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Pregnant women have been considered a high-risk group for SARS-CoV-2 infection; the impact of the disease on the health of a mother and her child is still being studied. The emotional impact of the pandemic on pregnant women has been extensively studied. Emotional distress is proposed as a perspective to explain the emotional manifestations in women during this stage as something common rather than pathological. The objective of this study was to explore the emotional experience of women who tested positive for SARS-CoV-2 towards the end of their pregnancy, during the first and second waves of COVID-19 in Mexico. A qualitative study was carried out: 18 pregnant women with COVID-19 were interviewed. A thematic analysis of the data was performed, resulting in 3 main themes and 14 subthemes. The COVID-19-infected mothers-to-be experienced mild to moderate emotional distress. It was more intense for those with comorbidities. This distress was aggravated during obstetrical complications and comorbidities, as well as during COVID-19 and postpartum. The emotional distress was appeased by both the perception of medical care and social support. The emotional distress of pregnant women with COVID-19 requires emotional support to reduce its impact.

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BACKGROUND: High levels of stress are frequent in university education, and a lack of sleep has been reported to make students more vulnerable to stress. The mechanisms through which sleep harms students have not been sufficiently clarified; therefore, this study aimed to explore the mediating role of self-control and resilience in the relationship between sleep quality and duration and perceived stress. METHODS: Of 32 first-year college students, 21 (78%) were women, with a mean age of 18.47 (±0.84). They responded to a self-administered survey that included questions on stress, resilience, and sleep quality and recorded their daily sleep duration using a wristband for six days. RESULTS: Perceived stress was significantly correlated with resilience (r = -0.63), self-control (r = -0.46), sleep duration (r = -0.35), and lower sleep quality (r = 0.57). Path analysis revealed that self-control and resilience were partially mediated by sleep quality (R2 = 0.62; p < 0.01) and completely mediated by sleep duration (R2 = 0.46; p < 0.01). In both models, self-control had a direct effect on resilience and had a good-fit index. CONCLUSION: Being resilient seems to play a mediating role in the relationship between sleep and perceived stress; this ability can be favored by self-control, which is directly influenced by sleep.

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Self-concept has been associated with health-related behaviors and emotional self-regulation, which can improve sleep. However, its involvement in sleep quality in a healthy adolescent population has been little studied. This study evaluated the association between self-concept and sleep quality in adolescents adjusting for sleep/wake habits. The cross-sectional study included 1,751 adolescents, 54% females, with an age of M = 16.76 ± 1.04 years. The information was collected through an electronic survey that contained the Patient Health Questionnaire, Sleep Habits Questionnaire, Pittsburgh Sleep Quality Index, and Self-Concept Scale. A significant association between self-concept, adjustment for adolescents´ characteristics and sleep/wake habits was observed (R2 = .17, F = 26.61, p < .001). That is, in addition to the adolescent habits, self-concept also contributed to the explanation of sleep/wake habits. These results reinforce the idea that the self-concept can be an essential factor that contributes to better sleep quality, despite the habits of adolescents.

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BACKGROUND: Fetal growth restriction (FGR) may be related to ethnicity. Additionally, ethnic groups experience adverse socioeconomic circumstances that increase FGR risk. However, the dearth of evidence of the interaction between socioeconomic factors and FGR highlights the need for additional research. OBJECTIVE: To analyze the association between socioeconomic factors and FGR in Maya and non-Maya populations in Yucatan, Mexico. METHODS: A total of 21,320 singleton births in 2017 in Yucatan were analyzed. The student's t-test and the chi-square test were used to compare the means and proportions of maternal and perinatal variables between the FGR group and the birthweight appropriate for gestational age (AGA) group. Path analysis was performed to identify the direct and indirect effects of socioeconomic factors on FGR and mediators between predictors and FGR. RESULTS: The prevalence of FGR at birth was 9.06%; this rate was higher in the Maya population (12.4, 95% CI 11.3-13.5), without differences between socioeconomic levels. Path analysis revealed sociostructural variables (ethnicity and poverty) are reliable predictors of FGR at birth mediated by maternal education (ß = -.152, p < .001) and teenage pregnancy (ß = .065, p = .037). The proposal path model had a good fit index CFI = .968, TLI = .920, RMSEA = .046. CONCLUSION: The prevalence of FGR was higher among Maya women than non-Maya women The socioeconomic conditions associated with FGR at birth were ethnicity, poverty, maternal education, and teenage pregnancy. Maternal education and teenage pregnancy act as mediators between sociostructural variables and FGR at birth.

