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Gilbert L, Sandoz V, Deforges C, Horsch A. A two-item screening of maternal or infant perceived life threat during childbirth prospectively associated with childbirth-related posttraumatic stress symptoms up to six months postpartum: two observational longitudinal studies. Front Psychiatry 2024; 15:1360189. [PMID: 38654730 PMCID: PMC11036539 DOI: 10.3389/fpsyt.2024.1360189] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2023] [Accepted: 03/18/2024] [Indexed: 04/26/2024] Open
Abstract
Objective This study investigated prospective relationships between the perception of threat to one's own life or to that of one's infant during childbirth and maternal childbirth-related posttraumatic stress symptoms (CB-PTSS) and probable childbirth-related posttraumatic stress disorder (CB-PTSD) in a community and a community and an emergency cesarean section (ECS) sample. Methods Study samples included 72 mothers from a community sample and 75 mothers after emergency cesarean section. Perceived maternal and infant life threat were assessed at ≤1 week postpartum. Maternal CB-PTSS and probable CB-PTSD were assessed with validated questionnaires up to 6 months postpartum. Covariates were extracted from hospital records. Secondary data analysis with logistic and linear regressions was performed. Results Globally, mothers were significantly more likely to perceive their infant's life to be threatened, rather than their own. Both types of perceived threat were prospectively but differentially associated with maternal CB-PTSS and probable CB-PTSD at 4-6 weeks and 6 months postpartum. Statistical significance was set at p<0.05. Conclusion The type of perceived threat differently influences maternal CB-PTSS and probable CB-PTSD up to 6 months postpartum. These results may be the basis for the development of a short screening instrument after traumatic childbirth in clinical settings. Future studies need to assess the psychometric properties and acceptability of such a brief screening tool.
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Affiliation(s)
- Leah Gilbert
- Department Woman-mother-child, Lausanne University Hospital, Lausanne, Switzerland
- Charles Perkins Center, Nepean Clinical School, Faculty of Medicine and Health, University of Sydney, Penrith, NSW, Australia
| | - Vania Sandoz
- Child Abuse and Neglect Team, Department Woman-mother-child, Lausanne University Hospital, Lausanne, Switzerland
- Institute of Higher Education and Research in Healthcare, University of Lausanne, Lausanne, Switzerland
| | - Camille Deforges
- Institute of Higher Education and Research in Healthcare, University of Lausanne, Lausanne, Switzerland
| | - Antje Horsch
- Department Woman-mother-child, Lausanne University Hospital, Lausanne, Switzerland
- Institute of Higher Education and Research in Healthcare, University of Lausanne, Lausanne, Switzerland
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Horsch A, Garthus-Niegel S, Ayers S, Chandra P, Hartmann K, Vaisbuch E, Lalor J. Childbirth-related posttraumatic stress disorder: definition, risk factors, pathophysiology, diagnosis, prevention, and treatment. Am J Obstet Gynecol 2024; 230:S1116-S1127. [PMID: 38233316 DOI: 10.1016/j.ajog.2023.09.089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Revised: 09/22/2023] [Accepted: 09/22/2023] [Indexed: 01/19/2024]
Abstract
Psychological birth trauma and childbirth-related posttraumatic stress disorder represent a substantial burden of disease with 6.6 million mothers and 1.7 million fathers or co-parents affected by childbirth-related posttraumatic stress disorder worldwide each year. There is mounting evidence to indicate that parents who develop childbirth-related posttraumatic stress disorder do so as a direct consequence of a traumatic childbirth experience. High-risk groups, such as those who experience preterm birth, stillbirth, or preeclampsia, have higher prevalence rates. The main risks include antenatal factors (eg, depression in pregnancy, fear of childbirth, poor health or complications in pregnancy, history of trauma or sexual abuse, or mental health problems), perinatal factors (eg, negative subjective birth experience, operative birth, obstetrical complications, and severe maternal morbidity, as well as maternal near misses, lack of support, dissociation), and postpartum factors (eg, depression, postpartum physical complications, and poor coping and stress). The link between birth events and childbirth-related posttraumatic stress disorder provides a valuable opportunity to prevent traumatic childbirths and childbirth-related posttraumatic stress disorder from occurring in the first place. Childbirth-related posttraumatic stress disorder is an extremely distressing mental disorder and has a substantial negative impact on those who give birth, fathers or co-parents, and, potentially, the whole family. Still, a traumatic childbirth experience and childbirth-related posttraumatic stress disorder remain largely unrecognized in maternity services and are not routinely screened for during pregnancy and the postpartum period. In fact, there are gaps in the evidence on how, when, and who to screen. Similarly, there is a lack of evidence on how best to treat those affected. Primary prevention efforts (eg, screening for antenatal risk factors, use of trauma-informed care) are aimed at preventing a traumatic childbirth experience and childbirth-related posttraumatic stress disorder in the first place by eliminating or reducing risk factors for childbirth-related posttraumatic stress disorder. Secondary prevention approaches (eg, trauma-focused psychological therapies, early psychological interventions) aim to identify those who have had a traumatic childbirth experience and to intervene to prevent the development of childbirth-related posttraumatic stress disorder. Tertiary prevention (eg, trauma-focused cognitive behavioural therapy and eye movement desensitization and reprocessing) seeks to ensure that people with childbirth-related posttraumatic stress disorder are identified and treated to recovery so that childbirth-related posttraumatic stress disorder does not become chronic. Adequate prevention, screening, and intervention could alleviate a considerable amount of suffering in affected families. In light of the available research on the impact of childbirth-related posttraumatic stress disorder on families, it is important to develop and evaluate assessment, prevention, and treatment interventions that target the birthing person, the couple dyad, the parent-infant dyad, and the family as a whole. Further research should focus on the inclusion of couples in different constellations and, more generally, on the inclusion of more diverse populations in diverse settings. The paucity of national and international policy guidance on the prevention, care, and treatment of psychological birth trauma and the lack of formal psychological birth trauma services and training, highlight the need to engage with service managers and policy makers.
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Affiliation(s)
- Antje Horsch
- Institute of Higher Education and Research in Healthcare, University of Lausanne, Lausanne, Switzerland; Department Woman-mother-child, Lausanne University Hospital, Lausanne.
| | - Susan Garthus-Niegel
- Institute for Systems Medicine (ISM), Faculty of Medicine, Medical School Hamburg, Hamburg, Germany; Institute and Policlinic of Occupational and Social Medicine, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany; Department of Childhood and Families, Norwegian Institute of Public Health, Oslo, Norway
| | - Susan Ayers
- Centre for Maternal and Child Health Research, School of Health and Psychological Sciences, City, University of London, London, United Kingdom
| | - Prabha Chandra
- Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bangalore, India
| | | | - Edi Vaisbuch
- Department of Obstetrics and Gynecology, Kaplan Medical Center, Rehovot, Israel; Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Joan Lalor
- School of Nursing and Midwifery, Trinity College Dublin, Ireland
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Ayers S, Horsch A, Garthus-Niegel S, Nieuwenhuijze M, Bogaerts A, Hartmann K, Karlsdottir SI, Oosterman M, Tecirli G, Turner JD, Lalor J. Traumatic birth and childbirth-related post-traumatic stress disorder: International expert consensus recommendations for practice, policy, and research. Women Birth 2024; 37:362-367. [PMID: 38071102 DOI: 10.1016/j.wombi.2023.11.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2023] [Revised: 11/22/2023] [Accepted: 11/23/2023] [Indexed: 03/05/2024]
Abstract
BACKGROUND Research suggests 1 in 3 births are experienced as psychologically traumatic and about 4% of women and 1% of their partners develop post-traumatic stress disorder (PTSD) as a result. AIM To provide expert consensus recommendations for practice, policy, and research and theory. METHOD Two consultations (n = 65 and n = 43) with an international group of expert researchers and clinicians from 33 countries involved in COST Action CA18211; three meetings with CA18211 group leaders and stakeholders; followed by review and feedback from people with lived experience and CA18211 members (n = 238). FINDINGS Recommendations for practice include that care for women and birth partners must be given in ways that minimise negative birth experiences. This includes respecting women's rights before, during, and after childbirth; and preventing maltreatment and obstetric violence. Principles of trauma-informed care need to be integrated across maternity settings. Recommendations for policy include that national and international guidelines are needed to increase awareness of perinatal mental health problems, including traumatic birth and childbirth-related PTSD, and outline evidence-based, practical strategies for detection, prevention, and treatment. Recommendations for research and theory include that birth needs to be understood through a neuro-biopsychosocial framework. Longitudinal studies with representative and global samples are warranted; and research on prevention, intervention and cost to society is essential. CONCLUSION Implementation of these recommendations could potentially reduce traumatic births and childbirth-related PTSD worldwide and improve outcomes for women and families. Recommendations should ideally be incorporated into a comprehensive, holistic approach to mental health support for all involved in the childbirth process.
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Affiliation(s)
- Susan Ayers
- Centre for Maternal and Child Health Research, School of Health and Psychological Sciences, City, University of London, EC1V 0HB, UK.
| | - Antje Horsch
- Institute of Higher Education and Research in Healthcare, University of Lausanne, Lausanne, Switzerland; Department Woman-Mother-Child, Lausanne University Hospital, Lausanne, Switzerland
| | - Susan Garthus-Niegel
- Institute for Systems Medicine (ISM), Faculty of Medicine, Medical School Hamburg, Hamburg, Germany; Institute and Policlinic of Occupational and Social Medicine, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany; Department of Childhood and Families, Norwegian Institute of Public Health, Oslo, Norway
| | - Marianne Nieuwenhuijze
- Research Centre for Midwifery Science, Zuyd University, Maastricht, the Netherlands; CAPHRI, Maastricht University, 6229 ER Maastricht, the Netherlands
| | - Annick Bogaerts
- REALIFE research group, Research Unit Woman and Child, Department of Development and Regeneration, KU Leuven, 3000 Leuven, Belgium
| | | | | | - Mirjam Oosterman
- Faculty of Behavioral and Movement Sciences, Department of Clinical Child & Family Studies, Vrije Universiteit Amsterdam and Amsterdam Public Health Research Institute, the Netherlands
| | - Gulcan Tecirli
- Health Technology Assessment Department, Republic of Turkiye Ministry of Health, Bilkent, Çankaya, Ankara, Turkiye
| | - Jonathan D Turner
- Department of Infection and Immunity, Luxembourg Institute of Health, Esch-sur-Alzette, Luxembourg
| | - Joan Lalor
- School of Nursing and Midwifery, Trinity College Dublin, Ireland
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Seefeld L, Handelzalts JE, Horesh D, Horsch A, Ayers S, Dikmen-Yildiz P, Kömürcü Akik B, Garthus-Niegel S. Going through it together: Dyadic associations between parents' birth experience, relationship satisfaction, and mental health. J Affect Disord 2024; 348:378-388. [PMID: 38154585 DOI: 10.1016/j.jad.2023.12.044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2023] [Revised: 10/27/2023] [Accepted: 12/20/2023] [Indexed: 12/30/2023]
Abstract
BACKGROUND Previous research suggests that a negative birth experience is associated with symptoms of postpartum depression and anxiety in mothers and partners. However, this has mostly been investigated within the first year postpartum and research on the long-term effects is lacking. Additionally, the role of relationship satisfaction and the interdependence between parents have not been considered so far. METHODS Couples (N = 1992) completed questionnaires on their birth experience, relationship satisfaction, and symptoms of depression and anxiety at two months, 14 months, and two years after birth, respectively. RESULTS Actor-Partner Interdependence Mediation Models indicated no partner effects, but several significant actor and indirect effects. A more positive birth experience was associated with higher relationship satisfaction and less depression and anxiety symptoms for both parents. Higher relationship satisfaction was in turn associated with less depression (mothers and partners) and anxiety symptoms (mothers). The association between birth experience and depression symptoms was partially mediated by relationship satisfaction for mothers and partners, while the association between birth experience and anxiety symptoms was partially mediated by relationship satisfaction only for mothers. LIMITATIONS Due to the highly educated, very healthy sample with low levels of depression and anxiety as well as high relationship satisfaction, results cannot be generalized to less privileged parents. Moreover, all effects were very small. CONCLUSIONS Results highlight the importance of a positive birth experience for parents' relationship satisfaction and mental health. Negative birth experiences need to be avoided to prevent a negative impact on the whole family.
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Affiliation(s)
- Lara Seefeld
- Department of Psychotherapy and Psychosomatic Medicine, Faculty of Medicine Technische Universität Dresden, Dresden, Germany; Institute and Policlinic of Occupational and Social Medicine, Faculty of Medicine Technische Universität Dresden, Dresden, Germany.
| | - Jonathan E Handelzalts
- School of Behavioral Sciences, The Academic College of Tel-Aviv Yaffo, Tel-Aviv, Israel; Psychiatry Department, University of Michigan, Ann Arbor, MI, USA
| | - Danny Horesh
- Department of Psychology, Bar-Ilan University, Ramat Gan, Israel; Department of Psychiatry, New York University Grossman School of Medicine, New York, NY, USA
| | - Antje Horsch
- Institute of Higher Education and Research in Healthcare, University of Lausanne, Lausanne, Switzerland; Department Woman-mother-child, Lausanne University Hospital, Lausanne, Switzerland
| | - Susan Ayers
- Centre for Maternal and Child Health Research, School of Health and Psychological Sciences, City, University of London, London, UK
| | | | - Burcu Kömürcü Akik
- Department of Psychology, Faculty of Languages and History-Geography, Ankara University, Ankara, Turkey
| | - Susan Garthus-Niegel
- Institute and Policlinic of Occupational and Social Medicine, Faculty of Medicine Technische Universität Dresden, Dresden, Germany; Institute for Systems Medicine (ISM) and Faculty of Human Medicine, MSH Medical School Hamburg, Hamburg, Germany; Department of Childhood and Families, Norwegian Institute of Public Health, Oslo, Norway
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Quansah DY, Gilbert L, Arhab A, Gonzalez-Rodriguez E, Hans D, Gross J, Lanzi S, Stuijfzand B, Lacroix A, Horsch A, Puder JJ. Effect of a prepartum and postpartum, complex interdisciplinary lifestyle and psychosocial intervention on metabolic and mental health outcomes in women with gestational diabetes mellitus (the MySweetheart trial): randomised, single centred, blinded, controlled trial. BMJ Med 2024; 3:e000588. [PMID: 38348309 PMCID: PMC10860000 DOI: 10.1136/bmjmed-2023-000588] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Accepted: 01/07/2024] [Indexed: 02/15/2024]
Abstract
Objective To test the effect of a complex, interdisciplinary, lifestyle and psychosocial intervention on metabolic and mental health outcomes in women with gestational diabetes mellitus during pregnancy and in the post partum. Design Single centred, single blinded, randomised, controlled trial (the MySweetheart trial). Setting Lausanne University Hospital, Switzerland, from 2 September 2016 to 25 October 2021. Participants 211 women aged at least 18 years with a diagnosis of gestational diabetes mellitus at 24-32 gestational weeks were randomly assigned (1:1) to the intervention (n=105) or to usual care (n=106). Interventions In addition to a comparator based on active guidelines for prepartum and postpartum usual care, the intervention consisted of four individual lifestyle visits during pregnancy and four interdisciplinary visits in the postpartum group, a peer support group workshop in pregnancy and post partum, and a bimonthly lifestyle coach support through telemedicine. The intervention focused on tailored behavioural and psychosocial strategies to improve diet, physical activity, mental health, social support, and adherence to gestational weight gain during pregnancy and weight retention recommendations. Main outcome measures Primary outcomes were between-group differences in the decrease in maternal weight and depression symptom scores between baseline and one year post partum. Secondary outcomes included changes in total and central body fat, anxiety, wellbeing, glycaemic parameters (homeostatic model assessment for insulin resistance (known as HOMA-IR) and Matsuda indices), aerobic fitness (maximal oxygen uptake), gestational weight gain, and weight retention. Assessors were blinded to primary and secondary outcomes. Results 84 (80%) of 105 women in the intervention and 95 (90%) of 106 in the usual care completed the study. There was not enough evidence of a difference in the decrease in weight (mean difference -0.38 kg (95% confidence interval -2.08 to 1.30)) or depression scores (-0.67 (-1.84 to 0.49)). The intervention led to an increase in fat-free mass (0.02 kg (0.01 to 0.03)). The intervention also decreased gestational weight gain since the first gestational diabetes mellitus visit (-1.20 kg (-2.14 to -0.26)) and weekly weight gain throughout the entire pregnancy (-0.14 kg (-0.25 to -0.03)), and led to a higher proportion of women without weight retention at one year post partum (34.1% (28/82) v 20.8% (20/96), P=0.034). Conclusions Compared with active usual care based on guidelines, there was not enough evidence to conclude that the intervention led to decrease in weight or depression symptoms. However, the intervention decreased gestational weight gain and increased the proportion of women without weight retention. Trial registration Clinicaltrials.gov NCT02890693.
