Assessing depression,anxiety and couple psychological well-being in pregnancy: a preliminary study

Objective: The aim of the study was to evaluate symptoms of depression and anxiety and psychological well-being in men and women in their third trimester of pregnancy, and to compare them with two control groups of men and non-pregnant women, both with children and without children. Background: Perinatal research has largely focused on maternal depression, anxiety and the state of the marital relationship, but few studies exist including partners and comparisons with control groups of men and women both with and without children. Methods: The study was a cross-sectional survey. The total sample was 156 participants. Approximately equal numbers of participants in each group were recruited through a local community health centre in Zaragoza (Spain) and completed questionnaires in the presence of a psychologist. Anxiety, depression and the couple’s self-ratings of their well-being were assessed with the Beck Depression Inventory, the State-Trait Anxiety Inventory, and Psychological Well-being in the couple Scale, respectively. Results: The results show higher levels of depression symptoms in the ‘pregnancy group’; specifically, pregnant women reported higher levels of depression than their male partners. Also, the ‘pregnancy group’ (men and women) show lower scores on psychological well-being in the couple compared with the control groups. No significant differences in anxiety-state between the groups and sex were obtained. Conclusion: These findings are important for both researchers and clinicians in practice, in order to improve the identification of women with antenatal depressive symptoms and offer more psychological support for women and their partners during and after pregnancy.     

The factor structure of prenatal psychological and psychosocial functioning in first-time expectant parents

To evaluate the psychological and psychosocial functioning of couples undergoing their first pregnancy, 327 couples from Melbourne, Victoria completed measures of depression, anger, anxiety, positive and negative affect, current social support, perceived quality of couple's relationship, and recalled childhood family relationships during the early third trimester of pregnancy. To examine the nature of the pregnant couples' experience of pregnancy, an exploratory factor analysis was conducted separately for males and females. Four similar but not identical clusters were identified for both the men and women. The first large general factor for both sexes was concerned with psychological dysphoria (anxiety, anger and gender role stress). Three group factors were concerned separately with the individual's relationship functioning, their social support from family and friends, and the quality of their recalled childhood family relationships. Confirmatory factor analysis indicated these four-dimensional solutions showed good fit to the data and indicated differences between the female and male underlying structures. The differences between the men and women's factor structure are examined and implications of these findings are discussed.     

Comparison of overall sexual function, sexual intercourse/activity, sexual satisfaction, and sexual desire during the three trimesters of pregnancy and assessment of their determinants

IntroductionPregnancy affects women's sexual function. However, few reports have addressed this phenomenon.AimTo examine overall sexual function and three dimensions of the Taiwan version of the Female Sexual Function Index and to assess their determinants during the three trimesters of pregnancy.MethodsCross‐sectional investigation of 663 pregnant women using the International Consultation on Incontinence Questionnaire—Urinary Incontinence Short Form, the Body Image Scale for Pregnant Women, and demographics questions.Main Outcome MeasuresUrinary incontinence, body image, obstetrical history, demographics, and other factors potentially influencing overall sexual function, intercourse/activity, satisfaction, and desire during pregnancy.ResultsMean scores for overall sexual function, intercourse/activity, and satisfaction differed significantly among the three trimesters (P = or <0.02), whereas mean scores for sexual desire did not. Mean scores for overall sexual function and intercourse were significantly lower during the third trimester than during the first trimester (P < 0.001) or second trimester (P < 0.001). Mean score for satisfaction was significantly higher during the third trimester than during the first trimester (P = 0.01). Significant effects included the following: (i) the discomfort and infertility experiences on overall sexual function and on intercourse, the interaction between body image and artificial abortion on satisfaction, spontaneous abortion on desire during the first trimester; (ii) the full‐time work and infertility experiences on overall sexual function and on intercourse, the interactions between body image and medical condition on desire during the second trimester; and (iii) the interaction between gestational age and HoLou ethnicity on overall sexual function, the interaction between body image and discomfort on overall sexual function and on intercourse, the interactions between body image and infertility experiences and gravidity on satisfaction, urinary incontinence on desire during the third trimester.ConclusionsResults demonstrated that biopsychosocial and cultural factors affected Female Sexual Function Index (FSFIT) scores throughout pregnancy. Chang S‐R, Chen K‐H, Lin H‐H, and Yu H‐J. Comparison of overall sexual function, sexual intercourse/activity, sexual satisfaction, and sexual desire during the three trimesters of pregnancy and assessment of their determinants. J Sex Med 2011;8:2859–2867.     

