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Amiel Castro RT, Pinard Anderman C, O'Connor TG, Glover V, Kammerer M. Maternal and paternal postpartum early mood and bonding. J Reprod Infant Psychol 2024; 42:741-752. [PMID: 36593232 DOI: 10.1080/02646838.2022.2159351] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Accepted: 12/12/2022] [Indexed: 01/04/2023]
Abstract
BACKGROUND Whereas the maternal 'blues' has been widely researched, comparatively less is known about the "highs" following childbirth, and the relation between mothers and fathers' mood in this early period. We aimed to investigate the association between maternal 'blues' and 'highs' with paternal postpartum mood (here described as 'lows' and 'highs') in the early postpartum and their associations with the quality of child bonding. METHODS Women and their cohabitating male partners, fathers of the index child (N = 98 couples), attending an obstetric hospital unit completed questionnaires on mood, bonding and socio-demographics between the 3rd and the 5th postpartum day. We used generalised estimating equations to analyse the data. RESULTS The 'blues' scores were higher in mothers, whereas 'highs' and bonding were higher in fathers. Maternal 'blues' were significantly correlated with paternal 'lows' (rs = .23, p < .05) and maternal 'highs' were also associated with paternal 'highs' (rs = .22, p < .05). Parental 'highs' were significantly associated with better baby bonding (B = .13, p = .02). CONCLUSIONS Our study demonstrates moderate associations between both 'blues/lows' and 'highs' in mothers and fathers shortly after the birth of the child. Associations between mood, particularly 'highs', and bonding were similar for mothers and fathers. Greater consideration of 'blues/lows' and 'highs' in both parents is needed to promote adjustment in the postpartum period.
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Affiliation(s)
- Rita T Amiel Castro
- Department of Clinical Psychology and Psychotherapy, University of Zurich, Zurich, Switzerland
| | - Claudia Pinard Anderman
- Department of Applied Psychology, Zurich University of Applied Sciences, ZHAW, Zürich, Switzerland
| | - Thomas G O'Connor
- Department of Psychiatry, University of Rochester Medical Center, Rochester, New York, USA
| | - Vivette Glover
- Imperial College London, Institute of Reproductive and Developmental Biology, Department of Metabolism, Digestion and Reproduction Hammersmith Hospital Campus, London, UK
| | - Martin Kammerer
- Imperial College London, Institute of Reproductive and Developmental Biology, Department of Metabolism, Digestion and Reproduction Hammersmith Hospital Campus, London, UK
- Outpatient Service, Alpine Health AG, Altendorf, Switzerland
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2
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Zhang J, Lu H, Sheng Q, Zang E, Zhang Y, Yuan H, Chen B, Tang W. The Influence of Perinatal Psychological Changes on Infant Neurodevelopment in Shanghai, China: A Longitudinal Group-based Trajectory Analysis. J Affect Disord 2024; 361:291-298. [PMID: 38876315 DOI: 10.1016/j.jad.2024.06.029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2024] [Revised: 05/29/2024] [Accepted: 06/11/2024] [Indexed: 06/16/2024]
Abstract
OBJECTIVE This prospective cohort study, conducted at the Fenglin Community Health Service Center (FCHC) in Xuhui District, Shanghai, aimed to investigate the impact of maternal psychological status on offspring neurodevelopment. METHODS A total of 430 mother-child pairs were included, with pregnant women enrolled between February 18, 2020, and April 19, 2021. Face-to-face interviews and electronic data collection on demographic characteristics, health conditions and medical history were employed at various stages of pregnancy and postpartum. Maternal depression and anxiety were assessed using the PHQ-9 and GAD-7 scales, while offspring neurodevelopment was measured at six months using the Ages and Stages Questionnaire 3rd Edition (ASQ-3). In statistical analyses, group-based trajectory modeling (GBTM) was employed to identify the latent groups for maternal psychological trajectories, including depression and anxiety, and logistic regression was used to explore associations between maternal psychological trajectories and offspring neurodevelopment, adjusting for potential confounders. RESULTS Five latent trajectory groups were identified for both depression and anxiety, exhibiting distinct patterns over time. Results indicated that maternal psychological trajectories were associated with various domains of offspring neurodevelopment, including communication, problem-solving, personal-social, and gross motor skills. Specifically, mothers in trajectory groups characterized by the highest level of depression or anxiety showed increased odds of offspring neurodevelopmental delays compared to reference groups. CONCLUSION Our findings underscore the importance of maternal mental health during the perinatal period and highlight the potential implications for offspring neurodevelopment. Further research is warranted to elucidate underlying mechanisms and inform targeted interventions to support maternal mental well-being and optimize offspring outcomes.
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Affiliation(s)
- Jiali Zhang
- Fenglin Community Health Service Center in Xuhui District, Shanghai, China
| | - Haidong Lu
- Department of Internal Medicine, Yale University School of Medicine, New Haven, CT, USA
| | - Qilei Sheng
- Department of Biostatistics and Epidemiology, Rutgers School of Public Health, Piscataway, NJ, USA
| | - Emma Zang
- Department of Sociology, Yale University, New Haven, CT, USA
| | - Yunxuan Zhang
- Department of Biostatistics, Yale University, New Haven, CT, USA
| | - Hualong Yuan
- Fenglin Community Health Service Center in Xuhui District, Shanghai, China
| | - Bihua Chen
- Fenglin Community Health Service Center in Xuhui District, Shanghai, China.
| | - Weiming Tang
- Dermatology Hospital of Southern Medical University, Guangzhou, China.
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3
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Penner F, Bunderson M, Bartz C, Brooker RJ, Rutherford HJV. Emotion regulation strategies and perceived stress during pregnancy in expectant mothers and fathers. J Reprod Infant Psychol 2024; 42:410-423. [PMID: 35949103 PMCID: PMC9911557 DOI: 10.1080/02646838.2022.2110224] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2021] [Accepted: 07/29/2022] [Indexed: 10/15/2022]
Abstract
BACKGROUND Stress during pregnancy can increase physical and mental health risks in parents and offspring. Emotion regulation (ER) may protect against prenatal stress; however, ER is understudied in expectant parents, particularly expectant fathers. This study aimed to evaluate associations between ER strategies (reappraisal, suppression, ratio of suppression-to-reappraisal) and perceived stress among expectant parents, and also test whether expectant mothers and fathers differed in ER strategy use and perceived stress levels. METHODS N = 83 expectant parents (62.7% mothers) in the third trimester completed measures assessing perceived stress,reappraisal, and suppression. ANCOVA, hierarchical regression, and multilevel models were used to evaluate associations between ER strategies and perceived stress, and test for sex differences. RESULTS Controlling for age and education, lower reappraisal and higher suppression were associated with higher perceived stress; in addition, higher suppression-to-reappraisal ratios were associated with greater perceived stress. Mothers and fathers did not differ in perceived stress, reappraisal, or suppression; however, suppression-to-reappraisal ratios significantly differed. CONCLUSION Increasing ER skills such as reappraisal while reducing suppression may be beneficial for decreasing stress in expectant parents. Expectant fathers report similar levels of perceived stress to mothers and would benefit from prenatal mental health screening and intervention.
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Affiliation(s)
| | - Madison Bunderson
- Yale Child Study Center, Yale University School of Medicine
- Graduate School of Education, Stanford University
| | - Cody Bartz
- Yale Child Study Center, Yale University School of Medicine
- School of Public Affairs, American University
| | - Rebecca J Brooker
- Department of Psychological and Brain Sciences, Texas A&M University
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4
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Gomà M, Arias-Pujol E, Prims E, Ferrer J, Lara S, Glover V, Martinez M, Llairó A, Nanzer N. Internet-based interdisciplinary therapeutic group (Grupo Interdisciplinar Online, GIO) for perinatal anxiety and depression-a randomized pilot study during COVID-19. Arch Womens Ment Health 2024; 27:405-415. [PMID: 38150150 PMCID: PMC11116180 DOI: 10.1007/s00737-023-01412-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2023] [Accepted: 12/09/2023] [Indexed: 12/28/2023]
Abstract
Early interventions may promote reductions in mothers' anxiety-depression (AD) symptoms and improvements in their offspring. This longitudinal randomized research was conducted to assess the effects of interdisciplinary online therapeutic groups (GIO) in at-risk mothers and babies during the COVID-19 pandemic in a disadvantaged neighborhood in Barcelona (Spain). A total of 135 babies were born from March 2020 to June 2021 in a primary healthcare center of Barcelona (Spain). Pregnant woman and new mothers were screened for AD symptomatology through EPDS and STAI questionnaires. Seventy-two of them met high-risk criteria for AD and were included in the study. They were randomly assigned into the two groups of the study: 40 participants were assigned to GIO, the therapeutic group (TG), while 32 of them were assigned to the control group (CG) and received treatment as usual. The course of the mothers' symptomatology was assessed, as well as the baby's development at 6 months old in a blind pediatric follow-up. No differences were found in AD between both groups before the intervention. However, we obtained a significant decrease in AD symptomatology (EPDS p < .001; STAI state p = .015 and STAI trait p < .001at 6 months of life) after the intervention in the TG compared to the CG. Pediatric follow-up at 6 months demonstrated significant differences between groups in babies' development assessment (manipulation p = .003; language p < .001; sociability p < .001). The GIO helped to ensure healthy development of the baby and reduction of the mothers' depressive-anxiety symptomatology.
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Affiliation(s)
- M Gomà
- Faculty of Psychology, Education and Sports Sciences Blanquerna, Ramon Llull University (URL), Barcelona, Spain.
- Department of Perinatal Care, Bruc Salut Clinical Psychology Center, Barcelona, Spain.
| | - E Arias-Pujol
- Faculty of Psychology, Education and Sports Sciences Blanquerna, Ramon Llull University (URL), Barcelona, Spain
| | - E Prims
- Roquetes-Canteres Primary Care Center, Catalan Public Health, Barcelona, Spain
| | - J Ferrer
- Roquetes-Canteres Primary Care Center, Catalan Public Health, Barcelona, Spain
| | - S Lara
- Roquetes-Canteres Primary Care Center, Catalan Public Health, Barcelona, Spain
| | - V Glover
- Institute of Reproductive and Developmental Biology, Imperial College London, London, UK
| | - M Martinez
- Roquetes-Canteres Primary Care Center, Catalan Public Health, Barcelona, Spain
| | - A Llairó
- Faculty of Psychology, Education and Sports Sciences Blanquerna, Ramon Llull University (URL), Barcelona, Spain
- Department of Perinatal Care, Bruc Salut Clinical Psychology Center, Barcelona, Spain
| | - N Nanzer
- Child and Adolescent Psychiatry Service, Geneva University Hospitals, Geneva, Switzerland
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Westberg SM, Arellano R, Cieri-Hutcherson NE, Heinrich NT, Herman AM, Lodise NM, McBane S, Ofili TU, O'Grady N, Sankey KH. Pharmacotherapy of Chronic Neuropsychiatric Conditions During Pregnancy. Nurs Womens Health 2024; 28:227-241. [PMID: 38702041 DOI: 10.1016/j.nwh.2023.12.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Revised: 12/08/2023] [Accepted: 03/28/2024] [Indexed: 05/06/2024]
Abstract
Many pregnant persons will experience neuropsychiatric conditions during pregnancy, including migraine, attention deficit disorder, depression, and anxiety. Treatment of each of these conditions requires shared decision-making among the individual, family, and health care team. Although medications may include risk, the benefits often outweigh the potential fetal risks. In this article, we review pharmacologic treatment options for each of these conditions and appropriate use in pregnancy to maintain the stability of conditions and to optimize maternal and fetal outcomes.
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Sarwinanti, Widyawati, Warsini S, Hakimi M, Ramdani WF. Identify mental health needs of adolescent pregnant women: a qualitative study. Int J Adolesc Med Health 2024; 0:ijamh-2024-0028. [PMID: 38713895 DOI: 10.1515/ijamh-2024-0028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2024] [Accepted: 04/15/2024] [Indexed: 05/09/2024]
Abstract
PURPOSE The purpose of this study is to explore adolescent pregnant women related to their pregnancy experience about mental health needs during pregnancy for the prevention of depression during pregnancy. METHODS This research is a qualitative study design with a phenomenological approach. Data collection using interviews (in-depth interviews). This study involved 18 participants consisting of 12 pregnant women aged 15-19 years and 6 midwives who work at the health center. The criteria for informants of pregnant women are pregnant with Trimester I to III, age 15-19 years and not experiencing complications of pregnancy. RESULTS Based on interviews conducted with informants, five themes were obtained about the experiences and needs of pregnant women in adolescence. These themes are (1). Risk of depression, (2). Social and family support needs, (3). Needs of mental health services, (4). Obstacles for midwives in providing mental health services, and (5). needs of mental health information media. CONCLUSIONS Five needs of teenage pregnant women are factors that can support mental health to prevent depression during pregnancy.
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Affiliation(s)
- Sarwinanti
- Doctoral Program, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia
| | - Widyawati
- Department of Pediatric and Maternity Nursing, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia
| | - Sri Warsini
- Department of Mental Health Nursing, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia
| | - Mohammad Hakimi
- Department of Medical and Health Sciences/Obstetrics and Gynaecology/Paediatrics and Reproductive, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia
| | - Wawan Febri Ramdani
- Department of Nursing, Faculty of Health Science, Aisyiyah University Yogyakarta, Yogyakarta, Indonesia
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Ou C, Daly Z, Carter M, Hall WA, Zusman EZ, Russolillo A, Duffy S, Jenkins E. Developing consensus to enhance perinatal mental health through a model of integrated care: Delphi study. PLoS One 2024; 19:e0303012. [PMID: 38722862 PMCID: PMC11081323 DOI: 10.1371/journal.pone.0303012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2023] [Accepted: 04/17/2024] [Indexed: 05/13/2024] Open
Abstract
Perinatal mental illness is an important public health issue, with one in five birthing persons experiencing clinically significant symptoms of anxiety and/or depression during pregnancy or the postpartum period. The purpose of this study was to develop a consensus-based model of integrated perinatal mental health care to enhance service delivery and improve parent and family outcomes. We conducted a three-round Delphi study using online surveys to reach consensus (≥75% agreement) on key domains and indicators of integrated perinatal mental health care. We invited modifications to indicators and domains during each round and shared a summary of results with participants following rounds one and two. Descriptive statistics were generated for quantitative data and a thematic analysis of qualitative data was undertaken. Study participants included professional experts in perinatal mental health (e.g., clinicians, researchers) (n = 36) and people with lived experience of perinatal mental illness within the past 5 years from across Canada (e.g., patients, family members) (n = 11). Consensus was reached and all nine domains of the proposed model for integrated perinatal mental health care were retained. Qualitative results informed the modification of indicators and development of an additional domain and indicators capturing the need for antiracist, culturally safe care. The development of an integrated model of perinatal mental health benefitted from diverse expertise to guide the focus of included domains and indicators. Engaging in a consensus-building process helps to create the conditions for change within health services.
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Affiliation(s)
- Christine Ou
- School of Nursing, University of Victoria, Victoria, Canada
| | - Zachary Daly
- School of Nursing, University of British Columbia, Vancouver, Canada
- Wellstream: The Canadian Centre for Innovation in Child and Youth Mental Health and Substance Use, Vancouver, Canada
| | - Michelle Carter
- School of Nursing, University of British Columbia, Vancouver, Canada
- Wellstream: The Canadian Centre for Innovation in Child and Youth Mental Health and Substance Use, Vancouver, Canada
- St. Paul’s Hospital, Providence Healthcare, Vancouver, Canada
| | - Wendy A. Hall
- School of Nursing, University of British Columbia, Vancouver, Canada
| | - Enav Z. Zusman
- Department of Obstetrics & Gynaecology, University of British Columbia, Vancouver, BC, Canada
| | - Angela Russolillo
- St. Paul’s Hospital, Providence Healthcare, Vancouver, Canada
- Faculty of Health Sciences, Simon Fraser University, Burnaby, BC, Canada
| | - Sheila Duffy
- Pacific Post Partum Support Society, Burnaby, BC, Canada
| | - Emily Jenkins
- School of Nursing, University of British Columbia, Vancouver, Canada
- Wellstream: The Canadian Centre for Innovation in Child and Youth Mental Health and Substance Use, Vancouver, Canada
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8
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Van den Bergh BRH, Antonelli MC, Stein DJ. Current perspectives on perinatal mental health and neurobehavioral development: focus on regulation, coregulation and self-regulation. Curr Opin Psychiatry 2024; 37:237-250. [PMID: 38415742 DOI: 10.1097/yco.0000000000000932] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/29/2024]
Abstract
PURPOSE OF REVIEW Perinatal mental health research provides an important perspective on neurobehavioral development. Here, we aim to review the association of maternal perinatal health with offspring neurodevelopment, providing an update on (self-)regulation problems, hypothesized mechanistic pathways, progress and challenges, and implications for mental health. RECENT FINDINGS (1) Meta-analyses confirm that maternal perinatal mental distress is associated with (self-)regulation problems which constitute cognitive, behavioral, and affective social-emotional problems, while exposure to positive parental mental health has a positive impact. However, effect sizes are small. (2) Hypothesized mechanistic pathways underlying this association are complex. Interactive and compensatory mechanisms across developmental time are neglected topics. (3) Progress has been made in multiexposure studies. However, challenges remain and these are shared by clinical, translational and public health sciences. (4) From a mental healthcare perspective, a multidisciplinary and system level approach employing developmentally-sensitive measures and timely treatment of (self-)regulation and coregulation problems in a dyadic caregiver-child and family level approach seems needed. The existing evidence-base is sparse. SUMMARY During the perinatal period, addressing vulnerable contexts and building resilient systems may promote neurobehavioral development. A pluralistic approach to research, taking a multidisciplinary approach to theoretical models and empirical investigation needs to be fostered.