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Affiliation(s)
- Dan Yedu Quansah
- Obstetric service, Department Woman-Mother-Child, Lausanne University Hospital, Lausanne, Switzerland
| | - Leah Gilbert
- Obstetric service, Department Woman-Mother-Child, Lausanne University Hospital, Lausanne, Switzerland
| | - Amar Arhab
- Obstetric service, Department Woman-Mother-Child, Lausanne University Hospital, Lausanne, Switzerland
| | - Elena Gonzalez-Rodriguez
- Interdisciplinary Center of Bone Diseases, Bone and Joint Department, Lausanne University Hospital, Lausanne, Switzerland
| | - Didier Hans
- Interdisciplinary Center of Bone Diseases, Bone and Joint Department, Lausanne University Hospital, Lausanne, Switzerland
| | - Justine Gross
- Service of Endocrinology, Diabetes and Metabolism, Department of Medicine, Lausanne University Hospital, Lausanne, Switzerland
| | - Stefano Lanzi
- Heart and Vessel Department, Division of Angiology, Lausanne University Hospital, Lausanne, Switzerland
| | - Bobby Stuijfzand
- Obstetric service, Department Woman-Mother-Child, Lausanne University Hospital, Lausanne, Switzerland
| | - Alain Lacroix
- Obstetric service, Department Woman-Mother-Child, Lausanne University Hospital, Lausanne, Switzerland
| | - Antje Horsch
- Institute of Higher Education and Research in Healthcare (IUFRS), University of Lausanne, Lausanne, Switzerland
- Neonatology service, Department Woman-Mother-Child, Lausanne University Hospital, Lausanne, Switzerland
| | - Jardena J Puder
- Obstetric service, Department Woman-Mother-Child, Lausanne University Hospital, Lausanne, Switzerland
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Nieuwenhuijze M, Leahy-Warren P, Healy M, Aktaş S, Aydin R, Calleja-Agius J, Goberna-Tricas J, Hadjigeorgiou E, Hartmann K, Henriksen L, Horsch A, Lange U, Murphy M, Pierron A, Schäfers R, Pajalic Z, Verhoeven C, Berdun DR, Hossain S. The impact of severe perinatal events on maternity care providers: a scoping review. BMC Health Serv Res 2024; 24:171. [PMID: 38326880 PMCID: PMC10848539 DOI: 10.1186/s12913-024-10595-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2023] [Accepted: 01/12/2024] [Indexed: 02/09/2024] Open
Abstract
BACKGROUND Severe events during the perinatal period can be experienced as traumatic by pregnant women, their partners or others who are closely involved. This includes maternity care providers who can be affected by being involved in or observing these events. This may have an impact on their personal well-being and professional practice, influencing quality of care. The aim of this study is to map research investigating the impact of severe events during the perinatal period on maternity care providers, and how these experiences affect their well-being and professional practice. METHOD A scoping review following the manual of the Joanna Briggs Institute was undertaken. The electronic bibliographic databases included PubMed/MEDLINE, CINAHL, PsycINFO, PsycARTICLES, SocINDEX, Cochrane, Scopus, Web of Science and databases for grey literature. Records passing the two-stage screening process were assessed, and their reference lists hand searched. We included primary research papers that presented data from maternity care professionals on the impact of severe perinatal traumatic events. A descriptive content analysis and synthesis was undertaken. RESULTS Following a detailed systematic search and screening of 1,611 records, 57 papers were included in the scoping review. Results of the analysis identified four categories, which highlighted the impact of traumatic perinatal events on maternity care providers, mainly midwives, obstetricians and nurses: Traumatic events, Impact of traumatic events on care providers, Changes in care providers' practice and Support for care providers; each including several subcategories. CONCLUSION The impact of traumatic perinatal events on maternity care providers ranged from severe negative responses where care providers moved position or resigned from their employment in maternity care, to responses where they felt they became a better clinician. However, a substantial number appeared to be negatively affected by traumatic events without getting adequate support. Given the shortage of maternity staff and the importance of a sustainable workforce for effective maternity care, the impact of traumatic perinatal events requires serious consideration in maintaining their wellbeing and positive engagement when conducting their profession. Future research should explore which maternity care providers are mostly at risk for the impact of traumatic events and which interventions can contribute to prevention.
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Affiliation(s)
- Marianne Nieuwenhuijze
- CAPHRI, Maastricht University, Universiteitssingel 60, 6229 ER, Maastricht, The Netherlands.
| | | | | | | | | | | | | | | | | | | | | | - Ute Lange
- University of Applied Sciences Bochum, Bochum, Germany
| | | | | | | | | | - Corine Verhoeven
- Amsterdam University Medical Centres, Amsterdam, The Netherlands
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Nicolazzi L, Gilbert L, Horsch A, Quansah DY, Puder JJ. Trajectories and associations of symptoms of mental health and well-being with insulin resistance and metabolic health in women with gestational diabetes. Psychoneuroendocrinology 2024; 160:106919. [PMID: 38091918 DOI: 10.1016/j.psyneuen.2023.106919] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Revised: 11/17/2023] [Accepted: 12/05/2023] [Indexed: 01/02/2024]
Abstract
BACKGROUND Gestational diabetes mellitus (GDM) is characterized by increased insulin resistance and carries perinatal and long-term risks for the mother and her offspring. There is a link between perinatal depression or anxiety and GDM. Mental health problems are associated with higher insulin resistance and could explain the underlying association between GDM and depression or anxiety symptoms. We investigated the trajectories and associations between symptoms of mental health and well-being with insulin resistance and metabolic health in women with GDM. METHODS This study included the control group (n = 106) of a randomized controlled trial in women with GDM that were followed-up during pregnancy and up to 1-year postpartum. We measured symptoms of mental health (Edinburgh Postnatal Depression Scale (EPDS), Anxiety subscale of the Hospital Anxiety and Depression Scale (HADS-A), well-being (The World Health Organization Well-Being Index (WHO-5)) and metabolic health, including insulin resistance variables (HOMA-insulin resistance (IR) and Matsuda Index of insulin sensitivity) as well as weight during pregnancy and in the postpartum. RESULTS Participants' pre pregnancy weight and BMI were 69.7 kg ± 16.1 and 25.9 kg/m2 ± 5.5 respectively. HOMA-IR was higher during pregnancy compared to 6-8 weeks postpartum and increased between 6-8 weeks and 1-year postpartum (all p < 0.05). Matsuda index decreased between 6-8 weeks and 1-year postpartum (p < 0.001). EPDS scores decreased between pregnancy and both 6-8 weeks and 1-year postpartum (all p < 0.05). HADS-A scores did not change between pregnancy and the postpartum. WHO-5 scores improved significantly from pregnancy and both 6-8 weeks and 1-year postpartum (p < 0.001). Correlation coefficients within outcome at the three different time points were high for metabolic measures and ranged between 0.94 and 0.96 for weight, from 0.77 to 0.89 for HOMA-IR and 0.64 for the Matsuda index (all p < 0.001). Mental health and well-being variables were moderately correlated in all three time points including r = 0.36-0.55 for the EPDS (p < 0.001), r = 0.58 for HADS (p < 0.001), and r = 0.43-0.52 for the WHO-5 (p < 0.01). After adjustment for age and pre-pregnancy BMI, Matsuda index was negatively associated with EPDS scores and positively associated to WHO-5 scores at 6-8 weeks postpartum. No other association between insulin resistance and mental health or well-being outcomes were found. CONCLUSION While insulin resistance fluctuated with values being lowest in the early postpartum and increasing thereafter, both depression and well-being scores decreased between pregnancy and the postpartum and did not change in the postpartum period. Intraindividual variability was larger for mental health and well-being than for metabolic health outcomes at different time points, indicating a higher plasticity for mental health and well-being outcomes that could be acted upon. We found only few associations between mental health and well-being and metabolic health outcomes.
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Affiliation(s)
- Ludmila Nicolazzi
- Department of Medicine, Internal Medicine service, Lausanne University Hospital, Lausanne, Switzerland.
| | - Leah Gilbert
- Obstetric service, Department Woman-Mother-Child, Lausanne University Hospital, Lausanne, Switzerland.
| | - Antje Horsch
- Institute of Higher Education and Research in Healthcare (IUFRS), University of Lausanne, Switzerland; Neonatalogy Service, Department Woman-Mother-Child, Lausanne University Hospital, Lausanne, Switzerland.
| | - Dan Yedu Quansah
- Obstetric service, Department Woman-Mother-Child, Lausanne University Hospital, Lausanne, Switzerland.
| | - Jardena J Puder
- Obstetric service, Department Woman-Mother-Child, Lausanne University Hospital, Lausanne, Switzerland.
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Chanvrier H, Rattaz V, Offredi V, Dupuis M, Horsch A. Swiss cohort on Traumatic Childbirth and Health (SwiTCH): protocol for a prospective, population-based cohort study on parents' mental health from pregnancy to one year postpartum. BMJ Open 2024; 14:e080557. [PMID: 38296274 PMCID: PMC10828876 DOI: 10.1136/bmjopen-2023-080557] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Accepted: 01/11/2024] [Indexed: 02/03/2024] Open
Abstract
INTRODUCTION Approximately 4%-5% of mothers develop childbirth-related post-traumatic stress disorder (CB-PTSD) and approximately 12.3% of mothers develop some CB-PTSD symptoms (CB-PTSS). To date, there is a dearth of studies on fathers and other coparents. Parental CB-PTSD and CB-PTSS may have a negative impact not only on the parents but also on the infant. Understanding risk and protective factors of CB-PTSD for both parents and its consequences on the family is key to detecting or anticipating it, to developing interventions aimed at reducing its detrimental effects and to supporting parents. METHODS AND ANALYSIS This study protocol describes an observational, population-based study, consisting of a longitudinal prospective cohort with online surveys at four time points. The population of interest consist of women, in the third trimester of pregnancy or at 6-12 weeks postpartum, and their partner/coparent, who will give birth or gave birth in the French-speaking part of Switzerland. The target sample size is 300-500 women and a proportional number of partners. The primary outcome of this study is the prevalence of CB-PTSD and CB-PTSS. The secondary outcomes focus on: (1) the impact of CB-PTSD and CB-PTSS on the marital and coparental relationships, the bonding with the infant, parental burnout and healthcare seeking behaviours, (2) the role of the childbirth experience in the development of CB-PTSD and CB-PTSS and (3) the social and economic determinants of CB-PTSD and CB-PTSS. ETHICS AND DISSEMINATION Ethical approval was granted by the human research ethics committee of the Canton de Vaud (study number 2022-00284). All study participants signed an informed consent form. Dissemination of results will occur via national and international conferences, in peer-reviewed journals, public conferences and social media. TRIAL REGISTRATION NUMBER NCT05865704.
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Affiliation(s)
- Hélène Chanvrier
- Institute of Higher Education and Research in Healthcare, University of Lausanne, Lausanne, Switzerland
| | - Valentine Rattaz
- Institute of Higher Education and Research in Healthcare, University of Lausanne, Lausanne, Switzerland
| | - Valentin Offredi
- Institute of Higher Education and Research in Healthcare, University of Lausanne, Lausanne, Switzerland
- University Department of Child and Adolescent Psychiatry, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Marc Dupuis
- Institute of Primary Health Care (BIHAM), University of Bern, Bern, Switzerland
| | - Antje Horsch
- Institute of Higher Education and Research in Healthcare, University of Lausanne, Lausanne, Switzerland
- Department of Woman Mother and Child, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
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Cai D, Villanueva P, Lu H, Zimmermann B, Horsch A. What matters to migrant women during labor and birth: Chinese mothers' experiences in Switzerland. BMC Pregnancy Childbirth 2024; 24:69. [PMID: 38245713 PMCID: PMC10799396 DOI: 10.1186/s12884-024-06271-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Accepted: 01/12/2024] [Indexed: 01/22/2024] Open
Abstract
BACKGROUND In Switzerland, foreigners account for 25.3% of the permanent resident population, and the fertility rate of migrant women is higher than that of Swiss women. However, migrant women from non-European countries are more likely to report having negative childbirth experiences than Swiss women. For example, during pregnancy, Chinese migrant mothers often felt dissatisfied with the follow-up pregnancy complications and lacked information on medical procedures and prenatal courses. In this paper, we explored their childbirth experiences in Swiss hospitals and how Swiss healthcare providers supported them. METHOD A qualitative study employing in-depth, semi-structured interviews was conducted with 14 Chinese mothers and 13 family members. All interviews were audio-recorded, transcribed, and translated into English for data analysis. Thematic analysis was employed to generate a detailed description. RESULTS Three main themes were extracted from the transcripts: (1) Sense of security, (2) Intrapartum care, and (3) Postpartum needs. CONCLUSIONS Our study shows Chinese migrant mothers prioritized giving birth in a physically and psychologically safe environment, with pain control and practical and emotional support from their intimate partners. They desired a physiological labor and birth with minimal obstetric interventions. Our research also reveals their postpartum needs, emphasizing the importance of postpartum support and obtaining culturally sensitive care during their postpartum hospital stay. The study adds new knowledge of specific migrant studies in Switzerland, as called for by the Swiss Federal Office of Public Health. The results call for the transcultural care skills training of Swiss healthcare providers to enable migrant women to have a more positive childbirth experience.
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Affiliation(s)
- Dingcui Cai
- Institute of Higher Education and Research in Healthcare (IUFRS), University of Lausanne, Lausanne, 1011, Switzerland
| | - Paulina Villanueva
- Institute of Higher Education and Research in Healthcare (IUFRS), University of Lausanne, Lausanne, 1011, Switzerland
| | - Hong Lu
- School of Nursing, Peking University, 38 Xueyuan Road, Haidian District, Beijing, 100191, China
| | - Basile Zimmermann
- Confucius Institute, University of Geneva, Rue du Général-Dufour 24, Geneva, 1211, Switzerland
| | - Antje Horsch
- Institute of Higher Education and Research in Healthcare (IUFRS), University of Lausanne, Lausanne, 1011, Switzerland.
- Department Woman-Mother-Child, Lausanne University Hospital and University of Lausanne, Lausanne, 1011, Switzerland.
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Alderdice F, Ayers S, Batorowicz E, Caparros-Gonzalez RA, Carone N, Darwin Z, Fallon V, Garthus-Niegel S, Hayes L, Horsch A, Iles J, Lafarge C, Martin C, Radoš SN, Newham J, Power C, Redshaw M, Seefeld L, Sheen K, Worobey J. Reflections on a successful year of the Society for Reproductive and Infant Psychology. J Reprod Infant Psychol 2024; 42:1-4. [PMID: 38088135 DOI: 10.1080/02646838.2023.2288447] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2023]
Affiliation(s)
- Fiona Alderdice
- National Perinatal Epidemiology Unit, Oxford Population Health, University of Oxford, Oxford, UK
| | - Susan Ayers
- Centre for Maternal and Child Health Research, School of Health and Psychological Sciences, City, University of London, London, UK
| | - Eleonora Batorowicz
- Institute of Psychology, Faculty of Educational Sciences, University of Łódź, Łódź, Poland
| | | | - Nicola Carone
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
| | - Zoe Darwin
- School of Human and Health Sciences, University of Huddersfield, Huddersfield, UK
| | - Vicky Fallon
- Department of Psychology, Institute of Population Health, University of Liverpool
| | - Susan Garthus-Niegel
- Institute for Systems Medicine (ISM) and Faculty of Medicine, Medical School Hamburg, Hamburg, Germany
- Institute and Policlinic of Occupational and Social Medicine, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
- Department of Childhood and Families, Norwegian Institute of Public Health, Oslo, Norway
| | - Liane Hayes
- School of Psychology, University of Chester, Chester, UK
| | - Antje Horsch
- Institute of Higher Education and Research in Healthcare, University of Lausanne, Lausanne, Switzerland
- Department Woman-mother-child, Lausanne University Hospital, Lausanne, Switzerland
| | - Jane Iles
- School of Psychology, University of Surrey, Guildford, UK
| | | | - Colin Martin
- Institute for Health and Wellbeing, University of Suffolk, Ipswich, UK
| | - Sandra Nakić Radoš
- Department of Psychology, Catholic University of Croatia, Zagreb, Croatia
| | - James Newham
- Department of Psychology, Northumbria University, Newcastle upon Tyne, UK
| | - Carmen Power
- Independent psychologist, consultant, researcher and educator, Bristol, UK
| | | | - Lara Seefeld
- Institute and Policlinic of Occupational and Social Medicine, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
- Department of Psychotherapy and Psychosomatic Medicine, Faculty of Medicine Technische Universität Dresden, Dresden, Germany & Institute and Policlinic of Occupational and Social Medicine, Faculty of Medicine Technische Universität Dresden, Dresden, Germany
| | - Kayleigh Sheen
- School of Social Sciences, University of the West of England, Bristol, UK
| | - John Worobey
- Department of Nutritional Sciences, Rutgers State University, New Brunswick, USA
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Diezi AS, Vanetti M, Robert M, Schaad B, Baud D, Horsch A. Informing about childbirth without increasing anxiety: a qualitative study of first-time pregnant women and partners' perceptions and needs. BMC Pregnancy Childbirth 2023; 23:797. [PMID: 37978462 PMCID: PMC10655283 DOI: 10.1186/s12884-023-06105-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Accepted: 11/03/2023] [Indexed: 11/19/2023] Open
Abstract
BACKGROUND Complications requiring medical interventions during childbirth are far from rare, even after uncomplicated pregnancies. It is often a challenge for maternity healthcare professionals to know how to prepare future parents for these eventualities without causing unnecessary anxiety. Studies on traumatic birth experiences have shown that feelings of loss of control, insufficient information, and lack of participation in medical decisions during childbirth are factors of difficult experiences. However, little is known about the information and communication needs of expectant parents about childbirth during the prenatal period. To gain a deeper understanding of the information and communication needs of first-time pregnant women and partners, we explored their perceptions and expectations for their upcoming childbirth, and the actions they initiated to prepare for it. METHODS Semi-structured interviews were conducted individually with first-time pregnant women and partners of pregnant women aged 18 years or older, with an uncomplicated pregnancy. Thematic analysis was used to identify themes and sub-themes. RESULTS Twenty expectant parents (15 pregnant women and five partners of pregnant women) were interviewed. Six themes were identified: Childbirth event; Childbirth experience; Childbirth environment; Organisation of care; Participation in decision making; Roles within the couple and transition to parenthood. CONCLUSIONS This study contributes to a better understanding of the information needs of future parents expecting their first child. Results highlighted that the notion of "childbirth risks" went beyond the prospect of complications during birth, but also encompassed concerns related to a feeling of loss of control over the event. Expectant parents showed an ambivalent attitude towards consulting risk information, believing it important to prepare for the unpredictability of childbirth, while avoiding information they considered too worrying. They expressed a desire to receive concrete, practical information, and needed to familiarise themselves in advance with the birth environment. Establishing a respectful relationship with the healthcare teams was also considered important. The findings suggest that information on childbirth should not be limited to the transmission of knowledge, but should primarily be based on the establishment of a relationship of trust with healthcare professionals, taking into account each person's individual values and expectations.
