Journal of Psychosomatic Obstetrics & Gynecology最新文献

Objective: To explore the global burden of female infertility from 1990 to 2021 by examining trends in prevalence and years lived with disability (YLD).

Methods: Data from the Global Burden of Disease Study 2021 (GBD 2021) were analyzed with a focus on the prevalence and YLD of female infertility in women aged 15-49 years. Statistical models were used to estimate ASPRs and YLD across regions and countries.

Results: The global prevalence of female infertility was 110.1 million in 2021, with an age-standardized rate of 2,764.6 per 100,000 population. The YLD for infertility in 2021 was 601,134, which represented a 33.1% increase since 1990. Regionally, East Asia and Eastern Europe had the highest rates of infertility, whereas Australasia had the lowest rate.

Conclusions: The study highlights a significant rise in the burden of female infertility, particularly in high-income regions. Study findings emphasize the need for targeted public health strategies and healthcare interventions to address this growing issue.

This study aimed to explore the psychological challenges faced by women living with polycystic ovary syndrome (PCOS) and their subjective experiences. Using a cross-sectional, questionnaire-based design, we first conducted a comparative analysis of responses from 54 PCOS patients and 54 age-matched healthy participants. The analysis revealed a significant difference in satisfaction with life (SWL) between the two groups (F = 9.426, p < .005), while no significant differences were found in levels of anxiety and depression. Additionally, depression was found to have a significant impact on SWL (F = 55.309, p < .001). To further investigate the subjective well-being of PCOS patients, a larger group of 389 PCOS patients (age: M = 32.18 years, SD = 8.34) completed the Polycystic Ovary Syndrome Questionnaire (PCOSQ) (QoL Scale). A ranking of their concerns revealed that obesity-related issues were the most significant, while concerns about developing cancer were ranked last. The PCOSQ scores showed a strong negative correlation with the BDI (r = -0.754, p < .001), highlighting the profound impact of PCOS symptoms on depression. These findings underscore the importance of prevention, screening and treatment for depression in PCOS patients, as well as the importance of educating patients to improve their risk perception and disease management strategies.

Despite evidence on effectivity and WHO recommendations, continuous care during labor is not yet available for all women. Options such as doula support are being considered, but face barriers in accessibility. To explore other implementation options, the Continuous Care Trial looked at the provision of continuous care by maternity care assistants. Maternity care assistants are well-established care providers within Dutch maternity care, routinely involved in the final stages of labor and postpartum. This qualitative study is an addition to the Continuous Care Trial and explores women's experiences with continuous care during labor by maternity care assistants in the Netherlands. Fourteen interviews were conducted, audio-recorded and transcribed verbatim for manifest content analysis, following the methodology of Graneheim and Lundman. The explored experiences were analyzed for evident similarities and differences. Findings were described in three themes: 'Women's experiences with continuous care,' 'Continuous care of maternity care assistants' and 'Perspectives on implementation.' Noted facilitators include positive effects of continuous care, a larger role of the partner, and recognition of the professional background of the maternity care assistant. Barriers include difficulty to decide when and what kind support to ask for and lack of knowledge on the effectivity of continuous support.

Objectives: Adverse Childhood Experiences (ACE) may be associated with unintended pregnancies (UPs). Our aim was to investigate whether there is an association between a history of ACE, type of ACE or number of ACE and the risk for UPs and if this risk is mediated by psychiatric vulnerabilities.

Study design: A cross-sectional study with participants recruited from the OLVG hospital was performed. Pregnant patients older than 18 years, literate in either Dutch or English were included. Patients with florid psychosis were excluded. ACEs were self-reported and assessed via the Childhood Trauma Questionnaire, pregnancy intention was extracted from the patient database and psychiatric vulnerability was self-reported. The association between ACE and UPs was analyzed by means of logistic regressions, followed by a mediation analysis with psychiatric vulnerability.

Results: A total of 269 participants, mostly with a university degree (66.5%) and with a mean age of 34 (SD 4.306) were included; 20.1% had at least one ACE and 22.3% had an UP. There was no significant association between UPs and a history of ACE regardless of the type and number of ACE.

Conclusions: Future studies should replicate our findings onf the associationimpact of ACEs and psychiatric vulnerabilities on pregnancy intention within a larger, and more representative sample.

Objective: Numerous studies have linked abortion to an elevated risk of suicide. One hypothesis is that this association is entirely incidental and most likely fully explained by preexisting mental illness. This hypothesis can be tested by examining women's own self-assessments of the degree, if any, that abortion and other pregnancy outcomes contributed to suicidal thoughts and behaviors.

Methods: A topic blind survey was distributed to 2829 American females 41-45 years of age. Respondents were asked about any history of attempted suicide(s) and reproductive histories. Grouped by reproductive history, respondents were then asked to rank on visual analog scales the degree, if any, to which their pregnancy outcome contributed to suicidal thoughts, self-destructive behaviors, and any attempted suicides.

Results: Aborting women were twice as likely to have attempted suicide compared to other women. Aborting women, especially those who underwent coerced or unwanted abortions, were significantly more likely to say their pregnancy outcomes directly contributed to suicidal thoughts and behaviors compared to women in all other groups.

Conclusions: The hypothesis that higher rates of suicide following abortion can be entirely explained by preexisting mental health problems is inconsistent with women's own self-assessments of the degree their abortions directly contributed to suicidal and self-destructive behaviors.

Background: In Sweden, women often meet with different midwives during antenatal, intrapartum, and postpartum care, due to the structure of maternity care, with few alternatives which provide continuity. This study aims to explore women's interest in having a midwife they know present during labor and birth and to identify the characteristics of women who prefer this option.

