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Tung I, Balaji U, Hipwell AE, Low CA, Smyth JM. Feasibility and acceptability of measuring prenatal stress in daily life using smartphone-based ecological momentary assessment and wearable physiological monitors. J Behav Med 2024:10.1007/s10865-024-00484-4. [PMID: 38581594 DOI: 10.1007/s10865-024-00484-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2023] [Accepted: 03/10/2024] [Indexed: 04/08/2024]
Abstract
High levels of stress during pregnancy can have lasting effects on maternal and offspring health, which disproportionately impacts families facing financial strain, systemic racism, and other forms of social oppression. Developing ways to monitor daily life stress during pregnancy is important for reducing stress-related health disparities. We evaluated the feasibility and acceptability of using mobile health (mHealth) technology (i.e., wearable biosensors, smartphone-based ecological momentary assessment) to measure prenatal stress in daily life. Fifty pregnant women (67% receiving public assistance; 70% Black, 6% Multiracial, 24% White) completed 10 days of ambulatory assessment, in which they answered smartphone-based surveys six times a day and wore a chest-band device (movisens EcgMove4) to monitor their heart rate, heart rate variability, and activity level. Feasibility and acceptability were evaluated using behavioral meta-data and participant feedback. Findings supported the feasibility and acceptability of mHealth methods: Participants answered approximately 75% of the surveys per day and wore the device for approximately 10 hours per day. Perceived burden was low. Notably, participants with higher reported stressors and financial strain reported lower burden associated with the protocol than participants with fewer life stressors, highlighting the feasibility of mHealth technology for monitoring prenatal stress among pregnant populations living with higher levels of contextual stressors. Findings support the use of mHealth technology to measure prenatal stress in real-world, daily life settings, which shows promise for informing scalable, technology-assisted interventions that may help to reduce health disparities by enabling more accessible and comprehensive care during pregnancy.
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Affiliation(s)
- Irene Tung
- Department of Psychology, California State University, Dominguez Hills, 1000 E. Victoria Street, Carson, CA, 90747, USA.
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA.
| | - Uma Balaji
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA
| | - Alison E Hipwell
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA
- Department of Psychology, University of Pittsburgh, Pittsburgh, PA, USA
| | - Carissa A Low
- Department of Medicine, University of Pittsburgh, Pittsburgh, PA, USA
| | - Joshua M Smyth
- Department of Psychology, The Ohio State University, Columbus, OH, USA
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2
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Collins E, Keedle H, Jackson M, Lequertier B, Schmied V, Boyle J, Kildea S, Dahlen HG. Telehealth use in maternity care during a pandemic: A lot of bad, some good and possibility. Women Birth 2024; 37:419-427. [PMID: 38218652 DOI: 10.1016/j.wombi.2023.12.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2023] [Revised: 11/18/2023] [Accepted: 12/26/2023] [Indexed: 01/15/2024]
Abstract
BACKGROUND To reduce transmission risk during the COVID-19 pandemic, 'telehealth' (health care delivered via telephone/video-conferencing) was implemented into Australian maternity services. Whilst some reports on telehealth implementation ensued, there was scant evidence on women and midwives' perspectives regarding telehealth use. METHODS A qualitative study was conducted in Australia during 2020-2021 using two data sources from the Birth in the Time of COVID-19 (BITTOC) study: i) interviews and ii) surveys (open-text responses). Content analysis was utilised to analyse the data and explore telehealth from the perspective of midwives and women accessing maternity care services. In-depth interviews were conducted with 20 women and 16 midwives. Survey responses were provided from 687 midwives and 2525 women who were pregnant or gave birth in 2021, generating 212 and 812 comments respectively. FINDINGS Telehealth delivery was variable nationally and undertaken primarily by telephone/videoconferencing. Perceived benefits included: reduced COVID-19 transmission risk, increased flexibility, convenience and cost efficiency. However, women described inadequate assessment, and negative impacts on communication and rapport development. Midwives had similar concerns and also reported technological challenges. CONCLUSION During the COVID-19 pandemic, telehealth offered flexibility, convenience and cost efficiency whilst reducing COVID-19 transmission, yet benefits came at a cost. Telehealth may particularly suit women in rural and remote areas, however, it also has the potential to further reduce equitable, and appropriate care delivery for those at greatest risk of poor outcomes. Telehealth may play an adjunct role in post-pandemic maternity services, but is not a suitable replacement to traditional face-to-face maternity care.
