Breastfeeding experiences during the COVID-19 pandemic in Spain:a qualitative study.

BACKGROUND: The pandemic caused by COVID-19 has affected reproductive and perinatal health both through the infection itself and, indirectly, as a consequence of changes in medical care, social policy or social and economic circumstances. The objective of this study is to explore the impact of the pandemic and of the measures adopted on breastfeeding initiation and maintenance. METHODS: A qualitative descriptive study was conducted by means in-depth semi-structured interviews, until reaching data saturation. The study was conducted between the months of January to May 2021. Participants were recruited by midwives from the Primary Care Centres of the Andalusian provinces provinces of Seville, Cádiz, Huelva, Granada, and Jaén. The interviews were conducted via phone call and were subsequently transcribed and analysed by means of reflexive inductive thematic analysis, using Braun and Clarke's thematic analysis. RESULTS: A total of 30 interviews were conducted. Five main themes and ten subthemes were developed, namely: Information received (access to the information, figure who provided the information), unequal support from the professionals during the pandemic (support to postpartum hospitalization, support received from Primary Health Care during the postpartum period), social and family support about breastfeeding (support groups, family support), impact of confinement and of social restriction measures (positive influence on breastfeeding, influence on bonding with the newborn), emotional effect of the pandemic (insecurity and fear related to contagion by coronavirus, feelings of loneliness). CONCLUSION: The use of online breastfeeding support groups through applications such as WhatsApp®, Facebook® or Instagram® has provided important breastfeeding information and support sources. The main figure identified that has provided formal breastfeeding support during this period was that of the midwife. In addition, the social restrictions inherent to the pandemic have exerted a positive effect for women in bonding and breastfeeding, as a consequence of the increase in the time spent at their homes and in the family nucleus co-living.

Effects of cognitive-behavioural therapy for stress management on stress and hair cortisol levels in pregnant women: A randomised controlled trial.

OBJECTIVE: To demonstrate the effectiveness of a cognitive behavioural therapy for stress management in pregnant women in the reduction of psychological stress and hair cortisol levels. METHODS: The trial was controlled and randomised, with a total of 78 pregnant women: control group (n-39) and Cognitive Behavioural Therapy group (n-39). To test the therapy's efficacy, an evaluation of the primary outcome (hair cortisol levels) and secondary outcomes (psychological stress, psychopathological symptomatology and resilience) was conducted before and after the treatment. The therapy was conducted during 8 sessions (one per week) in a group setting. The study was registered as a Randomised Controlled Trial with the code NCT03404141. RESULTS: The results showed a group time interaction between hair cortisol levels, psychological stress (perceived and pregnancy-specific), and in the exacerbation and severity of psychopathological symptoms. These variables presented reductions after treatment only in the Cognitive Behavioural Therapy group. CONCLUSIONS: Using a novel way of assessing chronic stress (psychological and objective measures as hair cortisol levels), this is the first study that has shown a decrease in both the levels of cortisol in hair and in psychological stress. This decline could have implications for maternal and fetal health.

[May pregestational body mass index be related to mother's psychological and physical condition during pregnancy?] / ¿Puede el índice de masa corporal pregestacional relacionarse con el estado psicológico y físico de la madre durante todo el embarazo?

INTRODUCTION: pregestational Body Mass Index (BMI) affects mother's health during and after pregnancy and is related to negative outcomes such as low birth weight and preterm birth. Higher pregestational BMI may increase anxiety, stress and depression. OBJECTIVES: to assess potential differences on stress, psychopathological symptoms and physiological variables during pregnancy, among pregnant women with normal pregestational BMI rates and high pregestational BMI rates. METHODS: a sample of 156 pregnant women were longitudinally assessed during the three trimesters of pregnancy. They were divided into two groups: a group with normal pregestational BMI rates (n = 115) and a group with high pregestational BMI rates (n = 41). Stress levels, psychopathological symptoms, blood pressure and glucose blood levels were assessed. RESULTS: in the first trimester, significant differences were found between groups regarding pregnancy-specific stress and some of the SCL-90-R subscales (depression, paranoid ideation and global wellness index). In the second trimester, there were differences regarding pregnancy-specific stress and some of the SCL-90-R subscales (somatization, obsessive-compulsive, interpersonal sensitivity, depression, anxiety, paranoid ideation and the general scales, global wellness index and symptoms free). In the third trimester, there were differences between groups regarding perceived stress and some of the SCL-90-R subscales (somatization, anxiety and the general scale symptoms free). Significant differences were found between groups on diastolic blood-pressure in the first trimester, and systolic and diastolic blood-pressure in the third trimester. CONCLUSIONS: higher pregestational BMI is related to higher psychological stress, higher psychopathological symptoms and elevated blood-pressure during pregnancy.

