Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 2.651
Filtrar
1.
J Health Commun ; 26(7): 473-479, 2021 07 03.
Artigo em Inglês | MEDLINE | ID: mdl-34528499

RESUMO

Pregnant women are especially vulnerable to COVID-19 while the short- and long-term impact of COVID-19 on maternal and infant health is only partially understood. We assessed the amount of uncertainty and anxiety pregnant women experienced about COVID-19 and whether, and the extent to which, they engaged in information seeking about COVID-19. In total, 320 pregnant women from 38 states took part in this research. The results showed that pregnant women experienced uncertainty and anxiety about pregnancy and breastfeeding and engaged in information seeking from their healthcare providers. Pregnant women's uncertainty influenced information seeking via anxiety, but the effect varied depending on participants' assessments of coping, communication, and target efficacy. While healthcare providers need to discuss ways to avoid COVID-19 infection, participants were assured that their providers had a plan to help them if they became infected with COVID-19.


Assuntos
Ansiedade/psicologia , COVID-19/psicologia , Comportamento de Busca de Informação , Pandemias , Gestantes/psicologia , Incerteza , Aleitamento Materno/psicologia , COVID-19/epidemiologia , COVID-19/prevenção & controle , Feminino , Humanos , Relações Médico-Paciente , Gravidez/psicologia , Estados Unidos/epidemiologia
2.
JAMA Netw Open ; 4(9): e2124273, 2021 09 01.
Artigo em Inglês | MEDLINE | ID: mdl-34524437

RESUMO

Importance: Early evidence shows a decrease in the number of US births during the COVID-19 pandemic, yet few studies have examined individual-level factors associated with pregnancy intention changes, especially among diverse study populations or in areas highly affected by COVID-19 in the US. Objective: To study changes in pregnancy intention following the outbreak of the COVID-19 pandemic and identify factors possibly associated with these changes. Design, Setting, and Participants: A cross-sectional, population-based study was conducted among women who were currently pregnant or had delivered a live infant and responded to a survey emailed to 2603 women (n = 1560). Women who were mothers of young children enrolled in the prospective New York University Children's Health and Environment Study birth cohort were included; women who were not currently pregnant or recently postpartum were excluded. Exposures: Demographic, COVID-19-related, stress-related, and financial/occupational factors were assessed via a survey administered from April 20 to August 31, 2020. Main Outcomes and Measures: Pregnancy intentions before the COVID-19 pandemic and change in pregnancy intentions following the outbreak. Results: Of the 2603 women who were sent the survey, 1560 (59.9%) who were currently pregnant or had delivered a live infant responded, and 1179 women (75.6%) answered the pregnancy intention questions. Mean (SD) age was 32.2 (5.6) years. Following the outbreak, 30 of 61 (49.2%) women who had been actively trying to become pregnant had ceased trying, 71 of 191 (37.2%) women who had been planning to become pregnant were no longer planning, and 42 of 927 (4.5%) women who were neither planning nor trying were newly considering pregnancy. Among those who ceased trying, fewer than half (13 [43.3%]) thought they would resume after the pandemic. Of those pre-COVID-19 planners/triers who stopped considering or attempting pregnancy, a greater proportion had lower educational levels, although the difference was not statistically significant on multivariable analysis (odds ratio [OR], 2.14; 95% CI, 0.92-4.96). The same was true for those with higher stress levels (OR, 1.09; 95% CI, 0.99-1.20) and those with greater financial insecurity (OR, 1.37; 95% CI, 0.97-1.92. Those who stopped considering or attempting pregnancy were more likely to respond to the questionnaire during the peak of the outbreak (OR, 2.04; 95% CI, 1.01-4.11). Of those pre-COVID-19 nonplanners/nontriers who reported newly thinking about becoming pregnant, a smaller proportion responded during the peak, although the finding was not statistically significant on multivariable analysis (OR, 0.52; 95% CI, 0.26-1.03). Likewise, fewer respondents who were financially insecure reported newly considering pregnancy, although the finding was not statistically significant (OR, 0.69; 95% CI, 0.46-1.03). They were significantly less likely to be of Hispanic ethnicity (OR, 0.27; 955 CI, 0.10-0.71) and more likely to have fewer children in the home (OR, 0.62; 95% CI, 0.40-0.98) or self-report a COVID-19 diagnosis (OR, 2.70; 95% CI, 1.31-5.55). Conclusions and Relevance: In this cross-sectional study of 1179 women who were mothers of young children in New York City, increased stress and financial insecurity owing to the COVID-19 pandemic paralleled a reduction in pregnancy intention in the early months of the pandemic, potentially exacerbating long-term decreases in the fertility rate.


