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1.
BMC Public Health ; 21(1): 368, 2021 02 17.
Artículo en Inglés | MEDLINE | ID: mdl-33596889

RESUMEN

BACKGROUND: Corona Virus Disease 19 (COVID-19) is a new pandemic, declared a public health emergency by the World Health Organization, which could have negative consequences for pregnant and postpartum women. The scarce evidence published to date suggests that perinatal mental health has deteriorated since the COVID-19 outbreak. However, the few studies published so far have some limitations, such as a cross-sectional design and the omission of important factors for the understanding of perinatal mental health, including governmental restriction measures and healthcare practices implemented at the maternity hospitals. Within the Riseup-PPD COST Action, a study is underway to assess the impact of COVID-19 in perinatal mental health. The primary objectives are to (1) evaluate changes in perinatal mental health outcomes; and (2) determine the risk and protective factors for perinatal mental health during the COVID-19 pandemic. Additionally, we will compare the results between the countries participating in the study. METHODS: This is an international prospective cohort study, with a baseline and three follow-up assessments over a six-month period. It is being carried out in 11 European countries (Albania, Bulgaria, Cyprus, France, Greece, Israel, Malta, Portugal, Spain, Turkey, and the United Kingdom), Argentina, Brazil and Chile. The sample consists of adult pregnant and postpartum women (with infants up to 6 months of age). The assessment includes measures on COVID-19 epidemiology and public health measures (Oxford COVID-19 Government Response Tracker dataset), Coronavirus Perinatal Experiences (COPE questionnaires), psychological distress (BSI-18), depression (EPDS), anxiety (GAD-7) and post-traumatic stress symptoms (PTSD checklist for DSM-V). DISCUSSION: This study will provide important information for understanding the impact of the COVID-19 pandemic on perinatal mental health and well-being, including the identification of potential risk and protective factors by implementing predictive models using machine learning techniques. The findings will help policymakers develop suitable guidelines and prevention strategies for perinatal mental health and contribute to designing tailored mental health interventions. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT04595123 .


Asunto(s)
/psicología , Salud Global/estadística & datos numéricos , Trastornos Mentales/epidemiología , Periodo Posparto/psicología , Mujeres Embarazadas/psicología , Adulto , Europa (Continente)/epidemiología , Femenino , Humanos , Embarazo , Estudios Prospectivos , Factores Protectores , Proyectos de Investigación , Factores de Riesgo
2.
BMC Pregnancy Childbirth ; 21(1): 112, 2021 Feb 08.
Artículo en Inglés | MEDLINE | ID: mdl-33557764

RESUMEN

BACKGROUND: Global crises inevitably increase levels of anxiety in postpartum populations. Effective and efficient measurement is therefore essential. This study aimed to create a 12-item research short form of the 51-item Postpartum Specific Anxiety Scale [PSAS] and validate it for use in rapid response research at a time of global crises [PSAS-RSF-C]. We also present the same 12-items, in five other languages (Italian, French, Chinese, Spanish, Dutch) to increase global accessibility of a psychometric tool to assess maternal mental health. METHODS: Twelve items from the PSAS were selected on the basis of a review of their factor loadings. An on-line sample of UK mothers (N = 710) of infants up to 12 weeks old completed the PSAS-RSF-C during COVID-19 'lockdown'. RESULTS: Principal component analyses on a randomly split sample (n = 344) revealed four factors, identical in nature to the original PSAS, which in combination explained 75% of the total variance. Confirmatory factor analyses (n = 366) demonstrated the four-factor model fit the data well. Reliability of the overall scale and of the underlying factors in both samples proved excellent. CONCLUSIONS: Findings suggest the PSAS-RSF-C may prove useful as a clinical screening tool and is the first postpartum-specific psychometric scale to be validated during the COVID-19 pandemic. This offers psychometrically sound assessment of postpartum anxiety. By increasing the accessibility of the PSAS, we aim to enable researchers the opportunity to measure maternal anxiety, rapidly, at times of global crisis.


