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Wei Q, Lin W, Zhang H, Lai Y, Zhuang S, Han Z, Wang Q, Wang L, Li W, Wen L, Hou H, Hu Q. Role of antenatal anxiety in the relationship between maternal exposure to nitrogen dioxide and small for gestational age: A birth cohort study. THE SCIENCE OF THE TOTAL ENVIRONMENT 2023; 900:165812. [PMID: 37499810 DOI: 10.1016/j.scitotenv.2023.165812] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Revised: 07/04/2023] [Accepted: 07/24/2023] [Indexed: 07/29/2023]
Abstract
BACKGROUND Both Nitrogen dioxide (NO2) exposure and antenatal anxiety have individually been associated with small for gestational age (SGA). Little is known, however, about whether there is effect modification of antenatal anxiety on NO2-related SGA. METHODS The prospective birth cohort study included 1823 mother-newborn pairs in Guangzhou, China, from January 2017 to April 2020. Exposure to NO2 during the pre-conceptional and prenatal periods was estimated using an inverse distance weighted method. Antenatal anxiety was assessed by Trait Anxiety Inventory. SGA was determined by the Chinese gestational age- and sex-specific birthweight standards. Cox proportional hazards regression models was used to estimate hazard ratios (HRs) and 95 % confidence intervals (CIs) for SGA as per 10 μg/m3 increase in NO2. Modifying effects of trait anxiety on NO2-related SGA were identified by stratified analyses, and three-dimensional response surface plots and two-dimensional heat maps. RESULTS Each 10 μg/m3 increase in NO2 exposure during the third trimester was significantly associated with SGA risk among overall participants (HR = 1.221, 95 % CI: 1.014-1.471) and primipara (HR = 1.271, 95 % CI: 1.023-1.579). We found significant effect modification of anxiety level for NO2-related SGA in the third trimester (Pinteraction < 0.05). Pregnant women with higher levels of trait anxiety were more likely to deliver SGA newborns, particularly for those with high trait anxiety (HR = 1.781, 95 % CI: 1.007-2.945). Primiparous women were more susceptible. CONCLUSIONS This study provides evidence that antenatal trait anxiety may modify the effects of maternal NO2 exposure on SGA risk. The third trimester could be a critical window of susceptibility.
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Affiliation(s)
- Qiannan Wei
- Department of Occupational and Environmental Health, School of Public Health, Sun Yat-Sen University, Guangzhou 510080, China
| | - Weiwei Lin
- Department of Occupational and Environmental Health, School of Public Health, Sun Yat-Sen University, Guangzhou 510080, China.
| | - Hedi Zhang
- Department of Occupational and Environmental Health, School of Public Health, Sun Yat-Sen University, Guangzhou 510080, China
| | - Yuming Lai
- Department of Occupational and Environmental Health, School of Public Health, Sun Yat-Sen University, Guangzhou 510080, China
| | - Shuling Zhuang
- Department of Occupational and Environmental Health, School of Public Health, Sun Yat-Sen University, Guangzhou 510080, China
| | - Zhenyan Han
- Department of Obstetrics and Gynecology, The Third Affiliated Hospital, Sun Yat-sen University, Guangzhou 510630, Guangdong, China
| | - Qingqing Wang
- Department of Obstetrics and Gynecology, The Third Affiliated Hospital, Sun Yat-sen University, Guangzhou 510630, Guangdong, China
| | - Lijie Wang
- Department of Occupational and Environmental Health, School of Public Health, Sun Yat-Sen University, Guangzhou 510080, China
| | - Wenzhuo Li
- Department of Occupational and Environmental Health, School of Public Health, Sun Yat-Sen University, Guangzhou 510080, China
| | - Li Wen
