Prenatal Stages Research Articles

The preimplantation genetic testing for monogenic disorders strategy for blocking the transmission of hereditary cancers through haplotype linkage analysis by karyomapping.

Providing feasible preimplantation genetic testing strategiesfor monogenic disorders (PGT-M) for prevention and control of genetic cancers. Inclusion of families with a specific pathogenic mutation or a clear family history of genetic cancers. Identification of the distribution of hereditary cancer-related mutations in families through genetic testing. After a series of assisted reproductive measures such as down-regulation, stimulation, egg retrieval, and in vitro fertilization, a biopsy of trophectoderm cells from a blastocyst was performed for single-cell level whole-genome amplification (WGA). Then, the detection of chromosomal aneuploidies was performed by karyomapping. Construction of a haplotype-based linkage analysis to determine whether the embryo carries the mutation. Meanwhile, we performed CNV testing. Finally, embryos can be selected for transfer, and the results will be verified in 18-22 weeks after pregnancy. Six couples with a total of 7 cycles were included in our study. Except for cycle 1 of case 5 which did not result in a transferable embryo, the remaining 6 cycles produced transferable embryos and had a successful pregnancy. Four couples have had amniotic fluid tests to confirm that the fetus does not carry the mutation, while 1 couple was not tested due to insufficient pregnancy weeks. And the remaining couples had to induce labor due to fetal megacystis during pregnancy. Our strategy has been proven to be feasible. It can effectively prevent transmission of hereditary cancer-related mutations to offspring during the prenatal stage.

Novel bi-allelic variants of CHMP1A contribute to pontocerebellar hypoplasia type 8: additional clinical and genetic evidence.

Pontocerebellar hypoplasia type 8(PCH8) is a rare neurodegenerative disorder, reportedly caused by pathogenic variants of the CHMP1A in autosomal recessive inheritance, and CHMP1A variants have also been implicated in other diseases, and yet none of the prenatal fetal features were reported in PCH8. In this study, we investigated the phenotype and genotype in a human subject with global developmental delay, including clinical data from the prenatal stage through early childhood. Prenatally, the mother had polyhydramnios, and the bilateral ventricles of the fetus were slightly widened. Postnatally, the infant was observed to have severely delayed psychomotor development and was incapable of visual tracking before 2 years old and could not fix on small objects. The young child had hypotonia, increased knee tendon reflex, as well as skeletal malformations, and dental crowding; she also had severe and recurrent pulmonary infections. Magnetic resonance imaging of the brain revealed a severe reduction of the cerebellum (vermis and hemispheres) and a thin corpus callosum. Through whole exome sequencing and whole genomics sequencing, we identified two novel compound heterozygous variations in CHMP1A [c.53 T > C(p.Leu18Pro)(NM_002768.5) and exon 1 deletion region (NC_000016.10:g.89656392_89674382del)]. cDNA analysis showed that the exon1 deletion region led to the impaired expression, and functional verification with zebrafish embryos using base edition indicated variant c.53 T > C (p.Leu18Pro), causing dysplasia of the cerebellum and pons. These results provide further evidence that CHMP1A variants in a recessive inheritance pattern contribute to the clinical characteristics of PCH8 and further expand our knowledge of the phenotype and genotype spectrum of PCH8.

Primer on FGF3

Though initially discovered as a proto-oncogene in virally induced mouse mammary tumors, FGF3 is primarily active in prenatal stages, where it is found at various sites at specific times. FGF3 is crucial during development, as its roles include tail formation, inner ear development and hindbrain induction and patterning. FGF3 expression and function are highly conserved in vertebrates, while it also interacts with other FGFs in various developmental processes. Intriguingly, while it is classified as a classical paracrine signaling factor, murine FGF3 was uniquely found to also act in an intracrine manner, depending on alternative translation initiation sites. Corresponding with its conserved role in inner ear morphogenesis, mutations in FGF3 in humans are associated with LAMM syndrome, a disorder that include hearing loss and inner ear malformations. While recent studies indicate of some FGF3 presence in post-natal stages, emerging evidences of its upregulation in various human tumors and cariogenic processes in mouse models, highlights the importance of its close regulation in adult tissues. Altogether, the broad and dynamic expression pattern and regulation of FGF3 in embryonic and adult tissues together with its link to congenital malformations and cancer, calls for further discoveries of its diverse roles in health and disease.