Association between psychological status with perceived social support in pregnant women referring to Tabriz health centers

Objective: The aim of this study was to determine the relationship between the psychological status of pregnant women with perceived social support.

Method: In this cross-sectional study, 372 Iranian women were selected randomly via a two-stage cluster sampling method at the third trimester of pregnancy in healthcare centers of Tabriz-Iran. Data were collected using the socio-demographic characteristics questionnaire, perceived social support (PRQ-85) and the short form of depression, anxiety, and stress (DASS-21). The statistical tests including Spearman’s correlation, Mann–Whitney, Kruskal Wallis, and linear regression model were used for data.

Results: The mean (SD) score of perceived social support 131.5 (18.9) with a range of 25–175 was achieved. In terms of the scale of mental health, median (25–75 percentile) of the score of anxiety 4.0 (3.0–7.0), depression 1.0 (0.0–6.0), and stress 8.0 (0.6–10.0) was achieved. There was a significant negative correlation between perceived social support with anxiety (r?=??.355, p?p?p?Conclusions: The results of this study showed that social support affects the mental state of women in the third trimester of pregnancy and the levels of anxiety, depression, and stress decrease in pregnant women with increasing of social support.     

Examining Relationships Between Body Dissatisfaction,Maladaptive Perfectionism,and Postpartum Depression Symptoms

ObjectiveTo explore body dissatisfaction and maladaptive perfectionism as risk factors for postpartum depression symptomatology.DesignProspective, cohort design.SettingUrban and suburban hospital‐based obstetrician and midwifery offices.ParticipantsForty‐six (46) adult ethnically diverse pregnant women with gestational age greater than or equal to 28 weeks.MethodBody dissatisfaction and maladaptive perfectionism were assessed in the offices of health care providers during the third trimester of pregnancy. Postpartum depression symptomatology was assessed at least 2 months postpartum using the Edinburgh Postnatal Depression Scale (EPDS) via postal mail or e‐mail.ResultsBody dissatisfaction predicted postpartum depression symptoms, even after controlling for previously established risk factors. No main effect emerged between maladaptive perfectionism and postpartum depression symptoms.ConclusionsBody dissatisfaction in the third trimester of pregnancy serves as a risk factor for postpartum depression. Therefore, assessment of body image during the third trimester of pregnancy may help health care providers identify women at risk of postpartum depression. Body dissatisfaction also may be an important target for postpartum depression prevention and treatment programs.     

Mature adrenomedullin concentrations in plasma during pregnancy

Objective: Adrenomedullin is a novel peptide that exerts a potent, dose-dependent and long-lasting hypotensive effect. In human plasma, adrenomedullin consists of two molecular forms: mature and immature. Immature adrenomedullin is much less bioactive than mature adrenomedullin. Although a gradual increase in plasma adrenomedullin has been reportedly observed as pregnancy progressed, mature adrenomedullin has not been examined. The aim of this study was to elucidate the plasma level of mature adrenomedullin in pregnant women. Methods: We measured the concentrations of mature adrenomedullin in ten pregnant women in the first trimester, ten pregnant women in the third trimester, and ten non-pregnant controls with the immunoradiometric assay. Results: The mean concentration of mature adrenomedullin was significantly increased in pregnant women in the first trimester compared to age-matched non-pregnant subjects (p < 0.05). The mean concentration of mature adrenomedullin was significantly increased in pregnant women in the third trimester compared with pregnant women in the first trimester (p < 0.005). Conclusion: Our study demonstrated that concentrations of mature adrenomedullin were elevated in pregnant women compared with non-pregnant women and its concentration in the third trimester was significantly higher than that in the first trimester.     

