Prenatal Distress Questionnaire Research Articles

The effect of home ultrasound on maternal anxiety in patients with previous recurrent pregnancy loss: A randomized control trial

BackgroundPatients with previous recurrent pregnancy loss are subject to increased maternal anxiety and reduced antenatal attachment during the subsequent pregnancy. Maternal anxiety is associated with worse pregnancy and neonatal outcomes. Home ultrasound is a feasible tool with the potential to alleviate maternal anxiety by ensuring fetal well-being. ObjectiveThis study aimed to investigate the impact of complementing standard prenatal care with twice-weekly telemedicine visits incorporating home ultrasound on maternal anxiety and antenatal attachment in individuals with a history of recurrent pregnancy loss. Study designIn this randomized controlled trial, patients with a history of 2 or more prior abortions were randomized early in their subsequent pregnancy in a 1:1 ratio into either the control group, which received standard high-risk prenatal care, or the study group, which received additional twice-weekly home-ultrasound sessions. The home-ultrasound scans assessed fetal pulse, movements, and amniotic fluid volume, aiming to provide maternal reassurance. Patients performed the scans themselves using the Pulsenmore device, with real-time guidance from a physician. Maternal anxiety was assessed using the validated State-Trait Anxiety Inventory Scale (STAI-S) and the Revised Prenatal Distress Questionnaire (NuPDQ), while maternal attachment was measured with the validated Maternal Antenatal Attachment Scale (MAAS-2) at 3 time points during pregnancy. The primary outcome was the STAI-S score at the final prenatal visit. A sample size of 50 patients was calculated to detect a 20% difference in the primary outcome. ResultsOf the 57 patients recruited, 50 completed the follow-up, 25 in each group. There were no significant differences in demographics between the groups. The primary outcome (STAI score at the last visit) was significantly lower in the device group compared to the control group (P=.037). In addition, the study group exhibited a greater reduction in STAI scores between the first and last visits (P=.045), and a significantly higher MAAS score at the end of the follow-up period (P=.046). ConclusionIntegrating routine home-ultrasound telemedicine visits into prenatal care can significantly reduce maternal anxiety during pregnancy and contribute to greater maternal attachment in individuals with a history of recurrent pregnancy loss. These results emphasize the potential benefits of home ultrasound as a tool to alleviate anxiety, provide a sense of control, and foster a deeper maternal connection among pregnant individuals who have experienced previous pregnancy loss.

Effect of high-risk pregnancy on prenatal stress level: a prospective case-control study

The study aimed to determine the effects of high-risk pregnancy on prenatal stress levels. The study was conducted with a case-control design in Turkey in September-December 2019. The sample included pregnant women diagnosed with high-risk pregnancy and were at their 36th or later gestational weeks as the case group (n = 121) and healthy pregnant women as the control group (n = 245). The Antenatal Perceived Stress Inventory (APSI) and the Revised Prenatal Distress Questionnaire (NUPDQ-17 Item Version) were used to assess the stress levels of the participants in the study. It was determined that high-risk pregnancy was associated with higher rates of prenatal stress (APSI: p < 0.001, effect size = 0.388; NUPDQ: p = 0.002, effect size = 0.272) compared to the control group. The results of the linear regression analysis showed that high-risk pregnancy affected APSI (R2 = 0.043, p < 0.001) and NUPDQ (R2 = 0.033, p = 0.009) scores, but education levels, number of pregnancies, and number of abortions did not affect APSI and NUPDQ scores. According to the results of this study, high-risk pregnant women are in a risk group for stress. It is of great importance for the course of a pregnancy that healthcare professionals assess the stress levels of pregnant women in the high-risk pregnancy category and provide psychological support to pregnant women who have high stress levels or are hospitalized.

