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Gelaw KA, Atalay YA, Walle BG, Gesese MM, Assfaw BB, Gebeyehu NA. Prevalence and Associated Factors of Cultural Malpractice During the Perinatal Period in Ethiopia: A Systematic Review and Meta-Analysis. Reprod Sci 2024; 31:661-674. [PMID: 37917296 DOI: 10.1007/s43032-023-01383-w] [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: 06/19/2023] [Accepted: 10/13/2023] [Indexed: 11/04/2023]
Abstract
The health of the mother and children are potentially affected by several types of cultural malpractices that occur during the perinatal period. Ethiopia is a multi-ethnic nation where a variety of cultural practices are observed, especially during pregnancy, delivery, and the postpartum period. This study aimed to assess the prevalence and associated factors of cultural malpractice during the perinatal period in Ethiopia. Data searches were conducted in PubMed/Medline, Web of Science, Scopus, Google Scholar, African Journals Online, and the Cochrane Library. Data were extracted using Microsoft Excel, and analysis was done using STATA version 14. Less than a p-value of 0.05 was regarded to indicate potential publication bias: the funnel plot, Begg, and Egger's regression tests were used to examine publication bias. This study included 18 studies and 7880 mothers. The pooled prevalence of cultural malpractice during pregnancy, childbirth, and postpartum was 34.95% (95% CI: 27, 42.56), 31.18% (95% CI: 19.61, 42.76), and 45.83% (95% CI: 34.22, 57.45) respectively in Ethiopia. In addition, the following factors are statistically associated with the perinatal period: pregnancy: ANC follow-up (AOR = 3.06, 95%CI = 2.04, 4.58), educational status (AOR = 3.30, 95%CI = 1.99, 5.48), and residence (AOR 2.47, 95%CI, 1.601, 3.81); childbirth: ANC follow-up (AOR = 9.94, 95%CI = 2.05, 48.09), maternal age (AOR = 2.27, 95%CI = 1.56, 3.29), and maternal education (AOR = 10.37, 95%CI = 6.145, 17.51); during postpartum: ANC follow-up (AOR = 3.67, 95%CI = 1.96, 6.844), maternal education (AOR = 6.87, 95%CI = 3.26, 14.49), and residence AOR4.79, 95%CI, 2.97, 7.49). The pooled prevalence of cultural malpractice during the perinatal period was high. Health professionals should encourage beneficial practices through health education for a healthy perinatal period for mothers.
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Affiliation(s)
- Kelemu Abebe Gelaw
- School of Midwifery, College of Health Science and Medicine, Wolaita Sodo University, Wolaita Sodo, Ethiopia.
| | - Yibeltal Assefa Atalay
- School of Public Health, College of Health Science and Medicine, Wolaita Sodo University, Wolaita Sodo, Ethiopia
| | - Belete Gelaw Walle
- School of Nursing, College of Health Science and Medicine, Wolaita Sodo University, Wolaita Sodo, Ethiopia
| | - Molalegn Mesele Gesese
- School of Midwifery, College of Health Science and Medicine, Wolaita Sodo University, Wolaita Sodo, Ethiopia
| | - Belete Birhan Assfaw
- Department of Psychiatry, College of Health Science and Medicine, Wolaita Sodo University, Wolaita Sodo, Ethiopia
| | - Natnael Atnafu Gebeyehu
- School of Midwifery, College of Health Science and Medicine, Wolaita Sodo University, Wolaita Sodo, Ethiopia
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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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Liu X, Trinh NT, Wray NR, Lupattelli A, Albiñana C, Agerbo E, Vilhjálmsson BJ, Bergink V, Munk-Olsen T. Impact of genetic, sociodemographic, and clinical features on antidepressant treatment trajectories in the perinatal period. Eur Neuropsychopharmacol 2024; 81:20-27. [PMID: 38310717 DOI: 10.1016/j.euroneuro.2024.01.010] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Revised: 01/24/2024] [Accepted: 01/26/2024] [Indexed: 02/06/2024]
Abstract
Pregnant women on antidepressants must balance potential fetal harm with the relapse risk. While various clinical and sociodemographic factors are known to influence treatment decisions, the impact of genetic factors remains unexplored. We conducted a cohort study among 2,316 women with diagnosed affective disorders who had redeemed antidepressant prescriptions six months before pregnancy, identified from the Danish Integrated Psychiatric Research study. We calculated polygenic risk scores (PGSs) for major depression (MDD), bipolar disorder (BD), and schizophrenia (SCZ) using individual-level genetic data and summary statistics from genome-wide association studies. We retrieved data on sociodemographic and clinical features from national registers. Applying group-based trajectory modeling, we identified four treatment trajectories across pregnancy and postpartum: Continuers (38.2 %), early discontinuers (22.7 %), late discontinuers (23.8 %), and interrupters (15.3 %). All three PGSs were not associated with treatment trajectories; for instance, the relative risk ratio for continuers versus early discontinuers was 0.93 (95 % CI: 0.81-1.06), 0.98 (0.84-1.13), 1.09 (0.95-1.27) for per 1-SD increase in PGS for MDD, BD, and SCZ, respectively. Sociodemographic factors were generally not associated with treatment trajectories, except for the association between primiparity and continuing antidepressant use. Women who received ≥2 classes or a higher dose of antidepressants had a higher probability of being late discontinuers, interrupters, and continuers. The likelihood of continuing antidepressants or restarting antidepressants postpartum increased with the previous antidepressant treatment duration. Our findings indicate that continued antidepressant use during pregnancy is influenced by the severity of the disease rather than genetic predisposition as measured by PGSs.
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Affiliation(s)
- Xiaoqin Liu
- NCRR-The National Centre for Register-based Research, Aarhus University, Denmark; CIRRAU-Centre for Integrated Register-base Research, Aarhus University, Denmark; iPSYCH-Lundbeck Foundation Initiative for Integrative Psychiatric Research, Denmark.
| | - Nhung Th Trinh
- PharmacoEpidemiology and Drug Safety Research Group, Department of Pharmacy, University of Oslo, Norway
| | - Naomi R Wray
- Institute for Molecular Bioscience, The University of Queensland, Brisbane, Australia; Queensland Brain Institute, The University of Queensland, Brisbane, Australia
| | - Angela Lupattelli
- PharmacoEpidemiology and Drug Safety Research Group, Department of Pharmacy, University of Oslo, Norway
| | - Clara Albiñana
- NCRR-The National Centre for Register-based Research, Aarhus University, Denmark; CIRRAU-Centre for Integrated Register-base Research, Aarhus University, Denmark; iPSYCH-Lundbeck Foundation Initiative for Integrative Psychiatric Research, Denmark; Institute for Molecular Bioscience, The University of Queensland, Brisbane, Australia; Queensland Brain Institute, The University of Queensland, Brisbane, Australia
| | - Esben Agerbo
- NCRR-The National Centre for Register-based Research, Aarhus University, Denmark; CIRRAU-Centre for Integrated Register-base Research, Aarhus University, Denmark; iPSYCH-Lundbeck Foundation Initiative for Integrative Psychiatric Research, Denmark
| | - Bjarni J Vilhjálmsson
- NCRR-The National Centre for Register-based Research, Aarhus University, Denmark; CIRRAU-Centre for Integrated Register-base Research, Aarhus University, Denmark; iPSYCH-Lundbeck Foundation Initiative for Integrative Psychiatric Research, Denmark; Bioinformatics Research Centre, Aarhus University, Denmark
| | - Veerle Bergink
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, USA; Department of Psychiatry, Erasmus Medical Center, Rotterdam, the Netherlands
| | - Trine Munk-Olsen
- NCRR-The National Centre for Register-based Research, Aarhus University, Denmark; CIRRAU-Centre for Integrated Register-base Research, Aarhus University, Denmark; iPSYCH-Lundbeck Foundation Initiative for Integrative Psychiatric Research, Denmark; Department of Clinical Research, University of Southern Denmark, Denmark
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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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Zhang ZY, Ji B, Liu YT, Fang Y, Ge YP, Xie YN, Wang JJ, Shi TY, Sakurai R, Rehan VK. Mechanism of effects of electroacupuncture on memory and cognitive impairment in offspring rats with perinatal nicotine exposure. Zhen Ci Yan Jiu 2023; 48:1218-1226. [PMID: 38146244 DOI: 10.13702/j.1000-0607.20230044] [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] [Subscribe] [Scholar Register] [Indexed: 12/27/2023]
Abstract
OBJECTIVES To observe the effects of electroacupuncture(EA) on memory, cognitive impairment, and the brain-derived neurotrophic factor(BDNF)/N-methyl-D-aspartate receptor subtype 1(NMDAR1) pathway in the brains of offspring rat with intrauterine growth restriction(IUGR) induced by perinatal nicotine exposure(PNE), so as to explore the underlying mechanism. METHODS SD rats were randomly divided into normal, model, and EA groups, with 4 mothers and 10 offspring rats of each mother in each group. The IUGR model was established by subcutaneous injection of nicotine during pregnancy and lactation. From the 6th day of pregnancy in the mothers until the 21st day after birth of the offspring rats, EA (2 Hz/15 Hz, 1 mA) was administered bilaterally at the "Zusanli"(ST36) of mothers, once daily for 20 min. The brain organ coefficient was used to evaluate the brain development of the offspring rats. The Y-maze test and novel object recognition experiments were performed to assess memory and cognitive function. HE staining was used to observe the development and cellular morphology of the hippocampus and prefrontal cortex in the offspring rats. UV spectrophotometry was used to measure the glutamate(Glu) content in the hippocampus. ELISA was used to detect the BDNF content in the hippocampus. Western blot was performed to measure the protein expression of NMDAR1 in the hippocampus. Immunohistochemistry was used to count the number of BDNF-positive cells in the hippocampus and prefrontal cortex. RESULTS Compared with the normal group, the brain organ coefficient, exploration time of the novel arm, spontaneous alternation rate, and novel object recognition index, contents of BDNF and expression of NMDAR1 proteins in the hippocampus, the number of BDNF-positive cells in the CA1 and CA3 regions of the hippocampus and prefrontal cortex were significantly reduced(P<0.01), while the Glu content in the hippocampus was significantly increased(P<0.01) in the model group of offspring rats;decreased cell number, scattered arrangement, and disrupted cellular structure were observed in the hippocampus and prefrontal cortex of offspring rats in the model group. Compared with the model group, the brain organ coefficient, exploration time of the novel arm, spontaneous alternation rate, and novel object recognition index, the BDNF contents and NMDAR1 protein expression in the hippocampus, the number of BDNF-positive cells in the hippocampal CA1 and CA3 regions and prefrontal cortex significantly increased(P<0.01, P<0.05), while the Glu content in the hippocampus was significantly decreased (P<0.01) in offspring rats of the EA group;increased cell number, neat arrangement, and reduced cellular damage were observed in the hippocampus and prefrontal cortex in the EA group. CONCLUSIONS EA has an improving effect on memory and cognitive function impairment in offspring rats with IUGR induced by PNE, and this mechanism may be associated with the regulation of BDNF/NMDAR1 pathway, thereby improving the neuronal quantity and structure of the hippocampus and prefrontal cortex in offspring rats.
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Affiliation(s)
- Zi-Yue Zhang
- College of Acupuncture-moxibustion and Massage, Beijing University of Chinese Medicine, Beijing 100029, China.
| | - Bo Ji
- College of Acupuncture-moxibustion and Massage, Beijing University of Chinese Medicine, Beijing 100029, China.
| | - Yi-Tian Liu
- College of Acupuncture-moxibustion and Massage, Beijing University of Chinese Medicine, Beijing 100029, China
| | - Yang Fang
- College of Acupuncture-moxibustion and Massage, Beijing University of Chinese Medicine, Beijing 100029, China
| | - Yun-Peng Ge
- College of Acupuncture-moxibustion and Massage, Beijing University of Chinese Medicine, Beijing 100029, China
| | - Ya-Na Xie
- College of Acupuncture-moxibustion and Massage, Beijing University of Chinese Medicine, Beijing 100029, China
| | - Jia-Jia Wang
- College of Acupuncture-moxibustion and Massage, Beijing University of Chinese Medicine, Beijing 100029, China
| | - Tian-Yu Shi
- College of Acupuncture-moxibustion and Massage, Beijing University of Chinese Medicine, Beijing 100029, China
| | - Reiko Sakurai
- Department of Pediatrics, Lundquist Institute for Biomedical Innovation at Harbor-UCLA Medical Center, David Geffen School of Medicine at UCLA, Los Angeles 90001, USA
| | - Virender Kumar Rehan
- Department of Pediatrics, Lundquist Institute for Biomedical Innovation at Harbor-UCLA Medical Center, David Geffen School of Medicine at UCLA, Los Angeles 90001, USA
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Alcantarilla L, López-Castro M, Betriu M, Torres A, Garcia C, Solé E, Gelabert E, Roca-Lecumberri A. Risk factors for relapse or recurrence in women with bipolar disorder and recurrent major depressive disorder in the perinatal period: a systematic review. Arch Womens Ment Health 2023; 26:737-754. [PMID: 37718376 DOI: 10.1007/s00737-023-01370-9] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2023] [Accepted: 09/08/2023] [Indexed: 09/19/2023]
Abstract
It is well known that the perinatal period supposes a considerable risk of relapse for women with bipolar disorder (BD) and recurrent major depressive disorder (rMDD), with the consequences that this entails. Therefore, the authors sought to provide a critical appraisal of the evidence related to specific risk factors for this population with the aim of improving the prevention of relapses during pregnancy and postpartum. The authors conducted a systematic review assessing 18 original studies that provided data on risk factors for relapse or recurrence of BD and/or rMDD in the perinatal period (pregnancy and postpartum). Recurrences of BD and rMDD are more frequent in the postpartum period than in pregnancy, with the first 4-6 weeks postpartum being especially complicated. In addition, women with BD type I are at higher risk than those with BD type II and rMDD, and the most frequent presentation of perinatal episodes of both disorders is a major depressive episode. Other risk factors consistently repeated were early age of onset of illnesses, severity criteria, primiparity, abrupt discontinuation of treatment, and personal or family history of perinatal affective episodes. This review shows that there are common and different risk factors according to the type of disorder and to perinatal timing (pregnancy or postpartum) that should be known for an adequate prevention of relapses.
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Affiliation(s)
- Laura Alcantarilla
- Perinatal Mental Health Unit CLINIC_BCN, Hospital Clínic de Barcelona, Barcelona, Spain
- Psychiatry Service, Hospital de Sagunto, Valencia, Spain
| | - María López-Castro
- Perinatal Mental Health Unit CLINIC_BCN, Hospital Clínic de Barcelona, Barcelona, Spain
- Psychiatry Service, Sant Pau's Biomedical Research Institute (IIB-SANT PAU), Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - Maria Betriu
- Perinatal Mental Health Unit CLINIC_BCN, Hospital Clínic de Barcelona, Barcelona, Spain
| | - Anna Torres
- Perinatal Mental Health Unit CLINIC_BCN, Hospital Clínic de Barcelona, Barcelona, Spain
| | - Cristina Garcia
- Perinatal Mental Health Unit CLINIC_BCN, Hospital Clínic de Barcelona, Barcelona, Spain
| | - Eva Solé
- Perinatal Mental Health Unit CLINIC_BCN, Hospital Clínic de Barcelona, Barcelona, Spain
| | - Estel Gelabert
- Department of Clinical Psychology and Health, Autonomous University of Barcelona, Barcelona, Spain
| | - Alba Roca-Lecumberri
- Perinatal Mental Health Unit CLINIC_BCN, Hospital Clínic de Barcelona, Barcelona, Spain.
