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1.
Psychiatr Danub ; 31(Suppl 3): 338-344, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31488750

RESUMO

INTRODUCTION: Mental difficulties are common in the postpartum period. They can manifest in a mild form, but also as serious disorders which need to be treated in a timely manner. The most common psychological problem is "Baby blues" characterized by relatively short duration without consequences and treatment is largely unnecessary. Postpartum depression is characterized by a sense of sadness, loss of interest, insomnia, discomfort, loss of energy, reduced concentration. Postpartum psychosis is the most serious disorder but is also rare and may have serious consequences for the mother and child. Important factors in the postpartum mental problems/difficulties are genetic factors, situation of unwanted pregnancy, a feeling of discomfort with the role of motherhood and sudden hormonal changes. AIM: to investigate the frequency and type of mental problems in postpartum period, as well as possible type of help needed by the women in postpartum period. SUBJECTS AND METHODS: One hundred (112) respondents participated in the survey. The survey was conducted from November to December 2017 through a "google docs" application. The survey was placed on different social networks, and the participation in the survey was voluntary and anonymous. A series of 14 questions with the offered answers was used in the survey. RESULTS: The results of the survey have shown that psychological difficulties and disturbances in the postpartum period to be common problems encountered by almost 50% of women (44.46%). The most common difficulty is Baby blues, followed by postpartum depression and anxiety disorders. Age and the mode of birth did not affect the emergence of changes, while social factors such as family support had a great impact. CONCLUSION: The provision of information to the mothers can help, but inaccurate information can do the opposite. Thus, the role of health care professionals is important for helping mothers in that period to prevent certain difficulties as well as in identifying and referring mothers to seek help in a timely fashion.


Assuntos
Ansiedade/epidemiologia , Depressão Pós-Parto/epidemiologia , Depressão Pós-Parto/psicologia , Mães/psicologia , Período Pós-Parto/psicologia , Transtornos Psicóticos/epidemiologia , Ansiedade/psicologia , Criança , Feminino , Humanos , Recém-Nascido , Mães/educação , Gravidez , Gravidez não Desejada/psicologia , Transtornos Psicóticos/psicologia , Inquéritos e Questionários
2.
Matern Child Health J ; 23(12): 1686-1698, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31529248

RESUMO

INTRODUCTION: The quality of the mother-child relationship in the first year of life has far reaching implications across the life course (Bornstein in Annu Rev Psychol 65:121-158, 2014). Yet little is known about predictors of maternal bonding and emotional availability in early infancy. In this study we examined the extent to which postnatal bonding, maternal mental health, and substance use at 8-weeks postpartum predicted mother-infant bonding (self-report) and mother emotional availability (observational) at 12-months of age. METHODS: Data were obtained from an Australian longitudinal cohort study of pregnancy (n = 308). Data were collected during pregnancy, at birth, and postnatally at 8-weeks and 12-months. RESULTS: The results show strong continuity between postnatal bonding at 8-weeks and 12-months. Early postpartum stress and depression were associated with bonding at 12-months; however, the effect did not persist after adjustment for bonding at 8-weeks. Tobacco use at 8-weeks, but no other indicators of mental health, predicted lower emotional availability scores at 12-months. DISCUSSION: Results suggest that the mother's felt bond to her child is stable across the first year of life and that early bonding is a more robust indicator of bonding at 12-months than a mother's mental health or substance use. These findings point to the importance of clinical and public health investments in establishing a strong bond between mother and child in the early postpartum period.


Assuntos
Saúde Mental , Relações Mãe-Filho/psicologia , Mães/psicologia , Apego ao Objeto , Gestantes/psicologia , Transtornos Relacionados ao Uso de Substâncias , Adulto , Austrália , Depressão Pós-Parto/psicologia , Emoções , Feminino , Humanos , Lactente , Estudos Longitudinais , Masculino , Período Pós-Parto/psicologia , Gravidez , Estudos Prospectivos , Inquéritos e Questionários , Adulto Jovem
3.
Int. j. clin. health psychol. (Internet) ; 19(3): 198-208, sept. 2019. graf, tab
Artigo em Inglês | IBECS | ID: ibc-184966

RESUMO

Background/Objective: The transition to parenthood encompasses several psychological and relational changes that might contribute to couples’ high levels of stress postpartum. Although common across the postpartum, couples’ sexual changes are frequently overlooked. Method: We surveyed 255 mixed-sex new parent couples to examine the associations between sexual well-being-sexual satisfaction, desire, and postpartum sexual concerns-and perceived stress postpartum. Couples completed self-report questionnaires assessing perceived stress and sexual well-being. Results: For both mothers and fathers, greater sexual satisfaction was associated with their partners’ lower perceived stress and, for fathers, this was also associated with their own lower perceived stress. For mothers, greater partner-focused sexual desire was associated with their own lower perceived stress whereas, for fathers, greater partner-focused sexual desire was associated with their partners' higher perceived stress. In addition, greater solitary sexual desire and postpartum sexual concerns were associated with both parents' own higher perceived stress. Conclusions: This study highlights the association between sexual well-being and couples’ postpartum stress, suggesting that more positive sexual experiences are linked to lower perceptions of stress across this vulnerable period. Couples' sexual well-being may be an important target for interventions aimed at helping postpartum couples cope with stress


