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Yazdanpanahi Z, Hajifoghaha M, Hesamabadi AK, Jafari SZ. Comparison of depression, anxiety, perceived stress, and resilience in parents faced with abortion in Iran: a longitudinal study. BMC Psychol 2024; 12:575. [PMID: 39425160 DOI: 10.1186/s40359-024-02078-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2024] [Accepted: 10/11/2024] [Indexed: 10/21/2024] Open
Abstract
BACKGROUND Abortion could impact the mental well-being of parents. Resilience also has a significant effect on the mental health of the family as a factor in coping with abortion. This study aimed to compare depression, anxiety, perceived stress, and resilience in parents after abortion. METHODS The present longitudinal study was performed on 200 hospitalized women and their spouses in the post-partum department of Shiraz hospitals in 2023. The instruments used in this study included questionnaires of fertility and demographic characteristics, hospital depression and anxiety (HADS), Connor's resilience, and Cohen's perceived stress. Data analysis was performed using SPSS 25. RESULTS The mean age of the fathers was 35.37 ± 4.99 and that of mothers was 31.35 ± 6.23. The scores of parents' anxiety, depression, and perceived stress in the first 24 h after facing abortion were in the highest possible state and decreased in 12 weeks, and their resilience also increased. In all three time periods, the mean scores of the fathers' anxiety, depression, and perceived stress were lower than those of the mothers, but the mean score of resilience was always higher in fathers. Fathers´ age and mothers' age, mothers' age at the time of marriage, fathers' job, number of children, gender of the last child (boy or girl), and unwanted pregnancy were among the predicting variables of anxiety, depression, perceived stress, and resilience of both parents faced with abortion. CONCLUSION Although mental disorders in fathers were fewer than mothers compared to post-abortion resilience, identifying and managing these issues promptly is crucial for enhancing post-abortion mental well-being in both parents. How parents navigate the challenges of pregnancy, childbirth, and abortion can significantly impact the couple's health.
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Affiliation(s)
- Zahra Yazdanpanahi
- Maternal-Fetal Medicine Research Center, Department of Midwifery, School of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mahboubeh Hajifoghaha
- Assistant Professor of Reproductive Health, Shiraz University of Medical Sciences, Shiraz, Iran
| | | | - Seyede Zahra Jafari
- Department of Midwifery, Student Research Center, School of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz, Iran.
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Hsu HW, Huang JP, Au HK, Lin CL, Chen YY, Chien LC, Chao HJ, Lo YC, Lin WY, Chen YH. Impact of miscarriage and termination of pregnancy on subsequent pregnancies: A longitudinal study of maternal and paternal depression, anxiety and eudaimonia. J Affect Disord 2024; 354:544-552. [PMID: 38479500 DOI: 10.1016/j.jad.2024.03.054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2023] [Revised: 02/27/2024] [Accepted: 03/09/2024] [Indexed: 03/26/2024]
Abstract
BACKGROUND Although miscarriage and termination of pregnancy affect maternal mental illnesses on subsequent pregnancies, their effects on the positive mental health (e.g., eudaimonia) of both first-time and multi-time parents have received minimal attention, especially for fathers. This longitudinal study examines the effects of experiences of miscarriage and termination on parental well-being in subsequent pregnancies from prenatal to postpartum years, while simultaneously considering parity. METHODS Pregnant women and their partners were recruited during early prenatal visits in Taiwan from 2011 to 2022 and were followed up from mid-pregnancy to 1 year postpartum. Six waves of self-reported assessments were employed. RESULTS Of 1813 women, 11.3 % and 14.7 % had experiences of miscarriage and termination, respectively. Compared with the group without experiences of miscarriage or termination, experiences of miscarriage were associated with increased risks of paternal depression (adjusted odds ratio = 1.6, 95 % confidence interval [CI] = 1.13-2.27), higher levels of anxiety (adjusted β = 1.83, 95 % CI = 0.21-3.46), and lower eudaimonia scores (adjusted β = -1.09, 95 % CI = -1.99 to -0.19) from the prenatal to postpartum years, particularly among multiparous individuals. Additionally, experiences of termination were associated with increased risks of depression in their partner. LIMITATIONS The experiences of miscarriage and TOP were self-reported and limited in acquiring more detailed information through questioning. CONCLUSIONS These findings highlight the decreased well-being of men whose partners have undergone termination of pregnancy or experienced miscarriage, and stress the importance of interventions aimed at preventing adverse consequences among these individuals.
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Affiliation(s)
- Hsueh-Wen Hsu
- Master Program in Applied Epidemiology, College of Public Health, Taipei Medical University, Taipei, Taiwan
| | - Jian-Pei Huang
- Department of Obstetrics and Gynecology, Mackay Memorial Hospital, Taipei, Taiwan
| | - Heng-Kien Au
- Department of Obstetrics and Gynecology, Taipei Medical University Hospital, Taipei, Taiwan; Department of Obstetrics and Gynecology, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Chen-Li Lin
- Department of Obstetrics & Gynecology, Taipei City Hospital, Heping Fuyou Branch, Taipei, Taiwan
| | - Yi-Yung Chen
- Department of Obstetrics and Gynecology, Mackay Memorial Hospital, Taipei, Taiwan
| | - Ling-Chu Chien
- School of Public Health, College of Public Health, Taipei Medical University, New Taipei City, Taiwan; Neuroscience Research Center, Taipei Medical University, Taipei, Taiwan
| | - Hsing Jasmine Chao
- School of Public Health, College of Public Health, Taipei Medical University, New Taipei City, Taiwan; Neuroscience Research Center, Taipei Medical University, Taipei, Taiwan
| | - Yu-Chun Lo
- Neuroscience Research Center, Taipei Medical University, Taipei, Taiwan; Ph.D Program in Medical Neuroscience, College of Medical Science and Techonology, Taipei Medical University, New Taipei City, Taiwan
| | - Wen-Yi Lin
- Ph.D. Program in Medical Neuroscience, College of Medical Science and Technology, Taipei Medical University and National Health Research Institutes, New Taipei City, Taiwan
| | - Yi-Hua Chen
- School of Public Health, College of Public Health, Taipei Medical University, New Taipei City, Taiwan; Neuroscience Research Center, Taipei Medical University, Taipei, Taiwan; Research Center of Health Equity, College of Public Health, Taipei Medical University, New Taipei City, Taiwan.
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Beringer S, Milewski N. A crisis in the life course? Pregnancy loss impacts fertility desires and intentions. ADVANCES IN LIFE COURSE RESEARCH 2024; 60:100612. [PMID: 38762969 DOI: 10.1016/j.alcr.2024.100612] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Revised: 03/21/2024] [Accepted: 03/22/2024] [Indexed: 05/21/2024]
Abstract
BACKGROUND An unintended spontaneous termination of a pregnancy can be a traumatic experience affecting the subsequent life course, but has received little attention in socio-demographic studies on fertility intentions or behavior. The theoretical background of our study draws on considerations from life course research, the Theory of Planned Behavior and the Traits-Desires-Intentions-Behavior framework. OBJECTIVE This study investigates whether the experience of pregnancy loss changes the fertility desires and intentions of women in their subsequent life course. METHODS We use 11 waves of the Panel Analysis of Intimate Relationships and Family Dynamics (pairfam) with 5197 women in total, of which 281 women (5.4%) reported a miscarriage. Data have been collected annually in Germany since 2008. We investigate four dependent variables capturing different indicators of the ideational dimension of fertility: Personal ideal number of children, realistic number of (additional) children, intention to have a(nother) child in the next two years and importance of having a(nother) child. We study the intrapersonal changes in these items among women after a pregnancy loss, applying linear fixed effect regression models. Controls include parity, age, partnership status, pregnancy status and the interaction of pregnancy loss with whether the woman already had children before the pregnancy loss. RESULTS We found that the importance of having a(nother) child and the intention to have a(nother) child in the next two years increase after a pregnancy loss. These patterns can only partially be explained by control variables. By contrast, an effect on the ideal number of children as well as the realistic number of children could not be found. The patterns varied, however, across age and stage in the life course, most importantly between mothers and childless women. CONCLUSIONS Our results demonstrate that the effect of pregnancy loss on the subsequent life course varies across the indicators used and by duration after the pregnancy loss. Overall, they suggest that specifically the younger women in our sample might perceive pregnancy loss as a temporary crisis in their transition to motherhood, or to having another child, and as an impetus to reinforce their fertility goals, while for older respondents this might mark the end of their fertility career. Against the backdrop of rising ages at childbirth, future research on fertility and reproductive health care should pay more attention to reproductive complications and how affected women can be supported in coping with them.
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Affiliation(s)
- Samira Beringer
- Federal Institute for Population Research (BiB), Wiesbaden, Germany.
| | - Nadja Milewski
- Federal Institute for Population Research (BiB), Wiesbaden, Germany
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Littell JH, Young S, Pigott TD, Biggs MA, Munk‐Olsen T, Steinberg JR. PROTOCOL: Abortion and mental health outcomes: A systematic review and meta-analysis. CAMPBELL SYSTEMATIC REVIEWS 2024; 20:e1410. [PMID: 38779333 PMCID: PMC11109527 DOI: 10.1002/cl2.1410] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Revised: 04/17/2024] [Accepted: 04/23/2024] [Indexed: 05/25/2024]
Abstract
This is a protocol for a systematic review and meta-analysis of research on mental health outcomes of abortion. Does abortion increase the risk of adverse mental health outcomes? That is the central question for this review. Our review aims to inform policy and practice by locating, critically appraising, and synthesizing empirical evidence on associations between abortion and subsequent mental health outcomes. Given the controversies surrounding this topic and the complex social, political, legal, and ideological contexts in which research and reviews on abortion are conducted, it is especially important to conduct this systematic review and meta-analysis with comprehensive, rigorous, unbiased, and transparent methods. We will include a variety of study designs to enhance understanding of studies' methodological strengths and weaknesses and to identify potential explanations for conflicting results. We will follow open science principles, providing access to our methods, measures, and results, and making data available for re-analysis.
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Affiliation(s)
- Julia H. Littell
- Graduate School of Social Work and Social ResearchBryn Mawr CollegeBryn MawrPennsylvaniaUSA
| | - Sarah Young
- Hunt LibraryCarnegie Mellon UniversityPittsburghPennsylvaniaUSA
| | - Therese D. Pigott
- College of Education and Human DevelopmentGeorgia State UniversityAtlantaGeorgiaUSA
| | - M. Antonia Biggs
- Advancing New Standards in Reproductive Health, Department of Obstetrics, Gynecology & Reproductive Sciences, School of MedicineUniversity of California San FranciscoOaklandCaliforniaUSA
| | - Trine Munk‐Olsen
- Department of PsychiatryUniversity of Southern DenmarkOdenseDenmark
| | - Julia R. Steinberg
- Department of Family Science, School of Public HealthUniversity of MarylandCollege ParkMarylandUSA
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Xu S, Zhao W, Zhang Y, Qiang C, Zhang C. The effect of previous induced abortion history on the assisted reproduction outcomes. Arch Gynecol Obstet 2024; 309:469-474. [PMID: 36708427 DOI: 10.1007/s00404-023-06928-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Accepted: 01/10/2023] [Indexed: 01/29/2023]
Abstract
PURPOSE To study whether the history of induced abortion has an effect on the assisted reproduction outcomes in patients undergoing in vitro fertilization-embryo transfer (IVF-ET). METHODS 3045 patients who underwent IVF-ET in the Department of Human Reproductive Center of Renmin Hospital from January 2017 to June 2021. They were divided into two groups according to whether there was a history of induced abortion in the past, and the outcomes were compared between the two groups. RESULTS The clinical pregnancy rate in the group with induced abortion history was lower than that in the group without induced abortion history (63.1% vs 67.1%), but the difference was not statistically significant (P = 0.059). The spontaneous abortion rate in the group with induced abortion history was higher than that in the group without induced abortion history (14.9% vs 11.2%) (P = 0.044). The live birth rate in the group with induced abortion history was lower than that in the group without induced abortion history (52.8% vs 59.0%) (P = 0.006). Stepwise logistic regression analysis showed that endometrial thickness (OR = 0.928, 95% CI = 0.886 ~ 0.972, P = 0.002) and live birth rate (OR = 0.682, 95% CI = 0.495 ~ 0.939, P = 0.019) were negatively correlated with induced abortion history. The rate of spontaneous abortion (OR = 1.452, 95% CI = 1.042 ~ 2.024, P = 0.028) was positively correlated with the history of induced abortion. CONCLUSIONS The previous history of induced abortion is related to the outcomes of IVF /ICSI-ET, the endometrial thickness on HCG trigger day decreased, the risk of spontaneous abortion increased and the live birth rate decreased in patients with induced abortion history when undergoing IVF/ICSI-ET.
