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Marvin-Dowle K, Soltani H. Inter-Generational Differences in Perinatal Health Behaviours: A Secondary Analysis of the Born in Bradford Cohort, Disentangling Ethnicity and Migration. Matern Child Health J 2023:10.1007/s10995-023-03637-0. [PMID: 37162712 DOI: 10.1007/s10995-023-03637-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/13/2023] [Indexed: 05/11/2023]
Abstract
OBJECTIVES There exists a body of research regarding ethnic differences in perinatal health whereas this is not the case concerning the role of migration status and acculturation in attenuating these differences. This study aims to investigate determinants of health during pregnancy up to one-year postpartum by migration status. METHODS The study utilises data collected by the Born in Bradford cohort. The focus of analysis was migration status groupings, based on self-reported country of birth of participants and their parents and grandparents. Chi-Square, one-way ANOVA and correlation coefficients examined relationships between variables. RESULTS Migrant women were less likely to smoke (native: 34.4%, 1st generation: 2.8%, 2nd generation: 8.6%) or to be obese (native: 25.5%, 1st generation: 17.4%, 2nd generation: 21.3%) compared to native women. Migrants were less physically active at 6 months (Mean (SD) minutes/week: native 265 (245), 1st generation 113 (162), 2nd generation 147 (182)) with larger increases in BMI over time compared to native women. Migrant women were more likely to be suffering psychological distress at baseline and 6 months postpartum and migrant families were more likely to live in areas of high socio-economic deprivation, despite higher levels of educational attainment. CONCLUSIONS FOR PRACTICE This study ethnicity and migration identifies some important differences between ethnic groups with different migration histories, therefore indicating that healthcare professionals should consider eliciting full migration histories to improve care. The impact of these differences on perinatal outcomes is a priority for future research.
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Affiliation(s)
- Katie Marvin-Dowle
- Faculty of Health and Wellbeing, College of Health, Wellbeing and Life Sciences, Sheffield Hallam University, Collegiate Crescent, Sheffield, S10 2BP, United Kingdom.
| | - Hora Soltani
- Faculty of Health and Wellbeing, College of Health, Wellbeing and Life Sciences, Sheffield Hallam University, Collegiate Crescent, Sheffield, S10 2BP, United Kingdom
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Kesande C, Bapolisi A, Kaggwa MM, Nakimuli-Mpungu E, Maling S, Ashaba S. Prevalence and factors associated with psychological distress among pregnant and non-pregnant youth living with HIV in rural Uganda: a comparative study. PSYCHOL HEALTH MED 2023; 28:344-358. [PMID: 35260003 PMCID: PMC9458768 DOI: 10.1080/13548506.2022.2050270] [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: 11/21/2020] [Accepted: 03/01/2022] [Indexed: 02/08/2023]
Abstract
Youth living with HIV (YLHIV) are prone to psychological distress, which may have detrimental effects on health outcomes. Pregnant youth have poor access to HIV care increasing the risk of vertical transmission of HIV to their infants. Both HIV and pregnancy are independently associated with poor mental health among adolescents. The factors that predispose women to poor mental health may also increase their risk of contracting HIV. Despite their desire to have children YLHIV are at a high risk of psychological distress. However, factors associated with psychological distress among YLHIV in rural Uganda are not well explored. Therefore, the purpose of this study was to determine the prevalence of, and factors associated with psychological distress among pregnant and non-pregnant YLHIV in south western Uganda. We enrolled 224 YLHIV aged 15-24 years both pregnant and nonpregnant (ratio 1:1) between December 2018 and March 2019. We obtained information on psychological distress and factors hypothesized to affect mental health outcomes among people living with HIV including internalized HIV stigma, intimate partner violence, self-esteem and social support. Bivariate and multivariable logistic regression analysis were used to estimate factors independently associated with psychological distress. The prevalence of psychological distress was 48.2%% among pregnant YLHIV and 32.14% among non-pregnant YLHIV. Factors significantly associated with psychological distress among pregnant YLHIV were HIV stigma (AOR=4.61; 95% CI 1.63-13.84; P=0.004), physical abuse (AOR=4.97; 95% CI 1.41- 17.56; P= 0.013), and separation from partner (AOR =0.03; 95% CI 0.001-0.580; P=0.020).
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Affiliation(s)
- Claire Kesande
- Mbarara University of science and Technology, Mbarara, Uganda
| | - Achille Bapolisi
- Catholic University of Bukavu, Bukavu, Democratic Republic of Congo
| | | | | | - Samuel Maling
- Mbarara University of science and Technology, Mbarara, Uganda
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3
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Sufredini F, Catling C, Zugai J, Chang S. The effects of social support on depression and anxiety in the perinatal period: A mixed-methods systematic review. J Affect Disord 2022; 319:119-141. [PMID: 36108877 DOI: 10.1016/j.jad.2022.09.005] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2021] [Revised: 08/24/2022] [Accepted: 09/06/2022] [Indexed: 11/26/2022]
Abstract
BACKGROUND The social support offered to women in the perinatal period can buffer against depression and anxiety. The sources and types of support that reduce maternal levels of depression and anxiety are not well understood. AIMS To investigate the effects of structural and functional support on depression and anxiety in women in the perinatal period, and to explore the experiences of women around support during the perinatal period. METHOD A comprehensive search of six electronic databases was undertaken. Relevant studies published from January 2010 to April 2020 were included (PROSPERO reference number: CRD42020194228). Quantitative and qualitative studies were eligible if they reported the effects of, or had themes related to receiving functional or structural support in the perinatal period on women's levels of depression or anxiety. Qualitative data was synthesised using a thematic synthesis method. Quantitative data could not be pooled due to the lack of comparable RCTs or cohort studies and was thus presented in a narrative form. RESULTS Fifty-one articles (41 quantitative and 10 qualitative studies) were included. Analysis of quantitative studies demonstrated that insufficient support from partner, friends and family was associated with greater risk of symptoms of depression and anxiety. Distance-delivered interventions (via internet or telephone) diminished levels of depression and anxiety. Qualitative data revealed three overarching themes: appreciating all forms of support in the perinatal period, recognising appropriate and inappropriate support from health professionals and services, and having barriers to mobilising functional and structural support. LIMITATIONS Grey literature was not explored and search strategies only included English, Spanish and Portuguese language articles. The reviewed studies were heterogeneous and for this reason, quantitative assessments were not feasible. CONCLUSION Support from specific sources such as family members, friends who are also mothers, health professionals, neighbours, supervisors, co-workers and online communities still need to be further investigated. Implications for health professionals involved in the care of women in the perinatal period are discussed.
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Affiliation(s)
| | - Christine Catling
- Centre for Midwifery, Child and Family Health, School of Nursing and Midwifery, Faculty of Health, University of Technology Sydney, Australia
| | - Joel Zugai
- School of Nursing and Midwifery, Faculty of Medicine, Nursing and Midwifery and Health Sciences, University of Notre Dame, Australia
| | - Sungwon Chang
- Improving Care for Palliative, Aged and Chronic Care through Clinical Research and Translation (IMPACCT), Faculty of Health, University of Technology Sydney, Australia
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Jihed A, Ben Rejeb M, Said Laatiri H, Zedini C, Mallouli M, Mtiraoui A. Prevalence and associated factors of perinatal depression among working pregnant women: a hospital-based cross-sectional study. Libyan J Med 2022; 17:2114182. [PMID: 36000708 PMCID: PMC9415599 DOI: 10.1080/19932820.2022.2114182] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Perinatal depression is a major public health problem having serious negative impacts on personal, family, and child developmental outcomes. This study aimed to determine the prevalence of major depressive disorder (MDD) and its associated factors in working pregnant women. This descriptive, cross-sectional study was performed on 389 working pregnant women enrolled from four Tunisian public maternity hospitals. Data collection tools were the sociodemographic, obstetric, family relationships, and work environment questionnaire, and the Center for Epidemiologic Studies Depression Scale (CES-D). The mean score of depression was 27.39 ± 6.97 and 76.1% of women had major depressive symptoms using cutoff points on the CES-D ≥ 23. Family income, diagnosis with a chronic illness, history of depression, and employment categories were associated with major depressive symptoms. In multivariate analyses, family income and work posture were significantly associated with MDD. These results suggest an increased burden of MDD during pregnancy in Tunisian women. Prevention, early detection, and interventions are needed to reduce the prevalence of perinatal depression.
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Affiliation(s)
- Abdallah Jihed
- Center for Evidence into Public Health Policy (C4EPH), Faculty of Medicine of Sousse, University of Sousse, Sousse, Tunisia
| | - Mohamed Ben Rejeb
- Center for Evidence into Public Health Policy (C4EPH), Faculty of Medicine of Sousse, University of Sousse, Sousse, Tunisia
| | - Houyem Said Laatiri
- Center for Evidence into Public Health Policy (C4EPH), Faculty of Medicine of Sousse, University of Sousse, Sousse, Tunisia
| | - Chekib Zedini
- Center for Evidence into Public Health Policy (C4EPH), Faculty of Medicine of Sousse, University of Sousse, Sousse, Tunisia.,Laboratory of Research LR12ES03, Department of Community and Family Health, Faculty of Medicine of Sousse, University of Sousse, Sousse, Tunisia
| | - Manel Mallouli
- Center for Evidence into Public Health Policy (C4EPH), Faculty of Medicine of Sousse, University of Sousse, Sousse, Tunisia.,Laboratory of Research LR12ES03, Department of Community and Family Health, Faculty of Medicine of Sousse, University of Sousse, Sousse, Tunisia
| | - Ali Mtiraoui
- Center for Evidence into Public Health Policy (C4EPH), Faculty of Medicine of Sousse, University of Sousse, Sousse, Tunisia.,Laboratory of Research LR12ES03, Department of Community and Family Health, Faculty of Medicine of Sousse, University of Sousse, Sousse, Tunisia
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5
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Pilav S, De Backer K, Easter A, Silverio SA, Sundaresh S, Roberts S, Howard LM. A qualitative study of minority ethnic women's experiences of access to and engagement with perinatal mental health care. BMC Pregnancy Childbirth 2022; 22:421. [PMID: 35585579 PMCID: PMC9116695 DOI: 10.1186/s12884-022-04698-9] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2021] [Accepted: 04/14/2022] [Indexed: 11/20/2022] Open
Abstract
Background Approximately one in five women will experience mental health difficulties in the perinatal period. However, for a large group of women, symptoms of adverse perinatal mental health remain undetected and untreated. This is even more so for women of ethnic minority background, who face a variety of barriers which prevents them from accessing appropriate perinatal mental health care. Aims To explore minority ethnic women’s experiences of access to and engagement with perinatal mental health care. Methods Semi-structured interviews were conducted with 18 women who had been diagnosed with perinatal mental health difficulties and who were supported in the community by a specialist perinatal mental health service in South London, United Kingdom. Women who self-identified as being from a minority ethnic group were purposefully selected. Data were transcribed verbatim, uploaded into NVivo for management and analysis, which was conducted using reflective thematic analysis. Results Three distinct overarching themes were identified, each with two or three subthemes: ‘Expectations and Experiences of Womanhood as an Ethnic Minority’ (Shame and Guilt in Motherhood; Women as Caregivers; Perceived to Be Strong and Often Dismissed), ‘Family and Community Influences’ (Blind Faith in the Medical Profession; Family and Community Beliefs about Mental Health and Care; Intergenerational Trauma and Family Dynamics) and ‘Cultural Understanding, Empowerment, and Validation’ (The Importance of Understanding Cultural Differences; The Power of Validation, Reassurance, and Support). Conclusion Women of ethnic minority background identified barriers to accessing and engaging with perinatal mental health support on an individual, familial, community and societal level. Perinatal mental health services should be aware ethnic minority women might present with mental health difficulties in different ways and embrace principles of cultural humility and co-production to fully meet these women’s perinatal mental health needs. Supplementary Information The online version contains supplementary material available at 10.1186/s12884-022-04698-9.
