El texto completo de este trabajo no está disponible en el Repositorio Académico UPC por restricciones de la casa editorial donde ha sido publicado.

Migraine is associated with a number of cardiometabolic risk factors including abnormalities in lipid metabolism. However, little is known about these associations among pregnant migraineurs. We conducted the present study to evaluate the extent to which altered lipid profiles are associated with history of migraine among pregnant women.

Objective To examine the independent and joint associations of childhood abuse and intimate partner violence with migraine among pregnant women. Background Childhood abuse and intimate partner violence have each been associated with migraine headaches in previous studies, but these associations have not been explored among pregnant women. Methods A cross-sectional study was conducted among a cohort of 2970 pregnant women attending prenatal clinics in Lima, Peru. History of childhood abuse (ie, physical or sexual abuse) was assessed using the Childhood Physical and Sexual Abuse Questionnaire. Intimate partner violence (IPV) was assessed using the World Health Organization questionnaire. Migraine classification (including migraine and probable migraine) was based on International Classification of Headache Disorders (ICHD)-III beta criteria. Multivariable logistic regression analyses were ...

bgelaye@hsph.harvard.edu

Abstract BACKGROUND: The PTSD Checklist-civilian (PCL-C) is one of the most commonly used self-report measures of PTSD symptoms, however, little is known about its validity when used in pregnancy. This study aims to evaluate the reliability and validity of the PCL-C as a screen for detecting PTSD symptoms among pregnant women. METHODS: A total of 3372 pregnant women who attended their first prenatal care visit in Lima, Peru participated in the study. We assessed the reliability of the PCL-C items using Cronbach's alpha. Criterion validity and performance characteristics of PCL-C were assessed against an independent, blinded Clinician-Administered PTSD Scale (CAPS) interview using measures of sensitivity, specificity and receiver operating characteristics (ROC) curves. We tested construct validity using exploratory and confirmatory factor analytic approaches. RESULTS: The reliability of t...

Background The Pittsburgh Sleep Quality Index (PSQI) and the Epworth Sleepiness Scale (ESS) are questionnaires used to assess sleep quality and excessive daytime sleepiness in clinical and population-based studies. The present study aimed to evaluate the construct validity and factor structure of the PSQI and ESS questionnaires among young adults in four countries (Chile, Ethiopia, Peru and Thailand). Methods A cross-sectional study was conducted among 8,481 undergraduate students. Students were invited to complete a self-administered questionnaire that collected information about lifestyle, demographic, and sleep characteristics. In each country, the construct validity and factorial structures of PSQI and ESS questionnaires were tested through exploratory and confirmatory factor analyses (EFA and CFA). Results The largest component-total correlation coefficient for sleep quality as asse...

El Institute 2009 de Medicina (IOM) recomendaciones de peso gestacional se adaptan a índice de masa corporal previo al embarazo de las mujeres (IMC). Las pruebas limitadas existe en métodos para la estimación pre-embarazo índice de masa corporal de las mujeres, especialmente para las mujeres que viven en países de bajos y medianos ingresos. Utilizando los datos de recogida entre las mujeres embarazadas peruanas, se comparó la concordancia entre la percepción subjetiva de IMC antes del embarazo con el IMC medido en la visita de estudio prenatal temprana.Los datos fueron de la Embarazo resultados maternos y neonatales Estudio (Promis), una cohorte de mujeres embarazadas en el Instituto Nacional Materno Perinatal (INMP) en Lima, Perú. 2605 mujeres de 18 a 49 años (media ± desviación estándar de edad gestacional = 10,9 ± 3,3 semanas) fueron incluidos en el estudio. Auto-reporte ...

STUDY OBJECTIVES: We sought to evaluate the construct validity and factor structure of the Spanish-language version of the Pittsburgh Sleep Quality Index (PSQI) among pregnant Peruvian women. METHODS: A cohort of 642 women were interviewed at ≤ 16 weeks of gestation. During interview, we ascertained information about lifestyles, demographics, sleep characteristics, and mood symptoms. Stress induced sleep disturbance, depressive symptoms, and anxiety symptoms were evaluated using the Ford Insomnia Response to Stress Test (FIRST), Patient Health Questionnaire-9 (PHQ-9), and Generalized Anxiety Disorder-7 (GAD-7) assessment scales, respectively. Consistency indices, exploratory and confirmatory factor analyses, correlations, and logistic regressions were used. RESULTS: Both exploratory and confirmatory factor analyses indicated a three-factor solution: sleep quality, sleep efficiency, and...