Asunto(s)
Ansiedad/epidemiología , /psicología , Salud Materna , Pandemias , Periodo Posparto/psicología , Escalas de Valoración Psiquiátrica , Psicometría/métodos , Adolescente , Adulto , Ansiedad/psicología , /virología , Análisis Factorial , Femenino , Humanos , Lactante , Recién Nacido , Salud Mental , Persona de Mediana Edad , Pandemias/prevención & control , Embarazo , Cuarentena/psicología , Reproducibilidad de los Resultados , Encuestas y Cuestionarios , Traducciones , Reino Unido/epidemiología , Adulto Joven
3.
Matern Child Health J ; 25(3): 349-352, 2021 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-33543374

RESUMEN

In the US, the COVID-19 pandemic adds a new source of stress for women in the perinatal period, a time when stress and anxiety are already heightened. The closures of physical mental health care spaces and lack of support could have devastating impacts on the health of postpartum women and their newborns. Yet, the pandemic creates an opportunity to innovate in the ways mental health care is delivered to pregnant and postpartum women. With the expanded capacity for video and telephone visits, researchers should continue to explore solutions for providing support networks to this vulnerable population.


Asunto(s)
/epidemiología , Salud Mental , Periodo Posparto/psicología , Adulto , Trastornos de Ansiedad/epidemiología , Depresión/epidemiología , Femenino , Humanos , Recién Nacido , Pandemias , Embarazo , Complicaciones del Embarazo/epidemiología , Mujeres Embarazadas/psicología , Estrés Psicológico/epidemiología , Poblaciones Vulnerables
4.
BMC Pregnancy Childbirth ; 21(1): 114, 2021 Feb 08.
Artículo en Inglés | MEDLINE | ID: mdl-33557768

RESUMEN

BACKGROUND: This retrospective study aimed to identify possible intensification of mental health difficulties among women seeking support in the postpartum period during the epidemic state in Poland. We assumed that the epidemic crisis, social isolation, and restrictions in hospitals which affect pregnant and postpartum women - lack of family labors, lack of the possibility to be with the newborn when he/she is hospitalized, may increase fear and reduce psychosocial resources of women, hinder their normal process of transition to motherhood and thus contribute to the intensified severity of depressive symptoms. METHODS: The study participants were women seeking support at the on-line platform of the project 'Next Stop: Mum', which is a part of the postpartum depression prevention's program implemented by the Ministry of Health in Poland, and enables remote self-screening for the severity of the postpartum depression symptoms with the Edinburgh Postnatal Depression Scale developed by Cox and collaborators. The analyzed data in this study were obtained from 139 women: 61 filled forms from October 1 - November 10, 2019 (non-epidemic period), and 78 filled forms from February 20-March 30 (beginning of the COVID-19 epidemic), 2020. RESULTS: A statistically significant difference in the severity of postpartum depression symptoms were observed among women making a self-assessment with EPDS scale at the beginning of the COVID-19 epidemic in Poland (M = 15.71; SD = 6.23), compared to the pre-epidemic neutral period (M = 13.56; SD = 6.46). CONCLUSIONS: The results of this study indicate that the epidemic crisis may be associated with an increased need for additional caution and support of women's mental health in the postpartum period. We believe that recommendations for medical staff, policy, and families of women struggling with postpartum depression symptoms during crisis should be widespread as the second wave of COVID-19 disease may develop in the autumn-winter 2020 and spring 2021.


Asunto(s)
/epidemiología , Depresión Posparto/epidemiología , Depresión/epidemiología , Salud Materna , Pandemias , Periodo Posparto/psicología , Sistemas de Apoyo Psicosocial , Adulto , Depresión/prevención & control , Depresión/psicología , Depresión Posparto/prevención & control , Depresión Posparto/psicología , Femenino , Humanos , Recién Nacido , Salud Mental , Polonia/epidemiología , Embarazo , Escalas de Valoración Psiquiátrica , Estudios Retrospectivos , Autoinforme , Autoevaluación
5.
Prax Kinderpsychol Kinderpsychiatr ; 70(2): 134-153, 2021 Feb.
Artículo en Alemán | MEDLINE | ID: mdl-33565952

RESUMEN

The Role of Partnership Status and Relationship Satisfaction in Inpatient Mother-Child Treatment in Postpartum Mental Disorders The study examines the partnership status and satisfaction in connection with symptoms of postpartum mental disorders, mother-child attachment and outcome of inpatient mother-child treatment. Two sub-studies were carried out. In the first study, N = 126 mothers with postpartum mental disorders who went to a preliminary consultation for inpatient mother-child treatment stated their symptom burden (SCL-90), mother-child attachment (PBQ) and satisfaction with their partner relationship (PFB-K). Mothers with stressed relationships showed the highest level of symptom burden and impaired attachment. Mothers without a partner reported the least amount of impairment in mother-child attachment. In the second study, N = 41 mothers were examined over the course of inpatient treatment (within-subject design with a waiting-list). The initial relationship satisfaction was not predictive of symptom reduction or improvement in mother-child attachment. An increase in satisfaction during the treatment was though correlated with an improvement in mother-child attachment.


