How is the COVID pandemic affecting perinatal mental health?

A recent review published in the journal Progress in Neurology and Psychiatry discusses the adverse effects of the ongoing coronavirus disease 2019 (COVID-19) pandemic on perinatal mental health. Study: Perinatal mental health during the COVID‐19 pandemic. Image Credit: Pormezz / Shutterstock.com Study: Perinatal mental health during the COVID‐19 pandemic. Image Credit: Pormezz / Shutterstock.com Background The initial few weeks following childbirth are physically, emotionally, and mentally taxing. Perinatal depression can occur as early as before conception or as late as approximately one-year post-delivery. Although women with pre-existing mental disorders are at an increased risk of relapse during the perinatal period, these disorders may also arise for the first time in women with no prior history of the condition. In fact, mental disorders, which are associated with poor maternal and child outcomes, are considered a major complication that women endure during the perinatal period and affect nearly one in five pregnant women. The impact of the COVID-19 pandemic on perinatal mental health During the COVID-19 pandemic, pregnant women were especially vulnerable to the psychological effects of lockdowns and other restrictions that were put in place to reduce the transmission of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Increased social isolation due to lockdowns and social distancing measures, combined with other socioeconomic stressors like financial hardships and occupational changes, have contributed to the development of mental health disorders, particularly in the perinatal population. Additional factors were also found to increase the likelihood of mental disorders in perinatal women during the COVID-19 pandemic. Travel restrictions, for example, increased the potential for relationship conflict, controlling behaviors, and, in some instances, domestic abuse and violence. Furthermore, social distancing limited contact with friends, family, and support from healthcare providers, which also contributed to anxiety in these individuals. Despite the need for moral and emotional support from their peers, pregnant women often remained isolated from their support systems during the pandemic. Related Stories Scientists develop a novel solution to evaluate airborne transmission of SARS-CoV-2 Study investigates the effect of vitamin D and fish oil on croup What is currently known about immune responses to COVID-19 vaccines and cellular immune responses against SARS-CoV-2? The replacement of in-person maternity care and perinatal mental health services with virtual visits, as well as new policies prohibiting partners from accompanying patients to their in-person visits, also contributed to the isolation of expectant mothers. The absence of customary birthing experiences also caused grief for many. Concerns regarding the exposure of pregnant women and their unborn children to SARS-CoV-2 also increased anxiety in this patient population. In general, pregnant women with COVID-19 are more likely to necessitate intensive care unit (ICU) admission than non-pregnant women with COVID-19 of the same reproductive age. Due to persisting disparities amongst various socioeconomic populations, pregnant women of minority ethnic groups are at a heightened risk for acquiring COVID-19 during the perinatal period as compared to pregnant women of other races. Alcohol consumption has also been found to increase in the general population during the pandemic. In fact, one non-perinatal American study reported that this increase is more pronounced in women than men. It should be noted that the potential for domestic violence, abuse, and mental illness increases with alcohol abuse. Global surveys report that healthcare personnel who were working in perinatal mental health settings at the onset of the pandemic identified several obstacles to assessing and providing care to perinatal women, as well as their infants and extended families. During remote consultations and follow-ups, staff often reported challenges regarding their ability to detect early signs of mental illness. Additional concerns on how to assess and encourage the interactions between the mother and infant through teleconsultations have also been described. Guidance for improving clinical care The COVID-19 pandemic has highlighted the importance of improving current perinatal mental healthcare services. For example, it is evident that virtual appointments are beneficial to some working mothers. The current pandemic also emphasized the need for collaborative care between professionals in mental health and other organizations capable of assisting vulnerable perinatal women. Several organizations have proposed guidelines to improve support for women suffering mental health problems during the pandemic. These guidelines emphasize the importance of recognizing the unpredictability of the current political climate and empowering women with information so that they can be equipped to handle the continuously changing situation. A better understanding of the experiences of perinatal women during the pandemic could guide the adaptation and formulation of services for providing support aimed at improving perinatal mental health.

