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Mahaffey BL, Levinson A, Preis H, Lobel M. Elevated risk for obsessive-compulsive symptoms in women pregnant during the COVID-19 pandemic. Arch Womens Ment Health 2022; 25:367-376. [PMID: 34269873 PMCID: PMC8282770 DOI: 10.1007/s00737-021-01157-w] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/24/2021] [Accepted: 06/14/2021] [Indexed: 12/17/2022]
Abstract
The COVID-19 pandemic has led to a public mental health crisis with many people experiencing new or worsening anxiety. Fear of contagion and the lack of predictability/control in daily life increased the risk for problems such as obsessive-compulsive disorder (OCD) in the general population. Pregnant women may be particularly vulnerable to such pandemic-related stressors yet the prevalence of OC symptoms in this population during the pandemic remains unknown. We examined the prevalence of OC symptoms in a sample of 4451 pregnant women in the USA, recruited via targeted online methods at the start of the pandemic. Participants completed self-report measures including the Obsessive-Compulsive Inventory-Revised and the Pandemic-Related Pregnancy Stress Scale. Clinically significant OC symptoms were present in 7.12% of participants, more than twice as high as rates of peripartum OCD reported prior to the pandemic. Younger maternal age, income loss, and suspected SARS-CoV-2 infection were all associated with higher OC symptoms. Two types of pregnancy-specific stress, pandemic-related and pandemic-unrelated, were both associated with higher levels of OC symptoms. Pandemic-related pregnancy stress predicted OC symptoms even after controlling for non-pandemic-related, pregnancy-specific stress. Elevated rates of OC symptoms were observed in women pregnant during the pandemic, particularly those experiencing elevated pandemic-related pregnancy stress. This type of stress confers a distinct risk for OC symptoms above and beyond pregnancy-specific stress and demographic factors. Healthcare providers should be prepared to see and treat more peripartum women with OC symptoms during this and future public health crises.
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Affiliation(s)
- Brittain L. Mahaffey
- Department of Psychiatry and Behavioral Health, Renaissance School of Medicine, Stony Brook University, Putnam Hall, New York, NY 11794 USA
| | - Amanda Levinson
- Department of Psychiatry and Behavioral Health, Renaissance School of Medicine, Stony Brook University, Putnam Hall, New York, NY 11794 USA ,Department of Psychology, Stony Brook University, New York, NY 11794 USA
| | - Heidi Preis
- Department of Psychology, Stony Brook University, New York, NY 11794 USA ,Department of Pediatrics, Renaissance School of Medicine, Stony Brook University, New York, NY 11794 USA
| | - Marci Lobel
- Department of Psychology, Stony Brook University, New York, NY 11794 USA
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Caparros-Gonzalez RA, Romero-Gonzalez B, Puertas-Gonzalez JA, Quirós-Fernández S, Coca-Guzmán B, Peralta-Ramirez MI. [Midwives and psychologists as profesionals to screen and prevent pregnancy-specific stress.]. Rev Esp Salud Publica 2021; 95:e202104060. [PMID: 33896933] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2020] [Accepted: 02/21/2021] [Indexed: 06/12/2023] Open
Abstract
Events that occur during fetal and perinatal life can have consequences on the health and disease of the offspring. The pioneering work on the "Fetal Programming Hypothesis" focused on pregnant women exposed to a great famine that occurred in the Netherlands at the end of World War II. The intrauterine environment of the babies during that famine caused them to low birthweight and determined the appearance of cardiovascular diseases in themselves when they reached adulthood, a risk that was transmitted even to the following generation. In addition to the general stress that a pregnant woman may suffer as a result of the death of a family member, suffering a war or natural disaster such as the SARS-CoV-2 coronavirus, there is another specific type of stress that refers exclusively to the pregnancy process; this is the pregnancy specific-stress. Pregnancy-specific stress is capable of sensitively predicting negative maternal and neonatal outcomes. This type of stress refers to the specific stress of pregnant women related to medical problems, the health of the newborn, the changes that the pregnancy will produce in their social relationships, prematurity, physical changes of pregnancy and fear of labor and birth. The objective of this article was to offer an updated information on pregnancy-specific stress and its consequences for maternal and neonatal health. Thus, we also proposed to offer strategies that midwives and psychologists can use to reduce pregnancy-specific stress levels. In conclusion, midwives and psychologists can work together to reduce pregnancy-specific stress levels.