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Affiliation(s)
- Shaoyuan Xu
- Department of Human Reproductive Center, Renmin Hospital, Hubei University of Medicine, Shiyan, Hubei, China
- Hubei Clinical Research Center for Reproductive Medicine, Shiyan, Hubei, China
| | - Wenxian Zhao
- Department of Human Reproductive Center, Renmin Hospital, Hubei University of Medicine, Shiyan, Hubei, China
- Hubei Clinical Research Center for Reproductive Medicine, Shiyan, Hubei, China
| | - Ying Zhang
- Department of Human Reproductive Center, Renmin Hospital, Hubei University of Medicine, Shiyan, Hubei, China
- Hubei Clinical Research Center for Reproductive Medicine, Shiyan, Hubei, China
| | - Cancan Qiang
- Department of Cardiology, Renmin Hospital, Hubei University of Medicine, Shiyan, China.
| | - Changjun Zhang
- Department of Human Reproductive Center, Renmin Hospital, Hubei University of Medicine, Shiyan, Hubei, China
- Hubei Clinical Research Center for Reproductive Medicine, Shiyan, Hubei, China
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Barbe C, Boiteux-Chabrier M, Charillon E, Bouazzi L, Maheas C, Merabet F, Graesslin O, Auer J, Hammami S, Rolland AC, Hurtaud A. Utility of early, short psychological care for women who experience early miscarriage: protocol for the randomized, controlled MisTher trial. BMC Psychol 2023; 11:368. [PMID: 37924101 PMCID: PMC10625184 DOI: 10.1186/s40359-023-01421-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Accepted: 10/31/2023] [Indexed: 11/06/2023] Open
Abstract
BACKGROUND Around one in ten women will have a miscarriage in their lifetime. Miscarriage is often considered a trivial event by caregivers, but it is associated with a high burden of psychological morbidity, especially during the first 6 months. There is no validated psychological management strategy for women who have had a miscarriage. The MisTher study aims to evaluate the utility of early, short psychological care for women who have had early miscarriage, in terms of anxiety, depression and post-traumatic stress disorder. METHODS This is a prospective, multicenter, randomized, controlled, superiority study. In total, 932 women who have experienced early miscarriage (spontaneous interruption of pregnancy prior to 14 weeks of gestation) will be randomly assigned to either the intervention or the control group. The intervention consists of 4 teleconsultations of 45 min with a psychologist. All women, regardless of their allocated group, will be encouraged to seek an early consultation with a general practitioner or midwife. The primary endpoint will be anxiety at 3 months after randomization evaluated using State Trait Anxiety Inventory. The secondary endpoints will be anxiety at 6 months evaluated using State Trait Anxiety Inventory, depression at 3 and 6 months evaluated with the Beck Depression Inventory, and post-traumatic stress disorder at 3 and 6 months, evaluated using the Posttraumatic stress disorder Checklist Scale. DISCUSSION This project will validate the importance of early psychological management, based on primary care and accessible to most women, via teleconsultation, in reducing the frequency of psychological disorders after early miscarriage. Our results should provide a basis for new recommendations for the management of women who have experienced miscarriage, notably by recommending the involvement of trained psychologists in the management pathway for these women. TRIAL REGISTRATION The trial is registered with ClinicalTrials.gov: NCT05653414. December 15th, 2022.
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Affiliation(s)
- Coralie Barbe
- Comité Universitaire de Ressources pour la Recherche en Santé, Université de Reims Champagne-Ardenne, UFR Médecine, 51 rue Cognacq Jay, 51100, Reims, France.
- Laboratoire C2S (Cognition, Santé, Société), EA6291, Université de Reims Champagne Ardenne, 51100, Reims, EA, France.
| | - Marie Boiteux-Chabrier
- Département de Médecine Générale, Université de Reims Champagne-Ardenne, UFR Médecine, 51 rue Cognacq Jay, 51100, Reims, France
| | - Emilie Charillon
- Comité Universitaire de Ressources pour la Recherche en Santé, Université de Reims Champagne-Ardenne, UFR Médecine, 51 rue Cognacq Jay, 51100, Reims, France
| | - Leïla Bouazzi
- Comité Universitaire de Ressources pour la Recherche en Santé, Université de Reims Champagne-Ardenne, UFR Médecine, 51 rue Cognacq Jay, 51100, Reims, France
| | - Chloe Maheas
- Comité Universitaire de Ressources pour la Recherche en Santé, Université de Reims Champagne-Ardenne, UFR Médecine, 51 rue Cognacq Jay, 51100, Reims, France
| | | | - Olivier Graesslin
- Service de Gynécologie et d'Obstétrique, Centre Hospitalier Universitaire de Reims, Avenue du Général Koenig, 51100, Reims, France
| | - Julie Auer
- Service de Psychothérapie de l'enfant et de l'adolescent, Pôle Femme-Parents-Enfant, Centre Hospitalier Universitaire de Reims, Avenue du Général Koenig, 51100, Reims, France
| | - Sabrina Hammami
- Laboratoire C2S (Cognition, Santé, Société), EA6291, Université de Reims Champagne Ardenne, 51100, Reims, EA, France
- Service de Psychothérapie de l'enfant et de l'adolescent, Pôle Femme-Parents-Enfant, Centre Hospitalier Universitaire de Reims, Avenue du Général Koenig, 51100, Reims, France
| | - Anne-Catherine Rolland
- Laboratoire C2S (Cognition, Santé, Société), EA6291, Université de Reims Champagne Ardenne, 51100, Reims, EA, France
- Service de Psychothérapie de l'enfant et de l'adolescent, Pôle Femme-Parents-Enfant, Centre Hospitalier Universitaire de Reims, Avenue du Général Koenig, 51100, Reims, France
| | - Aline Hurtaud
- Département de Médecine Générale, Université de Reims Champagne-Ardenne, UFR Médecine, 51 rue Cognacq Jay, 51100, Reims, France
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Doyle C, Che M, Lu Z, Roesler M, Larsen K, Williams LA. Women's desires for mental health support following a pregnancy loss, termination of pregnancy for medical reasons, or abortion: A report from the STRONG Women Study. Gen Hosp Psychiatry 2023; 84:149-157. [PMID: 37490825 DOI: 10.1016/j.genhosppsych.2023.07.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Revised: 07/14/2023] [Accepted: 07/18/2023] [Indexed: 07/27/2023]
Abstract
OBJECTIVE We report on women's mental health care desires following a miscarriage, medical termination, or abortion. METHOD 689 women completed a questionnaire on reproductive history, health care following miscarriage/medical termination/abortion, and current mental health. Descriptive statistics and logistic regression analyses examined: miscarriage/termination/abortion incidence, desires for mental health support following miscarriages/terminations/abortions, and current mental health. RESULTS Of 365 women with a pregnancy history, 37% reported ≥1 miscarriage, 9% ≥1 medical termination, 16% ≥1 abortion, and 3% endorsed all three. Current mental health did not differ between women with a history of miscarriage/termination/abortion and those with only live births (p = 0.82). Following miscarriage, 68% of women discussed options for the medical management of pregnancy loss with their provider, 32% discussed grief/loss, and 25% received mental health care recommendations. Engagement in mental health services was reported by 16% of women with a history of miscarriage, 38% after medical termination, and 19% following an abortion. Of women who became pregnant after their most recent miscarriage/termination/abortion and did not receive mental health care, 55% wished they had received services during the subsequent pregnancy. CONCLUSIONS Women desire mental health care after miscarriages, medical terminations, or abortions, warranting improved access to mental health care for these individuals.
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Affiliation(s)
- Colleen Doyle
- Women's Wellbeing Program, Department of Psychiatry and Behavioral Sciences, University of Minnesota Medical School, Minneapolis, MN, USA
| | - Mambo Che
- University of Minnesota Medical School, Minneapolis, MN, USA
| | - Zhanni Lu
- Division of Epidemiology & Clinical Research, Department of Pediatrics, University of Minnesota, Minneapolis, MN, USA
| | - Michelle Roesler
- Division of Epidemiology & Clinical Research, Department of Pediatrics, University of Minnesota, Minneapolis, MN, USA
| | - Karin Larsen
- Department of Obstetrics, Gynecology, and Women's Health, University of Minnesota Medical School, Minneapolis, MN, USA
| | - Lindsay A Williams
- Division of Epidemiology & Clinical Research, Department of Pediatrics, University of Minnesota, Minneapolis, MN, USA; Masonic Cancer Center, University of Minnesota, Minneapolis, MN, USA.
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Mendes DCG, Fonseca A, Cameirão MS. The psychological impact of Early Pregnancy Loss in Portugal: incidence and the effect on psychological morbidity. Front Public Health 2023; 11:1188060. [PMID: 37427267 PMCID: PMC10325666 DOI: 10.3389/fpubh.2023.1188060] [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: 03/16/2023] [Accepted: 06/06/2023] [Indexed: 07/11/2023] Open
Abstract
Introduction Worldwide, up to a quarter of all recognized pregnancies result in Early Pregnancy Loss (EPL), also known as miscarriage. For many women, this is a traumatic experience that leads to persistent negative mental health responses. The most common morbidity reported in studies from different countries is complicated grief, usually comorbid with depression, anxiety, and Post-Traumatic Stress Disorder (PTSD). To our best knowledge, no studies characterizing the psychological impact of EPL have been made in Portugal. Methods An online survey was conducted to evaluate clinical symptoms of perinatal grief, anxiety, depression, and PTSD in women who suffered a spontaneous loss within 20 weeks of gestation. Out of 1,015 women who answered this survey, 873 were considered eligible, and subsequently distributed in 7 groups according to the time passed between their loss and their participation in the study. Results The proportion of women showing symptoms of all comorbidities was greater in those whose loss had happened within a month, and there was a significant gradual decrease over time in scores and proportions of clinical perinatal grief and PTSD. In terms of depression symptoms, scores dropped significantly in the group whose loss occurred 13-24 months before their participation but proportions oscillated without great changes in the other groups. Regarding anxiety, there were small oscillations, but there was no significant decrease of symptoms over time. Discussion Overall, despite a general drop in scores for most morbidities over time, substantial proportions of women showed persistent symptoms of clinical morbidities 3 years or more after the loss. Therefore, it is essential to promote monitoring of possible complicated responses to the event, to provide appropriate and timely intervention to those women in need.
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Affiliation(s)
- Diana C. Gonçalves Mendes
- Faculdade de Ciências Exatas e da Engenharia & NOVA LINCS, Universidade da Madeira, Funchal, Portugal
- Agência Regional para o Desenvolvimento de Investigação, Tecnologia e Inovação (ARDITI), Funchal, Portugal
| | - Ana Fonseca
- University of Coimbra, Center for Research in Neuropsychology and Cognitive and Behavioral Intervention, Coimbra, Portugal
| | - Mónica S. Cameirão
- Faculdade de Ciências Exatas e da Engenharia & NOVA LINCS, Universidade da Madeira, Funchal, Portugal
- Agência Regional para o Desenvolvimento de Investigação, Tecnologia e Inovação (ARDITI), Funchal, Portugal
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You S, Yaesoubi R, Lee K, Li Y, Eppink ST, Hsu KK, Chesson HW, Gift TL, Berruti AA, Salomon JA, Rönn MM. Lifetime quality-adjusted life years lost due to genital herpes acquired in the United States in 2018: a mathematical modeling study. LANCET REGIONAL HEALTH. AMERICAS 2023; 19:100427. [PMID: 36950038 PMCID: PMC10025423 DOI: 10.1016/j.lana.2023.100427] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Revised: 10/19/2022] [Accepted: 12/26/2022] [Indexed: 02/10/2023]
Abstract
Background Genital herpes (GH), caused by herpes simplex virus type 1 and type 2 (HSV-1, HSV-2), is a common sexually transmitted disease associated with adverse health outcomes. Symptoms associated with GH outbreaks can be reduced by antiviral medications, but the infection is incurable and lifelong. In this study, we estimate the long-term health impacts of GH in the United States using quality-adjusted life years (QALYs) lost. Methods We used probability trees to model the natural history of GH secondary to infection with HSV-1 and HSV-2 among people aged 18-49 years. We modelled the following outcomes to quantify the major causes of health losses following infection: symptomatic herpes outbreaks, psychosocial impacts associated with diagnosis and recurrences, urinary retention caused by sacral radiculitis, aseptic meningitis, Mollaret's meningitis, and neonatal herpes. The model was parameterized based on published literature on the natural history of GH. We summarized losses of health by computing the lifetime number of QALYs lost per genital HSV-1 and HSV-2 infection, and we combined this information with incidence estimates to compute the total lifetime number of QALYs lost due to infections acquired in 2018 in the United States. Findings We estimated 0.05 (95% uncertainty interval (UI) 0.02-0.08) lifetime QALYs lost per incident GH infection acquired in 2018, equivalent to losing 0.05 years or about 18 days of life for one person with perfect health. The average number of QALYs lost per GH infection due to genital HSV-1 and HSV-2 was 0.01 (95% UI 0.01-0.02) and 0.05 (95% UI 0.02-0.09), respectively. The burden of genital HSV-1 is higher among women, while the burden of HSV-2 is higher among men. QALYs lost per neonatal herpes infection was estimated to be 7.93 (95% UI 6.63-9.19). At the population level, the total estimated lifetime QALYs lost as a result of GH infections acquired in 2018 was 33,100 (95% UI 12,600-67,900) due to GH in adults and 3,140 (95% UI 2,260-4,140) due to neonatal herpes. Results were most sensitive to assumptions on the magnitude of the disutility associated with post-diagnosis psychosocial distress and symptomatic recurrences. Interpretation GH is associated with substantial health losses in the United States. Results from this study can be used to compare the burden of GH to other diseases, and it provides inputs that may be used in studies on the health impact and cost-effectiveness of interventions that aim to reduce the burden of GH. Funding The Center for Disease Control and Prevention.
