Development of a mobile monitoring program for anxiety and depression in pregnancy and evaluation of 3-month results

BACKGROUND

The aims of this study were to develop a mobile mental health application (app) to scan the symptoms of anxiety, depression, and related factors during pregnancy; examine the effect of the app on pregnant women; and determine the factors related to using such an app.

METHODS

A software platform called Perinatal Anxiety Depression Monitoring Platform (PADIP) was developed. This study included 320 pregnant women: 160 in the PADIP group and 160 in the control group. The PADIP group was screened monthly for 3 months for depression, anxiety, and sleep quality, and instant feedback was provided on scale scores.

RESULTS

During the follow-up period, there was a significant decrease in depression and anxiety scale scores in the PADIP group but no significant difference in scale scores in the control group. The interface used for the app was important for scale scores. It was preferred by pregnant women with a high education level, higher Perinatal Anxiety Screening Scale scores, and lower sleep quality scores.

CONCLUSIONS

PADIP use was associated with a decrease in depression and anxiety scores of pregnant women. It was more useful for patients with higher education levels and a history of a psychiatric disorder, but further research is needed to develop a more comprehensive model.

Detection of depression and anxiety in the perinatal period using Marine Predators Algorithm and kNN

Undiagnosed prenatal anxiety and depression have the potential to worsen and have an adverse effect on both the mother and the infant. Although the diagnosis is made by specialist doctors, it is unclear which parameters are more effective. Especially in medicine, it is crucial to diagnose disease with high accuracy. For this reason, in this study, a questionnaire study was first conducted on pregnant women, and real original data were collected. Then, the Marine Predators Algorithm (MPA), one of the current metaheuristic algorithms inspired by nature, was combined with K-Nearest Neighbors (kNN) to determine high-priority features in the collected data. As a result, five of the 147 features selected by the proposed method were determined as high priority and approved by the doctors. In addition, the proposed method is compared with the Chi-square method, which is one of the filter-based feature selection methods. Thanks to the proposed feature selection method based on MPA and kNN, it has been observed that the classification gives more successful results in a shorter time with 98.11% success, and the model supports the diagnosis stage of the doctors.

Hematological Parameters to Predict the Severity of Hyperemesis Gravidarum and Ketonuria

OBJECTIVE

 Hyperemesis gravidarum (HG) is a pregnancy complication that can progress with persistent nausea and vomiting. The aim of the present study is to evaluate the relationship between hematological parameters and HG.

METHOD

 A total of 532 pregnant women with HG who were admitted to the Department of Obstetrics and Gynecology between March 2019 and February 2021, and 534 healthy pregnant women with characteristics similar to those of the case group were included in the study. The hematological parameters of both groups were compared. In addition, the hematological parametersof patients with HG according to the severity of ketonuria were compared.

RESULTS

 The mean age of the HG group (n = 532) was 26.3 ±  4.1 years, and that of the control group (n = 534) was 25.9 ±  4.8 years. Among patients with HG, 46% (n = 249) had ketone (+), 33% (n = 174), ketone (++), and 21% (n = 109), ketone (++ + ). The neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) were higher in the HG group than in the control group: 3.8 (2.8-5.8)/3.2 (2.6-4.0); p < 0.001; and 135.2 ±  30.4/108.9 ±  62.2; p < 0.001 respectively. The neutrophil count, NLR, and PLR were higher in the group with ketone (++ + ) than in the groups with ketone (+) or ketone (++): 7.6 ±  1.9/5.5 ±  2.4; p < 0.001; 3.8(2.8-4.6)/2.9(2.3-3.6); p < 0.001; and 149.9 ±  48.0/135.9 ±  65.7; p < 0.001 respectively. The mean corpuscular hemoglobin (MCH) level, the NLR, and the PLR were identified as independent predictors of the presence of HG and the level of ketone positivity in HG patients.

CONCLUSION

 The NLR and PLR were high in patients with HG, suggesting the its inflammatory activity. They may be important markers associated with the presence and severity of HG.

Health literacy and knowledge of antenatal care among pregnant women

Health literacy has a direct impact on pregnancy from the perspectives of both the mother and the baby. This study aimed to determine the level of health literacy and assess the knowledge of antenatal care among pregnant women. From among all pregnant women who presented to the hospital's obstetric polyclinic during the study's timeline, the study group consisted of 460 women who agreed to take part (492 women were invited and a response rate of 93.5% was achieved). A questionnaire prepared based on the literature in line with the study's objectives was completed by the participants under supervision. The Turkish Health Literacy Scale (THLS-32) was used to assess health literacy. In order to determine the women's prenatal care knowledge levels, a total of 20 knowledge-testing statements prepared using the literature were applied, 14 of which were true and six of which were false. The internal consistency of antenatal information questions during pregnancy was made and the Cronbach alpha coefficient was calculated as 0.77. It was determined that 33.9% of the participants had a sufficient level of health literacy. Health literacy was sufficient in young married women (19 years and less) in their first pregnancy and those who had regular reading habits, participated in healthcare activities and received postpartum care at a family health clinic (p < 0.05 for each). While the most accurately evaluated statement about antenatal care was 'It is normal to experience nausea/vomiting in the first trimester of pregnancy', the least accurately evaluated statement was 'Over 35% of women incorrectly believed it was normal to gain 20 kg of weight during pregnancy'. It was found that pregnant women with sufficient health literacy had higher levels of knowledge about antenatal care (p < 0.05). In this study, it was determined that approximately two-thirds of the participants had insufficient health literacy and the women with insufficient health literacy had low levels of knowledge about antenatal care.

