Maternal mental health predicts risk of developmental problems at 3 years of age: follow up of a community based trial

Effects of interview on mood status of pregnant women with high-risk delivery

BACKGROUND

Expectant mothers at high risk for preterm labor admitted to the Mother and Child Health Centers (MCH) often have psychological problems and mood disturbances. The purpose of the present study was to evaluate the effects of an interview by health professionals on their mood status.

METHODS

Participants consisted of 52 women admitted to the MCH of Kansai Medical University (KMU) hospital and who had delivered between December 2006 and September 2007. Interview sessions by health professionals consisting of a neonatologist and a clinical psychologist, termed 'KMU baby doctor-team interview', were held once a week. During the interview the neonatologist discussed the physiology of preterm infants and treatment for the possible complications while the clinical psychologist listened to the expectant mothers talk about their anxieties or complaints and responded to their requests as much as possible. To investigate their mood status objectively, the participants were asked to complete the Japanese version of the Profile of Mood States (POMS) before and after the first session.

RESULTS

On admission, more than 20% of participants ranging from 19 to 42 years of age had mood disturbances in Tension-Anxiety, Depression-Dejection, and Vigor categorized by POMS. The average score for Depression-Dejection, however, significantly improved after the first interview sessions.

CONCLUSIONS

Mood disturbances were observed in a considerable number of expectant mothers at high risk for preterm labor. Interviews by health professionals consisting of a neonatologist and a clinical psychologist may alter their mood status.

Parental mental health, education, age at childbirth and child development from six to 18 months

AIM

To investigate the effect six-month parental mental health has on children's six and 18-month development. Parental covariates of age and education were also analysed.

METHODS

Through a national random selection, 21 648 babies were selected. Parental self perceived overall mental health was measured using 36-Item Short Form Health Survey (SF-36) and children's development using the Taiwan Birth Cohort Study (TBCS) instrument which measures gross motor, fine motor, language and social dimensions of children's development.

RESULTS

Both multiple linear regression and structural equation modeling showed that when the covariates of parental education and age at childbirth were added, the effect parental mental health has on children's development decreases. Additionally, maternal mental health had a more persistent and pervasive effect than paternal mental health. Father's mental health at six months had a delayed effect, in that its influence was seen only with children's development at 18 months. Of the three factors of parental mental health, education and age at childbirth, parental education had the most pervasive and persistent effect on children's development.

CONCLUSION

Although parental mental health has an effect on children's development, parental education and age at childbirth are vital confounding factors, which should be considered in future studies. Clinical health care providers should provide childcare resources and instructions to younger, less educated and parents with mental symptoms.

Twin-singleton influence on infant development: a national birth cohort study

BACKGROUND

While studying the development of twins, gestational age and birthweight were suggested as two of the major mediators to be considered. In addition, maternal age, maternal education, parental income and assisted reproductive technologies (ART) also should be considered as moderators. Thus the purpose of this study was to investigate the mediators and moderators of twin and singleton development.

METHODS

Being a national birth cohort study, 21 648 infants were randomly selected and developmental measures were assessed at 6 and 18 months post partum. Children's development at 6 and 18 months were measured using the high reliable Taiwan Birth Cohort Study instrument, which measures children's development in four domains of gross motor, fine motor, language and social development. Additionally, maternal sociodemographics including maternal age, maternal education and parental income; children's characteristics including gender, birthweight, gestational age, single or multiple births, ART or natural conception information were also collected. These data were analysed using a three-step multiple linear regression analysis and further validated using structural equation modelling.

RESULTS

Parental sociodemographics, children characteristics and being twin all had effect on children's development. Additionally, ART and twin were mediators between maternal age and children's development. Mothers aged over 40 were more likely to choose ART, thus increases their likelihood of having twins. Additionally, mothers aged over 40 were more likely to give birth to premature or low-birthweight babies, regardless if they were twin or not. Twins had a higher prevalence of prematurity or low birthweight, which also affected their development in all four domains at 6 and 18 months. Thus prematurity and low birthweight were mediating factors between twin and children's development; with these two mediating factors controlled, there were no difference between twin and singleton development.

CONCLUSIONS

The conceptual construct of structural equation modelling showed these factors interacted and influenced children's development through multiple pathways. Medical intervention may facilitate children's development through prenatal growth and premature care.