O objetivo do estudo foi avaliar a influência da implantação do projeto Pré-natal do parceiro (PNP) no município de Ribeirão Preto sobre: 1) as taxas das infecções pelo vírus da imunodeficiência humana (HIV), vírus das hepatites B e C (VHB, VHC) e pelo Treponema pallidum (TP) entre gestantes; 2) as taxas de transmissão vertical (TV) dos VHB, VHC, do HIV e do TP; 3) os indicadores de qualidade do pré-natal (número de consultas; idade gestacional (IG) na primeira consulta; desfecho gestacional); 4) os indicadores perinatais (peso ao nascer; prematuridade; índice de Apgar no 1º e 5º minutos) e 5) as taxas das infecções pelos VHB, VHC, do HIV e do TP nos parceiros que aderiram ao projeto. Estudo transversal do grupo de gestantes (G) e nascidos vivos (NV) que tiveram seus parceiros participantes do projeto PNP (denominados G1 e NV1) e do grupo de gestantes e NV que não tiveram seus parceiros participantes do projeto PNP (denominados G2 e NV2). Os grupos de gestantes e parceiros foram incluídos no estudo no período de 1º de Julho de 2013 a 30 de Junho de 2014 e os grupos de NV, entre 1º de Julho de 2013 a 31 de Dezembro de 2014. Foram selecionadas 5391 gestantes (1781 do G1 e 3610 do G2), 1781 parceiros e 4044 NV (1376 do NV1 e 2668 do NV2). Utilizado o teste Quiquadrado de Pearson com um nível de significância de 5%. Os resultados demonstraram prognósticos estatisticamente mais favoráveis no grupo onde houve a participação do parceiro no pré-natal (G1 e NV1). Encontraram-se menores taxas de TV (0,7% no NV1 e 1,5% no NV2 com p= 0,04); início mais precoce do PN (com até 120 dias de gestação 88,3% no G1 e 84,5% no G2 com p< 0,01); mais de sete consultas no PN (80,8% no G1 e 74,3% no G2 com p< 0,01); desfecho gestacional favorável (95,9% no G1 e 94,2% no G2 com p= 0,01); menores taxas de prematuridade (10,3% no NV1 e 12,9% no NV2 com p= 0,01), menor ocorrência de baixo peso ao nascer (8,7% no NV1 e 11,4% no NV2 com p< 0,01) e melhores índices de Apgar no 5º minuto (2,5% de Apgar <= 7 no NV1 e 3,8% no NV2 com p= 0,03). Frente a estes dados foi possível concluir que a estratégia de inclusão do parceiro no PN foi importante na identificação e tratamento da sífilis reduzindo significativamente a taxa de TV do TP. A adesão do parceiro ao PNP foi fundamental para a adesão da gestante ao PN associando-se também à melhora significativa dos indicadores de saúde perinatal / The goal of these study was to evaluate of the influence of the implementation of the project \"Male Partner in the Prenatal Care (MPPC)\" in Ribeirao Preto city on: 1) the rates of infection by the human immunodeficiency virus (HIV), hepatitis virus B and C (HBV, HCV), and Treponema pallidum (TP) among pregnant women; 2) the vertical transmission (VT) rates of HBV, HCV, HIV and TP; 3) the prenatal care quality indicators (number of visits, gestational age (GA) at the first visit, gestational outcome); 4) the perinatal indicators (birth weight, prematurity, Apgar score at 1 and 5 minutes) and 5) the rates of infection with HIV, HBV, HCV and TP in partners that have joined the project. It is a cross-sectional study of group of the pregnant women (G) and born alive (BA) who had their partners participating MPPC project (called G1 and NV1) and the group of pregnant women and BA who have not had their partners participants (called G2 and NV2). The pregnant women groups and the male partners group were surveyed in the period from July 1, 2013 to June 30, 2014 and the BA groups, between July 1, 2013 to December 31, 2014. Were selected 5391 pregnant women (1781 of the G1 and 3610 of the G2), 1781 partners and 4044 BA (1376 of the NV1 and 2668 of the NV2). Used the Chi-square test of Pearson with a 5% significance level. The results showed statistically more favorable prognosis in the group where there was the partner\'s