Physiologic changes in the peripartum period put women with CHD at increased risk for morbidity. This study examines factors associated with peripartum complications and length of stay compared to patients without CHD.

This single-institution retrospective case-control study included women with CHD (2000–2017) and a control population without CHD. A review of clinical and echocardiographic data was used to assign baseline characteristics, disease severity, and adverse outcomes. Primary outcomes were composite variables of cardiac and obstetric adverse events, along with peripartum length of stay. The relationship between maternal CHD, baseline characteristics, and peripartum adverse events was evaluated by multivariable regression.

The cohort and control groups included 162 deliveries among 113 women and 321 deliveries among 321 women, respectively. Cardiac complications, including arrhythmia, heart failure, pulmonary oedema, and thromboembolic events, occurred in 8.6% of the cohort (RR 2.52, 95% CI 1.17–5.42), with the most common event being arrhythmia. Obstetric events, such as caesarean delivery, assisted vaginal delivery, preterm birth, and pre-eclampsia, occurred in 67.9% versus 56.1% in the control group (RR 1.21, 95% CI 1.05–1.40). In multivariable models, increasing age was associated with increased composite cardiac events. Length of stay was longer in the cohort group (p < 0.001) and significantly associated with modified World Health Organization classification (p = 0.016).

Women with CHD experience increased cardiac and obstetric morbidity compared to controls during peripartum admission. Those with CHD have longer hospital stays around delivery, which is associated with disease severity.

Certain prescription drugs used during pregnancy are associated with offspring autism spectrum disorder (ASD). Nonetheless, ASD risk following prenatal exposure to most drugs remains unknown. Furthermore, methodological challenges and ethical concerns hinder the scope for causal inference.

We used a case-cohort study design of a nationally representative sample from Israel to examine the associations between maternal prescription drug use during pregnancy and offspring ASD. To scrutinize these associations, the analyses were (a) adjusted for indication proxy (level 2 Anatomical Therapeutic Chemical (ATC) codes), (b) repeated using shared pharmacological targets as exposures, and (c) inspected further through target-enrichment analysis.

The sample included 1,400 individuals with and 94,713 without an ASD diagnosis. Among all drugs prescribed during pregnancy, five were statistically significantly associated with increased offspring ASD risk after adjustment for indication proxy (e.g., hazard ratio [95% confidence interval] cyproterone = 2.71 [1.17–6.25] and prednisolone = 2.10 [1.27–3.49]), and two with decreased risk (ferrous sulfate = 0.82 [0.68, 0.99] and lynestrenol = 0.43 [0.2, 0.93]). Further analysis revealed four pharmacological targets shared by these drugs, which were themselves associated with ASD (e.g., neuronal acetylcholine receptor α4β4 = 1.45 [1.05–1.99] and serotonin 2b receptor = 1.31 [1.04–1.61]). Enrichment analysis suggested the association between ASD and medications affecting cholinergic and serotonergic signaling.

Increased ASD risk followed prenatal exposure to five prescription drugs, and decreased risk followed exposure to two. Subsequent analyses suggested no confounding by indication in these associations, but further studies are warranted.

Fear of childbirth (FoB) is a common experience during pregnancy which can cause clinically significant distress and impairment. To date, a number of investigations of FoB have assumed that clinically significant FoB is best understood as a type of specific phobia. However, preliminary evidence suggests that specific phobia may not be the only diagnostic category under which clinically significant symptoms of FoB are best described.

The current study is the first to investigate which DSM-5 diagnostic categories best describe clinically significant symptoms of FoB.

Pregnant people reporting high levels of FoB (n=18) were administered diagnostic interviews related to their experience of FoB.

Participants (n=18) were predominantly nulliparous (73.3%), cisgender women (83.3%). Of these, 14 (77.8%) met criteria for one or more DSM-5 anxiety-related disorders. Preliminary findings suggest that primary FoB may align with specific phobia criteria, whereas secondary FoB (following a traumatic birth) may be better classified under post-traumatic stress disorder (PTSD). FoB also featured in other anxiety-related disorders but was not the primary focus (e.g. obsessive-compulsive disorder). Four participants did not meet criteria for any DSM-5 disorder.

Findings provide preliminary evidence that clinically significant FoB fits within existing DSM-5 categories, in particular specific phobia and PTSD. Although FoB-related concerns appears in other anxiety-related disorder categories, it does not appear as the primary focus. Although informative, due to the small sample employed in this research, replication in larger and more diverse samples is needed.

To describe the nutritional intake and status of pregnant women in Bloemfontein and compare across different household food security categories.

Cross-sectional.

Pelonomi Tertiary Hospital.

427 pregnant women were interviewed using a standard questionnaire and a quantitative FFQ to collect socio-demographic, HIV status, household food security, supplement and dietary intake data. Weight and height were measured using standard anthropometric techniques and capillary blood taken by finger-prick for anaemia, Fe and inflammation status assessment.

