü University, Malatya, Turkey
| | - Tuba Uçar
- Department of Midwifery, Faculty of Health Sciences, İnönü University, Malatya, Turkey
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16
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Atif M, Halaki M, Raynes-Greenow C, Chow CM. Perinatal depression in Pakistan: A systematic review and meta-analysis. Birth 2021; 48:149-163. [PMID: 33580505 DOI: 10.1111/birt.12535] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2019] [Revised: 01/11/2021] [Accepted: 01/16/2021] [Indexed: 11/27/2022]
Abstract
OBJECTIVE To estimate the prevalence and associated risk factors of perinatal depression in Pakistan. METHODS We conducted a systematic search of Medline, PsycINFO, CINAHL, EMBASE, and Global health, up through May 31, 2019. Studies reporting on the prevalence of perinatal depression in Pakistan with or without associated risks factors were included. RESULTS Forty-three studies reporting data from 17 544 women met the eligibility criteria and were included. Overall, the pooled prevalence of antenatal depression was 37% (95% CI: 30-44), while that of postnatal depression was 30% (95% CI: 25-36). The prevalence of perinatal depression in women residing in urban areas and those living in rural settings was not significantly different. The most frequently reported risk factors for antenatal depression were intimate partner violence and poor relationship with spouse, and that reported for postnatal depression was low-income level. An unintended pregnancy was significantly associated with perinatal depression in Pakistan. CONCLUSIONS We identified variability in prevalence rate of perinatal depression in Pakistan. It is difficult to gauge the true magnitude of this problem potentially due to differing risk factors between the antenatal and postnatal periods and the lack of uniformity of data collection protocols and procedures. The high prevalence rates of 30%-37% compared to global estimates suggest policy makers and stakeholders should direct additional resources toward improving perinatal mental health in Pakistan.
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Affiliation(s)
- Maria Atif
- Faculty of Health Sciences, The University of Sydney, Sydney, New South Wales, Australia
| | - Mark Halaki
- Discipline of Exercise and Sport Science, Faculty of Health Sciences, The University of Sydney, Sydney, New South Wales, Australia
| | - Camille Raynes-Greenow
- School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Chin-Moi Chow
- Discipline of Exercise and Sport Science, Faculty of Health Sciences, The University of Sydney, Sydney, New South Wales, Australia
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17
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Pak HJ, Choi HN, Lee HC, Yim JE. Effects of intragastric balloon on obesity in obese Korean women for 6 months post removal. Nutr Res Pract 2021; 15:456-467. [PMID: 34349879 PMCID: PMC8313389 DOI: 10.4162/nrp.2021.15.4.456] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2020] [Revised: 12/15/2020] [Accepted: 01/07/2021] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND/OBJECTIVES The prevalence of morbid obesity in Korean women has consistently been increasing, while the overall prevalence rate of obesity in Korean women seems to be stable. In addition to bariatric surgery, intragastric balloons (IGBs), as a nonsurgical therapy, have been reported to be effective in weight loss. However, the beneficial effects of IGB in Korean women with obesity have not been fully investigated. The aim of this study was to evaluate the changes in fat mass in Korean women with obesity who had undergone IGB treatment for 6 mon. SUBJECTS/METHODS Seventy-four women with obesity (body mass index [BMI] ≥ 25.0 kg/m2) were recruited. Clinical data, including general information, comorbidities with obesity, anthropometric data, and changes in the body fat composition before and after IGB treatment, were obtained from the subjects. RESULTS Most subjects had one or more comorbidities, such as osteoarthropathy and woman's disease, and had poor eating behaviors, including irregular mealtimes, eating quickly, and frequent overeating. Body composition measurements showed that weight, fat mass, and waist-hip circumference ratio decreased significantly at 6 mon after IGB treatment. In particular, women with morbid obesity (BMI ≥ 30 kg/m2) showed 33% excess weight loss. There was no significant difference in skeletal muscle mass and mineral contents after IGB treatment. CONCLUSIONS This study suggested that 6 mon of IGB treatment can be a beneficial treatment for obesity without muscle mass and bone mineral loss.