¿Puede el índice de masa corporal pregestacional relacionarse con el estado psicológico y físico de la madre durante todo el embarazo? / May pregestational body mass index be related to mother's psychological and physical condition during pregnancy?

Introducción: el índice de masa corporal (IMC) pregestacional afecta a la salud de la madre durante y después del embarazo, y se relaciona con un aumento del riesgo a sufrir diabetes gestacional, preeclampsia o muerte fetal. Además, el IMC pregestacional elevado aumenta los niveles de ansiedad, estrés y depresión, lo que conlleva al aumento de riesgo de aborto, bajo peso al nacer y prematuridad. Objetivos: comprobar si existen diferencias en estrés, síntomas psicopatológicos y variables fisiológicas durante el embarazo, entre embarazadas con IMC pregestacional normal e IMC pregestacional elevado. Métodos: han participado 156 mujeres embarazadas evaluadas longitudinalmente durante los tres trimestres de embarazo divididas en dos grupos: grupo con IMC pregestacional normal (n = 115) y grupo con IMC pregestacional elevado (n = 41). Se midieron niveles de estrés, síntomas psicopatológicos, hipertensión y glucosa. Resultados: los resultados mostraron que existían diferencias estadísticamente significativas entre los dos grupos en estrés específico del embarazo y en las subescalas del SCL-90-R: depresión, ideación paranoide y la escala de síntomas generales en el primer trimestre; en el segundo trimestre, en estrés específico del embarazo y subescalas (somatizaciones, obsesión compulsión, sensibilidad interpersonal, depresión, ansiedad, ideación paranoide y en las escalas generales; y en estrés percibido) y las subescalas somatizaciones, ansiedad y en la escala SP en el tercer trimestre. También se encontraron diferencias entre ambos grupos en tensión arterial diastólica en el primer trimestre, y en tensión arterial sistólica y diastólica en el tercer trimestre. Conclusiones: el IMC pregestacional elevado se relaciona con mayor estrés psicológico y con síntomas psicopatológicos y fisiológicos durante el embarazo

Introduction: pregestational Body Mass Index (BMI) affects mother's health during and after pregnancy and is related to negative outcomes such as low birth weight and preterm birth. Higher pregestational BMI may increase anxiety, stress and depression. Objectives: to assess potential differences on stress, psychopathological symptoms and physiological variables during pregnancy, among pregnant women with normal pregestational BMI rates and high pregestational BMI rates. Methods: a sample of 156 pregnant women were longitudinally assessed during the three trimesters of pregnancy. They were divided into two groups: a group with normal pregestational BMI rates (n = 115) and a group with high pregestational BMI rates (n = 41). Stress levels, psychopathological symptoms, blood pressure and glucose blood levels were assessed. Results: in the first trimester, significant differences were found between groups regarding pregnancy-specific stress and some of the SCL-90-R subscales (depression, paranoid ideation and global wellness index). In the second trimester, there were differences regarding pregnancy-specific stress and some of the SCL-90-R subscales (somatization, obsessive-compulsive, interpersonal sensitivity, depression, anxiety, paranoid ideation and the general scales, global wellness index and symptoms free). In the third trimester, there were differences between groups regarding perceived stress and some of the SCL-90-R subscales (somatization, anxiety and the general scale symptoms free). Significant differences were found between groups on diastolic blood-pressure in the first trimester, and systolic and diastolic blood-pressure in the third trimester. Conclusions: higher pregestational BMI is related to higher psychological stress, higher psychopathological symptoms and elevated blood-pressure during pregnancy

Hair cortisol levels, psychological stress and psychopathological symptoms as predictors of postpartum depression.

