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Bartmann C, Kimmel T, Davidova P, Kalok M, Essel C, Ben Ahmed F, McNeill RV, Wolfgang T, Reif A, Bahlmann F, Wöckel A, Trautmann-Villalba P, Kämmerer U, Kittel-Schneider S. The impact of the early COVID-19 pandemic on maternal mental health during pregnancy and postpartum. PLoS One 2024; 19:e0310902. [PMID: 39302940 DOI: 10.1371/journal.pone.0310902] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2024] [Accepted: 09/06/2024] [Indexed: 09/22/2024] Open
Abstract
PURPOSE The aim of this study was to investigate the effects of the COVID-19 pandemic on maternal mental health during pregnancy and the postpartum period. METHODS The impact of the COVID-19 pandemic situation during and post pregnancy was addressed on three main factors; maternal mental health, mother-child bonding, and maternal self-confidence. To do this, two different patient cohorts were compared; data from one cohort was collected pre-pandemic, and data was collected from the other cohort at the beginning of the pandemic. Questionnaires were used to collect data regarding depressive symptoms (Edinburgh Postnatal Depression Scale [EPDS]), anxiety (State Trait Anxiety Inventory [STAI]), maternal self-confidence (Lips Maternal Self-Confidence Scale [LMSCS]) and mother-child bonding (Postpartum Bonding Questionnaire [PBQ]). RESULTS There were no significant differences in depressive symptoms (EPDS with an average median of 4.00-5.00) or anxiety (STAI with an average median of 29.00-33.00) between the cohorts. However, the quality of postpartum maternal bonding was higher at 3-6 months in the pandemic cohort, which was also influenced by education and the mode and number of births. The maternal self-confidence was lower in the pandemic sample, also depending on the mode of birth delivery. CONCLUSIONS In this study, a differential effect of the COVID-19 pandemic on mother-child bonding and maternal self-confidence was observed. The results thereby identified possible protective factors of the pandemic, which could potentially be implemented to improve maternal mental health and bonding to the child under normal circumstances.
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Affiliation(s)
- Catharina Bartmann
- Department of Obstetrics and Gynecology, University Hospital, Würzburg, Germany
| | - Theresa Kimmel
- Department of Obstetrics and Gynecology, University Hospital, Würzburg, Germany
| | - Petra Davidova
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital Frankfurt, Goethe University, Frankfurt am Main, Germany
- Department of Ophthalmology, University Hospital Frankfurt, Goethe University, Frankfurt am Main, Germany
| | - Miriam Kalok
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital Frankfurt, Goethe University, Frankfurt am Main, Germany
| | - Corina Essel
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital Frankfurt, Goethe University, Frankfurt am Main, Germany
| | - Fadia Ben Ahmed
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital Frankfurt, Goethe University, Frankfurt am Main, Germany
| | - Rhiannon V McNeill
- Department of Psychiatry, Psychosomatics and Psychotherapy, Center of Mental Health, University Hospital, University of Würzburg, Würzburg, Germany
| | - Tanja Wolfgang
- Department of Obstetrics and Gynecology, University Hospital, Würzburg, Germany
- Department of Psychiatry, Psychosomatics and Psychotherapy, Center of Mental Health, University Hospital, University of Würzburg, Würzburg, Germany
| | - Andreas Reif
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital Frankfurt, Goethe University, Frankfurt am Main, Germany
| | - Franz Bahlmann
- Department of Obstetrics and Gynecology, Buergerhospital Frankfurt, Frankfurt/Main, Germany
| | - Achim Wöckel
- Department of Obstetrics and Gynecology, University Hospital, Würzburg, Germany
| | | | - Ulrike Kämmerer
- Department of Obstetrics and Gynecology, University Hospital, Würzburg, Germany
| | - Sarah Kittel-Schneider
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital Frankfurt, Goethe University, Frankfurt am Main, Germany
- Department of Psychiatry, Psychosomatics and Psychotherapy, Center of Mental Health, University Hospital, University of Würzburg, Würzburg, Germany
- Department of Psychiatry and Neurobehavioural Science, University College Cork, Acute Mental Health Unit, Cork University Hospital, Wilton, Cork, Ireland
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Garfield L, Watson-Singleton NN, Mathews HL, Witek Janusek L. Protocol for a pilot study assessing a virtual mindfulness intervention for postpartum African American women. BRAIN BEHAVIOR AND IMMUNITY INTEGRATIVE 2024; 6:100060. [PMID: 39036323 PMCID: PMC11258811 DOI: 10.1016/j.bbii.2024.100060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 07/23/2024]
Abstract
