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During the COVID-19 outbreak, the risk of depression has increased for pregnant women and especially for first-time mothers-to-be. Pre-COVID-19 literature showed that depression is negatively linked to mental representations during pregnancy. This pilot study explored the difference in depressive symptoms and maternal representations style in primiparous and multiparous pregnant women during the outbreak of COVID-19 (2020-2021). 25 women (14 primiparous, 11 multiparous) were recruited in their last trimester of pregnancy. Participants responded to the Edinburgh Postnatal Depression Scale (EPDS) and Interview for Maternal Representations during Pregnancy (Intervista sulle Rappresentazioni Materne in Gravidanza-IRMAG). Results showed that primiparous women presented higher depressive symptoms than multiparous ones. Moreover, primiparous women reported lower richness of perception (p = 0.008), openness to change (p = 0.035) and dominance of fantasies (p = 0.000) in maternal representation and, globally, more restricted representations (71.4%) than multiparous ones (18.2%) (p = 0.020). Mental representations were related to the level of depression, with integrated representations being associated with lower depression than restricted and ambivalent ones (p = 0.001). A preventive intervention to support primiparous pregnant women during future pandemics would be necessary in particular to avoid negative repercussions also in the post-partum experience.
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Objective This S2k guideline of the German Society for Gynecology and Obstetrics (DGGG) and the German Society of Perinatal Medicine (DGPM) contains consensus-based recommendations for the care and treatment of pregnant women, parturient women, women who have recently given birth, and breastfeeding women with SARS-CoV-2 infection and their newborn infants. The aim of the guideline is to provide recommendations for action in the time of the COVID-19 pandemic for professionals caring for the above-listed groups of people. Methods The PICO format was used to develop specific questions. A systematic targeted search of the literature was carried out using PubMed, and previously formulated statements and recommendations issued by the DGGG and the DGPM were used to summarize the evidence. This guideline also drew on research data from the CRONOS registry. As the data basis was insufficient for a purely evidence-based guideline, the guideline was compiled using an S2k-level consensus-based process. After summarizing and presenting the available data, the guideline authors drafted recommendations in response to the formulated PICO questions, which were then discussed and voted on. Recommendations Recommendations on hygiene measures, prevention measures and care during pregnancy, delivery, the puerperium and while breastfeeding were prepared. They also included aspects relating to the monitoring of mother and child during and after infection with COVID-19, indications for thrombosis prophylaxis, caring for women with COVID-19 while they are giving birth, the presence of birth companions, postnatal care, and testing and monitoring the neonate during rooming-in or on the pediatric ward.Copyright © 2023. Thieme. All rights reserved.
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Background. Postpartum mothers' mental health has a significant role in mothers' well-being and child's growth and develop-ment. This issue is worsened during a pandemic when social restrictions are regulated, resulting in perceived stress, baby blues, postpartum depression, and other mental health issues. Objective. This study intends to investigate postpartum moth-ers' mental health during the COVID-19 pandemic. Methods. This study's methodology is a scoping review using the prism-ScR checklist, the Joanna Briggs Institute critical appraisal tool, and a population, exposure, outcome framework. It uses 4 databases: Pubmed, Willey, Proquest, and ScienceDirect;its inclusion criteria is original English articles that can be accessed in full text between 2020 and 2022. Results. Out of 190 publications, we found 7 that are pertinent to the research goals. Qualitative research, cross-sectional studies, and longitudinal studies make up the research. The mapping result includes 4 themes: the types of mental health problems experi-enced by postpartum moms during the Pandemic, risk and predic-tive factors, postpartum mothers' experiences, and the effects of mothers' mental health problems. Conclusion. After giving birth, most mothers experience stress, anxiety, and depression. Postpartum mental health concerns are influenced by isolation, social exclusion, and crises. The cre-ation of a customized plan for early assistance for a woman's mental health requirements, as well as the establishment of an accessi-ble mental health provider, including medical personnel and medical facilities, is advised for pregnant and postpartum women. only.Copyright © the Author(s), 2023.
