Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 1.265
Filtrar
1.
BMC Pregnancy Childbirth ; 21(1): 80, 2021 Jan 25.
Artigo em Inglês | MEDLINE | ID: mdl-33494723

RESUMO

BACKGROUND: Prenatal anxiety has been a significant public health issue globally, leading to adverse health outcomes for mothers and children. The study aimed to evaluate the sociodemographic characteristics, knowledge, attitudes, and practices (KAP), and anxiety level of pregnant women during the coronavirus disease 2019 (COVID-19) epidemic in Wuhan and investigate the influencing factors for prenatal anxiety in this specific context. METHODS: Pregnant subjects' KAP towards COVID-19 and their sociodemographics and pregnancy information were collected using questionnaires. The Zung Self-Rating Anxiety Scale (SAS) was used to assess anxiety status. Factors associated with the level of prenatal anxiety were analyzed by Pearson's chi-square test and multivariable logistic regression analyses. RESULTS: The prenatal anxiety prevalence in this population was 20.8%. The mean score of knowledge was 13.2 ± 1.1 on a 0 ~ 14 scale. The attitudes and practices data showed that 580/ 817 (71.0%) were very concerned about the news of COVID-19, 455/817 (55.7%) considered the official media to be the most reliable information source for COVID-19, and 681/817 (83.4%) were anxious about the possibility of being infected by COVID-19. However, only 83/817 (10.2%) worried about contracting COVID-19 infection through the ultrasound transducer during a routing morphology scan. About two-thirds 528/817 (64.6%) delayed or canceled the antenatal visits. Approximately half of them 410/817 (50.2%) used two kinds of personal protection equipments (PPEs) during hospital visits. Logistic regression analysis revealed that the influential factors for prenatal anxiety included previous children in the family, knowledge score, media trust, worry of contracting the COVID-19 infection and worry about getting infected with COVID-19 from the ultrasound probe antenatal care (ANC) schedule. CONCLUSION: Prenatal anxiety was prevalent among pregnant women in Wuhan during the outbreak of COVID-19. The current findings identified factors associated with the level of prenatal anxiety that could be targeted for psychological care.


Assuntos
Ansiedade/psicologia , Conhecimentos, Atitudes e Prática em Saúde , Complicações Infecciosas na Gravidez/psicologia , Adulto , Ansiedade/epidemiologia , Ansiedade/prevenção & controle , /prevenção & controle , China/epidemiologia , Estudos Transversais , Parto Obstétrico/psicologia , Feminino , Humanos , Gravidez , Complicações Infecciosas na Gravidez/epidemiologia , Complicações Infecciosas na Gravidez/prevenção & controle , Cuidado Pré-Natal/psicologia
2.
Int J Gynaecol Obstet ; 153(1): 83-88, 2021 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-33368216

RESUMO

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


Assuntos
Parto Obstétrico , Depressão Pós-Parto , Parto/psicologia , Estresse Psicológico , Adulto , /prevenção & controle , Estudos Transversais , Parto Obstétrico/métodos , Parto Obstétrico/psicologia , Parto Obstétrico/estatística & dados numéricos , Depressão Pós-Parto/diagnóstico , Depressão Pós-Parto/epidemiologia , Feminino , Idade Gestacional , Humanos , Satisfação Pessoal , Período Pós-Parto/psicologia , Gravidez , Espanha/epidemiologia , Estresse Psicológico/epidemiologia , Estresse Psicológico/etiologia
3.
Artigo em Inglês | MEDLINE | ID: mdl-33374483

RESUMO

This study aimed to develop and validate two predictive models of postpartum post-traumatic stress disorder (PTSD) risk using a retrospective cohort study of women who gave birth between 2018 and 2019 in Spain. The predictive models were developed using a referral cohort of 1752 women (2/3) and were validated on a cohort of 875 women (1/3). The predictive factors in model A were delivery type, skin-to-skin contact, admission of newborn to care unit, presence of a severe tear, type of infant feeding at discharge, postpartum hospital readmission. The area under curve (AUC) of the receiver operating characteristic (ROC) in the referral cohort was 0.70 (95% CI: 0.67-0.74), while in the validation cohort, it was 0.69 (95% CI: 0.63-0.75). The predictive factors in model B were delivery type, admission of newborn to care unit, type of infant feeding at discharge, postpartum hospital readmission, partner support, and the perception of adequate respect from health professionals. The predictive capacity of model B in both the referral cohort and the validation cohort was superior to model A with an AUC-ROC of 0.82 (95% CI: 0.79-0.85) and 0.83 (95% CI: 0.78-0.87), respectively. A predictive model (model B) formed by clinical variables and the perception of partner support and appropriate treatment by health professionals had a good predictive capacity in both the referral and validation cohorts. This model is preferred over the model (model A) that was formed exclusively by clinical variables.


