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Costa B, Vale N. Advances in Psychotropic Treatment for Pregnant Women: Efficacy, Adverse Outcomes, and Therapeutic Monitoring. J Clin Med 2024; 13:4398. [PMID: 39124665 PMCID: PMC11312735 DOI: 10.3390/jcm13154398] [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: 05/27/2024] [Revised: 07/17/2024] [Accepted: 07/25/2024] [Indexed: 08/12/2024] Open
Abstract
Advancements in psychotropic therapy for pregnant women are pivotal for addressing maternal mental health during the perinatal period. Screening for mood and anxiety symptoms during pregnancy is recommended to enable early intervention. Psychotropic medications, including antidepressants, benzodiazepines, antipsychotics, and mood stabilizers, are commonly used, but challenges remain regarding their safety and efficacy during pregnancy. Pregnancy induces significant changes in pharmacokinetics, necessitating personalized dosing strategies and careful monitoring. Real-time monitoring technologies, such as smartphone-integrated platforms and home-based monitoring, enhance accessibility and accuracy. Prospective studies and collaboration among healthcare providers are essential for evidence-based guidelines and optimal treatment strategies. Reducing stigma around mental health during pregnancy is crucial to ensure women seek help and discuss treatment options, promoting understanding and acceptance within the community.
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Affiliation(s)
- Bárbara Costa
- PerMed Research Group, Center for Health Technology and Services Research (CINTESIS), Rua Doutor Plácido da Costa, 4200-450 Porto, Portugal;
- CINTESIS@RISE, Faculty of Medicine, University of Porto, Alameda Professor Hernâni Monteiro, 4200-319 Porto, Portugal
- Department of Community Medicine, Health Information and Decision (MEDCIDS), Faculty of Medicine, University of Porto, Alameda Professor Hernâni Monteiro, 4200-319 Porto, Portugal
- Centre for Parasite Biology and Immunology, Department of Infectious Diseases, National Health Institute Dr. Ricardo Jorge, Rua Alexandre Herculano 321, 4000-055 Porto, Portugal
| | - Nuno Vale
- PerMed Research Group, Center for Health Technology and Services Research (CINTESIS), Rua Doutor Plácido da Costa, 4200-450 Porto, Portugal;
- CINTESIS@RISE, Faculty of Medicine, University of Porto, Alameda Professor Hernâni Monteiro, 4200-319 Porto, Portugal
- Department of Community Medicine, Health Information and Decision (MEDCIDS), Faculty of Medicine, University of Porto, Alameda Professor Hernâni Monteiro, 4200-319 Porto, Portugal
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Aujla S, Sandeep M, Aparnavi P, Padhi BK, Shamim MA, Sahoo S, Gangane N, Gandhi AP. Effect of maternal obsessive-compulsive disorder (OCD) on feto-maternal outcomes: A systematic review and meta-analysis. Int J Gynaecol Obstet 2024. [PMID: 39007439 DOI: 10.1002/ijgo.15792] [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: 06/05/2024] [Accepted: 06/29/2024] [Indexed: 07/16/2024]
Abstract
BACKGROUND Mental health disorders in pregnant women have been related to unfavorable obstetric and neonatal outcomes. Obsessive-compulsive disorder (OCD) significantly distresses mothers and affects the maternal-infant bond. OBJECTIVES The present meta-analysis and systematic review aimed to assess the association of maternal OCD with adverse feto-maternal outcomes. SEARCH STRATEGY A systematic search was undertaken in the five databases-Cochrane, Embase, ProQuest, Web of Science, and PubMed-on September 5, 2023. SELECTION CRITERIA Studies that included pregnant women with OCD in whom the feto-maternal outcomes were reported were included in the systematic review. DATA COLLECTION AND ANALYSIS Two pass screening ("title-abstract screening" followed by "full-text review"), and data extraction by two authors independently using the Nested-Knowledge Auto living semi-automated systematic review platform was carried out. The decision for selected studies was reviewed by a third author. Of the 360 studies identified, eight were included for the meta-analysis. Meta-analysis was conducted using R software. MAIN RESULTS Of the 24 maternal and neonatal adverse outcomes assessed, 11 were found to be associated with maternal OCD, notably pre-eclampsia (odds ratio [OR] 1.37, 95% confidence interval [CI] 1.19-1.57), antepartum hemorrhage or placental abruption (OR 1.32, 95% CI 1.13-1.54), postpartum hemporrhage (OR 1.19, 95% CI 1.08-1.31), cesarean section delivery (OR 1.32, 95% CI 1.23-1.41), emergency cesarean section (OR 1.22, 95% CI 1.15-1.30), preterm birth (OR 1.41, 95% CI 1.21-1.64), low birth weight (OR 1.41, 95% CI 1.28-1.54), low Apgar score at 5 min (OR 2.37, 95% CI 1.32-4.27), neonatal hypoglycemia (OR 1.37, 95% CI 1.23-1.53), neonatal respiratory distress (OR 1.77, 95% CI 1.44-2.16), and major congenital malformations (OR 1.37, 95% CI 1.08-1.74). CONCLUSION OCD in pregnant women might be associated with multiple adverse feto-maternal outcomes.
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Affiliation(s)
| | | | - Periasamy Aparnavi
- Department of Community Medicine, KMCH Institute of Health Sciences and Research, Coimbatore, India
| | - Bijaya Kumar Padhi
- Department of Community Medicine and School of Public Health, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | | | - Swapnajeet Sahoo
- Department of Psychiatry, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Neha Gangane
- Department of Obstetrics and Gynecology, All India Institute of Medical Sciences, Nagpur, India
| | - Aravind P Gandhi
- Department of Community Medicine, All India Institute of Medical Sciences, Nagpur, India
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Staines L, Dooley N, Healy C, Kelleher I, Cotter D, Cannon M. Examining the association between prenatal and perinatal adversity and the psychotic experiences in childhood. Psychol Med 2024; 54:2087-2098. [PMID: 38433592 DOI: 10.1017/s0033291724000187] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/05/2024]
Abstract
BACKGROUND Prenatal and perinatal complications are established risk factors for psychotic disorder, but far less is known about these measures and psychotic experiences (PEs). We investigated the longitudinal effect of prenatal risk factors (maternal behavior, medication complications) and perinatal risk factors (birth weight, medical complications) on frequency of PEs. We also examined the cumulative risk of prenatal/perinatal risk factors, and differences between transient PE, persistent PE, and controls. METHODS The Adolescent Brain Cognitive Development study is a large child cohort (age 9-10 at baseline; n = 11 872 with PE data). PEs were measured longitudinally using the Prodromal Questionnaire-Brief, Child version, and included only if reported as distressing. Mixed-effects models were used for analysis, controlling for random effects, and a substantial number of fixed-effects covariates. RESULTS Urinary tract infection (β = 0.11, 95% confidence interval [CI] 0.03-0.19) and severe anemia (β = 0.18, 95% CI 0.07-0.29) increased frequency of distressing PEs in childhood. Number of prenatal complications increased frequency of PEs (β = 0.03, 95% CI 0.01-0.06) and risk of persistent PEs (odds ratio [OR] = 1.08, 95% CI 1.01-1.15). Maternal smoking was associated with an increased frequency of PEs (β = 0.11, 95% CI 0.04-0.18) and persistent PEs (OR = 1.31, 95% CI 1.04-1.66). Maternal substance use was a risk factor for a 48% increased risk of persistent PEs (OR = 1.48, 95% CI 1.08-2.01). Perinatal complications showed no effect on PEs. CONCLUSIONS This study provides evidence that certain prenatal medical complications (severe nausea, severe anemia), cumulative number of prenatal medical complications, and maternal behaviors (smoking during pregnancy), increased frequency of distressing PEs in childhood. Maternal smoking and substance use, as well as cumulative number of prenatal complications increased risk of persistent PEs.
