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Park S, Cho HY, Park JY, Chung K, Jhung K. Development and Evaluation of a Mindfulness-Based Mobile Intervention for Perinatal Mental Health: Randomized Controlled Trial. J Med Internet Res 2025; 27:e56601. [PMID: 39823585 PMCID: PMC11786135 DOI: 10.2196/56601] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2024] [Revised: 09/29/2024] [Accepted: 11/28/2024] [Indexed: 01/19/2025] Open
Abstract
BACKGROUND Perinatal mental health problems, such as anxiety, stress, and depression, warrant particularly close monitoring and intervention, but they are often unaddressed in both obstetric and psychiatric clinics, with limited accessibility and treatment resources. Mobile health interventions may provide an effective and more accessible solution for addressing perinatal mental health. Development and evaluation of a mobile mental health intervention specifically for pregnant women are warranted. OBJECTIVE This study aimed to evaluate the effectiveness of a 4-week, self-administered mobile mindfulness intervention in reducing anxiety, depression, and stress, and improving emotional well-being, maternal-fetal attachment, and mindfulness skills in a general population of pregnant women. METHODS Pregnant women were recruited and randomized to an intervention or a wait-list control group. The intervention group participated in a self-administered 4-week smartphone-based mindfulness program. Anxiety, depression, and stress were assessed as primary outcomes at baseline and postintervention. Secondary outcomes were mental health well-being, maternal-fetal attachment, and skills of mindfulness. The usability of the mobile intervention was also evaluated. RESULTS A total of 133 pregnant women were randomly assigned to the intervention (n=66) or the control group (n=67). The overall dropout rate was 30% (39/133). Anxiety scores of the intervention group significantly decreased from baseline to postintervention (P=.03, Wilcoxon Signed-Rank test), whereas no significant changes were observed in the control group. Depression and stress scores showed no significant changes. Emotional well-being significantly improved in the intervention group (P=.01). Improvements were observed in maternal-fetal attachment, particularly in attributing characteristics to the fetus (P=.003) and in differentiating the self from the fetus (P=.006). Mindfulness awareness also showed significant improvement (P=.008). Significant between-group effects were identified for mindfulness awareness (P=.006) and attributing characteristics to the fetus (P=.002). After applying the false discovery rate corrections, within-group improvements in emotional well-being, maternal-fetal attachment, and mindfulness awareness remained significant, while between-group differences for emotional well-being and differentiation were not significant. CONCLUSIONS A mobile mindfulness program effectively reduced anxiety and improved emotional well-being, maternal-fetal attachment, and mindfulness awareness in the general population of pregnant women. Mobile interventions may offer a cost-effective and feasible method for promoting perinatal mental health. TRIAL REGISTRATION Clinical Research Information Service KCT0007166; https://tinyurl.com/458vfc4r.
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Affiliation(s)
- Sehwan Park
- Biomedical Research Institute, Catholic Kwandong University International St. Mary's Hospital, Incheon, Republic of Korea
- Medical Research Team, Digital Medic co., Ltd., Seoul, Republic of Korea
| | - Hee Young Cho
- Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Jin Young Park
- Department of Psychiatry, Yongin Severance Hospital, Yonsei University College of Medicine, Yonsei University Health System, Yongin, Republic of Korea
- Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, Yonsei University Health System, Seoul, Republic of Korea
- Center for Digital Health, Yongin Severance Hospital, Yonsei University College of Medicine, Yonsei University Health System, Yongin, Republic of Korea
| | - Kyungmi Chung
- Department of Psychiatry, Yongin Severance Hospital, Yonsei University College of Medicine, Yonsei University Health System, Yongin, Republic of Korea
- Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, Yonsei University Health System, Seoul, Republic of Korea
- Center for Digital Health, Yongin Severance Hospital, Yonsei University College of Medicine, Yonsei University Health System, Yongin, Republic of Korea
| | - Kyungun Jhung
- Department of Psychiatry, Catholic Kwandong University International St. Mary's Hospital, Catholic Kwandong University College of Medicine, Incheon, Republic of Korea
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Kułak-Bejda A, Avci Aydin I, Çelik Eren D, Kourkouta L, Tsaloglidou A, Koukourikos K, Szpakow A, Khvoryk N, Hutsikava L, Waszkiewicz N. Impact of Pregnancy on Self-Efficacy and Personal Competence in the Context of Risk of Depression, Mental Health Status, and Satisfaction with Life. J Clin Med 2024; 13:533. [PMID: 38256666 PMCID: PMC10816068 DOI: 10.3390/jcm13020533] [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: 11/22/2023] [Revised: 01/07/2024] [Accepted: 01/10/2024] [Indexed: 01/24/2024] Open
Abstract
For many women, pregnancy and childbirth are often accompanied by strong emotions related to fear, stress, and anxiety about the health of the woman and her child. This study aimed to assess the effect of pregnancy on the risk of depression, mental health status, and satisfaction with life in women in Poland, Greece, Turkey, Belarus, and Russia. MATERIAL AND METHODS A cross-sectional comparative study was conducted among 2017 women surveyed, including 584 pregnant women, 528 postpartum women, and 906 women who had never been pregnant (the comparative group) from Poland, Greece, Turkey, Belarus, and Russia. The sample selection was purposive. Surveys were collected between November 2021 and December 2022. The study used the Beck Depression Inventory (BDI) Scale, the Satisfaction with Life Scale (SWLS), the Edinburgh Postpartum Depression Scale (EPDS), the GHQ-28 (General Health Questionnaire), the Schwarzer Generalized Self-Efficacy Scale (GSES), and the KompOs Personal Competence Scale. RESULTS A significantly lower risk of depression was observed in postpartum women in Poland and amongst pregnant women in Turkey. Pregnant women in Turkey (28.9 points) presented the highest satisfaction with life, while the lowest satisfaction was found amongst pregnant women in Poland and Greece (25.2 and 25.1 points, respectively). In Poland and Belarus, a higher risk of depression was noticed in women who had undergone an artificial abortion. In Turkey, a positive correlation was found in pregnant women concerning the number of children they had with a measure of depression and a negative correlation with life satisfaction. In Greece, non-pregnant women showed no correlation between mental status and scores on the GSES. Scores on satisfaction with SWLS were positively correlated with a sense of power, and the strength of the correlation was similar to results on the BDI and GHQ measures. Postpartum depression, according to the EPDS, was also the most severe in Turkish women. CONCLUSIONS The highest risk of depression was shown in the control group and amongst pregnant and postpartum women in Turkey and Greece, and the lowest such risk was in Poland. Pregnant and postpartum women showed by far the highest satisfaction with life in Turkey and the lowest in women from Greece. The risk of depression, the level of satisfaction with life, and the mental health of pregnant women were not influenced by the type of last delivery. However, the duration of the last delivery influenced the group from Belarus, and having children affected the mental health of women in the group from Turkey.
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Affiliation(s)
| | - Ilknur Avci Aydin
- Nursing, School of Health, Ondokuz Mayis University, Samsun 55139, Turkey; (I.A.A.); (D.Ç.E.)
| | - Dilek Çelik Eren
- Nursing, School of Health, Ondokuz Mayis University, Samsun 55139, Turkey; (I.A.A.); (D.Ç.E.)
| | - Lambrini Kourkouta
- Department of Nursing, International Hellenic University, 57400 Sindos, Greece; (L.K.); (A.T.); (K.K.)
| | - Areti Tsaloglidou
- Department of Nursing, International Hellenic University, 57400 Sindos, Greece; (L.K.); (A.T.); (K.K.)
| | - Konstantinos Koukourikos
- Department of Nursing, International Hellenic University, 57400 Sindos, Greece; (L.K.); (A.T.); (K.K.)
| | - Andriej Szpakow
- Department of Integrated Medical Care, Medical University of Bialystok, 15269 Bialystok, Poland;
| | - Natallia Khvoryk
- Department of Obstetrics and Gynecology, Grodno State Medical University, 230009 Grodno, Belarus; (N.K.); (L.H.)
| | - Liudmila Hutsikava
- Department of Obstetrics and Gynecology, Grodno State Medical University, 230009 Grodno, Belarus; (N.K.); (L.H.)
| | - Napoleon Waszkiewicz
- Department of Psychiatry, Medical University of Bialystok, 15269 Bialystok, Poland;
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Huang CJ, Han W, Huang CQ. Effect of Internet + continuous midwifery service model on psychological mood and pregnancy outcomes for women with high-risk pregnancies. World J Psychiatry 2023; 13:862-871. [DOI: 10.5498/wjp.v13.i11.862] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Revised: 09/05/2023] [Accepted: 10/25/2023] [Indexed: 11/17/2023] Open
Abstract
BACKGROUND There are many drawbacks to the traditional midwifery service management model, which can no longer meet the needs of the new era. The Internet + continuous midwifery service management model extends maternal management from prenatal to postpartum, in-hospital to out-of-hospital, and offline to online, thereby improving maternal and infant outcomes. Applying the Internet + continuous midwifery service management model to manage women with high-risk pregnancies (HRP) can improve their psycho-emotional opinion and, in turn, minimize the risk of adverse maternal and/or fetal outcomes.
