Screening for advanced liver disease incorporating the use of transitional elastography in primary care. / Detección de enfermedad hepática avanzada incorporando el uso de la elastografía de transición en atención primaria.

OBJECTIVES: To describe the proportion of patients with liver fibrosis in at-risk populations in primary care (PC). To know the agreement between FIB-4 and transitional elastography (TE), interobserver agreement between PC and hospital care (HC) in TE, and associated risk Factors (RF). METHODS: Observational, descriptive, cross-sectional study in ≥16 years of age with RF for chronic liver disease. Sex and age, RF (alteration of liver tests [LT], metabolic syndrome, diabetes, obesity, alcohol consumption, hepatic steatosis), and FIB-4, controlled attenuation parameter and TE in PC and in HC, were collected. According to a consensus algorithm, vibration-controlled TE was performed in PC in patients with FIB-4≥1,3, and those with measurement ≥8kPa were referred to HC. RESULTS: 326 patients were studied. 71% were not referred to HC, due to liver stiffness <8kPa. 83 of the 95 derivations did TE in HC. 45 (54%) had TE ≥8, and 25 (30%) ≥12. The proportion of patients with stiffness ≥8kPa was 13,8% (45/326) and ≥12kPa, 7,6% (25/326). The predictive values of the FIB-4 were low. The interobserver correlation coefficient between TE in PC and HC was 0,433. Variables associated with TE ≥8 in PC: LT alteration, diabetes and steatosis. With TE ≥12: LT alteration, diabetes and obesity. PREDICTOR VARIABLES: LT alteration and obesity. CONCLUSIONS: The study supports the sequential performance of serum indices and TE as a screening for fibrosis in the at-risk population in PC, which allows a reduction in the percentage of patients referred to AH, and a better stratification of risk patients.

[Impact of COVID-19 on the mental health of the population: Study in primary care]. / Impacto de la COVID-19 en la salud mental de la población: estudio en atención primaria.

OBJECTIVE: To determine the prevalence of COVID-19 and the characteristics of infected patients, as well as the prevalence of mental disorders associated with the infection and the associated risk factors. Secondary: to know the prevalence of the long COVID syndrome and the characteristics of this cohort. DESIGN: Incidence study of mental disorder in patients diagnosed with COVID-19 and case-control study of long COVID syndrome in the subsample of patients diagnosed with COVID-19 without a history of mental disorder. SITE: Primary care setting in Lleida. PARTICIPANTS: The 46,258 patients diagnosed of COVID-19 without a history of mental disorder were followed for 2 years. MAIN MEASUREMENTS: The dependent variable was the mental disorder in the period 03/11/2020 to 03/11/2022; and the independent variables were clinical and social variables. Its association with mental disorder was analyzed by calculating the adjusted hazard ratio using a logistic regression model. RESULTS: The average age of 46,258 patients at the beginning of the study was 43±17.9 years. 47% were women. The mental disorder rate for all period was 3.46% (59.20% anxiety). A predictive score was elaborated. The long COVID syndrome was more common in older women, without toxic habits, with obesity and associated comorbidity. CONCLUSIONS: COVID-19 has had an impact on the mental health of patients. Knowing the risk factors for developing these mental disorders and the long COVID syndrome would allow the clinician to be able to identify patients at risk in order to establish preventive measures and avoid their appearance.

[Evaluation of virtual consultation by primary care professionals: quality dimensions and opportunities for improvement]. / Evaluación de la interconsulta virtual por los profesionales de atención primaria: dimensiones de la calidad y oportunidades de mejora.

