Effects of mindfulness-based interventions (MBIs) on depression in pregnant women: A systematic review and meta-analysis.

OBJECTIVE: We synthesized the effects of mindfulness-based interventions (MBIs) on depression in pregnant women. METHOD: Ten electronic databases were searched from inception to September 2022. We reviewed studies on outcomes for pregnant women with depression receiving mindfulness-based interventions. We only reviewed studies written in English. A random-effects model was used to compute the effect size. Funnel plot, Q statistics, and I2 were used to test the heterogeneity across studies. We examined moderators to explore sources of heterogeneity. RESULTS: Across 19 included studies (N = 1480), 717 pregnant women participated in mindfulness interventions; 763 served as controls. Mean age ranged from 25.3 to 33.6 years. Overall, mindfulness-based interventions showed reduced depression compared to control groups (g = 0.457, 95%CI 0.254, 0.659, I2 = 68 %). With subgroup analysis, mindfulness-based cognitive therapy had a greater effect on reducing depressive symptoms (g = 1.13) than mindfulness-based stress reduction (g = 0.64) and adapted mindfulness-based interventions (g = 0.31). No quality indicators moderated the ES of mindfulness-based interventions on depression. CONCLUSION: Mindfulness-based interventions significantly improved depression among pregnant women, especially mindfulness-based cognitive therapy (MBCT). Clinicians and health providers should consider using MBIs as alternative complementary treatment for improving and preventing depression in pregnant women.

The perception of childbearing sense of coherence among Chinese couples: a qualitative study.

BACKGROUND: Although childbearing health care is wellness-based and promotes normal physiology, it is in a medical model and focuses on risk aversion and disease prevention. The salutogenic theory might provide an alternative perspective to health care concerning childbearing, supporting health-promoting factors, not solely on avoiding adverse events. However, there is a dearth of qualitative research exploring couples' perceptions of childbearing from the salutogenic lens. This study aimed to explore perceptions and experiences concerning childbearing among couples in the perinatal period and identify salutogenic aspects of it. METHODS: The qualitative descriptive study adopted a directed content analysis to analyse data from a semi-structured and individual interview with 25 purposively selected Chinese couples between July 2022 and December 2022. The concepts of the sense of coherence (SOC) from the salutogenic theory were used as the theory framework for coding. RESULTS: Definitions and content for the salutogenic aspects of Chinese couples' perception of childbearing sense of coherence were developed. For comprehensibility of childbearing, four subthemes were extracted (the challenge to health and endurance; transition to and identification with the new role; conflict and reconciliation in relationships; resistance and compromise between social culture and personal development). For manageability of childbearing, two subthemes were extracted (helplessness and hope of childbearing; self-doubt and self-assurance of childbearing). For meaningfulness of childbearing, three subthemes were extracted (personal realisation; family bonding and harmony; the continuation of life). CONCLUSIONS: The findings of this study could give a greater understanding in maintaining couples' health in the perinatal period from the salutogenic lens and provide a guide to further research that the salutogenic theory could bring a health and wellness-focused agenda in practice and policy-making in the perinatal period.

Maternidade distante do país de origem: "aqui a gente não tem uma aldeia" / Maternity far from the country of origin: "here we do not have a village" / Maternidad lejos del país de origen: "aquí no tenemos pueblo"

O presente estudo é um recorte de uma pesquisa mais ampla sobre a experiência da maternidade de mulheres brasileiras migrantes. Ele tem como objetivo investigar o apoio recebido por elas no processo de tornar-se mãe. Trata-se de uma pesquisa qualitativa na qual foram realizadas, em 2022, sete entrevistas com mulheres brasileiras que vivenciaram gestação, parto e primeiro ano de vida do filho (a) em Portugal, Reino Unido, Itália, Espanha e França. Os resultados apontam para a relevância da presença de pessoas que compartilham da mesma cultura de origem na construção da maternidade e na rede de apoio durante a perinatalidade. Conclui-se que o distanciamento da rede familiar, de amigos e de referenciais da cultura de origem da mulher migrante gerou o aumento das sobrecargas psíquica e física inerentes à maternidade. Ao mesmo tempo, de acordo com as participantes, o distanciamento da família e da cultura de origem proporcionou maior liberdade e abertura para a construção da maternidade, provendo novas representações culturais que contribuíram para a construção de sua forma de ser mãe.(AU)