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Affiliation(s)
- Hyeon-Ju Pak
- Department of Food and Nutrition, Changwon National University, Changwon 51140, Korea
| | - Ha-Neul Choi
- Department of Food and Nutrition, Changwon National University, Changwon 51140, Korea
| | | | - Jung-Eun Yim
- Department of Food and Nutrition, Changwon National University, Changwon 51140, Korea.,Interdisciplinary Program in Senior Human Ecology (BK21 Four Program), Changwon National University, Changwon 51140, Korea
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18
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Romero-Gonzalez B, Caparros-Gonzalez RA, Gonzalez-Perez R, Garcia-Leon MA, Arco-Garcia L, Peralta-Ramirez MI. "I am pregnant. Am I different?": Psychopathology, psychological stress and hair cortisol levels among pregnant and non-pregnant women. J Psychiatr Res 2020; 131:235-243. [PMID: 33032186 DOI: 10.1016/j.jpsychires.2020.09.023] [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: 04/13/2020] [Revised: 09/14/2020] [Accepted: 09/25/2020] [Indexed: 12/17/2022]
Abstract
Pregnancy is a life process that brings about a series of associated changes, both physical and psychological, in women. The psychopathological changes occurring in pregnant women due to the simple fact of this new vital stage are unknown. Therefore, the objective of this study was to compare the psychopathological symptoms present during pregnancy with those present in non-pregnant women, as well as the perceived stress and hair cortisol levels. For this, a group of non-pregnant women (n = 171) were compared with pregnant women who were in the first trimester (n = 124), second trimester (n = 200) and third trimester (n = 190). Moreover, 77 women were followed up to verify their psychopathological course of pregnancy. Differences were found between pregnant and non-pregnant women relating to a wide range of psychopathological symptoms, perceived stress and hair cortisol levels. The symptoms were greater in the group of pregnant women. By studying different types of psychopathological symptoms associated with pregnancy, it is possible to assign psychological interventions to given characteristics of pregnant women. In addition, we can broaden our knowledge about the psychological aspects of pregnancy and the changes associated with it.
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Affiliation(s)
- Borja Romero-Gonzalez
- Department of Personality, Assessment and Psychological Treatment, University of Granada, Granada, Spain; Brain, Mind and Behavior Research Center (CIMCYC), Faculty of Psychology, University of Granada, Granada, Spain
| | | | - Raquel Gonzalez-Perez
- Department of Pharmacology, CIBERehd, Faculty of Pharmacy, University of Granada, Granada, Spain
| | - Maria Angeles Garcia-Leon
- FIDMAG, Germanes Hospitalaries Research Foundation. Consorcio de Investigación en Red en Salud Mental CIBERSAM. Barcelona, Spain
| | - Laura Arco-Garcia
- Crecer Juntos, Gabinete de Pedagogia, Psicologia y Logopedia, Maracena, Granada, Spain
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Roberson DN, Roussos-Ross D, Goodin AJ. Impact of an on-site perinatal mood disorders clinic in the diagnosis and management of perinatal mood disorders. J Perinat Med 2020; 48:837-843. [PMID: 32764166 DOI: 10.1515/jpm-2020-0036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2020] [Accepted: 07/01/2020] [Indexed: 11/15/2022]
Abstract
Objectives To assess change in Edinburgh Postnatal Depression Scale (EPDS) scores in women treated at the Perinatal Mood Disorders Clinic (PMDC) as a measure of improvement in perinatal mood disorders (primary outcome), and treatment disposition at final visit. Methods Chart review was performed for all PMDC patients between March 1, 2017 and June 1, 2018 (n=120), as a self-controlled case series design. Two-tailed t-tests compared initial and final EPDS scores for all patients with >1 visit (n=64), where EPDS score of ≥13 indicated a positive screen for depression. A multivariable linear regression model with robust standard errors estimated the relationship between patient characteristics and final EPDS scores. Results Of 120 patients, n=56 had one visit and n=64 had >1 visit. Of these 64, mean final score (11.04) was lower than mean initial score (16.54; p<0.001). Additionally, certain patient characteristics were associated with higher final EPDS score, including history of mood disorder and treatment with both pharmacotherapy and psychotherapy. Conclusions Women treated at the PMDC showed improved EPDS scores when receiving at least two separate care visits. Therefore, the clinic may be filling a gap in access to timely care for women with perinatal mood disorders.
