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Kashiwagi M, Sieber S, Rechsteiner C, Lauper U, Zimmermann R, Ehlert U. Psychological mood state of opiate addicted women during pregnancy and postpartum in comparison to non-addicted healthy women. J Psychosom Obstet Gynaecol 2009; 30:201-4. [PMID: 18608820 DOI: 10.1080/01674820601095908] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
Abstract
Opiate addiction has been widely documented to have negative impact on pregnancy course and outcome. Unfavorable psychosocial situation of addicted women predispose for poor processing of the physiological and psychological demands of pregnancy. Thus aim of our study was to investigate the psychological mood state of opiate addicts during pregnancy and postpartum in comparison to healthy women. In a case-controlled, prospective, longitudinal study nine pregnant opiate addicts and nine healthy pregnant women matched by age, level of education and gestational age at birth were interviewed in the third trimester of pregnancy and postpartum. Standardized questionnaires and inventories for assessment of the general psychopathology and emotional state, the perceived self-efficacy expectancy, the psychosocial adaptation to pregnancy and the fear of delivery, respectively were applied. Addicted women achieved significantly higher scores in the test assessing general psychopathology and emotional state before delivery compared to abstinent women. Interestingly this difference was unverifiable postpartum. This study reaffirms the presumption of a disadvantageous psychological condition in pregnant opiate addicts in comparison to healthy pregnant women for the first time in a prospective case-control study design.
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Affiliation(s)
- Maki Kashiwagi
- Department of Obstetrics & Gynecology, Clinic of Obstetrics, University Hospital Zurich, 8091 Zurich, Switzerland.
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Golding J, Jones R, Preece A, Bruné MN, Pronczuk J. Choice of environmental components for a longitudinal birth cohort study. Paediatr Perinat Epidemiol 2009; 23 Suppl 1:134-53. [PMID: 19490453 DOI: 10.1111/j.1365-3016.2009.01014.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Various aspects of the environment of the mother and child may have major influences on the health and development of the child. Long-term influences can even affect chronic diseases of adulthood. Here we describe the major psychosocial and physical environmental factors that should be measured in longitudinal birth cohort studies.
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Beydoun H, Saftlas AF. Physical and mental health outcomes of prenatal maternal stress in human and animal studies: a review of recent evidence. Paediatr Perinat Epidemiol 2008; 22:438-66. [PMID: 18782252 DOI: 10.1111/j.1365-3016.2008.00951.x] [Citation(s) in RCA: 254] [Impact Index Per Article: 15.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Prenatal maternal stress (PNMS) has been linked with adverse health outcomes in the offspring through experimental studies using animal models and epidemiological studies of human populations. The purpose of this review article is to establish a parallel between animal and human studies, while focusing on methodological issues and gaps in knowledge. The review examines the quality of recent evidence for prevailing PNMS theoretical models, namely the biopsychosocial model for adverse pregnancy outcomes and the fetal programming model for chronic diseases. The investigators used PubMed (2000-06) to identify recently published original articles in the English language literature. A total of 103 (60 human and 43 animal) studies were examined. Most human studies originated from developed countries, thus limiting generalisability to developing nations. Most animal studies were conducted on non-primates, rendering extrapolation of findings to pregnant women less straightforward. PNMS definition and measurement were heterogeneous across studies examining similar research questions, thus precluding the conduct of meta-analyses. In human studies, physical health outcomes were often restricted to birth complications while mental health outcomes included postnatal developmental disorders and psychiatric conditions in children, adolescents and adults. Diverse health outcomes were considered in animal studies, some being useful models for depression, schizophrenia or attention deficit hyperactivity disorder in human populations. The overall evidence is consistent with independent effects of PNMS on perinatal and postnatal outcomes. Intervention studies and large population-based cohort studies combining repeated multi-dimensional and standardised PNMS measurements with biomarkers of stress are needed to further understand PNMS aetiology and pathophysiology in human populations.
