Birth-Issues in Perinatal Care最新文献

{"title":"The Efficacy of Psycho-Educational Interventions to Optimize Women's Sleep in Pregnancy: An Integrative Review","authors":"Vishnuvarthini Visvanathan,&nbsp;Wendy Pollock,&nbsp;Yasmin Zisin,&nbsp;Suzanne Willey","doi":"10.1111/birt.12902","DOIUrl":"10.1111/birt.12902","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Poor sleep in pregnancy is associated with several adverse maternal and infant outcomes. Psychoeducational interventions may offer a safe and acceptable first-line intervention to help with sleep disturbances.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>To identify and review studies that examined the effect of psycho-educational interventions on sleep in pregnancy and to identify moderators in the treatment effects of the interventions.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>An integrative review methodology was used. A comprehensive search in five electronic databases retrieved 1250 articles. Eligible studies (<i>n</i> = 12) were assessed for methodological quality according to the “QualSyst” rapid appraisal tool. Data were extracted and recorded using a modified Covidence form. Quantitative data were summarized in a meta-analysis or narrative synthesis. Qualitative data were narratively reported.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Findings</h3>\u0000 \u0000 <p>Twelve studies with three different sleep interventions: Cognitive Behavioral Therapy for Insomnia (CBT-I), Sleep Healthy Education (SHE) and relaxation training were included. Given the variation in study methodologies and interventions, only quantitative results from RCT trials using CBT-I were summarized in the meta-analysis. CBT-I was found to be statistically significant in improving sleep quality in pregnancy (Standard Mean Difference = −0.78; 95% CI = −1.01, −0.54, <i>p &lt;</i> 0.001). Few studies reported the efficacy of SHE and relaxation training. Potential moderators had no effect on the measured sleep quality outcome. Overall, psychoeducational interventions were acceptable to participants during pregnancy.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>There is insufficient evidence on which to base the recommendations about the effectiveness of all psychoeducational interventions to improve sleep. Based on the available literature, CBT-I is an evidence-based intervention to improve sleep quality in pregnancy.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55350,"journal":{"name":"Birth-Issues in Perinatal Care","volume":"52 2","pages":"228-242"},"PeriodicalIF":2.8,"publicationDate":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/birt.12902","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143588228","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"From Midwife to Lead Perinatal Practitioner: A Utopian Vision","authors":"John Pendleton,&nbsp;Sally Pezaro","doi":"10.1111/birt.12913","DOIUrl":"10.1111/birt.12913","url":null,"abstract":"<p>The professional title “midwife” is predicated on the understanding that people who access their services have a normative relationship between their gender and assigned sex. As trans and non-binary people increasingly require access to midwifery services, this paper proposes an alternative professional title that is inclusive and liberates midwives from continuously reinscribing the sex/gender binary in their nomenclature. We work with Levitas's <i>Utopia as Method</i> framework to propose the title of Lead Perinatal Practitioner. Working through the archaeological, ontological and architectural modes, we explain the rationale for each component part of the title. “Lead” foregrounds the profession's relationship with autonomy, which is considered foundational but threatened by encroaching medicalization. “Perinatal” encompasses not just the birthing person but also the neonate and the physiological process and timeframe encapsulating pregnancy and birth currently absent. “Practitioner” captures the reflexivity, skill, and active engagement already inscribed in allied healthcare professions that use this title. We argue that when combined, they signal a trailblazing contribution towards the eradication of gender inequalities in the reproductive arena by uncoupling the profession from patriarchal oppression inscribed in the sex/gender binary, which has hitherto been positioned as the sine qua non of midwifery.</p>","PeriodicalId":55350,"journal":{"name":"Birth-Issues in Perinatal Care","volume":"52 3","pages":"511-516"},"PeriodicalIF":2.5,"publicationDate":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/birt.12913","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143588220","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Women's Experiences of Induction of Labor and Birth After Prolonged Medical Induction: A Qualitative Study From Denmark.","authors":"Caroline Trillingsgaard Mejdahl, Lone Hvidman, Rikke Bek Helmig, Sidsel Boie, Anna Højkjær Larsen, Maria Lundbo, Jeanette Ziska, Stina Lou","doi":"10.1111/birt.12912","DOIUrl":"https://doi.org/10.1111/birt.12912","url":null,"abstract":"<p><strong>Background: </strong>The increasing frequency of induction of labor (IOL) prompts explorations into women's experiences. To inform individualized obstetric care, this study aimed to investigate the experiences of Danish pregnant women who underwent out-patient medical IOL and were not in active labor 48 h after IOL initiation.