RESUMO
Background and Objectives: One of the most significant psychiatric problems in women is depression related to the perinatal period. Our study aims to determine the frequency and course of depressive symptomatology in the perinatal period with particular reference to objective rate and outcome of postpartum depression. Materials and Methods: One hundred and eighty-eight pregnant/postnatal women were included in a prospective, longitudinal, observational study during which the depressive symptomatology was estimated at the third trimester of pregnancy, and the first, sixth, and twelfth month' postpartum. All participants completed a semi-structured sociodemographic questionnaire constructed for research purposes, the Edinburgh Postnatal Depression Scale, Toronto Alexithymia Scale, Beck Anxiety Inventory, and The Mood Disorder Questionnaire at each time point. Postpartum depression diagnosis was confirmed by a trained and certified psychiatrist with long-standing experience. For a better understanding of the trajectory of depressive symptomatology and genuine postpartum depression, we classified depression into those with new-onset and those left over from the previous observation period. Results: In general, 48.9% of participants in the study were depressed at some point during the investigation. A total of 10.6% of women were depressed in the third trimester. The highest percentage of new-onset depression (25%) was in the first month after giving birth and was maintained for up to six months, after which the appearance was sporadic. Most of the postpartum depression resolved in the period from the first month to the sixth month after childbirth (20.7%). The episodes mainly had characteristics of unipolar depression. Conclusions: Our results imply that a new onset of depression is most intensive during the first six months, and after that, it is sporadic. Further studies are needed to explore whether all depressive symptomatology in the postnatal period is the same, or perhaps postpartum depression, classified in this way, has specific characteristics, etiology, and consequently different treatment and preventive options.
Assuntos
Depressão Pós-Parto , Terceiro Trimestre da Gravidez , Humanos , Feminino , Gravidez , Adulto , Estudos Prospectivos , Depressão Pós-Parto/epidemiologia , Depressão Pós-Parto/psicologia , Depressão Pós-Parto/diagnóstico , Terceiro Trimestre da Gravidez/psicologia , Estudos Longitudinais , Depressão/epidemiologia , Depressão/psicologia , Depressão/diagnóstico , Escalas de Graduação Psiquiátrica , Paridade , Inquéritos e Questionários , Mães/psicologia , Mães/estatística & dados numéricos , Período Pós-Parto/psicologiaRESUMO
BACKGROUND: Diet quality during pregnancy is important for maternal health and offspring development. However, national dietary recommendations are not always met. A potential barrier for healthy food choices might be the experience of stress. Previous literature in non-pregnant populations suggests a negative effect of acute stress on diet quality. This preregistered study is the first to test whether an acute stressor leads to unhealthy food choices in pregnancy and examine the moderating role of stress, depressive and anxiety complaints in daily life. METHOD: Pregnant women (N = 110, 3rd trimester) completed online self-reported surveys measuring stress, depressive and anxiety complaints in daily life. Hereafter, participants were invited for a laboratory visit, in which they were exposed to the Trier Social Stress Test or a control task. After this manipulation, self-reported and actual food choices and food intake were assessed. At the end of the visit, a hair sample was collected. Throughout the visit, visual analogue scales on negative affect were completed and saliva samples were collected. RESULTS: The stress group experienced significantly more psychological stress than the control group during the experimental manipulation. Main regression analyses showed that the acute laboratory stressor did not cause unhealthy food choices in the third trimester of pregnancy. In fact, the stress group chose fewer unhealthy foods and consumed fewer kilocalories compared to the control group. Additionally, the findings point at a moderating role of depressive and stress complaints in daily life on food choices within the control group: higher scores were related to more unhealthy food choices and more kilocalories consumed. DISCUSSION: As this was the first study to test the effect of an acute stressor on food choices in pregnant women, more research is needed to obtain a better understanding of stress-related eating in pregnancy. This knowledge may inform future interventions to support pregnant women in improving their diet quality.
