Background: Perinatal mental health (PMH) conditions are associated with an increased risk of adverse perinatal outcomes including preterm birth. Midwifery caseload group practice (continuity of care, MCP) improves perinatal outcomes including a 24 % reduction of preterm birth. The evidence is unclear whether MCP has the same effect for women with perinatal mental health conditions.
Aim: To compare perinatal outcomes in women with a mental health history between MCP and standard models of maternity care. The primary outcome measured the rates of preterm birth.
Methods: A retrospective cohort study using routinely collected data of women with PMH conditions between 1st January 2018 - 31st January 2021 was conducted. We compared characteristics and outcomes between groups. Multivariate logistic regression models were performed adjusting for a-priori selected variables and factors that differ between models of care.
Results: The cohort included 3028 women with PMH, 352 (11.6 %) received MCP. The most common diagnosis was anxiety and depression (n = 723, 23.9 %). Women receiving MCP were younger (mean 30.9 vs 31.3, p = 0.03), Caucasian (37.8 vs 27.1, p < 0.001), socio-economically advantaged (31.0 % vs 20.2, p < 0.001); less likely to smoke (5.1 vs 11.9, p < 0.001) and with lower BMI (mean 24.3 vs 26.5, p < 0.001) than those in the standard care group. Women in MCP had lower odds of preterm birth (adjOR 0.46, 95 % CI 0.24-0.86), higher odds of vaginal birth (adjOR 2.55, 95 % CI 1.93-3.36), breastfeeding at discharge (adj OR 3.06, 95 % CI 2.10-4.55) with no difference in severe adverse neonatal outcome (adj OR 0.79, 95 % CI 0.57-1.09).
Conclusions: This evidence supports MCP for women with PMH. Future RCTs on model of care for this group of women is needed to establish causation.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1016/j.wombi.2022.08.002 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Anterior pituitary gland volume mediates associations between adrenarche and changes in transdiagnostic symptoms in youth.
Dev Cogn Neurosci
January 2025
Institute for Human Neuroscience, Boys Town National Research Hospital, Boys Town, NE, USA; Center for Pediatric Brain Health, Boys Town National Research Hospital, Boys Town, NE, USA; Department of Pharmacology & Neuroscience, Creighton University, Omaha, NE, USA.
The pituitary gland (PG) plays a central role in the production and secretion of pubertal hormones, with documented links to the increase in mental health symptoms during adolescence. Although literature has largely focused on examining whole PG volume, recent findings have demonstrated associations among pubertal hormone levels, including dehydroepiandrosterone (DHEA), PG subregions, and mental health symptoms during adolescence. Despite the anterior PG's role in DHEA production, studies have not yet examined potential links with transdiagnostic symptomology (i.
View Article and Find Full Text PDFDeep brain stimulation - A primer for psychiatrists.
Asian J Psychiatr
December 2024
OCD Clinic, Department of Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS), India.
Deep Brain Stimulation is a form of neurostimulation where electrical stimulation is delivered via intracranial electrodes over specific subcortical targets. It has been increasingly used as an alternative to ablative procedures for psychiatric disorders refractory to standard treatments. This review describes the common psychiatric indications for DBS, the current evidence base, putative mechanisms, and future directions.
View Article and Find Full Text PDFThe utility of multiple assessments in infancy and toddlerhood to predict middle childhood ADHD symptoms: Temperamental, behavioral, and genetic contributions.
Infant Behav Dev
January 2025
Department of Psychology, Arizona State University, USA.
Background: Early intervention is effective for reducing ADHD symptoms and related impairments, yet methods of identifying young children in need of services are lacking. Most early predictors of ADHD previously identified are of limited clinical utility. This study examines several theoretically relevant predictors of ADHD in infancy and toddlerhood and whether assessment at multiple time points improves prediction.
View Article and Find Full Text PDFTrends in Mental Health Outcomes of College Students Amid the Pandemic (Roadmap mHealth App): Longitudinal Observational Study.
J Med Internet Res
January 2025
Department of Pediatrics, Medical School, University of Michigan, Ann Arbor, MI, United States.
Background: The mental health crisis among college students intensified amid the COVID-19 pandemic, suggesting an urgent need for innovative solutions to support them. Previous efforts to address mental health concerns have been constrained, often due to the underuse or shortage of services. Mobile health (mHealth) technology holds significant potential for providing resilience-building support and enhancing access to mental health care.
View Article and Find Full Text PDFUser Outcomes for an App-Delivered Hypnosis Intervention for Menopausal Hot Flashes: Retrospective Analysis.
JMIR Form Res
January 2025
Mind-Body Medicine Lab, Department of Psychology and Neuroscience, Baylor University, Waco, TX, United States.
Background: Hypnotherapy has been shown to be a safe, nonhormonal intervention effective for treating menopausal hot flashes. However, women experiencing hot flashes may face accessibility barriers to in-person hypnotherapy. To solve this issue, a smartphone app has been created to deliver hypnotherapy.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!