1
|
Song B, Wang D, Yan X, Yan P, Liu H, Li H, Yi S. Physical activity and sleep quality among pregnant women during the first and second trimesters are associated with mental health and adverse pregnancy outcomes. BMC Womens Health 2024; 24:455. [PMID: 39138442 PMCID: PMC11321155 DOI: 10.1186/s12905-024-03126-8] [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: 11/14/2023] [Accepted: 05/02/2024] [Indexed: 08/15/2024] Open
Abstract
BACKGROUND Appropriate physical activity (PA) and good sleep are beneficial to maternal and fetal health. This paper sought to explore the associations of PA and sleep quality among healthy women at the first and second trimesters of pregnancy on mental health and pregnancy outcomes. METHODS Totally 268 healthy pregnant women were retrospectively analyzed as study subjects, 134 each in the first trimester (FT) and second trimester (ST). Their baseline clinical data were obtained respectively at two stages of pregnancy. The PA/sleep quality of subjects were assessed through the Pregnancy Physical Activity Questionnaire-Chinese version (PPAQ-C)/Pittsburgh Sleep Quality Index (PSQI) scale. The mental health was assessed via the Hospital Anxiety and Depression Scale (HADS). The correlations of PA and sleep quality with mental health were analyzed using Spearman correlation analysis. Pregnancy outcomes of all subjects, associations of moderate intensity (MI) PA and sleep quality with adverse pregnancy outcomes, and independent influencing factors for adverse outcomes were analyzed. RESULTS Pregnant women in the ST group exhibited higher levels of MI, worse sleep quality, and lower levels of anxiety and depression than those in the FT group. Anxiety and depression were negatively correlated with MI but positively linked with PSQI scores at the first and second trimesters. MI ≥ 7.5 MET-h/week and good sleep quality were associated with a reduced incidence of adverse pregnancy outcomes. CONCLUSION MI ≥ 7.5 MET-h/week and good sleep quality at the first and second trimesters of pregnancy benefit mental health and markedly reduce the occurrence of adverse pregnancy outcomes.
Collapse
Affiliation(s)
- Bin Song
- Department of Gynecology and Obstetrics, First Affiliated Hospital (Army Medical University), No. 30, Gaotanyan Street, Shapingba District, Chongqing, 400038, China
| | - Dan Wang
- Department of Gynecology and Obstetrics, First Affiliated Hospital (Army Medical University), No. 30, Gaotanyan Street, Shapingba District, Chongqing, 400038, China
| | - Xiaoli Yan
- Department of Gynecology and Obstetrics, First Affiliated Hospital (Army Medical University), No. 30, Gaotanyan Street, Shapingba District, Chongqing, 400038, China
| | - Ping Yan
- Department of Gynecology and Obstetrics, First Affiliated Hospital (Army Medical University), No. 30, Gaotanyan Street, Shapingba District, Chongqing, 400038, China
| | - Heying Liu
- Department of Gynecology and Obstetrics, First Affiliated Hospital (Army Medical University), No. 30, Gaotanyan Street, Shapingba District, Chongqing, 400038, China
| | - Hongyu Li
- Department of Gynecology and Obstetrics, First Affiliated Hospital (Army Medical University), No. 30, Gaotanyan Street, Shapingba District, Chongqing, 400038, China.
| | - Shuhua Yi
- Department of Gynecology and Obstetrics, First Affiliated Hospital (Army Medical University), No. 30, Gaotanyan Street, Shapingba District, Chongqing, 400038, China.
| |
Collapse
|
2
|
Hajure M, Alemu SS, Abdu Z, Tesfaye GM, Workneh YA, Dule A, Adem Hussen M, Wedajo LF, Gezimu W. Resilience and mental health among perinatal women: a systematic review. Front Psychiatry 2024; 15:1373083. [PMID: 39104881 PMCID: PMC11298415 DOI: 10.3389/fpsyt.2024.1373083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2024] [Accepted: 06/28/2024] [Indexed: 08/07/2024] Open
Abstract
Objective This review aimed to assess the current evidence on the relationship between resilience and mental health employed in response to the impacts of mental health. Method This review was conducted in accordance with the Preferred Reporting Items for Systematic Review and Meta-analysis (PRISMA). The protocol of this review was registered on the International Prospective Register of Systematic Reviews (PROSPERO: CRD42023470966). Three authors searched peer-reviewed articles using several electronic databases, including Scopus, PubMed/MEDLINE, Psych Info, EMBASE, and Web of Science, from September to October 2023 and included all the studies from any time until November 1, 2023. The review included all eligible quantitative observational and qualitative studies, irrespective of geographical boundaries. Result Depression, anxiety, and post-traumatic stress disorders were found to be the most common, but not the only, mental health disorders during the perinatal period, and higher maternal resilience during perinatal periods was found to reduce mental health disorders. It was also found that pregnant women were more resilient to mental health disorders than postpartum women. Tolerance of uncertainty and a positive cognitive appraisal, women's self-behavior and family functioning, and protective psychosocial resources such as dispositional optimism, parental sense of mastery, self-esteem, gratitude, and forgiveness were found to be the most common mechanisms of resilience among perinatal women. Older age, having an adolescent partner, family income, and distress were found to affect resilience. Conclusion Noting that women's resilience is an important tool to prevent perinatal mental health disorders, maternal healthcare providers need to counsel perinatal women on resilience-boosting mechanisms, such as applying self-behavior and having social support or close family relationships. It is recommended to counsel or provide psychosocial interventions for the woman's companion or partner to give strong support for the woman in each of the perinatal periods. Systematic review registration https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=470966, identifier CRD42023470966.
Collapse
Affiliation(s)
| | | | - Zakir Abdu
- Department of Psychiatry, College of Health Sciences, Mattu University, Mattu, Ethiopia
| | | | | | - Aman Dule
- Department of Psychiatry, College of Health Sciences, Mattu University, Mattu, Ethiopia
| | - Mustefa Adem Hussen
- Department of Midwifery, College of Health Sciences, Mattu University, Mattu, Ethiopia
| | - Lema Fikadu Wedajo
- Department of Midwifery, Institute of Health Sciences, Wollega University, Nekemte, Ethiopia
| | - Wubishet Gezimu
- Department of Nursing, College of Health Sciences, Mattu University, Mattu, Ethiopia
| |
Collapse
|
3
|
Bhamani SS, Van Parys AS, Arthur D, Letourneau N, Wagnild G, Degomme O. Promoting mental wellbeing in pregnant women living in Pakistan with the Safe Motherhood-Accessible Resilience Training (SM-ART) intervention: a randomized controlled trial. BMC Pregnancy Childbirth 2024; 24:452. [PMID: 38951777 PMCID: PMC11218085 DOI: 10.1186/s12884-024-06629-2] [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: 06/23/2023] [Accepted: 06/09/2024] [Indexed: 07/03/2024] Open
Abstract
BACKGROUND The negative impact of adverse perinatal mental health extends beyond the mother and child; therefore, it is essential to make an early intervention for the management of mental illness during pregnancy. Resilience-building interventions are demonstrated to reduce depression and anxiety among expectant mothers, yet research in this field is limited. This study aims to examine the effect of the 'Safe Motherhood-Accessible Resilience Training (SM-ART)' on resilience, marital adjustment, depression, and pregnancy-related anxiety in a sample of pregnant women in Karachi, Pakistan. METHOD In this single-blinded block randomized controlled study, 200 pregnant women were recruited and randomly assigned to either an intervention or a control group using computer-generated randomization and opaque sealed envelopes. The intervention group received the SM-ART intervention consisting of six, weekly sessions ranging from 60 to 90 min. Outcomes (Resilience, depression, pregnancy-related anxiety and marital harmony) were assessed through validated instruments at baseline and after six weeks of both intervention and control groups. RESULTS The results revealed a significant increase in mean resilience scores (Difference:6.91, Effect size: 0.48, p-value < 0.05) and a decrease in depressive symptoms (Difference: -2.12, Effect size: 0.21, p-value < 0.05) in the intervention group compared to the control group. However, no significant change was observed in anxiety and marital adjustment scores. CONCLUSION The SM-ART intervention has the potential to boost resilience scores and decrease depressive symptoms in pregnant women and offers a promising intervention to improve maternal psychological health. TRIAL REGISTRATION NCT04694261, Date of first trial registration: 05/01/2021.