Assuntos
Parto Obstétrico/psicologia , Período Pós-Parto , Transtornos de Estresse Pós-Traumáticos/etiologia , Adulto , Feminino , Humanos , Recém-Nascido , Gravidez , Curva ROC , Estudos Retrospectivos , Medição de Risco , Espanha/epidemiologia
4.
Niger J Clin Pract ; 23(10): 1456-1461, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-33047706

RESUMO

Background: Birth preparedness and complication readiness (BPCR) is a strategy with specific interventions to reduce pregnancy related morbidity and mortality. Aim: The study assessed the predictors of optimal birth preparedness and complication readiness among parturient in a tertiary health institution in Nigeria. Subject and Methods: This descriptive cross-sectional study was conducted among parturient at the labor and post-natal wards of University of Nigeria Teaching Hospital Enugu over a 6 months period. Demographic information and predictors of BPCR were analyzed by descriptive statistics and logistic regression respectively with P value of < 0.05 considered statistically significant. Results: Of the 420 parturient, 330 (78.6%) and 90 (21.4%) were booked and unbooked respectively. Majority (74.2%) of the booked and about half of the unbooked parturient were knowledgeable about BPCR. Most (92.4%) of the booked parturient were optimally birth prepared at delivery as against 22.2% of the unbooked. Higher parity (adj OR = 3.79; 95% CI = 1.46-9.82, P = 0.01), tertiary educational level (adj OR = 2.98; 95% CI = 1.23-7.20, P = 0.02), regular antenatal visit (adj OR = 2.68; 95% CI = 1.06-6.76, P = 0.04), information received on birth preparedness before delivery (adj OR = 0.21; 95% CI = 0.07-0.61, P = <0.01), and booked status (adj OR = 0.02; 95% CI = 0.01-0.05, P = <0.001) where significant predictors of optimal BPCR. Conclusion: Encouraging female education, regular antenatal visits, and participation in health talk is advocated to improve BPCR and ultimately reduce maternal and perinatal mortality/morbidity among women in southeast Nigeria.


Assuntos
Parto Obstétrico/psicologia , Conhecimentos, Atitudes e Prática em Saúde , Trabalho de Parto/psicologia , Complicações do Trabalho de Parto/psicologia , Parto/psicologia , Complicações na Gravidez/psicologia , Gestantes/psicologia , Cuidado Pré-Natal/métodos , Adulto , Estudos Transversais , Feminino , Hospitais de Ensino , Humanos , Modelos Logísticos , Nigéria , Paridade , Mortalidade Perinatal , Gravidez , Adulto Jovem
5.
Br J Clin Psychol ; 59(4): 480-502, 2020 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-32808684

RESUMO

OBJECTIVES: To investigate whether levels of perfectionism, organization, and intolerance of uncertainty predispose women to more negative birth experiences and post-partum post-traumatic stress symptoms (PTSS). Birth experience was also examined as a potential moderator of the relationship between levels of the personality traits and post-natal PTSS. DESIGN: Prospective survey. METHOD: First-time expectant mothers (N = 10,000) were contacted via Emma's Diary during the perinatal period. At 32-42 weeks' gestation, participants completed measures examining the three personality traits and prenatal mood. At 6-12 weeks' post-partum, instruments assessing childbirth experience, birth trauma, PTSS, and post-natal mood were completed. Data from 418 women were analysed. RESULTS: Higher perfectionism and intolerance of uncertainty were associated with more negative birth appraisals and PTSS. Organization was unrelated to birth experience or PTSS. In a regression, higher intolerance of uncertainty and perfectionism statistically predicted more negative birth appraisals. Only perfectionism predicted PTSS. Birth experience did not moderate the relationship between perfectionism or intolerance of uncertainty and PTSS. CONCLUSIONS: Personality risk factors for negative birth experiences and post-natal PTSS are identifiable prenatally. Maternity care providers could educate women about the unique roles of high perfectionism and intolerance of uncertainty during antenatal birth preparation. PRACTITIONER POINTS: Women who expect themselves to be more perfect or who find it more difficult to cope with uncertainty had more negative experiences of childbirth. Women with higher levels of perfectionism were more likely to experience more symptoms of post-traumatic stress during the early post-natal period. Being more perfectionistic continued to have a more negative effect on women's well-being after birth, regardless of whether they had a positive or negative experience of birth. Integrating these findings into antenatal discussion around birth preferences would increase women's awareness of predisposing and obstetric risk factors that partially explain experiences of unsatisfactory births and post-partum post-traumatic stress.


