Maternal Anxiety Scores Research Articles

The association between maternal depression and anxiety symptoms during pregnancy and child sleep patterns at age 3years.

Childhood sleep problems are common and impact physical and emotional health. Prior work suggests that prenatal maternal depression and anxiety associate with disturbed child sleep in infancy. The current study evaluated whether these same associations extend to children at 3years of age, and if so, whether the timing of symptoms in pregnancy is relevant. This study included 490 mother-child dyads from the Ontario Birth Study. The dependent variables included child sleep latency, total sleep duration and nighttime awakenings at 3years of age assessed via maternal reports. The main independent variables were maternal depressive and anxiety symptoms assessed using the Patient Health Questionnaire at 12-16 and 28-32weeks of pregnancy. We used linear regressions to evaluate the predictive value of maternal symptoms on each sleep measure. After controlling for potential confounding variables including maternal depression and anxiety scores at the time of the sleep assessments, there was a robust association between maternal depressive symptoms at 28-32weeks of pregnancy and the number of child awakenings at age 3 (t=3.08, p=.002). No significant associations between maternal prenatal anxiety and child sleep patterns were found in the multivariate analyses. During weeks 28-32 of pregnancy, fetal exposure to maternal symptoms of depression associates with increased child awakenings at age 3years. These results were not attributable to reporting bias related to maternal affective symptoms at the time of the sleep assessments. These findings point to a possible fetal programming effect on sleep that continues into the pre-school years.

Effect of Informative Cesarean Delivery Operative Steps Video on Maternal Anxiety Level: A Randomized Controlled Trial

Background Cesarean section is the most common obstetric procedure performed. This can lead to maternal anxiety, which is a significant contributor to postpartum depression. This can adversely affect pregnant women both mentally and emotionally, negatively impacting their well-being and family bonding. The aim of this study was to evaluate the effect of the addition of an informative cesarean section operative steps video on the maternal anxiety score compared with standard pre-cesarean section care. Methods This randomized controlled trial was conducted at Thammasat University Hospital, Thailand, between April and September 2023. Pregnant women who underwent their first cesarean section were allocated to two groups: intervention and control groups. Participants in the intervention group were required to watch a 5-minute informative video that elaborately described the process from pre-operative steps until post-operative care on the day scheduled for cesarean delivery. All participants received the same routine pre-operative and post-operative care. The State-Trait Anxiety Inventory (STAI) was used to measure both populations on two occasions: the day of scheduled cesarean delivery and postpartum day 1. Results A total of 178 women were recruited. The demographic and obstetric characteristics were similar between the two groups. The pre-operative STAI scores of the intervention and control groups were 42.9 and 44.1 points, respectively, with no significant difference. However, the post-operative anxiety score showed a significant decline in the intervention group compared to that in the control group (p = 0.002). Moreover, most of the participants in the intervention group showed a low level of anxiety after the operation, while half of the control group remained at a moderate to high level score. Conclusions The provision of an informative educational video before cesarean delivery is a powerful tool that significantly reduces cesarean operative anxiety and improves health outcomes. Thai Clinical Trials Registry on the 28 March 2023 (TCTR20230328001).

Effect of Informative Cesarean Delivery Operative Steps Video on Maternal Anxiety Level: A Randomized Controlled Trial

Background Cesarean section is the most common obstetric procedure performed. This can lead to maternal anxiety, which is a significant contributor to postpartum depression. This can adversely affect pregnant women both mentally and emotionally, negatively impacting their well-being and family bonding. The aim of this study was to evaluate the effect of the addition of an informative cesarean section operative steps video on the maternal anxiety score compared with standard pre-cesarean section care. Methods This randomized controlled trial was conducted at Thammasat University Hospital, Thailand, between April and September 2023. Pregnant women who underwent their first cesarean section were allocated to two groups: intervention and control groups. Participants in the intervention group were required to watch a 5-minute informative video that elaborately described the process from pre-operative steps until post-operative care on the day scheduled for cesarean delivery. All participants received the same routine pre-operative and post-operative care. The State-Trait Anxiety Inventory (STAI) was used to measure both populations on two occasions: the day of scheduled cesarean delivery and postpartum day 1. Results A total of 178 women were recruited. The demographic and obstetric characteristics were similar between the two groups. The pre-operative STAI scores of the intervention and control groups were 42.9 and 44.1 points, respectively, with no significant difference. However, the post-operative anxiety score showed a significant decline in the intervention group compared to that in the control group (p = 0.002). Moreover, most of the participants in the intervention group showed a low level of anxiety after the operation, while half of the control group remained at a moderate to high level score. Conclusions The provision of an informative educational video before cesarean delivery is a powerful tool that significantly reduces cesarean operative anxiety and improves health outcomes. Thai Clinical Trials Registry on the 28 March 2023 (TCTR20230328001).