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Affiliation(s)
- Dana N Roberson
- Department of Obstetrics and Gynecology, University of Florida College of Medicine, Gainesville, FL, USA
| | - Dikea Roussos-Ross
- Department of Obstetrics and Gynecology, University of Florida College of Medicine, Gainesville, FL, USA.,Department of Psychiatry, University of Florida College of Medicine, Gainesville, FL, USA
| | - Amie J Goodin
- Department of Pharmaceutical Outcomes and Policy, University of Florida College of Pharmacy, Gainesville, FL, USA.,Center for Drug Evaluation and Safety (CoDES), University of Florida, Gainesville, FL, USA
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20
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Sezer G, Sen S. The effect of individual counseling intervention on health practices in pregnancy: a randomized controlled trial. HEALTH EDUCATION RESEARCH 2020; 35:450-459. [PMID: 33090213 DOI: 10.1093/her/cyaa025] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/09/2020] [Accepted: 07/14/2020] [Indexed: 06/11/2023]
Abstract
This research was carried out to determine the effect of individual counseling intervention on health practices in pregnancy. This research is a single-blind randomized controlled experimental and follow-up design. Population of the research consisted of 126 pregnant women in total, with 64 of them being in the training group and 64 being in the control group. The research data were collected by using a 'Pregnant Identifying Information Form' and 'Health Practices in Pregnancy Questionnaire (HPQ)'. In this research, it was found that there was no significant difference in total score average of the HPQ before the individual counseling training between the pregnant women in the training and control groups (P > 0.05). It was also determined that there was a statistically significant difference in total score average of the HPQ after the individual counseling training during the second trimester between the two groups (P < 0.05). It was determined that there was a statistically significant difference in total score average of the HPQ during the third trimester between two groups (P < 0.05). It has been determined that the training provided with individual counseling to pregnant women is an effective initiative in increasing the health practices of pregnant women.
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Affiliation(s)
- Gozde Sezer
- Health Science Institute, Celal Bayar University, Yunusemre, Manısa, Turkey
| | - Selma Sen
- Midwifery Department, Faculty of Sciences, Celal Bayar University, Yunusemre, Manısa, Turkey
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Romero-Gonzalez B, Puertas-Gonzalez JA, Strivens-Vilchez H, Gonzalez-Perez R, Peralta-Ramirez MI. Effects of cognitive-behavioural therapy for stress management on stress and hair cortisol levels in pregnant women: A randomised controlled trial. J Psychosom Res 2020; 135:110162. [PMID: 32485622 DOI: 10.1016/j.jpsychores.2020.110162] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2020] [Revised: 05/19/2020] [Accepted: 05/24/2020] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To demonstrate the effectiveness of a cognitive behavioural therapy for stress management in pregnant women in the reduction of psychological stress and hair cortisol levels. METHODS The trial was controlled and randomised, with a total of 78 pregnant women: control group (n-39) and Cognitive Behavioural Therapy group (n-39). To test the therapy's efficacy, an evaluation of the primary outcome (hair cortisol levels) and secondary outcomes (psychological stress, psychopathological symptomatology and resilience) was conducted before and after the treatment. The therapy was conducted during 8 sessions (one per week) in a group setting. The study was registered as a Randomised Controlled Trial with the code NCT03404141. RESULTS The results showed a group time interaction between hair cortisol levels, psychological stress (perceived and pregnancy-specific), and in the exacerbation and severity of psychopathological symptoms. These variables presented reductions after treatment only in the Cognitive Behavioural Therapy group. CONCLUSIONS Using a novel way of assessing chronic stress (psychological and objective measures as hair cortisol levels), this is the first study that has shown a decrease in both the levels of cortisol in hair and in psychological stress. This decline could have implications for maternal and fetal health.
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Affiliation(s)
- Borja Romero-Gonzalez
- Brain, Mind and Behavior Research Center (CIMCYC), Faculty of Psychology, University of Granada, Granada, Spain; Department of Personality, Assessment and Psychological Treatment, University of Granada, Granada, Spain
| | - Jose A Puertas-Gonzalez
- Brain, Mind and Behavior Research Center (CIMCYC), Faculty of Psychology, University of Granada, Granada, Spain; Department of Personality, Assessment and Psychological Treatment, University of Granada, Granada, Spain
| | | | - Raquel Gonzalez-Perez
- Department of Pharmacology, CIBERehd, School of Pharmacy, Instituto de Investigación Biosanitariaibs.GRANADA, University of Granada, Granada, Spain.