Assuntos
Depressão , Preferências Alimentares , Estresse Psicológico , Humanos , Feminino , Gravidez , Estresse Psicológico/psicologia , Adulto , Preferências Alimentares/psicologia , Preferências Alimentares/fisiologia , Depressão/psicologia , Terceiro Trimestre da Gravidez/psicologia , Ansiedade/psicologia , Dieta , Comportamento Alimentar/psicologia , Comportamento Alimentar/fisiologia , Ingestão de Alimentos/psicologia , Ingestão de Alimentos/fisiologia , Comportamento de Escolha/fisiologia , Complicações na Gravidez/psicologia , Autorrelato , Gestantes/psicologiaRESUMO
RATIONALE: Body image undergoes significant changes during pregnancy, marking a pivotal phase in a woman's life. AIM AND OBJECTIVE: This study aimed to explore the body image perceptions of primiparous pregnant women during their third trimester. METHODS: Employing a qualitative research approach grounded in phenomenology, the study involved interviews to explore the experiences of primiparous pregnant women in their third trimester. The interviews were conducted via an online platform, with a sample group of 13 participants chosen through purposive sampling. Data analysis followed a content analysis approach, with the information being transferred to MAXQDA Analytics Pro Qualitative Data Analysis Programme for coding. The study adhered to the reporting guidelines outlined in the Consolidated Criteria for Reporting Qualitative Research (COREQ) checklist. RESULTS: Systematic analysis of the interview transcripts led to the identification of three main themes under the overarching framework of body image experiences among primiparous pregnant women during the third trimester: Physical Changes, Mental Changes, and Behavioural and Social Changes. Among the identified themes, pregnant women demonstrated a relatively lower level of discourse regarding Physical Changes, in contrast to a significant emphasis on Mental Changes. Within the latter theme, pregnant women exhibited significant dissatisfaction with their pregnancy experiences significantly. CONCLUSION: It was determined that pregnant women experience physical and psychological changes related to body image during pregnancy.
Assuntos
Imagem Corporal , Terceiro Trimestre da Gravidez , Pesquisa Qualitativa , Humanos , Feminino , Gravidez , Terceiro Trimestre da Gravidez/psicologia , Imagem Corporal/psicologia , Adulto , Turquia , Gestantes/psicologia , Adulto Jovem , Entrevistas como AssuntoRESUMO
BACKGROUND: Body image perception and social support during pregnancy can impact the psychological distress levels experienced by pregnant women. As a result, the purpose of this study was to examine the relationship between various components of social support and body image perception on psychological distress levels among pregnant women in their third trimester in Nigeria. METHOD: A cross-sectional study was conducted among 246 pregnant women who were in the third trimester and attending selected health care facilities in Ogbomoso, a semiurban city in Oyo State, Nigeria. Body image perception, social support, and psychological distress scales were used to collect the data. Data were analyzed and summarized using descriptive and inferential statistics (ANOVA and multiple regression), with significance set at p < 0.05. RESULTS: Regression analysis showed that 44% of the variation in psychological distress among pregnant women was explained by the background variables, marital status, body image perception, appraisal support, tangible support, belonging support, interaction between body image perception and appraisal support, belong support and tangible support. CONCLUSION: Intervention programs focusing on bolstering tangible support, belonging support and appraisal support are recommended at reducing the psychological distress due to body image perception among pregnant women at third trimester.
Assuntos
Imagem Corporal , Terceiro Trimestre da Gravidez , Angústia Psicológica , Apoio Social , Humanos , Feminino , Gravidez , Nigéria , Imagem Corporal/psicologia , Terceiro Trimestre da Gravidez/psicologia , Adulto , Estudos Transversais , Adulto Jovem , Estresse Psicológico/psicologia , Gestantes/psicologiaRESUMO
OBJECTIVE: The present study attempted to explore the psychological experiences of experiential avoidance, thought suppression, meta-cognition, self-compassion and body-checking during two stages of maternity (pregnancy and postpartum) among women embracing maternity for the first time. METHODS: The study used a cross sectional correlational design and enrolled 306 women participants who were in their third trimester of pregnancy or of postpartum (pregnant = 154 [50.3%]; postpartum = 152 [49.7%]) with ages ranging between 20 and 35 years (M = 26.62; SD = 2.19). The data was collected using the Brief Experiential Avoidance Questionnaire (BEAQ); Thought Control Questionnaire (TCQ); Metacognitions Questionnaire (MCQ); Self-Compassion Scale (SCS), and Body-checking Questionnaire (BCQ). Data was subjected to statistical analysis using SPSS version 21. RESULTS: A significant positive association was observed between experiential avoidance, thought suppression, meta-cognition, and body-checking while self-compassion showed reverse association with these variables. The body-checking outcome was significantly negatively predicted by self-compassionate attitude and positively by thought suppression in both groups (i.e., pregnant and postpartum). The experiential avoidance positively predicted body-checking among women in post-partum group only. Moreover, a mediating association of experiential avoidance and a moderating effect of self-compassion (self-kindness and common humanity) and meta-cognition (positive beliefs about worry and need to control thought) were also observed to moderate between thought suppression and body-checking outcomes. CONCLUSION: The study concluded that experiential avoidance and thought suppression contribute in developing body-checking behaviors among women who are pregnant or at postpartum stage of maternity. In addition, self-compassion and meta-cognition moderate this association with self-compassion playing potential buffer.