Collapse
Affiliation(s)
| | - An-Sofie Van Parys
- Department of Public Health and Primary Care, Ghent University, Ghent, Belgium
| | - David Arthur
- Bermi Acupuncture & Chinese Medicine Clinic, Bermagui, NSW, Australia
- Peking Union Medical, Beijing, China
| | | | | | - Olivier Degomme
- Department of Public Health and Primary Care, Ghent University, Ghent, Belgium
| |
Collapse
|
4
|
Liu Y, Zhang R, Zhang Z, Zhou L, Cheng B, Liu X, Lv B. Risk factors and predictive model for prenatal depression: A large retrospective study in China. J Affect Disord 2024; 354:1-10. [PMID: 38452936 DOI: 10.1016/j.jad.2024.02.090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Revised: 02/08/2024] [Accepted: 02/26/2024] [Indexed: 03/09/2024]
Abstract
BACKGROUND Prenatal depression, associated with adverse effects on mothers and fetuses, has received little attention. We conducted a large-sample study to investigate the risk factors of, and develop a predictive model for, prenatal depression in the Chinese population. METHODS This study enrolled 14,329 pregnant women who delivered at the West China Second University Hospital, Sichuan University from January 2017 to December 2020. Participants were divided into a training or validation cohort. Multiple variables were collected and selected using univariate logistic regression and least absolute shrinkage and selection operator penalty regression. After multivariate logistic analysis, a predictive model was developed and validated internally and externally. RESULTS Nine variables (employment, planned pregnancy, pregnancy number, conception methods, gestational diabetes mellitus, twin pregnancy, placenta previa, umbilical cord encirclement, and educational attainment) were identified as independent risk factors for prenatal depression. Receiver operating characteristic curves in both the training and validation cohorts showed excellent discrimination of the predictive model (the area under the curve: 0.746 and 0.732, respectively). LIMITATIONS The results of this retrospective study may be affected by confounding and information bias. Some important variables were excluded, such as family history of mental disorders. The study was conducted in China; its results may not be generalizable to other regions. CONCLUSION Our study identified nine significant risk factors for prenatal depression and constructed an accurate predictive model. This model could be applied as a clinical decision aid for individualized risk estimates and prevention of prenatal depression.
Collapse
Affiliation(s)
- Yi Liu
- Department of Gynecology and Obstetrics, West China Second University Hospital, Sichuan University, Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu 610041, Sichuan Province, China; Department of Thoracic Surgery and Institute of Thoracic Oncology, West China Hospital, Sichuan University, Chengdu, China
| | - Ren Zhang
- Department of Gynecology and Obstetrics, West China Second University Hospital, Sichuan University, Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu 610041, Sichuan Province, China; West China School of Medicine, Sichuan University, Chengdu, Sichuan, China
| | - Zhiwei Zhang
- West China School of Medicine, Sichuan University, Chengdu, Sichuan, China
| | - Letao Zhou
- Department of Gynecology and Obstetrics, West China Second University Hospital, Sichuan University, Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu 610041, Sichuan Province, China
| | - Bochao Cheng
- Department of Radiology, West China Second University Hospital, Sichuan University, Chengdu, China
| | - Xinghui Liu
- Department of Gynecology and Obstetrics, West China Second University Hospital, Sichuan University, Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu 610041, Sichuan Province, China
| | - Bin Lv
- Department of Gynecology and Obstetrics, West China Second University Hospital, Sichuan University, Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu 610041, Sichuan Province, China.
| |
Collapse
|
5
|
Wang Y, Gu J, Zhang F, Xu X. Path analysis of influencing factors for maternal antenatal depression in the third trimester. Sci Rep 2024; 14:4742. [PMID: 38413698 PMCID: PMC10899182 DOI: 10.1038/s41598-024-55355-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Accepted: 02/22/2024] [Indexed: 02/29/2024] Open
Abstract
Maternal antenatal depression (AD) is a nonpsychotic depressive episode during pregnancy that can harm both the pregnant woman and the fetus. This study aimed to investigate the intrinsic interrelationships between AD and its influencing factors by constructing a path model. This survey-based cross-sectional study included 1071 pregnant women who underwent pregnancy examinations in three hospitals in Nantong City, China, between February and June 2023. General information and information regarding maternal AD, pregnancy stress, prenatal anxiety, social support, marital satisfaction, sleep quality, and resilience were collected. Multiple linear regression analysis using SPSS 25.0 was employed to determine the factors influencing pregnancy depression, and Amos25.0 was used to construct a structural equation model. AD incidence was 19.4% (208/1071). The independent risk factors affecting AD in pregnant women have been integrated into the established path analysis model. The model demonstrated a good fit (χ2/DF = 1.238, comparative fit index = 0.999, goodness-of-fit index = 0.998, normed fit index = 0.996, adjusted goodness-of-fit index = 0.990, incremental fit index = 0.999, and root mean square error of approximation = 0.015). While prenatal anxiety (0.230) and hyperthyroidism (0.048) only had direct effects on AD, mental resilience was the biggest factor affecting AD, followed by pregnancy stress, marital satisfaction, prenatal anxiety, sleep quality, social support, and hyperthyroidism. Improved mental resilience, social support, sleep quality, and marital satisfaction; reduced pregnancy stress and prenatal anxiety; and effective hyperthyroidism treatment might reduce AD. This study underscored the significance of delivering actionable strategies and tangible assistance to pregnant women to reduce AD.
Collapse
Affiliation(s)
- Yanchi Wang
- Affiliated Nantong Hospital of Shanghai University (The Sixth People's Hospital of Nantong), Nantong, Jiangsu, China
- Medical School of Nantong University, Nantong, Jiangsu, China
- Department of Nursing, Affiliated Hospital of Nantong University, Nantong, 226001, Jiangsu, China
| | - Jian Gu
- Department of Epidemiology and Medical Statistics, School of Public Health, Nantong University, Nantong, Jiangsu, China
| | - Feng Zhang
- Medical School of Nantong University, Nantong, Jiangsu, China.
- Medical School (School of Nursing), Nantong University, Nantong, 226001, Jiangsu, China.
| | - Xujuan Xu
- Department of Nursing, Affiliated Hospital of Nantong University, Nantong, 226001, Jiangsu, China.
| |
Collapse
|
6
|
Ye Y, Liu Z, Pan D, Wu Y. Regression analysis of logistic model with latent variables. Stat Med 2023; 42:860-877. [PMID: 36624549 DOI: 10.1002/sim.9647] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2022] [Revised: 11/15/2022] [Accepted: 12/21/2022] [Indexed: 01/11/2023]
Abstract
We propose a joint modeling approach to investigating the effects of social-psychological factors on the onset of depression. The proposed model comprises two components. The first one is a confirmatory factor analysis model that summarizes latent factors through multiple correlated observed variables. The second one is a logistic regression model that investigates the effects of observed and latent influence factors on the occurrence of depression. We develop a hybrid procedure based on the borrow-strength estimation procedure and the weighted score function to estimate the model parameters. The asymptotic properties of the proposed estimators are established. Simulation studies demonstrate that the method we proposed performs well. An application to a study concerning the social-psychological factors of depression is provided.
