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Khoury JE, Atkinson L, Gonzalez A. A longitudinal study examining the associations between prenatal and postnatal maternal distress and toddler socioemotional developmental during the COVID-19 pandemic. INFANCY 2024; 29:412-436. [PMID: 38329905 DOI: 10.1111/infa.12584] [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: 07/14/2023] [Revised: 12/15/2023] [Accepted: 01/09/2024] [Indexed: 02/10/2024]
Abstract
Elevated psychological distress, experienced by pregnant women and parents, has been well-documented during the COVID-19 pandemic. Most research focuses on the first 6-months postpartum, with single or limited repeated measures of perinatal distress. The present longitudinal study examined how perinatal distress, experienced over nearly 2 years of the COVID-19 pandemic, impacted toddler socioemotional development. A sample of 304 participants participated during pregnancy, 6-weeks, 6-months, and 15-months postpartum. Mothers reported their depressive, anxiety, and stress symptoms, at each timepoint. Mother-reported toddler socioemotional functioning (using the Brief Infant-Toddler Social and Emotional Assessment) was measured at 15-months. Results of structural equation mediation models indicated that (1) higher prenatal distress was associated with elevated postpartum distress, from 6-weeks to 15-months postpartum; (2) associations between prenatal distress and toddler socioemotional problems became nonsignificant after accounting for postpartum distress; and (3) higher prenatal distress was indirectly associated with greater socioemotional problems, and specifically elevated externalizing problems, through higher maternal distress at 6 weeks and 15 months postpartum. Findings suggest that the continued experience of distress during the postpartum period plays an important role in child socioemotional development during the COVID-19 pandemic.
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Affiliation(s)
- Jennifer E Khoury
- Department of Psychology, Mount Saint Vincent University, Halifax, Nova Scotia, Canada
| | - Leslie Atkinson
- Department of Psychology, Metropolitan Toronto University, Toronto, Ontario, Canada
| | - Andrea Gonzalez
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada
- Offord Centre for Child Studies, McMaster University, Hamilton, Ontario, Canada
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Echabe-Ecenarro O, Orue I, Calvete E. Dispositional mindfulness profiles in pregnant women: relationships with dyadic adjustment and symptoms of depression and anxiety. Front Psychol 2023; 14:1237461. [PMID: 37736152 PMCID: PMC10509769 DOI: 10.3389/fpsyg.2023.1237461] [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: 06/09/2023] [Accepted: 08/21/2023] [Indexed: 09/23/2023] Open
Abstract
Introduction Pregnancy is a time of major transition that can be stressful for women. Dispositional mindfulness may protect individuals when they face stress. Recent studies have adopted a person-centered approach to examine the role of mindfulness by identifying subtypes of individuals based on their scores in five mindfulness facets. Latent profile analysis was used to identify different mindfulness profiles in a sample of pregnant women, and we explored the relationships between these profiles, depression and anxiety symptoms, and whether dyadic adjustment mediated these relationships. Method A total of 535 women aged 18-45 years in their 26th week of pregnancy completed questionnaires regarding mindfulness, dyadic satisfaction and cohesion, and depression and anxiety symptoms. Results Three profiles were identified: (1) low mindfulness (53.8%), (2) moderate mindfulness (34.3%), and (3) non-judgmentally aware (11.9%). The most adaptive profile was the non-judgmentally aware profile. Compared to the low mindfulness profile, the non-judgmentally aware profile and the moderate mindfulness profile were related to fewer symptoms of depression and anxiety, and these relationships were partly mediated by dyadic satisfaction. Discussion These results suggest that analyzing each pregnant woman's mindfulness profile can improve the prevention of and interventions for anxiety and depression.
