High-risk pregnancy and its relationship with the neurodevelopment and behavior of 2-year-old children.

High-risk pregnancies elevate maternal stress, impacting offspring neurodevelopment and behavior. This study, involving 112 participants, aimed to compare perceived stress, neurodevelopment, and behavior in high-risk and low-risk pregnancies. Two groups, high-risk and low-risk, were assessed during pregnancy for stress using hair cortisol and psychological analysis. At 24 months post-birth, their children's neurodevelopment and behavior were evaluated. Results revealed higher perceived stress and pregnancy-related concerns in high-risk pregnancies, contrasting with low-risk pregnancies. Offspring from high-risk pregnancies displayed elevated internalizing behavior scores, while low-risk pregnancies showed higher externalizing behavior scores. Additionally, women in low-risk pregnancies exhibited increased cortisol concentrations 24 months post-delivery. These findings underscore the necessity for early stress detection and prevention programs during pregnancy, particularly in high-risk cases, to enhance maternal and infant health.

Pregnant women's mental health during the COVID-19 pandemic according to the trimester of pregnancy.

AIM: This study aimed to analyse the psychological impact of the COVID-19 pandemic on pregnant women according to the pregnancy trimester, comparing their psychopathological symptomatology, pregnancy-specific stress, resilience and perceived stress to those of women pregnant before the pandemic. METHODS: A total of 797 pregnant women participated in the study, one group of 393 women pregnant before the pandemic and the other of 404 women pregnant during the pandemic. Student-t test was used to analyse continuous data and the Chi-square test was used for categorical data. RESULTS: Psychopathological symptomatology was significantly higher in six subscales of the SCL-90-R in pregnant women during COVID-19: somatisation, interpersonal sensitivity, depression, anxiety, phobic anxiety, obsessions-compulsions, mainly on the first two trimesters. There is also a higher level of pregnancy-specific stress in pregnant women during the pandemic on the first two trimesters, most likely due to the hypervigilance and fears related to the COVID-19 disease. Nevertheless, perceived stress, usually elevated during pregnancy, was lower in women pregnant during the pandemic in comparison to those pregnant before, as a positive consequence of being on lockdown and diminishing the exposure to daily stressful situations. CONCLUSIONS: Knowing the struggles these women go through during each trimester of pregnancy can be the key to a better health professional-patient relationship, consequently having a positive impact on their mental and physical health.

The role of resilience in the potential benefits of cognitive-behavioural stress management therapy during pregnancy.

PURPOSE: Stress during pregnancy has many negative repercussions on maternal and foetal health. It is therefore important to understand which therapies are effective in reducing stress levels and which variables influence the outcomes of these therapies. In this line, psychological resilience could play a key role. Thus, the aim of the study was to check whether pregnant women with different levels of resilience have different benefits in reducing cortisol levels, perceived stress, pregnancy worries, stress vulnerability, anxiety or depression through Cognitive Behavioural Stress Management Therapy. METHOD: The total sample consisted of 56 pregnant women: one group of pregnant women with high levels of resilience (n = 35); and another group with low levels of resilience (n = 21). Participants' cortisol concentration levels, perceived stress, pregnancy concerns, stress vulnerability, anxiety and depressive symptoms were assessed before and after therapy. Linear mixed models were performed to compare the two groups, which showed a group x time interaction for perceived stress. RESULTS: The low resilience group showed a reduction in their perceived stress levels with a medium effect after the intervention compared to the high resilience group, but no reduction was found in this group. No differences were found between the two groups on the other variables. CONCLUSION: Knowing which variables have a differential effect on the results of psychological therapy would allow delimiting the groups that obtain greater benefits from the therapy. This may lead to more efficient implementation of effective intervention programmes.

Symptoms of Anxiety in Mothers During the COVID-19 Lockdown: A Structural Equation Model Approach.

The COVID-19 global pandemic has forced millions of people to stay confined at home, increasing symptoms of anxiety and stress levels. Women who are also mothers, for their part, not only face the demands of motherhood but must combine working life with family life locked down in their homes. Main objective was to develop an explanatory model of the psychological consequences of COVID-19 and parental and perceived stress in mothers. A total of 261 mothers were evaluated coinciding with the lockdown imposed by the Spanish Government. The model displayed adequate indices and it was found that symptoms of anxiety in mothers increased the levels of perceived stress. The model allows to understand the close relationships between the psychological consequences of lockdown and stress in mothers. Understanding these relationships will help to prepare and direct psychological interventions in this population in the case of a possible new surge.

Resilience, stress and anxiety in pregnancy before and throughout the pandemic: a structural equation modelling approach.