Asunto(s)
Pacientes Internos/psicología , Relaciones Madre-Hijo/psicología , Madres/psicología , Apego a Objetos , Satisfacción Personal , Periodo Posparto/psicología , Parejas Sexuales/psicología , Depresión Posparto/psicología , Femenino , Humanos , Lactante , Recién Nacido , Estado Civil/estadística & datos numéricos
6.
MCN Am J Matern Child Nurs ; 46(2): 103-109, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33470613

RESUMEN

ABSTRACT: The COVID-19 pandemic led to several states mandating social distancing and sheltering in place along with a shift in health care delivery, unprecedented unemployment rates, financial stress, and emotional concerns. For pregnant and postpartum women, limited social support and social isolation with social distancing and fear of COVID-19 exposure or infection for themselves, their fetus, or their newborn infants, have implications for maternal mental health. An overview of the potential impact of COVID-19 on mental health risk for pregnant and postpartum women is presented with implications for nursing practice to promote maternal-infant wellbeing.


Asunto(s)
/epidemiología , Salud Mental , Periodo Posparto/psicología , Mujeres Embarazadas/psicología , Salud de la Mujer , Adulto , Femenino , Humanos , Pandemias , Neumonía Viral/epidemiología , Neumonía Viral/virología , Embarazo , Complicaciones Infecciosas del Embarazo/epidemiología , Complicaciones Infecciosas del Embarazo/virología , Apoyo Social
7.
Eur J Obstet Gynecol Reprod Biol ; 258: 162-167, 2021 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-33429166

RESUMEN

OBJECTIVE: To evaluate the relation between sexual function and depressive symptoms in puerperal women during the pandemic period. STUDY DESIGN: Prospective cohort with 125 women evaluated in the immediate postpartum period (before the pandemic - T1) in Hospital de Clínicas de Porto Alegre, 3 months (pandemic onset - T2) and 6 months (pandemic peak - T3) after birth by email and WhatsApp. The Female Sexual Function Index (FSFI) and the Edinburgh Postnatal Depression Scale (EPDS) were applied. RESULTS: Fifty puerperal women participated in the three periods of the study. The median age was 25 years. There was an inverse correlation between the ​​ FSFI and EPDS values at T2 (p < 0.001) and T3 (p < 0.001), demonstrating that the worsening sexual response was secondary to the higher prevalence of depressive symptoms in the puerperium in the COVID-19 pandemic. There was an increase in EPDS scores in the three periods: at T1, the EPDS scores ​​were 5.0 (2.0-9.0), increasing to 7.0 (4.0-14.0) at T2 and 6.5 (3.0-13.0) at T3 (p = 0.004). There was no difference between the FSFI index at the three evaluated times. CONCLUSIONS: Puerperal women are a susceptible subgroup for sexual dysfunction and depressive symptoms, which are correlated to each other and worsen in periods of stress, therefore, it is mandatory to investigate depressive symptoms in puerperal women with sexual complaints, especially during the COVID-19 pandemic.


Asunto(s)
/psicología , Depresión Posparto/epidemiología , Disfunciones Sexuales Psicológicas/epidemiología , Adulto , Brasil/epidemiología , Femenino , Humanos , Pandemias , Periodo Posparto/psicología , Embarazo , Estudios Prospectivos , Aislamiento Social/psicología , Encuestas y Cuestionarios
8.
BMC Pregnancy Childbirth ; 21(1): 81, 2021 Jan 25.
Artículo en Inglés | MEDLINE | ID: mdl-33494715

RESUMEN

BACKGROUND: Challenges with engaging in postnatal physical activity can negatively affect the health of women and their families. This study investigated women's physical activity decision-making processes and strategies to support their physical activity as part of a healthy postpartum transition. METHODS: Thirty healthy women with infants aged 2.5-12 months completed 3-day activity diaries and an individual interview. Using Glaser and Charmaz's grounded theory methodology, the core category, reconciling relationships with physical activity, was constructed, which explained women's processes of postnatal physical activity decision-making. RESULTS: Through reconciling relationships with physical activity, women discerned the types of physical activity they were comfortable pursuing at various points in the postpartum transition. Based on the meaning physical activity held for participants and their views about risks, supports, and resources, women gauged their capacity and the workability of their physical activity desires. Most women were uncertain of their capacity (physical, emotional) to return to physical activity and viewed the achievement of several or all of their desired physical activities as unworkable. Only a small group of women fully pursued the desirable physical activities they viewed as important for their well-being. Women adjusted the strategies they used to achieve physical activity when their expectations of capacity and workability did not align with their experiences. Some women lacked access to resources or supportive messaging about postpartum physical activity and downgraded their physical activity pursuit after negative personal physical or childcare experiences. CONCLUSIONS: Women can benefit from discussions about physiological birth recovery and navigating community and peer resources to support physical activity access and the safe return to physical activity following birth.


