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1.
BMC Pregnancy Childbirth ; 21(1): 768, 2021 Nov 12.
Article in English | MEDLINE | ID: covidwho-1528682

ABSTRACT

BACKGROUND: Pregnant and postpartum women face unique challenges and concerns during the COVID-19 pandemic. Thus far, no studies have explored the factors associated with increased levels of worry in this population globally. The current study sought to assess the frequency and sources of worry during the COVID-19 pandemic in an international sample of pregnant and postpartum women. METHODS: We conducted an anonymous, online, cross-sectional survey in 64 countries between May and June 2020. The survey was available in 12 languages and hosted on the Pregistry platform for COVID-19 studies. Participants were sought mainly on social media platforms and online parenting forums. The survey included questions related to demographics, level of worry, support, stress, COVID-19 exposure, frequency of media usage, and mental health indicators. RESULTS: The study included 7561 participants. Eighty-three percent of all participants indicated that they were either 'somewhat' or 'very' worried. Women 13-28 weeks pregnant were significantly more likely to indicate that they were 'very worried' compared to those who were postpartum or at other stages of pregnancy. When compared with women living in Europe, those in Africa, Asia and Pacific, North America and South/Latin America were more likely to have increased levels of worry, as were those who more frequently interacted with social media. Different forms of support and stress also had an impact upon level of worry, while indicators of stress and anxiety were positively associated with worry level. CONCLUSION: Pregnant and postpartum women are vulnerable to the changes in societal norms brought about by the COVID-19 pandemic. Understanding the factors associated with levels of worry within this population will enable society to address potential unmet needs and improve the current and future mental health of parents and children.


Subject(s)
Anxiety/etiology , COVID-19/psychology , Pregnancy Complications/etiology , Adolescent , Adult , Anxiety/epidemiology , Anxiety/psychology , Cross-Sectional Studies , Female , Global Health/statistics & numerical data , Health Surveys , Humans , Logistic Models , Odds Ratio , Postpartum Period/psychology , Pregnancy , Pregnancy Complications/epidemiology , Pregnancy Complications/psychology , Risk Factors , Stress, Psychological/epidemiology , Stress, Psychological/etiology , Stress, Psychological/psychology , Young Adult
2.
J Am Soc Nephrol ; 32(2): 375-384, 2021 02.
Article in English | MEDLINE | ID: covidwho-1496655

ABSTRACT

BACKGROUND: Recent clinical studies report that women with a history of AKI have an increased incidence of maternal and fetal adverse outcomes during pregnancy, despite fully recovering renal function prior to conception. The mechanisms contributing to such adverse outcomes in pregnancy after AKI are not yet understood. METHODS: To develop a rodent model to investigate fetal and maternal outcomes in female animals with a history of AKI, we used ischemia-reperfusion injury as an experimental model of AKI in female Sprague Dawley rats. The 12-week-old animals underwent warm bilateral ischemia-reperfusion surgery involving clamping of both renal arteries for 45 minutes or sham surgery (control). Rats were allowed to recover for 1 month prior to mating. Recovery from ischemia-reperfusion injury was confirmed by measurements of plasma creatinine and urinary protein excretion. We assessed maternal and fetal outcomes during late pregnancy on gestational day 20. RESULTS: After recovery from ischemia-reperfusion injury, compared with healthy sham-surgery controls, dams exhibited pregnancy-induced renal insufficiency with increases in plasma creatinine and urea, along with increased urinary protein excretion. Additionally, recovered ischemia-reperfusion dams experienced worse fetal outcomes compared with controls, with intrauterine growth restriction leading to higher rates of fetal demise and smaller pups. CONCLUSIONS: In this rat model, despite biochemical resolution of ischemia-reperfusion injury, subsequent pregnancy resulted in maternal renal insufficiency and significant impairments in fetal growth. This mirrors findings in recent reports in the clinical population, indicating that this model may be a useful tool to further explore the alterations in kidney function after AKI in women.


Subject(s)
Acute Kidney Injury/etiology , Pregnancy Complications/etiology , Reperfusion Injury/etiology , Animals , Disease Models, Animal , Female , Kidney Function Tests , Ligation , Pregnancy , Rats , Rats, Sprague-Dawley , Renal Artery/surgery
3.
Fam Pract ; 38(Suppl 1): i23-i29, 2021 Aug 27.
Article in English | MEDLINE | ID: covidwho-1281860

ABSTRACT

BACKGROUND: As a mitigation measure for COVID-19 pandemic, lockdown was implemented in India for a period of 2 months (24 March-31 May 2020). Disruption in antenatal care (ANC) provisions during lockdown is expected due to diversion of public health facilities on pandemic. OBJECTIVE: To assess the proportion of pregnant women who had not completed the ideal number of antenatal visits, availability of iron-folic acid (IFA) supplements and challenges in availing health services during the period of lockdown. METHODS: A concurrent mixed-methods study was conducted among pregnant women in Puducherry, India. Information on obstetric characteristics and details regarding antenatal visits were collected through telephonic interviews. In-depth interviews were conducted to understand the perceived challenges in availing health services during the lockdown period. RESULTS: Out of 150 pregnant women, 62 [41.3%; 95% confidence interval (CI) 33.6-49.3] did not complete the ideal number of visits and 61 (40.7%, 95% CI 32.7-49.0) developed health problems. Out of 44 women who received medical care for health problems, 11 (25%) used teleconsultation. Of all the women, 13 (8.7%, 95% CI 4.9-14.0) had not taken the IFA supplements as prescribed by the health provider. Economic hardship, restricted mobility, lack of information about the health system changes and psychological stress due to the fear of COVID were the challenges in accessing care. CONCLUSIONS: Two out of five pregnant women did not complete the ideal number of visits and developed health problems during the lockdown period.


Subject(s)
Abortion, Spontaneous/psychology , Anxiety/etiology , COVID-19/prevention & control , Health Services Accessibility/statistics & numerical data , Pregnancy Complications/etiology , Pregnant Women/psychology , Prenatal Care/statistics & numerical data , Adult , Anxiety/epidemiology , Attitude to Health , Cross-Sectional Studies , Facilities and Services Utilization/statistics & numerical data , Female , Humans , India/epidemiology , Interviews as Topic , Pregnancy , Pregnancy Complications/epidemiology , Pregnancy Complications/psychology , Prenatal Care/psychology , Qualitative Research , Socioeconomic Factors , Telemedicine/statistics & numerical data
4.
Psychosom Med ; 83(4): 345-350, 2021 05 01.
Article in English | MEDLINE | ID: covidwho-1218025

ABSTRACT

OBJECTIVE: According to recent studies, the COVID-19 pandemic has been associated with an increased risk of mental health problems across many subpopulations including pregnant and postnatal women. This study examined the prevalence and correlates of depressive symptoms (depression hereafter) in Chinese pregnant and postpartum women during the COVID-19 pandemic. METHODS: This was a multicenter, cross-sectional study comprising 1309 pregnant and postpartum women across 12 provinces in China during the COVID-19 pandemic. Depression was assessed using the nine-item Patient Health Questionnaire. Univariate analyses and multivariate logistic regression analyses were conducted. RESULTS: The prevalence of depression in pregnant and postpartum women was 27.43% (95% confidence interval [CI] = 25.01%-29.85%). Women who were worried about themselves or their babies being infected with COVID-19 (odds ratio [OR] = 2.562, 95% CI = 1.670-3.929), and those who had delayed regular medical checkups (OR = 2.434, 95% CI = 1.580-3.750) were at higher risk of depression. Compared with those living in central and western parts of China, women living in northern (OR = 0.513, 95% CI = 0.326-0.807) and southeastern parts of China (OR = 0.626, 95% CI = 0.463-0.846) were less likely to have depression. CONCLUSIONS: The COVID-19 pandemic was associated with an increased likelihood of mental health problems among pregnant and postnatal women. Over a quarter of the pregnant and postpartum women in China had depression during the COVID-19 pandemic. Considering the negative health impact of depression, preventive measures, regular mental health screening, and medical checkups are needed with the goal to reduce the risk of depression in this vulnerable population during a pandemic.


Subject(s)
COVID-19/psychology , Depression, Postpartum/epidemiology , Depression/epidemiology , Pregnancy Complications/psychology , Adult , COVID-19/complications , China/epidemiology , Cross-Sectional Studies , Depression/etiology , Depression, Postpartum/etiology , Female , Humans , Logistic Models , Pandemics/statistics & numerical data , Pregnancy , Pregnancy Complications/epidemiology , Pregnancy Complications/etiology , Prevalence , Surveys and Questionnaires
5.
Med Clin (Barc) ; 156(4): 172-176, 2021 02 26.
Article in English, Spanish | MEDLINE | ID: covidwho-1198965

ABSTRACT

BACKGROUND AND OBJECTIVES: The appearance of a highly contagious disease forced the confinement of the population in almost all parts of the world, causing an increase in psychological problems, with pregnant women being a particularly vulnerable group to suffer negative consequences. The aim of this research was to check which confinement or psychological stress variables are related to the increase of anxious and depressive symptoms in pregnant women, as a consequence of the pandemic caused by the COVID-19. MATERIALS AND METHODS: The sample was composed of 131 pregnant women who experienced the confinement imposed by the Government of Spain on March 14, 2020. Sociodemographic, obstetric, confinement related and psychological variables were collected. RESULTS: Perceived stress, pregnancy-specific stress, as well as insomnia are predictive variables in most anxious (obsessions and compulsions, anxiety and phobic anxiety) and depressive symptoms related to COVID-19. CONCLUSIONS: It is important to focus future psychological interventions in this population on stress control and sleep monitoring, since these variables influence the increase of anxiety and depression.


Subject(s)
Anxiety/etiology , COVID-19/prevention & control , COVID-19/psychology , Depression/etiology , Physical Distancing , Pregnancy Complications/etiology , Stress, Psychological/etiology , Adult , Anxiety/diagnosis , Anxiety/epidemiology , Depression/diagnosis , Depression/epidemiology , Female , Health Policy , Health Surveys , Humans , Pregnancy , Pregnancy Complications/diagnosis , Pregnancy Complications/epidemiology , Spain/epidemiology , Stress, Psychological/diagnosis , Stress, Psychological/epidemiology
6.
Birth ; 48(2): 242-250, 2021 06.
Article in English | MEDLINE | ID: covidwho-1119216

ABSTRACT

BACKGROUND: The COVID-19 pandemic introduced unparalleled uncertainty into the lives of pregnant women, including concerns about where it is the safest to give birth, while preserving their rights and wishes. Reports on the increased interest in community births (at home or in birth centers) are emerging. The purpose of this project was to quantitatively investigate psychological factors related to this birth preference. METHODS: This study included 3896 pregnant women from the COVID-19 Pregnancy Experiences (COPE) Study who were anticipating a vaginal birth. COPE Study participants were recruited online between April 24 and May 15, 2020, and completed a questionnaire that included preference with respect to place of birth and psychological constructs: fear of childbirth, basic beliefs about birth, pandemic-related preparedness stress, and pandemic-related perinatal infection stress. RESULTS: Women who preferred a community birth, on average, had less childbirth fear, had stronger beliefs that birth is a natural process, were less likely to see birth as a medical process, and were less stressed about being unprepared for birth and being infected with COVID-19. In multivariate models, higher stress about perinatal COVID-19 infection was associated with greater likelihood of preferring a community birth. The effect of perinatal infection stress on preference was stronger when preparedness stress was high. DISCUSSION: Women's birth preferences during the COVID-19 pandemic are associated with psychological processes related to risk perception. Community births are more appealing to women who view being in a hospital as hazardous because of the pandemic. Policies and prenatal care aimed to increase access to safe in-hospital and out-of-hospital birth services should be encouraged.


Subject(s)
Birthing Centers/statistics & numerical data , COVID-19 , Home Childbirth/statistics & numerical data , Parturition/psychology , Pregnancy Complications , Stress, Psychological , Adult , COVID-19/epidemiology , COVID-19/prevention & control , COVID-19/psychology , Fear , Female , Humans , Patient Preference/psychology , Patient Preference/statistics & numerical data , Pregnancy , Pregnancy Complications/diagnosis , Pregnancy Complications/epidemiology , Pregnancy Complications/etiology , Pregnant Women/psychology , SARS-CoV-2 , Social Perception , Stress, Psychological/diagnosis , Stress, Psychological/epidemiology , Stress, Psychological/etiology , Uncertainty
7.
Psychosom Med ; 83(4): 345-350, 2021 05 01.
Article in English | MEDLINE | ID: covidwho-990959