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Affiliation(s)
- Oiana Echabe-Ecenarro
- Department of Psychology, Faculty of Health Sciences, University of Deusto, Bilbao, Spain
- Basque Health Service, Osakidetza, Zumaia, Spain
| | - Izaskun Orue
- Department of Psychology, Faculty of Health Sciences, University of Deusto, Bilbao, Spain
| | - Esther Calvete
- Department of Psychology, Faculty of Health Sciences, University of Deusto, Bilbao, Spain
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Mashayekh-Amiri S, Jafarabadi MA, Montazeri M, Fallon V, Silverio SA, Mirghafourvand M. Validation of the Iranian version of the Postpartum Specific Anxiety Scale 12-item research short-form for use during global crises (PSAS-IR-RSF-C). BMC Psychiatry 2023; 23:511. [PMID: 37452292 PMCID: PMC10347867 DOI: 10.1186/s12888-023-04998-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/20/2022] [Accepted: 07/04/2023] [Indexed: 07/18/2023] Open
Abstract
BACKGROUND Due to its high pervasiveness and adversarial consequences, postpartum anxiety has been one of the most worrying public health concerns in the last decade. According to previous research, the occurrence of mental disorders among women in the postpartum period upsurges significantly in the course of universal disasters. The Postpartum Specific Anxiety Scale - Research Short Form - for use in global Crises [PSAS-IR-RSF-C] has not been used in Iran for postpartum women during a health system shock. Consequently, this study was conducted to determine the validity and reliability of the Persian version (PSAS-IR-RSF-C) during the COVID-19 pandemic. METHODS This cross-sectional study was performed with 180 women who were between six weeks and six months after delivery, by random sampling method from December 2021 to June 2022. The validity of the PSAS-RSF-C in terms of face, content, was analyzed, and the construct validity was assessed using exploratory and confirmatory factor analyses. Internal consistency and test-retest reliability of the questionnaire were measured using (Cronbach's alpha, McDonald's ω) and intraclass correlation coefficient (ICC), respectively. RESULTS The content validity index and content validity ratio of the Persian version of the PSAS-IR-RSF-C were 0.96 and 0.98, respectively. A three-factor structure was extracted during the exploratory factor analysis process, and model validity was confirmed by the values of fit indices. Cronbach's alpha coefficient, McDonald's ω and intra-cluster correlation coefficient (95% confidence interval) were 0.74, 0.92 (0.78 to 0.93) and 0.97 (0.93 to 0.98), respectively. CONCLUSIONS For the specific assessment of postpartum anxiety among Iranian women during crises, the Persian version of the PSAS-IR-RSF-C is a valid and reliable tool.
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Affiliation(s)
- Sepideh Mashayekh-Amiri
- Students Research Committee, Midwifery Department, Faculty of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mohammad Asghari Jafarabadi
- Cabrini Research, Cabrini Health, Melbourne, VIC 3144 Australia
- School of Public Health and Preventative Medicine, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, VIC 3004 Australia
- Road Traffic Injury Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Maryam Montazeri
- Department of Psychology, Institute of Population Health, University of Liverpool, Liverpool, UK
| | - Victoria Fallon
- Department of Women and Children’s Health, School of Life Course and Population Sciences, King’s College London, London, UK
| | - Sergio A. Silverio
- Social Determinants of Health Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mojgan Mirghafourvand
- Menopause Andropause Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
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Orsolini L, Pompili S, Mauro A, Volpe U. Foreign Nationality, Family Psychiatry History and Pregestational Neoplastic Disease as Predictors of Perinatal Depression in a Cohort of Healthy Pregnant and Puerperal Women during the COVID-19 Pandemic. Healthcare (Basel) 2023; 11:healthcare11030428. [PMID: 36767003 PMCID: PMC9914901 DOI: 10.3390/healthcare11030428] [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: 12/30/2022] [Revised: 01/28/2023] [Accepted: 01/30/2023] [Indexed: 02/05/2023] Open
Abstract
Background: Perinatal depression (PND) represents one of the most common mental disorders in the pregnancy and/or postpartum period, with a 5-25% prevalence rate. Our aim was to investigate predictors associated with PND in a cohort of pregnant and puerperal women based in an Italian setting during the COVID-19 pandemic. Methods: We retrospectively recruited 199 (55 pregnant and 144 puerperal) women, afferent to our Perinatal Mental Outpatient Service of Ancona (Italy). Participants were administered an ad hoc case-report form, Whooley Questions (WQ), the General Health Questionnaire-12 (GHQ-12), the Stress Holmes-Rahe scale (HR) and the Edinburgh Postnatal Depression Scale (EPDS). Results: Around 10% of the sample had a confirmed PND. Being a foreigner woman (RR = 3.8), having a positive psychiatric family history (RR = 5.3), a pre-pregnancy medical comorbidity (RR = 1.85) and a comorbid medical illness occurring during the pregnancy (RR = 2) were much likely associated with PND. Multiple linear regression analysis demonstrated that GHQ, medium- and high-risk at the HR, foreign nationality, positive family psychiatric history, and neoplastic disease before conception significantly predicted EPDS [F(1, 197) = 10.086, R2 = 0.324, p < 0.001]. Limitations: The sample size, poor heterogeneity in terms of socio-demographic, clinical and gynecological-obstetric characteristics, the cross-sectional design of the study. Conclusions: Our study showed a set of predictors associated with a higher risk for the PND onset, including gestational and pregestational medical disease. Our findings outline the need to screen all fertile women, particularly in gynecological and medical settings, in order to identify at-risk women for PND and promptly suggest a psychiatric consultation.