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Carlé C, Boucher D, Morelli L, Larue C, Ovtchinnikova E, Battut L, Boumessid K, Airaud M, Quaranta-Nicaise M, Ravanat JL, Dietrich G, Menard S, Eberl G, Barnich N, Mas E, Carriere M, Al Nabhani Z, Barreau F. Perinatal foodborne titanium dioxide exposure-mediated dysbiosis predisposes mice to develop colitis through life. Part Fibre Toxicol 2023; 20:45. [PMID: 37996842 PMCID: PMC10666382 DOI: 10.1186/s12989-023-00555-5] [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: 03/07/2023] [Accepted: 11/13/2023] [Indexed: 11/25/2023] Open
Abstract
BACKGROUND Perinatal exposure to titanium dioxide (TiO2), as a foodborne particle, may influence the intestinal barrier function and the susceptibility to develop inflammatory bowel disease (IBD) later in life. Here, we investigate the impact of perinatal foodborne TiO2 exposure on the intestinal mucosal function and the susceptibility to develop IBD-associated colitis. Pregnant and lactating mother mice were exposed to TiO2 until pups weaning and the gut microbiota and intestinal barrier function of their offspring was assessed at day 30 post-birth (weaning) and at adult age (50 days). Epigenetic marks was studied by DNA methylation profile measuring the level of 5-methyl-2'-deoxycytosine (5-Me-dC) in DNA from colic epithelial cells. The susceptibility to develop IBD has been monitored using dextran-sulfate sodium (DSS)-induced colitis model. Germ-free mice were used to define whether microbial transfer influence the mucosal homeostasis and subsequent exacerbation of DSS-induced colitis. RESULTS In pregnant and lactating mice, foodborne TiO2 was able to translocate across the host barriers including gut, placenta and mammary gland to reach embryos and pups, respectively. This passage modified the chemical element composition of foetus, and spleen and liver of mothers and their offspring. We showed that perinatal exposure to TiO2 early in life alters the gut microbiota composition, increases the intestinal epithelial permeability and enhances the colonic cytokines and myosin light chain kinase expression. Moreover, perinatal exposure to TiO2 also modifies the abilities of intestinal stem cells to survive, grow and generate a functional epithelium. Maternal TiO2 exposure increases the susceptibility of offspring mice to develop severe DSS-induced colitis later in life. Finally, transfer of TiO2-induced microbiota dysbiosis to pregnant germ-free mice affects the homeostasis of the intestinal mucosal barrier early in life and confers an increased susceptibility to develop colitis in adult offspring. CONCLUSIONS Our findings indicate that foodborne TiO2 consumption during the perinatal period has negative long-lasting consequences on the development of the intestinal mucosal barrier toward higher colitis susceptibility. This demonstrates to which extent environmental factors influence the microbial-host interplay and impact the long-term mucosal homeostasis.
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Affiliation(s)
- Caroline Carlé
- Institut de Recherche en Santé Digestive (IRSD), INSERM UMR-1220, Purpan Hospital, CS60039, University of Toulouse, INSERM, INRAE, ENVT, UPS, 31024, Toulouse Cedex 03, France
| | - Delphine Boucher
- M2iSH, Université Clermont Auvergne, UMR1071 INSERM, USC INRAE 1382, Clermont-Ferrand, France
| | - Luisa Morelli
- Department of Visceral Surgery and Medicine, Bern University Hospital, University of Bern, 3010, Bern, Switzerland
- Maurice Müller Laboratories, Department for Biomedical Research, University of Bern, 3008, Bern, Switzerland
| | - Camille Larue
- Laboratoire Ecologie Fonctionnelle et Environnement, Université de Toulouse, CNRS, Toulouse, France
| | - Ekaterina Ovtchinnikova
- Institut de Recherche en Santé Digestive (IRSD), INSERM UMR-1220, Purpan Hospital, CS60039, University of Toulouse, INSERM, INRAE, ENVT, UPS, 31024, Toulouse Cedex 03, France
| | - Louise Battut
- Institut de Recherche en Santé Digestive (IRSD), INSERM UMR-1220, Purpan Hospital, CS60039, University of Toulouse, INSERM, INRAE, ENVT, UPS, 31024, Toulouse Cedex 03, France
| | - Kawthar Boumessid
- Institut de Recherche en Santé Digestive (IRSD), INSERM UMR-1220, Purpan Hospital, CS60039, University of Toulouse, INSERM, INRAE, ENVT, UPS, 31024, Toulouse Cedex 03, France
| | - Melvin Airaud
- Institut de Recherche en Santé Digestive (IRSD), INSERM UMR-1220, Purpan Hospital, CS60039, University of Toulouse, INSERM, INRAE, ENVT, UPS, 31024, Toulouse Cedex 03, France
| | - Muriel Quaranta-Nicaise
- Institut de Recherche en Santé Digestive (IRSD), INSERM UMR-1220, Purpan Hospital, CS60039, University of Toulouse, INSERM, INRAE, ENVT, UPS, 31024, Toulouse Cedex 03, France
| | - Jean-Luc Ravanat
- Univ. Grenoble-Alpes, CEA, CNRS, IRIG-SyMMES, CIBEST, Grenoble, France
| | - Gilles Dietrich
- Institut de Recherche en Santé Digestive (IRSD), INSERM UMR-1220, Purpan Hospital, CS60039, University of Toulouse, INSERM, INRAE, ENVT, UPS, 31024, Toulouse Cedex 03, France
| | - Sandrine Menard
- Institut de Recherche en Santé Digestive (IRSD), INSERM UMR-1220, Purpan Hospital, CS60039, University of Toulouse, INSERM, INRAE, ENVT, UPS, 31024, Toulouse Cedex 03, France
| | - Gérard Eberl
- Institut Pasteur, Microenvironment and Immunity Unit, 75724, Paris, France
- INSERM U1224, Paris, France
| | - Nicolas Barnich
- M2iSH, Université Clermont Auvergne, UMR1071 INSERM, USC INRAE 1382, Clermont-Ferrand, France
| | - Emmanuel Mas
- Institut de Recherche en Santé Digestive (IRSD), INSERM UMR-1220, Purpan Hospital, CS60039, University of Toulouse, INSERM, INRAE, ENVT, UPS, 31024, Toulouse Cedex 03, France
- Gastroenterology, Hepatology, Nutrition, Diabetology and Hereditary Metabolic Diseases Unit, Hôpital des Enfants, CHU de Toulouse, 31300, Toulouse, France
| | - Marie Carriere
- Univ. Grenoble-Alpes, CEA, CNRS, IRIG-SyMMES, CIBEST, Grenoble, France
| | - Ziad Al Nabhani
- Department of Visceral Surgery and Medicine, Bern University Hospital, University of Bern, 3010, Bern, Switzerland.
- Maurice Müller Laboratories, Department for Biomedical Research, University of Bern, 3008, Bern, Switzerland.
| | - Frédérick Barreau
- Institut de Recherche en Santé Digestive (IRSD), INSERM UMR-1220, Purpan Hospital, CS60039, University of Toulouse, INSERM, INRAE, ENVT, UPS, 31024, Toulouse Cedex 03, France.
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8
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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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9
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Cao Q, Sun H, Wang H, Liu X, Lu Y, Huo L. Comparative study of neonatal brain injury fetuses using machine learning methods for perinatal data. Comput Methods Programs Biomed 2023; 240:107701. [PMID: 37480645 DOI: 10.1016/j.cmpb.2023.107701] [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] [Subscribe] [Scholar Register] [Received: 05/04/2021] [Revised: 06/20/2023] [Accepted: 06/28/2023] [Indexed: 07/24/2023]
Abstract
OBJECTIVE CTG is used to record the fetus's fetal heart rate and uterine contraction signal during pregnancy. The prenatal fetal intrauterine monitoring level can be used to evaluate the fetal intrauterine safety status and reduce the morbidity and mortality of the perinatal fetus. Perinatal asphyxia is the leading cause of neonatal hypoxic-ischemic encephalopathy and one of the leading causes of neonatal death and disability. Severe asphyxia can cause brain and permanent nervous system damage and leave different degrees of nervous system sequelae. METHODS This paper evaluates the classification performance of several machine learning methods on CTG and provides the auxiliary ability of clinical judgment of doctors. This paper uses the data set on the public database UCI, with 2126 samples. RESULTS The accuracy of each model exceeds 80%, of which XGBoost has the highest accuracy of 91%. Other models are Random tree (90%), light (90%), Decision tree (83%), and KNN (81%). The performance of the model in other indicators is XGBoost (precision: 90%, recall: 93%, F1 score: 90%), Random tree (precision: 88%, recall: 91%, F1 score: 89%), lightGBM (precision: 87%, recall: 93%, F1 score: 90%), Decision tree (precision: 83%, recall: 86%, F1 score: 84%), KNN (precision: 77%, recall: 85%, F1 score: 81%). CONCLUSION The performance of XGBoost is the best of all models. This result also shows that using the machine learning method to evaluate the fetus's health status in CTG data is feasible. This will also provide and assist doctors with an objective assessment to assist in clinical diagnosis.
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Affiliation(s)
- Qingjun Cao
- Department of Pediatrics, Shengjing Hospital of China Medical University, Shenyang 110004, China
| | - Hongzan Sun
- Department of Radiology, Shengjing Hospital of China Medical University, Shenyang 110004, China
| | - Hua Wang
- Department of Pediatrics, Shengjing Hospital of China Medical University, Shenyang 110004, China
| | - Xueyan Liu
- Department of Pediatrics, Shengjing Hospital of China Medical University, Shenyang 110004, China
| | - Yu Lu
- College of Big Data and Internet, Shenzhen Technology University, Shenzhen 518118, China
| | - Liang Huo
- Department of Pediatrics, Shengjing Hospital of China Medical University, Shenyang 110004, China.
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10
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Mitchell EA, Le Y, Hatch SG, Guttman S, Doss BD. Effects of online relationship programs for low-income couples during the perinatal period. Behav Res Ther 2023; 167:104337. [PMID: 37327534 DOI: 10.1016/j.brat.2023.104337] [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: 11/09/2022] [Revised: 05/04/2023] [Accepted: 05/19/2023] [Indexed: 06/18/2023]
Abstract
Low-income couples experience increased stress and declines in relationship quality during the perinatal period. They also encounter many barriers to accessing relationship services. Using a subsample of low-income perinatal couples (n = 180) from two randomized controlled trials, the current study examined the impact of online relationship interventions, OurRelationship (OR) and ePREP, in a Bayesian framework. From pre to post, relative to waitlist control couples, couples in OR and ePREP experienced improvements in relationship quality (Mean d = 0.51) and psychological distress (Mean d = 0.28); OR couples, relative to waitlist control couples, also experienced improvements in perceived stress (Mean d = 0.33). These improvements were maintained through four-month follow-up and did not differ across gender. These findings suggest brief online relationship interventions may be an important resource for low-income perinatal couples.
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11
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Fuse Y, Ogawa H, Tsukahara Y, Fuse Y, Ito Y, Shishiba Y, Irie M. Iodine Metabolism and Thyroid Function During the Perinatal Period: Maternal-Neonatal Correlation and Effects of Topical Povidone-Iodine Skin Disinfectants. Biol Trace Elem Res 2023; 201:2685-2700. [PMID: 35931927 DOI: 10.1007/s12011-022-03363-8] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2022] [Accepted: 07/15/2022] [Indexed: 11/02/2022]
Abstract
An adequate maternal iodine intake during pregnancy and lactation is essential for growth and mental development in fetuses and newborns. There are limited data on perinatal iodine metabolism in mothers and infants, as well as the effect of povidone-iodine (PVP-I) antiseptics used in cesarean delivery. The urinary iodine concentration (UIC), serum iodine, thyrotropin (TSH), free thyroxine (FT4), and breast milk iodine concentration (BMIC) were measured consecutively in a total of 327 mothers and 249 term-infants in two prospective studies. The maternal median UIC was 164 μg/L in the third trimester, increased to 256 μg/L at 44 h after birth, and then decreased to 116 μg/L 1 month later. The BMIC on the 4th and 32th postpartum days was 17.6 and 13.5 μg/100 g, respectively. In neonatal infants born to the mothers unexposed to PVP-I, the median UIC was 131 μg/L in the first voiding urine and increased to 272 μg/L on day 4 and then slightly decreased to 265 μg/L on day 28 suggesting sufficient iodine reserve at birth. PVP-I antiseptics containing 1 g of iodine for skin preparation at cesarean delivery transiently increased maternal serum iodine concentration (1.9-fold), UIC (7.8-fold) at 41 h after surgery and BMIC, while it had little effect on maternal TSH, FT4, and neonatal UIC, TSH, or FT4. The iodine status of pregnant women and their infants was adequate in this population; however, the UIC in lactating mothers at one postpartum month was low enough to suggest iodine deficiency or near iodine deficiency. Further studies are necessary.
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Affiliation(s)
- Yozen Fuse
- Foundation for Growth Science, Research Committee On Iodine Related Health Problems, 5-1-16 Hongo, Bunkyou-ku, Tokyo, 1130033, Japan.
| | - Hiroyasu Ogawa
- Ogawa Clinic, 29 Maioka-cho, Totsuka-ku, Yokohama, 2440813, Japan
| | - Yoshiaki Tsukahara
- Nakamachidai Ladies Clinic, 3-7-1 Nakamachidai, Tsuzuki-ku, Yokohama, 2240041, Japan
| | - Yoji Fuse
- Nakamachidai Ladies Clinic, 3-7-1 Nakamachidai, Tsuzuki-ku, Yokohama, 2240041, Japan
| | - Yoshiya Ito
- The Japanese Red Cross Hokkaido College of Nursing, 664-1, Akebonochou, Kitami, Hokkaido, 0900011, Japan
| | - Yoshimasa Shishiba
- Foundation for Growth Science, Research Committee On Iodine Related Health Problems, 5-1-16 Hongo, Bunkyou-ku, Tokyo, 1130033, Japan
| | - Minoru Irie
- Foundation for Growth Science, Research Committee On Iodine Related Health Problems, 5-1-16 Hongo, Bunkyou-ku, Tokyo, 1130033, Japan
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Ball MK, Seabrook RB, Corbitt R, Stiver C, Nardell K, Medoro AK, Beer L, Brown A, Mollica J, Bapat R, Cosgrove T, Texter KT. Safety and Feasibility of Skin-to-Skin Contact in the Delivery Room for High-Risk Cardiac Neonates. Pediatr Cardiol 2023; 44:1023-1031. [PMID: 36971793 PMCID: PMC10040310 DOI: 10.1007/s00246-023-03149-2] [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: 12/18/2022] [Accepted: 03/12/2023] [Indexed: 03/28/2023]
Abstract
Early skin-to-skin contact (SSC), beginning in the delivery room, provides myriad health benefits for mother and baby. Early SSC in the delivery room is the standard of care for healthy neonates following both vaginal and cesarean delivery. However, there is little published evidence on the safety of this practice in infants with congenital anomalies requiring immediate postnatal evaluation, including critical congenital heart disease (CCHD). Currently, the standard practice following delivery of infants with CCHD in many delivery centers has been immediate separation of mother and baby for neonatal stabilization and transfer to a different hospital unit or a different hospital altogether. However, most neonates with prenatally diagnosed congenital heart disease, even those with ductal-dependent lesions, are clinically stable in the immediate newborn period. Therefore, we sought to increase the percentage of newborns with prenatally diagnosed CCHD who are born in our regional level II-III delivery hospitals who receive mother-baby SSC in the delivery room. Using quality improvement methodology, through a series of Plan-Do-Study-Act cycles we successfully increased mother-baby skin-to-skin contact in the delivery room for eligible cardiac patients born across our city-wide delivery hospitals from a baseline 15% to greater than 50%.
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Affiliation(s)
- Molly K Ball
- Division of Neonatology, The Ohio State University Wexner Medical Center, 700 Children's Drive - FOB Suite 6.4A, Columbus, OH, 43205, USA.
| | - R B Seabrook
- Division of Neonatology, The Ohio State University Wexner Medical Center, 700 Children's Drive - FOB Suite 6.4A, Columbus, OH, 43205, USA
- The Fetal Center at Nationwide Children's Hospital, Columbus, OH, USA
| | - R Corbitt
- The Fetal Center at Nationwide Children's Hospital, Columbus, OH, USA
| | - C Stiver
- The Heart Center at Nationwide Children's Hospital, Columbus, OH, USA
| | - K Nardell
- The Heart Center at Nationwide Children's Hospital, Columbus, OH, USA
| | - A K Medoro
- Division of Neonatology, The Ohio State University Wexner Medical Center, 700 Children's Drive - FOB Suite 6.4A, Columbus, OH, 43205, USA
| | - L Beer
- Pediatrix Medical Group, Columbus, OH, USA
| | - A Brown
- Phoenix Children's Medical Group, Neonatology, Phoenix, AZ, USA
| | - J Mollica
- The Heart Center at Nationwide Children's Hospital, Columbus, OH, USA
| | - R Bapat
- Division of Neonatology, The Ohio State University Wexner Medical Center, 700 Children's Drive - FOB Suite 6.4A, Columbus, OH, 43205, USA
| | - T Cosgrove
- The Heart Center at Nationwide Children's Hospital, Columbus, OH, USA
| | - K T Texter
- The Fetal Center at Nationwide Children's Hospital, Columbus, OH, USA
- The Heart Center at Nationwide Children's Hospital, Columbus, OH, USA
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13
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Radjack R, Hemmerter S, Azria E, Moro MR. [Relevance of the transcultural approach to improve the care relationship in the perinatal period]. Gynecol Obstet Fertil Senol 2023; 51:342-347. [PMID: 37080294 DOI: 10.1016/j.gofs.2023.04.007] [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] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Revised: 04/10/2023] [Accepted: 04/12/2023] [Indexed: 04/22/2023]
Abstract
The international literature review highlights higher neonatal morbimortality in migrant patients and their babies. The explanatory hypotheses include late pregnancy follow-up with difficulty accessing care, language barriers, and different cultural representation in pregnancy support. On the one hand, we propose to explain the cultural factors that can impact the caring relationship during the perinatal period. On the other hand, we set out tools for anthropological and psychological understanding to enhance the sharing of cultural representations around pregnancy follow-up, the needs of a baby, and obstetrical or postnatal complications. The request for a specialised transcultural opinion needs to be more systematic; the transcultural posture is adaptable to each care professional. This requires the professional to address explicitly the impact of culture in care and consider their own cultural distance. Specialised advice is recommended in certain situations of cumulative vulnerability (complex trauma, perinatal depression with cultural coding of symptoms), blockage or refusal of care for cultural reasons and to avoid cultural misunderstandings. We detail two modalities: mediation and a discussion group around cultural issues set up in the maternity ward. The institutional work we propose within the multidisciplinary team in the maternity ward also allows the acquisition of transcultural competencies.
