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1.
PLoS One ; 17(11): e0277208, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-36441747

RESUMEN

BACKGROUND: Iodine is one of the crucial micronutrients needed by the human body, and is vitally important during pregnancy. This study aimed to determine the relationship between the iodine status of pregnant women and their knowledge, and practices regarding iodized salt. All participants were enrolled in the Butajira nutrition, mental health and pregnancy (BUNMAP) cohort, Butajira, Ethiopia in February-May, 2019. METHODS: In this cross-sectional study, 152 pregnant women without hypertension or known thyroid disease before or during pregnancy were randomly selected from the BUNMAP mother to child cohort (n = 832). Spot urine samples were collected to estimate the level of urinary iodine concentration (UIC). Salt samples were also collected from their homes. The Sandall-Kolthoff (S-K) method was used to measure the level of iodine in the urine samples, and iodometric titration was used to measure the level of iodine in the salt. Data was entered and cleaned using Epi-info version 3.5.3 and then exported to SPSS version 20 for further analysis. Multivariate logistic regression analysis was performed to identify associations in the collected data. RESULTS: The WHO recommended level of iodine for populations of pregnant women is 150-249 F06Dg/L. The median UIC among pregnant women in this study was 151.2 µg/L [interquartile range (IQR) = 85.5-236.2 F06Dg/L], at the low end of this range. About half (49.65%) of the participants were likely to be iodine deficient. There was a significant association between having a formal job (AOR = 2.56; CI = 1.11-5.96) and iodine sufficiency. Based on a cutoff of >15 ppm (mg/kg), 91.7% (95% CI: 87.2-96.2) of the salts collected from the household had adequate iodine content. The median iodine level of the collected salt samples was 34.9 mg/kg (ppm) (IQR = 24.2-44.6 mg/kg). CONCLUSIONS: The UNICEF 2018 guidelines for adequate iodine nutrition in pregnant women include both a recommended median range of 150-249 µg/L, and an upper limit of 20% on the fraction of the population with UIC below 50 µg/L. Because our study population's median level is 151.2 µg/L and the percentage of pregnant women with urinary iodine concentration of less than 50 µg/L is 9.7% (14/145), the women received adequate iodine nutrition. The availability of adequately iodized salt in households is more than 90%, as recommended by WHO. In light of previous iodine deficiency in this region of Ethiopia, the salt iodization program promotes the health of babies and mothers.


Asunto(s)
Conocimientos, Actitudes y Práctica en Salud , Yodo , Mujeres Embarazadas , Niño , Femenino , Humanos , Lactante , Embarazo , Estudios Transversales , Etiopía , Transmisión Vertical de Enfermedad Infecciosa , Yoduros , Madres , Cloruro de Sodio
2.
BMJ Open ; 12(11): e057327, 2022 11 21.
Artículo en Inglés | MEDLINE | ID: mdl-36410814

RESUMEN

INTRODUCTION: Complementary and alternative therapies (CATs) refer to a diverse range of approaches that can be used as add-on or an alternative to conventional therapies. While a number of individual studies and systematic reviews (SRs) or meta-analyses (MAs) have investigated the effectiveness of specific types of CATs to treat depressive symptoms at specific moments of the perinatal period, an overarching synthesis of the literature is currently lacking. We will conduct an umbrella review of SRs and MAs to assess to which extent CATs are associated with depressive symptoms reduction during pregnancy or after childbirth. METHODS AND ANALYSIS: We will search a broad set of electronic databases (MEDLINE via Ovid, Embase.com, CINAHL via EBSCOhost, PsycINFO via Ovid, AMED and Google Scholar). We will include SRs with or without MAs meeting the following criteria: (1) the review should focus mostly on individual studies reporting a randomised controlled design; (2) diagnosis should be made during pregnancy or during the post partum using a clinical interview according to DSM or ICD criteria; (3) the reviewed intervention should start during pregnancy or in the first postpartum year and meet the criteria for being considered as CAT. The main outcome will be depressive symptoms reduction during pregnancy or after childbirth. Secondary outcomes will include the remission of depression according to DSM criteria and intervention acceptability. Overlap between reviews will be described, quantified and discussed. We will rate the quality of the included SRs or MAs using the AMSTAR-2 tool. MAs will be performed by using the data from the individual RCT studies included in the SRs or MAs. Sensitivity analyses restricted to studies with a low-moderate risk of bias will be realised. Publication bias will be examined visually by using a funnel plot, and formally using the Egger's test and test of excess significance. ETHICS AND DISSEMINATION: We intend to publish the results of the umbrella review in an international peer-reviewed journal. Oral presentations in congresses and internal diffusion through the Rise up-PPD European COST Action network are also planned. PROSPERO REGISTRATION NUMBER: CRD42021229260.