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Chen H, Zou Y, Shi H, Ma H, Huang W, Wang S, Lu J. COVID-19 affects psychological symptoms of pregnant women indirectly by increasing their maternal concerns. J Affect Disord 2022; 317:79-83. [PMID: 36030996 PMCID: PMC9420000 DOI: 10.1016/j.jad.2022.08.069] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2021] [Revised: 05/11/2022] [Accepted: 08/21/2022] [Indexed: 12/25/2022]
Abstract
BACKGROUND Pregnant women themselves are at higher risk for psychological symptoms. The impact of ongoing COVID-19 may increase the risk. However, it is uncertain whether COVID-19 affects pregnant women's psychological symptoms directly or indirectly being mediated. METHODS This survey was conducted in four obstetrics and gynecology hospitals in Beijing from February 28, 2020, to April 26, 2020. Pregnant women who visited the antenatal-care clinic were mobilized to finish the online questionnaires, including the Generalized Anxiety Disorder 7-Item Scale, Patient Health Questionnaire-9, Connor-Davidson resilience scale, and Insomnia Severity Index. RESULTS A total of 828 pregnant women were included in the analysis. The estimated self-reported rates of anxiety, depression, insomnia, and any of the three were 12.2 %, 24.3 %, 13.3 %, and 33.1 %, respectively. Mediating effect analysis showed that pregnant women's response to COVID-19 was not directly associated with psychological symptoms but indirectly through the mediating effect of maternal concerns, which accounted for 32.35 % of the total effect. Stratified analysis by psychological resilience showed that women's attitude toward COVID-19 (OR, 2.68, 95 % CI: 1.16-6.18) was associated with a higher risk of psychological symptoms in those with poor psychological resilience. LIMITATIONS The study was a non-probability sampling survey, and the causal relationship between maternal concerns and psychological symptoms could not be determined due to the study's design. CONCLUSIONS Under public health emergencies such as COVID-19, routine antenatal care should still be prioritized, and concerns related to childbirth-related caused by such emergencies should also be addressed, especially for those with weak psychological resilience.
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Affiliation(s)
- Hongguang Chen
- Peking University Sixth Hospital (Institute of Mental Health), Key Laboratory of Mental Health, Ministry of Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing 100083, China
| | - Yusong Zou
- Beijing Chaoyang Hospital, Capital Medical University, Beijing 100020, China
| | - Hui Shi
- Beijing Chaoyang Hospital, Capital Medical University, Beijing 100020, China
| | - Hongyan Ma
- Beijing Chaoyang Hospital, Capital Medical University, Beijing 100020, China
| | - Wenyang Huang
- Beijing Chaoyang Hospital, Capital Medical University, Beijing 100020, China
| | - Shuzhen Wang
- Beijing Chaoyang Hospital, Capital Medical University, Beijing 100020, China
| | - Junli Lu
- Beijing Chaoyang Hospital, Capital Medical University, Beijing 100020, China.