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Affiliation(s)
- Sabrina Pilav
- Oxleas NHS Foundation Trust, Bexley, Bromley and Greenwich Perinatal Mental Health Service, Queen Mary's Hospital, I Block, Frognal Avenue, Sidcup, DA14 6LT, London, UK
| | - Kaat De Backer
- Department of Women & Children's Health, School of Life Course Sciences, Faculty of Life Sciences & Medicine, King's College London, 10th Floor North Wing, St., Thomas' Hospital, Westminster Bridge Road, London, SE1 7EH, UK
| | - Abigail Easter
- Department of Women & Children's Health, School of Life Course Sciences, Faculty of Life Sciences & Medicine, King's College London, 10th Floor North Wing, St., Thomas' Hospital, Westminster Bridge Road, London, SE1 7EH, UK. .,Section of Women's Mental Health, Institute of Psychiatry, Psychology and Neuroscience, King's College London, 16 De Crespigny Park, London, SE5 8AF, UK.
| | - Sergio A Silverio
- Department of Women & Children's Health, School of Life Course Sciences, Faculty of Life Sciences & Medicine, King's College London, 10th Floor North Wing, St., Thomas' Hospital, Westminster Bridge Road, London, SE1 7EH, UK
| | - Sushma Sundaresh
- Oxleas NHS Foundation Trust, Bexley, Bromley and Greenwich Perinatal Mental Health Service, Queen Mary's Hospital, I Block, Frognal Avenue, Sidcup, DA14 6LT, London, UK
| | - Sara Roberts
- Oxleas NHS Foundation Trust, Bexley, Bromley and Greenwich Perinatal Mental Health Service, Queen Mary's Hospital, I Block, Frognal Avenue, Sidcup, DA14 6LT, London, UK
| | - Louise M Howard
- Section of Women's Mental Health, Institute of Psychiatry, Psychology and Neuroscience, King's College London, 16 De Crespigny Park, London, SE5 8AF, UK
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Oftedal A, Bekkhus M, Haugen G, Braithwaite E, Bollerslev J, Godang K, Thorsby PM, Kaasen A. Changes in maternal cortisol, cortisol binding globulin and cortisone levels following diagnosis of fetal anomaly. Psychoneuroendocrinology 2022; 135:105574. [PMID: 34741978 DOI: 10.1016/j.psyneuen.2021.105574] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/18/2021] [Revised: 10/18/2021] [Accepted: 10/18/2021] [Indexed: 11/25/2022]
Abstract
The diagnosis of fetal anomaly can be a major stressor to the expectant mother. Current understanding of the relationship between psychological stress and cortisol in pregnancy is limited. This study examined: (1) differences in the ratio of serum cortisol to cortisol binding globulin (SC/CBG) and cortisone levels among women with and without a diagnosis of fetal anomaly, (2) the association between self-reported stress and cortisol from mid to late pregnancy, and (3) the agreement between two different techniques for analyzing cortisol: liquid chromatography-tandem mass spectrometry (LC-MS/MS) and radioimmunoassay (RIA). Thirty-six pregnant women with a diagnosis of fetal anomaly (study group) and 101 women with healthy pregnancies (comparison group) provided blood samples and completed self-report questionnaires at gestational weeks 18-24 (T1) and 30 (T2). In the comparison group, mean SC/CBG increased from 0.341 nmol/L at T1 to 0.415 at T2 (p < .001), whereas in the study group there was no change (0.342 nmol/L at T1, 0.343 at T2). There was no difference in cortisone levels between the groups at either timepoints. There was a negative association between both depression and traumatic stress at T1, and SC/CBG at T2 (p < .05). There was no association between general distress and SC/CBG. The two methods for analyzing cortisol gave similar results, but with LC-MS/MS showing a lower detection limit than RIA. Increased cortisol with advancing gestational age is expected, thus these findings indicate that under certain conditions of severe stress there may be a suppression of maternal cortisol increase from mid to late gestation. The discrepancy does not seem to be due to differences in the metabolization of cortisol, as indicated by the similar levels of cortisone. Further research is needed in order to understand the potential underlying mechanisms limiting the expression of cortisol in response to certain types of stress in pregnancy.
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Affiliation(s)
- Aurora Oftedal
- Oslo Metropolitan University, Faculty of Health Sciences, Norway.
| | - Mona Bekkhus
- Promenta Research Center, Department of Psychology, University of Oslo, Norway
| | - Guttorm Haugen
- Department of Fetal Medicine, Division of Obstetrics and Gynaecology, Oslo University Hospital, Norway; University of Oslo, Institute of Clinical Medicine, Norway
| | | | - Jens Bollerslev
- University of Oslo, Institute of Clinical Medicine, Norway; Section of Specialized Endocrinology, Department of Endocrinology, Oslo University Hospital Rikshospitalet, Oslo, Norway
| | - Kristin Godang
- Section of Specialized Endocrinology, Department of Endocrinology, Oslo University Hospital Rikshospitalet, Oslo, Norway
| | - Per M Thorsby
- Hormone Laboratory, Department of Medical Biochemistry, Biochemical Endocrinology And Metabolism Research Group, Oslo University Hospital, Aker, Oslo, Norway
| | - Anne Kaasen
- Oslo Metropolitan University, Faculty of Health Sciences, Norway
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Khaled K, Hundley V, Tsofliou F. Poor Dietary Quality and Patterns Are Associated with Higher Perceived Stress among Women of Reproductive Age in the UK. Nutrients 2021; 13:2588. [PMID: 34444749 PMCID: PMC8399887 DOI: 10.3390/nu13082588] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2021] [Revised: 07/24/2021] [Accepted: 07/26/2021] [Indexed: 12/19/2022] Open
Abstract
The aim of this study was to investigate the association between stress and diet quality/patterns among women of reproductive age in UK. In total, 244 reproductive aged women participated in an online survey consisting of the European Prospective into Cancer and Nutrition food frequency questionnaire in addition to stress, depression, physical-activity, adiposity, and socioeconomic questions. An a-priori diet quality index was derived by assessing the adherence to Alternate Mediterranean Diet (aMD). A-posteriori dietary-patterns (DPs) were explored through factor analysis. Regression models were used to assess the predictors of the DPs. Participants mainly had medium (n = 113) aMD adherence. Higher stress levels were reported by participants with low aMD adherence. Participants with high aMD adherence were of normal BMI. Factor analysis revealed three DPs: fats and oils, sugars, snacks, alcoholic-beverages, red/processed meat, and cereals (DP-1), fish and seafood, eggs, milk and milk-products (DP-2), and fruits, vegetables, nuts and seeds (DP-3). Regression models showed that DP-1 was positively associated with stress (p = 0.005) and negatively with age (p = 0.004) and smoking (p = 0.005). DP-2 was negatively associated with maternal educational-level (p = 0.01) while DP-3 was negatively associated with stress (p < 0.001), BMI (p = 0.001), and white ethnicity (p = 0.01). Stress was negatively associated with healthy diet quality/patterns among reproductive aged women.
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Affiliation(s)
- Karim Khaled
- Department of Rehabilitation & Sport Sciences, Faculty of Health & Social Sciences, Bournemouth University, Bournemouth BH8 8GP, UK;
| | - Vanora Hundley
- Centre for Midwifery, Maternal & Perinatal Health, Faculty of Health & Social Sciences, Bournemouth University, Bournemouth BH8 8GP, UK;
| | - Fotini Tsofliou
- Department of Rehabilitation & Sport Sciences, Faculty of Health & Social Sciences, Bournemouth University, Bournemouth BH8 8GP, UK;
- Centre for Midwifery, Maternal & Perinatal Health, Faculty of Health & Social Sciences, Bournemouth University, Bournemouth BH8 8GP, UK;
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Do HP, Baker PRA, Vo TV, Luong-Thanh BY, Nguyen LH, Valdebenito S, Eisner M, Tran BX, Hoang TD, Dunne MP. Brief screening for maternal mental health in Vietnam: Measures of positive wellbeing and perceived stress predict prenatal and postnatal depression. JOURNAL OF AFFECTIVE DISORDERS REPORTS 2021. [DOI: 10.1016/j.jadr.2020.100047] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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Akinbode TD, Pedersen C, Lara-Cinisomo S. The Price of Pre-adolescent Abuse: Effects of Sexual Abuse on Perinatal Depression and Anxiety. Matern Child Health J 2020; 25:1083-1093. [PMID: 33206305 DOI: 10.1007/s10995-020-03088-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/07/2020] [Indexed: 11/28/2022]
Abstract
INTRODUCTION Childhood abuse is a major public health concern and a risk factor for subsequent poor maternal mental health. This study of 176 racially diverse women explored the associations between the histories of childhood sexual abuse and depression and anxiety during pregnancy, at six weeks postpartum, and 12 weeks postpartum. METHODS Data on depressive and anxiety symptoms were gathered during pregnancy, at six weeks postpartum, and 12 weeks postpartum. Sociodemographic data were collected during pregnancy, while data on childhood sexual abuse were gathered during the 12-week postpartum period. Bivariate analyses and repeated mixed-effects linear regression with bootstrapping were used to assess the association between childhood sexual abuse and perinatal depressive and anxiety symptoms. RESULTS Childhood sexual abuse was significantly associated with depressive symptoms (β = 2.52, 95% CI 1.72, 3.32, p < .001) and anxiety symptoms (β = 4.44, 95% CI 3.70, 5.81, p < .001) over time, while controlling for demographic characteristics and lifetime major depression and anxiety. Depressive and anxiety symptoms decreased over the perinatal period and were highest during pregnancy. Black women were more likely to report higher depressive symptoms (β = 1.35, 95% CI 0.51, 2.19, p = .002) and anxiety symptoms (β = 3.29 95% CI 1.72, 4.87, p < .001) over time compared to White women. DISCUSSION The results highlight the importance of assessing the long-term effects of childhood sexual abuse on perinatal depressive and anxiety symptoms to help inform the development of interventions for women, particularly Black women.
