María Del Carmen Míguez

Introduction: Smoking during pregnancy poses significant risks to maternal and neonatal health. Nonetheless, a high proportion of women continue to smoke during this period, and effective interventions are thus needed to help pregnant women quit smoking. The aim of this review was to determine which psychological interventions for smoking cessation in pregnancy have been implemented and the efficacy rates of each. Methods: Thirty-five studies analyzing the efficacy of a psychological smoking cessation intervention, published between January 2010 and December 2024, were identified in PsycINFO, PubMed and Web of Science databases and included in this review. Results: Interventions were categorized as face-to-face (n = 17) and non-face-to-face (n = 18). Face-to-face interventions included brief interventions (n = 10), cognitive-behavioral interventions (n = 5) and interventions to enhance support (n = 2). Non-face-to-face interventions were delivered via text message (n = 10), a web-based system (n = 1), mobile app (n = 2), and phone calls (n = 5). The abstinence rates were between 8.4% and 51% for brief interventions and between 9.6% and 37.3% for cognitive-behavioral interventions. Only two of the non-face-to-face interventions were effective for smoking cessation, with abstinence rates of 57% at delivery for a mobile app and 14.4% abstinence at 6 months postpartum for a telephone intervention. Conclusions: Of the face-to-face interventions, brief interventions and cognitive-behavioral interventions are the most commonly used and effective option for smoking cessation in pregnancy. The most promising non-face-to-face interventions are interventions via mobile apps or phone calls, while further studies are required. Implications: This review reveals the state of research on smoking cessation psychological interventions in pregnancy in the last 15 years. It describes the most effective psychological treatment options, based on the mode of delivery (face-to-face and non-face-to-face). It also identifies the characteristics of the interventions in terms of the timing of their implementation, as well as the number, duration, and content of the sessions, offering guidelines for clinical practice necessary to implement future interventions to help women quit smoking during pregnancy.

Tobacco dependence and abstinence self-efficacy are interrelated, and both are relevant variables for quitting smoking. Previous literature suggests that sex may also be a key factor in this relationship. This study aims to examine the relationship between tobacco dependence, self-efficacy and 12-months abstinence, and to explore the role of sex in this relationship. A total sample of 288 adult treatment-seeking daily smokers ( M _age = 45.8, SD = 10.63; 62.5% females) was used. Participants were enrolled in a cognitive-behavioral smoking cessation treatment and were followed during a one-year period. We found a negative correlation between baseline tobacco dependence and smoking self-efficacy at the end of the intervention. Mediation analysis showed a significant indirect effect of tobacco dependence on quitting smoking via self-efficacy ( B = -0.162, SE = 0.053, 95% BootCI [-0.287, -0.082]). We also found that sex significantly moderated the relationship between baseline tobacco dependence and self-efficacy at the end of the intervention. This result indicates that the indirect effect of tobacco dependence on quitting success through smoking self-efficacy was significant for females ( B = -0.239, SE = 0.069, 95% BootCI [-0.402, -0.131]), but not for males. Self-efficacy has key role in the association between tobacco dependence and long-term abstinence, being particularly relevant for females. These findings contribute to understanding the role of tobacco dependence on abstinence, which is a well-known barrier to smoking cessation, and have several clinical implications as focusing on post-treatment self-efficacy in those with higher dependence could be relevant to improving the effectiveness of interventions to quit.

Introduction: Anxiety is a common problem during pregnancy and postpartum that can have important consequences for mothers and their babies. Having preventive psychological interventions to apply during the perinatal stage could help to reduce its adverse effects. The aim of this study was to find out which psychological interventions have been applied for the prevention of perinatal anxiety, what therapeutic approach and application format have been most commonly used, and which interventions have proven to be most effective. Methods: A literature review was conducted in the PsycInfo, Medline, and SCOPUS databases to identify articles published between March 2015 and March 2025. Results: Twenty studies were selected that met the inclusion criteria. Twelve of the interventions analyzed were indicated prevention programs and eight were universal prevention programs, with most taking place in pregnancy (n = 18). Mindfulness and cognitive behavioral therapy were the most commonly employed approaches. Regarding the application format, interventions conducted face-to-face and online were equally frequent, as well as those carried out individually or in groups. The duration ranged from 4 to 14 sessions. Cognitive behavioral therapy interventions, applied face-to-face and in groups, proved to be the most effective. Conclusions: Preventive psychological interventions are effective in reducing anxiety during pregnancy. Further research is needed to draw conclusive results on their long-term effects and efficacy in the postpartum period.

Anxiety is one of the most common mental health disorders during pregnancy, therefore, screening instruments are needed. The Edinburgh Postnatal Depression Scale (EPDS) is one of the most widely used self-report measures. However, it has an anxiety subscale (EDS-3A) which has so far been validated in only a few countries. The aim of this study is to validate the EDS-3A as a screening instrument to detect anxiety during pregnancy in Spanish women. A cross-sectional study was carried out with a total sample of 317 pregnant women. Anxiety was assessed using the EDS-3A and the DSM-5 Structured Clinical Interview (SCID-5). The area under the ROC curve (AUC), sensitivity, specificity, the positive predictive value (PPV) and the negative predictive value (NPV) were evaluated. The optimal cut-off point of the EDS-3A, according to the SCID-5, to detect generalized anxiety during pregnancy, was 7 or higher (AUC 0.82, sensitivity of 61.5%, specificity of 86.3%, PPV of 38.7% and NPV 94.1%). The prevalence of anxious symptoms found with the EDS-3A was 19.6%. The prevalence of GAD was 12.3%. The EDS-3A is an adequate instrument for screening anxiety in Spanish pregnant women. It can be considered a useful tool in clinical practice in the field of perinatal mental health given its characteristics of free availability, easy administration and brevity.