I Am a Woman and I’m Pregnant: Body Image of Women in Taiwan During the Third Trimester of Pregnancy

Abstract: Background: Women's body image in late pregnancy and its relationship to the assumption of the maternal role have not been fully addressed in transitional cultures like that of Taiwan. The purpose of this qualitative study was to explore body image and body satisfaction of women in Taiwan during the third trimester of pregnancy. Methods: Eighteen women in the 29th to 39th week of pregnancy who were receiving prenatal examinations at clinics at a medical center in Taipei, Taiwan, took part in open‐ended, face‐to‐face interviews concentrating on the women's reactions to the changes in their bodies. Interviews were analyzed using a phenomenological approach. Results: Two major themes central to women's experience of their bodies during late pregnancy were identified. One theme, “My body: where did it go?” reflects women's use of nonpregnant adult female standards of beauty to assess their pregnant bodies and their hope of regaining their “feminine self” after childbirth. The other theme, “My body = my baby's body,” reflects women's view of the changes in their bodies as an indication of their baby's health and growth and as a sign of their adequacy as mothers. Conclusions: Conflict between “what is good for me as a woman” and “what is good for my child or for me as a mother” is very apparent when examining women's experience of late pregnancy. Awareness of the complexity of body‐related experiences of pregnant women will help to identify sources of stress and concern that may interfere with the pregnant woman's self‐identity, her social functioning, and even her experience of birth itself, and may help health care professionals provide better social support and care for women approaching the end of pregnancy. (BIRTH 33:2 June 2006)     

Low plasma levels of decoy receptor 3 (DcR3) in the third trimester of pregnancy with preeclampsia

ObjectiveThe pathophysiology of preeclampsia, a major threat during pregnancy characterized by excessive inflammatory status, remains unclear. Decoy receptor 3 (DcR3), a soluble member of the tumor necrosis factor receptor (TNFR) superfamily, is capable of inducing anti-apoptosis via binding with TL1A and anti-inflammation by driving Th2 immune reactions. DcR3 may, therefore, play a role in immune modulation during pregnancy. The purpose of this study is to explore the role of DcR3 in normal and preeclamptic pregnancies.Materials and methodsPlasma samples from 104 normal pregnant women (26, 42, and 36 in the first, second, and third trimester, respectively) and 10 patients with preeclampsia in the third trimester were collected. Plasma DcR3 levels were determined by using commercial ELISA kits. ANOVA and linear regression analysis were performed to analyze the relationship between gestational age and DcR3 levels. After adjusting for gestational days, the levels of plasma DcR3 in preeclamptic and non-preeclamptic women in the third trimester were compared.ResultsThe plasma levels of DcR3 gradually decreased as the gestational days increased during pregnancy (p < 0.05). In the third trimester, pregnant women with preeclampsia had significantly lower plasma DcR3 levels compared to non-preeclamptic women (p < 0.05).ConclusionsWe found that plasma DcR3 levels gradually decreased as gestation progressed. The levels of plasma DcR3 in preeclamptic women were significantly lower than those of normal pregnant women, suggesting that a potential involvement of DcR3 in normal pregnancy and decreased levels of DcR3 may be related to preeclampsia.     

Use of herbal medicines among pregnant women attending family health centers in Alexandria

