Maternal Anxiety and Its Associated Factors During the First and Second Wave of COVID-19 Pandemic in Serbia: A Cross-Sectional Study.

Aim: The COVID 19-pandemic affects people differently, while pregnant women are among the most sensitive populations. The data about maternal mental health during the COVID-19 outbreak are in some ways consistent but also country-specific. Purpose: The study aims to explore the impact of the COVID-19 pandemic on pregnant women's anxiety and identify its associated factors. Patients and Methods: This cross-sectional study included a sample of 358 pregnant women during the first and second waves of the pandemic in Serbia. An anonymous survey included basic demographic questions, pregnancy-related background questions, the question of self-reported COVID-19-related fear, State-Trait Anxiety Inventory (STAI), and Multidimensional Scale of Perceived Social Support (MSPSS). Results: The study revealed no pregnant women with low anxiety levels measured by STAI-T and STAI-S, while the STAI-S and STAI-T scores indicated high anxiety in 32.4% and 42.7% of pregnant women, respectively. The obtained results pointed out the nonlinear dependence of state anxiety on observed associated factors and their complex interactions, including the data collecting period. Conclusion: Our findings reveal that COVID-19 affects pregnant women's mental health and makes it necessary for psychological monitoring and support for pregnant women, which may be reflected in their mental health but also the development of their offspring.

The Impact of Maternal Anxiety on Early Child Development During the COVID-19 Pandemic.

Background: Maternal prenatal anxiety is among important public health issues as it may affect child development. However, there are not enough studies to examine the impact of a mother's anxiety on the child's early development, especially up to 1 year. Objective: The present prospective cohort study aimed to examine whether maternal trait anxiety, perceived social support, and COVID-19 related fear impacted speech-language, sensory-motor, and socio-emotional development in 12 months old Serbian infants during the COVID-19 pandemic. Methods: This follow-up study included 142 pregnant women (Time 1) and their children at 12 months (Time 2). Antenatal maternal anxiety and children's development were examined. Maternal anxiety was assessed using the State-Trait Anxiety Inventory (STAI). Child speech-language, sensory-motor, and socio-emotional development were assessed using the developmental scale in the form of an online questionnaire that examined the early psychophysiological child development. Information on socioeconomic factors, child and maternal demographics, clinical factors, and perceived fear of COVID-19 viral infection were collected. Multivariable General Linear Model analysis was conducted, adjusted for demographic, clinical, and coronavirus prenatal experiences, maternal prenatal anxiety levels, perceived social support, speech-language, motor skills, and cognitive and socio-emotional development at the infants' age of 12 months. Results: The study revealed the influence of the COVID-19 pandemic on maternal trait anxiety. The association between selected independent factors and infants' development was found in a demographically unified sample except for employment and the number of children. There was a correlation between all observed developmental functions. Univariate General Linear model statistical analysis indicated that linear models with selected independent factors and covariates could account for 30.9% (Cognition) up to 40.6% (Speech-language) of variability in developmental functions. It turned out that two-way and three-way interactions had a dominant role on models, and STAI-T Level and COVID-19 related fear were present in all interaction terms. Conclusion: Our findings reveal important determinants of child developmental outcomes and underline the impact of maternal anxiety on early child development. These findings lay the groundwork for the following interdisciplinary research on pregnancy and child development to facilitate and achieve positive developmental outcomes and maternal mental health.

Fetal Middle Cerebral Artery Pulsatility Index in No-Risk Pregnancies: Effects of Auditory Stimulation and Pregnancy Order.

Pulsatility index (PI) values in a fetal middle cerebral artery (MCA) were compared in no-risk pregnancies to examine the differences related to auditory stimulation test and pregnancy order. The study included 196 women with no-risk pregnancies selected from the database of more than 1000 pregnant women divided into two groups. Group 1 consisted of 98 nulliparous women (C1 = 98) and Group 2 consisted of 98 parous women (C2 = 98). All pregnant women were of comparable age and fetal gestational age (GA) when MCA-PI values were recorded. Measurements of PI values in fetal MCA were obtained before and immediately after the application of fetal auditory stimulation test. The MCA-PI measuring was conducted in the period between the 36th and the 41st week of GA. The results showed that PI baseline values and PI values after defined auditory stimulation were significantly different when measured in nulliparous women compared to parous women (p = 0.001; p = 0.003, respectively), while no group differences were observed in relative PI value changes due to auditory stimulation. These findings suggest that hemodynamic changes in fetal MCA caused by defined auditory stimulation measured by PI value changes may be valuable in the assessment of fetal auditory perception functionality and its development.

Neurophysiological Approach to Examining Knowledge/Belief in the Prayer of an Untrained Person: A Case Study.

