Prenatal Health Research Articles

Challenges of Uncertainty in Prenatal Decision-Making: Skeletal Dysplasias.

When skeletal dysplasias are suspected in the prenatal period, investigation, counseling, and management become especially challenging. By better understanding the complex forces at play and parental values, prenatal health care providers may improve the ways in which they counsel patients to improve the decision-making process under conditions of significant uncertainty, including in cases of prenatally suspected skeletal dysplasia.

Predictors of body image dissatisfaction among women at different stages of pregnancy:A cross-sectional study

ObjectiveTo explore the levels and predictors of body image dissatisfaction among women at different stages of pregnancy. DesignThis was a cross-sectional study design. Setting and participantsA total of 863 Chinese pregnant women were recruited from a tertiary hospital via a convenience sampling method. Measurement and findingsEligible participants completed a demographic questionnaire and self-reported measures of body image dissatisfaction, pregnancy-related anxiety, prenatal depression, and appearance comparison. Results showed no statistical difference in body image dissatisfaction levels among early-mid pregnancy (47.6 ± 6.17), late-mid pregnancy (47.3 ± 7.56), and late pregnancy stages (48.4 ± 6.22). The generalized linear model showed that gestational weight gain, pregnancy-related anxiety, own/family's perception of pregnancy weight, and current ideal weight change were predictors of body image dissatisfaction in the early-mid pregnancy stage. In addition, pre-pregnancy BMI, appearance comparison, own /family's perception of pregnancy weight, current ideal weight change, and overeating during pregnancy significantly predicted body image dissatisfaction in the late-mid pregnancy stage. Predictors of body image dissatisfaction in the late pregnancy stage comprised planned pregnancy, pre-pregnancy eating disorders, own perception of pregnancy weight, current ideal weight change, pregnancy-related anxiety, and prenatal depression. Key conclusion and implication for practiceThe findings suggest that predictors of body image dissatisfaction differed according to pregnancy stage. Self-perception of pregnancy weight was primary predictor of body image dissatisfaction. Healthcare professionals are recommended to provide prenatal health education to reduce own/family's negative perception of pregnancy weight, so as to alleviate the body image dissatisfaction level of pregnant women.

Prenatal maternal cortisol, stress and anxiety, and childhood obesity at 5 years: a nested case–control study

ABSTRACT Background Paediatric obesity is a global public health issue. Prenatal maternal mental health is potentially implicated in the development of childhood obesity. This study examined associations between prenatal maternal cortisol, self-reported stress, anxiety and depression in the second trimester, and childhood overweight and obesity at 5 years of age. Methods A nested case–control study was conducted using data from the Irish prospective longitudinal birth cohort SCOPE BASELINE. Cases were children with overweight or obesity, operationalised as having a BMI z-score above +2 standard deviations. Controls were children with a BMI z-score between −0.5 and 0.5 standard deviations at 5 years of age. Two to one matching by sex was conducted. Thirty-eight cases and 83 sex-matched controls were included. Maternal serum cortisol concentration and self-reported stress, anxiety and depression were measured at 15 ± 1 and 20 ± 1 weeks gestation. Conditional logistic regression analyses were conducted to examine associations between prenatal maternal cortisol and self-reported stress, anxiety and depression, and childhood overweight and obesity. Results Despite some evidence for associations between anxiety and depression, and child BMI z-scores in univariate analyses, adjusted models indicated no associations between prenatal maternal stress (OR: 1.02, 95% CI: 0.94–1.12), anxiety (OR: 1.03, 95% CI: 0.97–1.09), depression (OR: 1.04, 95% CI: 0.91–1.19), or cortisol concentration (OR: 0.99, 95% CI: 0.99–1.00) and child BMI z-score. Conclusion Our findings do not provide support for associations between foetal exposure during the second trimester of pregnancy and maternal cortisol, stress and anxiety, and childhood overweight or obesity at 5 years of age.

Prenatal tobacco exposure associations with physical health and neurodevelopment in the ABCD cohort.