Asunto(s)
Terapias Complementarias , Periodo Periparto , Embarazo , Femenino , Humanos , Depresión , Revisiones Sistemáticas como Asunto , Periodo Posparto
3.
J Adolesc Health ; 71(6S): S24-S31, 2022 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-36404016

RESUMEN

Due to its long-term longitudinal design, the National Longitudinal Study of Adolescent to Adult Health (Add Health) has provided numerous valuable insights into adolescent and young adult sexual behavior. Framed by a conceptual model of sexual behavior and health, I review research using Add Health data to study sexual behavior and health. In this paper, I review research examining both predictors (e.g., neighborhood, family, genetic, individual) and health outcomes (e.g., sexually transmitted infections, mental health) of sexual behavior in adolescents and young adults. Where possible, I focus on long-term longitudinal studies that make use of the unique strengths of the Add Health data. Existing Add Health research has provided considerable information about both the predictors and health consequences of adolescent and young adult sexual behavior. Factors ranging from neighborhoods to genetics predict whether adolescent and young adults engage in sexual behaviors. Findings on long-term outcomes of adolescent sexual behavior suggest that early sexual behavior predicts higher rates of sexually transmitted infections and pregnancy in young adulthood, but not long-term changes to mental health. Unique contributions of Add Health include the ability to examine multidimensional bio-ecological predictors of sexual behavior and to examine long-term effects of sexual behavior and how sexual behaviors and their correlates change across adolescence into adulthood. Future work can leverage these strengths, and in particular the long-term longitudinal nature of the data, to uncover new insights about the developmental course of sexual behavior and health.


Asunto(s)
Conducta del Adolescente , Enfermedades de Transmisión Sexual , Adulto Joven , Embarazo , Femenino , Adolescente , Humanos , Adulto , Estudios Longitudinales , Conducta Sexual/psicología , Enfermedades de Transmisión Sexual/prevención & control , Enfermedades de Transmisión Sexual/psicología , Conducta del Adolescente/psicología , Salud del Adolescente
4.
BMC Pregnancy Childbirth ; 22(1): 868, 2022 Nov 23.
Artículo en Inglés | MEDLINE | ID: mdl-36419009

RESUMEN

BACKGROUND: Pregnancy and the postnatal period can be times of psychosocial stress and insecurity, but high quality maternity care and social support can help mothers cope with stress and feel more secure. The COVID-19 pandemic and associated social and economic disruption increased rates of antenatal and postnatal stress, anxiety and depression, and also had profound impacts on the organisation of maternity services in England. METHODS: This was a qualitative descriptive study of the impact of pandemic-related changes to maternity care on mothers' emotional wellbeing, using inductive thematic analysis of open text responses to the National Maternity Survey (NMS) 2020 in England. A random sample of 16,050 mothers who gave birth 11-24th May 2020 were invited to take part in the survey, and 4,611 responded, with 4,384 answering at least one open text question. RESULTS: There were three themes: 'Chaos: impact of uncertainty', 'Abandoned: impact of reduction in care', and 'Alone: impact of loss of social support'. Mothers valued maternity care and many experienced additional stress from chaotic changes and reduction in care during the pandemic; from health professionals' own uncertainty and anxiety; and from restrictions on essential social support during pregnancy, labour and birth. Others felt that health professionals had communicated and cared for them well despite the changes and restrictions, and these mothers felt psychologically safe. CONCLUSIONS: Planning for future crises should include considering how necessary adaptations to care can be implemented and communicated to minimise distress; ensuring that mothers are not deprived of social support at the time when they are at their most vulnerable; and supporting the psychological welfare of staff at a time of enormous pressure. There are also lessons for maternity care in 'normal' times: that care is highly valued, but trust is easily lost; that some mothers come into the maternity system with vulnerabilities that can be ameliorated or intensified by the attitudes of staff; that every effort should be made to welcome a mother's partner or chosen companion into maternity care; and that high quality postnatal care can make a real difference to mothers' wellbeing.


Asunto(s)
COVID-19 , Servicios de Salud Materna , Femenino , Humanos , Embarazo , Madres/psicología , Pandemias , COVID-19/epidemiología , Parto , Inglaterra
5.
BMC Womens Health ; 22(1): 444, 2022 11 11.
Artículo en Inglés | MEDLINE | ID: mdl-36368983

RESUMEN

BACKGROUND: Stress urinary incontinence (SUI), which causes involuntarily leakage of urine, has an impact on many women and may affect self-efficacy, which, in turn, can lead to poor health-related quality of life (QOL). This study aimed to explore the effects of sociodemographic and health information, symptom distress, self-efficacy, and positive thinking on the health-related QOL (general QOL and urinary incontinence-specific QOL) of women with SUI. METHODS: A cross-sectional study design was used. Women with SUI were recruited from the obstetrics and gynecology outpatient department and urodynamics examination room of a hospital by convenience sampling from August 2021 to March 2022. Participants were surveyed on the following questionnaires: Urogenital Distress Inventory, Geriatric Self-efficacy Index for Urinary Incontinence, Positive Thinking Scale, 12-Item Short-Form Health Survey (SF-12), and Incontinence Impact Questionnaire Short Form. RESULTS: Participants (N = 135) had a mean age of 53.76 years old. The mean SF-12 physical component summary score was 48.48 (physical QOL), and the mental component summary score was 46.56 (mental QOL). The urinary incontinence-specific QOL score was 16.01. Women with greater positive thinking and higher self-efficacy for urinary incontinence had better physical and mental QOL. Women with less symptom distress of urinary incontinence and higher self-efficacy for urinary incontinence had better urinary incontinence-specific QOL. CONCLUSION: The health-related QOL of women with SUI is affected by many factors, including positive thinking, self-efficacy, and symptom distress. Healthcare professionals can provide multifaceted programs to improve the health-related QOL of women with SUI.