Assuntos
COVID-19/prevenção & controle , Intenção , Mães/psicologia , Gravidez/psicologia , Quarentena/psicologia , Adolescente , Adulto , COVID-19/psicologia , Criança , Pré-Escolar , Estudos de Coortes , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Mães/estatística & dados numéricos , Cidade de Nova Iorque , Estudos Prospectivos , Inquéritos e Questionários
3.
Nutrients ; 13(9)2021 Sep 21.
Artigo em Inglês | MEDLINE | ID: mdl-34579175

RESUMO

Understanding women's perceptions of eating behaviors and dietary patterns can inform the 'teachable moment' model of pregnancy. Our objectives were to describe eating behaviors and dietary patterns in pregnancy. This was a cross-sectional, national electronic survey. Women were ≥18 years of age, living in the United States, currently pregnant or less than two years postpartum, and had internet access. Age, education, race, and marriage were included as covariates in ordinal and binary logistic regressions (significance p < 0.05). Women (n = 587 eligible) made positive or negative changes to their diets, while others maintained pre-existing eating behaviors. The majority of women did not try (84.9 to 95.1% across diets) and were unwilling to try (66.6 to 81%) specific dietary patterns during pregnancy. Concerns included not eating a balanced diet (60.1 to 65.9%), difficulty in implementation without family (63.2 to 64.8%), and expense (58.7 to 60.1%). Helpful strategies included being provided all meals and snacks (88.1 to 90.6%) and periodic consultations with a dietitian or nutritionist (85 to 86.7%). Responses differed across subgroups of parity, body mass index, and trimester, notably in women with obesity who reported healthier changes to their diet (p < 0.05). Our study underscores the importance of tailoring care early to individual needs, characteristics, and circumstances.


Assuntos
Dieta , Comportamento Alimentar , Gravidez/psicologia , Adulto , Estudos Transversais , Dieta/psicologia , Dieta/estatística & dados numéricos , Inquéritos sobre Dietas , Dieta Saudável/psicologia , Dieta Saudável/estatística & dados numéricos , Comportamento Alimentar/psicologia , Feminino , Inquéritos Epidemiológicos , Humanos , Fenômenos Fisiológicos da Nutrição Materna , Estado Nutricional , Gravidez/estatística & dados numéricos , Estados Unidos
4.
BMC Pregnancy Childbirth ; 21(1): 481, 2021 Jul 02.
Artigo em Inglês | MEDLINE | ID: mdl-34215199

RESUMO

BACKGROUND: The Lederman Prenatal Self-Evaluation Questionnaire (PSEQ) is used to assess psychosocial adaptation to pregnancy, labor, childbirth, and maternity. The PSEQ is a tool used in various countries and has been translated into Portuguese; however, it needs to be validated in Brazil. This study aimed to analyze the validity and reliability of the PSEQ in Brazilian pregnant women. METHOD: This methodological validity study investigated internal consistency and reliability using Cronbach's alpha and intraclass correlation coefficients. Construct validity was assessed using Pearson's correlation between domains and confirmatory factor analysis. To assess concurrent validity, Pearson's correlation between the different domains of the PSEQ and Prenatal Psychosocial Profile-Portuguese Version (PPP-VP) was determined. The level of significance was set at 5%. RESULTS: This study included 399 pregnant women in the northeastern region of Brazil. The internal consistency and reliability of the total PSEQ score were high (Cronbach's alpha = 0.89; intraclass correlation coefficient = 0.95). Validity analysis showed positive and significant correlations between all PSEQ domains, ranging from 0.14 to 0.56. Confirmatory factor analysis demonstrated the following values of goodness of fit: RMSEA = 0.05, SRMR = 0.08, CFI = 0.61, χ2/df = 1.77. The discriminant and concurrent validities of the PSEQ were confirmed. CONCLUSIONS: The Portuguese version of the PSEQ has adequate psychometric properties and is a valid and reliable tool to evaluate psychosocial adaptation to pregnancy in Brazilian pregnant women.


Assuntos
Adaptação Psicológica , Gravidez/psicologia , Psicometria/instrumentação , Inquéritos e Questionários , Adolescente , Adulto , Brasil , Análise Fatorial , Feminino , Humanos , Trabalho de Parto/psicologia , Parto/psicologia , Reprodutibilidade dos Testes , Adulto Jovem
5.
BMC Pregnancy Childbirth ; 21(1): 475, 2021 Jul 02.
Artigo em Inglês | MEDLINE | ID: mdl-34215219

