Journal of Psychosomatic Obstetrics & Gynecology最新文献

This study compared the efficacy of the Wijma Delivery Expectancy/Experience Questionnaire (W-DEQ) and the Childbirth Attitudes Questionnaire (CAQ) in assessing fear of childbirth (FOC) among hospitalized pregnant women, aiming to identify a practical screening tool. A total of 184 pregnant women were recruited from the Northwest Women's and Children's Hospital using convenience sampling. Data were collected through the General Demographic Questionnaire, Fear of Birth Scale (FOBS), W-DEQ, and CAQ. Using the FOBS as a reference, the diagnostic performance of the W-DEQ and CAQ was evaluated via receiver operating characteristic curves and Bayesian discriminant analysis. The area under the curve (AUC) for the W-DEQ (0.888) was significantly higher than that of the CAQ (0.789; Z = -2.189, p < 0.05). Optimal cutoff values were 80.5 for the W-DEQ and 31.5 for the CAQ. Cross-validation revealed accuracy rates of 75.6% and 70.7%, respectively. The incidence of FOC, as assessed by the W-DEQ, CAQ, and FOBS, was 29.9%, 43.9%, and 37.2%. Both tools demonstrated good reliability and validity, but the W-DEQ showed superior performance. It is recommended as the preferred tool for assessing FOC among pregnant women in China due to its comprehensive evaluation capacity.

This randomized controlled trial explored the feasibility and preliminary effectiveness of integrating mindfulness-based body scan (MBBS) interventions into multimodal pelvic floor physiotherapy for vulvodynia treatment. Participants received ten sessions of standardized physiotherapy. The mindfulness intervention group was instructed to additionally perform home-based audio-file guided MBBS five times a week. The primary study endpoint was feasibility. The effect on pain intensity, pain characteristics and sexuality were assessed with Numeric Rating scales (NRS), the McGill-Melzack Pain Questionnaire (MPQ), the Female Sexual Distress Scale (FSDS) and Female Sexual Function Index (FSFI) and digital assessment of pelvic floor. Thirty-three women were randomized and completed the end-of-treatment assessments and 26 (79%) attended the follow-up. 15 of 17 participants of the intervention group (88%) performed the body scans more than ten times and the feasibility criteria were achieved. The intervention group showed significantly better improvements in NRS of average pain, MPQ subscales and FSDS total score. Pelvic floor assessment showed a significant improvement of myofascial pressure points over time with no difference between study groups. Integration of MBBS trainings into multimodal pelvic floor physiotherapy for vulvodynia is feasible and well accepted and may improve pain reduction and sexual function.

Background: Human papillomavirus (HPV) is one of the most prevalent sexually transmitted infections (STIs). Individuals with depression face higher risks of other STIs; however, the relationship between depression and HPV remains unclear.

Objective: To investigate the association between depression and HPV among American women.

Methods: Data were sourced from the National Health and Nutrition Examination Survey (NHANES) conducted from 2005 to 2016. We employed weighted logistic regression models to explore the relationship between depression scores, depressive states, depression severity and HPV infection risk. The stability of intergroup relationships was assessed by subgroup analyses.

Results: Seven thousand and twenty-four American women were included, including 3138 HPV-positive individuals. Logistic regression analyses revealed a significant positive correlation between increased depression scores (OR = 1.02, 95% CI: 1.00-1.03, p = .009) and the presence of depression (OR = 1.33, 95% CI: 1.07-1.65, p = .010) with HPV infection risk. The HPV infection risk was elevated in the moderate depression group (OR = 1.32, 95% CI = 1.02-1.70, p = .036). Subgroup analyses indicated that marital status, body mass index and sexual activity frequency interacted with the relationship between depression and HPV (p-interaction < .05).

Conclusions: Our findings highlight an association between depression and increased HPV infection risk among American women, underscoring the importance of enhancing HPV protection awareness among women with depression.

Fear of childbirth (FOC) is associated with adverse outcomes, for the expecting woman as well as for her baby. In order to prevent and treat FOC, it is important to understand the psychological processes involved. Two potential key processes are intolerance of uncertainty and pain catastrophizing. The aim of this cross-sectional study was to explore intolerance of uncertainty and pain catastrophizing in pregnant individuals with severe vs. low/moderate FOC, and potential differences between nulliparas and multiparas. The sample of 332 individuals filled out a range of questionnaires, and were categorized as severe (n = 66) and low/moderate (n = 266) FOC. The results showed that participants with severe FOC (Wijma Delivery Expectancy Questionnaire, W-DEQ ≥85) reported higher levels of intolerance of uncertainty and pain catastrophizing than participants with low/moderate FOC. We did not find any significant differences between nulliparas and multiparas. Noteworthy, levels of pain catastrophizing in the severe FOC group were similar to those reported in chronic pain samples. Although we cannot draw any conclusions about causality or direction of proposed links, these findings warrant a need for identifying and developing treatment strategies to target intolerance of uncertainty and pain catastrophizing, in both nulliparas and multiparas with high levels of FOC.