Collapse
Affiliation(s)
- Yuan Ye
- School of Mathematics and Statistics, Huazhong University of Science and Technology, Wuhan, China
| | - Zhongchun Liu
- Department of Psychiatry, Renmin Hospital of Wuhan University, Wuhan, China
| | - Deng Pan
- School of Mathematics and Statistics, Huazhong University of Science and Technology, Wuhan, China
| | - Yuanshan Wu
- School of Statistics and Mathematics, Zhongnan University of Economics and Law, Wuhan, China
| |
Collapse
|
7
|
Han X, Cao M, He J, Xu D, Liang Y, Lang X, Guan R. A comprehensive psychological tendency prediction model for pregnant women based on questionnaires. Sci Rep 2023; 13:2. [PMID: 36593288 PMCID: PMC9807629 DOI: 10.1038/s41598-022-26977-3] [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: 10/05/2021] [Accepted: 12/22/2022] [Indexed: 01/04/2023] Open
Abstract
More and more people are under high pressure in modern society, leading to growing mental disorders, such as antenatal depression for pregnant women. Antenatal depression can affect pregnant woman's physical and psychological health and child outcomes, and cause postpartum depression. Therefore, it is essential to detect the antenatal depression of pregnant women early. This study aims to predict pregnant women's antenatal depression and identify factors that may lead to antenatal depression. First, a questionnaire was designed, based on the daily life of pregnant women. The survey was conducted on pregnant women in a hospital, where 5666 pregnant women participated. As the collected data is unbalanced and has high dimensions, we developed a one-class classifier named Stacked Auto Encoder Support Vector Data Description (SAE-SVDD) to distinguish depressed pregnant women from normal ones. To validate the method, SAE-SVDD was firstly applied on three benchmark datasets. The results showed that SAE-SVDD was effective, with its F-scores better than other popular classifiers. For the antenatal depression problem, the F-score of SAE- SVDD was higher than 0.87, demonstrating that the questionnaire is informative and the classification method is successful. Then, by an improved Term Frequency-Inverse Document Frequency (TF-IDF) analysis, the critical factors of antenatal depression were identified as work stress, marital status, husband support, passive smoking, and alcohol consumption. With its generalizability, SAE-SVDD can be applied to analyze other questionnaires.
Collapse
Affiliation(s)
- Xiaosong Han
- grid.64924.3d0000 0004 1760 5735Key Laboratory for Symbol Computation and Knowledge Engineering of National Education Ministry, College of Computer Science and Technology, Jilin University, Changchun, 130012 China
| | - Mengchen Cao
- grid.64924.3d0000 0004 1760 5735Key Laboratory for Symbol Computation and Knowledge Engineering of National Education Ministry, College of Computer Science and Technology, Jilin University, Changchun, 130012 China
| | - Junru He
- grid.64924.3d0000 0004 1760 5735Key Laboratory for Symbol Computation and Knowledge Engineering of National Education Ministry, College of Computer Science and Technology, Jilin University, Changchun, 130012 China
| | - Dong Xu
- grid.134936.a0000 0001 2162 3504Department of Electrical Engineering and Computer Science and Christopher S. Bond Life Sciences Center, University of Missouri, Columbia, MO 65211 USA
| | - Yanchun Liang
- grid.64924.3d0000 0004 1760 5735Key Laboratory for Symbol Computation and Knowledge Engineering of National Education Ministry, College of Computer Science and Technology, Jilin University, Changchun, 130012 China ,Zhuhai Laboratory of Key Laboratory for Symbol Computation and Knowledge Engineering of Ministry of Education, Zhuhai College of Science and Technology, Zhuhai, 519041 China
| | - Xiaoduo Lang
- Jilin Provincial Institute of Population Science and Technology, Changchun, 130000 China
| | - Renchu Guan
- grid.64924.3d0000 0004 1760 5735Key Laboratory for Symbol Computation and Knowledge Engineering of National Education Ministry, College of Computer Science and Technology, Jilin University, Changchun, 130012 China
| |
Collapse
|
8
|
The prevalence and associated factors of prenatal depression and anxiety in twin pregnancy: a cross-sectional study in Chongqing, China. BMC Pregnancy Childbirth 2022; 22:877. [DOI: 10.1186/s12884-022-05203-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Accepted: 11/09/2022] [Indexed: 11/28/2022] Open
Abstract
Abstract
Background
Pregnant women expecting twins are more likely to experience stress, which can lead to anxiety and depression. Our aim was to investigate the prevalence of prenatal anxiety and depressive symptoms in women with twin pregnancies and the associated factors.
Methods
In a cross-sectional survey, 210 women with twin pregnancies who satisfied the inclusion and exclusion criteria in two tertiary centers in Southwestern China were asked to complete a basic information form, the Self-Rating Anxiety Scale (SAS) and the Self-Rating Depression Scale (SDS). To compare statistics with normal distribution in distinct characteristic groups, a paired t-test, and one-way ANOVA were utilized. Binary logistic step regression was used to analyze the associated factors of antenatal anxiety and depressive symptoms.
Results
The 210 women with twin pregnancies (age = 30.8 ± 4.2 years) were between 7 and 37 gestational weeks (29.2 ± 1.2 weeks), were typically well-educated (72.4% had a post-high-school degree), and reasonably affluent (88.1% were above the low-income cutoff). Among them, 34.8% had symptoms associated with clinical levels of anxiety, and 37.1% had symptoms indicating possible depression. The prevalence of co-morbid anxiety and depressive symptoms was 24.3%. Binary stepwise logistic regression analysis showed that previous health status and sleep disturbance during pregnancy were the associated factors of anxiety symptoms in women with twin pregnancies (P < 0.05), whereas age, previous health status, negative life events, and physical activity during pregnancy were the associated factors of depressive symptoms in women with twin pregnancies (P < 0.05).
Conclusion
About one-third of women with twin pregnancies had symptoms of anxiety or depression; these were most strongly predicted by some modifiable factors, suggesting that early preventive mind-body interventions may be a promising strategy to protect against mental health issues for women with twin pregnancies.
Collapse
|
9
|
Bhamani SS, Arthur D, Van Parys AS, Letourneau N, Wagnild G, Premji SS, Asad N, Degomme O. Resilience and prenatal mental health in Pakistan: a qualitative inquiry. BMC Pregnancy Childbirth 2022; 22:839. [PMID: 36376896 PMCID: PMC9664804 DOI: 10.1186/s12884-022-05176-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2022] [Accepted: 11/02/2022] [Indexed: 11/16/2022] Open
Abstract
Background Women in Pakistan suffer from a high rate of depression. The stress of low-income, illiteracy, exposure to violence and living in a patriarchal society are predisposing vulnerabilities for depression, particularly during and following pregnancy. The resilience of an individual plays a significant role in promoting prenatal mental health, but this has yet to be thoroughly researched. In this article, our objective is to identify the core characteristics of resilience among pregnant women, which will then help us in developing an intervention. Methods The exploratory-descriptive study was conducted over 6 months in five different antenatal hospitals in Sindh, Pakistan. A total of 17 semi-structured interviews were conducted with pregnant women, purposefully selected with heterogeneous characteristics to explore diverse perspectives, while symptoms of depression were quantified by the Edinburgh Postnatal Depression Scale before the interview. Verbatim transcriptions were coded openly and merged into categories and themes. Result A total of six themes emerged from in-depth thematic analysis: 1) purpose of life, 2) dealing with emotions, 3) believing in yourself, 4) optimistic approach, 5) strengthening support and relationship and 6) spirituality and humanity. Women agreed that these characteristics could help them improve their mental health. Conclusion In conclusion, these themes were the core components of pregnant women’s resilience which ultimately could help to promote prenatal mental health. These pave a pathway towards developing culturally and contextually resilience interventions aimed at enhancing mental health of pregnant women which then may improve neonatal and family mental wellbeing.
