OBJECTIVETo investigate the impact of psychological factors on post-partum hemorrhage and labor duration.

METHODSA questionnaire-based investigation was conducted in 180 healthy single-fetus spontaneous delivery primigravida to understand their psychological status and related factors, and the duration of labor and postpartum hemorrhage were recorded.

RESULTSAnxiety and depression were common in pregnant women and positively related to age, profession, education and social support. The scores of SAS and SDS of postpartum hemorrhage-free group were significantly lower than those in postpartum hemorrhage group, and the duration of first and the second stage was significantly longer in women with high SAS and SDS score than in those with lower scores.

CONCLUSIONSThe mental health status of pregnant women may vary significantly depending on the social community they belong to. Anxiety and depression may increase the risk of postpartum hemorrhage and prolonged labor, so that psychological counseling can be of importance to improve the care in the department of obstetrics.

Adult ; Anxiety ; psychology ; China ; Delivery, Obstetric ; psychology ; Depression ; psychology ; Female ; Humans ; Obstetric Labor Complications ; psychology ; Postpartum Hemorrhage ; psychology ; Pregnancy ; Pregnancy Trimester, Third ; psychology ; Risk Factors ; Surveys and Questionnaires

OBJECTIVE: To investigate the factors related to prenatal anxiety, to observe the effect of prenatal anxiety on the mode of delivery, intrapartum hemorrhage, and to determine the correlation between prenatal anxiety and delivery outcome. METHODS: A total of 300 pregnant women were randomly enrolled from 3 hospitals of Changsha, China. The instruments of this survey were self-designed general information questionnaire, state-trait anxiety inventory (STAI), pregnancy pressure scale, and social support rating scale (SSRS). The delivery outcome was observed. RESULTS: The STAI showed that the state anxiety score of the pregnant women was 43.58±10.79, which was significantly higher than that of usual models (P<0.01). Multiple linear regression analysis showed that those factors, such as the item 2 of pregnancy pressure, relationship with mother-in-law, number of abortions, prenatal health condition, times of attending classes for pregnant women, psychological preparation for childbirth, relationship with mother, relationship with husband, item 3 and item 1 of pregnancy pressure, were all related to prenatal anxiety. The anxiety level between the non-indicative cesarean section group and the normal labor group had statistical difference (P<0.01). Intrapartum hemorrhage of cesarean section in the anxiety group had significant difference compared with the non-anxiety group (P<0.01). CONCLUSION Some factors have contributed to the anxiety level of the pregnant, such as psychological stress, relationship with mother-in-law, number of abortions, prenatal health conditions, times of attending classes for pregnant women, psychological preparation for childbirth, relationship with mother, and relationship with husband. Prenatal anxiety may lead to increased the rate of non-indicative cesarean section and intrapartum hemorrhage during the cesarean section.
Adult ; Anxiety ; etiology ; psychology ; Delivery, Obstetric ; Female ; Humans ; Pregnancy ; Pregnancy Complications ; etiology ; psychology ; Pregnancy Outcome ; Surveys and Questionnaires ; Young Adult

Objective: To investigate the second or third trimester pregnancy-related anxiety on small-for-gestational-age infants. Methods: This study was based on Ma'anshan Birth Cohort Study (MABC), with 3 040 maternal-singleton pairs finally selected for data analysis, from May 2013 to September 2014. The psychological state of pregnancy was evaluated according to a self-developed 'anxiety scale for gestation'. Small-for-gestational-age was defined as 'having birth weight below the 10(th) percentile at a particular gestational week', while large-for-gestational-age infants was defined as 'having birth weight above the 90(th) percentile'. Birth weight between the 10(th) and 90(th) percentile was classified as appropriate-for-gestational age infants. χ(2) test was used to compare the distribution of characteristics in pregnancy among three groups with different birth weights. Multivariate logistic regression models were conducted to evaluate the associations between third trimester pregnancy- related anxiety and birth weight. Results: The incidence rates of small- and large-gestational-age infants were 9.6% and 16.6%, respectively. Difference between women with only one of the second or third trimester pregnancy-related anxiety syndromes and small-for-gestational-age infants showed no statistical significance. Women with both second and third trimester pregnancy-related anxieties might increase the risk of small-for-gestational-age infants (OR=1.39, 95%CI: 1.04-1.87). However, there was no significant difference between pregnancy-related anxiety and large-for- gestational-age infants (OR=1.05, 95%CI: 0.81-1.35) noticed. Conclusion: Women with second and third trimester pregnancy-related anxiety appeared a risk factor for small-for-gestational-age infants.
Anxiety/psychology* ; Birth Weight ; China/epidemiology* ; Cohort Studies ; Female ; Gestational Age ; Humans ; Infant ; Infant, Newborn ; Infant, Small for Gestational Age ; Pregnancy ; Pregnancy Complications/psychology* ; Pregnancy Trimester, Third/psychology*

