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Willford JA, Kaufman JM. Through a teratological lens: A narrative review of exposure to stress and drugs of abuse during pregnancy on neurodevelopment. Neurotoxicol Teratol 2024; 105:107384. [PMID: 39187031 DOI: 10.1016/j.ntt.2024.107384] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2024] [Revised: 08/20/2024] [Accepted: 08/21/2024] [Indexed: 08/28/2024]
Abstract
Teratological research shows that both prenatal stress and prenatal substance exposure have a significant impact on neurodevelopmental outcomes in children. Using human research, the purpose of this narrative review is to explore the degree to which these exposures may represent complex prenatal and postnatal risks for the development of cognition and behavior in children. An understanding of the HPA axis and its function during pregnancy as well as the types and operationalization of prenatal stress provide a context for understanding the direct and indirect mechanisms by which prenatal stress affects brain and behavior development. In turn, prenatal substance exposure studies are evaluated for their importance in understanding variables that indicate a potential interaction with prenatal stress including reactivity to novelty, arousal, and stress reactivity during early childhood. The similarities and differences between prenatal stress exposure and prenatal substance exposure on neurodevelopmental outcomes including arousal and emotion regulation, cognition, behavior, stress reactivity, and risk for psychopathology are summarized. Further considerations for teratological studies of prenatal stress and/or substance exposure include identifying and addressing methodological challenges, embracing the complexity of pre-and postnatal environments in the research, and the importance of incorporating parenting and resilience into future studies.
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Affiliation(s)
- Jennifer A Willford
- Slippery Rock University, Department of Psychology, 1 Morrow Way, Slippery Rock, PA 16057, United States of America.
| | - Jesse M Kaufman
- Slippery Rock University, Department of Psychology, 1 Morrow Way, Slippery Rock, PA 16057, United States of America
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Zenouzi A, Moghadam ZB, Babayanzad S, Asghari M, Rezaei E. The Effect of Benson Relaxation Technique on Stress, Anxiety, and Depression in Pregnant Women. Holist Nurs Pract 2024; 38:227-237. [PMID: 34347634 DOI: 10.1097/hnp.0000000000000463] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Relaxation programs can be effective in establishing psychological tranquility for maternal and fetal health. This study was conducted to evaluate the effect of this low-cost, effective, easy method on the stress, anxiety, and depression in pregnant women. This randomized clinical trial study was conducted from July 2015 to July 2016. Seventy pregnant women in the third trimester of pregnancy were included in this study. Participants were randomly assigned to 2 groups of 35 subjects using a random number table. Participants in group 1 received relaxation training and group 2 received routine care. A demographic questionnaire and Depression, Anxiety, and Stress Scale (DASS-21) were completed before and 1 and 2 months after the intervention. The SPSS software version 18 was used for data analysis. There were significant differences in the mean difference of the total DASS score (14; 95% confidence interval [CI]: 4 to 32) as well as the scores of stress (4; 95% CI : 1 to 10), anxiety (6; 95% CI: 2 to 10), and depression (6; 95% CI: 2 to 12) 2 months after the intervention between the 2 groups. The Benson relaxation technique decreased DASS-21 scores in the intervention group.
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Affiliation(s)
- Azade Zenouzi
- Author Affiliations: School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran (Ms Zenouzi and Dr. Babayanzad); Islamic Azad University, Pishva Branch, Tehran, Iran (Mss Zenouzi and Asghari); Faculty of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran (Dr. Moghadam); and Reproductive Health Research Center, Clinical Research Institute, Urmia University of Medical Sciences, Urmia, Iran (Dr. Rezaei)
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Ryan N, Leahy-Warren P, Mulcahy H, O'Mahony S, Philpott L. The impact of perinatal maternal stress on the maternal and infant gut and human milk microbiomes: A scoping review protocol. PLoS One 2024; 19:e0304787. [PMID: 38837966 DOI: 10.1371/journal.pone.0304787] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2024] [Accepted: 05/17/2024] [Indexed: 06/07/2024] Open
Abstract
OBJECTIVE The objective of this scoping review is to review the research evidence regarding the impact of perinatal maternal stress on the maternal and infant gut and human milk microbiomes. INTRODUCTION Perinatal stress which refers to psychological stress experienced by individuals during pregnancy and the postpartum period is emerging as a public health concern. Early exposure of infants to perinatal maternal stress can potentially lead to metabolic, immune, and neurobehavioral disorders that extend into adulthood. The role of the gut and human milk microbiome in the microbiome-gut-brain axis as a mechanism of stress transfer has been previously reported. A transfer of colonised aberrant microbiota from mother to infant is proposed to predispose the infant to a pro- inflammatory microbiome with dysregulated metabolic process thereby initiating early risk of chronic diseases. The interplay of perinatal maternal stress and its relationship to the maternal and infant gut and human milk microbiome requires further systematic examination in the literature. INCLUSION CRITERIA This scoping review is an exploratory mapping review which will focus on the population of mothers and infants with the exploration of the key concepts of maternal stress and its impact on the maternal and infant gut and human milk microbiome in the context of the perinatal period. It will focus on the pregnancy and the post-natal period up to 6 months with infants who are exclusively breastfed. METHODS This study will be guided by the Joanna Briggs Institute's (JBI) methodology for scoping reviews along with use of the Prisma Scr reporting guideline. A comprehensive search will be conducted using the following databases, CINAHL Complete; MEDLINE; PsycINFO, Web of Science and Scopus. A search strategy with pre-defined inclusion and exclusion criteria will be used to retrieve peer reviewed data published in English from 2014 to present. Screening will involve a three-step process with screening tool checklists. Results will be presented in tabular and narrative summaries, covering thematic concepts and their relationships. This protocol is registered with Open Science Framework DOI 10.17605/OSF.IO/5SRMV.
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Affiliation(s)
- Niamh Ryan
- School of Nursing and Midwifery, University College Cork, Wilton, Cork, Ireland
| | | | - Helen Mulcahy
- School of Nursing and Midwifery, University College Cork, Wilton, Cork, Ireland
| | - Siobhain O'Mahony
- Department of Anatomy and Neuroscience, APC Microbiome Ireland, University College Cork, Ireland
| | - Lloyd Philpott
- School of Nursing and Midwifery, University College Cork, Wilton, Cork, Ireland
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Symanski E, Whitworth KW, Mendez-Figueroa H, Aagaard KM, Moussa I, Alvarez J, Chardon Fabian A, Kannan K, Walker CL, Coarfa C, Suter MA, Salihu HM. The Maternal and Infant Environmental Health Riskscape study of perinatal disparities in greater Houston: rationale, study design and participant profiles. FRONTIERS IN REPRODUCTIVE HEALTH 2024; 6:1304717. [PMID: 38712340 PMCID: PMC11070492 DOI: 10.3389/frph.2024.1304717] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2023] [Accepted: 04/01/2024] [Indexed: 05/08/2024] Open
Abstract
Introduction The Maternal and Infant Environmental Health Riskscape (MIEHR) Center was established to address the interplay among chemical and non-chemical stressors in the biological, physical, social, and built environments that disproportionately impact perinatal health among Black pregnant people in a large and diverse urban area with documented disparities in the U.S. Methods The MIEHR cohort is recruiting non-Hispanic Black and non-Hispanic white pregnant people who deliver their infants at major obstetric hospitals in Houston, Texas. At enrollment, all participants are asked to provide urine samples for chemical [metals, cotinine, and polycyclic aromatic hydrocarbons (PAHs)] analyses and blood samples. A subset of the cohort is asked to provide oral and vaginal swabs, and fecal samples. Questionnaire and electronic health record data gather information about residential address history during pregnancy, pregnancy history and prenatal care, sociodemographic and lifestyle factors, experiences of discrimination and stress, and sources of social support. Using information on where a participant lived during their pregnancy, features of their neighborhood environment are characterized. We provide summaries of key individual- and neighborhood-level features of the entire cohort, as well as for Black and white participants separately. Results Between April 2021 and February 2023, 1,244 pregnant people were recruited. Nearly all participants provided urine samples and slightly less than half provided blood samples. PAH exposure patterns as assessed on 47% of participants thus far showed varying levels depending on metabolite as compared to previous studies. Additionally, analyses suggest differences between Black and white pregnant people in experiences of discrimination, stress, and levels of social support, as well as in neighborhood characteristics. Discussion Our findings to date highlight racial differences in experiences of discrimination, stress, and levels of support, as well as neighborhood characteristics. Recruitment of the cohort is ongoing and additional neighborhood metrics are being constructed. Biospecimens will be analyzed for metals and PAH metabolites (urine samples), miRNAs (plasma samples) and the microbiome (oral swabs). Once enrollment ends, formal assessments are planned to elucidate individual- and neighborhood-level features in the environmental riskscape that contribute to Black-White disparities in perinatal health.
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Affiliation(s)
- Elaine Symanski
- Center for Precision Environmental Health, Baylor College of Medicine, Houston, TX, United States
- Section of Epidemiology and Population Sciences, Department of Medicine, Baylor College of Medicine, Houston, TX, United States
| | - Kristina W. Whitworth
- Center for Precision Environmental Health, Baylor College of Medicine, Houston, TX, United States
- Section of Epidemiology and Population Sciences, Department of Medicine, Baylor College of Medicine, Houston, TX, United States
| | - Hector Mendez-Figueroa
- Division of Maternal-Fetal Medicine, Department of Obstetrics, Gynecology and Reproductive Sciences, McGovern Medical School at UTHealth, Houston, TX, United States
| | - Kjersti M. Aagaard
- Division of Maternal-Fetal Medicine, Department of Obstetrics & Gynecology, Baylor College of Medicine & Texas Children’s Hospital, Houston, TX, United States
| | - Iman Moussa
- Center for Precision Environmental Health, Baylor College of Medicine, Houston, TX, United States
| | - Juan Alvarez
- Center for Precision Environmental Health, Baylor College of Medicine, Houston, TX, United States
| | - Adrien Chardon Fabian
- Center for Precision Environmental Health, Baylor College of Medicine, Houston, TX, United States
| | | | - Cheryl L. Walker
- Center for Precision Environmental Health, Baylor College of Medicine, Houston, TX, United States
- Department of Molecular and Cell Biology, Baylor College of Medicine, Houston, TX, United States
| | - Cristian Coarfa
- Center for Precision Environmental Health, Baylor College of Medicine, Houston, TX, United States
- Department of Molecular and Cell Biology, Baylor College of Medicine, Houston, TX, United States
| | - Melissa A. Suter
- Division of Maternal-Fetal Medicine, Department of Obstetrics & Gynecology, Baylor College of Medicine & Texas Children’s Hospital, Houston, TX, United States
| | - Hamisu M. Salihu
- Department of Family and Community Medicine, Baylor College of Medicine, Houston, TX, United States
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Horstman HK, Leverenz A, Morrison S, Jordan E, Baltazar A, Cen X, Charvat E, Okafor BE, Butauski M. Pregnancy During the COVID-19 Pandemic: Communicated Narrative Sense-Making and Resilience. HEALTH COMMUNICATION 2024; 39:205-215. [PMID: 36597255 DOI: 10.1080/10410236.2022.2163103] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/17/2023]
Abstract
Grounded in communicated narrative sense-making (CNSM) theory and communication theory of resilience (CTR), the current study investigated how women narratively constructed resilience surrounding pregnancy during the COVID-19 pandemic. Given the adverse effects of stress on pregnant individuals and their babies, it is important to understand the triggers and process of resilience in this context. We interviewed 21 cisgender women who were pregnant during the COVID-19 pandemic to solicit their stories of stress and resilience. Findings revealed that pregnant women managed structural, informational, and interpersonal stressors unique to the COVID-19 pandemic. They engaged in re-storying to reconcile the gap between their expected pregnancy, fueled by the U.S. master narrative of pregnancy and birth, and their lived pregnancy during a pandemic. Participants demonstrated narrative resilience through reconnecting, reframing, and recentering. These findings advance theorizing in communicated resilience by centering CNSM as the sense-making process of enacting resilience and recognizing the importance and burden of resilience during pregnancy. Practical applications are explored such as contributing to narrative-informed programming, interventions, and education efforts regarding future health crises.
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Affiliation(s)
| | | | | | - Ellen Jordan
- Department of Communication, University of Missouri
| | | | - Xu Cen
- Department of Communication, University of Missouri
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Baker BH, Freije S, MacDonald JW, Bammler TK, Benson C, Carroll KN, Enquobahrie DA, Karr CJ, LeWinn KZ, Zhao Q, Bush NR, Sathyanarayana S, Paquette AG. Placental transcriptomic signatures of prenatal and preconceptional maternal stress. Mol Psychiatry 2024; 29:1179-1191. [PMID: 38212375 PMCID: PMC11176062 DOI: 10.1038/s41380-023-02403-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2023] [Revised: 12/20/2023] [Accepted: 12/22/2023] [Indexed: 01/13/2024]
Abstract
Prenatal exposure to maternal psychological stress is associated with increased risk for adverse birth and child health outcomes. Accumulating evidence suggests that preconceptional maternal stress may also be transmitted intergenerationally to negatively impact offspring. However, understanding of mechanisms linking these exposures to offspring outcomes, particularly those related to placenta, is limited. Using RNA sequencing, we identified placental transcriptomic signatures associated with maternal prenatal stressful life events (SLEs) and childhood traumatic events (CTEs) in 1 029 mother-child pairs in two birth cohorts from Washington state and Memphis, Tennessee. We evaluated individual gene-SLE/CTE associations and performed an ensemble of gene set enrichment analyses combing across 11 popular enrichment methods. Higher number of prenatal SLEs was significantly (FDR < 0.05) associated with increased expression of ADGRG6, a placental tissue-specific gene critical in placental remodeling, and decreased expression of RAB11FIP3, an endocytosis and endocytic recycling gene, and SMYD5, a histone methyltransferase. Prenatal SLEs and maternal CTEs were associated with gene sets related to several biological pathways, including upregulation of protein processing in the endoplasmic reticulum, protein secretion, and ubiquitin mediated proteolysis, and down regulation of ribosome, epithelial mesenchymal transition, DNA repair, MYC targets, and amino acid-related pathways. The directional associations in these pathways corroborate prior non-transcriptomic mechanistic studies of psychological stress and mental health disorders, and have previously been implicated in pregnancy complications and adverse birth outcomes. Accordingly, our findings suggest that maternal exposure to psychosocial stressors during pregnancy as well as the mother's childhood may disrupt placental function, which may ultimately contribute to adverse pregnancy, birth, and child health outcomes.