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Affiliation(s)
| | - Marta C Antonelli
- Laboratorio de Programación Perinatal del Neurodesarrollo, Instituto de Biología Celular y Neurociencias "Prof.E. De Robertis", Facultad de Medicina. Universidad de Buenos Aires, Buenos Aires, Argentina
- Frauenklinik und Poliklinik, Klinikum rechts der Isar, Munich, Germany
| | - Dan J Stein
- South African Medical Research Council Unit on Risk and Resilience in Mental Disorders, Department of Psychiatry, University of Cape Town, Cape Town, South Africa
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Eleje GU, Oguejiofor CB, Oriji SO, Ekwuazi KE, Ugwu EO, Igbodike EP, Malachy DE, Nwankwo EU, Onah CE, Ugboaja JO, Ikechebelu JI, Nwagha UI. Depression, anxiety, and stress and adverse pregnancy outcomes in pregnant women with history of recurrent pregnancy loss in Nigeria. Int J Psychiatry Med 2024; 59:303-324. [PMID: 37641892 DOI: 10.1177/00912174231199215] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/31/2023]
Abstract
OBJECTIVE The primary purpose of this study was to examine whether pregnant women with a history of recurrent pregnancy loss (RPL) are more likely to experience moderate-to-severe depression, anxiety, or stress symptoms than pregnant women without a history of RPL. The secondary purpose was to determine whether women with prior RPL experienced more unfavorable pregnancy outcomes if they had depression, anxiety, or stress. METHODS A prospective case-control study was conducted that included 47 pregnant women with a history of RPL and 94 pregnant women without prior RPL. Participants 20 weeks of gestation or earlier were included. Both groups completed the Depression, Anxiety, and Stress Scale (DASS-21), and were followed up until delivery to determine the pregnancy outcomes. Multivariate logistic regression was used to compare adverse pregnancy outcomes. RESULT Among the 47 women with prior RPL, 10 had primary RPL (two or more miscarriages without a successful pregnancy) and 37 secondary RPL (two or more miscarriages with a history of successful pregnancy). RPL was significantly associated with moderate-to-severe levels of depression (P < .001), anxiety (P < .001), and stress (P < .001). Among the RPL group, high stress level was significantly associated with repeat miscarriage (adjusted odds ratio (AOR) = 5.28, 95%CI = 1.25-100.0, P = .03) and preterm labor (AOR = 6.07, 95%CI = 1.61-100.0, P = .04). Depression and anxiety were not associated with adverse pregnancy outcomes. CONCLUSION Pregnant women with a history of RPL had considerably higher rates of moderate-to-severe depression, anxiety, and stress. Repeat miscarriage and preterm labor were considerably higher among pregnant women with RPL who were experiencing high stress levels at baseline.
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Affiliation(s)
- George U Eleje
- Effective Care Research Unit, Department of Obstetrics and Gynaecology, Nnamdi Azikiwe University, Awka, Nigeria
- Institute of Maternal and Child Health, College of Medicine, University of Nigeria Ituku-Ozalla Campus, Nsukka, Nigeria
- Department of Obstetrics and Gynaecology, Nnamdi Azikiwe University Teaching Hospital Nnewi, Nnewi, Nigeria
| | - Charlotte B Oguejiofor
- Department of Obstetrics and Gynaecology, Nnamdi Azikiwe University Teaching Hospital Nnewi, Nnewi, Nigeria
| | - Sunday O Oriji
- Department of Mental Health, Nnamdi Azikiwe University, Awka, Nigeria
| | - Kingsley E Ekwuazi
- Department of Obstetrics and Gynaecology, College of Medicine, University of Nigeria Ituku-Ozalla, Nsukka, Nigeria
| | - Emmanuel O Ugwu
- Institute of Maternal and Child Health, College of Medicine, University of Nigeria Ituku-Ozalla Campus, Nsukka, Nigeria
- Department of Obstetrics and Gynaecology, College of Medicine, University of Nigeria Ituku-Ozalla, Nsukka, Nigeria
| | - Emeka P Igbodike
- Department of Obstetrics and Gynecology, Havana Specialist Hospital, Lagos, Nigeria
| | - Divinefavour E Malachy
- Effective Care Research Unit, Department of Obstetrics and Gynaecology, Nnamdi Azikiwe University, Awka, Nigeria
| | - Ekeuda U Nwankwo
- Rural Community Clinical School, School of Medicine, Deakin University, Burwood, VIC, Australia
| | - Christian E Onah
- Department of Medical Laboratory Science, Faculty of Health Sciences and Technology, Nnamdi Azikiwe University, Nnewi, Nigeria
| | - Joseph O Ugboaja
- Department of Obstetrics and Gynaecology, Nnamdi Azikiwe University Teaching Hospital Nnewi, Nnewi, Nigeria
| | - Joseph I Ikechebelu
- Effective Care Research Unit, Department of Obstetrics and Gynaecology, Nnamdi Azikiwe University, Awka, Nigeria
- Institute of Maternal and Child Health, College of Medicine, University of Nigeria Ituku-Ozalla Campus, Nsukka, Nigeria
- Department of Obstetrics and Gynaecology, Nnamdi Azikiwe University Teaching Hospital Nnewi, Nnewi, Nigeria
| | - Uchenna I Nwagha
- Institute of Maternal and Child Health, College of Medicine, University of Nigeria Ituku-Ozalla Campus, Nsukka, Nigeria
- Department of Obstetrics and Gynaecology, College of Medicine, University of Nigeria Ituku-Ozalla, Nsukka, Nigeria
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Reddish A, Golds L, MacBeth A. "It is not all glowing and kale smoothies": An exploration of mental health difficulties during pregnancy through women's voices. Psychol Psychother 2024. [PMID: 38661270 DOI: 10.1111/papt.12527] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2022] [Revised: 02/29/2024] [Accepted: 04/03/2024] [Indexed: 04/26/2024]
Abstract
OBJECTIVES This study aimed to explore the experiences of women with moderate-to-severe mental health difficulties during pregnancy, with a focus on establishing their psychological needs. Psychological distress caused by mental health difficulties during pregnancy is common and can significantly impact women and their babies. However, women's subjective experiences of difficulties with their mental health throughout pregnancy, alongside their experiences of staff, services and treatments are less well understood. DESIGN In this qualitative study, an Interpretive Phenomenological Analysis (IPA) approach was used. METHODS Semi-structured interviews were conducted with participants recruited via a regional Perinatal Mental Health Service. Interviews were transcribed and analysed following the IPA methodology. RESULTS Five superordinate themes were identified which represented the lived experiences of the 11 participants on their journey through pregnancy whilst living with mental health difficulties and subsequent psychological distress: (i) Feeling the 'wrong' feelings, (ii) Societal pressures and a desire for greater acceptance, (iii) Searching for answers despite a lack of resources, (iv) What made a difference and (v) Experiences and expectations of service provision. Within these themes, 13 subordinate themes were also identified. CONCLUSIONS These themes highlight the need for greater awareness and acceptance of mental health difficulties during pregnancy as well as postnatally. While perinatal mental health services are evolving, there is still an urgent requirement for services to continue to develop to meet women's needs, as well as to develop the role of clinicians as facilitators of engagement with needs-matched care.
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Affiliation(s)
- Alison Reddish
- NHS Grampian, Aberdeen, UK
- Clinical Psychology, School of Health in Social Science, University of Edinburgh, Edinburgh, Scotland, UK
| | - Lisa Golds
- Clinical Psychology, School of Health in Social Science, University of Edinburgh, Edinburgh, Scotland, UK
| | - Angus MacBeth
- NHS Grampian, Aberdeen, UK
- Clinical Psychology, School of Health in Social Science, University of Edinburgh, Edinburgh, Scotland, UK
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11
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El-Heis S, Barton SJ, Chang HF, Nield H, Cox V, Galani S, Cutfield W, Chan SY, Godfrey KM. Maternal mood, anxiety and mental health functioning after combined myo-inositol, probiotics, micronutrient supplementation from preconception: Findings from the NiPPeR RCT. Psychiatry Res 2024; 334:115813. [PMID: 38402742 PMCID: PMC11137872 DOI: 10.1016/j.psychres.2024.115813] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Revised: 11/24/2023] [Accepted: 02/22/2024] [Indexed: 02/27/2024]
Abstract
Observational studies have reported associations between nutrition during pregnancy and mental wellbeing. As secondary outcomes, the NiPPeR double-blind randomized trial in women planning conception investigated whether a myo-inositol, probiotics and enriched micronutrients formulation (intervention) taken preconception and throughout pregnancy could improve mental wellbeing during pregnancy and post-delivery, compared with a standard micronutrient supplement (control). Mood and anxiety symptoms were ascertained (Edinburgh Postnatal Depression Scale (EPDS), State-Trait Anxiety Inventory (STAI-state)) at preconception (baseline), 7, 28 and 34 weeks gestation, 3-weeks and 6-months post-delivery. EPDS>=13 was categorised as low mood; STAI-state>=45 as high anxiety. Change in mental health functioning was assessed as difference between preconception baseline and 6-month post-delivery 12-item Short-Form Health Survey (SF-12v2) mental component scores. Adjusting for site, ethnicity and baseline scores, there were no robust differences in EPDS and STAI-state scores between intervention and control groups across pregnancy (n = 630) and post-delivery (n = 532). Compared to controls, intervention group women averaged a 1.21 (95 %CI 0.04,2.39) higher change in SF-12v2 mental component score from preconception to 6-months post-delivery. Taking a myo-inositol, micronutrient and probiotic supplement during preconception/pregnancy had no effect on mood and anxiety, but there was evidence of a modest improvement in mental health functioning from preconception to 6-months post-delivery.
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Affiliation(s)
- Sarah El-Heis
- MRC Lifecourse Epidemiology Centre, University of Southampton, Southampton SO16 6YD, United Kingdom; National Institute for Health Research Southampton Biomedical Research Centre, University of Southampton, Southampton and University Hospital Southampton NHS Foundation Trust, SO16 6YD, United Kingdom.
| | - Sheila J Barton
- MRC Lifecourse Epidemiology Centre, University of Southampton, Southampton SO16 6YD, United Kingdom; National Institute for Health Research Southampton Biomedical Research Centre, University of Southampton, Southampton and University Hospital Southampton NHS Foundation Trust, SO16 6YD, United Kingdom
| | - Hsin Fang Chang
- Department of Obstetrics and Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore and National University Health System, Singapore, 119228
| | - Heidi Nield
- MRC Lifecourse Epidemiology Centre, University of Southampton, Southampton SO16 6YD, United Kingdom
| | - Vanessa Cox
- MRC Lifecourse Epidemiology Centre, University of Southampton, Southampton SO16 6YD, United Kingdom
| | - Sevasti Galani
- MRC Lifecourse Epidemiology Centre, University of Southampton, Southampton SO16 6YD, United Kingdom
| | - Wayne Cutfield
- Liggins Institute, University of Auckland, Auckland 1142, New Zealand
| | - Shiao-Yng Chan
- Department of Obstetrics and Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore and National University Health System, Singapore, 119228; Agency for Science, Technology and Research, Singapore Institute for Clinical Sciences, 117609, Singapore
| | - Keith M Godfrey
- MRC Lifecourse Epidemiology Centre, University of Southampton, Southampton SO16 6YD, United Kingdom; National Institute for Health Research Southampton Biomedical Research Centre, University of Southampton, Southampton and University Hospital Southampton NHS Foundation Trust, SO16 6YD, United Kingdom
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12
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Downes N, Kallas KA, Moirangthem S, Maguet C, Marr K, Tafflet M, Kirschbaum C, Heude B, Koehl M, Waerden JVD. Longitudinal effects of maternal depressive and anxious symptomatology on child hair cortisol and cortisone from pregnancy to 5-years: The EDEN mother-child cohort. Psychoneuroendocrinology 2024; 162:106957. [PMID: 38232529 DOI: 10.1016/j.psyneuen.2024.106957] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Revised: 01/02/2024] [Accepted: 01/03/2024] [Indexed: 01/19/2024]
Abstract
Exposure to maternal depressive and anxious symptomatology in utero and after birth can affect child outcomes. One proposed mechanism is through changes in child stress hormone levels, however current studies present inconsistent findings, and further research is needed to better understand the impact of maternal mental health on child stress response. This study aims to add to the limited literature by analysing longitudinal data ranging from 24 weeks amenorrhea to 5 years postpartum among 281 mother-child pairs from the French EDEN mother-child birth cohort. Hair cortisol and cortisone data were collected from children at four time points: birth, 1, 3, and 5 years. Mothers reported depressive symptomatology via the Center for Epidemiologic Studies Depression Scale (CES-D) (at 24-weeks amenorrhea, 3-, and 5-year follow-up), and the Edinburgh Postnatal Depression Scale (EPDS) (at 4, 8 and 12 months postpartum). Prenatal anxiety symptomatology was measured via the State Anxiety Inventory (STAI) at 24 weeks amenorrhea. Group-based trajectory modelling indicated a 1-cluster classification of longitudinal child hair cortisol, cortisone and cortisol-to-cortisone ratio, as analyses did not reveal a classification by subgroups representing different child profiles. After inverse probability weighting, small effects showed prenatal depressive symptomatology was significantly associated to higher levels of child hair cortisone at one year. Prenatal anxiety symptomatology was significantly linked to higher levels of child cortisol measured at birth and cortisone at birth and at 1 year. Postpartum depressive symptomatology at 8 months was related to higher levels of cortisone among 3-year-olds. These effects were not moderated by child sex or maternal socio-economic status. Further research is needed to understand why there are associations at some time points and not others to determine any potential buffering factors.
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Affiliation(s)
- Naomi Downes
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique (IPLESP), Equipe de Recherche en Epidémiologie Sociale (ERES), 75012 Paris, France.
| | - Kadri-Ann Kallas
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique (IPLESP), Equipe de Recherche en Epidémiologie Sociale (ERES), 75012 Paris, France
| | - Simi Moirangthem
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique (IPLESP), Equipe de Recherche en Epidémiologie Sociale (ERES), 75012 Paris, France
| | - Charlotte Maguet
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique (IPLESP), Equipe de Recherche en Epidémiologie Sociale (ERES), 75012 Paris, France
| | - Ketevan Marr
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique (IPLESP), Equipe de Recherche en Epidémiologie Sociale (ERES), 75012 Paris, France
| | - Muriel Tafflet
- Université Paris Cité and Université Sorbonne Paris Nord, Inserm, INRAE, Center for Research in Epidemiology and StatisticS (CRESS), 75004 Paris, France
| | - Clemens Kirschbaum
- Faculty of Psychology, Institute of Biopsychology, Technische Universität Dresden, 01062 Dresden, Germany
| | - Barbara Heude
- Université Paris Cité and Université Sorbonne Paris Nord, Inserm, INRAE, Center for Research in Epidemiology and StatisticS (CRESS), 75004 Paris, France
| | - Muriel Koehl
- Univ. Bordeaux, INSERM, Neurocentre Magendie, U1215, Neurogenesis and Pathophysiology group, 3300 Bordeaux, France
| | - Judith van der Waerden
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique (IPLESP), Equipe de Recherche en Epidémiologie Sociale (ERES), 75012 Paris, France
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13
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Alnasheet AM, Abdulaal NA, Kamal N. The Prevalence and Risk Factors of Pregnancy-Related Anxiety in Bahrain. Cureus 2024; 16:e57404. [PMID: 38694669 PMCID: PMC11062578 DOI: 10.7759/cureus.57404] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/22/2024] [Indexed: 05/04/2024] Open
Abstract
Objectives We aim to estimate the prevalence of anxiety among pregnant women, explore the possible risk factors, and compare the presence of anxiety in each gestational trimester in all pregnant women attending the antenatal care clinics at a tertiary care hospital in Manama, Bahrain. Methods This study followed a cross-sectional research design at the antenatal clinics of Salmaniya Medical Complex in Manama, Bahrain. Direct interviews with 513 participants were conducted using the Pregnancy Anxiety Questionnaire-Revised-2 (PRAQ-R2). Results Most participants (63%) were 25-35 years old. The majority (85.6%) were Bahraini nationals, and 52.2% were university-educated. Almost two-thirds were unemployed, 28.1% had associated chronic comorbidities, 3.1% had associated psychiatric disorders, 15% had a high level of anxiety, and 38% had a moderate level of anxiety. Employed participants had a significantly higher level of anxiety (p=0.022) than housewives/unemployed participants. Participants' levels of anxiety differed significantly according to their gestational age (p=0.043), with the highest anxiety among those in their third trimester (15.7%). Participants' anxiety levels were significantly higher among those with previously complicated pregnancies (p=0.002). Moreover, those with unplanned current pregnancy had significantly higher anxiety levels (p=0.019). Conclusions This study showed that anxiety seems to be a common disorder among pregnant women in Bahrain. It was more prevalent during the third trimester, and its occurrence was associated with the pregnant woman's employment, the occurrence of previously complicated pregnancies, and unplanned current pregnancies.
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Affiliation(s)
| | - Nada A Abdulaal
- Obstetrics and Gynecology, Al Kharj Military Industries Corporation Hospital (AKMICH), Riyadh, SAU
| | - Nahid Kamal
- Obstetrics and Gynecology, Salmaniya Medical Complex, Manama, BHR
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14
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Zhou T, Shen Y, Lyu J, Yang L, Wang HJ, Hong S, Ji Y. Medication Usage Record-Based Predictive Modeling of Neurodevelopmental Abnormality in Infants under One Year: A Prospective Birth Cohort Study. Healthcare (Basel) 2024; 12:713. [PMID: 38610136 PMCID: PMC11011488 DOI: 10.3390/healthcare12070713] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2024] [Revised: 03/16/2024] [Accepted: 03/20/2024] [Indexed: 04/14/2024] Open
Abstract
Early identification of children with neurodevelopmental abnormality is a major challenge, which is crucial for improving symptoms and preventing further decline in children with neurodevelopmental abnormality. This study focuses on developing a predictive model with maternal sociodemographic, behavioral, and medication-usage information during pregnancy to identify infants with abnormal neurodevelopment before the age of one. In addition, an interpretable machine-learning approach was utilized to assess the importance of the variables in the model. In this study, artificial neural network models were developed for the neurodevelopment of five areas of infants during the first year of life and achieved good predictive efficacy in the areas of fine motor and problem solving, with median AUC = 0.670 (IQR: 0.594, 0.764) and median AUC = 0.643 (IQR: 0.550, 0.731), respectively. The final model for neurodevelopmental abnormalities in any energy region of one-year-old children also achieved good prediction performance. The sensitivity is 0.700 (IQR: 0.597, 0.797), the AUC is 0.821 (IQR: 0.716, 0.833), the accuracy is 0.721 (IQR: 0.696, 0.739), and the specificity is 0.742 (IQR: 0.680, 0.748). In addition, interpretable machine-learning methods suggest that maternal exposure to drugs such as acetaminophen, ferrous succinate, and midazolam during pregnancy affects the development of specific areas of the offspring during the first year of life. This study established predictive models of neurodevelopmental abnormality in infants under one year and underscored the prediction value of medication exposure during pregnancy for the neurodevelopmental outcomes of the offspring.
