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  1. Fadzil A, Balakrishnan K, Razali R, Sidi H, Malapan T, Japaraj RP, et al.
    Asia Pac Psychiatry, 2013 Apr;5 Suppl 1:7-13.
    PMID: 23857831 DOI: 10.1111/appy.12036
    Anxiety and depression are prevalent during pregnancy. Estimates of the prevalence of anxiety and depression during pregnancy vary according to the criteria used, variable methodologies and population characteristics.
    Matched MeSH terms: Pregnancy Complications/psychology*
  2. Lim KG
    Med J Malaysia, 1987 Mar;42(1):16-21.
    PMID: 3431499
    Eleven maternal deaths were recorded in Hulu Terengganu between 1981-1985. This represents a high average maternal mortality rate of 1.4 per thousand deliveries annually over the five years. Nine of the 11 women were high priority pregnancies, but only three had hospital deliveries. The most common cause of death was post-partum haemorrhage (PPH), and PPH with a retained placenta. Hospital deliveries constitute only a low proportion of total deliveries in the district. In a survey of women with high priority pregnancies attending antenatal clinics in Hulu Terengganu, it was found that 79 (69%) out of 115 respondents were resistant to advice for hospital delivery. Grandmultiparae were a significant proportion of this group.
    Study site: Maternal Child Health Centre (Klinik Kesihatan), Hulu Terengganu, Malaysia
    Matched MeSH terms: Pregnancy Complications/psychology*
  3. Norhayati MN, Nik Hazlina NH, Aniza AA
    BMC Public Health, 2016 08 18;16(1):818.
    PMID: 27538506 DOI: 10.1186/s12889-016-3524-9
    BACKGROUND: Given the growing interest in severe maternal morbidity (SMM), the need to assess its effects on quality of life is pressing. The objective of this study was to compare the quality of life scores between women with and without SMM at 1-month and 6-month postpartum in Kelantan, Malaysia.

    METHODS: A prospective double cohort study design was applied at two tertiary referral hospitals over a 6-month period. The study population included all postpartum women who delivered in 2014. Postpartum women with and without SMM were selected as the exposed and non-exposed groups, respectively. For each exposed case identified, a non-exposed case with a similar mode of delivery was selected. The main outcome measures used were scores from the Short Form-12 Health Survey (SF-12).

    RESULTS: The study measured 145 exposed and 187 non-exposed women. The group-time interaction of the repeated measure analysis of variance (RM ANOVA) showed no significant difference in the mean overall SF-12 physical component summary score changes (P = 0.534) between women with and without SMM. Similarly, the group-time interaction of the RM ANOVA showed no significant difference in the mean overall SF-12 mental component summary score changes (P = 0.674) between women with and without SMM. However, women with SMM scored significantly lower on a general health perceptions subscale at 1-month (P = 0.031), role limitations due to physical health subscale at 6-month (P = 0.019), vitality subscale at 1-month (P = 0.007) and 6-month (P = 0.008), and role limitations due to emotional problems subscales at 6-month (P = 0.008).

    CONCLUSIONS: Women with severe maternal morbidity demonstrated comparable quality of life during the 6-month postpartum period compared to women without severe maternal morbidity.

    Matched MeSH terms: Pregnancy Complications/psychology*
  4. Leelavathi M, Danasamy RS
    Med J Malaysia, 2018 08;73(4):239-243.
    PMID: 30121687 MyJurnal
    BACKGROUND: Obesity in pregnancy causes both maternal and foetal complications hence adequate knowledge of obesity related pregnancy risks would ensure better outcomes. This study aims to determine the knowledge of obesity related pregnancy risks among pregnant women.

    METHODS: A cross-sectional study was conducted among pregnant women from four antenatal clinics in Seremban, between February and May 2015. Knowledge on pregnancy risks was assessed using questionnaire. Women were defined as having broad knowledge on obesity related pregnancy risks if they correctly identified that women who are very obese, are at higher risk of obesity related pregnancy complications and weight loss prior to pregnancy is associated with lower risk of obesity related pregnancy complications. Descriptive statistics and regression tests were used in the analysis.