Shared decision-making (SDM) is widely recognized for its benefits in patient-centered care, yet its application in the treatment of pelvic organ prolapse (POP) presents notable challenges. This study explores healthcare professionals (HCPs) experiences with SDM, identifying barriers and facilitators to its implementation. Twelve HCPs involved in POP management were interviewed. The data was analyzed using reflexive thematic analysis, revealing four key themes: (1) Experiences with SDM, (2) Differences in HCP perspectives, (3) Patient characteristics, and (4) Information provision. While HCPs value SDM, they face challenges including limited patient health literacy, time constraints, and differing patient expectations. Key facilitators included clear, tailored communication, structured patient education, and effective multidisciplinary collaboration. This study emphasizes the importance of preparing patients for active participation in SDM by enhancing health literacy and improving communication. Overcoming barriers and using facilitators can enhance SDM quality in clinical practice, improving patient outcomes and satisfaction in POP care.

Objective: This study evaluated the relationship between treatment for depression and anxiety in pregnancy and the risk of obesity.

Design: Multivariate logistic regression analysis, nested case control study design.

Setting: Births occurring 2008-2022 at an outer-suburban, lower socioeconomic maternity hospital in Australia. Population: 75,308 eligible births. Main outcome measures: BMI ≥ 30 (obesity), BMI ≥ 35 (severe obesity/obesity class II and III).

Results: In this analysis, we found an adjusted OR of 1.56 of BMI ≥ 30, p < .000 with CI (1.35-1.80) in women taking antidepressants in pregnancy, OR 1.56 of BMI ≥ 35, p < .000, CI (1.31-1.84). Within this dataset, a cohort of 7559 women with a history or current diagnosis of depression or anxiety were found; adjusted OR of 1.40 of BMI ≥ 30, p < .000, CI (1.22-1.60) in women within this group taking antidepressants. Rates of severe obesity were similar in this cohort, BMI ≥ 35; OR 1.39, p < .000; CI 1.18-1.62).

Conclusions: These results suggest an increase in rates of obesity in women taking antidepressants in pregnancy not accounted for by other risks for obesity which might accrue from current mental ill-health or other cohort effects such as genetic vulnerability or lifestyle factors. This outcome is important in relation to the care of pregnant women with depression and anxiety. In view of current high rates of prescribing of antidepressants in pregnancy and the postpartum, this research may help inform clinician decision-making for women at risk of obesity in pregnancy.

Background: With rapid social changes and evolving fertility policies in China, women experience significant fertility anxiety. However, existing tools focus on a single dimension, lacking a comprehensive measure tailored to Chinese women.

Methods: Based on cost-utility theory, policy cycle theory, social support theory, gender role theory, and conservation of resources theory, this study developed and validated the Fertility Anxiety Scale for Chinese Women (FAS-CW) through qualitative interviews and surveys.

Results: The scale, comprising cognitive and emotional anxiety, demonstrates strong reliability and validity.

Conclusion: The FAS-CW provides a reliable tool for assessing fertility anxiety among Chinese women and contributes to the understanding of its multidimensional structure.

Implications: The scale can support clinical practice by helping identify high-anxiety individuals and guide policy evaluation related to fertility and childcare. It also provides a basis for comparative research in other low-fertility contexts.

Background: Polycystic Ovary Syndrome (PCOS) affects 8-13% of females. US population-based research on PCOS limited. We compare PCOS knowledge and describe common PCOS symptoms in those with and without PCOS.

Methods: An internet panel survey of 382 (200 with PCOS) US females 18-30 years was administered. PCOS knowledge was assessed using 20 items classified as correct or incorrect summed to create a knowledge score. Respondents reported experience of each of 8 common PCOS symptoms. Body image and depression were assessed using the Body Image Measurement Scale and PHQ-9.

Results: The sample had a mean age of 26.2 years and was majority White, non-Hispanic (76.0%). Those with PCOS demonstrated better PCOS knowledge (mean score 10.7 vs. 9.8; p = 0.029) and were more likely to identify the cardiometabolic sequelae than those without PCOS. More than 50% of respondents with PCOS reported each of the common symptoms. Those with PCOS reported significantly poorer body image (mean 3.71 vs. 3.31; p < .0001) and higher depression symptoms (mean 14.88 vs. 10.69; p < .0001).

Conclusion: This study adds to the relatively small body of research on PCOS conducted among US females and highlights that knowledge about PCOS in US young adult females is low, regardless of PCOS status.

The aim of this study was to apply complexity theory to explain and understand how risk factors combined in complex ways, eventually leading to a high prevalence of depressive symptoms among pregnant women. We also aimed to evaluate whether depressive symptoms affected delivery approach. The study had a longitudinal design and was conducted between May and September 2017. A total of 481 pregnant women were recruited to participate and completed closed-end surveys at two distinct times: during prenatal care at the hospital after 26 weeks of pregnancy and 1 to 4 weeks after delivery. This study identified eleven different pathways that led to an increase in depressive symptoms. Each pathway differentiated the effects of different influencing factors. Among the 481 pregnant women, 128 (26.6%) had cesarean deliveries without medical indications. Although depressive symptoms could affect delivery approach, it was not the most important factor. Surprisingly, the first production emerged as the key factor determining delivery mode. This study was innovative in that it examined which factors and which combinations of factors were necessary for the development of depressive symptoms. Additionally, this study provided a better understanding of the mechanisms underlying the choice of cesarean section without medical indications.