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Futakawa K, Matsumura K, Tsuchida A, Konishi M, Sasaki H, Mezawa H, Yamamoto-Hanada K, Inadera H, Hasegawa T. Longitudinal study of the relationship between number of prior miscarriages or stillbirths and changes in quality of life of pregnant women: the Japan Environment and Children's Study (JECS). BMC Pregnancy Childbirth 2023; 23:297. [PMID: 37118672 PMCID: PMC10148530 DOI: 10.1186/s12884-023-05578-6] [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: 08/30/2022] [Accepted: 04/06/2023] [Indexed: 04/30/2023] Open
Abstract
BACKGROUND Although a history of miscarriage or stillbirth has been reported to negatively affect quality of life (QOL) during the subsequent pregnancy, the association between the number of previous miscarriages or stillbirths and QOL, as well as trends in QOL during pregnancy, has not been clarified. This study sought to determine this association during early and mid- to late pregnancy. METHODS Data from 82,013 pregnant women who participated in the Japan Environment and Children's Study (JECS) from January 2011 to March 2014 were analyzed. In early and mid/late pregnancy, participants completed questionnaires and QOL was assessed using the Physical and Mental Component Summary (PCS and MCS, respectively) scores from the 8-item Short-Form Health Survey (SF-8). The pregnant women were divided into four groups according to number of previous miscarriages or stillbirths (0, 1, 2, and ≥ 3), and the PCS and MCS scores in early pregnancy and mid/late pregnancy were compared between group 0 and groups 1, 2, and ≥ 3. Generalized linear mixed models were used for analysis. RESULTS PCS score in early pregnancy was lower in group 1 (β = - 0.29, 95% confidence interval [CI] - 0.42 to - 0.15), group 2 (β = - 0.45, 95% CI - 0.73 to - 0.18), and group ≥ 3 (β = - 0.87, 95% CI - 1.39 to - 0.35) than in group 0. Group 1 and group ≥ 3 showed a trend for increased PCS score during pregnancy (β = 0.22, 95% CI 0.07 to 0.37 and β = 0.75, 95% CI 0.18 to 1.33, respectively) compared with group 0. CONCLUSIONS PCS score in early pregnancy was lower with a more frequent history of miscarriage or stillbirth. However, in terms of changes in QOL during pregnancy, pregnant women with a history of miscarriage or stillbirth showed greater increases in PCS score during mid/late pregnancy than pregnant women with no history of miscarriage or stillbirth.
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Affiliation(s)
- Kaori Futakawa
- Department of Maternal Nursing, Faculty of Medicine, Academic Assembly, University of Toyama, 2630 Sugitani, Toyama-Shi, Toyama, 930-0194, Japan
| | - Kenta Matsumura
- Department of Public Health, Faculty of Medicine, University of Toyama, 2630 Sugitani, Toyama, Toyama-Shi, Toyama, 930-0194, Japan
- Toyama Regional Center for JECS, University of Toyama, 2630 Sugitani, Toyama-Shi, Toyama, 930-0194, Japan
| | - Akiko Tsuchida
- Department of Public Health, Faculty of Medicine, University of Toyama, 2630 Sugitani, Toyama, Toyama-Shi, Toyama, 930-0194, Japan
- Toyama Regional Center for JECS, University of Toyama, 2630 Sugitani, Toyama-Shi, Toyama, 930-0194, Japan
| | - Mizuho Konishi
- Department of Psychology, Tokyo Seitoku University, 1-7-13 Jujodai, Kita-Ku, Tokyo, 114-0033, Japan
- Medical Support Center for Japan Environment and Children's Study (JECS), National Center for Child Health and Development, 2-10-1 Okura, Setagaya-Ku, Tokyo, 157-8535, Japan
| | - Hatoko Sasaki
- Medical Support Center for Japan Environment and Children's Study (JECS), National Center for Child Health and Development, 2-10-1 Okura, Setagaya-Ku, Tokyo, 157-8535, Japan
- Shizuoka Graduate University of Public Health, 4-27-2, Kita-Ando, Aoi-Ku, Shizuoka-Shi, Shizuoka, 420-0881, Japan
| | - Hidetoshi Mezawa
- Medical Support Center for Japan Environment and Children's Study (JECS), National Center for Child Health and Development, 2-10-1 Okura, Setagaya-Ku, Tokyo, 157-8535, Japan
| | - Kiwako Yamamoto-Hanada
- Medical Support Center for Japan Environment and Children's Study (JECS), National Center for Child Health and Development, 2-10-1 Okura, Setagaya-Ku, Tokyo, 157-8535, Japan
| | - Hidekuni Inadera
- Department of Public Health, Faculty of Medicine, University of Toyama, 2630 Sugitani, Toyama, Toyama-Shi, Toyama, 930-0194, Japan
- Toyama Regional Center for JECS, University of Toyama, 2630 Sugitani, Toyama-Shi, Toyama, 930-0194, Japan
| | - Tomomi Hasegawa
- Department of Maternal Nursing, Faculty of Medicine, Academic Assembly, University of Toyama, 2630 Sugitani, Toyama-Shi, Toyama, 930-0194, Japan.
