1
|
Sobol M, Błachnio A, Plucińska E, Hryhorchuk I, Meisner M, Wdowiak A, Wdowiak N, Szczepaniak P, Jankowski KS. Associations of couples' balanced time perspective with maternal prenatal hair cortisol concentration and perceived stress. Psychoneuroendocrinology 2024; 168:107115. [PMID: 39002452 DOI: 10.1016/j.psyneuen.2024.107115] [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: 02/20/2024] [Revised: 06/22/2024] [Accepted: 06/27/2024] [Indexed: 07/15/2024]
Abstract
OBJECTIVE The stress experienced by a woman during pregnancy not only has a negative impact on her well-being and physical health but also adversely affects the fetus. Stress is strongly linked with time perspective, defined as the tendency to focus on the past, present, or future. The study aimed to investigate how couples' balanced time perspective was related to maternal prenatal hair cortisol concentration and perceived stress in the first and third trimesters of pregnancy. METHOD The participants were pregnant women and their male partners (84 couples). Women completed online questionnaires: the Zimbardo Time Perspective Inventory (ZTPI), the Dark Future Scale (DFS), and the Perceived Stress Scale, while men completed online versions of the ZTPI and the DFS. These questionnaire measurements were conducted in the first and third trimesters. Maternal cortisol levels were measured in hair samples taken during gynecological visits, in the first and third trimesters. RESULTS The study revealed that the more unbalanced the partner's time perspective, the more unbalanced the pregnant woman's time perspective and, consequently, the higher the stress perceived by the pregnant woman. This effect was present in both the first (B = 1.06, SE =.36, p <.001, 95 % CI [.398, 1.826]) and the third trimesters (B =.98, SE =.36, p <.001, 95 % CI [.327, 1.774]). Moreover, the more unbalanced the partner's time perspective, the more unbalanced the woman's time perspective and, consequently, the lower the hair cortisol concentration in the first trimester (B = -.08, SE =.04, p <.05, 95 % CI [-.171, -.010]). Partner's unbalanced time perspective in the first trimester was also a predictor of stress perceived by the woman in the third trimester (t = 2.38, p <.05). CONCLUSIONS The results suggest the significance of the partner's time perspective for the pregnant woman's mental health. The partner's unbalanced, negative time perspective in the first trimester may increase the pregnant woman's stress in the third trimester. This effect can be even stronger than that of the woman's time perspective.
Collapse
Affiliation(s)
- Małgorzata Sobol
- Department of Psychology, University of Warsaw, ul. Stawki 5/7, Warsaw 00-183, Poland.
| | - Agata Błachnio
- John Paul II Catholic University of Lublin, al. Raclawickie 14, Lublin 20-950, Poland
| | | | - Inna Hryhorchuk
- Żywiec Hospital, ul. Pola Lisickich 80, Żywiec 34-300, Poland
| | - Michał Meisner
- Department of Psychology, University of Warsaw, ul. Stawki 5/7, Warsaw 00-183, Poland
| | - Artur Wdowiak
- Medical University of Lublin, Al. Racławickie 1, Lublin 20-059, Poland
| | - Natalia Wdowiak
- Medical University of Lublin, Al. Racławickie 1, Lublin 20-059, Poland
| | | | - Konrad S Jankowski
- Department of Psychology, University of Warsaw, ul. Stawki 5/7, Warsaw 00-183, Poland
| |
Collapse
|
2
|
Kurbatfinski S, Woo J, Ntanda H, Giesbrecht G, Letourneau N. Perinatal Predictors and Mediators of Attachment Patterns in Preschool Children: Exploration of Children's Contributions in Interactions with Mothers. CHILDREN (BASEL, SWITZERLAND) 2024; 11:1022. [PMID: 39201958 PMCID: PMC11352242 DOI: 10.3390/children11081022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/03/2024] [Revised: 08/11/2024] [Accepted: 08/16/2024] [Indexed: 09/03/2024]
Abstract
Insecure and disorganized attachment patterns in children are linked to poor health outcomes over the lifespan. Attachment patterns may be predicted by variables that influence the quality of children's interactions with their primary caregivers/parents (usually mothers) such as prenatal and postnatal exposures and the children's own behaviours in interactions. The purposes of this exploratory study were to examine: (1) prenatal predictors of children's attachment patterns, and (2) postnatal mediators and moderators of associations between prenatal predictors and children's attachment patterns, with adjustment for relevant covariates. Mother-child dyads (n = 214) from the longitudinal Alberta Pregnancy Outcomes and Nutrition (APrON) cohort were studied using valid and reliable measures. Hayes' mediation analysis was employed to determine direct and indirect effects. Mothers' prenatal cortisol levels directly predicted disorganized (versus organized) child attachment in unadjusted models. Children's passivity (in adjusted models) and compulsivity (in unadjusted and adjusted models) in parent-child interactions mediated the pathway between mothers' prenatal cortisol levels and children's disorganized attachment patterns. Serial mediation analyses revealed that mothers' cortisol levels predicted their children's cortisol levels, which predicted children's compulsivity, and, ultimately, disorganized attachment in both unadjusted and adjusted models. No predictors were correlated with children's insecure (versus secure) attachment. This exploratory research suggests that prenatal exposure to mothers' cortisol levels and children's behavioural contributions to parent-child interaction quality should be considered in the genesis of children's attachment patterns, especially disorganization. Interventions focused on parent-child interactions could also focus on addressing children's behavioral contributions.
Collapse
Affiliation(s)
- Stefan Kurbatfinski
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB T2N 1N4, Canada; (S.K.); (G.G.)
- Owerko Centre, Alberta Children’s Hospital Research Institute, Calgary, AB T2N 1N4, Canada;
| | - Jennifer Woo
- Department of Psychiatry, University of Saskatchewan, Regina, SK S7N 0W8, Canada;
| | - Henry Ntanda
- Owerko Centre, Alberta Children’s Hospital Research Institute, Calgary, AB T2N 1N4, Canada;
| | - Gerald Giesbrecht
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB T2N 1N4, Canada; (S.K.); (G.G.)
- Owerko Centre, Alberta Children’s Hospital Research Institute, Calgary, AB T2N 1N4, Canada;
- Departments of Pediatrics, Cumming School of Medicine, University of Calgary, Calgary, AB T2N 1N4, Canada
| | - Nicole Letourneau
- Owerko Centre, Alberta Children’s Hospital Research Institute, Calgary, AB T2N 1N4, Canada;
- Owerko Centre, Faculty of Nursing and Cumming School of Medicine, Departments of Pediatrics, Psychiatry, and Community Health Sciences, University of Calgary, Calgary, AB T2N 1N4, Canada
| |
Collapse
|
3
|
Cioffredi LA, Yerby LG, Burris HH, Cole KM, Engel SM, Murray TM, Slopen N, Volk HE, Acheson A. Assessing prenatal and early childhood social and environmental determinants of health in the HEALthy Brain and Child Development Study (HBCD). Dev Cogn Neurosci 2024; 69:101429. [PMID: 39208687 PMCID: PMC11399805 DOI: 10.1016/j.dcn.2024.101429] [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: 03/11/2024] [Revised: 07/29/2024] [Accepted: 08/02/2024] [Indexed: 09/04/2024] Open
Abstract
The HEALthy Brain and Child Development (HBCD) Study, a multi-site prospective longitudinal cohort study, will examine human brain, cognitive, behavioral, social, and emotional development beginning prenatally and planned through early childhood. The charge of the HBCD Social and Environmental Determinants (SED) working group is to develop and implement a battery of assessments to broadly characterize the social and physical environment during the prenatal period and early life to characterize risk and resilience exposures that can impact child growth and development. The SED battery consists largely of measures that will be repeated across the course of the HBCD Study with appropriate modifications for the age of the child and include participant demographics, indicators of socioeconomic status, stress and economic hardship, bias and discrimination (e.g., racism), acculturation, neighborhood safety, child and maternal exposures to adversity, environmental toxicants, social support, and other protective factors. Special considerations were paid to reducing participant burden, promoting diversity, equity, and inclusion, and adopting trauma-informed practices for the collection of sensitive information such as domestic violence exposure and adverse childhood experiences. Overall, the SED battery will provide essential data to advance understanding of child development and approaches to advance health equity across infant and child development.
Collapse
Affiliation(s)
- Leigh-Anne Cioffredi
- University of Vermont Larner College of Medicine, Vermont Children's Hospital, USA.
| | - Lea G Yerby
- Department of Community Medicine and Population Health, The University of Alabama, USA.
| | - Heather H Burris
- Children's Hospital of Philadelphia, Division of Neonatology, USA; University of Pennsylvania Perelman School of Medicine, Department of Pediatrics, USA
| | - Katherine M Cole
- National Institutes of Health/National Institute on Drug Abuse, USA
| | - Stephanie M Engel
- Gillings School of Global Public Health, University of North Carolina at Chapel Hill, USA
| | - Traci M Murray
- National Institutes of Health/National Institute on Drug Abuse, USA
| | - Natalie Slopen
- Department of Social and Behavioral Sciences, Harvard T. H. Chan School of Public Health, USA
| | - Heather E Volk
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, USA
| | - Ashley Acheson
- Department of Psychiatry and Behavioral Sciences, University of Arkansas for Medical Sciences, USA.
| |
Collapse
|
4
|
Jackson L, Davies SM, Gaspar M, Podkujko A, Harrold JA, Pascalis LDE, Fallon V, Soulsby LK, Silverio SA. The social and healthcare professional support drawn upon by women antenatally during the COVID-19 pandemic: A recurrent, cross-sectional, thematic analysis. Midwifery 2024; 133:103995. [PMID: 38608542 DOI: 10.1016/j.midw.2024.103995] [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: 03/20/2023] [Revised: 04/06/2024] [Accepted: 04/08/2024] [Indexed: 04/14/2024]
Abstract
OBJECTIVE To explore antenatal experiences of social and healthcare professional support during different phases of social distancing restriction implementation in the UK. DESIGN Semi-structured interviews were conducted via telephone or video-conferencing software between 13 July 2020 - 2 September 2020. Interviews were transcribed and a recurrent, cross-sectional, thematic analysis was conducted. PARTICIPANTS Twelve antenatal women were interviewed during UK social distancing restrictions (Timepoint 1; T1) and a separate sample of twelve women were interviewed in the initial easing of these restrictions (Timepoint 2; T2). FINDINGS T1 themes were: 'Maternity care as non-essential' and 'Pregnancy is cancelled'. T2 themes were: 'Technology is a polarised tool' and 'Clinically vulnerable, or not clinically vulnerable? That is the question'. KEY CONCLUSIONS At T1, anxieties were ascribed to the exclusion of partners from routine care, and to perceived insensitivity and aggression from the public. For T2, insufficient Governmental transparency led to disillusionment, confusion, and anger. Covert workplace discrimination also caused distress at T2. Across timepoints: deteriorated mental wellbeing was attributed to depleted opportunities to interact socially and scaled back maternity care. IMPLICATIONS FOR PRACTICE Recommendations are made to: protect maternal autonomy; improve quality of mental health and routine care signposting; prioritise parental community support in the re-opening of 'non-essential' services; prioritise the option for face-to-face appointments when safe and legal; and protecting the rights of working mothers.
Collapse
Affiliation(s)
- Leanne Jackson
- Department of Psychology, Institute of Population Health, University of Liverpool, England
| | - Siân M Davies
- School of Psychology, Faculty of Health, Liverpool John Moores University, England; Department of Women & Children's Health, School of Life Course & Population Sciences, King's College London, England
| | - Monic Gaspar
- Department of Psychology, Institute of Population Health, University of Liverpool, England
| | - Anastasija Podkujko
- Department of Psychology, Institute of Population Health, University of Liverpool, England
| | - Joanne A Harrold
- Department of Psychology, Institute of Population Health, University of Liverpool, England
| | - Leonardo DE Pascalis
- Department of Psychology, Institute of Population Health, University of Liverpool, England
| | - Victoria Fallon
- Department of Psychology, Institute of Population Health, University of Liverpool, England
| | - Laura K Soulsby
- Department of Psychology, Institute of Population Health, University of Liverpool, England
| | - Sergio A Silverio
- Department of Women & Children's Health, School of Life Course & Population Sciences, King's College London, England.
| |
Collapse
|
5
|
Sacchi C, De Carli P, Gregorini C, Monk C, Simonelli A. In the pandemic from the womb. Prenatal exposure, maternal psychological stress and mental health in association with infant negative affect at 6 months of life. Dev Psychopathol 2024; 36:810-820. [PMID: 36794393 DOI: 10.1017/s0954579423000093] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/17/2023]
Abstract
For mother-infant health especially, the pandemic has brought multiple stressors inside a susceptible psychobiological system. We study the longitudinal associations between maternal prenatal and postpartum: (a) COVID-19 stressful events exposure, (b) pandemic psychological stress, and (c) mental health and infants' negative affect. A sample of 643 Italian pregnant women completed a web-based survey from April 8th to May 4th, 2020 and a follow-up at 6 months after delivery. Maternal assessment covered prenatal and postpartum measures for: COVID-19 stressful events exposure, pandemic psychological stress, mental health symptoms (i.e., depression, anxiety, posttraumatic stress disorder) and postpartum, social support and report of infants' negative affect. Maternal mental health symptoms during pregnancy, at the peak of pandemic, is longitudinally associated with infant negative affect, with postpartum mental health mediating this association. Also, maternal COVID-19 stressful events exposure in postpartum is associated with negative affect at 6 months mediated by postpartum mental health symptoms. Maternal pandemic psychological stress during pregnancy predicted mental health symptoms in postpartum. The study supports the association between pandemic-related maternal health across pregnancy and postpartum and offspring's development (i.e., negative affect). It also puts the spotlight on mental health risk in women experiencing lockdown during pregnancy, especially when feeling high psychological stress in pregnancy or when directly exposed to COVID-19 stressful events postpartum.
Collapse
Affiliation(s)
- Chiara Sacchi
- Department of Developmental and Social Psychology, University of Padova, Padua, Italy
| | - Pietro De Carli
- Department of Psychology, University of Milano Bicocca, Milano, Italy
| | - Camilla Gregorini
- Department of Psychology, University of Milano Bicocca, Milano, Italy
| | - Catherine Monk
- Departments of Obstetrics and Gynecology, Columbia University Irving Medical Center, New York, NY, USA
| | - Alessandra Simonelli
- Department of Developmental and Social Psychology, University of Padova, Padua, Italy
| |
Collapse
|
6
|
Lee Y, McDonald E, Gundogan F, Barry CV, Tallo V, Colt S, Friedman JF. Early-life matters: The role of fetal adrenal steroids in the relationship between cytokines within the placental circulation and cognitive development among infants in the Philippines. Brain Behav Immun 2024; 118:510-520. [PMID: 38431237 DOI: 10.1016/j.bbi.2024.02.036] [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: 04/10/2023] [Revised: 02/08/2024] [Accepted: 02/28/2024] [Indexed: 03/05/2024] Open
Abstract
Prenatal exposure to inflammation is related to the risk for cognitive impairment in offspring. However, mechanisms underlying the link between inflammatory cytokines at the maternal-fetal interface and human cognitive development are largely unknown. This study addressed this research gap by examining whether i) cytokines within the placenta are associated with different domains of neurocognitive development during infancy, and ii) if DHEA-S in cord blood mediates these associations. We also explored the role of early-life socioeconomic status (SES) in moderating the effect of fetal adrenal steroids on cognitive development in low- and middle-income country contexts. A cohort of 242 mother-infant dyads in Leyte, the Philippines participated in the study and all of them were followed from early pregnancy until 12-months. Concentrations of pro- and anti-inflammatory cytokines in the placenta, and DHEA-S in cord blood collected at delivery were evaluated. The multifactorial aspects of the infant's cognitive functioning were assessed based on the Bayley Scales of Infant Development, third edition (BSID-III). We used Structural Equation Modelling (SEM) with an orthogonal rotation to examine associated paths among latent variables of pro- and anti-inflammatory cytokines in the placenta, fetal neuroendocrine factors, and cognitive development. Pathway analyses showed that both pro- and anti-inflammatory cytokines in the placenta were indirectly related to cognitive (p < 0.05) and language developmental outcomes (p < 0.1) via DHEA-S in cord blood among the low SES group. Yet, we found no statistically significant indirect effect of pro- or anti-inflammatory cytokines on neurocognitive development among the high SES sub-sample. This study extends our understanding of how early-life socioeconomic conditions modify biological pathways underlying the relationship between prenatal factors and postpartum cognitive development.