26·7 % of participants were food secure, while 11·5 %, 32·1 % and 29·5 % experienced mild, moderate and severe food insecurity, respectively. 54·5 %, 41·7 % and 31·1 % were obese, anaemic and Fe deficient. Median energy intake was 8808 (6978–9223) KJ/d, with no significant differences between the food security groups (P = 0·517). Based on the dietary reference intakes, 98·1 % met the estimated average requirement (EAR) for carbohydrates, but the majority had sub-optimal intake of protein (58·3 %), fibre (60·9 %), pantothenic acid (67·0 %), vitamins C (65·6 %), D (68·4 %), E (59·0 %) and K (61·8 %), potassium (99·8 %), dietary Ca (95·8 %) and Fe (80·8 %). Compared with the moderately and severely food-insecure counterparts, food-secure participants had a higher intake of animal protein (P < 0·001), total fat (P = 0·014), monounsaturated fat (P = 0·002), vitamins B12 (P = 0·014), C (P < 0·001) and D (P = 0·003) and dietary Ca (P = 0·001). Dietary folate intake was below the EAR in 69·9 %, but was higher among severely food-insecure participants (463·94 (327·39, 609·71) µg than food secure (378·49 (265·99, 496·15) µg, P = 0·007)).

The findings show widespread inadequate nutrient intake among pregnant women in Bloemfontein, with food-insecure women showing significantly lower intake of specific nutrients.

Postpartum depression is prevalent among Black women and associated with intersecting systemic factors and interpersonal discrimination. However, gaps remain in understanding pregnancy-related changes in discrimination experiences that influence postpartum mental health and could inform preventive interventions. We hypothesized that young Black women would experience increasing levels of discrimination across the transition to parenthood, heightening depression risk relative to non-pregnant peers.

Participants comprised 335 Black primiparous women (ages 17-30 at delivery) and 335 age- and discriminationmatched non-pregnant controls from the Pittsburgh Girls Study. Self-reported discrimination experiences were collected at four timepoints: two years pre-pregnancy, one year pre-pregnancy, pregnancy, and one year postpartum for the childbearing sample, with corresponding data from the non-pregnant sample across the same interval (matched pairwise).

Linear increases in discrimination were observed for the nonpregnant participants (BS = .480, SE = .090, p <.001), while childbearing participants showed no overall changes, though younger age predicted greater increases over time. For childbearing participants, both baseline discrimination (BI = .626, SE = .077, p < .001) and increasing discrimination (BS = 2.55, SE = .939, p < .01) predicted postpartum depressive symptoms, controlling for pre-pregnancy depression. Among non-pregnant participants, only baseline discrimination predicted later depression (BI = .912, SE = .081, p < .001).

Experiencing increasing levels of interpersonal discrimination across the transition to parenthood may heighten postpartum depression risk among young Black women, indicating a need for interventions supporting well-being and promoting resilience before, during and after pregnancy.

About 13% of pregnant women with substance use disorder (SUD) receive treatment and many may encounter challenges in accessing perinatal care, making it critical for this population to receive uninterrupted care during a global pandemic.

From October 2021-January 2022, we conducted an online survey of pregnant and postpartum women and interviews with clinicians who provide care to this population. The survey was administered to pregnant and postpartum women who used substances or received SUD treatment during the COVID-19 pandemic.

Two hundred and ten respondents completed the survey. All respondents experienced pandemic-related barriers to routine health care services, including delays in prenatal care and SUD treatment. Disruptions in treatment were due to patient factors (38.2% canceled an appointment) and clinic factors (25.5% had a clinic cancel their appointment). Respondents were generally satisfied with telehealth (M = 3.97, SD = 0.82), though half preferred a combination of in-person and telehealth visits. Clinicians reported telehealth improved health care access for patients, however barriers were still observed.

Although strategies were employed to mitigate barriers in care during COVID-19, pregnant and postpartum women who used substances still experienced barriers in receiving consistent care. Telehealth may be a useful adjunct to enhance care access for pregnant and postpartum women during public health crises.

The purpose of this study was to report on the prevalence of hypertension and anaemia, and types of medications prescribed to expectant mothers attending antenatal clinics at Intermediate Hospital Katutura in Windhoek, Namibia.

Millennium Development Goals 4 and 5 speak to reduction of child mortality and improvement of maternal health by 2015, respectively. Gestational hypertension is a major contributor to maternal and perinatal mortality and is reported to affect up to 10% of women world-wide. Prevalence of anaemia among pregnant women is reported higher in low- and middle-income countries than in developed countries.

This was a cross-sectional study involving the review of outpatient and clinic health records for patients attending antenatal clinics at Intermediate Hospital Katutura, Windhoek during October to November 2022. Data for patients on first antenatal clinic visit were obtained from facility antenatal clinic patient registers while that of follow-up patients were from patient health passports. All expectant mothers over 18 years of age who had provided written consent to participate, were included. Data collected were: age, body weight, haemoglobin concentration, blood pressure, gravida, number of babies delivered, pregnancy stage, comorbidities, and prescribed medications. The results were summarised using descriptive statistics. A p-value <0.05 is considered to be statistically significant.

354 records were included: 303 (85.6%) first visit, and 51 follow-up (14.4%). There was a significant correlation between systolic blood pressure (BP) and body weight (r = 0.31, p < 0.001). 13.5% of first-time visitors had haemoglobin levels lower than the normal range (11 g/dL). Difference in haemoglobin levels between trimesters 1 and 3 were significant (p < 0.001). Methyldopa was prescribed for all hypertensive expectant mothers. To reduce the incidences of anaemia and hypertension during pregnancy, women of childbearing age should be encouraged to attend antenatal visits earlier in pregnancy and to take measures for body weight reduction, respectively.