Is It Useful to Screen for Anxiety using the GAD-7 in Pregnant Women?

Research Paper Title

Validation of the Generalised Anxiety Disorder Screener (GAD-7) in Spanish Pregnant Women.

Background

Anxiety during pregnancy is one of the most common mental health problems and a significant risk factor for postpartum depression. The Generalised Anxiety Disorder-7 (GAD-7) is one of the most widely used self-report measures of anxiety symptoms available in multiple languages. This study evaluates the psychometric properties and underlying factor structures of the Spanish GAD-7 among pregnant women in Spain.

Methods

Spanish-speaking pregnant women (N = 385) were recruited from an urban obstetrics setting in Northern Spain. Women completed the GAD-7 and the anxiety subscale of the Symptom Checklist (SCL90-R) at three time points, once per trimester. The reliability, concurrent validity, and factor analyses were conducted to evaluate the psychometric properties and factor structure, respectively.

Results

In the first trimester, the GAD-7 demonstrated good internal consistency (a = 0.89). GAD-7 is positively correlated with SCL90-R (anxiety subscale; r=0.75; p < 0.001). The proposed one-factor structure is found using exploratory factor analysis -FACTOR programme – with Unweighted Least Squares procedure and optimal implementation of parallel analysis (GFI = 0.99).

Conclusions

Health providers should screen for anxiety using the GAD-7 during pregnancy among urban Spanish-speaking samples to provide appropriate follow-up care.

Reference

Soto-Balbuena, C. Rodriguez-Munoz, M.F. & Le, H-N. (2021) Validation of the Generalized Anxiety Disorder Screener (GAD-7) in Spanish Pregnant Women. Psicothema. 33(1), pp.164-170. doi: 10.7334/psicothema2020.167.

Can Probiotics Improve Mental Health Outcomes in Pregnant Women with Obesity?

Research Paper Title

Probiotics and Maternal Mental Health: A Randomised Controlled Trial among Pregnant Women with Obesity.

Background

Poor maternal mental health has been associated with a myriad of pregnancy and child health complications.

Obesity in pregnancy is known to increase one’s risk of experiencing poor maternal mental health and associated physical and mental health complications.

Probiotics may represent a novel approach to intervene in poor mental health and obesity.

Methods

The reseaschers conducted this pre-specified secondary analysis of the Healthy Mums and Babies (HUMBA) randomised controlled trial to investigate whether probiotics would improve maternal mental health outcomes up to 36 weeks of pregnancy.

Two-hundred-and-thirty pregnant women with obesity (BMI ≥ 30.0 kg/m2) were recruited and randomised to receive probiotic (Lactobacillus rhamnosus GG and Bifidobacterium lactis BB12, minimum 6.5 × 109 CFU) or placebo capsules.

Depression, anxiety, and functional health and well-being were assessed at baseline (120-176 weeks’ gestation) and 36 weeks of pregnancy.

Results

Depression scores remained stable and did not differ between the probiotic (M = 7.18, SD = 3.80) and placebo groups (M = 6.76, SD = 4.65) at 36 weeks (p-values > 0.05).

Anxiety and physical well-being scores worsened over time irrespective of group allocation, and mental well-being scores did not differ between the two groups at 36 weeks.

Conclusions

Probiotics did not improve mental health outcomes in this multi-ethnic cohort of pregnant women with obesity.

Reference

Dawe, J.P., McCowan, L.M.E., Wilson, J., Okesene-Gafa, K.A.M. & Serlachius, A.S. (2020) Probiotics and Maternal Mental Health: A Randomised Controlled Trial among Pregnant Women with Obesity. Scientific Reports. 10(1), pp.1291. doi: 10.1038/s41598-020-58129-w.

Linking Prenatal Antidepressant Use & Risk of Adverse Neonatal Outcomes

Depression is common among pregnant women and, untreated, is associated with morbidity in both mother and child.

But what about the risks of treatment?

A large database study from the US, with information on the timing, dose, and type of antidepressant treatment in pregnancy, identifies a dose dependent increase in risk for newborn respiratory distress and a small increase in risk of preterm birth in those taking higher doses.

Maternal Mental Health MATTERS: Yes it Does

Research Paper Title

Maternal Mental Health MATTERS.

Background

Depression and anxiety during pregnancy and the postpartum period are common and have significant negative impacts on mother and child.