Asunto(s)
Incontinencia Urinaria de Esfuerzo , Incontinencia Urinaria , Embarazo , Femenino , Humanos , Anciano , Persona de Mediana Edad , Calidad de Vida , Autoeficacia , Optimismo , Estudios Transversales , Encuestas y Cuestionarios
6.
PLoS One ; 17(11): e0277501, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-36378675

RESUMEN

PURPOSE: This study aimed to develop and examine the effects of an internet-based intervention program on environmental perception and behavior among Korean pregnant women based on revised protection motivation theory. METHOD: This study was a non-equivalent control group pre-post-test design. The experimental program consisted of prenatal education, reduction of fine dust, birth education, environmental health promotion, and postnatal management education using zoom video conferences. The face-to-face interventions were provided through regular prenatal classes at public health services for the control group. The total participant was 49 pregnant women: 25 in the experimental group and 24 in the control group. The program adaptation was conducted between April 2021 and November 2021 in Korea. The data were analyzed by ANCOVA and t-test to examine the effects using SPSS 26.0 program. RESULTS: After intervention of the program, environmental severity (F = 17.96, p < .001), response efficacy (F = 15.69, p < .001), and total environmental perception (F = 7.80, p = .008) were higher in the experimental group than in the control group. There were no significant differences in feasibility, accessibility, satisfaction, susceptibility, self-efficacy, barrier, personal environmental behavior, and community environmental behavior between the two groups. CONCLUSION: The internet-based educational program can be the alternative for the face-to-face prenatal class to promote environmental health perceptions during pregnancy in the pandemic situations.


Asunto(s)
Intervención basada en la Internet , Humanos , Femenino , Embarazo , Mujeres Embarazadas/psicología , República de Corea , Salud Ambiental , Percepción , Internet
7.
BMC Pregnancy Childbirth ; 22(1): 876, 2022 Nov 25.
Artículo en Inglés | MEDLINE | ID: mdl-36434534

RESUMEN

BACKGROUND: Antenatal care coverage has dramatically increased in many low-and middle-income settings, including in the state of Telangana, India. However, there is increasing evidence of shortfalls in the quality of care women receive during their pregnancies. This study aims to examine dimensions of antenatal care quality in Telangana, India using four primary and secondary data sources. METHODS: Data from two secondary statewide data sources (National Family Health Survey (NFHS-5), 2019-21; Health Management Information System (HMIS), 2019-20) and two primary data sources (a facility survey in 19 primary health centres and sub-centres in selected districts of Telangana; and observations of 36 antenatal care consultations at these facilities) were descriptively analysed. RESULTS: NFHS-5 data showed about 73% of women in Telangana received all six assessed antenatal care components during pregnancy. HMIS data showed high coverage of antenatal care visits but differences in levels of screening, with high coverage of haemoglobin tests for anaemia but low coverage of testing for gestational diabetes and syphilis. The facility survey found missing equipment for several key antenatal care services. Antenatal care observations found blood pressure measurement and physical examinations had high coverage and were generally performed correctly. There were substantial deficiencies in symptom checking and communication between the woman and provider. Women were asked if they had any questions in 22% of consultations. Only one woman was asked about her mental health. Counselling of women on at least one of the ten items relating to birth preparedness and on at least one of six danger signs occurred in 58% and 36% of consultations, respectively. CONCLUSION: Despite high coverage of antenatal care services and some essential maternal and foetal assessments, substantial quality gaps remained, particularly in communication between healthcare providers and pregnant women and in availability of key services. Progress towards achieving high quality in both content and experience of antenatal care requires addressing service gaps and developing better measures to capture and improve women's experiences of care.


Asunto(s)
Mujeres Embarazadas , Atención Prenatal , Femenino , Embarazo , Humanos , Masculino , Calidad de la Atención de Salud , Personal de Salud , Encuestas y Cuestionarios
8.
Aten Primaria ; 54 Suppl 1: 102494, 2022 Oct.
Artículo en Español | MEDLINE | ID: mdl-36435587

RESUMEN

Adolescent pregnancy is generally an unwanted pregnancy, a situation that involves significant biological, psychological and social overloads, with repercussions on the health of the mother and the child. But the psychosocially important fact is that an unwanted pregnancy in its entirety gives rise to the birth of an ambivalently wanted child, a high-risk child. Those born in Spain in 2020 to women under 20 years of age were 8,305, which corresponds to 1.97% of all births. This review presents measures and recommendations for the protection and prevention of the mental health of the mother and child when pregnancy takes place in adolescence.


