Psychosocial health in pregnancy and postpartum among women living with - and without HIV and non-pregnant women living with HIV living in Nordic countries – Results from a longitudinal survey study

Abstract

Background The success of antiretroviral therapy has normalized pregnancy among women living with HIV (WWH) with a very low risk of perinatal transmission of HIV. Despite these advances, WWH still face complex medical and psychosocial issues during pregnancy and postpartum. The aim of this study was to assess differences in psychosocial health outcomes between pregnant WWH, non-pregnant WWH, and pregnant women without HIV, and further identify factors associated with probable depression in the third trimester and postpartum. Methods In a longitudinal survey study, participants were included from sites in Denmark, Finland, and Sweden during 2019–2020. Data was collected in the 3rd trimester, 3 and 6 months postpartum using standardized questionnaires assessing depression, perceived stress, loneliness, and social support. Mixed regression models were used to assess changes over time within and between groups. Logistic regression models were used to identify factors associated with depression in pregnancy and postpartum. Results A total of 47 pregnant WWH, 75 non-pregnant WWH, and 147 pregnant women without HIV were included. The prevalence of depression was high among both pregnant and non-pregnant WWH. There was no significant difference between pregnant and non-pregnant WWH in depression scores, perceived stress scores, or social support scores at any time point. Compared to pregnant women without HIV, pregnant WWH reported worse outcomes on all psychosocial scales. Social support and loneliness were associated with an increased odds of depressive symptoms in the adjusted analysis. Conclusions A high burden of adverse psychosocial outcomes was observed in both pregnant and non-pregnant women living with HIV compared to pregnant women without HIV. Loneliness and inadequate social support were associated with increased odds of depression in pregnancy and should be a focus in future support interventions.

Maternal mental health: Women’s voices and data from across the globe

“…These include commonly investigated experiences such as depression, anxiety, 'stress' [4] and 'distress' [5,6] as well as less commonly reported 'wellbeing' [7][8][9], 'emotional disorders' [10], symptoms of PTSD (Post Traumatic Stress Disorder) [11][12][13], suicidal ideation [14], mood instability [15], anger [16] and intolerance of uncertainty [17]. These experiences have been differentiated with regard to the 'antenatal' and 'postnatal' time periods, or both [18]. Some of the Collection papers refer specifically to the adverse experiences of pregnancy loss or bereavement [19], domestic violence [20] or being displaced during genocidal violence [21].…”

Overview of post-partum mother adaptation: A healthy lifestyle needs

“…The actions that result from these decisions may have either favorable or unfavorable effects on a person's health, but they nonetheless form a general pattern of healthy habits that make up a lifestyle (Cockerham, 2013;Cockerham, 2005). In the postpartum settings, we tried to emerge some indicators about healthy lifestyle needs among post-partum mother namely healthy diet, healthy body weight, healthy physical activity, and healthy psychological management (Gila-Díaz et al, 2021;Moseholm et al, 2022;Teh et al, 2021) (Figure 1).…”

Predicting maternal social loneliness by passive sensing with wearable devices

“…Maternal loneliness during pregnancy and the postpartum period is associated with several health issues for the mother and her child. Various studies showed a positive correlation between loneliness and depression during pregnancy across countries [5][6][7][8][9][10]. In addition, maternal loneliness is associated with life dissatisfaction and pair-relationship dissatisfaction [9].…”

“…Previous studies investigated loneliness during pregnancy and the postpartum period utilizing observational methods based on self-report measures, such as standard questionnaires [8] and interviews [16]. For example, Perzow et al in [5] used self-report questionnaires to discern symptoms of depression and anxiety, loneliness, and COVID-19-related adverse health outcomes.…”

“…Previous studies investigated loneliness during pregnancy and the postpartum period utilizing observational methods based on self-report measures, such as standard questionnaires [8] and interviews [16]. For example, Perzow et al .…”