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Affiliation(s)
- Anne-Sylvie Diezi
- Institute of Higher Education and Research in Healthcare (IUFRS), University of Lausanne, Route de La Corniche 10, 1011, Lausanne, Switzerland
- Communication Department, Lausanne University Hospital, Rue du Bugnon 21, 1011, Lausanne, Switzerland
| | - Mélanie Vanetti
- Institute of Higher Education and Research in Healthcare (IUFRS), University of Lausanne, Route de La Corniche 10, 1011, Lausanne, Switzerland
| | - Marie Robert
- Institute of Higher Education and Research in Healthcare (IUFRS), University of Lausanne, Route de La Corniche 10, 1011, Lausanne, Switzerland
| | - Béatrice Schaad
- Communication Department, Lausanne University Hospital, Rue du Bugnon 21, 1011, Lausanne, Switzerland
- Institute of Humanities in Medicine, Lausanne University Hospital and University of Lausanne, Av. de Provence 82, 1007, Lausanne, Switzerland
| | - David Baud
- Department Woman-Mother-Child, Lausanne University Hospital and University of Lausanne, Av. Pierre-Decker 10, 1011, Lausanne, Switzerland
| | - Antje Horsch
- Institute of Higher Education and Research in Healthcare (IUFRS), University of Lausanne, Route de La Corniche 10, 1011, Lausanne, Switzerland.
- Department Woman-Mother-Child, Lausanne University Hospital and University of Lausanne, Av. Pierre-Decker 10, 1011, Lausanne, Switzerland.
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12
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Quansah DY, Horsch A, Gilbert L, Donath MY, Puder JJ. C-reactive protein during pregnancy and in the early postpartum predicts adverse metabolic health outcomes at 1 year postpartum in women with gestational diabetes. Cardiovasc Diabetol 2023; 22:291. [PMID: 37891561 PMCID: PMC10612338 DOI: 10.1186/s12933-023-02034-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Accepted: 10/15/2023] [Indexed: 10/29/2023] Open
Abstract
BACKGROUND Women with gestational diabetes mellitus (GDM) have higher insulin resistance and/or reduced secretion, an increased risk of future diabetes and cardiovascular disease, which may be due to a pathological activation of the innate immune system. C-reactive protein (CRP) is induced by inflammatory cytokines and reflects innate immune activity. We investigated the prospective associations between CRP during the perinatal period with adverse metabolic outcomes at 1 year postpartum in women with previous GDM. METHODS We analyzed data from the MySweetheart trial that included 211 women with GDM at 28-32 weeks gestational age (GA). CRP was measured during pregnancy at 28-32 weeks GA, at 6-8 weeks and at 1 year postpartum. Metabolic outcomes at 1 year postpartum included weight, total and central body fat, measures of insulin resistance and secretion and presence of the metabolic syndrome (MetS). A 75 g oral glucose tolerance test was performed to measure glucose and insulin values every 30 min over 2 h to calculate indices of insulin resistance (MATSUDA, HOMA-IR) and of absolute (AUCins/glu, HOMA-B) and insulin resistance-adjusted insulin secretion (ISSI-2). RESULTS CRP during pregnancy and at 6-8 weeks postpartum predicted increased weight, body fat and visceral adipose tissue (VAT), insulin resistance (higher HOMA-IR, lower MATSUDA), absolute insulin secretion (HOMA-B, AUCins/glu), a reduced adjusted insulin secretion (ISSI-2) and a higher prevalence of the MetS at 1 year postpartum (all p ≤ 0.036). These relationships particularly those concerning CRP during pregnancy, were independent of weight ( for VAT, insulin resistance and secretion indices, MetS; all p ≤ 0.032) and of body fat ( for VAT, MATSUDA, MetS; all p ≤ 0.038). CONCLUSION: CRP during pregnancy and in the early postpartum predicted an adverse cardio-metabolic profile in women with prior GDM at 1 year postpartum independent of weight. The prospective association of CRP with increased insulin resistance and reduced adjusted insulin secretion hint to the role of inflammation in the development of impaired metabolism after GDM and could be used as an early marker for risk stratification.
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Affiliation(s)
- Dan Yedu Quansah
- Obstetric Service, Department Woman-Mother-Child, Lausanne University Hospital, Rue du Bugnon 21, CH-1011, Lausanne, Switzerland.
| | - Antje Horsch
- Institute of Higher Education and Research in Healthcare (IUFRS), University of Lausanne, Lausanne, Switzerland
- Neonatalogy Service, Department Woman-Mother-Child, Lausanne University Hospital, Lausanne, Switzerland
| | - Leah Gilbert
- Obstetric Service, Department Woman-Mother-Child, Lausanne University Hospital, Rue du Bugnon 21, CH-1011, Lausanne, Switzerland
| | - Marc Y Donath
- Endocrinology, Diabetes and Metabolism, University Hospital Basel, and Department of Biomedicine, University of Basel, Basel, Switzerland
| | - Jardena J Puder
- Obstetric Service, Department Woman-Mother-Child, Lausanne University Hospital, Rue du Bugnon 21, CH-1011, Lausanne, Switzerland
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13
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Avignon V, Gaucher L, Baud D, Legardeur H, Dupont C, Horsch A. What do mothers think about their antenatal classes? A mixed-method study in Switzerland. BMC Pregnancy Childbirth 2023; 23:741. [PMID: 37858110 PMCID: PMC10585766 DOI: 10.1186/s12884-023-06049-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2023] [Accepted: 10/04/2023] [Indexed: 10/21/2023] Open
Abstract
PROBLEM Research so far has evaluated the effect of antenatal classes, but few studies have investigated its usefulness from the perspective of mothers after birth. BACKGROUND Antenatal classes evolved from pain management to a mother-centred approach, including birth plans and parenting education. Evaluating the perception of the usefulness of these classes is important to meet mother's needs. However, so far, research on the mothers' perception of the usefulness of these classes is sparse, particularly when measured after childbirth. Given that antenatal classes are considered as adult education, it is necessary to carry out this evaluation after mothers have had an opportunity to apply some of the competences they acquired during the antenatal classes during their childbirth. AIM This study investigated mothers' satisfaction and perceived usefulness of antenatal classes provided within a university hospital in Switzerland, as assessed in the postpartum period. METHODS Primiparous mothers who gave birth at a Swiss university hospital from January 2018 to September 2020 were contacted. Those who had attended the hospital's antenatal classes were invited to complete a questionnaire consisting of a quantitative and qualitative part about usefulness and satisfaction about antenatal classes. Quantitative data were analysed using both descriptive and inferential statistics. Qualitative data were analysed using thematic analysis. FINDINGS Among the 259 mothers who answered, 61% (n = 158) were globally satisfied with the antenatal classes and 56.2% (n = 145) found the sessions useful in general. However, looking at the utility score of each theme, none of them achieved a score of usefulness above 44%. The timing of some of these sessions was questioned. Some mothers regretted the lack of accurate information, especially on labour complications and postnatal care. DISCUSSION Antenatal classes were valued for their peer support. However, in their salutogenic vision of empowerment, they did not address the complications of childbirth, even though this was what some mothers needed. Furthermore, these classes could also be more oriented towards the postpartum period, as requested by some mothers. CONCLUSION Revising antenatal classes to fit mothers' needs could lead to greater satisfaction and thus a better impact on the well-being of mothers and their families.
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Affiliation(s)
- Valérie Avignon
- Department Woman-Mother-Child, Obstetric Service, Lausanne University Hospital (CHUV) and University of Lausanne, Avenue Pierre-Decker 2, Lausanne, 1011, Switzerland
- Research on Healthcare Performance RESHAPE, INSERM U1290, Université Claude Bernard Lyon 1, Lyon, 69008, France
- Institute of Higher Education and Research in Healthcare-IUFRS, University of Lausanne, Lausanne University Hospital, Route de La Corniche 10 - Bâtiment Proline, Lausanne, CH-1010, Switzerland
| | - Laurent Gaucher
- Research on Healthcare Performance RESHAPE, INSERM U1290, Université Claude Bernard Lyon 1, Lyon, 69008, France
- Geneva School of Health Sciences, HES-SO University of Applied Sciences and Arts, Geneva, Western Switzerland, 1206, Switzerland
| | - David Baud
- Department Woman-Mother-Child, Obstetric Service, Lausanne University Hospital (CHUV) and University of Lausanne, Avenue Pierre-Decker 2, Lausanne, 1011, Switzerland
| | - Hélène Legardeur
- Department Woman-Mother-Child, Obstetric Service, Lausanne University Hospital (CHUV) and University of Lausanne, Avenue Pierre-Decker 2, Lausanne, 1011, Switzerland
| | - Corinne Dupont
- Research on Healthcare Performance RESHAPE, INSERM U1290, Université Claude Bernard Lyon 1, Lyon, 69008, France
| | - Antje Horsch
- Department Woman-Mother-Child, Obstetric Service, Lausanne University Hospital (CHUV) and University of Lausanne, Avenue Pierre-Decker 2, Lausanne, 1011, Switzerland.
- Institute of Higher Education and Research in Healthcare-IUFRS, University of Lausanne, Lausanne University Hospital, Route de La Corniche 10 - Bâtiment Proline, Lausanne, CH-1010, Switzerland.
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Sandoz V, Lacroix A, Jubin M, Hingray C, El Hage W, Horsch A. The latent factor structure and assessment of childbirth-related PTSD in fathers: Psychometric characteristics of the City Birth Trauma Scale-French version (partner version). Psychol Trauma 2023; 15:1145-1152. [PMID: 36689375 DOI: 10.1037/tra0001407] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
OBJECTIVE There is no evidence on the latent structure of symptoms of childbirth-related posttraumatic stress disorder (CB-PTSD) in fathers and to date, no validated French instrument exists to measure CB-PTSD in partners, although the City Birth Trauma Scale (partner version) (City BiTS (P)) was developed to measure such CB-PTSD symptoms. This study aimed to validate the French version of the City BiTS-P (City BiTS-F (P)) in partners attending childbirth and to examine its factor structure, reliability, and validity. METHOD French-speaking fathers of 1-to-12-month-olds participated in this online cross-sectional survey (n = 280). They completed the City BiTS-F (P), the PTSD Checklist, the Edinburgh Postnatal Depression Scale, and the anxiety subscale of the Hospital Anxiety and Depression Scale, as well as sociodemographic and medical items. RESULTS The four-factor model did not fit well the data, contrary to the two-factor model with birth-related symptoms (BRS) and general symptoms (GS). However, the bifactor model with a general factor and the BRS and GS provided the best fit to the data. High reliability (α = .88-.89), and good convergent and divergent validity were found. Fathers with a history of traumatic childbirth reported higher total and subscale scores. DISCUSSION Our findings provide evidence for the use of the City BiTS-F (P) as a reliable and validated tool to assess CB-PTSD symptoms in French-speaking partners. The use of the total score in addition to the BRS and GS subscale scores is warranted. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
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Affiliation(s)
- Vania Sandoz
- Institute of Higher Education and Research in Healthcare, University of Lausanne
| | - Alain Lacroix
- Institute of Higher Education and Research in Healthcare, University of Lausanne
| | - Maria Jubin
- Institute of Higher Education and Research in Healthcare, University of Lausanne
| | - Coraline Hingray
- Centre Psychotherapique de Nancy, Pole Hospitalo-Universitaire de Psychiatrie d'Adultes du Grand Nancy
| | - Wissam El Hage
- Centre Regional de Psychotraumatologie CVL, CHRU de Tours
| | - Antje Horsch
- Institute of Higher Education and Research in Healthcare, University of Lausanne
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15
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Devita S, Deforges C, Bickle-Graz M, Tolsa JF, Sandoz V, Horsch A. Maternal childbirth-related posttraumatic stress symptoms, bonding, and infant development: a prospective study. J Reprod Infant Psychol 2023:1-15. [PMID: 37740725 DOI: 10.1080/02646838.2023.2261057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Accepted: 09/15/2023] [Indexed: 09/25/2023]
Abstract
BACKGROUND Childbirth-related posttraumatic stress symptoms (CB-PTSS) including general symptoms (GS, i.e., mainly negative cognitions and mood and hyperarousal symptoms) and birth-related symptoms (BRS, i.e., mostly re-experiencing and avoidance symptoms) may disrupt mother-infant bonding and infant development. This study investigated prospective and cross-sectional associations between maternal CB-PTSS and mother-infant bonding or infant development (language, motor, and cognitive). METHOD We analysed secondary data of the control group of a randomised control trial (NCT03576586) with full-term French-speaking mother-infant dyads (n = 55). Maternal CB-PTSS and mother-infant bonding were assessed via questionnaires at six weeks (T1) and six months (T2) postpartum: PTSD Checklist for DSM-5 (PCL-5) and Mother-Infant Bonding Scale (MIBS). Infant development was assessed with the Bayley Scales of Infant Development at T2. Sociodemographic and medical data were collected from questionnaires and medical records. Bivariate and multivariate regression were used. RESULTS Maternal total CB-PTSS score at T1 was associated with poorer bonding at T2 in the unadjusted model (B = 0.064, p = 0.043). In the adjusted model, cross-sectional associations were found at T1 between a higher total CB-PTSS score and poorer bonding (B = 0.134, p = 0.017) and between higher GS and poorer bonding (B = 0.306, p = 0.002). Higher BRS at T1 was associated with better infant cognitive development at T2 in the unadjusted model (B = 0.748, p = 0.026). CONCLUSIONS Results suggest that CB-PTSS were associated with mother-infant bonding difficulties, while CB-PTSS were not significantly associated with infant development. Additional studies are needed to increase our understanding of the intergenerational consequences of perinatal trauma.
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Affiliation(s)
- Sella Devita
- Institute of Higher Education and Research in Healthcare (IUFRS), University of Lausanne and Lausanne University Hospital, Lausanne, Switzerland
| | - Camille Deforges
- Institute of Higher Education and Research in Healthcare (IUFRS), University of Lausanne and Lausanne University Hospital, Lausanne, Switzerland
| | - Myriam Bickle-Graz
- Department Woman-Mother-Child, Clinic of Neonatology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Jean-François Tolsa
- Department Woman-Mother-Child, Clinic of Neonatology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Vania Sandoz
- Institute of Higher Education and Research in Healthcare (IUFRS), University of Lausanne and Lausanne University Hospital, Lausanne, Switzerland
- Department Woman-Mother-Child, Child Abuse and Neglect Team, Lausanne University Hospital, Lausanne, Switzerland
| | - Antje Horsch
- Institute of Higher Education and Research in Healthcare (IUFRS), University of Lausanne and Lausanne University Hospital, Lausanne, Switzerland
- Department Woman-Mother-Child, Clinic of Neonatology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
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16
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Van Haeken S, Braeken MAKA, Horsch A, Oosterman M, Bogaerts A. Development of a resilience-enhancing intervention during and after pregnancy: a systematic process informed by the behaviour change wheel framework. BMC Psychol 2023; 11:267. [PMID: 37670333 PMCID: PMC10481562 DOI: 10.1186/s40359-023-01301-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Accepted: 08/23/2023] [Indexed: 09/07/2023] Open
Abstract
BACKGROUND Pregnancy and the transition to parenthood are accompanied by multiple changes and stress exposure. Resilience has the potential to counteract the negative impact of stress and can be a protective factor against mental health problems. To date, the use of a theoretical framework in the development or application of resilience interventions during pregnancy up to one year postpartum is missing. The aim of this study is to develop an intervention to enhance resilience for pregnant women up to one year postpartum. METHODS A systematic and theory-based approach informed by the Behaviour Change Wheel framework and the theoretical model of perinatal resilience was applied. The development took place in three phases and during the process, the target group, researchers and clinicians were involved. RESULTS A combination of resilience-enhancing exercises, group sessions and an online support platform, including follow-up at six and twelve months after delivery, was designed to enhance resilience during pregnancy and up to one year postpartum. This intervention incorporates 5 intervention functions delivered by 18 behaviour change techniques. CONCLUSIONS This study responds to the need for theory-based intervention programs aiming to enhance resilience to improve the psychological health of pregnant women. We developed a multicomponent resilience-enhancing intervention for pregnant women up to one year postpartum.
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Affiliation(s)
- Sarah Van Haeken
- Research & Expertise, Resilient People, UC Leuven-Limburg, Wetenschapspark 21, 3590, Diepenbeek, Belgium.