This study is a segment of a broader research project on the maternity experience of Brazilian migrant women. It aims to investigate the support received by these women in the process of becoming mothers. It encompasses a qualitative research study involving seven interviews conducted in 2022 with Brazilian women who experienced pregnancy, childbirth, and the first year of their child's life in Portugal, the United Kingdom, Italy, Spain, and France. The findings highlight the importance of having individuals sharing the same cultural background in the construction of motherhood and in the support network during the perinatal period. The distance from the family network, friends, and references of the migrant woman's culture of origin generated an increase in the psychic and physical burdens inherent to motherhood. Simultaneously, according to the participants, distancing from family and their cultural origins provided greater freedom and openness in constructing motherhood, offering new cultural representations that contributed to shaping their way of being mothers. (AU)

El presente estudio es parte de una investigación más amplia acerca de la experiencia de la maternidad de las mujeres migrantes brasileñas. Tiene como objetivo investigar el soporte recibido por ellas en el proceso de convertirse en madre. Se trata de una investigación cualitativa en la que, en 2022, se realizaron siete entrevistas con mujeres brasileñas que vivieron el embarazo, el parto y el primer año de vida de su hijo en Portugal, Reino Unido, Italia, España y Francia. Los resultados apuntan para la relevancia de la presencia de personas que comparten la misma cultura de origen en la construcción de la maternidad y en la red de apoyo durante la perinatalidad. Se concluye que el alejamiento de la red familiar, amigos y puntos de referencia de su cultura de origen de la mujer migrante ha generado un aumento de las sobrecargas psíquicas y físicas inherentes a la maternidad. Al mismo tiempo, según las participantes, el alejamiento de la familia y de la cultura de origen les ha proporcionado una mayor libertad y apertura para la construcción de la maternidad, brindando nuevas representaciones culturales que contribuyeron para la construcción de su forma de ser madre. (AU)

High care and low overprotection from both paternal and maternal parents predict a secure attachment style with a partner among perinatal Japanese women.

This study aimed to determine how paternal and maternal parenting before adolescence affects adult attachment to a partner during the perinatal period, using three different models of attachment. We used the Parental Bonding Instrument (PBI) and the Relationship Questionnaire (RQ) to examine perceived parenting practices and adult attachment styles, respectively. The participants included 4586 Japanese women who were pregnant or who had given birth, up until one month after childbirth. We performed structural equation modeling analysis between PBI and RQ scores with three different category models, including the four-category model (secure, fearful, preoccupied, and dismissive attachment) as Model 1, the two-category model (model of the self and others) as Model 2, and the single-category model (total attachment style) as Model 3. Models 1 and 2 showed a good fit. Both path models showed a significant association between adult attachment style and perceived paternal and maternal parenting before adolescence, where high care and low overprotection from both paternal and maternal parents predicted adult attachment. Our findings indicate that attachment styles are best described using the four-category and two-category models, and suggest that both paternal and maternal overprotection and care influence adult attachment with a partner during the perinatal period.

ForWhen Australian perinatal and infant mental health navigation programme: evaluation protocol.

