Incidence of pregnancy-related discomforts and management approaches to relieve them among pregnant women

The relationship of depression, anxiety, and stress with pregnancy symptoms and coping styles in pregnant women: A multi-group structural equation modeling analysis

BACKGROUND

The changes during pregnancy can increase susceptibility to mental health problems such as depression, anxiety and stress, which is why coping strategies are so important. The aim of this study is to investigate the relationships between depression, anxiety, stress, pregnancy symptoms and coping styles in pregnant women across trimesters, using a multigroup structural equation model.

METHODS

This cross-sectional and correlational study was conducted with 301 pregnant women who applied to the prenatal clinic of a state university's medical faculty. A hypothetical model was created based on transactional stress and coping theory and literature reviews. Data were collected using a participant information form, the Depression Anxiety Stress Scale, the Pregnancy Symptom Inventory and the Stress Coping Styles Scale.

RESULTS

Among pregnant women, 40.9 % had symptoms of stress, 52.8 % of anxiety and 37.2 % of depression. Pregnancy symptoms and emotion-focused coping are positively associated with depression, anxiety, and stress (β = 0.468-0.590; β = 0.222-0.373 respectively). Problem-focused coping is negatively associated with depression, anxiety, and stress. (β = -0.255:-0.389). Problem-focused coping is negatively associated with pregnancy symptoms in the whole sample (β = -0.121) and in the third trimester (β = -0.124). The model explained 51 % of the variance in the 1st, 42 % in the 2nd, and 64 % in the 3rd trimesters.

CONCLUSION

This study showed that problem-focused coping strategies are negatively associated with depression, anxiety and stress and play an important protective role in this context. These findings contribute to understanding the factors affecting mental health during pregnancy and emphasize the importance of developing problem-focused coping skills for pregnant women.

The Relationships Between Multidimensional Symptom Burden, Adaptation, and Depression During Pregnancy: A Cross-sectional Study

Prenatal depression is highly prevalent, but its relationship with the multidimensional burden of physical symptoms during pregnancy remains underexplored. The aim of this study was to examine the relationship between pregnancy-related physical symptom burden, including frequency, severity, and impact on life and pregnancy adaptation to prenatal depression, and to identify predictors of depression during pregnancy. The study was cross-sectional in design. A hospital-based setting providing comprehensive maternity care services from outpatient to inpatient. The sample consisted of two hundred forty-three pregnant individuals aged 20 and above with no major obstetrical complications. Structured questionnaires including demographic and obstetrical characteristics, depression, symptom burden, and pregnancy adaptation were used for data collection. Multiple linear regression analyses were performed to identify significant predictors of depression. The study revealed that approximately 32% of the variance in depression scores could be explained by the combined effects of pregnancy-related physical symptom burden and pregnancy adaptation. Specifically, low-level pregnancy adaptation, high-level symptom impact on life, unmarried status, and mid-level symptom severity were identified as the main predictors of prenatal depression among low-risk pregnant individuals. The findings contribute to the existing knowledge base, emphasizing the significance of addressing and managing pregnancy-related physical symptom burden while promoting effective adaptation to pregnancy as a means to mitigate the risk of prenatal depression.

Exploring women's self-reported health problems in pregnancy in the UK and Norway

Women usually conceptualize pregnancy as a normal physiological state. In contrast, formal maternity care provision tends to be focused on pathology and risk. The authors aim to explore the extent to which childbearing women apply a sickness lens to pregnancy. We have therefore examined antenatal problems spontaneously reported by 4,000 UK and Norwegian women who responded to the international social media-based Babies Born Better survey. We coded and classified the free-text comments of the respondents as either complaint or disease. We found striking differences in the rates and types of problems reported by the women. We discuss our findings by applying different perspectives of medicalization and of lay and biomedical knowledge.

Developmental neurotoxicity evaluation of three Chinese herbal medicines in zebrafish larvae by means of two behavioral assays: Touch-evoked response and light/dark transition

Chinese herbal medicine (CHM) is used among pregnant women. However, the question of its safety during pregnancy remains unclear. The use of these products relies on history of use data but there are specific toxicities like developmental neurotoxicity that are clearly understudied. Here we use the zebfrafish embryo developmental toxicity assay (ZEDTA) in combination with two behavioral assays: touch-evoked response and Light/Dark (L/D) transition assay to evaluate the neuro/developmental toxicity of three herbal products commonly used in CHM [Chinese name (abbreviation; part of the plant and Scientific name]: tian ma (TM; tuber form Gastrodia elata Blume), lei gong teng (LGT; root and rhizome of Tripterygium wilfordii Hook.f) and cha ye (green tea, leaves from Camellia sinensis (L.) Kuntze). In case significant alterations were detected, single components with potential exposure during pregnancy were identified in the literature and further tested. TM had no neurodevelopmental toxic potential in zebrafish embryos, while LGT and its main compounds triptolide and celastrol induced significant alterations in behavior. Developmental exposure to EGCG, the main catechin of green tea, also produced significant alterations in zebrafish embryos behavior after developmental exposure. A combination of ZEDTA with L/D Transition assay is proposed as a useful combination of alternative methods for DNT assessment of CHM products together with other New Approach Methodologies (NAMs).

The Awareness and Knowledge of Normal and Abnormal Signs and Symptoms of Pregnancy Among Women of Childbearing Age in Saudi Arabia

BACKGROUND

Pregnancy is a natural physiological process that leads to the outstanding outcome of giving birth. It involves normal and abnormal signs and symptoms that women need to be aware of during this period.

OBJECTIVES

This study aims to assess the awareness and knowledge about normal and abnormal signs and symptoms of pregnancy among women of childbearing age in Saudi Arabia.

METHODS

This is an online questionnaire-based cross-sectional study done in 2023 among women in Saudi Arabia, aged 18 to 45. The estimated sample size was 385 after applying inclusion and exclusion criteria. However, 981 responses were collected and included.

RESULTS

A total of 981 participants were included in our study. The study findings noted that the majority of women demonstrated a good level of knowledge about the normal signs and symptoms of pregnancy. About 82% of the women reported that they knew mood swings were normal symptoms during pregnancy, 80.1% were aware of nausea, 75.9% knew about fatigue, and 68.9% knew about fainting or dizziness. The findings noted that less than half of the participants were fully aware of the abnormal obstetric signs. For the abnormal signs and symptoms during the first trimester, only 45.2% were fully aware of the symptoms. In the second trimester, 39.0% were fully aware of the symptoms. Only 30.5% of the participants were fully aware of the abnormal signs and symptoms in the third trimester. The study established a statistically significant relationship between age and knowledge of abnormal symptoms during the first, second, and third trimesters (P=0.027, 0.041, and 0.006) (r=0.139, 0.105, and 0.146). Furthermore, a statistically significant relationship was found between the level of education of the participants and the level of awareness of abnormal symptoms during the first trimester (P=0.043). However, there was no significant relationship between education level and the level of knowledge regarding abnormal symptoms during the second and third trimesters (r=0.22, 0.061, P=0.578, 0.603).

