Journal of Psychosomatic Obstetrics & Gynecology最新文献

Background: Postpartum depression (PPD) is a significant public health concern affecting both mothers and fathers, with paternal well-being being a crucial yet often neglected factor in family mental health.

Objective: The present study investigated the impact of coping strategies training for fathers during pregnancy on couples' PPD.

Methods: A randomized controlled trial was conducted comprising 86 couples experiencing first-time pregnancy (43 per group) in Qazvin, Iran, in 2024. The intervention group received five virtual sessions (45-60 min each) on coping strategies, while the control group received routine prenatal education through their routine prenatal care visits.

Results: Post-intervention, couples' perceived stress scores decreased significantly at the first and second follow-up in the intervention vs. control group. The training significantly increased problem-focused strategy scores by 2.76 points among mothers (standardized mean difference [SMD] = 1.51) and 1.89 points among fathers (SMD = 0.99) compared to controls at one-month postpartum, while reducing emotion-focused coping among mothers by -2.23 points (SMD = -1.03) and among fathers by -1.71 points (SMD = -0.77). PPD scores were significantly lower in the intervention group (mean difference of -5.51 among women and -4.55 among men; both p < 0.001).

Conclusion: Antenatal coping strategies training for fathers can be an effective intervention to mitigate PPD by reducing their stress.

Objective: This study aimed to explore the association between gut microbiota and postpartum depression (PPD) through meta-analysis, providing a basis for effective clinical preventive interventions.​.

Methods: Systematic searches were conducted in English databases (Cochrane Library, Embase, Web of Science, PubMed) for studies published up to April 2025. Literature screening used a double-blind method, and quality assessment was performed with the AHRQ methodological tool evaluating 11 core dimensions. Meta-analysis was conducted using STATA 18.0 software on eligible studies.

Results: Twelve studies were included. α-Proteobacteria was a significant risk factor for PPD (OR = 1.19, 95%CI: 1.11-1.28, p < 0.05). Protective factors included Bifidobacterium (OR = 0.82), Ruminococcaceae (OR = 0.88), Prevotellaceae (OR = 0.89), Veillonellaceae (OR = 0.83), and Clostridia (OR = 0.84). Included studies showed low heterogeneity, with robust results and low publication bias risk.

Conclusion: PPD is closely linked to specific gut microbiota imbalances. α-Proteobacteria may increase PPD risk via inflammatory responses, while beneficial microbiota exert protective effects through neurotransmitter regulation, short-chain fatty acid metabolism, and gut-brain axis modulation. Gut microbiota could serve as a target for PPD intervention and prevention.

Objective: This study aims to systematically analyze the disease burden and epidemiological characteristics of depression among women of childbearing age (WCBA) globally and across regions from 1990 to 2021, as well as explore the current research status and hotspots.

Methods: Data from the 2021 Global Burden of Disease, Injuries, and Risk Factors Study (GBD 2021) were used to examine age-standardized incidence rates (ASIR) and disability-adjusted life years (DALYs) of depression among WCBA by region, age, and socio-demographic index (SDI) level. Relevant literature was retrieved from the Web of Science Core Collection, with bibliometric analyses (temporal-spatial distribution, themes, keywords) performed via VOSviewer and CiteSpace.

Results: In 2021, there were ~133 million new global cases of depression among WCBA, with an ASIR of 6,808.01 per 100,000 population. Incidence rose significantly since 1990, accelerating from 2019 to 2021. High SDI regions had higher ASIR, age-standardized DALY rates (ASDR), and average annual percentage change (AAPC). Globally, incidence peaked at 45-49 years with age growth, but younger WCBA (15-29 years) in high SDI regions had higher ASIR. Bibliometric analysis showed rapid research expansion in recent years, covering pregnancy, risk factors, and obesity, with "polycystic ovary syndrome" and "oxidative stress" as emerging hotspots.

Conclusion: The study highlights the rising global burden of depression among WCBA and disparities across regions, socioeconomic backgrounds, and age groups, providing scientific evidence for targeted public health interventions.

Objective: This meta-analysis aimed to assess the effectiveness of mindfulness-based interventions on depression, anxiety, stress, mindfulness, and neonatal outcomes in randomized controlled trials.

Methods: A systematic search of domestic and international databases was conducted to identify RCTs evaluating mindfulness-based interventions. Outcome measures included the Edinburgh Postnatal Depression Scale (EPDS), Self-Rating Depression Scale (SDS), Self-Rating Anxiety Scale (SAS), Perceived Stress Scale (PSS), Five Facet Mindfulness Questionnaire (FFMQ), and Apgar score. Statistical analysis involved calculating standardized mean differences (SMD) and assessing heterogeneity using I² values.

Results: A comprehensive literature search identified 790 articles, from which 9 studies (including 1024 participants) were included. No significant effect was found for depression (EPDS: SMD = -1.63, p > 0.05) or stress (PSS: SMD = -1.92, p > 0.05). Significant improvements were observed in anxiety (SAS: SMD = -0.64, p < 0.05) and neonatal outcomes (Apgar score: SMD = 0.87, p < 0.05). Mindfulness showed no significant difference (FFMQ: SMD = 2.27, p > 0.05). High heterogeneity was observed for most outcomes.

