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Daugirdaitė, Viltė, Olga van den Akker, and Satvinder Purewal. "Posttraumatic Stress and Posttraumatic Stress Disorder after Termination of Pregnancy and Reproductive Loss: A Systematic Review." Journal of Pregnancy 2015 (2015): 1–14. http://dx.doi.org/10.1155/2015/646345.
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Objective. The aims of this systematic review were to integrate the research on posttraumatic stress (PTS) and posttraumatic stress disorder (PTSD) after termination of pregnancy (TOP), miscarriage, perinatal death, stillbirth, neonatal death, and failed in vitro fertilisation (IVF).Methods. Electronic databases (AMED, British Nursing Index, CINAHL, MEDLINE, SPORTDiscus, PsycINFO, PubMEd, ScienceDirect) were searched for articles using PRISMA guidelines.Results. Data from 48 studies were included. Quality of the research was generally good. PTS/PTSD has been investigated in TOP and miscarriage more than perinatal loss, stillbirth, and neonatal death. In all reproductive losses and TOPs, the prevalence of PTS was greater than PTSD, both decreased over time, and longer gestational age is associated with higher levels of PTS/PTSD. Women have generally reported more PTS or PTSD than men. Sociodemographic characteristics (e.g., younger age, lower education, and history of previous traumas or mental health problems) and psychsocial factors influence PTS and PTSD after TOP and reproductive loss.Conclusions. This systematic review is the first to investigate PTS/PTSD after reproductive loss. Patients with advanced pregnancies, a history of previous traumas, mental health problems, and adverse psychosocial profiles should be considered as high risk for developing PTS or PTSD following reproductive loss.
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Orovou, Eirini, Maria Dagla, Panagiotis Eskitzis, Georgios S. Savvidis, Nikolaos Rigas, Alexandros Papatrechas, Angeliki Sarella, Christiana Arampatzi, and Evangelia Antoniou. "The Involvement of Past Traumatic Life Events in the Development of Postpartum PTSD after Cesarean Delivery." Healthcare 10, no. 9 (September 13, 2022): 1761. http://dx.doi.org/10.3390/healthcare10091761.
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Background: Although childbirth is considered a natural process, a high percentage of postpartum women consider it traumatic. Any previous traumatic event in a woman’s life can be revived through a traumatic birth experience, especially after a complicated vaginal delivery or cesarean delivery. The purpose of this study was to clarify the relationship between previous traumatic life events and posttraumatic stress disorder (PTSD) in postpartum women after cesarean section and which specific events exerted the greatest influence. Methods: A sample of 469 women who had undergone cesarean sections at a Greek university hospital consented to participate in this prospective study. Data from a medical/demographic questionnaire, life events checklist, perinatal stressor criterion A, and posttraumatic stress checklist were used to evaluate past traumatic life events and diagnose postpartum posttraumatic stress. Results: Out of 469 women, 25.97% had PTSD and 11.5% a PTSD profile, while 2.7% had PTSD and 2.7% a PTSD profile. Also, it appeared that only specific direct exposure to a traumatic event and/or witnessing one were predictors of postpartum PTSD. Conclusions: This survey identified specific traumatic life events, psychiatric history, stressor perinatal criterion A, preterm birth, and emergency cesarean section as risk factors for the development of PTSD or a PTSD profile in women after cesarean delivery.
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Johnson, Jennifer E., Ann B. Price, Alla Sikorskii, Kent D. Key, Brandon Taylor, Susan Lamphere, Christine Huff, Morgan Cinader, and Caron Zlotnick. "Protocol for the Healing After Loss (HeAL) Study: a randomised controlled trial of interpersonal psychotherapy (IPT) for major depression following perinatal loss." BMJ Open 12, no. 4 (April 2022): e057747. http://dx.doi.org/10.1136/bmjopen-2021-057747.
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IntroductionThis protocol describes a study testing the efficacy of interpersonal psychotherapy (IPT) for major depressive disorder following perinatal loss (early and late fetal death and early neonatal death). Perinatal loss is associated with elevated risk of major depressive disorder and post-traumatic stress disorder (PTSD). Perinatal loss conveys specific treatment needs. The trial will be the first fully powered randomised trial of treatment for any psychiatric disorder following perinatal loss.Methods and analysisA sample of 274 women in Flint and Detroit areas in Michigan who experience a major depressive episode following a perinatal loss will be randomised to group IPT for perinatal loss or to group coping with depression. We anticipate that 50% of the sample will have co-occurring PTSD. Assessments occur at baseline, mid-treatment (8 weeks), post-treatment (16 weeks) and follow-up (28 weeks). Clinical outcomes include time to recovery from major depressive episode (primary), depressive symptoms, PTSD symptoms and time to recovery from PTSD. Additional outcomes include social support, social role functioning (including parental functioning for those with living children), well-being, grief (including complicated grief and fault beliefs) and fear of subsequent pregnancies. Social support and grief are hypothesised mediators of IPT effects on time to recovery from major depressive episode.Ethics and disseminationThe trial was approved by Michigan State University’s Biomedical Institutional Review Board. It has a data and safety monitoring board and has been submitted to the community-based organisation partners community ethics review board. Written operating procedures outline methods for protecting confidentiality, monitoring and recording adverse events, and safeguarding participants. We will share study results with research and clinical communities, community organisations through which we recruited, and will offer results to study participants. Deidentified datasets will be available through the National Institute of Mental Health Data Archive and to qualified investigators on request.Trial registration numberNCT04629599.
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Haller, Deborah L., and Donna R. Miles. "Victimization and Perpetration among Perinatal Substance Abusers." Journal of Interpersonal Violence 18, no. 7 (July 2003): 760–80. http://dx.doi.org/10.1177/0886260503253239.
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This study examined associations between demographic, psychiatric, substance abuse, and childhood abuse variables and past 30-day victimization and perpetration among 77 perinatal substance abusers. Victimization rates were 70% emotional, 34% physical, 29% sexual, and 42% personal freedom violations. For perpetration, incidence was 71% emotional, 25% physical, 5% sexual, and 9% personal freedom violations. Through univariate regression, Addiction Severity Index (ASI) psychiatric and drug composite scores, childhood physical abuse, borderline personality disorder (BPD) and post-traumatic stress disorder (PTSD) were found to significantly predict victimization. In contrast, ASI psychiatric and drug composite scores, BPD, PTSD, and aggressive-sadistic and antisocial personality disorders were found to significantly predict perpetration. In multiple regression models, ASI drug and psychiatric composite scores accounted for the majority of the variance for both victimization and perpetration, suggesting that women with high ASI scores should be queried about their involvement in abusive acts at time of admission to drug treatment.
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Callahan, J. L., S. E. Borja, and M. T. Hynan. "Modification of the Perinatal PTSD Questionnaire to enhance clinical utility." Journal of Perinatology 26, no. 9 (July 6, 2006): 533–39. http://dx.doi.org/10.1038/sj.jp.7211562.
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Karkani, Anastasia, Martha Theodoraki, Natasa Paraskeva, Aristidis Kouros Pavlos, Perdikaris Pantelis, Ouriel Rosenblum, and Philippe Mazet. "Identifying mothers experiencing emotional distress in the neonatal intensive care unit. Application of PPTSD questionnaire in a Greek NICU population." Insights on the Depression and Anxiety 6, no. 1 (October 7, 2022): 025–31. http://dx.doi.org/10.29328/journal.ida.1001033.
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The birth of a high-risk infant such as an extremely premature infant can represent an important traumatic experience for mothers. Perinatal Post Traumatic Stress Disorder Questionnaire (PPTSDQ) explores retrospectively maternal post-traumatic stress reaction. This shelf-rating questionnaire explores the potential for experiencing posttraumatic symptoms related to childbirth and the ensuing post-natal period. The PTSD questionnaire was originally developed by DeMier and Hynan and their colleagues at the University of Wisconsin and has been widely used in research and in clinical practice for identifying mothers experiencing significant emotional distress during the post-natal period, so they may be referred for mental health services. The present study aims to introduce this tool in perinatal settings as an early intervention. It has been widely used with other measures of post-traumatic stress and depression, such as the Openness Scale from the NEO-PR, the self-report measure of depression BDI-II, the IES (Impact Event Scale) and the EPDS (Edinburgh Postnatal Depression Scale). Although already a useful clinical instrument the current study used the revised version. This modification refines the response options from dichotomous choices to a Likert scale format by Callahan Borja and Hynan. Numerous qualitative and quantitative studies state that premature delivery is a highly stressful event and document the full range of post-traumatic sequelae, such as intrusive recollections, behavioral avoidance, and hyperarousal, as well as attachment difficulties following childbirth. Furthermore, the severity of neonatal complications and gestational age have been found to be predictive of PTSD symptomatology in parents as measured by the PPQ. For this reason, the current study aims to give increased focus to mothers having a premature birth and often expecting their children to die. The sample comprises 25 mothers of prematurely born infants hospitalized in the NICU and 25 mothers of full-term infants born in the maternity ward of the same Greek hospital who responded to the Perinatal PTSD Questionnaire and equally the PERI a postnatal complication rating inventory and the clinical interview for parents CLIP. Mothers of high-risk infants present post-traumatic stress reactions related to prematurity. The Perinatal PTSD Questionnaire identifies postnatal maternal distress but should not substitute a clinical interview, yet findings indicate that equally identifies pre-existing distress symptoms associated with maternal personality traits that emerged with the traumatic event of the unexpected birth. Due to the consistency of the population of the experimental group, who come mostly from the provinces, the possibility of a follow- up of the cases is quite limited.
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OROVOU, EIRINI, Panagiotis Eskitzis, and Evangelia Antoniou. "Traumatic Birth Experience with Cesarean Section and Breastfeeding Outcomes." International Journal of Innovative Research in Medical Science 7, no. 11 (November 20, 2022): 690–91. http://dx.doi.org/10.23958/ijirms/vol07-i11/1561.
