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    Your baby has down syndrome: a reflexive thematic analysis of breaking the news to parents
    (Springer Science and Business Media LLC, 2025-05-06)
    TENORIO DELGADO, MARCELA  
    ;
    Johanna Sagner-Tapia
    ;
    Renata Garibaldi
    ;
    Vaso Totsika
    Scopus© Citations 1  6
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    A complex intervention to support breastfeeding: A feasibility and acceptability study
    (2023)
    Camila Lucchini‐Raies
    ;
    Francisca Marquez‐Doren
    ;
    PÉREZ EWERT, JANET CAROLA  
    ;
    Solange Campos
    ;
    Paulina Beca
    <jats:title>Abstract</jats:title><jats:sec><jats:title>Aims</jats:title><jats:p>The aims of this study are to assess the acceptability and feasibility of a multicomponent intervention to support breastfeeding women and their families and explore its effectiveness.</jats:p></jats:sec><jats:sec><jats:title>Methods</jats:title><jats:p>A pilot study with control and intervention groups was conducted using the complex intervention framework in two primary healthcare centres. Overall, 44 childbearing women, their partners/relatives and 20 healthcare professionals participated in the study. The intervention's feasibility and acceptability were measured. The percentage of exclusive breastfeeding rates and women's self‐efficacy were measured at pre‐intervention, at 10 days postpartum, and again at 2, 4 and 6 months postpartum. Postpartum depression risk was measured at 2 and 6 months postpartum. Professional self‐efficacy was measured at pre‐intervention and 3 months later.</jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p>The intervention was feasible and acceptable. No difference in self‐efficacy existed between the intervention and control groups. Preliminary effects of the intervention were found in exclusive breastfeeding percentage and postpartum depression risk in the intervention group.</jats:p></jats:sec><jats:sec><jats:title>Conclusion</jats:title><jats:p>The intervention is feasible and acceptable. The results are promising not only for breastfeeding maintenance but also for preventing postpartum depression and recovering exclusive breastfeeding during pandemics.</jats:p></jats:sec><jats:sec><jats:title>Trial registration</jats:title><jats:p><jats:ext-link xmlns:xlink="http://www.w3.org/1999/xlink" xlink:href="http://ClinicalTrials.gov">ClinicalTrials.gov</jats:ext-link> ID: NCT03944642.</jats:p></jats:sec>
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    Salud mental materna y efectos en el recién nacido durante la pandemia por COVID-19
    (2023)
    COO CALCAGNI, SOLEDAD  
    ;
    María Ignacia García
    ;
    Marcia Olhaberry
    <jats:p>Una de las principales consecuencias de la crisis sanitaria por COVID-19 ha sido el deterioro de la salud mental de la población, con variaciones en distintos grupos. En este escenario, la evidencia reporta un mayor riesgo de sintomatología ansiosa y depresiva durante el período perinatal, así como un impacto negativo en el recién nacido. Objetivo: Examinar las diferencias en la salud mental, variables obstétricas y del recién nacido. y experiencia de parto en los sistemas de salud público y privado, en mujeres primíparas chilenas, pre-pandemia y durante la pandemia. Sujetos y Método: Estudio cuantitativo comparando 2 cohortes. La primera incluyó madres con bebés nacidos antes de la pandemia por COVID-19 (N=81) y la segunda, madres con partos durante la pandemia (N = 71). Se evaluaron en ambos grupos antecedentes sociodemográficos y obstétricos, depresión, ansiedad y estrés a partir de cuestionarios de autorreporte. Las diferencias entre grupos fueron evaluadas con ANCOVA, pruebas t y prueba de chi cuadrado. Resultados: Las mujeres con partos durante la pandemia reportaron mayor sintomatología depresiva y sus bebés presentaron menor edad gestacional y, levemente, menor talla que los bebés nacidos antes del COVID-19. Sin embargo, este grupo mantuvo la lactancia exclusiva por más tiempo. No se observaron diferencias en la experiencia de parto entre los grupos, pero sí en relación con el carácter público o privado del hospital donde se atendieron las madres. Conclusiones: La pandemia afectó negativamente la salud mental de las madres, lo que plantea desafíos importantes para la promoción del bienestar emocional de las madres y sus bebés.</jats:p>