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Affiliation(s)
- Tanitoluwa Demilade Akinbode
- College of Agricultural, Consumer & Environmental Sciences, Department of Human Development & Family Studies, University of Illinois at Urbana-Champaign, 222 Bevier Hall, 905 S. Goodwin Avenue, Urbana, 61801, IL, USA.
| | - Cort Pedersen
- Department of Psychiatry, The University of North Carolina at Chapel Hill, CB #7160, Chapel Hill, 27599, NC, USA
| | - Sandraluz Lara-Cinisomo
- College of Applied Health Sciences, Department of Kinesiology & Community Health, University of Illinois at Urbana-Champaign, 1206 S. Fourth St, Champaign, 61820, IL, USA
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10
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Khaled K, Hundley V, Almilaji O, Koeppen M, Tsofliou F. A Priori and a Posteriori Dietary Patterns in Women of Childbearing Age in the UK. Nutrients 2020; 12:E2921. [PMID: 32987718 PMCID: PMC7598658 DOI: 10.3390/nu12102921] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Revised: 09/19/2020] [Accepted: 09/21/2020] [Indexed: 12/13/2022] Open
Abstract
Poor diet quality is a major cause of maternal obesity. We aimed to investigate a priori and a-posteriori derived dietary patterns in childbearing-aged women in UK. An online survey assessed food intake, physical activity (PA), anthropometry and socio-demographics. An a priori defined diet quality was determined via Mediterranean diet (MD) adherence score and Exploratory Factor Analysis (EFA) derived dietary patterns (DPs). Multiple linear regression explored associations between DPs with anthropometric measures, PA and socio-demographics. Participants (n = 123) had low-to-medium MD adherence (average MD-score: 4.0 (2.0)). Age was positively associated with higher MD adherence (X2 (2) = 13.14, p = 0.01). EFA revealed three DPs: 'fruits, nuts, vegetables and legumes' ("Vegetarian-style" DP); 'sweets, cereals, dairy products and potatoes' ("Dairy, sweets and starchy foods" DP); and 'eggs, seafood and meats' ("Protein-rich" DP). "Vegetarian-style" DP was positively associated with higher maternal educational level (p < 0.01) and PA (p = 0.01), but negatively with white ethnicity (p < 0.01). "Dairy, sweets and starchy foods" DP was positively associated with white ethnicity (p = 0.03) and negatively with age (p = 0.03). "Protein-rich" DP was positively associated with age (p < 0.001) and negatively with PA (p = 0.01). A poor diet quality was found among childbearing-aged women; notably in the younger age category, those of white ethnicity, that were more physically inactive and with a lower socioeconomic background.
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Affiliation(s)
- Karim Khaled
- Department of Rehabilitation & Sport Sciences, Faculty of Health & Social Sciences, Bournemouth University, Bournemouth BH1 3LT, UK; (K.K.); (M.K.)
| | - Vanora Hundley
- Centre for Midwifery, Maternal & Perinatal Health, Faculty of Health & Social Sciences, Bournemouth University, Bournemouth BH1 3LT, UK;
| | - Orouba Almilaji
- Department of Medical Science and Public Health, Faculty of Health & Social Sciences, Bournemouth University, Bournemouth BH1 3LT, UK;
| | - Mareike Koeppen
- Department of Rehabilitation & Sport Sciences, Faculty of Health & Social Sciences, Bournemouth University, Bournemouth BH1 3LT, UK; (K.K.); (M.K.)
| | - Fotini Tsofliou
- Department of Rehabilitation & Sport Sciences, Faculty of Health & Social Sciences, Bournemouth University, Bournemouth BH1 3LT, UK; (K.K.); (M.K.)
- Centre for Midwifery, Maternal & Perinatal Health, Faculty of Health & Social Sciences, Bournemouth University, Bournemouth BH1 3LT, UK;
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Insan N, Slack E, Heslehurst N, Rankin J. Antenatal depression and anxiety and early pregnancy BMI among White British and South Asian women: retrospective analysis of data from the Born in Bradford cohort. BMC Pregnancy Childbirth 2020; 20:502. [PMID: 32873239 PMCID: PMC7466782 DOI: 10.1186/s12884-020-03097-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2020] [Accepted: 07/07/2020] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Maternal obesity has severe physical impacts such as increased chances of pre-eclampsia and gestational diabetes. However, mental health impacts are given less attention within antenatal care. Evidence suggests that women with obesity carry increased risk of maternal depression and anxiety, however, this association is not well researched amongst South Asian women in the UK who are vulnerable to both. The aim of this study was to investigate the association between antenatal depression and anxiety and early pregnancy BMI, within and between White British and South Asian women, using data from the Born in Bradford cohort. METHODS Depression and anxiety were assessed using the General Health Questionnaire (GHQ); a GHQ score of > 0 for the depression subscale and > 6 for anxiety. Mother's BMI was stratified into six World Health Organisation BMI categories (underweight, recommended, overweight or obese class 1-3). To determine associations, univariate and multivariate logistic regression models (adjusting for maternal age, education, deprivation and smoking) were used. RESULTS There were 7824 women included (3514 White British and 4310 South Asian). South Asian women were more likely to have depression than White British (43.3% vs 36.1% p < 0.0001) and less likely to have anxiety (45.3% vs 48.4% p < 0.01). There were no significant associations between BMI and depression or anxiety in South Asian women. White British women with an overweight BMI had higher odds of anxiety compared with women with a recommended BMI (Adjusted Odds Ratio 1.25, 95% Confidence Interval 1.05-1.47). No significant associations were observed for other BMI categories. Smoking was a risk factor for antenatal depression (AOR 1.32, 95% CI 1.12-1.56; AOR 2.08, 95% CI 1.49-2.91) and anxiety (AOR 1.34, 95% CI 1.14-1.57; (AOR 2.87, 95% CI 2.02-4.07) in both White British and South Asian women, respectively. CONCLUSIONS Although South Asian women have a higher prevalence of depression than White women in this cohort, the known associations between maternal obesity and anxiety do not appear to be present. More studies are needed using validated depression tools for South Asian pregnant women. Mental health screening during antenatal care is important for South Asian women, with factors such as smoking considered.
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Affiliation(s)
- Nafisa Insan
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, NE2 4AX, UK
| | - Emma Slack
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, NE2 4AX, UK
| | - Nicola Heslehurst
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, NE2 4AX, UK
| | - Judith Rankin
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, NE2 4AX, UK.
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Bekkhus M, Oftedal A, Braithwaite E, Haugen G, Kaasen A. Paternal Psychological Stress After Detection of Fetal Anomaly During Pregnancy. A Prospective Longitudinal Observational Study. Front Psychol 2020; 11:1848. [PMID: 32849088 PMCID: PMC7403403 DOI: 10.3389/fpsyg.2020.01848] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2019] [Accepted: 07/06/2020] [Indexed: 11/13/2022] Open
Abstract
Background and Aims Knowledge of carrying a fetus with a prenatal diagnosed anomaly may cause acute psychological stress to the parents. Most studies focus on maternal stress, yet fathers are often present at the ultrasound examinations and birth, and therefore may be affected, similarly, to the expectant mother. However, to date no existing studies have examined how detection of a fetal anomaly emotionally affects the expectant fathers throughout the pregnancy. Our aim was to longitudinally examine general health perceptions, social dysfunction and psychological distress in a subgroup of men where fetal anomaly was detected during pregnancy. Methods and Results This study is part of the SOFUS study, a prospective, longitudinal, observational study. Participants were recruited when referred for an ultrasound examination conducted by a specialist in fetal medicine at Oslo University Hospital on suspicion of fetal malformation (study group). We examined differences between the men in the study group (N = 32) and a comparison group (N = 83) on the General Health Questionnaire (GHQ), Impact of Event Scale (IES) and Edinburgh Postnatal Depression Scale (EDPS) across four time points in pregnancy. Results from repeated measured ANOVA suggests that depression decreased over time among men in both groups (η2 = 0.15, p < 0.001). This effect was stronger in the study group, and differed from the comparison group (η2 = 0.08, p < 0.001). There was also a main effect of time on IES scores, which decreased over time for both men in the study group and in the comparison group (η2 = 0.32, p < 0.001). That is, men in the study group were higher on IES initially, but this effect decreased more in the study group than in the comparison group. Men in the study group and comparison group did not differ on perceived general health (GHQ: p = 0.864). Conclusion Results suggests that detection of a fetal anomaly has implications for paternal mental health during pregnancy. Expectant fathers scored higher on EPDS and IES than the comparison group in the acute phase after detection of fetal anomaly, thus there is impetus to provide psychological support for fathers, as well as mothers, at this difficult time.
