Predicting and Explaining Parenting Stress 3 Months After Birth Using Generalized Additive Model.

Parental stress affects parenting behaviour and the quality of dyadic parent-child interactions. Mothers generally show higher parental stress than fathers. Our aims were to assess the perceived level of parental stress in early parenthood and examine the differences between mothers and fathers within couples in relation to their levels of education, parental experience, existence of a parental role model and sense of coherence. In total, 307 mothers and 301 fathers of 18-month-old children answered the Swedish Parenthood Stress Questionnaire (SPSQ); and 318 mothers and 311 fathers answered the Sense of Coherence (SOC-3) scale; 283 couples answered both the SPSQ and SOC-3. Mothers perceived higher levels of stress than fathers in the sub-areas incompetence (p < 0.001), role restriction (p < 0.001), spouse relationship problems (p = 0.004) and health problems (p = 0.027), and in total (p = 0.001). In contrast, fathers perceived higher stress than mothers in the sub-area social isolation (p < 0.001). When the data were stratified with respect to education, parental experience, existence of a parental role model and sense of coherence, significant results were observed in some of these sub-areas. Mothers and fathers experience stress in different areas during their early parenthood. Healthcare professionals should be aware of the differences in stress that exist between mothers and fathers, so that parents can be adequately prepared for parenthood and avoid parental stress.

Pregnant women with psychosocial vulnerabilities should be offered perinatal interventions that include a parenting component to ameliorate the potential negative effects of maternal mental health problems and/or poor social network on parenting. One such intervention program is the Circle of Security-Parenting intervention (COS-P). The COS-P is a manualized video-based intervention that based on attachment theory seek to enhance maternal sensitivity and decrease the risk on insecure and disorganized attachment. We carried out a randomized controlled trial examining the efficacy of a perinatal adapted version of COS-P for women with psychosocial vulnerabilities (e.g. histories of mental health problems and/or poor social networks). Eligible participants (N = 78) were recruited to the study by midwives during regular prenatal sessions. Interventions were delivered individually at home by trained health nurses both pre and post birth. The primary outcome was maternal sensitivity assessed with the Coding Interactive Behavior Manual by blinded coders from video-recordings of mother-infant free play interactions. Secondary outcomes were mother-reported depressive symptoms, parental reflective functioning, parental stress, infant socio-emotional functioning, and maternal wellbeing. All outcomes were assessed at nine months infant age. We did not find an effect of the intervention on the primary outcome of maternal sensitivity (β = -0.08; 95% CI [-0.41, 0.26], p = .66). Neither did we find intervention effects on the secondary outcomes of depressive symptoms, parental reflective functioning, maternal well-being, or infant socio-emotional functioning. We did however find that the intervention decreased parental stress (β = -8.51; 95% CI [-16.6;-0.41], p = .04). The results are discussed in light of existing findings on the effect of COS-P and sample heterogeneity. Furthermore, we discuss the challenges of adapting the COS-P for pregnant women, some without prior experiences with caregiving. Future research with larger at-risk samples examining moderation factors (e.g. adult attachment, depression maternal-fetal attachment) are recommended.

Trisomy 18: Changes in sex ratio during intrauterine life

Gestational diabetes mellitus and hypertension are two common pregnancy complications, which seriously threaten the life safety of pregnant women and adversely affect the growth and development of the fetus. Therefore, it is of great significance to detect and prevent hypertension and diabetes at an early stage of pregnancy. Each pregnant woman will undergo multiple tests at different gestational weeks. This progress produces lots of pregnancy examination data. These data can reflect the dynamic changes of pregnant women’s health indicators during pregnancy. This study aims to establish gestational diabetes and hypertension prediction model with a machine learning method based on real pregnancy examination data from the hospital. We use Logistic Regression, XGBoost, LightGBM, and Neural Network Model based on LSTM to do the prediction, respectively, and compare the performance. We check the prediction accuracy at different stages of pregnancy. We found that with pregnancy examination data at all gestational weeks, the predictive AUCs for diabetes and hypertension can reach 0.92 and 0.87, respectively. At 16th gestational week, the AUCs are 0.68 for diabetes and 0.70 for hypertension. We extract the checking items which are most important and get a simplified model with a modest reduction in predictive accuracy. This study demonstrates that based on several routine pregnancy examination items we can establish a machine learning model to detect and predict gestational diabetes and hypertension. This can be used as a diagnostic aid and is conducive to early prevention and treatment.