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Tian Q, Zhang C, Guo P, Xu M, Yu S, Liu Y, Cao M, Yu L, Yang S, Zhang W. Cognitive appraisal of health and its influencing factors among pregnant women with gestational diabetes mellitus: A cross‐sectional study. J Obstet Gynaecol Res 2023. [DOI: 10.1111/jog.15635] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2022] [Accepted: 02/28/2023] [Indexed: 04/04/2023]
Affiliation(s)
- Qi Tian
- School of Nursing Jilin University Changchun Jilin China
| | - Chunmiao Zhang
- Department of Obstetrics and Gynecology The Second Hospital of Jilin University Changchun Jilin China
| | - Pingping Guo
- School of Nursing Jilin University Changchun Jilin China
| | - Mengmeng Xu
- School of Nursing Jilin University Changchun Jilin China
| | - Shuanghan Yu
- School of Nursing Jilin University Changchun Jilin China
| | - Yantong Liu
- School of Nursing Jilin University Changchun Jilin China
| | - Minglu Cao
- School of Nursing Jilin University Changchun Jilin China
| | - Lin Yu
- School of Nursing Jilin University Changchun Jilin China
| | - Shu Yang
- School of Nursing Jilin University Changchun Jilin China
| | - Wei Zhang
- School of Nursing Jilin University Changchun Jilin China
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Lazarides C, Moog NK, Verner G, Voelkle MC, Henrich W, Heim CM, Braun T, Wadhwa PD, Buss C, Entringer S. The association between history of prenatal loss and maternal psychological state in a subsequent pregnancy: an ecological momentary assessment (EMA) study. Psychol Med 2023; 53:855-865. [PMID: 34127159 PMCID: PMC9975992 DOI: 10.1017/s0033291721002221] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2021] [Revised: 05/06/2021] [Accepted: 05/17/2021] [Indexed: 01/13/2023]
Abstract
BACKGROUND Prenatal loss which occurs in approximately 20% of pregnancies represents a well-established risk factor for anxiety and affective disorders. In the current study, we examined whether a history of prenatal loss is associated with a subsequent pregnancy with maternal psychological state using ecological momentary assessment (EMA)-based measures of pregnancy-specific distress and mood in everyday life. METHOD This study was conducted in a cohort of N = 155 healthy pregnant women, of which N = 40 had a history of prenatal loss. An EMA protocol was used in early and late pregnancy to collect repeated measures of maternal stress and mood, on average eight times per day over a consecutive 4-day period. The association between a history of prenatal loss and psychological state was estimated using linear mixed models. RESULTS Compared to women who had not experienced a prior prenatal loss, women with a history of prenatal loss reported higher levels of pregnancy-specific distress in early as well as late pregnancy and also were more nervous and tired. Furthermore, in the comparison group pregnancy-specific distress decreased and mood improved from early to late pregnancy, whereas these changes across pregnancy were not evident in women in the prenatal loss group. CONCLUSION Our findings suggest that prenatal loss in a prior pregnancy is associated with a subsequent pregnancy with significantly higher stress and impaired mood levels in everyday life across gestation. These findings have important implications for designing EMA-based ambulatory, personalized interventions to reduce stress during pregnancy in this high-risk group.