OBJECTIVE: To know the opinion of Aragon primary care physicians about virtual consultation and its impact on the different healthcare quality domains. DESIGN: Cross-sectional study through a self-developed survey. Data collection was enabled from April 14th to May 31st, 2023. SITE: Physicians with healthcare duties in primary care in Aragon. PARTICIPANTS: Specialist physicians and resident interns in Family and Community Medicine. MEANSUREMENTS: Job characteristics, Likert variables assessing virtual consultation as a tool and its impact on healthcare quality domains, identification of advantages and disadvantages, and free answer questions proposing improvement strategies. RESULTS: 202 responses. 90.1% of participants consider virtual consultation useful, while 67.8% believe that it improves the quality of referrals. The main advantages identified are its contribution to professional enrichment and the integral visión of the patient, and the improvement of communication between the primary and secondary levels of care; the main drawback is the role of Primary Care as an intermediary in patient information. Efficiency and equity were the most highly rated quality domains, with safety being the least valued. CONCLUSIONS: Virtual consultation can promote communication and coordination of care, and enhance the primary care resolution capacity. Its success relies on training and time for its use, as well as on reaching a consensus on protocols and to homogenize resource distribution. Nevertheless, there are still opportunities for improvement, mainly in the realm of safety.

[Impact of a primary care pharmacy unit on the optimization of pharmacological treatment of type 2 diabetic patients]. / Impacto de una unidad de farmacia de atención primaria en la optimización del tratamiento farmacológico de pacientes diabéticos tipo 2.

OBJECTIVE: To evaluate the impact of a pharmaceutical intervention on treatment optimization in patients with type 2 diabetes mellitus. DESIGN: Before-after intervention study. SITE: Health centers of the Primary Care Department of Camp de Tarragona. PARTICIPANTS: Patients aged ≥ 18 years, diagnosed with type 2 diabetes mellitus and under treatment with antidiabetic drugs. INTERVENTIONS: Review of pharmacological treatment for type 2 diabetes mellitus and issuance of proposals for its adequacy. MAIN MEASUREMENTS: Demographic and clinical variables were collected to assess the adequacy of antidiabetic treatment. A consensus meeting was arranged with the patients' primary care physician to evaluate the proposals for improvement. The implementation of the proposals and the variation in postintervention glycemic control were assessed. RESULTS: A total of 907 patients (59% men) were included. A total of 782 proposals for intervention were made in 65.8% of the patients reviewed. Of the proposals, 43.5% corresponded to drug discontinuation, 16% to intensification of dosing and 12.6% to exchange for a therapeutic equivalent. Of the consensual proposals, 54.7% were implemented. HbA1c was reduced by 0.2% after the intervention (7.4 vs 7.2%). CONCLUSIONS: Review of the pharmacological treatment of patients with type 2 diabetes mellitus by a pharmacist or pharmacologist facilitates its optimization.

[When should a patient with obesity be referred to endocrinology? Current indications for bariatric surgery]. / ¿Cuándo derivar a endocrinología el paciente con obesidad? Indicaciones actuales de la cirugía bariátrica.

Bariatric surgery (BS) has been shown to be effective and efficient, but only 1% of selected patients will ever receive it. Compared to medical treatment of obesity, BS has demonstrated greater long-term sustained weight loss, a reduction in both total and cardiovascular (CV) mortality, improvement or remission of CV risk factors and other comorbidities associated with obesity, as well as improved mobility and quality of life. BS presents similar risks to other abdominal surgeries, with obesity as an added risk factor. However, mortality after this type of surgery is less than 1%, being in specialised centres even lower than 0.3%, with a morbidity of less than 7%. The most commonly performed surgical procedures at present are vertical gastrectomy and Roux---Y gastric bypass, preferably by laparoscopic approach.

Duration of severe and moderate symptoms in pharyngitis by cause.