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Affiliation(s)
- Rahmeth Radjack
- AP-HP, Maison de Solenn, Maison des adolescents de l'Hôpital Cochin, 75014 Paris, France; Université de Paris, PCPP, 92100 Boulogne-Billancourt, France; Université Paris-Saclay, UVSQ, CESP, Team DevPsy, Inserm, 94807 Villejuif, France.
| | - Stéphane Hemmerter
- Unit Director Hall ward, Department of Psychological Medicine, The Children's Hospital at Westmead, Westmead, NSW, Australia
| | - Elie Azria
- Maternité du Groupe Hospitalier Paris Saint Joseph, 75014 Paris, France; UMR 1153, Équipe de recherche en Epidémiologie Obstétricale, Périnatale et Pédiatrique (EPOPé); Université de Paris Cité, Paris, France
| | - Marie Rose Moro
- AP-HP, Maison de Solenn, Maison des adolescents de l'Hôpital Cochin, 75014 Paris, France; Université de Paris, PCPP, 92100 Boulogne-Billancourt, France; Université Paris-Saclay, UVSQ, CESP, Team DevPsy, Inserm, 94807 Villejuif, France
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14
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Serra R, Giacchetti N, Bersani FS, Cappannini G, Martucci M, Panfili M, Sogos C, Aceti F. The relationship between personality traits and individual factors with perinatal depressive symptoms: a cross-sectional study. BMC Pregnancy Childbirth 2023; 23:382. [PMID: 37231375 DOI: 10.1186/s12884-023-05701-7] [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: 09/15/2022] [Accepted: 05/11/2023] [Indexed: 05/27/2023] Open
Abstract
BACKGROUND Pregnancy is a crucial transition moment exposing women to potential mental health problems, especially depressive disturbances. Sociodemographic, pregnancy-related, and psychological factors have been related to depressive symptoms in the perinatal period. This study aims at (1) exploring personality and individual factors related with perinatal depressive symptoms, and (2) testing the mediating role of personality in the relation between characteristics of the woman's family of origin and depressive symptoms. METHODS Women in the perinatal period admitted to the gynecology unit for motherhood-related routine assessments (n = 241) were included in the study. A survey on individual sociodemographic, clinical, and pregnancy-related factors was administered, also including the Edinburgh Postnatal Depression Scale (EPDS) and the BIG-5 personality test. RESULTS Couple conflict and neuroticism were independent and directly correlated with EPDS total score (respectively: B = 2.337; p = .017; B = 0.303; p < .001). Neuroticism was a significant mediator of the relation between the presence of a psychiatric disorder diagnosis in participant's parents and the EPDS total score (indirect b = 0.969; BCCI95%=0.366-1.607). CONCLUSIONS Couple relation and neuroticism traits are individual factors related to depressive symptoms in the perinatal period. The family of origin also plays an indirect role on perinatal depressive symptoms. Screening of these factors could lead to early recognition and more tailored treatments, ultimately leading to better outcome for the entire family.
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Affiliation(s)
- Riccardo Serra
- Department of Human Neurosciences, Sapienza University of Rome, Viale delle Università, 30, Rome, Italy.
| | - Nicoletta Giacchetti
- Department of Human Neurosciences, Sapienza University of Rome, Viale delle Università, 30, Rome, Italy
| | - Francesco Saverio Bersani
- Department of Human Neurosciences, Sapienza University of Rome, Viale delle Università, 30, Rome, Italy
| | - Gaia Cappannini
- Department of Human Neurosciences, Sapienza University of Rome, Viale delle Università, 30, Rome, Italy
| | - Melania Martucci
- Department of Human Neurosciences, Sapienza University of Rome, Viale delle Università, 30, Rome, Italy
| | - Matteo Panfili
- Department of Human Neurosciences, Sapienza University of Rome, Viale delle Università, 30, Rome, Italy
| | - Carla Sogos
- Department of Human Neurosciences, Sapienza University of Rome, Viale delle Università, 30, Rome, Italy
| | - Franca Aceti
- Department of Human Neurosciences, Sapienza University of Rome, Viale delle Università, 30, Rome, Italy
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15
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Sun Y, Pan SL, Ji ZX, Luo G, Wan H, Chen TT, Zhang A, Chen R, Xing QS. [Integrated management during the perinatal period for total anomalous pulmonary venous connection]. Zhongguo Dang Dai Er Ke Za Zhi 2023; 25:502-507. [PMID: 37272177 DOI: 10.7499/j.issn.1008-8830.2211120] [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] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
OBJECTIVES To evaluate the clinical effectiveness of integrated management during the perinatal period for fetuses diagnosed with total anomalous pulmonary venous connection (TAPVC) by prenatal echocardiography. METHODS Clinical data of 64 cases of TAPVC fetuses diagnosed by prenatal echocardiography and managed with integrated perinatal care in Qingdao Women and Children's Hospital from January 2017 to December 2021 were retrospectively analyzed. Integrated perinatal care included multidisciplinary collaboration among obstetrics, fetal medicine, ultrasound, pediatric cardiology, pediatric anesthesia, and neonatology. RESULTS Among the 64 TAPVC fetuses, there were 29 cases of supracardiac type, 27 cases of intracardiac type, 2 cases of infracardiac type, and 6 cases of mixed type. Chromosomal analysis was performed in 42 cases, and no obvious abnormalities were found. Among the 64 TAPVC fetuses, 37 were induced labor, and 27 were followed up until term birth. Among the 27 TAPVC cases, 2 cases accepted palliative care, 2 cases were referred to another hospital for treatment and lost to follow-up, while the remaining 23 cases underwent primary repair surgery. One case died within 6 months after the operation due to low cardiac output syndrome, while the other 22 cases were followed up for (2.1±0.3) years with good outcomes (2 cases underwent a second surgery within 1 year after the first operation due to anastomotic stenosis or pulmonary vein stenosis). CONCLUSIONS TAPVC fetuses can achieve good outcomes with integrated management during the perinatal period.
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Affiliation(s)
- Yi Sun
- Heart Center, Women and Children's Hospital, Qingdao University/Qingdao Women and Children's Hospital, , Qingdao) Shandong, China 266034
| | - Si-Lin Pan
- Heart Center, Women and Children's Hospital, Qingdao University/Qingdao Women and Children's Hospital, , Qingdao) Shandong, China 266034
| | - Zhi-Xian Ji
- Heart Center, Women and Children's Hospital, Qingdao University/Qingdao Women and Children's Hospital, , Qingdao) Shandong, China 266034
| | - Gang Luo
- Heart Center, Women and Children's Hospital, Qingdao University/Qingdao Women and Children's Hospital, , Qingdao) Shandong, China 266034
| | | | | | | | - Rui Chen
- Heart Center, Women and Children's Hospital, Qingdao University/Qingdao Women and Children's Hospital, , Qingdao) Shandong, China 266034
| | - Quan-Sheng Xing
- Heart Center, Women and Children's Hospital, Qingdao University/Qingdao Women and Children's Hospital, , Qingdao) Shandong, China 266034
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Oğur NB, Kotan M, Balta D, Yavuz BÇ, Oğur YS, Yuvacı HU, Yazıcı E. Detection of depression and anxiety in the perinatal period using Marine Predators Algorithm and kNN. Comput Biol Med 2023; 161:107003. [PMID: 37224599 DOI: 10.1016/j.compbiomed.2023.107003] [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: 02/03/2023] [Revised: 04/19/2023] [Accepted: 05/02/2023] [Indexed: 05/26/2023]
Abstract
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.
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Affiliation(s)
- Nur Banu Oğur
- Sakarya University, Faculty of Computer and Information Sciences, Department of Computer Engineering, Sakarya, Turkey.
| | - Muhammed Kotan
- Sakarya University, Faculty of Computer and Information Sciences, Department of Information Systems Engineering, Sakarya, Turkey
| | - Deniz Balta
- Sakarya University, Faculty of Computer and Information Sciences, Department of Software Engineering, Sakarya, Turkey
| | - Burcu Çarklı Yavuz
- Sakarya University, Faculty of Computer and Information Sciences, Department of Information Systems Engineering, Sakarya, Turkey
| | - Yavuz Selim Oğur
- Sakarya University, Faculty of Medicine, Department of Psychiatry, Sakarya, Turkey
| | - Hilal Uslu Yuvacı
- Sakarya University, Faculty of Medicine, Department of Obstetrics and Gynecology, Sakarya, Turkey
| | - Esra Yazıcı
- Sakarya University, Faculty of Medicine, Department of Psychiatry, Sakarya, Turkey
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Fonseca A, Branquinho M, Monteiro F, Araújo-Pedrosa A, Bjørndal LD, Lupattelli A. Treatment options and their uptake among women with symptoms of perinatal depression: exploratory study in Norway and Portugal. BJPsych Open 2023; 9:e77. [PMID: 37139793 DOI: 10.1192/bjo.2023.56] [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] [Indexed: 05/05/2023] Open
Abstract
BACKGROUND Perinatal depression is the most undertreated clinical condition during the perinatal period. Knowledge about women's decision-making in seeking and receiving treatment is scarce. AIMS To investigate and compare treatment option uptake in perinatal women with depressive symptoms in Portugal and Norway, and to identify sociodemographic and health-related factors associated with treatment uptake. METHOD Participants were women resident in Portugal or Norway (≥18 years) who were pregnant or had given birth in the past 12 months, who presented with active depressive symptoms (Edinburgh Postnatal Depression Scale score ≥10). In an electronic questionnaire, women reported treatment received and sociodemographic and health-related factors. RESULTS The sample included 416 women from Portugal and 169 from Norway, of which 79.8% and 53.9%, respectively, were not receiving any treatment. Most Portuguese women were receiving psychological treatment, either alone (45.2%) or combined with pharmacological treatment (21.4%). Most Norwegian participants were receiving only pharmacological (36.5%) or combined treatment (35.4%). Compared with the Portuguese sample, a higher proportion of Norwegian women started treatment before pregnancy (P < 0.001). In Portugal, lower depressive symptoms and self-reported psychopathology were significantly associated with higher likelihood of receiving treatment. CONCLUSIONS We found that, in both Norway and Portugal, a substantial number of perinatal women with depressive symptoms do not receive any treatment. Differences exist regarding the chosen treatment option and timing of treatment initiation in the two countries. Only mental health-related factors were associated with treatment uptake for perinatal depression in Portugal. Our results highlight the importance of implementing strategies aimed to improve help-seeking behaviours.
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Affiliation(s)
- Ana Fonseca
- Center for Research in Neuropsychology and Cognitive Behavioral Intervention, Faculty of Psychology and Educational Sciences, University of Coimbra, Portugal
| | - Mariana Branquinho
- University of Coimbra, Center for Research in Neuropsychology and Cognitive Behavioral Intervention, Faculty of Psychology and Educational Sciences, Portugal
| | - Fabiana Monteiro
- Center for Research in Neuropsychology and Cognitive Behavioral Intervention, Faculty of Psychology and Educational Sciences, University of Coimbra, Portugal
| | - Anabela Araújo-Pedrosa
- Center for Research in Neuropsychology and Cognitive Behavioral Intervention, Faculty of Psychology and Educational Sciences, University of Coimbra, Portugal; and Clinical Psychology Service, Department of Gynaecology, Obstetrics, Reproduction and Neonatology (Maternity Daniel de Matos), Centro Hospitalar e Universitário de Coimbra, Portugal
| | - Ludvig D Bjørndal
- PROMENTA Research Center, Department of Psychology, University of Oslo, Norway
| | - Angela Lupattelli
- Pharmacoepidemiology and Drug Safety Research Group, Department of Pharmacy, Faculty of Mathematics and Natural Sciences, University of Oslo, Norway
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Valverde N, Mollejo E, Legarra L, Gómez-Gutiérrez M. Psychodynamic Psychotherapy for Postpartum Depression: A Systematic Review. Matern Child Health J 2023:10.1007/s10995-023-03655-y. [PMID: 37029894 DOI: 10.1007/s10995-023-03655-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] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/16/2023] [Indexed: 04/09/2023]
Abstract
OBJECTIVES Postpartum depression estimated prevalence in women is between 5 and 26% and it has adverse effects both on the mother, infant and her partner. Psychological treatments have proved to be effective for women with mild-to-moderate symptoms. Whereas several systematic reviews have assessed the effects of different psychological interventions for postpartum depression, such as cognitive-behavioural therapy or interpersonal therapy, no review assessing psychodynamic therapy has been carried out. A systematic review was conducted to evaluate the efficacy of psychodynamic therapy for postpartum depression. METHODS Studies were identified using the following databases: PsycINFO, Psycarticles and Pubmed over January 2023. The requirements for the studies were the following: they had to be quantitative, available in English, including a psychodynamic intervention targeting treatment or prevention of postpartum depression which starts during pregnancy or within the first 12 months after giving birth. Case studies, qualitative studies or studies focused on improving parent-infant relationship or infant outcome were excluded from this research. RESULTS Seven trials including 521 women met the inclusion criteria. In summary, three randomized controlled trials and four longitudinal studies were found. The most frequently used assessment tool was EPDS, five were individual interventions and the other two were group interventions. DISCUSSION All studies reported the efficacy of psychodynamic interventions for postpartum depression, both in home and clinical settings and both in group and individual format. The limited number of trials, small sample sizes and lack of appropriate control groups were the main limitations. CONCLUSIONS FOR PRACTICE Psychodynamic therapy is probably efficient intervention for postpartum depression. Future research with strong methodological designs is needed to confirm these findings. SIGNIFICANCE What is already known on this subject? Several systematic reviews have assessed the effects of different psychological interventions for postpartum depression, but no review assessing psychodynamic therapy has been carried out. What this study adds? A systematic review was conducted to evaluate the efficacy of psychodynamic therapy for postpartumdepression. This makes the systematic review a unique contribution to the literature.
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Affiliation(s)
- N Valverde
- Faculty of Psychology, Department of Assessment, Personality and Clinical Psychology, Complutense University of Madrid, Campus of Somosaguas s/n, Madrid, 28040, Spain.
| | - E Mollejo
- Department of Psychiatry and Mental Health, Southeast University Hospital of Madrid, Madrid, Spain
| | - L Legarra
- Faculty of Psychology, Department of Assessment, Personality and Clinical Psychology, Complutense University of Madrid, Campus of Somosaguas s/n, Madrid, 28040, Spain
| | - M Gómez-Gutiérrez
- Faculty of Psychology, Department of Assessment, Personality and Clinical Psychology, Complutense University of Madrid, Campus of Somosaguas s/n, Madrid, 28040, Spain
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Leahy-Warren P, Nieuwenhuijze M. Measuring women's empowerment during the perinatal period in high income countries: A scoping review of instruments used. Heliyon 2023; 9:e14591. [PMID: 37064454 PMCID: PMC10102201 DOI: 10.1016/j.heliyon.2023.e14591] [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: 07/12/2022] [Revised: 03/07/2023] [Accepted: 03/10/2023] [Indexed: 03/30/2023] Open
Abstract
Empowerment is acknowledged as a process facilitating those who are less powerful to be engaged in their problem identification, decision making and actions to gain control over their life. This is an important goal for women during the perinatal period in their transition to motherhood. A concept analysis of women's empowerment during the perinatal period found that psychological and social dimensions play a role in women's perinatal empowerment and identified several defining attributes. The aim of this study was to identify robust validated instruments that measure all the attributes of women's empowerment during the perinatal period. We did a scoping review of scientific literature following the methodology of the JBI Reviewer's Manual. We searched the database MEDLINE, CINAHL, PsycINFO, PsycARTICLES and SocINDEX and selected papers meeting the inclusion criteria. Instruments measuring empowerment or related concepts were identified in the selected papers. Two authors independently cross referenced the items of each instrument against the defining attributes for empowerment. Our search resulted in 9771 unique hits of which 36 papers were finally included. Studies were from various countries with a wide variety of aims, demographics of cohorts and timepoints across the perinatal period. Twenty-one different instruments were used to measure empowerment, of which 11 were validated among women during the perinatal period. However, no identified instrument was developed specifically for women during the perinatal period or included all the dimensions of empowerment and the defining attributes. There is a need for a theoretically sound valid and reliable instrument measuring all the dimensions of empowerment of women during the perinatal period. Once developed this instrument needs testing with a broad range of women. Results from such a study will inform the development of appropriate interventions that have a coherent theoretical basis and are empirically informed to enhance women's empowerment during the perinatal period.