participation in prenatal care (G1 and NV1). The lower VT rate was found (0.7% in NV 1 and 1.5% in NV2 p= 0.04); earlier initiation of PN (up to 120 days of gestation 88.3% in G1 and 74.3% in G2 with p< 0.01); more than seven consultations in PNC (80.8% in G1 and 74.3% in G2 with p< 0.01); favorable pregnancy outcome (95.9% in G1 and 94.2% in G2 with p= 0.01); lower prematurity rates (10.3% in the NV1 and 12.9% in the NV2 with p= 0.01); lower incidence of low birth weight (8.7% in NV1 and 11.4% in NV2 with p< 0.01) and better Apgar scores at five minutes (2.5% Apgar <= 7 in NV1 and 3.8% in NV2 with p= 0.03). Considering these data it was concluded that the male partner\'s inclusion strategy in prenatal care was important in the identification and treatment of syphilis reducing significantly the VT rate of the TP. The partner\'s adherence to MPPC project was essential to the mother\'s adherence to PNC and it was also associated with significant improvement in perinatal health indicators.

ObjeEste estudo teve como objetivo primário avaliar a estratégia de incluir o parceiro na assistência pré-natal no município de Franca-Brasil. Constituíram os objetivos secundários: 1) Detectar a prevalência de parceiros com dosagens alteradas de colesterol total, HDL-colesterol, LDL-colesterol e triglicérides; 2) Detectar a prevalência de parceiros com dosagens alteradas de glicemia de jejum; 3) Detectar a prevalência de parceiros com HAS; 4) Detectar a prevalência da sífilis, HIV, hepatites B e C entre gestantes; 5) Verificar a taxa de DMG e de DM entre as gestantes; 6) Detectar a prevalência da sífilis, HIV, hepatites B e C entre os parceiros das gestantes; 7) Avaliar a motivação da equipe de saúde em acolher a Estratégia Pré-natal do Parceiro; 8) Avaliar a aceitação materna e do parceiro sobre a estratégia de inclusão do parceiro na assistência PN. Estudo quantitativo, utilizado o teste \"t\" de Student para comparações das variáveis paramétricas e o teste Qui-quadrado para as variáveis não paramétricas, considerando significativo o valor de p< 0,05 em quaisquer dos testes. Os resultados identificaram quatro parceiros com hipertensão arterial (3,4%) e 51 (43,2%) com intolerância à glicose, verificando-se que em quatro casos, a glicemia possibilitou diagnosticar diabetes mellitus. Constatou-se que a prevalência de dislipidemias dos parceiros foi de 84,4%. No tocante às sorologias identificou-se um casal (1,5%) com sorologia discordante para sífilis (gestante com sífilis) e outro casal, no qual o parceiro foi diagnosticado como portador da infecção pelo vírus da imunodeficiência humana (HIV), cujo diagnóstico só foi possível por sua participação no PNP. Foi possível identificar que 57 parceiros (48,3%) qualificaram as equipes de saúde com não motivadoras para a adoção da estratégia PNP. No entanto, 58 (49,1%) participaram por motivação própria. A percepção paterna sobre o PNP foi referida como positiva por 77,9% dos parceiros e 93 gestantes/mães (78,8%) consideraram importante e positiva a inclusão do parceiro no PN. Foi identificado que a inclusão do parceiro no PN foi importante no diagnóstico e tratamento precoces de doenças de transmissão vertical e crônicas e que é necessário incentivar a equipe de saúde a difundir os benefícios dessa participação no PN, contribuindo com a saúde da tríade mãe, filho e parceiro. / This study\'s primary objective was to analyze the strategy of including the male partner in prenatal care in the city of Franca, Brazil. The secondary objectives were: 1) To detect the prevalence of male partners with abnormal levels of total cholesterol, HDL cholesterol, LDL cholesterol and triglycerides; 2) To detect the prevalence of male partners with abnormal levels of fasting blood glucose; 3) To detect the prevalence of systemic hypertension among male partners; 4) To