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Ab s t r ac t Aim: The aim of this study was to summarize different types of benefits that have been observed in the baby's development and the mother's psychological health during the postpartum period. Background(s): Breastfeeding is a natural process that plays a vital role in the physical as well as mental health of the mother and child. Breast milk is rich in contents such as proteins, fats, and vitamins, which are responsible for building the immune system of the baby. Lactation helps in decreasing the prevalence of infant mortality rate. It enhances the development of the physical health of the children. Breastfeeding protects the mother from many systemic conditions like endometrial cancer, ovarian cancer, breast cancer, etc. It has been observed that with an increase in healthy breastfeeding practices, there is a decline in the cases of maternal mental health issues reported mainly in the postpartum period. Review result: The authors have explained various types of advantages of breastfeeding on the child's and mother's health, their mechanism of action, effects on the baby, and mother-child relationship. Conclusion(s): The mother's mental health plays a crucial role in a healthy infant, and breastfeeding is key to it. The role of breastfeeding is therefore considered a boon for the mother because if there is a decrease in health issues in the child, the mother's mental condition improves automatically. Therefore, breastfeeding should be promoted at the national level. Clinical significance: Breastfeeding not only helps in reducing maternal stress and postpartum depression but also improves the physical health of the child and mother during the postpartum period. The clinicians should teach mothers about the importance and also the correct positions of breastfeeding. "Breastfeeding week" is celebrated every year from August 1 to August 7, as implemented by the Indian government.Copyright © The Author(s). 2023 Open Access.
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Background: External natural events, such as hurricanes, floods, and the COVID-19 pandemic can contribute to increased populational stress, especially for pregnant persons. Exposure to crises can produce short- and longterm health effects on pregnant persons and their offspring. There has been much interest in the association between maternal depression, anxiety, and stress during pregnancy and perinatal outcomes such as preterm birth (PTB) and low birth weight (LBW), before and since the COVID-19 pandemic, however results are controversial. Objective(s): Assess the association between prenatal mental health during the COVID-19 pandemic and preterm birth (delivery <37 weeks gestation) and low birthweight (<2,500 grams). Method(s): Pregnant individuals, >18 years, were recruited in Canada and provided data through a web-based questionnaire. We analyzed data on persons recruited between 06/2020-08/2021 who completed questionnaires while pregnant and two months post-partum. Data on maternal sociodemographics, comorbidities, medication use, mental health (Edinburgh Postnatal Depression Scale, General Anxiety Disorder-7, stress), pandemic hardship (CONCEPTION - Assessment of Stress from COVID-19), and on gestational age at delivery and birth weight, were selfreported. Crude and adjusted relative risks (aRR) with 95% confidence interval (95%CI) were calculated to quantify the association between PTB/LBW and maternal mental health. Result(s): A total of 1,265 and 1,233 participants were included in the analyses of PTB and LBW, respectively. No associations between PTB and prenatal mental health (depression [aRR 1.01, 95%CI 0.91-1.11], anxiety [aRR 1.04, 95%CI 0.93-1.17], stress [aRR 0.88, 95%CI 0.71-1.10], nor hardship [aRR 1.00, 95%CI 0.96-1.04]) after adjusting for potential confounders. The risk of PTB was increased with nonwhite ethnicity/race (aRR 3.85, 95%CI 1.35-11.00), consistently with the literature. Similar findings were observed for LBW (depression [aRR 1.03, 95%CI 0.96- 1.13], anxiety [aRR 1.05, 95%CI 0.95-1.17], COVID stress [aRR 0.92, 95%CI 0.77-1.09], or overall hardship [aRR 0.97, 95%CI 0.94-1.01]). Conclusion(s): No association was found between prenatal mental health nor hardship during the COVID-19 pandemic and the risk of PTB or LBW. However, it is imperative to continue the follow-up of mothers and their offspring to detect long-term health problems early.
