Efectividad de un programa educativo en conciencia plena (Mindfulness) para reducir el burnout y mejorar la empatía, en profesionales de atención primaria

Objetivos: Conocer la efectividad de un programa educativo en Conciencia plena para profesionales de Atención Primaria, orientado a la reducción de burnout y de la alteración emocional y al aumento de la empatía y de la conciencia plena. El programa consta de dos partes una fase intensiva y otra de mantenimiento. Los objetivos son dos: 1) comprobar la efectividad de la fase intensiva de forma aislada y 2) comprobar la efectividad del programa completo y la evolución de los participantes en diferentes momentos del mismo. Métodos: Para estudiar la efectividad de la fase intensiva utilizamos un diseño de ensayo clínico controlado y aleatorizado (estudio 1). La muestra estuvo compuesta de 68 profesionales de Atención Primaria y se dividió en dos grupos: 43 sujetos en el grupo experimental y 25 en el grupo control. Las variables dependientes fueron: Burnout (inventario de Burnout de Maslach (MBI), Alteración emocional (POMS), Empatía (Escala de Jefferson de Empatía en médicos, JSPE) y Conciencia plena o Mindfulness (Escala de Baer, FFMQ). Estas variables fueron evaluadas antes y al final de la intervención. Al final de la intervención se recogio la evaluación de los asistentes. La intervención duró 28 horas, con 9 sesiones donde se combinaban presentaciones sobre temas relevantes para la clínica, diálogo, además de ejercicios de Conciencia plena de tipo Contemplación-meditación y estiramientos tipo yoga. Para el segundo objetivo, orientado a comprobar la efectividad de todo el programa (estudio 2), utilizamos un diseño intrasujeto de muestras repetidas con 84 profesionales de Atención Primaria. Las variables evaluadas fueron las mismas del primer estudio y además administramos un test de Evaluación para conocer la valoración del programa por parte de los asistentes y la frecuencia de utilización de los ejercicios del programa. La intervención se realizó en dos fases, una intensiva de 8 semanas y una de mantenimiento de 10 meses. Las variables fueron evaluadas antes y después de la fase intensiva, a los 6 meses del comienzo y al final del programa (12 meses desde el comienzo). La intervención total duró 50 horas, repartidas en 17 sesiones durante 1 año, donde se trataban sobre temas relevantes para la clínica, además de ejercicios mencionados. Resultados: Respecto al primer estudio, en el grupo control no se observó diferencias en ninguna de las variables entre los dos momentos que se evaluaron. Sin embargo en el grupo experimental sí que se observaron diferencias: La puntuación de Burnout disminuyó 6.0 puntos (P0.05) un cambio pequeño (RME:0.31). La puntuación de Mindfulness, aumentó 12.0 puntos (P<0.001) un cambio moderado (RME:0.65).Las diferencias entre los cambios observados en el grupo experimental y control fueron significativas en todas las variables (empatía y burn out P<0.05, alteración emocional y mindfulness P<0.01). Los asistentes valoraron la intervención de forma muy positiva y atribuyeron cambios interesantes en su auto-cuidado y profesionalismo. El segundo estudio muestra como las mejoras obtenidas durante la fase intensiva en el grupo experimental, se consolidan y mantienen, con ligeras mejoras durante la fase de mantenimiento. El Burnout disminuye 9.2 puntos (P<0.001,). La reducción de la fase intensiva es (RME:0.40), mejorando durante la fase de mantenimiento, a los 6 meses (RME: 0.45) y al final (RME:0.64), con un cambio moderado. La Alteración emocional disminuye 8.8 puntos (P<0.001,). La reducción de la fase intensiva (RME:0.63), empeora ligeramente a los 6 meses (RME:0.43) y mejorando al final, con cambio grande (RME:0,8). La Empatía sube 6.7 puntos (P<0.001). Disminuye en a fase intensiva (RME 0.38), a los 6 meses (RME: 0.27) y al final, en grado moderado (RME:0.53). Mindfulness, aumenta 27.2 puntos (P<0.001). Aumenta en la fase intensiva (RME:1,20), que se mantiene a los 6 meses y aumenta al final con un cambio de gran magnitud (RME:1.40). El test de Evaluación nos permitió comprobar que al final de la intervención el 83% de los participantes utilizaba algún ejercicio del programa al menos 3 veces por semana y el 94% indicó que la mayor conciencia desarrollada había facilitado cambios interesantes en su actitudes,orientados a cuidarse y hacia un mayor profesionalismo. Conclusiones: El programa psico-educativo empleado basado en Mindfulness,tanto su fase intensiva, como en el programa completo, reduce el Burnout