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Introduction: This study was done to compare the prevalence of mental health disorders between COVID-19-infected and non-infected mothers during the COVID-19 pandemic. The secondary objective was to find out the risk factors and long-term outcome of peripartum depression (PPD). Material(s) and Method(s): This was an observational and comparative study using a questionnaire-based direct interview, conducted in a tertiary hospital. After judging the inclusion and exclusion criteria, 842 subjects were selected between September 2020 to December 2020. The Edinburgh postnatal depression scale (EPDS) and COVID-19 anxiety scale (CAS) was used for evaluation of the mental health. Subjects with PPD were followed up for a year. Result(s): The mean age of the subjects was 24.8 +/- 3.9 years, 142 (16.8%) were confirmed COVID-19 positive. Overall, 317 (37.6%) had possible PPD (EPDS >=14) and 763 (90.6%) had peripartum anxiety (EPDS anxiety subscore >=4). While there was no significant difference in the prevalence of PPD (32.6% vs 39%, p = 0.12), peripartum anxiety was higher among COVID non-infected subjects (91.6% vs 86.6%, p = 0.04). Furthermore, COVID-19-related anxiety was higher among COVID-19-infected compared to the non-infected [17 (10-28) vs 15 (8-25), p = 0.00]. In multivariate analysis, medical comorbidities (p = 0.000), history of psychiatric illness (p = 0.002), domestic violence (p = 0.032) and obstetric complications (p = 0.000) were significant risk factors for PPD. Among the subjects who had PPD, only 35% still had depression after a year. Conclusion(s): This study provides an in-depth analysis of PPD and anxiety during the COVID-19 pandemic, the risk factors, and the long-term effects. Clinical significance: It highlights the importance of routine screening for perinatal mental health disorders and early psychiatric consultation when required.Copyright © The Author(s).
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The aim of this review study is to examine the effects of Covid-19, a global health crisis that paves the way for a great increase in the morbidity of psychological and psychosocial disorders, on mothers in the groups at risk and the role of these effects in the maternal attachment relationship and the methods of coping with it are discussed within the framework of the literature. In addition to the life change and anxiety that comes with being a parent, the fear of contagion and uncertainty can negatively affect women's emotional well-being and cause anxiety. Sometimes mothers find it difficult to relate to their babies due to environmental factors such as stress, and such failure can have long-term effects on the baby. Considering that the pandemic period is a major source of stress in itself, it is predicted that the bonding process of mothers with their babies will be affected by the epidemic. In light of this information, healthcare providers and policy makers should be aware of the possible long-term impact on women and children of the significant burden of psychological morbidity during the perinatal period among Turkish women. Implementation of effective screening and intervention programs can help improve perinatal mental health and improve the quality of postnatal care in Turkey. (PsycInfo Database Record (c) 2023 APA, all rights reserved) (Turkish) Bu derleme calismasinin amaci, psikolojik ve psikososyal bozukluklarin morbiditesinde buyuk bir artisa zemin hazirlayan kuresel bir saglik krizi olan Covid-19'un risk altinda olan gruplarin icinde yer alan anneler uzerindeki etkileri ve bu etkilerin maternal baglanma iliskisindeki rolunun incelenmesi ve bununla bas etme yontemlerinin literatur cercevesinde tartisilmasidir. Ebeveyn olmanin getirdigi yasam degisikligi ve endiseye ek olarak bulasma korkusu ve belirsizlik kadinlarin duygusal refahini olumsuz etkileyerek endiseye neden olabilir. Bazen anneler stres gibi cevresel faktorlerden dolayi bebekleriyle iliski kurmakta zorlanir ve bu tur bir basarisizligin bebek uzerinde uzun vadeli etkileri olabilir. Pandemi doneminin basli basina buyuk bir stres kaynagi oldugu dusunuldugunde annelerin bebekleriyle bag kurma surecinin salgindan etkilenecegi ongorulmektedir. Bu bilgiler isiginda saglik saglayicilari ve politika yapicilar, Turk kadinlari arasinda perinatal donemdeki onemli psikolojik morbidite yukunun kadinlar ve cocuklar uzerindeki olasi uzun vadeli etkisinin farkinda olmalidir. Etkili tarama ve mudahale programlarinin uygulanmasi Turkiye'de perinatal ruh sagliginin gelistirilmesinde ve dogum sonrasi bakimin kalitesinin iyilestirilmesine yardimci olabilir. (PsycInfo Database Record (c) 2023 APA, all rights reserved)
