Background: Investigation of the evidence regarding the association between personality trait and antenatal depression is poor while the evidence regarding marital support, social support and ...antenatal depression is contradictive. The purpose of the present study was to investigate the predictive value of trait anxiety, social support and marital support on antenatal depression. Materials and Methods: The study (running in 2011) involved 165 pregnant women undergoing antenatal screening in a public clinic of Athens. Dependent variables were depression (CES-D), trait anxiety (STAI), marital satisfaction (QMI), and social support satisfaction (SSQ-6). Univariate (t-test, chi-square, One-way ANOVA) and multivariate statistical analyses (linear regression) were performed by SPSS version-20. Results: Previous history of miscarriage, low income and low educational level showed significant associations with antenatal depressive symptomatology at the univariate level (t=2.340, p=0.024, F=3.219, p=0.043; F=4.718, p=0.010, respectively). In addition, low marital satisfaction and high trait anxiety showed significant associations with antenatal depressive symptomatology at the multivariate level (?=-0.328, p=0.007; ?=0.713, p < 0.001, respectively). Conclusion: The importance of antenatal depression has been largely underestimated with the focus of research maintained on postnatal depression. The current study suggests that low marital satisfaction and high trait anxiety, which is a central component of neuroticism, are major risk factors of antenatal depression. Therefore, health care professionals must enhance the implementation of interventions and counseling services for decreasing the levels of trait anxiety and improving the marital relationships during pregnancy. 42 references
Alexithymia and stress are two main psychological factors which affect not only fertility, but also the outcome of assisted reproductive technology treatment.
The primary aim of this study was to ...compare the levels of alexithymia and stress between infertile women undergoing assisted reproductive treatment and women with no fertility issues. The present study aims to: (i) explore the relation between alexithymia and infertility, (ii) investigate whether women with infertility problems show elevated levels of alexithymia compared to women with no fertility problems, and (iii) compare stress levels between women undergoing assisted reproductive technology treatment and women with no fertility problems.
A case control trial was conducted. In total, data from 177 women were collected. The control group consisted of 102 women with no fertility problems, whilst the study group included 75 women undergoing assisted reproductive program. In order to measure the levels of alexithymia and the fertility-related stress among women in both groups and compare the results, validated questionnaires were distributed to every participant. Self-report instruments were used to measure alexithymia (TAS-20), fertility-related stress (FPI), depressive symptomatology (CES-D) and anxiety (STAI). Univariate and bivariate statistical analyses were used.
The mean values of alexithymia, anxiety and depressive symptomatology were higher in women with lower educational background and not within a marriage than in women with higher education and within marriage. Additionally, infertile women had similar levels of alexithymia, anxiety and depressive symptomatology compared to women with no fertility problems.
Results from the present study suggest that infertile women show similar levels of alexithymia and stress in comparison to women who have not been confronted with fertility problems. Our study findings are in accordance with many previous published studies that have concluded that alexithymia rates are similar between group of patients and group of healthy individuals. However, future studies should aim to investigate the prevalence of alexithymia in infertile women with idiopathic and non-idiopathic infertility as well as to assess the levels of alexithymia in infertile women that are not in a fertility treatment.
Invasive prenatal testing, amniocentesis, and chorionic villus sampling offer insights into fetal genetic integrity and health, but carry inevitable minor risks of miscarriage and infection, thus ...complicating the decision-making process for parents. Previous research has revealed several factors that influence the decision to undergo invasive prenatal testing, including demographic, clinical, and psychological aspects, and attitudes towards testing. Informed choice, involving understanding options and aligning them with personal values, is crucial, with healthcare providers playing a key role in offering unbiased information. This systematic review aims to gather and synthesize literature data on the above factors to draw conclusions to aid antenatal care providers in supporting couples to make more informed decisions about their prenatal care. A systematic search was performed in PubMed and PsycInfo databases using the appropriate keywords and an in-depth evaluation of the studies retrieved followed. Finally, 17 articles were eligible for our review investigating the decision-making process of invasive prenatal testing. Factors like maternal age, education, and ethnicity are pivotal during the decision-making process. Clinical characteristics also influence decisions and women with pregnancies categorized as high-risk or those who have undergone fertility treatment display a preference for invasive testing. There seems to be a direct correlation between a woman's willingness to consider pregnancy termination, deeply rooted in psychological and moral stances, and the inclination to undergo invasive testing. In the patient decision-making process, the provision and depth of knowledge are of paramount importance. A comprehensive understanding facilitates more informed decisions. Finally, attitudes towards termination of pregnancy, as another factor influencing the decision-making process, reveal a nuanced landscape where personal beliefs, religious considerations, legal restrictions, and perspectives on disability converge. Within this complex context, religion emerges as an important determinant, shaping individuals' views on the morality of abortion. This review sheds light on the most important factors influencing the couples' consent for invasive prenatal testing. Healthcare professionals must identify which factors are critical in every specific case among several sociodemographic, clinical, emotional, and religious factors. Thus, they will be able to provide balanced and comprehensive information to help couples under this stressful procedure. We advocate for a patient-centered multidisciplinary approach while navigating couples through the intricate landscape of decision-making concerning invasive prenatal testing.