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Affiliation(s)
- Shiying You
- Department of Health Policy and Management, Yale School of Public Health, New Haven, CT, USA
- Corresponding author. Yale School of Public Health, Department of Health Policy and Management, USA.
| | - Reza Yaesoubi
- Department of Health Policy and Management, Yale School of Public Health, New Haven, CT, USA
| | - Kyueun Lee
- Department of Health Policy and Management, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA
| | - Yunfei Li
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Samuel T. Eppink
- Division of STD Prevention, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Katherine K. Hsu
- Division of Sexually Transmitted Disease Prevention & HIV/AIDS Surveillance, Massachusetts Department of Public Health, Boston, MA, USA
| | - Harrell W. Chesson
- Division of STD Prevention, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Thomas L. Gift
- Division of STD Prevention, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Andrés A. Berruti
- Division of STD Prevention, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Joshua A. Salomon
- Center for Health Policy / Center for Primary Care and Outcomes Research, Stanford University, Stanford, CA, USA
| | - Minttu M. Rönn
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, MA, USA
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Shochet T, Berro Pizzarossa L, Larrea S, Blum J, Jelinska K, Comendant R, Sagaidac I. Self-managed abortion via the internet: Analysis of one year of service delivery data from Women Help Women. Gates Open Res 2023; 7:41. [PMID: 37123048 PMCID: PMC10130357 DOI: 10.12688/gatesopenres.14369.1] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/27/2023] [Indexed: 02/15/2023] Open
Abstract
Background: To better comprehend the demand for online medication abortion and to inform service delivery practice, we conducted an analysis of Women Help Women (WHW) service delivery statistics. The primary goals were to understand their user profile, evaluate self-reported outcomes and use of other medical services, and assess the overall experience both with the abortion itself and with the counseling and care provided by WHW. Methods: We retrospectively evaluated user characteristics, abortion outcomes, and acceptability of both the medication abortion and WHW’s services, using consultation data and corresponding evaluation data from a one-year period. For users who did not complete the evaluation form, WHW staff reviewed email correspondences to identify key outcomes. Results: From August 2016-July 2017, 3,307 individuals received abortion pills from WHW. Users were geographically located in thirty countries and correspondence was conducted in seven languages. Most reported their gestational age to be less than eight weeks. Of the 2,295 who took the pills and provided outcome information, almost all (99.1%, n=2275) reported that they were no longer pregnant. The majority (84.1%, n=1576/1875) used symptoms to confirm outcome; one fourth (22.8%, n=428) sought an ultrasound and one sixth (18.0%, n=338) used urine and/or serum testing. One in eight users (12.6%, n=292/2317) reported seeking additional medical care after taking the abortion pills. Most (87.5%, n=1551/1773) reported being satisfied or very satisfied with the abortion. Conclusions: Our study confirms that self-managed abortion is a process that people can do safely and effectively with community support and without medical supervision. In the context of a global backlash against abortion rights, self-managed abortion is an integral part of a spectrum of options for abortion care that must be made available to all.
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Affiliation(s)
| | | | - Sara Larrea
- Women Help Women, Amsterdam, The Netherlands
- Independent Researcher, Amstersdam, The Netherlands
| | | | | | - Rodica Comendant
- Women Help Women, Amsterdam, The Netherlands
- Reproductive Health Training Center, Chisinau, Moldova
| | - Irina Sagaidac
- Women Help Women, Amsterdam, The Netherlands
- Nicolae Testemitanu State University of Medicine and Pharmacy, Chisinau, Moldova
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11
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Lee K, You S, Li Y, Chesson H, Gift TL, Berruti AA, Hsu K, Yaesoubi R, Salomon JA, Rönn M. Estimation of the Lifetime Quality-Adjusted Life Years (QALYs) Lost Due to Syphilis Acquired in the United States in 2018. Clin Infect Dis 2023; 76:e810-e819. [PMID: 35684943 PMCID: PMC9907519 DOI: 10.1093/cid/ciac427] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Revised: 05/05/2022] [Accepted: 05/24/2022] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND The purpose of this study was to estimate the health impact of syphilis in the United States in terms of the number of quality-adjusted life years (QALYs) lost attributable to infections in 2018. METHODS We developed a Markov model that simulates the natural history and management of syphilis. The model was parameterized by sex and sexual orientation (women who have sex with men, men who have sex with women [MSW], and men who have sex with men [MSM]), and by age at primary infection. We developed a separate decision tree model to quantify health losses due to congenital syphilis. We estimated the average lifetime number of QALYs lost per infection, and the total expected lifetime number of QALYs lost due to syphilis acquired in 2018. RESULTS We estimated the average number of discounted lifetime QALYs lost per infection as 0.09 (95% uncertainty interval [UI] .03-.19). The total expected number of QALYs lost due to syphilis acquired in 2018 was 13 349 (5071-31 360). Although per-case loss was the lowest among MSM (0.06), MSM accounted for 47.7% of the overall burden. For each case of congenital syphilis, we estimated 1.79 (1.43-2.16) and 0.06 (.01-.14) QALYs lost in the child and the mother, respectively. We projected 2332 (1871-28 250) and 79 (17-177) QALYs lost for children and mothers, respectively, due to congenital syphilis in 2018. CONCLUSIONS Syphilis causes substantial health losses in adults and children. Quantifying these health losses in terms of QALYs can inform cost-effectiveness analyses and can facilitate comparisons of the burden of syphilis to that of other diseases.
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Affiliation(s)
- Kyueun Lee
- Department of Health Policy and Management, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Shiying You
- Department of Health Policy and Management, Yale School of Public Health, New Haven, Connecticut, USA
| | - Yunfei Li
- Department of Global Health and Population, Harvard T. H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Harrell Chesson
- Division of STD Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Thomas L Gift
- Division of STD Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Andrés A Berruti
- Division of STD Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Katherine Hsu
- Sexually Transmitted Disease Prevention & HIV/AIDS Surveillance, Massachusetts Department of Public Health, Boston, Massachusetts, USA
| | - Reza Yaesoubi
- Department of Health Policy and Management, Yale School of Public Health, New Haven, Connecticut, USA
| | - Joshua A Salomon
- Center for Health Policy/Center for Primary Care & Outcomes Research, Stanford University, Stanford, California, USA
| | - Minttu Rönn
- Department of Global Health and Population, Harvard T. H. Chan School of Public Health, Boston, Massachusetts, USA
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12
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Delgado L, Cobo J, Giménez C, Fucho-Rius GF, Sammut S, Martí L, Lesmes C, Puig S, Obregón N, Canet Y, Palao DJ. Initial Impact of Perinatal Loss on Mothers and Their Partners. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:1304. [PMID: 36674059 PMCID: PMC9858910 DOI: 10.3390/ijerph20021304] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Revised: 01/07/2023] [Accepted: 01/09/2023] [Indexed: 06/17/2023]
Abstract
(1) Background: Perinatal Loss affects one in ten women worldwide. It is known to have a deep impact on the physical and psychological wellbeing of the mother. Moreover, there is a lack of information in regard to gender differences. The role of culture, environment, personal characteristics, and gender is yet to be determined in most reports; (2) Objective and Methods: Our aim is to study the initial impact of perinatal losses in an unselected sample of couples, focusing on gender differences. We conducted a longitudinal prospective study with 29 mothers and 17 fathers. Upon discharge from the hospital, they filled out the Edinburgh Postnatal Depression Scale (EPDS), among others. After one-month post-loss, they performed the EPDS and the Short Version of the Perinatal Grief Scale. We used descriptive statistics for the sample and non-parametric tests for the comparison of gender; (3) Results: We found no gender differences in initial depressive symptoms, nor in depressive symptoms, perinatal grief symptoms, or grief level (total scores or complicated grief) one month after the loss; (4) Conclusions: we need to better understand the psychological evolution of couples in cases of perinatal loss without falling into preconceived ideas about the influence of gender.
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Affiliation(s)
- Laia Delgado
- Mental Health Department, Corporació Sanitària Parc Taulí, Universitat Autònoma de Barcelona, CIBERSAM, 08208 Sabadell, Spain
| | - Jesus Cobo
- Mental Health Department, Corporació Sanitària Parc Taulí, Universitat Autònoma de Barcelona, CIBERSAM, 08208 Sabadell, Spain
- Department of Psychiatry and Forensic Medicine, Universitat Autònoma de Barcelona, 08193 Bellaterra, Spain
- Institut d’Investigació i Innovació Parc Taulí (I3PT), CERCA, 08208 Sabadell, Spain
| | - Cristina Giménez
- Mental Health Department, Corporació Sanitària Parc Taulí, Universitat Autònoma de Barcelona, CIBERSAM, 08208 Sabadell, Spain
| | - Genís Felip Fucho-Rius
- Mental Health Department, Corporació Sanitària Parc Taulí, Universitat Autònoma de Barcelona, CIBERSAM, 08208 Sabadell, Spain
| | - Stephanie Sammut
- Perinatal Mental Health Program, Cerdanyola-Ripollet Outpatient Department, Sant Joan de Dèu Serveis de Salut Mental, 08291 Ripollet, Spain
| | - Laia Martí
- Gynaecology and Obstetrics Department, Hospital Universitari Parc Taulí, Corporació Sanitària Parc Taulí, Universitat Autònoma de Barcelona, 08208 Sabadell, Spain
| | - Cristina Lesmes
- Gynaecology and Obstetrics Department, Hospital Universitari Parc Taulí, Corporació Sanitària Parc Taulí, Universitat Autònoma de Barcelona, 08208 Sabadell, Spain
| | - Salut Puig
- Gynaecology and Obstetrics Department, Hospital Universitari Parc Taulí, Corporació Sanitària Parc Taulí, Universitat Autònoma de Barcelona, 08208 Sabadell, Spain
| | - Noemí Obregón
- Gynaecology and Obstetrics Department, Hospital Universitari Parc Taulí, Corporació Sanitària Parc Taulí, Universitat Autònoma de Barcelona, 08208 Sabadell, Spain
| | - Yolanda Canet
- Gynaecology and Obstetrics Department, Hospital Universitari Parc Taulí, Corporació Sanitària Parc Taulí, Universitat Autònoma de Barcelona, 08208 Sabadell, Spain
- Department of Medicine, Universitat Autònoma de Barcelona, 08193 Bellaterra, Spain
| | - Diego J. Palao
- Mental Health Department, Corporació Sanitària Parc Taulí, Universitat Autònoma de Barcelona, CIBERSAM, 08208 Sabadell, Spain
- Department of Psychiatry and Forensic Medicine, Universitat Autònoma de Barcelona, 08193 Bellaterra, Spain
- Institut d’Investigació i Innovació Parc Taulí (I3PT), CERCA, 08208 Sabadell, Spain
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13
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Rajkumar RP. The Relationship Between Access to Abortion and Mental Health in Women of Childbearing Age: Analyses of Data From the Global Burden of Disease Studies. Cureus 2022; 14:e31433. [DOI: 10.7759/cureus.31433] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/13/2022] [Indexed: 11/14/2022] Open
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14
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The influence of feminist abortion accompaniment on emotions related to abortion: A longitudinal observational study in Mexico. SSM Popul Health 2022; 19:101259. [PMID: 36238820 PMCID: PMC9552094 DOI: 10.1016/j.ssmph.2022.101259] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Revised: 09/28/2022] [Accepted: 10/02/2022] [Indexed: 11/22/2022] Open
Abstract
Emotions can reflect how individuals internalize identities, social roles, and broader power structures, including abortion stigma. Abortion accompaniment, in the form of logistical, informational, and emotional support offered by individuals and organizations, takes a person-centered, feminist, and rights-based approach. We tested the extent to which abortion accompaniment may decrease negative and increase positive feelings an individual holds related to their abortion. Using observational longitudinal data collected between January 2017 and mid-2018, we compared negative and positive emotional responses to a personal abortion experience one month and six months following the abortion to emotions immediately prior to the abortion ("baseline"), among women travelling from outside of Mexico City to abortion clinics in Mexico City with and without support of the accompaniment organization, Fondo MARIA. We used doubly robust longitudinal mixed effects models with inverse probability weighting methods. At baseline, accompanied and unaccompanied participants experienced an average of 4.9 and 4.4 negative emotions out of eight respectively (i.e., anguish, nervousness, scared, anxious, sadness, guilt, anger, shame) and 1.7 and 1.9 positive emotions of out 4 respectively (happiness, calmness, decidedness, and relief). From our model results, women accompanied (n = 77) had larger decreases in negative feelings (p < .05) and larger increases in positive feelings (p < .01) toward their abortion compared to those who were not accompanied (n = 119) at six months. These changes led the majority of accompanied respondents to have primarily positive feelings about their abortion by endline. Abortion accompaniment through Fondo MARIA in Mexico City was associated with a larger decrease in negative feelings, particularly those related to stigma, and a larger increase in positive feelings six months after abortion. Accompaniment's focus on person-centered support, self-determination, and autonomy may enable people seeking abortion to view their decision as one that is valid and legitimate, and resist the predominant stigmatizing narratives framing abortion as something that is transgressive.
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15
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Yoon MS, Jeon YB, Lee SB. Grief, Partner Support, Posttraumatic Growth among Women with Pregnancy Loss in Korea. JOURNAL OF LOSS & TRAUMA 2022. [DOI: 10.1080/15325024.2022.2106682] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/15/2022]
Affiliation(s)
- Myeong-Sook Yoon
- Department of Social Welfare, Jeonbuk National University, Jeonju-si, Republic of Korea
| | - Ye-Bin Jeon
- Department of Social Welfare, Jeonbuk National University, Jeonju-si, Republic of Korea
| | - Soo-Bi Lee
- Department of Social Welfare, Jeonbuk National University, Jeonju-si, Republic of Korea
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16
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Kukulskienė M, Žemaitienė N. Postnatal Depression and Post-Traumatic Stress Risk Following Miscarriage. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19116515. [PMID: 35682100 PMCID: PMC9180236 DOI: 10.3390/ijerph19116515] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/30/2022] [Revised: 05/23/2022] [Accepted: 05/25/2022] [Indexed: 12/10/2022]
Abstract
The experience of miscarriage is an important population-level problem that affects approximately 10–25% of pregnancies. The physical consequences of miscarriage have been researched extensively, but psychological sequelae less so. First-person accounts show that women who have experienced miscarriage feel pressured to stay silent, to grieve, and to fight intense physical and psychological challenges alone. There is ample scientific evidence on the links between miscarriage and physical and mental health disorders, such as complicated grief, anxiety, depression, post-traumatic stress, suicidal risk, psychosomatic disorders, sexual health disorders, etc. However, there is a lack of deeper understanding of the specifics of psychological morbidity after miscarriage, as well as of the information on vulnerability and resilience factors. This study aims to assess the risk of postnatal depression and post-traumatic stress following miscarriage. A total of 839 Lithuanian women who had one or more miscarriages were asked to complete an online questionnaire, including the Edinburgh Postnatal Depression Scale (EPDS) and the Impact of Events Scale-Revised (IES-R). Of the women, 59.1% were found to be at increased risk of postnatal depression and 48.9% at high risk of postnatal depression; 44.7% of the women were considered to be at increased risk of post-traumatic stress. An impaired relationship with one’s body and childlessness has been the strongest predictors of psychological morbidity risk.
