PROBLEM: Up to 75 % of at-risk perinatal women do not receive treatment in Czechia. BACKGROUND: Pregnant women with mental health difficulties are more likely to undergo less controversial nonpharmaceutical treatment during pregnancy, but structural and psychological barriers interfere with their capacity to seek professional help. AIM: We tested the effectiveness of the telephone-based peer support intervention Mom Supports Mom (MSM) in Czech pregnant women at risk of mental disorder. METHODS: The Edinburgh Postnatal Depression Scale (EPDS) was used to assess risk in women (EPDS ≥ 10). Women at risk were randomized into two groups; the intervention group received the MSM, while the control group received the care as usual, which did not contain any psychological support intervention. One month after completing the EPDS, the women's mental statuses were again measured and compared, this time with data before and after the intervention, using the Perinatal Anxiety Screening Scale (PASS) to measure anxiety, the EPDS to measure depression, the Prenatal Psychosocial Profile (PPP) to measure stress, and the Prenatal Attachment Inventory - Revised (PAI-R) to measure attachment. The trial was registered under the name Pregnancy without psychosocial stress (ClinicalTrials.gov ID NCT04853693). FINDINGS: A total of 167 women were included in the study and randomized into two groups. Depressive symptoms did not decrease (Cohen´s d; 95 % CI = 0.48; 0.17-0.79; p = .002), but levels of anxiety (Cohen´s d; 95 % CI = 0.44; 0.13-0.75; p = .005) and psychosocial stress (Cohen´s d; 95 % CI = 0.55; 0.20-0.82; p = .002) were reduced in women in the intervention group compared with women in the control. In addition, prenatal attachment increased among intervened women (Cohen´s d; 95 % CI = 0.48; 0.17-0.79; p = .002). DISCUSSION: The telephone-based peer support intervention MSM is effective in reducing stress and anxiety and increasing prenatal attachment but does not reduce depression among high-risk women.

• Klíčová slova
• Antenatal anxiety, Antenatal depression, Peer support, Pregnancy, Prenatal attachment, Psychosocial stress,
• MeSH
• dospělí MeSH
• lidé MeSH
• matky psychologie   MeSH
• prenatální péče metody   MeSH
• psychiatrické posuzovací škály MeSH
• sociální opora * MeSH
• těhotenství MeSH
• těhotné ženy psychologie   MeSH
• vyrovnaná skupina * MeSH
• Check Tag
• dospělí MeSH
• lidé MeSH
• těhotenství MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• randomizované kontrolované studie MeSH
• Geografické názvy
• Česká republika MeSH

BACKGROUND: Maternal-fetal attachment might be associated with maternal mental health issues, but previous results have been inconsistent, particularly regarding prenatal anxiety. We compared maternal-fetal attachment between pregnant women with and without symptoms of antenatal depression and anxiety. Additionally, we examined the relationships between prenatal depressive and anxiety symptoms, psychosocial stress, and maternal-fetal attachment. METHODS: We conducted a cross-sectional study involving a sample of 2,233 pregnant women. The data were collected between March 2021 and March 2023 at outpatient clinics in the Czech Republic. We used self-report questionnaires to assess symptoms of prenatal depression (Edinburgh Postnatal Depression Scale, EPDS), anxiety (Perinatal Anxiety Screening Scale, PASS), psychosocial stress (Prenatal Psychosocial Profile, PPP), and maternal-fetal attachment (Prenatal Attachment Inventory - Revised, PAI-R). RESULTS: Women without symptoms of antenatal depression had higher total scores on the PAI-R (U = 336,357; p = .013) and on the PAI-R Interaction subscale (U = 322,913; p < .001), suggesting a higher quality of maternal-fetal attachment than women with symptoms. No other significant associations were found between antenatal depression, anxiety and the PAI-R subscales scores. CONCLUSIONS: Our results suggest that women experiencing increased depressive, but not anxiety, symptoms in pregnancy, have a poorer quality of attachment to their child, although the effect size is small. Consequently, treating prenatal depression in women could have a positive effect on maternal-fetal attachment.

