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1.
Epidemiol Serv Saude ; 33: e2023993, 2024.
Artigo em Inglês, Português | MEDLINE | ID: mdl-38597529

RESUMO

OBJECTIVE: To analyze the association between intimate partner violence during pregnancy (IPVP) and quality of life (QOL). METHODS: A cross-sectional study was conducted with pregnant women receiving care in Primary Health Care in the municipality of Criciúma, Santa Catarina state, Brazil, in 2022; QOL was assessed in the physical, psychological, social relationship and environmental domains using WHOQOL-Bref instrument; IPVP was evaluated by means of the World Health Organization Violence Against Women; Crude and adjusted linear regression analyses were performed. RESULTS: A total of 389 pregnant women were evaluated; IPVP was observed in 13.6% of cases; in the adjusted analysis, IPVP remained associated with physical, psychological and social relationship domains; pregnant women who experienced IPVP had a reduction in their QOL score by 9.77, 11.07 and 8.95 points, respectively, when compared to those who did not experience IPVP. CONCLUSION: IPVP was associated with poorer QOL in the physical, psychological and social relationships domains. Health services equipped to address and prevent violence against pregnant women are essential. MAIN RESULTS: Intimate partner violence (IPV) was observed in 13.6% of pregnant women and was associated with poorer quality of life in the physical, psychological and social relationship domains. IMPLICATIONS FOR SERVICES: The results emphasize the need for an intersectoral approach in addressing the issue, with specialized healthcare centers for situations of violence integrated with social assistance and public security. PERSPECTIVES: Development of intersectoral policies and actions that strengthen existing ones and ensure social and healthcare assistance to pregnant women victims of violence and their children, given the negative impact of IPVP on quality of life.


Assuntos
Violência por Parceiro Íntimo , Qualidade de Vida , Criança , Feminino , Gravidez , Humanos , Estudos Transversais , Brasil , Gestantes/psicologia , Violência por Parceiro Íntimo/prevenção & controle , Violência por Parceiro Íntimo/psicologia
2.
Nutrients ; 16(5)2024 Mar 01.
Artigo em Inglês | MEDLINE | ID: mdl-38474846

RESUMO

This study aimed to examine the association of Mediterranean diet (MD) adherence and MD components with health-related quality of life (HRQoL) in pregnant women from Spain and Sweden. A total of 138 pregnant women from Spain (age: 32.9 ± 4.6 years old) and 302 pregnant women from Sweden (age: 31.3 ± 4.1 years old) were included. MD adherence was assessed with the Mediterranean food pattern (i.e., a MD index) at the 14-16th gestational weeks. HRQoL was assessed with the Spanish and Swedish versions of the 36-item Short-Form Health Survey (SF-36 and RAND-36, respectively) at the 14-16th and 34-37th gestational weeks. A greater MD adherence was associated with better physical functioning, bodily pain, vitality, emotional role, and mental health in cross-sectional associations (2nd trimester) in the Spanish sample (all p < 0.05). Furthermore, a greater MD adherence was associated with lower bodily pain in both Spanish and Swedish samples (both p < 0.05) in the 3rd trimester. The associations of MD adherence with pain seem to be explained by a greater intake of fiber, fish, fruits, nuts, and legumes (all p < 0.05). A greater MD adherence, driven by a higher intake of fiber, fish, fruits, nuts, and legumes, was associated with lower pain throughout pregnancy in both Mediterranean and non-Mediterranean populations.


Assuntos
Dieta Mediterrânea , Qualidade de Vida , Animais , Humanos , Feminino , Gravidez , Adulto , Estudos Transversais , Gestantes/psicologia , Verduras , Dor
3.
BMC Pregnancy Childbirth ; 24(1): 203, 2024 Mar 15.
Artigo em Inglês | MEDLINE | ID: mdl-38491430

RESUMO

BACKGROUND: Multiple gestations present numerous physical, psychological, social, and economic challenges for women. Understanding the problem-solving experiences of pregnant women carrying multiple can be invaluable. This study aimed to explore the experiences of Iranian women with multiple gestations. METHODS: This descriptive phenomenological study utilized purposive sampling and continued until data saturation. Data collection involved in-depth semi-structured interviews, with analysis performed using Colaizzi's 7-step method. MAXQDA software was employed for data management. RESULTS: This study involved 12 women with multiple gestations. The average age of the participants was 33.76 ± 6.22 years, and 9 were pregnant with triplets. The data were categorized into four primary themes: the paradox of emotions, the pregnancy prison, immersion in fear, and the crystallization of maternal love, encompassing 17 sub-themes. CONCLUSION: Pregnant women with multiple gestations undergo various changes and experience conflicting emotions. Enhancing their ability to adapt to and accept numerous pregnancies can be achieved through supportive, personalized, and family-centered care, along with improvements and revisions in care policies for multiple gestations.