</p><p><strong>Methods: </strong>A qualitative interview study with 28 women who had experienced prolonged IOL (all indications). The women were recruited at two obstetric departments approximately 48 h after IOL initiation and telephone interviewed 2-6 weeks after birth (average of 37 min duration). Interviews were recorded, transcribed, and analyzed using thematic analysis.</p><p><strong>Results: </strong>The first theme describes the underlying rationale in the women's description of IOL and birth: 'Motivated by the birth of a healthy baby.' The results show how the women accepted medical indications for IOL, found comfort in the out-patient regimen, and felt secure about the health of their baby, even if the prolonged IOL was frustrating. The results show how 'progress' became a primary motivator for suggesting and accepting interventions. The second theme describes four 'Situations of discouragement' that are clusters of events during IOL and birth that could challenge the women's expectations and boundaries, for example, experiencing excessive pain or not feeling heard. Despite challenges, most women viewed their experiences positively, remaining open to future IOL.</p><p><strong>Discussion: </strong>The findings underscore the complexity of women's experiences during IOL and birth, emphasizing the need for healthcare professionals to navigate diverse, individual preferences while prioritizing maternal and fetal well-being.</p>","PeriodicalId":55350,"journal":{"name":"Birth-Issues in Perinatal Care","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143574696","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Changes in Fear of Childbirth and Its Predictors Over Three COVID-19 Pandemic Waves in Poland.","authors":"Michalina Ilska, Anna Kołodziej-Zaleska, Anna Brandt-Salmeri, Heidi Preis, Marci Lobel","doi":"10.1111/birt.12904","DOIUrl":"https://doi.org/10.1111/birt.12904","url":null,"abstract":"<p><strong>Background: </strong>The COVID-19 pandemic posed new and unpredictable challenges worldwide, having a particular effect on vulnerable groups, including pregnant women. The occurrence of these stressful circumstances likely increased women's fear of childbirth, a critical issue in pregnancy with consequences for various outcomes.</p><p><strong>Methods: </strong>This cross-sectional study investigated fear of childbirth in pregnant women during three waves of the COVID-19 pandemic in Poland and identified factors predicting severe fear. Participants were recruited through social media platforms. In total, 2462 pregnant women completed the study questionnaire during the first (n = 1079), second (n = 1119), or third (n = 264) waves of the pandemic. Fear of childbirth was measured with the Fear of Birth visual analog scale (FOBS) using a cut-off score of ≥ 54 to indicate clinically relevant fear of childbirth. COVID-19-related stress was assessed using the Pandemic-Related Pregnancy Stress Scale (PREPS).</p><p><strong>Results: </strong>Fear of childbirth was present in 51.5%, 61.9%, and 56.8% of participants at the three waves, respectively. Women who were pregnant during the first and third waves had lower fear of childbirth scores than those who were pregnant during the second wave. This could be explained by changes in infection rates and the severity of the disease, restrictions in maternity care, and the availability of vaccinations. In successive pandemic waves, predictors of severe fear of childbirth (FoC), especially related to COVID-19, differed. Across waves, the most powerful predictor was stress originating from feeling unprepared for birth.</p><p><strong>Discussion: </strong>Fear of childbirth differed across pandemic time points. Pandemic waves should be considered in future review studies and meta-analyses.</p>","PeriodicalId":55350,"journal":{"name":"Birth-Issues in Perinatal Care","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143574695","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Birthing With Others: Exploring the Efficacy of One-On-One Professional Support on Physiological Birth and Flow State.","authors":"Orli Dahan, Alon Goldberg","doi":"10.1111/birt.12908","DOIUrl":"https://doi.org/10.1111/birt.12908","url":null,"abstract":"<p><strong>Background: </strong>One-on-one professional support during labor is recognized for its role in promoting physiological birth, reducing interventions, and enhancing women's birthing experiences. Throughout physiological birth, many women encounter an altered state of consciousness. This state not only facilitates the normal birth process but also empowers women during and after childbirth. Recently, the flow-a mental state of complete absorption and energized focus in an activity, with a sense of control and high motivation-has been identified as a measure of this experience during physiological birth. This study aimed to discover whether one-on-one continuous professional support would improve the childbirth experience by increasing the likelihood of physiological birth and a heightened state of flow during childbirth.