To investigate the strength and reproducibility of the teratogenic impact of prenatal tobacco exposure (PTE) on child physical health and neurodevelopmental outcomes, in the context of intersecting sociodemographic and other prenatal correlates, and test if early postnatal health mediates PTE associations with childhood outcomes. Among 9-10-year-olds (N = 8,803) in the Adolescent Brain Cognitive Development Study, linear mixed-effect models tested PTE associations with birth and childhood outcomes of physical health, cognitive performance, and brain structure, controlling for confounding sociodemographic and prenatal health correlates. Mediation analysis tested the extent to which health at birth explained the associations between PTE and childhood outcomes. PTE was reported by 12% of mothers (8% [n = 738] pre-knowledge of pregnancy only, and 4% [n = 361] pre- and post-knowledge of pregnancy). PTE was highest for children with a risk for passive smoke exposure. Overall, children with any PTE had shorter breastfeeding durations than those without PTE, and PTE following knowledge of pregnancy was associated with being small for gestational age having lower birth weight, and obesity and lower cortical volume and surface area in childhood. Among children from high-parent education households, any PTE was related to lower cognitive performance, which was partially mediated by duration of breastfeeding. PTE was linked to poorer health indicators at birth and neurodevelopmental outcomes at age 9-10 years in a large community cohort, independent of sociodemographic factors. Efficacious interventions for smoking-cessation during pregnancy are still needed and should incorporate support for breastfeeding to promote healthier development. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Risk of depression during pregnancy in usual risk antenatal care.

to identify the risk of depression during pregnancy among pregnant women receiving routine prenatal care and the associated factors. a cross-sectional study, carried out with 201 pregnant women, in a routine prenatal clinic of a university maternity hospital. Data were collected using an electronic form containing a characterization instrument and the Escala de Risco de Depressão na Gravidez (Depression during Pregnancy Scale). The dependent variable was the risk of depression during pregnancy. Statistical analysis was performed by calculating the Odds Ratio and using the Chi-square and Fischer's Exact tests. among the participants, 68.2% had a higher risk of depression during pregnancy. There was a statistically significant association between a higher risk of depression during pregnancy and occupation (p=0.04), that is, unemployment (OR=2.00) doubled the risk of depression. the high prevalence of the risk of depression during pregnancy indicates the necessity of planning, prioritizing, and integrating mental health into prenatal health services, especially in the primary healthcare environment, by health managers and policymakers.

Level of Knowledge of Mothers on the Effects of Teratogens A Basis for Pre-Natal Health Information Program

The setting will have an effect on the child in several well-documented ways. There are a lot of babies that are born defective as the result of events before and during the course of their pregnancy and such circumstances are classified as teratogens. Teratogens are environmental agents that will disturb the conventional fetal development once the mother is exposed to them, leading to prenatal maldevelopment or death (Kalter, 2010). This study made used a descriptive survey design as a method of research. A descriptive design is a type of quantitative research. The main source of data for this study were the pregnant mothers who are having their pre-natal consultation which includes all primigravida, multigravida, first trimester, second trimester, and third trimester patients of Gov. Faustino N. Dy Sr. Memorial Hospital. The study excludes those who are not patients of the said institution and are unwilling to participate in the survey. The research findings highlight the need for a comprehensive health education programs to address knowledge gaps and improve awareness among pregnant women. It is crucial to develop targeted educational initiatives that provide accurate information on the risks and consequences associated with teratogenic exposure during pregnancy. Collaborating with healthcare professionals and integrating teratogenic risk assessment and counseling into routine prenatal care can further enhance knowledge dissemination and informed decision-making.

Health care use and health consequences of geographic lack of access to abortion and maternity care.

