Prenatal Stress as a Risk Factor for Maternal-Foetal Morbidity: A Longitudinal Study.

Pregnancy is one of the most complex periods in a woman's life, not only because of the biological changes involved but also because of the psychological aspects. Stress during pregnancy refers to the concerns and distress that arise during pregnancy and that can be assessed by means of psychological and physiological scales. The aim of this study was to analyse prenatal stress and to evaluate its consequences on the health of both the mother and the foetus. A descriptive longitudinal study was carried out on a sample of 398 pregnant women being followed up during their entire pregnancy, who gave birth at the Punta de Europa University Hospital in Algeciras (Spain) between September 2021 and August 2023. The Prenatal Distress Questionnaire (PDQ) was used, as well as serum cortisol levels in each trimester of pregnancy and birth experience using the Childbirth Experience Questionnaire in its validated Spanish version, CEQ-E. Demographic and obstetric variables were included. One of the main findings was that experiencing more stress in late pregnancy had a negative impact on obstetric outcomes. Women who had higher levels of prenatal distress had higher blood cortisol levels and increased risk of having a caesarean section at delivery. A significant negative correlation was also found between stress and Apgar test values in the first minute of life. It is concluded that interventions promoted by the health system that provide comprehensive prenatal care contribute to decreased stress as perceived by these pregnant women, thus reducing the risk of maternal and foetal morbidity.

[End of the use of masks in public spaces during the COVID-19 pandemic: impact on the mental health of pregnant women]. / Fin del uso de la mascarilla en espacios públicos durante la pandemia por la COVID-19: impacto en la salud mental de las mujeres embarazadas.

OBJECTIVE: COVID-19 has affected the entire population, generating a greater impact on certain vulnerable groups, such as pregnant women. The aim of this study was to evaluate the levels of fear and anxiety regarding the COVID-19 disease in pregnant women, using the AMICO_Pregnant scale, in the final phase of the health crisis caused by the disease, marked by the relaxation of isolation measures in public spaces. METHODS: A descriptive cross-sectional study using the self-reported questionnaire AMICO_Pregnant was developed between March 24 and April 18, 2022. This was followed by a univariate and bivariate statistical analysis of the data collected. RESULTS: A total of 479 surveys of pregnant women of different gestational ages were obtained. The bivariate analysis showed statistical significance in the AMICO_Pregnant scale score about several variables over the previous year: contact with the disease (p=0.025); number of previous pregnancies (p=0.019); changes in the birth plan (p=0.001); and vaccination status (p=0.01). CONCLUSIONS: The COVID-19 pandemic has impacted pregnant women's mental health, producing a negative effect on emotions. The research carried out shows a statistically significant relationship between the levels of fear and anxiety in pregnant women and factors such as the number of previous pregnancies, contact with the previous disease, vaccination level or expectations regarding the delivery or birth plan.

OBJECTIVE: La COVID-19 ha afectado a toda la población, generando un mayor impacto en determinados grupos vulnerables, como es el caso de las mujeres gestantes. El objetivo de este estudio fue evaluar los niveles de miedo y ansiedad a la COVID-19 en la mujer gestante, mediante la escala AMICO_Gestante, en la fase final de la crisis sanitaria causada por dicha enfermedad, marcada por el relajamiento de las medidas de aislamiento en espacios públicos. METHODS: Se realizó un estudio transversal descriptivo mediante el uso de cuestionario autoinformado AMICO_Gestante, desarrollado entre el 24 de marzo y el 18 de abril de 2022. Tras ello, se ejecutó un análisis estadístico univariado y bivariado de los datos recogidos. RESULTS: Se obtuvieron un total de 479 encuestas de mujeres gestantes de diferente edad gestacional. El análisis bivariado mostró significación estadística en la puntuación de la escala AMICO_Gestante en relación con varias variables en relación al año anterior: contacto con la enfermedad (p=0,025); número de embarazos previos (p=0,019); cambios en el plan de parto (p=0,001); y estado vacunacional (p=0,01). CONCLUSIONS: La pandemia por la COVID-19 tiene un impacto en la salud mental de la mujer gestante, produciendo un efecto negativo en las emociones. La investigación realizada muestra una relación estadísticamente significativa entre los niveles de miedo y ansiedad en la mujer gestante y factores como el número de embarazos previos, el contacto con la enfermedad previa, el nivel de vacunación o las expectativas en relación al plan de parto o nacimiento.