Prenatal Stress as a Risk Factor for Maternal–Foetal Morbidity: A Longitudinal Study

Pregnancy is one of the most complex periods in a woman’s life, not only because of the biological changes involved but also because of the psychological aspects. Stress during pregnancy refers to the concerns and distress that arise during pregnancy and that can be assessed by means of psychological and physiological scales. The aim of this study was to analyse prenatal stress and to evaluate its consequences on the health of both the mother and the foetus. A descriptive longitudinal study was carried out on a sample of 398 pregnant women being followed up during their entire pregnancy, who gave birth at the Punta de Europa University Hospital in Algeciras (Spain) between September 2021 and August 2023. The Prenatal Distress Questionnaire (PDQ) was used, as well as serum cortisol levels in each trimester of pregnancy and birth experience using the Childbirth Experience Questionnaire in its validated Spanish version, CEQ-E. Demographic and obstetric variables were included. One of the main findings was that experiencing more stress in late pregnancy had a negative impact on obstetric outcomes. Women who had higher levels of prenatal distress had higher blood cortisol levels and increased risk of having a caesarean section at delivery. A significant negative correlation was also found between stress and Apgar test values in the first minute of life. It is concluded that interventions promoted by the health system that provide comprehensive prenatal care contribute to decreased stress as perceived by these pregnant women, thus reducing the risk of maternal and foetal morbidity.

Family Functioning as a Predictor of Maternal Mental Health During Pregnancy

Family support may be a protective factor against mental health issues during pregnancy. Little is known about the effect of family function on the mental health of pregnant women. This study aimed to examine the relationship between family functioning and the mental health of pregnant women. The research was conducted with 184 pregnant women. During prenatal care appointments, the participants completed five questionnaires: Family Assessment Device (FAD), State-Anxiety Inventory (SAI), Beck Depression Inventory (BDI-II), Prenatal Coping Inventory (Nu-PCI), and Revised Prenatal Distress Questionnaire (NuPDQ). The participants’ mean age was 27.2 (SD = 5.2) years, with a range between 18 and 45 years. No association was found between demographic variables and anxiety/depression or coping strategies. Family dysfunction was a positive determinant of depression (β = 0.345, p < .001) and anxiety (β = 0.199, p = .007). However, family dysfunction was negatively associated with coping planning (β = −0.192, p = .009) and spiritual coping (β = −0.154, p = .037). Our findings suggest that during prenatal care visits, healthcare providers should consider the negative impact of family dysfunction on the mental health of pregnant women.

Anxiety, prenatal distress, and resilience during the first trimester of gestation.

To describe and analyze the relationship between pregnancy-related anxiety, prenatal distress, and individual resilience in pregnant women during the first trimester of pregnancy and compare it with the obstetric variable of parity. Quantitative, descriptive, cross-sectional study using non-probabilistic circumstantial sampling. A total of 144 women participated. The Prenatal Distress Questionnaire, the Resilience Scale, and the Pregnancy-Related Anxiety Questionnaire were used. A descriptive analysis with measures of central tendency was performed, and the reliability of the instruments was assessed. The average age was 33.57 years. 58.3% were multiparous and 41.7% primiparous. Anxiety was found in 21.5% and very high levels of resilience in 54.9%. Primiparous women showed higher levels of worry about the future and fear of childbirth than multiparous women. Pregnant women with high resilience showed lower levels of anxiety and stress. Pregnant women with higher levels of resilience show less anxiety and stress during the first trimester of pregnancy. Primiparous women show more anxiety and stress than multiparous women.

Pandemic-related stress in pregnant women during the first COVID-19 lockdown and neonatal development

ABSTRACT Background Maternal stress and psychopathology have a negative effect on mothers and neonates. Maternal stress may affect neonatal growth and development both physically and psychologically. Purpose To study the impact of pandemic-related pregnancy stress and maternal psychopathological symptoms during the COVID-19 lockdown in 2020 on neonatal development. Methods A two-phase prospective study was carried out on a sample of 181 pregnant women ranged from 18 to 40 years old in Spain (Europe). Phase 1: Pandemic-related pregnancy stress (PREPS), Prenatal Distress Questionnaire (PDQ), Perceived Stress Scale (PSS) and the revised version of the Symptom Checklist-90 (SCL-90-R) were used to assess psychological symptoms during the lockdown. In the follow-up (Phase 2), obstetric, birth-related and anthropometric variables were collected from 81 pregnant women-neonates dyads. Results Primiparous women showed higher psychopathological symptoms and higher levels of pandemic-related pregnancy stress than multiparous women. A multiple linear regression model showed that pandemic-related pregnancy stress could predict the length of neonate by adjusting for maternal age and gestational age, especially for primiparous women. Implications for research Studies assessing neonates development should evaluate the long-term effect of the COVID-19 pandemic on neonates´ length. Implications for practice States the relation between pandemic-related pregnancy stress and neonatal development by being able to track the effects on neonates whose mothers had high levels of stress during the COVID-19 pandemic.