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Objectives: COVID-19-related stressors - including social distancing, material hardship, increased intimate partner violence, and loss of childcare, among others - may result in a higher prevalence of depression among postpartum individuals. This study examines trends in postpartum depression in the US from 2018 to 2022, as well as correlates of treatment choices among women with postpartum depression. Method(s): 1,108,874 women aged 14-64 in the Komodo Healthcare Map with 1+ live birth between April 2018 and December 2021 and had continuous enrollment 2+ years before and 4+ months after the delivery date were included. Prevalence of depression during postpartum (within 3 months after delivery) was calculated before (April 2018-March 2020) and during (April 2020-March 2022) COVID-19. Multinomial logistic regression was used to investigate correlates of treatment choices (no treatment, medication-only, psychotherapy-only, or both). Result(s): The prevalence of postpartum depression increased from 9.7% pre-pandemic to 12.0% during the pandemic (p < 0.001). Among 119,788 women with postpartum depression in 2018-2022, 47.0% received no treatment, 35.0% received medication-only, 10.0% received psychotherapy-only, and 7.4% received both within one month following their first depression diagnosis. Factors associated with an increase in the odds of receiving medication-psychotherapy treatment (vs. no treatment) included older ages;commercial insurance coverage;lower social vulnerability index;history of anxiety or mood disorder during and before pregnancy;and being diagnosed by a nurse practitioner, physician assistant, or behavioral care practitioner (vs. physician). Similar patterns were observed for medication-only and psychotherapy-only treatments. Conclusion(s): In this large, nationally representative sample of US insured population, the prevalence of postpartum depression increased significantly by 2.3 percentage-points during the pandemic (or a relative increase of 23.7%). Nonetheless, almost half of women with postpartum depression received no treatment, and only 7.5% received both medication and psychotherapy. The study highlighted potential socioeconomic and provider variation in postpartum depression treatment.Copyright © 2023
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Introduction: This study was done to compare the prevalence of mental health disorders between COVID-19-infected and non-infected mothers during the COVID-19 pandemic. The secondary objective was to find out the risk factors and long-term outcome of peripartum depression (PPD). Material(s) and Method(s): This was an observational and comparative study using a questionnaire-based direct interview, conducted in a tertiary hospital. After judging the inclusion and exclusion criteria, 842 subjects were selected between September 2020 to December 2020. The Edinburgh postnatal depression scale (EPDS) and COVID-19 anxiety scale (CAS) was used for evaluation of the mental health. Subjects with PPD were followed up for a year. Result(s): The mean age of the subjects was 24.8 +/- 3.9 years, 142 (16.8%) were confirmed COVID-19 positive. Overall, 317 (37.6%) had possible PPD (EPDS >=14) and 763 (90.6%) had peripartum anxiety (EPDS anxiety subscore >=4). While there was no significant difference in the prevalence of PPD (32.6% vs 39%, p = 0.12), peripartum anxiety was higher among COVID non-infected subjects (91.6% vs 86.6%, p = 0.04). Furthermore, COVID-19-related anxiety was higher among COVID-19-infected compared to the non-infected [17 (10-28) vs 15 (8-25), p = 0.00]. In multivariate analysis, medical comorbidities (p = 0.000), history of psychiatric illness (p = 0.002), domestic violence (p = 0.032) and obstetric complications (p = 0.000) were significant risk factors for PPD. Among the subjects who had PPD, only 35% still had depression after a year. Conclusion(s): This study provides an in-depth analysis of PPD and anxiety during the COVID-19 pandemic, the risk factors, and the long-term effects. Clinical significance: It highlights the importance of routine screening for perinatal mental health disorders and early psychiatric consultation when required.Copyright © The Author(s).