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Affiliation(s)
- Claudia Lazarides
- Institute of Medical Psychology, Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin, Germany
| | - Nora K. Moog
- Institute of Medical Psychology, Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin, Germany
| | - Glenn Verner
- Institute of Medical Psychology, Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin, Germany
| | - Manuel C. Voelkle
- Faculty of Life Science, Department of Psychology, Psychological Research Methods, Humboldt-University of Berlin, Berlin, Germany
| | - Wolfgang Henrich
- Department of Obstetrics, Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin, Germany
| | - Christine M. Heim
- Institute of Medical Psychology, Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin, Germany
| | - Thorsten Braun
- Department of Obstetrics, Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin, Germany
| | - Pathik D. Wadhwa
- Development, Health and Disease Research Program, University of California, Irvine, CA, USA
| | - Claudia Buss
- Institute of Medical Psychology, Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin, Germany
- Development, Health and Disease Research Program, University of California, Irvine, CA, USA
- Department of Pediatrics, University of California, Irvine, CA, USA
| | - Sonja Entringer
- Institute of Medical Psychology, Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin, Germany
- Development, Health and Disease Research Program, University of California, Irvine, CA, USA
- Department of Pediatrics, University of California, Irvine, CA, USA
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Iwanowicz-Palus G, Mróz M, Bień A, Jurek K. Social support and subjective assessment of psychophysical condition, health, and satisfaction with quality of life among women after pregnancy loss. BMC Pregnancy Childbirth 2021; 21:750. [PMID: 34740319 PMCID: PMC8569949 DOI: 10.1186/s12884-021-04093-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2020] [Accepted: 08/19/2021] [Indexed: 12/03/2022] Open
Abstract
Background The task of modern medicine is not just to heal, but also to improve the patient’s well-being and achieve non-medical goals in the therapy process that enable effective physical, mental and social functioning of the patient. Social support in difficult situations mobilizes an individual’s strength and resources to cope with problems. Research on social support and women’s condition after pregnancy loss reflects a holistic approach to the patient and is important from the perspective of increasing the level of hospital care. Objective The aim of our study was to assess the impact of social support on the psychophysical condition, health, and satisfaction with quality of life among women after miscarriage and ectopic pregnancy. Methods The cross-sectional study was carried out in a group of 500 patients after miscarriage and 110 with ectopic pregnancy, hospitalized in hospitals in Lublin (Poland). The study was conducted with the use of a diagnostic survey, comprising the Berlin Social Support Scales (BSSS) and an original survey questionnaire (psychophysical condition, satisfaction with health and quality of life on a scale of 1–4, sources of support on a scale of 1–10, with 1 being the poorest rating). Results Respondents after miscarriage and those after ectopic pregnancy assigned the highest scores to the degree of perceived available instrumental support (respectively, miscarriage: M = 3.79, EP: M = 3.77). Women after pregnancy loss assigned the highest score to the support obtained from their partner (respectively, miscarriage: M = 9.26, EP: M = 9.23). Social support was significantly correlated with the condition of patients hospitalized as a result of pregnancy loss (p < 0.05). The assessment of psychophysical condition, health, and QoL of the respondents is determined by their education, financial standing, and obstetric history (p < 0.05). Conclusions Women hospitalized due to miscarriage and ectopic pregnancy assigned high scores to the level of perceived available instrumental, emotional, and actually received social support. There is a positive relationship between social support and subjective opinion about psychophysical condition, health and satisfaction with quality of life among women after pregnancy loss. The assessment is determined by sociodemographic factors and the respondents’ obstetric history. Supplementary Information The online version contains supplementary material available at 10.1186/s12884-021-04093-w.