Recent years have brought substantial declines in geographic access to abortion facilities and maternity care across the US. The purpose of this study was to identify the reproductive health consequences of living in a county without access to comprehensive reproductive health care services. We analyzed National Center for Health Statistics data on all live births occurring in the US in 2020. We used data on locations of abortion facilities and availability of maternity care in order to classify counties by level of access to comprehensive reproductive health care services and defined comprehensive reproductive health care deserts as counties that did not have an abortion facility in the county or in any neighboring county and did not have any maternity care practitioners. We fit modified Poisson regression models with generalized estimating equations to estimate the degree to which living in a comprehensive reproductive health care desert was associated with receipt of timely and adequate prenatal care and risk of preterm birth, controlling for individual-level and county-level characteristics. In 2020, one third of counties in the US were comprehensive reproductive health care deserts (n = 1082), and 136,272 births occurred in these counties. In adjusted models, there was no difference in prenatal health care use (timeliness or adequacy of care) between persons in comprehensive reproductive health care deserts and those with full access to care, but the risk of preterm birth was significantly elevated (aRR =1.09, 95% CI = 1.06, 1.13). Lack of access to comprehensive reproductive health care services may increase the incidence of preterm birth.

Communication Between Pregnant People of Color and Prenatal Care Providers in the United States: An Integrative Review.

Racism and discrimination negatively affect patient-provider communication. Yet, pregnant people of color consistently report being discriminated against, disrespected, and ignored. The purpose of this integrated review was to identify studies that examined communication between pregnant people of color and their prenatal care providers and evaluate the factors and outcomes arising from communication. We searched the PubMed, Embase, CINAHL, and PsychINFO databases for studies published between 2001 and 2023. Articles were eligible for inclusion if they reported on primary research conducted in the United States, were written in English, and focused on patient-provider communication with a sample that included pregnant people of color, defined as those who self-identified as Black, African American, Hispanic, Latina/x/e, Indigenous, American Indian, Asian, Asian American, Native Hawaiian, and/or Pacific Islander American. Twenty-six articles were included in the review. Relevant data were extracted and compiled into an evidence table. We then applied the rating scale of the Johns Hopkins Evidence-Based Practice model to assess the level of evidence and quality of the studies. Themes were identified using a memoing technique and organized into 3 a priori categories: factors, outcomes, and recommendations. Two overarching themes emerged from our analysis: racism/discrimination and unmet information needs. Subthemes were then identified as factors, outcomes, or recommendations. Factors included provider behaviors, language barriers, structural barriers, provider type, continuity of care, and fear. Outcome themes were disrespect, trust, decision-making power, missed appointments, and satisfaction with care. Lastly, culturally congruent care, provider training, and workforce development were categorized as recommendations. Inadequate communication between prenatal care providers and pregnant people of color continues to exist. Improving access to midwifery education for people of color can contribute to delivering perinatal care that is culturally and linguistically aligned. Further research about digital prenatal health communication is necessary to ensure equitable prenatal care.

Maternal dietary patterns and acute leukemia in infants: results from a case control study in Mexico.

Childhood cancer is the leading cause of disease-related mortality among children aged 5-14 years in Mexico, with acute leukemia being the most common cancer among infants. Examining the overall dietary patterns allows for a comprehensive assessment of food and nutrient consumption, providing a more predictive measure of disease risk than individual foods or nutrients. This study aims to evaluate the association between maternal dietary patterns during pregnancy and the risk of acute leukemia in Mexican infants. A hospital-based case-control study was conducted, comparing 109 confirmed acute leukemia cases with 152 age-matched controls. All participants (≤24 months) were identified at hospitals in Mexico City between 2010 and 2019. Data on a posteriori dietary patterns and other relevant variables were collected through structured interviews and dietary questionnaires. Multivariate logistic regression was employed to estimate the association between maternal dietary patterns during pregnancy and the risk of acute leukemia in infants. The "Balanced & Vegetable-Rich" pattern, characterized by a balanced consumption of various food groups and higher vegetable intake, exhibited a negative association with acute leukemia when compared to the "High Dairy & Cereals" Pattern (adjusted odds ratio [OR] = 0.51; 95% confidence interval [CI]: 0.29, 0.90). We observed that mothers who gave birth to girls and adhered to a healthy dietary pattern during pregnancy exhibited significantly lower odds of their children developing AL compared to those who gave birth to boys [OR = 0.32 (95% CI 0.11, 0.97)]. Our results underscore the significance of maternal nutrition as a modifiable factor in disease prevention and the importance of prenatal health education.

