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1.
Psychiatry Res ; 332: 115683, 2024 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-38218050

RESUMEN

OBJECTIVE: This study examined associations between participation in virtual support groups for peripartum women and mental health outcomes at follow-up approximately 8 months later. METHODS: This cross-sectional online survey study assessed 383 women from the Perinatal Experiences and COVID-19 Effects (PEACE) study. Initial participants (T1) were re-contacted (T2) and self-reported mental health symptoms of depression (CES-D), anxiety (GAD-7), and COVID-related grief were assessed at both time points. Participants reported involvement in virtual support groups and their perception of the effectiveness of social media in addressing feelings of loneliness. RESULTS: The majority (62%) of respondents participated in a virtual support group, 99% of whom used informal social media-based groups (e.g. Facebook groups). At initial evaluation, virtual group participants reported higher levels of depressive symptoms (p=0.008) and COVID grief (p=0.004), but not higher levels of anxiety. Across the cohort, self-reported depressive, anxiety, and grief symptoms did not change significantly at follow-up in paired analysis, and virtual group participants did not demonstrate improvement in mental health symptoms. CONCLUSIONS: Participation in virtual support groups did not seem to improve mental health outcomes for peripartum women, and most women found social media engagement minimally effective at addressing loneliness.


Asunto(s)
COVID-19 , Periodo Periparto , Embarazo , Femenino , Humanos , Estudios Transversales , Pandemias , Ansiedad/epidemiología , Grupos de Autoayuda , Evaluación de Resultado en la Atención de Salud , Depresión/epidemiología
2.
Early Hum Dev ; 189: 105931, 2024 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-38215651

RESUMEN

BACKGROUND: The spread of the COVID-19 virus was declared a pandemic in March 2020. New restrictions such as 'lockdowns' and 'social distancing' created challenges for individuals' work-life balance, financial situation, family life, and physical and mental health. The global population's stress levels rose in response to these changes, leading to a widespread deterioration of mental health. One group particularly affected was parents of infants and very young children. Poor parental mental health may disrupt parent-infant bonding, with negative consequences for infant well-being and development. AIMS: To consider parent-infant bonding in relation to parents' perceived stress and psychological distress during the first lockdown, and to examine whether associations of stress with parent-infant bonding were mediated by parental mental health. METHODS: DREAMCORONA (n = 738: 471 mothers and 267 partners) is a sub-study of the prospective German cohort study 'DREAM'. The SPSS modelling tool PROCESS was used to assess whether parental mental health mediated the relationship between parents' perceived stress response to the COVID-19 pandemic and parent-infant bonding, while controlling for covariates. RESULTS: Higher levels of parental stress were strongly associated with higher levels of depression, anxiety, and aggression symptoms for both parents. In addition, there was a significant relationship between parents' self-reported stress levels and parent-infant bonding. This relationship was mediated by symptoms of depression and anxiety for fathers and by symptoms of anger-hostility for both parents. CONCLUSION: Increased parental stress during the early pandemic was associated with poorer parent-infant bonding. This has important implications for the management of any future public health crises.


Asunto(s)
COVID-19 , Pandemias , Humanos , Lactante , Niño , Preescolar , Salud Mental , Estudios Prospectivos , Estudios de Cohortes , COVID-19/epidemiología , Control de Enfermedades Transmisibles , Padres/psicología , Estrés Psicológico/epidemiología , Estrés Psicológico/psicología
3.
Am J Obstet Gynecol MFM ; 6(2): 101264, 2024 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-38135219

RESUMEN

BACKGROUND: Targeted programs aimed at improving maternal mental health, particularly among those exposed to social determinants of health, are increasingly critical since the onset of the COVID-19 pandemic, yet the impact of such programs is poorly understood. OBJECTIVE: This study aimed to evaluate the impact of a novel, language-concordant community-based program on perinatal mental health. STUDY DESIGN: We conducted a prospective cohort study of peripartum individuals referred to a new community-based intervention known as Helping Us Grow Stronger (HUGS/Abrazos). Participants received up to 4 remote sessions with a cognitive behavioral therapy trained social worker, up to 3 resource navigation sessions with a community health worker, and direct relief with a grocery gift card and care package. Before and after the program, participants completed validated survey instruments to assess mental health and social determinants of health. RESULTS: A total of 178 participants were assessed after program completion, including 133 who were assessed before and after the program. The cohort was composed of 62.9% Hispanic or Latinx participants with a mean age of 29.8 year (standard error of mean, 0.46). There were high rates of food insecurity (111/178; 62.4%), experiences of discrimination (119/178; 66.9%), and SARS-CoV-2 infection (105/178; 59.0%). The program was associated with statistically significant improvements in the Edinburgh Postnatal Depression scores (baseline [mean±standard error of mean], 8.44±0.55 vs 6.77±0.51 after program completion; P=.0001) and Perceived Stress Scale scores (baseline, 15.2±0.74 vs 14.0±0.71; P=.035). Participants exposed to stressors including food insecurity and experiences of discrimination had higher baseline depression, stress, and anxiety scores. Those with experiences of discrimination, food insecurity, and SARS-CoV-2 infection during pregnancy were more likely to have improvements in mental health scores postintervention. CONCLUSION: In this diverse urban cohort, a novel community-based intervention was associated with improvements in depressive symptoms, perceived stress, and anxiety, particularly among those with social determinants of health.