Asunto(s)
Trastornos Mentales , Embarazo en Adolescencia , Embarazo , Adolescente , Niño , Femenino , Humanos , Embarazo en Adolescencia/prevención & control , Salud Mental , Embarazo no Deseado , Trastornos Mentales/prevención & control , Atención Primaria de Salud
10.
BMC Pregnancy Childbirth ; 22(1): 832, 2022 Nov 11.
Artículo en Inglés | MEDLINE | ID: mdl-36368968

RESUMEN

BACKGROUND: Preeclampsia is associated with increased risk of cardiovascular disease later in life, but studies suggest that women with previous preeclampsia are not aware of this. Little is known about how these women perceive the condition and the associated long-term risks. We examined the experiences and perceptions of preeclampsia and the increased risk of cardiovascular disease (CVD) later in life among Danish women with previous preeclampsia and their attitudes towards CVD risk screening. METHODS: Ten individual semi-structured interviews were conducted with women with previous preeclampsia. Data were analysed using thematic analysis. RESULTS: We identified six themes: 1) Experiences and perceptions of being diagnosed with preeclampsia, 2) Awareness about increased risk of CVD later in life, 3) Knowledge as a precondition for action, 4) The perception of CVD risk as being modifiable, 5) Motivators for and barriers to a healthy lifestyle, and 6) Screening for CVD. Awareness of the severity of preeclampsia was limited prior to being diagnosed. Particularly among those with few or no symptoms, preeclampsia was perceived as a non-severe condition, which was further reinforced by the experience of having received very little information. Nonetheless, some women were shocked by the diagnosis and feared for the health of the offspring. Many women also experienced physical and psychological consequences of preeclampsia. Awareness of the increased risk of later CVD was lacking; yet, when informed, the women considered this to be essential knowledge to be able to act accordingly. The risk of future CVD was perceived to be partly modifiable with a healthy lifestyle, and the women expressed a need for counselling on appropriate lifestyle changes to reduce CVD risk. Other factors were also mentioned as imperative for lifestyle changes, including social support. The women were generally positive towards potential future screening for CVD because it could provide them with information about their health condition. CONCLUSIONS: After preeclampsia, women experienced a lack of knowledge on preeclampsia and the increased risk of CVD later in life. Improved information and follow-up after preeclampsia, including guidance on CVD risk reduction and support from health professionals and family, are warranted.


Asunto(s)
Enfermedades Cardiovasculares , Preeclampsia , Embarazo , Femenino , Humanos , Preeclampsia/epidemiología , Preeclampsia/psicología , Enfermedades Cardiovasculares/epidemiología , Enfermedades Cardiovasculares/etiología , Enfermedades Cardiovasculares/prevención & control , Factores de Riesgo , Factores de Riesgo de Enfermedad Cardiaca , Estilo de Vida
11.
J Paediatr Child Health ; 58(11): 2051-2057, 2022 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-36371627

RESUMEN

AIM: This paper aims to examine the maternal and child mental health and parenting outcomes in the context of COVID-19 pandemic conditions using a sample from Melbourne, Australia - a city exposed to one of the longest lockdowns world-wide in response to the pandemic. METHODS: This study utilises observational data from a prospective, pregnancy cohort, Mercy Pregnancy Emotional Wellbeing Study and includes 468 women and their children followed up in Melbourne to 3-4 years postpartum pre-COVID pandemic and compared to those followed up during the COVID-19 pandemic. RESULTS: When compared to mothers followed up at 3-4 years postpartum pre-pandemic, those followed up during the COVID-19 pandemic showed higher depressive symptoms with a steep incline in their symptom trajectory (EMMdifference  = 1.72, Bonferroni-corrected P < 0.01, d = 0.35) and had a three times higher risk of scoring 13 or above on the EPDS (aRR = 3.22, Bonferroni-corrected P < 0.01). Although this increase was not associated with the variation in the duration of exposure to pandemic conditions, the steep increase in depressive symptoms was more pronounced in those with pre-existing depressive disorders. There was no difference in parenting stress or adjusted childhood mental health symptoms or disorder. CONCLUSIONS: Our findings highlight the vulnerability of those with pre-existing clinical mental health disorders and the need for adequate clinical care for this vulnerable group. Equally, our study indicates the possibility that  parenting and early childhood mental health outcomes, at least in the short term, may be resilient.


Asunto(s)
COVID-19 , Responsabilidad Parental , Embarazo , Niño , Femenino , Preescolar , Humanos , Responsabilidad Parental/psicología , Pandemias , Salud Mental , Depresión/epidemiología , Depresión/diagnóstico , COVID-19/epidemiología , Estudios Prospectivos , Control de Enfermedades Transmisibles , Madres/psicología
12.
Artículo en Inglés | MEDLINE | ID: mdl-36429821

RESUMEN

Over the past decades, increasing research interest has been directed towards the psychosocial factors that impact Aboriginal health, including stress, coping and social support. However, there has been no study that examined whether the behaviours, cognitions and emotions related to stress, coping and social support constitute a psychological network in an Aboriginal population and that examined its properties. To address this gap, the current study employed a new methodology, network psychometrics, to evaluate stress, coping and social support in an Aboriginal Australian population. This study conducted a secondary analysis of the South Australian Aboriginal Birth Cohort (SAABC) study, a randomised controlled trial in South Australia, which included 367 pregnant Aboriginal women at study baseline. The Gaussian Graphical Model was estimated with least absolute shrinkage and selection operator (LASSO). Node centrality was evaluated with eigencentrality, strength and bridge centrality. Network communities were investigated with the walktrap algorithm. The findings indicated that stress, coping and social support constituted a connected psychological network in an Aboriginal population. Furthermore, at the centre of the network were the troubles experienced by the Aboriginal pregnant women, bridging their perceptions of stress and coping and constituting a potential target for future interventions.


