Pregnancy outcomes and anxiety in nulliparous women

Gimbel, Lauren A; Blue, Nathan R.; Allshouse, Amanda A.; Silver, Robert M.; Gimbel, Bruce; Grobman, William A.; Haas, David M.; Simhan, Hyagriv N.; Mercer, Brian M.; Hatfield, Tamera

doi:10.1080/14767058.2021.1998441

Cited by 7 publications

(3 citation statements)

References 45 publications

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“…Серед ускладнень у них -передчасні пологи, маленька дитина для гестаційного віку, відшарування плаценти, гіпертензивні розлади під час вагітності. Факт лікування тривожності не зменшує ризиків ускладнень, проте такі жінки рідше потребують лікування у відділеннях інтенсивного догляду [25].…”

Section: оглядиunclassified

Psychoemotional disorders in pregnant women and women in childbirth. Analytical review and practical aspects of the problem in Ukraine

Ischenko

2023

UJPP

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Psychoemotional disorders during pregnancy significantly affect the health of the mother and fetus. Purpose - to provide an analytical review of available sources on the impact of psycho-emotional stress disorders in pregnant women on the health of the mother and fetus to improve the provision of medical care to this population category. Among the negative consequences, the consequences in the mental and medical spheres should be divided. In the medical field, gestational complications are noted, for example, premature birth, obstetric complications, the most common of which are preeclampsia, eclampsia, anemia, gestational diabetes, placenta previa, vaginal bleeding, and consequences for the fetus, most often low weight and developmental delay in cardiovascular, nervous system, organs of vision. Among the psycho-emotional effects on the mental sphere, groups are divided: exacerbation of an existing disease, the appearance of new disorders, most often post-traumatic stress disorder, and negative consequences due to changes in behavior, for example, child care and the use of psychoactive substances. It has been proven that negative perinatal consequences occur precisely in the presence of stress disorders, and are less pronounced, for example, in depression. During the war in Ukraine, Ukrainians were exposed to excessive stress. This is especially noticeable among vulnerable sections of the population, such as pregnant women. This category of persons is in the field of action of obstetrician medical workers, who often lack time to properly assess mental disorders and refer patients to psychiatric specialists. Another problem is stigma - a prejudiced attitude towards specialists in the field of health care. Currently, there is quite limited data on psychoemotional disorders in pregnant women and women in labor. This literature review provides data from world literature and describes the peculiarities of the organization of assistance in the field of health care in Ukraine during the war. No conflict of interests was declared by the authors.

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Section: оглядиunclassified

Psychoemotional disorders in pregnant women and women in childbirth. Analytical review and practical aspects of the problem in Ukraine

Ischenko

2023

UJPP

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“…When untreated, maternal anxiety and sleep problems during pregnancy pose risks to both the mothers’ and infants’ health. Reported negative consequences of maternal anxiety and sleep problems include preterm birth, small for gestational age, placental abruption, and other gestational conditions; most of which are also predictors of poor neurodevelopmental outcomes for the child [3, 5].…”

Section: Introductionmentioning

confidence: 99%

Maternal Benzodiazepines and Z-Drugs Use during Pregnancy and Adverse Birth and Neurodevelopmental Outcomes in Offspring: A Population-Based Cohort Study