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Affiliation(s)
- Lorna Staines
- Department of Psychiatry, Royal College of Surgeons in Ireland, Dublin 2, Ireland
| | - Niamh Dooley
- Department of Psychiatry, Royal College of Surgeons in Ireland, Dublin 2, Ireland
| | - Colm Healy
- Department of Psychiatry, Royal College of Surgeons in Ireland, Dublin 2, Ireland
| | - Ian Kelleher
- Department of Psychiatry, Royal College of Surgeons in Ireland, Dublin 2, Ireland
- Division of Psychiatry, Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh EH10 5HF, UK
| | - David Cotter
- Department of Psychiatry, Royal College of Surgeons in Ireland, Dublin 2, Ireland
- Department of Psychiatry, Beaumont Hospital, Dublin 9, Ireland
| | - Mary Cannon
- Department of Psychiatry, Royal College of Surgeons in Ireland, Dublin 2, Ireland
- Department of Psychiatry, Beaumont Hospital, Dublin 9, Ireland
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Chhabria K, Selvaraj S, Refuerzo J, Truong C, Cazaban CG. Investigating the association between metabolic syndrome conditions and perinatal mental illness: a national administrative claims study. BMC Pregnancy Childbirth 2024; 24:409. [PMID: 38849738 PMCID: PMC11157911 DOI: 10.1186/s12884-024-06542-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2023] [Accepted: 04/25/2024] [Indexed: 06/09/2024] Open
Abstract
BACKGROUND Although the association between mental disorder and metabolic syndrome as a bidirectional relationship has been demonstrated, there is little knowledge of the cumulative and individual effect of these conditions on peripartum mental health. This study aims to investigate the association between metabolic syndrome conditions (MetS-C) and maternal mental illness in the perinatal period, while exploring time to incident mental disorder diagnosis in postpartum women. METHODS This observational study identified perinatal women continuously enrolled 1 year prior to and 1 year post-delivery using Optum's de-identified Clinformatics® Data Mart Database (CDM) from 2014 to 2019 with MetS-C i.e. obesity, diabetes, high blood pressure, high triglycerides, or low HDL (1-year prior to delivery); perinatal comorbidities (9-months prior to and 4-month postpartum); and mental disorder (1-year prior to and 1-year post-delivery). Additionally, demographics and the number of days until mental disorder diagnosis were evaluated in this cohort. The analysis included descriptive statistics and multivariable logistic regression. MetS-C, perinatal comorbidities, and mental disorder were assessed using the International Classification of Diseases, Ninth, and Tenth Revision diagnosis codes. RESULTS 372,895 deliveries met inclusion/exclusion criteria. The prevalence of MetS-C was 13.43%. Multivariable logistic regression revealed prenatal prevalence (1.64, CI = 1.59-1.70) and postpartum incident (1.30, CI = 1.25-1.34) diagnosis of mental health disorder were significantly higher in those with at least one MetS-C. Further, the adjusted odds of having postpartum incident mental illness were 1.51 times higher (CI = 1.39-1.66) in those with 2 MetS-C and 2.12 times higher (CI = 1.21-4.01) in those with 3 or more MetS-C. Young women (under the age of 18 years) were more likely to have an incident mental health diagnosis as opposed to other age groups. Lastly, time from hospital discharge to incident mental disorder diagnosis revealed an average of 157 days (SD = 103 days). CONCLUSION The risk of mental disorder (both prenatal and incident) has a significant association with MetS-C. An incremental relationship between incident mental illness diagnosis and the number of MetS-C, a significant association with younger mothers along with a relatively long period of diagnosis mental illness highlights the need for more screening and treatment during pregnancy and postpartum.
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Affiliation(s)
- Karishma Chhabria
- Division of Management Policy and Community Health, Center for Healthcare Data Research, The University of Texas Health Science Center at Houston School of Public Health, Houston, TX, USA.
- Department of Public Health, Usha Kundu MD College of Health, University of West Florida 11000 University Pkwy, Pensacola, FL, 32514, USA.
| | - Sudhakar Selvaraj
- Louis Faillace, MD, Department of Psychiatry and Behavioral Sciences, University of Texas Health Science Center at Houston, McGovern Medical School, Houston, TX, USA
- Clinical Development, Intra-Cellular Therapies, Inc., 430 East 29th Street, New York, NY, United States
| | - Jerrie Refuerzo
- Division of Maternal-Fetal Medicine, Department of Obstetrics, Gynecology, and Reproductive Sciences, McGovern Medical School, University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Chau Truong
- Division of Management Policy and Community Health, Center for Healthcare Data Research, The University of Texas Health Science Center at Houston School of Public Health, Houston, TX, USA
| | - Cecilia Ganduglia Cazaban
- Division of Management Policy and Community Health, Center for Healthcare Data Research, The University of Texas Health Science Center at Houston School of Public Health, Houston, TX, USA
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Dadi AF, He V, Brown K, Hazell-Raine K, Reilly N, Giallo R, Rae KM, Hazell P, Guthridge S. Association between maternal mental health-related hospitalisation in the 5 years prior to or during pregnancy and adverse birth outcomes: a population-based retrospective cohort data linkage study in the Northern Territory of Australia. THE LANCET REGIONAL HEALTH. WESTERN PACIFIC 2024; 46:101063. [PMID: 38659431 PMCID: PMC11040136 DOI: 10.1016/j.lanwpc.2024.101063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/30/2023] [Revised: 02/13/2024] [Accepted: 03/27/2024] [Indexed: 04/26/2024]
Abstract
Background Mental health conditions prior to or during pregnancy that are not addressed can have adverse consequences for pregnancy and birth outcomes. This study aimed to determine the extent to which women's mental health-related hospitalisation (MHrH) prior to or during pregnancy was associated with a risk of adverse birth outcomes. Methods We linked the perinatal data register for all births in the Northern Territory, Australia, from the year 1999 to 2017, to hospital admissions records to create a cohort of births to women aged 15-44 years with and without MHrH prior to or during pregnancy. We used Modified Poisson Regression and Latent Class Analysis to assess the association between maternal MHrH and adverse birth outcomes (i.e., stillbirth, preterm birth, low birth weight, and short birth length). We explored a mediation effect of covariates on theoretical causal paths. We calculated the adjusted Population Attributable Fraction (PAF) and Preventive Fractions for the Population (PFP) for valid associations. Findings From 72,518 births, 70,425 births (36.4% for Aboriginal women) were included in the analysis. The Latent Class Analys identified two classes: high (membership probability of 10.5%) and low adverse birth outcomes. Births to Aboriginal women with MHrH were around two times more likely to be in the class of high adverse birth outcomes. MHrH prior to or during pregnancy increased the risk of all adverse birth outcomes in both populations with risk ranging from 1.19 (95% CI: 1.05, 1.35) to 7.89 (1.17, 53.37). Eight or more antenatal care visits and intrauterine growth restriction mostly played a significant mediation role between maternal MHrH and adverse birth outcomes with mediation effects ranging from 1.04 (1.01, 1.08) to 1.39 (1.14, 1.69). MHrH had a low to high population impact with a PAF ranging from 16.1% (5.1%, 25.7%) to 87.3% (14.3%, 98.1%). Eight or above antenatal care visits avert extra adverse birth outcomes that range from 723 (332-765) stillbirths to 3003 (1972-4434) preterm births. Interpretation Maternal MHrH is a modifiable risk factor that explained a low to moderate risk of adverse birth outcomes in the Northern Territory. The knowledge highlights the need for the development and implementation of preconception mental health care into routine health services. Funding The Child and Youth Development Research Partnership (CYDRP) data repository is supported by a grant from the Northern Territory Government.