Antecedentes/Objetivo: La transición a la paternidad implica cambios psicológicos y relacionales que pueden contribuir a niveles de estrés postparto de las parejas. Aunque son comunes en el periodo de posparto, los cambios a nivel sexual de las parejas no se tienen en cuenta habitualmente. Método: Se examinó la asociación entre bienestar sexual-satisfacción sexual, deseo y preocupaciones sexuales postparto-y estrés percibido postparto en una muestra de 255 parejas de padres recientes. Resultados: En padres y madres, mayor satisfacción sexual se asoció con un menor estrés percibido de sus parejas y, para los padres, también se asoció con su propio menor estrés percibido. Para las madres, un mayor deseo sexual centrado en la pareja se asoció con su menor estrés percibido; para los padres, un mayor deseo sexual centrado en la pareja se asoció con un mayor estrés percibido de las madres. Mayor deseo sexual solitario y más preocupaciones sexuales posparto se asociaron con mayor estrés percibido de ambos padres. Conclusiones: Experiencias sexuales más positivas se asociaron con menor experiencia de estrés en el posparto, por lo que el bienestar sexual puede ser un componente importante para las intervenciones destinadas a ayudar a las parejas a enfrentar el estrés posparto


Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Seguridade Social , Comportamento Sexual/psicologia , Saúde Sexual , Assexualidade , Período Pós-Parto/psicologia , Estresse Psicológico , Parceiros Sexuais , Relações Interpessoais , Fatores Socioeconômicos
5.
AIDS Behav ; 23(9): 2610-2617, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31377894

RESUMO

Adherence to antiretroviral therapy (ART) during pregnancy and the postpartum period is necessary to prevent vertical HIV transmission and to secure the long-term health of an HIV-infected woman. Health behavior theory suggests that patients' attitudes towards medication can predict their medication-taking behaviour. This study sought to understand how women's attitudes towards ART changes between the pregnancy and postpartum periods, and the factors associated with these attitudes. The study enrolled 200 pregnant women living with HIV. Structured surveys were administered during pregnancy and at three and 6 months postpartum. Overall, attitudes towards ART were stable over time. More positive attitudes towards ART were associated with HIV acceptance, lower levels of depression, and lower levels of shame. Counselling interventions are needed to help HIV-infected women accept their status and reduce shameful emotions. Depression screening and treatment should be integrated into PMTCT services. This study emphasizes the importance of early attention to attitudes towards ART, in order to establish a trajectory of sustained care engagement.


Assuntos
Antirretrovirais/uso terapêutico , Infecções por HIV/tratamento farmacológico , Infecções por HIV/psicologia , Comportamentos Relacionados com a Saúde , Transmissão Vertical de Doença Infecciosa/prevenção & controle , Adesão à Medicação/psicologia , Complicações Infecciosas na Gravidez/tratamento farmacológico , Gestantes/psicologia , Adulto , Aconselhamento , Feminino , Infecções por HIV/etnologia , Comportamentos Relacionados com a Saúde/etnologia , Humanos , Estudos Longitudinais , Adesão à Medicação/etnologia , Adesão à Medicação/estatística & dados numéricos , Período Pós-Parto/psicologia , Gravidez , Gestantes/etnologia , Tanzânia/epidemiologia , Adulto Jovem
6.
BJOG ; 126 Suppl 4: 50-57, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31257691

RESUMO

OBJECTIVE: To assess the effectiveness of a counselling intervention in antenatal care settings for pregnant women who report domestic violence. DESIGN: Pre-experimental study with pretest-posttest design. SETTINGS: Two public hospitals in Mumbai, India. SAMPLE: In all, 2778 pregnant women accessing antenatal care (ANC) in the hospitals from February to November 2016 were approached for study participation; 2515 women consented. These women were screened by trained counsellors for domestic violence during pregnancy (domestic violence during pregnancy). Domestic violence during pregnancy was reported by 16.2% (408) of women. Of these, 155 women sought counselling services. Post-intervention analyses were carried out with 142 women at 6 weeks post-delivery; 13 women were not contactable. METHODS: The 442 women who reported domestic violence during pregnancy were provided a minimum of two counselling sessions by trained counsellors during their ANC visits. A counselling intake form was used to collect pre- and post-intervention data. MAIN OUTCOME MEASURES: Prevalence of domestic violence during pregnancy, change in women's ability to cope, safety, and health. RESULTS: Prevalence of domestic violence during pregnancy (16.1%) was comparable to those of common obstetric complications routinely screened for during ANC. In all, 60-65% women reported cognitive changes such as recognising impact of violence and need to speak out against it. In all, 50.7% women took action at the individual level to address domestic violence during pregnancy. This change was not statistically significant (P-value 0.193). Of the women studied, 35.9% adopted at least one safety measure, and 84% of the women reported better health status post-intervention. CONCLUSIONS: Routine enquiry and counselling for domestic violence during pregnancy are effective in improving women's ability to cope, safety, and health. FUNDING: This study was funded by The John D. and Catherine T. MacArthur Foundation. TWEETABLE ABSTRACT: Improving coping strategies, safety and health of pregnant women who reported domestic violence by providing counselling in antenatal care setting.