Chan¹,

Gao²,

Howard³

et al. 2023

Psychother Psychosom

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Introduction: The use of benzodiazepines and/or z-drugs in women of childbearing age has increased. Objective: The aim of the study was to evaluate whether gestational benzodiazepine and/or z-drug exposure is associated with adverse birth and neurodevelopmental outcomes. Methods: A population-based cohort including mother-child pairs from 2001 to 2018 in Hong Kong was analysed to compare gestationally exposed and nonexposed children on the risk of preterm birth, small for gestational age, autism spectrum disorder (ASD), and attention-deficit/hyperactivity disorder (ADHD) through logistic/Cox proportional hazards regression with a 95% confidence interval (CI). Sibling-matched analyses and negative control analyses were applied. Results: When comparing gestationally exposed with gestationally nonexposed children, the weighted odds ratio (wOR) was 1.10 (95% CI = 0.97–1.25) for preterm birth and 1.03 (95% CI = 0.76–1.39) for small for gestational age, while the weighted hazard ratio (wHR) was 1.40 (95% CI = 1.13–1.73) for ASD and 1.15 (95% CI = 0.94–1.40) for ADHD. Sibling-matched analyses showed no association between gestationally exposed children and their gestationally nonexposed siblings for all outcomes (preterm birth: wOR = 0.84, 95% CI = 0.66–1.06; small for gestational age: wOR = 1.02, 95% CI = 0.50–2.09; ASD: wHR = 1.10, 95% CI = 0.70–1.72; ADHD: wHR = 1.04, 95% CI = 0.57–1.90). Similarly, no significant differences were observed when comparing children whose mothers took benzodiazepines and/or z-drugs during pregnancy to children whose mothers took benzodiazepines and/or z-drugs before but not during pregnancy for all outcomes. Conclusions: The findings do not support a causal relationship between gestational benzodiazepines and/or z-drugs exposure and preterm birth, small for gestational age, ASD, or ADHD. Clinicians and pregnant women should carefully balance the known risks of benzodiazepines and/or z-drugs use against those of untreated anxiety and sleep problems.

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“…Pregnancy is a high-risk period for the onset or exacerbation of many mental health concerns, including anxiety and depression, which occur in approximately 20% of pregnancies. [1][2][3][4] Left untreated, anxiety and depression are associated with adverse effects for pregnant persons, newborns, and infants such as low birth weight, prematurity, 2,[4][5][6] poor infant attachment, low maternal confidence, postpartum depression, and lower rates of breastfeeding. 7,8 Suicide, a potential outcome of untreated depression, is a significant cause of pregnancy-associated death.…”

Section: Introductionmentioning

confidence: 99%

Antidepressant use During Pregnancy: Knowledge, Attitudes, and Decision‐Making of Patients and Providers

Eakley

Lyndon

2022

J Midwife Womens Health

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Introduction: Despite the risks associated with untreated perinatal depression and anxiety, both patients and clinicians are less likely to follow evidence-based guidelines including the use of antidepressants during pregnancy. The aim of this integrative review was to describe the perspectives of both patients and prescribing health care providers regarding the use of antidepressants during pregnancy. Methods:We performed a literature search in PubMed, CINAHL, ProQuest Central, and PsychINFO. Inclusion criteria were English language, original peer-reviewed research published within the previous 10 years that described perspectives regarding the use of antidepressants of pregnant patients or prescribing providers during pregnancy. Studies were excluded if their focus was on screening practices, treatment guidelines, or evaluation of decision support tool; medication or treatment broadly; bipolar disorder or serious mental illness; or they did not provide patient or provider perspective. This review was limited to professionals with scopes of practice that include prescriptive authority (eg, physicians, advanced practices nurses, midwives). Included articles were critically appraised and read in an iterative process to extract methodological details and synthesize findings.Results: Nineteen studies met criteria for inclusion and varied by design, sample, and quality. Together, the reviewed articles suggest that patients and prescribing providers hold a range of beliefs regarding the safety of antidepressant during pregnancy. Patients and providers appear to value different sources of information and varied in awareness of the negative impacts of untreated depression and anxiety during pregnancy. Many patients report dissatisfaction with available information and distress throughout the decision-making experience. Notably, patients and providers had incongruent perceptions of the others' experience.Discussion: Inconsistencies between knowledge, attitudes, and decision-making highlight the need for improved dissemination of evidence-based treatments and support increased training for psychopharmacology during pregnancy. Efforts to reduce patient distress regarding their decisions, such as adequate time and information, are indicated.

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Pregnancy outcomes and anxiety in nulliparous women

Cited by 7 publications

References 45 publications

Psychoemotional disorders in pregnant women and women in childbirth. Analytical review and practical aspects of the problem in Ukraine

Psychoemotional disorders in pregnant women and women in childbirth. Analytical review and practical aspects of the problem in Ukraine

Maternal Benzodiazepines and Z-Drugs Use during Pregnancy and Adverse Birth and Neurodevelopmental Outcomes in Offspring: A Population-Based Cohort Study

Antidepressant use During Pregnancy: Knowledge, Attitudes, and Decision‐Making of Patients and Providers

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