Cardiopatia congênita e percepções e sentimentos maternos / Congenital heart disease and maternal perceptions and feelings / Cardiopatías congénitas y percepciones y sentimientos maternos

Introdução: A Cardiopatia Congênita (CC) é uma doença crônica, caracterizada por anormalidades estruturais e funcionais no sistema cardiocirculatório, podendo ocorrer por fatores genéticos, mutações, alterações cromossômicas ou mesmo ter uma origem multifatorial. Estudos discutem sobre a possibilidade da CC criar um ambiente estressor para a criança e sua família, sobretudo para sua mãe, por ser o elemento da família que, geralmente, assume o acompanhamento e a execução dos cuidados com a criança. Objetivo: Identificar e descrever a percepção e sentimentos maternos acerca da doença do filho, suas dificuldades, o impacto da doença na qualidade de vida da família e suas angústias diante do futuro. Método: Pesquisa qualitativa, transversal, descritiva, com coleta de dados feita entre os meses de Dezembro de 2022 e Fevereiro de 2023, por meio de entrevistas semiestruturadas realizadas por ligação telefônica, gravada, com 13 mães de crianças com CC. O processo de análise foi orientado pela análise de conteúdo do tipo temática. Resultado: O estresse está presente na fala da maior parte das mães. Essas falas trazem à cena o fato de que este se condensa especialmente nos períodos iniciais do processo: descoberta da doença do filho, notícia da(s) cirurgia(s), responsabilidade pelos cuidados que se prolongam, isolamento materno. Conclusão: O medo da morte, do futuro e do desenvolvimento da criança são fantasmas que também circulam nas manifestações maternas e expressam a dificuldade em antecipar aos seus filhos uma subjetividade, condição de base para o desenvolvimento geral adequado. (AU)

Introduction: Congenital heart disease (CHD) is a chronic disease, characterized by structural and functional abnormalities in the cardiocirculatory system, which may occur due to genetic factors, mutations, chromosomal alterations, or even have a multifactorial origin. Studies discuss the possibility of CC creating a stressful environment for the child and his family, especially for his mother, as she is the family member who generally takes on the monitoring and execution of care for the child. Objective:To identify and describe maternal perceptions and feelings about their child's illness, their difficulties, the impact of the disease on the family's quality of life, and their anxieties about the future. Method:Qualitative, cross-sectional, descriptive research, with data collection carried out between December 2022 and February 2023, through semi-structured interviews conducted by telephone, recorded, with 13 mothers of children with CC. The analysis process was guided by thematic content analysis. Result:Stress is in the speech of most mothers. These statements bring to the fore the fact that stress is condensed especially in the early stages of the process: discovery of the child's illness, news of the surgery(s), responsibility for prolonged care, and maternal isolation. Conclusion: Fear of death, the future and the child's development are ghosts that also circulate in maternal manifestations and express the difficulty in anticipating their children, a basic condition for adequate general development. (AU)

Introducción: La cardiopatía congénita (CC) es una enfermedad crónica, caracterizada por anomalías estructurales y funcionales en el sistema cardiocirculatorio, que pueden deberse a factores genéticos, mutaciones, alteraciones cromosómicas o incluso tener un origen multifactorial. Los estudios discuten la posibilidad de que el CC genere un ambiente estresante para el niño y su familia, especialmente para su madre, ya que es ella la que generalmente asume el seguimiento y ejecución del cuidado del niño. Objetivo: Identificar y describir las percepciones y sentimientos maternos sobre la enfermedad del hijo, sus dificultades, el impacto de la enfermedad en la calidad de vida de la familia y sus angustias sobre el futuro. Método: Investigación cualitativa, transversal, descriptiva, con recolección de datos realizada entre diciembre de 2022 y febrero de 2023, a través de entrevistas semiestructuradas realizadas por teléfono, grabadas, con 13 madres de niños con CC. El proceso de análisis fue guiado por el análisis de contenido temático. Resultado: El estrés está presente en el habla de la mayoría de las madres. Estas declaraciones traen a la luz el hecho de que el estrés se condensa especialmente en las primeras etapas del proceso: descubrimiento de la enfermedad del niño, noticia de la(s) cirugía(s), responsabilidad por cuidados prolongados, aislamiento materno. Conclusión: El miedo a la muerte, al futuro y al desarrollo del niño son fantasmas que también circulan en las manifestaciones maternas y expresan la dificultad de anticiparse a sus hijos, condición básica para un adecuado desarrollo general. (AU).