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Affiliation(s)
- Hind Beydoun
- Department of Epidemiology, College of Public Health, University of Iowa, Iowa City, IA 52242, USA
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Vieten C, Astin J. Effects of a mindfulness-based intervention during pregnancy on prenatal stress and mood: results of a pilot study. Arch Womens Ment Health 2008; 11:67-74. [PMID: 18317710 DOI: 10.1007/s00737-008-0214-3] [Citation(s) in RCA: 196] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2007] [Accepted: 11/08/2007] [Indexed: 12/01/2022]
Abstract
Stress and negative mood during pregnancy increase risk for poor childbirth outcomes and postnatal mood problems and may interfere with mother-infant attachment and child development. However, relatively little research has focused on the efficacy of psychosocial interventions to reduce stress and negative mood during pregnancy. In this study, we developed and pilot tested an eight-week mindfulness-based intervention directed toward reducing stress and improving mood in pregnancy and early postpartum. We then conducted a small randomized trial (n=31) comparing women who received the intervention during the last half of their pregnancy to a wait-list control group. Measures of perceived stress, positive and negative affect, depressed and anxious mood, and affect regulation were collected prior to, immediately following, and three months after the intervention (postpartum). Mothers who received the intervention showed significantly reduced anxiety (effect size, 0.89; p<0.05) and negative affect (effect size, 0.83; p<0.05) during the third trimester in comparison to those who did not receive the intervention. The brief and nonpharmaceutical nature of this intervention makes it a promising candidate for use during pregnancy.
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Affiliation(s)
- C Vieten
- California Pacific Medical Center Research Institute, San Francisco, California, USA.
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55
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Abstract
OBJECTIVE To investigate the association between maternal exposure to severe life events and fetal growth (birthweight and small for gestational age). Stress has been associated with adverse pregnancy outcome. METHODS Mothers of 1.38 million singleton live births in Denmark between January 1, 1979 and December 31, 2002 were linked to information on their spouses, parents, siblings, and older children. Exposure was defined as death or serious illness in a relative during pregnancy or in the 6 months before conception. Linear regression was used to examine the effect of exposure on birthweight. Log-linear binomial regression was used to assess the effect of exposure on small for gestational age. RESULTS Death of a relative during pregnancy or in the 6 months before conception reduced birthweight by 27 g (adjusted estimate -27 g, 95% Confidence Interval (CI) = -33, -22). There was a significant association between maternal exposure to death of a relative and risk of a baby weighing below the 10th percentile (adjusted relative risk (RR) = 1.17, 95% CI = 1.13, 1.22) and 5th percentile (adjusted RR = 1.22, 95% CI = 1.15, 1.29). CONCLUSIONS Mothers exposed to severe life events before conception or during pregnancy have babies with significantly lower birthweight. If this association is causal, the potential mechanisms of stress-related effects on birthweight include changes in lifestyle due to the exposure and stress-related dysregulation of the hypothalamic-pituitary-adrenal axis during pregnancy.
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Rodrigues AV, Siqueira AAFD. Sobre as dores e temores do parto: dimensões de uma escuta. REVISTA BRASILEIRA DE SAÚDE MATERNO INFANTIL 2008. [DOI: 10.1590/s1519-38292008000200005] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
OBJETIVOS: desenvolver algumas reflexões sobre os possíveis efeitos benéficos de uma escuta responsiva à verbalização da presença de dor, medos e seus correlatos na cena do parto tomando como base dados empíricos de pesquisa realizada em maternidade situada na cidade de São Paulo, Brasil. MÉTODOS: estudo descritivo, de metodologia qualitativa, referenciado no quadro teórico da Psicologia Social, Psicanálise e Lingüística, utilizando entrevistas semi-estruturadas com 20 parturientes e sete doulas e observação de rotinas da maternidade. RESULTADOS: a análise, apoiada em categorias estabelecidas (subjetividade auto-referida, intersubjetividade, acolhimento, apropriação da experiência) mostrou, entre outros pontos, a importância e a valorização da interlocução qualificada no processo da parturição. Processo esse referido pelas parturientes como experiência de elevado grau de estresse, com vivências de dor, medos e ansiedades, porém mitigados pelo apoio recebido. CONCLUSÕES: a análise permitiu compreender as relações interpessoais como campo de interlocução e acolhimento percebidos pelas mulheres do estudo capazes de produzir efeitos favoráveis sobre as vivências do estresse materno, configurando-se como recurso técnico, qualificado e valioso, oferecido à parturiente.
