scholarly journals Risk for Depressive Symptoms among Hospitalized Women in High-Risk Pregnancy Units during the COVID-19 Pandemic

2020 ◽  
Vol 9 (8) ◽  
pp. 2449 ◽  
Author(s):  
Shanny Sade ◽  
Eyal Sheiner ◽  
Tamar Wainstock ◽  
Narkis Hermon ◽  
Shimrit Yaniv Salem ◽  
...  
Keyword(s):  
Logistic Regression ◽  
High Risk ◽  
Medical Center ◽  
Depression Scale ◽  
High Risk Pregnancy ◽  
Multivariable Logistic Regression ◽  
Risk Pregnancy ◽  
Increased Risk ◽  
Isolation Period ◽  
Risk For Depression

Objective: Higher rates of mental disorders, specifically depression, were found among affected people in previous epidemiological studies taken after disasters. The aim of the current study was to assess risk for depression among pregnant women hospitalized during the “coronavirus disease 2019” (COVID-19) pandemic, as compared to women hospitalized before the COVID-19 pandemic. Study design: A cross-sectional study was performed among women hospitalized in the high-risk pregnancy units of the Soroka University Medical Center (SUMC). All participating women completed the Edinburgh Postnatal Depression Scale (EPDS), and the results were compared between women hospitalized during the COVID-19 strict isolation period (19 March 2020 and 26 May 2020) and women hospitalized before the COVID-19 pandemic. Multivariable logistic regression models were constructed to control for potential confounders. Results: Women hospitalized during the COVID-19 strict isolation period (n = 84) had a comparable risk of having a high (>10) EPDS score as compared to women hospitalized before the COVID-19 pandemic (n = 279; 25.0% vs. 29.0%, p = 0.498). These results remained similar in the multivariable logistic regression model, while controlling for maternal age, ethnicity and known mood disorder (adjusted odds ratio (OR) 1.0, 95% CI 0.52–1.93, p = 0.985). Conclusion: Women hospitalized at the high-risk pregnancy unit during the COVID-19 strict isolation period were not at increased risk for depression, as compared to women hospitalized before the COVID-19 pandemic.

scholarly journals Anxiety and depression in women hospitalized due to high-risk pregnancy: An integrative quantitative and qualitative study

2021 ◽  
Author(s):  
Martina Smorti ◽  
Francesca Ginobbi ◽  
Tommaso Simoncini ◽  
Federica Pancetti ◽  
Alessia Carducci ◽  
...  
Keyword(s):  
Depressive Symptoms ◽  
High Risk ◽  
Risk Group ◽  
Depression Scale ◽  
High Risk Group ◽  
Low Risk ◽  
High Risk Pregnancy ◽  
Anxiety And Depression ◽  
Risk Pregnancy ◽  
Low Risk Pregnancy

AbstractLiterature has shown that hospitalized women with high-risk pregnancy tend to develop anxious and depressive symptoms. Research has used quantitative or qualitative methods. By integrating both quantitative and qualitative methods, this study aims to analyze: a) the level of depression, anxiety, and pregnancy-related anxiety in a group of women hospitalized with high-risk pregnancy (hospitalized high-risk) compared with a group of non-hospitalized women with low-risk pregnancy; b) the content of hospitalization-related emotions in a high-risk group. A cross-sectional study was conducted on 30 hospitalized high-risk pregnant women and 32 women with low-risk pregnancy. Participants completed the Edinburgh Postnatal Depression Scale, Hospital Anxiety and Depression Scale (Anxiety), and Pregnancy Related Anxiety Questionnaire. The hospitalized high-risk group also completed open-ended questions about emotions experienced during hospitalization. Univariate Analysis of Covariance showed that the hospitalized high-risk group reported higher general anxiety and depression than the low-risk pregnancy group. Low-risk group reported higher level of concerns about own appearance than high-risk group. Narratives showed that the anxious and depressive symptoms of hospitalized women are related to the loneliness of being away from family. Despite attempts to understand hospitalization, they express concerns about pregnancy. Psychological support for hospitalized pregnant women should be provided to facilitate the communication of emotions that leads women to elaborate the experience of hospitalization to better adapt and cope with the critical condition.

