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.

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.

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.

[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.

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.

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)