Partner's emotional reaction to pregnancy mediates the relationship between pregnancy planning and prenatal mental health

Time to initiation of antenatal care and its predictors among pregnant women who delivered in Arba Minch town public health facilities, Gamo Zone, southern Ethiopia, 2023: a retrospective follow-up study

BACKGROUND

Early antenatal care visit is important for optimal care and health outcomes for women and children. In the study area, there is a lack of information about the time to initiation of antenatal care. So, this study aimed to determine the time to initiation of antenatal care visits and its predictors among pregnant women who delivered in Arba Minch town public health facilities.

METHODS

An institution-based retrospective follow-up study was performed among 432 women. A systematic random sampling technique was employed to select the study participants. The Kaplan-Meier survival curve was used to estimate the survival time. A Multivariable Cox proportional hazard regression model was fitted to identify predictors of the time to initiation of antenatal care. An adjusted hazard ratio with a 95% confidence interval was used to assess statistical significance.

RESULTS

The median survival time to antenatal care initiation was 18 weeks (95% CI = (17, 19)). Urban residence (AHR = 2.67; 95% CI = 1.52, 4.71), Tertiary and above level of education of the women (AHR = 1.90; 95% CI = 1.28, 2.81), having pregnancy-related complications in a previous pregnancy (AHR = 1.53; 95% CI = 1.08, 2.16), not having antenatal care for previous pregnancy (AHR = 0.39; 95% CI = 0.21, 0.71) and unplanned pregnancy (AHR = 0.66; 95% CI = 0.48, 0.91) were statistically significant predictors.

CONCLUSION

Half of the women initiate their antenatal care visit after 18 weeks of their pregnancy which is not in line with the recommendation of the World Health Organization. Urban residence, tertiary and above level of education of the women, having pregnancy-related complications in a previous pregnancy, not having previous antenatal care visits and unplanned pregnancy were predictors of the time to initiation of antenatal care. Therefore, targeted community outreach programs including educational campaigns regarding antenatal care for women who live in rural areas, who are less educated, and who have no previous antenatal care experience should be provided, and comprehensive family planning services to prevent unplanned pregnancy are needed.

Does COVID-19 anxiety in pregnant women affect marital adjustment?

In this study, it was tried to determine the relationship between anxiety and marital adjustment in pregnant women during the epidemic, and to explain the variables affecting anxiety and marital adjustment. During the epidemic, many factors cause changes in the perceived anxiety level and marital adjustment in pregnant women. As the level of COVID-19 anxiety increases in pregnant women, marital adjustment scores decrease. It was determined that the anxiety levels were lower and marital adjustment was higher in pregnant women who had a planned pregnancy, did not have fears about childbirth, thought that their physical, mental health were not affected.

Perceived stress and life satisfaction in pregnant women during the COVID-19 pandemic: the mediating role of fear of childbirth and self-esteem

BACKGROUND

The COVID-19 pandemic adversely affected the functioning and well-being of pregnant women. Negative feelings during pregnancy and the difficult pandemic situation may be the reason behind the perceived fear of childbirth, which can negatively affect the pregnant women's life satisfaction. On the other hand, some protective factors, such as self-esteem, might mediate the relationship between perceived stress and well-being in pregnant women.

PARTICIPANTS AND PROCEDURE

Our study aimed to determine the relationship between perceived stress, fear of childbirth, self-esteem and life satisfaction. A total of 262 Polish pregnant women participated in this study. The Perceived Stress Scale (PSS-10), Fear of Childbirth Scale (KLP II), Self-Esteem Scale (SES) and Satisfaction with Life Scale (SWLS) were used in the study.

RESULTS

The results showed that perceived stress, fear of childbirth and self-esteem acted as significant predictors of life satisfaction in the tested group of pregnant women. Additionally, fear of childbirth and self-esteem played a mediational role in the relationship between perceived stress and life satisfaction.

CONCLUSIONS

According to Diener's concept, life satisfaction is an important component of one's subjective well-being and health. Therefore, it is important to analyse factors that may mediate the impact of stress on pregnant women's life satisfaction. The present results might suggest that during pregnancy and preparation for childbirth, women should be provided with appropriate psychological care. Support from medical and psychological specialists, as well as from relatives, can reduce the level of perceived fears and strengthen personal resources. Based on the present results, we conclude that the fear of childbirth and the self-esteem of pregnant women should not be underestimated, as they are important predictors of their life satisfaction.

