Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 3.896
Filtrar
1.
BMC Pregnancy Childbirth ; 22(1): 719, 2022 Sep 20.
Artigo em Inglês | MEDLINE | ID: mdl-36127633

RESUMO

BACKGROUND: During pregnancy, women`s bodies undergo rapid changes in body weight and body size within a relatively short period of time. Pregnancy may therefore be associated with an increased vulnerability for the development of body image dissatisfaction that has been linked to adverse health outcomes for mother and child. The present study aims to examine changes in body image during pregnancy as well as predictors of body image dissatisfaction. This is the first study using a tailored, multidimensional measure of body image especially developed for the pregnant population. METHODS: A prospective longitudinal design with a quantitative approach was applied. Healthy pregnant women (N = 222) were assessed using standardized instruments at two time points (T1: 18th-22th week of gestation, T2: 33th-37th week of gestation). The impact of demographic, weight- and health-related, behavioral, and psychological factors assessed at T1 on body image dissatisfaction at T1 and T2 was examined using stepwise linear regression analyses. RESULTS: T-tests for paired samples revealed that dissatisfaction with strength-related aspects of body image, dissatisfaction with body parts, and concerns about sexual attractiveness increased significantly from the middle to the end of pregnancy. In contrast, preoccupation with appearance, dissatisfaction with complexion, and prioritization of appearance over function were significantly reduced over time. Stepwise linear regression analyses revealed that factors influencing body image depend on the component of body image investigated. Overall, a low level of self-esteem and a high level of pregnancy-specific worries were risk factors for several components of body image dissatisfaction. Besides these, poor sleep quality, low levels of physical activity, disturbed eating behavior, and higher levels of BMI and weight gain were significant predictors. CONCLUSIONS: The results highlight the multidimensional nature of body image and show positive as well as negative changes during pregnancy. Overall, modifiable psychological, behavioral, and weight-related factors appear relevant to the extent of body image dissatisfaction.


Assuntos
Insatisfação Corporal , Imagem Corporal/psicologia , Criança , Feminino , Humanos , Gravidez , Gestantes/psicologia , Estudos Prospectivos , Autoimagem
2.
Reprod Health ; 19(1): 189, 2022 Sep 05.
Artigo em Inglês | MEDLINE | ID: mdl-36064560

RESUMO

BACKGROUND: The onset of mental illness such as depression and anxiety disorders in pregnancy and postpartum period is common. The coronavirus induced disease 2019 (COVID-19) pandemic and the resulting public policy responses represent an exceptional situation worldwide and there are hints for adverse psychosocial impact, hence, the study of psychological effects of the pandemic in women during hospitalization for delivery and in the postpartum period is highly relevant. METHODS: Patients who gave birth during the first wave of the COVID-19 pandemic in Germany (March to June 2020) at the Department of Obstetrics and Gynecology, University of Würzburg, Germany, were recruited at hospital admission for delivery. Biosamples were collected for analysis of SARS-CoV-2 infection and various stress hormones and interleukin-6 (IL-6). In addition to sociodemographic and medical obstetric data, survey questionnaires in relation to concerns about and fear of COVID-19, depression, stress, anxiety, loneliness, maternal self-efficacy and the mother-child bonding were administered at T1 (delivery stay) and T2 (3-6 months postpartum). RESULTS: In total, all 94 recruited patients had a moderate concern of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) at T1 with a significant rise at T2. This concern correlated with low to low-medium general psychosocial stress levels and stress symptoms, and the women showed a significant increase of active coping from T1 to T2. Anxiety levels were low and the Edinburgh Postnatal Depression Scale showed a medium score of 5 with a significant (T1), but only week correlation with the concerns about SARS-CoV-2. In contrast to the overall good maternal bonding without correlation to SARS-CoV-2 concern, the maternal self-efficiency correlated negatively with the obstetric impairment caused by the COVID-19 pandemic. CONCLUSION: Obstetric patients` concerns regarding SARS-CoV-2 and the accompanying pandemic increased during the course of the pandemic correlating positively with stress and depression. Of note is the increase in active coping over time and the overall good mother-child-bonding. Maternal self-efficacy was affected in part by the restrictions of the pandemic. Clinical trial registration DRKS00022506.