RESUMO

BACKGROUND: Pregnancy and childbirth are significant events in women's lives and most women have expectations or plans for how they hope their labour and birth will go. It is possible that strong expectations about labour and birth lead to dissatisfaction or other negative outcomes if these expectations are not met, but it is not clear if this is the case. The aim was therefore to synthesise prospective studies in order to understand whether unmet birth expectations are associated with adverse outcomes for women, their partners and their infants. METHOD: Searches were carried out in Academic Search Complete; CINAHL; Medline; PsycINFO, PsychArticles, PubMed, SCOPUS and Web of Science. Forward and backward searches were also completed. Studies were included if they reported prospective empirical research that examined the association between a mismatch in birth expectations/experience and postnatal outcomes in women, their children and/or their partners. Data were synthesised qualitatively using a narrative approach where study characteristics, context and methodological quality were extracted and summarised and then the differences and similarities among studies were used to draw conclusions. RESULTS: Eleven quantitative studies were identified for inclusion from nine countries. A mismatch between birth expectations and experiences was associated with reduced birth satisfaction. Three studies found a link between a mismatch and the development of postnatal post-traumatic stress disorder (PTSD). The evidence was inconsistent for postnatal depression, and fear of childbirth. Only one study looked at physical outcomes in the form of health-related quality of life. CONCLUSIONS: A mismatch between birth expectations and experiences is associated with birth satisfaction and it may increase the risk of developing postnatal PTSD. However, it is not clear whether a mismatch is associated with other postnatal mental health conditions. Further prospective research is needed to examine gaps in knowledge and provide standardised methods of measuring childbirth expectations-experiences mismatch. To ensure women's expectations are met, and therefore experience a satisfying birth experience, maternity providers should provide sensitive care, which acknowledges women's needs and preferences, is based on open and clear communication, is delivered as early in pregnancy as possible, and enables women to make their own decisions about care. TRIAL REGISTRATION: Protocol registration: PROSPERO CRD42020191081 .


Assuntos
Atitude , Motivação , Parto/psicologia , Gravidez/psicologia , Pesquisa Empírica , Feminino , Humanos
7.
MCN Am J Matern Child Nurs ; 46(4): 217-222, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34166239

RESUMO

PURPOSE: We aimed to understand the relationship between exercise and stress among socioeconomically at-risk women who participated in a home visitation service during pregnancy and postpartum. METHODS: A mixed-methods design was used to support and supplement quantitative data using qualitative data. Convenience sampling was used to collect data from at-risk women via questionnaires and follow-up interviews. The Perceived Stress Scale was used to assess stress. Frequency and duration of exercise were assessed based on the American College of Obstetricians and Gynecologists exercise guidelines. Regression analyses examined the association between stress and exercise controlling for covariates. Content analysis was used to understand women's stress management experiences. RESULTS: N = 114 women completed the questionnaire and a subgroup of 11 received follow-up interviews. Greater frequency of exercise was significantly associated with lower levels of stress. Approximately one-third of women reported experiencing significant stress. Talking to their husband or partner was the most used and exercise was the least used coping strategy. Many women recognized the importance of managing stress and benefits of exercise, but were hindered by barriers such as feeling tired, preventing them from exercising. CLINICAL IMPLICATIONS: A personalized and safe exercise program has the potential to be a low-cost stress management strategy for women during pregnancy and postpartum.


Assuntos
Exercício Físico/psicologia , Período Pós-Parto/psicologia , Gravidez/psicologia , Estresse Psicológico/terapia , Adulto , Exercício Físico/fisiologia , Terapia por Exercício/métodos , Terapia por Exercício/psicologia , Feminino , Comportamentos Relacionados com a Saúde , Humanos , Estresse Psicológico/psicologia , Inquéritos e Questionários , Saúde da Mulher
8.
Obstet Gynecol ; 137(6): 1032-1040, 2021 06 01.
Artigo em Inglês | MEDLINE | ID: mdl-33957663

RESUMO

OBJECTIVE: To assess the effect of a consumer-based mobile meditation application (app) on wellness in outpatient obstetric and gynecology patients during the coronavirus disease 2019 (COVID-19) pandemic. METHODS: We conducted a randomized controlled trial at a university outpatient clinic of obstetric and gynecology patients during the COVID-19 pandemic. Women were randomly assigned to the intervention group, who was prescribed a mobile meditation app for 30 days, or the control group, which received standard care. The primary outcome was self-reported perceived stress. Secondary outcomes included self-reported depression, anxiety, sleep disturbance, and satisfaction with the meditation app. A sample size of 80 participants (40 per group) was calculated to achieve 84% power to detect a 3-point difference in the primary outcome. RESULTS: From April to May 2020, 101 women were randomized in the study-50 in the meditation app group and 51 in the control group. Analysis was by intention-to-treat. Most characteristics were similar between groups. Perceived stress was significantly less in the intervention group at days 14 and 30 (mean difference 4.27, 95% CI 1.30-7.24, P=.005, d=0.69 and mean difference 4.28, 95% CI 1.68-6.88, P=.002, d=0.69, respectively). Self-reported depression and anxiety were significantly less in the intervention group at days 14 and 30 (depression: P=.002 and P=.04; anxiety: P=.01, and P=.04, respectively). Sleep disturbance was significantly less in the intervention group at days 14 and 30 (P=.001 and P=.02, respectively). More than 80% of those in the intervention group reported high satisfaction with the meditation app, and 93% reported that mindfulness meditation improved their stress. CONCLUSION: Outpatient obstetric and gynecology patients who used the prescribed consumer-based mobile meditation app during the COVID-19 pandemic had significant reductions in perceived stress, depression, anxiety, and sleep disturbance compared with standard care. CLINICAL TRIAL REGISTRATION: ClinicalTrials.gov, NCT04329533.