- Department of Occupational and Environmental Health, School of Public Health, Sun Yat-Sen University, Guangzhou 510080, China
| | - Hongying Hou
- Department of Obstetrics and Gynecology, The Third Affiliated Hospital, Sun Yat-sen University, Guangzhou 510630, Guangdong, China
| | - Qiansheng Hu
- Department of Occupational and Environmental Health, School of Public Health, Sun Yat-Sen University, Guangzhou 510080, China
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Meza-Rodríguez MDP, Farfan-Labonne B, Avila-García M, Figueroa-Damian R, Plazola-Camacho N, Pellón-Díaz G, Ríos-Flores BA, Olivas-Peña E, Leff-Gelman P, Camacho-Arroyo I. Psychological distress, anxiety, depression, stress level, and coping style in HIV-pregnant women in Mexico. BMC Psychol 2023; 11:366. [PMID: 37915068 PMCID: PMC10621089 DOI: 10.1186/s40359-023-01416-8] [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: 05/24/2023] [Accepted: 10/27/2023] [Indexed: 11/03/2023] Open
Abstract
PURPOSE To evaluate the presence of psychological distress (PD) and its association with the mental health and coping styles of pregnant women living with HIV (PWLWH). METHOD An observational, cross-sectional descriptive study was performed. Seventy-three PWLWH were included. Patients responded to a psychometric battery for PD, depression, anxiety, stress, and coping style evaluation. The scales used in the study were: Goldberg's 30-item General Health Questionnaire (GHQ-30), State-Trait Anxiety Inventory (STAI), Zung Depression Self-Measurement Scale (ZDS), Nowack Stress Profile, Lazarus and Folkman's Coping Styles Questionnaire. RESULTS PD was observed in 31.5% of the participants. PD-positive patients showed a higher probability of presenting traits of depression and anxiety and medium/high stress levels. Besides, they preferentially used emotion-focused coping styles. CONCLUSION PD is associated with a higher probability of presenting anxiety and depression in PWLWH. Emotion-focused coping style could be a factor in decision-making associated with risk behaviors in PWLWH.
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Affiliation(s)
- María Del Pilar Meza-Rodríguez
- Coordinación de Investigación en Psicología, Instituto Nacional de Perinatología, Montes Urales 800, CDMX, C.P. 11000, México
| | - Blanca Farfan-Labonne
- Departamento de Fisiología y Desarrollo Celular, Instituto Nacional de Perinatología, Montes Urales 800, CDMX, C.P. 11000, México
| | - Miroslava Avila-García
- Departamento de Infectología e Inmunología, Instituto Nacional de Perinatología, Montes Urales 800, CDMX, C.P. 11000, México
| | - Ricardo Figueroa-Damian
- Departamento de Infectología e Inmunología, Instituto Nacional de Perinatología, Montes Urales 800, CDMX, C.P. 11000, México
| | - Noemí Plazola-Camacho
- Departamento de Infectología e Inmunología, Instituto Nacional de Perinatología, Montes Urales 800, CDMX, C.P. 11000, México
| | - Gabriela Pellón-Díaz
- Departamento de Neurociencias, Instituto Nacional de Perinatología, Montes Urales 800, CDMX, C.P. 11000, México
| | - Braulio Alfonso Ríos-Flores
- Departamento de Neurociencias, Instituto Nacional de Perinatología, Montes Urales 800, CDMX, C.P. 11000, México
| | - Efraín Olivas-Peña
- Departamento de Neurociencias, Instituto Nacional de Perinatología, Montes Urales 800, CDMX, C.P. 11000, México
| | - Phillipe Leff-Gelman
- Departamento de Investigación en Salud Reproductiva y Perinatal, Instituto Nacional de Perinatología, Montes Urales 800, CDMX, C.P. 11000, México
| | - Ignacio Camacho-Arroyo
- Unidad de Investigación en Reproducción Humana, Instituto Nacional de Perinatología-Facultad de Química, Universidad Nacional Autónoma de México, Montes Urales 800, Lomas de Chapultepec Miguel Hidalgo, Ciudad de México, C.P. 11000, México.
