Overall Maternal Morbidity during Pregnancy Identified with the WHO-WOICE Instrument

Abstract

Objective. To evaluate the prevalence of nonsevere maternal morbidity (including overall health, domestic and sexual violence, functionality, and mental health) in women during antenatal care and further analyze factors associated with compromised mental functioning and clinical health by administration of the WHO’s WOICE 2.0 instrument. Method. A cross-sectional study was conducted at a referral center in Brazil with an interview and questionnaire administered to pregnant women at 28 weeks of gestation and beyond. Data collection and management were supported by REDCAP software. A descriptive analysis was performed, and a multiple regression analysis also investigated factors associated with impairment in mental conditions, functionality, and clinical health. Results. 533 women at a mean age of 28.9 years (±6.7) were included, and the majority had a partner (77.1%) and secondary education (67.7%). Exposure to violence occurred in 6.8%, and 12.7% reported substance use. Sexual satisfaction was reported by the vast majority (91.7%), although almost one-fifth were sexually abstinent. Overall, women reported very good and good health (72%), despite being told that they had a medical condition (66%). There was an overall rate of anxiety in 29.9%, depression in 39.5%, and impaired functioning in 20.4%. The perception of an abnormal clinical condition was the only factor independently associated with impaired functioning and mental health in the multiple regression model. Obesity was independently associated with clinical impairment. Conclusion. During antenatal care, pregnant women in the study reported having a high rate of anxiety, depression, impaired functioning, and substance use. These issues can affect a woman’s health and should be further addressed for specific interventions and improved quality of care.

Prevalence of Perinatal Anxiety and Related Disorders in Low- and Middle-Income Countries

“…Generalized anxiety disorder (including anxiety not specified) was the most commonly reported anxiety disorder, examined by 184 of 203 studies (90.6%) . The pooled point prevalence for generalized anxiety disorder was 22.2% (95% CI, 19.4%-25.0%; n = 173 553).…”

“…Our search identified 10 617 studies; 1231 full texts were reviewed, and of these, 203 studies were included (Figure 1; eTable 2 in Supplement 1). Cumulatively, outcomes were reported for 212 318 perinatal women (from conception to 12 months post birth) from 33 LMICs. The prevalence estimates of 6 anxiety and related disorders were reported: generalized anxiety disorder, social anxiety disorder, posttraumatic stress disorder, obsessive-compulsive disorder, panic disorder, and adjustment disorder.…”

Giving women WOICE postpartum: prevalence of maternal morbidity in high-risk pregnancies using the WHO-WOICE instrument

“…WOICE strengths the need to give voice to women during care: if we do not actively ask, we probably will not diagnose non-clinical and non-severe morbidities. However, if we really want to understand in depth the burden of maternal morbidity, we have to apply instruments that may bring to surface some underlying conditions, during antenatal care [ 32 ] and postpartum.…”

Rates of depressive and anxiety symptoms in the perinatal period during the COVID-19 pandemic: Comparisons between countries and with pre-pandemic data

“…In our sample, the Cronbach alpha was 0.90. The cutoff score GAD-7 ≥10 was based on the original validation study in the general population as well as previous studies in the perinatal population prior to and during the pandemic (e.g., Ceulemans et al, 2021 ; Ho-Fung et al, 2022 ; Lamus et al, 2021 ; Pabon et al, 2020 ; Soto-Balbuena et al, 2018).…”