SARS-CoV-2 prime and booster vaccinations found to improve pregnancy and birth outcomes

In a recent study posted to the medRxiv* preprint server, researchers evaluated the impact of coronavirus disease 2019 (COVID-19) prime vaccination and booster vaccination during pregnancy on maternal and fetal health outcomes. Study: The effect of COVID-19 vaccination and booster on maternal-fetal outcomes: a retrospective multicenter cohort study. Image Credit: Natalia Deriabina/Shutterstock Study: The effect of COVID-19 vaccination and booster on maternal-fetal outcomes: a retrospective multicenter cohort study. Image Credit: Natalia Deriabina/Shutterstock Studies have reported that severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections during pregnancy have worsened maternal and fetal health outcomes with increased mortality and morbidity from maternal SARS-CoV-2 infections. However, data on the protective role of COVID-19 prime and booster vaccinations during pregnancy are lacking since there have been concerns regarding the potential adverse effects of vaccines on the health of mothers and their fetuses. About the study In the present retrospective cohort study, researchers evaluated the immune protection conferred by prime and booster COVID-19 vaccinations during pregnancy for improved pregnancy and birth outcomes. The multicenter study was conducted on women aged 18 to 45 who delivered at PJSH (providence St. Joseph health, n=86,833) sites in California, Alaska, Oregon, Montana, Texas, Washington, and New Mexico between 26 January 2021 and 11 July 2022. Data were obtained from PJSH electronic health records (EHRs) of all participants with singleton pregnancies and delivery ≥20 weeks post-gestation. The study participants were categorized based on their status of vaccination during delivery as follows: (i) unvaccinated individuals (n=48,492), (ii) propensity score matched (PSM)-unvaccinated individuals (n=26,790), (iii) prime-vaccinated individuals (n=26,792; double vaccination with Moderna’s messenger ribonucleic acid (mRNA)-1273 or Pfizer-BioNTech’s BNT162b2 ≥2 weeks before delivery), and (iv) booster-vaccinated individuals (n=7,616). The prime study outcome was the maternal SARS-CoV-2 infection rate. Secondary maternal outcomes were the duration between breakthrough SARS-CoV-2 infection and complete vaccinations, COVID-19-associated hospital admission rates, oxygen supplementation requirements, vasopressor usage, SARS-CoV-2 infection severity, and medications. Other maternal health outcomes included rates of gestational hypertension, gestational diabetes, and preeclampsia. The secondary birth outcomes assessed were preterm births, stillbirths, gestational age at delivery, rates of low birth weight (below 2500g), and very low birth weight (below 1500g). COVID-19 was diagnosed based on polymerase chain reaction (PCR) reports. Results Related Stories Herpesvirus-6 and Epstein–Barr virus reactivation across acute SARS-CoV-2 patients What is currently known about immune responses to COVID-19 vaccines and cellular immune responses against SARS-CoV-2? Researchers find evidence of negative repercussions of immune history in SARS-CoV-2 infection The majority of maternal SARS-CoV-2 infection cases were reported in the unvaccinated cohort and a few individuals who received prime and/or booster vaccinations developed breakthrough SARS-CoV-2 infections before the SARS-CoV-2 Omicron variant became predominant. However, a few cases of maternal SARS-CoV-2 infections were reported among boosted individuals even during Omicron predominance. A significantly lower number of maternal COVID-19 cases were reported among booster-vaccinated individuals compared to prime-vaccinated individuals and significantly lesser maternal SARS-CoV-2 infections among vaccinated individuals compared to the unvaccinated PSM-matched or unmatched individuals. The vaccinated cohort with maternal SARS-CoV-2 infections during Omicron predominance showed a lower likelihood of seeking emergency care, with a greater likelihood of receiving care in outpatient settings compared to unvaccinated individuals. The vaccinated cohort showed a significantly lower likelihood of requiring vasopressors and oxygen supplementation than the unvaccinated matched cohort. Significantly lower rates of stillbirths, very low birth weight, and preterm births were reported for vaccinated individuals compared to the unvaccinated cohort. Three COVID-19-associated maternal deaths were reported, all of which were among unvaccinated individuals. Significantly lower rates of maternal SARS-CoV-2 infections were reported among boosted individuals with a lower likelihood of requiring hospital admissions and a longer duration between complete vaccination and breakthrough SARS-CoV-2 infections compared to prime vaccinated individuals. In addition, birth outcomes such as preterm births, stillbirths, very low birth weights and small gestational age were significantly lower among booster vaccinated individuals than in the prime vaccinated cohort. Vaccinated individuals showed an increased likelihood of being elder, non-Hispanics or Asians, residing in urban settings, with higher body mass index (BMI) values, insurance, lower socioeconomic vulnerability, negative history of chronic diabetes, gestational diabetes, preterm births, chronic hypertension, low parity, cesarean section delivery and fetus of the male sex. Vaccinated individuals were less likely to smoke or use non-illicit drugs. No significant differences were observed in the rates of severe or non-severe preeclampsia and gestational hypertension between the vaccinated cohort and unvaccinated cohort individuals. Overall, the study findings showed that COVID-19 vaccinations protect against poor maternal and fetal outcomes and vaccine boosters enhance the immune protection against SARS-CoV-2 infections. Therefore, pregnant women must be prioritized for SARS-CoV-2 prime and booster vaccinations. Further research must be conducted for exploring the immune benefit of fourth COVID-19 vaccinations during pregnancy. *Important notice medRxiv publishes preliminary scientific reports that are not peer-reviewed and, therefore, should not be regarded as conclusive, guide clinical practice/health-related behavior, or treated as established information.