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Affiliation(s)
- Tianyi Zhou
- Department of Maternal and Child Health, School of Public Health, Peking University, Beijing 100191, China; (T.Z.); (Y.S.); (J.L.); (H.-J.W.)
- Peking University Health Science Center-Weifang Joint Research Center for Maternal and Child Health, Beijing 100191, China
| | - Yaojia Shen
- Department of Maternal and Child Health, School of Public Health, Peking University, Beijing 100191, China; (T.Z.); (Y.S.); (J.L.); (H.-J.W.)
- Peking University Health Science Center-Weifang Joint Research Center for Maternal and Child Health, Beijing 100191, China
| | - Jinlang Lyu
- Department of Maternal and Child Health, School of Public Health, Peking University, Beijing 100191, China; (T.Z.); (Y.S.); (J.L.); (H.-J.W.)
- Peking University Health Science Center-Weifang Joint Research Center for Maternal and Child Health, Beijing 100191, China
| | - Li Yang
- Tongzhou Maternal and Child Health Care Hospital of Beijing, Beijing 101101, China;
| | - Hai-Jun Wang
- Department of Maternal and Child Health, School of Public Health, Peking University, Beijing 100191, China; (T.Z.); (Y.S.); (J.L.); (H.-J.W.)
- Peking University Health Science Center-Weifang Joint Research Center for Maternal and Child Health, Beijing 100191, China
| | - Shenda Hong
- National Institute of Health Data Science, Peking University, Beijing 100191, China;
| | - Yuelong Ji
- Department of Maternal and Child Health, School of Public Health, Peking University, Beijing 100191, China; (T.Z.); (Y.S.); (J.L.); (H.-J.W.)
- Peking University Health Science Center-Weifang Joint Research Center for Maternal and Child Health, Beijing 100191, China
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15
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Russell DJ, Wyrwoll CS, Preen DB, Kelty E. Investigating maternal and neonatal health outcomes associated with continuing or ceasing dexamphetamine treatment for women with attention-deficit hyperactivity disorder during pregnancy: a retrospective cohort study. Arch Womens Ment Health 2024:10.1007/s00737-024-01450-4. [PMID: 38424254 DOI: 10.1007/s00737-024-01450-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/19/2023] [Accepted: 02/20/2024] [Indexed: 03/02/2024]
Abstract
PURPOSE Attention-deficit hyperactivity disorder (ADHD) is becoming more commonly diagnosed in women, consequently, more women of reproductive age are taking ADHD medication, such as dexamphetamine. However, the safety associated with continuing or ceasing dexamphetamine during pregnancy is unclear. This study investigates outcomes associated with the continuation of dexamphetamine during pregnancy compared to those who ceased or were unexposed. METHODS A population-based retrospective cohort of women from Western Australia who had been dispensed dexamphetamine during pregnancy and gave birth between 2003 and 2018. Women had either continued to take dexamphetamine throughout pregnancy (continuers, n = 547) or ceased dexamphetamine before the end of the second trimester (ceasers, n = 297). Additionally, a matched (1:1) comparison group of women who were dispensed an ADHD medication prior to pregnancy but not during pregnancy (unexposed) was included in the study (n = 844). Multivariable generalised linear models were used to compare maternal and neonatal health outcomes. RESULTS Compared to continuers, ceasers had greater odds of threatened abortion (OR: 2.28; 95%CI: 1.00, 5.15; p = 0.049). The unexposed had some benefits compared to the continuers, which included lower risk of preeclampsia (OR: 0.58; 95%CI: 0.35, 0.97; p = 0.037), hypertension (OR: 0.32; 95%CI: 0.11, 0.93; p = 0.036), postpartum haemorrhage (OR: 0.57; 95%CI: 0.41, 0.80; p = 0.001), neonatal special care unit admittance (OR: 0.16; 95%CI: 0.12, 0.20; p < 0.001) and fetal distress (OR: 0.73; 95%CI: 0.54, 0.99; p = 0.042). CONCLUSION Continuing dexamphetamine throughout pregnancy was not associated with an increase in adverse neonatal and maternal health outcomes compared to ceasing. Ceasing dexamphetamine during pregnancy was associated with increased odds of threatened abortion compared with continuing dexamphetamine. However, this is something that requires further investigation due to the small sample size, difficulties examining timing, and the inability to examine spontaneous abortions. The unexposed showed some benefits compared to the continuers, suggesting that where possible the cessation of dexamphetamine prior to pregnancy may be advisable.
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Affiliation(s)
- Danielle J Russell
- School of Population and Global Health, University of Western Australia, Crawley, WA, Australia.
| | - Caitlin S Wyrwoll
- School of Human Sciences, University of Western Australia, Crawley, WA, Australia
| | - David B Preen
- School of Population and Global Health, University of Western Australia, Crawley, WA, Australia
| | - Erin Kelty
- School of Population and Global Health, University of Western Australia, Crawley, WA, Australia
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16
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Scarborough J, Iachizzi M, Schalbetter SM, Müller FS, Weber-Stadlbauer U, Richetto J. Prenatal and postnatal influences on behavioral development in a mouse model of preconceptional stress. Neurobiol Stress 2024; 29:100614. [PMID: 38357099 PMCID: PMC10865047 DOI: 10.1016/j.ynstr.2024.100614] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Revised: 01/12/2024] [Accepted: 02/02/2024] [Indexed: 02/16/2024] Open
Abstract
Depression during pregnancy is detrimental for the wellbeing of the expectant mother and can exert long-term consequences on the offspring's development and mental health. In this context, both the gestational environment and the postpartum milieu may be negatively affected by the depressive pathology. It is, however, challenging to assess whether the contributions of prenatal and postnatal depression exposure are distinct, interactive, or cumulative, as it is unclear whether antenatal effects are due to direct effects on fetal development or because antenatal symptoms continue postnatally. Preclinical models have sought to answer this question by implementing stressors that induce a depressive-like state in the dams during pregnancy and studying the effects on the offspring. The aim of our present study was to disentangle the contribution of direct stress in utero from possible changes in maternal behavior in a novel model of preconceptional stress based on social isolation rearing (SIR). Using a cross-fostering paradigm in this model, we show that while SIR leads to subtle changes in maternal behavior, the behavioral changes observed in the offspring are driven by a complex interaction between sex, and prenatal and postnatal maternal factors. Indeed, male offspring are more sensitive to the prenatal environment, as demonstrated by behavioral and transcriptional changes driven by their birth mother, while females are likely affected by more complex interactions between the pre and the postpartum milieu, as suggested by the important impact of their surrogate foster mother. Taken together, our findings suggest that male and female offspring have different time-windows and behavioral domains of susceptibility to maternal preconceptional stress, and thus underscore the importance of including both sexes when investigating the mechanisms that mediate the negative consequences of exposure to such stressor.
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Affiliation(s)
- Joseph Scarborough
- Institute of Pharmacology and Toxicology, University of Zurich-Vetsuisse, Zurich, Switzerland
| | - Monica Iachizzi
- Institute of Pharmacology and Toxicology, University of Zurich-Vetsuisse, Zurich, Switzerland
| | - Sina M. Schalbetter
- Institute of Pharmacology and Toxicology, University of Zurich-Vetsuisse, Zurich, Switzerland
| | - Flavia S. Müller
- Institute of Pharmacology and Toxicology, University of Zurich-Vetsuisse, Zurich, Switzerland
| | - Ulrike Weber-Stadlbauer
- Institute of Pharmacology and Toxicology, University of Zurich-Vetsuisse, Zurich, Switzerland
- Neuroscience Center Zurich, University of Zurich and ETH Zurich, Zurich, Switzerland
| | - Juliet Richetto
- Institute of Pharmacology and Toxicology, University of Zurich-Vetsuisse, Zurich, Switzerland
- Neuroscience Center Zurich, University of Zurich and ETH Zurich, Zurich, Switzerland
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17
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Wu Q, Radey M, Han SJ, Jalapa K, Tawfiq D, McWey L. Profiles of perceived resources among low-income, rural mothers: Prospective associations with maternal and child outcomes. FAMILY PROCESS 2024; 63:331-347. [PMID: 36720209 PMCID: PMC10387500 DOI: 10.1111/famp.12862] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/20/2022] [Revised: 12/01/2022] [Accepted: 01/09/2023] [Indexed: 06/18/2023]
Abstract
Low-income, rural families face significant mental health risks. However, the understanding of resources associated with mental health risks is limited. The present study investigated the associations between perceived resources of low-income, rural mothers, and longitudinal maternal and child outcomes. This study utilized longitudinal data from the Family Life Project (N = 1203), from US rural areas with high poverty rates. Mothers reported their resources at 6-month postpartum, and their levels of depression, anxiety, and role overload were assessed at 2-year postpartum. Mothers reported their children's behavioral problems at 3 years old. Using a person-centered approach, we identified four maternal profiles: lower resources (7.1%); higher intra-family support (11.1%); higher inter-family support (20.8%); and higher resources (60.9%). In general, the higher resource profile was associated with lower mental health concerns of mothers and lower levels of behavior problems of children. Mothers in the higher intra-family support profile had disproportionately higher role overload. Children of mothers in the higher inter-family support profile showed disproportionately higher behavioral problems. Maternal partner status and education were significant predictors of resource profiles. Findings support the heterogeneity in perceived resources among low-income, rural families and different risk levels. Identifying these subgroups has significant implications for policy and interventions aimed toward this vulnerable population.
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Affiliation(s)
- Qiong Wu
- Department of Human Development & Family Science, College of Health and Human Sciences, Florida State University
| | | | - Soo Jin Han
- Department of Human Development & Family Science, College of Health and Human Sciences, Florida State University
| | - Karina Jalapa
- Department of Human Development & Family Science, College of Health and Human Sciences, Florida State University
| | - Dania Tawfiq
- Department of Human Development & Family Science, College of Health and Human Sciences, Florida State University
| | - Lenore McWey
- Department of Human Development & Family Science, College of Health and Human Sciences, Florida State University
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18
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Ingeborgrud CB, Oerbeck B, Friis S, Pripp AH, Zeiner P, Aase H, Biele G, Dalsgaard S, Overgaard KR. Do maternal anxiety and depressive symptoms predict anxiety in children with and without ADHD at 8 years? Eur Child Adolesc Psychiatry 2024:10.1007/s00787-024-02374-1. [PMID: 38376613 DOI: 10.1007/s00787-024-02374-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2023] [Accepted: 01/08/2024] [Indexed: 02/21/2024]
Abstract
Maternal anxiety and depression during pregnancy and early childhood have been associated with child anxiety and attention-deficit/hyperactivity disorder (ADHD). However, previous studies are limited by their short follow-up, few assessments of maternal symptoms, and by not including maternal and child ADHD. The present study aimed to fill these gaps by investigating whether maternal anxiety and depressive symptoms from pregnancy to child age 5 years increase the risk of child anxiety disorders at age 8 years. This study is part of the population-based Norwegian Mother, Father, and Child Cohort Study. Maternal anxiety and depressive symptoms were assessed by the Hopkins Symptom Checklist (SCL) six times from pregnancy through early childhood, and ADHD symptoms by the Adult Self-Report Scale (ASRS). At age 8 years (n = 781), symptoms of anxiety disorders and ADHD were assessed, and disorders classified by the Child Symptom Inventory-4. Logistic regression models estimated the risk of child anxiety depending on maternal symptoms. The mothers of children classified with an anxiety disorder (n = 91) scored significantly higher on the SCL (at all time points) and ASRS compared with the other mothers. In univariable analyses, maternal anxiety and/or depression and ADHD were associated with increased risk of child anxiety (odds ratios = 2.99 and 3.64, respectively), remaining significant in the multivariable analysis adjusted for covariates. Our findings link maternal anxiety, depression, and ADHD during pregnancy and early childhood to child anxiety at age 8 years.
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Affiliation(s)
- Christine Baalsrud Ingeborgrud
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway.
- Division of Mental Health and Addiction, Child and Adolescent Psychiatry Unit, Institute of Clinical Medicine, University of Oslo, Blindern, 0315, Oslo, Norway.
| | - Beate Oerbeck
- Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
| | - Svein Friis
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
| | - Are Hugo Pripp
- Oslo Centre of Biostatistics and Epidemiology, Oslo University Hospital, Oslo, Norway
| | - Pål Zeiner
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
| | - Heidi Aase
- Department of Child Health and Development, Norwegian Institute of Public Health, Oslo, Norway
| | - Guido Biele
- Department of Child Health and Development, Norwegian Institute of Public Health, Oslo, Norway
| | - Søren Dalsgaard
- Institute of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
- Dept. of Child and Adolescent Psychiatry Glostrup, Mental Health Services of the Capital Region, Hellerup, Denmark
- School of Business and Social Sciences, National Centre for Register-Based Research, Aarhus University, Aarhus C, Denmark
| | - Kristin Romvig Overgaard
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
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19
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Yang W, Wang Y, Ko C, Niu X, Huang Y, Luo B, Wang G, He J, Li H. Effect of lite touch on the anxiety of low-risk pregnant women in the latent phase of childbirth: a randomized controlled trial. Front Psychol 2024; 15:1304274. [PMID: 38375113 PMCID: PMC10875089 DOI: 10.3389/fpsyg.2024.1304274] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2023] [Accepted: 01/22/2024] [Indexed: 02/21/2024] Open
Abstract
Introduction Women with perinatal anxiety have reduced coping capacity during labor, which affects labor progress and increases the likelihood of a cesarean section. Several non-pharmacological interventions for anxiety during childbirth are available. This study used the "lite touch" method, a non-pharmacological intervention based on physiological responses and obstetric clinical experience in women. We aimed to evaluate whether lite touch could relieve perinatal anxiety and investigate the effect of light skin stroking on the maternal hormones, catecholamine, and cortisol. Methods This randomized clinical trial involved women with low-risk singleton pregnancies at full term or near term. Eligible pregnant women who were latent and did not undergo epidural anesthesia were randomized into two groups. Participants in the intervention group underwent routine prenatal care, including lite touch, whereas the control group underwent routine prenatal care alone. Demographic data were collected through a questionnaire. Labor anxiety was assessed using the State Anxiety Inventory, and saliva was collected before and after the intervention. Changes in saliva cortisol and catecholamine levels were analyzed using a double-antibody sandwich enzyme-linked immunosorbent assay. Results In total, 83 participants were included, with 43 and 40 in the intervention and control groups, respectively. In the intervention group, pre-intervention anxiety scores were significantly lower (p < 0.01) than post-intervention anxiety scores, whereas the control group showed no difference in anxiety scores before and after intervention (p > 0.05). Cortisol and catecholamine levels in saliva were significantly lower in the intervention group than in the control group after the intervention (p < 0.01). Discussion Lite touch can reduce the latent anxiety state of low-risk pregnant women, thereby maintaining in vivo stability and facilitating labor. Clinical trial registration https://www.chictr.org.cn/aboutEN.html, ChiCTR2300070905, Retrospectively Registered Date: April 26, 2023.
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Affiliation(s)
- Wenqian Yang
- Department of Obstetrics Nursing, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, China
- Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, Sichuan, China
| | - Yonghong Wang
- Department of Obstetrics Nursing, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, China
- Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, Sichuan, China
| | - Chingyuan Ko
- Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, Sichuan, China
- Department of Nursing, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Xiaoyu Niu
- Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, Sichuan, China
- Department of Gynecology, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Yan Huang
- Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, Sichuan, China
- Department of Nursing, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Biru Luo
- Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, Sichuan, China
- Department of Nursing, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Guoyu Wang
- Department of Obstetrics Nursing, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, China
- Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, Sichuan, China
| | - Jingjing He
- Department of Obstetrics Nursing, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, China
- Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, Sichuan, China
| | - Huafeng Li
- Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, Sichuan, China
- Department of Anesthesiology, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, China
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20
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Caffieri A, Gómez‐Gómez I, Barquero‐Jimenez C, De‐Juan‐Iglesias P, Margherita G, Motrico E. Global prevalence of perinatal depression and anxiety during the COVID-19 pandemic: An umbrella review and meta-analytic synthesis. Acta Obstet Gynecol Scand 2024; 103:210-224. [PMID: 38113292 PMCID: PMC10823409 DOI: 10.1111/aogs.14740] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Revised: 11/08/2023] [Accepted: 11/09/2023] [Indexed: 12/21/2023]
Abstract
INTRODUCTION The prevalence of depression and anxiety symptoms in pregnant and postpartum women during the COVID-19 pandemic was assessed by several systematic reviews (SRs) and meta-analyses which provided contrasting and different results. We aimed to summarize the evidence relating to the global prevalence of anxiety and depression among pregnant and postpartum women during the COVID-19 pandemic. MATERIAL AND METHODS An umbrella review of SRs and meta-analyses was performed. Searches were conducted in electronic databases up to April 2023. SRs and meta-analyses reporting the prevalence of perinatal anxiety and depression during the COVID-19 pandemic were selected for eligibility. Primary studies extracted from eligible meta-analyses were included in the quantitative synthesis. The research protocol was registered on PROSPERO (CRD42020173125). RESULTS A total of 25 SRs (198 primary studies) and 12 meta-analyses (129 primary studies) were included in the qualitative and quantitative synthesis, respectively. Studies involved data from five continents and 45 countries. The pooled prevalence of antenatal and postpartum depression was 29% (n = 55; 95% CI: 25%-33%) and 26% (n = 54; 95% CI: 23%-30%), respectively. In the case of anxiety, the pooled antenatal and postnatal prevalence was 31% (n = 44; 95% CI: 26%-37%; n = 16; 95% CI: 24%-39%). Differences emerged between continents, with Africa having the highest prevalence of perinatal depression and Oceania and Europe having the highest prevalence of antenatal and postnatal anxiety. The prevalence also varied depending on the assessment tools, especially for antenatal anxiety. A medium-high quality of the studies was observed. One SR assessed strength-of-evidence, reporting very low strength. CONCLUSIONS During the COVID-19 pandemic, depression and anxiety were common, affecting almost one in three perinatal women globally. A high heterogeneity and a risk of publication bias were found, partially due to the variety of assessment tools and cut-offs. The results may not be generalized to minorities. Studies on the prevalence of clinical diagnoses are needed. Based on our results it is not possible to firmly affirm that the COVID-19 pandemic was the main factor that directly increased perinatal depression and anxiety during the past few years. Future studies should study other factors' impact.