- Faculty of Medicine, department of Development & Regeneration, REALIFE Research Group, Women & Child KU Leuven, Leuven, Belgium.
| | - Marijke A K A Braeken
- Faculty of Rehabilitation Sciences, REVAL-Rehabilitation Research Center, Hasselt University, Diepenbeek, Belgium
| | - Antje Horsch
- Institute of Higher Education and Research in Healthcare, University of Lausanne, Lausanne, Switzerland
- Department Woman-Mother-Child, Faculty of Biology and Medicine, Lausanne University Hospital, Lausanne, Switzerland
| | - Mirjam Oosterman
- Department of Clinical Child and Family Studies, Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - Annick Bogaerts
- Faculty of Medicine, department of Development & Regeneration, REALIFE Research Group, Women & Child KU Leuven, Leuven, Belgium
- Department of Nursing and Midwifery, CRIC Centre for Research & Innovation in Care, University of Antwerp, Antwerp, Belgium
- Faculty of Health, University of Plymouth, Devon, UK
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17
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Deforges C, Sandoz V, Noël Y, Avignon V, Desseauve D, Bourdin J, Vial Y, Ayers S, Holmes EA, Epiney M, Horsch A. Single-session visuospatial task procedure to prevent childbirth-related posttraumatic stress disorder: a multicentre double-blind randomised controlled trial. Mol Psychiatry 2023; 28:3842-3850. [PMID: 37759037 PMCID: PMC10730415 DOI: 10.1038/s41380-023-02275-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2023] [Revised: 09/10/2023] [Accepted: 09/14/2023] [Indexed: 09/29/2023]
Abstract
Preventive evidence-based interventions for childbirth-related posttraumatic stress disorder (CB-PTSD) are lacking. Yet, 18.5% of women develop CB-PTSD symptoms following an unplanned caesarean section (UCS). This two-arm, multicentre, double-blind superiority trial tested the efficacy of an early single-session intervention including a visuospatial task on the prevention of maternal CB-PTSD symptoms. The intervention was delivered by trained maternity clinicians. Shortly after UCS, women were included if they gave birth to a live baby, provided consent, and perceived their childbirth as traumatic. Participants were randomly assigned to the intervention or attention-placebo group (allocation ratio 1:1). Assessments were done at birth, six weeks, and six months postpartum. Group differences in maternal CB-PTSD symptoms at six weeks (primary outcomes) and six months postpartum (secondary outcomes) were assessed with the self-report PTSD Checklist for DSM-5 (PCL-5) and by blinded research assessors with the Clinician-administered PTSD scale for DSM-5 (CAPS-5). Analysis was by intention-to-treat. The trial was prospectively registered (ClinicalTrials.gov, NCT03576586). Of the 2068 women assessed for eligibility, 166 were eligible and 146 were randomly assigned to the intervention (n = 74) or attention-placebo control group (n = 72). For the PCL-5, at six weeks, a marginally significant intervention effect was found on the total PCL-5 PTSD symptom count (β = -0.43, S.E. = 0.23, z = -1.88, p < 0.06), and on the intrusions (β = -0.73, S.E. = 0.38, z = -1.94, p < 0.0525) and arousal (β = -0.55, S.E. = 0.29, z = -1.92, p < 0.0552) clusters. At six months, a significant intervention effect on the total PCL-5 PTSD symptom count (β = -0.65, S.E. = 0.32, z = -2.04, p = 0.041, 95%CI[-1.27, -0.03]), on alterations in cognition and mood (β = -0.85, S.E. = 0.27, z = -3.15, p = 0.0016) and arousal (β = -0.56, S.E. = 0.26, z = -2.19, p < 0.0289, 95%CI[-1.07, -0.06]) clusters appeared. No group differences on the CAPS-5 emerged. Results provide evidence that this brief, single-session intervention carried out by trained clinicians can prevent the development of CB-PTSD symptoms up to six months postpartum.
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Affiliation(s)
- Camille Deforges
- Institute of Higher Education and Research in Healthcare, University of Lausanne, Lausanne, Vaud, Switzerland
| | - Vania Sandoz
- Institute of Higher Education and Research in Healthcare, University of Lausanne, Lausanne, Vaud, Switzerland
- Department Woman-Mother-Child, Lausanne University Hospital, Lausanne, Vaud, Switzerland
| | - Yvonnick Noël
- Department of Psychology, Rennes 2 University, Rennes, France
| | - Valérie Avignon
- Institute of Higher Education and Research in Healthcare, University of Lausanne, Lausanne, Vaud, Switzerland
- Department Woman-Mother-Child, Lausanne University Hospital, Lausanne, Vaud, Switzerland
| | - David Desseauve
- Department Woman-Mother-Child, Lausanne University Hospital, Lausanne, Vaud, Switzerland
| | - Julie Bourdin
- Department Woman-Mother-Child, Lausanne University Hospital, Lausanne, Vaud, Switzerland
| | - Yvan Vial
- Department Woman-Mother-Child, Lausanne University Hospital, Lausanne, Vaud, Switzerland
| | - Susan Ayers
- Centre for Maternal and Child Health Research, City, University of London, London, UK
| | - Emily A Holmes
- Department of Psychology, Uppsala University, Uppsala, Sweden
| | - Manuella Epiney
- Department of Woman, Child and Teenager, Geneva University Hospitals, Geneva, Switzerland
| | - Antje Horsch
- Institute of Higher Education and Research in Healthcare, University of Lausanne, Lausanne, Vaud, Switzerland.
- Department Woman-Mother-Child, Lausanne University Hospital, Lausanne, Vaud, Switzerland.
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Baumann S, Staudt A, Horesh D, Eberhard-Gran M, Garthus-Niegel S, Horsch A. Perineal tear and childbirth-related posttraumatic stress: A prospective cohort study. Acta Psychiatr Scand 2023. [PMID: 37550260 DOI: 10.1111/acps.13595] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2023] [Revised: 07/03/2023] [Accepted: 07/15/2023] [Indexed: 08/09/2023]
Abstract
OBJECTIVE Quantitative studies examining the occurrence of childbirth-related posttraumatic stress disorder (CB-PTSD) following severe perineal rupture are lacking. The objective of this population-based study was to investigate the prospective associations between the degree of perineal tear during childbirth and CB-PTSD symptoms, when adjusting for known covariates (maternal age, years of school education, premature birth, and parity). We hypothesized that women with different degrees of perineal tear will differ regarding (1) the level of CB-PTSD symptoms at 8 weeks and 2 years postpartum and (2) the rate of change in CB-PTSD symptoms from 8 weeks to 2 years postpartum. METHOD Secondary data analysis from the Akershus Birth Cohort, a large population-based prospective cohort study using self-report questionnaires and hospital record data. RESULTS The degree of perineal tear was significantly associated with CB-PTSD symptoms at 8 weeks and 2 years postpartum. However, the degree of perineal tear was not significantly associated with the change in CB-PTSD symptoms over time. Similar patterns were found for both total CB-PTSD symptoms as well as for avoidance and intrusion symptoms only. CONCLUSION Results seem to support a dose-response model, suggesting that the higher the severity of the perineal tear, the higher the posttraumatic morbidity.
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Affiliation(s)
- Sophie Baumann
- Faculty of Medicine, Institute and Policlinic of Occupational and Social Medicine, Technische Universität Dresden, Dresden, Germany
- Department of Methods in Community Medicine, Institute for Community Medicine, University Medicine Greifswald, Greifswald, Germany
| | - Andreas Staudt
- Faculty of Medicine, Institute and Policlinic of Occupational and Social Medicine, Technische Universität Dresden, Dresden, Germany
- Department of Methods in Community Medicine, Institute for Community Medicine, University Medicine Greifswald, Greifswald, Germany
| | - Danny Horesh
- Department of Psychology, Bar-Ilan University, Ramat-Gan, Israel
- Department of Psychiatry, NYU Grossman School of Medicine, New York City, New York, USA
| | - Malin Eberhard-Gran
- Women and Children's Division, Norwegian Research Centre for Women's Health, Oslo University Hospital, Oslo, Norway
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Susan Garthus-Niegel
- Faculty of Medicine, Institute and Policlinic of Occupational and Social Medicine, Technische Universität Dresden, Dresden, Germany
- Faculty of Medicine, Medical School Hamburg, Institute for Systems Medicine (ISM), Hamburg, Germany
- Department of Childhood and Families, Norwegian Institute of Public Health, Oslo, Norway
| | - Antje Horsch
- Institute of Higher Education and Research in Healthcare, University of Lausanne, Lausanne, Switzerland
- Department Woman-mother-child, Lausanne University Hospital, Lausanne, Switzerland
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Gilbert L, Quansah DY, Arhab A, Schenk S, Gross J, Lanzi S, Stuijfzand B, Lacroix A, Horsch A, Puder JJ. Effect of the MySweetheart randomized controlled trial on birth, anthropometric and psychobehavioral outcomes in offspring of women with GDM. Front Endocrinol (Lausanne) 2023; 14:1148426. [PMID: 37351105 PMCID: PMC10284133 DOI: 10.3389/fendo.2023.1148426] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Accepted: 05/22/2023] [Indexed: 06/24/2023] Open
Abstract
Introduction Gestational diabetes mellitus (GDM) may negatively affect offspring outcomes. A lifestyle intervention may therefore not only improve maternal, but also offspring outcomes. The effects of lifestyle interventions on birth, anthropometric, and psychobehavioral outcomes in offspring of women with GDM need further evidence. Design The MySweetheart trial is a monocentric single-blind randomized controlled trial in 211 women with GDM. It tested the effect of a pre- and postpartum multidimensional interdisciplinary lifestyle and psychosocial intervention focusing on both the mothers and their infants and its effects on maternal (primary outcomes) and offspring (secondary outcomes) metabolic and psychobehavioral outcomes compared with guidelines-based usual-care. This paper focuses on offspring's birth, anthropometric, and maternal report of psychobehavioral outcomes at singular timepoints. Methods Women with GDM aged ≥18 years, between 24-32 weeks of gestation, speaking French or English were included and randomly allocated to either the intervention or to an active guidelines-based usual-care group using a 1:1 allocation ratio. The intervention lasted from pregnancy until 1 year postpartum and focused on improving diet, physical activity, and mental health in the mother. For the offspring it focused on supporting breastfeeding, delaying the timing of introduction of solid foods, reducing the consumption of sweetened beverages, increasing physical activity of the family, and improving parental responsiveness to infant distress, hunger, satiety and sleeping cues, and difficult behavior. Results Adverse birth and neonatal outcomes rarely occurred overall. There were no differences between groups in offspring birth, neonatal, anthropometric, or psychobehavioral outcomes up to one year. After adjustments for maternal age and the offspring's sex and age, there was a borderline significant between-group difference in birth length (β:-0.64, CI:-1.27; -0.01, p: 0.05), i.e., offspring of mothers in the intervention group were born 0.64 cm shorter compared to those in the usual-care group. Conclusion This is the first pre- and postpartum multidimensional interdisciplinary lifestyle and psychosocial intervention in GDM focusing on both the mother and the offspring. It did not lead to a significant improvement in most birth, anthropometric, and psychobehavioral outcomes in offspring of women with GDM. ClinicalTrials.gov Identifier: NCT02890693.
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Affiliation(s)
- Leah Gilbert
- Nepean Clinical School, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
- Obstetric Service, Department Woman-Mother-Child, Interdisciplinary GDM Group Lausanne, Lausanne University Hospital, Lausanne, Switzerland
| | - Dan Yedu Quansah
- Nepean Clinical School, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
| | - Amar Arhab
- Nepean Clinical School, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
| | - Sybille Schenk
- Nepean Clinical School, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
| | - Justine Gross
- Nepean Clinical School, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
| | - Stefano Lanzi
- Service d’angiologie, Département Cœur-Vaisseaux, Centre Hospitalier Universitaire Vaudois (CHUV), Lausanne, Switzerland
| | - Bobby Stuijfzand
- Nepean Clinical School, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
| | - Alain Lacroix
- Nepean Clinical School, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
| | - Antje Horsch
- Institute of Higher Education and Research in Healthcare (IUFRS), University of Lausanne, Lausanne, Switzerland
- Neonatology Service, Department Woman-Mother-Child, Lausanne University Hospital, Lausanne, Switzerland
| | - Jardena J. Puder
- Nepean Clinical School, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
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Corbaz F, Boussac E, Lepigeon K, Gomes Dias D, Marcadent S, Desseauve D, Horsch A. 'connEcted caesarean section': creating a virtual link between MOthers and their infanTs to ImprOve maternal childbirth experieNce - study protocol for a PILOT trial (e-motion-pilot). BMJ Open 2023; 13:e065830. [PMID: 37286319 DOI: 10.1136/bmjopen-2022-065830] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/09/2023] Open
Abstract
INTRODUCTION One-third of mothers rate their childbirth as traumatic. The prevalence of childbirth-related post-traumatic stress disorder (CB-PTSD) is 4.7%. Skin-to-skin contact is a protective factor against CB-PTSD. However, during a caesarean section (CS), skin-to-skin contact is not always feasible and mothers and infants are often separated. In those cases, there is no validated and available solution to substitute this unique protective factor. Based on the results of studies using virtual reality and head-mounted displays (HMDs) and studies on childbirth experience, we hypothesise that enabling the mother to have a visual and auditory contact with her baby could improve her childbirth experience while she and her baby are separated. To facilitate this connection, we will use a two-dimensional 360° camera filming the baby linked securely to an HMD that the mother can wear during the end of the surgery. METHODS AND ANALYSIS This study protocol describes a monocentric open-label controlled pilot trial with minimal risk testing the effects of a visual and auditory contact via an HMD worn by the mother airing a live video of her newborn compared with treatment-as-usual in 70 women after CS. The first 35 consecutive participants will be the control group and will receive the standard care. The next 35 consecutive participants will have the intervention. The primary outcome will be differences in maternal childbirth experience (Childbirth Experience Questionnaire 2) at 1-week postpartum between the intervention and control groups. Secondary outcomes will be CB-PTSD symptoms, birth satisfaction, mother-infant bonding, perceived pain and stress during childbirth, maternal anxiety and depression symptoms, anaesthesiological data and acceptability of the procedure. ETHICS AND DISSEMINATION Ethics approval was granted by the Human Research Ethics Committee of the Canton de Vaud (study number 2022-00215). Dissemination of results will occur via national and international conferences, peer-reviewed journals, public conferences and social media. TRIAL REGISTRATION NUMBER NCT05319665.
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Affiliation(s)
- Fiona Corbaz
- Woman-Mother-Child, Lausanne University Hospital, Lausanne, Switzerland
| | - Emilie Boussac
- Anesthesiology, Lausanne University Hospital, Lausanne, Switzerland
| | - Karine Lepigeon
- Woman-Mother-Child, Lausanne University Hospital, Lausanne, Switzerland
| | - Diana Gomes Dias
- Woman-Mother-Child, Lausanne University Hospital, Lausanne, Switzerland
| | | | - David Desseauve
- Woman-Mother-Child, Lausanne University Hospital, Lausanne, Switzerland
| | - Antje Horsch
- Woman-Mother-Child, Lausanne University Hospital, Lausanne, Switzerland
- Institute of Higher Education and Research in Healthcare, University of Lausanne, Lausanne, Switzerland
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Fort D, Deforges C, Messerli-Bürgy N, Michael T, Baud D, Lalor J, Rimmele U, Horsch A. Tackling childbirth-related intrusive memories with a single-session behavioural intervention involving a visuospatial task: protocol for a single-blind, waitlist-controlled randomised trial. BMJ Open 2023; 13:e073874. [PMID: 37247964 DOI: 10.1136/bmjopen-2023-073874] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/31/2023] Open
Abstract
INTRODUCTION Approximately 12.3% of mothers experience childbirth-related post-traumatic stress symptoms (CB-PTSS). However, evidence-based interventions to treat CB-PTSS are lacking. Intrusive memories (IM), a key CB-PTSS, are distressing and can trigger other PTSS by reliving the traumatic event. Emerging evidence shows that a behavioural intervention involving a visuospatial task (BI-VT) can reduce the number of IM and PTSS, supposedly by interfering with the reconsolidation of the trauma memory. This study aims to test the efficacy of a single-session BI-VT targeting IM to reduce the number of childbirth-related (CB-)IM and PTSS, in comparison to a waitlist control group (WCG). METHODS AND ANALYSIS In this multicentre, single-blind, randomised controlled trial being undertaken at one regional and one university hospital in Switzerland, 60 participants will be allocated to the Immediate Intervention Group (IIG), receiving the immediate intervention on day 15, and 60 participants to the WCG receiving the delayed intervention on day 30. All participants will report their CB-IM during the 2 weeks preimmediate and postimmediate intervention in diaries. The IIG will additionally report their CB-IM over weeks 5 and 6 postimmediate intervention. Self-report questionnaires will assess CB-PTSS at 2 weeks preimmediate and postimmediate intervention in both groups, and at 6 weeks postimmediate intervention in the IIG. A feedback questionnaire will evaluate the intervention acceptability. The primary outcome will be group differences in the number of CB-IM between the 2 weeks preimmediate and postimmediate intervention. Secondary outcomes will be CB-PTSS at 2 and 6 weeks postimmediate intervention, the number of CB-IM at weeks 5 and 6 postimmediate intervention, and intervention acceptability. ETHICS AND DISSEMINATION Ethical approval was granted by the Human Research Ethics Committee of the Canton of Vaud (study number 202200652). Participants will provide an informed consent before study participation. Results will be presented in peer-reviewed journals and at conferences. TRIAL REGISTRATION NUMBER NCT05381155.