ObjectiveThe aim of the study is to elucidate the use of herbal medicines in pregnant women and to explore patterns of herbal medication use including dietary supplements in pregnant women in Alexandria, Egypt.MethodologyA cross sectional study of pregnant females was conducted in a family health center in Alexandria between March and June 2011 utilizing a sample of 300 pregnant women (100 pregnant women in each trimester). A specially designed self administered questionnaire was used to collect the data.ResultsThe mean age of studied pregnant women was 26.9 ± 4.9 years. Only 27.3% of the studied pregnant women reported the use of herbal medicines during pregnancy while 89% reported the use of dietary supplements.The majority of pregnant women resorted to (family/friends) as primary source of information of herbal medicines (42.7% and 28%, respectively), while the majority of women using dietary supplements resorted to (physicians) as primary source of information (76%).52.4% of the studied pregnant women reported that they use ginger during the 1st trimester of pregnancy while 51.6% reported that they use fenugreek during the 3rd trimester of pregnancy.More than half of the studied pregnant women (64.6%) reported the efficacy of herbal medicines in relieving their complaints during pregnancy.ConclusionThe use of herbal medicines during pregnancy in Alexandria was uncommon while the use of dietary supplements was very common.About three quarters of studied sample reported that the physician was the person to recommend dietary supplement usage while the physician was rarely cited as the person recommending herbal usage.The most common herbs used by pregnant women were aniseed, fenugreek, ginger, while the least used was peppermint.Ginger was found to be used by a significantly higher percentage of pregnant women in the first trimester; on the other hand, fenugreek was used by a significantly higher percentage of pregnant women in the third trimester.RecommendationsResults of the following study suggest the following recommendations:General recommendationsGeneral health education for pregnant women about benefits and harms of herbal use during pregnancy in ante-natal care especially for herbs commonly used in Egypt.Specific recommendations

• ACare providers:

Training of family physicians in the family health centers on the use of herbal medicines in pregnancy and possible effects on the fetus.

• BPregnant women:

Health education program directed toward pregnant women to increase their awareness about the effects of herbal medicines.     

Effect of fetal gender on maternal serum human chorionic gonadotropin levels throughout pregnancy

Objectives: Maternal serum human chorionic gonadotropin (MshCG) levels are higher in pregnant women with female fetuses than in pregnant women with male fetuses in the third trimester of pregnancy. Our aim was to examine the effect of fetal sex on MshCG levels throughout the pregnancy. Materials and methods: Twenty-nine uncomplicated pregnancies (14 had male fetus and 15 had female fetus) were included in the study. MshCG levels were measured four times between 8–12, 14–18, 24–28 and 32–36 weeks of pregnancy. Results: MshCG levels were significantly higher in both sexes between 8–12 weeks than the other three measurement periods. At 8–12 and 14–18 weeks measurements, there were no sex related differences in the MshCG levels. At 24–28 (P<0.004) and 32–36 (P<0.001) weeks MshCG levels were significantly higher in pregnancies bearing female fetuses than those bearing male fetuses. Conclusions: Fetal gender has a significant effect on MshCG levels in the third trimester of pregnancy. Accordingly, no correlation seems to exist in the first and second trimesters.     

Routine Versus Indicated Third Trimester Ultrasound: Is a Randomized Trial Feasible?

ObjectiveAn adequate and contemporary randomized trial is needed to resolve whether routine third trimester ultrasound followed by adapted perinatal management improves perinatal outcomes in a population of women at low risk. We aimed to describe current practices regarding third trimester ultrasound in our centre and to evaluate the feasibility of a randomized trial.MethodsAll women with a singleton pregnancy managed from the beginning of pregnancy in our maternity unit who delivered after 28 weeks (N = 335) were assessed prospectively over a 50-day period. Details of maternal characteristics, medical and obstetrical history, management of pregnancy and delivery, ultrasound practices, and results were recorded. One hundred women had a brief personal interview to define their expectations and experience of third trimester ultrasound.ResultsThe women who were assessed had 2.9 ± 1.2 ultrasound scans during their pregnancy. All had a second trimester ultrasound scan and 53.7% had a third trimester scan. There was no medical indication for the third trimester ultrasound scan in 12.8% of the women. Among women with a low-risk pregnancy, 40% had a third trimester ultrasound, and 21.6% of those were done without medical indication. Among women with a low-risk pregnancy who had a third trimester ultrasound, the interview disclosed that 80% found that the test was not stressful. Of the low-risk population interviewed, 83.6% would agree to participate in a future trial.ConclusionAlthough any study designed to evaluate the effect of routine third trimester ultrasound on perinatal morbidity and mortality in a low-risk pregnant population would include a large patient sample, our study shows that a randomized trial is feasible because most women with a low-risk pregnancy do not consider this examination stressful and would volunteer to participate.     