Assuntos
Gravidez Múltipla , Gestantes , Feminino , Humanos , Gravidez , Adulto , Irã (Geográfico) , Gestantes/psicologia , Emoções , Família , Pesquisa Qualitativa
4.
BMC Psychol ; 12(1): 171, 2024 Mar 25.
Artigo em Inglês | MEDLINE | ID: mdl-38528622

RESUMO

BACKGROUND: To describe the changes in the level of sleep quality during pregnancy among pregnant women in Urumqi; also to construct a structural equation model of the factors influencing the sleep quality of pregnant women, to analyze the path relationship between the influencing factors, and to take reasonable interventions to prevent and reduce the occurrence of sleep disorders among pregnant women. METHODS: 986 pregnant women who gave birth in Urumqi Maternal and Child Health Hospital and Urumqi Youai Hospital between August 2021 and May 2023 were selected. The Pittsburgh Sleep Quality Index (PSQI), Self-Rating Anxiety Scale (SAS), and Edinburgh Postpartum Depression Scale (EPDS) were used to assess the sleep, anxiety, and depression of pregnant women, Building a structural equation model based on AMOS 23.0 Tools. RESULTS: The results of structural equation modeling showed that: basic characteristics, obstetrical characteristics, tocolysis, lifestyle, psychological had a direct effect on the PSQI, with path coefficients of 0.243, 0.106, 0.140, 0.174, 0.658, the corresponding T-values for each path are 4.585, 2.677, 2.578, 2.297, and 9.036. The indirect effect of basic characteristics, obstetric characteristics and lifestyle on PSQI was 0.123, 0.020, 0.027. CONCLUSIONS: The high incidence of sleep disorders in pregnant women and their close association with psychological symptoms in pregnant women should focus on screening and counseling regarding psychological disorders in pregnant women, thus improving the quality of sleep in pregnant women.


Assuntos
Complicações na Gravidez , Transtornos do Sono-Vigília , Criança , Gravidez , Feminino , Humanos , Qualidade do Sono , Complicações na Gravidez/epidemiologia , Gestantes/psicologia , Sono , Transtornos do Sono-Vigília/epidemiologia
5.
BMC Pregnancy Childbirth ; 24(1): 220, 2024 Mar 26.
Artigo em Inglês | MEDLINE | ID: mdl-38532382

RESUMO

BACKGROUND: Pregnancy is one of the most remarkable experiences in a woman's life. Prenatal depression, characterized by stress and worry associated with pregnancy, can reach severe levels. On a global scale, mental and addictive disorders affect more than one billion people, causing 19% of years lived with disability. It is estimated that 25-35% of pregnant women experience depressive symptoms, with 20% meeting the diagnostic criteria for major depression. METHODS: A systematic review and meta-analysis were conducted to examine depression during pregnancy in Ethiopia. The search was conducted from March 1-31, 2023. Data extraction used Microsoft Excel, and analysis was performed using STATA version 17. The New Castle-Ottawa Scale quality assessment tool was employed to evaluate the methodological quality of included studies. The Cochrane Q test and I2 statistics were used to assess heterogeneity. A weighted inverse variance random-effects model estimated the pooled level of antenatal depression (APD). Publication bias was detected using a funnel plot and Begg's and Egger's tests. RESULTS: Out of 350 studies searched, 18 were included in the analysis. The overall pooled prevalence of depression in Ethiopia was 27.85% (95% CI: 23.75-31.96). Harari region reported the highest prevalence (37.44%), while Amhara region had the lowest (23.10%). Factors significantly associated with depression included unplanned pregnancies, low social support, low income, previous history of depression, intimate partner violence, and history of abortion. CONCLUSION: This systematic review and meta-analysis demonstrate that approximately one-quarter of pregnant women in Ethiopia experience depression during pregnancy. Unplanned pregnancy, low social support, low income, previous history of depression, history of abortion, and intimate partner violence are determinants of depression. To address this high prevalence, the Ethiopian government and stakeholders should develop policies that incorporate counseling during pregnancy follow-ups. Improving the quality of life for pregnant women is crucial for the well-being of families, communities, and the nation as a whole.