    Scopus© Citations 5  1
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      1Scopus© Citations 10  1
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    Scopus© Citations 8  10
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    Lupus eritematoso neonatal, caso clínico
    (2023)
    Catalina Montané
    ;
    HOJMAN CANO, LIA PAULA  
    ;
    Trinidad Hasbún Zegpi
    <jats:p>El lupus eritematoso neonatal (LEN) es una patología autoinmune muy infrecuente, que ocurre en neonatos de madres que presentan auto-anticuerpos para antígenos citoplasmáticos del Síndrome de Sjögren. En la mayoría de los casos, la evolución es benigna hacia la resolución espontánea, pero existe un grupo de pacientes que desarrollan compromiso severo del tejido de conducción miocárdico, por lo que su detección oportuna es fundamental. Objetivo: Describir un caso clínico característico de lupus eritematoso neonatal y destacar la importancia del diagnóstico oportuno en madre y neonato. Caso Clínico: Mujer de 33 años, con antecedente de hipertensión arterial, consulta en dermatología por su neonato de 15 días de vida de sexo masculino, quien presenta aparición reciente de placas redondeadas, eritematosas, de bordes solevantados, no descamativas, compatibles con LEN. Se descartó compromiso de conducción miocárdica. En los exámenes del neonato destacaba neutropenia moderada, elevación leve de transaminasas y anticuerpos antiRo y antiLa positivos. En interrogación dirigida, la madre refiere historia personal de síntomas compatibles con enfermedades del tejido conectivo, tales como fatiga, alopecia y xeroftalmia. Se solicitan anticuerpos antinucleares a la madre, quien presenta título de 1/1280 con patrón moteado, anticuerpos anti Ro y La y anticuerpos anti-DNA doble hebra positivos, y Test de Schirmer compatible con ojo seco, por lo que se diagnostica Lupus Eritematoso Sistémico con Síndrome de Sjögren asociado. Se realiza seguimiento al lactante por 5 meses con remisión de los signos cutáneos y normalización de los exámenes de laboratorio. Conclusiones: Si bien, las manifestaciones cutáneas de LEN son transitorias y benignas en el neonato, estas pueden ir acompañadas de complicaciones de riesgo vital que requieren una búsqueda activa y un manejo oportuno por el equipo médico. Un 25% de las madres de hijos con LEN son asintomáticas, o desconocen su diagnóstico de LES previo al parto, por lo que el diagnóstico oportuno de LEN en un neonato permite diagnosticar a las madres asintomáticas, optimizando su seguimiento y manejo.</jats:p>
    Scopus© Citations 1  4
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    Interacciones entre las madres y sus bebés prematuros moderados durante la hospitalización
    (2022)
    MIRA OLIVOS, ANDREA  
    ;
    COO CALCAGNI, SOLEDAD  
    ;
    Rodolfo Bastías
    ;
    Ricardo González
    <jats:p>Los recién nacidos prematuros moderados son fisiológicamente inmaduros, su cerebro tiene que madurar y adaptarse al entorno extrauterino, lo que puede afectar su desarrollo neurológico. La interacción con sus cuidadores es crucial para su desarrollo, no obstante, estos pueden evidenciar problemáticas de salud mental como sintomatología depresiva y estrés parental. Objetivo: evaluar cómo la sintomatología depresiva y la percepción del estrés de las madres de bebés prematuros moderados durante la hospitalización puede afectar la interacción de la díada. Pacientes y Método: participaron 85 díadas. Durante la segunda y tercera semana de hospitalización, las madres completaron un cuestionario sociodemográfico, la escala de estrés parental y la Edinburgh postnatal depression scale (EPDS). La interacción madre-hijo fue evaluada y codificada con la Escala de Observación del Vínculo Madre-Bebé Hospitalizados. Resultados: las madres de bebés prematuros moderados hospitalizados en una unidad de neonatología pueden presentar una importante sintomatología depresiva y ésta se correlaciona con el estrés experimentado por la madre. El estrés parental y el ser pequeño para la edad gestacional evidenciaron una asociación negativa con las interacciones de las diadas. Conclusiones: El tener un bebé prematuro moderado puede impactar la salud mental de las madres y esto a su vez se relaciona con las interacciones que tienen con sus hijos/as. Del mismo modo se detectaron variables relacionadas con los bebés que también pueden disminuir las interacciones y contacto entre la diada.</jats:p>
      1Scopus© Citations 2  1
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    The Impact of an Interactive Guidance Intervention on Sustained Social Withdrawal in Preterm Infants in Chile: Randomized Controlled Trial
    (2022)
    Jorge Bustamante Loyola
    ;
    Marcela Pérez Retamal
    ;
    Andrés Mendiburo-Seguel
    ;
    Antoine Claude Guedeney
    ;
    Ricardo Salinas González
    <jats:sec><jats:title>Background</jats:title><jats:p>Sustained social withdrawal is a key indicator of child emotional distress and a risk factor for psychological development. Preterm infants have a higher probability of developing sustained social withdrawal than infants born full-term during their first year.</jats:p></jats:sec><jats:sec><jats:title>Objective</jats:title><jats:p>To compare the effect of a behavioral guidance intervention to that of routine pediatric care on sustained social withdrawal behavior in preterm infants.</jats:p></jats:sec><jats:sec><jats:title>Design</jats:title><jats:p>Multicenter randomized clinical trial.</jats:p></jats:sec><jats:sec><jats:title>Participants</jats:title><jats:p>Ninety nine moderate and late preterm newborns and their parents were recruited and randomized into two groups, i.e., Intervention (<jats:italic>n</jats:italic> = 49) and Control (<jats:italic>n</jats:italic> = 50). Both groups attended medical check-ups at 2, 6 and 12 months and were assessed with the Alarm Distress Baby Scale. The intervention group received a standardized behavioral intervention if the neonatologist detected sustained social withdrawal. Also, parents filled out the Edinburgh Postnatal Depression Scale, the modified-Perinatal Posttraumatic Stress Disorder Questionnaire, and the Impact of Event Scale-revised.</jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p>At baseline, the prevalence of withdrawal was 4.0% (95% CI: 0.03–14.2) for the control group and 22.4% (95% CI: 13.0–35.9) for the intervention group [OR = 0.22, <jats:italic>p</jats:italic> = 0.028 (95% CI =0.06–0.84)]. At 6 months, the prevalence was 10.0% (95% CI: 3.9–21.8) for the control group and 6.1% (95% CI: 2.1–16.5) for the intervention group [OR = 2.09, <jats:italic>p</jats:italic> = 0.318 (95% CI = 0.49–8.88)]. At 12 months, the prevalence was 22.0% (95% CI: 12.8–35.2) for the control group and 4.1% (95% CI: 1.1–13.7) for the intervention group [OR = 6.63, <jats:italic>p</jats:italic> = 0.018 (95% CI = 1.39–31.71)]. Logistic generalized estimating equation models were performed. The pooled crude OR (considering diagnosis at 6 and 12 months) was 3.54 [<jats:italic>p</jats:italic> = 0.022 (95% CI = 1.20–10.44); Cohen's d= 0.70]. In the case of pooled adjusted OR, the model considered diagnosis (0 = Withdrawal, 1 = Normal) as the dependent variable, time of evaluation (1= 6 months, 2 = 12 months) and group (0 = Control, 1 = Experimental) as factors. In this case, the pooled adjusted OR was 3.57 [<jats:italic>p</jats:italic> = 0.022 (95% CI = 1.20–10.65); Cohen's d = 0.70].</jats:p></jats:sec><jats:sec><jats:title>Conclusion</jats:title><jats:p>Assessment and intervention of sustained social withdrawal in preterm infants via standardized instruments benefits families by reducing its prevalence, and possible associated negative outcomes.</jats:p></jats:sec><jats:sec><jats:title>Clinical Trial Registration</jats:title><jats:p>ClinicalTrials.gov; <jats:ext-link>https://clinicaltrials.gov/ct2/show/NCT03212547</jats:ext-link>, identifier: NCT03212547.</jats:p></jats:sec>
    Scopus© Citations 1  1
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    Online intervention to prevent postnatal depression and anxiety in Chilean new mothers: Protocol for a feasibility trial
    (2022)
    PÉREZ EWERT, JANET CAROLA  
    ;
    ALDONEY RAMIREZ, DANIELA  
    ;
    Marcia Olhaberry
    ;
    Olga Fernández
    ;
    María I García