Assuntos
Atenção Plena , Gravidez/psicologia , Cuidado Pré-Natal/métodos , Atenção Primária à Saúde/métodos , Estresse Psicológico/prevenção & controle , Adulto , COVID-19 , Feminino , Ginecologia , Humanos , Meditação/psicologia , Pessoa de Meia-Idade , Aplicativos Móveis , Obstetrícia , Pandemias
9.
Matern Child Health J ; 25(7): 1057-1068, 2021 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-33929653

RESUMO

OBJECTIVE: Pregnancy and postpartum periods require continuity in care and counseling. During the pandemic process, telemedicine and telenursing applications have been used to meet the need for healthcare throughout the world, and skills in this area have been developed. This study aimed to identify the use of mobile applications by pregnant women in receiving health information, counseling, and healthcare during the COVID-19 pandemic and their distress levels during pregnancy. METHODS: This research was a descriptive cross-sectional study. The study was designed as an online survey administered between August 2020 and November 2020 via a questionnaire and the Tilburg Pregnancy Distress Scale (TPDS). A total of 376 women agreed to participate in the study. Women were included if they were literate, had a gestational age of ≥ 12th weeks, and accommodated within the Republic of Turkey's boundaries. RESULTS: A total of 77.9% of participants reported using pregnancy-related mobile applications during the pandemic. The mean total Tilburg Pregnancy Distress Scale score was 24.09, and 37.2% of the participants were found to be at risk for high distress according to the cut-off point. There was a significant difference between the change in receiving health services and the anxiety about coronavirus transmission and the Tilburg Pregnancy Distress Scale total score. (p ≤ 0.05). CONCLUSIONS: This study helped understand the pandemic's impact on pregnancy distress and usage of mobile health applications by pregnant women during the pandemic. Also, our results indicate that a decrease in pregnant women receiving health services during this period. Mobile health applications appear to be usable for prenatal follow-ups because mobile applications are common among pregnant women during the COVID-19 pandemic.


Assuntos
COVID-19/epidemiologia , Serviços de Saúde Materna , Aplicativos Móveis/estatística & dados numéricos , Angústia Psicológica , Telemedicina/métodos , Adolescente , Adulto , COVID-19/psicologia , Estudos Transversais , Escolaridade , Feminino , Humanos , Serviços de Saúde Materna/estatística & dados numéricos , Pessoa de Meia-Idade , Gravidez/psicologia , Inquéritos e Questionários , Telemedicina/estatística & dados numéricos , Turquia/epidemiologia , Adulto Jovem
10.
PLoS One ; 16(4): e0249780, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33882096

RESUMO

Pregnant and postpartum women face unique challenges during the COVID-19 pandemic that may put them at elevated risk of mental health problems. However, few large-scale and no cross-national studies have been conducted to date that investigate modifiable pandemic-related behavioral or cognitive factors that may influence mental health in this vulnerable group. This international study sought to identify and measure the associations between pandemic-related information seeking, worries, and prevention behaviors on perinatal mental health during the COVID-19 pandemic. An anonymous, online, cross-sectional survey of pregnant and postpartum women was conducted in 64 countries between May 26, 2020 and June 13, 2020. The survey, available in twelve languages, was hosted on the Pregistry platform for COVID-19 studies (https://corona.pregistry.com) and advertised in social media channels and online parenting forums. Participants completed measures on demographics, COVID-19 exposure and worries, information seeking, COVID-19 prevention behaviors, and mental health symptoms including posttraumatic stress via the IES-6, anxiety/depression via the PHQ-4, and loneliness via the UCLA-3. Of the 6,894 participants, substantial proportions of women scored at or above the cut-offs for elevated posttraumatic stress (2,979 [43%]), anxiety/depression (2,138 [31%], and loneliness (3,691 [53%]). Information seeking from any source (e.g., social media, news, talking to others) five or more times per day was associated with more than twice the odds of elevated posttraumatic stress and anxiety/depression, in adjusted models. A majority of women (86%) reported being somewhat or very worried about COVID-19. The most commonly reported worries were related to pregnancy and delivery, including family being unable to visit after delivery (59%), the baby contracting COVID-19 (59%), lack of a support person during delivery (55%), and COVID-19 causing changes to the delivery plan (41%). Greater worries related to children (i.e., inadequate childcare, their infection risk) and missing medical appointments were associated with significantly higher odds of posttraumatic stress, anxiety/depression and loneliness. Engaging in hygiene-related COVID-19 prevention behaviors (face mask-wearing, washing hands, disinfecting surfaces) were not related to mental health symptoms or loneliness. Elevated posttraumatic stress, anxiety/depression, and loneliness are highly prevalent in pregnant and postpartum women across 64 countries during the COVID-19 pandemic. Excessive information seeking and worries related to children and medical care are associated with elevated symptoms, whereas engaging in hygiene-related preventive measures were not. In addition to screening and monitoring mental health symptoms, addressing excessive information seeking and women's worries about access to medical care and their children's well-being, and developing strategies to target loneliness (e.g., online support groups) should be part of intervention efforts for perinatal women. Public health campaigns and medical care systems need to explicitly address the impact of COVID-19 related stressors on mental health in perinatal women, as prevention of viral exposure itself does not mitigate the pandemic's mental health impact.