The present study explored and compared the link between resilience and pregnancy-related stress, perceived stress, and anxiety, employing two structural equation models. One model focused on pregnant women before the outbreak of the pandemic, and the other on pregnancies throughout the pandemic. For this purpose, a total sample of 690 women during their pregnancy were collected: the Pre-Pandemic Group (P-PG) was composed of 341 pregnant women evaluated prior to the pandemic; and 349 pregnant women assessed at the time of the pandemic constituted the Pandemic Group (PG). The resilience, pregnancy-related stress, perceived stress, and anxiety symptomatology of the women were assessed. For both samples, resilience was found to lower levels of pregnancy-specific stress, as well as general perceived stress, and anxiety symptomatology. Furthermore, pregnancy-specific stress and perceived stress showed a covariance relationship and, that these, in turn, increased the anxiety. Moreover, the PG showed greater levels of pregnancy-specific stress, anxiety, somatisations, and obsessions-compulsions, while the P-PG presented higher perceived stress levels.

How prenatal cortisol levels may differentially affect the neurodevelopment of boys and girls.

BACKGROUND: Prenatal stress could have serious consequences on maternal and fetal health. In this sense, some studies have stated that maternal HCC during pregnancy could contribute to sex-specific effects on infant neurodevelopment, following the Developmental Origins of Health and Disease Hypothesis. AIM: This study aimed to determine whether maternal hair cortisol concentration (HCC) during each trimester of pregnancy and postpartum could predict the neurodevelopmental outcomes of their 12-month-old offspring, with sex-specific differences considered. STUDY DESIGN: longitudinal. SUBJECTS: The study involved 93 pregnant women and their babies. OUTCOME MEASURE: Hair samples collected during each trimester and postpartum and The Bayley Scales for Infant Development III was used to assess the infants' abilities. RESULTS: The results showed that maternal HCC during the first and second trimesters could predict language and motor abilities. However, when discriminated by sex, only females' cognitive, expressive language, and fine and gross motor skills were predicted by cortisol, not males. CONCLUSIONS: These findings support the idea that non-toxic levels of cortisol can positively influence infants' neurodevelopment.

Can we influence the neurological development and hair cortisol concentration of offspring by reducing the stress of the mother during pregnancy? A randomized controlled trial.

The objective was to evaluate the effects of a stress management cognitive behavioural therapy followed during pregnancy on subsequent childhood on hair cortisol at birth and on neurodevelopment and Hair Cortisol Concentrations (HCC) at 6 months of age. The study sample included 48 pregnant women, divided into two groups: 24 women in the Therapy Group (TG) and 24 women who received standard pregnancy care (control group (CG); CG). To test the therapy efficacy, an evaluation of the HCC and psychological stress, psychopathological symptomatology and resilience was conducted before and after the treatment. The level of cortisol in their hair was obtained during pregnancy and that of their babies at birth. Six months after birth, a cortisol sample was taken from the hair and the babies' neurodevelopment was evaluated based on a Bayley-III test. The TG presented reductions in psychological stress and psychopathological symptomatology after treatment. On the other hand, the CG increased their cortisol concentrations between the pre and post intervention, remaining stable in the TG. Moreover, results showed that TG babies had lower cortisol concentrations at birth and obtained significantly higher cognitive and motor development scores at 6 months. These findings support that providing psychological care to pregnant women may not only have a benefit on these women's mental state, but may also benefit the neurodevelopment of their offspring.

Online cognitive behavioural therapy as a psychological vaccine against stress during the COVID-19 pandemic in pregnant women: A randomised controlled trial.

The COVID-19 pandemic has affected the population's levels of stress and anxiety due to its contagious nature and the uncertainties generated by its novelty. One population that is especially vulnerable to these psychological consequences are pregnant women. This is why the objective of this study was to test the efficacy of an online stress management programme of a cognitive behavioural nature on pregnant women during the COVID-19 pandemic, in Spain. The trial was controlled and randomised, with a total of 207 pregnant women divided into three groups: the Online Cognitive Behavioural Therapy group (o-CBT) (N = 70); the Online Psychological Support group (o-PS) (N = 69); and the Usual Care group (UC) (N = 68). To test the therapy's efficacy, the women's resilience, perceived stress, pregnancy-specific stress and psychopathological symptoms were assessed before and after the intervention. The o-CBT and o-PS consisted of a programme of 8 group sessions (one per week). The results showed that pregnant women who participated in the o-CBT group presented lower rates of pregnancy-specific stress and perceived stress, as well as greater resilience and lower anxiety, depression and obsessions-compulsions symptoms. These data show the efficacy of the treatment programme and thus confirm the importance of implementing these types of interventions during a woman's pregnancy, especially over periods of major stress, such as during a pandemic.

Giving birth during a pandemic: From elation to psychopathology.