Assuntos
Aborto Espontâneo , Depressão , Feminino , Gravidez , Humanos , Etiópia/epidemiologia , Depressão/epidemiologia , Qualidade de Vida , Gestantes/psicologia , Prevalência
6.
BMC Psychol ; 12(1): 60, 2024 Feb 06.
Artigo em Inglês | MEDLINE | ID: mdl-38321553

RESUMO

BACKGROUND: Pregnancy period is an important experience in the life process of married women, which leads them to growth and development and is considered as a part of the puberty process. The aim of this research is to determine the mediating role of individual resilience in relation to family resilience, psychological well-being and life satisfaction of the pregnant women. The current study is correlational according to the practical purpose and based on data collection. METHODES: The study population of the current research is all pregnant women in 2021, and 361 of them responded to the self-report questionnaires of family resilience, psychological well-being, life satisfaction, and individual resilience. To analysis the model, the path analysis method was used utilization spss-26 and Lisrel 10.2 software. RESULTS: The results show a good fit of the model with the data. The results also showed a direct and significant effect between life satisfaction with obligation (ß = 0.22 and t = 3.42), with challenge (ß = 0.28 and t = 3.98), with control (ß = 0.11 and t = 2.13), psychological well-being with obligation (ß = 0.20 and t = 3.11), with challenge (ß = 0.20 and t = 2.73) and with control (ß = 0.45 and t = 10.34). CONCLUSION: The upshot of this research can be considered in interventions related to pregnant women. Strengthening resilience in this group can be useful for increasing life satisfaction and psychological well-being of pregnant women.


Assuntos
Gestantes , Resiliência Psicológica , Humanos , Feminino , Gravidez , Gestantes/psicologia , Bem-Estar Psicológico , Saúde da Família , Satisfação Pessoal
7.
Disaster Med Public Health Prep ; 18: e16, 2024 Feb 02.
Artigo em Inglês | MEDLINE | ID: mdl-38304943

RESUMO

OBJECTIVE: It is well known that natural disasters such as earthquakes negatively affect physical and mental health by exposing people to excessive stress. The aim of this study was to investigate determinants of psychosocial health status among the pregnant and postpartum women who experienced earthquake in Türkiye. METHODS: Pregnant and postpartum women (n = 125) living in tent cities in the Kahramanmaras region formed the study sample. Data were collected between February 20 and 26, 2023, through face-to-face interviews. The instruments used for data collection were the Introductory Form, the Depression Anxiety Stress Scale, the Traumatic Childbirth Perception Scale, and the Post-Traumatic Stress Disorder-Short Scale. RESULTS: A moderate positive relationship was found between stress and posttraumatic stress and traumatic childbirth perception in pregnant and postpartum women, and a high positive relationship was found between anxiety and depression. A high level of relationship was found between anxiety and stress and depression. CONCLUSIONS: It is seen that the psychosocial health of pregnant and postpartum women, who belong to the risk group in the earthquake zone, is at high risk. Psychological support is urgently needed to preserve and improve their psychosocial health.


Assuntos
Terremotos , Transtornos de Estresse Pós-Traumáticos , Gravidez , Feminino , Humanos , Turquia/epidemiologia , Inquéritos e Questionários , Transtornos de Estresse Pós-Traumáticos/epidemiologia , Transtornos de Estresse Pós-Traumáticos/etiologia , Transtornos de Estresse Pós-Traumáticos/psicologia , Nível de Saúde , Período Pós-Parto , Depressão/epidemiologia , Depressão/etiologia , Depressão/psicologia , Gestantes/psicologia
8.
BMC Pregnancy Childbirth ; 24(1): 159, 2024 Feb 23.
Artigo em Inglês | MEDLINE | ID: mdl-38395857

RESUMO

BACKGROUND: Nutrition during pregnancy is a major determinant of human health and child development, and the role of promoting essential nutrition actions (ENA) is of a paramount importance for the health of the mother and newborn. However, the practice of ENA could be hampered by many factors, which need to be understood for tailored actions. This study assessed the practice of key ENAs and associated factors among pregnant mothers in southwest Ethiopia. METHOD: A community-based cross-sectional study was employed among 373 pregnant mothers. A simple random sampling method was used to select the study participants. The data was entered into EpiData Manager and exported to SPSS version 21 for analysis. A bivariable logistic regression was conducted to explore the association between independent variables and the outcome variable. Variables with p-values less than 0.25 during bivariable analysis were entered into a multivariable logistic regression model. Level of statistical significance was declared at a p-value below 0.05. The crude and adjusted odds ratios, along with the 95% CI, were estimated to measure the strength of the association between the dependent variables and independent variables. RESULT: In this study, 373 pregnant mothers have participated, with a response rate of 97%. A total of 275 (73.7%; 95% CI: 68.9-78.0) women practiced key essential nutrition actions at optimal level. Monthly household income of 2500 ETB (AOR = 0.45, 95% CI: 0.23, 0.89), rural residence (AOR = 2.31, 95% CI: 1.25, 4.4), and poor knowledge of key ENA messages (AOR = 3.36, 95% CI: 1.81, 6.26) were factors that were significantly associated with poor practice of key ENA messages. CONCLUSIONS: The practice of key ENA messages was poor and closely linked to household income, residence, and knowledge of pregnant women's on ENA key messages. Therefore, nutritional intervention with a focus on intensified nutritional counseling is needed for better adoption of key ENA practices.