Collapse
Affiliation(s)
- Yeonjin Lee
- Department of Pathology and Laboratory Medicine, Warren Alpert Medical School of Brown University, Providence, RI, United States; Department of Sociology, Kookmin University, Seoul, South Korea.
| | - Emily McDonald
- Center for International Health Research, Rhode Island Hospital, Providence, RI, United States; Department of Pediatrics, Warren Alpert Medical School of Brown University, Providence, RI, United States
| | - Fusun Gundogan
- Department of Pathology and Laboratory Medicine, Warren Alpert Medical School of Brown University, Providence, RI, United States
| | - Christopher V Barry
- Center for International Health Research, Rhode Island Hospital, Providence, RI, United States; Warren Alpert Medical School of Brown University, Providence, RI, United States
| | - Veronica Tallo
- Research Institute for Tropical Medicine, Manila, Philippines
| | - Susannah Colt
- Center for International Health Research, Rhode Island Hospital, Providence, RI, United States; Department of Pediatrics, Warren Alpert Medical School of Brown University, Providence, RI, United States
| | - Jennifer F Friedman
- Center for International Health Research, Rhode Island Hospital, Providence, RI, United States; Warren Alpert Medical School of Brown University, Providence, RI, United States; Department of Epidemiology, Brown University, Providence, RI, United States; Department of Pediatrics, Warren Alpert Medical School of Brown University, Providence, RI, United States
| |
Collapse
|
7
|
Modde Epstein C, Rice MJ, French JA, Kupzyk KA, Houfek JF. Social Support Buffers the Effects of Prenatal Depressed Mood: A Mixed-Methods Study. J Am Psychiatr Nurses Assoc 2024; 30:95-107. [PMID: 35081823 DOI: 10.1177/10783903211073793] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND: Women use various coping strategies to deal with stress and depression. These strategies are shaped by social contexts over the life course and may attenuate and/or exacerbate the physiologic effects of depression. AIMS: The purpose of this study was to determine whether coping strategies (active, disengaged, or social support coping) moderate depression-related diurnal cortisol dysregulation and to explore how social context influences women's use of coping. METHODS: This was a mixed-methods study of pregnant women (N = 65) during mid-pregnancy. Cortisol was measured in saliva collected during the waking hours of the day. Participants completed the Edinburgh Depression Scale and the Brief COPE. A subset of the sample participated in semistructured qualitative interviews (n = 20). RESULTS: Social support coping, but not active or disengaged coping, moderated end-of-day cortisol levels. Among depressed women, higher use of social support was associated with lower and more dynamic (i.e., less flat) diurnal cortisol rhythms. The qualitative findings revealed how complex social dynamics related to financial insecurity, lack of mutuality, and social identity affected women's use of and access to social support. CONCLUSION: These findings support theories of the stress-buffering effects of social support. Future research is needed to examine how social determinants affect access to social support, and how early life social experiences condition women's adaptive formation of social support coping strategies over the life course. Clinically, these findings underscore the value of relationship-centered nursing care for depressed women.
Collapse
Affiliation(s)
- Crystal Modde Epstein
- Crystal Modde Epstein, PhD, RN, PMHNP-BC, University of Nebraska Medical Center, Omaha, NE, USA; University of North Carolina Greensboro, NC, USA
| | - Michael J Rice
- Michael J. Rice, PhD, APRN-NP, FAAN, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Jeffrey A French
- Jeffrey A. French, PhD, University of Nebraska at Omaha, NE, USA
| | - Kevin A Kupzyk
- Kevin A. Kupzyk, PhD, University of Nebraska Medical Center, Omaha, NE, USA
| | - Julia F Houfek
- Julia F. Houfek, PhD, APRN-CNS, University of Nebraska Medical Center, Omaha, NE, USA
| |
Collapse
|
8
|
Sands G, Blake H, Carter T, Spiby H. Nature-based interventions to support mental health and well-being of young women in pregnancy: exploratory work for future feasibility RCT. PUBLIC HEALTH RESEARCH 2023:1-23. [PMID: 38140912 DOI: 10.3310/npgr3411] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2023] Open
Abstract
Background The prevalence of mental health and well-being issues among young women is increasing. Pregnancy is a time when new mental health challenges may arise, or existing conditions can be exacerbated. This project presents preparatory work on how nature-based interventions may help to support the mental health and well-being of young pregnant women (aged 16-24 years) in a future study. Methods This project was formed of three main phases conducted from March to August 2022: (1) mapping nature activities available across the East Midlands region and two focus groups with providers of nature activities (n = 6); (2) public participation and involvement work to inform future research. This included four focus groups with young women (n = 11), leading to the formation of a new young women's panel (Research Influencers Group). Networking and stakeholder engagement to support future research. Results The mapping survey identified 68 nature-based organisations/projects operating in the region, many of whom expressed interest in being involved in future research. The young women's focus groups confirmed the importance of the topic and generated a wealth of information to support the intervention design. A Research Influencer Group of five young women was established from the focus group participants. The Research Influencer Group chose the nature-based intervention and had input into all aspects of the study design. This group will continue into future projects. Focus groups with providers of nature activities have further advanced the study design. The project team have developed relationships with relevant stakeholders and networks that will inform the future trial. Conclusion This preparatory co-design work suggested that a nature-based intervention may be acceptable to young women, and providers of such interventions felt it was feasible to offer these activities to young pregnant women. This preparatory work has led to an outline research plan which has been co-produced with public contributors and stakeholders throughout. Limitations This preparatory work is limited by small focus group samples, and the possibility that not all providers were reached through the snowballing approach to the mapping survey. Future work Future research is needed to test the nature-based intervention; this would be in the form of a feasibility randomised controlled trial of nature-based interventions to promote the mental health and well-being of young pregnant women. Funding This article presents independent research funded by the National Institute for Health and Care Research (NIHR) Public Health Research programme as award number NIHR135167.
Collapse
Affiliation(s)
- Gina Sands
- School of Health Sciences, University of Nottingham, Nottingham, UK
| | - Holly Blake
- School of Health Sciences, University of Nottingham, Nottingham, UK
- NIHR Nottingham Biomedical Research Centre, Nottingham, UK
| | - Tim Carter
- School of Health Sciences, University of Nottingham, Nottingham, UK
| | - Helen Spiby
- School of Health Sciences, University of Nottingham, Nottingham, UK
| |
Collapse
|
9
|
Wang G, Liu X, Zhu S, Lei J. Experience of mental health in women with Polycystic Ovary Syndrome: a descriptive phenomenological study. J Psychosom Obstet Gynaecol 2023; 44:2218987. [PMID: 37267127 DOI: 10.1080/0167482x.2023.2218987] [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: 04/12/2023] [Revised: 05/18/2023] [Accepted: 05/23/2023] [Indexed: 06/04/2023] Open
Abstract
Purpose: This study aims to investigate the experiences, emotional coping strategies, and help-seeking needs of women with PCOS from their perspective, considering common psychological issues such as stress, anxiety, and depression that are prevalent among individuals with PCOS. Materials and Methods: The study recruited 14 women with PCOS for semi-structured interviews between October and November 2022, using a descriptive phenomenology method design. The interviews were analyzed using NVivo 12 software. Results: Four themes and eleven subthemes were derived from the semi-structured interviews: (1) Negative Mental Health Status; (2) Four Patterns of Emotion Regulation; (3) The Psychological Double-Edged Sword: Family Social Network; (4) Strong Demands for Psychological Counseling and Lifestyle Guidance. Conclusion: The study suggests that interventions should focus on fostering internalized self-efficacy and emotional expression, promoting constructive familial support, and providing psychological counseling and lifestyle recommendations to alleviate psychological distress experienced by women with PCOS.
Collapse
Affiliation(s)
- Guangpeng Wang
- The Third Xiangya Hospital of Central South University, Changsha, China
- Xiangya School of Nursing, Central South University, Changsha, China
| | - Xueyan Liu
- School of Nursing, Shandong University, Jinan, China
| | - Shujuan Zhu
- The Third Xiangya Hospital of Central South University, Changsha, China
| | - Jun Lei
- The Third Xiangya Hospital of Central South University, Changsha, China
| |
Collapse
|
10
|
Barclay ME, Rinne GR, Somers JA, Lee SS, Coussons-Read M, Dunkel Schetter C. Maternal Early Life Adversity and Infant Stress Regulation: Intergenerational Associations and Mediation by Maternal Prenatal Mental Health. Res Child Adolesc Psychopathol 2023; 51:1839-1855. [PMID: 36508054 PMCID: PMC10258218 DOI: 10.1007/s10802-022-01006-z] [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] [Accepted: 11/28/2022] [Indexed: 12/14/2022]
Abstract
Early life adversity is a potent risk factor for poor mental health outcomes across the lifespan, including offspring vulnerability to psychopathology. Developmentally, the prenatal period is a sensitive window in which maternal early life experiences may influence offspring outcomes and demarcates a time when expectant mothers and offspring are more susceptible to stressful and salutary influences. This prenatal plasticity constituted the focus of the current study where we tested the association of maternal early life adversity with infant stress regulation through maternal prenatal internalizing symptoms and moderation by prenatal social support. Mother-infant dyads (n = 162) were followed prospectively and mothers completed assessments of social support and depressive and anxiety symptoms across pregnancy. Infants completed standardized stress paradigms at one month and six months. There were several key findings. First, maternal prenatal depressive symptoms significantly mediated predictions of infant cortisol reactivity to the heel stick at one month from maternal early life adversity: specifically, maternal early life adversity positively predicted depressive symptoms in pregnancy, which in turn predicted dampened infant cortisol reactivity. Second, prenatal social support did not significantly moderate predictions of depressive or anxiety symptoms in pregnancy from maternal early life adversity nor did it alter the associations of maternal depressive or anxiety symptoms with infant stress regulation. These results suggest that maternal prenatal mental health is a key mechanism by which maternal early life adverse experiences affect offspring risk for psychopathology. We discuss potential clinical and health implications of dysregulated infant cortisol reactivity with respect to lifespan development.
Collapse
|
11
|
Morris AR, Sellery PE, Truong V, Jeyasingh D, Haddan L, Saxbe DE. Maternal prenatal social contact during the COVID-19 pandemic predicts infant birth weight. Early Hum Dev 2023; 187:105881. [PMID: 37944266 PMCID: PMC10773973 DOI: 10.1016/j.earlhumdev.2023.105881] [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: 08/15/2023] [Revised: 10/19/2023] [Accepted: 10/20/2023] [Indexed: 11/12/2023]
Abstract
BACKGROUND Social connectedness and mental health have been associated with infant birth weight, and both were compromised by the COVID-19 pandemic. AIMS We sought to examine whether changes in maternal prenatal social contact due to the COVID-19 pandemic were associated with infant birth weight and if maternal prenatal mental health mediated this association. STUDY DESIGN A longitudinal study of mothers and their infants born during the first wave of the COVID-19 pandemic. SUBJECTS The sample consisted of 282 United States-based mother-infant dyads. OUTCOME MEASURES Depressive symptoms were measured with the Beck Depression Inventory-II, anxiety was measured with the State Anxiety Inventory, and stress was measured using the Perceived Stress Scale 14. We also asked participants about pandemic-related changes in social contact across various domains. Adjusted birth weight was calculated from birth records or participant-report when birth records were unavailable. RESULTS Decreases in social contact during the pandemic were associated with lower adjusted infant birth weight (B = 76.82, SE = 35.82, p = .035). This association was mediated by maternal prenatal depressive symptoms [Effect = 15.06, 95 % CI (0.19, 35.58)] but not by prenatal anxiety [95 % CI (-0.02, 32.38)] or stress [95 % CI (-0.31, 26.19)]. CONCLUSION These findings highlight concerns for both mothers and infants in the wake of the COVID-19 pandemic, since birth weight can have long-term health implications and the social restructuring occasioned by the pandemic may lead to lasting changes in social behavior.
Collapse
Affiliation(s)
- Alyssa R Morris
- Department of Psychology, University of Southern California, Los Angeles, CA, United States.
| | - Pia E Sellery
- Department of Psychology, University of Southern California, Los Angeles, CA, United States
| | - Van Truong
- Department of Psychology, University of Southern California, Los Angeles, CA, United States
| | - Divya Jeyasingh
- Department of Psychology, University of Southern California, Los Angeles, CA, United States
| | - Lila Haddan
- Department of Psychology, University of Southern California, Los Angeles, CA, United States
| | - Darby E Saxbe
- Department of Psychology, University of Southern California, Los Angeles, CA, United States
| |
Collapse
|
12
|
Fox MM, Knorr DA, Kwon D, Wiley KS, Parrish MH. How prenatal cortisol levels relate to grandmother-mother relationships among a cohort of Latina women. Am J Hum Biol 2023; 35:e23883. [PMID: 36862026 PMCID: PMC10474942 DOI: 10.1002/ajhb.23883] [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: 09/17/2022] [Revised: 02/09/2023] [Accepted: 02/10/2023] [Indexed: 03/03/2023] Open
Abstract
INTRODUCTION As part of the human reproductive strategy, mothers receive childcare assistance from others. For kin, allomothers are adaptively incentivized to provide assistance due to inclusive fitness benefits. Previous studies across a broad range of populations identify grandmothers as particularly consistent allomothers. Minimal attention has been paid to the possibility that allomothers may begin investing in offspring quality during the prenatal stage of life. Here, we innovate within the area of grandmother allocare research by examining the prenatal stage of life and biopsychosocial mechanisms by which prenatal grandmother effects may be enacted. METHODS Data derive from the Mothers' Cultural Experiences study, a cohort of 107 pregnant Latina women in Southern California. At <16 weeks' gestation, we administered questionnaires, collected morning urine samples, and measured cortisol by enzyme-linked immunosorbent assay, correcting for specific gravity. We measured the soon-to-be maternal and paternal grandmothers' relationship quality, social support, frequency of seeing each other, communicating, and geographic proximity to pregnant mothers, that is, their daughters and daughters-in-law. These measures were self-reported by the pregnant mothers. We assessed how grandmother constructs related to the pregnant women's depression, stress, anxiety, and cortisol levels. RESULTS We observed benefits conferred by maternal grandmothers for mothers' prenatal mental health and lower cortisol levels. Paternal grandmothers also conferred mental health benefits to pregnant daughters-in-law, but higher cortisol levels. CONCLUSION Our results suggest that grandmothers, especially maternal grandmothers, are able to improve their inclusive fitness by caring for pregnant daughters, and allomother support may positively impact prenatal health. This work extends the traditional cooperative breeding model by identifying a prenatal grandmother effect, and, by examining a maternal biomarker.
Collapse
Affiliation(s)
- Molly M. Fox
- Department of Anthropology, University of California, Los Angeles, Los Angeles, CA, 90095 USA
- Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, Los Angeles, CA, 90095 USA
| | - Delaney A. Knorr
- Department of Anthropology, University of California, Los Angeles, Los Angeles, CA, 90095 USA
| | - Dayoon Kwon
- Department of Epidemiology, UCLA Fielding School of Public Health, University of California, Los Angeles, Los Angeles, CA, 90095 USA
| | - Kyle S. Wiley
- Department of Anthropology, University of California, Los Angeles, Los Angeles, CA, 90095 USA
| | - Michael H. Parrish
- Department of Psychology, University of California, Los Angeles, CA 90095 USA
| |
Collapse
|
13
|
Msipu Phiri T, Nyamaruze P, Akintola O. Perspectives about social support among unmarried pregnant university students in South Africa. PLoS One 2023; 18:e0284906. [PMID: 37093843 PMCID: PMC10124874 DOI: 10.1371/journal.pone.0284906] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Accepted: 04/11/2023] [Indexed: 04/25/2023] Open
Abstract
BACKGROUND Pregnant young women in an academic environment are susceptible to stressors associated with unintended pregnancy and academic demands of universities. The challenges they face may be exacerbated by lack of social support, putting them at risk of psychological disorders such as depression. Women who receive social support during pregnancy and postpartum experience less emotional distress and report greater maternal satisfaction. However, very little is known about the perspectives about social support among unmarried pregnant students in tertiary institutions. METHODS Participants were purposively selected among unmarried pregnant students and those in the puerperal period at the time of the study. We conducted semi-structured qualitative interviews to explore the perspectives of unmarried pregnant students on the type of support that they need during pregnancy and the puerperium and the period when most support is needed. The data were audio-recorded and transcribed verbatim, then analysed using thematic analysis. RESULTS The findings show that social supports (emotional, instrumental, informational, and financial) were highlighted as important resources to cope with stressors during pregnancy and post-birth. Emotional support from male partners was the most important type of support needed as it entailed a sense of being loved and cared for. Social support was identified as important throughout the different phases of pregnancy and post birth, with different support needs expressed at each of these phases. CONCLUSION This study identified support needs of unmarried pregnant university students in their transition to motherhood. Given the several challenges that they are faced with, unmarried pregnant students need social support, including male partner support to enhance wellbeing as they try to cope with academic and pregnancy-related stressors.
Collapse
Affiliation(s)
- Thandiwe Msipu Phiri
- School of Public Health, Faculty of Community and Health Sciences, University of the Western Cape, Cape Town, South Africa
| | - Patrick Nyamaruze
- School of Public Health, Faculty of Community and Health Sciences, University of the Western Cape, Cape Town, South Africa
| | - Olagoke Akintola
- School of Public Health, Faculty of Community and Health Sciences, University of the Western Cape, Cape Town, South Africa
| |
Collapse
|
14
|
Khoury JE, Giles L, Kaur H, Johnson D, Gonzalez A, Atkinson L. Associations between psychological distress and hair cortisol during pregnancy and the early postpartum: A meta-analysis. Psychoneuroendocrinology 2023; 147:105969. [PMID: 36335755 DOI: 10.1016/j.psyneuen.2022.105969] [Citation(s) in RCA: 13] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2022] [Revised: 09/26/2022] [Accepted: 10/26/2022] [Indexed: 11/06/2022]
Abstract
Pregnancy and the early postpartum signify a period of high stress. Perinatal stress can include psychological distress (PD), such as anxiety, depression, and stress, as well as neuroendocrine stress, indexed by activation of the hypothalamic-pituitary-adrenal (HPA) axis and the production of the hormone cortisol. Elevated PD and cortisol levels during the perinatal period can have long-term implications for the mother and child. Methodological advances have enabled the sampling of cortisol from hair, to provide a retrospective marker of HPA axis activity over several months. Despite knowing that maternal PD and HPA activity during the perinatal period independently impact health and development, research to date is unclear as to the association between maternal PD and hair cortisol. The present meta-analysis included 29 studies to assess the strength of the relation between maternal PD and hair cortisol levels during pregnancy and the early postpartum period. Several sample and methodological factors were assessed as moderators of this effect. Analyses were conducted using multilevel meta-analysis. Results of the multilevel meta-analysis indicated that the overall effect size between PD and HCC was small but not significant z = 0.039, 95% CI [- 0.001, 0.079]. Moderator analyses indicated that the strength of the association between PD and hair cortisol was moderated by pregnancy status (i.e., effects were stronger in pregnant compared to postpartum samples), timing of HCC and PD measurements (i.e., effects were larger when PD was measured before HCC) and geographic location (i.e., effects were larger in North American studies). The findings advance our understanding of the link between PD and HPA activity during the perinatal period, a time of critical impact to child development.
