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1.
Life Sci ; 251: 117597, 2020 Jun 15.
Artigo em Inglês | MEDLINE | ID: mdl-32243926

RESUMO

Stress during pregnancy adversely affects foetal development and leads to later behavioural outcomes in offspring. Preclinical studies have reported conflicting effects of prenatal stress on depression-related symptoms in rodent offspring. This study aimed to study the combined effect of strain and sex on prenatal stress outcomes in a single study. To this end, male and female offspring from outbred Wistar and inbred Lewis rats, and outbred NMRI and inbred C57BL6 mice were compared. As outcomes we focussed on depression-related behaviour and related molecular and neurochemical parameters. Prenatally stressed and non-stressed offspring were subjected to the sucrose preference, novelty-suppressed feeding, tail suspension, and forced swim tests. We measured basal and stress-induced corticosterone levels in the serum, and brain-derived-neurotrophic-factor (BDNF), interleukin-1ß, tumor necrosis factor-α, glutamate and serotonin in the brain to determine changes in hypothalamic-pituitary-adrenal-(HPA)-axis function, neuroplasticity, neuroinflammation, and neurotransmission. Our findings revealed that prenatal stress increases depression-like behaviour, HPA-axis (re) activity, pro-inflammatory cytokines and glutamate levels, and decreases BDNF and serotonin levels in a strain and sex-dependent manner in rodent offspring. Overall, male and female Lewis rats, female Wistar rats, male NMRI mice and female C57BL6 mice were found to be most responsive to prenatal stress. Based on these results, we conclude that genetic background and sex contribute to the great diversity in the effects of prenatal maternal stress in rodents.


Assuntos
Depressão/psicologia , Complicações na Gravidez/psicologia , Efeitos Tardios da Exposição Pré-Natal/psicologia , Estresse Psicológico/psicologia , Animais , Encéfalo/metabolismo , Corticosterona/sangue , Feminino , Masculino , Camundongos , Camundongos Endogâmicos C57BL , Gravidez , Ratos , Ratos Endogâmicos Lew , Ratos Wistar , Fatores Sexuais , Especificidade da Espécie
2.
Orv Hetil ; 161(10): 374-381, 2020 Mar.
Artigo em Húngaro | MEDLINE | ID: mdl-32115991

RESUMO

Introduction: Pregnancy is usually desired, yet it has its own difficulties that can be overwhelming, thus depression might occur. The prevalence of this is 6.58-26.7% in the international literature and 6.5-17.9% in Hungarian studies. Aim: The aim was to analyze the data of the perinatal depression screening program of Békéscsaba which started in 2014. We wanted to study the pathological rate and the connection between demographic data and depression symptoms. Method: Until august 2019, 1708 women took part in the program. The screening is done by perinatal nurses: they explain the aims and hand over the Edinburgh Postnatal Depression Scale three times during pregnancy and once postpartum. They also suggest women in need to attend the psychological intervention as part of the screening. Results: The prevalence of the pathological questionnaires were 15.31%, 14.29%, 11.87%, and 12.68% at the four measuring occasions. In the whole sample, 18.27% of women had pathological score at least once. The depression scores of the four measurements correlated significantly with each other. Women who did not plan their pregnancies had higher level of depression in all four measurements. In the first trimester, women who were under 21 years old and/or were single had higher depression scores. In the second trimester, multipara women tended to have higher scores. Conclusion: The high prevalence and the constant level of depression emphasize the importance of the screening and psychological intervention, as previous studies found connection between depression and some perinatal complications. Some demographic factors can indicate more vulnerable women. Orv Hetil. 2020; 161(10): 374-381.


Assuntos
Depressão Pós-Parto/psicologia , Depressão/diagnóstico , Programas de Rastreamento/métodos , Complicações na Gravidez/psicologia , Cuidado Pré-Natal/métodos , Adulto , Depressão/epidemiologia , Depressão/psicologia , Depressão Pós-Parto/diagnóstico , Depressão Pós-Parto/epidemiologia , Feminino , Humanos , Hungria/epidemiologia , Idade Materna , Assistência Perinatal , Gravidez , Cuidado Pré-Natal/estatística & dados numéricos , Prevalência , Escalas de Graduação Psiquiátrica , Fatores de Risco , Adulto Jovem
3.
PLoS One ; 15(3): e0227944, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32196492

RESUMO

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 Social
4.
Medicina (B Aires) ; 80 Suppl 2: 47-52, 2020.
Artigo em Espanhol | MEDLINE | ID: mdl-32150713

RESUMO

This article is intended to review the effect of mindfulness-based interventions on perinatal mental health. A search of the literature published until September 2019 in the Web of Science (WOS) database was carried out. Taking into account the inclusion and exclusion criteria and after reading the title and abstracts of the articles found, 26 of them have been selected. Finally we only analyzed randomized controlled trials (RCTs) that show data on anxiety, depression, perceived stress and mindfulness before and after intervention and with follow-up data. The results found show that mindfulness-based interventions (IBMs) are more effective than the usual healthcare (TAU) that pregnant women receive for the reduction of depressive, anxious and perceived stress symptoms as well as increasing their postintervention mindfulness levels. For future research, a postpartum follow-up would be considered interesting taking into account variables such as the quality of the mother-baby attachment, adherence to breastfeeding and the evolutionary development of the newborn.