The global pandemic of COVID-19 (coronavirus induced disease 2019) is challenging our society in many ways. Especially pregnant women are facing extraordinary conditions and worries, like uncertain risks for mother and fetus in case of infection, restricted prenatal classes or restricted visitor regulations in hospitals. Particularly it is known that pregnancy and the postnatal period are presenting a more psychologically vulnerable time in a woman's life. Developing the GeZeCO study, we aimed to focus on the pandemic's effects on mental health of pregnant women during this time. Women giving birth in the department of obstetrics of the University Hospital Würzburg were asked to participate in the study. In total, 94 women completed several questionnaires concerning their mental health postpartum and again after 3 to 6 months. Further, we took blood samples of the women during the delivery stay and registered sociodemographic and obstetric data. Our results showed, that the women's concern relating to COVID-19, as well as the level of depression and anxiety raised during the pandemic. In addition, the self-efficacy of the mothers was affected by the restriction measures. Despite this, the women had at large a good mother­child-bonding and their competence of active coping increased during time. In summary, we did find that the mental health of obstetric patients is impaired by the COVID-19 pandemic. This points out the importance of not only attending to physical health but also taking care of psychological stress and mental health problems of obstetric patients during this exceptional time.


Assuntos
COVID-19 , Gestantes , COVID-19/epidemiologia , Feminino , Humanos , Pandemias , Parto , Gravidez , Gestantes/psicologia , SARS-CoV-2
3.
Artigo em Inglês | MEDLINE | ID: mdl-36078351

RESUMO

Exercise during pregnancy presents many benefits for the mother and baby. Yet, pregnancy is characterised by a decrease in exercise. Studies have reported barriers to antenatal exercise. The coronavirus (COVID-19) pandemic may have further exacerbated barriers to antenatal exercise as pregnant females faced many challenges. Rich, in-depth exploration into pregnant female's perceived barriers to antenatal exercise during COVID-19 is imperative. Questionnaires reporting physical activity levels were completed by all participants (n = 14). Semi-structured interviews were conducted between November 2020 and May 2021 in the UK. Interviews were analysed using thematic analysis and revealed four main themes: 'Perceptions of being an active person shaping activity levels in pregnancy', 'How do I know what is right? Uncertainty, seeking validation and feeling informed', 'Motivators to antenatal exercise' and 'A process of adaptations and adjustment'. Findings indicate that the COVID-19 pandemic exacerbated barriers to antenatal exercise and highlight the importance of direct psychosocial support and clear, trustworthy information. Findings also support the fundamental need for better education amongst healthcare professionals regarding antenatal exercise.


Assuntos
COVID-19 , COVID-19/epidemiologia , Exercício Físico , Feminino , Humanos , Mães , Pandemias , Gravidez , Gestantes/psicologia , Pesquisa Qualitativa
4.
Enferm Clin (Engl Ed) ; 32(5): 334-343, 2022.
Artigo em Espanhol | MEDLINE | ID: mdl-36084999

RESUMO

OBJECTIVE: This study aims to explore the perception of women and their husbands on the vulnerability of pregnant women to mental health disorders. METHOD: Qualitative study using a phenomenological approach. The inclusion criteria were pregnant women of the second and third-trimester gestation (13-35 weeks). The exclusion criteria were pregnant women with complications and who had a family record of mental disorders. Data was collected using focus group discussion and in-depth interviews at four Primary Health Cares in Surakarta, Indonesia. Then, the data were analyzed through thematic analysis, which was supported by the OpenCode 4.02® software. RESULTS: This study uncovered two main topics, firstly the factors that trigger the vulnerability of pregnant women to experience mental disorders and secondly perceived barriers to managing mental health during pregnancy and postpartum. Pregnant women and husbands recognize that they need to get mental health information. CONCLUSION: Unstable emotions during pregnancy are considered normal and neglected by their surroundings. Lack of knowledge about mental health in pregnancy justifies the need to increase education in this area in order to prevent prenatal and postpartum depression.


Assuntos
Complicações na Gravidez , Gestantes , Feminino , Humanos , Indonésia , Saúde Mental , Percepção , Gravidez , Complicações na Gravidez/prevenção & controle , Gestantes/psicologia , Cônjuges
5.
BMC Pregnancy Childbirth ; 22(1): 631, 2022 Aug 09.
Artigo em Inglês | MEDLINE | ID: mdl-35945522