Independent association between leptin and blood pressure during third trimester in normal and gestational diabetic pregnancies

OBJECTIVE: To assess the relationship between plasma leptin concentration during third trimester of pregnancy and blood pressure, independent of body mass index at examination and other potential confounders. STUDY DESIGN: A cross-sectional study was performed including 95 women (61 non-diabetic women, 34 women with gestational diabetes (GD)) in their third trimester of pregnancy. The relationship between plasma leptin and blood pressure was investigated using multiple linear regression analysis. RESULTS: Independent of body mass index (BMI), leptin was positively correlated to systolic (P = 0.024) and diastolic blood pressure (P = 0.002). Stepwise linear regression identified leptin as the only variable independently associated with systolic blood pressure (P = 0.003), while leptin (P < 0.001) and age (P = 0.024) were the only variables independently correlated to diastolic blood pressure. CONCLUSIONS: This study reports for the first time that, independent of BMI at examination, presence of GD or other confounders, plasma leptin is positively correlated with blood pressure in pregnant women.     

The effects of estrogen and progesterone on blood glutamate levels during normal pregnancy in women

Abstract

The purpose of this study was to examine whether changes in estrogen and progesterone levels observed during normal pregnancy influence blood glutamate levels. One-hundred and sixteen pregnant women were divided into three groups based on gestational age: group 1 included women in their first trimester, group 2 included women in their second trimester, and group 3 included women in their third trimester. A single venous blood sample was collected and analyzed for concentrations of estrogen, progesterone, glutamate-pyruvate transaminase (GPT), glutamate-oxaloacetate transaminase (GOT), and glutamate. Concentrations of blood glutamate were significantly lower during the second trimester (p?<?0.001) and third trimester (p?<?0.001). Blood glutamate levels were inversely correlated with levels of estrogen and progesterone throughout pregnancy (p?<?0.001). Levels of GOT and GPT remained stable during the course of pregnancy, apart from a moderate reduction in GPT during the third trimester. Increases in estrogen and progesterone levels during advanced stages of pregnancy were inversely correlated with maternal blood glutamate concentrations. Once a maximal blood glutamate-reducing effect was achieved, any additional estrogen and progesterone had a negligible effect on blood glutamate. This study demonstrates the glutamate-reducing effects of estrogen and progesterone, which is most likely not mediated by a GOT/GPT conversion mechanism.     

Israeli and British women's wellbeing and eating behaviours in pregnancy and postpartum

Objectives: The study had two main objectives: (a) track changes in self-esteem, eating behaviours and body satisfaction from early pregnancy to 24 months postpartum and (b) to compare changes by context (Israel vs. UK) and maternal body mass index (BMI).

Background: High maternal BMI is associated with negative body image and restrained eating, which are experienced differently across cultures.

Methods: 156 pregnant women were recruited from Israel and the UK. Seventy-three women were followed up every six months from early postpartum and until 24 months following birth. Women completed questionnaires assessing self-esteem (RSEQ), body image (BIS/BIDQ) and eating behaviours (DEBQ) and self-reported weights and heights so that BMI could be calculated.

Results: Women with higher BMI had higher levels of self-esteem and were less satisfied with their body. Healthy-weight women were more likely to lose all of their retained pregnancy weight compared to overweight and obese women. Self-esteem, body image and eating behaviours remained stable from pregnancy until 24 months postpartum. No significant differences were found for any measure by context.

Conclusion: BMI was the strongest predictor of self-esteem and body dissatisfaction and a higher BMI predicted less weight loss postpartum.     

