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Bodunde EO, Buckley D, O'Neill E, Al Khalaf S, Maher GM, O'Connor K, McCarthy FP, Kublickiene K, Matvienko-Sikar K, Khashan AS. Pregnancy and birth complications and long-term maternal mental health outcomes: A systematic review and meta-analysis. BJOG 2024. [PMID: 38887891 DOI: 10.1111/1471-0528.17889] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2023] [Revised: 05/21/2024] [Accepted: 05/29/2024] [Indexed: 06/20/2024]
Abstract
BACKGROUND Few studies have examined the associations between pregnancy and birth complications and long-term (>12 months) maternal mental health outcomes. OBJECTIVES To review the published literature on pregnancy and birth complications and long-term maternal mental health outcomes. SEARCH STRATEGY Systematic search of Cumulative Index to Nursing and Allied Health Literature (CINAHL), Excerpta Medica Database (Embase), PsycInfo®, PubMed® and Web of Science from inception until August 2022. SELECTION CRITERIA Three reviewers independently reviewed titles, abstracts and full texts. DATA COLLECTION AND ANALYSIS Two reviewers independently extracted data and appraised study quality. Random-effects meta-analyses were used to calculate pooled estimates. The Meta-analyses of Observational Studies in Epidemiology (MOOSE) guidelines were followed. The protocol was prospectively registered on the International Prospective Register of Systematic Reviews (PROSPERO: CRD42022359017). MAIN RESULTS Of the 16 310 articles identified, 33 studies were included (3 973 631 participants). Termination of pregnancy was associated with depression (pooled adjusted odds ratio, aOR 1.49, 95% CI 1.20-1.83) and anxiety disorder (pooled aOR 1.43, 95% CI 1.20-1.71). Miscarriage was associated with depression (pooled aOR 1.97, 95% CI 1.38-2.82) and anxiety disorder (pooled aOR 1.24, 95% CI 1.11-1.39). Sensitivity analyses excluding early pregnancy loss and termination reported similar results. Preterm birth was associated with depression (pooled aOR 1.37, 95% CI 1.32-1.42), anxiety disorder (pooled aOR 0.97, 95% CI 0.41-2.27) and post-traumatic stress disorder (PTSD) (pooled aOR 1.75, 95% CI 0.52-5.89). Caesarean section was not significantly associated with PTSD (pooled aOR 2.51, 95% CI 0.75-8.37). There were few studies on other mental disorders and therefore it was not possible to perform meta-analyses. CONCLUSIONS Exposure to complications during pregnancy and birth increases the odds of long-term depression, anxiety disorder and PTSD.
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Affiliation(s)
- Elizabeth O Bodunde
- School of Public Health, University College Cork, Cork, Ireland
- INFANT Research Centre, University College Cork, Cork, Ireland
| | - Daire Buckley
- INFANT Research Centre, University College Cork, Cork, Ireland
| | - Eimear O'Neill
- Perinatal Mental Health, Acute Mental Health Services (AMHS) and Child and Adolescent Mental Health Services (CAMHS), University College Cork, Cork, Ireland
| | | | - Gillian M Maher
- School of Public Health, University College Cork, Cork, Ireland
- INFANT Research Centre, University College Cork, Cork, Ireland
| | - Karen O'Connor
- RISE, Early Intervention in Psychosis Team, South Lee Mental Health Services, Cork, Ireland
- Department of Psychiatry and Neurobehavioral Science, University College Cork, Cork, Ireland
| | - Fergus P McCarthy
- INFANT Research Centre, University College Cork, Cork, Ireland
- Department of Obstetrics and Gynaecology, Cork University Maternity Hospital, Cork, Ireland
| | - Karolina Kublickiene
- Division of Renal Medicine, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden
| | | | - Ali S Khashan
- School of Public Health, University College Cork, Cork, Ireland
- INFANT Research Centre, University College Cork, Cork, Ireland
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Cersonsky TEK, Fain AC, Lewkowitz AK, Werner EF, Miller ES, Clark MA, Ayala NK. Proactive Coping in Early Pregnancy and Adverse Pregnancy Outcomes. Int J Womens Health 2024; 16:979-985. [PMID: 38835835 PMCID: PMC11147781 DOI: 10.2147/ijwh.s442977] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2023] [Accepted: 01/22/2024] [Indexed: 06/06/2024] Open
Abstract
Objective Outside of pregnancy, proactive coping has been associated with both mental and physical well-being and with improved quality of life in chronic disease, but its effects in pregnancy are understudied. Our objective was to evaluate whether early pregnancy proactive coping was associated with adverse perinatal outcomes. Study Design This was a planned secondary analysis of nulliparous pregnant people recruited from a tertiary care center. Participants completed a validated assessment of proactive coping (Proactive Coping Scale) at 8-20 weeks and were followed longitudinally through delivery. Detailed pregnancy and delivery data were collected by trained research personnel. The primary outcome was a composite of adverse perinatal outcomes including unplanned cesarean delivery, gestational diabetes, and hypertensive disorders of pregnancy. Secondary analyses included individual perinatal composite components and a neonatal morbidity composite measure. Multivariate regression compared adverse perinatal outcomes by Proactive Coping Scale quartile, controlling for a priori confounders. Results Of the 281 parturients, the median Proactive Coping Scale score was 45.0 (range 25-55), and 47% experienced an adverse perinatal outcome. After adjusting for confounders, those in the lowest Proactive Coping Scale quartile had 2.2 times higher odds of experiencing an adverse perinatal outcome compared to those in the highest Proactive Coping Scale quartile. There were no differences in odds of the individual composite components or the adverse neonatal outcome. Conclusion Lower early pregnancy proactive coping scores are associated with significant increase in adverse perinatal outcomes. Interventions that target improving proactive coping may be a novel mechanism for reducing perinatal morbidity.
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Affiliation(s)
- Tess E K Cersonsky
- Department of Obstetrics, Gynecology and Reproductive Science, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Audra C Fain
- Department of Obstetrics & Gynecology, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA
| | - Adam K Lewkowitz
- Warren Alpert Medical School of Brown University, Providence, RI, USA
- Department of Obstetrics & Gynecology, Women & Infants Hospital of Rhode Island, Providence, RI, USA
| | - Erika F Werner
- Department of Obstetrics & Gynecology, Tufts University School of Medicine, Boston, MA, USA
| | - Emily S Miller
- Warren Alpert Medical School of Brown University, Providence, RI, USA
- Department of Obstetrics & Gynecology, Women & Infants Hospital of Rhode Island, Providence, RI, USA
| | - Melissa A Clark
- Department of Obstetrics & Gynecology, Women & Infants Hospital of Rhode Island, Providence, RI, USA
- Department of Health Services, Policy and Practice, Brown School of Public Health, Providence, RI, USA
| | - Nina K Ayala
- Warren Alpert Medical School of Brown University, Providence, RI, USA
- Department of Obstetrics & Gynecology, Women & Infants Hospital of Rhode Island, Providence, RI, USA
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Ooba H, Maki J, Tabuchi T, Masuyama H. Partner relationships, hopelessness, and health status strongly predict maternal well-being: an approach using light gradient boosting machine. Sci Rep 2023; 13:17032. [PMID: 37813926 PMCID: PMC10562477 DOI: 10.1038/s41598-023-44410-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2023] [Accepted: 10/07/2023] [Indexed: 10/11/2023] Open
Abstract
No recent study has explicitly focused on predicting the well-being of pregnant women. This study used data from an extensive online survey in Japan to examine the predictors of the subjective well-being of pregnant women. We developed and validated a light Gradient Boosting Machine (lightGBM) model using data from 400 pregnant women in 2020 to identify three factors that predict subjective well-being. The results confirmed that the model could predict subjective well-being in pregnant women with 84% accuracy. New variables that contributed significantly to this prediction were "partner help", "hopelessness," and "health status". A new lightGBM model was built with these three factors, trained and validated using data from 400 pregnant women in 2020, and predicted using data from 1791 pregnant women in 2021, with an accuracy of 88%. These factors were also significant risk factors for subjective well-being in the regression analysis adjusted for maternal age, region, parity, education level, and the presence of mental illness. Mediation analysis, with "hopelessness" as the mediator, showed that both "partner help" and "health status" directly and indirectly affected the outcome.
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Affiliation(s)
- Hikaru Ooba
- Department of Obstetrics and Gynecology, Okayama University Hospital, Okayama, Okayama, Japan
| | - Jota Maki
- Department of Obstetrics and Gynecology, Okayama University Hospital, Okayama, Okayama, Japan.
| | - Takahiro Tabuchi
- Cancer Control Center, Osaka International Cancer Institute, Osaka, Osaka, Japan
| | - Hisashi Masuyama
- Department of Obstetrics and Gynecology, Okayama University Hospital, Okayama, Okayama, Japan
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Borrelli SE, Lecis A, Antolini L, Miglietta M, Zanini AA, Nespoli A, Fumagalli S. Pain Intensity, coping and maternal satisfaction in Low-Risk labouring Women: A prospective descriptive correlational study. SEXUAL & REPRODUCTIVE HEALTHCARE 2023; 36:100848. [PMID: 37084524 DOI: 10.1016/j.srhc.2023.100848] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Revised: 03/27/2023] [Accepted: 04/10/2023] [Indexed: 04/23/2023]
Abstract
OBJECTIVES The primary aim of the study was to explore pain intensity (PI) and pain coping (PC) scores and the relationship between them. The secondary aim was to explore the correlation between PI and PC scores with labour progress, parity, labour acceleration, labour augmentation and maternal satisfaction. METHODS A prospective descriptive correlational study was conducted in a maternity hospital in Northern Italy. The sample included 54 low-risk women in active labour at term of pregnancy. A data record sheet was used to collect the relevant variables and the Italian Birth Satisfaction Scale Revised (I-BSS-R) was administered to participants at least 24 h after birth. RESULTS In the first labour stage, the average PI score was 6.99 (SD = 1.95) and the average PC score was 6.5 (SD = 2.22). During the second labour stage, the average PI score was 7.75 (SD = 1.74) and the average PC score was 4.97 (SD = 2.76). The average PI score trend increased with labour progress. The average PC score improved between 4 and 7 cm of cervical dilatation. A significant positive correlation between PI scores and oxytocin augmentation (p < 0.001) and labour progression (p < 0.001) was noted. A significant positive correlation between PC scores and oxytocin augmentation (p = 0.02) was also observed. No significant differences were found for maternal satisfaction in regard to PI and PC scores. CONCLUSION coping in labour do not solely depend on PI but also on labour progress and oxytocin augmentation. Additional support to empower women to cope with pain may be required in case of labour augmentation.
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Affiliation(s)
- S E Borrelli
- University of Nottingham, School of Health Sciences, United Kingdom.
| | - A Lecis
- Department of Medicine and Surgery, University of Milano-Bicocca, Milan, Italy
| | - L Antolini
- Department of Medicine and Surgery, University of Milano - Bicocca, Milan, Italy
| | - M Miglietta
- Department of Obstetrics and Gynecology, Sacra Famiglia Hospital, Ordine Ospedaliero Fatebenefratelli, Erba (CO), Italy
| | - A A Zanini
- Department of Obstetrics and Gynecology, Sacra Famiglia Hospital, Ordine Ospedaliero Fatebenefratelli, Erba (CO), Italy
| | - A Nespoli
- University of Milano Bicocca, Dipartimento di Medicina e Chirurgia, Italy.
| | - S Fumagalli
- University of Milano Bicocca, School of Medicine and Surgery, Italy.