Background: Prenatal anxiety is a common problem affecting a large number of women. The presence of anxiety during pregnancy is associated with adverse consequences for both the mother and the baby. The main objective of this review was to determine the risk factors associated with anxiety during pregnancy in European women. Specifically, we wanted to know if these factors are the same as those found in other continents and if they are similar to those associated with depression during this stage. Methods: A literature review was carried out on studies that were published in the last 10 years in the PsycInfo, Medline, and SCOPUS databases. Thirteen studies were selected for the purposes of this review. Results: Sociodemographic risk factors associated with a higher level of anxiety during pregnancy included having a lower educational level and socioeconomic status. Obstetric and pregnancy-related risk factors included having had complications during pregnancy. Having a history of mental health problems, low social support, high levels of stress, and being exposed to adverse life events were the most relevant psychological factors for presenting prenatal anxiety. Furthermore, these factors are largely common to those associated with prenatal anxiety in other continents of the world and to those associated with prenatal depression. Conclusions: This review shows that there are multiple factors that contribute to women experiencing prenatal anxiety. Most can be identified at the beginning of pregnancy, and some factors, such as psychological ones, are potentially modifiable. This underlines the importance of carrying out a proper screening for anxiety during pregnancy in order to prevent its onset or treat it appropriately. Furthermore, the fact that risk factors are common for both prenatal anxiety and depression implies that the same intervention could reduce the probability of the onset of both pathologies and the possible consequences associated with them.

Introduction. Women have more difficulty quitting smoking and a greater risk of relapse in stressful situations. Although the menstrual cycle influences smoking cravings and withdrawal symptoms, the phase in which participants show higher rates of the latter has yet to be identified. Objective. To evaluate whether there are significant differences between three groups at different phases of the menstrual cycle in smoking cravings and withdrawal symptoms, after a stress induction task. Method. A quasi-experimental transversal design with pre-test and post-test measurements was used, with female smokers aged between 18 and 40 years old as participants. Researchers monitored the duration of their menstrual cycles and tobacco use patterns for approximately two months. They were then divided into three groups based on the three menstrual cycle phases and given the induction stress task, after which pre-test and post-test stress, withdrawal symptom, and smoking craving scores were obtained. Results. No differences were observed in smoking cravings or withdrawal symptoms in the three phases of the cycle. Mean stress was significantly higher during the late luteal phase, during which there was also a moderate correlation between the stress score and withdrawal symptoms. Mean post-test stress predicted withdrawal symptoms in the early follicular and late luteal phase groups. Discussion and conclusion. Although smoking cravings and withdrawal symptoms did not differ among groups, stress scores were higher during the early follicular phase and luteal phase. It is recommended that stress-management strategies be implemented during these two phases.

Background: This review focuses on analyzing the relationship between social support and women’s smoking during the perinatal period. Method: A literature search was conducted in PsycINFO, Medline, and SCOPUS covering the period between January 2010 and August 2024. Fifteen studies meeting the inclusion criteria were selected. Results: A total of 10 studies examined the relationships between social support and smoking during the perinatal period and 5 studies examined the influence of partner smoking during this period. Lack of social and partner support, an environment of smoking friends, and not having a partner were associated with continued smoking during pregnancy. Having a smoking partner was also associated with continued smoking during pregnancy or relapse postpartum. Conclusions: The absence of social support and having a partner who smokes were found to be related to women’s tobacco consumption during the perinatal period. Introducción:, Esta revisión se centra en el análisis de la relación entre el apoyo social y el consumo de tabaco por parte de las mujeres durante el periodo perinatal. ,Método:, Se realizó una búsqueda bibliográfica en PsycINFO, Medline y SCOPUS desde enero de 2010 a agosto de 2024. Se seleccionaron 15 estudios que cumplían los criterios de inclusión. ,Resultados:, Un total de 10 estudios examinaban las relaciones entre el apoyo social y el tabaquismo durante el periodo perinatal y 5 la influencia del tabaquismo de la pareja durante este periodo. La falta de apoyo social y de la pareja, un entorno de amigos fumadores y no tener pareja se asociaban con seguir fumando durante el embarazo. Tener una pareja fumadora también se asociaba con seguir fumando durante el embarazo o recaer después del parto. ,Conclusiones:, Se observó que la ausencia de apoyo social y tener pareja fumadora se relacionaban con el consumo de tabaco de la mujer durante la etapa perinatal.

Introduction. In women, smoking during pregnancy and the postpartum period has important consequences for maternal and infant health, and interventions to assist smoking cessation during this period are essential. Although smoking has been associated with the presence of mental health problems, few studies addressing the factors associated with perinatal smoking have examined the role of stress. The aim of this review was to identify the relationships between the presence of stress and smoking during pregnancy and the postpartum period. Method. A literature search of the PsycInfo, Pubmed and Web of Science databases was carried out to identify relevant articles published between January 2013 and June 2024. A total of 15 studies that met the inclusion criteria were selected for review. Results. Twelve of the studies analysed the relationship between stress and smoking during pregnancy, two studies involved the postpartum period, and one study included both periods. Diverse instruments were used to assess stress, although the PSS-14 was the most commonly used. Eleven of the studies found a relationship between stress and smoking in the perinatal period, with stress being a predictor of smoking. Conclusions. The findings highlight the need to consider stress management when developing effective interventions to help women quit smoking during pregnancy and maintain abstinence in the postpartum period.