Assuntos
Resultado da Gravidez , Gestantes , Feminino , Humanos , Recém-Nascido , Gravidez , Estudos Transversais , Etiópia , Mães/psicologia , Gestantes/psicologia , Cuidado Pré-Natal
9.
PLoS One ; 19(2): e0299219, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38416742

RESUMO

BACKGROUND: Pregnant women are among the most vulnerable and suffer the most during pandemics, according to earlier studies. Pregnant women had to seek healthcare for both themselves and their unborn child(ren) in the wake of the COVID-19 pandemic, which was unprecedented. Pregnant women's psychosocial experiences during pandemics are crucial since they both directly and indirectly affect the course of pregnancy and childbirth. The study therefore sought to explore the psychosocial experiences of pregnant women during the COVID-19 pandemic. METHODS: In this retrospective qualitative study, 15 nursing mothers who were attending a postnatal clinic at the Kwame Nkrumah University of Science and Technology (KNUST) hospital in Ghana were recruited. Individual interviews were conducted with mothers who were pregnant between March and December 2020. The audio-recorded interviews were transcribed verbatim and inductively analysed into themes. RESULTS: Nursing mothers were aged 25-30 years and had infants ranging from 5 months to 15 months. Thirteen (13) were married and two were single. Two (2) major themes and five (5) subthemes emerged from the study. The unpleasant feelings connected to the potential for contracting COVID-19 and experiencing stress were described by the theme, "Fear and Stress". Participants' social experiences (support from significant others), alterations in daily routine and the economic impact because of the pandemic were presented as the "Socioeconomic impact". CONCLUSION: Pregnant women go through several challenges during pregnancy such as perceived stress and anxiety. These are likely to heighten during a pandemic, as presented in the study. They therefore need emotional and psychosocial support in such uncertain times to improve outcomes of pregnancy.


Assuntos
COVID-19 , Gestantes , Lactente , Feminino , Gravidez , Humanos , Gestantes/psicologia , Pandemias , Estudos Retrospectivos , COVID-19/epidemiologia , Parto , Pesquisa Qualitativa
10.
Ceska Gynekol ; 89(1): 22-28, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38418249

RESUMO

AIMS:  The aim of this study was to investigate the levels of pandemic-related fear, depression, stress and anxiety in pregnant women in different trimesters after the pandemic and to examine their relationship with psychological resilience. Methods: A total of 250 women were included in the study, including 125 pregnant women and 125 healthy controls. The participants were divided into three groups according to their trimester of pregnancy. The Depression-Anxiety-Stress Scale 21 (DASS-21), the Epidemic Disease Anxiety Scale (EDAS) and the Short Psychological Resilience Scale (SPRS) were used to measure depression, anxiety, stress and psychological resilience. Results: Pregnant women had significantly higher DASS-21 total scores [19 (4-42) ] than healthy controls [11 (1-42) ], P = 0.001. The prevalence of depression, anxiety and stress was 23.2%, 44% and 20% respectively in pregnant women compared to 12.8%, 31.2% and 9.6% in healthy controls. DASS-21 total scores were highest in the 1st (21.2 ± 5.8) and 3rd (22.8 ± 8.9) trimesters and lowest in the 2nd (16.1 ± 6.9) trimesters. The DASS-21 total score was positively correlated with the EDAS total score and the pandemic perception subscale. SPRS total score was negatively correlated with anxiety, stress and DASS-21 total score. Conclusion: Pregnant women experienced higher levels of depression, anxiety, stress, and pandemic anxiety than non-pregnant women in the post-pandemic period. Psychological resilience was negatively associated with depression, anxiety, and stress in pregnant women. These findings indicate that the pandemic negatively affects the mental health of pregnant women and the importance of providing psychological support services to protect their mental health.


Assuntos
Gestantes , Resiliência Psicológica , Feminino , Humanos , Gravidez , Gestantes/psicologia , Pandemias , Turquia/epidemiologia , Depressão/epidemiologia , Depressão/psicologia , Estresse Psicológico/psicologia , Medo
11.
BMC Public Health ; 24(1): 481, 2024 Feb 15.
Artigo em Inglês | MEDLINE | ID: mdl-38360616