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Objective: To explore the clinical safety of lopinavir/ritonavir (LPV/r) by mining the risk signals of adverse events (AEs) related to LPV/r for the safe application of the drug in the treatment of novel coronavirus pneumonia (COVID-19). Method(s): The risk signals related to LPV/r in AE reports of US FDA Adverse Event Reporting System (FAERS) from the first quarter of 2010 to the third quarter of 2019 were mined by reporting odds ratio (ROR). An AE with reports more than 3 and 95% confidence interval (CI) lower limit of ROR greater than 1 was defined as a positive signal. AEs were counted and classified using the preferred system organ class (SOC) and preferred term (PT) of Medical Dictionary for Regulatory Activities (MedDRA). The PTs of top 50 adverse event reports and signal strength were selected and analyzed. Result(s): From the first quarter of 2010 to the third quarter of 2019, a total of 13 335 AE reports with LPV/r as the primary suspicious drug were reported in the FAERS database. Four hundred and fifty-five AE risk signals with reports more than 3 and the 95%CI lower limit of ROR greater than 1 were detected, involving 7 718 AE reports. The top 2 system organs involved in AE reports were "injury, poisoning and procedural complications" [13.6% (1 051/7 718)] and "pregnancy, puerperium and perinatal conditions" [11.7% (899/7 718)]. However, 998 (95.0%) of 1051 AE reports involved in "injury, poisoning and procedural complications" were related to drug exposure during pregnancy. The system organ with the highest signals was "congenital, familial and genetic disorders" [16.3% (74/455)]. In addition, 144 AEs caused by drug interactions were detected, which ranked the 7th in the AE reports. Conclusion(s): The risk signals of fetal, neonatal and infant abnormalities related to LPV/r during pregnancy were detected, suggesting that attention should be paid to the risk of using LPV/r in pregnant women and infants. The interaction between LPV/r and other drugs was also worthy of attention.Copyright © 2020 by the Chinese Medical Association.
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The article highlights and discusses several current topics that have been published in the field of anaesthesiology in obstetrics in the Czech Republic and abroad last year. It summarizes the influence of the COVID-19 pandemic on anesthesiological praxis in obstetrics. It also presents new developments in systemic and neuraxial obstetric analgesia, Caesarean Section anesthesia, and emergencies in the peripartum period.Copyright © 2022, Czech Medical Association J.E. Purkyne. All rights reserved.
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Coronavirus disease 2019 (COVID-19) is an infectious disease that can lead to severe respiratory symptoms. Pregnant women have an increased risk for a severe course. Therefore, the Association of the Scientific Medical Societies in Germany (AWMF) Guidelines 015/092 "SARS-CoV-2 in pregnancy, childbirth, and the puerperium" were established to standardize care in the COVID-19 pandemic. The guideline group used data from the "COVID-19 related obstetrics and neonatal outcome study" (CRONOS) to generate evidence-based recommendations for action. CRONOS collects data from more than 130 affiliated maternity hospitals nationwide in Germany. According to the study, pregnant women positive for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) are often asymptomatic;however, in 1 out of 25 detected infections there is a severe course requiring intensive medical treatment. Thromboembolism occurs in 1 out of 30 women hospitalized for COVID-19. An infection of the neonate of a mother infected peripartum is occasionally detected (about 1 out of 20 infants) and usually remains without consequence in the short-term outcome. Many other questions have been answered using CRONOS data. The registry is still open and recruiting and will also provide more in-depth information on different virus variants and vaccination in the future with more than 6000 cases. CRONOS is exemplary for an unprecedented cooperation of gynecologists during the pandemic.Copyright © 2022, The Author(s), under exclusive licence to Springer Medizin Verlag GmbH, ein Teil von Springer Nature.