Asunto(s)
COVID-19 , Salud Mental , Pruebas Psicológicas , Autoinforme , Femenino , Embarazo , Humanos , Adulto , Depresión/diagnóstico , Depresión/epidemiología , Depresión/prevención & control , Estudios Prospectivos , Pandemias , COVID-19/diagnóstico , COVID-19/epidemiología , COVID-19/prevención & control
4.
JMIR Ment Health ; 10: e52901, 2023 Dec 22.
Artículo en Inglés | MEDLINE | ID: mdl-38133912

RESUMEN

BACKGROUND: During the COVID-19 pandemic, the Oxford Precision Psychiatry Lab (OxPPL) developed open-access web-based summaries of mental health care guidelines (OxPPL guidance) in key areas such as digital approaches and telepsychiatry, suicide and self-harm, domestic violence and abuse, perinatal care, and vaccine hesitancy and prioritization in the context of mental illness, to inform timely clinical decision-making. OBJECTIVE: This study aimed to evaluate the practice of creating evidence-based health guidelines during health emergencies using the OxPPL guidance as an example. An international network of clinical sites and colleagues (in Australia, New Zealand, and the United Kingdom) including clinicians, researchers, and experts by experience aimed to (1) evaluate the clinical impact of the OxPPL guidance, as an example of an evidence-based summary of guidelines; (2) review the literature for other evidence-based summaries of COVID-19 guidelines regarding mental health care; and (3) produce a framework for response to future global health emergencies. METHODS: The impact and clinical utility of the OxPPL guidance were assessed using clinicians' feedback via an international survey and focus groups. A systematic review (protocol registered on Open Science Framework) identified summaries or syntheses of guidelines for mental health care during and after the COVID-19 pandemic and assessed the accuracy of the methods used in the OxPPL guidance by identifying any resources that the guidance had not included. RESULTS: Overall, 80.2% (146/182) of the clinicians agreed or strongly agreed that the OxPPL guidance answered important clinical questions, 73.1% (133/182) stated that the guidance was relevant to their service, 59.3% (108/182) said that the guidelines had or would have a positive impact on their clinical practice, 42.9% (78/182) that they had shared or would share the guidance, and 80.2% (146/182) stated that the methodology could be used during future health crises. The focus groups found that the combination of evidence-based knowledge, clinical viewpoint, and visibility was crucial for clinical implementation. The systematic review identified 2543 records, of which 2 syntheses of guidelines met all the inclusion criteria, but only 1 (the OxPPL guidance) used evidence-based methodology. The review showed that the OxPPL guidance had included the majority of eligible guidelines, but 6 were identified that had not been included. CONCLUSIONS: The study identified an unmet need for web-based, evidence-based mental health care guidance during the COVID-19 pandemic. The OxPPL guidance was evaluated by clinicians as having a real-world clinical impact. Robust evidence-based methodology and expertise in mental health are necessary, but easy accessibility is also needed, and digital technology can materially help. Further health emergencies are inevitable and now is the ideal time to prepare, including addressing the training needs of clinicians, patients, and carers, especially in areas such as telepsychiatry and digital mental health. For future planning, guidance should be widely disseminated on an international platform, with allocated resources to support adaptive updates.


Asunto(s)
COVID-19 , Psiquiatría , Telemedicina , Humanos , COVID-19/epidemiología , Salud Mental , Pandemias/prevención & control , Urgencias Médicas
5.
Andes Pediatr ; 94(3): 370-378, 2023 Jun.
Artículo en Inglés, Español | MEDLINE | ID: mdl-37909940

RESUMEN

The deterioration of mental health in the general population has been one of the main consequences of the COVID-19 health crisis, with differences in diverse groups. Specifically, recent studies report an increased risk for the development of symptoms of anxiety and depression during the perinatal period, as well as a negative impact on the newborn. OBJECTIVE: The objective of this study was to examine the differences in mental health, infant and obstetric variables, and childbirth experience in the public and private health systems in Chilean primiparous women before and during the CO- VID-19 pandemic. SUBJECTS AND METHOD: This quantitative study compared two cohorts. The first one included mothers with babies born before the COVID-19 pandemic (N = 81) and the second one involved mothers who delivered during the pandemic (N = 71). Sociodemographic and obstetric history, depression, anxiety, and stress were evaluated in both groups using self-report questionnaires (EPDS, DASS-21). Differences between groups were assessed with ANCOVA, t-tests, and chi-square tests. RESULTS: Women who delivered during the pandemic reported greater depressive symptoms and their babies were smaller and had less weeks of gestation than babies born before the COVID-19 pandemic. However, this group maintained exclusive breastfeeding for a longer period. There were no differences in the experience of childbirth between the groups, but there were differences in relation to the public or private nature of the hospital where the mothers were seen. CONCLUSIONS: The pandemic negatively affected the mental health of mothers, posing significant challenges to promoting the emotional well-being of mothers and their infants.