Assuntos
Aconselhamento , Violência Doméstica/psicologia , Gestantes/psicologia , Cuidado Pré-Natal/psicologia , Adulto , Terapia Cognitivo-Comportamental/métodos , Violência Doméstica/prevenção & controle , Violência Doméstica/estatística & dados numéricos , Família/psicologia , Feminino , Humanos , Índia/epidemiologia , Projetos Piloto , Período Pós-Parto/psicologia , Gravidez , Complicações na Gravidez/psicologia , Adulto Jovem
7.
Rev. pesqui. cuid. fundam. (Online) ; 11(4): 1096-1102, jul.-set. 2019.
Artigo em Inglês, Português | LILACS, BDENF - Enfermagem | ID: biblio-1005467

RESUMO

Objetivo: Compreender os riscos e os mecanismos de enfrentamento apresentados pelas puérperas diante dos transtornos mentais no pós-parto. Métodos: Pesquisa qualitativa, de caráter descritivo, realizada com 12 puérperas, na faixa etária de 16 a 35 anos, que fizeram o acompanhamento do pré-natal na unidade de Atendimento Multiprofissional Especializado em Petrolina/PE, por meio de entrevista semiestruturada e observação dos conteúdos implícitos no comportamento das puérperas. A coleta dos dados ocorreu em novembro e dezembro de 2016. Resultados: Identificou-se que fatores como gravidez precoce ou não planejada, carência de apoio do companheiro, instabilidade familiar e baixas condições socioeconômicas podem contribuir como agentes facilitadores no surgimento de algum transtorno mental na puérpera. Conclusão: Considerando que os transtornos mentais são comuns no puerpério, quanto mais precocemente detectar os fatores de risco, melhor assistência poderá ser oferecida à puérpera


Objective: To understand the risks and coping mechanisms presented by puerperal women in the face of postpartum mental disorders. Methods: A descriptive qualitative study was carried out with twelve puerperae, in the age group of 16 to 35 years old who underwent prenatal follow-up at the Multiprofessional Specialized Care Unit in Petrolina-PE, through a semi-structured interview and observation of the contents implicit in the behavior of puerperal women. Data collection took place in November and December 2016. Results: It was identified that factors such as early or unplanned pregnancy, lack of support from the partner, family instability and low socioeconomic conditions can contribute as facilitating agents in the emergence of some mental disorder in the puerpera. Conclusion: Considering that chronic disorders are common in the puerperium, the earlier the risk factors are detected, the better care can be given to the woman


Objetivo: Comprender los riesgos y mecanismos de enfrentamiento presentados por las puérperas ante los trastornos mentales en el posparto. Métodos: Investigación cualitativa, de carácter descriptivo, realizada con doce puérperas, en el grupo de edad de 16 a 35 años que hicieron el seguimiento del prenatal en la unidad de Atención Multiprofesional Especializado en Petrolina-PE, por medio de entrevista semiestructurada y observación de los contenidos implícitos en el comportamiento de las puérperas. La recolección de los datos ocurrió en noviembre y diciembre de 2016. Resultados: Se identificó que factores como embarazo precoz o no planificado, carencia de apoyo del compañero, inestabilidad familiar y bajas condiciones socioeconómicas pueden aportar como agentes facilitadores en el surgimiento de algún trastorno mental en la puérpera. Conclusión: Considerando que los trastornos mentales son comunes en el puerperio, cuanto más precozmente detecte los factores de riesgo, mejor asistencia podrá ser ofrecida a la puérpera


Assuntos
Humanos , Feminino , Gravidez , Recém-Nascido , Adolescente , Adulto , Depressão Pós-Parto/prevenção & controle , Depressão Pós-Parto/psicologia , Período Pós-Parto/psicologia , Transtornos Mentais/classificação , Transtornos Mentais/etiologia
8.
BMC Public Health ; 19(1): 792, 2019 Jun 21.
Artigo em Inglês | MEDLINE | ID: mdl-31226980

RESUMO

BACKGROUND: HIV disproportionately infects women in many regions. Zimbabwe is one of the countries, most heavily affected. Unequal gender power relations between men and women can increase women's vulnerability to HIV. The aim of this paper was to determine the relationship between gender power and HIV sero-status among postpartum women in Zimbabwe. METHODOLOGY: A cross-sectional survey was conducted among 2042 women aged 15-49 years, attending postnatal-care at six public primary health care clinics in low-income urban communities of Harare in 2011. Women were asked about relationship power factors using an interviewer-administered questionnaire. The questionnaire included adapted WHO multi-country study items, which measure partner violence perpetrated against women. HIV status data were based on rapid HIV diagnostic tests done during earlier antenatal visits. The analysis was restricted to women with known HIV test results (n = 1951). Multivariable logistic regression analyses were performed to assess the predictors of HIV and relationship power factors. RESULTS: HIV prevalence was 15.3% (n = 299/1951). Three quarters of the women (76.9%, n = 1438/1871) reported some level of relationship control in their current/most recent intimate relationship. HIV positive women reported higher levels of control by the male partner in their intimate relationships. In adjusted models, the study found a significant association between relationship-control by the male partner and women's HIV status (AOR 1.11, 95% CI 1.01-1.22), and the decision-making dimensions of relationship power. Although there were indications of high male partner control in participants' intimate relationships, some women still had agency, as they were able to make independent decisions to fall pregnant. These women were less likely to be HIV positive (AOR 0.54, 95% CI 0.29-1.00). Having a partner who ever refused use of a family planning method was associated with increased odds of having a positive HIV status among the postpartum women (AOR 1.88, 95% CI 1.20-2.90). CONCLUSION: Unequal gender power relations continue to be a risk factor for heterosexual transmission of HIV. This suggests that prevention efforts have not successfully resulted in gender equality. HIV prevention interventions should address gender power dynamics to help curb the disproportionate HIV burden among women.