正常妊娠妇女及新生儿脐血瘦素水平测定及其临床意义

目的 探讨正常妊娠妇女及新生儿脐血瘦素水平及其临床意义。方法 采用放射免疫法测定对照组的１０例正常未妊娠妇女、观察组的６３例妊娠妇女（其中早孕３１例,中孕１０例,晚孕２２例）、２７例分娩妇女、１８例产后妇女的血甭瘦素水平,及１８例新生儿脐血的瘦素水平。同时测定两组妇女的身高、体重、空腹胰岛素及血脂水平,并分析其与瘦素之间的关系。结果 ⑴妊娠妇女从孕中其开始,空腹胰岛素、胆固醇、甘油三酯明显升高,临     

Prevalence and relevant factors of anxiety and depression among pregnant women in a cohort study from south-east China

ABSTRACT

Objective: To describe the prevalence rate of prenatal anxiety and depression among pregnant women in a prospective cohort study and to explore the relevant factors of anxiety and depression during each trimester.

Methods: Pregnant women were recruited into the Zhoushan Pregnant Women Cohort at Zhoushan Maternal and Child Care Hospital from September 2011 to March 2015. A self-made questionnaire was used to collect information about social demography, reproductive history, physical activity, and life behaviour at the first, second and third trimester, respectively. The Self-Rating Anxiety Scale (SAS) and the Self-Rating Depression Scale (SDS) were used to assess anxiety and depression status at each trimester, respectively. Prevalence rates of prenatal anxiety and depression at each trimester were described.

Results: The prevalence of anxiety status was 22.7%, 17.4% and 20.8% in the first, second and third trimester, respectively. The corresponding prevalence rate of depression status was 35.7%, 24.0% and 26.1%, respectively. Furthermore, women with a lower education level (junior high school or below) and a more physical occupation had higher prevalence of anxiety and depression status.

Conclusions: The prevalence of prenatal anxiety and depression status was very common during pregnancy among pregnant women. Lower educational level and more physical occupations were associated with higher prevalence of anxiety and depression status.     

Longitudinal trajectory of vulvovaginal candidiasis,trichomoniasis, and bacterial vaginosis during pregnancy as well as the impact on pregnancy outcomes: a preliminary study

Objectives: The aims of this study were to describe the course of vulvovaginal candidiasis (VVC), trichomoniasis, and bacterial vaginosis (BV) in pregnancy and to explore the association between these longitudinal changes and pregnancy outcomes.

Methods: A total of 793 pregnant women were enrolled at the first trimester of pregnancy and were followed prospectively twice at the second and third trimester. VVC, trichomoniasis, and BV were evaluated at each trimester of pregnancy. Results were evaluated for trends of these three diseases and the association between these changes of trends and pregnancy outcomes.

Results: The trend of negative at all three time points was dominant for all three diseases compared with trend of positive throughout pregnancy was the most rare. In addition, for VVC, a trend toward positive can’t be ignored (7.5%). However, for BV, the distribution of other three trends (trend negative, trend positive, status random) were basically the same. Different trends of these three diseases were not associated with adverse pregnancy outcomes, with the exception of women who had a trend of BV positive throughout pregnancy were more likely to suffer from amniotic fluid infection (AFI) compared with women who were negative at all three time points (p?=?.016, OR: 17.29, 95% CI: 1.70–175.54).

Conclusions: In this population, the trend of negative throughout pregnancy was dominant for all three diseases compared with few women were positive across their pregnancy. BV may be associated with AFI during pregnancy.     

Transient vs enduring distress in late pregnancy using the EPDS: a brief longitudinal exploratory study

ABSTRACT

Background and Objective: The Edinburgh Postnatal Depression Scale (EPDS) is widely used to detect perinatal distress in women by one single administration. Recently, research has shown that during early pregnancy around half of the women scoring as ‘possibly depressed’ on the EPDS only have transient distress, when re-tested after few weeks. This finding may not occur if women are screened later in pregnancy, as their worries then may be more enduring; therefore an exploratory study was conducted to further investigate this issue.

Methods: Pregnant women (N = 84) attending a public hospital in Italy completed the EPDS in their third trimester (x = 33 weeks) and again 8–42 days later (while still pregnant). They had not received professional mental health intervention in this time interval.

Results: Approximately half of the women who initially scored high on the EPDS in late pregnancy no longer scored high just a few weeks later.