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Cena L, Trainini A, Tralli N, Nodari LS, Iacona E, Ronconi L, Testoni I. The Impact of the COVID-19 Pandemic on Perinatal Loss Experienced by the Parental Couple: Protocol for a Mixed Methods Study in Italy. JMIR Res Protoc 2022; 11:e38866. [PMID: 36044641 PMCID: PMC9472504 DOI: 10.2196/38866] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2022] [Revised: 06/10/2022] [Accepted: 08/06/2022] [Indexed: 12/21/2022] Open
Abstract
Background At the beginning of 2020, mothers and fathers who experienced perinatal events (from conception to pregnancy and postpartum period) found themselves facing problems related to the emergency caused by the COVID-19 pandemic and the associated difficulties for health care centers in providing care. In the unexpected and negative event of perinatal loss (ie, miscarriage, stillbirth, and neonatal death) more complications occurred. Perinatal loss is a painful and traumatic life experience that causes grief and can cause affective disorders in the parental couple—the baby dies and the couple’s plans for a family are abruptly interrupted. During the COVID-19 pandemic, limited access to perinatal bereavement care, due to the lockdown measures imposed on medical health care centers and the social distancing rules to prevent contagion, was an additional risk factor for parental mental health, such as facing a prolonged and complicated grief. Objective The main aims of this study are as follows: to investigate the impact of COVID-19 on mothers and fathers who experienced perinatal loss during the pandemic, comparing their perceptions; to evaluate their change over time between the first survey administration after bereavement and the second survey after 6 months; to examine the correlations between bereavement and anxiety, depression, couple satisfaction, spirituality, and sociodemographic variables; to investigate which psychosocial factors may negatively affect the mourning process; and to identify the potential predictors of the development of complicated grief. Methods This longitudinal observational multicenter study is structured according to a mixed methods design, with a quantitative and qualitative section. It will include a sample of parents (mothers and fathers) who experienced perinatal loss during the COVID-19 pandemic from March 2020. There are two phases—a baseline and a follow-up after 6 months. Results This protocol was approved by the Ethics Committee of Psychological Research, University of Padova, and by the Institutional Ethics Board of the Spedali Civili of Brescia, Italy. We expect to collect data from 34 or more couples, as determined by our sample size calculation. Conclusions This study will contribute to the understanding of the psychological processes related to perinatal loss and bereavement care during the COVID-19 pandemic. It will provide information useful to prevent the risk of complicated grief and psychopathologies among bereaved parents and to promote perinatal mental health. International Registered Report Identifier (IRRID) DERR1-10.2196/38866
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Affiliation(s)
- Loredana Cena
- Observatory of Perinatal Clinical Psychology, Department of Clinical and Experimental Science, University of Brescia, viale Europa 11 Brescia 25123, Brescia, IT
| | - Alice Trainini
- Observatory of Perinatal Clinical Psychology, Department of Clinical and Experimental Science, University of Brescia, viale Europa 11 Brescia 25123, Brescia, IT
| | - Nella Tralli
- Observatory of Perinatal Clinical Psychology, Department of Clinical and Experimental Science, University of Brescia, viale Europa 11 Brescia 25123, Brescia, IT
| | - Luisa Silvia Nodari
- Observatory of Perinatal Clinical Psychology, Department of Clinical and Experimental Science, University of Brescia, viale Europa 11 Brescia 25123, Brescia, IT
| | - Erika Iacona
- Department of Philosophy, Sociology, Education and Applied Psychology, University of Padova, Padova, IT
| | - Lucia Ronconi
- IT and Statistical Services, Multifunctional Centre of Psychology, University of Padova, Padova, IT
| | - Ines Testoni
- Department of Philosophy, Sociology, Education and Applied Psychology, University of Padova, Padova, IT
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Micha G, Hyphantis T, Staikou C, Valsamidis D, Arnaoutoglou E, Tzimas P, Vlahos N, Daponte A, Grypiotis I, Pappa P, Evangelaki E, Apostolidou S, Paschos V, Varvarousi G, Bareka M, Izountouemoi GE, Tsonis O, Koullourou I, Kalopita K, Kotsis K. Prevalence of postpartum depression and antenatal anxiety symptoms during COVID-19 pandemic: An observational prospective cohort study in Greece. Eur J Midwifery 2022; 6:23. [PMID: 35509983 PMCID: PMC9006185 DOI: 10.18332/ejm/146233] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2021] [Revised: 12/06/2021] [Accepted: 01/28/2022] [Indexed: 11/24/2022] Open