Effectiveness of ``Paket BerSIH'' on Prenatal Distress

Distress during the prenatal period arises because of the inability of pregnant women to adapt. A comprehensive assessment is needed so that prenatal distress can be immediately intervened. One of them was provided education using various media and packaged in “Paket BerSIH”. “Paket BerSIH” contains health education in which there is a variety of information about stress in pregnancy, especially overcoming prenatal distress. The research design used a quasi-experimental pre- and post-test approach with 30 respondents in intervention groups and 30 respondents in control groups. The independent variables researched included “Paket BerSIH” and prenatal distress as the dependent variables. Instruments used include the observation sheet for giving “Paket BerSIH” and prenatal distress questionnaire (PDQ). The bivariate analysis carried out in this study was an independent t-test (unpaired t-test). The results showed that that there was a significant difference in the mean of prenatal distress between the control groups and the intervention groups after giving “Paket BerSIH” (p = 0.001). Health workers can provide “Paket BerSIH” during ANC, which has been proven to be effective for pregnant women, and pregnant women were expected to take advantage of this package, so that they do not experience long periods of stress during pregnancy.&#x0D; Keywords: distress, paket BerSIH, prenatal

Factors Predicting Coping of Pregnant Women Working in the Manufacturing Industry: A Cross-sectional Study

Pregnant women working in the manufacturing industry are at risk of experiencing stress both from pregnancy itself and from their occupation. Supporting them to cope effectively with this stress is an important role of the nurse-midwife. This cross-sectional study investigated the predictive power of job strain, pregnancy-specific stress, sense of coherence, self-esteem, religious belief, and social support in predicting coping among pregnant women working in the manufacturing industry. The participants were 288 women visiting the antenatal department of five provincial hospitals in Thailand. The research instruments were a demographic data recording form, and the Thai versions of the Job Content Questionnaire, the Revised Prenatal Distress Questionnaire, the 13-item Sense of Coherence, the Rosenberg Self-Esteem Scale, the Buddhist Belief Questionnaire, the Social Support Questionnaire, and the Ways of Coping Checklist-Revised. Data were analyzed using descriptive statistics and hierarchical multiple regression. The study results revealed that job strain, pregnancy-specific stress, sense of coherence, self-esteem, religious belief, and social support altogether could explain 60% of the variance in problem-focused coping and 57% of the variance in emotion-focused coping of pregnant women working in the manufacturing industry. Social support was the strongest predictorof problem-focused coping, while the sense of coherence was the strongest predictor of emotion-focused coping. The findings can be used by nurse-midwives in planning interventions to promote coping of pregnant women working in the manufacturing industry, focusing on enhancing social support and a sense of coherence and reducing pregnancy-specific stress.

The effect of Covid-19 anxiety on prenatal distress and prenatal attachment in pregnant women

Objective: In this study, we aimed to investigate the effect of Coronavirus Disease 2019 (COVID-19) anxiety on pregnant women, whether it causes prenatal distress and may be changes on mother-infant attachment. Method: The research population consists of pregnant women in all trimesters. Exclusion criteria from the study; anomaly risk in the fetus, abnormal examination findings, systemic chronic disease and drug use, presence of diagnosed psychiatric disease, consanguineous marriage between the pregnant woman and her spouse. 323 pregnant women who did not meet these exclusion criteria and agreed to participate in the study were included in this study. In the study data form: Income status, education level, age, gravidity, parity, presence and number of miscarriages, gestational week, smoking status, history of COVID-19 infection, if yes, in which week of pregnancy she had, history of COVID-19 infection in her close family, planned pregnancy, in vitro fertilization-intrauterine insemination (IVF-IUI) or a spontaneous pregnancy status were questionnaired. The patients included in the study were administered the Coronavirus Anxiety Scale (CAS), Revised Prenatal Distress Questionnaire (NuPDQ), Prenatal Attachment Scale (PAS). Results: COVID-19 anxiety increases more if close relatives have coronavirus rather than participants themselves. We detected that high coronavirus anxiety also caused an increase in the sub-dimensions of prenatal distress. We also found that high COVID-19 anxiety negatively affects prenatal attachment. Conclusion: Pregnant women should be given information and education about the possible effects of coronavirus on their pregnancy during their routine follow-up during the pandemic period. Otherwise, both psychologically and physically unhealthy generations await the whole world.