Objective. The aim of this review was to evaluate the literature concerning modes of birth and their impact on the psychological and physical health of women. Methods. A search was conducted in ...PubMed Central and Scopus to identify relevant studies in the literature. The searching phrases were “mode of birth” AND “maternal health”. No date restriction was applied. The languages were restricted to English, German, and Greek. Results. Women giving birth through assisted vaginal births, especially by means of forceps, had a higher risk of dealing with different health problems in the postpartum period. Caesarean sections are not able to prevent long-term problems related to incontinence or sexuality. Conclusions. The mode of birth has an impact on the health of women postpartum and in some cases in the long term. Therefore, the mode of birth should be chosen deliberately for each individual woman, while having in mind the possible risks of the different modes of birth. Additionally, further research is needed to highlight the prevalence of postpartum morbidity.
The aim of this review was to examine studies describing the psychological stress and adjustment in pregnancy after an assisted reproductive technology (ART) treatment. A systematic search of the ...electronic databases was performed. This review considered only quantitative, primary studies in the English language, published during the period 2000-2014 and relevant to the objective. The population of interest was previously infertile pregnant women. Outcome variables were general anxiety, depressive symptoms, pregnancy-specific anxiety, quality of life, self-esteem, pregnancy attitudes and adjustment, and maternal-fetal attachment. Twenty studies met the inclusion and methodological criteria and were included in the review. The review revealed that compared to women who conceive naturally or to general norms, women who conceive after an in vitro fertilization treatment had greater pregnancy-specific anxiety, poorer quality of life, either the same or less depressive symptomatology, the same level of self-esteem, more positive attitudes toward pregnancy demands, and higher levels of maternal-fetal attachment. However, the evidence regarding the general anxiety levels in pregnancy after an ART treatment was inconclusive. Methodological limitations and differences across studies may explain the inconsistencies in their findings regarding the impact of ART. This review provides an insight into psychological reactions and adjustment in pregnancy after an ART treatment.
Worldwide, the cesarean section rate has steadily increased from 6.7% in 1990 to 21.1% in 2018 and is expected to rise even more. The World Health Organization propose the adoption of the Robson ...classification system as a global standard for monitoring, evaluating, and comparing delivery rates. The purpose of the current study is to use the Robson classification system to investigate how, independently of medical factors, the day of the week and time of delivery may be related to the mode of birth. In the sample analysis, we included the records of 8572 women giving birth in one private health facility in Greece. Over 60% of deliveries during the study period were performed by cesarean section, 30.6% by vaginal delivery, and 8.5% of deliveries were performed by operative vaginal delivery. The results of this study indicate that the lowest birth rates are observed on Monday, Saturday, and Sunday. Nulliparous women with no previous cesarean delivery, with a singleton in cephalic presentation ≥37 weeks with spontaneous labor (group 1) are 73% more likely to deliver by cesarean section between 08:00 A.M. and 03:59 P.M. compared to those who give birth between 12:00 A.M. and 07:59 A.M. Also, multiparous women with a single cephalic term pregnancy and one previous cesarean section (group 5.1) are 16.7 times more likely to deliver by cesarean section in the morning compared to overnight deliveries. These results point out two non-clinical variables that influences the CS rate. The Robson classification system was a useful tool for the above comparisons.