Effect of Informative Cesarean Delivery Operative Steps Video on Maternal Anxiety Level: A Randomized Controlled Trial

Background Cesarean section is the most common obstetric procedure performed. This can lead to maternal anxiety, which is a significant contributor to postpartum depression. This can adversely affect pregnant women both mentally and emotionally, negatively impacting their well-being and family bonding. The aim of this study was to evaluate the effect of the addition of an informative cesarean section operative steps video on the maternal anxiety score compared with standard pre-cesarean section care. Methods This randomized controlled trial was conducted at Thammasat University Hospital, Thailand, between April and September 2023. Pregnant women who underwent their first cesarean section were allocated to two groups: intervention and control groups. Participants in the intervention group were required to watch a 5-minute informative video that elaborately described the process from pre-operative steps until post-operative care on the day scheduled for cesarean delivery. All participants received the same routine pre-operative and post-operative care. The State-Trait Anxiety Inventory (STAI) was used to measure both populations on two occasions: the day of scheduled cesarean delivery and postpartum day 1. Results A total of 178 women were recruited. The demographic and obstetric characteristics were similar between the two groups. The pre-operative STAI scores of the intervention and control groups were 42.9 and 44.1 points, respectively, with no significant difference. However, the post-operative anxiety score showed a significant decline in the intervention group compared to that in the control group (p = 0.002). Moreover, most of the participants in the intervention group showed a low level of anxiety after the operation, while half of the control group remained at a moderate to high level score. Conclusions The provision of an informative educational video before cesarean delivery is a powerful tool that significantly reduces cesarean operative anxiety and improves health outcomes. Thai Clinical Trials Registry on the 28 March 2023 (TCTR20230328001).

Associations between maternal smartphone use and mother-infant responsiveness: A cluster analysis of potential risk and protective factors.

Contradictory results in the extant literature suggests that additional risk factors should be considered when exploring the impacts of maternal smartphone use on mother-infant relationships. This study used cluster analysis to explore whether certain risk factors were implicated in mother-infant dyads with high smartphone use and low mother-infant responsiveness. A cross-sectional survey of 450 participants in the UK measured infant social-emotional development, maternal depressive, anxiety and stress symptoms, wellbeing, social support, smartphone use, and mother-infant responsiveness. Participants were predominantly White (95.3%) and living with a partner (95.2%), with infants who were born full-term (88.9%). Cluster analysis identified three clusters characterized as; cluster (1) "infant at risk" showing high infant development concerns, high maternal smartphone use, and low mother-infant responsiveness; cluster (2) "mother at risk" showing high maternal depressive, anxiety, and stress scores, low social support, high maternal smartphone use, and low mother-infant responsiveness, and cluster (3) "low risk" showing low maternal smartphone use and high mother-infant responsiveness. Significant differences were found between all risk factors, except for maternal smartphone use and mother-infant responsiveness between clusters 1 and 2 suggesting that both clusters require early intervention, although interventions should be tailored towards the different risk factors they are presenting with.

Analysis of the Role of the Comprehensive Guided Labor Nursing Intervention in Improving Maternal Adverse Emotions