Suicide is a leading cause of maternal mortality.

Evidence-based efforts for screening, assessment, and treatment improve maternal and infant mental health, as well as overall family health, throughout the lives of women and children.

Reference

Kimmel, M. (2020) Maternal Mental Health MATTERS. North Carolina Medical Journal. 81(1), pp.45-50. doi: 10.18043/ncm.81.1.45.

The Importance of Positive Mental Health for both Mother & Child

Research Paper Title

Positive Maternal Mental Health, Parenting, and Child Development.

Background

While maternal mental health is an important influence on child development, the existing literature focuses primarily on negative aspects of maternal mental health, particularly symptoms of depression, anxiety, or states of distress.

The researchers provide a review of the evidence on the potential importance of positive mental health for both mother and child.

The evidence suggests that positive mental health is a distinct construct that is associated with improved birth outcomes and potentially with specific forms of parenting that promote both academic achievement and socioemotional function.

They review studies that provide a plausible biological basis for the link between positive mental health and parenting, focusing on oxytocin-dopamine interactions.

They caution that the evidence is largely preliminary and suggest directions for future research, noting the importance of identifying the operative dimensions of positive maternal mental health in relation to specific outcomes.

Finally, they suggest that the inclusion of positive maternal mental health provides the potential for a more comprehensive understanding of parental influences on child development.

Reference

Phua, D.Y., Lee, M.Z.L. & Meaney, M.J. (2020) Positive Maternal Mental Health, Parenting, and Child Development. Biological Psychiatry. 87(4), pp.328-337. doi: 10.1016/j.biopsych.2019.09.028. Epub 2019 Oct 16.

Preparation for Life…

“How has your field of study changed in the time you have been working in it?

We understand a lot more about how many mental health problems originate in early life. Experience in pregnancy sends a kind of weather report to the fetus to give it indicators of how life might be and to begin the process of preparation for that life. That is extraordinary and there is still a huge amount to learn.”

Reference

Ramchandani, P. (2020) The Back Pages: Q&A. New Scientist. 11 January 2020, pp.56.

Do Pregnant & Postpartum Women in OUD Treatment have the Potential to Benefit from Access to PSS throughout their Perinatal Period?

Research Paper Title

Peer support specialists and perinatal opioid use disorder: Someone that’s been there, lived it, seen it.

Background

Perinatal opioid use disorder (OUD) has increased drastically since 2000 and is associated with myriad adverse outcomes.

The Substance Abuse and Mental Health Services Administration (SAMHSA) recommends using peer support services to promote sustained remission from substance use disorders (SUDs).

Integrating peer support specialists into perinatal OUD treatment has the potential to improve maternal and child health.

However, there is limited published research on the experiences of pregnant and parenting women with peer support specialists during SUD treatment.

The purpose of this study was to:

  1. Describe experiences of perinatal women undergoing OUD treatment with peer support specialists; and
  2. Describe recommendations for improving or enhancing peer support services.

Methods

For this qualitative descriptive study, the researchers conducted two focus groups in a private location in a clinic that serves postpartum women with OUD (N = 9) who were parenting a child under the age of 5.

The focus groups were voice recorded, professionally transcribed, and analyzed in MAXQDA using content analysis.

Results

Four themes emerged from the data:

  1. Feeling Supported by Peer Support Specialists;
  2. Qualities of an ‘Ideal’ Peer Support Specialist;
  3. Strategies to Improve Interactions with Peer Support Specialists; and
  4. Importance of Communication Across the Perinatal Period.

Participants reported that PSSs had a strong, positive impact on their recovery.

Postpartum women report overall positive experiences receiving peer support services during their pregnancy and postpartum period.

However, participants offered suggestions to improve their interactions with PSSs, such as clarifying the boundaries between peer supporters and clients.

Conclusions

Pregnant and postpartum women in OUD treatment have the potential to benefit from access to PSS throughout their perinatal period.

Future research is needed to determine the impact of PSS on sustained recovery for perinatal women with OUD.

Reference

Fallin-Bennett, A., Elswick, A. & Ashford, K. (2019) Peer support specialists and perinatal opioid use disorder: Someone that’s been there, lived it, seen it. Addictive Behaviors. 102:106204. doi: 10.1016/j.addbeh.2019.106204. [Epub ahead of print].