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58
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Shanok AF, Miller L. Depression and treatment with inner city pregnant and parenting teens. Arch Womens Ment Health 2007; 10:199-210. [PMID: 17690952 DOI: 10.1007/s00737-007-0194-8] [Citation(s) in RCA: 55] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2006] [Accepted: 06/30/2007] [Indexed: 11/29/2022]
Abstract
BACKGROUND Between a quarter and half of pregnant adolescents are estimated to be depressed (Beardslee et al. 1988). Two recent open clinical trials found significant drops in depression levels among pregnant and newly parenting inner city teenagers after 12 weeks of Interpersonal Psychotherapy modified for pregnant teenagers (Miller et al. submitted). The current study addresses the nature of and contributors to participants' depression, and the active ingredients in their healing. METHOD Qualitative analyses of therapy sessions, clinical notes and post hoc interviews of clinicians were integrated with questionnaire data. RESULTS The most common symptoms of participant depression (n = 80) were anger/irritability and sadness and the cluster of depressive symptoms with the greatest variance was characterized by shame and guilt. Participants attributed symptoms of depression to feeling trapped or wronged, when family members were sad or rejecting and when the symptoms functioned to help participants meet their needs. Experiences associated with symptom relief were validation of pregnancies, successful use of self-advocacy and boundary setting skills and recognition of passage through important transitions. Support from participants' mothers was instrumental. CONCLUSIONS Interpersonal contexts may be pivotal in contributing, maintaining and/or alleviating depression among poor urban pregnant and newly parenting adolescents.
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Affiliation(s)
- A F Shanok
- Department of Counseling and Clinical Psychology, Teachers College, Columbia University, New York, NY 10027, USA.
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59
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Kashiwagi M, Sieber S, Rechsteiner C, Lauper U, Zimmermann R, Ehlert U. Psychological mood state of opiate addicted women during pregnancy and postpartum in comparison to non-addicted healthy women. J Psychosom Obstet Gynaecol 2007; 28:3-6. [PMID: 17454508 DOI: 10.1080/01674820601058104] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
Abstract
Opiate addiction has been widely documented to have a negative impact on pregnancy course and outcome. The unfavorable psychosocial situation of addicted women predispose for poor processing of the physiological and psychological demands of pregnancy. Thus the aim of our study was to investigate the psychological mood state of opiate addicts during pregnancy and postpartum in comparison to healthy women. In a case-controlled, prospective, longitudinal study, nine pregnant opiate addicts and nine healthy pregnant women matched by age, level of education and gestational age at birth were interviewed in the third trimester of pregnancy and postpartum. Standardized questionnaires and inventories for assessment of the general psychopathology and emotional state, the perceived self-efficacy expectancy, the psychosocial adaptation to pregnancy and the fear of delivery, respectively were applied. Addicted women achieved significantly higher scores in the test assessing general psychopathology and emotional state before delivery compared to abstinent women. Interestingly this difference was unverifiable postpartum. This study reaffirms the presumption of a disadvantageous psychological condition in pregnant opiate addicts in comparison to healthy pregnant women for the first time in a prospective case-control study design.
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Affiliation(s)
- Maki Kashiwagi
- Department of Obstetrics & Gynecology, Clinic of Obstetrics, University Hospital Zurich, Switzerland.
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60
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Elsenbruch S, Benson S, Rücke M, Rose M, Dudenhausen J, Pincus-Knackstedt MK, Klapp BF, Arck PC. Social support during pregnancy: effects on maternal depressive symptoms, smoking and pregnancy outcome. Hum Reprod 2006; 22:869-77. [PMID: 17110400 DOI: 10.1093/humrep/del432] [Citation(s) in RCA: 214] [Impact Index Per Article: 11.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND The goal was to study the effects of social support during pregnancy on maternal depressive symptoms, quality of life and pregnancy outcomes. METHODS Eight hundred ninety-six women were prospectively studied in the first trimester of pregnancy and following completion of the pregnancy. The sample was divided into quartiles yielding groups of low, medium and high social support based on perceived social support. RESULTS Pregnant women with low support reported increased depressive symptoms and reduced quality of life. The effects of social support on pregnancy outcomes were particularly pronounced in women who had smoked during pregnancy, with significant main effects of social support in a two-way analysis of variance (smoking status and social support) for child body length (F = 4.26, P = 0.04; 50.43 +/- 2.81 cm with low support versus 51.76 +/- 2.31 cm with high support) and birthweight (F = 11.35, P = 0.001; 3175 +/- 453 g with low support versus 3571 +/- 409 g with high support). In smokers, pregnancy complications occurred more frequently when given low support {34 versus 10.3% with high support, chi(2) = 5.49, P = 0.019; relative risk (RR) = 3.3 [95% confidence interval (95% CI) = 1.1-10.2]}, and the proportion of preterm deliveries was greater given low support (10.0 versus 0% with high support, chi(2) = 3.84, P = 0.05, odds ratio = 8.1). CONCLUSIONS Lack of social support constitutes an important risk factor for maternal well-being during pregnancy and has adverse effects on pregnancy outcomes.