Relationship between prenatal and maternal attachment: a longitudinal study from Turkey

The healthy development of the attachment which starts in the prenatal period and continues after the birth strengthens, positively supports the newborn care and contributes to raising healthy individuals in the future. This study was carried out to determine the effect of mother-fetus attachment that develops during pregnancy on mother-infant attachment in the postpartum period. This descriptive, correlational and longitudinal study was conducted with 150 volunteer mothers who could be reached again within 1-4 months after birth. Data were collected by the Questionnaire Form, the Prenatal Attachment Inventory (PAI) and the Maternal Attachment Scale (MAS). When the relationship between participants' PAI (41.20 ± 11.35) and MAS (26.05 ± 5.13) point averages was examined, it was observed that there was a weak, positive and statistically significant relationship between the two scales (r = 0.304, p=.000). It was observed that there was a relationship between the attachment between pregnant woman and developing fetus and the maternal attachment in the postnatal period.Impact statementWhat is already known on this subject? Attachment is a process which is formed by an interaction between the mother and the infant that is satisfying and enjoyed by both sides. It provides a basis for the establishment of relationships of the infant with the outside world and for the psychological development of the infant.What the results of this study add? This study has shown that a strong and healthy establishment of attachment in the prenatal period will positively contribute to the mother-infant attachment process in the postnatal period. A strong and healthy establishment of attachment in the prenatal period will positively contribute to the mother-infant attachment process in the postnatal period.What the implications are of these findings for clinical practice and/or further research? Mother-infant attachment can be strengthened just before the baby is born by determining the prenatal attachment and providing the appropriate approach to those who identify the problems in this regard, and thus, the risk of neglect and exploitation of the baby can be reduced and also the problems such as breastfeeding of the baby after birth, receiving proper care, and postnatal depression in the mother can even be reduced.

Evaluation of the presence of SARS-COV-2 in the vaginal fluid of reproductive-aged women

OBJECTIVES

Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) is mainly transmitted through respiration and direct contact. The status of the infection in the female genital system is still unknown. The study aimed to evaluate whether SARS-CoV-2 is present in the vaginal fluid of women with COVID-19 infection in reproductive period.

MATERIAL AND METHODS

Women who were between the ages of 18-50 years and clinically confirmed to have COVID-19 infection at our hospital between 20 April-31 May 2020 were included in the study. Women who were in their menstrual cycle during the study and who had a known cervical intraepithelial lesion and/or cancer, sexually transmitted disease and history and/or symptoms of vaginitis were excluded from the study. In patients in whom no pathology was detected during the examination, a sample was taken from the vaginal fluid for PCR by using Dacron tip swab. Analysis was performed with Genesig Real-Time PCR COVID-19 kit (Primer Design, England).

RESULTS

Eighteen women who were in reproductive period and diagnosed with severe COVID-19 pneumonia were included in the study. The mean age of the patients was 38.16 ± 8.54. None of the patients were in their menopause period. The clinical symptoms of these women were similar to those of confirmed severe COVID-19 cases. SARS-CoV-2 was found to be negative in the samples taken from the vaginal fluid in all patients.

CONCLUSIONS

SARS-CoV-2 virus was not detected in the vaginal fluid of the patients who tested positive for COVID-19 in reproductive period.

Factors Affecting Paternal Fetal Attachment

AIM

There are very few studies examining how the prenatal attachment of the father to the fetus affects father–infant attachment, while there are numerous studies on maternal–fetal, maternal–infant attachment. The pregnancy period is a potential opportunity to increase the paternal attachment of fathers whose wives are expecting a baby. The aim of this study was to determine paternal–fetal attachment and the factors with an effect.

METHODS

The sample group of this descriptive (comparative) study consisted of expectant fathers accompanied by their wives at 24–36 weeks of pregnancy (n = 182). Ethics committee approval and the necessary permissions were obtained from the relevant institution. The data were collected by the researchers using the Question Form and Paternal Fetal Attachment Scale. The data collected were analyzed using percentage distribution, the Independent samples t test and the one-way analysis of variance (ANOVA) test.

