Posttraumatic reactions are common among mothers of preterm infants and can have a negative influence on their quality of life and lead to interactional difficulties with their baby. Given the possible trajectories of posttraumatic reactions, we hypothesized that prevalences of postpartum posttraumatic reactions at given times underestimate the real amount of mothers experiencing these symptoms within 18 months following delivery. Additionally, we examined whether sociodemographic and clinical characteristics of dyads influence the expression of posttraumatic symptoms among these mothers. A sample of 100 dyads was included in this longitudinal study led by 3 french university hospitals. Preterm infants born before 32 weeks of gestation and their mothers were followed-up over 18 months and attended 5 visits assessing the infants’ health conditions and the mothers’ psychological state with validated scales. Fifty dyads were retained through the 18 months of the study. The period prevalence of posttraumatic reactions was calculated and a group comparison was conducted to determine their predictive factors. Thirty-six percent of the mothers currently suffered from posttraumatic symptoms 18 months after their preterm delivery. The 18 months period prevalence was 60.4% among all the mothers who participated until the end of the follow-up. There was a statistical link between posttraumatic symptoms and a shorter gestational age at delivery, C-section, and the mother’s psychological state of mind at every assessment time. Only a small proportion of mothers were receiving psychological support at 18 months. Preterm mothers are a population at risk of developing a long-lasting postpartum posttraumatic disorder, therefore immediate and delayed systematic screenings for posttraumatic symptoms are strongly recommended to guide at-risk mothers towards appropriate psychological support.

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Background The denial of pregnancy is the non-recognition of the state of the current pregnancy by a pregnant woman. It lasts for a few months or for the whole pregnancy, with generally few physical transformations. In this study, we will consider the denial of pregnancy as a late declaration of pregnancy (beyond 20 weeks of gestation) as well as a lack of objective perceptions of this pregnancy. The main objective of this study is to explore the relationship between pregnancy denial and the development of the infant (attachment pattern of the infant, early interactions of mother-infant dyads, and early development of the infant). Methods The design is a case-control prospective study, which will compare two groups of mother-infant dyads: a “case” group with maternal denials of pregnancy and a “control” group without denials of pregnancy. A total of 140 dyads (mother + infant) will be included in this study (70 cases and 70 controls) and followed for 18 months. The setting is a national recruitment setting with 10 centers distributed all over France. The follow-up of the “cases” and the “controls” will be identical and will occur over 5 visits. It will include measures of the infant attachment pattern, the quality of early mother-infant interaction and infant development. Discussion This study aims to examine the pathogenesis of pregnancy denial as well as its consequences on early infant development and early mother-infant interaction. Trial registration Clinical Trial Number: NCT02867579 on the date of 16 August 2016 (retrospectively registered).

INTRODUCCIÓNSe ha señalado recientemente que la enfermedad tromboembólica venosa (ETEV) constituye la cenicienta de las enfermedades cardiovasculares, si se compara con otras manifestaciones más estudiadas de trombosis arterial y presentadas clínicamente como infarto de miocardio (IAM), enfermedad cerebrovascular (ECV) o arteriopatía periférica (1). Sin embargo, la ETEV es una enfermedad frecuente, muchas veces infradiagnosticada y potencialmente mortal, debido a la posibilidad de fragmentación del trombo venoso con producción de un embolismo pulmonar (EP). Este constituye, de [0212-7199 (2005) RESUMENObjetivos: Comparar los costes del tratamiento ambulatorio por una Unidad de Hospitalización a Domicilio (HADO) frente a la hospitalización convencional en el tratamiento agudo de la trombosis venosa profunda (TVP) y embolismo pulmonar (EP).Métodos: Durante el año 2002 se trataron 21 pacientes con TVP en la Unidad de HADO. La mediana de edad fue de 81 años, 11 fueron mujeres (52%) y, excepto uno, todos los pacientes presentaban importante comorbilidad. El diagnóstico se realizó en el hospital por ecografía-doppler. En 13 casos se realizó además una gammagrafía pulmonar, objetivándose EP concomitante en 7 pacientes. El tratamiento se realizó mediante heparinas de bajo peso molecular (HBPM) seguidas de anticoagulantes orales en 3 pacientes. No hubo complicaciones excepto un caso que requirió un ingreso breve debido al pobre control sintomático de la TVP y cuyos costes se imputaron a HADO. El estudio comparativo de costes se realizó con respecto a pacientes con TVP (grupo de diagnóstico relacionado, GDR 131) y EP ingresados (GDR: 78). El coste farmacoló-gico para pacientes de HADO se calculó para 10 días.Resultados: La estancia media hospitalaria de los pacientes ingresados fue de 8,1 días en TVP y 13,1 en TEP frente a 1 día en los pacientes en HADO. El ahorro de costes en HADO para el tratamiento agudo fue estimado en 1.680 € por paciente.Conclusiones: El tratamiento ambulatorio mediante una unidad de HADO de pacientes con TVP (y TEP seleccionados) resultó una estrategia segura, eficaz y coste-efectiva. Tratamiento domiciliario de la trombosis venosa profunda. Comparación de costes con la hospitalización convencional

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Strategies to improve compliance in Spain aim mainly at improving the general perception of the method and the accessibility of family planning centers. Factors associated with compliance are still not well known in our country. Better knowledge of the determinants of non-compliance in Spain is needed. For this purpose, another research group was formed to conduct a national study among women.

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