Fin del uso de la mascarilla en espacios públicos durante la pandemia por la COVID-19: impacto en la salud mental de las mujeres embarazadas / End of the use of masks in public spaces during the COVID-19 pandemic: impact on the mental health of pregnant women

Background: COVID-19 has affected the entire population, generating a greater impact on certain vulnerable groups, such as pregnant women. The aim of this study was to evaluate the levels of fear and anxiety regarding the COVID-19 disease in pregnant women, using the AMICO_Pregnant scale, in the final phase of the health crisis caused by the disease, marked by the relaxation of isolation measures in public spaces. Methods: A descriptive cross-sectional study using the self-reported questionnaire AMICO_Pregnant was developed between March 24 and April 18, 2022. This was followed by a univariate and bivariate statistical analysis of the data collected. Results: A total of 479 surveys of pregnant women of different gestational ages were obtained. The bivariate analysis showed statistical significance in the AMICO_Pregnant scale score about several variables over the previous year: contact with the disease (p=0.025); number of previous pregnancies (p=0.019); changes in the birth plan (p=0.001); and vaccination status (p=0.01). Conclusions: The COVID-19 pandemic has impacted pregnant women’s mental health, producing a negative effect on emotions. The research carried out shows a statistically significant relationship between the levels of fear and anxiety in pregnant women and factors such as the number of previous pregnancies, contact with the previous disease, vaccination level or expectations regarding the delivery or birth plan.(AU)

Fundamentos: La COVID-19 ha afectado a toda la población, generando un mayor impacto en determinados grupos vulnerables, como es el caso de las mujeres gestantes. El objetivo de este estudio fue evaluar los niveles de miedo y ansiedad a la COVID-19 en la mujer gestante, mediante la escala AMICO_Gestante, en la fase final de la crisis sanitaria causada por dicha enfermedad, marcada porel relajamiento de las medidas de aislamiento en espacios públicos. Métodos: Se realizó un estudio transversal descriptivo mediante el uso de cuestionario autoinformadoAMICO_Gestante, desarrollado entre el 24 de marzo y el 18 de abril de 2022. Tras ello, se ejecutó un análisis estadístico univariado y bivariado de los datos recogidos. Resultados: Se obtuvieron un total de 479 encuestas de mujeres gestantes de diferente edad gestacional. El análisis bivariado mostró significación estadística en la puntuación de la escala AMICO_Gestante en relación con varias variables en relación al año anterior: contacto con la enfermedad (p=0,025); número de embarazos previos (p=0,019); cambios en el plan de parto (p=0,001); y estado vacunacional (p=0,01). Conclusiones: La pandemia por la COVID-19 tiene un impacto en la salud mental de la mujer gestante, produciendo un efecto negativo en las emociones. La investigación realizada muestra una relación estadísticamente significativa entre los niveles de miedo y ansiedad en la mujer gestante y factores como el número de embarazos previos, el contacto con la enfermedad previa, el nivel de vacunación o las expectativas en relación al plan de parto o nacimiento.(AU)

Assessment of Levels of Anxiety and Fear of Covid-19 in a Population of Pregnant Women in Spain.

Objective: The aim of the study was to assess the levels of fear and anxiety in the particularly vulnerable population group of women during pregnancy. Methods: Cross-sectional study between March 2022 and July 2022 involving 978 pregnant women aged 16 to 50 years. It was carried out based on the scale for the assessment of fear and anxiety in pregnant women (AMICO_Pregnant) and the collection of sociodemographic data. Normality analysis was performed prior to univariate and bivariate statistical analysis. Results: The sample was composed of a total of 978 pregnant women. The mean of the AMICO_Pregnant scale was intermediate (5.04 points; SD=2.36). The bivariate analysis showed a statistically significant relationship between the AMICO_Pregnant scale and the following variables: vaccination schedule status, contact with the disease, weeks of gestation, altered delivery or birth plan. Conclusion: Women with pregnancies closer to term, with no contact with the disease, without a complete vaccination schedule, or who had undergone changes in their delivery or birth plans, showed higher levels of fear and anxiety.