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Affiliation(s)
- Abel Fekadu Dadi
- Menzies School of Health Research, Charles Darwin University, Darwin, Australia
- Addis Continental Institute of Public Health, Addis Ababa, Ethiopia
| | - Vincent He
- Menzies School of Health Research, Charles Darwin University, Darwin, Australia
| | - Kiarna Brown
- Menzies School of Health Research, Charles Darwin University, Darwin, Australia
- Royal Darwin Hospital, Tiwi, NT 0810, Australia
| | - Karen Hazell-Raine
- Faculty of Health, Charles Darwin University, Darwin, Australia
- Faculty of Medicine and Health, The University of Sydney, Australia
| | - Nicole Reilly
- Discipline of Psychiatry and Mental Health, School of Clinical Medicine, UNSW Sydney and St John of God Burwood Hospital, Sydney, Australia
- Faculty of Science, Medicine and Health, Graduate School of Medicine, University of Wollongong, Australia
| | - Rebecca Giallo
- Faculty of Health, School of Psychology, Deakin University, Geelong, VIC, Australia
| | - Kym M. Rae
- Mater Research Institute, Aubigny Place, Raymond Terrace, South Brisbane, QLD, Australia
| | - Philip Hazell
- School of Medicine, Charles Darwin University, Australia
- School of Medicine, The University of Sydney, Australia
| | - Steven Guthridge
- Menzies School of Health Research, Charles Darwin University, Darwin, Australia
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Schonewille NN, Jonkman NH, van Kempen AAMW, van Pampus MG, van den Heuvel OA, Broekman BFP. Pregnancy intention in relation to maternal and neonatal outcomes in women with versus without psychiatric diagnoses. Acta Psychiatr Scand 2024; 149:110-123. [PMID: 37933529 DOI: 10.1111/acps.13625] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2023] [Revised: 10/04/2023] [Accepted: 10/08/2023] [Indexed: 11/08/2023]
Abstract
BACKGROUND Studies have identified adverse maternal and neonatal outcomes for women with psychiatric disorders. Additionally, psychiatric disorders may pose an increased risk for unintended pregnancies (UPs) which in turn may also impact negatively on outcomes. The present study aims to compare the incidence of UPs in women with versus without current/past psychiatric diagnoses and investigates whether psychiatric history modifies the relation between delivery outcomes in women with and without UPs. METHODS A retrospective cohort was compiled of women who gave birth in a large hospital in Amsterdam, the Netherlands. Women ≥18 years old with singleton pregnancies and birth registrations in the electronic patient file during January 1, 2015 to March 1, 2020 were included. Patient characteristics (including pregnancy intention and psychiatric history), maternal (gestational diabetes, mode of delivery) and neonatal outcomes (e.g., gestational age [GA], birthweight and Apgar scores) were registered by health care providers in hospital charts. Incidence of UPs was compared between women with versus without current/past psychiatric diagnoses. Maternal and neonatal outcomes were compared between women with versus without UPs with linear or logistic regression models adjusted for relevant confounders with an interaction term for UP with current/past psychiatric diagnoses. RESULTS We included 1219 women with and 1093 women without current/past psychiatric diagnoses. Current/past psychiatric diagnoses were significantly associated with UPs after adjustment for confounders (39.0% vs. 29.6%, OR 1.56, CI 1.23-2.00, p < 0.001). In sub-analyses, women with depressive (OR 1.67, CI 1.24-2.26, p = 0.001), personality (OR 2.64, CI 1.38-5.11, p = 0.004) and substance-related and addictive disorders (OR 4.29, CI 1.90-10.03, p = 0.001) had higher odds of UPs compared to women without current/past psychiatric diagnoses. Amongst women with UPs, current/past psychiatric diagnoses did not modify maternal or neonatal outcomes, except for GA at delivery as women with both UPs and current/past psychiatric diagnosis had a 2.21-day higher mean GA at delivery than women in the reference group (p-value interaction = 0.001). CONCLUSIONS Current/past psychiatric diagnoses are associated with a higher odd of UPs. In our sample, maternal and neonatal outcomes were comparable for women with and without UPs and these results were similar for women with and without current/past psychiatric diagnoses, except for GA at delivery. Although our study is limited by several factors, we found that women with current/past psychiatric diagnoses, irrespective of pregnancy planning status, do not have more adverse maternal or pregnancy outcomes. Increased efforts are needed to ensure that psychoeducation and conversations about pregnancy planning and UPs are available for women with current/past psychiatric diagnoses.