CONCLUSION

The study found that the majority of women had a good level of awareness and knowledge about normal signs and symptoms of pregnancy, while less than half of the women were fully aware of the abnormal signs and symptoms at different stages of pregnancy. The older respondents and people with higher levels of education demonstrated more knowledge. The two variables, age and education level, had a statistically significant relationship with knowledge of abnormal signs and symptoms of pregnancy with education level being only significant during the first trimester period. Our study concluded that women had different symptoms during pregnancy, both normal and abnormal. Their knowledge about these signs and symptoms was considerably moderate, but further awareness about the normality of these signs is needed. The study recommends more research to measure women's awareness about normal and abnormal symptoms of pregnancy, and more awareness programs should be carried out in the region as a way of enhancing a better understanding of normal and abnormal pregnancy symptoms. This will go a long way in helping women through their pregnancy and make them more comfortable.

Disability during Early Pregnancy: Using the Sheehan Disability Scale during the First Trimester in Japan

Background: Many pregnant women experience impairments in social, occupational, or other important functioning. Aim: This study aimed to confirm measurement and structural invariance of the Sheehan Disability Scale (SDS) and its validity during early pregnancy. Design: Longitudinal study with two observations. Methods: Questionnaires were distributed to pregnant women attending antenatal clinics at gestational weeks 10-13. Of 382 respondents, 129 responded to the SDS again 1 week later. Results: Confirmatory factor analysis shows good fit with the data: χ²/df = 0, comparative fit index (CFI) = 1.000, standardized root mean square residual (SRMR) = 0, and root mean square error of approximation (RMSEA) = 0.718. There is acceptable configural, measurement, and structural invariance of the factor structure between primiparas and multiparas as well as between two observation occasions. The Pregnancy-Unique Quantification of Emesis and Nausea, Patient Health Questionnaire-9, and Insomnia Severity Index subscales explain 47% of the variance in SDS scores. Conclusion: Perinatal health care professionals should pay more attention to the difficulties and disabilities that pregnant women face.

The predictive value of common symptoms in early pregnancy for complications later in pregnancy and at birth

INTRODUCTION

The aim was to investigate whether common pregnancy-related symptoms-nausea, vomiting, back pain, pelvic girdle pain, pelvic cavity pain, vaginal bleeding, itching of vulva, pregnancy itching, leg cramps, uterine contractions and varicose veins-in the first trimester of pregnancy add to the identification of women at high risk of future pregnancy and birth complications.

MATERIAL AND METHODS

Survey data linked to national register data. All women booking an appointment for a first prenatal visit in one of 192 randomly selected General Practices in East Denmark in the period April 2015-August 2016. The General Practices included 1491 women to this prospective study. Two outcomes, pregnancy complications and birth complications, were collected from the Danish Medical Birth Register.

RESULTS

Among the 1413 included women, 199 (14%) experienced complications in later pregnancy. The most serious complication, miscarriage, was experienced by 65 women (4.6%). Other common pregnancy complications were gestational diabetes mellitus (n = 11, 0.8%), gestational hypertension without proteinuria (n = 34, 2.4%), mild to moderate preeclampsia (n = 34, 2.4%) and gestational itching with effect on liver (n = 17, 1.2%). Women who experienced pelvic girdle pain, pelvic cavity pain or vaginal bleeding in the first trimester of pregnancy had a higher risk of pregnancy complications later on in later pregnancy. None of the other examined symptoms showed associations to pregnancy complications. No associations were found between pregnancy-related physical symptoms in first trimester and birth complications.

CONCLUSIONS

Symptoms in early pregnancy do not add much information about the risk of pregnancy or birth complications, although pain and bleeding may give reason for some concern. This is an important message to women experiencing these common symptoms and to their caregivers.

"This is hard to cope with": the lived experience and coping strategies adopted amongst Australian women with pelvic girdle pain in pregnancy

Background

Women with pregnancy-related pelvic girdle pain (PPGP) report diminished ability to perform physical activities and experience higher rates of mood disorders, such as anxiety and depression, than pregnant women without PPGP. Despite these physical and psychological impacts, little is known about the lived experiences of PPGP amongst Australian women and the ways in which they cope. Situated within biographical disruption and social support theories, this study sought to gain a conceptual understanding of the experience and impact of PPGP on daily life, and how women cope with this condition during pregnancy.

Methods

A qualitative research design, situated within a phenomenological framework, using individual, semi-structured interviews consisting of open-ended questions was used with a flexible and responsive approach. Purposive sampling of pregnant women attending a single hospital included 20 participants between 14 and 38 weeks gestation, classified with PPGP as per recommended guidelines, with a mean (SD) age of 31.37 (4.16) years. Thematic analysis was performed where interview data was transcribed, coded, grouped into meaningful categories and then constructed into broad themes.

Results

Three themes were identified: 1. a transformed biography; 2. coping strategies; and 3. what women want. The pain experienced created a dramatic change in women’s lives, making the pregnancy difficult to endure. Women utilised social support, such as family, to help them cope with pain, and a self-care approach to maintain a positive mindset and reduce stress. Although a few women received support from healthcare professionals, many reported a lack information on PPGP and limited societal recognition of the condition. Women wanted early education, personalised information and prompt referral to help them cope with PPGP.

Conclusions

Findings from this study highlighted the complexity of living with PPGP as women attempted to deal with the unexpected impact on daily life by seeking support from partners and families, while also struggling with societal expectations. Although women with PPGP used a number of coping strategies, they sought greater support from healthcare professionals to effectively manage PPGP. These findings have important implications for the provision of health care to women living with PPGP.

Trial registration

Australian New Zealand Clinical Trials Registry: ACTRN12618001423202.

Associations between Pregnancy-Related Symptoms, Serum 25(OH)D, and Physical Quality of Life in Pregnant Women

Vitamin D deficiency has been associated with pregnancy-related symptoms including fatigue, poor sleep quality, and musculoskeletal pain. Pregnant Black and Hispanic women are more likely to have vitamin D deficiency compared with pregnant non-Hispanic White women. Data are limited on the association of vitamin D deficiency with quality of life (QOL) among pregnant women. This study examined the association of serum 25(OH)D and pregnancy-related symptoms with QOL among pregnant predominantly minority women. Using a cross-sectional design, 119 pregnant Black and Hispanic women completed surveys and had blood drawn for serum 25(OH)D levels between 24–32 weeks gestation. Hierarchical regression analysis indicated that total pregnancy-related symptoms and serum 25(OH)D level were significant predictors of QOL, while controlling for covariates. Higher total pregnancy-related symptoms and lower serum 25(OH)D predicted poorer physical QOL. Screening for pregnancy-related symptoms and vitamin D levels among childbearing women might be important nursing interventions to improve physical QOL.

