Optimizing Psychological Health Across the Perinatal Period: An Update on Maternal Cardiovascular Health: A Scientific Statement From the American Heart Association

Journal of the American Heart Association, Journal Year: 2025, Volume and Issue: unknown

Published: Feb. 25, 2025

Perinatal psychological health conditions (eg, perinatal depression, anxiety) are some of the leading causes maternal mortality in United States and associated with adverse pregnancy outcomes, long‐term cardiovascular intergenerational effects on offspring neurodevelopment. These risks underscore importance addressing as a key determinant health. Thus, it is vital to recognize spectrum provide guidance for both patients clinicians screening management options across period. In this scientific statement from American Heart Association, we redefine include health, robust evidence association highlight social environmental underpinnings, finally, offer about how integrate into specific focus period (ie, through 1 year postpartum). We also describe opportunities creating care delivery models that recurrently address cardio‐obstetric care, using behavioral pharmacological interventions, an emphasis better integration longer postpartum follow‐up, evaluating comparative effectiveness these stakeholder partners.

Language: Английский

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Exploring trauma-informed prenatal care preferences through diverse pregnant voices

BMC Health Services Research, Journal Year: 2025, Volume and Issue: 25(1)

Published: March 27, 2025

There are no existing standards of care for integrating trauma-informed into prenatal in a patient-centered manner. This study aims to explore preferences pregnant people regarding care, providers, resources, and trauma inquiry response. utilized qualitative descriptive design as part longitudinal randomized controlled pilot trial. It was conducted at university-affiliated federally qualified health center multi-specialty clinic large metropolitan area among purposive sample 27 racially/ethnically diverse individuals. Eligible participants aged ≥ 18 between 10 24 weeks gestation were identified via medical charts recruited person by email. Interview-administered structured interviews provided the post-intervention assessment. Qualitative data collection extended from June 2023 through April 2024. We performed inductive analysis generate codes identify emergent themes derived participant responses. Participant interpreted lens six principles. Participants had an average age (M = 28, SD 4.5; range 19–38) years old. Of interviewed, 21 self-identified Black (77.8%) 5 Hispanic (18.5%). Three optimal preferences, including: (1) Agency Choice; (2) Emphasis on Maternal Child Wellbeing; (3) Universal Personalized Provision Information Resources. wanted their providers be Familiar Experienced; Personally Engaging; Emotionally Safe Supportive. additional focused patient addressing during visits, Value Addressing Trauma; Approaches Asking about Sensitive Empathic Inquiry Response. Patient this underscore need address psychological needs patients deliver high quality, comprehensive that is culturally-responsive. registered ClinicalTrials.gov ID: NCT05718479 08-02-2023.

Language: Английский

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Risk factors for food insecurity and association with prenatal care utilization among women who took opioids during pregnancy and unexposed controls

BMC Pregnancy and Childbirth, Journal Year: 2025, Volume and Issue: 25(1)

Published: April 4, 2025

Language: Английский

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A Pilot Randomized Controlled Trial of a Multimodal Wellness Intervention for Perinatal Mental Health

Journal of Midwifery & Women s Health, Journal Year: 2025, Volume and Issue: unknown

Published: April 10, 2025

Introduction Evidence has shown that pregnant women who report high rates of psychologic stress are at increased risk for perinatal complications. We conducted a pilot randomized controlled trial (RCT) multimodal wellness intervention (MWI) composed motivational interviewing and mental skills to examine feasibility acceptability MWI compare changes in subjective measures psychological socioemotional outcomes among through early postpartum. Methods Between March 2023 February 2024, eligible individuals aged 18 older, 10 24 weeks’ gestation, English‐speaking were recruited from university‐affiliated federally qualified health center (FQHC) large metropolitan area. Forty participants 1:1 4 weekly individual (45‐60 minutes) virtual sessions or prenatal education control. Patient‐reported distress indicators interview‐administered baseline, postintervention, 2 months 6 weeks This study was registered ClinicalTrials.gov (NCT05718479). Results The mean (SD) age 27.9 (5.7) years. Most identified as Black African American (70%) women, with three‐quarters being seen services an FQHC. number completed 3.3 (1.3), 75% completing all sessions. All reported satisfied the intervention, 73% very 86.7% found program useful. versus demonstrated medium‐ large‐sized effects on reducing anxiety mild minimal symptoms resulted significantly health‐promoting behaviors (eg, exercise, sleep, nutrition) follow‐up timepoints. Conclusions Findings suggest feasible acceptable, addition demonstrating larger reductions greater increases compared women. Further exploration efficacy would require sample size detect more precise functioning during period.

Language: Английский

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Association Between Maternal Adverse Childhood Experiences and Offspring Internalizing and Externalizing Behavior

Obstetrics and Gynecology, Journal Year: 2025, Volume and Issue: unknown

Published: May 15, 2025

OBJECTIVE: To estimate the association between historical maternal adverse childhood experiences (ACEs) and offspring internalizing (ie, depression, anxiety, social withdrawal) externalizing aggression, conduct disorders, attention-deficit/hyperactivity disorder) behavior symptoms not explained by ACEs. METHODS: This was a retrospective cohort study using adversity data collected from nationally representative sample of mothers enrolled in National Longitudinal Survey Youth 1979 their born 1970 2014 who were separate Child Young Adult cohort. The exposure ACEs categorized to assess dose-dependent associations (zero, one, two, or three more). outcomes assessed report age 4 14 years symptom scores Behavior Problem Index derived Checklist. We fit marginal structural models with robust SEs independent while adjusting for other selected covariates. RESULTS: Among 5,445 2,792 mothers, 60.0% reported no ACEs, 23.2% one ACE, 10.4% two 6.5% more Mothers frequently gave birth at younger ages, less married, had lower educational attainment. In adjusted independently associated 1.81- (95% CI, 0.87–2.75), 2.07- 0.71–3.43), 2.68- 1.00–4.36) point increase score 1.78- 0.83–2.73), 3.08- 1.74–4.41), 3.30- 1.47–5.13) score, respectively, suggesting dose-response association. CONCLUSION: Maternal elevated These findings support utility ACE screening prenatal period inform early interventions, services, referrals promote health potentially disrupt intergenerational transmission adversity.

