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BMC Psychol ; 9(1): 20, 2021 Feb 01.
Artículo en Inglés | MEDLINE | ID: mdl-33526088


BACKGROUND: Recently, we showed that 4-week mindfulness-based intervention (MBI) followed by 4-week existential approach (EXMIND) was as effective for developing self-compassion as 8-week MBI. This study aims to identify the predictors to EXMIND. METHODS: Of the 63 participants who completed the EXMIND group, 60 participants had baseline, 4-week, and 8-week total scores of the Self-Compassion Scale (SCS). Of the participants, 49 were female and 11 were male, with a mean age of 48.4 years. We investigated the participants' intervention response patterns, then used analysis of variance to compared those patterns by age, gender, and the baseline scores of the Temperament Evaluation of Memphis, Pisa and San Diego Auto-questionnaire, the Temperament and Character Inventory, Mini-Mental State Examination, the Japanese Adult Reading Test, Young Mania Rating Scale, Hamilton Rating Scale for Depression, the Parental Bonding Instrument, and the Purpose in Life Test. In addition, multivariate logistic regression analysis was performed to identify any response pattern predictors. RESULTS: Participants were divided into 4 groups based on response patterns in the changes of total SCS scores of the EXMIND group. The first group consisted of 15 participants who responded positively to MBI, but negatively to the existential approach (A group). The second group consisted of 23 participants who responded negatively to MBI, but positively to the existential approach (B group). The third group consisted of 20 participants who responded positively to both MBI and the existential approach (C group). The fourth group consisted of only 2 participants who responded negatively to both MBI and the existential approach (D group). Participants who responded positively to both MBI and the existential approach (C group) reported more maternal overprotectiveness than the other participants (groups A, B, and D). CONCLUSIONS: The present findings suggest that maternal overprotection may predict consistent improvement of self-compassion during EXMIND therapy.

Empatía , Existencialismo , Atención Plena , Autoimagen , Adulto , Femenino , Humanos , Masculino , Conducta Materna , Persona de Mediana Edad , Relaciones Madre-Hijo , Encuestas y Cuestionarios , Resultado del Tratamiento
BMC Pregnancy Childbirth ; 21(1): 83, 2021 Jan 25.
Artículo en Inglés | MEDLINE | ID: mdl-33494719


BACKGROUND: Postpartum maternal functioning has the potential to affect the quality of interaction between mother and child. A proper assessment of maternal functioning requires a comprehensive and accurate tool. The objective of this study was to prepare a Persian version of the Barkin Index of Maternal Functioning (BIMF) and evaluate its psychometric properties in order to determine its applicability in Iranian mothers. METHODS: The BIMF was translated into Persian and then culturally adapted for Iranian women. After evaluating face and content validity, to perform factor analysis, a cross-sectional study was conducted using the Persian version of BIMF. The data was collected from two unique groups of 250 mothers (in all 500 mothers) who had infants 2 to 12-months old and who were selected using a two-stage cluster sampling method. Factor analysis, Pearson's correlation, intra-class correlation coefficients (ICC), composite reliability (CR) and Cronbach's alpha were employed in order to evaluate structural validity and reliability. RESULTS: Exploratory factor analysis resulted in a five-factor structure consisting of 20 items. Subsequently, confirmatory factor analysis (X 2/ df = 1.61, RMSEA = 0.050, GFI = 0.91, CFI = 0.91) confirmed that the Persian version had satisfactory goodness of fit. Reliability and internal consistency were confirmed with a CR of 0.77, an ICC of 0.87 and a Cronbach's alpha of 0.81. CONCLUSIONS: The findings indicated that the Persian version of the BIMF is a valid and reliable instrument for assessing maternal functioning among Iranian mothers.

Conducta Materna/psicología , Relaciones Madre-Hijo , Periodo Posparto/psicología , Encuestas y Cuestionarios/normas , Adaptación Psicológica , Adulto , Características Culturales , Femenino , Humanos , Lactante , Cuidado del Lactante/psicología , Persia , Psicometría
PLoS One ; 15(10): e0240962, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-33064778


Due to the COVID- 19 outbreak in the Netherlands (March 2020) and the associated social distancing measures, families were enforced to stay at home as much as possible. Adolescents and their families may be particularly affected by this enforced proximity, as adolescents strive to become more independent. Yet, whether these measures impact emotional well-being in families with adolescents has not been examined. In this ecological momentary assessment study, we investigated if the COVID-19 pandemic affected positive and negative affect of parents and adolescents and parenting behaviors (warmth and criticism). Additionally, we examined possible explanations for the hypothesized changes in affect and parenting. To do so, we compared daily reports on affect and parenting that were gathered during two periods of 14 consecutive days, once before the COVID-19 pandemic (2018-2019) and once during the COVID-19 pandemic. Multilevel analyses showed that only parents' negative affect increased as compared to the period before the pandemic, whereas this was not the case for adolescents' negative affect, positive affect and parenting behaviors (from both the adolescent and parent perspective). In general, intolerance of uncertainty was linked to adolescents' and parents' negative affect and adolescents' positive affect. However, Intolerance of uncertainty, nor any pandemic related characteristics (i.e. living surface, income, relatives with COVID-19, hours of working at home, helping children with school and contact with COVID-19 patients at work) were linked to the increase of parents' negative affect during COVID-19. It can be concluded that on average, our sample (consisting of relatively healthy parents and adolescents) seems to deal fairly well with the circumstances. The substantial heterogeneity in the data however, also suggest that whether or not parents and adolescents experience (emotional) problems can vary from household to household. Implications for researchers, mental health care professionals and policy makers are discussed.