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Affiliation(s)
- Grażyna Iwanowicz-Palus
- Chair and Department of Development in Midwifery, Faculty of Health Sciences, Medical University of Lublin, 4-6 Staszica St., 20-081, Lublin, Poland
| | - Mariola Mróz
- Obstetrics and Gynecology Department and Clinic, Cardinal S. Wyszyński Regional Specialist Hospital in Lublin, Lublin, Poland.
| | - Agnieszka Bień
- Chair and Department of Development in Midwifery, Faculty of Health Sciences, Medical University of Lublin, 4-6 Staszica St., 20-081, Lublin, Poland
| | - Krzysztof Jurek
- Institute of Sociological Sciences, Faculty of Social Sciences, The John Paul II Catholic University of Lublin, Lublin, Poland
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Iwanowicz-Palus G, Mróz M, Bień A. Quality of life, social support and self-efficacy in women after a miscarriage. Health Qual Life Outcomes 2021; 19:16. [PMID: 33413432 PMCID: PMC7791812 DOI: 10.1186/s12955-020-01662-z] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2020] [Accepted: 12/23/2020] [Indexed: 02/25/2023] Open
Abstract
Background Pregnancy loss is typically experienced as a traumatic, critical event, which may lead to secondary psychological health disorders. Its burden involves both the experience of loss and related medical issues, which are associated with pain, hospitalization, limitation in one’s social roles, decreased sense of security, and changes in one’s perceived quality of life. The purpose of the present study was to evaluate levels of quality of life (QoL), social support and self-efficacy among women who had suffered a miscarriage. Methods The study was performed using a diagnostic survey method with questionnaires administered to 610 patients hospitalized due to spontaneous pregnancy loss in hospitals in Lublin (Poland). The instruments used were: the Berlin Social Support Scales (BSSS), the Generalized Self-Efficacy Scale (GSES), the WHOQoL–BREF questionnaire, and a standardized interview questionnaire. Results Respondents rated their overall quality of life (3.90 points) higher than their overall perceived health (3.66). In terms of social support, the highest scores were noted for perceived available instrumental support (M = 3.78), perceived available emotional support (M = 3.68) and actually received support (M = 3.60). The mean generalized self-efficacy score among the women after pregnancy loss was 30.29. Respondents’ QoL was significantly correlated with multiple social support subscales and self-efficacy (p < 0.05). Conclusions Women after a miscarriage perceive their overall quality of life as better than their overall health, while reporting the poorest QoL in the psychological domain. They also have a high level of self-efficacy. Regarding the types of social support, perceived available support, both instrumental and emotional, and actually received support was rated highly. Social support and self-efficacy contributed to better perceived QoL among the respondents.
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Affiliation(s)
- Grażyna Iwanowicz-Palus
- Chair and Department of Development in Midwifery, Faculty of Health Sciences, Medical University of Lublin, Lublin, Poland
| | - Mariola Mróz
- Obstetrics and Gynecology Department and Clinic, Cardinal S. Wyszyński Regional Specialist Hospital, Lublin, Poland.
| | - Agnieszka Bień
- Chair and Department of Development in Midwifery, Faculty of Health Sciences, Medical University of Lublin, Lublin, Poland
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Li G, Jiang Z, Han X, Shang X, Tian W, Kang X, Fang M. A moderated mediation model of perceived stress, negative emotions and mindfulness on fertility quality of life in women with recurrent pregnancy loss. Qual Life Res 2020; 29:1775-1787. [PMID: 32112277 DOI: 10.1007/s11136-020-02460-2] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/19/2020] [Indexed: 12/16/2022]
Abstract
PURPOSE This study aimed to investigate the level of fertility related quality of life (FertiQoL) in women with recurrent pregnancy loss (RPL), and to further examine moderated mediation effects of dispositional mindfulness and negative emotions on the relationship between perceived stress and FertiQoL. METHODS A cross-sectional study was conducted with 262 participants recruited from the infertility outpatient clinics. A self-administered, structured questionnaire including the Simplified Chinese version of FertiQoL tool, the Perceived Stress Scale-10 (PSS-10), the Chinese Version of the Hospital Anxiety and Depression Scale (HADS), and the Mindfulness Attention Awareness Scale (MAAS) was used to collect information in this research. The mediation model and moderated mediation model were conducted using the PROCESS macro for SPSS. RESULTS The mean score of Core FertiQoL was 64.59 (SD = 14.76) among women with RPL. Mediation analysis revealed that the association between perceived stress and FertiQoL was partially mediated by negative emotions (indirect effect = - 0.194 for anxiety, and - 0.151 for depression, all P < 0.001). Moderated mediation analysis indicated that the indirect effects of perceived stress on FertiQoL through negative emotions were significantly moderated by dispositional mindfulness. Specifically, the indirect effects of perceived stress on FertiQoL through negative emotions decreased were significant as dispositional mindfulness levels increased. CONCLUSION Overall, women with RPL experienced poor FertiQoL. The Moderated mediation model provides a better understanding of how perceived stress, negative emotions and dispositional mindfulness work together to affect FertiQoL. Interventions aiming to improve FertiQoL in women with RPL should consider targeting these aspects.