</p><p><strong>Methods: </strong>Women with childbirth experience were recruited through social media. Participants (n = 788) completed an online survey: the Flow State Scale (FSS) and a demographic questionnaire, including details about the professional support received during childbirth.</p><p><strong>Results: </strong>One-on-one professional support was significantly associated with natural childbirth (midwife: 80.9%, doula: 65.7%) and lower medical interventions (midwife: 19.1%, doula: 34.3%) compared to conventional professional assistance (natural birth: 44.4%, interventions: 55.6%). A MANCOVA analysis revealed significant differences in flow state levels, with women receiving one-on-one support experiencing the highest flow state.</p><p><strong>Conclusions: </strong>This research validates the significant correlation between one-on-one support-provided by midwives or doulas-and physiological birth. It also establishes for the first time a correlation between women in childbirth receiving continuous one-on-one professional support and heightened flow state levels, signifying a positive and empowering birthing experience.</p>","PeriodicalId":55350,"journal":{"name":"Birth-Issues in Perinatal Care","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143558888","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of Maternity Units' Organizational Levels on Maternal Birth Satisfaction: A Multicentric Cohort Study.","authors":"Simona Fumagalli, Antonella Nespoli, Maria Panzeri, Laura Antolini, Elisabetta Colciago, Anna Adami, Matilde Maria Canepa, Elsa Del Bo, Raffaella Ferrara, Paola Agnese Mauri, Angelo Cagnacci, Marcello Ceccaroni, Carmen Dattolo, Giovanna Esposito, Massimo Piergiuseppe Franchi, Franco Gorlero, Gianpaolo Grisolia, Francesca Grosso, Agnese Lecis, Marta Mazzeo Melchionda, Virginia Michelerio, Luana Mogavino, Chiara Ogliari, Michela Ramunno, Arsenio Spinillo, Sabrina Valletta, Patrizia Vergani, Anna Locatelli","doi":"10.1111/birt.12909","DOIUrl":"https://doi.org/10.1111/birt.12909","url":null,"abstract":"<p><strong>Introduction: </strong>Maternal birth satisfaction is correlated to long-term outcomes and is influenced by the place of birth. In Italy, most births occur in hospitals. Our study aimed to assess whether the organizational level (I vs. II) of the Maternity Unit (MU) had any impact on birth satisfaction.</p><p><strong>Methods: </strong>A multicentric cohort study was conducted in 11 Italian MUs, classified as Level I (for low-risk pregnancies or with minor complications) or Level II (for low and high-risk women) according to organizational, structural, and technical standards. Birth satisfaction was measured using the Italian version of the BSS-R, composed of three sub-scales. Data analysis was performed using Stata/MP18.0.</p><p><strong>Results: </strong>Among 1642 participants, maternal satisfaction was similar in I and II level MUs (27.7 vs. 27.2; p-value 0.096). Women who gave birth in an I level MU were found to have a greater Quality of care sub-scale score compared to participants who gave birth in a II level MU (14.28 vs. 13.87; p-value < 0.001). The three sub-scales contributed differently to the total score, with a minor contribution given by the Stress Experienced (8.65/16) and the Women's Attributes sub-scales (4.72/8).</p><p><strong>Conclusion: </strong>This study contributes to understanding how the level of the MU might impact women's birth satisfaction. Factors affecting the Women's Attributes and the Stress Experienced sub-scales' scores should be considered to increase maternal satisfaction with birth, improving the quality of maternity services.</p>","PeriodicalId":55350,"journal":{"name":"Birth-Issues in Perinatal Care","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143544588","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Racial Disparities in Nulliparous Singleton Term Vertex Cesarean Deliveries: Rates, Reasons, and Time to Delivery.","authors":"Kiran McCloskey, Amber Woodard, Chere Gregory, Lewis Lipscomb, Noellee Clarke, Jennifer Neilsen","doi":"10.1111/birt.12906","DOIUrl":"https://doi.org/10.1111/birt.12906","url":null,"abstract":"<p><strong>Background: </strong>Non-Hispanic Black individuals have the highest odds of having a nulliparous term singleton vertex (NTSV) cesarean birth out of all racial and ethnic groups, but this disparity is not well understood. This study assesses the factors associated with overall rates of NTSV cesarean delivery, differences in reasons for cesarean births, and door-to-delivery time among individuals who had an NTSV cesarean delivery.