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Affiliation(s)
- Brennan H Baker
- University of Washington, Seattle, WA, USA.
- Seattle Children's Research Institute, Seattle, WA, USA.
| | | | | | | | - Ciara Benson
- Global Alliance to Prevent Preterm Birth and Stillbirth (GAPPS), Lynnwood, WA, USA
| | | | | | | | - Kaja Z LeWinn
- University of California San Francisco, San Francisco, CA, USA
| | - Qi Zhao
- University of Tennessee Health Sciences Center, Memphis, TN, USA
| | - Nicole R Bush
- University of California San Francisco, San Francisco, CA, USA
| | - Sheela Sathyanarayana
- University of Washington, Seattle, WA, USA
- Seattle Children's Research Institute, Seattle, WA, USA
| | - Alison G Paquette
- University of Washington, Seattle, WA, USA
- Seattle Children's Research Institute, Seattle, WA, USA
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Rajasekera TA, Galley JD, Mackos AR, Chen HJ, Mitchell JG, Kleinman JJ, Cappelucci P, Mashburn-Warren L, Lauber CL, Bailey MT, Worly BL, Gur TL. Stress and depression-associated shifts in gut microbiota: A pilot study of human pregnancy. Brain Behav Immun Health 2024; 36:100730. [PMID: 38323225 PMCID: PMC10844036 DOI: 10.1016/j.bbih.2024.100730] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Revised: 12/22/2023] [Accepted: 01/22/2024] [Indexed: 02/08/2024] Open
Abstract
Background Psychosocial stress and mood-related disorders, such as depression, are prevalent and vulnerability to these conditions is heightened during pregnancy. Psychosocial stress induces consequences via several mechanisms including the gut microbiota-brain axis and associated signaling pathways. Previous preclinical work indicates that prenatal stress alters maternal gut microbial composition and impairs offspring development. Importantly, although the fecal and vaginal microenvironments undergo alterations across pregnancy, we lack consensus regarding which shifts are adaptive or maladaptive in the presence of prenatal stress and depression. Clinical studies interrogating these relationships have identified unique taxa but have been limited in study design. Methods We conducted a prospective cohort study of pregnant individuals consisting of repeated administration of psychometrics (Perceived Stress Scale (PSS) and Center for Epidemiological Studies Depression Scale (CES-D)) and collection of fecal and vaginal microbiome samples. Fecal and vaginal microbial community composition across psychometric responses were interrogated using full-length 16S rRNA sequencing followed by α and β-diversity metrics and taxonomic abundance. Results Early pregnancy stress was associated with increased abundance of fecal taxa not previously identified in related studies, and stress from late pregnancy through postpartum was associated with increased abundance of typical vaginal taxa and opportunistic pathogens in the fecal microenvironment. Additionally, in late pregnancy, maternal stress and depression scores were associated with each other and with elevated maternal C-C motif chemokine ligand 2 (CCL2) concentrations. At delivery, concordant with previous literature, umbilical CCL2 concentration was negatively correlated with relative abundance of maternal fecal Lactobacilli. Lastly, participants with more severe depressive symptoms experienced steeper decreases in prenatal vaginal α-diversity. Conclusion These findings a) underscore previous preclinical and clinical research demonstrating the effects of prenatal stress on maternal microbiome composition, b) suggest distinct biological pathways for the consequences of stress versus depression and c) extend the literature by identifying several taxa which may serve critical roles in mediating this relationship. Thus, further interrogation of the role of specific maternal microbial taxa in relation to psychosocial stress and its sequelae is warranted.
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Affiliation(s)
- Therese A. Rajasekera
- Department of Psychiatry and Behavioral Health, The Ohio State University Wexner Medical Center, Columbus, OH, USA
- Institute for Behavioral Medicine Research, The Ohio State University Wexner Medical Center, Columbus, OH, USA
| | - Jeffrey D. Galley
- Department of Psychiatry and Behavioral Health, The Ohio State University Wexner Medical Center, Columbus, OH, USA
- Institute for Behavioral Medicine Research, The Ohio State University Wexner Medical Center, Columbus, OH, USA
| | - Amy R. Mackos
- College of Nursing, The Ohio State University, Columbus, OH, USA
| | - Helen J. Chen
- Department of Psychiatry and Behavioral Health, The Ohio State University Wexner Medical Center, Columbus, OH, USA
- Institute for Behavioral Medicine Research, The Ohio State University Wexner Medical Center, Columbus, OH, USA
- Medical Scientist Training Program, The Ohio State University, Columbus, OH, USA
- Department of Neuroscience, The Ohio State University, Columbus, OH, USA
| | | | | | - Paige Cappelucci
- College of Medicine, The Ohio State University, Columbus, OH, USA
| | | | - Christian L. Lauber
- Institute for Genomic Medicine, Nationwide Children’s Hospital, Columbus, OH, USA
| | - Michael T. Bailey
- Institute for Behavioral Medicine Research, The Ohio State University Wexner Medical Center, Columbus, OH, USA
- Center for Microbial Pathogenesis, The Research Institute, Nationwide Children’s Hospital, Columbus, OH, USA
- Department of Pediatrics, The Ohio State University Wexner Medical Center, Columbus, OH, USA
| | - Brett L. Worly
- Obstetrics and Gynecology, The Ohio State University Wexner Medical Center, Columbus, OH, USA
| | - Tamar L. Gur
- Department of Psychiatry and Behavioral Health, The Ohio State University Wexner Medical Center, Columbus, OH, USA
- Institute for Behavioral Medicine Research, The Ohio State University Wexner Medical Center, Columbus, OH, USA
- Medical Scientist Training Program, The Ohio State University, Columbus, OH, USA
- College of Medicine, The Ohio State University, Columbus, OH, USA
- Dorothy M. Davis Heart and Lung Research Institute, The Ohio State University College of Medicine and Wexner Medical Center, Columbus, OH, USA
- Department of Neuroscience, The Ohio State University, Columbus, OH, USA
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Urizar GG, Murillo J, Miller K. Factors Associated with Prenatal Health Behaviors among Low-Income, Ethnic Minority Women. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:1695. [PMID: 36767060 PMCID: PMC9914291 DOI: 10.3390/ijerph20031695] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Revised: 01/10/2023] [Accepted: 01/12/2023] [Indexed: 06/18/2023]
Abstract
Less than one-third of pregnant women in the U.S. meet prenatal nutrition, exercise, and stress management health behavior guidelines. Low rates of these prenatal health behaviors have been especially observed among low-income, ethnic minority women, placing them and their infants at a disproportionally higher risk for health complications. Yet, few studies have identified factors associated with these prenatal health behaviors in this population. This study examined whether certain demographic (e.g., ethnicity) and psychosocial characteristics (i.e., coping, stress, pregnancy-specific stress, and depression) were associated with prenatal nutrition (i.e., high-fat food and fruit and vegetable intake), exercise, and stress management health behaviors in 100 low-income, pregnant women (39% African American, 30% foreign-born Latinas, 15% U.S.-born Latinas, 10% non-Hispanic white, and 6% Asian American/Pacific Islander) in southern California using an embedded, mixed-methods, cross-sectional design. Results demonstrated that ethnic minority women who experienced more stress and used more maladaptive coping strategies (e.g., avoidance) were particularly at risk of consuming more high-fat foods and engaging in less exercise and stress management during pregnancy. Qualitative responses revealed women's experiences with these prenatal health behaviors. These findings highlight the need for interventions and collaborative care models that target psychosocial factors in order to optimize prenatal health behaviors and health outcomes among ethnic minority women.
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Affiliation(s)
- Guido G. Urizar
- Department of Psychology, California State University, 1250 Bellflower Blvd, Long Beach, CA 90840-0901, USA
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Villar-Alises O, Martinez-Miranda P, Martinez-Calderon J. Prenatal Yoga-Based Interventions May Improve Mental Health during Pregnancy: An Overview of Systematic Reviews with Meta-Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:1556. [PMID: 36674309 PMCID: PMC9863076 DOI: 10.3390/ijerph20021556] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/17/2022] [Revised: 01/10/2023] [Accepted: 01/12/2023] [Indexed: 05/13/2023]
Abstract
An overview of systematic reviews with meta-analysis was developed to summarize evidence on the effectiveness of prenatal yoga-based interventions on pain, psychological symptoms, and quality of life during pregnancy. CINAHL (via EBSCOhost), Embase, PubMed, SPORTDiscus (via EBSCOhost), and the Cochrane Library were searched from inception to 15 December 2022. The intervention of interest was any prenatal yoga-based intervention. Pain, psychological symptoms, and quality of life were considered as outcome measures. The methodological quality of systematic reviews was judged using AMSTAR 2. The primary study overlap among systematic reviews was evaluated, building a citation matrix and calculating the corrected covered area (CCA). A total of ten systematic reviews, including fifteen meta-analyses of interest and comprising 32 distinct primary clinical trials, were included. Meta-analyses on pain and quality of life were not found. Most meta-analyses (93%) showed that prenatal yoga-based interventions are more effective than control interventions in reducing anxiety, depression, and stress symptoms. However, the overall methodological quality of systematic reviews was judged as critically low, and primary study overlap among systematic reviews was very high (CCA = 16%). Altogether, prenatal yoga-based interventions could improve the mental health of pregnant women, although due to the important methodological flaws that were detected, future systematic reviews should improve their methodological quality before drawing firm conclusions on this topic.
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Affiliation(s)
- Olga Villar-Alises
- Departamento de Fisioterapia, Facultad de Enfermería, Fisioterapia y Podología, Universidad de Sevilla, 41009 Sevilla, Spain
- Uncertainty, Mindfulness, Self, Spirituality (UMSS) Research Group, 41009 Sevilla, Spain
| | - Patricia Martinez-Miranda
- Departamento de Fisioterapia, Facultad de Enfermería, Fisioterapia y Podología, Universidad de Sevilla, 41009 Sevilla, Spain
- Uncertainty, Mindfulness, Self, Spirituality (UMSS) Research Group, 41009 Sevilla, Spain
| | - Javier Martinez-Calderon
- Departamento de Fisioterapia, Facultad de Enfermería, Fisioterapia y Podología, Universidad de Sevilla, 41009 Sevilla, Spain
- Uncertainty, Mindfulness, Self, Spirituality (UMSS) Research Group, 41009 Sevilla, Spain
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O'Connor A, Shand AW, Schneuer FJ, Nassar N, Austin MP. Assessing the relationship between psychosocial risk and pregnancy outcomes using the perinatal integrated psychosocial assessment (PIPA) tool. Birth 2022; 49:648-660. [PMID: 35233836 DOI: 10.1111/birt.12631] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2021] [Revised: 01/17/2022] [Accepted: 02/17/2022] [Indexed: 11/30/2022]
Abstract
BACKGROUND The Perinatal Integrated Psychosocial Assessment (PIPA) tool screens for anxiety, depression, and psychosocial factors in pregnancy. We aimed to assess the association between PIPA-determined psychosocial risk and obstetric and neonatal outcomes. METHODS Cohort study of all pregnant women who gave birth at ≥20 weeks of gestation in 2017-2019 at a tertiary maternity hospital in, Sydney, Australia. Women completed PIPA at their first antenatal visit and were assigned a PIPA risk category. At-risk women were reviewed and referred for support. The association between PIPA risk category and obstetric and neonatal outcomes was evaluated using multivariable logistic regression adjusting for sociodemographic and pregnancy factors. RESULTS In all, 5969 women completed PIPA; 71.4% were assessed no/low risk, 17.5% medium risk, and 11.1% medium-high/high risk. Compared with no/low-risk women, medium-high/high-risk women were more likely to remain in hospital for >72 hours (aOR 1.47 [95% CI 1.33-1.64]); to not be breastfeeding at discharge (aOR 1.77 [95% CI 1.20-2.61]); to have their infants experience birth complications (aOR 1.24 [95% CI 1.03-1.50]); and to be admitted to the NICU (aOR 1.63 [95% CI 1.26-2.11]). There was a modest increase in odds of cesarean birth (aOR 1.12 [95% CI 1.00-1.27]), and no association with preterm birth or low birthweight. The risk of adverse outcomes disappeared for medium-high/high-risk women referred for support. CONCLUSIONS The PIPA tool identified one in 10 women at high psychosocial risk with increased risk of adverse obstetric and neonatal outcomes. Adverse outcomes were attenuated for high-risk women who were referred for extra support, suggesting that psychosocial review and referral for high-risk women may reduce the risk of adverse obstetric and neonatal outcomes.