Assuntos
COVID-19/epidemiologia , COVID-19/psicologia , Transtornos Mentais/epidemiologia , Saúde Mental , Gravidez/psicologia , Adulto , Ansiedade/epidemiologia , Ansiedade/psicologia , Estudos Transversais , Depressão/epidemiologia , Depressão/psicologia , Feminino , Humanos , Solidão/psicologia , Pessoa de Meia-Idade , Pandemias , Parto/psicologia , Assistência Perinatal , Período Pós-Parto/psicologia , SARS-CoV-2/isolamento & purificação , Estresse Psicológico/epidemiologia , Estresse Psicológico/etiologia , Inquéritos e Questionários , Saúde da Mulher
11.
Rev Esp Salud Publica ; 952021 Apr 26.
Artigo em Espanhol | MEDLINE | ID: mdl-33896933

RESUMO

Events that occur during fetal and perinatal life can have consequences on the health and disease of the offspring. The pioneering work on the "Fetal Programming Hypothesis" focused on pregnant women exposed to a great famine that occurred in the Netherlands at the end of World War II. The intrauterine environment of the babies during that famine caused them to low birthweight and determined the appearance of cardiovascular diseases in themselves when they reached adulthood, a risk that was transmitted even to the following generation. In addition to the general stress that a pregnant woman may suffer as a result of the death of a family member, suffering a war or natural disaster such as the SARS-CoV-2 coronavirus, there is another specific type of stress that refers exclusively to the pregnancy process; this is the pregnancy specific-stress. Pregnancy-specific stress is capable of sensitively predicting negative maternal and neonatal outcomes. This type of stress refers to the specific stress of pregnant women related to medical problems, the health of the newborn, the changes that the pregnancy will produce in their social relationships, prematurity, physical changes of pregnancy and fear of labor and birth. The objective of this article was to offer an updated information on pregnancy-specific stress and its consequences for maternal and neonatal health. Thus, we also proposed to offer strategies that midwives and psychologists can use to reduce pregnancy-specific stress levels. In conclusion, midwives and psychologists can work together to reduce pregnancy-specific stress levels.


Assuntos
Serviços de Saúde Materna , Tocologia/métodos , Gravidez/psicologia , Papel Profissional , Estresse Psicológico/diagnóstico , Estresse Psicológico/prevenção & controle , Adulto , Feminino , Humanos , Saúde do Lactente , Recém-Nascido , Saúde Materna , Resultado da Gravidez/psicologia , Testes Psicológicos , Psicologia , Espanha , Estresse Psicológico/etiologia
12.
PLoS One ; 16(3): e0247198, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33760848

RESUMO

BACKGROUND: Climate change is expected to decrease food security globally. Many Indigenous communities have heightened sensitivity to climate change and food insecurity for multifactorial reasons including close relationships with the local environment and socioeconomic inequities which increase exposures and challenge adaptation to climate change. Pregnant women have additional sensitivity to food insecurity, as antenatal undernutrition is linked with poor maternal-infant health. This study examined pathways through which climate change influenced food security during pregnancy among Indigenous and non-Indigenous women in rural Uganda. Specific objectives were to characterize: 1) sensitivities to climate-associated declines in food security for pregnant Indigenous women; 2) women's perceptions of climate impacts on food security during pregnancy; and 3) changes in food security and maternal-infant health over time, as observed by women. METHODS: Using a community-based research approach, we conducted eight focus group discussions-four in Indigenous Batwa communities and four in non-Indigenous communities-in Kanungu District, Uganda, on the subject of climate and food security during pregnancy. Thirty-six women with ≥1 pregnancy participated. Data were analysed using a constant comparative method and thematic analysis. RESULTS: Women indicated that food insecurity was common during pregnancy and had a bidirectional relationship with antenatal health issues. Food security was thought to be decreasing due to weather changes including extended droughts and unpredictable seasons harming agriculture. Women linked food insecurity with declines in maternal-infant health over time, despite improved antenatal healthcare. While all communities described food security struggles, the challenges Indigenous women identified and described were more severe. CONCLUSIONS: Programs promoting women's adaptive capacity to climate change are required to improve food security for pregnant women and maternal-infant health. These interventions are particularly needed in Indigenous communities, which often face underlying health inequities. However, resiliency among mothers was strong and, with supports, they can reduce food security challenges in a changing climate.