Adaptation and psychometric study of the scale for the measurement of fear and anxiety of COVID-19 disease in pregnant women (AMICO_Pregnant).

Objective: The aim of this research was to adapt and explore the psychometric properties of a specific scale to assess the levels of fear and anxiety of COVID-19 disease in pregnant women. Methods: An adaptation phase, by a panel of experts, and a psychometric descriptive cross-sectional study were carried out on the final version of the 16-item, self-administered AMICO_Pregnant scale. Univariate and bivariate analyses were carried out, followed by exploratory factor analysis (EFA) and confirmatory factor analysis (CFA). The consistency of the scale was assessed using the Omega coefficient and Cronbach's Alpha. Results: With a sample of 1,013 pregnant women living in Spain and over 18 years of age, the mean age was 33 years. The scale showed a bifactor structure (anxiety and fear) that was confirmed with good fit parameters. Reliability was assessed in terms of internal consistency by calculating Cronbach's Alpha coefficient (0.95) and McDonald's Omega coefficient (0.94) as indicators of robustness of the scale's reliability. Conclusion: The AMICO_Pregnant scale of 16 items with scores ranging from 1 to 10 is a valid and reliable tool to assess levels of anxiety and fear of COVID_19 in Spanish pregnant women. Pregnant women have shown moderate levels of anxiety and fear regarding the COVID_19 disease in the final phase of the pandemic.

Fear and Anxiety in Pregnant Women During the COVID-19 Pandemic: A Systematic Review.

Objectives: The aim of this study was to explore the impact of the 2020-2022 pandemic on the levels of fear and anxiety in pregnant women and to identify risk and protective factors. Methods: A systematic review was conducted. Electronic databases were consulted for studies published between January 2020 and August 2022. The methodological quality was assessed using a critical appraisal tool for non-randomised studies. Results: Seventeen studies were included in the review. A high prevalence of levels of fear and anxiety were observed. Risk factors such as unplanned pregnancy, poor support from partners, or intolerance of uncertainty were identified for high levels of fear. Regarding anxiety, risk factors such as maternal age, social support, financial status, or concern about being able to maintain antenatal follow-ups were identified. Conclusion: The COVID-19 pandemic had a significant impact on the mental health of pregnant women through increased levels of fear and anxiety. It has not been possible to establish a relationship between significant factors such as gestational age or health emergency control measures with high levels of fear or anxiety.

Antenatal Fear of Childbirth as a Risk Factor for a Bad Childbirth Experience.

Giving birth is one of the most impressive experiences in life. However, many pregnant women suffer from fear of childbirth (FOC) and experience labour in very different ways, depending on their personality, previous life experiences, pregnancy, and birth circumstances. The aim of this study was to analyse how fear of childbirth affects the childbirth experience and to assess the related consequences. For this, a descriptive cross-sectional study was carried out in a sample of 414 women between 1 July 2021 and 30 June 2022. The Birth Anticipation Scale (BAS) was used to measure fear of childbirth and the Childbirth Experience Questionnaire (CEQ-E) was applied to measure satisfaction with the childbirth experience. Fear of childbirth negatively and significantly predicted the childbirth experience. In addition, women who were more fearful of childbirth were found to have worse obstetric outcomes and a higher likelihood of having a caesarean delivery (p = 0.008 C. I 95%). Fear behaved as a risk factor for the birth experience, so the greater the fear, the higher the risk of having a worse birth experience (OR 1.1). Encouraging active listening and support strategies may increase pregnant women's confidence, thus decreasing their fear of the process and improving their childbirth experience.

