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Objective: Meconium stained amniotic fluid (MSAF) is a well-established risk factor for neonatal short-term respiratory complications. Little is known regarding the long-term morbidity. We investigated the possible association between MSAF and offspring respiratory morbidity., Methods: A population-based, cohort study of singleton deliveries occurring between 1991 and 2014 at a sole regional tertiary medical center was performed. Incidence of offspring respiratory related hospitalizations up to the age of 18 years were evaluated and compared to unexposed offspring. A Kaplan-Meier survival curve was used to compare cumulative respiratory morbidity incidence, and a Cox proportional hazards model was used to control for confounders., Results: During the study period 242,342 deliveries met the inclusion criteria. Of them, 14.7% (n = 35,609) were complicated with MSAF. Incidence of respiratory-related hospitalizations was significantly lower in children exposed to MSAF as compared to the unexposed group (4.5% vs. 4.9%, respectively; p < .01). Specifically, hospitalizations involving pneumonitis were significantly less common among the MSAF group (odds ratio, 0.35; 95% confidence interval [95% CI], 0.13-0.96; p = .03). The Kaplan-Meier survival curve demonstrated significantly lower total cumulative respiratory morbidity rates in the MSAF exposed group (log rank p < .01). In the Cox model, controlled for clinically relevant confounders, MSAF exhibited an independent and significant protective effect on long-term childhood respiratory morbidity (aHR, 0.91; 95% CI, 0.86-0.96; p < .01)., Conclusions: Fetal exposure to MSAF during labor appears to be associated with lower rates of long-term respiratory related hospitalizations in the offspring. Changes in offspring microbiome, as well as functional and anatomical modulations possibly resulting from MSAF exposure, might offer a plausible explanation of our findings., (© 2021 Wiley Periodicals LLC.)

Objective: Higher rates of mental disorders, specifically depression, were found among affected people in previous epidemiological studies taken after disasters. The aim of the current study was to assess risk for depression among pregnant women hospitalized during the "coronavirus disease 2019" (COVID-19) pandemic, as compared to women hospitalized before the COVID-19 pandemic., Study Design: A cross-sectional study was performed among women hospitalized in the high-risk pregnancy units of the Soroka University Medical Center (SUMC). All participating women completed the Edinburgh Postnatal Depression Scale (EPDS), and the results were compared between women hospitalized during the COVID-19 strict isolation period (19 March 2020 and 26 May 2020) and women hospitalized before the COVID-19 pandemic. Multivariable logistic regression models were constructed to control for potential confounders., Results: Women hospitalized during the COVID-19 strict isolation period ( n = 84) had a comparable risk of having a high (>10) EPDS score as compared to women hospitalized before the COVID-19 pandemic ( n = 279; 25.0% vs. 29.0%, p = 0.498). These results remained similar in the multivariable logistic regression model, while controlling for maternal age, ethnicity and known mood disorder (adjusted odds ratio (OR) 1.0, 95% CI 0.52-1.93, p = 0.985)., Conclusion: Women hospitalized at the high-risk pregnancy unit during the COVID-19 strict isolation period were not at increased risk for depression, as compared to women hospitalized before the COVID-19 pandemic.

Scarce data exists regarding the prevalence of antenatal depression in hospitalized pregnant women, and its effect on perinatal outcome. We aimed to estimate the risk of maternal depression among women hospitalized in a high-risk pregnancy department, and to evaluate its potential association with adverse perinatal outcome. A depression screening self-questionnaire-based prospective study was performed, in which hospitalized pregnant women who screened positive for depression were compared to those who screened negative. The Edinburgh Postnatal Depression Scale (EPDS) was used for antenatal depression screening. Pregnancy course and perinatal outcome were compared between the groups. A multivariate logistic regression model was constructed to control for clinically relevant confounders. During the study period, 279 women met the inclusion criteria. Among them, 28.3% (n = 79) screened positive for depression (≥ 10 points on the EPDS). In the univariate analysis, a significantly higher incidence of preterm delivery (< 37 weeks), low birthweight (< 2500 g), low Apgar scores (at 1 and 5 min), and neonatal intensive care unit (NICU) admissions were noted among the screen positive group. In the multivariate regression model, controlled for maternal age, ethnicity, gestational diabetes mellitus, preeclampsia, past preterm delivery, and gestational age upon admission, maternal antenatal depression during hospitalization was noted as an independent risk factor for preterm delivery (adjusted OR 3.32, 95%CI 1.16-9.52, p = 0.026). Maternal antenatal depression during hospitalization is very common and appears to play a significant and independent role in the prediction of preterm delivery.

My aim in this paper is to examine the role of reverie in facilitating the development of the child-subject, that is, the child's continuous motion towards subjectivity. I begin by briefly reviewing the concept of reverie and proceed with an examination of elements I believe are fundamental and common to both reverie and child psychotherapy, that is, primary thought processes and primitive impulses. I then describe and demonstrate the atmosphere created by these elements using three examples from the psychotherapy of 8 year-old Jonathan. Next, I discuss an intersubjective parallel of Bion's reverie and a developmentally oriented version of Ogden's reverie, focusing on its relation to processes of destruction and recognition. I argue that reverie provides the recognition of the child's struggle for his own birth and growth as a subject, that is, of his child-subject. Finally, I refer to the presence of reverie from the primary preoccupation of mother and father till the child's reverie of himself, his day-dreaming., (Copyright © 2016 Institute of Psychoanalysis.)