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Affiliation(s)
- Déborah Fort
- Institute of Higher Education and Research in Healthcare, Faculty of Biology and Medicine, University of Lausanne, Lausanne, Switzerland
| | - Camille Deforges
- Institute of Higher Education and Research in Healthcare, Faculty of Biology and Medicine, University of Lausanne, Lausanne, Switzerland
| | - Nadine Messerli-Bürgy
- Family and Development Research Center (FADO), Faculty of Social and Political Sciences, University of Lausanne, Lausanne, Switzerland
| | - Tanja Michael
- Division of Clinical Psychology and Psychotherapy, Department of Psychology, Saarland University, Saarbrücken, Germany
| | - David Baud
- Materno-Fetal and Obstetrics Research Unit, Department Woman-Mother-Child, Lausanne University Hospital, Lausanne, Switzerland
| | - Joan Lalor
- School of Nursing and Midwifery, Trinity College Dublin, Dublin 2, Ireland
| | - Ulrike Rimmele
- Emotion and Memory Laboratory, Faculty of Education Sciences and Psychology, University of Geneva, Geneva, Switzerland
- Swiss Center for Affective Sciences (CISA), University of Geneva, Geneva, Switzerland
| | - Antje Horsch
- Institute of Higher Education and Research in Healthcare, Faculty of Biology and Medicine, University of Lausanne, Lausanne, Switzerland
- Neonatology Service, Department Woman-Mother-Child, Lausanne University Hospital, Lausanne, Switzerland
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Bartels HC, Horsch A, Cooney N, Brennan DJ, Lalor JG. Living with a diagnosis of Placenta Accreta Spectrum: Mothers' and Fathers' experience of the antenatal journey and the birth. PLoS One 2023; 18:e0286082. [PMID: 37216388 DOI: 10.1371/journal.pone.0286082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2022] [Accepted: 05/09/2023] [Indexed: 05/24/2023] Open
Abstract
OBJECTIVE Much research into Placenta Accreta Spectrum (PAS) has focussed on the associated maternal morbidity and mortality. However, mothers' and fathers' lived experiences of the aftermath of a diagnosis of PAS up to the birth and beyond has received little attention. Therefore, the aim of this study was to increase our understanding of the psychological consequences of PAS on women and their partners during pregnancy, up to and including the birth. METHODS In-depth interviews were conducted with 29 participants; 6 couples were interviewed together (n = 12), 6 couples were interviewed separately (n = 12), and 5 women were interviewed without their partner. Data from the antenatal and intrapartum periods are presented. Couples were eligible for inclusion if they had a diagnosis of PAS within the previous 5 years. An Interpretative Phenomenological Analysis approach was used to gather and analyse data. Virtual interviews were conducted over a 3-month period from February to April 2021. RESULTS Themes emerged relating to two distinct timepoints, the antenatal period and birth. The antenatal period had two main themes: the first antenatal main theme was "Living with PAS", which had two sub-themes: "Lack of knowledge of PAS" and "Experiences of varied approaches to care". The second antenatal main theme was "Coping with uncertainty", which had two sub-themes of "Getting on with it", and "Emotional toll". Relating to birth, two main themes emerged. The first main theme was "A traumatic experience", with three sub-themes of "Saying goodbye", "Experiencing trauma" and the "Witnessing of trauma" (by fathers). The second main theme which emerged was "Feeling safe in the hands of experts", with two subthemes of "Safety in expert team" and "Relief at surviving". CONCLUSIONS This study highlights the significant psychological consequences a diagnosis of PAS has on mothers and fathers, how they try to come to terms with the diagnosis and the experience of a traumatic birth, and how management within a specialist team can alleviate some of these fears.
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Affiliation(s)
- Helena C Bartels
- Dept of UCD Obstetrics and Gynaecology, School of Medicine, National Maternity Hospital, University College Dublin, Dublin, Ireland
| | - Antje Horsch
- Institute of Higher Education and Research in Healthcare, University of Lausanne, Lausanne, Switzerland
- Woman-Mother-Child Department, Lausanne University Hospital, Lausanne, Switzerland
| | - Naomi Cooney
- Placenta Accreta Ireland, Patient support and advocacy group, Dublin, Ireland
| | - Donal J Brennan
- Dept of UCD Obstetrics and Gynaecology, School of Medicine, National Maternity Hospital, University College Dublin, Dublin, Ireland
| | - Joan G Lalor
- School of Nursing & Midwifery, Trinity College Dublin, Dublin, Ireland
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Lesniara-Stachon A, Quansah DY, Schenk S, Retsa C, Halter RJ, Murray MM, Lacroix A, Horsch A, Toepel U, Puder JJ. Brain responses to food viewing in women during pregnancy and post partum and their relationship with metabolic health: study protocol for the FOODY Brain Study, a prospective observational study. BMJ Open 2023; 13:e067013. [PMID: 37072356 PMCID: PMC10124253 DOI: 10.1136/bmjopen-2022-067013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/20/2023] Open
Abstract
INTRODUCTION Food cravings are common in pregnancy and along with emotional eating and eating in the absence of hunger, they are associated with excessive weight gain and adverse effects on metabolic health including gestational diabetes mellitus (GDM). Women with GDM also show poorer mental health, which further can contribute to dysregulated eating behaviour. Food cravings can lead to greater activity in brain centres known to be involved in food 'wanting' and reward valuation as well as emotional eating. They are also related to gestational weight gain. Thus, there is a great need to link implicit brain responses to food with explicit measures of food intake behaviour, especially in the perinatal period. The aim of this study is to investigate the spatiotemporal brain dynamics to visual presentations of food in women during pregnancy and in the post partum, and link these brain responses to the eating behaviour and metabolic health outcomes in women with and without GDM. METHODS AND ANALYSIS This prospective observational study will include 20 women with and 20 without GDM, that have valid data for the primary outcomes. Data will be assessed at 24-36 weeks gestational age and at 6 months post partum. The primary outcomes are brain responses to food pictures of varying carbohydrate and fat content during pregnancy and in the post partum using electroencephalography. Secondary outcomes including depressive symptoms, current mood and eating behaviours will be assessed with questionnaires, objective eating behaviours will be measured using Auracle and stress will be measured with heart rate and heart rate variability (Actiheart). Other secondary outcome measures include body composition and glycaemic control parameters. ETHICS AND DISSEMINATION The Human Research Ethics Committee of the Canton de Vaud approved the study protocol (2021-01976). Study results will be presented at public and scientific conferences and in peer-reviewed journals.
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Affiliation(s)
- Anna Lesniara-Stachon
- Obstetric Service, Department Woman-Mother-Child, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
- Faculty of Biology and Medicine, University of Lausanne, Lausanne, Switzerland
| | - Dan Yedu Quansah
- Obstetric Service, Department Woman-Mother-Child, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Sybille Schenk
- Obstetric Service, Department Woman-Mother-Child, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
- Service of Endocrinology, Diabetes and Metabolism, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Chrysa Retsa
- Laboratory for Investigative Neurophysiology (the LINE), Radiology Department, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
- The Sense Innovation and Research Center, Lausanne and Sion, Switzerland
- CIBM Center for Biomedical Imaging, Lausanne, Switzerland
| | - Ryan J Halter
- Thayer School of Engineering, Dartmouth College, Hanover, New Hampshire, USA
- Department of Surgery, Geisel School of Medicine, Dartmouth College, Hanover, New Hampshire, USA
| | - Micah M Murray
- Laboratory for Investigative Neurophysiology (the LINE), Radiology Department, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
- The Sense Innovation and Research Center, Lausanne and Sion, Switzerland
- CIBM Center for Biomedical Imaging, Lausanne, Switzerland
| | - Alain Lacroix
- Institute of Higher Education and Research in Healthcare (IUFRS), University of Lausanne, Lausanne, Switzerland
- Neonatology service, Department Woman-Mother-Child, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Antje Horsch
- Institute of Higher Education and Research in Healthcare (IUFRS), University of Lausanne, Lausanne, Switzerland
- Neonatology service, Department Woman-Mother-Child, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Ulrike Toepel
- Laboratory for Investigative Neurophysiology (the LINE), Radiology Department, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Jardena J Puder
- Obstetric Service, Department Woman-Mother-Child, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
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Staudt A, Baumann S, Horesh D, Eberhard-Gran M, Horsch A, Garthus-Niegel S. Predictors and comorbidity patterns of maternal birth-related posttraumatic stress symptoms: A Latent Class Analysis. Psychiatry Res 2023; 320:115038. [PMID: 36603381 DOI: 10.1016/j.psychres.2022.115038] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Revised: 12/08/2022] [Accepted: 12/27/2022] [Indexed: 12/31/2022]
Abstract
Birth-related posttraumatic stress symptoms (PTSS) place a significant burden on mothers and their families. The aim was to (1) identify differential profiles of maternal birth-related PTSS; (2) determine the predictive value of established risk factors; (3) examine comorbidity patterns related to depression and anxiety symptoms. As part of the Norwegian Ahus Birth Cohort, 2,088 (expectant) mothers completed self-report questionnaires from 17 weeks of gestation to 2 years postpartum. The Impact of Event Scale was used to assess PTSS 8 weeks after birth. Latent class analysis revealed four latent classes: a High birth-related PTSS class (4%), a Moderate birth-related PTSS class (16%) particularly characterized by endorsement of intrusion symptoms, a Mild birth-related PTSS class (47%), as well as a No birth-related PTSS class (33%). We found similar (younger age, worse subjective birth experience, higher fear of childbirth) and differential predictors (prior posttraumatic stress disorder, lower education, birth complications). Women classified with High, Moderate, or Mild birth-related PTSS showed higher depression and anxiety symptoms compared to women with No birth-related PTSS. A considerable number of mothers experienced birth-related PTSS, most on a subclinical level, but these women still showed signs of mental distress 2 years postpartum, calling for more universal prevention approaches.
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Affiliation(s)
- Andreas Staudt
- Institute and Policlinic of Occupational and Social Medicine, Faculty of Medicine, TU Dresden, Dresden, Germany; Department of Methods in Community Medicine, Institute of Community Medicine, University Medicine Greifswald, Greifswald, Germany.
| | - Sophie Baumann
- Institute and Policlinic of Occupational and Social Medicine, Faculty of Medicine, TU Dresden, Dresden, Germany; Department of Methods in Community Medicine, Institute of Community Medicine, University Medicine Greifswald, Greifswald, Germany
| | - Danny Horesh
- Department of Psychology, Bar-Ilan University, Ramat-Gan, Israel; Department of Psychiatry, NYU Grossman School of Medicine, New York, USA
| | - Malin Eberhard-Gran
- Norwegian Research Centre for Women's Health, Women and Children's Division, Oslo University Hospital, Rikshospitalet, Oslo, Norway; Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Antje Horsch
- Institute of Higher Education and Research in Healthcare, University of Lausanne, Lausanne, Switzerland; Department Woman-Mother-Child, Lausanne University Hospital, Lausanne, Switzerland
| | - Susan Garthus-Niegel
- Institute and Policlinic of Occupational and Social Medicine, Faculty of Medicine, TU Dresden, Dresden, Germany; Institute for Systems Medicine (ISM), Faculty of Medicine, Medical School Hamburg, Hamburg, Germany; Department of Childhood and Families, Norwegian Institute of Public Health, Oslo, Norway
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Garthus-Niegel S, Horsch A. The Society for Reproductive and Infant Psychology and the Journal of Reproductive and Infant Psychology: Transitions and new beginnings. J Reprod Infant Psychol 2023; 41:1-2. [PMID: 36682378 DOI: 10.1080/02646838.2022.2158538] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Affiliation(s)
- Susan Garthus-Niegel
- Institute and Policlinic of Occupational and Social Medicine, Faculty of Medicine of the Technische Universität Dresden, Dresden, Germany.,Institute for Systems Medicine (ISM) and Faculty of Human Medicine, MSH Medical School Hamburg, Hamburg, Germany.,Department of Childhood and Families, Norwegian Institute of Public Health, Oslo, Norway
| | - Antje Horsch
- Institute of Higher Education and Research in Healthcare, University of Lausanne, Lausanne, Switzerland.,Department Woman-Mother-Child, Lausanne University Hospital, Lausanne, Switzerland
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Nakic Radoš S, Ayers S, Horsch A. Editorial: From childbearing to childrearing: Parental mental health and infant development. Front Psychol 2023; 13:1123241. [PMID: 36687935 PMCID: PMC9850224 DOI: 10.3389/fpsyg.2022.1123241] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Accepted: 12/14/2022] [Indexed: 01/06/2023] Open
Affiliation(s)
- Sandra Nakic Radoš
- Department of Psychology, Catholic University of Croatia, Zagreb, Croatia,*Correspondence: Sandra Nakić Radoš ✉
| | - Susan Ayers
- Centre for Maternal and Child Health Research, School of Health and Psychological Sciences, City, University of London, London, United Kingdom
| | - Antje Horsch
- Institute of Higher Education and Research in Healthcare-IUFRS, Faculty of Biology and Medicine, University of Lausanne, Lausanne, Switzerland,Department Woman-Mother-Child, Faculty of Biology and Medicine, Lausanne University Hospital, Lausanne, Switzerland
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Antoniou MC, Quansah DY, Mühlberg S, Gilbert L, Arhab A, Schenk S, Lacroix A, Stuijfzand B, Horsch A, Puder JJ. Maternal and fetal predictors of anthropometry in the first year of life in offspring of women with GDM. Front Endocrinol (Lausanne) 2023; 14:1144195. [PMID: 37056671 PMCID: PMC10086315 DOI: 10.3389/fendo.2023.1144195] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2023] [Accepted: 03/13/2023] [Indexed: 03/30/2023] Open
Abstract
INTRODUCTION Gestational Diabetes Mellitus (GDM) carries an increased risk for adverse perinatal and longer-term cardiometabolic consequences in offspring. This study evaluated the utility of maternal anthropometric, metabolic and fetal (cord blood) parameters to predict offspring anthropometry up to 1 year in pregnancies with GDM. MATERIALS AND METHODS In this prospective analysis of the MySweetheart study, we included 193/211 women with GDM that were followed up to 1 year postpartum. Maternal predictors included anthropometric (pre-pregnancy BMI, gestational weight gain (GWG), weight and fat mass at the 1st GDM visit), and metabolic parameters (fasting insulin and glucose, Homeostatic Model Assessment for Insulin Resistance (HOMA-IR), Quantitative insulin-sensitivity check index (QUICKI), HbA1c, triglycerides, and high-density lipoprotein (HDL) at the 1st visit and HbA1c at the end of pregnancy). Fetal predictors (N=46) comprised cord blood glucose and insulin, C-Peptide, HOMA-IR, triglycerides and HDL. Offspring outcomes were anthropometry at birth (weight/weight z-score, BMI, small and large for gestational age (SGA,LGA)), 6-8 weeks and 1 year (weight z-score, BMI/BMI z-score, and the sum of 4 skinfolds). RESULTS In multivariate analyses, birth anthropometry (weight, weight z-score, BMI and/or LGA), was positively associated with cord blood HDL and HbA1c at the 1st GDM visit, and negatively with maternal QUICKI and HDL at the 1st GDM visit (all p ≤ 0.045). At 6-8 weeks, offspring BMI was positively associated with GWG and cord blood insulin, whereas the sum of skinfolds was negatively associated with HDL at the 1st GDM visit (all p ≤0.023). At 1 year, weight z-score, BMI, BMI z-score, and/or the sum of skinfolds were positively associated with pre-pregnancy BMI, maternal weight, and fat mass at the 1st GDM visit and 3rd trimester HbA1c (all p ≤ 0.043). BMI z-score and/or the sum of skinfolds were negatively associated with cord blood C-peptide, insulin and HOMA-IR (all p ≤0.041). DISCUSSION Maternal anthropometric, metabolic, and fetal metabolic parameters independently affected offspring anthropometry during the 1st year of life in an age-dependent manner. These results show the complexity of pathophysiological mechanism for the developing offspring and could represent a base for future personalized follow-up of women with GDM and their offspring.
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Affiliation(s)
- Maria-Christina Antoniou
- Unit of Pediatric Endocrinology and Diabetology, Pediatric Service, Woman-Mother-Child Department, Lausanne University Hospital, Lausanne, Switzerland
| | - Dan Yedu Quansah
- Obstetric Service, Woman-Mother-Child Department, Lausanne University Hospital, Lausanne, Switzerland
| | - Suzanne Mühlberg
- Faculty of Biology and Medicine, University of Lausanne, Lausanne, Switzerland
| | - Leah Gilbert
- Obstetric Service, Woman-Mother-Child Department, Lausanne University Hospital, Lausanne, Switzerland
| | - Amar Arhab
- Obstetric Service, Woman-Mother-Child Department, Lausanne University Hospital, Lausanne, Switzerland
| | - Sybille Schenk
- Obstetric Service, Woman-Mother-Child Department, Lausanne University Hospital, Lausanne, Switzerland
| | - Alain Lacroix
- Obstetric Service, Woman-Mother-Child Department, Lausanne University Hospital, Lausanne, Switzerland
| | - Bobby Stuijfzand
- Obstetric Service, Woman-Mother-Child Department, Lausanne University Hospital, Lausanne, Switzerland
| | - Antje Horsch
- Institute of Higher Education and Research in Healthcare (IUFRS), University of Lausanne, Lausanne, Switzerland
- Neonatology Service, Woman-Mother-Child Department, Lausanne University Hospital, Lausanne, Switzerland
| | - Jardena Jacqueline Puder
- Obstetric Service, Woman-Mother-Child Department, Lausanne University Hospital, Lausanne, Switzerland
- *Correspondence: Jardena Jacqueline Puder,
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Guyon AJAA, Hildebrandt H, Güsewell A, Horsch A, Nater UM, Gomez P. How audience and general music performance anxiety affect classical music students’ flow experience: A close look at its dimensions. Front Psychol 2022; 13:959190. [PMID: 36389478 PMCID: PMC9649719 DOI: 10.3389/fpsyg.2022.959190] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Accepted: 09/26/2022] [Indexed: 11/25/2022] Open
Abstract
Flow describes a state of intense experiential involvement in an activity that is defined in terms of nine dimensions. Despite increased interest in understanding the flow experience of musicians in recent years, knowledge of how characteristics of the musician and of the music performance context affect the flow experience at the dimension level is lacking. In this study, we aimed to investigate how musicians’ general music performance anxiety (MPA) level (i.e., the general tendency to experience anxiety during solo music performances) and the presence of an audience influence the nine flow dimensions. The participants were 121 university music students who performed solo a music piece once by themselves (private performance) and once in front of an audience (public performance). Their general MPA level was measured with an adapted version of the STAI and ranged from 27 (very low MPA) to 76 (very high MPA). The level of the nine flow dimensions was assessed with the Flow State Scale-2 after each performance. The levels of “concentration on task at hand,” “sense of control,” and “autotelic experience” decreased significantly with increasing general MPA level. The levels of “unambiguous feedback” and “loss of self-consciousness” decreased significantly with increasing general MPA level during the public performance only. The level of “sense of control” was significantly lower during the public performance than the private performance across participants. The level of “unambiguous feedback” was significantly lower during the public performance than the private performance for participants with a general MPA level higher than 47. The level of “loss of self-consciousness” was significantly lower during the public performance than the private performance for participants with a general MPA level higher than 32. In contrast, the general MPA level and the audience did not significantly affect the levels of “challenge-skill balance,” “clear goals,” and “action-awareness merging.” These results show that the effects of general MPA level and audience vary greatly across flow state dimensions. We conclude that musicians’ flow state should be analyzed at the dimension level rather than as a global score. We discuss how our findings could inform the development and implementation of interventions.