detect the prevalence of syphilis, HIV, hepatitis B and hepatitis C among pregnant women; 5) To find out the frequency of Gestational diabetes mellitus (GDM) and of Diabetes mellitus (DM) among pregnant women; 6) To detect the prevalence of syphilis, HIV, hepatitis B and hepatitis C among the pregnant women\'s male partners; 7) To gauge the health team\'s motivation to implement the strategy of male involvement in prenatal care; 8) To assess maternal acceptance and male partner acceptance of the strategy of including the male partner in prenatal care. This was a quantitative study, which used the Student\'s t-test to compare parametric variables and the Chi-squared test for the nonparametric variables and which considered a p-value < 0.05 as significant in both tests. The results identified 4 male partners with hypertension (3.4%) and 51 male partners (43.2%) with glucose intolerance, of which four had a diagnosis of Diabetes mellitus as a result of the blood glucose test. We found that the Anexos 100 prevalence of dyslipidemia among the male partners was 84.4%. Regarding serology tests, we identified a couple (1.5%) with discordant syphilis serology (pregnant woman with syphilis) and another couple in which the male partner was diagnosed with Human Immunodeficiency Virus (HIV) infection with such diagnosis only having been possible because of his participation in prenatal care. We could identify that 57 male partners (48.3%) classified the health teams as not encouraging of the male involvement in prenatal care. However, 58 male partners (49.1%) participated by selfmotivation. The fathers\' perception of their involvement in prenatal care was referred to as positive by 77.9% of the male partners and 93 pregnant women / mothers (78.8%) considered the inclusion of the male partner in prenatal care important and positive. We identified that the inclusion of the male partner in prenatal care was important in the early diagnosis and early treatment of vertical transmission diseases and chronic diseases as well as that it is crucial to encourage health teams to communicate the benefits of the inclusion of the male partner in prenatal care, thus contributing to the health of the father- mother-child triad.

Introducción: Se han identificado diversos factores de riesgo para el desarrollo de discapacidad en niños, tales como edad materna avanzada, sexo masculino y prematuridad. Sin embargo, consideramos que existen muchos factores de riesgo que aún no han sido identificados. Por este motivo, tenemos el objetivo de evaluar factores neonatales, perinatales y de la infancia temprana asociados al desarrollo de discapacidad. Métodos: Se realizó un análisis secundario de la cohorte “Young Lives - Niños del milenio”. 2052 niños participaron en la cohorte menor de dicho estudio, nueve se excluyeron por presentar discapacidad al inicio de la cohorte y 134 fueron excluidos por falta de seguimiento o por no poseer datos acerca de discapacidad. El análisis bivariado y multivariado fue ajustado por conglomerados, debido al muestreo original. Al ser una cohorte, se obtuvo riesgos relativos (RR) para discapacidad mediante Regresión de Poisson. Resultados: Se incluyeron 1909 niños en el estudio. La incidencia acumulada de discapacidad en 15 años fue de 2.72%. Se encontró que tener bajo peso para la edad (RR 3.36 (IC95%: 1.90-5.93)) y haber sido hospitalizado (RR 2.26 (IC95%: 1.17-4.39)) durante los primeros dieciocho meses de vida se asociaban al desarrollo de discapacidad. La mayoría de las variables de exposición no fueron significativas. Conclusiones: Encontramos asociación entre desnutrición global y hospitalización durante los primeros dieciocho meses de vida con el desarrollo de discapacidad. Se deben establecer estrategias de seguimiento y tratamiento oportuno para los niños en quienes se identifiquen estos factores. / Introduction: Several risk factors for the development of disability have been identified, among which we can find advanced maternal age, male sex, prematurity, etc. Nonetheless, we consider that there are many risk factors that have not yet been identified. Therefore, we aim to assess neonatal, perinatal and early childhood factors associated with the development of disability. Methods: A secondary analysis of the “Young Lives – Niños del milenio” cohort was performed. 