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Affiliation(s)
- Noralie N Schonewille
- Department of Psychiatry and Medical Psychology, OLVG, Amsterdam, The Netherlands
- Department of Psychiatry, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Mental Health Program, Amsterdam Public Health, Amsterdam, The Netherlands
| | - Nini H Jonkman
- Department of Research and Epidemiology, OLVG, Amsterdam, The Netherlands
| | | | - Maria G van Pampus
- Department of Gynaecology and Obstetrics, OLVG, Amsterdam, The Netherlands
| | - Odile A van den Heuvel
- Department of Psychiatry, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Department of Anatomy & Neuroscience, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Compulsivity, Impulsivity & Attention Program, Amsterdam Neuroscience, Amsterdam, The Netherlands
| | - Birit F P Broekman
- Department of Psychiatry and Medical Psychology, OLVG, Amsterdam, The Netherlands
- Department of Psychiatry, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Mental Health Program, Amsterdam Public Health, Amsterdam, The Netherlands
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Bodunde EO, Buckley D, O'Neill E, Maher GM, Matvienko-Sikar K, O'Connor K, McCarthy FP, Khashan AS. Pregnancy and birth complications associations with long-term adverse maternal mental health outcomes: a systematic review and meta-analysis protocol. HRB Open Res 2023; 6:3. [PMID: 37954095 PMCID: PMC10636347 DOI: 10.12688/hrbopenres.13660.3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/17/2023] [Indexed: 11/14/2023] Open
Abstract
Background Existing studies have established an association between pregnancy, birth complications, and mental health in the first few weeks postpartum. However, there is no clear understanding of whether pregnancy and birth complications increase the risk of adverse maternal mental outcomes in the longer term. Research on maternal adverse mental health outcomes following pregnancy and birth complications beyond 12 months postpartum is scarce, and findings are inconsistent. Objective This systematic review and meta-analysis will examine the available evidence on the association between pregnancy and birth complications and long-term adverse maternal mental health outcomes. Methods and analysis We will include cohort, cross-sectional, and case-control studies in which a diagnosis of pregnancy and/or birth complication (preeclampsia, pregnancy loss, caesarean section, preterm birth, perineal laceration, neonatal intensive care unit admission, major obstetric haemorrhage, and birth injury/trauma) was reported and maternal mental disorders (depression, anxiety disorders, bipolar disorders, psychosis, and schizophrenia) after 12 months postpartum were the outcomes. A systematic search of PubMed, Embase, CINAHL, PsycINFO, and Web of Science will be conducted following a detailed search strategy until August 2022. Three authors will independently review titles and abstracts of all eligible studies, extract data using pre-defined standardised data extraction and assess the quality of each study using the Newcastle-Ottawa Scale. We will use random-effects meta-analysis for each exposure and outcome variable to calculate overall pooled estimates using the generic inverse variance method. This systematic review will follow the Preferred Reporting Items for Systematic reviews and Meta-Analyses guidelines. Ethical consideration The proposed systematic review and meta-analysis is based on published data; ethics approval is not required. The results will be presented at scientific meetings and publish in a peer-reviewed journal. PROSPERO registration CRD42022359017.
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Affiliation(s)
- Elizabeth O Bodunde
- School of Public Health, University College Cork, Cork, Ireland
- INFANT Research Centre, University College Cork, Cork, Ireland
| | - Daire Buckley
- INFANT Research Centre, University College Cork, Cork, Ireland
| | - Eimear O'Neill
- Perinatal Mental Health, AMHS and CAMHS, University College Cork, Cork, Ireland
| | - Gillian M. Maher
- School of Public Health, University College Cork, Cork, Ireland
- INFANT Research Centre, University College Cork, Cork, Ireland
| | | | - Karen O'Connor
- RISE, Early Intervention in Psychosis Team, South Lee Mental Health Services, Cork, Ireland
- Department of Psychiatry and Neurobehavioral Science, University College Cork, Cork, Ireland
| | - Fergus P. McCarthy
- INFANT Research Centre, University College Cork, Cork, Ireland
- Department of Obstetrics and Gynaecology, Cork University Maternity Hospital, Cork, Ireland
| | - Ali S. Khashan
- School of Public Health, University College Cork, Cork, Ireland
- INFANT Research Centre, University College Cork, Cork, Ireland
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Tung KTS, Wong RS, Mak RTW. Maternal n-3 PUFA Intake During Pregnancy and Perinatal Mental Health Problems: A Systematic Review of Recent Evidence. Curr Nutr Rep 2023; 12:426-438. [PMID: 37322309 DOI: 10.1007/s13668-023-00484-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] [Accepted: 05/24/2023] [Indexed: 06/17/2023]
Abstract
PURPOSE OF REVIEW Pregnant women are vulnerable to mental health problems. Increasing evidence shows that omega-3 polyunsaturated fatty acid (n-3 PUFA) intake during pregnancy is beneficial to maternal perinatal mental health. A systematic review is needed to examine the associations reported in recent studies. The objective of this review was to provide an updated review on the association of antenatal n-3 PUFA intake via different sources (seafood, fish, overall diet, and supplementation) with perinatal mental health problems including depression, anxiety, and psychological distress. RECENT FINDINGS Searches were performed in Web of Science, Embase, PubMed, and APA PsycInfo databases on 21 June 2021. A total of 2133 records were screened. Data including the name of the first author, publication year, study design, sample characteristics, dietary assessment time and tools, mental health outcome measures, and other relevant information were extracted. In total, 13 articles were included in this review and assessed qualitatively. The results demonstrated that dietary intake of n-3 PUFA during pregnancy was associated with perinatal mental health, but the effect of n-3 PUFA supplementation was influenced by pre-existing medical conditions, socio-demographic characteristics, and dietary and lifestyle patterns during pregnancy. Our review found that sources of n-3 PUFA may have differential effects on woman's mental health during and after pregnancy. Further research using large-size cohort or well-controlled trial protocol is needed to determine the effect of n-3 PUFA supplementation during pregnancy on perinatal mental health.
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Affiliation(s)
- Keith T S Tung
- Department of Paediatrics and Adolescent Medicine, The University of Hong Kong, Hong Kong SAR, China
| | - Rosa S Wong
- Department of Paediatrics and Adolescent Medicine, The University of Hong Kong, Hong Kong SAR, China.
- Department of Pharmacology and Pharmacy, The University of Hong Kong, Hong Kong SAR, China.
| | - Ray T W Mak
- Department of Paediatrics and Adolescent Medicine, The University of Hong Kong, Hong Kong SAR, China
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9
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Lin J, Yang Y, Nuermaimaiti A, Ye T, Liu J, Zhang Z, Chen Y, Li Q, Wu C, Liu B, Xu R, Xia Y, Xiang J. Impact of ambient temperature on adverse pregnancy outcomes: a birth cohort study in Fuzhou, China. Front Public Health 2023; 11:1183129. [PMID: 37483924 PMCID: PMC10359494 DOI: 10.3389/fpubh.2023.1183129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Accepted: 06/08/2023] [Indexed: 07/25/2023] Open
Abstract
Background Previous studies have identified a series of specific adverse pregnancy outcomes (APOs) linked with temperature extremes. Most of them focus on preterm birth, low birth weight, and stillbirth. Other possible adverse outcomes were under-researched. This study aimed to investigate the impact of ambient temperature on maternal complications, white blood cell count (WBC), newborn hearing, and neonatal jaundice. Methods A total of 418 participants were recruited from Fuzhou Maternity & Child Healthcare Hospital in 2016. Participants were invited to fill out a structured questionnaire. The gridded near-surface air temperatures at a resolution of 0.1°* 0.1° for Fuzhou were extracted from a published dataset. Meteorological data and PM2.5 were extracted based on participants' residential addresses using R packages "ncdf4" and "raster." Multivariate logistic regression models were used to quantify the effects of ambient temperature on APOs after controlling for confounders. Results Overall, there were 107 APOs, accounting for 25.6% of all participants. Every 1°C increase in mean temperature was associated with a 10.0% increase in APOs (aOR = 1.100, 95%CI 1.006-1.203) during the period of early pregnancy. However, negative associations were observed in the middle pregnancy period, and a 1°C increase in mean temperature was associated 8.8% decrease in APOs (aOR = 0.912, 95%CI 0.846-0.982). Diurnal temperature variation had a significant impact on APOs in the third trimester. Infant jaundice was negatively associated with temperature exposure in the middle and late pregnancy periods. The risk of neonatal jaundice increased at lag weeks 2-9 in the first trimester, with the greatest lagged effect (aOR = 1.201, 95%CI 1.020-1.413) observed at lag week 3. A 1°C increase in mean temperature led to a 29.6% (aOR = 1.296, 95%CI 1.019-1.649) increase in high WBC. A 1°C increase in temperature variation was associated with more than two times (aOR = 2.469, 95%CI 1.001-6.089) increase of high WBC in the first trimester and about five times (aOR = 4.724, 95%CI 1.548-14.409) increase in the third trimester. Conclusion Ambient temperature affects neonatal jaundice, newborn hearing loss, and infections during pregnancy. In addition to the identified epidemiologic link and susceptible exposure windows, there is a need to understand the underlying biological mechanisms for better recommendations for climate change adaptation policies.