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17
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Aldabbagh KA, Alnori MKJ, Almola KW. TORCH, Anti-cardiolepin, and Anti-phospholipids in Women with Repeated Miscarriage in Mosul City. Open Access Maced J Med Sci 2022. [DOI: 10.3889/oamjms.2022.9921] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Abstract
Background and Objective: The present study aimed to identify a connection between common viral infections and women who had repeatedly miscarriages.
Material and Methods: This study is a retrospective study which has been carried out on 2010 records in Mosul city/Iraq, and the patients were all women of child-bearing age (20-35 years old). All of the women had suffered from an abortion at least once before. The target viruses in charge for this study include; Toxoplasma gundi, Cytomegalovirus, Rubella virus, and Herpes virus.
Results and Conclusion: The analysis is based on the detection of the anti-bodies which confirmed a negative correlation between antibodies level and active viral infection, together with no clear association between the presence of active infectious status and miscarriage. Additionally, only few positive cases for each individual patient were positive for viral infection. Hence, the outcome confirmed no clear association between presence of infectious agent and repeated miscarriage. Nonetheless, rubella and cytomegalovirus have shown the highest contribution in this regard.
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18
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McKinlay AR, Fancourt D, Burton A. Factors affecting the mental health of pregnant women using UK maternity services during the COVID-19 pandemic: a qualitative interview study. BMC Pregnancy Childbirth 2022; 22:313. [PMID: 35413807 PMCID: PMC9005019 DOI: 10.1186/s12884-022-04602-5] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Accepted: 03/22/2022] [Indexed: 01/16/2023] Open
Abstract
Background People using maternity services in the United Kingdom (UK) have faced significant changes brought on by the COVID-19 pandemic and social distancing regulations. We focused on the experiences of pregnant women using UK maternity services during the pandemic and the impact of social distancing rules on their mental health and wellbeing. Methods We conducted 23 qualitative semi-structured interviews from June 2020 to August 2021, with women from across the UK who experienced a pregnancy during the pandemic. Nineteen participants in the study carried their pregnancy to term and four had experienced a miscarriage during the pandemic. Interviews took place remotely over video or telephone call, discussing topics such as mental health during pregnancy and use of UK maternity services. We used reflexive thematic analysis to analyse interview transcripts. Results We generated six higher order themes: [1] Some pregnancy discomforts alleviated by social distancing measures, [2] The importance of relationships that support coping and adjustment, [3] Missed pregnancy and parenthood experiences, [4] The mental health consequences of birth partner and visitor restrictions, [5] Maternity services under pressure, and [6] Lack of connection with staff. Many participants felt a sense of loss over a pregnancy experience that differed so remarkably to what they had expected because of the pandemic. Supportive relationships were important to help cope with pregnancy and pandemic-related changes; but feelings of isolation were compounded for some participants because opportunities to build social connections through face-to-face parent groups were unavailable. Participants also described feeling alone due to restrictions on their partners being present when accessing UK maternity services. Conclusions Our findings highlight some of the changes that may have affected pregnant women’s mental health during the COVID-19 pandemic. Reduced social support and being unable to have a partner or support person present during maternity service use were the greatest concerns reported by participants in this study. Absence of birth partners removed a protective buffer in times of uncertainty and distress. This suggests that the availability of a birth partner or support person must be prioritised wherever possible in times of pandemics to protect the mental health of people experiencing pregnancy and miscarriage. Supplementary Information The online version contains supplementary material available at 10.1186/s12884-022-04602-5.
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Affiliation(s)
- A R McKinlay
- Research Department of Behavioural Science and Health, Institute of Epidemiology & Health Care, University College London, 1-19 Torrington Place, London, WC1E 7HB, UK.
| | - D Fancourt
- Research Department of Behavioural Science and Health, Institute of Epidemiology & Health Care, University College London, 1-19 Torrington Place, London, WC1E 7HB, UK
| | - A Burton
- Research Department of Behavioural Science and Health, Institute of Epidemiology & Health Care, University College London, 1-19 Torrington Place, London, WC1E 7HB, UK
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19
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Tasnim S, Auny FM, Hassan Y, Yesmin R, Ara I, Mohiuddin MS, Kaggwa MM, Gozal D, Mamun MA. Antenatal depression among women with gestational diabetes mellitus: a pilot study. Reprod Health 2022; 19:71. [PMID: 35305655 PMCID: PMC8934461 DOI: 10.1186/s12978-022-01374-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Accepted: 03/03/2022] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
Gestational diabetes mellitus (GDM) is quite prevalent in low- and middle-income countries, and has been proposed to increase the risk of depression. There is only a prior study assessing antenatal depression among the subjects with GDM in the Bangladesh, which leads this study to be investigated.
Objective
To determine the prevalence of depressive symptoms and potential associations among pregnant women diagnosed with GDM.
Methods
A cross-sectional study was carried out among 105 pregnant women diagnosed with GDM over the period of January to December 2017 in 4- hospitals located in two different cities (Dhaka and Barisal). A semi-structured questionnaire was developed consisting of items related to socio-demographics, reproductive health history, diabetes, anthropometrics, and depression.
Results
Mild to severe antenatal depression was present in 36.2% of the subjects (i.e., 14.3%, 19% and 2.9% for mild, moderate and severe depression, respectively). None of the socio-demographic factors were associated with depression, but the history of reproductive health-related issues (i.e., abortion, neonatal death) and uncontrolled glycemic status were associated with the increased risk of depressive disorders.
Conclusions
GDM is associated with a high prevalence of depressive symptoms, which is enhanced by poor diabetes control. Thus, in women presenting with GDM, screening for depression should be pursued and treated as needed.
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20
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Blok LJ, Frijstein MM, Eysbouts YK, Custers J, Sweep F, Lok C, Ottevanger PB. The psychological impact of gestational trophoblastic disease: a prospective observational multicentre cohort study. BJOG 2021; 129:444-449. [PMID: 34314567 PMCID: PMC9292450 DOI: 10.1111/1471-0528.16849] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/10/2021] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To evaluate the short-term psychological consequences of gestational trophoblastic disease (GTD). DESIGN A prospective observational multicentre cohort study. SETTING Nationwide in the Netherlands. POPULATION GTD patients. METHODS Online questionnaires directly after diagnosis. MAIN OUTCOME MEASURES Hospital Anxiety and Depression Scale (HADS), Distress Thermometer (DT), Impact of Event Scale (IES) and Reproductive Concerns Scale (RCS). RESULTS Sixty GTD patients were included between 2017 and 2020. Anxious feelings (47%) were more commonly expressed than depressive feelings (27%). Patients experienced moderate to severe adaptation problems in 88%. Patients who already had children were less concerned about their reproductivity than were patients without children (mean score 10.4 versus 15.0, P = 0.031), and patients with children experienced lower distress levels (IES mean score 25.7 versus 34.7, P = 0.020). In addition, patients with previous pregnancy loss scored lower for distress compared with patients without pregnancy loss (IES mean score 21.1 versus 34.2, P = 0.002). DISCUSSION We recommend that physicians monitor physical complaints and the course of psychological wellbeing over time in order to provide personalised supportive care in time for patients who have high levels of distress at baseline. CONCLUSIONS GTD patients experience increased levels of distress, anxiety and depression, suggesting the diagnosis has a substantial effect on the psychological wellbeing of patients. The impact of GTD diagnosis on intrusion and avoidance seems to be ameliorated in patients who have children or who have experienced previous pregnancy loss. TWEETABLE ABSTRACT Patients with gestational trophoblastic disease (GTD) experience short-term psychological consequences such as distress, anxiety and depression, suggesting that the diagnosis GTD has a substantial effect on the psychological wellbeing of patients. Various patient characteristics affect the impact of GTD diagnosis.
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Affiliation(s)
- L J Blok
- Department of Obstetrics and Gynaecology, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - M M Frijstein
- Department of Gynaecologic Oncology, Centre of Gynaecologic Oncology Amsterdam, Amsterdam, The Netherlands
| | - Y K Eysbouts
- Department of Obstetrics and Gynaecology, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - Jae Custers
- Department of Medical Psychology, Radboud Institute for Health Sciences, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - Fcgj Sweep
- Department of Laboratory Medicine, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - Car Lok
- Department of Gynaecologic Oncology, Centre of Gynaecologic Oncology Amsterdam, Amsterdam, The Netherlands
| | - P B Ottevanger
- Department of Medical Oncology, Radboud University Medical Centre, Nijmegen, The Netherlands
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21
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Grauerholz KR, Berry SN, Capuano RM, Early JM. Uncovering Prolonged Grief Reactions Subsequent to a Reproductive Loss: Implications for the Primary Care Provider. Front Psychol 2021; 12:673050. [PMID: 34054675 PMCID: PMC8149623 DOI: 10.3389/fpsyg.2021.673050] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Accepted: 04/12/2021] [Indexed: 11/30/2022] Open
Abstract
Introduction There is a paucity of clinical guidelines for the routine assessment of maladaptive reproductive grief reactions in outpatient primary care and OB-GYN settings in the United States. Because of the disenfranchised nature of perinatal grief reactions, many clinicians may be apt to miss or dismiss a grief reaction that was not identified in the perinatal period. A significant number of those experiencing a reproductive loss exhibit signs of anxiety, depression, or post-traumatic stress disorder. Reproductive losses are typically screened for and recorded numerically as part of a woman’s well-visit intake, yet this process often fails to identify patients emotionally troubled by a prior pregnancy loss. Materials and Methods A summative content analysis of 164 recent website blogs from female participants who self-reported having experienced a miscarriage or abortion in their lifetime was conducted. The narratives were reviewed for details regarding the time span between the pregnancy loss and the composition of the blog post. The stories were analyzed for subsequent relationship problems and detrimental mental health conditions. Maladaptive reactions were contrasted for those that indicated a greater than 12 months’ time-lapse and those who had not. Results More than a third (39.6%) of the women reported in the narrative that at least one year or more had passed since experiencing the miscarriage or abortion. For those women, the median time span between the loss and composing the blog was 4 years with a range of 47 years. Mental health conditions attributed to the reproductive loss by those who reported longer bereavement times included subsequent relationship problems, substance misuse, depression, suicidal ideation, and PTSD. The percent of reported maladaptive issues was more than double (136.9% vs. 63.6%) for those who reported that a year or more had passed since the loss of the pregnancy. Discussion Grief reactions following the loss of a pregnancy may be prolonged or delayed for several months which can contribute to adverse biopsychosocial outcomes. Recognition and treatment of maladaptive grief reactions following a pregnancy loss are critical. Screening methods should be enhanced for clinicians in medical office settings to help identify and expedite the appropriate mental health assistance.
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Affiliation(s)
| | - Shandeigh N Berry
- Life Perspectives, San Diego, CA, United States.,Department of Nursing, College of Arts and Sciences, St. Martin's University, Lacey, WA, United States
| | - Rebecca M Capuano
- Life Perspectives, San Diego, CA, United States.,Blue Ridge Women's Center, Roanoke, VA, United States
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Moafi F, Momeni M, Tayeba M, Rahimi S, Hajnasiri H. Spiritual Intelligence and Post-abortion Depression: A Coping Strategy. JOURNAL OF RELIGION AND HEALTH 2021; 60:326-334. [PMID: 30242724 DOI: 10.1007/s10943-018-0705-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Loss of pregnancy is a major stressor which can cause mental disorders. In stressful conditions, spiritual intelligence can be used as a coping strategy to manage and cope with the stressor. It may also produce positive outcomes in spontaneous abortion. This study aimed to assess the relationship of spiritual intelligence with depression after spontaneous abortion. This cross-sectional descriptive-correlational study was done in 2015-2016 on 185 women with spontaneous abortion who were hospitalized in the postnatal care ward of Kowsar teaching hospital, Qazvin, Iran. Data collection was performed in two steps. In the first step, a demographic and obstetric characteristics questionnaire and the Spiritual Intelligence Self-Report Inventory were completed by participants during their hospital stay. In the second step, i.e., 7 days after spontaneous abortion, the Edinburgh Postnatal Depression Scale was completed for each participant over the phone. Variables which were found in univariate analysis to have a significant correlation with depression were entered into multiple logistic regression analysis to assess their roles in predicting depression. Most women were depressed (54%). Multiple logistic regression analysis revealed that the significant predictors of depression were women's educational status (OR 0.419; CI 0.18-0.93), gestational age at the time of abortion (OR 1.121; CI 1.02-1.22), and the personal meaning production dimension of spiritual intelligence (OR 0.82; CI 0.73-0.91). Spiritual intelligence is significantly correlated with post-abortion depression. Developing and following strategies for promoting spiritual intelligence can alleviate depression, stress, and anxiety after spontaneous abortion and also help manage complicated pregnancies.
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Affiliation(s)
- Farnoosh Moafi
- Midwifery Department, Qazvin University of Medical Sciences, Qazvin, Iran
| | - Maryam Momeni
- Nursing Department, Qazvin University of Medical Sciences, Qazvin, Iran
| | - Mohadeseh Tayeba
- Midwifery Department, Qazvin University of Medical Sciences, Qazvin, Iran
| | - Sarah Rahimi
- Nursing Department, Qazvin University of Medical Sciences, Qazvin, Iran
| | - Hamideh Hajnasiri
- Midwifery Department, Qazvin University of Medical Sciences, Qazvin, Iran.