Psychometric Properties of the Persian Version of Pregnancy Symptoms Inventory (PSI)

The aim of this study was to determine the psychometric properties of the Persian version of pregnancy symptoms inventory. A methodological study. This study was conducted on 220 pregnant women. Construct validity was measured by exploratory factor analysis and confirmatory factor analysis. Reliability was measured by intra-class correlation coefficient and internal consistency. Since the items 12 (snoring) and 16 (thrush) failed to obtain the minimum principal axis factoring in exploratory factor analysis, they were removed from the Persian version. Confirmatory factor analysis showed a good fit for the extracted model. Cronbach's alpha was .94 for the frequency items and .95 for the limitation items. Intra-class correlation coefficient was between .58 and 1 for frequency items and between .73 and 1 for limitation items. The Persian version of pregnancy symptoms inventory was a valid and reliable scale to be used for Iranian pregnant women.

Tradition, taste and taboo: the gastroecology of maternal perinatal diet

Background

Maternal malnutrition is a major source of regional health inequity and contributes to maternal and infant morbidity and mortality. Bihar, a state in eastern India adjacent to Jharkhand and West Bengal, has relatively high neonatal mortality rates because a large portion of infants are born to young mothers. Bihar has the second-highest proportion of underweight children under 3 in India, with infant mortality rates of 48 per 1000 live births. Maternal malnutrition remains a major threat to perinatal health in Bihar, where 58.3% of pregnant women are anaemic.

Methods

We examined dietary beliefs and practices among mothers, mothers-in-law and community members, including Accredited Social Health Activists (ASHAs), using focus group discussions (n=40 groups, 213 participants), key informant interviews (n=50 participants) and quantitative surveys (n=1200 recent mothers and 400 community health workers). We report foods that are added/avoided during the perinatal period, along with stated reasons underlying food choice. We summarise the content of the diet based on responses to the quantitative survey and identify influencers of food choice and stated explanations for adding and avoiding foods.

Key findings

Analyses for all methodologies included gathering frequency counts and running descriptive statistics by food item, recommendation to eat or avoid, pregnancy or post partum, food group and health promoting or risk avoiding. During pregnancy, commonly added foods were generally nutritious (milk, pulses) with explanations for consuming these foods related to promoting health. Commonly avoided foods during pregnancy were also nutritious (wood apples, eggplant) with explanations for avoiding these foods related to miscarriage, newborn appearance and issues with digestion. Post partum, commonly added foods included sweets because they ease digestion whereas commonly avoided foods included eggplants and oily or spicy foods. Family, friends, relatives or neighbours influenced food choice for both mothers and ASHAs more than ASHAs and other health workers.

Perinatal dietary beliefs and behaviours are shaped by local gastroecologies or systems of knowledge and practice that surround and inform dietary choices, as well as how those choices are explained and influenced. Our data provide novel insight into how health influencers operating within traditional and biomedical health systems shape the perinatal dietary beliefs of both mothers and community health workers.

Physical Activity Patterns of Women with a Twin Pregnancy-A Cross-Sectional Study

Background: No specific physical activity guidelines are available for women in multiple pregnancy. Aim of the study was to assess the knowledge and experience of women regarding physical activity during their latest twin pregnancy. Methods: A cross-sectional study including women after a twin delivery was conducted in Poland. A questionnaire was distributed in 2018 via web pages and Facebook groups designed for pregnant women. Results: 652 women filled out the questionnaire completely. Only 25% of women performed any physical exercises during twin gestation. The frequency of preterm delivery was similar in physically active and non-active participants. 35% of the respondents claimed to have gained information on proper activity from obstetricians during antenatal counselling while 11% claimed to be unable to identify the reliable sources of information. 7% of women admitted to feel discriminated by social opinion on exercising during a twin pregnancy. Conclusions: The population of women with a twin gestation is not sufficiently physically active and is often discouraged from performing exercises during gestation. Therefore, it is crucial to inform obstetricians to recommend active lifestyle during a twin gestation and to provide reliable information on physical activity to pregnant women. Further research on this topic is necessary in order for obstetric providers to counsel women on appropriate exercise with a twin pregnancy.

Sensory challenges experienced by autistic women during pregnancy and childbirth: a systematic review

PURPOSE

The aim of this systematic review was to identify challenges faced by autistic women during pregnancy and birth due to sensory issues or other features of Autism Spectrum Disorder.

METHODS

A systematic search of literature was conducted using Medline, PubMed, Embase, PsycINFO, CINAHL, MIDIRS, ProQuest Dissertations and Theses Global, and Open Access Theses and Dissertations. Eligible studies addressed autistic women's pregnancy or birth experiences, and were assessed for methodological quality.

RESULTS

The search generated 2656 results, with six meeting inclusion criteria. Data from 427 autistic participants were extracted from four qualitative and two quantitative studies for synthesis.

CONCLUSION

We found that the literature was exploratory and lacked focussed research questions addressing sensory issues in pregnancy. Sensory challenges were, however, identified as a key finding in all qualitative studies. Other challenges faced by autistic women during pregnancy and birth included communication issues in healthcare settings and lack of appropriate information and supports for pregnancy and birth. Implications for health professionals and challenges associated with research in this area are discussed.

A qualitative investigation of a prenatal yoga intervention to prevent excessive gestational weight gain: A thematic analysis of interviews

PURPOSE

To describe pregnant women's experiences and perceived facilitators/barriers of a prenatal yoga intervention to prevent excessive gestational weight gain (EGWG).

METHODS

Pregnant women (N = 13) were interviewed after participation in a 12-week prenatal yoga intervention to prevent EGWG. Interviews were summarized using thematic analysis.

RESULTS

Twelve themes were identified and organized into four categories: 1) experiences of prenatal yoga (positive experience/enjoyment, pain relief, connecting to body), 2) prenatal yoga and weight (increased mindfulness/self-awareness, increased physical activity, weight management), 3) barriers to prenatal yoga (physical body, commute/traffic, schedule), and 4) facilitators of prenatal yoga (healthy pregnancy, support from other pregnant women, the feeling from prenatal yoga).

CONCLUSION

Prenatal yoga may relieve pain and help women be more connected to their bodies. Prenatal yoga may also help women become more aware of their health behaviors and increases their physical activity which may have important implications for reducing EGWG.

[Effect of Lifestyle Intervention Program for Overweight and Obesity Pregnant Women]

PURPOSE

This study was conducted to identify the effects of a lifestyle intervention program on weight gain, dietary habits, fatigue and pregnancy stress, blood pressure, and neonatal birth weight, using Cox's interaction model of client health behavior for overweight and obese women.

METHODS

This was a quasi-experimental research with a non-equivalent control group pre-post test design. A total of 52 patients who met the selection criteria, including 25 in the experimental group and 27 in the control group, were the subjects of the study; they comprised overweight and obese pregnant women who were receiving prenatal care at A and B women's hospital in J province. The lifestyle intervention program ran for 12 weeks in total and consisted of interactions involving affective support, health information, and professional/technical competencies. The data collection period was from February 1, 2017 to August 31, 2017.