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Affiliation(s)
- Jinfeng Lin
- Fujian Center for Prevention and Control of Occupational Diseases and Chemical Poisoning, Fuzhou, Fujian, China
| | - Yan Yang
- Department of Preventive Medicine, School of Public Health, Fujian Medical University, Fuzhou, Fujian, China
| | - Ayinasaer Nuermaimaiti
- Department of Preventive Medicine, School of Public Health, Fujian Medical University, Fuzhou, Fujian, China
| | - Tingting Ye
- Climate, Air Quality Research Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - Jingwen Liu
- School of Public Health, The University of Adelaide, Adelaide, SA, Australia
| | - Zitong Zhang
- Department of Preventive Medicine, School of Public Health, Fujian Medical University, Fuzhou, Fujian, China
| | - Yifeng Chen
- Department of Preventive Medicine, School of Public Health, Fujian Medical University, Fuzhou, Fujian, China
| | - Qingyu Li
- Department of Preventive Medicine, School of Public Health, Fujian Medical University, Fuzhou, Fujian, China
| | - Chuancheng Wu
- Department of Preventive Medicine, School of Public Health, Fujian Medical University, Fuzhou, Fujian, China
| | - Baoying Liu
- Department of Preventive Medicine, School of Public Health, Fujian Medical University, Fuzhou, Fujian, China
| | - Rongxian Xu
- Department of Nutrition and Food Safety, School of Public Health, Fujian Medical University, Fuzhou, Fujian, China
| | - Yong Xia
- Fuzhou Maternity and Child Health Care Hospital, Fuzhou, Fujian, China
| | - Jianjun Xiang
- Department of Preventive Medicine, School of Public Health, Fujian Medical University, Fuzhou, Fujian, China
- School of Public Health, The University of Adelaide, Adelaide, SA, Australia
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10
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Bodunde EO, Buckley D, O'Neill E, Maher GM, Matvienko-Sikar K, O'Connor K, McCarthy FP, Khashan AS. Pregnancy and birth complications associations with long-term adverse maternal mental health outcomes: a systematic review and meta-analysis protocol. HRB Open Res 2023. [DOI: 10.12688/hrbopenres.13660.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
Abstract
Background: Existing studies have established an association between pregnancy, birth complications, and mental health in the first few weeks postpartum. However, there is no clear understanding of whether pregnancy and birth complications increase the risk of adverse maternal mental outcomes in the longer term. Research on maternal adverse mental health outcomes following pregnancy and birth complications beyond 12 months postpartum is scarce, and findings are inconsistent. Objective: This systematic review and meta-analysis will examine the available evidence on the association between pregnancy and birth complications and long-term adverse maternal mental health outcomes. Methods and analysis: We will include cohort, cross-sectional, and case-control studies in which a diagnosis of pregnancy and/or birth complication (preeclampsia, pregnancy loss, caesarean section, preterm birth, perineal laceration, neonatal intensive care unit admission, major obstetric haemorrhage, and birth injury/trauma) was reported and maternal mental disorders (depression, anxiety disorders, bipolar disorders, psychosis, and schizophrenia) after 12 months postpartum were the outcomes. A systematic search of PubMed, Embase, CINAHL, PsycINFO, and Web of Science will be conducted following a detailed search strategy until August 2022. Three authors will independently review titles and abstracts of all eligible studies, extract data using pre-defined standardised data extraction and assess the quality of each study using the Newcastle-Ottawa Scale. We will use random-effects meta-analysis for each exposure and outcome variable to calculate overall pooled estimates using the generic inverse variance method. This systematic review will follow the Preferred Reporting Items for Systematic reviews and Meta-Analyses guidelines. Ethical consideration: The proposed systematic review and meta-analysis is based on published data; ethics approval is not required. The results will be presented at scientific meetings and publish in a peer-reviewed journal. PROSPERO registration: CRD42022359017
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11
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Endres K, Razavi N, Tian Z, Zhou S, Krawiec C, Jasani S. A retrospective analysis of complications associated with postpartum hemorrhage up to 1 year postpartum in mothers with and without a pre-existing mental health diagnosis. WOMEN'S HEALTH (LONDON, ENGLAND) 2023; 19:17455057231211094. [PMID: 37966026 PMCID: PMC10652806 DOI: 10.1177/17455057231211094] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Revised: 10/03/2023] [Accepted: 10/12/2023] [Indexed: 11/16/2023]
Abstract
BACKGROUND/OBJECTIVES There is limited research on the associated immediate and long-term outcomes of postpartum hemorrhage. Mothers with a pre-existing psychiatric disease prior to delivery may be especially vulnerable to postpartum hemorrhage outcomes but little is known on this topic. Barriers to studying this population exist and add to knowledge gaps. The goal of this study is to determine the clinical characteristics and frequency of complications within 1 year of a postpartum hemorrhage diagnosis and the psychiatric sequelae within 7 days of a postpartum hemorrhage diagnosis in mothers with a pre-existing mental health diagnosis prior to delivery versus those without. METHODS/DESIGN This is a multicenter retrospective observational cohort study using TriNetX, a de-identified electronic health record database. The following electronic health record data were collected and evaluated in postpartum females who were billed for either a vaginal or cesarean delivery: age, race, ethnicity, diagnostic codes, medication codes, and number of deaths. RESULTS We included 10,649 subjects (6994 (65.7%) no mental health diagnosis and 3655 (34.3%) pre-existing mental health diagnosis). Haloperidol administration (118 (3.2%) versus 129 (1.8%), p < 0.001) was more prevalent in subjects with a pre-existing mental health diagnosis. Adjusting for demographics, pre-existing mental health diagnoses were associated with complications within 1 year after postpartum hemorrhage diagnosis (OR = 1.39, 95% CI: 1.26-1.52, p < 0.001). CONCLUSION Having a mental health disorder history is associated with a higher odds of developing subsequent complications within 1 year of postpartum hemorrhage diagnosis. Mothers with a pre-existing mental health disorder have a significantly higher frequency of certain severe postpartum hemorrhage sequelae, including acute respiratory distress syndrome, retained placenta, sickle cell crisis, and need for mechanical ventilation/tracheostomy up to 1 year after delivery. Medications such as haloperidol were ordered more frequently within 7 days of a postpartum hemorrhage diagnosis in these mothers as well. Further research is needed to understand and manage the unique consequences of postpartum hemorrhage in this vulnerable maternal population.