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Introduction A perinatal factor that appears to be highly correlated with postpartum PTSD is breastfeeding. There are several researchers who have studied the traumatic experience of birth and its impact on breastfeeding. More specifically, Türkmen in 2020 [1] reported a high correlation between Post Traumatic Stres Disorder (PTSD), traumatic perception of childbirth and low breastfeeding self-efficacy. According to the authors, the most important reason for low breastfeeding rates in PTSD postpartum women is the increased cortisol secretion, which suppresses oxytocin production resulting in reduced milk production. In another recent study published in 2018 [2], it is equally argued that postpartum PTSD can negatively affect the initiation and maintenance of lactation. It is a fact that a traumatic birth experience can create difficulties in breastfeeding from the beginning, and even undermine it completely. For example, in another study, mothers who had a complicated vaginal delivery or an Emergency Cesarean Section (EMCS) were more likely to suffer from PTSD and breastfeeding difficulties [3]. A possible explanation for this phenomenon was attempted by Beck in 2011 [4], describing how breastfeeding after a traumatic birth experience can trigger flashbacks to the traumatic birth and ultimately act as a deterrent to breastfeeding in the mother trying to avoid mental pain.
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Orovas, Christos, Eirini Orovou, Maria Dagla, Alexandros Daponte, Nikolaos Rigas, Stefanos Ougiaroglou, Georgios Iatrakis, and Evangelia Antoniou. "Neural Networks for Early Diagnosis of Postpartum PTSD in Women after Cesarean Section." Applied Sciences 12, no. 15 (July 26, 2022): 7492. http://dx.doi.org/10.3390/app12157492.
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The correlation between the kind of cesarean section and post-traumatic stress disorder (PTSD) in Greek women after a traumatic birth experience has been recognized in previous studies along with other risk factors, such as perinatal conditions and traumatic life events. Data from early studies have suggested some possible links between some vulnerable factors and the potential development of postpartum PTSD. The classification of each case in three possible states (PTSD, profile PTSD, and free of symptoms) is typically performed using the guidelines and the metrics of the version V of the Diagnostic and Statistical Manual of Mental Disorders (DSM-V) which requires the completion of several questionnaires during the postpartum period. The motivation in the present work is the need for a model that can detect possible PTSD cases using a minimum amount of information and produce an early diagnosis. The early PTSD diagnosis is critical since it allows the medical personnel to take the proper measures as soon as possible. Our sample consists of 469 women who underwent emergent or elective cesarean delivery in a university hospital in Greece. The methodology which is followed is the application of random decision forests (RDF) to detect the most suitable and easily accessible information which is then used by an artificial neural network (ANN) for the classification. As is demonstrated from the results, the derived decision model can reach high levels of accuracy even when only partial and quickly available information is provided.
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Crook, Helen, Athena Duffy, Bosky Nair, and Rose Waters. "Effectiveness of New Maternal Mental Health Service ‘Thrive’ in the Treatment of PTSD Symptoms Arising From Birth Trauma and Perinatal Loss." BJPsych Open 8, S1 (June 2022): S132. http://dx.doi.org/10.1192/bjo.2022.386.
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AimsThe NHS Long-Term Plan includes the perinatal mental health objective: by 2023/24 ‘Maternal Mental Health Services’ will be available across the country to provide psychological therapy for those who experience mental health difficulties directly arising from birth trauma and or/perinatal loss. We achieved early implementer status via application to NHS England and, using transformation funding received, ‘Thrive’ was piloted in East Kent. A gap in service provision was identified: some existing primary care services provide intervention for this cohort, however some people remain in psychological distress but do not meet the criteria for specialist perinatal mental health secondary care services; these secondary care services are not commissioned to support those who have experienced perinatal loss. Thrive is co-delivered by a mental health trust and acute healthcare trust; NICE recommended psychological interventions are provided by Psychological Therapists, Specialist Mental Health Midwives and a Peer Support Worker. The aim of this project was to evaluate the effectiveness of the Thrive pilot in reducing PTSD symptomology whilst also collating feedback from patients, their families and healthcare staff across the maternity system, in order to adapt the service offer for full county rollout.Methods40 people who received care from Thrive from 11th January 2021 to 31st December 2021 were included in this evaluation.Data were collected retrospectively at the end of each period of care via:Clinical outcomes measures (quantitative): •PCL-5: a 20-item self-report measure assessing the 20 DSM-5 symptoms of PTSD.•CORE-34: a universal method of establishing well-being and risk.•HoNOS (Health of the Nation Outcomes Scales): a measure of the health and social functioning of people with severe mental illness.Patient Satisfaction Survey (qualitative).Results•100% of patients improved following Thrive intervention: PCL-5 (significant change = a reduction in score by 10–20 points has been met) / CORE-34 (clinically significant change =score above 10 initially and below 10 after intervention).•Clinical improvement: HoNOS = 100% of patients improved following Thrive intervention.ConclusionEvaluation has evidenced the effectiveness of Thrive in successfully treating those with PTSD symptomology arising from their maternity experience. Post-treatment measures indicate that the level of trauma symptomology and the impact of psychological distress on the functioning of patients who have received intervention from Thrive has reduced to a sub-clinical level in all cases.
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Choi, Kristen, and Julia S. Seng. "Trauma-Informed Care With Childhood Maltreatment Survivors: What Do Maternity Professionals Want to Learn?" International Journal of Childbirth 4, no. 3 (2014): 191–201. http://dx.doi.org/10.1891/2156-5287.4.3.191.
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BACKGROUND: Posttraumatic stress disorder (PTSD) affects 8% of pregnant women, and the biggest risk factor for pregnancy PTSD is childhood maltreatment. The care they receive can lead to positive outcomes or to retraumatization and increased morbidity. The purpose of this study is to gather information from a range of clinicians about their continuing education needs to provide perinatal care to women with a maltreatment history and PTSD.METHOD: Maternity health care professionals were interviewed by telephone. Network sampling and purposive sampling were used to include physicians, nurse practitioners, midwives, nurses, and doulas (n = 20), and results were derived from content analysis.RESULTS: Most providers received little or no training on the issue of caring for women with a history of childhood maltreatment or PTSD during their original education but find working with this type of patient rewarding and wish to learn how to provide better care. Providers identified a range of educational needs and recommend offering a range of formats and time options for learning.CONCLUSIONS: Maternity health care providers desire to work effectively with survivor moms and want to learn best practices for doing so. Thus, educational programming addressing provider needs and preferences should be developed and tested to improve care experiences and pregnancy outcomes for women with a history of trauma or PTSD.
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Martinez-Vázquez, Sergio, Julián Rodríguez-Almagro, Antonio Hernández-Martínez, and Juan Miguel Martínez-Galiano. "Factors Associated with Postpartum Post-Traumatic Stress Disorder (PTSD) Following Obstetric Violence: A Cross-Sectional Study." Journal of Personalized Medicine 11, no. 5 (April 24, 2021): 338. http://dx.doi.org/10.3390/jpm11050338.
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To determine the association between experiencing obstetric violence and the incidence of postpartum post-traumatic stress disorder (PTSD). A cross-sectional study with puerperal women was conducted in Spain following ethical approval. The Perinatal Posttraumatic Stress Disorder Questionnaire (PPQ) was administered online. Sociodemographic, clinical, and obstetric violence variables and the risk of dichotomized PTSD (low/high) were studied by bivariate and multivariate analysis with binary logistic regression. 955 women were invited to participate. 53 women refused to participate, three did not complete all survey questions and, finally, 899 women were included. The risk of PTSD (score ≥ 19) using the PPQ was 12.7% (114). The mean score was 9.10 points (SD = 8.52). Risk factors identified were having a delivery plan that was not respected (aOR: 2.85, 95% CI 1.56–5.21), elective caesarean delivery (aOR: 2.53, 95% CI 1.02–2.26), emergency caesarean section (aOR: 3.58, 95% CI 1.83–6.99), admission of the newborn to the neonatal intermediate care unit (aOR: 4.95, 95% CI 2.36–10.36), admission to the intensive care unit (aOR: 2.25, 95% CI 1.02–4.97), formula feeding on discharge (aOR: 3.57, 95% CI 1.32–9.62), verbal obstetric violence (aOR: 5.07, 95% CI 2.98–8.63), and psycho-affective obstetric violence (aOR: 2.61, 95% CI 1.45–4.67). Various clinical practices were identified with the risk of PTSD, highlighting various types of obstetric violence. Partner support and early breastfeeding were identified as protective factors. Sensitizing professionals is essential to prevent the risk of PTSD.
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Quinnell, Francella A., and Michael T. Hynan. "Convergent and discriminant validity of the perinatal PTSD questionnaire (PPQ): A preliminary study." Journal of Traumatic Stress 12, no. 1 (January 1999): 193–99. http://dx.doi.org/10.1023/a:1024714903950.
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Gondwe, Kaboni Whitney, Qing Yang, Debra Brandon, Ellen Chirwa, and Diane Holditch-Davis. "Validation of the Chichewa Perinatal PTSD Questionnaire and Chichewa Child Health Worry Scale." International Journal of Africa Nursing Sciences 9 (2018): 42–48. http://dx.doi.org/10.1016/j.ijans.2018.07.003.
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Whitney, Donna Krupkin. "Emotional Sequelae of Elective Abortion: The Role of Guilt and Shame." Journal of Pastoral Care & Counseling: Advancing theory and professional practice through scholarly and reflective publications 71, no. 2 (June 2017): 98–105. http://dx.doi.org/10.1177/1542305017708159.
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Although estimates vary, many women experience long-term emotional, spiritual, psychological and interpersonal difficulties following abortion, including complicated grief, depression, post-traumatic stress disorder (PTSD) and relationship disturbances. Developmental, drive, object-relations and narcissism models for perinatal loss also illuminate the dynamics of post-abortion syndromes. Guilt and shame play important roles in generating and concealing post-abortion sequelae. Pastoral care and healthcare providers can increase their awareness of post-abortion sequelae and provide effective care for women experiencing these syndromes.
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Lao, Kristyn M., Katherine M. Chung, and Muhammad Zeshan. "49.9 MATERNAL PTSD AMONG ADOLESCENTS DURING THE PERINATAL PERIOD: A LITERATURE REVIEW AND DISCUSSION." Journal of the American Academy of Child & Adolescent Psychiatry 59, no. 10 (October 2020): S248. http://dx.doi.org/10.1016/j.jaac.2020.08.400.