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Affiliation(s)
| | - Marianne Nieuwenhuijze
- Research Centre for Midwifery Science, Academie Verloskunde Maastricht, Zuyd University, the Netherlands
- CAPHRI School for Public Health and Primary Care, Maastricht University, the Netherlands
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20
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Perera E, Chou S, Cousins N, Mota N, Reynolds K. Women's experiences of trauma, the psychosocial impact and health service needs during the perinatal period. BMC Pregnancy Childbirth 2023; 23:197. [PMID: 36944924 PMCID: PMC10028773 DOI: 10.1186/s12884-023-05509-5] [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] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Accepted: 03/09/2023] [Indexed: 03/23/2023] Open
Abstract
BACKGROUND Traumatic events are associated with psychological and physical health problems for women in the perinatal period (i.e., pregnancy-12-months after childbirth). Despite the negative impact of trauma on perinatal women, the long-term impact of such diverse trauma and women's experience during the perinatal period remains understudied. METHODS This study explored two research questions: 1) What are the psychological experiences of perinatal women who have experienced interpersonal traumatic events? And 2) What are the service needs and gaps expressed by women relating to perinatal medical protocols and psychological services? These questions were addressed via in-depth semi-structured qualitative interviews with nine perinatal women (one pregnant and eight postpartum) residing in central Canada who reported experiencing interpersonal traumatic events occurring from adolescence to the perinatal period. Recruitment and data collection occurred from October 2020 to June 2021. Interviews were audio-recorded, transcribed, and analyzed according to constructivist grounded theory. RESULTS The emergent grounded theory model revealed the central theme of the role of prior trauma in shaping women's perinatal experiences, with four related main themes including perinatal experiences during the COVID-19 pandemic, the role of social support in women's perinatal experiences, the barriers that women experienced while seeking psychological and medical services prior to the perinatal period and during the perinatal period, and the specific needs of perinatal women with a history of interpersonal trauma. CONCLUSIONS Findings of this research highlight the negative and long-lasting impact of traumatic events experienced on women's psychological health and psychosocial functioning during the perinatal period, as well as perinatal women's unmet psychological and medical service needs. A call to action for perinatal researchers and clinicians is imperative in furthering this important area of research and practicing person-centered and trauma-informed care with this population.
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Affiliation(s)
- Essence Perera
- Department of Psychology, University of Manitoba, P313 Duff Roblin Building, 190 Dysart Rd, Winnipeg, MB, R3T 2N2, Canada
| | - Sharon Chou
- Department of Psychology, University of Manitoba, P313 Duff Roblin Building, 190 Dysart Rd, Winnipeg, MB, R3T 2N2, Canada
| | - Nicole Cousins
- Department of Psychiatry, University of Manitoba, Winnipeg, MB, Canada
| | - Natalie Mota
- Department of Psychiatry, University of Manitoba, Winnipeg, MB, Canada
- Department of Clinical Health Psychology, University of Manitoba, Winnipeg, MB, Canada
| | - Kristin Reynolds
- Department of Psychology, University of Manitoba, P313 Duff Roblin Building, 190 Dysart Rd, Winnipeg, MB, R3T 2N2, Canada.
- Department of Psychiatry, University of Manitoba, Winnipeg, MB, Canada.
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21
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Hutchison SM, Brain U, Grunau RE, Kuzeljevic B, Irvine M, Mâsse LC, Oberlander TF. Associations between maternal depressive symptoms and selective serotonin reuptake inhibitor antidepressant treatment on internalising and anxiety behaviours in children: 12-year longitudinal study. BJPsych Open 2023; 9:e26. [PMID: 36721917 PMCID: PMC9970165 DOI: 10.1192/bjo.2022.623] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023] Open
Abstract
BACKGROUND Prenatal selective serotonin reuptake inhibitor (SSRI) antidepressant exposure is associated with increased internalising and anxious behaviours in young children; whether this continues into early adolescence is unknown. Also, it is not well established whether it is the in utero exposure to SSRIs or the underlying maternal mood that contributes more to these associations. AIMS To examine associations between maternal depressive symptoms, prenatal SSRI antidepressant treatment and internalising and anxiety behaviours from childhood into pre-adolescence. METHOD From a prospective longitudinal cohort, measures of maternal depressive symptoms and SSRI use and child outcomes (n = 191 births) were obtained from the second trimester to 12 years. Maternal reports of internalising and anxiety behaviours in children were obtained at 3, 6 and 12 years. RESULTS Multilevel mixed-effects models revealed that maternal depressed mood at the third trimester assessment, not prenatal SSRI exposure, was associated with longitudinal patterns of higher levels of internalising and anxiety behaviours across childhood from 3 to 12 years of age. At each age, hierarchical regressions showed that maternal mood at the third trimester, compared with current maternal depression or prenatal SSRI exposure, explained a greater proportion of the variance in internalising and anxiety behaviours. CONCLUSIONS Even with prenatal SSRI treatment, maternal depressed mood during the third trimester still had an enduring effect as it was associated with increased levels of internalising and anxiety behaviours across childhood and into early adolescence. Importantly, we found no evidence of a 'main effect' association between prenatal SSRI exposure and internalising and anxiety behaviours in children.
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Affiliation(s)
- Sarah M Hutchison
- Department of Pediatrics, University of British Columbia, Vancouver, Canada
| | - Ursula Brain
- Department of Pediatrics, University of British Columbia, Vancouver, Canada
| | - Ruth E Grunau
- Department of Pediatrics, University of British Columbia, Vancouver, Canada
| | - Boris Kuzeljevic
- (deceased), Department of Pediatrics, University of British Columbia, Vancouver, Canada
| | - Mike Irvine
- Department of Pediatrics, University of British Columbia, Vancouver, Canada
| | - Louise C Mâsse
- School of Population and Public Health, University of British Columbia, Vancouver, Canada
| | - Tim F Oberlander
- Department of Pediatrics, University of British Columbia, Vancouver, Canada; and School of Population and Public Health, University of British Columbia, Vancouver, Canada
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22
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Shahid Ali S, Letourneau N, Rajan A, Jaffer S, Adnan F, Asif N, Ali TS. Midwives' perspectives on perinatal mental health: A qualitative exploratory study in a maternity setting in Karachi, Pakistan. Asian J Psychiatr 2023; 80:103356. [PMID: 36470193 DOI: 10.1016/j.ajp.2022.103356] [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: 08/27/2022] [Revised: 10/29/2022] [Accepted: 11/25/2022] [Indexed: 11/27/2022]
Abstract
Women experience perinatal mental health problems (PMHP), such as anxiety and depression antenatally and/or postnatally. Among Asian countries, Pakistan has the highest prevalence of postnatal depression ranging from 28% to 63%. This study aimed to explore midwives' perceptions, understanding, thoughts, and feelings regarding perinatal mental health (PMH), as well as experiences and roles in identifying and managing perinatal women cases suffering from PMHP. A qualitative, descriptive, exploratory design was used. The study was conducted at Koohi Goth Hospital. Purposive sampling was used to recruit practicing midwives holding diplomas in midwifery and public health, and with at least two years of experience. Ten participants were recruited. Data were collected by conducting in-depth interviews using a semi-structured interview guide, translated into Urdu. Interviews were audio recorded. Ethics approval was attained by the institutional Ethical Review Committee. Data analysis was done manually by using the content analysis steps described by Creswell. From the analysis, three themes emerged: 1) Dearth of PMH competencies; 2) Importance of PMH; and 3) Myths related to PMH. PMHP undermine mothers' and infants outcomes, thus, midwives should be competent in assessing and managing symptoms in perinatal women to reduce suffering.
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Affiliation(s)
- Shahnaz Shahid Ali
- School of Nursing and Midwifery, Aga Khan University, Karachi, Pakistan.
| | | | | | | | - Farzana Adnan
- School of Nursing and Midwifery, Aga Khan University, Karachi, Pakistan
| | - Nimira Asif
- School of Nursing and Midwifery, Aga Khan University, Karachi, Pakistan
| | - Tazeen Saeed Ali
- School of Nursing and Midwifery, Aga Khan University, Karachi, Pakistan
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23
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Toh RKC, Shorey S. Experiences and needs of women from ethnic minorities in maternity healthcare: A qualitative systematic review and meta-aggregation. Women Birth 2023; 36:30-8. [PMID: 35717372 DOI: 10.1016/j.wombi.2022.06.003] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Revised: 05/13/2022] [Accepted: 06/08/2022] [Indexed: 01/28/2023]
Abstract
OBJECTIVES To consolidate the available evidence around ethnic minority women's experiences and needs when accessing maternity care. METHODS A qualitative systematic review and meta-aggregation of qualitative data were conducted. Nine electronic databases were searched for qualitative or mixed-methods studies from the inception of each database until January 2022. Using the Nested-Knowledge software, meta-aggregation was conducted according to the Joanna Briggs Institute (JBI) data synthesis approach to identify all potential intersections between different themes. Methodological quality of included studies was assessed using the JBI Qualitative Assessment and Review Instrument (JBI-QARI) and the mixed-methods appraisal tool (MMAT) checklists for qualitative and mixed-methods studies, respectively. RESULTS Twenty-two studies (nineteen qualitative and three mixed-methods) were included. All studies were of good methodological quality. An overarching theme 'the struggles and fears of ethnic minority women' was identified. The negative experiences with maternity care were attributed to barriers including ineffective communication, cultural and religious insensitivity, inattentiveness and disregard for women's needs, and isolation-related impact due to the COVID pandemic. CONCLUSIONS Overall, our review highlighted several significant gaps between the care provided and the expected care among ethnic minority women accessing maternity care services. This mismatch between their expectations and care resulted in negative experiences, as the women reported being discriminated against and disrespected. There is an urgent need to develop and implement maternity care policies that are inclusive of needs of the ethnic minority women to optimize their maternity care experience.
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Sorsa M, Hohenthal M, Pikulinsky M, Sellergren H, Puura K. Qualitative description of outreach and engagement in perinatal substance treatment in Finland. Subst Abuse Treat Prev Policy 2023; 18:6. [PMID: 36681846 PMCID: PMC9862241 DOI: 10.1186/s13011-022-00513-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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2022] [Accepted: 12/29/2022] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND Women with perinatal substance problems experience a multitude of barriers to care. They have specific early intervention needs, they endure societal stigma, and both substances and mental health issues influence the way they navigate within support and treatment systems. Early interventions for women with perinatal substance problems are underresearched contexts. The aim of the study is to describe building relationships and engagement within an outreach and low threshold service encounter tailored for pregnant women with SUD (substance use disorder). METHODS The data consist of online written narratives from 11 workers involved in the program and feedback from 504 families in the recovery process comprising 228 open-ended answers. The data were analyzed with a thematic analysis. RESULTS The programs are characterized by flexibility and the implementation of inclusive ways to approach families. The themes for enhancing relationships and engagement within outreach and low threshold programs are Acceptance and attitude: a sensitive approach of approval; flexibility within strictness to allow for diversity and individuality; availability and space to ensure a trustful atmosphere; negotiating via doing to build connections; and everyday life changes: imagining recovery. The themes represent the need of being available, focusing on the worker's attitudes and building connections by doing together, and visioning recovery together. CONCLUSIONS The study results can add to the understanding of SUD outreach and low threshold work during pregnancy. The elements described in this study need further theoretical development, research and critical assessment. Building relationships during pregnancy were characterized by connecting within everyday life situations and supporting the development of an attachment relationship between the baby and the parents. To promote recovery, a comprehensive approach in which substance-related issues and mental health conditions are interconnected can be favored. Engaging early on during pregnancy might enhance success during future rehabilitation.
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Affiliation(s)
- Minna Sorsa
- Child Psychiatry, Tampere University Hospital, Pirkanmaa Hospital District, Tampere, Finland
- Nursing Science, Faculty of Social Sciences, Tampere University, Biokatu 12, FM 5 (4-306), SF-33520 Tampere, Finland
| | - Maria Hohenthal
- The Federation of Mother and Child Homes and Shelters, Helsinki, Finland
| | - Miia Pikulinsky
- The Federation of Mother and Child Homes and Shelters, Helsinki, Finland
| | - Hanna Sellergren
- The Federation of Mother and Child Homes and Shelters, Helsinki, Finland
| | - Kaija Puura
- Child Psychiatry, Tampere University Hospital, Pirkanmaa Hospital District, Tampere, Finland
- Faculty of Medicine and Health Technology, TamCAM Research Centre, Tampere University, Tampere, Finland
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25
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Lewis G, Blake L, Seneviratne G. Delusional Misidentification Syndromes in Postpartum Psychosis: A Systematic Review. Psychopathology 2022:1-10. [PMID: 36116435 DOI: 10.1159/000526129] [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: 01/30/2022] [Accepted: 06/29/2022] [Indexed: 11/19/2022]
Abstract
INTRODUCTION Delusional misidentification syndromes (DMS) are a group of psychopathological experiences occurring in psychosis, involving the misidentification of a person or place. DMS are often accompanied by hostility towards the object of delusional misidentification. This is of a particular concern in perinatal mental illness due to the potential disruption of the mother-infant bond, and risk of neglect, violence, or infanticide towards a misidentified child. This review aimed to collate all published cases of DMS in postpartum psychosis to further understand how these syndromes present in perinatal mental illness. METHODS In August 2021, an online database search was conducted using PubMed, MEDLINE, PsycINFO, CINAHL, and Embase to identify all publications reporting DMS in the perinatal period. RESULTS Nine papers were included in the review involving 8 case reports of Capgras syndrome and one case series involving 4 cases of Fregoli syndrome. Three cases identified organic pathology, which may have contributed to the presentation. The most common subject of misidentification was the patient's husband (n = 7), followed by their baby (n = 6), hospital staff (n = 4), other family members (n = 3), and self (n = 1). Five cases remark on the impact of perinatal illness on the maternal-infant bond, of which four result in the mother being unwilling to care for the infant as the result of their delusional beliefs. CONCLUSION This is the first systematic review of the literature in this field. Although small in number, these cases reveal several important learning points including that DMS can occur with or without underlying organic disease. Active exploration of the nature of delusions in postpartum psychosis is required to mitigate the risk of harm to the infant and mother-infant bond. It may also uncover that these syndromes are more common in postpartum psychosis than previously realized.
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Affiliation(s)
- Gabriella Lewis
- Maudsley Hospital, South London and Maudsley NHS Foundation Trust, London, United Kingdom.,Institute of Psychiatry, Psychology & Neuroscience, Kings College London, London, United Kingdom
| | - Lucy Blake
- Maudsley Hospital, South London and Maudsley NHS Foundation Trust, London, United Kingdom.,Institute of Psychiatry, Psychology & Neuroscience, Kings College London, London, United Kingdom
| | - Gertrude Seneviratne
- Mother and Baby Unit, Bethlem Royal Hospital, South London and Maudsley NHS Foundation Trust, Beckenham, United Kingdom
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Grados L, Pérot M, Barbezier N, Delayre-Orthez C, Bach V, Fumery M, Anton PM, Gay-Quéheillard J. How advanced are we on the consequences of oral exposure to food contaminants on the occurrence of chronic non communicable diseases? Chemosphere 2022; 303:135260. [PMID: 35688194 DOI: 10.1016/j.chemosphere.2022.135260] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/18/2022] [Revised: 06/02/2022] [Accepted: 06/04/2022] [Indexed: 06/15/2023]
Abstract
The development of an individual during fetal life and childhood is characterized by rapid growth as well as gradual maturation of organs and systems. Beyond the nutritional intake in essential nutrients, food contaminants can permanently influence the way organs mature and function. These processes are called "programming" and play an essential role in the occurrence of non-communicable chronic diseases throughout the lifespan. Populations as pregnant women, fetuses and young children are vulnerable and particularly sensitive to food contaminants which can induce epigenetic modifications transmissible to future generations. Among these contaminants, pesticides are found in most food matrices exposing humans to cocktails of molecules through variable concentrations and duration of exposure. The Maillard reaction products (MRPs) represent other food contaminants resulting from heat treatment of food. Modern diet, rich in fats and sugars, is also rich in neoformed pathogenic compounds, Advanced Glycation End products (AGEs), the levels of which depend on the heat treatment of foods and eating habits and whose effects on health are controversial. In this review, we have chosen to present the current knowledge on the impacts of selected pesticides and MRPs, on the risk of developing during life non-communicable chronic diseases such as IBD, metabolic disorders or allergies. A large review of literature was performed via Pubmed, and the most appropriate studies were summarised.