Conducta del Adolescente/psicología , Betacoronavirus , Bienestar del Niño/psicología , Infecciones por Coronavirus/epidemiología , Infecciones por Coronavirus/psicología , Conducta Materna/psicología , Responsabilidad Parental/psicología , Padres/psicología , Conducta Paterna/psicología , Neumonía Viral/epidemiología , Neumonía Viral/psicología , Adolescente , Adulto , Afecto , Infecciones por Coronavirus/virología , Femenino , Estudios de Seguimiento , Humanos , Estudios Longitudinales , Masculino , Salud Mental , Persona de Mediana Edad , Países Bajos/epidemiología , Pandemias , Neumonía Viral/virología , Encuestas y Cuestionarios , Incertidumbre
Metas enferm ; 23(8): 27-32, oct. 2020. tab
Artículo en Español | IBECS | ID: ibc-196931


OBJETIVO: identificar la influencia del tipo de familia, así como de las características sociodemográficas y de salud en la adopción del rol materno (ARM) de madres primigestas del municipio de Teziutlán, Puebla (México). MÉTODOS: estudio descriptivo transversal realizado en el Centro de Salud con Servicios con Ampliados de Teziutlán, con una población de estudio de 726 mujeres primigestas. Muestreo no probabilístico por conveniencia, se incluyó a madres con hijos entre 1 y 12 meses que acudieron a consulta entre agosto y noviembre de 2019. Instrumentos de medida: cuestionario de datos sociodemográficos, familiares, del embarazo y la escala de ARM (nivel bajo (56 a 180 puntos), medio (181 a 202 puntos) y alto (203 a 224 puntos)). Se realizaron índices de estadística descriptiva y análisis bivariantes. RESULTADOS: participaron 126 madres. La ARM fue adquirida con mayor frecuencia niveles altos en mujeres entre 13 y 19 años (28,6%) o 30 a 52 (28,6%), amas de casa (26,8%) y con estudios de secundaria (27%), que tenían relación de pareja en unión libre (25,9%) o casada (22,2%), de duración igual o mayor a cuatro años (25,6%) y vivían en familia extensa con la familia de origen (28,6%). También en aquellas que planificaron su embarazo (36%), siguieron citas prenatales (27%) y no tenían abortos previos (23,8%). CONCLUSIÓN: la ARM varía en función del tipo de familia, viéndose favorecida por las relaciones de pareja superiores a cuatro años y la convivencia con la familia de la madre. También lo hace en función de otras características sociodemográficas y relacionadas con el embarazo

OBJECTIVE: to identify the influence of the type of family, as well as of sociodemographical and health characteristics, in the adaptation to the maternal role (AMR) in primiparous mothers from the Teziutlán district, in Puebla (Mexico). METHODS: a descriptive cross-sectional study conducted in the Teziutlán Public Health Centre with Expanded Services, on a study population of 726 primiparous women. Non-probabilistic convenience sampling was used, including mothers with 1-to-12-month children who attended the centre between August and November, 2019. Measurement instruments: questionnaire for sociodemographical, family and pregnancy data, and the ARM scale (low level: (56 to 180 scores), intermediate: (181 to 202 scores), and high level (203 to 224 scores)). Descriptive statistical indexes and bivariate analysis were conducted. RESULTS: the study included 126 mothers. High levels in ARM were more frequently obtained in 13-to-19-year-old (28.6%) or 30-to-52-year old women (28.6%), homemakers (26.8%) and with secondary education (27%), on a consensual union couple relationship (25.9%) or married (22.2%), for four years or longer (25.6%) and living with their extended family of origin (28.6%). Also in those who planned their pregnancy (36%), followed their prenatal appointments (27%) and had no previous miscarriages (23.8%). CONCLUSION: the ARM varies according to type of family, and increases when the couple relationship has lasted over four years and by living with the family of the mother. There are other sociodemographical and pregnancy-related characteristics which will also have a positive impact

Humanos , Femenino , Adolescente , Adulto Joven , Adulto , Conducta Materna/psicología , Relaciones Familiares/psicología , Relaciones Madre-Hijo/psicología , Salud Materno-Infantil , Enfermería Maternoinfantil , Estudios Transversales , Encuestas y Cuestionarios
Am J Perinatol ; 37(13): 1377-1384, 2020 11.
Artículo en Inglés | MEDLINE | ID: mdl-32898920


The novel coronavirus disease 2019 (COVID-19) pandemic has resulted in changes to perinatal and neonatal care, concentrating on minimizing risks of transmission to the newborn and health care staff while ensuring medical care is not compromised for both mother and infant. Current recommendations on infant care and feeding when mother has COVID-19 ranges from mother-infant separation and avoidance of human milk feeding, to initiation of early skin-to-skin contact and direct breastfeeding. Health care providers fearing risks of severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) maternal-infant transmission may veer toward restricted breastfeeding practices. We reviewed guidelines and published literature and propose three options for infant feeding depending on various scenarios. Option A involves direct breastfeeding with the infant being cared for by the mother or caregiver. In option B, the infant is cared for by another caregiver and receives mother's expressed milk. In the third option, the infant is not breastfed directly and does not receive mother's expressed milk. We recommend joint decision making by parents and the health care team. This decision is also flexible as situation changes. We also provide a framework for counseling mothers on these options using a visual aid and a corresponding structured training program for health care providers. Future research questions are also proposed. We conclude that evidence and knowledge about COVID-19 and breastfeeding are still evolving. Our options can provide a quick and flexible reference guide that can be adapted to local needs. KEY POINTS: · SARS-CoV-2 is unlikely transmitted via human milk.. · A shared decision making on infant feeding is the preferred approach.. · Mothers can safely breastfeed with appropriate infection control measures..