Assuntos
Ansiedade/terapia , Depressão/terapia , Atenção Plena/métodos , Gestantes/psicologia , Ansiedade/psicologia , Depressão/psicologia , Depressão Pós-Parto/psicologia , Depressão Pós-Parto/terapia , Feminino , Humanos , Assistência Perinatal/métodos , Gravidez , Complicações na Gravidez/psicologia , Complicações na Gravidez/terapia , Resultado do Tratamento
5.
BJOG ; 127(6): 750-756, 2020 May.
Artigo em Inglês | MEDLINE | ID: mdl-32036628

RESUMO

OBJECTIVE: To compare the obstetric outcomes and socio-demographic factors in electronic cigarette (EC) users with cigarette smokers and non-smokers in pregnancy. DESIGN: Prospective observational cohort study. SETTING: A large urban maternity hospital delivering almost 8500 infants per year. POPULATION: Pregnant women attending for antenatal care. METHODS: Electronic cigarette users at time of booking history were prospectively identified. Maternal and neonatal outcomes were compared with those of pregnant smokers and non-smokers. Multiple logistic regression analysis was performed to estimate the association between the explanatory variables and birthweight. MAIN OUTCOMES MEASURES: Infant birthweight, gestation at delivery, incidence of low birthweight. RESULTS: A total of 218 women with exclusive EC use and 195 women with dual use of both cigarettes and EC, had a live birth during the study period. EC users were of higher socio-economic status than smokers. Infants born to EC users had a mean birthweight of 3470 g (± 555 g), which was similar to that of non-smokers (3471 ± 504 g, P = 0.97) and significantly greater than that of smokers (3166 ± 502 g, P < 0.001). The mean birth centile of EC users was similar to non-smokers (51st centile versus 47th centile, P = 0.28) and significantly greater than that of smokers (27th centile, P < 0.001). Dual users had a mean birthweight and birth centile similar to that of smokers. CONCLUSION: The birthweight of infants born to EC users is similar to that of non-smokers, and significantly greater than cigarette smokers. Dual users of both cigarettes and EC have a birthweight similar to that of smokers. TWEETABLE EXTRACT: Birthweight of infants born to electronic cigarette users appears to be similar to that of non-smokers.


Assuntos
Fumar Cigarros/efeitos adversos , Complicações na Gravidez/psicologia , Resultado da Gravidez/epidemiologia , Cuidado Pré-Natal/estatística & dados numéricos , Vaping/efeitos adversos , Adulto , Peso ao Nascer , Feminino , Humanos , Incidência , Recém-Nascido de Baixo Peso , Recém-Nascido , Modelos Logísticos , Gravidez , Estudos Prospectivos , População Urbana
6.
JAMA Netw Open ; 3(1): e1919940, 2020 Jan 03.
Artigo em Inglês | MEDLINE | ID: mdl-31995213

RESUMO

Importance: Prenatal maternal stress is increasingly associated with adverse outcomes in pregnant women and their offspring. However, the association between maternal stress and human fetal brain growth and metabolism is unknown. Objective: To identify the association between prenatal maternal psychological distress and fetal brain growth, cortical maturation, and biochemical development using advanced 3-dimensional volumetric magnetic resonance imaging (MRI) and proton magnetic resonance spectroscopy (1H-MRS). Design, Setting, and Participants: This cohort study prospectively recruited pregnant women from low-risk obstetric clinics in Washington, DC, from January 1, 2016, to April 17, 2019. Participants were healthy volunteers with a normal prenatal medical history, no chronic or pregnancy-induced physical or mental illnesses, and normal results on fetal ultrasonography and biometry studies. Fetal brain MRI studies were performed at 2 time points between 24 and 40 weeks' gestation. Exposures: Prenatal maternal stress, anxiety, and depression. Main Outcomes and Measures: Volumes of fetal total brain, cortical gray matter, white matter, deep gray matter, cerebellum, brainstem, and hippocampus were measured from 3-dimensional reconstructed T2-weighted MRI scans. Cortical folding measurements included local gyrification index, sulcal depth, and curvedness. Fetal brain N-acetylaspartate, creatine, and choline levels were quantified using 1H-MRS. Maternal stress, depression, and anxiety were measured with the Perceived Stress Scale (PSS), Edinburgh Postnatal Depression Scale (EPDS), Spielberger State Anxiety Inventory (SSAI), and Spielberger Trait Anxiety Inventory (STAI). Results: A total of 193 MRI studies were performed in 119 pregnant women (67 [56%] carrying male fetuses and 52 [44%], female fetuses; maternal mean [SD] age, 34.46 [5.95] years) between 24 and 40 gestational weeks. All women were high school graduates, 99 (83%) were college graduates, and 100 (84%) reported professional employment. Thirty-two women (27%) had positive scores for stress, 31 (26%) for anxiety, and 13 (11%) for depression. Maternal trait anxiety was associated with smaller fetal left hippocampal volume (STAI score: -0.002 cm3; 95% CI, -0.003 to -0.0008 cm3; P = .004). Maternal anxiety and stress were associated with increased fetal cortical gyrification in the frontal lobe (ß for SSAI score: 0.004 [95% CI, 0.001-0.006; P = .002]; ß for STAI score: 0.004 [95% CI, 0.002-0.006; P < .001]; ß for PSS score: 0.005 [95% CI, 0.001-0.008; P = .005]) and temporal lobe (ß for SSAI score: 0.004 [95% CI, 0.001-0.007; P = .004]; ß for STAI score: 0.004 [95% CI, 0.0008-0.006; P = .01]). Elevated maternal depression was associated with decreased creatine (EPDS score: -0.04; 95% CI, -0.06 to -0.02; P = .005) and choline (EPDS score: -0.03; 95% CI, -0.05 to -0.01; P = .02) levels in the fetal brain. Conclusions and Relevance: This study found that the prevalence of maternal psychological distress in healthy, well-educated, and employed pregnant women was high, underappreciated, and associated with impaired fetal brain biochemistry and hippocampal growth as well as accelerated cortical folding. These findings appear to support the need for routine mental health surveillance for all pregnant women and targeted interventions in women with elevated psychological distress.