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Affiliation(s)
- S Elsenbruch
- Department of Medical Psychology, University Clinic of Essen, University of Duisburg-Essen, Essen, Germany.
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61
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Nystedt A, Högberg U, Dejin-Karlsson E, Lundman B. Low psychosocial resources during early pregnancy are not associated with prolonged labour. Eur J Obstet Gynecol Reprod Biol 2006; 125:29-33. [PMID: 16026919 DOI: 10.1016/j.ejogrb.2005.02.028] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Revised: 01/05/2005] [Accepted: 02/23/2005] [Indexed: 11/28/2022]
Abstract
OBJECTIVES To examine if a low level of psychosocial resources in early pregnancy is associated with the occurrence of prolonged labour. STUDY DESIGN A cross sectional study of 644 women expecting their first child. Participants were asked to complete a questionnaire at their first antenatal visit, measuring psychosocial resources defined as social network and support, work-related psychosocial factors, control of daily life and health characteristics. Outcome was prolonged labour at the end of the pregnancy. RESULTS A low level of psychosocial resources was not associated with prolonged labour. The majority of women reported that the degree of support was high in early pregnancy. CONCLUSIONS A perceived low level of psychosocial resources in early pregnancy did not increase the risk of prolonged labour at the subsequent delivery.
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Affiliation(s)
- Astrid Nystedt
- Department of Nursing, Umeå University, S-901 87 Umeå, Sweden.
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62
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Abstract
Prenatal maternal stress has been found to have long-lasting effects on the behavioral and physiological development of the offspring. These programming effects on the fetus would be physiologically mediated through heightened and/or abnormal activity of the maternal sympathetic-adrenal-medullary system (SAM) and especially of her hypothalamic-pituitary-adrenocortical axis (HPA-axis). The abnormalities in maternal physiology could be present in her basal functioning, but also in her physiological reactivity to stressors, which constitutes the topic of this paper. This article reviews studies that have used laboratory challenges to study physiological stress reactivity in pregnant women. It concentrates on stress tests designed to produce pain or discomfort, or cognitive and psychological stress, and that assess changes in blood pressure, heart rate and/or cortisol as reactivity measures. The general conclusion is that physiological stress reactivity appears to be dampened during pregnancy. Nonetheless, the physiological responses to laboratory challenges are clearly present and display enough inter-individual variability to enable the study of links between responsivity patterns, psychosocial variables, fetal behavior, pregnancy outcome and offspring development. This paper also looks into the methodological limitations present in the reviewed studies. Options for sound design of stress test protocols are discussed and recommendations for future studies are presented. These methodological points are general and can therefore also be of use for researchers studying human stress reactivity in other populations and ages.
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Affiliation(s)
- Carolina de Weerth
- Department of Psychiatry, University Medical Center Nijmegen, HP 333, P.O. Box 9101, 6500 HB Nijmegen, The Netherlands.
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63
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Torres-Arreola LP, Constantino-Casas P, Flores-Hernández S, Villa-Barragán JP, Rendón-Macías E. Socioeconomic factors and low birth weight in Mexico. BMC Public Health 2005; 5:20. [PMID: 15745443 PMCID: PMC554974 DOI: 10.1186/1471-2458-5-20] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2004] [Accepted: 03/03/2005] [Indexed: 11/12/2022] Open
Abstract
Background Low birth weight (LBW) is a public health problem linked to lack of equity in populations. Despite efforts to decrease the proportion of newborns with LBW, success has been quite limited. In recent years, studies focused on explaining how social factors influence this problem have shown that populations with greater inequities have a greater proportion of newborns with LBW. Methods The objective was to describe socioeconomic factors related to LBW adjusted by demographic, reproductive and health services variables in Mexico City. A case-control study was carried out in three hospitals with gynaecological and obstetrics services in Mexico City during the first half of 1996. During the recruiting period all children with LBW (cases), defined as newborns weighing <2500 grams, were matched with children born on the same day to control for time of birth. Upon arrival at the hospital for delivery, women were interviewed to determine if they met our inclusion criteria. Women with a history of chronic conditions and those with twin or multiple pregnancies were excluded. Variables with clinical and statistical significance were included in a multivariate model (logistic regression). Results We found that low socioeconomic level was the most important risk factor for LBW and was independent of other factors, including those related to reproduction and nutrition, smoking, morbidity during pregnancy, accessibility to health services and prenatal care (OR 2.68; 95% CI 1.19, 6.03). Conclusion We found that socioeconomic factors are relevant to LBW. However further research should be done in different population groups as well as developing precise ways of measuring socioeconomic factors and their role in reproductive health.