To compare quality of life and its related factors, which include sexual activity, sleep problems, depression, anxiety and attachment styles in close relationships, between gynaecological cancer survivors and noncancer women. The majority of studies focus on examining the relationships between the late-treatment side effects and quality of life in gynaecological cancer survivors. As a result, there is insufficient information about what are the correlations between psychosocial factors and quality of life in gynaecological cancer survivors. Cross-sectional study. The quality of life of the 85 gynaecological cancer patients who had completed active treatments for at least sixmonths was compared with the 85 age-matched women without cancer history. Measures included SF-12 Health Surveys, Medical Outcomes Study Sleep Scale, Beck Depression Inventory-II, State-Trait Anxiety Inventory, Sexual Activity Questionnaire and Experiences in Close Relationships-Revised. There were no significant differences in the quality of life between gynaecological cancer survivors and noncancer women. However, higher attachment-related anxiety in close relationship was the main factor associated with the lower physical quality of life in the gynaecological cancer survivor group. In contrast, older ages were correlated with lower physical quality of life in noncancer women. Anxiety level was the main factor associated with lower mental quality of life for both groups. Different from noncancer women, the psychosocial factor of insecure attachment in close relationships was the main factor associated with physical quality of life for gynaecological cancer survivors. Anxiety status was the common factor correlated with mental quality of life for cancer and noncancer women. Developing psychosocial interventions focusing on secure attachment in close relationships and anxiety management could improve physical and mental components of quality of life among gynaecological cancer survivors.

Perinatal depression (PND) is a mood disorder affecting 10-15% of women during pregnancy and postpartum. Its aetiology is complex with contribution from both genetic background and psychosocial as well as environmental stressors that determine individual responses shaped by chronic and acute disease burden (1). It is thought that the molecular basis of PND involves dysregulation of the HPA axis associated with neurotransmitter and neuroactive steroids imbalance. Inflammation appears to be a contributing mechanism, with increased levels of cytokines exerting adverse effects on serotonin metabolism, neuroplasticity and HPA hyperactivity (2). With only 50% of women detected through current screening strategies, there is an urgent unmet need for the development of biomarker-based strategies to identify women at risk of PND. In this study we used data and blood samples from the prospective Coventry and Warwickshire PND study; we investigated for inflammatory markers associated with depressive symptoms, assessed using the Edinburgh Postnatal Depression Score (EPDS) questionnaire between 24-29 weeks of gestation and again 6-10 weeks postpartum. A cut-off score of 10 categorize ‘high’ or ‘low’ risk for depression. Blood samples collected at 28 weeks of gestation were profiled for either IL-6 and IL-10 levels or a panel of 92 inflammatory markers. Individual inflammatory markers were compared across groups using Welch’s ANOVA. Results suggest that IL-10 levels were significantly correlated with EPDS score, exerting a protective effect (r= -.10), with reduced levels in the highest severity category (EPDS ≥ 15). The IL-6/IL-10 ratio was also associated with a raised EPDS score (r=.10, p=.01), as well as delivery complications (r=.09). The highest IL-6/IL-10 ratio is observed in women who had emergency caesarean section. Bayes’ theorem analysis suggested that IL-6/IL-10 ratio could be used as a negative screen to rule out low risk pregnancies. From the 92 inflammatory markers, 14 analytes were below the limit of detection for more than 50% of samples and so were excluded from further analysis. Upon comparison of groups determined by antenatal and postnatal EPDS scores, 29 markers displayed a significance value of P<0.05. Upon the application of post hoc tests, 8 markers including: STAM-BP, SIRT2, CD40, CASP8 and ADA, all associated with apoptotic processes, remained statistically significant in pregnant women with raised antenatal EPDS scores. This data support an association between inflammatory markers and perinatal depression and adverse pregnancy outcomes. Detailed quantitative analysis of such biomarker signatures at different stages of pregnancy, might lead to early detection of disease and application of targeted treatment. (1) Pariante, C. M. & Lightman, S. L. (2008) Trends Neurosci, 31 (9): 464-468. (2) Raison et al., (2006) Trends Immunol, 27 (1): 24-31.

To investigate the correlation between lipid levels during gestation and the incidence rate of gestational diabetes mellitus (GDM) and macrosomia. Clinical records of 607 pregnant women with GDM (GDM group) who delivered in the Obstetrics Department of Fujian Maternal and Child Health Hospital from May to December 2018 and of 833 women with uncomplicated pregnancies (control group) were retrospectively analyzed. After delivery, the entire cohort was further grouped based on the weight of the neonates: women who delivered newborns with body mass <4 kg comprised the normal group (n = 1367), and pregnancies that resulted in delivery of neonates with body mass >4 kg were classified as the macrosomia group (n = 73). Fasting serum levels of triglycerides (TG), total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), and TG/HDL-C ratio were compared between the groups at the early (10-12 weeks), middle (24-28 weeks), and late (28 weeks-delivery) stages of pregnancy, and the correlation between the lipid indices and the rates of GDM and macrosomia were analyzed. There was a gradual increase in TC, TG, LDL-C, and TG/HDL-C levels with increasing gestational weeks in pregnant women. TG and TG/HDL-C levels were markedly higher, while HDL-C was lower in women with GDM compared with women of the same gestational age with uncomplicated pregnancies (p < 0.05). Lipid metabolism disorders exist in pregnant women with GDM at different gestational stages and are closely related to the higher incidence of macrosomia. TG, TG/HDL-C, and HDL-C in early and late pregnancy are independent risk factors for macrosomia in all trimesters, and TG/HDL-C ratio at different gestational stages has a good predictive value for macrosomia.