RESUMO

BACKGROUND: Self-care behaviors during pregnancy significantly impacts mother and children's health. This study aimed to explore the self-care behaviors and the associations of these behaviors with the psychological well-being of women during pregnancy, as well as the mediating effects of different social support with these associations. METHODS: A cross-sectional data of 562 pregnant women at Hanoi Obstetrics & Gynecology Hospital and Ca Mau Obstetrics & Pediatrics in Vietnam were analyzed. Questions about self-care behaviors, pregnancy characteristics, social support, and psychological well-being were asked. Multivariate regression models were performed. Structural Equation Modeling (SEM) was employed to test the mediating effects of different social support with the association between self-care behaviors and psychological well-being. FINDINGS: Only 13% of pregnant women often or always did physical exercise at least three times a week, and 40% consumed enough fiber and five servings of vegetables a day. Only 78.7% always avoided alcohol drinking, and 53.9% of pregnant women avoided being exposed to second-hand smoking and 71,7% avoided using traditional medicine without physicians' prescriptions. Around 66% of pregnant women always or often had prenatal care checkups as scheduled. Information sources, social support and childbirth expectation were major drivers for self-care practices. SEM model showed that social support mediated the relationship between maternal health behaviors and mental well-being. CONCLUSION: This study highlighted the remarkable gaps in self-care practices among our pregnant women, which were significantly associated with their mental well-being. Social support-oriented consultancy and interventions should be warranted for improving behaviors and the mental well-being of pregnant women in Vietnam.


Assuntos
Gestantes , Autocuidado , Criança , Estudos Transversais , Feminino , Comportamentos Relacionados com a Saúde , Humanos , Gravidez , Gestantes/psicologia , Cuidado Pré-Natal
6.
PLoS One ; 17(8): e0272862, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35951588

RESUMO

During the COVID-19 pandemic, pregnant women have been at high risk for psychological distress. Lifestyle factors may be modifiable elements to help reduce and promote resilience to prenatal stress. We used Machine-Learning (ML) algorithms applied to questionnaire data obtained from an international cohort of 804 pregnant women to determine whether physical activity and diet were resilience factors against prenatal stress, and whether stress levels were in turn predictive of sleep classes. A support vector machine accurately classified perceived stress levels in pregnant women based on physical activity behaviours and dietary behaviours. In turn, we classified hours of sleep based on perceived stress levels. This research adds to a developing consensus concerning physical activity and diet, and the association with prenatal stress and sleep in pregnant women. Predictive modeling using ML approaches may be used as a screening tool and to promote positive health behaviours for pregnant women.


Assuntos
COVID-19 , Complicações na Gravidez , Feminino , Humanos , Aprendizado de Máquina , Pandemias , Gravidez , Complicações na Gravidez/epidemiologia , Gestantes/psicologia , Estudos Prospectivos , Estresse Psicológico/psicologia
7.
J Affect Disord ; 316: 245-253, 2022 Nov 01.
Artigo em Inglês | MEDLINE | ID: mdl-35964769

RESUMO

BACKGROUND: The COVID-19 pandemic was a significant threat to perinatal mental health. This study examined differences in clinically significant depression, anxiety, and co-morbid symptoms among pregnant and postpartum women across several countries and compared prevalence of perinatal depression and anxiety before and during the pandemic in each participating country. METHODS: Participants were 3326 pregnant and 3939 postpartum women (up to six months postpartum) living in Brazil, Chile, Cyprus, Greece, Israel, Portugal, Spain, Turkey, and the United Kingdom. An online survey was completed between June 7th and October 31st 2020, and included the Edinburgh Postnatal Depression Scale (EPDS) and the Generalized Anxiety Disorder Screener (GAD-7). The pre-pandemic studies were identified through literature review. RESULTS: Prevalence of clinically significant depression (EPDS≥13), anxiety (GAD-7 ≥ 10), and co-morbid (EPDS≥13 and GAD-7 ≥ 10) symptoms was 26.7 %, 20 % and 15.2 %, in pregnant women, and 32.7 %, 26.6 % and 20.3 %, in postpartum women, respectively. Significant between-country differences were found in all mental health indicators in both perinatal periods. Higher levels of symptoms were observed during (versus before) the pandemic, especially among postpartum women. LIMITATIONS: Participants were mostly highly educated and cohabiting with a partner. The online nature of the survey may have limited the participation of women from vulnerable socio-economically backgrounds. CONCLUSIONS: Our findings expand previous literature on the negative impact of the COVID-19 pandemic on perinatal mental health, by highlighting that this may be influenced by country of residence. Mental health care policies and interventions should consider the unique needs of perinatal women in different parts of the world.