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Introduction: The COVID-19 pandemic has had a significant impact on pregnant persons' mental health. Prepandemic data reports an impact of depression, anxiety, and stress on the emotional and behavioral development of the child. Objective(s): We aimed to evaluate the impact of gestational maternal depression, anxiety, and stress during the COVID-19 pandemic on the child's cognitive development at 18 months. Method(s): The CONCEPTION study is a prospective mother-child cohort, established since June 23, 2020, during the COVID-19 pandemic. Depression and anxiety were assessed during pregnancy using validated tools in French and English (Edinburgh Postnatal Depression Scale [EPDS] and General Anxiety Disorder-7 [GAD-7]) as well as stress and antidepressant consumption. The child's cognitive development was reported by the mother using the third edition of Ages and stages questionnaires (ASQ-3) at 18 months of age. Data on other covariates were collected electronically. Multivariate linear regression models were built to assess the association between prenatal maternal depression, anxiety, stress, and child development across domains: communication, gross motor, fine motor, problem solving, and personal-social domains while adjusting for covariates. In addition, sensitivity analyses have been added like COVID-19 diagnosis. Result(s): Overall, 445 mother-child dyads were included in analyses (mean gestational age at delivery 39.2 weeks +/-1.8). Mean gestational scores were, for depression (EDPS, 7.8+/-5.4), anxiety (GAD-7, 4.4+/-4.0), and stress (4.3+/-2.1). Adjusting for potential confounders, as well as for maternal depression and anxiety during pregnancy, maternal prenatal stress was associated with communication skills (adjusted beta = 1.5, CI 95 % (0.34, 2.7)) and fine motor skills (adjusted beta = 1.06, CI 95 % (0.02, 2.6)) at 18 months age. Gestational depression, anxiety, and antidepressants use were not associated with any of the ASQ-3's domains. In addition, no significant association was found in stratified analysis for COVID-19 diagnosis. Conclusion(s): During the COVID-19 pandemic, gestational maternal stress was associated with some aspects of childhood cognitive problems, including communication and fine motor skills. Our results highlight the need to continue following-up on children until kindergarten to better understand the impact of maternal mental health during pregnancy on the child's cognitive development in the era of COVID-19.
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This study examined the prevalence and coping strategies of Postnatal Depression (PND) among mothers in Bayelsa, the state of Nigeria. The general aim was to describe the level of PND experienced by women and the methods they adopt to cope with this syndrome. This study was a cross-sectional survey of 345 women with babies between 1-6 weeks old. The women were selected purposively at health and maternity centres and clinics in Bayelsa state. A structured questionnaire was used in data collection. The data gathered were analysed using univariate, bivariate and multivariate analyses at a p=0.05 level of significance. The prevalence rate of PND ranged from mild depression (37.7%), moderate depression (3.5%) to severe depression (3.2%). There is a statistically significant relationship between socio-demographic variables and PND among mothers (p=0.000). PND prevalent among the study population exerts adverse effects on the health and cognitive development of the mother and child. However, the strategies adopted by mothers to cope with PND ranged from social support to music therapy. This study recommended that counselling of mothers during and after childbirth should be carried out as part of the routine for mothers and childcare.
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Aims: This study examines the impact of COVID-19 lockdown on postpartum mothers in England, with the aim of identifying opportunities to improve maternal experience and wellbeing. The postpartum/postnatal period is widely acknowledged as a time when mothers require greater levels of support from multiple sources. However, stay-at-home orders, commonly known as "lockdown," deployed in some countries to limit COVID-19 transmission reduced access to support. In England, many postpartum mothers navigated household isolation within an intensive mothering and expert parenting culture. Examining the impact of lockdown may reveal strengths and weaknesses in current policy and practice. Subject and methods: We conducted online focus groups involving 20 mothers living in London, England, with "lockdown babies," following up on our earlier online survey on social support and maternal wellbeing. We thematically analysed focus group transcripts, and identified key themes around Lockdown Experience and Determinants of Lockdown Experience. Results: Participants raised some positives of lockdown, including fostering connections and protection from external expectations, but also raised many negatives, including social isolation, institutional abandonment, and intense relationships within the household. Potential reasons behind variations in lockdown experience include physical environments, timing of birth, and number of children. Our findings reflect how current systems may be "trapping" some families into the male-breadwinner/female-caregiver family model, while intensive mothering and expert parenting culture may be increasing maternal stress and undermining responsive mothering. Conclusions: Facilitating partners to stay at home during the postpartum period (e.g., increasing paternity leave and flexible working) and establishing peer/community support to decentre reliance on professional parenting experts may promote positive postpartum maternal experience and wellbeing. Supplementary Information: The online version contains supplementary material available at 10.1007/s10389-023-01922-4.
