Resilience and psychological distress in pregnant women during quarantine due to the COVID-19 outbreak in Spain: a multicentre cross-sectional online survey.

PURPOSE: To examine the prevalence of depressive and anxiety symptoms and the corresponding risk factors among pregnant women during the confinement due to the COVID-19 outbreak in Spain. MATERIALS AND METHODS: Between 15 April and 14 May 2020, a multicentre cross-sectional survey was performed to study depression, anxiety and resilience in a sample of Spanish pregnant women during the lockdown set up by the Government in response to COVID-19 pandemic outbreak. We designed an anonymous online self-administered questionnaire (https://bit.ly/34RRpq1) that included the Spanish validated versions of the Edinburgh Postpartum Depression Scale (EPDS), the State-Trait Anxiety Inventory (STAI) and the Connor-Davidson Resilience 10-items Scale (CD-RISC-10). RESULTS: A total of 514 pregnant women completed the survey. 72.8% had been confined < 40 days and 27.2% between 41 and 60 days. 182 (35.4%) participants scored over 10, with 21.3% scoring over 13 (75th Percentile) in depressive symptoms rates. We found high trait and anxiety scores, with 223 (43.4%) and 227 (44.2%) pregnant women scoring over the trait and state mean scores. Neither depression, anxiety or resilience levels showed any significant correlation with the length of confinement. We found low CD-RISC-10 scores. CONCLUSIONS: We found a high prevalence of depression and anxiety symptoms during the quarantine, although we did not find an increased prevalence of psychological distress according to length of home confinement. Resilience correlated negatively with depression and anxiety.

Incontinencia urinaria 6 meses tras parto. Factores de riesgo asociados / Urinary incontinence since 6 months after delivery. Associated risk factors

Este estudio permite aproximarnos a la incidencia de incontinencia urinaria de esfuerzo a los 6 meses postparto en nuestro medio, lo que puede ser útil para proponer una actuación tanto a nivel de atención primaria como hospitalaria para poder disminuir el impacto que los posibles factores de riesgo ejercen, como por ejemplo un buen programa de entrenamiento de la musculatura pélvica con ejercicios de Kegel podría reducir la aparición de esta patología, de esta forma, se podría minimizar la morbilidad que sufren estas pacientes. Handa y cols. (21) concluyó que las pacientes que presentaban incontinencia urinaria o anal presentaban un moderado o alto impacto negativo en su vida diaria tras encuestar a 759 pacientes. Para finalizar, se concluye que existen diferentes evidencias en cuanto a los factores de riesgo asociados a la aparición de incontinencia urinaria postparto. El tipo de parto no tiene relación estadísticamente significativa con la aparición de esta sintomatología. No obstante, al existir literatura a favor y en contra de esta hipótesis se precisan más estudios que permiten concluir que vía del parto es la menos favorable para presentar incontinencia urinaria. Los autores, admiten que se podrían inferir más datos si se aumenta el número de pacientes evaluadas (AU)

This study allows us to approach the incidence of stress urinary incontinence at 6 months postpartum in our setting, which may be useful to propose a performance at both primary and hospital care levels, in order to reduce the impact that possible risk factors exert, such as for example, a good pelvic muscle training program with Kegel exercises could reduce the onset of this pathology, thus minimizing the morbidity of these patients. Handa et al. (21) concluded that patients with urinary incontinence or anal had a moderate or high negative impact in their daily lives after surveying 759 patients. Finally, we conclude that there is different evidence regarding the risk factors associated with the occurrence of postpartum urinary incontinence. The type of delivery has no statistically significant relationship with the appearance of this symptomatology. However, because there is literature for and against this hypothesis, more studies are needed to conclude that the way of delivery is the least favorable for presenting urinary incontinence. The authors admit that more data could be evidenced by increasing the number of patients evaluated (AU)

Influencia de la obesidad en la evolución del parto / Influence of obesity on mode of delivery

Objetivo: Analizar la influencia de la obesidad mórbida en la vía y comienzo del parto. Hipótesis: La obesidad mórbida aumenta la tasa de cesáreas e inducciones. Sujetos y métodos: Se diseñó un estudio retrospectivo, descriptivo poblacional, con gestantes que dieron a luz durante el año 2012 en el Hospital Universitario Reina Sofía; fueron excluidas las gestaciones gemelares. Se incluyó en el grupo de gestantes con obesidad mórbida a aquellas con un índice de masa corporal en la primera visita de embarazo (en torno a las 8 semanas de gestación) igual o superior a 40. El resto de las gestantes se incluyeron en el grupo de gestantes control. Las variables analizadas fueron: edad, paridad, comienzo del parto y tipo de parto. Resultados: Las gestantes con obesidad mórbida tienen una tasa más elevada de cesáreas que el resto de las gestantes (36,76% vs. 18,49%), p < 0,001, al igual que un mayor porcentaje de inducciones (50,79% vs. 25,81%), p < 0,001. Conclusiones: La obesidad mórbida aumenta el riesgo de cesáreas e inducciones (AU)

Objective: To analyze the influence of morbid obesity on mode of delivery and onset of labor. Hypothesis: Morbid obesity increases the cesarean section and induction rates. Subjects and methods: A population-based, retrospective, descriptive study was designed in women giving birth in 2012 at the Reina Sofía Hospital. Twin pregnancies were excluded. The women were classified according to body mass index (BMI) at the first prenatal visit (at around 8 weeks of gestation) into those who were morbidly obese (BMI greater than or equal to 40 kg/m2) and a control group (BMI less than 40 kg/m2). The variables analyzed were age, parity, onset of labor, and mode of delivery. Results: Morbidly obese pregnant women have a higher rate of cesarean sections than the control group (36.76% vs. 18.49%, P<.001) and a higher rate of inductions (50.79% vs. 25.81%, P<.001). Conclusions: Morbid obesity increases the risk of cesarean sections and inductions (AU)