Asunto(s)
Actitud Frente a la Salud , Toma de Decisiones , Ejercicio Físico/psicología , Periodo Posparto/psicología , Adulto , Femenino , Humanos , Lactante , Investigación Cualitativa , Apoyo Social , Adulto Joven
9.
BMC Pregnancy Childbirth ; 21(1): 83, 2021 Jan 25.
Artículo en Inglés | MEDLINE | ID: mdl-33494719

RESUMEN

BACKGROUND: Postpartum maternal functioning has the potential to affect the quality of interaction between mother and child. A proper assessment of maternal functioning requires a comprehensive and accurate tool. The objective of this study was to prepare a Persian version of the Barkin Index of Maternal Functioning (BIMF) and evaluate its psychometric properties in order to determine its applicability in Iranian mothers. METHODS: The BIMF was translated into Persian and then culturally adapted for Iranian women. After evaluating face and content validity, to perform factor analysis, a cross-sectional study was conducted using the Persian version of BIMF. The data was collected from two unique groups of 250 mothers (in all 500 mothers) who had infants 2 to 12-months old and who were selected using a two-stage cluster sampling method. Factor analysis, Pearson's correlation, intra-class correlation coefficients (ICC), composite reliability (CR) and Cronbach's alpha were employed in order to evaluate structural validity and reliability. RESULTS: Exploratory factor analysis resulted in a five-factor structure consisting of 20 items. Subsequently, confirmatory factor analysis (X 2/ df = 1.61, RMSEA = 0.050, GFI = 0.91, CFI = 0.91) confirmed that the Persian version had satisfactory goodness of fit. Reliability and internal consistency were confirmed with a CR of 0.77, an ICC of 0.87 and a Cronbach's alpha of 0.81. CONCLUSIONS: The findings indicated that the Persian version of the BIMF is a valid and reliable instrument for assessing maternal functioning among Iranian mothers.


Asunto(s)
Conducta Materna/psicología , Relaciones Madre-Hijo , Periodo Posparto/psicología , Encuestas y Cuestionarios/normas , Adaptación Psicológica , Adulto , Características Culturales , Femenino , Humanos , Lactante , Cuidado del Lactante/psicología , Persia , Psicometría
10.
Int J Gynaecol Obstet ; 153(1): 83-88, 2021 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-33368216

RESUMEN

OBJECTIVE: To understand how giving birth during the coronavirus disease 2019 (COVID-19) pandemic affected women based on birth parameters (gestational age, type of birth and body weight at birth), satisfaction with childbirth, and development of postpartum depression. METHODS: This is a cross-sectional study of 162 Spanish women. They were divided into two groups: those who gave birth before the pandemic (n = 82; from September 1, 2019 to March 1, 2020) and during the pandemic (n = 75; from April 1, 2020 to July 1, 2020). They were assessed using psychological instruments for postpartum childbirth satisfaction and postpartum depression. RESULTS: It was found that women who gave birth during the pandemic suffered higher levels of stress during childbirth (U = 2652.50; P = 0.040) and gave a worse rating of the quality of care received (U = 2703.50; P = 0.041). In addition, the percentage of postpartum depression was much higher in women who gave birth during the pandemic (χ2  = 4.31; P  = 0.038). CONCLUSION: Giving birth during the COVID-19 pandemic could have an impact on greater dissatisfaction with childbirth, as well as increasing the risk of postpartum depression.