• Klíčová slova
• Antenatal anxiety, Antenatal depression, Maternal-fetal attachment, Pregnancy,
• MeSH
• deprese * psychologie   epidemiologie   MeSH
• dospělí MeSH
• komplikace těhotenství * psychologie   MeSH
• lidé MeSH
• maternofetální vztahy * psychologie   MeSH
• mladý dospělý MeSH
• připoutání k objektu * MeSH
• průřezové studie MeSH
• psychický stres * psychologie   MeSH
• těhotenství MeSH
• úzkost * psychologie   epidemiologie   MeSH
• Check Tag
• dospělí MeSH
• lidé MeSH
• mladý dospělý MeSH
• těhotenství MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• Geografické názvy
• Česká republika epidemiologie   MeSH

OBJECTIVE: To compare the effects of childbirth fear and trait anxiety on the risk of emergency cesarean section; to analyze whether emergency cesarean section is associated with low mastery and maternal self-esteem; to examine whether stress and low social support in pregnancy may be considered risk factors for emergency cesarean section. DESIGN: Original study. SETTING: Department of Psychology, Faculty of Arts, Charles University, Prague. METHODS: The study sample consisted of 447 women who gave birth at a maternity hospital in Vysočina Region (Havlíčkův Brod, Jihlava, Pelhřimov, Třebíč, Nové Město na Moravě) between October 2013 and September 2014. In the last trimester of pregnancy, the women completed validated questionnaires designed to assess fear of childbirth, general anxiety, maternal self-esteem, mastery, perceived stress and social support. Data regarding the course of labor were extracted from medical records. The association between the psychosocial factors and the risk of delivery via emergency cesarean section was analyzed using multiple logistic regression adjusted for marital status, parity, childs sex and epidural anesthesia. RESULTS: A total of 73 women (16.3%) delivered by emergency cesarean section. The only statistically significant psychosocial predictor of emergency cesarean section was fear of childbirth (the women with strong fear had a twice higher risk; OR = 2.01; p = 0.021), whereas low maternal self-esteem was marginally significant (OR = 1.68; p = 0.082) in the adjusted analysis. No association between emergency cesarean section and general anxiety, mastery, stress or social support in pregnancy was found. The risk of cesarean section was higher for primiparous women and lower for women who gave birth to a girl. CONCLUSION: Fear of childbirth but not general anxiety is associated with a higher risk of emergency cesarean section. The women who experience strong fear of childbirth during pregnancy should be recommended to attend antenatal classes or, in case of extremely severe childbirth fear, to seek psychological counseling.

• Klíčová slova
• cesarean section, childbirth, cohort studies, fear of childbirth, pregnancy, psychosocial aspects,
• MeSH
• císařský řez psychologie   MeSH
• dospělí MeSH
• lidé MeSH
• náhlé příhody psychologie   MeSH
• porod MeSH
• porodní děj psychologie   MeSH
• průzkumy a dotazníky MeSH
• rizikové faktory MeSH
• strach * MeSH
• těhotenství MeSH
• úzkost psychologie   MeSH
• Check Tag
• dospělí MeSH
• lidé MeSH
• těhotenství MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH

We present the results from the largest clinical application of QF-PCR for antenatal rapid aneuploidy detection (RAD) in routine prenatal diagnosis in the Czech Republic. QF-PCR was performed in addition to karyotyping (dual testing) in two settings: the first was a single multiplex reaction testing only trisomy 21 and amelogenin X/Y alleles in the second trimester screened positive cases (T21 test), and the second setting consisted of two multiplexes (2M test) for common aneuploidies (13, 18, 21, X and Y) in cases with other RAD indications such as ultrasound findings, late booking or maternal anxiety. Dual testing was performed in 6349/12,778 (49.7%) of prenatal samples using either T21 or 2M test between 2002 and 2007. The clinical acceptability of our dual testing policy, methodological efficiency of RAD and residual risks of other chromosomal aberrations (CHAs) were evaluated. QF-PCR detected 92% (175/190) of significant CHAs. The 2M test identified 93.5% and the T21 test identified 87.5% of the significant CHAs with complete specificity. The residual risk of significant CHA was 1/231 in the 2M test and 1/565 in the T21 test. If RAD for all common aneuploidies is used as the sole prenatal diagnosis method, the odds of missing a CHA of any type are 1:90 and the odds of missing significant CHA with no ultrasound findings are 1:1513. If prenatal karyotyping were used as an additional procedure to RAD in cases only with ultrasound findings, 186/190 (97.8%) of the significant CHAs would be detected when 15.7% cases were karyotyped, according to our data. We consider RAD directed towards trisomy 21 alone (our T21 test) as an economically and clinically acceptable part of second trimester screening for Down syndrome. Both RAD tests allow fast alleviation of maternal anxiety with low residual risk when the test results are negative, and allow fast decision making if the results are positive. However, replacement of dual testing with only the RAD procedure in specific indications accepted in some countries (Great Britain) remains in the Czech Republic a theme for debate.

