Journal of Psychosomatic Obstetrics & Gynecology最新文献

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.

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.

The neurobiological mechanisms linking perinatal pain and mood disorders remain unclear. Emotional dimensions of labor pain, particularly unpleasantness, may reflect engagement of limbic pathways shared with affective disorders. This study examined whether prenatal quantitative sensory testing (QST) parameters are associated with the sensory and emotional dimensions of labor pain. Healthy primiparous women were enrolled and followed from third trimester through delivery. Prenatal QST assessed mechanical and thermal thresholds, tolerances, and temporal summation. Labor pain was recorded hourly using a validated electronic diary. Univariable linear regression evaluated relationships between QST measures and labor pain outcomes. Of 164 participants completing QST, , 55 had complete labor pain diaries. Prenatal QST parameters were associated with emotional, but not sensory, aspects of labor pain. Pain unpleasantness was associated with average heat threshold (Coefficient = 40.3, SE = 17.2, p = 0.02), post wind-up pain (Coefficient = -48.9, SE = 25.3, p = 0.06) and post probe pain (Coefficient = -52.7, SE = 26.8, p = 0.06), using a p < 0.1 threshold to identify associations. Although exploratory, these findings suggest that prenatal QST, particularly thermal threshold and central sensitization measures, may help identify individuals at risk for maladaptive labor pain and postpartum mood disorders.

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.

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.

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: This study aimed to determine predictive factors for peripartum depression (PPD).

Methods: We collected pre-natal sociodemographic data, blood markers and psychosocial questionnaires from 237 mothers. We detected the oxytocin (OXT) concentrations in saliva and administered the Edinburgh Postnatal Depression Scale (EPDS) within 1-2 days postpartum. The multivariable logistic regression analysis model was applied to analyze the factors related to PPD at 4 weeks postpartum. A nomogram model was constructed and evaluated.

Results: Multivariable logistic regression showed that OXT levels (OR = 0.984, 95% CI 0.971-0.997), EPDS scores (OR = 1.284, 95% CI 1.154-1.428), and lack of social support (OR = 3.562, 95% CI 1.444-8.784) were predictive factors for PPD (all p < 0.05). A nomogram model was constructed based on these factors. The model's C-index was 0.846 (95% CI 0.777-0.908). The calibration curve indicated good agreement between the predicted probabilities of PPD and the actual probabilities (Hosmer-Lemeshow test p = 0.928). The area under the Receiver Operating Characteristic (ROC) curve was 0.820 (95% CI 0.749-0.891). The results of the decision curve analysis showed that the model had good clinical utility.

Conclusions: The predictive model can be used to identify high-risk parturients of PPD early.

Background: Infertility affects many reproductive-aged couples, with assisted reproductive technology (ART) offering hope but also significant emotional stress due to invasive procedures, hormonal fluctuations, uncertainty, and financial and emotional burden of repeated cycles. Ovarian hyperstimulation syndrome (OHSS), a common ART complication, may further aggravate psychological distress, yet its mental health impact remains understudied.

Methods: This longitudinal study included 1,429 women undergoing their first ART cycle at a reproductive center in China. Psychological assessments were conducted at four critical time points: before ART, post-surgery (early pregnancy), mid-pregnancy and late pregnancy. Validated scales (SAS, CES-D, CPSS, PSQI) measured anxiety, depression, stress, and sleep quality. OHSS was diagnosed per clinical guidelines. Generalized estimating equations (GEEs) assessed changes over time and the moderating effects of OHSS, adjusting for age, education level and income.

Results: OHSS occurred in 9.2% of participants, who tended to be younger and have higher socioeconomic status. Anxiety peaked after surgery and remained elevated; stress declined steadily; sleep quality improved; depression rebounded slightly in late pregnancy. OHSS significantly intensified anxiety and stress but had no clear impact on depression or sleep.

Conclusions: Emotional responses during ART are dynamic. OHSS amplifies anxiety and stress, warranting integrated psychological support within ART programs, particularly for OHSS-affected women.

To determine the prevalence of depression and anxiety among infertile women in Zanzibar and explore their risk factors, infertile female patients were recruited from Mnazi Mmoja Hospital in Zanzibar. The questionnaire survey was adopted. Ordinal univariate and multivariate logistic regression analyses were separately conducted to identify the risk factors associated with depression and anxiety in this sample. Among 330 infertile women, the overall prevalence of depression among patients with infertility was 40.3% and the incidence of anxiety was 66.06%. Older age (odds ratios (ORs): 1.056, 95%CI: 1.004-1.112, p = .035) and low education level (OR: 0.685, 95%CI: 0.475-0.987, p = .042) were the independent risk factors for depression. Low educational level (OR: 0.678, 95%CI: 0.482-0.954, p = .026) and primary infertility (OR: 1.546; 95%CI: 1.028-2.324, p = .036) were the risk factors for anxiety. Low educational level is a risk factor for both depression and anxiety in infertile women. Older age is a risk factor for depression and primary infertility is a risk factor for anxiety.