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Crowe S, Sarma K. Coping with Covid-19: stress, control and coping among pregnant women in Ireland during the Covid-19 pandemic. BMC Pregnancy Childbirth 2022; 22:274. [PMID: 35365093 PMCID: PMC8972984 DOI: 10.1186/s12884-022-04579-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Accepted: 03/14/2022] [Indexed: 01/30/2023] Open
Abstract
Background The aim of the current study is to investigate the relationship between perceived control, coping and psychological distress among pregnant women in Ireland during the Covid-19 pandemic. It is hypothesised that lower levels of perceived control, greater use of avoidant coping and greater Covid-19 related pregnancy concern will be associated with psychological distress. In addition, it is hypothesised that the relationship between Covid-19 related pregnancy concern and psychological distress will be moderated by perceived control and avoidant coping. Method The study is cross-sectional, utilizing an online questionnaire, which was completed by 761 women in January 2021. The questionnaire includes measures of perceived control, coping style, perceived stress, anxiety and depression. Results Correlation analyses found that lower levels of perceived control were associated with higher levels of avoidant coping and psychological distress. There was also a significant positive relationship between avoidant coping and psychological distress. Using multiple regression, perceived control, avoidant coping and Covid-19 related pregnancy concern were found to predict 51% of the variance in psychological distress. However, in the moderation analysis, perceived control and avoidant coping were not found to moderate the relationship between Covid-19 related pregnancy concern and psychological distress. Conclusion The results from this study suggest that pregnant women in Ireland are experiencing increased levels of psychological distress during the Covid-19 pandemic. The findings also suggest that perceptions of control and avoidant coping are associated with psychological distress in this group and could be used as intervention targets.
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Affiliation(s)
- Sarah Crowe
- National University of Ireland, Galway, Ireland.
| | - Kiran Sarma
- National University of Ireland, Galway, Ireland
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McLeod C, Ebeling MD, Baatz JE, Shary JR, Mulligan JR, Wagner CL. Sociodemographic factors affecting perceived stress during pregnancy and the association with immune-mediator concentrations. J Perinat Med 2022; 50:192-199. [PMID: 34757701 DOI: 10.1515/jpm-2021-0227] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2021] [Accepted: 10/07/2021] [Indexed: 11/15/2022]
Abstract
OBJECTIVES Determine which sociodemographic factors are most associated with increased maternal perceived stress during pregnancy. Evaluate the association between maternal stress and plasma immune-mediator concentrations (IMCs). METHODS As part of a prospective, randomized clinical trial, 247 participants completed a Perceived Stress Scale survey (PSS-10) during each trimester of pregnancy. Blood samples were collected from participants and were analyzed for 25-hydroxyvitamin D (25(OH)D) concentration and for several IMCs: interferon-gamma, interleukins (IL-) IL-2, IL-4, IL-5, IL-10, vascular endothelial growth factor, c-reactive protein, and tumor necrosis factor alpha (TNF-α) (R&D Elisa). The potential associations between PSS-10 scores, sociodemographic factors, and IMCs were assessed. RESULTS In bivariate analysis, participants who were not married and/or had high risk pregnancies were more likely to have increased PSS-10 scores (p<0.05). Increased PSS-10 scores were associated with higher serum concentrations of IL-2 and TNF-α, and decreased concentrations of IL-10 and 25(OH)D. In linear regression analysis, single marital status, high-risk pregnancy, IL-2, and TNF-α were independent predictors of PSS-10 scores. CONCLUSIONS This study identifies specific sociodemographic factors that are associated with increased perceived stress during pregnancy. This study also provides evidence that increased perceived stress is associated with physiological changes as measured by changes in circulating IL-2, TNF-α, IL-10, and 25(OH)D concentrations.
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Affiliation(s)
- Caroline McLeod
- College of Medicine, Shawn Jenkins Children's Hospital, Medical University of South Carolina, Charleston, SC, USA
| | - Myla D Ebeling
- Division of Neonatology, Shawn Jenkins Children's Hospital, Medical University of South Carolina, Charleston, SC, USA
| | - John E Baatz
- Division of Neonatology, Shawn Jenkins Children's Hospital, Medical University of South Carolina, Charleston, SC, USA
| | - Judy R Shary
- Division of Neonatology, Shawn Jenkins Children's Hospital, Medical University of South Carolina, Charleston, SC, USA
| | - Jennifer R Mulligan
- Division of Pulmonary, Critical Care and Sleep Medicine, University of Florida-Gainesville, Gainesville, FL, USA
| | - Carol L Wagner
- Division of Neonatology, Shawn Jenkins Children's Hospital, Medical University of South Carolina, Charleston, SC, USA
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Associations of objectively measured physical activity and sedentary time with pregnancy-specific health-related quality of life. Midwifery 2022; 104:103202. [PMID: 34801955 PMCID: PMC8671341 DOI: 10.1016/j.midw.2021.103202] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2021] [Revised: 10/25/2021] [Accepted: 11/06/2021] [Indexed: 01/03/2023]
Abstract
PURPOSE To examine associations of objectively measured moderate-to-vigorous-intensity physical activity (MVPA) and sedentary behavior (SED) with pregnancy-specific health-related quality of life (QoL) across pregnancy trimesters. MATERIALS AND METHODS Women (N=131, mean age 30.9 years ± 4.9) were recruited from two large health care systems in the United States. MVPA and SED were estimated using a waist-worn ActiGraph GT3X and thigh-worn activPAL3 micro, respectively, for seven days in each trimester of pregnancy. Questionnaires were administered in each trimester to assess pregnancy-specific health-related QoL using the Nausea and Vomiting of Pregnancy Specific health Related Quality of Life (NVPQoL) questionnaire. Mixed effects linear regression examined associations of MVPA and SED with the NVPQoL total score and domain-specific scores (physical symptoms, fatigue, emotions, and limitations) across trimesters. RESULTS The NVPQoL total score and domain-specific scores significantly varied across trimesters, with highest scores (indicating worse QoL) observed in the first trimester and lowest scores (indicating better QoL) in the second trimester. A 1-standard deviation (SD) increment in MVPA (16.0 min/day or 1.8%) was associated with better QoL as indicated by the lower NVPQoL total score (β=-4.06, p=0.024) and limitations score (β = -2.80, p<0.001). A 1-SD increment in SED (1.5 hr/day or 10.0%) was associated with worse QoL as indicated by the higher fatigue score (β = 0.82, p=0.041). CONCLUSIONS Pregnancy-specific health-related QoL varies across trimesters. Both lower SED, and to a greater extent higher MVPA are potential behavioral targets for improving pregnancy-specific health-related QoL.
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Tani F, Ghinassi S, Ponti L. The Role of Maternal Perceived Social Support on the Relation Between Prenatal Depressive Symptoms and Labor Experience. EUROPEAN JOURNAL OF HEALTH PSYCHOLOGY 2021. [DOI: 10.1027/2512-8442/a000103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Abstract. Background: Depression during pregnancy is a severe risk factor for negative outcomes in women and children. In particular, prenatal symptoms of depression are linked to a more complicated labor experience, characterized by more painful labor and more frequent recourse to epidural analgesia and/or oxytocin. Although this link is evident, less is known about possible mediators of this relationship. Aims: This study investigated the mediating role of perceived maternal social support on the relationship between prenatal maternal depression and labor experience. Methods: Participants were 152 Italian nulliparous women ( Mage = 31.68 years, SD = 4.94). Data were collected at two different times: T1 (at week 30–33 of gestation) women completed the Beck Depression Inventory and the Maternal Social Support Scale; T2 (at childbirth) clinical data regarding labor was registered from hospital records (duration of labor in hours and administration of oxytocin and epidural analgesia in hours). Results: The Structural Equation Modeling showed that prenatal symptoms of depression are linked to a more complicated labor experience (β = .31, p < .001). However, the quality of the maternal social support can mediate this relationship (indirect effect: β = .17, p < .000). Limitations: The complexity of the proposed model, the characteristics of the sample, the variables investigated, and the questionnaires used are discussed. Conclusion: The perception of having a good social network is an important predictor of women’s health in the transition to motherhood, decreasing the negative effect of maternal prenatal depressive symptoms on the quality of women’s labor experience.
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Affiliation(s)
- Franca Tani
- Department of Health Sciences, University of Florence, Italy
| | - Simon Ghinassi
- Department of Health Sciences, University of Florence, Italy
| | - Lucia Ponti
- Department of Humanities, University “Carlo Bo” of Urbino, Italy
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Duroux M, Stuijfzand S, Sandoz V, Horsch A. Investigating prenatal perceived support as protective factor against adverse birth outcomes: a community cohort study. J Reprod Infant Psychol 2021:1-12. [PMID: 34644205 DOI: 10.1080/02646838.2021.1991565] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
BACKGROUND Studies show that prenatal maternal anxiety may act as a risk factor for adverse birth outcomes, whilst prenatal social support may rather act as a protective factor. However, studies examining prenatal anxiety symptoms, prenatal perceived support, and neonatal and/or obstetric outcomes are lacking. OBJECTIVE This study investigated whether, in a community sample, prenatal perceived support: (1) had a protective influence on birth outcomes (gestational age (GA), birthweight (BW), 5-minute Apgar score, and mode of delivery); (2) acted as a protective factor, moderating the relationship between anxiety symptoms and the aforementioned birth outcomes. METHOD During their third trimester of pregnancy, 182 nulliparous child-bearers completed standardized questionnaires of anxiety (HADS-A) and perceived support (MOS-SSS). Birth outcomes data was extracted from medical records. RESULTS (1) Perceived support did not significantly predict any birth outcomes. However, perceived tangible support - MOS-SSS subscale assessing perceived material/financial aid - significantly positively predicted the 5-minute Apgar score. (2) Perceived support did not significantly moderate the relationship between anxiety symptoms and birth outcomes. However, perceived tangible support significantly moderated the relationship between anxiety symptoms and the 5-minute Apgar score. CONCLUSION When experienced within non-clinical thresholds, prenatal anxiety symptoms do not increase the risk of adverse neonatal and obstetric outcomes when perceived support is present.
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Affiliation(s)
- Mathilde Duroux
- Department of Psychology, University of Fribourg, Fribourg, Switzerland
| | - Suzannah Stuijfzand
- Faculty of Biology and Medicine, Institute of Higher Education and Research in Healthcare (LUFRS), University of Lausanne, Lausanne, Switzerland
| | - Vania Sandoz
- Faculty of Biology and Medicine, Institute of Higher Education and Research in Healthcare (LUFRS), University of Lausanne, Lausanne, Switzerland
| | - Antje Horsch
- Faculty of Biology and Medicine, Institute of Higher Education and Research in Healthcare (LUFRS), University of Lausanne, Lausanne, Switzerland.,Department Women-Mother-Child, Lausanne University Hospital, Lausanne, Switzerland
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A model of risk for perinatal posttraumatic stress symptoms. Arch Womens Ment Health 2021; 24:259-270. [PMID: 32995950 DOI: 10.1007/s00737-020-01068-2] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/18/2019] [Accepted: 09/23/2020] [Indexed: 10/23/2022]
Abstract
Existing research suggests that childbirth may be a significant trigger of posttraumatic stress symptoms (PTSS). The current study examined whether subjective birthing experiences and objective childbirth characteristics mediated the association between predisposing psychosocial factors measured during pregnancy (e.g., fear of childbirth, history of trauma, and social support) and PTSS during the postpartum period. Women were recruited during pregnancy from a large Midwestern hospital. Symptoms of posttraumatic stress, obsessive compulsive disorder (OCD), and depression, as well as PTSS-related risk factors, including social support, lifetime trauma exposure, fear of childbirth, subjective perceptions, and objective characteristics of childbirth, were measured during pregnancy and 4, 8, and 12 weeks postpartum. A path model revealed that subjective perceptions of childbirth mediated the association between fear of childbirth and PTSS at 4 weeks postpartum. Objective childbirth characteristics mediated the association between fear of childbirth and PTSS at 8 weeks postpartum, and there was a direct association between fear of childbirth and PTSS. Subjective perceptions of childbirth also mediated the effect of fear of childbirth on PTSS at 4 weeks postpartum when controlling for OCD symptoms. Further, the direct effect of fear of childbirth on PTSS at 8 weeks postpartum remained significant when controlling for OCD symptoms. The current study emphasizes the importance of fear of childbirth and subjective and objective birthing experiences in predicting postpartum psychopathology. Future research should examine these models in diverse and at-risk samples. Valid assessments and effective interventions for perinatal PTSS should be explored.