Elevated perinatal depressive symptoms are more common among disadvantaged African American women, and they are almost four times as likely to have postpartum posttraumatic stress compared to white women. For new mothers, depressive symptoms and posttraumatic stress can lead to negative parenting, poor mother-infant bonding, and delayed infant development. For African American women, a culturally adapted mindfulness-based intervention offers great potential as an acceptable approach to reduce psycho-behavioral symptoms and improve mother-infant interactions (i.e., bonding). Additionally, it is critical that mindfulness interventions consider time constraints of new mothers, provide accessible intervention delivery, address parenting, and consider the challenges of caring for an infant. Given these considerations, we describe a pilot research protocol in which we evaluate a culturally adapted mindfulness program: Mindfulness for African Americans Postpartum (MAAP). The intervention is based upon Kabat-Zinn's Mindfulness Based Stress Reduction program, but is adapted to include culturally relevant concepts of spirituality, inter-dependence, self-empowerment, and storytelling, which are salient to African American culture. To accommodate the needs of new mothers, a certified mindfulness interventionist delivers each session virtually using Zoom. The investigation uses a randomized controlled design in which African American women within 12 months of giving birth are randomized either to the MAAP intervention or to an Education Program. The primary aim is to determine the extent to which the MAAP intervention decreases maternal psycho-behavioral symptoms (perceived stress, depressive symptoms, anxiety, poor sleep, posttraumatic stress, and fatigue) and improves mother-infant bonding. A secondary aim is to explore the effects of MAAP on proinflammatory cytokines and oxytocin. Culturally adapted mindfulness interventions delivered virtually will make mindfulness more accessible and meaningful to populations, like African American new mothers, who are at higher risk for postpartum mood disorders and poor infant outcomes.
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Affiliation(s)
- Lindsey Garfield
- Marcella Niehoff School of Nursing, 2160 S. First Ave, Maywood, IL 60153, United States
| | - Natalie N. Watson-Singleton
- Spelman College, Department of Psychology, 350 Spelman Lane, Box 1657 Giles Hall 317, Atlanta, GA 30314, United States
| | - Herbert L. Mathews
- Stritch School of Medicine, Department of Microbiology and Immunology, Loyola University Chicago, United States
| | - Linda Witek Janusek
- Marcella Niehoff School of Nursing, Loyola University Chicago, United States
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Shebelsky R, Sadi W, Heesen P, Aber RN, Fein S, Iluz-Freundlich D, Shmueli A, Azem K, Radyan Tamayev I, Binyamin Y, Orbach-Zinger S. The relationship between postpartum pain and mother-infant bonding: A prospective observational study. Anaesth Crit Care Pain Med 2024; 43:101315. [PMID: 37865216 DOI: 10.1016/j.accpm.2023.101315] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Revised: 10/10/2023] [Accepted: 10/12/2023] [Indexed: 10/23/2023]
Abstract
INTRODUCTION Postpartum pain is associated with impaired maternal recovery and may influence mother-infant bonding. METHODS Participants who underwent a vaginal or cesarean delivery were assessed 24 h postpartum. Postpartum pain intensity was measured using the Verbal Numeric Score (VNS) (0-10) and classified as non-severe (<8) or severe pain (≥8). Maternal-infant bonding was evaluated using the Post-Partum Bonding Questionnaire (PBQ; 0-125), with a score > 5 defining impaired bonding. Demographic data included age, BMI, parity, education level, economic status, partnership, prior history of depression, familial history of depression, desire to breastfeed, epidural analgesia during labor, rooming in, and Edinburgh Postnatal Depression Scale (EPDS). Data were analyzed using 2 separate multivariable logistic regression models for vaginal and cesarean deliveries, where maximum postpartum pain was the independent variable and impaired postpartum bonding was the dependent variable and controlled for the other factors collected. RESULTS Severe postpartum pain (VNS ≥ 8) showed no significant relationship with impaired bonding when controlling for confounding variables. In vaginal deliveries, there was an association between a history of depression and impaired bonding (Odds Ratio 2.2 [1.07-4.65], p = 0.04) and EPDS > 10 and impaired bonding (OR 11.5 [3.2-73.6], p < 0.001). For cesarean deliveries, rooming in with the baby had a protective effect (OR 11.5 [3.2-73.6], p < 0.001). CONCLUSIONS Contrary to expectations, severe postpartum pain did not influence maternal-infant binding in the cohort of patients with vaginal and cesarean deliveries. Instead, factors such as maternal mental health and rooming-in practices appeared to exert more significant influence. CLINICAL TRIAL REGISTRATION NCT05206552.