Asunto(s)
Parto Obstétrico , Depresión Posparto , Parto/psicología , Estrés Psicológico , Adulto , /prevención & control , Estudios Transversales , Parto Obstétrico/métodos , Parto Obstétrico/psicología , Parto Obstétrico/estadística & datos numéricos , Depresión Posparto/diagnóstico , Depresión Posparto/epidemiología , Femenino , Edad Gestacional , Humanos , Satisfacción Personal , Periodo Posparto/psicología , Embarazo , España/epidemiología , Estrés Psicológico/epidemiología , Estrés Psicológico/etiología
11.
MCN Am J Matern Child Nurs ; 46(1): 30-35, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33048860

RESUMEN

For new families giving birth in a hospital setting, the COVID-19 pandemic has presented numerous challenges to their birth, breastfeeding, and postpartum experiences. We present experiences of three first-time, healthy mothers and their babies, as they gave birth in the hospital and were breastfeeding during the start of the pandemic in Philadelphia, PA. Each case is framed in the mother's prenatal goals, infant feeding intentions, birth, breastfeeding, and postpartum experiences. Shared concerns and experiences among the three participants are described in five key areas: 1) Recommendations changing every day, 2) Guilt, concern, and stress, 3) In-person versus telehealth visits, 4) Missing time with family and friends, and 5) Silver linings. Through these mothers' experiences, nurses and other health care providers can learn from their perceptions and events and proactively work to ensure we provide sound anticipatory guidance, enhance our communication, and improve provision of evidence-based lactation care and support.


Asunto(s)
Lactancia Materna/psicología , Atención Posnatal/psicología , Periodo Posparto/psicología , Adulto , Ansiedad/psicología , Femenino , Humanos , Recién Nacido , Trabajo de Parto , Embarazo , Autoimagen
12.
PLoS One ; 15(12): e0243936, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-33315905

RESUMEN

BACKGROUND: The etiology of postpartum psychopathologies are not well understood, but folate metabolism pathways are of potential interest. Demands for folate increase dramatically during pregnancy, low folate level has been associated with psychiatric disorders, and supplementation may improve symptomatology. The MTHFR C677T variant influences folate metabolism and has been implicated in depression during pregnancy. OBJECTIVE: To conduct a prospective longitudinal study to explore the relationship between MTHFR C677T genotype, folate levels, and postpartum psychopathology in at-risk women. HYPOTHESIS: In the first three months postpartum, folate will moderate a relationship between MTHFR genotype and depression, with TT homozygous women having more symptoms than CC homozygous women. METHODS: We recruited 365 pregnant women with a history of mood or psychotic disorder, and at 3 postpartum timepoints, administered the Edinburgh Postnatal Depression Scale (EPDS); Clinician-Administered Rating Scale for Mania (CARS-M) and the Positive and Negative Symptom Scale (PANSS) and drew blood for genotype/folate level analysis. We used robust linear regression to investigate interactions between genotype and folate level on the highest EPDS and CARS-M scores, and logistic regression to explore interactions with PANSS psychosis scores above/below cut-off. RESULTS: There was no significant interaction effect between MTHFR genotype and folate level on highest EPDS (p = 0.36), but there was a significant interaction between genotype, folate level and log(CARS-M) (p = 0.02); post-hoc analyses revealed differences in the effect of folate level between CC/CT, and TT genotypes, with folate level in CC and CT having an inverse relationship with symptoms of mania, while there was no relationship in participants with TT genotype. There was no significant interaction between MTHFR genotype and folate level on the likelihood of meeting positive symptom criteria for psychosis on the PANSS (p = 0.86). DISCUSSION: These data suggest that perhaps there is a relationship between MTHFR C677T, folate level and some symptoms of postpartum psychopathology.


Asunto(s)
Depresión Posparto/genética , Ácido Fólico/genética , Metilenotetrahidrofolato Reductasa (NADPH2)/genética , Periodo Posparto/genética , Adulto , Alelos , Depresión Posparto/sangre , Depresión Posparto/patología , Depresión Posparto/psicología , Femenino , Ácido Fólico/sangre , Predisposición Genética a la Enfermedad , Estudio de Asociación del Genoma Completo , Genotipo , Humanos , Estudios Longitudinales , /patología , Persona de Mediana Edad , Periodo Posparto/psicología , Embarazo , Estudios Prospectivos , Trastornos Psicóticos/genética , Trastornos Psicóticos/patología , Trastornos Psicóticos/psicología , Factores de Riesgo , Adulto Joven
13.
Artículo en Inglés | MEDLINE | ID: mdl-33348568

RESUMEN

The aim of this study was to analyze stress and anxiety levels experienced by pregnant and post-partum women during the COVID-19 pandemic, as well as to indicate the social and medical factors that could contribute to stress and anxiety. A total of 210 patients were enrolled in the study. Two well-established test-tools were applied: State-Trait Anxiety Inventory (STAI) and Perceived Stress Scale (PSS-10). The study revealed that the levels of stress and anxiety experienced by the surveyed patients were moderate to high. We demonstrated that women with mental treatment history, those in the first trimester of pregnancy and the ones that are single or in an informal relationship tend to experience higher levels of psychological distress and anxiety. Such factors as age, education, parity, eventful obstetric history, comorbidities, and the number of hospital stays proved to be statistically insignificant in the analysis. Our findings could be used to identify patients at greater risk of experiencing adverse mental effects and to provide them with adequate psychological support. Further multi-center studies are warranted in order to draw final conclusions.