    RESULTS: A total of 315 women participated in this study. Their mean age is 29.3 (SD±4.8) years and majority were Malay (72.4%). More than half of them were overweight and obese (60.6%). About 63.2% participants had broad knowledge on obesity related pregnancy risk. Education is a significant predictor of broad knowledge as women with tertiary education had higher odds of having broad knowledge compared to those with only school education (OR 2.1; 95%CI: 1.28 to 3.59).

    CONCLUSIONS: This study found that more than half of the participants had knowledge of obesity related pregnancy risks and that education is a significant predictor for knowledge. Pre-pregnancy care education programmes can help identify barriers, introduce simple weight management strategies to overcome obesity, to ensure better maternal and foetal outcome.

    Matched MeSH terms: Pregnancy Complications/psychology*
  5. Mohamad Yusuff AS, Tang L, Binns CW, Lee AH
    Women Birth, 2015 Mar;28(1):25-9.
    PMID: 25466643 DOI: 10.1016/j.wombi.2014.11.002
    BACKGROUND: Postnatal depression can have serious consequences for both the mother and infant. However, epidemiological data required to implement appropriate early prevention are still lacking in Malaysia.
    AIM: To investigate the prevalence of postnatal depression within six months postpartum and associated risk factors among women in Sabah, Malaysia.
    METHODS: A prospective cohort study of 2072 women was conducted in Sabah during 2009-2010. Participants were recruited at 36-38 weeks of gestation and followed up at 1, 3 and 6 months postpartum. The presence of depressive symptoms was assessed using the validated Malay version of the Edinburgh Postnatal Depression Scale. Logistic regression analyses were performed to ascertain risk factors associated with postnatal depression.
    FINDINGS: Overall, 14.3% of mothers (95% confidence interval (CI) 12.5-16.2%) had experienced depression within the first six months postpartum. Women depressed during pregnancy (odds ratio (OR) 3.71, 95% CI 2.46-5.60) and those with consistent worries about the newborn (OR 1.68, 95% CI 1.16-2.42) were more likely to suffer from depression after childbirth. Women whose husband assisted with infant care (OR 0.43, 95% CI 0.20-0.97) and mothers who were satisfied with their marital relationship (OR 0.27, 95% CI 0.09-0.81) appeared to incur a reduced risk of postnatal depression.
    CONCLUSION: A substantial proportion of mothers suffered from postnatal depression in Sabah, Malaysia. Screening and intervention programmes targeting vulnerable subgroups of women during antenatal and early postpartum periods are recommended to deal with the problem.
    KEYWORDS: EPDS; Malaysia; Postnatal depression; Prevalence; Risk factors
    Study site: five maternal and child health clinics in Kota Kinabalu and Penampang Districts of Sabah, Malaysia
    Matched MeSH terms: Pregnancy Complications/psychology*
  6. Lee KW, Ching SM, Hoo FK, Ramachandran V, Chong SC, Tusimin M, et al.
    Midwifery, 2020 Feb;81:102586.
    PMID: 31830674 DOI: 10.1016/j.midw.2019.102586
    OBJECTIVE: Prevalence of depression, anxiety and stress symptoms in gestational diabetes mellitus ranges from 10.2% to 39.9% based on previous studies in Malaysia. Presence of depression, anxiety or stress in pregnancy may increase the risk of neonatal morbidity and mortality. The aim of this study was to determine the prevalence of neonatal outcomes and its association among mothers with gestational diabetes mellitus with and without the presence of depression, anxiety and stress symptoms in Malaysia.

    DESIGN: This was a cross-sectional study.

    SETTING: Tertiary hospitals in Malaysia.