It has been proven that periconceptional folic acid (FA) supplementation could prevent neural tube defects. However, FA supplementation during different stages of pregnancy and its association with the neurobehavioral development of offspring remains unclear, particularly the effects of continued FA supplementation during the second and third trimesters. This study aimed to investigate the relationship between maternal FA supplementation at various stages of pregnancy and infant neurobehavioral development. In a prospective birth cohort study involving 3246 parent-child pairs, 2905 infants completed neurobehavioral development assessments at 6 months and 3005 infants at 18 months. Information regarding micronutrient supplementation at various stages of pregnancy was recorded. Multivariable logistic regression was used to evaluate the association between FA supplementation and infant neurobehavioral developmental delays. In addition, propensity score analysis was performed to correct the potential imbalances in the distribution of related factors between the groups. During the periconceptional period, maternal standardized FA supplementation (taking 0.4 mg FA daily before and in early pregnancy, as officially recommended) was associated with a reduced risk of possible development delays in 18-month-old infants in the communication domain (RR = 0.48, 95% CI: 0.26-0.86; P = 0.015). After the 12th gestational week, maternal continuous FA supplementation in the second and third trimesters was significantly associated with a decreased risk of possible neurobehavioral development delay in 6-month-old infants in fine motor domain (RR = 0.31, 95% CI: 0.12-0.82; P = 0.019) and the problem-solving domain (RR = 0.20, 95% CI: 0.05-0.79; P = 0.022). These associations remained significant after adjusting for confounders and propensity scores. FA supplementation at different stages of pregnancy may enhance neurobehavioral development in offspring. To confirm these findings, additional investigations or trials with larger sample sizes and consistent tracking of folate status throughout pregnancy are recommended.

The study focused on stability and prediction of parenting stress experiences over a 6‐year period. Mothers (N=93) who had received a clinical intervention for feeding or sleeping problems during infancy (Time 1; T 1) were followed‐up when the children were 5–10 years old (Time 2; T 2). An age‐ and sex‐of‐child matched normal group was used for comparison of stress levels at T 2. Parenting stress was measured by the Swedish Parenthood Stress Questionnaire, which consists of a general parenting stress scale and sub‐scales tapping different aspects of parenting stress experiences. T 1 predictors were clinical assessments of child problem load, maternal unresponsiveness, and family psychosocial problems. T 2 predictors were mother‐reported concurrent child problem load and psychosocial problems. The individual stability in stress experiences was moderate. Effect sizes indicated that mothers with early clinical contacts had reduced their stress to levels close to those in the normal sample. Parenting stress at T 2 could be predicted from early and from concurrent child and family problems. The results point to the relevance of early clinical assessments and to the importance of a sub‐area approach in parenting stress research, as there were differences between stress sub‐areas regarding both prediction and stability. Copyright © 2007 John Wiley &amp; Sons, Ltd.

有鑑於親職壓力與社會支持皆是影響身心障礙者家長與普通家長生活品質的重要因子，本研究乃結合後設分析、路徑分析與聯合t檢定等方法，探討與比較兩組家長在親職壓力、社會支持與生活品質之間的關係。研究結果發現，兩組家長的親職壓力與社會支持間有負相關，親職壓力與生活品質間有負相關，社會支持與生活品質間則是正相關；兩組家長的親職壓力不僅均對生活品質產生直接負向效果，也會透過社會支持對生活品質產生間接負向效果；而且儘管兩組家長在親職壓力對社會支持的負向效果差不多，身心障礙者家長在社會支持對生活品質的正向效果及親職壓力對生活品質的負向效果等卻不及普通家長。綜上所述，本研究建議未來宜持續發展與實施能有效減緩家長親職壓力及增進社會支持品質的具體方案，以利提升家長的生活品質。也由於身心障礙者家長的親職壓力與社會支持對生活品質的預測效果並不高，建議未來研究應持續探討其他預測因子，以利擴充家長生活品質的理論基礎。