Assuntos
Segurança Alimentar/estatística & dados numéricos , Povos Indígenas/estatística & dados numéricos , Gravidez/fisiologia , Adulto , Mudança Climática/estatística & dados numéricos , Feminino , Grupos Focais , Abastecimento de Alimentos , Humanos , Povos Indígenas/psicologia , Lactente , Saúde do Lactente , Desnutrição , Saúde Materna , Mães , Gravidez/psicologia , População Rural , Estações do Ano , Uganda/epidemiologia
13.
Health Qual Life Outcomes ; 19(1): 66, 2021 Mar 01.
Artigo em Inglês | MEDLINE | ID: mdl-33648521

RESUMO

BACKGROUND: The impact of COVID-19 pandemic on mental health of pregnant and lactating women is unclear. This study aimed to assess the impact of COVID-19 on psychological health, sexual function, and quality of life (QoL) in Iranian pregnant and lactating women and compare the results with non-pregnant/non-lactating women. METHOD: This comparative cross-sectional study was carried out on pregnant and lactating women, with non-pregnant/non-lactating women from May to Jun 2020. Patients were asked to complete three questionnaires: Hospital Anxiety and Depression Scale (HADS), Female Sexual Function Index (FSFI), and Short-Form Health Survey (SF-12). One-way ANOVA was used to reveal the statistical differences between the three groups. RESULT: The mean age of patients was 20.81 ± 5.92 years old. The mean (SD) score of HADS in pregnant, lactating and non-pregnant / non-lactating women were 12.11 (6.72), 11.98 (8.44) and 9.38 (6.2) respectively, and the results showed that the scores in pregnant, lactating women were higher than non-pregnant / non-lactating women (P < 0.001). Also the mean (SD) score of QOL and FSFI was 68.29 (9.47), 74.18 (12.65), 79.03 (10.48) and 22.71 (8.16), 22.72 (8.16), 26.19 (3.93) in three groups and the scores in pregnant, lactating women were lower than non-pregnant/non-lactating women (P < 0.001). CONCLUSION: The COVID-19 epidemic increases the risk of depression, anxiety, FSD, and lowers QoL in pregnant and lactating women, with the general population. This suggests the urgent need for psychological intervention in the maternal population during the epidemic.


Assuntos
COVID-19/psicologia , Lactação/psicologia , Saúde Mental , Gravidez/psicologia , Qualidade de Vida , Adolescente , Adulto , Análise de Variância , Ansiedade/epidemiologia , Aleitamento Materno , Estudos Transversais , Depressão/epidemiologia , Feminino , Humanos , Irã (Geográfico)/epidemiologia , Disfunções Sexuais Psicogênicas/epidemiologia , Inquéritos e Questionários , Adulto Jovem
14.
Ann Allergy Asthma Immunol ; 126(6): 713-721.e1, 2021 06.
Artigo em Inglês | MEDLINE | ID: mdl-33639261

RESUMO

BACKGROUND: It is suggested that maternal mental health during pregnancy may affect offspring immune and respiratory features, based on the developmental origins of health and disease hypothesis. OBJECTIVE: To evaluate whether maternal quality of life (QoL) and depression during pregnancy leads to wheezing, asthma, and food allergy of the offspring at 3 years of age. METHODS: We conducted a nationwide, multicenter, prospective birth cohort study, Japan Environment and Children's Study. All variables were collected from questionnaires. Health-related QoL was measured using the Medical Outcomes Survey Short Form-8 questionnaire with a physical component summary and a mental component summary score. We conducted logistic regression analyses to evaluate the associations of offspring's wheezing, asthma, and food allergy with maternal QoL and depression. RESULTS: There were 72,685 participants with no missing variables. Maternal physical component summary scores of the Medical Outcomes Survey Short Form-8 questionnaire were negatively associated with offspring's asthma (adjusted odds ratio [aOR], 0.99; 95% confidence interval [CI], 0.99-1.00), current wheezing (aOR, 0.99; 95% CI, 0.99-0.99), and food allergy diagnoses (aOR, 0.99; 95% CI, 0.98-0.99) in children. Offspring's wheezing and asthma were also associated with maternal depression and anxiety during pregnancy. CONCLUSION: Poor maternal prenatal QoL increased the risk of wheezing, asthma, and food allergy in offspring. In addition, maternal depression and anxiety increased the risk of offspring's wheezing, asthma, and food allergy.


Assuntos
Transtornos de Ansiedade/epidemiologia , Asma/epidemiologia , Depressão/epidemiologia , Hipersensibilidade Alimentar/epidemiologia , Gravidez/psicologia , Efeitos Tardios da Exposição Pré-Natal/epidemiologia , Qualidade de Vida , Sons Respiratórios , Adulto , Pré-Escolar , Estudos de Coortes , Feminino , Humanos , Lactente , Japão/epidemiologia , Masculino , Razão de Chances
15.
Contraception ; 103(6): 380-385, 2021 06.
Artigo em Inglês | MEDLINE | ID: mdl-33587906

