Women undergoing assisted reproduction treatment without being able to become pregnant, and experiencing pregnancy loss after assisted reproduction, are triggering factors for prolonged grief and mourning. This review aims to investigate the psychosocial aspects of gestational grief among women who have undergone infertility treatment. We searched the databases of MEDLINE/PubMed, EMBASE, CINAHL, Scopus, ScienceDirect, and Lilacs for works published up to 5 March 2021. The outcomes analyzed were negative and positive psychosocial responses to gestational grief among women suffering from infertility and undergoing assisted human reproduction treatment. Eleven studies were included, which yielded 316 women experiencing infertility who were undergoing treatment. The most frequently reported negative psychosocial manifestations of grief response were depression (6/11, 54.5%), despair or loss of hope/guilt/anger (5/11, 45.5%), anxiety (4/11, 36.4%), frustration (3/11, 27.3%), and anguish/shock/suicidal thoughts/isolation (2/11, 18.2%). Positive psychosocial manifestations included the hope of becoming pregnant (4/6, 66.6%) and acceptance of infertility after attempting infertility treatment (2/6, 33.3%). We identified several negative and positive psychosocial responses to gestational grief in women experiencing infertility. Psychological support before, during, and after assisted human reproduction treatment is crucial for the management of psychosocial aspects that characterize the grief process of women experiencing infertility who become pregnant and who lose their pregnancy. Our results may help raise awareness of the area of grief among infertile women and promote policy development for the mental health of bereaved women.

Background: Cannabis is the most commonly used illicit substance among young adults and is associated with a variety of negative consequences. Studies have shown that both cannabis demand and certain cannabis motives are associated with higher levels and frequency of cannabis use, as well as associated problems. No study has yet to examine the relationship between cannabis use motives and cannabis demand. The purpose of the current study was to examine the associations between individual cannabis motives and cannabis demand. Methods: Data were collected from 95 young adult cannabis users who reported using cannabis at least once in the last 30 days. (M age = 20.63; Female = 50.5%; M cannabis use days per month = 14.64). Participants completed questionnaires assessing cannabis use frequency, cannabis use motives, and a cannabis purchase task. Amplitude, representative of the amount consumed at an unrestricted price, and persistence, representative of sensitivity to escalating price, were calculated and used in the analyses. Results: Initial correlational analyses demonstrated significant relationships between demand and total number of cannabis motives and conformity, enjoyment, coping, experimentation, boredom, celebration, and sleep motives (ps < .05). A series of hierarchical linear regressions were conducted to determine the specific associations between the aforementioned individual cannabis motives and amplitude and persistence. Step one controlled for age, gender, and cannabis use frequency, and the motives were added in step two. Regression models indicated that total number of motives, enjoyment, conformity, and coping motives were significant predictors of persistence even after controlling for cannabis use frequency. Motives were not significant predictors of amplitude. Conclusion: Findings from this study suggest that young adults who use cannabis for enjoyment, conformity, or coping reasons may experience greater reinforcement efficacy of cannabis which may place them at increased risk to develop cannabis use disorder or other related problems associated with their use. Further, young adults with these cannabis use motives may be less sensitive to increases in price and continue to purchase cannabis at higher prices. These findings can be used to inform cannabis interventions by targeting specific motives for use.

Introduction: Approximately 21% of congenital anomalies (CA) involve the Central Nervous System (CNS), constituting one of the most common birth defects, affecting 1 to 10: 1,000 of live births. Objective: To analyze the prevalence of CNS anomalies diagnosed by obstetric ultrasound. Methods: Prospective longitudinal cohort study carried out in a public fetal medicine service in Goiânia with pregnant women who were attended in high-risk prenatal care. The patients were followed up during the ultrasound exams from March 2018 to March 2019. Results: 225 cases of pregnant women with ultrasound diagnoses of CA were surveyed during the investigated period. CNS anomalies were the most prevalent, being present in 34.22% (77/225) of the cases. The mean maternal age of pregnant women was 25.55 years and mean gestational age was 28.84 weeks. Hydrocephalus was identified in 23 pregnant women (29.87%), being the most prevalent CNS anomalie. Anencephaly was present in 24.68% (19/77) and holoprosencephaly in 18.18% (14/77). Other CA were also diagnosed (21/77), such as meningocele, spina bifida, acrania, among others. However, they showed a lower prevalence in relation to hydrocephalus, anencephaly and holoprosencephaly. Conclusion: The findings are essential for the planning and allocation of hospital resources and investment in health. Besides that, to adequate and specific prenatal care, is indispensable in the search for reducing the incidence of these malformations, morbidity and improving survival rates of the affected population.

Objetivo: Avaliar o uso dos anti-inflamatórios não esteroidais (AINEs) na prevalência de malformações congênitas (MC) estruturais. Métodos: Estudo do tipo caso-controle, realizado em um hospital público referência em medicina fetal. Foi aplicado um questionário para avaliar os fatores sociodemográficos e obstétricos. A avaliação da morfologia fetal foi realizada através da avaliação ultrassonográfica. Resultados: Das 282 gestantes avaliadas, 28,72% (81/282) relataram uso de anti-inflamatórios durante a gravidez, sendo 75,1% (n = 60) do grupo caso e 25,9% (n = 21) do grupo controle. Entre os anti-inflamatórios, os mais utilizados foram nimesulida (17,38%; n = 49), diclofenaco (10,99%; n = 31) e ibuprofeno (3,19%; n = 9). O uso de AINEs em geral e específico (nimesulida, diclofenaco, ibuprofeno) não apresentou diferença entre os grupos. No entanto, foi observado o maior uso de ibuprofeno no grupo caso (4,46%; n = 9) vs controle (0%; n = 0) com OR = 7,904, p = 0,05. O uso de AINEs foi maior em gestantes que apresentavam fetos com MC da face (55,6%), parede abdominal (38,10%) e do sistema nervoso central (SNC) (30,30%). Conclusão: Embora não tenham sido observadas diferenças entre os grupos, o uso de AINES foi considerável em pacientes que tiveram feto com malformações fetais da face, parede abdominal e SNC. Devido à alta frequência de algumas malformações, especialmente as da face, deve-se ter o cuidado com a indicação e principalmente com a automedicação dessa classe medicamentosa durante a gravidez.