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Amiel Castro RT, Pinard Anderman C, O'Connor TG, Glover V, Kammerer M. Maternal and paternal postpartum early mood and bonding. J Reprod Infant Psychol 2024; 42:741-752. [PMID: 36593232 DOI: 10.1080/02646838.2022.2159351] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Accepted: 12/12/2022] [Indexed: 01/04/2023]
Abstract
BACKGROUND Whereas the maternal 'blues' has been widely researched, comparatively less is known about the "highs" following childbirth, and the relation between mothers and fathers' mood in this early period. We aimed to investigate the association between maternal 'blues' and 'highs' with paternal postpartum mood (here described as 'lows' and 'highs') in the early postpartum and their associations with the quality of child bonding. METHODS Women and their cohabitating male partners, fathers of the index child (N = 98 couples), attending an obstetric hospital unit completed questionnaires on mood, bonding and socio-demographics between the 3rd and the 5th postpartum day. We used generalised estimating equations to analyse the data. RESULTS The 'blues' scores were higher in mothers, whereas 'highs' and bonding were higher in fathers. Maternal 'blues' were significantly correlated with paternal 'lows' (rs = .23, p < .05) and maternal 'highs' were also associated with paternal 'highs' (rs = .22, p < .05). Parental 'highs' were significantly associated with better baby bonding (B = .13, p = .02). CONCLUSIONS Our study demonstrates moderate associations between both 'blues/lows' and 'highs' in mothers and fathers shortly after the birth of the child. Associations between mood, particularly 'highs', and bonding were similar for mothers and fathers. Greater consideration of 'blues/lows' and 'highs' in both parents is needed to promote adjustment in the postpartum period.
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Affiliation(s)
- Rita T Amiel Castro
- Department of Clinical Psychology and Psychotherapy, University of Zurich, Zurich, Switzerland
| | - Claudia Pinard Anderman
- Department of Applied Psychology, Zurich University of Applied Sciences, ZHAW, Zürich, Switzerland
| | - Thomas G O'Connor
- Department of Psychiatry, University of Rochester Medical Center, Rochester, New York, USA
| | - Vivette Glover
- Imperial College London, Institute of Reproductive and Developmental Biology, Department of Metabolism, Digestion and Reproduction Hammersmith Hospital Campus, London, UK
| | - Martin Kammerer
- Imperial College London, Institute of Reproductive and Developmental Biology, Department of Metabolism, Digestion and Reproduction Hammersmith Hospital Campus, London, UK
- Outpatient Service, Alpine Health AG, Altendorf, Switzerland
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2
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Rigato S, Vrticka P, Stets M, Holmboe K. Mother-infant interaction characteristics associate with infant falling reactivity and child peer problems at pre-school age. PLoS One 2024; 19:e0302661. [PMID: 38833457 PMCID: PMC11149888 DOI: 10.1371/journal.pone.0302661] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Accepted: 04/10/2024] [Indexed: 06/06/2024] Open
Abstract
This longitudinal study investigated the associations between mother-infant interaction characteristics at 9 months of age, maternal mental health, infant temperament in the first year postpartum, and child behaviour at 3 years of age. The infants (N = 54, 22 females) mainly had White British ethnic backgrounds (85.7%). Results showed that i) mother-infant dyadic affective mutuality positively correlated with infant falling reactivity, suggesting that better infant regulatory skills are associated with the dyad's ability to share and understand each other's emotions; and ii) maternal respect for infant autonomy predicted fewer child peer problems at 3 years of age, suggesting that maternal respect for the validity of the infant's individuality promotes better social and emotional development in early childhood.
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Affiliation(s)
- Silvia Rigato
- Department of Psychology, Centre for Brain Science, University of Essex, Colchester, England
| | - Pascal Vrticka
- Department of Psychology, Centre for Brain Science, University of Essex, Colchester, England
| | - Manuela Stets
- Department of Psychology, Centre for Brain Science, University of Essex, Colchester, England
| | - Karla Holmboe
- School of Psychological Science, University of Bristol, Bristol, United Kingdom
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Thamby A, Bajaj A, L M, G SK, Gr G, K T, Ts J. Impaired mother-infant bonding: a community study from India. J Reprod Infant Psychol 2024; 42:528-539. [PMID: 36138562 DOI: 10.1080/02646838.2022.2125938] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Accepted: 09/13/2022] [Indexed: 10/14/2022]
Abstract
PURPOSE Impaired mother-infant bonding (MIB) is associated with inadequate maternal skills and pose a higher risk for impaired learning, child abuse, and psychiatric disorders in children. There are approximately 24 million births annually in India; however, community data on MIB from India is lacking. METHODS The study reports the findings of a cross-sectional survey of 8189 mothers with children of age between 13 and 15 months from the state of Kerala, India. Bonding was assessed using the Mother-infant bonding scale (MIBS). Other correlates assessed include obstetric and birth history, chronic pain, postpartum depression and temperamental issues in the infant. RESULTS The prevalence of impaired MIB in our sample was 12.3%. Those in extended/joint family, experiencing postpartum complications, supplementary breastfeeding in the first 6 months, postpartum depression and temperamental issues in infant were found to be associated with increased MIBS scores in a multivariate mixed-effect zero-inflated poisson model. CONCLUSION Experience of impaired MIB is not uncommon among mothers in India. More needs to be done to explore these issues, especially among those with higher risk to ensure appropriate interventions to mitigate long-term consequences.
