Effectiveness of a Postpartum Breastfeeding Support Group Intervention in Promoting Exclusive Breastfeeding and Perceived Self-Efficacy: A Multicentre Randomized Clinical Trial.

There are numerous recognized benefits of breastfeeding; however, sociocultural, individual, and environmental factors influence its initiation and continuation, sometimes leading to breastfeeding rates that are lower than recommended by international guidelines. The aim of this study was to evaluate the effectiveness of a group intervention led by midwives supporting breastfeeding during the postpartum period in promoting exclusive breastfeeding, as well as to assess the impact of this intervention on perceived self-efficacy. This was a non-blind, multicentric, cluster-randomized controlled trial. Recruitment started October 2021, concluding May 2023. A total of 382 women from Andalusia (Spain) participated in the study. The results showed that at 4 months postpartum there was a higher prevalence of breastfeeding in the intervention group compared to formula feeding (p = 0.01), as well as a higher prevalence of exclusive breastfeeding (p = 0.03), and also at 6 months (p = 0.01). Perceived self-efficacy was similar in both groups for the first two months after delivery, which then remained stable until 4 months and decreased slightly at 6 months in both groups (p = 0.99). The intervention improved the average scores of perceived self-efficacy and indirectly caused higher rates of exclusive breastfeeding (p = 0.005). In conclusion, the midwife-led group intervention supporting breastfeeding proved to be effective at maintaining exclusive breastfeeding at 6 months postpartum and also at increasing perceived self-efficacy.

Neuropsychological Stimulation Program for Children from Low Socioeconomic Backgrounds: Study Protocol for a Randomized Controlled Trial.

BACKGROUND: Guatemala remains one of the poorest countries in Central America and suffers from high rates of social inequality and violence. In addition to the negative impact that two years without attending school has had on Guatemalan children due to the consequences of the COVID-19 pandemic, this unfavourable socioeconomic context poses a risk to children's emotional and cognitive development. This work presents a protocol for implementing a cognitive and emotional stimulation program aimed at increasing the academic performance of these children and consequently improving their quality of life. METHODS: The protocol proposes the implementation of a randomized controlled trial to assess the efficacy of a 24-session-long stimulation program. It targets the cognitive functions of attention, language, executive functions, and social cognition, using the digital neurorehabilitation platform NeuronUP. The participants (n = 480) will be randomly assigned to an Experimental or Control group. Pre- and post-intervention assessments will be carried out, together with a follow-up in the next academic year, in which both groups will change roles. Results will be compared for the first and second years, looking for differences in academic and cognitive performance between groups. DISCUSSION: Mid- and long-term outcomes are still unknown, but effective interventions based on this protocol are expected to facilitate the following benefits for participants: (1) improved cognitive and emotional development; (2) improved academic performance; (3) improved well-being. We expect to create a validated neuropsychological stimulation program that could be applied in similar socioeconomically disadvantaged contexts around the world to help these children improve their life chances.

Evaluation of the Impact of a Midwife-Led Breastfeeding Group Intervention on Prevention of Postpartum Depression: A Multicentre Randomised Clinical Trial.

Postpartum depression is a significant health issue affecting both mothers and newborns during the postpartum period. Group support interventions during this period have proven effective in helping women cope with depression and improving breastfeeding rates. This study aimed to assess the effectiveness of a midwife-led breastfeeding support group intervention on breastfeeding rates, postpartum depression and general self-efficacy. This was a multicentric cluster randomised controlled trial with control and intervention groups and was not blinded. It was conducted in Andalusia (southern Spain) from October 2021 to May 2023. A total of 382 women participated in the study. The results showed a significant difference in exclusive breastfeeding rates at 4 months postpartum between the groups (control 50% vs. intervention 69.9%; p < 0.001). Additionally, there was a lower mean score on the Edinburgh Postnatal Depression Scale in the intervention group (12.49 ± 3.6 vs. 13.39 ± 4.0; p = 0.044). Similarly, higher scores of general self-efficacy were observed among breastfeeding women at 2 and 4 months postpartum (77.73 ± 14.81; p = 0.002 and 76.46 ± 15.26; p < 0.001, respectively). In conclusion, midwife-led breastfeeding support groups enhanced self-efficacy, prolonged breastfeeding and reduced postpartum depression 4 months after giving birth.