Perspectives about social support among unmarried pregnant university students in South Africa

BACKGROUND

Pregnant young women in an academic environment are susceptible to stressors associated with unintended pregnancy and academic demands of universities. The challenges they face may be exacerbated by lack of social support, putting them at risk of psychological disorders such as depression. Women who receive social support during pregnancy and postpartum experience less emotional distress and report greater maternal satisfaction. However, very little is known about the perspectives about social support among unmarried pregnant students in tertiary institutions.

METHODS

Participants were purposively selected among unmarried pregnant students and those in the puerperal period at the time of the study. We conducted semi-structured qualitative interviews to explore the perspectives of unmarried pregnant students on the type of support that they need during pregnancy and the puerperium and the period when most support is needed. The data were audio-recorded and transcribed verbatim, then analysed using thematic analysis.

RESULTS

The findings show that social supports (emotional, instrumental, informational, and financial) were highlighted as important resources to cope with stressors during pregnancy and post-birth. Emotional support from male partners was the most important type of support needed as it entailed a sense of being loved and cared for. Social support was identified as important throughout the different phases of pregnancy and post birth, with different support needs expressed at each of these phases.

CONCLUSION

This study identified support needs of unmarried pregnant university students in their transition to motherhood. Given the several challenges that they are faced with, unmarried pregnant students need social support, including male partner support to enhance wellbeing as they try to cope with academic and pregnancy-related stressors.

The Important Role of Partner Support in Women's Mental Disorders During the Perinatal Period. A Literature Review

The arrival of a newborn is often a happy event in a woman's life. However, many women experience perinatal distress such as anxiety disorders and depression during pregnancy or postpartum period. Although the positive interpersonal relationships of women with their wider environment seem to be a support network, research shows that support provided by partners is a very important protective factor in reducing mental health disorders in both prenatal and postnatal period in a woman's life. for this reason, more research needs to be done in the field of perinatal distress in order to clarify the causes that lead to mental disorders and to strengthen the partner's role in the management of perinatal mental disorders of women.

Perinatal Mental Health; The Role and the Effect of the Partner: A Systematic Review

Pregnancy is a transitional period involving the most complex experiences in a woman's life, during which the woman's psychological status can be affected by a wide range of psychosocial variables. However, positive interpersonal relationships appear to constitute a supportive network that significantly influences perinatal mental health. Therefore, the presence of a supportive partner works psycho-protectively against the difficulties and pressures created by the transition to maternity. The aim of this study was to review systematically the influence of the partner on the woman's psychology during the perinatal period. Fourteen research articles from PubMed/Medline, Google Scholar and PsycINFO were included in the review from a total of 1846 articles. Most studies have shown a correlation between the support from the partner and prenatal depression and anxiety. Support from the spouse during childbirth is related to the extent to which women feel safe during labor as well as the stress during childbirth. The role of the partner is very important in the occurrence of perinatal mental disorders in women. Of course, more research needs to be done in the field of perinatal mental health. The risk factors that lead to mental disorders need to be clarified and the role of the partner in the perinatal period requires reinforcement and needs to be given the necessary importance.

Psychometric properties of psychosocial dimensions associated with postpartum depression

AIM

The aim of the study was psychometric properties of a questionnaire for assessing psychosocial dimensions associated with postpartum depression (PAPP).

METHODS

Initial form of the questionnaire for assessing PAPP was developed based on the results of a qualitative study. Principal component analysis was used to determine the construct validity, as well as Cronbach's alpha and intraclass correlation coefficient to determine the reliability of the questionnaire. Construct validity, predictability of the questionnaire, and confirmatory factor analysis were evaluated in a longitudinal study on 303 pregnant women in the third trimester of pregnancy. Also, using Edinburgh postnatal depression scale, the level of depression was evaluated 6 weeks after childbirth.

RESULTS

Exploratory factor analysis led to a 47-item questionnaire with five dimensions and confirmed that five factors determined 42.31% variance. Cronbach's alpha was 0.851 for the total score of questionnaire and for the factors, ranged from 0.84 to 0.92. ICC of total was 0.92 (95% confidence interval (CI): 0.69-0.93). Analyzing the confirmatory factor analysis showed that the 47 items questionnaire had a good construct validity (CMIN/DF = 2.01, p = 0.122). The level of the PAPP in women suffered from postpartum depression was higher than women without postpartum depression (odds ratio = 1.01, 95% CI: 1.01-1.02, p = 0.001). A cut-off score of 42 provided the best sensitivity (0.75) and specificity (0.50) for PAPP.

CONCLUSION

The psychometric properties of the PAPP showed an appropriate validity and reliability, and it may applicable to predict of at risk pregnant women for postpartum depression who seeking antenatal care services.