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Affiliation(s)
- Anne O'Connor
- Royal Hospital for Women, Sydney, New South Wales, Australia
| | - Antonia W Shand
- Department of Maternal Fetal Medicine, Royal Hospital for Women, Sydney, New South Wales, Australia.,Child Population and Translational Health Research, Children's Hospital at Westmead Clinical School, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Francisco J Schneuer
- Child Population and Translational Health Research, Children's Hospital at Westmead Clinical School, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Natasha Nassar
- Child Population and Translational Health Research, Children's Hospital at Westmead Clinical School, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia.,Financial Markets Foundation for Children, Sydney, New South Wales, Australia
| | - Marie-Paule Austin
- Perinatal & Women's Mental Health, Royal Hospital for Women, Sydney, New South Wales, Australia.,School of Psychiatry, University of New South Wales, Sydney, New South Wales, Australia.,Perinatal & Women's Mental Health Unit, St John of God Burwood Hospital, Sydney, New South Wales, Australia
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11
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Omowale SS, Gary-Webb TL, Wallace ML, Wallace JM, Rauktis ME, Eack SM, Mendez DD. Stress during pregnancy: An ecological momentary assessment of stressors among Black and White women with implications for maternal health. WOMEN'S HEALTH (LONDON, ENGLAND) 2022; 18:17455057221126808. [PMID: 36148967 PMCID: PMC9510975 DOI: 10.1177/17455057221126808] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/03/2022]
Abstract
BACKGROUND Stress can lead to adverse physiological and psychological outcomes. Therefore, understanding stress during pregnancy provides insight into racial disparities in maternal health, particularly Black maternal health. OBJECTIVES This study aimed to describe (1) daily exposure to self-reported stress levels during pregnancy, and (2) sources of stress among participants that identified as Black or White using data collected via ecological momentary assessment. METHODS We leveraged survey data from the Postpartum Mothers Mobile Study, a prospective longitudinal study using ecological momentary assessment data collection methods to describe patterns of stress during pregnancy. This article is descriptive and documents patterns of self-reported stress levels and sources of stress. Frequencies and percentages of stress responses were computed to describe these patterns. RESULTS The sample (n = 296) was 27% Black (n = 78) and 63% White (n = 184). Results were based on at least one measurement of that stress level during pregnancy. A similar number of Black and White participants reported no stress during pregnancy. White (85%-95%) and Black (60%-70%) participants reported low to moderate levels of stress. Black participants (38%) and White participants (35%) reported experiencing high stress. Black and White participants reported similar sources of stress: stress from a partner, too many things to do, a baby or other children, and financial concerns. White participants reported work as a top stressor, and Black participants reported financial issues as a top source of stress. CONCLUSION This study provides insight into daily exposure to stress that has implications for maternal health. We described patterns of self-reported stress and sources of stress among Black and White participants. The daily exposures to stress reported by this sample exist within a context of root causes of structural inequities in education, health care, income, wealth, and housing that must be addressed to achieve maternal health equity.
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Affiliation(s)
- Serwaa S Omowale
- California Preterm Birth Initiative,
University of California San Francisco, San Francisco, CA, USA,Department of Obstetrics, Gynecology
& Reproductive Sciences, School of Medicine, University of California San
Francisco, San Francisco, CA, USA,School of Social Work, University of
Pittsburgh, Pittsburgh, PA, USA
| | - Tiffany L Gary-Webb
- Department of Epidemiology, School of
Public Health, University of Pittsburgh, Pittsburgh, PA, USA
| | | | - John M Wallace
- School of Social Work, University of
Pittsburgh, Pittsburgh, PA, USA
| | - Mary E Rauktis
- School of Social Work, University of
Pittsburgh, Pittsburgh, PA, USA
| | - Shaun M Eack
- School of Social Work, University of
Pittsburgh, Pittsburgh, PA, USA
| | - Dara D Mendez
- Department of Epidemiology, School of
Public Health, University of Pittsburgh, Pittsburgh, PA, USA,Department of Behavioral and Community
Health Sciences, School of Public Health, University of Pittsburgh, Pittsburgh, PA,
USA,Division of General Internal Medicine,
School of Medicine, University of Pittsburgh, Pittsburgh, PA, USA,Dara D Mendez, Department of Epidemiology,
School of Public Health, University of Pittsburgh, 5130 Public Health, 130 De
Soto Street, Pittsburgh, PA 15261, USA.
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12
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Goplerud DK, Hernandez RG, Johnson SB. Prenatal subjective social status and birth weight. J Psychosom Obstet Gynaecol 2022; 43:279-284. [PMID: 33397183 PMCID: PMC8255327 DOI: 10.1080/0167482x.2020.1864728] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Revised: 11/07/2020] [Accepted: 12/12/2020] [Indexed: 10/22/2022] Open
Abstract
PURPOSE Subjective social status (SSS), perceived social standing relative to others, has been associated with health status, independent of objective socioeconomic status (SES). Few studies have examined the relationship of prenatal maternal SSS with birth outcomes. We evaluated the association of SSS in pregnancy with low birth weight (LBW) and high birth weight (HBW). METHODS A total of 378 pregnant women rated their SSS from 1 (low) to 10 (high) compared to others in the United States (SSS-US) and compared to their community (SSS-Comm). Multivariable logistic regression was used to examine the relationship between SSS and odds of LBW or HBW. RESULTS Higher SSS-US was associated with lower odds of HBW in unadjusted models (OR 0.76, 95% CI 0.60-0.96; p < 0.05); this relationship persisted after controlling for objective SES, health, and demographic factors (OR 0.73, 95% CI 0.53-0.99; p < 0.05). Neither SSS measure was associated with LBW. CONCLUSIONS Pregnant women who view themselves as having lower status than others in the US have greater odds of HBW, over and above the influence of factors known to be associated with birth weight. SSS, a brief and non-stigmatizing measure, might help identify women at elevated social risk for adverse birth outcomes.
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Affiliation(s)
- Dana K. Goplerud
- Department of Pediatrics, Johns Hopkins School of Medicine, Baltimore, MD
| | - Raquel G. Hernandez
- Department of Pediatrics, Johns Hopkins School of Medicine, Baltimore, MD
- Department of Pediatrics, Johns Hopkins All Children’s Hospital, St. Petersburg, FL
| | - Sara B. Johnson
- Department of Pediatrics, Johns Hopkins School of Medicine, Baltimore, MD
- Department of Population, Family & Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
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13
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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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14
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Corrigan L, Moran P, McGrath N, Eustace-Cook J, Daly D. The characteristics and effectiveness of pregnancy yoga interventions: a systematic review and meta-analysis. BMC Pregnancy Childbirth 2022; 22:250. [PMID: 35337282 PMCID: PMC8957136 DOI: 10.1186/s12884-022-04474-9] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2021] [Accepted: 02/14/2022] [Indexed: 11/10/2022] Open
Abstract
Background Yoga is a popular mind-body medicine frequently recommended to pregnant women. Gaps remain in our understanding of the core components of effective pregnancy yoga programmes. This systematic review and meta-analysis examined the characteristics and effectiveness of pregnancy yoga interventions, incorporating the FITT (frequency, intensity, time/duration and type) principle of exercise prescription. Methods Nine electronic databases were searched: MEDLINE, PsycINFO, EMBASE, CINAHL, WHOLiS, AMED, ScieLo, ASSIA and Web of Science. Randomised control trials and quasi-experimental studies examining pregnancy yoga interventions were eligible. Covidence was used to screen titles, abstracts, and full-text articles. Outcomes of interest were stress, anxiety, depression, quality of life, labour duration, pain management in labour and mode of birth. The Cochrane Collaboration’s Risk of Bias Assessment tool was used to assess methodological quality of studies and GRADE criteria (GRADEpro) evaluated quality of the evidence. Meta-analysis was performed using RevMan 5.3. Results Of 862 citations retrieved, 31 studies met inclusion criteria. Twenty-nine studies with 2217 pregnant women were included for meta-analysis. Pregnancy yoga interventions reduced anxiety (SMD: -0.91; 95% CI: − 1.49 to − 0.33; p = 0.002), depression (SMD: -0.47; 95% CI: − 0.9 to − 0.04, P = 0.03) and perceived stress (SMD: -1.03; 95% CI: − 1.55 to − 0.52; p < 0.001). Yoga interventions also reduced duration of labour (MD = − 117.75; 95% CI − 153.80 to − 81.71, p < 0.001) and, increased odds of normal vaginal birth (OR 2.58; 95% CI 1.46–4.56, p < 0.001) and tolerance for pain. The quality of evidence (GRADE criteria) was low to very low for all outcomes. Twelve or more yoga sessions delivered weekly/bi-weekly had a statistically significant impact on mode of birth, while 12 or more yoga sessions of long duration (> 60 min) had a statistically significant impact on perceived stress. Conclusion The evidence highlights positive effects of pregnancy yoga on anxiety, depression, perceived stress, mode of birth and duration of labour. Systematic review registration: PROSPERO, CRD42019119916. Registered on 11th January 2019. Supplementary Information The online version contains supplementary material available at 10.1186/s12884-022-04474-9.
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Affiliation(s)
- Lisa Corrigan
- School of Nursing & Midwifery, Trinity College Dublin, Dublin, Ireland.
| | - Patrick Moran
- School of Nursing & Midwifery, Trinity College Dublin, Dublin, Ireland
| | - Niamh McGrath
- School of Public Health, University College Dublin, Dublin, Ireland
| | | | - Deirdre Daly
- School of Nursing & Midwifery, Trinity College Dublin, Dublin, Ireland
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15
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Lamichhane DK, Jung DY, Shin YJ, Lee KS, Lee SY, Ahn K, Kim KW, Shin YH, Suh DI, Hong SJ, Kim HC. Association between ambient air pollution and perceived stress in pregnant women. Sci Rep 2021; 11:23496. [PMID: 34873215 PMCID: PMC8648786 DOI: 10.1038/s41598-021-02845-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2021] [Accepted: 11/17/2021] [Indexed: 11/23/2022] Open
Abstract
Air pollution may influence prenatal maternal stress, but research evidence is scarce. Using data from a prospective cohort study conducted on pregnant women (n = 2153), we explored the association between air pollution and perceived stress, which was assessed using the 14-item Perceived Stress Scale (PSS), among pregnant women. Average exposures to particulate matter with an aerodynamic diameter of < 2.5 µm (PM2.5) or < 10 µm (PM10), nitrogen dioxide (NO2), and ozone (O3) for each trimester and the entire pregnancy were estimated at maternal residential addresses using land-use regression models. Linear regression models were applied to estimate associations between PSS scores and exposures to each air pollutant. After adjustment for potential confounders, interquartile-range (IQR) increases in whole pregnancy exposures to PM2.5, PM10, and O3 in the third trimester were associated with 0.37 (95% confidence interval [CI] 0.01, 0.74), 0.54 (95% CI 0.11, 0.97), and 0.30 (95% CI 0.07, 0.54) point increases in prenatal PSS scores, respectively. Furthermore, these associations were more evident in women with child-bearing age and a lower level of education. Also, the association between PSS scores and PM10 was stronger in the spring. Our findings support the relationship between air pollution and prenatal maternal stress.
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Affiliation(s)
- Dirga Kumar Lamichhane
- grid.202119.90000 0001 2364 8385Department of Occupational and Environmental Medicine, Inha University School of Medicine, Incheon, Republic of Korea
| | - Dal-Young Jung
- grid.202119.90000 0001 2364 8385Department of Occupational and Environmental Medicine, Inha University School of Medicine, Incheon, Republic of Korea
| | - Yee-Jin Shin
- grid.15444.300000 0004 0470 5454Department of Psychiatry, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Kyung-Sook Lee
- grid.444037.00000 0000 9208 7123Department of Rehabilitation, Hanshin University, Osan, Gyeonggi-do Republic of Korea
| | - So-Yeon Lee
- grid.413967.e0000 0001 0842 2126Department of Pediatrics, Childhood Asthma Atopy Center, Humidifier Disinfectant Health Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Kangmo Ahn
- grid.414964.a0000 0001 0640 5613Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea ,grid.414964.a0000 0001 0640 5613Environmental Health Center for Atopic Diseases, Samsung Medical Center, Seoul, Republic of Korea
| | - Kyung Won Kim
- grid.15444.300000 0004 0470 5454Department of Pediatrics, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Youn Ho Shin
- grid.413793.b0000 0004 0624 2588Department of Pediatrics, CHA Gangnam Medical Center, CHA University School of Medicine, Seoul, Republic of Korea
| | - Dong In Suh
- grid.31501.360000 0004 0470 5905Department of Pediatrics, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Soo-Jong Hong
- Department of Pediatrics, Childhood Asthma Atopy Center, Humidifier Disinfectant Health Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.
| | - Hwan-Cheol Kim
- Department of Occupational and Environmental Medicine, Inha University School of Medicine, Incheon, Republic of Korea.
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16
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Antoniou E, Stamoulou P, Tzanoulinou MD, Orovou E. Perinatal Mental Health; The Role and the Effect of the Partner: A Systematic Review. Healthcare (Basel) 2021; 9:1572. [PMID: 34828618 PMCID: PMC8624285 DOI: 10.3390/healthcare9111572] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2021] [Revised: 11/10/2021] [Accepted: 11/17/2021] [Indexed: 11/17/2022] Open
Abstract
Pregnancy is a transitional period involving the most complex experiences in a woman's life, during which the woman's psychological status can be affected by a wide range of psychosocial variables. However, positive interpersonal relationships appear to constitute a supportive network that significantly influences perinatal mental health. Therefore, the presence of a supportive partner works psycho-protectively against the difficulties and pressures created by the transition to maternity. The aim of this study was to review systematically the influence of the partner on the woman's psychology during the perinatal period. Fourteen research articles from PubMed/Medline, Google Scholar and PsycINFO were included in the review from a total of 1846 articles. Most studies have shown a correlation between the support from the partner and prenatal depression and anxiety. Support from the spouse during childbirth is related to the extent to which women feel safe during labor as well as the stress during childbirth. The role of the partner is very important in the occurrence of perinatal mental disorders in women. Of course, more research needs to be done in the field of perinatal mental health. The risk factors that lead to mental disorders need to be clarified and the role of the partner in the perinatal period requires reinforcement and needs to be given the necessary importance.
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Affiliation(s)
- Evangelia Antoniou
- Department of Midwifery, University of West Attica, 12243 Athens, Greece; (P.S.); (M.-D.T.); (E.O.)