Assuntos
Encéfalo/crescimento & desenvolvimento , Córtex Cerebral/diagnóstico por imagem , Desenvolvimento Fetal/fisiologia , Substância Cinzenta/diagnóstico por imagem , Complicações na Gravidez/diagnóstico por imagem , Estresse Psicológico/patologia , Adulto , Estudos de Coortes , Feminino , Humanos , Imageamento Tridimensional/métodos , Recém-Nascido , Imagem por Ressonância Magnética/métodos , Gravidez , Complicações na Gravidez/psicologia , Estudos Prospectivos , Fatores de Risco , Índice de Gravidade de Doença , Estresse Psicológico/diagnóstico por imagem
7.
J Matern Fetal Neonatal Med ; 33(2): 212-216, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-30033785

RESUMO

Objective: We hypothesized that women with a positive antenatal Edinburgh Depression Screen (EPDS) (≥10), undergoing behavioral or pharmacologic therapy have improved maternal and neonatal outcomes.Study design: This is a retrospective study of singleton pregnancies at UC, San Diego from 2010 to 2014. Patients with an antenatal EPDS were subdivided based on their intervention: negative score, positive score no treatment, behavioral therapy only, and pharmacologic therapy. The primary outcome was rate of preterm birth with secondary outcomes of maternal and neonatal outcomes.Results: Patients with a positive EPDS had a higher rate of preterm delivery, small-for-gestational age, NICU admission and Apgar score <7. Rates of adverse outcomes were highest among women receiving pharmacologic therapy. Rates of adverse outcomes women were not increased in the behavioral therapy group compared to the negative EPDS group. When adjusting for confounding variables, patient with a positive EPDS were more likely deliver preterm with an adjusted odds ratio of 1.71. Among varying treatment modalities, the odds ratio for preterm delivery was not statistically significant.Conclusion: Adverse pregnancy outcomes were highest among those requiring pharmacotherapy. Behavioral therapy had a positive effect on outcomes. Intervention to reduce these adverse outcomes in these patients needs further study.


Assuntos
Antidepressivos/administração & dosagem , Terapia Cognitivo-Comportamental , Depressão/terapia , Complicações na Gravidez/terapia , Resultado da Gravidez/epidemiologia , Adulto , Antidepressivos/efeitos adversos , Índice de Apgar , Depressão/psicologia , Feminino , Humanos , Recém-Nascido , Recém-Nascido Pequeno para a Idade Gestacional , Unidades de Terapia Intensiva Neonatal/estatística & dados numéricos , Gravidez , Complicações na Gravidez/psicologia , Nascimento Prematuro/epidemiologia , Estudos Retrospectivos
8.
Nurs Res ; 69(1): 82-88, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31373995

RESUMO

BACKGROUND: Pregnant women with depressive symptoms face significant treatment challenges and are in great need of safe, effective, accessible, inexpensive, and nonpharmacological self-management therapies to enhance well-being, reduce the burden of symptoms both during their pregnancy and postpartum, and prevent chronic sequelae. OBJECTIVES: In this article, we describe the protocol for our pilot study testing a self-management intervention entitled, "Mindful Moms," designed to foster women's ability to address current depressive symptoms and enhance resilience to prevent recurrence. METHODS: We will conduct a longitudinal pilot trial of the 12-week intervention with pregnant women with depressive symptoms (n = 40); the primary aim is to determine the feasibility and acceptability of the intervention. The secondary aim is to examine preliminary effects of the intervention on maternal psychobehavioral outcomes in pregnancy and 6 weeks postpartum. The third aim will quantify genome-wide and gene-specific DNA methylation patterns associated with depressive symptoms during pregnancy and investigate whether intervention participation influences these patterns. RESULTS: This study is currently ongoing. DISCUSSION: Findings from this study will inform future research addressing the need for nonpharmacological self-management interventions for pregnant women with depressive symptoms.