Assuntos
Empatia , Período Pós-Parto , Humanos , Feminino , Adulto , Gravidez , Estudos Transversais , Período Pós-Parto/psicologia , Adulto Jovem , Inquéritos e Questionários , Autoimagem , Metacognição , Imagem Corporal/psicologia , Cognição , Aprendizagem da Esquiva , Terceiro Trimestre da Gravidez/psicologiaRESUMO
In late December 2019, the COVID-19 pandemic caused a great threat to people's lives worldwide. As a special category of the population, pregnant women are vulnerable during emergencies. This study was designed to explore whether or not the COVID-19 pandemic has influenced maternal and infant outcomes. We collected maternal characteristics, laboratory results, condition in the third trimester, maternal outcome, fetal or neonatal outcomes, and characteristics of amniotic fluid, umbilical cord and placenta from pregnant women and fetals or newborns in the first affiliated hospital of Jinan university from 24 January to 31 March 2020 (peak period), chose the same types of data at the hospital during the same period in 2019 and 1 January-23 January 2020 (prior to the outbreak of COVID-19 in 2020) as a control. Our study focused on uncomplicated singleton pregnancies among women not infected by COVID-19. The results demonstrated that there was not an increase in adverse outcomes of pregnant women and newborns during the COVID-19 pandemic; This might be associated with the updated design of major epidemic prevention and control systems in Guangzhou, and the extension of pregnant women's rest time during the third trimester of pregnancy. Nevertheless, the survey showed an increased incidence rate of 25-hydroxyvitamin D and zinc deficiency in newborns during the epidemic, implying that pregnant women should participate in appropriate physical exercise, increase their exposure to outdoor sunlight and improve nutrition intake to ensure healthy newborns during the quarantine period. Our study has provided some guidance for maternal management during the COVID-19 pandemic.
Assuntos
COVID-19/epidemiologia , COVID-19/psicologia , Complicações Infecciosas na Gravidez/epidemiologia , Complicações Infecciosas na Gravidez/psicologia , Resultado da Gravidez/epidemiologia , Resultado da Gravidez/psicologia , Adulto , COVID-19/prevenção & controle , China/epidemiologia , Estudos de Coortes , Feminino , Humanos , Recém-Nascido , Pandemias/prevenção & controle , Gravidez , Complicações Infecciosas na Gravidez/prevenção & controle , Terceiro Trimestre da Gravidez/psicologia , Estudos RetrospectivosRESUMO
BACKGROUND: Maternal-Fetal Attachment (MFA) describes the cognitive-representational, emotional, and behavioral aspects of the mother-fetus relationship that develops during pregnancy. We present two studies conducted on pregnant Italian women. In Study I, we aimed to explore multifaceted associations of MFA with variables important for a healthy pregnancy (e.g., maternal mental health, the couple's relationship). In Study II, we investigated the predictive role of MFA on observed maternal caregiving during the first months of the infant's life. METHODS: In Study I, 113 pregnant Italian women were assessed on MFA (Maternal Antenatal Attachment Scale, MAAS), maternal depression (Beck Depression Inventory-II, BDI-II), maternal anxiety (State Trait Anxiety Inventory - State version, STAI), adjustment of the couple (Dyadic Adjustment Scale, DAS), and perceived parental care (The Parental Bonding Instrument, PBI). In Study II, 29 mother-infant pairs were followed up at 4 months to assess observational variables of maternal caregiving through the Emotional Availability Scale (EAS) and to test for an association with MFA in pregnancy. RESULTS: Study I showed a significant association between MFA and the quality of the couple relationship (ß = .49, P < .001) and between MFA and the recall of memories of care received in childhood (ß = .22, P = .025). Study II showed a predictive effect of MFA on maternal structuring observed during mother-infant interactions at 4 months of age (ß = 0.36, P = .046). CONCLUSION: The study points out relevant relationship contexts that might receive care and support throughout pregnancy to protect MFA. The findings also provide thoughtful insights on the role of MFA in early maternal caregiving, suggesting that MFA might be a candidate as one putative antecedent of mother-infant interaction processes.
Assuntos
Cuidado do Lactente/psicologia , Relações Materno-Fetais/psicologia , Relações Mãe-Filho/psicologia , Terceiro Trimestre da Gravidez/psicologia , Gestantes/psicologia , Adulto , Feminino , Humanos , Lactente , Recém-Nascido , Itália , Estudos Longitudinais , Apego ao Objeto , GravidezRESUMO
Objective: During the perinatal period, women are at an increased risk for the onset/exacerbation of obsessive-compulsive disorder (OCD) and may experience perinatal-specific obsessions and/or compulsions. Past research has provided preliminary findings regarding the prevalence of OCD in the perinatal period but has often reported limited metrics and ignored perinatal specific symptoms. This research aimed to assess the prevalence and incidence of maternal OCD between the third trimester in pregnancy and 6 months postpartum.Methods: An unselected sample of 763 English-speaking pregnant women and new mothers participated in a longitudinal, province-wide study between their third trimester in pregnancy and 9 months postpartum. They completed 3 online questionnaires and interviews (data collected between February 9, 2014, and February 14, 2017) and were administered a diagnostic interview to determine OCD status based on DSM-5 diagnostic criteria.Results: A weighted prenatal period prevalence of 7.8% and a postpartum period prevalence of 16.9% were found. The average, prenatal, point prevalence estimate was 2.9%, and the average, postpartum, point prevalence estimate was 7.0%. Point prevalence gradually increased over the course of pregnancy and the early postpartum, attaining a peak of close to 9% at approximately 8 weeks postpartum, with a gradual decline thereafter. The cumulative incidence of new OCD diagnoses was estimated at 9% by 6 months postpartum.Conclusions: Our study suggests that when women are encouraged to report their perinatal-specific symptoms, and current diagnostic criteria are applied, estimates for perinatal OCD may be higher than previously believed.
