Carmen Hernández-Chávez

Background/Objectives: Women exposed to high psychosocial stress in pregnancy have higher risk of postpartum health conditions, but it still is unknown whether high pregnancy stress exposure alters the maternal metabolome at one-month postpartum. Methods: We analyzed data from 625 women participating in the PROGRESS study, a longitudinal pregnancy cohort. Women answered validated psychometric tests (i.e., EPDS, PSS and NLE) during the second or third trimester of pregnancy and provided serum samples at one-month postpartum for metabolomic assessment. Untargeted metabolomics were analyzed using chromatography high-resolution mass spectrometry (LC-HRMS). We used a metabolome-wide association study, using both traditional robust regressions and variance tests, to evaluate associations between pregnancy psychosocial stress and one-month postpartum serum metabolomics. Results: We found a few nominally significant associations between prenatal psychosocial stress scores and the maternal metabolome. However, these findings did not remain after adjusting for multiple testing, with the only exception of epiandrosterone glucuronide, a steroid hormone metabolite, and lithocholyltaurine, a lipid-like molecule. Conclusions: We did not find significant associations between prenatal psychosocial stress and postpartum serum metabolomic profiles, except for two metabolites showing suggestive associations warranting further investigation.

Background and objective: Depression is the most common mental health problem in women during pregnancy, associated with psychological, social, and medical factors characteristic of this stage. However, a lack of knowledge and limited attention to this condition can aggravate its consequences and restrict access to appropriate treatment. This research seeks to fill a gap in the scientific literature by exploring the association between eating habits and dietary diversity with depressive symptomatology in a group with high psychosocial vulnerability: pregnant adolescents. Material and methods: A cross-sectional analytical study was conducted with a sample of 344 pregnant adolescents attending prenatal care at the National Institute of Perinatology (INPer), a tertiary care center. Non-probabilistic sampling was used for recruitment. Relevant information was collected using a pre-validated structured questionnaire administered via interview. Depressive symptomatology was assessed using the Edinburgh Postnatal Depression Scale (EPDS), with a score of ≥12 considered indicative of a higher risk of depression. Eating habits were evaluated based on meal omission, activities performed during meals, and dietary diversity, comparing them with national recommendations. Food group consumption was assessed using a semi-quantitative Food Frequency Questionnaire (FFQ). Robust variance Poisson regression models were employed to evaluate the independent association between undesirable eating habits, inadequate food group intake, and the presence of depressive symptomatology. Results: A significant association was observed between the presence of depressive symptoms (EPDS ≥ 12) and the omission of main meals. Specifically, skipping breakfast was associated with a higher prevalence of EPDS scores ≥ 12 (aPR = 1.55; 95% CI: 1.10–2.19; p = 0.013). Similarly, adolescents who skipped lunch showed a higher prevalence of depressive symptomatology compared to those who did not (aPR = 2.02; 95% CI: 1.11–3.68; p = 0.022). Regarding food groups, only insufficient intake of milk and dairy products was significantly associated with the presence of depressive symptoms (aPR: 1.78; 95% CI: 1.16–2.73; p = 0.008). Conclusions: This cross-sectional study found a significant association between breakfast skipping, distraction while eating, and inadequate dairy intake with a higher prevalence of depressive symptoms in socially vulnerable pregnant adolescents treated at a tertiary care center. However, due to the study’s design, causality or the direction of the relationship cannot be established (it could be bidirectional), and it cannot be affirmed that modifying the diet will necessarily reduce depression. Furthermore, the results are not generalizable to all pregnant adolescents, and future research (longitudinal or interventional) is needed to better understand these associations before developing specific dietary interventions.

This study investigated the intricate relationship between sociodemographic factors and mental health indicators among a cohort of pregnant adolescents. We conducted a cross-sectional analysis of 338 primigravidas, aged 11–19 years, systematically collecting sociodemographic data, including age, socioeconomic status, schooling, occupation, marital status, and family structure. Mental health was assessed using validated scales for depressive symptoms (EPDS), state–trait anxiety inventory (STAI), self-esteem (Coopersmith), and perceived stress (PSS-4). A substantial portion of the cohort presented with significant mental health challenges: 33.5% screened positive for depressive symptoms, 18% for state anxiety, 23% for trait anxiety, 67% reported low self-esteem, and 52% experienced high perceived stress. Specifically, working adolescents exhibited markedly higher odds of depressive symptoms (OR 3.516), low self-esteem (OR 1.091), elevated state anxiety (OR 2.803), and increased trait anxiety (OR 2.455). Adolescents living with a partner also showed a greater likelihood of reporting depressive symptoms (OR 1.921), heightened state anxiety (OR 1.772), and increased trait anxiety (OR 2.335). Additionally, lower educational attainment (OR 1.885) and residing in extended family structures (OR 1.894) were associated with diminished self-esteem. These findings underscore the significant influence of occupation, family structure, and marital status on the mental health trajectories of pregnant adolescents. Consequently, promoting educational continuity and fostering greater autonomy in personal life decisions for adolescents could be crucial interventions to improve their emotional well-being during pregnancy.