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Affiliation(s)
- Rostislav Shebelsky
- Department, Department of Anaesthesia, Beilinson Hospital, Petach Tikvah, and Sackler Medical School, Tel Aviv University, Tel Aviv, Israel
| | - Wadeea Sadi
- Department, Department of Anaesthesia, Beilinson Hospital, Petach Tikvah, and Sackler Medical School, Tel Aviv University, Tel Aviv, Israel
| | | | - Rachel N Aber
- Tel Aviv University Sackler Faculty of Medicine, Tel Aviv, Israel
| | - Shai Fein
- Department, Department of Anaesthesia, Beilinson Hospital, Petach Tikvah, and Sackler Medical School, Tel Aviv University, Tel Aviv, Israel
| | - Daniel Iluz-Freundlich
- Department, Department of Anaesthesia, Beilinson Hospital, Petach Tikvah, and Sackler Medical School, Tel Aviv University, Tel Aviv, Israel
| | - Anat Shmueli
- Department, Department of Anaesthesia, Beilinson Hospital, Petach Tikvah, and Sackler Medical School, Tel Aviv University, Tel Aviv, Israel
| | - Karam Azem
- Department, Department of Anaesthesia, Beilinson Hospital, Petach Tikvah, and Sackler Medical School, Tel Aviv University, Tel Aviv, Israel
| | - Inbar Radyan Tamayev
- Department, Department of Anaesthesia, Beilinson Hospital, Petach Tikvah, and Sackler Medical School, Tel Aviv University, Tel Aviv, Israel
| | - Yair Binyamin
- Department of Anesthesiology, Soroka University Medical Center and the Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel.
| | - Sharon Orbach-Zinger
- Department, Department of Anaesthesia, Beilinson Hospital, Petach Tikvah, and Sackler Medical School, Tel Aviv University, Tel Aviv, Israel
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Bladh M, Sydsjö G, Ekselius L, Vingård E, Agnafors S. Sense of coherence and health in women: a 25-year follow-up study. BMC Womens Health 2023; 23:670. [PMID: 38093276 PMCID: PMC10720174 DOI: 10.1186/s12905-023-02834-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2022] [Accepted: 12/07/2023] [Indexed: 12/17/2023] Open
Abstract
BACKGROUND Health and Sense of Coherence (SOC) has been shown to be intertwined and argued to have a reciprocal relationship. The theory of SOC implies relatively stable scores during adulthood, however there are few longitudinal studies on the association between SOC and mental and somatic health. The main aim of the present study was to examine how SOC and self-rated health (SRH) are related during 25 years of follow-up. METHODS Using paper questionnaires distributed by postal services, 415 mothers were followed from childbirth and 25 years prospectively. SOC was measured at three, 12 and 25 years after inclusion. Self-reports on health status were obtained at the 25-year follow-up. The association between SOC and self-reported health as well as the effect of sociodemographic factors and experience of stressful life events was assessed through regression models. RESULTS SOC scores increased between three and 12 years after inclusion, and slightly decreased at the 25-year follow-up. Women of good health had a higher SOC-score at all three measurements compared to women of poor health. Multiple logistic regression showed that the likelihood of reporting good health increased with the number of times the women had reported SOC-scores above the 75th percentile. Moreover, women who had not been through a divorce were close to 60% more likely to report good health compared to women who had been through a divorce, whereas women not reporting stressful life events during the past two years were more than twice as likely to report good health. Symptoms below cut-off for postpartum depression and not having been through a divorce were associated with SOC scores above the 75th percentile. CONCLUSION This 25-year follow-up study of a cohort of women reports good stability of SOC assessments in the vast majority of women. There was a stronger and more stable SOC in women with better health. The findings are in line with other studies on the predictive value of SOC and self-perceived health.
