Maternity care changes and postpartum mental health during the COVID-19 pandemic: a Spanish cross-sectional study.

BACKGROUND: The coronavirus disease 2019 (COVID-19) pandemic led to abrupt changes in maternity care, but the impact of these changes has not yet been deeply evaluated. This study aimed to assess the impact of the unexpected changes in maternity care due to the COVID-19 pandemic on postpartum mental health (depression, anxiety and posttraumatic stress disorder). METHODS: A cross-sectional, web-based study was conducted in Spain during the second half of 2020. The eligibility criteria were women≥18 years with a child≤6 months. The Edinburgh Postnatal Depression Scale (EPDS), the Generalized Anxiety Disorder-7 Screener (GAD-7) and a subset of the PTSD checklist (PCL-5) were used to assess postpartum mental health. Information regarding sociodemographic characteristics and maternity care changes was collected, and multivariate regression models were used. RESULTS: Among 1781 participants, 29.3% and 33% had clinically significant depressive and anxiety symptoms, respectively. The most prevalent unexpected changes reported were related to the exclusion of supportive relatives during birth and postpartum. Changes reported during birth showed a minor association with PTSD symptomatology, and those that occurred during the postpartum period were associated with clinical depression, anxiety and PTSD symptoms. CONCLUSIONS: The unexpected changes in maternity care due to the COVID-19 pandemic, especially those that occurred during the postpartum period, increased the risk of mental health problems.

La fotografía y el duelo perinatal. Revisión de la literatura / Photography and perinatal grief. Literature review

Objetivo: Analizar el uso de la fotografía como intervención profesional de las matronas ante una pérdida perinatal, y su impacto en el proceso de duelo de las parejas atendidas. Metodología: Revisión bibliográfica en cinco bases de datos (PubMed, Scopus, Medline, CUIDEN y Cuidatge) y páginas web de asociaciones de madres en duelo españolas. Resultados: De los 169 artículos iniciales, 10 fueron seleccionados según los criterios de inclusión propuestos. Los artículos muestran que la fotografía puede constituir un recuerdo positivo de los momentos vividos con la criatura fallecida. Conclusiones: La fotografía puede utilizarse como recurso de apoyo al tránsito de la familia en su duelo perinatal. Estos recursos están influenciados en gran medida por el contexto sociocultural; se necesita más investigación sobre el impacto que pueden tener en la salud mental materna. La matrona puede ser una profesional referente en la realización de las fotografías, si cuenta con la formación necesaria. (AU)

Objective: To analyse the use of photography in miscarriage and stillbirth by midwives, and their impact on couples who suffer the death of a baby. Methodology: We conducted a literature review in 5 databases (PubMed, Scopus, Medline, CUIDEN and Cuidatge), and web sites of mothers’ in grief Spanish associations. Results: 169 papers were identified, only 10 articles met all requirements and were included in the review. The studies analysed show photography could offer a positive memento for parents. Conclusions: Pictures could end up to be a positive memento for parents. Rituals are greatly influenced by the social and cultural background. More evidence is needed to determine the impact care has on maternal mental health. Midwives can aid the pictures’ taking. (AU)

Quantification and Progress Over Time of Specific Antibodies Against Severe Acute Respiratory Syndrome Coronavirus 2 in Breast Milk of Lactating Women Vaccinated With BNT162b2 Pfizer-BioNTech Coronavirus Disease 2019 Vaccine (LacCOVID).