Frequency of maternal stress and psychic risk in newborns who have been hospitalized in a neonatal intensive care unit / Frequência de estresse materno e de risco psíquico em recém-nascidos que foram hospitalizados em unidade de terapia intensiva neonatal

Abstract Objectives: describe the frequency of maternal stress and psychic risk indicators in newborns who were exposed to the neonatal intensive care unit (NICU) after hospital discharge. Methods: observational, analytical, cohort study, sample of 26 participants (13 exposed and 13 not exposed to the NICU). Maternal stress was assessed by Inventário de Sintomas de Stress para Adultos de Lipp (ISSL) (Lipp's Stress Symptoms Inventory for Adults) and psychological risk by Indicadores Clínicos de Risco para o Desenvolvimento Infantil (IRDI) (Clinical Risk Indicators for Child Development), 15 days after hospital discharge and at 4 months of corrected age. Results: the study found a frequency of stress of 23.1% in mothers of newborns who were exposed to NICUs and 38.5% of psychological risk in these newborns. The following associations were found: maternal stress and newborn exposure to the NICU (p=0.037); maternal stress and newborn exposure time to NICU (p=0.031); psychological risk and prematurity (p=0.014). There were no association between psychic risk and maternal stress; and there was no diference in the frequency of psychological risk between the groups of newborns. Conclusions: newborn hospitalization in the NICU is associated with maternal stress, but not with psychological risk. Prematurity can cause psychological risk. Maternal stress was not associated with psychological risk.

Resumo Objetivos: descrever a frequência de estresse materno e indicadores de risco psíquico em recém-nascidos que foram expostos à unidade de terapia intensiva neonatal (UTIN). Métodos: estudo observacional, analítico, coorte, amostra de 26 participantes (13 expostos e 13 não expostos a UTIN). O estresse materno foi avaliado pelo Inventário de Sintomas de Stress para Adultos de Lipp e o risco psíquico pelo IRDI (Indicadores Clínicos de Risco para o Desenvolvimento Infantil), 15 dias após a alta hospitalar e aos quatro meses de idade corrigida. Resultados: o estudo encontrou frequência de estresse de 23,1% nas mães de RN que foram expostos a UTIN e 38,5% de risco psíquico nestes bebês. Encontrou as seguintes associações: estresse materno e exposição do RN à UTIN (p=0,037); estresse materno e tempo de exposição do RN à UTIN (p=0,031); risco psíquico e prematuridade (p=0,014). Não encontrou associação entre risco psíquico e estresse materno; e não encontrou diferença na frequência de risco psíquico entre os grupos de RN. Conclusões: a internação do RN em UTIN está associada a estresse materno, mas não a risco psíquico. A prematuridade pode causar risco psíquico. O estresse materno não apresentou associação com risco psíquico.

Maternal Gestation Induced-stress Alters Reproductive Outcome in Adult Female Rats, Offspring Survival Rate and Sex–ratio

@#Introduction: Investigations relating to the effect of stress on reproductive outcome, offspring survival rate and chances of still births are currently attracting global concern. The present study evaluated the effect of maternal gestation induced-stress in the altered reproductive outcome of adult female Wistar rats, offspring sex – ratio and survival following exposure to different stress models. Methods: The study protocol involved two parts. Seventy-eight adult healthy female Wistar rats aged between 12 – 14 weeks and weighing between 150-180g were procured and utilized for part 1 study. The rats were exposed to three stressors; restraint, mirror and intruder, respectively, for three hours per day for three weeks. For part 2 experiment twenty-four female offspring rats from the part 1 study were used. Results: Exposure of rats to the varying stressors increased gestate on length, decreased mean pup weights and litter size at birth especially when the rats were stressed by exposure to restraint or intruder stressor. The effect of stress on gestation period, pup weights and litter size were largely variable and dependent on the nature of stressor applied. There was significant (p<0.05) reduction in the survival rates of offspring of rats exposed to the different nature of stressors especially when stressed with restraint or intruder stressors. The stressors’ impact was greatest when the rats were exposed to the varying stressors up to the end of the 2nd trimester and beyond. Furthermore, the male sex ratio of offspring of stressed rats was significantly (p<0.05) reduced than the females. Conclusion: Stressful maternal condition tends to compromise the fetal outcome, sex ratio specificity and the survival rate of offspring.