RESULTS

This study showed differences in the appropriate weight gain rate (χ²=6.17, p=.013), suppression of an increase in fatigue (t=-2.32, p=.012), and an increase in pregnancy stress (t=-1.87, p=.034). Yet, no differences in physical activity, dietary habits change, blood pressure, and neonatal birth weight (p>.05) were found.

CONCLUSION

The study findings indicate that this program could be an effective intervention for the control of appropriate weight gain, fatigue, and pregnancy stress. Therefore, a lifestyle intervention program based on Cox's interaction model of client health behavior could be an efficient strategy for a positive health outcome of overweight and obesity pregnant women.

Short Meal-to-Bed Time Is a Predominant Risk Factor of Gastroesophageal Reflux Disease in Pregnancy

BACKGROUND

Short meal-to-bed time (MTBT) has been reported to relate to gastroesophageal reflux disease (GERD), but evidence is lacking in pregnant women. We aimed to assess the characteristics of GERD and the association between MTBT and GERD during pregnancy.

PATIENTS AND METHODS

A cross-sectional study was carried out on 400 pregnant women aged 18 years and older visiting the antenatal clinic of Gia-Dinh People's Hospital, Vietnam. GERD was defined as having troublesome heartburn and/or regurgitation at least once a week. Reflux-related insomnia was defined as having difficulties in initiating or maintaining sleep through the night. MTBT was defined as "short" if it was ≤2 hours in more than two thirds of days in a week.

RESULTS

There were 154 (38.5%) patients with GERD and 20 (13.0%) patients with reflux-related insomnia. In multivariate analysis, there were 3 factors significantly associated with GERD: third trimester [odds ratio (OR)=1.66; 95% confidence interval (CI): 1.03-2.69], previous history of typical reflux symptoms (OR=9.05; 95% CI: 5.29-15.50), and short MTBT (OR=12.73; 95% CI: 2.92-55.45). The frequency of reflux symptoms progressively increased across subgroups of patients with no short MTBT, either daytime or nighttime short MTBT, and with both daytime and nighttime short MTBT. Nighttime MTBT was also a significant risk factor for reflux-related insomnia (OR=4.60; 95% CI: 1.64-12.92).

CONCLUSIONS

We reported for the first time that short MTBT was a predominant risk factor of GERD in pregnancy. This dieting habit was significantly associated with reflux symptom frequency and reflux-related insomnia.

Association of Self-Reported Physical Fitness with Pregnancy Related Symptoms the GESTAFIT Project

We explored the association of physical fitness (PF) with pregnancy-related symptoms, at the 16th and 34th gestational weeks (g.w.). The International Fitness Scale and the Pregnancy Symptoms Inventory were employed to assess self-reported PF and pregnancy-related symptoms, respectively. At the 16th g.w. greater self-reported overall PF was associated with lower incidence of urinary frequency (p = 0.020); greater overall PF, cardiorespiratory fitness (CRF), muscular strength and speed-agility were associated with lower incidence of tiredness-fatigue (all, p < 0.05); greater overall PF and speed-agility were associated with lower incidence of poor sleep (both, p < 0.05); greater CRF and flexibility were associated with lower limitations by tiredness-fatigue (both, p < 0.05); and greater flexibility was associated with lower limitations by poor sleep (p = 0.021). At the 34th g.w. greater self-reported overall PF, CRF and muscular strength were associated with lower incidence of tiredness-fatigue (all, p < 0.05); greater CRF was associated with lower incidence of poor sleep (p = 0.019); and, greater flexibility was associated with lower incidence of increased vaginal discharge (p = 0.023). Adequate levels of PF, especially CRF, may help women to cope with the most endorsed pregnancy-related symptoms and its limitations, especially tiredness-fatigue and poor sleep.

The associations of pregnancy-related symptoms with health-related quality of life at midpregnancy: the PregnActive project

AIM

To analyze the associations between the wide range of pregnancy-related symptoms and health-related quality of life.

MATERIAL AND METHODS

A cross-sectional study was developed among 155 healthy low-risk pregnant women, aged 18-45 years, participated in the study at midpregnancy. Health-related quality of life and pregnancy symptoms were assessed using the Medical Outcome Study 36-item short form questionnaire and the Pregnancy Symptoms Inventory, respectively. Simple correlations, hierarchical linear regressions and standard multiple regressions were performed.

RESULTS

Significant correlations, after adjusting for sociodemographic and anthropometric characteristics, were found between five pregnancy-related symptoms and physical component of health-related quality of life and between thirteen pregnancy-related symptoms and mental component. However, when all pregnancy symptoms were entered simultaneously into a multiple regression model, back pain and shortness of breath on the physical components, and feeling depressed and anxiety on the mental component were the main explanatory factors of health-related quality of life.

CONCLUSION

Among the wide range of pregnancy-related symptoms, back pain, hip or pelvic pain, shortness of breath, and feeling depressed and anxiety are the main symptoms affecting the physical and the mental components of health-related quality of life, respectively. An early detection of the pregnancy-related symptoms that may affect health-related quality of life enables early interventions aimed at ameliorating their negative impact on health-related quality of life and daily living activities at midpregnancy.

Turkish translation, cross-cultural adaptation, and psychometric validation of the pregnancy symptoms inventory: An instrument to assess the full spectrum of pregnancy symptoms

OBJECTIVE

To translate the PSI (Pregnancy Symptoms Inventory) into Turkish, to perform its cultural adaptation, to establish its reliability and validity, and to examine the prevalence of perceived pregnancy symptoms frequency and symptom-related limitation in Turkish pregnant women.

DESIGN

This cross-sectional study included healthy pregnant women over 18 years old from all 3 pregnancy trimesters. In the reliability analysis, the test-retest reliability was investigated by the Pearson correlation analysis. For the criterion validity of the PSI, correlations between the total pregnancy symptom frequency scores and the total scores of the Tilburg Pregnancy Distress Scale, the State-Trait Anxiety Inventory, the Beck Depression Inventory, and the Nottingham Health Profile were analyzed. Frequency and limitation perception prevalence of the symptoms were calculated as a percentage based on the response to each symptom. Statistical significance level was accepted as p<0.05.

MEASUREMENTS AND FINDINGS

In the present study, 210 pregnant women participated, and 42 pregnant women filled out the Turkish-PSI twice for the test-retest analysis. In the frequency and limitation sections of the PSI, the test-retest correlations for each symptom were found to vary between medium and very strong (0.42-1.00 and 0.39-1.00, p <0.05, respectively). Moderate correlations (rho = 0.39-0.58, p <0.05, p ≤ 0.001) were detected between the frequency section total score and the total scores of the other scales. The top four symptoms indicated as "often" by the Turkish pregnant women were urinary frequency (42.4%), fatigue/tiredness (28.6%), increased vaginal discharge (26.7%), and upper/lower back pain (23.8%).