Assuntos
COVID-19 , Depressão Pós-Parto , Ansiedade/epidemiologia , COVID-19/epidemiologia , Depressão/epidemiologia , Depressão Pós-Parto/psicologia , Feminino , Humanos , Pandemias , Parto , Período Pós-Parto/psicologia , Gravidez , Gestantes/psicologia
8.
Artigo em Inglês | MEDLINE | ID: mdl-36011811

RESUMO

Smoking during pregnancy and postpartum remains an important public health problem. No known prior study has prospectively examined mutual changes in risk factors and women's smoking trajectory across pregnancy and postpartum. The objective of this study was to report methods used to implement a prospective cohort (Msgs4Moms), present participant baseline characteristics, and compare our sample characteristics to pregnant women from national birth record data. The cohort study was designed to investigate smoking patterns, variables related to tobacco use and abstinence, and tobacco treatment quality across pregnancy through 1-year postpartum. Current smokers or recent quitters were recruited from obstetrics clinics. Analyses included Chi-square and independent sample t-tests using Cohen's d. A total of 62 participants (41 smokers and 21 quitters) were enrolled. Participants were Black (45.2%), White (35.5%), and multiracial (19.3%); 46.8% had post-secondary education; and most were Medicaid-insured (64.5%). Compared with quitters, fewer smokers were employed (65.9 vs 90.5%, Cohen's d = 0.88) and more reported financial strain (61.1% vs 28.6%; Cohen's d = 0.75). Women who continue to smoke during pregnancy cope with multiple social determinants of health. Longitudinal data from this cohort provide intensive data to identify treatment gaps, critical time points, and potential psychosocial variables warranting intervention.


Assuntos
Abandono do Hábito de Fumar , Estudos de Coortes , Feminino , Humanos , Período Pós-Parto , Gravidez , Gestantes/psicologia , Estudos Prospectivos , Abandono do Hábito de Fumar/métodos
9.
J Affect Disord ; 316: 50-55, 2022 Nov 01.
Artigo em Inglês | MEDLINE | ID: mdl-35932938

RESUMO

BACKGROUND: The literature reports that teenage pregnancy is considered a risk factor for anxiety disorders (ADs). However, research on this topic is limited. This study aimed to investigate if pregnant adolescents presented a greater likelihood of having ADs by comparing two samples of pregnant women in a southern city of Brazil. We also observed the prevalence rates of antenatal ADs among adolescents and adult women. METHODS: In this cross-sectional study, we evaluated 1852 women from two different studies: 995 pregnant adolescents attending prenatal care in the public health system (convenience sample) and 857 pregnant women from a population-based study. We used the Mini International Neuropsychiatric Interview (MINI Plus) to assess antenatal ADs, using the Social Anxiety Disorder (SAD) and Generalized Anxiety Disorder (GAD) modules. The primary aim of this study was tested through multivariate analysis using Poisson regression. RESULTS: The prevalence of ADs was 11.0 % among pregnant adolescents and 13.8 % among adult pregnant women. Both samples presented similar rates of ADs (p = 0.065). In the adjusted analysis, maternal age did not predict antenatal ADs (PR = 0.97; p = 0.853). LIMITATIONS: Considering the particularities of each study where the samples came from, it was not possible to include other ADs such as panic disorder or phobias. CONCLUSIONS: Our findings suggest that pregnancy in adolescence does not increase the likelihood of antenatal ADs. However, we emphasize the importance of an adequate psychological screening and care in pregnancy in order to prevent possible psychiatric disorders.


Assuntos
Complicações na Gravidez , Gravidez na Adolescência , Adolescente , Adulto , Ansiedade , Transtornos de Ansiedade/diagnóstico , Transtornos de Ansiedade/epidemiologia , Transtornos de Ansiedade/psicologia , Estudos Transversais , Feminino , Humanos , Gravidez , Complicações na Gravidez/epidemiologia , Complicações na Gravidez/psicologia , Gravidez na Adolescência/psicologia , Gestantes/psicologia , Prevalência
10.
Eur Rev Med Pharmacol Sci ; 26(15): 5581-5586, 2022 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-35993656

RESUMO

OBJECTIVE: We aimed to determine the COVID-19 anxiety level in pregnant women who presented to an outpatient clinic during the COVID-19 pandemic. PATIENTS AND METHODS: This is a descriptive cross-sectional study including 203 of 310 pregnant women who presented to the outpatient clinic of a training and research hospital of the Ministry of Health between 29 September-1 October, 2020. The level of anxiety was assessed with the COVID-19 Anxiety Inventory (CAS) using a face-to-face survey method. RESULTS: The mean age of the patients was 28.15±5.95 years. In the study, while 6.2% of women over 30 years old was identified to have psychological problems, 0.7% of those under 30 years old had such problems. The rate of diagnosis of COVID-19 in the family/acquaintances of those with an educational level of high school or higher was 56.9%, and those who had an educational level under high school had a corresponding rate of 39.5%. The rate of COVID-19 diagnosis in the family/acquaintances of those with an educational level of high school or higher was significantly higher (p<0.05). The mean COVID-19 anxiety scale score was 0.18±0.47; COVID-19 anxiety was not observed in pregnant women. CONCLUSIONS: This study detected no anxiety in pregnant women. Therefore, it can be said that pregnant women do not need immediate psycho-social support.