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Affiliation(s)
- Alessia Caffieri
- Department of Humanistic StudiesUniversity of Naples Federico IINaplesItaly
| | | | | | | | - Giorgia Margherita
- Department of Humanistic StudiesUniversity of Naples Federico IINaplesItaly
| | - Emma Motrico
- Department of PsychologyUniversidad Loyola AndalucíaSevilleSpain
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21
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Reissland N, Ustun B, Einbeck J. The effects of lockdown during the COVID-19 pandemic on fetal movement profiles. BMC Pregnancy Childbirth 2024; 24:56. [PMID: 38212680 PMCID: PMC10782783 DOI: 10.1186/s12884-024-06259-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2023] [Accepted: 01/04/2024] [Indexed: 01/13/2024] Open
Abstract
PURPOSE The current study investigated the direct impact of the COVID-19 lockdown on fetal movements, addressing a critical research gap. While previous research has predominantly examined the effects of lockdown on maternal health and postnatal outcomes, little attention has been paid to the direct consequences on fetal well-being as indicated by their movement profile. METHODS We conducted analysis of movement profiles in 20 healthy fetuses during the COVID-19 pandemic lockdown (third national UK lockdown period between January and March 2021) and compared them with 20 healthy fetuses from pre-covid pregnancies, all at 32 weeks gestation. We controlled for maternal stress, depression, and anxiety. RESULTS Pregnant mothers during pre-covid compared with those during the COVID-19 lockdown reported similar levels of stress (p = 0.47), depression (p = 0.15), and anxiety (p = 0.07). Their fetuses, however, differed in their movement profiles with mouth movement frequencies significantly higher during COVID-19 lockdown (COVID-19 lockdown: mean of 5.909) compared to pre-Covid pregnancies (mean of 3.308; p = 0.029). Furthermore, controlling for maternal anxiety a regression analysis indicated that frequency of fetal mouth movements (p = 0.017), upper face movements (p = 0.008), and touch movements (p = 0.031) were all significantly higher in fetuses observed during lockdown compared to fetuses before the Covid period. CONCLUSION Fetuses show an effect of lockdown independent of maternal anxiety, stress, or depression. These findings contribute to our understanding of fetal development during extraordinary circumstances, raising questions about the potential effects of having to stay indoors during lockdowns.
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Affiliation(s)
- N Reissland
- Department of Psychology, Durham University, Science Site, South Road, Durham, UK.
| | - B Ustun
- Division of Human Nutrition and Health, Wageningen University & Research, Stippeneng 4, Wageningen, 6708 WE, The Netherlands
| | - J Einbeck
- Department of Mathematical Sciences, Durham University, Durham, UK
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22
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Haile TT, Kebede AA, Gessesse DN, Tsega NT, Aklil MB, Temesgan WZ, Anteneh TA, Tibebu NS, Alemu HN, Seyoum AT, Tiguh AE, Yismaw AE, Mihret MS, Nenko G, Wondie KY, Taye BT, Abegaz MY. Anxiety and associated factors in Northwest Ethiopian pregnant women: a broad public health concern. Front Public Health 2024; 11:1300229. [PMID: 38259803 PMCID: PMC10800707 DOI: 10.3389/fpubh.2023.1300229] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2023] [Accepted: 11/22/2023] [Indexed: 01/24/2024] Open
Abstract
Introduction Pregnancy-related anxiety is a prevalent mental health issue that mostly affects women in low-income countries such as Ethiopia. It has been linked to unfavorable pregnancy outcomes, such as miscarriage, prematurity, and low birth weight. However, it has often received less attention, and community-based evidence lacks its prevalence and associated factors. Thus, the purpose of this study was to assess the prevalence and associated factors of anxiety in Northwest Ethiopian pregnant women in Gondar city. Methods A community-based cross-sectional study was conducted from 1 July to 30 August 2021 in Gondar city. A cluster sampling technique was used to select a sample of 872 pregnant women, and in-person interviews were conducted to gather data. Descriptive and analytical statistical procedures were carried out. Results Of the participants, pregnancy-related anxiety was reported in 29.4% (95% CI: 26.3, 32.4) of women. The likelihood of having anxiety was higher among women who had known medical illness (AOR = 3.16; 95% CI: 1.8, 5.35), loneliness (AOR = 2.52; 95% CI: 1.34, 4.73), depression (AOR = 2.38; 95% CI: 1.48, 3.85), poor social support (AOR = 1.93; 95% CI: 1.21, 3.07), and intimate partner violence (AOR = 2.87; 95% CI: 2.04, 4.04). Conclusion In this study, three out of ten women have suffered from anxiety. It is strongly advised to identify and treat known medical illnesses early in pregnancy, enhance social support, diagnose and treat depression, and limit intimate partner violence through multimodal and integrative activities with concerned bodies.
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Affiliation(s)
- Tsion Tadesse Haile
- Department of General Midwifery, School of Midwifery, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Azmeraw Ambachew Kebede
- Department of Clinical Midwifery, School of Midwifery, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Dereje Nibret Gessesse
- Department of Clinical Midwifery, School of Midwifery, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Nuhamin Tesfa Tsega
- Department of Women’s and Family Health, School of Midwifery, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Mastewal Belayneh Aklil
- Department of Clinical Midwifery, School of Midwifery, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Wubedle Zelalem Temesgan
- Department of Clinical Midwifery, School of Midwifery, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Tazeb Alemu Anteneh
- Department of Women’s and Family Health, School of Midwifery, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Nebiyu Solomon Tibebu
- Department of Clinical Midwifery, School of Midwifery, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Haymanot Nigatu Alemu
- Department of Clinical Midwifery, School of Midwifery, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Asmra Tesfahun Seyoum
- Department of General Midwifery, School of Midwifery, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Agumas Eskezia Tiguh
- Department of Clinical Midwifery, School of Midwifery, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Ayenew Engida Yismaw
- Department of Clinical Midwifery, School of Midwifery, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Muhabaw Shumye Mihret
- Department of Clinical Midwifery, School of Midwifery, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Goshu Nenko
- Department of Psychiatry, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Kindu Yinges Wondie
- Department of Clinical Midwifery, School of Midwifery, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Birhan Tsegaw Taye
- School of Nursing and Midwifery, Asrat Woldeyes Health Science Campus, Debre Berhan University, Debre Berhan, Ethiopia
| | - Marta Yimam Abegaz
- Department of Clinical Midwifery, School of Midwifery, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
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Hennessey EMP, Swales DA, Markant J, Hoffman MC, Hankin BL, Davis EP. Maternal anxiety during pregnancy predicts infant attention to affective faces. J Affect Disord 2024; 344:104-114. [PMID: 37802320 PMCID: PMC10841611 DOI: 10.1016/j.jad.2023.09.031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2023] [Revised: 08/24/2023] [Accepted: 09/24/2023] [Indexed: 10/08/2023]
Abstract
BACKGROUND Prenatal maternal anxiety is a known influence on offspring development. General anxiety and pregnancy-related anxiety (a distinct type of anxiety encompassing fears associated with pregnancy) are associated with offspring socioemotional development, with potential consequences for later emotional and behavioral problems. This study examines whether maternal pregnancy-related and general anxiety relate to infant attention to affective faces, a process which plays an integral role in early socioemotional development. METHODS Participants included 86 mothers and their 6-month-old infants (56.3 % female). Mothers completed measures of pregnancy-related and general anxiety three times through gestation. Infants' attention to affective faces was assessed with an eye-tracking task during which a series of face pairs were presented (happy, angry, or sad face paired with a neutral face). Overall attention measures included attention-holding (total looking time) and attention-orienting (latency to faces); affect-biased attention measures included proportion of total looking time to emotional faces and latency difference score. RESULTS Higher maternal pregnancy-related anxiety across gestation predicted decreased infant attention-holding to affective faces [F(1,80) = 7.232, p = .009, partial η2 = 0.083]. No differences were found in infant attention-orienting or affect-biased attention. LIMITATIONS Reliance on a correlational study design precludes the ability to make causal inferences. CONCLUSIONS Maternal pregnancy-related anxiety is an important predictor of child outcomes. We provide novel evidence that pregnancy-related anxiety predicts infant attention to emotional faces, behaviors which have important implications for socioemotional development. Providers may consider pregnancy-related anxiety as a target for screening and treatment that may benefit both pregnant individual and offspring.
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Affiliation(s)
| | - Danielle A Swales
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Julie Markant
- Department of Psychology & Tulane Brain Institute, Tulane University, New Orleans, LA, USA
| | - M Camille Hoffman
- Department of Obstetrics and Gynecology, Division of Maternal and Fetal Medicine, University of Colorado Denver School of Medicine, Aurora, CO, USA
| | - Benjamin L Hankin
- Department of Psychology, University of Illinois at Urbana-Champaign, Champaign, IL, USA
| | - Elysia Poggi Davis
- Department of Psychology, University of Denver, Denver, CO, USA; Department of Pediatrics, University of California, Irvine, CA, USA
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24
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Roy U, Swain D. A prospective cohort study to assess the prevalence and risk factors of antepartum depression and its effect on maternal and fetal outcome. Asian J Psychiatr 2024; 91:103873. [PMID: 38154353 DOI: 10.1016/j.ajp.2023.103873] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Revised: 12/11/2023] [Accepted: 12/13/2023] [Indexed: 12/30/2023]
Abstract
Antepartum depression (APD) is a public health issue has negative repercussions on the health of the mother, child, and family. Early screening for APD will help in early detection and further prevention of postpartum depression and adverse maternal and fetal outcomes. This study was designed to determine i) the prevalence rate of APD in the Indian population and its associated risk factors, ii) the impact of APD on maternal and fetal outcomes. A retrospective cohort study was conducted among antenatal women in the third trimester and screened for antepartum depression between October 2021 and March 2022 by adopting the Edinburgh Postnatal Depression Scale (EPDS). In the study population, 36.6 % had mild to moderate level of depressive symptoms (EPDS score of 8-12) and 28 % had high levels of depressive symptoms (EPDS score of ≥13). An unplanned pregnancy, a history of abortion, and a history of any pregnancy complications were the likely maternal risk factors for developing antepartum depression. The APD risk was also likely to be increased by sociodemographic and personal factors such as insufficient family support, a history of domestic violence, marital dissatisfaction, and a partner with a poor level of education (P < 0.05). Women screened with antepartum depression had 58.34 times the likelihood of developing postpartum depression and a threefold greater risk of having premature delivery. These findings may help to improve pregnancy outcomes by early identification, referral for early treatment of antepartum depression, also inform maternal mental health service development and utilization for boosting women's mental wellbeing.
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Affiliation(s)
- Ushma Roy
- College of Nursing, AIIMS Bhubaneswar, Odisha, India
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25
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Skelton E, Webb R, Malamateniou C, Rutherford M, Ayers S. The impact of antenatal imaging on parent experience and prenatal attachment: a systematic review. J Reprod Infant Psychol 2024; 42:22-44. [PMID: 35736666 DOI: 10.1080/02646838.2022.2088710] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2021] [Accepted: 06/04/2022] [Indexed: 10/17/2022]
Abstract
INTRODUCTION Medical imaging in pregnancy (antenatal imaging) is routine. However, the effect of seeing fetal images on the parent-fetal relationship is not well understood, particularly for fathers or partners, or when using advanced imaging technologies. This review aimed to explore how parent experience and prenatal attachment is impacted by antenatal imaging. METHOD Database searches were performed between September 2020 and April 2021 Inclusion criteria were English language primary research studies published since 2000, describing or reporting measures of attachment after antenatal imaging in expectant parents. The Pillar Integration Process was used for integrative synthesis. FINDINGS Twenty-three studies were included. Six pillar themes were developed: 1) the scan experience begins before the scan appointment; 2) the scan as a pregnancy ritual; 3) feeling actively involved in the scan; 4) parents' priorities for knowledge and understanding of the scan change during pregnancy; 5) the importance of the parent-sonographer partnership during scanning; and 6) scans help to create a social identity for the unborn baby. CONCLUSION Antenatal imaging can enhance prenatal attachment. Parents value working collaboratively with sonographers to be actively involved in the experience. Sonographers can help facilitate attachment by delivering parent-centred care tailored to parents' emotional and knowledge needs.
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Affiliation(s)
- Emily Skelton
- Division of Radiography and Midwifery, City University of London, London, UK
| | - Rebecca Webb
- Centre for Maternal and Child Health Research, City University of London, London, UK
| | | | | | - Susan Ayers
- Centre for Maternal and Child Health Research, City University of London, London, UK
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Lasso-Olayo L, Pasierb D, Berdejo V, Gasch-Gallén Á. Psychological response of pregnant women during COVID-19 pandemic lockdown. Rev Esc Enferm USP 2023; 57:e20230088. [PMID: 38131440 PMCID: PMC10740368 DOI: 10.1590/1980-220x-reeusp-2023-0088en] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Accepted: 10/18/2023] [Indexed: 12/23/2023] Open
Abstract
OBJECTIVE In this study we explore anxiety and fear of COVID-19 in women in the process of pregnancy during lockdown due to the SARS CoV-2 pandemic and their relationship with sociodemographic and clinical factors in a tertiary referral level hospital. METHOD A descriptive cross-sectional study was carried out in pregnant women at the Lozano Blesa University Clinical Hospital in Zaragoza (Spain), from April 15, 2020 to May 15, 2020. A total of 168 women was recruited when they went to the hospital for a routine blood test for pregnancy. They answered a sociodemographic and clinical data questionnaire, the Spielberg state-trait anxiety questionnaire for anxiety, and a visual analog scale for fear of COVID. RESULTS Frequency of Trait anxiety was 50.7% (95% CI: 42.7-58.7) and 52.7% (95% CI: 44.7-60.7) for State anxiety. The mean visual analog scale for fear of COVID-19 in relation to pregnancy was 57.2 (95% CI: 52.4-61.8). A positive correlation was found between the scales. Statistically significant differences were found between rural and urban areas. CONCLUSION The emotional impact of the COVID-19 is high among pregnant women and the levels of anxiety are higher than usual in these groups of women during the pandemic lockdown.
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Affiliation(s)
- Laura Lasso-Olayo
- Universidad de Zaragoza, Facultad de Ciencias de la Salud, Departamento de Fisiatría y Enfermería, Zaragoza, Spain
| | - Dominika Pasierb
- University of Rzeszow, Institute of Health Sciences, College of Medical Sciences, Rzeszow, Poland
| | - Víctor Berdejo
- Universidad de Zaragoza, Facultad de Ciencias, Departamento de Física Aplicada, Zaragoza, Spain
| | - Ángel Gasch-Gallén
- Universidad de Zaragoza, Facultad de Ciencias de la Salud, Departamento de Fisiatría y Enfermería, Zaragoza, Spain
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27
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Kumpulainen V, Copeland A, Pulli EP, Silver E, Kataja EL, Saukko E, Merisaari H, Lewis JD, Karlsson L, Karlsson H, Tuulari JJ. Prenatal and Postnatal Maternal Depressive Symptoms Are Associated With White Matter Integrity in 5-Year-Olds in a Sex-Specific Manner. Biol Psychiatry 2023; 94:924-935. [PMID: 37220833 DOI: 10.1016/j.biopsych.2023.05.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Revised: 04/18/2023] [Accepted: 05/14/2023] [Indexed: 05/25/2023]
Abstract
BACKGROUND Prenatal and postnatal maternal psychological distress predicts various detrimental consequences on social, behavioral, and cognitive development of offspring, especially in girls. Maturation of white matter (WM) continues from prenatal development into adulthood and is thus susceptible to exposures both before and after birth. METHODS WM microstructural features of 130 children (mean age, 5.36 years; range, 5.04-5.79 years; 63 girls) and their association with maternal prenatal and postnatal depressive and anxiety symptoms were investigated with diffusion tensor imaging, tract-based spatial statistics, and regression analyses. Maternal questionnaires were collected during first, second, and third trimesters and at 3, 6, and 12 months postpartum with the Edinburgh Postnatal Depression Scale (EPDS) for depressive symptoms and Symptom Checklist-90 for general anxiety. Covariates included child's sex; child's age; maternal prepregnancy body mass index; maternal age; socioeconomic status; and exposures to smoking, selective serotonin reuptake inhibitors, and synthetic glucocorticoids during pregnancy. RESULTS Prenatal second-trimester EPDS scores were positively associated with fractional anisotropy in boys (p < .05, 5000 permutations) after controlling for EPDS scores 3 months postpartum. In contrast, postpartum EPDS scores at 3 months correlated negatively with fractional anisotropy (p < .01, 5000 permutations) in widespread areas only in girls after controlling for prenatal second-trimester EPDS scores. Perinatal anxiety was not associated with WM structure. CONCLUSIONS These results suggest that prenatal and postnatal maternal psychological distress is associated with brain WM tract developmental alterations in a sex- and timing-dependent manner. Future studies including behavioral data are required to consolidate associative outcomes for these alterations.