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Affiliation(s)
- Kodi Endres
- Penn State College of Medicine, Pennsylvania State University, Hershey, PA, USA
| | - Nina Razavi
- Penn State College of Medicine, Pennsylvania State University, Hershey, PA, USA
| | - Zizhong Tian
- Division of Biostatistics and Bioinformatics, Department of Public Health Sciences, Penn State College of Medicine, Pennsylvania State University, Hershey, PA, USA
| | - Shouhao Zhou
- Division of Biostatistics and Bioinformatics, Department of Public Health Sciences, Penn State College of Medicine, Pennsylvania State University, Hershey, PA, USA
| | - Conrad Krawiec
- Pediatric Critical Care Medicine, Department of Pediatrics, Penn State Hershey Children’s Hospital, Hershey, PA, USA
| | - Sona Jasani
- Division of Obstetric Specialties and Midwifery, Department of Obstetrics, Gynecology & Reproductive Sciences, Yale School of Medicine, New Haven, CT, USA
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12
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Moreira LKS, Moreira CVL, Custódio CHX, Dias MLP, Rosa DA, Ferreira-Neto ML, Colombari E, Costa EA, Fajemiroye JO, Pedrino GR. Post-partum depression: From clinical understanding to preclinical assessments. Front Psychiatry 2023; 14:1173635. [PMID: 37143780 PMCID: PMC10151489 DOI: 10.3389/fpsyt.2023.1173635] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Accepted: 03/29/2023] [Indexed: 05/06/2023] Open
Abstract
Post-partum depression (PPD) with varying clinical manifestations affecting new parents remains underdiagnosed and poorly treated. This minireview revisits the pharmacotherapy, and relevant etiological basis, capable of advancing preclinical research frameworks. Maternal tasks accompanied by numerous behavioral readouts demand modeling different paradigms that reflect the complex and heterogenous nature of PPD. Hence, effective PPD-like characterization in animals towards the discovery of pharmacological intervention demands research that deepens our understanding of the roles of hormonal and non-hormonal components and mediators of this psychiatric disorder.
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Affiliation(s)
| | | | | | - Matheus L. P. Dias
- Institute of Biological Sciences, Federal University of Goiás, Goiania, GO, Brazil
| | - Daniel A. Rosa
- Institute of Biological Sciences, Federal University of Goiás, Goiania, GO, Brazil
| | - Marcos L. Ferreira-Neto
- Department of Physiology, Institute of Biomedical Sciences, Federal University of Uberlândia, Uberlândia, Brazil
| | - Eduardo Colombari
- Department of Physiology and Pathology, School of Dentistry, São Paulo State University (UNESP), Araraquara, Brazil
| | - Elson A. Costa
- Institute of Biological Sciences, Federal University of Goiás, Goiania, GO, Brazil
| | - James O. Fajemiroye
- Institute of Biological Sciences, Federal University of Goiás, Goiania, GO, Brazil
- Graduate Program in Pharmaceutical Sciences, Campus Arthur Wesley Archibald, Evangelical University of Goiás, Anápolis, Brazil
- *Correspondence: James O. Fajemiroye,
| | - Gustavo R. Pedrino
- Institute of Biological Sciences, Federal University of Goiás, Goiania, GO, Brazil
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13
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Kim J, Kelley J, Davidson L, Richards N, Adams T. Depression and Anxiety Incidence During Pregnancy Between Bariatric Surgery Patients and Matched Control Subjects. Obes Surg 2022; 32:1962-1968. [DOI: 10.1007/s11695-022-06037-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2022] [Revised: 03/21/2022] [Accepted: 03/22/2022] [Indexed: 01/03/2023]
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14
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Hamidia A, Kheirkhah F, Chehrazi M, Basirat Z, Ghadimi R, Barat S, Cuijpers P, O'Connor E, Mirtabar SM, Faramarzi M. Screening of psychiatric disorders in women with high-risk pregnancy: Accuracy of three psychological tools. Health Sci Rep 2022; 5:e518. [PMID: 35224219 PMCID: PMC8855636 DOI: 10.1002/hsr2.518] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2021] [Revised: 12/02/2021] [Accepted: 12/09/2021] [Indexed: 01/12/2023] Open
Abstract
PURPOSE This study investigated the optimal cutoff points of three psychological tools for screening psychiatric disorders in women with high-risk pregnancy. DESIGN AND METHODS In this cross-sectional study (N = 155), sensitivity/specificity of the Edinburgh Postnatal Depression Scale (EPDS), the Brief Symptom Inventory 53-items (BSI-53), and the BSI-18 were computed with respect to having a psychiatric diagnosis based on the clinical interview. RESULTS The usual cutoffs (≥13 for EPDS, T-score of 63 for BSI-53) demonstrated poor diagnostic accuracy. The optimal thresholds were computed for EPDS cutoff of 6.5, GSI = 0.47 for BSI-53, and GSI = 0.5 for BSI-18. PRACTICE IMPLICATIONS The use of psychological tools among pregnant women with high-risk pregnancy may need to be modified in order to accurately identify psychiatric disorders.