    PARTICIPANTS: Mothers with gestational diabetes mellitus (n = 418) who deliver their neonates at two major tertiary hospitals in Malaysia.

    MEASUREMENTS: Neonatal outcomes, such as low birth weight, preterm birth, macrosomia, metabolic and electrolyte disorders, neonatal respiratory distress and congenital anomalies were determined.

    FINDINGS: Prevalence of low birth weight in neonates born to mothers with gestational diabetes mellitus was 14.6%, followed by metabolic and electrolyte disorders 10.5%, preterm birth 9.1%, macrosomia 4.8%, neonatal respiratory distress 5.8% and congenital anomalies (2.4%). Among the adverse neonatal outcomes, neonatal respiratory distress was significantly associated with the presence of depression symptoms in mothers with gestational diabetes mellitus using univariate analysis (p = 0.010). After controlling for confounding factors, predictors for neonatal respiratory distress at delivery were the presence of depression symptoms in mothers with gestational diabetes mellitus (Adjusted OR = 3.87, 95% CI = 1.32-11.35), living without a husband (Adjusted OR = 9.74, 95% CI = 2.04-46.51), preterm delivery (Adjusted OR = 7.20, 95% CI = 2.23-23.30), caesarean section (Adjusted OR = 3.33, 95% CI = 1.09-10.15), being nulliparous and primiparous (Adjusted OR = 3.62, 95% CI = 1.17-11.17) and having family history of diabetes (Adjusted OR = 3.20, 95% CI = 1.11-9.21).

    KEY CONCLUSIONS: The findings of this study demonstrate the positive association of neonatal respiratory distress with the presence of depression symptoms in mothers with gestational diabetes mellitus.

    IMPLICATIONS FOR PRACTICE: It is therefore important to identify depression symptoms after a diagnosis of gestational diabetes mellitus in pregnant mothers is made to enable early referral and interventions.

    Matched MeSH terms: Pregnancy Complications/psychology*
  7. Chaudhuri JD
    Indian J Med Sci, 2000 Dec;54(12):545-54.
    PMID: 11354820
    Most of the features of fetal alcohol syndrome (FAS) have been replicated in experimental models. They provide an insight into the effects of alcohol on the developing embryo, however, satisfactory explanations for these effects are still not available. Certain maternal characteristics of children with FAS have been identified. However, it is not absolute as at times the most unlikely women are susceptible to problems of maternal alcoholism. The levels of awareness of FAS among the general public and health workers are inadequate. Measures need to be taken to remedy this condition.
    Matched MeSH terms: Pregnancy Complications/psychology
  8. Rashid A, Mohd R
    Reprod Health, 2017 Nov 02;14(1):144.
    PMID: 29096646 DOI: 10.1186/s12978-017-0404-4
    BACKGROUND: Depression, a type of mental disorder which is portrayed by marked alterations in mood, is associated with distress and/or impaired functioning. Poor social support is an important risk factor for depression in pregnancy. An extensive literature search failed to show any published study conducted in Malaysia on antenatal depressive symptoms and the risk of poor social support on it. The aim of the study was to determine the risk of antenatal depressive symptoms due to poor social support.
    METHODS: This cross sectional study was conducted among 3000 pregnant women attending antenatal clinics in Penang, Malaysia. Edinburgh Postnatal Depression Scale (EPDS) was used to screen for antenatal depressive symptoms and the Oslo-3 Social Support Scale (OSS-3) was used to measure social support. Odds ratio and adjusted odds ratio were used to quantify the risk of antenatal depressive symptoms due to poor social support.
    RESULTS: The prevalence of depressive symptoms was 20%. Using OSS-3 scale to gauge social support, most of the participants had moderate support (61.3%) followed by poor support (22%) and strong support (16.7%). Social support was found to be significantly associated with depressive symptoms in this study (OR 2.2, aOR 2.1, AR 45%).
    CONCLUSIONS: Considering that an expecting mother's psychological factors are important in the wellbeing of the mother and child, antenatal depression must be quickly identified. Screening pregnant women for social support can help identify women with higher risk of depression.
    Study site: Antenatal clinics (klinik kesihatan), Pulau Pinang, Malaysia
    Matched MeSH terms: Pregnancy Complications/psychology
  9. Rahman M, Islam MJ, Haque SE, Saw YM, Haque MN, Duc NH, et al.
    Public Health Nutr, 2017 Feb;20(2):305-314.
    PMID: 27608854 DOI: 10.1017/S136898001600224X
    OBJECTIVE: To explore the association between high-risk fertility behaviours and the likelihood of chronic undernutrition, anaemia and the coexistence of anaemia and undernutrition among women of reproductive age.