Asunto(s)
Ansiedad/epidemiología , Pandemias , Periodo Posparto/psicología , Mujeres Embarazadas/psicología , Estrés Psicológico/epidemiología , Depresión , Femenino , Humanos , Embarazo
14.
Sci Rep ; 10(1): 22380, 2020 12 24.
Artículo en Inglés | MEDLINE | ID: mdl-33361797

RESUMEN

The mental health effects of the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) and the Coronavirus Disease 2019 (COVID-19) pandemic on postpartum women are of increasing concern among mental health practitioners. To date, only a handful of studies have explored the emotional impact of the pandemic surrounding pregnancy and none have investigated the consequence of pandemic-related social restrictions on the postpartum mood of those living among different socioeconomic status (SES). All postpartum patients appearing to the Mount Sinai Health System for their postpartum appointment between January 2, 2020 and June 30, 2020, corresponding to before and during pandemic imposed social restrictions, were screened for mood symptomatology using the Edinburgh Postnatal Depression Scale (EPDS). Each patient's socioeconomic status (high/low) was determined by their location of clinical service. A total of 516 postpartum patients were screened. While no differences in EPDS scores were observed by SES prior to social restrictions (U = 7956.0, z = - 1.05, p = .293), a significant change in mood symptomatology was observed following COVID-19 restrictions (U = 4895.0, z = - 3.48, p < .001), with patients living in lower SES reporting significantly less depression symptomatology (U = 9209.0, z = - 4.56, p < .001). There was no change in symptomatology among patients of higher SES (U = 4045.5, z = - 1.06, p = .288). Postpartum depression, the most common complication of childbearing, is a prevalent, cross-cultural disorder with significant morbidity. The observed differences in postpartum mood between patients of different SES in the context of temporarily imposed COVID-19-related social restrictions present a unique opportunity to better understand the specific health and social support needs of postpartum patients living in urban economic poverty. Given that maternal mental illness has negative long-term developmental implications for the offspring and that poor mental health reinforces the poverty cycle, future health policy specifically directed towards supporting postpartum women living in low SES by ameliorating some of the early maternal burdens associated with balancing employment-family-childcare demands may assist in interrupting this cycle while simultaneously improving the long-term outcomes of their offspring.


Asunto(s)
Afecto , /prevención & control , Depresión Posparto/epidemiología , Pandemias/prevención & control , Periodo Posparto/psicología , Cuarentena/psicología , Clase Social , Adolescente , Adulto , Estudios de Cohortes , Depresión Posparto/diagnóstico , Femenino , Humanos , Salud Mental , Ciudad de Nueva York/epidemiología , Prevalencia , Escalas de Valoración Psiquiátrica , Adulto Joven
15.
BMC Pregnancy Childbirth ; 20(1): 703, 2020 Nov 18.
Artículo en Inglés | MEDLINE | ID: mdl-33208115

RESUMEN

BACKGROUND: Trauma, natural and man-made catastrophic events can be predictors of postpartum psychological distress. In a public health response due to coronavirus disease 2019 outbreak, the Italian government imposed a lockdown from March 9 to May 3. This extraordinary situation may have been challenging for maternal psychological health. The aim of this study was to investigate the prevalence of depressive and post-traumatic stress symptoms in women giving birth during the Covid-19 pandemic and its associations with quarantine measures, obstetrical factors, and relational attachment style. METHODS: Women who gave birth in a high-volume obstetric/gynaecological medical centre located in an epidemic area during the Covid-19 pandemic (March 8 to June 15) were asked to complete an online survey about their childbirth experience and the perceived effect of the pandemic. The Edinburgh Postnatal Depression Scale (EPDS), the Impact of Event Scale-Revised (IES-R), and the Relationship Questionnaire (RQ) were administered to assess levels of postpartum depressive and post-traumatic stress symptoms (PTSS) and relational style of attachment, respectively. Multivariate analysis was applied to identify associations between quarantine measures, childbirth experience, attachment style, and EPDS and IES-R scores. RESULTS: The survey was completed by 163 women (response rate 60.8%). The prevalence of depressive symptoms was 44.2% (EPDS cut-off score ≥ 11) and the PTSS rate was 42.9% (IES-R cut-off score ≥ 24). Dismissive and fearful avoidant attachment styles were significantly associated with the risk of depression and PTSS, respectively. Perceived pain during birth was a risk factor for postpartum depression. Perceived support provided by healthcare staff was a protective factor against depression and PTSS. Another protective factor against PTSS was quiet on the ward due to the absence of hospital visitors. CONCLUSION: This study reports a high prevalence of postpartum depressive and PTSS in women who gave birth during the Covid-19 pandemic. Postnatal psychological distress seemed to be associated more with the prenatal experience and other individual factors than with the pandemic hospital restrictions. Early detection during pregnancy of an insecure attachment style is fundamental to provide targeted preventive and therapeutic psychological interventions.