Assuntos
Transtorno Obsessivo-Compulsivo/epidemiologia , Período Pós-Parto/psicologia , Complicações na Gravidez/psicologia , Adolescente , Adulto , Colúmbia Britânica/epidemiologia , Feminino , Humanos , Incidência , Entrevista Psicológica , Estudos Longitudinais , Pessoa de Meia-Idade , Transtorno Obsessivo-Compulsivo/etiologia , Gravidez , Complicações na Gravidez/epidemiologia , Terceiro Trimestre da Gravidez/psicologia , Prevalência , Adulto JovemRESUMO
BACKGROUND: Prenatal depression and adult attachment are factors that affect the establishment of an intimate relationship between a mother and fetus. The study explored differences in prenatal depression and maternal-fetal attachment (MFA) scores between different types of adult attachment and the effects of maternal depression scores and attachment dimensions on maternal intimacy with the fetus. METHODS: The Edinburgh Postnatal Depression Scale (EPDS), Experience of Close Relationship (ECR) scale, Maternal Antenatal Attachment Scale (MAAS) and a general data scale were used to investigate 260 primigravida. An exploratory analysis was performed to analyze the effects of the depression score and adult attachment on MFA. RESULTS: The results showed that pregnant women with insecure attachment exhibited an increased prevalence of prenatal depression, lower total MFA scores, and lower MFA quality compared with those women with secure adult attachment. The explorative analysis showed that the depression scores mediated the relationship between adult attachment avoidance and MFA quality. CONCLUSIONS: Primigravida who had insecure adult attachment exhibited an increased prevalence of prenatal depression and lower MFA. Maternal depression and adult attachment may affect the emotional bond between a mother and fetus. This finding should be seriously considered, and timely intervention needs to take personality traits into consideration.
Assuntos
Depressão/psicologia , Relações Materno-Fetais/psicologia , Apego ao Objeto , Terceiro Trimestre da Gravidez/psicologia , Adolescente , Adulto , Feminino , Feto , Número de Gestações , Humanos , Pessoa de Meia-Idade , Gravidez , Complicações na Gravidez/psicologia , Escalas de Graduação Psiquiátrica , Inquéritos e Questionários , Adulto JovemRESUMO
The purpose of our study was to elucidate the association between obstetric and psychological factors and fear of childbirth (FOC) during the third trimester of pregnancy and to identify women at risk of severe FOC in Poland. An additional goal of the study was to verify the Polish version of the Wijma Delivery Expectancy Questionnaire (W-DEQ) and to establish its psychometric characteristics. Cross-sectional study with a total of 359 women recruited during routine visits to an antenatal clinic in Poland during the third trimester (≥ 27 weeks gestation). The survey included obstetric details (parity, obstetric history and preferred mode of delivery), and standardized psychological measures: the W-DEQ (fear of childbirth) and the EPDS (depressive symptoms). We demonstrated the satisfactory psychometric properties of the Polish version of the W-DEQ. Our findings confirm the one-factor structure found by the authors of the original version of the scale. A greater FOC was reported by women with unplanned pregnancies, women whose preferred mode of delivery was a cesarean section, and women who had previously undergone psychiatric treatment. The risk factors for severe FOC were depression, unplanned pregnancy or parity, and disagreement with the birth plan proposed by the obstetrician. The W-DEQ is a widely used, valid instrument for the assessment of FOC in pregnant women and can be used in Poland. Findings support the key role of obstetric and psychological variables in predicting fear of childbirth.