Fertility-related stress can negatively impact infertile couples’ quality of life (QoL). Most previous studies have concentrated on the effects of stress and infertility on individual persons, ...especially women, though infertility affects the QoL of both spouses. Our research aimed to investigate the roles of infertility and stress in couples’ quality of life as a single unit. The research sample consisted of 202 spouses, i.e., 101 couples, with a mean age of 39.5 years (SD = 4.9 years) undergoing fertility treatment at Athens Naval Hospital-Assisted Reproduction Unit. Data collection was completed via self-administered questionnaires: the FertiQoL International Questionnaire for measuring the quality of life in infertility and The Demographic Information and Medical History Questionnaire. Data collection was conducted between January and November 2022. Quantitative variables are expressed as mean values (standard deviation) and as median interquartile range, and qualitative variables are expressed as absolute and relative frequencies. Pearson’s (r) and Spearman’s (rho) correlations coefficients were used to explore the association of two continuous variables. Multiple linear regression analysis was used with dependence on the Ferti-QoL’s subscales. The regression equation included terms for participants’ demographics and information from their medical history. Adjusted regression coefficients (β) with standard errors (SE) were computed from the results of the linear regression analyses. All reported p values are two-tailed. Statistical significance was set to p < 0.05, and analyses were conducted using SPSS statistical software (version 22.0). We found that greater anxiety and depression were significantly associated with worse quality of life. Additionally, quality of life, according to Ferti-QoL, was significantly worse in women, participants with a high level of education, those with greater depressive symptoms, and those with greater state scores. Findings of this study highlight the need for implementing interventions of supportive care methods, counseling, stress reduction methods, and improving the fertility-related quality of life of infertile couples.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
Cesarean sections have become the most commonly performed operations around the world. The World Health Organization recommended the use of the Robson classification system as a universal standard to ...establish a joint control system in healthcare facilities. The aim of this study was to implement the Robson classification for the first time in Greece to identify trends in cesarean births and examine the groups of women who are the main contributors to the increasing rates. Moreover, the indicators for cesarean sections will be evaluated as per the Robson classification. In the sample analysis, we included the records of 8572 women giving birth in one private health facility in Greece. A total of 8572 women gave birth during the study period, of which 5224 (60.9%) were cesarean section births and 3348 (39.1%) were vaginal births. In our study, according to the Robson classification, the largest contributors to the overall CS rate were as follows: (a) nulliparous women with a single cephalic term pregnancy, who were either labor induced or delivered by cesarean section before labor-Group 2 (34.6%); (b) multiparous women with a single cephalic term pregnancy and at least one previous cesarean section-Group 5 (30.7%); (c) women with a single cephalic preterm pregnancy-Group 10 (11.7%); (d) women with multiple pregnancies-Group 8 (7.0%). Our study is expected to assist policymakers in Greece in planning further interventions for each subgroup of women in order to reduce the overall CS rate and unnecessary CSs.
Infertility is an issue that affects many parameters peoples' lives, as individuals and as couples. Besides the physical and economic impact of infertility on the couples, there is a significant ...reflection of infertility on their mental health and well-being, which follows them from the moment of the diagnosis up until the end of their treatment.
The aim of this review was to investigate whether psychological factors such as stress, anxiety or depression have an impact on the assisted reproduction treatment outcome and whether the use of supporting methods may help couples to minimize their fertility related stress, anxiety and depression and improve the treatment outcome.
After a systematic search of the electronic databases, fourteen studies were included in this umbrella review. The included studies were systematic reviews and meta-analyses published between January 2015 and February 2020. The population of interest was women, men or couples facing infertility and undergoing fertility treatment. The included studies assessed the relationship between stress and anxiety in couples undergoing fertility treatment and the outcome of the treatment, the psychological state and psychological adjustment of the couples after a negative result and the impact of interventional methods for reducing stress, anxiety or depression on the psychological state of the couples undergoing treatment and their pregnancy outcomes.
This review fails to provide a certain answer to our research hypothesis due to conflicting results in the included studies. However, it has been observed that couples who reported better psychological state or have been treated with an interventional method for psychological support, were more likely to adjust better to the treatment procedure and the outcome as well.
Psychological support and consultation during assisted reproduction treatment is highly recommended by researchers and clinicians.
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