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MAZLOOMYMAHMOODABAD SEYEDSAEED, SADEGHI SAEEDEH, KHODAYARIAN MAHSA, NADJARZADEH AZADEH, FALLAHZADEH HOSSEIN. Exploring the nutritional beliefs of pregnant women in Yazd city. JOURNAL OF PREVENTIVE MEDICINE AND HYGIENE 2021; 61:E545-E552. [PMID: 33628959 PMCID: PMC7888392 DOI: 10.15167/2421-4248/jpmh2020.61.4.1625] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/06/2020] [Accepted: 08/17/2020] [Indexed: 11/16/2022]
Abstract
Introduction During the pregnancy, a woman as a healthy person grows another human being in her body and needs more cares due to changes in psychological and physical needs. This study aimed to explore the nutritional beliefs of pregnant women in Yazd city. Methods This was a qualitative study conducted with a conventional content analysis approach. A total of 12 participants were selected from women referred to the community health centers in Yazd, Iran, by the purposeful sampling method. Data were collected through recorded semi-structured interviews that were transcribed verbatim and analyzed by the Lundman and Granheim's content analysis method. Results In this study, after analyzing the data, 10 main categories and 26 subcategories were extracted. The codes were 446 cases with no overlap, which was reduced after careful review and integration of similar items. Topics of categories included: The concept of nutrition during pregnancy, Nutrition limitations during pregnancy, Myths about food during pregnancy, Doubts about nutrition during pregnancy, Pregnancy food style, Sources of nutritional information in pregnancy, Positive Consequences of Healthy Nutrition in Pregnancy, Consequences of inappropriate pregnancy nutrition, Religious Beliefs in Pregnancy Nutrition, social support. Conclusion The results indicated that the women were committed to their own nutritional beliefs that derive from their culture and this study provided a clear picture of the cultural beliefs of Yazdi women regarding pregnancy nutrition. According to the results, it is necessary to design the education process based on the culture of the community in order for that process to be effective.
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Affiliation(s)
- SEYED SAEED MAZLOOMYMAHMOODABAD
- Social Science Research Center of Health, School of Public Health, Shahid Sadoughi University of Medical Science, Yazd, Iran
| | - SAEEDEH SADEGHI
- Health Education and Promotion, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd-Iran
- Correspondence: Saeedeh Sadeghi, Health Education and Promotion, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd-Iran - Tel. 093 0858 0486 - E-mail:
| | - MAHSA KHODAYARIAN
- Social Determinants of Health Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - AZADEH NADJARZADEH
- Nutrition and Food Security Research Center, Shahid Sadoughi University of Medical Sciences, Yazd-Iran
- Department of Nutrition, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - HOSSEIN FALLAHZADEH
- Research Center of Prevention and Epidemiology of Non-Communicable Disease, Departments of biostatistics and Epidemiology, Faculty of Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
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Braun K, Bock J, Wainstock T, Matas E, Gaisler-Salomon I, Fegert J, Ziegenhain U, Segal M. Experience-induced transgenerational (re-)programming of neuronal structure and functions: Impact of stress prior and during pregnancy. Neurosci Biobehav Rev 2020; 117:281-296. [DOI: 10.1016/j.neubiorev.2017.05.021] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2016] [Revised: 05/23/2017] [Accepted: 05/24/2017] [Indexed: 12/11/2022]
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Surkan PJ, Hong X, Zhang B, Nawa N, Ji H, Tang WY, Ji Y, Kimmel MC, Wang G, Pearson C, Wang X. Can social support during pregnancy affect maternal DNA methylation? Findings from a cohort of African-Americans. Pediatr Res 2020; 88:131-138. [PMID: 31349361 PMCID: PMC6982603 DOI: 10.1038/s41390-019-0512-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2019] [Revised: 06/25/2019] [Accepted: 06/29/2019] [Indexed: 01/25/2023]
Abstract
BACKGROUND While stress and the absence of social support during pregnancy have been linked to poor health outcomes, the underlying biological mechanisms are unclear. METHODS We examined whether adverse experiences during pregnancy alter DNA methylation (DNAm) in maternal epigenomes. Analyses included 250 African-American mothers from the Boston Birth Cohort. Genome-wide DNAm profiling was performed in maternal blood collected after delivery, using the Infinium HumanMethylation450 Beadchip. Linear regression models, with adjustment of pertinent covariates, were applied. RESULTS While self-reported maternal psychosocial lifetime stress and stress during pregnancy was not associated with DNAm alterations, we found that absence of support from the baby's father was significantly associated with maternal DNAm changes in TOR3A, IQCB1, C7orf36, and MYH7B and that lack of support from family and friends was associated with maternal DNA hypermethylation on multiple genes, including PRDM16 and BANKL. CONCLUSIONS This study provides intriguing results suggesting biological embedding of social support during pregnancy on maternal DNAm, warranting additional investigation, and replication.
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Affiliation(s)
- Pamela J. Surkan
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland,Corresponding author: Pamela J. Surkan, Social and Behavioral Interventions Program, Department of International Health, Johns Hopkins Bloomberg School of Public Health, 615 North Wolfe St., Room E5523, Baltimore, MD, USA, 21205-2179. . Phone: 410-502-7396. Fax: 410-502-6733
| | - Xiumei Hong
- Center on the Early Life Origins of Disease, Department of Population, Family and Reproductive Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland
| | - Boyang Zhang
- Department of Biostatistics, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland
| | - Nobutoshi Nawa
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Hongkai Ji
- Center on the Early Life Origins of Disease, Department of Population, Family and Reproductive Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland,Department of Biostatistics, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland
| | - Wan-Yee Tang
- Department of Environmental Health and Engineering, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland
| | - Yuelong Ji
- Center on the Early Life Origins of Disease, Department of Population, Family and Reproductive Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland
| | - Mary C. Kimmel
- Department of Psychiatry, University of North Carolina at Chapel Hill’s School of Medicine, Chapel Hill, North Carolina
| | - Guoying Wang
- Center on the Early Life Origins of Disease, Department of Population, Family and Reproductive Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland
| | - Colleen Pearson
- Department of Pediatrics, Boston University School of Medicine and Boston Medical Center, Boston, Massachusetts
| | - Xiaobin Wang
- Center on the Early Life Origins of Disease, Department of Population, Family and Reproductive Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland,Division of General Pediatrics & Adolescent Medicine, Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, Maryland
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Gallagher A, Kring D, Whitley T. Effects of yoga on anxiety and depression for high risk mothers on hospital bedrest. Complement Ther Clin Pract 2020; 38:101079. [DOI: 10.1016/j.ctcp.2019.101079] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2019] [Revised: 12/10/2019] [Accepted: 12/10/2019] [Indexed: 12/16/2022]
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McQuire C, Daniel R, Hurt L, Kemp A, Paranjothy S. The causal web of foetal alcohol spectrum disorders: a review and causal diagram. Eur Child Adolesc Psychiatry 2020; 29:575-594. [PMID: 30648224 PMCID: PMC7250957 DOI: 10.1007/s00787-018-1264-3] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2018] [Accepted: 12/05/2018] [Indexed: 12/21/2022]
Abstract
Foetal alcohol spectrum disorders (FASDs) are a leading cause of developmental disability. Prenatal alcohol use is the sole necessary cause of FASD, but it is not always sufficient. Multiple factors influence a child's susceptibility to FASD following prenatal alcohol exposure. Much of the FASD risk factor literature has been limited to discussions of association, rather than causation. While knowledge of predictor variables is important for identifying who is most at risk of FASD and for targeting interventions, causal knowledge is important for identifying effective mechanisms for prevention and intervention programmes. We conducted a systematic search and narrative synthesis of the evidence and used this to create a causal diagram (directed acyclic graph; DAG) to describe the causal pathways to FASD. Our results show that the aetiology of FASD is multifaceted and complex. FASD risk is determined by a range of lifestyle, sociodemographic, maternal, social, gestational, and genetic factors. The causal diagram that we present in this review provides a comprehensive summary of causal risk factors for FASD and can be used as a tool to inform data collection and statistical modelling strategies to minimise bias in future studies of FASD.
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Affiliation(s)
- Cheryl McQuire
- Population Health Sciences, Bristol Medical School, University of Bristol, Canynge Hall, 39 Whatley Road, Bristol, BS8 2PS, UK.
| | - R. Daniel
- Division of Population Medicine, Cardiff University, 3rd Floor, Neuadd Meirionnydd, Heath Park, Cardiff, CF14 4YS UK
| | - L. Hurt
- Division of Population Medicine, Cardiff University, 3rd Floor, Neuadd Meirionnydd, Heath Park, Cardiff, CF14 4YS UK
| | - A. Kemp
- Division of Population Medicine, Cardiff University, 3rd Floor, Neuadd Meirionnydd, Heath Park, Cardiff, CF14 4YS UK
| | - S. Paranjothy
- Division of Population Medicine, Cardiff University, 3rd Floor, Neuadd Meirionnydd, Heath Park, Cardiff, CF14 4YS UK
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Horsch A, Gilbert L, Lanzi S, Kang JS, Vial Y, Puder JJ. Prospective associations between maternal stress during pregnancy and fasting glucose with obstetric and neonatal outcomes. J Psychosom Res 2019; 125:109795. [PMID: 31421320 DOI: 10.1016/j.jpsychores.2019.109795] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2019] [Revised: 07/31/2019] [Accepted: 08/04/2019] [Indexed: 11/17/2022]
Abstract
OBJECTIVE This prospective study investigated associations between maternal stress exposure and maternal psychological stress measures during pregnancy with obstetric and neonatal outcomes. We also tested whether any observed associations would be moderated by increasing glucose levels, as increased glycaemia is also associated with adverse obstetric and neonatal outcomes. METHODS 203 women between 24 and 30 weeks gestation completed validated questionnaires assessing pregnancy-related major events and major life events, maternal perceived stress, and depression, anxiety, and stress symptoms. Glucose was measured using fasting morning blood samples. Instrumental delivery represented an obstetric outcome. Neonatal outcomes included Apgar score, large and small for gestational age weight, cord blood pH, NICU hospitalization, and neonatal hypoglycaemia. RESULTS Regarding the obstetric outcome, pregnancy-related major life events OR = 1.346 (1.016-1.783; p = .016) were related to more incidences of instrumental delivery. Regarding neonatal outcomes, exposure to major life events in the last 12 months was associated with lower cord blood pH values B = -0.155 (-0.059 to -0.002; p = .036) and with more incidences of hypoglycaemia OR = 0.165 (0.012-0.169; p = .04). Maternal psychological stress measures were related to more incidences of instrumental delivery OR = 1.018 (1.003-1.032; p = .013). Maternal stress perception was associated with higher cord blood pH values B = 0.155 (0-0.003; p = .046) and fewer NICU hospitalisations OR = -0.170 (-0.009 to -0.001; p = .019). Some of these associations between life events and stress perceptions with neonatal outcomes were moderated by fasting glucose levels. CONCLUSION Maternal pregnancy events as well as stress, depression and anxiety symptoms have a negative impact on obstetric outcomes and maternal life events are associated with negative neonatal outcomes. Higher fasting glucose levels moderate some of the relationships between stress and neonatal outcomes.