KEY CONCLUSIONS

The Turkish-PSI is a comprehensive, reliable, and valid inventory for evaluating a wide range of pregnancy symptoms in Turkish pregnant women. Further studies are needed to examine the sensitivity of the Turkish-PSI to treatment-induced changes.

IMPLICATIONS FOR PRACTICE

Comprehensive and practical symptom questioning tools such as the PSI during pregnancy can lead to the early detection of pregnancy symptoms and to initiate effective non-pharmacological interventions.

The Effect of Combined Inhalation Aromatherapy with Lemon and Peppermint on Nausea and Vomiting of Pregnancy: A Double-Blind, Randomized Clinical Trial

Background:

Nausea and vomiting are almost inevitable features of pregnancy which have a serious impact on the quality of life of pregnant women. This study aimed to determine the effects of combined inhalation aromatherapy with lemon and peppermint on nausea and vomiting of pregnancy.

Materials and Methods:

The parallel randomized clinical trial was conducted on 90 pregnant women suffering from nausea and vomiting of pregnancy referred to health centers in Birjand-Iran- from February 2015 to August 2016. Participants were randomly divided into two groups. The combined lemon and peppermint essential oils were used as an inhaler for the intervention and the placebo for the control group. Both groups were trained to place three drops of the solution onto a cotton ball and keep it in a 3-cm distance of their nose. The intensity of nausea, vomiting and fatigue was assessed through 24-hour Pregnancy Unique Quantization of Emesis (PUQE-24) questionnaire and Fatigue Severity Scale (FSS), respectively.

Results:

Mean (SD) scores of nausea and vomiting intensity before the intervention and on the first day of intervention were not significantly different between the two groups, but became significant on the second, third, and fourth days of intervention. The results showed that the effect of time on the mean intensity of nausea and vomiting was significant in the aromatherapy group (F_2,84 = 22.92, p < 0.001) but was not significant in the placebo group (F_2,78 = 0.26, p = 0.836).

Conclusions:

The combined lemon and peppermint aromatherapy could reduce mild to moderate intensity of nausea and vomiting during pregnancy.

Do birthrates contribute to sickness absence differences in women? A cohort study in Catalonia, Spain, 2012-2014

Aims

This study explores the differences in sickness absence trends in women according to reproductive age group and medical diagnoses.

Methods

Data were obtained from two administrative registries: the Continuous Working Life Sample and the Catalonian Institute of Medical Evaluations from 2012 to 2014, containing 47,879 female employees. Incidence rates and incidence risk ratios derived from Poisson and negative binomial models were calculated to compare sickness absence trends among reproductive age groups based on Catalonian birthrates: early-reproductive (25–34 years old), middle-reproductive (35–44) and late-reproductive (45–54), according to diagnostic groups, selected diseases, type of contract, occupational category, and country of origin.

Results

Younger women show a higher incidence of overall sickness absence compared to late-reproductive-aged women. Incidence risk ratios of sickness absence decreased significantly from early-reproductive to late-reproductive age for low back pain, hemorrhage in early pregnancy, nausea and vomiting, and abdominal and pelvic pain.

Discussion

The higher incidence of sickness absence due to pregnancy-related health conditions in early-reproductive women compared to other reproductive age groups, may explain the sickness absence differences by age in women. Proper management of sickness absence related to pregnancy should be a goal to reduce the sickness absence gap between younger and older women.

Do the Dietary Intakes of Pregnant Women Attending Public Hospital Antenatal Clinics Align with Australian Guide to Healthy Eating Recommendations?

The maternal diet influences the long-term health status of both mother and offspring. The current study aimed to compare dietary intakes of pregnant women compared to food and nutrient recommendations in the Australian Guide to Healthy Eating (AGHE) and Nutrient Reference Values (NRVs). Usual dietary intake was assessed in a sample of women in their 3rd trimester of pregnancy attending antenatal outpatient clinics at John Hunter Hospital, Newcastle, New South Wales (NSW). Dietary intake was measured using the Australian Eating Survey, a validated, semi-quantitative 120-item food frequency questionnaire. Daily food group servings and nutrient intakes were compared to AGHE and NRV targets. Of 534 women participating, none met the AGHE recommendations for all food groups. Highest adherence was for fruit serves (38%), and lowest for breads and cereals (0.6%). Only four women met the pregnancy NRVs for folate, iron, calcium, zinc and fibre from food alone. Current dietary intakes of Australian women during pregnancy do not align with national nutrition guidelines. This highlights the importance of routine vitamin and mineral supplementation during pregnancy, as intakes from diet alone may commonly be inadequate. Future revisions of dietary guidelines and pregnancy nutrition recommendations should consider current dietary patterns. Pregnant women currently need more support to optimise food and nutrient intakes.

Examining to what extent pregnancy-related physical symptoms worry women in the first trimester of pregnancy: a cross-sectional study in general practice

BACKGROUND

Women often wish to discuss their pregnancy symptoms with their GP. However, the two parties' understanding of symptoms may not be aligned.

AIM

To examine to what degree a specific pregnancy-related symptom worried women in the first trimester and analyse the characteristics of the most worried women.

DESIGN & SETTING

A cross-sectional study was performed in general practice in Denmark from 1 March 2015-15 August 2016.

METHOD

Women attending the first prenatal care visit completed a questionnaire about pregnancy-related physical symptoms and worries. Women were recruited from 125 GP practices and 294 GPs participated in the study. Further data were obtained from their pregnancy health record. Multivariable logistic regression analysis was used to assess the associations between the women's worries and the severity of the symptoms, which were adjusted for age and parity.

RESULTS

A total of 1508 women, aged 16-45 years, were included and 1455 completed the questionnaire. Nausea, vomiting, pelvic cavity pain, and back pain were the most common symptoms, and 88% reported having two or more symptoms simultaneously. Among the 1278 women reporting nausea, only 21% were worried, while 88% of the 252 women reporting vaginal bleeding were worried. Primigravidae (those pregnant for the first time) were significantly more worried about vomiting and nausea than multigravidae (those who have experienced pregnancy previously). Those aged >35 years were more worried about pelvic girdle pain and pelvic cavity pain than younger women.

CONCLUSION

Pregnancy-related physical symptoms are frequent in the first trimester. The severity of worries depends on the symptom. Vaginal bleeding and pain give rise to the majority of severe worries, especially among young women.

Nausea and vomiting of pregnancy and hyperemesis gravidarum

Nausea and vomiting of pregnancy (NVP) is a common condition that affects as many as 70% of pregnant women. Although no consensus definition is available for hyperemesis gravidarum (HG), it is typically viewed as the severe form of NVP and has been reported to occur in 0.3-10.8% of pregnant women. HG can be associated with poor maternal, fetal and child outcomes. The majority of women with NVP can be managed with dietary and lifestyle changes, but more than one-third of patients experience clinically relevant symptoms that may require fluid and vitamin supplementation and/or antiemetic therapy such as, for example, combined doxylamine/pyridoxine, which is not teratogenic and may be effective in treating NVP. Ondansetron is commonly used to treat HG, but studies are urgently needed to determine whether it is safer and more effective than using first-line antiemetics. Thiamine (vitamin B1) should be introduced following protocols to prevent refeeding syndrome and Wernicke encephalopathy. Recent advances in the genetic study of NVP and HG suggest a placental component to the aetiology by implicating common variants in genes encoding placental proteins (namely GDF15 and IGFBP7) and hormone receptors (namely GFRAL and PGR). New studies on aetiology, diagnosis, management and treatment are under way. In the next decade, progress in these areas may improve maternal quality of life and limit the adverse outcomes associated with HG.