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Affiliation(s)
- Emma Collins
- School of Nursing and Midwifery, Western Sydney University, Locked Bag 1797, Penrith 2751 NSW Australia
| | - Hazel Keedle
- School of Nursing and Midwifery, Western Sydney University, Locked Bag 1797, Penrith 2751 NSW Australia
| | - Melanie Jackson
- School of Nursing and Midwifery, Western Sydney University, Locked Bag 1797, Penrith 2751 NSW Australia
| | - Belinda Lequertier
- Molly Wardaguga Research Centre, College of Nursing and Midwifery, Charles Darwin University, Level 11, East Tower, 410 Ann Street, Brisbane, Qld 4000, Australia
| | - Virginia Schmied
- School of Nursing and Midwifery, Western Sydney University, Locked Bag 1797, Penrith 2751 NSW Australia
| | - Jacqueline Boyle
- Monash Centre of Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Locked Bag 29, Clayton, VIC 3168, Australia
| | - Sue Kildea
- Molly Wardaguga Research Centre, College of Nursing and Midwifery, Charles Darwin University, Brisbane, Queensland, Australia
| | - Hannah Grace Dahlen
- School of Nursing and Midwifery, Western Sydney University, Locked Bag 1797, Penrith 2751 NSW Australia.
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Mazaheri Habibi MR, Moghbeli F, Langarizadeh M, Fatemi Aghda SA. Mobile health apps for pregnant women usability and quality rating scales: a systematic review. BMC Pregnancy Childbirth 2024; 24:34. [PMID: 38183035 PMCID: PMC10768378 DOI: 10.1186/s12884-023-06206-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Accepted: 12/15/2023] [Indexed: 01/07/2024] Open
Abstract
OBJECTIVE This study is to identify the apps used by pregnant women during the technology era and to choose the best app from the point of view of pregnant women and experts. METHODS The article is a research article that uses PRISMA flowchart. Given that there are many apps in the field of pregnancy and due to technological advances, the articles of the last 13 years that have been scientifically published in the databases of Google Scholar, PubMed, and Science Direct have been analyzed. The most widely used and, at the same time, the best app is introduced in terms of its high usability in users' attitude. Finally, Apps will be compared in terms of accuracy, precision, and usability of the dimensions of Jacob Nielsen's five principles. RESULTS According to the search strategy, 23 articles were identified qualitatively by reviewing both authors. Then, the types of apps were divided into three general categories, pregnant entertainment apps, pregnant information apps, and monitoring apps for mothers' physical health. Finally, 10 apps were selected and the Amila app was introduced as the best due to its high usability (Effectiveness %66.66) and users' satisfaction or women's choice (%98). CONCLUSION Using trusted apps to maintain their health and reduce traffic will be very important. Given that this research article was written with the aim of choosing the best app, that not only provides the required information to mothers, but also the ability to interact with doctors and specialists.
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Affiliation(s)
| | - Fateme Moghbeli
- Department of Health Information Technology, Varastegan Institute for Medical Sciences, Mashhad, Iran
| | - Mostafa Langarizadeh
- Department of Health Information Management, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Seyed Ali Fatemi Aghda
- Department of Health Information Management, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran.
- Research Center for Health Technology Assessment and Medical Informatics, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.
