By Pooja Toshniwal Paharia Mar 17 2023 Reviewed by Danielle Ellis, B.Sc.
In a recent study published in JAMA Network Open, researchers assessed the relationship between coronavirus disease 2019 (COVID-19)-associated stress in the antenatal period and the mental well-being of mothers and their infants in the postpartum period. Study: Association of Antenatal COVID-19–Related Stress With Postpartum Maternal Mental Health and Negative Affectivity in Infants. Image Credit: GrooveZ/Shutterstock Background
Studies have reported that antenatal stressors significantly increase the risk of adverse postpartum outcomes regarding mental well-being, such as cognitive and behavioral problems among infants. Cases of anxiety and depression during pregnancy have significantly increased during the severe acute respiratory coronavirus 2 (SARS-CoV-2) pandemic, with lowered positive affectivity, worsened orienting behavior, and higher surgency among infants.
However, the association between COVID-19-associated stress and postpartum maternal and infant outcomes is not completely understood. Previous studies evaluating the effects of antenatal stressors on maternal and infantile health outcomes were largely cross-sectional, single-center, retrospective, with small sample populations, and often utilized unvalidated assessment measures with no documentation of psychometric properties. About the study
In the present longitudinal survey-based study, researchers evaluated the impact of antenatal SARS-CoV-2 infection-associated stress on postpartum maternal and infant mental health outcomes.
The study comprised 318 individuals aged ≥11.0 years who participated in the coronavirus disease 2019 risks across lifespan (CORAL) study conducted in the United Kingdom (UK), United States (US), and Australia. Females who were expecting at the initial evaluation between 5 May and 30 September 2020 and completed two follow-up evaluations between 28 October 2021 and 24 April 2022 at three-month intervals were considered for the analysis.
In addition, the participants were invited to fill out a fourth survey on maternal mental well-being and infant temperament in the follow-up period. COVID-19-associated stress levels were evaluated using the pandemic anxiety measurement scale. The team used the eight-component patient health questionnaire to assess depression among mothers and the seven-component general anxiety disorder (GAD) scale to assess generalized anxiety levels.
During follow-ups, postpartum distress levels were evaluated using the 10.0-component postpartum distress assessment measure, and health outcomes among infants were assessed using the Infant Behavior questionnaire. Individuals were recruited for the study through paid advertising, social media, mothers' group newsletters, mental well-being organizations, and web-based pregnancy forums. Related StoriesHyperinflammation triggers long COVID headachesWhat is the gastrointestinal impact of Long Covid?Early outpatient treatment of COVID-19 with metformin could reduce the risk of developing long COVID
Linear mixed-effects modeling was performed for the analysis. Sensitivity analyses were performed controlling for maternal mental health at initial evaluation and COVID-19 risks experienced during pregnancy and the age of the infants during follow-up assessments. The study participants were provided Amazon gift vouchers of A$100 for the initial survey and A$20 for follow-up surveys. Results
The mean age of the study participants was 32 years, and among the study participants, 28% (n=88), 30% (n=94), and 43% (n=136) resided in Australia, the United States, and the United Kingdom, respectively, among whom, 87% (n=276) were White, and 81% (n=256) had university degrees. A history of psychiatric disorders was reported by 36% (n=114) of the study participants.
Other races and ethnicities included in the sample population were Aboriginal or Torres Strait Islander, Asian, Hispanic, mixed, or other, among two, 12, eight, seven, and 10 participants, respectively. High school education was attained by 19 women and professional or vocational training by 41 women.
At the initial evaluation, the mean values for the number of children and the gestational age (in months) were 1.20 and 5.80, respectively. At the final evaluation, the mean infant age was 14 months. COVID-19-associated stress in the antenatal period showed significant associations with distress, anxiety, and depression among mothers and negative affectivity among infants in the postpartum period. Sensitivity analyses yielded similar findings.
At the initial evaluation, three women showed mild GAD and depression (mean scores on the GAD-7 scale and Patient Health questionnaire of 6.70 and 7.80, respectively), and symptoms remained elevated for 17.0 months postpartum. There were no interactive associations between the age of the infants and antenatal SARS-CoV-2 infection-associated stress with infant health outcomes. Conclusions
Overall, the study findings showed that antenatal pandemic-associated stressors must be targeted to improve mothers' and infants' postpartum outcomes. Expecting women must be considered vulnerable and prioritized during COVID-19 and other pandemics and provided appropriate care for physical and mental well-being.
Further research must be conducted to determine methods of reducing pandemic-associated stress to promote maternal and neonatal well-being in the postpartum period. The long-term relationships between SARS-CoV-2 infection-associated stress and maternal and neonatal health must be assessed.