Affiliation(s)
- Georgia Micha
- Department of Anesthesiology, “Helena Venizelou” General and Maternity Hospital of Athens, Athens, Greece
| | - Thomas Hyphantis
- Department of Psychiatry, Faculty of Medicine, School of Health Sciences, University of Ioannina, Ioannina, Greece
| | - Chryssoula Staikou
- 1st Department of Anesthesiology, Aretaieion Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Dimitrios Valsamidis
- Department of Anesthesiology, Alexandra General Hospital of Athens, Athens, Greece
| | - Eleni Arnaoutoglou
- Department of Anesthesiology, Faculty of Medicine, School of Health Sciences, University of Thessaly, Larissa, Greece
| | - Petros Tzimas
- Department of Anesthesiology and Postoperative Intensive Care, Faculty of Medicine, School of Health Sciences, University of Ioannina, Ioannina, Greece
| | - Nikolaos Vlahos
- 2nd Department of Obstetrics and Gynecology, Aretaieion Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Alexandros Daponte
- Department of Obstetrics and Gynecology, Faculty of Medicine, School of Health Sciences, University of Thessaly, Larissa, Greece
| | - Ioannis Grypiotis
- Department of Anesthesiology, “Helena Venizelou” General and Maternity Hospital of Athens, Athens, Greece
| | - Polyxeni Pappa
- Department of Anesthesiology, “Helena Venizelou” General and Maternity Hospital of Athens, Athens, Greece
| | - Erofili Evangelaki
- Department of Anesthesiology, “Helena Venizelou” General and Maternity Hospital of Athens, Athens, Greece
| | - Sofia Apostolidou
- 1st Department of Anesthesiology, Aretaieion Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Vasileios Paschos
- 2nd Department of Obstetrics and Gynecology, Aretaieion Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Giolanda Varvarousi
- Department of Anesthesiology, Alexandra General Hospital of Athens, Athens, Greece
| | - Metaxia Bareka
- Department of Anesthesiology, Faculty of Medicine, School of Health Sciences, University of Thessaly, Larissa, Greece
| | - Gloria E. Izountouemoi
- Department of Anesthesiology and Postoperative Intensive Care, Faculty of Medicine, School of Health Sciences, University of Ioannina, Ioannina, Greece
| | - Orestis Tsonis
- Department of Obstetrics and Gynecology, University Hospital of Ioannina, University of Ioannina, Ioannina, Greece
| | - Iouliani Koullourou
- Mental Health Center, “G. Hatzikosta” General Hospital of Ioannina, Ioannina, Greece
| | - Konstantina Kalopita
- Department of Anesthesiology, “Helena Venizelou” General and Maternity Hospital of Athens, Athens, Greece
| | - Konstantinos Kotsis
- Department of Psychiatry, Faculty of Medicine, School of Health Sciences, University of Ioannina, Ioannina, Greece
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Socioemotional development in infants of pregnant women during the COVID-19 pandemic: the role of prenatal and postnatal maternal distress. Child Adolesc Psychiatry Ment Health 2022; 16:28. [PMID: 35361233 PMCID: PMC8969812 DOI: 10.1186/s13034-022-00458-x] [Citation(s) in RCA: 21] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/22/2021] [Accepted: 03/14/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND An upsurge in psychological distress was documented in pregnant women during the COVID-19 pandemic. We investigated with a longitudinal design whether prenatal and postnatal maternal distress during the COVID-19 pandemic was associated with lower infant socioemotional development. METHODS Pregnant women (N = 468, Mage = 30,00, 97.6% White) were recruited during the first COVID-19 mandatory lockdown in Quebec, Canada, from April 2nd to April 13th 2020 and were re-contacted at two months postpartum to complete self-reported measures of general (i.e. not specifically related to the COVID-19 pandemic) anxio-depressive symptoms and infant development. Structural equation modeling analyses were performed using maximum likelihood parameter estimation. RESULTS Higher maternal prenatal distress significantly contributed to poorer infant socioemotional development. A mediation model showed that postnatal distress significantly mediated the association between prenatal distress and infant socioemotional development, whereas the direct effect of prenatal distress was no longer significant. Prenatal and postnatal maternal distress accounted for 13.7% of the variance in infant socioemotional development. CONCLUSION Our results call for special means of clinical surveillance in mothers and for innovative (online) interventions aiming to support maternal mental health during pregnancy and after delivery.