Pregnancy information Sonographers can help enhance parents' emotional connection to the unborn baby during pregnancy

A systematic review of twenty-three studies suggests that, during pregnancy, expectant parents' feelings towards their unborn baby (fetus) can be positively enhanced by sonographers (specialist healthcare professionals who are trained to perform pregnancy ultrasound scans) making imaging examinations a truly parent-centered experience. Such an experience can allay feelings of anxiety and stress in the parents, helping them to feel more informed about the health and well-being of their unborn baby, and reassured of their emotional investment in the ongoing pregnancy. Conducted by the Centre for Maternal and Child Health Research at City, University of London, the review provides a holistic interpretation of the current evidence on the effect of antenatal (before birth) imaging on expectant parents' feelings towards their unborn baby. To date, whilst the provision of ultrasound scans during pregnancy has been generally regarded as a positive experience for parents, and may predict the quality of the parent-child relationship after birth, there is evidence to suggest that the experience may also lead to increased anxiety and stress in parents, particularly those who are unable to interpret the scan images. Seventeen of the studies analyzed in the review related to the mother's experience only, five included both parents and one study recruited fathers only. Six central themes were developed from analysis of the included studies: the scan experience begins before the scan appointment; including parents looking forward to the scan, but being simultaneously apprehensive of the potential to receive unexpected news about their baby the scan as a pregnancy ritual; parents regarded scans as a milestone event, which they expected, and wanted feeling actively involved in the scan; with the presence of fathers at scans important, not only for maternal support, but also as attending fathers felt closer to their unborn baby than those who were not parents' priorities for knowledge and understanding of the scan change during pregnancy; at earlier stages of pregnancy, parents prioritized knowing that their pregnancy was viable, at later stages it was important for parents to know about the presence of fetal anomalies the importance of the parent–sonographer partnership during scanning; parents' confidence in their sonographer was linked with narration of the scan, and limiting the use of non-medical terminology humanized the fetus, and implied to parents that the sonographer recognized their unborn baby as an individual rather than a medical entity scans help to create a social identity for the unborn baby; many parents centered their news about pregnancies around a scan, with some waiting until their first scan to tell friends and family about their pregnancies, and sharing their scan pictures or videos so that their support circle had a sense of knowing the baby even before birth Related Stories Study investigates the effect of vitamin D and fish oil on croup A mother's diet during pregnancy is linked to her child's food preferences Dolutegravir-based regimen more effective for treating pregnant people with HIV-1 The review also identified a lack of published research studies exploring the impact of fetal MRI (magnetic resonance imaging) on expectant parents' emotional connection to their unborn baby. Fetal MRI is becoming more commonly used to complement ultrasound imaging when a fetal anomaly is suspected. Hence, the authors stress that more research needs to be undertaken in this area to help understand the acceptability of this type of scan to parents and its potential effect on their feelings towards their unborn child. Lead author, Emily Skelton, is a sonographer, lecturer and College of Radiographers Doctoral Fellow within the Department of Radiography and Midwifery at City, University of London. We know how important scans during pregnancy are to provide clinical information about fetal growth and development, but there are additional benefits for expectant parents, who, in their transition to parenthood, may feel closer to their unborn babies after "seeing" them on scan. This review highlights the integral role of the sonographer in facilitating the developing connection between expectant parents and their unborn babies, through an informative, supportive and inclusive parent-centred approach to care that parents feel actively involved in."