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Affiliation(s)
- Lucien Grados
- PériTox, Périnatalité & Risques Toxiques, UMR-I 01 INERIS, Université Picardie Jules Verne, CURS, CHU Amiens Picardie, Avenue René Laennec, Amiens, France; CHU Amiens-Picardie, Service D'hépato-gastro-entérologie, Rond-point Du Pr Cabrol, Amiens, France
| | - Maxime Pérot
- Transformations and Agroressources (URL 7519), Institut Polytechnique UniLaSalle, Université D'Artois, 19 Rue Pierre Waguet, BP 30313, 60026, Beauvais, France
| | - Nicolas Barbezier
- Transformations and Agroressources (URL 7519), Institut Polytechnique UniLaSalle, Université D'Artois, 19 Rue Pierre Waguet, BP 30313, 60026, Beauvais, France
| | - Carine Delayre-Orthez
- Transformations and Agroressources (URL 7519), Institut Polytechnique UniLaSalle, Université D'Artois, 19 Rue Pierre Waguet, BP 30313, 60026, Beauvais, France
| | - Véronique Bach
- PériTox, Périnatalité & Risques Toxiques, UMR-I 01 INERIS, Université Picardie Jules Verne, CURS, CHU Amiens Picardie, Avenue René Laennec, Amiens, France
| | - Mathurin Fumery
- PériTox, Périnatalité & Risques Toxiques, UMR-I 01 INERIS, Université Picardie Jules Verne, CURS, CHU Amiens Picardie, Avenue René Laennec, Amiens, France; CHU Amiens-Picardie, Service D'hépato-gastro-entérologie, Rond-point Du Pr Cabrol, Amiens, France
| | - Pauline M Anton
- Transformations and Agroressources (URL 7519), Institut Polytechnique UniLaSalle, Université D'Artois, 19 Rue Pierre Waguet, BP 30313, 60026, Beauvais, France
| | - Jérôme Gay-Quéheillard
- PériTox, Périnatalité & Risques Toxiques, UMR-I 01 INERIS, Université Picardie Jules Verne, CURS, CHU Amiens Picardie, Avenue René Laennec, Amiens, France.
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Vermeulen J, Bilsen J, Buyl R, De Smedt D, Gucciardo L, Faron G, Fobelets M. Women's experiences with being pregnant and becoming a new mother during the COVID-19 pandemic. Sex Reprod Healthc 2022; 32:100728. [PMID: 35490479 PMCID: PMC9040428 DOI: 10.1016/j.srhc.2022.100728] [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] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Revised: 03/08/2022] [Accepted: 04/20/2022] [Indexed: 11/19/2022]
Abstract
OBJECTIVE During the COVID-19 pandemic a national quarantine was imposed in Belgium, which led to changes in the maternity care provision. Despite emerging literature, it remains unclear how pregnant women and women who have recently given birth experienced this period. With this study we aim to explore these women's experiences during the COVID-19 pandemic. METHODS This qualitative study is a part of a large longitudinal study on women's health-related quality of life (HRQoL), during the COVID-19 pandemic. An open-ended question, in an online survey, asking women about their experiences during the perinatal period was analysed using a thematic analysis. RESULTS Of the 1007 women who participated in the HRQoL-study in June 2020, 556 (55%) women answered the open question. In general, we identified a multiplicity of mixed and interconnected feelings. Many women reported negative feelings; nevertheless, the pandemic also had some positive aspects for respondents. Six overreaching themes were identified: fear of contamination, feeling isolated and unsupported, not able to share experiences, disrupted care, feeling unprepared and experience a peaceful period. CONCLUSION Although perinatal healthcare professionals did their utmost to provide the necessary care, being pregnant or being a new mother during this pandemic was challenging at times. However, this period was also experienced as a peaceful period with lot of opportunities to rest. Some of the changes such as telework and restricted visiting policies were experienced positively by many. Lessons learned can support perinatal healthcare professionals and policy makers in the organisation of maternity care in the post-pandemic era.
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Affiliation(s)
- Joeri Vermeulen
- Department Health Care, Brussels Centre for Healthcare Innovation, Erasmus Brussels University of Applied Sciences and Arts, Brussels, Belgium; Faculty of Medicine and Pharmacy, Department of Public Health, Biostatistics and Medical Informatics Research group, Vrije Universiteit Brussel (VUB), Brussels, Belgium.
| | - Johan Bilsen
- Faculty of Medicine and Pharmacy, Department of Public Health, Mental Health and Wellbeing Research Group, Vrije Universiteit Brussel (VUB), Brussels, Belgium
| | - Ronald Buyl
- Faculty of Medicine and Pharmacy, Department of Public Health, Biostatistics and Medical Informatics Research group, Vrije Universiteit Brussel (VUB), Brussels, Belgium
| | - Delphine De Smedt
- Department of Public Health and Primary Care, Ghent University, Ghent, Belgium
| | - Léonardo Gucciardo
- Department of Obstetrics and Prenatal Medicine, Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel (VUB), Brussels, Belgium
| | - Gilles Faron
- Department of Obstetrics and Prenatal Medicine, Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel (VUB), Brussels, Belgium
| | - Maaike Fobelets
- Department Health Care, Brussels Centre for Healthcare Innovation, Erasmus Brussels University of Applied Sciences and Arts, Brussels, Belgium; Faculty of Medicine and Pharmacy, Department of Public Health, Biostatistics and Medical Informatics Research group, Vrije Universiteit Brussel (VUB), Brussels, Belgium
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28
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魏 思. Recent research on the effect of common treatments given in the perinatal period on neurodevelopment in offspring. Zhongguo Dang Dai Er Ke Za Zhi 2022; 24:332-338. [PMID: 35351267 PMCID: PMC8974644 DOI: 10.7499/j.issn.1008-8830.2111002] [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] [Subscribe] [Scholar Register] [Received: 11/02/2021] [Accepted: 01/20/2022] [Indexed: 06/14/2023]
Abstract
The perinatal period is the key period for the development of brain and central nervous system, and different events in this period will have a profound influence on brain development. Glucocorticoids, antibiotics, magnesium sulfate, caffeine, pulmonary surfactant, and mild hypothermia treatment are commonly used drugs or treatment methods in the perinatal period and are closely associated with the prognosis of neonatal neurodevelopment. This article reviews the latest research on the effect of perinatal treatments on neonatal neurodevelopment, so as to provide a reference for clinical decision making.
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Grand-Guillaume-Perrenoud JA, Origlia P, Cignacco E. Barriers and facilitators of maternal healthcare utilisation in the perinatal period among women with social disadvantage: A theory-guided systematic review. Midwifery 2022; 105:103237. [PMID: 34999509 DOI: 10.1016/j.midw.2021.103237] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2020] [Revised: 11/25/2021] [Accepted: 12/19/2021] [Indexed: 11/19/2022]
Abstract
BACKGROUND Women with social disadvantage have poorer perinatal outcomes compared to women in advantaged social positions, which may be linked to poorer healthcare utilisation. Disadvantaged groups may experience a greater diversity of barriers (e.g., feeling embarrassed about pregnancy, lack of transportation) or barriers judged to be particularly difficult (e.g., embarrassment about pregnancy). They may also experience barriers more frequently (e.g., depression). Using Levesque et al.'s (2013) framework of healthcare access, our review identifies the barriers and facilitators that affect maternal healthcare utilisation in the perinatal period among women with social disadvantage in high-income nations. OBJECTIVES Our review searches for the barriers and facilitators affecting maternal healthcare utilisation in the perinatal period, from pregnancy to the first year postpartum, among women with social disadvantage (Prospero registration CRD42020151506). DESIGN We conducted a theory-guided systematic review. PubMed, Embase, MEDLINE, PsycINFO, and Social Science Citation Index databases were searched for publications between 1999 and 2018. FINDINGS 37 articles out of 12'972 were included in the qualitative synthesis. 19 domains of barriers and facilitators were extracted. Domains on the provider side includes 'information regarding available treatments' and 'trustful relationships.' On the user-side, domains include 'awareness of pregnancy' and 'unplanned/unwanted pregnancy' KEY CONCLUSIONS: Provider- and user-side characteristics interact to affect access. User-side characteristics that pose a barrier can be offset by provider-side characteristics that lower barriers to access. IMPLICATIONS FOR PRACTICE User-side characteristics (e.g., lack of awareness of pregnancy) play an important role in the initial steps toward access. Among women with social disadvantage, reducing barriers may require active outreach on the part of providers.
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Affiliation(s)
| | - Paola Origlia
- Bern University of Applied Sciences, Department of Health Professions, Division of Midwifery, Murtenstrasse 10, 3008 Bern, Switzerland.
| | - Eva Cignacco
- Bern University of Applied Sciences, Department of Health Professions, Division of Midwifery, Murtenstrasse 10, 3008 Bern, Switzerland.
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Fang Q, Lin L, Chen Q, Yuan Y, Wang S, Zhang Y, Liu T, Cheng H, Tian L. Effect of peer support intervention on perinatal depression: A meta-analysis. Gen Hosp Psychiatry 2022; 74:78-87. [PMID: 34942447 DOI: 10.1016/j.genhosppsych.2021.12.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Accepted: 12/06/2021] [Indexed: 01/20/2023]
Abstract
BACKGROUND To assess the effect of peer support on preventing or treating perinatal depression. METHODS Eight databases (Wanfang, VIP, CNKI, CBM, Pubmed, Embase, PsycINFO, and Cochrane) were systematically searched for eligible randomized controlled trials from inception to July 2021. Two reviewers critically and independently assessed the risk of bias using Cochrane Collaboration criteria and extracted correlated data using the designed extraction form. RESULTS A total of 16 studies (including 3154 participants, peer support group: 1568, control group: 1586) were included in this meta-analysis. The intervention group (peer support) had significantly better effect on preventing or treating perinatal depression than the control group [SMD = -0.39, 95% CI (-0.54, -0.24), P < 0.00001, I2 = 78%]. The results of subgroup analyses showed that peer support interventions provided in the perinatal period [SMD = -0.51, 95% CI (-0.93, -0.09), P = 0.02] or only in the postpartum period could improve the depression of mothers [SMD = -0.44, 95% CI (-0.62, -0.26), P < 0.00001]. Face-to-face interventions [SMD = -0.28, 95% CI (-0.40, -0.15), P < 0.0001] and telephone/internet-based interventions [SMD = -0.73, 95% CI (-0.95, -0.50), P < 0.00001] were both effective for perinatal depression. As for form of intervention, the combination of individual and group sessions had the best effect on improving perinatal depression [SMD = -0.63, 95% CI (-1.04, -0.23), P = 0.002]. Peer support with the frequency of at least once a week had a significant effect on perinatal depression [SMD = -0.88, 95% CI (-1.32, -0.44), P < 0.0001]. Interventions with a length of ≤3 months [SMD = -2.20, 95% CI (-3.35, -1.04), P = 0.0002] worked better than those lasting for 3-36 months [SMD = -1.64, 95% CI (-2.38, -0.90), P < 0.0001] in perinatal depression management. Peer support could improve perinatal depression both in low- and middle-income countries [SMD = -0.70, 95% CI (-0.95, -0.45), P < 0.00001] and high-income countries [SMD = -0.15, 95% CI (-0.28, -0.02), P = 0.03]. CONCLUSIONS Providing peer support during the perinatal period or only postpartum period, using Internet or telephone approaches, a combination of group and individual, at least once a week can be regarded as an effective measure to manage perinatal depression.
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Ji C, Zhang G, Xu S, Xiang Q, Huang M, Zhao M, Bai X. Antibiotic treatments to mothers during the perinatal period leaving hidden trouble on infants. Eur J Pediatr 2022; 181:3459-71. [PMID: 35680662 DOI: 10.1007/s00431-022-04516-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Accepted: 05/31/2022] [Indexed: 12/04/2022]
Abstract
UNLABELLED Antibiotic application during the perinatal period is unavoidable in the clinic, but the potential effects on mothers and infants remain unknown. Herein, 25 breast milk samples from mothers who received cefuroxime (CXM) or CXM + cefoxitin (CFX) treatments and fecal samples from their infants were collected to investigate the undesirable effects of antibiotics on the microbiota of mothers and neonates. Furthermore, five fecal samples of infants, whose mothers had antibiotic treatments, were collected at a 6-month postpartum follow-up visit to evaluate the long-term effects on infants' gut microbiota. Moreover, the relative abundance of antibiotic resistance genes (ARGs) in fecal samples was compared to investigate the transfer of ARGs in the infant gut microbiota. The results indicated that the antibiotic treatments had no influence on the microbiota of breast milk. The dominant bacterial phyla in the fecal samples changed to Firmicutes and Proteobacteria after antibiotic treatments, while the bacterial community showed a recuperative trend at the follow-up visits. In addition, the abundance of ARGs in the infant gut microbiota demonstrated a declining trend in the CXM- and CXM + CFX-treated groups, while ARG abundance presented a significant increasing trend after a 6-month recovery period. CONCLUSION Antibiotic treatments for mothers during the perinatal period disturb the gut microbiota in neonates. The infants' gut microbiota would partly return to their initial state after rehabilitation, but the transfer of ARGs would leave the hidden trouble of antibiotic resistance. Overall, the data presented here can help to guide the scientific use of antibiotics during the perinatal period and provide potential approaches to mitigate the negative consequences. WHAT IS KNOWN • Antibiotic application during the perinatal period is unavoidable in the clinic. • Misuse of antibiotics can cause various unintended consequences, especially for antibiotic resistance. WHAT IS NEW • Antibiotic treatments had no influence on the microbiota of breast milk but greatly disturbed the gut microbiota composition in infants. • The gut microbiota in infants would partly return to its initial state after rehabilitation but the transfer of ARGs would leave the hidden trouble of antibiotic resistance.
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Harauma A, Nakamura S, Wakinaka N, Mogi K, Moriguchi T. Influence of ω3 fatty acids on maternal behavior and brain oxytocin in the murine perinatal period. Prostaglandins Leukot Essent Fatty Acids 2022; 176:102386. [PMID: 34896909 DOI: 10.1016/j.plefa.2021.102386] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [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: 09/08/2021] [Revised: 11/24/2021] [Accepted: 12/01/2021] [Indexed: 11/26/2022]
Abstract
INTRODUCTION Perinatal women often experience mood disorders and postpartum depression due to the physical load and the rapid changes in hormone levels caused by pregnancy, childbirth, and nursing. When the mother's emotions become unstable, their parental behavior (maternal behavior) may decline, the child's attachment may weaken, and the formation of mother-child bonding can become hindered. As a result, the growth of the child may be adversely affected. The objective of this study was to investigate the effect of ω3 fatty acid deficiency in the perinatal period on maternal behavior and the oxytocin concentration and fatty acid composition in brain tissue. MATERIALS AND METHODS Virgin female C57BL/6 J mice fed a ω3 fatty acid-deficient (ω3-Def) or adequate (ω3-Adq) diet were mated for use in this study. To assess maternal behavior, nest shape was evaluated at a fixed time from gestational day (GD) 15 to postpartum day (PD) 13, and a retrieval test was conducted on PD 3. For neurochemical measurement, brains were removed from PD 1-6 dams and hippocampal fatty acids and hypothalamic oxytocin concentrations were assessed. RESULTS Peripartum nest shape scores were similar to those reported previously (Harauma et al., 2016); nests in the ω3-Def group were small and of poor quality whereas those in the ω3-Adq group were large and elaborate. The inferiority of nest shape in the ω3-Def group continued from PD 0-7. In the retrieval test performed on PD 3, dams in the ω3-Def group took longer on several parameters compared with those in the ω3-Adq group, including time to make contact with pups (sniffing time), time to start retrieving the next pup (interval time), and time to retrieve the last pup to the nest (grouping time). Hypothalamic oxytocin concentrations on PD 1-6 were lower in the ω3-Def group than in the ω3-Adq group. DISCUSSION Our data show that ω3 fatty acid deficiency reduces maternal behavior, a state that continued during pup rearing. This was supported by the observed decrease in hypothalamic oxytocin concentration in the ω3-Def group. These results suggest that ω3 fatty acid supplementation during the perinatal period is not only effective in delivering ω3 fatty acids to infants but is also necessary to activate high-quality parental behavior in mothers.