Background: Several observational studies demonstrated the passage of postvaccine antibodies through breast milk in women vaccinated against coronavirus disease 2019 (COVID-19), mostly with messenger RNA (mRNA)-based vaccines, but lacked long-term data. Methods: A 6-month prospective cohort study was performed to determine severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccine-induced antibody levels in the breast milk of 33 lactating healthcare workers at different timepoints after mRNA BNT162b2 Pfizer-BioNTech COVID-19 vaccination. Moreover, we examined the correlation of SARS-CoV-2 antibody levels between serum and breast milk, adverse events related to vaccination, and rate of SARS-CoV-2 infections. Results: Mothers' median age was 38 (interquartile range [IQR], 36-39) years and 15 (IQR, 10-22) months for infants. Median (IQR) SARS-CoV-2 immunoglobulin G (IgG) spike protein subunit S1 (S1) vaccine-induced levels at different timepoints for serum-milk pairs were 519 (234-937) to 1 (0-2.9) arbitrary units (AU)/mL at 2 weeks after first dose and 18 644 (9923-29 264) to 78 (33.7-128), 12 478 (6870-20 801) to 50.4 (24.3-104), 4094 (2413-8480) to 19.9 (10.8-51.9), 1350 (831-2298) to 8.9 (7.8-31.5) AU/mL at 2, 4, 12 and 24 weeks after second dose, respectively. We observed a positive correlation of antibody levels between serum and breast milk, no serious adverse events related to vaccination, and 2 (6%) COVID-19 vaccine breakthrough infections. Conclusions: Women vaccinated with Pfizer-BioNTech transmit antibodies into breast milk with a positive correlation with serum levels. Both decreased over time in a 6-month follow-up.

Experiencia acerca del traslado de un hospital general y su repercusión en la actividad asistencial / Experience of the moving day of a general hospital and effect on clinical activity

Objetivos Describir el proceso del día del traslado de un hospital general. Analizar el impacto en la actividad asistencial en los primeros meses después del traslado. Método Hospital general de ámbito comarcal, en Cataluña, que se traslada a un nuevo edifico. Se describe el proceso del traslado de los pacientes y se analiza el impacto en la actividad (se comparan 3 meses a partir del traslado [período 2] con los mismos meses del año anterior [período1]).Resultados Se trasladaron 37 pacientes sin incidencias. Se atendieron 18.786 urgencias en el período 1 y 21.266 en el período 2 (+13,2%). El número de ingresos urgentes/programados fue de 1314/803 en el período 1 y de 1427/979 en el período 2 (+8,59%/+21,91%). Las visitas realizadas en consultas externas fueron 32.116 en el período 1 y 30.777 en el período 2 (-4,16%)Conclusiones Una adecuada planificación y coordinación permitió realizar un traslado de hospital sin incidencias y sin reducir la actividad asistencial(AU)

Objectives To describe the moving day of a general hospital and to analyze the impact on clinical activity in the first few months after the move. Methods We describe the process of patient transfer and analyze the impact on activity of moving a regional general hospital in Catalonia (Spain) to a new building. Activity was compared in two periods: the first 3 months after the move (period 2) and the same 3 months in the previous year (period 1).Results We moved 37 patients without incidents. A total of 18,786 patients were admitted to the emergency room in period 1 and 21,266 were admitted in period 2 (+13.2%). The number of admissions from the emergency room vs elective admissions was 1,314/803 in period 1 and 1,427/979 in period 2 (+8.59%/ +21.91%). The number of outpatient visits in period 1 was 32,116 and 30,777 in period 2 (-4.16%).Conclusions Proper planning and coordination allowed the hospital to be moved without incidents and without decreasing activity(SU)

[Experience of the moving day of a general hospital and effect on clinical activity]. / Experiencia acerca del traslado de un hospital general y su repercusión en la actividad asistencial.

OBJECTIVES: To describe the moving day of a general hospital and to analyze the impact on clinical activity in the first few months after the move. METHODS: We describe the process of patient transfer and analyze the impact on activity of moving a regional general hospital in Catalonia (Spain) to a new building. Activity was compared in two periods: the first 3 months after the move (period 2) and the same 3 months in the previous year (period 1). RESULTS: We moved 37 patients without incidents. A total of 18,786 patients were admitted to the emergency room in period 1 and 21,266 were admitted in period 2 (+13.2%). The number of admissions from the emergency room vs elective admissions was 1,314/803 in period 1 and 1,427/979 in period 2 (+8.59%/ +21.91%). The number of outpatient visits in period 1 was 32,116 and 30,777 in period 2 (-4.16%). CONCLUSIONS: Proper planning and coordination allowed the hospital to be moved without incidents and without decreasing activity.