Paternal Postnatal Depression During COVID-19 Pandemic: The Role of Health Care Providers.

BACKGROUND: The fast spread of COVID-19 can cause some psychological disorders for men. One of the psychological disorders is paternal postpartum depression (PPD). The aim of the present research was to review studies that have investigated paternal postpartum depression during the COVID-19 pandemic. MATERIALS AND METHODS: For this narrative review, databases such as Google Scholar, Scientific Information Databases (SID), Magiran, PubMed, Web of Science, and Scopus were searched for the full texts of published studies in the Persian and English languages in the period of 2019 to 2021. Finally, 3 articles were selected and reviewed in this study. RESULTS: The results of this review study were classified into 3 main categories such as (1) The psychological status of men during the COVID-19 pandemic, (2) The effect of paternal PPD on children's development and family psychological status during the COVID-19 pandemic, and (3) The role of healthcare providers in the management of paternal PPD. The findings of the studies showed that paternal PPD increases the rate of child maltreatment, maternal depression, and domestic violence. The promotion of the interpersonal skills of healthcare providers with fathers suffering from depression or psychological problems is the determinant factor of successful results. CONCLUSIONS: The results showed that paternal PPD has a wide range of consequences in this pandemic. Therefore, it would be recommended that healthcare staff have close contact with families and screen fathers for paternal PPD during the COVID-19 pandemic.

Impact of COVID-19 Infection on Neonatal Birth Outcomes.

INTRODUCTION: There is limited data on newborns born to mothers with COVID-19 infection. This multicenter cohort study aimed to investigate the clinical characteristics and outcomes of neonates born to mothers with and without COVID-19 infection to fill a gap in the literature review. METHODS: The medical records of all neonates in Isfahan, Iran, between October 2020 and March 2021, were retrospectively reviewed. RESULTS: Among the 600 neonates in this study, 255 (42.5%) were in the infected group and 345 (57.5%) were assigned to the control group as they were born to non-infected mothers. In the infected group, sepsis, fever and pneumothorax were detected in 3 (1.2%), 3 (1.2%) and 4 (1.6%) neonates, respectively, compared with no case in the control group. In the infected group, neonatal respiratory distress (NRDS) (32, 12.5%) was significantly higher than the control group (27, 10.6%). Asphyxia in the infected group was 22(6.4%), compared with 19 (5.5%), in the control group. Preterm labor (PTL) (55, 21.65%), premature rupture of membranes (PROMs) (24, 9.4%) and intra-uterine growth retardation (IUGR) (15, 5.9%) were significantly higher in women with COVID-19 (45, 13.0%, 4, 1.2% and 7, 2.0%, respectively). Low birth weight (LBW) accounted for 42 (16.5%) neonates in the infected group and 25 (7.2%) in the control group (p < 0.05). Of the 255 neonates born to infected mothers, 38 (14.9%) were admitted to the Neonatal Intensive Care Unit (NICU), compared with 31 out of 345 (9.0%) in the control group (p < 0.05). RT-PCR test results were positive in two newborns (0.8%), one of whom died of necrotizing enterocolitis. CONCLUSION: As a result of maternal COVID-19 infections, neonates experienced higher rates of sepsis, fever, pneumothorax, asphyxia and NRDS in addition to PTL, PROMs, IUGR, and LBW.

Contradictory results have been reported on the impact of COVID-19 infection on neonatal outcomes. We conducted a review of 600 cases of neonates, with 255 (42.5%) in the COVID-19 infected and 345 (57.5%) in the control group. The results indicated that neonates born to women with COVID-19 showed higher rates of sepsis, fever, pneumothorax, asphyxia and neonatal respiratory distress in addition to preterm labor, premature rupture of membranes, intra-uterin growth retardation and low birth weight.

Development and Psychometric Properties of a Spiritual Needs Assessment Scale for Patients With COVID-19.

The current mixed methods, exploratory study aimed to develop and determine the psychometrics of a scale to assess the spiritual needs of patients with coronavirus disease 2019 (COVID-19). The study was performed in two stages: qualitative and quantitative. Through 14 interviews with patients with COVID-19, three themes, including Composure, Meaning in Life, and Global Responsibility, were formed. In the quantitative stage, content validity was achieved through the comments of 10 experts and patients. A total of 330 participants completed the instrument to assess construct validity. Exploratory factor analysis with 29 items and four subscales was performed, indicating a 6-point Likert scale. Cronbach's alpha coefficients ranged from 0.82 for the whole scale and 0.85, 0.81, 0.79, and 0.72 for the Composure, Communication, Meaning in Life, and Global Responsibility subscales, respectively. Intraclass correlation coefficient (test-retest analysis) was 0.79 and showed acceptable stability for the scale. The "Spiritual Needs Assessment Scale for COVID-19 Patients" is a 29-item multi-dimensional scale with robust psychometric properties, which can measure various aspects regarding the spiritual needs of patients with COVID-19. [Journal of Psychosocial Nursing and Mental Health Services, 60(4), 47-54.].