Assuntos
Medo/psicologia , Parto/psicologia , Gestantes/psicologia , Adulto , Feminino , Humanos , Polônia , Gravidez , Terceiro Trimestre da Gravidez/psicologiaRESUMO
This study was conducted to determine prenatal distress levels of pregnant women from seven provinces of Turkey and factors affecting prenatal distress levels. The multicentre descriptive study included 2365 pregnant women who were in the twentieth gestational week and above. The data were collected using the pregnancy information form, prenatal distress questionnaire and spousal support scale. Descriptive statistics, Student's t-test, ANOVA and logistic regression were used to evaluate the data. The results of this study demonstrated that pregnant women's prenatal distress levels are affected by such factors as the region lived in, lack of spousal support and being a primary school graduate. Nurses should develop intervention strategies that involve the pregnant woman's spouse to reduce prenatal distress and the factors affecting prenatal distress.Impact statementWhat is already known on this subject? Prenatal distress can have significant effects on pregnancy, maternal health and human development across the lifespan.What the results of this study add? Spousal support could also have an effect on the psychological health of mothers.What the implications are of these findings for clinical practice and/or further research? Nurses and midwives monitor the pregnant women, and therefore, they should evaluate the prenatal distress levels in the prenatal period, plan intervention strategies for pregnant women with high stress levels and include the pregnant women's spouses in these intervention strategies.
Assuntos
Complicações na Gravidez/epidemiologia , Gestantes/psicologia , Angústia Psicológica , Estresse Psicológico/epidemiologia , Adulto , Análise de Variância , Escolaridade , Feminino , Geografia , Humanos , Modelos Logísticos , Gravidez , Complicações na Gravidez/psicologia , Segundo Trimestre da Gravidez/psicologia , Terceiro Trimestre da Gravidez/psicologia , Apoio Social , Cônjuges/psicologia , Estresse Psicológico/psicologia , Inquéritos e Questionários , Turquia/epidemiologiaRESUMO
INTRODUCTION: Adverse pregnancy outcomes are less common among physically active women, and children born to such mothers are less likely to be at risk for macrosomia, obesity and metabolic diseases in the future. OBJECTIVES: The aims of the study were to establish physical activity (PA) patterns among pregnant women in the third trimester, and to determine the attitudes of prenatal care providers to maternal PA during pregnancy. MATERIAL AND METHODS: The study was conducted in 2017 using surveys from the Polish Pregnancy-related Assessment Monitoring System program (Pol-PrAMS). The study included 3,451 postpartum women. The Pregnancy Physical Activity Questionnaire was used to investigate their PA. This part of Pol-PrAMS study was completed by 2,744 postpartum women who were subjected to statistical analysis. RESULTS: Sedentary or light physical activity comprised 75% of the overall PA in the third trimester of pregnancy (mean values of energy expenditure: 67 and 93.3 MET-h/week, respectively). Household or caregiving activities accounted for almost 50% of all activities and were the most common PA types (mean energy expenditure: 105 MET-h/week). Restriction of PA in pregnancy was reported by over 60% of the women, most often due to concerns over proper foetal development. Over 85% of prenatal care providers either did not address the issue of PA with the future mothers at all, or recommended PA restriction. CONCLUSIONS: Sedentary and light-intensity PA are the two predominant types of physical activity in the third trimester. The most energy-consuming tasks involve household and caregiving activities. Restriction of activity was reported by the majority of the respondents. Prenatal care providers either did not address the matter of PA in pregnancy or recommended PA restriction.
Assuntos
Atitude , Exercício Físico , Pessoal de Saúde/psicologia , Terceiro Trimestre da Gravidez/fisiologia , Terceiro Trimestre da Gravidez/psicologia , Adolescente , Adulto , Feminino , Humanos , Polônia , Gravidez , Adulto JovemRESUMO
PURPOSE: To assess the association between depression symptoms and pain characteristics, including pain intensity, location, and effectiveness of pain management strategies, among women in their third trimester of pregnancy. DESIGN: Descriptive, exploratory cross-sectional study. SETTING: Mobile health pregnancy application (app). PARTICIPANTS: A convenience sample of women in their third trimester of pregnancy from across the United States. METHODS: Women completed demographic questionnaires, the Brief Pain Inventory, and Edinburgh Postnatal Depression Scale (EPDS) through an online Web site. RESULTS: N = 132 women participated. The sample was demographically diverse. . Women ranged in age from 18 to 39 years (M 28.1 ± SD 5.2). Most women were Caucasian (68%), with smaller percentages of Hispanic (12%) and African American (11%) women. Most had commercial insurance (59%) and a partner (85%). Of the 132 women, 79.6% reported moderate-to-severe pain. Approximately 93% experienced back and pelvic pain, whereas 27% experienced moderate-to-severe depression symptoms. Bivariate and linear regression analyses revealed that higher EPDS depression scores were associated with higher levels of pain (p < .01). Other variables significantly associated with higher EPDS scores were White race (p = .04), marital status (p = .05), and headache (p < .01). CLINICAL IMPLICATIONS: In the third trimester of pregnancy, pain affects more than two-thirds of women and may occur with and without depression symptoms. Although the value of universal depression screening during pregnancy is widely recognized, our findings suggest clinical outcomes for pregnant women would improve with a standardized, multidimensional screen for both pain and depression symptoms. Nurses are ideally positioned to assess and advocate for the combined treatment of pain and depression.