RESUMO

OBJECTIVE: To understand how the COVID-19 pandemic affected women of reproductive age, specifically their economic conditions, desire for pregnancy, and access to contraceptive services during the pandemic. STUDY DESIGNS: A total of 554 women respondents age 18 to 49 and reside in the United States were recruited using social media between May 16, 2020 and June 16, 2020. Logistic regression models assessed predictors of reporting pandemic-related changes in economic conditions, desire for pregnancy, and contraceptive access. RESULTS: Compared to White/Caucasian respondents, Hispanics/Latinx and Black/African Americans have 4 times the odds of experiencing inability to afford food, transportation, and/or housing (p < 0.01) during the pandemic; Hispanics/Latinx have twice the odds of experiencing food insecurity (p < 0.05). Inability to afford food, transportation, and/or housing was associated with drop in desire to be pregnant (p < 0.01). Despite the 25% of participants who reported a drop in desire for pregnancy, 1 in 6 reported difficulty accessing contraceptives, particularly those who experienced reduced income (p < 0.01). CONCLUSIONS: In our sample, the pandemic unevenly affected people from different socioeconomic groups. Many simultaneously experienced reduced income, difficulties in accessing contraception, and a greater desire to avoid a pregnancy. This combination of factors increases the chance that people will experience unintended pregnancies. IMPLICATIONS: The pandemic caused economic hardship and an increased desire to postpone or prevent pregnancy at the same time that it created new barriers to contraceptive services. This pattern may lead to a potential net effect of an increase in unintended pregnancy, particularly among people who had difficulty affording food, transportation, and/or housing during the pandemic.


Assuntos
COVID-19/economia , Serviços de Planejamento Familiar/provisão & distribuição , Acesso aos Serviços de Saúde/estatística & dados numéricos , Intenção , Pobreza , Gravidez não Planejada , Gravidez/psicologia , Adolescente , Adulto , COVID-19/epidemiologia , Anticoncepcionais/provisão & distribuição , Economia , Grupos Étnicos , Serviços de Planejamento Familiar/economia , Feminino , Acesso aos Serviços de Saúde/economia , Humanos , Modelos Logísticos , Pessoa de Meia-Idade , Pandemias , Pobreza/economia , Pobreza/etnologia , Pobreza/psicologia , Gravidez/etnologia , Estados Unidos/epidemiologia , Adulto Jovem
16.
J Occup Health ; 63(1): e12196, 2021 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-33470006

RESUMO

OBJECTIVES: Maternity harassment, known in English as pregnancy discrimination, remains prevalent in developed countries. However, research examining the mental health effects of maternity harassment is lacking. We aimed to examine the association between maternity harassment and depression during pregnancy in Japan. METHODS: A cross-sectional Internet survey was conducted on 359 pregnant employees (including women who were working at the time their pregnancy was confirmed) from May 22 to May 31, 2020, during which time a COVID-19 state of emergency was declared. Maternity harassment was defined as being subjected to any of the 16 adverse treatments prohibited by national guidelines. Depression was defined as a score of ≥9 on the Edinburgh Postnatal Depression Scale (Japanese version). Logistic regression analysis was performed. RESULTS: Overall, 24.8% of the pregnant employees had experienced maternity harassment by supervisors and/or colleagues. After adjusting for demographics, pregnancy status, work status, and fear of COVID-19, pregnant employees who experienced maternity harassment were more likely to have depression than those who did not (odds ratio 2.48, 95% confidential interval 1.34-4.60). This association was not influenced by whether they were teleworking or not as a COVID-19 measure. CONCLUSIONS: One quarter of pregnant employees experienced maternity harassment and had a higher prevalence of depression than those who did not. Being physically away from the office through teleworking may not reduce the effect of maternal harassment on depression. To protect the mental health and employment of pregnant women, employers should comply with the laws and take measures to prevent maternity harassment.


Assuntos
COVID-19/complicações , Depressão/complicações , Complicações na Gravidez/psicologia , Gravidez/psicologia , Preconceito/psicologia , Adulto , COVID-19/psicologia , Estudos Transversais , Depressão/etiologia , Emprego/psicologia , Emprego/estatística & dados numéricos , Feminino , Humanos , Japão/epidemiologia , Complicações na Gravidez/epidemiologia , Preconceito/estatística & dados numéricos , Escalas de Graduação Psiquiátrica , Inquéritos e Questionários
18.
Neuroimage ; 230: 117776, 2021 04 15.
Artigo em Inglês | MEDLINE | ID: mdl-33516895

RESUMO

Reproduction induces changes within the brain to prepare for gestation and motherhood. However, the dynamic of these central changes and their relationships with the development of maternal behavior remain poorly understood. Here, we describe a longitudinal morphometric neuroimaging study in female mice between pre-gestation and weaning, using new magnetic resonance imaging (MRI) resources comprising a high-resolution brain template, its associated tissue priors (60-µm isotropic resolution) and a corresponding mouse brain atlas (1320 regions of interest). Using these tools, we observed transient hypertrophies not only within key regions controlling gestation and maternal behavior (medial preoptic area, bed nucleus of the stria terminalis), but also in the amygdala, caudate nucleus and hippocampus. Additionally, unlike females exhibiting lower levels of maternal care, highly maternal females developed transient hypertrophies in somatosensory, entorhinal and retrosplenial cortices among other regions. Therefore, coordinated and transient brain modifications associated with maternal performance occurred during gestation and lactation.