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Women's experiences with information before medication abortion at home, support during the process and follow-up procedures - A qualitative study. SEXUAL & REPRODUCTIVE HEALTHCARE 2020; 27:100582. [PMID: 33296849 DOI: 10.1016/j.srhc.2020.100582] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2020] [Revised: 10/18/2020] [Accepted: 11/21/2020] [Indexed: 01/10/2023]
Abstract
OBJECTIVE To explore women's experiences of having a medication abortion at home in regard to their perceptions of the information provided before the abortion, support throughout the process and follow-up procedures. STUDY DESIGN A qualitative study based on interviews with 23 women between October 2019 and January 2020. Systematic text condensation was used for data analysis. RESULTS Three themes were identified from the analysis. The first theme covers how the women found the information given before the abortion to be inadequate and how this affected their feelings of safety. In the second theme, the participants described how they experienced lack of acknowledgement from health care professionals, and how this affected their feeling of support. The third theme covers how the women perceived access to health care professionals during the home abortion, and how this affected their feeling of well-being. CONCLUSIONS In general, the women stated that the information provided was inadequate, especially in regard to bleeding and pain. The women also found support during and after the abortion to be insufficient and would have preferred more help and information throughout the process. This suggests that health care professionals should improve their procedures for providing information, support and care.
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Rocca CH, Samari G, Foster DG, Gould H, Kimport K. Emotions and decision rightness over five years following an abortion: An examination of decision difficulty and abortion stigma. Soc Sci Med 2020; 248:112704. [DOI: 10.1016/j.socscimed.2019.112704] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2019] [Revised: 10/23/2019] [Accepted: 11/26/2019] [Indexed: 01/26/2023]
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Adib-Rad H, Basirat Z, Faramarzi M, Mostafazadeh A, Bijani A. Psychological distress in women with recurrent spontaneous abortion: A case-control study. Turk J Obstet Gynecol 2019; 16:151-157. [PMID: 31673466 PMCID: PMC6792057 DOI: 10.4274/tjod.galenos.2019.88899] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2019] [Accepted: 06/09/2019] [Indexed: 12/29/2022] Open
Abstract
Objective The aim of the present study was to evaluate psychological problems in women with recurrent spontaneous abortion (RSA). Materials and Methods In this case-control study, 115 women with RSA were assigned to the case group and 240 non-pregnant women comprised the control group. The revised version of the Symptom Checklist-90 (SCL-90-R) and the Intolerance of Uncertainty scale (IUS) were used for assessing mental health problems. Results The results showed that the mean Global Severity Index (GSI) of the SCL-90-R and the IUS scores in the case and control groups were 109.10±59.85 and 68.91±22.17, and 82.98±52.99 and 59.19±23.01, respectively. GSI was the strongest predictor of RSA [odds ratio (OR)=6.43; 95% confidence interval (CI): 3.52-11.72]. The chance estimate of RSA was approximately 2.1 times higher in women in rural areas (OR=2.07; 95% CI: 1.16-3.69), and 2 times higher at 12 months after the last pregnancy (OR=1.99; 95% CI: 1.42-2.78). Conclusion Psychological problems are greater after RSA. Therefore, it is suggested that the treatment of RSA emphasizes psychological counseling and psychological management.
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Affiliation(s)
- Hajar Adib-Rad
- Babol University of Medical Sciences, Institute of Health Research, Infertility and Reproductive Health Research Center, Babol, Iran
| | - Zahra Basirat
- Babol University of Medical Sciences, Institute of Health Research, Infertility and Reproductive Health Research Center, Babol, Iran
| | - Mahbobeh Faramarzi
- Babol University of Medical Sciences, Institute of Health Research, Infertility and Reproductive Health Research Center, Babol, Iran
| | - Amrollah Mostafazadeh
- Babol University of Medical Sciences, Institute of Health Research, Cellular and Molecular Biology Research Center, Babol, Iran
| | - Ali Bijani
- Babol University of Medical Sciences, Institute of Health Research, Social Determinants of Health Research Center, Babol, Iran
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26
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He L, Wang T, Xu H, Chen C, Liu Z, Kang X, Zhao A. Prevalence of depression and anxiety in women with recurrent pregnancy loss and the associated risk factors. Arch Gynecol Obstet 2019; 300:1061-1066. [DOI: 10.1007/s00404-019-05264-z] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2019] [Accepted: 08/06/2019] [Indexed: 10/26/2022]
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Jacob L, Gerhard C, Kostev K, Kalder M. Association between induced abortion, spontaneous abortion, and infertility respectively and the risk of psychiatric disorders in 57,770 women followed in gynecological practices in Germany. J Affect Disord 2019; 251:107-113. [PMID: 30921593 DOI: 10.1016/j.jad.2019.03.060] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2019] [Revised: 03/06/2019] [Accepted: 03/19/2019] [Indexed: 10/27/2022]
Abstract
AIM Our goal was to analyze the association between induced abortion, spontaneous abortion, and infertility respectively and the risk of psychiatric disorders in 57,770 women followed in gynecological practices in Germany. METHODS This case-control study was based on data from the Disease Analyzer database (IQVIA). Women with a first documentation of depression, anxiety, adjustment disorder, or somatoform disorder in one of 281 gynecological practices in Germany between January 2013 and December 2017 were included in this study (index date). Controls without depression, anxiety, adjustment disorder, or somatoform disorder were matched (1:1) to cases by age, index year, and physician. A total of 57,770 women were included in the present study. The main outcome of the study was the risk of psychiatric disorders (i.e. depression, anxiety, adjustment disorder, somatoform disorder) as a function of induced abortion, spontaneous abortion, and infertility. RESULTS The mean age was 29.2 years (SD = 6.4 years) in women with and without psychiatric disorders. Induced abortion (odds ratios [ORs] ranging from 1.75 to 2.01), spontaneous abortion (ORs ranging from 2.16 to 2.60), and infertility (OR = 2.13) were positively associated with the risk of psychiatric disorders. CONCLUSIONS A positive relationship between induced abortion, spontaneous abortion, and infertility respectively and psychiatric disorders was observed in gynecological practices in Germany.
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Affiliation(s)
- Louis Jacob
- Faculty of Medicine, University of Versailles Saint-Quentin-en-Yvelines, Montigny-le-Bretonneux, France
| | - Christian Gerhard
- Department of Gynecology and Obstetrics, Philipps University of Marburg, Marburg, Germany
| | | | - Matthias Kalder
- Department of Gynecology and Obstetrics, Philipps University of Marburg, Marburg, Germany
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Farren J, Mitchell-Jones N, Verbakel JY, Timmerman D, Jalmbrant M, Bourne T. The psychological impact of early pregnancy loss. Hum Reprod Update 2019; 24:731-749. [PMID: 30204882 DOI: 10.1093/humupd/dmy025] [Citation(s) in RCA: 109] [Impact Index Per Article: 21.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2018] [Accepted: 07/31/2018] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Early pregnancy loss (EPL) is a common event, with scope for long-term personal and societal impact. There are three decades worth of published evidence of profound psychological sequelae in a significant proportion of women. However, the wide variety of outcomes, screening instruments, assessment timings and geographical locations makes it challenging to form a coherent picture of the morbidity within the whole group and its subgroups. OBJECTIVE AND RATIONALE This review aims to investigate three questions. (1) What is the evidence for depression, anxiety and post-traumatic stress disorder (PTSD) following a miscarriage or an ectopic pregnancy in women and/or their partners? (2) What is the intensity and duration of these conditions, and how do they compare to those without losses? (3) Which patients have been found to be at highest risk of psychopathology? Answers to these questions are salient not only in day-to-day clinical interactions with those experiencing EPL, whose psychological needs may not be prioritized, but should also form the basis for tailoring healthcare policy in terms of screening for and treating the associated psychological morbidity. SEARCH METHODS The following databases were searched, from the start of each database up to July 2017: MEDLINE (Ovid interface, 1948 onwards), Embase classic + Embase (Ovid interface, 1947 onwards), and PsychINFO (Ovid interface, 1806 onwards). Search strategies were developed using medical subject headings (MeSH). The concepts of psychological morbidity (anxiety, depression or PTSD) and pregnancy loss (miscarriage or ectopic pregnancy) were first expanded with the Boolean operator 'or', then linked together using 'and'. Included studies were of prospective cohort design, including women or men following EPL (with the majority to have experienced losses before 24 weeks gestation), and reporting standardized psychometric measures for anxiety, depression and post-traumatic stress disorder. The timing of follow-up had to be specified and standardized across participants. Manuscript quality and risk of bias was assessed using the Newcastle-Ottawa Scale. OUTCOMES We found evidence of significant depression and anxiety in the first month following EPL in women. Partners were also shown to display depression and anxiety, albeit to a generally lower level. There is also evidence of post-traumatic stress symptoms relating to the EPL in three studies. WIDER IMPLICATIONS In view of their high frequency, EPLs can significantly contribute to the overall burden of psychopathology within a population. Recognition of this impact is important, so that severely affected individuals may be screened and treated appropriately. Further research to establish risk factors to promptly identify and treat these patients, and to optimize their management, is crucial.
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Affiliation(s)
- Jessica Farren
- Tommy's National Centre for Miscarriage Research, Queen Charlottes and Chelsea Hospital, Imperial College, London, UK.,Department of Obstetrics and Gynaecology, Imperial College Healthcare Trust, London, UK
| | - Nicola Mitchell-Jones
- Tommy's National Centre for Miscarriage Research, Queen Charlottes and Chelsea Hospital, Imperial College, London, UK.,Department of Obstetrics and Gynaecology, Chelsea and Westminster NHS Trust, London, UK
| | - Jan Y Verbakel
- KU Leuven, ACHG, Department of Public Health and Primary Care, Kapucijnenvoer 33, Leuven, Belgium.,Nuffield Department of Primary Care Health Sciences, University of Oxford, Woodstock Road, Oxford, UK
| | - Dirk Timmerman
- KU Leuven, Department of Obstetrics and Gynaecology, Herestraat, Leuven, Belgium
| | - Maria Jalmbrant
- Tommy's National Centre for Miscarriage Research, Queen Charlottes and Chelsea Hospital, Imperial College, London, UK
| | - Tom Bourne
- Tommy's National Centre for Miscarriage Research, Queen Charlottes and Chelsea Hospital, Imperial College, London, UK.,Department of Obstetrics and Gynaecology, Imperial College Healthcare Trust, London, UK.,KU Leuven, Department of Obstetrics and Gynaecology, Herestraat, Leuven, Belgium
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San Lazaro Campillo I, Meaney S, Sheehan J, Rice R, O'Donoghue K. University students' awareness of causes and risk factors of miscarriage: a cross-sectional study. BMC WOMENS HEALTH 2018; 18:188. [PMID: 30453933 PMCID: PMC6245715 DOI: 10.1186/s12905-018-0682-1] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/29/2018] [Accepted: 11/07/2018] [Indexed: 11/28/2022]
Abstract
Background Spontaneous miscarriage is the most common complication of pregnancy, occurring in up to 20% of pregnancies. Despite the prevalence of miscarriage, little is known regarding peoples’ awareness and understanding of causes of pregnancy loss. The aim of this study was to explore university students’ understanding of rates, causes and risk factors of miscarriage. Methods A cross-sectional study including university students. An online questionnaire was circulated to all students at the University College Cork using their university email accounts in April and May 2016. Main outcomes included identification of prevalence, weeks of gestation at which miscarriage occurs and causative risk factors for miscarriage. Results A sample of 746 students were included in the analysis. Only 20% (n = 149) of students correctly identified the prevalence of miscarriage, and almost 30% (n = 207) incorrectly believed that miscarriage occurs in less than 10% of pregnancies. Female were more likely to correctly identify the rate of miscarriage than men (21.8% versus 14.5%). However, men tended to underestimate the rate and females overestimate it. Students who did not know someone who had a miscarriage underestimated the rate of miscarriage, and those who were aware of some celebrities who had a miscarriage overestimated the rate. Almost 43% (n = 316) of students correctly identified fetal chromosomal abnormalities as the main cause of miscarriage. Females, older students, those from Medical and Health disciplines and those who were aware of a celebrity who had a miscarriage were more likely to identify chromosomal abnormalities as a main cause. However, more than 90% of the students believed that having a fall, consuming drugs or the medical condition of the mother was a causative risk factor for miscarriage. Finally, stress was identified as a risk factor more frequently than advanced maternal age or smoking. Conclusion Although almost half of the participants identified chromosomal abnormalities as the main cause of miscarriage, there is still a lack of understanding about the prevalence and most important risk factors among university students. University represents an ideal opportunity for health promotion strategies to increase awareness of potential adverse outcomes in pregnancy. Electronic supplementary material The online version of this article (10.1186/s12905-018-0682-1) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Indra San Lazaro Campillo
- Pregnancy Loss Research Group, The Irish Centre for Fetal and Neonatal Translational Research, University College Cork, Cork, Ireland. .,National Perinatal Epidemiology Centre, Department of Obstetrics and Gynaecology, University College Cork, 5th floor, Cork University Maternity Hospital, Wilton, Cork, T12 YE02, Ireland.
| | - Sarah Meaney
- Pregnancy Loss Research Group, The Irish Centre for Fetal and Neonatal Translational Research, University College Cork, Cork, Ireland.,National Perinatal Epidemiology Centre, Department of Obstetrics and Gynaecology, University College Cork, 5th floor, Cork University Maternity Hospital, Wilton, Cork, T12 YE02, Ireland
| | - Jacqueline Sheehan
- Pregnancy Loss Research Group, The Irish Centre for Fetal and Neonatal Translational Research, University College Cork, Cork, Ireland
| | - Rachel Rice
- Pregnancy Loss Research Group, The Irish Centre for Fetal and Neonatal Translational Research, University College Cork, Cork, Ireland
| | - Keelin O'Donoghue
- Pregnancy Loss Research Group, The Irish Centre for Fetal and Neonatal Translational Research, University College Cork, Cork, Ireland
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30
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Price J, Kalil A. The Effect of Mother-Child Reading Time on Children's Reading Skills: Evidence From Natural Within-Family Variation. Child Dev 2018; 90:e688-e702. [PMID: 30151955 DOI: 10.1111/cdev.13137] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Children's exposure to book reading is thought to be an influential input into positive cognitive development. Yet there is little empirical research identifying whether it is reading time per se, or other factors associated with families who read, such as parental education or children's reading skill, that improves children's achievement. Using data on 4,239 children ages 0-13 of the female respondents of the 1979 National Longitudinal Survey of Youth, this study applies two different methodologies to identify the causal impact of mother-child reading time on children's achievement scores by controlling for several confounding child and family characteristics. The results show that a 1 SD increase in mother-child reading time increases children's reading achievement by 0.80 SDs.