| | - M Isabel Peralta-Ramirez
- Department of Personality, Assessment and Psychological Treatment, University of Granada, Granada, Spain
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Hadian T, Sanaz M, Shahla M, Sakineh MAC, Eesa M, Mojgan M. Predictors of health practices among a group of Iranian adolescent pregnant women: a cross-sectional study. Int J Adolesc Med Health 2020; 34:155-161. [PMID: 32549175 DOI: 10.1515/ijamh-2020-0006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2020] [Accepted: 02/11/2020] [Indexed: 11/15/2022]
Abstract
Introduction The health practices of pregnant women can affect maternal and fetal health, and pregnancy outcomes. Understanding the predictors of health practices in adolescent pregnant women can help improve these practices. The present study aimed to determine the predictors of health practices in adolescent pregnant women. Materials and methods This cross-sectional study was conducted on 316 adolescent pregnant women in health centers of Tehran (capital of Iran). The participants were selected through the census method. The data were collected using the socio-demographic, obstetrics and health practices questionnaires and analyzed using Pearson correlation coefficient, independent t-test, one-way ANOVA, and general linear model. Results The mean score of health practice was 135.29 ± 9.08, ranging from 34 to 170. The highest and the lowest mean score pertained to the avoidance of harmful drugs and opiates subscale (29.79) and the balance of rest and exercise subscale (13.15), respectively. The general linear model showed that a lower level of education, a history of abortion, lack of involvement in pre-pregnancy counseling, and delayed attendance for prenatal care, reduced the health practice score. However, high level of emotional support from the spouse increased the health practice score. Conclusions The findings highlighted the factors effective on health practices including involvement in pre-pregnancy counseling, early prenatal care and emotional support for the adolescent pregnant woman.
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Affiliation(s)
- Tahereh Hadian
- Students' Research Committee, Tabriz University of Medical sciences, Tabriz, Islamic Republic of Iran
| | - Moosavi Sanaz
- Women Reproductive Health Research Center, Tabriz University of Medical Sciences, Tabriz, Islamic Republic of Iran
| | - Meedya Shahla
- Member of South Asia Infant Feeding Research Network (SAIFRN), School of Nursing, Faculty of Science, Medicine and Health, University of Wollongong, Wollongong, Australia
| | | | - Mohammadi Eesa
- Department of Nursing, School of Medicine, Tarbiat Modares University, Tehran, Islamic Republic of Iran
| | - Mirghafourvand Mojgan
- Midwifery Department, Social Determinants of Health Research Center, Tabriz University of Medical Sciences, Tabriz, Islamic Republic of Iran
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Jussila H, Ekholm E, Pajulo M. A New Parental Mentalization Focused Ultrasound Intervention for Substance Using Pregnant Women. Effect on Self-reported Prenatal Mental Health, Attachment and Mentalization in a Randomized and Controlled Trial. Int J Ment Health Addict 2020. [DOI: 10.1007/s11469-019-00205-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
Abstract
AbstractThe effect of a novel mentalization-based parenting intervention was explored on prenatal self-reported mentalization (P-PRFQ), attachment (MFAS), depression (EPDS) and anxiety (STAI) among women with substance use problems. The participants were 90 pregnant women referred to obstetric outpatient care due to recent or current substance use and randomized into intervention (n = 46) and control (n = 44) groups. The intervention group received three interactive 4D ultrasound sessions and a week-by-week pregnancy diary. The control condition was constituted of treatment-as-usual in obstetric care. Unfortunately, the efficacy of the intervention on maternal prenatal mental health, attachment, and parental mentalization was not substantiated. The negative results may be related to the small sample size, the patient-reported outcomes, or insufficient efficacy within this high-risk group. In the context of high psychosocial risks and follow-up by Child Welfare Services, the patient-reported outcomes may have underestimated prenatal adversity. The role of the research context, methodology, and possible sources of bias in the outcome assessment are discussed.The trial registration number in the ClinicalTrials.gov: NCT03413631
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Choi E, Cho HN, Seo DH, Park B, Park S, Cho J, Kim S, Park YR, Choi KS, Rhee Y. Socioeconomic inequalities in obesity among Korean women aged 19-79 years: the 2016 Korean Study of Women's Health-Related Issues. Epidemiol Health 2019; 41:e2019005. [PMID: 30917463 PMCID: PMC6446067 DOI: 10.4178/epih.e2019005] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2018] [Accepted: 02/13/2019] [Indexed: 01/11/2023] Open
Abstract