Lactancia Materna/métodos , Infecciones por Coronavirus , Control de Infecciones/métodos , Transmisión Vertical de Enfermedad Infecciosa/prevención & control , Leche Humana/virología , Pandemias , Neumonía Viral , Complicaciones Infecciosas del Embarazo , Betacoronavirus , Infecciones por Coronavirus/epidemiología , Infecciones por Coronavirus/prevención & control , Consejo/métodos , Toma de Decisiones , Femenino , Humanos , Recién Nacido , Conducta Materna , Madres/psicología , Pandemias/prevención & control , Neumonía Viral/epidemiología , Neumonía Viral/prevención & control , Embarazo , Complicaciones Infecciosas del Embarazo/epidemiología , Complicaciones Infecciosas del Embarazo/prevención & control , Ajuste de Riesgo/métodos
Am J Perinatol ; 37(13): 1310-1316, 2020 11.
Artículo en Inglés | MEDLINE | ID: mdl-32882743


OBJECTIVE: The novel virus known as severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) has led to a terrifying pandemic. The range of illness severity among children is variable. This study aims to assess the characteristics of newborns born to SARS-CoV-2-positive women compared with those mothers who tested negative. STUDY DESIGN: This was a retrospective cohort study performed at Brookdale Hospital Medical Center in New York City from March to May 2020. Electronic medical records of mother-baby dyads were reviewed. RESULTS: Seventy-nine mothers tested for SARS-CoV-2 were included, out of which 18.98% of mothers tested SARS-CoV-2 positive. We found a significant association between symptoms and SARS-CoV-2 status. We observed a significant association between newborns of SARS-CoV-2 positive and SARS-CoV-2 negative mothers regarding skin-to-skin contact (p < 0.001). Both groups showed significant differences regarding isolation (p < 0.001). Interestingly, regarding SARS-CoV-2 infection in newborns, only one newborn tested SARS-CoV-2 positive and was unstable in the neonatal intensive care unit (NICU). With the multivariable logistic regression model, babies of SARS-CoV-2 positive mothers were three times as likely to have desaturations in comparison to newborns from negative mothers. Also, newborns of SARS-CoV-2-positive mothers were four times more likely to have poor feeding, compared with newborns of SARS-CoV-2-negative mothers. Finally, babies of SARS-CoV-2-positive mothers were ten times more likely to be symptomatic at the 2-week follow-up. CONCLUSION: SARS-CoV-2 has caused major morbidity and mortality worldwide. Neonates born to mothers with confirmed or suspected SARS-CoV-2 are most of the time asymptomatic. However, neonatal critical illness due to SARS-CoV-2 is still a possibility; thus, isolation precautions (such as avoiding skin-to-skin contact and direct breastfeeding) and vertical transmission should be studied thoroughly. In addition, testing these newborns by nasopharyngeal swab at least at 24 hours after birth and monitoring them for the development of symptoms for 14 days after birth is needed. KEY POINTS: · For SARS-CoV-2-positive mothers, reducing transmission of infection to newborns is crucial.. · Newborns of SARS-CoV-2-positive mothers are usually asymptomatic and may not be easily infected.. · Critical illness in the newborn may still happen, so monitoring is needed..

Betacoronavirus/aislamiento & purificación , Técnicas de Laboratorio Clínico , Infecciones por Coronavirus , Transmisión Vertical de Enfermedad Infecciosa , Pandemias , Neumonía Viral , Complicaciones Infecciosas del Embarazo , Enfermedades Asintomáticas/epidemiología , Técnicas de Laboratorio Clínico/métodos , Técnicas de Laboratorio Clínico/estadística & datos numéricos , Infecciones por Coronavirus/diagnóstico , Infecciones por Coronavirus/epidemiología , Infecciones por Coronavirus/prevención & control , Infecciones por Coronavirus/transmisión , Femenino , Humanos , Recién Nacido , Transmisión Vertical de Enfermedad Infecciosa/prevención & control , Transmisión Vertical de Enfermedad Infecciosa/estadística & datos numéricos , Cuidado Intensivo Neonatal/estadística & datos numéricos , Masculino , Conducta Materna , Monitoreo Fisiológico/métodos , Tamizaje Neonatal/métodos , Ciudad de Nueva York/epidemiología , Oximetría/estadística & datos numéricos , Pandemias/prevención & control , Neumonía Viral/diagnóstico , Neumonía Viral/epidemiología , Neumonía Viral/prevención & control , Neumonía Viral/transmisión , Embarazo , Complicaciones Infecciosas del Embarazo/diagnóstico , Complicaciones Infecciosas del Embarazo/epidemiología , Complicaciones Infecciosas del Embarazo/prevención & control , Estudios Retrospectivos , Medición de Riesgo/métodos , Factores de Riesgo
Av. enferm ; 38(3): 335-346, 01 Sep. 2020.
Artículo en Español | LILACS, BDENF - Enfermería, COLNAL | ID: biblio-1141284


Objetivo: develar la vivencia de la Ley de Postnatal Parental en madres trabajadoras y sus hijos en dos ciudades del sur de Chile, 2018. Metodología: investigación cualitativa fenomenológica con referente filosófico en Schutz. Recolección por entrevista fenomenológica y análisis a través de la definición de metacategorías y categorías intermedias. El muestreo se define por saturación teórica y la recolección por medio de entrevista fenomenológica a fin de aprehender los objetos vividos. Esta se realiza en el lugar y horario acordado, previa firma de formulario de consentimiento informado, y se autoriza la grabación del discurso. Resultados: emergieron las metacategorías experiencia beneficiosa para díadas, beneficios para el lactante, sobrecarga materna y desprotección por déficit de información. Teniendo en cuenta las perspectivas de género imperantes, retornar al trabajo implica culpa y sobrecarga materna al conciliar ambos roles. Conclusiones: se perciben miedos a perder el trabajo y perjuicios por hacer uso del permiso parental. Se deben buscar estrategias que faciliten la entrega de información y valorar redes de apoyo maternas para facilitar la conciliación familiar.

Objetivo: apresentar a experiência da Lei do Pós-natal (Ley de Postnatal Parental) em mães trabalhadoras e seus filhos em duas cidades do sul do Chile, 2018. Metodologia: pesquisa fenomenológica qualitativa com referencial filosófico de Schutz; coleta por entrevista fenomenológica e análise por meio da definição de metacategorias e categorias intermediárias. A amostragem é definida por saturação teórica e a coleta por entrevista fenomenológica para a apreensão dos objetos vividos. A entrevista foi realizada em local e horário acordados após a assinatura do Termo de Consentimento Livre e Esclarecido, sendo autorizada a gravação do discurso. Resultados: surgiram metacategorias experiência benéfica para as díades, benefícios para o bebê, sobrecarga materna e falta de proteção por causa do deficit de informações. Devido às perspectivas predominantes de gênero, o retorno ao trabalho implica culpa e sobrecarga materna ao conciliar os dois papéis. Conclusões: o medo de perder trabalho e preconceitos por usar a licença-maternidade são percebidos. Estratégias que facilitam a entrega de informações e valorizam as redes de apoio materno devem ser buscadas para promover a reconciliação familiar.

