Depressive symptoms and mental representations in a sample of pregnant Italian women during COVID-19: comparison of primipara and multipara

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.

Parent-Infant Skin-to-Skin Contact and Stress Regulation: A Systematic Review of the Literature

Several studies have focused on neonatal maternal separation (MS) to investigate behavioural and neuroendocrine reactions to lack of contact, but only a few have focused on early separation in the first days or weeks after birth. This literature review investigates the vital importance of contact and touch by exploring how skin-to-skin contact (SSC) regulates stress in the mother-infant relationship. Various databases such as PubMed, Scopus, and ScienceDirect were searched for literature published between 2015 and 2020. From 1141 articles, 22 were declared eligible. The reviewed articles showed how SSC regulates child stress by biological indicators such as the autonomic nervous system (ANS), heart rate variability (HRV), cortisol, and oxytocin. This research concludes the importance of SSC for stress regulation, especially during the COVID-19 pandemic. With no research to date indicating a possible risk of neonatal COVID-19 transmission following SSC, SSC should continue to be practiced for all women, as recommended by the WHO.