Objective: To analyze the application value of the comprehensive guided labor nursing model in improving maternal negative emotions. Methods: Eighty cases of mothers admitted to the hospital from June 2022 to June 2023 were sampled and randomly grouped, with comprehensive guided labor nursing intervention included in Group A and conventional care included in Group B. Emotion scores, labor and delivery, pregnancy outcomes, and nursing satisfaction were compared. Results: Maternal self-rating anxiety (SAS) and depression (SDS) scale scores were lower in Group A than in Group B (P < 0.05). Maternal visual analog scores (VAS) and postpartum hemorrhage were lower in Group A than in Group B (P < 0.05). Additionally, the duration of each stage of labor was shorter than in Group B (P < 0.05). The incidence of adverse pregnancy outcomes was lower in Group A than in Group B, and the rate of spontaneous deliveries was higher in Group A compared to Group B (P < 0.05). Furthermore, nursing care satisfaction was higher in Group A than in Group B (P < 0.05). Overall, Group A had a higher rate of maternal nursing satisfaction than Group B (P < 0.05). Conclusion: Comprehensive guided labor nursing can shorten the duration of labor, reduce postpartum hemorrhage, and decrease the rate of adverse pregnancy outcomes, thereby contributing to the improvement of maternal mood. This approach proves to be efficient and feasible in clinical practice.

The impact of maternal anxiety during pregnancy on children's eczema and allergic rhinitis: The Ma'anshan birth cohort study

ObjectiveThe objective of this study was to investigate the associations between maternal exposure to anxiety during pregnancy and the susceptibility of offspring to eczema and allergic rhinitis and the possibility of sensitivity periods and cumulative effects. MethodsThe study's sample consisted of 3160 mother-child pairs from the Ma'anshan Birth Cohort Study. Maternal anxiety was repeatedly measured in the 1st, 2nd, and 3rd trimesters of pregnancy using the Chinese version of the Pregnancy-Related Anxiety Scale. Information regarding children's eczema and allergic rhinitis diagnoses was collected through parental reports at 12, 24, 36 and 48 months of age. Binary logistic regression models were used for statistical analysis and corrected for multiple comparisons using the false discovery rate (FDR) method. ResultsChildren whose mothers experienced anxiety throughout pregnancy had the highest odds of developing total eczema (aOR 1.45, 95% CI 1.02–2.07) and total allergic rhinitis (aOR 1.67, 95% CI 1.17–2.37) between the ages of 6 and 48 months. The higher the trajectory of the maternal anxiety scores throughout pregnancy, the higher the odds of total eczema (aOR 1.65, 95% CI 1.14–2.40) and allergic rhinitis (aOR 1.84, 95% CI 1.28–2.66) in their offspring. The association between maternal anxiety and children's eczema was mainly concentrated in the first 24 months, whereas the association with allergic rhinitis was mainly concentrated in the 36–48 months. ConclusionMaternal anxiety during any trimester of pregnancy, especially with a consistently high trajectory of anxiety scores, was associated with higher odds of children's eczema and allergic rhinitis.

Pre-pandemic adversity and maternal mental health during the COVID-19 pandemic: the mediating role of pandemic stress and family relationships

BackgroundThe COVID-19 pandemic was a time of increased stress for families. Parents with a history of adversity may have been at higher risk of experiencing mental health problems during this time. The current study aims to investigate the relationship between pre-pandemic adversity pandemic related stressors and maternal mental health outcomes during the pandemic. MethodsData was drawn from the Mothers' and Young People's Study (MYPS), a longitudinal of first time mothers and their children. Participants were 418 mothers who completed the MYPS COVID-19 sub-study. Data was collected during pregnancy, at 1, 4, 10 years postpartum, and during the COVID-19 pandemic (approximately 14 years postpartum). Path-analysis was used to test the relationship indirect relationship between pre-pandemic adversity and maternal depressive and anxiety symptoms, via family functioning and pandemic related stress. ResultsThe hypothesised model was a good fit to the data accounting for 34 % and 33 % of the variance in maternal depressive and anxiety scores, respectively. A significant indirect effect was found between pre-pandemic adversity and both maternal anxiety and depressive systems via family relationships during the pandemic and pandemic related stress. LimitationsMYPS participants who took part in the COVID-19 sub-study were more likely to be older, have a higher level of education, and speak English as a first language, compared to the total MYPS sample. ConclusionsFamily inclusive service responses which aim to strengthen family relationships may be particularly important for families where there is a history of adversity to support parental mental health.

Prenatal diagnosis, management, and outcomes of fetuses with tetralogy of Fallot in China after prenatal counseling: a prospective cohort study.