Collapse
|
10
|
Cevik A, Onat Koroglu C, Karacam Z, Gokyildiz Surucu S, Alan S. Effects of the Covid-19 Pandemic on the Prevalence of Insomnia, Anxiety, and Depression During Pregnancy: A Systematic Review and Meta-Analysis. Clin Nurs Res 2022; 31:1405-1421. [PMID: 35912813 DOI: 10.1177/10547738221112748] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
This systematic review and meta-analysis study aims to determine the effects of the Covid-19 pandemic on the prevalence of insomnia, anxiety, and depression symptoms during pregnancy. Reviews were done through PubMed, EBSCO (Medline, CINAHL), Embase (OVID), Web of Science, PsycINFO, TR Index, Turkish Thesis Center databases using (pregnancy OR pregnant) and (sleep OR sleep disorders OR insomnia), and (anxiety OR depression) keywords between April and May 2021. The meta-analysis included 48 articles (sample: 77,299). It was found that the Covid-19 pandemic did not affect the prevalence of depression symptoms and anxiety during pregnancy, but it increased insomnia. While insomnia ratio was reported 39.6% (95% CI: 0.253-0.560) in the studies conducted before the pandemic, it was reported 88.8% (95% CI: 0.821-0.921) in the studies conducted during the pandemic. This study found that the Covid-19 pandemic did not have effects on depression symptoms and anxiety, but it increased insomnia complaints.
Collapse
|
11
|
Studniczek A, Kossakowska K. Experiencing Pregnancy during the COVID-19 Lockdown in Poland: A Cross-Sectional Study of the Mediating Effect of Resiliency on Prenatal Depression Symptoms. Behav Sci (Basel) 2022; 12:bs12100371. [PMID: 36285940 PMCID: PMC9598781 DOI: 10.3390/bs12100371] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2022] [Revised: 09/09/2022] [Accepted: 09/19/2022] [Indexed: 11/28/2022] Open
Abstract
The COVID-19 pandemic in Poland brought uncertainty, not only to the general population but also to women preparing for childbirth, which increased the risk of mental health illnesses during this special period of life. Resilience, which refers to positive adaptation or the ability to maintain good mental health, can be a protective factor against the development of psychiatric problems such as depressive symptoms. This study aimed to assess the protective role of resilience in the relationship of such risk factors as traumatic childbirth perception and pandemic-related pregnancy stress with prenatal depressive symptoms. The study was performed at the end of the first wave of the COVID-19 pandemic. A total of 80 pregnant women took part. A mediation analysis, an independent t-test, and a Pearson correlation analysis were conducted. The lower resilience group declared the inclusion of slightly more participants (n = 41; 51.2%); 39 women (48.8%) demonstrated a higher risk of prenatal depression. The analysis revealed a significant direct effect between pandemic-related stress and prenatal depression (βc = 0.285, SE = 0.05, t = 2.63, p < 0.05) as well as between pandemic-related stress and resilience (βa = −0.283, SE = 0.07, t = −2.61, p < 0.05) and between resilience and prenatal depression (βb = −0.585, SE = 0.07, t = −6.34, p < 0.001). After the introduction of resilience as a mediator, the strength of the relationship not only decreased, but also ceased to be statistically significant (βc′ = 0.120, SE = 0.04, t = 1.29, p = 0.19), which indicates that it was in a full mediation state (R2 = 0.39, F = 25.31, p < 0.001; Z = 2.43, p < 0.05). The results indicate that in pregnant women, a high level of resilience protects them from the effects of pandemic-related stress on perinatal depression symptoms.
Collapse
Affiliation(s)
- Anna Studniczek
- Expert’s Antenatal School, St. Family’s Maternity Hospital in Warsaw, 02-544 Warsaw, Poland
| | - Karolina Kossakowska
- Department of Clinical Psychology and Psychopathology, Institute of Psychology, Faculty of Educational Sciences, University of Lodz, Rodziny Scheiblerów Avenue 2, 90-128 Lodz, Poland
- Correspondence: ; Tel.: +48-426655581
| |
Collapse
|
12
|
Imran A, Tariq S, Kapczinski F, de Azevedo Cardoso T. Psychological resilience and mood disorders: a systematic review and meta-analysis. TRENDS IN PSYCHIATRY AND PSYCHOTHERAPY 2022; 46:e20220524. [PMID: 36215270 PMCID: PMC11332678 DOI: 10.47626/2237-6089-2022-0524] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Accepted: 09/20/2022] [Indexed: 06/16/2023]
Abstract
OBJECTIVE This systematic review aims to describe the relationship between psychological resilience and mood disorders. METHODS This is a systematic review and meta-analysis. The following databases were searched on November 6, 2020: PubMed, PsycINFO, and Embase. RESULTS Twenty-three articles were included and the majority of the studies included (95.7%) showed that psychological resilience has a positive impact in mood disorders. Our meta-analysis showed that individuals with bipolar disorder presented significantly lower levels of psychological resilience compared to controls (standardized mean difference [SDM]: -0.99 [95% confidence interval {95%CI}: -1.13 to -0.85], p < 0.001). In addition, individuals with depression had significantly lower levels of psychological resilience compared to controls (SDM: -0.71 [95%CI -0.81 to -0.61], p < 0.001). CONCLUSION Our results showed that individuals with mood disorders are less resilient than individuals without mood disorders. Our findings reinforce the importance of investigating interventions that may help to improve psychological resilience considering its positive impact in the context of mood disorders.
Collapse
Affiliation(s)
- Areeba Imran
- Life Sciences ProgramSchool of Interdisciplinary ScienceMcMaster UniversityHamiltonONCanada Life Sciences Program, School of Interdisciplinary Science, McMaster University, Hamilton, ON, Canada.
| | - Suleman Tariq
- Health Sciences ProgramFaculty of Health SciencesMcMaster UniversityHamiltonONCanada Health Sciences Program, Faculty of Health Sciences, McMaster University, Hamilton, ON, Canada.
| | - Flavio Kapczinski
- Department of Psychiatry and Behavioural NeurosciencesMcMaster UniversityHamiltonONCanada Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada.
- Instituto Nacional de Ciência e Tecnologia Translacional em MedicinaPorto AlegreRSBrazil Instituto Nacional de Ciência e Tecnologia Translacional em Medicina (INCT-TM), Porto Alegre, RS, Brazil.
- Laboratório de Psiquiatria MolecularHospital de Clínicas de Porto AlegrePorto AlegreRSBrazil Laboratório de Psiquiatria Molecular, Hospital de Clínicas de Porto Alegre, Porto Alegre, RS, Brazil.
- Departamento de PsiquiatriaUniversidade Federal do Rio Grande do SulPorto AlegreRSBrazil Departamento de Psiquiatria, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil.
| | - Taiane de Azevedo Cardoso
- Life Sciences ProgramSchool of Interdisciplinary ScienceMcMaster UniversityHamiltonONCanada Life Sciences Program, School of Interdisciplinary Science, McMaster University, Hamilton, ON, Canada.
