Effects of mindfulness-based interventions (MBIs) on depression in pregnant women: A systematic review and meta-analysis.

OBJECTIVE: We synthesized the effects of mindfulness-based interventions (MBIs) on depression in pregnant women. METHOD: Ten electronic databases were searched from inception to September 2022. We reviewed studies on outcomes for pregnant women with depression receiving mindfulness-based interventions. We only reviewed studies written in English. A random-effects model was used to compute the effect size. Funnel plot, Q statistics, and I2 were used to test the heterogeneity across studies. We examined moderators to explore sources of heterogeneity. RESULTS: Across 19 included studies (N = 1480), 717 pregnant women participated in mindfulness interventions; 763 served as controls. Mean age ranged from 25.3 to 33.6 years. Overall, mindfulness-based interventions showed reduced depression compared to control groups (g = 0.457, 95%CI 0.254, 0.659, I2 = 68 %). With subgroup analysis, mindfulness-based cognitive therapy had a greater effect on reducing depressive symptoms (g = 1.13) than mindfulness-based stress reduction (g = 0.64) and adapted mindfulness-based interventions (g = 0.31). No quality indicators moderated the ES of mindfulness-based interventions on depression. CONCLUSION: Mindfulness-based interventions significantly improved depression among pregnant women, especially mindfulness-based cognitive therapy (MBCT). Clinicians and health providers should consider using MBIs as alternative complementary treatment for improving and preventing depression in pregnant women.

The perception of childbearing sense of coherence among Chinese couples: a qualitative study.

BACKGROUND: Although childbearing health care is wellness-based and promotes normal physiology, it is in a medical model and focuses on risk aversion and disease prevention. The salutogenic theory might provide an alternative perspective to health care concerning childbearing, supporting health-promoting factors, not solely on avoiding adverse events. However, there is a dearth of qualitative research exploring couples' perceptions of childbearing from the salutogenic lens. This study aimed to explore perceptions and experiences concerning childbearing among couples in the perinatal period and identify salutogenic aspects of it. METHODS: The qualitative descriptive study adopted a directed content analysis to analyse data from a semi-structured and individual interview with 25 purposively selected Chinese couples between July 2022 and December 2022. The concepts of the sense of coherence (SOC) from the salutogenic theory were used as the theory framework for coding. RESULTS: Definitions and content for the salutogenic aspects of Chinese couples' perception of childbearing sense of coherence were developed. For comprehensibility of childbearing, four subthemes were extracted (the challenge to health and endurance; transition to and identification with the new role; conflict and reconciliation in relationships; resistance and compromise between social culture and personal development). For manageability of childbearing, two subthemes were extracted (helplessness and hope of childbearing; self-doubt and self-assurance of childbearing). For meaningfulness of childbearing, three subthemes were extracted (personal realisation; family bonding and harmony; the continuation of life). CONCLUSIONS: The findings of this study could give a greater understanding in maintaining couples' health in the perinatal period from the salutogenic lens and provide a guide to further research that the salutogenic theory could bring a health and wellness-focused agenda in practice and policy-making in the perinatal period.

Maternidade distante do país de origem: "aqui a gente não tem uma aldeia" / Maternity far from the country of origin: "here we do not have a village" / Maternidad lejos del país de origen: "aquí no tenemos pueblo"

O presente estudo é um recorte de uma pesquisa mais ampla sobre a experiência da maternidade de mulheres brasileiras migrantes. Ele tem como objetivo investigar o apoio recebido por elas no processo de tornar-se mãe. Trata-se de uma pesquisa qualitativa na qual foram realizadas, em 2022, sete entrevistas com mulheres brasileiras que vivenciaram gestação, parto e primeiro ano de vida do filho (a) em Portugal, Reino Unido, Itália, Espanha e França. Os resultados apontam para a relevância da presença de pessoas que compartilham da mesma cultura de origem na construção da maternidade e na rede de apoio durante a perinatalidade. Conclui-se que o distanciamento da rede familiar, de amigos e de referenciais da cultura de origem da mulher migrante gerou o aumento das sobrecargas psíquica e física inerentes à maternidade. Ao mesmo tempo, de acordo com as participantes, o distanciamento da família e da cultura de origem proporcionou maior liberdade e abertura para a construção da maternidade, provendo novas representações culturais que contribuíram para a construção de sua forma de ser mãe.(AU)

This study is a segment of a broader research project on the maternity experience of Brazilian migrant women. It aims to investigate the support received by these women in the process of becoming mothers. It encompasses a qualitative research study involving seven interviews conducted in 2022 with Brazilian women who experienced pregnancy, childbirth, and the first year of their child's life in Portugal, the United Kingdom, Italy, Spain, and France. The findings highlight the importance of having individuals sharing the same cultural background in the construction of motherhood and in the support network during the perinatal period. The distance from the family network, friends, and references of the migrant woman's culture of origin generated an increase in the psychic and physical burdens inherent to motherhood. Simultaneously, according to the participants, distancing from family and their cultural origins provided greater freedom and openness in constructing motherhood, offering new cultural representations that contributed to shaping their way of being mothers. (AU)