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Affiliation(s)
- Venla Kumpulainen
- FinnBrain Birth Cohort Study, Turku Brain and Mind Center, Department of Clinical Medicine, University of Turku, Turku, Finland; Centre for Population Health Research, Turku University Hospital and University of Turku, Turku, Finland.
| | - Anni Copeland
- FinnBrain Birth Cohort Study, Turku Brain and Mind Center, Department of Clinical Medicine, University of Turku, Turku, Finland; Centre for Population Health Research, Turku University Hospital and University of Turku, Turku, Finland
| | - Elmo P Pulli
- FinnBrain Birth Cohort Study, Turku Brain and Mind Center, Department of Clinical Medicine, University of Turku, Turku, Finland; Centre for Population Health Research, Turku University Hospital and University of Turku, Turku, Finland
| | - Eero Silver
- FinnBrain Birth Cohort Study, Turku Brain and Mind Center, Department of Clinical Medicine, University of Turku, Turku, Finland; Centre for Population Health Research, Turku University Hospital and University of Turku, Turku, Finland
| | - Eeva-Leena Kataja
- FinnBrain Birth Cohort Study, Turku Brain and Mind Center, Department of Clinical Medicine, University of Turku, Turku, Finland; Centre for Population Health Research, Turku University Hospital and University of Turku, Turku, Finland
| | - Ekaterina Saukko
- Department of Radiology, Turku University Hospital, Turku, Finland
| | - Harri Merisaari
- FinnBrain Birth Cohort Study, Turku Brain and Mind Center, Department of Clinical Medicine, University of Turku, Turku, Finland; Centre for Population Health Research, Turku University Hospital and University of Turku, Turku, Finland; Department of Radiology, Turku University Hospital, Turku, Finland
| | - John D Lewis
- Montreal Neurological Institute, McGill University, Montreal, Canada
| | - Linnea Karlsson
- FinnBrain Birth Cohort Study, Turku Brain and Mind Center, Department of Clinical Medicine, University of Turku, Turku, Finland; Centre for Population Health Research, Turku University Hospital and University of Turku, Turku, Finland; Department of Clinical Medicine, Paediatrics and Adolescent Medicine, Turku University Hospital and University of Turku, Turku, Finland
| | - Hasse Karlsson
- FinnBrain Birth Cohort Study, Turku Brain and Mind Center, Department of Clinical Medicine, University of Turku, Turku, Finland; Centre for Population Health Research, Turku University Hospital and University of Turku, Turku, Finland; Department of Psychiatry, Turku University Hospital and University of Turku, Turku, Finland
| | - Jetro J Tuulari
- FinnBrain Birth Cohort Study, Turku Brain and Mind Center, Department of Clinical Medicine, University of Turku, Turku, Finland; Centre for Population Health Research, Turku University Hospital and University of Turku, Turku, Finland; Department of Psychiatry, Turku University Hospital and University of Turku, Turku, Finland; Turku Collegium for Science, Medicine and Technology, University of Turku, Turku, Finland; Department of Psychiatry, University of Oxford, Oxford, United Kingdom
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28
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Xu Y, Zheng P, Feng W, Chen L, Sun S, Liu J, Tang W, Bao C, Xu L, Xu D, Zhao K. Patterns of attentional bias in antenatal depression: an eye-tracking study. Front Behav Neurosci 2023; 17:1288616. [PMID: 38192488 PMCID: PMC10773570 DOI: 10.3389/fnbeh.2023.1288616] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2023] [Accepted: 11/07/2023] [Indexed: 01/10/2024] Open
Abstract
Introduction One of the most common mental disorders in the perinatal period is depression, which is associated with impaired emotional functioning due to alterations in different cognitive aspects including thought and facial emotion recognition. These functional impairment may affect emerging maternal sensitivity and have lasting consequences for the dyadic relationship. The current study aimed to investigate the impact of depressive symptoms on the attention bias of infant stimuli during pregnancy. Methods Eighty-six pregnant women completed the Edinburgh Postnatal Depression Scale and an eye-tracking task comprising infant-related emotion images. All participants showed biased attention to infant-related images. Results First, compared to healthy pregnant women, pregnant women with depression symptoms initially directed their attention to infant-related stimuli more quickly (F (1, 84) = 6.175, p = 0.015, η2 = 0.068). Second, the two groups of pregnant women paid attention to the positive infant stimuli faster than the neutral infant stimuli, and the first fixation latency bias score was significantly smaller than that of the infant-related negative stimulus (p = 0.007). Third, compared with the neutral stimulus, the non-depression group showed a longer first gaze duration to the negative stimulus of infants (p = 0.019), while the depressive symptoms group did not show this difference. Conclusion We speculate that structural and functional changes in affective motivation and cognitive-attention brain areas may induce these attentional bias patterns. These results provide suggestions for the implementation of clinical intervention programs to correct the attention bias of antenatal depressed women.
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Affiliation(s)
- Yao Xu
- School of Mental Health, Wenzhou Medical University, Wenzhou, China
| | - Peiwen Zheng
- School of Mental Health, Wenzhou Medical University, Wenzhou, China
| | - Wenqian Feng
- Sichuan Provincial Center for Mental Health, Sichuan Academy of Medical Science and Sichuan Provincial People's Hospital, Chengdu, China
| | - Lipeng Chen
- School of Mental Health, Wenzhou Medical University, Wenzhou, China
| | - Shiyu Sun
- School of Mental Health, Wenzhou Medical University, Wenzhou, China
| | - Jie Liu
- School of Mental Health, Wenzhou Medical University, Wenzhou, China
| | - Weina Tang
- Shaoxing 7th People’s Hospital, Shaoxing, China
| | - Ciqing Bao
- Wenzhou Seventh People’s Hospital, Wenzhou, China
| | - Ling Xu
- Wenzhou Seventh People’s Hospital, Wenzhou, China
| | - Dongwu Xu
- School of Mental Health, Wenzhou Medical University, Wenzhou, China
| | - Ke Zhao
- Lishui Second People’s Hospital Affiliated to Wenzhou Medical University, Lishui, China
- The Affiliated Kangning Hospital of Wenzhou Medical University Zhejiang Provincial Clinical Research Center for Mental Disorder, Wenzhou, China
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29
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Sandonis M, Temprado J, Hernández-Fleury A, Parramón-Puig G, Dip ME, Ramos-Quiroga JA, Maiz N, Carreras E, Brik M. Impact of the trait anxiety during pregnancy on birth weight: an observational cohort study. J Psychosom Obstet Gynaecol 2023; 44:2241631. [PMID: 37548020 DOI: 10.1080/0167482x.2023.2241631] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Revised: 07/21/2023] [Accepted: 07/23/2023] [Indexed: 08/08/2023] Open
Abstract
To explore the effects of antenatal anxiety on fetal growth an observational cohort study was performed, including a cohort of 204 women with singleton pregnancies during the strict lockdown of the COVID-19 pandemic in 2020. Psychosocial factors, maternal demographics, obstetric outcomes, social support (Medical Outcomes Study Social Support Survey, MOS-SSS), and symptoms of anxiety (State-Trait Anxiety Inventory, STAIs and STAIt) and depression (Edinburgh Postpartum Depression Scale, EPDS) were studied as potential predictors of low birth weight. Main outcome measures were birth weight, head circumference and length. Results showed a negative correlation between STAIt score (trait anxiety) and birth weight percentile (r = -0.228, p = .047). In the univariate linear regression analysis, a lower maternal weight and BMI before pregnancy, parity, increased STAIt score and preterm birth below 37 weeks of gestation (p = .008, p = .015, p = .028, p = .047 and p = .022, respectively) were identified as predictive risk factors for low birth weight, whereas in the multivariate lineal regression analysis only a lower maternal weight before pregnancy and an increased STAIt score were independent predictors for low birth weight (p = .020, p = .049, respectively). To conclude, anxiety during pregnancy impacts birth weight, and specifically the trait anxiety, is a predictor for low birth weight.
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Affiliation(s)
- Miguel Sandonis
- Mental Health Department, Hospital Universitari Vall d'Hebron, Barcelona, Spain
- Department of Psychiatry and Forensic Medicine, Universitat Autònoma de Barcelona, Spain
| | - Joaquín Temprado
- Obstetrics Department, Maternal-Fetal Medicine Unit, Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | - Alina Hernández-Fleury
- Obstetrics Department, Maternal-Fetal Medicine Unit, Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | - Gemma Parramón-Puig
- Mental Health Department, Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | - María Emilia Dip
- Mental Health Department, Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | - Josep Antoni Ramos-Quiroga
- Mental Health Department, Hospital Universitari Vall d'Hebron, Barcelona, Spain
- Biomedical Network Research Centre on Mental Health (CIBERSAM), Madrid, Spain
| | - Nerea Maiz
- Obstetrics Department, Maternal-Fetal Medicine Unit, Hospital Universitari Vall d'Hebron, Barcelona, Spain
- Universidad Autónoma de Barcelona, Barcelona, Spain
| | - Elena Carreras
- Obstetrics Department, Maternal-Fetal Medicine Unit, Hospital Universitari Vall d'Hebron, Barcelona, Spain
- Universidad Autónoma de Barcelona, Barcelona, Spain
| | - Maia Brik
- Obstetrics Department, Maternal-Fetal Medicine Unit, Hospital Universitari Vall d'Hebron, Barcelona, Spain
- Universidad Autónoma de Barcelona, Barcelona, Spain
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Caparros-Gonzalez RA, Essau C, Gouin JP, Pemau A, Galvez-Merlin A, de la Torre-Luque A. Perinatal, obstetric and parental risk factors for asthma in the offspring throughout childhood: a longitudinal cohort study. J Perinat Med 2023; 51:1163-1170. [PMID: 37326102 DOI: 10.1515/jpm-2022-0543] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Accepted: 04/29/2023] [Indexed: 06/17/2023]
Abstract
OBJECTIVES Asthma is a common chronic and burdensome disease which typically begins in childhood. The aim of this study was to assess perinatal and obstetric factors which may increase the risk of developing asthma in the offspring. METHODS Data from five consecutive waves (n=7,073 children, from birth to 15 years old) from a nationally-representative birth cohort of people born in the United Kingdom between 2000 and 2002, the Millennium Cohort Study (MCS), were used. The Kaplan-Meier survival curve was used to graphically display the risk of developing asthma from early childhood to adolescence. The Z-based Wald test was used to prove significant covariate loading. RESULTS Cox regression analyzing the influence of covariates on asthma development risk showed a significant likelihood ratio test, χ2(18)=899.30, p<0.01. A parent with asthma (OR=2.02, p<0.01), a younger maternal age at delivery (OR=0.98, p<0.05), and the use of assisted reproductive technology (OR=1.43, p<0.05) were associated with an increased risk of developing asthma in the offspring. CONCLUSIONS Perinatal factors (a younger maternal age, assisted reproductive technology) and a parental factor (a parent with asthma) increased the risk for developing asthma in the offspring.
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Affiliation(s)
- Rafael A Caparros-Gonzalez
- Department of Nursing, Faculty of Health Sciences, University of Granada, Granada, Spain
- Instituto de Investigacion Biosanitaria ibs.GRANADA, Granada, Spain
| | - Cecilia Essau
- School of Psychology, University of Roehampton, London, UK
| | | | - Andres Pemau
- Department of Personality, Assessment and Clinical Psychology, Universidad Complutense de Madrid, Madrid, Spain
| | - Alejandra Galvez-Merlin
- Department of Personality, Assessment and Clinical Psychology, Universidad Complutense de Madrid, Madrid, Spain
| | - Alejandro de la Torre-Luque
- Department of Legal Medicine, Psychiatry and Pathology, Universidad Complutense de Madrid, Madrid, Spain
- Centre for Biomedical Research in Mental Health (CIBERSAM), Madrid, Spain
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Tao L, Wu R, Song X, Xia M, Yao R. The associations between 2D:4D ratio and behavior problems among Chinese preschool children: A cross-sectional study. Early Hum Dev 2023; 186:105871. [PMID: 37797473 DOI: 10.1016/j.earlhumdev.2023.105871] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/20/2023] [Revised: 09/28/2023] [Accepted: 09/29/2023] [Indexed: 10/07/2023]
Abstract
BACKGROUND Digit ratio (2D:4D) is considered a biomarker of prenatal androgen activity, the prenatal hormone exposure may affect children's psychology and behavior. OBJECTIVE The aim of this study was to analyze the associations between 2D:4D ratio and behavior problems in Chinese preschool children, and to provide ideas for early intervention of children's behavior problems. METHODS A total of 548 Chinese preschool children aged 3-6 years were recruited using a stratified cluster sampling method. The Child Behavior Checklist (CBCL) was used to assess the children's behavior. Basic information of the children and their parents was also collected, finger length was directly measured by electronic vernier caliper. RESULTS We found that sex and age of the child, mother's educational level, and whether the child was an only child were the influencing factors of behavior problems (P < 0.05). Right-handed 2D:4D was negatively correlated with parent-reported anxiety/depression (P < 0.05), father-reported aggression (P < 0.05) and attention problems (P < 0.01), that is, high levels of testosterone may increase the risk of anxiety and depression, our results were in contrast to previous studies. CONCLUSION The 2D:4D ratio may be related to behavior problems among Chinese preschool children, and prenatal testosterone exposure may be an important factor affecting behavior problems.
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Affiliation(s)
- Lan Tao
- Department of Child and Adolescents Health, School of Public Health, Bengbu Medical College, 2600 East Sea Avenue, Bengbu 233030, Anhui, China
| | - Ruoyao Wu
- Fengxian District Center for Disease Control and Prevention, Jiefang E Rd, Shanghai 201400, China
| | - Xingxing Song
- Department of Child and Adolescents Health, School of Public Health, Bengbu Medical College, 2600 East Sea Avenue, Bengbu 233030, Anhui, China
| | - Moyan Xia
- Department of Child and Adolescents Health, School of Public Health, Bengbu Medical College, 2600 East Sea Avenue, Bengbu 233030, Anhui, China
| | - Rongyin Yao
- Department of Child and Adolescents Health, School of Public Health, Bengbu Medical College, 2600 East Sea Avenue, Bengbu 233030, Anhui, China.
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Lugo-Candelas C, Hwei T, Lee S, Lucchini M, Smaniotto Aizza A, Kahn LG, Buss C, O'Connor TG, Ghassabian A, Padula AM, Aschner J, Deoni S, Margolis AE, Canino G, Monk C, Posner J, Duarte CS. Prenatal sleep health and risk of offspring ADHD symptomatology and associated phenotypes: a prospective analysis of timing and sex differences in the ECHO cohort. LANCET REGIONAL HEALTH. AMERICAS 2023; 27:100609. [PMID: 38106969 PMCID: PMC10725065 DOI: 10.1016/j.lana.2023.100609] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/24/2023] [Revised: 09/12/2023] [Accepted: 09/21/2023] [Indexed: 12/19/2023]
Abstract
Background Sleep difficulties are common in pregnancy, yet poor prenatal sleep may be related to negative long-term outcomes for the offspring, including risk for attention-deficit/hyperactivity disorder (ADHD). Existing studies are few and have not examined timing of exposure effects or offspring sex moderation. We thus aimed to test the hypotheses that poor sleep health in pregnancy is associated with increased risk for ADHD symptoms and offspring sleep problems at approximately 4 years of age. Methods Participants were 794 mother-child dyads enrolled in the NIH Environmental Influences on Child Health Outcomes Study (ECHO). Participants self-reported on sleep duration, quality, and disturbances during pregnancy and on children's ADHD symptoms and sleep problems on the Child Behaviour Checklist. Findings Pregnant participants were 32.30 ± 5.50 years and children were 46% female. 44 percent of pregnant participants identified as Hispanic or Latine; 49% identified as White. Second-trimester sleep duration was associated with offspring ADHD symptoms (b = -0.35 [95% CI = -0.57, -0.13], p = 0.026), such that shorter duration was associated with greater symptomatology. Poorer sleep quality in the second trimester was also associated with increased ADHD symptomatology (b = 0.66 [95% CI = 0.18, 1.14], p = 0.037). Greater sleep disturbances in the first trimester were associated with offspring ADHD (b = 1.03 [95% CI = 0.32, 1.03], p = 0.037) and in the second trimester with sleep problems (b = 1.53 [95% CI = 0.42, 2.92], p = 0.026). We did not document substantial offspring sex moderation. Interpretation Poor prenatal sleep health, particularly quality and duration in the second trimester, may be associated with offspring risk of neurodevelopmental disorders and sleep problems in early childhood. Further research is needed to understand mechanisms, yet our study suggests that prenatal maternal sleep may be a modifiable target for interventions aimed at optimizing early neurodevelopment. Funding NIH grants U2COD023375, U24OD023382, U24OD023319, UH3OD023320, UH3OD023305, UH3OD023349, UH3OD023313, UH3OD023272, UH3OD023328, UH3OD023290, K08MH117452 and NARSAD Young Investigator Award 28545.
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Affiliation(s)
- Claudia Lugo-Candelas
- New York State Psychiatric Institute/Columbia University Irving Medical Center, 1051 Riverside Drive, New York, NY, 10032, USA
| | - Tse Hwei
- New York State Psychiatric Institute/Columbia University Irving Medical Center, 1051 Riverside Drive, New York, NY, 10032, USA
| | - Seonjoo Lee
- New York State Psychiatric Institute/Columbia University Irving Medical Center, 1051 Riverside Drive, New York, NY, 10032, USA
| | | | - Alice Smaniotto Aizza
- New York State Psychiatric Institute/Columbia University Irving Medical Center, 1051 Riverside Drive, New York, NY, 10032, USA
| | - Linda G. Kahn
- NYU Grossman School of Medicine, 227 East 34th Street, Room 811, New York, NY, 10016, USA
| | - Claudia Buss
- Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Luisenstrasse 57, 10117, Berlin, Germany
| | | | - Akhgar Ghassabian
- NYU Grossman School of Medicine, 227 East 34th Street, Room 811, New York, NY, 10016, USA
| | - Amy M. Padula
- University of California, San Francisco, 490 Illinois Street, Box 0132, San Francisco, CA, 94158, USA
| | - Judy Aschner
- Hackensack Meridian School of Medicine, Nutley NJ and Albert Einstein College of Medicine, Bronx, NY, USA
| | - Sean Deoni
- Bill & Melinda Gates Foundation, 500 Mercer Str, Seattle, WA, 98275, USA
| | - Amy E. Margolis
- New York State Psychiatric Institute/Columbia University Irving Medical Center, 1051 Riverside Drive, New York, NY, 10032, USA
| | - Glorisa Canino
- University of Puerto Rico Medical Sciences Campus, Behavioral Sciences Research Institute, 9th Floor, Rio Piedras, PR, 00935, Puerto Rico
| | - Catherine Monk
- New York State Psychiatric Institute/Columbia University Irving Medical Center, 1051 Riverside Drive, New York, NY, 10032, USA
| | - Jonathan Posner
- Duke University, North Pavilion Building, 2400 Pratt Street, Durham, NC, 27705, USA
| | - Cristiane S. Duarte
- New York State Psychiatric Institute/Columbia University Irving Medical Center, 1051 Riverside Drive, New York, NY, 10032, USA
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Ballarotto G, Murray L, Bozicevic L, Marzilli E, Cerniglia L, Cimino S, Tambelli R. Parental sensitivity to toddler's need for autonomy: An empirical study on mother-toddler and father-toddler interactions during feeding and play. Infant Behav Dev 2023; 73:101892. [PMID: 37839158 DOI: 10.1016/j.infbeh.2023.101892] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Revised: 08/11/2023] [Accepted: 10/03/2023] [Indexed: 10/17/2023]
Abstract
During the second year of life, children's need for autonomy grows, and their behaviors become increasingly complex. Parental sensitivity to children's different cues is important in supporting adaptive psycho-emotional development. The present study assumes that mothers and fathers may respond with varying levels of sensitivity to the child's different cues, with particular attention to requests for greater autonomy. The study also examines the possible role played by interactive contexts (ie., play and feeding) and children's and parents' individual factors. The sample comprised N = 91 families with children aged between 12 and 24 months. Mother-toddler and father-toddler interactions were assessed during feeding and play. Parents completed questionnaires assessing children's temperament, psychopathological risk, and parenting stress. RESULTS: showed that toddlers' demands for autonomy were the most frequent cues in both play and feeding contexts, both with mothers and fathers. Furthermore, parents were more sensitive to toddlers' requests for cooperation than their requests for autonomy, in both interactive contexts. Moreover, mothers and fathers showed higher sensitivity to toddlers' demands for greater autonomy in the play context rather than in the feeding context. Mothers were more sensitive than fathers to toddlers' cues of resistance to parents' actions and to toddlers' requests for cooperation. Results showed differences and specificities in mother-toddler and father-toddler interactions in the two interactive contexts, showing associations between child negative emotionality, parental psychopathological risk and parenting stress, and maternal and paternal sensitivity to toddlers' demands for greater autonomy during play and feeding, respectively. These results confirm the initial hypotheses regarding parental sensitivity and its differential expression according to child cues. Implications are discussed.