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Affiliation(s)
- Antje Horsch
- Institute of Higher Education in Healthcare Research, University of Lausanne, Lausanne, Switzerland; Department Woman-Mother-Child, Lausanne University Hospital, Lausanne, Switzerland.
| | - Leah Gilbert
- Department Woman-Mother-Child, Lausanne University Hospital, Lausanne, Switzerland
| | - Stefano Lanzi
- Service of Endocrinology, Diabetes and Metabolism, Lausanne University Hospital, Lausanne, Switzerland; Division of Angiology, Heart and Vessel Department, Lausanne University Hospital, Switzerland
| | - Ji Seon Kang
- Service of Endocrinology, Diabetes and Metabolism, Lausanne University Hospital, Lausanne, Switzerland
| | - Yvan Vial
- Department Woman-Mother-Child, Lausanne University Hospital, Lausanne, Switzerland
| | - Jardena J Puder
- Department Woman-Mother-Child, Lausanne University Hospital, Lausanne, Switzerland
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Racine N, Plamondon A, Hentges R, Tough S, Madigan S. Dynamic and bidirectional associations between maternal stress, anxiety, and social support: The critical role of partner and family support. J Affect Disord 2019; 252:19-24. [PMID: 30954841 DOI: 10.1016/j.jad.2019.03.083] [Citation(s) in RCA: 62] [Impact Index Per Article: 12.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2018] [Revised: 03/26/2019] [Accepted: 03/29/2019] [Indexed: 01/09/2023]
Abstract
BACKGROUND Stress and anxiety in pregnancy and the postpartum period are associated with poor long-term maternal and child health outcomes. Social support has been shown to mitigate the effects of maternal stress and anxiety; however, the directionality and longitudinal associations among these variables are poorly understood. Using a novel multilevel modeling approach called dynamic structural equation modeling (DSEM), we examined within-person (state-level) autoregressive and cross-lagged associations among stress, anxiety, and social support in the perinatal period in order to elucidate directional associations over time. METHODS Mothers from a longitudinal pregnancy cohort (N = 3,388) completed self-report measures of stress, anxiety, and social support across 4 time points from pregnancy to 12 months postpartum. RESULTS Higher than average levels of stress and anxiety led to elevations in anxiety and stress and decreases in social support at subsequent time points. Importantly, earlier individual levels of partner and family support predicted subsequent decreases in stress and anxiety. LIMITATIONS Support was measured via maternal self-report thus extrapolations cannot be made to tangible or instrumental supports and lagged relationships represent average lags over time. CONCLUSIONS Using a novel statistical approach, these results suggest that increases in both partner and family support may be powerful protective factors for decreasing mental health difficulties in pregnancy and the postpartum, highlighting the importance of targeting and increasing this type of support from pregnancy to the postpartum period.
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Affiliation(s)
- Nicole Racine
- Department of Psychology, Faculty of Arts, University of Calgary, 2500 University Dr. NW, Calgary, T2N 1N4 Alberta, Canada.
| | - André Plamondon
- Département des fondements et pratiques en éducation, Université Laval, Pavillon des Sciences de l'éducation, local 954, 2320, rue des Bibliotheques, Quebec, Canada; Department of Applied Psychology and Human Development, University of Toronto, Toronto, Ontario, Canada.
| | - Rochelle Hentges
- Department of Psychology, Faculty of Arts, University of Calgary, 2500 University Dr. NW, Calgary, T2N 1N4 Alberta, Canada.
| | - Suzanne Tough
- Department of Community Health Sciences, University of Calgary, Alberta, Canada; Department of Pediatrics, University of Calgary, 2500 University Dr. NW, Calgary, T2N 1N4 Alberta, Canada.
| | - Sheri Madigan
- Department of Psychology, Faculty of Arts, University of Calgary, Alberta Children's Hospital Research Institute, 2500 University Dr. NW, Calgary, T2N 1N4 Alberta, Canada.
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Morin M, Claris O, Dussart C, Frelat A, de Place A, Molinier L, Matillon Y, Elhinger V, Vayssiere C. Health-related quality of life during pregnancy: A repeated measures study of changes from the first trimester to birth. Acta Obstet Gynecol Scand 2019; 98:1282-1291. [PMID: 30985917 DOI: 10.1111/aogs.13624] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2018] [Revised: 04/04/2019] [Accepted: 04/08/2019] [Indexed: 12/15/2022]
Abstract
INTRODUCTION The objective was to evaluate the quality of life of pregnant women with a full-term birth from the first trimester to the 9th month using the EQ5D-3L questionnaire, comparing physiological, simple pathological, or complex pathological pregnancies. MATERIAL AND METHODS A prospective cohort of 500 pregnant women over the age of 18 was monitored between 2015 and 2017 at the Toulouse University Hospital (France). The data were collected monthly with an online report. Given that the decrease in quality of life was not linear during pregnancy, unadjusted and adjusted piecewise linear regression models were performed, considering 3 periods of time during pregnancy: 3-4, 4-8, and 8-9 months. The 5 dimensions of the EQ5D-Index and perceived health status were also analyzed. RESULTS In total, 1847 questionnaires were collected. Between the 4th and 8th months, the quality of life was lower for pathological pregnancies (P < 0.001) than for physiological ones and decreased over time for each type of pregnancy (physiological: -0.08 points per month, P < 0.001; simple pathological: -0.12 points per month, P < 0.001; complex pathological: -0.11 points per month, P < 0.001). Interestingly, the perceived health status was lower at the 9th month than at the 3rd month of pregnancy, for physiological pregnancies (mean difference = -10.5 points, P < 0.001), pathological pregnancies (mean difference = -10.0 points, P < 0.002), and for complex pathological pregnancies (mean difference = -7.8 points, P = 0.058). CONCLUSIONS In our population, the quality of life decreased between the 4th and 8th months, and decreased to a greater degree in a pathological pregnancy.
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Affiliation(s)
- Mathieu Morin
- Department of Obstetrics and Gynecology, Paule de Viguier Hospital, CHU Toulouse, Toulouse, France.,Department of Pathways to Systemic Health-P2S-EA 4129, University Claude Bernard of Lyon I, Lyon, France
| | - Olivier Claris
- Department of Pathways to Systemic Health-P2S-EA 4129, University Claude Bernard of Lyon I, Lyon, France.,Department of Neonatology and Neonatal Intensive Care, Lyon University Hospital, Lyon, France
| | - Claude Dussart
- Department of Pathways to Systemic Health-P2S-EA 4129, University Claude Bernard of Lyon I, Lyon, France
| | - Alais Frelat
- Department of Obstetrics and Gynecology, Paule de Viguier Hospital, CHU Toulouse, Toulouse, France
| | - Alice de Place
- Department of Obstetrics and Gynecology, Paule de Viguier Hospital, CHU Toulouse, Toulouse, France
| | - Laurent Molinier
- Department of Medical Information, CHU Toulouse, Toulouse III University, Toulouse, France.,UMR 1027 INSERM, Team 5-Cancer and Chronic Disease: Social Inequalities in Health, Primary and Secondary Access to Care, Toulouse III University, Toulouse, France
| | - Yves Matillon
- Department of Pathways to Systemic Health-P2S-EA 4129, University Claude Bernard of Lyon I, Lyon, France
| | - Virginie Elhinger
- UMR 1027 INSERM, Team SPHERE-Study of Perinatal, Pediatric and Adolescent Health: Epidemiological Research and Evaluation, Toulouse III University, Toulouse, France
| | - Christophe Vayssiere
- Department of Obstetrics and Gynecology, Paule de Viguier Hospital, CHU Toulouse, Toulouse, France.,UMR 1027 INSERM, Team SPHERE-Study of Perinatal, Pediatric and Adolescent Health: Epidemiological Research and Evaluation, Toulouse III University, Toulouse, France
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Surkan PJ, Dong L, Ji Y, Hong X, Ji H, Kimmel M, Tang WY, Wang X. Paternal involvement and support and risk of preterm birth: findings from the Boston birth cohort. J Psychosom Obstet Gynaecol 2019; 40:48-56. [PMID: 29144191 PMCID: PMC6143424 DOI: 10.1080/0167482x.2017.1398725] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
OBJECTIVE To investigate to what extent paternal involvement and support during pregnancy were associated with preterm (PTB) and small-for-gestational age (SGA) births. METHODS Using data from the Boston Birth Cohort (n = 7047), multiple logistic regression models were performed to estimate the log odds of either PTB or SGA birth, with paternal involvement, paternal social support, and family and friend social support variables as the primary independent variables. RESULTS About 10% of participating mothers reported their husbands not being involved or supportive during their pregnancies. Lack of paternal involvement was associated with 21% higher risk of PTB (OR = 1.21, 95% CI: 1.01-1.45). Similarly, lack of paternal support was borderline associated with PTB (OR = 1.13, 95% CI: 0.94-1.35). Also marginally significant, lack of paternal involvement (OR = 1.18, 95% CI: 0.95-1.47) and father's support (OR = 1.19, 95% CI: 0.96-1.48) were associated with higher odds of SGA birth. No associations were found between familial and friend support during pregnancy and PTB or SGA. CONCLUSIONS Among predominantly low-income African Americans, lack of paternal involvement and lack of paternal support during pregnancy were associated with an increased risk of PTB, and suggestive of SGA birth. These findings, if confirmed in future research, underscore the important role a father can play in reducing PTB and/or SGA.
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Affiliation(s)
- Pamela J. Surkan
- Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe Street, Baltimore, MD, USA, 21205, 410-502-7396,
| | - Liming Dong
- University of Michigan School of Public Health, Ann Arbor, MI, USA, 48109, 734-763-3645,
| | - Yuelong Ji
- Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe Street, Baltimore, MD, USA, 21205, 213-509-7601,
| | - Xiumei Hong
- Department of Population, Family and Reproductive Health, Center on the Early Life Origins of Disease, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA 21205, , 410-502-8919
| | - Hongkai Ji
- Johns Hopkins Bloomberg School of Public Health, 615 North Wolfe Street, Room E3638, Baltimore, MD 21205, USA, 410-955-3517,
| | - Mary Kimmel
- University of North Carolina-Chapel Hill Department of Psychiatry, Campus Box #7160, Chapel Hill, NC USA 27599-7160, 919-445-0216,
| | - Wan-yee Tang
- Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe Street, Room E4132, Baltimore, MD, USA, 21205, 410-614-3910,
| | - Xiaobin Wang
- Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe Street, Room E4132, Baltimore, MD, USA, 21205, 410-955-5824,
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Lagadec N, Steinecker M, Kapassi A, Magnier AM, Chastang J, Robert S, Gaouaou N, Ibanez G. Factors influencing the quality of life of pregnant women: a systematic review. BMC Pregnancy Childbirth 2018; 18:455. [PMID: 30470200 PMCID: PMC6251086 DOI: 10.1186/s12884-018-2087-4] [Citation(s) in RCA: 132] [Impact Index Per Article: 22.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2018] [Accepted: 11/13/2018] [Indexed: 12/31/2022] Open
Abstract
Background Pregnancy is a period of transition with important physical and emotional changes. Even in uncomplicated pregnancies, these changes can affect the quality of life (QOL) of pregnant women, affecting both maternal and infant health. The objectives of this study were to describe the quality of life during uncomplicated pregnancy and to assess its associated socio-demographic, physical and psychological factors in developed countries. Methods A systematic review was performed according to the PRISMA guidelines. Searches were made in PubMed, EMBASE and BDSP (Public Health Database). Two independent reviewers extracted the data. Countries with a human development index over 0.7 were selected. The quality of the articles was evaluated on the basis of the STROBE criteria. Results In total, thirty-seven articles were included. While the physical component of QOL decreased throughout pregnancy, the mental component was stable and even showed an improvement during pregnancy. Main factors associated with better QOL were mean maternal age, primiparity, early gestational age, the absence of social and economic problems, having family and friends, doing physical exercise, feeling happiness at being pregnant and being optimistic. Main factors associated with poorer QOL were medically assisted reproduction, complications before or during pregnancy, obesity, nausea and vomiting, epigastralgia, back pain, smoking during the months prior to conception, a history of alcohol dependence, sleep difficulties, stress, anxiety, depression during pregnancy and sexual or domestic violence. Conclusions Health-related quality of life refers to the subjective assessment of patients regarding the physical, mental and social dimensions of well-being. Improving the quality of life of pregnant women requires better identification of their difficulties and guidance which offers assistance whenever possible.