Prenatal testing - diagnostic possibilities in the 21st century with special emphasis on the diagnosis of genetic defects and heart defects

Introduction: Prenatal diagnosis is a branch of medicine that deals with the detection of possible genetic and developmental abnormalities at the fetal life stage. Due to the rapid development of technology in recent decades, diagnostic capabilities at the prenatal stage have also changed their face.
 Aim of the study: The aim of the study is to review the available scientific literature in order to systematize the current knowledge of prenatal diagnosis with particular emphasis on the diagnosis of genetic diseases and diagnosis of heart defects.
 Results: Prenatal diagnosis is divided into invasive and non-invasive diagnostics. Non-invasive diagnostics include ultrasound, maternal blood biochemical tests and NIPT tests. Invasive diagnostics include tests such as amniocentesis and chorionic villus biopsy. Prenatal tests provide information on the risk of genetic diseases such as trisomy 21, 13 and 18 chromosome. In addition, serious structural heart defects such as tetralogy of Fallot are likely to be detected during prenatal diagnosis. Prenatal testing can also detect fetal heart rhythm abnormalities, which makes it possible to start treatment at an early stage. Modern ultrasound technology also allows 3D imaging, which can also provide valuable diagnostic information.
 Summary: Prenatal diagnosis is a highly developed field of medicine that combines knowledge from various specialties. Thanks to prenatal diagnosis, it is possible to detect various abnormalities at an early stage of fetal life, which enables early treatment.

Prenatal harmful substances: Thai pregnant women's experiences.

The exposure of unborn babies to harmful substances during prenatal stages can lead to fetal anomalies, emphasizing the significance of pregnant women's practices in ensuring optimal fetal outcomes. However, there is a lack of understanding regarding this issue from the perspective of pregnant women. This study aimed to describe the experiences of pregnant women in avoiding harmful substances to their unborn babies. This study used a qualitative descriptive approach. Data were collected between September 2020 and April 2021 through in-depth interviews with 17 pregnant women purposively selected from two hospitals in southern Thailand. Data were transcribed verbatim and analyzed using thematic analysis. Four themes emerged from the participants' experiences: 1) understanding of harms, which included substance characteristics, exposure characteristics, body's protective mechanism, personal experiences, and obtained information; 2) practices for safety, which consisted of food safety, work safety, ambient air safety, and safety in personal/household products; 3) challenges in avoiding harmful substances, which were unrecognition, unavailability of safe substances, discomfort and inconvenience, inevitability, and family traditions; and 4) overcoming the challenges through personal changes, obtaining support, and ensuring a peaceful mind. The findings provide valuable insights into prenatal exposure to harmful substances, which can serve as a basis for developing comprehensive guidelines for best practices. It is crucial for nurses to receive training that enables them to educate pregnant women, enhancing their awareness of important harmful substances and promoting effective methods for maintaining safety in their daily activities. Additionally, nurses can develop interventions to empower pregnant women to overcome challenges by involving significant individuals, particularly family members, in providing support and creating an optimal prenatal environment.

Charting the Path: Navigating Embryonic Development to Potentially Safeguard against Congenital Heart Defects.