Conclusion: Mindfulness-based interventions significantly reduce anxiety and improve neonatal outcomes. However, their effects on depression, stress, and mindfulness require further investigation due to high heterogeneity across studies.

Background: A gynecological examination is a crucial component of gynecological care. Many women undergoing examinations may experience anxiety, particularly when insufficient precautions are taken to ensure bodily privacy.

Objective: This study aimed to assess women's perspectives on bodily privacy during gynecological examinations and to investigate the correlation between body privacy and anxiety levels.

Methods: A single-center cross-sectional study was conducted, enrolling 270 women who underwent gynecological examinations. Three self-report measures were utilized to assess attitudes, perceptions of bodily privacy, and anxiety after examination.

Results: The findings revealed that 74.1% of women reported feelings of shame and embarrassment, and nearly 60% experienced stress. A strong positive correlation was observed between privacy scores and anxiety (r = 0.660, 95% CI: 0.566-0.738, p < 0.001). Multiple regression analysis indicated that five variables explained 44.7% of the variance in anxiety (R²adj = 0.447, p < 0.001), with privacy being the sole variable demonstrating a significant association (β = 0.649, 95% CI:0.368-0.489, p < 0.001).

Conclusions: These results suggest that, from a woman's perspective, the high importance placed on bodily privacy contributes to increased anxiety during gynecological examinations. Therefore, it is paramount to prioritize patients' needs and expectations. Furthermore, educational programs and the implementation of measures, such as training caregivers to increase ethical sensitivity regarding patient privacy, could prove highly beneficial.

Background: Pain Management Programmes (PMPs) are recommended for chronic pain, but their effectiveness for endometriosis-associated chronic pelvic pain (CPP) remains unclear. This study evaluates outcomes from a specialised, multidisciplinary Pelvic Pain Management Programme (PPMP) for women with chronic pelvic pain. It compares results between women with and without an endometriosis diagnosis.

Methods: Validated patient-reported outcome measures (PROMs) capturing pain, physical function, and psychological wellbeing were collected at baseline (T1), post-treatment (T2), and 6-month follow-up (T3)for women completing a Pelvic PMP (September 2014 - June 2019). Outcomes were compared between women with and without endometriosis.

Results: At T2, clinically significant change was observed across pain (distress 45%), physical function (disability 24%, activity capacity 27-31%), psychological outcomes (self-efficacy 55%, depression 42%, acceptance 53% and catastrophising 43%). At T3, gains were maintained or increased pain (distress 53%), physical function (disability 42%, activity capacity 42-44%) and psychological outcomes (self-efficacy 68%, depression 56%, acceptance 64% and catastrophising 63%). Outcomes were comparable irrespective of diagnosis across all time points.

Conclusions: The specialised PPMP produced meaningful improvements irrespective of diagnosis, suggesting shared central and psychosocial pain mechanisms. Findings support the need for equitable access to PPMPs and for future multicentre research evaluating long-term sustainability.

Background: Pregnancy loss may trigger complicated grief. Self-judgment and pressure to abort contrary to one's preferences may increase the risk and severity of complicated grief reactions.

Method: A topic-blind survey was offered to a random panel of 41- to 45-year-old American females. Of 2361 eligible respondents, 1925 (82%) usable surveys were collected.

Results: The highest levels of grief were associated women whose abortions were self-reported as inconsistent with their values and preferences. The grief scores of women who had natural pregnancy losses were most similar to those of the women who had unwanted abortions. Higher levels of grief were associated with self-judgement, intrusion, pressure to abort, immediate or persistent negative reactions, and reactions that interfered more with work, relationships and other activities. Nearly 40% reported that the worst of their negative feelings attributed to their pregnancy losses continue and persist today.

Conclusions: Compared to a natural pregnancy loss, persistent and complicated grief following an induced abortion may be more or less common depending on the degree that the abortion was consistent, or inconsistent, with a woman's own values and preferences. With 40% reporting persistent negative emotions, even 20 years later, more interventions and resources are warranted.

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.

Whilst the negative impact of fear of childbirth (FOC) is well established, there is limited understanding of the factors that reduce it. This study, aimed to explore the relationship between positive mental well-being, childbirth self-efficacy, and FOC during pregnancy through a Salutogenic lens. Using a cross-sectional design, 88 pregnant women recruited from a public hospital in North East Scotland completed an online survey including the Warwick Edinburgh Mental Well-Being Scale (WEMWBS), Childbirth Self-Efficacy Inventory (CBSEI), and Wijma Delivery Expectancy/Experience Questionnaire (W-DEQ). The sample scored a mean of 50.36 on WEMWBS, 84.63 for efficacy-expectancy, 127.00 for efficacy-outcome on CBSEI, and 62.19 on W-DEQ. Twelve per cent exhibited a severe FOC. FOC was negatively correlated with mental well-being, childbirth self-efficacy expectancy, and self-efficacy outcome. Multiple regression analysis indicated that higher mental well-being (β = -0.39, p < 0.001) was the strongest predictor of lower FOC. The findings highlights the important role of positive mental well-being and childbirth self-efficacy in reducing FOC, and suggest a need for antenatal education targeted at mastering childbirth techniques and enhancing positive emotions, sense of purpose, and meaning. These findings align with global health priorities by emphasizing the importance of antenatal care that supports and promotes both physical and mental well-being.