Collapse
Affiliation(s)
- Jennifer E Khoury
- Department of Psychology, Mount Saint Vincent University, Halifax, NS Canada.
| | - Lauren Giles
- Department of Psychology, Mount Saint Vincent University, Halifax, NS Canada
| | - Hargun Kaur
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON Canada
| | - Dylan Johnson
- Department of Applied Psychology and Human Development, University of Toronto, Toronto, ON Canada
| | - Andrea Gonzalez
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON Canada; Offord Centre for Child Studies, McMaster University, Hamilton, ON Canada
| | - Leslie Atkinson
- Department of Psychology, Toronto Metropolitan University, Toronto, ON Canada
| |
Collapse
|
15
|
Nolvi S, Merz EC, Kataja EL, Parsons CE. Prenatal Stress and the Developing Brain: Postnatal Environments Promoting Resilience. Biol Psychiatry 2022; 93:942-952. [PMID: 36870895 DOI: 10.1016/j.biopsych.2022.11.023] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Revised: 11/14/2022] [Accepted: 11/18/2022] [Indexed: 12/25/2022]
Abstract
Heightened maternal stress during pregnancy is associated with atypical brain development and an elevated risk for psychopathology in offspring. Supportive environments during early postnatal life may promote brain development and reverse atypical developmental trajectories induced by prenatal stress. We reviewed studies focused on the role of key early environmental factors in moderating associations between prenatal stress exposure and infant brain and neurocognitive outcomes. Specifically, we focused on the associations between parental caregiving quality, environmental enrichment, social support, and socioeconomic status with infant brain and neurocognitive outcomes. We examined the evidence that these factors may moderate the effects of prenatal stress on the developing brain. Complementing findings from translational models, human research suggests that high-quality early postnatal environments are associated with indices of infant neurodevelopment that have also been associated with prenatal stress, such as hippocampal volume and frontolimbic connectivity. Human studies also suggest that maternal sensitivity and higher socioeconomic status may attenuate the effects of prenatal stress on established neurocognitive and neuroendocrine mediators of risk for psychopathology, such as hypothalamic-pituitary-adrenal axis functioning. Biological pathways that may underlie the effects of positive early environments on the infant brain, including the epigenome, oxytocin, and inflammation, are also discussed. Future research in humans should examine resilience-promoting processes in relation to infant brain development using large sample sizes and longitudinal designs. The findings from this review could be incorporated into clinical models of risk and resilience during the perinatal period and used to design more effective early programs that reduce risk for psychopathology.
Collapse
Affiliation(s)
- Saara Nolvi
- Department of Psychology and Speech-Language Pathology, Turku Institute for Advanced Studies, University of Turku, Turku, Finland; Department of Clinical Medicine, FinnBrain Birth Cohort Study, Center for Population Health Research, University of Turku, Turku, Finland.
| | - Emily C Merz
- Department of Psychology, Colorado State University, Fort Collins, Colorado
| | - Eeva-Leena Kataja
- Department of Clinical Medicine, FinnBrain Birth Cohort Study, Center for Population Health Research, University of Turku, Turku, Finland
| | - Christine E Parsons
- Department of Clinical Medicine, Interacting Minds Center, Aarhus University, Aarhus, Denmark
| |
Collapse
|
16
|
Murray AL, Taut D, Baban A, Hemady CL, Walker S, Osafo J, Sikander S, Tomlinson M, Toit SD, Marlow M, Ward CL, Fernando A, Madrid B, Van Thang V, Tuyen HD, Dunne M, Hughes C, Fearon P, Valdebenito S, Eisner M. Associations Between ADHD Symptoms and Maternal and Birth Outcomes: An Exploratory Analysis in a Multi-Country Cohort of Expectant Mothers. J Atten Disord 2022; 26:1882-1894. [PMID: 35815439 PMCID: PMC9597155 DOI: 10.1177/10870547221105064] [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] [Indexed: 12/26/2022]
Abstract
OBJECTIVE ADHD symptoms can adversely impact functioning in a range of domains relevant for maternal well-being and fetal development; however, there has been almost no research examining their impact during pregnancy. We aimed to address this gap. METHOD We used data (n = 1,204) from a longitudinal birth cohort study spanning eight countries to address this gap. RESULTS ADHD symptoms in the third trimester of pregnancy were associated with lower social support from family (b = -0.16, p = .031), friends (b = -0.16, p = .024), and significant others (b = -0.09, p = .001); higher stress (b = 0.34, p < .001) and depressive symptoms (b = 0.31, p < .001), and increased likelihood of an unwanted pregnancy (b = 0.30, p = .009). Significant associations with tobacco use (b = 0.36, p = .023) and premature birth (b = 0.35, p = .007) did not survive correction for multiple comparisons and there were no significant associations with alcohol use, low birth weight, or unplanned pregnancy. CONCLUSION Results suggest that women with ADHD symptoms could benefit from earlier, more regular screening for mental health difficulties and greater mental health support during pregnancy.
Collapse
Affiliation(s)
- Aja Louise Murray
- University of Edinburgh, UK,Aja Louise Murray, Department of
Psychology, University of Edinburgh, 7 George Square, Edinburgh EH8 9JZ, UK.
| | - Diana Taut
- Babes-Bolyai University, Cluj-Napoca,
Romania
| | | | | | - Susan Walker
- The University of the West Indies,
Kingston, Jamaica
| | | | | | - Mark Tomlinson
- Stellenbosch Uni`versity, Cape Town,
South Africa,Queens University, Belfast, UK
| | | | | | | | | | | | | | | | - Michael Dunne
- Queensland University of Technology,
Brisbane, Australia
| | | | | | | | - Manuel Eisner
- University of Cambridge, UK,University of Zurich,
Switzerland
| |
Collapse
|
17
|
Manning KY, Long X, Watts D, Tomfohr-Madsen L, Giesbrecht GF, Lebel C. Prenatal Maternal Distress During the COVID-19 Pandemic and Associations With Infant Brain Connectivity. Biol Psychiatry 2022; 92:701-708. [PMID: 35871095 PMCID: PMC9110020 DOI: 10.1016/j.biopsych.2022.05.011] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Revised: 04/25/2022] [Accepted: 05/09/2022] [Indexed: 11/30/2022]
Abstract
BACKGROUND The COVID-19 pandemic has caused substantially elevated distress in pregnant individuals, which has the potential to affect the developing infant brain. Our main objective was to understand how prenatal distress was related to infant brain structure and function and whether social support moderated the associations. METHODS The Pregnancy during the COVID-19 Pandemic (PdP) cohort study collected Patient-Reported Outcomes Measurement Information System Anxiety scale, Edinburgh Postnatal Depression Scale, and Social Support Effectiveness Questionnaire data from a population-based sample of pregnant individuals living in Canada (N = 8602). For a subsample of participants, their infants (n = 75) underwent magnetic resonance imaging at 3 months of age to examine whether prenatal maternal distress was associated with infant brain architecture, including the role of social support as a potential protective factor. RESULTS Overall, 33.4% of participants demonstrated clinically elevated depression symptoms and 47.1% of participants demonstrated clinically elevated anxiety symptoms. We identified lower social support as a significant predictor of clinically elevated prenatal maternal distress (t8598 = -22.3, p < .001). Fifty-eight diffusion image datasets (20 female/38 male, 92 ± 14 days old) and 41 functional datasets (13 female/28 male, 92 ± 14 days old) were included in our analysis after removal of poor-quality images and infants without postpartum maternal distress scores. We found significant relationships between prenatal maternal distress and infant amygdala-prefrontal microstructural and functional connectivity measures, and we demonstrate for the first time that social support moderates these relationships. CONCLUSIONS Our findings suggest a potentially long-lasting impact of the COVID-19 pandemic on children and show that social support acts as a possible mediator not just for pregnant individuals but also developing infants. These findings provide timely evidence to inform clinical practice and policy surrounding the care of pregnant individuals and highlight the importance of social support.
Collapse
Affiliation(s)
- Kathryn Y Manning
- Department of Radiology, University of Calgary, Calgary, Alberta, Canada; Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada; Alberta Children's Hospital Research Institute, University of Calgary, Calgary, Alberta, Canada
| | - Xiangyu Long
- Department of Radiology, University of Calgary, Calgary, Alberta, Canada; Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada; Alberta Children's Hospital Research Institute, University of Calgary, Calgary, Alberta, Canada
| | - Dana Watts
- Department of Psychology, University of Calgary, Calgary, Alberta, Canada
| | - Lianne Tomfohr-Madsen
- Department of Psychology, University of Calgary, Calgary, Alberta, Canada; Department of Pediatrics, University of Calgary, Calgary, Alberta, Canada; Alberta Children's Hospital Research Institute, University of Calgary, Calgary, Alberta, Canada; Department of Educational and Counselling Psychology, University of British Columbia, Vancouver, British Columbia, Canada
| | - Gerald F Giesbrecht
- Department of Psychology, University of Calgary, Calgary, Alberta, Canada; Department of Pediatrics, University of Calgary, Calgary, Alberta, Canada; Department of Community Health Sciences, University of Calgary, Calgary, Alberta, Canada; Alberta Children's Hospital Research Institute, University of Calgary, Calgary, Alberta, Canada
| | - Catherine Lebel
- Department of Radiology, University of Calgary, Calgary, Alberta, Canada; Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada; Alberta Children's Hospital Research Institute, University of Calgary, Calgary, Alberta, Canada.
| |
Collapse
|
18
|
Pagès N, Gorgui J, Wang C, Wang X, Zhao JP, Tchuente V, Lacasse A, Côté S, King S, Muanda F, Mufike Y, Boucoiran I, Nuyt AM, Quach C, Ferreira E, Kaul P, Winquist B, O’Donnell KJ, Eltonsy S, Chateau D, Hanley G, Oberlander T, Kassai B, Mainbourg S, Bernatsky S, Vinet É, Brodeur-Doucet A, Demers J, Richebé P, Zaphiratos V, Bérard A. The Impact of COVID-19 on Maternal Mental Health during Pregnancy: A Comparison between Canada and China within the CONCEPTION Cohort. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:12386. [PMID: 36231687 PMCID: PMC9566261 DOI: 10.3390/ijerph191912386] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/12/2022] [Revised: 09/23/2022] [Accepted: 09/26/2022] [Indexed: 06/16/2023]
Abstract
The effect of the COVID-19 pandemic on maternal mental health has been described in Canada and China but no study has compared the two countries using the same standardized and validated instruments. In this study, we aimed to evaluate and compare the impact of COVID-19 public health policies on maternal mental health between Canada and China, as we hypothesize that geographical factors and different COVID-19 policies are likely to influence maternal mental health. Pregnant persons >18 years old were recruited in Canada and China using a web-based strategy. All participants recruited between 26 June 2020 and 16 February 2021 were analyzed. Self-reported data included sociodemographic variables, COVID-19 experience and maternal mental health assessments (Edinburgh Perinatal Depression Scale (EPDS), Generalized Anxiety Disorders (GAD-7) scale, stress and satisfaction with life). Analyses were stratified by recruitment cohort, namely: Canada 1 (26 June 2020-10 October 2020), Canada 2 and China (11 October 2020-16 February 2021). Overall, 2423 participants were recruited, with 1804 participants within Canada 1, 135 within Canada 2 and 484 in China. The mean EDPS scores were 8.1 (SD, 5.1) in Canada 1, 8.1 (SD, 5.2) in Canada 2 and 7.7 (SD, 4.9) in China (p-value Canada 2/China: p = 0.005). The mean GAD-7 scores were 2.6 (SD, 2.9) in China, 4.3 (SD, 3.8) in Canada 1 (p < 0.001) and 5.8 (SD, 5.2) in Canada 2 (p < 0.001). When adjusting for stress and anxiety, being part of the Chinese cohort significantly increased the chances of having maternal depression by over threefold (adjusted OR 3.20, 95%CI 1.77-5.78). Canadian and Chinese participants reported depressive scores nearly double those of other crises and non-pandemic periods. Lockdowns and reopening periods have an important impact on levels of depression and anxiety among pregnant persons.
Collapse
Affiliation(s)
- Nicolas Pagès
- Research Center CHU Ste-Justine, Montreal, QC H3T 1C5, Canada
- Faculty of Medicine, Université Claude Bernard Lyon 1, 69003 Lyon, France
| | - Jessica Gorgui
- Research Center CHU Ste-Justine, Montreal, QC H3T 1C5, Canada
- Faculty of Pharmacy, University of Montreal, Montreal, QC H3T 1J4, Canada
| | - Chongjian Wang
- College of Public Health, Zhengzhou University, Zhengzhou 450001, China
| | - Xian Wang
- College of Public Health, Zhengzhou University, Zhengzhou 450001, China
| | - Jin-Ping Zhao
- Research Center CHU Ste-Justine, Montreal, QC H3T 1C5, Canada
| | - Vanina Tchuente
- Research Center CHU Ste-Justine, Montreal, QC H3T 1C5, Canada
| | - Anaïs Lacasse
- Health Sciences Department, Université du Québec en Abitibi-Témiscamingue, Rouyn-Noranda, QC J9X 5E4, Canada
| | - Sylvana Côté
- Research Center CHU Ste-Justine, Montreal, QC H3T 1C5, Canada
- Faculty of Medicine, School of Public Health, University of Montreal, Montreal, QC H3T 1J4, Canada
| | - Suzanne King
- Faculty of Medicine, McGill University, Montreal, QC H3G 2M1, Canada
| | - Flory Muanda
- Department of Epidemiology & Biostatistics, Western University, London, ON N6A 5W9, Canada
- ICES Western, Western University, London, ON N6A 5W9, Canada
| | - Yves Mufike
- Department of Family Medicine, Protestant University in Congo, Kinshasa II, Kinshasa P.O. Box 4745, Democratic Republic of the Congo
| | - Isabelle Boucoiran
- Research Center CHU Ste-Justine, Montreal, QC H3T 1C5, Canada
- Department of Obstetrics and Gynecology, School of Public Health, University of Montreal, Montreal, QC H3N 1X9, Canada
| | - Anne Monique Nuyt
- Research Center CHU Ste-Justine, Montreal, QC H3T 1C5, Canada
- Department of Pediatrics, CHU Sainte-Justine, University of Montreal, Montreal, QC H3T 1C5, Canada
| | - Caroline Quach
- Research Center CHU Ste-Justine, Montreal, QC H3T 1C5, Canada
- Department of Microbiology, Infectious Diseases and Immunology, University of Montreal, Montreal, QC H3T 1J4, Canada
| | - Ema Ferreira
- Faculty of Pharmacy, University of Montreal, Montreal, QC H3T 1J4, Canada
- Pharmacy Department, CHU Sainte-Justine, Montreal, QC H3T 1C5, Canada
| | - Padma Kaul
- Department of Medicine, 4-120 Katz Group Centre for Pharmacy and Health Research, University of Alberta, Edmonton, AL T6G 2R7, Canada
| | - Brandace Winquist
- Department of Community Health and Epidemiology, College of Medicine, University of Saskatchewan, Saskatoon, SK S7N 5E5, Canada
| | - Kieran J. O’Donnell
- Yale Child Study Center, Department of OB/GYN and Reproductive Sciences, Yale School of Medicine, New Haven, CT 06510, USA
- Douglas Research Center, Department of Psychiatry, McGill University, Montreal, QC H4H 1R3, Canada
| | - Sherif Eltonsy
- Rady Faculty of Health Sciences, College of Pharmacy, University of Manitoba, Winnipeg, MB R3E 0W2, Canada
| | - Dan Chateau
- Manitoba Center for Health Policy, Winnipeg, MB R3E 3P5, Canada
| | - Gillian Hanley
- Department of Obstetrics & Gynaecology, University of British Columbia, Vancouver, BC V6T 1Z4, Canada
| | - Tim Oberlander
- Department of Pediatrics, School of Population and Public Health, University of BC, Vancouver, BC V6T 1Z4, Canada
| | - Behrouz Kassai
- Faculty of Medicine, Université Claude Bernard Lyon 1, 69003 Lyon, France
- Department of Clinical Epidemiology, UMR 5558 CNRS, Clinical Investigation Centre, Inserm-Hospices Civils de Lyon, Claude Bernard University Lyon 1, 69003 Lyon, France
| | - Sabine Mainbourg
- Research Center CHU Ste-Justine, Montreal, QC H3T 1C5, Canada
- Department of Clinical Epidemiology, UMR 5558 CNRS, Clinical Investigation Centre, Inserm-Hospices Civils de Lyon, Claude Bernard University Lyon 1, 69003 Lyon, France
| | - Sasha Bernatsky
- Divisions of Clinical Epidemiology and Rheumatology, McGill University Health Centre, Montreal, QC H3A 0G4, Canada
| | - Évelyne Vinet
- Divisions of Clinical Epidemiology and Rheumatology, McGill University Health Centre, Montreal, QC H3A 0G4, Canada
| | - Annie Brodeur-Doucet
- Dispensaire Diététique de Montréal/Montreal Diet Dispensary, Montreal, QC H3H 1J3, Canada
| | - Jackie Demers
- Dispensaire Diététique de Montréal/Montreal Diet Dispensary, Montreal, QC H3H 1J3, Canada
| | - Philippe Richebé
- Department of Anesthesiology and Pain Medicine, CIUSSS de l’Est de l’Ile de Montreal, Maisonneuve-Rosemont Hospital, University of Montreal, Montreal, QC H1T 2M4, Canada
| | - Valerie Zaphiratos
- Department of Anesthesiology and Pain Medicine, CIUSSS de l’Est de l’Ile de Montreal, Maisonneuve-Rosemont Hospital, University of Montreal, Montreal, QC H1T 2M4, Canada
| | - Anick Bérard
- Research Center CHU Ste-Justine, Montreal, QC H3T 1C5, Canada
- Faculty of Medicine, Université Claude Bernard Lyon 1, 69003 Lyon, France
- Faculty of Pharmacy, University of Montreal, Montreal, QC H3T 1J4, Canada
| |
Collapse
|
19
|
Li B, Zhang H, Cao Y, Li Z, Xu X, Song Z, Wang JH. Molecular changes in nucleus accumbens due to amelioration of depressive-like behavior by housing with companion. Brain Res Bull 2022; 189:34-43. [PMID: 35998792 DOI: 10.1016/j.brainresbull.2022.08.010] [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: 04/06/2022] [Revised: 08/10/2022] [Accepted: 08/11/2022] [Indexed: 11/02/2022]
Abstract
Social support are positively and causally related to mental health. Higher levels of perceived social support and group memberships are shown to be associated with lower depression symptomatology and recovery from depression, but the molecular biological mechanism behind its remains largely unknown. Here, we report that accompanying with companion ameliorated chronic unpredictable mild stress (CUMS) induced depression-like behaviors in mice. Accompanying with companion altered RNA expression profiles of nucleus accumbens (NAc) in CUMS-induced susceptible and resilience mice. 117 differentially expressed genes (DEGs) were found to be associated with depression-like behaviors, 17 DEGs associated with resilient behaviors, 43 DEGs associated with accompanying with companion. Importantly, 234 differentially expressed miRNAs that associated with accompanying with companion were obtained, and the miRNA-mRNA network associated with companion was established in NAc, based on the miRNA and mRNA profiles. Taken together, our findings revealed a potential new approach to improve depression-like behaviors, as well as many potential drug targets for the prevention or treatment of depression.