Assuntos
Ansiedade/psicologia , Parto Obstétrico/psicologia , Serviços de Saúde Materna/organização & administração , Parto/psicologia , Personalidade , Transtornos de Estresse Pós-Traumáticos/diagnóstico , Estresse Psicológico/complicações , Incerteza , Adulto , Parto Obstétrico/efeitos adversos , Parto Obstétrico/normas , Depressão/psicologia , Depressão Pós-Parto/psicologia , Feminino , Humanos , Gravidez , Estudos Prospectivos , Fatores de Risco , Transtornos de Estresse Pós-Traumáticos/etiologia , Transtornos de Estresse Pós-Traumáticos/psicologia , Estresse Psicológico/psicologia , Inquéritos e Questionários
6.
J Postgrad Med ; 66(3): 133-140, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32675449

RESUMO

Background: Respectful maternity care is a rightful expectation of women. However, disrespectful maternity care is prevalent in various settings. Therefore, a systematic review and meta-analysis were conducted to identify various forms of ill-treatment, determinants, and pooled prevalence of disrespectful maternity care in India. Methods: A systematic review was performed in various databases. After quality assessment, seven studies were included. Pooled prevalence was estimated using the inverse variance method and the random-effects model using Review Manager Software. Results: Individual study prevalence ranged from 20.9% to 100%. The overall pooled prevalence of disrespectful maternity care was 71.31% (95% CI 39.84-102.78). Pooled prevalence in community-based studies was 77.32% (95% CI 56.71-97.93), which was higher as compared to studies conducted in health facilities, this being 65.38% (95% CI 15.76-115.01). The highest reported form of ill-treatment was non-consent (49.84%), verbal abuse (25.75%) followed by threats (23.25%), physical abuse (16.96%), and discrimination (14.79%). Besides, other factors identified included lack of dignity, delivery by unqualified personnel, lack of privacy, demand for informal payments, and lack of basic infrastructure, hygiene, and sanitation. The determinants identified for disrespect and abuse were sociocultural factors including age, socioeconomic status, caste, parity, women autonomy, empowerment, comorbidities, and environmental factors including infrastructural issues, overcrowding, ill-equipped health facilities, supply constraints, and healthcare access. Conclusion: The high prevalence of disrespectful maternity care indicates an urgent need to improve maternity care in India by making it more respectful, dignified, and women-centered. Interventions, policies, and programs should be implemented that will protect the fundamental rights of women.


Assuntos
Atitude do Pessoal de Saúde , Parto Obstétrico/psicologia , Serviços de Saúde Materna/estatística & dados numéricos , Serviços de Saúde Materna/normas , Abuso Físico/estatística & dados numéricos , Relações Profissional-Paciente , Adulto , Parto Obstétrico/métodos , Feminino , Humanos , Índia , Parto , Gravidez , Qualidade da Assistência à Saúde , Respeito
7.
BJOG ; 127(10): 1229-1240, 2020 09.
Artigo em Inglês | MEDLINE | ID: mdl-32583536

RESUMO

OBJECTIVES: To investigate the mental status of pregnant women and to determine their obstetric decisions during the COVID-19 outbreak. DESIGN: Cross-sectional study. SETTING: Two cities in China--Wuhan (epicentre) and Chongqing (a less affected city). POPULATION: A total of 1947 pregnant women. METHODS: We collected demographic, pregnancy and epidemic information from our pregnant subjects, along with their attitudes towards COVID-19 (using a self-constructed five-point scale). The Self-Rating Anxiety Scale (SAS) was used to assess anxiety status. Obstetric decision-making was also evaluated. The differences between cities in all of the above factors were compared and the factors that influenced anxiety levels were identified by multivariable analysis. MAIN OUTCOME MEASURES: Anxiety status and its influencing factors. Obstetric decision-making. RESULTS: Differences were observed between cities in some background characteristics and women's attitudes towards COVID-19 in Wuhan were more extreme. More women in Wuhan felt anxious (24.5 versus 10.4%). Factors that influenced anxiety also included household income, subjective symptom and attitudes. Overall, obstetric decisions also revealed city-based differences; these decisions mainly concerned hospital preference, time of prenatal care or delivery, mode of delivery and infant feeding. CONCLUSIONS: The outbreak aggravated prenatal anxiety and the associated factors could be targets for psychological care. In parallel, key obstetric decision-making changed, emphasising the need for pertinent professional advice. Special support is essential for pregnant mothers during epidemics. TWEETABLE ABSTRACT: The COVID-19 outbreak increased pregnant women's anxiety and affected their decision-making.


Assuntos
Ansiedade , Infecções por Coronavirus , Parto Obstétrico , Pandemias , Pneumonia Viral , Complicações na Gravidez , Gestantes/psicologia , Cuidado Pré-Natal , Adulto , Ansiedade/diagnóstico , Ansiedade/epidemiologia , Ansiedade/etiologia , Betacoronavirus , China/epidemiologia , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/prevenção & controle , Infecções por Coronavirus/psicologia , Estudos Transversais , Parto Obstétrico/métodos , Parto Obstétrico/psicologia , Parto Obstétrico/estatística & dados numéricos , Autoavaliação Diagnóstica , Feminino , Humanos , Pandemias/prevenção & controle , Pneumonia Viral/epidemiologia , Pneumonia Viral/prevenção & controle , Pneumonia Viral/psicologia , Gravidez , Complicações na Gravidez/diagnóstico , Complicações na Gravidez/epidemiologia , Complicações na Gravidez/etiologia , Cuidado Pré-Natal/métodos , Cuidado Pré-Natal/psicologia , Cuidado Pré-Natal/estatística & dados numéricos , Pesquisa Qualitativa
8.
BMC Public Health ; 20(1): 933, 2020 Jun 15.
Artigo em Inglês | MEDLINE | ID: mdl-32539758