AIM To explore the effectiveness of a midwife-led Internet + continuous midwifery service model for women with HRP.
METHODS We retrospectively analyzed the clinical data of 439 women with HRP who underwent prenatal examination and delivered at Shanghai Sixth People's Hospital (affiliated to the Shanghai Jiao Tong University School of Medicine) from April to December 2022. Among them, 239 pregnant women underwent routine obstetric management, and 200 pregnant women underwent Internet + continuous midwifery service mode management. We used the State-Trait Anxiety Inventory, Edinburgh Postnatal Depression Scale, and analysis of delivery outcomes to compare psychological mood and the incidence of adverse delivery outcomes between the two groups.
RESULTS The data showed that in early pregnancy, the anxiety and depression levels of the two groups were similar; the levels gradually decreased as pregnancy progressed, and the decrease in the continuous group was more significant [31.00 (29.00, 34.00) vs 34.00 (32.00, 37.00), 8.00 (6.00, 9.00) vs 12.00 (10.00, 13.00), P < 0.05]. The maternal self-efficacy level and strategy for weight gain management were better in the continuous group than in the traditional group, and the effective rate of midwifery service intervention in the continuous group was significantly higher than in the control group [267.50 (242.25, 284.75) vs 256.00 (233.00, 278.00), 74.00 (69.00, 78.00) vs 71.00 (63.00, 78.00), P < 0.05]. The incidence of adverse delivery outcomes in pregnant women and newborns and fear of maternal childbirth were lower in the continuous group than in the traditional group, and nursing satisfaction was higher [10.50% vs 18.83%, 8.50% vs 15.90%, 24.00% vs 42.68%, 89.50% vs 76.15%, P < 0.05].
CONCLUSION The Internet + continuous midwifery service model promotes innovation through integration and is of great significance for improving and promoting maternal and child health in HRP.
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Affiliation(s)
- Cao-Jun Huang
- Delivery Room, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai 200233, China
| | - Wei Han
- Department of Maternity Ward, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai 200233, China
| | - Cui-Qin Huang
- Department of Maternity Ward, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai 200233, China
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Kılıç S, Dereli Yılmaz S. Virtual Reality Headset Simulating a Nature Environment to Improve Health Outcomes in Pregnant Women: A Randomized-Controlled Trial. Clin Nurs Res 2023; 32:1104-1114. [PMID: 37408298 DOI: 10.1177/10547738231184923] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/07/2023]
Abstract
The single-blind randomized-controlled experimental study aimed to determine the effects of watching nature images through virtual reality (VR) headset on stress, anxiety, and attachment levels of pregnant women with preterm birth threats (PBTs). The participants were 131 primiparous pregnant women admitted to the perinatology clinic due to PBT between April 5, 2022 and July 20, 2022. The intervention group watched videos containing nature images accompanied by nature sounds in six sessions through VR headset three times daily for 2 days. Each session lasted for 5 min. The data were accumulated with the Information Form, Stress Subscale of Depression Anxiety Stress Scale-21, State Anxiety Inventory, Prenatal Attachment Inventory, and Information Form of Satisfaction Level of VR Headset. State anxiety and stress levels of pregnant women in intervention group were statistically significantly lower than those in controls. There was no difference in prenatal attachment levels concerning intragroup comparisons of intervention group.
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Wang XJ, Li XT, Chen N, Huang L, Huang SX, Chen TT, Liu GH, Hu RF. Mental health, sleep quality, and hormonal circadian rhythms in pregnant women with threatened preterm labor: a prospective observational study. BMC Pregnancy Childbirth 2023; 23:501. [PMID: 37420176 DOI: 10.1186/s12884-023-05801-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2022] [Accepted: 06/20/2023] [Indexed: 07/09/2023] Open
Abstract
BACKGROUND Threatened preterm labor (TPL) is an important obstetrical challenge. Pregnant women with TPL may develop psychological and physical problems such as mental health disorders, sleep disturbance, and hormonal circadian rhythm disruption. This study aimed to investigate the current state of mental health, sleep quality, and circadian rhythms of cortisol and melatonin secretion in pregnant women with TPL and normal pregnant women (NPW). METHODS A prospective observational clinical study was conducted at a maternal and child health hospital in Fuzhou, China, between June and July 2022. A total of 50 women between 32 and 36 weeks of gestation (TPL group, n = 20; NPW group, n = 30) were recruited. Data on anxiety symptom (Zung's Self-rating Anxiety Scale, SAS), depression symptom (Edinburgh Postnatal Depression Scale, EPDS), subjective sleep quality (Pittsburgh Sleep Quality Index, PSQI) and objective sleep outcomes (measured by actigraphy) of the pregnant women were collected at the time of enrolment. Salivary samples were collected once every 6 h (i.e., at 06:00, 12:00, 18:00, and 00:00) during 2 consecutive days to measure the circadian rhythm of hormone (cortisol and melatonin). RESULTS There were no differences found in the total scores of SAS, EPDS scores, subjective sleep quality between the TPL and NPW groups (P > 0.05). In contrast, significant differences were found in sleep efficiency, total sleep time, wake time after sleep onset, and average awakening time between the groups (P < 0.05). The circadian rhythm of melatonin secretion was disrupted in the TPL group (P = 0.350); however, it was maintained in the NPW group (P = 0.044). The circadian rhythm of cortisol secretion was disrupted in both groups (P > 0.05). CONCLUSIONS In the third trimester of pregnancy, women with TPL suffer from poorer sleep quality and disruption of circadian rhythm of melatonin secretion compared with NPW. Nevertheless, there were no differences found in mental health (i.e., anxiety and depression) and circadian rhythm of cortisol secretion. Large-scale studies should be conducted to evaluate these changes in women with TPL. TRIAL REGISTRATION The study was registered from Chinese Clinical Trial Registry (Number: ChiCTR2200060674) on 07/06/2022.
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Affiliation(s)
- Xiao-Juan Wang
- School of Nursing, Fujian Medical University, 1 Xue Yuan Road, University Town, Fujian, Fuzhou, China
| | - Xiao-Ting Li
- School of Nursing, Fujian Medical University, 1 Xue Yuan Road, University Town, Fujian, Fuzhou, China
| | - Na Chen
- School of Nursing, Fujian Medical University, 1 Xue Yuan Road, University Town, Fujian, Fuzhou, China
| | - Long Huang
- School of Nursing, Fujian Medical University, 1 Xue Yuan Road, University Town, Fujian, Fuzhou, China
| | - Shui-Xiu Huang
- School of Nursing, Fujian Medical University, 1 Xue Yuan Road, University Town, Fujian, Fuzhou, China
| | - Ting-Ting Chen
- School of Nursing, Fujian Medical University, 1 Xue Yuan Road, University Town, Fujian, Fuzhou, China
| | - Gui-Hua Liu
- School of Nursing, Fujian Medical University, 1 Xue Yuan Road, University Town, Fujian, Fuzhou, China.
| | - Rong-Fang Hu
- School of Nursing, Fujian Medical University, 1 Xue Yuan Road, University Town, Fujian, Fuzhou, China.
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Varela P, Lykeridou A, Zervas I, Deltsidou A. Psychometric properties of the Greek Version of the Traumatic Event Scale (TES) (Version A) among low-risk pregnant women. BMC Psychol 2023; 11:105. [PMID: 37029446 PMCID: PMC10082481 DOI: 10.1186/s40359-023-01152-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Accepted: 03/30/2023] [Indexed: 04/09/2023] Open
Abstract
BACKGROUND The Traumatic Event Scale (TES) is one of the most often used instruments for the assessment of the Posttraumatic Stress Disorder (PTSD) symptomatology during pregnancy which is linked with adverse effects. The aim of the study was to assess the psychometric properties of the TES (version A) in a sample of Greek pregnant women. METHODS Two hundred one low risk pregnant women in their second or third trimester were invited to participate in the study. Participants completed a number of questionnaires including the Greek versions of TES-A, State-Trait Anxiety Inventory (STAI), Coping Orientations to Problems Experienced (Brief COPE), Perceived Stress Scale (PSS-10) and Edinburgh Postnatal Depression Scale (EPDS). Confirmatory factor analysis (CFA) was conducted in order to test how well the already TES-A five-factor model fits the data from Greece. RESULTS Participants' average age was 34.2 years (SD = 4.3 years). Through CFA the already five-factor structure of the TES-A (Anticipation of trauma, Intrusion, Avoidance, Resignation, Hyperstimulation) was applied to our sample. All five factors were significantly and positively correlated with each other. All Cronbach's alpha were over 0.7, indicating acceptable reliability of the factors. Relatively convergent validity, all factors of the Greek version of the TES-A were significantly associated with stress, anxiety, depression and coping strategies. CONCLUSION The Greek version of TES-A is detected to be a valid and reliable instrument of prenatal Posttraumatic Stress Disorder (PTSD) symptomatology among low-risk Greek pregnant women.