Assuntos
Infecções por HIV/epidemiologia , Relações Interpessoais , Período Pós-Parto/psicologia , Pobreza/estatística & dados numéricos , Parceiros Sexuais/psicologia , População Urbana , Adolescente , Adulto , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Gravidez , Prevalência , Fatores de Risco , Inquéritos e Questionários , População Urbana/estatística & dados numéricos , Adulto Jovem , Zimbábue/epidemiologia
9.
BMC Public Health ; 19(1): 696, 2019 Jun 06.
Artigo em Inglês | MEDLINE | ID: mdl-31170958

RESUMO

BACKGROUND: Obstetrical fistula (OF) is a public health challenge that is among the previously neglected components of maternal health in the developing world. The condition, which in the recent past has increasingly drawn more attention from the public, has a devastating impact on the health and wellbeing of both women and girls worldwide. The most common cause of obstetric fistula in developing countries is prolonged obstructed labor affecting approximately 2 million women and girls across Africa and Asia. The objective of this study was to examine the post-effects of fistula and reintegration strategies of fistula survivors in Uganda. METHODS: A descriptive case study design was used to collect data from women aged 15-49 years who had experienced OF and been successfully treated/repaired. Data collection was aided by in-depth interview guides designed for collecting qualitative data which was analyzed using thematic and content analysis. RESULTS: The study results showed that 45.6% were aged 18-24 years, 43% had only primary level education and 55.7% of the women were married. Fistula survivors continue to suffer from shame, rejection, isolation and stigma, trauma and disgrace among other effects even after successful repair/surgery. Some of the reintegration strategies for fistula survivors include; seeking for successful repair, remarriage and relocation from their parent communities to new environments. CONCLUSION: In addition to capacity building, changing attitudes and strengthening the health system, a comprehensive and holistic fistula care approach is required to facilitate the reintegration process and restoration of women dignity.


Assuntos
Complicações do Trabalho de Parto/psicologia , Estigma Social , Sobreviventes/psicologia , Fístula Vaginal/psicologia , Adolescente , Adulto , Feminino , Humanos , Pessoa de Meia-Idade , Período Pós-Parto/psicologia , Gravidez , Projetos de Pesquisa , Uganda , Fístula Vaginal/etiologia , Adulto Jovem
10.
BMC Public Health ; 19(1): 710, 2019 Jun 07.
Artigo em Inglês | MEDLINE | ID: mdl-31174494

RESUMO

BACKGROUND: The changes in China's family planning policy in recent years have led to changes in the age structure of pregnant women, and the prevalence of postpartum depression (PPD) is also on the rise. Cognitive Behaviour Training (CBT) as an effective intervention is widely used for postpartum depression. However, the shortage and health disparities of mental health resources, the stigma of postpartum depression in postpartum women and the need for postpartum recovery and child care prevent postpartum women from seeking traditional face-to-face CBT. Therefore, the purpose of this proposed study is to examine the effect of mobile phone applications (App) based CBT on postpartum depression, anxiety, pressure and parenting sense of competence. METHODS: A double blind, randomized controlled trial will be used in this study to examine the effectiveness of App-based CBT in reducing the prevalence of postpartum depression compared with usual postpartum care in China. A total of 120 participants will be recruited in this study. The intervention consists of a weekly theme module app for continuous six weeks, each module including learning content and assignments. The control group received usual postpartum care content through the App. Outcome measures include postpartum depression, anxiety, pressure and parenting sense of competence at 0-, 3- and 6-month after the intervention. DISCUSSION: If our intervention is effective, it will provide a time-friendly and unrestricted intervention for the psychological care of perinatal women, which can effectively solve the shortage and unevenness of mental health resources. TRIAL REGISTRATION: Chinese Clinical Trial Registry, ChiCTR1900020735 . Registered 15 January 2019.


Assuntos
Terapia Cognitivo-Comportamental/métodos , Depressão Pós-Parto/prevenção & controle , Aplicativos Móveis , Período Pós-Parto/psicologia , Telemedicina/métodos , Adulto , Ansiedade/prevenção & controle , Ansiedade/psicologia , China , Depressão Pós-Parto/psicologia , Método Duplo-Cego , Feminino , Humanos , Poder Familiar/psicologia , Gravidez , Ensaios Clínicos Controlados Aleatórios como Assunto
11.
Women Birth ; 32(5): 404-411, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31202584