OBJECTIVES While the prevalence of obesity in Asian women has remained stagnant, studies of socioeconomic inequalities in obesity among Asian women are scarce. This study aimed to examine the recent prevalence of obesity in Korean women aged between 19 years and 79 years and to analyze socioeconomic inequalities in obesity. METHODS Data were derived from the 2016 Korean Study of Women’s Health-Related Issues. The chi-square test and logistic regression analysis were used to analyze the associations between socioeconomic factors and obesity using Asian standard body mass index (BMI) categories: low (<18.5 kg/m2 ), normal (18.5-22.9 kg/m2 ), overweight (23.0-24.9 kg/m2 ), and obese (≥25.0 kg/ m2 ). As inequality-specific indicators, the slope index of inequality (SII) and relative index of inequality (RII) were calculated, with adjustment for age and self-reported health status. RESULTS Korean women were classified into the following BMI categories: underweight (5.3%), normal weight (59.1%), overweight (21.2%), and obese (14.4%). The SII and RII revealed substantial inequalities in obesity in favor of more urbanized women (SII, 4.5; RII, 1.4) and against of women who were highly educated (SII, -16.7; RII, 0.3). Subgroup analysis revealed inequalities in obesity according to household income among younger women and according to urbanization among women aged 65-79 years. CONCLUSIONS Clear educational inequalities in obesity existed in Korean women. Reverse inequalities in urbanization were also apparent in older women. Developing strategies to address the multiple observed inequalities in obesity among Korean women may prove essential for effectively reducing the burden of this disease.
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Affiliation(s)
- Eunji Choi
- Graduate School of Cancer Science and Policy, National Cancer Center, Goyang, Korea
| | - Ha Na Cho
- Graduate School of Cancer Science and Policy, National Cancer Center, Goyang, Korea
| | - Da Hea Seo
- Department of Endocrinology and Metabolism, Inha University School of Medicine, Incheon, Korea
| | - Boyoung Park
- Department of Medicine, Hanyang University College of Medicine, Seoul, Korea
| | - Sohee Park
- Graduate School of Public Health, Yonsei University, Seoul, Korea
| | - Juhee Cho
- Department of Clinical Research and Evaluation, Sungkyunkwan University, Seoul, Korea
| | - Sue Kim
- College of Nursing, Yonsei University, Seoul, Korea
| | - Yeong-Ran Park
- Division of Silver Industry, Kangnam University, Yongin, Korea
| | - Kui Son Choi
- Graduate School of Cancer Science and Policy, National Cancer Center, Goyang, Korea
| | - Yumie Rhee
- Department of Internal Medicine, Endocrine Research Institute, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
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Palagini L, Cipollone G, Masci I, Novi M, Caruso D, Kalmbach DA, Drake CL. Stress-related sleep reactivity is associated with insomnia, psychopathology and suicidality in pregnant women: preliminary results. Sleep Med 2019; 56:145-150. [PMID: 30803833 DOI: 10.1016/j.sleep.2019.01.009] [Citation(s) in RCA: 40] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2018] [Revised: 01/04/2019] [Accepted: 01/10/2019] [Indexed: 11/18/2022]
Abstract
INTRODUCTION Depression and anxiety symptoms are commonly experienced by women during pregnancy and may have negative consequences on mothers and newborns. Deterioration of sleep quality throughout pregnancy increases insomnia, which may lead to adverse outcomes including increased psychopathology in the perinatal period. Thus, identifying women at high risk of developing insomnia may have important clinical implications on maternal-fetal outcomes. Stress-related sleep reactivity is a well-established risk factor for future insomnia, depression, and anxiety in general adult samples. However, little is known of sleep reactivity and its relations to sleep and mood pathology in pregnancy. Therefore, we explored sleep reactivity in pregnant women and its relations to prenatal symptoms of insomnia, depression, anxiety, and suicidality. METHOD Sixty-two pregnant women (mean age 33.6 ± 3 years, 20.6 ± 0.6 weeks of pregnancy) were evaluated during their routine visit at the Gynecological Unit of the University of Pisa, Italy, using the Insomnia Severity Index (ISI) for insomnia symptoms, the Ford Insomnia Response to Stress Test for sleep reactivity (FIRST), Edinburgh Postnatal Depression Scale (EPDS) for depressive symptoms, and the Zung Self Rating Anxiety Scale (SAS) for anxiety symptoms. Item #10 of the EPDS was used to assess for suicidality. Differences in means between women with high vs low stress-related sleep reactivity were calculated using t-test or Mann-Whitney U/Wilcoxon test. Linear/multiple regression analyses have been performed to study associations between variables. RESULTS Pregnant women with high stress-related sleep reactivity, relative to those with low reactivity, reported greater symptoms of insomnia (t = 6.5, 0.004) as well as higher rates of depression (62.0% vs 6.1%, p < 0.001), anxiety (55.1% vs 15.1%, p = 0.030), and suicidality (17.2% vs 3.0%, p = 0.025). Multivariate models revealed sleep reactivity to correlate independently with symptoms of insomnia, depression, and anxiety, when controlling for comorbid symptoms. CONCLUSIONS In mid-pregnancy, women with high sleep reactivity report elevated symptoms of insomnia, depression, and anxiety, and are more likely to endorse suicidal ideation. As a prognostic marker of future insomnia and psychiatric illness, early detection of high prenatal sleep reactivity holds potential to prevent the development of sleep and mood pathology during pregnancy, thereby potentially improving maternal and child outcomes.
