Maternal-fetal attachment and anxiety in pregnant women who conceived through assisted reproductive technology: A longitudinal study

Background: Pregnancy through assisted reproductive technology (ART) is a stressful experience that may affect prenatal attachment. However, maternal-fetal attachment (MFA) and anxiety in pregnancy after ART are understudied in Iran. Objective: To compare changes in MFA and pregnancy-related anxiety (PRA) in the first and third trimester of pregnancy in women who conceived through ART compared to those who conceived naturally. Materials and Methods: This longitudinal study was conducted in 2019 with 187 pregnant women (ART conception = 43, natural conception = 144). Participants were recruited using the consecutive sampling method from a prenatal clinic in Tehran. The Cranley MFA Scale and the Van Den Bergh PRA Questionnaire were used to collect the data. Results: The MFA score in the 12th wk of gestation was lower in the women who conceived with ART compared to in the women who conceived naturally, but there was no statistically significant difference between the groups in wk 36. MFA in both groups was significantly higher at gestational wk 36 than wk 12 (p ≤ 0.001). The increase in MFA score was significantly higher in the women who conceived with ART than in those who conceived naturally (p ≤ 0.001). The anxiety score declined in the two groups and no statistically significant difference was observed in the changes of anxiety scores between the two groups (p = 0.84). Conclusion: Pregnant women who conceived through ART were as attached to their fetus in the third trimester of pregnancy as other women and did not experience more PRA. Key words: Attachment, Maternal fetal relations, Assisted reproductive technology, Pregnancy, Anxiety.

“The Mental Health Piece is Huge”: perspectives on developing a prenatal maternal psychological intervention for congenital heart disease

Objectives: Women carrying a fetus diagnosed with congenital heart disease often experience significant distress because of their medical diagnosis. Given the well-documented impact associated with elevated prenatal stress and critical importance of developing targeted interventions, this study aims to examine stressors, coping and resilience resources, and mental health treatment preferences in pregnant women receiving a congenital heart disease diagnosis to inform the development of a psychological intervention to reduce maternal distress prenatally. Methods: Three groups of participants were included consisting of two pregnant women carrying a fetus with congenital heart disease, five women of children (4−16 months) with congenital heart disease, and five paediatric cardiology medical providers. Responses were gathered via semi-structured interviews and analysed using qualitative thematic analysis. Results: Information regarding four broad areas were analysed of emotional distress during pregnancy; experience of initial diagnosis; coping and resilience; and perspectives on a mental health intervention in pregnancy. Anxiety regarding baby’s future, guilt following diagnosis, and various coping strategies emerged as primary themes among the participant sample. Medical staff corroborated mothers’ heightened anxiety and viewed a psychotherapeutic intervention during the prenatal period as essential and complimentary to standard of care. Conclusion: We identified salient themes and preferred components for a future psychological intervention delivered prenatally. Practice Implications: Patients’ and providers’ perspectives regarding the nature of maternal distress, resilience and treatment preferences can inform the development of interventions to support the emotional well-being of pregnant women carrying a fetus with congenital heart disease to optimise care and potentially improve outcomes for fetal brain development.

Pengaruh Terapi Akupresur terhadap Tingkat Kecemasan pada Ibu Hamil Trimester III

Introduction: The prevalence of pregnancy anxiety is around 14-54%, highest in the first and third trimesters. Acupressure attracts attention as a non-pharmacological therapy for natural relaxation. The research aims to determine the effect of acupressure therapy on anxiety levels. Method: This study was conducted at the Health Centers of Tamalanrea Jaya and Antang, the study used a quasi-experimental design with the pre and post test approach in the intervention group and the control group. The total of research subjects 40 trimester III pregnant mothers who had experience anxiety. The intervention group (21 samples) with acupressure therapy and the control group (19 samples) with placebo therapy. Measuring anxiety using the Hamilton Anxiety Rating Scale (HARS). Result: in the intervention group, the mean of anxiety before the intervention was 26.6 and after the intervention was 22.3 (p value <0.001), while in the control group it was 26.1 before and 25.1 after the intervention (p value = 0.072). The mean reduction in pregnancy anxiety level in the intervention group was more significant than the control group. Conclusion: Acupressure therapy has a significant effect on decreasing anxiety levels in pregnant mothers in the intervention group (p<0.001) and acupressure therapy can be used as one of the effective non-pharmacological methods to reduce symptoms of anxiety in pregnancy.