Characteristics and outcomes of COVID-19 pneumonia in pregnancy compared with infected nonpregnant women.

OBJECTIVE: To compare the clinical and paraclinical features and outcomes of pregnant and nonpregnant women with COVID-19. METHODS: A multicenter retrospective cohort study of pregnant and nonpregnant women of reproductive age hospitalized between March and October 2020 in Tehran, Iran. Medical records were reviewed and women who tested positive for SARS-CoV-2 on RT-PCR were included. Extracted data were compared and logistic regression performed. RESULTS: A total of 110 pregnant and 234 nonpregnant COVID-19-positive women were included. Frequency of severe disease was higher in nonpregnant women than pregnant women (29% vs 11.8%; P < 0.001). Symptoms including cough, dyspnea, chill, fatigue, and headache were more frequent in nonpregnant women (P < 0.05). Pregnant women had higher oxygen saturation levels and lower lymphocyte count (P = 0.001). Six (5.5%) pregnant and 12 (5.1%) nonpregnant women died (P = 0.80). No significant differences between the groups were found for ICU admission and end organ failure. Significantly more nonpregnant women had acute respiratory distress syndrome (ARDS, 9.4% vs 0%; P = 0.001). Univariate regression indicated association between hypertension and death; oxygen saturation and ARDS; and body mass index and ICU admission. No association was found between pregnancy and death, ICU admission, or ARDS. CONCLUSION: Pregnant women with COVID-19 are not at higher risk of adverse outcomes compared with nonpregnant women.

The mental health of healthcare workers in the COVID-19 pandemic: A systematic review.

Purpose: The novel coronavirus 2019 (COVID-19) is widely spreading all over the world, causing mental health problems for most people. The medical staff is also under considerable psychological pressure. This study aimed to review all research carried out on the mental health status of health care workers (HCWs) to bring policymakers and managers' attention. Methods: A literature search conducted through e-databases, including PubMed, EMBASE, Scopus, and Web of Science (WoS) from December 2019 up to April 12th 2020. All cross- sectional studies published in English which assessed the health workers' psychological well-being during the SARS-CoV-2 pandemic included. Study quality was analyzed using NHLBI Study Quality assessment tools. Results: One hundred relevant articles were identified through systematic search; of which eleven studies were eligible for this review. Their quality score was acceptable. The lowest reported prevalence of anxiety, depression, and stress among HCWs was 24.1%, 12.1%, and 29.8%, respectively. In addition, the highest reported values for the aforementioned parameters were 67.55%, 55.89%, and 62.99%, respectively. Nurses, female workers, front-line health care workers, younger medical staff, and workers in areas with higher infection rates reported more severe degrees of all psychological symptoms than other health care workers. Moreover, vicarious traumatization in non-front-line nurses and the general public was higher than that of the front-line nurses. Conclusion: During SARS-CoV-2 outbreak, the health care workers face aggravated psychological pressure and even mental illness. It would be recommended to the policymakers and managers to adopt the supportive, encouragement & motivational, protective, and training & educational interventions, especially through information and communication platform.

Analysis of Maternal Coronavirus Infections and Neonates Born to Mothers with 2019-nCoV; a Systematic Review.

INTRODUCTION: The emergence and fast spread of 2019 novel coronavirus (2019-nCoV) threatens the world as a new public health crisis. This study aimed to clarify the impact of novel coronavirus disease (COVID-19) on pregnant patients and maternal and neonatal outcomes. METHODS: A comprehensive literature search was conducted in databases including PubMed, Scopus, Embase, ProQuest, and Science Direct. All studies including original data; case reports, case series, descriptive and observational studies, and randomized controlled trials were searched from December 2019 until 19 March 2020. RESULTS: The search identified 1472 results and 939 abstracts were screened. 928 articles were excluded because studies did not include pregnant women. Full texts of eleven relevant studies were reviewed and finally nine studies were included in this study. The characteristics of 89 pregnant women and their neonates were studied. Results revealed that low-grade fever and cough were the principal symptoms in all patients. The main reported laboratory findings were lymphopenia, elevated C-Reactive Protein (CRP), Amino alanine transferase (ALT), and Aspartate amino transferase (AST). In all symptomatic cases, chest Computerized Tomography (CT) scans were abnormal. Fetal distress, premature rupture of membranes and preterm labor were the main prenatal complications. Two women needed intensive care unit admission and mechanical ventilation, one of whom developed multi-organ dysfunction and was on Extracorporeal Membrane Oxygenation (ECMO). No case of maternal death was reported up to the time the studies were published. 79 mothers delivered their babies by cesarean section and five women had a vaginal delivery. No fetal infection through intrauterine vertical transmission was reported. CONCLUSIONS: Available data showed that pregnant patients in late pregnancy had clinical manifestations similar to non-pregnant adults. It appears that the risk of fetal distress, preterm delivery and prelabor rupture of membranes (PROM) rises with the onset of COVID-19 in the third trimester of pregnancy. There is also no evidence of intrauterine and transplacental transmission of COVID-19 to the fetus in the third trimester of pregnancies.