Prevalence of and relevant factors for depression and anxiety symptoms among pregnant women on the eastern seaboard of China in the post-COVID-19 era: a cross-sectional study

Pregnant Women's Dyadic Coping and Associated Factors: A Cross-Sectional Study Utilizing Latent Profile Analysis

Background

The problem of maternal mental health is a priority issue of global concern. Dyadic coping refers to the co-managing and making decisions between two parties in response to a joint stressful event. At present, china has limited focus on dyadic coping for pregnant women during pregnancy. This study aimed to investigate different categories and characteristics of dyadic coping in pregnant women throughout pregnancy and to analyze the factors that influence these categories.

Methods

This study was a cross-sectional, and 376 pregnant women who visited the obstetric clinic at a tertiary hospital in Sichuan province from June to September 2023 were interviewed face-to-face using convenience sampling. Data were collected using a sociodemographic questionnaire, dyadic coping scale, and family adaptability and cohesion evaluation scale. The data were imported into excel and exported to spss 27.0 to analyze the potential characteristics of pregnant women's dyadic coping during pregnancy and to explore the effects of this using univariate analysis and multifactorial logistic regression.

Results

A total of 376 valid questionnaires were collected. The results of the potential profile analysis showed that the dyadic coping of pregnant women during pregnancy could be categorized into three different groups: the "low coping group" (21.3%), the "general coping group" (67.5%), and the "high coping group" (11.2%). Multiple logistic regression analyses revealed that low monthly family income, early pregnancy, primipara, family adaptability and cohesion were the factors influencing the dyadic coping of pregnant women during pregnancy.

Conclusion

During pregnancy, pregnant women exhibit moderate levels of dyadic coping. Three different categories of dyadic coping patterns were exhibited: low coping group, general coping group, and high coping group, with significant heterogeneity. Therefore, there is a need to focus on the dyadic coping status of various categories of pregnant women and implement targeted couple and family-wide interventions.

Psychological impact and associated factors of the COVID-19 pandemic among pregnant women in Fafan Zone health institutions, Somali Region, Eastern Ethiopia, 2021

BACKGROUND

Despite pregnant women's vulnerability to respiratory illnesses and pregnancy complications during the COVID-19 pandemic, research on its psychological impact in the study area, is limited.

OBJECTIVE

This study aims to fill this gap by examining the prevalence and factors linked to the psychological impact among pregnant women in the Fafan zone, Somali region of Ethiopia.

METHODS

A cross-sectional study conducted from April 1st to April 30th, 2021, randomly selected health facilities for inclusion. The Impact of Event Scale-Revised (IES-R) assessed psychological impact, and data were analyzed using SPSS V 22. Variables with a p-value ≤ 0.25 in bivariate analysis were considered for multivariate analysis via multiple logistic regressions with the backward elimination method.

RESULTS

The study involved 294 pregnant women, constituting 73% of the respondents. The prevalence of psychological impact attributed to the COVID-19 pandemic was 27.2%. Factors such as being in the first trimester of pregnancy (AOR: 5.32), travel history to infected areas (AOR: 3.71), obtaining COVID-19 information from television (AOR: 4.81), and using social media for 1 to 2 hours daily for updates (AOR: 1.35) were significantly associated with this impact.

CONCLUSION

While the psychological impact among pregnant women in this study was relatively lower compared to other research, factors such as gestational age, TV media exposure, travel history, and social media usage for COVID-19 updates were strongly linked to this impact, highlighting the necessity for psychological support services for pregnant women during challenging times.

Are Providers Adequately Screening for Anxiety Symptoms During Pregnancy?

OBJECTIVE

To examine the difference in prevalence of self-reported anxiety symptoms throughout pregnancy compared to clinical diagnosis of an anxiety disorder by a provider.

DESIGN

Secondary data analysis of a prospective cohort study of 50 pregnant individuals.

SETTING/LOCAL PROBLEM

Pregnant individuals commonly experience heightened anxiety symptoms, which are associated with adverse perinatal outcomes. However, a diagnosis of an anxiety disorder by a health care provider is less common, which may result in insufficient mental health intervention.

PARTICIPANTS

Pregnant individuals were recruited at their first prenatal appointment and followed until birth.

INTERVENTION/MEASUREMENTS

We examined anxiety symptoms using the Edinburgh Postnatal Depression Scale Anxiety subscale. We conducted a medical record review to examine if pregnant individuals were clinically diagnosed with an anxiety disorder.