RESULTS

The results of the study showed that the participants who experienced fatherhood for the first time and felt ready to be a father had higher paternal attachment scores than experienced fathers.

CONCLUSION

For the establishment of healthy attachment starting in the prenatal period and continuing thereafter, there are important tasks for healthcare professionals to ensure that fathers can cope with the new roles and responsibilities just as well as the mothers.

Effect of newborn bathing training with the swaddled and tub bathing methods given to primiparous pregnant women on the mother's experience, satisfaction and newborn's stress during the first bathing of the newborn at home: A mixed method study

AIM

The aim of this study is to compare the effect of two different bathing methods training given during pregnancy on the mother's experience, satisfaction and newborn's physiological and behavioral parameters during the first bathing of the newborn at home.

METHODS

A mixed methods research was used in this study. The groups were determined as swaddled bathing (SB) (n = 31) and tub bathing (TB) (n = 31). After training given to the groups, the first bath of the newborn in both groups was built by the mothers. The body temperature, heart rate, oxygen saturation, respiration rate, crying times, stress parameters of the newborns and mother satisfaction in both groups were evaluated. The open-ended questions were used to determine mothers' experiences.

RESULTS

There was a statistically significant difference between the groups in terms of oxygen saturation, respiration rate, crying time, face/forehead grimacing, unrest and maternal satisfaction. Four categories and 14 subcategories made up the qualitative part of the study which includes the experiences of the mother about two different bathing methods. "The feelings and worries of the mothers about first bathing" refers to the participants in both groups how they feel during the first bathing; "Positive aspects of this method compared to other bath method" and "Negative aspects of this method compared to other bath method" refers to positive and negative aspects of different bathing methods applied to groups; "Difference between the applied bathing method and other methods" refers to differences they observed when compared to other bathing methods. The mothers in the SB group had less fear of drowning hazard and injuring the newborn, and the fear of uneasiness and the newborn slipping down from hands were more frequent in the TB group.

CONCLUSION

It was determined that both bath methods reduced body temperature, the SB method decreased the stress of newborns and had a positive effect on mother satisfaction and experience.

SARS-CoV-2 is not present in the vaginal fluid of pregnant women with COVID-19

BACKGROUND

Data concerning the presence of SARS-CoV-2 in the female genital system is scarce; however, this information is important for understanding whether the virus can transmit sexually or from mother to child. The aim of this study was to investigate whether pregnant women with COVID-19 have virus in their lower genital tract.

METHODS

In this cross-sectional study, we present an analysis of prospectively gathered data collected at a single tertiary university hospital from 19 April to 19 May 2020. We included 13 pregnant women hospitalized with suspected COVID-19. Results of laboratory tests, imaging tests, and nucleic acid tests on vaginal swabs for SARS-CoV-2 were also analyzed for pregnant women with a clinical diagnosis of COVID-19.

RESULTS

Twelve pregnant women with confirmed COVID-19 were included in this study. Mean age was 32 ± 7.9 years. All patients had mild symptoms and were followed in the maternity ward, with none of them needing critical care unit follow-up. All lower genital tract samples were negative for SARS-CoV-2.

CONCLUSION

We demonstrated that SARS-CoV-2 was not present in the vaginal fluid of pregnant women. This finding may indicate that the female genital tract is not a route of SARS-CoV-2 transmission.

Can the neutrophil-to-lymphocyte ratio (NLR) predicts fetal loss in preeclampsia with severe features?

INTRODUCTION

Preeclampsia (PE) is one of the most common causes of major maternal and fetal adverse events including mortality and preterm birth Grill et al. (2009). The neutrophil-to-lymphocyte ratio (NLR) and other hematologic indexes of systemic inflammation have been investigated in patients with PE for the prediction of the severity or presence of the disease. Despite these studies, we found no trials investigating the relationship between NLR and fetal outcomes in PE patients. In this study, we aimed to investigate the relationship between NLR and fetal outcomes.

METHODS

We retrospectively analyzed the demographic data and laboratory tests to determine the NLR of 175 pregnant women with severe PE admitted to our clinic between January 2015 and December 2018.

RESULTS

NLR in the first (2.4 ± 1.1 vs 2.9 ± 1.4, P = 0.18) and second trimesters (3.6 ± 0.7 vs 3.8 ± 1.3, P = 0.25) were not different between the groups, but third trimester NLR was significantly higher in patients with fetal loss (6.5 ± 5.4 vs 4.2 ± 2.7, P = 0.009). The area under the receiver operating characteristic curve for NLR in the third trimester was 0.66 and NLR > 3.9 predicted fetal loss with a sensitivity of 75% and a specificity of 61% (0.684, 95% confidence interval 0.48-0.83, P = 0.05).

CONCLUSION

We demonstrated that third trimester NLR is associated with fetal loss in patients with severe PE.