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Pontones CA, Titzmann A, Huebner H, Danzberger N, Ruebner M, Häberle L, Eskofier BM, Nissen M, Kehl S, Faschingbauer F, Beckmann MW, Fasching PA, Schneider MO. Feasibility and Acceptance of Self-Guided Mobile Ultrasound among Pregnant Women in Routine Prenatal Care. J Clin Med 2023; 12:4224. [PMID: 37445258 DOI: 10.3390/jcm12134224] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2023] [Revised: 05/30/2023] [Accepted: 06/20/2023] [Indexed: 07/15/2023] Open
Abstract
BACKGROUND AND OBJECTIVES Mobile and remote ultrasound devices are becoming increasingly available. The benefits and possible risks of self-guided ultrasound examinations conducted by pregnant women at home have not yet been well explored. This study investigated aspects of feasibility and acceptance, as well as the success rates of such examinations. METHODS In this prospective, single-center, interventional study, forty-six women with singleton pregnancies between 17 + 0 and 29 + 6 weeks of gestation were included in two cohorts, using two different mobile ultrasound systems. The participants examined the fetal heartbeat, fetal profile and amniotic fluid. Aspects of feasibility and acceptance were evaluated using a questionnaire. Success rates in relation to image and video quality were evaluated by healthcare professionals. RESULTS Two thirds of the women were able to imagine performing the self-guided examination at home, but 87.0% would prefer live support by a professional. Concerns about their own safety and that of the child were expressed by 23.9% of the women. Success rates for locating the target structure were 52.2% for videos of the fetal heartbeat, 52.2% for videos of the amniotic fluid in all four quadrants and 17.9% for videos of the fetal profile. CONCLUSION These results show wide acceptance of self-examination using mobile systems for fetal ultrasonography during pregnancy. Image quality was adequate for assessing the amniotic fluid and fetal heartbeat in most participants. Further studies are needed to determine whether ultrasound self-examinations can be implemented in prenatal care and how this would affect the fetomaternal outcome.
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Affiliation(s)
- Constanza A Pontones
- Department of Obstetrics and Gynaecology, Universitätsklinikum Erlangen, 91054 Erlangen, Germany
| | - Adriana Titzmann
- Department of Obstetrics and Gynaecology, Universitätsklinikum Erlangen, 91054 Erlangen, Germany
| | - Hanna Huebner
- Department of Obstetrics and Gynaecology, Universitätsklinikum Erlangen, 91054 Erlangen, Germany
| | - Nina Danzberger
- Department of Obstetrics and Gynaecology, Universitätsklinikum Erlangen, 91054 Erlangen, Germany
| | - Matthias Ruebner
- Department of Obstetrics and Gynaecology, Universitätsklinikum Erlangen, 91054 Erlangen, Germany
| | - Lothar Häberle
- Department of Obstetrics and Gynaecology, Universitätsklinikum Erlangen, 91054 Erlangen, Germany
| | - Bjoern M Eskofier
- Machine Learning and Data Analytics Lab, Friedrich-Alexander-Universität Erlangen-Nürnberg, 91052 Erlangen, Germany
| | - Michael Nissen
- Machine Learning and Data Analytics Lab, Friedrich-Alexander-Universität Erlangen-Nürnberg, 91052 Erlangen, Germany
| | - Sven Kehl
- Department of Obstetrics and Gynaecology, Universitätsklinikum Erlangen, 91054 Erlangen, Germany
| | - Florian Faschingbauer
- Department of Obstetrics and Gynaecology, Universitätsklinikum Erlangen, 91054 Erlangen, Germany
| | - Matthias W Beckmann
- Department of Obstetrics and Gynaecology, Universitätsklinikum Erlangen, 91054 Erlangen, Germany
| | - Peter A Fasching
- Department of Obstetrics and Gynaecology, Universitätsklinikum Erlangen, 91054 Erlangen, Germany
| | - Michael O Schneider
- Department of Obstetrics and Gynaecology, Universitätsklinikum Erlangen, 91054 Erlangen, Germany
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Collins TE, Akselrod S, Altymysheva A, Nga PTQ, Banatvala N, Berlina D. The promise of digital health technologies for integrated care for maternal and child health and non-communicable diseases. BMJ 2023; 381:e071074. [PMID: 37220916 DOI: 10.1136/bmj-2022-071074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Affiliation(s)
- Téa E Collins
- Global NCD Platform, World Health Organization, Geneva, Switzerland
| | | | | | | | - Nick Banatvala
- Secretariat, United Nations Interagency Task Force, World Health Organization, Geneva, Switzerland
| | - Daria Berlina
- Global NCD Platform, World Health Organization, Geneva, Switzerland
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6