Asunto(s)
COVID-19 , Salud Mental , Lactante , Recién Nacido , Embarazo , Humanos , Femenino , Pandemias , COVID-19/epidemiología , Ansiedad/epidemiología , Ansiedad/etiología , Madres
6.
Matern Child Health J ; 27(Suppl 1): 5-13, 2023 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-37792151

RESUMEN

INTRODUCTION: The Association of Maternal & Child Health Programs (AMCHP) and the Association of State and Territorial Health Officials (ASTHO) launched the PRISM (Promoting Innovation in State and Territorial MCH Policymaking) Learning Community, funded by the U.S. Department of Health and Human Services (HHS), Health Resources and Services Administration (HRSA), Maternal and Child Health Bureau (MCHB). The goal of PRISM was to build state and territorial health agency program and policy-making capacity to address substance use and mental health in the maternal and child health (MCH) population. Expanding access to care and treatment for perinatal substance use disorders (SUD) emerged as the issue of greatest need for state teams. METHODS: The PRISM Learning Community consisted of three major components: (1) intensive capacity building for cross-agency state teams, which involved action planning, peer-to-peer learning, and technical assistance; (2) programming to inform the MCH field broadly about innovations in perinatal SUD policy and practice; and (3) a program evaluation involving pre-, mid-, and post-assessments and follow-up key informant interviews with state teams. This manuscript is not based on clinical study or patient data, therefore IRB approval was not required. RESULTS: States reported that their knowledge of perinatal SUDs increased and their cross-agency partnerships were strengthened as a result of their participation in PRISM. States identified four key priorities for their continued work: to improve multisector collaborations, to institute equitable SUD screening practices for pregnant people, to strengthen the perinatal behavioral health workforce, and to enhance Medicaid coverage for perinatal SUD prevention and treatment services. The need to respond to urgent demands of COVID-19 and the stigma associated with perinatal SUDs were the most significant barriers to advancing state action plan goals. DISCUSSION: Since 2018, the PRISM project has supported nine jurisdictions across two cohorts. Participation in PRISM advanced state policies and programs to improve perinatal SUD care through capacity building, technical assistance, and virtual programming. Findings and lessons learned from PRISM may inform the activities of other states seeking to address perinatal substance use disorders.


Asunto(s)
Salud Infantil , Trastornos Relacionados con Sustancias , Niño , Embarazo , Femenino , Estados Unidos , Humanos , Evaluación de Programas y Proyectos de Salud , Formulación de Políticas , Familia
7.
BMJ Open ; 13(10): e071084, 2023 10 06.
Artículo en Inglés | MEDLINE | ID: mdl-37802623

RESUMEN

OBJECTIVES: Perinatal mental health disorders such as anxiety, depression and bipolar disorder can negatively impact the health of women and their children without appropriate detection and treatment. Due to increases in mental health symptoms and transmission risks associated with in-person appointments, many clinics transitioned to providing telepsychiatry care during the COVID-19 pandemic. This study sought to identify the facilitators and barriers to receiving perinatal telepsychiatry care from the perspective of patients, clinic staff and psychiatrists. DESIGN: Qualitative study based on analysis of in depth semistructured interviews. SETTING: The study was conducted in a virtual specialty mental health clinic in an academic setting. PARTICIPANTS: Eight patients who had been scheduled for an appointment with the perinatal telepsychiatry clinic between 14 May 2021 and 1 August 2021, seven of whom had attended their scheduled appointment with the clinic and one of whom had not, and five staff members including psychiatrists, navigators and clinic managers, participated in in-depth interviews. RESULTS: Telepsychiatry was perceived by most as preferable to in-person care and easy to attend and navigate. Alternatively, technological difficulties, personal preference for in-person care and scheduling conflicts related to the perinatal period were identified as barriers by some. Participants identified communication between care staff and patients, online patient portals, and appointment reminders as important for facilitating appointment preparedness and attendance. CONCLUSIONS: The findings from this study suggest that telepsychiatry services are perceived positively by patients and care staff and have the potential to improve access to mental healthcare for perinatal patients.