Asunto(s)
Infecciones por Coronavirus/psicología , Depresión Posparto , Neumonía Viral/psicología , Periodo Posparto/psicología , Mujeres Embarazadas/psicología , Distrés Psicológico , Cuarentena/psicología , Adulto , Betacoronavirus , Control de Enfermedades Transmisibles/métodos , Infecciones por Coronavirus/epidemiología , Infecciones por Coronavirus/prevención & control , Estudios Transversales , Depresión Posparto/epidemiología , Depresión Posparto/etiología , Depresión Posparto/prevención & control , Femenino , Humanos , Italia/epidemiología , Pandemias/prevención & control , Parto/psicología , Neumonía Viral/epidemiología , Neumonía Viral/prevención & control , Embarazo , Prevalencia , Psicología , Sistemas de Apoyo Psicosocial , Trastornos por Estrés Postraumático/epidemiología , Trastornos por Estrés Postraumático/etiología , Trastornos por Estrés Postraumático/prevención & control
17.
PLoS One ; 15(10): e0239310, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-33064737

RESUMEN

Infants born to HIV-infected mothers are more likely to be low birthweight (LBW) than other infants, a condition that is stigmatized in many settings worldwide, including sub-Saharan Africa. Few studies have characterized the social-cultural context and response to LBW stigma among mothers in sub-Saharan Africa or explored the views of women living with HIV (WLHIV) on the causes of LBW. We purposively sampled thirty postpartum WLHIV, who had given birth to either LBW or normal birthweight infants, from two tertiary hospitals in Accra, Ghana. Using semi-structured interviews, we explored women's understanding of the etiology of LBW, and their experiences of caring for a LBW infant. Interviews were analyzed using interpretive phenomenology. Mothers assessed their babies' smallness based on the baby's size, not hospital-recorded birthweight. Several participants explained that severe depression and a loss of appetite, linked to stigma following an HIV diagnosis during pregnancy, contributed to infants being born LBW. Women with small babies also experienced stigma due to the newborns' "undesirable" physical features and other people's unfamiliarity with their size. Consequently, mothers experienced blame, reluctance showing the baby to others, and social gossip. As a result of this stigma, women reported self-isolation and depressive symptoms. These experiences were layered on the burden of healthcare and infant feeding costs for LBW infants. LBW stigma appeared to attenuate with increased infant weight gain. A few of the women also did not breastfeed because they thought their baby's small size indicated pediatric HIV infection. Among WLHIV in urban areas in Ghana, mother and LBW infants may experience LBW-related stigma. A multi-component intervention that includes reducing LBW incidence, treating antenatal depression, providing psychosocial support after a LBW birth, and increasing LBW infants' weight gain are critically needed.


Asunto(s)
Infecciones por VIH/psicología , Madres/psicología , Periodo Posparto/psicología , Estereotipo , Adolescente , Adulto , Depresión/etiología , Femenino , Ghana , Infecciones por VIH/patología , Humanos , Lactante , Recién Nacido de Bajo Peso , Entrevistas como Asunto , Aislamiento Social , Aumento de Peso , Adulto Joven
18.
Obstet Gynecol ; 136(5): 1030-1035, 2020 11.
Artículo en Inglés | MEDLINE | ID: mdl-33030876

RESUMEN

The rising maternal mortality rate has drawn increased focus to postpartum depression. However, other mental health conditions, such as birth-related postpartum traumatic stress disorder, have not garnered the same level of attention. The majority of research about postpartum posttraumatic stress disorder (PTSD) is published in journals focused on psychiatry, psychology, and nursing, where this phenomenon is well recognized. In contrast, there is a lack of awareness among most obstetricians. Consequently, few recommendations are available to guide clinical practice. This commentary will present a clinical vignette, provide background that is key to the detection of PTSD, explore available data on postpartum PTSD, and provide recommendations for recognition and prevention of this disorder.