2,052 children participated in the younger cohort; nine were excluded for having disability at the beginning of the cohort and 134 were excluded due to lack of follow-up or because they did not have data about disability. The bivariate and multivariate analysis were adjusted for clusters, due to the original sampling. Being a cohort, relative risks (RR) for disability were obtained through Poisson regression. Results: 1909 children were included in the study. The cumulative incidence of disability during fifteen years was 2.72%. We found that being underweight for age (RR 3.36 (95% CI: 1.90-5.93)) and having been hospitalized (RR 2.26 (95% CI: 1.17-4.39)) within the first eighteen months of life were associated with the development of disability. Most of the exposure variables were not significant. Conclusions: We found association between global malnutrition and hospitalization during the first eighteen months of life with the development of disability. Follow-up and proper treatment strategies should be established for children in whom these factors are identified. / Tesis

Cette recherche de thèse propose un travail pluridisciplinaire d’épistémologie de la clinique et d’analyse socio historique de l’émergence et de l’organisation des formes de prise en charge des femmes qui présentent des troubles psychopathologiques et de leur bébé pendant la période périnatale, des conduites thérapeutiques préconisées et des dispositifs de soins mis en place à cette période. Une attention particulière a été portée aux idées, concepts et processus qui ont façonné cette offre de soins récente. L’objet de la recherche se situe donc à l’intersection d’une réflexion clinique (scientifique), institutionnelle (prévention précoce) et organisationnelle (travail en réseau). Prenant la psychologie clinique en actes comme sujet d’étude, il se fonde sur un cadre méthodologique approprié pour produire et analyser une généalogie de savoirs et d’interventions ainsi que des données inédites sur ce que nous appellerons : l’invention, la fabrique d’un nouveau champ intellectuel et de pratiques cliniques qui s’est constitué comme une innovation organisationnelle autour de la prise en charge des vulnérabilités psychiques maternelles pendant la période périnatale. / This thesis proposes a multidisciplinary epistemology of the clinic and a socio-historical analysis of the emergence and organization of forms of care for women who present psychopathological disorders and their baby during the perinatal period, professional therapeutic response, and the care arrangements put in place during this period. Particular attention is paid to the ideas, concepts and processes that shape this novel provision of care. The object of this research rests, therefore, at the intersection of clinical (scientific), institutional (early prevention) and organizational (networking) axes. Taking clinical psychology into action as a subject of study, it is based on grounded theory and discourse analysis to produce and analyze a genealogy of knowledge and intervention as well as new data on what we call: the invention, the creation of a new intellectual field and clinical practice that has been constituted as an innovative organizational structure around the management of maternal psychic vulnerabilities during the perinatal period.