OBJECTIVE: To compare the postpartum psychopathological symptoms of women who gave birth before the pandemic with those who gave birth during the pandemic. METHODS: A total of 212 women participated in the study, of which 96 gave birth before the pandemic and 116 during the pandemic. Psychopathological symptoms, postpartum depression, perceived stress, and resilience were evaluated. RESULTS: Women who gave birth during the pandemic had higher scores on somatization, obsessions and compulsions, interpersonal sensitivity, depression, anxiety, hostility, phobic anxiety, and psychoticism. In addition, perceived stress was the common predictor of an increase in these symptoms. CONCLUSION: Postpartum is a complicated period in a woman's life. Many psychological adaptations take place and women may be subject to psychological alterations during this period. In addition, women who gave birth during the COVID-19 crisis may show greater psychological vulnerability, due to the specific situation experienced during the pandemic. The COVID-19 pandemic may have played a role in the increase in psychopathological symptoms after childbirth. Detecting possible symptoms postpartum plays a crucial role, because it allows intervening and preventing the development of psychopathologies.

Stress and Psychopathology Reduction in Pregnant Women through Online Cognitive Behavioural Therapy during COVID-19: A Feasibility Study.

BACKGROUND: The global pandemic has affected the psychological health of the population, including pregnant women. Due to the difficulty of offering conventional therapies to reduce stress in this population, studies are needed to show the effect of online therapies. Therefore, the objective was to test the effect of online cognitive behavioural therapy in pregnant women during the pandemic on the main variables of stress and psychopathology. METHODS: The sample consisted of 16 pregnant women who participated in a weekly cognitive behavioural intervention for 8 weeks. Prenatal concerns, general stress, stress vulnerability, resilience and psychopathology were assessed. RESULTS: The results show a reduction in prenatal concerns, perceived stress, stress vulnerability and psychopathology, as well as an increase in resilience. CONCLUSIONS: Online cognitive behavioural intervention may be effective in pregnant women, so it is important to conduct a randomised controlled trial to certify these findings.

The psychological impact of the COVID-19 pandemic on pregnant women.

The aim was to examine the psychological effects caused by the COVID-19 pandemic on pregnant women, as well as the factors influencing these effects. The study design was cross-sectional and the participants were 200 pregnant women. The first group called the Pandemic Group (PG) included 100 women who were evaluated with psychological assessment instruments during the COVID-19 pandemic. The second group titled Pre-Pandemic Group (PPG) consisted of 100 women who were evaluated prior to the pandemic. Perceived stress, prenatal concerns and psychopathological symptoms were evaluated and compared. Pandemic Group scored significantly higher than Pre-Pandemic Group in the depression dimension of the SCL-90, in the phobic anxiety dimension, and in the Perceived Stress Scale. In addition, insomnia, along with having recently suffered the loss of a loved one explained 25% of the score variance in the depression dimension of the SCL-90. Insomnia also explained 13% of the variance of the results found in the Perceived Stress Scale. The fear of contagion by COVID-19 increased the scores obtained in the phobic anxiety dimension, explaining 11% of the variance. Thus, the COVID-19 pandemic could produce an increase in psychopathological symptomatology and stress, which can lead to negatively affecting pregnant women's mental health.

Giving birth during the COVID-19 pandemic: The impact on birth satisfaction and postpartum depression.

OBJECTIVE: To understand how giving birth during the coronavirus disease 2019 (COVID-19) pandemic affected women based on birth parameters (gestational age, type of birth and body weight at birth), satisfaction with childbirth, and development of postpartum depression. METHODS: This is a cross-sectional study of 162 Spanish women. They were divided into two groups: those who gave birth before the pandemic (n = 82; from September 1, 2019 to March 1, 2020) and during the pandemic (n = 75; from April 1, 2020 to July 1, 2020). They were assessed using psychological instruments for postpartum childbirth satisfaction and postpartum depression. RESULTS: It was found that women who gave birth during the pandemic suffered higher levels of stress during childbirth (U = 2652.50; P = 0.040) and gave a worse rating of the quality of care received (U = 2703.50; P = 0.041). In addition, the percentage of postpartum depression was much higher in women who gave birth during the pandemic (χ2  = 4.31; P  = 0.038). CONCLUSION: Giving birth during the COVID-19 pandemic could have an impact on greater dissatisfaction with childbirth, as well as increasing the risk of postpartum depression.

[Confinement variables by COVID-19 predictors of anxious and depressive symptoms in pregnant women]. / Variables del confinamiento por COVID-19 predictoras de sintomatología ansiosa y depresiva en mujeres embarazadas.