Emotional Distress Caused by the Measures Taken in Assisted Reproductive Treatments during the COVID-19 Confinement in Spain.

During the pandemic, assisted reproductive treatments suffered from major disruptions in their terms due to the restrictions imposed. The objective of this study is to evaluate the level of anxiety of women whose treatments were either suspended or delayed. METHODS: Descriptive cross-sectional study conducted between April and May 2020. The State-Trait Anxiety Inventory was applied by telephone in a Spanish adapted version. The research also included social, personal, and work aspects which may be involved in the challenging situation. RESULTS: A total of 115 patients participated in the study (73.7%). Women showed a mean in trait anxiety of 17.79 (SD = 8.80) and a mean in state anxiety of 19.95 (SD = 9.08). Neither the type of treatment nor the time of infertility were predictors of trait anxiety or state anxiety. Greater age pressure and more worry were associated to greater trait and state anxiety (p < 0.001). The most common emotional reactions to discontinuation of fertility treatments were sadness and anxiety. CONCLUSIONS: Discontinuation of fertility treatments due to confinement restrictions had a negative impact on the mental health of women who were following a process of assisted reproduction treatment, increasing their levels of emotional distress and anxiety.

The 5Cs of Positive Youth Development and Risk Behaviors in a Sample of Spanish Emerging Adults: A Partial Mediation Analysis of Gender Differences.

Positive Youth Development (PYD) emerged as a holistic and strength-based perspective that focuses on the fact that young people may have the internal and external resources for healthy and successful development through five dimensions (5Cs) that empower them: Perceived Competence, Confidence, Character, Connection, and Caring. The aim of this study was to examine the relationship between the overall PYD factor, the 5Cs, and risk behaviors, in addition to analyzing gender differences. This study showed the results of a cross-sectional study of 1044 emerging adults from 11 Spanish universities in 2021. Data collection was performed by applying an online self-report measure. The results showed that the Character was protective against substance abuse, mainly in women, while the connection was related to the participation of betting money and online betting in men. Caring was protective against money bets in the men's sample. However, controversial results were found regarding Perceived competence, which had a positive association with substance abuse, money bets, and drunk driving. It seems that high levels of Perceived competence, rather than objective competence, were associated with engagement in various risk behaviors. Concerning gender differences, men showed more risky behaviors than women. A partial mediation model pointed out that lower character and higher perceived competence in men partly explained the higher presence of risky behavior compared to women. These results underline the need to promote PYD within the university context to prevent risky behaviors by addressing gender differences and the separate role of the 5Cs.

Alcohol Consumption Assessed by a Biomarker and Self-Reported Drinking in a Sample of Pregnant Women in the South of Europe: A Comparative Study.

(1) Background: Alcohol consumption during pregnancy is a major concern, particularly in Europe and North America. Its prevalence has so far been under-researched. In most studies, the determination of this consumption may be underestimated, as it is based on the information obtained from questionnaires rather than from biomarkers, which will provide a much more reliable approach. The main objective of this study was to compare the prevalence of consumption during pregnancy as assessed by a questionnaire and a hair biomarker. (2) Method: A cross-sectional study with a random sample of 425 pregnant women treated in public hospital consultations in Seville (Spain) and in the 20th week of their pregnancy, orally interviewed using an elaborated ad hoc questionnaire that evaluated variables of sociodemographic, obstetric, and alcohol consumption. Furthermore, the ethyl glucuronide metabolite (EtG) was tested on a hair sample in 252 pregnant women who agreed to facilitate it. Once the data obtained through the questionnaire and hair test were analyzed, the level of metabolites and self-reported alcohol consumption were compared. (3) Results: The prevalence of self-reported alcohol consumption (questionnaire) was 20.7%, and the real consumption (metabolite analysis) was 20.2%. In 16.8% of pregnant women who declared not consuming alcohol during their pregnancy, noticeable consumption was detected according to the metabolite test. No relevant level of variability in estimated alcohol consumption was detected in the biomarker with respect to the sociodemographic and obstetric variables studied. (4) Conclusions: The prevalence of alcohol consumption during pregnancy obtained through both questionnaires and metabolite analyses was similar and high. There is no association between consumption and sociodemographic factors in this sample. The determination of consumption through biomarkers allows for a more accurate approximation of the prevalence of consumption than estimated through questionnaires. Larger sample-sized studies are needed to determine consumption patterns and thus guide the adoption of more precise policies fostering abstinence from alcohol consumption since the preconception period.