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Affiliation(s)
- Amélie J. A. A. Guyon
- Department of Occupational and Environmental Health, Center for Primary Care and Public Health (Unisanté), University of Lausanne, Lausanne, Switzerland
| | - Horst Hildebrandt
- Swiss University Center for Music Physiology, Basel University of the Arts, Basel, Switzerland
- Swiss University Center for Music Physiology, Zurich University of the Arts, Zurich, Switzerland
| | - Angelika Güsewell
- HEMU–Haute Ecole de Musique, HES-SO University of Applied Sciences and Arts Western Switzerland, Lausanne, Switzerland
| | - Antje Horsch
- Institute of Higher Education and Research in Healthcare (IUFRS), University of Lausanne, Lausanne, Switzerland
- Neonatology Service, Department Woman-Mother-Child, Lausanne University Hospital, Lausanne, Switzerland
| | - Urs M. Nater
- Department of Clinical and Health Psychology, University of Vienna, Vienna, Austria
- University Research Platform “Stress of life (SOLE) – Processes and Mechanisms underlying Everyday Life Stress”, University of Vienna, Vienna, Austria
| | - Patrick Gomez
- Department of Occupational and Environmental Health, Center for Primary Care and Public Health (Unisanté), University of Lausanne, Lausanne, Switzerland
- *Correspondence: Patrick Gomez,
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Lovey O, Bickle-Graz M, Morisod Harari M, Horsch A, Schneider J. The Joint Observation in Neonatology and Neurodevelopmental Outcome of Preterm Infants at Six Months Corrected Age: Secondary Outcome Data from a Randomised Controlled Trial. Children 2022; 9:children9091380. [PMID: 36138689 PMCID: PMC9497992 DOI: 10.3390/children9091380] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Revised: 09/07/2022] [Accepted: 09/08/2022] [Indexed: 11/29/2022]
Abstract
This study aimed to evaluate the impact of a standardised joint observation (JOIN) performed in the neonatal intensive care unit (NICU) on the neurodevelopment of preterm infants at six months corrected age (CA) compared with a preterm control group. In this monocentric interventional randomised controlled trial, we allocated 76 mothers and their preterm neonates to either JOIN, an early one-session intervention, or standard care during the NICU hospitalisation. The neurodevelopment of the preterm infants was assessed by standardised developmental tests at six months CA and compared between the intervention and the control groups. This randomised controlled trial was registered on clinicaltrials.gov (NCT02736136) in April 2016. Sixty-five infants underwent neurodevelopmental assessment at six months CA. There were no significant differences between the two groups in neurodevelopmental outcome measures. The JOIN intervention was not associated with significant improvement in neurodevelopment at six months CA in preterm infants.
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Affiliation(s)
- Oriane Lovey
- Medicine School, University of Lausanne, 1015 Lausanne, Switzerland
| | - Myriam Bickle-Graz
- Department of Woman-Mother-Child, Clinic of Neonatology, Lausanne University Hospital and University of Lausanne, Avenue Pierre-Decker 2, 1011 Lausanne, Switzerland
| | - Mathilde Morisod Harari
- Department of Psychiatry, Division of Child and Adolescent Psychiatry, Lausanne University Hospital and University of Lausanne, 1011 Lausanne, Switzerland
| | - Antje Horsch
- Department of Woman-Mother-Child, Clinic of Neonatology, Lausanne University Hospital and University of Lausanne, Avenue Pierre-Decker 2, 1011 Lausanne, Switzerland
- Institute of Higher Education and Research in Healthcare, University of Lausanne, 1010 Lausanne, Switzerland
| | - Juliane Schneider
- Department of Woman-Mother-Child, Clinic of Neonatology, Lausanne University Hospital and University of Lausanne, Avenue Pierre-Decker 2, 1011 Lausanne, Switzerland
- Correspondence: ; Tel.: +41-21-314-91-95
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Avignon V, Baud D, Gaucher L, Dupont C, Horsch A. Author Correction: Childbirth experience, risk of PTSD and obstetric and neonatal outcomes according to antenatal classes attendance. Sci Rep 2022; 12:11923. [PMID: 35831414 PMCID: PMC9279495 DOI: 10.1038/s41598-022-16464-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- Valérie Avignon
- Department Woman-Mother-Child, Lausanne University Hospital (CHUV), Avenue Pierre-Decker 2, 1011, Lausanne, Switzerland. .,Research On Healthcare Performance RESHAPE, INSERM U1290, Université Claude Bernard Lyon 1, Domaine Rockefeller 8 avenue Rockefeller 69373 Lyon cedex 08, Lyon, France. .,Institute of Higher Education and Research in Healthcare (IUFRS), University of Lausanne, Route de la Corniche 10, 1010, Lausanne, Switzerland.
| | - David Baud
- Department Woman-Mother-Child, Lausanne University Hospital (CHUV), Avenue Pierre-Decker 2, 1011, Lausanne, Switzerland
| | - Laurent Gaucher
- Research On Healthcare Performance RESHAPE, INSERM U1290, Université Claude Bernard Lyon 1, Domaine Rockefeller 8 avenue Rockefeller 69373 Lyon cedex 08, Lyon, France.,Geneva School of Health Sciences, HES-SO University of Applied Sciences and Arts, Western Switzerland, Geneva, Switzerland
| | - Corinne Dupont
- Research On Healthcare Performance RESHAPE, INSERM U1290, Université Claude Bernard Lyon 1, Domaine Rockefeller 8 avenue Rockefeller 69373 Lyon cedex 08, Lyon, France
| | - Antje Horsch
- Department Woman-Mother-Child, Lausanne University Hospital (CHUV), Avenue Pierre-Decker 2, 1011, Lausanne, Switzerland.,Institute of Higher Education and Research in Healthcare (IUFRS), University of Lausanne, Route de la Corniche 10, 1010, Lausanne, Switzerland
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Gilbert L, Sandoz V, Quansah DY, Puder JJ, Horsch A. Prospective Associations Between Maternal Depression and Infant Sleep in Women With Gestational Diabetes Mellitus. Front Psychol 2022; 13:926315. [PMID: 35769757 PMCID: PMC9234523 DOI: 10.3389/fpsyg.2022.926315] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2022] [Accepted: 05/20/2022] [Indexed: 12/27/2022] Open
Abstract
BackgroundWomen with gestational diabetes mellitus have higher rates of perinatal depressive symptoms, compared to healthy pregnant women. In the general population, maternal depressive symptoms have been associated with infant sleep difficulties during the first year postpartum. However, there is lack of data on infants of mothers with gestational diabetes mellitus.MethodsThis study assessed the prospective associations between maternal perinatal depressive symptoms and infant sleep outcomes. The study population consisted of 95 Swiss women with gestational diabetes mellitus and their infants, enrolled in the control group of the MySweetheart trial (NCT02890693). Perinatal depressive symptoms were assessed with the Edinburgh Postnatal Depression Scale at the first gestational diabetes mellitus visit during pregnancy, at 6–8 weeks postpartum, and 1 year postpartum. The Brief Infant Sleep Questionnaire was used to assess infant sleep (i.e., nocturnal sleep duration, number of night waking, and maternal perception of infant sleep) at 1 year postpartum. Relevant maternal and infant measurements (e.g., infant sex or maternal age or social support) were collected or extracted from medical records as covariates.ResultsAntenatal maternal depressive symptoms at the first gestational diabetes mellitus visit were inversely associated with infant nocturnal sleep duration at 1 year postpartum (β = –5.9, p = 0.046). This association became marginally significant when covariates were added (β = –5.3, p = 0.057). Maternal depressive symptoms at 6–8 weeks postpartum were negatively and prospectively associated with infant nocturnal sleep duration (β = –9.35, p = 0.016), even when controlling for covariates (β = –7.32, p = 0.042). The association between maternal depressive symptoms and maternal perception of infant sleep as not a problem at all was significant at 1 year postpartum (β = –0.05, p = 0.006), although it became non-significant when controlling for appropriate covariates. No other significant associations were found.LimitationsThis study solely included measures derived from self-report validated questionnaires.ConclusionOur findings suggest it is of utmost importance to support women with gestational diabetes mellitus as a means to reduce the detrimental impact of maternal perinatal depressive symptoms on infant sleep, given its predictive role on infant metabolic health.
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Affiliation(s)
- Leah Gilbert
- Department Woman-Mother-Child, Interdisciplinary GDM Group Lausanne, Obstetric Service, Lausanne University Hospital, Lausanne, Switzerland
| | - Vania Sandoz
- Faculty of Biology and Medicine, Lausanne Perinatal Research Group, Institute of Higher Education and Research in Healthcare, University of Lausanne, Lausanne, Switzerland
- Department Woman-Mother-Child, Child Abuse and Neglect Team, Lausanne University Hospital, Lausanne, Switzerland
| | - Dan Yedu Quansah
- Department Woman-Mother-Child, Interdisciplinary GDM Group Lausanne, Obstetric Service, Lausanne University Hospital, Lausanne, Switzerland
| | - Jardena J. Puder
- Department Woman-Mother-Child, Interdisciplinary GDM Group Lausanne, Obstetric Service, Lausanne University Hospital, Lausanne, Switzerland
| | - Antje Horsch
- Faculty of Biology and Medicine, Lausanne Perinatal Research Group, Institute of Higher Education and Research in Healthcare, University of Lausanne, Lausanne, Switzerland
- Neonatalogy Unit, Department Woman-Mother-Child, Lausanne University Hospital, Lausanne, Switzerland
- *Correspondence: Antje Horsch,
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Affiliation(s)
- Susan Garthus-Niegel
- Institute for Systems Medicine and Faculty of Medicine, MSH Medical School Hamburg, Hamburg, Germany
- Institute and Outpatient Clinics of Occupational and Social Medicine, Faculty of Medicine of the Technische Universität Dresden, Dresden, Germany
- Department of Child Health and Development, Norwegian Institute of Public Health, Oslo, Norway
| | - Sandra Nakic Radoš
- Department of Psychology, Catholic University of Croatia, Zagreb, Croatia
| | - Antje Horsch
- Institute of Higher Education and Healthcare Sciences, University of Lausanne, Lausanne, Switzerland
- Department Woman-Mother-Child, Lausanne University Hospital, Lausanne, Switzerland
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Bartels HC, Horsch A, Cooney N, Brennan DJ, Lalor JG. Living beyond placenta accreta spectrum: parent's experience of the postnatal journey and recommendations for an integrated care pathway. BMC Pregnancy Childbirth 2022; 22:397. [PMID: 35538441 PMCID: PMC9092796 DOI: 10.1186/s12884-022-04726-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Accepted: 04/27/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Placenta Accreta Spectrum is associated with significant clinical maternal morbidity and mortality, which has been extensively described in the literature. However, there is a dearth of research on the lived experiences of pregnant people and their support partners. The aim of this study is to describe living beyond a pregnancy and birth complicated by PAS for up to four years postpartum. Participants experiences inform the development of an integrated care pathway of family centered support interventions. METHODS An Interpretative Phenomenological Analysis approach was applied to collect data through virtual interviews over a 3-month period from February to April 2021. Twenty-nine participants shared their stories; six people with a history of PAS and their support partners were interviewed together (n = 12 participants), six were interviewed separately (n = 12 participants), and five were interviewed without their partner. Pregnant people were eligible for inclusion if they had a diagnosis of PAS within the previous 5 years. This paper focuses on the postnatal period, with data from the antenatal and intrapartum periods described separately. RESULTS One superordinate theme "Living beyond PAS" emerged from interviews, with 6 subordinate themes as follows; "Living with a different body", "The impact on relationships", "Coping strategies", "Post-traumatic growth", "Challenges with normal care" and recommendations for "What needs to change". These themes informed the development of an integrated care pathway for pregnant people and their support partners to support them from diagnosis up to one year following the birth. CONCLUSION Parents described the challenges of the postnatal period in terms of the physical and emotional impact, and how some were able to make positive life changes in the aftermath of a traumatic event. An integrated care pathway of simple supportive interventions, based on participant recommendations, delivered as part of specialist multidisciplinary team care may assist pregnant people and their support partners in alleviating some of these challenges.
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Affiliation(s)
- Helena C Bartels
- Dept of UCD Obstetrics and Gynaecology, School of Medicine, University College Dublin, National Maternity Hospital, Holles Street, Dublin 2, Ireland
| | - Antje Horsch
- Institute of Higher Education and Research in Healthcare, University of Lausanne, Lausanne, Switzerland.,Woman-Mother-Child Department, Lausanne University Hospital, Lausanne, Switzerland
| | - Naomi Cooney
- Placenta Accreta Ireland, Patient Support and Advocacy Group, Dublin, Ireland
| | - Donal J Brennan
- Dept of UCD Obstetrics and Gynaecology, School of Medicine, University College Dublin, National Maternity Hospital, Holles Street, Dublin 2, Ireland
| | - Joan G Lalor
- School of Nursing and Midwifery, Trinity College Dublin, Dublin 2, Ireland.
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Branquinho M, Shakeel N, Horsch A, Fonseca A. Frontline health professionals’ perinatal depression literacy: A systematic review. Midwifery 2022; 111:103365. [DOI: 10.1016/j.midw.2022.103365] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Revised: 03/15/2022] [Accepted: 05/09/2022] [Indexed: 11/15/2022]
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Deforges C, Fort D, Stuijfzand S, Holmes EA, Horsch A. Reducing childbirth-related intrusive memories and PTSD symptoms via a single-session behavioural intervention including a visuospatial task: A proof-of-principle study. J Affect Disord 2022; 303:64-73. [PMID: 35108604 DOI: 10.1016/j.jad.2022.01.108] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2021] [Revised: 12/03/2021] [Accepted: 01/28/2022] [Indexed: 11/29/2022]
Abstract
BACKGROUND Intrusive memories (IMs) of traumatic events are a key symptom of posttraumatic stress disorder (PTSD), and contribute to its maintenance. This translational proof-of-principle study tested whether a single-session behavioural intervention reduced the number of childbirth-related IMs (CB-IMs) and childbirth-related PTSD (CB-PTSD) symptoms, in women traumatised by childbirth. The intervention was assumed to disrupt trauma memory reconsolidation. METHODS In this pre-post study, 18 participants, whose traumatic childbirth had occurred between seven months and 6.9 years before, received an intervention combining childbirth-related reminder cues (including the return to maternity unit) with a visuospatial task. They recorded their daily CB-IMs in the two weeks pre-intervention (diary 1), the two weeks post-intervention (diary 2; primary outcome), and in week 5 and 6 post-intervention (diary 3). CB-PTSD symptom severity was assessed five days pre-intervention and one month post-intervention. RESULTS Compared to diary 1, 15/18 participants had ≥ 50% fewer CB-IMs in diary 2. The median (IQR) reduction of the number of CB-IMs was 81.89% (39.58%) in diary 2, and persisted in diary 3 (n = 17). At one month post-intervention, CB-PTSD symptom severity was reduced by ≥ 50% in 10/18 participants. Of the 8 participants with a CB-PTSD diagnosis pre-intervention, none met diagnostic criteria post-intervention. The intervention was rated as highly acceptable. LIMITATIONS The design limits the causal interpretation of observed improvements. CONCLUSION This is the first time such a single-session behavioural intervention was tested for old and real-life single-event trauma. The promising results justify a randomized controlled trial, and may be a first step toward an innovative CB-PTSD treatment.
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Affiliation(s)
- Camille Deforges
- Institute of Higher Education and Research in Healthcare (IUFRS), University of Lausanne and Lausanne University Hospital, Lausanne, Switzerland
| | - Déborah Fort
- Institute of Higher Education and Research in Healthcare (IUFRS), University of Lausanne and Lausanne University Hospital, Lausanne, Switzerland
| | - Suzannah Stuijfzand
- Institute of Higher Education and Research in Healthcare (IUFRS), University of Lausanne and Lausanne University Hospital, Lausanne, Switzerland
| | - Emily A Holmes
- Department of Psychology, Uppsala University, Uppsala, Sweden
| | - Antje Horsch
- Institute of Higher Education and Research in Healthcare (IUFRS), University of Lausanne and Lausanne University Hospital, Lausanne, Switzerland; Woman-Mother-Child Department, Lausanne University Hospital, Lausanne, Switzerland.