Quality of life, perceived stress and caregiver burden in mothers of children with childhood psychiatric disorders in Kerala, India

Background: Common childhood psychiatric problems like attention deficit hyperkinetic disorder (ADHD), Pervasive developmental disorder (PDD) and learning disability (LD) often co-exists with each other and form a constellation of behavioural manifestations that require extra attention from the caregivers. Having a differentially-abled child is challenging and most parents have to learn to restructure their lives around that of the child. There is a difference in the attitudes of both the parents as far as parenting a disabled child is concerned. Mothers often shoulder the primary caregiving role however the psychological costs borne by women go unrecognized. The study aims to assess the care giver burden (BOC) and perceived stress (PS) and quality of life (QOL) in mothers of children with ADHD, PDD and LD.Methods: It was a cross-sectional study with 336 child mother pairs. The mothers were asked to rate their burden and stress symptoms on the perceived stress scale and Burden of care scale. The mothers were also asked to rate their quality of life on the quality of life scale.Results: The mean PS score was highest in the PDD group. The mean BOC was lowest in the LD group. The QOL score was highest in the LD group.  There is statistically significant difference in the PS, BOC and QOL scores among the three groups.Conclusions: There is a hidden lacuna of psychological stress in mothers of children with common psychiatric problems. The study also establishes that these mothers have poorer quality of life. It is necessary to address these psychological issues of the mother at every visit and equip them with coping strategies so that they can look after both themselves and their special needs child.

Development of perceived prenatal maternal stress scale

Background: Pregnancy is a state, which is often associated with extreme joy and happiness. Women undergo a number of physiological and psychological changes during pregnancy, which are often stressful if aligned with other adverse life events, compromising their health and well-being. However, there exists no comprehensive psychological instruments for measuring this stress. Objectives: The study was conducted to develop a multidimensional scale to assess prenatal maternal stress (PNMS) comprehensively. Methods: The initial phase of the study focuses on developing items and assessing the content validity of these items. The second phase focuses on pilot-testing and field-testing the newly developed perceived PNMS scale (PPNMSS) among 356 pregnant women belonging to different parity and trimester from November 2015 to October 2016. Results: The underlying factor structure of the 28-item PPNMSS had explored using exploratory factor analysis. The final scale is retained with 15 items having considerable item loading under four major factors as follows: perceived social support, pregnancy-specific concerns, intimate partner relations, and financial concerns. Reliability of each of these dimensions was assessed using Cronbach's alpha. Convergent and divergent validity of the scale was assessed by correlating the scores with perceived stress scale and the World Health Organization (five) well-being index (1998 version). Conclusions: As a comprehensive scale, PPNMSS is efficient to measure PNMS, which facilitates an early detection of stress and depression among pregnant women and timely intervention by health care professionals.

Maternal foetal attachment and perceived stress during pregnancy

Background: In recent years, the construct of maternal foetal attachment (MFA) has gained a lot of attention. The significance of the bond between the mother and her child she is carrying has led researchers to study how the expecting woman’s feelings towards the unborn child, have long lasting effects on the child. Although several psychological factors, such as maternal anxiety, attitude towards the baby and access to foetal imaging procedures, have been established to significantly influence a mother’s attachment to her foetus, there seems to be a paucity of empirical work on the relationship between maternal stress during pregnancy and maternal foetal attachment. The present research is a step in this direction and purports to explore this relationship.Methods: The study explored the relationship between MFA and stress using the maternal foetal attachment scale by Cranley and the stress scale of the ADSS by Bhatnagar et al. The sample consisted of 53 pregnant women with a mean age of 26.4.Results: The results suggest a significant negative relationship between stress and MFA, r=-0.55 (p<0.01). Stress also showed a negative correlation with the subscales of MFAS, with highly stressed women reporting lower levels of self-giving behavior, fewer thoughts of role taking and lesser interactive behavior with the foetus.Conclusions: High stress during pregnancy could impede the formation of a strong bond between the expecting woman and her foetus. Thus the best practices during pregnancy should aim to reduce stress and encourage maternal foetal interaction.

