A Mindfulness-Based App Intervention for Pregnant Women: Protocol for a Pilot Feasibility Study.

BACKGROUND: Pregnancy is a complex time characterized by major transformations in a woman, which impact her physical, mental, and social well-being. How a woman adapts to these changes can affect her quality of life and psychological well-being. The literature indicates that pregnant women commonly experience psychological symptoms, with anxiety, stress, and depression being among the most frequent. Hence, promoting a healthy lifestyle focused on women's psychological well-being is crucial. Recently developed digital solutions have assumed a crucial role in supporting psychological well-being in physiologically pregnant women. Therefore, the need becomes evident for the development and implementation of digital solutions, such as a virtual coach implemented in a smartphone, as a support for the psychological well-being of pregnant women who do not present psychological and psychiatric disorders. OBJECTIVE: This study aims to assess the feasibility, acceptability, and utility of a mindfulness-based mobile app. The primary objective is to explore the feasibility of using a virtual coach, Maia, developed within the TreC Mamma app to promote women's psychological well-being during pregnancy through a psychoeducational module based on mindfulness. Finally, through the delivery of this module, the level of psychological well-being will be explored as a secondary objective. METHODS: This is a proof-of-concept study in which a small sample (N=50) is sufficient to achieve the intended purposes. Recruitment will occur within the group of pregnant women belonging to the pregnancy care services of the Trento Azienda Provinciale per i Servizi Sanitari di Trento. The convenience sampling method will be used. Maia will interact with the participating women for 8 weeks, starting from weeks 24 and 26 of pregnancy. Specifically, there will be 2 sessions per week, which the woman can choose, to allow more flexibility toward her needs. RESULTS: The psychoeducational pathway is expected to lead to significant results in terms of usability and engagement in women's interactions with Maia. Furthermore, it is anticipated that there will be improvements in psychological well-being and overall quality of life. The analysis of the data collected in this study will be mainly descriptive, orientated toward assessing the achievement of the study objectives. CONCLUSIONS: Literature has shown that women preferred web-based support during the perinatal period, suggesting that implementing digital interventions can overcome barriers to social stigma and asking for help. Maia can be a valuable resource for regular psychoeducational support for women during pregnancy. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): RR1-10.2196/53890.

Women's experience of continuity of midwifery care in North-Eastern Italy: A qualitative study.

INTRODUCTION: The establishment of a maternity path is often hampered by the fragmentation of care processes resulting in discontinuity of care. The interruption of continuity of care negatively affects the experience of maternity. The purpose of this research is to analyze the experience of women who get midwifery continuity of care from pregnancy till after childbirth. METHODS: A qualitative study using a phenomenological-grounded approach was undertaken. Audio-recorded semi-structured interviews were taken from 11 pregnant women who received midwifery care during maternity. This research was carried out between March 2020 and February 2021. RESULTS: Continuous and quality care is what allows women to develop new skills, increasing awareness and confidence in themselves and in their abilities both during pregnancy and after delivery. Assistance provided by competent professionals allows women to be taken in charge globally with greater personalization of care.Since the research was carried out during the first wave of the COVID-19 pandemic, some of the repercussions that the situation had on women during maternity were also experienced negatively, such as the interruption of continuity of care or the inability to choose whom to have next to. CONCLUSIONS: From the perspective of prevention and protection of maternal and child health, in the short- and long-term, it becomes essential to focus on developing maternal competencies. This may be possible by implementing midwifery continuity of care pathways with an appropriate and flexible organizational system capable of responding to women's needs throughout the maternity journey, even during periods of a health emergency.

Esiti avversi perinatali correlati all'indice di massa corporea pregravidico.

BACKGROUND: a high body mass index (BMI) during pregnancy has been associated with an increased risk of complications and adverse outcomes for both mother and infant. OBJECTIVES: to analyse the main adverse maternal and neonatal outcomes associated with maternal excess weight and obesity. DESIGN: retrospective epidemiological study. SETTING AND PARTICIPANTS: data extrapolated from the Birth Attendance Certificate information flow of the Autonomous Province of Trento (Northern Italy) between 2015 and 2019. A total of 20,756 women with data regarding maternal height and weight at the start of pregnancy were included in the analysis. MAIN OUTCOME MEASURES: gestational outcome variables studied were gestational diabetes, hypertensive disorders, premature birth, and still births. Outcomes considered during labour and delivery were type of delivery, induction, episiotomy and post-partum haemorrhage. Neonatal outcomes were birth weight, Apgar score, need for resuscitation, and hospitalisation in the neonatal intensive care unit (NICU). Lastly, exclusive breastfeeding at discharge was analysed. RESULTS: considering the population of pregnant women, 68.3% of women were classified as normal-weight, 9.5% as underweight, 16.0% as overweight, and 6.3% as obese. Maternal excess weight and obesity were seen to be associated with an increased risk of gestational diabetes, gestational hypertension, preeclampsia, caesarean section, induction, post-partum bleeding, foetal macrosomia, and the need for neonatal resuscitation and hospitalisation in the NICU. Infants born to overweight and obese mothers were also less likely to be breastfed. CONCLUSIONS: excess weight and obesity are important risk factors for health and contribute to the onset of complications during pregnancy and adverse perinatal and long-term outcomes. Programming and implementing public health promotion schemes aimed at preventing excessive weight gain in the reproductive age could significantly improve maternal and foetal health.