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Cluxton-Keller F, Olson A. A Family-Based Collaborative Care Model for Treatment of Depressive and Anxiety Symptoms in Perinatal Women: Results from a Pilot Study (Preprint). JMIR Pediatr Parent 2023; 6:e45616. [PMID: 37052997 PMCID: PMC10141279 DOI: 10.2196/45616] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Revised: 02/06/2023] [Accepted: 02/07/2023] [Indexed: 02/10/2023] Open
Abstract
BACKGROUND Untreated perinatal depression and anxiety can have detrimental consequences on family function. Logistical barriers prevent many perinatal women from accessing treatment, and these barriers are compounded for women residing in rural areas. This paper describes a Family-Based Collaborative Care Model (FBCCM) that is designed to bypass barriers to increase access to care for depressed and anxious perinatal women in rural regions of the United States. The FBCCM includes the following two components: (1) a 10-session video-delivered family therapy treatment for perinatal depression and anxiety and (2) a video-delivered infant care provider training on addressing the parenting needs of depressed and anxious mothers. OBJECTIVE This paper describes the feasibility of implementing the FBCCM with families and infant care providers. Findings are presented on the preliminary effectiveness of the video-delivered family therapy treatment in reducing maternal depressive and anxiety symptoms, and family conflict. METHODS This pilot study was carried out using an implementation-effectiveness hybrid trial design without a comparison group. Changes in maternal depressive symptoms, maternal anxiety symptoms, and family conflict were measured at posttreatment, 3 months, and 6 months later. RESULTS On average, mothers (n=24) attended 9.79 (SD 1.02) sessions. On average, their family members (n=24) attended 9.42 (SD 1.28) sessions. A total of 31 infant care providers attended the training on addressing the parenting needs of depressed and anxious mothers. Mothers reported a significant reduction in depressive symptoms (P<.001) and anxiety symptoms (P<.001) from baseline to the 6-month follow-up. Mothers reported a significant reduction in conflict (P<.001), and their family members also reported a significant reduction in conflict (P=.007) from baseline to the 6-month follow-up. CONCLUSIONS The findings from this study provide support for the feasibility and preliminary effectiveness of the FBCCM. The findings will be used to inform a larger study of the FBCCM.
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Affiliation(s)
- Fallon Cluxton-Keller
- Department of Psychiatry, Geisel School of Medicine at Dartmouth, Lebanon, NH, United States
| | - Ardis Olson
- Department of Pediatrics, Geisel School of Medicine at Dartmouth, Lebanon, NH, United States
- Department of Community and Family Medicine, Geisel School of Medicine at Dartmouth, Lebanon, NH, United States
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Khouj MA, Albasri S, Albishri AA, Softa SM, Almaslamani AS, Ahmad HM. Prevalence of Stress, Anxiety, and Depression Among Pregnant Women in Jeddah. Cureus 2022; 14:e27174. [PMID: 36039202 PMCID: PMC9394746 DOI: 10.7759/cureus.27174] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/23/2022] [Indexed: 12/04/2022] Open
Abstract
Objectives: To estimate the prevalence of depression, anxiety, and stress among pregnant women living in Jeddah, Saudi Arabia, and to assess associated risk factors. Methods: The study, which was a cross-sectional design, was conducted under the supervision of King Abdulaziz University Hospital, a tertiary care center in Jeddah, Saudi Arabia, in May and June of 2021. The sample consisted of 200 pregnant women who completed an online questionnaire that included sociodemographic variables, obstetric information, pregnancy-related depression, stress, and anxiety symptoms, which were evaluated using the Depression Anxiety Stress Scale (DASS-21) and the Perinatal Anxiety Screening Scale (PASS). Results: DASS-21 scores indicated the prevalence of depression, anxiety, and stress were 37.5%, 54.0%, and 25.0%, respectively. The PASS revealed that 29.5% of participants had minimal anxiety symptoms, 44.5% had mild-to-moderate anxiety symptoms, and 26.0% had severe anxiety symptoms. The three psychological health conditions were significantly associated with family/husband support, history of caesarean section, parity, and abortion. Conclusions: Pregnant women should be screened routinely for any psychological disturbances, and women who are at high risk for mental illness should receive proper psychological care. Pregnant women, their families, and members of society should receive health-related education in order to prevent prenatal psychological issues as much as possible.