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Martínez-Vazquez, Sergio, Julián Rodríguez-Almagro, Antonio Hernández-Martínez, Miguel Delgado-Rodríguez, and Juan Miguel Martínez-Galiano. "Long-Term High Risk of Postpartum Post-Traumatic Stress Disorder (PTSD) and Associated Factors." Journal of Clinical Medicine 10, no. 3 (January 30, 2021): 488. http://dx.doi.org/10.3390/jcm10030488.
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Postpartum post-traumatic stress disorder (PTSD) is not a specific process but can last for months and may manifest itself during any subsequent pregnancies or even become chronic. This study aimed to determine the factors associated with long-term PTSD symptoms one year after delivery. A cross-sectional study was conducted on 1301 Spanish puerperal women. Data were collected on sociodemographic, obstetric, and neonatal variables. The Perinatal Post-Traumatic Stress Disorder Questionnaire (PPQ) was administered online through midwives’ associations across Spain. Crude odds ratio (OR) and adjusted odds ratio (aOR) and their 95% confidence intervals were calculated. A PPQ score ≥ 19 (high-risk) was recorded for 13.1% (171) of the participants. Identified risk factors were not respecting a birth plan (aOR = 1.89 (95% CI 1.21–2.94)), formula-feeding of the baby at discharge (aOR = 2.50 (95% CI 1.20–5.17)), postpartum surgical intervention (aOR = 2.23 (95% CI 1.02–4.85)), hospital readmission (aOR = 3.45 (95% CI 1.21–9.84)), as well as verbal obstetric violence (aOR = 3.73 (95% CI 2.52–5.53)) and psycho-affective obstetric violence (aOR = 3.98 (95% CI 2.48–6.39)). During childbirth, some clinical practices, such as formula-feeding of the newborn at discharge or types of obstetric violence towards the mother, were associated with a higher risk of PTSD symptoms one year after delivery.
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Dikmen-Yildiz, Pelin, Susan Ayers, and Louise Phillips. "Depression, anxiety, PTSD and comorbidity in perinatal women in Turkey: A longitudinal population-based study." Midwifery 55 (December 2017): 29–37. http://dx.doi.org/10.1016/j.midw.2017.09.001.
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Liu, Cindy H., Carmina Erdei, and Leena Mittal. "Risk factors for depression, anxiety, and PTSD symptoms in perinatal women during the COVID-19 Pandemic." Psychiatry Research 295 (January 2021): 113552. http://dx.doi.org/10.1016/j.psychres.2020.113552.
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Wetherell, Silvia. "Investigating the impact of eye movement desensitization and reprocessing (EMDR) in reducing birth trauma symptoms." Annals of Psychophysiology 9, no. 2 (December 1, 2022): 67–75. http://dx.doi.org/10.29052/2412-3188.v9.i2.2022.67-75.
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Background: Childbirth-related traumatic experiences are an overlooked area of psychological suffering, often leading to Post-Traumatic Stress Disorder, Perinatal Mood and Anxiety Disorders, and difficulties in bonding between mother and baby. This study aimed to evaluate the effectiveness of Eye Movement Desensitization and Reprocessing as a brief psychological intervention in reducing Birth Trauma symptoms.
Methodology: Using a prospective experimental longitudinal design, 12 women residing in Singapore with Birth Trauma symptoms received three 90-minute eye-movement and desensitization (EMDR) sessions over two weeks on average. Participants were assessed through two trauma self-report questionnaires and underwent a brief Autonomic Nervous System (ANS) assessment.
Results: Post-treatment assessment showed significant differences in mean trauma scores with a 76% reduction on the Modified Perinatal PTSD Questionnaire (z = -3.061, p = .002) and 70% reduction on the Impact of Event Scale Revised (z = -3.061, p = 0.002). Skin conductance response changes from baseline to stressor reduced by 4% but were not statistically significant (z = -.863, p = 0.39).
Conclusion: Brief EMDR has shown promise as an effective treatment for Birth Trauma. Larger controlled randomized studies are required to evaluate the effectiveness of EMDR when compared to a placebo control group.
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Chifa, Maria, Tamar Hadar, Nina Politimou, Gemma Reynolds, and Fabia Franco. "The Soundscape of Neonatal Intensive Care: A Mixed-Methods Study of the Parents’ Experience." Children 8, no. 8 (July 27, 2021): 644. http://dx.doi.org/10.3390/children8080644.
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Parents who have infants hospitalised in neonatal intensive care units (NICUs) experience high levels of stress, including post-traumatic stress disorder (PTSD) symptoms. However, whether sounds contribute to parents’ stress remains largely unknown. Critically, researchers lack a comprehensive instrument to investigate the relationship between sounds in NICUs and parental stress. To address this gap, this report presents the “Soundscape of NICU Questionnaire” (SON-Q), which was developed specifically to capture parents’ perceptions and beliefs about the impact that sound had on them and their infants, from pre-birth throughout the NICU stay and in the first postdischarge period. Parents of children born preterm (n = 386) completed the SON-Q and the Perinatal PTSD Questionnaire (PPQ). Principal Component Analysis identifying underlying dimensions comprising the parental experience of the NICU soundscape was followed by an exploration of the relationships between subscales of the SON-Q and the PPQ. Moderation analysis was carried out to further elucidate relationships between variables. Finally, thematic analysis was employed to analyse one memory of sounds in NICU open question. The results highlight systematic associations between aspects of the NICU soundscape and parental stress/trauma. The findings underscore the importance of developing specific studies in this area and devising interventions to best support parents’ mental health, which could in turn support infants’ developmental outcomes.
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Erickson, Nora, Megan Julian, and Maria Muzik. "Perinatal depression, PTSD, and trauma: Impact on mother–infant attachment and interventions to mitigate the transmission of risk." International Review of Psychiatry 31, no. 3 (February 27, 2019): 245–63. http://dx.doi.org/10.1080/09540261.2018.1563529.
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Fredman, Steffany J., Yunying Le, Amy D. Marshall, Walter Garcia Hernandez, Mark E. Feinberg, and Robert T. Ammerman. "Parents’ PTSD symptoms and child abuse potential during the perinatal period: Direct associations and mediation via relationship conflict." Child Abuse & Neglect 90 (April 2019): 66–75. http://dx.doi.org/10.1016/j.chiabu.2019.01.024.
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Szpunar, Mercedes J., Jennifer N. Crawford, Selena A. Baca, and Ariel J. Lang. "Suicidal Ideation in Pregnant and Postpartum Women Veterans: An Initial Clinical Needs Assessment." Military Medicine 185, no. 1-2 (July 9, 2019): e105-e111. http://dx.doi.org/10.1093/milmed/usz171.
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Abstract Introduction Pregnancy and postpartum, or the perinatal period, are times when women are particularly vulnerable to mental health concerns, including suicidal ideation. Risk factors for suicidal ideation during this period of a woman’s life are depression and exposure to trauma, the latter of which may occur during military operations. The number of women veterans in the United States continues to rise, as does their use of maternity benefits. In this pilot study, we examined the feasibility of recruiting pregnant veterans for longitudinal research. We hypothesized that hopelessness and depressive symptoms would be related to suicidal ideation during the perinatal period, and we investigated a possible relationship between post-traumatic stress symptoms (PTSS) and suicidal ideation. Materials and Methods Using the designated Veterans Affairs (VA) maternity care coordinator’s census, we contacted pregnant women veterans for assessment during the 3rd trimester of pregnancy and 6 weeks postpartum at the San Diego VA. Between September 2017 and October 2018, 28 women volunteers completed the following measures: the Columbia-Suicide Severity Rating Scale (C-SSRS); the Beck Hopelessness Scale (BHS); the Edinburgh Postnatal Depression Scale (EPDS); and the PTSD Checklist for DSM-5 (PCL-5). We used correlational analyses and descriptive statistics to determine associations among the measures. Results As gathered from the C-SSRS, over 30% of the veteran women had past lifetime suicide attempts, and over 10% of the veterans had suicidal ideation in the perinatal period. Both depression and PTSS rates neared 30% during pregnancy and postpartum. Hopelessness and depressive symptoms were positively correlated at both time points. While the intensity of lifetime suicidal ideation was correlated with postpartum depressive symptoms, there was no correlation with current suicidal ideation and depressive symptoms. PTSS correlated with both depressive symptoms and hopelessness, but not suicidal ideation, at both time points. There was no correlation between hopelessness and suicidal ideation during the perinatal period in this cohort. Conclusions It is important to understand the mental health needs of perinatal veterans given their vulnerability to develop mental health concerns, including suicidal ideation. The unpredicted pattern of correlations determined in this study implies the need for multifaceted measures for safety-related mental health assessment of perinatal veterans, including assessment for PTSS. Strengths of this study include its longitudinal assessment and a sampling from a general population of veterans. Limitations include small sample size, a single gestational time point, and loss of participants who did not return for their postpartum assessment. We demonstrated the feasibility of longitudinal research with pregnant and postpartum veterans, but additional assessment points during the perinatal period could help identify critical times for mental health intervention in this population.
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Rurangirwa, Akashi Andrew, Ingrid Mogren, Joseph Ntaganira, Kaymarlin Govender, and Gunilla Krantz. "Intimate partner violence during pregnancy in relation to non-psychotic mental health disorders in Rwanda: a cross-sectional population-based study." BMJ Open 8, no. 7 (July 2018): e021807. http://dx.doi.org/10.1136/bmjopen-2018-021807.
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ObjectivesTo investigate the prevalence of non-psychotic mental health disorders (MHDs) and the association between exposure to all forms of intimate partner violence (IPV) during pregnancy and MHDs.DesignCross-sectional population-based study conducted in the Northern Province of Rwanda and Kigali city.Participants and settingsTotally, 921 women who gave birth ≤13 months before being interviewed were included. Simple random sampling was done to select villages, households and participants. Community health workers helped to identify eligible participants and clinical psychologists, nurses or midwives conducted face-to-face interviews. The collected data were analysed using descriptive statistics and bivariable and multivariable logistic regression modellingResultsThe prevalence rates of generalised anxiety disorder, suicide ideation and post-traumatic stress disorder (PTSD) were 19.7%, 10.8% and 8.0%, respectively. Exposure to the four forms of IPV during pregnancy was highly associated with the likelihood of meeting diagnostic criteria for each of the non-psychotic MHDs investigated. Physical, psychological and sexual violence, showed the strongest association with PTSD, with adjusted ORs (aORs) of 4.5, 6.2 and 6.3, respectively. Controlling behaviour had the strongest association with major depressive episode in earlier periods with an aOR of 9.2.ConclusionIPV and MHDs should be integrated into guidelines for perinatal care. Moreover, community-based services aimed at increasing awareness and early identification of violence and MHDs should be instituted in all villages and health centres in Rwanda. Finally, healthcare providers need to be educated and trained in a consistent manner to manage the most challenging cases quickly, discreetly and efficiently.