Asunto(s)
COVID-19 , Psiquiatría , Telemedicina , Embarazo , Niño , Humanos , Femenino , Pandemias , COVID-19/epidemiología , Atención a la Salud
8.
BMC Pregnancy Childbirth ; 23(1): 636, 2023 Sep 04.
Artículo en Inglés | MEDLINE | ID: mdl-37667206

RESUMEN

OBJECTIVE: The objective of this study was to qualitatively examine coping mechanisms and desired supports in pregnant and birthing Black and Biracial adolescent and young adult women during the COVID-19 pandemic. METHODS: Black and Biracial participants ages 16-23 were recruited for virtual individual semi-structured interviews. Participants (n = 25) were asked about pre- and post-natal experiences with the healthcare system, effects of the pandemic, and participants' experiences of or desires for ideal care within the healthcare system. Interviews were transcribed verbatim and coded for qualitative analysis using nVivo. Discussions around postpartum mental health evolved organically when asked about how participants were coping postpartum. RESULTS: Nearly half the interviewees organically reported mental health symptoms consistent with postpartum depression (PPD) during questions regarding their postpartum experience. Of the 11 interviewees who reported mental health symptoms consistent with PPD, 2 were afraid to disclose their symptoms to a healthcare provider due to fear of child protective services involvement and their belief they would be treated unfairly because of their race. CONCLUSION: Clinicians who care for Black and Biracial adolescent and young adult mothers must be particularly attuned to structural barriers for appropriate screening and treatment of postpartum depression. Expanding investigations of intersectional influences on young mothers' perinatal health and PPD are needed.


Asunto(s)
COVID-19 , Depresión Posparto , Adolescente , Niño , Embarazo , Adulto Joven , Femenino , Humanos , Salud Mental , Pandemias , COVID-19/epidemiología , Depresión Posparto/epidemiología , Periodo Posparto , Progresión de la Enfermedad
9.
Can J Public Health ; 114(5): 755-773, 2023 10.
Artículo en Inglés | MEDLINE | ID: mdl-37668893

RESUMEN

OBJECTIVE: Assess the association between prenatal mental health during the COVID-19 pandemic and preterm birth (PTB; delivery < 37 weeks gestation) and low birth weight (LBW; < 2500 g). METHODS: Pregnant individuals, > 18 years, were recruited in Canada and provided data through a web-based questionnaire. We analyzed data on persons recruited between 06/2020 and 08/2021 who completed questionnaires while pregnant and 2 months post-partum. Data on maternal sociodemographics, comorbidities, medication use, mental health (Edinburgh Postnatal Depression Scale, General Anxiety Disorder-7, stress), pandemic hardship (CONCEPTION-Assessment of Stress from COVID-19), and on gestational age at delivery and birth weight were self-reported. Crude and adjusted odds ratios (aOR) with 95% confidence interval (95%CI) were calculated to quantify the association between PTB/LBW and maternal mental health. RESULTS: A total of 1265 and 1233 participants were included in the analyses of PTB and LBW, respectively. No associations were observed between PTB and prenatal mental health (depression [aOR 1.01, 95%CI 0.91-1.11], anxiety [aOR 1.04, 95%CI 0.93-1.17], stress [aOR 0.88, 95%CI 0.71-1.10], or hardship [aOR 1.00, 95%CI 0.96-1.04]) after adjusting for potential confounders. The risk of PTB was increased with non-white ethnicity/race (aOR 3.85, 95%CI 1.35-11.00), consistent with the literature. Similar findings were observed for LBW (depression [aOR 1.03, 95%CI 0.96-1.13], anxiety [aOR 1.05, 95%CI 0.95-1.17], COVID stress [aOR 0.92, 95%CI 0.77-1.09], or overall hardship [aOR 0.97, 95%CI 0.94-1.01]). CONCLUSION: No association was found between prenatal mental health nor hardship during the COVID-19 pandemic and the risk of PTB or LBW. However, it is imperative to continue the follow-up of mothers and their offspring to detect long-term health problems early.