Assuntos
Depressão/psicologia , Dor/psicologia , Terceiro Trimestre da Gravidez/psicologia , Adolescente , Adulto , Depressão/complicações , Feminino , Humanos , Dor/complicações , Manejo da Dor/métodos , Manejo da Dor/normas , Gravidez , Gestantes/psicologia , Escalas de Graduação Psiquiátrica , Psicometria/instrumentação , Psicometria/métodos , Inquéritos e QuestionáriosRESUMO
Reactivity to emotional information, measurable at the level of neural activity using event-related potentials, is linked to symptoms of affective disorders. Behavioral evidence suggests that contextual factors, such as social support, can alter emotional reactivity such that affective responding is normalized when social support is high. This possibility remains largely untested at the neural level, specifically through approaches that can offer insight into the mechanistic processes contributing to individual differences in emotional reactivity. Yet, such knowledge could be useful for prevention and intervention efforts, particularly with groups at risk for increased emotional reactivity, such as pregnant mothers for whom emotional distress predicts both maternal and child outcomes. Expectant mothers took part in a longitudinal study that tested whether the late positive potential (LPP), a neural index of reactivity to emotional information, was moderated by maternal perceptions of social support. In the third trimester of pregnancy, lower perceived social support was associated with an absence of a traditional LPP effect, which differentiates valenced from neutral stimuli. Findings suggest that perceptions of social support may normalize emotional processing at the neural level and highlight the potential importance of social support modulation of emotional reactivity during times of known biological change.
Assuntos
Regulação Emocional/fisiologia , Potenciais Evocados/fisiologia , Terceiro Trimestre da Gravidez/fisiologia , Terceiro Trimestre da Gravidez/psicologia , Apoio Social , Adulto , Eletroencefalografia , Feminino , Humanos , Estudos Longitudinais , Gravidez , Adulto JovemRESUMO
BACKGROUND: Exclusive breastfeeding (EBF) is advocated by the WHO for the first 6 months. In Rwanda, the percentage of infants who are exclusively breastfed decreases from 94% among infants aged 0-1 month to 81% among those aged 4-5 months. Little is known about what influences mothers' breastfeeding practices. This study aimed to gain insights into expectant mothers' prenatal feeding intentions, the underlying reasons, actual practices after birth, and factors facilitating or impeding EBF for the first 6 months of a child's life in Muhanga District, Rwanda. METHODS: This qualitative longitudinal study, conducted between December 2016 and October 2017 as part of a larger study, recruited a purposive sample of 39 pregnant women attending prenatal consultations during their last trimester in two rural health centers. Women were interviewed during pregnancy, within the first week after birth and at 4 and 6 months postpartum to explore intentions, actual practices, critical transition points, and facilitating or impeding factors. Interviews were recorded, transcribed verbatim, and analyzed thematically. RESULTS: Of the 39 participants, 38 intended to breastfeed within the first hour after birth, and 32 intended to breastfeed exclusively for the first 6 months. In practice, 34 initiated breastfeeding within the first hour, and 12 breastfed exclusively for 6 months. Impeding factors include perceived breastmilk insufficiency, pressure from family members, past experiences, mothers' concerns over their infants' health, mothers' heavy workload, poverty and food insecurity. Factors facilitating early initiation and EBF include mothers' awareness of EBF's advantages, confidence in their breastfeeding ability, and support from health professionals and family members. CONCLUSION: Despite participants' intentions about breastfeeding, there was a gap between intentions and actual practices. An interplay of barriers at individual, group and societal levels impeded women from EBF for the first 6 months. EBF promotion interventions should consider supporting and equipping breastfeeding mothers with skills to deal with perceived breastmilk insufficiency and to recognize the true signs of baby hunger cues. Furthermore, important influential family and community members should be targeted to support mothers to breastfeed. Interventions that consider addressing the issue of poverty-driven food insecurity should not be overlooked either.