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Affiliation(s)
- Laura Palagini
- University Psychiatric Clinic, Department of Clinical and Experimental Medicine, Azienda Ospedaliero Universitaria Pisana- AUOP, Italy.
| | - Giada Cipollone
- University Psychiatric Clinic, Department of Clinical and Experimental Medicine, Azienda Ospedaliero Universitaria Pisana- AUOP, Italy
| | - Isabella Masci
- University Psychiatric Clinic, Department of Clinical and Experimental Medicine, Azienda Ospedaliero Universitaria Pisana- AUOP, Italy
| | - Martina Novi
- University Psychiatric Clinic, Department of Clinical and Experimental Medicine, Azienda Ospedaliero Universitaria Pisana- AUOP, Italy
| | - Danila Caruso
- University Psychiatric Clinic, Department of Clinical and Experimental Medicine, Azienda Ospedaliero Universitaria Pisana- AUOP, Italy
| | - David A Kalmbach
- Henry Ford Hospital Sleep Disorders and Research Center, Detroit, MI, USA
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Prevalence and Risk Factors for Antenatal Depression in Ethiopia: Systematic Review. DEPRESSION RESEARCH AND TREATMENT 2018; 2018:3649269. [PMID: 30112199 PMCID: PMC6077581 DOI: 10.1155/2018/3649269] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/17/2018] [Revised: 05/06/2018] [Accepted: 05/21/2018] [Indexed: 12/12/2022]
Abstract
INTRODUCTION Antenatal depression is a syndrome, in which women experience depressed mood, excessive anxiety, insomnia, and change in weight during the period of pregnancy. Maternal depression negatively influences child outcomes and maternal health. Antenatal depression was measured by different rating scales, namely, BDI, EPDS, and PHQ. The objective of this systematic review was to synthesize logical evidence about the prevalence and potential risk factors of antenatal depression in Ethiopia. METHODS Our team explored multiple databases including PSYCHINFO, MEDLINE, Embase, Google Scholar, and Google Search to detect studies published with data on the prevalence of antenatal depression. We found 246 research papers on antenatal depression, of which 210 did not correspond to the title and 27 were duplicates. Subsequently, nine articles were used for synthesis prevalence, of which four studies were selected in the analysis of the effect of unplanned pregnancy on antenatal depression. Figures were extracted from published reports and grey literature, and any lost information was requested from investigators. Estimates were pooled using random-effects meta-analyses. RESULTS The pooled prevalence of antenatal depression for five studies selected, which had used BDI, was 25.33 (20.74, 29.92). The other four studies that had included other screening tools (3 EPDS and 1 PHQ) had the prevalence decreased to 23.56 (19.04, 28.07), and the pooled effect of unplanned pregnancy on antenatal depression was 1.93 (1.81, 2.06). Factors such as age, marital status, income, occupation, history of the previous mental disorder, antenatal follow-up, unplanned pregnancy, complication during to pregnancy, age of mother during pregnancy, conflict, and social support were associated with antenatal depression. CONCLUSIONS Antenatal depression is a common maternal problem; further attention should be given to the effect of unplanned pregnancy, social support, pregnancy-related complications, family conflicts, and violence on pregnant women. All these are possible risk factors for antenatal depression.