Tecnologías de la información y la comunicación para el abordaje de los problemas de salud mental / Information and communication technologies for approach to the mental health problems

Las nuevas tecnologías junto con las Tecnologías de la Información y la Comunicación permiten el intercambio de información entre los usuarios y pueden aportar muchos beneficios a las personas que padecen problemas de salud mental, ya que internet permite acceder a información sobre la salud y brinda la posibilidad de recibir el apoyo de fuentes variadas. El objetivo de este manuscrito es evaluar el impacto de las nuevas tecnologías en la sociedad española, describir las ventajas y desventajas de su aplicación para la atención y el control de la salud mental como problemática de salud pública, además de identificar la tipología de las nuevas tecnologías y su utilidad en los principales trastornos de salud mental.En psicología clínica se han desarrollado algunos sistemas tecnológicos como la realidad virtual, la realidad aumentada y la telemedicina, con el objetivo de promocionar, monitorizar y mejorar el estado de salud de las personas, ayudando a su vez a los profesionales de la salud en el logro de esta compleja tarea. (AU)

New technologies together with Information and Communication Technologies allow the exchange of information between users and can bring many benefits to people suffering from mental health problems, as the internet allows access to health information and provides the possibility of receiving support from a variety of sources. The aim of this manuscript was to assess the impact of new technologies in the Spanish society, to describe the advantages and disadvantages of their application for the care and control of mental health as a public health problem, and to identify the typology of new technologies and their usefulness in the main mental health disorders.In clinical psychology, some technological systems have been developed, such as virtual reality, augmented reality, and telemedicine, with the aim of promoting, monitoring, and improving people’s state of health, in turn helping health professionals to achieve this complex task. (AU)

Influence of Pregnancy on Sexual Desire in Pregnant Women and Their Partners: Systematic Review.

Objectives: Pregnancy is a stage in which different physical and psychological changes take place that can affect the sexuality of the couple. The aim of the study is to identify how the physical and psychological changes derived from pregnancy affect the sexual desire of women and men. Methods: A systematic review of the literature was carried out in five databases, from which a total of 16,126 documents were obtained. After applying the PRISMA selection criteria, a total of 19 documents were selected. Results: Levels of sexual desire fluctuate during pregnancy, being the second trimester of gestation the period in which desire is at its highest and in which physical limitations and emotional changes decrease. Women have lower levels of sexual desire in the first trimester, while men have the lowest levels of desire in the third trimester. Conclusion: Pregnancy is a stage marked by physiological and psychological changes that modify several areas, including sexuality. Healthcare professionals should promote a healthy sexuality, avoiding the appearance of fears or sexual dysfunctions caused by the changes that occur during pregnancy.

Suicidal ideation and suicide attempts in healthcare professionals during the COVID-19 pandemic: A systematic review.

Background: COVID-19 has caused a series of economic, social, personal, and occupational consequences that may affect the mental health of healthcare workers (HCWs), with the consequent risk of developing suicidal ideation and behaviors. Objectives: The aim of this study was to identify the main risk factors that may predispose HCWs to suicidal ideation and suicide attempts during the COVID-19 pandemic. Methods: A systematic review of studies published between January 2020 and August 2022 was conducted following the PRISMA guidelines in the following electronic databases: Pubmed, Scopus, Web of Science, CINAHL, and PsycINFO. Methodological quality was assessed using the critical appraisal tools for non-randomized studies of the Joanna Briggs Institute (JBI). The followed protocol is listed in the International Prospective Register of Systematic Reviews (PROSPERO) with code CRD42022340732. Results: A total of 34 studies were included in this review. There are a number of underlying factors such as higher rates of depression, anxiety, pre-pandemic lifetime mental disorders or previous lifetime suicide attempt, living alone, having problems with alcohol and/or other drugs, etc. that favor the emergence of suicidal tendencies and ideation in times of COVID-19. Similarly, the pandemic may have precipitated a series of factors such as economic concerns, assessing one's working conditions as poor, having family members or friends infected, changes in services or functions, and feeling discriminated against or stigmatized by society. Other factors such as age, sex, or type of healthcare worker show differences between studies. Conclusion: Organizations should ensure the adoption of strategies and programmes for early detection of suicides as well as increased attention to the mental health of professions with a high workload. Systematic review registration: PROSPERO, identifier CRD42022340732.

Quality of Life and Anxiety Levels in Latin American Immigrants as Caregivers of Older Adults in Spain.