y la Alteración emocional y aumenta la Conciencia plena y la Empatía en profesionales de atención primaria. Tambien produce cambios en los profesionales orientados hacia un mejor auto-cuidado y un mayor profesionalismo.Objectives: To determine the effectiveness of an educational program in Mindfulness for Primary Care professionals, aimed at reducing Burnout and Mood states, developing Empathy and Mindfulness. The program consists of two parts, an intensive and maintenance one. The objectives are twofold: 1) test the effectiveness of the intensive phase alone and 2) test the effectiveness of the entire program, with the evolution of the participants at different times of it. Methods: To study the effectiveness of the intensive phase we used a randomized controlled trial. The sample consisted of 68 primary care professionals, divided into two groups: 43 subjects in the experimental group and 25 in the control group. The dependent variables were: Burnout (Maslach Burnout Inventory (MBI), Mood states (POMS), Empathy (Jefferson Empathy Scale doctors, JSPE) and Mindfulness (Baer, FFMQ). These variables were assessed before and after the intervention. The participants evaluated the program at the end. The intervention lasted 28 hours, with 9 sessions each combining presentations on topics relevant to clinical practice, a dialogue, plus Contemplation-meditation exercises and yoga stretching. For the second objective, aimed at testing the effectiveness of the entire program, we used a repeated measures design, with 84 primary care providers. The variables evaluated were the same as the first study, plus a test to determine the evaluation of program by the participants and the frequency of use of mindfulness exercises. The intervention was conducted in two phases, an intensive 8-week and maintenance over 10 months. Variables were assessed before and after the intensive phase, at 6 months of the beginning and end of program (12 months from the start). The participants evaluated the whole program at the end. The total intervention lasted 50 hours over 17 sessions for 1 year, the program of the maintenance phase dealt with issues relevant to the clinic, in addition to the mentioned exercises. Results: On the first study we observed significant differences between the experimental and control in the four variables. Burnout score decreased 6.0 points (P 0.05, 95% CI, -0.1 to 7.0) a small change (SMR: 0.31), while the difference between groups on changes is 5.2 points (P <0.05). Mindfulness score, rose 12.0 points (P <0.001, 95% CI, 6.0 to 18.1) a moderate change (SMR: 0.65), while the difference between groups on changes is 11.0 points (P <0.01). While in the control group no significant changes took place in these variables. Participants indicated high value for the program and registered changes in their attitude towards self-care and professionalism. The second study shows how the improvements achieved during the intensive phase in the experimental group, consolidate and maintain during the maintenance phase. Burnout decreased 9.2 points (P <0.001, 95% CI, -12.5 to -5.8). The reduction of the intensive phase is moderate (SMR: 0.40), improved during the maintenance phase, at 6 months (SMR: 0.45) ending, with a moderate change (SMR: 0.64). The Mood State decreased 8.8 points (P <0.001, 95% CI, -11.3 to -6.3). The reduction of the intensive phase is moderate (SMR: 0.63), slightly worse at 6 months (SMR: 0.43) and improving at the end, with large change (SMR: 0.8). Empathy, up 6.7 points (P <0.001, 95% CI, 3.8 to 9.6). Decreases to intensive phase moderately (SMR 0.38), at 6 months (SMR: 0.27) and raises finally, to a moderate extent (SMR: 0.53). Mindfulness, increasing 27.2 points (P <0.001, 95% CI, 22.5 to 31.8). Increases in the intensive phase largely (SMR: 1.20), maintained at 6 months and increases the end with a large change (SMR: 1.40). The Evaluation test allowed us to verify that at the end of intervention 83% of participants used Mindfulness exercises at least 3 times per week and 94% indicated that developed awareness had facilitated interesting changes in their attitudes. Moreover the participants developed better self care and attitudes towards improving their professionalism. Conclusions: A psycho-educational program based on Mindfulness facilitates reductions in Burnout, improved Mood states, and increased Mindfulness and Empathy. The participants appreciated the program and attributed to it positive changes in their personal attitudes towards self-care and better professionalism