El presente estudio es parte de una investigación más amplia acerca de la experiencia de la maternidad de las mujeres migrantes brasileñas. Tiene como objetivo investigar el soporte recibido por ellas en el proceso de convertirse en madre. Se trata de una investigación cualitativa en la que, en 2022, se realizaron siete entrevistas con mujeres brasileñas que vivieron el embarazo, el parto y el primer año de vida de su hijo en Portugal, Reino Unido, Italia, España y Francia. Los resultados apuntan para la relevancia de la presencia de personas que comparten la misma cultura de origen en la construcción de la maternidad y en la red de apoyo durante la perinatalidad. Se concluye que el alejamiento de la red familiar, amigos y puntos de referencia de su cultura de origen de la mujer migrante ha generado un aumento de las sobrecargas psíquicas y físicas inherentes a la maternidad. Al mismo tiempo, según las participantes, el alejamiento de la familia y de la cultura de origen les ha proporcionado una mayor libertad y apertura para la construcción de la maternidad, brindando nuevas representaciones culturales que contribuyeron para la construcción de su forma de ser madre. (AU)

High care and low overprotection from both paternal and maternal parents predict a secure attachment style with a partner among perinatal Japanese women.

This study aimed to determine how paternal and maternal parenting before adolescence affects adult attachment to a partner during the perinatal period, using three different models of attachment. We used the Parental Bonding Instrument (PBI) and the Relationship Questionnaire (RQ) to examine perceived parenting practices and adult attachment styles, respectively. The participants included 4586 Japanese women who were pregnant or who had given birth, up until one month after childbirth. We performed structural equation modeling analysis between PBI and RQ scores with three different category models, including the four-category model (secure, fearful, preoccupied, and dismissive attachment) as Model 1, the two-category model (model of the self and others) as Model 2, and the single-category model (total attachment style) as Model 3. Models 1 and 2 showed a good fit. Both path models showed a significant association between adult attachment style and perceived paternal and maternal parenting before adolescence, where high care and low overprotection from both paternal and maternal parents predicted adult attachment. Our findings indicate that attachment styles are best described using the four-category and two-category models, and suggest that both paternal and maternal overprotection and care influence adult attachment with a partner during the perinatal period.

Validity of the Maternal Antenatal Attachment Scale-Spanish Version for Mexican Pregnant Women / Validez de la Escala de Apego Prenatal Materno: versión en español para mujeres mexicanas embarazadas

During pregnancy, parents experiment emotions, thoughts, and behaviors related to their unborn child as precursors of attachment in the caretaker-infant dyad. The Maternal Antenatal Attachment Scale (MAAS) is an instrument that has shown adequate psychometric properties to evaluate this construct in developed countries. The aim of this study was to assess the reliability and concurrent validity of the Maternal Antenatal Attachment Scale-Spanish version for Mexican women (MAAS-Spanish version). A sample of 142 women in their third trimester of pregnancy who received care in a tertiary hospital was selected. The full scale of the MAAS-Spanish version obtained a Cronbach alpha of .79. A significant negative correlation was found between the global MAAS-Spanish version score (r = -.23, p ≤ .01) and the Postpartum Depression Predictors Inventory-Revised and depressive symptoms (r = -.36 , p ≤ .01). The translated and adapted scale has adequate internal consistency and concurrent validity to measure this construct in this population. ()AU)

Durante el embarazo, los padres experimentan emociones, pensamientos e ideas sobre su nonato relevantes en el estudio de precursores del apego en la díada cuidador-infante. La Escala de Apego Prenatal Materno (MAAS) es un instrumento que ha mostrado adecuadas propiedades psicométricas para evaluar este constructo en países desarrollados. El propósito de este estudio fue evaluar la confiabilidad y validez concurrente de dicha escala—versión en español para mujeres mexicanas (MAAS—versión en español). Se seleccionó a una muestra de 142 mujeres en tercer trimestre gestacional, que recibían atención en un hospital de tercer nivel. La escala total obtuvo un alfa de Cronbach de .79. Se evidenció una correlación negativa significativa de la puntuación global de la MAAS de r = -.23, (p ≤ .01) con la PDPI-R y de r = -.36, (p ≤ .01) con la sintomatología depresiva (EPDS). La escala traducida cuenta con una consistencia interna y validez concurrente adecuadas para medir este constructo en esta población. (AU)

Differences in Psychological Symptoms in Pregnancy and Postpartum before and during COVID-19: A Cross-sectional Study / Las diferencias en los síntomas psicológicos durante el embarazo y el postparto antes y después del COVID-19: un estudio transversal

