Parenting problems postpartum can be detected early in pregnancy in patients with rheumatoid arthritis

Smeele, H. T.; Man, Yaël A de; Röder, Esther; Wintjes, Hetty; Hazes, Johanna M. W.; Dolhain, Radboud J E M

doi:10.1136/rmdopen-2020-001276

Cited by 6 publications

(7 citation statements)

References 12 publications

(15 reference statements)

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“…All instruments with at least one reported psychometric property were classified by assessment type in Table 2. Thirteen studies used six instruments ( Baby Care Assessment , ADL Profile adapted for use with parents , Concern for Children Scale , Parental Disability Index , Postpartum Support Questionnaire , Pregnancy and Motherhood Evaluation Questionnaire ) that were specifically validated for parents with a PD (Kirshbaum, 2013; Major et al, 2018; Panuccio et al, 2020) or a specific sub‐group of parents with a PD, which were either mothers with multiple sclerosis (Farber et al, 2015; Gulick, 2003; Harrison & Stuifbergen, 2002) or mothers with rheumatoid arthritis (Katz et al, 2003; Poole et al, 2009, 2011, 2012, 2014; Smeele et al, 2020; Zelkowitz et al, 2013). Overall, the dimensions of parenting practices, experience, and responsibility were assessed and are further described below.…”

Section: Resultsmentioning

confidence: 99%

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Parenting with a physical disability: A scoping review of assessment methods

Pastor-Bédard

Pituch

Lamata

et al. 2022

Aus Occup Therapy J

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Introduction Daily childcare can be challenging for parents with a physical disability who have young children. Occupational therapists are valuable facilitators to family participation. However, occupational therapists have reported significant gaps in knowledge when documenting the parenting role of parents with a physical disability in occupational therapy practice. This study explored and described the parenting assessment methods used with parents with a physical disability in the scientific literature. Methods A scoping review was conducted, and search results were reviewed by two separate reviewers. The search strategy was applied to five databases (Embase, CINAHL, MEDLINE, HaPI, PsycInfo). Numerical and thematic analyses were conducted. Results Four thousand one hundred fifty articles were screened, and 73 relevant scientific articles were included. Seventy‐six assessment methods were identified, including 20 assessment instruments with few reported population‐specific psychometric studies. Most assessments were conducted via interviews (n = 45), followed by questionnaires (n = 27), and only six were performance based. Parenting practices and experience were the two dimensions most assessed, with little attention given to parenting responsibility. Mothers with multiple sclerosis, spinal cord injury, rheumatoid arthritis, and cerebral palsy were the most assessed. Conclusion Further research is needed to develop specific, multidimensional, and validated parenting assessments for all parents with a physical disability, including performance‐based assessments. Formal assessments should be conducted by professionals, including occupational therapists, who have the necessary training.

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Section: Resultsmentioning

confidence: 99%

“…Studied population: Mothers w/ RA (Katz et al, 2003; Smeele et al, 2020), systemic sclerosis (Poole et al, 2009; Poole et al, 2011; Poole et al, 2014), lupus (Poole et al, 2012) and inflammatory arthritis (Zelkowitz et al, 2013). Fathers w/ inflammatory arthritis (Zelkowitz et al, 2013)…”

Section: Resultsmentioning

confidence: 99%

Parenting with a physical disability: A scoping review of assessment methods

Pastor-Bédard

Pituch

Lamata

et al. 2022

Aus Occup Therapy J

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“…In their work, high Health Assessment Questionnaire (HAQ) scores in the first trimester, high disease activity in the first trimester, disease duration and the presence of erosive disease were predictive for developing parenting disability after delivery. Unfortunately, whether mothers’ disabilities could affect the children was not investigated ( Smeele et al, 2020 ).…”