The study aimed to monitor fetuses with tetralogy of Fallot (TOF) after prenatal counseling and how it influenced the decision of parents to terminate the pregnancy. Fetuses with isolated TOF diagnosed between January 2019 and December 2021 were prospectively enrolled. The follow-up period extended until termination or 6 months after the operation. Of the 1,026 fetuses diagnosed with cardiac defects, 129 were identified to have isolated TOF and completed the follow-up. A total of 55 (42.6%) fetuses were terminated, with larger maternal age (odds ratio: 0.893, 95% confidence interval: 0.806-0.989, P = 0.031) as the protective factor. The maternal anxiety score, gestational weeks, and pulmonary-to-aortic-diameter ratio lost significance in multivariate analysis. Subjectively, the two most common reasons for terminating the pregnancy were worries about the prognosis (41.8%) and concerns about the possible suffering of the unborn child (18.2%). The prenatal diagnosis was accurate in 73 of the 74 (98.6%) live births. Out of the 64 live births that underwent surgical repair in our center, 57 (89.1%) received primary repair, with a median age of 104 days, and 49 (76.6%) underwent valve-sparing repair. No perioperative death occurred. Termination for fetuses with TOF remains common in China. Live births with TOF can be safely and effectively managed.

Changes and predictors of maternal depressive and anxiety symptoms during the COVID-19 pandemic.

Longitudinal changes in maternal depressive and anxiety symptoms and predictors of symptom variation among a group of middle-to-upper income Canadian women (n = 2152) were examined prior to the pandemic (2017-2019) and at three pandemic timepoints (May-July 2020, March-April 2021, November-December 2021). Mean maternal depression and anxiety scores were elevated throughout the pandemic. Pre-pandemic depressive symptoms were associated with greater increases in depressive symptoms. Coping and relationship quality were protective factors. Supporting the development of coping strategies may mitigate mental health concerns among mothers.

An investigation into the relationship between community engagement and maternal mental health in Calgary, Alberta using the All Our Families cohort.

Existing literature shows that increased community engagement is associated with decreased depressive symptoms. To our knowledge, no existing studies have investigated the relationship between community engagement and adverse mental health among mothers in a Canadian context, nor has this relationship been studied over time. The current study aims to address these gaps by modelling the association between community engagement and anxiety and depression longitudinally using a cohort of prenatal and postnatal mothers living in Calgary, Alberta. We used data from the All our Families (AOF) study, a prospective cohort study of expectant and new mothers in Calgary, Alberta from 2008 to 2017 across seven timepoints. We used three-level latent growth curves to model the relationship between individual-level community engagement and maternal depression and anxiety scores, while adjusting for both individual and neighborhood-level characteristics. The study sample consisted of 2129 mothers across 174 neighborhoods in Calgary. Adjusted latent growth curve models demonstrated that community engagement was associated with lower depression (b = -0.28, 95% CI -0.33, -0.23) and anxiety (b = -0.07, 95% CI -0.12, -0.02) scores among mothers over time. Adjusted results show that community engagement has a protective effect against depression and anxiety amongst mothers. The results of this study are in line with existing evidence suggesting that social cohesion, civic participation, and community engagement are protective against adverse mental health outcomes.

Perinatal Depression and Anxiety Symptoms, Parental Bonding and Dyadic Sensitivity in Mother–Baby Interactions at Three Months Post-Partum

The quality of the early parent-infant relationship is crucial for the child's optimal development, and parental sensitivity plays a key role in early interactions. The purpose of the study was to evaluate the influence of maternal perinatal depression and anxiety symptoms on dyadic sensitivity at three months post-partum, also considering a large set of maternal and infant variables. At the third trimester of pregnancy (T1) and at three months postpartum (T2), 43 primiparous women filled in a set of questionnaires evaluating symptoms of depression (CES-D) or anxiety (STAI), the woman's parental bonding experiences (PBI), alexithymia (TAS-20), maternal attachment to the baby (PAI, MPAS) and the perceived social support (MSPSS). At T2 mothers also completed a questionnaire on infant temperament and took part in the CARE-Index videotaped procedure. Dyadic sensitivity was predicted by higher maternal trait anxiety scores in pregnancy. In addition, the mother's experience of being cared for by her father in childhood was predictive of her infant's lower compulsivity, while paternal overprotection predicted higher unresponsiveness. The results highlight the influence of perinatal maternal psychological well-being and maternal childhood experiences on the quality of the dyadic relationship. The results may be useful to foster mother-child adjustment during the perinatal period.