RESUMO

BACKGROUND: Reducing maternal mortality ratio (MMR) is a high priority public health issue in developing countries such as Indonesia. The current MMR in Indonesia is 126/100,000 live births. Optimum use of available healthcare facilities for delivery can avert maternal deaths. This study aimed to determine the factors associated with healthcare facility utilization for childbirth in Kuantan Singingi regency, Riau province, Indonesia 2017. METHODS: We conducted a community-based cross-sectional study in 15 sub-districts of Kuantan Singingi regency from May-June 2017. We selected 320 mothers from 15 sub-districts who delivered in the last 3 months (February-April 2017). Trained data enumerators collected the relevant data by using a pre-tested semi-structured questionnaire. We used Cox regression analysis to determine the factors associated with delivery at healthcare facilities. Prevalence Ratio (PR) with a 95% confidence interval (CI) for childbirth at healthcare facilities was the key outcome measure. RESULTS: Only 54.4% (174) of the 320 mothers delivered at healthcare facilities. Knowledge about pregnancy danger signs (PR = 1.59, 95%CI:1.15-2.2), attitude towards healthcare services (PR = 0.79, 95%CI:0.33-1.89), and access to health care services (PR = 0.39, 95%CI:0.18-0.84) were the dominant factors of childbirth at healthcare facilities. There was an interaction between attitude and access to healthcare influencing delivery at healthcare facilities. CONCLUSIONS: Utilization of healthcare facilities for childbirth was low in Kuantan Singingi regency. Knowledge of pregnancy danger signs was an independent correlate of childbirth at healthcare facilities. Also, the interaction between attitude and access to healthcare showed a significant influence on childbirth at healthcare facilities. We recommend strengthening of existing maternal and child health program with a particular emphasis on complete and quality antenatal care, health education on danger signs of pregnancy and childbirth, and promoting positive attitudes towards healthcare facilities.


Assuntos
Parto Obstétrico/psicologia , Parto Obstétrico/estatística & dados numéricos , Instalações de Saúde/estatística & dados numéricos , Mães/psicologia , Aceitação pelo Paciente de Cuidados de Saúde/psicologia , Aceitação pelo Paciente de Cuidados de Saúde/estatística & dados numéricos , Cuidado Pré-Natal/psicologia , Adolescente , Adulto , Estudos Transversais , Países em Desenvolvimento/estatística & dados numéricos , Feminino , Humanos , Indonésia , Morte Materna/prevenção & controle , Pessoa de Meia-Idade , Mães/estatística & dados numéricos , Gravidez , Cuidado Pré-Natal/estatística & dados numéricos , Inquéritos e Questionários , Adulto Jovem
9.
BMC Public Health ; 20(1): 602, 2020 May 01.
Artigo em Inglês | MEDLINE | ID: mdl-32357872

RESUMO

BACKGROUND: Infection is a leading cause of maternal and newborn mortality in low- and middle-income countries (LMIC). Clean birthing practices are fundamental to infection prevention efforts, but these are inadequate in LMIC. This scoping study reviews the literature on studies that describe determinants of clean birthing practices of healthcare workers or mothers during the perinatal period in LMIC. METHODS: We reviewed literature published between January 2000 and February 2018 providing information on behaviour change interventions, behaviours or behavioural determinants during the perinatal period in LMIC. Following a multi-stage screening process, we extracted key data manually from studies. We mapped identified determinants according to the COM-B behavioural framework, which posits that behaviour is shaped by three categories of determinants - capability, opportunity and motivation. RESULTS: Seventy-eight studies were included in the review: 47 observational studies and 31 studies evaluating an intervention. 51% had a household or community focus, 28% had a healthcare facility focus and 21% focused on both. We identified 31 determinants of clean birthing practices. Determinants related to clean birthing practices as a generalised set of behaviours featured in 50 studies; determinants related specifically to one or more of six predefined behaviours - commonly referred to as "the six cleans" - featured in 31 studies. Determinants of hand hygiene (n = 13) and clean cord care (n = 11) were most commonly reported. Reported determinants across all studies clustered around psychological capability (knowledge) and physical opportunity (access to resources). However, greater heterogeneity in reported behavioural determinants was found across studies investigating specific clean birthing practices compared to those studying clean birthing as a generalised set of behaviours. CONCLUSIONS: Efforts to combine clean birthing practices into a single suite of behaviours - such as the "six cleans"- may simplify policy and advocacy efforts. However, each clean practice has a unique set of determinants and understanding what drives or hinders the adoption of these individual practices is critical to designing more effective interventions to improve hygiene behaviours and neonatal and maternal health outcomes in LMIC. Current understanding in this regard remains limited. More theory-grounded formative research is required to understand motivators and social influences across different contexts.