Assuntos
Aleitamento Materno/psicologia , Conhecimentos, Atitudes e Prática em Saúde , Intenção , Mães/psicologia , Período Pós-Parto/psicologia , Terceiro Trimestre da Gravidez/psicologia , Adolescente , Adulto , Estudos de Coortes , Feminino , Humanos , Lactente , Recém-Nascido , Entrevistas como Assunto , Estudos Longitudinais , Masculino , Gravidez , Pesquisa Qualitativa , Ruanda , Adulto JovemRESUMO
BACKGROUND: Pregnancy involves physiological changes in reproductive and endocrine systems, and social role changes that can increase the risk of mental health problems. In China, greater emphasis has been given to postpartum depression and its negative impact on infant development. This study examined depression in pregnant women in Inner Mongolia, who are under the influence of cultural values of collectivism and social factors specific to China. Chinese society adheres firmly to traditional values, while market reform, birth-control policy, together with high parental investment in childcare and rearing construct a unique and sometimes unfavorable environment for Chinese women that may influence their depression expression. THE AIMS OF THIS STUDY ARE TWOFOLD: First, it validated the Chinese Multidimensional Depression Assessment Scale (MDAS), a holistic self-report questionnaire measuring depression severity in four domains of depression-emotional, somatic, cognitive and interpersonal in pregnant women in Inner Mongolia; second, it examined the influences of demographic characteristics (including age, education and employment), pregnancy characteristics (week of gestation, first pregnancy), self-esteem, social support, social activity, work stress, and work-family balance on depression. METHODS: A total of 234 pregnant women, mostly in their third trimester, were recruited in an antenatal hospital in Inner Mongolia and self-reported questionnaires were completed. RESULTS: Using Confirmatory factor analysis (CFA), MDAS gave rise to a best-fit four-factor model corresponding to each subscale when it was first developed. MDAS also reported high Cronbach's alpha (0.96) and good convergent validity. Using hierarchical multiple linear regressions with significant demographic variables controlled for, self-esteem, work-family conflict, and social support were found to be significant predictors for depression. CONCLUSIONS: MDAS is a valid scale to be used with Chinese pregnant women, especially in more collectivistic geographical areas. Risk factors specific to the Chinese context add insights to the experience of antenatal depression in China and contribute to understanding depression in from a global mental health perspective.
Assuntos
Depressão/diagnóstico , Política de Planejamento Familiar , Complicações na Gravidez/diagnóstico , Gestantes/psicologia , Escalas de Graduação Psiquiátrica , Adulto , China , Depressão/epidemiologia , Depressão/psicologia , Feminino , Saúde Holística , Humanos , Gravidez , Complicações na Gravidez/epidemiologia , Complicações na Gravidez/psicologia , Terceiro Trimestre da Gravidez/psicologia , Fatores de Risco , Autorrelato/estatística & dados numéricos , Apoio SocialRESUMO
OBJECTIVES: To test the psychometric properties of the culturally adapted Chinese version of the self-administered Australian Pelvic Floor Questionnaire (APFQ) in pregnant and postpartum women. STUDY DESIGN: Between November 2018 and December 2018, a total of 316 pregnant women who met the inclusion criteria in an outpatient setting were enrolled. The participants completed the questionnaire during the third trimester and twice after delivery. The test for validity was composed of face/content validity and construct validity. Reliability testing included internal consistency and test-retest reliability. The degree of responsiveness was assessed using effect size (ES) and standardized response mean (SRM). RESULTS: Two hundred and seventy-four women completed all questionnaires. Content validity, missing data did not exceed 4 % for any questions in the Chinese version of the self-administered APFQ. Construct validity, there was statistically significant difference in the symptoms scores of women with and without subjective suffering bothersome symptoms in bladder function, bowel function, prolapse and sexual function during pregnancy and postpartum periods. Reliability, the total Cronbach's alpha coefficients of the questionnaire in pregnancy and postpartum periods were 0.8, 0.9 and 0.9, respectively, and the intraclass correlation coefficient (ICC) of the total questionnaire was 0.8 during the test-retest. Responsiveness, the Chinese version of APFQ can track changes in bladder function domain and bowel function domain for the women with standardized response mean equal to 0.6 and 0.2, respectively. CONCLUSIONS: The Chinese version of the self-administered APFQ had satisfactory reliability and validity, and can longitudinally monitor changes in pelvic floor symptoms during pregnancy and postpartum periods.
Assuntos
Povo Asiático/psicologia , Competência Cultural/psicologia , Distúrbios do Assoalho Pélvico/psicologia , Complicações na Gravidez/psicologia , Inquéritos e Questionários/normas , Adulto , Austrália , China/etnologia , Feminino , Humanos , Distúrbios do Assoalho Pélvico/etnologia , Período Pós-Parto/etnologia , Período Pós-Parto/psicologia , Gravidez , Complicações na Gravidez/etnologia , Terceiro Trimestre da Gravidez/psicologia , Gestantes/etnologia , Gestantes/psicologia , Psicometria , Reprodutibilidade dos Testes , Comportamento Sexual/psicologiaRESUMO
BACKGROUND: The independent effect of sedentary behavior (SB) on maternal mental health is still unclear. The purpose of this study was to examine the different relationships of SB with maternal distress in pregnant women across the three trimesters, controlling for the confounding factors including physical activity (PA), diet and gestational weight gain. METHODS: Survey data were collected from 1272 participants in different trimesters of pregnancy. The data were divided into three data sets based on trimester, and regression analysis was conducted on each data set. Both the linear and quadratic relationships between SB and mental distress were estimated. RESULTS: There was no significant association between SB and any mental distress symptoms in the first trimester. In the second trimester, SB was positively associated with higher mental overall distress symptoms (ß=0.34, P < 0.001), including depress and anxiety. There is an inverted-U shaped curvilinear relationship between SB and mental distress in the third trimester, as SB-squared is significantly associated with mental overall distress (GSI: ß=-0.65, Pâ¯=â¯0.002, depression: ß=-0.53, Pâ¯=â¯0.014, anxiety: ß=-0.46, Pâ¯=â¯0.031). LIMITATIONS: The data were collected from only one city in China, which may limit the generalizability of the findings for all Chinese women. This was an observational study and causality cannot be established. CONCLUSION: This study found that the relationship between SB and maternal mental distress depends on trimesters. The stage of pregnancy should be considered when designing interventions for pregnant women to change SB to reduce mental distress.