The Effect of Maternity Support Garments on Alleviation of Pains and Discomforts during Pregnancy: A Systematic Review

Maternity support garments (MSGs) are widely available and commonly recommended and used for alleviation of lower back pain (LBP) and pelvic girdle pain (PGP) during pregnancy; however, most studies available use the garments as a conjunct intervention with other therapies, with scarce research demonstrating the effects of the garments as a sole intervention. This study aims to review the available literature on the effects of using MSGs as sole intervention for comfort improvement of women during pregnancy, as well as to discuss the attributes of the garments which may influence their performance. A systematic review was undertaken, which adheres to PRISMA guideline for systematic reviews. Multiple databases, such as ScienceDirect, CINAHL, EBSCO, Elsevier, SCOPUS, Wiley Online Library, ProQuest, ProQuest Health and Medical Complete, PubMed, and Cochrane Central Register of Controlled Trials, were electronically searched. Six studies met the inclusion criteria and covered three trial studies, two pilot studies and one observational study. Three outcome measurements were identified from the included studies: alleviation of pain, improvement of balance, and improvement of functionality and mobility. The study concluded that wearing MSGs during pregnancy could have beneficial effects in women such as LBP and PGP alleviation, improvement of functionality and mobility, and reduction of risk of fall during pregnancy; however, the mechanisms of the garments' actions as well as the duration of the garments' effectiveness are not elucidated through the studies. This study contributes to the understanding of the effects and effectiveness of the use of MSGs as a sole intervention for improvement of comfort during pregnancy as well as information about the different types of garments commercially available and the attributes that may influence the garment performance.

Impact of a peer virtual community on pregnant women's well-being: A repeated-measure and quasi-experimental study

AIM

To investigate the effects of a virtual community on pregnant women's well-being.

BACKGROUND

The virtual social network has been growing rapidly but its effects remain unclear.

DESIGN

A repeated-measure and quasi-experimental study.

METHODS

We designed a closed Facebook community for peer-to-peer interaction with no mediator. A total of 121 pregnant women were assigned to either experimental or control group. Data were collected from May 2012-January 2015 using five instruments related to pregnant women's well-being.

RESULTS

Significant differences on pregnant women's well-being were not found between groups. However, higher adherence to the virtual community was significantly related to first-time pregnant women and women whose pregnancy was assisted by a technology treatment.

CONCLUSIONS

Nurses and midwifes are recommended to pay more attentions on first-time pregnant women and women whose pregnancy was assisted by a technology treatment regarding their pregnancy-related concerns.

TRIAL REGISTRATION NUMBER

ClinicalTrials.gov NCT03692923.

Effects of prenatal education on complaints during pregnancy and on quality of life

OBJECTIVE

The study was conducted to determine the effects of prenatal education on quality of life and complaints during pregnancy.

METHODS

This study is a quasi-experimental research with a control group. Personal Information Form and Scale of Complaints during Pregnancy and their Effects on Quality of Life (SCPEQL) were used to collect the data. Thirty participants were included in both the control and the intervention groups (N = 60).

RESULTS

The mean scores of SCPEQL of the intervention group was 46.2 ± 21.1 and the mean scores of SCPEQL of the control group was 99.8 ± 21.6 in 2nd trimester. In the 3rd trimester, the mean score of SCPEQL of the intervention group was 43.5 ± 16.4, and the mean score of SCPEQL of the control group was 108.0 ± 16.8. The difference between the groups was statistically significant in 2nd and 3rd trimesters (p < 0.05).

CONCLUSION

Findings of the study suggest that providing prenatal education reduces complaints and increases quality of life of pregnant women.

PRACTICE IMPLICATIONS

Assessing complaints during pregnancy by nurses is a part of the prenatal care. Therefore, nurses should evaluate pregnancy-related complaints. Quality of life should be increased by giving effective education about complaints during pregnancy.

Physician Parents Attending Work Despite Own Sick Children: A Qualitative Study on Caregiver Presenteeism Among Norwegian Hospital Physicians

BACKGROUND

Studies have shown that physicians manifest a clear duty to work, even in the face of personal risk, and despite their own symptoms of ill health; this is termed presenteeism. We lack knowledge on their willingness to attend work when their children are sick or in times of concern for their unborn; this is termed caregiver presenteeism. To gain a comprehensive knowledge on the occurrence of presenteeism among physicians, it is important to include caregiver presenteeism.

OBJECTIVE

The aim of this study is to explore the perception and experience with caregiver presenteeism among hospital physicians who are parents or pregnant and to explore its foundations and its consequences.

METHODS

Secondary thematic analysis of semi-structured interviews of hospital physicians (N = 18).

RESULTS

Positive and negative dimensions associated with (1) situations with severe pregnancy symptoms or responsibility for sick children; (2) the perceived impact on their work commitments, personal health, and adequate care for own children; (3) accompanying moderators in the organisational structure and professional culture; and (4) proposed approaches to resolve caregiver and work responsibilities simultaneously contributing to caregiver presenteeism.

CONCLUSIONS

The study underlines the impact of factors in organisational structure, professional culture, and the personal sphere affecting caregiver presenteeism. It appears that targeting factors contributing to attendance pressure in physicians, including those who are pregnant, is particularly important. This includes changing attitudes towards caregiver responsibilities among physician colleagues, department leaders, and physicians themselves, as well as simple cost-efficient organisational interventions in staffing, routines of absence, and work adjustment.

Explanatory factors and levels of health-related quality of life among healthy pregnant women at midpregnancy: A cross-sectional study of The PregnActive Project

AIMS

To identify potential explanatory factors and establish health-related quality of life (HRQoL) levels of healthy pregnant women at midpregnancy.

BACKGROUND

The HRQoL levels perceived by pregnant women are lower than those perceived by women of similar age and decline during the course of pregnancy.

DESIGN

An exploratory cross-sectional design was used.

METHODS

One hundred thirty-four healthy women from antenatal clinics completed questionnaires were administered a cardiorespiratory fitness (CRF) test and wore a multisensor body monitor for 7 days at midpregnancy. Data were collected from September 2015-December 2016.

RESULTS

Cardiorespiratory fitness, musculoskeletal symptoms, and age were identified as explanatory factors of the physical component summary of HRQoL. Explanatory factors of the mental component summary included musculoskeletal and psychological symptoms and light activity. Significant differences in HRQoL levels were identified among groups of pregnant women stratified by age, occupational status, pregnancy symptoms, and CRF.