Mindfulness y regulación emocional: Un estudio piloto

This quasi-experimental study examines the effects of Mindfulness-based Stress Reduction (MBSR) on emotional regulation (DERS) in a non-clinical population. The sample consists of a MBSR group (n = 33 adults, 66.7% women, Mage = 42.7 SD=8.9) and a matched control group (n = 14 adults, 64.3% women, Mage = 38.8 SD=9.3). The MBSR group obtain a significant improvement in the index of emotional regulation (p=0,03), specifically a decrease in emotional dyscontrol (p= 0,047) and life interference (p=0,02), compared with the control group. In conclusion, the mindfulness practice can help a person regulate their emotions in a more adaptative way, so it is an useful tool for the promotion of psychological wellness and the prevention of psychological disorders associated with stress.Este estudio cuasi-experimental explora los efectos del programa Mindfulness-based Stress Reduction (MBSR) en la regulación emocional (escala DERS) en población no clínica. La muestra está formada por un grupo MBSR (n=33 adultos; 66.7% mujeres, Medad=42.7 SD=8.9) y un grupo control (n= 14 adultos; 64.3% mujeres, Medad= 38.8 SD=9.3). El grupo que ha recibido MBSR, presenta una mejora significativa en el índice de regulación emocional (p=0,03), específicamente a partir de una reducción en el descontrol emocional (p= 0,047) e interferencia cotidiana (p=0,02), comparado con el grupo control. En conclusión, la práctica de mindfulness puede ayudar a la persona a regular sus emociones de una manera más adaptativa, por lo que constituye una herramienta muy útil para la promoción del bienestar psicológico y prevención de aparición de trastornos psicológicos asociados al estrés.   Detectar idiomaAfrikáansAlbanésAlemánÁrabeArmenioAzeríBengalíBielorrusoBirmanoBosnioBúlgaroCanarésCatalánCebuanoChecoChichewaChino (Simp)Chino (Trad)CincalésCoreanoCriollo haitianoCroataDanésEslovacoEslovenoEspañolEsperantoEstonioEuskeraFinlandésFrancésGalésGallegoGeorgianoGriegoGujaratiHausaHebreoHindiHmongHolandésHúngaroIgboIndonesioInglésIrlandésIslandésItalianoJaponésJavanésJemerKazajoLaoLatínLetónLituanoMacedonioMalayalamMalayoMalgacheMaltésMaoríMaratíMongolNepalíNoruegoPersaPolacoPortuguésPunjabíRumanoRusoSerbioSesotoSomalíSuajiliSuecoSundanésTagaloTailandésTamilTayikoTeluguTurcoUcranianoUrduUzbecoVietnamitaYidisYorubaZulú AfrikáansAlbanésAlemánÁrabeArmenioAzeríBengalíBielorrusoBirmanoBosnioBúlgaroCanarésCatalánCebuanoChecoChichewaChino (Simp)Chino (Trad)CincalésCoreanoCriollo haitianoCroataDanésEslovacoEslovenoEspañolEsperantoEstonioEuskeraFinlandésFrancésGalésGallegoGeorgianoGriegoGujaratiHausaHebreoHindiHmongHolandésHúngaroIgboIndonesioInglésIrlandésIslandésItalianoJaponésJavanésJemerKazajoLaoLatínLetónLituanoMacedonioMalayalamMalayoMalgacheMaltésMaoríMaratíMongolNepalíNoruegoPersaPolacoPortuguésPunjabíRumanoRusoSerbioSesotoSomalíSuajiliSuecoSundanésTagaloTailandésTamilTayikoTeluguTurcoUcranianoUrduUzbecoVietnamitaYidisYorubaZulú         La función de sonido está limitada a 100 caracteres Opciones : Historia : Ayuda : FeedbackCerra

Reducción de estrés mediante atención plena: la técnica MBSR en la formación de profesionales de la salud