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17
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Friedman R, Giampaolo J, Vanhaecke L, Jarrett RB. Advancing health through research: A scoping review of and model for adjunctive psychosocial interventions to improve outcomes for perinatal women with bipolar disorder. J Affect Disord 2021; 294:586-591. [PMID: 34332359 DOI: 10.1016/j.jad.2021.07.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2020] [Revised: 06/18/2021] [Accepted: 07/11/2021] [Indexed: 10/20/2022]
Abstract
BACKGROUND We aimed to identify randomized clinical trials (RCTs) which evaluated the efficacy of adjunctive psychosocial interventions to improve outcomes during the perinatal period for women with bipolar disorder (BD). METHODS We scanned the literature to identify RCTs evaluating the efficacy of adjunctive psychosocial therapies or interventions provided during the perinatal period to women with BD. We searched from 1946 to July 2020 using Embase, Ovid Medline, PsycINFO, and Scopus. We then searched for future, current, and recently completed RCTs described on www.ClinicalTrials.gov. RESULTS This scoping review (1946 - July 2020) revealed no published RCTs for this population. The findings expose an important gap in research and knowledge, as well as a health disparity. CONCLUSION We heuristically tied a mechanistic stress reduction model to relevant findings. The initial hypotheses are informed by effective stress reducing psychosocial interventions for: a) people with BD outside the perinatal period and b) perinatal women with major depressive disorder (MDD may improve the health of perinatal women with BD). We hypothesize that the perinatal trajectory of health for women with BD will improve by adding psychosocial interventions or therapies to treatment as usual. We propose maternal stress reduction as a potential mediator/mechanism. LIMITATIONS Findings reported are limited to the methods of a scoping review. Reproductive status tends to be a missing variable; we highlight the need for its inclusion. Interdisciplinary, collaborative research to improve the treatment outcome for perinatal women with BD is warranted and ripe for advancement.
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Affiliation(s)
- Ran Friedman
- Department of Psychiatry, The University of Texas Southwestern Medical Center, Dallas, TX, United States.
| | - Jennifer Giampaolo
- Department of Psychiatry, The University of Texas Southwestern Medical Center, Dallas, TX, United States
| | - Liselotte Vanhaecke
- Department of Counseling, Simmons School of Education & Human Development, Southern Methodist University, Dallas, Texas, United States
| | - Robin B Jarrett
- Department of Psychiatry, The University of Texas Southwestern Medical Center, Dallas, TX, United States.
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18
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A Scoping Review of Life-Course Psychosocial Stress and Kidney Function. CHILDREN-BASEL 2021; 8:children8090810. [PMID: 34572242 PMCID: PMC8467128 DOI: 10.3390/children8090810] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Revised: 09/06/2021] [Accepted: 09/08/2021] [Indexed: 11/16/2022]
Abstract
Increased exposure to maternal psychosocial stress during gestation and adverse neonatal environments has been linked to alterations in developmental programming and health consequences in offspring. A programmed low nephron endowment, among other altered pathways of susceptibility, likely increases the vulnerability to develop chronic kidney disease in later life. Our aim in this scoping review was to identify gaps in the literature by focusing on understanding the association between life-course exposure to psychosocial stress, and the risk of reduced kidney function. A systematic search in four databases (PubMed, ProQuest, Wed of Science, and Scopus) was performed, yielding 609 articles. Following abstract and full-text review, we identified 19 articles meeting our inclusion criteria, reporting associations between different psychosocial stressors and an increase in the prevalence of kidney disease or decline in kidney function, mainly in adulthood. There are a lack of studies that specifically evaluated the association between gestational exposure to psychosocial stress and measures of kidney function or disease in early life, despite the overall evidence consistent with the independent effects of prenatal stress on other perinatal and postnatal outcomes. Further research will establish epidemiological studies with clear and more comparable psychosocial stressors to solve this critical research gap.
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19
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Saur AM, Dos Santos MA. Risk factors associated with stress symptoms during pregnancy and postpartum: integrative literature review. Women Health 2021; 61:651-667. [PMID: 34311677 DOI: 10.1080/03630242.2021.1954132] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Stressful events during prenatal and postpartum have been associated with an increase in the susceptibility to the onset of various diseases, threatening mental and physical health of mother and baby. The aim of this study was to synthesize and analyze the literature related to risk factors associated with stress symptoms during pregnancy and immediate postpartum by means of an integrative review. The search was conducted from January 2013 to July 2020, consulting the following databases: PubMed, PsycINFO, CINAHL, Web of Science and LILACS. In total, 1,677 studies were identified, resulting in 38 articles included in this review. The risk factors most associated with stress in pregnancy and postpartum were related to emotional factors (including mental health, traumatic events and obstetric complications); social and economic factors; mother's health conditions and life style behaviors, and social support and partner related stress. The results are discussed under the light of the biopsychosocial model, which proposes that biological, psychological, and social domains should be considered in order to minimize psychosocial risk conditions. It is concluded that strategies to promote psychological care, education, additional social support and health behaviors should be considered to prevent adverse birth outcomes and to increase maternal well-being.
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Affiliation(s)
- Adriana Martins Saur
- Department of Psychology, University of São Paulo, Faculty of Philosophy, Sciences and Letters at Ribeirão Preto, Brazil
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20
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Barger MK. Current Resources for Evidence-Based Practice, May/June 2021. J Midwifery Womens Health 2021; 66:413-421. [PMID: 34166576 DOI: 10.1111/jmwh.13257] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2021] [Accepted: 05/13/2021] [Indexed: 12/01/2022]
Affiliation(s)
- Mary K Barger
- Hahn School of Nursing and Health Science, Beyster Institute for Nursing Research, University of San Diego, San Diego, California
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21
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Takács L, Štipl J, Gartstein M, Putnam SP, Monk C. Social support buffers the effects of maternal prenatal stress on infants' unpredictability. Early Hum Dev 2021; 157:105352. [PMID: 33839479 DOI: 10.1016/j.earlhumdev.2021.105352] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2021] [Accepted: 03/09/2021] [Indexed: 11/17/2022]
Abstract
OBJECTIVE Exposure to stress in pregnancy has been shown to affect fetal development with short- and long-term physiological and behavioral consequences for the offspring. Although social support is known to lower perceived stress, no prior study has investigated the buffering role of social support in the context of prenatal stress effects on infant temperament. The aim of this study was to examine interactive effects of prenatal stress and social support on several dimensions of infant temperament at 9 months postpartum. STUDY DESIGN A total of 272 mothers completed the Perceived Stress Scale and the Perceived Social Support Scale in the 3rd trimester of pregnancy. Infant temperament was assessed by mothers at 9 months postpartum using the Infant Characteristics Questionnaire. Linear regression models were performed to assess the effects of perceived stress, social support, and their interaction on infant temperament. RESULTS Prenatal stress interacted with social support, such that prenatal stress increased infant unpredictability when social support was below -0.5 SD. CONCLUSIONS Prenatal stress was found to be a risk factor for infant temperamental unpredictability when combined with low social support perceived by the mother during pregnancy. Support of others, not previously examined in this context, can reduce the impact of prenatal stress.
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Affiliation(s)
- Lea Takács
- Department of Psychology, Faculty of Arts, Charles University, Prague, Czech Republic.
| | - Jiří Štipl
- Department of Psychology, Faculty of Arts, Charles University, Prague, Czech Republic
| | - Maria Gartstein
- Department of Psychology, Washington State University, Pullman, WA, USA
| | - Samuel P Putnam
- Department of Psychology, Bowdoin College, Brunswick, ME, USA
| | - Catherine Monk
- Department of Obstetrics & Gynecology, and Psychiatry, Columbia University, New York, NY, USA; New York State Psychiatric Institute, New York, NY, USA
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22
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Mahrer NE, Guardino CM, Hobel C, Dunkel Schetter C. Maternal Stress Before Conception Is Associated with Shorter Gestation. Ann Behav Med 2021; 55:242-252. [PMID: 32686836 PMCID: PMC7980768 DOI: 10.1093/abm/kaaa047] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023] Open
Abstract
BACKGROUND Stress in pregnancy predicts adverse birth outcomes. Stressors occurring prior to conception may also pose risk for the mother and child. The few published studies on preconception stress test a single stress measure and examine only linear associations with birth outcomes. PURPOSE Guided by findings in the prenatal stress literature, the current study aimed to (i) identify latent factors from a set of preconception stress measures and (ii) examine linear and curvilinear associations between these stress factors and length of gestation. METHODS Study 1 utilized a sample of 2,637 racially/ethnically diverse women to develop a measurement model of maternal stress from assessments of seven acute and chronic stress measures. Factor analysis revealed three latent factors representing stressors (life events, financial strain, interpersonal violence, discrimination), stress appraisals (perceived stress, parenting stress), and chronic relationship stress (family, partner stress). Study 2 examined the associations of these three latent preconception stress factors with the length of gestation of a subsequent pregnancy in the subset of 360 women who became pregnant within 4.5 years. RESULTS Controlling for prenatal medical risks, there was a significant linear effect of stress appraisals on the length of gestation such that more perceived stress was associated with shorter gestation. There was a curvilinear effect of stressors on the length of gestation with moderate levels associated with longer gestation. CONCLUSIONS These results have implications for research on intergenerational origins of developmental adversities and may guide preconception prevention efforts. Findings also inform approaches to the study of stress as a multidimensional construct.
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Affiliation(s)
- N E Mahrer
- Department of Psychology, University of California, Los Angeles, CA, USA
- Psychology Department, University of La Verne, CA, USA
| | - C M Guardino
- Department of Psychology, Dickinson College, PA, USA
| | - C Hobel
- Department of Obstetrics and Gynecology, Cedars-Sinai, CA, USA
| | - C Dunkel Schetter
- Department of Psychology, University of California, Los Angeles, CA, USA
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23
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Ramiro-Cortijo D, de la Calle M, Benitez V, Gila-Diaz A, Moreno-Jiménez B, Arribas SM, Garrosa E. Maternal Psychological and Biological Factors Associated to Gestational Complications. J Pers Med 2021; 11:183. [PMID: 33807903 PMCID: PMC8000308 DOI: 10.3390/jpm11030183] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2021] [Revised: 02/18/2021] [Accepted: 03/02/2021] [Indexed: 01/07/2023] Open
Abstract
Early detection of gestational complications is a priority in obstetrics. In our social context, this is linked to maternity age. Most studies are focused on biological factors. However, pregnancy is also influenced by social and psychological factors, which have not been deeply explored. We aimed to identify biopsychosocial risk and protective factors associated with the development of maternal and fetal complications. We enrolled 182 healthy pregnant women, and plasma melatonin and cortisol levels were measured in the first trimester by chemiluminescent immunoassays. At different time points along gestation, women answered several questionnaires (positive and negative affect schedule, hospital anxiety and depression scale, pregnancy concerns scale, life orientation test, resilience scale, life satisfaction scale and life-work conflicts scale). They were followed up until delivery and categorized as normal pregnancy, maternal or fetal complications. Maternal complications were associated with low melatonin (OR = 0.99 [0.98; 1.00]; p-value = 0.08) and life satisfaction (OR = 0.64 [0.41; 0.93]; p-value = 0.03) and fetal complications were associated with high cortisol (OR = 1.06 [1.02; 1.13]; p-value = 0.04), anxiety (OR = 2.21 [1.10; 4.55]; p-value = 0.03) and life-work conflicts (OR = 1.92 [1.04; 3.75]; p-value = 0.05). We conclude that psychological factors influence pregnancy outcomes in association with melatonin and cortisol alterations. High maternal melatonin and life satisfaction levels could be potential protective factors against the development of maternal complications during pregnancy. Low anxiety and cortisol levels and reduced work-life conflicts could prevent fetal complications.
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Affiliation(s)
- David Ramiro-Cortijo
- Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, 330 Brookline Avenue, Boston, MA 02215, USA;
- Department of Physiology, Faculty of Medicine, Universidad Autónoma de Madrid, C/Arzobispo Morcillo 2, 28029 Madrid, Spain;
| | - Maria de la Calle
- Obstetric and Gynecology Service, Hospital Universitario La Paz, Universidad Autónoma de Madrid, Paseo de la Castellana 261, 28046 Madrid, Spain;
| | - Vanesa Benitez
- Department of Agricultural and Food Chemistry, Faculty of Science, Universidad Autónoma de Madrid, C/Francisco Tomas y Valiente 7, 28049 Madrid, Spain;
| | - Andrea Gila-Diaz
- Department of Physiology, Faculty of Medicine, Universidad Autónoma de Madrid, C/Arzobispo Morcillo 2, 28029 Madrid, Spain;
- Pharmacology and Physiology PhD Program, Doctoral School, Universidad Autónoma de Madrid, C/Francisco Tomas y Valiente 2, 28049 Madrid, Spain
| | - Bernardo Moreno-Jiménez
- Department of Biological and Health Psychology, Faculty of Psychology, Universidad Autonoma de Madrid, C/Ivan Pavlov 6, 28049 Madrid, Spain;
| | - Silvia M. Arribas
- Department of Physiology, Faculty of Medicine, Universidad Autónoma de Madrid, C/Arzobispo Morcillo 2, 28029 Madrid, Spain;
| | - Eva Garrosa
- Department of Biological and Health Psychology, Faculty of Psychology, Universidad Autonoma de Madrid, C/Ivan Pavlov 6, 28049 Madrid, Spain;
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Cattane N, Räikkönen K, Anniverno R, Mencacci C, Riva MA, Pariante CM, Cattaneo A. Depression, obesity and their comorbidity during pregnancy: effects on the offspring's mental and physical health. Mol Psychiatry 2021; 26:462-481. [PMID: 32632208 PMCID: PMC7850968 DOI: 10.1038/s41380-020-0813-6] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2019] [Revised: 05/20/2020] [Accepted: 06/05/2020] [Indexed: 02/08/2023]
Abstract
Depression and obesity represent two of the most common complications during pregnancy and are associated with severe health risks for both the mother and the child. Although several studies have analysed the individual effects of depression or obesity on the mothers and their children, the effects associated with the co-occurrence of both disorders have so far been poorly investigated. The relationship between depression and obesity is very complex and it is still unclear whether maternal depression leads to obesity or vice versa. It is well known that the intrauterine environment plays an important role in mediating the effects of both depression and obesity in the mother on the fetal programming, increasing the child's risk to develop negative outcomes.