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Ahmad M, Vismara L. The Psychological Impact of COVID-19 Pandemic on Women's Mental Health during Pregnancy: A Rapid Evidence Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:7112. [PMID: 34281049 PMCID: PMC8297318 DOI: 10.3390/ijerph18137112] [Citation(s) in RCA: 70] [Impact Index Per Article: 23.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/24/2021] [Revised: 06/25/2021] [Accepted: 06/29/2021] [Indexed: 02/06/2023]
Abstract
BACKGROUND The perinatal period is a particularly vulnerable period in women's lives that implies significant physiological and psychological changes that can place women at higher risk for depression and anxiety symptoms. In addition, the ongoing pandemic of coronavirus disease 2019 (COVID-19) is likely to increase this vulnerability and the prevalence of mental health problems. This review aimed to investigate the existing literature on the psychological impact of the COVID-19 pandemic on women during pregnancy and the first year postpartum. METHOD The literature search was conducted using the following databases: Pubmed, Scopus, WOS-web of science, PsycInfo and Google Scholar. Out of the total of 116 initially selected papers, 17 have been included in the final work, according to the inclusion criteria. RESULTS The reviewed contributions report a moderate to severe impact of the COVID-19 outbreak on the mental health of pregnant women, mainly in the form of a significant increase in depression-up to 58% in Spain-and anxiety symptoms-up to 72% in Canada. In addition to the common psychological symptoms, COVID-19-specific worries emerged with respect to its potential effects on pregnancy and the well-being of the unborn child. Social support and being engaged in regular physical activities appear to be protective factors able to buffer against the effects of the pandemic on maternal mental health. CONCLUSIONS Despite the limitations of the study design, the evidence suggests that it is essential to provide appropriate psychological support to pregnant women during the emergency in order to protect their mental health and to minimize the risks of long-term effects on child development.
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Affiliation(s)
| | - Laura Vismara
- Department of Pedagogy, Psychology, Philosophy, Faculty of Human Studies, University of Cagliari, 09124 Cagliari, Italy;
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Roldán-Merino J, Ortega-Cejas CM, Lluch-Canut T, Farres-Tarafa M, Biurrun-Garrido A, Casas I, Castrillo-Pérez MI, Vicente-Hernández MM, Jimenez-Barragan M, Martínez-Mondejar R, Hurtado-Pardos B, Cabrera-Jaime S. Validity and reliability of the Spanish version of the "Wijma Delivery Expectancy/Experience Questionnaire" (W-DEQ-B). PLoS One 2021; 16:e0249942. [PMID: 33901208 PMCID: PMC8075224 DOI: 10.1371/journal.pone.0249942] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2021] [Accepted: 03/26/2021] [Indexed: 11/18/2022] Open
Abstract
The Wijma Delivery Expectancy/Experience Questionnaire (W-DEQ-B) is an instrument that allows the experiences around fear of childbirth to be examined after the birth. It is currently the most widely used to measure different aspects related to the fear of childbirth and enables healthcare and additional assistance to women after birth to be adapted according to their needs. The objective of this study was to translate the W-DEQ-B into Spanish and analyse its reliability and validity. The study was carried out in two phases: (1) transcultural adaption of the questionnaire to Spanish and (2) a transversal study in a sample of 190 postpartum women from Sexual and Reproductive Health Clinics in the province of Barcelona (Spain). The psychometric properties were examined in terms of reliability (internal consistency and temporal stability) and construct validity (confirmatory factorial analysis [CFA] and exploratory factorial analysis [EFA]). The results of the CFA did not confirm unidimensionality of the W-DEQ-B questionnaire. The EFA suggested four very similar, but not identical, dimensions to those obtained in other studies in which the W-DEQ-B has been evaluated. Both the Cronbach's alpha and the omega coefficient were adequate for the total questionnaire and for each of the four dimensions. The results of this study confirm that the W-DEQ-B is multi-dimensional. In the Spanish version of the W-DEQ-B-Sp four dimensions have been identified that allow the experiences around fear of childbirth to be examined after the birth. The Spanish version of the WDEQ-B (WDEQ-B-Sp) is reliable and valid for the measurement of fear of childbirth in clinical practice and for use in future research.