</p><p><strong>Methods: </strong>Retrospective analyses assessed n = 31,826 NTSV births from January 1, 2016 to December 31, 2021 at 11 medical centers in North Carolina. For each outcome variable, multivariate regression estimated Black-White disparities while controlling for clinical and social covariates. Models included random intercepts for facility and delivery provider.</p><p><strong>Results: </strong>After accounting for covariates, non-Hispanic Black patients were more likely to have an NTSV cesarean delivery compared to non-Hispanic White patients (AOR = 1.48, 95% CI 1.47, 1.69). Among those who had an NTSV cesarean delivery, non-Hispanic Black patients were more likely than non-Hispanic White patients to have a cesarean delivery due to fetal intolerance of labor (AOR = 2.10, 95% CI 1.87, 2.42). Non-Hispanic Black patients had a shorter door-to-delivery time for unscheduled NTSV cesarean deliveries than non-Hispanic White patients (b = -1.80, 95% CI -2.50, -1.11).</p><p><strong>Conclusions: </strong>We confirmed the persistence of a racial disparity in cesarean delivery rates after controlling for multiple social and clinical factors. As fetal intolerance of labor has been described as a subjective indicator, and faster door-to-delivery time for cesarean deliveries may indicate faster decision making, our findings indicate a need to better understand decision making around cesarean deliveries.</p>","PeriodicalId":55350,"journal":{"name":"Birth-Issues in Perinatal Care","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143544590","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Abuse and Disrespect in Obstetric Care in the United States: A Qualitative Descriptive Study of Nurse Experiences.","authors":"Umber Darilek, Sara L Gill","doi":"10.1111/birt.12905","DOIUrl":"https://doi.org/10.1111/birt.12905","url":null,"abstract":"<p><strong>Background: </strong>This qualitative descriptive study of the experiences of US labor and delivery nurses follows the World Health Organization's call to address abuse and disrespect of women in maternity care. The majority of research about abuse and disrespect for childbearing women has been conducted in Africa, Asia, and Europe, but the US is unique as a high-income country with largely capitalist or privatized health care. The objective of this study was to gain knowledge about abuse and disrespect in hospital-based maternity care in the US from the perspective of labor and delivery nurses.</p><p><strong>Methods: </strong>Using a qualitative descriptive methodology, online data collection followed by optional interviews, we solicited the experiences of labor and delivery nurses regarding their experiences with patients being treated unethically in obstetric care. Content analysis was used to interpret the data into themes.</p><p><strong>Results: </strong>One hundred sixty-eight (N = 168) participants provided written examples of unethical treatment they had witnessed in their professional experience, and 7 interviews were conducted. Four major themes were identified: Violation of the Trust that We are Going to Keep You and Your Baby Safe; Assault; Stripping a Patient of Autonomy; and Failure of the Hospital to Provide Safe Conditions for Birth.</p><p><strong>Discussion: </strong>People within the healthcare system are aware of abuse and disrespect, but it is often hidden by stakeholders who have conflicting interests. Perpetrators of abuse and disrespect are people and systems. More research is necessary to quantify and address the problems from within the healthcare system.</p>","PeriodicalId":55350,"journal":{"name":"Birth-Issues in Perinatal Care","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143544583","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Do Antenatal Interventions Improve Maternal and Perinatal Outcomes for Migrant Women Living in High-Income Countries and What Guidelines Exist for Migrant Women? A Systematic Review and Meta-Analysis.","authors":"Sharon Weerasingha, Kirstin Tindal, Kirsten Palmer, Stacey J Ellery, Miranda Davies-Tuck","doi":"10.1111/birt.12903","DOIUrl":"https://doi.org/10.1111/birt.12903","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Given the rise in migrant women giving birth in high-income countries (HICs) there is a need to identify and evaluate the efficacy of existing interventions that address disparities in adverse pregnancy outcomes experienced by migrant women.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;This review aims to identify any antenatal interventions offered to migrant women living in HICs, evaluate their efficacy at improving perinatal and maternal adverse outcomes, and to identify and evaluate pregnancy management guidelines relating to migrant status or ethnicity-specific practices or recommendations.