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Introduction: During the Covid-19 pandemic, isolation, fear of contagion, changes in care circumstances, and suspended or restricted visitor access impacted the psychological wellbeing of puerperae. As shown in literature [1,2], Covid-19 pandemic increased depressive and post-traumatic stress related symptoms in mothers in the postnatal period. Moreover, it could determine serious psychological challenges for pregnant and postpartum women, with potential "short" and "long" term consequences for the health of mothers and their children [2]. Healthcare providers should guarantee easy access to mental health services, as a primary strategy to support the health of both mothers and children [2]. After the worldwide spread of Covid-19 the organization of every hospital ward changed, including the obstetric and neonatal units. Compared to the pre-pandemic period, a reduction of the average length of stay in hospital for the new mothers was instituted [3]. This was the result of a reduction of the hospital beds, mostly because of the need to allocate mothers tested positive for Covid-19 in a separate area and to lower the risk of Covid-19 transmission in hospitals. The Obstetric Psychological Service of the Spedali Civili hospital in Brescia started a screening program for the wellbeing of the perinatal period in 2018, with a gradual development and improvement of the organization of this activity [4]. Screening was suspended during the first wave of Covid-19 pandemic from 6th of March to 4th of May 2020. Nevertheless, it was necessary to cope with the Covid-19 pandemic changing demands and methods in order to continue with the screening of women admitted in obstetrics ward. Method(s): A screening of psychological perinatal wellbeing was performed in puerperae admitted to the Second Department of Obstetrics at Spedali Civili hospital in Brescia. Screening consisted in a psychological consult, during which the psychologist illustrated the Obstetric Psychological Service to the woman and identified her psychological need, without using tests. This was eventually followed by an assessment consultation, specialist care and referral to the out-of-hospital psychological services, if required by the woman or considered necessary by the psychologist. It was made a comparison between data collected from October 2019 to January 2020 and from May 2020 to December 2021. Result(s): Compared to the pre-pandemic period, average length of stay in the Second Division of Obstetrics was reduced. In particular, starting from March 2020, the expected discharge of the puerpera was about 24 hours after vaginal birth and 48 hours after cesarean delivery, if no complications occurred for both mother and newborn. Previously, discharge was expected after about 48 hours and 72 hours, respectively. Discharge that occurs 24 hours after vaginal birth is named "Early discharge" and requires the activation of the out-of-hospital services, with home visits by an obstetrician. From October 2019 to January 2020, 470 admitted women were screened, of which 23 (4,9%) demanded a further psychological consultation[4]. Between May 2020 and December 2021, 5145 screening were performed. Among them 550 (10.7%) demanded a further psychological consultation. From those data we can affirm that there was an increase in psychological consultations (from 4.9% to 10.7%), after exhibiting a psychological need during the postnatal screening. Conclusion(s): Covid-19 pandemic changed the care conditions of the woman during the pregnancy and the immediate post-partum. The reduction of the average length of hospital stay of the women in the postpartum did not stop the Psychological Service prevention program. The Obstetric Psychological Service of the Spedali Civili hospital in Brescia implemented his activity increasing the pace of work, to be able to screen as many admitted women as possible. It was noticed that, after the Covid-19 first outbreak, the demand for psychological consultation after the screening consult was more than doubled in comparison to the pre-pandemic perio . This emphasized the benefit of an early interception of the psychological need of the women in the immediate post-partum period, especially during the Covid-19 pandemic.