Rationale: Pregnant women are especially vulnerable to mental health problems, including stress, anxiety, and depression. This risk has been increased during the COVID-19 pandemic and differences in psychological symptoms in pregnancy and postpartum before and during COVID-19 exists. Mental health problems can have adverse effects on both the woman, and the neonate, including miscarriages, premature births, low birth weight, and higher rates of cesarean sections and instrument-assisted deliveries. Aim: To evaluate the prevalence of psychological symptoms of pregnant women before and during the COVID-19 pandemic. Method: A cross-sectional study was carried out to assess the psychological profile in a sample of pregnant women selected before the pandemic and a sample of women studied during the first wave of the pandemic. A total of 122 women were selected prior to the pandemic and 181 women during the COVID-19 outbreak. The Symptom Checklist-90 Revised (SCL-90-R) was used to assess depression and anxiety during pregnancy and in the postpartum period. Results: The prevalence of symptoms of depression and anxiety during pregnancy were higher in the sample of women studied during the pandemic (SCL-90-R: M = 54.6 vs. 42.6 and M = 62.6 vs. 51.7 respectively). In the postpartum the difference between both samples of women was even higher for depression and anxiety (SCL-90-R: M = 50.4 vs. 35.0 and M = 51.3 vs. 36.0 respectively). Being a pregnant woman at the COVID-19 outbreak was directly associated with a higher score of depression symptoms (aOR = 8.67, 95% CI [3.26, 23.02], p < .001). Anxiety during childbirth was more frequently reported by women before the pandemic (aOR = 5.13, 95% CI [2.53, 10.44], p < .001). The variable stage (before /during pandemic) was also associated with having a clinical SCL-90-R score above 70 (aOR = 7.61, 95% CI [2.7, 21.47], p < .001). (AU)

Justificación: Las mujeres embarazadas son especialmente vulnerables a los problemas de salud mental, como el estrés, la ansiedad y la depresión. Este riesgo se ha incrementado durante la pandemia de COVID-19, habiendo diferencias en los síntomas psicológicos en el embarazo y el puerperio antes y después de la pandemia. Los problemas de salud mental pueden tener efectos perjudiciales tanto en la mujer como en el recién nacido, como abortos espontáneos, partos prematuros, bajo peso al nacer y tasas más altas de cesáreas y partos asistidos. Objetivo: Evaluar la prevalencia de síntomas psicológicos de gestantes antes y durante la pandemia de COVID-19. Método: Se realizó un estudio transversal para evaluar el perfil psicológico en una muestra de mujeres embarazadas seleccionadas antes de la pandemia y una muestra de mujeres estudiadas durante la primera ola de la pandemia. Se seleccionó un total de 122 mujeres antes de la pandemia y 181 mujeres durante el brote de COVID-19. Se utilizó la Inventario de Verificación de Síntomas-90 Revisada (SCL-90-R) para evaluar la depresión y la ansiedad durante el embarazo y el puerperio. Resultados: La prevalencia de síntomas de depresión y ansiedad durante el embarazo fue mayor en la muestra de mujeres estudiadas durante la pandemia (SCL-90-R: M = 54.6 vs. 42.6 y M = 62.6 vs. 51.7 respectivamente). En el postparto la diferencia entre ambas muestras de mujeres fue aún mayor para depresión y ansiedad (SCL-90-R: M = 50.4 vs. 35.0 y M = 51.3 vs. 36.0 respectivamente). Ser mujer embarazada en el brote de COVID-19 se asoció directamente con una mayor puntuación de síntomas de depresión (aOR = 8.67, IC 95% [3.26, 23.02, p < .001). Las mujeres manifestaron ansiedad durante el parto con mayor frecuencia antes de la pandemia (aOR = 5.13, IC 95% 2.53, 10.44], p < .001). La variable estadio (antes/durante la pandemia) también se asoció con tener una puntuación clínica SCL-90-R superior a 70 (aOR = 7.61, IC 95% [2.7, 21.47], p < .001). (AU)

ForWhen Australian perinatal and infant mental health navigation programme: evaluation protocol.

INTRODUCTION: Many parents and carers experience mental health challenges during pregnancy and early postpartum years, and there are cumulative shortfalls in the identification, follow-up, and treatment of those experiencing perinatal and infant mental health (PIMH) challenges. ForWhen is a new national navigation programme in Australia that aims to improve outcomes for families by supporting parents and carers to access PIMH services that best meet their needs. This paper presents the protocol of an evaluation of the ForWhen programme, to be conducted over the first 3 years of its implementation. The specific objectives of the evaluation include examining the characteristics of navigation service delivery, its implementation and clinical impact, and identifying potential moderators of change. METHODS AND ANALYSIS: Utilising a mixed-methods design, this evaluation will incorporate three phases that reflect the stages of the programme life-cycle: (1) programme description, (2) implementation evaluation and (3) outcomes evaluation. The evaluation will use a mix of quantitative and qualitative data including deidentified routinely collected service data, participant observations, semistructured interviews, surveys and questionnaires, and a resource audit. DISCUSSION: Evaluation findings will be used to inform the development of a refined clinical navigation model, identify barriers and facilitators to successful navigation programme implementation, examine the impact of the ForWhen programme on client clinical outcomes and health service utilisation, understand how the programme is/can be best embedded in the evolving service system, and assess the cost-effectiveness and sustainability of a national navigation programme in improving health outcomes for PIMH in Australia. ETHICS AND DISSEMINATION: This research was approved by South Western Sydney Local Health District Human Research Ethics Committee (2021/ETH11611). This study was registered on the Australian New Zealand Clinical Trials Registry (ACTRN12622001443785). Results will be disseminated at conferences, in scientific journals, and in a final evaluation report.

