Comparing the effectiveness of virtual and semi-attendance Stress Inoculation Training [SIT] techniques in improving the symptoms of anxiety, depression, and stress of pregnant women with psychological distress: a multicenter randomized controlled trial.

BACKGROUND: Some studies indicate that more than 10% of pregnant women are affected by psychological problems. The current COVID-19 pandemic has increased mental health problems in more than half of pregnant women. The present study compared the effectiveness of virtual (VSIT) and semi-attendance Stress Inoculation Training (SIT) techniques on the improvement of the symptoms of anxiety, depression, and stress of pregnant women with psychological distress. METHODS: This study was conducted on 96 pregnant women with psychological distress in a 2-arm parallel-group, randomized control trial between November 2020 and January 2022. The semi-attendance SIT received treatment for six sessions, sessions 1, 3 and 5 as individual face-to-face and sessions 2, 4 and 6 as virtual once a week for 60 min continuously [n = 48], and the virtual SIT received six sessions simultaneously once a week for 60 min (n = 48) in pregnant women of 14-32 weeks' gestation referred to two selected hospitals. The primary outcome of this study was BSI-18 [Brief Symptom Inventory] and NuPDQ-17 [Prenatal Distress Questionnaire]. The secondary outcomes were the PSS-14 [Cohen's General Perceived Stress Scale]. Both groups completed questionnaires measuring anxiety, depression, pregnancy-specific stress, and generally perceived stress questionnaires before and after the treatment. RESULTS: The post-intervention results showed that the stress inoculation training technique in both VSIT and SIT interventions effectively reduced anxiety, depression, psychological distress, pregnancy-specific stress and general perceived stress [P < 0.01]. Also, the SIT interventions on decreasing anxiety [P < 0.001, η2 = 0.40], depression [P < 0.001, η2 = 0.52] and psychological distress [P < 0.001, η2 = 0.41] were more considerable than that of VSIT. However, There was no significant difference between SIT and VSIT intervention in terms of their effects on pregnancy-specific stress [P < 0.38, η2 = 0.01] and general stress [P < 0.42, η2 = 0.008]. CONCLUSION: The semi-attendance SIT group has been a more effective and practical model than the VSIT group, for reducing psychological distress. Therefore, semi-attendance SIT is recommended for pregnant women.

Predictors of Cranial Ultrasound Abnormalities in Intrauterine Growth-Restricted Fetuses Born between 28 and 34 Weeks of Gestation: A Prospective Cohort Study.

BACKGROUND: Doppler parameters have been commonly used for the prediction of neonatal outcomes. However, controversies exist with regard to the value of Doppler parameters in predicting the risk of neurological outcomes among neonates. OBJECTIVE: This prospective cohort study attempted to assess the value of Doppler parameters in predict ing cranial ultrasound abnormalities (CUAs) in intrauterine growth restriction (IUGR) among fetuses at 28-34 weeks of gestation. METHODS: This was a prospective cohort study of 83 delivered IUGR fetuses and 75 control fetuses matched for gestational age (GA). The value of mentioned Doppler parameters and GA in predicting the risk of CUAs, including periventricular leukomalacia (PVL), intraventricular hemorrhage (IVH), and basal ganglia lesions (BGLs), was analyzed. RESULTS: The incidence of CUAs among IUGR fetuses (66.3%) was significantly higher (p < 0.001) than in the control group (40%). The incidence of neonatal mortality among IUGR fetuses was significantly higher (p < 0.001) than in the control group. Absent or reversed end-diastolic velocity (AREDV) in the umbilical artery (UA) and the ductus venosus (DV) after adjustment for GA was associated with increased odds of IVH, PVL, BGLs, and any CUA. CONCLUSIONS: GA at birth and AREDV in the UA and the DV within 1 week before childbirth were reliable predictors of CUAs during the neonatal period.

Correlation of Maternal Stress Because of Positive Aneuploidy Screening Serum Analytes and Uterine Arteries' Doppler Ultrasound Index: A Prospective Cohort Study.

BACKGROUND: Antenatal anxiety or maternal stress is a prevalent chronic mental disorder in pregnant women. We have assessed the effect of maternal stress from positive aneuploidy screening results on the changes in uterine artery blood flow. MATERIALS AND METHODS: We performed a prospective cohort (one sample) pilot study at a hospital in Tehran, Iran. A total of 60 pregnant women who were candidates for amniocentesis due to abnormal sequential screening test results entered the study. We conducted 2 standard psychological tests, the Spielberger's State-Trait Anxiety Inventory and the Beck Anxiety Inventory, to determine anxiety levels in the participants before amniocentesis and two weeks after amniocentesis. The uterine artery resistance index was also measured before and two weeks after amniocentesis. The level of maternal stress was compared with the uterine artery resistance index. RESULTS: Patients had a mean State Trait Anxiety Inventory score before amniocentesis of greater than 40, which meant that the mothers experienced high anxiety. There were no correlations between both inventories' anxiety scores and uterine artery blood flow before amniocentesis. However, two weeks after amniocentesis, we observed significant negative correlations between the State Anxiety (P=0.0041) and Trait Anxiety (P=0.010) Inventory scores and the uterine artery resistance indexes. Also, there was an association between the decreased right uterine artery resistance index and State Anxiety scores (P=0.036). There were significant correlations between State and Trait Anxiety scores and second trimester analytes of ß-human chorionic gonadotropin (ß-hCG, P<0.001), α-fetoprotein (P<0.001), and unconjugated estriol (P=0.048). CONCLUSION: Maternal anxiety because of positive aneuploidy screening serum analytes and amniocentesis can affect perinatal outcomes via mood-based alterations in blood flow of the uterine arteries and the screening markers ß-hCG,unconjugated estriol, and α-fetoprotein.