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This article presents current data on the impact of COVID-19 (SARS-CoV-2) on pregnancy and perinatal consequences. The working theories of the pathogenesis of obstetric and fetal complications due to infection during pregnancy, already proven to date, are considered. Symptoms of COVID-19 disease, the risk of their development, and frequency of severe disease in non-pregnant and pregnant women of reproductive age do not differ significantly. However, there are powerful studies that have shown that this infection in pregnant women leads to a high probability of a dramatically severe and fulminant course. Pregnant women with SARS-CoV-2 infection have an increased risk of preeclampsia, incl. severe, hemolysis, thrombocytopenia and increased levels of liver enzymes compared with pregnant women without infection. Women who have COVID-19 are twice as likely to have preterm rupture of the membranes and three times as likely to have a preterm birth compared to the not infected pregnant women. Vertical transmission of the virus from mother to fetus is likely, but data are insufficient to be certain. There is also insufficient evidence of an increased miscarriage rate and teratogenic effects of the COVID-19 virus. However, antenatal fetal death is statistically significantly more common in infected pregnant women than in uninfected pregnant women. Morphological and functional disorders in the chorion/placenta are the main pathogenetic factor in the development of preeclampsia, intrauterine growth retardation, antenatal fetal death and impaired state of the fetus and children born by women with COVID-19. Many studies report that mothers with confirmed COVID-19 infection has asymptomatic babies. At the same time, some studies indicate adverse complications in newborns from infected mothers. The most common neonatal disorders in babies from pregnant women with COVID-19 are tachypnea, hyperthermia, and gastrointestinal disorders, in particular vomiting and flatulence. Further research of the COVID-19 impact on pregnancy and perinatal outcomes is urgently needed.Copyright © 2022 Trylyst. All rights reserved.
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BACKGROUND: Traumatic events are associated with psychological and physical health problems for women in the perinatal period (i.e., pregnancy-12-months after childbirth). Despite the negative impact of trauma on perinatal women, the long-term impact of such diverse trauma and women's experience during the perinatal period remains understudied. METHODS: This study explored two research questions: 1) What are the psychological experiences of perinatal women who have experienced interpersonal traumatic events? And 2) What are the service needs and gaps expressed by women relating to perinatal medical protocols and psychological services? These questions were addressed via in-depth semi-structured qualitative interviews with nine perinatal women (one pregnant and eight postpartum) residing in central Canada who reported experiencing interpersonal traumatic events occurring from adolescence to the perinatal period. Recruitment and data collection occurred from October 2020 to June 2021. Interviews were audio-recorded, transcribed, and analyzed according to constructivist grounded theory. RESULTS: The emergent grounded theory model revealed the central theme of the role of prior trauma in shaping women's perinatal experiences, with four related main themes including perinatal experiences during the COVID-19 pandemic, the role of social support in women's perinatal experiences, the barriers that women experienced while seeking psychological and medical services prior to the perinatal period and during the perinatal period, and the specific needs of perinatal women with a history of interpersonal trauma. CONCLUSIONS: Findings of this research highlight the negative and long-lasting impact of traumatic events experienced on women's psychological health and psychosocial functioning during the perinatal period, as well as perinatal women's unmet psychological and medical service needs. A call to action for perinatal researchers and clinicians is imperative in furthering this important area of research and practicing person-centered and trauma-informed care with this population.
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COVID-19 , Maternal Health Services , Pregnancy , Adolescent , Female , Humans , Pandemics , Parturition/psychology , Postpartum Period/psychology , Qualitative ResearchABSTRACT
BACKGROUND: Most evidence on the impact of pandemic on perinatal population's experiences has reported such effects in a portion of the pandemic. OBJECTIVES: The aim of this study was to understand the postpartum people's experiences of and responses to the coronavirus disease 2019 pandemic during the first year and to identify their health care needs. DESIGN: This is a descriptive qualitative study. METHODS: This study was conducted in British Columbia, Canada, between March 2020 and April 2021. Participants (N = 268) were at 4 months postpartum and were recruited as part of the Pregnancy Specific Anxiety Tool study through prenatal care clinics and classes, community laboratory services and social media. Qualitative data were obtained using six online open-ended questions and were analysed using thematic analysis. RESULTS: Findings were grouped under five central themes: protecting baby (with three categories including hypervigilance, constant decision-making to find balance and developmental issues); psychological adjustments (with three categories including coping, anxiety and grief); experience of isolation and lack/loss of support (with two categories including isolation and loss of expected support); unexpected interruptions and life events (with four categories including interrupted maternity leave, unexpected changes/life events, positive impacts and interruption in health care services); and perceived postpartum care needs (with five categories including in-person visits, allowing support persons, providing information/education/support groups, mental health and social support and pro-active check-ins). CONCLUSION: Several impacts of the pandemic persisted throughout the first year, particularly isolation and lack of support. These findings can inform responsive health care services to address the emerging needs of postpartum people throughout the pandemic.