    DESIGN: The 2011 Bangladesh Demographic and Health Survey, conducted from 8 July to 27 December 2011.

    SETTING: Selected urban and rural areas of Bangladesh.

    SUBJECTS: A total of 2197 ever-married women living with at least one child younger than 5 years. Exposure was determined from maternal reports of high-risk fertility behaviours. We considered three parameters, maternal age at the time of delivery, birth order and birth interval, to define the high-risk fertility behaviours. Chronic undernutrition, anaemia and the coexistence of anaemia and undernutrition among women were the outcome variables.

    RESULTS: A substantial percentage of women were exposed to have a high-risk fertility pattern (41·8 %); 33·0 % were at single high-risk and 8·8 % were at multiple high-risk. After adjusting for relevant covariates, high-risk fertility behaviours were associated with increased likelihood of chronic undernutrition (adjusted relative risk; 95 % CI: 1·22; 1·03, 1·44), anaemia (1·12; 1·00, 1·25) and the coexistence of anaemia and undernutrition (1·52; 1·17, 1·98). Furthermore, multiple high-risk fertility behaviours appeared to have more profound consequences on the outcome measured.

    CONCLUSIONS: Maternal high-risk fertility behaviours are shockingly frequent practices among women in Bangladesh. High-risk fertility behaviours are important predictors of the increased likelihood of women's chronic undernutrition, anaemia and the coexistence of anaemia and undernutrition.

    Matched MeSH terms: Pregnancy Complications/psychology
  10. Hasan SS, Thiruchelvam K, Ahmed SI, Clavarino AM, Mamun AA, Kairuz T
    Diabetes Metab Syndr, 2013;7(4):191-7.
    PMID: 24290082 DOI: 10.1016/j.dsx.2013.10.023
    AIMS: The aim of this study was to investigate the association between pregnancy complications, mental health-related problems, and type 2 diabetes mellitus (T2DM) in Malaysian women.
    MATERIALS AND METHODS: A case-control study of women with T2DM (n=160) matched by age range to controls without T2DM (n=160). Data were collected in the Negeri Sembilan and PutraJaya regions in Malaysia, from two hospital outpatient clinics, PutraJaya Hospital and Tuanku Jaa'far Hospital Seremban, and one health clinic at Seremban. Validated, interviewer-administered questionnaires were used to obtain the data. The unadjusted and adjusted estimates were calculated using the Mantel-Haenszel method.
    RESULTS: Neither depression (RR 0.74, 95% CI: 0.39-1.41) nor anxiety (RR 1.00, 95% CI: 0.53-1.88) symptoms increased the risk of T2DM significantly. However, gestational diabetes (RR 1.35, 95% CI: 1.02-1.79), and ≥3 pregnancies (RR 1.39, 95% CI: 1.08-1.79) were significant risk factors for the development of T2DM. T2DM was not a significant risk factor for either depression (RR 1.26, 95% CI: 0.91-1.74) or anxiety symptoms (RR 1.13, 95% CI: 0.59-2.19).
    CONCLUSION: In this study, T2DM is not a significant risk factor for depression and anxiety; similarly, neither are depression and anxiety significant risk factors for T2DM. Although prevalence of depression and anxiety is not alarming, the findings reported here should alert clinicians to screen and treat anxiety and depression in people with diabetes and also note the importance of monitoring women with complications in pregnancy for risk of later T2DM.