Health Management: Evaluating the Relationship between Organizational Factors, Psychosocial Risks at Work, Performance Management, and Hospital Outcomes.

Introduction-Health system (HS) health organizations are complex and are in constant dynamic interaction with multiple elements, including political, environmental, societal, legal, and organizational factors, along with human components, such as human resources, patients, and other stakeholders. Objective-This research aimed to study three HS organizations, identifying and characterizing the elements of health organizations and the factors related to professionals, determining their influence on economic and financial performance results, as well as results related to the professionals and to the patients comprising the institutions. Method-A quantitative study was conducted in which data were collected through questionnaires from various sources to better understand and characterize the factors related to organizations, professionals, and patients (470 health professionals and 768 patients). To test the integrated evaluation model for health organizations, path analysis was used. Results-The results reveal that the organizational culture (OC) presents a positive relationship between the professional's quality of life (QL) and the performance management (PM) of the professionals, along with a negative relationship with the psychosocial work risks (PWR). There is also a relationship between the OC and patient satisfaction (PS), professional job satisfaction (PJS), and economic and financial results (EFR). In the relationship between the processes and the results, there are significant relationships between PM and PJS and PWR and PJS. In terms of the results, there is a significant relationship between the EFR and the PS. Conclusions-This study contributes to a deeper knowledge of the factors that influence the quality of health organizations and their results and produces recommendations for health organizations to address the current challenges.

Satisfaction of basic psychological needs and European entrepreneurs' well-being and health: The association with job satisfaction and entrepreneurial motivation.

PURPOSE: We examine an integrative model associating entrepreneurial motivation and job satisfaction with basic psychological needs satisfaction and the psychological well-being (PWB) and health problems of European entrepreneurs. In contrast with previous literature that focuses mainly on hedonic well-being, this study examines well-being by using a eudaimonic perspective and the link between entrepreneurial motivation and entrepreneurs' PWB. DESIGN/METHODOLOGY/APPROACH: Based on the self-determination theory (SDT) and using structural equation modeling, this study examines a European representative sample composed of 7,878 entrepreneurs from the sixth European Working Conditions Survey (6th EWCS; Eurofound [2015] database). FINDINGS: This study finds a positive relationship between the satisfaction of the need for autonomy and competence and opportunity motivation, which in turn is positively associated with job satisfaction. This study also finds that need satisfaction is positively associated with entrepreneurs' PWB and job satisfaction, which in turn is positively associated with entrepreneurs' PWB and health. Results highlight the relevance of SDT, opportunity motivation, and job satisfaction to understanding entrepreneurs' PWB and health. ORIGINALITY: To the best of our knowledge, this is the first integrative model relating satisfaction of basic psychological needs (autonomy and competence) and diverse individual outcomes related to work (job satisfaction, PWB, and health) of European entrepreneurs by considering entrepreneurial motivation. This study examines a large and representative European sample, in contrast with previous research focusing on the Anglosphere nations.

Relationship between social support and perinatal depression during the COVID-19 pandemic.