Subject(s)
COVID-19 , Humans , Female , Pregnancy , Pandemics , Postpartum Period , Adaptation, Psychological , Mental HealthABSTRACT
Subjective quality of life could be considered one of the indicators of health behavior and wellbeing of women in the perinatal period. Accordingly, the aim of this paper was to examine how women in perinatal period perceive quality of life in various domains. Its relationship to age, number of pregnancies, course of pregnancies, and method of delivery and experience with Covid-19 pandemic was investigated, as well. Our sample consisted of 366 pregnant women in any period of pregnancy who came in for regular outpatient examinations and control, those who were hospitalized due to pathological pregnancy or due to the need for intensive care, as well as women in their postnatal period, one year after delivery, who were seeking professional advice from a gynecologist. The majority were aged 20 to 30 years (53.8%). The findings showed that assessed domains of subjective quality of life were related to a variety of experiences with the Covid-19 pandemic. The results are presented and discussed in detail. Implications and limitations are given, as well.
Subject(s)
COVID-19 , Pregnancy Complications, Infectious , Pregnancy , Humans , Female , Quality of Life , Pandemics , Republic of North Macedonia/epidemiology , Pregnancy Complications, Infectious/epidemiologyABSTRACT
Experts suggest how 6 research articles can be used in nursing practice.
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OBJECTIVES: To consolidate the available evidence around ethnic minority women's experiences and needs when accessing maternity care. METHODS: A qualitative systematic review and meta-aggregation of qualitative data were conducted. Nine electronic databases were searched for qualitative or mixed-methods studies from the inception of each database until January 2022. Using the Nested-Knowledge software, meta-aggregation was conducted according to the Joanna Briggs Institute (JBI) data synthesis approach to identify all potential intersections between different themes. Methodological quality of included studies was assessed using the JBI Qualitative Assessment and Review Instrument (JBI-QARI) and the mixed-methods appraisal tool (MMAT) checklists for qualitative and mixed-methods studies, respectively. RESULTS: Twenty-two studies (nineteen qualitative and three mixed-methods) were included. All studies were of good methodological quality. An overarching theme 'the struggles and fears of ethnic minority women' was identified. The negative experiences with maternity care were attributed to barriers including ineffective communication, cultural and religious insensitivity, inattentiveness and disregard for women's needs, and isolation-related impact due to the COVID pandemic. CONCLUSIONS: Overall, our review highlighted several significant gaps between the care provided and the expected care among ethnic minority women accessing maternity care services. This mismatch between their expectations and care resulted in negative experiences, as the women reported being discriminated against and disrespected. There is an urgent need to develop and implement maternity care policies that are inclusive of needs of the ethnic minority women to optimize their maternity care experience.
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The purpose of this dissertation was to provide a foundation for future research aimed at understanding associations between social network analysis measures and perinatal depression symptoms among military spouses. This work summarizes how social network analysis measures have been associated with depression in adults (systematic literature review), what is known regarding perinatal depression in the military-affiliated population (scoping literature review), and provides a description of women's experience of the perinatal period and social support during the COVID-19 pandemic (phenomenological qualitative study).There is a gap in the literature regarding how structural, compositional, and functional SNA characteristics associate with depressive symptoms among adults. However, it does appear that having similar others and various types of social support consistently associates with decreased symptomology. Future studies examining SNA properties and associations with depression in adults should adequately describe the population of interest and statistical analysis methodology. More specific information on which qualities of homophily relate to decreased depression will be helpful to design treatment interventions.I found 10 articles that warranted inclusion in the scoping review addressing perinatal depression among military-affiliated women-there is a scarcity of research being conducted in this field. Major findings include a lack of information from analytical and qualitative study designs. Documenting conflicts of interest and study limitations such as the self-report nature of PND screening tools, were not adequately addressed in the included studies. Future studies should define periods of separation to accurately reflect the influence of deployments and temporary duties as well as aim to capture risk and protective factors for military spouses versus active-duty military women.Lastly, I carried out a phenomenological qualitative study to better understand women's perinatal and social support experiences during the pandemic. My findings indicate that women experienced a wide range of emotions, changes to their perinatal care and social support, other factors that compounded being pregnant or having a baby during a pandemic, and a dissatisfaction with postpartum care. Implications for more effective communication and information on how to receive support during a period of isolation are warranted among this population. (PsycInfo Database Record (c) 2022 APA, all rights reserved)
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The perinatal period is a high risk for onset and relapse of mental health problems. The COVID-19 pandemic is a particularly stressful occurrence with reported negative impacts on perinatal mental health, hence the need to understand these impacts on pregnant and post-partum childbearing women and people, and prioritise interventions to alleviate them. This is the first of two articles.