Asunto(s)
Servicios de Salud del Indígena , Femenino , Humanos , Embarazo , Estrés Psicológico/psicología , Nativos de Hawái y Otras Islas del Pacífico , Australia , Adaptación Psicológica , Apoyo Social
13.
Artículo en Inglés | MEDLINE | ID: mdl-36360851

RESUMEN

CONTEXT: COVID-19 was declared 'a global pandemic' by the World Health Organization in March 2020. India's lockdown, one of the harshest in the world, came with additional challenges for women. This paper aims to assess the impact of COVID-19 pandemic-related pathways on the first thousand days of life in the Integrated Child Development Scheme and the public distribution ecosystem in India. DATA SOURCES: Using Cochrane guidelines, electronic databases, namely Google Scholar and PubMed-NCBI, were searched for evidence between 1 March 2020 and 1 May 2022. A total of 73 studies were identified in initial search; 20 met the inclusion criteria and, thus, were included in the research analysis. Primary studies were conducted throughout pan-India in rural, urban, and semi-urban areas to study the impact of COVID-19 pandemic-related pathways on the first 1000 days of life. The impact of social security, food insecurity, service delivery, nutrition of pregnant and nursing mothers (P&NMs), and infant and young child feeding (IYCF) varied between geographies and within geographies. Most of the primary studies were conducted at small scale, while only three studies were pan-Indian. The majority of studies were conducted on the mental health of P&NMs and pre-natal and post-natal service delivery disruption. The paucity of the available literature highlights the need to undertake research on the impact of the COVID-19 pandemic-related pathways on 1000 days of life in India and worldwide. The best implementation practices were observed where cross-sectional programs were carried out in relation to health services and social security for P&NMs and children.


Asunto(s)
COVID-19 , Lactante , Niño , Embarazo , Femenino , Humanos , COVID-19/epidemiología , Pandemias , Salud Pública , Estudios Transversales , Seguridad Social , Ecosistema , Control de Enfermedades Transmisibles , India/epidemiología
14.
Artículo en Inglés | MEDLINE | ID: mdl-36429541

RESUMEN

Increasing evidence suggests that during the COVID-19 pandemic, anxiety and depression during the perinatal period increased. The aim of the study is to estimate the prevalence of risk for both maternal depression and anxiety among women attending 18 healthcare centres in Italy during the SARS-COV-2 pandemic and to investigate the psychosocial risks and protective factors associated. It was divided into a retrospective phase (2019, 2020, and the first nine months of 2021) and a prospective phase (which began in November 2021 and it is still ongoing), which screened 12,479 and 2349 women, respectively, for a total of 14,828 women in the perinatal period. To evaluate the risk of anxiety and depression, the General Anxiety Disorder-7 (GAD-7), the Edinburgh Postnatal Depression Scale (EPDS), and an ad hoc form were used to collect sociodemographic variables. In the prospective study, the average age of the women is 31 (range 18-52) years. Results showed that the percentage of women who had EPDS score ≥9 increased from 11.6% in 2019 to 25.5% in the period ranging from November 2021 to April 2022. In logistic regression models, the variables associated with the risk of depression at a level ≤0.01 include having economic problems (OR 2.16) and not being able to rely on support from relatives or friends (OR 2.36). Having the professional status of the housewife is a lower risk (OR 0.52). Those associated with the risk of anxiety include being Italian (OR 2.97), having an education below secondary school level (OR 0.47), having some or many economic problems (OR 2.87), being unable to rely on support from relatives or friends (OR 2.48), and not having attended an antenatal course (OR 1.41). The data from this survey could be useful to determine the impact of the SARS-COV-2 pandemic on women and to establish a screening program with common and uniformly applied criteria which are consistent with national and international women's mental health programs.


