Objectives: To investigate prospectively the impact of physical activity during pregnancy on infant neurodevelopment, considering relevant confounding factors, physical activity intensity and the trimester of pregnancy in which it is performed.
Methods: Prospective follow-up study of 791 pregnant women from the first trimester of pregnancy to 40 days postpartum. Three intensity levels of physical activity were assessed in each trimester of pregnancy by the International Physical Activity Questionnaire (IPAQ). Infant neuro development was assessed at 40 days postpartum by the third edition of the Bayley Scales for Infant Development-Third Edition (BSID-III). Analysis adjusted by sociodemographics, anxiety symptoms, lifestyle habits, quality of diet, body mass index, postpartum depressive symptoms and mother-infant attachment.
Results: ANCOVA analysis have shown that 40 days old infants of mothers in the moderate and high PA groups in the third trimester obtained 3.2 and 3.8 points higher scores respectively in the language total scale; and 4.1 and 5.1 points higher scores respectively in the motor total scale than infants of mothers in the low PAgroup.
Conclusion: Moderate to high intensity physical activity during pregnancy has a positive impact on infant neurodevelopment. More specific recommendations must be incorporated in international guidelines and into maternal education sessions to improve infants’ neurodevelopment.

Background: Tobacco consumption during pregnancy is one of the most modifiable causes of morbidity and mortality for both pregnant smokers and their foetus. Even though pregnant smokers are conscious about the negative effects of tobacco consumption, they also had barriers for smoking cessation and most of them continue smoking, being a major public health problem. The aim of this study is to determine the effectiveness of an application (App) for mobile devices, designed with a gamification strategy, in order to help pregnant smokers to quit smoking during pregnancy and in the long term.Methods: This study is a multicentre randomized community intervention trial. It will recruit pregnant smokers (200 participants/group), aged more than 18 years, with sporadically or daily smoking habit in the last 30 days and who follow-up their pregnancy in the Sexual and Reproductive Health Care Services of the Camp de Tarragona and Central Catalonia Primary Care Departments. All the participants will have the usual clinical practice intervention for smoking cessation, whereas the intervention group will also have access to the App. The outcome measure will be prolonged abstinence at 12 months after the intervention, as confirmed by expired-carbon monoxide and urinary cotinine tests. Results will be analysed based on intention to treat. Prolonged abstinence rates will be compared, and the determining factors will be evaluated using multivariate statistical analysis.Discussion: The results of this study will offer evidence about the effectiveness of an intervention using a mobile App in smoking cessation for pregnant smokers, to decrease comorbidity associated with long-term smoking. If this technology is proven effective, it could be readily incorporated into primary care intervention for all pregnant smokers.

BACKGROUND: The changes in shield strategies, treatments, emergence variants, and healthcare pathways might shift the profile and outcome of patients hospitalized with COVID-19 in successive waves of the outbreak. METHODS: We retrospectively analysed the characteristics and in-hospital outcomes of all patients admitted with COVID-19 in eight university hospitals of Catalonia (North-East Spain) between Feb 28, 2020 and Feb 28, 2021. Using a 7-joinpoint regression analysis, we split admissions into four waves. The main hospital outcomes included 30-day mortality and admission to intensive care unit (ICU). FINDINGS: The analysis included 17,027 subjects admitted during the first wave (6800; 39.9%), summer wave (1807; 10.6%), second wave (3804; 22.3%), and third wave (4616; 27.1%). The highest 30-day mortality rate was reported during the first wave (17%) and decreased afterwards, remaining stable at 13% in the second and third waves (overall 30% reduction); the lowest mortality was reported during the summer wave (8%, 50% reduction). ICU admission became progressively more frequent during successive waves. In Cox regression analysis, the main factors contributing to differences in 30-day mortality were the epidemic wave, followed by gender, age, diabetes, chronic kidney disease, and neoplasms. INTERPRETATION: Although in-hospital COVID-19 mortality remains high, it decreased substantially after the first wave and is highly dependent of patient’s characteristics and ICU availability. Highest mortality reductions occurred during a wave characterized by younger individuals, an increasingly frequent scenario as vaccination campaigns progress. FUNDING: This work did not receive specific funding.

Migrants are likely to experience mental health conditions, being one of the most vulnerable groups during the COVID-19 pandemic. The present study aims to: (1) estimate the prevalence of depressive and anxious symptoms and (2) examine the impact of risk and protective factors on this symptomatology. A sample of 129 migrants living in Spain during the COVID-19 pandemic completed an anonymous online survey, including information on sociodemographic and individual characteristics, migration, basic needs, social environment and perceived health domains. Multiple Poisson regression models analysed the effects of risk and protective factors on depression and anxiety symptoms. The prevalence of depressive and anxiety symptoms was 22.3% and 21.4%, respectively. Risk factors such as living in a rented house and previous mental health conditions were associated with higher depression symptoms, whereas unemployment was related to anxiety symptoms. Conversely, older age, better self-esteem, and higher levels of social support were associated with fewer depression symptoms. Older age and better quality of life were related to fewer anxiety symptoms. These findings addressing risk and protective factors (e.g., social support, self-esteem) help to design culturally effective programs, particularly in migrants with pre-existing mental health conditions, adjusting the organisation of mental healthcare services in difficult times in Spain.