Assuntos
Parto Obstétrico/psicologia , Parto Obstétrico/normas , Higiene/normas , Controle de Infecções/normas , Mães/psicologia , Pobreza/psicologia , Gestantes/psicologia , Adulto , Países em Desenvolvimento/estatística & dados numéricos , Feminino , Humanos , Recém-Nascido , Controle de Infecções/estatística & dados numéricos , Mães/estatística & dados numéricos , Pobreza/estatística & dados numéricos , Guias de Prática Clínica como Assunto , Gravidez
10.
Afr J Reprod Health ; 24(1): 121-132, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-32358944

RESUMO

In efforts to reduce maternal and neonatal mortality, it is recommended that all pregnant women be counseled on signs of pregnancy related complications and neonatal illness. In resource limited settings, such counselling may be task-shifted to lay health workers. We conducted a community-based cross-sectional survey of community health workers/volunteers in North and East Kamagambo of the Rongo Sub- County of Migori County, Kenya, between January-April 2018. A survey tool was administered through face-to-face interviews to investigate the level of knowledge of obstetric and neonatal danger signs among community health workers in North Kamagambo after one year of participation in the Lwala program, as well as to evaluate baseline knowledge of community health volunteers in East Kamagambo at the beginning of Lwala's expansion and prior to their receiving training from Lwala. The North Kamagambo group identified more danger signs in each category. The percentage of participants with adequate knowledge in the pregnancy, postpartum, and neonatal categories was significantly higher in North Kamagambo than in East Kamagambo. Sixty percent of participants in North Kamagambo knew 3 or more danger signs in 3 or more categories, compared to 24% of participants in East Kamagambo. Location in North Kamagambo (OR 2.526, p=0.03) and a shorter time since most recent training (OR 2.291, p=0.025) were associated with increased knowledge. Our study revealed varying levels of knowledge among two populations of lay health workers. This study highlights the benefit of frequent trainings and placing greater emphasis on identified gaps in knowledge of the labor and postpartum periods.


Assuntos
Competência Clínica , Agentes Comunitários de Saúde/psicologia , Conhecimentos, Atitudes e Prática em Saúde , Complicações do Trabalho de Parto/prevenção & controle , Complicações na Gravidez/prevenção & controle , Adulto , Pesquisa Participativa Baseada na Comunidade , Estudos Transversais , Parto Obstétrico/efeitos adversos , Parto Obstétrico/psicologia , Feminino , Humanos , Lactente , Mortalidade Infantil , Recém-Nascido , Entrevistas como Assunto , Quênia , Gravidez , Gestantes , Cuidado Pré-Natal/estatística & dados numéricos , Pesquisa Qualitativa , População Rural/estatística & dados numéricos , Inquéritos e Questionários
11.
Obstet Gynecol ; 136(1): 33-36, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-32384386

RESUMO

With the current global coronavirus disease 2019 (COVID-19) pandemic, new challenges arise as social distancing and isolation have become the standard for safety. Evidence supports the protective benefits of social connections and support during pregnancy and labor; there are increased maternal, fetal, and pregnancy risks when pregnant and laboring women lack support. As health care professionals take appropriate precautions to protect patients and themselves from infection, there must be a balance to ensure that we do not neglect the importance of social and emotional support during important milestones such as pregnancy and childbirth. Resources are available to help pregnant women, and technology represents an opportunity for innovation in providing care.


Assuntos
Betacoronavirus , Infecções por Coronavirus/prevenção & controle , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Complicações Infecciosas na Gravidez/prevenção & controle , Cuidado Pré-Natal/psicologia , Quarentena/psicologia , Infecções por Coronavirus/virologia , Parto Obstétrico/psicologia , Feminino , Humanos , Pneumonia Viral/virologia , Gravidez , Complicações Infecciosas na Gravidez/virologia , Resultado da Gravidez/epidemiologia , Apoio Social
14.
BJOG ; 127(11): 1382-1390, 2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-32339378

RESUMO

OBJECTIVE: Women's levels of resilience and attitudes towards perineal lacerations vary greatly. Some women see them as part of the birthing process, while others react with anger, depressed mood or even thoughts of self-harm. A previous study has reported increased risk of postpartum depressive (PPD) symptoms in women with severe perineal lacerations. The aim of this study was to assess the association between severe obstetric perineal lacerations and PPD. A secondary objective was to assess this association among women with low resilience. DESIGN: Nested cohort study. SETTING: Uppsala, Sweden. SAMPLE: Vaginally delivered women with singleton pregnancies (n = 2990). METHODS: The main exposure was obstetric perineal lacerations. Resilience was assessed in gestational week 32 using the Swedish version of the Sense of Coherence Scale. A digital acyclic graph was used to identify possible confounders and mediators. Logistic regression was used to estimate odds ratios (OR) and 95% confidence intervals (CI). A sub-analysis was run after excluding women with normal or high resilience. MAIN OUTCOME MEASURES: Postpartum depression, assessed with the Depression Self-Reporting Scale, completed at 6 weeks postpartum. RESULTS: There was no significant association between severe obstetric perineal lacerations and PPD at 6 weeks postpartum. However, a significant association was found between severe lacerations and PPD in women with low resilience (OR = 4.8, 95% CI 1.2-20), persisting even after adjusting for confounding factors. CONCLUSION: Healthcare professionals might need to identify women with low resilience, as they are at increased risk for PPD after a severe perineal laceration. TWEETABLE ABSTRACT: Severe perineal lacerations associated with postpartum depression in women with low resilience in a Swedish cohort.