Este estudio examina la eficacia del programa para la reducción del estrés denominado Mindfulness-Based Stress Reduction (MBSR) con un grupo de 28 voluntarios, en su mayoría profesionales de la salud. El 75% de las participantes completó el programa y el malestar psicológico de estos se redujo en un 49 % según el SCL-90R. El malestar físico también mejoró, con una reducción de! 44% de los síntomas médicos, medidos según el MSCL. Estos resultados son satisfactorios y similares a los citados en otros estudios comparables. Por ello, pensamos que la técnica MBSR puede ser aplicable en España para la reducción del estrés en el ámbito sanitario, con Igual efectividad que en Estados Unidos. Esta técnica, que se Imparte en grupo, con carácter formativo y con un coste reducido, puede ser útil para prevenir riesgos psico-sociales, como el estrés, en los Planes de Prevención de Riesgos LaboralesThis work examines the efficiency of the program Mindfulness-Based Stress Reduction (MBSR) with a group of 28 volunteers, mostly health professionals. 75% of the participants finished the program and experienced a distress reduction of 49%, measured with the SCL-90R. The physical status also Improved, with a 44% reduction of medical symptoms measured with MSCL. These results are satisfactory and similar to comparable research reported elsewhere. Therefore, we consider that the MBSR program can be applicable in Spain for stress reduction of health professionals with same efficiency as in the United Estates of America. This technique, delivered to groups within a training format at a low cost, can reduce psycho-social risks, such as stress, and therefore is applicable to Occupational Risk Prevention Plan

Efectividad de un programa educativo en conciencia plena (Mindfulness) para reducir el burnout y mejorar la empatía, en profesionales de atención primaria

Objetivos: Conocer la efectividad de un programa educativo en Conciencia plena para profesionales de Atención Primaria, orientado a la reducción de burnout y de la alteración emocional y al aumento de la empatía y de la conciencia plena. El programa consta de dos partes una fase intensiva y otra de mantenimiento. Los objetivos son dos: 1) comprobar la efectividad de la fase intensiva de forma aislada y 2) comprobar la efectividad del programa completo y la evolución de los participantes en diferentes momentos del mismo. Métodos: Para estudiar la efectividad de la fase intensiva utilizamos un diseño de ensayo clínico controlado y aleatorizado (estudio 1). La muestra estuvo compuesta de 68 profesionales de Atención Primaria y se dividió en dos grupos: 43 sujetos en el grupo experimental y 25 en el grupo control. Las variables dependientes fueron: Burnout (inventario de Burnout de Maslach (MBI), Alteración emocional (POMS), Empatía (Escala de Jefferson de Empatía en médicos, JSPE) y Conciencia plena o Mindfulness (Escala de Baer, FFMQ). Estas variables fueron evaluadas antes y al final de la intervención. Al final de la intervención se recogio la evaluación de los asistentes. La intervención duró 28 horas, con 9 sesiones donde se combinaban presentaciones sobre temas relevantes para la clínica, diálogo, además de ejercicios de Conciencia plena de tipo Contemplación-meditación y estiramientos tipo yoga. Para el segundo objetivo, orientado a comprobar la efectividad de todo el programa (estudio 2), utilizamos un diseño intrasujeto de muestras repetidas con 84 profesionales de Atención Primaria. Las variables evaluadas fueron las mismas del primer estudio y además administramos un test de Evaluación para conocer la valoración del programa por parte de los asistentes y la frecuencia de utilización de los ejercicios del programa. La intervención se realizó en dos fases, una intensiva de 8 semanas y una de mantenimiento de 10 meses. Las variables fueron evaluadas antes y después de la fase intensiva, a los 6 meses del comienzo y al final del programa (12 meses desde el comienzo). La intervención total duró 50 horas, repartidas en 17 sesiones durante 1 año, donde se trataban sobre temas relevantes para la clínica, además de ejercicios mencionados. Resultados: Respecto al primer estudio, en el grupo control no se observó diferencias en ninguna de las variables entre los dos momentos que se evaluaron. Sin embargo en el grupo experimental sí que se observaron diferencias: La puntuación de Burnout disminuyó 6.0 puntos (P0.05) un cambio pequeño (RME:0.31). La puntuación de Mindfulness, aumentó 12.0 puntos (P 0.05, 95% CI, -0.1 to 7.0) a small change (SMR: 0.31), while the difference between groups on changes is 5.2 points (P <0.05). Mindfulness score, rose 12.0 points (P <0.001, 95% CI, 6.0 to 18.1) a moderate change (SMR: 0.65), while the difference between groups on changes is 11.0 points (P <0.01). While in the control group no significant changes took place in these variables. Participants indicated high value for the program and registered changes in their attitude towards self-care and professionalism. The second study shows how the improvements achieved during the intensive phase in the experimental group, consolidate and maintain during the maintenance phase. Burnout decreased 9.2 points (P <0.001, 95% CI, -12.5 to -5.8). The reduction of the intensive phase is moderate (SMR: 0.40), improved during the maintenance phase, at 6 months (SMR: 0.45) ending, with a moderate change (SMR: 0.64). The Mood State decreased 8.8 points (P <0.001, 95% CI, -11.3 to -6.3). The reduction of the intensive phase is moderate (SMR: 0.63), slightly worse at 6 months (SMR: 0.43) and improving at the end, with large change (SMR: 0.8). Empathy, up 6.7 points (P <0.001, 95% CI, 3.8 to 9.6). Decreases to intensive phase moderately (SMR 0.38), at 6 months (SMR: 0.27) and raises finally, to a moderate extent (SMR: 0.53). Mindfulness, increasing 27.2 points (P <0.001, 95% CI, 22.5 to 31.8). Increases in the intensive phase largely (SMR: 1.20), maintained at 6 months and increases the end with a large change (SMR: 1.40). The Evaluation test allowed us to verify that at the end of intervention 83% of participants used Mindfulness exercises at least 3 times per week and 94% indicated that developed awareness had facilitated interesting changes in their attitudes. Moreover the participants developed better self care and attitudes towards improving their professionalism. Conclusions: A psycho-educational program based on Mindfulness facilitates reductions in Burnout, improved Mood states, and increased Mindfulness and Empathy. The participants appreciated the program and attributed to it positive changes in their personal attitudes towards self-care and better professionalism