RESUMO

Intimate partner violence (IPV) occurs at alarmingly high rates towards pregnant women in South Africa. Experiences of emotional, physical, and sexual IPV in pregnancy can adversely impact the health and safety of mother and fetus. Furthermore, IPV is associated with increased risk of HIV, exacerbating the public health impact of violence among pregnant women in this HIV endemic setting. In-depth understanding of cultural and contextual drivers of experiences of IPV is a critical precursor to development of interventions effectively addressing this issue among pregnant women in South Africa. The present study examines factors contributing to IPV among pregnant women to identify potential points of intervention. We conducted twenty in-depth interviews with postpartum women who used oral pre-exposure prophylaxis (PrEP) in pregnancy and reported recent experiences of IPV and/or ongoing alcohol use in a township near Cape Town, South Africa that experiences a heavy burden of both HIV and IPV. Interpretive thematic analysis was used. Several patterns of IPV during pregnancy were identified and violence was frequently described as co-occurring with male partner alcohol use. A majority of women referenced oral PrEP as their preferred method for HIV prevention, highlighting the agency and discretion it provided as beneficial attributes for women experiencing IPV. Fear of judgement from peers for remaining with an abusive partner and a lack of clear community messaging around IPV were identified as barriers to disclosure and support-seeking. Addressing the lack of social support received by women experiencing IPV during pregnancy in South Africa is essential to comprehensive IPV programming.


Assuntos
Infecções por HIV , Violência por Parceiro Íntimo , Feminino , Humanos , Masculino , Gravidez , África do Sul/epidemiologia , Gestantes/psicologia , Violência por Parceiro Íntimo/prevenção & controle , Violência por Parceiro Íntimo/psicologia , Infecções por HIV/prevenção & controle , Infecções por HIV/epidemiologia , Período Pós-Parto
12.
Gac Sanit ; 38: 102359, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38330537

RESUMO

OBJECTIVE: To determine the effectiveness of mindfulness interventions on anxiety through a systematic review. METHOD: Systematic review by searching articles through the PubMed, ProQuest, Science Direct, Wiley Library, Sage Journal, and Cochrane Library databases with publication years January 2012 to January 2022 RESULTS: Eleven articles met the inclusion criteria covering several countries, including Canada 1 article, Egypt 1 article, Taiwan 1 article, Amsterdam 2 articles, Iran 1 article, Austria 1 article, San Francisco 1 article, Germany 1 article, Sweden 1 article, China 1 article, and Spain 1 article. CONCLUSIONS: Management of anxiety about childbirth is important for pregnant women. Mindfulness interventions are effective for reducing anxiety about labor and increasing comfort during labor. Mindfulness intervention mechanisms have the potential to reduce anxiety by increasing skills to regulate emotions.


Assuntos
Trabalho de Parto , Atenção Plena , Gravidez , Feminino , Humanos , Ansiedade/prevenção & controle , Gestantes/psicologia , Parto Obstétrico , Depressão
13.
Artigo em Inglês | MEDLINE | ID: mdl-38397698

RESUMO

A 28-week supported online intervention for pregnant women, informed by the Behavior Change Wheel Framework, was developed. The intervention included exercises, group sessions and a peer support platform. The aim of this study was to examine the potential effectiveness of the intervention in enhancing resilience and promoting maternal mental health. Using a quasi-experimental design, assessments were conducted at baseline, postintervention and follow-ups at six and 12 months after childbirth. Resilience, resilience attributes, and maternal mental health were measured using standardised scales. The intervention group received the intervention (N = 70), while the control group (N = 32) received care-as-usual. A repeated-measures ANOVA was used to determine within- and between-group changes. Results showed no significant differences between groups regarding resilience and maternal mental health. However, the intervention group demonstrated stable resilience (p = 0.320) compared to a significant decrease in the control group (p = 0.004). Within the intervention group, perceived social support remained stable during the intervention, but decreased significantly at the first follow-up (p = 0.012). All participants faced additional stress from the COVID-19 pandemic alongside the challenges of parenthood. This study contributes to maternal mental health literature with an innovative, supported online intervention. The intervention consists of different deployable components, designed to be offered online, and the current pilot data are promising. Further research is warranted to explore its full potential in clinical practice.


Assuntos
Intervenção Baseada em Internet , Resiliência Psicológica , Feminino , Gravidez , Humanos , Gestantes/psicologia , Projetos Piloto , Pandemias , Parto
14.
Nurs Health Sci ; 26(1): e13082, 2024 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-38355938

RESUMO

Social support is an important factor in reducing fear of childbirth (FOC). Recently, the Internet and Social Networking Services (SNS) have become new forms of social support. However, it is unclear whether such support can reduce pregnant women's fear. This study aimed to investigate the association between FOC and social support through the Internet and SNS in pregnant women. A cross-sectional study using a web-based questionnaire including questions about FOC, social support, the Internet and SNS usage, psychological variables, and sociodemographic variables was conducted. Data from 111 participants were analyzed. A greater number of social support from people who are often seen during pregnancy, and becoming relieved by interaction with others through the Internet and SNS were negatively associated with FOC. This study showed that face-to-face social support was associated with lower FOC, while social support through the Internet and SNS was not. Further research is needed on how to use Internet and SNS to reduce FOC in pregnant women.