RESUMO

OBJECTIVE: The aim of this study was to investigate the relationship between perceived discrimination in perinatal care and birth outcomes of women giving birth to an Aboriginal baby in South Australia using methods designed to respect Aboriginal culture and communities. DESIGN AND SETTING: Population-based study of women giving birth to Aboriginal infants in South Australia, July 2011-June 2013. Women completed a structured questionnaire with an Aboriginal researcher. Study measures include: standardised measure of perceived discrimination in perinatal care; maternal smoking, cannabis use and exposure to stressful events and social health issues; infant birthweight and gestation. PARTICIPANTS: 344 women (mean age 25, range 15-43 years) living in urban, regional and remote areas of South Australia. RESULTS: Half of women (51%) perceived that they had experienced discrimination or unfair treatment by hospitals or health services providing care during pregnancy and soon after childbirth. Women experiencing three or more stressful events or social health issues were more likely to perceive that care was discriminatory or unfair. Aboriginal women who perceived that they had experienced discrimination in perinatal care were more likely to have a baby with a low birthweight (Adj Odds Ratio 1.9, 95% CI 1.0-3.8) or small for gestational age (Adj Odds Ratio 1.9, 95% CI 1.0-3.5), adjusting for parity, smoking and cannabis use. CONCLUSIONS: The study provides evidence of the 'inverse care law'. Aboriginal women most at risk of poor infant health outcomes were the least likely to perceive that they received care well matched to their needs. Building stronger evidence about what works to create cultural safety in perinatal health care is an urgent priority.


Assuntos
Disparidades em Assistência à Saúde , Mães/psicologia , Grupo com Ancestrais Oceânicos/psicologia , Grupo com Ancestrais Oceânicos/estatística & dados numéricos , Satisfação do Paciente/etnologia , Complicações na Gravidez/psicologia , Qualidade da Assistência à Saúde , Estresse Psicológico/psicologia , Adolescente , Adulto , Feminino , Serviços de Saúde do Indígena , Humanos , Lactente , Recém-Nascido de Baixo Peso , Recém-Nascido , Recém-Nascido Pequeno para a Idade Gestacional , Serviços de Saúde Materna , Período Pós-Parto/psicologia , Gravidez , Fumar , Austrália do Sul , Inquéritos e Questionários , Adulto Jovem
12.
BMC Public Health ; 19(1): 724, 2019 Jun 10.
Artigo em Inglês | MEDLINE | ID: mdl-31182062

RESUMO

BACKGROUND: Intimate partner violence (IPV) around the time of pregnancy is a recognized global health problem with damaging consequences. However, little is known about the effect of violence assessment and intervention during pregnancy. We hypothesise that routine enquiry about IPV during pregnancy, in combination with information about IPV and safety behaviours, has the potential to increase the use of these behaviours and prevent and reduce IPV. METHODS: The Safe Pregnancy study is a randomised controlled trial (RCT) to test the effectiveness of a tablet-based intervention to promote safety behaviours among pregnant women. Midwives include women who attend routine antenatal care. The intervention consists of a screening questionnaire for violence and information about violence and safety behaviours through a short video shown on a tablet. The materials are available in different languages to ensure participation of Norwegian, Urdu, Somali and English-speaking women. Eligible women answer baseline questions on the tablet including the Abuse Assessment Scale (AAS). Women who screen positive on the AAS will be randomized to an intervention video that contains information about violence and safety behaviours and women in the control group to a video with general information about a healthy and a safe pregnancy. All women receive information about referral resources. Follow up will be at three months post-partum, when the woman attends the maternal and child health centre (MCHC) for the baby's check-up. Outcome measures are: Use of safety behaviours and quality of life (primary outcomes), prevalence of violence, mental health measures and birth outcomes (secondary outcomes). Intention to treat analysis will be performed. DISCUSSION: The project will provide evidence on whether enquiry about violence and a short video intervention on a tablet is effective and feasible to prevent or reduce harm from IPV among women who attend antenatal care. TRIAL REGISTRATION: This study is registered in ClinicalTrials.gov. Identifier: NCT03397277 (Registered 11th January 2018).


Assuntos
Promoção da Saúde/métodos , Violência por Parceiro Íntimo/prevenção & controle , Cuidado Pré-Natal/métodos , Telemedicina/métodos , Adulto , Computadores de Mão , Grupos Étnicos , Feminino , Humanos , Violência por Parceiro Íntimo/etnologia , Violência por Parceiro Íntimo/psicologia , Centros de Saúde Materno-Infantil , Noruega , Paquistão , Período Pós-Parto/etnologia , Período Pós-Parto/psicologia , Gravidez , Gestantes/etnologia , Gestantes/psicologia , Prevalência , Qualidade de Vida , Ensaios Clínicos Controlados Aleatórios como Assunto , Encaminhamento e Consulta , Somália , Inquéritos e Questionários , Traduções
13.
Womens Health Issues ; 29(3): 259-266, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31072756

RESUMO

BACKGROUND: Postpartum relapse to cigarette smoking is common and relapse prevention interventions have indicated limited efficacy. Abstinence motivations and self-efficacy are two factors that might fluctuate during the postpartum period and predict smoking abstinence. The present study was a secondary analysis that examined statistical trends in motivations and self-efficacy to sustain postpartum abstinence and evaluated their association with sustained abstinence from pregnancy through 52 weeks postpartum. METHODS: Former smokers (N = 300) were recruited for a parent study evaluating two postpartum behavioral relapse prevention interventions. Participants completed assessments prenatally (baseline) and at 12, 24, and 52 weeks postpartum. Motivations to sustain abstinence for internal (intrinsic motivation) and external (extrinsic motivation) reasons, for the health of the baby (baby's health motivation), to maintain a healthy pregnancy (pregnancy motivation), and to avoid children becoming smokers (parenting motivation) were measured at each assessment. Confidence in maintaining abstinence, despite negative affective experiences (internal self-efficacy) and outside circumstances (external self-efficacy), was also assessed. Smoking was biochemically verified at each assessment. RESULTS: Linear mixed models indicated decreasing intrinsic, baby's health, and parenting motivations from baseline to 12 and 24 weeks postpartum and increasing motivations from 24 to 52 weeks postpartum (ps < .03). Higher baseline internal self-efficacy was associated with lower probability of relapse at 24 weeks postpartum (odds ratio, 0.92; 95% CI, 0.87-0.98), although this effect became nonsignificant after adjustment for multiple statistical tests. Abstinence motivations and external self-efficacy were not significantly associated with relapse (ps > .10). CONCLUSIONS: Levels of abstinence motivations fluctuated from pregnancy through postpartum. Future work should investigate more potent predictors of postpartum abstinence.