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Rafie Z, Vakilian K, Zamanian M, Eghbali H. The effectiveness of solution-focused counseling on the mental health of mothers with gestational diabetes under treatment with insulin – A randomized clinical trial. INTERNATIONAL JOURNAL OF HEALTHCARE MANAGEMENT 2022. [DOI: 10.1080/20479700.2022.2095083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Affiliation(s)
- Zahra Rafie
- Arak University of Medical Sciences, Arak, Iran
| | - Katayon Vakilian
- Department of midwifery, School of Medicine, Traditional and Complementary Medicine Research Center(TCMRC), Arak University of Medical Sciences, Arak, Iran
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Shay M, MacKinnon AL, Metcalfe A, Giesbrecht G, Campbell T, Nerenberg K, Tough S, Tomfohr-Madsen L. Depressed mood and anxiety as risk factors for hypertensive disorders of pregnancy: a systematic review and meta-analysis. Psychol Med 2020; 50:2128-2140. [PMID: 32912348 DOI: 10.1017/s0033291720003062] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
BACKGROUND Psychosocial factors have been implicated as both a cause and consequence of hypertension in the general population but are less understood in relation to hypertensive disorders of pregnancy (HDP). The aims of this review were to (1) synthesize the existing literature examining associations between depression and/or anxiety in pregnancy and HDP and (2) assess if depression and/or anxiety in early pregnancy was a risk factor for HDP. METHODS A comprehensive search of Medline, Embase, CINAHL, and PsycINFO was conducted from inception to March 2020 using terms related to 'pregnancy', 'anxiety', 'depression', and 'hypertensive disorders'. English-language cohort and case-control studies were included if they reported: (a) the presence or absence of clinically significant symptoms of depression/anxiety, or a medical record diagnosis of depression or an anxiety disorder in pregnancy; (b) diagnosis of HDP; and/or (c) data comparing the depressed/anxious group to the non-depressed/anxious group on HDP. Data related to depression/anxiety, HDP, study characteristics, and aspects related to study quality were extracted independently by two reviewers. Random-effects meta-analyses of estimated pooled relative risks (RRs) were conducted for depression/anxiety in pregnancy and HDP. RESULTS In total, 6291 citations were retrieved, and 44 studies were included across 61.2 million pregnancies. Depression and/or anxiety were associated with HDP [RR = 1.39; 95% confidence interval (CI) 1.25-1.54]. CONCLUSIONS When measurement of anxiety or depression preceded diagnosis of hypertension, the association remained (RR = 1.27; 95% CI 1.07-1.50). Women experiencing depression or anxiety in pregnancy have an increased prevalence of HDP compared to their non-depressed or non-anxious counterparts.
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Affiliation(s)
- Matthew Shay
- Department of Psychology, University of Calgary, Calgary, Alberta, Canada
| | - Anna L MacKinnon
- Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Amy Metcalfe
- Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
- Department of Obstetrics and Gynaecology, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Gerald Giesbrecht
- Department of Paediatrics, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Tavis Campbell
- Department of Psychology, University of Calgary, Calgary, Alberta, Canada
| | - Kara Nerenberg
- Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
- Department of Obstetrics and Gynaecology, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
- Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Suzanne Tough
- Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
- Department of Paediatrics, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Lianne Tomfohr-Madsen
- Department of Psychology, University of Calgary, Calgary, Alberta, Canada
- Department of Paediatrics, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
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Effati-Daryani F, Zarei S, Mohammadi A, Hemmati E, Ghasemi Yngyknd S, Mirghafourvand M. Depression, stress, anxiety and their predictors in Iranian pregnant women during the outbreak of COVID-19. BMC Psychol 2020; 8:99. [PMID: 32962764 PMCID: PMC7506842 DOI: 10.1186/s40359-020-00464-8] [Citation(s) in RCA: 80] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2020] [Accepted: 09/03/2020] [Indexed: 12/29/2022] Open
Abstract
Background Pregnancy as a sensitive period of a woman’s life can be affected by various psychological factors that can have adverse effects on the woman, her fetus and future baby. Since COVID-19 is a new phenomenon with limited information available, it may have adverse psychological effects on pregnant women. Therefore, this study was conducted to determine the status of depression, stress, anxiety and their predictors in Iranian pregnant women during the outbreak of COVID-19. Methods This descriptive-analytical cross-sectional study was performed on 205 pregnant women covered by Tabriz health centers in Iran. The sampling method used was cluster sampling. The data collection tool was the socio-demographic characteristics questionnaire and the DASS-21 (Depression, Anxiety and Stress Scale-21), which were completed online by pregnant women. The general linear model was used to determine the predictive factors of depression, anxiety and stress. Results The mean (SD) score of depression, stress, and anxiety were 3.91 (3.9), 6.22 (4.25), and 3.79 (3.39), respectively; the score range of 0 to 21. Depression, stress, and anxiety symptoms were observed in 32.7, 32.7, and 43.9% of the participants, respectively, with varying degrees from mild to very severe. Based on the adjusted general linear model, variables of education level, spouse’s job and marital life satisfaction were the predictors of depressive symptoms. Variables of spouse’s education level, spouse’s support, marital life satisfaction and the number of pregnancies were the predictive factors of anxiety symptoms and the variables of spouse’s education level, household income sufficiency, spouse’s support and marital life satisfaction were predictors of stress symptoms. Conclusions Considering the role of marital life satisfaction, high level of spouse’s education and income in reducing symptoms of stress, anxiety, and depression in pregnant women in critical situations such as the prevalence of COVID-19, it seems that using strategies to promote marital life satisfaction and socio-economic status can play an effective role in controlling anxiety and reducing stress and depression in pregnant women.