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BACKGROUND: As part of the Person and Family Centred Care, involvement of relatives is a key concept. This means that an unrestricted visiting policy in hospitals wards is widely accepted and implemented. In maternity care, benefits and drawbacks of unrestricted visiting is still discussed, while it is acknowledged that a quiet environment is important for both new parents and newborns to enhance breastfeeding. The COVID-19 lockdown provided an opportunity to study how the restrictions for visitors influenced the work of maternity care staff in Denmark. OBJECTIVE: This study aimed to explore the experience of maternity care staff on how visitation restrictions for visitors influenced the care of new families in a maternity ward. METHODS: Individual interviews (n = 10) were performed between 20 November 2020 and 25 February 2021. A qualitative descriptive study was performed using thematic analysis. RESULTS: One overarching theme was identified: "Framing time to the experience of becoming a parent". Further, five sub-themes were identified and illuminated in the analysis: "Increasing confidentiality and presence", "Changing availability and space for guidance", "Welcoming peacefulness", "Being gatekeepers", and "Structuring time is caring". CONCLUSION: Restrictions for visitors influenced the care of new families because it encourages the space and place of becoming a parent. The hospital environment was shaped in a calm way, which increased the staffs' bedside time. The experience of an increased confidentiality with new parents led to in-depth conversations, making it easier to identify new parents' needs, focus on the initiation of breastfeeding, and individual guidance.
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COVID-19 , Maternal Health Services , Obstetrics , Humans , Female , Infant, Newborn , Pregnancy , Communicable Disease Control , Qualitative ResearchABSTRACT
Background: Antenatal care (ANC) services are the care provided by skilled healthcare professionals to pregnant women to ensure the best health for both mother and baby during pregnancy and after delivery. In Namibia, utilization of antenatal care services has been reported to be dropping from 97% in 2013 to 91% in 2016. Objectives: The objectives of this study were to investigate the factors affecting the utilization of ANC services. Methods: A quantitative approach and a cross-sectional analytical design were used to carry out the study. The study population was all mothers who delivered and were admitted to the postnatal ward of Intermediate Hospital Katutura and Windhoek Central Hospital during the time of the study. Data were collected from 320 participants using self-administered structured questionnaires. The data were analyzed using the Statistical Package for Social Science (SPSS) Version 25 software. Results: Participants were aged between 16 and 42 years with a mean age of 27 years. The results show that 229 (71.6%) utilized ANC while 91(28.4%) did not utilize ANC services. Factors such as the negative attitude of health care workers, long distance to and from health facilities, lack of transport money to travel to and from the health facilities, lack of knowledge regarding antenatal care, attitude towards pregnancy, and others, were found as hindrances to the utilization of antenatal care services. Participants also indicated motivators for ANC utilization such as preventing complications, knowing their HIV status, getting health education, knowing the estimated date of delivery, and identifying and treatment of medical conditions. The study reveals the higher knowledge of participants on ANC utilization, most participants have the right to make decisions and had positive attitudes toward the quality of ANC services. The level of attitude toward pregnancy was associated with the utilization of antenatal care services with an odd ratio OR=2.132; and P=0.014. Conclusions: The study identified factors that affect utilization of ANC services such as age, marital status, mother's education, partner's formal education, negative attitude toward health providers, long distance to and from ANC health care facilities, fear of HIV test and results, Covid-19 regulations, inability to determine the pregnancy at the earlier stages and financial constraints Based on this study findings, it is recommended that the utilization of ANC might be improved through effective community mobilization and outreach maternity services to educate and improve awareness on the importance of ANC.
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Researchers have found that women who deliver babies in the midst of a pandemic are more likely to have mental health consequences, including postpartum depression, and their infants are likely to suffer as well, if the stressors are not mitigated. The cohort study of 318 mothers in the United States, Australia, and the United Kingdom found that COVID‐related stress was significantly associated with poor postpartum mental health and increased negative affectivity among infants.