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Affiliation(s)
- G Ballarotto
- Department of Dynamic and Clinical Psychology, Sapienza - University of Rome, Rome, Italy.
| | - L Murray
- School of Psychology and Clinical Language Sciences, Earley Gate, University of Reading, United Kingdom
| | - L Bozicevic
- Institute of Population Health, Department of Primary Care & Mental Health, Faculty of Health and Life Sciences, University of Liverpool, United Kingdom
| | - E Marzilli
- Department of Dynamic and Clinical Psychology, Sapienza - University of Rome, Rome, Italy
| | - L Cerniglia
- Department of Psychology, International Telematic University Uninettuno, Rome, Italy
| | - S Cimino
- Department of Dynamic and Clinical Psychology, Sapienza - University of Rome, Rome, Italy
| | - R Tambelli
- Department of Dynamic and Clinical Psychology, Sapienza - University of Rome, Rome, Italy
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Gebeyehu NA, Tegegne KD, Abebe K, Asefa Y, Assfaw BB, Adella GA, Alemu BW, Sewyew DA. Global prevalence of post-abortion depression: systematic review and Meta-analysis. BMC Psychiatry 2023; 23:786. [PMID: 37884930 PMCID: PMC10605843 DOI: 10.1186/s12888-023-05278-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Accepted: 10/13/2023] [Indexed: 10/28/2023] Open
Abstract
BACKGROUND Depression after abortion is a common problem for all women of reproductive age. However, there are not any data on post-abortion depression at a global level. Consequently, the purpose of this study was to find out the global prevalence of post-abortion depression. METHODS The present study involved a comprehensive search of several databases, including Science Direct, Scopus, EMBSE, Google Scholar, and PubMed. The search was conducted between February 1, 2023, and March 10, 2023. The data was extracted using Microsoft Excel (version 14) and analyzed using STATA statistical software. To evaluate publication bias, a forest plot, Begg's test, and Egger's test were employed. Heterogeneity was assessed using I2, and a pooled estimated analysis was conducted. Additionally, subgroup analysis was performed based on the study continent/region, World Bank income group, screening instrument, and study design. RESULTS This analysis included 15 papers with a total of 18,207 research participants out of a total of 657 articles. The overall pooled prevalence of post-abortion depression was found to be 34.5% (95% CI: 23.34, 45.68), with an I2 value of 71.6%. The prevalence of post-abortion depression varied based on geographic location, World Health Organization (WHO) regions, World Bank income category, screening approach, and study design. The highest proportion of post-abortion depression was observed in Asia (37.5%), while the WHO's Eastern Mediterranean region had the greatest rate of post-abortion depression (43.1%). Lower-middle-income countries had the highest frequency of post-abortion depression (42.91%) based on World Bank economic classification. The Center of Epidemiological Studies Depression Scale was found to have the highest incidence of reported depression prevalence (30%) across diagnostic tools. Furthermore, the prevalence of depression was higher in cross-sectional study designs (36.42%) compared to cohort studies (22.7%). CONCLUSION In conclusion, the occurrence of post-abortion depression has been observed to be widespread globally. The prevalence of post-abortion is found to be influenced by several factors, including the methodology employed in the study, the diagnostic tool utilized, the geographical location, and the socioeconomic status of the population. Healthcare providers should prioritize the provision of post-abortion counseling, care, and emotional support to women.
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Affiliation(s)
- Natnael Atnafu Gebeyehu
- School of Midwifery, College of Medicine and Health Sciences, Wolaita Sodo University, Sodo, Ethiopia.
| | - Kirubel Dagnaw Tegegne
- Department of Comprehensive Nursing, College of Medicine and Health Science, Wollo University, Dessie, Ethiopia
| | - Kelemu Abebe
- School of Midwifery, College of Medicine and Health Sciences, Wolaita Sodo University, Sodo, Ethiopia
| | - Yibeltal Asefa
- Department of Public Health, College of Medicine and Health Science, Wolaita Sodo University, Sodo, Ethiopia
| | - Belete Birhan Assfaw
- Department of Psychiatry, College of Medicine and Health Science, Wolaita Sodo University, Sodo, Ethiopia
| | - Getachew Asmare Adella
- Department of Reproductive Health, College of Medicine and Health Science, Wolaita Sodo University, Sodo, Ethiopia
| | - Biresaw Wassihun Alemu
- Department of Midwifery, College of Medicine and Health Science, Indiana University, Injibara, Ethiopia
| | - Dagne Addisu Sewyew
- Department of Midwifery, College of Medicine and Health Science, Debre Tabor University, Debre Tabor, Ethiopia
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Howard A, Wang S, Adachi J, Yadama A, Bhat A. Facilitators of and barriers to perinatal telepsychiatry care: a qualitative study. BMJ Open 2023; 13:e071084. [PMID: 37802623 PMCID: PMC10565296 DOI: 10.1136/bmjopen-2022-071084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Accepted: 09/04/2023] [Indexed: 10/10/2023] Open
Abstract
OBJECTIVES Perinatal mental health disorders such as anxiety, depression and bipolar disorder can negatively impact the health of women and their children without appropriate detection and treatment. Due to increases in mental health symptoms and transmission risks associated with in-person appointments, many clinics transitioned to providing telepsychiatry care during the COVID-19 pandemic. This study sought to identify the facilitators and barriers to receiving perinatal telepsychiatry care from the perspective of patients, clinic staff and psychiatrists. DESIGN Qualitative study based on analysis of in depth semistructured interviews. SETTING The study was conducted in a virtual specialty mental health clinic in an academic setting. PARTICIPANTS Eight patients who had been scheduled for an appointment with the perinatal telepsychiatry clinic between 14 May 2021 and 1 August 2021, seven of whom had attended their scheduled appointment with the clinic and one of whom had not, and five staff members including psychiatrists, navigators and clinic managers, participated in in-depth interviews. RESULTS Telepsychiatry was perceived by most as preferable to in-person care and easy to attend and navigate. Alternatively, technological difficulties, personal preference for in-person care and scheduling conflicts related to the perinatal period were identified as barriers by some. Participants identified communication between care staff and patients, online patient portals, and appointment reminders as important for facilitating appointment preparedness and attendance. CONCLUSIONS The findings from this study suggest that telepsychiatry services are perceived positively by patients and care staff and have the potential to improve access to mental healthcare for perinatal patients.
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Affiliation(s)
- Anna Howard
- Department of Epidemiology, University of Washington, Seattle, Washington, USA
| | - Sunny Wang
- Department of Health Systems and Population Health, University of Washington, Seattle, Washington, USA
| | - Jamie Adachi
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, Washington, USA
| | - Alexa Yadama
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, Washington, USA
| | - Amritha Bhat
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, Washington, USA
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Anns F, Waldie KE, Peterson ER, Walker C, Morton SMB, D'Souza S. Behavioural outcomes of children exposed to antidepressants and unmedicated depression during pregnancy. J Affect Disord 2023; 338:144-154. [PMID: 37295656 DOI: 10.1016/j.jad.2023.05.097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Revised: 05/30/2023] [Accepted: 05/31/2023] [Indexed: 06/12/2023]
Abstract
BACKGROUND Antenatal exposure to both antidepressants and maternal depression has been associated with child behavioural difficulties. However, previous research has not adequately distinguished between the effects of the antidepressants and the underlying maternal depression. METHODS Child behavioural difficulties were assessed using the Strengths and Difficulties Questionnaire at 2-, 4.5-, and 8-years of age by mothers in the Growing Up in New Zealand study (N = 6233 at 2-years; N = 6066 at 4.5-years; N = 4632 at 8-years). Mothers were classified as either on antidepressants, unmedicated depression, or neither based on self-reported antidepressant intake during pregnancy and the Edinburgh Postnatal Depression Scale. Hierarchical multiple logistic regressions were used to examine whether antenatal exposure to antidepressants and unmedicated depression had a differential association with child behavioural outcomes relative to no exposure. RESULTS When later life depression in the mother and a range of birth and sociodemographic variables were accounted for, neither antenatal exposure to unmedicated depression or antidepressants remained associated with an increased risk of behavioural difficulties at the ages investigated. However, maternal later life depression was associated with behavioural difficulties in the fully adjusted analyses at all three ages investigated. LIMITATIONS The current study relied on mother-report of child behaviour which may be susceptible to bias due to maternal mental health problems. CONCLUSIONS Adjusted results did not show an adverse association between antenatal antidepressant exposure or unmedicated depression in relation to child behaviour. Findings also suggest that efforts to improve child behaviour need to include more family-based approaches that support maternal wellbeing.
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Affiliation(s)
- Francesca Anns
- School of Psychology, The University of Auckland, Auckland, New Zealand; Centre of Methods and Policy Application in the Social Sciences, University of Auckland, Auckland, New Zealand
| | - Karen E Waldie
- School of Psychology, The University of Auckland, Auckland, New Zealand; Centre for Longitudinal Research - He Ara ki Mua, The University of Auckland, Auckland, New Zealand
| | - Elizabeth R Peterson
- School of Psychology, The University of Auckland, Auckland, New Zealand; Centre for Longitudinal Research - He Ara ki Mua, The University of Auckland, Auckland, New Zealand
| | - Caroline Walker
- Centre for Longitudinal Research - He Ara ki Mua, The University of Auckland, Auckland, New Zealand; School of Population Health, The University of Auckland, Auckland, New Zealand
| | - Susan M B Morton
- Centre for Longitudinal Research - He Ara ki Mua, The University of Auckland, Auckland, New Zealand; School of Population Health, The University of Auckland, Auckland, New Zealand; INSIGHT, University of Technology Sydney, Sydney, Australia
| | - Stephanie D'Souza
- Centre of Methods and Policy Application in the Social Sciences, University of Auckland, Auckland, New Zealand; School of Social Sciences, The University of Auckland, Auckland, New Zealand.
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Chaudhary R, Rohilla M, Chauhan S, Saini M, Aman S, Singla H, bibi A, Ahmed S, Shriwastav S, Kaur N, Dev J, Chalotra R, Singh TG, Mehta S. The pandemic's unseen wounds: COVID-19's profound effects on mental health. Ann Med Surg (Lond) 2023; 85:4954-4963. [PMID: 37811101 PMCID: PMC10552974 DOI: 10.1097/ms9.0000000000001223] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Accepted: 08/12/2023] [Indexed: 10/10/2023] Open
Abstract
Objective This review aims to explore the impact of the COVID-19 pandemic on mental health, with a focus on the physiological and psychological consequences, including comorbidities. The goal is to understand the direct and indirect populations affected by mental distress and identify potential interventions. Methodology A comprehensive literature search was conducted using various databases, including Google Scholar, ResearchGate, ScienceDirect, PubMed, PLoS One, and Web of Science. The search utilized relevant keywords to investigate the direct and indirect impacts of COVID-19 on mental health. The selected articles were critically evaluated and analyzed to identify key findings and insights. Main findings Mental health, being an intrinsic component of overall well-being, plays a vital role in physiological functioning. The COVID-19 pandemic, caused by the emergence of the novel SARS-CoV-2 virus, has had a devastating global impact. Beyond the respiratory symptoms, individuals recovering from COVID-19 commonly experience additional ailments, such as arrhythmia, depression, anxiety, and fatigue. Healthcare professionals on the frontlines face an elevated risk of mental illness. However, it is crucial to recognize that the general population also grapples with comparable levels of mental distress. Conclusion The COVID-19 pandemic has underscored the significance of addressing mental health concerns. Various strategies can help mitigate the impact, including counselling, fostering open lines of communication, providing mental support, ensuring comprehensive patient care, and administering appropriate medications. In severe cases, treatment may involve the supplementation of essential vitamins and antidepressant therapy. By understanding the direct and indirect impacts of COVID-19 on mental health, healthcare providers and policymakers can develop targeted interventions to support individuals and communities affected by the pandemic. Continued research and collaborative efforts are essential to address this pervasive issue effectively.
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Affiliation(s)
| | - Manni Rohilla
- Chitkara College of Pharmacy, Chitkara University
- Swami Vivekanand College of Pharmacy, Rajpura, Punjab
| | | | - Monika Saini
- M.M. College of Pharmacy
- Swami Vivekanand College of Pharmacy, Rajpura, Punjab
| | - Shahbaz Aman
- Department of Microbiology, M.M. Institute of Medical Science and Research, Maharishi Markandeshwar (Deemed to be University), Mullana, Ambala, Haryana
| | | | | | | | - Shalini Shriwastav
- Department of Microbiology, M.M. Institute of Medical Science and Research, Maharishi Markandeshwar (Deemed to be University), Mullana, Ambala, Haryana
| | - Narinder Kaur
- Department of Microbiology, M.M. Institute of Medical Science and Research, Maharishi Markandeshwar (Deemed to be University), Mullana, Ambala, Haryana
| | - Jai Dev
- Department of Microbiology, M.M. Institute of Medical Science and Research, Maharishi Markandeshwar (Deemed to be University), Mullana, Ambala, Haryana
| | - Rishabh Chalotra
- Department of Pharmacology, Central University of Punjab, Bathinda, India
| | | | - Sachin Mehta
- Birat Medical college Teaching Hospital, Kathmandu University, Nepal
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Miles A, Lovell M, Ibrahim R, Dagli TE, Dagli FS, Sethna DV. A feasibility study of Online Mellow Bumps: A Turkish pilot study of an online group-based antenatal parenting intervention. Midwifery 2023; 125:103772. [PMID: 37451037 DOI: 10.1016/j.midw.2023.103772] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2022] [Revised: 05/29/2023] [Accepted: 07/07/2023] [Indexed: 07/18/2023]
Abstract
BACKGROUND As a result of the COVID-19 pandemic, Mellow Parenting proposed online strategies for some of their interventions. One such intervention was Mellow Bumps - becoming Online Mellow Bumps. The objective of this study was to evaluate the implementation of antenatal parenting intervention Mellow Bumps in an online format and determine if this can be done safely and without detriment to pregnant women in Turkey. METHOD The study used an exploratory study design to investigate routine evaluation data collected pre- and post-intervention. Outcomes were online feasibility, mental health symptoms (depression, anxiety and stress), maternal subjective well-being, perceived quality of relationship with baby, maternal confidence and maternal social connectivity. 128 mums-to-be took part in the intervention between January 2021 and May 2021 from a total of 21 different provinces in Turkey. RESULTS 57 pre- and post-intervention responses were eligible for analysis. This gives a response rate of 44.5% for evaluation, though the intervention completion rate was high at 89.5%, suggesting the intervention is engaging and accessible. Improvements were found for maternal stress levels, maternal subjective well-being and perceived relationship with baby. Improvements were also found for maternal confidence and maternal social connectivity. CONCLUSIONS This is the first study to evaluate the antenatal parenting intervention Mellow Bumps in an online format, namely Online Mellow Bumps. The online format makes the programme accessible for at-risk mothers and families, with the potential to continue reaching wider audiences beyond the pandemic who otherwise might struggle to access support. The findings show that the online group can be effective in improving mental health symptoms and mental well-being, supporting expectant mothers before the baby is born. Future research using a control group, a larger and more inclusive sample, and assessing the longer-term effects on parent and child would be beneficial.
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Affiliation(s)
- Alex Miles
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, Strand, London WC2R 2LS, United Kingdom.
| | - Michael Lovell
- Mellow Parenting, Unit 4, Six Harmony Row, Glasgow G51 3BA, Scotland
| | - Raquib Ibrahim
- Mellow Parenting, Unit 4, Six Harmony Row, Glasgow G51 3BA, Scotland
| | - Tolga E Dagli
- Department of Pediatric Surgery, Marmara University Faculty of Medicine, Istanbul, Turkey
| | - Figen Sahin Dagli
- Department of Pediatrics, Gazi University Faculty of Medicine, Ankara, Turkey
| | - Dr Vaheshta Sethna
- Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, Psychology and Neuroscience, King's College London, Strand, London WC2R 2LS, United Kingdom
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Bulterys MA, Njuguna I, Mahy M, Gulaid LA, Powis KM, Wedderburn CJ, John-Stewart G. Neurodevelopment among children exposed to HIV and uninfected in sub-Saharan Africa. J Int AIDS Soc 2023; 26 Suppl 4:e26159. [PMID: 37909232 PMCID: PMC10618877 DOI: 10.1002/jia2.26159] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Accepted: 08/21/2023] [Indexed: 11/02/2023] Open
Abstract
INTRODUCTION The population of 16 million children exposed to HIV and uninfected (CHEU) under 15 years of age continues to expand rapidly, and the estimated prevalence of CHEU exceeds 20% in several countries in sub-Saharan Africa with high HIV prevalence. Some evidence suggests that CHEU experience suboptimal neurodevelopmental outcomes compared to children born to women without HIV. In this commentary, we discuss the latest research on biologic and socio-behavioural factors associated with neurodevelopmental outcomes among CHEU. DISCUSSION Some but not all studies have noted that CHEU are at risk of poorer neurodevelopment across multiple cognitive domains, most notably in language and motor skills, in diverse settings, ages and using varied assessment tools. Foetal HIV exposure can adversely influence infant immune function, structural brain integrity and growth trajectories. Foetal exposure to antiretrovirals may also influence outcomes. Moreover, general, non-CHEU-specific risk factors for poor neurodevelopment, such as preterm birth, food insecurity, growth faltering and household violence, are amplified among CHEU; addressing these factors will require multi-factorial solutions. There is a need for rigorous harmonised approaches to identify children at the highest risk of delay. In high-burden HIV settings, existing maternal child health programmes serving the general population could adopt structured early child development programmes that educate healthcare workers on CHEU-specific risk factors and train them to conduct rapid neurodevelopmental screening tests. Community-based interventions targeting parent knowledge of optimal caregiving practices have shown to be successful in improving neurodevelopmental outcomes in children and should be adapted for CHEU. CONCLUSIONS CHEU in sub-Saharan Africa have biologic and socio-behavioural factors that may influence their neurodevelopment, brain maturation, immune system and overall health and wellbeing. Multidisciplinary research is needed to disentangle complex interactions between contributing factors. Common environmental and social risk factors for suboptimal neurodevelopment in the general population are disproportionately magnified within the CHEU population, and it is, therefore, important to draw on existing knowledge when considering the socio-behavioural pathways through which HIV exposure could impact CHEU neurodevelopment. Approaches to identify children at greatest risk for poor outcomes and multisectoral interventions are needed to ensure optimal outcomes for CHEU in sub-Saharan Africa.