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Affiliation(s)
- Abel Thamby
- Department of Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, India
| | - Aakash Bajaj
- Department of Biostatistics, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, India
| | - Manoj L
- National Health Mission (Kerala), Thiruvananthapuram, India
| | - Sunil Kumar G
- National Health Mission (Kerala), Thiruvananthapuram, India
| | - Gokul Gr
- National Health Mission (Kerala), Thiruvananthapuram, India
| | - Thennarasu K
- Department of Biostatistics, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, India
| | - Jaisoorya Ts
- Department of Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, India
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4
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Carvalho Hilje C, Bauer NH, Reis D, Kapp C, Ostermann T, Vöhler F, Längler A. The role of breastfeeding and formula feeding regarding depressive symptoms and an impaired mother child bonding. Sci Rep 2024; 14:11417. [PMID: 38763963 PMCID: PMC11102907 DOI: 10.1038/s41598-024-62168-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2024] [Accepted: 05/14/2024] [Indexed: 05/21/2024] Open
Abstract
Associations between depressive symptoms and breastfeeding are well documented. However, evidence is lacking for subdivisions of feeding styles, namely exclusive breastfeeding, exclusive formula feeding and a mixed feeding style (breastfeeding and formula feeding). In addition, studies examining associations between mother-child-bonding and breastfeeding have yielded mixed results. The aim of this study is to provide a more profound understanding of the different feeding styles and their associations with maternal mental health and mother-child-bonding. Data from 307 women were collected longitudinally in person (prenatally) and by telephone (3 months postnatally) using validated self-report measures, and analyzed using correlational analyses, unpaired group comparisons and regression analyses. Our results from a multinomial regression analysis revealed that impaired mother-child-bonding was positively associated with mixed feeding style (p = .003) and depressive symptoms prenatal were positively associated with exclusive formula feeding (p = .013). Further studies could investigate whether information about the underlying reasons we found for mixed feeding, such as insufficient weight gain of the child or the feeling that the child is unsatiated, could help prevent impaired mother-child-bonding. Overall, the results of this study have promising new implications for research and practice, regarding at-risk populations and implications for preventive measures regarding postpartum depression and an impaired mother-child-bonding.
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Affiliation(s)
- Clara Carvalho Hilje
- Department of Pediatrics, Gemeinschaftskrankenhaus Herdecke, Herdecke, Germany
- Professorship for Integrative Pediatrics, Institute for Integrative Medicine, Witten/Herdecke University, Witten, Germany
| | - Nicola H Bauer
- Institute of Midwifery Science, Faculty of Medicine, University of Cologne, Cologne, Germany
| | - Daniela Reis
- Department of Pediatrics, Gemeinschaftskrankenhaus Herdecke, Herdecke, Germany.
- Professorship for Integrative Pediatrics, Institute for Integrative Medicine, Witten/Herdecke University, Witten, Germany.
| | - Claudia Kapp
- Department of Psychology and Psychotherapy, Faculty of Health, Witten/Herdecke University, Witten, Germany
| | - Thomas Ostermann
- Department of Psychology and Psychotherapy, Faculty of Health, Witten/Herdecke University, Witten, Germany
| | - Franziska Vöhler
- Department of Obstetrics, Gemeinschaftskrankenhaus Herdecke, Herdecke, Germany
| | - Alfred Längler
- Department of Pediatrics, Gemeinschaftskrankenhaus Herdecke, Herdecke, Germany
- Professorship for Integrative Pediatrics, Institute for Integrative Medicine, Witten/Herdecke University, Witten, Germany
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5
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Khalil D, George Z, Dannawey E, Hijawi J, ElFishawy S, Jenuwine E. Maternal stressors and maternal bonding among immigrant and Refugee Arab Americans resettled in the United States. Res Nurs Health 2024; 47:141-150. [PMID: 38149856 DOI: 10.1002/nur.22365] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Revised: 12/02/2023] [Accepted: 12/13/2023] [Indexed: 12/28/2023]
Abstract
Maternal bonding with the infant and child is essential for the growth and development of the child, and for establishing the relationship between them. The effect of maternal acculturative stress, trauma, and depressive symptoms on maternal bonding has been established in nonimmigrant populations, but not in immigrant and refugee populations. In this study, we aimed to (1) examine the relationships among maternal psychosocial stress (acculturative stress, posttraumatic stress), depressive symptoms, and maternal bonding, and (2) examine whether maternal depression is a mediator of the relationship between maternal psychosocial stress and maternal bonding among a sample of Arab American immigrant and refugee mothers. Using a cross-sectional design, we recruited 78 immigrant and refugee Arab American mothers. Acculturative stress was correlated with posttraumatic stress (ρ = 0.56, p < 0.001), depressive symptoms (ρ = 0.48, p < 0.001), and bonding impairment (ρ = 0.39, p < 0.001). Posttraumatic stress and depressive symptoms were also correlated with maternal bonding impairment (ρ = 0.39, and 0.52, respectively, p < 0.001 for both). The effect of maternal psychosocial stress on maternal bonding was mediated by depressive symptoms. We concluded that higher levels of acculturative stress and posttraumatic stress were associated with higher levels of depressive symptoms and impairment of maternal bonding. Additionally, maternal depressive symptoms mediated the relationship between maternal stress and bonding. Assessing the stressors and depressive symptoms of immigrant and refugee mothers is key to avoiding negative effects on child outcomes.
