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Offer S, Taubman-Ben-Ari O. The experience of mothering a preterm: a prolonged crisis with the potential for personal growth. J Reprod Infant Psychol 2024; 42:502-516. [PMID: 35946423 DOI: 10.1080/02646838.2022.2110222] [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: 11/07/2021] [Accepted: 07/29/2022] [Indexed: 10/15/2022]
Abstract
OBJECTIVE AND BACKGROUND The nine months of pregnancy allow mothers to plan for the birth of their child practically and emotionally. A very preterm birth, which is generally unexpected and requires the infant's stay in the Neonatal Intensive Care Unit (NICU), is perceived as a crisis by most mothers. This study sought to investigate the significance for the mother of the combined experience of a very preterm birth and the infant's stay in the NICU two-three years after the birth. METHODS Using qualitative methodology, semi-structured in-depth interviews were conducted with 13 mothers (age 26-44) whose infants were born at 24-32 weeks. The analysis adopted the approach of multi-level listening to the diverse voices of the interviewees. RESULTS Four core themes emerged: negative feelings about the preterm birth; the NICU experience as a crisis; long-term effects of the very preterm birth and NICU experience; personal growth following the preterm birth and NICU. DISCUSSION In view of the findings, we discuss the meaning of the circumstances surrounding preterm birth on motherhood, and offer recommendations for practitioners.
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Affiliation(s)
- Sigalit Offer
- Gender Studies Program, Bar-Ilan University, Ramat Gan, Israel
| | - Orit Taubman-Ben-Ari
- The Louis and Gabi Weisfeld School of Social Work, Bar-Ilan University, Ramat Gan, Israel
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2
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Yehouetome M, Golse B, Beauquier-Maccotta B. [Parenthood put to the test by average prematurity]. Soins Pediatr Pueric 2024; 45:26-31. [PMID: 38697722 DOI: 10.1016/j.spp.2024.03.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/05/2024]
Abstract
Any premature birth can be traumatic, and a risk factor for the parenting process and the quality of parent-baby interactions. Average prematurity is no exception. It can undermine essential parenting functions, such as availability and sensitivity to the child, and generate interactive dysfunctions within parent-baby dyads. In some cases, it can lead to genuine psychopathological states.
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Affiliation(s)
- Marielle Yehouetome
- Centre de PMI, Institut Paris-Brune, 26 boulevard Brune, 75014 Paris, France; Université Paris-Cité, Laboratoire de psychologie clinique, psychopathologie, psychanalyse (PCPP), 71 avenue Édouard-Vaillant, 92100 Boulogne-Billancourt, France; Hôpital de pédiatrie et de rééducation, Longchêne, 78830 Bullion, France.
| | - Bernard Golse
- Université Paris-Cité, Laboratoire de psychologie clinique, psychopathologie, psychanalyse (PCPP), 71 avenue Édouard-Vaillant, 92100 Boulogne-Billancourt, France; Institut contemporain de l'enfance, 30 rue de Bourgogne, 75007 Paris, France
| | - Bérengère Beauquier-Maccotta
- Université Paris-Cité, Laboratoire de psychologie clinique, psychopathologie, psychanalyse (PCPP), 71 avenue Édouard-Vaillant, 92100 Boulogne-Billancourt, France; Unité de pédopsychiatrie périnatale, EPS Ville-Evrard, 202 avenue Jean-Jaurès, 93330 Neuilly-sur-Marne, France
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3
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Fitzallen GC, Kirby JN, Taylor HG, Liley HG, Bora S. Evaluating multidimensional facets of the maternal experience after preterm birth. J Perinatol 2024; 44:635-642. [PMID: 38238445 PMCID: PMC11090785 DOI: 10.1038/s41372-024-01865-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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2022] [Revised: 12/15/2023] [Accepted: 01/02/2024] [Indexed: 05/15/2024]
Abstract
OBJECTIVE Describe self-relating (self-criticism, self-compassion) and parenting competence (satisfaction, self-efficacy) in mothers of children born preterm, and their associations with child characteristics, maternal sociodemographics at childbirth, and maternal concurrent well-being. STUDY DESIGN The sample comprised 1926 biological mothers of 3- to18-year-old children born preterm with self-ratings on the standardized Forms of Self-Criticising/Attacking & Self-Reassuring Scale, Self-Compassion Scale, and Parenting Sense of Competence Scale. RESULTS Mothers of children in early childhood reported significantly (p < 0.05) lower self-compassion than in middle childhood and adolescence. They also reported significantly lower parenting satisfaction than mothers of adolescents and higher self-efficacy than their middle childhood counterparts. Maternal psychosocial well-being was most strongly associated with self-compassion, parenting satisfaction, and self-efficacy after accounting for maternal psychopathology, child gestation, and child age. CONCLUSION Longer-term associations of preterm birth with maternal self-relating and parenting competence emphasize broadening the scope of neonatal follow-up services, extending beyond child neurodevelopmental surveillance and postpartum psychopathology screening.
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Affiliation(s)
- Grace C Fitzallen
- School of Psychological Sciences, College of Health and Medicine, University of Tasmania, Launceston, TAS, Australia
- School of Psychology, Faculty of Health and Behavioural Sciences, The University of Queensland, Brisbane, QLD, Australia
- Mater Research Institute, Faculty of Medicine, The University of Queensland, Brisbane, QLD, Australia
| | - James N Kirby
- School of Psychology, Faculty of Health and Behavioural Sciences, The University of Queensland, Brisbane, QLD, Australia
| | - H Gerry Taylor
- Center for Biobehavioral Health, Abigail Wexner Research Institute at Nationwide Children's Hospital, and Department of Pediatrics, The Ohio State University, Columbus, OH, USA
| | - Helen G Liley
- Mater Research Institute, Faculty of Medicine, The University of Queensland, Brisbane, QLD, Australia
| | - Samudragupta Bora
- Mater Research Institute, Faculty of Medicine, The University of Queensland, Brisbane, QLD, Australia.
- Department of Pediatrics, University Hospitals Rainbow Babies & Children's Hospital, Case Western Reserve University School of Medicine, Cleveland, OH, USA.
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Hacin Beyazoglu K, Paro-Panjan D, Šušteršič B, Kodrič J. The knowledge about long-term consequences of preterm birth among health professionals, educational professionals, and parents in Slovenia. Croat Med J 2024; 65:76-84. [PMID: 38706233] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/07/2024] Open
Abstract
AIM To assess the knowledge about the long-term consequences of preterm birth and the need for training and information among various professionals working with preterm children and parents of preterm children. METHODS In February and March 2018, physicians, psychologists, special education needs teachers, teachers, preschool teachers, and parents (N=488) filled in the Preterm Birth-Knowledge Scale and a survey regarding their perceptions and attitudes toward working with preterm children. RESULTS Physicians and psychologists were most knowledgeable among the groups about the long-term consequences of preterm birth. Teachers, preschool teachers, and parents had significantly lower knowledge (F=23.18, P<0.001). The majority of professionals indicated that they did not feel adequately equipped to support the learning and development of preterm children and that they had not received sufficient training in this area. More than half indicated that they had received no formal training. In general, the participants tended to underestimate the long-term problems of preterm children. CONCLUSION The findings underscore the importance of integrating the issue of the long-term outcomes of preterm birth and working with preterm children into formal education, and in other forms of educational activities.
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Affiliation(s)
| | | | | | - Jana Kodrič
- Jana Kodrič, Child Psychiatry Unit, Division of Paediatrics, University Medical Centre Ljubljana, Bohoričeva 20, 1000 Ljubljana, Slovenia,
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Coughlan S, Quigley J, Nixon E. Parent-infant conversations are differentially associated with the development of preterm- and term-born infants. J Exp Child Psychol 2024; 239:105809. [PMID: 37967481 DOI: 10.1016/j.jecp.2023.105809] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Revised: 10/10/2023] [Accepted: 10/25/2023] [Indexed: 11/17/2023]
Abstract
Preterm birth is a risk factor for language difficulties. To better understand the language development of preterm-born infants, the current study investigated the concurrent associations between parent-infant conversations and the development of 22 preterm-born and 25 term-born infants at 2 years of age. Conversations occurring during mother/father-infant free-play interactions were analyzed to characterize features of parental speech (volubility, speech rate, lexical diversity, and morphosyntactic complexity) and parent-infant exchanges (parent responsiveness, turn-taking, and conversational balance). The infants' language development (receptive communication and expressive communication) and non-language development (cognitive, social-emotional, and executive function) was assessed using standardized measures. Parent-infant conversations were associated with both language and non-language development. This suggests that parent-infant conversations may support language development directly and/or through advancing non-language skills that could promote language learning. The associations between parent-infant conversations and development varied as a function of birth status (preterm or term). This finding may signal the operation of different developmental processes within preterm- and term-born groups. Finally, infant development was differentially associated with mother-infant and father-infant conversations. This may point to the distinct contributions made by mothers and fathers to the development of both preterm- and term-born infants. To optimize language outcomes, these findings indicate that families should be guided to tailor parent-infant conversations to the unique developmental needs and processes of preterm-born infants. Families should also be supported to leverage the distinct developmental contributions of mothers and fathers. Future recommendations are made regarding how to investigate the proposed preterm-term differences in language development processes and the differential developmental contribution of mothers and fathers.
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Affiliation(s)
- Sarah Coughlan
- School of Psychology, Trinity College Dublin, Dublin 2, Ireland.
| | - Jean Quigley
- School of Psychology, Trinity College Dublin, Dublin 2, Ireland
| | - Elizabeth Nixon
- School of Psychology, Trinity College Dublin, Dublin 2, Ireland
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Mackay CA, Gray C, Campbell C, Sharp MJ. Young adult outcomes following premature birth: A Western Australian experience. Early Hum Dev 2024; 188:105920. [PMID: 38128445 DOI: 10.1016/j.earlhumdev.2023.105920] [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: 10/10/2023] [Revised: 12/11/2023] [Accepted: 12/11/2023] [Indexed: 12/23/2023]
Abstract
BACKGROUND Childhood outcomes following preterm birth are widely published, however long-term adult outcomes are less well described. We aimed to determine the quality of life and burden of co-morbidities experienced by preterm-born young adults in Western Australia. METHODS A retrospective observational study was conducted. Participants born at 23-33 weeks gestation cared for at King Edward Memorial Hospital during 1990 and 1991 were recruited from a historical birth cohort. Participants completed general, medical and reproductive health questionnaires. Results were compared with contemporaneous cohort data and/or population statistics. RESULTS Questionnaires were received from 73 young adults aged 28 to 30 years. The majority of respondents completed high school (94.5 %), were employed fulltime (74.0 %) and had close friends and family relationships. Almost all the participants considered their health to be good (94.0 %) and participated in light exercise (90.0 %). Increased hypertension, hypercholesterolaemia, asthma, neuropsychiatric conditions and visual impairment were reported. Depression Anxiety and Stress Scale (DASS-21) scoring identified increased mild anxiety. Increased consultation with healthcare workers and use of prescription medications were reported. CONCLUSION The group of preterm-born adults surveyed reported a good quality of life, supportive interpersonal relationships and they provided significant contributions to society. They did report increased medical and psychological conditions than the general population.
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Affiliation(s)
- Cheryl A Mackay
- Neonatal Directorate, Child and Adolescent Health Service, Perth, Western Australia, Australia; University of Western Australia, Australia.
| | - Caitlin Gray
- Telethon Kids Institute, Perth, Western Australia, Australia
| | - Catherine Campbell
- Neonatal Directorate, Child and Adolescent Health Service, Perth, Western Australia, Australia
| | - Mary J Sharp
- Neonatal Directorate, Child and Adolescent Health Service, Perth, Western Australia, Australia; University of Western Australia, Australia
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Schinz D, Schmitz‐Koep B, Zimmermann J, Brandes E, Tahedl M, Menegaux A, Dukart J, Zimmer C, Wolke D, Daamen M, Boecker H, Bartmann P, Sorg C, Hedderich DM. Indirect evidence for altered dopaminergic neurotransmission in very premature-born adults. Hum Brain Mapp 2023; 44:5125-5138. [PMID: 37608591 PMCID: PMC10502650 DOI: 10.1002/hbm.26451] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2022] [Revised: 06/23/2023] [Accepted: 07/28/2023] [Indexed: 08/24/2023] Open
Abstract
While animal models indicate altered brain dopaminergic neurotransmission after premature birth, corresponding evidence in humans is scarce due to missing molecular imaging studies. To overcome this limitation, we studied dopaminergic neurotransmission changes in human prematurity indirectly by evaluating the spatial co-localization of regional alterations in blood oxygenation fluctuations with the distribution of adult dopaminergic neurotransmission. The study cohort comprised 99 very premature-born (<32 weeks of gestation and/or birth weight below 1500 g) and 107 full-term born young adults, being assessed by resting-state functional MRI (rs-fMRI) and IQ testing. Normative molecular imaging dopamine neurotransmission maps were derived from independent healthy control groups. We computed the co-localization of local (rs-fMRI) activity alterations in premature-born adults with respect to term-born individuals to different measures of dopaminergic neurotransmission. We performed selectivity analyses regarding other neuromodulatory systems and MRI measures. In addition, we tested if the strength of the co-localization is related to perinatal measures and IQ. We found selectively altered co-localization of rs-fMRI activity in the premature-born cohort with dopamine-2/3-receptor availability in premature-born adults. Alterations were specific for the dopaminergic system but not for the used MRI measure. The strength of the co-localization was negatively correlated with IQ. In line with animal studies, our findings support the notion of altered dopaminergic neurotransmission in prematurity which is associated with cognitive performance.
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Affiliation(s)
- David Schinz
- Department of Neuroradiology, School of MedicineTechnical University of MunichMunichGermany
- TUM‐NIC Neuroimaging Center, School of MedicineTechnical University of MunichMunichGermany
| | - Benita Schmitz‐Koep
- Department of Neuroradiology, School of MedicineTechnical University of MunichMunichGermany
- TUM‐NIC Neuroimaging Center, School of MedicineTechnical University of MunichMunichGermany
| | - Juliana Zimmermann
- Department of Neuroradiology, School of MedicineTechnical University of MunichMunichGermany
- TUM‐NIC Neuroimaging Center, School of MedicineTechnical University of MunichMunichGermany
| | - Elin Brandes
- Department of Neuroradiology, School of MedicineTechnical University of MunichMunichGermany
- TUM‐NIC Neuroimaging Center, School of MedicineTechnical University of MunichMunichGermany
| | - Marlene Tahedl
- Department of Neuroradiology, School of MedicineTechnical University of MunichMunichGermany
- TUM‐NIC Neuroimaging Center, School of MedicineTechnical University of MunichMunichGermany
| | - Aurore Menegaux
- Department of Neuroradiology, School of MedicineTechnical University of MunichMunichGermany
- TUM‐NIC Neuroimaging Center, School of MedicineTechnical University of MunichMunichGermany
| | - Juergen Dukart
- Institute of Neuroscience and MedicineBrain & Behaviour (INM‐7), Research Centre JülichJülichGermany
- Institute of Systems Neuroscience, Medical FacultyHeinrich Heine University DüsseldorfDüsseldorfGermany
| | - Claus Zimmer
- Department of Neuroradiology, School of MedicineTechnical University of MunichMunichGermany
- TUM‐NIC Neuroimaging Center, School of MedicineTechnical University of MunichMunichGermany
| | - Dieter Wolke
- Department of PsychologyUniversity of WarwickCoventryUK
- Warwick Medical SchoolUniversity of WarwickCoventryUK
| | - Marcel Daamen
- Clinical Functional Imaging Group, Department of Diagnostic and Interventional RadiologyUniversity Hospital BonnBonnGermany
- Department of NeonatologyUniversity Hospital BonnBonnGermany
| | - Henning Boecker
- Clinical Functional Imaging Group, Department of Diagnostic and Interventional RadiologyUniversity Hospital BonnBonnGermany
| | - Peter Bartmann
- Department of NeonatologyUniversity Hospital BonnBonnGermany
| | - Christian Sorg
- Department of Neuroradiology, School of MedicineTechnical University of MunichMunichGermany
- TUM‐NIC Neuroimaging Center, School of MedicineTechnical University of MunichMunichGermany
- Department of Psychiatry, School of MedicineTechnical University of MunichMunichGermany
| | - Dennis M. Hedderich
- Department of Neuroradiology, School of MedicineTechnical University of MunichMunichGermany
- TUM‐NIC Neuroimaging Center, School of MedicineTechnical University of MunichMunichGermany
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Dawes L, Waugh JJS, Lee A, Groom KM. Psychological well-being of women at high risk of spontaneous preterm birth cared for in a specialised preterm birth clinic: a prospective longitudinal cohort study. BMJ Open 2022; 12:e056999. [PMID: 35232790 PMCID: PMC8889323 DOI: 10.1136/bmjopen-2021-056999] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVES To assess the psychological well-being of pregnant women at increased risk of spontaneous preterm birth, and the impact of care from a preterm birth clinic. DESIGN Single-centre longitudinal cohort study over 1 year, 2018-2019. SETTING Tertiary maternity hospital in Auckland, New Zealand. PARTICIPANTS Pregnant women at increased risk of spontaneous preterm birth receiving care in a preterm birth clinic. INTERVENTION Participants completed three sets of questionnaires (State-Trait Anxiety Inventory, Edinburgh Postnatal Depression Scale, and 36-Item Short Form Survey)-prior to their first, after their second, and after their last clinic appointments. Study-specific questionnaires explored pregnancy-related anxiety and perceptions of care. PRIMARY AND SECONDARY OUTCOME MEASURES The primary outcome was the mean State-Anxiety score. Secondary outcomes included depression and quality of life measures. RESULTS 73/97 (75.3%) eligible women participated; 41.1% had a previous preterm birth, 31.5% a second trimester loss and 28.8% cervical surgery; 20.6% had a prior mental health condition. 63/73 (86.3%) women completed all questionnaires. The adjusted mean state-anxiety score was 39.0 at baseline, which decreased to 36.5 after the second visit (difference -2.5, 95% CI -5.5 to 0.5, p=0.1) and to 32.6 after the last visit (difference -3.9 from second visit, 95% CI -6.4 to -1.5, p=0.002). Rates of anxiety (state-anxiety score >40) and depression (Edinburgh Postnatal Depression Scale score >12) were 38.4%, 34.8%, 19.0% and 13.7%, 8.7%, 9.5% respectively, at the same time periods. Perceptions of care were favourable; 88.9% stated the preterm birth clinic made them significantly or somewhat less anxious and 87.3% wanted to be seen again in a future pregnancy. CONCLUSIONS Women at increased risk of spontaneous preterm birth have high levels of anxiety. Psychological well-being improved during the second trimester; women perceived that preterm birth clinic care reduced pregnancy-related anxiety. These findings support the ongoing use and development of preterm birth clinics.