Asunto(s)
COVID-19 , Pandemias , Humanos , Femenino , Embarazo , Adolescente , Adulto Joven , Adulto , Persona de Mediana Edad , Estudios Prospectivos , COVID-19/epidemiología , Depresión/epidemiología , Salud Mental , Estudios Retrospectivos , Datos Preliminares , SARS-CoV-2 , Trastornos de Ansiedad/epidemiología , Ansiedad/epidemiología , Ansiedad/diagnóstico
15.
BMC Pregnancy Childbirth ; 22(1): 841, 2022 Nov 15.
Artículo en Inglés | MEDLINE | ID: mdl-36380278

RESUMEN

BACKGROUND: Anxiety is increasingly acknowledged as a common mental health issue during the perinatal period. Its prevalence as well as the associated adverse effects constitute screening imperative. This study evaluates the psychometric properties and underlying factor structures of a Greek version of GAD-7 among pregnant and postpartum women (up to 6 months) in Cyprus. METHODS: This study was conducted from June to December 2020. A total of 457 Cypriot women in the perinatal period (222 pregnant and 235 postpartum) were surveyed. The assessment included anxiety (GAD-7) and depression (EPDS), and psychosocial factors related with anxiety. The internal consistency and factor structure of GAD-7 were evaluated using reliability coefficients, Cronbach's Alpha and McDonald's Omega, and factor analysis, both Exploratory as well as Confirmatory. RESULTS: GAD-7 demonstrated good internal consistency (α = 0.907; Ω = 0.909). Horn's parallel analysis indicated a single factor as the most appropriate. CFA using the standard ML method indicated a good model fit, χ2 = 21.207, p = 0.096; CFI = 0.999; SRMR = 0.027. More studies are needed to determinate the cut-off point and the maximisation of the scale's sensitivity and specificity in pregnant and postpartum Greek Cypriot women. CONCLUSIONS: GAD-7 is a valid and reliable measure and healthcare professionals should utilize GAD-7 as a standard instrument for the screening of anxiety symptoms in pregnant and postpartum Greek Cypriot women.


Asunto(s)
Trastornos de Ansiedad , Cuestionario de Salud del Paciente , Embarazo , Femenino , Humanos , Reproducibilidad de los Resultados , Trastornos de Ansiedad/diagnóstico , Trastornos de Ansiedad/psicología , Periodo Posparto/psicología , Psicometría , Ansiedad/diagnóstico
16.
PLoS One ; 17(11): e0277773, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-36441705

RESUMEN

OBJECTIVES: Nurse home visiting (NHV) is widely implemented to address inequities in child and maternal health. However, few studies have examined longer-term effectiveness or delivery within universal healthcare systems. We evaluated the benefits of an Australian NHV program ("right@home") in promoting children's language and learning, general and mental health, maternal mental health and wellbeing, parenting and family relationships, at child ages 4 and 5 years. SETTING AND PARTICIPANTS: Randomised controlled trial of NHV delivered via universal, child and family health services (the comparator). Pregnant women experiencing adversity (≥2 of 10 risk factors) were recruited from 10 antenatal clinics across 2 states (Victoria, Tasmania) in Australia. INTERVENTION: Mothers in the intervention arm were offered 25 nurse home visits (mean 23·2 home visits [SD 7·4, range 1-43] received) of 60-90 minutes, commencing antenatally and continuing until children's second birthdays. PRIMARY AND SECONDARY OUTCOMES MEASURED: At 4 and 5 years, outcomes were assessed via parent interview and direct assessment of children's language and learning (receptive and expressive language, phonological awareness, attention, and executive function). Outcomes were compared between intervention and usual care arms (intention to treat) using adjusted regression with robust estimation to account for nurse/site. Missing data were addressed using multiple imputation and inverse probability weighting. RESULTS: Of 722 women enrolled in the trial, 225 of 363 (62%) intervention and 201 of 359 (56%) usual care women provided data at 5 years. Estimated group differences showed an overall pattern favouring the intervention. Statistical evidence of benefits was found across child and maternal mental health and wellbeing, parenting and family relationships with effect sizes ranging 0·01-0·27. CONCLUSION: An Australian NHV program promoted longer-term family functioning and wellbeing for women experiencing adversity. NHV can offer an important component of a proportionate universal system that delivers support and intervention relative to need. TRIAL REGISTRATION: 2013-2016, registration ISRCTN89962120.


Asunto(s)
Visita Domiciliaria , Enfermeros de Salud Comunitaria , Embarazo , Niño , Femenino , Humanos , Preescolar , Masculino , Estudios de Seguimiento , Responsabilidad Parental , Victoria
17.
BMC Womens Health ; 22(1): 468, 2022 11 24.
Artículo en Inglés | MEDLINE | ID: mdl-36434557