OBJECTIVE: This study aimed to assess the cause of acute pharyngitis and determine the duration of severe and moderate symptoms based on the aetiology. DESIGN: Prospective observational study. SITE: One urban health care centre. PARTICIPANTS: Patients aged 15 or older with acute pharyngitis were included. INTERVENTIONS: Bacterial identification was carried out in the microbiology lab using MALDI-TOF in two throat samples. Patients received a symptom diary to return after one week. MAIN MEASUREMENTS: Number of days with severe symptoms, scoring 5 or more in any of the symptoms included in the symptom diary, and moderate symptoms, scoring 3 or more. RESULTS: Among the 149 patients recruited, beta-haemolytic streptococcus group A (GABHS) was the most common aetiology. Symptoms and signs alone as well as the mean Centor score cannot distinguish between GABHS and other bacterial causes in patients with acute pharyngitis. However, there was a trend indicating that infections caused by Streptococcus dysgalactiae and Streptococcus agalactiae presented more severe symptoms, whereas infections attributed to the Streptococcus anginosus group, Fusobacterium spp., and those where oropharyngeal microbiota was isolated tended to have milder symptoms. S. dysgalactiae infections showed a trend towards longer severe and moderate symptom duration. CONCLUSION: GABHS was the most prevalent, but group C streptococcus caused more severe and prolonged symptoms.

[Effectiveness of the clinical assistant in the control of hypertensive and diabetic patients in primary care]. / Efectividad del asistente clínico en el control de pacientes hipertensos y diabéticos en atención primaria.

OBJECTIVE: To evaluate the effectiveness of the incorporation of the clinical assistant in improving the control of type 2 diabetes mellitus and hypertension in a primary care center. DESIGN: Quasi-experimental study (pre-post), with a control group, with a 1-year follow-up. SETTING: Primary care center. PARTICIPANTS: Patients between the ages of 18 and 85 with a diagnosis of diabetes type 2 and/or hypertension were selected. INTERVENTION: Incorporation of the figure of the clinical assistant, previously trained. The latter contacted the patient to explain their role and obtain informed consent, assessed compliance with the protocols, and when they were incomplete and/or detected warning signs, referred the patient directly to medicine and/or nursing. RESULTS: Three thousand and sixty-four patients participated, 30.74% assigned to the intervention group. Fifty percent were women. The mean age was 68.5 years (SD 11.07). 93.59% of diabetic patients in the intervention group had at least one determination of glycosylated hemoglobin compared to 86.83% in the control group (p=0.003). Fundus and diabetic foot screening was significantly higher in the intervention group (94.31% and 85.41% vs. 83.49% and 72.38%). 88.43% of the patients in the intervention group had registered blood pressure figures compared to 62.06% of the patients in the control group (p<0.05). There were not statistically significant differences in the control of blood pressure between the patients with recorded measures (p=0.478). CONCLUSIONS: Clinical assistants can facilitate the implementation and compliance with chronic diseases protocols, and in the long run improve the degree of control of these patients and the quality of care.

Use of tele-nursing in primary care: A qualitative study on its negative and positive aspects.

OBJECTIVE: To analyze the opinions of nursing professionals on the current limitations and future potential of digital tools in healthcare. DESIGN: Qualitative and descriptive study. LOCATION: The study took place during an asynchronous MOODLE course on the use of ICT in healthcare, specifically aimed at nursing professionals. PARTICIPANTS: The number of nurses enrolled in the course was 150. METHODS: A qualitative study was conducted focusing on the positive and negative aspects that telenursing can offer in the context of a Moodle training in new technologies for nurses. A thematic analysis was carried out following the method proposed by Braun and Clarke. RESULTS: In the end 68 nurses participated in the forum. Their statements, opinions and perceptions were analyzed and 28 descriptive codes were obtained and subsequently categorized into positive and negative aspects. CONCLUSIONS: Nurses positively value the usefulness of digital tools and identify a wide range of benefits of telenursing in daily practice. At the same time, they point out crucial limitations that may slow down the adoption of telenursing, pointing to areas for improvement such as training and digital literacy of both patients and professionals. They consider that telenursing can humanise care, but insist on the need to prevent its use from increasing health inequalities.