RéSUMé: OBJECTIF: Évaluer l'association entre la santé mentale prénatale pendant la pandémie de COVID-19 et les naissances prématurées (accouchement < 37 semaines de gestation) et les faibles poids à la naissance (< 2 500 g). MéTHODES: Des personnes enceintes de plus de 18 ans ont été recrutées au Canada et ont fourni des données prénatales via un questionnaire en ligne. Nous avons analysé les données des personnes recrutées entre 06/2020 et 08/2021, ayant rempli deux questionnaires dont un pendant la grossesse et un 2 mois post-partum. Les données sur les caractéristiques sociodémographiques maternelles, les comorbidités, l'utilisation de médicaments, la santé mentale (Échelle de dépression postnatale d'Édimbourg [EPDS], trouble anxieux généralisé-7 [GAD-7], stress), les difficultés liées à la pandémie (CONCEPTION­Évaluation du stress lié à la COVID-19) ainsi que l'âge gestationnel à l'accouchement et le poids à la naissance ont été auto-déclarées. Les rapports de cotes bruts et ajustés (aRC) avec un intervalle de confiance à 95% (IC 95%) ont été calculés pour quantifier l'association entre la prématurité/petit poids à la naissance et la santé mentale maternelle. RéSULTATS: Un total de 1 265 et 1 233 participants ont été inclus dans les analyses de NP et de FPN, respectivement. Aucune association n'a été observée entre la prématurité et la santé mentale prénatale (dépression [aRC 1,01, IC 95% 0,91­1,11], anxiété [aOR 1,04, IC 95% 0,93­1,17], stress [aRC 0,88, IC 95% 0,71­1,10], ni difficultés liées à la COVID-19 [aOR 1,00, IC 95% 0,96­1,04]) après ajustement pour les facteurs de confusion potentiels. Le risque de prématurité était plus élevé chez les personnes d'ethnie/race non blanche (aRC 3,85, IC 95% 1,35­11,00), en accord avec la littérature. Des résultats similaires ont été observés pour le faible poids à la naissance (dépression [aRC 1,03, IC 95% 0,96­1,13], anxiété [aRC 1,05, IC 95% 0,95­1,17], stress lié à la COVID [aRC 0,92, IC 95% 0,77­1,09], ou difficultés en lien avec la COVID-19 [aRC 0,97, IC 95% 0,94­1,01]). CONCLUSION: Aucune association n'a été trouvée entre la santé mentale prénatale ni les difficultés pendant la pandémie de COVID-19 et le risque de prématurité ou de petit poids à la naissance. Cependant, il est impératif de poursuivre le suivi des mères et de leurs enfants pour détecter précocement d'éventuels problèmes de santé à long terme.


Asunto(s)
COVID-19 , Nacimiento Prematuro , Recién Nacido , Femenino , Embarazo , Humanos , Salud Mental , Pandemias , COVID-19/epidemiología , Nacimiento Prematuro/epidemiología , Estudios de Casos y Controles , Madres
10.
J Psychosom Obstet Gynaecol ; 44(1): 2245556, 2023 12.
Artículo en Inglés | MEDLINE | ID: mdl-37615367

RESUMEN

PURPOSE: The study aims to investigate risk factors of paternal perinatal depression during the COVID-19 pandemic. METHODS: We conducted an online cross-sectional study of 473 prenatal fathers and 1246 postnatal fathers in August 2021. We applied a modified Poisson regression to estimate relative risk ratios of possible factors for paternal perinatal depression (measured by Edinburgh Postnatal Depression Scale), sequentially introducing the following factors into the model: individual factors, interpersonal factors, obstetric/pediatric factors, and service utilization factors. RESULTS: Prenatal fathers with the following risk factors were at an increased risk for having depressive symptoms: adverse childhood experiences (risk ratio; RR 1.61), past depression (RR 1.63), fear of COVID-19 (RR 2.09), lower social support (RR 1.91), low family resources (RR 1.95), and intimate partner violence (IPV) victimization (RR 1.29). Postnatal fathers having the following risk factors were at an increased risk for having depressive symptoms: past depression (RR 1.67), fear of COVID-19 (RR 1.26), low family resources (RR 1.85), IPV victimization. (RR 1.18), and preterm birth (RR 1.18). CONCLUSION: The study showed risk factors such as past history of depression, high fear of COVID-19, low family functionality, and IPV victimization were associated with perinatal depressive symptoms. The findings should contribute to future directions of interventions for paternal perinatal mental health.


Asunto(s)
COVID-19 , Nacimiento Prematuro , Recién Nacido , Femenino , Embarazo , Humanos , Niño , Japón/epidemiología , Estudios Transversales , Depresión/epidemiología , Pandemias , Factores de Riesgo
11.
Birth ; 50(4): 651-656, 2023 12.
Artículo en Inglés | MEDLINE | ID: mdl-37455498

RESUMEN

In summary, birthing women are at risk of poor mental health particularly in a pandemic. Identified protective factors such as social support, good sleep, exercise, and access to prenatal care, among others are pertinent to reducing negative effects on perinatal mental health should future crises occur.


Asunto(s)
COVID-19 , Salud Mental , Embarazo , Humanos , Femenino , Pandemias , Factores Protectores , Factores de Riesgo
12.
J Fam Psychol ; 37(7): 1083-1094, 2023 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-37471029

RESUMEN

Pregnant women were classified as a risk group during the COVID-19 pandemic, and restrictions resulted in nonbirthing parents being excluded from antenatal care and in uncertain or brief involvement in the birth of the child. Sweden presents a unique context for examining parents' experiences during the pandemic because of the country's policy to not enforce lockdown and its commitment to gender equality in parenting. This study aimed to explore the experiences and mental health of expecting parents in Sweden by combining qualitative content analysis of parents' own narratives (n = 212) and quantitative analysis of established measures of perinatal depression, anxiety, and self-efficacy (N = 378). Content analysis indicated that parents reported feeling isolated and missing social support. Regarding the medical context, nonbirthing parents reported feeling excluded, and birthing parents reported increased worry about a potential birth with their partner absent. However, parents with a partner also reported feeling closer with their coparent and appreciating the increased time and nearness. Quantitative results indicated that symptoms of depression and anxiety significantly predicted mentions of feeling isolated and absence of mentions of positives. Concerns of exclusion were significantly linked to lower self-efficacy. Together, the findings highlight the risks of reducing social support and excluding nonbirthing parents in health care during the pandemic, as well as the potential for more positive perinatal experiences if parents' time together is enabled in the prenatal period. Implications for health care and workplaces are discussed. (PsycInfo Database Record (c) 2023 APA, all rights reserved).