Increased life expectancy in Spain has highlighted the need for formal caregivers who care for older adults who live at home. In many cases, families choose to hire immigrants from Latin America who, on many occasions, have been forced to emigrate, which causes a considerable psychological impact on them. To this, other factors such as precarious working conditions, loneliness, or high workload are added, which leads to many caregivers becoming sick. The aim of this study was to assess the quality of life and the level of anxiety derived from the workload of Latin American immigrants who come to Spain to care for older adults. A descriptive cross-sectional study was carried out using two validated questionnaires to measure this relationship. A correlation was also established between quality of life and anxiety as expressed by the participants. The sample consisted of a total of 426 subjects. One of the main results showed that the lower the caregiver's quality of life, the higher their level of anxiety (OR = 1.06; 95% CI). Live-in caregivers had a lower quality of life than people who did not live in the same house as the cared-for person (OR = 2.22; 95% CI). Working long hours and having a high workload was associated with poorer quality of life and higher levels of anxiety. Assessing immigrants who are formal caregivers and providing them with the support that helps to improve their quality of life is suggested to reduce the occurrence of anxiety disorders.

Body Image Dissatisfaction as a Risk Factor for Postpartum Depression.

Background and Objectives: Pregnancy and postpartum are periods that imply numerous physical and psychological changes that could lead to mental health consequences. The aim of the present study is to identify whether women who had body image dissatisfaction had a higher incidence of postpartum depression 6 months after birth than women who did not have body image dissatisfaction. Materials and Methods: A descriptive cross-sectional study was designed with a sample of 450 women from two hospitals in Andalusia. Quantitative variables were age and scores on the Edinburgh Postnatal Depression Scale (EPDS) and the Body Shape Questionnaire (BSQ) for body image dissatisfaction. The qualitative variables used were marital status, self-perceived health status, diet or physical exercise, type of delivery, and others. Results: Body dissatisfaction was positively correlated with the symptomatology of postpartum depression. Thus, for each point increased in body dissatisfaction, the occurrence of depression also increased. There was a relationship between the study variables, so women who were more dissatisfied with their body image were more frequently depressed. Conclusions: In conclusion, it can be established that postpartum depression seems to be related to the presence of poor body image.

Satisfaction with the Care Received and the Childbirth and Puerperium Experience in Christian and Muslim Pregnant Women.

Over the last three decades, there has been an increase in the population as a result of the migratory flow due to the arrival of migrants to Spain, including young women of childbearing age and with reproductive capacity. This phenomenon has made childbirth assistance an extremely important priority in recent years. The aim of this study was to assess the satisfaction and experience during childbirth and the postpartum period in pregnant women according to their religion after assistance in a tertiary hospital. A descriptive cross-sectional study was conducted on a sample of 242 women using the validated Spanish version of the Mackey Childbirth Satisfaction Rating Scale (MCSRS) to measure satisfaction with the childbirth experience during the months of January to April 2021. Statistically significant differences were found in the domains of birth satisfaction (p < 0.01), satisfaction with the obstetrician (p < 0.01), and perception of pain during labour (p < 0.01). The Christian group of women scored higher in these three domains as compared to the Muslim group. The rate of breastfeeding at birth was 5.26 times higher among the Muslim group compared to the Christian group (p = 0.02). The experience of childbirth and the puerperium significantly influenced the levels of satisfaction of pregnant women with the process of childbirth in a different way according to the religious culture of the patient.

Cuidados en el puerperio durante la crisis sanitaria por COVID-19 / Care in puerperium during health crisis due to COVID-19