Evaluating the Reliability and Validity of the Korean Version of the Pandemic-Related Pregnancy Stress Scale.

This study aimed to translate the Pandemic-Related Pregnancy Stress Scale into Korean and validate the translated instrument. After translating the instrument, seven items of two factors (preparedness and perinatal infection stress) were selected for content validity testing. Validity and reliability were evaluated using SPSS 25.0 and AMOS 26.0. An online survey, via Google Forms, was conducted from January 20 to January 26, 2022. Participants were 283 pregnant women in Korea who consented to participate in the study. Exploratory factor analysis revealed factor loadings on two factors of 0.64-0.87 with a total variance explained of 69.77%. Confirmatory factor analysis indicated good model fit (RMR = 0.03, RMSEA = 0.06, GFI = 0.98, SRMR = 0.03), and convergent and discriminant validity were established. Concurrent validity was established based on the correlation with the Revised Prenatal Distress Questionnaire (r = 0.45), and the reliability of the final instrument was indicated by Cronbach's α = 0.87. The Pandemic-Related Pregnancy Stress Scale was validated for use in the Korean population. The Korean version of the Pandemic-Related Pregnancy Stress Scale can be utilized to measure pandemic-related stress in pregnant women.

Self perceived health and stress in the pregnancy during the COVID-19 pandemic.

The COVID-19 pandemic has had numerous maternal and neonatal consequences, especially at the mental level. Pregnant women experience a rise in anxiety symptoms and prenatal stress. The aim was to describe self-perceived health status, general stress and prenatal stress and to analyze relations and associations with sociodemographic factors. A quantitative, descriptive and cross-sectional study was conducted using non-probabilistic circumstantial sampling. The sample was recruited during the first trimester of pregnancy during the control obstetrical visit. The Google Forms platform was used. A total of 297 women participated in the study. The Prenatal Distress Questionnaire (PDQ), the Perceived Stress Score (PSS) and the General Health Questionnaire (GHQ-28) were used. Primiparas presented higher levels of worry about childbirth and the baby (10.93 ± 4.73) than multiparous women (9.88 ± 3.96). Somatic symptoms were present in 6% of the women. Anxiety-insomnia was scored positively by 18% of the women. In the Spearman correlation analysis, statistically significant values were found between almost all study variables. A positive correlation was observed between self-perceived health and prenatal and general stress levels. During the first trimester of gestation, prenatal concerns increase when levels of anxiety, insomnia and depression also increase. There is a clear relationship between prenatal worries, anxiety, insomnia and depression with stress. Health education that focuses on mental health of pregnant women would help reduce worries during pregnancy and would improve the pregnant women perception of her health and well-being.

The effect of COVID-19 fear on prenatal distress and childbirth preference in primipara

The purpose of this study was to examine the effect of COVID-19 fear on prenatal distress and childbirth preference in primipara. This descriptive and cross-sectional study was conducted with 206 primipara women in Istanbul between June and December 2021. The data were collected with an information form, "The Fear of COVID-19 Scale" and "The Prenatal Distress Questionnaire." The median of the Fear of COVID-19 Scale was 14.00 (7-31) and the median of the Prenatal Distress Questionnaire was 10.00 (0-21). A statistically significant positive and weak correlation was found between "The Fear of COVID-19 Scale" and "The Prenatal Distress Questionnaire" (r=0.21; p=0.00). Overall, 75.2% of pregnant women preferred normal (vaginal) delivery. There was no statistically significant relationship between "The Fear of COVID-19 Scale" and childbirth preference (p>0.05). It was determined that fear of coronavirus increases prenatal distress. Women should be supported to cope with fear of COVID-19 and prenatal distress, both during the preconceptional and antenatal periods.