CONCLUSIONS

Modifiable factors of HRQoL, such as CRF and active lifestyle may be important areas to target in interventions aimed at promoting HRQoL in healthy women at midpregnancy. The identification of the groups of pregnant women with lower levels of HRQoL may help midwives and health professional to focus their advice and conduct interventions on these groups of pregnant women. These modifiable factors should be considered in future longitudinal studies to determine causal effects, will likely help improve multidisciplinary treatments.

Factors related to vegetable intake among pregnant Japanese women: A cross-sectional study

INTRODUCTION

Vegetable intake (VI) is important for both fetal and maternal health. However, VI is insufficient among many pregnant Japanese women. This study aimed to identify the factors related to VI during pregnancy.

METHODS

A cross-sectional study was conducted in 2014, at a university hospital in Tokyo, Japan. Dietary intake was assessed using a brief-type self-administered diet history questionnaire. Demographic, physical, and psychological characteristics, dietary habits, and health-related behaviors were investigated using another questionnaire. Multiple linear regression analysis was used to identify factors related to VI.

RESULTS

Data of 273 healthy pregnant women was analyzed. The median value of energy-adjusted VI was 140.4 g/1000 kcal. Severe pregnancy-associated nausea (β = -0.148), a habit of eating out (β = -0.174), a habit of eating confectioneries (β = -0.158), and perceived barriers to obtaining vegetables (β = -0.149) were negatively associated with the energy-adjusted VI. In contrast, exercise habits (β = 0.193), knowledge of the recommended VI amounts for non-pregnant adults (β = 0.105), and the Vegetable Intake Self-Efficacy scale scores (β = 0.193) were positively associated with the energy-adjusted VI.

CONCLUSIONS

Pregnant women with severe pregnancy-associated nausea, or those who habitually eat out or eat confectioneries, may be a potential high-risk population for low VI. Enhancing knowledge and self-efficacy regarding VI would be effective in increasing VI during pregnancy.

Effect of Nausea and Vomiting on Anxiety and Depression Levels in Early Pregnancy

Objective

Nausea and vomiting of pregnancy (NVP) have been reported to be associated with distinct physiological responses to psychosocial stress. In this study, we aimed to evaluate the impact of nausea and vomiting on anxiety and depression during pregnancy.

Materials and Methods

Eighty-three pregnant women with nausea and vomiting and 83 healthy pregnant women were included. All participants completed the demography- and pregnancy-related questionnaire, including Rhodes Index of Nausea and Vomiting, Beck Anxiety Inventory (BAI), and Edinburgh Postnatal Depression Scale (EPDS).

Results

The median BAI and EPDS levels were 13 (min-max: 0-43) and 7 (min-max: 0-20) for the study group and 4 (min-max: 0-26) and 4 (min-max: 0-16) for control group, respectively. A univariate analysis revealed a statistically significant increase in terms of BAI levels (p<0.001) between the groups, but no significant difference was observed in terms of EPDS. In a logistic regression analysis, both anxiety (p=0.018) and depression (p=0.022) were found to be affected by NVP. The BAI levels of the NVP group correlated with the severity of NVP.

Conclusion

According to the results of the present study, women with severe NVP experienced a higher level of anxiety and depression, which necessitates an extra awareness from healthcare professionals in order to be able to contribute effectively.

The use of complementary and alternative medicine (CAM) for pregnancy related low back and/ or pelvic girdle pain: An online survey

Low back and pelvic girdle pain (LBPGP) is a common complaint among pregnant women, which increases throughout pregnancy and women use various complementary and alternative medicine (CAM) therapies to manage their pain. Using an online survey, CAM treatments used by pregnant women in the UK and their perceptions of these therapies to relieve LBPGP were investigated. 191 women completed the survey and 70% experienced LBPGP lasting more than one week. Over half of women who sought treatment from a GP or physiotherapist were dissatisfied. 25% of participants used CAM during pregnancy, the most popular being aromatherapy (21%), acupuncture (21%), and reflexology (15%). 81% of women used CAM to manage their LBPGP and 85% found it useful for pregnancy symptoms. Women experience high levels of pain during pregnancy with limited treatment options. Research into effective CAM treatments for LBPGP is required to allow women to make informed decisions regarding treatment options.

Exploring factors behind pregnant women's quality of life in Iran: a qualitative study

BACKGROUND AND OBJECTIVE

Pregnancy-related physiologic and psychosocial alterations can impact on the body and cause symptoms which may affect quality of life. Since qualitative studies can provide more in-depth understanding of quality of life and its determining factors, this study was conducted with the aim of exploring factors affecting pregnant women's quality of life.

METHODS

A qualitative descriptive study with conventional content analysis approach was made using the conventional content analysis approach on a purposeful sample of sixteen pregnant Iranian women in Hamadan, Iran from May 2015 to December 2015. Sampling was continued until data saturation. Data were collected through in-depth semi-structured personal interviews, and were analyzed using the conventional content analysis approach.

RESULTS

Data analysis resulted in three main categories, namely, the effects of pregnancy on different aspects of health (including psychological disorders, impaired interactions, disturbances in doing daily activities, disturbed body image, alterations in sexual relationships, physical disorders, and alterations in dietary habits and treatment regimens), pregnancy-related concerns (regarding the gender of the fetus, financial problems, childbirth, health, and the future), and coping with pregnancy (through strategies such as spirituality, positive attitude toward pregnancy, distraction and imagination, and support).

CONCLUSIONS

This study showed that different factors can affect pregnant women's quality of life. Nonetheless, prenatal care services are mainly focused on pregnancy-related physical problems, and other aspects of care are usually taken for granted. Consequently, healthcare professionals need to pay greater attention to pregnant women's quality of life and its contributing factors.

Disorders Affecting Quality of Life During Pregnancy: A Qualitative Study

INTRODUCTION

Pregnancy is a special condition which results in unique physiological responses which is more than any other physiological event and it increase stress in women's body. Information about the changes experienced by pregnant women in physical, psychological, and social areas is limited, indicating that the quality of life and changeable areas in pregnant women require more attention.

AIM

This study was aimed to identify the disorders affecting the quality of life during pregnancy.

MATERIALS AND METHODS

A qualitative study was performed with the conventional content analysis approach. Participants included 16 pregnant women who were recruited using purposive sampling and performed with maximum variety. The semi-structured in depth interview started face to face with the general question and was followed with specific questions. The interviews were conducted in Fatemieh Hospital in Hamadan, Iran. Data analysis and data collection were conducted concurrently and the interviews were continued until achieving data saturation.

RESULTS

Five main categories emerged in this study including "psychological disorders of pregnancy", "disorders of activities", "body-image disorder", "disorders in sexual intercourse" and "physical disorders" that were analyzed revolves common around of disorders affecting quality of life.

CONCLUSION

Pregnancy can have undesirable effects on various aspects of women's lives in their point of view and lead to a decreased life quality. Therefore, it is essential in prenatal care. In addition to addressing the physical aspects of maternal health, other aspects are also evaluated, and in case of any disorder, the necessary consultation should be done.