Postpartum depression affects a huge number of women and has detrimental consequences. Knowing the factors associated with postpartum depression during pregnancy can help its prevention. Although there is evidence surrounding behavioral or psychological predictors of postpartum depression, there is a lack of evidence of biological forecasters. The aim of this study was to analyze the sociodemographic, obstetric, and psychological variables along with hair cortisol levels during the first, second, and third trimesters of pregnancy that could predict postpartum depression symptoms. A sample of 44 pregnant women was assessed during 3 trimesters of pregnancy and the postpartum period using psychological questionnaires and hair cortisol levels. Participants were divided into 2 groups: a group with postpartum depression symptoms and a group with no postpartum depression symptoms. Results showed significant positive differences between groups in the first trimester regarding the Somatization subscale of the SCL-90-R (p < .05). In the second trimester, significant differences were found in the Somatization, Depression, Anxiety, and GSI subscales (p < .05). In the third trimester significant differences between both groups were found regarding pregnancy-specific stress. We found significant positive differences between groups regarding hair cortisol levels in the first and the third trimester. Hair cortisol levels could predict 21.7% of the variance of postpartum depression symptoms. In conclusion, our study provided evidence that psychopathological symptoms, pregnancy-specific stress, and hair cortisol levels can predict postpartum depression symptoms at different time-points during pregnancy. These findings can be applied in future studies and improve maternal care in clinical settings.

[Effect of soybeans and soy sauce on vasomotor symptoms during menopause]. / Efectos de la soja en los síntomas vasomotores de la menopausia.

During menopause, some women experience symptoms which can interfere with their living quality. Some of these symptoms are the so-called vasomotor symptoms which include suffocations, hot flashes, and nocturnal sweats. Up to now, the most effective remedy was hormone treatment, but a study of isoflavines, such as soybean, suggests it is possible to alleviate the disturbances caused by menopause. Due to this study we consider that the addition of isoflavines can provide benefits to women. Therefore, it is correct to include them in the field of medicines which give an alternative to estrogen therapy. However, one must bear in mind that data about the efficiency and security of alternative medicines in the treatment of menopause symptoms are not conclusive since each woman is unique and it is necessary to have consensus on an individualized health plan which permits one to carry out adequate therapeutic adjustments in accordance to the needs which occur over the entire menopause process.

Efectos de la soja en los síntomas vasomotores de la menopausia / Effect of soybeans and soy gauce on vasomotor symptoms during menopause

Durante la etapa de la menopausia, algunas mujeres experimentan sfntomasque pueden interferir con su calidad de vida. Algunos, los llamados vasomotores, incluyen sofocos y sudores nocturnos. Hasta ahora, el tratamiento con hormonas era el remedio más efectivo, pero el estudio de las Isoflavonas, como la soja, sugiere la posibilidad de aliviar los trastornos propios del climario. Tras el estudio realizado consideramos que el aporte en la dieta de ispflavonas puede ofrecer beneficios a las mujeres, por lo que es acertado incluirlos en el campo de los medicamentos alternativos a la terapia estrogénica. Si bien hay que tener presente que los datos sobre eficacia y seguridad de la mediana alternativa en el tratamiento de los síntomas menopaúsicos no son concluyentes, dado que cada mujeres única y resulta necesario consensuar un plan de salud individual que permita realizar los ajustes rapéuticos adecuados a las necesidades que surján, a lo largo del tiempo, durante su climaterio

During menopause, some women experience symptoms which can interfere with their living quality. Some of these symptoms are the so-called vasomotor symptoms which includes suffocations, hot flashes, and nocturnal sweats. Up to now, the most effective remedy was hormone treatment, but a study of isoflavines, such as soybean, suggests it is possible to alleviate the disturbances caused bymenopause. Due to this study, we consider that the addition of isoflavines can provide benefits to women. Therefore, it is correct to include them in the field of medicines which give an alternative to estrogen therapy. However, one must bear in mind that data about the efficiency and security of alternative medicines in the treatment of menopause symptoms are not conclusive since each woman is unique and it is necessary to have consensus on an individualized health plan which permits one to carry out adequate therapeutic adjustments in accordance to the needs which occur over the entire menopause process