Assuntos
Parto Obstétrico/psicologia , Depressão Pós-Parto/psicologia , Lacerações/psicologia , Complicações do Trabalho de Parto/psicologia , Períneo/lesões , Resiliência Psicológica , Adulto , Parto Obstétrico/efeitos adversos , Feminino , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Lacerações/etiologia , Modelos Logísticos , Gravidez , Fatores de Risco , Suécia
15.
BMC Pregnancy Childbirth ; 20(1): 136, 2020 Mar 02.
Artigo em Inglês | MEDLINE | ID: mdl-32122310

RESUMO

BACKGROUND: The purpose of this study was to evaluate the maternal omentin-1 level, quality of life and marital satisfaction of women with cesarean and vaginal delivery. METHODS: This prospective cohort study was conducted on 45 women with elective cesarean delivery and 45 women with vaginal delivery who referred to a public hospital in Tehran, Iran. Maternal omentin-1 level was measured by ELISA kits within 24 h after delivery. The maternal quality of life and marital satisfaction in the third trimester of pregnancy and at 12 weeks postpartum were measured using WHOQOL-BREF and the Kansas marital satisfaction questionnaires, respectively. For making between-groups and within-groups comparison, independent samples t-test, paired samples t-test and chi-square test were applied accordingly. RESULTS: The level of maternal omentin-1 was reported to be higher in vaginal delivery group compared to the cesarean group (p = 0.02). No significant difference was found in the quality of life between the two groups in the third trimester of pregnancy and at 12 weeks postpartum period. However, women in both groups had lower scores in physical dimension at 12 weeks postpartum compared to the third trimester of their pregnancy [mean ± SD in vaginal group = 59.28 ± 15.5 vs. 64.44 ± 15.05, p = 0.003 and mean ± SD in cesarean group = 60.07 ± 14.84 vs. 66.50 ± 11.32, p <  0.001]. The results of paired samples t-test indicated that women in NVD group had significantly higher psychological wellbeing at 12 weeks postpartum compared to the third trimester of pregnancy [mean ± SD 68.9 ± 16.82 vs. 65.73 ± 16.87, p = 0.001]. There was no significant difference in marital satisfaction between the two groups at 12 weeks postpartum (P = 0.07). The results of paired samples t-test showed that women in CS group had significantly lower marital satisfaction at 12 weeks postpartum compared to the third trimester of pregnancy [mean SD 18.86 ± 2.04 vs. 19.28 ± 1.79, p = 0.01]. CONCLUSIONS: Our findings demonstrated that women with NVD had higher omentin-1 level than women with CS. No significant difference was found in quality of life and marital satisfaction between NVD and CS and omentin-1 level. High level of omentin-1 in NVD may act as a protective factor for mother against metabolic disorders.


Assuntos
Citocinas/sangue , Parto Obstétrico/psicologia , Lectinas/sangue , Casamento/psicologia , Satisfação Pessoal , Qualidade de Vida , Adulto , Cesárea/psicologia , Estudos de Coortes , Feminino , Proteínas Ligadas por GPI/sangue , Humanos , Irã (Geográfico) , Período Pós-Parto , Gravidez , Terceiro Trimestre da Gravidez , Estudos Prospectivos , Inquéritos e Questionários
16.
Niger J Clin Pract ; 23(3): 362-370, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-32134036

RESUMO

Background: Birth preparedness and complication readiness (BPCR) reduces delays in obstetric care, improves health-seeking behavior during an obstetric emergency, and improves knowledge on danger signs of pregnancy. Aims: To assess the knowledge, perception, and practice of women on BPCR. Subjects and Methods: This was a cross-sectional study conducted at Federal Teaching Hospital in Ebonyi state, Nigeria at the postnatal ward from June to December 2016. Women who delivered were recruited consecutively on discharge from the postnatal ward. Their knowledge, perception, and practice of BPCR in the last pregnancy were sought. Information obtained were analyzed using 2008 Epi-info™ software version 3.5.1 (Atlanta Georgia USA). Result: A total of 438 of 445 questionnaires were correctly filled and analyzed giving a response rate of 98.4%. Most of the women knew about birth preparedness 384 (87.7%) and complication readiness 348 (79.5%). A significant number of women did not access antenatal care within the first trimester 236 (53.9%), did not know that family planning is important in BPCR 216 (49.3%), and did not identify means of transport in the event of emergency 354 (80.8%). No provision of blood during antenatal care for the blood banking system was a common finding 258 (58.9%). In multivariate logistic regression analysis, choosing a health care provider was a common finding among literate mothers (OR = 2.8,95% CI = 1.02,7.72), woman within 25-29 years (OR = 1.09, 95%CI = 1.02,1.16), and multiparas (OR = 0.82, 95% CI = 0.67,0.99). Conclusion: There is increased knowledge and awareness of BPCR but the comprehensive components and practices of BPCR are still not optimal in our setting.