An adult female (22 years) of Christian orthodox religion was examined during the silent Lord's prayer, the most common, short prayer, with the aim of possible differentiation between belief and knowledge in her experience, analyzing the behavior of subgroups of theta and beta cerebral EEG rhythms, which occur through constant and occasional activation of cerebral regions. The participant was not trained in reading the prayer to herself or other people. EEG examination was performed by Nihon Kohden Corporation, EEG-1200-K Neurofax apparatus, in the monopolar longitudinal montage in the system of 10/20 electrodes aimed at determining the peak frequency value of each exploratory site. The method of result analysis was based on connecting cerebral regions into networks of 3 or more members according to identical peak frequency value, which was observed within subgroups of theta and beta frequencies and analyzed through a proximity index and continuity and discontinuity of activation during the observed period. Out of the definite observation sample of 3 s from each subperiods (beginning, middle and end), a window of 2 s was moving from the beginning till end of the period with 200-ms time lag. This resulted in six subsamples for each electrode and for each experimental situation (resting state, situation of prayer). Stable and unstable activity of the regions was assessed within subgroups via cartographic formulas equivalent to the states which subgroups of theta and beta imply in psychophysiological sense. The results indicated that through participant's inner dialogue-monologue there are elements of both knowledge and belief, and that this phenomenon is possible considering insufficiently specific circumstances of the experiment and the participant herself, such as her relatively young age and insufficient practice of praying. The paper discusses the types of connections between regions which imply knowledge and those related to belief according to our understanding and regarding findings in literature.

Correlation between maternal anxiety, reactivity of fetal cerebral circulation to auditory stimulation, and birth outcome in normotensive and gestational hypertensive women.

This study investigated the correlation between maternal anxiety and blood flow changes through the fetal middle cerebral artery (MCA) after defined acoustic stimulation in 43 normotensive (C) and 40 gestational hypertensive (GH) subjects. Neonatal outcomes (gestational age at birth, Apgar score, birth weight) in the C and GH groups were analyzed. State (STAI-S) and trait (STAI-T) anxiety was assessed using Spielberger's questionnaire. The MCA blood flow was assessed once between 28 and 41 weeks of gestation using color Doppler ultrasound before and after application of defined acoustic stimulus. Relative size of the Pulsatility index (Pi) change (RePi) was calculated. The general hypotheses were: (1) women in GH group would have higher anxiety; (2) higher anxiety correlates with higher RePi change and poorer neonatal outcome; (3) fetuses from the GH group would have poorer neonatal outcome. Subjects from the GH group had higher STAI-T and RePi compared to the C group. A positive correlation between RePi and STAI-S, STAI-T, and systolic/diastolic blood pressure was found in both groups. There were more preterm deliveries in the GH group compared to the C group. A significant effect of STAI-T on body weight was observed in the C and GH group. There was a predictive effect of STAI-T and RePi on the C group, and STAI-S, STAI-T, diastolic blood pressure, and RePi on the GH group in terms of neonatal body weight. This study demonstrates an association between antenatal anxiety in GH women and increased fetal cerebral circulation in response to defined auditory stimulation.

Correlation between Balance Ability and Speech-Language Development in Children.

The longitudinal study was conducted in order to establish whether the success rate of reflexes related to maintaining balance at birth is in correlation with the success rate of maintaining balance in early childhood, as well as to examine the correlation of a certain level of speech and language development with the ability of maintaining balance at birth and at the age of 5. The main study group included 54 children of both genders, aged 5.0 to 5.4, whose balance ability and speech and language status were evaluated based on the battery of standardized tests, whereas the group of reflexes related to the function of the vestibular sense was clinically tested on the 3rd day upon birth, within the same sample of children. The data at birth and at the age of 5 were recorded by means of a digital camera, then scored and statistically and descriptively processed. The research results indicated a statistically significant correlation between the achieved level of balance ability in the newborns and five-year-olds, as well as between balance skills and a certain level of speech and language development in children at the age of 5. The importance of this research lies in new knowledge in the domain of maturation of vestubular function immediately after birth, given that this segment of physiology of a newborn has not so far been processed in such a way, as well as in the recognition of function of the vestibular sense as another parametre of a child's maturation.

Fetus sound stimulation: cilia memristor effect of signal transduction.