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Affiliation(s)
- Joseph Price
- Brigham Young University and National Bureau of Economic Research
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31
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Abajobir AA, Alati R, Kisely S, Najman JM. Are Past Adverse Pregnancy Outcomes Associated with Maternal Anxiety and Depressive Symptoms in a Sample of Currently Pregnant Women? Ethiop J Health Sci 2018; 27:351-362. [PMID: 29217937 PMCID: PMC5615024 DOI: 10.4314/ejhs.v27i4.6] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Background There has been a great deal of concern about the mental health of women whose pregnancies involve miscarriage, termination of a pregnancy (ToP), child death or where a child has been given up for adoption. Despite this concern there has been remarkably little population-based research which has addressed the long-term consequences of pregnancy loss and child death. This study investigated the maternal mental health consequences of women whose pregnancies involve miscarriage, ToP, child death or where a child has been given up for adoption at two different time points, adjusting for socio-demographic characteristics and baseline mental health. Methods The Mater-University of Queensland Study of Pregnancy is a prospective pre-birth cohort study. Women were recruited early in pregnancy over the period 1981 to 1983 at their first antenatal clinic visit (FCV). Women were interviewed again at the 14-year follow-up. Data from 4403 mothers were analysed using maternal reports of a prior history of giving a child up for adoption, miscarriage, ToP, and neonatal, infant and/or child deaths. Symptoms of maternal anxiety and depression were measured at FCV and the 14-year follow-up using the Delusions-Symptoms-States Inventory. We carried out logistic regression analysis using Stata 13. Odds ratios (ORs) with 95% confidence intervals (CIs) were used to display the findings. Results A prior miscarriage was associated with anxiety (adjusted OR (AOR) = 1.30; 95% CI: 1.10-1.66) and depressive (AOR = 1.70; 95% CI: 1.21-2.39) symptoms at the 14-year follow-up. Having had a neonatal, infant and/or child deaths was associated with symptoms of depression at 14-year follow-up (AOR = 2.12; 95% CI: 1.06-4.25). Conclusion The period after a child loss which involves a new pregnancy may be associated with relatively good mental health despite the fact that some mothers have experienced previous adverse pregnancy outcomes.
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Affiliation(s)
| | - Rosa Alati
- School of Public Health, The University of Queensland, Australia.,Centre for Youth Substance Abuse Research, The University of Queensland, Australia
| | - Steve Kisely
- School of Medicine, University of Queensland, Australia.,Departments of Psychiatry, Community Health and Epidemiology, Dalhousie University, Canada
| | - Jake Moses Najman
- School of Public Health, The University of Queensland, Australia.,School of Social Sciences, The University of Queensland, Australia.,Queensland Alcohol and Drug Research and Education Centre, the University of Queensland, Australia
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Luo M, Jiang X, Wang Y, Wang Z, Shen Q, Li R, Cai Y. Association between induced abortion and suicidal ideation among unmarried female migrant workers in three metropolitan cities in China: a cross-sectional study. BMC Public Health 2018; 18:625. [PMID: 29764402 PMCID: PMC5952593 DOI: 10.1186/s12889-018-5527-1] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2017] [Accepted: 05/01/2018] [Indexed: 11/30/2022] Open
Abstract
Background Despite reports of mental health issues, suicidality has not been closely examined among the migrant population. The association between induced abortion and suicidal ideation is unknown among unmarried female migrant workers of reproductive age in China. This study aims to examine induced abortion and suicidality among the Chinese migrant population. Methods We recruited 5115 unmarried female migrant workers during 2015 to 2016 from Shanghai, Beijing and Guangzhou, and collected demographic, psychosocial, reproductive and mental health information using structured questionnaires. We used logistic regression models to examine the association between lifetime induced abortion and suicidal ideation during the past year among the subjects. Results Overall, 8.2% of the subjects had suicidal ideation during the past year, and 15.5% of the subjects experienced induced abortion. Induced abortion was associated with nearly twice the odds of having past-year suicidal ideation (Odds ratio, OR = 1.89; 95% confidence interval, CI: 1.46, 2.44) after adjusting for age, education, years in the working place, tobacco use, alcohol consumption, daily internet use, attitude towards premarital pregnancy, multiple induced abortion, self-esteem, loneliness, depression, and anxiety disorders. The association was stronger in those aged > 25 (OR = 3.37, 95% CI = 2.16, 5.28), with > 5 years of stay in the working place (OR = 2.98, 95% CI = 2.02, 4.39), the non-anxiety group (OR = 2.28, 95% CI = 1.74, 3.00), and the non-depression group (OR = 2.94, 95% CI = 2.08, 4.15). Conclusions Induced abortion was associated with increased odds for suicidal ideation among the unmarried female migrant workers in urban cities in China. More attention should be paid to the mental health of the population.
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Affiliation(s)
- Mengyun Luo
- School of Public Health, School of Medicine, Shanghai Jiao Tong University, Shanghai, 200025, People's Republic of China
| | - Xueqin Jiang
- School of Public Health, School of Medicine, Shanghai Jiao Tong University, Shanghai, 200025, People's Republic of China
| | - Ying Wang
- School of Public Health, School of Medicine, Shanghai Jiao Tong University, Shanghai, 200025, People's Republic of China
| | - Zezhou Wang
- School of Public Health, School of Medicine, Shanghai Jiao Tong University, Shanghai, 200025, People's Republic of China
| | - Qiuming Shen
- School of Public Health, School of Medicine, Shanghai Jiao Tong University, Shanghai, 200025, People's Republic of China
| | - Rui Li
- Department of Public Health Sciences, University of Rochester School of Medicine and Dentistry, Rochester, NY, 14642, USA.
| | - Yong Cai
- School of Public Health, School of Medicine, Shanghai Jiao Tong University, Shanghai, 200025, People's Republic of China.
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Abstract
BACKGROUND Twenty percent of pregnant women undergo an abortion. Reviews of previous studies on the effects of abortion on mental health have been inconclusive. Little research has been carried out in this direction in our country. AIMS This study aims to study the psychological effects of abortions and the associated sociodemographic and other parameters. SETTING AND DESIGN It is a cross-sectional study, conducted in five different government hospitals of Hyderabad. MATERIALS AND METHODS After identifying the participants, an interview was conducted. First, sociodemographic and other parameters were collected by an interviewer. Then, another interviewer conducted the interview using diagnostic tools (Impact of Events Scale-Revised [IES-R] and Goldberg Health Questionnaire-12 [GHQ-12]). Analysis was carried out using SPSS software. RESULTS Sixty cases of spontaneous abortion, 31 therapeutic and 9 elective abortions, were collected. Overall, on GHQ-12, 57% women had no distress, 11% had typical distress, while 14% had more than typical distress, 15% had psychological distress, and 3% of them had severe distress. On IES-R, 16% women had little or no symptoms of posttraumatic stress disorder PTSD, 57% had several symptoms, while 27% of them were likely to have PTSD. CONCLUSIONS Women who underwent elective abortion showed less distress than the other types. Those that underwent a late abortion were more likely to suffer from psychological distress than those having an early one. The medical history was a significant factor in determining the mental health outcome of the women who underwent abortion.
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Affiliation(s)
- Sameera Kotta
- House Surgeon, Department of Psychiatry, Gandhi Medical College and Hospital, Hyderabad, Telangana, India
| | - Umashankar Molangur
- Professor of Psychiatry and Head of Department, Gandhi Medical College and Hospital, Hyderabad, Telangana, India
| | - Rajshekhar Bipeta
- Associate Professor of Psychiatry, Department of Psychiatry, Gandhi Medical College and Hospital, Hyderabad, Telangana, India
| | - Radhika Ganesh
- Assistant Professor of Obstetrics and Gynecology, Gandhi Medical College and Hospital, Hyderabad, Telangana, India
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Sharma R, Radhakrishnan G, Bhatia MS, Gupta R, Mehdiratta A. Satisfaction and psychological after effects of legal abortion at a tertiary care teaching hospital of North India. J OBSTET GYNAECOL 2018. [DOI: 10.1080/01443615.2017.1416596] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Affiliation(s)
- Richa Sharma
- Department of Obstetrics & Gynecology, University College of Medical Sciences and Guru Teg Bahadur Hospital, Delhi, India
| | - Gita Radhakrishnan
- Department of Obstetrics & Gynecology, University College of Medical Sciences and Guru Teg Bahadur Hospital, Delhi, India
| | - M. S. Bhatia
- Department of Psychiatry, University College of Medical Sciences and Guru Teg Bahadur Hospital, Delhi, India
| | - Rashmi Gupta
- Department of Obstetrics & Gynecology, University College of Medical Sciences and Guru Teg Bahadur Hospital, Delhi, India
| | - Anita Mehdiratta
- Department of Obstetrics & Gynecology, University College of Medical Sciences and Guru Teg Bahadur Hospital, Delhi, India
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Weng SC, Chang JC, Yeh MK, Wang SM, Lee CS, Chen YH. Do stillbirth, miscarriage, and termination of pregnancy increase risks of attempted and completed suicide within a year? A population-based nested case-control study. BJOG 2018; 125:983-990. [DOI: 10.1111/1471-0528.15105] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/12/2017] [Indexed: 01/18/2023]
Affiliation(s)
- S-C Weng
- Bachelor's Degree Program of Golden-Age Well-being Management; Yuanpei University of Medical Technology; Hsinchu Taiwan
| | - J-C Chang
- School of Nursing; College of Medicine; National Taiwan University; Taipei Taiwan
| | - M-K Yeh
- Graduate Institute of Medical Science and School of Pharmacy; National Defense Medical Centre; Taipei Taiwan
| | - S-M Wang
- Department of Health Services Administration; China Medical University; Taichung Taiwan
- Department of Biotechnology and Pharmaceutical Technology; Yuanpei University of Medical Technology; Hsinchu Taiwan
| | - C-S Lee
- Department of Psychiatry; Mackay Memorial Hospital; Taipei Taiwan
- Department of Medicine; Mackay Medical College; New Taipei City Taiwan
| | - Y-H Chen
- School of Public Health; College of Public Health; Taipei Medical University; Taipei Taiwan
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Abstract
SummaryA recent Royal College of Psychiatrists' statement concluded that current evidence on abortion and mental health is inconclusive. This contribution examines the background to the Royal College of Psychiatrists' statement and the issues it raises. It is concluded that the best route to resolving such issues is through further and better research.
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Jacob L, Polly I, Kalder M, Kostev K. Prevalence of depression, anxiety, and adjustment disorders in women with spontaneous abortion in Germany - A retrospective cohort study. Psychiatry Res 2017; 258:382-386. [PMID: 28865722 DOI: 10.1016/j.psychres.2017.08.064] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2017] [Revised: 08/18/2017] [Accepted: 08/23/2017] [Indexed: 11/19/2022]
Abstract
The aim of this study was to analyze the prevalence of depression, anxiety, and adjustment disorders in women within the year following miscarriage in Germany. This study included women between the ages of 16 and 45 with a first pregnancy terminated by spontaneous abortion between January 2007 and December 2015 (index date). These women were followed in 262 gynecological practices. Women with a spontaneous abortion were matched (1:1) with pregnant women without spontaneous abortion by age, index year, diagnosis of female infertility prior to the index date, procreative management prior to the index date, and physician. This retrospective cohort study included 12,158 women with a spontaneous abortion and 12,158 pregnant women without a spontaneous abortion. The mean age was 31.6 (SD: 5.5).years. One year after the index date, 8.9% of women with spontaneous abortion and 5.7% of controls were diagnosed with depression, anxiety, or adjustment disorder. Individuals who had previously undergone a spontaneous abortion were more likely to have one of these three psychiatric disorders compared to controls (OR = 1.53). Similar results were found in the age groups 21-30 and 31-40. Spontaneous abortion is associated with an increased prevalence of developing psychiatric diseases within the first year.