Una psicoterapia centrada en la parentalidad para tratar la psicopatología perinatal, sostener el vínculo madre-bebé y prevenir los trastornos en el niño / A psychotherapy focused on parenting to treat perinatal psychopathology, to support the mother-baby bond and to prevent disorders in the child

El embarazo y el año que sigue al parto son los períodos de la vida más propiciospara la emergencia de trastornos psicológicos en la mujer. Las consecuencias pueden convertirse en dramáticas paraella, para el vínculo con su hijo y para el desarrollo somático, social y psíquico de este último. Este artículo muestrapor qué es importante cuidar la dimensión psíquica de la parentalidad para un tratamiento eficaz de estos trastornos,a fin de que los efectos terapéuticos beneficien a la vez a la mujer, al vínculo madre-bebé y al niño. Se propone unmodelo de psicoterapia breve centrada en la parentalidad que permite intervenir desde el embarazo y luego incluir elniño en el posparto.(AU)

The pregnancy and first year following childbirth are the most conduciveperiods of life for the emergence of psychological disorders in women. The consequences can be dramatic forthem, for the bond with their child and for the child’s somatic, social and psychological development. This articleshows why it is important to take care of the psychic dimension of parenthood for an effective treatment ofthese disorders, so that the therapeutic effects benefit at the same time the woman, the mother-baby bondand the child. A model of brief psychotherapy focused on parentality is proposed, which allows to intervenefrom pregnancy and then to include the child in the postpartum period.(AU)

L’embaràs i l’any que segueix al part són els períodes de la vida més propicisper a l’emergència de trastorns psicològics en la dona. Les conseqüències poden esdevenir dramàtiques per aella, per al vincle amb el seu fill i per al desenvolupament somàtic, social i psíquic d’aquest. Aquest article mostraper què és important tenir cura de la dimensió psíquica de la parentalitat per a un tractament eficaç d’aqueststrastorns, per tal que els efectes terapèutics beneficiïn al mateix temps la dona, el vincle mare-nadó i el nen. Esproposa un model de psicoteràpia breu centrada en la parentalitat que permet intervenir des de l’embaràs idesprés incloure el nen al postpart.(AU)

El abordaje perinatal interdisciplinar desde Atención Primaria de Salud (APS): el desarrollo de una atención bio-psico-social integrada / The interdisciplinary perinatal approach from Primary Health Care (PHC): the development of an integrated bio-psycho-social care

El Equipo de Atención Primaria (EAP) Roquetes-Canteres de Barcelona se plantea, en el marcode investigación impulsada por Bruc Salut (equipo psicoterapéutico), una intervención bio-psico-social integrada. Eneste artículo se describe la investigación desde su inicio y los diferentes programas que se están llevando a cabo desde2014 con un recorrido por todos los programas desarrollados. Se explica detenidamente cómo se han creado, llevadoa cabo, evaluado y su funcionamiento actual, gracias al trabajo coordinado del equipo interdisciplinar para atenderlos aspectos emocionales de la parentalidad, el establecimiento del vínculo y el buen desarrollo del bebé, así como lasensibilización y contención de los profesionales del equipo. Finalmente, se define la figura del profesional sanitariode enlace del EAP, que se ha creado para coordinar y guiar el equipo y fomentar la mirada bio-psico-social entre losprofesionales, vital para evitar una visión fragmentada de las familias.(AU)

The Primary Health Care Team (EAP) Roquetes-Canteres in Barcelona is considering, within theresearch framework promoted by Bruc Salut (a psychotherapeutic team), an integrated bio-psycho-social intervention.This article describes the research since its beginning and the different programmes that are being carried out since2014 with a tour of all the developed programmes. It explains thoroughly how they have been created, carried out,evaluated and their current operation, thanks to the coordinated work of the interdisciplinary team to address theemotional aspects of parenthood, the establishment of the bond and the good development of the baby, as well asthe awareness and self-restraint of the team professionals. Finally, the figure of the EAP liaison health professional isdefined, which has been created to coordinate and guide the team and to promote the bio-psycho-social view amongthe professionals, vital to avoid a fragmented view of the families.(AU)