Language: Английский

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Evidence and best practices for trauma-informed care in gynecologic oncology patients

International Journal of Gynecological Cancer, Journal Year: 2024, Volume and Issue: 34(7), P. 1077 - 1088

Published: May 30, 2024

Diagnosing, treating, and managing gynecologic cancer can lead to significant physical emotional stress, which may have lasting effects on a patient's overall health quality of life. The symptoms cancer, such as pain, discomfort, loss function, also contribute distress anxiety. Further, the diagnosis, treatment, surveillance be traumatic due need for invasive exams procedures, especially in women with history sexual assault or other experiences.Women experience various psychological symptoms, including anxiety, depression, post-traumatic stress disorder, fear recurrence. Trauma-informed care is an approach healthcare that emphasizes recognition response impact trauma trauma-informed acknowledges prior experiences affect mental system unintentionally re-traumatize patients.Implementation improve patient outcomes, increase satisfaction care, reduce risk re-traumatization during treatment follow-up care. Therefore, oncology providers should become familiar principles practices implement screening tools identify patients who benefit from additional support referrals services. This review will explore importance its outcomes. we discuss evidence-based strategies

Language: Английский

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Mother–Infant Dyadic Synchrony and Interaction Patterns After Infant Cardiac Surgery

Journal of Pediatric Psychology, Journal Year: 2023, Volume and Issue: 49(1), P. 13 - 26

Published: Oct. 23, 2023

Abstract Objective Parents and their infants with complex congenital heart disease (CHD) face relational challenges, including marked distress, early separations, infant hospitalizations medical procedures, yet the prevalence of parent-infant interaction difficulties remains unclear. Using a standardized observational paradigm, this study investigated mother-infant dyadic synchrony, interactional patterns, associated predictors in pairs affected by CHD, compared typically-developing pairs. Methods In prospective, longitudinal cohort study, mothers requiring cardiac surgery before age 6-months (n=110 pairs) an age- sex-matched Australian community sample (n=85 participated filmed, free-play at 6.9±1.0 months. Mother-infant maternal risk were assessed using Child-Adult Relationship Experimental (CARE) Index. Maternal 32 weeks gestation, 3- postpartum. Results Most interactions classified as “high risk” or “inept” (cardiac: 94%, control: 81%; p=.007). Dyadic synchrony (p<.001), sensitivity (p=.001), cooperativeness (p=.001) lower for than control Higher traumatic stress postpartum predicted CHD (B=−.04, p=.03). was higher among older total (B=.40, p=.003) but not (B=.24, p=.06). Conclusions Relational almost universal also high sample. Widespread education initiatives are recommended to increase awareness heightened care well-child settings, alongside relationally-focused prevention intervention programs.

Language: Английский

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Personalized Mobile Health-Enhanced Cognitive Behavioral Intervention for Maternal Distress: Examining the Moderating Role of Adverse Childhood Experiences

The Permanente Journal, Journal Year: 2024, Volume and Issue: 28(1), P. 111 - 123

Published: Jan. 24, 2024

Maternal history of trauma is a risk factor for distress during pregnancy. The purpose this paper was to examine the theorized differential impact cognitive behavioral intervention (Mothers and Babies Personalized; MB-P) on maternal emotional regulation those with ≥ 1 adverse childhood experiences (ACEs; vs no ACEs) from pregnancy 3 months postpartum.

Language: Английский

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Risk factors for food insecurity and association with prenatal care utilization among women who took opioids during pregnancy

Research Square (Research Square), Journal Year: 2024, Volume and Issue: unknown

Published: March 25, 2024

Abstract Background. Food insecurity during pregnancy is associated with poorer outcomes for both mothers and their newborns. Given the ongoing opioid crisis in United States, who take opioids may be at particular risk of experiencing food insecurity. Methods. This research utilized data from 254 biological infants Advancing Clinical Trials Neonatal Opioid Withdrawal Syndrome (ACT NOW) Outcomes Babies Exposure (OBOE) Study. We examined factors among antenatal exposure unexposed (control) counterparts. Chi-square tests logistic regression were used to compare by sociodemographic characteristics, use, prior traumatic experiences, housing instability. Similar analyses conducted examine relationship between receipt adequate prenatal care. Results. Overall, 58 (23%) screened positive was more common took (28% vs. 14%; p =0.007), had public insurance (25% 8%; = 0.027), instability 11%, 0.002), experienced three or adverse experiences childhood (37% 17%; < 0.001), reported physical emotional abuse (44% 0.001). Mothers less likely have received care (78% 90%; 0.020). difference remained after controlling demographic characteristics (AOR (95% CI) 0.39 (0.16, 1.00), 0.049). Conclusions. study adds body evidence supporting need screening development interventions address pregnancy, particularly exposure, which limited are available. The findings revealed that frequently co-occurs trauma, indicating a multifaceted intervention incorporating principles trauma-informed health needed. Although those increased poor outcomes, they despite high levels coverage participants, suggesting additional strategies needed barriers this population. Trial registration. Study registered Trials.gov (NCT04149509) (04/11/2019).

Language: Английский

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Resilient Infant Feeding Among Young Women With Histories of Maltreatment and Poor Support

JOGN Nursing, Journal Year: 2024, Volume and Issue: 53(5), P. 511 - 521

Published: May 20, 2024

Language: Английский

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