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Affiliation(s)
- Lisa Dawes
- Liggins Institute, The University of Auckland, Auckland, New Zealand
- National Women's Health, Auckland City Hospital, Auckland, New Zealand
| | - Jason J S Waugh
- National Women's Health, Auckland City Hospital, Auckland, New Zealand
- Department of Obstetrics and Gynaecology, The University of Auckland, Auckland, New Zealand
| | - Arier Lee
- Section of Epidemiology and Biostatistics, The University of Auckland, Auckland, New Zealand
| | - Katie M Groom
- Liggins Institute, The University of Auckland, Auckland, New Zealand
- National Women's Health, Auckland City Hospital, Auckland, New Zealand
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Eick SM, Goin DE, Cushing L, DeMicco E, Smith S, Park JS, Padula AM, Woodruff TJ, Morello-Frosch R. Joint effects of prenatal exposure to per- and poly-fluoroalkyl substances and psychosocial stressors on corticotropin-releasing hormone during pregnancy. J Expo Sci Environ Epidemiol 2022; 32:27-36. [PMID: 33824413 PMCID: PMC8492777 DOI: 10.1038/s41370-021-00322-8] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/03/2020] [Revised: 02/26/2021] [Accepted: 03/18/2021] [Indexed: 05/05/2023]
Abstract
BACKGROUND Prenatal exposure to per- and poly-fluoroalkyl substances (PFAS) and psychosocial stressors has been associated with adverse pregnancy outcomes, including preterm birth. Previous studies have suggested that joint exposure to environmental chemical and social stressors may be contributing to disparities observed in preterm birth. Elevated corticotropin-releasing hormone (CRH) during mid-gestation may represent one biologic mechanism linking chemical and nonchemical stress exposures to preterm birth. METHODS Using data from a prospective birth cohort (N = 497), we examined the cross-sectional associations between five individual PFAS (ng/mL; PFNA, PFOA, PFOS, PFHxS, and Me-PFOSA-AcOH) and CRH (pg/mL) using linear regression. PFAS and CRH were measured during the second trimester in serum and plasma, respectively. Coefficients were standardized to reflect change in CRH associated with an interquartile range (IQR) increase in natural log-transformed PFAS. We additionally examined if the relationship between PFAS and CRH was modified by psychosocial stress using stratified models. Self-reported depression, stressful life events, perceived stress, food insecurity, and financial strain were assessed using validated questionnaires during the second trimester and included as binary indicators of psychosocial stress. RESULTS An IQR increase in PFNA was associated with elevated CRH (β = 5.17, 95% confidence interval [CI] = 1.79, 8.55). Increased concentrations of PFOA were also moderately associated with CRH (β = 3.62, 95% CI = -0.42, 7.66). The relationship between PFNA and CRH was stronger among women who experienced stressful life events, depression, food insecurity, and financial strain compared to women who did not experience these stressors. CONCLUSIONS This cross-sectional study is the first to examine the relationship between PFAS exposure and CRH levels in mid-gestation. We found that these associations were stronger among women who experienced stress, which aligns with previous findings that chemical and nonchemical stressor exposures can have joint effects on health outcomes.
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Affiliation(s)
- Stephanie M Eick
- Program on Reproductive Health and the Environment, Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco, San Francisco, CA, USA.
| | - Dana E Goin
- Program on Reproductive Health and the Environment, Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco, San Francisco, CA, USA
| | - Lara Cushing
- Department of Environmental Health Sciences, Fielding School of Public Health, University of California, Los Angeles, Los Angeles, CA, USA
| | - Erin DeMicco
- Program on Reproductive Health and the Environment, Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco, San Francisco, CA, USA
| | - Sabrina Smith
- Environmental Chemistry Laboratory, Department of Toxic Substances Control, California Environmental Protection Agency, Berkeley, CA, USA
| | - June-Soo Park
- Environmental Chemistry Laboratory, Department of Toxic Substances Control, California Environmental Protection Agency, Berkeley, CA, USA
| | - Amy M Padula
- Program on Reproductive Health and the Environment, Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco, San Francisco, CA, USA
| | - Tracey J Woodruff
- Program on Reproductive Health and the Environment, Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco, San Francisco, CA, USA
| | - Rachel Morello-Frosch
- Program on Reproductive Health and the Environment, Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco, San Francisco, CA, USA.
- Department of Environmental Science, Policy and Management and School of Public Health, University of California, Berkeley, Berkeley, CA, USA.
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10
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Reno R, Burch J, Stookey J, Jackson R, Joudeh L, Guendelman S. Preterm birth and social support services for prenatal depression and social determinants. PLoS One 2021; 16:e0255810. [PMID: 34388192 PMCID: PMC8362957 DOI: 10.1371/journal.pone.0255810] [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] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2021] [Accepted: 07/25/2021] [Indexed: 12/18/2022] Open
Abstract
Preterm birth (PTB; <37 weeks gestation), is a leading cause of infant mortality and morbidity. Among those born preterm, risk increases as gestational age at birth decreases. Psychosocial factors such as depression symptoms and social determinants of health (SDH) may increase risk for PTB. Research is needed to understand these risk factors and identify effective interventions. This retrospective cohort study recruited English- and Spanish-speaking women presenting symptoms of preterm labor or admitted for PTB from an urban county hospital in the San Francisco Bay Area (n = 47). We used an iterative analytic approach by which qualitative data informed an exploratory quantitative analysis. Key exposures were presence of self-reported depression symptoms during pregnancy, SDH along eight domains, and receipt of behavioral health services. The outcome was gestational age at birth. T-tests, Wilcoxon rank sum tests, and linear regression models were used to test associations between the exposures and gestational age. Most participants were Black (25.5%) or Latina (59.6%). After adjusting for covariates, participants with depression symptoms had an average gestational age 3.1 weeks shorter (95% CI: -5.02, -1.20) than women reporting no symptoms. After adjusting for covariates, high number of adverse social determinants (≥ 4) suggested an association with shorter gestational age (p = 0.07, 1.65 weeks, 95% CI: -3.44, 0.14). Receipt of behavioral health services was associated with a significantly later gestational age; the median difference was 5.5 weeks longer for depression symptoms, 3.5 weeks longer for high social determinants, and 6 weeks longer for depression symptoms and high social determinants. Among a cohort of high-risk pregnant women, both depression symptoms during pregnancy and co-occurring with exposure to high adverse SDH are associated with shorter gestational age at birth, after controlling for psychosocial factors. Receipt of behavioral health services may be an effective intervention to address disparities in PTB.
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Affiliation(s)
- Rebecca Reno
- Center of Excellence in Maternal, Child, and Adolescent Health, School of Public Health, University of California Berkeley, Berkeley, California, United States of America
| | - Johanna Burch
- Dept. of Obstetrics, Gynecology, and Reproductive Sciences, University of California San Francisco, San Francisco, California, United States of America
| | - Jodi Stookey
- San Francisco Department of Public Health, San Francisco, California, United States of America
| | - Rebecca Jackson
- Dept. of Obstetrics, Gynecology, and Reproductive Sciences, University of California San Francisco, San Francisco, California, United States of America
| | - Layla Joudeh
- Dept. of Obstetrics, Gynecology, and Reproductive Sciences, University of California San Francisco, San Francisco, California, United States of America
| | - Sylvia Guendelman
- Center of Excellence in Maternal, Child, and Adolescent Health, School of Public Health, University of California Berkeley, Berkeley, California, United States of America
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11
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Alves AC, Cecatti JG, Souza RT. Resilience and Stress during Pregnancy: A Comprehensive Multidimensional Approach in Maternal and Perinatal Health. ScientificWorldJournal 2021; 2021:9512854. [PMID: 34434079 PMCID: PMC8382548 DOI: 10.1155/2021/9512854] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2021] [Accepted: 08/10/2021] [Indexed: 11/18/2022] Open
Abstract
This narrative review addresses resilience and stress during pregnancy, which is part of a broader concept of maternal health. Pregnancy and postpartum are opportune periods for health promotion interventions, especially because the close contact of the women with health professionals. In this way, it can be considered a useful window of opportunity to identify women at higher risk for adverse outcomes. Integrated health is a concept that aims at providing comprehensive care related to the promotion of individuals' physical, mental, and social well-being. In this context, stress during pregnancy has been targeted as a remarkable condition to be addressed whether due to individual issues, social issues, or specific pregnancy issues, since it is directly and indirectly associated with pregnancy complications. Stress is associated with preterm birth, postpartum depression, anxiety, child neurodevelopment, and fetal distress. The way that an individual faces a stressful and adverse situation is called resilience; this reaction is individual, dynamic, and contextual, and it can affect maternal and fetal outcomes. Low resilience has been associated with poorer pregnancy outcomes. The social context of pregnancy can act as a protective or contributory (risk) factor, indicating that environments of high social vulnerability play a negative role in resilience and, consequently, in perceived stress. A given stressor can be enhanced or mitigated depending on the social context that was imposed, as well as it can be interpreted as different degrees of perceived stress and faced with a higher or lower degree of resilience. Understanding these complex mechanisms may be valuable for tackling this matter. Therefore, in the pregnancy-puerperal period, the analysis of the stress-resilience relationship is essential, especially in contexts of greater social vulnerability, and is a health-promoting factor for both the mother and baby.
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Affiliation(s)
- A. C. Alves
- Department of Obstetrics and Gynecology, School of Medical Sciences, University of Campinas, Campinas, SP, Brazil
| | - J. G. Cecatti
- Department of Obstetrics and Gynecology, School of Medical Sciences, University of Campinas, Campinas, SP, Brazil
| | - R. T. Souza
- Department of Obstetrics and Gynecology, School of Medical Sciences, University of Campinas, Campinas, SP, Brazil
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Affiliation(s)
- Lauren Rissman
- Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois
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Cai M, Zhang B, Yang R, Zheng T, Dong G, Lin H, Rigdon SE, Xian H, Hinyard L, Xaverius PK, Liu E, Burroughs TE, Jansson DR, LeBaige MH, Yang S, Qian Z. Association between maternal outdoor physical exercise and the risk of preterm birth: a case-control study in Wuhan, China. BMC Pregnancy Childbirth 2021; 21:206. [PMID: 33711947 PMCID: PMC7955628 DOI: 10.1186/s12884-021-03678-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2020] [Accepted: 02/10/2021] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND China had the second largest proportion of preterm birth (PTB) internationally. However, only 11% of pregnant women in China meet international guidelines for maternal physical activity, a significantly lower proportion than that in Western countries. This study aims to examine the association between outdoor physical exercise during pregnancy and PTB among Chinese women in Wuhan, China. METHODS A case-control study was conducted among 6656 pregnant women (2393 cases and 4263 controls) in Wuhan, China from June 2011 to June 2013. Self-reported measures of maternal physical exercise (frequency per week and per day in minutes) were collected. Adjusted odds ratios were estimated using Bayesian hierarchical logistic regression and a generalized additive mixed model (GAMM). RESULTS Compared to women not involved in any physical activity, those who participated in physical exercise 1-2 times, 3-4 times, and over five times per week had 20% (aOR: 0.80, 95% credible interval [95% CI]: 0.68-0.92), 30% (aOR: 0.70, 95% CI: 0.60-0.82), and 32% (aOR: 0.68, 95% CI: 0.59-0.78) lower odds of PTB, respectively. The Bayesian GAMM showed that increasing physical exercise per day was associated with lower risk of PTB when exercise was less than 150 min per day; however, this direction of association is reversed when physical exercise was more than 150 min per day. CONCLUSION Maternal physical exercise, at a moderate amount and intensity, is associated with lower PTB risk. More data from pregnant women with high participation in physical exercise are needed to confirm the reported U-shape association between the physical exercise and risk of preterm birth.