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Affiliation(s)
- Mona Bekkhus
- Department of Psychology, PROMENTA Research Center, University of Oslo, Oslo, Norway
| | - Aurora Oftedal
- Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway
| | - Elizabeth Braithwaite
- Department of Psychology, Manchester Metropolitan University, Manchester, United Kingdom
| | - Guttorm Haugen
- Department of Fetal Medicine Oslo, University Hospital and Institute of Clinical Medicine University of Oslo, Oslo, Norway
| | - Anne Kaasen
- Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway
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Kirby N, Wright B, Allgar V. Child mental health and resilience in the context of socioeconomic disadvantage: results from the Born in Bradford cohort study. Eur Child Adolesc Psychiatry 2020; 29:467-477. [PMID: 31243580 PMCID: PMC7103573 DOI: 10.1007/s00787-019-01348-y] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2018] [Accepted: 04/03/2019] [Indexed: 01/05/2023]
Abstract
Socioeconomic disadvantage has been linked to mental health difficulties in children and adolescents, although many children appear to do well despite exposure to financial adversity in childhood. Our study looked at the effects of family financial difficulty on children's mental health outcomes (n = 636) at 4-5 years in a multi-ethnic UK cohort, the Born in Bradford cohort. We considered potential parent and child variables promoting resilience in this population. Univariate linear regression was used to identify associations between family financial difficulty measured antenatally and child mental health difficulties measured by teacher-rated Strengths and Difficulties (SDQ) scores at 4-5 years. Hierarchical multivariate regression was used to test for potential moderating effects of parent and child factors. Mothers completed the General Health Questionnaire-28, Kessler-6 Questionnaire and questions related to parenting warmth, hostility and confidence. Parent-rated Infant Characteristic Questionnaires and teacher-rated Early Years Foundation Stage scores provided information on child temperament, literacy and physical development as potential moderators. Financial difficulty was associated with worse mental health outcomes in children. High parent warmth, high child literacy scores and physical development scores were all associated with positive child mental health outcomes at 4-5 years. In terms of protective effects, only maternal warmth was found to significantly moderate the relationship between financial difficulty and child mental health difficulties. The current study demonstrates that family financial difficulty is associated with poorer child mental health outcomes in a UK cohort of mothers and their school-aged children. It provides evidence of the positive relationships between warm parenting, child literacy and child physical development with mental health in young children. The study supports the finding that warm parenting moderates the relationship between family financial difficulty and interventions supporting this aspect of parenting may therefore provide particular benefit to children growing up in this context.
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Affiliation(s)
- Natalie Kirby
- Hull York Medical School, University of York, York, UK.
- Tees Esk and Wear Valleys Foundation Trust, York, UK.
| | - Barry Wright
- Hull York Medical School, University of York, York, UK
- Leeds and York Partnership Foundation Trust, York, UK
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KARATAŞ BARAN G, ŞAHİN S, ÖZTAŞ D, DEMİR P, DESTİCİOĞLU R. Gebelerin algılanan stres düzeylerinin ve stres nedenlerinin değerlendirilmesi. CUKUROVA MEDICAL JOURNAL 2020. [DOI: 10.17826/cumj.633534] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Rousou E, Kouta C, Middleton N, Karanikola M. Mental health among single mothers in Cyprus: a cross-sectional descriptive correlational study. BMC WOMENS HEALTH 2019; 19:67. [PMID: 31096963 PMCID: PMC6524274 DOI: 10.1186/s12905-019-0763-9] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/11/2018] [Accepted: 05/03/2019] [Indexed: 11/23/2022]
Abstract
Background International literature reveals that single mothers experience increased levels of chronic stress, which is mainly due to economic hardship and reduced levels of social support. Eventually this leads to psychological distress. While most of the studies commonly identify that mental health disorders are common among single mothers compared to their married counterparts, the magnitude of the problem might be even larger since diagnosis-specific tools may mask important levels of distress of milder intensity. This study aims to assess the level of mental distress experienced by single mothers as measured by the GHQ-28, and how it is influenced by socioeconomic factors, as well as the level of perceived social support. Methods Between January and March 2012, Greek speaking single mothers who reside in Cyprus were recruited by either personal conduct through Single Mothers’ Association (SMA), or by using snowball sampling technic. Mental distress was assessed with the General Health Questionnaire (GHQ-28) and perceived social support with the Social Provision Scale (SPS). All scales were completed anonymously and voluntarily by 316 single mothers. Univariable and multivariable associations with socio-demographic characteristics were investigated using chi-square tests and in multivariable backward stepwise logistic regression models respectively. Odds ratio of psychological distress across decreasing levels of social support were estimated in logistic regression models. . Results As many as 44.6% of the sample appeared to experience psychological distress (GHQ-28 total score ≥ 5). Strong associations with all health assessment tools were observed with variables relating to the lowest monthly family income, the presence of economic difficulties, the higher educational level, the age group 35–44 years and pre-existing illness. Social support as perceived by the mothers displayed a strong negative independent association with psychological distress, even after adjusting confounders. Conclusion This study highlights that single mothers are very likely to experience poor psychological well-being. With a steady rise in the proportion of single-parent families headed by a mother, these findings highlight a significant issue that would adversely affect many women and consequently their children and the community. It also emphasizes the necessity for interventions and strategies at community level in order to support this vulnerable population group.
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Affiliation(s)
- Elena Rousou
- Department of Nursing, School of Health Sciences, Cyprus University of Technology, 15, Vragadinou str, 3041, Limassol, Cyprus.
| | - Christiana Kouta
- Department of Nursing, School of Health Sciences, Cyprus University of Technology, 15, Vragadinou str, 3041, Limassol, Cyprus
| | - Nicos Middleton
- Department of Nursing, School of Health Sciences, Cyprus University of Technology, 15, Vragadinou str, 3041, Limassol, Cyprus
| | - Maria Karanikola
- Department of Nursing, School of Health Sciences, Cyprus University of Technology, 15, Vragadinou str, 3041, Limassol, Cyprus
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Ogunyemi D, Jovanovski A, Liu J, Friedman P, Sugiyama N, Creps J, Madan I. The Contribution of Untreated and Treated Anxiety and Depression to Prenatal, Intrapartum, and Neonatal Outcomes. AJP Rep 2018; 8:e146-e157. [PMID: 29998037 PMCID: PMC6039295 DOI: 10.1055/s-0038-1661379] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/15/2017] [Accepted: 02/23/2018] [Indexed: 12/02/2022] Open
Abstract
Objective To determine independent perinatal associations of anxiety and depression in women who were and were not treated with psychotropic drugs in comparison to unaffected pregnancies. Study Design From 2013 to 2014, 978 (6.3%) cases of anxiety/depression, of which 35% used psychotropic drugs, were compared with 14,514 (93.7%) unaffected pregnancies using logistic regression. Results Subjects were more likely to be Non-Hispanic Whites, use tobacco and illegal substances, be unmarried, use public insurance, and have medical complications of pregnancy. For independent maternal outcomes, untreated anxiety/depression was associated with labor induction (adjusted odds ratio [aOR] = 2.02), cesarean deliveries (aOR = 1.69), longer length of stay (aOR = 1.96), readmission (aOR = 2.40), fever (aOR = 2.03), magnesium exposure (aOR = 1.82), and postpartum hemorrhage (aOR = 2.57), whereas treated cases were associated with increased blood transfusion (aOR = 4.81), severe perineal lacerations (aOR = 2.93), and postpartum hemorrhage (aOR = 3.85), but decreased risk of cesarean deliveries (aOR = 0.59). Independent neonatal outcomes included small for gestational age (aOR = 3.04), meconium-stained fluid (aOR = 1.85; 2.61), respiratory failure (aOR = 5.84), neonatal adaptation syndrome (aOR = 11; 10.2), and neonatal seizures (aOR = 12.3) in treated cases, whereas untreated cases were associated with hypoxia (aOR = 2.83), low Apgar score (aOR = 3.82), and encephalopathy (aOR = 18.3). Exposure to multiple psychotropic medications independently increased the risk of neonatal adaptation syndrome, neonatal length of stay, and hypoglycemia. Conclusion Untreated cases were associated with increased maternal adverse outcomes, whereas treated cases were associated with more adverse neonatal outcomes when compared with unaffected pregnancies.
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Affiliation(s)
- Dotun Ogunyemi
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Beaumont Hospital, Royal Oak, Michigan.,Department of Obstetrics and Gynecology, Oakland University, William Beaumont School of Medicine, Rochester Hills, Michigan
| | - Andrew Jovanovski
- Department of Obstetrics and Gynecology, Oakland University, William Beaumont School of Medicine, Rochester Hills, Michigan
| | - James Liu
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Beaumont Hospital, Royal Oak, Michigan.,Department of Obstetrics and Gynecology, Oakland University, William Beaumont School of Medicine, Rochester Hills, Michigan
| | - Perry Friedman
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Beaumont Hospital, Royal Oak, Michigan.,Department of Obstetrics and Gynecology, Oakland University, William Beaumont School of Medicine, Rochester Hills, Michigan
| | - Nathaniel Sugiyama
- University of Vermont Robert Larner College of Medicine, Burlington, Vermont
| | - James Creps
- Department of Obstetrics and Gynecology, Oakland University, William Beaumont School of Medicine, Rochester Hills, Michigan
| | - Ichchha Madan
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Beaumont Hospital, Royal Oak, Michigan.,Department of Obstetrics and Gynecology, Oakland University, William Beaumont School of Medicine, Rochester Hills, Michigan
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Tajvar M, Grundy E, Fletcher A. Social support and mental health status of older people: a population-based study in Iran-Tehran. Aging Ment Health 2018; 22:344-353. [PMID: 27976913 DOI: 10.1080/13607863.2016.1261800] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
OBJECTIVES To investigate direct and stress-buffering associations between social support from family and the mental health of older people in Iran, a country which has recently undergone an exceptionally fast fertility transition and is consequently experiencing rapid population ageing. METHOD A cross-sectional stratified random survey of 800 people aged 60+ years resident in Tehran was conducted. In total, 644 people responded. The Social Provisions Scale and the General Health Questionnaire were used to measure perceived social support and mental health, respectively. Multilevel mixed-effects models were used to examine the hypotheses. RESULTS The findings supported the hypothesis of a direct association between perceived and received social support and mental health. However, we did not find strong evidence to suggest that social support buffered the effects of stress arising from limitations of physical functioning. Lack of help doing paperwork was associated with worse mental health for women but not men. Source of support did not seem to be important. CONCLUSION Our results indicated that in Tehran, as in Western settings, social support is important for the mental well-being of older people. Recommendations for policy and further research priorities based on the study findings were provided.