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Affiliation(s)
- Juan Roldán-Merino
- Campus Docent, Sant Joan de Déu—Fundació Privada, School of Nursing, University of Barcelona, Barcelona, Spain
- Research Group GIES (Grupo de investigación en Enfermería, Educación y Sociedad), Barcelona, Spain
- Research Group GEIMAC (Consolidated Group 2017–1681: Group of Studies of Invariance of the Instruments of Measurement and Analysis of Change in the Social and Health Areas), Barcelona, Spain
| | - Celia Maria Ortega-Cejas
- Midwife, Sexual and Reproductive Health Clinic (ASSIR), Mollet del Vallès Barcelona, Barcelona, Spain
| | - Teresa Lluch-Canut
- Research Group GEIMAC (Consolidated Group 2017–1681: Group of Studies of Invariance of the Instruments of Measurement and Analysis of Change in the Social and Health Areas), Barcelona, Spain
- Faculty of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain
| | - Mariona Farres-Tarafa
- Campus Docent, Sant Joan de Déu—Fundació Privada, School of Nursing, University of Barcelona, Barcelona, Spain
- Research Group GIES (Grupo de investigación en Enfermería, Educación y Sociedad), Barcelona, Spain
- Member Research Group GRISIMula (Grupo emergente 2017 SGR 531; Grupo en Recerca Enfermera en Simulación), Barcelona, Spain
- Secretary, GRISCA Research Group (Nursing Simulation in Catalonia and Andorra Research Group), Barcelona, Spain
| | - Ainoa Biurrun-Garrido
- Campus Docent, Sant Joan de Déu—Fundació Privada, School of Nursing, University of Barcelona, Barcelona, Spain
- Research Group GIES (Grupo de investigación en Enfermería, Educación y Sociedad), Barcelona, Spain
| | - Irma Casas
- Universitat Autònoma de Barcelona, Barcelona, Spain
- Preventive Medicine Service, Hospital Germans Trias i Pujol, Barcelona, Spain
- Research Group Innovation in Respiratory Infections and Tuberculosis Diagnosis (Group Consolidat 2017 SGR 494), Barcelona, Spain
| | | | | | - Marta Jimenez-Barragan
- Midwifery Coordinator, Sexual and Reproductive Health Clinic (ASSIR) Fundació Assistencial Mútua Terrassa, (Terrassa) Midwife, Sexual and Reproductive Health Clinic (ASSIR) Rambla Terrassa, (Terrassa) Docente en Fundació Universitaria del Bages, Barcelona, Spain
| | | | - Barbara Hurtado-Pardos
- Campus Docent, Sant Joan de Déu—Fundació Privada, School of Nursing, University of Barcelona, Barcelona, Spain
- Research Group GIES (Grupo de investigación en Enfermería, Educación y Sociedad), Barcelona, Spain
| | - Sandra Cabrera-Jaime
- Faculty of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain
- Corporate Care Management, Institut Català d’Oncologia (ICO), L’Hospitalet de LLobregat, Barcelona, Spain
- GRIN Group, IDIBELL, Institute of Biomedical Research, Barcelona, Spain
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Sun Y, Li Y, Wang J, Chen Q, Bazzano AN, Cao F. Effectiveness of Smartphone-Based Mindfulness Training on Maternal Perinatal Depression: Randomized Controlled Trial. J Med Internet Res 2021; 23:e23410. [PMID: 33502326 PMCID: PMC7875700 DOI: 10.2196/23410] [Citation(s) in RCA: 49] [Impact Index Per Article: 16.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2020] [Revised: 12/17/2020] [Accepted: 12/29/2020] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Despite potential for benefit, mindfulness remains an emergent area in perinatal mental health care, and evidence of smartphone-based mindfulness training for perinatal depression is especially limited. OBJECTIVE The objective of this study was to evaluate the effectiveness of a smartphone-based mindfulness training intervention during pregnancy on perinatal depression and other mental health problems with a randomized controlled design. METHODS Pregnant adult women who were potentially at risk of perinatal depression were recruited from an obstetrics clinic and randomized to a self-guided 8-week smartphone-based mindfulness training during pregnancy group or attention control group. Mental health indicators were surveyed over five time points through the postpartum period by online self-assessment. The assessor who collected the follow-up data was blind to the assignment. The primary outcome was depression as measured by symptoms, and secondary outcomes were anxiety, stress, affect, sleep, fatigue, memory, and fear. RESULTS A total of 168 participants were randomly allocated to the mindfulness training (n=84) or attention control (n=84) group. The overall dropout rate was 34.5%, and 52.4% of the participants completed the intervention. Mindfulness training participants reported significant improvement of depression (group × time interaction χ24=16.2, P=.003) and secondary outcomes (χ24=13.1, P=.01 for anxiety; χ24=8.4, P=.04 for positive affect) compared to attention control group participants. Medium between-group effect sizes were found on depression and positive affect at postintervention, and on anxiety in late pregnancy (Cohen d=0.47, -0.49, and 0.46, respectively). Mindfulness training participants reported a decreased risk of positive depressive symptom (Edinburgh Postnatal Depression Scale [EPDS] score>9) compared to attention control participants postintervention (odds ratio [OR] 0.391, 95% CI 0.164-0.930) and significantly higher depression symptom remission with different EPDS reduction scores from preintervention to postintervention (OR 3.471-27.986). Parity did not show a significant moderating effect; however, for nulliparous women, mindfulness training participants had significantly improved depression symptoms compared to nulliparous attention control group participants (group × time interaction χ24=18.1, P=.001). CONCLUSIONS Smartphone-based mindfulness training is an effective intervention in improving maternal perinatal depression for those who are potentially at risk of perinatal depression in early pregnancy. Nulliparous women are a promising subgroup who may benefit more from mindfulness training. TRIAL REGISTRATION Chinese Clinical Trial Registry ChiCTR1900028521; http://www.chictr.org.cn/showproj.aspx?proj=33474.