Collapse
Affiliation(s)
- Bo Li
- Department of Pharmacology, Qingdao University School of Pharmacy, Qingdao, Shandong 266021, China
| | - Hao Zhang
- Department of Pharmacology, Qingdao University School of Pharmacy, Qingdao, Shandong 266021, China
| | - Yi Cao
- Biomedical Center, Qingdao Medical College, Qingdao University, China
| | - Zhao Li
- Department of Pharmacology, Qingdao University School of Pharmacy, Qingdao, Shandong 266021, China
| | - Xinlei Xu
- Department of Pharmacology, Qingdao University School of Pharmacy, Qingdao, Shandong 266021, China
| | - Zhenhua Song
- Department of Pharmacology, Qingdao University School of Pharmacy, Qingdao, Shandong 266021, China.
| | - Jin-Hui Wang
- University of Chinese Academy of Sciences, Beijing 100049, China.
| |
Collapse
|
20
|
Moran LJ, Lee J, Jones D, Fronberg K, Feinberg ME. Coparenting-focused preventive intervention reduces postnatal maternal BMI and buffers impact of cortisol. Obesity (Silver Spring) 2022; 30:1564-1572. [PMID: 35854331 PMCID: PMC9543348 DOI: 10.1002/oby.23466] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Revised: 03/22/2022] [Accepted: 04/10/2022] [Indexed: 11/26/2022]
Abstract
OBJECTIVE The postpartum period is a key life stage, contributing to increased maternal obesity risk. Current lifestyle interventions do not consider the role of a woman's partner in reducing stress and supporting lifestyle change. The objective of this study was to assess the effect of an intervention that seeks to enhance coparenting relationship quality on maternal BMI from before conception to 12 months post partum and whether the intervention moderated the association of changes in cortisol and BMI. METHODS A randomized controlled trial was used to assess an intervention (eight classes: four during and four following pregnancy) focusing on enhancing couple coparenting relationships during pregnancy and post partum (n = 57) compared with standard care (n = 53). RESULTS The main outcome measures were changes in maternal BMI and cortisol. There was a smaller increase in BMI for mothers in intervention compared with control groups (mean [SE], -1.03 [0.42] kg/m2 , p = 0.015). There was an interaction between intervention status and cortisol change predicting BMI change (p = 0.026), such that cortisol change significantly predicted BMI change among mothers in the control (p = 0.049) but not the intervention groups (p = 0.204). CONCLUSIONS A coparenting intervention improved maternal postpartum BMI, with this effect potentially related to ameliorating the negative effect of stress, as measured by cortisol, on BMI. The role of enhanced coparenting in improving maternal anthropometry warrants urgent attention.
Collapse
Affiliation(s)
- Lisa J. Moran
- Monash Centre for Health Research and ImplementationMonash UniversityMelbourneVictoriaAustralia
| | - Jin‐Kyung Lee
- Institute for Poverty Alleviation and International Development, Yonsei UniversitySeoulSouth Korea
| | - Damon Jones
- Edna Bennett Pierce Prevention Research CenterPennsylvania State UniversityState CollegePennsylvaniaUSA
| | - Kaitlin Fronberg
- College of Health and Human DevelopmentPennsylvania State UniversityState CollegePennsylvaniaUSA
| | - Mark E. Feinberg
- College of Health and Human DevelopmentPennsylvania State UniversityState CollegePennsylvaniaUSA
| |
Collapse
|
21
|
Jia R, Carlisle S, Vedhara K. The Association of Lifestyle and Mood with Long-Term Levels of Cortisol: A Systematic Review. COGENT PSYCHOLOGY 2022. [DOI: 10.1080/23311908.2022.2036487] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
Affiliation(s)
- Ru Jia
- School of Medicine, University of Nottingham, University Park, Nottingham, NG7 2RD, UK
| | - Sophie Carlisle
- School of Medicine, University of Nottingham, University Park, Nottingham, NG7 2RD, UK
| | - Kavita Vedhara
- School of Medicine, University of Nottingham, University Park, Nottingham, NG7 2RD, UK
| |
Collapse
|
22
|
Aba YA, Dulger O, Sık BA, Ozolcay O. Levels and Predictors of Anxiety and Depression in Turkish Pregnant Woman During the Covid-19 Pandemic. REVISTA BRASILEIRA DE GINECOLOGIA E OBSTETRICIA : REVISTA DA FEDERACAO BRASILEIRA DAS SOCIEDADES DE GINECOLOGIA E OBSTETRICIA 2022; 44:100-108. [PMID: 35213907 PMCID: PMC9948054 DOI: 10.1055/s-0041-1741033] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
OBJECTIVE In addition to being a medical phenomenon, pandemics affect the individual and society on several levels and lead to disruptions. In the pandemic process, different groups in the population, including pregnant women as a defenseless group, are subjected to psychological threat. The present study aimed to determine the levels of anxiety and depression and related factors in pregnant women during the the coronavirus disease 2019 (Covid-19) pandemic. METHODS The present cross-sectional study was conducted with 269 pregnant women through face-to-face interviews held in Istanbul, Turkey. Regarding the data collection tools, the Cronbach α reliability coefficient was of 0.90 for the Beck Anxiety Inventory, and of 0.85 for the Beck Depression Inventory. RESULTS Among the participating pregnant women, 30.5% had mild, 17.5% had moderate, and 5.9% had severe anxiety symptoms, whereas 35.3% had mild, 16.7% had moderate, and 2.2% had severe depression symptoms. We found that those who were concerned about their health had 5.36 times (p = 0.04) more risk of developing anxiety, and 4.82 times (p = 0.01) more risk of developing depression than those who were not concerned. Those who had a history of psychiatric disease had 3.92 times (p = 0.02) more risk of developing anxiety than those without it. CONCLUSION We determined that about half of the pregnant women included in the study had some degree of anxiety and depression during the COVID-19 pandemic. The risk factors for anxiety and depression among the pregnant women were determined as smoking, concerns about health and getting infected with the coronavirus, history of psychiatric disease, and undergoing regular antenatal care.
Collapse
Affiliation(s)
- Yılda Arzu Aba
- Department of Nursing, Faculty of Health Sciences, Bandırma Onyedi Eylül University, Balıkesir, Turkey
| | - Ozlem Dulger
- Deparment of Gynecology and Obstetrics, Süleymaniye Education and Research Hospital, Istanbul, Turkey
| | - Bulat Aytek Sık
- Department of Reproductive Endocrinology and Infertility, Istanbul Aydın University, Istanbul, Turkey
| | - Ozan Ozolcay
- Karamanoğlu Mehmetbey University, School of Medicine, Department of Gynecology and Obstetrics, Karaman, Turkey
| |
Collapse
|
23
|
Letourneau N, Aghajafari F, Bell RC, Deane AJ, Dewey D, Field C, Giesbrecht G, Kaplan B, Leung B, Ntanda H. The Alberta Pregnancy Outcomes and Nutrition (APrON) longitudinal study: cohort profile and key findings from the first three years. BMJ Open 2022; 12:e047503. [PMID: 35131812 PMCID: PMC8823238 DOI: 10.1136/bmjopen-2020-047503] [Citation(s) in RCA: 21] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
PURPOSE The objectives of the ongoing Canadian longitudinal cohort called the Alberta Pregnancy Outcomes and Nutrition (APrON) study are to: (1) determine the relationship between maternal nutrient intake and status before, during, after pregnancy, and (a) maternal mental health, (b) pregnancy and birth outcomes, and (c) infant/child neurodevelopment and behavior; (2) identify maternal mental health and nutrient predictors of child behaviour; and (3) establish a DNA biobank to explore genomic predictors of children's neurodevelopment and behavior. The purpose of this paper is to describe the participants, measures, and key findings on maternal and paternal mental health, maternal nutrition, and child outcomes to when children are 3 years of age. PARTICIPANTS Participants included mothers and their children (n=2189) and mothers' partners (usually fathers; n=1325) from whom data were collected during the period from pregnancy to when children were 3 years of age, in Alberta, Canada. More than 88% of families have been retained to take part in completed data collection at 8 years of age. FINDINGS TO DATE Data comprise: questionnaires completed by pregnant women/mothers and their partners on mothers', fathers' and children's health; dietary interviews; clinical assessments; linkage to hospital obstetrical records; and biological samples such as DNA. Key findings on mental health, nutrition and child outcomes are presented. APrON women who consumed more selenium and omega-3 were less likely to develop symptoms of perinatal depression. Higher prenatal consumption of choline rich foods such as eggs and milk were recommended as was vitamin D supplementation for both mothers and children to meet guidelines. Couples in which both mothers and fathers were affected by perinatal depression reported lower incomes and higher maternal prenatal depressive symptoms and lower support from fathers postnatally and their children presented with the most behavioural problems. Maternal experiences of early adversity predicted increased likelihood of perinatal depression and anxiety and children's behavioural problems. FUTURE PLANS The APrON cohort offers a unique opportunity to advance understanding of the developmental origins of health and disease. There is a planned follow-up to collect data at 12 years of age.
Collapse
Affiliation(s)
- Nicole Letourneau
- Faculty of Nursing, University of Calgary, Calgary, Alberta, Canada
- Cumming School of Medicine (Departments of Paediatrics, Psychiatry & Community Health Sciences), University of Calgary, Calgary, Alberta, Canada
| | - Fariba Aghajafari
- Cumming School of Medicine (Family Medicine & Community Health Sciences), University of Calgary, Calgary, Alberta, Canada
| | - Rhonda C Bell
- Faculty of Agricultural, Food and Nutritional Science, University of Alberta, Edmonton, Alberta, Canada
| | - Andrea J Deane
- Cumming School of Medicine (Pediatrics), University of Calgary, Calgary, Alberta, Canada
| | - Deborah Dewey
- Cumming School of Medicine (Pediatrics), University of Calgary, Calgary, Alberta, Canada
| | - Catherine Field
- Faculty of Agricultural, Food and Nutritional Science, University of Alberta, Edmonton, Alberta, Canada
| | - Gerald Giesbrecht
- Cumming School of Medicine (Pediatrics & Community Health Sciences), University of Calgary, Calgary, Alberta, Canada
| | - Bonnie Kaplan
- Cumming School of Medicine (Pediatrics & Community Health Sciences), University of Calgary, Calgary, Alberta, Canada
| | - Brenda Leung
- Health Science - Public Health Program, University of Lethbridge, Lethbridge, Alberta, Canada
| | - Henry Ntanda
- Cumming School of Medicine (Pediatrics), University of Calgary, Calgary, Alberta, Canada
| |
Collapse
|
24
|
Xiao M, Chen X, Yi H, Luo Y, Yan Q, Feng T, He Q, Lei X, Qiu J, Chen H. Stronger functional network connectivity and social support buffer against negative affect during the COVID-19 outbreak and after the pandemic peak. Neurobiol Stress 2021; 15:100418. [PMID: 34805450 PMCID: PMC8592855 DOI: 10.1016/j.ynstr.2021.100418] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2021] [Revised: 09/27/2021] [Accepted: 11/15/2021] [Indexed: 01/17/2023] Open
Abstract
Health and financial uncertainties, as well as enforced social distancing, during the COVID-19 pandemic have adversely affected the mental health of people. These impacts are expected to continue even after the pandemic, particularly for those who lack support from family and friends. The salience network (SN), default mode network (DMN), and frontoparietal network (FPN) function in an interconnected manner to support information processing and emotional regulation processes in stressful contexts. In this study, we examined whether functional connectivity of the SN, DMN, and FPN, measured using resting-state functional magnetic resonance imaging before the pandemic, is a neurobiological marker of negative affect (NA) during the COVID-19 pandemic and after its peak in a large sample (N = 496, 360 females); the moderating role of social support in the brain-NA association was also investigated. We found that participants reported an increase in NA during the pandemic compared to before the pandemic, and the NA did not decrease, even after the peak period. People with higher connectivity within the SN and between the SN and the other two networks reported less NA during and after the COVID-19 outbreak peak, and the buffer effect was stronger if their social support was greater. These findings suggest that the functional networks that are responsible for affective processing and executive functioning, as well as the social support from family and friends, play an important role in protecting against NA under stressful and uncontrollable situations.
Collapse
Affiliation(s)
- Mingyue Xiao
- Key Laboratory of Cognition and Personality (SWU), Ministry of Education, Chongqing, China.,Department of Psychology, Southwest University, Chongqing, China
| | - Ximei Chen
- Key Laboratory of Cognition and Personality (SWU), Ministry of Education, Chongqing, China.,Department of Psychology, Southwest University, Chongqing, China
| | - Haijing Yi
- Key Laboratory of Cognition and Personality (SWU), Ministry of Education, Chongqing, China.,Department of Psychology, Southwest University, Chongqing, China
| | - Yijun Luo
- Key Laboratory of Cognition and Personality (SWU), Ministry of Education, Chongqing, China.,Department of Psychology, Southwest University, Chongqing, China
| | - Qiaoling Yan
- Key Laboratory of Cognition and Personality (SWU), Ministry of Education, Chongqing, China.,Department of Psychology, Southwest University, Chongqing, China
| | - Tingyong Feng
- Key Laboratory of Cognition and Personality (SWU), Ministry of Education, Chongqing, China.,Department of Psychology, Southwest University, Chongqing, China
| | - Qinghua He
- Key Laboratory of Cognition and Personality (SWU), Ministry of Education, Chongqing, China.,Department of Psychology, Southwest University, Chongqing, China
| | - Xu Lei
- Key Laboratory of Cognition and Personality (SWU), Ministry of Education, Chongqing, China.,Department of Psychology, Southwest University, Chongqing, China
| | - Jiang Qiu
- Key Laboratory of Cognition and Personality (SWU), Ministry of Education, Chongqing, China.,Department of Psychology, Southwest University, Chongqing, China
| | - Hong Chen
- Key Laboratory of Cognition and Personality (SWU), Ministry of Education, Chongqing, China.,Department of Psychology, Southwest University, Chongqing, China
| |
Collapse
|
25
|
Mountain RV, Zhu Y, Pickett OR, Lussier AA, Goldstein JM, Roffman JL, Bidlack FB, Dunn EC. Association of Maternal Stress and Social Support During Pregnancy With Growth Marks in Children's Primary Tooth Enamel. JAMA Netw Open 2021; 4:e2129129. [PMID: 34751761 PMCID: PMC8579236 DOI: 10.1001/jamanetworkopen.2021.29129] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Accepted: 08/10/2021] [Indexed: 12/14/2022] Open
Abstract
Importance Exposure to maternal psychosocial stressors during the prenatal and perinatal periods can have major long-term mental health consequences for children. However, valid and inexpensive biomarkers are currently unavailable to identify children who have been exposed to psychosocial stress and the buffers of stress exposure. Objective To assess whether a growth mark in tooth enamel, the neonatal line, is associated with exposure to prenatal and perinatal maternal psychosocial factors. Design, Setting, and Participants This prospective cohort study used exfoliated primary canine teeth and epidemiological survey data from 70 children enrolled in the Avon Longitudinal Study of Parents and Children, a birth cohort based in Bristol, England. Exfoliated teeth were collected from children at 5 to 7 years of age. Data were collected from January 1, 1991, to December 31, 1998, and were analyzed from January 1, 2019, to August 10, 2021. Exposures Four types of prenatal and perinatal maternal psychosocial factors were studied: stressful life events, psychopathological history, neighborhood disadvantage, and social support. Data were collected from mailed-in questionnaires completed during and shortly after pregnancy. Main Outcomes and Measures Neonatal line width measured within 3 portions of the tooth crown (the cuspal, middle, and innermost third) in exfoliated primary canines. Results A total of 70 children (34 of 70 [48.7%] male; 63 of 67 [94.0%] White) were studied. Most children were born full term (57 [83.8%]) and to mothers of typical child-bearing age (60 [88.2%]). Neonatal lines were wider in the canines of children born to mothers who self-reported severe lifetime depression (β = 3.35; 95% CI, 1.48-5.23; P = .001), any lifetime psychiatric problems (β = 2.66; 95% CI, 0.92-4.41; P = .003), or elevated anxiety or depressive symptoms at 32 weeks' gestation (β = 2.29; 95% CI, 0.38-4.20; P = .02). By contrast, neonatal lines were narrower in children born to mothers who self-reported high social support shortly after birth (β = -2.04; 95% CI, -3.70 to -0.38; P = .02). The magnitude of these associations was large, up to 1.2 SD unit differences, and persisted after adjusting for other risk factors. Conclusions and Relevance In this cohort study, neonatal line width was associated with exposure to maternal perinatal psychosocial factors. Replication and validation of these findings can further evaluate teeth as possible new biomarkers.