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Affiliation(s)
- Marie Bladh
- Department of Biomedical & Clinical Sciences (BKV), BKH/Obstetrics & Gynaecology, Faculty of Medicine and Health Sciences, Linköping University, Linköping, SE-58185, Sweden.
| | - Gunilla Sydsjö
- Department of Biomedical & Clinical Sciences (BKV), BKH/Obstetrics & Gynaecology, Faculty of Medicine and Health Sciences, Linköping University, Linköping, SE-58185, Sweden
| | - Lisa Ekselius
- Women's Mental Health during the Reproductive Lifespan, Department of Women's and Children's Health, Uppsala University, Uppsala, SE-75185, Sweden
| | - Eva Vingård
- Department of Occupational and Environmental Medicine, Uppsala University, Uppsala, SE-75185, Sweden
| | - Sara Agnafors
- Department of Biomedical & Clinical Sciences (BKV), BKH/Obstetrics & Gynaecology, Faculty of Medicine and Health Sciences, Linköping University, Linköping, SE-58185, Sweden
- Department of Research, Södra Älvsborgs Hospital, Borås, Sweden
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Yamakawa Y, Maruta M, Higuchi Y, Tokunaga A, Iwanaga R, Honda S, Imamura A, Tanaka G. Factors influencing postpartum depression among Japanese parents: A prospective longitudinal study. Neuropsychopharmacol Rep 2023. [PMID: 36915226 DOI: 10.1002/npr2.12326] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2022] [Revised: 02/17/2023] [Accepted: 02/23/2023] [Indexed: 03/16/2023] Open
Abstract
AIM Postpartum depression (PPD) may have negative effects on the parents and lead to impaired cognitive, socioemotional, and behavioral development in their children. The purpose of this study was to examine factors associated with PPD in parents during the first year after delivery. METHODS This study used a self-administered questionnaire. Questionnaires were mailed at 5 days, 3 months, 6 months, and 1 year after delivery, respectively. The particpants were 107 pairs of mothers and fathers. PPD was assessed using the Edinburgh Postnatal Depression Scale (EPDS). Data on sense of coherence (SOC), Quality Marriage Index, Social Support Scale, Mother-to-Infant Bonding Scale, and sociodemographic variables were collected. Multiple regression analysis was performed to examine the strength of the association between several variables and the EPDS at each survey period for fathers and mothers, respectively. RESULTS The prevalence of PPD in the first-year postpartum ranged from 12.1%-23.4% to 7.5%-8.4% for fathers and mothers, respectively. SOC had the strongest impact on EPDS scores for both fathers and mothers at all four survey periods. CONCLUSIONS Our findings suggest that stress coping skills are an important factor affecting PPD throughout the first-year postpartum for both fathers and mothers.