AIMS/BACKGROUND: This research aimed to identify the sources of social support and its relationship with perinatal depression (PPD) during the coronavirus (COVID-19) pandemic. DESIGN/METHODS: We carried out a cross-sectional study with a sample of 3,356 women during perinatal period living in Spain. We used five items from the Spanish version of the Coronavirus Perinatal Experiences - Impact Survey to assess the impact of COVID-19 on social support and, the Edinburgh Postnatal Depression Scale was used to assess depressive symptomatology. RESULTS: The results obtained identified a possible relationship between seeking in-person support (OR = 0.51; 0.67, during pregnancy and after delivery respectively) and degree of feeling social support (OR = 0.77; 0.77) during the COVID-19 pandemic with a lower prevalence of depression. Otherwise, requiring the help of a mental health professional (OR = 2.92; 2.41) and weeks of confinement (OR = 1.03; 1.01) appeared to be associated with a higher prevalence of depression. During pregnancy, a possible association was found between the degree of concern about future changes in support and involvement of family and friends (OR = 1.75) with a higher prevalence of depression. On the other hand, in the postpartum period, there seems to be a relationship between seeking social support through social media (OR = 1.32) with a higher prevalence of depression and receiving support from friends (OR = 0.70) and health professionals (OR = 0.53) with a lower prevalence of depression. CONCLUSION: These results highlighted the importance of protecting perinatal mental health during the COVID-19 pandemic by protecting and developing social support networks.

Leisure Time Activities and Subjective Happiness in Early Adolescents from Three Ibero-American Countries: The Cases of Brazil, Chile and Spain.

(1) Background: The aim of the present study is to analyze subjective happiness in relation to leisure time in 10-year-old boys and girls from Brazil, Chile and Spain and to determine which leisure time activity has a greater effect on their subjective happiness and whether there are differences according to gender. (2) Methods: Data from the third wave of the Children's Worlds Project was used, which was collected by administering self-report measures to representative samples in each country. The sample was composed of 4008 early adolescents from Brazil (22.1%, n = 886), Chile (22.8%, n = 913) and Spain (55.1%, n = 2209). The mean age of the sample was 10.17 years (SD = 0.57), and 51.7% were girls. (3) Results: In terms of subjective happiness, moderate to high means were observed, with higher scores in boys and the Spanish sample. The results showed some differences in leisure time activities among children from Brazil, Chile and Spain. Furthermore, the results highlighted the importance of relaxation time with the family to promote happiness in pre-adolescence across genders and countries. Additionally, playing outdoors and doing homework were also found to be protective factors for subjective happiness. (4) Conclusions: In Brazil, Chile and Spain the most consistent result was the positive effect of spending time relaxing with the family on subjective happiness.

The socio-demographic profile associated with perinatal depression during the COVID-19 era.

BACKGROUND: Coronavirus disease 2019 (COVID-19) has caused an increase in perinatal depression. The aim of this research was to identify which sociodemographic variables are related to the increase in perinatal depression due to the pandemic. In addition to estimating to what extent they predict perinatal depression, differentiating the prenatal and postnatal periods. METHODS: The sample consisted of 3,356 subjects, 1,402 in the prenatal period and 1,954 in the postnatal period. The Edinburgh Postnatal Depression Scale was used to assess depressive symptomatology. A subset of 14 questions was included to collect demographic data. Items from the Spanish version of the Coronavirus Perinatal Experiences Survey were also included. RESULTS: Experiencing the change of environment due to COVID-19 as negative and having a history of mental health predict perinatal depression, otherwise having higher education decreases the risk. In the prenatal stage having symptoms compatible with COVID-19 is a predictor of perinatal depression and having more than 3 years living together with the partner and being a housewife decreases the risk. In the postnatal stage being unemployed is a predictor of prenatal depression and being a first-time mother decreases the risk. CONCLUSIONS: This study highlights the relevance of sociodemographic status. It is essential to be aware of the risk factors of perinatal depression, to make adequate prevention, and to create health policies to alleviate the consequences of the pandemic.

The Importance of the 5Cs of Positive Youth Development to Depressive Symptoms: A Cross-Sectional Study with University Students from Peru and Spain.