The impact of maternal ACEs on obstetric outcomes and psychosocial wellbeing during pregnancy

Adverse childhood experiences (ACE) are traumatic events, such as physical or emotional abuse/neglect, sexual abuse, and household dysfunction, that confer an increased lifetime risk of chronic disease. We examined the relationship between maternal ACEs and adverse obstetric and psychosocial outcomes. This is a secondary analysis of a larger clinical trial (CRADLE study) that compared group vs individual prenatal care on pregnancy outcomes. The Behavioral Risk Factor Surveillance System ACE questionnaire and psychosocial measures (Center for Epidemiological Studies-Depression Screen, Prenatal Anxiety Screen, and Prenatal Distress Questionnaire) were administered to all participants. Pregnancy outcomes were obtained via chart abstraction; the primary outcome was a composite of preterm birth (PTB, < 37 weeks), low birth weight (LBW, < 2,500g), and intrauterine fetal demise (IUFD). Secondary outcomes included 1) composite of maternal morbidity (BMI >35, hypertensive disorders of pregnancy, gestational diabetes), 2) NICU admission, and 3) psychosocial measures or new diagnosis of anxiety/depression. Multivariable logistic regression models were performed. 2221 patients were included; 40.1% Black, 36.5% White, 21.4% Hispanic, and 1.3% Other. 96.4% were Medicaid eligible and 65.9% reported an unintended pregnancy. There was no relationship between ACE scores and PTB, LBW, IUFD, or the composite (p >0.10). Higher ACE scores were associated with increased risk of composite maternal morbidity (p< 0.01) and NICU admission (p< 0.01). Higher ACE scores were also associated with positive CES-D, prenatal anxiety, prenatal distress, and a new depression and/or anxiety diagnosis during the study (p< 0.01). We did not identify an increased risk of PTB or LBW with ACE >5. Higher ACE scores were associated with maternal morbidity, NICU admission, and psychosocial stress during pregnancy. Future projects should seek avenues by which screening, supportive treatment or counseling could improve outcomes for women identified at risk, specifically those with ACE >5 at entry to prenatal care.View Large Image Figure ViewerDownload Hi-res image Download (PPT)

What is prenatal stress? A scoping review of how prenatal stress is defined and measured within the context of food insecurity, housing instability, and immigration in the United States.

Stress during pregnancy can lead to significant adverse outcomes for maternal mental health. Early evaluation of prenatal stress can help identify treatment needs and appropriate interventions. Disparities in the social determinants of health can contribute to stress, but what constitutes stress during pregnancy within the social determinants of health framework is poorly understood. To scope how prenatal stress is defined and measured among pregnant people exposed to three prominent social stressors in the United States: insecurity pertaining to food, housing, and immigration. We included all studies that focused on stress during pregnancy in the context of food insecurity, housing instability, and immigration, given their recent policy focus due to the COVID-19 pandemic and ongoing political discourse, in addition to their importance in American College of Obstetricians and Gynecologists (ACOG's) social determinants of health screening tool. We searched PubMed, Scopus, and Web of Science for articles published between January 2012 and January 2022. Using a piloted charting tool, we extracted relevant study information from the selected articles and analyzed the content pertaining to stress. An initial search identified 1,023 articles, of which 24 met our inclusion criteria. None of the studies defined prenatal stress, and only one used the Prenatal Distress Questionnaire, a prenatal stress-specific tool to measure it. The Perceived Stress Scale was the most common instrument used in seven studies. Fifteen studies measured over 25 alternative exposures that researchers theorized were associated with stress, and 4 of the 15 studies did not explain the association between the measure and stress. Our findings demonstrate a fundamental inconsistency in how prenatal stress is defined and measured in the context of social determinants of health, limiting the comparison of results across studies and the potential development of effective interventions to promote better maternal mental health.

Pregnancy-Specific Stress during the First Lockdown of the COVID-19 Pandemic: Assessing Face-to-Face versus Online Recruitment.

The study aims to assess pregnancy-specific stress among pregnant women in Spain during the first lockdown of the COVID-19 pandemic. Two samples of pregnant women from the south of Spain (Andalusia) were assessed using the Prenatal Distress Questionnaire (PDQ) and a sociodemographic and obstetric questionnaire. Group 1 (N = 155) was recruited face-to-face, whereas Group 2 (N = 78) was recruited online. Pregnancy-specific stress levels were significantly different in both groups. The face-to-face group (Group 1) had higher pregnancy-specific stress levels than the online group (Group 2). The online sample over-represents young adult pregnant women with high education levels and a high number of previous miscarriages. The face-to-face study seems more accessible to racially and ethnically diverse groups. The main concern among both groups was the risk of having a sick neonate. Research during the COVID-19 pandemic can benefit from using online resources to collect data to screen and identify perinatal mental health problems in a crisis environment. Nevertheless, researchers should be aware of the potential limitations this strategy can have, for example, certain groups of people may have limited access to the internet.