- Department of Psychiatry and Behavioural NeurosciencesMcMaster UniversityHamiltonONCanada Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada.
| |
Collapse
|
13
|
Zeng K, Li Y, Yang R. The mediation role of psychological capital between family relationship and antenatal depressive symptoms among women with advanced maternal age: a cross sectional study. BMC Pregnancy Childbirth 2022; 22:488. [PMID: 35701762 PMCID: PMC9195371 DOI: 10.1186/s12884-022-04811-y] [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: 09/03/2021] [Accepted: 06/03/2022] [Indexed: 11/27/2022] Open
Abstract
Background Due to changes in family policy in China, pregnancy at advanced age (30 years old or above) is prevalent. Advanced maternal age is known to be related to a variety of negative health outcomes, including antenatal depression. Family relationship quality might be an important factor for antenatal depressive symptoms among Chinese women with advanced maternal age. However, the underlying mechanisms in which family relationship quality can affect antenatal depressive symptoms among this population and how positive psychological capital (PsyCap) intervenes in this impact are not clear. Objectives To describe the prevalence and demographic characteristics of antenatal depressive symptoms among Chinese pregnant women with advanced maternal age, and to explore the mediation effect of PsyCap in the associations between family relationship quality and antenatal depressive symptoms. Methods We conducted a cross-sectional survey at a tertiary hospital in China. A total of 192 women with maternal age of 30 years or older completed the questionnaires. Data on antenatal depressive symptoms, PsyCap, family relationship quality and demographic characteristics were collected. The multiple mediation models in SPSS’s PROCESS macro were used to test whether PsyCap mediated the relationship between family relationship quality and antenatal depressive symptoms. Results Approximately 28.6% of participants had antenatal depressive symptoms and 6.8% reported poor family relationship quality. Participants with higher education (p = .02) and better family relationship quality (p = .00) were less likely to have antenatal depressive symptoms. PsyCap collectively (β = 1.14, p < .05), or more specifically resilience (β = 0.61, p < .05) significantly mediated the relationship between poor family relationship quality and antenatal depressive symptoms. Discussion The relationship between family relationship quality and antenatal depressive symptoms can be mediated by PsyCap collectively or via resilience specifically. It is important to screen antenatal depressive symptoms among pregnant women with advanced age, especially those who have poor family relationship quality. Counseling and psychotherapy initiatives for resilience-enhancing training for pregnant women at advanced age may provide a promising target to break the link between poor family relationship quality and antenatal depressive symptoms.
Collapse
Affiliation(s)
- Kai Zeng
- School of Nursing, Southern Medical University, Baiyun District, Shatai South Road, Guangzhou, No.1023-1063, Guangdong, China
| | - Yang Li
- University of Texas at Austin School of Nursing, #3.446; 1710 Red River St, Austin, TX, 78712, USA
| | - Rumei Yang
- School of Nursing, Nanjing Medical University, No.818, Tianyun Road, Jiangning District, Nanjing, Jiangsu, China.
| |
Collapse
|
14
|
Gui Y, Deng Y, Sun X, Li W, Rong T, Wang X, Jiang Y, Zhu Q, Liu J, Wang G, Jiang F. Early childhood sleep trajectories and association with maternal depression: a prospective cohort study. Sleep 2022; 45:zsac037. [PMID: 35554573 DOI: 10.1093/sleep/zsac037] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2021] [Revised: 01/12/2022] [Indexed: 09/21/2023] Open
Abstract
STUDY OBJECTIVES To investigate trajectories of early childhood sleep in the first 3 years and their association with maternal depressive symptoms. METHODS Data were from 243 Chinese mother-child dyads. Children's sleep duration and night-waking were assessed using the Brief Infant Sleep Questionnaire (BISQ) at 42 days, 3, 6, 9, 12, 18, 24, and 36 months postpartum. The Center for Epidemiological Survey-Depression Scale (CES-D), Edinburgh Postnatal Depression Scale (EPDS), and Profile of Mood States (POMS) were used to assess maternal depressive symptoms at late pregnancy, 42 days, and 36 months postpartum, respectively. Early childhood sleep trajectories were estimated with group-based trajectory models. The association between early childhood sleep trajectories and maternal depressive symptoms was examined with binary and multinomial logistic regression models and linear regression models. RESULTS Three trajectories of daytime sleep duration ("short", 14.4%; "medium", 60.4%; "long", 25.2%), nighttime sleep duration ("increasing", 17.6%; "stable", 76.3%; "decreasing", 6.1%), and total sleep duration ("short", 21.5%; "medium", 59.9%; "long",18.6%), and two trajectories of night-waking ("resolving", 22.9%; "persistent", 77.1%) were identified. Controlling for confounding factors, maternal depression at 42 days postpartum was associated with higher risks for short daytime sleep duration and persistent night-waking in children. Persistent night-waking in children was associated with increased maternal depressive symptoms at 36 months postpartum. CONCLUSION Early childhood sleep follows distinct trajectories in the first 3 years of life. The trajectories of short daytime sleep duration and persistent night-waking are associated with maternal depression. The findings indicate tailored interventions should target both unfavorable early childhood sleep trajectories and maternal depression.
Collapse
Affiliation(s)
- Yiding Gui
- Pediatric Translational Medicine Institution, Shanghai Children's Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
- Department of Developmental and Behavioral Pediatrics, Shanghai Children's Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
- MOE-Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
- Shanghai Center for Brain Science and Brain-Inspired Technology, Shanghai, China
| | - Yujiao Deng
- Pediatric Translational Medicine Institution, Shanghai Children's Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
- Department of Developmental and Behavioral Pediatrics, Shanghai Children's Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
- MOE-Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
- Shanghai Center for Brain Science and Brain-Inspired Technology, Shanghai, China
| | - Xiaoning Sun
- Pediatric Translational Medicine Institution, Shanghai Children's Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
- Department of Developmental and Behavioral Pediatrics, Shanghai Children's Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
- MOE-Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
- Shanghai Center for Brain Science and Brain-Inspired Technology, Shanghai, China
| | - Wen Li
- Department of Pediatrics, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Tingyu Rong
- Pediatric Translational Medicine Institution, Shanghai Children's Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
- Department of Developmental and Behavioral Pediatrics, Shanghai Children's Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
- MOE-Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
- Shanghai Center for Brain Science and Brain-Inspired Technology, Shanghai, China
| | - Xuelai Wang
- Department of Developmental and Behavioral Pediatrics, Shanghai Children's Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Yanrui Jiang
- Pediatric Translational Medicine Institution, Shanghai Children's Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
- Department of Developmental and Behavioral Pediatrics, Shanghai Children's Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
- MOE-Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Qi Zhu
- Pediatric Translational Medicine Institution, Shanghai Children's Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
- Department of Developmental and Behavioral Pediatrics, Shanghai Children's Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
- MOE-Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Jianghong Liu
- Department of Family and Community Health, University of Pennsylvania, School of Nursing, Philadelphia, PA, USA
| | - Guanghai Wang
- Pediatric Translational Medicine Institution, Shanghai Children's Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
- Department of Developmental and Behavioral Pediatrics, Shanghai Children's Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
- MOE-Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
- Shanghai Center for Brain Science and Brain-Inspired Technology, Shanghai, China
| | - Fan Jiang
- Pediatric Translational Medicine Institution, Shanghai Children's Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
- Department of Developmental and Behavioral Pediatrics, Shanghai Children's Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
- MOE-Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
- Shanghai Center for Brain Science and Brain-Inspired Technology, Shanghai, China
| |
Collapse
|
15
|
Pathways from Neuroticism, Social Support, and Sleep Quality to Antenatal Depression during the Third Trimester of Pregnancy. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19095602. [PMID: 35565028 PMCID: PMC9100278 DOI: 10.3390/ijerph19095602] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Revised: 04/26/2022] [Accepted: 04/29/2022] [Indexed: 02/04/2023]
Abstract
Background: Antenatal depression is a severe public health problem. Many studies support the concept that neuroticism, social support, and sleep quality are closely related to antenatal depression. However, there is little evidence concerning the influencing pathways of these variables on antenatal depression. The aim of this study is to investigate the pathways from neuroticism, social support, and sleep quality to antenatal depression during the third trimester of pregnancy. Methods: A cross-sectional study design was used. A total of 773 eligible women in the third trimester of pregnancy submitted valid questionnaires from June 2016 to April 2017. Instruments with good reliability and validity were used to measure neuroticism, social support, sleep quality, and antenatal depression. Structural equation modeling was used to explore the pathways from neuroticism, social support, and sleep quality to antenatal depression during the third trimester of pregnancy. Results: Antenatal depression is shown to be positively correlated with neuroticism and negatively correlated with social support and sleep quality. Neuroticism is shown to have a direct effect and indirect effects through social support and sleep quality on antenatal depression. Conclusions: Neuroticism influences antenatal depression directly and indirectly. Social support and sleep quality are the mediators of the indirect relationship between neuroticism and antenatal depression. Our results suggest that a personality test offered to all pregnant women could help detect a vulnerability to depression, whereupon intervention in the domains of sleep and social support could prove preventive.