Depression i samband med graviditet förekommer hos ungefär 10% av gravida och medför risker för den gravida och barnet. Många erhåller inte behandling. IKBT kan öka behandlingstillgängligheten och har visat sig effektivt jämfört med sedvanlig mödravård. Utvärderingens syfte var att undersöka skillnader i depressionssymtom före och efter fyra veckor i en IKBT-behandling mot antenatal depression och att jämföra skillnaderna med en tidigare RCT på en snarlik behandling. Huvudfrågeställningen var huruvida depressionssymtom minskar hos patienter med antenatal depression efter fyra veckor i en IKBT-behandling. 26 personer deltog i behandlingen. Förmätning jämfördes med senast kända mätningen efter fyra veckor. Dessa och de veckovisa mätningarna fram till vecka fyra, jämfördes med två icke-randomiserade kontrollgrupper. Skillnad mellan förmätning och senaste mätningen avseende grad av depressionssymtom var signifikant i genomfört t-test och symtomreduktionen tycks vara i nivå med resultat från den tidigare RCT-studien. IKBT skulle således kunna utgöra ett behandlingsalternativ för gravida med depression. Slutsatser bör dras med försiktighet. Framtida forskning inom fältet är av vikt för att validera resultat och för att ge underlag till utvecklingen av behandling vid antenatal depression. / Pregnancy related depression exists in approximately 10% of pregnant people and adds risks for the pregnant individual and the baby. Many are not treated. ICBT may increase the treatment availability and appears to be more effective than conventional maternal health care. The purpose of this evaluation was to examine differences in symptoms of depression before and after four weeks of ICBT-treatment for antenatal depression and to compare the differences with a prior RCT of a similar treatment. The main research question was whether symptom of depression decreases in patients with antenatal depression after four weeks when being treated with an ICBT-treatment. 26 persons participated in the treatment. Pre-measures was compared to the most recent measurement after four weeks. These, and the weekly done measurements up to week four, was compared with two non-randomized control groups. The difference between pre-measures and the most recent measurement regarding degree of depressive symptoms was significant in completed t-test and the reduction of symptoms appears to be on a par with results from the prior RCT. ICBT could be a treatment alternative for pregnant people with depression. Conclusions should be done with caution. Further studies in this field are of importance for validating results and to provide knowledge for the development of treatment for antenatal depression.

[pt] O luto vivenciado a partir de uma perda gestacional ou neonatal apresenta características e reações semelhantes a outros tipos de luto, entretanto, muitas vezes é não-reconhecido (Doka, 1989). Espera-se que a chegada de um novo bebê seja capaz de resolver o luto. O vínculo entre cuidador primário e a criança é fundamental para a sobrevivência física e emocional e, por isso, essa relação inicial é tão importante para o desenvolvimento de todos os indivíduos. O objetivo da pesquisa foi investigar as repercussões da perda gestacional ou neonatal prévia no processo de construção do vínculo da mãe com o bebê que nasce durante o processo de luto. O estudo de cunho qualitativo entrevistou 17 mulheres que tiveram ao menos uma perda gestacional ou neonatal e tiveram um novo bebê após a perda. Os resultados demonstraram a necessidade das mães explicarem detalhadamente a experiência de perda, em uma possível busca de construção de sentido. A tristeza e a culpa foram identificadas como principais reações frente ao luto que foi vivenciado de maneira silenciosa. A maioria das mães referiu medo relacionado à gravidez subsequente e à vinculação com o bebê durante o período gestacional. O contato corporal foi o principal sistema parental identificado nas interações. O trabalho concluiu que apesar de serem comuns e frequentes e, muitas vezes não- reconhecidas, perdas perinatais são vividas de maneira singular, repercutem nas interações e não são resolvidas com o nascimento de um novo bebê. Acredita-se que esse estudo possa contribuir para a legitimação e o reconhecimento do luto por perda gestacional e neonatal e para a maior atenção às interações iniciais nesse contexto. / [en] The grief experienced after a miscarriage, stillbirth, or neonatal loss presents characteristics and reactions similar to other types of bereavement although it is often unrecognized (Doka, 1989). It is expected that the arrival of a new baby should be able to resolve the grief. The bond between the primary caregiver and the child is fundamental for physical and emotional survival and that is why this initial relationship is so important for the development of all individuals. The objective of this research was to investigate the repercussions of a previous perinatal loss in the process of building the mother s bond with the baby born during the grieving process. The qualitative study interviewed 17 women who had at least one perinatal loss and had a new baby after such loss. The results demonstrated the need for mothers to explain the loss experience in detail, possibly searching for the meaning reconstruction. Sadness and guilt were identified as the main reactions to the grief, which was experienced silently. Most mothers reported fear related to the subsequent pregnancy and to bonding with the baby during the gestational period. Body contact was the main parental system identified in the interactions. The study concluded that, although common and frequent and, many times, unrecognized, perinatal losses are experienced in a unique way, impact on interactions, and are not necessarily resolved with the birth of a new baby. We believe that this study may contribute to the legitimacy and recognition of mourning from perinatal loss and to greater attention to the initial interactions in this context.