Introducción: la infección por el nuevo coronavirus COVID-19, es actualmente una emergencia de salud pública internacional y ha sido declarada pandemia por la OMS. Aún se desconocen ciertos datos sobre su etiopatogenia, surgiendo la necesidad de analizar la influencia de la enfermedad por coronavirus durante la etapa puerperal y sus consecuencias. Objetivo: sintetizar el conocimiento y las últimas recomendaciones disponibles acerca de los cuidados específicos durante el periodo del puerperio, en relación con la crisis sanitaria por COVID-19. Metodología: se llevó a cabo una búsqueda sistemática en la literatura científica para localizar los documentos de evidencia científica disponibles en las principales bases de datos referenciales: Pubmed, Biblioteca Cochrane y Science Direct. Resultados: la lactancia materna aporta numerosos beneficios al recién nacido, entre ellos, la protección frente a infecciones respiratorias como el coronavirus. Si el estado materno y neonatal lo permite, se recomienda promover la lactancia materna durante el periodo de riesgo infeccioso. La SEGO y la SETH recomiendan la administración de heparina de bajo peso molecular a dosis profilácticas para evitar la enfermedad tromboembólica. La evidencia actual indica que el riesgo de transmisión a través de la lactancia materna al recién nacido es muy poco probable. Discusión/conclusiones: la limitación principal fue la escasez de literatura científica sobre el COVID-19 en relación con el periodo puerperal. Es fundamental que cualquier puérpera con una infección por COVID-19 y su recién nacido sean valorados de manera individualizada, precozmente y evaluada por un equipo multidisciplinar para prevenir resultados adversos..Au

Introduction: the new coronavirus COVID-19 infection is currently an international public health emergency and it has been declared a pandemic by the WHO. Certain data about its etiopathogenesis is still unknown, arising the need to analyse the influence of coronavirus disease during the puerperal stage and its consequences. Objective: to synthesize the knowledge and the latest available recommendations about specific care during puerperium period, related to the health crisis due to COVID-19. Methodology: a systematic search was carried out in the scientific literature in order to locate the scientific evidence documents available in the main reference databases: PubMed, Cochrane Library and Science Direct. Results: breastfeeding brings many benefits to newborns, including protection against respiratory infections, such as coronavirus. If maternal and neonatal status allows it, it is recommended promoting breastfeeding during the infectious risk period. Both SEGO and SETH recommend the administration of low molecular weight heparin at prophylactic doses in order to avoid thromboembolic disease. Discussion/conclusions: the main limitation was the paucity of scientific literature about COVID-19 in relation to puerperal period. It is essential that any puerperal woman with COVID-19 infection and her newborn are assessed individually, early and evaluated by a multidisciplinary team to prevent adverse outcomes..Au

[Pregnancy care during COVID-19 epidemic, a drive for change?] / Atención del embarazo durante la epidemia de COVID-19, ¿un impulso para el cambio?

Prenatal care, understood as routine care provided during pregnancy, should be based on basic pillars, such as taking into account the sociocultural context in which such care is offered, ensuring that the service is appropriate, accessible and of high quality, and also with care personalized. According to World Health Organization, the minimum number of recommended visits during pregnancy should be eight, with the different professionals involved in the process, in addition to preparing for childbirth or maternal education. Since the pandemic erupted due to SARS-CoV-2, many of the usual social health services have had to adapt to provide safety and prevent infection, a priority in vulnerable groups where pregnant women are found. Professionals have had to adapt to telematics care, thus attending consultations to reduce the mobility of pregnant women to health centers, thus avoiding unnecessary risks. Therefore, all this situation has opened a virtual field of work that, although previously carried out in different areas, now more than ever acquires special relevance and for which professional training is necessary, as a complement to face-to-face appointments.

La atención prenatal, entendida como cuidados habituales brindados durante la gestación, debe estar basada en pilares básicos tales como tener en cuenta el contexto sociocultural en el que se ofrece dicha atención, garantizar que el servicio sea apropiado, accesible, y de alta calidad, y además permitir una atención personalizada. Según la Organización Mundial de la Salud el número mínimo de visitas recomendables durante el embarazo debe ser ocho, con los distintos profesionales implicados en el proceso, además de la preparación al nacimiento o educación maternal. Desde que estalló la pandemia provocada por el SARS-CoV-2, muchos de los servicios habituales sociosanitarios han tenido que adaptarse para proporcionar seguridad y evitar el contagio, algo prioritario en los grupos vulnerables en los que encontramos a las embarazadas. Los profesionales han tenido que acomodarse a una atención telemática, aunando consultas para una menor movilidad de la gestante a los centros sanitarios evitando así riesgos innecesarios. Por lo que toda esta situación ha abierto un campo de trabajo virtual que, si bien antes era llevado a cabo en diferentes ámbitos, ahora más que nunca cobra especial relevancia y requiere una formación profesional para que pueda llegar erigirse como complemento a las citas presenciales.