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Affiliation(s)
- Pinelopi Varela
- General Hospital of Athens "Alexandra", Department of Midwifery, University of West Attica, Athens, Greece.
| | | | - Ioannis Zervas
- Professor of Psychiatry and Psychosomatic Medicine, Head of the Women's mental health and reproductive psychiatric clinic, National and Kapodistrian University of Athens Medical School, Eginition University Hospital, Athens, Greece
| | - Anna Deltsidou
- Department of Midwifery, University of West Attica, Athens, Greece
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Guillen-Burgos HF, Galvez-Florez JF, Miranda J, Hincapie-Porras C, Perez-Olivo JL, Piraquive-Caicedo JP, Becerra-Mojica CH, Parra-Ardila SX, Parra-Saavedra MA. Pregnancy and mental health outcomes during the COVID-19 pandemic in Colombia: A nationwide cross-sectional study. JOURNAL OF AFFECTIVE DISORDERS REPORTS 2023; 12:100488. [PMID: 36718157 PMCID: PMC9877320 DOI: 10.1016/j.jadr.2023.100488] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2022] [Revised: 01/19/2023] [Accepted: 01/25/2023] [Indexed: 01/27/2023] Open
Affiliation(s)
- Hernan Felipe Guillen-Burgos
- Center for Clinical and Translational Research, La Misericordia Clínica Internacional, Barranquilla, Colombia.,School of Health Sciences, Universidad Simon Bolivar, Barranquilla, Colombia.,Instituto Cardiovascular del Cesar, Valledupar, Atlántico
| | - Juan Francisco Galvez-Florez
- Center for Clinical and Translational Research, La Misericordia Clínica Internacional, Barranquilla, Colombia.,Latin American Society of Consultation-Liaison Psychiatry, Bogota, Colombia
| | - Jezid Miranda
- Department of Obstetrics and Gynecology, School of Medicine, Grupo de Investigación en Cuidado Intensivo y Obstetricia (GRICIO), Universidad de Cartagena, Cartagena de Indias, Bolívar, Colombia.,Department of Maternal-Fetal Medicine, Centro Hospitalario Serena del Mar, Cartagena de Indias, Bolívar, Colombia
| | - Cristian Hincapie-Porras
- Department of Obstetrics and Gynecology, Hospital Universitario San Jorge, Pereira, Risaralda, Colombia
| | - Jose L Perez-Olivo
- Department of Obstetrics and Gynecology, Clínica La Ermita, Cartagena de Indias, Colombia
| | | | - Carlos H Becerra-Mojica
- Centro de Atención Maternofetal INUTERO, Clínica Carlos Ardila Lulle, Bucaramanga, Santander, Colombia.,Department of Obstetrics and Gynecology, School of Medicine, Universidad Industrial de Santander. Bucaramanga, Santander, Colombia
| | - Sonia X Parra-Ardila
- Instituto de Cirugía y Terapia Fetal del Caribe, Barranquilla, Atlántico, Colombia
| | - Miguel A Parra-Saavedra
- School of Health Sciences, Universidad Simon Bolivar, Barranquilla, Colombia.,Instituto de Cirugía y Terapia Fetal del Caribe, Barranquilla, Atlántico, Colombia
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Ribeiro GDM, Cieto JF, Silva MMDJ. Risk of depression in pregnancy among pregnant women undergoing high-risk prenatal care. Rev Esc Enferm USP 2022; 56:e20210470. [PMID: 35858012 PMCID: PMC10081607 DOI: 10.1590/1980-220x-reeusp-2021-0470en] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Accepted: 05/31/2022] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE to identify the risk of depression in pregnancy among pregnant women undergoing follow-up in high-risk prenatal care, to assess the factors associated with higher risk of depression in pregnancy and to compare the risk of depression in each gestational trimester. METHOD this is a descriptive, correlational, cross-sectional study, conducted with 151 pregnant women in prenatal care in a high-risk pregnancy outpatient clinic at a university hospital in the state of São Paulo, Brazil. Data were collected through an online form. Chi-square and Fisher's exact tests were performed. After the bivariate analysis, the variables were included in the logistic regression model. In the final model, the Odds Ratio was calculated. RESULTS 118 (78.1%) pregnant women had a higher risk of depression during pregnancy, which was higher in the first trimester, but without statistical significance. The number of pregnancies (OR = 0.32) and marital status (OR = 0.07) remained significantly associated with higher risk of depression during pregnancy as protective factors. CONCLUSION the results elucidate the importance of screening for depression risk and the significant need to improve access to effective interventions for preventing prenatal depression and promoting mental health.
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Affiliation(s)
| | - Julia Ferreira Cieto
- Universidade de São Paulo, Escola de Enfermagem de Ribeirão Preto, Ribeirão Preto, SP, Brazil
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Smorti M, Gemignani A, Bonassi L, Mauri G, Carducci A, Ionio C. The impact of Covid-19 restrictions on depressive symptoms in low-risk and high-risk pregnant women: a cross-sectional study before and during pandemic. BMC Pregnancy Childbirth 2022; 22:191. [PMID: 35260098 PMCID: PMC8902730 DOI: 10.1186/s12884-022-04515-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2021] [Accepted: 02/03/2022] [Indexed: 11/10/2022] Open
Abstract
Background The COVID-19 social restrictions have increased the risk for depression compared to the previous period in Italian women with Low-Risk Pregnancy (LRP). lLess is known about the impact of COVID-19 restrictions on High-Risk Pregnancy (HRP). This study aimed: 1) to explore levels of depression in women who become pregnant before and during COVID-19 pandemic, distinguishing between LRP and HRP; 2) to analyze the impact of COVID-19 restrictions on pregnancy experience in LRP and HRP. Methods A before-during COVID-19 pandemic cross-sectional study was carried out on 155 pregnant women (Mean age = 34.18), between 23 and 32 weeks of gestation. 77 women were recruited before COVID-19 pandemic (51.9% LRP; 48.1% HRP) and 78 women were recruited during COVID-19 pandemic (51.3% LRP; 48.7% HRP). HRP group was enrolled during hospitalization for high-risk pregnancy. Participants filled out Edinburgh Postnatal Depression Scale. Moreover, only COVID-19 group answered an open-ended question about the impact of restriction on pregnancy experience. Results HRP women reported higher levels of depressive symptoms than LRP. No difference emerged for COVID (before/during) but an interaction effect between COVID-19 and obstetric condition was found. The qualitative results showed the impact of restrictions on emotions and concerns. Conclusion Respect to the previous period, LRP women during COVID-19 presented an increased risk for depressive symptoms than HRP. The HRP women during COVID-19 seemed to use hospitalization as a resource to find a social support network with other pregnant women and to be reassured on the clinical ongoing of pregnancy.