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Fernandes Santos, C. "Women’s Mental Health and Pregnancy Loss: What Should We Be Aware Of?" European Psychiatry 65, S1 (June 2022): S862. http://dx.doi.org/10.1192/j.eurpsy.2022.2234.
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Introduction Pregnancy loss (PL) – by induced or spontaneous termination of pregnancy – is common, although its consequences on women’s mental health are often neglected in clinical practice. Objectives To understand the existence of psychiatric morbidity in women, associated with PL, as well as related risk factors. Methods Non-systematic review of literature through search on PubMed/MEDLINE for publications up to 2021, following the terms ‘pregnancy loss’, ‘psychiatry disorder’, ‘depression’ and ‘anxiety’. Results After a PL, anxiety is the most frequent symptomatology in 41% of women. Depression occurs in 22-36% of women in the first two weeks after PL, declining over time. Symptoms compatible with Post Traumatic Stress Disorder (PTSD) are found in 25% of women with PL in the first month. Women who meet criteria for PTSD are more likely to present criteria for Depressive Episode. Substance Use Disorder and Prolonged Grief Disorder are also reported, the latter having, as predictors, previous relational difficulties, poor social support and absence of descendants. Risk factors associated with significant psychopathology within PL are, for example, nulliparity, infertility, previous PL, longer gestation time, lower marital satisfaction, previous psychiatric illness, and history of abuse. Conclusions In clinical practice, the risk of psychopathology in women with PL should be considered. This population should be actively questioned about the presence of symptoms, as well as their persistence and impact, requiring timely and appropriate pharmacological and psychotherapeutic intervention. Perinatal Mental Health interventions show important gains in the overall health of women and their offspring. Disclosure No significant relationships.
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Roch, K. Le, M. Lasater, G. Woldeyes, A. Solomon-Osborne, X. Phan, C. Bizouerne, and S. Murray. "Improving maternal mental health through postnatal services use for south sudanese mothers and their babies living in nguynyel refugee camp in gambella, Ethiopia." European Psychiatry 64, S1 (April 2021): S127. http://dx.doi.org/10.1192/j.eurpsy.2021.356.
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IntroductionPoor maternal mental health during the perinatal period leads to serious complications, especially in humanitarian settings where both mothers and children have often been exposed to multiple stressful events. In those contexts, culturally relevant mental health and psychosocial interventions are required to support mother-infant dyads and ultimately to alleviate potential negative outcomes on child’s health and development.ObjectivesThis study aims at assessing the use of postnatal services by mothers and infants under 2 and its impact on maternal mental health.MethodsA process evaluation of Baby Friendly Spaces (BFS) program was conducted in Nguynyel refugee camp (Ethiopia) and a prospective quantitative assessment was administered to lactating women at baseline and endline (2 months later) to measure maternal functional impairment (WHODAS 2.0), general psychological distress (Kessler scale-K6); depression symptoms (Patient Health Questionnaire-PHQ9) and post-traumatic stress symptoms (PTSD Checklist-PCL-6).Results201 lactating women and their babies were enrolled between October 2018 and March 2019. Statistically significant reductions were observed in all mental health outcomes at follow-up. Total mean scores decrease by 19% (p<0.001) for general psychological distress and posttraumatic stress, by 23% (p<0.001) for the depression and by 15% (p<0.001) for the functional impairment. Examination of the compliance to the services revealed that mothers who dropped out early had statistically significantly lower depression scores (p=0.01), and functional impairment scores (p<0.001) than mothers who stayed in the program.ConclusionsThe integration of maternal mental health interventions within perinatal services is challenging but essential for identifying and treating maternal common mental disorders.DisclosureNo significant relationships.
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Perez, Gabriela R., Sara M. Stasik-O’Brien, Lauren M. Laifer, and Rebecca L. Brock. "Psychological and Physical Intimate Partner Aggression Are Associated with Broad and Specific Internalizing Symptoms during Pregnancy." International Journal of Environmental Research and Public Health 19, no. 3 (January 31, 2022): 1662. http://dx.doi.org/10.3390/ijerph19031662.
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Background: Intimate partner violence (IPV) has serious consequences, particularly during high-risk periods such as pregnancy, which poses a significant risk to maternal mental health. However, it is unclear whether IPV presents a broad risk for psychopathology or is specific to distinct diagnoses or symptom dimensions (e.g., panic, social anxiety). Further, the relative impact of physical versus psychological aggression remains unclear. Methods: One hundred and fifty-nine pregnant couples completed surveys assessing psychological and physical intimate partner aggression unfolding in the couple relationship, as well as a range of internalizing symptoms. Results: Psychological and physical aggression were each associated with broad negative affectivity, which underlies mood and anxiety disorders; however, only psychological aggression demonstrated a unique association. Further, for pregnant women, aggression was uniquely associated with several symptom dimensions characteristic of PTSD. In contrast, men demonstrated a relatively heterogeneous symptom presentation in relation to aggression. Conclusion: The present study identifies unique symptom manifestations associated with IPV for couples navigating pregnancy and suggests psychological aggression can be more detrimental to mental health than physical aggression. To promote maternal perinatal mental health, clinicians should screen for covert forms of psychological aggression during pregnancy (e.g., raised voices, insults), trauma-related distress, and symptom elevations in women and their partners.
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Mazurkiewicz, Dariusz Wojciech, Jolanta Strzelecka, and Dorota Izabela Piechocka. "Adverse Mental Health Sequelae of COVID-19 Pandemic in the Pregnant Population and Useful Implications for Clinical Practice." Journal of Clinical Medicine 11, no. 8 (April 7, 2022): 2072. http://dx.doi.org/10.3390/jcm11082072.
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The COVID-19 pandemic has increased risk of disturbances in the functioning of everyday life, directly or indirectly has influenced the risk of mental disorders in the most vulnerable populations, including pregnant women. The aim of this study was to analyze adverse mental health effects in the pregnant population during the COVID-19 pandemic, investigate risk factors for adverse mental health outcomes, identify protective factors, and create practical implications for clinical practice, bearing in mind the need to improve perinatal mental healthcare during such pandemics. Qualitative research was conducted in the electronic databases PubMed and Web of Sciences for the keywords COVID-19, pregnancy, depression, anxiety, and telemedicine for relevant critical articles (n = 3280) published from 2020 until October 2021, outlining the outcomes of control studies, meta-analysis, cross-sectional studies, face-to-face evaluation survey studies, remotely administered survey studies, and observational studies regarding the main topic; all were evaluated. Mental health problems among pregnant women linked to the COVID-19 pandemic, in most cases, show symptoms of depression, anxiety, insomnia, and PTSD and may cause adverse outcomes in pregnancy and fetus and newborn development, even at later stages of life. Therefore, useful implications for clinical practice for improving the adverse mental health outcomes of pregnant women associated with the COVID-19 pandemic are highly desirable. Our research findings support and advocate the need to modify the scope of healthcare provider practice in the event of a disaster, including the COVID-19 pandemic, and may be implemented and adopted by healthcare providers as useful implications for clinical practice.
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Verstraeten, Barbara S. E., Guillaume Elgbeili, Ashley Hyde, Suzanne King, and David M. Olson. "Maternal Mental Health after a Wildfire: Effects of Social Support in the Fort McMurray Wood Buffalo Study." Canadian Journal of Psychiatry, November 11, 2020, 070674372097085. http://dx.doi.org/10.1177/0706743720970859.
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Objective: Following disasters, perinatal women are vulnerable to developing post-traumatic stress disorder (PTSD)-like symptoms. Little is known about protective factors. We hypothesized that peritraumatic stress would predict PTSD-like symptoms in pregnant and postpartum women and would be moderated by social support and resilience. Method: Women ( n = 200) who experienced the 2016 Fort McMurray Wood Buffalo wildfire during or shortly before pregnancy completed the Peritraumatic Distress Inventory (PDI), Peritraumatic Dissociative Experiences Questionnaire, and the Impact of Event Scale-Revised for current PTSD-like symptoms. They also completed scales of social support (Social Support Questionnaire-Short Form) and resilience (Connor-Davidson Resilience Scale). Results: Greater peritraumatic distress ( r = 0.56) and dissociative experiences ( r = 0.56) correlated with more severe PTSD-like symptoms. Greater social support satisfaction was associated with less severe post-traumatic stress symptoms but only when peritraumatic distress was below average; at more severe levels of PDI, this psychosocial variable was not protective. Conclusions: Maternal PTSD-like symptoms after a wildfire depend on peritraumatic distress and dissociation. Higher social support satisfaction buffers the association with peritraumatic distress, although not when peritraumatic reactions are severe. Early psychosocial interventions may protect perinatal women from PTSD-like symptoms after a wildfire.
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Bauer, Annette, Emily Garman, Donela Besada, Sally Field, Martin Knapp, and Simone Honikman. "Costs of common perinatal mental health problems in South Africa." Global Mental Health, August 23, 2022, 1–10. http://dx.doi.org/10.1017/gmh.2022.48.