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Affiliation(s)
- Nolwenn Lagadec
- Department of Education and Research in General Medicine, Faculty of Medicine Pierre et Marie Curie, 27, rue Chaligny - 75571, cedex 12, Paris, France
| | - Magali Steinecker
- Department of Education and Research in General Medicine, Faculty of Medicine Pierre et Marie Curie, 27, rue Chaligny - 75571, cedex 12, Paris, France
| | - Amar Kapassi
- Department of Education and Research in General Medicine, Faculty of Medicine Pierre et Marie Curie, 27, rue Chaligny - 75571, cedex 12, Paris, France
| | - Anne Marie Magnier
- Department of Education and Research in General Medicine, Faculty of Medicine Pierre et Marie Curie, 27, rue Chaligny - 75571, cedex 12, Paris, France
| | - Julie Chastang
- Department of Education and Research in General Medicine, Faculty of Medicine Pierre et Marie Curie, 27, rue Chaligny - 75571, cedex 12, Paris, France
| | - Sarah Robert
- Sorbonne Universités, UPMC Univ Paris 06, INSERM, Institut Pierre Louis d'épidémiologie et de Santé Publique (IPLESP UMRS 1136), F75012, Paris, France
| | - Nadia Gaouaou
- Department of Education and Research in General Medicine, Faculty of Medicine Pierre et Marie Curie, 27, rue Chaligny - 75571, cedex 12, Paris, France
| | - Gladys Ibanez
- Sorbonne Universités, UPMC Univ Paris 06, INSERM, Institut Pierre Louis d'épidémiologie et de Santé Publique (IPLESP UMRS 1136), F75012, Paris, France.
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Horsch A, Gilbert L, Lanzi S, Gross J, Kayser B, Vial Y, Simeoni U, Hans D, Berney A, Scholz U, Barakat R, Puder JJ. Improving cardiometabolic and mental health in women with gestational diabetes mellitus and their offspring: study protocol for MySweetHeart Trial, a randomised controlled trial. BMJ Open 2018; 8:e020462. [PMID: 29487077 PMCID: PMC5855393 DOI: 10.1136/bmjopen-2017-020462] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/06/2017] [Accepted: 11/10/2017] [Indexed: 02/06/2023] Open
Abstract
INTRODUCTION Gestational diabetes mellitus (GDM) carries prenatal and perinatal risk for the mother and her offspring as well as longer-term risks for both the mother (obesity, diabetes, cardiovascular disease) and her child (obesity, type 2 diabetes). Compared with women without GDM, women with GDM are twice as likely to develop perinatal or postpartum depression. Lifestyle interventions for GDM are generally limited to physical activity and/or nutrition, often focus separately on the mother or the child and take place either during or after pregnancy, while their results are inconsistent. To increase efficacy of intervention, the multifactorial origins of GDM and the tight link between mental and metabolic as well as maternal and child health need to be heeded. This calls for an interdisciplinary transgenerational approach starting in, but continuing beyond pregnancy. METHODS AND ANALYSIS This randomised controlled trial will assess the effect of a multidimensional interdisciplinary lifestyle and psychosocial intervention aimed at improving the metabolic and mental health of 200 women with GDM and their offspring. Women with GDM at 24-32 weeks gestational age who understand French or English, and their offspring and partners can participate. The intervention components will be delivered on top of usual care during pregnancy and the first year postpartum. Metabolic and mental health outcomes will be measured at 24-32 weeks of pregnancy, shortly after birth and at 6-8 weeks and 1 year after childbirth. Data will be analysed using intention-to-treat analyses. The MySweetHeart Trial is linked to the MySweetHeart Cohort (clinicaltrials.gov/ct2/show/NCT02872974). ETHICS AND DISSEMINATION We will disseminate the findings through regional, national and international conferences and through peer-reviewed journals. TRIAL REGISTRATION NUMBER NCT02890693; Pre-results.
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Affiliation(s)
- Antje Horsch
- Woman-Mother-Child Department, Lausanne University Hospital, Lausanne, Switzerland
- Institute of Higher Education and Research in Healthcare (IUFRS), University of Lausanne, Lausanne, Switzerland
| | - Leah Gilbert
- Service of Endocrinology, Diabetes and Metabolism, Lausanne University Hospital, Lausanne, Switzerland
| | - Stefano Lanzi
- Service of Endocrinology, Diabetes and Metabolism, Lausanne University Hospital, Lausanne, Switzerland
- Service of Angiology, Heart and Vessel Department, Lausanne University Hospital, Lausanne, Switzerland
| | - Justine Gross
- Service of Endocrinology, Diabetes and Metabolism, Lausanne University Hospital, Lausanne, Switzerland
| | - Bengt Kayser
- Institute of Sport Sciences, University of Lausanne, Lausanne, Switzerland
| | - Yvan Vial
- Woman-Mother-Child Department, Lausanne University Hospital, Lausanne, Switzerland
| | - Umberto Simeoni
- DOHad Laboratory, Pediatrics Division, Woman-Mother-Child Department, Lausanne University Hospital, Lausanne, Switzerland
| | - Didier Hans
- Center of Bone Diseases, Rheumatology Service, Bone and Joint Department, Lausanne University Hospital, Lausanne, Switzerland
| | - Alexandre Berney
- Consultation Liaison Psychiatry, Lausanne University Hospital, Lausanne, Switzerland
| | - Urte Scholz
- Applied Social and Health Psychology, Department of Psychology, University Research Priority Program Dynamics of Healthy Aging, University of Zurich, Lausanne, Switzerland
| | - Ruben Barakat
- Facultad de Ciencias de la Actividad Física y del Deporte-INEF, Universidad Politécnica de Madrid, Madrid, Spain
| | - Jardena J Puder
- Institute of Higher Education and Research in Healthcare (IUFRS), University of Lausanne, Lausanne, Switzerland
- Service of Pediatric Endocrinology, Diabetology and Obesity, Lausanne University Hospital, Lausanne, Switzerland
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22
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Yohai D, Alharar D, Cohen R, Kaltian Z, Aricha-Tamir B, Ben Aion S, Yohai Z, Weintraub AY. The effect of attending a prenatal childbirth preparedness course on labor duration and outcomes. J Perinat Med 2018; 46:47-52. [PMID: 28245192 DOI: 10.1515/jpm-2016-0345] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2016] [Accepted: 01/16/2017] [Indexed: 11/15/2022]
Abstract
OBJECTIVE To evaluate the effect of attending a prenatal childbirth preparation course (CPC) on labor duration and outcomes. METHODS A cross sectional study of 53 primiparous women who attended and 54 women who did not attend a CPC was conducted. The state-trait anxiety inventory (STAI) score was used to diagnose anxiety. Clinical and obstetrical data were collected from the perinatal database of our center. Through post-partum interviews, coping strategies were assessed, patients graded their childbirth experience and breastfeeding was evaluated. Data were analyzed using description analyses and a P-value <0.05 was considered statistically significant. RESULTS The STAI score was significantly lower in the study group compared with controls (P=0.025). The first stage and the entire duration of labor were significantly shorter (P=0.036 and P=0.026, respectively) in women who attended the CPC. No significant differences were found with regard to the mode of delivery, rate of episiotomy, use of analgesics and neonatal outcomes between the groups. Women in the study group rated their labor experience significantly higher (P=0.016) and exhibited significantly higher rates of breastfeeding (P<0.001) than controls. CONCLUSIONS The knowledge acquired in the CPC has positive effects on the course of labor and delivery outcomes as well as higher rates of breastfeeding.
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Affiliation(s)
- David Yohai
- Department of Obstetrics and Gynecology, Soroka University Medical center, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva, Israel
| | - Debi Alharar
- Department of Obstetrics and Gynecology, Soroka University Medical center, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva, Israel
| | - Ruthi Cohen
- Department of Obstetrics and Gynecology, Soroka University Medical center, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva, Israel
| | - Zohar Kaltian
- Department of Obstetrics and Gynecology, Soroka University Medical center, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva, Israel
| | - Barak Aricha-Tamir
- Department of Obstetrics and Gynecology, Soroka University Medical center, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva, Israel
| | - Saviona Ben Aion
- Department of Obstetrics and Gynecology, Soroka University Medical center, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva, Israel
| | - Zehava Yohai
- Department of Obstetrics and Gynecology, Soroka University Medical center, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva, Israel
| | - Adi Y Weintraub
- Department of Obstetrics and Gynecology, Soroka University Medical center, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva, Israel
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Women's Perspectives of Needs Surrounding Adverse Birth Outcomes: A Qualitative Assessment of the Neighborhood Impact of Adverse Birth Outcomes. Matern Child Health J 2017; 21:2219-2228. [PMID: 28755043 DOI: 10.1007/s10995-017-2343-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Objectives African Americans are two times more likely to suffer adverse birth outcomes (i.e., low birth weight, preterm birth, and infant mortality) when compared to all other ethnic groups and this pattern is no different for Douglas County, Nebraska, where the majority of African Americans in Nebraska reside. Our goal was to identify factors, as described by local women, that contribute to adverse birth outcomes in the predominantly African American community of Northeast Douglas County in Omaha, NE, to ensure that these women's voices were included in the development of interventions to improve their neighborhood's birth outcomes. The paper describes the results of a qualitative needs assessment of these women which will aid in the design and implementation of neighborhood-based solutions. Methods We brought together a group of women with varying levels of birthing experience, time spent living in the neighborhood, and overall community involvement. Individual in-depth, in person, and telephone interviews were used to collect participants' perceptions of birth outcomes, neighborhood resources for pregnant women, and neighborhood strengths and weaknesses. Results The needs assessment identified that, although women in this neighborhood have experience with adverse birth outcomes, these experiences are not discussed resulting in a lack of awareness of the wide spread racial disparities in birth outcomes and the efforts and resources to address this public health problem. Conclusions for Practice This study reveals the power of direct conversations with women impacted by adverse birth outcomes, as they must be primary partners in any efforts to improve birth outcomes.
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Effati- Daryani F, Mirghafourvand M, Mohammad-Alizadeh-Charandabi S, Shiri-Sarand F, Zarei S. Sleep quality and its relationship with quality of life in Iranian pregnant women. Int J Nurs Pract 2017; 23. [DOI: 10.1111/ijn.12518] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2016] [Revised: 10/02/2016] [Accepted: 12/04/2016] [Indexed: 12/01/2022]
Affiliation(s)
| | - Mojgan Mirghafourvand
- Faculty of Nursing and Midwifery; Tabriz University of Medical Sciences; Tabriz Iran
| | | | - Fatemeh Shiri-Sarand
- Research Committee, Faculty of Nursing and Midwifery; Tabriz University of Medical Sciences; Aras International Branch; Tabriz Iran
| | - Somayeh Zarei
- Faculty of Nursing and Midwifery; Tabriz University of Medical Sciences; Tabriz Iran
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Haghighi L, Nohesara S, Moradi Y, Rashidi M, Moridi M. Psychological Disorders in Women with Spontaneous Preterm Delivery. ACTA ACUST UNITED AC 2016. [DOI: 10.17795/semj39033] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
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Abstract
The purpose of this study is to explore labor pain coping methods among Jordanian parturients. Descriptive statistics and content analysis were used to analyze data on demographics and coping methods from 100 low-risk parturients who were recruited from the postpartum unit in a major hospital in Jordan: Four labor pain-coping methods that included physiological, psychological, spiritual, and cognitive coping were reported. This study confirms previous findings regarding coping methods and adds new knowledge on coping with labor pain among Jordanian parturients: The significance of childbirth education as a means to inform Jordanian women about coping with labor pain is emphasized. This study also highlighted the important roles that nurses and midwives can play as educators and supporters during pregnancy and labor.