INTRODUCTION: Many parents and carers experience mental health challenges during pregnancy and early postpartum years, and there are cumulative shortfalls in the identification, follow-up, and treatment of those experiencing perinatal and infant mental health (PIMH) challenges. ForWhen is a new national navigation programme in Australia that aims to improve outcomes for families by supporting parents and carers to access PIMH services that best meet their needs. This paper presents the protocol of an evaluation of the ForWhen programme, to be conducted over the first 3 years of its implementation. The specific objectives of the evaluation include examining the characteristics of navigation service delivery, its implementation and clinical impact, and identifying potential moderators of change. METHODS AND ANALYSIS: Utilising a mixed-methods design, this evaluation will incorporate three phases that reflect the stages of the programme life-cycle: (1) programme description, (2) implementation evaluation and (3) outcomes evaluation. The evaluation will use a mix of quantitative and qualitative data including deidentified routinely collected service data, participant observations, semistructured interviews, surveys and questionnaires, and a resource audit. DISCUSSION: Evaluation findings will be used to inform the development of a refined clinical navigation model, identify barriers and facilitators to successful navigation programme implementation, examine the impact of the ForWhen programme on client clinical outcomes and health service utilisation, understand how the programme is/can be best embedded in the evolving service system, and assess the cost-effectiveness and sustainability of a national navigation programme in improving health outcomes for PIMH in Australia. ETHICS AND DISSEMINATION: This research was approved by South Western Sydney Local Health District Human Research Ethics Committee (2021/ETH11611). This study was registered on the Australian New Zealand Clinical Trials Registry (ACTRN12622001443785). Results will be disseminated at conferences, in scientific journals, and in a final evaluation report.

Desire to Avoid Pregnancy scale: clinical considerations and comparison with other questions about pregnancy preferences.

BACKGROUND: Clinicians and women of reproductive age would benefit from a reliable way to identify who is likely to become pregnant in the next year, in order to direct health advice. The 14-item Desire to Avoid Pregnancy (DAP) scale is predictive of pregnancy; this paper compares it with other ways of assessing pregnancy preferences to shortlist options for clinical implementation. METHODS: A cohort of 994 UK women of reproductive age completed the DAP and other questions about pregnancy preferences, including the Attitude towards Potential Pregnancy Scale (APPS), at baseline and reported on pregnancies quarterly for a year. For each question, DAP item and combinations of DAP items, we examined the predictive ability, sensitivity, specificity, area under the receiver operating curve (AUROC), and positive and negative predictive values. RESULTS: The AUROCs and predictive ability of the APPS and DAP single items were weaker than the full DAP, though all except one had acceptable AUROCs (>0.7). The most predictive individual DAP item was 'It would be a good thing for me if I became pregnant in the next 3 months', where women who strongly agreed had a 66.7% chance of pregnancy within 12 months and the AUROC was acceptable (0.77). CONCLUSION: We recommend exploring the acceptability to women and healthcare professionals of asking a single DAP item ('It would be a good thing for me if I became pregnant in the next 3 months'), possibly in combination with additional DAP items. This will help to guide service provision to support reproductive preferences.

Pregnancy-Specific Stress and Racial Discrimination Among U.S. Women.

OBJECTIVES: Adverse birth outcomes among children born to women of color (WOC) have been associated with discrimination during pregnancy; however, little research has explored stressed caused by discrimination as well as pregnancy-specific stress. The purpose of this study was to examine differences in stress and racial discrimination (lifetime and during pregnancy) between U.S. women of different racial/ethnic groups. METHODS: Women between 18 and 45 years (n = 198; 101 non-Hispanic White, 58 Black, and 39 other WOC [i.e., Hispanic, Asian/Pacific Islander, American Indian, Mixed Race]) completed an online, cross-sectional survey between December 2019 and March 2020. Participants reported pregnancy-specific stress using the pregnancy distress questionnaire (PDQ) and pregnancy life events scale (PLE) and discrimination via the general ethnic discrimination scale (GED). ANOVAs explored differences between racial/ethnic groups' stress and discrimination. RESULTS: We found non-Hispanic White (p < 0.05) and other WOC (p < 0.01) reported higher distress during pregnancy than Black women, and other WOC (p < 0.05) reported more stressful prenatal life events (p < 0.05) than non-Hispanic Whites. However, Black (p < 0.001) and other WOC (p < 0.001) both experienced more ethnic discrimination throughout their lifetime and during their pregnancy than non-Hispanic Whites. Also, Black women experienced five times the stress from these encounters than White women (p < 0.001). CONCLUSIONS FOR PRACTICE: Previously developed pregnancy distress questionnaires may be better suited for non-Hispanic White populations and may miss important experiences unique to marginalized populations such as racial/ethnic discrimination. Adaptations to pregnancy-related stress scales are warranted given the toxicity of discrimination during pregnancy.