P5353Pregnancy in congenital heart disease - risk stratificaton

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
S Pataki ◽  
M Szegedi ◽  
A Temesvari ◽  
L Ablonczy ◽  
P Andreka ◽  
...  
Keyword(s):  
Congenital Heart Disease ◽  
Heart Disease ◽  
High Risk ◽  
Premature Birth ◽  
Congenital Heart ◽  
Left Ventricular ◽  
High Risk Pregnancy ◽  
Cardiac Events ◽  
Risk Pregnancy ◽  
Increased Risk

Abstract Introduction Maternal congenital heart disease is a leading cause of peripartum maternal mortality, which is also associated with increased risk of fetal morbidity and mortality. We aimed to provide risk stratification for congenital heart disease patients using the recently introduced CARPREG (Cardiac Disease in Pregnancy) II score at our Institute. Patients and methods We enrolled 191 pregnant women with congenital heart disease (mean age at pregnancy 29.2±5,7 years). We recorded all foetal (premature birth, abortion, congenital heart abnormalities) and maternal (postpartum heart failure, stroke, hypertension) events in 276 pregnancies. High-risk pregnancy was defined as a CARPREG II score of 4≤. Results High-risk pregnancy was detected in 14.1%. We found fetal and maternal events in 13.8% and 14.5% of all pregnancies, respectively, which both were more prevalent in the high-risk group (p<0.001). No maternal death occurred, whereas premature birth and abortion was detected in 7.6 and 2.9%, respectively, both complications were more frequent in the high-risk patient population as compared to the lower risk patients (30.8 vs. 7.2%, p<0.001). In univariate analysis, CARPREG II of 4≤ was significantly associated with fetal (p<0.001, OR: 4.2) and maternal (p<0.001, OR: 5.3) events. Risk factors of the CARPREG II were further analyzed using multivariate logistic regression analysis: prior cardiac events or arrhythmias (p=0.027) and cyanosis (p=0.026) were independent predictors of fetal complications. Left ventricular outflow tract obstruction (p<0.001), cardiac interventions (p=0.024) and prior cardiac events or arrhythmias (p=0.001) demonstrated significant association with maternal events. Conclusion The CARPREG II could help in the identification of high-risk pregnancies and thus aids the selection of patients for strict monitoring and special therapies. In line with previous studies we detected higher rates of fetal and maternal events among patients with CARPREG II of 4≤ score.

scholarly journals Ansiedade traço-estado, risco de depressão e ideação suicida em gestantes de alto risco

2021 ◽  
Vol 1 (54) ◽  
pp. 206
Author(s):  
Alice Correia Barros ◽  
Verônica De Medeiros Alves ◽  
Mara Cristina Ribeiro ◽  
Amuzza Aylla Pereira Dos Santos ◽  
Leilane Camila Ferreira de Lima Francisco ◽  
...  
Keyword(s):  
Suicidal Ideation ◽  
High Risk ◽  
Pregnant Women ◽  
State Anxiety ◽  
Family Income ◽  
Depression Scale ◽  
Anxiety State ◽  
Risk Pregnancy ◽  
Anxiety Trait ◽  
Risk For Depression

<p><span class="fontstyle0">Pregnancy is a period in the life of a woman that requires special attention due to the various physical, hormonal, psychological and social insertion changes. In this context, we thought about the following guiding question: Do high-risk pregnant women in Alagoas have high levels of anxiety trait and/or state, risk of depression and suicidal ideation? This study aims to evaluate the levels of anxiety trait and state, risk of depression and suicidal ideation in high-risk pregnant women, assisted by the health service of Alagoas, Brazil. It is a cross-sectional, descriptive study with quantitative approach. The research was conducted with a sample of 247 high-risk pregnant women in the four and only reference ambulatory clinics for high-risk pregnancy in the State of Alagoas. Four data collection instruments were used: Identification form, Anxiety Inventory, Depression Scale and Suicidal Ideation Scale. Descriptive Analysis through relative frequency, bivariate analysis through chi-square, Kolmogorov-Smirnov, Mann-Whitney and Pearson’s correlation. Regarding the level of anxiety, state anxiety was classified as high (9.7%), moderate (53.4%) and low (36.8%) and trait anxiety was classified as high 7.7%, moderate 59.5% and low 32.8%. A total of 62.8% pregnant women at risk for depression and 2.4% with suicidal ideation were identified. The higher the risk for depression, the greater the risk of having anxiety trait/state moderate and high (p &lt; 0.00). The main risk factors found in this study are low schooling, low family income and non-pregnancy planning.<br />There was no relationship between depression and suicide attempt in high-risk pregnant women. The study shows that<br />high-risk pregnant women have moderate/high trait/state anxiety and risk for depression</span> <br /><br /></p>

scholarly journals Depresi dan Kesejahteraan Spiritual pada Ibu Hamil Risiko Tinggi