Collapse
Affiliation(s)
- Rebecca V. Mountain
- Psychiatric and Neurodevelopmental Genetics Unit, Center for Genomic Medicine, Massachusetts General Hospital, Boston
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston
| | - Yiwen Zhu
- Psychiatric and Neurodevelopmental Genetics Unit, Center for Genomic Medicine, Massachusetts General Hospital, Boston
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Olivia R. Pickett
- Psychiatric and Neurodevelopmental Genetics Unit, Center for Genomic Medicine, Massachusetts General Hospital, Boston
| | - Alexandre A. Lussier
- Psychiatric and Neurodevelopmental Genetics Unit, Center for Genomic Medicine, Massachusetts General Hospital, Boston
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston
| | - Jill M. Goldstein
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston
- Henry and Allison McCance Center for Brain Health, Massachusetts General Hospital, Boston
- Department of Obstetrics, Gynecology, and Reproductive Biology, Massachusetts General Hospital, Boston
- Innovation Center on Sex Differences in Medicine, Massachusetts General Hospital, Boston
| | - Joshua L. Roffman
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston
| | - Felicitas B. Bidlack
- Forsyth Institute, Cambridge, Massachusetts
- Department of Developmental Biology, Harvard School of Dental Medicine, Boston, Massachusetts
| | - Erin C. Dunn
- Psychiatric and Neurodevelopmental Genetics Unit, Center for Genomic Medicine, Massachusetts General Hospital, Boston
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston
- Henry and Allison McCance Center for Brain Health, Massachusetts General Hospital, Boston
| |
Collapse
|
26
|
Hagaman A, LeMasters K, Zivich PN, Sikander S, Bates LM, Bhalotra S, Chung EO, Zaidi A, Maselko J. Longitudinal effects of perinatal social support on maternal depression: a marginal structural modelling approach. J Epidemiol Community Health 2021; 75:936-943. [PMID: 33712512 PMCID: PMC8434957 DOI: 10.1136/jech-2020-215836] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2020] [Revised: 02/22/2021] [Accepted: 03/02/2021] [Indexed: 12/18/2022]
Abstract
BACKGROUND Depression in the perinatal period, during pregnancy or within 1 year of childbirth, imposes a high burden on women with rippling effects through her and her child's life course. Social support may be an important protective factor, but the complex bidirectional relationship with depression, alongside a paucity of longitudinal explorations, leaves much unknown about critical windows of social support exposure across the perinatal period and causal impacts on future depressive episodes. METHODS This study leverages marginal structural models to evaluate associations between longitudinal patterns of perinatal social support and subsequent maternal depression at 6 and 12 months postpartum. In a cohort of women in rural Pakistan (n=780), recruited in the third trimester of pregnancy and followed up at 3, 6 and 12 months postpartum, we assessed social support using two well-validated measures: the Multidimensional Scale of Perceived Social Support (MSPSS) and the Maternal Social Support Index (MSSI). Major depressive disorder was assessed with the Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders (DSM IV). RESULTS High and sustained scores on the MSPSS through the perinatal period were associated with a decreased risk of depression at 12 months postpartum (0.35, 95% CI: 0.19 to 0.63). Evidence suggests the recency of support also matters, but estimates are imprecise. We did not find evidence of a protective effect for support based on the MSSI. CONCLUSIONS This study highlights the protective effect of sustained social support, particularly emotional support, on perinatal depression. Interventions targeting, leveraging and maintaining this type of support may be particularly important for reducing postpartum depression.
Collapse
Affiliation(s)
- Ashley Hagaman
- Social Behavioral Sciences, Yale University School of Public Health, New Haven, Connecticut, USA
- Center for Methods in Implementation and Prevention Science, Yale University, New Haven, Connecticut, USA
| | - Katherine LeMasters
- Department of Epidemiology, Gillings School of Global Public Health, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
- Carolina Population Center, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Paul N Zivich
- Department of Epidemiology, Gillings School of Global Public Health, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
- Carolina Population Center, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Siham Sikander
- Human Development Research Foundation, Islamabad, Pakistan
- Global Health Department, Health Services Academy, Islamabad, Pakistan
| | - Lisa M Bates
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York, USA
| | - Sonia Bhalotra
- Department of Economics, University of Warwick, UK, Coventry, Warwickshire, UK
| | - Esther O Chung
- Department of Epidemiology, Gillings School of Global Public Health, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
- Carolina Population Center, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Ahmed Zaidi
- Human Development Research Foundation, Islamabad, Pakistan
| | - Joanna Maselko
- Department of Epidemiology, Gillings School of Global Public Health, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
- Carolina Population Center, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| |
Collapse
|
27
|
Bedaso A, Adams J, Peng W, Sibbritt D. Prevalence and determinants of low social support during pregnancy among Australian women: a community-based cross-sectional study. Reprod Health 2021; 18:158. [PMID: 34315486 PMCID: PMC8314443 DOI: 10.1186/s12978-021-01210-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2020] [Accepted: 07/19/2021] [Indexed: 12/13/2022] Open
Abstract
Background Pregnancy is a time for women in which the need for social support is crucial. Social support reduces stressors and improves the emotional and physical well-being of pregnant women. Women receiving low social support during pregnancy are at risk of substances use, developing mental illness, and adverse birth outcomes. The current study aims to determine the prevalence and determinants of low social support during pregnancy among Australian women. Methods Data were obtained from the 1973–1978 cohort of Australian Longitudinal Study on Women’s Health (ALSWH) and those who report being pregnant (n = 493) were included in the current analyses. Social support was assessed using Medical Outcomes Study Social Support index (MOSS). A logistic regression model was applied to identify determinants of low social support, separately for each MOSS domain. Result The study found that 7.1% (n = 35) of pregnant women reported low social support. Significant determinants of low emotional support were non-partnered (AOR = 4.4, 95% CI: 1.27, 14.99), difficulty managing on available income (AOR = 3.1, 95% CI: 1.18, 8.32), experiencing depressive symptoms (AOR = 8.5, 95% CI: 3.29, 22.27) and anxiety symptoms (AOR = 2.9, 95% CI: 1.26, 7.03). Significant determinants of low affectionate support were suffering from depressive symptoms (AOR = 5.3, 95% CI: 1.59, 17.99), having anxiety symptoms (AOR: 6.9, 95% CI: 2.21, 22.11) and being moderately/very stressed (AOR: 3, 95% CI: 1.17, 7.89). Significant determinants of low tangible support were difficulty managing available income (AOR = 3, 95% CI: 1.29, 6.95), and being depressed (AOR = 2.8, 95% CI: 1.48, 5.34). Conclusion The study revealed that 7.1% of pregnant women reported low social support. Having a mental health problems, being stressed, being from low socio-economic status and being non-partnered were significant determinants of low social support during pregnancy. Maternal health professionals and policymakers can use this information to screen pregnant women at risk of receiving low social support and improve the level of support being provided. Providing strong social support improves emotional and physical well-being, strengthens social relationships, promotes health, and enhances the stress coping ability of pregnant women. However, pregnant women receiving low social support are at risk of substances use, developing mental illness, and adverse birth outcomes. The current study aims to determine the prevalence and determinants of low social support during pregnancy among Australian women. Data were obtained from Survey 6 of the 1973–1978 cohort of the Australian Longitudinal Study on Women’s Health (ALSWH) (n = 493, pregnant women aged 34–39 years). This cohort is one of ALSWH ongoing community-based study focusing on the health of women in Australia. Social support provided for a pregnant woman was the outcome variable, assessed using the 19-item Medical Outcomes Study Social Support index (MOSS). The prevalence of low social support in each domain was calculated for each of the independent variables. A logistic regression model, using a backward stepwise elimination approach, was employed to identify determinants of low social support. In the final model, the strength of association measured by adjusted odds ratios (AOR) with 95% confidence intervals. The significance level was set at p < 0.05. From the total participant pregnant women, 7.1% of them reported low social support. Significant determinants of low social support among pregnant Australian women were, having a mental illness, being stressed and/or being from low socio-economic status and being non-partnered. Maternal health professionals can use this information to screen pregnant women at risk of receiving low social support as well as develop policy to help enhance the social support being given and the psychological wellbeing being of pregnant women.
Collapse
Affiliation(s)
- Asres Bedaso
- College of Medicine and Health Sciences, Faculty of Health, School of Nursing, Hawassa University, Hawassa, Ethiopia. .,Australian Centre for Public and Population Health Research, School of Public Health, Faculty of Health, University of Technology Sydney, Ultimo, NSW, Australia.
| | - Jon Adams
- Australian Centre for Public and Population Health Research, School of Public Health, Faculty of Health, University of Technology Sydney, Ultimo, NSW, Australia
| | - Wenbo Peng
- Australian Centre for Public and Population Health Research, School of Public Health, Faculty of Health, University of Technology Sydney, Ultimo, NSW, Australia
| | - David Sibbritt
- Australian Centre for Public and Population Health Research, School of Public Health, Faculty of Health, University of Technology Sydney, Ultimo, NSW, Australia
| |
Collapse
|
28
|
Covariation of psychobiological stress regulation with valence and quantity of social interactions in everyday life: disentangling intra- and interindividual sources of variation. J Neural Transm (Vienna) 2021; 128:1381-1395. [PMID: 34181094 PMCID: PMC8423684 DOI: 10.1007/s00702-021-02359-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2021] [Accepted: 05/27/2021] [Indexed: 12/20/2022]
Abstract
While the overall effects of social relationships on stress and health have extensively been described, it remains unclear how the experience of social interactions covaries with the activity of psychobiological stress in everyday life. We hypothesized that the valence as well as quantitative characteristics of social interactions in everyday life would attenuate psychobiological stress. Sixty healthy participants provided data for the analyses. Using an ecological momentary assessment design, participants received 6 prompts on their smartphone for 4 days. At each prompt, they reported on social interactions since the last prompt (any occurrence, frequency, duration, quality, and perceived social support), current subjective stress, and provided one saliva sample for the analyses of cortisol (sCort) and alpha-amylase (sAA). Experiencing any contact within days as well as higher daily levels of contact quality and perceived social support were associated with reduced levels of sCort. Furthermore, on a daily level, experiencing at least one contact in-between prompts more often as well as having more contacts on average attenuated the sAA output. Perceived social support and contact quality as well as higher daily contact durations were associated with lower subjective stress. For sCort, daily levels of stress moderated the effects of experiencing any contact within days while daily perceived social support moderated the effects of subjective stress. For sAA, experiencing at least one contact in-between prompts more often on a daily level moderated the effects of subjective stress. There were no between-person effects throughout all analyses. The results show ecologically valid evidence for direct attenuating effects of social interactions on psychobiological stress as well as for the stress-buffering hypothesis in everyday life. Increasing the quantity and improving the valence of social interactions on an intrapersonal level can possibly reduce psychobiological stress and prevent its consequences.
Collapse
|
29
|
The Psychological Impact of the COVID-19 Pandemic on Pregnant Women. Healthcare (Basel) 2021; 9:healthcare9060725. [PMID: 34204712 PMCID: PMC8231526 DOI: 10.3390/healthcare9060725] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2021] [Revised: 06/04/2021] [Accepted: 06/08/2021] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND The COVID-19 pandemic has meant significant precautions and changes in delivering healthcare services. The aim of the study was to explore the lifestyle changes of pregnant women during the COVID-19 pandemic in Romania, the changes in prenatal care and delivery during the pandemic and the psychological impact on women and to determine how healthcare providers can help them to overcome this period. METHODS A cross-sectional survey was conducted anonymously and distributed among pregnancy-related groups from Romania, recruiting 559 study participants, between May and October 2020. A total of 559 pregnant women completed an online 26-item questionnaire but we only validated 557 responses for study. The survey included basic demographic questions, pregnancy-related questions, questions regarding the pregnant women's lifestyle changes during the pandemic and their perception of the COVID-19 pandemic and questions which evaluated the impact of the pandemic on prenatal care and delivery in Romania. RESULTS The pandemic restrictions affected women's routine activities regarding professional, familial and social life. Therefore, for pregnant women who were emotionally vulnerable, these restrictions had a great impact on their mental health. The majority of the study participants (78.8%, N = 439) were emotionally affected by the pandemic. The fear related to the possibility of having their pregnancy affected by the virus was dominant in the group (45.8%). A high number of women (69.5%) felt safe when they accessed health services, but private hospitals were considered safer (53.1%) compared to public hospitals (14.4%). The majority of participants (53.7%) used to have prenatal care in a private healthcare system. During the pandemic, preventive measures were associated with low confidence in the healthcare system. Of the total group of participants, 123 women (22.1%) gave birth during the pandemic. Of these, a majority of the study participants considered that it was very difficult for them to cope without their partner during the hospitalization and labor period. CONCLUSIONS The main anxiety of pregnant women were related to threats to their lives and their baby's health because of the uncertainty caused by pandemic. It is important to know that the restrictions and the changes in maternity care had a negative impact on them. This conclusion must be taken into account when preventive measures will be decided for helping them to get through such a period. Additionally, psychological support will be essential for improving the mental health of pregnant women and for preventing a negative outcome of the pregnancy. These feelings must be taken into account when preventive measures will be established during pandemic and a psychological support will be essential for improving their mental health for preventing negative outcome of pregnancy.
Collapse
|
30
|
Thompson LA, White B. Social Network and Behavioral Synchrony Influences On Maternal and Infant Cortisol Response. JOURNAL OF HUMAN BEHAVIOR IN THE SOCIAL ENVIRONMENT 2021; 32:574-590. [PMID: 35757570 PMCID: PMC9216205 DOI: 10.1080/10911359.2021.1931618] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
This study examined the contributions of mothers' social network stability and mother-infant behavioral synchrony on cortisol response in infants and their mothers during separation. The quality and stability of mothers' social network system and mother-infant bond have both been shown to affect infant neuroendocrine response. Yet, no studies have directly addressed how these two forms of social relationships might differentially affect infants' and mothers' neuroendocrine responses during separation. First-time mothers (N = 133) and their 3-month-old infants participated in the study. Maternal social network stability, mother-infant behavioral synchrony, and mother and infant cortisol response during an infant challenge task were assessed. Behavioral synchrony accounted for significant variance in infants' cortisol response, and after adjusting for synchrony, mothers' network stability measures did not explain variance in infant cortisol. Social network stability, but not synchrony, accounted for significant variance in mothers' cortisol response. These results demonstrate that, when mothers and infants experience brief separation, the quality of their bond is associated with a lower stress response for infants; but for mothers, it is the longevity of her social relationships outside of the mother-infant relationship context that is associated with her lower stress response.
Collapse
Affiliation(s)
| | - Bryan White
- Psychology Department, New Mexico State University
| |
Collapse
|
31
|
Greene CA, McCoach DB, Briggs-Gowan MJ, Grasso DJ. Associations among childhood threat and deprivation experiences, emotion dysregulation, and mental health in pregnant women. PSYCHOLOGICAL TRAUMA : THEORY, RESEARCH, PRACTICE AND POLICY 2021; 13:446-456. [PMID: 33475412 PMCID: PMC8217136 DOI: 10.1037/tra0001013] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
OBJECTIVE Women who have experienced childhood maltreatment are at increased risk for experiencing mental health problems. When these occur during pregnancy, they are associated with birth complications and worse developmental outcomes for children. Emotion dysregulation (ED) may be an important, and potentially modifiable, mechanism that links women's maltreatment experiences with their mental health. However, there is limited information about the emotion regulation skills of pregnant women to guide treatment. The current study examines the unique effects of childhood threat (physical, sexual, and emotional abuse and exposure to violence) and deprivation (physical and emotional neglect and separation from primary caregivers) experiences on pregnant women's ED, posttraumatic stress and negative emotional symptoms, and social support. METHOD Two hundred forty-three women were recruited from an urban prenatal care clinic, the majority of whom identified as Latinx (80%) and low-income (90%). The mean age of the women was 27 years (SD = 5.5). RESULTS Structural equation modeling revealed significant indirect pathways from childhood threat experiences to posttraumatic stress and negative emotional symptoms via women's ED. In contrast, childhood deprivation experiences were associated with inattention to one's emotions and low perceived social support. CONCLUSIONS These results underscore the importance of identifying women during pregnancy who may be at risk for ED or emotional inattentiveness due to childhood maltreatment experiences and providing prevention and intervention efforts aimed at enhancing their emotional awareness and regulation. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
Collapse
Affiliation(s)
- Carolyn A. Greene
- Department of Psychiatry, University of Connecticut School of Medicine
| | | | | | - Damion J. Grasso
- Department of Psychiatry, University of Connecticut School of Medicine
| |
Collapse
|
32
|
Giesbrecht GF, Bagshawe M, van Sloten M, MacKinnon AL, Dhillon A, van de Wouw M, Vaghef-Mehrabany E, Rojas L, Cattani D, Lebel C, Tomfohr-Madsen L. Protocol for the Pregnancy During the COVID-19 Pandemic (PdP) Study: A Longitudinal Cohort Study of Mental Health Among Pregnant Canadians During the COVID-19 Pandemic and Developmental Outcomes in Their Children. JMIR Res Protoc 2021; 10:e25407. [PMID: 33848971 PMCID: PMC8080963 DOI: 10.2196/25407] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2020] [Revised: 04/08/2021] [Accepted: 04/13/2021] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND The COVID-19 pandemic and countermeasures implemented by governments around the world have led to dramatically increased symptoms of depression and anxiety. Pregnant individuals may be particularly vulnerable to the negative psychological effects of COVID-19 public health measures because they represent a demographic that is most affected by disasters and because pregnancy itself entails significant life changes that require major psychosocial and emotional adjustments. OBJECTIVE The PdP study was designed to investigate the associations among exposure to objective hardship caused by the pandemic, perceived stress and psychological distress in pregnant individuals, and developmental outcomes in their offspring. METHODS The PdP study comprises a prospective longitudinal cohort of individuals who were pregnant at enrollment, with repeated follow-ups during pregnancy and the postpartum period. Participants were eligible if they were pregnant, ≥17 years old, at ≤35 weeks of gestation at study enrollment, living in Canada, and able to read and write in English or French. At enrollment, participants completed an initial survey that assessed demographic and socioeconomic characteristics, previous pregnancies and births, prepregnancy health, health conditions during pregnancy, medications, psychological distress, social support, and hardships experienced because of the COVID-19 pandemic (eg, lost employment or a loved one dying). For the first three months following the initial survey, participants received a monthly email link to complete a follow-up survey that asked about their experiences since the previous survey. After three months, follow-up surveys were sent every other month to reduce participant burden. For each of these surveys, participants were first asked if they were still pregnant and then routed either to the next prenatal survey or to the delivery survey. In the postpartum period, surveys were sent at 3, 6, and 12 months of infant age to assess maternal stress, psychological distress, and infant development. RESULTS Participant recruitment via social media (Facebook and Instagram) began on April 5, 2020, and is ongoing. As of April 2021, more than 11,000 individuals have started the initial survey. Follow-up data collection is ongoing. CONCLUSIONS This longitudinal investigation seeks to elucidate the associations among hardships, maternal psychological distress, child development during the COVID-19 pandemic, and risk and resilience factors that amplify or ameliorate these associations. The findings of this study are intended to generate knowledge about the psychological consequences of pandemics on pregnant individuals and point toward prevention and intervention targets. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/25407.