Assuntos
Parto Obstétrico/psicologia , Conhecimentos, Atitudes e Prática em Saúde/etnologia , Complicações na Gravidez/psicologia , Gestantes/psicologia , Cuidado Pré-Natal/psicologia , Adulto , Estudos Transversais , Feminino , Humanos , Nigéria , Gravidez
17.
Ann Afr Med ; 19(1): 60-67, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32174617

RESUMO

Context: Birth preparedness and complication readiness (BPCR) have been shown to increase knowledge of danger signs and enhance access to skilled obstetric care. Previous studies have focused on intermediate outcomes of BPCR such as utilization of skilled care for pregnancy and delivery. Aims: This study aims to determine the maternal and perinatal outcomes associated with birth preparedness and complication readiness. Settings and Design: A cross-sectional study involving 827 recently delivered women, attending selected health facilities in Ikenne, southwestern Nigeria. Materials and Methods: BPCR was determined from a set of eight indicators that were developed by the John Hopkin's Bloomberg School of Public Health. Statistical Analysis: The data were analyzed using SPSS version 21. Bivariate analysis was done using Chi-square test, and binary logistic regression model was used to assess factors related to BPCR practice among respondents. The level of statistical significance was set to P < 0.05. Results: BPCR was observed in 470/827 (56.8%) of the participants. Only a minority had knowledge of financial - 125/827 (15.1%) and transportation assistance - 56/827 (6.8%). Knowledge of ≥ 5 danger signs of pregnancy was also low, 286/827 (34.6%). Institutional delivery was in only 331/827 (40%), and it depended on being birth prepared and complication ready (adjusted odds ratio [AOR] =0.534, 95% confidence interval [CI] =0.319-0.893). Significantly more perinatal deaths occurred to women who were not birth prepared (AOR = 2.951, 95% CI = 1.436-6.062), although no difference existed for perinatal (AOR = 1.202, 95% CI = 0.653-2.214) and maternal (AOR = 0.744, 95% CI = 0.452-1.226) morbidities. Conclusion: The knowledge and practice of key indicators of BPCR that reflect utilization of community resources in Ikenne Local Government Area is very poor. BPCR was an important determinant of perinatal survival.


Assuntos
Parto Obstétrico/psicologia , Conhecimentos, Atitudes e Prática em Saúde , Complicações do Trabalho de Parto/psicologia , Complicações na Gravidez/prevenção & controle , Gestantes/psicologia , Cuidado Pré-Natal/estatística & dados numéricos , Adolescente , Adulto , Estudos Transversais , Feminino , Humanos , Pessoa de Meia-Idade , Complicações do Trabalho de Parto/prevenção & controle , Gravidez , Complicações na Gravidez/epidemiologia , Resultado da Gravidez , Adulto Jovem
18.
J Clin Nurs ; 29(17-18): 3565-3574, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32045047

RESUMO

AIM: This article explores the literature on women's expectations for birth, the sociocultural context from which these expectations originate and their impact on the interpretation of birth experience. BACKGROUND: Childbirth is associated with specific expectations from women with the potential for dissatisfaction if these expectations are not met. DESIGN: This paper presents a systematic analysis of the concept of vulnerability in childbirth. FINDINGS: A framework was extracted from the literature that linked the themes of a discourse of control, construction of inadequacy and shame of exposure to explain the sociocultural origin of dominant childbirth expectations in the literature. The experience of vulnerability unique to the birthing event is suggested as exposing the woman to this underlying contextual framework and impacting the interpretation of her birth. CONCLUSION: This synthesis has exposed the transient experience of vulnerability during birth as a significant contributor to the birthing woman's interpretation of the birth and her place within it. RELEVANCE TO CLINICAL PRACTICE: An explanatory framework is offered to clinicians that could increase their awareness of sociocultural and historical factors impacting a woman's expectations for birth. Appreciation of the woman's vulnerability in birth, exposing her to the influence of this framework, can assist clinicians to facilitate a quality birth experience for women. Furthermore, supporting women and midwives to accept this experience of birth vulnerability as a "negative capability," can facilitate an empowering birth experience.


