Development of a Predictive Model for Skin-to-Skin Contact Immediately after Birth: A Cross-Sectional Study.

The aim of this study was to develop and validate a predictive model for the establishment of skin-to-skin contact immediately after birth. A descriptive cross-sectional study was conducted during the last trimester of 2022 and the first trimester of 2023 with women who had given birth in Spain. A questionnaire containing sociodemographic, psychosocial, and health variables referring to the mother and the newborn, as well as the Bond and Attachment questionnaire (VAMF, for its name in Spanish) for the analysis of the mother-child bond and attachment, were administered. A multivariate analysis was performed, and areas under the ROC curve (AUC) with their 95% confidence intervals (CI) and the predictive characteristics of these models were estimated. In total, 1077 women participated. The prevalence of early skin-to-skin contact after delivery was 50.2% (468) in the derivation cohort and 49.8% (464) in the validation cohort. Multivariate analysis showed that prematurity, type of delivery, and birth experience were statistically significant, so they were included in the model (p ≤ 0.05). The predictive ability (AUC ROC) was good in both the derivation cohort, yielding 0.92 (95% CI: 0.89-0.95), and in the validation cohort, yielding 0.89 (95% CI: 0.85-0.93). This study developed a predictive model identifying factors facilitating early skin-to-skin contact between a mother and her newborn immediately after birth.

Factors related to a disturbance in the mother-child bond and attachment.

INTRODUCTION: Establishing an adequate bond and attachment between a mother and child is essential for preventing pathologies and developing this relationship in the future. PURPOSE: To identify the factors related to a disturbance of the mother-child bond or attachment. METHODS: A cross-sectional descriptive study was carried out with women with a biological child between 6 weeks and 18 months of age. The Mother-Child Bond-Attachment Questionnaire (VAMF, for its name in Spanish) was administered to measure the bond and postnatal attachment together with a questionnaire containing sociodemographic, psychosocial, and health variables referring to the mother and the newborn. RESULTS: 1114 women participated. The multivariate analysis showed that skin-to-skin contact (aOR = 0.58; 95% CI: 0.37, 0.90) and breastfeeding (aOR = 0.55; 95% IC: 0.35, 0.86) reduce the probability of presenting a bond disturbance. Anxiety during pregnancy, childbirth, and the puerperium (aOR = 3.95; 95% CI: 2.57, 6.05) and postpartum complications (aOR = 1.60; 95% CI: 1.03, 2.48) increase the chance of having a bond disturbance. Skin-to-skin contact (aOR = 0.61; 95% CI: 0.38, 1.00), breastfeeding (aOR = 0.47; 95% CI: 0.27, 0.80,) and an older age of the infant (months) (aOR = 0.77: 95% CI: 0.72, 0.82) reduces the probability of presenting an attachment disturbance. CONCLUSIONS: Skin-to-skin contact and breastfeeding are associated with a lower probability of impaired bonding and attachment. Anxiety states during pregnancy, childbirth, and the puerperium, and complications after childbirth increase the probability of developing a bond disorder. The older the age of the infant, the lower the frequency of having an impaired attachment. IMPLICATIONS TO PRACTICE: Identifying the factors associated with the establishment of the mother-child bond and attachment is essential for the development of prevention strategies and early identification of cases that may present alterations and avoid their consequences on the health of the mother and child.

Miastenia gravis y maternidad / Myasthenia gravis and pregnancy

OBJETIVOS: Conocer el imaginario de las mujeres embarazadas sobre la maternidad. MATERIAL Y MÉTODO: Estudio llevado a cabo con metodología cualitativa. La información se generó mediante entrevistas semiestructuradas y se realizó un análisis sociológico de los discursos. Los sujetos de estudio fueron 10 mujeres embarazadas de 36-37 semanas de gestación. Se atendió a los aspectos éticos y legales. RESULTADOS: La decisión de ser madre es, en ocasiones, poco explícita: la maternidad aparece como destino femenino, enaltecida por ser fuente de nuevas experiencias y satisfacciones, pero también relacionada con un aumento de las obligaciones y las responsabilidades, con las consiguientes repercusiones en la vida personal y laboral. Las mujeres expresan inseguridad e incertidumbre ante el nuevo papel requerido: el de madre. El instinto maternal aparece en el imaginario de las mujeres, pero no el paternal. CONCLUSIONES: La fuerte asociación entre maternidad e identidad femenina en el orden cultural y simbólico hegemónico actúa como motor en la decisión de ser madre. El instinto maternal aparece en el imaginario de las mujeres para dar una explicación naturalista al rol de madre. Surge la preocupación acerca de las estrategias necesarias para conciliar la vida laboral con la familiar: las renuncias laborales están relacionadas con la naturalización del rol de madre. La maternidad es una experiencia individual contextualizada en un entorno social, cultural, histórico, económico y laboral. Estudiar las creencias y los valores de una sociedad androcéntrica nos permitirá conocer las interacciones que se dan en ella, y reconocer a las mujeres como agentes capaces de construir nuevos significados. Una madre no nace, se hace

OBJECTIVES: To know how pregnancy, delivery and postpartum period are affected by myasthenia gravis and to analyze the management of the disease during this period. METHODS: A bibliographic search has been done in CINAHL, PubMed, Science Direct, Scopus, Proquest, Lilacs, Scielo, Cochrane Plus, Cuiden Plus and IME databases. RESULTS: We have chosen 40 articles. Myasthenia in pregnancy is associated to an increased risk of preterm delivery, premature ruptured membranes and neonatal mortality. Instrumental labor is recommended to avoid maternal weakness. Breastfeeding is not contraindicated if maternal disease is well-controlled. CONCLUSIONS: Myasthenia gravis increases the risk of complications during this period. Pregnancy has to be planned in advance. Fetal monitoring is essential