Delivery-Dependent Shift in Oxytocin-Responsive Cell Population in the Central Amygdala of the Female Rat.

INTRODUCTION: Despite its recent reputation as prosocial neurohormone, the most important physiological role of oxytocin (OT) is stimulating uterine contractions. Though it is well known that plasma OT concentrations change drastically during delivery, it remains unexplored whether and how OT receptors in the maternal brain are activated. We examined whether the responses of cells in the central amygdala (CeA), an OT receptor-rich limbic site involved in pain and fear memory regulation, to exogenously applied OT analogue, Thr-Gly-OT (TGOT), vary depending on delivery. METHODS: Intracellular Ca2+ dynamics of the CeA cells were visualized in brain slices from female rats at virgin (VG), during pregnancy term (PT) days 16-21, within 24 h after delivery (G0), and within 1-3 days after delivery (G3). The Ca2+ responses to 1 µM TGOT, 20 mM KCl (high K), and 300 µM ADP were compared. RESULTS: We found that fraction of cells responding to TGOT, high K, and ADP differed significantly between the four delivery-associated terms. In particular, the fraction of cells responding to TGOT (TGOT responders) significantly increased from VG and PT at G0 and G3. Furthermore, the significant positive correlation between TGOT and high K response in TGOT and high K responders was reduced at G0, while that between TGOT and ADP responses in TGOT and ADP responders was increased at G0. CONCLUSION: These results indicate that the responses of CeA cells to an OT receptor agonist markedly change around delivery, which might play a role in controlling the labor-related pain and post-delivery emotional complications.

Construção mulher-mãe: dispositivos que envolvem maternidade, mídia e seus movimentos atuais / Construcción de la madre-mujer: dispositivos que involucran la maternidad, medios de comunicación y sus movimientos actuales / Mother-woman construction: devices which involve maternity, media and their current movements

RESUMO. O pré-natal tornou-se um modo de investir na gestação, porém, a forma como cada mulher vai exercer o cuidado envolve um conjunto heterogêneo de práticas. O objetivo deste artigo é problematizar como os discursos se articulam nas redes sociais e direcionam a mulher a um modelo específico de maternidade. O percurso metodológico dá-se pela cartografia, com apoio de ferramentas foucaultianas: verdade, poder e subjetividade. Nas discussões e resultados, percebemos que o discurso de medicalização do corpo se desdobra em um investimento na família moderna, que seria um agente privilegiado de medicalização, e que as mulheres são interpeladas diretamente por este processo. Concluiu-se que o processo de medicalização atua, no corpo, por meio de uma série de saberes e discursos e compõe uma política normativa de um modelo de maternidade a partir de diferentes enunciações.

RESUMEN. El prenatal se hizo una manera de invertir en la concepción, sin embargo, la forma en que cada mujer ejercita el cuidado involucra un grupo heterogéneo de las prácticas. El objetivo de este artículo es problematizar como todos los discursos que se articulan en las redes sociales y van dirigiendo a la mujer hacia un modelo específico de maternidad. El itinerario metodológico se da por la cartografía, con el soporte de herramientas foucaultianas: la verdad, el poder y la subjectividad. En las discusiones y los resultados, nos dimos cuenta de que el discurso de medicalización del cuerpo se desdobla en una inversión en la familia moderna, que sería un agente privilegiado de medicalización, y que las mujeres son interpeladas directamente por este proceso. Se concluyó que el proceso de medicalización actúa en el cuerpo a través de una serie de saberes y discursos y compone una política normativa de un modelo de maternidad basado en diferentes enunciados.

ABSTRACT. Prenatal care has become a way to invest in gestation, but the way each woman will carry it out involves a heterogeneous set of practices. This article is aimed to problematize how the discourses are articulated in the social networks and may direct the woman to a specific model of maternity. The methodological course is given by cartography, having as a basis the Foucauldian tools: truth, power and subjectivity. In the discussions and the results, it is possible to realize that the medicalization discourse of the body unfolds in an investment for the modern family, which would be a privileged agent of medicalization, and that women are directly interpellated by this process. It was concluded that the medicalization process acts in the body through a series of knowledge and discourses and composes a normative policy of a maternity model based on different enunciations.