Collapse
Affiliation(s)
- Gerald F Giesbrecht
- Department of Pediatrics, University of Calgary, Calgary, AB, Canada
- Alberta Children's Hospital Research Institute, Calgary, AB, Canada
- Department of Psychology, University of Calgary, Calgary, AB, Canada
- Department of Community Health Sciences, University of Calgary, Calgary, AB, Canada
| | | | | | - Anna L MacKinnon
- Alberta Children's Hospital Research Institute, Calgary, AB, Canada
- Department of Psychology, University of Calgary, Calgary, AB, Canada
| | - Ashley Dhillon
- Department of Psychology, University of Calgary, Calgary, AB, Canada
| | | | | | - Laura Rojas
- Department of Pediatrics, University of Calgary, Calgary, AB, Canada
- Alberta Children's Hospital Research Institute, Calgary, AB, Canada
| | - Danielle Cattani
- Department of Pediatrics, University of Calgary, Calgary, AB, Canada
| | - Catherine Lebel
- Alberta Children's Hospital Research Institute, Calgary, AB, Canada
- Department of Radiology, University of Calgary, Calgary, AB, Canada
| | - Lianne Tomfohr-Madsen
- Department of Pediatrics, University of Calgary, Calgary, AB, Canada
- Alberta Children's Hospital Research Institute, Calgary, AB, Canada
- Department of Psychology, University of Calgary, Calgary, AB, Canada
| |
Collapse
|
33
|
Ashrap P, Aker A, Watkins DJ, Mukherjee B, Rosario-Pabón Z, Vélez-Vega CM, Alshawabkeh A, Cordero JF, Meeker JD. Psychosocial status modifies the effect of maternal blood metal and metalloid concentrations on birth outcomes. ENVIRONMENT INTERNATIONAL 2021; 149:106418. [PMID: 33548848 PMCID: PMC7897320 DOI: 10.1016/j.envint.2021.106418] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/12/2020] [Revised: 01/20/2021] [Accepted: 01/22/2021] [Indexed: 05/05/2023]
Abstract
BACKGROUND Metal exposure and psychosocial stress in pregnancy have each been associated with adverse birth outcomes, including preterm birth and low birth weight, but no study has examined the potential interaction between them. OBJECTIVES We examined the modifying effect of psychosocial stress on the association between metals and birth outcomes among pregnant women in Puerto Rico Testsite for Exploring Contamination Threats (PROTECT) birth cohort study. METHODS In our analysis of 682 women from the PROTECT study, we measured 16 essential and non-essential metals in blood samples at two time points. We administered questionnaires to collect information on depression, perceived stress, social support, and life experience during pregnancy. Using K-means clustering, we categorized pregnant women into one of two groups: "good" and "poor" psychosocial status. We then evaluated whether the effect of blood metals (geometric average) on adverse birth outcomes (gestational age, preterm birth [overall and spontaneous], birth weight z-score, small for gestation [SGA], large for gestation [LGA]) vary between two clusters of women, adjusting for maternal age, maternal education, pre-pregnancy body mass index (BMI), and second-hand smoke exposure. RESULTS Blood manganese (Mn) was associated with an increased odds ratio (OR) of overall preterm birth (OR/interquartile range [IQR] = 2.76, 95% confidence interval [CI] = 1.25, 6.12) and spontaneous preterm birth (OR/IQR: 3.68, 95% CI: 1.20, 6.57) only among women with "poor" psychosocial status. The association between copper (Cu) and SGA was also statistically significant only among women having "poor" psychosocial status (OR/IQR: 2.81, 95% CI: 1.20, 6.57). We also observed associations between nickel (Ni) and preterm birth and SGA that were modified by psychosocial status during pregnancy. CONCLUSIONS Presence of "poor" psychosocial status intensified the adverse associations between Mn and preterm birth, Cu and SGA, and protective effects of Ni on preterm. This provides evidence that prenatal psychosocial stress may modify vulnerability to metal exposure.
Collapse
Affiliation(s)
- Pahriya Ashrap
- University of Michigan School of Public Health, Department of Environmental Health Sciences, Ann Arbor, MI, United States
| | - Amira Aker
- Department of Health and Society, University of Toronto Scarborough, Scarborough, Ontario, Canada
| | - Deborah J Watkins
- University of Michigan School of Public Health, Department of Environmental Health Sciences, Ann Arbor, MI, United States
| | - Bhramar Mukherjee
- University of Michigan School of Public Health, Department of Biostatistics, Ann Arbor, MI, United States
| | - Zaira Rosario-Pabón
- University of Puerto Rico Graduate School of Public Health, UPR Medical Sciences Campus, San Juan, PR, United States
| | - Carmen M Vélez-Vega
- University of Puerto Rico Graduate School of Public Health, UPR Medical Sciences Campus, San Juan, PR, United States
| | - Akram Alshawabkeh
- College of Engineering, Northeastern University, Boston, MA, United States
| | - José F Cordero
- Department of Epidemiology and Biostatistics, University of Georgia, Athens, GA, United States
| | - John D Meeker
- University of Michigan School of Public Health, Department of Environmental Health Sciences, Ann Arbor, MI, United States.
| |
Collapse
|
34
|
La Marca-Ghaemmaghami P, Zimmermann R, Haller M, Ehlert U. Cortisol and estriol responses to awakening in the first pregnancy trimester: Associations with maternal stress and resilience factors. Psychoneuroendocrinology 2021; 125:105120. [PMID: 33385739 DOI: 10.1016/j.psyneuen.2020.105120] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2020] [Revised: 11/08/2020] [Accepted: 12/18/2020] [Indexed: 10/22/2022]
Abstract
BACKGROUND Little is known about the maternal cortisol awakening response (CAR) in the first pregnancy trimester. Similarly unknown is how the CAR in early gestation relates to other steroid hormones, such as estriol. Maternal estriol in blood and urine is used to monitor fetal well-being since it is produced by the fetoplacental unit from fetal precursors. Low levels have been associated with maternal-fetal complications. We were recently able to show that estriol is measurable in maternal saliva from 6 weeks' gestation onwards. However, its pattern following morning awakening and potential links with salivary cortisol in early gestation is relatively unknown. In this prospective study, we explored the cortisol and estriol responses to morning awakening in first-trimester pregnant women, the potential association of these endocrine variables with maternal stress and resilience factors, and their predictive value for the further pregnancy course. METHODS Fifty-one women with an uncomplicated, singleton pregnancy responded to questionnaires measuring chronic and pregnancy-specific stress, emotional support, and daily uplifts at 6 weeks' gestation. At 8 and 10 weeks, the women collected saliva samples immediately, 30, and 60 min after morning awakening. After 12 weeks, 40 women reported on the further pregnancy course, of whom 6 had developed complications. RESULTS In response to morning awakening, cortisol levels increased significantly at 10 weeks (p = .04), while estriol levels decreased significantly at both 8 and 10 weeks (p < .001). A stronger cortisol increase was linked to a stronger estriol decrease at 8 (p = .03), but not at 10 weeks. Then, perceived emotional support at 6 weeks was negatively associated with cortisol baseline at 8 (p = .01) and positively with estriol baseline at 10 weeks (p = .03). Moreover, higher pregnancy-specific stress was related to a lower estriol baseline at 8 weeks (p = .047). Furthermore, compared to healthy women, those with complications at follow-up had already reported less emotional support (p = .03) and fewer daily uplifts (p = .03) at 6 weeks. These women also seemed to lack a significant estriol response to morning awakening at 8 weeks (p > .10). DISCUSSION These findings advance our knowledge of cortisol and estriol secretion following morning awakening and encourage the investigation of E3 in addition to cortisol when researching prenatal stress and its consequences for maternal and fetal health.
Collapse
Affiliation(s)
- Pearl La Marca-Ghaemmaghami
- Department of Clinical Psychology and Psychotherapy, University of Zurich, Binzmuehlestrasse 14/Box 26, Zurich 8050, Switzerland.
| | - Roland Zimmermann
- Department of Obstetrics, University Hospital of Zurich, Frauenklinikstrasse 10, Zurich 8091, Switzerland.
| | - Marina Haller
- Department of Psychological Methods, Evaluation and Statistics, University of Zurich, Binzmuelestrasse 14/Box 27, Zurich 8050, Switzerland.
| | - Ulrike Ehlert
- Department of Clinical Psychology and Psychotherapy, University of Zurich, Binzmuehlestrasse 14/Box 26, Zurich 8050, Switzerland.
| |
Collapse
|
35
|
Aochi Y, Honjo K, Kimura T, Ikehara S, Iso H. Association between maternal employment status during pregnancy and risk of depressive symptomatology 1 month after childbirth: the Japan Environment and Children's Study. J Epidemiol Community Health 2021; 75:jech-2020-213943. [PMID: 33468603 PMCID: PMC8142450 DOI: 10.1136/jech-2020-213943] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2020] [Revised: 11/03/2020] [Accepted: 11/09/2020] [Indexed: 11/26/2022]
Abstract
BACKGROUND Previous studies, which examined the association between employment status and postpartum depression, were limited by binary or ternary employment status measures (employed/unemployed or full-time/part-time/unemployed). This study examined the association between detailed employment status during pregnancy and risk of depressive symptomatology 1 month after childbirth, and the effect modification by one's perceived level of social support and household equivalent income. METHODS Our study examined 76 822 participants in the Japan Environment and Children's Study. The exposure included maternal employment status during pregnancy (regular workers, dispatched workers, part-time workers, self-employed workers, non-employed and others), and the outcome was depressive symptomatology 1 month after childbirth: Edinburgh Postnatal Depression Scale (EPDS scores ≥9 and ≥13). Adjusted ORs and 95% CIs of depressive symptomatology associated with employment status were calculated by multivariable logistic regression. Subgroup analyses by perceived level of social support and household equivalent income were conducted. RESULTS Compared with regular workers, the risk of depressive symptomatology (EPDS score ≥9) was higher for non-employed and others, and that (EPDS score ≥13) was so for part-time workers. There was no significant interaction by perceived level of social support and household equivalent income in the associations. However, part-time workers and non-employed had excess risk of depressive symptomatology among women with lower perceived level of social support, but not among those with the higher one. CONCLUSION Compared with regular workers, part-time workers and non-employed had an increased risk of depressive symptomatology, which was confined to women with lower perceived level of social support.
Collapse
Affiliation(s)
- Yuri Aochi
- Public Health, Department of Social Medicine, Osaka University Graduate School of Medicine, Suita, Osaka, Japan
| | - Kaori Honjo
- Social and Behavioral Sciences, Faculty of Medicine, Osaka Medical College, Takatsuki, Osaka, Japan
| | - Takashi Kimura
- Department of Public Health, Hokkaido University Graduate School of Medicine, Sapporo, Hokkaido, Japan
| | - Satoyo Ikehara
- Public Health, Department of Social Medicine, Osaka University Graduate School of Medicine, Suita, Osaka, Japan
| | - Hiroyasu Iso
- Public Health, Department of Social Medicine, Osaka University Graduate School of Medicine, Suita, Osaka, Japan
- Department of Public Health Medicine, Faculty of Medicine, University of Tsukuba, Ibaraki, Japan
| |
Collapse
|
36
|
Değirmenci F, Vefikuluçay Yılmaz D. The relationship between psychosocial health status and social support of pregnant women. J Psychosom Obstet Gynaecol 2020; 41:290-297. [PMID: 31619093 DOI: 10.1080/0167482x.2019.1678021] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
Abstract
PURPOSE The aim of this study was to determine the relationship between psychosocial health status and social support, which has important effects on pregnancy, and to determine the factors related to both psychosocial health and social support. METHOD The research was planned to be a descriptive study. The sample of the study consisted of 393 pregnant women. 'Personal Information Form', 'Pregnancy Psychosocial Health Assessment Scale (PPHAS)', and 'Multidimensional Scale of Perceived Social Support (MSPSS)' were used to collect data, and Student's t-test, ANOVA and Tukey's HSD tests were used for the data analysis. The relationship between the two continuous variables was evaluated according to the Pearson correlation coefficient. RESULTS Psychosocial health conditions and perceived social supports of pregnant women whose spouses were working were determined to be significantly higher (p < .05), and at a lower level (p < .05) in pregnant women with two or more children. As MSPSS total mean scores of the pregnant women increased, their PPHAS total mean scores were weakly affected in the positive direction (r = 0.393, p < .01). CONCLUSIONS It is recommended that health care needs of pregnant women should be evaluated not only in terms of physical health but also together with their psychosocial health and social supports. Furthermore, this assessment should be done in their own home environment with their spouses and other family members.
Collapse
Affiliation(s)
- Filiz Değirmenci
- Department of Obstetrics and Gynecology Nursing, Faculty of Nursing, Mersin University, Mersin, Turkey
| | - Duygu Vefikuluçay Yılmaz
- Department of Obstetrics and Gynecology Nursing, Faculty of Nursing, Mersin University, Mersin, Turkey
| |
Collapse
|
37
|
Lebel C, MacKinnon A, Bagshawe M, Tomfohr-Madsen L, Giesbrecht G. Elevated depression and anxiety symptoms among pregnant individuals during the COVID-19 pandemic. J Affect Disord 2020; 277:5-13. [PMID: 32777604 PMCID: PMC7395614 DOI: 10.1016/j.jad.2020.07.126] [Citation(s) in RCA: 527] [Impact Index Per Article: 131.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2020] [Revised: 07/10/2020] [Accepted: 07/28/2020] [Indexed: 12/29/2022]
Abstract
BACKGROUND Anxiety and depression symptoms in pregnancy typically affect between 10 and 25% of pregnant individuals. Elevated symptoms of depression and anxiety are associated with increased risk of preterm birth, postpartum depression, and behavioural difficulties in children. The current COVID-19 pandemic is a unique stressor with potentially wide-ranging consequences for pregnancy and beyond. METHODS We assessed symptoms of anxiety and depression among pregnant individuals during the current COVID-19 pandemic and determined factors that were associated with psychological distress. 1987 pregnant participants in Canada were surveyed in April 2020. The assessment included questions about COVID-19-related stress and standardized measures of depression, anxiety, pregnancy-related anxiety, and social support. RESULTS We found substantially elevated anxiety and depression symptoms compared to similar pre-pandemic pregnancy cohorts, with 37% reporting clinically relevant symptoms of depression and 57% reporting clinically relevant symptoms of anxiety. Higher symptoms of depression and anxiety were associated with more concern about threats of COVID-19 to the life of the mother and baby, as well as concerns about not getting the necessary prenatal care, relationship strain, and social isolation due to the COVID-19 pandemic. Higher levels of perceived social support and support effectiveness, as well as more physical activity, were associated with lower psychological symptoms. CONCLUSION This study shows concerningly elevated symptoms of anxiety and depression among pregnant individuals during the COVID-19 pandemic, that may have long-term impacts on their children. Potential protective factors include increased social support and exercise, as these were associated with lower symptoms and thus may help mitigate long-term negative outcomes.