Assuntos
Parto/psicologia , Adulto , Parto Obstétrico/psicologia , Medo/psicologia , Feminino , Humanos , Tocologia , Gravidez
19.
Obstet Gynecol ; 135(3): 583-590, 2020 03.
Artigo em Inglês | MEDLINE | ID: mdl-32028504

RESUMO

OBJECTIVE: To estimate whether maternal sense of control in labor is associated with breastfeeding at 4-8 weeks postpartum. METHODS: This is a secondary analysis of data from a multicenter randomized controlled trial of elective induction of labor at 39 weeks of gestation in low-risk nulliparous women. In this trial, women completed the Labor Agentry Scale, a validated measure of women's feelings of control over the childbirth process, 6-96 hours after delivery. The Labor Agentry Scale score, which is higher with more perceived control during childbirth, was analyzed both as a continuous and a categorical variable (quintiles). Self-reported breastfeeding at 4-8 weeks postpartum was categorized as exclusive breastfeeding, breastfeeding and formula feeding, or exclusive formula feeding. Women were included in this analysis if they labored, filled out a Labor Agentry Scale questionnaire, had a neonate who survived until the postpartum visit, and provided information on infant feeding. Multinomial logistic regression was used to adjust for confounders. RESULTS: Of 5,185 women, 32.9% (n=1,705) were exclusively breastfeeding, 31.2% (n=1,620) were breastfeeding and formula feeding, and 35.9% (n=1,860) were exclusively formula feeding 4-8 weeks after delivery. Overall Labor Agentry Scale score ranged from 34 to 203 (median 167, interquartile range 145-182). The median Labor Agentry Scale score was 169 (interquartile range 151-183) for women exclusively breastfeeding, 166 (interquartile range 142-182) for women who were breastfeeding and formula feeding, and 164 (interquartile range 142-181) for women who were only formula feeding (P<.001). In the unadjusted multinomial model, women with Labor Agentry Scale scores in the lowest two quintiles (ie, those with lower perceived control during childbirth) were less likely to be exclusively breastfeeding (as compared with those exclusively formula feeding) than women in the highest Labor Agentry Scale quintile. When controlling for confounders, however, this association was no longer significant. CONCLUSION: After adjustment for confounders, perceived control during childbirth was not associated with breastfeeding at 4-8 weeks postpartum among nulliparous women. CLINICAL TRIAL REGISTRATION: ClinicalTrials.gov, NCT01990612.


Assuntos
Aleitamento Materno/psicologia , Parto Obstétrico/psicologia , Autonomia Pessoal , Adulto , Feminino , Humanos , Gravidez , Adulto Jovem
20.
BMC Pregnancy Childbirth ; 20(1): 86, 2020 Feb 10.
Artigo em Inglês | MEDLINE | ID: mdl-32041564

RESUMO

BACKGROUND: In Ethiopia, approximately three-fourths of mothers do not deliver in health facilities. Disrespect and abuse during childbirth fallouts in underutilization of institutional delivery that upshots maternal morbidity and mortality. Thus, the ambition of this study was to assess respectful maternity care and associated factors in Harar hospitals, Eastern Ethiopia. METHODS: A facility-based cross-sectional study was conducted from April 01 to July 01, 2017. A total of 425 women, delivered at Harar town hospitals, were nominated using a systematic random sampling technique. A pretested and organized questionnaire was used to collect the data. After checking for completeness, the data were entered into EpiData version 3.1 and exported to SPSS version 22.0 for cleaning and analyses. Both bivariate and multivariable logistic regression was computed to identify factors associated with respectful maternity care. Statistical significance was declared at a P-value of < 0.05. RESULTS: Data were collected on 425 women. Overall, only 38.4% (95% CI: 33.7, 42.0%) of women received respectful maternity care. Delivering at private hospitals [AOR: 2.3, 95% CI: 1.25, 4.07], having ANC follow-up [AOR: 1.8, 95% CI: 1.10, 3.20], planned pregnancy [AOR: 3.0, 95% CI: 1.24, 7.34], labor attended by male provider [AOR: 1.8, 95% CI: 1.14, 2.77] and normal maternal outcome [AOR: 2.3, 95% CI: 1.13, 4.83] were significantly associated with respectful maternity care. CONCLUSIONS: Only four out of ten women received respectful care during labor and delivery. Providing women-friendly, abusive free, timely and discriminative free care are the bases to improve the uptake of institutional delivery. Execution of respectful care advancement must be the business of all healthcare providers. Furthermore, to come up with a substantial reduction in maternal mortality, great emphasis should be given to make the service woman-centered.


Assuntos
Pessoal de Saúde/psicologia , Serviços de Saúde Materna/estatística & dados numéricos , Mães/psicologia , Aceitação pelo Paciente de Cuidados de Saúde/psicologia , Relações Profissional-Paciente , Respeito , Adulto , Atitude do Pessoal de Saúde , Estudos Transversais , Parto Obstétrico/psicologia , Etiópia , Feminino , Hospitais/estatística & dados numéricos , Humanos , Trabalho de Parto/psicologia , Parto/psicologia , Aceitação pelo Paciente de Cuidados de Saúde/estatística & dados numéricos , Gravidez , Qualidade da Assistência à Saúde , Inquéritos e Questionários , Adulto Jovem
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA
...