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Abstract Background Perinatal mental health problems, defined as mental health problems occurring from the start of pregnancy to one year after birth, substantially affect women's and children's quality of life in low- and middle-income countries. In South Africa, despite high prevalence and documented negative impacts, most women do not receive any care. Methods A modelling study examined the costs of perinatal mental health problems, namely depression and anxiety, for a hypothetical cohort of women and their children in South Africa over part of their life course (10 years for women, 40 years for children). In sensitivity analysis, additional impacts of post-traumatic stress disorder (PTSD) and completed suicide were included. Data sources were published findings from cohort studies, as well as epidemiological and economic data from South Africa. Data from international studies were considered where no data from South Africa were available. Results Lifetime costs of perinatal depression and anxiety in South Africa amount to USD 2.8 billion per annual cohort of births. If the impacts of PTSD and suicide are included, costs increase to USD 2.9 billion. This includes costs linked to losses in quality of life (USD 1.8 billion), losses in income (USD 1.1 billion) and public sector costs (USD 3.5 million). Conclusions Whilst important progress has been made in South Africa with regards to mental health policies and interventions that include assessment and management of perinatal mental health problems, substantial underinvestment prevents progress. Findings from this study strengthen the economic case for investing in perinatal mental health care.
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Hernández-Martínez, Antonio, Sergio Martínez-Vázquez, Julian Rodríguez-Almagro, Khalid Saeed Khan, Miguel Delgado-Rodríguez, and Juan Miguel Martínez-Galiano. "Validation of perinatal post-traumatic stress disorder questionnaire for Spanish women during the postpartum period." Scientific Reports 11, no. 1 (March 10, 2021). http://dx.doi.org/10.1038/s41598-021-85144-2.
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AbstractTo determine the psychometric properties of the Perinatal Post-Traumatic Stress Disorder (PTSD) Questionnaire (PPQ) in Spanish. A cross-sectional study of 432 Spanish puerperal women was conducted, following ethical approval. The PPQ was administered online through midwives' associations across Spain. The Edinburgh Postnatal Depression Scale was used to diagnose postnatal depression for examining criterion validity. Data were collected on sociodemographic, obstetric, and neonatal variables. An exploratory factorial analysis (EFA) was performed with convergence and criterion validation. Internal consistency was evaluated using Cronbach's α. The EFA identified three components that explained 63.3% of variance. The PPQ's convergence validation associated the risk of PTSD with variables including birth plan, type of birth, hospital length of stay, hospital readmission, admission of the newborn to care unit, skin-to-skin contact, maternal feeding at discharge, maternal perception of partner support, and respect shown by healthcare professionals during childbirth and puerperium. The area under the ROC curve for the risk of postnatal depression (criterion validity) was 0.86 (95% CI 0.82–0.91). Internal consistency with Cronbach's α value was 0.896. The PPQ used when screening for PTSD in postpartum Spanish women showed adequate psychometric properties.
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He, Zonglin, Joyce Wai-Ting Chiu, Yuchen Lin, Babatunde Akinwunmi, Tak Hap Wong, Casper J. P. Zhang, and Wai-Kit Ming. "The Construct Structures of Psychological and Behavioral Responses to COVID-19 Pandemic in Pregnant Women." Frontiers in Psychiatry 13 (July 12, 2022). http://dx.doi.org/10.3389/fpsyt.2022.796567.
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AimThe present study aimed to investigate the construct structure behind the psychosocial response, behavioral response, prenatal depression, and post-traumatic stress disorder (PTSD) in pregnant women during the COVID-19 pandemic in China.MethodThe validated Chinese version of the Edinburgh Postnatal Depression Scale (EPDS), PTSD CheckList (PCL)-6, and two newly established scales for COVID-19-related psychological and behavioral responses were used. Structural equation modeling (SEM) analysis was applied to evaluate the structural relationships of psychological and behavioral responses during the COVID-19 pandemic.ResultsOf the 1,908 mothers who completed the questionnaires, 1,099 met the criteria for perinatal depression, and 287 were positively screened for PTSD, where 264 women exceed the cut-off points for both. Pregnant women with full-time or part-time jobs tended to have the lowest scores of EPDS (10.07 ± 5.11, P < 0.001) and stress levels (23.85 ± 7.96, P = 0.004), yet they were more likely to change their behavior in accordance with the COVID-19 outbreak (13.35 ± 3.42, P = 0.025). The structural model fit the data (χ2 = 43.260, p < 0.001) and resulted in satisfactory fit indices (CFI = 0.984, TLI = 0.959, RMSEA = 0.072, and χ2/df = 10.815), all path loadings were significant (p < 0.05). The SEM indicates that the level of QoL was attributable to the occurrence of PND, leading to PTSD, and COVID-19 related behavioral and psychological responses.ConclusionThe inter-relationships between the COVID-19-related psychosocial and behavioral responses have been assessed, indicating that the pandemic increased the burden of perinatal depression. Psychoeducation, as well as other psychological interventions, may be needed to alleviate the COVID-19-based anxiety and increase their engagement in protective behaviors.
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Pinto, Tiago Miguel, Inês Jongenelen, Diogo Lamela, Rita Pasion, Ana Morais, and Raquel Costa. "Childbirth-related post-traumatic stress disorder symptoms and mother–infant neurophysiological and behavioral co-regulation during dyadic interaction: study protocol." BMC Psychology 11, no. 1 (February 9, 2023). http://dx.doi.org/10.1186/s40359-023-01070-0.
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Abstract Background Mother’s childbirth-related posttraumatic stress disorder (PTSD) symptoms have a negative impact on mother and infant’s behaviors during dyadic interactions which may increase mother–infant neurophysiological and behavioral co-regulation difficulties, leading to dysregulated mother–infant interactions. This study was specifically designed to analyze: (1) the sociodemographic and obstetric factors associated with mother’s childbirth-related PTSD symptoms; (2) mother–infant neurophysiological functioning and behavioral co-regulation during dyadic interaction; (3) the impact of mother’s childbirth-related PTSD symptoms on neurophysiological and behavioral mother–infant co-regulation during dyadic interaction; (4) the moderator role of previous trauma on the impact of mother’s childbirth-related PTSD symptoms on neurophysiological and behavioral mother–infant co-regulation during dyadic interaction; and (5) the moderator role of comorbid symptoms of anxiety and depression on the impact of mother’s childbirth-related PTSD symptoms on neurophysiological and behavioral mother–infant co-regulation during dyadic interaction. Methods At least 250 mothers will be contacted in order to account for refusals and dropouts and guarantee at least 100 participating mother–infant dyads with all the assessment waves completed. The study has a longitudinal design with three assessment waves: (1) 1–3 days postpartum, (2) 8 weeks postpartum, and (3) 22 weeks postpartum. Between 1 and 3 days postpartum, mothers will report on-site on their sociodemographic and obstetric characteristics. At 8 weeks postpartum, mothers will complete online self-reported measures of birth trauma, previous trauma, childbirth-related PTSD, anxiety, and depressive symptoms. At 22 weeks postpartum, mothers will complete online self-reported measures of childbirth-related PTSD, anxiety, and depressive symptoms. Mothers and infants will then be home-visited to observe and record their neurophysiological, neuroimaging and behavioral data during dyadic interactions using the Still-face Paradigm. Activation patterns in the prefrontal cortices of mother and infant will be recorded simultaneously using hyperscanning acquisition devices. Unadjusted and adjusted multilevel linear regression models will be performed to analyze objectives 1 to 3. Moderation models will be performed to analyze objectives 4 and 5. Discussion Data from this study will inform psychological interventions targeting mother–infant interaction, co-regulation, and infant development. Moreover, these results can contribute to designing effective screenings to identify mothers at risk of perinatal mental health problems and those who may need specialized perinatal mental health care.
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Liu, Ying, Lan Zhang, Nafei Guo, and Hui Jiang. "Postpartum depression and postpartum post-traumatic stress disorder: prevalence and associated factors." BMC Psychiatry 21, no. 1 (October 5, 2021). http://dx.doi.org/10.1186/s12888-021-03432-7.
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Abstract Background Despite the increased global interest from researchers in postpartum depression (PPD) and postpartum post-traumatic stress disorder (PP-PTSD), studies of PPD in China have shown a wide range of variability. Indeed, the prevalence and risk factors for PP-PTSD have received little attention in China. Aim To determine the prevalence of PPD and PP-PTSD in China, and to examine the relationships between a range of sociodemographic, pregnancy-related, and newborn-related variables, and PPD and PP-PTSD. Methods A cross-sectional study involving 1136 women who returned to the obstetrics clinic for routine postpartum examination were enrolled. The sociodemographic, pregnancy-related, and newborn-related characteristics were collected. Social support, and PPD and PP-PTSD symptoms were measured by the Perceived Social Support Scale (PSSS), the Edinburgh Postnatal Depression Scale (EPDS), and the Perinatal Post-traumatic Stress Questionnaire (PPQ). Results The prevalence rates of PPD and PP-PTSD symptoms were 23.5 and 6.1%, respectively. A multivariate model showed that the presence of PP-PTSD was the strongest risk factor for PPD symptoms and vice versa. Other risk factors for PPD included low sleep quality, low social support and newborn’s incubator admission. In terms of PP-PTSD symptoms, risk factors included the presence of PPD symptoms, non-Han ethnicity, and low social support, while having one child was a protective factor. Conclusions This study addressed some gaps in the literature and provided a better understanding of PPD and PP-PTSD in China, which may contribute to early detection and intervention. Attention should be paid to women who are most susceptible to PPD and/or PP-PTSD, including those with low social support, low sleep quality, newborn’s incubator admission, non-Han ethnicity, and women with siblings.
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Liu, Ying, Lan Zhang, Nafei Guo, and Hui Jiang. "Postpartum depression and postpartum post-traumatic stress disorder: prevalence and associated factors." BMC Psychiatry 21, no. 1 (October 5, 2021). http://dx.doi.org/10.1186/s12888-021-03432-7.
