State anxiety in pregnancies affected by obstetric complications: A systematic review
Antenatal anxiety; Medically high-risk pregnancy; Obstetric complications; State anxiety
BACKGROUND: Maternal mental health status remains an important area of study due to its influence on maternal health outcomes. Past reviews on anxiety in pregnancy have included multiple mental health diagnoses and pre-existing conditions. A systematic review was performed to understand maternal state anxiety during pregnancies affected by obstetrical complications. METHODS: A systematic search of electronic databases was performed including quantitative, primary studies in the English language. The population of interest was women whose pregnancies were affected by maternal and/or fetal obstetric (not pre-existing) complications with state anxiety as the outcome. Twenty-six studies met the inclusion and methodological criteria and were included in the review. RESULTS: The review revealed that 20% to 100% of women experiencing pregnancies affected by obstetric complications had high levels of state anxiety, and these rates are negatively influenced by complication type and severity, demographic characteristics, and maternal perceptions and expectations. Overall, antenatal state anxiety was shown to improve over the course of the pregnancy, though levels remained above clinical thresholds. LIMITATIONS: This review was based only on English peer-reviewed articles, many of which used convenience sampling with homogenous samples, limiting generalizability. Additional limitations include how anxiety prevalence was aggregated due to differences in measurement across studies. CONCLUSIONS: Anxiety is prevalent among women experiencing pregnancies affected by obstetric complications. Based on this review, we recommend that all women treated for obstetric complications are screened for anxiety; facilitating detection, referral, and treatment, ultimately contributing to optimal maternal outcomes.
Fischbein Rebecca L; Nicholas Lauren; Kingsbury Diana M; Falletta Lynn M; Baughman Kristin R; VanGeest Jonathan
Journal of Affective Disorders
2019
2019-10
<a href="http://doi.org/10.1016/j.jad.2019.07.007" target="_blank" rel="noreferrer noopener">10.1016/j.jad.2019.07.007</a>
Twin anemia-polycythemia sequence and routine monitoring practices amongst maternal-fetal medicine specialists in the United States: an initial investigation
diagnosis; maternal-fetal medicine; monitoring; monochorionic-diamniotic pregnancy; routine monitoring; twin anemia-polycythemia sequence
Background The purpose of this initial investigation was to begin to understand the routine twin anemia-polycythemia sequence (TAPS) monitoring practices of maternal-fetal medicine specialists (MFM specialists) in the United States in the absence of a formal guideline. Methods This study used an anonymous, online survey of 90 MFM specialists who were practicing in the United States. A $5 gift card to an online store was used to incentivize participants. Descriptive statistics were calculated. Results All MFM specialists reported at least some familiarity (100.00%) with TAPS. Most participants (92.94%) were familiar with methods for monitoring patients for TAPS and nearly all (97.50%) responded that they use 'Doppler MCA-PSV' to make a prenatal TAPS diagnosis. Nearly two-thirds of MFM specialists surveyed (65.06%) reported performing regular TAPS monitoring for patients with monochorionic-diamniotic (MCDA) pregnancies. Conclusion Despite no formal guidelines, the majority of American MFM specialists surveyed are using routine TAPS screening in their management of MCDA twin pregnancies, suggesting that the MFM specialists included in this study consider it a valuable diagnostic tool. Future research should further explore this possible trend toward routine TAPS monitoring amongst MFM specialists in the United States, as well as the potential value of routine TAPS monitoring in MCDA pregnancy.
Nicholas Lauren D; Fischbein Rebecca L; Bhamidipalli Surya S
Journal of Perinatal Medicine
2019
2019-05
<a href="http://doi.org/10.1515/jpm-2018-0240" target="_blank" rel="noreferrer noopener">10.1515/jpm-2018-0240</a>
Pregnant or recently pregnant opioid users: contraception decisions, perceptions and preferences.