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Affiliation(s)
- Rafael A Caparros-Gonzalez
- Facultad de Ciencias de la Salud. Departamento de Enfermería. Universidad de Granada. Granada. España
- Centro de Investigación Mente, Cerebro y Comportamiento (CIMCYC). Universidad de Granada. Granada. España
| | - Borja Romero-Gonzalez
- Departamento de Psicología. Facultad de Educación. Campus Duques de Soria, Universidad de Valladolid. Soria. España
| | - José A Puertas-Gonzalez
- Centro de Investigación Mente, Cerebro y Comportamiento (CIMCYC). Universidad de Granada. Granada. España
- Departamento de Personalidad, Evaluación y Tratamiento Psicológico. Facultad de Psicología. Universidad de Granada. Granada. España
| | - Sara Quirós-Fernández
- Servicio de Obstetricia y Ginecología. Área de Paritorio. Hospital de Antequera. Málaga. España
| | - Bárbara Coca-Guzmán
- Servicio de Obstetricia y Ginecología. Hospital Clínico de Granada. Granada. España
| | - María Isabel Peralta-Ramirez
- Centro de Investigación Mente, Cerebro y Comportamiento (CIMCYC). Universidad de Granada. Granada. España
- Departamento de Personalidad, Evaluación y Tratamiento Psicológico. Facultad de Psicología. Universidad de Granada. Granada. España
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Boekhorst MGBM, Muskens L, Hulsbosch LP, Van Deun K, Bergink V, Pop VJM, van den Heuvel MI. The COVID-19 outbreak increases maternal stress during pregnancy, but not the risk for postpartum depression. Arch Womens Ment Health 2021; 24:1037-1043. [PMID: 33830373 PMCID: PMC8027291 DOI: 10.1007/s00737-021-01104-9] [Citation(s) in RCA: 32] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/03/2020] [Accepted: 01/14/2021] [Indexed: 12/26/2022]
Abstract
The COVID-19 pandemic affects society and may especially have an impact on mental health of vulnerable groups, such as perinatal women. This prospective cohort study of 669 participating women in the Netherlands compared perinatal symptoms of depression and stress during and before the pandemic. After a pilot in 2018, recruitment started on 7 January 2019. Up until 1 March 2020 (before the pandemic), 401 women completed questionnaires during pregnancy, of whom 250 also completed postpartum assessment. During the pandemic, 268 women filled out at least one questionnaire during pregnancy and 59 postpartum (1 March-14 May 2020). Pregnancy-specific stress increased significantly in women during the pandemic. We found no increase in depressive symptoms during pregnancy nor an increase in incidence of high levels of postpartum depressive symptoms during the pandemic. Clinicians should be aware of the potential for increased stress in pregnant women during the pandemic.
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Affiliation(s)
- Myrthe G B M Boekhorst
- Department of Medical and Clinical Psychology, Tilburg University, Warandelaan 2, 5037 AB, Tilburg, The Netherlands.
- Department of Cognitive Neuropsychology, Tilburg University, Tilburg, The Netherlands.
| | - Lotte Muskens
- Department of Medical and Clinical Psychology, Tilburg University, Warandelaan 2, 5037 AB, Tilburg, The Netherlands
| | - Lianne P Hulsbosch
- Department of Medical and Clinical Psychology, Tilburg University, Warandelaan 2, 5037 AB, Tilburg, The Netherlands
| | - Katrijn Van Deun
- Department of Methodology & Statistics, Tilburg University, Tilburg, The Netherlands
| | - Veerle Bergink
- Departments of Psychiatry and Obstetrics, Icahn School of Medicine At Mount Sinai, New York, NY, USA
| | - Victor J M Pop
- Department of Medical and Clinical Psychology, Tilburg University, Warandelaan 2, 5037 AB, Tilburg, The Netherlands
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Fu W, Wilhelm LO, Wei Y, Zhou G, Schwarzer R. Emotional intelligence and dyadic satisfaction buffer the negative effect of stress on prenatal anxiety and depressive symptoms in Chinese women who are pregnant with twins. Anxiety Stress Coping 2020; 33:466-478. [PMID: 32192362 DOI: 10.1080/10615806.2020.1745193] [Citation(s) in RCA: 12] [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] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Background: Pregnancy-related stress in women who are pregnant with twins, may increase the risk of adverse emotional outcomes such as depressive symptoms and anxiety. Possible protective coping resources of pregnant women could be their socio-economic background, their marital relationship quality (dyadic satisfaction), or their emotional intelligence. Objectives: The study aims at exploring the mechanisms by which protective factors are associated with pregnancy-related stress and adverse emotional outcomes such as depression and anxiety. Methods and Design: Hospitals in Beijing, China, provided questionnaire data from 134 women who were pregnant with twins. Pregnancy-related stress, anxiety, depression, and three resource factors (socio-economic status, emotional intelligence, and dyadic marital satisfaction) were measured. Results: The experience of pregnancy-related stress mediated between resource factors and adverse consequences. While some socio-economic background variables had a main effect, personal and social resources exerted a buffer effect: emotional intelligence as well as dyadic satisfaction buffered the negative effects of stress on prenatal anxiety and depressive symptoms, respectively. Conclusions: A unique mechanism was identified that may explain how protective coping resources are associated with psychosocial stress and adverse outcomes in pregnant at-risk women. Future studies should substantiate this finding using longitudinal research designs.