[How to improve community engagement in health: Analysis of proposed actions following the implementation of a community engagement assessment tool]. / ¿Cómo mejoramos la participación comunitaria en salud? Análisis de las acciones propuestas tras la aplicación de una herramienta de evaluación.

OBJECTIVE: To analyse the lines of action identified in the health promotion projects participating in the EvaluA GPS research, and their relationship with the scores assigned in EvalGuia, a tool for evaluating evidence-based community participation. DESIGN: Qualitative-quantitative multicentre study. SETTING: Primary care or intersectoral network of primary care and municipalities in five autonomous communities in Spain. PARTICIPANTS: Participants of 10 health promotion projects, selected with convenience sampling, following inclusion criteria (projects with a minimum of community engagement and centred on community health). METHOD: Data were collected through questionnaires (EvalGuía tool) and participatory workshops. Quantitative data were analysed with descriptive statistics, qualitative data were analysed using matrix analysis. RESULTS: After implementing the EvalGuide tool, the lowest scores were assigned in outcome evaluation, knowledge of policies related to community participation, diversity in the core working group, inclusivity policies, financial resources and diffusion of results. The lines of action proposed were heterogeneous and did not always match with those prioritised as lower score. The prioritised lines revolved around project organisation and communication. CONCLUSIONS: The EvalGuide tool can be helpful to design action plans in Health Promotion projects. The implementation of measures in 12 months to increase the diversity of the core working group, to incorporate work-life balance measures or to improve evaluation is difficult. More time is needed to implement such measures.

Assessing patient satisfaction with telephone-based consultations before, during and after the COVID-19 pandemic in Spain.

OBJECTIVE: To validate a questionnaire to analyze the perception of users of primary care (PC) with telephone consultation (TC), and to study the satisfaction with TC by users of PC services. DESIGN: A two-phase study was conducted. Firstly, a questionnaire on satisfaction with telemedicine services was validated. Secondly, a cross-sectional study on satisfaction with TC was conducted. SETTING: PC. PARTICIPANTS: 405 users of PC services in Zaragoza (Spain). MAIN OUTCOME MEASURE: Our main outcome was the satisfaction with telemedicine services PC services. Factor analysis was carried out using the exploratory factor analysis with Varimax rotation. The reliability of the dimensions obtained was analyzed using Cronbach's alpha. The inferential analysis was conducted using parametric tests. RESULTS: The questionnaire was a valid and reliable tool (α>0.9) to assess the satisfaction of PC service users with telemedicine services. Before COVID-19, the satisfaction of the users with PC was adequate (mean=6111/10). However, during the COVID-19 the attention in PC centers became mostly telephone-based and satisfaction lowered as disappointing (mean=3555/10). Regarding the future of telemedicine, users considered it as unsatisfactory (mean=2977/10). Being a woman, being unemployed and belonging to an area of low vulnerability led to a worse perception of telemedicine. CONCLUSION: This questionnaire was a valid and reliable tool to assess the satisfaction of PC service users with telemedicine services. Perceptions of patient satisfaction decreased during COVID-19. Thus, TC seems to be a good option when the patients consider it to be a complementary rather than a substitute tool to follow-up their conditions.

[Systematic review of the primary care quality assessment instruments used in the last 10 years]. / Revisión sistemática de los instrumentos de evaluación de la calidad de Atención Primaria utilizados en los últimos 10 años.