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This chapter provides descriptions, typical clinical presentations, and case reviews of perinatal anxiety and perinatal obsessive-compulsive disorder. The discussed anxiety disorders include generalized anxiety disorder, panic disorder, and illness anxiety disorder as encountered in the perinatal period including pregnancy and 12 months' postpartum. Suggestions for provider advocacy during increased rates of intimate partner violence during COVID-19 are provided. (PsycInfo Database Record (c) 2022 APA, all rights reserved)
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The COVID-19 pandemic has turned perinatal healthcare into a worldwide public health challenge. Although initial data did not demonstrate pregnancy as a more susceptible period to adverse outcomes of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection, an increasing number of reports now certify maternal illness as a high-risk condition for the development of maternal-fetal complications. Despite the rarity of SARS-CoV-2 vertical transmission, severe maternal illness might induce adverse perinatal and neonatal outcomes. Additionally, perinatal COVID-19 data may raise concerns about long-term harmful consequences to the offspring in the framework of non-communicable diseases. The World Health Organisation, as well as scientific literature, consider the protection of the maternal-fetal dyad against COVID-19 as a critical issue and, therefore, strongly promote and encourage the vaccination of pregnant and lactating women. Furthermore, the pandemic has triggered an unprecedented recession, leading to historic levels of unemployment and deprivation, while health, societal, economic and gender inequities particularly affecting low-income and middle-income countries, have increased. This mini-review provides an updated brief report on historical, clinical, psychological and socioeconomic aspects of the COVID-19 pandemic based on 10 lectures presented at the 9th Maria-Delivoria-Papadopoulos Perinatal Symposium, held virtually on 19 March 2022.
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COVID-19 , Pregnancy Complications, Infectious , Pregnancy , Infant, Newborn , Female , Humans , COVID-19/epidemiology , COVID-19/prevention & control , Pandemics , SARS-CoV-2 , Lactation , Pregnancy Complications, Infectious/epidemiology , Pregnancy Complications, Infectious/prevention & control , Infectious Disease Transmission, Vertical/prevention & control , Socioeconomic Factors , Pregnancy OutcomeABSTRACT
Objective: To study SARS-CoV-2 viral load in maternal and neonatal bodily fluids, Passage of anti-SARS-CoV-2 antibody through placenta and breastmilk, and incidence of fetoplacental infection. Methods: The data were gathered from five databases and included a review of research articles published between 2020 and 2021. PubMed Google Scholar The following terms were used in the search: 1. Clinical symptoms of the mother, 2. The ratio of negative to positive RT-PCR test results in infants, 3. Ratios of normal to aberrant IgG and IgM, 4. Antibody Placental Transfer, 5. Time period for maternal immunization to produce effective antibodies, 6. Neonatal Immune Response, 7. Antibodies are transferred through breast milk after moms have been immunised. Results: Several prospective and retrospective studies conducted in Wuhan, Philadelphia, Florida and Massachusetts consisted of seropositive as well as seronegative pregnant women. SARS-CoV-2 antibodies were detected in the sera of the mother and correlated with the antibodies detected in the neonatal blood. Significant transfer of IgG SARS-CoV-2 antibodies through placenta and breast milk was observed;that is, positive correlation was found between SARS-CoV-2 IgG concentrations in cord and maternal sera (= 0.886;< .001). Not only passively, but mothers infected during the peripartum period protect the newborn by actively stimulating and training the neonate system via breastmilk immune complexes. Conclusion: We here highlight novel insights arising from recent research endeavours on the transmission of SARS-CoV-2 antibodies from a mother to an infant.