Assuntos
Transtorno Depressivo/prevenção & controle , Complicações na Gravidez/psicologia , Complicações na Gravidez/terapia , Gestantes/psicologia , Autogestão/métodos , Adulto , Feminino , Humanos , Estudos Longitudinais , Projetos Piloto , Gravidez , Projetos de Pesquisa
9.
Aten. prim. (Barc., Ed. impr.) ; 51(10): 626-636, dic. 2019. tab, graf
Artigo em Inglês | IBECS | ID: ibc-185945

RESUMO

Objective: To study the relationship between maternal affective disorders (AD) before and during pregnancy, and pre-term birth. Design: Retrospective observational study. Location: Sexual and reproductive health units at the Institut Català de la Salut (ICS) in Catalonia, Spain. Participants: Pregnant women with a result of live-born child from 1/1/2012 to 30/10/2015. Interventions: Data were obtained from the ICS Primary Care electronic medical record. Main measurements: Diagnosis of AD before and during pregnancy, months of pregnancy, and possible confusion factors were collected. Descriptive statistical analysis (median, interquartile range, and absolute and relative frequency), bivariate analysis (Wilcoxon test and Chi-square test), and multivariate analysis (logistic regression) were performed. Results: 102,086 women presented valid information for the study. Prevalence of AD during pregnancy was 3.5% (4.29% in pre-term and 3.46% in term births; p < 0.004). Pregnant women with pre-term births presented a higher age, smoking habit, lower inter-pregnancy interval, and a lower socio-economic status. Pre-term birth was significantly associated to previous history of stress and dissociative disorder (SDD), anxiety, obsessive-compulsive disorder (OCD) and eating disorders (ED), and use of antidepressants. It was also associated to abuse of alcohol, smoking, and use of psychoactive substances, as well as SDD, ED, use of antipsychotics, and divorce during pregnancy. Multivariate analysis confirmed the relationship between pre-term birth and history of AD, SDD, ED, and smoking, but not with AD during pregnancy. Conclusions: Examining the previous history of SDD and ED in pregnant women, and SDD, and ED during pregnancy is highly relevant to avoid pre-term birth


Objetivo: Estudiar la relación entre diagnósticos de trastornos afectivos (TA) antes y durante el embarazo, y factores de confusión con prematuridad del neonato. Diseño: Estudio observacional retrospectivo. Emplazamiento: Servicios de atención sexual y reproductiva del Institut Català de la Salut (ICS) en Cataluña, España. Participantes: Embarazadas atendidas con resultado de hijo vivo del 1/1/2012 al 30/10/2015. Intervenciones: Datos recogidos en la base de datos de la historia clínica informatizada. Mediciones: Se recogió los diagnósticos de TA antes y durante el embarazo, meses de gestación y posibles factores de confusión. Se realizó análisis estadístico descriptivo (mediana y rango intercuartílico y frecuencias absoluta y relativa), bivariante (test de Wilcoxon y Chi-cuadrado) y multivariante (regresión logística). Resultados: Ciento dos mil ochenta y seis mujeres presentaban información válida para el estudio. La prevalencia de TA durante el embarazo fue del 3,5% (4,29% en prematuros y 3,46% en a término; p<0,004). Las embarazadas con partos prematuros presentan mayor edad, más tabaquismo, menor tiempo entre embarazos y menor nivel socioeconómico. La prematuridad se asoció a antecedentes previos de trastorno por estrés y disociativo (TED), de ansiedad y obsesivo-compulsivo, de conducta alimentaria (TCA) y uso de antidepresivos. También a abuso de alcohol, tabaco y sustancias psicoactivas; TED, TCA, uso de antipsicóticos y divorcio durante el embarazo. El análisis multivariante confirmó la relación de prematuridad con antecedentes de TA, TED, TCA y tabaquismo, pero no con TA durante el embarazo. Conclusiones: Es importante explorar antecedentes de TED y TA en la embarazada y los TED durante el embarazo, para disminuir la prematuridad


Assuntos
Humanos , Feminino , Gravidez , Transtornos do Humor/complicações , Complicações na Gravidez/psicologia , Trabalho de Parto Prematuro/epidemiologia , Fatores de Risco , Fatores de Confusão Epidemiológicos , Estudos Retrospectivos , Modelos Logísticos , Fatores Socioeconômicos
10.
Psychoanal Rev ; 106(6): 509-536, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31877074

RESUMO

The psychological processes involved during the transition to motherhood are capable of transforming addiction problems. Notably, these processes can facilitate the reorganization of object relations and allow the investment in the real child, whose otherness is gradually acknowledged. This investment, however, differs from one woman to another and depends on each woman's ability to gradually incorporate and develop, first, the psychological and physical changes induced by pregnancy and, second, the issues remobilized by the regression induced by caring for the baby. This period is often fragile and is frequently influenced by the neonatal abstinence syndrome and by marital dynamics, which may lead to a drug relapse.