Ter um fiho durante a pós-graduação em enfermagem: perspectivas e desafios / Having a child during graduate nursing: perspectives and challenges / Tener un hijo durante la carrera de enfermería: perspectivas y retos

Objetivo: compreender como enfermeiras percebem a vivência de uma gravidez e os primeiros meses após o nascimento de um filho durante o mestrado/doutorado. Método: estudo qualitativo, exploratório-descritivo, desenvolvido com nove pós-graduandas em enfermagem de uma universidade pública do estado do Paraná. A coleta de dados foi realizada nos meses de agosto e setembro de 2022, a partir de entrevistas individuais semiestruturadas que foram audiogravadas, transcritas e submetidas à análise de conteúdo, modalidade temática proposta por Bardin. Resultados: emergiram três categorias temáticas: 1) Enfrentando desafios: conciliar tarefas é uma necessidade; 2) Rede de apoio como facilitadora na conciliação da maternidade com os estudos e; 3) Aumento do tempo de licença-maternidade, flexibilização e apoio interno para inclusão de mulheres mães na ciência. Conclusão: as vivências da maternidade vivenciadas por mulheres na pós-graduação foram pautadas na sobrecarga das mães pesquisadoras, repercutindo em atrasos no cumprimento de prazos, dificuldade em manter a amamentação e preocupação com a saúde dos filhos, refletindo em escolhas e renúncias da maternidade nesta etapa da vida.

Objective: to understand how nurses perceive the experience of pregnancy and the first months after the birth of a child during their master's/doctoral studies. Method: qualitative, exploratory-descriptive study, developed with nine graduate students in nursing at a public university in the state of Paraná. Data collection was carried out in August and September 2022, based on semi-structured individual interviews that were audio-recorded, transcribed and submitted to content analysis, the thematic modality proposed by Bardin. Results: three thematic categories emerged: 1) Facing challenges: reconciling tasks is a necessity; 2) Support network as a facilitator in reconciling motherhood with studies and; 3) Increased maternity leave, flexibility and internal support for the inclusion of women mothers in science. Conclusion: the experiences of motherhood experienced by women in graduate school were based on the overload of research mothers, resulting in delays in meeting deadlines, difficulty in maintaining breastfeeding and concern for the health of their children, reflecting on choices and waivers of motherhood in this life stage.

Objetivo: comprender cómo las enfermeras perciben la experiencia del embarazo y los primeros meses después del nacimiento de un hijo durante sus estudios de maestría/doctorado. Método: estudio cualitativo, exploratorio-descriptivo, desarrollado con nueve estudiantes de postgrado en enfermería de una universidad pública del estado de Paraná. La recolección de datos se realizó en agosto y septiembre de 2022, a partir de entrevistas individuales semiestructuradas que fueron grabadas en audio, transcritas y sometidas a análisis de contenido, modalidad temática propuesta por Bardin. Resultados: emergieron tres categorías temáticas: 1) Enfrentar desafíos: conciliar tareas es una necesidad; 2) Red de apoyo como facilitadora en la conciliación de la maternidad con los estudios y; 3) Aumento de la licencia de maternidad, flexibilidad y apoyo interno para la inclusión de mujeres madres en la ciencia. Conclusión: las experiencias de maternidad vividas por las mujeres en el posgrado se basaron en la sobrecarga de las madres investigadoras, resultando en retrasos en el cumplimiento de los plazos, dificultad para mantener la lactancia materna y preocupación por la salud de sus hijos, reflexionando sobre las opciones y renuncias de la maternidad en esta etapa de la vida.

[Denial of pregnancy: focus on clinical specificities]. / Déni de grossesse : mise au point sur les spécificités cliniques.