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Affiliation(s)
- Akiko Harauma
- Laboratory for Functional Lipid Science, School of Life and Environmental Science, Azabu University, 1-17-71 Fuchinobe, Sagamihara, Kanagawa 252-5201, Japan
| | - Shunichi Nakamura
- Laboratory of Food and Nutritional Science, Department of Food and Life Science, School of Life and Environmental Science, Azabu University, 1-17-71 Fuchinobe, Sagamihara, Kanagawa 252-5201, Japan
| | - Natsuko Wakinaka
- Laboratory of Food and Nutritional Science, Department of Food and Life Science, School of Life and Environmental Science, Azabu University, 1-17-71 Fuchinobe, Sagamihara, Kanagawa 252-5201, Japan
| | - Kazutaka Mogi
- Laboratory of Companion Animal Research, Department of Animal Science and Biotechnology, Azabu University, 1-17-71 Fuchinobe, Sagamihara, Kanagawa 252-5201, Japan
| | - Toru Moriguchi
- Laboratory for Functional Lipid Science, School of Life and Environmental Science, Azabu University, 1-17-71 Fuchinobe, Sagamihara, Kanagawa 252-5201, Japan; Laboratory of Food and Nutritional Science, Department of Food and Life Science, School of Life and Environmental Science, Azabu University, 1-17-71 Fuchinobe, Sagamihara, Kanagawa 252-5201, Japan.
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Abstract
Postpartum psychosis is the most severe psychiatric disorder associated with childbirth. The risk is particularly high for women with a history of bipolar disorder or schizoaffective disorder, or those who have suffered a previous episode of postpartum psychosis. However, the aetiology of the illness remains unclear. Pregnancy and the early postpartum are times of significant immunological change. Furthermore, alterations to the immune system have been implicated in the onset and course of various psychopathologies, both related and unrelated to childbirth. Emerging evidence, from studies on immune related disorders, immune cells and inflammatory markers, suggests that the immune system might also be involved in the pathophysiology of postpartum psychosis. Furthermore, recent research has also begun to explore the potential mechanisms underlying immune dysfunction in postpartum psychosis (e.g., disturbances in the Treg-CCN3 protein-(re)myelination axis). Nevertheless, more research is required to understand whether immune dysfunction is a cause or consequence of postpartum psychosis and to clarify the exact mechanisms involved. The aim of this short review is to present the current findings on immune system dysregulation in postpartum psychosis, discuss possible mechanisms underlying the association, highlight potential challenges and confounders and provide suggestions for future research.
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Affiliation(s)
- Katie Hazelgrove
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
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Vanstone RN, Fergus K, Ladhani NNN, Warner E. Reproductive concerns and fear of cancer recurrence: a qualitative study of women's experiences of the perinatal period after cancer. BMC Pregnancy Childbirth 2021; 21:738. [PMID: 34717568 DOI: 10.1186/s12884-021-04208-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2021] [Accepted: 09/27/2021] [Indexed: 11/23/2022] Open
Abstract
Background Young female cancer survivors are at a disproportionate risk of suffering significant psychological distress following treatment, particularly fears of cancer recurrence (FCR). While previous research has established the robust relationship between FCR and family matters (e.g., family planning and motherhood), there is a paucity of information about how a history of cancer affects women’s psychological functioning throughout the perinatal period. The present investigation sought to better understand women’s experiences of pregnancy and the postpartum period following cancer treatment through a qualitative analysis. Methods Ten women participated in a semi-structured, one-on-one interview either over telephone or video conferencing (Zoom). Women were recruited from Sunnybrook Health Sciences Centre in Toronto, as well as through online cancer support platforms, and social media sites. Participants all had a past cancer diagnosis; no active disease; were 45-years of age or younger; currently in the perinatal period; and spoke English fluently. The study employed a grounded theory analysis by which verbatim interview data were analysed using a constant comparison method until data saturation was reached. Results The qualitative analysis yielded I’m So Happy, But Also Terrified, as the core category, indicative of the duality of emotional experience that characterized the perinatal period for these women. Additionally, four higher-order categories emerged revealing how women go through a process of grief related to potential fertility loss; conditional joy during and after pregnancy due to the lingering weight of cancer; frustration with a lack of resources regarding perinatal health after cancer; and hope as they enter into motherhood. Conclusion These results suggest that women in the perinatal period with a history of cancer may be at an increased risk for psychological distress and require additional fertility and reproductive resources both during and after cancer treatment. This research is an important step in further understanding women’s experiences of pregnancy after cancer and may help to inform future research and healthcare practices, in addition to improving perinatal care after cancer. Supplementary Information The online version contains supplementary material available at 10.1186/s12884-021-04208-3.
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Agako A, Donegan E, McCabe RE, Frey BN, Streiner D, Green S. The role of emotion dysregulation in cognitive behavioural group therapy for perinatal anxiety: Results from a randomized controlled trial and routine clinical care. J Affect Disord 2021; 292:517-525. [PMID: 34147963 DOI: 10.1016/j.jad.2021.05.084] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [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: 09/30/2020] [Revised: 04/11/2021] [Accepted: 05/30/2021] [Indexed: 10/21/2022]
Abstract
BACKGROUND Emotion dysregulation (ED) has been implicated in anxiety disorders and may play an important role in Cognitive Behavioural Therapy (CBT) treatment for perinatal anxiety outcomes although there is a dearth of research in this area. The current study investigated the role of ED in perinatal anxiety treatment outcome to determine whether it impacts CBT treatment outcomes and whether CBT reduces ED. METHODS Secondary analyses were run on a sample of N = 75 women participating in a CBT for perinatal anxiety randomized controlled trial (RCT), and N = 47 women who received the treatment as part of routine clinical care. Participants completed measures of anxiety, depression and ED at baseline, post-CBT/post-waitlist and 3-month follow-up (CBT-RCT group only). MANOVAs were conducted to determine if level of ED moderates treatment outcomes and whether CBT reduces ED. Reliable and clinically meaningful change was calculated. RESULTS Baseline level of ED did not moderate treatment outcomes. There were significant changes in some ED subscales over time in the CBT group compared to waitlist. Changes were reliable and clinically meaningful in 28.6% (RCT) and 16% (routine clinical care) of participants. Participants with high ED at baseline remained in the high range at post-treatment. LIMITATIONS Limitations include low sample size; homogeneity of sample, use of measures not validated in perinatal populations. CONCLUSIONS These findings suggest that ED during the perinatal period may be a stand-alone factor that will need to be separately addressed in psychological treatment.
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Affiliation(s)
- Arela Agako
- Department of Psychology, Neuroscience and Behaviour, McMaster University, Hamilton, ON, Canada; Women's Health Concerns Clinic, St. Joseph's Healthcare Hamilton, ON, Canada.
| | - Eleanor Donegan
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada
| | - Randi E McCabe
- Department of Psychology, Neuroscience and Behaviour, McMaster University, Hamilton, ON, Canada; Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada; Women's Health Concerns Clinic, St. Joseph's Healthcare Hamilton, ON, Canada
| | - Benicio N Frey
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada; Women's Health Concerns Clinic, St. Joseph's Healthcare Hamilton, ON, Canada
| | - David Streiner
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada; Women's Health Concerns Clinic, St. Joseph's Healthcare Hamilton, ON, Canada
| | - Sheryl Green
- Department of Psychology, Neuroscience and Behaviour, McMaster University, Hamilton, ON, Canada; Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada; Women's Health Concerns Clinic, St. Joseph's Healthcare Hamilton, ON, Canada
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Miller-Graff LE, Howell KH, Paulson JL, Jamison LE. I'll catch you when you fall: Social safety nets and housing instability in IPV-exposed pregnant women. J Affect Disord 2021; 291:352-358. [PMID: 34087631 DOI: 10.1016/j.jad.2021.05.023] [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: 04/14/2020] [Revised: 05/10/2021] [Accepted: 05/14/2021] [Indexed: 10/21/2022]
Abstract
BACKGROUND Intimate partner violence (IPV) has significant consequences for women's mental health, and it also compromises women's economic security and livelihood, including housing stability. There is a dearth of research, however, on protective factors in the link between housing instability and psychopathology in IPV-exposed women. METHODS The current study examines the protective role of social support in the association between housing instability and mental health (depression, posttraumatic stress) in a sample of pregnant, IPV-exposed women (N = 137). RESULTS Overall models for both depression and posttraumatic stress were significant (F = 6.42, p<.001; R2=16.3%; F = 15.09, p<.001; R2=31.0%, respectively). Housing instability was significantly associated with higher levels of depressed mood (β=0.20, p<.016), but not posttraumatic stress symptoms. Social support was significantly associated with lower levels of depressed mood (β=-0.17, p<.036) and posttraumatic stress (β=-0.38, p =0.001). The addition of the interaction term (housing instability*social support) resulted in a significant improvement in variance explained from the main effects model for depression (F = 4.90, p<.028, ∆R2=3.0%) and the interaction term was significant (β=-0.60, p=.029). An interaction effect of housing instability and social support on posttraumatic stress was not identified. LIMITATIONS Although the current study is the first to examine protective factors in the relationship between housing instability and psychopathology in IPV-exposed pregnant women, data were cross-sectional and therefore directionality and temporality cannot be inferred. CONCLUSIONS Results suggest that housing instability may play a greater role in women's depressed mood than in their experience of posttraumatic stress symptoms, and the presence of social support may substantially ameliorate the effect of this adversity.
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Affiliation(s)
- Laura E Miller-Graff
- Associate Professor of Psychology and Peace Studies Department of Psychology Kroc Institute for International Peace Studies 390 Corbett Family Hall Notre Dame, IN 46556, USA.
| | - Kathryn H Howell
- Associate Professor, Department of Psychology University of Memphis Psychology Building, Room 356 Memphis, TN 38152, Egypt.
| | - Julia L Paulson
- Doctoral Student, Clinical Psychology University of Notre Dame, 390 Corbett Family Hall Notre Dame, IN 46556, US.
| | - Lacy E Jamison
- Doctoral Student, Clinical Psychology University of Memphis Psychology Building, Room 356 Memphis, TN 38152, Egypt.
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Li B, Liu Z, Liu X, Liu D, Duan M, Gu Y, Liu Q, Ma Q, Wei Y, Wang Y. Efficacy and safety of tenofovir disoproxil fumarate and tenofovir alafenamide fumarate in preventing HBV vertical transmission of high maternal viral load. Hepatol Int 2021; 15:1103-1108. [PMID: 34312798 DOI: 10.1007/s12072-021-10235-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [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: 12/17/2020] [Accepted: 07/08/2021] [Indexed: 11/27/2022]
Abstract
BACKGROUND Hepatitis B virus (HBV) infection is a significant global health problem and > 42-52% of patients are infected during perinatal period. Tenofovir alafenamide fumarate (TAF) and tenofovir disoproxil fumarate (TDF) have been widely recognized as the main compounds used for antiviral treatment of hepatitis B. The present study evaluated the efficacy and safety of TAF in reducing HBV vertical transmission. METHODS A total of 72 pregnant women, who met the inclusion criteria, were randomly divided into the TDF (300 mg/day, n = 36) and TAF (25 mg/day, n = 36) groups. Clinical and laboratory data were analyzed and compared between the two groups. RESULTS No significant differences in alanine aminotransferase, total bilirubin, blood creatinine and blood urea nitrogen levels were noted between the two groups after treatment. The serum HBV DNA viral load and hepatitis B e antigen (HBeAg) levels of the two groups were significantly decreased following treatment, whereas the difference between the two groups was not statistically significant. The levels of urine retinol-binding protein and β2-microglobulin had no significant change after TAF treatment (p > 0.05), but increased significantly after TDF treatment (p < 0.05). All drug concentrations were undetectable in umbilical cord blood (UCB) and breast milk samples of the TAF group, while the drug concentration of UCB and breast milk samples in the TDF group was 2.98 ± 1.44 and 19.16 ± 15.26 ng/ml, respectively. All infants were tested negative for serum hepatitis B surface antigen, HBV DNA, and HBeAg. CONCLUSIONS Both TAF and TDF effectively block the mother-to-child transmission of hepatitis B. TAF was superior to TDF with regard to renal safety and breastfeeding.
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Affiliation(s)
- Baijun Li
- Cadre's Ward, The Sixth People's Hospital of Shenyang, Shenyang, 110006, Liaoning, People's Republic of China
| | - Zhaozhe Liu
- Oncology Department, General Hospital of Northern Theater Command, Shenyang, 110016, Liaoning, People's Republic of China
| | - Xing Liu
- Science and Education Department, The Sixth People's Hospital of Shenyang, Shenyang, 110006, Liaoning, People's Republic of China
| | - Dongchun Liu
- School of Traditional Chinese Materia Medica, Shenyang Pharmaceutical University, Shenyang, 110016, Liaoning, People's Republic of China
| | - Mingyu Duan
- Clinical Chemistry Laboratory, Shenyang Beichuang Laboratory Co. Ltd, Shenyang, 110117, Liaoning, People's Republic of China
| | - Ye Gu
- Gastroenterology Departmentepartment, The Sixth People's Hospital of Shenyang, Shenyang, 110006, Liaoning, People's Republic of China
| | - Qiong Liu
- Cadre's Ward, The Sixth People's Hospital of Shenyang, Shenyang, 110006, Liaoning, People's Republic of China
| | - Qiang Ma
- Cadre's Ward, The Sixth People's Hospital of Shenyang, Shenyang, 110006, Liaoning, People's Republic of China
| | - Yushi Wei
- Liaoning University of Traditional Chinese Medicine, Shenyang, 110034, Liaoning, People's Republic of China
| | - Yan Wang
- Science and Education Department, The Sixth People's Hospital of Shenyang, Shenyang, 110006, Liaoning, People's Republic of China.
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Nard N, Moulier V, Januel D, Guillin O, Rothärmel M. [Electroconvulsive therapy during the perinatal period: Representations of mental health professionals]. Encephale 2021; 47:445-451. [PMID: 34148646 DOI: 10.1016/j.encep.2021.02.020] [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: 10/22/2020] [Accepted: 02/17/2021] [Indexed: 11/25/2022]
Abstract
INTRODUCTION Psychiatric disorders are common in peripartum and are associated with adverse outcomes for mother and fetus. Electroconvulsive therapy (ECT) is one of the most effective and safe options to treat severe mental illness, including during the perinatal period. Nevertheless, it remains underutilized during this period, possibly due to negative representations. Research has been carried out on the representations and attitudes of caregivers towards ECT, but the specificities of these attitudes during peripartum have not been explored. OBJECTIVES We aimed to assess the attitudes towards ECT during the peripartum among psychiatrists, nurses, social workers and psychologists. The primary objective was to compare the score of favorability for ECT during peripartum according to the profession. The secondary objective was to highlight other factors involved in the favorability for ECT in peripartum. METHODS We investigated mental health professionals' attitudes sending by e-mail an anonymous questionnaire in five hospitals in France. The questionnaire was composed of demographic details, one scale about the attitudes towards ECT (the Questionnaire on Attitudes and Knowledge of ECT (QuAKE)) used in several studies; in this questionnaire, a specific part for perinatal period has been added for our study, both using a Likert scale. The completion time for this online questionnaire was approximately 5 to 7minutes. A score of favorability for ECT in general and in peripartum was established for each participant. These scores represented the percentage of positive responses to favorable items and of negative responses to unfavorable items towards ECT. Comparison of the QuAKE answers with a sample of English caregivers in 2001 has been determined with χ2 tests. A Bonferroni correction was applied due to the large number of tests performed. Factors involved in the favorability for ECT have been studied with Pearson correlation, Kruskall-Wallis and Wilcoxon tests. RESULTS Two hundred and twenty one professionals (80 psychiatrists, 78 nurses, 19 social workers and 44 psychologists) were included in the study. Their answers to the QuAKE questionnaire were comparable or more favorable to ECT than the English sample answered in 2001. The perinatal part of questionnaire had a good internal consistency (Cronbach coefficient: 0,91). Participants were less favorable to ECT in perinatal period (favorability score: 44.2) than in general (63.6). They more often responded « uncertain » to the perinatal questionnaire (44,9 % against 18.4 % for the ECT in general; W=19931,5; P<0,001). The favorability for ECT in general and during peripartum were statistically associated with profession (psychiatrists were more favorable), specific training and experience in ECT. Gender, perinatal specialization, age, and the number of years in professional service were not associated with favorability for ECT in general and during peripartum in this study. CONCLUSIONS In this study, we have found that profession, training and experience in ECT are linked to the attitudes towards ECT, including in the perinatal period. It is necessary to inform professionals about the possibility of prescribing ECT in the perinatal period by training them in the specificities of pregnancy.