Asunto(s)
Trastornos Puerperales/prevención & control , Trastornos por Estrés Postraumático/prevención & control , Adulto , Femenino , Humanos , Periodo Posparto/psicología , Embarazo , Trastornos Puerperales/psicología , Trastornos por Estrés Postraumático/psicología
19.
Adv Exp Med Biol ; 1252: 199-207, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32816283

RESUMEN

Young breast cancer patients face numerous challenges during the cancer trajectory. As in the last decade, women tend to delay pregnancies to a later time in life, and clinicians are often faced with young breast cancer patients who want to start a family or complete it. Becoming a mother is a delicate developmental process in which the woman redefines and restructures her identity as she gets prepared for her new role and responsibilities. When there is a history of cancer or cancer diagnosis is communicated during the pregnancy, fears, worries, and concerns emerge and specific support may be necessary. Follow-ups during the post-partum period are also recommended as lactation issues should not be overlooked. In this chapter, we analyze the psychological aspects of cancer survivors and women with pregnancy-associated breast cancer, and the management of these issues.


Asunto(s)
Neoplasias de la Mama/psicología , Lactancia/psicología , Complicaciones Neoplásicas del Embarazo/psicología , Ansiedad , Lactancia Materna , Femenino , Humanos , Periodo Posparto/psicología , Embarazo
20.
Am J Perinatol ; 37(12): 1271-1279, 2020 10.
Artículo en Inglés | MEDLINE | ID: mdl-32757185

RESUMEN

OBJECTIVE: This study was aimed to describe the hospitalization and early postpartum psychological experience for asymptomatic obstetric patients tested for severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) as part of a universal testing program and report the impact of this program on labor and delivery health care workers' job satisfaction and workplace anxiety. STUDY DESIGN: This is a cohort study of asymptomatic pregnant women who underwent SARS-CoV-2 testing between April 13, 2020 and April 26, 2020. Semistructured interviews were conducted via telephone at 1 and 2 weeks posthospitalization to assess maternal mental health. Depression screening was conducted using the patient health questionnaire-2 (PHQ-2). An online survey of labor and delivery health care workers assessed job satisfaction and job-related anxiety before and during the novel coronavirus disease 2019 (COVID-19) pandemic, as well as employees' subjective experience with universal testing. Patient and employee responses were analyzed for recurring themes. RESULTS: A total of 318 asymptomatic women underwent SARS-CoV-2 testing during this 2-week period. Six of the eight women (75%) who tested positive reported negative in-hospital experiences secondary to perceived lack of provider and partner support and neonatal separation after birth. Among the 310 women who tested negative, 34.4% of multiparous women reported increased postpartum anxiety compared with their prior deliveries due to concerns about infectious exposure in the hospital and lack of social support. Only 27.6% of women, tested negative, found their test result to be reassuring. Job satisfaction and job-related anxiety among health care workers were negatively affected. Universal testing was viewed favorably by the majority of health care workers despite concerns about delays or alterations in patient care and maternal and neonatal separation. CONCLUSION: Universal testing for SARS-CoV-2 in obstetric units has mixed effects on maternal mental health but is viewed favorably by labor and delivery employees. Ongoing evaluation of new testing protocols is paramount to balance staff and patient safety with quality and equality of care. KEY POINTS: · Women with SARS-CoV-2 had a negative hospital experience.. · A negative SARS-CoV-2 test was not reassuring for patients.. · COVID-19 negatively impacts healthcare workers' well-being..


Asunto(s)
Actitud Frente a la Salud , Infecciones por Coronavirus/diagnóstico , Personal de Salud/psicología , Tamizaje Masivo/psicología , Aislamiento de Pacientes/psicología , Neumonía Viral/diagnóstico , Periodo Posparto/psicología , Mujeres Embarazadas/psicología , Apoyo Social , Adulto , Ansiedad , Infecciones Asintomáticas/psicología , Actitud del Personal de Salud , Betacoronavirus , Técnicas de Laboratorio Clínico , Femenino , Hospitalización , Humanos , Recién Nacido , Satisfacción en el Trabajo , Partería , Enfermeras y Enfermeros/psicología , Enfermería Obstétrica , Estrés Laboral/psicología , Pandemias , Parto , Cuestionario de Salud del Paciente , Médicos/psicología , Embarazo
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