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Affiliation(s)
- Michelle A Bulterys
- Department of Epidemiology, University of Washington, Seattle, Washington, USA
- Department of Global Health, University of Washington, Seattle, Washington, USA
| | - Irene Njuguna
- Department of Global Health, University of Washington, Seattle, Washington, USA
- Kenyatta National Hospital, Nairobi, Kenya
| | | | - Laurie A Gulaid
- UNICEF, eastern and southern Africa Regional Office, Nairobi, Kenya
| | - Katheen M Powis
- Harvard Medical School, Boston, Massachusetts, USA
- Department of Immunology and Infectious Diseases, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
- Department of Internal Medicine and Pediatrics, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Catherine J Wedderburn
- Department of Pediatrics and Child Health and Neuroscience Institute, University of Cape Town, Cape Town, South Africa
- Department of Clinical Research, London School of Hygiene & Tropical Medicine, London, UK
| | - Grace John-Stewart
- Department of Epidemiology, University of Washington, Seattle, Washington, USA
- Department of Global Health, University of Washington, Seattle, Washington, USA
- Department of Pediatrics, University of Washington, Seattle, Washington, USA
- School of Medicine, University of Washington, Seattle, Washington, USA
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Amiel Castro RT, Schaal NK, Meyerhoff H, Preis H, Mahaffey B, Lobel M, La Marca-Ghaemmaghami P. Investigating Factors Influencing Prenatal Stress, Anxiety, and Fear of Childbirth During the COVID-19 Pandemic in Germany and Switzerland: An Online Survey. Matern Child Health J 2023; 27:1864-1875. [PMID: 37470899 DOI: 10.1007/s10995-023-03758-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/09/2023] [Indexed: 07/21/2023]
Abstract
OBJECTIVES Pregnant women are likely to experience high levels of stress during the COVID-19 pandemic. However, the factors that might influence the extent of experienced emotional distress are poorly understood. Therefore, we aimed to investigate potential correlates of prenatal emotional distress during the COVID-19 pandemic. METHODS In total, N = 1437 pregnant women from Germany and Switzerland participated in an online study during the first wave of the COVID-19 pandemic (May-August 2020). The survey assessed prenatal distress, pandemic-related pregnancy stress, general anxiety, fear of childbirth, and several socio-demographic, pregnancy- and COVID-19-related factors. Linear multivariate regression models were the main analytical strategy. RESULTS The results highlight that several factors such as full-time employment, nulliparity, high-risk pregnancy, emotional problems, cancelled prenatal appointments, and stating that COVID-19 affected the choice of birth mode were significantly associated with elevated prenatal distress, anxiety, pandemic-related pregnancy stress, and fear of childbirth. Conversely, access to an outdoor space was a protective factor for pandemic-related pregnancy stress and prenatal distress. CONCLUSIONS FOR PRACTICE Overall, the study highlights significant correlates influencing the levels of emotional distress pregnant women experienced during the COVID-19 pandemic. These findings may contribute to the improvement of maternal prenatal medical and psychological care during a public health crisis of international concern, such as the COVID-19 pandemic.
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Affiliation(s)
- Rita T Amiel Castro
- Department of Clinical Psychology and Psychotherapy, University of Zurich, Zurich, Switzerland
| | - Nora K Schaal
- Institute of Experimental Psychology, Heinrich-Heine-University, Dusseldorf, Germany
| | - Hannah Meyerhoff
- Department of Clinical Psychology and Psychotherapy, University of Zurich, Zurich, Switzerland
| | - Heidi Preis
- Department of Psychology, Stony Brook University, Stony Brook, NY, USA
- Department of Obstetrics, Gynecology and Reproductive Medicine, Renaissance School of Medicine, Stony Brook University, Stony Brook, NY, USA
| | - Brittain Mahaffey
- Department of Psychology, Stony Brook University, Stony Brook, NY, USA
| | - Marci Lobel
- Department of Psychology, Stony Brook University, Stony Brook, NY, USA
- Department of Obstetrics, Gynecology and Reproductive Medicine, Renaissance School of Medicine, Stony Brook University, Stony Brook, NY, USA
| | - Pearl La Marca-Ghaemmaghami
- Psychology Counselling and Research Institute for Sexuality, Marriage and the Family, International Academy for Human Sciences and Culture, Staadweg 3, P.O. Box 57, 8880, Walenstadt, Switzerland.
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Yong R, Chai H, Ran L, Li Y, An B. Depression in the next generation is related with maternal behaviors: A cross-comparison by alternating rat's mother care. PLoS One 2023; 18:e0291952. [PMID: 37733756 PMCID: PMC10513200 DOI: 10.1371/journal.pone.0291952] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Accepted: 09/09/2023] [Indexed: 09/23/2023] Open
Abstract
This study investigated the potential impacts of depressive rats' maternal behavior as an early life stress on the outcome of offspring as an adulthood. Offspring from the same mother were divided into two groups, half of them were fostered or remained by a depressive mother, and the other half remained or fostered by a control mother, respectively. The results showed that offspring fostered by depressive mothers presented significant depressive behaviors. Meanwhile, depressive mothers engaged in more grooming during the light cycle, but less off-the-pup behavior during the dark phase. In conclusion, offspring exposed to a postnatal depressive maternal environment developed a depressive-like behavior. Contrarily, postpartum maternal behaviors play an essential role, which might determine the outcome of the next generation. Furthermore, the appropriate timing of postpartum maternal caring sequences, which might eliminate prenatal stressful influences, was recognized and might be a promising approach for reducing children's predisposition to mental disorders in their life time.
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Affiliation(s)
- Ruixin Yong
- The First Hospital of Lanzhou University, Lanzhou University, Lanzhou, Gansu, China
| | - Hongxia Chai
- The First Hospital of Lanzhou University, Lanzhou University, Lanzhou, Gansu, China
| | - Lei Ran
- School of Basic Medical Sciences, Lanzhou University, Lanzhou, Gansu, China
| | - Yuhao Li
- School of Basic Medical Sciences, Lanzhou University, Lanzhou, Gansu, China
| | - Bei An
- School of Basic Medical Sciences, Lanzhou University, Lanzhou, Gansu, China
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Phua DY, Chew CSM, Tan YL, Ng BJK, Lee FKL, Tham MMY. Differential effects of prenatal psychological distress and positive mental health on offspring socioemotional development from infancy to adolescence: a meta-analysis. Front Pediatr 2023; 11:1221232. [PMID: 37780045 PMCID: PMC10536167 DOI: 10.3389/fped.2023.1221232] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2023] [Accepted: 08/29/2023] [Indexed: 10/03/2023] Open
Abstract
The impact of prenatal maternal mental health on offspring socioemotional development is substantial and enduring. Existing literature primarily focuses on the effects of psychological distress during pregnancy, emphasizing adverse child outcomes. Recent studies, however, highlight the unique impact of positive maternal mental health on child outcomes. To elucidate the differential associations of maternal psychological distress and positive mental health during pregnancy with child outcomes, we conducted a systematic literature search and random-effects meta-analyses on studies investigating the associations of prenatal maternal mental health with child socioemotional development. Our analyses, comprising 74 studies with 321,966 mother-child dyads across 21 countries, revealed significant associations of prenatal psychological distress with both adverse and positive child socioemotional outcomes. Notably, the effect sizes for the association of psychological distress with positive child outcomes were smaller compared to adverse outcomes. Positive prenatal mental health, on the other hand, was significantly associated with positive socioemotional outcomes but not adverse outcomes. This meta-analysis highlights the independence of negative and positive prenatal mental health constructs and their distinct relationships with child socioemotional development. The findings underscore the importance of considering the positive spectrum of maternal mental health and developmental outcomes to enhance our understanding of prenatal influences on child development. Systematic Review Registration: https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=335227, identifier CRD42022335227.
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Affiliation(s)
- Desiree Y. Phua
- Singapore Institute for Clinical Sciences (SICS), Agency for Science, Technology and Research (A*STAR), Singapore, Singapore
| | - Chermaine S. M. Chew
- Singapore Institute for Clinical Sciences (SICS), Agency for Science, Technology and Research (A*STAR), Singapore, Singapore
| | - Yang Lik Tan
- Singapore Institute for Clinical Sciences (SICS), Agency for Science, Technology and Research (A*STAR), Singapore, Singapore
- School of Management and Communication, Republic Polytechnic, Singapore, Singapore
| | - Benjamin J. K. Ng
- Singapore Institute for Clinical Sciences (SICS), Agency for Science, Technology and Research (A*STAR), Singapore, Singapore
- School of Management and Communication, Republic Polytechnic, Singapore, Singapore
| | - Florence K. L. Lee
- Singapore Institute for Clinical Sciences (SICS), Agency for Science, Technology and Research (A*STAR), Singapore, Singapore
- School of Management and Communication, Republic Polytechnic, Singapore, Singapore
| | - Megan M. Y. Tham
- Singapore Institute for Clinical Sciences (SICS), Agency for Science, Technology and Research (A*STAR), Singapore, Singapore
- School of Management and Communication, Republic Polytechnic, Singapore, Singapore
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Jimenez-Barragan M, del Pino Gutierrez A, Garcia JC, Monistrol-Ruano O, Coll-Navarro E, Porta-Roda O, Falguera-Puig G. Study protocol for improving mental health during pregnancy: a randomized controlled low-intensity m-health intervention by midwives at primary care centers. BMC Nurs 2023; 22:309. [PMID: 37674184 PMCID: PMC10483870 DOI: 10.1186/s12912-023-01440-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2023] [Accepted: 08/08/2023] [Indexed: 09/08/2023] Open
Abstract
BACKGROUND Pregnancy-related anxiety and depression has received considerable attention worldwide. Mental health problems in pregnant women already since early weeks of gestation may have important consequences to the fetus. The necessity for more effective health care pathways, including some early interventions that reduce the overall burden of the childbearing situation appears a key factor for a successful birth and care of the baby. The few studies focalized in interventions, are focused on delivery and postpartum, without taking into account the whole maternity process. Current literature recommends the use of interventions based on new technologies for the treatment of mood disorders, already during the prenatal period. There have been scarce well-designed intervention studies that test technological low-intensity interventions by midwives to address pregnant women's mental health, diminishing anxiety and depression during pregnancy. METHODS/DESIGN Adult pregnant women (weeks 12-14 of gestation) will be recruited and screened from different primary care centers in Catalonia, Spain. Women who pass the initial mental screening will be randomly allocated to the relaxation virtual reality intervention or control group. The intervention aims to improve mental state of pregnant women during pregnancy, work through breathing, mindfulness and muscle relaxation techniques. Women in the control group will receive standard care offered by the public funded maternity services in Catalonia. The primary outcome measures will include the Edinburg Postnatal Depression (EPDS), State Trait Anxiety Inventory (STAI), Symptom Checklist-90 (SCL-90), and the Cambridge Worry Scale (CWS) instruments. Secondary outcome measures will include the Temperament and Character Inventory-Revised (TCI-R) and the Whooley and Generalized Anxiety Disorder-2 (GAD-2) questions. Routinary pregnancy monitoring measures will be also evaluated. DISCUSSION This study aims to test the efficacy of a low-intensity, midwife-led e-health intervention based on new technologies to work on women's anxiety and depression during pregnancy. We hypothesize that low-intensity mental health intervention during pregnancy, using an e-health (virtual reality) as a support tool, will be effective in reducing of anxiety, depressive symptoms, and improving satisfaction with pregnancy follow-up. TRIAL REGISTRATION Clinical Trials ID NCT05756205.
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Affiliation(s)
- Marta Jimenez-Barragan
- Fundació Assistencial Mútua Terrassa, (Terrassa), Universitat de Barcelona, Barcelona, Spain
- Research Group Atenció a La Salut Sexual I Reproductiva (GRASSIR), Institut Universitari d’Investigació en Atenció Primària Jordi Gol (IDIAP Jordi Gol), Barcelona, Spain
- Universitat de Barcelona, Barcelona, Spain
| | - Amparo del Pino Gutierrez
- Departament de Salut Pública, Salut Mental I Materno-Infantil, Facultat de Medicina I Ciències de La SalutUniversitat de Barcelona, Barcelona, Spain
- Ciber Fisiopatología Obesidad Y Nutrición (CIBERObn), Instituto Salud Carlos III, Madrid, Spain
| | - Jorge Curto Garcia
- Departament de Salut Pública, Salut Mental I Materno-Infantil, Facultat de Medicina I Ciències de La SalutUniversitat de Barcelona, Barcelona, Spain
| | - Olga Monistrol-Ruano
- Patient Safety and Research Nurse, Fundació Assistencial Mútua Terrassa, Terrassa, Spain
| | | | - Oriol Porta-Roda
- Obstetrics and Gynecology Department, Hospital Universitari Mútua Terrassa, Universitat de Barcelona, Barcelona, Spain
| | - Gemma Falguera-Puig
- Research Group Atenció a La Salut Sexual I Reproductiva (GRASSIR), Institut Universitari d’Investigació en Atenció Primària Jordi Gol (IDIAP Jordi Gol), Barcelona, Spain
- Direcció d’Atenció Primària Metropolitana Nord, Atenció a La Salut Sexual I Reproductiva Metropolitana Nord, Institut Català de La Salut, Barcelona, Spain
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Majlander S, Kinnunen TI, Lilja E, Gissler M, Castaneda AE, Lehtoranta L, Koponen P. Potentially traumatic experiences pre-migration and adverse pregnancy and childbirth outcomes among women of Somali- and Kurdish-origin in Finland. BMC Pregnancy Childbirth 2023; 23:589. [PMID: 37592250 PMCID: PMC10433655 DOI: 10.1186/s12884-023-05906-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2022] [Accepted: 08/07/2023] [Indexed: 08/19/2023] Open
Abstract
BACKGROUND Women in precarious conditions in their countries of origin, especially those who have left the country as refugees, may have been victims of serious mental and physical violence. These potentially traumatic experiences may threaten women's reproductive health. This study examines the prevalence of potentially traumatic experiences pre-migration and female genital mutilation/cutting (FGM/C) and their associations with adverse reproductive outcomes among migrant women of Somali- and Kurdish-origin who have been pregnant in Finland. METHODS Survey and register data of the participants of the Finnish Migrant Health and Wellbeing Study (Maamu), conducted in 2010-2012, were used. Women of 18 to 64 years of age, 185 Somali- and 230 Kurdish-origin, who had at least one pregnancy or birth in Finland were included in the analysis. The survey data were linked to the Finnish Medical Birth Register, the Register of Induced Abortions, and the Care Register for Health Care until 2018. For each outcome, logistic regression was used and adjusted for age, body mass index, time lived in Finland, and the number of births. RESULTS A total of 67% of Somali-origin and 71% of Kurdish-origin women had experienced potentially traumatic experiences pre-migration and 64% of Somali- and 32% of Kurdish-origin women had also undergone FGM/C. In Kurdish-origin women, complications during pregnancy (e.g. bleeding in the first trimester, known or suspected fetal abnormality, signs of fetal hypoxia, death of the fetus and other problems) were significantly more common among women without potentially traumatic experiences (70%) than among women with potentially traumatic experiences (48%) (p-value 0.005). No associations between potentially traumatic experiences or FGM/C and other adverse reproductive outcomes were observed among Somali- or Kurdish-origin women. CONCLUSION Past trauma is common among Somali- and Kurdish-origin women and this needs to be evaluated in maternity care. However, we found no association between potentially traumatic experiences pre-migration and adverse reproductive outcomes.
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Affiliation(s)
- Satu Majlander
- Department of Public Health and Welfare, Unit of Equality, Finnish Institute for Health and Welfare, Mannerheimintie 166, PL 30, Helsinki, 00271, Finland.
- Unit of Health Sciences, Faculty of Social Sciences, Tampere University, Arvo Ylpön katu 34, Tampere, 33014, Finland.
| | - Tarja I Kinnunen
- Unit of Health Sciences, Faculty of Social Sciences, Tampere University, Arvo Ylpön katu 34, Tampere, 33014, Finland
| | - Eero Lilja
- Department of Public Health and Welfare, Unit of Equality, Finnish Institute for Health and Welfare, Mannerheimintie 166, PL 30, Helsinki, 00271, Finland
| | - Mika Gissler
- Department of Knowledge Brokers, Finnish Institute for Health and Welfare, Mannerheimintie 166, PL 30, Helsinki, Helsinki, 00271, Finland
- Region Stockholm, Academic Primary Health Care Centre, Stockholm, Sweden
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden
- Research Centre for Child Psychiatry and Invest Research Flagship, University of Turku, Turku, Finland
| | - Anu E Castaneda
- Department of Public Health and Welfare, Unit of Equality, Finnish Institute for Health and Welfare, Mannerheimintie 166, PL 30, Helsinki, 00271, Finland
| | - Lara Lehtoranta
- Department of Public Health and Welfare, Population Health Unit, Finnish Institute for Health and Welfare, Mannerheimintie 166, PL 30, Helsinki, 00271, Finland
| | - Päivikki Koponen
- Department of Public Health and Welfare, Finnish Institute for Health and Welfare, Mannerheimintie 166, PL 30, Helsinki, 00271, Finland
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Sawyer G, Heron J, Joinson C. The relationship between maternal psychopathology and offspring incontinence and constipation at school age: A prospective cohort study. J Affect Disord 2023; 335:1-9. [PMID: 37156278 DOI: 10.1016/j.jad.2023.05.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Revised: 04/26/2023] [Accepted: 05/02/2023] [Indexed: 05/10/2023]
Abstract
BACKGROUND There is evidence for an association between maternal psychopathology and offspring incontinence and constipation, but it is unclear if there is a critical/sensitive period of exposure to maternal depression and/or anxiety in the antenatal or postnatal period. METHODS Mothers from the Avon Longitudinal Study of Parents and Children provided data on their depression and anxiety (antenatal and postnatal) and their child's urinary and faecal incontinence and constipation at age 7 (6489 participants). We used multivariable logistic regression to examine evidence for independent effects of maternal depression/anxiety on offspring incontinence/constipation and to investigate if there was a critical/sensitive period of exposure. We examined evidence for causal intra-uterine effects using a negative control design. RESULTS Postnatal maternal psychopathology was associated with an increased risk of offspring incontinence and constipation (e.g. postnatal anxiety and daytime wetting OR: 1.53; 95 % CI: 1.21-1.94). Data were consistent with a postnatal critical period model and there was evidence for an independent effect of maternal anxiety. Antenatal maternal psychopathology was associated with offspring constipation (e.g. antenatal anxiety OR: 1.57; 95 % CI: 1.25-1.98), but there was no evidence for a causal intra-uterine effect. LIMITATIONS Attrition and maternal reports without use of diagnostic criteria for incontinence/constipation are potential limitations. CONCLUSIONS Children exposed to maternal postnatal psychopathology had a greater risk of incontinence/constipation, and maternal anxiety had stronger associations than depression. Health professionals should be vigilant to effects of maternal psychopathology on child development. Identification of mechanisms linking maternal psychopathology to child incontinence/constipation is required to inform evidence-based support.