OBJECTIVE: There are numerous instruments in the scientific literature for the evaluation of the quality of Primary Care (PC) and to know which of them are the most used and in which countries provides more information to make a well-founded decision. The aim is to determine which, between 2013 and 2023, have been the instruments used to assess the international quality of PC, its evolution and geographical distribution. DESIGN: Systematic review. DATA SOURCES: PubMed and Embase. From March to December 2023. INCLUSION CRITERIA: 1) Validation studies of specific assessment instruments to measure the quality of PC and/or the satisfaction of patients, providers or managers. 2) carried out in the field of PC and 3) published between 1/01/2013 and 01/02/2023. 83 full-text articles were included. DATA EXTRACTION: From each publication, an instrument used to evaluate the quality of the PC, attributes of the PC it evaluates, recipient of the evaluation, user, provider or manager, year, and country. RESULTS: Fifteen PC assessment instruments were found. The most widely used is the Primary Care Assessing Tool (PCAT), with wide geographical distribution, versions in several languages, is more limited in Europe, except in Spain, and is mostly used in the Primary Care Assessing Tool (PCAT). CONCLUSIONS: The PCAT, due to its cultural adaptability, availability in several languages, its ability to evaluate the fundamental principles of PC enunciated by the World Health Organization and to contemplate the perspectives of all health agents, is a complete, versatile, and consistent questionnaire for the evaluation of the quality of PC.

Strengthening primary health care in Europe with digital solutions.

This article provides an in-depth analysis of digital transformation in European primary healthcare (PHC). It assesses the impact of digital technology on healthcare delivery and management, highlighting variations in digital maturity across Europe. It emphasizes the significance of digital tools, especially during the COVID-19 pandemic, in enhancing accessibility and efficiency in healthcare. It discusses the integration of telehealth, remote monitoring, and e-health solutions, showcasing their role in patient empowerment and proactive care. Examples are included from various countries, such as Greece's ePrescription system, Lithuania's adoption of remote consultations, Spain's use of risk stratification solutions, and the Netherlands' advanced use of telemonitoring solutions, to illustrate the diverse implementation of digital solutions in PHC. The article offers insights into the challenges and opportunities of embedding digital technologies into a multidisciplinary healthcare framework, pointing towards future directions for PHC in Europe.

[Community reorientation of primary care in a health area: ROCAP project]. / Reorientación comunitaria de la atención primaria en un área de salud: proyecto ROCAP.

AIM: Evaluate the effectiveness of an intervention to incorporate group and community activities on a sustained basis in all the Basic Health Zones (ZBS) of a health area. DESIGN: During January and February 2019, two members of the research team traveled to each ZBS to interview the medical and nursing coordinators who had previously received an ad hoc initial assessment questionnaire (QAI) by email. PLACE: The scope is the 11 ZBS of a health area. PARTICIPANTS: The study population is the ZBS and the respective teams represented by the medical and nursing coordinations. INTERVENTIONS: Promote a community health commission, carry out training actions, record activities in clinical history and incorporate management objectives. MAIN MEASUREMENTS: Quantitative and qualitative analysis was carried out pre and post after the first year of intervention. RESULTS: In the pre-evaluation: 6 primary care teams (EAP) reported having group activities, 4 were participating in local action projects, 4 had a professional referent for community activities, 3 participated in projects with populations in vulnerable situations and 4 stated have specific meetings on community health. After the intervention: 11 EAPs had group activities, 8 had a reference professional, 6 were participating in local action projects, 4 collaborated in projects with vulnerable populations and 5 held meetings on community health. CONCLUSIONS: The intervention proved effective after its first year of implementation, since all the EAPs carried out group activities and collaborated with the local councils in the area; the majority had leading professionals in community care and, to a lesser extent, participation in local action projects and in vulnerable populations increased.

[Primary approach to migrant mental health and female genital mutilation]. / Abordaje de la salud mental del migrante y de la mutilación genital femenina en atención primaria.

Mental Health (MH) and Female Genital Mutilation (FGM) are two aspects of migrant health that should be addressed and screened in primary care. These topics are inherently sensitive, often challenging and difficult to approach in routine consultations. Providing comprehensive care and management needs both knowledge and a careful approach, yet these factors may sometimes result in low screening of both health issues. Migration itself does not inherently lead to MH disorders. However, the various experiences encountered throughout the migration process can contribute to MH challenges. Migrants face the same issues as the rest of the population, but their expressions may differ. Therefore, it is important to understand the cultural contexts and create a supportive environment within healthcare to effectively address both MH and FGM. FGM is a serious health issue for girls and women that should be assessed in primary care. This includes prevention for at-risk girls, support and care for affected women and community initiatives. To engage with individuals from high-risk countries, both men and women is essential to facilitate change and help to end this harmful practice.