Symptom Experience in Late Pregnancy

OBJECTIVE

To evaluate the frequency, severity, distress, and correlates of common and rare symptoms reported by nulliparous women during the last month of pregnancy.

DESIGN

Secondary cross-sectional analysis of data obtained in a larger randomized clinical trial.

SETTING

San Francisco Bay area.

PARTICIPANTS

Nulliparous, ethnically diverse, predominantly low-income pregnant women 18 to 47 years of age (N = 151).

METHODS

Participants at or beyond 36 weeks gestation used the Memorial Symptom Assessment Scale (MSAS) to provide self-reports of general symptom experience. Other symptom measures were also completed for comparison. Demographic characteristics, including gestational weight gain, were also collected. Gestational weight gain was categorized in relation to the Institute of Medicine's 2009 recommendations for weight gain during pregnancy.

RESULTS

Women endorsed an average of 10.6 ± 5.6 symptoms on the MSAS. Prevalent symptoms (reported by at least half the sample) included lack of energy, pain, difficulty sleeping, worrying, irritability, drowsiness, shortness of breath, and nervousness. Among the women who reported these symptoms, relatively few described them as occurring with high frequency or severity or as causing much distress. One of the most prevalent symptoms (reported by 68% of women) was difficulty sleeping, which also had among the greatest ratings for frequency, severity, and distress. Although few maternal characteristics were associated with symptom experience, women who gained more weight than the Institute of Medicine's recommendation had worse MSAS total scores than women who gained the recommended amount or less.

CONCLUSION

In nulliparas, symptom frequency, severity, and distress varied and were related to excessive gestational weight gain.

Associations between Nausea, Vomiting, Fatigue and Health-Related Quality of Life of Women in Early Pregnancy: The Generation R Study

The objective of this study was to evaluate the independent associations between nausea, vomiting, fatigue and health-related quality of life of women in early pregnancy in the Generation R study, which is a prospective mother and child cohort. Analyses were based on 5079 women in early pregnancy in the Rotterdam area, the Netherlands. The information on nausea, vomiting and fatigue in the previous three months was measured in the questionnaire at enrollment, as well as potential confounders (i.e., maternal/gestational age, ethnic background, educational level, parity, marital status, body mass index, tobacco and alcohol use, chronic/infectious conditions, uro-genital conditions/symptoms, sleep quality, headache, anxiety, and depression). Health-related quality of life was assessed by the 12-item Short Form Health Survey and physical and mental component summary scores were calculated. Multivariate regression models were performed to evaluate the independent associations of the presence of nausea, vomiting and fatigue with health-related quality of life, adjusting for potential confounders. 33.6% of women experienced daily presence of nausea, 9.6% for vomiting and 44.4% for fatigue. Comparing with women who never reported nausea, vomiting and fatigue, women with daily presence of at least one of these symptoms had significantly lower scores of physical component summary and mental component summary, after adjusting for potential confounders. Our study shows how common nausea, vomiting and fatigue are among women in early pregnancy and how much each of these symptoms negatively impact on health-related quality of life. We call for awareness of this issue from health care professionals, pregnant women and their families.

Effects of tobacco exposure on perinatal suicidal ideation, depression, and anxiety

Background

Previous studies have stressed the importance of tobacco exposure for the mood disorders of depression and anxiety. Although a few studies have focused on perinatal women, none have specifically considered the effects of smoking and secondhand smoke exposure on perinatal suicidal ideation. Thus, this study aimed to investigate the relationships of smoking/secondhand smoke exposure status with suicidal ideation, depression, and anxiety from the first trimester to the first month post partum.

Methods

This cross-sectional study based on self-reported data was conducted at five hospitals in Taipei, Taiwan from July 2011 to June 2014. The questionnaire inquired about women’s pregnancy history, sociodemographic information, and pre-pregnancy smoking and secondhand smoke exposure status, and assessed their suicidal ideation, depression, and anxiety symptoms. Logistic regression models were used for analysis.

Results

In the 3867 women in the study, secondhand smoke exposure was positively associated with perinatal depression and suicidal ideation. Compared with women without perinatal secondhand smoke exposure, women exposed to secondhand smoke independently exhibited higher risks for suicidal ideation during the second trimester (odds ratio (OR) = 7.63; 95 % confidence interval (CI) = 3.25–17.93) and third trimester (OR = 4.03; 95 % CI = 1.76–9.23). Women exposed to secondhand smoke had an increased risk of depression, especially those aged 26–35 years (OR = 1.71; 95 % CI = 1.27–2.29).

Conclusions

Secondhand smoke exposure also considerably contributes to adverse mental health for women in perinatal periods, especially for the severe outcome of suicidal ideation. Our results strongly support the importance of propagating smoke-free environments to protect the health of perinatal women.

Electronic supplementary material

The online version of this article (doi:10.1186/s12889-016-3254-z) contains supplementary material, which is available to authorized users.

Ptyalism in pregnancy - a review of epidemiology and practices

Ptyalism gravidarum is an oral pathological condition specific to gravidity. We present a review of the literature regarding epidemiology internationally, and then highlight therapies reported by patients and caregivers. This often distressing repeated filling of the mouth with watery saliva in a pregnant patient was previously exclusively associated with hyperemesis gravidarum, and the consequent maternal-fetal risk. Our dissertation includes reference to a rare case of isolated sialorrhoea of pregnancy, without nausea or emesis. Both pharmacological and homoeopathic therapies are discussed, and inherent risks to mother and infant are highlighted. It is strongly recommended that this condition be given attention in antenatal care settings, to optimize short, middle and long term pregnancy outcomes.

Relationship between Fatigue, Sleep Disturbance, and Gestational Stress among Pregnant Women in the Late Stages

PURPOSE

The objective of this study was to investigate the relationship between fatigue, sleep disturbance, and gestational stress in women during late stage of pregnancy.

METHODS

This study was conducted with 113 healthy pregnant women at gestational age greater than 27 weeks who were registered at community health centers and received prenatal care. A structured questionnaire regarding fatigue, sleep disturbance, and gestational stress was used. The data was analyzed using a t-test, an ANOVA, and Pearson correlation coefficients.

RESULTS

The subjects with unplanned pregnancies and irregular exercise patterns showed a higher level of fatigue than those with planned pregnancies and regular exercise patterns. Pregnant women with caffeine intake manifested higher levels of gestational stress and sleep disturbance than those without. The levels of sleep disturbance and gestational stress increased as the fatigue levels increased. The fatigue levels increased with increased levels of sleep disturbance.

CONCLUSION

Planned pregnancy, regular exercise patterns, and caffeine intake were related with fatigue, sleep disturbance, and gestational stress in women during late stages of pregnancy. Fatigue, sleep disturbance, and gestational stress had close associations to each other. In the future, such results should guide development of nursing intervention programs for women in late stages of pregnancy.