Contraception; Opioid Drug Use; Pregnancy
Background: Multiple factors are linked to extremely high unintended pregnancy rates among women who use opioids, including various barriers to contraception adherence. These include patient level barriers such as lack of knowledge and education about highly effective contraception, and potential provider barriers. Using a mixed-methods framework to examine the contraception-related perceptions and preferences of opioid using women is a necessary next step to understanding this phenomenon. Methods: A mixed-method study was conducted which included both self-report questionnaires along with a semi-structured qualitative interview of opioid-using pregnant or recently pregnant women in two drug treatment facilities in Ohio. Results: Forty-two women completed the study. The majority of recent (75%) and total pregnancies were unintended. Male condoms were reported as the highest form of lifetime contraception used within the present sample (69%). Participants reported low lifetime use of long acting reversible contraception (LARC) (ranging from 5 to 12%). Participants preferred hormonal injections first (40%), followed by IUDs (17%). Reasons for preferences of injections and LARC were similar: not needing to remember, side effects, and long-term effectiveness. Conclusions: Most of the study population participants stated they would utilize contraception, particularly Tier 1 LARC methods, if freely available; however, high rates of unintended pregnancy were observed in this sample. This indicates the need for contraception education, and addressing the procedural, logistical and economic barriers that may be preventing the use of LARC among this population.
Fischbein Rebecca L; Lanese Bethany G; Falletta Lynn; Hamilton Kelsey; King Jennifer A; Kenne Deric R
Contraception and reproductive medicine
2018
2018
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
<a href="http://doi.org/10.1186/s40834-018-0056-y" target="_blank" rel="noreferrer noopener">10.1186/s40834-018-0056-y</a>
The Use of Substances Other Than Nicotine in Electronic Cigarettes Among College Students.
College – United States; college students; Cross Sectional Studies; Electronic cigarettes; Electronic Cigarettes; Human; Logistic Regression; Medical Marijuana; Nicotine; other substance use; Public Health; smoking; Street Drugs; Students; Substance Abuse; Surveys; Undergraduate; United States; vaping; young adults
INTRODUCTION: Electronic cigarettes (e-cigarettes) have grown in popularity, especially among youth and young adults. Although e-cigarettes were originally intended to vaporize a liquid mixture containing nicotine, there appears to be an increasing trend in other substance use in e-cigarettes (OSUE). MATERIALS AND METHODS: Cross-sectional data from 1542 undergraduate college student e-cigarette users from a large Midwestern university were collected via online survey to assess prevalence of e-cigarette use, reasons for use, perceived harm, and prevalence and predictors of OSUE. RESULTS: Nearly 7% (6.94%) reported using an e-cigarette to vaporize and inhale a substance other than nicotine. Current tobacco cigarette smokers were significantly more likely to report OSUE (51.0%) as compared with never (33.7%) and former (15.4%) smokers. Among respondents reporting OSUE, the primary reason for e-cigarette use was "safer than cigarettes" (21.7%), followed by "experimentation" (18.9%) and "friends use" (17.0%). Most (77.9%) reported using cannabis or some derivative of cannabis in an e-cigarette. Binomial logistic regression found that women were less likely to report OSUE by a factor of 0.60, former tobacco cigarette smokers as compared with never smokers were more likely to report OSUE by a factor of 1.87, and e-cigarette users who reported using e-cigarettes for "cool or trendy" reasons were more likely to report OSUE by a factor of 2.89. DISCUSSION: Little is known regarding the health effects of cannabis and cannabis derivatives delivered through e-cigarettes. Concern may also be warranted regarding the potential dangers of this young population using substances more dangerous than cannabis in e-cigarettes. Knowledge is limited regarding the public health impact of vaping cannabis or other illicit substances among college student populations. This study stresses the need for continued research regarding the vaping of cannabis and other illicit substances among college students.
Kenne Deric R; Fischbein Rebecca L; Tan Andy Sl; Banks Mark
Substance abuse : research and treatment
2017
1905-07
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
<a href="http://doi.org/10.1177/1178221817733736" target="_blank" rel="noreferrer noopener">10.1177/1178221817733736</a>