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Habituation difficulties may suggest neurocognitive impairment. Periventricular echogenicity (PVE) potentially causes subtle damage that poses neuropsychological risk. Habituation was evaluated through heart rate and behavioral states in infants at 36-37 weeks of corrected age between control and PVE groups. PVE infants showed early alertness and abrupt changes in behavioral states. However, the comparison group could better regulate their states. Heart rate was significantly high and remained unchanged in the PVE group but decreased in the control group. Alterations during the habituation paradigm in PVE infants could be early indicators of neuropsychological risk impairment. Scope of early habituation assessment is discussed.

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To evaluate the association between circadian health parameters and psychological and biological vulnerability, a cross-sectional study was conducted with 15 undergraduate medical interns using the Brief Resilience Scale, the Mini International Neuropsychiatric Interview, and an ambulatory circadian monitoring device. Circadian Health construct was confirmed by factor analysis. Vulnerability factors (history of depression and low resilience) were associated to lower circadian health of motor activity and temperature rhythms. The findings suggest that not only being depressed but also having had depressive episodes in the past, as well as having low resilience, are associated with chronodisruption, and may increase the risk for developing new episodes of depression.

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The medical career is considered highly stressful, especially during internships when academic and clinical demands, combined with changes in sleep patterns, increase students' likelihood to develop depression. Resilience, which is considered as opposite vulnerability to stress and, along with another protective factor, namely morningness, may cause a student to be less reactive to stimuli and, therefore, less prone to depression. The objective of this study was to evaluate the role of resilience and morningness facing to sleep quality and main risk factors, on the development of depression symptoms in a group of students with sleep pattern alterations. To this end, an observational and longitudinal study was performed with 30 undergraduate interns, with an average age of 22.63 years (SE ± 0.13), 33% men and 67% women. A survey was conducted in three different times during the year of internship: at the beginning (T1), in the middle (T2) and the end (T3). The instruments were the Brief Resilience Scale, Composite Scale of Morningness, Pittsburgh Sleep Quality Index and Patient Health Questionnaire. The path analysis examined the roles of morningness, sleep quality and resilience as potential mediators between family history of depression and depression symptoms at different times. The results showed that resilience had a protective effect on depression symptoms at T2 (ß = -0.18, p < 0.05) and with greater power at T3 (ß = -0.41, p < 0.05), as did morningness, although less strongly, on the symptoms at T3 (ß = -0.13, p < 0.05). A relationship between these two mediating variables was also observed (ß = 0.30, p < 0.05). The initial sleep quality had an effect on the increase of depression symptoms at T1 (ß = 0.61, p < 0.05) and T3 (ß = 0.21, p < 0.05), while family history of depression had a direct effect on the measures of depression at T2 (ß = 0.49, p < 0.05) and T3 (ß = 0.19, p < 0.05). Aside from personal risk factors, it is possible to conclude that the levels of resilience, morningness and sleep quality manifested by students at the beginning of their internship may explain the decrease in depression symptoms at the end of the course.