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Affiliation(s)
- Laura P Torres-Arreola
- Health Services and Epidemiologic Research Unit. National Medical Centre Century XXI, Mexican. Institute of Social Security, Mexico
| | | | - Sergio Flores-Hernández
- Health Research Coordination. Centre Century XXI, Mexican Institute of Social Security, Mexico
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64
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Lederman SA, Rauh V, Weiss L, Stein JL, Hoepner LA, Becker M, Perera FP. The effects of the World Trade Center event on birth outcomes among term deliveries at three lower Manhattan hospitals. ENVIRONMENTAL HEALTH PERSPECTIVES 2004; 112:1772-8. [PMID: 15579426 PMCID: PMC1253672 DOI: 10.1289/ehp.7348] [Citation(s) in RCA: 135] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/17/2023]
Abstract
The effects of prenatal exposure to pollutants from the World Trade Center (WTC) disaster on fetal growth and subsequent health and development of exposed children remain a source of concern. We assessed the impact of gestational timing of the disaster and distance from the WTC in the 4 weeks after 11 September on the birth outcomes of 300 nonsmoking women who were pregnant at the time of the event. They were recruited at delivery between December 2001 and June 2002 from three hospitals close to the WTC site. Residential and work addresses of all participants for each of the 4 weeks after 11 September 2001 were geocoded for classification by place and timing of exposure. Average daily hours spent at each location were based on the women's reports for each week. Biomedical pregnancy and delivery data extracted from the medical records of each mother and newborn included medical complications, type of delivery, length of gestation, birth weight, birth length, and head circumference. Term infants born to women who were pregnant on 11 September 2001 and who were living within a 2-mile radius of the WTC during the month after the event showed significant decrements in term birth weight (-149 g) and birth length (-0.82 cm), compared with infants born to the other pregnant women studied, after controlling for sociodemographic and biomedical risk factors. The decrements remained significant with adjustment for gestational duration (-122 g and -0.74 cm, respectively). Women in the first trimester of pregnancy at the time of the WTC event delivered infants with significantly shorter gestation (-3.6 days) and a smaller head circumference (-0.48 cm), compared with women at later stages of pregnancy, regardless of the distance of their residence or work sites from the WTC. The observed adverse effects suggest an impact of pollutants and/or stress related to the WTC disaster and have implications for the health and development of exposed children.
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Affiliation(s)
- Sally Ann Lederman
- Columbia Center for Children's Environmental Health, Mailman School of Public Health, Columbia University, New York, New York, USA.
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65
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Westfall RE, Benoit C. The rhetoric of “natural” in natural childbirth: childbearing women's perspectives on prolonged pregnancy and induction of labour. Soc Sci Med 2004; 59:1397-408. [PMID: 15246169 DOI: 10.1016/j.socscimed.2004.01.017] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
It is widely known that the notion of prolonged pregnancy, defined medically as 41+ or 42+ weeks gestation, has been hotly debated within the medical and midwifery communities for many decades. Within this debate, pregnant women's voices have rarely been heard. Presented here are the results of a qualitative study of self-care in pregnancy, birth and lactation with a non-random sample of women in British Columbia, Canada. A panel of 27 women was interviewed in the third trimester of pregnancy, and 23 of the same participants were re-interviewed post-partum (50 interviews in total). Interviews were tape-recorded, transcribed, and analyzed thematically. Many of the women said they favoured a natural birth and were opposed to labour induction at the time of the first interview. Yet all but one of the ten women who went beyond 40 weeks gestation used self-help measures to stimulate labour. These women did not perceive prolonged pregnancy as a medical problem per se. Rather they saw it as an inconvenience, a worry to their friends, families and maternity care providers, and a prolongation of physical discomfort. The findings are interpreted by examining the literature on the medicalization/healthicization of childbirth.
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Affiliation(s)
- Rachel Emma Westfall
- Department of Anthropology, Box 3050, University of Victoria, Victoria, BC, V8W 3P5, Canada.