Desenvolvimento do bebê nos dois primeiros meses de vida: variáveis maternas e sociodemográficas / Baby development in first two months of life: maternal and demographic main measurements

No presente estudo, realizado com dezesseis mães, discute-se sobre fatores de risco para o desenvolvimento do bebê, em especial, variáveis maternas e sociodemográficas. As mães responderam a uma entrevista e inventários para avaliação de ansiedade e estresse. Os bebês foram avaliados pelo Inventário Portage Operacionalizado. Os resultados apontaram correlações positivas entre ansiedade e autocuidado e negativas entre estresse materno e desenvolvimento cognitivo dos bebês. Houve correlações significantes entre idade materna e desenvolvimento motor e cognitivo no segundo mês (p=0,005; 0,013). A idade gestacional mostrou-se significante para a área motora no segundo mês de vida do bebê (p=0,026), mas a correlação foi negativa. A variável peso ao nascer apontou diferença significante e negativa para cognição no segundo mês (p=0,29) e a escolaridade materna foi significante e positiva para a área de linguagem no primeiro mês (p=0,000).Os dados referendam a importância da orientação e acompanhamento de mães durante o pós-parto...

In the present study, participated sixteen mothers. We discuss about risk factors for the development of the baby, especially main measurements maternal and sociodemographic. Mothers were interviewed and inventories to assess anxiety and stress. The babies were assessed from 'Inventário Operacionalizado Portage. The results pointed positive correlations between anxiety and self-care, and negative associations between maternal stress and cognitive development of infants. There were significant correlations between maternal age and cognitive, and motor development in the second month (p=0.005; 013). Gestational age was significant for the motor area in the second month of a baby's life (p=0.026), however this correlate was negative. The variable birth weight showed significant difference in cognition and negative in the second month (p=0.29); and maternal education was significant positive for the language area in the first month (p=0.000). These results emphasized the importance of guidance and monitoring of mothers during the postpartum...

Inseguridad Alimentaria, estrés materno y sobrepeso en niños que asisten a dos salas municipales / Food insecurity, maternal stress and overweight in children attending two primary health care centers / Insegurança Alimentícia, estressematerno e sobrepeso em crianças quefrequentam duas aulas municipais

Estudio observacional en dos centros de la ciudad de Mar del Plata. Objetivo identificar la relación entre el sobre-peso de los niños y el estrés materno en hogares con algún grado de inseguridad alimentaria. Material y métodos: Muestra aleatoria de 90 niños de entre 1 y 18 años de edad. La Seguridad alimentaria (SA) se midió utilizando métodos cualitativos y cuantitativos. Para el estrés materno (EM), se utilizó un cuestionario para evaluar los siguientes factores estresantes: físico, mental, financiero y familiar. Evaluación antropométrica: IMC/edad para niños de entre 6 y 18 años y adecuación P/T para menores de 6 años. Resultados: El sobrepeso hallado fue del 28,57%. El porcentaje de obesidad fue de 9,89% en los hogares sinestrés y se incrementó al 18,68 % en los hogares con estrés.Como variable continua, la correlación es aún más significativa (C.O.= 0.302). El nivel de inseguridad alimentaria observado asciende al 59%. No se encontró relación entre esta variable y el IMC de los niños. La correlación observada entre el IMC del niño y el EM aumentó cuando se consideraron solamente hogares con SA (0.511 vs 0.246 en hogares sin SA), en forma concordante conel trabajo de Gundersen y col.Conclusiones:El EM aparece como factor influyente en el estado nutricional de los niños en hogares con SA,pero no en hogares con algún grado de inseguridad. Nuestros hallazgos fueron similares a los hallados porGundersen y Col.

This is an observational study conducted at two clinics in Mar del Plata city. The aim of this study was to identify the relationship between overweight children and maternal stress in households facing some degree of food insecurity. Material and methods: Random sample of 90 children between 1 and 18 years of age. Food security was measured using qualitative and quantitative methods. For materna stress (MS), we used a questionnaire to assess physical,mental, financial and family-structure stressors. Anthropometric assessment: BMI/age for children between 6 and 18 years old and weight-height adequacy for children under 6 years. Results: 28.57% of the participants were overweight. The obesity rate was 18.68% and 9.89% for stressed and not stressed households, respectively. As a continuous variable, the correlation is even more significant (P = 0.302). The level of food insecurity was 59%. No relationship was found between this variable and the children's BMI. The correlation between the children's BMI and MS increased when considering only food secure households (0.511 vs.0.246 for food insecure households), which is consistent with data from Gundersen et al. Conclusions: MS appears to influence the nutritional status of children in food secure households, but this is not the case for households facing some degree of food insecurity. Our findings were similar to that of Gundersen et al.

