Identifying the women at risk of antenatal anxiety and depression: A systematic review.

Maternal lipid levels during pregnancy and gestational diabetes: a systematic review and meta-analysis

Personality factors in stress and anxiety, J.Brebner personal and interpersonal determinants of children's anxiety, Y.Teichman, H.Gilaie self-esteem, realization of life-purposes and level of anxiety in the Aged, I.Paspalanov Emotional Patterns In Stress Situations And Their relationship to somatic disease, K.Wrzesnieski an experimental analysis of sport related trait anxiety, D.Hackfort.

Cross-Cultural Anxiety

ContextChorioamnionitis has been implicated in the pathogenesis of cerebral
palsy, but most studies have not reported a significant association. Cystic
periventricular leukomalacia (cPVL) is believed to be a precursor of cerebral
palsy in preterm infants.ObjectivesTo determine whether chorioamnionitis is associated with cerebral palsy
or cPVL and to examine factors that may explain differences in study results.Data SourcesSearches of MEDLINE (1966-1999), Index Medicus (1960-1965), Doctoral
Dissertation Abstracts On-Line (1861-1999), bibliographies, and online conference
proceedings (1999) were performed for English-language studies with titles
or abstracts that discussed prenatal risk factors for cerebral palsy or cPVL.Study SelectionOf 229 initially identified publications, meta-analyses were performed
on studies that addressed the association between clinical (n = 19) or histologic
(n = 7) chorioamnionitis and cerebral palsy or cPVL in both preterm and full-term
infants. Inclusion criteria were: presence of appropriate exposure and outcome
measures, case-control or cohort study design, and provision of sufficient
data to calculate relative risks (RRs) or odds ratios with 95% confidence
intervals (CIs). Studies evaluating risk of cerebral palsy following maternal
fever, urinary tract infection, or other maternal infection were collected,
but not included in the meta-analysis.Data ExtractionInformation from individual studies was abstracted using standardized
forms by 2 independent observers blinded to authors' names, journal titles,
and funding sources.Data SynthesisUsing a random effects model, clinical chorioamnionitis was significantly
associated with both cerebral palsy (RR, 1.9; 95% CI, 1.4-2.5) and cPVL (RR,
3.0; 95% CI, 2.2-4.0) in preterm infants. The RR of histologic chorioamnionitis
and cerebral palsy was 1.6 (95% CI, 0.9-2.7) in preterm infants, and histologic
chorioamnionitis was significantly associated with cPVL (RR, 2.1; 95% CI,
1.5-2.9). Among full-term infants, a positive association was found between
clinical chorioamnionitis and cerebral palsy (RR, 4.7; 95% CI, 1.3-16.2).
Factors explaining differences in study results included varying definitions
of clinical chorioamnionitis, extent of blinding in determining exposure status,
and whether individual studies adjusted for potential confounders.ConclusionOur meta-analysis indicates that chorioamnionitis is a risk factor for
both cerebral palsy and cPVL.

Chorioamnionitis as a Risk Factor for Cerebral Palsy: A Meta-Analysis

Complications related to preterm birth (PTB) and low birth weight (LBW) are leading causes of infant morbidity and mortality. Prenatal depression is a hypothesized psychosocial risk factor for both birth outcomes. The purpose of this systematic review was to examine evidence published between 1977 and 2013 on prenatal depression and risks of these primary adverse birth outcomes. A systematic search of the PUBMED and PsycINFO databases was conducted to identify studies testing the associations between prenatal depressive symptoms, or diagnoses of depression, and risk of PTB or LBW. We systematically selected 50 published reports on PTB and length of gestation, and 33 reports on LBW and BW. Results were reviewed by two independent reviewers and we evaluated the quality of the evidence with an established systematic review method, the Newcastle Ottawa Scale. We then undertook a narrative synthesis of the results following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Less than a quarter of 50 published reports found that prenatal depression was significantly associated with PTB or gestational age. In contrast, slightly more than half of the 33 reports found that prenatal depression was associated with LBW or BW. When weighing methodological features, we determined that the effects of prenatal depression on LBW are more consistent than effects on length of gestation or PTB. Although the evidence may not be strong enough to support routine depression screening for risk of adverse outcomes, screening to enable detection and timely treatment to reduce risk of postpartum depression is warranted. Further rigorous research on prenatal depression and adverse birth outcomes is needed.

https://escholarship.org/content/qt73v8n90f/qt73v8n90f.pdf?t=ni7s7a

Prenatal depression and adverse birth outcomes: an updated systematic review.