RESUMEN

BACKGROUND: The burden of HIV is disproportionately higher among women of reproductive age contributing more than half of the global share. The situation in Ethiopia is not exceptional. The present study was done to determine the proportion of HIV among pregnant women in Amhara Regional State, Ethiopia. METHOD: Institutions-based cross-sectional study was conducted from October 2020 to December 2020. Systematic random sampling technique was used to select 538 study participants from pregnant women who had ANC follow-up in Referral Hospitals of the Amhara Regional State. Data on socio-demographic, clinical, obstetric, behavioral as well as psychosocial characteristics were gathered using an interviewer administered structured and standardized instruments. The data was entered into Epi-Data Manager V4.6.0.0 and exported to STATA version 14 for data analyses. Descriptive statics were computed to summarize the participant's characteristics. Bi-variable and multivariable logistic regression analyses were conducted to identify the association between dependent and independent variables. Independent variables with a p-value of less than 0.05 were considered to be statistically significant at 95% confidence level (CI). RESULTS: The proportion of HIV infection among pregnant women was 8.68% (95% CI: 6.5, 11.4). Completing secondary school education (Adjusted Odds Ratio (AOR = 0.15; 95% CI: 0.04-0.53), graduated from college (AOR = 0.03; 95% CI: 0.01-0.22), and family monthly income greater than 8001 ETB (1 USD = 56 ETB) (AOR = 0.19; 95% CI: 0.04-0.87) were protective factors associated with maternal HIV. On the other hand, history of previous abortion (AOR = 7.73; 95% CI: 3.33-17.95) and positive syphilis status (AOR = 10.28; 95% CI: 2.80-37.62) were risk factors associated with maternal HIV status. CONCLUSION: The proportion of HIV infection among pregnant women was found to be high. Advanced level of education, relatively higher monthly income, history of abortion and previous syphilis status were associated factors with HIV status. Strengthening women's formal education; empowering women in all spheres of life (especially improving their economic standing that prevents women from engaging in risky sexual practices); educating women about HIV transmission methods and HIV prevention and control strategies using behavior change intervention strategy prepared for women to reduce their vulnerability; advocating for the use of family planning to reduce unsafe abortions and syphilis; as well as regular screening and testing for syphilis are recommended.


Millions lost their lives for HIV/AIDS while many more live with the virus with significantly compromised degree of quality of life. Women are more affected than men because of various contributing factors. This study was aimed to determine the proportion and associated factors of HIV status among pregnant women attending ANC at referral hospitals of the Amhara Regional State, Ethiopia. The study was conducted from October 2020 to December 2020. A total of 538 pregnant women were included in the study selected from three referral hospitals.  An interviewer-administered questionnaire was used to collect the data. A binary logistic regression analysis was used to identify the association between factors of the study participants and HIV status. The result revealed that the overall proportion of HIV among pregnant women was 8.68%. Women who completed secondary education, graduated from higher education and having a relatively adequate monthly income were found to have less chance of contracting HIV. On the other hand, pregnant women who had history of previous abortion and positive for syphilis had a higher chance to be infected with HIV. Such a high HIV proportion among the participants in the study area implies that there might be lack of awareness about HIV infection transmission methods as well as HIV prevention and control strategies. In this connection, behavior change intervention strategy prepared specifically for women is recommended to reduce their vulnerability. Besides promoting the use of family planning methods to reduce unsafe abortions and syphilis as well as regular screening and testing for syphilis are important to consider.


Asunto(s)
Infecciones por VIH , Sífilis , Femenino , Humanos , Embarazo , Mujeres Embarazadas/psicología , Estudios Transversales , Sífilis/complicaciones , Etiopía/epidemiología , Infecciones por VIH/epidemiología , Infecciones por VIH/complicaciones , Salud Pública , Hospitales , Derivación y Consulta
18.
Clín. salud ; 33(3): 117-125, nov. 2022. tab
Artículo en Inglés | IBECS | ID: ibc-LC-118

RESUMEN

Background: The prevalence of peripartum depression (PPD) has increased substantially since the start of the COVID-19 pandemic. To reduce the probability of contagion, hospitals had to adapt their care protocols, including the care of women in the perinatal period. Method: A cross-sectional study was used in a total sample of 3,356 women, 1,402 in the prenatal period and 1,954 in the postnatal period. They completed the Edinburgh Postnatal Depression Scale to assess depressive symptoms and the Spanish version of the Coronavirus Perinatal Experiences to assess health experience. Results: The results showed that feeling very well supported by a health professional was associated with a lower risk of PPD. On the other hand, believing it very important to have access to a mental health professional and being concerned about changes in infant care due to COVID-19 were associated with a higher risk of PPD. Conclusion: The results showed the relationship between health experience and the risk of depressive symptoms, highlighting the importance of considering the psychological aspects in the development of measures and protocols for perinatal care. (AU)


Antecedentes: La prevalencia de la depresión perinatal ha aumentado sustancialmente desde el inicio de la pandemia debido al coronavirus (COVID-19). Para reducir la probabilidad de contagio, los hospitales tuvieron que adaptar sus protocolos asistenciales, incluyendo la atención a las mujeres en el periodo perinatal. Método: Se utilizó un estudio transversal en una muestra total de 3,356 mujeres, 1,402 en el período prenatal y 1,954 en el período postnatal. Cumplimentaron la Escala de Depresión Postnatal de Edimburgo para evaluar los síntomas depresivos y la versión española de la Encuesta sobre Experiencias Perinatales durante el Coronavirus para evaluar la experiencia de la atención sanitaria. Resultados. Los resultados mostraron que sentirse muy bien apoyada por un profesional de la salud se asoció con un menor riesgo de desarrollar depresión perinatal. Por otro lado, creer que es muy importante tener acceso a un profesional de la salud mental y estar preocupada por los cambios en el cuidado del bebé debido al COVID-19 se asociaron con un mayor riesgo de depresión perinatal. Conclusión: Los resultados mostraron la relación entre la experiencia sanitaria y el riesgo de síntomas depresivos, destacando la importancia de considerar los aspectos psicológicos en el desarrollo de medidas y protocolos de atención perinatal. (AU)