Conclusions: Approximately half of women who initially score high on the EPDS when screened in pregnancy only have transient distress in both the second and third trimester. To label these women as being ‘possibly depressed’, and mixing them with women who show enduring distress, represents a possible weakness in research studies, and may also overburden clinical services. We would therefore recommend, as research and clinical practice, a second administration of the EPDS if a woman initially scores in the distressed range at any stage in pregnancy.     

Effect of Sexual Esteem and Sexual Communication on the Relationship Between Body Image and Sexual Function in Chinese Heterosexual Women

BackgroundSexual self-esteem and communication on sexual issues with a partner contribute greatly to an individual's quality of sex life; however, their effects on the relationship between body image and sexual function are underexplored.AimTo test a serial mediating pathway of sexual self-esteem and sexual communication underlying the relationship between body image and sexual function.MethodsA total of 510 women aged 18–53 years (mean = 28, SD = 5.5) who were involved in an intimate relationship completed an online survey.OutcomesWomen's (i) body appreciation, (ii) body image self-consciousness during sexual intimacy, (iii) sexual self-esteem, (iv) dyadic sexual communication, (v) negative disclosure apprehension, and (vi) sexual function were assessed.ResultsFindings revealed that sexual self-esteem and dyadic sexual communication played a serial mediating role in the relationship between body image (body appreciation and body image self-consciousness during sexual intimacy) and sexual function, and the relationship between body image and arousal, lubrication, orgasm, satisfaction, and pain. Sexual self-esteem and negative disclosure apprehension also played a serial mediating role in the relationship between body image and sexual pain. In addition, dyadic sexual communication played a unique mediating role in the relationship between body image and sexual function, which is isolated from the effect of sexual self-esteem.Clinical ImplicationsWomen's sexual self-esteem and sexual communication with their partner can make beneficial contributions to the relationship between body image and sexual function. Therefore, promoting women's positive body image, sexual self-esteem, and sexual communication skills deserves attention from women themselves and clinicians.Strengths & LimitationsThis study used a robust method of data analysis to test the mediating effect of sexual self-esteem and sexual communication to clarify the mechanism underlying the relationship between body image and sexual function among Chinese women; however, causal conclusions cannot be drawn. Furthermore, various demographics including participants' age, education level, sexual orientation—factors such as relationship status and length, relationship functioning, and partner-related variables—and other aspects of sexual self-concept and sexual communication should be examined in future research.ConclusionThe current study indicates that women's thoughts and feelings regarding sexuality and communicating sexual issues with their partner are associated closely with their body image and sexual function.Wu T, Zheng Y. Effect of Sexual Esteem and Sexual Communication on the Relationship Between Body Image and Sexual Function in Chinese Heterosexual Women. J Sex Med 2021;18:474–486.     

Self-reported leisure-time physical activity during pregnancy and relationship to psychological well-being

The psychological benefits of physical exercise have been reported in numerous populations. While studies have found elevated stress and depressed mood during pregnancy and no adverse birth effects associated with low to moderate intensity exercise, few have examined exercise in relation to psychosocial outcomes during pregnancy. The present study examined leisure-time physical activity (LTPA) patterns during pregnancy and its association to psychological well-being. In each trimester of pregnancy 180 women self-reported on frequency, form and duration of LTPA through structured interviews. Beginning in the third month of pregnancy, data was collected monthly on depressed mood (Lubin depression adjective checklist), state-anxiety, pregnancy-specific stress (pregnancy experiences questionnaire) and Hassles Scale. Independent samples t-tests comparing exercisers and non-exercisers in each trimester showed exercisers reported significantly less depressed mood, daily hassles, state-anxiety and pregnancy-specific stress in the first and second trimester. Women who exercised in the third trimester reported less state-anxiety in that trimester compared to non-exercisers. The results indicate a consistent association between enhanced psychological well-being, as measured by a variety of psychosocial inventories, and LTPA participation particularly during the first and second trimesters of pregnancy. In healthy pregnant women, even low-intensity regular exercise may be a potentially effective low-cost method of enhancing psychological well-being.