Comparing Effectiveness of Cognitive Behavioral Training and Positive Psychology Training on Psychological Health of Pregnant Women with Pregnancy Anxiety

This study compares effectiveness of cognitive behavioral training (CBT) and positive psychology training (PPT) on psychological health of pregnant women with pregnancy anxiety. We studied forty-five pregnant women with pregnancy anxiety in two experimental and control groups. All participants completed demographic questionnaire, PDQ, ASI, WHOQOL-BREF and CD-RISC in two stages and CBT and PPT were taught for experimental groups. The results showed a significant difference between experimental and control groups in total score of pregnancy anxiety, quality of life, anxiety sensitivity and resilience (F(8,70)=11.63, P &lt;.001, Wilks'Λ = .184, partial η2 = .571) but no meaningful difference between effectiveness of CBT and PPT on psychological health of pregnant women with pregnancy anxiety (P &gt; .001). According to the results, CBT and PPT both have substantial impacts on improving psychological health of pregnant women with pregnancy anxiety; however, there is no statistically significant difference between the efficiency of CBT and PPT.

Teknik Relaksasi untuk Menurunkan Kecemasan Pada Ibu Hamil di Wilayah Puskesmas Pakualaman

The purpose of group therapy conducted in this research was to determine the effect of relaxation technique to reduce anxiety in pregnant women within the working area of Pakualaman Community Health Center. The research subjects consisted of seven pregnant women who experienced anxiety disorder in the moderate category. The methods for data collection were observation, interview, and focus group discussion, as well as a pre-test using a pregnancy anxiety scale with the results of Cronbach a = 0.896 at 28 items and reliability of 0.896. Data analysis techniques were carried out qualitatively based on the results of the therapy process and quantitatively by conducting a post-test. The research results revealed a decrease in anxiety, both qualitatively and quantitatively. The qualitative results showed that the research subjects were able to feel more positive, calmer, and more comfortable during their pregnancy and being optimistic when they were about to face the delivery process, which affected the perceived behavior such as reduced dizziness and comfortable sleep. Meanwhile, the quantitative results showed a decrease in score and the level of anxiety experienced by the research subjects between before and after participating in the group therapy process with the value of z = -2.366 with a significance of p = 0.018 (p <0.05). Thus, it can be concluded that group therapy with relaxation technique could reduce anxiety in pregnant women within the working area of Pakualaman Community Health Center.

Analysis of Improvement of Pregnancy During Pandemic at Pondok Gede Health Centre Bekasi City in 2021

Pregnant women at Pondok Gede Health Center experienced an increase in visits to pregnancies of at-risk mothers in 2019 which consisted of 23 people, while in 2020 there were 103 people. The main cause of pregnancy at risk age is the non- compliance of family planning, the work of WFH during the pandemic. Efforts to reduce risky age pregnancies, BKKBN urges couples of reproductive age to plan pregnancy, using contraception (condoms). The analysis of the causes of increased pregnancy at risk is a large picture of pregnant women with maternal age ≤ 20 years and ≥ 35 years. This research aimed to determine the analysis of the causes of increased pregnancies at risky ages during the pandemic at Pondok Gede Health Center, Bekasi City in 2021. Research analytic by using the method cross-sectional. Sample were 82 respondents with accidental sampling technique. The instrument research was a questionnaire. Data analyzed using univariat and bivariat by test statistic chi square. The result is pregnant women with age ≥ 35 years were 75.6%, who had good knowledge was 54.9%. who have access to family planning services was 53.7%, who were planned was 56.1%, anxiety was 54.9%, who have unmet need pregnancy was 51.2%, and who work WFH was 72,0%. There was no significant relationship between knowledge, access to family planning services, planned pregnancy, anxiety, unmet need pregnancy, work during the pandemic and pregnancy at the age of mothers at risk at Pondok Gede Health Center, Bekasi City with a p value <0.05.