Background Perinatal markers of prenatal development are associated with offspring psychiatric symptoms. However, there is little research investigating the specificity of perinatal markers for the development of specific disorders. This study aimed to explore if perinatal markers are specifically associated with adolescent substance use disorder (SUDs). Methods Adolescent participants from two study centers, one for SUD patients (n = 196) and one for general psychopathology (n = 307), were recruited for participation. Since the SUD participants presented with a number of comorbid disorders, we performed a 1-on-1 matching procedure, based on age, gender, and specific pattern of comorbid disorders. This procedure resulted in n = 51 participants from each group. From all participants and their mothers we recorded perinatal markers (mode of birth, weeks of completed pregnancy, birth weight, Apgar score after 5 min) as well as intelligence quotient (IQ). The SUD sample additionally filled out the Youth Safe Report (YSR) as well as the PQ-16 and the DUDIT. We aimed to distinguish the two groups (SUD sample vs. general psychiatric sample) based on the perinatal variables via a logistic regression analysis. Additionally, linear regressions were performed for the total group and the subgroups to assess the relationship between perinatal variables and IQ, YSR, DUDIT and PQ-16. Results The perinatal variables were not able to predict group membership (X2 [4] = 4.77, p = .312, Cox & Snell R² = 0.053). Odds ratios indicated a small increase in probability to belonging to the general psychiatric sample instead of the SUD sample if birth was completed via C-section. After Bonferroni-correction, the linear regression models showed no relation between perinatal markers and IQ (p = .60, R² = 0.068), YSR (p = .09, R² = 0.121), DUDIT (p = .65, R² = 0.020), and PQ-16 (p = .73, R² =0.021).

Background: The bonding process can start to develop as early as the planning of a pregnancy and can affect the relationship between mother and child through childhood. If proper bonding is not established, the child can present symptoms of depression, failure to thrive or delays in social and emotional, language or motor development. Stimulation programs implemented during pregnancy may positively affect the bonding process that act as a protective factor against negative outcomes in childhood, adolescence and adult life, for instance substance abuse, poor social coping skills and academic failure. Objectives: To determine and describe the effectiveness of The Baby Bond comprehensive stimulation program on bonding six weeks post intervention. Method: The researcher employed an experimental, pre-test-post-test randomised control group design in this study. Experimental and control groups randomly received the same pre- and post-test: the Prenatal Attachment Inventory within the third trimester of pregnancy and the Maternal Attachment Inventory six weeks post birth. The Baby Bond sensory stimulation program was added to standard antenatal care for the experimental group and the control group received a general stimulation program and standard antenatal care. The data was analysed with the SPSS program version 22.0 by the Statistical Consultation Services at the North-West University, Potchefstroom campus. SPSS was used to compile descriptive statistics from the experimental and control groups, Mann Whitney test and the effect size. Results: The twelve participants that were included in this study were from a variety of ethnic origins, in stable relationships and their ages ranged from 20-34 years. In the results, no statistical significant changes were found between the two groups with the Mann Whitney test. The pre-intervention variables (mean = 66.45) were not significantly different from the post-intervention measurements (mean = 101.03). A medium practical significant difference was identified between the groups (d=0.52) which can indicate that some changes in bonding did take place when implementing the comprehensive sensory stimulation program: The Baby Bond. Conclusion: The Baby Bond sensory stimulation program did not indicate a significant improved bonding as compared to general antenatal care between the mother and baby at six weeks after birth. However, future research in the optimal time for bonding interventions in larger sample sizes is needed, for more conclusive findings. / MCur, North-West University, Potchefstroom Campus, 2015