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Affiliation(s)
- Nadia Cattane
- Biological Psychiatry Unit, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - Katri Räikkönen
- Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Roberta Anniverno
- Department of Neuroscience, ASST Fatebenefratelli Sacco, Milan, Italy
| | - Claudio Mencacci
- Department of Neuroscience, ASST Fatebenefratelli Sacco, Milan, Italy
| | - Marco A Riva
- Department of Pharmacological and Biomolecular Sciences, University of Milan, Milan, Italy
| | - Carmine M Pariante
- Stress, Psychiatry and Immunology Laboratory, Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College, London, UK
| | - Annamaria Cattaneo
- Biological Psychiatry Unit, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy.
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Comparing the effect of group- based training along with text messaging and compact disc- based training on men's knowledge and attitude about participation in perinatal care: a cluster randomized control trial. BMC Pregnancy Childbirth 2020; 20:765. [PMID: 33298001 PMCID: PMC7726853 DOI: 10.1186/s12884-020-03471-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2020] [Accepted: 12/02/2020] [Indexed: 11/17/2022] Open
Abstract
Background Men’s participation in perinatal care is one of the key factors in promoting maternal and neonatal health. The effects of various methods of training on men’s knowledge and attitude about participation in perinatal care can be different. So, this study aimed to compare the effect of two methods of training on men’s knowledge and attitude about participation in perinatal care. Methods This cluster randomized control trial was conducted in three midwifery clinics in Tabriz, Iran between May and August 2018. Each clinic was randomly assigned to intervention (group- based training along with text messaging and CD- based training) and control groups. Seventy-five men were enrolled in three groups and evaluated for their knowledge and attitude about participation in perinatal care. Before and 3 months after the intervention, a researcher-made questionnaire was completed by the participants. Data were analyzed using descriptive and inferential statistics (paired t-test, one-way ANOVA, ANCOVA, chi-square, Kruskal-Wallis and Fisher exact tests). Results The mean (SD) score of men, s knowledge and attitude about participation in perinatal care had a significant increase in group- based training along with text messaging after the intervention compared to the score of before the intervention (p < 0.001, p = 0.005, respectively), but the mean (SD) score of men, s knowledge and attitude had not a significant increase in CD- based training and control group after the intervention compared to the score of before the intervention. The mean (SD) score of men,s knowledge and attitude about participation in perinatal care in group- based training along with text messaging were significantly higher than in CD- based training (p < 0.001, p = 0.039, respectively) and control group (p = 0.001, p = 0.021, respectively) after the intervention, respectively. However, the mean (SD) score of men, s knowledge and attitude in CD- based training were not significantly different from the control group after the intervention. Conclusion Group- based training along with text messaging was more effective in improving the knowledge and attitude of men about participation in perinatal care compared to CD- based training. So, its implication in educational programs for the men is recommended. Trial registration IRCT, IRCT20160224026756N4. Registered 27 May 2018.
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Pham A, Zhang J, Feng L. Exposure to perfluorobutane sulfonate and perfluorooctanesulfonic acid disrupts the production of angiogenesis factors and stress responses in human placental syncytiotrophoblast. Reprod Toxicol 2020; 98:269-277. [PMID: 33144174 DOI: 10.1016/j.reprotox.2020.10.013] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2020] [Revised: 10/14/2020] [Accepted: 10/25/2020] [Indexed: 12/18/2022]
Abstract
Poly- and per-fluoroalkyl substances (PFAS) have attracted widespread attention in recent years due to their bioaccumulation, toxicity, and ubiquitous nature. We and others have reported that maternal exposure to PFAS is associated with adverse birth outcomes due to altered placental functions. In this study, we investigated the effects of two major PFAS compounds, perfluorobutane sulfonate (PFBS) and perfluorooctanesulfonic acid (PFOS), on the regulation of the production of angiogenic factors and stress response in placental multinucleated syncytial BeWo cells using qRT-PCR and ELISA. Using this in vitro model, we showed that 1) PFOS or PFBS treatment did not seem to interrupt BeWo cell fusion through syncytins; 2) Exposure to PFOS at 10 μM decreased a potent angiogenic factor PlGF gene expression, which is implicated in preeclampsia; 3) Exposure to either PFOS or PFBS significantly decreased the production of CGB7 and hCG except hCG secretion in PFOS (10 nM) and PFBS (100 nM) treatment groups; 4) Exposure to PFOS (10 μM) increased the gene expression of the stress response molecules CRH while neither PFOS nor PFBS treatment affected a stress mitigation factor 11β-HSD2 expression. Our results demonstrate that exposure to PFOS or PFBS impacts several key pathways involved in placental cell functions. PFOS seems more potent than PFBS. These novel findings provide a potential explanation for the adverse reproductive complications associated with prenatal exposure to PFOS or PFBS, including preeclampsia and contribute to our knowledge of the reproductive toxicity of PFAS, specifically PFOS and PFBS.
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Affiliation(s)
- Angela Pham
- Department of Obstetrics and Gynecology, Duke University School of Medicine, Durham, NC, United States
| | - Jun Zhang
- MOE-Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital, Jiao Tong University School of Medicine, Shanghai, China
| | - Liping Feng
- Department of Obstetrics and Gynecology, Duke University School of Medicine, Durham, NC, United States; MOE-Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital, Jiao Tong University School of Medicine, Shanghai, China.
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Immunosuppressive and Immunomodulating Therapy for Atopic Dermatitis in Pregnancy: An Appraisal of the Literature. Dermatol Ther (Heidelb) 2020; 10:1215-1228. [PMID: 33140290 PMCID: PMC7649192 DOI: 10.1007/s13555-020-00457-w] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2020] [Indexed: 12/27/2022] Open
Abstract
The aim of this appraisal of the literature is to elucidate the effects of immunosuppressive and immunomodulating agents used to treat atopic dermatitis (AD) on risk factors for fertility, pregnancy, and breastfeeding. Negative side effects of the psychological and physical stresses associated to AD flairs and uncontrolled AD are discussed, in order to evaluate the consequences of abstaining from treatment. Research on pregnancies in Danish women suggests a tendency towards an increased use of topical steroids and ultraviolet light therapy during pregnancy, compared to before conception, confirming the need for these patients to receive treatment, as well as decreased use of systemic treatments, suggesting a tendency towards undertreatment in this patient population. It is important that effective treatment be provided to pregnant women with AD. Here we present an appraisal of current knowledge on treatments for AD and the risks of exposure for the fetus and breastfed infant. Since little is known about the association between AD, pregnancy, and systemic treatment, we generalize conclusions based on studies on treatments of pregnant women who have undergone organ transplantation and who have inflammatory bowel disease, rheumatic disease, and autoimmune disease. The majority of recommendations are therefore based on a low or very low quality of evidence according to the GRADE system. The selected studies reflect the authors’ assessment regarding originality and importance in the context of this appraisal. It is always the treating doctor’s responsibility to stay updated on current literature when treating patients, especially pregnant patients.
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Mayeur A, Binois O, Gallot V, Hesters L, Benoit A, Oppenheimer A, Presse M, Zeghari F, BenguigUi J, Grynberg M, Frydman N, Sonigo C. First follow-up of art pregnancies in the context of the COVID-19 outbreak. Eur J Obstet Gynecol Reprod Biol 2020; 253:71-75. [PMID: 32805629 PMCID: PMC7836367 DOI: 10.1016/j.ejogrb.2020.07.050] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2020] [Revised: 07/21/2020] [Accepted: 07/27/2020] [Indexed: 01/25/2023]
Abstract
Objective The aims of this study were to follow up the monitoring, health and anxiety from women who became pregnant after an embryo transfer or a intrauterine insemination during the COVID-19 epidemic in France Study Design This is a single centre, retrospective study from December 2019 to March 2020 based on a phone call interview using a specific questionnaire sheet specially developed for this study. Questionnaires from 104 pregnant women were completed and descriptive data are then analyzed. Results Women with ongoing pregnancies (n = 88) did not change their physician visits. The COVID-19 outbreak has created no or few additional stresses for 77 % of pregnant women since the lockdown started. We report a miscarriage rate of 14.4 % (n = 15) and documented 10 patients (11.3 %) who had symptoms related to COVID-19. No severe symptoms and no hospitalization in intensive care unit were identified. Conclusion The epidemic context did not disrupt the medical monitoring of pregnancies and we did not recover an increased rate of miscarriage after ART. None of the patients who had COVID-related symptoms presented with severe clinical manifestations. Surprisingly, pregnant women were psychologically able to experience the lockdown.
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Affiliation(s)
- Anne Mayeur
- Reproductive Biology Unit CECOS, Paris-Saclay University, Antoine Béclère Hospital, APHP, Clamart 92140, France.
| | - Olivier Binois
- Reproductive Biology Unit CECOS, Paris-Saclay University, Antoine Béclère Hospital, APHP, Clamart 92140, France
| | - Vanessa Gallot
- Reproductive Biology Unit CECOS, Paris-Saclay University, Antoine Béclère Hospital, APHP, Clamart 92140, France; Department of Reproductive Medicine and Fertility Preservation, Paris-Saclay University, Antoine Béclère Hospital, APHP, Clamart 92140, France
| | - Laetitia Hesters
- Reproductive Biology Unit CECOS, Paris-Saclay University, Antoine Béclère Hospital, APHP, Clamart 92140, France
| | - Alexandra Benoit
- Department of Reproductive Medicine and Fertility Preservation, Paris-Saclay University, Antoine Béclère Hospital, APHP, Clamart 92140, France
| | - Anne Oppenheimer
- Department of Reproductive Medicine and Fertility Preservation, Paris-Saclay University, Antoine Béclère Hospital, APHP, Clamart 92140, France
| | - Marion Presse
- Department of Reproductive Medicine and Fertility Preservation, Paris-Saclay University, Antoine Béclère Hospital, APHP, Clamart 92140, France
| | - Faycal Zeghari
- Department of Reproductive Medicine and Fertility Preservation, Paris-Saclay University, Antoine Béclère Hospital, APHP, Clamart 92140, France
| | - Jonas BenguigUi
- Department of Reproductive Medicine and Fertility Preservation, Paris-Saclay University, Antoine Béclère Hospital, APHP, Clamart 92140, France
| | - Michael Grynberg
- Department of Reproductive Medicine and Fertility Preservation, Paris-Saclay University, Antoine Béclère Hospital, APHP, Clamart 92140, France
| | - Nelly Frydman
- Reproductive Biology Unit CECOS, Paris-Saclay University, Antoine Béclère Hospital, APHP, Clamart 92140, France
| | - Charlotte Sonigo
- Department of Reproductive Medicine and Fertility Preservation, Paris-Saclay University, Antoine Béclère Hospital, APHP, Clamart 92140, France
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Mohammadpour M, Mohammad-Alizadeh Charandabi S, Malakouti J, Nadar Mohammadi M, Mirghafourvand M. Effect of counselling with men on perceived stress and social support of their pregnant wives. J Reprod Infant Psychol 2020; 40:118-132. [PMID: 32673065 DOI: 10.1080/02646838.2020.1792428] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
BACKGROUND Given the important role of spouses during pregnancy, this study aimed to determine the effect of counseling with men on stress and social support of their women (primary outcomes), anxiety, depression, weight gain, newborns' anthropometric indicators, frequency of cesarean section and preterm delivery (secondary outcomes). METHODS 102 pregnant women were randomly assigned to two groups of counseling and control. Four sessions of counseling were held for the spouses of intervention group. Perceived Personal Resource Questionnaire-85-Part2, Perceived Stress Scale, Edinburgh's Postpartum Depression Scale, and Spielberger's State and Trait Anxiety Inventory were completed before and four weeks after intervention. The participants were followed up until delivery, and newborns' anthropometric indicators, delivery type, and preterm delivery were recorded. RESULTS The mean score of social support increased significantly 4 weeks after intervention in the counseling group compared to the control group (MD:12.7; 95%CI: 18.5 to 6.9). There was no significant difference between groups in the mean score of stress, anxiety, depression, and weight gain during pregnancy at four weeks after intervention and also frequency of cesarean delivery, preterm delivery, and anthropometric indicators of newborns (p>0.05). CONCLUSIONS Counseling with fathers can be recommended as an effective intervention to increase social support of pregnant women. TRIAL REGISTRATION IRCT2017042910324N38. Registered 25 June 2017, http://en.irct.ir/trial/10813.
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Affiliation(s)
| | | | - Jamileh Malakouti
- Midwifery Department, Tabriz University of Medical Sciences, Tabriz, Iran
| | | | - Mojgan Mirghafourvand
- Social Determinants of Health Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
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Hair Cortisol Concentrations as a Biological Marker of Maternal Prenatal Stress: A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17114002. [PMID: 32512943 PMCID: PMC7313007 DOI: 10.3390/ijerph17114002] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/05/2020] [Revised: 05/30/2020] [Accepted: 06/01/2020] [Indexed: 12/19/2022]
Abstract
Recently, biological markers of maternal prenatal stress, hair cortisol, along with saliva, blood, and urine cortisol, have received attention. However, it is necessary to validate measuring hair cortisol concentrations (HCC) as a biomarker of perceived stress among healthy and high-risk pregnant women. This study aimed to confirm the correlation between HCC and the perceived stress of pregnant women over 18 years of age. In this systematic review, we used various search engines to extract relevant articles using specific keywords related to pregnancy, hair cortisol, and psychological stress. Four out of 3639 studies met the inclusion criteria. We conducted a quality assessment with the help of three independent reviewers using the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement. The correlation between HCC and perceived stress was confirmed in one study. There was only one study on hair washing, shampoo, conditioner, and hair structure that could affect hair samples. In four studies, hair samples differed in length, methods of storage, and laboratory analysis. The review was limited to confirming the relationship between HCC and perceived stress in pregnant women based on the current evidence. Studies on hair cortisol need regulated and standardized methods for collection, storage, and analysis of hair samples.