Methods: A comparative study was conducted involving two Swedish nationwide cohorts of Swedish-speaking pregnant women. The first cohort included 3,061 women, and the second 1,812 women. Descriptive statistics and odds ratios were calculated.

Results: In total, 4,873 pregnant women completed the survey. Most participants were aged 25-35 years, living with a partner, and born in Sweden. Interest in having a midwife they know increased from 53% in 1999 to 76% in 2024. Key factors associated with this preference included primiparity (OR 3.80; 95% CI 3.27-4.40), being pregnant in 2024 (OR 3.21; 2.70-3.86), being born outside Sweden (OR 2.73; 2.11-3.54), and fear of birth (OR 2.03; 1.56-2.63).

Conclusions: Interest in having a known midwife during childbirth has grown significantly in Sweden, highlighting the need for policy changes that promote awareness and expand this option for women.

Purpose: Whilst the antenatal period is well established as a period of increased vulnerability to mental health difficulties, restrictions resulting from COVID-19 lockdown in the UK are likely to have negatively affected psychosocial outcomes in these women.

Materials and Methods: This study aimed to describe prevalence rates of clinically relevant antenatal anxiety and depression, and explore whether psychosocial changes as a result of the pandemic were predictive of clinically relevant anxiety and depression. Antenatal women (N = 684) completed an online survey of psychosocial measures during the UK government's initial lockdown restrictions.

Results: Descriptive statistics indicate women experienced high levels of anxiety and depression and that changes resulting from restrictions were perceived negatively. Whilst 11.7% of women reported a current, clinical diagnosis of depression, 47.8% reported a score of ≥13 on the EPDS, indicating clinically relevant depression. Similarly, 18.7% of women reported a current, clinical diagnosis of anxiety, but 68.1% scored ≥40 on the STAI, indicating clinically relevant anxiety. After controlling for known demographic risk factors, only psychosocial change because of COVID-19 restrictions predicted clinically relevant anxiety (28%) and depression (27%).

Conclusions: This study highlights the importance of considering antenatal women as a high-priority group, and ensuring antenatal care remains accessible and uninterrupted in any future crises.

Purpose: Loss of control while eating (LOC) or feeling unable to control the amount or type of food consumed during an eating episode, is the core psychopathology in binge eating disorders. Yet, the impact of LOC on other psychiatric symptoms during pregnancy is not known. This study evaluated the contribution of prenatal LOC to psychological distress and disordered eating attitudes.

Methods: Pregnant individuals with BMI ≥ 25 (N = 312) recruited for a perinatal health promotion trial self-reported past-month LOC; eating, shape, and weight concerns; prenatal depressive symptoms, anxiety, and stress. Propensity scores were used to reduce bias associated with cross-sectional data.

Results: Overall, 34.3% (n = 107) reported LOC. Individuals with prenatal LOC, relative to those without, endorsed more eating disorder symptoms (ps<.001) as well as more symptoms of depression (7.1$\pm$0.3 vs. 5.4$\pm$4.9) and anxiety (38.1 ± 11.7 vs. 33.4 ± 11.7) and greater perceived stress (25.0 ± 7.9 vs. 22.0$\pm$9.9, ps<.001). LOC frequency was associated with significantly more prenatal psychological distress, beyond the effect of other factors that increase the likelihood of LOC. (ps<.005).

Conclusions: Among individuals with elevated BMI, prenatal LOC is common and relates to eating disorder and other psychiatric symptoms. Prenatal LOC may represent a behavioral mechanism for improved psychological health.

The diagnosis gestational trophoblastic disease (GTD) is known to have a significant psychological impact on women. Our objective was to provide insight in the psychological and physical consequences of women with GTD, while also reflecting on their coping strategies and their experiences of received care. A qualitative study was carried out using semi-structured interviews among women recently diagnosed with GTD. Interviews were audio-recorded, transcribed verbatim and analyzed using a thematic network approach. Eight interviews were analyzed. The abruptness of the diagnosis resulted in women feeling sad, uncertain and powerless. Coping strategies included seeking emotional support, accurate information, peer connections and distraction. Women were generally satisfied with care, emphasizing personalization, empathy, medical expertise and feeling heard as important aspects. They appreciated offered psychological support from specialized nurses. Nevertheless, aspects such as provided information, communication and logistical issues need improvement. The results of this study emphasize the importance of comprehensive patient information, the need for personalized psychological support and more frequent consultations at reference centers, while treatment is conducted locally.

Childbirth-related posttraumatic stress symptoms (CB-PTSS) affect around 12% of postpartum individuals. While the subjective experience of childbirth is a key predictor of CB-PTSS, the specific defining characteristics of negative birth experiences remain poorly understood. This study aims to refine our understanding of negative birth experiences by investigating intrapartum hotspots, i.e. moments of extreme distress, and their association with CB-PTSS. In a cross-sectional study of N = 1,140 individuals who had given birth eight to ten weeks before, we examined the following: the types of hotspots, differences in hotspot-related distress, interpersonal difficulties during the hotspot, and CB-PTSS between the various types of hotspots and whether hotspot-related distress and interpersonal difficulties independently predicted CB-PTSS. Participants completed several items based on previous qualitative work [1] to assess the worst hotspot, hotspot-related distress, and interpersonal difficulties during the hotspot and the City Birth Trauma Scale to measure CB-PTSS, alongside relevant pregnancy- and birth-related questions. Medical interventions were the most frequently experienced worst hotspot and separation from the child was associated with the highest levels of hotspot-related distress, interpersonal difficulties, and CB-PTSS. Hotspot-related distress and interpersonal difficulties independently predicted CB-PTSS. Examining intrapartum hotspots poses a promising approach to define highly negative birth experiences.