[Outpatient breech birth attendance.] / Atención al parto en presentación podálica en el medio extrahospitalario.

Nowadays, care for a breech delivery in the out-of-hospital environment through the vaginal route can be a frequent process caused by the change in the scientific literature favoring the free evolution of the delivery of a breech presentation compared to the previous literature where the Caesarean section scheduled at week 37 of gestation, avoiding its free evolution. Furthermore, among the statistical data consulted at the INE (Instituto Nacional de Estadística), there is an increase in preterm deliveries outside the hospital, which increases the presentation of buttocks more frequently, between 25-32 weeks, around 42%. Therefore, the objective of this manuscript was to instruct the health professionals of the out-of-hospital emergency services in the event of imminent delivery in breech presentation. This type of training would consist of maintaining an expectant attitude during the expulsion period until the lower angle of the newborn's scapula is visible, followed by manual assistance by detaching the shoulders while gently and slowly removing the fetal head.

Hoy en día la atención a un parto de nalgas en el medio extrahospitalario por vía vaginal puede ser un proceso frecuente ocasionado por el cambio en la literatura científica, que favorece la libre evolución del parto de una presentación podálica frente a la literatura anterior donde se llevaba a cabo la cesárea programada en la semana 37 de gestación, evitando la libre evolución del mismo. Además, entre los datos estadísticos consultados en el INE (Instituto Nacional de Estadística) existe un incremento de partos prematuros fuera del hospital que aumenta que la presentación de nalgas sea más frecuente, entre las 25-32 semanas entorno a un 42%. Por lo tanto, el objetivo de este manuscrito fue instruir a los profesionales sanitarios de los servicios de urgencias extrahospitalaria ante una situación de parto inminente en presentación podálica. Este tipo de formación consistiría en mantener una actitud expectante durante el periodo expulsivo hasta que el ángulo inferior de la escápula del recién nacido sea visible, seguido de la ayuda manual desprendiendo los hombros mientras se extrae con suavidad y lentitud la cabeza fetal.

[Coronavirus Covid-19 infection and breastfeeding: an exploratory review]. / Infección por coronavirus Covid-19 y lactancia materna: una revisión exploratoria.

BACKGROUND: The new coronavirus disease is an infectious disease caused by the SARS-Cov-2 virus, considered by the World Health Organization (WHO) an international public health emergency that may have negative consequences during breastfeeding. The objective of this work is to investigate the action plan on breastfeeding in postpartum women with SARS-CoV-2 and her newborn. METHODS: A literature search has been conducted through the Medline, Web of Science, Scopus, BVS, and Cuiden databases. The methodological quality of the articles has been assessed using the "Grading of Recommendations Assessment, Development and Evaluation" (GRADE). This study has not been registered in PROSPERO. RESULTS: A total of 14 documents have been found, of which 9 are observational empirical studies. Most of the studies were conducted in China, Italy, the USA, and Australia. A total of 114 mothers infected with coronavirus with their respective newborns have been assessed. The analyzed investigations state that it is best for the newborn to be breastfed; given that mother's milk samples were analyzed, detecting the presence of antibodies of the coronavirus in them, being a protective factor against infection. CONCLUSIONS: Breastfeeding in postpartum women with SARS-CoV-2 is highly recommended for the newborn, if the health of the mother and newborn allow it. When direct breastfeeding is favoured, the appropriate respiratory hygiene measures always have to be considered. Whether the mother's health does not permit direct breastfeeding, her breast milk should be previously extracted and kept unpasteurized. To secure the newborn feeding, milk banks are also an appropriate option.