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Purpose of Study: Residents have experienced changes in educational structure, format, content, and patient experience due to the COVID-19 pandemic. Resident physicians across the country have reported changes in workload including a decrease in well child checks and immunizations resulting in limited clinical exposure. This study aimed to assess the confidence of first year pediatric residents (interns) in conducting routine preventive screening for children and to identify potential gaps in knowledge among this cohort. Methods Used: We conducted a cross-sectional observation study that included 13 categorical first year pediatric residents. A voluntary, anonymous online survey was administered in September 2022. The survey assessed confidence levels, and perceived comfort regarding common preventive pediatric encounters and screening tools. The survey included 7-questions based on the 4th Edition Bright Future's Guidelines and respondents rated their answers on a 5-point Likert scale. The surveys were distributed anonymously via e-mail using Survey Monkey, a web-based software platform that provided an intuitive interface for validated data capture. Participants were given 2 weeks to complete the survey and reminders were sent via email. Summary of Results: Eight of 13 interns participated for a response rate of 62%. Sixty-three percent of the residents had completed a subinternship in pediatrics. Of our respondents, 75% reported feeling "not at all confident" in executing well child check-ups for children <12months old and 63% reported feeling "very confident" in examining children> 13months old. Regarding the ability to perform a genitourinary examination in children >12years of age, 63% of respondents stated that they were "slightly" or "not at all confident". We asked interns to rate their confidence in providing anticipatory guidance to their patients. Interns perceived being somewhat confident regarding guidance about safe sex, tobacco use, and healthy lifestyles but less confident regarding newborn care, breast feeding and infant nutrition. Nearly 40% reported comfort in recommending and advising parents about the risks and benefits of age appropriate immunizations. We asked residents to report their ability in administering and interpreting screening tools (ASQ, MCAT, EPDS). Interns reported that were able to interpret results but lacked confidence in providing guidance. Conclusion(s): Our study identifies opportunities to bridge experiential knowledge gaps and confidence among pediatric interns who may have had limited clinical exposure to pediatrics following the COVID-19 pandemic. Graduate medical education programs should consider developing tailored educational interventions specifically geared for identified learning gaps to mitigate the challenges posed by the pandemic.
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Background: Few studies have evaluated postnatal depression before and during the Covid-19 pandemic using comparable data across time. We used data from three national maternity surveys in England to compare prevalence and risk factors for postnatal depression before and during the pandemic. Methods: Analysis was conducted using population-based surveys carried out in 2014 (n = 4571), 2018 (n = 4509), and 2020 (n = 4611). Weighted prevalence estimates for postnatal depression (EPDS score ≥13) were compared across surveys. Modified Poisson regression was used to estimate adjusted risk ratios (aRR) for the association between sociodemographic, pregnancy- and birth-related, and biopsychosocial factors, and postnatal depression. Findings: Prevalence of postnatal depression increased from 10.3% in 2014 to 16.0% in 2018 (difference = +5.7% (95% CI: 4.0-7.4); RR = 1.55 (95% CI: 1.36-1.77)) and to 23.9% in 2020 (difference = +7.9% (95% CI: 5.9-9.9); RR = 1.49 (95% CI: 1.34-1.66)). Having a long-term mental health problem (aRR range = 1.48-2.02), antenatal anxiety (aRR range = 1.73-2.12) and antenatal depression (aRR range = 1.44-2.24) were associated with increased risk of postnatal depression, whereas satisfaction with birth (aRR range = 0.89-0.92) and social support (aRR range = 0.73-0.78) were associated with decreased risk before and during the pandemic. Interpretation: This analysis indicates that Covid-19 had an important negative impact on postnatal women's mental health and may have accelerated an existing trend of increasing prevalence of postnatal depression. Risk factors for postnatal depression were consistent before and during the pandemic. Timely identification, intervention and follow-up are key to supporting women at risk, and it is essential that mechanisms to support women are strengthened during times of heightened risk such as the pandemic. Funding: NIHR Policy Research Programme.
