The Psychological Impact of the COVID-19 Outbreak on Pregnancy and Mother-infant Prenatal Bonding

Neonatal outcomes of maternal prenatal coronavirus infection

The coronavirus disease 2019 (COVID-19) pandemic has led to significant changes in life and healthcare all over the world. Pregnant women and their newborns require extra attention due to the increased risk of adverse outcomes. Adverse pregnancy outcomes include intensive care unit (ICU) admission, pulmonary, cardiac, and renal impairment leading to mortality. Immaturity and variations of the neonatal immune system may be advantageous in responding to the virus. Neonates are at risk of vertical transmission and in-utero infection. Impaired intrauterine growth, prematurity, vertical transmission, and neonatal ICU admission are the most concerning issues. Data on maternal and neonatal outcomes should be interpreted cautiously due to study designs, patient characteristics, clinical variables, the effects of variants, and vaccination beyond the pandemic. Cesarean section, immediate separation of mother-infant dyads, isolation of neonates, and avoidance of breast milk were performed to reduce transmission risk at the beginning of the pandemic in the era of insufficient knowledge. Vertical transmission was found to be low with favorable short-term outcomes. Serious fetal and neonatal outcomes are not expected, according to growing evidence. Long-term effects may be associated with fetal programming. Knowledge and lessons from COVID-19 will be helpful for the next pandemic if it occurs. IMPACT: Prenatal infection with SARS-CoV-2 is associated with adverse maternal and neonatal outcomes. Our review includes the effects of COVID-19 on the fetus and neonates, transmission routes, placental effects, fetal and neonatal outcomes, and long-term effects on neonates. There is a growing body of data and evidence about the COVID-19 pandemic. Knowledge and lessons from the pandemic will be helpful for the next pandemic if it happens.

Intrapartum ultrasound and mother acceptance: A study with informed consent and questionnaire

Introduction

Intrapartum ultrasound (IU) is used in the delivery ward; even if IU monitors the labouring women, it could be perceived as a discomfort and even as an" obstetric violence", because it is a young technique, not often well "accepted". A group of clinicians aimed at obtain an informed consent from patients, prior to perform a translabial ultrasound (TU). The aim of this study was to evaluate the acceptance of both translabial and transabdominal IU.

Methods

In this study, performed at the University Hospital of Bari (Unit of Obstetrics and Gynecology), were enrolled 103 patients in the first or second stage of labor in singleton cephalic presentation. A statistical frequency and an association analysis were performed. As a significant result, we consider the peace of mind/satisfaction and the" obstetric violence". IU was performed both transabdominal and translabial to determine the presentation, head positions, angle of progression and head perineum distance. During the first and second stage of labor, the ASIUG questionnaires (Apulia study intrapartum ultrasonography group) were administered.

Results

74 (71, 84%) patients underwent IU and 29 had a vaginal examination (28, 15%). Significant less "violence" has been experienced with a IU (73 out 74/98, 65%) and only one person (1 /1, 35%) recorded that. On the contrary, 10 patients (10/29) perceived that "violence" (34, 48%) while 19 (65, 52%) did not respond on a similar way, after a vaginal examination (VE). More patients felt satisfaction (71 out 74/95, 95%) with the use of IU and only 3 (3/4, 05%) felt unease. A different picture was evident in the vaginal examination group. Only 17 patients (17 out 29/58, 62%) felt comfort while 12 (41, 38%) felt unease.

Conclusions

In our study, IU use is well accepted by most of patients, because it could reassure women about their fetal condition. Moreover, they can see the fetus on the screen, while the obstetrician is performing the US and this is important for a visual feedback, in comparison with the classical VE.

Factors influencing maternal-fetal attachment in pregnant women during the COVID-19 pandemic: a cross-sectional study

Purpose: Coronavirus disease 2019 (COVID-19) has spread widely throughout the world, causing psychological problems such as fear, anxiety, and stress. During the COVID-19 pandemic, pregnant women have been concerned about both their own health and the health of their fetuses, and these concerns could negatively affect maternal-fetal attachment. Thus, this study aimed to explore the level of COVID-19 stress, resilience, and maternal-fetal attachment among pregnant women during the COVID-19 pandemic, and to identify factors influencing maternal-fetal attachment.Methods: In total, 118 pregnant women past 20 weeks gestation were recruited from two maternity clinics in Daegu, Korea, to participate in this descriptive correlational study during COVID-19. The factors influencing maternal-fetal attachment were analyzed using hierarchical multiple regression analysis.Results: The mean scores for COVID-19 stress, resilience, and maternal-fetal attachment were 57.18±10.32 out of 84, 67.32±15.09 out of 100, and 77.23±9.00 out of 96, respectively. Nulliparous pregnant women reported greater maternal-fetal attachment than multiparous pregnant women (p=0.03). Religious pregnant women also reported greater maternal-fetal attachment than non-religious pregnant women (p=.039). Resilience (β=.29, p=.002), COVID-19 stress (β=.20, p=.030) and parity (β=–.17, p=.047) were factors influencing maternal-fetal attachment, and these factors explained 26.4% of the variance in maternal-fetal attachment (F=10.12, p<.001). Conclusion: Converse to common sense, COVID-19 stress exerted a positive influence on maternal-fetal attachment in pregnant women during the COVID-19 pandemic. Healthcare providers need to recognize the positive influence of COVID-19 stress and implement intervention strategies to strengthen resilience in pregnant women to improve attachment with their fetuses.