Análisis y modificación de conducta

Resumen tomado de la publicaciónSe examina la eficacia del programa para la reducción del estrés denominado Mindfulness-Based Stress Reduction (MBSR) con un grupo de 28 voluntarios, en su mayoría profesionales de la salud. El 75 por ciento de los participantes completó el programa y el malestar psicológico de estos se redujo en un 49 por ciento según el SCL-90R. El malestar físico también mejoró, con una reducción del 44 por ciento de los síntomas médicos, medidos según el MSCL. Estos resultados son satisfactorios y similares a los citados en otros estudios comparables. Por ello, se piensa que la técnica MBSR puede ser aplicable en España para la reducción del estrés en el ámbito sanitario, con igual efectividad que en Estados Unidos. Esta técnica que se imparte en grupo, con carácter formativo y con un coste reducido, puede ser útil para prevenir riesgos psico-sociales, como el estrés, en los Planes de Prevención de Riesgos Laborales.ValenciaES

Face-to-face versus online: A comparative study of mindfulness-based stress reduction program in a general Spanish population

Objectives Explore the reduction in general psychological distress after a face-to-face versus an online mindfulness-based stress reduction (MBSR) program in a Spanish population. In addition, we study if program adherence and satisfaction differ between modalities. Methods We performed an 8-week quasi-experimental study in which 373 participants took part in an MBSR program in which face-to-face (n=109) and online (n=264) modalities were compared. Results Participants in both modalities showed a significant reduction in distress (P<0.001). However, there was no significant difference in this reduction between modalities (P=0.314). Adherence (P<0.001) and satisfaction (P=0.024) were significantly better in face-to-face sessions (P<0.001) compared to online ones. Conclusions The MBSR program reduces general psychological distress in both modalities (face-to-face and online). However, the face-to-face modality has higher levels of adherence and program satisfaction.Objetivos Explorar las diferencias entre el efecto de un programa presencial u online de reducción del estrés basado en mindfulness (REBM) sobre el malestar psicológico general en población española. Además, se estudia si la adhesión y satisfacción con el programa difiere entre ambas modalidades. Metodología Estudio cuasiexperimental en el que 373 participantes realizaron un programa REBM de 8 semanas. Se compararon 2 modalidades: presencial (n = 109) y online (n = 264). Resultados Los participantes de ambas modalidades presentaron reducciones significativas de malestar (p < 0,001). No hubo una diferencia significativa en la reducción de malestar entre ambas modalidades (p = 0,314). La adhesión (p < 0,001) y satisfacción (p = 0,024) fueron significativamente superiores en los participantes de la modalidad presencial (p < 0,001) que en los de la modalidad online. Conclusiones Ambas modalidades de REBM (presencial y online) reducen el malestar psicológico general. Sin embargo, la modalidad presencial tiene mayores niveles de adhesión y satisfacción