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Affiliation(s)
- Martina Smorti
- Department of Surgical, Medical and Molecular Pathology and Critical Care Medicine, University of Pisa, Via Savi 10, 56126, Pisa, Italy.
| | - Angelo Gemignani
- Department of Surgical, Medical and Molecular Pathology and Critical Care Medicine, University of Pisa, Via Savi 10, 56126, Pisa, Italy
| | - Lucia Bonassi
- Department of Mental Health, ASST Bergamo-Est, Seriate, Italy
| | - Giulia Mauri
- Department of Surgical, Medical and Molecular Pathology and Critical Care Medicine, University of Pisa, Via Savi 10, 56126, Pisa, Italy
| | - Alessia Carducci
- Department of Surgical, Medical and Molecular Pathology and Critical Care Medicine, University of Pisa, Via Savi 10, 56126, Pisa, Italy
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Hamidia A, Kheirkhah F, Chehrazi M, Basirat Z, Ghadimi R, Barat S, Cuijpers P, O'Connor E, Mirtabar SM, Faramarzi M. Screening of psychiatric disorders in women with high-risk pregnancy: Accuracy of three psychological tools. Health Sci Rep 2022; 5:e518. [PMID: 35224219 PMCID: PMC8855636 DOI: 10.1002/hsr2.518] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2021] [Revised: 12/02/2021] [Accepted: 12/09/2021] [Indexed: 01/12/2023] Open
Abstract
PURPOSE This study investigated the optimal cutoff points of three psychological tools for screening psychiatric disorders in women with high-risk pregnancy. DESIGN AND METHODS In this cross-sectional study (N = 155), sensitivity/specificity of the Edinburgh Postnatal Depression Scale (EPDS), the Brief Symptom Inventory 53-items (BSI-53), and the BSI-18 were computed with respect to having a psychiatric diagnosis based on the clinical interview. RESULTS The usual cutoffs (≥13 for EPDS, T-score of 63 for BSI-53) demonstrated poor diagnostic accuracy. The optimal thresholds were computed for EPDS cutoff of 6.5, GSI = 0.47 for BSI-53, and GSI = 0.5 for BSI-18. PRACTICE IMPLICATIONS The use of psychological tools among pregnant women with high-risk pregnancy may need to be modified in order to accurately identify psychiatric disorders.
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Affiliation(s)
- Angela Hamidia
- Social Determinants of Health Research Center, Health Research Institute, Department of PsychiatryBabol University of Medical SciencesBabolIran
| | - Farzan Kheirkhah
- Social Determinants of Health Research Center, Health Research Institute, Department of PsychiatryBabol University of Medical SciencesBabolIran
| | - Mohammad Chehrazi
- Department of Biostatistics and Epidemiology, School of Public HealthBabol University of Medical SciencesBabolIran
| | - Zahra Basirat
- Infertility and Health Reproductive Research Center, Health Research Institute, Department of Obstetrics and GynecologyBabol University of Medical SciencesBabolIran
| | - Reza Ghadimi
- Social Determinants of Health Research Center, Health Research Institute, Social Medicine DepartmentBabol University of Medical SciencesBabolIran
| | - Shahnaz Barat
- Infertility and Health Reproductive Research Center, Health Research Institute, Department of Obstetrics and GynecologyBabol University of Medical SciencesBabolIran
| | - Pim Cuijpers
- Department of Clinical Neuro and Developmental Psychology, Amsterdam Public Health Research InstituteVrije Universiteit AmsterdamAmsterdamNetherlands
| | | | | | - Mahbobeh Faramarzi
- Social Determinants of Health Research Center, Health Research Institute, Department of General CoursesBabol University of Medical SciencesBabolIran
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Kazemi A, Dadkhah A. Changes in prenatal depression and anxiety levels in low risk pregnancy among Iranian women: A prospective study. Asia Pac Psychiatry 2022; 14:e12419. [PMID: 32875714 DOI: 10.1111/appy.12419] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2020] [Accepted: 08/17/2020] [Indexed: 01/05/2023]
Abstract
INTRODUCTION Increasing of depression and anxiety in high risk pregnancy is well known but there is limited information on the changes of psychological symptoms in low risk pregnancies and the aim of the study was evaluation depression and anxiety changes in pregnant women with high risk pregnancy. METHODS This prospective study was performed on 256 pregnant women at the beginning of the first trimester of pregnancy. Inclusion criteria included the absence of pre-pregnancy depression and anxiety and poor pregnancy history. Exclusion criteria were the incidence of pregnancy complications. The level of their depression and anxiety at the time of entering the study were completed by self-report using the DASS questionnaire at 9-10, 11-12, 24-25, and 33-35 weeks of pregnancy. RESULTS The results of the study indicated that the effect of time on the level of perinatal depression and anxiety was significant (P < .001). These findings showed that the level of depression increased significantly from 9 to 24 weeks of pregnancy and decreased in the 32-34 weeks, but did not reach the level of depression at 9 weeks of pregnancy. Also, the anxiety level increased significantly from the onset of pregnancy to the 24 weeks gestation but did not change during the second and third trimesters. CONCLUSION The results of the study showed that the level of depression and anxiety of women in low risk pregnancies increase during pregnancy and psychological health screenings in the second trimester of pregnancy should be performed in pregnant women.
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Affiliation(s)
- Ashraf Kazemi
- Reproductive Health Department, Nursing and Midwifery Care Research Center, School of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Aazam Dadkhah
- Reproductive Health Department, Isfahan University of Medical Sciences, Isfahan, Iran
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12
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Dawes L, Waugh JJS, Lee A, Groom KM. Psychological well-being of women at high risk of spontaneous preterm birth cared for in a specialised preterm birth clinic: a prospective longitudinal cohort study. BMJ Open 2022; 12:e056999. [PMID: 35232790 PMCID: PMC8889323 DOI: 10.1136/bmjopen-2021-056999] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/04/2021] [Accepted: 12/22/2021] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVES To assess the psychological well-being of pregnant women at increased risk of spontaneous preterm birth, and the impact of care from a preterm birth clinic. DESIGN Single-centre longitudinal cohort study over 1 year, 2018-2019. SETTING Tertiary maternity hospital in Auckland, New Zealand. PARTICIPANTS Pregnant women at increased risk of spontaneous preterm birth receiving care in a preterm birth clinic. INTERVENTION Participants completed three sets of questionnaires (State-Trait Anxiety Inventory, Edinburgh Postnatal Depression Scale, and 36-Item Short Form Survey)-prior to their first, after their second, and after their last clinic appointments. Study-specific questionnaires explored pregnancy-related anxiety and perceptions of care. PRIMARY AND SECONDARY OUTCOME MEASURES The primary outcome was the mean State-Anxiety score. Secondary outcomes included depression and quality of life measures. RESULTS 73/97 (75.3%) eligible women participated; 41.1% had a previous preterm birth, 31.5% a second trimester loss and 28.8% cervical surgery; 20.6% had a prior mental health condition. 63/73 (86.3%) women completed all questionnaires. The adjusted mean state-anxiety score was 39.0 at baseline, which decreased to 36.5 after the second visit (difference -2.5, 95% CI -5.5 to 0.5, p=0.1) and to 32.6 after the last visit (difference -3.9 from second visit, 95% CI -6.4 to -1.5, p=0.002). Rates of anxiety (state-anxiety score >40) and depression (Edinburgh Postnatal Depression Scale score >12) were 38.4%, 34.8%, 19.0% and 13.7%, 8.7%, 9.5% respectively, at the same time periods. Perceptions of care were favourable; 88.9% stated the preterm birth clinic made them significantly or somewhat less anxious and 87.3% wanted to be seen again in a future pregnancy. CONCLUSIONS Women at increased risk of spontaneous preterm birth have high levels of anxiety. Psychological well-being improved during the second trimester; women perceived that preterm birth clinic care reduced pregnancy-related anxiety. These findings support the ongoing use and development of preterm birth clinics.
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Affiliation(s)
- Lisa Dawes
- Liggins Institute, The University of Auckland, Auckland, New Zealand
- National Women's Health, Auckland City Hospital, Auckland, New Zealand
| | - Jason J S Waugh
- National Women's Health, Auckland City Hospital, Auckland, New Zealand
- Department of Obstetrics and Gynaecology, The University of Auckland, Auckland, New Zealand
| | - Arier Lee
- Section of Epidemiology and Biostatistics, The University of Auckland, Auckland, New Zealand
| | - Katie M Groom
- Liggins Institute, The University of Auckland, Auckland, New Zealand
- National Women's Health, Auckland City Hospital, Auckland, New Zealand
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Korukcu O, Ozkaya M, Boran OF, Bakacak M. Factors associated with antenatal depression during the COVID-19 (SARS-CoV2) pandemic: A cross-sectional study in a cohort of Turkish pregnant women. Perspect Psychiatr Care 2022; 58:61-70. [PMID: 33772802 PMCID: PMC8251216 DOI: 10.1111/ppc.12778] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2020] [Revised: 03/03/2021] [Accepted: 03/06/2021] [Indexed: 12/14/2022] Open
Abstract
PURPOSE To determine the effect of the COVID-19 pandemic on antenatal depression in Turkish pregnant women. DESIGN AND METHODS In this cross-sectional study, data were collected from 497 pregnant women between May and July 2020 using the Edinburgh Depression Scale (EDS) to determine the effect of obstetrics history, fear of hospitalization, concerns about the pandemic, birth, and the health of both mother and infant, on antenatal depression during the COVID-19 outbreak in Turkey. FINDINGS The general EDS mean score of the total group was determined as mean 13.70 ± 6.22, which was higher than the critical cutoff point of 13. According to the multiple linear regression model applied in the study, the best predictive variables for the mean EDS score were determined to be concerned about completing a healthy pregnancy (r = -0.45), social media and news programs related to COVID-19 increasing levels of concern (r = -0.31), fear of hospitalization as the birth approaches (r = -0.45), having bad dreams during the COVID-19 pandemic (r = -0.41), the request for an elective cesarean delivery because of fear of catching COVID-19 (r = -0.40), fear of breastfeeding the infant (r = -0.45), and concerns that their own health would be negatively affected because of the pandemic (r = - 0.39), and these variables affected the mean EDS score negatively (total variance 40.5%, R = 0.642). PRACTICAL IMPLICATIONS The COVID-19 pandemic has created an urgent need to implement specific antenatal programs to promote the psychological health of pregnant women and reduce antenatal depression during this or similar crises.