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Valsamakis G, Papatheodorou D, Chalarakis N, Manolikaki M, Margeli A, Papassotiriou I, Barber TM, Kumar S, Kalantaridou S, Mastorakos G. Maternal chronic stress correlates with serum levels of cortisol, glucose and C-peptide in the fetus, and maternal non chronic stress with fetal growth. Psychoneuroendocrinology 2020; 114:104591. [PMID: 32007670 DOI: 10.1016/j.psyneuen.2020.104591] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2019] [Revised: 10/18/2019] [Accepted: 01/20/2020] [Indexed: 01/30/2023]
Abstract
INTRODUCTION During pregnancy, maternal stressors cause changes in both maternal and fetal HPA axes. We therefore investigated the impact of maternal non chronic and chronic stress on fetal glucose metabolism and growth, and serum levels of cortisol in the fetus. MATERIALS AND METHODS Normal weight pregnant women (n = 192; mean ± SD 27.9 ± 4.2 years old, and; 26.9 ± 2.4 kg/m²) were assessed during the 2nd and 3rd trimester with anthropometry, fetal ultrasound, blood samples for serum CRH, cortisol and IL6, and STAI trait and state stress questionnaires. We measured serum cortisol, insulin and c-peptide, and plasma glucose from cord blood. Neonates underwent anthropometry at the 3rd post-delivery day. RESULTS In both 2nd and 3rd trimesters, women with STAI trait scores ≥40 had significantly greater levels of fasting serum CRH and cortisol than those with STAI trait scores<40. 2nd trimester: STAI trait scores correlated positively with cord blood glucose and c-peptide. Maternal serum CRH correlated negatively with U/S fetal biparietal head diameter, while serum cortisol correlated positively with abdominal circumference. Maternal serum IL6, CRH and cortisol all correlated positively with birth waist circumference. 3rd trimester: Women with STAI state scores ≥40 had fetuses with larger U/S abdominal and smaller head circumferences compared to those of women with STAI scores <40. Women with STAI trait scores ≥40 had greater levels of cord blood cortisol, glucose, and c-peptide compared to women with STAI scores <40. STAI state scores ≥40 correlated positively with maternal CRH and U/S fetal abdominal circumference, and negatively with fetal head circumference and biparietal diameter. STAI trait scores correlated positively with cord blood c-peptide, glucose, insulin and cortisol. Maternal serum levels of CRH correlated positively with U/S fetal abdominal circumference and cord blood cortisol, and negatively with fetal head circumference and biparietal head diameter. Maternal serum levels of both CRH and cortisol correlated positively with cord blood c-peptide, glucose, and insulin. STAI trait was the best positive predictor of cord blood cortisol, glucose and c-peptide, whilst STAI state was the best positive and negative predictor, respectively of fetal abdominal circumference and fetal head circumference or biparietal diameter. CONCLUSIONS Increased maternal chronic stress (reflected by the STAI trait score) associates with increased fetal cortisol, glucose, c-peptide secretion and thus, insulin resistance. Maternal non chronic stress (STAI state) in the 3rd trimester associates with changes in fetal growth pattern, including increased and decreased measurements of fetal abdominal and head growth respectively.
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Affiliation(s)
- Georgios Valsamakis
- Endocrine Unit, 2nd Department of Obstetrics and Gynecology, Aretaieion University Hospital, Athens Medical School, Athens, Greece; 3rd Department of Obstetrics and Gynecology, Attikon University Hospital, Athens Medical School, Athens, Greece; Warwickshire Institute for the Study of Diabetes, Endocrinology and Metabolism (WISDEM), University Hospital Coventry and Warwick Medical School, Coventry, UK.
| | - Dimitrios Papatheodorou
- Endocrine Unit, 2nd Department of Obstetrics and Gynecology, Aretaieion University Hospital, Athens Medical School, Athens, Greece
| | - Nikolaos Chalarakis
- Endocrine Unit, 2nd Department of Obstetrics and Gynecology, Aretaieion University Hospital, Athens Medical School, Athens, Greece
| | - Maria Manolikaki
- Endocrine Unit, 2nd Department of Obstetrics and Gynecology, Aretaieion University Hospital, Athens Medical School, Athens, Greece
| | - Alexandra Margeli
- Department of Clinical Biochemistry, "Aghia Sophia" Children's Hospital, Athens, Greece
| | - Ioannis Papassotiriou
- Department of Clinical Biochemistry, "Aghia Sophia" Children's Hospital, Athens, Greece
| | - Thomas M Barber
- Warwickshire Institute for the Study of Diabetes, Endocrinology and Metabolism (WISDEM), University Hospital Coventry and Warwick Medical School, Coventry, UK
| | - Sudhesh Kumar
- Warwickshire Institute for the Study of Diabetes, Endocrinology and Metabolism (WISDEM), University Hospital Coventry and Warwick Medical School, Coventry, UK
| | - Sophia Kalantaridou
- 3rd Department of Obstetrics and Gynecology, Attikon University Hospital, Athens Medical School, Athens, Greece
| | - George Mastorakos
- Endocrine Unit, 2nd Department of Obstetrics and Gynecology, Aretaieion University Hospital, Athens Medical School, Athens, Greece
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Burgueño AL, Juárez YR, Genaro AM, Tellechea ML. Prenatal stress and later metabolic consequences: Systematic review and meta-analysis in rodents. Psychoneuroendocrinology 2020; 113:104560. [PMID: 31884321 DOI: 10.1016/j.psyneuen.2019.104560] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2019] [Revised: 12/16/2019] [Accepted: 12/17/2019] [Indexed: 12/19/2022]
Abstract
BACKGROUND Numerous rodent studies have evaluated the effects of maternal stress (MS) on later in life susceptibility to Metabolic Syndrome (MetS) intermediate phenotypes with varying results. The aim of this study was to quantitatively synthesize the available data on the effects of MS on offspring obesity, estimated indirectly by body mass (BM), body fat (BF) and plasma leptin; systolic blood pressure (SBP); plasma glucose (and insulin) and blood lipid concentrations. METHODS Literature was screened and summary estimates of the effect of MS outcomes were calculated by using random-effects models. Data on the effects of exogenous corticosteroid administration (or inhibition of 11β-HSD2) during pregnancy in rodents was analysed separately to characterize the direct phenotypic effects of prenatal corticosteroid excess (PCE). RESULTS We conducted 14 separate meta-analyses and synthesized relevant data on outcomes scarcely reported in literature. Both MS and PCE were associated with low birth weight without rapid catch-up growth resulting in decreased body mass later in life. Our analysis also revealed significant and contradictory effects on offspring adiposity. Little evidence was found for effects on glucose metabolism and blood lipids. We identified increased SBP in offspring exposed to PCE; however, there is not enough data to draw any conclusion about effects of MS on SBP. CONCLUSIONS Neonatal weight proved to be decreased in offspring prenatally exposed to stress or corticosteroids, but laboratory rodents in the absence of a challenging environment did not show catch-up growth. The available evidence is inconclusive regarding the effect on adiposity revealing clear methodological and knowledge gaps. This meta-analysis also confirmed a significant positive association between PCE and SBP. Nevertheless, additional studies should address the association with MS.
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Affiliation(s)
- Adriana L Burgueño
- Instituto de Investigaciones Biomédicas, Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET) - Pontificia Universidad Católica Argentina, Alicia Moreau de Justo 1600, C1107AFF, Buenos Aires, Argentina.
| | - Yamila R Juárez
- Instituto de Investigaciones Biomédicas, Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET) - Pontificia Universidad Católica Argentina, Alicia Moreau de Justo 1600, C1107AFF, Buenos Aires, Argentina.
| | - Ana M Genaro
- Instituto de Investigaciones Biomédicas, Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET) - Pontificia Universidad Católica Argentina, Alicia Moreau de Justo 1600, C1107AFF, Buenos Aires, Argentina.
| | - Mariana L Tellechea
- Centro de Investigaciones Endocrinológicas "Dr. César Bergadá", Consejo Nacional de Investigaciones Científicas y Técnicas - Fundación de Endocrinología Infantil - División de Endocrinología - Hospital de Niños Ricardo Gutiérrez, Gallo 1330, C1425EFD Buenos Aires, Argentina.
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Matvienko-Sikar K, Cooney J, Flannery C, Murphy J, Khashan A, Huizink A. Maternal stress in the first 1000 days and risk of childhood obesity: a systematic review. J Reprod Infant Psychol 2020; 39:180-204. [PMID: 32046507 DOI: 10.1080/02646838.2020.1724917] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
Objective: Maternal stress is associated with adverse child outcomes. Conception to 2-years postpartum (the first 1000 days) is a developmentally sensitive period for stress exposure. The role of maternal stress in the first 1000 days on child obesity risk is unclear. This review systematically examines the relationship between maternal stress across the first 1000 days and child obesity risk. Methods: The Cochrane Library, MEDLINE, PsycINFO, EMBASE, CINAHL, and Maternity and Infant Care were searched from inception to June 2018. Eligible studies included women who experienced maternal stress in the first 1000 days; an included a measure of maternal stress and of child anthropometrics. Results: Sixteen studies met inclusion criteria, the majority of these examined prenatal stress exposure. Inconsistent effects were observed for psychological and physiological stress responses, on child weight outcomes. Environmental stress exposures, including natural disaster and bereavement, were more consistently associated with increased obesity risk. Conclusion: This review does not provide support for the effects of psychological or physiological maternal stress on child weight outcomes; there is some evidence of associations between environmental stress exposures and greater childhood adiposity. Variation in conceptualisation and measurement of stress, timing of stress exposure, and limited examination of stress-related behaviours were noted.
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Affiliation(s)
| | - Jennifer Cooney
- School of Applied Psychology, University College Cork , Cork, Ireland
| | - Caragh Flannery
- School of Public Health, University College Cork , Cork, Ireland
| | - Jennifer Murphy
- School of Public Health, University College Cork , Cork, Ireland
| | - Ali Khashan
- School of Public Health, University College Cork , Cork, Ireland.,Irish Centre for Fetal and Neonatal Transnational Research (INFANT) Centre, Cork University Maternity Hospital , Cork, Ireland
| | - Anja Huizink
- Department of Clinical, Neuro- and Developmental Psychology, VU University Amsterdam , Amsterdam, The Netherlands
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Obrochta CA, Chambers C, Bandoli G. Psychological distress in pregnancy and postpartum. Women Birth 2020; 33:583-591. [PMID: 32035798 DOI: 10.1016/j.wombi.2020.01.009] [Citation(s) in RCA: 42] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2019] [Revised: 12/16/2019] [Accepted: 01/19/2020] [Indexed: 11/29/2022]
Abstract
PURPOSE Depression, stress, and anxiety, termed 'psychological distress,' are common in pregnancy and postpartum periods. However, it is unclear whether prenatal psychological distress predicts postpartum psychological distress. We studied the prevalence, comorbidity and associations of maternal depression, stress, and anxiety in the prenatal period in relation to the occurrence of these same measures in the postpartum period. METHODS Data originated from the MotherToBaby study of pregnant women residing in the U.S or Canada (2016-2018). Risk ratios and 95% Confidence Intervals using modified-Poisson regression models were used to investigate associations between prenatal psychological distress and postpartum psychological distress. RESULTS Of the 288 women in the analysis, 21.2% and 26.7% of women had evidence of prenatal and postnatal psychological distress, respectively. Among those with prenatal psychological distress, 43 (70.5%) also had postpartum psychological distress. Twenty-five (41%) of those with prenatal and 46 (60%) of those with postpartum psychological distress had comorbidity of at least two of the measures. Prenatal measures independently predicted the same postnatal measures; prenatal anxiety also independently predicted postpartum stress. Participants who experienced more types of prenatal psychological distress were at higher risk for postpartum depression, stress, and anxiety. CONCLUSION Depression, stress, and anxiety are common in pregnant women and often occur together. Prenatal psychological distress measures are associated with postnatal psychological distress measures, with stronger associations among women with more than one type of psychological distress in pregnancy. Interventions during pregnancy may reduce the risk of postpartum psychological distress.
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Affiliation(s)
- Chelsea A Obrochta
- School of Public Health, San Diego State University, United States; University of California San Diego, School of Medicine, United States.
| | | | - Gretchen Bandoli
- University of California San Diego, School of Medicine, United States
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Lim HA, Chua TE, Malhotra R, Allen JC, Chern BSM, Tan KH, Chen H. Trajectories of antenatal maternal psychological stress and their association with gestational age and neonatal anthropometry: A prospective cohort study of multi-ethnic Asian women in an urban setting. Asian J Psychiatr 2020; 48:101923. [PMID: 31896435 DOI: 10.1016/j.ajp.2019.101923] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2019] [Revised: 12/26/2019] [Accepted: 12/26/2019] [Indexed: 02/06/2023]
Abstract
PURPOSE To determine common temporal change patterns (i.e., trajectories) of perceived antenatal psychological stress throughout the pregnancy, and to examine associations between these identified trajectories and neonatal birth outcomes. METHODS 926 participants from a prospective cohort study of multi-ethnic Asian women from an urban setting with uncomplicated singleton pregnancies completed the Perceived Stress Scale in their first, second, and third trimesters, and just prior to parturition. Gestational age, neonatal weight, length, and head circumference were recorded at birth. Longitudinal trajectories of antenatal psychological stress were characterized with group-based trajectory modelling; associations between trajectories and neonatal outcomes were assessed with analyses of covariance and covariate-adjusted linear regressions. RESULTS Three distinct non-fluctuating trajectories of antenatal psychological stress were identified, with 43 % of women experiencing significant levels of stress throughout the pregnancy. Women in this persistently-higher stress trajectory delivered neonates who were 57.5 g lighter and with head circumferences of 20 mm less than their counterparts in the other trajectories. Each one-point increase on the Perceived Stress Scale was associated with a decrease of 5.64 g in birthweight and a decrease of 0.4 mm in head circumference. CONCLUSIONS This study delineated three meaningful trajectories of antenatal psychological stress. The persistently-higher antenatal psychological stress trajectory, experienced by two in five women, was associated with lower birthweight and possibly smaller head circumference. While further research is needed to better appreciate the clinical relevance of these findings, it highlights the importance of psychosocial support even for healthy pregnant women with uncomplicated pregnancies in Asian settings.