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Affiliation(s)
- Miao Cai
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, 74 Zhongshan 2nd Road, Yuexiu District, Guangzhou, 510080 China
| | - Bin Zhang
- Wuhan Children’s Hospital (Wuhan Maternal and Child Healthcare Hospital), Tongji Medical College, Huazhong University of Science & Technology, 100 Xianggang Road, Jiangan District, Wuhan, 430015 China
| | - Rong Yang
- Wuhan Children’s Hospital (Wuhan Maternal and Child Healthcare Hospital), Tongji Medical College, Huazhong University of Science & Technology, 100 Xianggang Road, Jiangan District, Wuhan, 430015 China
| | - Tongzhang Zheng
- Department of Epidemiology Brown School of Public Health, 121 S Main St, Providence, RI 02903 USA
| | - Guanghui Dong
- Department of Toxicology, School of Public Health, Sun Yat-sen University, 74 Zhongshan 2nd Road, Yuexiu District, Guangzhou, 510080 China
| | - Hualiang Lin
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, 74 Zhongshan 2nd Road, Yuexiu District, Guangzhou, 510080 China
| | - Steven E. Rigdon
- Department of Epidemiology and Biostatistics, College for Public Health & Social Justice, Saint Louis University, 3545 Lafayette Avenue, Saint Louis, MO 63104 USA
| | - Hong Xian
- Department of Epidemiology and Biostatistics, College for Public Health & Social Justice, Saint Louis University, 3545 Lafayette Avenue, Saint Louis, MO 63104 USA
| | - Leslie Hinyard
- Center for Health Outcomes Research, Saint Louis University, 3545 Lafayette Avenue, Saint Louis, MO 63104 USA
| | - Pamela K. Xaverius
- Department of Epidemiology and Biostatistics, College for Public Health & Social Justice, Saint Louis University, 3545 Lafayette Avenue, Saint Louis, MO 63104 USA
| | - Echu Liu
- Department of Health Management and Policy, College for Public Health and Social Justice, Saint Louis University, 3545 Lafayette Avenue, Saint Louis, MO 63104 USA
| | - Thomas E. Burroughs
- Center for Health Outcomes Research, Saint Louis University, 3545 Lafayette Avenue, Saint Louis, MO 63104 USA
| | - Daire R. Jansson
- Department of Epidemiology and Biostatistics, College for Public Health & Social Justice, Saint Louis University, 3545 Lafayette Avenue, Saint Louis, MO 63104 USA
| | - Morgan H. LeBaige
- Department of Epidemiology and Biostatistics, College for Public Health & Social Justice, Saint Louis University, 3545 Lafayette Avenue, Saint Louis, MO 63104 USA
| | - Shaoping Yang
- Wuhan Children’s Hospital (Wuhan Maternal and Child Healthcare Hospital), Tongji Medical College, Huazhong University of Science & Technology, 100 Xianggang Road, Jiangan District, Wuhan, 430015 China
| | - Zhengmin Qian
- Department of Epidemiology and Biostatistics, College for Public Health & Social Justice, Saint Louis University, 3545 Lafayette Avenue, Saint Louis, MO 63104 USA
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Brunson E, Thierry A, Ligier F, Vulliez-Coady L, Novo A, Rolland AC, Eutrope J. Prevalences and predictive factors of maternal trauma through 18 months after premature birth: A longitudinal, observational and descriptive study. PLoS One 2021; 16:e0246758. [PMID: 33626102 PMCID: PMC7904178 DOI: 10.1371/journal.pone.0246758] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Accepted: 01/25/2021] [Indexed: 12/15/2022] Open
Abstract
Posttraumatic reactions are common among mothers of preterm infants and can have a negative influence on their quality of life and lead to interactional difficulties with their baby. Given the possible trajectories of posttraumatic reactions, we hypothesized that prevalences of postpartum posttraumatic reactions at given times underestimate the real amount of mothers experiencing these symptoms within 18 months following delivery. Additionally, we examined whether sociodemographic and clinical characteristics of dyads influence the expression of posttraumatic symptoms among these mothers. A sample of 100 dyads was included in this longitudinal study led by 3 french university hospitals. Preterm infants born before 32 weeks of gestation and their mothers were followed-up over 18 months and attended 5 visits assessing the infants’ health conditions and the mothers’ psychological state with validated scales. Fifty dyads were retained through the 18 months of the study. The period prevalence of posttraumatic reactions was calculated and a group comparison was conducted to determine their predictive factors. Thirty-six percent of the mothers currently suffered from posttraumatic symptoms 18 months after their preterm delivery. The 18 months period prevalence was 60.4% among all the mothers who participated until the end of the follow-up. There was a statistical link between posttraumatic symptoms and a shorter gestational age at delivery, C-section, and the mother’s psychological state of mind at every assessment time. Only a small proportion of mothers were receiving psychological support at 18 months. Preterm mothers are a population at risk of developing a long-lasting postpartum posttraumatic disorder, therefore immediate and delayed systematic screenings for posttraumatic symptoms are strongly recommended to guide at-risk mothers towards appropriate psychological support.
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Affiliation(s)
- Emilie Brunson
- Université de Formation et de Recherche de médecine, Université de Reims Champagne-Ardenne, Reims, France
| | - Aurore Thierry
- Unité d’Aide Méthodologique, Hôpital Robert Debré, Centre Hospitalier Universitaire de Reims, Reims, France
| | - Fabienne Ligier
- Pôle Universitaire de Psychiatrie de l’Enfant et de l’Adolescent, Centre Psychothérapique de Nancy, Laxou, France
- Unité de recherche EA 4360 APEMAC Adaptation, Mesure et Evaluation en Santé, Approches Interdisciplinaires, Université de Lorraine, Nancy, France
| | - Laurianne Vulliez-Coady
- Service de Psychiatrie de l’Enfant et de l’Adolescent, Hôpital Saint Jacques, Centre Hospitalier Universitaire de Besançon, Besançon, France
| | - Alexandre Novo
- Université de Formation et de Recherche de médecine, Université de Reims Champagne-Ardenne, Reims, France
- Centre de Recherches Psychanalyse, Médecine et Société, Institut des Humanités, Sciences et Sociétés, Université de Paris, Paris, France
- Service de Psychothérapie de l’Enfant et de l’Adolescent, Hôpital Robert Debré, Centre Hospitalier Universitaire Reims, Reims, France
| | - Anne-Catherine Rolland
- Université de Formation et de Recherche de médecine, Université de Reims Champagne-Ardenne, Reims, France
- Service de Psychothérapie de l’Enfant et de l’Adolescent, Hôpital Robert Debré, Centre Hospitalier Universitaire Reims, Reims, France
- Département de Psychologie, Laboratoire Cognition Santé Société (EA 6291), Université de Reims Champagne-Ardenne, Reims, France
| | - Julien Eutrope
- Université de Formation et de Recherche de médecine, Université de Reims Champagne-Ardenne, Reims, France
- Service de Psychothérapie de l’Enfant et de l’Adolescent, Hôpital Robert Debré, Centre Hospitalier Universitaire Reims, Reims, France
- Département de Psychologie, Laboratoire Cognition Santé Société (EA 6291), Université de Reims Champagne-Ardenne, Reims, France
- * E-mail:
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Hansen LB, Hvidt NC, Mortensen KE, Wu C, Prinds C. How Giving Birth Makes Sense: A Questionnaire Study on Existential Meaning-Making Among Mothers Giving Birth Preterm or at Term. J Relig Health 2021; 60:335-353. [PMID: 33123971 DOI: 10.1007/s10943-020-01106-4] [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] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 10/06/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND Women's reflections on existential meaning-making in relation to giving birth may seem indistinct in maternity services and have not been thoroughly explored in secular contexts. However, research suggests that childbirth accentuates spiritual and existential considerations and needs even in secular contexts highlighting the importance of care for such needs in maternity care practices. The objectives of this study were two-fold: Firstly, to explore how first-time mothers, living in a secular context, experience their first birth in relation to existential meaning-making. Secondly, to describe the relationship between existential meaning-making reflections and gestational week at birth. METHODS A nationwide cross-sectional study in Denmark based on the questionnaire "Faith, existence and motherhood" was conducted in 2011. Eight core items related to birth experience informed this study. The cohort was sampled from the Danish Medical Birth Registry and consisted of 913 mothers having given birth 6-18 months previously. Twenty-eight per cent had given birth preterm (PT) and 72% had given birth at full-term (FT). A total of 517 mothers responded. RESULTS In relation to the birth of their first child, both FT and PT mothers answered, that they had existential meaning-making reflections. The consent to the 8 items ranged from 17 to 73% among FT mothers and from 19 to 58% among PT mothers. Mothers who gave birth preterm mainly identified the negative aspects of birth, whereas mothers, who gave birth at full-term, to a higher degree identified positive aspects. CONCLUSIONS Findings suggest that not only traumatic birth events accentuate existential reflections, but that even normal childbirth to most mothers is an existential event. However, the quality of existential reflections differs when comparing normal and traumatic birth. The study points towards change in education and organization of maternity care to better care for existential needs and reflections specific to every new mother and birthing woman.
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Affiliation(s)
- Line Bruun Hansen
- University College South Denmark, Degnevej 16, 6705, Esbjerg Ø, Denmark.
- University Library of Southern Denmark, Niels Bohrs Vej 9-10, 6700, Esbjerg Ø, Denmark.
| | - Niels Christian Hvidt
- Institute of Public Health, University of Southern Denmark, J.B. Winsløws Vej 9, 5000, Odense C, Denmark
| | - Katrine Ernst Mortensen
- Department of Gynaecology and Obstetrics, Odense University Hospital, Sdr. Boulevard 29, 5000, Odense C, Denmark
| | - Chunsen Wu
- Department of Gynaecology and Obstetrics, Odense University Hospital, Sdr. Boulevard 29, 5000, Odense C, Denmark
- Department of Clinical Institute, Faculty of Health Sciences, University of Southern Denmark, Kløvervænget 10, 5000, Odense C, Denmark
| | - Christina Prinds
- University College South Denmark, Degnevej 16, 6705, Esbjerg Ø, Denmark
- Department of Clinical Institute, Faculty of Health Sciences, University of Southern Denmark, Kløvervænget 10, 5000, Odense C, Denmark
- OPEN - Odense Patient Data Explorative Network, Odense University Hospital, J.B. Winsløws Vej 9, 5000, Odense C, Denmark
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Khemakhem R, Bourgou S, Selmi I, Azzabi O, Belhadj A, Siala N. Preterm birth, mother psychological state and mother- infant bonding. Tunis Med 2020; 98:992-997. [PMID: 33480002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
BACKGROUND The preterm birth represents a stressful situation that can lead to questions about the survival of the child and the possible consequences. AIM To examine the interactions between mothers and premature babies in the neonatal care unit (NCU) and assess the psychological state of the mothers. METHODS Cross-sectional study conducted from March to May 2017 in the Department of Pediatrics and Neonatology of the Mongi Slim Hospital (Tunis, Tunisia). Ten mothers of premature babies hospitalized in NCU were involved and responded to the Postpartum Bonding Questionnaire (PBQ), the Edinburgh Postnatal Depression Scale (EPDS) (cut off≥10) and the Hospital Anxiety and Depression Scale (HADS). RESULTS The mean age of the mothers was 31 years. A personal history of depression was found in two mothers. The current pregnancy was not desired in three cases, two corresponded to mothers with a history of depression. According to interactions, the median PBQ score was 11. The EPDS median score was six; four mothers had a score greater than 10. A high level on the anxiety sub-scale of the HADS was found in the two mothers who had a personal psychiatric history. The more depressed or anxious the mothers were, the higher the interaction scores (p = 0.012 and p = 0.032, respectively). CONCLUSION Preterm birth seems to affect the psychological state of mothers and their interactions with their baby.
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Faleschini S, Matte-Gagné C, Luu TM, Côté S, Tremblay RE, Boivin M. Trajectories of Overprotective Parenting and Hyperactivity-Impulsivity and Inattention Among Moderate-Late Preterm Children: A Population-Based Study. J Abnorm Child Psychol 2020; 48:1555-1568. [PMID: 32936392 DOI: 10.1007/s10802-020-00704-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [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] [Accepted: 09/08/2020] [Indexed: 11/24/2022]
Abstract
Parents of preterm children are more likely to adopt non-optimal parenting behaviors than parents of full-term (FT) children. However, there is a lack of studies on parents of children born moderate to late preterm (MLP; 32-36 gestational weeks). In this study, we aimed to examine: (1) the association between MLP birth status and the trajectory of parental overprotection throughout preschool years, and (2) the role of parental overprotection, MLP birth status, and their interaction in the prediction of the trajectories of hyperactivity-impulsivity and inattention throughout childhood. Data comes from a Canadian representative population-based cohort including 2028 FT, 100 MLP children, and their parents. Overprotective parenting was measured when children were 5, 17, and 29 months old. Hyperactivity-impulsivity and inattention symptoms were measured repeatedly from 4 to 8 years of age. Trajectories of parents' overprotectiveness and children's hyperactivity-impulsivity and inattention were modeled. MLP birth status was associated with an increase in parental overprotectiveness across the preschool period. MLP birth status and parental overprotection were both found to be associated with higher levels of hyperactivity-impulsivity symptoms across childhood. No interaction was found between birth status and parental overprotection. The results suggest that parents of MLP children become more overprotective across time compared to parents of FT children and that children born MLP and/or exposed to higher levels of parental overprotection demonstrated higher levels of hyperactivity-impulsivity symptoms across childhood.
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Affiliation(s)
| | | | - Thuy Mai Luu
- Department of Pediatrics, Sainte-Justine University Hospital Research Centre, University of Montreal, Montreal, Canada
| | - Sylvana Côté
- Department of Social and Preventive Medicine, University of Montreal, Montreal, Canada
| | - Richard E Tremblay
- Department of Pediatrics, Sainte-Justine University Hospital Research Centre, University of Montreal, Montreal, Canada
| | - Michel Boivin
- School of Psychology, Laval University, Quebec, Canada
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Bryant AS, Riley LE, Neale D, Hill W, Jones TB, Jeffers NK, Loftman PO, Clare CA, Gudeman J. Communicating with African-American Women Who Have Had a Preterm Birth About Risks for Future Preterm Births. J Racial Ethn Health Disparities 2020. [PMID: 31950364 DOI: 10.1007/s40615020-00697-8] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/08/2023]
Abstract
PURPOSE African-American women are at higher risk of preterm birth (PTB) compared with other racial/ethnic groups in the USA. The primary objective was to evaluate the level of understanding among a group of African-American women concerning risks of PTB in future pregnancies. Secondary objectives were to evaluate how some women obtain information about PTB and to identify ways to raise their awareness. METHODS Six focus groups were conducted in three locations in the USA during 2016 with women (N = 60) who had experienced ≥ 1 PTB (< 37 weeks of gestation) during the last 5 years. The population was geographically, economically, and educationally diverse. RESULTS We observed a tendency to normalize PTB. Knowledge about potential complications for the infant was lacking and birth weight was prioritized over gestational age as an indicator of PTB. Participants were largely unaware of factors associated with increased PTB risk, such as a previous PTB and race/ethnicity. The most trusted information source was the obstetrical care provider, although participants reported relying on mobile apps, websites, and chat rooms. The optimal time to receive information about PTB risk in subsequent pregnancies was identified as the postpartum visit in the provider's office. CONCLUSIONS Awareness of the risks of recurrent PTB was limited in this diverse population. Educational programs on the late-stage development of neonates may strengthen knowledge on the relationship between gestational age and PTB and associated health/developmental implications. For educational efforts to be successful, a strong nonjudgmental, positive, solutions-oriented message focused on PTB risk factors is crucial.
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Affiliation(s)
- Allison S Bryant
- Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, Massachusetts General Hospital, 55 Fruit Street, Boston, MA, 02114-2696, USA.
| | - Laura E Riley
- Department of Obstetrics and Gynecology, Weill Cornell Medicine, New York Presbyterian Hospital, 525 East 68th Street, New York, NY, 10065, USA
| | - Donna Neale
- Division of Maternal-Fetal Medicine, The Johns Hopkins University, Johns Hopkins University School of Medicine, 600 North Wolfe Street, Baltimore, MD, 21287-1228, USA
| | - Washington Hill
- Obstetrics, Gynecology, Maternal-Fetal Medicine, Florida Department of Health-Sarasota County, Sarasota Memorial Healthcare System, Center Place Health, 1750 17th Street, Building E, Sarasota, FL, 34234, USA
| | - Theodore B Jones
- Department of Obstetrics and Gynecology, Wayne State University School of Medicine, Detroit, MI, USA
- Oakwood Hospital - Dearborn, 18101 Oakwood Blvd, Suite 126, Dearborn, MI, 48124, USA
| | - Noelene K Jeffers
- Johns Hopkins University School of Nursing, 525 North Wolfe Street, Baltimore, MD, 21205, USA
| | | | - Camille A Clare
- Department of Obstetrics and Gynecology, New York Medical College, Valhalla, NY, USA
- New York City Health + Hospitals/Metropolitan, 1901 First Avenue Room 4B5, New York, NY, 10029, USA
| | - Jennifer Gudeman
- Medical Affairs, AMAG Pharmaceuticals, Inc., 1100 Winter Street, Waltham, MA, 02451, USA
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Leahy-Warren P, Coleman C, Bradley R, Mulcahy H. The experiences of mothers with preterm infants within the first-year post discharge from NICU: social support, attachment and level of depressive symptoms. BMC Pregnancy Childbirth 2020; 20:260. [PMID: 32349685 PMCID: PMC7191776 DOI: 10.1186/s12884-020-02956-2] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2019] [Accepted: 04/20/2020] [Indexed: 01/25/2023] Open
Abstract
BACKGROUND The estimated global premature birth rate for 2014 was 10.6%, equating to an estimate of 14.84 million live premature births. The experience of premature birth does not impact solely on the infant and mother as individuals but occurs in the context of a critical point in time when they are developing a relationship with one another. The aim of this study was to investigate the relationships between social support, mother to infant attachment, and depressive symptoms of mothers with preterm infants within the first 12 months' post discharge from the Neonatal Intensive Care Unit (NICU). METHODS A correlational cross-sectional study design was used. Data were collected using a four-part online survey which included the Perinatal Social Support Questionnaire (PICSS), Maternal Postnatal Attachment Scale (MPAS) and the Edinburgh Postnatal Depression Scale (EPDS) with mothers of preterm infants (n = 140). RESULTS The prevalence of postnatal depression was 37.9% (95% CI: 29.8 to 46.4%). In univariable analyses, history of depression (p = 0.005), aged 35-39 years (p = 0.006), no formal social support (p = 0.040), less informal social supports (p = 0.018), lower overall maternal attachment (p < 0.001) and lower overall functional social support (p < 0.001) were significantly associated with a higher level of depressive symptoms. Lower scores on two of the maternal attachment subscales (quality of attachment and absence of hostility) and all four of the functional social support subscales were significantly associated with a higher level of depressive symptoms (p < 0.001 for all). In the multivariable analysis, prior history of depression (p = 0.028), lower score of maternal attachment (p < 0.001) and lower emotional functional social support (p = 0.030) were significantly associated with a higher level of depressive symptoms. CONCLUSION Women who experience a premature birth, have a prior history of depression, poor infant attachment and poor emotional social support have a higher level of depressive symptoms. Results emphasise the need for professionals to encourage mobilisation of maternal formal and informal social supports. It is important to intervene early to address maternal emotional well-being and enhance the developing mother-preterm infant relationship.