Hormonal changes associated with pregnancy promote oral bacterial growth, which may affect salivary nitric oxide (NO) levels, oxidative stress (OS), and antioxidant capacity (AC). We hypothesized that caries-related bacterial load, NO level, and OS in the saliva change with advancing gestation. The aim of this study was to investigate longitudinal changes in salivary NO, OS, and AC during pregnancy and correlate them with Streptococcus mutans (SM) and Lactobacillus (LB) colonization at different stages of pregnancy. We assessed NO level by Griess method, OS by measuring malondialdehyde (MDA), AC by ABTS radicals and bacterial load by culturing SM and LB in the saliva of pregnant women (n = 96) and compared with non-pregnant women (n = 50) as well as between different stages of pregnancy. Compared with non-pregnant women, NO was 77% higher (4.73 ± 2.87 vs. 2.67 ± 1.55 µM; p < 0.001), MDA was 13% higher (0.96 ± 0.27 vs. 0.85 ± 0.22 nM; p = 0.0055), and AC was 34% lower (60.35 ± 14.33 vs. 80.82 ± 11.60%; p < 0.001) in the late third trimester. NO increased with advancing gestation, but AC and OS did not change significantly during pregnancy. SM were more abundant in pregnant women compared with non-pregnant (p = 0.0012). Pregnancy appears to have an adverse impact on oral health emphasizing the importance optimal oral healthcare during pregnancy.

The quality of life (QoL) of families caring for children with neurodevelopmental disorders is influenced by the severity of the disorder, family support, and access to specialized services. Parental stress also affects family dynamics and QoL due to the additional demands of care, particularly focusing on the management of activities of daily living (ADLs). This study aimed to analyze the relationship between parents' QoL and stress, involving 46 parents of children aged 3 to 12 years with neurodevelopmental disorders, while also examining the relationship with the performance in ADLs, sensory processing, and executive functioning of children with neurodevelopmental disorders. Significant positive associations were found between factor 1 of the "Assessment of Sensory Processing and Executive Functions in Childhood" (EPYFEI) with perceived stress (r=0.401, p≤0.01), and parents physical component summary (PCS) (r=0.330, p≤0.05). Significant negative correlations were observed between ADL performance and parents' physical component summary (PCS) of SF-12 (r=-0.356, p≤0.05). Conversely, a significant negative association was found between factors 1 and 4 of the EPYFEI and ADL performance (r=-0.392, p≤0.01 and r=-0.660, p≤0.01). Furthermore, a significant positive association was found between parents' perceived stress and the PCS of SF-12 (r=0.471, p≤0.01), and a negative association between perceived stress and parents' mental component summary (MCS) (r=-0.300, p≤0.05). The study revealed that QoL and parental stress are closely linked to functioning in ADLs and executive functioning of children with neurodevelopmental disorders. Interventions to strengthen these areas might improve parents' well-being and QoL. Additionally, it underscores the importance of teaching these parents stress management strategies.

Exploring the quality of life and factors affecting hospitalized pregnant and postpartum women with SARS-CoV-2 infection and thus providing a basis for improving the quality of health services. Hospitalized pregnant and postpartum women with SARS-CoV-2 infection in Suzhou City between October 2022 and December 2024 were taken as the study subjects, and questionnaires were administered to 512 patients using self-designed questionnaires and the EQ-5D scale. Univariate chi-square test, multivariate Logistic regression, and quantile regression analysis methods were used to analyze the quality of life and its influencing factors in hospitalized patients with SARS-CoV-2 infection. Of the five dimensions related to quality of life, the highest percentage of problems occurred with pain/discomfort (15.1%), followed by mobility impact (10.4%); median VAS score was 89. The results of multifactorial analysis showed that seven factors, including different stages of pregnancy, pre-pregnancy BMI, disease severity, and different stages of epidemic development, influenced the physical dimension-related EQ-5D; family income and disease severity had an effect on the psychological dimension-related EQ-5D. The education level and the presence of severe infection were identified as influencing factors for the 25th percentile of VAS scores, and being in the early stage of the epidemic and the presence of severe infection were influencing factors for the median VAS score. During the hospitalization of patients with SARS-CoV-2 infection, indicators of physical and psychological dimensions related to quality of life were affected to some extent, and as the epidemic progressed, the proportion of re-infected persons increased, and the impact on VAS scores decreased. Special attention should be paid to the fact that during the period of hospitalization, the indicators of psychological dimensions are influenced by the economic level of the family, in addition to the severity of the disease.

Emotion regulation, parental stress and family functioning: Families of children with disabilities vs normative families

Toxoplasma gondii: The effects of infection at different stages of pregnancy on the offspring of mice