Assuntos
Parto , Gestantes , Gravidez , Feminino , Humanos , Gestantes/psicologia , Parto/psicologia , Estudos Transversais , Medo/psicologia , Apoio Social , Inquéritos e Questionários , Parto Obstétrico/psicologia
15.
BMC Psychiatry ; 24(1): 157, 2024 Feb 22.
Artigo em Inglês | MEDLINE | ID: mdl-38388417

RESUMO

OBJECTIVE: The purpose of the study was to investigate the status of pregnancy stress and to explore factors associated with pregnancy stress among women by China's two-child policy. METHODS: A mixed-method study involving both quantitative and qualitative methods was conducted using questionnaires and semi-structured interviews. The questionnaires encompassed socio-demographic and obstetric characteristics, as well as the Pregnancy Stress Rating Scale (PSRS) and the Social Support Rating Scale (SSRS). Initially, the participants were required to complete the questionnaires, enabling us to assess their respective pregnancy stress statuses. Subsequently, we selectively interviewed pregnant women with a second child and exhibited at least mild pregnancy stress. The qualitative study sought to uncover the factors contributing to their stress during pregnancy. RESULTS: A total of 463 subjects were enrolled; of the subjects, 22 (4.8%) had no stress, 407 (87.9%) had mild stress, 34 (7.3%) had moderate stress. Generalized linear regression analysis revealed significant factors (P<0.05) related to pregnancy stress, including family financial burden, subjective support, fertility desire, gender of the first child, and gender preference. Additionally, 16 subjects were interviewed, and through analysis, three major themes emerged, each comprising 12 sub-themes associated with pregnancy stress. These themes were identified as fertility factors (worry about maternal and child health, birth experience, and parenting stress), family factors ( financial burden, second child care problems, first child's acceptance of the second child, family concerns, fertility desire, and gender preference) and social factors (involving life events, career development and workload). CONCLUSION: The diver factors contribute to pregnancy stress among pregnant women under China's two-child policy. Our study could be used to develop appropriate interventions to reduce pregnancy stress and to enhance the mental health of women pregnant with a second child.


Assuntos
Fertilidade , Gestantes , Gravidez , Feminino , Humanos , Gestantes/psicologia , Comportamento Sexual , Políticas , China
16.
PLoS One ; 19(1): e0290868, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38165879

RESUMO

In Kenya, approximately one in five girls aged 15-19 years old are pregnant or already a mother. Adolescent girls and young women experience significant mental health vulnerabilities during the pregnancy and postpartum periods, leading to poor antenatal and postnatal care attendance and inferior infant and maternal health outcomes. Pregnant adolescents often experience stigma and disenfranchisement due to their pregnancy status and at the same time lack access to mental health support within health settings, schools, religious institutions, and communities. This paper presents the results of qualitative interviews embedded within the human-centered design (HCD) process used to adapt the Helping Adolescents Thrive (HAT) program for Kenyan peripartum adolescents including young fathers. This qualitative study used two phases. First, a HAT advisory group participated in a series of four workshops to help identify and articulate mental health promotion needs and deepened the team's understanding of youth-centered thinking. Second, qualitative interviews were conducted with 39 pregnant and parenting adolescents to understand their perspectives on mental health prevention and promotion. Pregnant and parenting adolescents articulated different needs including poor support, stigma, and psychological disturbances. Parenting adolescents reported disturbed relationships, managing motherhood, poor health, and social empowerment. Participants highlighted sources of stress including economic challenges, fear of delivery, strained relationships, rejection, and stigma. Participants described psychological disturbances such as feeling stressed, worthless, withdrawn, and suicidal. Coping mechanisms reported by participants included engaging in domestic activities, hobbies, and social networking. Peers, family and spirituality were identified as important sources of support, as well as school integration, livelihoods, support groups and mentorships. Findings from this study can be used to strengthen and adapt HAT program, policy and practice for mental health prevention and promotion for pregnant and parenting adolescents.