Objective: To reveal the experience of the Parental Postnatal Law in working mothers and their children in two cities in southern Chile, 2018. Methodology: Phenomenological qualitative research with Schutz philosophical reference. Data was collected by phenomenological interview and analysis, defining a set of metacategories and intermediate categories. Sampling is defined by theoretical saturation and data collection carried out by phenomenological interview in order to apprehend the objects lived. Interviews were performed at the agreed place and time, after signing an informed consent form, and included an authorized recording of the speech. Results: The emerged metacategories correspond to beneficial experience for dyads, benefits for the infant, maternal overload, and deprotection due to information deficit. Considering the prevailing gender perspectives, returning to work implies guilt and maternal overload when reconciling both roles. Conclusion: Fears of losing the job and prejudices are perceived when making use of a parental leave. Strategies aimed at easing the delivery of information and valuing maternal support networks that smooth family reconciliation should be considered.

Humanos , Femenino , Embarazo , Recién Nacido , Atención Posnatal , Legislación Laboral , Investigación Cualitativa , Acontecimientos que Cambian la Vida , Conducta Materna
Pediatrics ; 146(Suppl 1): S81-S85, 2020 08.
Artículo en Inglés | MEDLINE | ID: mdl-32737238


Jahi McMath's story has been an important reference in medicine and ethics as the landscape of the understanding of death by neurologic criteria is shifting, with families actively questioning the once-firm criterion. Palliative care providers have a role in seeking understanding and collaborating with families and clinical teams to navigate the many challenges that arise when a medical team has determined that a child has died, and their parents disagree. In this case-based narrative discussion we consider the complexity of the family experience of brain death.

Muerte Encefálica/diagnóstico , Familia , Cuidados Paliativos , Religión y Medicina , Adolescente , Curación por la Fe/psicología , Femenino , Historia del Siglo XXI , Humanos , Conducta Materna , Examen Neurológico , Relaciones Profesional-Familia , Pronóstico
Adv Exp Med Biol ; 1284: 49-62, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32852740


In mammals, parental care is essential for the survival of the young; therefore, it is vitally important to the propagation of the species. These behaviors, differing between the two sexes, are innate, stereotyped, and are also modified by an individual's reproductive experience. These characteristics suggest that neural mechanisms underlying parental behaviors are genetically hardwired, evolutionarily conserved as well as sexually differentiated and malleable to experiential changes. Classical lesion studies on neural control of parental behaviors, mostly done in rats, date back to the 1950s. Recent developments of new methods and tools in neuroscience, which allow precise targeting and activation/inhibition of specific populations of neurons and their projections to different brain structures, have afforded fresh opportunities to dissect and delineate the detailed neural circuit mechanisms that govern distinct components of parental behaviors in the genetically tractably organism, the laboratory mouse (Mus musculus). In this review, we summarize recent discoveries using modern neurobiological tools within the context of traditional lesion studies. In addition, we discuss interesting cross talk between neural circuits that govern parent care with those that regulate other innate behaviors such as feeding and mating.

Encéfalo/citología , Encéfalo/fisiología , Conducta Materna/fisiología , Vías Nerviosas/fisiología , Neuronas/fisiología , Conducta Paterna/fisiología , Animales , Ratones , Modelos Animales
Public Health Rep ; 135(5): 658-667, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32805192


OBJECTIVES: The health profile of Arab American mothers and infants may differ from that of non-Arab American mothers and infants in the United States as a result of social stigma experienced in the historical and current sociopolitical climate. The objective of our study was to compare maternal health behaviors, maternal health outcomes, and infant health outcomes of Arab American mothers and non-Hispanic white mothers in Massachusetts and to assess the role of nativity as an effect modifier. METHODS: Using data from Massachusetts birth certificates (2012-2016), we conducted adjusted logistic and linear regression models for maternal health behaviors, maternal health outcomes, and infant health outcomes. We used Arab ethnicity as the exposure of interest and nativity as an effect modifier. RESULTS: Arab American mothers had higher odds than non-Hispanic white mothers of initiating breastfeeding (adjusted odds ratio [aOR] = 2.61; 95% CI, 2.39-2.86), giving birth to small-for-gestational-age infants (aOR = 1.28; 95% CI, 1.18-1.39), and having gestational diabetes (aOR = 1.31; 95% CI, 1.20-1.44). Among Arab American mothers, non-US-born mothers had higher odds than US-born mothers of having gestational diabetes (aOR = 1.80; 95% CI, 1.33-2.44) and lower odds of initiating prenatal care in the first trimester (aOR = 0.41; 95% CI, 0.33-0.50). In linear regression models, infants born to non-US-born Arab American mothers weighed 42.1 g (95% CI, -75.8 to -8.4 g) less than infants born to US-born Arab American mothers. CONCLUSION: Although Arab American mothers engage in positive health behaviors, non-US-born mothers had poorer maternal health outcomes and access to prenatal care than US-born mothers, suggesting the need for targeted interventions for non-US-born Arab American mothers.