Congenital heart diseases (CHDs) are structural or functional defects present at birth due to improper heart development. Current therapeutic approaches to treating severe CHDs are primarily palliative surgical interventions during the peri- or prenatal stages, when the heart has fully developed from faulty embryogenesis. However, earlier interventions during embryonic development have the potential for better outcomes, as demonstrated by fetal cardiac interventions performed in utero, which have shown improved neonatal and prenatal survival rates, as well as reduced lifelong morbidity. Extensive research on heart development has identified key steps, cellular players, and the intricate network of signaling pathways and transcription factors governing cardiogenesis. Additionally, some reports have indicated that certain adverse genetic and environmental conditions leading to heart malformations and embryonic death may be amendable through the activation of alternative mechanisms. This review first highlights key molecular and cellular processes involved in heart development. Subsequently, it explores the potential for future therapeutic strategies, targeting early embryonic stages, to prevent CHDs, through the delivery of biomolecules or exosomes to compensate for faulty cardiogenic mechanisms. Implementing such non-surgical interventions during early gestation may offer a prophylactic approach toward reducing the occurrence and severity of CHDs.

Markers of dental pulp stem cells in in vivo developmental context

Teeth and their associated tissues contain several populations of mesenchymal stem cells, one of which is represented by dental pulp stem cells (DPSCs). These cells have mainly been characterised in vitro and numerous positive and negati ve markers for these cells have been suggested. To investigate the presence and localization of these molecules during development, forming dental pulp was examined using the mouse first mandibular molar as a model. The stages corresponding to postnatal (P) days 0, 7, 14, and 21 were investigated. The expression was monitored using customised PCR Arrays. Additionally, in situ localization of the key trio of markers (Cd73, Cd90, Cd105 coded by genes Nt5e, Thy1, Eng) was performed at prenatal and postnatal stages using immunohistochemistry. The expression panel of 24 genes assigned as in vitro markers of DPSCs or mesenchymal stem cells (MSCs) revealed their developmental dynamics during formation of dental pulp mesenchyme. Among the positive markers, Vcam1, Fgf2, Nes were identified as increasing and Cd44, Cd59b, Mcam, Alcam as decreasing between perinatal vs. postnatal stages towards adulthood. Within the panel of negative DPSC markers, Cd14, Itgb2, Ptprc displayed increased and Cd24a decreased levels at later stages of pulp formation. Within the key trio of markers, Nt5e did not show any significant expression difference within the investigated period. Thy1 displayed a strong decrease between P0 and P7 while Eng increased between these stages. In situ localization of Cd73, Cd90 and Cd105 showed them overlap in differentiated odontoblasts and in the sub-odontoblastic layer that is speculated to host odontoblast progenitors. The highly prevalent expression of particularly Cd73 and Cd90 opens the question of potential multiple functions of these molecules. The results from this study add to the in vitro based knowledge by showing dynamics in the expression of DPSC/MSC markers during dental pulp formation in an in vivo context and thus with respect to the natural environment important for commitment of stem cells.

Spatial Prediction of Stunting Incidents Prevalence Using Support Vector Regression Method

Stunting in toddlers is a major nutritional problem faced by Indonesia, with a high incidence rate occurring in several provinces across the country. This nutritional issue can occur at any age, starting from the prenatal stage, infancy, childhood, adolescence, adulthood, and even in the elderly. To reduce the prevalence of stunting in affected provinces, prevention efforts are essential, including predicting the spread of stunting incidents in each region. Therefore, this research conducted spatial prediction of the prevalence rate of stunting incidents using Machine Learning, specifically Support Vector Machine based Regression. The results of this study produced a prediction model with an RMSE (Root Mean Square Error) value of 0.008689303 and a multiple correlation coefficient of 0.65912721. Based on these findings, the predictive model utilized demonstrated satisfactory performance in predicting the prevalence rate of stunting incidents in each area

Outcomes after HSCT for mucolipidosis II (I-cell disease) caused by novel compound heterozygous GNPTAB mutations.

Mucolipidosis type II (MLII), or I-cell disease, is a rare lysosomal storage disease (LSD) caused by variants in the GNPTAB gene. MLII patients exhibit clinical phenotypes in the prenatal or neonatal stage, such as marked dysmorphic features, cardiac involvement, respiratory symptoms, dysostosis multiplex, severe growth abnormalities, and mental and motor developmental abnormalities. The median age at diagnosis for MLII is 0.7 years, the median survival is 5.0 years, and the median age at death is 1.8 years. No cure for MLII exists. Sanger sequencing of the GNPTAB gene identified the compound heterozygous mutations c.673C > T in exon 7 and c.1090C > T in exon 9, which were novel double heterozygous mutations first reported in China. For the first time, we describe our experience in the use of HSCT for MLII. Our patient underwent HSCT with cells from a 9/10 human leukocyte antigen (HLA)-matched unrelated donor at 12 months of age. Myeloid neutrophil and platelet engraftment occurred on Days 10 and 11, respectively. The patient's limb muscle tension was significantly reduced, and his gross and fine motor skills were improved four months after transplantation. DST(Developmental Screen Test) results showed that the patient's fine motor skills and mental development were improved compared with before HSCT. MLII is a very severe lysosomal storage disease, to date, only 3 cases have been reported on the use of HSCT to treat MLII. Our data show that HSCT is a potential way to prolong the life of patients and improve their quality of life. Due to the lack of comparable data and time, the exact benefit remains unclear in MLII patients. Longer-term follow-up and in-depth prospective studies are indispensable.

Diagnostics for Genetically Inherited Disorders: From Cytogenetics to Genomics Technologies- A Review

The frequent occurrence of chromosomal abnormalities in humans is one of the main factors responsible for the birth of children with disabilities. More than 7.6 million infants per year are diagnosed with severe genetic abnormalities. An increase in genetic abnormalities among children may be attributed to women suffering from hormonal disorders. Genetic malformations can either be hereditary or spontaneous due to the exposure of germinal cells to toxins and mutagens or even oxidative stress. Most genetic disorders lack proper treatment. However, proper counseling, therapy, and medication can minimize its impact. Early diagnosis of abnormalities in the fetus will benefit the parents in options assessment. Fetal chromosomal analysis is the best option for an appropriate genetic disorder diagnosis. The latest and emerging technologies involved in detecting chromosomal abnormalities at the prenatal stage are discussed in this review. Significant developments in prenatal diagnostics and the best globally available economical options were also discussed.

Therapeutic Targeting of the GSK3β-CUGBP1 Pathway in Myotonic Dystrophy

Myotonic Dystrophy type 1 (DM1) is a neuromuscular disease associated with toxic RNA containing expanded CUG repeats. The developing therapeutic approaches to DM1 target mutant RNA or correct early toxic events downstream of the mutant RNA. We have previously described the benefits of the correction of the GSK3β-CUGBP1 pathway in DM1 mice (HSALR model) expressing 250 CUG repeats using the GSK3 inhibitor tideglusib (TG). Here, we show that TG treatments corrected the expression of ~17% of genes misregulated in DM1 mice, including genes involved in cell transport, development and differentiation. The expression of chloride channel 1 (Clcn1), the key trigger of myotonia in DM1, was also corrected by TG. We found that correction of the GSK3β-CUGBP1 pathway in mice expressing long CUG repeats (DMSXL model) is beneficial not only at the prenatal and postnatal stages, but also during adulthood. Using a mouse model with dysregulated CUGBP1, which mimics alterations in DM1, we showed that the dysregulated CUGBP1 contributes to the toxicity of expanded CUG repeats by changing gene expression and causing CNS abnormalities. These data show the critical role of the GSK3β-CUGBP1 pathway in DM1 muscle and in CNS pathologies, suggesting the benefits of GSK3 inhibitors in patients with different forms of DM1.

Transverse Canal Foramen and Pericarotid Venous Network in Metatheria and Other Mammals

Transverse Canal Foramen and Pericarotid Venous Network in Metatheria and Other Mammals

Different types of bisphenols alter ovarian steroidogenesis: Special attention to BPA

Endocrine disruptors such as bisphenol A (BPA) and some of its analogues, including BPS, BPAF, and BPE, are used extensively in the manufacture of plastics. These synthetic chemicals could seriously alter the functionality of the female reproductive system. Although the number of studies conducted on other types of bisphenols is smaller than the number of studies on BPA, the purpose of this review study was to evaluate the effects of bisphenol compounds, particularly BPA, on hormone production and on genes involved in ovarian steroidogenesis in both in vitro (human and animal cell lines) and in vivo (animal models) studies.The current data show that exposure to bisphenol compounds has adverse effects on ovarian steroidogenesis. For example, BPA, BPS, and BPAF can alter the normal function of the hypothalamic-pituitary-gonadal (HPG) axis by targeting kisspeptin neurons involved in steroid feedback signals to gonadotropin-releasing hormone (GnRH) cells, resulting in abnormal production of LH and FSH. Exposure to BPA, BPS, BPF, and BPB had adverse effects on the release of some hormones, namely 17-β-estradiol (E2), progesterone (P4), and testosterone (T). BPA, BPE, BPS, BPF, and BPAF are also capable of negatively altering the transcription of a number of genes involved in ovarian steroidogenesis, such as the steroidogenic acute regulatory protein (StAR, involved in the transfer of cholesterol from the outer to the inner mitochondrial membrane, where the steroidogenesis process begins), cytochrome P450 family 17 subfamily A member 1 (Cyp17a1, which is involved in the biosynthesis of androgens such as testosterone), 3 beta-hydroxysteroid dehydrogenase enzyme (3β-HSD, involved in the biosynthesis of P4), and cytochrome P450 family 19 subfamily A member 1 (Cyp19a1, involved in the biosynthesis of E2). Exposure to BPA, BPB, BPF, and BPS at prenatal or prepubertal stages could decrease the number of antral follicles by activating apoptosis and autophagy pathways, resulting in decreased production of E2 and P4 by granulosa cells (GCs) and theca cells (TCs), respectively. BPA and BPS impair ovarian steroidogenesis by reducing the function of some important cell receptors such as estrogens (ERs, including ERα and ERβ), progesterone (PgR), the orphan estrogen receptor gamma (ERRγ), the androgen receptor (AR), the G protein-coupled estrogen receptor (GPER), the FSHR (follicle-stimulating hormone receptor), and the LHCGR (luteinizing hormone/choriogonadotropin receptor). In animal models, the effects of bisphenol compounds depend on the type of animals, their age, and the duration and dose of bisphenols, while in cell line studies the duration and doses of bisphenols are the matter.

Risk factors of postpartum hemorrhage due to uterine atony: a retrospective cohort study

Background: Postpartum hemorrhage (PPH) continues to be a significant global burden leading to high maternal mortality and morbidity rates. Uterine atony is the most prevalent cause of postpartum hemorrhage, accounting for 75% to 90% of cases.
 Aim: Research uterine atony related PPH at Hospital of Hue University of Medicine and Pharmacy’s Department of Obstetrics and Gynecology.
 Materials and methods: In this study, we conducted a retrospective case-control study to determine the risk factors for PPH among a cohort of women who gave birth between August 2020 and June 2021 at the Department of Obstetrics and Gynecology, Hue University of Medicine and Pharmacy Hospital. PPH was defined as an estimated blood loss ≥500 mL. Logistic regression analysis was used to identify independent risk factors for PPH.
 Results: After the vaginal deliveries, we collected data from 147 patients, including 49 women with PPH caused by uterine atony and 98 without PPH. Maternal characteristics significantly associated with PPH included: pre-delivery anemia (adjusted OR [aOR] 4.0, 95% Confidence interval [CI]: 1.7 - 11.2), macrosomia (aOR = 4.3; 95%CI 1.1 - 16.8) and grand parity (aOR = 4.7; 95%CI: 1.7 - 13.9).
 Conclusions: All pregnant women should have their risks associated with postpartum hemorrhage evaluated and monitored during their pregnancies’ prenatal, labor, and postpartum stages.

A homozygous EVC mutation in a prenatal fetus with Ellis-van Creveld syndrome.

Ellis-van Creveld (EvC) syndrome, caused by variants in EVC, is a rare genetic skeletal dysplasia. Its clinical phenotype is highly diverse. EvC syndrome is rarely reported in prenatal stages because its presentation overlaps with other diseases. A Chinese pedigree diagnosed with EvC syndrome was enrolled in this study. Whole-exome sequencing (WES) was applied in the proband to screen potential genetic variant(s), and then Sanger sequencing was used to identify the variant in family members. Minigene experiments were applied. WES identified a homozygous variant (NM_153717.3:c.153_174 + 42del) in EVC which was inherited from the heterozygous parents and confirmed by Sanger sequencing. Further experiments demonstrated that this variant disrupts the canonical splicing site and produces a new splicing site at NM_153717.3: c.-164_174del, which ultimately leads to a 337 bp deletion at the 3' end of exon 1 and loss of the start codon. This is the first reported case of EvC syndrome based on a splicing variant and detailed delineation of the aberrant splicing effect in the fetus. Our study demonstrates the pathogenesis of this new variant, expands the spectrum of EVC mutations, and demonstrates that WES is a powerful tool in the clinical diagnosis of diseases with genetic heterogeneity.

Prenatal maternal depressive symptoms are associated with neonatal left amygdala microstructure in a sex-dependent way.

Exposures to prenatal maternal depressive symptoms (PMDS) may lead to neurodevelopmental changes in the offspring in a sex-dependent way. Although a connection between PMDS and infant brain development has been established by earlier studies, the relationship between PMDS exposures measured at various prenatal stages and microstructural alterations in fundamental subcortical structures such as the amygdala remains unknown. In this study, we investigated the associations between PMDS measured during gestational weeks 14, 24 and 34 and infant amygdala microstructural properties using diffusion tensor imaging. We explored amygdala mean diffusivity (MD) alterations in response to PMDS in infants aged 11 to 54 days from birth. PMDS had no significant main effect on the amygdala MD metrics. However, there was a significant interaction effect for PMDS and infant sex in the left amygdala MD. Compared with girls, boys exposed to greater PMDS during gestational week 14 showed significantly higher left amygdala MD. These results indicate that PMDS are linked to infants' amygdala microstructure in boys. These associations may be relevant to later neuropsychiatric outcomes in the offspring. Further research is required to better understand the mechanisms underlying these associations and to develop effective interventions to counteract any potential adverse consequences.

ULTRASOUND FEATURES OF ANTENATAL MIDGUT VOLVULUS PRESENTING AS AN OBSTRUCTION IN 24 WEEKS FETUS: A RARE CASE REPORT

Mid- gut volvulus is an embryological abnormal xation of small bowel mesentery that commonly occurs during fetal development leading to ischemia of the involved intestine if not intervened. It is a rare and life-threatening condition that is difcult to diagnose in the prenatal stage. It is usually diagnosed at 27 weeks of gestation, but our case is reported at 24 weeks of gestation. A fetus of 26 years old primigravida with 24 weeks of gestation was discovered to have mid-gut volvulus with small bowel obstruction and absence of peristalsis on ultrasonographic examination antenatally. Ultrasonographic signs showed the presence of extensively dilated loops of bowel in a coffee bean shape and anatomic position reversed between the superior mesenteric vein (SMV) and superior mesenteric artery (SMA), as a sign of malrotation. Moreover, the presence of a "whirlpool sign” (wrapping of SMV and mesentery around SMA) was evaluated on color doppler. Close prenatal follow-up, appropriate delivery, and timing of therapeutic intervention may signicantly lower morbidity and mortality.