Assuntos
Saúde Mental , Período Periparto , Gravidez , Feminino , Adolescente , Humanos , Adulto Jovem , Adulto , Quênia , Gestantes/psicologia , Mães
17.
Sex Reprod Healthc ; 39: 100949, 2024 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-38281399

RESUMO

OBJECTIVE: The Covid-19 pandemic led to a reorganization of antenatal care including the cancellation or shift into telemedicine of consultations and restrictions to the presence of an accompanying person. The aim was to explore healthcare professionals' and women's lived experience of such reorganisation consequences on the quality of care and specific challenges they faced, with a particular emphasis on telemedicine and equity. METHODS: Exploratory qualitative study using semi-structured interviews and focus group discussions of women and healthcare providers in New Aquitaine (France) and in the Basque Country (Spain). We collected data from a purposive sampling of women (n = 33) and professionals (n = 19) who had received or provided antenatal care in hospitals and ambulatory facilities between March 2020 and December 2021. Participants' narratives were thematically analysed to identify themes that were subsequently contextualised to the two territories. RESULTS: Antenatal care professionals and pregnant women experienced strong emotions and suffered from organizational changes that compromised the quality and equity of care. The pandemic and associated restrictions were sources of emotional distress, fear and loneliness, especially among more disadvantaged and isolated women. Among professionals, the lack of adequate means of protection and the multiple changes in caring protocols generated burnout, feeling of abandonment and emotional distress. CONCLUSIONS: The Covid-19 experience should serve to critically consider the unexpected consequences of reorganising healthcare services and the need to meet patients' needs, with a particular consideration for disadvantaged groups. Future scenarios of telemedicine generalisation should consider a combination of in presence and remote consultations ensuring antenatal care quality and equity.


Assuntos
COVID-19 , Cuidado Pré-Natal , Feminino , Gravidez , Humanos , Cuidado Pré-Natal/psicologia , Pandemias , Gestantes/psicologia , Pesquisa Qualitativa , Europa (Continente)
18.
BMC Pregnancy Childbirth ; 24(1): 88, 2024 Jan 29.
Artigo em Inglês | MEDLINE | ID: mdl-38287284

RESUMO

BACKGROUND: This study aimed to assess the impacts of closed-off measures with different strictness levels (lockdown, partial lockdown and non-lockdown) and geographic proximity to patients with coronavirus disease 2019 (COVID-19) on prenatal depression during an epidemic rebound of COVID-19. METHODS: This was a cross-sectional web-based survey including 880 pregnant women. Depressive symptoms were measured by Self-Rating Depression Scale (SDS) and geographic proximity was calculated using Geographic Information Systems. Linear and logistic regression were used to assess the associations of closed-off measures and geographic proximity with SDS scores and depressive symptoms. Restricted cubic splines were used to model non-linear associations between geographic proximity and depression symptoms. RESULTS: Compared with those living in non-lockdown areas, women in lockdown areas had higher SDS scores (adjusted ß: 3.51, 95% CI: 1.80, 5.21) and greater risk of depressive symptoms (adjusted OR: 4.00, 95% CI: 2.18, 7.35), but evidence for partial lockdown was not obvious. A progressive increase in the risk of depressive symptoms was found with decreasing distance to COVID-19 patients when geographic proximity was <8 kilometers. Compared to those in the 5th quintile of geographic proximity, women in the first, second and third quintiles had at least 6 times higher risk of depressive symptoms. CONCLUSIONS: Pregnant women under strict closed-off management during COVID-19 epidemic have high risk of depression. A specific range around the residences of reported COVID-19 patients should be underlined as potential clustering of high prenatal depression levels. Our findings highlight the importance of enhancing mental health management during the COVID-19 epidemic for pregnant women.


Assuntos
COVID-19 , Recidiva , Feminino , Humanos , Gravidez , Ansiedade/psicologia , Controle de Doenças Transmissíveis , COVID-19/epidemiologia , COVID-19/psicologia , Estudos Transversais , Depressão/psicologia , SARS-CoV-2 , Gestantes/psicologia
19.
Arch Argent Pediatr ; 122(3): e202310217, 2024 06 01.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-38231589

RESUMO

Maternal mental health problems during pregnancy, childbirth, and the postpartum period are a challenge for public health. Not recognizing them hinders a timely diagnosis and treatment and has an impact on the mother and the establishment of the fundamental bond of the mother-child dyad. We must recognize the risk factors (age, socioeconomic status, mental health history, family dysfunction, unfavorable environment), clinical manifestations, and screening tools. There is evidence that the effect of stress, anxiety, and depression during pregnancy negatively affect fetal neurodevelopment and condition child developmental outcomes. Here we describe the negative impact of postpartum depression during the first months of life, which affects mother-child bonding, postnatal development (emotional, behavioral, cognitive, language), and the maintenance of breastfeeding. We also recognize protective factors that mitigate its effects. It is essential to establish preventive strategies and interdisciplinary diagnostic and therapeutic approaches to minimize the risks to the mother and her children.