[Initial assessment of immigrant patients in primary care]. / Atención inicial al paciente inmigrante en atención primaria.

The clinical interview of immigrant patients requires cultural competence to ensure good understanding and correct communication, in addition to collecting specific information that differs from that of native patients, such as origin and migratory route or cultural identity. Screening for latent tuberculosis infection is recommended in certain cases and screening for other infections, both cosmopolitan with a higher prevalence in migrants (HIV, syphilis, hepatitis B and C) and imported (Chagas, intestinal parasites, strongyloidiasis, schistosomiasis), depending on origin. It is essential to check the vaccination status and complete the vaccination schedule, adapting it to the current calendar, prioritizing vaccines such as measles, rubella and poliomyelitis. We propose preventive activities to be carried out when traveling to countries of origin, due to their special characteristics and risks: general advice, exploring the risk of malaria, assessing specific vaccinations, advice regarding sexually transmitted infections and special considerations if they have chronic diseases; and addressing, if appropriate, the risks of female genital mutilation.

[Implementation and use of telemedicine in health care during the outbreak of monkeypox in the health area of Ibiza and Formentera]. / Implantación y uso de la telemedicina en la asistencia sanitaria del brote de viruela símica en el Área de Salud de Ibiza y Formentera.

OBJECTIVE: The objective of this work is to describe how the use of the information and communication technologies has been used in the clinical control, follow-up and treatment of all the patients affected by monkeypox in our health area. DESIGN AND SITE: A descriptive, observational and retrospective work has been carried out to show the clinical management of the monkeypox cases assisted in the Health Area of Ibiza and Formentera (ASEF), in the field of the primary care. PARTICIPANTS AND METHODS: All patients affected by monkeypox who met the inclusion criteria were included in the study (a total of 79 patients), covering the period from 01/06/22 to 30/11/22. A protocol was designed in order to recruit the patients, extract the samples, monitor the close contacts, notify the cases to the health authorities, clinical assistance and administrative processing of the sick leaves. RESULTS AND CONCLUSIONS: The adherence of the patients with the control system was majoritarian. Telemedicine has been a useful tool for the exchange of information during the provision of continuous medical care to patients affected by the outbreak of monkeypox infection, guaranteeing their safety and privacy and allowing the management of an infectious disease that requires isolation, control, and medical monitoring.

Effectiveness of a training program for the management of risky alcohol use in primary care professionals based on motivational interviewing.

OBJECTIVE: To assess the effectiveness of a training program for Primary Care (PC) professionals developed to increase knowledge, attitudes, and skills for managing patients with risky alcohol use and in the motivational interview. DESIGN: Multicenter, two-arm parallel, randomized, open-label controlled clinical trial. SETTING: PC of the Andalusian Health Service. PARTICIPANTS: The study was completed by 80 healthcare professionals from 31 PC centers. INTERVENTIONS: In both experimental and control groups, a workshop on managing patients with risky alcohol consumption and the resolution of two videotaped clinical cases with standardized patients were conducted. The experimental group attended a workshop on motivational interviewing. MAIN MEASUREMENTS: Knowledge about managing risky alcohol use, clinical performance in patients with this health problem, and assessment of the motivational interview. RESULTS: Mean age was 39.50±13.06 - SD - (95% CI: 36.59-42.41); 71.3% (95% CI: 61.1-80.9%) were women. The average score of both groups in the knowledge questionnaire before the training program was 15.10±4.66, becoming 21.99±3.93 points after the training (95% CI: 5.70-7.92; p<0.001). The experimental group showed an average score of 18.53±13.23 before the intervention with the motivational interview and 28.33±11.86 after this intervention (p=0.002). In contrast, no significant variation was found in the score of the control group. CONCLUSIONS: A training program aimed at PC professionals designed to increase knowledge on how to manage risky alcohol use and acquire communication skills in motivational interviewing is effective.