• MeSH
• aneuploidie * MeSH
• chromozomální aberace MeSH
• karyotypizace MeSH
• lidé MeSH
• polymerázová řetězová reakce metody   MeSH
• prenatální diagnóza * MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• Geografické názvy
• Česká republika MeSH

INTRODUCTION: Prenatal mental health problems are associated with morbidity for the pregnant person, and their infants are at long-term risk for poor health outcomes. We aim to explore how the SARS-CoV-2 pandemic affected the mental health of pregnant people in the United Kingdom (UK), and to further identify resilience factors which may have contributed to varying mental health outcomes. We also aim to examine the quality of antenatal care provided during the pandemic in the UK and to identify potential inadequacies to enhance preparedness for future events. METHODS: During June-November 2020, we recruited 3666 individuals in the UK for the EPPOCH pregnancy cohort (Maternal mental health during the COVID-19 pandemic: Effect of the Pandemic on Pregnancy Outcomes and Childhood Health). Participants were assessed for depression, anxiety, anger and pregnancy-related anxiety using validated scales. Additionally, physical activity, social support, individualized support and personal coping ability of the respondents were assessed as potential resilience factors. RESULTS: Participants reported high levels of depression (57.05%), anxiety (58.04%) and anger (58.05%). Higher levels of social and individualized support and personal coping ability were associated with lower mental health challenges. Additionally, pregnant individuals in the UK experienced higher depression during the pandemic than that reported in Canada. Finally, qualitative analysis revealed that restrictions for partners and support persons during medical appointments as well as poor public health communication led to increased mental health adversities and hindered ability to make medical decisions. DISCUSSION: This study revealed increased mental health challenges among pregnant individuals in the UK during the SARS-CoV-2 pandemic. These results highlight the need for reassessing the mental health support measures available to pregnant people in the UK, both during times of crisis and in general.

• Klíčová slova
• anxiety, depression, maternal mental health, mixed methods, pregnancy, resilience, social support,
• Publikační typ
• časopisecké články MeSH

INTRODUCTION: Both maternal depression problems during pregnancy and prenatal exposure to air pollution have been associated with changes in the brain as well as worse mood and anxiety in the offspring in adulthood. However, it is not clear whether these effects are independent or whether and how they might interact and impact the brain age and mental health of the young adult offspring. METHODS: A total of 202 mother-child dyads from a prenatal birth cohort were assessed for maternal depression during pregnancy through self-report questionnaires administered in the early 90s, exposure to air pollutants (Sulfur dioxide [SO2], nitrogen oxides [NOx], and suspended particle matter [SPM]) during each trimester based on maternal address and air quality data, mental health of the young adult offspring (28-30 years of age; 52% men, all of European ancestry) using self-report questionnaires for depression (Beck Depression Inventory), mood dysregulation (Profile of Mood States), anxiety (State-Trait Anxiety Inventory), and psychotic symptoms (Schizotypal Personality Questionnaire), and brain age, estimated from structural magnetic resonance imaging (MRI) and previously published neuroanatomical age prediction model using cortical thickness maps. The brain age gap estimate (BrainAGE) was computed by subtracting structural brain age from chronological age. Trajectories of exposure to air pollution during pregnancy were assessed using Growth Mixture Modeling. The interactions of prenatal depression and prenatal exposure to air pollutants on adult mental health and BrainAGE were assessed using hierarchical linear regression. RESULTS: We revealed two distinct trajectories of exposure to air pollution during pregnancy: "early exposure," characterized by high exposure during the first trimester, followed by a steady decrease, and "late exposure," characterized by low exposure during the first trimester, followed by a steady increase in the exposure during the subsequent trimesters. Maternal depression during the first half of pregnancy interacted with NOX exposure trajectory, predicting mood dysregulation and schizotypal symptoms in young adults. In addition, maternal depression during the second half of pregnancy interacted with both NOx and SO2 exposure trajectories, respectively, and predicted BrainAGE in young adults. In those with early exposure to NOx, maternal depression during pregnancy was associated with worse mental health and accelerated brain aging in young adulthood. In contrast, in those with early exposure to SO2, maternal depression during pregnancy was associated with slower brain aging in young adulthood. CONCLUSIONS: Our findings provide the first evidence of the combined effects of prenatal exposure to air pollution and maternal depression on mental health outcomes and brain age in young adult offspring. Moreover, they point out the importance of the timing and trajectory of the exposure during prenatal development.