Psychological and biological vulnerability markers among a more diverse group of pregnant women belonging to different ethnicities and residing in different geographical regions must be identified to personalize antenatal healthcare. Journal reference: Schweizer, S. et al. (2023) "Association of Antenatal COVID-19–Related Stress With Postpartum Maternal Mental Health and Negative Affectivity in Infants", JAMA Network Open, 6(3), p. e232969. doi: 10.1001/jamanetworkopen.2023.2969. https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2802388
The Menendez brothers’ bid for freedom through resentencing can continue with the hearing scheduled for Thursday, a judge has ruled.
Lyle, 57, and Erik, 54, received life sentences without the possibility of parole after being convicted of murdering their parents, Jose and Kitty Menendez, at their Beverly Hills home in 1989.
Lyle was 21 at the time, Erik was 18.
Last year, Los Angeles district attorney George Gascon asked a judge to change the brothers’ sentence from life without the possibility of parole to 50 years to life. That would make them immediately eligible for parole because they committed the crime when they were younger than 26.
But Mr Gascon’s successor Nathan Hochman submitted a motion last month to withdraw the resentencing request,saying the brothers must fully acknowledge lies they told about the murder of their parents before he would support their release from prison.
Separately, Governor Gavin Newsom, who has the power to commute their sentences, has asked the parole board to consider whether the brothers would represent a public safety risk if released.
Image: Anamaria Baralt, cousin of Erik and Lyle Menendez, hugs attorney Mark Geragos. Pic: AP
In light of Mr Hochman’s opposition, Los Angeles County Superior Court judge Michael Jesic ruled on Friday that the court can move forward with the hearing.
“Everything you argued today is absolutely fair game for the resentencing hearing next Thursday,” he said.
From prison, the brothers watched through a video link and could be seen in court seated next to each other in blue.
Speaking after the hearing, the brothers’ lawyer said: “Today is a good day. Justice won over politics.”
Prosecutors accused the brothers of killing their parents for a multimillion-dollar inheritance, although their defence team argued they acted out of self-defence after years of sexual abuse by their father.
Image: The brothers were convicted in 1996 of first-degree murder. Pic: AP
The brothers have maintained their parents abused them since they were first charged with the murders.
A Netflix drama series and subsequent documentary about the brothers thrust them back into the spotlight last year, and led to renewed calls for their release – including from some members of their family.
Erin Brockovich says a chance conversation about a muddy stiletto with her chiropractor led to the making of the award-winning film about her life.
The climate activist, who was played by Julia Roberts in the movie, told Sky News: “My girlfriend, who was a chiropractor, was giving me a chiropractic adjustment and asked me why I had mud on my stilettos.
“I said, ‘Oh, I’ve been collecting dead frogs’. She goes, ‘What is wrong with you?’ So, I started telling her what I was doing.”
Then just a junior paralegal, Brockovich was in fact pulling together evidence that would see her emerge victorious from one of the largest cases of water contamination in US history in Hinkley, California.
Her hard work would see her win a record settlement from Pacific Gas & Electric Company – $333m (£254m) – but that was all still to come.
Little did Brockovich know, but her tale of a muddy stiletto would get back to actor Danny DeVito and his Jersey Films producing partner Michael Schamburg, and through them to the film’s director Steven Soderbergh.
Brockovich says Soderbergh was “wowed” by what he heard.
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She says he realised her image “was something that Hollywood might be drawn to that I was never thinking of – the short skirt, the attitude, the big bust, the stilettos, the backcombed hair. Somehow, it came together.”
‘I was always going to be misunderstood’
Released in 2000, the powerful story of one woman’s fight for justice made Brockovich a household name, and the film won actress Julia Roberts an Oscar.
Now, 25 years on, Brockovich says she believes her legal victory was helped in part by an unlikely ally – her learning difficulty.
Image: Julia Roberts and Russell Crowe win best actress and actor at
the 2001 Oscars. Pic: AP/Richard Drew
Brockovich says: “Had I not been dyslexic, I might have missed Hinkley.”
Recently named a global ambassador for charity Made By Dyslexia, she’s been aware of her learning differences since childhood and still struggles today.
She says “moments of low self-esteem” still “creep back in”, and she long ago accepted “I was always going to be misunderstood”.
But for Brockovich, recognising her dyslexic strengths while working in Hinkley proved a pivotal moment: “My observations are wickedly keen. I feel like a human radar some days… Things you might not see as a pattern, I recognise. There are things that intuitively, I absolutely know.
“It will take me some time in my visual patterns of what I’m seeing, how to organise that. And it was in Hinkley that that moment happened for me because it was so omnipresent [and] in my face. Everything that should have been normal was not.”
‘A huge perfect storm’
Brockovich paints a bleak picture of what she saw in the small town: “The trees were secreting poison, the cows were covered in tumours, the chickens had wry neck [a neurological condition that causes the head to tilt abnormally], the people were sick and unbeknown to them, I knew they were all having the exact same health patterns. To the green water, to the two-headed frog, all of that was just I was like on fire, like electricity going, ‘Oh my gosh, what’s going on out here?'”
She describes it as “a huge, perfect storm that came together for me in Hinkley”.
