Prenatal maternal stress during the COVID-19 pandemic and birth outcomes: Is the newborn spared?

The COVID-19 pandemic has generated numerous stressors among the general population, but more specifically in pregnant women because of disruptions in prenatal care and delivery conditions. Studies suggest that prenatal maternal stress increased during the pandemic (Berthelot et al., 2020; Perzow et al., 2021; Tomfohr-Madsen et al., 2021). Considering what is known about the fetal programming potential of prenatal maternal stress, several researchers, early in the pandemic, raised concerns over the significant negative consequences that the pandemic context could have on birth outcomes. Studies comparing birth outcomes during versus before the pandemic suggest a marginal increase in birthweight and a significant decrease in preterm birth (Yang et al., 2022), but individual variations in prenatal maternal stress during the pandemic have received less attention. The objective of the present study is to examine the association between prenatal maternal stress during the COVID-19 pandemic and birth outcomes. During pregnancy, 195 expecting mothers reported on their general and pandemic-related stress. When their child was 6 months old, mothers completed a questionnaire collecting information on birth outcomes (gestational age, birthweight, head circumference and Apgar scores). Hierarchical linear regressions show that none of the maternal prenatal stress variables significantly predicted variations in birth outcomes. Potential pandemic-related protective factors (e.g., changes in life and hygiene habits, rest imposed by lockdowns) and the need to offer support to pregnant women are discussed.

A systematic review and meta-analysis of the efficacy of the long-term treatment and support of substance use disorders.

RATIONALE: The reconceptualization of substance use disorders (SUD) as a chronic phenomenon calls for a paradigm shift in service provision, particularly by way of long-term treatment and support. Studies that have evaluated the efficacy of long-term treatment models seem to indicate that they are an improvement on more standard short-term treatments, even though these studies do not take the durations into consideration. OBJECTIVE: Measure the efficacy of SUD treatments and support lasting 18 months or more regarding their ability to decrease substance use as compared to shorter treatments. METHODS: A meta-analysis based on a systematic literature review was conducted. Eight databases were consulted for peer-reviewed studies. Certain variables were coded as moderators: intervention length, participant characteristics, and treatment characteristics. RESULTS: The main results suggest that the people who received a planned long-term treatment or support had a 23.9 % greater chance of abstaining or consuming moderately than did people who received a shorter standard treatment (OR = 1.347 [CI 95 % = 1.087-1.668], p < .006, adjusted OR = 1.460 [CI 95 % = 1.145-1.861]). None of the moderation analyses revealed any variation in the efficacy of the long-term treatments and support. CONCLUSIONS: The reconceptualization of the SUD as a chronic disorder among people with this problem leads us to reconsider both the length of the services provided and the paradigms underlying their organization.

A case study illustrating the use of an attachment video-feedback intervention strategy.

Children from high-risk environments are more likely to experience problems in development. Many difficulties are linked to early experiences in the context of the emerging attachment relationship. Over the past 20 years, our group has collaborated with government agencies to develop and implement an attachment-based video-feedback intervention strategy (AVI) that targets parental sensitivity and attachment. This case study presents the manner in which a young mother and her 6-month-old son experienced AVI. The study shows how the absence of maternal sensitivity and responsiveness to infant signals, difficulties in helping the child regulate affect, and problems in autonomy support are addressed via eight semi-structured mentoring visits. Discussion focuses on how AVI may be a helpful addition to primary prevention programs.

Intervention with Adolescent Mother-Child Dyads and Cognitive Development in Early Childhood: a Meta-Analysis.

The cognitive development of children of adolescent mothers has often been considered to be at risk. The purpose of this meta-analysis is to examine whether early intervention could help foster more positive cognitive development in the 0- to 4-year-old children of adolescent mothers. Twenty-two studies were reviewed, involving 29 different intervention strategies and 3577 participants. An overall effect size (corrected for publication bias) of d = .24 was found (95% CI .11, .36). Intervention strategies that focused specifically on the quality of parent-child interaction (d = .89; 95% CI .36, 1.43) or that included parent-child interaction as an important target of intervention (d = .53; 95% CI .34, .73) yielded greater effect sizes than those that emphasized maternal support and education (d = .23; 95% CI .12, .34). Intervention that was delivered in groups (d = .56; 95% CI .36, .74) yielded greater effectiveness than dyadic intervention (d = .27; 95% CI .14, .39). Intervention delivered by trained professionals (d = .39; 95% CI .22, .56) was more effective than that delivered by paraprofessionals (d = .20; 95% CI -.02, .61). Older studies (slope = -.015) and those that involved smaller numbers of participants (slope = -.0008) also yielded greater effect sizes. There was also a marginal tendency for shorter intervention strategies (slope = -.002), and those that involved younger children (slope = -.005) and mothers (slope = -.074) to show greater effects. Discussion focuses on the developmental and practical implications of these results.