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Affiliation(s)
- Gemma Sawyer
- MRC Integrative Epidemiology Unit, University of Bristol, Bristol, UK; Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK.
| | - Jon Heron
- MRC Integrative Epidemiology Unit, University of Bristol, Bristol, UK; Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK; Centre for Academic Mental Health, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Carol Joinson
- Centre for Academic Child Health, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
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Ayraler A, Tosun ŞA, Özkök S. Pregnancy school education program in mother friendly training and research hospital impact on stress and anxiety. REVISTA DA ASSOCIACAO MEDICA BRASILEIRA (1992) 2023; 69:e20230279. [PMID: 37585990 PMCID: PMC10427180 DOI: 10.1590/1806-9282.20230279] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Accepted: 05/07/2023] [Indexed: 08/18/2023]
Abstract
OBJECTIVE This study aimed to investigate prenatal education and its relationship with anxiety and stress in pregnant women. METHODS This research was carried out between July 1, 2022, and December 1, 2023, at Giresun Gynecology and Pediatrics Training and Research Hospital. Women aged >18 years at >20 weeks of pregnancy were included. Patients were randomized into two groups, and one group received a 4 week training on meditation, breathing exercises, and pregnancy-related health issues. A questionnaire was applied to both groups to analyze sociodemographic characteristics, pregnancy, birth, medical history, the Pregnancy Stress Rating Scale, and the State Trait Anxiety Inventory. RESULT The groups were similar in terms of age, educational status, anthropometric characteristics, occupation, economic status, and gestational week. There was no difference between the trained and nontrained groups in terms of the Pregnancy Stress Rating Scale score and the State Trait Anxiety Inventory-state score. The State Trait Anxiety Inventory-trait was significantly lower in the trained group (p=0.033). There were weak positive correlations between Pregnancy Stress Rating Scale score and medication use and between State Trait Anxiety Inventory-state score and age. A negative correlation was found between the State Trait Anxiety Inventory-state score and working status, showing that employed women had lower anxiety scores irrespective of training. Another weak positive correlation was found between the State Trait Anxiety Inventory-trait score and the presence of comorbidities. CONCLUSION State Trait Anxiety Inventory-trait anxiety was lower in pregnant women who received training on prenatal meditation, exercise, and pregnancy health; however, State Trait Anxiety Inventory-state and Pregnancy Stress Rating Scale scores were similar in the two groups. Unemployed pregnant women and those with chronic diseases appear to need closer follow-up to reduce anxiety levels.
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Affiliation(s)
- Arzu Ayraler
- Giresun University, Faculty of Medicine, Department of Family Medicine – Giresun, Turkey
| | - Şebnem Alanya Tosun
- Giresun University, Faculty of Medicine, Department of Obstetrics and Gynecology – Giresun, Turkey
| | - Senem Özkök
- Giresun University, Faculty of Medicine, Department of Family Medicine – Giresun, Turkey
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Ahmed SR, Watt F, Mahfoud ZR, Korayem M, Buhmaid S, Alberry M, Ibrahim IM, Tandon SD. Examining Feasibility, Acceptability, and Preliminary Outcomes of a Culturally Adapted Evidence-Based Postpartum Depression Preventive Intervention for Women in Doha, Qatar: Protocol for a Randomized Controlled Trial. JMIR Res Protoc 2023; 12:e11623. [PMID: 37566449 PMCID: PMC10457694 DOI: 10.2196/11623] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Revised: 06/02/2023] [Accepted: 06/05/2023] [Indexed: 08/12/2023] Open
Abstract
BACKGROUND Postpartum depression and anxiety are the 2 most common perinatal mental health disorders, with prevalence rates higher among women living in the Middle East than in most Western countries. The negative outcomes associated with postpartum depression and anxiety are profound and include less responsive parenting and compromised infant and young child development. Although interventions exist to prevent postpartum depression and anxiety, to date, there have been no studies that have attempted to prevent postpartum depression or anxiety among Arabic-speaking women in the Middle East, including Qatar. OBJECTIVE The purpose of this study is to conduct a randomized controlled trial (RCT) of an evidence-based postpartum depression preventive intervention-Mothers and Babies (MB)-culturally adapted for use with Arabic-speaking women in Doha, Qatar. MB is guided by a cognitive behavioral therapy framework that focuses on increasing pleasant activities, promoting healthy thought patterns, and increasing the type and frequency of personal contacts. MB is tailored to specific needs and issues related to pregnancy and the postpartum period. METHODS A multidisciplinary and multiethnic investigator team adapted MB to promote cultural and contextual fit for Arabic-speaking women. Intervention concepts were reviewed to ensure core content would be understood by Arabic-speaking women in Qatar. Subsequently, images, activities, and examples in the intervention manuals were adapted, as needed, to make the content more relevant to Arab culture. To deliver the adapted intervention, 30 Arabic-speaking individuals with mental health backgrounds were trained. The adapted intervention was subsequently pilot-tested with 10 pregnant women receiving prenatal care at Sidra Hospital in Doha. We are now conducting an RCT to examine the effectiveness of the adapted intervention. We plan to enroll 210 pregnant individuals who are Arabic-speaking, with 1:1 randomization to the MB intervention or usual prenatal care. Among the enrolled participants, a stratified subsample of 40 pregnant women with diabetes is being recruited. Data collection will take place at baseline and a 6-month follow-up. The primary outcomes are depressive and anxiety symptoms and perceived stress. Diabetes self-care is the exploratory outcome for the subsample of individuals with diabetes. Intervention implementation will be assessed via client and provider surveys during and after intervention delivery. Power and sample size were calculated using a 2-sided 5% effort rate and assumed analyses on the individual level, accounting for attrition of 20%. RESULTS The cultural adaptation and pilot study of the adapted MB intervention are completed. A total of 157 women have been enrolled in the RCT as of March 31, 2023. CONCLUSIONS This study is highly innovative, as it is the first study to our knowledge to examine the effectiveness of an evidence-based postpartum depression preventive intervention in the Middle East. Limitations include a single follow-up time point and a small subsample of individuals with diabetes. TRIAL REGISTRATION ClinicalTrials.gov NCT04442529; https://www.clinicaltrials.gov/study/NCT04442529. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/11623.
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Affiliation(s)
- Sawssan R Ahmed
- Department of Psychology, California State University-Fullerton, Fullerton, CA, United States
| | | | | | | | | | | | | | - S Darius Tandon
- Center for Community Health, Northwestern University Feinberg School of Medicine, Chicago, IL, United States
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Milgrom J, Hirshler Y, Holt C, Skouteris H, Galbally M, East C, Glover V, Reece J, O'Donnell KJ, Walker SP, Malloy S, Gemmill AW. Early intervention to prevent adverse child emotional and behavioural development following maternal depression in pregnancy: study protocol for a randomised controlled trial. BMC Psychol 2023; 11:222. [PMID: 37542332 PMCID: PMC10401817 DOI: 10.1186/s40359-023-01244-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Accepted: 07/03/2023] [Indexed: 08/06/2023] Open
Abstract
BACKGROUND Substantial evidence indicates that maternal depression during pregnancy (i.e., antenatal depression) is associated not only with maternal wellbeing but also with child emotional and behavioural development. Children of antenatally depressed women are at risk of emotional and behavioural problems, including internalising problems (e.g., anxiety and depression) and externalising problems (e.g., attention problems), that may last at least to adolescence. These enduring effects also constitute an enormous economic cost. Despite the seriousness of this problem, until recently there existed very few controlled studies evaluating whether active psychological treatment for antenatal depression can prevent adverse child outcomes. Our previous pilot randomised controlled trial (RCT) exploring the effect of cognitive behavioural therapy (CBT) for antenatal depression on child outcomes showed promising results. We aim to assess whether treating antenatal depression with an evidence-based 8-week structured CBT program can prevent or ameliorate adverse child developmental outcomes at 2 years of age. METHODS Pregnant women ≤ 30 weeks gestation diagnosed with a depressive disorder are recruited and randomised to CBT or treatment as usual (TAU). The target sample size is 230 and the primary outcome measure is the infant Internalising scale of the Child Behaviour Checklist (CBCL) at 24 months of age. Secondary infant outcome measures at 24 months are the Externalising scale of the CBCL and the motor and cognitive development subscales of the Ages & Stages Questionnaire (ASQ-3). Additional secondary outcome measures are subscales of the Revised Infant Behaviour Questionnaire (IBQ-R), ASQ-3 and the ASQ-Socio-Emotional (ASQ-SE) at 3 and 12 months of age and the quality of mother-infant interaction at 3 and 24 months. Maternal measures, including demographic data, depression diagnosis, depressive and anxiety symptoms, perceived stress and parenting stress, are collected across all time points. DISCUSSION The trial is ongoing and recruitment was slowed due to the COVID-19 pandemic. If results suggest a beneficial effect of antenatal depression treatment on infant outcomes, the project could have repercussions for standard antenatal care, for maternal and infant health services and for preventing the intergenerational transmission of mental health disorders. TRIAL REGISTRATION Australia and New Zealand Clinical Trials Register: ACTRN12618001925235 Date Registered: 27 November 2018.
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Affiliation(s)
- Jeannette Milgrom
- Parent-Infant Research Institute, Austin Health, 300 Waterdale Road, Heidelberg Heights, VIC, 3081, Australia
- Melbourne School of Psychological Sciences, University of Melbourne, Grattan Street, Parkville, VIC, 3010, Australia
| | - Yafit Hirshler
- Parent-Infant Research Institute, Austin Health, 300 Waterdale Road, Heidelberg Heights, VIC, 3081, Australia
| | - Charlene Holt
- Parent-Infant Research Institute, Austin Health, 300 Waterdale Road, Heidelberg Heights, VIC, 3081, Australia
| | - Helen Skouteris
- Health and Social Care Unit, School of Public Health and Preventive Medicine, Monash University, 553 St Kilda Road, Melbourne, VIC, 3004, Australia
| | - Megan Galbally
- Health Futures Institute, Murdoch University, 90 South Street, Murdoch, WA, 6150, Australia
- School of Clinical Sciences, Monash University, Clayton, VIC, 3168, Australia
- Mental Health, Program Monash Medical Centre, Monash Health, 246 Clayton Road, Clayton, VIC, 3168, Australia
| | - Christine East
- Judith Lumley Centre, School of Nursing and Midwifery, La Trobe University, Plenty Rd & Kingsbury Drive, Bundoora, VIC, 3086, Australia
- Mercy Hospital for Women, 163 Studley Road, Heidelberg, VIC, 3084, Australia
| | - Vivette Glover
- Institute of Reproductive and Developmental Biology, Imperial College London, Du Cane Road, London, W12 ONN, UK
| | - John Reece
- School of Psychological Sciences, Australian College of Applied Professions, 123 Lonsdale Street, Melbourne, VIC, 3000, Australia
| | - Kieran J O'Donnell
- Yale Child Study Center, Yale School of Medicine, 230 South Frontage Road, New Haven, CT, 06519, USA
- Department of Obstetrics Gynecology and Reproductive Sciences, 230 South Frontage Road, New Haven, CT, 06519, USA
- Department of Psychiatry, McGill University, 1033 Pine Avenue West, Montreal, QC, H3A 1A1, Canada
| | - Susan P Walker
- Mercy Hospital for Women, 163 Studley Road, Heidelberg, VIC, 3084, Australia
- Melbourne Medical School, University of Melbourne, Grattan Street, Parkville, VIC, 3010, Australia
| | | | - Alan W Gemmill
- Parent-Infant Research Institute, Austin Health, 300 Waterdale Road, Heidelberg Heights, VIC, 3081, Australia.
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Loret de Mola C, Carpena MX, Dias IM, Meucci R, Goicochea-Romero A, Cesar J. Sleep and its association with depressive and anxiety symptoms during the last weeks of pregnancy: A population-based study. Sleep Health 2023; 9:482-488. [PMID: 37391279 DOI: 10.1016/j.sleh.2023.05.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2022] [Revised: 04/21/2023] [Accepted: 05/03/2023] [Indexed: 07/02/2023]
Abstract
OBJECTIVE To evaluate the association between sleep characteristics and depressive and anxiety symptoms during the immediate postpartum period. METHODS People who had hospital births during 2019 in the municipality of Rio Grande (southern Brazil) were assessed with a standardized questionnaire concerning sociodemographic (eg, age and self-reported skin color) and health-related variables (eg, parity and stillbirth) (n = 2314) 24-48 hours after birth. We used the Munich Chronotype Questionnaire to assess sleep latency, inertia, duration, and chronotype; the Edinburgh Postpartum Depression Scale for depressive symptoms; and the General Anxiety Disorder 7-Item Scale to evaluate anxiety symptoms. We used logistic regression models to calculate odds ratios. RESULTS The prevalence of depressive symptoms was 13.7%, and of anxiety symptoms was 10.7%. Depressive symptoms were more likely in those with vespertine chronotype (odds ratios = 1.63; 95% CI: 1.14-2.35) and those with a sleep latency of more than 30 minutes (OR = 2.36; 95% CI: 1.68-3.32). The probability of depressive symptoms decreased by 16% for each additional hour of sleep (OR = 0.84; 95% CI: 0.77-0.92). Sleep inertia of 11-30 minutes increased the probability of anxiety on free days (OR = 1.73; 95% CI: 1.27-2.36) and increased the probability of depressive (OR = 2.68; 95% CI: 1.82-3.83) and anxiety symptoms (OR = 1.69; 95%CI: 1.16-2.44) on workdays. CONCLUSION Participants with vespertine chronotype or shorter sleep duration were more likely to have depressive symptoms. Those who took more time to fall asleep or get out of bed were more likely to have both anxiety and depressive symptoms, but the association was stronger for depressive symptoms.
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Affiliation(s)
- Christian Loret de Mola
- Programa de Pós-Graduação em Saúde Pública, FURG, Rio Grande, RS, Brazil; Grupo de Pesquisa e Inovação em Saúde, Universidade Federal do Rio Grande (FURG), Rio Grande, RS, Brazil; Universidad Cientifica del Sur, Lima, Peru.
| | - Marina X Carpena
- Grupo de Pesquisa e Inovação em Saúde, Universidade Federal do Rio Grande (FURG), Rio Grande, RS, Brazil; Programa de Pós-Graduação em Epidemiologia da Universidade Federal de Pelotas (UFPel), Pelotas, RS, Brazil
| | - Ingrid Moura Dias
- Programa de Pós-Graduação em Saúde Pública, FURG, Rio Grande, RS, Brazil
| | - Rodrigo Meucci
- Programa de Pós-Graduação em Saúde Pública, FURG, Rio Grande, RS, Brazil
| | | | - Juraci Cesar
- Programa de Pós-Graduação em Saúde Pública, FURG, Rio Grande, RS, Brazil
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50
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Niazi A, Alekozay M, Osmani K, Najm AF. Prevalence and associated factors of depression, anxiety, and stress among pregnant women in Herat, Afghanistan: A cross-sectional study. Health Sci Rep 2023; 6:e1490. [PMID: 37575205 PMCID: PMC10416610 DOI: 10.1002/hsr2.1490] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Revised: 07/26/2023] [Accepted: 07/31/2023] [Indexed: 08/15/2023] Open
Abstract
Background and Aims Pregnancy is an important and natural event in a woman's life. It represents a time of substantial social and bio-psychological challenges for a pregnant woman that may increase vulnerability to emotional disturbances such as depression, anxiety, and stress (DAS). This study aims to assess the prevalence and associated factors of DAS among pregnant women in Herat city of Afghanistan. Methods This hospital-based cross-sectional study was conducted between July and November 2019, on 691 Dari-speaking pregnant women aged 15-49 years, who attended the antenatal clinic of Herat Razaei Maternity Hospital. The interview process involved the use of a structured questionnaire that collected data on sociodemographic characteristics of participants, as well as the validated Dari-translated version of DASS-42 questionnaire. A χ 2 test was used to test for association between categorical data. Forward likelihood ratio was used to assess the strength of association between sociodemographic variables and DAS; independently. The significance level was set to 0.05 and the confidence interval to 95% in all statistical analyses. Statistical analyses were performed in IBM SPSS Statistics (version 27). Results The mean age of participants was 26.17 ± 6.06. The overall prevalence of DAS among study participants were 42.8%, 40.0%, and 59.5%, respectively. Planning of current pregnancy, women's health, husband's health, women's nutrition, family support, husband's support, women's education, women's employment, and family economy were significantly associated with DAS, while gestational age was not significantly associated with DAS. Conclusion The prevalence of DAS among pregnant women in Herat city of Afghanistan is very high. Considering scientific evidence on high prevalence and associated factors of DAS among pregnant women, policymakers, public health authorities, and medical practitioners must devote significant attention in reducing the magnitude of these mental disorders and/or reducing their impact on women, their families, and the society.
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Affiliation(s)
- Aziz‐ur‐Rahman Niazi
- Department of Public Health and Infectious Diseases, Faculty of MedicineHerat UniversityHeratAfghanistan
| | - Mina Alekozay
- Department of Public Health and Infectious Diseases, Faculty of MedicineHerat UniversityHeratAfghanistan
| | - Khadejah Osmani
- Department of Surgery, Division of Obstetrics and Gynecology, Faculty of MedicineHerat UniversityHeratAfghanistan
| | - Abdul Fattah Najm
- Mental Health ProgramInternational Assistance MissionHeratAfghanistan
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