Fetal Risks,Relative Risks,and Relatives' Risks

Several factors related to fetal risk render it more or less acceptable in justifying constraints on the behavior of pregnant women. Risk is an unavoidable part of pregnancy and childbirth, one that women must balance against other vital personal and family interests. Two particular issues relate to the fairness of claims that pregnant women are never entitled to put their fetuses at risk: relative risks and relatives' risks. The former have been used—often spuriously—to advance arguments against activities, such as home birth, that may incur risk; the latter implicate the nature of relationships in determining the acceptability of coercing or precluding activities. Motivated reasoning by clinicians and judges leads to inaccurate risk assessments, and judgments based on false claims to objectivity. Such judgments undermine the moral and legal standing of pregnant women and do not advance the interests of fetuses, pregnant women, families, or states.     

Influence of in utero exposure to maternal depression and natural disaster-related stress on infant temperament at 6 months: The children of Superstorm Sandy

This study examined the effects of in utero exposure to maternal depression and Superstorm Sandy, a hurricane that hit metropolitan New York in 2012, on infant temperament at 6 months. Temperament was assessed using the Infant Behavior Questionnaire-Revised. Maternal depression was measured by the Edinburgh Postnatal Depression Scale. The main effects and the interaction of maternal depression and Sandy exposure on infant temperament were examined using a multivariable generalized linear model. Results show that prenatal maternal depression was associated with lower emotion regulation and greater distress. Stratification and interaction analyses suggested that the adverse effects of prenatal maternal depression on problematic temperament were amplified by in utero Sandy exposure. This study underscores the importance of providing prenatal screening and treatment for maternal depression during pregnancy while also identifying high-risk families who may have suffered from disaster-related traumas to provide necessary services. As the frequency of natural disasters may increase due to climate change, it is important to understand the consequences of in utero stress on child development and to formulate plans for early identification.     

孕期生活事件与妊娠压力：心理健康的中介效应和丈夫支持的调节作用

用问卷调查法对上海市403名单胎、孕周在24～33周的孕妇进行研究,探讨怀孕过程中孕妇经历的生活事件和妊娠压力的关系,以及孕妇的心理健康状况和丈夫支持在其中所起的作用。结果表明：（1）怀孕计划的主效应显著,孕龄的主效应不显著,怀孕计划和孕龄的交互作用显著;妊娠压力在怀孕计划上的主效应显著,意外怀孕的孕妇的妊娠压力显著高于计划怀孕的孕妇的妊娠压力;（2）怀孕过程中孕妇经历的生活事件与妊娠压力呈显著正相关,与孕妇的心理健康呈显著负相关;（3）孕妇的心理健康状况在生活事件和妊娠压力的关系中起部分中介效应,即生活事件部分通过孕妇的心理健康状况影响孕妇的妊娠压力;而丈夫支持则对孕妇心理健康的中介效应起调节作用,当丈夫支持高时,心理健康状况越好的孕妇,其妊娠压力越低,心理健康状况对孕妇妊娠压力预测显著;当丈夫支持低时,心理健康状况对妊娠压力的预测不显著。     

替代指标在心血管疾病临床决策中的正确认识

在心血管疾病临床试验中,替代指标常用于评价干预措施的疗效。但替代指标在心血管疾病临床试验中非常复杂,因此,心血管医生在解读和评价心血管疾病临床试验的结果时,应正确认识替代指标的内涵、应用背景及其局限性,同时,还应客观地评价相关替代指标的证据强度,以寻找最好的医学证据指导其临床决策和实践。     

Measuring grief: A short version of the perinatal grief scale

Despite a considerable number of studies, there are two major drawbacks in the literature on grief and bereavement. One is a lack of adequate and generally agreed upon measures for assessing grief. The second is a lack of ability to predict from existing measures the likelihood of what has been termed chronic or pathological grief reactions. This paper reports the results of the development of a bereavement measure for the study of perinatal loss which attempts to address these gaps. The measure is specific to a pregnancy-related loss, although it has the potential for adaptation to use for other types of loss. Analysis of responses from 138 women has resulted in the reduction of the original measure from 104 to a more manageable and almost equally comprehensive and reliable 33 items. In addition, a factor analysis has produced three factors, two of which indicate the possibility for longer-term and more severe grief reactions. Because of its sound psychometric qualities and interesting factor structure, the measure shows promise of being useful for both research and clinical purposes.This research was funded by National Institute of Child Health and Human Development Grant R01 H18431-04, with additional assistance from the Center for Social Research at Lehigh University. Dr. Potvin is supported by the Quebec Health Research Fund.     

The hope of the future: The experience of pregnancy influences women’s implicit space–time mappings

It has long been observed that speakers employ spatial concepts “front” and “back” to talk about temporal concepts “past” and “future.” However, the direction of space-time mappings varies across cultures. According to Temporal Focus Hypothesis (TFH), people’s implicit associations between space and time are conditioned by their temporal focus. Here we tested whether pregnancy can affect Chinese women’s temporal focus and thereby influence their space-time mappings. One of the most striking characteristics of pregnant women noted by previous research is their future-oriented thought. Based on this, we predicted that pregnant women should be more future-focused. Consistent with this prediction, the results demonstrated that pregnant women tended to be more future-focused than non-pregnant women and demonstrated a greater tendency to conceptualize the future as in front of them, supporting the TFH. The current research offers a new perspective that culture-external factors such as pregnancy can also influence people’s spatialization of time.     

Parenting Competency Across Pregnancy and Postpartum Among Urban Minority Women

Taking a life-course perspective, we explored the sense of parenting efficacy during the pregnancy-postpartum transition among a group under-represented in much of adult developmental research, minority women. Our intent was to describe the women's report of parenting competency in a major life transition occurring within the context of an impoverished urban environment. We also explored associations with depression, social support, and life events. One hundred and eighty-two African-American and Hispanic mothers at community health centers in low-income urban areas completed measures early in the third trimester and again at 3 months postpartum. Across time, the levels of reported parental efficacy and satisfaction increased while depressive symptoms decreased. Negative life events and levels of depressive symptomatology differentially influenced women's experience of parenting satisfaction and efficacy feelings before and after their babies were born.     

Mandated Interventions with Drug-Dependent, Pregnant Women

Increased concern about the influence of pregnant women's substance use on fetal health has prompted a variety of actions, including calls for legal interventions against some pregnant women with chronic substance abuse problems. In this paper I examine the legal and social science arguments used to support and oppose these interventions. Several assumptions about the behaviors of pregnant women that are used to support the arguments are described. The types of social science research that could inform the ongoing debate about interventions with pregnant women are explored.