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Search strategy: &lt;/strong&gt;Medline, Embase, CINAHL, Scopus, TRIP, ProQuest, and the International Guidelines Library were searched from January 2010 to March 2023.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Selection criteria: &lt;/strong&gt;English-language randomized controlled trials, mixed-methods, and observational studies reporting perinatal and maternal outcomes in women living in HICs receiving a migrant-specific antenatal intervention. An additional search of any pregnancy management guidelines relating to migrant status or ethnicity-specific practices or recommendations was completed.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Data collection and analysis: &lt;/strong&gt;Two authors independently conducted data extraction. Outcomes of interest included perinatal (stillbirth, neonatal death, 5-min post-delivery Apgar score &lt; 7, NICU admission, small for gestational age, large for gestational age, low birth weight, and preterm birth) and maternal outcomes (mortality, gestational diabetes, gestational hypertension, pre-eclampsia, caesarean birth, instrumental birth, and induction of labour). Odds ratios (OR) and 95% confidence intervals (95% CI) were calculated and pooled for meta-analysis using a random-effects model. All studies and guidelines were assessed using relevant risk assessment tools.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Main results: &lt;/strong&gt;Six studies met the inclusion criteria for this review. Meta-analysis showed that infants born to women offered a migrant-specific antenatal intervention had lower odds of stillbirth (OR 0.60 95% CI 0.37-0.97, p = 0.04, I&lt;sup&gt;2&lt;/sup&gt; = 0%) when compared to those in the standard care group. However, the use of migrant-specific interventions increased the odds of labor induction (OR 1.38 95% CI 1.27-1.49, p = &lt; 0.01, I&lt;sup&gt;2&lt;/sup&gt; = 0%). Additionally, we identified 18 guidelines; however, no migrant or ethnicity-specific recommendations were supported by high-level evidence.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;Several migrant-specific antenatal interventions exist for migrant women living in HICs. These include fetal monitoring, group antenatal care programs, and a cultural training program for midwives. Despite heterogeneity between interventions, together they reduced the odds of stillbirth. Of the pregnancy management guidelines identified, most recommendations were largely based on findings from systematic reviews of observational and cohort studies, hig","PeriodicalId":55350,"journal":{"name":"Birth-Issues in Perinatal Care","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143544586","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Cost of Untreated Perinatal Mood and Anxiety Disorders (PMADs) in Montana: An Economic Analysis of Perinatal Mental Health in a Rural State.","authors":"Jessica L Liddell, Alison Monroe, Tess A Carlson, Katrina Mullan","doi":"10.1111/birt.12901","DOIUrl":"10.1111/birt.12901","url":null,"abstract":"<p><strong>Background: </strong>Although extremely common, and with a broad range of associated negative outcomes for both parents and infants, the full impact and cost of perinatal mood and anxiety disorders (PMADs) is under-researched. Rural states, such as Montana, in particular experience gaps in access to mental healthcare and high rates of PMADs, emphasizing a need for an economic analysis of untreated PMADs. To address this gap, a cost analysis of the impact of untreated PMADs in Montana was conducted using 2021 birth data.</p><p><strong>Methods: </strong>A cost-of-illness analysis was conducted to estimate the incremental costs of untreated PMADs in Montana. Secondary data sources and peer-reviewed literature were utilized to provide baseline estimates of the prevalence of maternal and birth outcomes in Montana and to estimate the impact of PMADs on these outcomes from the perinatal period through the first year postpartum.</p><p><strong>Results: </strong>Using 15% as the PMAD prevalence rate in Montana, the total estimated incremental cost of untreated perinatal mood and anxiety disorders for births in 2021 is about $21.7 million. This is about $12,897 per impacted mother-child pair.</p><p><strong>Discussion: </strong>This study provides needed insight into the economic impact of untreated PMADs and highlights the broad range of negative impacts PMADs have on the well-being of parents and infants. This study highlights the importance of providing effective treatment to people experiencing PMADs to improve the health of both parents and their infants and has important policy implications for increased funding and workforce development for the detection and treatment of PMADs.</p>","PeriodicalId":55350,"journal":{"name":"Birth-Issues in Perinatal Care","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12434807/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143392067","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}