Los problemas de salud mental materna durante el embarazo, parto y puerperio son un desafío para la salud pública. Su falta de reconocimiento atenta contra el diagnóstico y tratamientos oportunos, e impacta en la madre y el establecimiento del vínculo fundamental del binomio. Debemos reconocer los factores de riesgo (edad, situación socioeconómica, antecedentes psicopatológicos, disfunción familiar, entorno desfavorable), las manifestaciones clínicas y las herramientas de detección. Existen evidencias de que el efecto del estrés, la ansiedad y la depresión durante el embarazo afectan negativamente el neurodesarrollo fetal y condicionan los resultados del desarrollo infantil. Describimos el impacto negativo de la depresión puerperal durante los primeros meses de vida, que afecta el vínculo madre-hija/o, el desarrollo posnatal (emocional, conductual, cognitivo, lenguaje) y el mantenimiento de la lactancia materna. También reconocemos factores protectores que atemperan sus efectos. Es fundamental establecer estrategias preventivas y abordajes diagnósticos y terapéuticos interdisciplinarios para minimizar los riesgos sobre la madre y sus hijas/os.


Assuntos
Depressão Pós-Parto , Humanos , Feminino , Gravidez , Lactente , Depressão Pós-Parto/diagnóstico , Depressão Pós-Parto/etiologia , Gestantes/psicologia , Relações Mãe-Filho/psicologia , Mães/psicologia , Parto , Cognição
20.
BMC Pregnancy Childbirth ; 24(1): 29, 2024 Jan 04.
Artigo em Inglês | MEDLINE | ID: mdl-38178015

RESUMO

BACKGROUND: Low birth weight (LBW) rates are high in the northern region of Ghana, as is tolerance for intimate partner violence (IPV). However, the relationship between the two incidents has not been established. This study assessed the magnitude of IPV against pregnant women and its association with LBW in the northern region of Ghana. METHODS: A cross-sectional study was conducted among 402 postnatal women from five public health care facilities in the Tamale Metropolitan Area, northern Ghana. Data were collected electronically during face-to-face interviews. Validated methods were used to determine IPV exposure during pregnancy and birth weight. Multivariable logistic regression was used to identify the independent association between prenatal exposure to IPV and LBW. RESULTS: Of the 402 women, 46.5% (95% CI: 41.7, 51.4) experienced IPV during their most recent pregnancy. Of these, 34.8% were psychologically abused, 24.4% were sexually abused, and 6.7% were physically abused. Prenatal IPV exposure was found to be significantly associated with birth weight. Low birth weight was twice as likely among exposed women as among unexposed women (AOR = 2.42; 95% CI: 1.12, 5.26, p < 0.05). Low birth weight risk was also higher among women with anaemia in the first trimester (AOR = 3.47; 95% CI: 1.47, 8.23, p < 0.01), but was lower among women who made at least four antenatal care visits before delivery (AOR = 0.35; 95% CI: 0.14, 0.89, p < 0.05) and male newborns (AOR = 0.23; 95% CI: 0.11, 0.49, p < 0.001). CONCLUSION AND RECOMMENDATION: IPV during pregnancy is prevalent in the research population, with psychological IPV being more widespread than other kinds. Women who suffered IPV during pregnancy were more likely to have LBW than those who did not. It is essential to incorporate questions about domestic violence into antenatal care protocols. In particular, every pregnant woman should be screened for IPV at least once during each trimester, and those who have experienced violence should be closely monitored for weight gain and foetal growth in the study setting to avert the LBW associated with IPV. In the northern region of Ghana, the number of babies born with low birth weight is high, as is the number of adults who are willing to put up with intimate partner violence. However, there has not been any proof that these two incidents are connected. This study looked at how frequently intimate partner violence occurs among pregnant women and how it is linked to low birth weight in northern Ghana's Tamale Metropolitan Area. A cross-sectional study was conducted with 402 postnatal women from five public health care facilities in the study setting. Information on exposure to intimate partner violence during pregnancy and the birth weight of babies was collected electronically during face-to-face interviews. The study found that of the 402 women, 46.5% had experienced violence by an intimate partner during their most recent pregnancy. Out of these, 34.8% were abused psychologically, 24.4% were abused sexually, and 6.7% were abused physically. Women who were abused were more likely than those who were not to have babies with low birth weight. We concluded that intimate partner violence is common during pregnancy in the study setting and that more women suffered psychological intimate partner violence than other types of violence. Intimate partner violence during pregnancy was linked to low birth weight in the study setting. It is important for antenatal care plans to include questions about intimate partner violence. In particular, every pregnant woman should be assessed for intimate partner violence at least once during each trimester for monitoring.


Assuntos
Violência por Parceiro Íntimo , Gestantes , Adulto , Feminino , Gravidez , Recém-Nascido , Masculino , Humanos , Gestantes/psicologia , Autorrelato , Peso ao Nascer , Estudos Transversais , Gana/epidemiologia , Violência por Parceiro Íntimo/psicologia , Recém-Nascido de Baixo Peso , Modelos Logísticos , Parto , Fatores de Risco
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