Assuntos
Mães/psicologia , Tratamento de Substituição de Opiáceos/psicologia , Transtornos Relacionados ao Uso de Opioides/psicologia , Complicações na Gravidez/psicologia , Gravidez/psicologia , Adulto , Feminino , Humanos , Transtornos Relacionados ao Uso de Opioides/tratamento farmacológico , Complicações na Gravidez/tratamento farmacológico , Pesquisa Qualitativa , Adulto Jovem
11.
PLoS One ; 14(12): e0226144, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31887159

RESUMO

OBJECTIVE: To investigate the association between maternal antenatal and/or postnatal psychosocial risk factors (including depression, psychological distress, alcohol abuse and intimate partner violence (IPV) and infant lower respiratory tract infection (LRTI) in a low- and middle-income-country (LMIC). STUDY DESIGN: Pregnant women (n = 1137) enrolled in a South African birth cohort study, the Drakenstein Child Health Study (DCHS) were longitudinally assessed for psychosocial risk factors including depression, psychological distress, alcohol abuse and/or intimate partner violence (IPV). Infants were followed from birth until one year of age for the development of LRTI by active surveillance. Two outcomes were evaluated: any LRTI, and severe and/or hospitalised LRTI. Logistic regression was used to identify associations between individual maternal psychosocial risk factors and LRTI outcomes. Analyses stratified by age were also performed to determine which age groups related to infant LRTI were linked with maternal psychosocial risk factors. RESULTS: There were 606 LRTI episodes in 369 infants in the first year (crude incidence rate = 0.53 episodes per person-year, 95%CI: 0.50; 0.56); 31% (n = 186) of episodes were severe or hospitalised events. Maternal psychosocial risk factors were associated with LRTI and severe LRTI, particularly postnatal and long-term maternal psychological distress, antenatal maternal alcohol consumption, and postnatal maternal IPV. Age stratified analyses found that antenatal maternal alcohol consumption was associated with early infant LRTI, while antenatal maternal depression was linked with infant severe LRTI between 3 and 6 months of age, and postnatal maternal IPV was associated with early LRTI and severe forms of LRTI. CONCLUSION: The associations between maternal psychosocial risk factors and infant LRTI highlight the potential value of screening for maternal psychosocial risk factors in clinical settings and developing targeted interventions. Such interventions may not only improve maternal well-being, but also help reduce the burden of infant LRTI in LMIC settings.


Assuntos
Consumo de Bebidas Alcoólicas/epidemiologia , Depressão Pós-Parto/epidemiologia , Complicações na Gravidez/psicologia , Infecções Respiratórias/epidemiologia , Adulto , Consumo de Bebidas Alcoólicas/psicologia , Estudos de Coortes , Depressão Pós-Parto/psicologia , Países em Desenvolvimento , Feminino , Humanos , Lactente , Modelos Logísticos , Estudos Longitudinais , Masculino , Idade Materna , Gravidez , Complicações na Gravidez/epidemiologia , África do Sul , Adulto Jovem
13.
Medicina (Kaunas) ; 55(10)2019 Oct 01.
Artigo em Inglês | MEDLINE | ID: mdl-31581510

RESUMO

Introduction: Pregnancy, delivery and postpartum periods are associated with fast changesleading to decreased self-confidence, anxiety, stress or even maternal depression impairing theirquality of life (QOL). Although considered important, QOL of women during pregnancy is poorlyunderstood. The aim of our study was to assess factors influencing QOL during first trimester ofpregnancy. The secondary goal of our study was to evaluate whether QOL during first trimester ofpregnancy is associated with newborn weight. Materials and methods: A prospective cohort studywas performed including pregnant women during the first trimester visit. Our questionnaireconsisted of the SF-36 QOL questionnaire, Wexner fecal incontinence scale, and other additionalinformation. The SF-36 questionnaire mental (MCS) and physical (PCS) health scores were used inorder to evaluate QOL of women during first trimester of pregnancy. Two multiple logisticregression models were created in order to determine independent variables that influence the QOL.Results: 440 pregnant women were included in the study. The two main domains that were used inthe study were MCS and PCS, their medians were 50.0 (25.0; 50.0) and 50.1 (39.4; 59.0) pointsrespectively. From the two logistic regression models we determined several independent factorsthat influence QOL of women during the first trimester of pregnancy. Additionally, we determinedthat women who reported worse QOL tended to give birth to newborns large for their gestationalage. Conclusions: We found several significant variables that influence QOL of women during thefirst trimester of pregnancy. We also found that that lower MCS and PCS scores during the firsttrimester are associated with newborns large for gestational age.