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Affiliation(s)
| | | | | | | | | | - Kok Hian Tan
- Duke-NUS Medical School, Singapore; KK Women's and Children's Hospital, Singapore
| | - Helen Chen
- Duke-NUS Medical School, Singapore; KK Women's and Children's Hospital, Singapore.
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Corrigan L, Eustace-Cook J, Moran P, Daly D. The effectiveness and characteristics of pregnancy yoga interventions: a systematic review protocol. HRB Open Res 2020; 2:33. [PMID: 32296751 PMCID: PMC7140767 DOI: 10.12688/hrbopenres.12967.2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/07/2020] [Indexed: 12/19/2022] Open
Abstract
Background: The purpose of this review is to systematically examine the reported clinical effectiveness of pregnancy yoga. The review will use the FITT (frequency, intensity, time/duration and type) principle of physical activity to characterise the different types of yoga interventions that have been evaluated in the included studies. Studies will be categorised as effectiveness or efficacy studies and this continuum of efficacy versus effectiveness will be incorporated into the full review. Methods/design: The following electronic databases will be searched using a detailed search strategy: MEDLINE, PsycINFO, EMBASE, CINAHL, WHOLiS, AMED, ScieLo, ASSIA and Web of Science. Randomised control trials and quasi-experimental studies examining pregnancy yoga and reporting on effect will be included. Titles, abstracts and full articles will be screened by two investigators independently to identify eligible studies. The Cochrane Collaboration's Risk of Bias Assessment tool will be used to assess study quality. Quality of the evidence will be evaluated using the GRADE criteria. A standardised data extraction form will be used to extract data. Effect sizes will be estimated using mean differences for continuous outcomes, and relative risks for dichotomous outcome. Where possible, pooling of effect estimates will be done using a random effect model. The outcomes of interest are quality of life, stress, anxiety, depression, mode of birth, labour duration and pain management in labour. Discussion: This review will synthesise the best available evidence on the effectiveness of yoga during pregnancy and provide valuable high-quality information for clinicians and health policymakers. Findings will be disseminated through publication in a peer-reviewed journal and presentation at relevant conference proceedings. The review will make recommendations for the appropriate volume, intensity and type of pregnancy yoga for maximum effect and may have implications for policy and practice relating to pregnancy yoga as an intervention. Registration: PROSPERO, CRD42019119916. Registered on 11th January 2019.
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Affiliation(s)
- Lisa Corrigan
- School of Nursing & Midwifery, University of Dublin, Dublin, Ireland
| | | | - Patrick Moran
- School of Nursing & Midwifery, University of Dublin, Dublin, Ireland
| | - Deirdre Daly
- School of Nursing & Midwifery, University of Dublin, Dublin, Ireland
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Corrigan L, Eustace-Cook J, Moran P, Daly D. The effectiveness and characteristics of pregnancy yoga interventions: a systematic review protocol. HRB Open Res 2019; 2:33. [PMID: 32296751 PMCID: PMC7140767 DOI: 10.12688/hrbopenres.12967.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/18/2019] [Indexed: 03/29/2024] Open
Abstract
Background: The purpose of the proposed review is to systematically examine the clinical effectiveness of pregnancy yoga. The review will use the FITT (frequency, intensity, time/duration and type) principle of physical activity to characterise the different types of yoga interventions that have been evaluated in the included studies. Methods/design: The following electronic databases will be searched using a detailed search strategy: MEDLINE, PsycINFO, EMBASE, CINAHL, WHOLiS, AMED, ScieLo, ASSIA and Web of Science. Randomised control trials and quasi-experimental studies examining pregnancy yoga will be included. Titles, abstracts and full articles will be screened by two investigators independently to identify eligible studies. The Cochrane Collaboration's Risk of Bias Assessment tool will be used to assess study quality. Quality of the evidence will be evaluated using the GRADE criteria. A standardised data extraction form will be used to extract data. Effect sizes will be estimated using mean differences for continuous outcomes, and relative risks for dichotomous outcome. Where possible, pooling of effect estimates will be done using a random effect model. Discussion: This review will synthesise the best available evidence on the effectiveness of yoga during pregnancy and provide valuable high-quality information for clinicians and health policymakers. Findings will be disseminated through publication in a peer-reviewed journal and presentation at relevant conference proceedings. The review will make recommendations for the appropriate volume, intensity and type of pregnancy yoga for maximum effect and may have implications for policy and practice relating to pregnancy yoga as an intervention. Registration: PROSPERO, CRD42019119916. Registered on 11th January 2019.
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Affiliation(s)
- Lisa Corrigan
- School of Nursing & Midwifery, University of Dublin, Dublin, Ireland
| | | | - Patrick Moran
- School of Nursing & Midwifery, University of Dublin, Dublin, Ireland
| | - Deirdre Daly
- School of Nursing & Midwifery, University of Dublin, Dublin, Ireland
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Lim HA, Chua TE, Malhotra R, Allen JC, Teo I, Chern BSM, Tan KH, Chen H. Identifying trajectories of antenatal depression in women and their associations with gestational age and neonatal anthropometry: A prospective cohort study. Gen Hosp Psychiatry 2019; 61:26-33. [PMID: 31710855 DOI: 10.1016/j.genhosppsych.2019.09.001] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2019] [Revised: 09/11/2019] [Accepted: 09/11/2019] [Indexed: 12/20/2022]
Abstract
OBJECTIVE The present study sought to determine the longitudinal trajectories of antenatal depression and examine their associations with birth outcomes. METHOD 926 healthy women with uncomplicated singleton pregnancies within 14 weeks of gestation participated in this prospective cohort study. Women completed a sociodemographic and medical questionnaire and the locally-validated Edinburgh Postnatal Depression Scale (EPDS) in their first, second, and third trimesters, and prior to parturition. Gestational age and neonatal weight, length, and head circumference were recorded at birth. Group-based trajectory modelling characterized trajectories of antenatal depression. Analyses of covariance and covariate-adjusted linear regressions identified associations between trajectories and neonatal outcomes. RESULTS Four distinct non-fluctuating trajectories of depressive symptoms were identified, with 9% women suffering from probable clinical depression throughout the pregnancy. Women in this persistently-moderate depression trajectory delivered 2.48 days earlier than in other trajectories; a one-point increase in EPDS scores was associated with an adjusted reduction of 5.82 g in birthweight. CONCLUSIONS Although meaningful trajectories were identified, no clinically relevant associations between persistently-moderate depressive symptoms with neonatal outcomes were found. The stability of these trajectories, however, suggests the importance of screening for depressive symptoms early in pregnancy to identify women who may benefit from greater formal and informal support.
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Affiliation(s)
- Haikel A Lim
- Duke-NUS Medical School, 8 College Road, Singapore 169857, Singapore.
| | - Tze-Ern Chua
- Duke-NUS Medical School, 8 College Road, Singapore 169857, Singapore; KK Women's and Children's Hospital, 100 Bukit Timah Road, Singapore 229899, Singapore.
| | - Rahul Malhotra
- Duke-NUS Medical School, 8 College Road, Singapore 169857, Singapore.
| | - John C Allen
- Duke-NUS Medical School, 8 College Road, Singapore 169857, Singapore.
| | - Irene Teo
- Duke-NUS Medical School, 8 College Road, Singapore 169857, Singapore.
| | - Bernard S M Chern
- KK Women's and Children's Hospital, 100 Bukit Timah Road, Singapore 229899, Singapore.
| | - Kok Hian Tan
- Duke-NUS Medical School, 8 College Road, Singapore 169857, Singapore; KK Women's and Children's Hospital, 100 Bukit Timah Road, Singapore 229899, Singapore.
| | - Helen Chen
- Duke-NUS Medical School, 8 College Road, Singapore 169857, Singapore; KK Women's and Children's Hospital, 100 Bukit Timah Road, Singapore 229899, Singapore.
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Hair cortisol levels, psychological stress and psychopathological symptoms prior to instrumental deliveries. Midwifery 2019; 77:45-52. [DOI: 10.1016/j.midw.2019.06.015] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2019] [Revised: 06/19/2019] [Accepted: 06/21/2019] [Indexed: 01/05/2023]
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Hoff CE, Movva N, Rosen Vollmar AK, Pérez-Escamilla R. Impact of Maternal Anxiety on Breastfeeding Outcomes: A Systematic Review. Adv Nutr 2019; 10:816-826. [PMID: 31079143 PMCID: PMC6743815 DOI: 10.1093/advances/nmy132] [Citation(s) in RCA: 41] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2018] [Revised: 09/08/2018] [Accepted: 12/31/2018] [Indexed: 11/14/2022] Open
Abstract
Prenatal and postpartum anxiety may impair maternal functioning and disrupt mother-infant behaviors including breastfeeding. The objective of this narrative review is to examine the association between maternal anxiety from pregnancy to 12 mo postpartum and breastfeeding initiation, duration, and exclusivity. Using a combination of Medical Subject Headings terms and text words, relevant studies were identified through PubMed and PsycINFO. Studies that were conducted in high-income countries, assessed anxiety during gestation and/or postpartum through a standardized measure, and evaluated the impact of anxiety on any of the primary outcomes were included. Sixteen studies met the eligibility criteria although they varied greatly in methodological rigor. A negative association between postpartum anxiety and breastfeeding initiation, duration, and exclusivity was suggested. No associations were found between prenatal anxiety and breastfeeding initiation or exclusivity. Evidence is mixed regarding the association between prenatal anxiety and breastfeeding duration. All studies included in the review were of low or very low quality. Although there was consistency in the association between maternal anxiety and breastfeeding outcomes in the included studies, future studies with greater methodological rigor are needed to determine the extent of the relation between prenatal and/or postpartum anxiety and breastfeeding outcomes.
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Affiliation(s)
- Chantal E Hoff
- Departments of Social and Behavioral Sciences, New Haven, CT
| | | | - Ana K Rosen Vollmar
- Environmental Health Sciences, Yale University School of Public Health, New Haven, CT
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Systematic review and meta-analysis on the relationship between prenatal stress and metabolic syndrome intermediate phenotypes. Int J Obes (Lond) 2019; 44:1-12. [PMID: 31332277 DOI: 10.1038/s41366-019-0423-z] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2019] [Revised: 05/30/2019] [Accepted: 06/02/2019] [Indexed: 12/29/2022]
Abstract
BACKGROUND Metabolic Syndrome (MetS) can be considered as a consequence of a complex interplay between genetic and environmental factors and can be influenced by changes in the environment early in life. Prenatal stress (PS) exposure likely represents an important adverse intrauterine environment that may impact the biology of the developing organism. The aim of this study was to quantitatively synthesize the available data on the effects of PS on offspring's obesity, estimated indirectly by body mass index (BMI) and body fat; blood pressure, plasma glucose and blood lipid concentrations (triglycerides and high-density lipoprotein cholesterol). METHODS Literature searches for eligible studies on PubMed were conducted until October 8, 2018. Full text review yielded 24 publications for inclusion into the systematic review. Meta-analyses were performed for the outcomes BMI and body fat. 62 effect sizes from 19 studies together with relevant moderators were collected. Summary estimates were calculated by using random-effects model. RESULTS The combined standardized mean difference (d) for the relation between BMI and PS indicated that despite significant heterogeneity, stress exposure of expectant mothers was associated with increased BMI of their offspring [d (95% CI) = 0.268 (0.191; 0.345)]. Both objective and subjective stress have been linked to increased overweight. Preliminary results of the relationship between PS and body fat suggested that the contribution of PS to body fat should be at least further considered [d (95% CI) = 0.167 (0.016; 0.317)]. Evidence from a limited number of published studies do not sustains an effect on blood pressure, glucose metabolism or circulating lipids, however these outcomes have only been scarcely investigated. CONCLUSIONS A direct association between PS and BMI was found and further studies are needed to confirm the relationship between maternal stress during gestation and body fat. Overall, findings suggest that PS could contribute to alterations to the post-natal offspring phenotype.
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Hypertensive Disorders of Pregnancy and Symptoms of Depression and Anxiety as Related to Gestational Age at Birth: Findings From the All Our Families Study. Psychosom Med 2019; 81:458-463. [PMID: 30985405 DOI: 10.1097/psy.0000000000000695] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE The aim of the study was to investigate whether symptoms of depression or state anxiety changed the strength or nature of the association between hypertensive disorders of pregnancy (HDP) and gestational age at birth. METHODS We conducted a secondary analysis of data from the All Our Families Cohort, a prospective pregnancy cohort study based in Calgary, Alberta, Canada. Self-reported depressive symptoms and state anxiety were assessed between 3 and 5 months of gestation, and obstetrical information, including diagnosis of HDP, parity, type of delivery, and gestational age at birth, was retrieved from the maternal discharge abstract. All models were adjusted for sociodemographic and obstetric confounders. RESULTS Of 2763 women who had a singleton pregnancy and live birth, 247 (9%) were diagnosed with HDP. Women with HDP had significantly shorter gestational length relative to those without the diagnosis (M = 37.87 versus M = 38.99 weeks of gestation), t(2761) = 9.43, p < .001. Moderation analyses showed significant HDP by depressive symptoms and HDP by state anxiety interactions, such that the strength of the association between HDP and gestational age at birth increased alongside greater depressive symptom and state anxiety severity. CONCLUSIONS Results suggest that depressive symptoms and state anxiety may add to the increased risk for shortened gestation associated with HDP. Women at high risk of cardiovascular complications during pregnancy may benefit from additional resources to manage symptoms of depression or anxiety.