2018 ◽  
Vol 8 (2) ◽  
pp. 145
Author(s):  
Fitrias Putri Handayani ◽  
Endang Fourianalistyawati
Keyword(s):  
High Risk ◽  
Negative Relationship ◽  
Depression Scale ◽  
Sampling Technique ◽  
Well Being ◽  
Epidemiological Studies ◽  
High Risk Pregnancy ◽  
Significance Level ◽  
Risk Pregnancy ◽  
Spiritual Well Being

This study aims to investigate the relationship between depression and spiritual well-being among women with a high-risk pregnancy. A quantitative method with correlational design was employed. Eighty-five participants were recruited for this study using accidental sampling technique. All participants were pregnant women with a high-risk pregnancy (between 24 and 36 weeks of gestation). Data were collected using two instruments, namely an adapted CESD-R (Center for Epidemiological Studies-Depression Scale Revised) to measure depression and an adapted Gomez & Fisher’s SWBQ (Spiritual Well-Being Questionnaire) to measure spiritual well-being. Results shows that there is a significant negative relationship between depression and spiritual well-being (r = -0,422 in the significance level of 0.01). It can be concluded from the result that the low level of depression correlates with the high spiritual well-being. Key words: Depression, spiritual well-being, high-risk pregnancyAbstrak: Penelitian ini bertujuan untuk melihat depresi dan kesejahteraan spiritual pada ibu hamil risiko tinggi. Metode penelitian ini adalah kuantitatif dengan desain korelasional. Dalam penelitian ini depresi dan kesejahteraan spiritual diukur dengan alat ukur yang telah diadaptasi, depresi diukur dengan Center For Epidemiological Studies - Depression Scale Revised (CESD-R) sedangkan kesejahteraan spiritual diukur dengan Spiritual Well-being Questionnaire (SWBQ). Pengambilan sampel dilakukan dengan teknik accidental sampling dan sebanyak 89 ibu hamil risiko tinggi dengan usia kehamilan diatas 6 bulan (24 – 36 minggu) menjadi partisipan dalam penelitian ini. Hasil menunjukkan terdapat hubungan yang signifikan dan bernilai negatif antara depresi dengan kesejahteraan spiritual sebesar r= - 0,422 (hubungan sedang) dengan signifikansi 0,01. Kesimpulan dari hasil penelitian ini adalah tingkat depresi yang rendah memiliki hubungan dengan kesejahteraan spiritual yang tinggi.

scholarly journals Role of Modified Biophysical Profile in High Risk Pregnancy in Predicting Fetal Outcome

2020 ◽  
Vol 18 (3) ◽  
pp. 401-405
Author(s):  
Santosh Jha ◽  
Ganesh Dangal
Keyword(s):  
High Risk ◽  
Amniotic Fluid ◽  
Neonatal Resuscitation ◽  
Fetal Outcome ◽  
High Risk Pregnancy ◽  
Amniotic Fluid Index ◽  
Cross Sectional ◽  
Risk Pregnancy ◽  
Increased Risk ◽  
Biophysical Profile

Background: High risk pregnant women have increased risk of maternal and neonatal morbidity and mortality. Antepartum surveillance is important and should be effective in such conditions. Modified biophysical profile is the method of antepartum surveillance which comprises of cardiotocography and amniotic fluid index. Methods: A cross-sectional study was carried out in Paropakar Maternity and Women’s Hospital from February 2019 to January 2020 to determine the effectiveness of modified biophysical profile. Cardiotocography was interpreted as reactive, equivocal and non-reactive. AFI was considered normal if it was 5 to 24 cm. In the study 172 high risk cases at term and not in labor were included. Each case was subjected to cardiotocography then amniotic fluid index was obtained using real time sonography where it was measured from all four quadrants. Modified biophysical results were obtained and then were divided into 2 arms as normal modified biophysical profile and abnormal modified biophysical profile then analysis was done. Results: Of 172 cases, there were 97 (56.4%) cases in normal modified biophysical profile and remaining 75 (43.6%) in abnormal modified biophysical profile group. The rate of cesarean section increased when there was abnormal modified biophysical profile.  Neonatal resuscitation and admission was increased in abnormal modified biophysical profile. Conclusions: Normal modified biophysical profile in high risk pregnancy had more cases of vaginal delivery and less adverse fetal outcome like low APGAR score, neonatal resuscitation and neonatal intensive care admission. Keywords: Amniotic fluid index; cardiotocography; fetal surveillance; modified biophysical profile

scholarly journals Evaluation of perinatal outcome in high-risk pregnancy at tertiary care centre