DENIAL OF PREGNANCY: FOCUS ON CLINICAL SPECIFICITIES Denial of pregnancy corresponds to an evolving pregnan¬cy without the woman being aware of being pregnant. It is generally associated with an absence of gravidic signs such as amenorrhea, abdominal swelling, breast tension, morning sickness, or maternal perception of fetal move¬ments. Although this phenomenon is not well known and is sometimes considered a myth by the medical world, it represents a significant public health problem. Indeed, the lack of obstetric monitoring and preparation for pa¬renthood are the cause of maternal, fetal and neonatal morbidity. The discovery of a denial of pregnancy should lead to the exploration of its clinical characteristics, its risk factors and the keys to its management. Although its causes are still unknown, recent discoveries in the neu¬roscience of maternal interoception could provide a better understanding of this phenomenon.

DÉNI DE GROSSESSE : MISE AU POINT SUR LES SPÉCIFICITÉS CLINIQUES Le déni de grossesse correspond à une grossesse évolu¬tive sans que la femme ne soit consciente d'être enceinte. Il est généralement associé à une absence de signes gravidiques comme l'aménorrhée, le gonflement abdomi¬nal, la tension mammaire, les nausées matinales, ou en¬core la perception maternelle des mouvements foetaux. Phénomène méconnu, parfois considéré comme un mythe par le monde médical, il représente pourtant un problème conséquent de santé publique. En effet, l'absence de suivi obstétrical et de préparation à la parentalité font le lit de morbidités maternelle, foetale et néonatale. La découverte d'un déni de grossesse doit amener à ex¬plorer ses caractéristiques cliniques, ses facteurs de risque et les clés de sa prise en charge. Bien que ses causes soient encore inconnues, les découvertes récentes en neurosciences sur l'intéroception maternelle pour¬raient permettre de mieux comprendre ce phénomène.

[The significance of menopause for Chilean women attending primary health care centers]. / El significado de la menopausia para un grupo de mujeres chilenas atendidas en el sistema público de salud.

BACKGROUND: Menopause connects a biological event with social representations related to aging Aim: To assess the meaning of menopause in a group of Chilean women attending primary health care. MATERIAL AND METHODS: Secondary analysis of a descriptive qualitative study of in-depth interviews to explore the meaning of menopause in fifteen women aged 55 to 71 years who experienced menopause between 2 and 29 years before. Data were collected using the method proposed by the Grounded Theory. Guba's criteria of scientific rigor were used. RESULTS: Relational analysis shows that menopause divides the life cycle of women into two stages related with the possibility of having children, which is heavily influenced by the cultural significance of menopause. CONCLUSIONS: Women perceive that menopause is a natural stage and that it is the end of a period focused on tasks related to reproduction and motherhood. However, that "normality" includes a suffering process, loaded with negative cultural beliefs about menopause passed down for generations.

Risk of depression in pregnancy among pregnant women undergoing high-risk prenatal care.

OBJECTIVE: to identify the risk of depression in pregnancy among pregnant women undergoing follow-up in high-risk prenatal care, to assess the factors associated with higher risk of depression in pregnancy and to compare the risk of depression in each gestational trimester. METHOD: this is a descriptive, correlational, cross-sectional study, conducted with 151 pregnant women in prenatal care in a high-risk pregnancy outpatient clinic at a university hospital in the state of São Paulo, Brazil. Data were collected through an online form. Chi-square and Fisher's exact tests were performed. After the bivariate analysis, the variables were included in the logistic regression model. In the final model, the Odds Ratio was calculated. RESULTS: 118 (78.1%) pregnant women had a higher risk of depression during pregnancy, which was higher in the first trimester, but without statistical significance. The number of pregnancies (OR = 0.32) and marital status (OR = 0.07) remained significantly associated with higher risk of depression during pregnancy as protective factors. CONCLUSION: the results elucidate the importance of screening for depression risk and the significant need to improve access to effective interventions for preventing prenatal depression and promoting mental health.

Problematic behaviours associated with generalized anxiety disorder during pregnancy and the postpartum period: A thematic analysis.