L’Equip d’Atenció Primària (EAP) Roquetes-Canteres de Barcelona es planteja,en el marc de la investigació impulsada per Bruc Salut (equip psicoterapèutic), una intervenció biopsicosocialintegrada. En aquest article es descriuen la investigació des de l’inici i els diferents programes que s’estan duenta terme des de 2014 amb un recorregut per tots els programes desenvolupats. S’explica detingudament coms’han creat, dut a terme, avaluat i el funcionament actual, gràcies al treball coordinat de l’equip interdisciplinariper atendre els aspectes emocionals de la parentalitat, l’establiment del vincle, el bon desenvolupament del nadói també la sensibilització i contenció dels professionals de l’equip. Finalment, es defineix la figura del professionalsanitari d’enllaç de l’EAP, que s’ha creat per coordinar i guiar l’equip i fomentar la mirada biopsicosocial entreels professionals, vital per evitar una visió fragmentada de les famílies.(AU)

Documento del Grupo de Estudios Neonatales sobre el acompañamiento de padres y madres a recién nacidos en las Unidades de Cuidados Intensivos Neonatales y Maternidades durante la pandemia por SARS-CoV-2 / Document of the Neonatal Study Group on the accompaniment of parents of newborns in Neonatal Intensive Care Units and Maternity Units during the SARS-CoV-2 pandemic

El documento partede una reflexión sobre la política de restricción de visitas de los padres en las unidades neonatales y del acompañamientoen las plantas de maternidad que se aplicó en los hospitales en las primeras fases de la pandemia. Casi un año tras suinicio, un grupo de neonatólogos con espíritu autocrítico trabajamos de forma conjunta, en el marco del Grup d’EstudisNeonatals, con la voluntad de analizar los posibles efectos adversos de las medidas sobre aspectos fundamentales comoson el neurodesarrollo del recién nacido, la lactancia materna y la salud psicológica de los progenitores. Y, finalmente,desde el conocimiento y recursos que teníamos en ese momento, elaborar nuevas recomendaciones.(AU)

The document is based on a reflection on the policy ofrestricting parental visits in neonatal units and the accompanying in maternity wards that was applied in hospitals inthe early phases of the pandemic. Almost a year after its beginning, a group of neonatologists with a self-critical spiritworked together, within the framework of the Grup d’Estudis Neonatals, with the aim of analyzing the possible adverseeffects of the measures on fundamental aspects such as the neurodevelopment of the newborn, breastfeeding andthe psychological health of the parents. And, finally, from the knowledge and resources we had at that time, to developnew recommendations.(AU)

El document parteix d’una reflexiósobre la política de restricció de visites dels pares a les unitats neonatals i de l’acompanyament a les plantes dematernitat que es va aplicar als hospitals a les primeres fases de la pandèmia. Gairebé un any després del seu inici,un grup de neonatòlegs amb esperit autocrític treballem conjuntament, en el marc del Grup d’Estudis Neonatals,amb la voluntat d’analitzar els possibles efectes adversos de les mesures sobre aspectes fonamentals com sónel neurodesenvolupament del nounat, la lactància materna i la salut psicològica dels progenitors. I, finalment, desdel coneixement i recursos que teníem en aquell moment, elaborar noves recomanacions.(AU)

Trastornos del vínculo con origen en la etapa perinatal. Contribuciones del psicoanálisis y la neurociencia / Bonding disorders starting in the perinatal stage. Contributions of psychoanalysis and neuroscience

Sepresentan en este artículo dos casos atendidos en un centro de salud mental infanto-juvenil (CSMIJ) en los cuales elvínculo materno filial está gravemente comprometido desde etapas prenatales. Tanto desde aportes psicoanalíticoscomo de estudios neurocientíficos actuales, se expone cómo el periodo perinatal es clave para que el bebé puedaconstruir una base emocional sana que repercutirá en su desarrollo posterior. Se subraya la importancia de destinarrecursos a la intervención precoz en mujeres gestantes o en periodo de puerperio que puedan presentar dificultadesemocionales, para fortalecer el vínculo con sus hijos e hijas y prevenir una mayor tendencia a problemas de saludmental en estos.(AU)

Thisarticle presents two cases attended in a child and adolescent mental health center (CSMIJ) in which thematernal-filial bond is severely compromised since prenatal stages. Both psychoanalytical contributions andcurrent neuroscientific studies show how the perinatal period is key for the baby to build a healthy emotionalbase that will have repercussions on its later development. The importance of allocating resources to earlyintervention in pregnant or postpartum women who may present emotional difficulties is emphasized, in orderto strengthen the bond with their children and prevent a greater tendency to mental health problems in them.(AU)

Espresenten en aquest article dos casos atesos en un centre de salut mental infantil i juvenil (CSMIJ) en què el vinclematernofilial està greument compromès des d’etapes prenatals. Tant des d’aportacions psicoanalítiques comd’estudis neurocientífics actuals, s’exposa com el període perinatal és clau perquè el nadó pugui construir unabase emocional sana que repercutirà en el desenvolupament posterior. Se subratlla la importància de destinarrecursos a la intervenció precoç en dones gestants o en període de puerperi que puguin presentar dificultatsemocionals, per enfortir el vincle amb els seus fills i filles i prevenir una tendència més gran a problemes de salutmental en aquests.(AU)

Desire to Avoid Pregnancy scale: clinical considerations and comparison with other questions about pregnancy preferences.