    Study site: two hospital outpatient clinics, PutraJaya Hospital and Tuanku Jaa'far Hospital Seremban, and one health clinic at Seremban, Negeri Sembilan, Malaysia
    Matched MeSH terms: Pregnancy Complications/psychology*
  11. Abd Aziz CB, Ahmad Suhaimi SQ, Hasim H, Ahmad AH, Long I, Zakaria R
    J Integr Med, 2019 Jan;17(1):66-70.
    PMID: 30591413 DOI: 10.1016/j.joim.2018.12.002
    OBJECTIVE: This study was done to determine whether Tualang honey could prevent the altered nociceptive behaviour, with its associated changes of oxidative stress markers and morphology of the spinal cord, among the offspring of prenatally stressed rats.

    METHODS: Pregnant rats were divided into three groups: control, stress, and stress treated with Tualang honey. The stress and stress treated with Tualang honey groups were subjected to restraint stress from day 11 of pregnancy until delivery. Ten week old male offspring (n = 9 from each group) were given formalin injection and their nociceptive behaviours were recorded. After 2 h, the rats were sacrificed, and their spinal cords were removed to assess oxidative stress activity and morphology. Nociceptive behaviour was analysed using repeated measures analysis of variance (ANOVA), while the levels of oxidative stress parameters and number of Nissl-stained neurons were analysed using a one-way ANOVA.

    RESULTS: This study demonstrated that prenatal stress was associated with increased nociceptive behaviour, changes in the oxidative stress parameters and morphology of the spinal cord of offspring exposed to prenatal stress; administration of Tualang honey reduced the alteration of these parameters.

    CONCLUSION: This study provides a preliminary understanding of the beneficial effects of Tualang honey against the changes in oxidative stress and neuronal damage in the spinal cord of the offspring of prenatally stressed rats.

    Matched MeSH terms: Pregnancy Complications/psychology
  12. Khaironisak H, Zaridah S, Hasanain FG, Zaleha MI
    Women Health, 2017 09;57(8):919-941.
    PMID: 27636717 DOI: 10.1080/03630242.2016.1222329
    Violence against women is a worldwide public health problem and becomes more crucial when it involves pregnant women. The primary aim of this study was to determine the prevalence of violence against pregnant women (VAPW), while the secondary aim was to identify the factors associated with violence and complications of violence during pregnancy. This was a cross-sectional study conducted in 1,200 postnatal women from March 1, 2015 through August 31, 2015 using a validated Malay Version of the WHO Women's Health and Life Experiences Questionnaire. Data on pregnancy complications were obtained from antenatal records and discharge summaries. The prevalence of any form of VAPW was 35.9%, consisting of: any psychological (29.8%); any physical (12.9%); and any sexual (9.8%) violence. VAPW was significantly associated with: (1) women's use of drugs, having had exposure to violence during childhood, having a violence-supporting attitude, having two or more children; and (2) having partners who were smokers, alcohol drinkers, or had controlling behavior. VAPW was significantly associated with anemia, urinary tract infection, premature rupture of membranes, antepartum hemorrhage, poor weight gain during pregnancy, low birth weight, and prematurity. In conclusion, the high prevalence of violence requires further research on preventive strategies for VAPW.
    Matched MeSH terms: Pregnancy Complications/psychology*
  13. Nasreen HE, Rahman JA, Rus RM, Kartiwi M, Sutan R, Edhborg M
    BMC Psychiatry, 2018 06 15;18(1):195.
    PMID: 29902985 DOI: 10.1186/s12888-018-1781-0
    BACKGROUND: Research on antepartum psychiatric morbidities investigating depressive and anxiety symptoms in expectant mothers and fathers is lacking in low- and middle-income countries. This study aimed to estimate the prevalence of antepartum depressive, anxiety and co-occurring significant symptoms and explore the associated factors in a cross-section of Malaysian expectant mothers and fathers.

