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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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    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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    The role of interpersonal emotional regulation on maternal mental health
    (2020)
    COO CALCAGNI, SOLEDAD  
    ;
    Maria Ignacia García
    ;
    Fernanda Prieto
    ;
    Franco Medina
    Scopus© Citations 29  6
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    Interactive Guidance Intervention to Address Sustained Social Withdrawal in Preterm Infants in Chile: Protocol for a Randomized Controlled Trial
    (2020)
    Jorge Bustamante Loyola
    ;
    Marcela Perez Retamal
    ;
    Monica Isabel Morgues Nudman
    ;
    MATURANA PEREA, ANDRES  
    ;
    Ricardo Salinas Gonzalez
    <jats:sec> <jats:title>Background</jats:title> <jats:p>Preterm newborns can be exposed early to significant perinatal stress, and this stress can increase the risk of altered socioemotional development. Sustained social withdrawal in infants is an early indicator of emotional distress which is expressed by low reactivity to the environment, and if persistent, is frequently associated with altered psychological development. Infants born prematurely have a higher probability of developing sustained social withdrawal (adjusted odds ratio 1.84, 95% CI 1.04-3.26) than infants born full term, and there is a correlation between weight at birth and sustained social withdrawal at 12 months of age.</jats:p> </jats:sec> <jats:sec> <jats:title>Objective</jats:title> <jats:p>The aims of this study are to compare the effect of the interactive guidance intervention to that of routine pediatric care on sustained social withdrawal in infants born moderately or late preterm and to explore the relationship between sustained social withdrawal in these infants and factors such as neonatal intensive care unit hospitalization variables, parental depression, and posttraumatic stress symptoms.</jats:p> </jats:sec> <jats:sec> <jats:title>Methods</jats:title> <jats:p>This study is designed as a multicenter randomized controlled trial. Moderate and late preterm newborns and their parents were recruited and randomized (1:1 allocation ratio) to control and experimental groups. During neonatal intensive care unit hospitalization, daily duration of skin-to-skin contact, breastfeeding, and parental visits were recorded. Also, a daily score for neonatal pain and painful invasive procedures were recorded. After discharge from neonatal intensive care, for the duration of the study, both groups will attend follow-up consultations with neonatologists at 2, 6, and 12 months of age (corrected for gestational age) and will receive routine pediatric care. Every consultation will be recorded and assessed with the Alarm Distress Baby Scale to detect sustained social withdrawal (indicated by a score of 5 or higher). The neonatologists will perform an interactive guidance intervention if an infant in the intervention group exhibits sustained social withdrawal. In each follow-up consultation, parents will fill 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>Recruitment for this trial started in September 2017. As of May 2020, we have completed enrollment (N=110 infants born moderately or late preterm). We aim to publish the results by mid-2021.</jats:p> </jats:sec> <jats:sec> <jats:title>Conclusions</jats:title> <jats:p>This is the first randomized controlled trial with a sample of infants born moderately or late preterm infants who will attend pediatric follow-up consultations during their first year (corrected for gestational age at birth) with neonatologists trained in the Alarm Distress Baby Scale and who will receive this interactive guidance intervention. If successful, this early intervention will show significant potential to be implemented in both public and private health care, given its low cost of training staff and that the intervention takes place during routine pediatric follow-up.</jats:p> </jats:sec> <jats:sec> <jats:title>Trial Registration</jats:title> <jats:p>ClinicalTrials.gov NCT03212547; https://clinicaltrials.gov/ct2/show/NCT03212547.</jats:p> </jats:sec> <jats:sec> <jats:title>International Registered Report Identifier (IRRID)</jats:title> <jats:p>DERR1-10.2196/17943</jats:p> </jats:sec>
      6Scopus© Citations 1
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    Scopus© Citations 6  5
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    Scopus© Citations 18  5