Assuntos
Transtorno Depressivo/psicologia , Complicações na Gravidez/psicologia , Cuidado Pré-Natal , Qualidade de Vida , Adulto , Peso ao Nascer , Estudos de Coortes , Feminino , Humanos , Recém-Nascido , Gravidez , Primeiro Trimestre da Gravidez , Estudos Prospectivos , Inquéritos e Questionários
14.
Shanghai Kou Qiang Yi Xue ; 28(3): 297-300, 2019 Jun.
Artigo em Chinês | MEDLINE | ID: mdl-31489420

RESUMO

PURPOSE: To evaluate the effect of minimally invasive technique in the treatment of deep caries during pregnancy, and to assess the impact of dental treatment on pain and anxiety among pregnant women. METHODS: From January 2017 to November 2017, 60 pregnant women with class I deep caries of the posterior teeth were recruited and divided into experimental group and control group randomly. The third generation chemical decaying technique plus traditional decaying method were used in the experimental group, and traditional decaying method alone was performed in the control group. Pulse and blood pressure during operation, duration of treatment for one tooth, and treatment results and complications at the end of follow-up were measured and recorded. Anxiety was assessed using the general hospital anxiety/depression scale (HAD) during treatment. The data were analyzed with SPSS 22.0 software package for Chi-square test. RESULTS: There was no significant difference in microleakage, secondary caries and shedding rate between the experimental group and control group. However, the experimental group was superior to the control group in terms of treatment time, inhibition of plaque, patients' fear degree, pain sensation and retention of healthy dental tissue. Minimally invasive scavenging technique can effectively relieve pain and anxiety of pregnant women during treatment. CONCLUSIONS: Minimally invasive decaying technique is superior to traditional decaying method in the treatment of deep caries in pregnant women and is worth wide application.


Assuntos
Ansiedade , Assistência Odontológica , Cárie Dentária , Manejo da Dor , Complicações na Gravidez , Cárie Dentária/psicologia , Cárie Dentária/terapia , Feminino , Humanos , Dor , Gravidez , Complicações na Gravidez/psicologia , Complicações na Gravidez/terapia
15.
Psychiatr Danub ; 31(Suppl 3): 615-618, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31488801

RESUMO

The psychological and physiological interaction between anorexia and the pregnant state has a large intrapartum and postpartum impact on mother and baby. Current research has attempted to discern the short and long term effects of eating disorders (EDs) on pregnancy as well as mother and baby-related sequelae; however little is understood about which management strategies are likely to prove most successful in mitigating these risks. The incidence and effect of low pre-pregnancy body mass index (BMI) on obstetric outcomes, and possible health complications in the future child, has attracted widespread attention. Especially concerning is the fact that it has long been known that the incidence of EDs in women of childbearing age is not only the highest out of all age categories but also is on an increasing trajectory. This paper aims to highlight the recent evidence underpinning the management of pregnant women with EDs in the light of the discussed short and long term effects of the disorders on mother and baby. We shall focus on those women who have a previous diagnosis of an ED prior to being pregnant. Particular attention will be paid to those studies considering anorexia nervosa. We argue for the use of early intervention strategies for the management of pregnant women with eating disorders, and for the use of a multidisciplinary approach in the treatment of these patients with complex problems.


Assuntos
Transtornos da Alimentação e da Ingestão de Alimentos/psicologia , Mães/psicologia , Complicações na Gravidez/psicologia , Gestantes/psicologia , Anorexia Nervosa/psicologia , Anorexia Nervosa/terapia , Índice de Massa Corporal , Transtornos da Alimentação e da Ingestão de Alimentos/terapia , Feminino , Humanos , Lactente , Gravidez , Complicações na Gravidez/terapia , Resultado da Gravidez
16.
Int J Gynaecol Obstet ; 147(3): 368-374, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31502667

RESUMO

OBJECTIVE: To evaluate drug use among mothers during the postpartum period after a severe pregnancy-related complication. METHODS: A retrospective cohort study of maternal morbidity including maternal near-miss and control groups conducted in a tertiary hospital in Campinas, Brazil, between July 2008 and June 2012. The Alcohol, Smoking, and Substance Involvement Screening Test (ASSIST) was used to assess drug use during lifetime, pregnancy, and in the previous 3 months. RESULTS: Of 638 women evaluated, drug use was reported by 165 (25.8%). Alcohol was the most common substance used (n=133, 20.6%), followed by tobacco (n=85, 13.2%), and cocaine (n=15, 2.3%). The highest risk for postpartum drug use was among those using drugs during pregnancy. There were no differences between the morbidity and control groups, but there was a significant difference in the need for intervention to reduce alcohol consumption in the severe maternal morbidity group. Risk for substance abuse intervention increased three-fold in women with PTSD criteria, and all aspects of quality of life were worse among drug users. CONCLUSION: Drug use during pregnancy and maternal complications are linked to postpartum drug abuse. These women should be managed during pregnancy; postpartum follow-up requires updated guidance and must go beyond family planning.