Objective: To investigate the relationship of pregnancy-related anxiety of pregnant women in second/third trimesters and autism-like behaviors in their offspring at 18 months of age. Methods: Based on a prospective cohort study design, we evaluated the situation of pregnancy-related anxiety of women during second and third trimesters through a Pregnancy-Related Anxiety Questionnaire. Subjects under study were classified into three groups, 1) those with pregnancy- related anxiety during both trimesters, 2) those with pregnancy-related anxiety at one trimester and 3) those without pregnancy-related anxiety in either trimester. When their children were 18 months, autism-like behaviors (ALB) were evaluated, using the part A of Checklist for Autism in Toddlers-23, and then classified into three groups as non-ALB group, minor ALB group and major ALB group. Multi-nominal logistic Regression was used to analyze the relationship of pregnancy-related anxiety with autism-like behaviors. Results: Compared with non-ALB group, children whose mother with pregnancy-related anxiety during both trimesters presented significant higher risk on ALB than children whose mother without pregnancy-related anxiety in these two periods (relative risk, RR=2.43, 95% CI: 1.21-4.86, P=0.012), major factors as pregnant women's IQ and gestational diabetes mellitus, premature delivery and education levels of fosterers on these pregnant women were under control. Our results from the stratified analysis showed: when in the subgroup that mother was the main fosterer of the child, there was an significant increase of risk in children whose mothers with pregnancy-related anxiety during both trimesters (RR=4.22, 95%CI: 1.73-10.32, P=0.002). Conclusion: The association between pregnancy-related anxiety and autism-like behavior was not strong but influenced by the fosterer of the child.
Anxiety/psychology* ; Autistic Disorder/epidemiology* ; China/epidemiology* ; Female ; Humans ; Logistic Models ; Mothers/psychology* ; Pregnancy ; Pregnancy Complications/psychology* ; Pregnancy Trimester, Third ; Pregnancy Trimesters/psychology* ; Pregnant Women/psychology* ; Prospective Studies ; Surveys and Questionnaires

OBJECTIVEThis study aimed to investigate the depression status among high-risk pregnancy women, and to analyze its relevant social and psychological factors.

METHODSA total of 42 high-risk pregnancy women and 40 normal pregnancy women in a teaching hospital in Harbin city were followed up at time points of 32 - 36 weeks pregnancy, one week before labor, one week postpartum, and six weeks postpartum, respectively. During follow-up, the basic situation, social psychosocial factors of pregnancy women were collected and the depression of pregnancy women was measured by self-designed questionnaire and self-rating depression scale. The Edinburgh Postnatal Depression Scale (EPDS) was applied at timepoint of one week postpartum. Single factor analysis and the unconditional multivariate logistic regression were applied for analyzing the on the related social-psychosocial factors among high-risk pregnancy women.

RESULTSThe age of high-risk pregnancy women was (31.0±5.6), and the age of normal pregnancy women was (30.5±3.8) (t=0.169, P>0.05). The results showed that the depression rate in high-risk pregnancy women was 45.2% (19/42), which was 25.0% (10/40) in normal pregnancy women, the difference was significant (χ2=3.671, P=0.045). The depression rates at different time points were 30.9% (13/42), 42.9% (18/42), 23.8% (10/42), 26.2% (11/42) in high-risk pregnancy women respectively, and 25.0% (10/40), 15.0% (6/40), 20.0% (8/40), 17.5% (7/40) in the control group respectively, the difference of the depression rates among groups at one week before labor was significant (χ2=7.680, P<0.01), the difference among groups at 32-36 weeks pregnancy (χ2=0.133, P=0.80), at one week postpartum (χ2=0.174, P=0.79) and at six weeks postpartum (χ2=0.903, P=0.43) were not significant. At one week postpartum and six weeks postpartum periods, the EPDS depression rate were 12.5% (4/32), 30.4% (7/23) in case group respectively, 8.3% (3/36), 22.9% (8/35) in control group respectively, the difference were not significant (χ2=0.319, 0.416, P=0.573, 0.519). There were significantly associations between the depression mood of one week before labor and the depressive symptoms of six weeks postpartum in both groups (r=0.824, 0.677, both P values were <0.05). The risk factors for maternal depression among high-risk pregnancy women were not ready for production (OR=2.73, P<0.01) and fearing of childbirth safety (OR=2.89, P<0.01).