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Affiliation(s)
- Angela Hamidia
- Social Determinants of Health Research Center, Health Research Institute, Department of PsychiatryBabol University of Medical SciencesBabolIran
| | - Farzan Kheirkhah
- Social Determinants of Health Research Center, Health Research Institute, Department of PsychiatryBabol University of Medical SciencesBabolIran
| | - Mohammad Chehrazi
- Department of Biostatistics and Epidemiology, School of Public HealthBabol University of Medical SciencesBabolIran
| | - Zahra Basirat
- Infertility and Health Reproductive Research Center, Health Research Institute, Department of Obstetrics and GynecologyBabol University of Medical SciencesBabolIran
| | - Reza Ghadimi
- Social Determinants of Health Research Center, Health Research Institute, Social Medicine DepartmentBabol University of Medical SciencesBabolIran
| | - Shahnaz Barat
- Infertility and Health Reproductive Research Center, Health Research Institute, Department of Obstetrics and GynecologyBabol University of Medical SciencesBabolIran
| | - Pim Cuijpers
- Department of Clinical Neuro and Developmental Psychology, Amsterdam Public Health Research InstituteVrije Universiteit AmsterdamAmsterdamNetherlands
| | | | | | - Mahbobeh Faramarzi
- Social Determinants of Health Research Center, Health Research Institute, Department of General CoursesBabol University of Medical SciencesBabolIran
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15
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Tamiru D, Misgana T, Tariku M, Tesfaye D, Alemu D, Weldesenbet AB, Gebremichael B, Dheresa M. Prevalence and Associated Factors of Common Mental Disorders Among Pregnant Mothers in Rural Eastern Ethiopia. Front Psychiatry 2022; 13:843984. [PMID: 35418883 PMCID: PMC8995426 DOI: 10.3389/fpsyt.2022.843984] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/27/2021] [Accepted: 03/01/2022] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND Antenatal common mental disorder is a significant public health issue, especially in low- and middle-income countries with an extensive treatment gap. Common mental disorders have multifaceted implications on maternal and fetal health outcomes during pregnancy with long-running economic and social sequels. This study aimed to determine the prevalence of common mental disorder and associated factors among pregnant mothers in eastern Ethiopia, Kersa and Haramaya Health, and Demographic surveillance sites. METHODS A community-based cross-sectional study was conducted in Kersa and Haramaya health and demographic surveillance sites from January 30 to April 30, 2021. World Health Organization Self-Reporting Questionnaire (SRQ-20) was used to measure common mental disorder among 1,015 randomly selected pregnant women. Data were collected face-to-face using open data kit software. Logistic regression was fitted to identify factors associated with common mental disorders. RESULTS The overall prevalence of common mental disorders (SRQ > 6) among pregnant women was 37.5% (95% CI: 34.5, 40.5). Current substance use (AOR = 1.99, 95% CI 1.37, 2.88), intimate partner violence (AOR = 2.67, 95% CI 2.02, 3.53), null parity (AOR = 3.10, 95% CI 1.65, 5.84), gestational age [first trimester (AOR = 2.22, 95% CI 1.01, 4.93) and third trimester (AOR = 1.74, 95% CI 1.31, 2.31)], history of abortion (AOR = 2.03, 95% CI 1.27, 3.24), and absence of antenatal care follow-up (AOR = 1.43, 95% CI 1.08, 1.89) were significantly associated with common mental disorder during pregnancy. CONCLUSION Common mental disorders are prevalent among pregnant women in the study area with significant correlates. Administration of regular screening programs for maternal mental health conditions in rural, low-income communities, integrating into primary health care settings is imperative to reduce the risk.
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Affiliation(s)
- Dawit Tamiru
- Department of Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Tadesse Misgana
- Department of Psychiatry, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Mandaras Tariku
- Department of Psychiatry, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Dejene Tesfaye
- Department of Psychiatry, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Daniel Alemu
- Department of Psychiatry, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Adisu Birhanu Weldesenbet
- School of Public Health, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Berhe Gebremichael
- School of Public Health, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Merga Dheresa
- School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
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16
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An Assessment of the Level of COVID-19 Anxiety among Pregnant Women in Poland: A Cross-Sectional Study. J Clin Med 2021; 10:jcm10245869. [PMID: 34945161 PMCID: PMC8706480 DOI: 10.3390/jcm10245869] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2021] [Revised: 12/09/2021] [Accepted: 12/13/2021] [Indexed: 12/02/2022] Open
Abstract
Introduction: The COVID-19 pandemic has caused general anxiety worldwide. Pregnant women are at a much higher risk of developing the infection due to multiple changes that occur in the body during this period. The consequences of the disease can be dramatic not only for the expectant mothers, but also for their unborn children. SARS-CoV-2 infection is generally known to cause serious concerns about future health and life. The data on the severity of COVID-19 pandemic-related anxiety in pregnant women are insufficient. The aim of the study was to assess the level of COVID-19-related anxiety among pregnant women in Poland. Materials and Methods: The study included 173 pregnant women who volunteered for the research. The research was conducted by means of an online diagnostic survey containing an original questionnaire and the following standardized tools: State-Trait Anxiety Inventory (STAI), Short Health Anxiety Inventory (SHAI), and General Anxiety Disorder-7 (GAD-7). Results: Women hospitalised during pregnancy differed statistically significantly in terms of STAI-X1 scores. Primiparas obtained statistically significantly higher SHAI scores than multiparas. Women with higher education had higher SHAI scores. In the GAD-7 scale, 13.3% of respondents obtained a score suggesting a suspected generalised anxiety disorder. Conclusions: Pregnant women are concerned about both developing COVID-19 and the consequences of infection for themselves and their unborn children. The study demonstrated anxiety of varying severity (depending on the tool used). Hospital stay during pregnancy is an additional stressor in expectant women. Further studies are needed to assess the level of COVID-19-related anxiety to assess this phenomenon in Poland in more detail.
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Luong TC, Pham TTM, Nguyen MH, Do AQ, Pham LV, Nguyen HC, Nguyen HC, Ha TH, Dao HK, Trinh MV, Do TV, Nguyen HQ, Nguyen TTP, Tran CQ, Tran KV, Duong TT, Pham HX, Do TT, Nguyen PB, Tra AL, Phan DT, Do BN, Duong TV. Fear, anxiety and depression among pregnant women during COVID-19 pandemic: impacts of healthy eating behaviour and health literacy. Ann Med 2021; 53:2120-2131. [PMID: 34761972 PMCID: PMC8592601 DOI: 10.1080/07853890.2021.2001044] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/13/2021] [Accepted: 10/27/2021] [Indexed: 01/12/2023] Open
Abstract
INTRODUCTION The COVID-19 pandemic has been influencing people's psychological health, especially in pregnant women. We aimed to examine associated factors of fear of COVID-19, anxiety and depression among pregnant women during the pandemic where the impacts of healthy eating behaviour (HES) and health literacy (HL) were emphasized. METHODS A cross-sectional study was conducted between 14 February 2020 and 31 May 2020 in 18 health centres and hospitals across Vietnam. Data of 518 pregnant women were analysed, including socio-demographics, pregnant-related factors, HES, HL, health-related behaviours, fear of COVID-19 scale (FCoV-19S), anxiety (using the generalized anxiety disorder (GAD-7)) and depression (using the patient health questionnaire with 9 items (PHQ-9)). Regression analysis was utilized to explore the associations. RESULTS Pregnant women with higher scores of HES and HL had lower likelihood of anxiety (odds ratio, OR, 0.79; 95% confidence interval (95%CI), 0.73, 0.87; p < .001; and OR, 0.94; 95%CI, 0.90, 0.99; p = .018) and depression (OR, 0.84; 95%CI, 0.78, 0.91; p < .001; and OR, 0.96; 95%CI, 0.91, 0.99; p = .044), respectively. Pregnant women being employed had a lower FCoV-19S score (regression coefficient, B, -1.46; 95%CI, -2.51, -0.40; p = .007). Besides, other significant predictors of anxiety were eating healthier during the pandemic, unchanged or more physical activity, elevated gestational age and smoking. Other significant predictors of depression were eating healthier during the pandemic, elevated gestational age and smoking. CONCLUSIONS Among others, HES and HL had positive impacts on protecting pregnant women against anxiety and depression. Improving HES and HL should be addressed as a strategic approach to improve reproductive health during the pandemic.KEY MESSAGEThe COVID-19 pandemic influences antenatal mental disorders with the higher level as opposed to that before the pandemic.Healthy eating behaviour and better health literacy (HL) had critical roles in lowering prenatal anxiety and depression during the COVID-19 crisis.Strategic approaches for improving healthy eating and HL should be recommended for protecting pregnant women from mental health problems during the pandemic.