Section: The Long-term Outcome Of Children Born To Women With Inflammmentioning

confidence: 99%

The Influence of Treatment of Inflammatory Arthritis During Pregnancy on the Long-Term Children’s Outcome

et al. 2021

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The management of reproductive issues in women with inflammatory arthritis has greatly changed over decades. In the 1980–1990s, women with refractory forms of arthritis were either not able to get pregnant or did choose not to get pregnant because of their disabling disease. Hence, the traditional belief that pregnancy can induce a remission of arthritis. The availability of biologic agents has allowed a good control of aggressive forms of arthritis. The main topic of discussion during preconception counselling is the use of drugs during pregnancy and breastfeeding. Physicians are now supported by international recommendations released by the European League Against Rheumatism and the American College of Rheumatology, but still they must face with cultural reluctance in accepting that a pregnant woman can take medications. Patient-physician communication should be centered on the message that active maternal disease during pregnancy is detrimental to fetal health. Keeping maternal disease under control with drugs which are not harmful to the fetus is the best way to ensure the best possible outcome for both the mother and the baby. However, there might be concerns about the influence of the in utero exposure to medications on the newborn’s health conditions. Particularly, studies suggesting an increased risk of autism-spectrum-disorders in children born to women with rheumatoid arthritis has raised questions about neuropsychological impairment in the offspring of women with chronic arthritis. As a multidisciplinary group of rheumatologists and child neuropsychiatrists, we conducted a study on 16 women with chronic forms of arthritis whose diagnosis was determined before pregnancy and their 18 school-age children. The children underwent a complete neurological examination and validated tests/questionnaires. Behavioral aspects of somatization and anxiety/depression (internalizing problem) or an “adult profile” were found in nearly one third of children. Children at a high risk of neurodevelopmental problems were born to mothers with a longer history of arthritis and were breastfeed for less than 6 months of age or were not breastfeed at all. No association was found with other maternal characteristics such as autoantibody existence and disease activity during and after the pregnancy.

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“…No study has examined mothers’ subjective accounts of the coping strategies that they adopt as part of navigating experiences of distress and wellbeing with RA. There is limited evidence that RA can affect the performance of mothering roles due to pain, fatigue and impaired movement [ 13 – 15 ]. As part of coping with RA, women have reported altering daily care activities to accommodate physical limitations, including planning activities in advance to manage fatigue and having time out when in pain [ 16 , 17 ].…”

Section: Introductionmentioning

confidence: 99%

Mothers’ experiences of wellbeing and coping while living with rheumatoid arthritis: a qualitative study

2022

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Background Rheumatoid arthritis (RA) can result in difficulties for mothers when undertaking daily care activities and increased psychological distress. However, few studies have examined how women with RA subjectively experience coping and wellbeing as part of their motherhood. Methods Twenty mothers with a diagnosis of RA and a dependent child (18 years or younger) who were living in Australia took part in a semi-structured interview between June and November 2017. Purposive sampling was undertaken to include participants across degree of current RA severity, number and age of children, and having received a diagnosis before or after a first child to take account of variability across these experiences. A qualitative thematic analysis was conducted on the interview transcripts. Results The following themes were identified: ‘Burden and complexity in the mothering role’, ‘Losing control: Women’s experiences of distress’, and ‘Adjusting and letting go: Women’s experiences of wellbeing’. Experiences of distress, including feelings of failure, were associated with accounts of a loss of control over mothering practices among women, regardless of child age. In contrast, accounts of adjusting mothering practices and relinquishing control were associated with reports of enhanced wellbeing. In addition, some mothers reported greater ease due to increased independence of older children. The absence of social support exacerbated burden and distress in the women’s accounts, while the availability of support alleviated burden and was associated with reports of wellbeing. Conclusion Health professionals and services can provide support to mothers with RA by addressing feelings of failure, acknowledging strategies of adjustment and letting go, and encouraging access to social support.

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Parenting problems postpartum can be detected early in pregnancy in patients with rheumatoid arthritis

Cited by 6 publications

References 12 publications

Parenting with a physical disability: A scoping review of assessment methods

Parenting with a physical disability: A scoping review of assessment methods

The Influence of Treatment of Inflammatory Arthritis During Pregnancy on the Long-Term Children’s Outcome

Mothers’ experiences of wellbeing and coping while living with rheumatoid arthritis: a qualitative study

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