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Affiliation(s)
- Maryam Tajvar
- a Department of Health Management and Economic Sciences, School of Public Health , Tehran University of Medical Sciences , Tehran , Iran
| | - Emily Grundy
- b Department of Social Policy , London School of Economics and Political Science , London , United Kingdom
| | - Astrid Fletcher
- c Faculty of Epidemiology & Population Health , London School of Hygiene and Tropical Medicine , London , United Kingdom
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Sattler MC, Jelsma JGM, Bogaerts A, Simmons D, Desoye G, Corcoy R, Adelantado JM, Kautzky-Willer A, Harreiter J, van Assche FA, Devlieger R, Jans G, Galjaard S, Hill D, Damm P, Mathiesen ER, Wender-Ozegowska E, Zawiejska A, Blumska K, Lapolla A, Dalfrà MG, Bertolotto A, Dunne F, Jensen DM, Andersen LLT, Snoek FJ, van Poppel MNM. Correlates of poor mental health in early pregnancy in obese European women. BMC Pregnancy Childbirth 2017; 17:404. [PMID: 29202779 PMCID: PMC5715612 DOI: 10.1186/s12884-017-1595-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2017] [Accepted: 11/24/2017] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND Depression during pregnancy is associated with higher maternal morbidity and mortality, and subsequent possible adverse effects on the cognitive, emotional and behavioral development of the child. The aim of the study was to identify maternal characteristics associated with poor mental health, in a group of overweight/obese pregnant women in nine European countries, and thus, to contribute to better recognition and intervention for maternal depression. METHODS In this cross-sectional observational study, baseline data from early pregnancy (< 20 weeks) of the DALI (Vitamin D and Lifestyle Intervention for gestational diabetes mellitus prevention) study were analyzed. Maternal mental health was assessed with the World Health Organization Well-Being Index (WHO-5). Women were classified as having a low (WHO-5 ≤ 50) or high wellbeing. RESULTS A total of 735 pregnant women were included. The prevalence of having a low wellbeing was 27.2%, 95% CI [24.0, 30.4]. Multivariate analysis showed independent associations between low wellbeing and European ethnicity, OR = .44, 95% CI [.25, .77], shift work, OR = 1.81, 95% CI [1.11, 2.93], insufficient sleep, OR = 3.30, 95% CI [1.96, 5.55], self-efficacy, OR = .95, 95% CI [.92, .98], social support, OR = .94, 95% CI [.90, .99], and pregnancy-related worries (socioeconomic: OR = 1.08, 95% CI [1.02, 1.15]; health: OR = 1.06, 95% CI [1.01, 1.11]; relationship: OR = 1.17, 95% CI [1.05, 1.31]). CONCLUSIONS Mental health problems are common in European overweight/obese pregnant women. The identified correlates might help in early recognition and subsequent treatment of poor mental health problems during pregnancy. This is important to reduce the unfavorable effects of poor mental health on pregnancy outcomes. TRIAL REGISTRATION ISRCTN70595832 , 02.12.2011.
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Affiliation(s)
- Matteo C. Sattler
- Institute of Sport Science, University of Graz, Mozartgasse 14, 8010, Graz, Austria
| | - Judith G. M. Jelsma
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, VU University Medical Centre, Amsterdam, the Netherlands
| | - Annick Bogaerts
- Department of Development and Regeneration KULeuven, University of Leuven, Leuven, Belgium and Faculty of Medicine and Health Sciences, Centre for Research and Innovation in Care (CRIC), University of Antwerp, Belgium and Faculty of Health and Social Work, research unit Healthy Living, UC Leuven-Limburg, Leuven, Belgium
| | - David Simmons
- Institute of Metabolic Science, Addenbrookes Hospital, Cambridge, England and Macarthur Clinical School, Western Sydney University, Sydney, Australia
| | - Gernot Desoye
- Department of Obstetrics and Gynecology, Medizinische Universität Graz, Graz, Austria
| | - Rosa Corcoy
- Institut de Recerca de L’Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
- CIBER Bioengineering, Biomaterials and Nanotechnology, Instituto de Salud Carlos III, Zaragaza, Spain
| | - Juan M. Adelantado
- Institut de Recerca de L’Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - Alexandra Kautzky-Willer
- Division of Endocrinology and Metabolism, Department of Medicine III, Medical University of Vienna, Vienna, Austria
| | - Jürgen Harreiter
- Division of Endocrinology and Metabolism, Department of Medicine III, Medical University of Vienna, Vienna, Austria
| | - Frans A. van Assche
- KU Leuven Department of Development and Regeneration: Pregnancy, Fetus and Neonate, Gynaecology and Obstetrics, University Hospitals, Leuven, Belgium
| | - Roland Devlieger
- KU Leuven Department of Development and Regeneration: Pregnancy, Fetus and Neonate, Gynaecology and Obstetrics, University Hospitals, Leuven, Belgium
| | - Goele Jans
- KU Leuven Department of Development and Regeneration: Pregnancy, Fetus and Neonate, Gynaecology and Obstetrics, University Hospitals, Leuven, Belgium
| | - Sander Galjaard
- KU Leuven Department of Development and Regeneration: Pregnancy, Fetus and Neonate, Gynaecology and Obstetrics, University Hospitals, Leuven, Belgium
- Department of Obstetrics and Gynaecology Division of Obstetrics and Prenatal Medicine, Erasmus Medical Centre, Rotterdam, The Netherlands
| | - David Hill
- Recherche en Santé Lawson SA, Bronschhofen, Switzerland
| | - Peter Damm
- Center for Pregnant Women with Diabetes, Departments of Endocrinology and Obstetrics, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Elisabeth R. Mathiesen
- Center for Pregnant Women with Diabetes, Departments of Endocrinology and Obstetrics, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | | | - Agnieszka Zawiejska
- Division of Reproduction, Poznan University of Medical Sciences, Poznan, Poland
| | - Kinga Blumska
- Division of Reproduction, Poznan University of Medical Sciences, Poznan, Poland
| | | | | | | | | | | | | | - Frank J. Snoek
- Department of Medical Psychology, VU University Medical Centre, Amsterdam, the Netherlands
- Department of Medical Psychology, Academic Medical Centre, Amsterdam, the Netherlands
| | - Mireille N. M. van Poppel
- Institute of Sport Science, University of Graz, Mozartgasse 14, 8010, Graz, Austria
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, VU University Medical Centre, Amsterdam, the Netherlands
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Ayre K, Khalifeh H. Immigrant women and women with learning disabilities have complex mental health needs and service use in the perinatal period. EVIDENCE-BASED MENTAL HEALTH 2017; 20:55-57. [PMID: 28377384 PMCID: PMC10688522 DOI: 10.1136/eb-2017-102607] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/14/2017] [Revised: 03/28/2017] [Accepted: 03/29/2017] [Indexed: 11/04/2022]
Affiliation(s)
- Karyn Ayre
- Section of Women's Mental Health, Institute of Psychiatry, Psychology and Neuroscience, Kings College London, London, UK
- South London and Maudsley NHS Foundation Trust, London, UK
| | - Hind Khalifeh
- Section of Women's Mental Health, Institute of Psychiatry, Psychology and Neuroscience, Kings College London, London, UK
- South London and Maudsley NHS Foundation Trust, London, UK
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Kaasen A, Helbig A, Malt UF, Næs T, Skari H, Haugen G. Maternal psychological responses during pregnancy after ultrasonographic detection of structural fetal anomalies: A prospective longitudinal observational study. PLoS One 2017; 12:e0174412. [PMID: 28350879 PMCID: PMC5369773 DOI: 10.1371/journal.pone.0174412] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2016] [Accepted: 03/08/2017] [Indexed: 01/08/2023] Open
Abstract
In this longitudinal prospective observational study performed at a tertiary perinatal referral centre, we aimed to assess maternal distress in pregnancy in women with ultrasound findings of fetal anomaly and compare this with distress in pregnant women with normal ultrasound findings. Pregnant women with a structural fetal anomaly (n = 48) and normal ultrasound (n = 105) were included. We administered self-report questionnaires (General Health Questionnaire-28, Impact of Event Scale-22 [IES], and Edinburgh Postnatal Depression Scale) a few days following ultrasound detection of a fetal anomaly or a normal ultrasound (T1), 3 weeks post-ultrasound (T2), and at 30 (T3) and 36 weeks gestation (T4). Social dysfunction, health perception, and psychological distress (intrusion, avoidance, arousal, anxiety, and depression) were the main outcome measures. The median gestational age at T1 was 20 and 19 weeks in the group with and without fetal anomaly, respectively. In the fetal anomaly group, all psychological distress scores were highest at T1. In the group with a normal scan, distress scores were stable throughout pregnancy. At all assessments, the fetal anomaly group scored significantly higher (especially on depression-related questions) compared to the normal scan group, except on the IES Intrusion and Arousal subscales at T4, although with large individual differences. In conclusion, women with a known fetal anomaly initially had high stress scores, which gradually decreased, resembling those in women with a normal pregnancy. Psychological stress levels were stable and low during the latter half of gestation in women with a normal pregnancy.
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Affiliation(s)
- Anne Kaasen
- Department of Nursing and Health Promotion, Oslo and Akershus University College of Applied Sciences, Oslo, Norway
- * E-mail:
| | - Anne Helbig
- Department of Obstetrics, Oslo University Hospital, Oslo, Norway
| | - Ulrik F. Malt
- Department of Research and Education, Division of Clinical Neuroscience, Oslo University Hospital, Oslo, Norway
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Tormod Næs
- Nofima Food Research, Ås, Norway
- Department of Food Science, Spectroscopy and Chemometrics, University of Copenhagen, Copenhagen, Denmark
| | - Hans Skari
- Department of Gastrointestinal- and Pediatric Surgery, Oslo University Hospital, Oslo, Norway
| | - Guttorm Haugen
- Department of Obstetrics, Oslo University Hospital, Oslo, Norway
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
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Association of physical activity and sedentary behavior with depression and anxiety symptoms during pregnancy in a multiethnic cohort of Asian women. Arch Womens Ment Health 2016; 19:1119-1128. [PMID: 27664104 DOI: 10.1007/s00737-016-0664-y] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2016] [Accepted: 09/02/2016] [Indexed: 12/26/2022]
Abstract
OBJECTIVES This study aimed to investigate associations of physical activity (PA) and sedentary behavior (SB) with depression and anxiety symptoms during pregnancy among Chinese, Malay, and Indian women. METHODS Women answered PA and SB (sitting time and television time) interview questions and self-completed the Edinburgh Postnatal Depression Scale (EPDS) and State-Trait Anxiety Inventory (STAI) questionnaires, at week 26-28 gestation. Sufficient levels of PA (≥600MET-minutes/week) and higher sitting time (≥7 h/day) were determined. Associations of PA and SB with probable antenatal depression (EPDS-score ≥15), higher state anxiety (score ≥42), and higher trait anxiety (score ≥43) were determined by logistic regression analysis. RESULTS Among the 1144 pregnant women included in the study, 7.3, 22.5, and 23.6 % had probable antenatal depression, higher state anxiety, and higher trait anxiety symptoms, respectively. In the adjusted models, women with sufficient level of PA were less likely to have probable antenatal depression (OR 0.54, 95 % CI 0.31-0.94, p = 0.030) and higher trait anxiety symptoms (OR 0.68, 95 % CI 0.48-0.94, p = 0.022). PA was not associated with state anxiety symptoms. SB was not associated with any of the investigated outcomes. CONCLUSIONS Sufficient PA was associated with a reduced likelihood of probable antenatal depression and trait anxiety symptoms. Further investigation of these findings is warranted to determine cause-effect relationships and identify potential preventive strategies.