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Shirvanian-Dehkordi M, Zare-Farashbandi F, Samouei R, Nouri R. Mobile health applications for pregnancy in Iran: Current state investigation. JOURNAL OF EDUCATION AND HEALTH PROMOTION 2022; 11:338. [PMID: 36567998 PMCID: PMC9768709 DOI: 10.4103/jehp.jehp_1126_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/31/2021] [Accepted: 01/05/2022] [Indexed: 06/17/2023]
Abstract
BACKGROUND The expansion of pregnancy-related mobile applications has led to an increase in the usage of these applications by Iranian women, which has the potential to have a long-term impact on women's pregnancy health and, as a result, community health. The goal of this research was to investigate the state of pregnancy-related mobile applications in Iran. MATERIALS AND METHODS This was a descriptive-applied research approach which was conducted in 2020. One hundred and fifty-seven pregnancy apps from different Iranian mobile app markets were installed and were examined in terms of the resources used and their validity, subject distribution, participation of obstetricians in the app development, apps volume, rank acquired by users and distribution of apps according to the developers. The relationship between the number of resources used and user rankings was also tested. RESULTS A total of 157 apps were categorized into 12 subject categories based on their content. Only 1.3% of the apps were developed with the participation of obstetricians. Only 5% of the apps had used reliable information resources. Furthermore, the number of resources referenced in the studied apps did not have a significant relationship with star ratings (r = 0.03, P = 0.64), according to the Pearson correlation test. CONCLUSION Iranian mobile applications in the field of pregnancy have grown significantly in terms of quantity, subject diversity, and user acceptance; however, the credibility of the information in these apps cannot be validated. This serves as a reminder to users to exercise caution while using such apps.
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Affiliation(s)
- Mahboubeh Shirvanian-Dehkordi
- Department of Medical Library and Information Sciences, School of Management and Medical Information, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Firoozeh Zare-Farashbandi
- Health Information Technology Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Rahele Samouei
- Social Determinants of Health Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Rasool Nouri
- Health Information Technology Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
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7
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Simmons LA, Phipps JE, Overstreet C, Smith PM, Bechard E, Liu S, Walker C, Noonan D. Goals for reaching optimal wellness (GROWell): A clinical trial protocol of a digital dietary intervention for pregnant and postpartum people with prenatal overweight or obesity. Contemp Clin Trials 2021; 113:106627. [PMID: 34813963 PMCID: PMC9044978 DOI: 10.1016/j.cct.2021.106627] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Revised: 11/05/2021] [Accepted: 11/11/2021] [Indexed: 11/15/2022]
Abstract
Background: Excess gestational weight gain (EGWG) is associated with multiple
pregnancy complications and health risks for birthing people and their
infants. Likewise, postpartum weight retention (PPWR), or not losing all
pregnancy weight, has long-term health consequences. EGWG among people who
enter pregnancy with overweight or obesity have worse obstetric outcomes and
increased PPWR compared to women who gain within Institute of Medicine
guidelines. Methods: This study protocol describes the details of a blinded, randomized
clinical trial of GROWell: Goals for Reaching Optimal
Wellness, a mHealth tool designed to improve diet quality among people who
enter pregnancy with overweight or obese BMIs to help them achieve
appropriate GWG and safe postpartum pregnancy weight loss. Individuals with
overweight and obesity will be randomly assigned to an attention control or
intervention arm. The intervention group will receive personalized,
goal-oriented text messages regarding dietary choices, while the attention
control group will receive text messages about healthy pregnancy, labor,
delivery, and early infancy. Both groups will complete online surveys at
baseline, follow up, 3 and 6 months postpartum. Results and discussion: Currently, 162 subjects have been enrolled. Outcomes associated with
GWG and pregnancy are expected in late 2023, while outcomes on postpartum
weight retention GROWell adherence are expected in late
2024. The results of this trial will support the use of an evidence-based
mHealth tool to be integrated into clinical practice to reduce EGWG and PPWR
among pregnant people with overweight and obese BMIs, a resource that is
currently lacking. Trial registration: ClinicalTrials.gov identifier: NCT04449432. Registered on June 26, 2020.