Asunto(s)
COVID-19 , Salud Mental , Niño , Humanos , Femenino , Embarazo , Suecia/epidemiología , Pandemias , Control de Enfermedades Transmisibles , Padres/psicología
13.
Psychiatr Q ; 94(3): 385-398, 2023 09.
Artículo en Inglés | MEDLINE | ID: mdl-37477821

RESUMEN

The study was designed to examine the mental health impact of COVID-19 infection in postpartum women and its effects on mother-infant bonding during the first eight weeks postpartum. Fifty-seven consenting eligible postpartum women were recruited for the study. They were assessed at two time points using standardized rating scales to measure distress and uniquely designed scales assessing COVID-19-specific outcome fears and bonding. Almost half [42%] of postpartum women with COVID-19 suffered from a probable anxiety disorder, and one-third [33.3%] suffered from probable depression. The overwhelming majority [91.2%] experienced COVID-19-specific fear. There was an inverse relationship between one dimension of maternal caregiving and self-report depression and anxiety scores, respectively. Additionally, despite discharge, 25% of the mothers had not breastfed the infants till the 8th-week postpartum period, which is in discordance with the World Health Organization (WHO) recommendation of exclusive breastfeeding up to 6 months of age that is widely practiced in India. The novel COVID-19 pandemic was associated with anxiety and depression, impacting mother-infant bonding. Therefore, there is a need for specialized mental health services and individualized breastfeeding interventions for this vulnerable population to ensure positive outcomes.


Asunto(s)
COVID-19 , Depresión Posparto , Lactante , Femenino , Humanos , Madres/psicología , Salud Mental , Relaciones Madre-Hijo/psicología , Pandemias , COVID-19/epidemiología , Periodo Posparto , India/epidemiología , Depresión Posparto/epidemiología , Depresión Posparto/psicología
14.
Adv Exp Med Biol ; 1428: 269-285, 2023.
Artículo en Inglés | MEDLINE | ID: mdl-37466778

RESUMEN

The COVID-19 pandemic has impacted many aspects of health and society worldwide. One vulnerable group that faced SARS-CoV-2 infection is pregnant women, who were considered to have potentiated risk factors. In physiological pregnancy, maternal systems have several changes and adaptations to support fetal development. These changes involve regulations of cardiovascular, respiratory, and immunologic systems, among others, which SARS-CoV-2 could severely alter. Furthermore, the systemic effects of viral infection could be associated with placental dysfunction and adverse pregnancy outcomes, which have been studied from the start of the pandemic to date. Additionally, pregnancy is a condition of more significant mental health vulnerability, especially when faced with highly stressful situations. In this chapter, we have collected information on the effect of COVID-19 on maternal mortality, the SARS-CoV-2 infection rate in pregnancy, and the impact on pregnancy outcomes, maternal mental health, and placental function, with a particular focus on studies that consider the Latin American population.


Asunto(s)
COVID-19 , Complicaciones Infecciosas del Embarazo , Femenino , Embarazo , Humanos , COVID-19/epidemiología , Resultado del Embarazo , SARS-CoV-2 , América Latina/epidemiología , Placenta , Pandemias , Salud Mental , Complicaciones Infecciosas del Embarazo/epidemiología , Transmisión Vertical de Enfermedad Infecciosa
15.
Birth ; 50(4): 877-889, 2023 12.
Artículo en Inglés | MEDLINE | ID: mdl-37431957