Collapse
|
16
|
Holland C, Richmond MM. Advocating for Interventions When Depression Complicates Preeclampsia. Nurs Womens Health 2022; 26:152-160. [PMID: 35189119 DOI: 10.1016/j.nwh.2022.01.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2021] [Revised: 12/15/2021] [Accepted: 12/23/2021] [Indexed: 06/14/2023]
Abstract
Preeclampsia is a condition of pregnancy that is associated with high morbidity and mortality rates. Individuals diagnosed with preeclampsia have an increased chance of developing depression during pregnancy and in the postpartum period. This ultimately increases the risk for negative physical and emotional outcomes. A review of the etiology, pathophysiology, symptomatology, and risk factors for preeclampsia and depression, as well as the impact of COVID-19, can improve outcomes by helping nurses provide evidence-based holistic care. This article focuses on providing enhanced knowledge to help nurses identify the psychosocial aspects of preeclampsia and advocate for appropriate mental health assessment and intervention for affected individuals.
Collapse
|
17
|
Mei X, Mei R, Liu Y, Wang X, Chen Q, Lei Y, Ye Z. Associations among fear of childbirth, resilience and psychological distress in pregnant women: A response surface analysis and moderated mediation model. Front Psychiatry 2022; 13:1091042. [PMID: 36590638 PMCID: PMC9797834 DOI: 10.3389/fpsyt.2022.1091042] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/06/2022] [Accepted: 11/28/2022] [Indexed: 12/23/2022] Open
Abstract
INTRODUCTION Prenatal psychological distress is prevalent during pregnancy. This study aimed to estimate the associations among fear of childbirth, resilience and psychological distress. METHODS A total of 1,060 Chinese pregnant women were enrolled from Be Resilient to Postpartum Depression (ChiCTR2100048465) and the following instruments were administered to them: Childbirth Attitudes Questionnaire, Connor-Davidson Resilience Scale, Perceived Social Support Scale, General Self-Efficacy Scale, Adverse Childhood Experience scale and Hospital Anxiety and Depression Scale. A dominance, a response surface analysis and a moderated mediation analysis were performed. RESULTS In terms of psychological distress, resilience and fear of childbirth could explain 41.6% (0.148/0.356) and 33.1% (0.118/0.356), respectively. Pregnant women with high resilience-low fear of childbirth had significantly lower levels of psychological distress than those with low resilience-high fear of childbirth. The indirect effects of fear of childbirth on psychological distress through resilience was significantly (B = 0.054, 95% CI 0.038 to 0.070). The interactions between fear of childbirth and adverse childhood experiences (β = 0.114, 95% CI -0.002 to 0.231, p = 0.054) and between resilience and adverse childhood experiences (β = -0.118, 95% CI -0.222 to -0.012, p < 0.05) were significant. CONCLUSION Resilience, fear of childbirth and adverse childhood experiences may be three important factors to psychological distress in Chinese pregnant women.
Collapse
Affiliation(s)
- Xiaoxiao Mei
- School of Nursing, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China
| | - Ranran Mei
- Affiliated Cancer Hospital and Institute of Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Yuling Liu
- The First Affiliated Hospital, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China
| | - Xinqin Wang
- School of Nursing, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China
| | - Qianwen Chen
- School of Nursing, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China
| | - Youjin Lei
- The First Affiliated Hospital, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China
| | - Zengjie Ye
- School of Nursing, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China
| |
Collapse
|
18
|
Chen Y, Gu H, Zhou N, Zhou W, Cao J, Chen Q, Zhang H. Pre-pregnancy BMI was associated with gestational depressive phenotypes in a population of 12,099 women in Chongqing, China. Front Endocrinol (Lausanne) 2022; 13:1058160. [PMID: 36704036 PMCID: PMC9871462 DOI: 10.3389/fendo.2022.1058160] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Accepted: 12/15/2022] [Indexed: 01/11/2023] Open
Abstract
OBJECTIVE To investigate the association between pre-pregnancy body mass index (BMI) and gestational depressive phenotypes. METHODS The pregnant women receiving the first prenatal examination (4th -13th week of gestation) in Chongqing Health Center for Women and Children were recruited between February 2020 and September 2021. Depressive phenotypes was assessed by the Patient Health Questionnaire (PHQ-9) and the Symptom Checklist 90 (SCL-90) scale at recruitment. Pre-pregnancy weight and height were self-reported by the participants. Demographic and obstetric characteristics were obtained from the hospital information system. The association between pre-pregnancy BMI and the scores of PHQ-9 or SCL-90 scale was investigated by uni-variate analysis with Kruskal-Wallis test and by multi-variate analysis with linear regression model with adjustment of age, parity, smoking, alcohol consumption, and assisted reproduction. The association between pre-pregnancy BMI and PHQ-9 or SCL-90 diagnosed depressive phenotypes was analyzed by Chi-square test and logistic regression respectively. RESULTS A total of 12,099 pregnant women were included, where 100% of them filled out the PHQ-9 scale and 99.6% filled out the SCL-90 scale, and 47.26% and 4.62% of the pregnant women had depressive phenotypes, respectively. Women with higher pre-pregnancy BMI had lower depressive phenotypes scores during pregnancy. Multivariable analysis of the PHQ-9 scale showed that overweight/obese subjects had a higher incidence of depressive phenotypes compared with subjects with normal BMI (OR=0.803, 95% CI [0.723, 0.892]). In a stratified analysis assessed by the PHQ-9, women who were overweight/obese prior to pregnancy were less likely to develop depressive phenotypes during pregnancy than women who were normal weight prior to pregnancy, regardless of whether they were nulliparous (OR=0.795, 95%CI[0.696,0.908]) or multiparous (OR=0.809, 95%CI[0.0.681,0.962]), while in the three age groups of 25-29 years, 30-34 years and ≥35 years, pre-pregnancy overweight/obesity were associated with lower risk of gestational depressive phenotypes. However, analysis of the SCL-90 scale showed no statistical association between depressive symptom and BMI. No substantial interaction was observed between BMI and parity or age. CONCLUSIONS Increased pre-pregnancy BMI may be associated with reduced risk of gestational depressive phenotypes in Chinese women. Independent studies are warranted to validate the findings of the present study.