SUMMARY Background: There are few surveys of antenatal depression and anxiety in Eastern-European countries. The aim of the present study was to gather prevalence data from a Hungarian sample and to search for associations between antenatal depression/anxiety and some psycho-social variables. Subjects and methods: A population-based monitoring system was created, covering every pregnant woman in the town of Szombathely, Western-Hungary for symptoms of depression and anxiety during the first trimester of pregnancy. Data were gathered in the period February 1, 2008 - February 1, 2010. Five-hundred and three pregnant women were included in the sample under survey. Results: Mean age of our participants was 29.8 yr. (SD=4.94/). One fifth (19.9%; 95%CI = 16.6-23.6) of pregnant women were suffering from mild to severe depression as measured by the Beck Depression Inventory. Frequency of severe depression was low (1.4%). 14.2% of the sample (95%CI = 11.5-17.6) showed signs of trait anxiety as measured by the Spielberger Inventory. Mean scores for depression and anxiety proved to be significantly higher among women who were unemployed, less than 20 years of age, having low educational or/and socio-economic status, and displaying higher level of social mistrust. Those living in common-law marriage had more depressive symptoms while reciprocity was associated only to anxiety. Conclusions: Except for prevalence of severe depression, our data did not differ from prevalence found in market economic countries. Teen age, unfavourable socio-economic conditions and high social mistrust were associated with the emergence of clinically meaningful depression and anxiety during the first trimester of pregnancy.

Prevalence and psychosocial background of anxiety and depression emerging during the first trimester of pregnancy: data from a Hungarian population-based sample.

Effects of depression, anxiety, self-esteem, and health behaviour on neonatal outcomes in a population-based Hungarian sample.

OBJECTIVE To assess neonatal outcomes and associated findings in pregnant women identified after delivery as having had underlying subclinical chorioamnionitis by either histology or bacterial culture. METHODS In 16 years, 8974 clinical, histological, and bacterial culture data were obtained retrospectively. RESULTS Placental histology was analyzed in 4237 pregnancies (2785 term and 1452 preterm) and 4737 amniotic cavity cultures were obtained during 5446 cesarean deliveries (3268 term and 1469 preterm). Histological results and bacterial cultures were both available in 1270 of the preterm deliveries. Histology revealed inflammation, suggestive of infection, in 13.6% of placentas. Subclinical acute chorioamnionic inflammation was confirmed in 142 out of 2785 term pregnancies (5.1%) and in 436 out of 1452 preterm pregnancies (30.0%, P<0.001). Bacteriological culture of the intrauterine cavity was obtained from the lower uterine segment of the uterus during cesarean section. A positive culture was found in 19.9% of all cases (941/4737), this proportion was significantly higher in preterm deliveries (343/1273, 26.9%) than in term (17.3%, P<0.001). The lower the birth-weight or gestational age, the higher the frequency of silent infections in the uterine cavity. CONCLUSIONS Our study findings support the association between intra-amniotic infections and preterm delivery.

Silent chorioamnionitis and associated pregnancy outcomes: a review of clinical data gathered over a 16-year period.

Background: The aim of our study was to elucidate the association of the metabolic syndrome with the risk of unsuccessful pregnancy. Methods: This was a retrospective observational study conducted at Markusovszky Teaching Hospital, Szombathely, Hungary, a tertiary health care center. During the study period of 2007–2011 (5 years), 7373 pregnancies were followed. Pregnant women who were suffering from metabolic syndrome in the first trimester of gestation during the study period were compared to all other pregnant women without the syndrome. Retrospectively, 219 (2.9%) patients met the criteria of metabolic syndrome during the first trimester. Our goal was to evaluate the prevalence of the metabolic syndrome in normal pregnancies and in those complicated by either premature birth, or intrauterine growth retardation (IUGR), pregnancy-induced hypertension, and preeclampsia. Results: The rate of preterm birth was 15.2% [32/219 in the metabolic syndrome group vs. 11.1% (p=0.051) in the control group]....

Tamás Bödecs

Papers

Prevalence and psychosocial background of anxiety and depression emerging during the first trimester of pregnancy: data from a Hungarian population-based sample.

Effects of depression, anxiety, self-esteem, and health behaviour on neonatal outcomes in a population-based Hungarian sample.

Silent chorioamnionitis and associated pregnancy outcomes: a review of clinical data gathered over a 16-year period.

Metabolic Syndrome in Normal and Complicated Pregnancies

Histological chorioamnionitis is associated with cerebral palsy in preterm neonates