COVID-19 Pandemic-Related Anxiety in Pregnant Women

The COVID-19 pandemic outbreak influenced general and mental health worldwide. The objective of this study was to assess the anxiety level during the COVID-19 pandemic among pregnant women and compare it between COVID-infected and non-infected groups. We prospectively assessed the daily routine and anxiety level using a bespoke questionnaire and GAD-7 scale validated for pregnant women. With logistic regression, we established possible risk factors of generalized anxiety disorder spectrum and main causes of concern. The dataset included 439 responders of our survey. Of which, 21% had COVID-19 infection during pregnancy; 38% were screened for possible generalized anxiety disorder and the proportion was higher in women who suffered from COVID-19 (48% vs. 35%, p = 0.03). Pre-pregnancy anxiety or depression diagnosis and intentional social contact avoidance increased the risk of anxiety (aOR 3.4 and 3.2). Fetal wellbeing was the main concern for 66% of the responders. The COVID-19 pandemic and related restrictions substantially altered daily lives of pregnant women, exaggerating the prevalence of anxiety compared with the pre-COVID-19 studies (38% vs. 15%). COVID-19 infection during pregnancy was associated with increased levels of generalized anxiety scores. Patient-tailored psychological support should be a mainstay of comprehensive antenatal medical care in order to avoid anxiety- and stress-related complications.

A review of Mobile ‘Apps’ for women with anxiety in pregnancy: Maternity care professionals guide to locating and assessing Anxiety Apps (Preprint)

BACKGROUND Mental health and pregnancy Apps are widely available and have the potential to improve health outcomes and enhance women’s experience of pregnancy. Women frequently access digital information throughout their pregnancy. Healthcare providers and women have little information to guide them to potentially helpful or effective Apps. OBJECTIVE To develop a methodology to systematically search and evaluate commercially available Apps in order to assist maternity care professionals to identify resources to recommend to pregnant women with symptoms of anxiety. METHODS A stepwise systematic approach to identify, select, describe and assess the most popular and user rated Apps available in the UK from January – March 2021. This included developing a script-based search strategy and search process, developing evaluation criteria and conducting a narrative evaluation and description of the selected Apps. RESULTS Useful search terms were identified which included non-clinical, aspirational and problem-based phrases. There were 39 Apps selected for inclusion in the review. No Apps were located which specifically targeted women with anxiety in pregnancy. Of the 39 Apps included in the review, 33 focused solely on mind-body techniques to promote relaxation, stress reduction and psychological wellbeing. Only eight of the 39 Apps included in the review reported that healthcare professionals had contributed to the App development and only one provided empirical evidence on the effectiveness and acceptability of the App. The top 12 Apps were evaluated by two independent reviewers using the developed criteria and scores. The was a small negative correlation between the reviewers scores and App user rating scores, with higher user rating scores associated with lower reviewer scores. CONCLUSIONS App developers, publishers and maternity care professionals should seek advice from women with lived experience of pregnancy anxiety symptoms to assist in locating, promoting and optimising the visibility of Apps for pregnant women. There is a lack of resources which provide coping strategies based on current evidence for the treatment of anxiety in pregnancy. Maternity Care Providers are hindered in their ability to locate and recommend acceptable and trustworthy Apps due to the lack of information on the evidence-base, development and testing of Apps. Maternity care professionals and women need access to libraries of trusted Apps which have been evaluated against relevant and established criteria.

Guided Imagery Technique Implementation Reducing Primigravida Pregnancy Anxiety Before Childbirth Delivery

Anxiety is the most common psychiatric condition found throughout the world. Anxiety in pregnancy is an emotional reaction that occurs in pregnant women related to the concern of the mother with the welfare of herself and her fetus. Guided imagery is the development of mental functions that express oneself dynamically through a psychophysiological process involving all senses and bringing about changes in behavior, perception, or physiological responses with someone's guidance or through the media. This scientific case study aims to determine the application of nursing care to primigravida mothers in dealing with the labor process using guided imagery techniques. The data collection techniques used were interviews, observation, physical examination, and documentation study. This scientific paper shows that there is a decrease in the level of anxiety in the patient after doing the guided imagery technique for 3 meetings. Based on these results, it can be concluded that the intervention from journals related to nursing care in primigravida mothers who experience anxiety has been implemented well. The results of this scientific case study are expected to be implemented as a basis for developing nursing care management and assisting nurses to increase client’s satisfaction with caring provided. Keywords: anxiety, guided imagery, primigravida pregnancy.