Estudo observacional em dois centros da cidade de Mardel Plata: Objetivo identificar a relação entre o sobrepeso das crianças e o estresse materno em lares com algum grau de insegurança alimentícia. Material e métodos:Amostra aleatória de 90 crianças entre 1 e 18 anos de idade. A Segurança alimentícia (SA) foi medida utilizando métodos qualitativos e quantitativos. Para o estresse materno (EM), foi utilizado um questionário para avaliar os seguintes fatores estressantes: físico, mental, financeiro e familiar.Avaliação antropométrica:IMC/idade para crianças entre 6 2 18 anos e adequação P/T para menores de 6 anos.Resultados: O sobrepeso constatado foi de 28,57%. A porcentagem de obesidade foi de 9,89%,nos lares sem estresse e aumentou 18,68% nos lares com estresse. Como variável contínua, a correlação é ainda mais significativa (C.O.= 0.302). O nível de insegurança alimentícia observado supera 59%. Não foi constatado relação entre esta variável e o IMC das crianças. A correlação observada entre o IMC da criança e o IMC aumentou quando foram considerados somente lares com SA (0.511versus 0.246 em lares sem AS), de forma concordante com o trabalho de Gundersen e col. 27 Conclusões: O EM aparece com fator influente no estado nutricional das crianças em lares com SA, mas não em lares com algum grau de insegurança. Nossas conclusões foram similares às conclusões de Gundersen e Col.

The effects of lactational maternal stress on neuronal behavior of adolescent offspring in mice / 中华行为医学与脑科学杂志

Objective To explore the effects of lactational maternal stress on neurobehavioral development of offsprings.Methods Maternal mice were divided into normal control,maternal deprivation and maternal stress group.A 5-min/day cold water swimming was used as maternal stress for continuously of 14 day since the 7th postnatal day.The increasing bodyweight and neurobehavior of adolescent offspring mice were assessed by forced swimming test,tail suspension test and locomotor activity in the 35th postnatal day.Results Maternal chronic stress in lactational stage significantly increased the vulnerability of offspring to acute stress,which was reflected by significantly increased immobility time of adolescent offspring in forced swimming test (female:(139±6) s,(138±9) s,(96±9) s respectively; male:(139±9) s,(112±9) s,(96±9) s respectively) and in tail suspension test (femal:(127±8) s,(123±8) s,(98±6) s respectively ; male:(141 ±7) s,(105±5) s,(92±6) s respectively).Meanwhile,sexual difference occurred for adolescent offspring to acute stress,and the female offspring were more vulnerable to acute stress.Conclusion Lactational maternal stress may be important factors for development of adolescent depression.Our findings highlight the area of early prevention and intervention for adolescent depression.

Estrés materno y configuración familiar: estudio comparativo en familias chilenas monoparentales y nucleares de bajos ingresos / Maternal Stress and Family Constitution: Comparative Study on Chilean, Single-Mother and Nuclear, Low-Income Families

Los estudios sobre estrés materno durante la crianza infantil han considerado variables contextuales para explicarlo. El nivel socioeconómico (NSE) así como la configuración familiar han sido variables relevantes, asociándose monoparentalidad en familias de bajos ingresos a mayores niveles de estrés materno. Se estudian los niveles de estrés materno en familias chilenas nucleares y monoparentales de NSE bajo, considerando el estrés en distintas dimensiones, asociado al rol materno, a la interacción madre-hijo y a la percepción de dificultades en el niño percibidas por la madre. Se estudia un total de 169 diadas, 80 pertenecientes a familias monoparentales y 89 pertenecientes a familias nucleares con niños entre los 4 y 15 meses de edad. Se evaluaron los niveles de estrés materno con el Parental Stress Index, versión abreviada, desarrollado por R. Abidin (1995). Los resultados muestran niveles de estrés significativamente más altos en las madres pertenecientes a familias monoparentales en el estrés asociado al rol materno, a la percepción del niño como difícil y en el estrés total.