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Heyne CS, Kazmierczak M, Souday R, Horesh D, den Berg MLV, Weigl T, Horsch A, Oosterman M, Dikmen-Yildiz P, Garthus-Niegel S. Prevalence and risk factors of birth-related posttraumatic stress among parents: A comparative systematic review and meta-analysis. Clin Psychol Rev 2022; 94:102157. [DOI: 10.1016/j.cpr.2022.102157] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Revised: 02/05/2022] [Accepted: 04/13/2022] [Indexed: 11/03/2022]
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Cai D, Villanueva P, Stuijfzand S, Lu H, Zimmermann B, Horsch A. The pregnancy experiences and antenatal care services of Chinese migrants in Switzerland: a qualitative study. BMC Pregnancy Childbirth 2022; 22:148. [PMID: 35193501 PMCID: PMC8863093 DOI: 10.1186/s12884-022-04444-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Accepted: 01/31/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Differences in reproductive health outcomes according to the mothers' origins have been reported in Switzerland, for example, women from European countries and non-European countries. The Swiss Federal Office of Public Health has therefore called for specific Swiss-wide studies on migrant populations. This study explores the pregnancy and antenatal care experiences of Chinese migrants in Switzerland, intending to clarify their maternity care needs. METHODS In-depth interviews of 14 Chinese mothers and 13 family members were conducted in Chinese or English and audio recorded. All audio-recordings were transcribed verbatim. All Chinese transcripts were translated into English. Thematic analysis was performed with the assistance of the qualitative data analysis software, MAXQDA Analytics Pro 2020. RESULTS Five themes were extracted from the transcripts: (1) Motivations and concerns about having children, (2) The merits of the Swiss maternity care system, (3) The inconveniences and barriers of accessing Swiss maternity care services, (4) Strategies to deal with the inconveniences of the Swiss maternity care system, and (5) The need for culturally sensitive care. CONCLUSIONS The results of our study provide new knowledge and understanding of pregnancy experiences and antenatal care services of Chinese mothers and their families in Switzerland. Their unique positive experiences included: family planning, the continuity of maternity services, humane care with the privacy respected, personalized sensitive care needs, preferences for female obstetricians and obstetricians of Asian origin. Several barriers were highlighted, such as information seeking difficulties, communication difficulties, and a rigid appointment system. Reducing barriers enabling access to maternity care services within the Swiss healthcare system is necessary to provide equal quality maternity care for individuals, irrespective of their origins.
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Affiliation(s)
- Dingcui Cai
- Institute of Higher Education and Research in Healthcare (IUFRS), University of Lausanne, Route de la Corniche 10, Lausanne, 1011, Switzerland
| | - Paulina Villanueva
- Institute of Higher Education and Research in Healthcare (IUFRS), University of Lausanne, Route de la Corniche 10, Lausanne, 1011, Switzerland
| | - Susannah Stuijfzand
- Institute of Higher Education and Research in Healthcare (IUFRS), University of Lausanne, Route de la Corniche 10, Lausanne, 1011, Switzerland
| | - Hong Lu
- School of Nursing, Peking University, 38 Xueyuan Road, Haidian District, Beijing, 100191, China
| | - Basile Zimmermann
- Confucius Institute, University of Geneva, Rue de Candolle, Geneva, 1211, Switzerland
| | - Antje Horsch
- Institute of Higher Education and Research in Healthcare (IUFRS), University of Lausanne, Route de la Corniche 10, Lausanne, 1011, Switzerland. .,Department Woman-Mother-Child, Lausanne University Hospital and University of Lausanne, Lausanne, 1011, Switzerland.
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Quansah DY, Gross J, Gilbert L, Pauchet A, Horsch A, Benhalima K, Cosson E, Puder JJ. Cardiometabolic and Mental Health in Women With Early Gestational Diabetes Mellitus: A Prospective Cohort Study. J Clin Endocrinol Metab 2022; 107:e996-e1008. [PMID: 34718650 DOI: 10.1210/clinem/dgab791] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2021] [Indexed: 11/19/2022]
Abstract
CONTEXT Early diagnosis and treatment of gestational diabetes (GDM) may reduce adverse obstetric and neonatal outcomes, especially in high-risk women. However, there is a lack of data for other outcomes. OBJECTIVE We compared cardiometabolic and mental health outcomes in women with early (eGDM) and classical (cGDM) GDM. METHODS This prospective cohort included 1185 All women with cGDM and 76 women with eGDM. The eGDM group had GDM risk factors (BMI >30 kg/m2, family history of diabetes, history of GDM, ethnicity), were tested at <20 weeks gestational age, and diagnosed using American Diabetes Association prediabetes criteria. All women underwent lifestyle adaptations. Obstetric, neonatal, mental, and cardiometabolic outcomes were assessed during pregnancy and postpartum. RESULTS The eGDM group had lower gestational weight gain than cGDM (10.7 ± 6.2 vs 12.6 ± 6.4; P = 0.03) but needed more medical treatment (66% vs 42%; P < 0.001). They had similar rates of adverse maternal and neonatal outcomes, except for increased large-for-gestational-age infants (25% vs 15%; P = 0.02). Mental health during pregnancy and postpartum did not differ between groups. eGDM had more atherogenic postpartum lipid profile than cGDM (P ≤ 0.001). In eGDM, the postpartum prevalence of the metabolic syndrome (MetS) was 1.8-fold, prediabetes was 3.1-fold, and diabetes was 7.4-fold higher than cGDM (waist circumference-based MetS: 62% vs 34%/BMI-based MetS: 46% vs 24%; prediabetes: 47.5% vs 15.3%; diabetes: 11.9% vs 1.6%, all P < 0.001). These differences remained unchanged after adjusting for GDM risk factors. CONCLUSION Compared with cGDM, eGDM was not associated with differences in mental health, but with increased adverse cardiometabolic outcomes, independent of GDM risk factors and gestational weight gain. This hints to a preexisting risk profile in eGDM.
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Affiliation(s)
- Dan Yedu Quansah
- Obstetric Service, Department Woman-Mother-Child, Lausanne University Hospital, Lausanne, Switzerland
| | - Justine Gross
- Service of Endocrinology, Diabetes and Metabolism, Department of Medicine, Lausanne University Hospital, Lausanne, Switzerland
| | - Leah Gilbert
- Obstetric Service, Department Woman-Mother-Child, Lausanne University Hospital, Lausanne, Switzerland
| | - Amelie Pauchet
- Service of Endocrinology, Diabetes and Metabolism, Department of Medicine, Lausanne University Hospital, Lausanne, Switzerland
| | - Antje Horsch
- Institute of Higher Education and Research in Healthcare (IUFRS), University of Lausanne, Lausanne, Switzerland
- Neonatology service, Department Woman-Mother-Child, Lausanne University Hospital, Lausanne, Switzerland
| | - Katrien Benhalima
- Department of Endocrinology, UZ Gasthuisberg, KU Leuven, Leuven, Belgium
| | - Emmanuel Cosson
- Department of Endocrinology-Diabetology-Nutrition, AP-HP, Avicenne Hospital, Paris 13 University, Sorbonne Paris Cité, CRNH-IdF, CINFO, Bobigny, France
- Sorbonne Paris Cité, UMR U1153 Inserm/U1125 Inra/Cnam/Université Paris 13, Bobigny, France
| | - Jardena J Puder
- Obstetric Service, Department Woman-Mother-Child, Lausanne University Hospital, Lausanne, Switzerland
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Schobinger E, Vanetti M, Ramelet AS, Horsch A. Social support needs of first-time parents in the early-postpartum period: A qualitative study. Front Psychiatry 2022; 13:1043990. [PMID: 36590631 PMCID: PMC9794858 DOI: 10.3389/fpsyt.2022.1043990] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Accepted: 11/23/2022] [Indexed: 12/15/2022] Open
Abstract
Background The early postpartum period is a critical time for first-time parents as they adapt to their new role. Perceived lack of social support is a risk factor for developing mental health problems. Insufficient or inappropriate professional support for both parents has been reported by many studies. Social support that appropriately meets parents' needs is an important protective factor for parents' wellbeing; however, little is known about the social support needs of both first-time parents. Aims and objectives To describe both first-time parents' formal social support needs in the early postpartum period. Method Individual semi-structured interviews were conducted with first-time parents recruited on the postpartum ward of a Swiss university hospital. Thematic analysis was used to identify themes and sub-themes. Results Fifteen mothers and eleven fathers were interviewed. Twelve themes were identified. Mothers' themes were "experiencing postpartum changes," "creation of a family unit," "self-esteem," "emotional needs," "difficulty in communicating their needs," and "the postpartum stay." Fathers' themes were "to be included in care procedures on the postpartum ward," "to be reassured," "to anticipate their postpartum stay" and "to consider their need as non-priority." Parental shared needs were: "to care for their newborn," and "returning home." Conclusion Mothers' and fathers' needs differed. Mothers needed more emotional support than fathers and fathers considered themselves as the main support for their partner. Fathers wanted to be integrated in the care of their newborn.
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Affiliation(s)
- Elisabeth Schobinger
- Institute of Higher Education and Research in Healthcare (IUFRS), University of Lausanne, Lausanne, Switzerland
| | - Mélanie Vanetti
- Institute of Higher Education and Research in Healthcare (IUFRS), University of Lausanne, Lausanne, Switzerland
| | - Anne-Sylvie Ramelet
- Institute of Higher Education and Research in Healthcare (IUFRS), University of Lausanne, Lausanne, Switzerland.,Department Woman-Mother-Child, University Hospital, Lausanne, Switzerland
| | - Antje Horsch
- Institute of Higher Education and Research in Healthcare (IUFRS), University of Lausanne, Lausanne, Switzerland.,Department Woman-Mother-Child, University Hospital, Lausanne, Switzerland
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Abstract
This cohort study of children in a single day care examines their ability to correctly identify emotions of caregivers with and without face masks.
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Affiliation(s)
- Juliane Schneider
- Neonatology Developmental Unit, Woman-Mother-Child Department, University Hospital Lausanne, Switzerland
| | - Vania Sandoz
- Institute of Higher Education and Research in Healthcare, University of Lausanne, Switzerland
| | - Lucile Equey
- Neonatology Developmental Unit, Woman-Mother-Child Department, University Hospital Lausanne, Switzerland
| | - Joanne Williams-Smith
- Neonatology Developmental Unit, Woman-Mother-Child Department, University Hospital Lausanne, Switzerland
| | - Antje Horsch
- Neonatology Developmental Unit, Woman-Mother-Child Department, University Hospital Lausanne, Switzerland,Institute of Higher Education and Research in Healthcare, University of Lausanne, Switzerland
| | - Myriam Bickle Graz
- Neonatology Developmental Unit, Woman-Mother-Child Department, University Hospital Lausanne, Switzerland
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Schobinger E, Stuijfzand S, Horsch A. Corrigendum: Acute and Post-traumatic Stress Disorder Symptoms in Mothers and Fathers Following Childbirth: A Prospective Cohort Study. Front Psychiatry 2022; 13:790170. [PMID: 35222113 PMCID: PMC8881194 DOI: 10.3389/fpsyt.2022.790170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Accepted: 01/17/2022] [Indexed: 11/13/2022] Open
Abstract
[This corrects the article DOI: 10.3389/fpsyt.2020.562054.].
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Affiliation(s)
- Elisabeth Schobinger
- Institute of Higher Education and Research in Healthcare in French, University of Lausanne, Lausanne, Switzerland
| | - Suzannah Stuijfzand
- Institute of Higher Education and Research in Healthcare in French, University of Lausanne, Lausanne, Switzerland
| | - Antje Horsch
- Institute of Higher Education and Research in Healthcare in French, University of Lausanne, Lausanne, Switzerland.,Department Woman-Mother-Child, Lausanne University Hospital, Lausanne, Switzerland
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Quansah DY, Gilbert L, Kosinski C, Le Dizès O, Horsch A, Benhalima K, Cosson E, Puder JJ. Cardio-Metabolic and Mental Health Outcomes Before and During the COVID-19 Pandemic in a Cohort of Women With Gestational Diabetes Mellitus in Switzerland. Front Endocrinol (Lausanne) 2022; 13:948716. [PMID: 35957818 PMCID: PMC9361046 DOI: 10.3389/fendo.2022.948716] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2022] [Accepted: 06/20/2022] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND The COVID-19 pandemic has been associated with worsened metabolic and mental health in the general and perinatal population. The postpartum is a critical moment regarding these outcomes particularly in women with gestational diabetes mellitus (GDM). We investigated the cardio-metabolic and mental health outcomes before and during the pandemic in this population. METHODS This cohort study included 418 women with GDM, recruited during two distinct periods. This included 180 women exposed to the pandemic (E+) and recruited between May 2020-April 2021 and 238 women who were not exposed to the pandemic during their postpartum period (attended a year before=non-exposed (E-)) and recruited between January-December 2019. Among the E+, a nested-subcohort of 120 women were exposed both during pregnancy and postpartum. During the pandemic, we adopted a hybrid follow-up of women that consisted of in-person consultations, regular contact via phone calls (35%), sent recorded exercise guide to patients to follow at home and linked to our website. We specifically focused on maintaining motivation and keeping a strong focus on healthy lifestyle behaviors. Obstetric, neonatal, cardio-metabolic and mental health outcomes were assessed during pregnancy and postpartum. RESULTS The pandemic was not associated with worsened weight, weight retention, glucose tolerance, metabolic syndrome, well-being or depression in the postpartum with the exception of a minimally increased HbA1c, diastolic blood pressure and lower emotional eating scores in E+ women (all p ≤ 0.046). In the nested subcohort, E+ women had a slightly increased HbA1c at the first GDM visit and a higher need for glucose-lowering medication (both p ≤ 0.014), but HbA1c at the end of pregnancy and other cardio-metabolic, mental health, obstetric and neonatal outcomes during pregnancy were similar. CONCLUSIONS The pandemic was not associated with any clinically relevant worsening of cardio-metabolic, mental health, obstetrical and neonatal outcomes in our GDM cohort. This was possibly due to a continued hybrid follow-up, and the partial lockdown in Switzerland.
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Affiliation(s)
- Dan Yedu Quansah
- Obstetric Service, Department Woman-Mother-Child, Lausanne University Hospital, Lausanne, Switzerland
- *Correspondence: Dan Yedu Quansah,
| | - Leah Gilbert
- Obstetric Service, Department Woman-Mother-Child, Lausanne University Hospital, Lausanne, Switzerland
| | - Christophe Kosinski
- Service of Endocrinology, Diabetes and Metabolism, Department of Medicine, Lausanne University Hospital, Lausanne, Switzerland
| | - Olivier Le Dizès
- Service of Endocrinology, Diabetes and Metabolism, Department of Medicine, Lausanne University Hospital, Lausanne, Switzerland
| | - Antje Horsch
- Institute of Higher Education and Research in Healthcare (IUFRS), University of Lausanne, Lausanne, Switzerland
- Neonatology Service, Department Woman-Mother-Child, Lausanne University Hospital, Lausanne, Switzerland
| | - Katrien Benhalima
- Department of Endocrinology, UZ Gasthuisberg, KU Leuven, Leuven, Belgium
| | - Emmanuel Cosson
- Department of Endocrinology-Diabetology-Nutrition, AP-HP, Avicenne Hospital, Paris 13 University, Sorbonne Paris Cité, CRNH-IdF, CINFO, Bobigny, France
- Sorbonne Paris Cité, UMR U1153 Inserm/U1125 Inra/Cnam/Université Paris 13, Bobigny, France
| | - Jardena J. Puder
- Obstetric Service, Department Woman-Mother-Child, Lausanne University Hospital, Lausanne, Switzerland
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Deforges C, Noël Y, Eberhard-Gran M, Garthus-Niegel S, Horsch A. Prenatal insomnia and childbirth-related PTSD symptoms: A prospective population-based cohort study. J Affect Disord 2021; 295:305-315. [PMID: 34488084 DOI: 10.1016/j.jad.2021.08.024] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2021] [Revised: 08/17/2021] [Accepted: 08/19/2021] [Indexed: 10/20/2022]
Abstract
BACKGROUND Certain populations are at high risk of experiencing a traumatic event and developing post-traumatic stress disorder (PTSD). Yet, primary preventive interventions against PTSD are lacking. It is therefore crucial to identify pre-traumatic risk factors, which could be targeted with such interventions. Insomnia may be a good candidate, but studies on civilians are sparse. Furthermore, the mechanisms at stake in the relationship between pre-traumatic insomnia and PTSD symptoms are unclear. METHODS This prospective population-based cohort study (n = 1,610) examined the relationship between insomnia symptoms at 32 weeks of pregnancy and childbirth-related PTSD (CB-PTSD) symptoms at eight weeks postpartum. Postnatal insomnia symptoms, prenatal psychological symptoms (depression, anxiety, PTSD, fear of childbirth), subjective birth experience (SBE) and birth medical severity were included as covariates in the analyses, which were based on a Piecewise Structural Equation Modelling approach. RESULTS The relationship between prenatal insomnia and CB-PTSD symptoms was mediated by negative SBE and postnatal insomnia symptoms. All relationships involving insomnia symptoms had small or very small effect sizes. LIMITATIONS This study used self-report questionnaires. Postnatal insomnia and CB-PTSD symptoms were concurrently measured. CONCLUSION Prenatal insomnia symptoms may impair the ability to cope with a difficult birth experience and contribute to postnatal insomnia, a risk factor for CB-PTSD. Thus, prenatal insomnia symptoms may be a promising target for CB-PTSD primary preventive interventions, although other prenatal psychological symptoms could also be considered. Even beyond the perinatal context, future studies on pre-traumatic insomnia and PTSD should include post-traumatic insomnia as a covariate.