2019 ◽  
Vol 8 (5) ◽  
pp. 2083
Author(s):  
Anupam Rani ◽  
Urmila Karya ◽  
Sweta Kumari
Keyword(s):  
High Risk ◽  
Perinatal Outcome ◽  
Tertiary Care ◽  
Perinatal Outcomes ◽  
High Risk Pregnancy ◽  
Control Group ◽  
Tertiary Care Centre ◽  
Related Complication ◽  
Risk Pregnancy ◽  
Increased Risk

Background: A high risk pregnancy is one in which mother, fetus or neonate is at increased risk of morbidity or mortality before or after delivery. Hence a relatively small percentage of high risk obstetric population gives rise to a disproportionately high percentage of perinatal and maternal morbidity and mortality. The perinatal outcome can be changed significantly by early detection and special intensive care to high risk pregnancies. Hence Identification of women at risk for these complicated pregnancies with poor outcome is fundamental to antenatal check-up.Methods: 86 high risk antenatal patients attending the outpatient department and labour room were recruited after informed consent.70 normal pregnancy was taken as control group. Perinatal outcomes were compared between high risk and normal pregnancies.Results: Adverse perinatal outcomes were more in high risk pregnancies as compared to normal pregnancies.Conclusions: This study emphasizes on pregnancy related complication leading to adverse perinatal outcome so evaluating patients for high risk factors, early diagnosis, proper antenatal care, prompt treatment, regular follow up, and timely management thus can improve maternal and perinatal outcome.

scholarly journals 62. Factors Associated with 30-Day ED Readmission Following Initial ED Discharge for Suspected Sepsis

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S51-S51
Author(s):  
Anna E Moscowitz ◽  
Esther Y Bae ◽  
Ricardo M La Hoz ◽  
James B Cutrell ◽  
Marguerite Monogue
Keyword(s):  
Logistic Regression ◽  
Medical Center ◽  
Multivariable Analysis ◽  
P Value ◽  
Multivariable Logistic Regression Model ◽  
Suspected Sepsis ◽  
Screening Criteria ◽  
Factors Associated ◽  
Multivariable Logistic Regression ◽  
Increased Risk

Abstract Background Given the increased mortality associated with delayed recognition of sepsis, emergency departments (ED) often use protocols to rapidly identify and treat suspected sepsis. However, screening criteria such as systemic inflammatory response syndrome (SIRS) lack specificity and may over-diagnose sepsis in patients otherwise stable for discharge. Our study describes outcomes and identifies factors associated with ED readmission in those initially discharged directly from the ED who met sepsis criteria. Methods This retrospective cohort study evaluated adult patients (≥ 18 years) seen in the ED at UTSW Medical Center from January to June 2018 who met all the following: ≥ 2 SIRS criteria; received ≥ 1 dose of intravenous (IV) broad-spectrum antibiotic(s) in the ED; were discharged home. A multivariable logistic regression model identified factors associated with 30-day re-admission to our ED, using clinically significant variables parsimoniously. A two-sided P value &lt; 0.05 was considered significant. Results A total of 179 patients were included. Forty-four patients (25%) returned to the ED within 30 days of their initial visit; of those 44, 63.6% (28) returned for issues related to their prior visit, and 50% (22) were admitted to the hospital. Table 1 compares baseline demographics of patients with suspected sepsis readmitted to the ED with those not readmitted within 30 days after initial ED discharge. In univariable analysis, quick Sequential Organ Failure Assessment (qSOFA), and length of antibiotic therapy (ED plus discharge antibiotics) were associated with ED re-admission (table 1). Receipt of antibiotics on discharge was not significant. In the final multivariable analysis (table 2), initial qSOFA ≥ 2 alone was associated with increased risk of ED re-admission (OR 7.5, p=0.01). Table 1. Baseline demographics of patients readmitted and not readmitted to the ED within 30 days after ED discharge with suspected sepsis Table 2. Multivariable logistic regression of risk factors for patients readmitted and not readmitted to the ED within 30 days after ED discharge with suspected sepsis Conclusion In this cohort, 25% of patients with suspected sepsis initially discharged from the ED were readmitted to our ED within 30 days. A qSOFA ≥ 2 at the initial ED visit was associated with increased risk of readmission, suggesting a potential use of qSOFA to triage those warranting admission or closer follow-up. Larger prospective studies are warranted in this understudied population of patients who meet screening sepsis criteria but are discharged from the ED. Disclosures All Authors: No reported disclosures

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