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Witteveen AB, De Cock P, Huizink AC, De Jonge A, Klomp T, Westerneng M, Geerts CC. Pregnancy related anxiety and general anxious or depressed mood and the choice for birth setting: a secondary data-analysis of the DELIVER study. BMC Pregnancy Childbirth 2016; 16:363. [PMID: 27871257 PMCID: PMC5118894 DOI: 10.1186/s12884-016-1158-7] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2016] [Accepted: 11/14/2016] [Indexed: 11/10/2022] Open
Abstract
Background In several developed countries women with a low risk of complications during pregnancy and childbirth can make choices regarding place of birth. In the Netherlands, these women receive midwife-led care and can choose between a home or hospital birth. The declining rate of midwife-led home births alongside the recent debate on safety of home births in the Netherlands, however, suggest an association of choice of birth place with psychological factors related to safety and risk perception. In this study associations of pregnancy related anxiety and general anxious or depressed mood with (changes in) planned place of birth were explored in low risk women in midwife-led care until the start of labour. Methods Data (n = 2854 low risk women in midwife-led care at the onset of labour) were selected from the prospective multicenter DELIVER study. Women completed the Pregnancy Related Anxiety Questionnaire-Revised (PRAQ-R) to assess pregnancy related anxiety and the EuroQol-6D (EQ-6D) for an anxious and/or depressed mood. Results A high PRAQ-R score was associated with planned hospital birth in nulliparous (aOR 1.92; 95% CI 1.32–2.81) and parous women (aOR 2.08; 95% CI 1.55–2.80). An anxious or depressed mood was associated with planned hospital birth (aOR 1.58; 95% CI 1.20–2.08) and with being undecided (aOR 1.99; 95% CI 1.23–2.99) in parous women only. The majority of women did not change their planned place of birth. Changing from an initially planned home birth to a hospital birth later in pregnancy was, however, associated with becoming anxious or depressed after 35 weeks gestation in nulliparous women (aOR 4.17; 95% CI 1.35–12.89) and with pregnancy related anxiety at 20 weeks gestation in parous women (aOR 3.91; 95% CI 1.32–11.61). Conclusion Low risk women who planned hospital birth (or who were undecided) more often reported pregnancy related anxiety or an anxious or depressed mood. Women who changed from home to hospital birth during pregnancy more often reported pregnancy related anxiety or an anxious or depressed mood in late pregnancy. Anxiety should be adequately addressed in the process of informed decision-making regarding planned place of birth in low risk women.
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Affiliation(s)
- A B Witteveen
- Department of Midwifery Science, AVAG and the EMGO Institute for Health and Care Research, VU University Medical Center, Van der Boechorststraat 7, 1081 BT, Amsterdam, The Netherlands.
| | - P De Cock
- Department of Midwifery Science, AVAG and the EMGO Institute for Health and Care Research, VU University Medical Center, Van der Boechorststraat 7, 1081 BT, Amsterdam, The Netherlands
| | - A C Huizink
- Department of Developmental Psychology, VU University Amsterdam, Amsterdam, The Netherlands.,EMGO+ Institute for Health and Care Research, VU Medical Center, Amsterdam, The Netherlands.,Department of Clinical Child and Family Studies, VU University Amsterdam, Amsterdam, The Netherlands
| | - A De Jonge
- Department of Midwifery Science, AVAG and the EMGO Institute for Health and Care Research, VU University Medical Center, Van der Boechorststraat 7, 1081 BT, Amsterdam, The Netherlands
| | - T Klomp
- Department of Midwifery Science, AVAG and the EMGO Institute for Health and Care Research, VU University Medical Center, Van der Boechorststraat 7, 1081 BT, Amsterdam, The Netherlands
| | - M Westerneng
- Department of Midwifery Science, AVAG and the EMGO Institute for Health and Care Research, VU University Medical Center, Van der Boechorststraat 7, 1081 BT, Amsterdam, The Netherlands
| | - C C Geerts
- Department of Midwifery Science, AVAG and the EMGO Institute for Health and Care Research, VU University Medical Center, Van der Boechorststraat 7, 1081 BT, Amsterdam, The Netherlands
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23
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Stacey T, Prady S, Haith-Cooper M, Downe S, Simpson N, Pickett K. Ethno-Specific Risk Factors for Adverse Pregnancy Outcomes: Findings from the Born in Bradford Cohort Study. Matern Child Health J 2016; 20:1394-404. [PMID: 26983444 PMCID: PMC4909785 DOI: 10.1007/s10995-016-1936-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Objectives Preterm birth (PTB) and small for gestational age (SGA) are major causes of perinatal mortality and morbidity. Previous studies indicated a range of risk factors associated with these poor outcomes, including maternal psychosocial and economic wellbeing. This paper will explore a range of psycho-social and economic factors in an ethnically diverse population. Methods The UK's Born in Bradford cohort study recruited pregnant women attending a routine antenatal appointment at 26-28 weeks' gestation at the Bradford Royal Infirmary (2007-2010). This analysis includes 9680 women with singleton live births who completed the baseline questionnaire. Data regarding maternal socio-demographic and mental health were recorded. Outcome data were collected prospectively, and analysed using multivariate regression models. The primary outcomes measured were: PTB (<37 weeks' gestation) and SGA (<10th customised centile). Results After adjustment for socio-demographic and medical factors, financial strain was associated with a 45 % increase in PTB (OR 1.45: 95 % CI 1.06-1.98). Contrary to expectation, maternal distress in Pakistani women was negatively associated with SGA (OR 0.65: CI 0.48-0.88). Obesity in White British women was protective for PTB (OR 0.67: CI 0.45-0.98). Previously recognized risk factors, such as smoking in pregnancy and hypertension, were confirmed. Conclusions This study confirms known risk factors for PTB and SGA, along with a new variable of interest, financial strain. It also reveals a difference in the risk factors between ethnicities. In order to develop appropriate targeted preventative strategies to improve perinatal outcome in disadvantaged groups, a greater understanding of ethno-specific risk factors is required.
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Affiliation(s)
- Tomasina Stacey
- />School of Healthcare, University of Leeds, Leeds, LS2 9JT UK
| | - Stephanie Prady
- />Department of Health Sciences, University of York, Heslington, York, Yorkshire YO10 5DD UK
| | - Melanie Haith-Cooper
- />School of Health Studies, University of Bradford, Richmond Road, Bradford, Yorkshire BD7 1DP UK
| | - Soo Downe
- />School of Health, University of Central Lancashire, Brook Building, Preston, PR1 2HE UK
| | - Nigel Simpson
- />Department of Women’s and Children’s Health, Level 9, University of Leeds, Worsley Building, Clarendon Way, Leeds, LS2 9NL UK
| | - Kate Pickett
- />Department of Health Sciences, University of York, Heslington, York, Yorkshire YO10 5DD UK
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Prady SL, Pickett KE, Croudace T, Mason D, Petherick ES, McEachan RRC, Gilbody S, Wright J. Maternal psychological distress in primary care and association with child behavioural outcomes at age three. Eur Child Adolesc Psychiatry 2016; 25:601-13. [PMID: 26415597 PMCID: PMC4889639 DOI: 10.1007/s00787-015-0777-2] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2015] [Accepted: 09/16/2015] [Indexed: 01/04/2023]
Abstract
Observational studies indicate children whose mothers have poor mental health are at increased risk of socio-emotional behavioural difficulties, but it is unknown whether these outcomes vary by the mothers' mental health recognition and treatment status. To examine this question, we analysed linked longitudinal primary care and research data from 1078 women enrolled in the Born in Bradford cohort. A latent class analysis of treatment status and self-reported distress broadly categorised women as (a) not having a common mental disorder (CMD) that persisted through pregnancy and the first 2 years after delivery (N = 756, 70.1 %), (b) treated for CMD (N = 67, 6.2 %), or (c) untreated (N = 255, 23.7 %). Compared to children of mothers without CMD, 3-year-old children with mothers classified as having untreated CMD had higher standardised factor scores on the Strengths and Difficulties Questionnaire (d = 0.32), as did children with mothers classified as having treated CMD (d = 0.27). Results were only slightly attenuated in adjusted analyses. Children of mothers with CMD may be at risk for socio-emotional and behavioural difficulties. The development of effective treatments for CMD needs to be balanced by greater attempts to identify and treat women.
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Affiliation(s)
- Stephanie L Prady
- Department of Health Sciences, University of York, York, YO10 5DD, UK.
| | - Kate E Pickett
- Department of Health Sciences, University of York, York, YO10 5DD, UK
| | - Tim Croudace
- School of Nursing and Health Sciences, University of Dundee, Dundee, DD1 4HN, UK
- Social Dimensions of Health Institute, University of Dundee, Dundee, DD1 4HN, UK
| | - Dan Mason
- Bradford Institute for Health Research, Bradford Royal Infirmary, Duckworth Lane, Bradford, BD9 6RJ, UK
| | - Emily S Petherick
- Bradford Institute for Health Research, Bradford Royal Infirmary, Duckworth Lane, Bradford, BD9 6RJ, UK
| | - Rosie R C McEachan
- Bradford Institute for Health Research, Bradford Royal Infirmary, Duckworth Lane, Bradford, BD9 6RJ, UK
| | - Simon Gilbody
- Department of Health Sciences, University of York, York, YO10 5DD, UK
- Hull York Medical School, University of York, York, YO10 5DD, UK
| | - John Wright
- Bradford Institute for Health Research, Bradford Royal Infirmary, Duckworth Lane, Bradford, BD9 6RJ, UK
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25
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Prady SL, Pickett KE, Petherick ES, Gilbody S, Croudace T, Mason D, Sheldon TA, Wright J. Evaluation of ethnic disparities in detection of depression and anxiety in primary care during the maternal period: combined analysis of routine and cohort data. Br J Psychiatry 2016; 208:453-61. [PMID: 26795424 PMCID: PMC4853643 DOI: 10.1192/bjp.bp.114.158832] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2014] [Revised: 05/15/2015] [Accepted: 05/18/2015] [Indexed: 11/23/2022]
Abstract
BACKGROUND There are limited data on detection disparities of common mental disorders in minority ethnic women. AIMS Describe the natural history of common mental disorders in primary care in the maternal period, characterise women with, and explore ethnic disparities in, detected and potentially missed common mental disorders. METHOD Secondary analyses of linked birth cohort and primary care data involving 8991 (39.4% White British) women in Bradford. Common mental disorders were characterised through indications in the electronic medical record. Potentially missed common mental disorders were defined as an elevated General Health Questionnaire (GHQ-28) score during pregnancy with no corresponding common mental disorder markers in the medical record. RESULTS Estimated prevalence of pre-birth common mental disorders was 9.5%, rising to 14.0% 3 years postnatally. Up to half of cases were potentially missed. Compared with White British women, minority ethnic women were twice as likely to have potentially missed common mental disorders and half as likely to have a marker of screening for common mental disorders. CONCLUSIONS Common mental disorder detection disparities exist for minority ethnic women in the maternal period.