Asunto(s)
Humanos , Femenino , Embarazo , Adulto , Pandemias , Infecciones por Coronavirus/epidemiología , Depresión , Trastorno Depresivo , Estudios Transversales , Atención Perinatal , España
19.
Clín. salud ; 33(3): 127-135, nov. 2022. tab
Artículo en Inglés | IBECS | ID: ibc-LC-119

RESUMEN

Background: Since February 24th, 2022, the beginning of Russia’s aggression against Ukraine, more than 80,000 women were expected to give birth. Therefore, understanding the impact of war on the perinatal health of women is an important requisite to improve perinatal care. This narrative synthesis has two main purposes: on one hand, it aims to summarize the current evidence available based on perinatal health outcomes and care among perinatal women; on the other, it attempts to identify the gaps still present in research in relation to perinatal care. Method: A literature search was completed in diverse databases (e.g., Medline, PsychInfo). Results: Emergent matters related to practice and research in perinatal refugee women have been discussed. Conclusions: In the face of the war in Ukraine, we need to build up further research to provide an evidence-based foundation for preventing and treating the psychological consequences of pregnant women exposed directly to war and those who have been forced into a refugee status during this vulnerable period. Also, it is essential to support not only women transitioning to motherhood, but also supporting midwives and nurses in their work. (AU)


Antecedentes: Desde el 24 de febrero de 2022, el comienzo de la agresión de Rusia contra Ucrania, se esperaba que más de 80,000 mujeres dieran a luz. Por lo tanto, comprender el impacto de la guerra en la salud perinatal de las mujeres es un requisito importante para mejorar la atención perinatal. Esta revisión narrativa tiene dos propósitos principales: por un lado, tiene como objetivo resumir la evidencia actual disponible basada en los resultados de salud perinatal y la atención a las mujeres perinatales y, por otro lado, intenta identificar las brechas aún presentes en la investigación en relación con la atención perinatal. Método: Se completó una búsqueda bibliográfica en diversas bases de datos (p. ej., Medline, PsychInfo). Resultados: Se han discutido temas emergentes relacionados con la práctica y la investigación en mujeres refugiadas perinatales. Conclusiones: Frente a la guerra en Ucrania necesitamos más investigación para construir una base partiendo de la evidencia con el fin de prevenir y tratar las consecuencias psicológicas de las mujeres embarazadas expuestas directamente a la guerra y de aquellas que se han visto obligadas al estatus de refugiadas durante este período vulnerable. Además, es esencial apoyar no solo a las mujeres en transición a la maternidad, sino también a las matronas y enfermeras en su trabajo. (AU)


Asunto(s)
Humanos , Femenino , Embarazo , Guerra/psicología , Salud Mental , Emigración e Inmigración , Ucrania , Atención Perinatal , Embarazo/psicología
20.
Front Public Health ; 10: 986430, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-36330111

RESUMEN

Objective: Cigarettes have become the the biggest killer of contemporary female's health and beauty. What kind of health information is suitable for the general public is an important issue to be discussed globally. The purpose of this study is to generate systematic, rigorous, public-demand-oriented and appropriate core information relevant to tobacco control based on the best available evidence, combined with audience preferences and pre-dissemination content review from multidisciplinary expertise in order to improve the effectiveness of health communication of tobacco control. Methods: Relevant systematic reviews meta-analysis that reported smoking on risks of female disease were identified by searching PubMed, Embase, the Cochrane Library, Web of Science, Clinical Trials.gov, and the International Clinical Trial Registry Platform. The Grading of Recommendations Assessment, Development and Evaluation (GRADE) process was applied to assess the evidence in order to make rigorous core information. The audience prevalence survey was conducted to ensure that core information was targeted and tailored. Finally, the expert assessment was used for a pre-dissemination content review and to evaluate whether the core information was appropriate or not. Results: The final core information consisted of eight parts concerning the effects of smoking and female cardiovascular disease, diabetes, rheumatoid arthritis, respiratory disease, digestive system disease, mental disease, non-pregnant female reproductive system disease, as well as pregnant women and their fetuses. A total of 35 items of core information suitable for dissemination was included and the quality of evidence, the degree of public demand and the outcome of pre-dissemination content review were reported. Conclusion: The core information related to female cardiovascular system diseases, as well as liver cancer and upper gastrointestinal cancer is the preferred content for health communication of tobacco control. The quality of evidence for core information related to pregnant women and their infants, as well as diseases of reproductive system, respiratory system, and diabetes needs to be improved to meet high public demand. The core information related to mental disease is more suitable for dissemination to patients with mental illness than to the general public. Besides, dissemination of core information should be individualized. Evidence-based Core Information for Health Communication of Tobacco Control would be helpful to provide evidence support for health communication related to tobacco control and enhance public health literacy for international communities that have high smoking prevalence and related disease burden.


Asunto(s)
Diabetes Mellitus , Comunicación en Salud , Cese del Hábito de Fumar , Lactante , Femenino , Humanos , Embarazo , Fumar/epidemiología , Tabaco
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