Generalized anxiety disorder (GAD) is one of the most common anxiety disorders in pregnancy and the postpartum (perinatal) period. Perinatal women with GAD engage in problematic behaviours, yet the focus and function of these behaviours remain unknown. OBJECTIVE: Given that worry during the perinatal period is largely maternally focused, the objective of this study was to explore the accompanying behavioural features of GAD during pregnancy and the postpartum period. DESIGN: A qualitative study was conducted. METHODS: Twenty-five pregnant (n = 10) and postpartum (n = 15) women were recruited through clinical referrals and the Hamilton community. Following the completion of a semistructured diagnostic interview and symptom measures, participants participated in one of seven focus groups to learn about behaviours utilized in response to their worries. A thematic analysis was conducted to identify behaviour themes and subthemes in pregnant and postpartum women. RESULTS: Five behaviour themes and 12 subthemes were identified. Specifically, participants endorsed engaging in excessive reassurance seeking, checking and repeating, overcontrol, overpreparation and avoidance behaviours. CONCLUSIONS: Our results confirm that perinatal women with GAD engage in comparable problematic behaviours to those with GAD in the general population, yet the presentation, frequency and focus of those behaviours differ. These findings have implications for theoretical formulations of GAD, and the clinical management of this disorder during the perinatal period.

The impact of Covid-19 restrictions on depressive symptoms in low-risk and high-risk pregnant women: a cross-sectional study before and during pandemic.

BACKGROUND: The COVID-19 social restrictions have increased the risk for depression compared to the previous period in Italian women with Low-Risk Pregnancy (LRP). lLess is known about the impact of COVID-19 restrictions on High-Risk Pregnancy (HRP). This study aimed: 1) to explore levels of depression in women who become pregnant before and during COVID-19 pandemic, distinguishing between LRP and HRP; 2) to analyze the impact of COVID-19 restrictions on pregnancy experience in LRP and HRP. METHODS: A before-during COVID-19 pandemic cross-sectional study was carried out on 155 pregnant women (Mean age = 34.18), between 23 and 32 weeks of gestation. 77 women were recruited before COVID-19 pandemic (51.9% LRP; 48.1% HRP) and 78 women were recruited during COVID-19 pandemic (51.3% LRP; 48.7% HRP). HRP group was enrolled during hospitalization for high-risk pregnancy. Participants filled out Edinburgh Postnatal Depression Scale. Moreover, only COVID-19 group answered an open-ended question about the impact of restriction on pregnancy experience. RESULTS: HRP women reported higher levels of depressive symptoms than LRP. No difference emerged for COVID (before/during) but an interaction effect between COVID-19 and obstetric condition was found. The qualitative results showed the impact of restrictions on emotions and concerns. CONCLUSION: Respect to the previous period, LRP women during COVID-19 presented an increased risk for depressive symptoms than HRP. The HRP women during COVID-19 seemed to use hospitalization as a resource to find a social support network with other pregnant women and to be reassured on the clinical ongoing of pregnancy.

The mediating role of coping styles in the relationship between perceived social support and antenatal depression among pregnant women: a cross-sectional study.

BACKGROUND: Antenatal depression (AD) is common in pregnant women and is associated with adverse outcomes for the mother, fetus, infant and child. The influencing factors of AD among pregnant women have been studied; however, the mechanisms of these factors remain unclear. This study was designed to examine the direct and serial mediating roles of coping styles in the relationship between perceived social support and AD among pregnant women. METHODS: A cross-sectional study was conducted among 1486 pregnant women who registered to give birth at a tertiary hospital. A self-developed questionnaire was administered to obtain sociodemographic and obstetric data. The Perceived Social Support Scale (PSSS), Simplified Coping Style Questionnaire (SCSQ), and Edinburgh Postnatal Depression Scale (EPDS) were administered to measure the perceived social support, coping styles, and depressive symptoms of pregnant women, respectively. Multiple linear stepwise regression analysis was used, and then, the specific relationships among influencing factors were determined through structural equation modelling (SEM). RESULTS: The prevalence of AD was 24.02%. The average scores of intrafamily support, extrafamily support, positive coping styles, negative coping styles and EPDS reported by pregnant women were 24.16 ± 3.09, 44.52 ± 6.16, 27.34 ± 4.89, 9.79 ± 3.82, and 7.44 ± 3.56, respectively. Multiple regression analysis showed that pregnant women with a higher level of intrafamily support exhibited a positive coping style and a decreased risk of AD. Compared with extrafamily support, the direct effect (-0.16 vs. -0.10, P < 0.05) and indirect effect of intrafamily support through coping styles (-0.028 vs. -0.027, P < 0.05) on AD were stronger. Two indirect pathways explained 17.46% of the variance in the EPDS scores. CONCLUSION: Higher social support decreased the likelihood of AD, not only directly but also through the mediating roles of coping styles. Social support should be strengthened, and positive coping styles should be advocated in every stage of pregnancy. Specifically, intrafamily support should be given more attention for pregnant Chinese women.

