OAR@UM Collection:

The impact of COVID-19 on breastfeeding rates : an international cross-sectional study

2026-05-12T06:10:52Z

Title: The impact of COVID-19 on breastfeeding rates : an international cross-sectional study Authors: Ganho-Ávila, Ana; Guiomar, Raquel; Sobral, Mónica; Pacheco, Francisca; Caparros-Gonzalez, Rafael A.; Diaz-Louzao, Carla; Motrico, Emma; Domínguez-Salas, Sara; Mesquita, Ana; Costa, Raquel; Vousoura, Eleni; Hadjigeorgiou, Eleni; Bina, Rena; Buhagiar, Rachel; Mateus, Vera; Contreras-García, Yolanda; Wilson, Claire A.; Ajaz, Erilda; Hancheva, Camellia; Dikmen-Yildiz, Pelin; de la Torre-Luque, Alejandro Abstract: Background: Breastfeeding promotes children’s health and is associated with positive effects to maternal physical and mental health. Uncertainties regarding SARS-CoV-2 transmission led to worries experienced by women and health professionals which impacted breastfeeding plans. We aimed to investigate the im- pact of self-reported and country-specific factors on breastfeeding rates during the COVID-19 pandemic.; Methods: This study is part of a broader international prospective cohort study about the impact of the COVID-19 pandemic on perinatal mental health (Riseup-PPD-COVID-19). We analysed data from 5612 women, across 12 countries. Potential covariates of breastfeeding (sociodemographic, perinatal, physical/mental health, professional perinatal care, changes in healthcare due to the pandemic, COVID-19 related, breastfeeding support, governmental containment measures and countries’ inequality levels) were studied by Generalized Linear Mixed-Effects Models.; Results: A model encompassing all covariates of interest explained 24% of the variance of breastfeeding rates across countries (first six months postpartum). Overall, first child ( β= -0.27), age of the child ( β= -0.29), preterm birth ( β= -0.52), admission to the neonatal/pediatric care ( β= -0.44), lack of breastfeeding support ( β= -0.18), current psychiatric treatment ( β= -0.69) and inequality ( β= -0.71) were negatively associated with breastfeeding ( p < .001). Access to postnatal support groups was posi tively associated with breastfeeding ( β= 0.59; p < .001). In countries with low-inequality, governmental measures to contain virus transmission had a deleterious effect on breastfeeding ( β= -0.16; p < .05) while access to maternity leave protected breastfeeding ( β= 0.50; p < .001).; Discussion: This study shows that mother’s COVID-19 diagnosis and changes in healthcare and birth/postnatal plans did not influence breastfeeding rates. Virtual support groups help women manage breastfeeding, particularly when their experiencing a first child and for those under psychiatric treatment. The complex associations between covariates and breastfeeding vary across countries, suggesting the need to define context-specific measures to support breastfeeding.

The impact of a psychological skills training and mindfulness-based intervention on the mental toughness, competitive anxiety, and coping skills of futsal players — a longitudinal convergent mixed-methods design

2026-05-07T09:40:20Z

Title: The impact of a psychological skills training and mindfulness-based intervention on the mental toughness, competitive anxiety, and coping skills of futsal players — a longitudinal convergent mixed-methods design Authors: Vella Fondacaro, Daniel; Romano-Smith, Stephanie Abstract: Despite the sport’s popularity, there is a paucity in futsal psychological interventional research. This study analysed the impact of a ten-session psychological skills training and mindfulness-based intervention (PSTMI) on the mental toughness, competitive anxiety, and athletic coping skills of national league futsal players (n = 13). It also analysed whether these variables were predicted by playing experience. Pre-/post-intervention questionnaires were filled in and analysed (Competitive State Anxiety Inventory-2, Sport Mental Toughness Questionnaire, and Athletic Coping Skills Inventory-28). Semi-structured interviews were also conducted with seven athletes; quantitative and qualitative data were integrated in a convergent parallel mixed-methods design. Results revealed significant medium-to-large improvements in mental toughness, cognitive anxiety, and coping skills following the PSTMI. Years of playing experience positively and significantly predicted better self-confidence and coping skills. Thematic analysis generated five themes: (1) post-intervention enhancement in athletic performance and well-being; (2) the non-athletic commitments of futsal players; (3) diverse views on how to improve the intervention; (4) instilling social identity through sport psychology sessions; and (5) the impact of years of experience on skill learning. Results mirrored those from other sporting disciplines. The PSTMI was well-received and equipped athletes with beneficial psychological skills, stressing the need for more sport psychology resources in futsal.