Collapse
Affiliation(s)
- Catherine Lebel
- Department of Radiology, University of Calgary, Calgary, Alberta, Canada; Alberta Children's Hospital Research Institute, University of Calgary, 28 Oki Drive, Alberta T3B 6A8, Canada; Hotchkiss Brain Institute, University of Calgary, Canada.
| | - Anna MacKinnon
- Alberta Children's Hospital Research Institute, University of Calgary, 28 Oki Drive, Alberta T3B 6A8, Canada,Department of Psychology, University of Calgary, Canada
| | - Mercedes Bagshawe
- Department of Radiology, University of Calgary, Calgary, Alberta, Canada,Alberta Children's Hospital Research Institute, University of Calgary, 28 Oki Drive, Alberta T3B 6A8, Canada,Hotchkiss Brain Institute, University of Calgary, Canada
| | - Lianne Tomfohr-Madsen
- Alberta Children's Hospital Research Institute, University of Calgary, 28 Oki Drive, Alberta T3B 6A8, Canada,Department of Psychology, University of Calgary, Canada,Department of Pediatrics, University of Calgary, Canada
| | - Gerald Giesbrecht
- Alberta Children's Hospital Research Institute, University of Calgary, 28 Oki Drive, Alberta T3B 6A8, Canada,Department of Psychology, University of Calgary, Canada,Department of Pediatrics, University of Calgary, Canada
| |
Collapse
|
38
|
Mendez DD, Sanders SA, Lai YH, Wallace ML, Rathbun SL, Gary-Webb TL, Davis EM, Burke LE. Ecological momentary assessment of stress, racism and other forms of discrimination during pregnancy using smartphone technology. Paediatr Perinat Epidemiol 2020; 34:522-531. [PMID: 31930744 PMCID: PMC11219027 DOI: 10.1111/ppe.12619] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2019] [Revised: 09/17/2019] [Accepted: 10/28/2019] [Indexed: 01/19/2023]
Abstract
BACKGROUND In the United States, there are considerable racial inequities in adverse perinatal outcomes. Exposure to racism, sexism, and other forms of oppression may help explain these inequities. OBJECTIVES To describe the application of real-time data collection using ecological momentary assessment (EMA) and smartphone technology to assess exposure to stress, racism, sexism, microaggressions, and other forms of oppression. METHODS The Postpartum Mothers Mobile Study (PMOMS) is an ongoing longitudinal cohort study that began recruitment in December 2017. Participants delivering at a hospital in Pittsburgh, PA are recruited by 29 weeks' gestation. Using smartphones and smart scales, participants complete daily surveys related to psychosocial, behavioural, and contextual factors and weigh themselves weekly for approximately 15 months. We provide a preliminary descriptive analysis of EMA self-reported measures of stress, racism, sexism, and microaggressions; and non-EMA measures of stress and major discrimination. RESULTS The sample (n = 230) is 63.5% White, 24.8% Black/African American, and 7% Hispanic origin. The most commonly reported item from the Major Discrimination Scale is being unfairly fired (18.1% of the sample). Of those, 31.7% and 17.1% attribute unfair firing to their gender and race, respectively. From the random EMA measures, on average, participants report experiences of racism and sexism at least once daily, in an average 12-hour day over the 4-week period. Black participants indicate about two experiences per day of racism, and White participants indicate more than 1 per day of sexism. Mean stress levels from the EMA measures were similar to the stress measures collected at baseline. CONCLUSIONS The methods applied in PMOMS provide real-time data regarding how participants' daily experiences of stress and discrimination influence their lives. Future work will include understanding if and how these EMA measures may relate to already established measures of racism, sexism, and stress; and ultimately understanding associations with perinatal inequities.
Collapse
Affiliation(s)
- Dara D. Mendez
- Department of Epidemiology, University of Pittsburgh Graduate School of Public Health, Pittsburgh, PA, USA
- Behavioral and Community Health Sciences, University of Pittsburgh Graduate School of Public Health, Pittsburgh, PA, USA
| | - Sarah A. Sanders
- Behavioral and Community Health Sciences, University of Pittsburgh Graduate School of Public Health, Pittsburgh, PA, USA
| | - Yu-Hsuan Lai
- Department of Epidemiology, University of Pittsburgh Graduate School of Public Health, Pittsburgh, PA, USA
| | | | - Stephen L. Rathbun
- Department of Epidemiology and Biostatistics, University of Georgia College of Public Health, Athens, GA, USA
| | - Tiffany L. Gary-Webb
- Department of Epidemiology, University of Pittsburgh Graduate School of Public Health, Pittsburgh, PA, USA
- Behavioral and Community Health Sciences, University of Pittsburgh Graduate School of Public Health, Pittsburgh, PA, USA
| | - Esa M. Davis
- Division of Internal Medicine, University of Pittsburgh Department of Medicine, Pittsburgh, PA, USA
| | - Lora E. Burke
- School of Nursing, University of Pittsburgh, Pittsburgh, PA, USA
| |
Collapse
|
39
|
Yu Y, Zhu X, Xu H, Hu Z, Zhou W, Zheng B, Yin S. Prevalence of depression symptoms and its influencing factors among pregnant women in late pregnancy in urban areas of Hengyang City, Hunan Province, China: a cross-sectional study. BMJ Open 2020; 10:e038511. [PMID: 32873680 PMCID: PMC7467533 DOI: 10.1136/bmjopen-2020-038511] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2020] [Revised: 06/02/2020] [Accepted: 07/29/2020] [Indexed: 11/03/2022] Open
Abstract
OBJECTIVES To evaluate the prevalence of depressive symptoms and its influencing factors in late pregnancy. DESIGN Cross-sectional study. SETTING Fourteen community in urban areas of Hengyang City. PARTICIPANTS The study conducted from July to October 2019, and surveyed 813 women in late pregnancy who lived in urban areas of Hengyang for more than 6 months, signed an informed consent and were without cognitive disorders, severe mental illnesses or other serious diseases. MEASURES Perinatal depression symptoms were evaluated using the Patient Health Questionnaire-9, and perinatal anxiety symptoms were evaluated using the Generalised Anxiety Disorder-7 Scale. Sociodemographic variables, obstetric characteristics, lifestyle behaviours, family factors, social support, sleep quality and self-efficacy were obtained through structured questionnaires. RESULTS The prevalence of depression symptoms among pregnant women in late pregnancy was 9.2% (95% CI 7.2%-11.2%). Protective factor: age between 25 and 29 years (OR=0.398; 95% CI 0.16-0.991). RISK FACTORS a normal relationship with her mother-in-law (OR=5.309; 95% CI 1.122-4.184), artificial insemination (OR=4.339; 95% CI 1.492-12.623), no exercise during pregnancy (OR=2.666; 95% CI 1.177-6.039), low self-efficacy (OR=4.253; 95% CI 1.518-11.916), low social support (OR=2.371; 95% CI 1.206-4.661), poor sleep quality (OR=2.134; 95% CI 1.131-4.027), existence of anxiety symptoms (OR=17.654; 95% CI 8.494-36.689). CONCLUSION The prevalence of depression symptoms is lower than that in developing countries, but due to the large population base of China, the problem should still be taken seriously. To prevent mental disorders of pregnant women, early screening for mental disorders, promotion of healthy lifestyles, mental healthcare during pregnancy and improved family and social support should be implemented during pregnancy nursing.
Collapse
Affiliation(s)
- Yunhan Yu
- Department of Social Medicine and Health Management, Central South University Xiangya School of Public Health, Changsha, Hunan, China
| | - Xidi Zhu
- Department of Social Medicine and Health Management, Central South University Xiangya School of Public Health, Changsha, Hunan, China
| | - Huilan Xu
- Department of Social Medicine and Health Management, Central South University Xiangya School of Public Health, Changsha, Hunan, China
| | - Zhao Hu
- Department of Social Medicine and Health Management, Central South University Xiangya School of Public Health, Changsha, Hunan, China
| | - Wensu Zhou
- Department of Social Medicine and Health Management, Central South University Xiangya School of Public Health, Changsha, Hunan, China
| | - Baohua Zheng
- Department of Social Medicine and Health Management, Central South University Xiangya School of Public Health, Changsha, Hunan, China
| | - Shilin Yin
- Department of Social Medicine and Health Management, Central South University Xiangya School of Public Health, Changsha, Hunan, China
| |
Collapse
|
40
|
Yalnız Dilcen H, Aslantekin F, Aktaş N. The relationship of psychosocial well‐being and social support with pregnant women's perceptions of traumatic childbirth. Scand J Caring Sci 2020; 35:650-658. [DOI: 10.1111/scs.12887] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2020] [Revised: 06/08/2020] [Accepted: 06/14/2020] [Indexed: 01/08/2023]
Affiliation(s)
- Hacer Yalnız Dilcen
- Department of Midwifery Faculty of Health Sciences Bartın University Bartin Turkey
| | - Filiz Aslantekin
- Department of Midwifery Faculty of Health Sciences Balıkesir University Balikesir Turkey
| | - Naciye Aktaş
- Karadeniz Ereğli 04 Famıly Health Center Zonguldak Turkey
| |
Collapse
|
41
|
Nyman T, Pegg S, Kiel EJ, Mistry-Patel S, Becker-Schmall LJ, Brooker RJ. Perceived social support moderates neural reactivity to emotionally valenced stimuli during pregnancy. Psychophysiology 2020; 57:e13647. [PMID: 32715514 DOI: 10.1111/psyp.13647] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2019] [Revised: 05/28/2020] [Accepted: 06/24/2020] [Indexed: 01/17/2023]
Abstract
Reactivity to emotional information, measurable at the level of neural activity using event-related potentials, is linked to symptoms of affective disorders. Behavioral evidence suggests that contextual factors, such as social support, can alter emotional reactivity such that affective responding is normalized when social support is high. This possibility remains largely untested at the neural level, specifically through approaches that can offer insight into the mechanistic processes contributing to individual differences in emotional reactivity. Yet, such knowledge could be useful for prevention and intervention efforts, particularly with groups at risk for increased emotional reactivity, such as pregnant mothers for whom emotional distress predicts both maternal and child outcomes. Expectant mothers took part in a longitudinal study that tested whether the late positive potential (LPP), a neural index of reactivity to emotional information, was moderated by maternal perceptions of social support. In the third trimester of pregnancy, lower perceived social support was associated with an absence of a traditional LPP effect, which differentiates valenced from neutral stimuli. Findings suggest that perceptions of social support may normalize emotional processing at the neural level and highlight the potential importance of social support modulation of emotional reactivity during times of known biological change.
Collapse
Affiliation(s)
- Tristin Nyman
- Department of Psychological and Brain Sciences, Texas A&M University, College Station, TX, USA
| | - Samantha Pegg
- Department of Psychology and Human Development, Vanderbilt University, Nashville, TN, USA
| | | | - Sejal Mistry-Patel
- Department of Psychological and Brain Sciences, Texas A&M University, College Station, TX, USA
| | - Lisa J Becker-Schmall
- Department of Physical Therapy and Rehabilitation Science, The University of Iowa, Iowa City, IA, USA
| | - Rebecca J Brooker
- Department of Psychological and Brain Sciences, Texas A&M University, College Station, TX, USA
| |
Collapse
|
42
|
Letourneau N, Anis L, Ntanda H, Novick J, Steele M, Steele H, Hart M. Attachment & Child Health (ATTACH) pilot trials: Effect of parental reflective function intervention for families affected by toxic stress. Infant Ment Health J 2020; 41:445-462. [PMID: 32533796 DOI: 10.1002/imhj.21833] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
Toxic stressors (e.g., parental violence, depression, low income) place children at risk for insecure attachment. Parental reflective function-parents' capacity to understand their own and their child's mental states and thus regulate their own feelings and behavior toward their child-may buffer the negative effects of toxic stress on attachment. Our objective was to test the effectiveness of the Attachment and Child Health (ATTACH) intervention, focusing on improving reflective function and children's attachment security, for at-risk mothers and children <36 months of age. Three pilot studies were conducted with women and children from an inner city agency serving vulnerable, low-income families and a family violence shelter. Randomized control trial (n = 20, n = 10 at enrollment) and quasi-experimental (n = 10 at enrollment) methods tested the effect of the ATTACH intervention on the primary outcome of reflective function scores, from transcribed Parent Development Interviews. Our secondary outcome was children's attachment patterns from Ainsworth's Strange Situation Procedure. Despite some attrition, mixed methods analysis of covariance and t tests revealed significant differences in maternal, child, and overall reflective function, with moderate effect sizes. While more children whose mothers received the ATTACH program were securely attached posttreatment, as compared with controls, significant differences were not observed, which may be due to missing observations (n = 5 cases). Understanding the effectiveness of programs like the ATTACH intervention contributes to improved programs and services to promote healthy development of children affected by toxic stress.
Collapse
Affiliation(s)
- Nicole Letourneau
- Faculty of Nursing and Cumming School of Medicine, Departments of Pediatrics, Psychiatry, & Community Health Sciences, University of Calgary, Calgary, Alberta, Canada, T2N 1N4.,Owerko Centre at the Alberta Children's Hospital Research Institute, University of Calgary, Calgary, Alberta, Canada, T2N 1N4
| | - Lubna Anis
- Owerko Centre at the Alberta Children's Hospital Research Institute, University of Calgary, Calgary, Alberta, Canada, T2N 1N4.,Faculty of Nursing and Cumming School of Medicine, Department of Pediatrics, University of Calgary, Calgary, Alberta, Canada, T2N 1N4
| | - Henry Ntanda
- Owerko Centre at the Alberta Children's Hospital Research Institute, University of Calgary, Calgary, Alberta, Canada, T2N 1N4.,Cumming School of Medicine, Department of Pediatrics, University of Calgary, Calgary, Alberta, Canada, T2N 1N4
| | - Jason Novick
- Owerko Centre at the Alberta Children's Hospital Research Institute, University of Calgary, Calgary, Alberta, Canada, T2N 1N4.,Cumming School of Medicine, Department of Pediatrics, University of Calgary, Calgary, Alberta, Canada, T2N 1N4
| | - Miriam Steele
- Department of Psychology, The New School, New York City, NY, 1011
| | - Howard Steele
- Department of Psychology, The New School, New York City, NY, 1011
| | - Martha Hart
- Owerko Centre at the Alberta Children's Hospital Research Institute, University of Calgary, Calgary, Alberta, Canada, T2N 1N4.,Faculty of Nursing and Cumming School of Medicine, Department of Pediatrics, University of Calgary, Calgary, Alberta, Canada, T2N 1N4
| |
Collapse
|
43
|
Sicorello M, Dieckmann L, Moser D, Lux V, Luhmann M, Schlotz W, Kumsta R. Oxytocin and the stress buffering effect of social company: a genetic study in daily life. Soc Cogn Affect Neurosci 2020; 15:293-301. [PMID: 32227088 PMCID: PMC7235964 DOI: 10.1093/scan/nsaa034] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2020] [Revised: 02/27/2020] [Indexed: 11/13/2022] Open
Abstract
Social relationships are a crucial determinant of both mental and physical health. This effect is partly due to social buffering of stress. Animal studies suggest that social buffering is mediated via the oxytocin system, while studies in humans are sparse and limited by the low ecological validity of laboratory settings. In the present study, participants (N = 326) completed smartphone questionnaires four times a day over 4 to 5 days, measuring stressors, negative affect, and social context to assess social buffering. We found that under stress, participants reported a higher need for social company. Further, the impact of prior stressful events on momentary negative affect was attenuated by the perceived pleasantness of current social company. This social buffering effect was moderated by haplotypes of the oxytocin receptor gene, based on two well-described single nucleotide polymorphisms (rs2268498, rs53576). Effects were robust when controlling for gender and age, applying different data quality criteria, and even apparent in genotype-based analyses. Our findings demonstrate that social buffering and its modulation by oxytocin system characteristics have implications for life as lived outside the laboratory.
Collapse
Affiliation(s)
- Maurizio Sicorello
- Department of Genetic Psychology, Faculty of Psychology, Ruhr-University Bochum, 44801 Bochum, Germany
| | - Linda Dieckmann
- Department of Genetic Psychology, Faculty of Psychology, Ruhr-University Bochum, 44801 Bochum, Germany
| | - Dirk Moser
- Department of Genetic Psychology, Faculty of Psychology, Ruhr-University Bochum, 44801 Bochum, Germany
| | - Vanessa Lux
- Department of Genetic Psychology, Faculty of Psychology, Ruhr-University Bochum, 44801 Bochum, Germany
| | - Maike Luhmann
- Department of Psychological Methods, Faculty of Psychology, Ruhr-University Bochum, 44801 Bochum, Germany
| | - Wolff Schlotz
- Max-Planck-Institute for Empirical Aesthetics, Frankfurt am Main, Frankfurt am Main, Germany
- Institute of Psychology, Goethe University, Frankfurt am Main, Frankfurt am Main, Germany
| | - Robert Kumsta
- Department of Genetic Psychology, Faculty of Psychology, Ruhr-University Bochum, 44801 Bochum, Germany
| |
Collapse
|
44
|
Tian Y, Ming H, Huang S, Zhang H. Discrimination Increases the Association Between Parental and Adolescent Allostatic Load in Chinese Rural-to-Urban Migrants. J Adolesc Health 2020; 66:499-505. [PMID: 31974015 DOI: 10.1016/j.jadohealth.2019.11.303] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/06/2019] [Revised: 09/26/2019] [Accepted: 11/08/2019] [Indexed: 01/05/2023]
Abstract
PURPOSE This study was designed to examine the extent to which parents' allostatic load (AL) and adolescents' perceived discrimination are interrelated in the prediction of adolescents' AL among rural-to-urban migrants in China, as well as the possible buffering role of social support. METHODS Multi-informant data were collected in this study. A total of 158 rural-to-urban migrant adolescents (Meanage = 11.62 years) and one of each of their parents (Meanage = 39.84 years) were recruited from the suburbs of Beijing, China. Both adolescents' and parents' AL scores were based on 10 physiological indices. Migrant adolescents were asked to report their perceived discrimination and social support. RESULTS Parents' AL was significantly positively related to adolescents' AL. The relationship between parents' and adolescents' AL was stronger among adolescents reporting higher perceived discrimination than among those reporting lower. Social support moderated the adverse effects of parents' AL and perceived discrimination on adolescents' AL. Specifically, among adolescents reporting higher social support, the relationships between parents' and adolescents' AL were not significant for those with either high or low perceived discrimination. However, among adolescents reporting lower social support, the positive association was significant for those with high perceived discrimination but not for those with low perceived discrimination. CONCLUSIONS Parents' AL was a strong predictor of migrant adolescents' AL, and perceived discrimination acted as a catalyst to increase the association. The relationships of parental AL and perceived discrimination with AL were not significant for adolescents who received high social support.