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Affiliation(s)
- Wenyang Fu
- Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing, People's Republic of China
| | - Lea O Wilhelm
- Department of Education and Psychology, Health Psychology, Freie Universität Berlin, Berlin, Germany
| | - Yuan Wei
- Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing, People's Republic of China
| | - Guangyu Zhou
- School of Psychological and Cognitive Sciences and Beijing Key Laboratory of Behaviour and Mental Health, Peking University, Beijing, People's Republic of China
| | - Ralf Schwarzer
- Department of Education and Psychology, Health Psychology, Freie Universität Berlin, Berlin, Germany.,SWPS University of Social Sciences and Humanities, Wroclaw, Poland
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Dolatian M, Mahmoodi Z, Dilgony T, Shams J, Zaeri F. The Structural Model of Spirituality and Psychological Well-Being for Pregnancy-Specific Stress. J Relig Health 2017; 56:2267-2275. [PMID: 28447176 DOI: 10.1007/s10943-017-0395-z] [Citation(s) in RCA: 5] [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] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Women experience different types of stress in their lifetime. The present study was conducted to examine the structural model of spirituality and psychological well-being for pregnancy-specific stress. The present descriptive correlational study was conducted on 450 pregnant Iranian women (150 women from each trimester) in Dehdasht city in 2015. Data were collected using the personal-social questionnaire, the pregnancy-specific stress questionnaire, the spirituality questionnaire and the psychological well-being questionnaire and were then analyzed in SPSS-16 and Lisrel-8.8 for carrying out a path analysis. The fit indices of the model indicate the good fit and high compatibility of the model and rational relationships between the variables (GFI = 0.94, NFI = 0.85, CFI = 0.94 and RMSEA = 0.048). Of the variables that affected pregnancy-specific stress through both paths, spirituality had a positive effect (B = 0.11) and the personal-social variable a negative effect (B = -0.37). Psychological well-being affected pregnancy-specific stress negatively and directly and through one path only (B = -0.59). The results obtained through the model confirm the effect of spirituality and psychological well-being in reducing pregnancy-specific stress. Given that handling stress has a major role in the quality of daily life in pregnant women, stress management skills are recommended to be promoted among pregnant women so as to mitigate stress and its negative consequences.
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Affiliation(s)
- Mahrokh Dolatian
- Department of Midwifery and Reproductive Health, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Zohreh Mahmoodi
- Department of Midwifery, Faculty of Nursing and Midwifery, Alborz University of Medical Sciences, Karaj, Iran.
| | - Taibeh Dilgony
- Department of Midwifery, International Branch, Shahid Beheshti University of Medical Sciences, Tehran, Iran
- Department of Midwifery and Reproductive Health, Student Research Committee, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Jamal Shams
- Department of Psychiatry, Behavioral Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Farid Zaeri
- Department of Biostatistics, Faculty of Paramedicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Levine TA, Alderdice FA, Grunau RE, McAuliffe FM. Prenatal stress and hemodynamics in pregnancy: a systematic review. Arch Womens Ment Health 2016; 19:721-39. [PMID: 27329120 DOI: 10.1007/s00737-016-0645-1] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [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: 09/27/2015] [Accepted: 06/02/2016] [Indexed: 10/21/2022]
Abstract
Maternal prenatal stress is associated with preterm birth, intrauterine growth restriction, and developmental delay. However, the impact of prenatal stress on hemodynamics during pregnancy remains unclear. This systematic review was conducted in order to assess the quality of the evidence available to date regarding the relationship between prenatal stress and maternal-fetal hemodynamics. The PubMed/Medline, EMBASE, PsycINFO, Maternity and Infant Care, Trip, Cochrane Library, and CINAHL databases were searched using the search terms pregnancy; stress; fetus; blood; Doppler; ultrasound. Studies were eligible for inclusion if prenatal stress was assessed with standardized measures, hemodynamics was measured with Doppler ultrasound, and methods were adequately described. A specifically designed data extraction form was used. The methodological quality of included studies was assessed using well-accepted quality appraisal guidelines. Of 2532 studies reviewed, 12 met the criteria for inclusion. Six reported that prenatal stress significantly affects maternal or fetal hemodynamics; six found no significant association between maternal stress and circulation. Significant relationships between prenatal stress and uterine artery resistance (RI) and pulsatility (PI) indices, umbilical artery RI, PI, and systolic/diastolic ratio, fetal middle cerebral artery PI, cerebroplacental ratio, and umbilical vein volume blood flow were found. To date, there is limited evidence that prenatal stress is associated with changes in circulation. More carefully designed studies with larger sample sizes, repeated assessments across gestation, tighter control for confounding factors, and measures of pregnancy-specific stress will clarify this relationship.
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Affiliation(s)
- Terri A Levine
- School of Nursing and Midwifery, Queen's University Belfast, Belfast, Northern Ireland
| | - Fiona A Alderdice
- School of Nursing and Midwifery, Queen's University Belfast, Belfast, Northern Ireland
| | - Ruth E Grunau
- School of Nursing and Midwifery, Queen's University Belfast, Belfast, Northern Ireland.,Department of Pediatrics, University of British Columbia, Vancouver, British Columbia, Canada.,Child and Family Research Institute, Vancouver, Canada
| | - Fionnuala M McAuliffe
- UCD Obstetrics and Gynaecology, School of Medicine and Medical Science, University College Dublin, National Maternity Hospital, Dublin, Northern Ireland.
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