OBJETIVO: El nuevo coronavirus es una enfermedad infecciosa causada por el virus SARS-Cov-2, considerada por la Organización Mundial de la Salud (OMS) una emergencia de salud pública de interés internacional (ESPII), la cual podría tener consecuencias negativas durante la lactancia materna. El objetivo de este trabajo fue conocer el plan de actuación sobre la lactancia materna ante una mujer recién parida enferma de SARS-CoV-2 y su recién nacido. METODOS: Se realizó una búsqueda de la literatura a través de las bases de datos Medline, Web of Science, Scopus, BVS y Cuiden. Se evaluó la calidad metodológica de los artículos mediante la herramienta "Grading of Recommendations Assessment, Development and Evaluation" (GRADE). No se registró en PROSPERO. RESULTADOS: En total se encontraron 14 documentos, de los cuales 9 estudios empíricos estaban realizados mayormente en China, Italia, EEUU y Australia, estando basados en 114 madres infectadas de coronavirus SARS-CoV-2 y sus respectivos recién nacidos. Los estudios analizados afirmaron que lo mejor para el recién nacido es ser alimentado con la leche materna, ya que se analizaron muestras de leche de madres infectadas por coronavirus detectándose la presencia de anticuerpos del virus en las mismas, siendo un factor protector contra la infección del virus. CONCLUSIONES: La lactancia materna en recién paridas con SARS-CoV-2 es muy recomendable para el recién nacido, si el estado de salud de la madre y del neonato lo permiten, favoreciéndose el amamantamiento de forma directa y teniendo siempre las medidas adecuadas de higiene respiratoria. En el caso de que el estado de salud de la madre no permita el amamantamiento directo se debería alimentar con leche materna extraída previamente de su madre y sin pasteurizar, o procedente de un banco de leche.

Changes in Sexual Desire in Women and Their Partners during Pregnancy.

When studying sexual desire during pregnancy, most research focuses on the pregnant woman's sexual desire and almost never takes into account her sexual partner. The novelty of this study is that sexual desire during pregnancy is studied from the point of view of the pregnant woman and from that of her male partner. The goal of this study is to see how sexual desire behaves during pregnancy in both partners. For this, a descriptive, longitudinal, and multistage study was designed. Methodologically, in the first stage, the different study variables were described through a single-variate analysis. In the second stage, one variable was related to others by means of a bivariate analysis. Finally, in the third stage, a multivariate analysis was done, composed of binary logistic regression models and latent growth curves. The results confirm that pregnancy influences the sexual desire of both partners, and that sexual desire behaves differently in women than in men during pregnancy. Men have higher levels of sexual desire throughout pregnancy as compared to women. The first trimester of pregnancy is the period when women have less sexual desire.

Atención al parto en presentación podálica en el medio extrahospitalario / Outpatient breech birth attendance

Hoy en día la atención a un parto de nalgas en el medio extrahospitalario por vía vaginal puede ser un proceso frecuente ocasionado por el cambio en la literatura científica, que favorece la libre evolución del parto de una presentación podálica frente a la literatura anterior donde se llevaba a cabo la cesárea programada en la semana 37 de gestación, evitando la libre evolución del mismo. Además, entre los datos estadísticos consultados en el INE (Instituto Nacional de Estadística) existe un incremento de partos prematuros fuera del hospital que aumenta que la presentación de nalgas sea más frecuente, entre las 25-32 semanas entorno a un 42%. Por lo tanto, el objetivo de este manuscrito fue instruir a los profesionales sanitarios de los servicios de urgencias extrahospitalaria ante una situación de parto inminente en presentación podálica. Este tipo de formación consistiría en mantener una actitud expectante durante el periodo expulsivo hasta que el ángulo inferior de la escápula del recién nacido sea visible, seguido de la ayuda manual desprendiendo los hombros mientras se extrae con suavidad y lentitud la cabeza fetal

Nowadays, care for a breech delivery in the out-of-hospital environment through the vaginal route can be a frequent process caused by the change in the scientific literature favoring the free evolution of the delivery of a breech presentation compared to the previous literature where the Caesarean section scheduled at week 37 of gestation, avoiding its free evolution. Furthermore, among the statistical data consulted at the INE (Instituto Nacional de Estadística), there is an increase in preterm deliveries outside the hospital, which increases the presentation of buttocks more frequently, between 25-32 weeks, around 42%. Therefore, the objective of this manuscript was to instruct the health professionals of the out-of-hospital emergency services in the event of imminent delivery in breech presentation. This type of training would consist of maintaining an expectant attitude during the expulsion period until the lower angle of the newborn's scapula is visible, followed by manual assistance by detaching the shoulders while gently and slowly removing the fetal head