Effects of Mediterranean Diet or Mindfulness-Based Stress Reduction on Prevention of Small-for-Gestational Age Birth Weights in Newborns Born to At-Risk Pregnant Individuals: The IMPACT BCN Randomized Clinical Trial

Importance: Being born small for gestational age (SGA) is a leading cause of perinatal morbidity and mortality with no effective prevention or therapy. Maternal suboptimal nutrition and high stress levels have been associated with poor fetal growth and adverse pregnancy outcomes. Objective: To investigate whether structured interventions based on a Mediterranean diet or mindfulness-based stress reduction (stress reduction) in high-risk pregnancies can reduce the percentage of newborns who were born SGA and other adverse pregnancy outcomes. Design, setting, and participants: Parallel-group randomized clinical trial conducted at a university hospital in Barcelona, Spain, including 1221 individuals with singleton pregnancies (19-23 weeks' gestation) at high risk for SGA. Enrollment took place from February 1, 2017, to October 10, 2019, with follow-up until delivery (final follow-up on March 1, 2020). Interventions: Participants in the Mediterranean diet group (n = 407) received 2 hours monthly of individual and group educational sessions and free provision of extra-virgin olive oil and walnuts. Individuals in the stress reduction group (n = 407) underwent an 8-week stress reduction program adapted for pregnancy, consisting of weekly 2.5-hour sessions and 1 full-day session. Individuals in the usual care group (n = 407) received pregnancy care per institutional protocols. Main outcomes and measures: The primary end point was the percentage of newborns who were SGA at delivery, defined as birth weight below the 10th percentile. The secondary end point was a composite adverse perinatal outcome (at least 1 of the following: preterm birth, preeclampsia, perinatal mortality, severe SGA, neonatal acidosis, low Apgar score, or presence of any major neonatal morbidity). Results: Among the 1221 randomized individuals (median [IQR] age, 37 [34-40] years), 1184 (97%) completed the trial (392 individuals assigned to the Mediterranean diet group, 391 to the stress reduction group, and 401 to the usual care group). SGA occurred in 88 newborns (21.9%) in the control group, 55 (14.0%) in the Mediterranean diet group (odds ratio [OR], 0.58 [95% CI, 0.40-0.84]; risk difference [RD], -7.9 [95% CI, -13.6 to -2.6]; P = .004), and 61 (15.6%) in the stress reduction group (OR, 0.66 [95% CI, 0.46-0.94]; RD, -6.3 [95% CI, -11.8 to -0.9]; P = .02). The composite adverse perinatal outcome occurred in 105 newborns (26.2%) in the control group, 73 (18.6%) in the Mediterranean diet group (OR, 0.64 [95% CI, 0.46-0.90]; RD, -7.6 [95% CI, -13.4 to -1.8]; P = .01), and 76 (19.5%) in the stress reduction group (OR, 0.68 [95% CI, 0.49-0.95]; RD, -6.8 [95% CI, -12.6 to -0.3]; P = .02). Conclusions and relevance: In this randomized trial conducted at a single institution in Spain, treating pregnant individuals at high risk for SGA with a structured Mediterranean diet or with mindfulness-based stress reduction, compared with usual care, significantly reduced the percentage of newborns with birth weight below the 10th percentile. Due to important study limitations, these findings should be considered preliminary and require replication, as well as assessment in additional patient populations, before concluding that these treatments should be recommended to patients

Maternal Stress, Anxiety, Well-Being, and Sleep Quality in Pregnant Women throughout Gestation