Árabes/psicología , Grupo de Ascendencia Continental Europea/psicología , Salud del Lactante/estadística & datos numéricos , Conducta Materna/psicología , Salud Materna/estadística & datos numéricos , Madres/psicología , Características de la Residencia/estadística & datos numéricos , Adulto , Árabes/estadística & datos numéricos , Grupo de Ascendencia Continental Europea/estadística & datos numéricos , Femenino , Conductas Relacionadas con la Salud , Humanos , Lactante , Recién Nacido , Masculino , Massachusetts , Madres/estadística & datos numéricos
PLoS Med ; 17(8): e1003158, 2020 08.
Artículo en Inglés | MEDLINE | ID: mdl-32810187


BACKGROUND: Most of the women who smoke before pregnancy continue smoking during pregnancy, and some start to quit smoking after being pregnant, although existing guidelines for pregnancy recommend that women who smoke should quit smoking before pregnancy. Findings about the timing and intensity of maternal smoking, especially low-intensity smoking (1-9 cigarettes per day), and preterm birth are still inconsistent and ambiguous. This study aimed to examine the association of the timing of smoking and doses of smoking before pregnancy and during the first or second trimester of pregnancy with preterm birth in a large-scale population-based retrospective cohort study. METHODS AND FINDINGS: We used nationwide birth certificate data from singleton mother-infant pairs in the United States National Vital Statistics System, 2011-2018. All adult women with live singleton births, without preexisting hypertension or diabetes, and with complete data on smoking and gestational age at delivery were included. Participants reported their smoking status (yes or no) and daily number of cigarettes consumed before and during each trimester of pregnancy. The outcome of interest was preterm birth, defined as a birth before 37 weeks of gestation. Logistic regression models were used to estimate the odds ratio (OR) with 95% confidence intervals (CIs) of preterm birth associated with smoking status and the number of cigarettes consumed, adjusting for maternal age, race/ethnicity, parity, education levels, prepregnancy BMI, previous history of preterm birth, marital status, infant sex, and initiation of prenatal care. This study included 25,623,479 women, with a mean age of 29 years (range 20-50 years); 13,742,486 (53.6%) participants were of non-Hispanic white ancestry, 5,971,598 (23.3%) of Hispanic ancestry, and 3,417,456 (13.34%) of non-Hispanic black ancestry. The prevalence of preterm birth was 9.3% (n = 2,378,398). We found that maternal smoking during pregnancy, even at a very low level of intensity, was associated with an increased risk of preterm delivery. The adjusted ORs (95% CI) of preterm birth for mothers who smoked 1-2, 3-5, 6-9, 10-19, and ≥20 cigarettes per day during the first trimester compared with mothers who did not smoke were 1.31 (1.29-1.33), 1.31 (1.30-1.32), 1.33 (1.31-1.35), 1.44 (1.43-1.45), and 1.53 (1.52-1.55), respectively (all P values < 0.001), whereas for those who smoked during the second trimester, the corresponding ORs were 1.37 (1.35-1.39), 1.36 (1.35-1.38), 1.36 (1.34-1.38), 1.48 (1.47-1.49), and 1.59 (1.58-1.61), respectively (all P values < 0.001). Furthermore, smokers who quit before pregnancy, regardless of smoking intensity, had a comparable risk of preterm birth with nonsmokers, although this was not the case when cessation occurred in the first or second trimester of pregnancy. The major limitation of this study is the self-reported information about smoking, which may be subject to information bias. In addition, we cannot rule out the possibility of residual confounding caused by unmeasured factors in an observational research design. CONCLUSIONS: In this study, we observed that low-intensity cigarette consumption during either the first or second trimester of pregnancy, even as low as 1-2 cigarettes per day, was associated with an increased risk of preterm birth. These findings suggest that there is no safe level or safe trimester for maternal smoking during pregnancy. Women of reproductive age who smoke should be strongly encouraged and supported to quit smoking before pregnancy.

Fumar Cigarrillos/efectos adversos , Fumar Cigarrillos/epidemiología , Conducta Materna , Nacimiento Prematuro/epidemiología , Efectos Tardíos de la Exposición Prenatal/epidemiología , Adulto , Fumar Cigarrillos/tendencias , Relación Dosis-Respuesta a Droga , Femenino , Humanos , Persona de Mediana Edad , Embarazo , Nacimiento Prematuro/diagnóstico , Nacimiento Prematuro/etiología , Efectos Tardíos de la Exposición Prenatal/diagnóstico , Efectos Tardíos de la Exposición Prenatal/etiología , Factores de Riesgo , Autoinforme , Estados Unidos/epidemiología , Adulto Joven
PLoS One ; 15(8): e0237933, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32822407


Defining the relationship between maternal care, sensory development and brain gene expression in neonates is important to understand the impact of environmental challenges during sensitive periods in early life. In this study, we used a selection approach to test the hypothesis that variation in maternal licking and grooming (LG) during the first week of life influences sensory development in Wistar rat pups. We tracked the onset of the auditory brainstem response (ABR), the timing of eye opening (EO), middle ear development with micro-CT X-ray tomography, and used qRT-PCR to monitor changes in gene expression of the hypoxia-sensitive pathway and neurotrophin signaling in pups reared by low-LG or high-LG dams. The results show the first evidence that the transcription of genes involved in the hypoxia-sensitive pathway and neurotrophin signaling is regulated during separate sensitive periods that occur before and after hearing onset, respectively. Although the timing of ABR onset, EO, and the relative mRNA levels of genes involved in the hypoxia-sensitive pathway did not differ between pups from different LG groups, we found statistically significant increases in the relative mRNA levels of four genes involved in neurotrophin signaling in auditory brain regions from pups of different LG backgrounds. These results suggest that sensitivity to hypoxic challenge might be widespread in the auditory system of neonate rats before hearing onset, and that maternal LG may affect the transcription of genes involved in experience-dependent neuroplasticity.