• Klíčová slova
• Air pollution, Brain aging, Longitudinal, Maternal antenatal depression, Prenatal birth cohort,
• MeSH
• deprese * chemicky indukované   MeSH
• dospělí MeSH
• duševní zdraví MeSH
• kohortové studie MeSH
• látky znečišťující vzduch škodlivé účinky   toxicita   MeSH
• lidé MeSH
• magnetická rezonanční tomografie MeSH
• mozek * účinky léků   růst a vývoj   diagnostické zobrazování   MeSH
• stárnutí MeSH
• těhotenství MeSH
• znečištění ovzduší * škodlivé účinky   MeSH
• zpožděný efekt prenatální expozice * chemicky indukované   psychologie   MeSH
• Check Tag
• dospělí MeSH
• lidé MeSH
• mužské pohlaví MeSH
• těhotenství MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• Názvy látek
• látky znečišťující vzduch MeSH

Sexual problems and dysfunctions during pregnancy are often led by the anxiety of hurting the fetus. Males are also afraid of hurting a female and females are afraid of insufficient satisfaction of a male partner. Just 12-14% of couples deny sexual problems after the childbirth. The main postpartum risk factor for dyspareunia is the extent of a birth injury. Breastfeeding is linked to a low coital activity, low sexual desires and low sexual satisfaction of females and their partners. Breastfeeding females start with a sexual life later; more often suffer from dyspareunia and indicate a lower satisfaction with the sexual intercourse. Further, episiotomy is associated with a higher prevalence of a postpartum dyspareunia. Low interest of antenatal and postnatal care providers in the issues of sexuality is documented. Lack of relevant information is the common reason for avoiding this topic. 76% of pregnant females would recommend a discussion on sexuality during pregnancy as a topic in an antenatal clinic and almost a half of pregnant women evaluate the information received from health care providers as insufficient (Ref. 48). Full Text (Free, PDF) www.bmj.sk.

• MeSH
• kojení MeSH
• libido * MeSH
• lidé MeSH
• poporodní období * MeSH
• sexuální chování * MeSH
• těhotenství * MeSH
• Check Tag
• lidé MeSH
• mužské pohlaví MeSH
• těhotenství * MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• přehledy MeSH

OBJECTIVES: The current best practice implementation project aimed to improve the quality of continuity of care and emotional well-being in women with high-risk pregnancies. INTRODUCTION: Perinatal mental health disorders, such as perinatal depression and anxiety, are considered major health issues and are associated with poor maternal and neonatal outcomes. Women with high-risk pregnancies are considered a group of women with a substantial vulnerability and the value of continuity of care is vital in this group. METHODS: The current project used the pre-post implementation clinical audit following the JBI Evidence Implementation framework. A baseline audit and a follow-up audit were conducted involving 120 high-risk pregnant women in a hospital's obstetric unit. An intervention was performed establishing a midwife consultation and a referral circuit for the different healthcare professionals. A screening was performed through several validated questionnaires. RESULTS: To reflect the continuum of care, three topics were selected, including antenatal psychosocial assessment, intrapartum care and postpartum depression assessment, with a total of 10 criteria. The baseline audit results showed 0% compliance in all the criteria since the proposed standards of care did not exist before the audit. After the implementation of the strategies, the compliance achieved 100% in all audit criteria. A multidisciplinary hospital guideline was established for standardized care and mental well-being care for high-risk pregnant women. CONCLUSION: Follow-up in the mental health of pregnant women is insufficient. Improving emotional well-being in pregnancy should be a target of clinical practice. More national and international guidelines to assess mental well-being during pregnancy and the postpartum period should be developed.

• MeSH
• babictví * metody   MeSH
• duševní zdraví MeSH
• kontinuita péče o pacienty MeSH
• lidé MeSH
• novorozenec MeSH
• porod MeSH
• rizikové těhotenství MeSH
• těhotenství MeSH
• Check Tag
• lidé MeSH
• novorozenec MeSH
• těhotenství MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH