Mental health among pregnant women during the pandemic in Sweden– a mixed methods approach using data from the Mom2B mobile application for research

AbstractPublic health emergencies such as the coronavirus (SARS-CoV-2) pandemic have significant impact on mental health, and have been shown to impact on already prevalent affective disorders during and after pregnancy. The aim of this study was to utilize modern tools to assess depressive and anxiety symptoms, as well as wellbeing and life changes in pregnant women during the pandemic in Sweden, where no lockdown has been in place.Data from the Mom2B, a national ongoing mobile application-based study of pregnant and newly-delivered women were utilized. Participants (n= 1345) filled out self-report screeners of depression, anxiety and wellbeing. Questions about COVID symptoms and effects on life and health care were added from March 2020. Movement data was collected using the phone’s GPS sensor. Mood scores were compared with throughout the months of 2020 and to the levels of a previous collected material. Highest levels of depression and anxiety were evident in April and October 2020. Symptoms were higher among those feeling socially isolated, but not for those infected or with symptomatic family members. Wellbeing and mobility were strongly positively correlated and were lowest in April. Women reported on cancelled healthcare appointments and worry about their partners being absent from the delivery.The Mom2B application enabled gathering information at a national level in real-time as the pandemic has been evolving. Levels of perinatal affective symptoms and low wellbeing were elevated compared with previous years as well as with months with fewer cases of SARS-Cov-2. Similar applications can help healthcare providers and governmental bodies to in real time monitor high-risk groups during crises, as well as to adjust measures and the support offered.FundingThis project was funded by the Uppsala Region to AS, the Swedish Association of Local Authorities and Regions (SKR) to the department of Obstetrics and Gynecology, Akademiska University Hospital, the Swedish Research Council (Grant number 2020-01965) to AS, as well as the Fredrik and Inger Thuring’s Foundation to EF.

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Determinants of preconception care among pregnant women in an urban and a rural health facility in Kenya: a qualitative study

BMC Pregnancy and Childbirth ◽

10.1186/s12884-021-04201-w ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

J. K. Okemo ◽

D. Kamya ◽

A. M. Mwaniki ◽

M. Temmerman

Keyword(s):

Child Health ◽

Pregnant Women ◽

Preconception Care ◽

Healthcare Providers ◽

Preventive Health Care ◽

Structured Interview ◽

University Hospital ◽

Rural Setting ◽

Rural Settings ◽

And Child Health

Abstract Background Preconception care (PCC) is a form of preventive health care that is offered to women and couples before conception, with the aim of improving their health status and mitigating various risk factors that could contribute to poor maternal and child health outcomes. The levels of PCC utilization are still low globally, especially in developing countries and in rural areas. Little is known regarding PCC use in Kenya that could help in addressing this shortfall. This study aimed to qualitatively assess the determinants of PCC in urban and rural settings in Kenya. Methods A qualitative approach was employed to assess determinants of PCC using a semi-structured interview guide. The study was conducted from May to October 2017. Selected pregnant women seeking antenatal care (ANC) were recruited by quota sampling, at the Mother and Child Health (MCH) clinics in Aga Khan University Hospital, Nairobi (AKUH, N-urban) and Maragua Level Four Hospital (MLFH-rural). The interviews were thereafter transcribed verbatim and analyzed thematically. Findings A total of 26 women were invited, of whom 21 accepted to participate in in-depth interviews (IDIs). Saturation of themes occurred with 13 interviews (7 at AKUH and 6 at MLFH). Transcription, coding and thematic analysis of the IDIs yielded 12 themes. Eleven of these themes were identified as determinants of PCC. The twelfth theme contained suggested strategies of increasing PCC awareness and utilization, such as using the media, setting up PCC clinics and integrating PCC into other clinics. The dominant themes were awareness about PCC and attitudes towards PCC and pregnancy. The broad determinants of PCC were similar in urban and rural settings – with a few notable exceptions. For example, in the rural setting, women’s level of education and a pervasive history of poor interactions with healthcare providers were major determinants of PCC. Conclusion From this study we conclude that women’s lack of awareness about PCC, in conjunction with attitudes towards PCC and pregnancy impact strongly on its utilization. This lack of awareness could be addressed through health education programs for both the public and for healthcare providers, as well as integrating PCC in the curricula of the later.

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Needle Stick and Sharp Injuries Among Healthcare Workers: A retrospective six-year study

Sultan Qaboos University Medical Journal [SQUMJ] ◽

10.18295/squmj.2020.20.01.008 ◽

2020 ◽

Vol 20 (1) ◽

pp. 54

Author(s):

Rami Saadeh ◽

Khaled Khairallah ◽

Hussein Abozeid ◽

Lama Al Rashdan ◽

Mahmoud Alfaqih ◽

...

Keyword(s):

Healthcare Workers ◽

Medical Center ◽

National Level ◽

Risk Groups ◽

Self Report ◽

Medicine Department ◽

Needle Stick ◽

Job Title ◽

Hospital Wards ◽

And Training

Objectives: This study aimed to examine the proportion of needle stick and sharp injuries (NSSIs) among healthcare workers at King Hussein Medical Center (KHMC), Amman, Jordan. Methods: All NSSI reports referred from departments at KHMC to the Preventive Medicine Department between 2013–2018 were retrospectively reviewed. Proportion of NSSIs were calculated and stratified according to age, gender, job title, place and site of injury and the procedure/task during which the injury occurred. Results: There were a total of 393 NSSIs. A significant association was found between the proportion of NSSIs and all tested variables (P <0.001). The reported proportion of NSSIs was highest among nurses (39.7%) followed by cleaners (36.3%), physicians (10.4%), other workers (7.4%) and lab technicians (5.9%) during the study’s six-year period. Hospital wards were the most common locations (46.1%) where injuries took place. Injuries also occurred most frequently during medical waste collection (38.2%). Conclusion: The proportion of NSSIs was highest among nurses and cleaners. Safety policies and training among high-risk groups should be reviewed to reduce the risk of NSSIs. Multicentre studies at a national level should be conducted to examine whether this study’s findings reflect national trends.Keywords: Needlestick Injuries; Safety; Self Report; Nurses; Accident Prevention; Jordan.

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Determinants of Preconception care among Pregnant Women In an Urban and a Rural Health Facility In Kenya: A Qualitative Study

10.21203/rs.3.rs-228068/v1 ◽

2021 ◽

Author(s):

Joan Khavugwi Okemo ◽

Dorothy Kamya ◽

Abraham Mukaindo Mwaniki ◽

Marleen Temmerman

Keyword(s):

Child Health ◽

Pregnant Women ◽

Preconception Care ◽

Healthcare Providers ◽

Preventive Health Care ◽

Structured Interview ◽

University Hospital ◽

Rural Setting ◽

Rural Settings ◽

And Child Health

Abstract BACKGROUNDPreconception care (PCC) is a form of preventive health care that is offered to women and couples before conception, with the aim of improving their health status and mitigating various risk factors that could contribute to poor maternal and child health outcomes. The levels of PCC utilization are still low globally, especially in developing countries and in the rural areas. Little is known regarding PCC use in Kenya that could help in bridging this gap. This study aimed to assess the determinants of PCC in urban and rural settings in Kenya.METHODSSelected pregnant women seeking antenatal care (ANC) were recruited by purposive sampling at the Mother and Child Health (MCH) clinics in Aga Khan University Hospital, Nairobi (AKUH, N-urban) and Maragua Level Four Hospital (MLFH-rural). A qualitative approach was employed to assess determinants of PCC using a semi-structured interview guide. The interviews were transcribed verbatim and analyzed thematically.RESULTS A total of 26 women were invited, of whom 21 accepted to participate in in-depth interviews (IDIs). Saturation of themes occurred after 13 interviews (7 at AKUH and 6 at MLFH).Transcription, coding and thematic analysis of the IDIs yielded 12 main themes. Eleven of the main themes were identified as determinants of PCC while the twelfth theme contained suggested strategies of increasing PCC awareness and utilization, such as using the media, setting up PCC clinics and integrating PCC into other clinics. The dominant themes were awareness about PCC and attitudes towards PCC and pregnancy.The broad determinants of PCC were similar in urban and rural settings – with a few notable exceptions. For example, in the rural setting, women’s level of education and a pervasive history of poor interactions with healthcare providers were major determinants of PCC.CONCLUSIONFrom this study we conclude that women’s lack of awareness about PCC, in conjunction with attitudes towards PCC and pregnancy impact strongly on its utilization. This lack of awareness could be addressed through health education programs for both the public and for healthcare providers, as well as integrating PCC in the curricula of nurses and doctors.

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Parental Mental Health, Fathers’ Involvement and Bedtime Resistance in Infants

Italian Journal of Pediatrics ◽

10.1186/s13052-019-0731-x ◽

2019 ◽

Vol 45 (1) ◽

Cited By ~ 3

Author(s):

Benedetta Ragni ◽

Simona De Stasio ◽

Daniela Barni ◽

Simonetta Gentile ◽

Rosaria Giampaolo

Keyword(s):

Mental Health ◽

Post Partum ◽

Healthcare Providers ◽

Sleep Onset ◽

Relative Weight ◽

Paternal Involvement ◽

Self Report ◽

Future Research ◽

Parental Mental Health ◽

Parental Factors

Abstract Background Around the age of 6 months, difficulties in settling to sleep and frequent night awakenings are generally occurring in 20 to 30% of infants. According to the transactional model parental factors can play a significant role in influencing infant sleep development. The purpose of the current study was to explore the combined effect of infants’ factors (temperament and sleep onset problems), and parental factors (parental mental health in terms of post-partum affective disorders, consistent bedtime routines and fathers’ involvement at bedtime), on infant bedtime difficulties (e.g. fussing, crying or protesting), including both maternal and paternal perspectives. Methods Sixty Italian intact two-parent families of infants (34 boys and 26 girls) ageing from 8 to 12 months (M = 10.73, SD = 2.54) were enrolled in the study. The parents filled out self-report questionnaires to measure the aforementioned variables. To investigate which infant and parental factors predicted infants’ bedtime difficulties, two multiple linear regressions (MR), one for fathers and one for mothers, and relative weight analyses (RWA) were conducted. Results With regard to infants’ bedtime difficulties reported by fathers (R2 = .35) they were explained by infant involvement in constant bedtime routines (β = −.35, p = .030) and paternal involvement at bedtime (β = −.45, p = .007). Instead infants’ bedtime difficulties reported by mothers (R2 = .32) were explained by minutes the child taken to fall asleep (β = .24, p = .04), infant involvement in constant bedtime routines (β = −.31, p = .01) and bedtime paternal involvement (β = −.27, p = .05). Conclusions The main results of this study emphasized the protective role of consistent bedtime routines and bedtime paternal involvement in reducing infants’ bedtime difficulties perceived both from mothers and fathers. Future research could help to raise awareness and improve understanding of the familial influences on children’s sleep, providing recommendations for educating families, school professionals, healthcare providers, and the general public on risk and protective factors that could play a meaningful role in infants and children’s developing sleep patterns.

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Perinatal mental health around the world: priorities for research and service development in Italy

BJPsych International ◽

10.1192/bji.2019.31 ◽

2019 ◽

Vol 17 (1) ◽

pp. 8-10 ◽

Cited By ~ 3

Author(s):

Pietro Grussu ◽

Ilaria Lega ◽

Rosa Maria Quatraro ◽

Serena Donati

Keyword(s):

Mental Health ◽

Pregnant Women ◽

Postpartum Period ◽

Local Level ◽

Family Care ◽

Psychosocial Interventions ◽

Population Based ◽

University Hospital ◽

Perinatal Mental Health ◽

Service Development

In Italy, most studies on perinatal mental health and initiatives aimed at improving the early detection and management of perinatal mental disorders have been carried out at the local level. National population-based studies are lacking. A study of pregnant women, recruited and diagnosed by a university hospital, found a 12.4% prevalence of minor and major depression during pregnancy, and a prevalence of 9.6% in the postpartum period. In a population-based surveillance system, covering 77% of national births, suicide was identified to be one of the main causes of maternal death within the first year after birth, yet half of those who were known to have a high suicide risk during the postpartum period had not been referred to a mental health service. The value of recognising depressive or anxiety symptoms early, during pregnancy, has been emphasised by recent research and should be linked to multi-professional psychosocial interventions. Since 2017, the Italian public primary care services that are dedicated to pregnancy assistance (Family Care Centres) have been tasked to provide free psychological assessment to pregnant and postpartum women. Action is now needed in order to improve access to Italian Family Care Centres for pregnant women and to develop an integrated care model involving obstetric and mental health services.

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Mindfulness-based stress reduction adapted to pregnant women with psychosocial vulnerabilities—a protocol for a randomized feasibility study in a Danish hospital-based outpatient setting

Pilot and Feasibility Studies ◽

10.1186/s40814-021-00860-w ◽

2021 ◽

Vol 7 (1) ◽

Author(s):

S. Skovbjerg ◽

D. Birk ◽

S. Bruggisser ◽

A. L. A. Wolf ◽

L. Fjorback

Keyword(s):

Mental Health ◽

Randomized Controlled Trial ◽

Usual Care ◽

Pregnant Women ◽

Feasibility Study ◽

Stress Reduction ◽

Controlled Trial ◽

University Hospital ◽

Randomized Controlled ◽

Mindfulness Based Stress Reduction

Abstract Background This protocol is for a feasibility study of a mindfulness-based stress reduction (MBSR) program adapted for pregnant women with psychosocial vulnerabilities. The rationale for the study is the need for a wider array of evidence-based options to address prenatal mental health care needs in pregnant women. MBSR is a promising mental health intervention but has not yet been adapted for pregnant women with the aim of addressing prenatal mental health. The purpose is thus to evaluate the feasibility, acceptability, and clinical outcomes of an adapted MBSR program, prenatal MBSR, compared to usual care to inform a randomized controlled trial. Methods/design Pregnant women (n = 60) referred to an outpatient clinic at Copenhagen University Hospital, Amager and Hvidovre, Denmark, will be recruited for the study. The design is a single-center feasibility trial, with prenatal MBSR, as an add-on to usual care. The primary outcome is to assess the feasibility of a full-scale randomized controlled trial. The secondary feasibility outcome includes possible effects of the adapted MBSR program estimated by self-report questionnaires measuring stress, anxiety, depression, well-being, decentering, reflective functioning, mindfulness, and compassion. Participants will be randomized in a 1:1 ratio to prenatal MBSR or usual care. Discussion The study is part of the Good Start to Family Life study anchored at Copenhagen University Hospital, Amager and Hvidovre, Denmark. Teaching the skills of mindfulness meditation to a psychosocially vulnerable group of pregnant women could prove a viable and non-pharmacological approach to reduce stress, improve mental health, and provide support in the transition to parenthood. The outcomes of the feasibility study will inform the design of a fully powered randomized controlled trial. Trial registration ClinicalTrials.gov, NCT04571190. Registered on September 30, 2020

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Mental health of Covid-19 risk groups during the first Covid-19 lockdown in Germany: a cross-sectional study

10.21203/rs.3.rs-612420/v1 ◽

2021 ◽

Author(s):

Daniel Deimel ◽

Thorsten Köhler ◽

Janina Dyba ◽

Niels Graf ◽

Christine Firk

Keyword(s):

Mental Health ◽

Online Survey ◽

Psychosocial Support ◽

Risk Groups ◽

Low Risk ◽

Self Report ◽

Severe Illness ◽

Cross Sectional ◽

Health Burden ◽

Increased Risk

Abstract Background The ongoing Covid-19 pandemic not only threats physical health, but also affects the mental health of people. Yet, health consequences of the pandemic do not affect all members of society equally. We, therefore, assessed the mental health burden of individuals who are at increased risk of severe illness from Covid-19 compared to individuals who are at low risk of severe illness during the first lockdown in Germany. Furthermore, we investigated variables mediating the effect of being an individual at increased risk of serve illness on depression. Methods Adult German residents (n = 2.369) provided responses to a cross-sectional online survey about risk factors for an increased risk of severe illness from Covid-19 and various aspects of mental health during the first Covid-19 lockdown in Germany. Standardized and validated self-report measures (e.g. PHQ-9, GAD-7) were used using Mann-Whitney U-tests as well as regression and mediation analyses. Results The results clearly show that the mental health burden is higher among persons at increased risk of severe illness from Covid-19 compared to persons at low risk of severe illness from Covid-19. Moreover, our findings indicate that individuals at increased risk of severe illness are more worried about their health during the pandemic and may therefore respond with social withdrawal to protect themselves and, consequently, experience higher levels of loneliness, which in turn has an impact on depressive symptoms. Conclusions Individuals at increased risk of severe illness have an increased need for psychosocial support during times of lockdown. Future public health policies should pay special attention to these individuals and support them by targeted offers. More research, however, is needed on possible long-term consequences of social distancing on mental health.

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Adult Mental Health and Loneliness During the COVID-19 Pandemic in Late 2020

European Journal of Psychology Open ◽

10.1024/2673-8627/a000001 ◽

2021 ◽

Author(s):

Elif Emir Öksüz ◽

Bilal Kalkan ◽

Nesime Can ◽

Abdulkadir Haktanir

Keyword(s):

Mental Health ◽

Psychological Symptoms ◽

Risk Groups ◽

Interpersonal Sensitivity ◽

Self Report ◽

Psychological Status ◽

Adult Mental Health ◽

Demographic Questionnaire ◽

Study Results ◽

The Mean

Abstract. The COVID-19 pandemic had an adverse impact on the mental health of numerous people. To examine the psychological status of the general public across Turkey during the COVID-19 pandemic, we collected data from 1,109 adults, ages ranging from 18 to 72 years. We used a demographic questionnaire, the Symptom Checklist-90-R (SCL-90-R), and the abbreviated version of the UCLA Loneliness Scale. The mean score of the participants on the SCL-90-R was 1.14 ( SD = .78), and 16% of the participants scored 1 standard deviation above the mean. Some groups, including women and students, showed more severe psychological symptoms. The obsessive-compulsiveness, interpersonal sensitivity, and depression subscales had the highest three mean scores. We compared the SCL-90-R scores to previous study results and found a significant increase during the pandemic. Finally, individual stressors, COVID-19-related stressors, and perceived loneliness were found to be significant predictors, explaining 31% of the variance in psychological symptoms. Although collecting data online through self-report inventories limits the generalizability of the results, this study has important implications. Its results suggest that future clinical interventions should focus on obsessive-compulsiveness, interpersonal sensitivity, and depression among specific risk groups.

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Increasing incidence of parosmia and phantosmia in patients recovering from COVID-19 smell loss

10.1101/2021.08.28.21262763 ◽

2021 ◽

Author(s):

Kathrin Ohla ◽

Maria Geraldine Veldhuizen ◽

Tomer Green ◽

Mackenzie E. Hannum ◽

Alyssa J. Bakke ◽

...

Keyword(s):

Mental Health ◽

Time Course ◽

Treatment Options ◽

Disease Onset ◽

Healthcare Providers ◽

Olfactory Dysfunction ◽

Self Report ◽

Physical And Mental Health ◽

Smell Loss

AbstractImportanceSudden smell loss is a specific early symptom of COVID-19, with an estimated prevalence of ~40% to 75%. Smell impairment affects physical and mental health, and dietary behavior. Thus, it is critical to understand the rate and time course of smell recovery.ObjectiveTo characterize smell function and recovery up to 11 months post COVID-19 infection.Settings, ParticipantsThis longitudinal survey of individuals suffering COVID-19-related smell loss assessed disease symptoms and gustatory and olfactory function. Participants (n=12,313) who completed an initial respiratory symptoms, chemosensory function and COVID-19 diagnosis survey (S1) between April and September 2020 and completed a follow-up survey (S2) between September 2020 and February 2021; 27.5% participants responded (n=3,386), with 1,468 being diagnosed with COVID-19 and suffering co-occurring smell and taste loss at the beginning of their illness.Main Outcomes & MeasuresPrimary outcomes are ratings of smell and taste function on a visual analog scale, and self-report of parosmia (smell distortions) and phantosmia (unexplained smells). Secondary outcomes include a checklist of other COVID-19 symptoms.ResultsOn follow-up (median time since COVID-19 onset ~200 days), ~60% of women and ~48% of men reported less than 80% of their pre-illness smell ability. Taste typically recovered faster than smell, and taste loss rarely persisted if smell recovered. Prevalence of parosmia and phantosmia was ~10% of participants in S1 and increased substantially in S2: ~47% for parosmia and ~25% for phantosmia. Persistent smell impairment was associated with more symptoms overall, suggesting it may be a key marker of long-COVID. During COVID-19 illness, the ability to smell was slightly lower among those who did not recover their pre-illness ability to smell at S2.Conclusions and RelevanceWhile smell loss improves for many individuals who lost it due to COVID-19, the prevalence of parosmia and phantosmia increases substantially over time. Olfactory dysfunction is also associated with wider COVID-19 symptoms and may persist for many months after COVID-19 onset. Taste loss in the absence of smell loss is rare. Persistent qualitative smell symptoms are emerging as common long term sequelae; more research into treatment options is strongly warranted given that conservative estimates suggest millions of individuals may experience parosmia following COVID-19. Healthcare providers worldwide need to be prepared to treat post COVID-19 secondary effects on physical and mental health.Trial registrationThis project was pre-registered at OSF: https://osf.io/3e6zc.Graphical abstractKey PointsQuestionWhat are the characteristics of smell and taste recovery of COVID-19 patients?FindingsIn this preregistered observational study of 1,468 participants, smell loss is associated with a higher number of COVID-19 symptoms, and may persist for at least 11 months following disease onset. While a majority of participants report quantitative improvement in their ability to smell, the prevalence of parosmia and phantosmia increases substantially at follow-up. Taste recovers faster than smell, suggesting taste and smell recover separately and can be distinguished by the respondents.MeaningOlfactory dysfunction appears to be a component of long-COVID, with parosmia as a prominent symptom in almost half of those with smell loss. More research into treatment is needed, especially given that olfactory dysfunction is associated with depression and loss of appetite. Health professionals should be aware of these common and long lasting effects.

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Antenatal Toxoplasma gondii, Rubella and Cytomegalovirus Infection Screening Among Pregnant Women Attending Tertiary University Hospital

Gynecology Obstetrics and Reproductive Medicine ◽

10.21613/gorm.2019.903 ◽

2019 ◽

pp. 1

Author(s):

Beril Gurlek ◽

Sabri Colak

Keyword(s):

Toxoplasma Gondii ◽

Pregnant Women ◽

Cytomegalovirus Infection ◽

Acute Infection ◽

Risk Groups ◽

First Trimester ◽

University Hospital ◽

Screening Tests ◽

High Avidity ◽

Serological Screening

Objective: The present study was designed to determine the seroprevalance of Toxoplasma gondii, Rubella, and cytomegalovirus, to investigate the frequency of low and high avidity results among pregnant women and to contribute to the data of our country with the results obtained.Study Design: In the present study, the hospital records of the women who applied to the antenatal outpatient of the Rize Recep Tayyip Erdoğan University Medical Faculty during the first trimester between January 2016 and October 2018 were retrospectively reviewed. Toxoplasma gondii, RRubella and cytomegalovirus IgM, IgG and IgG avidity results were evaluated.Result: IgM positivity was found to be 0.83% (29/3490) for Toxoplasma gondii, 0.92% (32/3459) for Rubella and 1.90% (65/3404) for cytomegalovirus; IgG positivity was found to be 33.64% (1174/3490) for Toxoplasma gondii, 90.70% for Rubella (3140/3459), and 99.17% (3376/3404) for cytomegalovirus. Avidity of Toxoplasma gondii was found to be low (3.70%) in 1 patient, borderline (11.11%) in 3 patients, and high avidity in 23 patients (85.18%). Avidity of cytomegalovirus was found to be low (1.75%) in 1 patient, borderline (3.50%) in 2 patients and high avidity (94.73%) in 54 patients. Avidity of Rubella was found to be low (4%) in 1 patient, and high avidity (96%) was found in 24 patients.Conclusions: In our study, although the prevalence of acute infection with Rubella, cytomegalovirus and Toxoplasma gondii was shown to be low in pregnancy in Rize province, serological screening tests for monitoring and informing high-risk groups that are particularly seronegative appear to be important.

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