BACKGROUND: Clinicians and women of reproductive age would benefit from a reliable way to identify who is likely to become pregnant in the next year, in order to direct health advice. The 14-item Desire to Avoid Pregnancy (DAP) scale is predictive of pregnancy; this paper compares it with other ways of assessing pregnancy preferences to shortlist options for clinical implementation. METHODS: A cohort of 994 UK women of reproductive age completed the DAP and other questions about pregnancy preferences, including the Attitude towards Potential Pregnancy Scale (APPS), at baseline and reported on pregnancies quarterly for a year. For each question, DAP item and combinations of DAP items, we examined the predictive ability, sensitivity, specificity, area under the receiver operating curve (AUROC), and positive and negative predictive values. RESULTS: The AUROCs and predictive ability of the APPS and DAP single items were weaker than the full DAP, though all except one had acceptable AUROCs (>0.7). The most predictive individual DAP item was 'It would be a good thing for me if I became pregnant in the next 3 months', where women who strongly agreed had a 66.7% chance of pregnancy within 12 months and the AUROC was acceptable (0.77). CONCLUSION: We recommend exploring the acceptability to women and healthcare professionals of asking a single DAP item ('It would be a good thing for me if I became pregnant in the next 3 months'), possibly in combination with additional DAP items. This will help to guide service provision to support reproductive preferences.

Pregnancy-Specific Stress and Racial Discrimination Among U.S. Women.

OBJECTIVES: Adverse birth outcomes among children born to women of color (WOC) have been associated with discrimination during pregnancy; however, little research has explored stressed caused by discrimination as well as pregnancy-specific stress. The purpose of this study was to examine differences in stress and racial discrimination (lifetime and during pregnancy) between U.S. women of different racial/ethnic groups. METHODS: Women between 18 and 45 years (n = 198; 101 non-Hispanic White, 58 Black, and 39 other WOC [i.e., Hispanic, Asian/Pacific Islander, American Indian, Mixed Race]) completed an online, cross-sectional survey between December 2019 and March 2020. Participants reported pregnancy-specific stress using the pregnancy distress questionnaire (PDQ) and pregnancy life events scale (PLE) and discrimination via the general ethnic discrimination scale (GED). ANOVAs explored differences between racial/ethnic groups' stress and discrimination. RESULTS: We found non-Hispanic White (p < 0.05) and other WOC (p < 0.01) reported higher distress during pregnancy than Black women, and other WOC (p < 0.05) reported more stressful prenatal life events (p < 0.05) than non-Hispanic Whites. However, Black (p < 0.001) and other WOC (p < 0.001) both experienced more ethnic discrimination throughout their lifetime and during their pregnancy than non-Hispanic Whites. Also, Black women experienced five times the stress from these encounters than White women (p < 0.001). CONCLUSIONS FOR PRACTICE: Previously developed pregnancy distress questionnaires may be better suited for non-Hispanic White populations and may miss important experiences unique to marginalized populations such as racial/ethnic discrimination. Adaptations to pregnancy-related stress scales are warranted given the toxicity of discrimination during pregnancy.

Delivery-Dependent Shift in Oxytocin-Responsive Cell Population in the Central Amygdala of the Female Rat.

INTRODUCTION: Despite its recent reputation as prosocial neurohormone, the most important physiological role of oxytocin (OT) is stimulating uterine contractions. Though it is well known that plasma OT concentrations change drastically during delivery, it remains unexplored whether and how OT receptors in the maternal brain are activated. We examined whether the responses of cells in the central amygdala (CeA), an OT receptor-rich limbic site involved in pain and fear memory regulation, to exogenously applied OT analogue, Thr-Gly-OT (TGOT), vary depending on delivery. METHODS: Intracellular Ca2+ dynamics of the CeA cells were visualized in brain slices from female rats at virgin (VG), during pregnancy term (PT) days 16-21, within 24 h after delivery (G0), and within 1-3 days after delivery (G3). The Ca2+ responses to 1 µM TGOT, 20 mM KCl (high K), and 300 µM ADP were compared. RESULTS: We found that fraction of cells responding to TGOT, high K, and ADP differed significantly between the four delivery-associated terms. In particular, the fraction of cells responding to TGOT (TGOT responders) significantly increased from VG and PT at G0 and G3. Furthermore, the significant positive correlation between TGOT and high K response in TGOT and high K responders was reduced at G0, while that between TGOT and ADP responses in TGOT and ADP responders was increased at G0. CONCLUSION: These results indicate that the responses of CeA cells to an OT receptor agonist markedly change around delivery, which might play a role in controlling the labor-related pain and post-delivery emotional complications.