Studies on maternal stress during child raising have taken into consideration contextual variables to explain it. The socioeconomic level, as well as the family constitution have been relevant variables, associating single-parenting in low-income families with greater levels of maternal stress. Maternal stress levels in Chilean, nuclear and single-mother low income families are studied, considering stress in various dimensions, associated to the maternal role, to the mother-child interaction and to the difficulties the mother perceives in the child. 169 Dyads are studied, 80 of them of single-mother families and the other 89 of nuclear families, with children between the ages of 4 to 15 months. Maternal stress levels were measured with the Parental Stress Index, abbreviated version, developed by R. Abidin (1995). The results show significantly higher stress levels in mothers of single-parent families on stress associated to the maternal role, to the perception of a difficult child, and to total stress.

The Relation of Maternal Stress with Nutrients Intake and Pregnancy Outcome in Pregnant Women

Maternal stress was one of the common symptoms that pregnant women could have experienced during pregnant period. The purpose of this study was to investigate the relation of maternal stress with maternal nutrients intake and pregnancy outcome. Subjects were 248 pregnant women and were recruited at two hospitals in Seoul area. Individual stress levels were divided by the stress scores (total 41 scores), as low stressed group ( or = 12). The social characteristics, nutrient intake, anthropometric measurements and pregnancy outcome were compared between low stressed group (LSG) and high stressed group (HSG) to recognize risk factor of maternal stress. We found that subjects experience stress by various factors which were concern about newborn (40.4%), concern about health (28.8%), economic difficulties (13.2%), depress (10.1%), family relationship (2.9%), concern of house work (2.5%), human relationship (2%). In HSG, unemployed rate (p < 0.05) and pre-pregnancy BMI (p < 0.05) were higher than in LSG. Family size in HSG was larger than that in LSG (p < 0.01). Doing regular exercise with the light activity level was significantly higher in LSG (p < 0.05). The nutrient intake in LSG was slightly higher than that in HSG, but not statistically significant. Pregnancy outcome was not significantly affected by the maternal stress. In conclusion, the risk of maternal stress may be related with a life style during pregnancy. Therefore, life style for maternal stress control, such as weight control and regular exercise is recommended to prevent maternal stress.

Estratégias de coping de mães de portadores de autismo: lidando com dificuldades e com a emoção / Coping strategies of mothers of autistic children: dealing with behavioral problems and emotions

Estudos têm apontado evidências de estresse em famílias de portadores de autismo. Neste processo, deve-se considerar as estratégias de coping utilizadas pelos familiares frente às circunstâncias adversas. O objetivo deste estudo foi verificar as estratégias de coping maternas frente a dificuldades dos portadores de autismo, assim como as estratégias das mães para lidar com as próprias emoções desencadeadas pelo estresse. Participaram 30 mães, entre 30 a 56 anos, cujos filhos apresentam diagnóstico de autismo e freqüentam instituições de atendimento. Utilizou-se uma entrevista semi-estruturada, a qual foi transcrita e analisada com base na Análise de Conteúdo. As principais dificuldades se referem ao comportamento do filho, frente às quais as mães utilizam predominantemente as estratégias de ação direta e de aceitação. Quanto às estratégias para lidar com as emoções, as categorias mais freqüentes foram distração, busca de apoio social/religioso, inação e evitação. Os resultados são discutidos considerando-se o estresse e a adaptação materna.

Many studies have shown evidence of high levels of stress in families with autistic children. Concerning this process, it is important to consider the coping strategies used by family members in face of the adverse circumstances. The purpose of this study is to investigate the coping strategies of mothers when dealing with their autistic children, as well as how they deal with their own emotions unleashed by the stress. Thirty mothers, between 30 and 56 years old participated in the study. Their children have met the criteria for autism and attended special education schools. The coping strategies were investigated using a semi-structured interview, which was transcribed and analyzed by content analysis. The main difficulties refer to the child's behavior. In relation to these difficulties, the strategy used by the mothers was predominantly direct action and acceptance. Concerning the strategies to deal with their own emotions, the most frequent categories were distraction, reaching out for social/religious support, lack of action and avoidance. Results are discussed in terms of stress and maternal adaptation model.