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Prevalence of Antenatal Depression and Associated Factors among Pregnant Women Attending Antenatal Care at Dubti Hospital: A Case of Pastoralist Region in Northeast Ethiopia. DEPRESSION RESEARCH AND TREATMENT 2018; 2018:1659089. [PMID: 30906594 PMCID: PMC6398073 DOI: 10.1155/2018/1659089] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/01/2018] [Revised: 08/25/2018] [Accepted: 09/18/2018] [Indexed: 11/18/2022]
Abstract
BACKGROUND Globally, depression affects an estimated 10 % to 20% of women during pregnancy. There is limited evidence on antenatal depression in Northeast Ethiopia. This study aimed to assess prevalence of antenatal depression and associated factors among Dubti Hospital Antenatal care attendants. METHODS Institution based cross-sectional study was conducted among 363 Antenatal care attendants at Dubti Hospital from March 07 to May 07, 2016. Beck's Depression Inventory tool was used to collect data. Data were entered into Epi-Data 3.1 and analyzed using SPSS 20. Bivariable and multivariable logistic regression analyses were fitted. Variables having p value < 0.05 were considered as statistically significant. RESULTS A total of 357 pregnant women were interviewed. The prevalence of antenatal depression was 17.9% [95% CI (14.0, 22.0%). Pregnancy planning [AOR: 0.04; 95% CI (0.014, 0.114), social support [AOR: 0.21; 95% CI (0.07, 0.66), and marital conflict [AOR: 6.45; 95% CI (2.1, 17.9)] were significantly associated with antenatal depression. CONCLUSIONS Nearly one in five pregnant women had depression. Marital conflict, pregnancy planning, and social support were significant predictors of antenatal depression. Dubti Hospital should strengthen its effort on prevention of unplanned pregnancy. Healthcare workers in antenatal care unit have to deal with marital conflict and social support as part of their routine investigation to avoid complications through early detection of antenatal depression.
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Lowenhoff C, Appleton JV, Davison-Fischer J, Pike N. NICE guideline for antenatal and postnatal mental health: The health visitor role. ACTA ACUST UNITED AC 2017. [DOI: 10.12968/johv.2017.5.6.290] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Catherine Lowenhoff
- PhD student, Department of Psychology, Social Work and Public Health, Oxford Brookes University
| | - Jane V Appleton
- Professor of primary and community care, Oxford Brookes University
| | | | - Nick Pike
- Research visiting fellow in social work, Oxford Brookes University
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Alhusen JL, Geller R, Dreisbach C, Constantoulakis L, Siega-Riz AM. Intimate Partner Violence and Gestational Weight Gain in a Population-Based Sample of Perinatal Women. J Obstet Gynecol Neonatal Nurs 2017; 46:390-402. [PMID: 28294945 PMCID: PMC5423819 DOI: 10.1016/j.jogn.2016.12.003] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/01/2016] [Indexed: 12/15/2022] Open
Abstract
OBJECTIVE To examine the effects of intimate partner violence (IPV) at varied time points in the perinatal period on inadequate and excessive gestational weight gain. DESIGN Retrospective cohort using population-based secondary data. SETTING Pregnancy Risk Assessment Monitoring System and birth certificate data from New York City and 35 states. PARTICIPANTS Data were obtained for 251,342 U.S. mothers who gave birth from 2004 through 2011 and completed the Pregnancy Risk Assessment Monitoring System survey 2 to 9 months after birth. METHODS The exposure was perinatal IPV, defined as experiencing physical abuse by a current or ex-partner in the year before or during pregnancy. Adequacy of gestational weight gain (GWG) was categorized using 2009 Institute of Medicine guidelines. Weighted descriptive statistics and multivariate logistic regression models were used. RESULTS Approximately 6% of participants reported perinatal IPV, 2.7% reported IPV in the year before pregnancy, 1.1% reported IPV during pregnancy only, and the remaining 2.5% reported IPV before and during pregnancy. Inadequate GWG was more prevalent among participants who experienced IPV during pregnancy and those who experienced IPV before and during pregnancy (23.3% and 23.5%, respectively) than in participants who reported no IPV (20.2%; p < .001). Participants who experienced IPV before pregnancy only were significantly more likely to have excessive GWG (p < .001). Results were attenuated in the multivariate modeling; only participants who experienced IPV before pregnancy had weakly significant odds of excessive GWG (adjusted odds ratio = 1.14, 95% CI [1.02, 1.26]). CONCLUSION The association between perinatal IPV and inadequate GWG was explained by confounding variables; however, women who reported perinatal IPV had greater rates of GWG outside the optimal range. Future studies are needed to determine how relevant confounding variables may affect a woman's GWG.
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