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Affiliation(s)
- Yuko Yamakawa
- Department of Occupational Therapy Sciences, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Michio Maruta
- Department of Health Sciences, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | | | - Akiko Tokunaga
- Department of Health Sciences, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Ryoichiro Iwanaga
- Department of Occupational Therapy Sciences, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Sumihisa Honda
- Department of Nursing Sciences, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Akira Imamura
- Department of Occupational Therapy Sciences, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Goro Tanaka
- Department of Occupational Therapy Sciences, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
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Redshaw M, Wynter K. Maternal mental health: Women’s voices and data from across the globe. BMC Pregnancy Childbirth 2022; 22:796. [PMID: 36307777 PMCID: PMC9614766 DOI: 10.1186/s12884-022-05064-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2022] [Accepted: 09/21/2022] [Indexed: 11/10/2022] Open
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Paiz JC, de Jezus Castro SM, Giugliani ERJ, Dos Santos Ahne SM, Aqua CBD, Giugliani C. Association between mistreatment of women during childbirth and symptoms suggestive of postpartum depression. BMC Pregnancy Childbirth 2022; 22:664. [PMID: 36028806 PMCID: PMC9413948 DOI: 10.1186/s12884-022-04978-4] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2021] [Accepted: 08/05/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Postpartum depression is a common condition in the pregnancy and postpartum cycle. The development of this condition is multifactorial and can be influenced by previous traumas. This study sought to verify whether there is an association between having been exposed to mistreatment during childbirth and presenting symptoms suggestive of postpartum depression. METHODS This is a cross-sectional study, with the inclusion of 287 women without complications in childbirth, randomly selected from two maternity hospitals of Porto Alegre, southern Brazil, in 2016. Four weeks after delivery, the postpartum women answered a face-to-face interview about socioeconomic aspects, obstetric history, health history, and childbirth experience (practices and interventions applied) and completed the Edinburgh Postnatal Depression Scale (EPDS). From the perception of women regarding the practices performed in the context of childbirth care, a composite variable was created, using item response theory, to measure the level of mistreatment during childbirth. The items that made up this variable were: absence of a companion during delivery, feeling insecure and not welcome, lack of privacy, lack of skin-to-skin contact after delivery, not having understood the information shared with them, and not having felt comfortable to ask questions and make decisions about their care. To define symptoms suggestive of postpartum depression, reflecting on increased probability of this condition, the EPDS score was set at ≥ 8. Poisson Regression with robust variance estimation was used for modeling. RESULTS Women who experienced mistreatment during childbirth had a higher prevalence of symptoms suggestive of postpartum depression (PR 1.55 95% CI 1.07-2.25), as well as those with a history of mental health problems (PR 1.69 95% CI 1.16-2.47), while higher socioeconomic status (A and B) had an inverse association (PR 0.53 95% CI 0.33-0.83). CONCLUSIONS Symptoms suggestive of postpartum depression seem to be more prevalent in women who have suffered mistreatment during childbirth, of low socioeconomic status, and with a history of mental health problems. Thus, qualifying care for women during pregnancy, childbirth and postpartum and reducing social inequalities are challenges to be faced in order to eliminate mistreatment during childbirth and reduce the occurrence of postpartum depression.
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Affiliation(s)
- Janini Cristina Paiz
- Graduate Program in Epidemiology, Faculty of Medicine, Universidade Federal do Rio Grande do Sul (UFRGS), Ramiro Barcelos, 2400 - Santa Cecília, Porto Alegre, RS, Brazil.
| | - Stela Maris de Jezus Castro
- Graduate Program in Epidemiology, Faculty of Medicine, Universidade Federal do Rio Grande do Sul (UFRGS), Ramiro Barcelos, 2400 - Santa Cecília, Porto Alegre, RS, Brazil
- Department of Statistics, Universidade Federal do Rio Grande do Sul (UFRGS), Ramiro Barcelos, 2400 - Santa Cecília, Porto Alegre, RS, Brazil
- Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
| | - Elsa Regina Justo Giugliani
- Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
- Graduate Program in Child and Adolescent Health, Faculty of Medicine, Universidade Federal do Rio Grande do Sul (UFRGS), Ramiro Barcelos, 2400 - Santa Cecília, Porto Alegre, RS, Brazil
| | - Sarah Maria Dos Santos Ahne
- Faculty of Medicine, Universidade Federal do Rio Grande do Sul (UFRGS), Ramiro Barcelos, 2400 - Santa Cecília, Porto Alegre, RS, Brazil
| | - Camila Bonalume Dall' Aqua
- Graduate Program in Epidemiology, Faculty of Medicine, Universidade Federal do Rio Grande do Sul (UFRGS), Ramiro Barcelos, 2400 - Santa Cecília, Porto Alegre, RS, Brazil
| | - Camila Giugliani
- Graduate Program in Epidemiology, Faculty of Medicine, Universidade Federal do Rio Grande do Sul (UFRGS), Ramiro Barcelos, 2400 - Santa Cecília, Porto Alegre, RS, Brazil
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