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Affiliation(s)
- Fatemeh Effati-Daryani
- Reproductive Health Research Center, Midwifery Department, Faculty of Nursing and Midwifery, Urmia University of Medical Sciences, Urmia, Iran
| | - Somayeh Zarei
- Department of Midwifery, Shohada Hospital, Qom University of Medical Sciences, Qom, Iran
| | - Azam Mohammadi
- Nursing and Midwifery Care Research Center, Midwifery and Reproductive Health Department, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran
| | - Elnaz Hemmati
- Department of Midwifery, Faculty of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran
| | | | - Mojgan Mirghafourvand
- Social Determinants of Health Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.
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Association Between Gestational Diabetes and Mental Illness. Can J Diabetes 2020; 44:566-571.e3. [PMID: 32792108 DOI: 10.1016/j.jcjd.2020.06.014] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/29/2019] [Revised: 06/16/2020] [Accepted: 06/17/2020] [Indexed: 12/19/2022]
Abstract
The rates of both gestational diabetes mellitus (GDM) and mental illness in pregnancy are rising. There is an association between type 2 diabetes and major depressive disorder, anxiety and schizophrenia, thus there is a need for greater understanding of the relationship between GDM and mental illness. This review suggests that there is a bidirectional and complex relationship between antenatal depression, gestational diabetes and postpartum depression. The combined effect of both a history of depression and gestational diabetes significantly increases the risk of postpartum depression. There is an association between severe mental illness and GDM; however, it is strongly mediated by antipsychotic medications and psychosocial factors, in addition to the disease itself. Medication has a major role in treating mental illness during pregnancy and is not directly linked with GDM in either depression or psychosis. Health-care providers should be mindful of the association between GDM and mental illness to appropriately screen and treat both disorders.
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Ijabi J, Afrisham R, Moradi-Sardareh H, Roozehdar P, Seifi F, Ijabi R. The Correlation of SKA2 with Cortisol, IL-1β and Anxiety in Pregnant Women with the Risk of Preterm Delivery. Psychiatry Investig 2020; 17:387-394. [PMID: 32375462 PMCID: PMC7265031 DOI: 10.30773/pi.2019.0127] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2019] [Accepted: 12/18/2019] [Indexed: 01/08/2023] Open
Abstract
OBJECTIVE The association between preterm birth (PTB), Spindle and Kinetochore Associated Complex Subunit 2 gene (SKA2), cortisol and anxiety have been shown, but in this study, we aimed to clarify whether the expression of the SKA2 gene plays a role in interleukin1β (IL-1β) level since increasing level of IL-1β is linked with PTB. METHODS The case-control study was conducted on 49 and 51 women with preterm and term delivery, respectively. The score of anxiety was ranked according to the Spielberger state trait Anxiety Inventory. The concentration of cortisol and IL-1β was determined by the ELISA method. The expression of SKA2 gene was assessed by the quantitative real time real time polymerase chain reaction (qRT-PCR). The western blot analysis was also performed to confirm the expression of SKA2 at the levels of protein. RESULTS The results showed that the gene/protein expression of SKA2, the concentrations of cortisol and IL-1β were significantly higher in the preterm than the term group. In the preterm group, the expression of SKA2 was positively correlated to the other factors including cortisol, IL-1β, and the degree of anxiety. CONCLUSION Our findings suggest that the expression of SKA2 was correlated positively to the levels of cortisol, IL-1β and the rate of anxiety in women with PTB.