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González-Mesa ES, Arroyo-González ML, Ibrahim-Díez N, Cazorla-Granados O. Mood state at the beginning of the pregnancy and its influence on obstetric and perinatal outcomes. J Psychosom Obstet Gynaecol 2019; 40:106-113. [PMID: 29363374 DOI: 10.1080/0167482x.2018.1427726] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
Abstract
Aim: We designed this study to ascertain the prevalence of depressive disorders and anxiety at the beginning of the pregnancy, studying possible associated factors and assessing the influence of mood disorders on perinatal outcomes. Methods: A representative sample of 191 pregnant women at first trimester of their pregnancies completed a questionnaire that included the Whooley´s questions, the Spanish version of the Beck Depression Inventory (BDI), the State-Trait Anxiety Inventory and a series of questions related to health status, general mood and sociodemographic variables. Later, we prospectively evaluated the influence of anxiety and depression on the perinatal and obstetric results in 145 of them. Results: More than 20% of pregnant women presented high levels of anxiety. The mean values of the state and trait anxiety scores were 38.7 (SD 9.8) and 34.5 (SD 9.5). The mean BDI score was 5.97 (SD 4.9), with 9.5% of participants achieving scores compatible with depression, (61% mild in, 22.2% moderate, and 16.6% severe). BDI scores were significantly lower in women who became pregnant after assisted reproductive techniques. We observed an association between depression and trait anxiety scores with an infant's low birth weight. The multivariate analysis showed that the feeling of happiness at the beginning of pregnancy was the best predictor of foetal weight. Conclusion: The prevalence of emotional disorders in the first trimester of pregnancy is high, with more than 20% of pregnant women presenting high levels of anxiety, and more than 9.5% presenting depression. During the first trimester, depression and anxiety were associated with low birth weight.
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Affiliation(s)
- Ernesto S González-Mesa
- a Obstetrics & Gynecology Department , Malaga University School of Medicine , Málaga , Spain.,b Department of Obstetrics & Gynecology , Málaga Regional & University Hospital , Málaga , Spain
| | - M Luisa Arroyo-González
- a Obstetrics & Gynecology Department , Malaga University School of Medicine , Málaga , Spain
| | - Nadia Ibrahim-Díez
- b Department of Obstetrics & Gynecology , Málaga Regional & University Hospital , Málaga , Spain
| | - Olga Cazorla-Granados
- a Obstetrics & Gynecology Department , Malaga University School of Medicine , Málaga , Spain
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Larrañaga I, Santa-Marina L, Molinuevo A, Álvarez-Pedrerol M, Fernández-Somoano A, Jimenez-Zabala A, Rebagliato M, Rodríguez-Bernal CL, Tardón A, Vrijheid M, Ibarluzea J. Poor mothers, unhealthy children: the transmission of health inequalities in the INMA study, Spain. Eur J Public Health 2019; 29:568-574. [PMID: 30462218 DOI: 10.1093/eurpub/cky239] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND The health of pregnant women and their fetuses are especially sensitive to socioeconomic conditions. This study analyzes the impact of maternal socioeconomic status (SES), evaluated by occupation and maternal education level, in preterm births (PTBs) and in small for gestational age (SGA) fetuses, considering the effect of the potential mediating factors on the SES and birth outcomes. METHODS A total of 2497 mother/newborn dyads from the INMA-Spain project were studied. We examined maternal occupation and education in relation to PTB and SGA along with covariate data, using logistic regression analysis. Adjusted models for each of the outcome variables in relation to SES indicators were estimated, considering potential mediating factors. RESULTS About 4.7% of babies were PTB and 9.7% SGA. Full adjusted logistic regression models showed similar odds ratio (OR) for SGA in both SES indicators. Manual working women or without university studies had higher risk of SGA than their counterpart groups (OR = 1.39% CI = 1.03-1.88 and OR = 1.39% CI = 1.00-2.00, respectively). Likewise, mothers with a manual occupation were at more risk of PTB than those with a non-manual occupation (OR = 1.74 95% CI = 1.13-2.74), but there was no association between education and PTB. Smoking, pre-pregnancy BMI and underweight gain during pregnancy were significantly associated to SGA births. The mother's age, presence of complications and overweight gain during pregnancy were related to PTB. CONCLUSION The mother's socioeconomic disadvantage was consistently associated with birth outcomes giving rise to intergenerational transmission of health inequalities. Reducing inequalities requires eliminating the upstream causes of poverty itself.
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Affiliation(s)
- Isabel Larrañaga
- Planning and Evaluation Service, Department of Health of the Basque Government, San Sebastián, Spain.,Biodonostia Health Research Institute, San Sebastian, Spain
| | - Loreto Santa-Marina
- Biodonostia Health Research Institute, San Sebastian, Spain.,Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Barcelona, Spain.,Public Health Department of Gipuzkoa, San Sebastián, Spain
| | - Amaia Molinuevo
- Biodonostia Health Research Institute, San Sebastian, Spain.,Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Barcelona, Spain
| | - Mar Álvarez-Pedrerol
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Barcelona, Spain.,ISGlobal, Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain.,Universitat Pompeu Fabra (UPF), Barcelona, Spain
| | - Ana Fernández-Somoano
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Barcelona, Spain.,IUOPA-Departamento de Medicina, Universidad de Oviedo, Oviedo, Spain
| | - Ana Jimenez-Zabala
- Biodonostia Health Research Institute, San Sebastian, Spain.,Public Health Department of Gipuzkoa, San Sebastián, Spain
| | - Marisa Rebagliato
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Barcelona, Spain.,Universitat Jaume I, Castellon, Spain
| | - Clara L Rodríguez-Bernal
- FISABIO Salud Pública, Health Services Research Unit, Valencia, Spain.,FISABIO-Universitat Jaume I-Universitat de València, Joint Research Unit of Epidemiology and Environmental Health, Valencia, Spain
| | - Adonina Tardón
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Barcelona, Spain.,IUOPA-Departamento de Medicina, Universidad de Oviedo, Oviedo, Spain
| | - Martine Vrijheid
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Barcelona, Spain.,ISGlobal, Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain.,Universitat Pompeu Fabra (UPF), Barcelona, Spain
| | - Jesús Ibarluzea
- Biodonostia Health Research Institute, San Sebastian, Spain.,Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Barcelona, Spain.,Public Health Department of Gipuzkoa, San Sebastián, Spain.,School of Psychology, University of the Basque Country (UPV-EHU), San Sebastian, Spain
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Cooney J, Flannery C, Khashan AS, Huizink AC, Matvienko-Sikar K. The relationship between maternal stress during pregnancy and up to two years after birth and risk of child overweight and obesity: Protocol for a Systematic Review. HRB Open Res 2019. [DOI: 10.12688/hrbopenres.12887.3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Background: Childhood obesity presents a significant public health challenge globally. The period from conception to two years after birth, the first 1000 days, represents a critical period during which the experience of maternal stress may be related to the development of childhood obesity. Research to date suggests some positive associations between maternal stress during the first 1000 days and childhood obesity, but findings are inconsistent and have not yet been comprehensively synthesised. The purpose of this review is to systematically examine the association between maternal stress during the first 1000 days and the risk of child overweight and obesity. Methods: The following electronic databases will be searched from inception using a detailed search strategy: the Cochrane Library, MEDLINE, PsycINFO, EMBASE, CINAHL, Maternity and Infant Care, and Web of Science. Cohort, case-control, and cross-sectional studies examining maternal stress during the first 1000 days and child overweight and obesity up to the age of 10 years will be included. Titles, abstracts and full articles will be screened by two investigators independently to identify eligible studies. A standardised data extraction form will be used to extract data including: study design; maternal stress exposure; child outcome; exclusion criteria; participant characteristics; and assessment methods. The Cochrane Collaboration’s bias classification tool for observational studies will be used to assess study quality. This protocol is reported according to the Preferred Reporting Items for Systematic reviews and Meta-Analyses protocol (PRISMA-P) checklist, and the systematic review will be conducted and reported following the PRISMA checklist. If possible, random effects models will be used to perform meta-analyses. Ethics and dissemination: Ethical approval is not required for this study as it will not involve conducting experimental research, nor include identifying personal data. The systematic review will be disseminated in peer-reviewed journals. PROSPERO registration number: CRD42018100363
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Effects of maternal stress during pregnancy and up to two years after birth on risk of child overweight and obesity: Protocol for a Systematic Review. HRB Open Res 2019. [DOI: 10.12688/hrbopenres.12887.2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Background: Childhood obesity presents a significant public health challenge globally. The period from conception to two years after birth, the first 1000 days, represents a critical period during which the experience of maternal stress may be related to the development of childhood obesity. Research to date suggests some positive associations between maternal stress during the first 1000 days and childhood obesity, but findings are inconsistent and have not yet been comprehensively synthesised. The purpose of this review is to systematically examine the association between maternal stress during the first 1000 days and the risk of child overweight and obesity. Methods: The following electronic databases will be searched from inception using a detailed search strategy: the Cochrane Library, MEDLINE, PsycINFO, EMBASE, CINAHL, Maternity and Infant Care, and Web of Science. Cohort, case-control, and cross-sectional studies examining maternal stress during the first 1000 days and child overweight and obesity up to the age of 10 years will be included. Titles, abstracts and full articles will be screened by two investigators independently to identify eligible studies. A standardised data extraction form will be used to extract data including: study design; maternal stress exposure; child outcome; exclusion criteria; participant characteristics; and assessment methods. The Cochrane Collaboration’s bias classification tool for observational studies will be used to assess study quality. This protocol is reported according to the Preferred Reporting Items for Systematic reviews and Meta-Analyses protocol (PRISMA-P) checklist, and the systematic review will be conducted and reported following the PRISMA checklist. If possible, random effects models will be used to perform meta-analyses. Ethics and dissemination: Ethical approval is not required for this study as it will not involve conducting experimental research, nor include identifying personal data. The systematic review will be disseminated in peer-reviewed journals. PROSPERO registration number: CRD42018100363
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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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Relationships between stress, demographics and dietary intake behaviours among low-income pregnant women with overweight or obesity. Public Health Nutr 2019; 22:1066-1074. [PMID: 30621807 DOI: 10.1017/s1368980018003385] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
OBJECTIVE To identify demographic risk factors associated with high stress and examine the relationships between levels of stress, demographics and dietary fat, fruit and vegetable intakes in low-income pregnant women with overweight or obesity. DESIGN A cross-sectional study. SETTING Participants were recruited from the Special Supplemental Nutrition Program for Women, Infants, and Children in Michigan, USA.ParticipantsParticipants (n 353) were non-Hispanic Black (black) or White (white). RESULTS Women aged 35 years or older (OR=4·09; 95% CI 1·45, 11·51) and who had high school or less education (OR=1·88; 95% CI 1·22, 2·89) or were unemployed (OR=1·89; 95% CI 1·15, 3·12) were significantly more likely to report high stress than women who were younger, had at least some college education or were employed/homemakers. However, race and smoking status were not associated with level of stress. Women with high stress reported significantly lower fruit and vegetable intakes but not fat intake than women with low stress. Women aged 35 years or older reported significantly higher vegetable but not fat or fruit intake than women who were 18-24 years old. Black women reported significantly higher fat but not fruit or vegetable intake than white women. Education, employment and smoking status were not significantly associated with dietary intake of fat, fruits and vegetables. CONCLUSIONS Nutrition counselling on reducing fat and increasing fruit and vegetable intakes may consider targeting women who are black or younger or who report high stress, respectively.
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Survey to Assess Interest in a Mindfulness Intervention at a Midwifery and Women's Health Clinic. Holist Nurs Pract 2018; 32:261-267. [PMID: 30113960 DOI: 10.1097/hnp.0000000000000286] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
We conducted a voluntary survey among ethnically and socioeconomically diverse women. About half of the respondents reported experiencing at least one health issue; over half were interested in attending a mindfulness class to reduce stress. Our study suggests interest in participating in a mindfulness intervention, primarily among those with more health issues.
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Cooney J, Flannery C, Khashan AS, Huizink AC, Matvienko-Sikar K. Effects of maternal stress during pregnancy and up to two years after birth on risk of child overweight and obesity: Protocol for a Systematic Review. HRB Open Res 2018. [DOI: 10.12688/hrbopenres.12887.1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
Background: Childhood obesity presents a significant public health challenge globally. The period from conception to two years after birth, the first 1000 days, represents a critical period during which the experience of maternal stress may be related to the development of childhood obesity. Research to date suggests some positive associations between maternal stress during the first 1000 days and childhood obesity, but findings are inconsistent and have not yet been comprehensively synthesised. The purpose of this review is to systematically examine the association between maternal stress during the first 1000 days and the risk of child overweight and obesity. Methods: The following electronic databases will be searched from inception using a detailed search strategy: the Cochrane Library, MEDLINE, PsycINFO, EMBASE, CINAHL, Maternity and Infant Care, and Web of Science. Cohort, case-control, and cross-sectional studies examining maternal stress during the first 1000 days and child overweight and obesity up to the age of 12 years will be included. Titles, abstracts and full articles will be screened by two investigators independently to identify eligible studies. A standardised data extraction form will be used to extract data including: study design; maternal stress exposure; child outcome; exclusion criteria; participant characteristics; and assessment methods. The Cochrane Collaboration’s bias classification tool for observational studies will be used to assess study quality. This protocol is reported according to the Preferred Reporting Items for Systematic reviews and Meta-Analyses protocol (PRISMA-P) checklist, and the systematic review will be conducted and reported following the PRISMA checklist. If possible, random effects models will be used to perform meta-analyses. Ethics and dissemination: Ethical approval is not required for this study as it will not involve conducting experimental research, nor include identifying personal data. The systematic review will be disseminated in peer-reviewed journals. PROSPERO registration number: CRD42018100363
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