RESUMEN

BACKGROUND: Mounting evidence shows the risk of COVID-19 on perinatal outcomes, as well as the safety and efficacy of vaccination during pregnancy. However, little is known about vaccine uptake among pregnant women in Australia, including women who are culturally and linguistically diverse (CALD), and about sources of information pregnant women use when making decisions about vaccines. We aimed to determine the proportion of pregnant women who had been vaccinated and to identify factors associated with vaccine uptake or decline during pregnancy. METHOD: A cross-sectional, anonymous, online survey was conducted from October 2021 to January 2022 in two metropolitan hospitals in New South Wales, Australia. RESULTS: Of 914 pregnant women, 406 (44%) did not speak English at home. Overall, 101 (11%) received a vaccine prepregnancy and 699 (76%) during pregnancy. In the nonvaccinated cohort, 87 (76%) declined vaccination during pregnancy. The uptake was more than 87% among women during pregnancy who received information from government or health professional websites but 37% when received from personal blogs. The main reasons for vaccine uptake were (1) hearing that COVID-19 affects pregnant women, (2) being concerned about the COVID-19 outbreak, and (3) receiving vaccine recommendation from a general practitioner. In a multivariable logistic regression, three main factors associated with declining or feeling unsure about vaccination were (1) concerns about the safety of the COVID-19 vaccine, (2) lack of trust and being unsatisfied with the information received about COVID-19 vaccination during pregnancy, and (3) doubting the importance of COVID-19 vaccine. CONCLUSION: Clinicians play a critical role in counseling women to alleviate vaccine fear, support vaccine acceptance, and direct women to use reliable information sources, such as government and professional healthcare organizations, for information about vaccines.


Asunto(s)
COVID-19 , Vacunas contra la Influenza , Femenino , Embarazo , Humanos , Mujeres Embarazadas/psicología , Vacunas contra la COVID-19 , Estudios Transversales , Conocimientos, Actitudes y Práctica en Salud , Encuestas y Cuestionarios , COVID-19/prevención & control , Vacunación/psicología , Australia
16.
Issues Ment Health Nurs ; 44(8): 746-757, 2023 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-37437242

RESUMEN

AIMS: This research explores how health care providers determine the mental health needs of immigrant women in the perinatal phase of childbirth. The contextual factors that affect the mental health of these women and influence their engagement with the British Columbian communities in which they reside are investigated. METHOD: Using a critical ethnographic approach, eight health care providers were interviewed to gain insight into health care provider's health literacy and immigrant perinatal women's mental health. Each participant was interviewed for 45-60 min in the period from January to February 2021 to obtain relevant data. RESULTS: Three themes emerged from the data analysis: the health care provider's role and his/her health literacy, the health literacy of the participant, and the impact of the ongoing COVID-19 pandemic on the participant's situation. CONCLUSIONS: The findings indicate that a healthy working relationship between the health care provider and an immigrant woman in the perinatal phase of childbirth is essential to facilitate an effective interchange of health information.


Asunto(s)
COVID-19 , Emigrantes e Inmigrantes , Alfabetización en Salud , Embarazo , Humanos , Femenino , Masculino , Salud Mental , Colombia Británica , Pandemias , Antropología Cultural , Personal de Salud/psicología
17.
BMC Pregnancy Childbirth ; 23(1): 494, 2023 Jul 04.
Artículo en Inglés | MEDLINE | ID: mdl-37403018

RESUMEN

BACKGROUND: Uncertainty around the risk of COVID-19 to pregnant women and their babies prompted precautionary restrictions on their health and care during the pandemic. Maternity services had to adapt to changing Government guidance. Coupled with the imposition of national lockdowns in England and restrictions on daily activities, women's experiences of pregnancy, childbirth and the postpartum period, and their access to services, changed rapidly. This study was designed to understand women's experiences of pregnancy, labour and childbirth and caring for a baby during this time. METHODS: This was an inductive longitudinal qualitative study, using in-depth interviews by telephone with women in Bradford, UK, at three timepoints during their maternity journey (18 women at timepoint one, 13 at timepoint two and 14 at timepoint three). Key topics explored were physical and mental wellbeing, experience of healthcare services, relationships with partners and general impact of the pandemic. Data were analysed using the Framework approach. A longitudinal synthesis identified over-arching themes. RESULTS: Three longitudinal themes captured what was important to women: (1) women feared being alone at critical points in their maternity journey, (2) the pandemic created new norms for maternity services and women's care, and (3) finding ways to navigate the COVID-19 pandemic in pregnancy and with a baby. CONCLUSIONS: Modifications to maternity services impacted significantly on women's experiences. The findings have informed national and local decisions about how best to direct resources to reduce the impact of COVID-19 restrictions and the longer-term psychological impact on women during pregnancy and postnatally.


Asunto(s)
COVID-19 , Servicios de Salud Materna , Femenino , Embarazo , Humanos , Pandemias , COVID-19/epidemiología , Control de Enfermedades Transmisibles , Parto , Mujeres Embarazadas/psicología , Investigación Cualitativa , Padres
18.
J Perinat Neonatal Nurs ; 37(3): 187-195, 2023.
Artículo en Inglés | MEDLINE | ID: mdl-37494686

RESUMEN

PURPOSE: Risks for burnout among nurses have been understudied in public and community health settings. This qualitative descriptive study aimed to describe the experiences of nurses working in a perinatal community health program for high-risk families with a focus on challenges and risks for burnout. METHODS: We conducted field observation and semistructured individual interviews in 2019 with nurses at 2 sites implementing Prenatal Care Coordination (PNCC), a Medicaid benefit for high-risk pregnant people and infants in Wisconsin. A larger parent study assessed the implementation of PNCC overall through a thematic analysis process. Initial deductive coding was guided by the Consolidated Framework for Implementation Research. FINDINGS: Emergent themes demonstrated that PNCC nurses face several significant barriers and known risks for burnout, including role strain related to scope of practice and training, discordant racial and socioeconomic identities leading to role conflict, and low control combined with high psychological demand. CONCLUSIONS: Given that the COVID-19 pandemic has exacerbated burnout risk among nurses in hospital settings, and that nurses addressing social determinants of health may be at increased risk for burnout, these findings represent a critical perspective on the experiences and needs of perinatal nurses in public and community health settings.


