Journal of Psychosomatic Obstetrics & Gynecology最新文献

Background: The endometriosis painful symptoms-4 dimensions ENDOPAIN-4D is a multidimensional questionnaire designed to assess endometriosis-related pain. This study aimed to translate, culturally adapt, and validate ENDOPAIN-4D for European Portuguese.

Methodology: Translation and content validity assessment were assessed in 32 women with endometriosis. For psychometric validation, 386 patients completed an online sociodemographic and clinical questionnaire, the Portuguese ENDOPAIN-4D, and the Endometriosis Health Profile Questionnaire-30 (EHP-30). Statistical analyses included descriptive statistics, exploratory factor analysis, internal consistency, item-total correlation, and concurrent validity.

Results: Factor analysis of the "usual pain" dimension supported the original four-factor structure, accounting for 63.7% of variance (Cronbach's α = 0.91). A novel three-factor structure was identified for the "worst pain" dimension, previously psychometrically untested, with good internal consistency (Cronbach's α = 0.83) and acceptable item-total correlations. Concurrent validity with the EHP-30 ranged from weak to strong across domains.

Conclusions: The Portuguese ENDOPAIN-4D is a culturally adapted and validated instrument for multidimensional pain assessment in European Portuguese women with endometriosis, with validity likely limited for other Portuguese-speaking communities. The newly identified three-factor structure for worst pain may aid individualized pain management and follow-up in clinical and psychosomatic care. Further studies should evaluate concurrent validity and the stability and responsiveness of the new algorithms.

Background: Rates of hypertensive disorders affecting pregnancy are increasing, and bipolar disorder is more common in pregnancy than previously thought.

Objective: The authors investigated differences in the incidence of hypertensive disorders of pregnancy between those with and without bipolar disorder (BPD) and between those receiving and not receiving pharmacotherapy for BPD. Differences in the incidence of hypertensive disorders of pregnancy in those with BPD between those on prophylactic aspirin (ASA) and not, were also examined.

Methods: EPIC COSMOS was used to examine records from 2019 to 2023.

Results: The authors found a meaningful difference in proportions between those with and without BPD when observing development of hypertensive disorders of pregnancy across years. Slightly increased odds of hypertensive disorders were found among those reporting BPD pharmacotherapy compared to those not. Slightly increased odds of hypertensive disorders occurred in those with BPD reporting ASA.

Conclusions: The increased odds among those reporting BPD pharmacotherapy could be due to sequelae of disease, medication used, or comorbidities. These findings further corroborate prior evidence of the increasing prevalence of both maternal health complications and mental health disorders int eh United States.

Background/objective: This study investigates factors associated with long-term posttraumatic stress following later termination of pregnancy due to fetal anomaly.

Methods: N = 159 women undergoing later termination of pregnancy were assessed at four time points: pre-termination (T0), at four months (T1, N = 115), one year (T2, N = 99), and four years post-termination (T3, N = 90). Participants answered a questionnaire containing questions about posttraumatic stress (IES), optimism (LOT-R), social support (F-SozU) and several sociodemographic as well as pregnancy related variables. To assess changes in posttraumatic stress over time and possible predictors, generalized estimating equations were calculated.

Results: Average posttraumatic stress declined significantly from T1 (52.3% above average) to T2 (20.0%) and T3 (17.8%). Optimism at T0 was a significant predictor for lower overall posttraumatic stress, avoidance and intrusion. Having previous children and higher gestational age were significant predictors for higher intrusion scores.

Conclusions: Findings align with research indicating that most women recover from the initial distress, though some experience prolonged symptoms and should thus receive adequate psychological support. Lower optimism, having previous children and higher gestational age may be risk factors for higher posttraumatic stress levels. Further research should examine the sources of posttraumatic stress among people seeking abortion later in pregnancy due to fetal anomaly.

Purpose: This systematic review synthesizes evidence on depressive symptoms and access to mental health care following miscarriage. It examines differences between women in general care settings and those with recurrent pregnancy loss to explore differential psychological vulnerability and care gaps.

Methods: A search of four databases (inception-June 2025) followed PRISMA guidelines. Studies reporting depressive symptoms or barriers and facilitators to care were included. Given methodological heterogeneity, findings were synthesized narratively using a SWiM framework, stratifying populations by miscarriage history and assessing quality with risk-of-bias tools.

Results: Of 1,140 records, 46 were included. Depressive symptoms were common, though prevalence varied by timing, tools, and characteristics. Evidence suggests a possible graded association between recurrent loss and symptoms, although this was inconsistent and often attenuated in acute assessments. Key correlates included childlessness, prior psychiatric history, repeated loss, and low social support. Barriers included insensitive communication, lack of follow-up, and financial constraints. Facilitators included empathetic interactions, clear information, and supportive networks.

Conclusions: Miscarriage is frequently associated with significant distress, yet evidence certainty varies regarding recurrence and intervention effectiveness. Findings highlight a persistent gap between women's mental health needs and healthcare responses.

Objective: This study aimed to investigate mental health disparities and their underlying determinants among women with pelvic organ prolapse (POP) in urban and rural China.