BACKGROUND AND OBJECTIVES: The appearance of a highly contagious disease forced the confinement of the population in almost all parts of the world, causing an increase in psychological problems, with pregnant women being a particularly vulnerable group to suffer negative consequences. The aim of this research was to check which confinement or psychological stress variables are related to the increase of anxious and depressive symptoms in pregnant women, as a consequence of the pandemic caused by the COVID-19. MATERIALS AND METHODS: The sample was composed of 131 pregnant women who experienced the confinement imposed by the Government of Spain on March 14, 2020. Sociodemographic, obstetric, confinement related and psychological variables were collected. RESULTS: Perceived stress, pregnancy-specific stress, as well as insomnia are predictive variables in most anxious (obsessions and compulsions, anxiety and phobic anxiety) and depressive symptoms related to COVID-19. CONCLUSIONS: It is important to focus future psychological interventions in this population on stress control and sleep monitoring, since these variables influence the increase of anxiety and depression.

[Cognitive-behavioral therapy as a damper of the negative psychological effects of confinement by COVID-19 on pregnant women.] / La terapia cognitiva-conductual como amortiguadora de los efectos psicológicos negativos del confinamiento por la COVID-19 en mujeres embarazadas.

OBJECTIVE: The pandemic caused by COVID-19, at a psychological level, can cause an increase in levels of stress and anxiety due to the fear of contagion and its consequences. Pregnant women are especially vulnerable to these psychological consequences. Thus, the objective of this study was to verify the efficacy of a cognitive-behavioral stress control program in reducing psychological stress and increasing resilience in pregnant women, which ended at the begining of the confinement due to COVID-19 in Spain. METHODS: The study included 22 pregnant women who were randomly divided into two groups: the experimental group (GT) consisted of 11 participants and the control group (GC) also consisted of 11 participants. Participants were recruited from the Hospital Universitario Clínico San Cecilio in the province of Granada (Spain), where the weekly cognitive behavioral intervention was also carried out, which was implemented between January 22 and March 11, 2020. They used the assessment instruments: Pregnancy Distress Questionnaire (PDQ), Perceived Stress Scale (EEP-14), Inventory of Vulnerability to Stress (IVE) and Connor Davidson Resilience Scale (CD-RISC). A mixed ANOVA of repeated measures 2*2 was performed, with the variable between groups having two levels (CG and GT), and the within-subject having two time periods (pre and post). RESULTS: The repeated measures ANOVA analysis showed group*time interaction effects between the therapy group and the control group and the CD-RISC scores (F1,20=10.658; p<0.02). Intrasubject differences in CD-RISC scores were found in the (GT) (t=-2.529; p<0.05), with a moderate effect size. CONCLUSIONS: It can be affirmed that cognitive behavioral intervention in pregnant women, administrated prior to confinement in Spain and during the COVID-19 pandemic, has resulted in increased levels of resilience in this population.

OBJETIVO: La pandemia provocada por la COVID-19, a nivel psicológico, puede producir un aumento en los niveles de estrés y ansiedad por el miedo al contagio y sus consecuencias. Un grupo especialmente vulnerable a dichas consecuencias psicológicas es el de mujeres embarazadas. Así, el objetivo de este estudio fue comprobar la eficacia de un programa de control del estrés, de carácter cognitivo-conductual, en la reducción de estrés psicológico y el aumento de la resiliencia en mujeres embarazadas, que finalizó en el momento de la instauración del confinamiento por la COVID-19 en España. METODOS: El estudio quedó constituido por veintidós mujeres embarazadas que fueron divididas en dos grupos de forma aleatoria: once constituyeron el grupo experimental (GT) y once el grupo control (GC). Las participantes fueron reclutadas del Hospital Universitario Clínico San Cecilio de la provincia de Granada (España), donde también se llevó a cabo la intervención cognitivo-conductual de carácter semanal, que se implementó entre el 22 de enero y el 11 de marzo de 2020. Se emplearon los siguientes instrumentos de evaluación: Cuestionario de Preocupaciones Prenatales (PDQ), Escala de Estrés Percibido (EEP-14), Inventario de Vulnerabilidad al Estrés (IVE) y Escala de Resiliencia de Connor y Davidson (CD-RISC). Se realizó un ANOVA mixto de medidas repetidas 2*2, teniendo la variable entre grupos dos niveles (GC y GT), y la variable intrasujeto dos momentos temporales (pre y post). RESULTADOS: El análisis ANOVA de medidas repetidas mostró efectos de interacción grupo*tiempo entre los grupos de terapia y control y las puntuaciones del CD-RISC (F1,20=10,658; p<0,02). Se encontraron en el grupo de terapia diferencias intrasujeto en las puntuaciones del CD-RISC (t=-2,529; p<0,05), con un tamaño del efecto medio. CONCLUSIONES: Se puede afirmar que la intervención cognitivo-conductual en mujeres embarazadas, impartida de manera previa al confinamiento en España y durante la pandemia provocada por la COVID-19, ha provocado un incremento de los niveles de resiliencia en dicha población.