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Affiliation(s)
- Oznur Korukcu
- Department of Obstetrics and Gynecological Nursing, Faculty of Nursing, Akdeniz University, Antalya, Turkey
| | - Meltem Ozkaya
- Department of Obstetrics and Gynecological Nursing, Faculty of Nursing, Akdeniz University, Antalya, Turkey
| | - Omer Faruk Boran
- Department of Anesthesiology and Reanimation, Faculty of Medicine, Kahramanmaras Sutcu Imam University, Kahramanmaras, Turkey
| | - Murat Bakacak
- Department of Anesthesiology and Reanimation, Faculty of Medicine, Kahramanmaras Sutcu Imam University, Kahramanmaras, Turkey
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Ribeiro GDM, Cieto JF, Silva MMDJ. Risco de depressão na gravidez entre gestantes inseridas na assistência pré-natal de alto risco. Rev Esc Enferm USP 2022. [DOI: 10.1590/1980-220x-reeusp-2021-0470pt] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
RESUMO Objetivo: identificar o risco de depressão na gravidez entre gestantes em acompanhamento na assistência pré-natal de alto risco, avaliar os fatores associados ao maior risco de depressão na gravidez e comparar o risco de depressão em cada trimestre gestacional. Método: estudo descritivo, correlacional, transversal, realizado com 151 gestantes em acompanhamento pré-natal em ambulatório de gestação de alto risco de um hospital universitário no estado de São Paulo, Brasil. Os dados foram coletados por um formulário online. Foram realizados os Testes do Qui-Quadrado e Exato de Fisher. Após a análise bivariada, as variáveis foram incluídas no modelo de regressão logística. No modelo final, foi calcula a Razão de Chances. Resultados: 118 (78,1%) gestantes apresentaram maior risco de depressão na gravidez, o qual foi maior no primeiro trimestre, mas sem significância estatística. O número de gestações (OR = 0,32) e o estado civil (OR = 0,07) permaneceram associados significativamente ao maior risco de depressão na gravidez como fatores de proteção. Conclusão: os resultados elucidam a importância do rastreamento do risco de depressão e a necessidade significativa de melhorar o acesso a intervenções eficazes para prevenção da depressão pré-natal e promoção da sua saúde mental.
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Cumulative life stressors and stress response to threatened preterm labour as birth date predictors. Arch Gynecol Obstet 2021; 305:1421-1429. [PMID: 34549310 DOI: 10.1007/s00404-021-06251-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2021] [Accepted: 09/01/2021] [Indexed: 02/05/2023]
Abstract
PURPOSE Preterm birth represents one of the main causes of neonatal morbimortality and a risk factor for neurodevelopmental disorders. Appropriate predictive methods for preterm birth outcome, which consequently would facilitate prevention programs, are needed. We aim to predict birth date in women with a threatened preterm labour (TPL) based on stress response to TPL diagnosis, cumulative life stressors, and relevant obstetric variables. METHODS A prospective cohort of 157 pregnant women with TPL diagnosis between 24 and 31 weeks gestation formed the study sample. To estimate the stress response to TPL, maternal salivary cortisol, α-amylase levels, along with anxiety and depression symptoms were measured. To determine cumulative life stressors, previous traumas, social support, and family functioning were registered. Then, linear regression models were used to examine the effect of potential predictors of birth date. RESULTS Lower family adaptation, higher Body Mass Index (BMI), higher cortisol levels and TPL diagnosis week were the main predictors of birth date. Gestational week at TPL diagnosis showed a non-linear interaction with cortisol levels: TPL women with middle- and high-cortisol levels before 29 weeks of gestation went into imminent labour. CONCLUSION A combination of stress response to TPL diagnosis (salivary cortisol) and cumulative life stressors (family adaptation) together with obstetric factors (TPL gestational week and BMI) was the best birth date predictor. Therefore, a psychosocial therapeutic intervention program aimed to increase family adaptation and decrease cortisol levels at TPL diagnosis as well as losing weight, may prevent preterm birth in symptomatic women.
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Tsakiridis I, Dagklis T, Mamopoulos A, Athanasiadis A, Pearson R, Papazisis G. Antenatal depression and anxiety during the COVID-19 pandemic: a cross-sectional study in pregnant women from routine health care contact in Greece. J Perinat Med 2021; 49:656-663. [PMID: 33725757 DOI: 10.1515/jpm-2020-0473] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/09/2020] [Accepted: 12/27/2020] [Indexed: 12/13/2022]
Abstract
OBJECTIVES The impact of the COVID-19 pandemic and the public health measures introduced to control it, on mental health, is largely unknown. Research conducted during past epidemics found that pregnant women are more vulnerable psychologically. The aim of this study was to investigate antenatal depressive and anxiety symptoms during this pandemic in Greece. METHODS All women receiving routine antenatal care, during a three-month period, starting one week after the total lockdown in Greece, in a University department, were asked to fill in two questionnaires, the Edinburg Postnatal Depression Scale (EPDS) and the State-Trait Anxiety Inventory (STAI). RESULTS Overall, 505 women (93.3% of the eligible population) agreed to participate. The prevalence of antenatal depression (EPDS score≥13) in the population of the study was 13.5%. Unplanned pregnancy (OR: 2.447; 95% CI: 1.235-4.846), smoking (OR: 2.268; 95% CI: 1.166-4.411) and antenatal anxiety (OR: 5.074; 95% CI: 2.898-8.883) increased the risk of antenatal depression during the COVID-19 pandemic. State (current)-anxiety affected 34.1% of the participants, whereas Trait (lifetime)-anxiety affected 15.8%. The State-anxiety score (median) was significantly higher than the Trait-anxiety (median) (41 vs. 36; p<0.001), revealing an increase in the levels of anxiety in the pandemic, while there was also a positive linear correlation between the two scales (rho=0.592; p<0.001). CONCLUSIONS The unprecedented situation of the COVID-19 pandemic has increased anxiety, but not depression levels of pregnant women in Greece. Population level interventions to address adverse effects on anxiety status in the initial phases of similar situations may be helpful in the future.
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Affiliation(s)
- Ioannis Tsakiridis
- 3rd Department of Obstetrics and Gynaecology, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Themistoklis Dagklis
- 3rd Department of Obstetrics and Gynaecology, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Apostolos Mamopoulos
- 3rd Department of Obstetrics and Gynaecology, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Apostolos Athanasiadis
- 3rd Department of Obstetrics and Gynaecology, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Rebecca Pearson
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Georgios Papazisis
- Department of Clinical Pharmacology, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
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Toscano M, Royzer R, Castillo D, Li D, Poleshuck E. Prevalence of Depression or Anxiety During Antepartum Hospitalizations for Obstetric Complications: A Systematic Review and Meta-analysis. Obstet Gynecol 2021; 137:881-891. [PMID: 33831928 PMCID: PMC8087456 DOI: 10.1097/aog.0000000000004335] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2020] [Accepted: 01/14/2021] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To systematically review the prevalence of antenatal depression and anxiety in women hospitalized in an antepartum unit for obstetric complications. DATA SOURCES We searched PubMed, EMBASE, CINAHL, PsycINFO, and ClinicalTrials.gov for English-language articles published from database inception through March 2020. METHODS OF STUDY SELECTION We included cross-sectional, cohort, case-control, quasi-experimental, and randomized controlled studies from any country that reported the proportion of pregnant women with an elevated depression or anxiety screening scale or diagnostic interview during antepartum hospitalization of any duration and at any gestational age. TABULATION, INTEGRATION, AND RESULTS We identified 8,799 articles and reviewed 79, 39 of which were included in a systematic review and 18 in meta-analysis of the primary outcome. Two raters independently assessed quality of individual studies using a 14-question tool. A random effects meta-analysis model was used to estimate prevalence and 95% CI of depression or anxiety. Heterogeneity was examined with the I2 test, and funnel plots were used to assess publication bias. After meta-analysis, the estimated prevalence of depression was 34% (95% CI 27-41%) and of anxiety 29% (95% CI 16-43%). There was expected substantial clinical and methodologic heterogeneity between studies that persisted even after planned a priori subgroup analyses and meta-regression. Even so, the direction of effect was consistent across studies. No publication bias was found. CONCLUSION The current meta-analysis suggests that one in three women hospitalized during pregnancy for obstetric complications report clinical levels of depression or anxiety symptoms, twice the reported prevalence of antenatal depression or anxiety in the general obstetric population. SYSTEMATIC REVIEW REGISTRATION PROSPERO, CRD42020172111.