Background: The bonding process can start to develop as early as the planning of a pregnancy and can affect the relationship between mother and child through childhood. If proper bonding is not established, the child can present symptoms of depression, failure to thrive or delays in social and emotional, language or motor development. Stimulation programs implemented during pregnancy may positively affect the bonding process that act as a protective factor against negative outcomes in childhood, adolescence and adult life, for instance substance abuse, poor social coping skills and academic failure. Objectives: To determine and describe the effectiveness of The Baby Bond comprehensive stimulation program on bonding six weeks post intervention. Method: The researcher employed an experimental, pre-test-post-test randomised control group design in this study. Experimental and control groups randomly received the same pre- and post-test: the Prenatal Attachment Inventory within the third trimester of pregnancy and the Maternal Attachment Inventory six weeks post birth. The Baby Bond sensory stimulation program was added to standard antenatal care for the experimental group and the control group received a general stimulation program and standard antenatal care. The data was analysed with the SPSS program version 22.0 by the Statistical Consultation Services at the North-West University, Potchefstroom campus. SPSS was used to compile descriptive statistics from the experimental and control groups, Mann Whitney test and the effect size. Results: The twelve participants that were included in this study were from a variety of ethnic origins, in stable relationships and their ages ranged from 20-34 years. In the results, no statistical significant changes were found between the two groups with the Mann Whitney test. The pre-intervention variables (mean = 66.45) were not significantly different from the post-intervention measurements (mean = 101.03). A medium practical significant difference was identified between the groups (d=0.52) which can indicate that some changes in bonding did take place when implementing the comprehensive sensory stimulation program: The Baby Bond. Conclusion: The Baby Bond sensory stimulation program did not indicate a significant improved bonding as compared to general antenatal care between the mother and baby at six weeks after birth. However, future research in the optimal time for bonding interventions in larger sample sizes is needed, for more conclusive findings. / MCur, North-West University, Potchefstroom Campus, 2015

The median prevalence of smoking among women of childbearing age in the United States is 22.4%. Of women who identify themselves as smokers in the three months prior to conception, 55% quit during pregnancy; however, 40% of those who quit relapse and return to smoking within six months after delivery. Smoking has been identified as an important means of stress management among smokers in general, and though limited to the perinatal period, pregnancy-specific stress adds to a woman’s typical day-to-day stress burden. Little data exists as to the effect of SHS exposure on smoking status during pregnancy and the impact of SHS exposure on the maternal perception of stress is unknown. Due to limited evidence, a critical need exists to examine the relationships of perceived maternal stress, SHS exposure, and perinatal smoking status in order to better understand perinatal smoking behaviors. The purposes of this dissertation were to: 1) evaluate the literature examining the relationship between the variables of maternal stress, SHS exposure, and perinatal smoking status; 2) determine the reliability and validity of the Everyday Stressors Index (ESI) use in pregnant women; and 3) to investigate the impacts of maternal perception of everyday stress, and SHS exposure on perinatal smoking status. Evidence obtained from the critical review of the literature supported an association between psychosocial stress and smoking during pregnancy or postpartum. Little information regarding the role of SHS exposure on perinatal smoking status was discovered. Psychometric testing of the ESI demonstrated strong internal consistency reliability, and factor analysis yielded three factors capturing three important domains of everyday stress. SHS exposure emerged as the most significant predictor of smoking status. Persistent smokers/relapsers had the highest ESI scores, followed by quitters, and then nonsmokers. While ESI means decreased in all smoking status groups from the first to the third trimester, the magnitude of decrease was not predictive. A significant interaction effect of SHS exposure in the home and decrease in ESI score occurred in the quit group only with quitters 1.14 times more likely to experience a decrease in ESI score compared to smokers/relapsers.