Methods: From August 2022 to August 2023, a convenience sampling method was employed to select 322 POP patients at a tertiary specialized hospital in Nanjing, China. The study used a general information questionnaire, General Health Questionnaire-28, and Perceived Social Support Scale. Influencing factors on mental health were analyzed using univariate and multivariate logistic regression.

Results: Among the 322 POP patients, 68.01% (219 cases) were from urban areas, and 31.99% (103 cases) were from rural areas. Significant baseline differences were observed, with urban patients having higher education levels and rural patients having a greater number of childbirths and longer disease duration. Based on the General Health Questionnaire-28, urban POP patients scored higher on somatic symptoms, anxiety and insomnia, severe depression, and overall score, compared to rural POP patients (P < 0.05).

Conclusions: Mental health issues are prevalent among POP patients, with urban POP female patients facing a greater mental health burden than rural patients. Our findings highlight the need for targeted nursing and psychological interventions for this group, especially for urban patients, to improve health conditions.

Background: Postpartum depression (PPD) disrupts early mother-infant synchrony, a key determinant of healthy socio-emotional development. The relational impact of prior early pregnancy loss (EPL) remains largely underexplored.

Objective: This exploratory cross-sectional study examined the independent and combined effects of PPD severity and prior EPL on mother-infant synchrony.

Method: Ninety-six mother-infant dyads, recruited from a population vulnerable to depressive symptoms, were assigned to a control group or to one of three PPD severity groups (mild, moderate, severe). Dyadic synchrony was assessed using the CARE-Index, and EPL history was recorded. Chi-square tests and binary logistic regressions evaluated the effects of PPD severity and EPL on low synchrony.

Results: EPL significantly predicted low synchrony (OR = 7.50, 95% CI [1.16-48.36], p = 0.034), independently of PPD severity. Although depressive symptoms showed no overall significant effect (p = 0.123), a severity-response trend emerged: mild (OR = 3.06, p = 0.09), moderate (OR = 3.57, p = 0.06), severe (OR = 7.50, p = 0.01). No interaction between EPL and PPD was found.

Conclusions: Prior EPL appears to have lasting effects on mother-infant synchrony, independent of current depressive severity. Larger studies are needed to confirm these findings.

Objectives: To assess the reliability of the 10-item and 4-item Perceived Stress Scale (PSS-10 and PSS-4) in the obstetric population, compared with the original 14-item scale (PSS-14).

Methods: Data were drawn from two Brazilian multicenter studies: a prospective cohort of pregnant women at 27-29 weeks and a cross-sectional study of postpartum women. Central tendency measures and centiles were compared across versions for overall, pregnant, and postpartum groups. Analyses included concordance, internal consistency, correlation, and reliability.

Results: A total of 1,034 women completed the PSS-14. Median scores differed significantly across versions (PSS-10: 47.5; PSS-4: 43.7; PSS-14: 46.4; p < 0.001). Both shortened versions correlated strongly with PSS-14 (PSS-10: r = 0.958; PSS-4: r = 0.814), but agreement was poor (mean difference PSS-14 vs. PSS-10: -0.366 [-8.56 to 7.83], p < 0.001; vs. PSS-4: 5.700 [-14.43 to 25.83], p < 0.001). Reliability was acceptable for PSS-10 (Cronbach's α = 0.704) but low for PSS-4 (α = 0.516).

Conclusion: In the obstetric population, PSS-10 may overestimate and PSS-4 underestimate stress levels compared to PSS-14. Further studies are needed to refine the psychometric properties of shorter versions and clarify the clinical implications of score differences.

Synopsis: Our findings indicate that the current shortened versions of the Perceived Stress Scale (PSS-10 and PSS-4) might not be a suitable alternative to the original version (PSS-14) in the obstetric population.

Background: The relation between maternal mental health and breastfeeding is complex, with breastfeeding often associated with improved well-being.

Objective: This study investigates associations between breastfeeding outcomes and psychological well-being in women with traumatic birth experience (TBE).

Methods: This exploratory secondary analysis utilized data from the PERCEIVE randomized controlled trial, which assessed the effectiveness of early eye movement desensitization and reprocessing (EMDR) therapy on posttraumatic stress disorder (PTSD) symptoms after TBE. Women with self-reported TBE (n = 143) were recruited between 2020 and 2023 from a hospital and midwifery practices in the Netherlands. Breastfeeding status was assessed at two (T0) and nine (T1) weeks postpartum. Outcomes were assessed using validated questionnaires on mother‒infant bonding (PBQ), PTSD symptoms (PCL-5), depression (EPDS), fear of childbirth (W-DEQ-B), and quality of life (WHOQOL-BREF).

Results: Among 143 participants, 126 initiated breastfeeding. At T0, breastfeeding women reported fewer symptoms of mother‒infant bonding difficulties, compared with non-breastfeeding women, p = 0.004. At T1, descriptive analyses found that participants who stopped breastfeeding reported more PTSD and depression symptoms.

Conclusions: Our findings suggest that breastfeeding enhances mother-infant bonding after TBE. The weaker bonding reported in nonbreastfeeding participants, coupled with possible poorer mental health outcomes, underscores the need for targeted interventions to support breastfeeding and bonding in this population.