Coping strategies and depression during the COVID-19 pandemic in pregnant women: a cross sectional study.

BACKGROUND: Pregnant women are vulnerable to psychological problems depending on the adaptive capacities of their personality and coping strategies. This study aimed to investigate the association between coping strategies of pregnant women during the COVID-19 pandemic and depression. METHODS: This web-based cross-sectional study was conducted in 2021 on 318 pregnant women in Amol, Iran. Data collection was performed via questionnaires (Brief cope, Edinburgh Postnatal Depression Scale, CDA, and Demographic questionnaire). The questionnaires were completed through the WhatsApp and Telegram applications. Data were analyzed using the hierarchical regression analysis and SPSS software (v. 21) at the significance level of 0.05. RESULTS: About 40% of participants had depression. The most prevalent coping strategy used by pregnant women was the avoidance strategy. Hierarchical regression revealed that the coping strategy of avoidance was a significant predictor of depression (ß = 0.226, p = 0.046) after controlling background characteristics. CONCLUSIONS: The findings of this study suggest that avoidance style associated with depression in pregnant women. Therefore, obtaining further knowledge about impacts of coping strategies on pregnant women seems to be essential.

Pregnancy planning and acceptance and maternal psychological distress during pregnancy: results from the National Perinatal Survey, France, 2016.

BACKGROUND: Studies report heightened risks of mental health problems among women who experience an unintended pregnancy, but few consider the complexity of pregnancy intentions. In this study, we evaluate how different dimensions of pregnancy intentions (pregnancy planning and pregnancy acceptance) relate to two maternal depressive symptoms and perceived psychological distress. METHODS: This study draws from a cross-sectional national survey conducted in all maternities in France over a one-week period in 2016. All mothers 18 years and older who had a live birth during the study period were invited to participate. After excluding women who underwent infertility treatment, our analytical sample included 10,339 women. We first described levels and correlates of pregnancy planning and acceptance, defined in four categories; planned/welcomed, unplanned/welcomed, planned/unwelcomed, unplanned/unwelcomed. We then assessed the bivariate and multivariate associations between pregnancy planning and acceptance and two outcomes: women's self-perceived psychological health and the presence of two depressive symptoms during pregnancy. We used multivariate logistic regressions to evaluate these associations, after adjusting for socio-demographic and medical factors. RESULTS: Altogether 7.5 to 24.1% of mothers perceived their psychological health during pregnancy was poor, according to pregnancy planning and acceptance categories and 10.3 to 22.4% indicated feelings of sadness and loss of interest during pregnancy, according to pregnancy planning and acceptance categories. As compared to women with planned/welcomed pregnancies, the odds of perceived poor psychological health and depressive symptoms were 2.55 times (CI 2.20-2.95) and 1.75 times higher (CI 1.51-2.02), respectively, among unplanned/unwelcomed pregnancies and 2.02 (CI 1.61-2.53) and 2.07 (CI 1.7-2.5) higher, among planned/unwelcomed pregnancies. Among women with unplanned pregnancies, we also found higher odds of perceived poor psychological health among women whose pregnancy was unwelcomed while the odds of depressive symptoms were not different by pregnancy planning status among women with unwelcomed pregnancies. CONCLUSIONS: These findings consolidate previous reports of the association between pregnancy intentions and maternal psychological distress, while further specifying the relationship, which mostly depends on the acceptance of pregnancy timing rather than on pregnancy planning. Identifying women with low pregnancy acceptance can potentially enhance current medical practice by improving early detection of maternal depression.