But a side effect of the movie – overnight global fame – wasn’t always easy to deal with.
Image: Pic. Made By Dyslexia
Brockovich calls it “scary,” admitting, “when the film first came out the night of the premiere, I was literally shaking so bad, I was so overwhelmed, that Universal Studios said, ‘If we can’t get you to calm down, I think we need to take you home’. It was a lot”.
Brockovich says she kept grounded by staying focused on her work, her family and her three children.
With Hollywood not always renowned for its faithful adherence to fact, Brockovich says the film didn’t whitewash the facts.
“I think they really did a good job at pointing out our environmental issues. Hollywood can do that, they can tell a good story. And I’m glad it was not about fluff and glamour. I’m glad it was about a subject that oftentimes we don’t want to talk about. Water pollution, environmental damage. People being poisoned.”
‘Defend ourselves against environmental assaults’
While environmental awareness is now part of the daily conversation in a way it wasn’t a quarter of a century ago, the battle to protect the climate is far from over.
Just last month, Donald Trump laid out plans to slash over 30 climate and environmental regulations as part of an ongoing effort to boost US industries from coal to manufacturing and ramp up oil and minerals production.
In response, Brockovich says, “We’re not going to stop it, but we can defend against these environmental assaults.
“We can do better with infrastructure. We can do better on a lot of policy-making. I think there’s a moment here. We have to do that because the old coming into the new isn’t working.
“I’ve recognised the patterns for 30-plus years, we just keep doing the same thing over and over and over and over again, expecting a different result.
“For me, sometimes it’s like, ‘Oh my gosh, just get your ego out of the way’. We have to accept that this might be something greater than us, but we can certainly defend ourselves and protect ourselves and prepare ourselves better so we can get through that storm.”
You can listen to Brockovich speaking about her dyslexia with Made By Dyslexia founder Kate Griggs on the first episode of the new season of the podcast Lessons In Dyslexic Thinking, wherever you get your podcasts.
MPs will today debate emergency laws to save British Steel after the prime minister warned the country’s “economic and national security is on the line”.
Sir Keir Starmer said the future of the company’s Scunthorpe plant – which employs about 3,500 people – “hangs in the balance” after its owner said the cost of running it was unsustainable.
The prime minister said legislation would be passed in one day to allow the government to “take control of the plant and preserve all viable options”.
MPs and Lords are being summoned from their Easter recess to debate the move and will sit from 11am.
The last time parliament was recalled was on 18 August 2021 to debate the situation in Afghanistan.
The government has been considering nationalising British Steel after Jingye, the Chinese owner, cancelled future orders for iron ore, coal and other raw materials needed to keep the blast furnaces running.
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The furnaces are the last in the UK capable of making virgin steel.
The steel from the plant is used in the rail network and the construction and automotive industries. Without it, Britain would be reliant on imports at a time of trade wars and geopolitical instability.
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3:31
Inside the UK’s last blast furnaces
In a statement on Friday, Sir Keir said: “I will always act in the national interest to protect British jobs and British workers.
“This afternoon, the future of British Steel hangs in the balance. Jobs, investment, growth, our economic and national security are all on the line.”
The prime minister said steel was “part of our national story, part of the pride and heritage of this nation” and “essential for our future”.
He said the emergency law would give the business secretary powers to do “everything possible to stop the closure of these blast furnaces”.
This includes the power to direct the company’s board and workforce. It will also ensure it can order the raw materials to keep the furnaces running and ensure staff are paid.
Image: The Scunthorpe plant is the last in the UK that can make virgin steel. Pic: Reuters
Image: One of the two blast furnaces at Scunthorpe
Chancellor Rachel Reeves said the government was “taking action to save British steel production and protect British jobs”, while Business Secretary Jonathan Reynolds said the owner had left the government with “no choice”.
Mr Reynolds said Jingye had confirmed plans to close the Scunthorpe furnaces immediately despite months of talks and the offer of £500m of co-investment.
The company said it had invested £1.2bn since taking over in 2020, but that the plant is losing £700,000 a day.
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1:15
What will happen with British Steel?
Conservative leader Kemi Badenoch said the government had landed itself in a “steel crisis entirely of their own making”.
She said when she was business secretary, she had negotiated a plan with British Steel “to limit job losses and keep the plant running”.
Ms Badenoch said the government had “bungled the negotiations, insisting on a Scunthorpe-only deal that the company has deemed unviable”.
She added: “Keir Starmer should have seen this coming. But instead of addressing it earlier in the week when parliament was sitting, their incompetence has led to a last-minute recall of parliament.”
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Plaid Cymru has questioned why the government didn’t take similar action there.
The party’s Westminster leader, Liz Saville Roberts, said: “Parliament is being recalled to debate the nationalisation of Scunthorpe steelworks.
“But when global market forces devastated Welsh livelihoods in Port Talbot, Labour dismissed Plaid Cymru’s calls for nationalisation as ‘pipe dreams’.”