    <jats:p> Symptoms of postpartum depression and anxiety in new mothers are prevalent and negatively impact maternal emotional wellbeing and infant development. Barriers to accessing treatment prevent women from receiving mental health care, a situation that has worsened due to the COVID-19 pandemic. mHealth interventions hold the potential to support women during the transition to parenthood despite these barriers and to promote the use of preventive interventions. This study uses a mixed methods design to assess the feasibility and preliminary effectiveness of a psychoeducational, guided mHealth intervention to prevent postpartum mental health difficulties in women who receive care in primary health centers in Chile. The study will contribute to evidence-based research on the effectiveness of mHealth interventions for new mothers from an understudied cultural background. The findings will also enable the development of a larger randomized controlled trial to assess the effectiveness of the intervention, which, if effective, could significantly contribute to the emotional wellbeing of women and their families. </jats:p>
      16  1Scopus© Citations 4
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    Discrepancies in infant feeding recommendations between grandmothers and healthcare providers in rural Mexico
    (2022)
    Paulina Luna
    ;
    Nerli Paredes-Ruvalcaba
    ;
    Tania Valdes
    ;
    Barbara Guerrero
    ;
    Angélica García-Martínez
    <jats:title>Abstract</jats:title><jats:sec> <jats:title>Background</jats:title> <jats:p>Infant feeding practices are rapidly changing within rural areas in Mexico, including indigenous communities. The aim of this study was to compare infant feeding recommendations between grandmothers and healthcare providers, to better understand the factors that may influence these practices within these communities. This study builds on research that recognizes the legacy of colonization as an ongoing process that impacts the lives of people through many pathways, including the substandard healthcare systems available to them.</jats:p> </jats:sec><jats:sec> <jats:title>Methods</jats:title> <jats:p>Qualitative study based on secondary data analysis from interviews and focus groups guided by a socioecological framework conducted in 2018 in two rural, Indigenous communities in Central Mexico. Participants were purposively selected mothers (<jats:italic>n</jats:italic> = 25), grandmothers (<jats:italic>n</jats:italic> = 11), and healthcare providers (<jats:italic>n</jats:italic> = 24) who offered care to children up to two years of age and/or their mothers. Data were coded and thematically analyzed to contrast the different perspectives of infant feeding recommendations and practices between mother, grandmothers, and healthcare providers.</jats:p> </jats:sec><jats:sec> <jats:title>Results</jats:title> <jats:p>Grandmothers and healthcare providers differed in their beliefs regarding appropriate timing to introduce non-milk foods and duration of breastfeeding. Compared to grandmothers, healthcare providers tended to believe that their recommendations were superior to those from people in the communities and expressed stereotypes reflected in negative attitudes towards mothers who did not follow their recommendations. Grandmothers often passed down advice from previous generations and their own experiences with infant feeding but were also open to learning from healthcare providers through government programs and sharing their knowledge with their daughters and other women. Given the contradictory recommendations from grandmothers and healthcare providers, mothers often were unsure which advice to follow.</jats:p> </jats:sec><jats:sec> <jats:title>Conclusions</jats:title> <jats:p>There are important differences between grandmothers and healthcare providers regarding infant feeding recommendations. Healthcare providers may perceive their recommendations as superior given the neocolonial structures of the medical system. Public health policies are needed to address the different recommendations mothers receive from different sources, by harmonizing them and following an evidence-informed approach. Breastfeeding programs need to value and to seek the participation of grandmothers.</jats:p> </jats:sec>
    Scopus© Citations 2  2