Conducta Animal/fisiología , Encéfalo/crecimiento & desarrollo , Encéfalo/metabolismo , Potenciales Evocados Auditivos del Tronco Encefálico/fisiología , Aseo Animal/fisiología , Conducta Materna/fisiología , Factores de Crecimiento Nervioso/metabolismo , Animales , Animales Recién Nacidos , Ojo/crecimiento & desarrollo , Regulación del Desarrollo de la Expresión Génica/genética , Regulación del Desarrollo de la Expresión Génica/fisiología , Audición , Hipoxia/genética , Hipoxia/metabolismo , Factores de Crecimiento Nervioso/genética , Plasticidad Neuronal/fisiología , Ratas , Ratas Wistar , Transducción de Señal/genética , Transducción de Señal/fisiología , Microtomografía por Rayos X
PLoS One ; 15(7): e0230992, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32722725


BACKGROUND: Psychological aspects of labor and birth have received little attention within maternity care service planning or clinical practice. The aim of this paper is to propose a model demonstrating how neurohormonal processes, in particular oxytocinergic mechanisms, not only control the physiological aspects of labor and birth, but also contribute to the subjective psychological experiences of birth. In addition, sensory information from the uterus as well as the external environment might influence these neurohormonal processes thereby influencing the progress of labor and the experience of birth. METHODOLOGY: In this new model of childbirth, we integrated the findings from two previous systematic reviews, one on maternal plasma levels of oxytocin during physiological childbirth and one meta-synthesis of women´s subjective experiences of physiological childbirth. FINDINGS: The neurobiological processes induced by the release of endogenous oxytocin during birth influence maternal behaviour and feelings in connection with birth in order to facilitate birth. The psychological experiences during birth may promote an optimal transition to motherhood. The spontaneous altered state of consciousness, that some women experience, may well be a hallmark of physiological childbirth in humans. The data also highlights the crucial role of one-to-one support during labor and birth. The physiological importance of social support to reduce labor stress and pain necessitates a reconsideration of many aspects of modern maternity care. CONCLUSION: By listening to women's experiences and by observing women during childbirth, factors that contribute to an optimized process of labor, such as the mothers' wellbeing and feelings of safety, may be identified. These observations support the integrative role of endogenous oxytocin in coordinating the neuroendocrine, psychological and physiological aspects of labor and birth, including oxytocin mediated. decrease of pain, fear and stress, support the need for midwifery one-to-one support in labour as well as the need for maternity care that optimizes the function of these neuroendocrine processes even when birth interventions are used. Women and their partners would benefit from understanding the crucial role that endogenous oxytocin plays in the psychological and neuroendocrinological process of labor.

Trabajo de Parto/fisiología , Trabajo de Parto/psicología , Oxitocina/sangre , Parto/fisiología , Parto/psicología , Femenino , Humanos , Conducta Materna , Servicios de Salud Materna , Partería , Modelos Biológicos , Periodo Posparto/fisiología , Periodo Posparto/psicología , Embarazo , Apoyo Social , Estrés Fisiológico
PLoS One ; 15(7): e0236787, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32730322


The nature and timing of caregivers' speech provides an important foundation for infant attention and language development in the first year of life. Infant-directed speech is a key component of responsive parent-infant communication that is typically characterised by exaggerated intonation and positive affect. This study examines the effect of postnatal depression on the expression of positive vocal affect and pitch, the quantity of mothers' infant-directed speech input and the timing of vocal responses between mother and infant. Postnatal mothers currently experiencing symptoms of depression (n = 13) were matched to postnatal mothers who were not experiencing symptoms of depression (n = 13), and audio-recorded while playing with their 6-month-old infants. Compared with depressed mothers, non-depressed mothers used a higher mean pitch and pitch range, spoke more, gave faster verbal responses and were rated as expressing more positive valence in their voice. These preliminary findings indicate that mothers experiencing low mood use less infant-directed speech and less exaggerated pitch with prelinguistic infants. Postnatal depression is a major health issue that adversely impacts the parent and child. Early interventions for PND may benefit from identifying ways to support the timing of conversations and mothers' use of appropriate vocal pitch and infant-directed speech modifications. Further research is needed to confirm whether these strategies support early conversations.

Acústica , Depresión/fisiopatología , Desarrollo del Lenguaje , Conducta Materna , Canto/fisiología , Habla , Adolescente , Adulto , Femenino , Humanos , Lactante , Masculino , Relaciones Madre-Hijo , Adulto Joven
CuidArte, Enferm ; 14(2): 219-225, jul.-dez.2020.
Artículo en Portugués | BDENF - Enfermería | ID: biblio-1147317


Introdução: No Brasil, a asfixia é uma das principais causas de morbimortalidade em crianças. A manobra de Heimlich é uma técnica de primeiros socorros utilizada em casos de emergência em asfixia. Assim, é importante que as mães sejam orientadas e capacitadas para uma eventual necessidade de socorro à criança, diante dessa ocorrência. Objetivo: Identificar o grau de conhecimento de puérperas sobre a manobra de Heimlich e elaborar uma cartilha educativa sobre a manobra e o atendimento emergencial. Método: Pesquisa descritiva, exploratória, quali-quantitativa, realizada junto a puérperas de uma maternidade do interior paulista. Resultados: Participaram do estudo 50 puérperas. Foi elaborada uma cartilha explicativa no socorro à criança sob risco ou em asfixia. Quanto ao conhecimento sobre a manobra de Heimlich, 44% das mulheres desconheciam-na, 40% alegaram conhecê-la e 16% declararam ter pouco conhecimento sobre a técnica. Com relação às técnicas que executariam para atender a criança, 32% detalharam técnicas incorretas, 32% demonstraram algum conhecimento, 18% buscariam ajuda de pessoas leigas, 16% chamariam um socorro especializado e apenas 2% tinham conhecimento suficiente. Sobre educação em saúde e conhecimento da manobra de ressuscitação: 80% informaram não haver recebido orientação sobre a manobra de Heimlich, destas, 78% demonstraram interesse em conhecer o conteúdo explicativo da cartilha. Conclusão: O conhecimento insuficiente das puérperas e a falta de orientações sobre como socorrer a criança asfixiada requer intervenções específicas. Assim, a elaboração da cartilha educativa intitulada "Criança engasgada: orientações e primeiros socorros" se mostrou adequada para a população do estudo.(AU)