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Abstract Background Despite the increased global interest from researchers in postpartum depression (PPD) and postpartum post-traumatic stress disorder (PP-PTSD), studies of PPD in China have shown a wide range of variability. Indeed, the prevalence and risk factors for PP-PTSD have received little attention in China. Aim To determine the prevalence of PPD and PP-PTSD in China, and to examine the relationships between a range of sociodemographic, pregnancy-related, and newborn-related variables, and PPD and PP-PTSD. Methods A cross-sectional study involving 1136 women who returned to the obstetrics clinic for routine postpartum examination were enrolled. The sociodemographic, pregnancy-related, and newborn-related characteristics were collected. Social support, and PPD and PP-PTSD symptoms were measured by the Perceived Social Support Scale (PSSS), the Edinburgh Postnatal Depression Scale (EPDS), and the Perinatal Post-traumatic Stress Questionnaire (PPQ). Results The prevalence rates of PPD and PP-PTSD symptoms were 23.5 and 6.1%, respectively. A multivariate model showed that the presence of PP-PTSD was the strongest risk factor for PPD symptoms and vice versa. Other risk factors for PPD included low sleep quality, low social support and newborn’s incubator admission. In terms of PP-PTSD symptoms, risk factors included the presence of PPD symptoms, non-Han ethnicity, and low social support, while having one child was a protective factor. Conclusions This study addressed some gaps in the literature and provided a better understanding of PPD and PP-PTSD in China, which may contribute to early detection and intervention. Attention should be paid to women who are most susceptible to PPD and/or PP-PTSD, including those with low social support, low sleep quality, newborn’s incubator admission, non-Han ethnicity, and women with siblings.
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Gökçe İsbir, Gözde, Figen İnci, Burcu Kömürcü Akik, Wilson Abreu, and Gill Thomson. "Birth-related PTSD symptoms and related factors following preterm childbirth in Turkey." Current Psychology, October 29, 2022. http://dx.doi.org/10.1007/s12144-022-03805-5.
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AbstractObjective: To examine factors associated with birth-related post-traumatic stress disorder (PTSD) among women who had preterm birth in their last pregnancy in Turkey.Methods: 304 women were asked to report sociodemographic factors, perinatal factors, birth-related factors, preterm birth/premature infant characteristics, and social support factors and PTSD symptoms. Data were collected using online surveys between November 2020 and February 2021. Hierarchical multiple linear regression was used. Results: The prevalence of birth-related PTSD symptoms following preterm birth was 71.1%. Older age, the woman being positively affected by her own mother’s birth experience, not having traumatic experience in pregnancy and in the postnatal period, lower stress level after traumatic events experienced during birth, not feeling that their life/physical integrity was at risk during birth, having amniotomy, feeling psychologically well after childbirth, not being negatively affected by witnessing other parents’ happy moments with their babies in friend/family groups, the absence of infant illness and mother’s reporting higher positive interactions with healthcare team were associated with decreased likelihood of birth-related PTSD. Except for age and traumatic event in the postnatal period, all the variables explained 43% of the variance with a small effect size (f2 = 0.04). Stress level after the traumatic events experienced during labor was the strongest predictor of birth-related PTSD symptoms (β = 0.33). Conclusion: Wellbeing of mother and baby, facilitating interventions at labor, and positive communication with the healthcare team was associated with lower birth-related PTSD symptoms. The study findings highlighted on birth-related PTSD symptoms in mothers of preterm infants in Turkey.
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Stevens, Natalie R., Michelle L. Miller, Christina Soibatian, Caitlin Otwell, Anne K. Rufa, Danie J. Meyer, and Madeleine U. Shalowitz. "Exposure therapy for PTSD during pregnancy: a feasibility, acceptability, and case series study of Narrative Exposure Therapy (NET)." BMC Psychology 8, no. 1 (December 2020). http://dx.doi.org/10.1186/s40359-020-00503-4.
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Abstract Background Prenatal posttraumatic stress disorder (PTSD) is a significant complication of pregnancy linked to increased risk of adverse perinatal outcomes. Although 1 in 5 pregnant trauma-exposed individuals have PTSD, most PTSD treatment trials exclude participants who are pregnant, and none focus on treatment specifically during pregnancy. Moreover, access to mental health treatment is particularly challenging in low-resource settings with high rates of trauma. This study examined implementation of Narrative Exposure Therapy (NET), a short-term evidence-based PTSD treatment, in an urban prenatal care setting. Partial telehealth delivery was used to increase accessibility. Study aims were to examine (a) feasibility, (b) acceptability, and (c) case-based treatment outcomes associated with NET participation. Method Eight pregnant participants (median age = 27, median gestational week in pregnancy = 22.5) received up to six sessions of NET with partial telehealth delivery. PTSD and depression symptoms were assessed at pre-treatment intake (T1), at each session (T2), and 1-week post-treatment (T3). A multiple case study approach was used to examine recruitment and engagement, retention, treatment completion, treatment barriers, use of telehealth, participants’ experiences of treatment, and PTSD and depression symptoms. Results Nine of the 16 participants (56%) who were invited to participate engaged in treatment, and one dropped out after the first session. Eight participants completed the minimum “dose” of 4 NET sessions (N = 8/9, 89%). Seven participants gave the highest ratings of treatment acceptability. The most frequently reported barriers to treatment were competing priorities of work and caring for other children. Pre-post treatment symptom measures revealed clinically meaningful change in PTSD severity for nearly all participants (7/8, 88%). Conclusions Results suggest that a brief exposure therapy PTSD treatment can be successfully implemented during pregnancy, suggesting promising results for conducting a larger-scale investigation. Trial registration ClinicalTrials.gov, NCT04525469. Registered 20 August 2020–Retrospectively registered, https://register.clinicaltrials.gov/prs/app/template/EditRecord.vm?epmode=View&listmode=Edit&uid=U00058T2&ts=3&sid=S000A59A&cx=-w1vnvn
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Barthel, Dana, Ariane Göbel, Claus Barkmann, Nadine Helle, and Carola Bindt. "Does Birth-Related Trauma Last? Prevalence and Risk Factors for Posttraumatic Stress in Mothers and Fathers of VLBW Preterm and Term Born Children 5 Years After Birth." Frontiers in Psychiatry 11 (December 15, 2020). http://dx.doi.org/10.3389/fpsyt.2020.575429.
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Previous research suggests that the birth of a preterm child with very low birth weight (VLBW; <1,500 g) can be traumatic for both parents and lead to short-term consequences like clinical levels of posttraumatic stress symptoms (PTSS) or even to the development of a Posttraumatic Stress Disorder (PTSD). However, little is known about possible mid- and long-term psychological consequences in affected parents. The purpose of this study were (a) to examine the prevalence of parental birth-related PTSS and PTSD in a group of parents with VLBW preterm infants compared to parents of full-term infants 5 years after birth and (b) to investigate potential associations with risk factors for parental PTSS at 5 years postpartum. Perinatal factors (VLBW preterm or term, perceived stress during birth), psychological factors (perceived social support and PTSS 4–6 weeks postpartum, psychiatric lifetime diagnosis) and sociodemographic characteristics (number of children, singleton or multiple birth, socio-economic status), were included in the analysis. The sample consisted of 144 families (77 VLBW, 67 term birth) who participated in the prospective longitudinal cohort study “Hamburg study of VLBW and full-term infant development” (HaFEn-study) and were initially recruited at three perinatal care centers in Hamburg, Germany. PTSD prevalence and PTSS of mothers and fathers were assessed with the Impact of Event Scale-Revised (IES-R), social support with the Questionnaire of Social Support (SOZU-K-22), and lifetime psychiatric diagnoses with the Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (SCID-I). Data were analyzed by hierarchic multiple regression analyses. Results showed that 5 years after birth none of the parents fulfilled the criteria for a birth-related PTSD diagnosis. For mothers, postnatal PTSS and a VLBW preterm birth significantly predicted PTSS 5 years postpartum. For fathers, psychiatric lifetime diagnosis and postnatal PTSS significantly predicted PTSS 5 years after birth. Early identification of parents with higher risk of PTSS, especially after VLBW preterm birth, and their clinical needs seems beneficial to reduce the risk of long-term consequences. More research is needed on the paternal perspective and on potential effects of preterm birth on both parents and their children's mental health outcomes.
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Barthel, Dana, Ariane Göbel, Claus Barkmann, Nadine Helle, and Carola Bindt. "Does Birth-Related Trauma Last? Prevalence and Risk Factors for Posttraumatic Stress in Mothers and Fathers of VLBW Preterm and Term Born Children 5 Years After Birth." Frontiers in Psychiatry 11 (December 15, 2020). http://dx.doi.org/10.3389/fpsyt.2020.575429.
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Previous research suggests that the birth of a preterm child with very low birth weight (VLBW; <1,500 g) can be traumatic for both parents and lead to short-term consequences like clinical levels of posttraumatic stress symptoms (PTSS) or even to the development of a Posttraumatic Stress Disorder (PTSD). However, little is known about possible mid- and long-term psychological consequences in affected parents. The purpose of this study were (a) to examine the prevalence of parental birth-related PTSS and PTSD in a group of parents with VLBW preterm infants compared to parents of full-term infants 5 years after birth and (b) to investigate potential associations with risk factors for parental PTSS at 5 years postpartum. Perinatal factors (VLBW preterm or term, perceived stress during birth), psychological factors (perceived social support and PTSS 4–6 weeks postpartum, psychiatric lifetime diagnosis) and sociodemographic characteristics (number of children, singleton or multiple birth, socio-economic status), were included in the analysis. The sample consisted of 144 families (77 VLBW, 67 term birth) who participated in the prospective longitudinal cohort study “Hamburg study of VLBW and full-term infant development” (HaFEn-study) and were initially recruited at three perinatal care centers in Hamburg, Germany. PTSD prevalence and PTSS of mothers and fathers were assessed with the Impact of Event Scale-Revised (IES-R), social support with the Questionnaire of Social Support (SOZU-K-22), and lifetime psychiatric diagnoses with the Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (SCID-I). Data were analyzed by hierarchic multiple regression analyses. Results showed that 5 years after birth none of the parents fulfilled the criteria for a birth-related PTSD diagnosis. For mothers, postnatal PTSS and a VLBW preterm birth significantly predicted PTSS 5 years postpartum. For fathers, psychiatric lifetime diagnosis and postnatal PTSS significantly predicted PTSS 5 years after birth. Early identification of parents with higher risk of PTSS, especially after VLBW preterm birth, and their clinical needs seems beneficial to reduce the risk of long-term consequences. More research is needed on the paternal perspective and on potential effects of preterm birth on both parents and their children's mental health outcomes.