This study was partially funded by the "LaCaixa" Foundation under grant agreements LCF/PR/GN14/10270005 and LCF/PR/GN18/10310003, the CEREBRA Foundation for the Brain Injured Child (Carmarthen, Wales, UK) and the Departament de Recerca i Universitats de la Generalitat de Catalunya 2021-SGR-01422. LB and FC have received funding from the Instituto de Salud Carlos III (ISCIII) through the projects CM21/00058 and INT21/00027 which are co-funded by the European Union. Funders played no role in the study's design, data collection, data analysis, data interpretation, or the writing of the manuscript.Background: Maternal stress, anxiety, well-being, and sleep quality during pregnancy have been described as influencing factors during pregnancy. Aim: We aimed to describe maternal stress, anxiety, well-being, and sleep quality in pregnant women throughout gestation and their related factors. Methods: A prospective study including pregnant women attending BCNatal, in Barcelona, Spain (n = 630). Maternal stress and anxiety were assessed by the Perceived Stress Scale (PSS) and State-Trait Anxiety Inventory (STAI)-validated questionnaires. Maternal well-being was assessed using the World Health Organization Well-Being Index Questionnaire (WHO-5), and sleep quality was assessed using the Pittsburgh Sleep Quality Index Questionnaire (PSQI). All questionnaires were obtained twice during the second and third trimester of pregnancy. A multivariate analysis was conducted to assess factors related to higher maternal stress and anxiety and worse well-being and sleep quality. Results: High levels of maternal stress were reported in 23.1% of participants at the end of pregnancy, with maternal age <40 years (OR 2.02; 95% CI 1.08-3.81, p = 0.03), non-white ethnicity (OR 2.09; 95% CI 1.19-4.02, p = 0.01), and non-university studies (OR 1.86; 95% CI 1.08-3.19, p = 0.02) being the parameters mostly associated with it. A total of 20.7% of women had high levels of anxiety in the third trimester and the presence of psychiatric disorders (OR 3.62; 95% CI 1.34-9.78, p = 0.01) and non-university studies (OR 1.70; 95% CI 1.11-2.59, p = 0.01) provided a significant contribution to high anxiety at multivariate analysis. Poor maternal well-being was observed in 26.5% of women and a significant contribution was provided by the presence of psychiatric disorders (OR 2.96; 95% CI 1.07-8.25, p = 0.04) and non-university studies (OR 1.74; 95% CI 1.10-2.74, p = 0.02). Finally, less sleep quality was observed at the end of pregnancy (p < 0.001), with 81.1% of women reporting poor sleep quality. Conclusion: Maternal stress and anxiety, compromised maternal well-being, and sleep quality disturbances are prevalent throughout pregnancy. Anxiety and compromised sleep quality may increase over gestation. The screening of these conditions at different stages of pregnancy and awareness of the associated risk factors can help to identify women at potential risk

Mediterranean diet, Mindfulness-Based Stress Reduction and usual care during pregnancy for reducing fetal growth restriction and adverse perinatal outcomes: IMPACT BCN (Improving Mothers for a better PrenAtal Care Trial BarCeloNa): a study protocol for a randomized controlled trial

Background: Fetal growth restriction (FGR) affects 7-10% of all pregnancies resulting in a higher risk of perinatal morbidity and mortality, long-term disabilities, and cognitive impairment. Due to its multifactorial etiology, changes in maternal lifestyle, including suboptimal maternal diet and stress, have increasingly been associated with its prevalence. We present a protocol for the Improving Mothers for a better PrenAtal Care Trial Barcelona (IMPACT BCN), which evaluates two different maternal lifestyle strategies (improved nutrition by promoting Mediterranean diet and stress reduction program based on mindfulness techniques) on perinatal outcomes. The primary objective is to reduce the prevalence of FGR. Secondary aims are to reduce adverse perinatal outcomes and to improve neurodevelopment and cardiovascular profile in children at 2 years of age. Methods: A randomized parallel, open-blind, single-center trial following a 1:1:1 ratio will select and randomize high-risk singleton pregnancies for FGR (N=1218), according to the criteria of the Royal College of Obstetricians and Gynaecologists (19.0-23.6 weeks' gestation), into three arms: Mediterranean diet, mindfulness-based stress reduction program, and usual care without any intervention. Compliance to the interventions will be randomly tested in 30% of participants with specific biomarkers. Maternal socio-demographic, clinical data, biological samples, and lifestyle questionnaires will be collected at enrollment and at the end of the interventions (34.0-36.6 weeks' gestation), together with a fetoplacental ultrasound and magnetic resonance. Fetoplacental biological samples and perinatal outcomes will be recorded at delivery. Postnatal follow-up is planned up to 2 years of corrected age including neurodevelopmental tests and cardiovascular assessment. Intention-to-treat and population per-protocol analysis will be performed. Discussion: This is the first randomized study evaluating the impact of maternal lifestyle interventions during pregnancy on perinatal outcomes. The maternal lifestyle interventions (Mediterranean diet and mindfulness-based stress reduction program) are supported by scientific evidence, and their compliance will be evaluated with several biomarkers