Introduction: In Brazil, asphyxiation is one of the main causes of morbidity and mortality in children. The Heimlich maneuver is a first aid technique used in cases of asphyxiation emergencies. Thus, it is important that mothers are guided and trained for a possible need to help the child, given this occurrence. Objective: To identify the degree of knowledge of puerperal women about the Heimlich maneuver and to elaborate an educational booklet on the maneuver and emergency care. Method: Descriptive, exploratory, qualitative-quantitative research, carried out with postpartum women from a maternity hospital in the interior of São Paulo. Results: 50 puerperal women participated in the study. An explanatory booklet was elaborated to help the child at risk or in asphyxia. As for the knowledge about the Heimlich maneuver, 44% of the women were unaware of it, 40% claimed to know it and 16% said they had little knowledge about the technique. Regarding the techniques they would perform to care for the child, 32% detailed incorrect techniques, 32% showed some knowledge, 18% would seek help from lay people, 16% would call for specialized help and only 2% had sufficient knowledge. On health education and knowledge of the resuscitation maneuver: 80% reported not having received guidance on the Heimlich maneuver, of which 78% showed interest in knowing the explanatory content of the booklet. Conclusion: The insufficient knowledge of postpartum women and the lack of guidance on how to rescue the asphyxiated child requires specific interventions. Thus, the elaboration of the educational booklet entitled "Child choking: orientations and first aid" proved adequate for the study population.(AU)

Introducción: En Brasil, la asfixia es una de las principales causas de morbilidad y mortalidad en niños. La maniobra de Heimlich es una técnica de primeros auxilios utilizada en casos de emergencia en asfixia. Por lo tanto, es importante que las madres sean orientadas y entrenadas para una posible necesidad de ayuda al niño, en vista de este acontecimiento. Objetivo: Identificar el grado de conocimiento de las mujeres puerperales sobre la maniobra de Heimlich y elaborar un folleto educativo sobre la maniobra y la atención de emergencia. Método: Investigación descriptiva, exploratoria, cualitativa y cuantitativa, realizada con mujeres puerperales de un hospital de maternidad en el interior de Sao Paulo. Resultados: Cincuenta mujeres puerperales participaron en el estudio. Se preparó un folleto explicativo para ayudar a los niños en riesgo o en asfixia. En cuanto al conocimiento sobre la maniobra de Heimlich, el 44% de las mujeres no lo sabían, el 40% afirmaba conocerla y el 16% informaba tener poco conocimiento sobre la técnica. En cuanto a las técnicas que realizarían para cuidar al niño, el 32% de técnicas incorrectas detalladas, el 32% demostró algunos conocimientos, el 18% buscaría ayuda de laicos, el 16% llamaría a una ayuda especializada y sólo el 2% tenía suficiente conocimiento. En cuanto a la educación sanitaria y el conocimiento de la maniobra de reanimación: el 80% informó no haber recibido orientación sobre la maniobra de Heimlich, de los cuales el 78% mostró interés en conocer el contenido explicativo del folleto. Conclusión: El conocimiento insuficiente de las mujeres puerperales y la falta de orientación sobre cómo ayudar al niño asfixiado requiere intervenciones específicas. Así, la elaboración del folleto educativo titulado "Ninõ asfixiante: pautas y primeiros auxilios" resultó adecuada para la población del estudio.(AU)

Humanos , Femenino , Educación en Salud , Urgencias Médicas/enfermería , Maniobra de Heimlich , Conducta Materna , Asfixia , Mortalidad Infantil , Enfermería Maternoinfantil
Chemosphere ; 258: 127383, 2020 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-32559491


The application of pesticides typically leads to lethal and sublethal exposure of non-target insects. Whereas our current understanding of these sublethal effects typically focuses on reproductive and physiological parameters, recent works emphasize that sublethal effects on behaviors such as maternal care could be of major importance in non-target species. However, it remained unknown whether these sublethal effects occur in insects. Here, we tested if exposure to sublethal doses of deltamethrin - a pyrethroid insecticide commonly used in crops - alters the expression of maternal egg care in females of the European earwig Forficula auricularia, a predator insect and pest control. Our results first reveal that deltamethrin exposure impaired the expression of three forms of maternal egg care: It decreased the likelihood of mothers to gather their otherwise scattered clutch of eggs, increased the time during which the female abandoned the clutch after a predator attack and reduced egg grooming duration. These sublethal effects did not reflect a lower activity of deltamethrin-exposed females, as these females increased their expression of self-grooming, and deltamethrin exposure did not affect females' exploration and mobility. Finally, we found that the negative effects of deltamethrin on egg care did not modify egg development, hatching rate and juvenile weight, possibly due to the transient effects of deltamethrin on maternal behaviors. Overall, our results reveal that sublethal exposure to a pesticide may diminish maternal egg care in a natural pest control and call for the integration of this measurement in assays on pesticides application.

Conducta Animal/efectos de los fármacos , Insectos/efectos de los fármacos , Insecticidas/toxicidad , Conducta Materna/efectos de los fármacos , Nitrilos/toxicidad , Óvulo/crecimiento & desarrollo , Piretrinas/toxicidad , Animales , Relación Dosis-Respuesta a Droga , Femenino , Insectos/fisiología , Reproducción/efectos de los fármacos
Rev. esp. nutr. comunitaria ; 26(2): 0-0, abr.-jun. 2020. ilus, tab
Artículo en Español | IBECS | ID: ibc-194450


FUNDAMENTOS: Una alimentación adecuada durante los primeros años de vida resulta imprescindible para alcanzar un crecimiento óptimo. Esto depende fundamentalmente de los conocimientos y prácticas maternas, por lo que es esencial contar con instrumentos validados que permitan su identificación. El objetivo fue diseñar y validar un cuestionario para identificar conocimientos y prácticas maternas de alimentación complementaria en una población vulnerable. MÉTODOS: Estudio de validación. El cuestionario fue diseñado a partir de una revisión de la literatura, validado mediante juicio de 6 expertos y un pilotaje cognitivo en 50 madres de niños de 6 a 23 meses de edad de la localidad de Taco Pozo, Chaco, Argentina. RESULTADOS: El instrumento inicial contó con 40 ítems, distribuidos en 4 bloques. El test demostró una excelente claridad y comprensión (97%), y una aceptación superior al 90% para la coherencia, claridad y relevancia evaluados por los jueces, con un Coeficiente de Correlación Intraclase de 0,823; 0,888 y 0,508, respectivamente. Se demostró la unidimensionalidad de la herramienta (Kaiser-Meyer-Olkin = 0,414 y prueba de esfericidad de Bartlett = 0,007). CONCLUSIONES: La validación del cuestionario resultó satisfactoria para la determinación de los conocimientos y prácticas maternas de alimentación complementaria, útil para la planificación de futuras intervenciones educativas