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Mirghafourvand M, Mohammad-Alizadeh-Charandabi S, Asghari Jafarabadi M, Shiri F, Ghanbari-Homayi S. Feasibility, Reliability, and Validity of the Iranian Version of the Quality of Life Questionnaire for Pregnancy. IRANIAN RED CRESCENT MEDICAL JOURNAL 2016; 18:e35382. [PMID: 28144461 PMCID: PMC5253432 DOI: 10.5812/ircmj.35382] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/09/2015] [Revised: 01/20/2016] [Accepted: 02/17/2016] [Indexed: 11/16/2022]
Abstract
Background Clinical studies are giving increased importance to quality of life assessments as measures of the relative effectiveness of prevention and treatment programs used during pregnancy and antenatally. Objectives The aim of this study was to validate the Quality of life gravidarum (QOL-GRAV) questionnaire for Iranian women during the pregnant period Patients and Methods In this cross-sectional methodological study, content validity following back and forward translation was assessed by a panel of experts. Using the two-stage cluster sampling method, 565 pregnant women referred to health care centers from April to June 2015 in Tabriz, Iran were enrolled in the study. Construct validity by assessing the factor structure, and convergent and discriminant validity were evaluated using scale-item correlations and known group analyses. Internal consistency and test–retest reliability were assessed in a sample of 30 pregnant women by the Cronbach’s α coefficient and intra-class correlation coefficient (ICC). Results The QOL-GRAV showed good content validity (CVI value = 0.95 and CVR value = 1), internal consistency (α = 0.79), and test–retest reliability (ICC = 0.86). The results of the CFA for two-factor models indicate an acceptable fit of the proposed model (RMSEA; 90% CI = 0.083; 0.068–0.099, CFI = 0.95, GFI = 0.96, and AGFI = 0.92). Conclusions The findings support the validity and reliability of the Iranian version of the QOL-GRAV questionnaire. Therefore, it is recommended to be used for both clinical and research purposes.
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Affiliation(s)
- Mojgan Mirghafourvand
- Nursing and Midwifery Faculty, Midwifery Department, Tabriz University of Medical Sciences, Tabriz, IR Iran
| | - Sakineh Mohammad-Alizadeh-Charandabi
- Midwifery Department, Research Center of Social Determinants of Health, Nursing and Midwifery Faculty, Tabriz University of Medical Sciences, Tabriz, IR Iran
| | - Mohammad Asghari Jafarabadi
- Road Traffic Injury Research Center, Faculty of Health, Tabriz University of Medical Sciences, Tabriz, IR Iran
| | - Fatemeh Shiri
- Students’ Research Committee, Faculty of Nursing and Midwifery, Tabriz University of Medical Sciences (International Branch Aras), Tabriz, IR Iran
| | - Solmaz Ghanbari-Homayi
- Students’ Research Committee, Faculty of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, IR Iran
- Corresponding Author: Solmaz Ghanbari-Homayi, Students’ research committee, Faculty of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, IR Iran. Tel: +98-4134772699, Fax: +98-4134752839, E-mail:
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Congdon JL, Adler NE, Epel ES, Laraia BA, Bush NR. A Prospective Investigation of Prenatal Mood and Childbirth Perceptions in an Ethnically Diverse, Low-Income Sample. Birth 2016; 43:159-66. [PMID: 26948850 PMCID: PMC5518740 DOI: 10.1111/birt.12221] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/12/2015] [Indexed: 02/03/2023]
Abstract
INTRODUCTION Few studies have examined prenatal mood as a means to identify women at risk for negative childbirth experiences. We explore associations between prenatal mood and birth perceptions in a socioeconomically diverse, American sample. METHODS We conducted a prospective study of 136 predominantly low-income and ethnic minority women of mixed parity. Prenatal measures of perceived stress, pregnancy-related anxiety, and depressive symptoms were used to predict maternal perceptions of birth experiences 1 month postpartum, using the childbirth experience questionnaire (CEQ; 1). RESULTS After adjusting for sociodemographic variables and mode of delivery, higher third-trimester stress predicted worse CEQ total scores. This association was predominantly explained by two CEQ domains: own capacity (e.g., feelings of control and capability), and perceived safety. Pregnancy-related anxiety and depressive symptoms correlated with perceived stress, though neither independently predicted birth experience. An unplanned cesarean delivery was associated with a worse CEQ total score. Vaginal delivery predicted greater perceived safety. Altogether, sociodemographic covariates, mode of delivery, and prenatal mood accounted for 35 percent of the variance in birth experience (p < 0.001). DISCUSSION Our finding that prenatal stress explains a significant and likely clinically meaningful proportion of the variance in birth experience suggests that women perceive and recall their birth experiences through a lens that is partially determined by preexisting personal circumstances and emotional reserves. Since childbirth perceptions have implications for maternal and child health, patient satisfaction, and health care expenditures, these findings warrant consideration of prenatal stress screening to target intervention for women at risk for negative birth experiences.
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Affiliation(s)
- Jayme L Congdon
- Department of Pediatrics at Stanford University, Stanford, CA, USA
- University of California Berkeley-University of California San Francisco Joint Medical Program, Berkeley, CA, USA
| | | | | | - Barbara A Laraia
- Community Health and Human Development in the School of Public Health at the University of California Berkeley, CA, USA
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Ugwa EA. Nutritional Practices and Taboos Among Pregnant Women Attending Antenatal Care at General Hospital in Kano, Northwest Nigeria. Ann Med Health Sci Res 2016; 6:109-14. [PMID: 27213094 PMCID: PMC4866363 DOI: 10.4103/2141-9248.181846] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Background: Food taboos among rural women have been identified as one of the factors contributing to maternal undernutrition in pregnancy. Aim: The aim of this study was to explore some of the taboos and nutritional practices among pregnant women attending antenatal care at a General Hospital in Dawakin Kudu LGA, Kano, Nigeria. Subjects and Methods: This was a cross-sectional study involving 220 pregnant women. Interviewer-administered structured questionnaire was used to interview the respondents, which showed various sociodemographic information, cultural nutritional processes, taboos of the community, and a 24 h food recall. The ages, parities, and gestational ages of the women were collated. Descriptive statistics was used. Data were analyzed using SPSS statistical software Version 17.0 (SPSS Inc., Chicago, IL, USA). Association between sociodemographic factors and nutritional practices and taboos was determined using Chi-square test and P < 0.05 was considered statistically significant. Results: At the end of the study, 200 participants (91%) gave complete information. Most of the women, 70% (140/200) were in the 20–39 years age range with mean (standard deviation [SD]) age of 23.7 (6.1) years, mostly uneducated, 70% (140/200), and unemployed, 51% (102/200). Most of the women did a child spacing of 12–24 months, 62% (124/200) with mean (SD) child spacing interval of 26.32 (10.19) months. Gestational age at booking was mostly 13–26 weeks, 48% (96/200) with an average of 26.60 (8.01). Most of the women had 1–4 children, 54.5% (109/200) with mean (SD) of 2.47 (2.50). Most of the women agreed that they had adequate intake of oil, 86% (172/200), meat/fish, 92% (194/200), fruit/vegetables 56% (112/200), and had 3 meals/day 80% (152/200), and did not practice pica 83% (166/200). All of the women, 100% (200/200) believe that women should eat more during pregnancy in order to have healthy babies. They were mostly supported by their husbands, 53% (106/200) and less likely by the community, 34% (17/200). The nutritional practices and taboos of the women showed a statistically significant association with age, parity, and support received from husband and community (P < 0.05). Educational status is not associated with their nutritional practices and taboos. Conclusion: Although sociocultural indices of the respondents were poor, their intake of good nutrition and abstinence from nutrition taboos were satisfactory. Further studies are intended to objectively study the nutritional practices/taboos in pregnancy.
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Affiliation(s)
- E A Ugwa
- Department of Obstetrics and Gynecology, Federal Medical Centre, Birnin Kudu, Jigawa State, Nigeria
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Zilcha-Mano S, Langer E. Mindful Attention to Variability Intervention and Successful Pregnancy Outcomes. J Clin Psychol 2016; 72:897-907. [DOI: 10.1002/jclp.22294] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2015] [Revised: 01/10/2016] [Accepted: 02/05/2016] [Indexed: 11/06/2022]
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Varea C, Terán JM, Bernis C, Bogin B, González-González A. Is the economic crisis affecting birth outcome in Spain? Evaluation of temporal trend in underweight at birth (2003-2012). Ann Hum Biol 2016; 43:169-82. [PMID: 26653704 DOI: 10.3109/03014460.2015.1131847] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND There is growing evidence of the impact of the current European economic crisis on health. In Spain, since 2008, there have been increasing levels of impoverishment and inequality, and important cuts in social services. AIM The objective is to evaluate the impact of the economic crisis on underweight at birth in Spain. METHOD Trends in underweight at birth were examined between 2003 and 2012. Underweight at birth is defined as a singleton, term neonatal weight lesser than -2 SD from the median weight at birth for each sex estimated by the WHO Standard Growth Reference. Using data from the Statistical Bulletin of Childbirth, 2 933 485 live births born to Spanish mothers have been analysed. Descriptive analysis, seasonal decomposition analysis and crude and adjusted logistic regression including individual maternal and foetal variables as well as exogenous economic indicators have been performed. RESULTS AND CONCLUSIONS Results demonstrate a significant increase in the prevalence of underweight at birth from 2008. All maternal-foetal categories were affected, including those showing the lowest prevalence before the crisis. In the full adjusted logistic regression, year-on-year GDP per capita remains predictive on underweight at birth risk. Previous trends in maternal socio-demographic profiles and a direct impact of the crisis are discussed to explain the trends described.
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Affiliation(s)
- Carlos Varea
- a Department of Biology, Faculty of Sciences , c/Darwin, 2, Madrid Autonomous University , Madrid , Spain
| | - José Manuel Terán
- a Department of Biology, Faculty of Sciences , c/Darwin, 2, Madrid Autonomous University , Madrid , Spain
| | - Cristina Bernis
- a Department of Biology, Faculty of Sciences , c/Darwin, 2, Madrid Autonomous University , Madrid , Spain
| | - Barry Bogin
- b School of Sport, Exercise and Health Sciences, Loughborough University , Loughborough , Leicestershire , UK , and
| | - Antonio González-González
- c Department of Obstetrics and Gynecology, Faculty of Medicine , c/ Arzobispo Morcillo, 4, Madrid Autonomous University , Madrid , Spain
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Bussières EL, Tarabulsy GM, Pearson J, Tessier R, Forest JC, Giguère Y. Maternal prenatal stress and infant birth weight and gestational age: A meta-analysis of prospective studies. DEVELOPMENTAL REVIEW 2015. [DOI: 10.1016/j.dr.2015.04.001] [Citation(s) in RCA: 54] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Newham JJ, Wittkowski A, Hurley J, Aplin JD, Westwood M. Effects of antenatal yoga on maternal anxiety and depression: a randomized controlled trial. Depress Anxiety 2014; 31:631-40. [PMID: 24788589 DOI: 10.1002/da.22268] [Citation(s) in RCA: 75] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2013] [Revised: 02/27/2014] [Accepted: 03/01/2014] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND Antenatal depression and anxiety are associated with adverse obstetric and mental health outcomes, yet practicable nonpharmacological therapies, particularly for the latter, are lacking. Yoga incorporates relaxation and breathing techniques with postures that can be customized for pregnant women. This study tested the efficacy of yoga as an intervention for reducing maternal anxiety during pregnancy. METHODS Fifty-nine primiparous, low-risk pregnant women completed questionnaires assessing state (State Trait Anxiety Inventory; STAI-State), trait (STAI-Trait), and pregnancy-specific anxiety (Wijma Delivery Expectancy Questionnaire; WDEQ) and depression (Edinburgh Postnatal Depression Scale; EPDS) before randomization (baseline) to either an 8-week course of antenatal yoga or treatment-as-usual (TAU); both groups repeated the questionnaires at follow-up. The yoga group also completed pre- and postsession state anxiety and stress hormone assessments at both the first and last session of the 8-week course. RESULTS A single session of yoga reduced both subjective and physiological measures of state anxiety (STAI-S and cortisol); and this class-induced reduction in anxiety remained at the final session of the intervention. Multiple linear regression analyses identified allocation to yoga as predictive of greater reduction in WDEQ scores (B = -9.59; BCa 95% CI = -18.25 to -0.43; P = .014; d = -0.57), while allocation to TAU was predictive of significantly increased elevation in EPDS scores (B = -3.06; BCa 95% CI = -5.9 to -0.17; P = .042; d = -0.5). No significant differences were observed in state or trait anxiety scores between baseline and follow-up. CONCLUSION Antenatal yoga seems to be useful for reducing women's anxieties toward childbirth and preventing increases in depressive symptomatology.