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Motrico, Emma, Rena Bina, Sara Domínguez-Salas, Vera Mateus, Yolanda Contreras-García, Mercedes Carrasco-Portiño, Erilda Ajaz, et al. "Impact of the Covid-19 pandemic on perinatal mental health (Riseup-PPD-COVID-19): protocol for an international prospective cohort study." BMC Public Health 21, no. 1 (February 17, 2021). http://dx.doi.org/10.1186/s12889-021-10330-w.
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Abstract Background Corona Virus Disease 19 (COVID-19) is a new pandemic, declared a public health emergency by the World Health Organization, which could have negative consequences for pregnant and postpartum women. The scarce evidence published to date suggests that perinatal mental health has deteriorated since the COVID-19 outbreak. However, the few studies published so far have some limitations, such as a cross-sectional design and the omission of important factors for the understanding of perinatal mental health, including governmental restriction measures and healthcare practices implemented at the maternity hospitals. Within the Riseup-PPD COST Action, a study is underway to assess the impact of COVID-19 in perinatal mental health. The primary objectives are to (1) evaluate changes in perinatal mental health outcomes; and (2) determine the risk and protective factors for perinatal mental health during the COVID-19 pandemic. Additionally, we will compare the results between the countries participating in the study. Methods This is an international prospective cohort study, with a baseline and three follow-up assessments over a six-month period. It is being carried out in 11 European countries (Albania, Bulgaria, Cyprus, France, Greece, Israel, Malta, Portugal, Spain, Turkey, and the United Kingdom), Argentina, Brazil and Chile. The sample consists of adult pregnant and postpartum women (with infants up to 6 months of age). The assessment includes measures on COVID-19 epidemiology and public health measures (Oxford COVID-19 Government Response Tracker dataset), Coronavirus Perinatal Experiences (COPE questionnaires), psychological distress (BSI-18), depression (EPDS), anxiety (GAD-7) and post-traumatic stress symptoms (PTSD checklist for DSM-V). Discussion This study will provide important information for understanding the impact of the COVID-19 pandemic on perinatal mental health and well-being, including the identification of potential risk and protective factors by implementing predictive models using machine learning techniques. The findings will help policymakers develop suitable guidelines and prevention strategies for perinatal mental health and contribute to designing tailored mental health interventions. Trial registration ClinicalTrials.gov Identifier: NCT04595123.
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Lamon, Lieselotte, Marc De Hert, Johan Detraux, and Titia Hompes. "Depression and post-traumatic stress disorder (PTSD) after perinatal loss in fathers: a systematic review." European Psychiatry, October 28, 2022, 1–25. http://dx.doi.org/10.1192/j.eurpsy.2022.2326.
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Thomson, Gill, Magali Quillet Diop, Suzannah Stuijfzand, Antje Horsch, Joan G. Lalor, Wilson de Abreu, Valérie Avignon, et al. "Policy, service, and training provision for women following a traumatic birth: an international knowledge mapping exercise." BMC Health Services Research 21, no. 1 (November 6, 2021). http://dx.doi.org/10.1186/s12913-021-07238-x.
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Abstract Background High numbers of women experience a traumatic birth, which can lead to childbirth-related post-traumatic stress disorder (CB-PTSD) onset, and negative and pervasive impacts for women, infants, and families. Policies, suitable service provision, and training are needed to identify and treat psychological morbidity following a traumatic birth experience, but currently there is little insight into whether and what is provided in different contexts. The aim of this knowledge mapping exercise was to map policy, service and training provision for women following a traumatic birth experience in different European countries. Methods A survey was distributed as part of the COST Action “Perinatal mental health and birth-related trauma: Maximizing best practice and optimal outcomes”. Questions were designed to capture country level data; care provision (i.e., national policies or guidelines for the screening, treatment and/or prevention of a traumatic birth, service provision), and nationally mandated pre-registration and post-registration training for maternity professionals. Results Eighteen countries participated. Only one country (the Netherlands) had national policies regarding the screening, treatment, and prevention of a traumatic birth experience/CB-PTSD. Service provision was provided formally in six countries (33%), and informally in the majority (78%). In almost all countries (89%), women could be referred to specialist perinatal or mental health services. Services tended to be provided by midwives, although some multidisciplinary practice was apparent. Seven (39%) of the countries offered ‘a few hours’ professional/pre-registration training, but none offered nationally mandated post-registration training. Conclusions A traumatic birth experience is a key public health concern. Evidence highlights important gaps regarding formalized care provision and training for care providers.
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Anderson, Elizabeth H., Carolyn Morrow, Kristin M. Mattocks, and Geetha Shivakumar. "Perinatal Symptoms and Treatment Engagement in Female Veterans." Military Medicine, July 9, 2021. http://dx.doi.org/10.1093/milmed/usab278.
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ABSTRACT Introduction Women veterans using Veterans Health Care Administration maternity benefits have a high prevalence of mental health disorders, including depression, PTSD, and anxiety. Additionally, women with psychiatric histories often experience a relapse or worsening of symptoms during pregnancy and postpartum. Adequate perinatal mental healthcare engagement is critical to optimizing outcomes for mother and child. Materials and Methods This study evaluated psychiatric symptom severity and predictors of women veteran’s mental health treatment engagement during pregnancy and postpartum at the VA North Texas Health Care System. Seventy women using Veterans Health Administration were assessed longitudinally via chart review and interviews (including the Edinburgh Postnatal Depression Scale) during pregnancy and postpartum. A Friedman test was used to evaluate the change in symptom severity during (1) the 6 months before pregnancy, (2) pregnancy, and (3) postpartum. Multivariate logistic regressions were used to determine predictors of attending outpatient mental health appointments. Potential predictors examined included sociodemographic factors, symptoms of depression, history of military sexual assault, presence of a pre-pregnancy psychiatric diagnosis, and attendance of mental health appointments before pregnancy. Results Approximately 40% of participants demonstrated at least mild psychiatric symptoms before pregnancy, and symptom severity did not significantly change across the perinatal period (pre-pregnancy, pregnancy, and postpartum) X2 (2, n = 70) = 3.56, P = .17. Depressive symptoms during the 2nd or 3rd trimester were a significant predictor for attendance of mental health appointments during both pregnancy (OR = 1.18, 95% CI, 1.04 to 1.34) and postpartum (OR = 1.18, 95% CI, 1.02 to 1.36). An active psychiatric diagnosis during the 6 months before pregnancy was also a significant predictor of attendance following delivery (OR = 14.63, 95% CI, 1.55 to 138.51). Conclusion Our results demonstrate that women with prior histories of mental health conditions will continue to be symptomatic, and this is a good predictor of mental health treatment engagement during the perinatal period.
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de Graaff, Anne M., Pim Cuijpers, Mariska Leeflang, Irene Sferra, Jana R. Uppendahl, Ralph de Vries, and Marit Sijbrandij. "A systematic review and meta-analysis of diagnostic test accuracy studies of self-report screening instruments for common mental disorders in Arabic-speaking adults." Global Mental Health 8 (2021). http://dx.doi.org/10.1017/gmh.2021.39.
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Abstract Background Self-report screening instruments are frequently used as scalable methods to detect common mental disorders (CMDs), but their validity across cultural and linguistic groups is unclear. We summarized the diagnostic accuracy of brief questionnaires on symptoms of depression, anxiety and posttraumatic stress disorder (PTSD) among Arabic-speaking adults. Methods Five databases were searched from inception to 22 January 2021 (PROSPERO: CRD42018070645). Studies were included when diagnostic accuracy of brief (maximally 25 items) psychological questionnaires was assessed in Arabic-speaking populations and the reference standard was a clinical interview. Data on sensitivity/specificity, area under the curve, and data to generate 2 × 2 tables at various thresholds were extracted. Meta-analysis was performed using the diagmeta package in R. Quality of studies was assessed with QUADAS-2. Results Thirty-two studies (Nparticipants = 4042) reporting on 17 questionnaires with 5–25 items targeting depression/anxiety (n = 14), general distress (n = 2), and PTSD (n = 1) were included. Seventeen studies (53%) scored high risk on at least two QUADAS-2 domains. The meta-analysis identified an optimal threshold of 11 (sensitivity 76.9%, specificity 85.1%) for the Edinburgh Postnatal Depression Scale (EPDS) (nstudies = 7, nparticipants = 711), 7 (sensitivity 81.9%, specificity 87.6%) for the Hospital Anxiety and Depression Scale (HADS) anxiety subscale and 6 (sensitivity 73.0%, specificity 88.6%) for the depression subscale (nstudies = 4, nparticipants = 492), and 8 (sensitivity 86.0%, specificity 83.9%) for the Self-Reporting Questionnaire (SRQ-20) (nstudies = 4, nparticipants = 459). Conclusion We present optimal thresholds to screen for perinatal depression with the EPDS, anxiety/depression with the HADS, and CMDs with the SRQ-20. More research on Arabic-language questionnaires, especially those targeting PTSD, is needed.
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Moran Vozar, Tracy E., Amy Van Arsdale, Lauren A. Gross, Elizabeth Hoff, and Stephanie Pinch. "The elephant in the delivery room: Enhancing awareness of the current literature and recommendations for perinatal PTSD." Practice Innovations, December 3, 2020. http://dx.doi.org/10.1037/pri0000134.
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Kendall-Tackett, Kathleen. "Psychological Trauma and Breastfeeding: What We Know So Far." Medical Research Archives 10, no. 11 (2022). http://dx.doi.org/10.18103/mra.v10i11.3288.