Assuntos
Gestantes/psicologia , Comportamento Sedentário , Estresse Psicológico/psicologia , Adulto , Povo Asiático/psicologia , China/epidemiologia , Exercício Físico , Feminino , Humanos , Gravidez , Segundo Trimestre da Gravidez/psicologia , Terceiro Trimestre da Gravidez/psicologia , Trimestres da Gravidez/psicologia , Estresse Psicológico/epidemiologia , Inquéritos e Questionários , Adulto JovemRESUMO
Using data from a large international sample (Nâ¯=â¯385) of first-time expectant parents, the current analysis investigated whether parents demonstrated diurnal cortisol linkage in late pregnancy and whether self-reported psychological stress moderated this linkage. At approximately 36 weeks gestation, mothers and fathers collected saliva samples in their home at three times on two consecutive days and reported on their psychological stress. Results from multilevel models indicated that there was significant positive within-couple diurnal cortisol linkage on average for the whole sample. However, this linkage was moderated by maternal self-reported psychological stress. Specifically, for couples with higher maternal psychological stress, cortisol linkage was strong. Conversely, for couples with lower maternal psychological stress, maternal and paternal cortisol were unrelated. These findings suggest that among higher-maternal-stress couples, lower paternal cortisol may buffer maternal cortisol, whereas higher paternal cortisol may amplify maternal cortisol. Our results support the idea that interpersonal psychological and physiological stress in close relationships is interdependent and mutually influenced. Further, our findings contribute to the field's understanding of interpersonal processes during pregnancy, which may have health-related implications in the prenatal and postnatal periods for both parents and the developing child.
Assuntos
Hidrocortisona/análise , Terceiro Trimestre da Gravidez/psicologia , Estresse Psicológico/metabolismo , Adulto , Ansiedade , Pai/psicologia , Feminino , Idade Gestacional , Humanos , Sistema Hipotálamo-Hipofisário/fisiologia , Relações Interpessoais , Masculino , Mães/psicologia , Sistema Hipófise-Suprarrenal/fisiologia , Gravidez , Complicações na Gravidez/psicologia , Efeitos Tardios da Exposição Pré-Natal , Estudos Prospectivos , Saliva/química , Autorrelato , Estresse Fisiológico/fisiologiaRESUMO
BACKGROUND: Antenatal depression (AD) is considered as one of the major health burdens and has adverse effects on the outcome of expectant mothers and newborns. The present study aims to investigate the prevalence of antenatal depression (AD), and to explore the potential risk factors of AD among pregnant women in Chengdu, including personal background, related social factors, family factors and cognitive factors. METHODS: The prospective nested case-control study included pregnant women who were in their second pregnancy and attended prenatal care at three tertiary hospitals and one regional hospital in Chengdu, China, between March 2015 and May 2016. Self-designed questionnaires were given to participants in their second and third trimesters to collect information on clinical and demographic characteristics, and a modified edition of Edinburgh Postnatal Depression Scale (EPDS) were used to measure AD. The logistic regression was applicated in analyses. RESULTS: A total of 996 pregnant women were included in analysis. Ninety-three women suffered from AD symptoms only in their second trimester, 96 only in their third trimester, and 107 displayed persistent depression in both trimesters. In the univariate analyses, age and marital relationships were linked with AD occurrence in both second and third trimester. In addition, increasing age, full-time job, higher education level, and no gender preference of spouse were associated with reduced persistent depression. Multivariate analysis showed that gender preference and marital relationship were the potential risk factors of persistent depression. CONCLUSIONS: Age, marital relationship relationships, with parents-in-law, the negative recognition of this pregnancy and husband's gender preference were found as risk factors of AD occurrence in some specific trimester. Gender preference of husbands and marital relationships were independently associated with persistent depression. These findings suggest that stronger family support can help improve mental health of pregnant women.