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Affiliation(s)
- Marika Toscano
- Division of Maternal-Fetal Medicine, Department of Obstetrics & Gynecology, the Edward G. Miner Library, Institute for Innovative Education, the Department of Public Health Sciences, the Department of Obstetrics & Gynecology, and the Department of Psychiatry, University of Rochester Medical Center, and the School of Medicine and Dentistry, University of Rochester, Rochester, New York
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18
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Hung HY, Su PF, Wu MH, Chang YJ. Status and related factors of depression, perceived stress, and distress of women at home rest with threatened preterm labor and women with healthy pregnancy in Taiwan. J Affect Disord 2021; 280:156-166. [PMID: 33212407 DOI: 10.1016/j.jad.2020.10.062] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2020] [Revised: 09/11/2020] [Accepted: 10/29/2020] [Indexed: 12/18/2022]
Abstract
BACKGROUND Women with threatened preterm labor (TPTL) resting at home face several life challenges, but their psychological well-being has been ignored. This study aimed to explore the status and related factors of the psychological status of women with TPTL resting at home, and to compare the psychological status differences between TPTL and healthy pregnant women. METHODS A cross-sectional, multiple time-point study was conducted to repeatedly assess depression, perceived stress, and distress in 49 TPTL women and 62 healthy pregnant women during pregnancy in Taiwan. Mann-Whitney U tests were used to compare the psychological status differences between these women and the generalized estimating equation was used to identify the factors related to their psychological status. RESULTS The TPTL women's perceived stress at 24-27 weeks (p=0.047) and 32-35 weeks (p=0.04) and distress at each time point was significantly greater than that of healthy pregnant women (p<0.001). The common distress experienced by TPTL women was the inability to provide self-care and family care, the baby's health and safety, and to request leave from work for bed rest. Positive personalities, gestational age, preterm birth history, follow-up status and employment have been shown to be related to the psychological status of TPTL women. LIMITATIONS The major limitation of this study is the small sample size. CONCLUSION This study contributed to a better understanding of the emotional burdens of women with TPTL resting at home. Such findings highlight the need for constructing effective interventions to alleviate the psychological burden of these women.
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Affiliation(s)
- Hsiao-Ying Hung
- Department of Nursing, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Pei-Fang Su
- Department of Statistics, National Cheng Kung University, Tainan, Taiwan
| | - Meng-Hsing Wu
- Department of Obstetrics and Gynecology, College of Medicine, National Cheng Kung University, Tainan, Taiwan; Department of Obstetrics and Gynecology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Ying-Ju Chang
- Institute of Allied Health Sciences & Department of Nursing, College of Medicine, National Cheng Kung University, Tainan, Taiwan; Department of Nursing, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
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19
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Goetz M, Schiele C, Müller M, Matthies LM, Deutsch TM, Spano C, Graf J, Zipfel S, Bauer A, Brucker SY, Wallwiener M, Wallwiener S. Effects of a Brief Electronic Mindfulness-Based Intervention on Relieving Prenatal Depression and Anxiety in Hospitalized High-Risk Pregnant Women: Exploratory Pilot Study. J Med Internet Res 2020; 22:e17593. [PMID: 32780023 PMCID: PMC7448174 DOI: 10.2196/17593] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2019] [Revised: 06/03/2020] [Accepted: 06/15/2020] [Indexed: 02/06/2023] Open
Abstract
Background Peripartum depression and anxiety disorders are highly prevalent and are correlated with adverse maternal and neonatal outcomes. Antenatal care in Germany does not yet include structured screening and effective low-threshold treatment options for women facing peripartum depression and anxiety disorders. Mindfulness-based interventions (MBIs) are increasingly becoming a focus of interest for the management of such patients. Studies have shown a decrease in pregnancy-related stress and anxiety in expectant mothers following mindfulness programs. Objective The aim of this study was to explore the clinical effectiveness of a 1-week electronic course of mindfulness on prenatal depression and anxiety in hospitalized, high-risk pregnant women. We hypothesized that participating in a 1-week electronic MBI (eMBI) could alleviate symptoms of depression and anxiety during the hospital stay. Methods A prospective pilot study with an explorative study design was conducted from January to May 2019 in a sample of 68 women hospitalized due to high-risk pregnancies. After enrolling into the study, the participants were given access to an eMBI app on how to deal with stress, anxiety, and symptoms of depression. Psychometric parameters were assessed via electronic questionnaires comprising the Edinburgh Postnatal Depression Scale (EPDS), State-Trait Anxiety Inventory (STAI-S), and abridged version of the Pregnancy-Related Anxiety Questionnaire (PRAQ-R). Results We observed a high prevalence of peripartum depression and anxiety among hospitalized high-risk pregnant women: 39% (26/67) of the study participants in the first assessment and 41% (16/39) of the participants in the second assessment achieved EPDS scores above the cutoff value for minor/major depression. The number of participants with anxiety levels above the cutoff value (66% [45/68] of the participants in the first assessment and 67% [26/39] of the participants in the second assessment) was significantly more than that of the participants with anxiety levels below the cutoff value, as measured with the STAI-S. After completing the 1-week electronic course on mindfulness, the participants showed a significant reduction in the mean state anxiety levels (P<.03). Regarding pregnancy-related anxiety, participants who completed more than 50% of the 1-week course showed lower scores in PRAQ-R in the second assessment (P<.05). No significant changes in the EPDS scores were found after completing the intervention. Conclusions Peripartum anxiety and depression represent a relevant health issue in hospitalized pregnant patients. Short-term eMBIs could have the potential to reduce anxiety levels and pregnancy-related anxiety. However, we observed that compliance to eMBI seems to be related to lower symptoms of pregnancy-related stress among high-risk patients. eMBIs represent accessible mental health resources at reduced costs and can be adapted for hospitalized patients during pregnancy.
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Affiliation(s)
- Maren Goetz
- Department of Obstetrics and Gynecology, University of Heidelberg, Heidelberg, Germany.,Department of General Pediatrics, University Children's Hospital, Heidelberg, Germany
| | - Claudia Schiele
- Department of Obstetrics and Gynecology, University of Heidelberg, Heidelberg, Germany
| | - Mitho Müller
- Department of Psychology, Ludwig Maximilian University, Munich, Germany
| | - Lina M Matthies
- Department of Obstetrics and Gynecology, University of Heidelberg, Heidelberg, Germany
| | - Thomas M Deutsch
- Department of Obstetrics and Gynecology, University of Heidelberg, Heidelberg, Germany
| | - Claudio Spano
- Department of Psychology, Ludwig Maximilian University, Munich, Germany
| | - Johanna Graf
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital Tuebingen, Tuebingen, Germany
| | - Stephan Zipfel
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital Tuebingen, Tuebingen, Germany
| | - Armin Bauer
- Research Institute for Women's Health, Department of Women's Health, University Hospital Tuebingen, Tuebingen, Germany
| | - Sara Y Brucker
- Department of Women's Health, University Hospital Tuebingen, Tuebingen, Germany
| | - Markus Wallwiener
- Department of Obstetrics and Gynecology, University of Heidelberg, Heidelberg, Germany
| | - Stephanie Wallwiener
- Department of Obstetrics and Gynecology, University of Heidelberg, Heidelberg, Germany
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20
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Ni Q, Cheng G, Chen A, Heinonen S. Early detection of mental illness for women suffering high-risk pregnancies: an explorative study on self-perceived burden during pregnancy and early postpartum depressive symptoms among Chinese women hospitalized with threatened preterm labour. BMC Psychiatry 2020; 20:250. [PMID: 32434583 PMCID: PMC7240988 DOI: 10.1186/s12888-020-02667-0] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2020] [Accepted: 05/13/2020] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND The mental health of pregnant women, particularly those with elevated risks, has been an issue of global concern. Thus far, few studies have addressed the mental health of pregnant women with threatened preterm labour (TPL). This study investigated the prevalence of self-perceived burden (SPB) among Chinese women hospitalized due to TPL during pregnancy and early postpartum depressive disorders, exploring the effect of SPB and other potential risk factors on the early signs of postpartum depressive disorders. METHODS A self-reported survey was conducted in the obstetrics department of Anhui Provincial Hospital, China. Women hospitalized with TPL were approached 1 week after delivery. One hundred fifty women were recruited from January 2017 to December 2017. The Self-Perceived Burden Scale (SPBS) and Edinburgh Postnatal Depression Scale (EPDS) were the main measures. Descriptive statistics, Spearman correlations, and a multiple logistic regression were employed for data analysis. RESULTS SPB and early postpartum depressive disorders were commonly experienced by Chinese women hospitalized with TPL, and SPB was positively and significantly correlated with depressive symptoms. A multiple logistic regression analysis revealed that for the women hospitalized with TPL during pregnancy, the emotional aspect of SPB (OR = 1.42, 95% CI = 1.11-1.83, p = 0.006), age (OR = 1.14, 95% CI = 1.02-1.27, p = 0.023), occupation (OR = 3.48, 95% CI = 1.18-10.20, p = 0.023), the history of scarred uterus (OR = 7.96, 95% CI = 1.49-42.48, p = 0.015), the delivery mode of the present birth (OR = 6.19, 95% CI = 1.72-22.30, p = 0.005), and family support during pregnancy (OR = 0.60, 95% CI = 0.45-0.82, p = 0.001) were significant factors predicting early postpartum depressive symptoms. CONCLUSION This study indicates that SPB and early postpartum depressive disorders are prevalent mental issues among Chinese women hospitalized with TPL, and that SPB, especially perceived emotional burden, is a strong predictor of early postpartum depressive disorders. Our study suggests the necessity of paying attention to mental health issues, e.g. SPB and postpartum depressive symptoms among hospitalized women with TPL, and providing appropriate interventions at the prenatal stage to prevent adverse consequences.