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Affiliation(s)
- Leigh Ann Simmons
- University of California Davis, Department of Human Ecology, Davis, CA 95616, United States of America.
| | - Jennifer E Phipps
- University of California Davis, Department of Human Ecology, Davis, CA 95616, United States of America
| | - Courtney Overstreet
- University of California Davis Health, Obstetrics and Gynecology Department, Sacramento, CA 95817, United States of America
| | - Paige M Smith
- University of California Davis, Department of Human Ecology, Davis, CA 95616, United States of America
| | - Elizabeth Bechard
- Duke Integrative Medicine, Durham, NC 27705, United States of America
| | - Siwei Liu
- University of California Davis, Department of Human Ecology, Davis, CA 95616, United States of America
| | - Cheryl Walker
- University of California Davis Health, Obstetrics and Gynecology Department, Sacramento, CA 95817, United States of America
| | - Devon Noonan
- Duke University School of Nursing, Durham, NC 27710, United States of America
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8
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Palmer KR, Tanner M, Davies-Tuck M, Rindt A, Papacostas K, Giles ML, Brown K, Diamandis H, Fradkin R, Stewart AE, Rolnik DL, Stripp A, Wallace EM, Mol BW, Hodges RJ. Widespread implementation of a low-cost telehealth service in the delivery of antenatal care during the COVID-19 pandemic: an interrupted time-series analysis. Lancet 2021; 398:41-52. [PMID: 34217399 PMCID: PMC8248925 DOI: 10.1016/s0140-6736(21)00668-1] [Citation(s) in RCA: 54] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Revised: 03/03/2021] [Accepted: 03/11/2021] [Indexed: 12/24/2022]
Abstract
BACKGROUND Little evidence is available on the use of telehealth for antenatal care. In response to the COVID-19 pandemic, we developed and implemented a new antenatal care schedule integrating telehealth across all models of pregnancy care. To inform this clinical initiative, we aimed to assess the effectiveness and safety of telehealth in antenatal care. METHODS We analysed routinely collected health data on all women giving birth at Monash Health, a large health service in Victoria (Australia), using an interrupted time-series design. We assessed the impact of telehealth integration into antenatal care from March 23, 2020, across low-risk and high-risk care models. Allowing a 1-month implementation period from March 23, 2020, we compared the first 3 months of telehealth integrated care delivered between April 20 and July 26, 2020, with conventional care delivered between Jan 1, 2018, and March 22, 2020. The primary outcomes were detection and outcomes of fetal growth restriction, pre-eclampsia, and gestational diabetes. Secondary outcomes were stillbirth, neonatal intensive care unit admission, and preterm birth (birth before 37 weeks' gestation). FINDINGS Between Jan 1, 2018, and March 22, 2020, 20 031 women gave birth at Monash Health during the conventional care period and 2292 women gave birth during the telehealth integrated care period. Of 20 154 antenatal consultations provided in the integrated care period, 10 731 (53%) were delivered via telehealth. Overall, compared with the conventional care period, no significant differences were identified in the integrated care period with regard to the number of babies with fetal growth restriction (birthweight below the 3rd percentile; 2% in the integrated care period vs 2% in the conventional care period, p=0·72, for low-risk care models; 5% in the integrated care period vs 5% in the conventional care period, p=0·50 for high-risk care models), number of stillbirths (1% vs 1%, p=0·79; 2% vs 2%, p=0·70), or pregnancies complicated by pre-eclampsia (3% vs 3%, p=0·70; 9% vs 7%, p=0·15), or gestational diabetes (22% vs 22%, p=0·89; 30% vs 26%, p=0·06). Interrupted time-series analysis showed a significant reduction in preterm birth among women in high-risk models (-0·68% change in incidence per week [95% CI -1·37 to -0·002]; p=0·049), but no significant differences were identified in other outcome measures for low-risk or high-risk care models after telehealth integration compared with conventional care. INTERPRETATION Telehealth integrated antenatal care enabled the reduction of in-person consultations by 50% without compromising pregnancy outcomes. This care model can help to minimise in-person interactions during the COVID-19 pandemic, but should also be considered in post-pandemic health-care models. FUNDING None.