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AIM: To assess the prevalence of domestic violence/intimate partner violence, aggressors, types of violence and associated factors in women who attend an antenatal and postnatal care service in a public hospital in Brazil. DESIGN: Cross-sectional study. METHODS: We interviewed women attending antenatal and postpartum care services in a Brazilian public tertiary woman's hospital in Campinas, São Paulo, between July 2019 and September 2021. Data were collected through interviewer-administered questionnaires previously used in healthcare settings: Abuse Assessment Screen (AAS); Woman Abuse Screening Tool (WAST); Hurt, Insulted, Threatened with Harm and Screamed (HITS). We evaluated the relationship between the sociodemographic characteristics of women and domestic/intimate violence using bivariate and multivariable logistic regression analyses. RESULTS: Of the 600 pregnant and postpartum women interviewed, 138 (23%) had suffered any abuse. Some participants disclosed physical violence during pregnancy (2.3%) and during the last 12 months (5.3%). The partner was identified as the main aggressor in most of the cases (60%). When women had a partner, 3.5% reported domestic violence and 6.7% disclosed intimate partner violence during pregnancy or postpartum period. Women with non-white skin colour (OR = 1.53; 95% CI 1.01-2.34; p = .048), gestational age ≤ 13 weeks (OR = 3.41; 95% CI 1.03-11.25; p = .044) and in postpartum period (OR = 2.81; 95% CI 1.32-5.99; p = .008) were more likely to experience domestic violence at some time in their lives. Women interviewed before the COVID-19 pandemic were more likely to disclose that they had suffered any abuse. CONCLUSION: Experience of violence during pregnancy and postpartum period was more frequent in women with non-white skin colour, in their first gestational trimester and in the postpartum period, and was more reported before the COVID-19 pandemic. Antenatal and postpartum care services could be safe places to support violence survivors. IMPACT: Pregnant and postpartum women are a vulnerable group to experiencing domestic violence/intimate partner violence. Violence can negatively affect women's and children's health and well-being. Antenatal and postpartum care should be considered as a moment to routinely inquiry women about past and current violence experiences. Regular contact among healthcare professionals and women during this period offers a window of opportunities for implementing psychosocial interventions among women at risk of violence. Healthcare providers (i.e., physicians, psychologists, social workers, nurses and midwives) have an important role in identifying survivors, offering support and providing quality information to women.
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The proceedings contain 71 papers. The topics discussed include: experience of learning human anatomy and histology during COVID-19 pandemic in Kharkiv National Medical University;using musculoskeletal modelling to investigate the functional significance of craniofacial form variation within the genus homo;a morphometric analysis of the cranial fossae in patients with scaphocephaly;exploring the thalamus in young adolescents with psychotic experiences;to replace or not replace that is the question: addressing fate decisions during minipig tooth replacement;anatomy of termination of popliteal artery: a multidetector CT angiographic study;anatomical variation between populations of British red squirrels: the potential impact of supplementary feeding;revealing the biomechanics of the masticatory muscles in the eastern grey squirrel (Sciurus carolinensis) using multibody dynamics analysis;and myoepithelial and immune cell dynamics in the ovine mammary gland during postnatal development.
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Background: Following the pandemic caused by the Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2), and considering its capacity for rapid mutation, there have been many studies and articles on this novel coronavirus over the past three years. Therefore, providing knowledge and directions for management of SARS-CoV-2, for hospital staff is crucial. Hence, we collected the research information from different perspectives and summarized the guidelines for perinatal care on the topic of SARS-CoV-2, and for possible future viral pandemics. Method(s): A systematic review aimed at assessing the publications written in English and Chinese, offering different perspectives on the topic of perinatal care concerning SARS-CoV-2, was conducted using PubMed and Google Scholar from 2020 to 2022. In addition, we summarized the guidelines from the Taiwan Association of Obstetrics and Gynecology, American College of Obstetricians and Gynecologists, Society for Maternal-Fetal Medicine, Maternal Immunization Task Force and Partners, and Academy of Breastfeeding Medicine. Result(s): Due to physiological changes, pregnant patients may be prone to have complications, especially pre-eclampsia, affecting morbidity and mortality. Most neonates of coronavirus disease (COVID-19) infected mothers did not show any clinical abnormalities due to the infection. However, compared to the general population, infected neonates needed more invasive ventilation care, while the proportion of asymptomatic neonates was less than that in the general population. Further, long term complications are still under investigation. Evidence of vertical transmission via the placenta and umbilical cord is rare but not absent. Paxlovid (nirmatrelvir/ritonavir) can be administered to patients with comorbidities, and indications for cesarean delivery does not include COVID-19 infection. Vaccination against COVID-19 should not be delayed during pregnancy and lactation. Conclusion(s): Obstetricians and gynecologists should pay more attention to pregnant women with SARS-CoV-2 because of the physiological changes and higher risks of complications, morbidity, and mortality. Early prevention with vaccination in pregnant women is the key to controlling the COVID-19 pandemic, from which we can learn how to manage the next pandemic.Copyright © 2023 The Author(s).