Collapse
Affiliation(s)
- Yi Chen
- Key Lab of Medical Protection for Electromagnetic Radiation, Ministry of Education of China, Institute of Toxicology, College of Preventive Medicine, Third Military Medical University (Army Medical University), Chongqing, China
- School of Public Health, Guizhou Medical University, Guiyang, China
| | - Huayan Gu
- Department of Obstetrics and Gynecology, Women and Children’s Hospital of Chongqing Medical University, Chongqing Health Center for Women and Children, Chongqing, China
| | - Niya Zhou
- Department of Clinical Research Center, Women and Children’s Hospital of Chongqing Medical University, Chongqing Health Center for Women and Children, Chongqing, China
| | - Wenzheng Zhou
- Department of Quality Management, Women and Children’s Hospital of Chongqing Medical University, Chongqing Health Center for Women and Children, Chongqing, China
| | - Jia Cao
- Key Lab of Medical Protection for Electromagnetic Radiation, Ministry of Education of China, Institute of Toxicology, College of Preventive Medicine, Third Military Medical University (Army Medical University), Chongqing, China
| | - Qing Chen
- Key Lab of Medical Protection for Electromagnetic Radiation, Ministry of Education of China, Institute of Toxicology, College of Preventive Medicine, Third Military Medical University (Army Medical University), Chongqing, China
- *Correspondence: Qing Chen, ; Haiyan Zhang,
| | - Haiyan Zhang
- Department of Obstetrics and Gynecology, Women and Children’s Hospital of Chongqing Medical University, Chongqing Health Center for Women and Children, Chongqing, China
- *Correspondence: Qing Chen, ; Haiyan Zhang,
| |
Collapse
|
19
|
The prevalence and predictors of fear of childbirth among pregnant Chinese women: a hierarchical regression analysis. BMC Pregnancy Childbirth 2021; 21:643. [PMID: 34551755 PMCID: PMC8456556 DOI: 10.1186/s12884-021-04123-7] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2021] [Accepted: 09/15/2021] [Indexed: 12/20/2022] Open
Abstract
Background Fear of childbirth (FOC) occurs before, during and after pregnancy and is harmful to both the pregnant woman and the fetus. Identifying the prevalence and predictors of FOC can help us generate strategies for alleviating women’s FOC. Methods A cross-sectional study was conducted among a convenience sample of 646 pregnant women receiving antenatal care at a subordinate hospital of a university in China. Data were collected using a basic information form, the Childbirth Attitude Questionnaire, the Childbirth Self-Efficacy Inventory, and the 10-item Connor-Davidson Resilience Scale. The minimum and maximum total scores of the Childbirth Attitude Questionnaire are 16 and 64, respectively, with higher scores reflecting a greater degree of FOC. We conducted hierarchical regression analysis to explore the predictors of FOC and used a structural equation model to further examine the direct and indirect associations between FOC, resilience and childbirth self-efficacy. Results The total prevalence of FOC was 67.1%. The percentages of women with mild (score of 28–39), moderate (40–51), and severe FOC (52–64) were 45.4, 19.5, and 2.2%, respectively. The average score on the Childbirth Attitude Questionnaire was 32.49, indicating mild FOC. The final regression analysis revealed six variables predicting FOC that explained 64.5% of the variance in FOC: age, gestational age, parity, spousal support, resilience, and childbirth self-efficacy. Furthermore, childbirth self-efficacy mediated the relationship between resilience and FOC, and the mediation effect rate was 53.5%. Conclusions A high prevalence of FOC among pregnant Chinese women was found in this study. Age, gestational age, parity, spousal support, resilience, and childbirth self-efficacy were predictors of FOC. It is suggested that healthcare professionals should pay close attention to FOC and implement targeted interventions in accordance with these predictors, especially resilience and childbirth self-efficacy.
Collapse
|
20
|
Ma R, Yang F, Zhang L, Sznajder KK, Zou C, Jia Y, Cui C, Zhang W, Zhang W, Zou N, Yang X. Resilience mediates the effect of self-efficacy on symptoms of prenatal anxiety among pregnant women: a nationwide smartphone cross-sectional study in China. BMC Pregnancy Childbirth 2021; 21:430. [PMID: 34140012 PMCID: PMC8212491 DOI: 10.1186/s12884-021-03911-5] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2020] [Accepted: 05/24/2021] [Indexed: 11/24/2022] Open
Abstract
Background Prenatal anxiety is one of the most prevalent mental disorders during pregnancy. This study assessed the prevalence of prenatal anxiety and examined whether resilience could play the mediating role in the association between self-efficacy and symptoms of prenatal anxiety among pregnant women in China. Methods A nationwide smartphone cross-sectional study was carried out in three cities (Shenyang of Liaoning Province, Zhengzhou of Henan Province and Chongqing Municipality) in China from July 2018 to July 2019. The questionnaire consisted of questions on demographic characteristics, the Generalized Anxiety Disorder Scale (GAD-7), the Chinese version of General Self-efficacy Scale (GSES), and the 14-item Wagnild and Young Resilience Scale (RS-14). A total of 665 pregnant women were recruited in this study. A hierarchical multiple regression model was employed to explore the associate factors and mediators of symptoms of prenatal anxiety. A structural equation model was employed to test the hypothesis that resilience mediates the association between self-efficacy and symptoms of prenatal anxiety. Results The prevalence of symptoms of prenatal anxiety was 36.4% in this study. Self-efficacy was negatively correlated with symptoms of prenatal anxiety (r = -0.366, P < 0.01). Resilience had a significant positive correlation with self-efficacy (r = 0.612, P < 0.01) and had a negative correlation with symptoms of prenatal anxiety (r = -0.427, P < 0.01). The hierarchical multiple regression model indicated that self-efficacy and resilience were the main factors associated with symptoms of prenatal anxiety and contributed to 11.9% and 6.3% to the variance of symptoms of prenatal anxiety, respectively. Resilience served as a mediator between self-efficacy and symptoms of prenatal anxiety (a*b = -0.198, Bias-corrected and accelerated bootstrap 95% Confidence interval: -0.270, -0.126). Conclusions Self-efficacy was a negative predictor of symptoms of prenatal anxiety among pregnant women. Moreover, resilience mediated the relation between self-efficacy and symptoms of prenatal anxiety among pregnant women in China. It was observed in this study that psychological interventions might be beneficial for pregnant women to relieve symptoms of prenatal anxiety through improved self-efficacy and resilience. Supplementary Information The online version contains supplementary material available at 10.1186/s12884-021-03911-5.
Collapse
Affiliation(s)
- Ruqing Ma
- Department of Social Medicine, School of Public Health, China Medical University, No.77 Puhe Road, Shenyang North New Area, Shenyang, Liaoning Province, China
| | - Fengzhi Yang
- Department of Social Medicine, School of Public Health, China Medical University, No.77 Puhe Road, Shenyang North New Area, Shenyang, Liaoning Province, China
| | - Lijuan Zhang
- Department of Obstetrics and Gynecology, Shengjing Hospital of China Medical University, Shenyang, Liaoning Province, China
| | - Kristin K Sznajder
- Department of Public Health Sciences, College of Medicine, Pennsylvania State University, Hershey, PA, USA
| | - Changqing Zou
- Department of Humanities and Social Sciences, China Medical University, Shenyang, Liaoning Province, China
| | - Yajing Jia
- Department of Social Medicine, School of Public Health, China Medical University, No.77 Puhe Road, Shenyang North New Area, Shenyang, Liaoning Province, China
| | - Can Cui
- Department of Social Medicine, School of Public Health, China Medical University, No.77 Puhe Road, Shenyang North New Area, Shenyang, Liaoning Province, China
| | - Weiyu Zhang
- Department of Social Medicine, School of Public Health, China Medical University, No.77 Puhe Road, Shenyang North New Area, Shenyang, Liaoning Province, China
| | - Wenzhu Zhang
- Department of Obstetrics and Gynecology, Shengjing Hospital of China Medical University, Shenyang, Liaoning Province, China
| | - Ning Zou
- Department of Obstetrics and Gynecology, Shengjing Hospital of China Medical University, Shenyang, Liaoning Province, China
| | - Xiaoshi Yang
- Department of Social Medicine, School of Public Health, China Medical University, No.77 Puhe Road, Shenyang North New Area, Shenyang, Liaoning Province, China.