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Affiliation(s)
- Kirsten R Palmer
- Monash Women's and Newborn, Monash Health, Melbourne, VIC, Australia; Department of Obstetrics and Gynaecology, Monash University, Clayton, VIC, Australia.
| | - Michael Tanner
- Department of Obstetrics and Gynaecology, Monash University, Clayton, VIC, Australia
| | | | - Andrea Rindt
- Monash Women's and Newborn, Monash Health, Melbourne, VIC, Australia
| | - Kerrie Papacostas
- Monash Women's and Newborn, Monash Health, Melbourne, VIC, Australia
| | - Michelle L Giles
- Monash Women's and Newborn, Monash Health, Melbourne, VIC, Australia; Department of Obstetrics and Gynaecology, Monash University, Clayton, VIC, Australia
| | - Kate Brown
- Monash Women's and Newborn, Monash Health, Melbourne, VIC, Australia
| | - Helen Diamandis
- Monash Women's and Newborn, Monash Health, Melbourne, VIC, Australia
| | - Rebecca Fradkin
- Monash Women's and Newborn, Monash Health, Melbourne, VIC, Australia
| | - Alice E Stewart
- Monash Women's and Newborn, Monash Health, Melbourne, VIC, Australia
| | - Daniel L Rolnik
- Monash Women's and Newborn, Monash Health, Melbourne, VIC, Australia; Department of Obstetrics and Gynaecology, Monash University, Clayton, VIC, Australia
| | - Andrew Stripp
- Faculty of Medicine, Nursing and Health Sciences, Monash University, Clayton, VIC, Australia; Monash Health, Clayton, VIC, Australia
| | - Euan M Wallace
- Department of Obstetrics and Gynaecology, Monash University, Clayton, VIC, Australia; Safer Care Victoria, Melbourne, VIC, Australia
| | - Ben W Mol
- Monash Women's and Newborn, Monash Health, Melbourne, VIC, Australia; Department of Obstetrics and Gynaecology, Monash University, Clayton, VIC, Australia
| | - Ryan J Hodges
- Monash Women's and Newborn, Monash Health, Melbourne, VIC, Australia; Department of Obstetrics and Gynaecology, Monash University, Clayton, VIC, Australia
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9
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Ceulemans M, Verbakel JY, Van Calsteren K, Eerdekens A, Allegaert K, Foulon V. SARS-CoV-2 Infections and Impact of the COVID-19 Pandemic in Pregnancy and Breastfeeding: Results from an Observational Study in Primary Care in Belgium. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E6766. [PMID: 32957434 PMCID: PMC7559009 DOI: 10.3390/ijerph17186766] [Citation(s) in RCA: 39] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/28/2020] [Revised: 09/11/2020] [Accepted: 09/14/2020] [Indexed: 12/26/2022]
Abstract
COVID-19 also affects pregnant and breastfeeding women. Hence, clinicians and policymakers require reliable evidence on COVID-19 epidemiology and consequences in this population. We aimed to assess the susceptibility of pregnant women to SARS-CoV-2 and women's perceived impact of the pandemic on their breastfeeding practices, medical counseling and social support. We performed a cross-sectional study using an online survey in primary care in Belgium. Pregnant and breastfeeding women and women who breastfed in the preceding four weeks were eligible to participate. The survey was distributed through social media in April 2020. In total, 6470 women participated (i.e., 2647 pregnant and 3823 breastfeeding women). Overall, 0.3% of all respondents reported to have tested positive for SARS-CoV-2, not indicating a higher susceptibility of pregnant women to contracting COVID-19. More than 90% refuted that the pandemic affected their breastfeeding practices, nor indicated that the coronavirus was responsible for breastfeeding cessation. Half of the women even considered giving longer breastmilk because of the coronavirus. In contrast, women's medical counseling and social support were negatively affected by the lockdown. Women without previous breastfeeding experience and in the early postpartum period experienced a higher burden in terms of reduced medical counseling and support. In the future, more consideration and alternative supportive measures such as tele-visits by midwives or perinatal organizations are required for these women.