Assuntos
COVID-19 , Adulto , COVID-19/epidemiologia , Teste para COVID-19 , Estudos Transversais , Feminino , Humanos , Pandemias , Gravidez , Gestantes/psicologia , SARS-CoV-2 , Adulto Jovem
11.
PLoS One ; 17(8): e0262805, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35944014

RESUMO

BACKGROUND: If pregnant mothers have no medical or obstetrical complications, they are encouraged to maintain active lifestyles during their pregnancies. Benefits of exercise during pregnancy include; prevention of gestational diabetes, pre-eclampsia and reduced low back pain. Therefore this study is done to assess knowledge, attitude and practice towards antenatal exercise among pregnant women who are attending antenatal care at health centers of Mekelle, Tigray Region, Ethiopia. METHOD: For this study cross-sectional study design was used. It was conducted from October 2019 up to January 2020 among 255 pregnant women who are attending antenatal care at selected health centers of Mekelle city. After the data were collected it was entered into epi-data 4.2.0 and was analyzed by using SPSS version 23. RESULT: Among the study participants of pregnant women 51%, 56% and 16.6% had good knowledge, positive attitude and practice towards antenatal exercise respectively. Among those 38.8%, 45.9% and 49.8% were expressed as antenatal exercise can decrease back pain, prevents excessive weight gain and increase energy and stamina during pregnancy respectively. Among those who practiced antenatal exercise, 95% and 83.4% was practicing with frequency ≥ three times per week and ≥20 minutes of the duration of exercise per session respectively. DISCUSSION: Generally, this study showed that the level of knowledge, attitude and practice of pregnant mothers regarding antenatal exercise is poor. Therefore, health care providers who work on maternal health (Gynecologists, Midwives, Nurses, Health extension workers and other community workers) should provide counseling and health education on antenatal exercise.


Assuntos
Gestantes , Cuidado Pré-Natal , Estudos Transversais , Etiópia , Feminino , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Gravidez , Gestantes/psicologia , Cuidado Pré-Natal/psicologia
12.
J Nepal Health Res Counc ; 20(1): 234-240, 2022 Jun 02.
Artigo em Inglês | MEDLINE | ID: mdl-35945882

RESUMO

BACKGROUND: Mental health of pregnant individuals has been profoundly affected by the COVID-19 pandemic. Effective coping strategies are found to be associated with better psychological wellbeing during the COVID-19 pandemic. The objective of the present study is to assess psychological distress and coping among pregnant women during the COVID-19 pandemic. METHODS: A descriptive cross sectional study was conducted from May 2020 to July 2020 among 115 pregnant women attending obstetric unit of a tertiary care centre using convenience sampling technique. Ethical approval was obtained from the Institutional Review Committee of the Institute. Covid-19 Peritraumatic Distress Index and Brief COPE inventory was used to collect the data. Data entry was done in Microsoft Office Excel 2007 and analysed in SPSS version 16. RESULTS: Psychological distress was found in 2.6% of the participants. Psychological distress was significantly associated with occupation, fear of ANC visit, fear of visit to hospital for other health problems and fear of being alone or without help around delivery. Emotion focused coping was the most commonly used coping strategies among the pregnant women with the mean score of 21.37±3.130. Psychological distress and over all coping strategies had a positive correlation (<0.001). CONCLUSIONS: Psychological distress was found to be low among the pregnant women in this study. Fear of being without help and fear of contacting the virus during the visit to the hospital during the Covid-19 pandemic were the likely reasons of the psychological distress in the pregnant women.


Assuntos
COVID-19 , Angústia Psicológica , Adaptação Psicológica , COVID-19/epidemiologia , Estudos Transversais , Feminino , Humanos , Nepal/epidemiologia , Pandemias , Gravidez , Gestantes/psicologia , Estresse Psicológico/epidemiologia , Estresse Psicológico/psicologia
13.
BMC Pregnancy Childbirth ; 22(1): 662, 2022 Aug 25.
Artigo em Inglês | MEDLINE | ID: mdl-36008799