Effectiveness of the Incredible Years parenting program for children with behavioral problems: An experience in a developing country during a pandemic

Although parenting programs have been supported as an effective family-based intervention for children’s behavioral problems, they are underutilized in developing countries. This randomized controlled study aims to determine the effectiveness of the Incredible Years parenting program (IYPP) in improving behavioral problems in children, parenting stress, and parental mental health. Seventy mother–child dyads from three tertiary hospitals in Malaysia were divided into the IYPP and waitlist control groups. Weekly parent training sessions were adjusted during the pandemic period. Child’s total difficulty scores of the Strength and Difficulty Questionnaire (SDQ-TDS), Parental Stress Scale (PSS) scores, and parental DASS-21 scores were measured at pre- and post-intervention, and follow-up, and analyzed using generalized estimating equation (GEE). Compared to the control group at baseline, the intervention group showed a 4.2- and a 3.5-point significantly lower SDQ-TDS at 2 weeks post-intervention and 3 months follow-up, respectively (B = -4.20, 95 % CI: −6.68, −1.72, p = 0.001; B = -3.51, 95 % CI:-6.37, −0.66, p = 0.016), a 5.0-point significantly lower PSS at 3 months follow-up (B = -5.03, 95 % CI: −9.16, −0.90, p = 0.017), and a 4.1-point significantly lower general stress scores at 2 weeks post-intervention (B = -4.06, 95 % CI: −7.20, −0.92, p = 0.011). Effect sizes were small (ds = 0.28–0.40). There was no significant intervention effect on maternal anxiety and depression scores. The modified parenting program was effective in improving children’s behavior, parenting stress, and general stress among mothers of children aged 6–12 years presented with borderline and abnormal levels of behavioral problems, with sustained effects demonstrated for child behavior. However, the interpretation of these findings requires careful consideration of potential pandemic-instigated challenges and implications.

Physical Fitness and Maternal Psychosocial Status in Children With Autism Attending a Regular Physical Activity Program

The aim of this study was to compare physical fitness-related parameters in Turkish children with mild to moderate autism and their typically developing (TD) peers to determine maternal anxiety level and quality of life. Children with autism had significantly worse scores for all Munich Fitness Test (MFT) parameters except step test heart rate and had lower physical activity levels compared to the TD children ( p < .05). There was no difference between groups in terms of postural deviations or maternal anxiety scores ( p > .05). The MFT total score was associated with higher maternal quality of life scores ( r = .605, p = .006). This study showed that despite participating in a regular physical activity program, children with mild to moderate autism have lower physical fitness and activity levels compared to their TD peers, whereas better physical fitness in children with autism has a positive effect on their mothers’ quality of life.

THE EFFECT OF SPIRITUAL EMOTIONAL FREEDOM TECHNIQUE (SEFT) ON ANXIETY DURING THE ACTIVE PHASE I LABOR

Anxiety often occurs in maternity mothers and not being treated will have an impact on the mother's physical and psychological. As many as 9% of mothers who experience anxiety will increase pain and result in a long labor process. Therefore, it is necessary to take action by the midwife to control anxiety so that the delivery process runs smoothly. SEFT is a psycho-religious therapy that can reduce maternal anxiety without causing side effects. To determine the effect of SEFT on anxiety in maternity mothers during the active phase I. This is pre-experimental research with one group pre-post-test design. This study used purposive sampling. The statistical test used the dependent t-test. The average anxiety score before SEFT therapy was 24.44, with a minimum score was 20 and a maximum score was 29. The average anxiety score after SEFT therapy was 19.06, with a minimum score was 14 and a maximum score was 25. The results of the dependent t-test showed a p-value 0.000 (0.05) which means that there is a difference in the average anxiety score before and after the application of SEFT. There is an effect of the Spiritual Emotional Freedom Technique (SEFT) on reducing maternal anxiety scores during the Active Phase I in the Dempet Health Center Work Area. The application of SEFT can increase the relaxation that can be obtained from conditions of solemnity, sincerity, resignation, confidence, and gratitude so that mothers can produce responses that can reduce anxiety during the delivery process.

Maternal self-efficacy and emotional well-being in Chilean adolescent mothers: the relationship with their children's social-emotional development.

BackgroundLow maternal self-efficacy and high levels of anxiety, depression, and stress can be triggered in adolescent mothers due to an incomplete development process that makes them physically or psychologically unprepared for the responsibilities of motherhood and parenting. These factors may be linked to difficulties with their children’s social-emotional development. The present study aims to: (a) analyze the relationship between maternal self-efficacy and stress, depression, and anxiety levels in low-income adolescent mothers; (b) examine the relationship between maternal self-efficacy and well-being with children’s social-emotional development; and (c) describe the effects of maternal self-efficacy on children’s social-emotional development, mediated by maternal well-being.MethodsA sample of 79 dyads comprising low-income Chilean adolescent mothers aged from 15 to 21 years old (M = 19.1, SD = 1.66) and their children aged 10 to 24 months (M = 15.5, SD = 4.2) participated in this research. A set of psychometric scales was used to measure maternal self-efficacy (Parental Evaluation Scale, EEP), the mothers’ anxiety and depression (Hospital Anxiety and Depression Scale, HADS), maternal stress (Parental Stress Scale, PSS), and the children’s social-emotional development (Ages and Stages Questionnaire Socio-emotional, ASQ-SE). Bivariate analyses and mediation models were employed to estimate and test the relevant relationships.ResultsA bivariate analysis showed that maternal self-efficacy was negatively related to the mother’s anxiety, depression, and stress. Moreover, there was a significant relationship between maternal self-efficacy and maternal stress, and children’s self-regulation and social-emotional development. Maternal self-efficacy, mediated by maternal anxiety, depression, and stress scores, had a significant effect on the development of children’s self-regulation.ConclusionsThe results confirm the importance of adolescent mothers’ emotional well-being and maternal self- efficacy with respect to their children’s social-emotional development. This makes it necessary to have detailed information about how emotional and self-perception status influences a mother’s role in the development of her children.

Effect of Kangaroo Mother Care on Maternal Anxiety and Depression States at the Neonatal ICU: A Prospective Cohort Study

Objectives. To determine the effect of kangaroo mother care (KMC) on anxiety and depression of mothers of low-birth-weight neonates during the immediate newborn period.
 Method. Eligible participants were mothers of low-birth-weight infants (birth weight ≤2500 grams) admitted at a tertiary hospital's neonatal intensive care unit. Mothers were instructed on providing KMC daily to their infants during the study period (first seven days of life).
 Main Outcome Measure(s). The primary study outcome was the effect of KMC in improving maternal anxiety and depression scores in the immediate postpartum period using the locally validated Hospital Anxiety and Depression Scale-Pilipino (HADS/HADS-P).
 Results. A total of 171 mothers were enrolled in the study. Only 79 mothers provided KMC, and the rest (92) did not provide KMC. The anxiety and depression scores improved significantly from day 1 to 7 postpartum in both groups (p<0.05). Frequency of mothers categorized as having severe anxiety significantly decreased over time whether they provided KMC or not (KMC: 40.5%, 13.9%, 7.6% at Day 1 and 7 postpartum and day of discharge; No KMC: 35.9% and 27.2% at Day 1 and Day 7 postpartum). There was a significant reduction in the percentage of mothers categorized in the depressed group from Day 1 to Day 7 postpartum, among those who rendered KMC compared with those who did not (KMC: 7.6%, 2.5%, 0% at Day 1 and 7 postpartum and at the day of discharge vs. No KMC: 7.6% and 10.9% at Day 1 and 7 postpartum). There were no significant differences in the anxiety and depression scores at any period between mothers who rendered KMC > 6 hours and KMC ≤ 6 hours/day.
 Conclusion. Anxiety and depression scores significantly decreased over time in both mothers who rendered and did not render KMC to their infants. However, there was a significant reduction in the percentage of mothers categorized as having severe depression over time among those who rendered KMC compared to those who did not. Other factors aside from KMC may affect the maternal anxiety and depression states, such as instability of the infant.