Self-care practices of pregnant women: A qualitative study in a Nigerian rural community

Context: Inadequate self-care during pregnancy is a contributor to the poor maternal health indices in Cross River State; including the high maternal mortality ratio of 2,000/100,000 live births.
 Objectives: The objectives of the study were to identify self-care practices adopted by women during pregnancy and delivery and to identify barriers to quality self care.
 Methods: Focus Group Discussions, Key informant interviews and in-depth interviews were conducted among pregnant women, women of reproductive age and other stakeholders in Biase Local Government Area of Cross River State.
 Results: The study revealed inadequate knowledge and practice of self-care during pregnancy. Some pregnant women were unable to recognize early signs of pregnancy while others, especially young unmarried girls, tried to hide the pregnancy. Barriers to effective self-care identified included myths and misconceptions, especially the belief that health-related events during pregnancy are caused by witches and wizards, lack of preparation for pregnancy and abandonment of pregnant women by partners, usually due to unwillingness and/or inability to father the child.
 Conclusion: There is need for pre-marital and pre-natal counselling and health education so as to address identified gaps in knowledge and practice and lack of male involvement in maternal healthcare.

A scoping review of health promotion interventions delivered via social media to women of reproductive age.

Adult women of reproductive age are highly engaged with social media, suggesting its utility for conveying health information to this population, at scale. This scoping review aimed to describe health promotion interventions conducted via social media and assess their effectiveness to improve health outcomes, engagement and acceptability in adult women of reproductive age. Six databases were searched on 13 May 2022. Two reviewers independently screened studies. Data were extracted and risk of bias assessed using the Joanna Briggs Critical Appraisal Tools. Eligible studies conducted an intervention primarily via social media, with or without a comparison intervention, and reported health-related outcomes/behaviours pre- and post-intervention. Results were presented in narrative form. Adult women (mean age 18-45 years). Nine eligible studies were identified: six randomised control trials, two quasi-experimental studies and one cross-sectional study. Interventions focused on prenatal, antenatal or postpartum health or physical activity. Seven studies utilised Facebook for intervention delivery, one conducted a digital campaign across four platforms and one used WeChat. Studies reported significant improvements in a range of outcomes, including increased parenting competence, longer duration of breast-feeding and higher rates of physical activity. Social media interventions had greater engagement than control interventions. We identified nine diverse health promotion interventions conducted via social media, which appear acceptable and effective for improving various health outcomes in adult women of reproductive age. While this supports the utility of social media to convey health information, further research is required to prove effectiveness and superiority over other intervention strategies.

Knowledge and Practice Behaviours of Obstetricians/Gynecologists and Midwives Concerning Periodontal Health and Pregnancy.

The purpose of the present study was to evaluate the level of knowledge of prenatal health professionals concerning the relationship between periodontal diseases and pregnancy complications, as well as their professional implications in the oral health field. A questionnaire was distributed to obstetricians/gynecologists, interns specialised in obstetrics/gynecology, midwives, and student midwives at Loire Atlantique and Vendée hospitals (France). The questionnaire included 5 sociodemographic questions and 14 questions regarding the level of knowledge about the relationship between periodontal diseases and pregnancy complications as well as the professionals' level of involvement in oral health care. Twenty-three obstetricians/gynecologists and 55 midwives responded to the questionnaire. Preterm delivery and chorioamnionitis were the most frequently mentioned complications of pregnancy, whereas the risk of pre-eclampsia was rarely mentioned. Half of the professionals said they were aware of the oral manifestations of pregnancy. Gingivitis and an increased risk of caries were the most frequently mentioned items, whereas epulis was the least frequently mentioned item. The level of involvement of prenatal care practitioners in oral health care was limited due to a lack of competence and time. Nevertheless, 64% of the participants discussed the risks of poor oral hygiene with their patients. There is good knowledge among French gynecologists/obstetricians and midwives regarding the oral manifestations of pregnancy. However, there is still a lack of knowledge concerning the links between periodontal diseases and pregnancy complications. The involvement and behaviour of pregnancy professionals in the oral health field is inadequate. The present survey highlights the need to improve the initial and continuing education of obstetricians and midwives on this topic.

Implementing a Prenatal Oral Health Program for Dental Students: Lessons Learned.

The Prenatal Oral Health Program (pOHP) was developed to educate dental students on prenatal oral health and promote access to dental care for pregnant women. Program advancement has occurred in support of quality improvement. This mixed-methods design combined quantitative data from fourth-year dental students who participated the pOHP (N = 81) and qualitative data from a student-faculty-staff focus group discussion (N = 7). Different clinical structures, appropriate leveling in the curriculum, management with a patient care coordinator, and inclusion of interprofessional learning experiences (IPE) were compared. The survey response rate was 96.4% (N = 81). Trends were noted between students who provided clinical care for a pregnant patient (31%) versus those who did not. Results indicated that an integrated clinic was preferred, though students who had treated a pOHP patient showed greater support for a standalone clinic model. Survey and focus group data agreed that pOHP should occur during the third-year dental school training; however, students with patient experience favored second-year placement. Survey and focus group data emphasize the importance of a patient care coordinator for clinical management and IPE as an essential learning element. Innovating new clinical models requires a period of evolution to determine preferred and sustainable infrastructure. Results reveal the advantages and disadvantages of various program implementation models and demonstrate that student perceptions were influenced by their clinical experiences. Study findings will inform implementation and guide other programs as they create and modify existing curricula to enhance prenatal oral health.

Maternal prenatal social contact during the COVID-19 pandemic predicts infant birth weight

BackgroundSocial connectedness and mental health have been associated with infant birth weight, and both were compromised by the COVID-19 pandemic. AimsWe sought to examine whether changes in maternal prenatal social contact due to the COVID-19 pandemic were associated with infant birth weight and if maternal prenatal mental health mediated this association. Study designA longitudinal study of mothers and their infants born during the first wave of the COVID-19 pandemic. SubjectsThe sample consisted of 282 United States-based mother-infant dyads. Outcome measuresDepressive symptoms were measured with the Beck Depression Inventory-II, anxiety was measured with the State Anxiety Inventory, and stress was measured using the Perceived Stress Scale 14. We also asked participants about pandemic-related changes in social contact across various domains. Adjusted birth weight was calculated from birth records or participant-report when birth records were unavailable. ResultsDecreases in social contact during the pandemic were associated with lower adjusted infant birth weight (B = 76.82, SE = 35.82, p = .035). This association was mediated by maternal prenatal depressive symptoms [Effect = 15.06, 95 % CI (0.19, 35.58)] but not by prenatal anxiety [95 % CI (−0.02, 32.38)] or stress [95 % CI (−0.31, 26.19)]. ConclusionThese findings highlight concerns for both mothers and infants in the wake of the COVID-19 pandemic, since birth weight can have long-term health implications and the social restructuring occasioned by the pandemic may lead to lasting changes in social behavior.

Investigating the Transition to Parenting within a Digital Health Context

Abstract Background The ubiquity of digital technology use created the need to understand parents’ digital technology use in pre-conception, pregnancy and the postpartum period (the transition to parenting). This research investigated the role of digital technology in the lives of individuals in the transition to parenting. Methods A qualitative descriptive study used purposive sampling. Participants were eligible if they were new parents, up to 2 years postpartum, were 16-35 years old, and English speaking. Focus groups were recorded and transcribed; thematic data analysis was used. Results 26 participants identified as heterosexual females reported prolific use of digital technologies to direct fertility (e.g., ovulation timing), for information seeking regarding foetal growth and development, to prepare for labour and delivery, and in searching for a sense of community during postpartum. Smartphone technologies, social media, and prenatal apps were predominantly used. Participants expressed concerns related to their personal patterns of use, and the potential negative impacts. Themes included: “Is this normal; is this happening to you?!”, “Am I having a heart attack; what is this?”, “Anyone can put anything on Wikipedia”: Managing the Negative Impacts of Digital Information. Conclusions Digitally informed parenting practices include enhanced access to information regarding normal infant growth and development. Immediacy of information access was valued over integrity. Important implications of this work relate to the need for effective digital health literacy skills. Future research on the gendered use of digital technologies among parents is needed. Key messages • Digital technology use creates important health implications for pre and post-natal care among parents. • Digital technology use is requisite for prenatal public health education.