Assuntos
Mães/psicologia , Motivação , Período Pós-Parto/psicologia , Prevenção Secundária/métodos , Autoeficácia , Abandono do Hábito de Fumar/psicologia , Prevenção do Hábito de Fumar/métodos , Adulto , Feminino , Humanos , Gravidez
14.
Rev. enferm. UFPE on line ; 13(5): 1300-1307, maio 2019. ilus, tab
Artigo em Português | BDENF - Enfermagem | ID: biblio-1024298

RESUMO

Objetivo: identificar a média do traço e o estado de ansiedade entre puérperas e verificar sua relação com as características sociodemográficas, reprodutivas e a experiência de violência. Método: trata-se de estudo quantitativo, descritivo, tipo transversal, com 302 mulheres com, pelo menos, 24 horas de pós-parto. Obtiveram-se os dados por meio de entrevistas, a partir de um formulário. Analisaram-se os dados pelo Stata 13.0. Apresentaram-se os resultados em forma de tabelas. Resultados: nota-se que a média do traço de ansiedade foi maior entre as puérperas que não apresentam companheiro, com menor escolaridade, não possuem trabalho remunerado, têm renda familiar igual ou inferior a 1100,00 reais, não planejaram ou desejaram a gravidez e sofreram violência física na gestação. Percebe-se que o estado de ansiedade teve maior média entre as mulheres de menor renda familiar e que não desejaram a gravidez (p<0,05). Conclusão: conclui-se que o traço e o estado de ansiedade estão presentes no período puerperal e são maiores no grupo de mulheres com piores condições socioeconômicas, que não planejaram/desejaram a gestação e vivenciaram a violência nesse período.(AU)


Objective: to identify the mean of the trait and the state of anxiety among puerperae and verify their relation with the sociodemographic, reproductive characteristics and the experience of violence. Method: this is a quantitative, descriptive, cross-sectional study of 302 women with at least 24 hours postpartum. The data was obtained through interviews with a questionnaire. Data were analyzed by Stata 13.0. Results were presented in the form of tables. Results: it was observed that the average anxiety trait was higher among puerperal women who did not have a partner, had less schooling, had no paid work, had a family income of 1100.00 reais or less, did not plan or desired pregnancy and suffered physical violence during pregnancy. It is noticed that the state of anxiety had a higher average among the women with lower family income and who did not wish to be pregnant (p <0.05). Conclusion: it is concluded that the trait and the state of anxiety are present in the puerperal period and are higher in the group of women with worse socioeconomic conditions, who did not plan / wanted gestation and experienced violence during this period.(AU)


Objetivo: identificar el promedio del trazo y el estado de ansiedad entre puérperas y verificar su relación con las características sociodemográficas, reproductivas y la experiencia de violencia. Método: se trata de un estudio cuantitativo, descriptivo, tipo transversal, realizado con 302 mujeres con al menos 24 horas de postparto. Se obtuvieron los datos a través de entrevistas, a partir de un formulario. Se analizaron los datos por el Stata 13.0. Se presentaron los resultados en forma de tablas. Resultados: se nota que el promedio del trazo de ansiedad fue mayor entre las que habían tenido compañero, con menor escolaridad, no tienen trabajo remunerado, tienen ingresos familiares igual o inferior a 1100,00 reales, no planificaron o desearon el embarazo y sufrieron violencia física en la gestación. Se percibe que el estado de ansiedad tuvo mayor promedio entre las mujeres de menor renta familiar y que no desearon el embarazo (p <0,05). Conclusión: se concluye que el trazo y el estado de ansiedad están presentes en el período puerperal y son mayores en el grupo de mujeres con peores condiciones socioeconómicas, que no planificaron / desearon el embarazo y vivenciaron la violencia en ese período.(AU)


Assuntos
Humanos , Feminino , Gravidez , Adulto , Ansiedade , Ansiedade/epidemiologia , Condições Sociais , Mulheres , Perfil de Saúde , Período Pós-Parto , Período Pós-Parto/psicologia , Mães , Epidemiologia Descritiva , Estudos Transversais
15.
Lancet Psychiatry ; 6(9): 786-792, 2019 09.
Artigo em Inglês | MEDLINE | ID: mdl-30981755

RESUMO

The recent conceptualisation of bipolar disorder as a neuroprogressive illness has highlighted the potential importance of prevention and early intervention in high-risk populations. Undiagnosed bipolar disorder early in the disease course is associated with adverse clinical outcomes and impaired functioning for patients, which in turn has economic consequences. Despite the mounting evidence that childbirth is one of the most potent and specific triggers of manic symptoms, studies are not available on the effectiveness of targeted interventions in the prevention of bipolar disorder in women who have recently given birth. In this Personal View, we describe the clinical characteristics of women at risk of developing bipolar disorder after childbirth, before discussing opportunities for prevention and early intervention and outlining challenges in the assessment and management of women at risk of transitioning to bipolar disorder after childbirth. Existing evidence, although scarce, supports a clinical staging model by which at-risk women are managed with a variety of behavioural and pharmacological interventions aimed at preventing bipolar disorder. Close monitoring and early intervention might reduce the risk of hypomanic or manic symptoms in women at risk of developing bipolar disorder after childbirth; however, the potential benefits of early identification and intervention need to be carefully balanced against the additional risks for affected women.