Background: Depression and anxiety during pregnancy are global public health issues, as both are linked to adverse outcomes for mothers and their newborns. This study aimed to determine the prevalence of depression and anxiety during pregnancy and identify the factors associated with these conditions in Mexican women. Methods: This prospective cohort study included 288 participants. The Edinburgh Postnatal Depression Scale and the State-Trait Anxiety Inventory were applied during the second trimester of pregnancy. The factors associated with depression and anxiety were analyzed. Results: The prevalence of depression and anxiety was 20.5% (95% confidence interval (CI) 16.1–25.7) and 22.2% (95% CI 17.8–27.3), respectively. The factors independently associated with an increased risk of depression, expressed as adjusted odds ratios with (95% CI), were anxiety, 10.8 (5.4–21.6), p = 0.0001, and educational level, secondary school and high school, 2.6 (1.10–6.14). In contrast, a bachelor’s degree was associated with a lower risk of depression, 0.38 (0.16–0.90), p = 0.03. The factors independently associated with a higher risk of anxiety were depression, 11.2 (5.6–22.1), and having children, 3.1 (1.6–6.1), p = 0.03. Conclusions: Our results show that one in five pregnant women exhibit clinical symptoms of depression or anxiety, and one in eight women have both conditions simultaneously. These findings highlight the importance of routine mental health screening and assessment during pregnancy. The factors linked to depression include anxiety and having completed secondary or high school education, while depression and having children were associated with anxiety.

Background/Objectives: Overweight and obesity during pregnancy are metabolic risk factors that may compromise offspring brain development. The first 1000 days of life represent a critical window in which neurodevelopmental trajectories are shaped by intrauterine and early-life exposures. The 6- and 12-month milestones are key checkpoints where deviations may emerge, and interventions are most effective. This study evaluated the association between maternal pregestational weight status and infant neurodevelopment at 6 and 12 months of age. Methods: Mother and infant pairs from the OBESO perinatal cohort in Mexico City were included. Women in the first trimester of pregnancy were classified as normal weight and overweight/obesity according to their pregestational body mass index (pBMI), calculated from self-reported pre-pregnancy weight. Infant neurodevelopment was assessed at 6 and 12 months using the Bayley Scales of Infant Development III, Third Edition (BSID-III). Descriptive, bivariate and multiple linear regression analyses with mixed effects correction were conducted. Results: Among 97 mother–infant pairs, infants of mothers with overweight/obesity had lower language and socio-emotional scores at 12 months. Higher maternal pBMI was correlated with lower motor scores at 6 and 12 months, and with lower language scores at 12 months. Longitudinal analysis showed that maternal overweight/obesity was associated with a significant decline in language development from 6 to 12 months. (p = 0.002). Conclusions: Maternal pregestational overweight or obesity may negatively influence early neurodevelopment, particularly affecting language and cognitive domains during the first year of life. These early deficits could reflect alterations in intrauterine programming associated with maternal metabolic status.

Background: Breastfeeding is essential for preventing non-communicable diseases. However, mothers with chronic illnesses tend to breastfeed less, increasing the likelihood of abandoning breastfeeding, especially if they experience gestational complications. Objective: To analyze the association between factors such as prepregnancy maternal characteristics, gestational complications, food security, barriers, and facilitators with the practice of exclusive breastfeeding. Methods: Cross-sectional study with 566 women who had prenatal care and gave birth at the National Institute of Perinatology (Mexico City) between 2021 and 2024. Surveys were administered on breastfeeding practices, food insecurity, barriers, and facilitators of exclusive breastfeeding in mothers. In addition, sociodemographic information, medical history (prepregnancy conditions and complications), gestational weight gain, and neonatal outcomes were recorded. Results: Of the 566 women, only 43.6% practiced exclusive breastfeeding, with a median duration of 4 months. Exclusive breastfeeding was more frequent in young, stay-at-home mothers with lower educational attainment and in those with food insecurity, who also tended to delay the introduction of complementary foods until after six months. Prepregnancy risk conditions (OR 1.56, 95% CI 1.06–2.30) and multiparity (OR 1.64, 95% CI 1.08–2.49) increased the risk of non-exclusive breastfeeding. Conversely, food insecurity (OR 0.40, 95% CI 0.20–0.78) and counseling from healthcare personnel (OR 0.09, 95% CI 0.01–0.51) showed a protective effect. The analysis also showed that paid employment (OR 4.68, 95% CI 1.65–13.21), the perception of low milk production (OR 6.45, 95% CI 2.95–14.10), maternal illness/medication (OR 3.91, 95% CI 1.36–11.28), and fatigue (OR 4.67, 95% CI 1.36–11.28) increased the probability of non-exclusive breastfeeding. Conclusions: In Mexico, the promotion of exclusive breastfeeding faces challenges, especially in mothers who begin pregnancy with significant chronic conditions such as diabetes, hypertension, obesity, advanced maternal age, and hypothyroidism, among others. Healthcare personnel should provide personalized advice to each woman from the prenatal stage on strategies to achieve and maintain exclusive breastfeeding.