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Affiliation(s)
- Thuc C. Luong
- Department of Cardiology, Cardiovascular Center, Military Hospital 103, Hanoi, Vietnam
- Director Office, Military Hospital 103, Hanoi, Vietnam
| | - Thu T. M. Pham
- School of Public Health, College of Public Health, Taipei Medical University, Taipei, Taiwan
- Faculty of Public Health, Hai Phong University of Medicine and Pharmacy, Hai Phong, Vietnam
| | - Minh H. Nguyen
- International Ph.D. Program in Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Anh Q. Do
- International Ph.D. Program for Cell Therapy and Regeneration Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
- Department of Obstetrics and Gynecology, Hai Phong University of Medicine and Pharmacy, Hai Phong, Vietnam
| | - Linh V. Pham
- Department of Pulmonary and Cardiovascular Diseases, Hai Phong University of Medicine and Pharmacy Hospital, Hai Phong, Vietnam
- Director Office, Hai Phong University of Medicine and Pharmacy Hospital, Hai Phong, Vietnam
| | - Hoang C. Nguyen
- Director Office, Thai Nguyen National Hospital, Thai Nguyen, Vietnam
- President Office, Thai Nguyen University of Medicine and Pharmacy, Thai Nguyen, Vietnam
| | - Huu C. Nguyen
- Director Office, E Hospital, Hanoi, Vietnam
- Department of Thoracic and Cardiovascular Surgery, E Hospital, Hanoi, Vietnam
| | - Tung H. Ha
- Director Office, General Hospital of Agricultural, Hanoi, Vietnam
| | - Hung K. Dao
- Director Office, Bac Ninh Obstetrics and Pediatrics Hospital, Bac Ninh, Vietnam
| | - Manh V. Trinh
- Director Office, Quang Ninh General Hospital, Quang Ninh, Vietnam
| | - Thinh V. Do
- Director Office, Bai Chay Hospital, Quang Ninh, Vietnam
| | - Hung Q. Nguyen
- Director Office, Quang Ninh Obstetrics and Pediatrics Hospital, Quang Ninh, Vietnam
| | - Thao T. P. Nguyen
- Health Management Training Institute, University of Medicine and Pharmacy, Hue University, Thua Thien Hue, Vietnam
| | - Cuong Q. Tran
- Director Office, Thu Duc District Health Center, Ho Chi Minh City, Vietnam
- Faculty of Health, Mekong University, Vinh Long, Vietnam
| | - Khanh V. Tran
- Director Office, Le Van Thinh Hospital (previously Hospital District 2), Ho Chi Minh City, Vietnam
| | - Trang T. Duong
- Nursing Office, Tan Phu District Hospital, Ho Chi Minh City, Vietnam
| | - Hai X. Pham
- Director Office, Thu Duc District Health Center, Ho Chi Minh City, Vietnam
| | - Thao T. Do
- Department of Oral Pathology and Periodontology, Faculty of Odonto-Stomatology, Can Tho University of Medicine and Pharmacy, Can Tho, Vietnam
| | | | - Anh L. Tra
- Department of Rehabilitation & Physiotherapy, Da Nang University of Medical Technology and Pharmacy, Da Nang, Vietnam
| | - Dung T. Phan
- Nursing Office, Thien An Obstetrics and Gynecology Hospital, Hanoi, Vietnam
- Faculty of Nursing, Hanoi University of Business and Technology, Hanoi, Vietnam
| | - Binh N. Do
- Department of Infectious Diseases, Vietnam Military Medical University, Hanoi, Vietnam
- Division of Military Science, Military Hospital 103, Hanoi, Vietnam
| | - Tuyen Van Duong
- School of Nutrition and Health Sciences, Taipei Medical University, Taipei, Taiwan
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Kumar M, Saadaoui M, Elhag DA, Murugesan S, Al Abduljabbar S, Fagier Y, Ortashi O, Abdullahi H, Ibrahim I, Alberry M, Abbas A, Ahmed SR, Hendaus MA, Kalache K, Terranegra A, Al Khodor S. Omouma: a prospective mother and child cohort aiming to identify early biomarkers of pregnancy complications in women living in Qatar. BMC Pregnancy Childbirth 2021; 21:570. [PMID: 34412611 PMCID: PMC8377974 DOI: 10.1186/s12884-021-04029-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2021] [Accepted: 07/29/2021] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Pregnancy is governed by multiple molecular and cellular processes, which might influence pregnancy health and outcomes. Failure to predict and understand the cause of pregnancy complications, adverse pregnancy outcomes, infant's morbidity and mortality, have limited effective interventions. Integrative multi-omics technologies provide an unbiased platform to explore the complex molecular interactions with an unprecedented depth. The objective of the present protocol is to build a longitudinal mother-baby cohort and use multi-omics technologies to help identify predictive biomarkers of adverse pregnancy outcomes, early life determinants and their effect on child health. METHODS/DESIGN One thousand pregnant women with a viable pregnancy in the first trimester (6-14 weeks of gestation) will be recruited from Sidra Medicine hospital. All the study participants will be monitored every trimester, at delivery, and one-year post-partum. Serial high-frequency sampling, including blood, stool, urine, saliva, skin, and vaginal swabs (mother only) from the pregnant women and their babies, will be collected. Maternal and neonatal health, including mental health and perinatal growth, will be recorded using a combination of questionnaires, interviews, and medical records. Downstream sample processing including microbial profiling, vaginal immune response, blood transcriptomics, epigenomics, and metabolomics will be performed. DISCUSSION It is expected that the present study will provide valuable insights into predicting pregnancy complications and neonatal health outcomes. Those include whether specific microbial and/or epigenomics signatures, immune profiles are associated with a healthy pregnancy and/or complicated pregnancy and poor neonatal health outcome. Moreover, this non-interventional cohort will also serve as a baseline dataset to understand how familial, socioeconomic, environmental and lifestyle factors interact with genetic determinants to influence health outcomes later in life. These findings will hold promise for the diagnosis and precision-medicine interventions.
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Affiliation(s)
- Manoj Kumar
- Research Department, Sidra Medicine, Doha, Qatar
| | | | | | | | | | - Yassin Fagier
- Obstetrics and Gynecology, Sidra Medicine, Doha, Qatar
| | - Osman Ortashi
- Obstetrics and Gynecology, Sidra Medicine, Doha, Qatar
| | | | | | | | - Anthony Abbas
- Maternal Fetal Medicine, Sidra Medicine, Doha, Qatar
| | | | | | - Karim Kalache
- Maternal Fetal Medicine, Sidra Medicine, Doha, Qatar
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