    METHODS: We used cross-sectional data from a prospective cohort study of 911 expectant mothers and 587 expectant fathers during their third trimester of pregnancy, from health clinics of two states in the east and west coasts of Malaysia. The validated Malay version of Edinburgh Postnatal Depression Scale and the anxiety sub-scale of Depression, Anxiety and Stress Scale were used to measure the depressive and anxiety symptoms. Multiple logistic regression analyses identified the determinants of antepartum depressive and anxiety symptoms (ADS and AAS).

    RESULTS: Prevalence of ADS was 12.2% in expectant mothers and 8.4% in expectant fathers, while AAS was 28.8% in expectant mothers and 13.3% in expectant fathers, and co-occurring significant symptoms was 8.0% in expectant mothers and 4.0% in expectant fathers. Expectant mothers and fathers having perceived social/family support were less likely to suffer from ADS. Intimate partner violence, poor relationship with husbands, depression in earlier pregnancy and husband's depression in current pregnancy in expectant mothers, and living in rented house, sex preference for the unborn child, stressful life events and wife's depression in current pregnancy in expectant fathers were associated with a greater likelihood of ADS. The determinants for AAS were living in rented house and with parents/in-laws, poor relationship with husbands, restrictions during pregnancy and stressful life events for expectant mothers, and stressful life events and being unsupportive towards wives in household chores for expectant fathers.

    CONCLUSION: Both ADS and AAS are prevalent in expectant mothers and fathers, and largely an undetected problem in Malaysia. Administration of couple-based screening and referral program during antenatal check-up should be universal practices to identify and treat the psychiatric morbidities.
    Matched MeSH terms: Pregnancy Complications/psychology
  14. Nagandla K, De S
    Postgrad Med J, 2013 Jul;89(1053):402-10.
    PMID: 23524988 DOI: 10.1136/postgradmedj-2012-131634
    Restless legs syndrome (RLS) is a common sensory motor neurological disorder that is characterised by an irresistible urge to move the legs that significantly affects the quality of life of the patient. Prevalence in the general population is 5-25% and it is twice as prevalent in women as in men. RLS is the most common movement disorder in pregnancy with a fourfold increased risk of developing this disorder later in life. The pathophysiology of RLS is centred on dopaminergic dysfunction, reduced central nervous system iron, genetic linkages, or alteration in neurotransmitters such as hypocretins, endorphins levels and immune dysfunction and inflammatory mechanisms. With the emergence of new evidence, there are changes to the previous treatment recommendations for RLS. There is sufficient evidence to conclude that dopamine agonists such as rotigotine transdermal patch, pramipexole, ropinirole, gabapentin enacarbil, pregabalin and gabapentin are effective in the short-term treatment of RLS and rotigotine, followed by gabapentin enacarbil, ropinirole, pramipexole and gabapentin for long-term treatment. Based on expert consensus, the recommendation for daily RLS is dopamine agonists or gabapentin or low-potency opioids. Levodopa is less preferred for treating daily RLS due to its high risk of augmentation. For intermittent RLS, it is levodopa or dopamine agonists or low-potency opioids or benzodiazepines. For refractory RLS, the choice is to change to gabapentin or a different dopamine agonist, addition of a second agent like gabapentin or benzodiazepine to the existing drug or changing to a high-potency opioid or tramadol. Medications with safety record in pregnancy include opioids and antiepileptics such as carbamazepine and gabapentin. There are concerns that patients with RLS are at risk for metabolic deregulation, autonomic dysfunction and cardiovascular morbidity. However, a recent study concluded that RLS is not associated with increased risk of cardiovascular complications.
    Matched MeSH terms: Pregnancy Complications/psychology
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