Prenatal counseling and maternal health behavior: The case of Ramadan fasting during pregnancy

Abstract Background Ramadan during pregnancy has been found to be associated with various adverse health effects in the offspring, which are largely attributed to maternal intermittent fasting. At the same time, many pregnant Muslims decide to fast during Ramadan. With a growing Muslim population in Europe, Ramadan fasting during pregnancy may become an even more prominent issue in the future. Since pregnant women regularly exchange with healthcare professionals, it is pivotal to evaluate the role of prenatal consultation on Ramadan for the maternal fasting decision. Methods This study uses survey data on pregnant Muslims from Mainz, Germany (N = 326). Data on fasting during pregnancy, consultation with healthcare professionals on fasting during pregnancy, as well as a rich set of socio-economic background characteristics were collected. We estimate the effect of prenatal consultation on the number of days fasted using a log-normal hurdle model. To test whether our controlled estimates might be biased by unobservable confounders, we use the Oster (2019) method. Results The share of women who fasted at least one day was 36.5% (mean: 17 fasted days). Among these women, receiving prenatal consultation on fasting during pregnancy reduced the number of fasted days by 10.8 days (95% CI: -19.03, -2.56). Results from the Oster method show that this result is not biased by unobservable confounders. Conclusions This study shows that prenatal consultation on Ramadan fasting reduces the number of fasted days among pregnant Muslims who intend to fast during pregnancy. These findings imply that prenatal caregivers should be encouraged to discuss Ramadan fasting with their Muslim patients. Further research is needed to develop guidelines for prenatal advice on Ramadan during pregnancy in a framework of shared decision-making. Key messages • Controlled effect estimates show that potentially harmful maternal Ramadan fasting behavior during pregnancy can be mitigated by prenatal caregivers. • This study demonstrates a novel way to exploit real-world data in the absence of randomization by quantitatively assessing the impact of unobservable confounders.

Effect of urban green space on parental sleep quality in the two years after childbirth

Abstract Background Green spaces are beneficial for sleep quality, particularly for maternal sleep quality, which in turn affects maternal health as well as the growth and development of offspring. However, few studies have examined the effect of green space on parental sleep quality, and even fewer have utilized the Normalized Difference Vegetation Index (NDVI). This study thus aims to explore the impact of urban green spaces on parental sleep quality during the two years after childbirth. Methods Participants were selected from the Longitudinal Examination across Prenatal and Postpartum Health in Taiwan cohort study. The study recruited and followed participants from early pregnancy to 6 years postpartum at five hospitals in Taipei since 2011. Participants who had used hypnotics were excluded. Sleep quality was assessed using self-reported questions at 24 months postpartum. Urban greenness was assessed using NDVI within a designated radius (250, 750, and 1500m) of participants’ residences during both the pregnancy and postpartum. Data were analyzed using multiple logistic regression. Results Out of the 804 pairs included in the analysis, we observed that an increase of 0.1 units in NDVI within a 1500m radius during pregnancy and postpartum periods (0-24 months) was associated with a 1.24 and 1.25-fold increase in maternal better sleep quality (95%CI:1.07,1.43 and 1.08, 1.43, respectively), after adjustment. These findings were consistent for both NDVI_250m and NDVI_750m. However, we did not find any association between NDVI and paternal sleep quality at any radius or time period. Conclusions We highlight a positive association between exposure to urban green spaces during perinatal periods and better maternal sleep quality. These findings have implications for parents in choosing their living environment, as well as for policymakers in urban planning and environmental improvement initiatives to promote both maternal and child health. Key messages • Urban green spaces have a positive impact on maternal sleep quality from pregnancy to postpartum periods. • The residential environment is critical to facilitate sleep quality and promote maternal and child health.

