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Neuroticism is not independently associated with adverse obstetric or neonatal outcomes: An observational study
Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Psykiatri, Akademiska sjukhuset.
Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa. (Obstetrik)ORCID-id: 0000-0001-7948-7912
Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Forskargrupper (Inst. för kvinnor och barns hälsa), Obstetrisk och reproduktiv hälsoforskning.ORCID-id: 0000-0003-0180-0280
Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Forskargrupper (Inst. för kvinnor och barns hälsa), Klinisk obstetrik.
Vise andre og tillknytning
(engelsk)Inngår i: Artikkel i tidsskrift (Fagfellevurdert) Submitted
HSV kategori
Forskningsprogram
Psykiatri; Obstetrik och gynekologi
Identifikatorer
URN: urn:nbn:se:uu:diva-361592OAI: oai:DiVA.org:uu-361592DiVA, id: diva2:1251012
Tilgjengelig fra: 2018-09-25 Laget: 2018-09-25 Sist oppdatert: 2018-10-24
Inngår i avhandling
1. Perinatal Complications: Associations with Postpartum depressive symptoms and Neuroticism
Åpne denne publikasjonen i ny fane eller vindu >>Perinatal Complications: Associations with Postpartum depressive symptoms and Neuroticism
2018 (engelsk)Doktoravhandling, med artikler (Annet vitenskapelig)
Abstract [en]

Even though most pregnancies and deliveries are uncomplicated, still fifteen percent of all women in developed countries suffer pregnancy-related complications. The aim of this thesis was to explore the associations between perinatal complications and perinatal maternal health, with emphasis on postpartum depressive symptoms (PPDS) and neuroticism taking into account potential confounding or mediating factors such as history of depression, antenatal depressive symptoms and delivery experience.

In the first study (n=446), the association between heavy postpartum haemorrhage and PPDS at six weeks postpartum was delineated by using path-analysis in order to provide insight into the complex mediating roles of several consequences of postpartum haemorrhage. There was no direct association between postpartum haemorrhage and PPDS, only an indirect one via anaemia at discharge and negative delivery experience.

The second study (n=3888) examined the association of mode of delivery with PPDS at 6 weeks postpartum. The results indicate that the association between elective caesarean section and PPDS is highly confounded by history of depression and fear of delivery, while emergency caesarean section and vacuum extraction increase odds for PPDS by leading to postpartum complications and negative delivery experience.

The third study (n=1503) investigated the association between the use of epidural analgesia during delivery and PPDS. A positive association in the crude analysis was no longer present after adjustment for sociodemographic, psychosocial and obstetrical variables, indicating that pain relief through epidural analgesia is not likely to affect risk for PPDS.

In the last study (n=1969), the association between neuroticism and perinatal complications was explored. Neuroticism was not associated with adverse perinatal outcomes, except for gestational diabetes mellitus. The association, however, became statistically non-significant after adjusting for psychiatric morbidity.

In summary, the current studies do no find evidence for a direct association between perinatal complications and postpartum depressive symptoms or neuroticism. However, several important mediators have been identified, among which postpartum anaemia and negative delivery experience deserve special attention. Also, earlier psychiatric history needs to be addressed as an important confounder.

sted, utgiver, år, opplag, sider
Uppsala: Acta Universitatis Upsaliensis, 2018. s. 87
Serie
Digital Comprehensive Summaries of Uppsala Dissertations from the Faculty of Medicine, ISSN 1651-6206 ; 1503
Emneord
antenatal depression, ceasarean section, delivery complications, Edinburgh postnatal depression scale, EPDS, epidural analgesia, gestational diabetes mellitus, instrumental delivery, neonatal complications, neuroticism, obstetric complications, personality, perinatal complications, postpartum depression, postpartum haemorrhage, pregnancy complications, vacuum extraction, vaginal delivery
HSV kategori
Forskningsprogram
Obstetrik och gynekologi; Psykiatri
Identifikatorer
urn:nbn:se:uu:diva-362566 (URN)978-91-513-0466-3 (ISBN)
Disputas
2018-11-30, Sal IX, Universitetshuset, Biskopsgatan 3, Uppsala, 09:15 (svensk)
Opponent
Veileder
Tilgjengelig fra: 2018-11-01 Laget: 2018-10-08 Sist oppdatert: 2018-11-19
2. Anxious personality traits in pregnant women: Associations with postpartum depression, delivery complications and health care use
Åpne denne publikasjonen i ny fane eller vindu >>Anxious personality traits in pregnant women: Associations with postpartum depression, delivery complications and health care use
2018 (engelsk)Doktoravhandling, med artikler (Annet vitenskapelig)
Abstract [en]

Anxious personality traits, including those encompassed by negative emotionality (neuroticism) and the tendency to worry about close relationships (attachment anxiety) during pregnancy were the focus of this thesis. The overall aim was to examine perinatal correlates of these characteris-tics in terms of psychiatric and obstetric health as well as antenatal care (ANC).

Papers I-II were part of a large population-based project on pregnant women in Uppsala in 2009-2012 (n=2160). Papers III-IV adjoined participants from several projects in 2005-2011, on oral contraceptive use, infertility, induced abortion, premenstrual mood disorder, and perina-tal depression (n=2819). The participants reported on the Swedish universities Scales of Per-sonality for neuroticism (papers II-IV) and the Attachment Style Questionnaire (ASQ) for attachment anxiety (papers I-II). The participants also answered the Edinburgh Postnatal De-pression Scale on depressive symptoms (paper II). In paper III, information on obstetric com-plications for primiparous women with singleton pregnancies (n=1969) was extracted from Swedish national health registers. In paper IV, ANC use was derived from medical records of obstetric low-risk women residing in Uppsala (n=1052).

The ASQ had similar psychometric properties in pregnant women (n=1631) as in previous reports (paper I). In non-depressed pregnant women (n=1431), the combination of neuroticism and attachment anxiety was the best risk indicator of postpartum depressive symptoms (paper II). Whereas high neuroticism was not related to obstetric complications (paper III), it was associated with higher use of ANC (paper IV).

Summarized, this thesis illustrates how anxious personality traits may predispose for post-partum depression and higher use of ANC in the absence of obstetric complications. Future development of these findings should be to evaluate individual and societal benefits of a greater emphasis on psychological support in ANC.

sted, utgiver, år, opplag, sider
Uppsala: Acta Universitatis Upsaliensis, 2018. s. 67
Serie
Digital Comprehensive Summaries of Uppsala Dissertations from the Faculty of Medicine, ISSN 1651-6206 ; 1510
Emneord
Personality, neuroticism, adult attachment, perinatal depression, postpartum depression, obstetric complications, health care use
HSV kategori
Forskningsprogram
Psykiatri
Identifikatorer
urn:nbn:se:uu:diva-359600 (URN)978-91-513-0488-5 (ISBN)
Disputas
2018-12-14, Auditorium minus, Museum Gustavianum, Akademigatan 3, Uppsala, 13:00 (engelsk)
Opponent
Veileder
Tilgjengelig fra: 2018-11-21 Laget: 2018-10-24 Sist oppdatert: 2018-11-30

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