BACKGROUND: Prior research has documented the protective role of the 5Cs of Positive Youth Development (PYD) on adjustment problems, such as depressive symptoms. Nonetheless, more research is needed, especially in non-US contexts. The main objective of the present study was to assess associations between the 5Cs and depressive symptoms in Peru and Spain, considering gender differences across contexts. METHODS: Cross-sectional data was collected from undergraduate students from Peru [n = 250] and Spain [n = 1044]. RESULTS: The results revealed significant negative associations of Competence, Confidence, Character and Connection with depressive symptoms, while Caring was positively and significantly related to depressive symptoms in both samples. Regarding gender differences, female undergraduates in both samples reported high levels of Caring, while Competence was predominant among males compared to females in both countries. Likewise, higher scores in Competence and Confidence were registered among Peruvian male undergraduates compared to Spanish students, while Caring and Character were more prevalent in Spanish female undergraduates compared to Peruvian students. CONCLUSIONS: These findings confirm the importance of targeting the 5Cs of PYD alongside the role of gender and country context in intervention programs, put together to address the mental health of students in Peru and Spain.

The Relationship between Healthcare Experience and Perinatal Depression during COVID-19 Pandemic / La relación entre la experiencia de la atención sanitaria y la depresión perinatal durante la pandemia COVID-19

Background: The prevalence of peripartum depression (PPD) has increased substantially since the start of the COVID-19 pandemic. To reduce the probability of contagion, hospitals had to adapt their care protocols, including the care of women in the perinatal period. Method: A cross-sectional study was used in a total sample of 3,356 women, 1,402 in the prenatal period and 1,954 in the postnatal period. They completed the Edinburgh Postnatal Depression Scale to assess depressive symptoms and the Spanish version of the Coronavirus Perinatal Experiences to assess health experience. Results: The results showed that feeling very well supported by a health professional was associated with a lower risk of PPD. On the other hand, believing it very important to have access to a mental health professional and being concerned about changes in infant care due to COVID-19 were associated with a higher risk of PPD. Conclusion: The results showed the relationship between health experience and the risk of depressive symptoms, highlighting the importance of considering the psychological aspects in the development of measures and protocols for perinatal care. (AU)

Antecedentes: La prevalencia de la depresión perinatal ha aumentado sustancialmente desde el inicio de la pandemia debido al coronavirus (COVID-19). Para reducir la probabilidad de contagio, los hospitales tuvieron que adaptar sus protocolos asistenciales, incluyendo la atención a las mujeres en el periodo perinatal. Método: Se utilizó un estudio transversal en una muestra total de 3,356 mujeres, 1,402 en el período prenatal y 1,954 en el período postnatal. Cumplimentaron la Escala de Depresión Postnatal de Edimburgo para evaluar los síntomas depresivos y la versión española de la Encuesta sobre Experiencias Perinatales durante el Coronavirus para evaluar la experiencia de la atención sanitaria. Resultados. Los resultados mostraron que sentirse muy bien apoyada por un profesional de la salud se asoció con un menor riesgo de desarrollar depresión perinatal. Por otro lado, creer que es muy importante tener acceso a un profesional de la salud mental y estar preocupada por los cambios en el cuidado del bebé debido al COVID-19 se asociaron con un mayor riesgo de depresión perinatal. Conclusión: Los resultados mostraron la relación entre la experiencia sanitaria y el riesgo de síntomas depresivos, destacando la importancia de considerar los aspectos psicológicos en el desarrollo de medidas y protocolos de atención perinatal. (AU)

Cross-Sectional Associations between Playing Sports or Electronic Games in Leisure Time and Life Satisfaction in 12-Year-Old Children from the European Union.