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Affiliation(s)
- Stephanie L Prady
- Stephanie L. Prady, PhD, Kate E. Pickett, PhD, Department of Health Sciences, University of York, York; Emily S. Petherick, PhD, Bradford Institute for Health Research, Bradford Royal Infirmary, Bradford; Simon Gilbody, DPhil, FRCPsych, Tim Croudace, PhD, Department of Health Sciences and Hull York Medical School, University of York, York; Dan Mason, PhD, Bradford Institute for Health Research, Bradford Royal Infirmary, Bradford; Trevor A. Sheldon, DSc, Hull York Medical School, University of York, York; John Wright, FRCP, Bradford Institute for Health Research, Bradford Royal Infirmary, Bradford, UK
| | - Kate E Pickett
- Stephanie L. Prady, PhD, Kate E. Pickett, PhD, Department of Health Sciences, University of York, York; Emily S. Petherick, PhD, Bradford Institute for Health Research, Bradford Royal Infirmary, Bradford; Simon Gilbody, DPhil, FRCPsych, Tim Croudace, PhD, Department of Health Sciences and Hull York Medical School, University of York, York; Dan Mason, PhD, Bradford Institute for Health Research, Bradford Royal Infirmary, Bradford; Trevor A. Sheldon, DSc, Hull York Medical School, University of York, York; John Wright, FRCP, Bradford Institute for Health Research, Bradford Royal Infirmary, Bradford, UK
| | - Emily S Petherick
- Stephanie L. Prady, PhD, Kate E. Pickett, PhD, Department of Health Sciences, University of York, York; Emily S. Petherick, PhD, Bradford Institute for Health Research, Bradford Royal Infirmary, Bradford; Simon Gilbody, DPhil, FRCPsych, Tim Croudace, PhD, Department of Health Sciences and Hull York Medical School, University of York, York; Dan Mason, PhD, Bradford Institute for Health Research, Bradford Royal Infirmary, Bradford; Trevor A. Sheldon, DSc, Hull York Medical School, University of York, York; John Wright, FRCP, Bradford Institute for Health Research, Bradford Royal Infirmary, Bradford, UK
| | - Simon Gilbody
- Stephanie L. Prady, PhD, Kate E. Pickett, PhD, Department of Health Sciences, University of York, York; Emily S. Petherick, PhD, Bradford Institute for Health Research, Bradford Royal Infirmary, Bradford; Simon Gilbody, DPhil, FRCPsych, Tim Croudace, PhD, Department of Health Sciences and Hull York Medical School, University of York, York; Dan Mason, PhD, Bradford Institute for Health Research, Bradford Royal Infirmary, Bradford; Trevor A. Sheldon, DSc, Hull York Medical School, University of York, York; John Wright, FRCP, Bradford Institute for Health Research, Bradford Royal Infirmary, Bradford, UK
| | - Tim Croudace
- Stephanie L. Prady, PhD, Kate E. Pickett, PhD, Department of Health Sciences, University of York, York; Emily S. Petherick, PhD, Bradford Institute for Health Research, Bradford Royal Infirmary, Bradford; Simon Gilbody, DPhil, FRCPsych, Tim Croudace, PhD, Department of Health Sciences and Hull York Medical School, University of York, York; Dan Mason, PhD, Bradford Institute for Health Research, Bradford Royal Infirmary, Bradford; Trevor A. Sheldon, DSc, Hull York Medical School, University of York, York; John Wright, FRCP, Bradford Institute for Health Research, Bradford Royal Infirmary, Bradford, UK
| | - Dan Mason
- Stephanie L. Prady, PhD, Kate E. Pickett, PhD, Department of Health Sciences, University of York, York; Emily S. Petherick, PhD, Bradford Institute for Health Research, Bradford Royal Infirmary, Bradford; Simon Gilbody, DPhil, FRCPsych, Tim Croudace, PhD, Department of Health Sciences and Hull York Medical School, University of York, York; Dan Mason, PhD, Bradford Institute for Health Research, Bradford Royal Infirmary, Bradford; Trevor A. Sheldon, DSc, Hull York Medical School, University of York, York; John Wright, FRCP, Bradford Institute for Health Research, Bradford Royal Infirmary, Bradford, UK
| | - Trevor A Sheldon
- Stephanie L. Prady, PhD, Kate E. Pickett, PhD, Department of Health Sciences, University of York, York; Emily S. Petherick, PhD, Bradford Institute for Health Research, Bradford Royal Infirmary, Bradford; Simon Gilbody, DPhil, FRCPsych, Tim Croudace, PhD, Department of Health Sciences and Hull York Medical School, University of York, York; Dan Mason, PhD, Bradford Institute for Health Research, Bradford Royal Infirmary, Bradford; Trevor A. Sheldon, DSc, Hull York Medical School, University of York, York; John Wright, FRCP, Bradford Institute for Health Research, Bradford Royal Infirmary, Bradford, UK
| | - John Wright
- Stephanie L. Prady, PhD, Kate E. Pickett, PhD, Department of Health Sciences, University of York, York; Emily S. Petherick, PhD, Bradford Institute for Health Research, Bradford Royal Infirmary, Bradford; Simon Gilbody, DPhil, FRCPsych, Tim Croudace, PhD, Department of Health Sciences and Hull York Medical School, University of York, York; Dan Mason, PhD, Bradford Institute for Health Research, Bradford Royal Infirmary, Bradford; Trevor A. Sheldon, DSc, Hull York Medical School, University of York, York; John Wright, FRCP, Bradford Institute for Health Research, Bradford Royal Infirmary, Bradford, UK
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26
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McEachan RRC, Prady SL, Smith G, Fairley L, Cabieses B, Gidlow C, Wright J, Dadvand P, van Gent D, Nieuwenhuijsen MJ. The association between green space and depressive symptoms in pregnant women: moderating roles of socioeconomic status and physical activity. J Epidemiol Community Health 2016; 70:253-9. [PMID: 26560759 PMCID: PMC4789818 DOI: 10.1136/jech-2015-205954] [Citation(s) in RCA: 175] [Impact Index Per Article: 21.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2015] [Revised: 09/08/2015] [Accepted: 09/20/2015] [Indexed: 01/28/2023]
Abstract
BACKGROUND The current study explored the association between green space and depression in a deprived, multiethnic sample of pregnant women, and examined moderating and mediating variables. METHOD 7547 women recruited to the 'Born in Bradford' cohort completed a questionnaire during pregnancy. A binary measure of depressive symptoms was calculated using a validated survey. Two green space measures were used: quintiles of residential greenness calculated using the normalised difference vegetation index for three neighbourhood sizes (100, 300 and 500 m buffer zones around participant addresses); access to major green spaces estimated as straight line distance between participant address and nearest green space (>0.5 hectares). Logistic regression analyses examined relationships between green space and depressive symptoms, controlling for ethnicity, demographics, socioeconomic status (SES) and health behaviours. Multiplicative interactions explored variations by ethnic group, SES or activity levels. Mediation analysis assessed indirect effects via physical activity. RESULTS Pregnant women in the greener quintiles were 18-23% less likely to report depressive symptoms than those in the least green quintile (for within 100 m of green space buffer zone). The green space-depressive symptoms association was significant for women with lower education or who were active. Physical activity partially mediated the association of green space, but explained only a small portion of the direct effect. CONCLUSIONS Higher residential greenness was associated with a reduced likelihood of depressive symptoms. Associations may be stronger for more disadvantaged groups and for those who are already physically active. Improving green space is a promising intervention to reduce risk of depression in disadvantaged groups.
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Affiliation(s)
- R R C McEachan
- Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford, UK
| | - S L Prady
- Department of Health Sciences, University of York, York, UK
| | - G Smith
- Institute for Environment and Sustainability Research, Staffordshire University, Stoke-on-Trent, UK
| | - L Fairley
- Division of Epidemiology and Biostatistics, University of Leeds, Leeds, UK
| | - B Cabieses
- Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford, UK Faculty of Medicine- Clínica Alemana de Santiago, Universidad del Desarrollo, Santiago, Chile
| | - C Gidlow
- Centre for Sport, Health and Exercise Research, Staffordshire University, Stoke-on-Trent, UK
| | - J Wright
- Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford, UK
| | - P Dadvand
- Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain
| | - D van Gent
- Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain
| | - M J Nieuwenhuijsen
- Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain
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27
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Biaggi A, Conroy S, Pawlby S, Pariante CM. Identifying the women at risk of antenatal anxiety and depression: A systematic review. J Affect Disord 2016; 191:62-77. [PMID: 26650969 PMCID: PMC4879174 DOI: 10.1016/j.jad.2015.11.014] [Citation(s) in RCA: 835] [Impact Index Per Article: 104.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/14/2015] [Revised: 10/19/2015] [Accepted: 11/11/2015] [Indexed: 12/11/2022]
Abstract
BACKGROUND Pregnancy is a time of increased vulnerability for the development of anxiety and depression. This systematic review aims to identify the main risk factors involved in the onset of antenatal anxiety and depression. METHODS A systematic literature analysis was conducted, using PubMed, PsychINFO, and the Cochrane Library. Original papers were included if they were written in English and published between 1st January 2003 and 31st August 2015, while literature reviews and meta-analyses were consulted regardless of publication date. A final number of 97 papers were selected. RESULTS The most relevant factors associated with antenatal depression or anxiety were: lack of partner or of social support; history of abuse or of domestic violence; personal history of mental illness; unplanned or unwanted pregnancy; adverse events in life and high perceived stress; present/past pregnancy complications; and pregnancy loss. LIMITATIONS The review does not include a meta-analysis, which may have added additional information about the differential impact of each risk factor. Moreover, it does not specifically examine factors that may influence different types of anxiety disorders, or the recurrence or persistence of depression or anxiety from pregnancy to the postpartum period. CONCLUSIONS The results show the complex aetiology of antenatal depression and anxiety. The administration of a screening tool to identify women at risk of anxiety and depression during pregnancy should be universal practice in order to promote the long-term wellbeing of mothers and babies, and the knowledge of specific risk factors may help creating such screening tool targeting women at higher risk.