The artificial intelligence revolution in primary care: Challenges, dilemmas and opportunities.

Artificial intelligence (AI) can be a valuable tool for primary care (PC), as, among other things, it can help healthcare professionals improve diagnostic accuracy, chronic disease management and the overall efficiency of the care they provide. It is important to emphasise that AI should not be seen as a replacement tool, but as an aid to PC professionals. Although AI is capable of processing large amounts of data and generating accurate predictions, it cannot replace the skill and expertise of professionals in clinical decision making. AI still requires the interpretation and clinical judgement of a trained healthcare professional and cannot provide the empathy and emotional support often required in healthcare.

[Impact of primary care nursing discharge follow-up on early hospital readmissions. Observational longitudinal study]. / Impacto del seguimiento al alta de Enfermería en Atención Primaria sobre los reingresos hospitalarios tempranos. Estudio observacional longitudinal.

AIM: To determine the proportion of people who undergo discharge follow-up when indicated. DESIGN: Retrospective longitudinal observational study, with an analytical approach. POPULATION: persons discharged from the Hospital Universitario de la Princesa of any age and sex, with any reason for admission and with an indication for discharge follow-up in Primary Care. Users who did not have an assigned Autonomous Personal Identification Code (CIPA) were excluded. Random sample (n=289). VARIABLES: Discharge follow-up and readmissions (<30 days). Sociodemographic, clinical and discharge follow-up variables were included from the electronic medical records of Primary and Hospital Care. A descriptive analysis of the sociodemographic and clinical characteristics of the study population was conducted. To analyze the association between discharge follow-up and readmissions, a logistic regression model was used. RESULTS: Age 72.4 years (RIQ 60-87). 55.2% of the population were women. Follow-up was conducted in 61.2% of those indicated. According to the logistic regression model performed between early readmission and discharge follow-up, adjusted for all other factors, the group with discharge follow-up had a 66% lower likelihood of hospital readmission (OR 0.34, 95% CI (0.18-0.67)). CONCLUSIONS: These findings suggest that nursing discharge follow-up conducted in primary care reduces the risk of early readmission.

[Postpartum progression of anxiety and depression levels in mothers of premature newborns]. / Progresión posparto de los niveles de ansiedad y depresión en madres de recién nacidos prematuros.

OBJECTIVE: The postpartum period represents a vulnerable time for women's mental health, especially for those with complications and prematurity. This study aims to explore the evolution of depression and anxiety levels during the 12 weeks postpartum in mothers of premature babies. DESIGN: Prospective study of two parallel cohorts. SETTING: Hospital Clínic of Barcelona. PARTICIPANTS: Women with obstetric complications [premature rupture of membranes or preeclampsia] requiring hospitalization and preterm delivery (< 37 weeks of gestation); 2) Women without complications with term delivery. MAIN MEASURES: Validated questionnaires were administered to measure anxiety (State-Trait Anxiety Inventory, STAI) and depression (Edinburgh Postnatal Depression Scale, EPDS) during the first week, and at 6 and 12 weeks postpartum. RESULTS: 182 women were analyzed: 90 with uncomplicated pregnancies and term deliveries, and 92 with complications requiring preterm delivery. During the follow-up, women with premature newborns showed a significantly unfavorable progression in depression (p <0.001) and anxiety (p <0.001) scores, as well as a higher proportion of abnormal scores on both scales (p <0.001 and p=0.004, respectively) CONCLUSIONS: Women with preterm delivery show higher anxiety and depression levels than those with term delivery during the 12 weeks postpartum. It is essential to ensure a seamless transition between care levels to effectively address postpartum mental health.