Lead (Pb) is a potent neurotoxicant, but few studies have evaluated its effect on neurobehavioral measures that can be used in multiple species including humans. We investigated the effect of prenatal and childhood Pb exposure on children’s rate of forgetting using a delayed matching-to-sample (DMTS) task among children 6 to 8 years of age. Blood Pb was measured during pregnancy (second and third trimesters) and at 4 to 6 years of age. A nonlinear modified power function was used to predict the forgetting rates on the DMTS task, using separate models for prenatal and childhood Pb. Higher childhood Pb [median (interquartile range), 1.7 (1.3) (μg/dl)] was associated with a faster rate of forgetting (β = −0.05; 95% confidence interval: −0.09, −0.01). Higher maternal intelligence quotient and child’s age were significantly associated with a slower rate of forgetting. We validated a unique power function statistical approach for rates of forgetting using Pb exposure.

Background: Early childhood development (ECD) is essential in human capacity building and a critical element in the intergenerational process of human development. In some countries, social programs targeted at improving ECD have proven to be successful. Oaxaca is one of the States with the greatest social inequities in Mexico. Therefore, children in Oaxaca are at a high risk of suboptimal ECD. In 2014, the non-governmental organization (NGO) Un Kilo de Ayuda started to implement the Neurological and Psycho-affective Early Childhood Development Program in eighty marginalized communities of Oaxaca. In this article, we present the impact evaluation design to estimate the effect of this program on ECD. Methods: We will use a cluster randomized stepped-wedge design with an allocation ratio of 1:1. Communities will be randomly assigned to each study group: four groups of twenty communities each. We expect that children from intervened communities will show better ECD outcomes. Discussion: This study is one of the few rigorous assessments of the effect of an ECD program on the neurodevelopment of Mexican children recruited in their first 3 years of life from communities of high social vulnerability. Our study design is recommended when the way in which outcomes are measured and assessed depends on age, self-selection is present, and assignment is performed at an aggregate level. Implementation research will be conducted prior to study launch and quality control measures will be in place to maximize the fidelity of study design implementation. Trial registration: ClinicalTrials.gov NCT04210362

Skipping breakfast might have an impact on cognitive functions, such as interference, which is a basic capacity of executive functions that denotes the possibility of controlling an automated response. This study aimed to analyze the association between nutritional quality of breakfast and cognitive interference in a sample of university students. A cross-sectional study was conducted, a total of 422 students between 18 and 25 years participated. Cognitive interference was assessed with the Stroop Test. Breakfast was assessed with a questionnaire assigning a score for each serving of each food group that was consumed. Logistic regression models were performed. The performance in cognitive tasks was slower in those who had a poor breakfast (32.9 ± 6 vs 29.3 ± 6 s, p < 0.050). Poor cognitive interference was greater in students with poor breakfast (53% versus 23%, p = 0.001). A slower word reading was associated with skipping vegetables (OR: 2.78, 95% CI: 0.09–2.13), and cereals (OR: 1.70, 95% CI: 1.03–2.81). Wrong color identification was associated with skipping fruits (OR: 1.55, 95% CI: 1.43–1.99) and animal protein sources (OR: 1.63, 95% CI: 1.07–2.49). Skipping fat-rich cereals was a protector factor (OR: 0.55, 95% CI: 0.36–0.85). Difficulty in the ability to inhibit interference was associated with skipping vegetables (OR: 2.72, 95% CI: 1.25–4.80) and cereals (OR: 2.65, 95% CI: 1.28–4.68). The nutritional quality of breakfast was associated with the time spent answering the Stroop test, but not with cognitive interference.