Riesgo de depresión materna perinatal tras una pérdida gestacional: prevalencia y factores asociados. Un estudio exploratorio / Risk of perinatal maternal depression after pregnancy loss: prevalence and associated factors. An exploratory study

Objetivo: Evaluar la prevalencia del riesgo de depresión materna en el periodo perinatal, y los factores asociados a la misma, en las mujeres atendidas en Parc Taulí Hospital Universitari de Sabadell (Barcelona) que han tenido una pérdida gestacional de más de 13 semanas de gestación. Material y método: Se diseñó un estudio observacional de tipo analítico. Las variables estudiadas fueron: el riesgo de depresión materna perinatal, el tiempo transcurrido entre el diagnóstico y la expulsión, las pérdidas gestacionales previas, la viabilidad fetal, ver y sostener al bebé, la obtención de huellas y fotografías de recuerdo, y percibir contradicciones profesionales. El riesgo de depresión posparto fue evaluado mediante la Escala de Edimburgo. Se realizó un análisis de regresión múltiple por pasos para evaluar el efecto de las variables de estudio sobre la depresión posparto al alta. Resultados: Participaron 29 mujeres entre julio de 2018 y diciembre de 2020. El 37,9 % (n= 11/29) de las participantes al alta y el 26,7 % (n= 4/15) al mes presentaban puntuaciones superiores a 13 en la Escala de Edimburgo. La ecuación de la regresión fue estadísticamente significativa (F(4,23)= 7,31, p <0,001), llegando a explicar el 48,3 % (R2 ajustada) de la varianza de la depresión posparto al alta. El tiempo transcurrido entre el diagnóstico y la expulsión superior a 24 horas (B= 4,91; IC del 95 %= 0,83-8,99), así como las pérdidas gestacionales previas (B= 5,99; IC del 95 %= 1,92-10,06) se asociaron con una mayor puntuación en la Escala de Edimburgo, mientras que ver al hijo/a (B= –5,84; IC del 95 % = –11,55 a –0,12) se asoció con una disminución de la puntuación. (AU)

Objective: To evaluate the prevalence of the risk of maternal depression in the perinatal period and the factors associated with it, in women treated at Hospital Parc Taulí Hospital Universitari of Sabadell (Barcelona), who have had a gestational loss of more than 13 weeks of gestation. Material and method: An analytical observational study was designed. The variables studied were: the risk of perinatal maternal depression, the time elapsed between diagnosis and expulsion, previous pregnancy losses, fetal viability, seeing and holding the baby, obtaining footprints and souvenir photographs, and perceiving professional contradictions. The risk of postpartum depression was assessed using the Edinburgh Scale. A stepwise multiple regression analysis was performed to evaluate the effect of the study variables on postpartum depression at discharge. Results: 29 women participated between July 2018 and December 2020. 37.9% (n= 11/29) of the participants at discharge and 26.7% (n= 4/15) at one month had scores higher than 13 on the Edinburgh Scale. The regression equation was statistically significant (F(4,23)= 7.31, p <0.001) explaining 48.3% (R2 Adjusted) of the variance of postpartum depression at discharge. The time elapsed between diagnosis and expulsion greater than 24 hours (B = 4.91; 95% CI = 0.83 – 8.99), as well as previous pregnancy losses (B = 5.99; 95% CI = 1.92 – 10.06) were associated with a higher score on the Edinburgh Scale, while seeing the child (B = -5.84; 95% CI = -11.55 – -0.12 ) was associated with a decrease in score. (AU)

Quality of life deterioration and associated factors in prenatal care pregnant women: assessment with the WHOQOL-BREF scale / Deterioro de la calidad de vida y factores asociados en gestantes en control prenatal: evaluación con la escala WHOQOL-BREF

Introduction: Quality of life is a set of situations that contribute to people's well-being. In pregnantwomen, it is necessary to explore the emotional, social and physical aspects. Few studies in the LatinAmerican population explore the quality of life of pregnant women. The objective was to establishthe frequency of deterioration of the physical, psychological, social and environmental quality of lifeand to identify the associated factors in pregnant women residing in cities of the ColombianCaribbean who attended prenatal consultation.Material and methods: A cross-sectional study was conducted on 509 pregnant women whoperformed daily activities and participated voluntarily and anonymously after signing informedconsent. They filled out a form that explored sociodemographic and clinical characteristics andapplied the WHOQOL-BREF scale, identifying the poor quality of life. Adjusted logistic regressionwas performed to estimate the association between quality of life (dependent variable) andbiopsychosocial factors (independent variables).Results: The age of the participants was 26.8 ± 6.2 years. In 250 (49.1%) physical or mentaldeterioration was identified, in 281 (55.2%) deterioration of the social relationship and in 270(53.0%) of the environmental relationship. Diabetes OR:6.01[95%CI:1.20-18.42], depressionOR:4.71[95%CI:1-20-18.42], living in a rural area OR:2.96[95%CI :1.78-4.91], anguish withpregnancy OR:2.87[95%CI:1.65-5.01], financial problems OR:2.61[95%CI:1.54-4.40 ] or coupleOR:2.60[95%CI:1.03-6.69], were associated with impaired quality of life (p<0.01). Beingcohabiting, compared to being alone, and being a student/employee versus a housewife, wereassociated with a lower possibility of deterioration in quality of life (p<0.01).Conclusions: Deterioration of each quality of life domain was identified in half of the pregnantwomen and several biopsychosocial factors were significantly associated. ... (AU)