life styale Study investigates the effect of vitamin D and fish oil on croup

Babies and children under three years old are less likely to develop croup if their mothers took fish oil and vitamin D supplements during pregnancy, according to new results from a clinical trial. The findings are from a randomized controlled trial – the 'gold standard' for medical research – that will be presented at the European Respiratory Society International Congress in Barcelona, Spain. It is the first large study of its kind to investigate the effects of vitamin D and fish oil on croup. Croup is a viral chest infection that affects young children. It causes a characteristic 'barking' cough, a hoarse voice and difficulty breathing. Croup is common and usually mild, but some children will need hospital treatment and breathing support. The study was presented by Dr Nicklas Brustad, a clinician and postdoctoral researcher working on the Copenhagen Prospective Studies on Asthma in Childhood (COPSAC) at Copenhagen University Hospital, Denmark. There is currently no vaccine against the pathogen that causes this disease. Therefore, other preventive strategies are needed, and measures initiated during pregnancy might be important since croup occurs in babies and young children. For such purpose, there is evidence that both vitamin D and fish oil could have an influence on the immune system." Dr Nicklas Brustad, Clinician and Postdoctoral Researcher, Copenhagen University Hospital The study included 736 pregnant women being cared for by COPSAC from 2010. The women were divided up into four groups. One group were given a high-dose vitamin D supplement (2800 international units per day) and fish oil containing long-chain n-3-polyunsaturated fatty acids (2.4 grams), the second group were given high-dose vitamin D and olive oil, the third group were given standard-dose vitamin D (400 international units per day) and fish oil, and the final group were given standard-dose vitamin D and olive oil. All the women took the supplements daily from their 24th week of pregnancy until one week after their babies were born. Neither the women nor the researchers knew which supplements they were taking until the end of the study. Researchers monitored the children until they were three years old and any who were suspected of suffering from croup were diagnosed by a doctor or via their medical records. There was a total of 97 cases of croup amongst the children. Related Stories A mother's diet during pregnancy is linked to her child's food preferences The dynamics of neutralizing antibodies in a cohort of children and adolescents after SARS-CoV-2 infection Mercury level during pregnancy not likely to affect child development provided the mother eats fish Overall, children whose mothers took the fish oil had an 11% risk of croup, compared to 17% in the children whose mothers took olive oil (a 38% decrease). Children whose mothers took high-dose vitamin D had an 11% risk of croup, compared to an 18% risk in those whose mothers took the standard-dose vitamin D (a 40% decrease). Dr Brustad said: "Our findings suggest that vitamin D and fish oil could be beneficial against childhood croup in sufficiently high doses. These are relatively cheap supplements meaning that this could be a very cost-effective approach to improving young children's health. "We are not sure of the exact mechanisms behind the beneficial effects of vitamin D and fish oil, but it could be that they can stimulate the immune system to help babies and young children clear infections more effectively." The research team working at COPSAC have already investigated other potential benefits of vitamin D and fish oil during pregnancy, including its effects on bone development, the central nervous system, body composition and asthma. They will continue to follow the children in the study and plan to investigate why some children are more prone to infections in childhood than others. Professor Rory Morty from the University of Heidelberg is chair of European Respiratory Society's lung and airway developmental biology group and was not involved in the research. He said: "We know that lung health in babies and young children can be influenced during pregnancy. For example, babies whose mothers smoke tend to have worse lung health. We are increasingly seeing that elements of a mother's diet can also help or hinder a baby's lung development. "This research suggests that taking vitamin D and fish oil supplements during pregnancy could have benefits for babies and young children. We would like to see further research in this area to support these findings as this could lead to new recommendations for supplementation during pregnancy. Pregnant women should always speak to their doctor before taking supplements."

Study improves understanding of net worth poverty and child development

When people talk about poverty in the United States, most talk about income. But income is just half of the story, says Christina Gibson-Davis, a professor of public policy and sociology at Duke's Sanford School of Public Policy and an affiliate of Center for Child and Family Policy. The other half of the financial equation is family wealth: the value of a family's assets, like savings and property, minus their debt. Gibson-Davis is part of a research team that set out to find how children are affected by net worth poverty, defined as having wealth less than one-fourth of the federal poverty line, a standard set by income. In 2022, for example, the federal poverty line for a family of four living in the contiguous 48 states is $27,750. The team looked at wealth and income information, as well as cognitive and behavioral data, of children ages 3 to 17 years. The data was collected from 2002 to 2019 by the Panel Study of Income Dynamics. Their analysis indicated that net worth poverty is linked to lower cognitive scores and increases in problem and behavior scores in children. The new research appears Sept. 6 in Socius: Sociological Research for a Dynamic World, an open access journal. We now know that wealth deprivation likely has effects on children. Typically, people talk about the harms of income poverty, yet net worth poverty can also contribute to adverse outcomes. We have been focusing on one type of poverty and ignoring another." Christina Gibson-Davis, professor of public policy and sociology, Duke's Sanford School of Public Policy Related Stories Study addresses food texture challenges in the life of children with Down syndrome Caffeine metabolite could become a valuable treatment for myopia in children Using AI to foster productivity in pharmaceutical research and development "Very few families are just income poor," Gibson-Davis says. "Most poor parents experience net worth poverty. We should think about policies that focus on building wealth." Interventions such as the earned income tax credit focus on increasing cash flow to households. But that only has limited effectiveness if a family doesn't have an economic buffer. Building financial security through wealth can help families overcome tough financial periods. Their findings suggest policies that speak to both income and wealth might have bigger impacts for children, such as distributing "baby bonds" to apply to a child's future education. Providing reparations are another way. Previously, the same research team looked at who experiences net worth poverty and found that Black families with children are more likely than white families with children to have net worth poverty. Parents who are net-worth poor may be limited in the investments they can make in their children, Gibson-Davis adds, which includes everything from housing, schooling, social peers and greenspace. "Wealth is really fundamental to a child's well-being," Gibson-Davis says. "It affects children's visions of their future and what they think is possible." Research reported in this publication was supported by the National Institutes of Health's Eunice Kennedy Shriver National Institute of Child Health and Human Development under Award Number R21HD107249. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. Source: Duke University Journal reference:

life styale Vivo Surgical honored with the esteemed WIPO-IPOS IP for Innovation Award

Vivo Surgical, a pioneering medical device company based in Singapore, has become the first start-up to win the prestigious WIPO-IPOS IP for Innovation Award for 2022. Now in its 10th year, this award celebrates Singaporean companies that have achieved outstanding growth through the successful application of intangible assets and intellectual property. Over 40 organizations have received this highly regarded accolade since its inception, with this year’s criteria centered around adaptable and resilient companies emerging through recent global challenges. Vivo Surgical’s products and pipeline comprise innovative medical devices that enhance how surgeries are performed worldwide. Related Stories Vivo Surgical’s KLARO™ provides unparalleled illumination of surgical cavities The company is currently developing the world’s first disposable robot for natural orifice transluminal endoscopic surgeries (NOTES), and a portable endoscopic diagnostic device – ENLYT™ – with technologies that will eventually be incorporated into the robot’s final design. These solutions will complement the company’s existing CE-certified KLARO™ in vivo lighting device, which is designed to address inadequate illumination in operating theatres, providing a clearer view of surgical cavities. The company is now working with several renowned hospitals across the US, Europe and Asia, and its devices are distributed in multiple international territories. In just four-and-a-half years, we have built a company that focuses on addressing clinical needs with cutting-edge technologies. Being recognized with this award is a huge moment, not only for the team at Vivo Surgical, but also for all the patients our products help around the world. We hope that this achievement demonstrates how a young company like ours can punch above its weight on the world stage, and inspire other start-ups to do the same.”

LIFE STYale Vivo Surgical honored with the esteemed WIPO-IPOS IP for Innovation Award

Vivo Surgical, a pioneering medical device company based in Singapore, has become the first start-up to win the prestigious WIPO-IPOS IP for Innovation Award for 2022. Now in its 10th year, this award celebrates Singaporean companies that have achieved outstanding growth through the successful application of intangible assets and intellectual property. Over 40 organizations have received this highly regarded accolade since its inception, with this year’s criteria centered around adaptable and resilient companies emerging through recent global challenges. Vivo Surgical’s products and pipeline comprise innovative medical devices that enhance how surgeries are performed worldwide. Related Stories Vivo Surgical’s KLARO™ provides unparalleled illumination of surgical cavities The company is currently developing the world’s first disposable robot for natural orifice transluminal endoscopic surgeries (NOTES), and a portable endoscopic diagnostic device – ENLYT™ – with technologies that will eventually be incorporated into the robot’s final design. These solutions will complement the company’s existing CE-certified KLARO™ in vivo lighting device, which is designed to address inadequate illumination in operating theatres, providing a clearer view of surgical cavities. The company is now working with several renowned hospitals across the US, Europe and Asia, and its devices are distributed in multiple international territories. In just four-and-a-half years, we have built a company that focuses on addressing clinical needs with cutting-edge technologies. Being recognized with this award is a huge moment, not only for the team at Vivo Surgical, but also for all the patients our products help around the world. We hope that this achievement demonstrates how a young company like ours can punch above its weight on the world stage, and inspire other start-ups to do the same.”