Pregnant Women Kesti: Assistance Program "Pregnant Women Know Stunting" as an Effort to Prevent Stunting and Accidents in Bandengan, Pekalongan City

The prevalence of stunted growth among toddlers in Indonesia is a significant factor contributing to its fifth-place ranking globally, with 38% of the total number of toddlers affected by this condition. The prevalence of stunting in Pekalongan City remains considerably high, as evidenced by the recorded figure of 1,421 under-five children who were found to be stunted during the year 2021. The 1000 HPK program is an initiative aimed at preventing stunts. This 1000-day window presents an opportunity to prioritize the nutritional status, health, and psychosocial stimulation of the child during the prenatal, breastfeeding, and complementary feeding stages. The mother's involvement is crucial, as is the role of the husband or other close family members. The Bandengan sub-district region is pertinent in the context of stunting prevention, a chronic nutritional issue that arises from prolonged insufficient nutrient intake, leading to growth impairments in children, specifically a below-average height or dwarfism relative to their age standard. Support is provided through educational interventions aimed at identifying growth and development, nutritional education for expectant mothers, physical exercises, and educational strategies for expectant mothers who are breastfeeding. The outcomes of the mentoring program entail the execution of counseling sessions aimed at enhancing awareness and comprehension of maternal health and balanced nutrition during pregnancy. The objective is to emphasize the significance of fulfilling a healthy and balanced diet to prevent early childhood stunting among pregnant women

The socio-demographic profile associated with perinatal depression during the COVID-19 era

BackgroundCoronavirus disease 2019 (COVID-19) has caused an increase in perinatal depression. The aim of this research was to identify which sociodemographic variables are related to the increase in perinatal depression due to the pandemic. In addition to estimating to what extent they predict perinatal depression, differentiating the prenatal and postnatal periods.MethodsThe sample consisted of 3,356 subjects, 1,402 in the prenatal period and 1,954 in the postnatal period. The Edinburgh Postnatal Depression Scale was used to assess depressive symptomatology. A subset of 14 questions was included to collect demographic data. Items from the Spanish version of the Coronavirus Perinatal Experiences Survey were also included.ResultsExperiencing the change of environment due to COVID-19 as negative and having a history of mental health predict perinatal depression, otherwise having higher education decreases the risk. In the prenatal stage having symptoms compatible with COVID-19 is a predictor of perinatal depression and having more than 3 years living together with the partner and being a housewife decreases the risk. In the postnatal stage being unemployed is a predictor of prenatal depression and being a first-time mother decreases the risk.ConclusionsThis study highlights the relevance of sociodemographic status. It is essential to be aware of the risk factors of perinatal depression, to make adequate prevention, and to create health policies to alleviate the consequences of the pandemic.

Humanized childbirth, a link to humanitarian treatment, synonymous with quality obstetric care at the 1st level of care in Mexico

Bringing a new being into the world is a relevant and transcendent event in a woman's life, which will be marked for the rest of her life. However, it can be experienced as a painful and traumatic experience. Objective: Analyze the most effective actions to improve the quality of humanized delivery care in low-risk pregnant women in hospitals of 1st and 2nd level of care. Methodology: A narrative review was carried out that includes a critical, reflective analysis of humanized childbirth. The review of: original articles, revision of doctoral and master's theses was carried out. The adopted search strategy included keywords or descriptors, connected by means of the boolean operator and. The keywords used were "humanization", "delivery", "human needs", and breastfeeding, these being identified through Medical Subject Headings 2020 Serach MeSH, in this way the referred articles, descriptors in language were used for the search. Spanish and English. The search was carried out in various databases. Information collection time 6 months, (August 2022 to February 2023). Results: The review allowed us to analyze in a standardized way the historical evolution of humanized childbirth and the transcultural significance that it represents and to a large extent to be carried out, and how it will reinforce the multidisciplinary health team that cares for women in this process, to offer different strategies. to be this stage an unforgettable and humanistic experience that you will never forget. Conclusions: Humanized childbirth is translated into a birth with a humanistic character which includes: the prenatal stage, labor, delivery and the puerperium, where the protagonists are the pregnant woman and the newborn, receiving dignified, free treatment. of violence and based on human and ethical rights