Assuntos
Atlas como Assunto , Encéfalo/diagnóstico por imagem , Encéfalo/fisiologia , Lactação/fisiologia , Comportamento Materno/fisiologia , Gravidez/fisiologia , Animais , Feminino , Lactação/psicologia , Estudos Longitudinais , Masculino , Comportamento Materno/psicologia , Camundongos , Gravidez/psicologia
19.
Surg Today ; 51(2): 309-321, 2021 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-32901376

RESUMO

PURPOSE: To identify the conflicts between a career as a surgeon and pregnancy and childbirth for women in Japan. METHODS: The Japan Surgical Society conducted a nationwide survey on pregnancy and childbirth among its members who are women. The questionnaire included items regarding demography, working styles, and pregnancy and childbirth, including adverse events and harassment. RESULTS: The response rate was 29.9% (1068 responses, median age, 37 years). Among the responders, 61% were married and 47% had children (average number of children, 1.7). Half of the respondents reported having experienced sexual harassment and 62% reported having received unwelcome comments about pregnancy. About 20% had undergone fertility treatment. In total, 51% had pregnancies, with miscarriages in 33% of these. The top answer for the best timing for pregnancy and childbirth was after becoming board-certified. Nearly one-third of first-time mothers experienced adverse events during pregnancy and delivery, and 28% quit or changed their job because of their pregnancy and the birth of their first child. CONCLUSIONS: Japanese women who choose a career as a surgeon face obstacles during pregnancy and childbirth. It is vital to share the findings of this study and understand the issues associated with pregnancy and childbirth regardless of gender. Interventions are essential to ensure that every pregnant surgeon has a safe working environment to allow unobstructed development of her career.


Assuntos
Escolha da Profissão , Cirurgia Geral/organização & administração , Saúde do Trabalhador , Estresse Ocupacional/psicologia , Parto/psicologia , Médicas/psicologia , Gravidez/psicologia , Gravidez/estatística & dados numéricos , Sociedades Médicas/organização & administração , Cirurgiões/psicologia , Inquéritos e Questionários , Local de Trabalho/psicologia , Adulto , Feminino , Humanos , Japão , Assédio Sexual/psicologia
20.
Women Birth ; 34(2): e153-e161, 2021 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-32312651

RESUMO

PROBLEM AND BACKGROUND: The preconception period provides a significant opportunity to engage women in healthy behaviour change for improved maternal and child health outcomes. However, there is limited research exploring women's pregnancy planning in Australia. AIM: This study investigated associations between pregnancy planning, socio-demographics and preconception health behaviours in Australian women. METHODS: A retrospective cross-sectional survey of pregnant women ≥18-years-of-age recruited through a Victorian public maternity service and a national private health insurer. RESULTS: Overall 317 women (30±4.7 years) participated (public: n=225, private: n=92). Planned pregnancies were reported by 74% of women and were independently associated with marital status (AOR=5.71 95% CI 1.92-17.00, p=0.002); having ≤2 children (AOR=3.75 95% CI 1.28-11.05, p=0.016); and having private health insurance (AOR=2.51 95% CI 1.08-5.81, p=0.03). Overall, women reported preconception: any folic-acid supplementation (59%), up-to-date cervical screening (68%), weight management attempts (75%), accessing information from health professionals (57%) and immunisation reviews (47%). Pregnancy planners were more likely to use folic-acid (AOR=17.13 95% CI 7.67-38.26, p<0.001), review immunisations (AOR=2.09 95% CI 1.07-4.10, p=0.03) and access information (AOR=3.24 95% CI 1.75-6.00, p<0.001) compared to non-planners. Women <25-years-of-age were less likely to access information (AOR=0.38 95% CI 0.16-0.89, p=0.03) and take folic-acid (AOR=0.23 95% CI 0.09-0.59, p=0.002) and were more likely to smoke 3-months preconception (AOR=6.68 95% CI 1.24-36.12, p=0.03). CONCLUSIONS: Women with planned and unplanned pregnancies reported variable preconception health behaviour uptake and limited healthcare engagement. Opportunities exist to improve awareness and healthcare engagement for optimising preconception health and pregnancy planning benefits including collaborative health promotion. Population-based and targeted approaches reaching pregnancy planners and non-planners are required.


Assuntos
Comportamentos Relacionados com a Saúde , Conhecimentos, Atitudes e Prática em Saúde , Saúde Materna , Cuidado Pré-Concepcional/métodos , Gravidez/psicologia , Adulto , Austrália , Estudos Transversais , Serviços de Planejamento Familiar , Feminino , Estilo de Vida Saudável , Humanos , Recém-Nascido , Gestantes , Saúde Pública , Saúde Reprodutiva , Estudos Retrospectivos , Adulto Jovem
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA
...