RESULTS

Based on an Edinburgh Postnatal Depression Scale Anxiety subscale cutoff score of ≥5, 40% (n = 20) of individuals experienced anxiety symptoms during pregnancy. However, only 16% (n = 8) of participants were diagnosed with an anxiety disorder by a health care provider.

CONCLUSION

Anxiety symptoms are prevalent throughout pregnancy and may be underdiagnosed by health care providers. An intervention to increase clinical diagnosis of an anxiety disorder and subsequent referral to a mental health specialist may be indicated.

The knowns and unknowns of long COVID-19: from mechanisms to therapeutical approaches

The coronavirus disease 2019 (COVID-19) pandemic caused by SARS-CoV-2 has been defined as the greatest global health and socioeconomic crisis of modern times. While most people recover after being infected with the virus, a significant proportion of them continue to experience health issues weeks, months and even years after acute infection with SARS-CoV-2. This persistence of clinical symptoms in infected individuals for at least three months after the onset of the disease or the emergence of new symptoms lasting more than two months, without any other explanation and alternative diagnosis have been named long COVID, long-haul COVID, post-COVID-19 conditions, chronic COVID, or post-acute sequelae of SARS-CoV-2 (PASC). Long COVID has been characterized as a constellation of symptoms and disorders that vary widely in their manifestations. Further, the mechanisms underlying long COVID are not fully understood, which hamper efficient treatment options. This review describes predictors and the most common symptoms related to long COVID's effects on the central and peripheral nervous system and other organs and tissues. Furthermore, the transcriptional markers, molecular signaling pathways and risk factors for long COVID, such as sex, age, pre-existing condition, hospitalization during acute phase of COVID-19, vaccination, and lifestyle are presented. Finally, recommendations for patient rehabilitation and disease management, as well as alternative therapeutical approaches to long COVID sequelae are discussed. Understanding the complexity of this disease, its symptoms across multiple organ systems and overlapping pathologies and its possible mechanisms are paramount in developing diagnostic tools and treatments.

Prevalence of Perinatal Anxiety and Related Disorders in Low- and Middle-Income Countries: A Systematic Review and Meta-Analysis

Importance

Anxiety disorders are associated with poor maternal and neonatal outcomes. Women in low- and middle-income countries (LMICs) are thought to be disproportionally burdened by these disorders, yet their prevalence is unclear.

Objective

To conduct a systematic review and meta-analysis to determine the prevalence of 6 anxiety and related disorders among perinatal women in LMICs.

Data Sources

Embase, MEDLINE, PsycINFO, Cochrane Library, CINAHL, and Web of Science databases were searched from inception until September 7, 2023.

Study Selection

Studies conducted in World Bank-defined LMICs and reporting prevalence of generalized anxiety disorder, obsessive-compulsive disorder, social anxiety disorder, posttraumatic stress disorder, panic disorder, or adjustment disorder during the perinatal period (conception to 12 months post partum) using a validated method were included.

Data Extraction and Synthesis

This study followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses reporting guideline. Study eligibility, extracted data, and risk of bias of included studies were assessed by 2 independent reviewers. Random-effects meta-analysis was used to estimate pooled point prevalence. Subgroup analyses were performed by specific anxiety disorder.

Main Outcomes and Measures

Main outcomes were prevalence estimates of each anxiety disorder, measured as percentage point estimates and corresponding 95% CIs.

Results

At total of 10 617 studies were identified, 203 of which met the inclusion criteria and reported the outcomes of 212 318 women from 33 LMICs. Generalized anxiety disorder was the most reported (184 studies [90.6%]) and most prevalent disorder at 22.2% (95% CI, 19.4%-25.0%; n = 173 553). Posttraumatic stress disorder was the second most prevalent (8.3%; 95% CI, 5.0%-12.2%; 33 studies; n = 22 452). Adjustment disorder was least prevalent (2.9%; 95% CI, 0.0%-14.1%; 2 studies; n = 475). The prevalence of generalized anxiety varied by country income status, with the highest prevalence among lower-middle-income countries (27.6%; 95% CI, 21.6%-33.9%; 59 studies; n = 25 109), followed by low-income (24.0%; 95% CI, 15.3%-33.8%; 11 studies; n = 4961) and upper-middle-income (19.1%; 95% CI, 16.0%-22.4%; 110 studies; n = 138 496) countries.

Conclusions and Relevance

These findings suggest that 1 in 5 women living in LMICs experience anxiety disorders during pregnancy and post partum. Targeted action is needed to reduce this high burden.