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Affiliation(s)
- Alessandra Biaggi
- PO63 Section of Perinatal Psychiatry, Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, De Crespigny Park, London SE5 8AF, United Kingdom.
| | - Susan Conroy
- Section of Perinatal Psychiatry, Department of Psychological Medicine, Institute of Psychiatry Psychology & Neuroscience, King's College London, London, United Kingdom
| | - Susan Pawlby
- Section of Perinatal Psychiatry, Department of Psychological Medicine, Institute of Psychiatry Psychology & Neuroscience, King's College London, London, United Kingdom
| | - Carmine M Pariante
- Section of Perinatal Psychiatry, Department of Psychological Medicine, Institute of Psychiatry Psychology & Neuroscience, King's College London, London, United Kingdom
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28
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Waldie KE, Peterson ER, D'Souza S, Underwood L, Pryor JE, Carr PA, Grant C, Morton SMB. Depression symptoms during pregnancy: Evidence from Growing Up in New Zealand. J Affect Disord 2015; 186:66-73. [PMID: 26231443 DOI: 10.1016/j.jad.2015.06.009] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2015] [Revised: 06/03/2015] [Accepted: 06/10/2015] [Indexed: 12/28/2022]
Abstract
BACKGROUND Depression during pregnancy has significant implications for pregnancy outcomes and maternal and child health. There is a need to identify which family, physical and mental health factors are associated with depression during pregnancy. METHODS An ethnically and socioeconomically diverse sample of 5664 pregnant women living in New Zealand completed a face-to-face interview during the third trimester. Antenatal depression (AD) symptoms were assessed using the Edinburgh Postnatal Depression Scale (EPDS). Maternal demographic, physical and mental health, and family and relationship characteristics were measured. The association between symptoms of AD and maternal characteristics was determined using multiple logistic regression. RESULTS 11.9% of the participating women had EPDS scores (13+) that indicated probable AD. When considering sociodemographic predictors of AD symptoms, we found that women from non-European ethnicities, specifically Pacific Islander, Asian and other, were more likely to suffer from AD symptoms. Greater perceived stress during pregnancy and a diagnosis of anxiety both before and during pregnancy were also associated with greater odds of having AD according to the EPDS. LIMITATIONS The women were in their third trimester of pregnancy at the interview. Therefore, we cannot discount the possibility of recall bias for questions relating to pre-pregnancy status or early-pregnancy behaviours. CONCLUSIONS AD is prevalent amongst New Zealand women. Ethnicity, perceived stress and anxiety are particularly associated with a greater likelihood of depression during pregnancy. Further attention to supporting maternal mental health status in the antenatal period is required.
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Affiliation(s)
- Karen E Waldie
- School of Psychology, The University of Auckland, Auckland, New Zealand.
| | | | - Stephanie D'Souza
- School of Psychology, The University of Auckland, Auckland, New Zealand; Centre for Longitudinal Research - He Ara ki Mua, The University of Auckland, Auckland, New Zealand
| | - Lisa Underwood
- Centre for Longitudinal Research - He Ara ki Mua, The University of Auckland, Auckland, New Zealand
| | - Jan E Pryor
- Roy McKenzie Centre for the Study of Families, Victoria University, New Zealand
| | - Polly Atatoa Carr
- Centre for Longitudinal Research - He Ara ki Mua, The University of Auckland, Auckland, New Zealand
| | - Cameron Grant
- Centre for Longitudinal Research - He Ara ki Mua, The University of Auckland, Auckland, New Zealand; School of Population Health, The University of Auckland, Auckland, New Zealand
| | - Susan M B Morton
- Centre for Longitudinal Research - He Ara ki Mua, The University of Auckland, Auckland, New Zealand; School of Population Health, The University of Auckland, Auckland, New Zealand
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29
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Shakeel N, Eberhard-Gran M, Sletner L, Slinning K, Martinsen EW, Holme I, Jenum AK. A prospective cohort study of depression in pregnancy, prevalence and risk factors in a multi-ethnic population. BMC Pregnancy Childbirth 2015; 15:5. [PMID: 25616717 PMCID: PMC4310137 DOI: 10.1186/s12884-014-0420-0] [Citation(s) in RCA: 65] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2014] [Accepted: 12/09/2014] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND Depression in pregnancy increases the risk of complications for mother and child. Few studies are done in ethnic minorities. We wanted to identify the prevalence of depression in pregnancy and associations with ethnicity and other risk factors. METHOD Population-based, prospective cohort of 749 pregnant women (59% ethnic minorities) attending primary antenatal care during early pregnancy in Oslo between 2008 and 2010. Questionnaires covering demographics, health problems and psychosocial factors were collected through interviews. Depression in pregnancy was defined as a sum score ≥ 10 by the Edinburgh Postnatal Depression Scale (EPDS) at gestational week 28. RESULTS The crude prevalence of depression was; Western Europeans: 8.6% (95% CI: 5.45-11.75), Middle Easterners: 19.5% (12.19-26.81), South Asians: 17.5% (12.08-22.92), and other groups: 11.3% (6.09-16.51). Median EPDS score was 6 in Middle Easterners and 3 in all other groups. Middle Easterners (OR = 2.81; 95% CI (1.29-6.15)) and South Asians (2.72 (1.35-5.48)) had significantly higher risk for depression than other minorities and Western Europeans in logistic regression models. When adjusting for socioeconomic position and family structure, the ORs were reduced by 16-18% (OR = 2.44 (1.07-5.57) and 2.25 (1.07-4.72). Other significant risk factors were the number of recent adverse life events, self-reported history of depression and poor subjective health three months before conception. CONCLUSION The prevalence of depression in pregnancy was higher in ethnic minorities from the Middle East and South Asia. The increased risk persisted after adjustment for risk factors.
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Affiliation(s)
- Nilam Shakeel
- University of Oslo Institue for health and society, departement of general practice, Norway, Avdeling for allmennmedisin, institutt for helse og samfunn, Universitetet i Oslo, Norge, Postboks 1130 Blindern, Oslo, 0318, Norway.
| | - Malin Eberhard-Gran
- Department of Psychosomatics and Health Behaviour, Division of Mental Health, Norwegian Institute of Public Health, Oslo, Norway. .,Health Services Research Center, Akershus University Hospital, Lørenskog, Norway. .,Institute of Clinical Medicine, Campus Ahus, University of Oslo, Lørenskog, Norway.
| | - Line Sletner
- Department of Child and Adolescents Medicine, Akershus University Hospital, Lørenskog, Norway.
| | - Kari Slinning
- The Center for Child and Adolescent Mental Health, Eastern and Southern Norway (RBUP), Oslo, Norway. .,Department of psychology, University of Oslo, Oslo, Norway.
| | - Egil W Martinsen
- Division of Mental Health and Addiction, Oslo University Hospital, Institute of Clinical Medicine, University of Oslo, Oslo, Norway.
| | - Ingar Holme
- Oslo University Hospital Ullevål, departement of Biostatic, Epidemiology and Health economics, Oslo, Norway.
| | - Anne Karen Jenum
- Department of General Practice, Institute of Health and Society, Faculty of Medicine, University of Oslo, Oslo, Norway. .,Faculty of Health Sciences, Oslo and Akershus University College of Applied Sciences, Oslo, Norway.
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30
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Kingori C, Haile ZT, Ngatia P. Depression symptoms, social support and overall health among HIV-positive individuals in Kenya. Int J STD AIDS 2014; 26:165-72. [PMID: 24759561 DOI: 10.1177/0956462414531933] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
In Kenya, there was a reported decline in HIV incidence and prevalence among those aged 15 to 64 years and children. Despite the decline, closer assessment of psychosocial issues like depression, contextual factors (family and community), and social support is necessary given the likely impact on overall health and HIV prevention. This paper examines an association between symptoms of depression and social support on overall health among HIV-positive participants recruited from an HIV clinic in Kenya. Descriptive statistics and logistic regression analyses were utilized. Findings reveal that compared to those with minimal depression (referent category) participants with mild, moderate, moderately severe/severe depression had higher odds of having poor health. For social support, compared with participants with no social support (referent category), participants with high social support had lower odds of having poor overall health in both unadjusted and multivariable-adjusted models. In conclusion, this study suggests that HIV clinics and interventions need to focus more on the psychological and/or mental health status of HIV-infected individuals while providing avenues such as social support groups that can be a buffer against the negative impact of HIV infection and depression on overall health outcomes.
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Affiliation(s)
- Caroline Kingori
- Department of Social and Public Health, Ohio University, Athens, OH, USA
| | - Zelalem T Haile
- Department of Epidemiology, West Virginia University School of Public Health, Morgantown, WV, USA
| | - Peter Ngatia
- African Medical Research Foundation, Nairobi, Kenya
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31
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Kim Y, Chung CW. Factors of Prenatal Depression by Stress-vulnerability and Stress-coping Models. KOREAN JOURNAL OF WOMEN HEALTH NURSING 2014; 20:38-47. [PMID: 37684779 DOI: 10.4069/kjwhn.2014.20.1.38] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/10/2023] Open
Abstract
PURPOSE This study aimed to identify related factors of prenatal depression by stress-vulnerability and stress-coping models for pregnant women. METHODS A cross-sectional survey design with a convenience sampling was used. A total of 107 pregnant women who visited a general hospital in a metropolitan city were recruited from August to October, 2013. A structured questionnaire included the Korean version of Beck Depression Inventory II, and the instruments measuring Self-Esteem, Marital Satisfaction, Pregnancy Stress, Stressful Life Events, and Coping. The data were analyzed using descriptive statistics, t-test, Parson's correlation analysis, and stepwise multiple regression. RESULTS The mean score of prenatal depression was 11.95+/-6.2, then showing 19.6% with mild depression, 15.0% with moderate depression, and 0.9% with severe depression on BDI II scale. Prenatal depression had positive correlation with pregnancy stress (r=.55, p<.01), stressful life events (r=.26, p<.01) and negative correlation with self-esteem (r=-.38, p<.01), marital satisfaction (r=-.40, p<.01), and coping (r=-.21, p<.05). Factors of pregnancy stress, self-esteem, stressful life events, and planned pregnancy explained 38% of the total variance of prenatal depression. CONCLUSION These findings show that health providers need to assess prenatal depression and to control the influencing factors.
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Affiliation(s)
- Younglan Kim
- Graduate School, College of Nursing, Seoul National University, Seoul, Korea
| | - Chae Weon Chung
- Graduate School, College of Nursing, Seoul National University, Seoul, Korea
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