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Affiliation(s)
- James J Newham
- Maternal and Fetal Health Research Centre, Manchester Academic Health Sciences Centre, University of Manchester, Manchester, UK; Maternal and Fetal Health Research Centre, Manchester Academic Health Sciences Centre, St Mary's Hospital Central Manchester Universities NHS Foundation Trust, Manchester, UK
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Sanguanklin N, McFarlin BL, Park CG, Giurgescu C, Finnegan L, White-Traut R, Engstrom JL. Effects of the 2011 flood in Thailand on birth outcomes and perceived social support. J Obstet Gynecol Neonatal Nurs 2014; 43:435-44. [PMID: 24956975 DOI: 10.1111/1552-6909.12466] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVE To determine the effects of displacement due to flooding during pregnancy on birth outcomes (infant birth weight and gestational age) and the moderating effect of perceived social support on the relationship between displacement and birth outcomes. DESIGN A descriptive, longitudinal study. SETTING A university-affiliated hospital in Pathum Thani, Thailand. PARTICIPANTS Pregnant women (N = 175) in the third trimester that had uncomplicated pregnancies and no history of mental illness. METHODS During pregnancy, the participants completed standardized measurements of depression symptoms, perceived social support, and questionnaires concerning the effect of the flood. After giving birth, infant birth weight and gestational age at birth were retrieved from delivery records. RESULTS Seventy percent (n = 123) of the participants experienced displacement during the flood. The displaced women had a mean infant birth weight of 175 grams less than that of the nondisplaced women, t(173) = -2.38, p = .02, whereas infant gestational age was not different. Displacement and other variables explained approximately 8% of the variance in infant birth weight. The interaction term between displacement and perceived social support was statistically significant and additionally explained the variance in infant birth weight, F(6, 168) = 3.24, p = .005. CONCLUSION Being displaced during pregnancy due to a natural disaster affected fetal growth rather than length of gestation. Health care providers should closely monitor maternal weight gain and fetal growth of pregnant women who experience displacement. Among the displaced women, social support was associated with higher infant birth weight; therefore, high levels of perceived social support may be protective for pregnant women who experience stressful events such as displacement from flooding.
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Harris LF, Roberts SCM, Biggs MA, Rocca CH, Foster DG. Perceived stress and emotional social support among women who are denied or receive abortions in the United States: a prospective cohort study. BMC Womens Health 2014; 14:76. [PMID: 24946971 PMCID: PMC4080695 DOI: 10.1186/1472-6874-14-76] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2014] [Accepted: 06/16/2014] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Examining women's stress and social support following denial and receipt of abortion furthers understanding of the effects of unwanted childbearing and abortion on women's well-being. This study investigated perceived stress and emotional social support over time among women who were denied wanted abortions and who received abortions, and compared outcomes between the groups. METHODS The Turnaway Study is a prospective cohort study of women who sought abortions at 30 abortion facilities across the United States, and follows women via semiannual phone interviews for five years. Participants include 956 English or Spanish speaking women aged 15 and over who sought abortions between 2008 and 2010 and whose gestation in pregnancy fit one of three groups: women who presented up to three weeks beyond a facility's gestational age limit and were denied an abortion; women presenting within two weeks below the limit who received an abortion; and women who received a first trimester abortion. The outcomes were modified versions of the Perceived Stress Scale and the Multidimensional Scale of Perceived Social Support. Longitudinal mixed effects models were used to assess differences in outcomes between study groups over 30 months. RESULTS Women denied abortions initially had higher perceived stress than women receiving abortions near gestational age limits (1.0 unit difference on 0-16 scale, P = 0.003). Women receiving first-trimester abortions initially had lower perceived stress than women receiving abortions near gestational age limits (0.6 difference, P = 0.045). By six months, all groups' levels of perceived stress were similar, and levels remained similar through 30 months. Emotional social support scores did not differ among women receiving abortions near gestational limits versus women denied abortions or women having first trimester abortions initially or over time. CONCLUSIONS Soon after being denied abortions, women experienced higher perceived stress than women who received abortions. The study found no longer-term differences in perceived stress or emotional social support between women who received versus were denied abortions.
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Affiliation(s)
- Laura F Harris
- University of California Berkeley, University of California San Francisco, Joint Medical Program, 570 University Hall #1190, Berkeley, CA 94720, USA
| | - Sarah CM Roberts
- Advancing New Standards in Reproductive Health (ANSIRH), University of California San Francisco, 1330 Broadway, Suite 1100, Oakland, CA 94612, USA
| | - M Antonia Biggs
- Advancing New Standards in Reproductive Health (ANSIRH), University of California San Francisco, 1330 Broadway, Suite 1100, Oakland, CA 94612, USA
| | - Corinne H Rocca
- Advancing New Standards in Reproductive Health (ANSIRH), University of California San Francisco, 1330 Broadway, Suite 1100, Oakland, CA 94612, USA
| | - Diana Greene Foster
- Advancing New Standards in Reproductive Health (ANSIRH), University of California San Francisco, 1330 Broadway, Suite 1100, Oakland, CA 94612, USA
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Tragea C, Chrousos GP, Alexopoulos EC, Darviri C. A randomized controlled trial of the effects of a stress management programme during pregnancy. Complement Ther Med 2014; 22:203-11. [DOI: 10.1016/j.ctim.2014.01.006] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2012] [Revised: 01/14/2014] [Accepted: 01/22/2014] [Indexed: 11/25/2022] Open
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Abstract
Extensive evidence documents that prenatal maternal stress predicts a variety of adverse physical and psychological health outcomes for the mother and baby. However, the importance of the ways that women cope with stress during pregnancy is less clear. We conducted a systematic review of the English-language literature on coping behaviours and coping styles in pregnancy using PsycInfo and PubMed to identify 45 cross-sectional and longitudinal studies involving 16,060 participants published between January 1990 and June 2012. Although results were often inconsistent across studies, the literature provides some evidence that avoidant coping behaviours or styles and poor coping skills in general are associated with postpartum depression, preterm birth and infant development. Variability in study methods including differences in sample characteristics, timing of assessments, outcome variables and measures of coping styles or behaviours may explain the lack of consistent associations. To advance the scientific study of coping in pregnancy, we call attention to the need for a priori hypotheses and greater use of pregnancy-specific, daily process, and skills-based approaches. There is promise in continuing this area of research, particularly in the possible translation of consistent findings to effective interventions, but only if the conceptual basis and methodological quality of research improve.
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Birth weight, domestic violence, coping, social support, and mental health of young Iranian mothers in Tehran. J Nerv Ment Dis 2013; 201:602-8. [PMID: 23817159 DOI: 10.1097/nmd.0b013e3182982b1d] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
The aim of this study was to investigate associations of birth weight with sociodemographic variables, domestic violence, ways of coping, social support, and general mental health of Iranian mothers. Six hundred mothers aged 15 to 29 years participated between June 2009 and November 2010. t-Test, analysis of variance, Spearman's correlation, and multiple regression were used. The results showed that there was no significant association between birth weight and general mental health of the mothers. Prenatal care visits, the mothers' history of having children with low birth weight (LBW), and weight gain during pregnancy were significantly associated with birth weight. The women who reported physical abuse during pregnancy had infants with lower birth weight. Satisfaction with social support and use of positive reappraisal were significantly associated with higher birth weight. In conclusion, a high quality of prenatal care and screening of pregnant women are recommended. Social environments good enough during pregnancy have protective effects against LBW.
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Liu L, Setse R, Grogan R, Powe NR, Nicholson WK. The effect of depression symptoms and social support on black-white differences in health-related quality of life in early pregnancy: the health status in pregnancy (HIP) study. BMC Pregnancy Childbirth 2013; 13:125. [PMID: 23731625 PMCID: PMC3679771 DOI: 10.1186/1471-2393-13-125] [Citation(s) in RCA: 17] [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: 07/06/2012] [Accepted: 05/24/2013] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Lower physical and social functioning in pregnancy has been linked to an increased risk of preterm delivery and low birth weight infants, butt few studies have examined racial differences in pregnant women's perception of their functioning. Even fewer studies have elucidated the demographic and clinical factors contributing to racial differences in functioning. Our objective was to determine whether there are racial differences in health-related quality of life (HRQoL) in early pregnancy; and if so, to identify the contributions of socio-demographic characteristics, depression symptoms, social support and clinical factors to these differences. METHODS Cross-sectional study of 175 women in early pregnancy attending prenatal clinics in urban setting. In multivariate analysis, we assessed the independent relation of black race (compared to white) to HRQoL scores from the eight domains of the Medical Outcomes (SF-36) SURVEY: Physical Functioning, Role-Physical, Bodily Pain, Vitality, General Health, Social Functioning, Role-Emotional, and Mental Health. We compared socio-demographic and clinical factors and depression symptoms between black and white women and assessed the relative importance of these factors in explaining racial differences in physical and social functioning. RESULTS Black women comprised 59% of the sample; white women comprised 41%. Before adjustment, black women had scores that were 14 points lower in Physical Function and Bodily Pain, 8 points lower in General Health, 4 points lower in Vitality and 7 points lower in Social Functioning. After adjustment for depression symptoms, social support and clinical factors, black women still had HRQoL scores that were 4 to 10 points lower than white women, but the differences were no longer statistically significant. Level of social support and payment source accounted for most of the variation in Physical Functioning, Bodily Pain and General Health. Social support accounted for most of the differences in Vitality and Social Functioning. CONCLUSIONS Payment source and social support accounted for much of the racial differences in physical and social function scores. Efforts to reduce racial differences might focus on improving social support networks and Socio-economic barriers.
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Affiliation(s)
- Li Liu
- Department of International Health, Johns Hopkins University, Baltimore, USA
| | - Rosanna Setse
- Department of Epidemiology, Johns Hopkins University, Baltimore, USA
| | - Ruby Grogan
- Department of Medicine University of California, San Francisco, USA
- Department of Obstetrics and Gynecology, University of North Carolina, Chapel Hill, USA
| | - Neil R Powe
- Department of Medicine University of California, San Francisco, USA
| | - Wanda K Nicholson
- Department of Obstetrics and Gynecology, University of North Carolina, Chapel Hill, USA
- Center for Women’s Health Research, University of North Carolina, Chapel Hill, USA
- Diabetes Center, University of North Carolina, Chapel Hill, USA
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Abstract
OBJECTIVE The aim of this study was to evaluate the association between exposure to life-threatening rocket attacks and spontaneous abortions (SAs). STUDY DESIGN This is a historical cohort study comparing 1345 pregnancies of female residents of a town exposed to rocket attacks with 2143 pregnancies of female residents of an unexposed town. Demographic and medical data were obtained from hospital records and exposure information from official local databases. Intensity of exposure was calculated for preconception and pregnancy periods. RESULTS Compared with unexposed group, women in the exposed group had higher rates of SA (6.9% versus 4.7%, adjusted odds ratio = 1.59, 95% confidence interval = 1.17-2.2, p = .003). Intensity of preconception and pregnancy exposure were nonlinearly associated with SA risk; both the highest and the lowest quintiles of exposure were associated with increased risk of SA. CONCLUSIONS Stress during preconception and pregnancy was associated with increased risk of SA.