Maternal Anxiety and Infants Birthweight and Length of Gestation. A sibling design

BackgroundThe overall aim of this study is to examine the effect of prenatal maternal anxiety on birthweight and gestational age, controlling for shared family confounding using a sibling comparison design.MethodsThe data on 77,970 mothers and their 91,165 children from the population-based Mother, Father and Child Cohort Study and data on 12,480 pairs of siblings were used in this study. The mothers filled out questionnaires for each unique pregnancy, at 17th and 30th week in pregnancy. Gestational age and birth weight was extracted from the Medical Birth Registry of Norway (MBRN). Associations between prenatal maternal anxiety (measured across the 17th and 30th weeks) and birth outcomes (birthweight and gestational age) were examined using linear regression with adjustment for shared-family confounding in a sibling comparison design.ResultsIn the population level analysis the maternal anxiety score during pregnancy was inversely associated with new-born’s birthweight (Beta = -63.8 95% CI: -92.6, -35.0) and gestational age (Beta = -1.52, 95% CI: -2.15, -0.89) after adjustment for several covariates. The association of the maternal anxiety score with birthweight was no longer significant, but remained for maternal anxiety at 30th week with gestational age (Beta = -1.11, 95% CI: -1.82, -0.4) after further adjusting for the shared-family confounding in the sibling comparison design.ConclusionNo association was found for maternal prenatal anxiety with birth weight after multiple covariates and family environment were controlled. However, there was an association between prenatal maternal anxiety at 30th week only with gestational age, suggesting a timing effect for maternal anxiety in third trimester.

Developmental and Behavioral Problems of Preschool-Age Children with Chronic Rheumatic Diseases.

Juvenile idiopathic arthritis (JIA) is the most common autoimmune and familial Mediterranean fever (FMF) the most common autoinflammatory chronic rheumatic disease in childhood. We aimed first to identify developmental and behavioral problems of preschool-age children with common chronic rheumatic diseases, second to compare the diagnostic categories, and third to elucidate the associated factors with these difficulties. Of the 91 participants included in this study, 46 were children with rheumatic diseases (27 with JIA and 19 with FMF) and 45 were healthy children. The general developmental and emotional/behavioral problems of each child were evaluated by the Ages and Stages Questionnaire and Child Behavior Checklist-1½-5, respectively. The State-Trait Anxiety Inventory and Beck Depression Inventory were used for maternal well-being. Internalizing problem scores were increased, and the percentage of children who failed at least 1 developmental domain and experienced delays in fine motor and problem-solving domains were higher in children with chronic rheumatic diseases when compared with healthy children. Being in the group of rheumatic diseases, fewer maternal education years and higher screen time were found to be independent risk factors significantly associated with any developmental delay in the multivariable model. Maternal trait anxiety scores were positively associated with internalizing and total problems only in FMF. Preschool-age children with a diagnosis of chronic rheumatic diseases were more vulnerable for developmental and behavioral problems compared with healthy children. The management of chronic rheumatic diseases in the early years should include the screening of developmental and behavioral problems.

Maternal mental distress and cortisol levels in pregnancies with congenital heart disease.

Prenatal maternal stress is associated with adverse offspring outcomes, which may be mediated by maternal stress hormones. However, evidence supporting the association between maternal stress and cortisol levels in high-risk pregnancies is limited. This study aims to determine the relationship between self-reported maternal mental distress and maternal salivary cortisol levels in pregnancies complicated by foetal CHD compared with healthy pregnancies. We recruited women with pregnancies complicated by foetal CHD and healthy pregnancies. Maternal saliva was collected between 22 and 40 gestational weeks. Standardized questionnaires measuring stress, depression, and anxiety were completed by patients. Generalized estimating equation was used to evaluate associations between maternal mental distress scales and cortisol levels. We studied 165 women (55 CHD, 110 controls) and collected 504 cortisol samples (160 CHD, 344 controls). Women carrying CHD foetuses had higher stress, anxiety, and depression scores compared to women carrying healthy foetuses. However, maternal cortisol levels did not significantly differ in CHD and controls. Cortisol levels were higher in women carrying foetuses with functionally single-ventricle versus two-ventricle CHD. In both CHD and controls, there was no significant association between maternal stress, depression or anxiety scores and cortisol levels. Our data suggest that self-reported maternal stress, anxiety, and depression are not associated with maternal salivary cortisol levels in CHD and healthy pregnancies. The impact of maternal mental distress on foetal health may be through other mediating pathways other than maternal cortisol concentrations.