El texto completo de este trabajo no está disponible en el Repositorio Académico UPC por restricciones de la casa editorial donde ha sido publicado.

Objectives To examine the associations of Intimate partner violence (IPV) with stress-related sleep disturbance (measured using the Ford Insomnia Response to Stress Test [FIRST]) and poor sleep quality (measured using the Pittsburgh Sleep Quality Index [PSQI]) during early pregnancy. Methods This cross-sectional study included 634 pregnant Peruvian women. In-person interviews were conducted in early pregnancy to collect information regarding IPV history, and sleep traits. Adjusted odds ratios (aOR) and 95% confidence intervals (95%CIs) were calculated using logistic regression procedures. Results Lifetime IPV was associated with a 1.54-fold increased odds of stress-related sleep disturbance (95% CI: 1.08–2.17) and a 1.93-fold increased odds of poor sleep quality (95% CI: 1.33–2.81). Compared with women experiencing no IPV during lifetime, the aOR (95% CI) for stress-related sleep dis...

Purpose Preterm birth (PTB) is a major cause of neonatal mortality. The vaginal microbiome is associated with PTB, but results vary across racial/ethnic populations. Some evidence suggests gestational age affects this association. We investigated these associations in a novel population, conducting a post hoc analysis assessing if associations differed between women swabbed at different gestational ages. Methods We compared vaginal microbiomes from women with PTB (n = 25) to a random sample of women with term births (n = 100) among participants in the Pregnancy Outcomes, Maternal and Infant Study, conducted in Lima, Peru. Using DADA2, we identified taxa from 16S DNA sequencing and used Dirichlet multinomial mixture models to group into community state types (CSTs). Results If gestational age at sampling was not considered, no CST (diverse, Lactobacillus-dominated or Lactobacillus inersâ€...

Purpose Experiencing childhood abuse (CA) or intimate partner violence (IPV) has been linked to adverse pregnancy outcomes. We examined whether CA history and current IPV are independently and jointly associated with placental abruption (PA). Methods We recruited 662 PA cases and 665 controls in Lima, Peru. We used multivariate logistic regression to calculate odds ratios (OR), adjusting for age, education, and parity. Results Approximately 42% of cases and controls reported CA; 50% of cases and 49% of controls reported IPV. History of any CA was not associated with PA, but history of severe CA was associated with 38% increased odds of PA (adjusted OR [aOR], 1.38; 95% confidence interval (CI), 1.07–1.80), adjusting for IPV. There was a statistically nonsignificant association between severe IPV and odds of PA (aOR, 1.22; 95% CI, 0.92–1.62), adjusting for CA. Women who experienced sev...

Background: : Few investigators have evaluated the association between early pregnancy social support and depression; however, increased social support may improve mental health during pregnancy. Our objective is to examine whether in early pregnancy there is an association between social support and maternal depression among women in Peru. Methods: : 2,062 pregnant women participated in structured interviews. Early pregnancy social support was measured using the Social Support Questionnaire (SSQ-6). We evaluated the number of individuals that participants could turn to in different situations (Social Support Number Score; SSQN) and their satisfaction with support received (Social Support Satisfaction Score; SSQS). Median SSQN and SSQS characterized participants according to high and low levels of support. SSQN family vs. non-family support were also evaluated separately. Antepartum depr...

We sought to evaluate the psychometric properties of two resilience scales; the Resilience Inventory (IRES) and the 14-item Resilience Scale (RS-14) among Peruvian postpartum adolescent mothers. This cross-sectional study included 785 adolescent mothers who delivered at a maternity hospital in Lima, Peru. The Spanish versions of IRES and RS-14 were used to evaluate the properties of the measures. We examined reliability using Cronbach’s alpha. We used exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) to assess the construct validity and factor structures of the two scales. Both scales had good internal consistency (Cronbach’s alpha > 0.7). Correlation between IRES and RS-14 scores was fair (r = 0.53). The EFA results of both scales yielded a three-factor structure. EFA including all items from IRES and RS-14 yielded a six-factor structure. CFA results corrobora...