| |
Collapse
|
21
|
Gou M, Li L, Fu W, Gong X, Wei Y, Zhou G, Schwarzer R. Prenatal maternal depressive symptoms of Chinese pregnant women and twin newborns' physical health: the moderating role of infant sex. PSYCHOL HEALTH MED 2021; 27:1682-1692. [PMID: 33879007 DOI: 10.1080/13548506.2021.1916957] [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] [Indexed: 10/21/2022]
Abstract
Consequences of prenatal maternal depressive symptoms on infant health are well established. But the results of infants' sex differences of such consequences are mixed. The current study examines whether any association exists between prenatal maternal depressive symptoms and infant physical health different for the sex of newborns. A sample of 84 women pregnant with twins reported depressive symptoms using the Edinburgh Postnatal Depression Scale (EPDS) in the late gestational stage. The Apgar scores of newborns were assessed by healthcare providers at 1, 5, and 10 minutes after birth. The relationship of maternal prenatal depressive symptoms and newborns' physical health was moderated by infant sex. Higher depressive symptoms were associated with a lower Apgar index among newborn boys but not girls. Fetus environment or biomarkers related to sex may be a key mechanism of the effect of prenatal depression symptoms on newborns' health. Tailored interventions targeting maternal depression symptoms may be warranted.
Collapse
Affiliation(s)
- Mengke Gou
- School of Psychological and Cognitive Sciences and Beijing Key Laboratory of Behaviour and Mental Health, Peking University, Beijing, China
| | - Luyao Li
- Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing, China
| | - Wenyang Fu
- Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing, China
| | - Xiaoli Gong
- Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing, China
| | - Yuan Wei
- Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing, China
| | - Guangyu Zhou
- School of Psychological and Cognitive Sciences and Beijing Key Laboratory of Behaviour and Mental Health, Peking University, Beijing, China
| | - Ralf Schwarzer
- SWPS University of Social Sciences and Humanities, Wroclaw, Poland.,Department of Education and Psychology, Health Psychology, Freie Universität Berlin, Berlin, Germany
| |
Collapse
|
22
|
Jin X, Xu X, Qiu J, Xu Z, Sun L, Wang Z, Shan L. Psychological Resilience of Second-Pregnancy Women in China: A Cross-sectional Study of Influencing Factors. Asian Nurs Res (Korean Soc Nurs Sci) 2021; 15:121-128. [PMID: 33484908 DOI: 10.1016/j.anr.2021.01.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2020] [Revised: 01/05/2021] [Accepted: 01/08/2021] [Indexed: 10/22/2022] Open
Abstract
PURPOSE The aim of the study was to evaluate the status of psychological resilience among women in their second pregnancy and to investigate the possible influencing factors. METHODS A total of 275 women in their second pregnancy and who met the criteria were surveyed from two public hospitals in China from July 2018 to January 2019. The instruments included the General Self-designed Questionnaire, Connor-Davidson Resilience Scale, Social Support Rate Scale, and 36-item Pregnancy Stress Rating Scale. RESULTS The total psychological resilience score of second-pregnancy women was relatively low. Multivariate regression analysis identified five factors associated with psychological resilience: intimacy with husbands, social support utilization, gender of the first child, high-risk pregnancy of the first child, and the stress caused by worrying about the health and safety of the mother and fetus. CONCLUSION Women in their second pregnancy represent a unique population, and their low psychological resilience score deserves attention. Identification of factors contributing to decreased psychological resilience may enable us to design prevention and intervention strategies and to deliver specific psychological supports to pregnant women at high risk of developing negative psychology.
Collapse
Affiliation(s)
- Xiaohuan Jin
- Department of Nursing, Lianyungang Maternal and Child Health Hospital Affiliated to Kangda College of Nanjing Medical University, Lianyungang, China; Department of Nursing, Kangda College of Nanjing Medical University, Lianyungang, China.
| | - Xinyuan Xu
- Department of Nursing, Kangda College of Nanjing Medical University, Lianyungang, China
| | - Junyan Qiu
- Department of Nursing, Kangda College of Nanjing Medical University, Lianyungang, China
| | - Zexun Xu
- Department of Nursing, Kangda College of Nanjing Medical University, Lianyungang, China
| | - Lixue Sun
- Department of Nursing, Kangda College of Nanjing Medical University, Lianyungang, China
| | - Zhilin Wang
- Mental Health Education and Research Center, Nanjing Medical University, Nanjing, China
| | - Ling Shan
- Department of Nursing, Lianyungang Maternal and Child Health Hospital Affiliated to Kangda College of Nanjing Medical University, Lianyungang, China.
| |
Collapse
|
23
|
Tuksanawes P, Kaewkiattikun K, Kerdcharoen N. Prevalence and Associated Factors of Antenatal Depressive Symptoms in Pregnant Women Living in an Urban Area of Thailand. Int J Womens Health 2020; 12:849-858. [PMID: 33116934 PMCID: PMC7573318 DOI: 10.2147/ijwh.s278872] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2020] [Accepted: 09/29/2020] [Indexed: 11/23/2022] Open
Abstract
Background Depression is a major public health problem in middle- and low-income countries. Depression in pregnancy has adverse effects on obstetric outcomes. Maternal depression remains under-recognized, under-diagnosed and undertreated in Thailand. Antenatal screening of depression is an important strategy to improve maternal and neonatal outcomes. This problem has rarely been investigated in Thailand, especially in urban areas. Objective To discover the prevalence, associated factors, and predictive factors of depression in pregnant women living in an urban area. Materials and Methods This cross-sectional study of 402 pregnant women was conducted during antenatal care at the Department of Obstetrics and Gynecology, Faculty of Medicine Vajira Hospital, Navamindradhiraj University, Bangkok, Thailand, from 10 September to 31 November 2019. The participants were interviewed using a structured questionnaire that included a demographic profile, obstetric conditions, socio-cultural characteristics, and a Thai language version of the Center for Epidemiologic Studies-Depression Scale to assess depressive symptoms. Results Among a total 402 pregnant women, the prevalence of depressive symptoms in pregnant women in an urban area was 18.9%. Depressive symptoms in pregnant women were significantly associated with divorce (p < 0.001), low family income (p < 0.03), financial insufficiency (p < 0.001), extended family (p < 0.001), history of previous abortion (p = 0.033), history of previous pregnancy complications (p = 0.044), current alcohol use (p = 0.03), current tobacco use (p = 0.009), current substance abuse (p = 0.002), marital conflict (p < 0.001), and family conflict (p < 0.001). The significant factors predicting depression in pregnant women were extended family (AOR 3.0, 95% CI 1.59–5.51, p=0.001) and marital conflict (AOR 4.7, 95% CI 2.37–9.11, p<0.001). Conclusion This study revealed that the prevalence of depressive symptoms in pregnant women living in an urban area in Thailand was 18.9%. The significant associated factors of depressive symptoms were divorce, low family income, financial insufficiency, extended family, previous abortion, previous pregnancy complications, current alcohol use, current tobacco use, current substance abuse, marital conflict, and family conflict. Extended family and marital conflict were significant predictive factors for antenatal depressive symptoms.
Collapse
Affiliation(s)
- Pawanruj Tuksanawes
- Department of Obstetrics & Gynecology, Faculty of Medicine Vajira Hospital, Navamindradriraj University, Bangkok, Thailand
| | - Kasemsis Kaewkiattikun
- Department of Obstetrics & Gynecology, Faculty of Medicine Vajira Hospital, Navamindradriraj University, Bangkok, Thailand
| | | |
Collapse
|