Background: Estimates of the association between COVID-19 vaccines and myo-/pericarditis risk vary widely across studies due to scarcity of events, especially in age- and sex-stratified analyses.Methods: Population-based cohort study with nested self-controlled risk interval (SCRI) using healthcare data from five European databases. Individuals were followed from 01/01/2020 until end of data availability (31/12/2021 latest). Outcome was first myo-/pericarditis diagnosis. Exposures were first and second dose of Pfizer, AstraZeneca, Moderna, and Janssen COVID-19 vaccines. Baseline incidence rates (IRs), and vaccine- and dose-specific IRs and rate differences were calculated from the cohort The SCRI calculated calendar time-adjusted IR ratios (IRR), using a 60-day pre-vaccination control period and dose-specific 28-day risk windows. IRRs were pooled using random effects meta-analysis. Findings: Over 35 million individuals (49 & BULL;2% women, median age 39-49 years) were included, of which 57 & BULL;4% received at least one COVID-19 vaccine dose. Baseline incidence of myocarditis was low. Myocarditis IRRs were elevated after vaccination in those aged < 30 years, after both Pfizer vaccine doses (IRR = 3 & BULL;3, 95%CI 1 & BULL;2-9.4; 7 & BULL;8, 95%CI 2 & BULL;6-23 & BULL;5, respectively) and Moderna vaccine dose 2 (IRR = 6 & BULL;1, 95%CI 1 & BULL;1-33 & BULL;5). An effect of AstraZeneca vaccine dose 2 could not be excluded (IRR = 2 & BULL;42, 95%CI 0 & BULL;96-6 & BULL;07). Pericarditis was not associated with vaccination.Interpretation: mRNA-based COVID-19 vaccines and potentially AstraZeneca are associated with increased myocarditis risk in younger individuals, although absolute incidence remains low. More data on children (& LE; 11 years) are needed.

Background: Short-chain fatty acids (SCFA) play a key role in the gut microbiota-brain crosstalk regulating the main neurodevelopmental processes during pregnancy. The aim of this study is to investigate the longitudinal relationship between prenatal levels of the main SCFAs in maternal serum and infant cognitive development and temperament on day 40 postpartum after adjusting for several pre-, peri- and post-natal confounders. Methods: A sample of 357 healthy mother-infant pairs were followed from the beginning of pregnancy to 40 days after birth. Serum SCFA concentrations were assessed in the first and third trimester of pregnancy by LC-MS/MS; and socio-demographic, nutritional, and psychological variables were collected. At 40 days, the Bayley Scales of Infant Development-III and the Early Infancy Temperament Questionnaire were administered. Results: Lower serum levels of acetic, butyric and isobutyric acid, mainly during the first trimester, were related to better language and psychomotor development and, in the case of butyric acid, better intensity behavior in infants. Medium levels of propionic acid were related to better scores for development, mood and temperament. Conclusions: These findings suggest that in a community sample of healthy pregnant women from a Mediterranean region of northern Spain, lower serum levels of SCFAs, especially in the first trimester of pregnancy, seem to be related to better infant neurodevelopment

Background and aims Previous studies have shown beneficial associations between fruit and vegetable (FV) consumption and cardiometabolic risk factors. However, variety in FV, which may play an important role on cardiovascular health due to the different nutrient and phytochemical content among the different groups and subgroups of FV has been poorly investigated. We longitudinally investigated associations between 1-year changes in variety and quantity of FV and concurrent changes in cardiometabolic risk factors in elderly subjects with overweight/obesity and metabolic syndrome. Methods a one-year data longitudinal analysis of 6647 PREDIMED-plus study participants (48% women) was conducted. Data were collected at baseline, six months and 1-year of follow-up. Variety and quantity of FV were estimated using a food frequency questionnaire and continuous scores for variety were created based on items/month of FV. Linear mixed-models adjusted for potential confounders were performed to estimate associations (beta-coefficients and 95% confidence interval) between 1-year changes in FV variety and/or quantity and concurrent changes in cardiometabolic risk factors. Results Two points increment in the FV variety score over one year was associated with a concurrent decrease in glucose (-0.33 mg/dL (0.58, -0.07)), body weight (-0.07 kg (-0.13, -0.02)) and waist circumference (WC) (-0.08 cm (-0.16, -10.01)). An increment of 100 g/d of FV over one year was associated with a concurrent decrease in triglycerides (-0.50 mg/dL (-0.93, -0.08)), glucose (-0.21 mg/dL (-0.32, -0.11)), body weight (-0.11 kg (-0.15, -0.07)) and WC (-0.10 cm (-0.14, -0.06)) over 1-year. Changes in FV consumption which led to higher quantity and variety over one year were associated with downward changes in glucose (-1.26 mg/dL (-2.09, -0.43)), body weight (-0.40 kg (-0.58, -0.23)) and WC (-0.50 cm (-0.73, -0.28)). Conclusion Greater variety, in combination with higher quantity of FV was significantly associated with a decrease in several cardiometabolic risk factors among elderly subjects at high cardiovascular risk.