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Affiliation(s)
- Noémie Nard
- Service Hospitalo-Universitaire, centre hospitalier du Rouvray, 4, rue Paul Eluard, 76300 Sotteville-lès-Rouen, France; Faculté de médecine, université de Normandie, 22, boulevard Gambetta, 76000 Rouen, France
| | - Virginie Moulier
- Service Hospitalo-Universitaire, centre hospitalier du Rouvray, 4, rue Paul Eluard, 76300 Sotteville-lès-Rouen, France; EPS Ville-Evrard, unité de Recherche Clinique, 202, avenue Jean Jaurès, 93330 Neuilly-sur-Marne, France
| | - Dominique Januel
- EPS Ville-Evrard, unité de Recherche Clinique, 202, avenue Jean Jaurès, 93330 Neuilly-sur-Marne, France
| | - Olivier Guillin
- Service Hospitalo-Universitaire, centre hospitalier du Rouvray, 4, rue Paul Eluard, 76300 Sotteville-lès-Rouen, France; Faculté de médecine, université de Normandie, 22, boulevard Gambetta, 76000 Rouen, France; CHU de Rouen, 37, boulevard Gambetta, 76000 Rouen, France
| | - Maud Rothärmel
- Service Hospitalo-Universitaire, centre hospitalier du Rouvray, 4, rue Paul Eluard, 76300 Sotteville-lès-Rouen, France; CHU de Rouen, 37, boulevard Gambetta, 76000 Rouen, France.
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Gu X, Chen J, Li H, Song Z, Chang L, He X, Fan Z. Isomaltooligosaccharide and Bacillus regulate the duration of farrowing and weaning-estrous interval in sows during the perinatal period by changing the gut microbiota of sows. ACTA ACUST UNITED AC 2021; 7:72-83. [PMID: 33997334 PMCID: PMC8110870 DOI: 10.1016/j.aninu.2020.06.010] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [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: 02/07/2020] [Revised: 04/24/2020] [Accepted: 06/17/2020] [Indexed: 02/08/2023]
Abstract
This study investigated the effects of isomaltooligosaccharide (IMO) and Bacillus in perinatal diets on the duration of farrowing and post-weaning estrus, serum reproductive hormone concentrations, and gut microbiota and its metabolites of sows. Multiparous sows (n = 130) were fed diets without IMO (control, CON group), or diets containing only IMO (IMO group), IMO and Bacillus subtilis (IMOS group), IMO and Bacillus licheniformis (IMOL group), and IMO and B. subtilis and B. licheniformis (IMOSL group), respectively. The results indicate that the duration of farrowing and post-weaning estrus was shorter in sows in the IMOS, IMOL, and IMOSL groups, and the weaning-estrous interval was lower in sows in the IMOL greoup. In addition, the lowest fecal score was observed in the IMOL group during d 106 to 112 of gestation. Sows in most of the treatment groups had a higher concentration of serum prolactin and prostaglandin at farrowing, but a lower serum concentration of estradiol, oxytocin, and progesterone on d 18 of lactation than sows in the CON group. The treatment groups had a higher abundance of Candidatus Methanoplasma and Bacillus and a lower abundance of Escherichia-Shigella in their feces at farrowing. Furthermore, the treatment groups had higher concentrations of total short-chain fatty acids (SCFA) in feces at farrowing and a higher concentration of branched fatty acids in feces on d 18 of lactation. Furthermore, the abundance of Bacillus in feces was positively correlated with serum prostaglandin concentrations and fecal total SCFA of sows at farrowing, but was negatively correlated with the duration of farrowing. Overall, dietary IMO and Bacillus supplementation affected the concentration of serum reproductive hormones and the duration of farrowing and post-weaning estrus, and the gut microbiota is a key factor.
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Affiliation(s)
- Xueling Gu
- Engineering Research Center for Feed Safety and Efficient Utilization of Ministry of Education, Institute of Animal Nutrition, Hunan Agricultural University, Hunan, 410128, China.,Hunan Co-Innovation Center of Animal Production Safety, Hunan Agricultural University, Hunan, 410128, China
| | - Jiang Chen
- Engineering Research Center for Feed Safety and Efficient Utilization of Ministry of Education, Institute of Animal Nutrition, Hunan Agricultural University, Hunan, 410128, China.,Hunan Co-Innovation Center of Animal Production Safety, Hunan Agricultural University, Hunan, 410128, China
| | - Hao Li
- Engineering Research Center for Feed Safety and Efficient Utilization of Ministry of Education, Institute of Animal Nutrition, Hunan Agricultural University, Hunan, 410128, China.,Hunan Co-Innovation Center of Animal Production Safety, Hunan Agricultural University, Hunan, 410128, China
| | - Zehe Song
- Engineering Research Center for Feed Safety and Efficient Utilization of Ministry of Education, Institute of Animal Nutrition, Hunan Agricultural University, Hunan, 410128, China.,Hunan Co-Innovation Center of Animal Production Safety, Hunan Agricultural University, Hunan, 410128, China
| | - Ling Chang
- Engineering Research Center for Feed Safety and Efficient Utilization of Ministry of Education, Institute of Animal Nutrition, Hunan Agricultural University, Hunan, 410128, China.,Hunan Co-Innovation Center of Animal Production Safety, Hunan Agricultural University, Hunan, 410128, China
| | - Xi He
- Engineering Research Center for Feed Safety and Efficient Utilization of Ministry of Education, Institute of Animal Nutrition, Hunan Agricultural University, Hunan, 410128, China.,Hunan Co-Innovation Center of Animal Production Safety, Hunan Agricultural University, Hunan, 410128, China
| | - Zhiyong Fan
- Engineering Research Center for Feed Safety and Efficient Utilization of Ministry of Education, Institute of Animal Nutrition, Hunan Agricultural University, Hunan, 410128, China.,Hunan Co-Innovation Center of Animal Production Safety, Hunan Agricultural University, Hunan, 410128, China
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Koukopoulos AE, De Chiara L, Simonetti A, Kotzalidis GD, Janiri D, Manfredi G, Angeletti G, Sani G. The Koukopoulos mixed depression rating scale (KMDRS) and the assessment of mixed symptoms during the perinatal period. J Affect Disord 2021; 281:980-988. [PMID: 33039189 DOI: 10.1016/j.jad.2020.08.080] [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] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/09/2020] [Revised: 07/05/2020] [Accepted: 08/24/2020] [Indexed: 01/30/2023]
Abstract
BACKGROUND Mixed symptoms in depression may underlie bipolar diathesis rather than unipolarity. Uncovering mixed depression (MxD) is crucial for appropriate management, especially in the perinatal period, as it may affect treatment planning and impact future child development. We used a scale specific for identifying MxD and tested its validity in pregnant and postpartum women with depression. METHODS Women developing a major depressive episode (MDE) during their perinatal period extending from pregnancy to one year postpartum from November-2012 through June-2019 were assessed with BPRS-18, EPDS, CGI-S, GAF, HAM-A, HAM-D, Koukopoulos' Mixed Depression Rating Scale (KMDRS), TEMPS, and YMRS. They were classified, based on KMDRS criteria, as with mixed (MxD) or without (nonMxD) mixed symptoms. We conducted ROC analysis and performed factor analysis of the KMDRS. RESULTS Of 45 included, MxD (N = 19) were biased towards diagnosis of bipolar disorder and nonMxD (N = 26) towards major depressive disorder. Other sociodemographic variables did not differ significantly between MxD and nonMxD. MxD scored higher on total YMRS, BPRS, and KMDRS, and on KMDRS-6 Subjective Feelings of Irritability and KMDRS-12 Suicidal Impulsiveness items. The KMDRS correlated in the entire sample, in MxD and nonMxD, with the YMRS and the BPRS, while correlating with the HAM-D in nonMxD only. The KMDRS showed acceptable AUC distribution, with a 68% sensitivity and 58% specificity. Best-fit was three-factor-structure, explaining 54.66% of cumulative variance. LIMITATIONS Small sample and cross-sectional design. CONCLUSIONS The KMDRS is fit for investigating MxD along with the YMRS and the BPRS in perinatal women with a MDE.
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Affiliation(s)
- Alexia E Koukopoulos
- Azienda Ospedaliera Universitaria Policlinico Umberto I, Viale dell'Università 30, Rome 00185, Italy; Centro Lucio Bini, Via Crescenzio 42, Rome 00193, Italy.
| | - Lavinia De Chiara
- Centro Lucio Bini, Via Crescenzio 42, Rome 00193, Italy; Department of Neurosciences, Mental Health, and Sensory Organs (NESMOS), Sapienza University, Via di Grottarossa 1035-1039, Rome 00189, Italy; Center for Prevention and Treatment of Women's Mental Health at Sant'Andrea Hospital of Rome, Sapienza University, Via di Grottarossa 1035-1039, Rome 00189, Italy
| | - Alessio Simonetti
- Centro Lucio Bini, Via Crescenzio 42, Rome 00193, Italy; Department of Neurosciences, Mental Health, and Sensory Organs (NESMOS), Sapienza University, Via di Grottarossa 1035-1039, Rome 00189, Italy; Department of Human Neurosciences, Sapienza University, Viale dell'Università 30, Rome 00185, Italy; Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, United States
| | - Georgios D Kotzalidis
- Centro Lucio Bini, Via Crescenzio 42, Rome 00193, Italy; Department of Neurosciences, Mental Health, and Sensory Organs (NESMOS), Sapienza University, Via di Grottarossa 1035-1039, Rome 00189, Italy; Center for Prevention and Treatment of Women's Mental Health at Sant'Andrea Hospital of Rome, Sapienza University, Via di Grottarossa 1035-1039, Rome 00189, Italy
| | - Delfina Janiri
- Centro Lucio Bini, Via Crescenzio 42, Rome 00193, Italy; Department of Human Neurosciences, Sapienza University, Viale dell'Università 30, Rome 00185, Italy
| | - Giovanni Manfredi
- Centro Lucio Bini, Via Crescenzio 42, Rome 00193, Italy; Center for Prevention and Treatment of Women's Mental Health at Sant'Andrea Hospital of Rome, Sapienza University, Via di Grottarossa 1035-1039, Rome 00189, Italy; UOC Psichiatria, Day Hospital, Azienda Ospedaliera-Universitaria Sant'Andrea, Via di Grottarossa 1035-1039, Rome 00189, Italy
| | - Gloria Angeletti
- Centro Lucio Bini, Via Crescenzio 42, Rome 00193, Italy; Department of Neurosciences, Mental Health, and Sensory Organs (NESMOS), Sapienza University, Via di Grottarossa 1035-1039, Rome 00189, Italy; Center for Prevention and Treatment of Women's Mental Health at Sant'Andrea Hospital of Rome, Sapienza University, Via di Grottarossa 1035-1039, Rome 00189, Italy
| | - Gabriele Sani
- Departmentof Neuroscience, Section of Psychiatry, Università Cattolica del Sacro Cuore, Largo F. Vito 1, Rome 00168, Italy; Fondazione Policlinico Universitario "Agostino Gemelli" IRCCS, Rome, Italy
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Conde A, Costa R, Figueiredo B. Anxiety and depressive symptoms effects on cortisol trajectories from pregnancy to postpartum: Differences and similarities between women and men. Horm Behav 2021; 128:104917. [PMID: 33387466 DOI: 10.1016/j.yhbeh.2020.104917] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [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: 01/13/2020] [Revised: 12/11/2020] [Accepted: 12/19/2020] [Indexed: 01/19/2023]
Abstract
Anxiety and depressive symptoms may influence cortisol trajectories in women and men during pregnancy and the postpartum period. Using a multilevel approach, anxiety and depressive symptoms effects on 24-hour urinary free cortisol trajectories from the 2nd trimester to 3-months postpartum were examined in a sample of 66 women and 65 men with no known psychosocial or medical risk (N = 131; 33 (50%) of them were couples that participated in the same assessment waves). Results showed that both anxiety and depressive symptoms influence women's and men's cortisol trajectories from mid-pregnancy to 3-months postpartum. Women with high depressive symptoms and men with high anxiety or high depressive symptoms exhibited less accentuated variations in the 24-hour urinary free cortisol trajectories compared with women with low depressive symptoms and men with low anxiety or depressive symptoms, respectively. These effects were significant for women's cortisol trajectories from the 2nd to the 3rd pregnancy trimester and for men's cortisol trajectories throughout the entire period. The effect of anxiety and depressive symptoms on HPA axis functioning and cortisol production during pregnancy and postpartum, seems to be sex-specific. Reproductive-related alterations (associated with gestation, parturition and lactation) in women's HPA axis functioning may explain these sex-specific effects.
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Affiliation(s)
- Ana Conde
- INPP - Portucalense Institute for Human Development, Portucalense University, Porto, Portugal; Psychology Research Center, School of Psychology, University of Minho, Braga, Portugal.
| | - Raquel Costa
- Universidade Europeia, Lisboa, Portugal; EPIUnit, ISPUP - Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal
| | - Bárbara Figueiredo
- Psychology Research Center, School of Psychology, University of Minho, Braga, Portugal
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Abstract
Research shows that a woman's brain and body undergo drastic changes to support her transition to parenthood during the perinatal period. The presence of this plasticity suggests that mothers' brains may be changed by their experiences. Exposure to severe stress may disrupt adaptive changes in the maternal brain and further impact the neural circuits of stress regulation and maternal motivation. Emerging literature of human mothers provides evidence that stressful experience, whether from the past or present environment, is associated with altered responses to infant cues in brain circuits that support maternal motivation, emotion regulation, and empathy. Interventions that reduce stress levels in mothers may reverse the negative impact of stress exposure on the maternal brain. Finally, outstanding questions regarding the timing, chronicity, types, and severity of stress exposure, as well as study design to identify the causal impact of stress, and the role of race/ethnicity are discussed.
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Affiliation(s)
- Pilyoung Kim
- Department of Psychology, University of Denver, Denver, CO, United States.
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Abstract
Diffuse interstitial lung disease of infancy (chILD) shows a spectrum of disease substantially different from that of adults. Established classification systems divide chILD into conditions that are more prevalent in infancy and conditions that occur at any age. The classification is based on a multidisciplinary approach including clinical, radiological, genetic, and histological findings. Lung biopsies become necessary if other diagnostic investigations have not identified a precise chILD or if severe or refractory respiratory distress of unknown cause is present. As the majority of pediatric lung biopsies will be received first by pathologists outside of specialist centers this review summarizes relevant clinical and histological findings of chILD.
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Chen LC, Chen MH, Hsu JW, Huang KL, Bai YM, Chen TJ, Wang PW, Pan TL, Su TP. Association of parental depression with offspring attention deficit hyperactivity disorder and autism spectrum disorder: A nationwide birth cohort study. J Affect Disord 2020; 277:109-114. [PMID: 32805586 DOI: 10.1016/j.jad.2020.07.059] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [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: 01/02/2020] [Revised: 05/14/2020] [Accepted: 07/05/2020] [Indexed: 02/06/2023]
Abstract
BACKGROUND Studies have indicated that parental depression was slightly related to the increased risk of offspring attention deficit hyperactivity disorder (ADHD) and autism spectrum disorder (ASD). However, the association between exposure to parental depression at different neurodevelopmental stages (i.e., perinatal or postnatal period) and subsequent ADHD and ASD development remained uncertain. METHOD 708,515 children born between 2001 and 2008 were screened for ADHD and ASD based on ICD-9-CM codes of 314 and 299 given by psychiatrists from their birth to the end of 2011. Paternal and maternal depression was separately assessed during five periods, namely those before pregnancy (pre-pregnancy), during pregnancy (perinatal), and <1, 1-3, and >3 years after childbirth (postnatal). Cox regression analyses were performed. RESULTS Both paternal and maternal depression occurring in the pre-pregnancy, perinatal and postnatal periods were significantly associated with subsequent ADHD and ASD in the offspring, with hazard ratios between 1.42 (95% confidence interval [CI]: 1.35-1.49) and 2.25 (2.09-2.41). The chronicity and additive effect of paternal and maternal depression were related to increased risks of offspring ADHD and ASD. The effects of maternal depression were stronger than the effects of paternal depression for offspring ADHD (HR: 1.35, 95% CI: 1.27-1.45) and ASD (HR: 1.23, 95% CI: 1.05-1.46) risks. CONCLUSION Both paternal depression and maternal depression in the pre-pregnancy, perinatal and postnatal periods increases offspring ADHD and ASD risks, and these risks increase further with increases in the duration of parental depression and with the additive effect of parental and maternal depression.