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66
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Glazier RH, Elgar FJ, Goel V, Holzapfel S. Stress, social support, and emotional distress in a community sample of pregnant women. J Psychosom Obstet Gynaecol 2004; 25:247-55. [PMID: 15715023 DOI: 10.1080/01674820400024406] [Citation(s) in RCA: 175] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
Abstract
Emotional distress in women during pregnancy has been shown to increase the risk of adverse outcomes for women and newborns. Increasingly, assessment and management of mood and anxiety problems during pregnancy entail consideration of life stress and interpersonal relationships with partners, friends, and family members. This study describes cross-sectional relations between life stress, perceived social support, and symptoms of depression and anxiety as well as the mediating influence of social support on relations between stress and symptoms. A community sample of women (N = 2,052) provided self-report data during their second trimester of pregnancy. Empirical fit was found for a structural equation model that depicted the combined influences of sociodemographic factors (i.e., socioeconomic status, age, parity), stress (partner conflict and life events), and social support on symptoms of depression and anxiety, chi2 (df 51) = 310.65, p <.05; CFI=.91. Women who reported low levels of social support showed stronger relations between stress and symptoms than women who reported high levels of social support--indicative of a mediating effect of social support. Consistent with previous studies, results suggest that dyadic psychosocial assessment of pregnant women and their partners may facilitate interventions to augment support networks, thereby reducing the risk of emotional distress.
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Affiliation(s)
- R H Glazier
- Department of Family and Community Medicine, University of Toronto, Toronto, Canada
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67
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Elgar FJ, McGrath PJ, Waschbusch DA, Stewart SH, Curtis LJ. Mutual influences on maternal depression and child adjustment problems. Clin Psychol Rev 2004; 24:441-59. [PMID: 15245830 DOI: 10.1016/j.cpr.2004.02.002] [Citation(s) in RCA: 165] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2003] [Revised: 01/27/2004] [Accepted: 02/13/2004] [Indexed: 11/19/2022]
Abstract
Often undetected and poorly managed, maternal depression and child adjustment problems are common health problems and impose significant burden to society. Studies show evidence of mutual influences on maternal and child functioning, whereby depression in mothers increases risk of emotional and behavioral problems in children and vice versa. Biological mechanisms (genetics, in utero environment) mediate influences from mother to child, while psychosocial (attachment, child discipline, modeling, family functioning) and social capital (social resources, social support) mechanisms mediate transactional influences on maternal depression and child adjustment problems. Mutual family influences in the etiology and maintenance of psychological problems advance our understanding of pathways of risk and resilience and their implications for clinical interventions. This article explores the dynamic interplay of maternal and child distress and provides evidence for a biopsychosocial model of mediating factors with the aim of stimulating further research and contributing to more inclusive therapies for families.
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Affiliation(s)
- Frank J Elgar
- Cardiff Institute of Society, Health and Ethics, Cardiff University, 53 Park Place, CF10 3WT, Wales, UK.
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68
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Priel B, Besser A. Perceptions of early relationships during the transition to motherhood: The mediating role of social support. Infant Ment Health J 2002. [DOI: 10.1002/imhj.10021] [Citation(s) in RCA: 34] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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69
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Chang HL, Chang TC, Lin TY, Kuo SS. Psychiatric morbidity and pregnancy outcome in a disaster area of Taiwan 921 earthquake. Psychiatry Clin Neurosci 2002; 56:139-44. [PMID: 11952916 DOI: 10.1046/j.1440-1819.2002.00948.x] [Citation(s) in RCA: 114] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
We investigated the prevalence of minor psychiatric morbidity in a group of women who were pregnant during or immediately after a major earthquake disaster and we investigated the prognostic factors that may have influenced the perinatal outcome of the pregnancy. The study was initiated 6 months after the earthquake and enrolled 171 women in a town near the epicentre. A Post-Earthquake Questionnaire, Chinese Health Questionnaire (CHQ-12) and posttraumatic stress disorder (PTSD) symptoms checklist were completed before delivery while the perinatal data were retrieved from hospital obstetrical records. The prevalence of minor psychiatric morbidity (MPM) was 29.2%. Women with starvation experience, higher negative attitude scores about the influence of earthquake on pregnancy and more casualties among relatives were significantly correlated with high CHQ. A significant positive correlation between the MPM and PTSD scores was noticed. Among the 115 pregnancies with known perinatal outcome, there were nine (7.8%) low-birth weight neonates, defined as birth weight < or = 2500 g. Maternal history of abdominal injury, spouse casualty and instability in living condition were significantly correlated with low birth weight. Spouse casualty was the only significant factor that predicts neonatal low birth weight.
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Affiliation(s)
- Hseuh-Ling Chang
- Department of Child Psychiatry, Chang-Gung Children's Hospital Linkou Medical Center, Kwei-Shan, Tao-Yuan, Taiwan.
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