Erschöpfung und Depression in der Schwangerschaft: Hintergrund und therapeutische Behandlung

Neonatal therapy after maternal central neurotropic drug exposure-a retrospective cohort study

OBJECTIVE

Evaluation of neonatal morbidity after maternal central neurotropic drug exposure.

METHODS

Retrospective single-center level-III neonatology cohort analysis of neonates after CND from 2018 to 2021. Control group of neonates born to mothers without CND cared for at the maternity ward.

RESULTS

Significantly more frequent therapy need of neonates with CND [OR 23 (95% CI: 7.8-62); RR 14 (95% CI: 5.4-37); p < 0.01]. Neonates after CND had lower Apgar-scores LM 1 [CND 8.1; CG 8.6; p < 0.05]; LM 5 [CND 9; CG 9.7; p < 0.01]; LM 10 [CND 9.6; CG 9.9; p < 0.05]. The first symptom occurred in 95.35% within 24 h (mean: 3.3 h). CND group showed significantly more often preterm delivery [OR 3.5; RR 3.2; p < 0.05], and especially cumulative multiple symptoms [OR 9.4; RR 6.6; p < 0.01] but no correlation to multiple maternal medication use (p = 0.3).

CONCLUSIONS

Neonates exposed to CND are at increased risk for postnatal therapy, often due to multiple symptoms. Neonates should be continuously monitored for at least 24 h.

Prevalence of anxiety and depression among pregnant women during the COVID-19 pandemic: a meta-analysis

PURPOSE

Coronavirus disease (COVID-19) is a newly emerged respiratory illness, which has spread around the world. Pregnant women are exposed to additional pressure due to the indirect adverse effects of this pandemic on their physical and mental health. Since the psychological wellness framework is weak in developing countries, it is likely that geographical factors affect the prevalence. Therefore, the goal of this meta-analysis is to investigate the prevalence of anxiety and depression among pregnant women during the COVID-19 pandemic.

METHODS

We searched databases including PubMed/MEDLINE, Web of Science, Cochrane Library for articles. The quality of studies was determined based on the STROBE checklist. I2 and Cochrane Q-test were used to determine heterogeneity. Fixed effects and/or random effects models were also employed to estimate pooled prevalence.

RESULTS

Since heterogeneity was fairly high in all analyses, the random effect model was used. According to the results of random effects in the meta-analysis, the pooled prevalence was 18.7% (95% CI: 0.06-0.36%; I2=99%,P<0.001) for anxiety and 25.1% (95% CI: 0.18-0.33%; I2=97%, P<0.001) for depression. The results of continent subgroup analysis showed that the prevalence of anxiety was higher in western country (38%) than in Asia country (7.8%). The prevalence of anxiety in Italy (38%), Canada (56%), Pakistan (14%), Greece (53%), Sri Lanka (17.5%), and China (0.3-29%) and Iran 3.8% as well as the prevalence of depression in Canada (37%), Belgium (25%), Turkey (35.4%), Sri Lanka (19.5%), and China (11-29%) has been reported.

CONCLUSION

Covid-19 may impose extra pressure on the emotional wellbeing of pregnant women. Therefore, there is an urgent need for resources to help mitigate anxiety and depression in pregnant women.

The influence of general anxiety and childbirth-specific anxiety on birth outcome

In the present study, we examined a German sample to determine whether anxiety symptoms during pregnancy had an impact on the duration and method of childbirth. Data of N = 88 women recruited at the Heidelberg University Hospital were used in the analyses. Prepartum anxiety symptoms were assessed with the State-Trait Anxiety Inventory (STAI, general anxiety) and the Pregnancy Related Anxiety Questionnaire (PRAQ-R, pregnancy-specific anxiety). Obstetric outcome was taken from birth records and operationalized by two parameters: the total duration of birth (dilation and fetal expulsion) and the incidence of pregnancy or birth-related interventions (ventouse, planned, and unplanned Cesarean section). The data show that childbirth-specific anxiety assessed by the PRAQ-R is an important predictor of total birth duration. In contrast, general anxiety measured by the STAI had no effect. The incidence of birth intervention was explained by parity. Anxiety, however, had no predictive value. In addition to medical factors, childbirth-specific anxiety during pregnancy plays an important role in the process of childbirth. The findings of the present study point to the need of implementing psychological interventions to reduce childbirth-specific anxiety and thereby positively influencing birth outcome.