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Introduction: Teenage pregnancy has a negative impact both on mother's health and on her offspring quality life and development. In spite of its important social relevance, behavioral factors that can favor its occurrence have not been extensively explored. Objective: To compare symptoms of inattention and hyperactivity between adolescents with and without a history of pregnancy. Method: A sociodemographic record and the attention deficit hyperactivity disorder questionnaire (ADD) of the Neuropsi instrument were applied to 60 adolescents: 30 cases and 30 controls. The ADD was answered by the adolescents themselves, as well as by a close relative (parent or spouse) or by one of their teachers. Results: From the perspective of others (parents and teachers), adolescents with a history of pregnancy showed more symptoms of attention deficit and higher attention deficit and hyperactivity overall score (both p ≤ 0.01). In addition, ADD overall score was found to be associated with adolescent pregnancy (OR = 1.11, 95% CI = 1.01-1.24, p = 0.036). Conclusions: Symptoms of attention deficit and hyperactivity can represent another factor associated with teenage pregnancy.

Introducción: El embarazo adolescente ejerce un impacto negativo tanto en la salud de la madre como en la calidad de vida y desarrollo de sus hijos. Pese a su importante carga social, no se han explorado con detalle los factores conductuales que pueden favorecer su presencia. Objetivo: Comparar los síntomas de inatención e hiperactividad entre adolescentes con y sin antecedente de embarazo. Método: A 60 adolescentes se aplicó una ficha de datos sociodemográficos y el Cuestionario de Trastorno por Déficit de Atención e Hiperactividad (DDA) del Neuropsi, 30 casos y 30 controles. El DDA fue contestado por las propias adolescentes, así como por un familiar cercano (padre o pareja) y/o por un profesor del adolescente. Resultados: Desde la perspectiva de los otros (padres y profesores), las adolescentes con antecedentes de embarazo presentaron más síntomas de déficit de atención y mayor puntuación global de déficit de atención e hiperactividad (ambas con p ≤ 0.01). Asimismo, se encontró que la puntuación global del DDA se asoció con el embarazo adolescente (RM = 1.11, IC 95 % = 1.01-1.24, p = 0.036). Conclusiones: Los síntomas de déficit de atención e hiperactividad pueden representar otro factor asociado con el embarazo adolescente.

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Desde la etapa neonatal, la detección temprana de marcadores conductuales de alteraciones sutiles en el neurodesarrollo, es un campo todavía en crecimiento. El objetivo de esta revisión es describir los mecanismos que subyacen a la conducta del neonato durante la aplicación de la subescala de habituación que forma parte de la Neonatal Behavioral Assessment Scale (NBAS), con especial énfasis en la vía visual. Se destacan el papel de la habituación y la regulación de los estados de conciencia como los mecanismos fundamentales durante el primer estímulo y del segundo al décimo estímulo, en dicha escala. Estos procesos representan una capacidad fundamental para la adaptación del recién nacido y se discuten sus posibles implicaciones en el desempeño cognitivo posterior.

Since the neonatal stage, early detection of behavioral markers of subtle impairments in neurodevelopment is a field still under growth. The objective of this review is to describe the mechanisms underlying neonatal behavior during the habituation scale of NBAS, that emphasizes the visual pathway. The role of habituation and the regulation of behavioral states are highlighted during the first stimuli and the second to ten stimuli, during performance of NBAS. Those processes represent a fundamental capacity for newborns´ adaptation and are discussed in line to later cognitive performance.

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BACKGROUND: The aim of this study was to analyze whether late-onset fetal growth restriction (FGR) alters regulatory capability in infants, and whether this can be detected using both the neonatal behavior assessment scale (NBAS) and brainstem auditory-evoked potentials (BAEP). METHODS: The diagnosis of FGR was made on Doppler examination in the third trimester of pregnancy. NBAS and BAEP measurement were performed at 1 month of corrected postnatal age. RESULTS: The group with late-onset FGR was integrated with 17 infants and the control group consisted of 14 subjects. The NBAS range of state score, which reflects organization of behavioral state, was low in infants with late-onset FGR. No differences were found in BAEP between groups. No association between NBAS and BAEP was detected. CONCLUSION: Late-onset FGR has a deleterious effect on NBAS range of state, but possibly does not alter BAEP response. It is proposed that regulatory capabilities in the neonatal period play a primary role in subtle cognitive difficulties in infants with late-onset FGR in the long term.

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