Association between social support and pregnancy stress: a cross-sectional study of neighbors’ interactions

BackgroundPregnancy is associated with substantial stressful experiences. There are controversies concerning the positive and negative roles of social support during pregnancy. This research aimed to study the association of social support with the pregnancy-related stress.MethodsIn the current cross-sectional research, 200 pregnant women were recruited through convenience sampling from two teaching hospitals affiliated with Babol University of Medical Sciences and a private obstetric clinic. The women completed two self-reported questionnaires during prenatal care appointments. The questionnaires included the Revised Prenatal Distress Questionnaire (NuPDQ) and Social Support Questionnaire (SSQ).ResultsA significantly positive association was observed between the social support of neighbors and the total score of pregnancy stress (P<0.001), as well as the scores of its four subscales, namely medical problems (P<0.001), parenting (P=0.25), infant health stress (P=0.006), and pregnancy symptoms (P=0.001). Based on the linear regression models, the social support of neighbors was significantly related to the medical problem-associated stress in pregnant women (β = 0.147, 95% CI: 0.14 to 0.62, p = 0.047), pregnancy symptom (β = 0.203, 95% CI: −0.01 to 0.327, p = 0.017), and fear of childbirth (β = 0.164, 95% CI: 0.05 to 0.38, p = 0.046). Furthermore, the neighbors’ social support (β = 0.172, 95% CI: 0.02 to 0.32, p = 0.04) and the total score of social support (β = 0.155, 95% CI: 0.01 to 0.304, p = 0.046) were significantly associated with the total score of pregnancy stress.ConclusionsNeighbors’ support, as a component of social support, was found to be significantly related to pregnancy stress. This study recommends that healthcare providers consider the positive and negative impacts of social support during the pregnancy period.

The Effectiveness of Adlerian Group Counseling Approach on Mother's Distress and Self-care During Pregnancy: A Randomized Controlled Trial

Introduction: Distress is the most perceived behavioral state manifested by pregnant women and can directly or indirectly increase the risk of experiencing prenatal complications. Objective: The present study was conducted to determine the effectiveness of the Adlerian group counseling approach on a mother's distress and self-care during pregnancy. Materials and Methods: This randomized controlled trial was conducted on 79 eligible pregnant women referred to seven community health centers in Karaj City, Iran, from March 2018 to December 2019. The eligible women were assigned to the intervention (n=40) and control (n=39) groups using the block randomization method. The intervention group (gestational age of 22-32 weeks) received the Adlerian group counseling approach, while the control group received routine individual counseling. The study data were collected using the quality of prenatal self-care questionnaire and prenatal distress questionnaire at three time points; baseline, after, and one month after the intervention or routine counseling. The study data were analyzed by the Chi-squared test, Fisher exact test, and independent t test, as well as repeated measures analysis of variance. Results: The mean ± SD ages of the intervention and the control groups were 23.39±2.85 and 23.39±2.85 years, respectively. After the intervention, the results of repeated measures analysis of variance showed a statistically significant difference between the intervention and control groups regarding the changes in the mean scores of prenatal distresses (P=0.0001) and four domains (physical health, behavioral assessment, healthy relationships, and social health) of self-care (P=0.0001). Conclusion: The Adlerian group counseling approach effectively improved prenatal distress and self-care during pregnancy.

Partner relationship quality, social support and maternal stress during pregnancy and the first COVID-19 lockdown

Introduction: Pregnancy has been associated with diminished maternal mental health and a deterioration in partner relationship quality. The recent COVID-19 quarantine measures have created additional stressors for pregnant women due to isolation and a surge in partner conflict. Objective: The purpose of this study was to assess how partner relationship conflict and social support may mediate mental health outcomes during the COVID-19 lockdown. Methods: A cross-sectional study with a sample of 152 pregnant women using psychological measures, (i.e. Prenatal Distress Questionnaire, Symptom Checklist-90-R, Duke-UNC-11 Functional Social Support Questionnaire, Perceived Stress Scale). Demographic characteristics, obstetrics history, and partner relationship conflict were assessed using questionnaires. Results: While there were few reports of physical violence in this sample, between 18% and 59% of women reported partner relationship conflict on the psychological subscale (e.g. afraid of one’s partner or screamed at by one’s partner). Further, the psychological subscale was significantly associated with symptoms of psychopathology. There was a significant negative association between social support and pregnancy-specific stress (p = .005), and perceived stress (p= .038). Conclusions: These findings suggest that partner relationship conflict and social support may act as important buffers for prenatal mental health in childbearing women during vulnerable situations, such as the COVID-19 pandemic.