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Affiliation(s)
- Camille Deforges
- Institute of Higher Education and Research in Healthcare (IUFRS), University of Lausanne and Lausanne University Hospital, Lausanne, Switzerland.
| | - Yvonnick Noël
- Laboratory of Psychology, Cognition, Behavior and Communication, Univ Rennes, Rennes, France.
| | - Malin Eberhard-Gran
- Norwegian Research Centre for Women's Health, Women and Children's Division, Oslo University Hospital, Rikshospitalet, Oslo Norway; Institute of Clinical Medicine, University of Oslo, Oslo, Norway.
| | - Susan Garthus-Niegel
- Department of Medicine, Faculty of Medicine, Medical School Hamburg, Hamburg, Germany; Department of Child Health and Development, Norwegian Institute of Public Health, Oslo, Norway; Institute and Policlinic of Occupational and Social Medicine, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany.
| | - Antje Horsch
- Institute of Higher Education and Research in Healthcare (IUFRS), University of Lausanne and Lausanne University Hospital, Lausanne, Switzerland; Woman-Mother-Child Department, Lausanne University Hospital, Lausanne, Switzerland.
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Thomson G, Diop MQ, Stuijfzand S, Horsch A. Policy, service, and training provision for women following a traumatic birth: an international knowledge mapping exercise. BMC Health Serv Res 2021; 21:1206. [PMID: 34742293 PMCID: PMC8571982 DOI: 10.1186/s12913-021-07238-x] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2021] [Accepted: 10/21/2021] [Indexed: 12/23/2022] Open
Abstract
Background High numbers of women experience a traumatic birth, which can lead to childbirth-related post-traumatic stress disorder (CB-PTSD) onset, and negative and pervasive impacts for women, infants, and families. Policies, suitable service provision, and training are needed to identify and treat psychological morbidity following a traumatic birth experience, but currently there is little insight into whether and what is provided in different contexts. The aim of this knowledge mapping exercise was to map policy, service and training provision for women following a traumatic birth experience in different European countries. Methods A survey was distributed as part of the COST Action “Perinatal mental health and birth-related trauma: Maximizing best practice and optimal outcomes”. Questions were designed to capture country level data; care provision (i.e., national policies or guidelines for the screening, treatment and/or prevention of a traumatic birth, service provision), and nationally mandated pre-registration and post-registration training for maternity professionals. Results Eighteen countries participated. Only one country (the Netherlands) had national policies regarding the screening, treatment, and prevention of a traumatic birth experience/CB-PTSD. Service provision was provided formally in six countries (33%), and informally in the majority (78%). In almost all countries (89%), women could be referred to specialist perinatal or mental health services. Services tended to be provided by midwives, although some multidisciplinary practice was apparent. Seven (39%) of the countries offered ‘a few hours’ professional/pre-registration training, but none offered nationally mandated post-registration training. Conclusions A traumatic birth experience is a key public health concern. Evidence highlights important gaps regarding formalized care provision and training for care providers. Supplementary Information The online version contains supplementary material available at 10.1186/s12913-021-07238-x.
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Affiliation(s)
- Gill Thomson
- School of Community Health & Midwifery, University of Central Lancashire, Preston, UK.
| | - Magali Quillet Diop
- Institute of Higher Education and Research in Healthcare, University of Lausanne, Lausanne, Switzerland
| | - Suzannah Stuijfzand
- Institute of Higher Education and Research in Healthcare, University of Lausanne, Lausanne, Switzerland
| | - Antje Horsch
- Institute of Higher Education and Research in Healthcare, University of Lausanne, Lausanne, Switzerland.,Department Woman-Mother-Child, Lausanne University Hospital, Lausanne, Switzerland
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Boussac É, Berna C, Gomes Dias D, Horsch A, Desseauve D. [Contribution of the use of virtual reality in childbirth: A narrative review of the literature]. Rev Med Suisse 2021; 17:1779-1784. [PMID: 34669292] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
The current use of virtual reality (VR) in medicine is expanding rapidly. This non-pharmacological option is increasingly proposed as primary or complementary/multimodal analgesic or anxiolytic management. The role of VR in obstetrics remains to be defined. We propose a narrative review of the literature on the role of VR in obstetrics during childbirth, which shows promise. If used properly, this technique could help improve the experience of childbirth.
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Affiliation(s)
- Émilie Boussac
- Service d'anesthésiologie, Département des centres interdisciplinaires, CHUV, 1011 Lausanne
| | - Chantal Berna
- Service d'anesthésiologie, Centre de médecine intégrative et complémentaire, CHUV, 1011 Lausanne
| | - Diana Gomes Dias
- Service d'obstétrique, Département femme-mère-enfant, CHUV, 1011 Lausanne
| | - Antje Horsch
- Institut universitaire de formation et recherche en soins, Université de Lausanne, 1010 Lausanne
- Service de néonatologie, Département femme-mère-enfant, CHUV, 1011 Lausanne
| | - David Desseauve
- Service d'obstétrique, Département femme-mère-enfant, CHUV, 1011 Lausanne
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Duroux M, Stuijfzand S, Sandoz V, Horsch A. Investigating prenatal perceived support as protective factor against adverse birth outcomes: a community cohort study. J Reprod Infant Psychol 2021:1-12. [PMID: 34644205 DOI: 10.1080/02646838.2021.1991565] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
BACKGROUND Studies show that prenatal maternal anxiety may act as a risk factor for adverse birth outcomes, whilst prenatal social support may rather act as a protective factor. However, studies examining prenatal anxiety symptoms, prenatal perceived support, and neonatal and/or obstetric outcomes are lacking. OBJECTIVE This study investigated whether, in a community sample, prenatal perceived support: (1) had a protective influence on birth outcomes (gestational age (GA), birthweight (BW), 5-minute Apgar score, and mode of delivery); (2) acted as a protective factor, moderating the relationship between anxiety symptoms and the aforementioned birth outcomes. METHOD During their third trimester of pregnancy, 182 nulliparous child-bearers completed standardized questionnaires of anxiety (HADS-A) and perceived support (MOS-SSS). Birth outcomes data was extracted from medical records. RESULTS (1) Perceived support did not significantly predict any birth outcomes. However, perceived tangible support - MOS-SSS subscale assessing perceived material/financial aid - significantly positively predicted the 5-minute Apgar score. (2) Perceived support did not significantly moderate the relationship between anxiety symptoms and birth outcomes. However, perceived tangible support significantly moderated the relationship between anxiety symptoms and the 5-minute Apgar score. CONCLUSION When experienced within non-clinical thresholds, prenatal anxiety symptoms do not increase the risk of adverse neonatal and obstetric outcomes when perceived support is present.
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Affiliation(s)
- Mathilde Duroux
- Department of Psychology, University of Fribourg, Fribourg, Switzerland
| | - Suzannah Stuijfzand
- Faculty of Biology and Medicine, Institute of Higher Education and Research in Healthcare (LUFRS), University of Lausanne, Lausanne, Switzerland
| | - Vania Sandoz
- Faculty of Biology and Medicine, Institute of Higher Education and Research in Healthcare (LUFRS), University of Lausanne, Lausanne, Switzerland
| | - Antje Horsch
- Faculty of Biology and Medicine, Institute of Higher Education and Research in Healthcare (LUFRS), University of Lausanne, Lausanne, Switzerland.,Department Women-Mother-Child, Lausanne University Hospital, Lausanne, Switzerland
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Lambelet V, Ceulemans M, Nordeng H, Favre G, Horsch A, Stojanov M, Winterfeld U, Baud D, Panchaud A, Pomar L. Impact of the COVID-19 pandemic on Swiss pregnant and breastfeeding women - a cross-sectional study covering the first pandemic wave. Swiss Med Wkly 2021; 151:w30009. [PMID: 34546015 DOI: 10.4414/smw.2021.w30009] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Information on the impact of the COVID-19 pandemic on pregnancy and breastfeeding experiences, as well as on perinatal mental health in Switzerland is limited. In Switzerland, there are few national studies and little information. Using an anonymous online survey accessible after the first wave of the outbreak in Switzerland, we have investigated how this pandemic affected pregnant and breastfeeding women. Among women who completed the survey, 69.0% (1050/1518) indicated the first wave of the pandemic affected their personal habits, 61.0% (689/1131) were affected in their work and 40.0% (632/1573) reported impaired relations with healthcare services (different denominators correspond to the number of participants who answered the question). 36.8% (110/299) of women reported an impact of the pandemic on their current pregnancy experience or breastfeeding experience (8.2%, 46/555). Overall, 11.6% (170/1467) of participants who completed the validated screening tests for mental health symptoms (Edinburgh Postnatal Depression Scale, Generalized Anxiety Disorder 7, Perceived Stress Scale) presented a score compatible with symptoms of major depression, severe anxiety or high perceived stress, which is higher than in the pre-pandemic period according to literature. Risk factors independently associated with impaired mental health were being hospitalized, having symptoms of COVID-19, living with a person with COVID-19 symptoms, having comorbidities, having experienced reduced healthcare services, having restricted usual activities and being a housewife. Protective factors independently associated were a high level of education and living with a partner. Our findings suggest that the COVID-19 pandemic might have significantly affected the well-being and mental health of pregnant and breastfeeding women, directly in the case of exposure, and indirectly as a result of the potential modifications in their life habits and in healthcare facilities.
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Affiliation(s)
- Valentine Lambelet
- Department Woman-Mother-Child, Lausanne University Hospital, Switzerland
| | - Michael Ceulemans
- Department of Pharmaceutical and Pharmacological Sciences, KU Leuven, Belgium.,Teratology Information Service, Pharmacovigilance Centre Lareb, 's Hertogenbosch, the Netherlands
| | - Hedvig Nordeng
- Institute of Higher Education and Research in Healthcare, Faculty of Biology and Medicine, University of Lausanne, Switzerland
| | - Guillaume Favre
- Department Woman-Mother-Child, Lausanne University Hospital, Switzerland
| | - Antje Horsch
- Department Woman-Mother-Child, Lausanne University Hospital, Switzerland.,Institute of Higher Education and Research in Healthcare, Faculty of Biology and Medicine, University of Lausanne, Switzerland
| | - Milos Stojanov
- Department Woman-Mother-Child, Lausanne University Hospital, Switzerland
| | - Ursula Winterfeld
- Swiss Teratogen Information Service, Service de Pharmacologie Clinique, Lausanne University Hospital and University of Lausanne, Switzerland
| | - David Baud
- Department Woman-Mother-Child, Lausanne University Hospital, Switzerland
| | - Alice Panchaud
- Institute of Primary Health Care (BIHAM), University of Bern, Bern, Switzerland,Service of Pharmacy, Lausanne University Hospital and University of Lausanne, Switzerland
| | - Léo Pomar
- Department Woman-Mother-Child, Lausanne University Hospital, Switzerland.,School of Health Sciences (HESAV), University of Applied Sciences and Arts Western Switzerland, Lausanne, Switzerland
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Sandoz V, Hingray C, Stuijfzand S, Lacroix A, El Hage W, Horsch A. Measurement and conceptualization of maternal PTSD following childbirth: Psychometric properties of the City Birth Trauma Scale-French Version (City BiTS-F). Psychol Trauma 2021; 14:696-704. [PMID: 34292038 DOI: 10.1037/tra0001068] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVE The City Birth Trauma Scale (City BiTS) assesses posttraumatic stress disorder symptoms following childbirth (PTSD-FC). Recent studies investigating the latent factor structure of PTSD-FC in women reported mixed results. No validated French questionnaire exists to measure PTSD-FC symptoms. Therefore, this study first aimed to validate the French version of the City BiTS (City BiTS-F). Second, it aimed to establish the latent factor structure of PTSD-FC. METHOD French-speaking women with infants aged 1 to 12 months old (n = 541) completed an online cross-sectional survey. Questionnaires included the City BiTS-F, the PTSD Checklist, the Edinburgh Postnatal Depression Scale, and the anxiety subscale of the Hospital Anxiety and Depression Scale. Additionally, sociodemographic and medical data were collected. RESULTS The two-factor model with birth-related symptoms (BRS) and general symptoms (GS) fit the data well, whereas the four-factor model was not confirmed. The bifactor model with a general factor and the BRS and GS gave the best fit to the data, suggesting that use of the total score in addition to the BRS and GS subscales scores is justified. High reliability (α = .88 to .90) and good convergent and divergent validity were obtained. Discriminant validity was calculated with weeks of gestation, gravidity, history of traumatic childbirth and event, and mode of delivery. DISCUSSION The City BiTS-F is a reliable and valid measure of PTSD-FC symptoms in French-speaking women. Both total score and BRS or GS subscale scores can be calculated. This psychometric tool is of importance for clinical and research purposes. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
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Affiliation(s)
- Vania Sandoz
- Institute of Higher Education and Research in Healthcare
| | - Coraline Hingray
- Pole Hospitalo-Universitaire de Psychiatrie d'Adultes du Grand Nancy
| | | | - Alain Lacroix
- Institute of Higher Education and Research in Healthcare
| | | | - Antje Horsch
- Institute of Higher Education and Research in Healthcare
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Lalor J, Ayers S, Celleja Agius J, Downe S, Gouni O, Hartmann K, Nieuwenhuijze M, Oosterman M, Turner JD, Karlsdottir SI, Horsch A. Balancing restrictions and access to maternity care for women and birthing partners during the COVID-19 pandemic: the psychosocial impact of suboptimal care. BJOG 2021; 128:1720-1725. [PMID: 34268858 PMCID: PMC8441715 DOI: 10.1111/1471-0528.16844] [Citation(s) in RCA: 31] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/02/2021] [Indexed: 11/30/2022]
Affiliation(s)
- J Lalor
- School of Nursing and Midwifery, Trinity College Dublin, Dublin 2, Ireland
| | - S Ayers
- Centre for Maternal and Child Health, City University of London, London, UK
| | - J Celleja Agius
- Faculty of Medicine and Surgery, University of Malta, Msida, Malta
| | - S Downe
- University of Central Lancashire, Preston, UK
| | - O Gouni
- Cosmoanelixis Prenatal & Life sciences, Athens, Greece
| | - K Hartmann
- Mother Hood e.V., Bundeselterninitiative zum Schutz von Mutter und Kind während Schwangerschaft, Bonn, Germany
| | - M Nieuwenhuijze
- Research Centre for Midwifery Science Maastricht, Zuyd University, Maastricht, The Netherlands
| | - M Oosterman
- Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - J D Turner
- Department of Infection and Immunity, Luxembourg Institute of Health, Strassen, Luxembourg
| | | | - A Horsch
- University of Lausanne, Lausanne, Switzerland
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Gilbert L, Rossel JB, Quansah DY, Puder JJ, Horsch A. Mental health and its associations with weight in women with gestational diabetes mellitus. A prospective clinical cohort study. J Psychosom Res 2021; 146:110489. [PMID: 33895430 DOI: 10.1016/j.jpsychores.2021.110489] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/05/2020] [Revised: 04/06/2021] [Accepted: 04/09/2021] [Indexed: 10/21/2022]
Abstract
OBJECTIVE Despite the prevalence of depression in women with gestational diabetes mellitus (GDM) and the relationship between mental health (depression and well-being) and metabolic health, little is known about mental health or its metabolic impact in GDM pregnancy. This prospective clinical cohort study aimed to investigate associations between 1) well-being and depression, and 2) mental health and weight/weight gain in women with GDM. METHODS We included 334 pregnant women with GDM treated at a Swiss University Hospital between January 2016 and December 2018. They completed two self-report questionnaires: The World Health Organization well-being index (WHO-5) at the first (29 weeks of gestation) and last (36 weeks of gestation) GDM visits during pregnancy and the Edinburgh Postnatal Depression Scale (EPDS) at the first GDM visit. A cut-off of ≥11 was selected for this questionnaire to indicate the presence of elevated depression scores. RESULTS There was an inverse association between the well-being and depression total scores at the first GDM visit during pregnancy (r = -0.55; p < 0.0001). Elevated depression scores at the first GDM visit were associated with subsequent weight gain in GDM pregnancy (β = 1.249; p = 0.019). CONCLUSION In women with GDM, elevated depression scores during pregnancy are prospectively associated with weight gain. Depression symptoms should therefore be screened for and treated in women with GDM to reduce the risks associated with excessive weight gain during pregnancy.
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Affiliation(s)
- Leah Gilbert
- Obstetric service, Department Woman-Mother-Child, Lausanne University Hospital, Lausanne, Switzerland.
| | - Jean-Benoît Rossel
- Obstetric service, Department Woman-Mother-Child, Lausanne University Hospital, Lausanne, Switzerland; Clinical Trials Unit, University of Bern, Bern, Switzerland
| | - Dan Yedu Quansah
- Obstetric service, Department Woman-Mother-Child, Lausanne University Hospital, Lausanne, Switzerland
| | - Jardena J Puder
- Obstetric service, Department Woman-Mother-Child, Lausanne University Hospital, Lausanne, Switzerland
| | - Antje Horsch
- Institute of Higher Education and Research in Healthcare (IUFRS), University of Lausanne, Lausanne, Switzerland; Neonatology Service, Department Woman-Mother-Child, Lausanne University Hospital, Lausanne, Switzerland
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