The mental health of women with gestational diabetes during the COVID-19 pandemic : an international cross-sectional survey

2025-05-22T13:11:26Z

Title: The mental health of women with gestational diabetes during the COVID-19 pandemic : an international cross-sectional survey Authors: Wilson, Claire A.; Gómez-Gómez, Irene; Parsons, Judith; Costa, Raquel; Mesquita, Ana; Vousoura, Eleni; Contreras-García, Yolanda; Levy, Drorit; Mateus, Vera; Christoforou, Andri; Felice, Ethel; Dikmen-Yildiz, Pelin; Domínguez-Salas, Sara; Motrico, Emma Abstract: Background: There is evidence that women with gestational diabetes are at increased risk of the common mental disorders of anxiety and depression. The COVID-19 pandemic may have exerted an additional burden on the mental health of this population. The aim of this analysis was to compare levels of symptoms of common mental disorders and experiences during the COVID-19 pandemic between pregnant and postnatal women exposed and unexposed to gestational diabetes.; Methods: Cross-sectional study utilizing quantitative data from an online survey administered across 10 countries to women who were pregnant or up to 6 months postpartum from 15 June to October 31, 2020. Women self-reported gestational diabetes and completed the Edinburgh Postnatal Depression Scale and GAD-7 (Generalized Anxiety Disorder 7 items) measures. The COPE-IS (Coronavirus Perinatal Experiences-Impact Survey) tool was also administered. Complete case analyses were conducted on a sample of 7,371 women.; Results: There was evidence of an association between gestational diabetes and increased levels of depression symptoms, which was robust to adjustment for age, education, and employment status. There was only evidence of an association with anxiety in postnatal women. There was also evidence that women with gestational diabetes, particularly those in the postnatal period, experienced higher levels of pandemic-related distress, although they did not experience higher levels of COVID-19 infection in this sample.; Conclusions: The increased risk of common mental disorders in women with gestational diabetes underscores the importance of integrated physical and mental health care for pregnant and postnatal women both during and beyond the pandemic. Clinical Trial Registration no. NCT04595123.

Unmet needs in mental healthcare for women with clinically significant symptoms of perinatal depression and/or anxiety during the COVID-19 pandemic

2025-05-22T13:01:43Z

Title: Unmet needs in mental healthcare for women with clinically significant symptoms of perinatal depression and/or anxiety during the COVID-19 pandemic Authors: Costa, Raquel; Mesquita, Ana; Motrico, Emma; Domínguez-Salas, Sara; Dikmen-Yildiz, Pelin; Saldivia, Sandra; Vousoura, Eleni; Osorio, Ana; Wilson, Claire A.; Bina, Rena; Levy, Drorit; Christoforou, Andri; González, Maria Fernanda; Hancheva, Camelia; Felice, Ethel; Pinto, Tiago Miguel Abstract: Objective/Background: Unmet needs in perinatal mental healthcare are an important public health issue particularly in the context of a stressful life event such as the COVID-19 pandemic but data on the extent of this problem are needed.; Aim: The aim of this study is to determine the (1) proportion of women with clinically significant symptoms of perinatal depression, anxiety or comorbid symptoms of depression and anxiety, receiving mental healthcare overall and by country and (2) factors associated with receiving mental healthcare.; Method: Women in the perinatal period (pregnancy or up to 6 months post-partum) participating in the Riseup-PPD-COVID-19 cross-sectional study, reported on sociodemographic, social support health-related factors, andCOVID-19 related factors, and on symptoms of depression (Edinburgh Postnatal Depression Scale [EPDS]) and anxiety (Generalised Anxiety Disorder[GAD-7]) using self-report questionnaires. Clinically significant symptoms were defined as EPDS ≥ 13 for depression and GAD-7 ≥ 10 for anxiety. Mental healthcare was defined as self-reported current mental health treatment.; Results: Of the 11 809 participants from 12 countries included in the analysis, 4 379 (37.1%) reported clinically significant symptoms of depression (n = 1 228; 10.4%; EPDS ≥ 13 and GAD-7 ⟨ 10), anxiety (n = 848; 7.2%; GAD-7 ≥ 10 and EPDS ⟨ 13) or comorbid symptoms of depression and anxiety (n = 2 303; 19.5%; EPDS ≥ 13 and GAD-7 ≥ 10). Most women with clinically significant symptoms of depression, anxiety, or comorbid symptoms of depression and anxiety were not receiving mental healthcare (89.0%). Variation in the proportion of women with clinically significant symptoms of depression and/or anxiety reporting mental healthcare was high (4.7% in Turkey to 21.6% in Brazil). Women in the postpartum (vs. pregnancy) were less likely (OR 0.72; 95% CI 0.59-0.88), whereas women with previous mental health problems (vs. no previous mental health problems) (OR 5.56; 95% CI 4.41-7.01), were more likely to receive mental healthcare.; Conclusion: There are high unmet needs in mental healthcare for women with clinically significant symptoms of perinatal depression and/or anxiety across countries during the COVID-19 pandemic. Studies beyond the COVID-19 pandemic and covering the whole range of mental health problems in the perinatal period are warranted to understand the gaps in perinatal mental healthcare.