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Affiliation(s)
- Patricia Leahy-Warren
- School of Nursing and Midwifery, University College Cork, Brookfield Health Sciences Complex, College Road, Cork, T12 AK54, Ireland.
| | - Chelsea Coleman
- School of Nursing and Midwifery, University College Cork, Brookfield Health Sciences Complex, College Road, Cork, T12 AK54, Ireland
| | - Róisín Bradley
- School of Nursing and Midwifery, University College Cork, Brookfield Health Sciences Complex, College Road, Cork, T12 AK54, Ireland
| | - Helen Mulcahy
- School of Nursing and Midwifery, University College Cork, Brookfield Health Sciences Complex, College Road, Cork, T12 AK54, Ireland
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Petrou S, Krabuanrat N, Khan K. Preference-Based Health-Related Quality of Life Outcomes Associated with Preterm Birth: A Systematic Review and Meta-analysis. Pharmacoeconomics 2020; 38:357-373. [PMID: 31814079 DOI: 10.1007/s40273-019-00865-7] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/20/2023]
Abstract
OBJECTIVES Assessments of health-related quality of life outcomes associated with preterm birth provide valuable complementary data to the objective biomedical assessments that have traditionally been reported. The objective of this study was to perform a systematic review and meta-analysis of health utility values associated with preterm birth generated using preference-based approaches to health-related quality of life measurement. METHODS Systematic searches of MEDLINE, Web of Science, EconLit, EMBASE, CINAHL, PsycINFO, the Cochrane Library and SCOPUS were performed, covering the literature from inception of the search engines to 26 June 2018. Studies reporting health utility values estimated using either direct or indirect utility elicitation methods and published in the English language were included. Central descriptive statistics and measures of variability surrounding health utility values for each study and control group, and differences between comparator groups, are reported for each included article. The effect of preterm birth on health utility values was estimated using a hierarchical linear model in a linear mixed-effects meta-regression. RESULTS Of 2139 unique articles retrieved, 20 articles met the inclusion criteria. All but one study used the Health Utilities Index (HUI) Mark 2 (HUI2) or Mark 3 (HUI3) measures as their primary health utility assessment method. All studies reporting health utility values for individuals born preterm or at low birthweight and a control group of individuals born at full term or normal birthweight reported lower utility values in the study groups, regardless of age at assessment, respondent type or valuation method. The meta-regression revealed that preterm birth was associated with a mean utility decrement of 0.066 (95% confidence interval [CI] 0.035-0.098; p < 0.001) after controlling for valuation method, respondent type, administration mode, year of publication, geographical region of study, study setting and age at assessment. CONCLUSION Evidence identified by this review can act as data inputs into future economic evaluations of preventive or treatment interventions for preterm birth. Future research should focus particularly on estimating health utility values during the various stages of adulthood, and incorporating the effects of preterm birth on the preference-based health-related quality of life outcomes of parents and other family members.
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Affiliation(s)
- Stavros Petrou
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Radcliffe Observatory Quarter, Woodstock Road, Oxford, OX2 6GG, UK.
- Warwick Clinical Trials Unit, Warwick Medical School, University of Warwick, Coventry, CV4 7AL, UK.
| | - Natnaree Krabuanrat
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Radcliffe Observatory Quarter, Woodstock Road, Oxford, OX2 6GG, UK
| | - Kamran Khan
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Radcliffe Observatory Quarter, Woodstock Road, Oxford, OX2 6GG, UK
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Abstract
IMPORTANCE Children born preterm are at an elevated risk of academic underachievement. However, the extent to which performance across domain-specific subskills in reading and mathematics is associated with preterm birth remains unclear. OBJECTIVE To conduct a systematic review and meta-analysis of academic outcomes of school-aged children born preterm, compared with children born at term, appraising evidence for higher- and lower-order subskills in reading and mathematics. DATA SOURCES PubMed/MEDLINE, PsycINFO, and the Cumulative Index of Nursing and Allied Health Literature electronic databases from January 1, 1980, to July 30, 2018, were searched for population, exposure, and outcome terms such as child (population), preterm birth (exposure), and education* (outcome). STUDY SELECTION Peer-reviewed English-language publications that included preterm-born children and a comparison group of term-born children aged 5 to 18 years and born during or after 1980 and that reported outcomes on standardized assessments from cohort or cross-sectional studies were screened. Of the 9833 articles screened, 33 unique studies met the inclusion criteria. DATA EXTRACTION AND SYNTHESIS Data were analyzed from August 1 to September 29, 2018. The Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines were followed. Two reviewers independently screened the databases and extracted sample characteristics and outcomes scores. Pooled mean differences (MDs) were analyzed using random-effects models. MAIN OUTCOMES AND MEASURES Performance on standardized assessment of higher-order subskills of reading comprehension and applied mathematics problems; lower-order reading subskills of decoding, pseudoword decoding, and word identification; and lower-order mathematics subskills of knowledge, calculation, and fluency. RESULTS Outcomes data were extracted for 4006 preterm and 3317 term-born children, totaling 7323 participants from 33 unique studies. Relative to children born at term, children born preterm scored significantly lower in reading comprehension (mean difference [MD], -7.96; 95% CI, -12.15 to -3.76; I2 = 81%) and applied mathematical problems (MD, -11.41; 95% CI, -17.57 to -5.26; I2 = 91%) assessments. Across the assessments of lower-order skills, children born preterm scored significantly lower than their term-born peers in calculation (MD, -10.57; 95% CI, -15.62 to -5.52; I2 = 92%), decoding (MD, -10.18; 95% CI, -16.83 to -3.53; I2 = 71%), mathematical knowledge (MD, -9.88; 95% CI, -11.68 to -8.08; I2 = 62%), word identification (MD, -7.44; 95% CI, -9.08 to -5.80; I2 = 69%), and mathematical fluency (MD, -6.89; 95% CI, -13.54 to -0.23; I2 = 72%). The associations remained unchanged after sensitivity analyses for reducing heterogeneity. CONCLUSIONS AND RELEVANCE These findings provide evidence that preterm birth is associated with academic underperformance in aggregate measures of reading and mathematics, as well as a variety of related subskills.
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Affiliation(s)
- Melinda McBryde
- Currently graduate students at School of Psychology, Faculty of Health and Behavioural Sciences, The University of Queensland, Brisbane, Australia
- Mothers, Babies and Women’s Health Program, Mater Research Institute, Faculty of Medicine, The University of Queensland, Brisbane, Australia
| | - Grace C. Fitzallen
- Currently graduate students at School of Psychology, Faculty of Health and Behavioural Sciences, The University of Queensland, Brisbane, Australia
- Mothers, Babies and Women’s Health Program, Mater Research Institute, Faculty of Medicine, The University of Queensland, Brisbane, Australia
| | - Helen G. Liley
- Mothers, Babies and Women’s Health Program, Mater Research Institute, Faculty of Medicine, The University of Queensland, Brisbane, Australia
| | - H. Gerry Taylor
- Abigail Wexner Research Institute, Biobehavioral Health Centre, Nationwide Children’s Hospital, Columbus, Ohio
- Department of Pediatrics, The Ohio State University, Columbus
| | - Samudragupta Bora
- Mothers, Babies and Women’s Health Program, Mater Research Institute, Faculty of Medicine, The University of Queensland, Brisbane, Australia
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Adhikari K, Patten SB, Williamson T, Patel AB, Premji S, Tough S, Letourneau N, Giesbrecht G, Metcalfe A. Neighbourhood socioeconomic status modifies the association between anxiety and depression during pregnancy and preterm birth: a Community-based Canadian cohort study. BMJ Open 2020; 10:e031035. [PMID: 32047008 PMCID: PMC7045250 DOI: 10.1136/bmjopen-2019-031035] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [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] [Indexed: 11/28/2022] Open
Abstract
OBJECTIVE This study examined the association of anxiety alone, depression alone and the presence of both anxiety and depression with preterm birth (PTB) and further examined whether neighbourhood socioeconomic status (SES) modified this association. DESIGN Cohort study using individual-level data from two community-based prospective pregnancy cohort studies (All Our Families; AOF) and Alberta Pregnancy Outcomes and Nutrition (APrON) and neighbourhood SES data from the 2011 Canadian census. SETTING Calgary, Alberta, Canada. PARTICIPANTS Overall, 5538 pregnant women who were <27 weeks of gestation and >15 years old were enrolled in the cohort studies between 2008 and 2012. 3341 women participated in the AOF study and 2187 women participated in the APrON study, with 231 women participated in both studies. Women who participated in both studies were only counted once. PRIMARY AND SECONDARY OUTCOME MEASURES PTB was defined as delivery prior to 37 weeks of gestation. Depression was defined as an Edinburgh Postnatal Depression Scale (EPDS) score of ≥13, anxiety was defined as an EPDS-anxiety subscale score of ≥6, and the presence of both anxiety and depression was defined as meeting both anxiety and depression definitions. RESULTS Overall, 7.3% of women delivered preterm infants. The presence of both anxiety and depression, but neither of these conditions alone, was significantly associated with PTB (OR 1.6, 95% CI 1.1 to 2.3) and had significant interaction with neighbourhood deprivation (p=0.004). The predicted probability of PTB for women with both anxiety and depression was 10.0%, which increased to 15.7% if they lived in the most deprived neighbourhoods and decreased to 1.4% if they lived in the least deprived neighbourhoods. CONCLUSIONS Effects of anxiety and depression on risk of PTB differ depending on where women live. This understanding may guide the identification of women at increased risk for PTB and allocation of resources for early identification and management of anxiety and depression.
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Affiliation(s)
- Kamala Adhikari
- Department of Community Health Sciences, University of Calgary, Calgary, Alberta, Canada
| | - Scott B Patten
- Department of Community Health Sciences, University of Calgary, Calgary, Alberta, Canada
| | - Tyler Williamson
- Department of Community Health Sciences, University of Calgary, Calgary, Alberta, Canada
| | - Alka B Patel
- Department of Community Health Sciences, University of Calgary, Calgary, Alberta, Canada
- Applied Research and Evaluation- Primary Health Care, Alberta Health Services, Calgary, Alberta, Canada
| | - Shahirose Premji
- School of Nursing, Faculty of Health, York University, Calgary, Alberta, Canada
| | - Suzanne Tough
- Department of Community Health Sciences, University of Calgary, Calgary, Alberta, Canada
- Department of Pediatrics, University of Calgary, Calgary, Alberta, Canada
| | - Nicole Letourneau
- Department of Community Health Sciences, University of Calgary, Calgary, Alberta, Canada
- Department of Pediatrics, University of Calgary, Calgary, Alberta, Canada
- Faculty of Nursing, University of Calgary, Calgary, Alberta, Canada
- Deprtment of Psychiatry, University of Calgary, Calgary, Alberta, Canada
| | - Gerald Giesbrecht
- Department of Community Health Sciences, University of Calgary, Calgary, Alberta, Canada
- Department of Pediatrics, University of Calgary, Calgary, Alberta, Canada
| | - Amy Metcalfe
- Department of Community Health Sciences, University of Calgary, Calgary, Alberta, Canada
- Department of Obstetrics and Gynecology, University of Calgary, Calgary, Alberta, Canada
- Department of Medicine, University of Calgary, Calgary, Alberta, Canada
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23
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Edwards BN, McLemore MR, Baltzell K, Hodgkin A, Nunez O, Franck LS. What about the men? Perinatal experiences of men of color whose partners were at risk for preterm birth, a qualitative study. BMC Pregnancy Childbirth 2020; 20:91. [PMID: 32041561 PMCID: PMC7011522 DOI: 10.1186/s12884-020-2785-6] [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] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2019] [Accepted: 01/31/2020] [Indexed: 12/05/2022] Open
Abstract
BACKGROUND Preterm birth in the United States is associated with maternal clinical factors such as diabetes, hypertension and social factors including race, ethnicity, and socioeconomic status. In California, 8.7% of all live births are preterm, with African American and Black families experiencing the greatest burden. The impact of paternal factors on birth outcomes has been studied, but little is known about the experience of men of color (MOC). The purpose of this study was to explore the experiences of MOC who are partners to women at medical and social risk for preterm birth. METHODS This study used a qualitative research design and focus group methods. The research was embedded within an existing study exploring experiences of women of color at risk for preterm birth conducted by the California Preterm Birth Initiative. RESULTS Twelve MOC participated in the study and among them had 9 preterm children. Four themes emerged from thematic analysis of men's experiences: (1) "Being the Rock": Providing comfort and security; (2) "It's a blessing all the way around": Keeping faith during uncertainty; (3) "Tell me EVERYTHING": Unmet needs during pregnancy and delivery; (4) "Like a guinea pig": Frustration with the healthcare system. Participants identified many barriers to having a healthy pregnancy and birth including inadequate support for decision making, differential treatment, and discrimination. CONCLUSIONS This study shows novel and shared narratives regarding MOC experiences during pregnancy, birth, and postpartum periods. Healthcare providers have an essential role to acknowledge MOC, their experience of discrimination and mistrust, and to assess needs for support that can improve birth outcomes. As MOC and their families are at especially high social and medical risk for preterm birth, their voice and experience should be central in all future research on this topic.
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Affiliation(s)
- Brittany N Edwards
- Central California Faculty Medical Group/UCSF Fresno, 2625 E Divisadero St, Fresno, CA, 93721, USA.
| | | | | | | | - Olga Nunez
- California State University, Fresno, USA
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24
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Sumbul T, Spellen S, McLemore MR. A Transdisciplinary Conceptual Framework of Contextualized Resilience for Reducing Adverse Birth Outcomes. Qual Health Res 2020; 30:105-118. [PMID: 31752598 DOI: 10.1177/1049732319885369] [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] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
Abstract
Research in preterm birth has focused on the disparate outcomes for Black, Hispanic, and Latina women as compared with White women. However, research studies have not focused on centering these women in frameworks that discuss how resilience is embodied. This article is a presentation of our transdisciplinary contextual framework of resilience, building on work that centers Black, Hispanic, and Latina women, as well as historical oppression and trauma resilience frameworks developed by transcultural psychiatry, psychology, public health, anthropology, medicine, nursing, sociology, and social work. To develop the model, we reviewed 115 articles and books (1977-2019), which were then evaluated and synthesized to develop a transdisciplinary framework of contextualized resilience to enable a better understanding of the complex interplay of medical and social conditions influencing preterm birth. The framework includes multiple ecological layers that cross the individual, familial and intimate, community, structural, policy and law, and hegemonic domains.
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Affiliation(s)
- Tijen Sumbul
- University of California, San Francisco, San Francisco, California, USA
| | - Solaire Spellen
- University of California, Berkeley, Berkeley, California, USA
| | - Monica R McLemore
- University of California, San Francisco, San Francisco, California, USA
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25
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Ellouze S, Aloulou J, Halouani N, Turki M, Ben Thabet A, Gargouri A, Amami O. [Premature birth: a risk factor for maternal depression?]. Soins Pediatr Pueric 2020; 41:32-36. [PMID: 32200969 DOI: 10.1016/j.spp.2019.12.008] [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] [Indexed: 06/10/2023]
Abstract
Premature birth constitutes a major ordeal not only for the child but also the mother. It reveals the psychological capacities of mothers with depressive affects as signs. Hedi Chaker university hospital in Sfax in Tunisia carried out a study on mothers of premature babies. These mothers were significantly more depressed. Certain factors appear to favour the occurrence of postnatal maternal depression and must therefore benefit from specific support.
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Affiliation(s)
- Sahar Ellouze
- Service de psychiatrie B, Hôpital Razi, La Mannouba, Tunisie.
| | - Jihen Aloulou
- Service de psychiatrie B, Centre hospitalo-universitaire Hédi-Chaker, 3029 Sfax, Tunisie
| | - Najla Halouani
- Service de psychiatrie B, Centre hospitalo-universitaire Hédi-Chaker, 3029 Sfax, Tunisie
| | - Mariem Turki
- Service de psychiatrie B, Centre hospitalo-universitaire Hédi-Chaker, 3029 Sfax, Tunisie
| | - Afef Ben Thabet
- Service de néonatologie, Centre hospitalo-universitaire Hédi-Chaker, 3029 Sfax, Tunisie
| | - Abdellatif Gargouri
- Service de néonatologie, Centre hospitalo-universitaire Hédi-Chaker, 3029 Sfax, Tunisie
| | - Othman Amami
- Service de psychiatrie B, Centre hospitalo-universitaire Hédi-Chaker, 3029 Sfax, Tunisie
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26
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Mallinson DC, Grodsky E, Ehrenthal DB. Gestational age, kindergarten-level literacy, and effect modification by maternal socio-economic and demographic factors. Paediatr Perinat Epidemiol 2019; 33:467-479. [PMID: 31503367 PMCID: PMC6823120 DOI: 10.1111/ppe.12588] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [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: 03/20/2019] [Revised: 08/16/2019] [Accepted: 08/16/2019] [Indexed: 11/28/2022]
Abstract
BACKGROUND Shorter gestational age at birth is associated with worse academic performance in childhood. Socio-economic and demographic factors that affect a child's development may modify the relationship between gestational age and later academic performance. OBJECTIVE The purpose of this study was to investigate socio-economic and demographic effect modification of gestational age's association with kindergarten-level literacy skills in a longitudinal Wisconsin birth cohort. METHODS We sampled 153 145 singleton births (2007-2010) that linked to Phonological Awareness Literacy Screening-Kindergarten (PALS-K) scores (2012-2016 school years). PALS-K outcomes included meeting the screening benchmark (≥28 points, range 0-102 points) and the standardised score. Multivariable linear regressions of PALS-K outcomes on gestational age (completed weeks) included individual interactions for five maternal attributes measured at delivery: Medicaid coverage, education, age, race/ethnicity, and marital status. RESULTS Each additional completed gestational week was associated with a 0.5 percentage point increase in the probability of meeting the PALS-K literacy benchmark. The benefit of an additional week of gestational age was 0.5 percentage points (95% confidence interval 0.3, 0.7 percentage points) greater for Medicaid-covered births (0.8 percentage points) relative to non-Medicaid births (0.3 percentage points). Relative to only completing high school, having college education weakened this association by 0.3-0.6 percentage points, depending on years in college. Similar but modest relations emerged with standardised scores. CONCLUSIONS Socio-economic advantage as indicated by non-Medicaid coverage or higher levels of completed maternal education may diminish the cost of preterm birth on a child's kindergarten-level literacy skills.
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Affiliation(s)
- David C. Mallinson
- Department of Population Health Sciences, School of Medicine and Public Health, University of Wisconsin-Madison
| | - Eric Grodsky
- Department of Sociology, College of Letters & Science, University of Wisconsin-Madison
- Department of Educational Policy Studies, School of Education, University of Wisconsin-Madison
| | - Deborah B. Ehrenthal
- Department of Population Health Sciences, School of Medicine and Public Health, University of Wisconsin-Madison
- Department of Obstetrics & Gynecology, School of Medicine and Public Health, University of Wisconsin-Madison
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27
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Drummond D, Hadchouel A, Torchin H, Rozé JC, Arnaud C, Bellino A, Couderc L, Marret S, Mittaine M, Pinquier D, Vestraete M, Rousseau J, Ancel PY, Delacourt C. Educational and health outcomes associated with bronchopulmonary dysplasia in 15-year-olds born preterm. PLoS One 2019; 14:e0222286. [PMID: 31509594 PMCID: PMC6738652 DOI: 10.1371/journal.pone.0222286] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2019] [Accepted: 08/26/2019] [Indexed: 11/19/2022] Open
Abstract
Introduction To evaluate the consequences of bronchopulmonary dysplasia (BPD) on academic outcomes and healthcare use in adolescents born very preterm. Methods This cohort study included 15-year-old adolescents born very preterm (< 32 weeks) between 2011 and 2013, with and without BPD, and controls born full term. Data regarding academic performance, current medical follow-up, and family characteristics were collected. Multivariate logistic regression was used to quantify relationships between academic outcomes and BPD. Results From the 1341 children included in the initial cohort, 985 adolescents were eligible and 351 included (55 preterms with a history of BPD, 249 without, and 47 controls). Among adolescents born very preterm, a history of BPD was associated with a higher risk to attend a school for children with special needs (p < 0.05) and to have repeated a grade (p = 0.01). It was also associated with an increased number of medical and paramedical consultations. A history of BPD was not associated with the parents’ employment status, family structure, or the presence of younger siblings. Conclusion This study highlights that a history of BPD is associated with poorer academic outcomes and high healthcare use in adolescence.
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Affiliation(s)
- David Drummond
- Paediatric Pulmonology, University Hospital Necker-Enfants Malades, AP-HP, Paris, France
- Paris Descartes University, Paris, France
- * E-mail:
| | - Alice Hadchouel
- Paediatric Pulmonology, University Hospital Necker-Enfants Malades, AP-HP, Paris, France
- Paris Descartes University, Paris, France
| | - Heloise Torchin
- Paris Descartes University, Paris, France
- Port Royal Hospital, AP-HP, Paris, France
| | - Jean-Christophe Rozé
- Department of Neonatal Medicine, Nantes University Hospital, Nantes, France
- CIC004, Nantes University Hospital, Nantes, France
| | - Catherine Arnaud
- UMR1027, INSERM, Toulouse, France
- Paul Sabatier University, Toulouse, France
- Clinical Epidemiology Unit, CHU Purpan, Toulouse, France
| | - Adèle Bellino
- Clinical Research Unit Cochin-Necker, AP-HP, Paris, France
| | - Laure Couderc
- Rouen University Hospital, Pediatric Pulmonology and Allergology, Inserm CIC-CRB 1404 Rouen, France
| | - Stéphane Marret
- INSERM U1245, Team 4, Perinatal Neurological Handicap and Brain Protection, IRIB, School of Medicine, Normandy University, Rouen, France and Department of Neonatal Medicine and Neuropediatrics, Rouen University Hospital, Rouen, France
| | - Marie Mittaine
- Paediatric Pulmonology and Allergology Department, CHU Purpan, Toulouse, France
| | - Didier Pinquier
- INSERM U1245, Team 4, Perinatal Neurological Handicap and Brain Protection, IRIB, School of Medicine, Normandy University, Rouen, France and Department of Neonatal Medicine and Neuropediatrics, Rouen University Hospital, Rouen, France
| | | | - Jessica Rousseau
- Obstetrical, Perinatal, and Paediatric Epidemiology Team, Epidemiology and Biostatistics Sorbonne Paris Cité Research Centre (U1153), INSERM, Paris, France
| | - Pierre-Yves Ancel
- Paris Descartes University, Paris, France
- Obstetrical, Perinatal, and Paediatric Epidemiology Team, Epidemiology and Biostatistics Sorbonne Paris Cité Research Centre (U1153), INSERM, Paris, France
- Clinical Research Unit, Centre for Clinical Investigation, P1419 Cochin Broca Hôtel-Dieu, APHP, Paris, France
| | - Christophe Delacourt
- Paediatric Pulmonology, University Hospital Necker-Enfants Malades, AP-HP, Paris, France
- Paris Descartes University, Paris, France
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Gormley JE, Williams DL. Providing Supportive Hospital Environments to Promote the Language Development of Infants and Children Born Prematurely: Insights From Neuroscience. J Pediatr Health Care 2019; 33:520-528. [PMID: 30871967 DOI: 10.1016/j.pedhc.2019.01.007] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2018] [Accepted: 01/22/2019] [Indexed: 11/19/2022]
Abstract
INTRODUCTION Rapid neural development occurs beginning in utero and extending throughout a child's first years of life, shaped by environmental input, which is essential for language learning. If this development is disrupted by premature birth and/or related repeated hospitalizations, atypical language development may result even in the absence of severe neurologic damage. METHOD This narrative review describes typical neurodevelopment associated with language and the atypical neurodevelopment often experienced by children born prematurely that can adversely affect their language development. RESULTS We describe evidence-based intervention strategies applicable in the hospital setting that can support the language development of young children who are born prematurely. DISCUSSION To promote neurodevelopmental growth that will support language learning, children born prematurely need to engage in supportive interactions with others. Awareness of evidence-based strategies can equip health care staff to provide a supportive hospital environment to promote the language development of children born premature.
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Mendonça M, Bilgin A, Wolke D. Association of Preterm Birth and Low Birth Weight With Romantic Partnership, Sexual Intercourse, and Parenthood in Adulthood: A Systematic Review and Meta-analysis. JAMA Netw Open 2019; 2:e196961. [PMID: 31298716 PMCID: PMC6628597 DOI: 10.1001/jamanetworkopen.2019.6961] [Citation(s) in RCA: 45] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
IMPORTANCE Social relationships are important determinants of well-being, health, and quality of life. There are conflicting findings regarding the association between preterm birth or low birth weight and experiences of social relationships in adulthood. OBJECTIVE To systematically investigate the association between preterm birth or low birth weight and social outcomes in adulthood. DATA SOURCES PubMed, PsycINFO, Web of Science, and Embase were searched for peer-reviewed articles published through August 5, 2018. STUDY SELECTION Prospective longitudinal and registry studies reporting on selected social outcomes in adults who were born preterm or with low birth weight (mean sample age ≥18 years) compared with control individuals born at term. DATA EXTRACTION AND SYNTHESIS The meta-analysis followed Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines. The data were collected and extracted by 2 independent reviewers. Pooled analyses were based on odds ratios (ORs) with 95% confidence intervals and Hedges g, which were meta-analyzed using random-effects models. MAIN OUTCOMES AND MEASURES Ever being in a romantic partnership, ever having experienced sexual intercourse, parenthood, quality of romantic relationship, and peer social support. RESULTS Twenty-one studies were included of the 1829 articles screened. Summary data describing a maximum of 4 423 798 adult participants (179 724 preterm or low birth weight) were analyzed. Adults born preterm or with low birth weight were less likely to have ever experienced a romantic partnership (OR, 0.72; 95% CI, 0.64-0.81), to have had sexual intercourse (OR, 0.43; 95% CI, 0.31-0.61), or to have become parents (OR, 0.77; 95% CI, 0.65-0.91) than adults born full-term. A dose-response association according to degree of prematurity was found for romantic partnership and parenthood. Overall, effect sizes did not differ with age and sex. When adults born preterm or with low birth weight were in a romantic partnership or had friends, the quality of these relationships was not poorer compared with adults born full-term. CONCLUSIONS AND RELEVANCE These findings suggest that adults born preterm or with low birth weight are less likely to experience a romantic partnership, sexual intercourse, or to become parents. However, preterm birth or low birth weight does not seem to impair the quality of relationships with partners and friends. Lack of sexual or partner relationships might increase the risk of decreased well-being and poorer physical and mental health.
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Affiliation(s)
- Marina Mendonça
- Department of Psychology, University of Warwick, Coventry, United Kingdom
| | - Ayten Bilgin
- Department of Psychology, University of Warwick, Coventry, United Kingdom
- Psychologische Hochschule Berlin, Berlin, Germany
| | - Dieter Wolke
- Department of Psychology, University of Warwick, Coventry, United Kingdom
- Division of Mental Health and Wellbeing, Warwick Medical School, University of Warwick, Coventry, United Kingdom
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Abstract
Parenting preterm infants is a unique experience distinct from parenting full-term infants, characterized by a delayed transition to parenthood and limited caregiving opportunities. This study explored mothers' and fathers' lived experiences of parenting during infancy in the context of preterm birth. Semistructured qualitative interviews were conducted with 13 parents (6 fathers, 7 mothers) of preterm infants. Data were analyzed using interpretative phenomenological analysis. Four superordinate themes emerged: (a) An unnatural disaster: The traumatic nature of preterm birth, (b) The immediate aftermath: Disconnected and displaced, (c) Breaking the ice: Moving from frozen to melted, and (d) Aftershocks: Transitioning home. Both parents experienced preterm birth as traumatic. Similarities and differences in mothers' and fathers' experiences were identified. Preterm birth posed challenges for nurturant and social caregiving and resulted in anxiety, hypervigilance, and overprotective parenting behavior. The results highlight the need for trauma-informed care and further research developing and testing empirically based interventions.
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Affiliation(s)
| | - Elizabeth Nixon
- School of Psychology, Trinity College Dublin, Dublin, Ireland
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31
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Monteiro TM, Katz L, Bento SF, Amorim MM, Moriel PC, Pacagnella RC. Reasons given by pregnant women for participating in a clinical trial aimed at preventing premature delivery: a qualitative analysis. BMC Pregnancy Childbirth 2019; 19:97. [PMID: 30894167 PMCID: PMC6425624 DOI: 10.1186/s12884-019-2240-8] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2018] [Accepted: 03/06/2019] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND In clinical trials, pregnant women are potentially vulnerable, and the fetus is exposed to the intervention. This study aimed to identify the reasons that led pregnant women at a high risk of premature delivery to participate in a randomized clinical trial. METHODS The women participating in the main trial were contacted by telephone postpartum and invited to answer an open questionnaire in a cross-sectional study. Data were collected by telephone and analyzed using thematic analysis. After the analysis categories were defined, all the answers were reviewed, categorized and grouped. A descriptive summary of the content of each category was then made. RESULTS Overall, 208 women from different geographical regions of the country agreed to participate. Four categories were identified: 1) The risk of losing the baby; 2) A previous experience of premature delivery; 3) The role of the doctor and other health professionals, and 4) The availability of quality medical care and free medication. The main reason given for agreeing to participate was to reduce the risks associated with the baby being born prematurely, particularly when the woman herself or someone close to her had already experienced premature delivery. Other reasons were having received clear guidance and explanations from the doctor regarding prematurity and about the study and being given the opportunity to receive free treatment with greater access to the public healthcare system. CONCLUSIONS The decision to participate in a clinical trial is not easy, particularly when the individual is vulnerable and in a critical situation as in the case of a pregnant woman at a high risk of delivering prematurely. Fears and uncertainties regarding the pregnancy outcome, as well as the woman's previous experiences and her awareness of the actual risks she faces will affect her decision regarding whether or not to participate. Recruitment challenges could be overcome by ensuring that the research team provides adequate information and support, thus creating a bond with participants that would foster a sense of safety and trust in the study proposals.
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Affiliation(s)
- Thaís M. Monteiro
- Instituto de Medicina Integral Prof. Fernando Figueira (IMIP), Recife, Pernambuco Brazil
| | - Leila Katz
- Instituto de Medicina Integral Prof. Fernando Figueira (IMIP), Recife, Pernambuco Brazil
| | - Silvana F. Bento
- Prof. Dr. José A Pinotti Women’s Hospital, Center of Integral Services for the Health of Women (CAISM), University of Campinas (UNICAMP), Campinas, SP Brazil
| | - Melania M. Amorim
- Instituto de Medicina Integral Prof. Fernando Figueira (IMIP), Recife, Pernambuco Brazil
| | - Patrícia C. Moriel
- Instituto de Medicina Integral Prof. Fernando Figueira (IMIP), Recife, Pernambuco Brazil
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Abstract
Children born preterm (PT) have a higher risk of language delays than children born full-term (FT). Expressive vocabulary plays a central role in language development, as later grammar ability can be predicted from earlier vocabulary size.To determine the effects of preterm birth on expressive vocabulary at the age of 36 to 41 months.Cross-sectional study of 27 PT (children with a gestational age of ≤ 32 + 0 weeks and/or a birth weight ≤ 1500 g) and 26 FT children (from several kindergartens in Vienna, Austria). The groups were matched regarding age, sex, and monolingual Austrian German speech. They were all examined using the active vocabulary test (AWST-R) and the development test, Bayley Scales of Infant and Toddler Development, Third Edition (Bayley-III).The AWST-R revealed significantly lower scores (46% vs 52%, P = .027) for PT children. The Bayley-III revealed significantly lower scores in language development (mean 96.3 ± 11.81 vs 105.1 ± 6.24, P = .002) and the expressive communication subscale (8.78 ± 2.01 vs 10.69 ± 1.49, P < .001) for PT children, but no differences in cognitive development (98.5 ± 11.08 vs 100.8 ± 6.43, P = .369) or on the receptive communication subscale (10.15 ± 2.23 vs 11.08 ± 1.09, P = .060).Preterm children tested had less expressive vocabulary (AWST-R and Bayley-III) than those born full-term, while test results in their cognitive development and receptive communication (Bayley-III) did not differ.
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Affiliation(s)
- Nina Brósch-Fohraheim
- Department of Paediatrics and Adolescent Medicine, Wilhelminenspital Vienna
- Research Unit for Neonatal Infectious Diseases and Epidemiology, Medical University of Graz
| | - Renate Fuiko
- Department of Pediatrics and Adolescent Medicine, Division of Neonatology, Pediatric Intensive Care and Neuropediatrics, Medical University of Vienna, Vienna
| | - Peter B. Marschik
- iDN – interdisciplinary Developmental Neuroscience, Department of Phoniatrics, Medical University of Graz
- Department of Child and Adolescent Psychiatry and Psychotherapy, iDN – interdisciplinary Developmental Neuroscience, University Medical Center of Goettingen, Goettingen, Germany
- Center of Neurodevelopmental Disorders (KIND), Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden
| | - Bernhard Resch
- Research Unit for Neonatal Infectious Diseases and Epidemiology, Medical University of Graz
- Division of Neonatology, Department of Paediatrics and Adolescent Medicine, Medical University of Graz, Graz, Austria
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Bidzan M, Lutkiewicz K. Perceived Stress as a Predictor of Partnership Relation Quality in Polish Mothers of Preterm-Born Children. Int J Environ Res Public Health 2019; 16:ijerph16030355. [PMID: 30691188 PMCID: PMC6388279 DOI: 10.3390/ijerph16030355] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/25/2018] [Revised: 01/14/2019] [Accepted: 01/17/2019] [Indexed: 11/16/2022]
Abstract
The aim of the study was to identify whether perceived stress and significant life changes are related with partnership relation quality in mothers of preterm-born children. The study group consisted of 260 women, who gave a preterm birth. In most cases the delivery took place in the 34⁻36th week of pregnancy. The research consisted of two phases. Phase 1 was carried out in the Department of Obstetrics at the Medical University of Gdansk in the neonatal period (2⁻3 days after birth). Phase 2 was carried out in the place of residence of the mother and child during early childhood (24⁻30th month of the child's life). The following research tools were used in the first phase of the research project: Analysis of nursing and medical reports, an interview questionnaire and psychological interview, The Perceived Stress Questionnaire (PSQ) (Lavenstein, the Polish version, after Plopa, 2008), The Recent Life Changes Questionnaire (RLCQ) (Rahe and Holmes, 1975), the Polish version, after Terelak 1995), and the Dyadic Adjustment Scale (DAS) (Spanier, 1976, the Polish version, after Cieślak, 1989). In the second phase of the study the respondents were once again examined using the DAS. It was shown that stress is related to partnership relationship quality and of all its components, except cohesion. The findings demonstrated that important life events are associated with a couple's emotional expression in the neonatal period. Stressful life events do not correlate with relationship quality.
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Affiliation(s)
- Mariola Bidzan
- Institute of Psychology, University of Gdansk, Bażyńskiego 4, 80-309 Gdansk, Poland.
| | - Karolina Lutkiewicz
- Institute of Psychology, University of Gdansk, Bażyńskiego 4, 80-309 Gdansk, Poland.
- The Toronto Institute for Relational Psychotherapy, Toronto, ON M4T 1K2, Canada.
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Abstract
OBJECTIVE To investigate the relationship between depressive symptoms and preterm birth (PTB) while adjusting for social support, both general and from the father of the baby. DESIGN Retrospective study design. SETTING Participants of the Life-course Influences of Fetal Environments (LIFE) study were recruited from a suburban hospital in Metropolitan Detroit, Michigan. PARTICIPANTS The LIFE data consisted of 1,410 self-identified Black women age 18 to 45 years; 1,207 women were included in this analysis. METHODS Women were interviewed using a structured questionnaire administered 24 to 48 hours after birth during their postpartum hospitalization. Data on the newborns and their mothers' health were collected through medical record abstraction. The Center for Epidemiologic Studies Depression Scale (CES-D) was used to measure symptoms of depression. The CES-D scores ≥23 were considered severe symptoms of depression. Modified Poisson regression models were built using a stepwise approach to assess association between symptoms of depression and PTB. RESULTS Approximately, 17% of women had a PTB and 20% of women in the sample had a CES-D scores ≥23. Women who had CES-D score ≥23 were about 70% more likely to have a PTB compared with women with CES-D scores <23 (PR = 1.68, 95% CI: 1.24-2.16) after adjustment for both general social support and father of the baby support. CONCLUSION Women with CES-D scores ≥23 were almost twice more likely to have PTB compared with women with CES-D scores <23. Referrals for mental healthcare providers might benefit women with symptoms of depression and improve birth outcomes. Nurses should encourage women to seek support beyond the father of the baby.
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Affiliation(s)
- Jerry John Nutor
- Jerry John Nutor is a Student, College of Nursing and Health Professions, Drexel University, Philadelphia, PA. The author can be reached via e-mail at Jaime C. Slaughter-Acey is an Assistant Professor, College of Nursing and Health Professions, Drexel University, Philadelphia, PA. Carmen Giurgescu is an Associate Professor, College of Nursing, The Ohio State University, Columbus, OH. Dawn P. Misra is a Professor and Associate Chair of Research, Department of Family Medicine and Public Health Sciences, Wayne State University, Detroit, MI
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Abstract
Background Antenatal anxiety may have long-term negative effects on pregnancy outcome. Antenatal anxiety can also be detrimental to maternal health during pregnancy. Therefore, this study aimed to determine the association between pregnancy-specific anxiety and preterm birth in pregnant women. Methods This prospective cohort study was conducted on 208 pregnant women who were referred to the prenatal clinic of Al-Zahra hospital in Rasht. Sampling was conducted through convenient (simple) method. Data gathering tools were a demographic characteristics questionnaire and pregnancy-specific anxiety scale. The data were analyzed using SPSS version 19. General Linear Model (GLM)-Repeated Measures test were used to study variations in anxiety along pregnancy period and tested levels of significance among inter-trimester anxiety scores. Results Results of the study showed that change in pregnancy-specific anxiety is significantly associated with preterm birth among participants in this study. Second trimester pregnancy-specific anxiety was not associated with preterm birth, but third trimester pregnancy-specific anxiety was associated with preterm birth. Conclusion According to the results of this study, third trimester pregnancy-specific anxiety was associated with preterm birth. Therefore, the health care providers should pay special attention to pregnancy-specific anxiety.
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Affiliation(s)
| | - Mahshid Bokaie
- Research Center for Nursing and Midwifery Care, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
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Baron R, Te Velde SJ, Heymans MW, Klomp T, Hutton EK, Brug J. The Relationships of Health Behaviour and Psychological Characteristics with Spontaneous Preterm Birth in Nulliparous Women. Matern Child Health J 2018; 21:873-882. [PMID: 27581004 PMCID: PMC5378731 DOI: 10.1007/s10995-016-2160-4] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Objectives Preterm birth is the leading pregnancy outcome associated with perinatal morbidity and mortality and remains difficult to prevent. There is evidence that some modifiable maternal health characteristics may influence the risk of preterm birth. Our aim was to investigate the relationships of self-reported maternal health behaviour and psychological characteristics in nulliparous women with spontaneous preterm birth in prenatal primary care. Methods The data of our prospective study was obtained from the nationwide DELIVER multicentre cohort study (September 2009–March 2011), which was designed to examine perinatal primary care in the Netherlands. In our study, consisting of 2768 nulliparous women, we estimated the relationships of various self-reported health behaviours (smoking, alcohol consumption, folic acid supplementation, daily fruit, daily fresh vegetables, daily hot meal and daily breakfast consumption) and psychological characteristics (anxious/depressed mood and health control beliefs) with spontaneous preterm birth as a dichotomous outcome. Due to the clustering of clients within midwife practices, Generalized Estimating Equations was used for these analyses. Results Low health control beliefs was the sole characteristic significantly associated with spontaneous preterm birth (odds ratio 2.26; 95 % confidence interval 1.51, 3.39) after being adjusted for socio-demographics, anthropometrics and the remaining health behaviour and psychological characteristics. The other characteristics were not significantly associated with spontaneous preterm birth. Conclusions for Practice Maternal low health control beliefs need to be explored further as a possible marker for women at risk for preterm birth, and as a potentially modifiable characteristic to be used in interventions which are designed to reduce the risk of spontaneous preterm birth.
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Affiliation(s)
- Ruth Baron
- Department of Midwifery Science, Midwifery Academy Amsterdam Groningen (AVAG) and the EMGO Institute for Health and Care Research, VU University Medical Centre, P.O. Box 7057, 1007 MB, Amsterdam, The Netherlands.
| | - Saskia J Te Velde
- Department of Epidemiology and Biostatistics and the EMGO Institute for Health and Care Research, VU University Medical Centre, P.O. Box 7057, 1007 MB, Amsterdam, The Netherlands
| | - Martijn W Heymans
- Department of Epidemiology and Biostatistics and the EMGO Institute for Health and Care Research, VU University Medical Centre, P.O. Box 7057, 1007 MB, Amsterdam, The Netherlands
- Department of Methodology and Applied Biostatistics, Faculty of Earth and Life Sciences, VU University Amsterdam, De Boelelaan 1085, 1081 HV, Amsterdam, The Netherlands
| | - Trudy Klomp
- Department of Midwifery Science, Midwifery Academy Amsterdam Groningen (AVAG) and the EMGO Institute for Health and Care Research, VU University Medical Centre, P.O. Box 7057, 1007 MB, Amsterdam, The Netherlands
| | - Eileen K Hutton
- Department of Midwifery Science, Midwifery Academy Amsterdam Groningen (AVAG) and the EMGO Institute for Health and Care Research, VU University Medical Centre, P.O. Box 7057, 1007 MB, Amsterdam, The Netherlands
- Department of Obstetrics and Gynecology, McMaster University, 1280 Main Street West, MDCL 2210, Hamilton, ON, L8S 4K1, Canada
| | - Johannes Brug
- Department of Epidemiology and Biostatistics and the EMGO Institute for Health and Care Research, VU University Medical Centre, P.O. Box 7057, 1007 MB, Amsterdam, The Netherlands
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Mahurin-Smith J, DeThorne LS, Petrill SA. Longitudinal Associations Across Prematurity, Attention, and Language in School-Age Children. J Speech Lang Hear Res 2017; 60:3601-3608. [PMID: 29204607 PMCID: PMC6111521 DOI: 10.1044/2017_jslhr-l-17-0015] [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] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/13/2017] [Revised: 06/01/2017] [Accepted: 08/03/2017] [Indexed: 05/12/2023]
Abstract
Purpose This research note explores the potential role of attention in mediating previously reported associations between language outcomes and prematurity. Method As a follow-up investigation to Mahurin Smith, DeThorne, Logan, Channell, and Petrill (2014), we employed multilevel modeling to analyze longitudinal data on language and attention collected when children were, on average, ages of 7, 8, and 10 years. The sample of 114 children taken from the Western Reserve Reading and Math Project was selected to oversample children with a history of prematurity while also controlling for differences in confounding influences such as age, gender, parental education, and race. Results As predicted, attention differentially predicted language outcomes based on form of measurement. Specifically, parent and examiner ratings of attention were significantly associated with standardized test performance at all 3 time points (R2 = 15.2%-20%). Associations between attention and language sample measures were less consistent across home visits and tended to be smaller in effect size. Conclusion Attention abilities are associated with children's language performance even in the absence of an attention-deficit/hyperactivity disorder diagnosis. Clinical implications, particularly as related to assessment, are discussed.
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Affiliation(s)
- Jamie Mahurin-Smith
- Department of Communication Sciences and Disorders, Illinois State University, Normal
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Ncube CN, Enquobahrie DA, Gavin AR. Racial Differences in the Association Between Maternal Antenatal Depression and Preterm Birth Risk: A Prospective Cohort Study. J Womens Health (Larchmt) 2017; 26:1312-1318. [PMID: 28622475 PMCID: PMC5733649 DOI: 10.1089/jwh.2016.6198] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [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] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND In the United States, racial/ethnic disparities in preterm birth (PTB) are well documented, but explanations for why the disparity persists remain to be fully explored. We examined racial/ethnic differences in the association of maternal antenatal depression with PTB (<37 completed weeks of gestation) risk. METHODS In a prospective cohort study, participants (n = 2073) included non-Hispanic (NH) black, NH white, Asian, and Hispanic women who received prenatal care at a university obstetric clinic January 2004-March 2010, and delivered at the university's hospital. We obtained data from self-reported questionnaires and electronic medical records. We assessed antenatal depression using the Patient Health Questionnaire-9 and self-reported antenatal antidepressant medication use. Poisson regression models were used to estimate the association between antenatal depression and PTB risk, within strata of race/ethnicity. RESULTS NH black (risk ratio [RR] = 1.89; 95% confidence interval [CI]: 0.94, 3.80), NH white (RR = 1.58, 95% CI: 1.04, 2.39), and Asian (RR = 2.06; 95% CI: 0.69, 6.13) women with antenatal depression were at increased risk for delivering preterm infants, compared with women without antenatal depression, although the associations were statistically significant only among NH white women. There was no evidence of an association between antenatal depression and risk of PTB among Hispanic women (RR = 0.96; 95% CI: 0.28, 3.25); p-value for interaction = 0.81. CONCLUSION Our findings suggest race-specific associations of antenatal depression with an increased risk of delivering a preterm infant, supporting the importance of considering race/ethnicity when examining risk factors for health outcomes.
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Affiliation(s)
- Collette N. Ncube
- Department of Epidemiology, School of Public Health, University of Washington, Seattle, Washington
| | - Daniel A. Enquobahrie
- Department of Epidemiology, School of Public Health, University of Washington, Seattle, Washington
| | - Amelia R. Gavin
- School of Social Work, University of Washington, Seattle, Washington
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Urech C, Scherer S, Emmenegger M, Gaab J, Tschudin S, Hoesli I, Berger T, Alder J. Efficacy of an internet-based cognitive behavioral stress management training in women with idiopathic preterm labor: A randomized controlled intervention study. J Psychosom Res 2017; 103:140-146. [PMID: 29167041 DOI: 10.1016/j.jpsychores.2017.10.014] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [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: 07/02/2017] [Revised: 09/29/2017] [Accepted: 10/25/2017] [Indexed: 12/20/2022]
Abstract
OBJECTIVE This randomized controlled trial aimed at evaluating the efficacy of an internet-based cognitive behavioral stress management program (IB-CBSM) for pregnant women with preterm labor (PTL) on birth outcome and stress-related psychological and biological parameters. METHODS 93 pregnant women with PTL (gestational age 18-32) were assigned to either the IB-CBSM (n=50) or a control group (CG) based on distraction (n=43). Participants in both groups worked through six weekly modules. Birth outcome measures included gestational age, neonatal weight and length at birth and the rate of preterm birth (PTB). Questionnaires assessed psychological wellbeing and the activity of the HPA-axis was measured with the cortisol awakening reaction (CAR), both before (T1) and after the intervention (T2). RESULTS Birth outcome and psychological wellbeing did not differ between IB-CBSM and CG. However, psychological wellbeing was higher after both interventions (PSS: ηp2=0.455, STAIX1: ηp2=0.455, STAIX2: ηp2=0.936, PRAT: ηp2=0.465, EPDS: ηp2=0.856). Cortisol levels were stable and did not alter differently between groups from T1 to T2. Higher cortisol levels were associated with lower gestational age at birth, whereas no significant correlations were found between weight and length at birth. CONCLUSIONS Although there were no significant differences between the two groups and birth outcome, psychological and biological parameters, both interventions (CBSM and CG) showed equivalent effects and proved to be beneficial with regard to psychosocial distress and well-being. Further research is needed to investigate CBSM and distraction interventions for pregnant women at risk for PTB together with a non-intervention control condition.
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Affiliation(s)
- Corinne Urech
- Clinic of Obstetrics and Gynecology, University Hospital Basel, Switzerland.
| | - Sandra Scherer
- Clinic of Obstetrics and Gynecology, University Hospital Basel, Switzerland
| | - Martina Emmenegger
- Clinical Psychology and Psychotherapy, Faculty of Psychology, University of Basel, Switzerland
| | - Jens Gaab
- Clinical Psychology and Psychotherapy, Faculty of Psychology, University of Basel, Switzerland
| | - Sibil Tschudin
- Clinic of Obstetrics and Gynecology, University Hospital Basel, Switzerland
| | - Irène Hoesli
- Clinic of Obstetrics and Gynecology, University Hospital Basel, Switzerland
| | - Thomas Berger
- Clinical Psychology and Psychotherapy, Department of Psychology, University of Bern, Switzerland
| | - Judith Alder
- Clinical Psychology and Psychotherapy, Faculty of Psychology, University of Basel, Switzerland
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Rommel AS, James SN, McLoughlin G, Brandeis D, Banaschewski T, Asherson P, Kuntsi J. Altered EEG spectral power during rest and cognitive performance: a comparison of preterm-born adolescents to adolescents with ADHD. Eur Child Adolesc Psychiatry 2017; 26:1511-1522. [PMID: 28577262 PMCID: PMC5600884 DOI: 10.1007/s00787-017-1010-2] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [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: 12/10/2016] [Accepted: 05/26/2017] [Indexed: 12/03/2022]
Abstract
Preterm birth has been associated with an increased risk for ADHD-like behavioural symptoms and cognitive impairments. However, direct comparisons across ADHD and preterm-born samples on neurophysiological measures are limited. The aim of this analysis was to test whether quantitative EEG (QEEG) measures identify differences or similarities in preterm-born adolescents, compared to term-born adolescents with and without ADHD, during resting-state and cognitive task conditions. We directly compared QEEG activity between 186 preterm-born adolescents, 69 term-born adolescents with ADHD and 135 term-born control adolescents during an eyes-open resting-state condition (EO), which previously discriminated between the adolescents with ADHD and controls, and during a cued continuous performance task (CPT-OX). Absolute delta power was the only frequency range to demonstrate a significant group-by-condition interaction. The preterm group, like the ADHD group, displayed significantly higher delta power during EO, compared to the control group. In line with these findings, parent-rated ADHD symptoms in the preterm group were significantly correlated with delta power during rest. While the preterm and control groups did not differ with regard to absolute delta power during CPT-OX, the ADHD group showed significantly higher absolute delta power compared to both groups. Our results provide evidence for overlapping excess in the absolute delta range in preterm-born adolescents and term-born adolescents with ADHD during rest. During CPT-OX, preterm-born adolescents resembled controls. Increased delta power during rest may be a potential general marker of brain trauma, pathology or neurotransmitter disturbances.
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Affiliation(s)
- Anna-Sophie Rommel
- MRC Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, DeCrespigny Park, London, SE5 8AF, UK
| | - Sarah-Naomi James
- MRC Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, DeCrespigny Park, London, SE5 8AF, UK
- Medical Research Council Unit for Lifelong Health and Ageing at University College London, London, UK
| | - Gráinne McLoughlin
- MRC Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, DeCrespigny Park, London, SE5 8AF, UK
| | - Daniel Brandeis
- Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim/Heidelberg University, Mannheim, Germany
- Department of Child and Adolescent Psychiatry and Psychotherapy, Psychiatric Hospital, University of Zurich, Zurich, Switzerland
- Center for Integrative Human Physiology, University of Zurich, Zurich, Switzerland
- Neuroscience Center Zurich, University of Zurich, Zurich, Switzerland
| | - Tobias Banaschewski
- Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim/Heidelberg University, Mannheim, Germany
| | - Philip Asherson
- MRC Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, DeCrespigny Park, London, SE5 8AF, UK
| | - Jonna Kuntsi
- MRC Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, DeCrespigny Park, London, SE5 8AF, UK.
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Nusinovici S, Olliac B, Flamant C, Müller JB, Olivier M, Rouger V, Gascoin G, Basset H, Bouvard C, Rozé JC, Hanf M. Impact of preterm birth on parental separation: a French population-based longitudinal study. BMJ Open 2017; 7:e017845. [PMID: 29150469 PMCID: PMC5701975 DOI: 10.1136/bmjopen-2017-017845] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [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] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVE The objective of this study was to investigate both the effects of low gestational age and infant's neurodevelopmental outcome at 2 years of age on the risk of parental separation within 7 years of giving birth. DESIGN Prospective. SETTING 24 maternity clinics in the Pays-de-la-Loire region. PARTICIPANTS This study included 5732 infants delivered at <35 weeks of gestation born between 2005 and 2013 who were enrolled in the population-based Loire Infant Follow-up Team cohort and who had a neurodevelopmental evaluation at 2 years. This neurodevelopmental evaluation was based on a physical examination, a psychomotor evaluation and a parent-completed questionnaire. OUTCOME MEASURE Risk of parental separation (parents living together or parents living separately). RESULTS Ten percent (572/5732) of the parents reported having undergone separation during the follow-up period. A mediation analysis showed that low gestational age had no direct effect on the risk of parental separation. Moreover, a non-optimal neurodevelopment at 2 years was associated with an increased risk of parental separation corresponding to a HR=1.49(1.23 to 1.80). Finally, the increased risk of parental separation was aggravated by low socioeconomic conditions. CONCLUSIONS The effect of low gestational age on the risk of parental separation was mediated by the infant's neurodevelopment.
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Affiliation(s)
- Simon Nusinovici
- INSERM, Clinical Investigation Center, Nantes University Hospital, Nantes, France
| | - Bertrand Olliac
- Department of Child and Adolescent Psychiatry, Centre Hospitalier Esquirol, Limoges, Limousin, France
- Tropical Neuroepidemiology, National Institute of Health and Medical Research, Limoges, Limousin, France
| | - Cyril Flamant
- INSERM, Clinical Investigation Center, Nantes University Hospital, Nantes, France
- Department of Neonatalogy, Nantes University Hospital, Nantes, France
| | | | - Marion Olivier
- Réseau “Grandir Ensemble”, Nantes University Hospital, Nantes, France
| | - Valérie Rouger
- Réseau “Grandir Ensemble”, Nantes University Hospital, Nantes, France
| | - Géraldine Gascoin
- Department of Neonatal Medicine, Angers University Hospital, Angers, France
| | - Hélène Basset
- Department of Neonatal Medicine, Le Mans Hospital, Le Mans, France
| | - Charlotte Bouvard
- SOS Prema (Parents of French Preterm Children Organization), Rue du Chemin Vert, Boulogne-Billancourt, France
| | - Jean-Christophe Rozé
- INSERM, Clinical Investigation Center, Nantes University Hospital, Nantes, France
- Department of Neonatalogy, Nantes University Hospital, Nantes, France
- Réseau “Grandir Ensemble”, Nantes University Hospital, Nantes, France
| | - Matthieu Hanf
- INSERM, Clinical Investigation Center, Nantes University Hospital, Nantes, France
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Abstract
BACKGROUND Globally, prematurity is the leading cause of death in children under the age of 5. Many efforts have focused on clinical approaches to improve the survival of premature babies. There is a need, however, to explore psychosocial, sociocultural, economic, and other factors as potential mechanisms to reduce the burden of prematurity. Women's empowerment may be a catalyst for moving the needle in this direction. The goal of this paper is to examine links between women's empowerment and prematurity in developing settings. We propose a conceptual model that shows pathways by which women's empowerment can affect prematurity and review and summarize the literature supporting the relationships we posit. We also suggest future directions for research on women's empowerment and prematurity. METHODS The key words we used for empowerment in the search were "empowerment," "women's status," "autonomy," and "decision-making," and for prematurity we used "preterm," "premature," and "prematurity." We did not use date, language, and regional restrictions. The search was done in PubMed, Population Information Online (POPLINE), and Web of Science. We selected intervening factors-factors that could potentially mediate the relationship between empowerment and prematurity-based on reviews of the risk factors and interventions to address prematurity and the determinants of those factors. RESULTS There is limited evidence supporting a direct link between women's empowerment and prematurity. However, there is evidence linking several dimensions of empowerment to factors known to be associated with prematurity and outcomes for premature babies. Our review of the literature shows that women's empowerment may reduce prematurity by (1) preventing early marriage and promoting family planning, which will delay age at first pregnancy and increase interpregnancy intervals; (2) improving women's nutritional status; (3) reducing domestic violence and other stressors to improve psychological health; and (4) improving access to and receipt of recommended health services during pregnancy and delivery to help prevent prematurity and improve survival of premature babies. CONCLUSIONS Women's empowerment is an important distal factor that affects prematurity through several intervening factors. Improving women's empowerment will help prevent prematurity and improve survival of preterm babies. Research to empirically show the links between women's empowerment and prematurity is however needed.
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Affiliation(s)
- Patience A. Afulani
- Preterm Birth Initiative, University of California, San Francisco (UCSF), San Francisco, CA USA
- UCSF School of Medicine, San Francisco, CA USA
| | - Molly Altman
- Preterm Birth Initiative, University of California, San Francisco (UCSF), San Francisco, CA USA
- UCSF School of Nursing, San Francisco, CA USA
| | - Joseph Musana
- Preterm Birth Initiative, University of California, San Francisco (UCSF), San Francisco, CA USA
- UCSF School of Medicine, San Francisco, CA USA
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Hall RAS, Hoffenkamp HN, Braeken J, Tooten A, Vingerhoets AJJM, van Bakel HJA. Maternal psychological distress after preterm birth: Disruptive or adaptive? Infant Behav Dev 2017; 49:272-280. [PMID: 29073522 DOI: 10.1016/j.infbeh.2017.09.012] [Citation(s) in RCA: 7] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2017] [Revised: 09/19/2017] [Accepted: 09/19/2017] [Indexed: 11/18/2022]
Abstract
BACKGROUND Maternal postpartum distress is often construed as a marker of vulnerability to poor parenting. Less is known, however, about the impact of postpartum distress on parenting an infant born prematurely. The present study investigated whether high distress levels, which are particularly prevalent in mothers of preterm born infants, necessarily affect a mother's quality of parenting. METHOD Latent Class Analysis was used to group mothers (N=197) of term, moderately, and very preterm born infants, based on their levels of distress (depression, anxiety, and PTSD symptoms) at one month postpartum, and their quality of parenting at one and six months postpartum. Parenting quality was assessed on the basis of maternal interactive behaviors (sensitivity, intrusiveness, and withdrawal) using observations, and maternal attachment representations (balanced, disengaged, or distorted) using interviews. RESULTS A 5-Class model yielded the best fit to the data. The first Class (47%) of mothers was characterized by low distress levels and high-quality parenting, the second Class (20%) by low distress levels and low-quality parenting, the third Class (22%) by high distress levels and medium-quality parenting, the fourth Class (9%) by high distress levels and high-quality parenting, and finally the fifth Class (2%) by extremely high levels of distress and low-quality parenting. CONCLUSIONS While heightened distress levels seem inherent to preterm birth, there appears to be substantial heterogeneity in mothers' emotional responsivity. This study indicates that relatively high levels of distress after preterm birth do not necessarily place these mothers at increased risk with regard to poor parenting. Conversely, low distress levels do not necessarily indicate good-quality parenting. The results of the present study prompt a reconsideration of the association between postpartum distress and parenting quality, and challenge the notion that high levels of maternal distress always result in low-quality parenting practices.
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Affiliation(s)
- Ruby A S Hall
- Department of Tranzo, Scientific Center for Care and Welfare, Tilburg University, The Netherlands.
| | - Hannah N Hoffenkamp
- International Victimology Institute Tilburg, Tilburg University, The Netherlands.
| | - Johan Braeken
- Centre for Educational Measurement, University of Oslo, Norway.
| | - Anneke Tooten
- International Victimology Institute Tilburg, Tilburg University, The Netherlands.
| | - Ad J J M Vingerhoets
- Department of Medical and Clinical Psychology, Tilburg University, The Netherlands.
| | - Hedwig J A van Bakel
- Department of Tranzo, Scientific Center for Care and Welfare, Tilburg University, The Netherlands; Virenze: Centre for Infant Mental Health, The Netherlands; Herlaarhof: Centre for Child and Adolescent Psychiatry, The Netherlands.
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Gatta M, Miscioscia M, Svanellini L, Peraro C, Simonelli A. A Psychological Perspective on Preterm Children: The Influence of Contextual Factors on Quality of Family Interactions. Biomed Res Int 2017; 2017:9152627. [PMID: 29159182 PMCID: PMC5660765 DOI: 10.1155/2017/9152627] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/16/2017] [Revised: 08/14/2017] [Accepted: 08/21/2017] [Indexed: 11/29/2022]
Abstract
Preterm birth has a critical influence on interactive, communicative, and expressive child behaviour, particularly during the first years of life. Few studies have stressed the assessment of mother-father-child interaction in families with preterm children, generating contradictory results. The present study wished to develop these fields: (i) comparing the quality of family interactions between families with preterm children and families with children born at full term; (ii) observing the development of family interactions after six months in the families with children born preterm; (iii) assessing family and contextual factors, as parental stress and social support, in parents of preterm children in order to observe their influence on the quality of family interactions. 78 families are recruited: 39 families with preterm children (M = 19,8 months, SD = 11,05) and 39 families with full-term children (M = 19,66 months; SD = 13,10). Results show that families with preterm children display a low quality of mother-father-child interactions. After six months, family interactions result is generally stable, except for some LTP-scales reflecting a hard adjustment of parenting style to the evolution of the child. In families with preterm children, the parenting stress seemed to be correlated with the quality of mother-father-child interactions.