BACKGROUND: This experimental study evaluates fetal middle cerebral artery (MCA) circulation after the defined prenatal acoustical stimulation (PAS) and the role of cilia in hearing and memory and could explain signal transduction and memory according to cilia optical-acoustical properties. METHODS: PAS was performed twice on 119 no-risk term pregnancies. We analyzed fetal MCA circulation before, after first and second PAS. RESULTS: Analysis of the Pulsatility index basic (PIB) and before PAS and Pulsatility index reactive after the first PAS (PIR 1) shows high statistical difference, representing high influence on the brain circulation. Analysis of PIB and Pulsatility index reactive after the second PAS (PIR 2) shows no statistical difference. Cilia as nanoscale structure possess magnetic flux linkage that depends on the amount of charge that has passed between two-terminal variable resistors of cilia. Microtubule resistance, as a function of the current through and voltage across the structure, leads to appearance of cilia memory with the "memristor" property. CONCLUSION: Acoustical and optical cilia properties play crucial role in hearing and memory processes. We suggest that fetuses are getting used to sound, developing a kind of memory patterns, considering acoustical and electromagnetically waves and involving cilia and microtubules and try to explain signal transduction.

Change of pulsatility index of the fetal middle cerebral artery after auditory stimulation in no risk pregnancies and in pregnancies with gestational hypertension.

PURPOSE: An aim was to determine the degree and the mode of variation of PI of middle cerebral artery in no risk pregnancies and in pregnancies with gestational hypertension, after the constant sound stimuli. METHOD: Study included 343 patients divided in two groups. Group 1: low risk pregnancies and group 2: gestational hypertension. Ultrasound prenatal auditory screening was performed after the 27th week of gestation. RESULTS: The percentage of fetuses with increase of cerebral blood flow was slightly higher in the pregnancies with hypertension. CONCLUSION: An average change of PI of median cerebral artery was higher in this group.

Changes in Doppler blood flow velocity in middle cerebral artery in response to airborne sound in low- and high-risk human fetuses.

OBJECTIVE: To examine fetal auditory perception in low- and high-risk pregnancies in period from 27 to 31 weeks gestational age with the aim to establish diagnostic parameters in prenatal detection of the degree of hearing development in a fetus. METHODS: Method of prenatal hearing screening was applied on 80 women divided in two groups: Control group (C=22), consisted of pregnant women with low-risk pregnancies, and Experimental group (E=58), consisted of pregnant women with high-risk pregnancies (pregnancies with diagnosis of: preterm delivery, hypertension and/or intrauterine growth restriction (IUGR), diabetes). PHS was applied in period from 27 to 31 weeks gestational age. Brain circulation changes in fetal middle cerebral artery (MCA) caused by defined sound stimulus, as the indicator of fetal auditory reactions, were registered on Doppler ultrasound apparatus. After visualization of MCA, a sound stimulus was delivered. The stimulus consisted of one defined sound which is a digitally produced sound with the intensity of 90 dB, frequency range of 1500-4500 Hz, and duration of 0.2s (click) and it was presented only once. Measurements in observed artery were taken before (baseline) and after defined sound stimulation. RESULTS: Results showed that the absolute and relative difference in Pulsatility index (baseline and after sound stimulation) were greater for the high-risk group compared to the low-risk group (absolute difference: mean=0.36 vs mean=0.36) (relative difference: mean = ∼ 18% vs mean = ∼ 12%). When the low-risk group and the three high-risk group mean pairs were compared using multiple t-test, the diabetic group differed from the low-risk and two other high-risk groups; the low-risk and the two other high-risk groups did not differ from each other. Fetuses from pregnancies with diagnosis of diabetes demonstrated the most expressive reactibility and significantly higher absolute and relative changes of Pi values (absolute difference: mean=0.54, relative difference: mean=25.49%). CONCLUSION: The values of Pulsatility index (Pi) registered by PHS in low- and high-risk pregnancies may be used as differential and diagnostic parameters in fetal auditory perception examination. Fetuses from pregnancies with diagnosis of diabetes demonstrated significantly higher absolute and relative changes of Pi values compared to other groups of examined fetuses.

Comparison of mapping quantitative theta encephalograms during directed and required visual-verbal activity and passive period in children with different disorders of speech-language functioning.

Aim of the research was to examine similarities and differences between the periods of experiencing visually stimulated directed speech-language information and periods of undirected attention. The examined group comprised N = 64 children, aged 4-5, with different speech-language disorders (developmental dysphasia, hyperactive syndrome with attention disorder, children with borderline intellectual abilities, autistic complex). Theta EEG was registered in children in the period of watching and describing the picture ("task"), and in the period of undirected attention ("passive period"). The children were recorded in standard EEG conditions, at 19 points of EEG registration and in longitudinal bipolar montage. Results in the observed age-operative theta rhythm indicated significant similarities and differences in the prevalence of spatial engagement of certain regions between the two hemispheres at the input and output of processing, which opens the possibility for more detailed analysis of conscious control of speech-language processing and its disorders.