RESUMO

BACKGROUND: The RAPID-2 intervention has been developed to support women with symptoms of mild-to-moderate anxiety in pregnancy. The intervention consists of supportive discussions with midwives, facilitated discussion groups and access to self-management materials. This paper reports the development of a training programme to prepare midwives and maternity support workers to facilitate the intervention. METHODS: Kern's six-step approach for curriculum development was used to identify midwives and maternity support workers training needs to help support pregnant women with anxiety and facilitate a supportive intervention. The stages of development included feedback from a preliminary study, stakeholder engagement, a review of the literature surrounding midwives' learning and support needs and identifying and supporting the essential process and functions of the RAPID intervention. RESULTS: Midwives' reported training needs were mapped against perinatal mental health competency frameworks to identify areas of skills and training needed to facilitate specific intervention mechanisms and components. A training plan was developed which considered the need to provide training with minimal additional resources and within midwives' scope of practice. The training plan consists of two workshop teaching sessions and a training manual. CONCLUSION: Future implementation is planned to include a post-training evaluation of the skills and competencies required to fully evaluate the comprehensive programme and deliver the RAPID-2 intervention as planned. In addition, the RAPID-2 study protocol includes a qualitative evaluation of facilitators' views of the usefulness of the training programme.


Assuntos
Tocologia , Enfermeiras Obstétricas , Ansiedade/prevenção & controle , Feminino , Humanos , Saúde Mental , Tocologia/educação , Enfermeiras Obstétricas/educação , Gravidez , Gestantes/psicologia , Pesquisa Qualitativa
14.
J Womens Health (Larchmt) ; 31(9): 1232-1240, 2022 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-35856836

RESUMO

Background: There is evidence that women with gestational diabetes are at increased risk of the common mental disorders of anxiety and depression. The COVID-19 pandemic may have exerted an additional burden on the mental health of this population. The aim of this analysis was to compare levels of symptoms of common mental disorders and experiences during the COVID-19 pandemic between pregnant and postnatal women exposed and unexposed to gestational diabetes. Methods: Cross-sectional study utilizing quantitative data from an online survey administered across 10 countries to women who were pregnant or up to 6 months postpartum from 15 June to October 31, 2020. Women self-reported gestational diabetes and completed the Edinburgh Postnatal Depression Scale and GAD-7 (Generalized Anxiety Disorder 7 items) measures. The COPE-IS (Coronavirus Perinatal Experiences-Impact Survey) tool was also administered. Complete case analyses were conducted on a sample of 7,371 women. Results: There was evidence of an association between gestational diabetes and increased levels of depression symptoms, which was robust to adjustment for age, education, and employment status. There was only evidence of an association with anxiety in postnatal women. There was also evidence that women with gestational diabetes, particularly those in the postnatal period, experienced higher levels of pandemic-related distress, although they did not experience higher levels of COVID-19 infection in this sample. Conclusions: The increased risk of common mental disorders in women with gestational diabetes underscores the importance of integrated physical and mental health care for pregnant and postnatal women both during and beyond the pandemic. Clinical Trial Registration no. NCT04595123.


Assuntos
COVID-19 , Diabetes Gestacional , Ansiedade/diagnóstico , Ansiedade/epidemiologia , COVID-19/epidemiologia , Estudos Transversais , Depressão/diagnóstico , Diabetes Gestacional/epidemiologia , Feminino , Humanos , Saúde Mental , Pandemias , Gravidez , Gestantes/psicologia , SARS-CoV-2
15.
Soc Sci Med ; 307: 115181, 2022 08.
Artigo em Inglês | MEDLINE | ID: mdl-35792411

RESUMO

Maternity care increasingly focuses on evaluating psychosocial vulnerability during pregnancy. Research and nationwide (public health) programs, both in the USA and Europe, led to the development of new protocols and screening instruments for care providers to systematically screen for psychosocial vulnerability in pregnant women. However, standardised screening for vulnerability is complex since it requires discussion of sensitive issues. Women may fear stigmatisation and may have limited trust in their care providers or the health system. Our study contributes to the growing field of client-facing risk work by exploring care providers' interpretations and evaluation of psychosocial vulnerability in pregnant women. Drawing on semi-structured interviews with Dutch maternity care providers, we explore how they conceptualise risk and vulnerability and identify 'vulnerable pregnant women' in their practices. We find that care providers conceptualise 'vulnerability' as primarily based on risk, which contributes to an imbalanced focus on individual mothers, rather than on both parents and the social context. Our findings highlight care providers' concerns around 'care avoidance', seen as a risk factor affecting 'vulnerability' during pregnancy and as a possible consequence of risk screening. The care providers we interviewed employ "in between-strategies" based on intuition, emotion, and trust to skillfully attend to the risk that comes with risk work, in terms of its potential impact on relationships of trust and open communication. We conclude that 'vulnerability' should be understood as a multi-layered, situated and relational concept rather than simply as an epidemiological category. Since a trusting relationship between pregnant women and care providers is crucial for the evaluation of vulnerability, we reflect critically on the risk of standardised perinatal psychosocial risk evaluations. Policy should recognise providers' "in between-strategies" to embed epidemiological understandings of risk in the context of everyday risk work.