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Affiliation(s)
- Michael Ceulemans
- Clinical Pharmacology and Pharmacotherapy, Department of Pharmaceutical and Pharmacological Sciences, KU Leuven, Herestraat 49, 3000 Leuven, Belgium; (K.A.); (V.F.)
| | - Jan Y. Verbakel
- Academic Center for General Practice, Department of Public Health and Primary Care, KU Leuven, Kapucijnenvoer 33, 3000 Leuven, Belgium;
| | - Kristel Van Calsteren
- Department of Obstetrics and Gynecology, University Hospitals Leuven Gasthuisberg, Herestraat 49, 3000 Leuven, Belgium;
- Woman and Child, Department of Development and Regeneration, KU Leuven, Herestraat 49, 3000 Leuven, Belgium;
| | - An Eerdekens
- Woman and Child, Department of Development and Regeneration, KU Leuven, Herestraat 49, 3000 Leuven, Belgium;
- Department of Pediatrics and Neonatology, University Hospitals Leuven Gasthuisberg, Herestraat 49, 3000 Leuven, Belgium
| | - Karel Allegaert
- Clinical Pharmacology and Pharmacotherapy, Department of Pharmaceutical and Pharmacological Sciences, KU Leuven, Herestraat 49, 3000 Leuven, Belgium; (K.A.); (V.F.)
- Woman and Child, Department of Development and Regeneration, KU Leuven, Herestraat 49, 3000 Leuven, Belgium;
- Department of Clinical Pharmacy, Erasmus MC Sophia Children’s Hospital, Zimmermanweg 11, 3015 CP Rotterdam, The Netherlands
| | - Veerle Foulon
- Clinical Pharmacology and Pharmacotherapy, Department of Pharmaceutical and Pharmacological Sciences, KU Leuven, Herestraat 49, 3000 Leuven, Belgium; (K.A.); (V.F.)
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10
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Allegaert K, van den Anker JN. Perinatal Clinical Pharmacology: Optimizing Pharmacotherapy for Pregnant Women, Their Fetuses and Infants. Curr Pharm Des 2020; 25:467-468. [PMID: 31215371 DOI: 10.2174/138161282504190516090723] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Affiliation(s)
- Karel Allegaert
- Department of Pediatrics, Division of Neonatology, Erasmus MC-Sophia Children's Hospital, Rotterdam, Netherlands.,Department of Development and Regeneration, KU Leuven, Leuven, Belgium
| | - John N van den Anker
- Division of Clinical Pharmacology, Department of Pediatrics, Children's National Health System, Washington, DC, United States.,Intensive Care and Department of Pediatric Surgery, Erasmus MC-Sophia Children's Hospital, Rotterdam, Netherlands.,Division of Paediatric Pharmacology and Pharmacometrics, University of Basel Children's Hospital, Basel, Switzerland
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