Assuntos
Consumo de Bebidas Alcoólicas/epidemiologia , Complicações na Gravidez/psicologia , Transtornos Relacionados ao Uso de Substâncias/epidemiologia , Adulto , Consumo de Bebidas Alcoólicas/psicologia , Brasil/epidemiologia , Estudos de Casos e Controles , Feminino , Humanos , Morbidade , Período Pós-Parto , Gravidez , Complicações na Gravidez/epidemiologia , Qualidade de Vida , Estudos Retrospectivos , Transtornos Relacionados ao Uso de Substâncias/psicologia
17.
Chiropr Man Therap ; 27: 34, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31417671

RESUMO

Background: There is insufficient evidence regarding psychosocial factors and its long-term association with persistent pregnancy-related lumbopelvic pain. The overall aim of this study was to investigate women with persistent pregnancy-related lumbopelvic pain 12 years postpartum based on psychosocial and behavioural characteristics using the Swedish version of the Multidimensional Pain Inventory (MPI-S) classification system. Material and methods: This is a cross-sectional study based on a previous cohort. Data collection took place through a questionnaire. A total of 295 women from the initial cohort (n = 639) responded to the questionnaire giving a response rate of 47.3%. To determine the relative risk (RR) of reporting pain 12 years postpartum, a robust modified Poisson regression was used. This is the first study using the MPI-S as a predictive variable on women with persistent pregnancy-related lumbopelvic pain. Results: The MPI-S classification procedure was carried out on a total of n = 226 women, where 53 women were classified as interpersonally distressed (ID), 82 as dysfunctional (DYS), and 91 as adaptive copers (AC). Women in the ID and DYS subgroups had a relative risk (RR) of reporting persistent pregnancy-related lumbopelvic pain 12 years postpartum that was more than twice as high compared to the AC subgroup (95% confidence interval (CI) in parenthesis): RR 2.57 (CI 1.76 - 3.75), p<0.0001 and RR 2.23 (CI 1.53 - 3.25), p<0.0001 respectively. Women in the DYS subgroup had more than 5 times increased risk of reporting sick leave the past 12 months compared to the AC subgroup (RR 5.44; CI 1.70 - 17.38, p=0.004). Conclusions: The present study demonstrates that it is possible to classify women with persistent pregnancy-related lumbopelvic pain 12 years postpartum into relevant clinical subgroups based on psychosocial and behavioural characteristics using the MPI-S questionnaire.


Assuntos
Dor Lombar/psicologia , Dor Pélvica/psicologia , Período Pós-Parto/psicologia , Complicações na Gravidez/psicologia , Adulto , Estudos de Coortes , Estudos Transversais , Feminino , Humanos , Pessoa de Meia-Idade , Gravidez , Suécia , Mulheres/psicologia
18.
BMC Pregnancy Childbirth ; 19(1): 299, 2019 Aug 16.
Artigo em Inglês | MEDLINE | ID: mdl-31419964

RESUMO

BACKGROUND: Antenatal clinical guidelines recommend that during initial and subsequent antenatal visits all pregnant women: have their alcohol consumption assessed; be advised that it is safest not to consume alcohol during pregnancy and of the potential risks of consumption; and be offered referrals for further support if required. However, the extent to which pregnant women attending public antenatal services receive guideline recommended care at these visits, and the characteristics associated with its receipt, is unknown. The purpose of this study was to examine: 1) pregnant women's reported receipt of guideline recommended care addressing alcohol consumption during pregnancy; 2) characteristics associated with the receipt of care; and 3) pregnant women's acceptability of care. METHODS: From July 2017 - February 2018 a survey (telephone or online) was undertaken with 1363 pregnant women who had recently visited a public antenatal service in one health district in Australia. Receipt and acceptability of recommended care were assessed via descriptive statistics and associations via logistic regression analyses. RESULTS: At the initial antenatal visit, less than two thirds (64.3%) of pregnant women reported that they received an assessment of their alcohol consumption and just over one third (34.9%) received advice and referral appropriate to their self-reported level of alcohol consumption since pregnancy recognition. Less than 10% of women received such care at subsequent antenatal visits. Characteristics that significantly increased the odds of receiving all guideline elements at the initial antenatal visit included: less than university attainment (OR = 1.93; 95% CI:1.12, 3.34), not residing in an advantaged area (OR = 2.11; 95% CI:1.17, 3.79), first pregnancy (OR = 1.91; 95% CI:1.22, 2.99) and regional/rural service location (OR = 2.38; 95% CI:1.26, 4.48); and at subsequent visits: younger age (OR = 0.91; 95% CI:0.84, 0.99) and Aboriginal origin (OR = 3.17; 95% CI:1.22, 8.24). Each of the recommended care elements were highly acceptable to pregnant women (88.3-99.4%). CONCLUSIONS: Although care for alcohol consumption is both recommended by clinical guidelines and highly acceptable to pregnant women, its receipt in public antenatal services is suboptimal. There is a need and an opportunity for interventions to support antenatal care providers to routinely and consistently provide such care to all pregnant women.