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Introduction: Childhood and adult trauma are common experiences in perinatal women worldwide. Psychological trauma has a well-documented effect on mothers’ mental health, but less is known about its impact on breastfeeding. Objectives: This article synthesizes the results from recent studies on trauma on breastfeeding and perinatal mental health. I describe possible mechanisms by which trauma influences breastfeeding and mental health and provide practical suggestions for working effectively with this population. Method: Studies were identified via searches in PubMed and PsychInfo. Key words were adverse childhood experiences, child abuse, child maltreatment, intimate partner violence, birth trauma, pregnancy, postpartum, breastfeeding, postpartum depression, postpartum anxiety, and posttraumatic stress disorder (PTSD). Preference was given to studies published in the past 5 years, but older studies were included if more recent studies were not available. Review articles were also included. Results: Psychological trauma can affect anyone regardless of income, religion, country of origin, age, or race and ethnicity. Pregnant and postpartum women are no exception. Traumatic experiences can make breastfeeding more difficult, but it is often an important goal for trauma survivors. Some studies have found that trauma survivors are more likely to breastfeed. Breastfeeding may be particularly important for trauma survivors in that it lessens trauma symptoms, improves mental health, and lowers the risk of mothers maltreating their children. When working with trauma survivors, it is important that practitioners avoid making assumptions that mothers will not breastfeed. It is important to support their breastfeeding goals. Clinical Implications: Providers who work with new mothers will likely encounter a substantial percentage who are trauma survivors. Trauma survivors may not share their stories with providers, even if they directly ask, but these mothers’ experiences can influence both breastfeeding and their mental health. Practitioners who understand trauma and support breastfeeding in a trauma-informed way can positively influence both breastfeeding and mental health outcomes. Both childhood and adult trauma can have a negative effect on breastfeeding, but the mechanism may vary. Recent trauma can directly impact hormones needed for breastfeeding whereas childhood trauma may impact it via trauma sequelae, such as depression, anxiety, and PTSD.
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IBADOV, Ravshan Alievich, Khilola Pulatovna ALIMOVA, and Gavkhar Alisherovna VOITOVA. "Outcomes of pregnant women with coronavirus disease 2019 (COVID-19) admitted to intensive care unit in Uzbekistan." Journal of Life Science and Biomedicine, September 25, 2022, 82–88. http://dx.doi.org/10.54203/jlsb.2022.10.
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Aim. The present study aimed to investigate outcomes of pregnant women with severe acute respiratory syndrome coronavirus 2 (SARS‑CoV‑2 or COVID-19) in the intensive care unit (ICU). Methods. A total of 3080 pregnant women infected with COVID-19 during treatment were studied in the maternity ward of the Zangiota-1 Republican Specialized Infectious Diseases Hospital from December 2020 to January, 2022. At the time of admission of patients to the hospital, 28.9% of women were in the first trimester of pregnancy, 34.3% and 36.8% were in the second and third trimester of pregnancy, respectively. 1980 cases (64.3%) showed a moderate course of pneumonia and in 48% (1478 cases), bilateral pneumonia was detected. At the same time, 60.0% of patients had lung damage (up to 50%) according to CT dataset. Results. A total of 677 out of 3080 pregnant women with COVID-19 pneumonia (22.0%) needed treatment at the ICU. 490 cases out of 677 patients showed severe clinical course of COVID-19, while 277 cases (41%) showed multiple organ dysfunction syndrome (MODS). Of 277 MODS cases, 209 (75.4%) were those in the third trimester of pregnancy and 170 (61.4%) had initially severe clinical picture of COVID-19. Mortality rate in ICU was 9.4% (64 cases out of 677) while 56.6% experienced post-traumatic stress disorder (PTSD) at baseline, 26.7% had general anxiety disorders, and 16.7% (113 of 677) of women experienced depression symptoms. In the postpartum period, 46.1% (312 of 677) cases showed combinations of PTSD, anxiety and depression according to the combined Patient Health Questionnaire Anxiety and Depression Scale (PHQ-ADS) assessment, which was typical for women with severe and extremely severe COVID-19, preterm birth, miscarriages and perinatal mortality. Conclusion. The ICU hospitalization rate for COVID-19 pneumonia in pregnant women was 22.0%, among which the vast majority (72.4%) were cases with severe clinical course of COVID-19 and PTSD (56.6%). Women in the third trimester of pregnancy were most susceptible to developing MODS and severe COVID-19 pneumonia. Recommendation. In promoting pregnant women's mental and physical health, understanding the characteristics of psycho-emotional stress disorders during the COVID-19 pandemic and learning how to deal with them is critical.
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Petelos, E., V. Vivilaki, M. Papadakaki, E. Sioti, and E. Triantafyllou. "Training development in the ORAMMA (Operational Refugee and Migrant Maternal Approach) project." European Journal of Public Health 29, Supplement_4 (November 1, 2019). http://dx.doi.org/10.1093/eurpub/ckz186.049.
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Abstract Background ORAMMA is a European capacity-building project (GR, NL, UK) for pregnant migrant, asylum-seeking and refugee (MAR) women to improve maternal and newborn outcomes. ORAMMA is an operational and strategic approach for mother-centred, community-oriented, gender-sensitive, interdisciplinary and compassionate care, to meet the needs of MAR women in Europe. Objectives ORAMMA developed training for midwives and other primary health and social care (PC) professionals to meet the needs of MAR women. Methodology comprised three phases: evidence synthesis and needs assessment, training material development, and community enablement through locally recruited women in the innovative role of Maternal Peer Supporters (MPSs). Results Needs assessment highlighted the need to train ORAMMA’s teams of midwives and other PC professionals to care for women who suffered undue hardship, oftentimes leading to PTSD, i.e., victims of trafficking, rape, underage women, sufferers of acute or chronic conditions, and sole family carers. The experiences encountered informed curriculum development for midwives and other PC professionals. Interprofessional training for integrated perinatal care delivery was developed for and delivered in three phases, i.e., detection of pregnancy (GP coordination), care during pregnancy (midwive coordination), and support after birth (social worker coordination), with special modules developed in a participatory manner on: migration status and policies, maternity care for MAR women, and communication and culturally sensitive practices. Conclusions Training midwives and other PC professionals along with members of MAR communities in the MPS role was identified to be a key element to efficiently support women and their families, to propagate key perinatal and public health messages, and to advocate for the rights of MAR women to ensure access equity to quality care in a highly responsive manner. ORAMMA’s tools are available in easily accessible platform online. Key messages ORAMMA developed multilingual material to meet the needs of PC professionals and of MAR women, in an innovative manner and with high relevance for cross-border knowledge transfer. ORAMMA addressed key aspects in delivery and access, focusing on cultural awareness and communication; its relevance extends well beyond perinatal care to improved family outcomes and public health.
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Testoni, Ines, Lucia Ronconi, Erika Iacona, Alice Trainini, Nella Tralli, Luisella Nodari, Giulia Limongelli, and Loredana Cena. "The impact of the COVID-19 pandemic on perinatal loss among Italian couples: A mixed-method study." Frontiers in Psychology 13 (September 12, 2022). http://dx.doi.org/10.3389/fpsyg.2022.929350.
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BackgroundPerinatal bereavement is an event that greatly impacts the emotional, psychological, and psychosocial aspects of those who want to have a child.ObjectivesSince there are few studies on the psychological impact of the COVID-19 pandemic on couples grieving for perinatal loss, this research aimed to survey this experience.ParticipantsBetween 2020 and 2021, in Italian provinces highly affected by the COVID-19 pandemic, 21 parents participated: 16 mothers (76%; mean age 36.2; SD: 3.1) and 5 fathers (24%; mean age 40.2; SD: 3.4), among which there were 4 couples.MethodsA mixed-method design was used through self-report questionnaires and in-depth interviews. Accompanied by a sociodemographic form, the following questionnaires were administered: Prolonged Grief-13, the Parental Assessment of Paternal Affectivity (PAPA) (to fathers), the Parental Assessment of Maternal Affectivity (PAMA) (to mothers), the Dyadic Adjustment Scale short version, the Daily Spiritual Experiences Scale, and the Impact of Event Scale-Revised. The texts obtained through the in-depth interviews underwent thematic analysis.ResultsFifty per cent of participants suffered from Post-Traumatic Stress Disorders (PTSD) symptoms and 20% suffered from relational dyadic stress. Four areas of thematic prevalence emerged: psychological complexity of bereavement, the impact of the COVID-19, disenfranchisement vs. support, and spirituality and contact with the lost child. Participants interpreted their distress as related to inadequate access to healthcare services, and perceiving the pandemic restrictions to be responsible for less support and lower quality of care. Furthermore, they needed psychological help, and most of them were unable to access this service. Spirituality/religiosity did not help, while contact with the fetus and burial did.ConclusionIt is important to implement psychological services in obstetrics departments to offer adequate support, even in pandemic situations.
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White, Sarah J., Jacqueline Sin, Angela Sweeney, Tatiana Salisbury, Charlotte Wahlich, Camila Margarita Montesinos Guevara, Steven Gillard, et al. "Global Prevalence and Mental Health Outcomes of Intimate Partner Violence Among Women: A Systematic Review and Meta-Analysis." Trauma, Violence, & Abuse, February 24, 2023, 152483802311555. http://dx.doi.org/10.1177/15248380231155529.
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The aim of this systematic review was to assess the magnitude of the association between types of intimate partner violence (IPV) and mental health outcomes and shed light on the large variation in IPV prevalence rates between low- to middle-income countries and high-income countries. The study is a systematic review and meta-analysis. The following databases were searched for this study: Cochrane, MEDLINE, EMBASE, PsycINFO, Cumulative Index to Nursing and Allied Health Literature, and the Applied Social Sciences Index and Abstracts. The inclusion criteria for this study are as follows: quantitative studies published from 2012 to 2020 on IPV exposure in women aged 16+, using validated measures. Random effects meta-analyses and subgroup analysis exploring heterogeneity across population groups in different economic contexts are used in this study. In all, 201 studies were included with 250,599 women, primarily from high-income countries. Higher prevalence rates were reported for women’s lifetime IPV than past year IPV. Lifetime psychological violence was the most prevalent form of IPV. Women in the community reported the highest prevalence for physical, psychological, and sexual violence in the past year compared to clinical groups. Perinatal women were most likely to have experienced lifetime physical IPV. Prevalence rates differed significantly ( p = .037 to <.001) for “any IPV” and all subtypes by income country level. Meta-analysis suggested increased odds for all mental health outcomes associated with IPV including depression (odds ratio [OR] = 2.04–3.14), posttraumatic stress disorder (PTSD) (OR = 2.15–2.66), and suicidality (OR = 2.17–5.52). Clinical and community populations were exposed to high prevalence of IPV and increased likelihood of depression, PTSD, and suicidality. Future research should seek to understand women’s perspectives on service/support responses to IPV to address their mental health needs. Work with IPV survivors should be carried out to develop bespoke services to reduce IPV in groups most at risk such as pregnant and/or help-seeking women.