The relationship between parental mental health and preschoolers’ stress hormone and development

Abstract Background Hair cortisol concentration (HCC) has been identified as a biomarker that reflects chronic physiological stress. However, research on the association between mental health and HCC has been limited and yielded inconsistent results. This study thus aims to investigate the relationship between parental mental health and HCC and explore the relationship between parental mental health and HCC in preschoolers and their development. Methods Data from the ongoing project of Longitudinal Examination Across Prenatal and Postpartum Health in Taiwan (LEAPP-HIT) conducted in Taipei between 2017 and 2022 was utilized. A total of 131 families completed a self-reported questionnaire and provided hair samples from early pregnancy to four years postpartum. Of these families, 68 were followed up until the postpartum years and provided information on their preschoolers’ developmental outcomes. Multiple regression was utilized for analyses. Results We found that paternal eudaimonia was significantly negatively associated with paternal HCC (r= -0.49, p < 0.05) and maternal anxiety (r = 0.21, p < 0.05) and perceived stress (r = 0.39, p < 0.05) were significantly positively associated with maternal HCC. Furthermore, maternal higher HCC was associated with preschoolers’ higher HCC (β = 0.34, 95%CI=0.05-0.53) and higher risks of preschoolers’ suspected developmental delay (odds ratio (OR)=3.25; 95%CI=1.02-10.3). Conclusions Poorer mental health was associated with elevated cortisol levels in mothers and fathers. Maternal higher HCC was positively associated with preschoolers’ HCC and their higher risks of suspected developmental delay. We thus highlight the importance of early screening and health education programs during pregnancy for both mothers and fathers to reduce parental stress and the following risks of developmental delay in preschool-aged children. Key messages • Parental Hair cortisol may effectively reflect the association between mental health and physical stress. • Maternal higher HCC was associated with preschoolers’ higher HCC and higher risks of preschoolers’ suspected developmental delay.

The role of childhood adversity and prenatal mental health as psychosocial risk factors for adverse delivery and neonatal outcomes

ObjectiveExposure to adverse childhood experiences (ACEs) is a significant predictor for physical and mental health problems later in life, especially during the perinatal period. Prenatal common mental disorders (PCMDs) are well-established as a risk for obstetric interventions but knowledge on combined effects of multiple psychosocial risk factors is sparse. We aim to examine a comprehensive model of ACEs and PCMDs as risk factors for poor delivery and neonatal outcomes. MethodWith structural equation modeling, we examined direct and indirect pathways between psychosocial risk and delivery and neonatal outcomes in a prospective cohort from pregnancy to birth in Iceland. ResultsExposure to ACEs increased risk of PCMDs [β = 0.538, p < .001, CI: 0.195–1.154] and preterm delivery [β = 0.768, p < .05, CI: 0.279–1.007)]. An indirect association was found between ACEs and increased risk of non-spontaneous delivery [β = 0.054, p < .05, CI: 0.004–0.152], mediated by PCMDs. Identical findings were observed for ACEs subcategories. ConclusionACEs are strong predictors for mental health problems during pregnancy. Both ACEs and PCMDs diagnosis are associated with operative delivery interventions and neonatal outcomes. Findings underscore the importance of identifying high-risk women and interventions aimed at decreasing psychosocial risk during the prenatal period.

High-risk groups of neonatal lupus erythematosus in term infants: a birth cohort study.

After standardized prenatal health care, there is still a high risk of dermal, hepatic, or hematological system involvement for high-risk groups of NLE. There are no specific indicators for the prediction of whether babies will develop NLE. All of these patients need to be followed up closely within one year after birth. • Neonatal lupus erythematosus (NLEs) can affect the cardiac, dermal, hepatic, and hematological systems of infants. • After standardized prenatal health care employing good multidepartment cooperation in our center, no neonates had cardiac block in this study. However, dermal, hepatic, and hematological system involvement of NLE can still gradually appear (as long as 60days after birth in some cases) during follow-up, and some of these conditions are serious and require timely and active intervention. No single factor has been found to predict whether offspring at high-risk of NLE whose mothers are positive for anti-SSA, SSB and/or RNP will develop NLE.