Leisure time activities in childhood may have a crucial role in the development of subjective well-being. Nevertheless, more research is needed with cross-national samples concerning the differential effects of lifestyles on life satisfaction. The aim of this cross-sectional study was to analyze the associations between the frequency of playing sports/exercise or playing electronic games on life satisfaction in a sample of 12-year-old children from nine countries from the European Union. The data used in this publication come from the third wave of the Children's Worlds project, an international survey of children's lives and well-being whose administration started in 2017. The sample was composed of 10,626 children (50.9% boys) from Estonia, Belgium, Croatia, Hungary, Italy, Malta, Poland, Romania, and Spain. They completed the Student Life Satisfaction Scale and answered two questions to assess the frequency of playing sport or exercise, and the frequency of playing electronic games. The results indicated notable scores in life satisfaction in all participating countries. The results showed some differences between boys and girls, and among the countries, in the frequency of sport practice and electronic games in the leisure time, as well as in the overall level of life satisfaction. The results also underlined that sport practice had a greater positive effect on life satisfaction than the use of electronic games. Thus, this study highlights the need to design programs to promote sport practice in leisure time for 12-year-old children in Europe, in order to protect their subjective well-being.

Positive Youth Development and Internet Use in a Sample of Spanish Adolescents.

During the COVID-19 pandemic, the use of Internet in the adolescent population has increased. A growing research interest has been developed about the consequences of Internet use for adolescent development. Despite most studies have examined the impact of Internet use on some indicators of psychological maladjustment, few studies have addressed the detrimental impact on the positive indicators of mental health. Positive youth development (PYD) represents a positive view of adolescent transition to adulthood which focuses on building the strengths that make young people more resistant to negative outcomes and more capable to choose a positive life direction. This study aimed to analyze the relationships between different aspects of Internet use and overall PYD in a sample of Spanish adolescents. To reach this aim, a sample of 1,038 adolescents (50.1% boys, M age = 14.19, SD = 1.38), enrolled in 14 high schools in the city of Huelva (Spain), filled in some self-report measures of PYD and Internet use and experience, such as the frequency of Internet use on weekdays or weekends, the different uses of Internet (i.e., social networks, playing online, reading, surfing or looking for information, playing or downloading music, and searching, selling, or buying products), and the subjective experience using the Internet (i.e., acknowledgment of spending too much time playing or in the networks, and being in a bad mood if they do not play or use the networks). Results of a hierarchical regression analysis showed that the more hours using Internet on weekdays, the less PYD. Moreover, the experience of feeling bad when not using the networks and spending too much time with online playing was related to lower PYD. However, the use of Internet for reading or looking for information had a positive association with PYD. These results suggest some implications for practice, such as the need to promote an adaptive Internet use, by providing a safe online context that encourages the acquisition of positive social values and life skills.

The influence of lifestyles to cope with stress over mental health in pregnant and postpartum women during the COVID-19 pandemic.

The COVID-19 pandemic affected daily life routines and lifestyles of pregnant and postpartum women and increased their stress and risk of suffering from mental health problems. The aim of this study was to analyse which sociodemographic variables, COVID-19 exposure variables and lifestyles to cope with stress variables predicted anxiety, depression, and PTSD symptoms in pregnant and postpartum women during the COVID-19 pandemic. A cross-sectional design was performed with a sample of 3356 Spanish women participating in the Riseup-PPD-COVID-19 study. These participants completed an online survey composed of measures of anxiety (GAD-7), depression (EPDS), and PTSD related to COVID-19 (Checklist DSM-5), as well as demographics, exposure to COVID-19, and lifestyles to cope with stress. Regarding results, 47.2% showed depression and a third reported anxiety, whereas moderate scores were observed in PTSD symptoms. The most commonly used strategies to cope with stress in the COVID-19 pandemic were talking with friends and family and increasing time with social networks. Better results in mental health were associated with coping strategies such as talking with family and friends or participating in family activities, physical activity, sleeping well at night, eating healthier, and increasing personal care. Furthermore, poor results in mental health were observed in those participants who increased time with screens, ate fast food, reported substance use, and talked more frequently with health professionals. More symptoms were also observed in younger women, primiparous women, and those who reported more exposure to COVID-19. The results underline the need to strengthen the mental health of pregnant and postpartum women. Trial registration: ClinicalTrials.gov Identifier: NCT04595123.