ABSTRACT

OBJECTIVE: According to recent studies, the COVID-19 pandemic has been associated with an increased risk of mental health problems across many subpopulations including pregnant and postnatal women. This study examined the prevalence and correlates of depressive symptoms (depression hereafter) in Chinese pregnant and postpartum women during the COVID-19 pandemic. METHODS: This was a multicenter, cross-sectional study comprising 1309 pregnant and postpartum women across 12 provinces in China during the COVID-19 pandemic. Depression was assessed using the nine-item Patient Health Questionnaire. Univariate analyses and multivariate logistic regression analyses were conducted. RESULTS: The prevalence of depression in pregnant and postpartum women was 27.43% (95% confidence interval [CI] = 25.01%-29.85%). Women who were worried about themselves or their babies being infected with COVID-19 (odds ratio [OR] = 2.562, 95% CI = 1.670-3.929), and those who had delayed regular medical checkups (OR = 2.434, 95% CI = 1.580-3.750) were at higher risk of depression. Compared with those living in central and western parts of China, women living in northern (OR = 0.513, 95% CI = 0.326-0.807) and southeastern parts of China (OR = 0.626, 95% CI = 0.463-0.846) were less likely to have depression. CONCLUSIONS: The COVID-19 pandemic was associated with an increased likelihood of mental health problems among pregnant and postnatal women. Over a quarter of the pregnant and postpartum women in China had depression during the COVID-19 pandemic. Considering the negative health impact of depression, preventive measures, regular mental health screening, and medical checkups are needed with the goal to reduce the risk of depression in this vulnerable population during a pandemic.


Subject(s)
COVID-19/psychology , Depression, Postpartum/epidemiology , Depression/epidemiology , Pregnancy Complications/psychology , Adult , COVID-19/complications , China/epidemiology , Cross-Sectional Studies , Depression/etiology , Depression, Postpartum/etiology , Female , Humans , Logistic Models , Pandemics/statistics & numerical data , Pregnancy , Pregnancy Complications/epidemiology , Pregnancy Complications/etiology , Prevalence , Surveys and Questionnaires
8.
BJOG ; 127(10): 1229-1240, 2020 09.
Article in English | MEDLINE | ID: covidwho-614342

ABSTRACT

OBJECTIVES: To investigate the mental status of pregnant women and to determine their obstetric decisions during the COVID-19 outbreak. DESIGN: Cross-sectional study. SETTING: Two cities in China--Wuhan (epicentre) and Chongqing (a less affected city). POPULATION: A total of 1947 pregnant women. METHODS: We collected demographic, pregnancy and epidemic information from our pregnant subjects, along with their attitudes towards COVID-19 (using a self-constructed five-point scale). The Self-Rating Anxiety Scale (SAS) was used to assess anxiety status. Obstetric decision-making was also evaluated. The differences between cities in all of the above factors were compared and the factors that influenced anxiety levels were identified by multivariable analysis. MAIN OUTCOME MEASURES: Anxiety status and its influencing factors. Obstetric decision-making. RESULTS: Differences were observed between cities in some background characteristics and women's attitudes towards COVID-19 in Wuhan were more extreme. More women in Wuhan felt anxious (24.5 versus 10.4%). Factors that influenced anxiety also included household income, subjective symptom and attitudes. Overall, obstetric decisions also revealed city-based differences; these decisions mainly concerned hospital preference, time of prenatal care or delivery, mode of delivery and infant feeding. CONCLUSIONS: The outbreak aggravated prenatal anxiety and the associated factors could be targets for psychological care. In parallel, key obstetric decision-making changed, emphasising the need for pertinent professional advice. Special support is essential for pregnant mothers during epidemics. TWEETABLE ABSTRACT: The COVID-19 outbreak increased pregnant women's anxiety and affected their decision-making.


Subject(s)
Anxiety , Coronavirus Infections , Delivery, Obstetric , Pandemics , Pneumonia, Viral , Pregnancy Complications , Pregnant Women/psychology , Prenatal Care , Adult , Anxiety/diagnosis , Anxiety/epidemiology , Anxiety/etiology , Betacoronavirus , COVID-19 , China/epidemiology , Coronavirus Infections/epidemiology , Coronavirus Infections/prevention & control , Coronavirus Infections/psychology , Cross-Sectional Studies , Delivery, Obstetric/methods , Delivery, Obstetric/psychology , Delivery, Obstetric/statistics & numerical data , Diagnostic Self Evaluation , Female , Humans , Pandemics/prevention & control , Pneumonia, Viral/epidemiology , Pneumonia, Viral/prevention & control , Pneumonia, Viral/psychology , Pregnancy , Pregnancy Complications/diagnosis , Pregnancy Complications/epidemiology , Pregnancy Complications/etiology , Prenatal Care/methods , Prenatal Care/psychology , Prenatal Care/statistics & numerical data , Qualitative Research , SARS-CoV-2
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