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Affiliation(s)
- Qianqian Ni
- grid.59053.3a0000000121679639The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, 230001 Anhui China
| | - Guizhi Cheng
- grid.59053.3a0000000121679639The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, 230001 Anhui China
| | - An Chen
- Institute of Healthcare Engineering, Management and Architecture (HEMA), Department of Industrial Engineering and Management, Aalto University, Maarintie 8, 02150, Espoo, Finland.
| | - Seppo Heinonen
- grid.15485.3d0000 0000 9950 5666Department of Obstetrics and Gynaecology, Helsinki University Hospital and University of Helsinki, Haartmaninkatu 2, 00290 Helsinki, Finland
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Tsakiridis I, Mamopoulos A, Athanasiadis A, Dagklis T. Trends in Induced Abortions in Greece: A Cross-sectional Study. J Pediatr Adolesc Gynecol 2020; 33:149-152. [PMID: 31751764 DOI: 10.1016/j.jpag.2019.11.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/03/2019] [Revised: 10/27/2019] [Accepted: 11/08/2019] [Indexed: 11/15/2022]
Abstract
STUDY OBJECTIVE Teenage pregnancies and associated induced abortions represent an important public health issue. The aim of this study was to investigate the prevalence, the time trends, and associated factors of teenage induced abortions in Greece. DESIGN A cross-sectional study was conducted between 2018 and 2019. SETTING Third Academic Department of Obstetrics and Gynecology of the Aristotle University of Thessaloniki. PARTICIPANTS All pregnant women who underwent a second trimester anomaly scan were eligible for the study. INTERVENTIONS AND MAIN OUTCOME MEASURES Epidemiological characteristics were recorded and 5 age groups were created. Trends in the rates of teenage induced abortions were analyzed and we compared several parameters between women with and without history of abortions. RESULTS Overall, 3370 women were eligible and agreed to participate in the study. The prevalence of women who reported a history of at least 1 abortion at 15-19 years was 9.7% (n = 328/3370). The abortion rates across the 5 age groups were: 20-24: 7.5%; 25-29: 8.4%; 30-34: 8.2%; 35-39: 12%; and 40 years and older: 13.9%. Moreover, a history of 1 or more teenage abortions was more common in multiparous women (58.2% vs 46.5%; P < .001; odds ratio, 1.605; 95% confidence interval, 1.274-2.022) and in current smokers (27.4% vs 11%; P < .001; odds ratio, 3.066; 95% confidence interval, 2.346-4.008). CONCLUSION A significant decline in the teenage induced abortion rates was identified in the study population. A history of teenage induced abortion was associated with smoking and multiparity. More efforts are needed to provide appropriate education on effective contraception and family planning.
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Affiliation(s)
- Ioannis Tsakiridis
- Third Department of Obstetrics and Gynaecology, Faculty of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece.
| | - Apostolos Mamopoulos
- Third Department of Obstetrics and Gynaecology, Faculty of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Apostolos Athanasiadis
- Third Department of Obstetrics and Gynaecology, Faculty of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Themistoklis Dagklis
- Third Department of Obstetrics and Gynaecology, Faculty of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
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Magnitude and Predictors of Antenatal Depression among Pregnant Women Attending Antenatal Care in Sodo Town, Southern Ethiopia: Facility-Based Cross-Sectional Study. DEPRESSION RESEARCH AND TREATMENT 2020; 2020:6718342. [PMID: 32308994 PMCID: PMC7152952 DOI: 10.1155/2020/6718342] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/30/2019] [Revised: 02/06/2020] [Accepted: 02/21/2020] [Indexed: 11/17/2022]
Abstract
BACKGROUND Depression affects approximately 10 to 20% of pregnant women globally, and one in ten and two in five women in developed and developing countries develop depression during pregnancy, respectively. However, evidence regarding its magnitude and predictors in Southern Ethiopia is limited. The present study is aimed at assessing the magnitude and predictors of antenatal depression among pregnant women attending antenatal care in Sodo town. METHODS A facility-based cross-sectional study was conducted among 403 antenatal care attendants in Sodo town from November 2 to January 30, 2017. Systematic random sampling was used to select the study population, and data were collected by using a pretested and structured questionnaire. Data were entered using Epi-data 4.2 and then exported and analyzed using SPSS version 20. Bivariate and multivariable logistic regression analyses were used to assess the association between the dependent variable and independent variables. Variables with P value less than 0.05 were considered as statistically significant. RESULTS A total of 400 pregnant women were interviewed. The magnitude of antenatal depression was 16.3% (95% CI (12.8%, 19.9%)). Husband's educational status, at the college and above (AOR: 0.09; 95% CI (0.03, 0.34), regular exercise (AOR: 0.16; 95% CI (0.07, 0.36)), planned pregnancy (AOR: 0.16; 95% CI (0.06, 0.44)), use of family planning (AOR: 0.31; 95% CI (0.14, 0.66)), previous history of anxiety (AOR: 2.96; 95% CI (1.30, 6.74)), previous history of obstetric complications (AOR: 19.03; 95% CI (5.89, 61.47)), and current obstetric complications (AOR: 30.38; 95% CI (3.14, 294.19)) were significant predictors of antenatal depression. CONCLUSION Nearly one in six pregnant women had antenatal depression. The husband's educational status, regular exercise, planned pregnancy, use of family planning, previous history of anxiety, previous history of obstetric complications, and current history of obstetric complications were significant predictors of antenatal depression. Screening for depression during routine antenatal care could be essential and recommended to identify early and prevent further morbidities and mortalities due to antenatal depression.
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Tsakiridis I, Bousi V, Dagklis T, Sardeli C, Nikolopoulou V, Papazisis G. Epidemiology of antenatal depression among women with high-risk pregnancies due to obstetric complications: a scoping review. Arch Gynecol Obstet 2019; 300:849-859. [PMID: 31422459 DOI: 10.1007/s00404-019-05270-1] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2019] [Accepted: 08/06/2019] [Indexed: 02/07/2023]
Abstract
PURPOSE Antenatal depression is a common mental health problem among pregnant women that negatively affects maternal and neonatal outcomes. Women with obstetric complications, defined as high-risk pregnancies, seem to be at particularly increased risk for developing depressive symptomatology. The purpose of this study was to review the prevalence of antenatal depression among pregnant women with obstetric complications and to identify possible associated factors. METHODS A literature search was performed in the PubMed database and a scoping review was conducted to identify studies with data on the prevalence of antenatal depression and associated factors among high-risk pregnancies due to obstetric complications. The included studies were written in English and published up to 31/12/2018. RESULTS The prevalence of antenatal depression among pregnant women with high-risk pregnancies ranges from 12.5 to 44.2% among the reviewed studies. The associated factors significantly associated with antenatal depression include maternal age, maternal education, dwelling place, relationship with the partner, previous psychiatric diagnosis, perceived stress, antenatal attachment, abortion thoughts, smoking, diabetes, parity, number of pregnancies, gestational age, threatened preterm labour, preeclampsia and oligohydramnios. CONCLUSIONS Our findings indicate a high prevalence of depressive disorders in women with obstetric complications, suggesting the need for more rigorous screening among this population. The identification of associated factors also merits clinical attention. Further research is warranted to develop evidence-based effective screening strategies and relevant interventions.