The Role of Developmental Assets in Gender Differences in Anxiety in Spanish Youth.

Anxiety disorders are the most prevalent psychological disorders during emerging adulthood. Some consistent gender differences have been reported in anxiety with women suffering more anxiety than men, which has detrimental consequences in most life spheres in the youth and later life stages. The understanding of the development of anxiety in emerging adulthood requires a developmental perspective. The Developmental Assets Theory was postulated to describe the individual and the contextual resources which may foster positive youth development and mental health. The present study aims to analyze to what extent the gender differences in anxiety may be partly explained by gender differences in developmental assets. For this purpose, a cross-sectional study was conducted in which a sample of 1,044 youths (75.5% women; age range = 18-28; M age = 20.47, SD = 3.08) enrolled in 11 universities from different regions in Spain filled in self-report measures of developmental assets and anxiety symptoms. The participants completed an online survey with the scales, Developmental Assets Profile developed by the Search Institute (1) and Generalized Anxiety Disorder-7 (GAD-7) (2). The results showed more anxiety in the female subsample (at both the symptoms and clinical levels). Some gender differences in developmental assets were also observed. A partial mediation model, based on regression analyses, indicated that gender differences in anxiety were partly explained by gender differences in developmental assets. Thus, higher anxiety in the women was partly due to lower scores in positive identity and higher scores in positive values. These results suggested the need to design programs to prevent anxiety with specific measures for women youth to nurture positive identity and promote strengths and coping skills that allow them to get the benefits of well-being derived from positive values, thus, preventing worry and stress overload, which may lead to anxiety.

The Impact of the COVID-19 Pandemic on Perinatal Depression and Anxiety: A Large Cross-sectional Study in Spain.

BACKGROUND: The current COVID-19 pandemic is a unique stressor with potentially negative consequences for pregnant and postpartum women. We investigated the impact of the COVID-19 pandemic on perinatal depression and anxiety in Spain. METHOD: This cross-sectional study was conducted from June to December 2020. A total of 3,356 adult pregnant and postpartum women (with infants up to 6 months of age) from all Spanish regions were surveyed. The assessment included measures of Coronavirus Perinatal Experiences (COPE-IS questionnaire) and Generalized Anxiety Disorder Screener (GAD-7=10) and Edinburgh Postnatal Depression Scale (EPDS=10). RESULTS: The prevalence of perinatal anxiety and depression (above established cut-offs) was 33.3% and 47.2%, respectively; 29.2% of women screened positive for both conditions. Higher rates of perinatal depression and anxiety were associated with increased concern about threats of COVID-19, especially employment and the financial impact, along with increased overall levels of distress. Exposure to COVID-19 and its symptoms did not appear to be a relevant risk factor. More COVID-19-related predictors and a higher rate of depression were found in postpartum women. CONCLUSIONS: The current study highlights the substantial increase in symptoms of perinatal depression and anxiety, especially in postpartum women. Interventions for perinatal mental health should be a priority.

Relationship between Eating Habits, Physical Activity and Tobacco and Alcohol Use in Pregnant Women: Sociodemographic Inequalities.

Pregnant women must maintain or acquire healthy habits during pregnancy to protect both their own health and their child's. Such habits include an adequate eating pattern along with good adherence to the intake of certain supplements, practice of moderate physical activity and avoiding the consumption of toxic products such as tobacco and alcohol. The objective of this study is to assess the interrelation between such habits and their association with sociodemographic variables. To such end, a cross-sectional study was conducted with a representative sample of pregnant women who attended the scheduled morphology echography consultation at the 20th gestational week in their reference public hospital in the city of Seville (Spain). Results: Younger pregnant women and with lower educational levels are the ones that present the worst eating habits and the highest smoking rate. Pregnant women with lower educational levels are the least active. Non-smoking pregnant women present better eating habits than those who smoke. Pregnant women with lower educational levels are those who accumulate more unhealthy habits during pregnancy. This should be taken into account when planning the health care provided to pregnant women and in public health intersectoral policies.