CONCLUSIONThe depression date of high-risk pregnancy was high, especially at the time point one week before labor. Risk factors of maternal depression among high-risk pregnancy were "not ready for production" and "fear of childbirth safety".

Adult ; China ; epidemiology ; Cohort Studies ; Depression ; epidemiology ; psychology ; Depression, Postpartum ; epidemiology ; psychology ; Female ; Humans ; Logistic Models ; Postpartum Period ; psychology ; Pregnancy ; Pregnancy Complications ; epidemiology ; psychology ; Pregnancy, High-Risk ; psychology ; Risk Factors

OBJECTIVETo study the effect of maternal Hashimoto's disease (an autoimmune thyroid disease) on intellectual development of infants.

METHODSFrom July 2001 to June 2003, 21 infants born by mothers suffered from Hashimoto's disease were followed up with provincial neonatal disease screening network system. Their thyroid function was assessed and their mental development was evaluated with Gesell development schedules.

RESULT(1) Among the 21 infants, 8 showed normal thyroid function, 11 showed hyperthyrotropinemia, 2 cases had congenital hypothyroidism, which showed significant differences from those born by healthy mothers. (2) The mental and psychomotor development of infants whose mothers suffered from Hashimoto's disease lagged behind those with the healthy mothers (P <0.05).

CONCLUSIONMaternal Hashimoto's disease may affects infants' thyroid function and mental development.

Adult ; Child Development ; Congenital Hypothyroidism ; etiology ; psychology ; Female ; Hashimoto Disease ; complications ; Humans ; Hyperthyroidism ; congenital ; psychology ; Infant ; Infant, Newborn ; Intelligence ; Intelligence Tests ; Pregnancy ; Pregnancy Complications

OBJECTIVETo analyze the associations between pregnancy-related anxiety and the prevalence of subthreshold autism trait (SAT) in preschool children.

METHODSBaseline data came from the Ma'anshan Birth Cohort Study, a part of the China-Anhui Birth Cohort Study (C-ABCS). All the participants were enrolled among pregnant women who received prenatal health care in 4 municipal medical centers during Oct. 2008 to Oct. 2010. A total of 5 084 pregnant women were recruited at the beginning and 4 669 singleton live births were included until childbirth. The situation about pregnancy-specific anxiety during trimester and third trimester of women were evaluated by Pregnancy-specific Anxiety Questionnaire (PAQ). Between April 2014 and April 2015, the cohort was followed up again, and the Clancy Autism Behavior Scale (CABRS) filled out by parents was used for telling the SAT children from the healthy children among 3 663 preschool children. Univariate and binary regression model was used to estimate associations between the pregnancy-related anxiety during trimester and third trimester and the subthreshold autism trait in children.

RESULTSDuring the pregnancy, the detected rates of women with pregnancy-specific anxiety in trimester and the third trimester were 25.5%(935/3 663), 13.9%(501/3 592) respectively, and the detected rate of maternal pregnancy-specific anxiety in both periods was 7.7%(278/3 592). There were 290 positive children with SAT and the detection rate was 7.9%. After controlling possible confounding factors including children's genders, place of residence, supplement folic acid during pregnancy, preterm birth, exposure to second-hand smoke during pregnancy, the father (mother) cultural levels, the father (mother) nature of work and family income, the results of multinomial logistic regression analysis showed that maternal pregnancy-specific anxiety in trimester was the risk factor for SAT in preschool children (OR=1.51, 95% CI: 1.11-2.04), and there was no association between maternal pregnancy-specific anxiety in the third trimester and SAT in preschool children (OR=1.36, 95% CI: 0.82-2.22). Compared with the single function of maternal pregnancy-specific anxiety in trimester or the third trimester for SAT in preschool children, maternal pregnancy-specific anxiety in both periods presented a joint action that increasing the risk for SAT (OR=2.02, 95% CI: 1.36-2.98).

CONCLUSIONMaternal pregnancy-related anxiety was a risk factor for subthreshold autism trait in preschooler children. Pregnant women should try to keep a good mental state to create a good environment for fetal growth.