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Affiliation(s)
- Louis Jacob
- Faculty of Medicine, University of Paris 5, Paris, France
| | - Ines Polly
- Department of Gynecology and Obstetrics, Philipps-University Marburg, Marburg, Germany
| | - Matthias Kalder
- Department of Gynecology and Obstetrics, Philipps-University Marburg, Marburg, Germany
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Che Y, Dusabe-Richards E, Wu S, Jiang Y, Dong X, Li J, Zhang WH, Temmerman M, Tolhurst R. A qualitative exploration of perceptions and experiences of contraceptive use, abortion and post-abortion family planning services (PAFP) in three provinces in China. BMC Womens Health 2017; 17:113. [PMID: 29157259 PMCID: PMC5697166 DOI: 10.1186/s12905-017-0458-z] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2016] [Accepted: 10/30/2017] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND The INPAC project aims to evaluate the effectiveness of integrated post-abortion family planning (PAFP) services into existing hospital based abortion services in China. A qualitative study was conducted in three provinces to contribute to developing effective PAFP services through understanding influences on contraceptive use, experiences of abortion and existing PAFP, and their effect on future contraceptive practices from the perspective of users, in the context of social and institutional change. METHODS Twenty-nine in-depth interviews (IDIs) were undertaken with women who had experienced abortion between 1 and 6 months prior to interview, recruited from three urban and two rural facilities in each province. Thirteen IDIs were also conducted with male partners. Six focus group discussions (FGDs) were carried out with community members from different social groups, including unmarried and married women and men, urban residents and rural-to-urban migrants. RESULTS Social networks and norms are important in shaping attitudes and behaviour towards abortion and contraception. Widespread concerns were expressed about side-effects, reliability and effects on future fertility of some modern contraceptives. The combination of limited information and choices and a lack of person-centred counselling in PAFP with anxieties about side effects underlies the widespread use of unreliable methods. Gendered power relations significantly influence contraceptive (non)use, with several examples illustrating women's relative lack of power to decide on a method, particularly in the case of condoms. Although the availability of contraceptive information from respected providers can offer impetus for individual behaviour change, social distance from providers reduces opportunities for clients to discuss their difficulties regarding contraceptive use; particularly, but not exclusively for young, unmarried clients. CONCLUSIONS Increased access to non-commercial, reliable information on contraceptive methods is needed. PAFP services must go beyond simple information provision to ensure that providers take a more person-centred approach, which considers the most appropriate method for individual clients and probes for the underlying influences on contraceptive (non)use. More sensitive reflection on gender norms and relationships is required during counselling and, where women choose this, efforts should be made to include their male partners. Specific attention to provider positionality and skills for counselling young, unmarried clients is needed.
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Affiliation(s)
- Yan Che
- Key Laboratory of Reproduction Regulation of NPFPC (SIPPR, IRD), Fudan University, Shanghai, China
- Chinese Society for Family Planning, China Medical Association, Beijing, China
| | - Esther Dusabe-Richards
- Department of International Public Health, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool, L3 5QA UK
| | - Shangchun Wu
- National Research Institute for Family Planning, Beijing, China
| | - Yi Jiang
- Public Health and Management Department, Chongqing Medical University, Chongqing, China
| | - Xiaojing Dong
- The second affiliated hospital of Chongqing Medical University, Chongqing, China
| | - Jian Li
- Chinese Society for Family Planning, China Medical Association, Beijing, China
| | - Wei-Hong Zhang
- International Centre for Reproductive Health, University of Ghent, Ghent, Belgium
| | - Marleen Temmerman
- International Centre for Reproductive Health, University of Ghent, Ghent, Belgium
| | - Rachel Tolhurst
- Department of International Public Health, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool, L3 5QA UK
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Reardon DC, Thorp JM. Pregnancy associated death in record linkage studies relative to delivery, termination of pregnancy, and natural losses: A systematic review with a narrative synthesis and meta-analysis. SAGE Open Med 2017; 5:2050312117740490. [PMID: 29163945 PMCID: PMC5692130 DOI: 10.1177/2050312117740490] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2016] [Accepted: 10/09/2017] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVES Measures of pregnancy associated deaths provide important guidance for public health initiatives. Record linkage studies have significantly improved identification of deaths associated with childbirth but relatively few have also examined deaths associated with pregnancy loss even though higher rates of maternal death have been associated with the latter. Following PRISMA guidelines we undertook a systematic review of record linkage studies examining the relative mortality risks associated with pregnancy loss to develop a narrative synthesis, a meta-analysis, and to identify research opportunities. METHODS MEDLINE and SCOPUS were searched in July 2015 using combinations of: mortality, maternal death, record linkage, linked records, pregnancy associated mortality, and pregnancy associated death to identify papers using linkage of death certificates to independent records identifying pregnancy outcomes. Additional studies were identified by examining all citations for relevant studies. RESULTS Of 989 studies, 11 studies from three countries reported mortality rates associated with termination of pregnancy, miscarriage or failed pregnancy. Within a year of their pregnancy outcomes, women experiencing a pregnancy loss are over twice as likely to die compared to women giving birth. The heightened risk is apparent within 180 days and remains elevated for many years. There is a dose effect, with exposure to each pregnancy loss associated with increasing risk of death. Higher rates of death from suicide, accidents, homicide and some natural causes, such as circulatory diseases, may be from elevated stress and risk taking behaviors. CONCLUSIONS Both miscarriage and termination of pregnancy are markers for reduced life expectancy. This association should inform research and new public health initiatives including screening and interventions for patients exhibiting known risk factors.
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Affiliation(s)
| | - John M Thorp
- Department of Obstetrics and Gynecology, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
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Opportunities, challenges and systems requirements for developing post-abortion family planning services: Perceptions of service stakeholders in China. PLoS One 2017; 12:e0186555. [PMID: 29045434 PMCID: PMC5646849 DOI: 10.1371/journal.pone.0186555] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2017] [Accepted: 09/15/2017] [Indexed: 11/19/2022] Open
Abstract
Post-abortion family planning (PAFP) has been proposed as a key strategy to decrease unintended pregnancy and repeat induced abortions. However, the accessibility and quality of PAFP services remain a challenge in many countries including China where more than 10 million unintended pregnancies occur each year. Most of these unwanted pregnancies end in repeated induced abortions. This paper aims to explore service providers' perceptions of the current situation regarding family planning and abortion service needs, provision, utilization, and the feasibility and acceptability of high quality PAFP in the future. Qualitative methods, including in-depth interviews and focus group discussions, were used with family planning policy makers, health managers, and service providers. Three provinces-Zhejiang, Hubei and Yunnan-were purposively selected, representing high, medium and relatively undeveloped areas of China. A total of fifty-three in-depth interviews and ten focus-group discussions were conducted and analysed thematically. Increased numbers of abortions among young, unmarried women were perceived as a major reason for high numbers of abortions. Participants attributed this to increasing socio-cultural acceptability of premarital sex, and simultaneously, lack of understanding or awareness of contraception among young people. The majority of service stakeholders acknowledged that free family planning services were neither targeted at, nor accessible to unmarried people. The extent of PAFP provision is variable and limited. However, service providers expressed willingness and enthusiasm towards providing PAFP services in the future. Three main considerations were expressed regarding the feasibility of developing and implementing PAFP services: policy support, human resources, and financial resources. The study indicated that key service stakeholders show demand for and perceive considerable opportunities to develop PAFP in China. However, changes are needed to enable the systematic development of high quality PAFP, including actively targeting young and unmarried people in service provision, obtaining policy support and increasing the investment of human and financial resources.
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41
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Sharp L, Morgan E, Drummond FJ, Gavin A. The psychological impact of prostate biopsy: Prevalence and predictors of procedure-related distress. Psychooncology 2017; 27:500-507. [DOI: 10.1002/pon.4521] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2016] [Revised: 05/26/2017] [Accepted: 07/17/2017] [Indexed: 11/06/2022]
Affiliation(s)
- Linda Sharp
- Newcastle University; Newcastle upon Tyne UK
| | - Eileen Morgan
- Northern Ireland Cancer Registry; Queen's University Belfast; Belfast UK
| | | | - Anna Gavin
- Northern Ireland Cancer Registry; Queen's University Belfast; Belfast UK
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42
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Shapiro GD, Séguin JR, Muckle G, Monnier P, Fraser WD. Previous pregnancy outcomes and subsequent pregnancy anxiety in a Quebec prospective cohort. J Psychosom Obstet Gynaecol 2017; 38:121-132. [PMID: 28079434 PMCID: PMC5383417 DOI: 10.1080/0167482x.2016.1271979] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
INTRODUCTION Pregnancy anxiety is an important psychosocial risk factor that may be more strongly associated with adverse birth outcomes than other measures of stress. Better understanding of the upstream predictors and causes of pregnancy anxiety could help to identify high-risk women for adverse maternal and infant outcomes. The objective of the present study was to measure the associations between five past pregnancy outcomes (live preterm birth (PTB), live term birth, miscarriage at <20 weeks, stillbirth at ≥20 weeks, and elective abortion) and pregnancy anxiety at three trimesters in a subsequent pregnancy. METHODS Analyses were conducted using data from the 3D Cohort Study, a Canadian birth cohort. Data on maternal demographic characteristics and pregnancy history for each known previous pregnancy were collected via interviewer-administered questionnaires at study entry. Pregnancy anxiety for the index study pregnancy was measured prospectively by self-administered questionnaire following three prenatal study visits. RESULTS Of 2366 participants in the 3D Study, 1505 had at least one previous pregnancy. In linear regression analyses with adjustment for confounding variables, prior live term birth was associated with lower pregnancy anxiety in all three trimesters, whereas prior miscarriage was significantly associated with higher pregnancy anxiety in the first trimester. Prior stillbirth was associated with greater pregnancy anxiety in the third trimester. Prior elective abortion was significantly associated with higher pregnancy anxiety scores in the first and second trimesters, with an association of similar magnitude observed in the third trimester. DISCUSSION Our findings suggest that the outcomes of previous pregnancies should be incorporated, along with demographic and psychosocial characteristics, into conceptual models framing pregnancy anxiety.
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Affiliation(s)
- Gabriel D. Shapiro
- Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, Canada,CHU Sainte-Justine Research Centre, Université de Montréal, Montreal, Canada
| | - Jean R. Séguin
- CHU Sainte-Justine Research Centre, Université de Montréal, Montreal, Canada,Department of Psychiatry, Université de Montréal, Montreal, Canada
| | - Gina Muckle
- Centre de Recherche du Centre hospitalier universitaire de Québec, Quebec, Canada,École de psychologie, Université Laval, Quebec, Canada
| | - Patricia Monnier
- Department of Obstetrics and Gynecology, McGill University Health Centre, Montreal, Canada
| | - William D. Fraser
- CHU Sainte-Justine Research Centre, Université de Montréal, Montreal, Canada,Department of Obstetrics and Gynaecology, Université de Sherbrooke, and Centre de recherche du CHUS, Sherbrooke, Canada
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Restrepo D, Duque M, Montoya L, Hoyos C. [A 38-year-old Woman with a Legal and Voluntary Interruption of Pregnancy due to Mental Health Risk. An Unexpected Outcome]. ACTA ACUST UNITED AC 2017; 46:116-120. [PMID: 28483171 DOI: 10.1016/j.rcp.2016.05.006] [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: 02/13/2016] [Revised: 05/08/2016] [Accepted: 05/23/2016] [Indexed: 10/21/2022]
Abstract
OBJECTIVE To describe a case of legal and voluntary interruption of pregnancy due to a mental health risk in the mother. However, the foetus survived and the mother decided to care for the child. METHODS Description of the case and a non-systematic review of the relevant literature. RESULTS A multiparous woman of 38 years with unknown gestational age who requests legal and voluntary interruption of pregnancy. After abortion a male child born of 1050 grams was born, intubated and admitted to intensive care. Subsequently, the mother, without the mental problems that led to abortion, gradually assumed the care of the child. DISCUSSION To address this complex case, several aspects are analysed: first, the change of mind of a woman in her desire to be a mother. Second, the disappearance of mental symptoms in the immediate postpartum. Third, the need to review the clinical, ethical and legal foundations of the legal ruling that allows therapeutic abortion in Colombia.
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Affiliation(s)
- Diana Restrepo
- Medicina, Psiquiatría, CES University, Medelllín, Colombia.
| | - Marle Duque
- Medicina, Psiquiatría, CES University, Medelllín, Colombia
| | - Laura Montoya
- Medicina, Psiquiatría, CES University, Medelllín, Colombia
| | - Catalina Hoyos
- Medicina, Psiquiatría, CES University, Medelllín, Colombia
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Kirkman M, Apicella C, Graham J, Hickey M, Hopper JL, Keogh L, Winship I, Fisher J. Meanings of abortion in context: accounts of abortion in the lives of women diagnosed with breast cancer. BMC Womens Health 2017; 17:26. [PMID: 28381301 PMCID: PMC5382471 DOI: 10.1186/s12905-017-0383-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2016] [Accepted: 03/30/2017] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND A breast cancer diagnosis and an abortion can each be pivotal moments in a woman's life. Research on abortion and breast cancer deals predominantly with women diagnosed during pregnancy who might be advised to have an abortion. The other-discredited but persistent-association is that abortions cause breast cancer. The aim here was to understand some of the ways in which women themselves might experience the convergence of abortion and breast cancer. METHODS Among 50 women recruited from the Australian Breast Cancer Family Study and interviewed in depth about what it meant to have a breast cancer diagnosis before the age of 41, five spontaneously told of having or contemplating an abortion. The transcripts of these five women were analysed to identify what abortion meant in the context of breast cancer, studying each woman's account as an individual "case" and interpreting it within narrative theory. RESULTS It was evident that each woman understood abortion as playing a different role in her life. One reported an abortion that she did not link to her cancer, the second was relieved not to have to abort a mid-treatment pregnancy, the third represented abortion as saving her life by making her cancer identifiable, the fourth grieved an abortion that had enabled her to begin chemotherapy, and the fifth believed that her cancer was caused by an earlier abortion. CONCLUSIONS The women's accounts illustrate the different meanings of abortion in women's lives, with concomitant need for diverse support, advice, and information.