Objective We sought to evaluate the validity of the Spanish language version of the patient health questionnaire-9 (PHQ-9) depression scale in a large sample of pregnant Peruvian women using Rasch item response theory (IRT) approaches. We further sought to examine the appropriateness of the response formats, reliability and potential differential item functioning (DIF) by maternal age, educational attainment and employment status. Methods This cross-sectional study was conducted among 1520 pregnant women in Lima, Peru. A structured interview was used to collect information on demographic characteristics and PHQ-9 items. Data from the PHQ-9 were fitted to the Rasch IRT model and tested for appropriate category ordering, the assumptions of unidimensionality and local independence, item fit, reliability and presence of DIF. Results The Spanish language version of PHQ-9 demonstrated unidimen...

LED and HS have been funded by startup funds from Stanford and a pilot grant to LED from the Stanford Center for Clinical and Translation Research and Education (UL1 TR001085, PI Greenberg). LED has also been funded by Cohen Veterans Bioscience (CVB), and she is part of the CVB Working Group for PTSD Adaptive Platform Trial. BG has been funded by the NIH (R01-HD-059835, PI Williams) and CVB. HH has been funded by the NIH (NIH K01DK114379 and NIH R21AI139012), the Zhengxu and Ying He Foundation, and the Stanley Center for Psychiatric Research. MBR received funds from WPA Congress Mexico City 2018, Guayaquil CEPAM 2019, Asunción X CONGRESO LATINOAMERICANO DE LA FLAPB 2018, Guayaquil 2019 (Bago), and Lancet Psychiatry, London (commission on Violence against women) 2019. SS declares no potential conflict of interest.

Genome-wide approaches including polygenic risk scores (PRSs) are now widely used in medical research; however, few studies have been conducted in low- and middle-income countries (LMICs), especially in South America. This study was designed to test the transferability of psychiatric PRSs to individuals with different ancestral and cultural backgrounds and to provide genome-wide association study (GWAS) results for psychiatric outcomes in this sample. The PrOMIS cohort (N = 3308) was recruited from prenatal care clinics at the Instituto Nacional Materno Perinatal (INMP) in Lima, Peru. Three major psychiatric outcomes (depression, PTSD, and suicidal ideation and/or self-harm) were scored by interviewers using valid Spanish questionnaires. Illumina Multi-Ethnic Global chip was used for genotyping. Standard procedures for PRSs and GWAS were used along with extra steps to rule out confoundin...

Objective We examined the ability of anthropometric measures to predict the risk of metabolic syndrome (MetS) and its components in Peruvian adults. Methods Participants were 1,815 Peruvian adults. Body mass index (BMI), waist circumference (WC), A Body Shape Index (ABSI), Body Roundness Index (BRI) and Visceral Adiposity Index were examined. MetS components were defined using the National Cholesterol Education Program’s Adult Treatment Panel III. Logistic regression was used to calculate odds ratios of MetS and MetS components in relation to increases in anthropometric measures. Receiver operating characteristic curves (and area under the curve) were calculated to compare each measure’s power to predict MetS and MetS components. Results BRI performed similar to or better than BMI and WC at predicting MetS and MetS components. ABSI underperformed other measures. In men, the odds of M...

Background Preterm birth is a leading cause of perinatal morbidity and mortality worldwide, resulting in a pressing need to identify risk factors leading to effective interventions. Limited evidence suggests potential relationships between maternal sleep or vital exhaustion and preterm birth, yet the literature is generally inconclusive. Methods We examined the relationship between maternal sleep duration and vital exhaustion in the first six months of pregnancy and spontaneous (non-medically indicated) preterm birth among 479 Peruvian women who delivered a preterm singleton infant (<37 weeks gestation) and 480 term controls who delivered a singleton infant at term (≥37 weeks gestation). Maternal nightly sleep and reports of vital exhaustion were ascertained through in-person interviews. Spontaneous preterm birth cases were further categorized as those following either spontaneous pret...

BACKGROUND: Suicide is a leading cause of maternal death globally, and suicide prevalence rates have been shown to be increased in those with migraine. No previous study has examined the association between migraine and suicidal ideation during pregnancy. OBJECTIVE: To examine the association between migraine and suicidal ideation among a cohort of pregnant women. METHODS: A cross-sectional study was conducted among 3372 pregnant women attending prenatal care clinics in Lima, Peru. Suicidal ideation and depression were assessed using the Patient Health Questionnaire-9 (PHQ-9) scale during early pregnancy. Migraine classification (including migraine and probable migraine) was based on International Classification of Headache Disorders-III beta criteria. Multivariable logistic regression analyses were performed to estimate odds ratios (OR) and 95% confidence intervals (95%CI). RESULTS: Sui...