Introducción: La calidad de vida es un conjunto de situaciones que contribuyen al bienestar de laspersonas. En las mujeres embarazadas es necesario explorar los aspectos emocionales, sociales yfísicos. Son pocos los estudios en población latinoamericana que exploran la calidad de vida de lasgestantes. El objetivo fue establecer la frecuencia de deterioro de la calidad de vida física,psicológica, social y ambiental e identificar los factores asociados en gestantes residentes en ciudadesdel Caribe colombiano que acudieron a consulta prenatal.Material y métodos: Se realizó un estudio transversal en 509 gestantes que realizaban actividadescotidianas y participaban de forma voluntaria y anónima previa firma del consentimiento informado.Llenaron un formulario que exploró características sociodemográficas y clínicas y aplicaron la escalaWHOQOL-BREF, identificando la mala calidad de vida. Se realizó una regresión logística ajustadapara estimar la asociación entre calidad de vida (variable dependiente) y factores biopsicosociales(variables independientes).Resultados: La edad de los participantes fue de 26,8 ± 6,2 años. En 250 (49,1%) se identificódeterioro físico o mental, en 281 (55,2%) deterioro de la relación social y en 270 (53,0%) de larelación ambiental. Diabetes OR:6.01[IC95%:1.20-18.42], depresión OR:4.71[IC95%:1-20-18.42],vivir en zona rural OR:2.96[IC95% :1.78-4.91], angustia con embarazo OR:2,87[IC95%:1,65-5,01],problemas financieros OR:2,61[IC95%:1,54-4,40] o pareja OR:2,60[IC95%:1,03-6,69], se asociaroncon deterioro de la calidad de vida (p<0,01). Ser conviviente, comparado con estar solo, y serestudiante/empleado versus ama de casa, se asoció con una menor posibilidad de deterioro en lacalidad de vida (p<0,01).Conclusiones: Se identificó deterioro de cada dominio de la calidad de vida en la mitad de lasgestantes y varios factores biopsicosociales se asociaron significativamente. ... (AU)

Construção mulher-mãe: dispositivos que envolvem maternidade, mídia e seus movimentos atuais / Construcción de la madre-mujer: dispositivos que involucran la maternidad, medios de comunicación y sus movimientos actuales / Mother-woman construction: devices which involve maternity, media and their current movements

RESUMO. O pré-natal tornou-se um modo de investir na gestação, porém, a forma como cada mulher vai exercer o cuidado envolve um conjunto heterogêneo de práticas. O objetivo deste artigo é problematizar como os discursos se articulam nas redes sociais e direcionam a mulher a um modelo específico de maternidade. O percurso metodológico dá-se pela cartografia, com apoio de ferramentas foucaultianas: verdade, poder e subjetividade. Nas discussões e resultados, percebemos que o discurso de medicalização do corpo se desdobra em um investimento na família moderna, que seria um agente privilegiado de medicalização, e que as mulheres são interpeladas diretamente por este processo. Concluiu-se que o processo de medicalização atua, no corpo, por meio de uma série de saberes e discursos e compõe uma política normativa de um modelo de maternidade a partir de diferentes enunciações.

RESUMEN. El prenatal se hizo una manera de invertir en la concepción, sin embargo, la forma en que cada mujer ejercita el cuidado involucra un grupo heterogéneo de las prácticas. El objetivo de este artículo es problematizar como todos los discursos que se articulan en las redes sociales y van dirigiendo a la mujer hacia un modelo específico de maternidad. El itinerario metodológico se da por la cartografía, con el soporte de herramientas foucaultianas: la verdad, el poder y la subjectividad. En las discusiones y los resultados, nos dimos cuenta de que el discurso de medicalización del cuerpo se desdobla en una inversión en la familia moderna, que sería un agente privilegiado de medicalización, y que las mujeres son interpeladas directamente por este proceso. Se concluyó que el proceso de medicalización actúa en el cuerpo a través de una serie de saberes y discursos y compone una política normativa de un modelo de maternidad basado en diferentes enunciados.

ABSTRACT. Prenatal care has become a way to invest in gestation, but the way each woman will carry it out involves a heterogeneous set of practices. This article is aimed to problematize how the discourses are articulated in the social networks and may direct the woman to a specific model of maternity. The methodological course is given by cartography, having as a basis the Foucauldian tools: truth, power and subjectivity. In the discussions and the results, it is possible to realize that the medicalization discourse of the body unfolds in an investment for the modern family, which would be a privileged agent of medicalization, and that women are directly interpellated by this process. It was concluded that the medicalization process acts in the body through a series of knowledge and discourses and composes a normative policy of a maternity model based on different enunciations.