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Affiliation(s)
- Guopeng Li
- Center for Reproductive Medicine, Shandong University, Jingliu Road, Shizhong District, Jinan, 250000, Shandong, People's Republic of China
| | - Zhenhua Jiang
- Center for Reproductive Medicine, Shandong University, Jingliu Road, Shizhong District, Jinan, 250000, Shandong, People's Republic of China
| | - Xue Han
- Center for Reproductive Medicine, Shandong University, Jingliu Road, Shizhong District, Jinan, 250000, Shandong, People's Republic of China
| | - Xue Shang
- Center for Reproductive Medicine, Shandong University, Jingliu Road, Shizhong District, Jinan, 250000, Shandong, People's Republic of China
| | - Wanli Tian
- Center for Reproductive Medicine, Shandong University, Jingliu Road, Shizhong District, Jinan, 250000, Shandong, People's Republic of China
| | - Xiaofei Kang
- Center for Reproductive Medicine, Shandong University, Jingliu Road, Shizhong District, Jinan, 250000, Shandong, People's Republic of China
| | - Mei Fang
- Center for Reproductive Medicine, Shandong University, Jingliu Road, Shizhong District, Jinan, 250000, Shandong, People's Republic of China. .,Center for Reproductive Medicine, Shandong Provincial Hospital Affiliated to Shandong University, Jingliu Road, Shizhong District, Jinan, 250000, Shandong, People's Republic of China.
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The relationships between timing of first childbirth, parity, and health-related quality of life. Qual Life Res 2017; 27:937-943. [PMID: 29280040 DOI: 10.1007/s11136-017-1770-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/12/2017] [Indexed: 12/13/2022]
Abstract
PURPOSE A few studies have investigated the relationship between age at first childbirth and health-related quality of life (HRQoL). This study examined the relationship between age at first childbirth and HRQoL and whether parity mediates this timing of the first childbirth-HRQoL relationship in women aged 50 years or above. METHODS The study population included 5146 parous women ≥ 50 years in the cross-sectional survey, the Korea National Health and Nutrition Examination Survey 2010-2012. HRQoL was evaluated by the EuroQol five-dimensional descriptive system. Participants were grouped according to quartiles of age at first childbirth (ranges: 13-21, 22-23, 24-25, and 26-44 years). This study used linear regression analysis to examine the relationship between age at first childbirth and HRQoL and on each dimension. Mediation analysis was used to examine the contribution of age at first childbirth to HRQoL and to each dimension. RESULTS This study found the increasing pattern of HRQoL across quartiles of age at first childbirth (P for trend = 0.030). Odds of problems in self-care and anxiety/depression dimensions significantly increased across the quartiles. Women with later age at first childbirth tended to have better HRQoL (B = 0.352, P = 0.003); parity significantly contributed to this relationship. Decreasing parity accounted for 33.5% of the relationship between late first childbirth and increased HRQoL. Early age at first childbirth significantly increased odds of the mobility problem through increasing parity. CONCLUSIONS Women of an early age at first childbirth tended to have lower HRQoL through giving more deliveries. Our findings suggest that more attention needs to be given to women with early pregnancy and more delivery to prevent impaired HRQoL.
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