Collapse
Affiliation(s)
- Yuan Tian
- Institute of Developmental Psychology, Beijing Normal University, Beijing, China; Faculty of Psychology, Beijing Normal University, Beijing, China
| | - Hua Ming
- Institute of Developmental Psychology, Beijing Normal University, Beijing, China; Faculty of Psychology, Beijing Normal University, Beijing, China
| | - Silin Huang
- Institute of Developmental Psychology, Beijing Normal University, Beijing, China; Faculty of Psychology, Beijing Normal University, Beijing, China.
| | - Hongchuan Zhang
- School of Sociology and Psychology, Central University of Finance and Economics, Beijing, China
| |
Collapse
|
45
|
Malina A, Głogiewicz M, Piotrowski J. Supportive Social Interactions in Infertility Treatment Decrease Cortisol Levels: Experimental Study Report. Front Psychol 2019; 10:2779. [PMID: 31920828 PMCID: PMC6927458 DOI: 10.3389/fpsyg.2019.02779] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2019] [Accepted: 11/26/2019] [Indexed: 11/22/2022] Open
Abstract
PURPOSE The aim of the research project was to analyze the importance of supportive social interactions in the process of infertility treatment. The acceptance rates of ART (Assisted Reproductive Technology) in Poland are lower than in western European countries and the social stigma of infertility exists. The research project draws attention to the issue of disclosure of fertility problems and the ability to seek support in Polish couples. METHODS An experimental study was conducted with 51 heterosexual couples who qualified for IVF. The participants were randomly divided into an experimental and control group. The first stage of the research procedure, with all the couples, was to extract a saliva (cortisol) sample as a biomarker for stress. In the second stage the control group viewed an informational (non-emotional) video about human embryology. The experimental group took part in a supportive social interaction process. In the supportive social interaction process, a maximum of five couples, were led through a broad general understanding of their IVF experience by an experienced group psychologist. The third stage of the research involved the second extraction of a saliva (cortisol) sample form all participants. In addition, demographic and medical history related to fertility was collected. RESULTS The statistical analysis indicates a significant decrease in the level of stress experienced after the supportive social interaction. The reported differences between the experimental group and the control group indicated a larger decrease of cortisol level for women and men. CONCLUSION In the current study, the hypothesis that taking part in supportive social interaction significantly lowers stress levels (measured via cortisol) of infertile couples (men and women) was supported. Further the project indicates that a supportive social interaction has a beneficial effect on infertile couple's health and well-being. The results of the study clearly point to the benefits of couples involved in infertility treatment to express and share their experience, and in doing so, provides measurable physiological and psychological benefits.
Collapse
Affiliation(s)
- Alicja Malina
- Department of Pedagogy and Psychology, Kazimierz Wielki University in Bydgoszcz, Bydgoszcz, Poland
| | - Małgorzata Głogiewicz
- Department of Obstetrics, Gynecology and Gynecological Oncology, Faculty of Health Sciences, Nicolaus Copernicus University in Toruń, Bydgoszcz, Poland
| | - Jakub Piotrowski
- Department of Immunology, Faculty of Biology and Environment Protection, Nicolaus Copernicus University in Toruń, Torun, Poland
| |
Collapse
|
46
|
Letourneau N, Leung B, Ntanda H, Dewey D, Deane AJ, Giesbrecht GF. Maternal and paternal perinatal depressive symptoms associate with 2- and 3-year-old children's behaviour: findings from the APrON longitudinal study. BMC Pediatr 2019; 19:435. [PMID: 31722682 PMCID: PMC6852959 DOI: 10.1186/s12887-019-1775-1] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2019] [Accepted: 10/07/2019] [Indexed: 01/30/2023] Open
Abstract
BACKGROUND Prenatal and postnatal depressive symptoms are common in expectant and new mothers and fathers. This study examined the association between four patterns of probable perinatal depression (mother depressed, father depressed, both depressed, neither depressed) in co-parenting mothers and fathers and their children's internalizing and externalizing behaviours at 24 and 36 months of age. The influence of sociodemographic, risk and protective factors was also examined. METHODS Depressive symptoms were measured during pregnancy and at 3 months postpartum and children's behaviour was assessed at 24 and 36 months of age. Families (n = 634) provided data on their children's internalizing (i.e. emotionally reactive, anxious/depressed, somatic complaints, withdrawn and total) and externalizing (i.e. attention problems, aggression and total) behaviour. Marginal models were employed to determine the relationship between children's behaviour over the two time points and the four patterns of probable parental depression. Sociodemographic variables as well as risk (stress) and protective (social support) factors were included in these models. RESULTS In the perinatal period 19.40% (n = 123) of mothers scored as probably depressed and 10.57% (n = 67) of fathers. In 6.31% (n = 40) of the participating families, both parents scored as probably depressed and in 63.72% (n = 404) neither parent scored as depressed. For children's emotionally reactive, withdrawn and total internalizing behaviours, both mothers' probable depression and mothers and fathers' co-occurring probable depression predicted higher scores, while for children's aggressive behaviour, attention problems, and total externalizing behaviours, only mothers' probable depression predicted higher scores, controlling for sociodemographic, risk and protective factors. CONCLUSIONS While probable perinatal depression in mothers predicted 2 and 3 year-old children's behavioural problems, co-occurrence of depression in mothers and fathers had an increased association with internalizing behavioural problems, after considering sociodemographic, risk and protective factors. Health care providers are encouraged to consider the whole family in preventing and treating perinatal depression.
Collapse
Affiliation(s)
- Nicole Letourneau
- Faculty of Nursing and Cumming School of Medicine, Departments of Pediatrics, Psychiatry, & Community Health Sciences, University of Calgary, Calgary, AB, T2N 1N4, Canada. .,Owerko Centre at the Alberta Children's Hospital Research Institute, University of Calgary, Calgary, AB, T2N 1N4, Canada.
| | - Brenda Leung
- Cumming School of Medicine, Department of Community Health Sciences, University of Calgary, Calgary, AB, T2N 1N4, Canada
| | - Henry Ntanda
- Cumming School of Medicine, Department of Pediatrics, University of Calgary, Calgary, AB, T2N 1N4, Canada
| | - Deborah Dewey
- Cumming School of Medicine, Departments of Pediatrics & Community Health Sciences, University of Calgary, Calgary, AB, T2N 1N4, Canada
| | - Andrea J Deane
- Cumming School of Medicine, Department of Pediatrics, University of Calgary, Calgary, AB, T2N 1N4, Canada
| | - Gerald F Giesbrecht
- Cumming School of Medicine, Departments of Pediatrics, Psychology, & Community Health Sciences, University of Calgary, Calgary, AB, T2N 1N4, Canada
| | | |
Collapse
|
47
|
Spontaneous Coronary Artery Dissection (SCAD): FEMALE SURVIVORS' EXPERIENCES OF STRESS AND SUPPORT. J Cardiopulm Rehabil Prev 2019; 38:374-379. [PMID: 29939880 DOI: 10.1097/hcr.0000000000000330] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
PURPOSE Spontaneous coronary artery dissection (SCAD) is a nonatherosclerotic type of acute myocardial infarction that primarily affects young, healthy women without typical risk factors for heart disease. Few investigations have examined psychosocial variables in this population and none have looked at patient perceptions of the experience and stresses associated with having a SCAD event or the resources currently available to SCAD survivors. This investigation describes survivors' subjective experiences of SCAD. Participants also provided information about types and helpfulness of resources available to them post-SCAD, including cardiac rehabilitation. METHODS Participants were recruited online and completed a one-time questionnaire. RESULTS Participants (n = 409) completed a questionnaire concerning their experiences with their SCAD event in the 1 y and 2 wk prior to the SCAD event. Their responses reflected moderate to high perceptions of stress. Participants experienced the SCAD event as highly stressful and frightening and their heart health presents as a moderate-severe source of current, post-diagnosis stress. Spontaneous coronary artery dissection-based informational support was frequently rated as inadequate, whereas other supportive resources varied in their helpfulness and accessibility. Participants reported positive experiences in cardiac rehabilitation and strong interest in SCAD-specific, professionally led, online patient education and support groups. CONCLUSIONS This study is the largest to date investigation of SCAD survivors and their experiences in this understudied and perhaps underrecognized condition. Opportunities for researchers and providers to develop, tailor, and disseminate SCAD-specific interventions are discussed.
Collapse
|
48
|
Mendez DD, Sanders SA, Karimi HA, Gharani P, Rathbun SL, Gary-Webb TL, Wallace ML, Gianakas JJ, Burke LE, Davis EM. Understanding Pregnancy and Postpartum Health Using Ecological Momentary Assessment and Mobile Technology: Protocol for the Postpartum Mothers Mobile Study. JMIR Res Protoc 2019; 8:e13569. [PMID: 31244478 PMCID: PMC6617916 DOI: 10.2196/13569] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2019] [Revised: 05/12/2019] [Accepted: 05/12/2019] [Indexed: 12/24/2022] Open
Abstract
Background There are significant racial disparities in pregnancy and postpartum health outcomes, including postpartum weight retention and cardiometabolic risk. These racial disparities are a result of a complex interplay between contextual, environmental, behavioral, and psychosocial factors. Objective This protocol provides a description of the development and infrastructure for the Postpartum Mothers Mobile Study (PMOMS), designed to better capture women’s daily experiences and exposures from late pregnancy through 1 year postpartum. The primary aims of PMOMS are to understand the contextual, psychosocial, and behavioral factors contributing to racial disparities in postpartum weight and cardiometabolic health, with a focus on the daily experiences of stress and racism, as well as contextual forms of stress (eg, neighborhood stress and structural racism). Methods PMOMS is a longitudinal observation study that is ancillary to an existing randomized control trial, GDM2 (Comparison of Two Screening Strategies for Gestational Diabetes). PMOMS uses an efficient and cost-effective approach for recruitment by leveraging the infrastructure of GDM2, facilitating enrollment of participants while consolidating staff support from both studies. The primary data collection method is ecological momentary assessment (EMA) and through smart technology (ie, smartphones and scales). The development of the study includes: (1) the pilot phase and development of the smartphone app; (2) feedback and further development of the app including selection of key measures; and (3) implementation, recruitment, and retention. Results PMOMS aims to recruit 350 participants during pregnancy, to be followed through the first year after delivery. Recruitment and data collection started in December 2017 and are expected to continue through September 2020. Initial results are expected in December 2020. As of early May 2019, PMOMS recruited a total of 305 participants. Key strengths and features of PMOMS have included data collection via smartphone technology to reduce the burden of multiple on-site visits, low attrition rate because of participation in an ongoing trial in which women are already motivated and enrolled, high EMA survey completion and the use of EMA as a unique data collection method to understand daily experiences, and shorter than expected timeframe for enrollment because of the infrastructure of the GDM2 trial. Conclusions This protocol outlines the development of the PMOMS, one of the first published studies to use an ongoing EMA and mobile technology protocol during pregnancy and throughout 1 year postpartum to understand the health of childbearing populations and enduring racial disparities in postpartum weight and cardiometabolic health. Our findings will contribute to the improvement of data collection methods, particularly the role of EMA in capturing multiple exposures and knowledge in real time. Furthermore, the results of the study will inform future studies investigating weight and cardiometabolic health during pregnancy and the postpartum period, including how social determinants produce population disparities in these outcomes. International Registered Report Identifier (IRRID) DERR1-10.2196/13569
Collapse
Affiliation(s)
- Dara D Mendez
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, United States
| | - Sarah A Sanders
- Behavioral and Community Health Sciences, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, United States
| | - Hassan A Karimi
- Geoinformatics Laboratory, School of Computing and Information, University of Pittsburgh, Pittsburgh, PA, United States
| | - Pedram Gharani
- Geoinformatics Laboratory, School of Computing and Information, University of Pittsburgh, Pittsburgh, PA, United States
| | - Stephen L Rathbun
- Department of Epidemiology and Biostatistics, College of Public Health, University of Georgia, Athens, GA, United States
| | - Tiffany L Gary-Webb
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, United States.,Behavioral and Community Health Sciences, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, United States
| | - Meredith L Wallace
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, United States
| | - John J Gianakas
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, United States
| | - Lora E Burke
- Department of Health and Community Systems, School of Nursing, University of Pittsburgh, Pittsburgh, PA, United States
| | - Esa M Davis
- Division of General Internal Medicine, Department of Medicine, University of Pittsburgh, Pittsburgh, PA, United States
| |
Collapse
|
49
|
Racine N, Plamondon A, Hentges R, Tough S, Madigan S. Dynamic and bidirectional associations between maternal stress, anxiety, and social support: The critical role of partner and family support. J Affect Disord 2019; 252:19-24. [PMID: 30954841 DOI: 10.1016/j.jad.2019.03.083] [Citation(s) in RCA: 62] [Impact Index Per Article: 12.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2018] [Revised: 03/26/2019] [Accepted: 03/29/2019] [Indexed: 01/09/2023]
Abstract
BACKGROUND Stress and anxiety in pregnancy and the postpartum period are associated with poor long-term maternal and child health outcomes. Social support has been shown to mitigate the effects of maternal stress and anxiety; however, the directionality and longitudinal associations among these variables are poorly understood. Using a novel multilevel modeling approach called dynamic structural equation modeling (DSEM), we examined within-person (state-level) autoregressive and cross-lagged associations among stress, anxiety, and social support in the perinatal period in order to elucidate directional associations over time. METHODS Mothers from a longitudinal pregnancy cohort (N = 3,388) completed self-report measures of stress, anxiety, and social support across 4 time points from pregnancy to 12 months postpartum. RESULTS Higher than average levels of stress and anxiety led to elevations in anxiety and stress and decreases in social support at subsequent time points. Importantly, earlier individual levels of partner and family support predicted subsequent decreases in stress and anxiety. LIMITATIONS Support was measured via maternal self-report thus extrapolations cannot be made to tangible or instrumental supports and lagged relationships represent average lags over time. CONCLUSIONS Using a novel statistical approach, these results suggest that increases in both partner and family support may be powerful protective factors for decreasing mental health difficulties in pregnancy and the postpartum, highlighting the importance of targeting and increasing this type of support from pregnancy to the postpartum period.
Collapse
Affiliation(s)
- Nicole Racine
- Department of Psychology, Faculty of Arts, University of Calgary, 2500 University Dr. NW, Calgary, T2N 1N4 Alberta, Canada.
| | - André Plamondon
- Département des fondements et pratiques en éducation, Université Laval, Pavillon des Sciences de l'éducation, local 954, 2320, rue des Bibliotheques, Quebec, Canada; Department of Applied Psychology and Human Development, University of Toronto, Toronto, Ontario, Canada.
| | - Rochelle Hentges
- Department of Psychology, Faculty of Arts, University of Calgary, 2500 University Dr. NW, Calgary, T2N 1N4 Alberta, Canada.
| | - Suzanne Tough
- Department of Community Health Sciences, University of Calgary, Alberta, Canada; Department of Pediatrics, University of Calgary, 2500 University Dr. NW, Calgary, T2N 1N4 Alberta, Canada.
| | - Sheri Madigan
- Department of Psychology, Faculty of Arts, University of Calgary, Alberta Children's Hospital Research Institute, 2500 University Dr. NW, Calgary, T2N 1N4 Alberta, Canada.
| |
Collapse
|
50
|
Spicer J, Giesbrecht GF, Aboelela S, Lee S, Liu G, Monk C. Ambulatory Blood Pressure Trajectory and Perceived Stress in Relation to Birth Outcomes in Healthy Pregnant Adolescents. Psychosom Med 2019; 81:464-476. [PMID: 31090671 PMCID: PMC6715293 DOI: 10.1097/psy.0000000000000698] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE An early decline in resting blood pressure (BP), followed by an upward climb, is well documented and indicative of a healthy pregnancy course. Although BP is considered both an effector of stress and a clinically meaningful measurement in pregnancy, little is known about its trajectory in association with birth outcomes compared with other stress effectors. The current prospective longitudinal study examined BP trajectory and perceived stress in association with birth outcomes (gestational age (GA) at birth and birth weight (BW) percentile corrected for GA) in pregnant adolescents, a group at risk for stress-associated poor birth outcomes. METHODS Healthy pregnant nulliparous adolescents (n = 139) were followed from early pregnancy through birth. At three time points (13-16, 24-27, and 34-37 gestational weeks ±1 week), the Perceived Stress Scale was collected along with 24-hour ambulatory BP (systolic and diastolic) and electronic diary reporting of posture. GA at birth and BW were abstracted from medical records. RESULTS After adjustment for posture and pre-pregnancy body mass index, hierarchical mixed-model linear regression showed the expected early decline (B = -0.18, p = .023) and then increase (B = 0.01, p < .001) of diastolic BP approximating a U-shape; however, systolic BP displayed only an increase (B = 0.01, p = .010). In addition, the models indicated a stronger systolic and diastolic BP U-shape for early GA at birth and lower BW percentile and an inverted U-shape for late GA at birth and higher BW percentile. No effects of perceived stress were observed. CONCLUSIONS These results replicate the pregnancy BP trajectory from previous studies of adults and indicate that the degree to which the trajectory emerges in adolescence may be associated with variation in birth outcomes, with a moderate U-shape indicating the healthiest outcomes.
Collapse
Affiliation(s)
- Julie Spicer
- Department of Psychiatry, Icahn School of Medicine at
Mount Sinai
| | - Gerald F. Giesbrecht
- Departments of Pediatrics & Community Health Sciences,
University of Calgary, AB, Canada
| | | | - Seonjoo Lee
- Department of Psychiatry, Columbia University
| | - Grace Liu
- Department of Psychiatry, Columbia University
| | - Catherine Monk
- Department of Psychiatry, Columbia University
- Department of Obstetrics and Gynecology, Columbia
University
- New York State Psychiatric Institute
| |
Collapse
|