Pre-pregnancy complications - associated factors and wellbeing in early pregnancy: a Swedish cohort study

BACKGROUND

Many couples experience difficulties to become pregnant or carry a pregnancy to term due to unknown causes. Here we define pre-pregnancy complications as having prior recurrent pregnancy loss, prior late miscarriages, time to pregnancy more than one year, or the use of artificial reproductive technologies. We aim to identify factors associated with pre-pregnancy complications and poor well-being in early pregnancy.

METHODS

Online questionnaire data from 5330 unique pregnancies in Sweden were collected from November 2017 - February 2021. Multivariable logistic regression modelling was used to investigate potential risk factors for pre-pregnancy complications and differences in early pregnancy symptoms.

RESULTS

Pre-pregnancy complications were identified in 1142 participants (21%). Risk factors included diagnosed endometriosis, thyroid medication, opioids and other strong pain medication, body mass index > 25 kg/m² and age over 35 years. Different subgroups of pre-pregnancy complications had unique risk factors. The groups also experienced different pregnancy symptoms in early pregnancy, where women that had experienced recurrent pregnancy loss were at higher risk of depression in their current pregnancy.

CONCLUSION

We report one of the largest pregnancy cohorts with high frequency of pre-pregnancy complications compared to the Swedish population. Prescribed drug use and body weight were the top potentially modifiable risk factors in all groups. Participants that experienced pre-pregnancy complications also had higher risk of depression and pregnancy problems in early pregnancy.

Fatigue During Pregnancy: A Bibliometric Analysis

OBJECTIVE

This study uses a systematic review with bibliometric analysis methods to investigate the characteristics of the most cited research papers in the field of nursing fatigue and pregnancy.

METHODS

In the Web of Science (WoS) database. We used the keywords "fatigue" and "pregnancy" to search for articles published from 2000 to 2020, limited to SSCI and Science Citation Index (SCI) journal-type articles. This study identifies the most cited studies in the WoS database based on PRISMA guidelines (Preferred reporting items for systematic reviews and meta-analyses). These studies form the research data, then visualized and analyzed using a retrospective bibliometric analysis and VOSviewer.

RESULTS

The studies in the dataset were analyzed in 319 different journals in 51 countries between 2000 and 2020. The study was found that the United States (US) was the country with the highest yield. The most frequent keywords were postpartum, depression, sleep, and postpartum depression.

CONCLUSION

The research results further laid the foundation of bibliometrics for scholars and identified researchers, scientific journals, countries, and hot topics for fatigue-related pregnancy literature. Journals with high impact factors contain the most cited research and open new horizons for research in the nursing field of pregnancy-related fatigue, thus providing research inspiration for investigators in this field.

The association of a past childbirth experience with a variety of early physical and mental symptoms in subsequent pregnancies

BACKGROUND

Some women have a perceived negative experience of childbirth due to various reasons- e.g., obstetric complications or the feeling of loss of control. We do not know enough about the effects of a perceived negative experience of a childbirth on a woman's subsequent pregnancies. The aim of this study was to investigate whether a previously perceived negative childbirth experience affects a woman's physical and mental well-being in a later pregnancy.

METHODS

A prospective cohort study in Danish general practice, based on information about women's childbirth experiences from the Pregnancy Health Record filled in by the general practitioner (GP) and data from an electronic questionnaire completed by the women.

RESULTS

A total of 1288 women were included in the analysis. Women who had given birth before were found to have a significantly higher risk of experiencing nausea, varicose veins and uterine contractions, and a lower risk of pelvic cavity pain in the current pregnancy. Women having given birth before were significantly more likely to assess their physical fitness as poor and to experience poor well-being. Women with a perceived negative experience of childbirth had more sleep problems and a higher prevalence of poor self-rated health than women with unproblematic childbirth experience.

CONCLUSION

This study showed that women with a previously perceived negative experience of childbirth are affected according to their mental health in their subsequent pregnancy.

Turkish translation, cross-cultural adaptation, and psychometric validation of the pregnancy symptoms inventory: An instrument to assess the full spectrum of pregnancy symptoms

OBJECTIVE

To translate the PSI (Pregnancy Symptoms Inventory) into Turkish, to perform its cultural adaptation, to establish its reliability and validity, and to examine the prevalence of perceived pregnancy symptoms frequency and symptom-related limitation in Turkish pregnant women.

DESIGN

This cross-sectional study included healthy pregnant women over 18 years old from all 3 pregnancy trimesters. In the reliability analysis, the test-retest reliability was investigated by the Pearson correlation analysis. For the criterion validity of the PSI, correlations between the total pregnancy symptom frequency scores and the total scores of the Tilburg Pregnancy Distress Scale, the State-Trait Anxiety Inventory, the Beck Depression Inventory, and the Nottingham Health Profile were analyzed. Frequency and limitation perception prevalence of the symptoms were calculated as a percentage based on the response to each symptom. Statistical significance level was accepted as p<0.05.

MEASUREMENTS AND FINDINGS

In the present study, 210 pregnant women participated, and 42 pregnant women filled out the Turkish-PSI twice for the test-retest analysis. In the frequency and limitation sections of the PSI, the test-retest correlations for each symptom were found to vary between medium and very strong (0.42-1.00 and 0.39-1.00, p <0.05, respectively). Moderate correlations (rho = 0.39-0.58, p <0.05, p ≤ 0.001) were detected between the frequency section total score and the total scores of the other scales. The top four symptoms indicated as "often" by the Turkish pregnant women were urinary frequency (42.4%), fatigue/tiredness (28.6%), increased vaginal discharge (26.7%), and upper/lower back pain (23.8%).

KEY CONCLUSIONS

The Turkish-PSI is a comprehensive, reliable, and valid inventory for evaluating a wide range of pregnancy symptoms in Turkish pregnant women. Further studies are needed to examine the sensitivity of the Turkish-PSI to treatment-induced changes.

IMPLICATIONS FOR PRACTICE

Comprehensive and practical symptom questioning tools such as the PSI during pregnancy can lead to the early detection of pregnancy symptoms and to initiate effective non-pharmacological interventions.