Maternal–fetal stress and DNA methylation signatures in neonatal saliva: an epigenome-wide association study

BackgroundMaternal stress before, during and after pregnancy has profound effects on the development and lifelong function of the infant’s neurocognitive development. We hypothesized that the programming of the central nervous system (CNS), hypothalamic–pituitary–adrenal (HPA) axis and autonomic nervous system (ANS) induced by prenatal stress (PS) is reflected in electrophysiological and epigenetic biomarkers. In this study, we aimed to find noninvasive epigenetic biomarkers of PS in the newborn salivary DNA.ResultsA total of 728 pregnant women were screened for stress exposure using Cohen Perceived Stress Scale (PSS), 164 women were enrolled, and 114 dyads were analyzed. Prenatal Distress Questionnaire (PDQ) was also administered to assess specific pregnancy worries. Transabdominal fetal electrocardiograms (taECG) were recorded to derive coupling between maternal and fetal heart rates resulting in a ‘Fetal Stress Index’ (FSI). Upon delivery, we collected maternal hair strands for cortisol measurements and newborn’s saliva for epigenetic analyses. DNA was extracted from saliva samples, and DNA methylation was measured using EPIC BeadChip array (850 k CpG sites). Linear regression was used to identify associations between PSS/PDQ/FSI/Cortisol and DNA methylation. We found epigenome-wide significant associations for 5 CpG with PDQ and cortisol at FDR < 5%. Three CpGs were annotated to genes (Illumina Gene annotation file): YAP1, TOMM20 and CSMD1, and two CpGs were located approximately lay at 50 kb from SSBP4 and SCAMP1. In addition, two differentiated methylation regions (DMR) related to maternal stress measures PDQ and cortisol were found: DAXX and ARL4D.ConclusionsGenes annotated to these CpGs were found to be involved in secretion and transportation, nuclear signaling, Hippo signaling pathways, apoptosis, intracellular trafficking and neuronal signaling. Moreover, some CpGs are annotated to genes related to autism, post-traumatic stress disorder (PTSD) and schizophrenia. However, our results should be viewed as hypothesis generating until replicated in a larger sample. Early assessment of such noninvasive PS biomarkers will allow timelier detection of babies at risk and a more effective allocation of resources for early intervention programs to improve child development. A biomarker-guided early intervention strategy is the first step in the prevention of future health problems, reducing their personal and societal impact.

Effect of the Mindfulness-Based Stress Reduction program on stress, anxiety, and childbirth fear in pregnant women diagnosed with COVID-19

ObjectiveThis study aims to examine the effectiveness of a live online Mindfulness-Based Stress Reduction (MBSR) program in preventing distress, anxiety and childbirth fear in pregnant women diagnosed with COVID-19. Material and methodsDesigned as a randomized-controlled trial, this study was performed with the participation of pregnant women who were diagnosed with COVID-19. The sample comprised 84 pregnant women, including 42 in the experimental group and 42 in the control group. The online MBSR program composed of eight sessions and lasting four weeks was provided to the pregnant women in the experimental group, whereas such an initiative was not provided to the control group. The data were collected via the Revised Prenatal Distress Questionnaire (NuPDQ), the Beck Anxiety Inventory (BAI), and the Childbirth Attitudes Questionnaire (CAQ). ResultsAfter the MBSR program, the mean NuPDQ, BAI and CAQ scores of the pregnant women in the experimental group were significantly lower than the mean scores of those in the control group (p < 0.001). ConclusionThe online MBSR program may be utilized to reduce the distress, anxiety and childbirth fear levels of pregnant women diagnosed with COVID-19. By using the MBSR program, health professionals might improve the psychological well-being of pregnant women diagnosed with COVID-19.