Assuntos
Alcoolismo/diagnóstico , Aceitação pelo Paciente de Cuidados de Saúde/psicologia , Complicações na Gravidez/diagnóstico , Gestantes/psicologia , Cuidado Pré-Natal/psicologia , Diagnóstico Pré-Natal/psicologia , Adolescente , Adulto , Consumo de Bebidas Alcoólicas/psicologia , Alcoolismo/psicologia , Austrália , Feminino , Fidelidade a Diretrizes , Humanos , Guias de Prática Clínica como Assunto , Gravidez , Complicações na Gravidez/psicologia , Cuidado Pré-Natal/normas , Diagnóstico Pré-Natal/normas , População Rural , Inquéritos e Questionários , Adulto Jovem
19.
Artigo em Inglês | MEDLINE | ID: mdl-31405014

RESUMO

INTRODUCTION: Postpartum symptoms of anxiety and depression are known to have a negative impact on mother and child, and major life events constitute a major risk factor for these symptoms. We aimed to investigate to what extent specific life events during pregnancy, delivery complications, unfavorable obstetric outcomes, and antenatal levels of anxiety or depression symptoms were independently associated with postpartum levels of anxiety and depression symptoms. METHODS: Within a prospective population-based cohort study (n = 3842) in The Netherlands, antenatal symptoms of anxiety or depression were measured at the end of the first trimester and at five months postpartum. Antenatal life events were assessed during the third trimester, and information on delivery and obstetric outcomes was obtained from midwives and gynecologists. Linear regression analyses were performed to quantify the associations. RESULTS: Antenatal levels of both anxiety and depression symptoms were associated with postpartum levels of anxiety and depression symptoms. Life events related to health and sickness of self or loved ones, to the relation with the partner or conflicts with loved ones, or to work, finance, or housing problems were significantly associated with higher postpartum levels of anxiety symptoms (p < 0.001) and depression symptoms (p < 0.001) adjusted for antenatal levels. No statistically significant results were observed for pregnancy-related events, delivery complications, or unfavorable obstetric outcomes. CONCLUSIONS: Women with increased antenatal levels of anxiety or depression symptoms are at increased risk of elevated levels of both postpartum depression and anxiety symptoms. Experiencing life events during pregnancy that were not related to the pregnancy was associated with higher levels of anxiety and depression in the postpartum period, as opposed to pregnancy-related events, delivery complications, or unfavorable obstetric outcomes. These results suggest that events during pregnancy but not related to the pregnancy and birth are a highly important predictor for postpartum mental health.


Assuntos
Transtornos de Ansiedade/diagnóstico , Depressão Pós-Parto/psicologia , Acontecimentos que Mudam a Vida , Mães/psicologia , Período Pós-Parto/psicologia , Adulto , Ansiedade/psicologia , Estudos de Coortes , Feminino , Humanos , Países Baixos , Gravidez , Complicações na Gravidez/psicologia , Terceiro Trimestre da Gravidez , Estudos Prospectivos , Fatores de Risco
20.
Artigo em Inglês | MEDLINE | ID: mdl-31412544

RESUMO

Recent research has found that most U.S. state policies related to alcohol use during pregnancy adversely impact health. Other studies indicate that state policymaking around substance use in pregnancy-especially in the U.S.-appears to be influenced by an anti-abortion agenda rather than by public health motivations. This commentary explores the ways that scientists' aversion to abortion appear to influence science and thus policymaking around alcohol and pregnancy. The three main ways abortion aversion shows up in the literature related to alcohol use during pregnancy include: (1) a shift from the recommendation of abortion for "severely chronic alcoholic women" to the non-acknowledgment of abortion as an outcome of an alcohol-exposed pregnancy; (2) the concern that recommendations of abstinence from alcohol use during pregnancy lead to terminations of otherwise wanted pregnancies; and (3) the presumption of abortion as a negative pregnancy outcome. Thus, abortion aversion appears to influence the science related to alcohol use during pregnancy, and thus policymaking-to the detriment of developing and adopting policies that reduce the harms from alcohol during pregnancy.


Assuntos
Aborto Induzido/psicologia , Consumo de Bebidas Alcoólicas/psicologia , Complicações na Gravidez/psicologia , Comportamento Reprodutivo/psicologia , Transtornos Relacionados ao Uso de Substâncias/psicologia , Aborto Induzido/estatística & dados numéricos , Tomada de Decisões , Feminino , Humanos , Políticas , Gravidez , Comportamento Reprodutivo/estatística & dados numéricos
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