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Affiliation(s)
- Ioannis Tsakiridis
- 3rd Department of Obstetrics and Gynaecology, School of Medicine, Aristotle University of Thessaloniki, Thessaloníki, Greece
| | - Vasiliki Bousi
- Department of Clinical Pharmacology, School of Medicine, Aristotle University of Thessaloniki, Thessaloníki, Greece
| | - Themistoklis Dagklis
- 3rd Department of Obstetrics and Gynaecology, School of Medicine, Aristotle University of Thessaloniki, Thessaloníki, Greece
| | - Chrysanthi Sardeli
- Department of Clinical Pharmacology, School of Medicine, Aristotle University of Thessaloniki, Thessaloníki, Greece
| | - Vasiliki Nikolopoulou
- Department of Clinical Pharmacology, School of Medicine, Aristotle University of Thessaloniki, Thessaloníki, Greece
| | - Georgios Papazisis
- Department of Clinical Pharmacology, School of Medicine, Aristotle University of Thessaloniki, Thessaloníki, Greece.
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Pulliainen H, Niela-Vilén H, Ekholm E, Ahlqvist-Björkroth S. Experiences of interactive ultrasound examination among women at risk of preterm birth: a qualitative study. BMC Pregnancy Childbirth 2019; 19:338. [PMID: 31533655 PMCID: PMC6751623 DOI: 10.1186/s12884-019-2493-2] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2018] [Accepted: 09/05/2019] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND Pregnant women who are at risk of preterm birth are often stressed, anxious and depressed because of worries and fears related to the health of the unborn baby, their own health and uncertainty about the future. Only a few studies have assessed the types of psychological support that would relieve these stress symptoms among women with high-risk pregnancies. The aim of this study was to describe 1) how women at risk of preterm birth experienced an interactive 3/4-dimensional (3/4D) ultrasound examination, and 2) their need for psychological support during the antenatal period. METHODS This qualitative study was conducted at one university hospital in Finland in 2017. Women with a singleton pregnancy of 26-32 gestational weeks (gwks) were included in the study. The interactive 3/4D ultrasound included a joint observation of the baby, based on the mother's wishes, with an obstetrician and psychologist. After the examination, the experiences were explored with a semi-structured interview. The data was analyzed using inductive thematic analysis. RESULTS The women enjoyed the fact that the staff were focused on her fetus and genuinely present during the session and also enabled the women to actively participate. Watching the baby and her/his activities made the baby more concrete and relieved their concerns. The need for additional psychological support varied individually. CONCLUSIONS Interactive ultrasound examination is an interesting way to awaken mental images, increase attachment, and reduce stress. The results imply that an interactive way of jointly looking at the fetus supports pregnant women at risk of preterm birth and may be useful in clinical practice.
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Affiliation(s)
| | | | - Eeva Ekholm
- Department of Obstetrics and Gynecology, Turku University Hospital and University of Turku, Turku, Finland
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Tsakiridis I, Dagklis T, Zerva C, Mamopoulos A, Athanasiadis A, Papazisis G. Depression in pregnant women hospitalized due to intrauterine growth restriction: Prevalence and associated factors. Midwifery 2018; 70:71-75. [PMID: 30584971 DOI: 10.1016/j.midw.2018.12.008] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2018] [Revised: 11/12/2018] [Accepted: 12/11/2018] [Indexed: 02/03/2023]
Abstract
OBJECTIVE Pregnancies complicated with intrauterine growth restriction (IUGR) may require hospitalization in a high-risk pregnancy unit (HRPU). A complicated pregnancy and hospital admission may negatively affect the pregnant woman's mental health. Several factors have been identified as possible risk factors for depression, which is proven to lead to several adverse perinatal outcomes. The purpose of this study was to screen for depression in women admitted to an HRPU due to IUGR pregnancy and also to identify associated risk factors. STUDY DESIGN All pregnant women admitted at ≥ 24 gestational weeks with the diagnosis of IUGR were eligible for the study. The Greek version of the Edinburgh Postnatal Depression Scale was used as screening tool on admission. A cut-off score ≥ 13 was used to identify depression, while possible risk factors were also investigated. RESULTS Overall, 73 women were eligible for the study and agreed to complete the questionnaire. The mean age of the pregnant women was 31.4 ± 6.7 years and the mean gestational week at admission was 33.6 ± 2.9 weeks. The prevalence of depressive symptoms (score ≥ 13) was 32.9% (24/73). In the multivariable model, depressive symptoms were significantly correlated with lower gestational age (OR: 3.459 95%CI: 1.124-10.648) and smoking during pregnancy (OR: 3.926 95% CI: 1.141-13.507). CONCLUSIONS About one third of pregnant women hospitalized in the HRPU with IUGR pregnancies showed signs of depression at the time of admission. Early-IUGR and smoking were found to be associated with antenatal depressive symptoms.
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Affiliation(s)
- Ioannis Tsakiridis
- 3rd Department of Obstetrics and Gynaecology, Faculty of Medicine, Aristotle University of Thessaloniki, Greece
| | - Themistoklis Dagklis
- 3rd Department of Obstetrics and Gynaecology, Faculty of Medicine, Aristotle University of Thessaloniki, Greece
| | - Christina Zerva
- 3rd Department of Obstetrics and Gynaecology, Faculty of Medicine, Aristotle University of Thessaloniki, Greece; Department of Clinical Pharmacology, Faculty of Medicine, Aristotle University of Thessaloniki, Greece
| | - Apostolos Mamopoulos
- 3rd Department of Obstetrics and Gynaecology, Faculty of Medicine, Aristotle University of Thessaloniki, Greece
| | - Apostolos Athanasiadis
- 3rd Department of Obstetrics and Gynaecology, Faculty of Medicine, Aristotle University of Thessaloniki, Greece
| | - Georgios Papazisis
- Department of Clinical Pharmacology, Faculty of Medicine, Aristotle University of Thessaloniki, Greece.
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Pampaka D, Papatheodorou SI, AlSeaidan M, Al Wotayan R, Wright RJ, Buring JE, Dockery DW, Christophi CA. Depressive symptoms and comorbid problems in pregnancy - results from a population based study. J Psychosom Res 2018; 112:53-58. [PMID: 30097136 DOI: 10.1016/j.jpsychores.2018.06.011] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/26/2017] [Revised: 06/12/2018] [Accepted: 06/21/2018] [Indexed: 12/18/2022]
Abstract
OBJECTIVE To estimate the prevalence of antenatal depressive symptoms, identify relevant risk factors, and assess comorbid mental health problems, among pregnant women enrolled in a population based study. METHODS This was a secondary analysis of data collected from 1916 pregnant women who participated in the TRansgenerational Assessment of Children's Environmental Risk (TRACER) study in Kuwait, and had answered the Baseline Questionnaire and completed the Edinburgh Depression Scale (EDS). Logistic regression models were used to examine the association of depressive symptoms with baseline socio-demographic characteristics and psychosocial indicators. RESULTS The prevalence of antenatal depressive symptoms, using a cut-off of EDS score ≥ 10, was 20.1%. Depressive symptoms were reported more by women of lower family income and had self-reported history of depression prior to pregnancy, with women in the third trimester having higher odds of antenatal depressive symptoms compared to those in the second trimester. Pregnancy-related anxiety, higher perceived stress levels, and post-traumatic stress disorder symptoms were comorbid with the presence of depressive symptoms. CONCLUSION The findings showed that one in five pregnant women in Kuwait experiences antenatal depressive symptoms and that these symptoms are comorbid with other mental health problems. Screening for antenatal depression and providing support to pregnant women should be considered.
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Affiliation(s)
- Despina Pampaka
- Cyprus International Institute for Environmental and Public Health, Cyprus University of Technology, Limassol, Cyprus.
| | - Stefania I Papatheodorou
- Cyprus International Institute for Environmental and Public Health, Cyprus University of Technology, Limassol, Cyprus
| | | | | | - Rosalind J Wright
- Department of Pediatrics, Institute for Exposomic Research, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Julie E Buring
- Division of Preventive Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Douglas W Dockery
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA; Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Costas A Christophi
- Cyprus International Institute for Environmental and Public Health, Cyprus University of Technology, Limassol, Cyprus; Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA
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