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Affiliation(s)
- Maggie Kirkman
- Jean Hailes Research Unit, School of Public Health and Preventive Medicine, Monash University, 553 St Kilda Road, Melbourne, 3004 Australia
- Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Australia
| | - Carmel Apicella
- Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Australia
| | - Jillian Graham
- Jean Hailes Research Unit, School of Public Health and Preventive Medicine, Monash University, 553 St Kilda Road, Melbourne, 3004 Australia
| | - Martha Hickey
- School of Medicine, The University of Melbourne, Melbourne, Australia
| | - John L. Hopper
- Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Australia
| | - Louise Keogh
- Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Australia
| | - Ingrid Winship
- School of Medicine, The University of Melbourne, Melbourne, Australia
| | - Jane Fisher
- Jean Hailes Research Unit, School of Public Health and Preventive Medicine, Monash University, 553 St Kilda Road, Melbourne, 3004 Australia
- Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Australia
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45
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Pereira J, Pires R, Canavarro MC. Psychosocial adjustment after induced abortion and its explanatory factors among adolescent and adult women. J Reprod Infant Psychol 2017. [PMID: 29517360 DOI: 10.1080/02646838.2016.1276281] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
OBJECTIVE To compare the depressive symptoms and quality of life (QoL) among adolescents (<20 years) and adult women who have had an abortion and to explore individual, social, relational and decision-making explanatory factors for (mal)adjustment in each group. BACKGROUND International findings are not consistent regarding the presence of negative psychosocial outcomes after abortion or about the explanatory factors for occurrence among adolescents and adult women. METHODS In this cross-sectional study, 177 adolescents (65.1%) and 95 adult women (34.9%) who underwent abortion were recruited. Data on individual, social, relational and decision-making characteristics, depressive symptoms (Edinburgh Postnatal Depression Scale) and QoL (EUROHIS-QOL-8) were collected through self-report questionnaires at 16 healthcare services that provide abortion. RESULTS Although adolescents are not at greater risk of maladjustment than adult women, abortion may be an emotionally significant event for both age groups. Regarding adolescents, feelings of being pressured into abortion and lower satisfaction with the abortion decision were significantly associated with depressive symptoms and lower QoL. Lower support from the mother was also associated with lower QoL. With regard to adult women, lower satisfaction with the abortion decision was significantly associated with depressive symptoms. None of variables was significantly associated with QoL. CONCLUSION Our results suggest that adolescents are not at greater risk of psychosocial maladjustment than are adult women. Factors from different ecological contexts and specific factors depending on age group should be considered in preventive interventions for (mal)adjustment after abortion.
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Affiliation(s)
- Joana Pereira
- a Faculty of Psychology and Educational Sciences , University of Coimbra , Coimbra , Portugal.,b Psychological Intervention Unit of the Maternity Daniel de Matos , Centro Hospitalar e Universitário de Coimbra, EPE , Coimbra , Portugal
| | - Raquel Pires
- a Faculty of Psychology and Educational Sciences , University of Coimbra , Coimbra , Portugal.,c School of Psychology and Life Sciences , Lusófona University of Humanities and Technology , Lisbon , Portugal
| | - Maria Cristina Canavarro
- a Faculty of Psychology and Educational Sciences , University of Coimbra , Coimbra , Portugal.,b Psychological Intervention Unit of the Maternity Daniel de Matos , Centro Hospitalar e Universitário de Coimbra, EPE , Coimbra , Portugal
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46
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Ambriz-López R, Guerrero-González G, Rodríguez-Valero C, Treviño-Montemayor O, Guzmán-López A, Saldívar-Rodríguez D. Evaluation of symptoms of anxiety and depression in patients with a miscarriage. MEDICINA UNIVERSITARIA 2017. [DOI: 10.1016/j.rmu.2017.02.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Huang Z, Hao J, Su P, Huang K, Xing X, Cheng D, Xiao L, Xu Y, Zhu X, Tao F. The Impact of Prior Abortion on Anxiety and Depression Symptoms During a Subsequent Pregnancy: Data From a Population-Based Cohort Study in China. ACTA ACUST UNITED AC 2016. [DOI: 10.5455/bcp.20111102040509] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Affiliation(s)
- Zhaohui Huang
- Anhui Provincial Key Laboratory of Population Health & Aristogenics, Anhui, China
- Department of Maternal, Child & Adolescent Health, School of Public Health, Anhui Medical University, Hefei 230032, China
- Shaoxing Center for Disease Control and Prevention, Shaoxing 312071, Zhejiang Province, China
| | - Jiahu Hao
- Anhui Provincial Key Laboratory of Population Health & Aristogenics, Anhui, China
- Department of Maternal, Child & Adolescent Health, School of Public Health, Anhui Medical University, Hefei 230032, China
- Shaoxing Center for Disease Control and Prevention, Shaoxing 312071, Zhejiang Province, China
| | - Puyu Su
- Anhui Provincial Key Laboratory of Population Health & Aristogenics, Anhui, China
- Department of Maternal, Child & Adolescent Health, School of Public Health, Anhui Medical University, Hefei 230032, China
| | - Kun Huang
- Anhui Provincial Key Laboratory of Population Health & Aristogenics, Anhui, China
- Department of Maternal, Child & Adolescent Health, School of Public Health, Anhui Medical University, Hefei 230032, China
| | - Xiuya Xing
- Anhui Provincial Key Laboratory of Population Health & Aristogenics, Anhui, China
- Department of Maternal, Child & Adolescent Health, School of Public Health, Anhui Medical University, Hefei 230032, China
| | - Daijuan Cheng
- Anhui Provincial Key Laboratory of Population Health & Aristogenics, Anhui, China
- Department of Maternal, Child & Adolescent Health, School of Public Health, Anhui Medical University, Hefei 230032, China
| | - Limin Xiao
- Anhui Provincial Key Laboratory of Population Health & Aristogenics, Anhui, China
- Department of Maternal, Child & Adolescent Health, School of Public Health, Anhui Medical University, Hefei 230032, China
| | - Yuanyuan Xu
- Anhui Provincial Key Laboratory of Population Health & Aristogenics, Anhui, China
- Department of Maternal, Child & Adolescent Health, School of Public Health, Anhui Medical University, Hefei 230032, China
| | - Xiaoming Zhu
- Anhui Provincial Key Laboratory of Population Health & Aristogenics, Anhui, China
- Department of Maternal, Child & Adolescent Health, School of Public Health, Anhui Medical University, Hefei 230032, China
| | - Fangbiao Tao
- Anhui Provincial Key Laboratory of Population Health & Aristogenics, Anhui, China
- Department of Maternal, Child & Adolescent Health, School of Public Health, Anhui Medical University, Hefei 230032, China
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Christiansen DM. Posttraumatic stress disorder in parents following infant death: A systematic review. Clin Psychol Rev 2016; 51:60-74. [PMID: 27838460 DOI: 10.1016/j.cpr.2016.10.007] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2016] [Revised: 10/24/2016] [Accepted: 10/24/2016] [Indexed: 11/19/2022]
Abstract
Parents who have lost an infant prior to, during, or following birth often interpret the event as highly traumatic. The present systematic review included 46 articles based on 31 different studies of posttraumatic stress disorder (PTSD) in parents bereaved by infant death. The PTSD prevalence in mothers differed widely across studies with estimated rates at 0.6-39%. PTSD in fathers following infant loss has been less extensively studied but PTSD levels were generally much lower than in mothers with reported prevalence rates at 0-15.6% across studies. PTSD symptoms were not found to differ much depending on whether the death occurred prior to, during, or following birth and nor was gestational age consistently associated with PTSD severity. A number of risk and protective factors have been found to be associated with PTSD severity. Relevant focus areas for future research are presented along with considerations for future pregnancies and children. The suffering associated with PTSD following infant loss is overwhelming because of the rates at which such losses occur around the world. For this reason, it is problematic that not all types of infant loss resulting in sufficient symptoms of re-experiencing, avoidance, and arousal can elicit a DSM-5 PTSD diagnosis.
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Affiliation(s)
- Dorte M Christiansen
- Institute of Psychology, Aarhus University, Bartholins Allé 9, 8000 Aarhus C, Denmark; National Center for Psychotraumatology, Institute of Psychology, University of Southern Denmark, Campusvej 55, 5230 Odense M, Denmark.
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Holmlund S, Kauko T, Matomäki J, Tuominen M, Mäkinen J, Rautava P. Induced abortion - impact on a subsequent pregnancy in first-time mothers: a registry-based study. BMC Pregnancy Childbirth 2016; 16:325. [PMID: 27776483 PMCID: PMC5078979 DOI: 10.1186/s12884-016-1109-3] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2016] [Accepted: 10/11/2016] [Indexed: 12/03/2022] Open
Abstract
Background To date, several studies concerning the effects of induced abortion (IA) on women’s later psychosocial well-being and future delivery complications have been published. However, the lack of reports on woman’s physical well-being during their first full-term pregnancy occurring after IA is what inspired the current study. Here, we evaluate the physical well-being and use of maternity services of first-time mothers with a history of IA. Methods Finnish National Birth Registry data from 2008 to 2010 were linked with the Induced Abortion Registry data from 1983 to 2007. After excluding first-time mothers with a history of miscarriage, ectopic pregnancy or delivery, 57,406 mothers were eligible for the study, with 5,167 (9.0 %) having experienced prior IA. Data from the pregnancy follow-up visits were evaluated and compared between IA mothers and primiparous mothers. Results Women with IA had higher rates of smoking after the first trimester and were more likely to be overweight (body mass index >25 kg/m2) than the control group mothers. A higher use of maternity health clinic (MHC) services, thrombosis prophylaxis and participation in a second trimester ultrasound and amniotic fluid sample testing were evident in IA mothers, whereas the likelihood of assisted fertilisation procedure(s) was elevated in the control group. A shorter interpregnancy interval (IPI) seemed to contribute to a late first MHC visit and first trimester serum screening test participation, a higher incidence of placenta samples and an increased presence of preeclampsia and maternal care for poor foetal growth. Conclusions IA is associated with being overweight before the subsequent pregnancy and with smoking after the first trimester. More frequent pregnancy follow-up visits in the IA group may be due to greater participation in the placenta sample testing and use of thrombosis prophylaxis. No association between IA and preeclampsia, hypertension, gestational diabetes or preterm premature rupture of membranes was evident in the pregnancy parameters. According to our findings, experiencing IA decreased the need for fertilisation procedures before the next pregnancy when compared to primiparous mothers. Among the IA mothers, the short IPI seemed to contribute to the higher risk for preeclampsia and maternal care for poor foetal growth. However, more research is needed around the IPI before establishing its effect on later pregnancy.
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Affiliation(s)
- Susanna Holmlund
- Department of Public Health, University of Turku, 20014, Turun yliopisto, Finland. .,Säkylä Main Health Centre, Säkylä, Finland. .,Department of Obstetrics and Gynecology, University of Turku, Turku, Finland.
| | - Tommi Kauko
- Turku Clinical Research Centre, Turku University Hospital, Turku, Finland
| | - Jaakko Matomäki
- Department of Biostatistics, University of Turku, Turku, Finland
| | - Miia Tuominen
- Department of Public Health, University of Turku, 20014, Turun yliopisto, Finland.,Health Care Faculty, Turku University of Applied Sciences, Turku, Finland
| | - Juha Mäkinen
- Department of Obstetrics and Gynecology, University of Turku, Turku, Finland.,Department of Obstetrics and Gynecology, Turku University Hospital, Turku, Finland
| | - Päivi Rautava
- Department of Public Health, University of Turku, 20014, Turun yliopisto, Finland.,Turku Clinical Research Centre, Turku University Hospital, Turku, Finland
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Toffol E, Pohjoranta E, Suhonen S, Hurskainen R, Partonen T, Mentula M, Heikinheimo O. Anxiety and quality of life after first-trimester termination of pregnancy: a prospective study. Acta Obstet Gynecol Scand 2016; 95:1171-80. [PMID: 27500660 DOI: 10.1111/aogs.12959] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2016] [Accepted: 07/31/2016] [Indexed: 11/27/2022]
Abstract
INTRODUCTION Possible effects of termination of pregnancy (TOP) on mental health are a matter of debate. MATERIAL AND METHODS We assessed anxiety and quality of life during a one-year follow up after first-trimester TOP using the State-Trait Anxiety Inventory (STAI) Scale and EuroQoL Quality of Life Questionnaire (EQ-5D, EQ-VAS) in 742 women participating in a randomized controlled trial on early provision of intrauterine contraception. The measurements were performed before TOP, at 3 months and 1 year after TOP. Inclusion criteria were age ≥18 years, residence in Helsinki, duration of gestation <12 weeks, non-medical indication for TOP, and approval of intrauterine contraception. The trial was registered with Clinical Trials [NCT01223521]. RESULTS When compared with baseline, the overall anxiety level was significantly lower and quality of life higher at 3 months and at 1 year. Reduction of anxiety and improvement of quality of life was especially evident (p < 0.001) in the 58% of women reporting clinically relevant anxiety at baseline. High levels of anxiety at baseline, history of psychiatric morbidity and smoking predicted significantly greater risk of poorer quality of life and elevated level of anxiety during the follow up. CONCLUSIONS TOP is associated with a significant overall reduction of anxiety and an improvement of quality of life among women undergoing it for non-medical indications. High baseline anxiety, history of psychiatric morbidity and smoking are risk factors of persistently high levels of anxiety and poor quality of life after an induced abortion. These data are important when designing and providing post-abortion care.
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Affiliation(s)
- Elena Toffol
- Department of Health, National Institute for Health and Welfare, Helsinki, Finland
| | - Elina Pohjoranta
- Department of Obstetrics and Gynecology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Satu Suhonen
- Department of Social Services and Health Care, Centralized Family Planning, Helsinki, Finland
| | - Ritva Hurskainen
- Department of Obstetrics and Gynecology, Hyvinkää Hospital, Hyvinkää, Finland
| | - Timo Partonen
- Department of Health, National Institute for Health and Welfare, Helsinki, Finland
| | - Maarit Mentula
- Department of Obstetrics and Gynecology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Oskari Heikinheimo
- Department of Obstetrics and Gynecology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
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