Mass vaccination against COVID-19 is necessary to control the pandemic. COVID-19 vaccines are now recommended during pregnancy to prevent the disease. A systematic review of the literature in the electronic databases PubMed and EMBASE was performed and we aimed to investigate the attitude of documents towards COVID-19 vaccination and the prognostic factors of vaccination hesitation. A meta-analysis was also conducted to estimate the overall percentage of pregnant women who were willing to be vaccinated or had been vaccinated against COVID-19. A total of 18 studies were included in the review and meta-analysis. The acceptance rate of vaccination against COVID-19 among pregnant women ranged from 17.6% to 84.5%. The pooled proportion of acceptance of vaccination against COVID-19 in pregnant women was 0.53 (95% CI: 0.44–0.61). Predictors of acceptance of COVID-19 vaccination were older age, White race, occupational status, higher level of education, comorbidities, third trimester of pregnancy, influenza vaccination, knowledge about COVID-19, and confidence that vaccines for COVID-19 are safe and effective. The prevalence of COVID-19 vaccination in pregnant women is low. Targeted information campaigns are needed to increase vaccine education in this population.

Breastfeeding is considered to be the cornerstone of child health. In Europe however, overall breastfeeding rates remain low. The present study aimed at estimating the frequency of breastfeeding in Greece during the COVID-19 pandemic period and comparing findings with the latest national study in order to identify a potential impact of the pandemic. Additionally, possible correlations of socio-cultural and demographic characteristics with breastfeeding indicators were investigated. This prospective cohort study included 847 women from five tertiary maternity hospitals, between January and December 2020. Data were collected by a structured questionnaire via interview during hospitalization and via telephone in the first, third and sixth month postpartum. Results showed that all breastfeeding indicators improved over the last three years. Full breastfeeding reached 7.2%, contrary to 0.78% of the latest national study at six months postpartum. Employment, marital status, educational level, mode of delivery, type of maternity hospital, body mass index before pregnancy, previous breastfeeding experience of the mother and infant’s birth weight correlated significantly with breastfeeding indicators at different time periods. The COVID-19 pandemic seems to have favorably influenced breastfeeding initiation and duration in Greece due to lockdowns, home confinement and teleworking.

Pharmacological treatment may become a barrier for a mother’s breastfeeding goals. We aimed to investigate maternal medication intake as a factor for non-initiation and cessation of breastfeeding and the effect of professional counseling on maternal decision-making. Throughout 2020, 847 women were recruited from five healthcare institutions. Information was gathered prospectively with an organized questionnaire through interview during hospitalization and through telephone at 1, 3 and 6 months postpartum. Results revealed that from the 57 cases of breastfeeding cessation due to medication intake, only 10.5% received evidence-based counseling from a physician. Unfortunately, 68.4% (n = 39/57) of the participants ceased breastfeeding due to erroneous professional advice. The compatibility of medicines with breastfeeding was examined according to the Lactmed and Hale classification systems, which showed discrepancy in 8 out of 114 medicines used, while 17.5% and 13.2% of the medicines, respectively, were not classified. Educational level, employment at six months postpartum, mode of delivery, previous breastfeeding experience, medication intake for chronic diseases, physician’s recommendation and smoking before pregnancy were factors significantly correlated with breastfeeding discontinuation due to medication intake. The COVID-19 restrictions protected women from ceasing breastfeeding due to medication intake. Maternal and lactation consultancy should be strictly related to evidence-based approaches.

Neonatal brain injury (NBI) is a critical condition for preterm neonates with potential long-term adverse neurodevelopmental outcomes. This prospective longitudinal case–control study aimed at investigating the levels and prognostic value of serum neuron-specific enolase (NSE) during the first 3 days of life in preterm neonates (<34 weeks) that later developed brain injury in the form of either periventricular leukomalacia (PVL) or intraventricular hemorrhage (IVH) during their hospitalization. Participants were recruited from one neonatal intensive care unit, and on the basis of birth weight and gestational age, we matched each case (n = 29) with a neonate who had a normal head ultrasound scan (n = 29). We report that serum NSE levels during the first three days of life do not differ significantly between control and preterm neonates with NBI. Nevertheless, subgroup analysis revealed that neonates with IVH had significantly higher concentrations of serum NSE in comparison to controls and neonates with PVL on the third day of life (p = 0.014 and p = 0.033, respectively). The same pattern on the levels of NSE on the third day of life was also observed between (a) neonates with IVH and all other neonates (PVL and control; p = 0.003), (b) neonates with II–IV degree IVH and all other neonates (p = 0.003), and (c) between control and the five (n = 5) neonates that died from the case group (p = 0.023). We conclude that NSE could be an effective and useful biomarker on the third day of life for the identification of preterm neonates at high risk of developing severe forms of IVH.

Midwives’ self-efficacy can significantly affect the provided care and, therefore, maternal and neonatal outcomes. The aim of the present study was to investigate associations of perceived self-efficacy with emotional intelligence, personality, resilience, and attitudes towards death among midwives in Greece. From 2020 to 2022, a total of 348 midwives were recruited in this descriptive cross-sectional study. The participants were employed as independent professionals, in public hospitals or regional health authorities. Data collection involved five research instruments: the General Self-Efficacy Scale (GSES), the Trait Emotional Intelligence Questionnaire-Short Form (TEIQue-SF), the Eysenck Personality Questionnaire (EPQ), the Connor-Davidson Resilience scale (CD-RISC), and the Death Attitude Profile-Revised (DAP-R) scale. The mean score for the GSES was 29.1 (SD = 4.2), suggesting a moderately elevated level of self-efficacy among midwives. The results revealed that higher scores on the GSES were significantly associated with higher scores on the Extraversion subscale (p < 0.001) and lower scores on the Neuroticism (p < 0.001) and Lie (p = 0.002) subscales of the EPQ. Additionally, high self-efficacy was significantly correlated with high emotional intelligence (p < 0.001), high neutral acceptance of death (p = 0.009), and high resilience (p < 0.001). These findings highlight the relationship between the self-efficacy of Greek midwives and various psychological factors, as well as the multifaceted nature of self-efficacy and its importance for midwives’ psychological well-being and professional functioning.

Background: Secondary PTSD is defined as the natural, consequential behaviors and emotions that result from knowledge about a traumatic event experienced by a significant other deriving from working with suffering individuals. Pediatric health providers with symptoms of PTSD report problems with relationships and general life dissatisfaction as well as and anxiety, depression and burnout syndrome. Aim: The aim of this systematic review was to estimate the risk of developing secondary PTSD among pediatric health care providers as well as all additional contributing factors. In more detail, we investigated the PTSD symptomatology between pediatric health care providers and the extent to which parameters such as the job, gender, department and other factors had an impact on the mental health status of pediatric health care providers. Methodology: We searched all published English papers in PubMed, Google Scholar and the Cochrane Library from September to November 2022. We excluded reviews, systematic reviews and meta-analyses as well as letters to editors. From a total of 748 papers, we included only 12 research articles that met the admission criteria. Results: According to our results, the prevalence of secondary PTSD ranges from 13% to 94%. Burnout, nurses, the female gender, intensive care units, past traumatic life events and a psychiatric history identified as factors contributing to the development of secondary PTSD. Conclusions: Health policy-makers should take the specificity in the working environment of the pediatric sector seriously into consideration, especially emergency departments.