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Affiliation(s)
- Michela Gatta
- Childhood Adolescence Family Unit, ULSS6 Veneto, Padua, Italy
- Department of Women's and Children's Health, Padua University, Padua, Italy
| | - Marina Miscioscia
- Department of Women's and Children's Health, Padua University, Padua, Italy
- Department of Developmental and Social Psychology, Padua University, Padua, Italy
| | - Lorenza Svanellini
- Department of Women's and Children's Health, Padua University, Padua, Italy
| | - Chiara Peraro
- Department of Developmental and Social Psychology, Padua University, Padua, Italy
| | - Alessandra Simonelli
- Department of Developmental and Social Psychology, Padua University, Padua, Italy
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Levine TA, Grunau RE, Segurado R, Daly S, Geary MP, Kennelly MM, O’Donoghue K, Hunter A, Morrison JJ, Burke G, Dicker P, Tully EC, Malone FD, Alderdice FA, McAuliffe FM. Pregnancy-specific stress, fetoplacental haemodynamics, and neonatal outcomes in women with small for gestational age pregnancies: a secondary analysis of the multicentre Prospective Observational Trial to Optimise Paediatric Health in Intrauterine Growth Restriction. BMJ Open 2017; 7:e015326. [PMID: 28637734 PMCID: PMC5734406 DOI: 10.1136/bmjopen-2016-015326] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2016] [Revised: 03/12/2017] [Accepted: 04/24/2017] [Indexed: 02/07/2023] Open
Abstract
OBJECTIVES To examine associations between maternal pregnancy-specific stress and umbilical (UA PI) and middle cerebral artery pulsatility indices (MCA PI), cerebroplacental ratio, absent end diastolic flow (AEDF), birthweight, prematurity, neonatal intensive care unit admission and adverse obstetric outcomes in women with small for gestational age pregnancies. It was hypothesised that maternal pregnancy-specific stress would be associated with fetoplacental haemodynamics and neonatal outcomes. DESIGN This is a secondary analysis of data collected for a large-scale prospective observational study. SETTING This study was conducted in the seven major obstetric hospitals in Ireland and Northern Ireland. PARTICIPANTS Participants included 331 women who participated in the Prospective Observational Trial to Optimise Paediatric Health in Intrauterine Growth Restriction. Women with singleton pregnancies between 24 and 36 weeks gestation, estimated fetal weight <10th percentile and no major structural or chromosomal abnormalities were included. PRIMARY AND SECONDARY OUTCOME MEASURES Serial Doppler ultrasound examinations of the umbilical and middle cerebral arteries between 20 and 42 weeks gestation, Pregnancy Distress Questionnaire (PDQ) scores between 23 and 40 weeks gestation and neonatal outcomes. RESULTS Concerns about physical symptoms and body image at 35-40 weeks were associated with lower odds of abnormal UAPI (OR 0.826, 95% CI 0.696 to 0.979, p=0.028). PDQ score (OR 1.073, 95% CI 1.012 to 1.137, p=0.017), concerns about birth and the baby (OR 1.143, 95% CI 1.037 to 1.260, p=0.007) and concerns about physical symptoms and body image (OR 1.283, 95% CI 1.070 to 1.538, p=0.007) at 29-34 weeks were associated with higher odds of abnormal MCA PI. Concerns about birth and the baby at 29-34 weeks (OR 1.202, 95% CI 1.018 to 1.421, p=0.030) were associated with higher odds of AEDF. Concerns about physical symptoms and body image at 35-40 weeks were associated with decreased odds of neonatal intensive care unit admission (OR 0.635, 95% CI 0.435 to 0.927, p=0.019). CONCLUSIONS These findings suggest that fetoplacental haemodynamics may be a mechanistic link between maternal prenatal stress and fetal and neonatal well-being, but additional research is required.
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Affiliation(s)
- Terri A Levine
- School of Nursing and Midwifery, Queen’s University Belfast, Belfast, Northern Ireland
- Newborn Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - Ruth E Grunau
- Department of Pediatrics, University of British Columbia, Vancouver, British Columbia, Canada
- Child and Family Research Institute, Vancouver, British Columbia, Canada
| | - Ricardo Segurado
- UCD CSTAR and School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin, Ireland
| | - Sean Daly
- Department of Obstetrics and Gynaecology, Coombe Women and Infants University Hospital, Dublin, Ireland
| | - Michael P Geary
- Department of Obstetrics and Gynaecology, Rotunda Hospital, Dublin, Ireland
| | - Mairead M Kennelly
- University College Dublin Centre for Human Reproduction, Coombe Women and Infants University Hospital, Dublin, Ireland
| | - Keelin O’Donoghue
- Department of Obstetrics and Gynaecology, University College Cork, Cork University Maternity Hospital, Cork, Ireland
| | - Alyson Hunter
- Department of Obstetrics and Gynaecology, Royal Jubilee Maternity Hospital, Belfast, Northern Ireland
| | - John J Morrison
- Department of Obstetrics and Gynaecology, National University of Ireland, Galway, Ireland
| | - Gerard Burke
- Department of Obstetrics and Gynaecology, Mid-Western Regional Maternity Hospital, Limerick, Ireland
| | - Patrick Dicker
- Department of Epidemiology and Public Health, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Elizabeth C Tully
- Department of Obstetrics and Gynaecology, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Fergal D Malone
- Department of Obstetrics and Gynaecology, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Fiona A Alderdice
- School of Nursing and Midwifery, Queen’s University Belfast, Belfast, Northern Ireland
- National Perinatal Epidemiology Unit, Oxford University, Oxford, UK
| | - Fionnuala M McAuliffe
- UCD Perinatal Research Centre, Obstetrics and Gynaecology, School of Medicine, University College Dublin, National Maternity Hospital, Dublin, Ireland
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Giurgescu C, Slaughter-Acey JC, Templin TN, Misra DP. The Impact of Symptoms of Depression and Walking on Gestational Age at Birth in African American Women. Womens Health Issues 2017; 27:181-187. [PMID: 28215983 PMCID: PMC5357440 DOI: 10.1016/j.whi.2016.12.010] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2016] [Revised: 12/19/2016] [Accepted: 12/21/2016] [Indexed: 11/16/2022]
Abstract
BACKGROUND Symptoms of depression have been related to lower gestational age and preterm birth (<37 completed weeks gestation). Leisure time physical activity may have protective effects on preterm birth; however, less has been published with regard to other domains of physical activity such as walking for a purpose (e.g., for transportation) or the pathways by which symptoms of depression impact gestational age at birth. METHODS This was a secondary analysis of available data of African American women. Women were interviewed within 3 days after birth. We proposed a model in which walking for a purpose during pregnancy mediated the effects of symptoms of depression (measured by the 20-item Center for Epidemiologic Studies-Depression [CES-D] scale) on gestational age at birth in a sample of 1,382 African American women. RESULTS Using structural equation modeling, we found that the direct effect of CES-D scores of 23 or greater, which have been correlated with major depression diagnosis, on gestational age at birth was -4.23 (p < .001). These results indicate that symptoms of depression were associated with a decrease in gestational age at birth of 4.23 days. Walking for a purpose mediated the effect of CES-D scores of 23 or greater on gestational age at birth. CONCLUSIONS Compared with African American women without symptoms of depression, African American women who had symptoms of depression walked less for a purpose during their pregnancy and delivered infants with lower gestational age at birth. If not medically contraindicated, clinicians should incorporate walking as part of prenatal care recommendations and reassure women about safety of walking during pregnancy.
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Affiliation(s)
| | - Jaime C Slaughter-Acey
- College of Nursing and Health Professions, Drexel University, Philadelphia, Pennsylvania
| | | | - Dawn P Misra
- Department of Family Medicine and Public Health Sciences, School of Medicine, Wayne State University, Detroit, Michigan
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47
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Sigalla GN, Mushi D, Meyrowitsch DW, Manongi R, Rogathi JJ, Gammeltoft T, Rasch V. Intimate partner violence during pregnancy and its association with preterm birth and low birth weight in Tanzania: A prospective cohort study. PLoS One 2017; 12:e0172540. [PMID: 28235031 PMCID: PMC5325295 DOI: 10.1371/journal.pone.0172540] [Citation(s) in RCA: 71] [Impact Index Per Article: 10.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2016] [Accepted: 02/05/2017] [Indexed: 11/18/2022] Open
Abstract
Introduction Intimate partner violence (IPV) is a public health problem that affects millions of women worldwide. The role of violence as an underlying factor in poor birth outcomes remains an area where strong evidence is lacking. The aim of this study was to determine the association between intimate partner violence (IPV) and preterm delivery (PTB) and low birth weight (LBW). Materials and methods A prospective cohort study was conducted among 1112 pregnant women attending antenatal care in Moshi–Tanzania. The women were enrolled before 24 weeks gestation, followed-up at week 34 to determine exposure to violence during pregnancy, and after delivery to estimate gestation age at delivery and birth weight. Logistic regression analysis was performed to assess the association between exposure to IPV during pregnancy and PTB and LBW while adjusting for possible confounders. In addition, stratified analysis based on previous history of adverse pregnancy outcome was performed. Results One-third of the women experienced IPV during pregnancy, 22.3% reported emotional, 15.4% sexual and 6.3% physical violence. Women exposed to physical IPV were three times more likely to experience PTB (AOR = 2.9; CI 95%: 1.3–6.5) and LBW (AOR = 3.2; CI 95%: 1.3–7.7). Women with previous adverse pregnancy outcomes and exposure to physical IPV had a further increased risk of PTB (AOR = 4.5; CI 95%: 1.5–13.7) and LBW (AOR = 4.8; CI 95%: 1.6–14.8) compared to those without previous history of adverse outcome. Conclusion Women who are exposed to IPV during pregnancy are at increased risk of PTB and LBW. The risk is even stronger if the women additionally have suffered a previous adverse pregnancy outcome. Interventions addressing IPV are urgently needed to prevent occurrence and reoccurrence of PTB and LBW.
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Affiliation(s)
- Geofrey Nimrod Sigalla
- Institute of Public Health, Kilimanjaro Christian Medical University College, Moshi, Tanzania
- Department of Health, Evangelical Lutheran Church in Tanzania, Arusha, Tanzania
- * E-mail:
| | - Declare Mushi
- Institute of Public Health, Kilimanjaro Christian Medical University College, Moshi, Tanzania
| | | | - Rachel Manongi
- Institute of Public Health, Kilimanjaro Christian Medical University College, Moshi, Tanzania
| | - Jane Januarius Rogathi
- Institute of Public Health, Kilimanjaro Christian Medical University College, Moshi, Tanzania
| | - Tine Gammeltoft
- Department of Anthropology, University of Copenhagen, Copenhagen, Denmark
| | - Vibeke Rasch
- Department of Obstetrics and Gynecology, Odense University Hospital, Odense, Denmark
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark
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Lakshmanan A, Agni M, Lieu T, Fleegler E, Kipke M, Friedlich PS, McCormick MC, Belfort MB. The impact of preterm birth <37 weeks on parents and families: a cross-sectional study in the 2 years after discharge from the neonatal intensive care unit. Health Qual Life Outcomes 2017; 15:38. [PMID: 28209168 PMCID: PMC5312577 DOI: 10.1186/s12955-017-0602-3] [Citation(s) in RCA: 77] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2016] [Accepted: 01/24/2017] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Little is known about the quality of life of parents and families of preterm infants after discharge from the neonatal intensive care unit (NICU). Our aims were (1) to describe the impact of preterm birth on parents and families and (2) and to identify potentially modifiable determinants of parent and family impact. METHODS We surveyed 196 parents of preterm infants <24 months corrected age in 3 specialty clinics (82% response rate). Primary outcomes were: (1) the Impact on Family Scale total score; and (2) the Infant Toddler Quality of Life parent emotion and (3) time limitations scores. Potentially modifiable factors were use of community-based services, financial burdens, and health-related social problems. We estimated associations of potentially modifiable factors with outcomes, adjusting for socio-demographic and infant characteristics using linear regression. RESULTS Median (inter-quartile range) infant gestational age was 28 (26-31) weeks. Higher Impact on Family scores (indicating worse effects on family functioning) were associated with taking ≥3 unpaid hours/week off from work, increased debt, financial worry, unsafe home environment and social isolation. Lower parent emotion scores (indicating greater impact on the parent) were also associated with social isolation and unpaid time off from work. Lower parent time limitations scores were associated with social isolation, unpaid time off from work, financial worry, and an unsafe home environment. In contrast, higher parent time limitations scores (indicating less impact) were associated with enrollment in early intervention and Medicaid. CONCLUSIONS Interventions to reduce social isolation, lessen financial burden, improve home safety, and increase enrollment in early intervention and Medicaid all have the potential to lessen the impact of preterm birth on parents and families.
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Affiliation(s)
- Ashwini Lakshmanan
- Center for Fetal and Neonatal Medicine, USC Division of Neonatal Medicine, Children's Hospital Los Angeles; Keck School of Medicine, University of Southern California, 4650 Sunset Boulevard, MS #31, CA, 90027, Los Angeles, USA.
- Newborn and Infant Critical Care Unit, Children's Hospital Los Angeles, 4650 Sunset Boulevard, MS #31, CA, 90027, Los Angeles, USA.
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA.
- Center for Health Policy and Economics, University of Southern California, Los Angeles, CA, USA.
| | - Meghana Agni
- Drexel School of Medicine, Philadelphia, PA, USA
| | - Tracy Lieu
- Division of Research, Kaiser Permanente, Oakland, CA, USA
| | - Eric Fleegler
- Division of Emergency Medicine, Boston Children's Hospital, Boston, MA, USA
| | - Michele Kipke
- Saban Research Institute, Children's Hospital Los Angeles, Los Angeles, CA, USA
| | - Philippe S Friedlich
- Center for Fetal and Neonatal Medicine, USC Division of Neonatal Medicine, Children's Hospital Los Angeles; Keck School of Medicine, University of Southern California, 4650 Sunset Boulevard, MS #31, CA, 90027, Los Angeles, USA
| | - Marie C McCormick
- Division of Newborn Medicine, Boston Children's Hospital, Boston, MA, USA
- Beth Israel Deaconess Medical Center, Boston, MA, USA
- Department of Social and Behavioral Sciences, The Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Mandy B Belfort
- Department of Pediatric Newborn Medicine, Brigham and Women's Hospital, Boston, MA, USA
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Giurgescu C, Engeland CG, Templin TN. Symptoms of Depression Predict Negative Birth Outcomes in African American Women: A Pilot Study. J Midwifery Womens Health 2016; 60:570-7. [PMID: 26461192 DOI: 10.1111/jmwh.12337] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/26/2015] [Indexed: 11/30/2022]
Abstract
INTRODUCTION African American women have higher rates of preterm birth and low-birth-weight infants compared with non-Hispanic white women. Symptoms of depression have also been related to these negative birth outcomes. Lower levels of social support and higher levels of avoidance coping and cortisol have been related to more symptoms of depression in pregnant women. The purpose of this pilot study was to examine the relationships among symptoms of depression, social support, avoidance coping, cortisol, and negative birth outcomes (ie, preterm birth, low-birth-weight infants) in a sample of African American women. METHODS This study used a prospective design. A convenience sample of 90 African American women completed questionnaires and had blood drawn in the second trimester of pregnancy. Birth data were collected from medical records. RESULTS Based on the Center for Epidemiological Studies-Depression (CES-D) Scale scores, 28% of women were at increased risk for clinical depression (CES-D ≥ 16). Compared to women who gave birth at term, women who had preterm birth had higher CES-D scores (11.67 and 19.0, respectively) and used avoidance coping more often (7.98 and 13.14, respectively). Compared to women with normal-birth-weight infants, women with low-birth-weight infants had higher levels of cortisol (61.75 mcg/dL and 89.72 mcg/dL, respectively). Women at increased risk for clinical depression were 16 times more likely to have preterm birth and 4 times more likely to have low-birth-weight infants. Women with plasma cortisol levels in the top 25th percentile were 7 times more likely to have low-birth-weight infants. Preeclampsia during pregnancy also predicted preterm birth and low-birth-weight infants. DISCUSSION Symptoms of depression in pregnancy may predict adverse birth outcomes. Interventions that have the potential to improve the mental health of pregnant women and ultimately birth outcomes need to be explored.
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50
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Abstract
Objective To document interactions during the antenatal consultation between parents and neonatologist that parents linked to their satisfaction with their participation in shared decision making for their infant at risk of being born at the limit of viability. Methods This multiple-case ethnomethodological qualitative research study, included mothers admitted for a threatened premature delivery between 200/7 and 266/7 weeks gestation, the father, and the staff neonatologist conducting the clinical antenatal consultation. Content analysis of an audiotaped post-antenatal consultation interview with parents obtained their satisfaction scores as well as their comments on physician actions that facilitated their desired participation. Results Five cases, each called a “system—infant at risk”, included 10 parents and 6 neonatologists. From the interviews emerged a blueprint for action by physicians, including communication strategies that parents say facilitated their participation in decision making; such as building trustworthy physician-parent relationships, providing "balanced" information, offering choices, and allowing time to think. Conclusion Parent descriptions indicate that the opportunity to participate to their satisfaction in the clinical antenatal consultation depends on how the physician interacts with them. Practice implications The parent-identified communication strategies facilitate shared decision making regarding treatment in the best interest of the infant at risk to be born at the limit of viability.
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Affiliation(s)
- Thierry Daboval
- Children’s hospital of Eastern Ontario. Department Pediatrics. The Ottawa Hospital, Department of Obstetrics and Gynecology. University of Ottawa, Ottawa, Canada
- * E-mail:
| | - Sarah Shidler
- Department of Health Science Sciences, University of Quebec in Abitibi-Temiscamingue, Rouyn-Noranda, Québec, Canada
| | - Daniel Thomas
- Department of Human Sciences, University of Quebec in Abitibi-Temiscamingue, Rouyn-Noranda, Québec, Canada
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