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Affiliation(s)
- Janat Ijabi
- Department of Hematology, School of Allied Health, Iran University of Medical Sciences, Tehran, Iran
| | - Reza Afrisham
- Department of Clinical Biochemistry, Faculty of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Hemen Moradi-Sardareh
- Department of Clinical Biochemistry, Faculty of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Parisa Roozehdar
- Department of Medical Veterinary, Azad University, Garmsar Branch, Garmsar, Iran
| | - Fatemeh Seifi
- Counseling and Reproductive Health Research Centre, Golestan University of Medical Sciences, Gorgan, Iran
| | - Roghayeh Ijabi
- Counseling and Reproductive Health Research Centre, Golestan University of Medical Sciences, Gorgan, Iran
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Neonatal outcomes and its association among gestational diabetes mellitus with and without depression, anxiety and stress symptoms in Malaysia: A cross-sectional study. Midwifery 2019; 81:102586. [PMID: 31830674 DOI: 10.1016/j.midw.2019.102586] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2019] [Revised: 11/19/2019] [Accepted: 11/20/2019] [Indexed: 12/15/2022]
Abstract
OBJECTIVE Prevalence of depression, anxiety and stress symptoms in gestational diabetes mellitus ranges from 10.2% to 39.9% based on previous studies in Malaysia. Presence of depression, anxiety or stress in pregnancy may increase the risk of neonatal morbidity and mortality. The aim of this study was to determine the prevalence of neonatal outcomes and its association among mothers with gestational diabetes mellitus with and without the presence of depression, anxiety and stress symptoms in Malaysia. DESIGN This was a cross-sectional study. SETTING Tertiary hospitals in Malaysia. PARTICIPANTS Mothers with gestational diabetes mellitus (n = 418) who deliver their neonates at two major tertiary hospitals in Malaysia. MEASUREMENTS Neonatal outcomes, such as low birth weight, preterm birth, macrosomia, metabolic and electrolyte disorders, neonatal respiratory distress and congenital anomalies were determined. FINDINGS Prevalence of low birth weight in neonates born to mothers with gestational diabetes mellitus was 14.6%, followed by metabolic and electrolyte disorders 10.5%, preterm birth 9.1%, macrosomia 4.8%, neonatal respiratory distress 5.8% and congenital anomalies (2.4%). Among the adverse neonatal outcomes, neonatal respiratory distress was significantly associated with the presence of depression symptoms in mothers with gestational diabetes mellitus using univariate analysis (p = 0.010). After controlling for confounding factors, predictors for neonatal respiratory distress at delivery were the presence of depression symptoms in mothers with gestational diabetes mellitus (Adjusted OR = 3.87, 95% CI = 1.32-11.35), living without a husband (Adjusted OR = 9.74, 95% CI = 2.04-46.51), preterm delivery (Adjusted OR = 7.20, 95% CI = 2.23-23.30), caesarean section (Adjusted OR = 3.33, 95% CI = 1.09-10.15), being nulliparous and primiparous (Adjusted OR = 3.62, 95% CI = 1.17-11.17) and having family history of diabetes (Adjusted OR = 3.20, 95% CI = 1.11-9.21). KEY CONCLUSIONS The findings of this study demonstrate the positive association of neonatal respiratory distress with the presence of depression symptoms in mothers with gestational diabetes mellitus. IMPLICATIONS FOR PRACTICE It is therefore important to identify depression symptoms after a diagnosis of gestational diabetes mellitus in pregnant mothers is made to enable early referral and interventions.
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McCoyd JLM, Curran L, Munch S. They Say, “If You Don’t Relax…You’re Going to Make Something Bad Happen”: Women’s Emotion Management During Medically High-Risk Pregnancy. PSYCHOLOGY OF WOMEN QUARTERLY 2019. [DOI: 10.1177/0361684319883199] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Little is known about how women with medically high-risk pregnancy manage their emotions while worried about their pregnancies. This study aimed to phenomenologically explore 16 hospitalized women’s emotional reactions and coping during medically high-risk pregnancy with a focus on how emotion management techniques were utilized and what rationales women used for employing them, along with their interpretations of health care providers’ and family members’ advice regarding emotional expression. Respondents universally feared that experienced stress and the resulting distress (negative emotions such as anxiety, sadness, and anger) could harm their fetus. They experienced double binds including believing they must “be positive” to enhance fetal health, despite anxiety and sadness; feeling responsible for housework yet being told not to do it; and needing medical treatments they feared would harm their fetus. In attempting to avoid tears and fears, they expended tremendous energy, leaving themselves depleted and less able to cope. Ubiquitous “think positive” messages amplify women’s sense of failure when distress due to the medically high-risk pregnancy spills over. With little attention to women’s emotional experiences, even to the point of complimenting them as “good incubators,” health care providers may unintentionally shift emotional labor onto vulnerable women. Understanding women’s needs for assistance with emotion management during medically high-risk pregnancy provides important guidance for development of best practices for this population.
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Affiliation(s)
- Judith L. M. McCoyd
- School of Social Work, Rutgers, The State University of New Jersey, New Brunswick, NJ, USA
| | - Laura Curran
- School of Social Work, Rutgers, The State University of New Jersey, New Brunswick, NJ, USA
| | - Shari Munch
- School of Social Work, Rutgers, The State University of New Jersey, New Brunswick, NJ, USA
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