Asunto(s)
Agotamiento Profesional , COVID-19 , Enfermeros de Salud Comunitaria , Enfermeras y Enfermeros , Lactante , Embarazo , Femenino , Humanos , Pandemias , Enfermeros de Salud Comunitaria/psicología , Agotamiento Profesional/epidemiología , Agotamiento Profesional/psicología , Agotamiento Psicológico
19.
Psychiatr Clin North Am ; 46(3): 415-426, 2023 09.
Artículo en Inglés | MEDLINE | ID: mdl-37500241

RESUMEN

Women are at the highest risk of pandemic adversities as they represent the majority of health and frontline workers in addition to their essential roles at home. We review gender differences during the COVID-19 pandemic by demonstrating risk-exposure during specific situations such as pregnancy, women's mental health fallouts, COVID-19 disease itself and exposure to different forms of violence. We discuss the particularities that women face in developing countries with depicted examples from some countries in Africa and the Middle East. Women mental health care service stands out as an essential component of the national response to pandemics. Women's integration and leadership in the national pandemic response planning is crucial.


Asunto(s)
COVID-19 , Embarazo , Femenino , Humanos , Pandemias , Salud Mental , SARS-CoV-2 , Salud de la Mujer
20.
Clín. salud ; 34(2): 71-78, jul. 2023. tab
Artículo en Inglés | IBECS | ID: ibc-223207

RESUMEN

Few studies have shown the psychological impact of the COVID-19 pandemic on new mothers’ health, but the long-term consequences of the crisis are yet unknown. This study aimed at evaluating the changes experienced in perinatal mental health 6 months after the start of the COVID-19 pandemic in Spain. Women (n = 176, average age = 33.80) were recruited during the pandemic. Participants completed the Edinburgh Postnatal Depression Scale, the Satisfaction With Life Scale and Positive, and the Negative Affect Schedule. Results showed a decrease in depressive symptoms, t(174) = 2.58, p = .01, d = 0.02, whereas anxiety symptoms remained high, t(174) = 1.31, p = .19. In terms of psychological well-being, the results showed a decrease in life satisfaction, t(175) = 2.58, p = .011, d = 0.16, and negative affect, t(175) = 3.15, p = .002, d = 0.26, and an increase in positive affect, t(175) = -4.45, p < .001, d = 0.35. This study is expected to shed light on the design of future interventions aimed at the prevention of symptoms and to enhance life satisfaction during the perinatal stage. (AU)


Algunos estudios han mostrado el impacto psicológico de la pandemia de COVID-19 en la salud mental perinatal, pero aún se desconocen las consecuencias a largo plazo de esta crisis sanitaria. El presente estudio tuvo como objetivo evaluar los cambios en la salud mental perinatal tras 6 meses del inicio de la pandemia de la COVID-19 en España. Se reclutaron mujeres en etapa perinatal (n = 176, edad promedio = 33.80) durante la pandemia. Las participantes cumplimentaron la Escala de Depresión Postparto de Edimburgo, una escala de satisfacción con la vida y otra de afecto positivo y negativo. Los resultados mostraron una disminución de los síntomas depresivos a los 6 meses, t(174) = 2.58, p = .01, d = 0.02, mientras que los síntomas de ansiedad se mantuvieron elevados, t(174) = 1.31, p = .19. En cuanto al bienestar psicológico, los resultados mostraron una disminución en la satisfacción con la vida, t(175) = 2.58, p = .01, d = 0.16, y en el afecto negativo, t(175) = 3.15, p = .002, d = 0.26, y un aumento en el afecto positivo, t(175) = -4,45, p < .001, d = 0.35. Se espera que este estudio arroje luz sobre el diseño de futuras intervenciones dirigidas a la prevención de síntomas y a la mejora de la satisfacción con la vida durante la etapa perinatal. (AU)


Asunto(s)
Humanos , Femenino , Adulto Joven , Adulto , Persona de Mediana Edad , Pandemias , Infecciones por Coronavirus/epidemiología , Infecciones por Coronavirus/psicología , Salud Mental , Coronavirus Relacionado al Síndrome Respiratorio Agudo Severo , Estudios Longitudinales , España
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