Assuntos
Serviços de Saúde Materna , Gestantes , Feminino , Humanos , Mães/psicologia , Parto , Gravidez , Gestantes/psicologia , Pesquisa Qualitativa , Confiança
16.
Int J Eat Disord ; 55(9): 1208-1218, 2022 09.
Artigo em Inglês | MEDLINE | ID: mdl-35844188

RESUMO

Pregnancy is a vulnerable period for eating disorder (ED) occurrence and maternal EDs are associated with heightened risk of adverse pregnancy and infant outcomes. This highlights the need to identify pregnant women with past or current EDs in order to offer appropriate support. However, there is a knowledge and practice gap on screening pregnant women for EDs. Clinical guidance is lacking in international treatment guidelines, which is unsurprising given that no validated ED screening tool specifically designed for use in antenatal populations exists. Moreover, data on the effectiveness of general population screening tools for identifying EDs in pregnant women are scarce. This article provides a synthesis of current evidence, treatment guidelines, and data on the diagnostic accuracy for screening for EDs in antenatal samples from three studies with different screening approaches. We outline recommendations for future steps to tackle the knowledge and practice gap on screening for EDs in pregnant women, including next steps for the development of a pregnancy-specific ED screener and the use of general mental health screeners to detect EDs during pregnancy. Up-to-date, the jury is still out as how to best identify current or past EDs in pregnancy. More research is needed to assess the efficacy of using general mental health screeners versus ED-specific screening instruments to detect ED in pregnancy. Additionally, clinicians have to be trained on how to assess and manage EDs during pregnancy. PUBLIC SIGNIFICANCE: Identifying pregnant women with eating disorders (EDs) is a public health concern which can be addressed using multiple approaches, including implementation of general and specific assessments within routine antenatal care, and training of healthcare professionals.


Assuntos
Transtornos da Alimentação e da Ingestão de Alimentos , Gestantes , Transtornos da Alimentação e da Ingestão de Alimentos/diagnóstico , Feminino , Pessoal de Saúde , Humanos , Programas de Rastreamento , Gravidez , Gestantes/psicologia , Cuidado Pré-Natal
17.
Ned Tijdschr Geneeskd ; 1662022 06 16.
Artigo em Holandês | MEDLINE | ID: mdl-35899730

RESUMO

Women with mental health issues may wish to get pregnant. In some situations a pregnancy is contra-indicated or not be in the best interests of the future child. This article analyses the way treating physicians may assist these women and, if needed, treat these women by using somatic of psychiatric care. This on the basis of the Dutch Patients' Rights Act and mental health legislation. The recent Dutch Mandatory Health Care Act provides physicians more opportunities to act in comparison with the previous situation.


Assuntos
Coerção , Serviços de Saúde Mental , Gestantes , Feminino , Humanos , Serviços de Saúde Mental/legislação & jurisprudência , Países Baixos , Gravidez , Gestantes/psicologia
18.
Womens Health (Lond) ; 18: 17455057221104657, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35900027

RESUMO

INTRODUCTION: Pregnant Black women are at disproportionate risk for adverse birth outcomes, in part associated with higher prevalence of stress. Stress increases risk of depression, a known risk factor for preterm birth. In addition, multiple dimensions of stress, including perceived stress and stressful life events, are associated with adverse birth outcomes, independent of their association with prenatal depression. We use an intersectional and contextualized measure of gendered racial stress to assess whether gendered racial stress constitutes an additional dimension to prenatal depression, independent of stressful life events and perceived stress. METHODS: In this cross-sectional study of 428 Black women, we assessed gendered racial stress (using the 39-item Jackson Hogue Phillips Reduced Common Contextualized Stress Measure), perceived stress (using the Perceived Stress Scale), and stressful life events (using a Stressful Life Event Index) as psychosocial predictors of depressive symptoms (measured by the Edinburgh Depression Scale). We used bivariate analyses and multivariable regression to assess the association between the measures of stress and prenatal depression. RESULTS: Results revealed significant bivariate associations between participant scores on the full Jackson Hogue Phillips Reduced Common Contextualized Stress Measure and its 5 subscales, and the Edinburgh Depression Scale. In multivariable models that included participant Perceived Stress Scale and/or Stressful Life Event Index scores, the Jackson Hogue Phillips Reduced Common Contextualized Stress Measure contributed uniquely and significantly to Edinburgh Depression Scale score, with the burden subscale being the strongest contributor among all variables. No sociodemographic characteristics were found to be significant in multivariable models. CONCLUSION: For Black women in early pregnancy, gendered racial stress is a distinct dimension of stress associated with increased depressive symptoms. Intersectional stress measures may best uncover nuances within Black women's complex social environment.