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Pereira M, Canavarro MC. Quality of Life and Emotional Distress among HIV-Positive Women during Transition to Motherhood. SPANISH JOURNAL OF PSYCHOLOGY 2013; 15:1303-14. [DOI: 10.5209/rev_sjop.2012.v15.n3.39416] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
The purpose of this preliminary study was to describe the quality of life (QOL) and emotional distress during pregnancy and early postpartum, and to examine the ability of psychopathological symptoms to predict QOL at early postpartum.Asample of 75 pregnant women (31 HIV-positive and 44 HIV-negative) was assessed during the second trimester of pregnancy and two to four days postpartum. QOL was assessed with the WHOQOL-Bref. The emotional distress was assessed with the Brief Symptom Inventory, and with the Emotional Assessment Scale. Seropositive women reported increased negative emotional reactivity and lower scores in social relationships and overall QOL during pregnancy than HIV-negative women. Both HIV-positive and HIV-negative women reported better QOL after the birth of their child, when compared with the pregnancy period. Among HIV-positive women, lower anxiety and depressive symptoms during pregnancy were, respectively, significant predictors of better psychological QOL and overall QOL at early postpartum. Less intense somatic symptoms predicted better physical QOL. Longitudinal assessment of QOL and emotional status may provide potentially useful information for tailoring psychological interventions in the maternity care of HIV-infected women, during their transition to motherhood.
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Alderdice F, Lynn F, Lobel M. A review and psychometric evaluation of pregnancy-specific stress measures. J Psychosom Obstet Gynaecol 2012; 33:62-77. [PMID: 22554138 DOI: 10.3109/0167482x.2012.673040] [Citation(s) in RCA: 144] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
Considerable evidence has accumulated on the association between pregnancy-specific stress and adverse birth outcomes with an increasing number of measures of pregnancy-specific stress being developed internationally. However, the introduction of these measures has not always been theoretically or psychometrically grounded, resulting in questions about the quality and direction of such research. This review summarizes evidence on the reliability and validity of pregnancy-specific stress measures identified between 1980 and October 2010. Fifteen pregnancy-specific stress measures were identified. Cronbach's alpha coefficient ranged from 0.51-0.96 and predictive validity data on preterm birth were reported for five measures. Convergent validity data suggest that pregnancy-specific stress is related to, but distinct from, global stress. Findings from this review consolidate current knowledge on pregnancy-specific stress as a consistent predictor of premature birth. This review also advances awareness of the range of measures of pregnancy-specific stress and documents their strengths and limitations based on published reliability and validity data. Careful consideration needs to be given as to which measures to use in future research to maximize the development of stress theory in pregnancy and appropriate interventions for women who experience stress in pregnancy. An international, strategic collaboration is recommended to advance knowledge in this area of study.
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Affiliation(s)
- Fiona Alderdice
- School of Nursing and Midwifery, Queens University Belfast, Belfast, UK.
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44
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Chen MJ, Grobman WA, Gollan JK, Borders AEB. The use of psychosocial stress scales in preterm birth research. Am J Obstet Gynecol 2011; 205:402-34. [PMID: 21816383 PMCID: PMC3205306 DOI: 10.1016/j.ajog.2011.05.003] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2011] [Revised: 04/13/2011] [Accepted: 05/01/2011] [Indexed: 10/18/2022]
Abstract
Psychosocial stress has been identified as a potential risk factor for preterm birth. However, an association has not been found consistently, and a consensus on the extent to which stress and preterm birth are linked is still lacking. A literature search was performed with a combination of keywords and MeSH terms to detect studies of psychosocial stress and preterm birth. Studies were included in the review if psychosocial stress was measured with a standardized, validated instrument and if the outcomes included either preterm birth or low birthweight. Within the 138 studies that met inclusion criteria, 85 different instruments were used. Measures that had been designed specifically for pregnancy were used infrequently, although scales were sometimes modified for the pregnant population. The many different measures that have been used may be a factor that accounts for the inconsistent associations that have been observed.
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Affiliation(s)
- Melissa J Chen
- Department of Obstetrics and Gynecology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
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45
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Association of Low Birth Weight Infants and Maternal Sociodemographic Status in Tuzla Canton during 1992-1995 War Period in Bosnia and Herzegovina. Int J Pediatr 2011; 2010:789183. [PMID: 21490700 PMCID: PMC3068307 DOI: 10.1155/2010/789183] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2010] [Revised: 10/21/2010] [Accepted: 12/01/2010] [Indexed: 11/07/2022] Open
Abstract
Objectives. We examined association between incidence rate of low birth weight in liveborn infants and maternal sociodemographic status in Tuzla Canton during 1992–1995 war in Bosnia and Herzegovina. Methods. The present study covers a 22-year period (1988–2009), including the war period (1992–1995), and we retrospectively collected data on a total of 108 316 liveborn infants and their mothers from three different socioeconomic periods: before (1988–1991), during (1992–1995), and after the war (1996–2009). Association between incidence rate of low birth weight in liveborn infants and maternal sociodemographic status were determined for each study period. Results. There were 23 194 live births in the prewar, 18 302 during the war, and 66 820 in the postwar period. Among the liveborn infants born during the war, 1373 (7.5%) had birth weight of <2500 g, which is significantly more in comparison with 851 (3.6%) liveborn infants in this birth weight group born before and 1864 (2.8%) after the war. We found the number of examinations during pregnancy was 1.8 per pregnant woman in the war period, which was low in comparison with the number of examinations before (4.6 per pregnant woman) and after (7.1 per pregnant woman) the war (P<.001 for both). Prewar perinatal mortality LBW infants of 6.2 per 1000 live births increased to 10.8 per 1000 live births during the war (P<.001), but after the war, perinatal mortality LBW infants (5.2‰) and early neonatal mortality (2.4‰) decreased. Conclusions. We found statistically significant association between low-birth-weight and maternal sociodemographic status in Tuzla Canton during 1992–1995 war in Bosnia and Herzegovina.
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Roberts L, Gulliver B, Fisher J, Cloyes KG. The Coping With Labor Algorithm: An Alternate Pain Assessment Tool for the Laboring Woman. J Midwifery Womens Health 2010; 55:107-16. [DOI: 10.1016/j.jmwh.2009.11.002] [Citation(s) in RCA: 57] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2008] [Revised: 11/04/2009] [Accepted: 11/04/2009] [Indexed: 11/16/2022]
Affiliation(s)
| | - Brenda Gulliver
- Clinical Nurse on Labor and delivery at the University of Utah Hospital, Salt Lake City, UT
| | - Janet Fisher
- Faculty Member and researcher at the University of Utah College of Nursing, Salt Lake City, UT
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47
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Littleton HL, Bye K, Buck K, Amacker A. Psychosocial stress during pregnancy and perinatal outcomes: a meta-analytic review. J Psychosom Obstet Gynaecol 2010; 31:219-28. [PMID: 21039328 DOI: 10.3109/0167482x.2010.518776] [Citation(s) in RCA: 100] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
The objective of this study was to evaluate the relationship between psychosocial stress in pregnancy and negative perinatal outcomes and to identify key moderators of this relationship. To evaluate this relationship, a meta-analytic review was conducted of studies that prospectively assessed the relationship between psychosocial stress in pregnancy and perinatal outcomes. A total of 35 studies, written or published between 1991 and 2009, involving 31,323 women were located. The overall association between psychosocial stress and negative perinatal outcomes was significant, but negligibly small in size (r (35) = -0.04, CI = -0.08, -0.01). Examining specific perinatal outcomes, only the associations with neonatal weight (r (14) = -0.07, CI = -0.03, -0.01) and risk for low birth weight (r (5) = 0.07, CI = 0.03, 0.10) were statistically significant, but again, very small. Results support that psychosocial stress explains a negligible to very small amount of the variability in perinatal outcomes. Future research should focus on identifying other psychosocial and lifestyle variables that alone or in interaction with other factors explain larger amounts of the variability in perinatal outcomes. Future research should also examine whether psychosocial stress increases risk for negative outcomes in combination with other biomedical and psychosocial risk factors.
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48
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Da Costa D, Dritsa M, Verreault N, Balaa C, Kudzman J, Khalifé S. Sleep problems and depressed mood negatively impact health-related quality of life during pregnancy. Arch Womens Ment Health 2010; 13:249-57. [PMID: 19728037 DOI: 10.1007/s00737-009-0104-3] [Citation(s) in RCA: 78] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2009] [Accepted: 08/10/2009] [Indexed: 10/20/2022]
Abstract
The objectives of this study were to evaluate and identify determinants of health related quality of life (HRQoL) during pregnancy. Pregnant women (n = 245) completed questionnaires measuring: HRQoL (Short Form Health Survey SF-36), life stress, social support, sleep, and depressed mood in the third trimester. Demographics and medical variables were also collected. Compared to Canadian normative data, our sample scored significantly poorer on the following HRQoL domains: physical functioning, role limitations due to physical health problems, bodily pain, vitality, and social functioning. Multivariate linear regressions were used to model each of the SF-36 subscales. Experiencing sleep problems emerged as a significant determinant of poorer HRQoL in all domains, with the exception of emotional role. Higher depressed mood scores was independently associated with lower HRQoL in six of the eight domains, including bodily pain, general health, vitality, social functioning, emotional role, and mental health. Greater pregnancy-related anxiety was independently associated with lower scores on physical functioning and role limitations due to physical health problems. Women experience lower HRQoL during pregnancy, particularly in the physical domains. The importance of identifying and managing modifiable determinants early in pregnancy to enhance maternal health status is discussed.
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49
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Abstract
OBJECTIVE To describe coping in healthy pregnant women and examine sociodemographic factors associated with coping styles. DESIGN A cross-sectional descriptive survey. SETTING Childbirth classes at 2 Midwestern urban hospitals. PARTICIPANTS Healthy primigravidae (N=159), ages 18 to 34, in their third trimester. METHODS A cross-sectional, descriptive survey of healthy pregnant women using 2 reliable coping tools to measure pregnancy coping and general coping styles and determine their associations with sociodemographic factors. RESULTS Prayer and task coping were the most frequently used coping styles; avoidance and emotion coping were used least frequently. Younger age was associated with greater use of preparation and distraction coping. Non-White race was associated with frequent use of prayer, task, and distraction coping. Education less than graduate school was associated with frequent use of preparation. CONCLUSION Healthy pregnant women used a variety of coping styles, and sociodemographic factors influenced them. Future research requires diverse samples to explore prayer in pregnancy and the influence of stress and other psychological factors on coping styles. Nurses have many opportunities to assess coping during pregnancy. Nurse-directed community-based programs that promote healthy coping can optimize maternal and newborn health.
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Affiliation(s)
- Kathy E Borcherding
- College of Nursing, University of Missouri at Saint Louis, One University Boulevard, St. Louis, MO 63121-4400, USA.
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50
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Flynn PM, Foster EM, Brost BC. Indicators of acculturation related to Somali refugee women's birth outcomes in Minnesota. J Immigr Minor Health 2009; 13:224-31. [PMID: 19757054 DOI: 10.1007/s10903-009-9289-9] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2009] [Accepted: 09/02/2009] [Indexed: 11/30/2022]
Abstract
We investigated the effect of indicators of acculturation among Somali refugee women's birth outcomes. Data were extracted from medical records of 584 Somali women delivering infants at a Midwestern hospital between 1993 and 2006. Bivariate analyses measured relationships between independent factors and the dependent variables of gestational age and birthweight. Structural equation modeling (SEM) determined the fit between factors hypothesized to reflect acculturation and the data. Significant increases noted over time were substance use/exposure, interpreter use, body mass index, hemoglobin levels, gestational diabetes and preterm birth. Bivariate analyses showed significance between prenatal care utilization and both preterm birth and gestational age. SEM results indicated a moderate to good fit between the hypothesized model and available data. Factors hypothesized to reflect acculturation and effect birth outcomes among Somali women are increasing but did not account for increased preterm birth. Further investigation is warranted to identify and truncate further disparate birth outcomes.
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