Assuntos
Transtorno Bipolar/prevenção & controle , Infanticídio/prevenção & controle , Parto/psicologia , Período Pós-Parto/psicologia , Tentativa de Suicídio/prevenção & controle , Adolescente , Transtorno Bipolar/diagnóstico , Transtorno Bipolar/epidemiologia , Transtorno Ciclotímico/psicologia , Diagnóstico Precoce , Feminino , Indicadores Básicos de Saúde , Humanos , Recém-Nascido , Infanticídio/psicologia , Monitorização Fisiológica/métodos , Gravidez , Estudos Prospectivos , Transtornos Puerperais/prevenção & controle , Transtornos Puerperais/psicologia , Tentativa de Suicídio/psicologia , Adulto Jovem
16.
BMC Pregnancy Childbirth ; 19(1): 125, 2019 Apr 11.
Artigo em Inglês | MEDLINE | ID: mdl-30975095

RESUMO

BACKGROUND: Bonding refers to emotions and cognitions towards one's infant. Breastfeeding is believed to facilitate bonding, yet only a handful of studies have empirically tested this assertion. This study aimed to confirm whether a positive association between breastfeeding and bonding exists and whether breastfeeding may be protective against the negative consequences of mood and sleep disturbances on bonding. METHOD: A cross-sectional survey was administered to a convenience sample of Israeli mothers of infants ages 1-9 months. The main outcome measures were breastfeeding history, bonding (Postpartum Bonding Questionnaire, PBQ), mood (Edinburgh Postnatal Depression Scale, EPDS) and sleep (Pittsburgh Sleep Quality Index, PSQI). RESULTS: Two hundred seventy-one mothers (21-46 years) completed the survey. 65.7% reported current breastfeeding, 22.1% past breastfeeding, 12.2% never nursed. The PBQ correlated with both the EPDS and PSQI. Breastfeeding was associated with greater daytime fatigue, but not with any other sleep problem, and was not associated with bonding. This negative result was confirmed with Bayesian analysis demonstrating that the probability for the null hypothesis was 4.5 times greater than the hypothesized effect. Further, hierarchical regression revealed a positive relationship between bonding, daytime fatigue and depression symptoms only among women who were currently breastfeeding. CONCLUSIONS: These findings suggest that among healthy mothers, breastfeeding may not be a central factor in mother-infant bonding, nor is it protective against the negative impact of mood symptoms and bonding difficulties. Theoretical and methodological bases of these findings are discussed.


Assuntos
Aleitamento Materno/psicologia , Relações Mãe-Filho/psicologia , Mães/psicologia , Apego ao Objeto , Período Pós-Parto/psicologia , Adulto , Afeto , Teorema de Bayes , Estudos Transversais , Emoções , Feminino , Humanos , Lactente , Recém-Nascido , Gravidez , Escalas de Graduação Psiquiátrica , Sono , Transtornos do Sono-Vigília/psicologia , Inquéritos e Questionários
17.
J Fam Psychol ; 33(4): 401-411, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-30973256

RESUMO

First-time and experienced mothers' prenatal expectations, postnatal experiences, and postnatal desires regarding the division of infant caregiving responsibilities with her partner were examined to explore whether postnatal desires may be a better indicator of mothers' postnatal adaptation (self-efficacy, satisfaction, stress, depressive symptoms, and state anxiety) than prenatal expectations and postnatal experiences. Mothers (N = 132) completed a prenatal questionnaire during their third trimester and a postnatal questionnaire at 8 weeks postpartum. Women's parental status (first-time vs. experienced) and their postnatal work status were associated with their expectations, experiences, and desires for the division of caregiving. Women whose partners were involved in the caregiving tasks reported more positive postnatal adaptation, whereas women, and particularly first-time mothers, who desired more partner involvement had poorer postnatal adaptation. The results suggest that mothers' postnatal desires concerning the division of caregiving is important to consider in examining mothers' postnatal adaptation. (PsycINFO Database Record (c) 2019 APA, all rights reserved).