Anxiety ; epidemiology ; Autistic Disorder ; epidemiology ; Child ; Child, Preschool ; China ; Cohort Studies ; Dietary Supplements ; Female ; Humans ; Infant, Newborn ; Pregnancy ; Pregnancy Complications ; psychology ; Pregnancy Trimester, Third ; psychology

BACKGROUND: To examine changes in psychological distress prevalence among pregnant women in Miyagi Prefecture, which was directly affected by the Great East Japan Earthquake and tsunami, and compare it with the other, less damaged areas of Japan. METHODS: This study was conducted in conjunction with the Japan Environment and Children`s Study. We examined 76,152 pregnant women including 8270 in Miyagi Regional Center and 67,882 in 13 other regional centers from the all-birth fixed data of the Japan Environment and Children's Study. We then compared the prevalence and risk of distress in women in Miyagi Regional Center and women in the 13 regional centers for 3 years after the disaster. RESULTS: Women in the Miyagi Regional Center suffered more psychological distress than those in the 13 regional centers: OR 1.38 (95% CI, 1.03-1.87) to 1.92 (95% CI, 1.42-2.60). Additionally, women in the inland area had a consistently higher prevalence of psychological distress compared to those from the 13 regional centers: OR 1.67 (95% CI, 1.18-2.38) to 2.19 (95% CI, 1.60-2.99). CONCLUSIONS The lack of pre-disaster data in the Japan Environment and Children's Study made it impossible to compare the incidence of psychological distress before and after the March 2011 Great East Japan Earthquake. However, 3 years after the Great East Japan Earthquake, the prevalence of pregnant women with psychological distress did not improve in Miyagi Regional Center. Further, the prevalence of mental illness in inland areas was consistently higher than that in the 13 regional centers after the disaster.
Adolescent ; Adult ; Disasters ; Earthquakes ; Female ; Humans ; Japan/epidemiology* ; Pregnancy ; Pregnancy Complications/psychology* ; Pregnant Women/psychology* ; Prevalence ; Psychological Distress ; Tsunamis ; Young Adult

PURPOSE: Despite the high prevalence of back pain and its subsequent effects in post-partum women, intervention programs are scarce. The purpose of this study was to test the effects of a back-pain-reducing program on post-partum women who experienced low-back pain during pregnancy. METHODS: A non-equivalent control-group pretest-posttest design was used. Pregnant women who attended a hospital for prenatal check-ups and experienced back pain participated in an intervention program (n=27), and the results were compared with women in a control group from another hospital (n=25). RESULTS: At 8 weeks post-partum, the pain intensity, functional limitations were lower in the intervention group than in the control group. However, differences in mean change of the pain intensity and functional limitations between 36 and 39 weeks of gestation and at 8 weeks post-partum were not statistically significant between the groups. Moreover, the flexibility, post-partum functional status, and post-partum depression did not differ significantly between the groups. CONCLUSIONS: A back-pain-relief program in this study was not effective to reduce the back-pain intensity in post-partum women and to decrease the associated functional limitations. The implications for nursing practice and directions for future research are discussed.
Activities of Daily Living ; Adult ; Back Pain/psychology/*therapy ; Depression, Postpartum/etiology ; Exercise ; Female ; Humans ; Korea ; Patient Education as Topic ; Pregnancy ; Pregnancy Complications/*therapy ; *Prenatal Care ; Puerperal Disorders/*prevention & control

Systemic lupus erythematosus (SLE) predominantly affects women in their reproductive years and has a significant impact on childbearing. We investigated the influence of personal decision on family size among Korean women with SLE and factors that affect the decisions. A case-control study comparing childbearing history and decisions of 112 SLE patients and 135 controls was performed. Women with SLE participating in the Network for Lupus Clinical Research in South Korea and matching controls between ages of 18-45, who are/were married or living with a partner were included. Data regarding socio-demographics, reproductive history, and childbearing decisions were collected through a survey using a standardized questionnaire and medical record review. More women with SLE reported at least one pregnancy (85.7% vs. 71.9%, P = 0.009) or at least one live birth (85.7% vs. 71.9%, P = 0.003) compared with controls. Mean number of pregnancies was significantly higher (2.4 ± 1.6 vs. 1.4 ± 1.3, P < 0.001), and mean number of live births was significantly lower in women with SLE (1.2 ± 0.8 vs. 1.6 ± 0.8, P < 0.001). Significantly more women with SLE made the decision not to have children compared with controls (54.5% vs. 40.7%, P = 0.031), and health-related concerns were the major cause of the decision. Other socio-demographic factors did not influence the decision to limit childbearing in SLE women. The disease-related concerns had significant impact on family size and childbearing decisions among Korean women with SLE.
Adolescent ; Adult ; Asian Continental Ancestry Group ; Case-Control Studies ; Demography ; Family Characteristics ; Female ; Humans ; Live Birth ; Lupus Erythematosus, Systemic/*pathology/psychology ; Odds Ratio ; Pregnancy ; Pregnancy Complications ; Reproductive Behavior/*psychology ; Republic of Korea ; Surveys and Questionnaires ; Tertiary Care Centers ; Young Adult