Assuntos
Complicações na Gravidez , Nascimento Prematuro , Afro-Americanos/psicologia , Estudos Transversais , Depressão/diagnóstico , Feminino , Humanos , Recém-Nascido , Gravidez , Complicações na Gravidez/epidemiologia , Gestantes/psicologia , Estresse Psicológico
19.
J Pregnancy ; 2022: 5543684, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35774471

RESUMO

Aims & Backgrounds. Reduced physical activity in pregnant women is highly stemmed from their misconceptions and attitudes during pregnancy. This study is aimed at recognizing the facilitators, barriers, and structural factors that influence activity among pregnant women. Participants & Methods. This qualitative study was conducted from January to June 2020 in nulliparous pregnant women. Forty participants selected randomly from the Pounak Health Center of Tehran City, Iran, answered open-ended questions about the obstacles that deprived them of physical activity during pregnancy. Data were analyzed by MAXQDA 12 software. Findings. 620 primary codes, 42 secondary codes, 11 subthemes, and 6 themes were extracted. These themes were divided into the PEN-3 categories: facilitators, barriers, and structural factors. The nurture factors as facilitators had communication and support from others as subthemes. Barriers consisted of sociocultural (participate in pregnancy class with a companion, social beliefs, and culture of poverty), socioeconomic (financial problems), and individual factors (physical, psychoemotional, and spiritual dimensions), and structural factors consisted of environmental (equipment) and organizational (possibilities in health centers) factors. Conclusion. Lack of awareness and misinformation, accessibility obstacles, and economic problems are the worst physical activity barriers during pregnancy. Being among other pregnant women and the physicians' recommendations are the best facilitators of physical activity during pregnancy.


Assuntos
Exercício Físico , Gestantes , Feminino , Humanos , Irã (Geográfico) , Paridade , Gravidez , Gestantes/psicologia , Pesquisa Qualitativa
20.
BMC Pregnancy Childbirth ; 22(1): 536, 2022 Jul 02.
Artigo em Inglês | MEDLINE | ID: mdl-35780118

RESUMO

BACKGROUND: Tailoring an intervention to the needs and wishes of pregnant women in vulnerable situations (e.g., socioeconomic disadvantages) can reduce the risk of adverse outcomes and empower these women. A relatively high percentage of pregnant women in the North of the Netherlands are considered vulnerable to adverse pregnancy outcomes because of their low socioeconomic status and the intergenerational transmission of poverty. In order to improve perinatal and maternal health, next to standard prenatal care, various interventions for pregnant women in vulnerable situations have been developed. We do not know to what extent these additional interventions suit the needs of (pregnant) women. Therefore, the aim of this study is to gain insight into the experiences and needs of women in vulnerable situations who receive additional maternity care interventions in the Northern Netherlands. METHODS: Qualitative research was performed. We used a phenomenological framework, which is geared towards understanding people's experiences in the context of their everyday lives. In-depth semi-structured interviews were conducted with 17 pregnant women in vulnerable situations living in the Northern Netherlands. A thematic analysis was carried out. RESULTS: We found three themes that reflect the experiences and needs of pregnant women in vulnerable situations in relation to the intervention they receive. These themes relate to the care provided by health professionals, to the impact of being offered an intervention, and to practical issues related to receiving an additional intervention. We found that the needs of pregnant women in vulnerable situations who received an additional maternity care intervention varied. This variation in needs was mainly related to practical issues. Women also expressed common needs, namely the desire to have control over their situation, the wish to receive tailor-made information about the intervention, and the wish for the intervention to be specifically tailored to their circumstances. CONCLUSIONS: Living in vulnerable situations and being offered additional care evoked diverse reactions and emotions from pregnant women. We recommend that health professionals ensure open and clear communication with women, that they ensure continuity of care and relationship-centered care, and that they become aware of the process of stigmatization of women in vulnerable situations.


Assuntos
Serviços de Saúde Materna , Obstetrícia , Feminino , Humanos , Parto/psicologia , Gravidez , Gestantes/psicologia , Pesquisa Qualitativa
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA
...