Assuntos
Adaptação Psicológica , Relações Mãe-Filho/psicologia , Mães/psicologia , Período Pós-Parto/psicologia , Adulto , Afeto , Feminino , Humanos , Lactente , Recém-Nascido , Percepção , Satisfação Pessoal , Gravidez , Inquéritos e Questionários
18.
Neurobiol Aging ; 78: 1-17, 2019 06.
Artigo em Inglês | MEDLINE | ID: mdl-30825663

RESUMO

The maternal brain displays considerable plasticity, and motherhood is associated with changes in affective and cognitive function. Motherhood can alter the trajectory of brain aging, including modifications to neuroplasticity and cognition. Here, we investigated the short- and long-term effects of motherhood on hippocampal neurogenesis, microglial density and morphology, and circulating cytokines, domains known to be altered with age and implicated in cognition and mood. Female rats were bred then euthanized during gestation or at various postpartum time points, culminating in middle age, and nulliparous rats served as age-matched controls. Hippocampal neurogenesis was significantly suppressed during gestation and the postpartum period. Interestingly, neurogenesis declined significantly in middle-aged nulliparous rats but increased in primiparous rats across the same period. Transient postpartum adaptations to the neuroimmune environment of the hippocampus were evidenced, as Iba-1-immunoreactive microglia assumed a deramified morphology followed by increased density. Intriguingly, aging-related changes in circulating cytokines were dependent on parity. These adaptations in neurogenic and immune processes may have ramifications for maternal mood and cognition across the peripartum period and beyond.


Assuntos
Envelhecimento , Citocinas/metabolismo , Hipocampo/fisiologia , Microglia/fisiologia , Mães , Neurogênese/fisiologia , Afeto , Envelhecimento/imunologia , Envelhecimento/metabolismo , Envelhecimento/patologia , Envelhecimento/fisiologia , Animais , Proteínas de Ligação ao Cálcio , Contagem de Células , Cognição , Feminino , Hipocampo/imunologia , Humanos , Masculino , Proteínas dos Microfilamentos , Microglia/patologia , Proteínas Associadas aos Microtúbulos , Mães/psicologia , Neuroimunomodulação , Neuropeptídeos , Período Pós-Parto/fisiologia , Período Pós-Parto/psicologia , Gravidez , Ratos Sprague-Dawley
19.
Biol Psychol ; 144: 11-19, 2019 05.
Artigo em Inglês | MEDLINE | ID: mdl-30885739

RESUMO

Prenatal social stress "programs" offspring immune activity in animal models, but how the prenatal social environment affects human offspring inflammation is not known. Here, we test associations between prenatal partner support quality, i.e. positive/helpful support, negative/upsetting support, and their interaction, and infant inflammatory markers. A sample of 113 women from the Alberta Pregnancy Outcomes and Nutrition (APrON) cohort were followed from early pregnancy to 3-months postpartum. Partner support quality was measured during pregnancy and the postpartum period. Three-month-old infant blood samples were assayed for inflammatory markers, i.e., adaptive immune markers IFNγ, IL12p70 and IL10. The prenatal positive-by-negative partner support interaction predicted infant IFNγ, IL12p70, and IL10, p's<.035, independent of covariates and postpartum partner support. When negative partner support was high, high positive support predicted higher infant IFNγ, IL12p70, and IL10. As such, partner support during pregnancy that is both highly negative/upsetting and also highly positive/helpful predicted adaptive immunity markers in infants at 3 months of age.


Assuntos
Mediadores da Inflamação/sangue , Complicações na Gravidez/psicologia , Efeitos Tardios da Exposição Pré-Natal/sangue , Parceiros Sexuais/psicologia , Apoio Social , Adulto , Alberta , Estudos de Coortes , Feminino , Humanos , Lactente , Inflamação , Masculino , Período Pós-Parto/psicologia , Gravidez , Resultado da Gravidez , Efeitos Tardios da Exposição Pré-Natal/psicologia , Estresse Psicológico/psicologia , Adulto Jovem
20.
Eur J Contracept Reprod Health Care ; 24(2): 161-165, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-30920324

RESUMO

OBJECTIVE: Intention to use modern contraception in women with severe acute maternal morbidity (SAMM) presents a window of opportunity to scale up postpartum family planning to prevent future complications. The aim of this study was to determine the factors that affect the contraceptive intentions of women who survive SAMM in Kaduna State, northern Nigeria. METHODS: SAMM survivors aged 15-49 years were recruited after recovery and interviewed before discharge from hospital. RESULTS: Of the 330 women studied, 246 (74.5%) had wanted the index pregnancy. Although their knowledge of modern contraception was good (89.1%), only 44.5% had ever used modern contraception. The main reason given for not wanting to use modern contraception was that God should decide on the number of children. Injectables, pills, implants and male condoms were the commonest contraceptive methods used. Of the women who gave reasons for stopping these contraceptives, the main reasons in 61% were desire to conceive and fear of side effects. The majority (72.4%) of the women wished to have more children and 69.1% intended to use contraception in the future. The husband's permission was needed by 78.2% of respondents before using contraception. The commonest reason given for not wanting to get pregnant again was to avoid complications (30.4%) and that family size had been completed (28.6%). CONCLUSION: Male partner involvement and counselling to address religious views and fear of side effects are critical to the acceptance of postpartum family planning in SAMM survivors.


Assuntos
Comportamento Contraceptivo/psicologia , Anticoncepção/psicologia , Período Pós-Parto/psicologia , Complicações na Gravidez/psicologia , Sobreviventes/psicologia , Doença Aguda , Adolescente , Adulto , Anticoncepção/métodos , Serviços de Planejamento Familiar/métodos , Feminino , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Intenção , Masculino , Pessoa de Meia-Idade , Nigéria , Gravidez , Complicações na Gravidez/prevenção & controle , Parceiros Sexuais/psicologia , Adulto Jovem
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