Madeleine Schauer1, Elisabetta Latartara1,2, Maria Alonso-Espias1,3, Emma Rossetti1,4, Pimrapat Gebert5,6, Wolfgang Henrich1, Larry Hinkson7,8. 1. Department of Obstetrics, Charité Hospital, Humboldt University, Berlin, Germany. 2. Università Cattolica del Sacro Cuore Largo Francesco Vito, Rome, Italy. 3. La Paz University Hospital, Madrid, Spain. 4. University of Udine, Udine, Italy. 5. Institute of Biometry and Clinical Epidemiology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität Zu Berlin, Berlin Institute of Health, Berlin, Germany. 6. Berlin Institute of Health (BIH), Berlin, Germany. 7. Department of Obstetrics, Charité Hospital, Humboldt University, Berlin, Germany. larry.hinkson@charite.de. 8. , 8. Floor, Bettenhochhaus, Campus Mitte, Chariteplatz 1, 10117, Berlin, Germany. larry.hinkson@charite.de.
Abstract
PURPOSE: This study aims to evaluate the level of psychological distress for women with breech compared to cephalic presentation. We hypothesized, that women with breech presentation have higher levels of depression, stress and anxiety. Secondary objectives were to analyze potential demographic risk factors and comorbidity of psychological distress in breech pregnancy. METHODS: The breech study group was formed by 379 women with breech presentation. A sample of 128 women with cephalic presentation was recruited during routine clinical care. Depression, anxiety and stress symptoms were ascertained by means of the Depression-Anxiety-Stress-Score (DASS)-21 questionnaire. Categorial data was analyzed with Chi-square or exact test, continuous data with unpaired t test or Mann-Whitney U test. Demographic risk factors were identified using a binary logistic regression model. RESULTS: Prevalence of psychological distress among women with breech was not higher compared to those of other pregnant women. Symptomatic depression, anxiety and stress affected 5.8%, 14.5% and 11.9% of women with breech, respectively. Decreasing age was identified as a risk factor for anxiety (p = 0.006). Multiparity increased risk for depression (p = 0.001), for anxiety (p = 0.026) and for perinatal stress (p = 0.010). More than 80% of women with depressive symptoms had comorbidities of psychological distress. CONCLUSIONS: Breech presentation compared to cephalic presentation was not associated with higher levels of psychological distress. However, breech pregnancies are affected by symptoms of potential mental disorder. Multiparous women and younger women may need additional support and would benefit from a standardized screening tool for the assessment of perinatal psychological distress. CLINICAL TRIAL REGISTRATION: Ethical approval (EA2/241/18) was granted by the Ethics Commission of the Charité University Hospital on the 23.01.2019 (ClinicalTrials.gov Identifier: NCT03827226).
PURPOSE: This study aims to evaluate the level of psychological distress for women with breech compared to cephalic presentation. We hypothesized, that women with breech presentation have higher levels of depression, stress and anxiety. Secondary objectives were to analyze potential demographic risk factors and comorbidity of psychological distress in breech pregnancy. METHODS: The breech study group was formed by 379 women with breech presentation. A sample of 128 women with cephalic presentation was recruited during routine clinical care. Depression, anxiety and stress symptoms were ascertained by means of the Depression-Anxiety-Stress-Score (DASS)-21 questionnaire. Categorial data was analyzed with Chi-square or exact test, continuous data with unpaired t test or Mann-Whitney U test. Demographic risk factors were identified using a binary logistic regression model. RESULTS: Prevalence of psychological distress among women with breech was not higher compared to those of other pregnant women. Symptomatic depression, anxiety and stress affected 5.8%, 14.5% and 11.9% of women with breech, respectively. Decreasing age was identified as a risk factor for anxiety (p = 0.006). Multiparity increased risk for depression (p = 0.001), for anxiety (p = 0.026) and for perinatal stress (p = 0.010). More than 80% of women with depressive symptoms had comorbidities of psychological distress. CONCLUSIONS: Breech presentation compared to cephalic presentation was not associated with higher levels of psychological distress. However, breech pregnancies are affected by symptoms of potential mental disorder. Multiparous women and younger women may need additional support and would benefit from a standardized screening tool for the assessment of perinatal psychological distress. CLINICAL TRIAL REGISTRATION: Ethical approval (EA2/241/18) was granted by the Ethics Commission of the Charité University Hospital on the 23.01.2019 (ClinicalTrials.gov Identifier: NCT03827226).
Authors: Georg Macharey; Mika Gissler; Leena Rahkonen; Veli-Matti Ulander; Mervi Väisänen-Tommiska; Mika Nuutila; Seppo Heinonen Journal: Arch Gynecol Obstet Date: 2017-02-07 Impact factor: 2.344
Authors: J Zeitlhofer; M Steiner; E Zadrobilek; E Häusl; P Sporn; S Asenbaum; W Oder; C Baumgartner; L Deecke Journal: Anaesthesist Date: 1989-01 Impact factor: 1.041