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Affiliation(s)
- Li-Chi Chen
- Department of Psychiatry, Taipei Veterans General Hospital, No. 201, Shih-Pai Road, Sec. 2, 11217 Taipei, Taiwan; Department of Psychiatry, Cheng Hsin General Hospital, Taipei, Taiwan
| | - Mu-Hong Chen
- Department of Psychiatry, Taipei Veterans General Hospital, No. 201, Shih-Pai Road, Sec. 2, 11217 Taipei, Taiwan; Division of Psychiatry, School of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Ju-Wei Hsu
- Department of Psychiatry, Taipei Veterans General Hospital, No. 201, Shih-Pai Road, Sec. 2, 11217 Taipei, Taiwan; Division of Psychiatry, School of Medicine, National Yang-Ming University, Taipei, Taiwan.
| | - Kai-Lin Huang
- Department of Psychiatry, Taipei Veterans General Hospital, No. 201, Shih-Pai Road, Sec. 2, 11217 Taipei, Taiwan; Division of Psychiatry, School of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Ya-Mei Bai
- Department of Psychiatry, Taipei Veterans General Hospital, No. 201, Shih-Pai Road, Sec. 2, 11217 Taipei, Taiwan; Division of Psychiatry, School of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Tzeng-Ji Chen
- Department of Family Medicine, Taipei Veterans General Hospital, Taipei, Taiwan; Institute of Hospital and Health Care Administration, National Yang-Ming University, Taipei, Taiwan
| | - Pei-Wen Wang
- Department of Medical Research, China Medical University Hospital, China Medical University, Taichung, Taiwan
| | - Tai-Long Pan
- School of Traditional Chinese Medicine, Chang Gung University, Taoyuan, Taiwan; Liver Research Center, Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Tung-Ping Su
- Department of Psychiatry, Taipei Veterans General Hospital, No. 201, Shih-Pai Road, Sec. 2, 11217 Taipei, Taiwan; Division of Psychiatry, School of Medicine, National Yang-Ming University, Taipei, Taiwan; Department of Psychiatry, Cheng Hsin General Hospital, Taipei, Taiwan.
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Vacheron MN, Tessier V, Rossignol M, Deneux-Tharaux C; Comité National d’Experts sur la Mortalité Maternelle. [Maternal deaths due to suicide in France 2013-2015]. ACTA ACUST UNITED AC 2021; 49:38-46. [PMID: 33161187 DOI: 10.1016/j.gofs.2020.11.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Pregnancy represents a period of significant psychological vulnerability for women. During the perinatal period, twenty percent of them would present with mental disorders ranging from anxiety to depression. In those with pre-existing mental illness, the risk of acute decompensation is significant. For this reason, the World Health Organization recommends classifying suicides occurring during pregnancy and up to one-year post-partum as maternal deaths. Thus, between 2013 and 2015, 35 maternal suicides occurred in France, representing a maternal mortality ratio of 1:4 per 100,000 live births (95% CI: 1.0-2.0). By constituting 13.4% of all maternal deaths for the period, this group is the one of the 2 leading causes of maternal mortality. A total of 23% occurred in the first 42 days post-partum, and 77% between 43 days and one year after birth. 33.3% of the suicidal mothers had a known psychiatric history and 30.3% had a history of psychiatric care, unknown to obstetrical teams. Non-optimal care was present in 72% of cases with 91 % of suicides were potentially preventable, preventability factors beinga lack of multidisciplinary care and inadequate interaction between the patient and the care system. Strong messages were drawn from the analysis of these cases to optimize care: improve knowledge of the psychiatric history from the time of enrolment in maternity units, improve the identification of warning symptoms and the use of the psychologist and/or psychiatrist, set up a specific care pathway and multidisciplinary collaboration in case of known psychiatric disease.
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Navarrete L, Nieto L, Lara MA. Intimate partner violence and perinatal depression and anxiety: Social support as moderator among Mexican women. Sex Reprod Healthc 2020; 27:100569. [PMID: 33157402 DOI: 10.1016/j.srhc.2020.100569] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [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: 06/04/2020] [Revised: 09/23/2020] [Accepted: 10/10/2020] [Indexed: 11/26/2022]
Abstract
AIMS To assess the frequency of perinatal Intimate Partner Violence (IPV), the association between IPV and depressive and anxiety symptoms, and the role of social support (SS) in the relation between IPV and depressive and anxiety symptoms, controlling for sociodemographic factors. METHOD Women were assessed during pregnancy and at six months postpartum (n = 210). The instruments used were: Stressful Life Events Scale; the Patient Health Questionnaire-9; the Anxiety Subscale of the Symptom Checklist-90 and the Social Support Subscale of the Postpartum Depression Predictors Inventory-Revised. RESULTS The prevalence of IPV was 10.7% in pregnancy and 11% during postpartum. IPV increases the risk of suffering depression in pregnancy (OR = 3.5) and at six months postpartum (OR = 18.3), as well as anxiety (OR = 5.9 and OR = 6.2, respectively). Women with lower educational attainment (OR = 3.8) and income (OR = 3.0) had a higher risk of being victims of IPV during pregnancy. Likewise, lack of SS has a great impact on IPV both during pregnancy (OR = 14.12) and the postpartum period (OR = 5.49). This association decreases the impact and significance of the relationship between perinatal depression and anxiety and IPV. CONCLUSIONS High levels of SS may partially offset the effect of IPV on postpartum depressive s and perinatal anxiety symptoms. it is necessary for IPV victims to have multiple protective factors. Lack of access to education, poverty and women's submissive role in relation to men lead to greater vulnerability, constituting a distinct social disadvantage for women.
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Affiliation(s)
- Laura Navarrete
- Ramón de la Fuente Muñiz National Institute of Psychiatry, Calzada México-Xochimilco 101, San Lorenzo Huipulco, Tlalpan, México, D.F. 14370, Mexico
| | - Lourdes Nieto
- Ramón de la Fuente Muñiz National Institute of Psychiatry, Calzada México-Xochimilco 101, San Lorenzo Huipulco, Tlalpan, México, D.F. 14370, Mexico
| | - Ma Asunción Lara
- Ramón de la Fuente Muñiz National Institute of Psychiatry, Calzada México-Xochimilco 101, San Lorenzo Huipulco, Tlalpan, México, D.F. 14370, Mexico.
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kassaw C, Pandey D. The prevalence of general anxiety disorder and its associated factors among women's attending at the perinatal service of Dilla University referral hospital, Dilla town, Ethiopia, April, 2020 in Covid pandemic. Heliyon 2020; 6:e05593. [PMID: 33294715 PMCID: PMC7701184 DOI: 10.1016/j.heliyon.2020.e05593] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [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: 10/16/2020] [Revised: 11/06/2020] [Accepted: 11/20/2020] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Coronavirus is rapidly increasing in Ethiopia, and the number of perinatal service users at the hospital decreased due to the fear of contracting the virus. The mental health of a pregnant mother is vital for preventing pregnancy and birth-related complications. This study aimed to determine the magnitude and associated factors of General anxiety disorder among perinatal service users in Dilla University referral hospital, Dilla, Ethiopia. METHODS A hospital-based cross-sectional study was conducted among 178 respondents from April 6 - May 6, 2020. The sampling technique of this study was Consecutive sampling. Data were collected using a structured interview. General anxiety disorder (GAD-7) was used to determine the outcome variable. Logistic regression analysis and adjusted odd ratio at 95% CI and p < 0.05 was used to determine the statistically significant association between general anxiety disorder and its predictors. RESULT A total of 178 respondents with a 100% response rate were enrolled in the study. The mean income of respondents was 1500 (±700) Ethiopian birr. The overall prevalence of general anxiety disorder (GAD) was 32.2%. Living in Rural area [AOR = 0.48; 95% CI: (0.25-0.9) P = 0.02∗], Primary level of education [AOR = 0.41; 95%CI:(0.21-0.75), P = 0.03∗], poor social support [AOR = 4.3995%CI:(2.29-12.53), P = 0.001∗∗] and primigravida [AOR = 3.05; 95% CI: (1.53-6.08), P = 0.001∗∗] were variables significantly associated with general anxiety disorder at 95% confidence interval, p < 0.05. CONCLUSIONS This study found that nearly one-third of the respondents had general anxiety disorder. Therefore, working on the mental health impact of the pandemic among perinatal service users is an urgent solution to promote their physical, mental, and psychological health of a mother and her baby.
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Affiliation(s)
- Chalachew kassaw
- Department of Psychiatry, College of Health Science, Dilla University, P.O. Box 419, Dilla, Ethiopia
| | - Digvijay Pandey
- Department of Technical Education, IET, Lucknow 226021, India
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Yount KM, James-Hawkins L, Abdul Rahim HF. The Reproductive Agency Scale (RAS-17): development and validation in a cross-sectional study of pregnant Qatari and non-Qatari Arab Women. BMC Pregnancy Childbirth 2020; 20:503. [PMID: 32873247 PMCID: PMC7466495 DOI: 10.1186/s12884-020-03205-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [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: 12/18/2018] [Accepted: 08/21/2020] [Indexed: 11/30/2022] Open
Abstract
Background Sustainable Development Goal (SDG) 5 prioritizes women’s empowerment and gender equality, alone and as drivers of other SDGs. Efforts to validate universal measures of women’s empowerment have eclipsed efforts to develop refined measures in local contexts and lifecycle stages. Measures of women’s empowerment across the reproductive lifecycle remain limited, including in the Arab Middle East. Methods In this sequential, mixed-methods study, we developed and validated the Reproductive Agency Scale 17 (RAS-17) in 684 women having a normal pregnancy and receiving prenatal care at Hamad Medical Corporation in Doha, Qatar. Participants varied in age (19–46 years), trimester, gravidity (M3.3[SD2.1], range 1–14), and parity (M2.1[SD1.5], range 0–7). Using qualitative research and questionnaire reviews, we developed 44 pregnancy-specific and non-pregnancy-specific agency items. We performed exploratory then confirmatory factor analyses (EFA/CFA) in random split-half samples and multiple-group CFA to assess measurement invariance of the scale across Qatari (n = 260) and non-Qatari Arab (n = 342) women. Results Non-Qatari women agreed more strongly than Qatari women that every woman should have university education, and working outside home benefitted women. Qatari women agreed more strongly than non-Qatari women that a woman should be free to sell her property. Qatari women reported more influence than non-Qatari women in decisions about spending their money (M4.6 versus M4.4), food they can eat (M4.4 versus M4.2), and rest during pregnancy (M4.5 versus M4.2). Qatari and non-Qatari women typically reported going most places with permission if accompanied. A 17-item, three-factor model measuring women’s intrinsic agency or awareness of economic rights (5 items) and instrumental agency in decision-making (5 items) and freedom of movement (7 items) had good fit and was partially invariant across groups. Conclusions The RAS-17 is a contextual, multidimensional measure of women’s reproductive agency validated in pregnant Qatari and non-Qatari Arab women. This scale integrates pregnancy-specific and non-pregnancy-specific items in dimensions of intrinsic agency and instrumental agency relevant to Arab women of reproductive age. The RAS-17 may be useful to screen for low reproductive agency as a predictor of maternal and perinatal outcomes. The RAS-17 should be validated in other samples to assess its full applicability across the reproductive life cycle.
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Affiliation(s)
- Kathryn M Yount
- Hubert Department of Global Health and Department of Sociology, Emory University, 1518 Clifton Rd. NE, Atlanta, GA, 30322, USA.
| | - Laurie James-Hawkins
- Department of Sociology, University of Essex, Wivenhoe Park, Colchester, CO4 3SQ, UK
| | - Hanan F Abdul Rahim
- Department of Public Health, College of Health Sciences, QU Health, Qatar University, P.O.Box 2713, Doha, Qatar
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Caropreso L, Saliba S, Hasegawa L, Lawrence J, Davey CJ, Frey BN. Quality assurance assessment of a specialized perinatal mental health clinic. BMC Pregnancy Childbirth 2020; 20:485. [PMID: 32831041 PMCID: PMC7444031 DOI: 10.1186/s12884-020-03174-6] [Citation(s) in RCA: 8] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2020] [Accepted: 08/12/2020] [Indexed: 11/10/2022] Open
Abstract
Background Mood and anxiety issues are the main mental health complaints of women during pregnancy and the postpartum period. Services targeting such women can reduce perinatal complications related to psychiatric difficulties. This quality assurance project aimed to examine changes in mood and anxiety symptoms in pregnant and postpartum women referred to the Women’s Health Concerns Clinic (WHCC), a specialized outpatient women’s mental health program. Methods We extracted patient characteristics and service utilization from electronic medical records of women referred between 2015 and 2016. We also extracted admission and discharge scores on the Edinburgh Postnatal Depression Scale (EPDS) and the Generalized Anxiety Disorder-7 (GAD-7) scale. Results Most patients accessed the WHCC during pregnancy (54%), had a diagnosis of major depressive disorder (54.9%), were prescribed a change in their medication or dose (61.9%), and accessed psychotherapy for perinatal anxiety (30.1%). There was a significant decrease in EPDS scores between admission and discharge (t(214) = 11.57; p = .000; effect size d = .86), as well as in GAD-7 scores (t(51) = 3.63; p = .001; effect size d = .61). A secondary analysis showed that patients with more severe depression and anxiety symptoms demonstrated even greater effect sizes. Conclusions Changes in EPDS and GAD-7 scores indicate that the WHCC is effective in reducing mood and anxiety symptoms associated with the perinatal period. This project highlights the importance of quality assurance methods in evaluating the effectiveness of clinical services targeting perinatal mental health, in order to inform policy and funding strategies.
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Affiliation(s)
- Luisa Caropreso
- Women's Health Concerns Clinic, St Joseph's Healthcare Hamilton, Hamilton, ON, Canada.,Department of Psychiatry & Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada
| | - Sarah Saliba
- Michael G. DeGroote School of Medicine, McMaster University, Hamilton, Ontario, Canada.,Department of Obstetrics and Gynaecology, University of Toronto, Toronto, Ontario, Canada
| | - Lindsay Hasegawa
- Michael G. DeGroote School of Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Jack Lawrence
- Department of Psychiatry & Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada
| | - Caitlin J Davey
- Department of Psychiatry & Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada.,Mood Disorders Program, St Joseph's Healthcare Hamilton, 100 West 5th St., Suite C124, Hamilton, Ontario, L8N 3K7, Canada
| | - Benicio N Frey
- Women's Health Concerns Clinic, St Joseph's Healthcare Hamilton, Hamilton, ON, Canada. .,Department of Psychiatry & Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada. .,Mood Disorders Program, St Joseph's Healthcare Hamilton, 100 West 5th St., Suite C124, Hamilton, Ontario, L8N 3K7, Canada.
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Li J, Du YJ, Wang HL, Du JY, Qu PF, Zhang R, Guo LQ, Yan H, Dang SN. [Association between maternal passive smoking during perinatal period and congenital heart disease in their offspring-based on a case-control study]. Zhonghua Liu Xing Bing Xue Za Zhi 2020; 41:884-9. [PMID: 32564554 DOI: 10.3760/cma.j.cn112338-20190710-00509] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To explore the association between maternal passive smoking during perinatal period and congenital heart disease (CHD) in their offspring. Methods: A case-control study was designed. Data being used was based on a case-control study of congenital heart disease collected in Shaanxi province from January 2014 to December 2016. Cases under this study were perinatal infants diagnosed as CHD from 28 weeks of gestation to 7 days after birth, and fetus less than 28 weeks of gestation but diagnosed as CHD by ultrasonography. The controls would include newborn infants without any birth defects, born at the same period of the cases. Logistic regression model with confounding factors adjusted was established to analyze the association between maternal passive smoking status during perinatal period and CHD in their offspring. Subgroup analysis was carried out to explore its stability. Results: A total of 2 259 subjects, consisting 695 cases and 1 564 controls were included in this study. Passive smokers accounted for 26.76% in the case group while only 6.01% in the control group. After adjusting for related confounding factors, the risk of CHD in the offspring of passive smokers was 3.32 times higher than that of the non-passive smokers (OR=3.32, 95%CI: 2.41-4.56), during the perinatal period. Results also showed that related risk accumulated with the increase of exposure frequency to passive smoking. For mothers who smoked passively for 1-3 days per week, the risk of CHD in their offspring was 2.75 times higher than that of those non-passive smokers (OR=2.75, 95%CI: 1.62-4.66). For mothers who smoked passively for more than 3 days per week, the risk was 3.62 times higher than the non-passive smokers (OR=3.62, 95%CI: 2.48-5.29). Data from the subgroup analysis showed that the association between maternal passive smoking during perinatal period and CHD in their offspring appeared stable. Conclusions: Maternal passive smoking during perinatal period seemed a risk factor for congenital heart disease related to their offspring. Pregnant women should avoid exposure to second-hand smoke as much as possible, so as to prevent the harm from passive smoking.
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