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Affiliation(s)
- Yaoyao Sun
- School of Nursing and Rehabilitation, Shandong University, Jinan, China
| | - Yanyan Li
- School of Nursing and Rehabilitation, Shandong University, Jinan, China
| | - Juan Wang
- School of Nursing and Rehabilitation, Shandong University, Jinan, China
| | - Qingyi Chen
- School of Nursing and Rehabilitation, Shandong University, Jinan, China
| | - Alessandra N Bazzano
- Tulane University School of Public Health and Tropical Medicine, New Orleans, LA, United States
| | - Fenglin Cao
- School of Nursing and Rehabilitation, Shandong University, Jinan, China
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Bottemanne H, Vahdat B, Jouault C, Tibi R, Joly L. Becoming a Mother During COVID-19 Pandemic: How to Protect Maternal Mental Health Against Stress Factors. Front Psychiatry 2021; 12:764207. [PMID: 35368728 PMCID: PMC8964966 DOI: 10.3389/fpsyt.2021.764207] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2021] [Accepted: 12/30/2021] [Indexed: 01/15/2023] Open
Abstract
During the COVID-19 pandemic, there were an increasing prevalence of perinatal psychiatric symptoms, such as perinatal anxiety, depression, and post-traumatic stress disorders. This growth could be caused by a range of direct and indirect stress factors related to the virus and changes in health, social and economic organization. In this review, we explore the impact of COVID-19 pandemic on perinatal mental health, and propose a range of hypothesis about their etiological mechanisms. We suggest first that the fear of being infected or infected others (intrauterine transmission, passage of the virus from mother to baby during childbirth, infection through breast milk), and the uncertainty about the effect of the virus on the fetuses and infants may have played a key-role to weakening the mental health of mothers. We also highlight that public health policies such as lockdown, limiting prenatal visits, social distancing measures, and their many associated socio-economic consequences (unemployment, loss of income, and domestic violence) may have been an additional challenge for perinatal mental health. Ground on these hypotheses, we finally purpose some recommendations to protect perinatal mental health during a pandemic, including a range of specific support based on digital technologies (video consultations, phone applications) during pregnancy and the postpartum period.
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Affiliation(s)
- Hugo Bottemanne
- Department of Psychiatry, Sorbonne University, Pitié-Salpêtrière Hospital, DMU Neurosciences, Assistance Publique-Hôpitaux de Paris (AP-HP), Paris, France.,Paris Brain Institute - Institut du Cerveau (ICM), UMR 7225/UMRS 1127, Pitié-Salpêtrière Hospital, Sorbonne University/CNRS/INSERM, Paris, France.,Sorbonne University, Department of Philosophy, SND Research Unit, UMR 8011, Paris, France
| | - Brune Vahdat
- Department of Psychiatry, Sorbonne University, Pitié-Salpêtrière Hospital, DMU Neurosciences, Assistance Publique-Hôpitaux de Paris (AP-HP), Paris, France
| | - Cleo Jouault
- Department of Psychiatry, Sorbonne University, Pitié-Salpêtrière Hospital, DMU Neurosciences, Assistance Publique-Hôpitaux de Paris (AP-HP), Paris, France
| | - Ruben Tibi
- Department of Psychiatry, Sorbonne University, Pitié-Salpêtrière Hospital, DMU Neurosciences, Assistance Publique-Hôpitaux de Paris (AP-HP), Paris, France.,Perinatal Psychiatry Unit, Department of Psychiatry, Robert Ballanger Hospital, GHT Grand Paris Nord-Est, Paris, France
| | - Lucie Joly
- Department of Psychiatry, Sorbonne University, Pitié-Salpêtrière Hospital, DMU Neurosciences, Assistance Publique-Hôpitaux de Paris (AP-HP), Paris, France
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