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Background: Infections during pregnancy can increase the risk for neurodevelopmental disorders in offspring. This study aimed to prospectively monitor children exposed in utero to SARS-CoV-2 from birth to 15 years of age with a secondary aim to identify biomarkers of neurodevelopmental impairments. Method(s): Women infected with SARS-CoV-2 during pregnancy and sociodemographic and age matched non-exposed women were recruited from Monash Health, Australia (N=112 mother-infant dyads). Demographics, biospecimens and clinical data are collected at multiple time points from birth-15 years using standardised sample collection and neurological and behavioural scales. We present here the birth data. Result(s): Mother-infant dyads are classified as;non-exposed, mild SARS-CoV-2 (limitation of activities) and severe SARS-CoV-2 (hospitalised). Edinburgh postnatal depression scale scores were significantly higher in severe SARS-CoV-2 vs. non-exposed mothers (p<0.05). Maternal attachment scores were unchanged. Hammersmith neonatal neurological assessment scores were unchanged across groups, as were anthropometric measures. Severe SARS-CoV-2 exposed infants had lower scores on the sensory profile 2 questionnaire auditory domain than non-exposed infants (p<0.05). Analysis of infant buccal DNA (Illumina MethylationEPIC BeadChip >850,000 CpGs, N=8) showed hypomethylation of the gene AFAP-1 (q value<0.0008), and hypermethylation of neurodevelopmental pathways;'dendrite morphology' and 'axogenesis' in SARS-CoV-2 infants vs. non-exposed. Conclusion(s): While most assessments show no group differences thus far, the severe SARS-CoV-2 exposed group are faring worse in terms of maternal mental health, infant auditory domains and infant hypermethylation of genes belonging to neurodevelopmental pathways. Follow up assessments at 1-15 years will inform as to whether these initial group differences are early signs of more severe neurodevelopmental outcomes. Funding Source: Other - One in Five Philanthropic organisation Keywords: SARS-CoV-2, Pregnancy, DNA methylation, in utero, Neurodevelopmental trajectoriesCopyright © 2023
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Background: Maternal and child health (MCH) services have been affected by the Coronavirus disease (COVID-19) pandemic in all countries, including Indonesia. Information regarding the impact of COVID-19 on MCH service access and provision is limited, particularly in the context of rural Indonesian communities. This study aimed to explore the experiences of Indonesian mothers and midwives from a rural regency regarding MCH services delivery during the pandemic. Methods: This study was a sub-study of a pre-existing cohort study conducted in four sub-districts in Banggai, Indonesia, as the qualitative research. This study was conducted from November 2020 to April 2021, involving 21 mothers and six midwives. We selected the participants using snowball sampling. In-depth interviews were conducted in Bahasa. The study used both deductive and inductive approaches for analysis. Data analysis was performed using NVivo v.12. Results: The study identified three themes and eight sub-themes from the analysis incorporating the midwives' and mothers' data. The themes included health service change, perceived barriers to service delivery, and family impact. This study highlights health service changes due to the pandemic, such as relocating the MCH services. Mothers perceived barriers to accessing health services, including distance reasons and fear of COVID-19. Only the shortages of staff affected the midwives in providing optimal services. Conclusion: The pandemic triggered health service changes and caused some barriers to service delivery. This study recommends that the local government and stakeholders should pay more attention to the health service changes according to the mothers' experiences and address barriers to optimize access to MCH services during the pandemic.