BACKGROUND: Adequate food during the first years of life is essential to achieve optimal growth. This depends fundamentally on maternal knowledge and practices, so it is essential to have validated instruments that allow their identification. The objective was to design and validate a questionnaire to identify knowledge or maternal practices of complementary feeding. METHODS: Validation study. The questionnaire was designed based on a review of the literature, and validated by trial of 6 experts and a cognitive pilot in 50 mothers of children 6 to 23 months of age from the town of Taco Pozo, Chaco, Argentina. RESULTS: The initial instrument had 40 items, distributed in 4 blocks. The test showed excellent clarity and understanding (97%), and an acceptance greater than 90% for the coherence, clarity and relevance evaluated by the judges, with an Intraclass Correlation Coefficient of 0.823; 0.888 and 0.508, respectively. The unidimensionality of the tool was demonstrated (Kaiser-Meyer-Olkin = 0.414 and Bartlett's test of sphericity = 0.007). CONCLUSIONS: The validation of the questionnaire was satisfactory for the determination of the knowledge and maternal practices of complementary feeding, useful for the planning of future educational interventions

Humanos , Masculino , Femenino , Lactante , Fenómenos Fisiológicos Nutricionales del Lactante/fisiología , Nutrición del Lactante , Conocimientos, Actitudes y Práctica en Salud , Nutrición de los Grupos de Riesgo , Encuestas y Cuestionarios , Conducta Materna , Psicometría
Sci Rep ; 10(1): 8087, 2020 05 15.
Artículo en Inglés | MEDLINE | ID: mdl-32415196


Maternal behaviors benefit the survival of young, contributing directly to the mother's reproductive fitness. An extreme form of this is seen in matriphagy, when a mother performs the ultimate sacrifice and offers her body as a meal for her young. Whether matriphagy offers only a single energy-rich meal or another possible benefit to the young is unknown. Here, we characterized the toxicity of a bacterial secondary metabolite, namely, violacein, in Caenorhabditis elegans and found it is not only toxic towards adults, but also arrests growth and development of C. elegans larvae. To counteract this, C. elegans resorted to matriphagy, with the mothers holding their eggs within their bodies and hatching the young larvae internally, which eventually led to the mothers' death. This violacein-induced matriphagy alleviated some of the toxic effects of violacein, allowing a portion of the internally-hatched young to bypass developmental arrest. Using genetic and pharmacological experiments, we found the consumption of oleate, a monounsaturated fatty acid produced by the mother, during matriphagy is partially responsible. As such, our study provides experimental evidence of why such a drastic and peculiar maternal behavior may have arisen in nematode natural habitats.

Bacterias/metabolismo , Caenorhabditis elegans/crecimiento & desarrollo , Indoles/toxicidad , Larva/crecimiento & desarrollo , Conducta Materna , Muerte Materna , Ácido Oléico/farmacología , Animales , Caenorhabditis elegans/efectos de los fármacos , Femenino , Larva/efectos de los fármacos
Artículo en Inglés | MEDLINE | ID: mdl-32408556


Postpartum depression (PPD) has adverse effects on the mother's ability to work, her relationships, performance in other roles, and caregiving ability. The aim of this study was to compare levels of maternal functioning between mothers with depression symptoms and those without. The participants of this case-control study included 80 postpartum women (n = 40 with depressive symptoms and n = 40 with no depressive symptoms) referred to health centers in Tabriz, Iran, in 2018-2019. The case and control groups were matched for the number of deliveries (first or second deliveries) and the type of delivery (vaginal or cesarean section). A sociodemographic questionnaire, Edinburgh Postpartum Depression Scale (EPDS), and Barkin Index of Maternal Functioning (BIMF) were used for data collection. The relationship between maternal functioning and depression was assessed by conducting independent t-tests and Pearson correlation tests in bivariate analysis and applying the general linear model (GLM) in a multivariate analysis. There was no statistically significant difference between the two groups in terms of sociodemographic information. The mean (SD) total scores of maternal functioning in the case (depressed) and control (non-depressed) groups were 63.4 (12.2) and 93.3 (13.0), respectively. According to the independent t-test, this value in the control group was significantly higher than that of the case group (mean difference: -30.0; 95% confidence interval: -35.6 to -24.3; p < 0.001). In terms of the domains of the BIMF, based on the independent t-test, the mean score of all domains in the control group was significantly higher than that of the case group, except for the mother-child interaction dimension (p = 0.219). Based on the Pearson correlation test, there was significant negative correlation between the PPD score and total score of BIMF (r = -0.79, p < 0.001) and its domains (r = -0.81 to -0.54, p < 0.001). In addition, based on the GLM with adjusting the sociodemographic and obstetrics characteristics, the score of maternal functioning was significantly lower in the case group compared to the control group [ß = -30.1; 95% CI: -36.8 to -23.4; p = 0.001]. The results of this study indicate that women with depressive symptoms have lower maternal functioning. Depressed women may find it difficult to perform their maternal duties and take care of themselves and other family members due to the burden of the depressive symptoms. Therefore, early diagnosis and treatment of postpartum depression can play an important role in improving daily maternal functioning.

Depresión Posparto , Conducta Materna , Madres , Adulto , Estudios de Casos y Controles , Cesárea , Niño , Femenino , Humanos , Irán , Masculino , Embarazo