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Affiliation(s)
- Dalia Khalil
- College of Nursing, Wayne State University, Detroit, Michigan, USA
| | - Zinah George
- College of Nursing, Wayne State University, Detroit, Michigan, USA
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Chen C, Okawa S, Okubo R, Hagiwara K, Mizumoto T, Higuchi N, Nakagawa S, Tabuchi T. Mother-to-infant bonding difficulties are associated with future maternal depression and child-maltreatment behaviors: A Japanese nationwide longitudinal study. Psychiatry Res 2024; 334:115814. [PMID: 38412713 DOI: 10.1016/j.psychres.2024.115814] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Revised: 11/29/2023] [Accepted: 02/22/2024] [Indexed: 02/29/2024]
Abstract
BACKGROUND Mother-to-infant bonding difficulties (MIBD) are considered risk factors for postpartum depression and child-maltreatment behaviors. However, few longitudinal studies have examined this hypothesis. This study aims to explore the relationship between MIBD and subsequent maternal depression and child-maltreatment behaviors using longitudinal data from a 2021 Japanese nationwide survey. METHODS We studied 658 first-time mothers who had given birth within the past year and had not reported postpartum depression or child-maltreatment behaviors at baseline. The Japanese version of Mother-to-Infant Bonding Scale (MIBS) was used to measure MIBD. Subjects were monitored for six months and subsequently completed the Edinburgh Postnatal Depression Scale and responded to inquiries about child-maltreatment behaviors. RESULTS After adjusting for covariates, MIBD was associated with higher odds of maternal depression (OR=1.737, 95 % CI [1.078, 2.797]) and child-maltreatment behaviors (OR=2.040, 95 % CI [1.401, 2.970]) six months later. Further analysis indicated that MIBD was particularly associated with a heightened risk of emotional abuse (OR=2.172, 95 % CI [1.486, 3.176]). Sensitivity analysis confirmed these findings through multiple approaches, such as applying inverse probability weighting to mitigate selection bias, using an alternative MIBS cutoff score of 5, and adopting a time-varying model to account for the dynamic nature of depressive symptoms and child-maltreatment behaviors. CONCLUSION Proactive screening for MIBD could serve as a valuable tool in the early detection of maternal depression and potential child-maltreatment behaviors.
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Affiliation(s)
- Chong Chen
- Division of Neuropsychiatry, Department of Neuroscience, Yamaguchi University Graduate School of Medicine, Ube, Japan.
| | - Sumiyo Okawa
- Institute for Global Health Policy Research, Bureau of International Health Cooperation, National Center for Global Health and Medicine, Tokyo, Japan
| | - Ryo Okubo
- Department of Psychiatry, National Hospital Organization Obihiro Hospital, Obihiro, Japan
| | - Kosuke Hagiwara
- Division of Neuropsychiatry, Department of Neuroscience, Yamaguchi University Graduate School of Medicine, Ube, Japan
| | - Tomohiro Mizumoto
- Division of Neuropsychiatry, Department of Neuroscience, Yamaguchi University Graduate School of Medicine, Ube, Japan
| | - Naoko Higuchi
- Division of Neuropsychiatry, Department of Neuroscience, Yamaguchi University Graduate School of Medicine, Ube, Japan
| | - Shin Nakagawa
- Division of Neuropsychiatry, Department of Neuroscience, Yamaguchi University Graduate School of Medicine, Ube, Japan
| | - Takahiro Tabuchi
- Cancer Control Center, Osaka International Cancer Institute, Osaka, Japan
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7
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Shiga T, Furui T, Morishige KI. Examination of risk factors for high Edinburgh postnatal depression scale scores: a retrospective study at a single university hospital in Japan. Matern Health Neonatol Perinatol 2024; 10:6. [PMID: 38433275 PMCID: PMC10910686 DOI: 10.1186/s40748-024-00176-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Accepted: 01/23/2024] [Indexed: 03/05/2024] Open
Abstract
BACKGROUND Perinatal mental health, such as postpartum depression, is an important issue that can threaten the lives of women and children. It is essential to understand the risk factors in advance and intervene before they can lead to postnatal depression. The risk factors of postpartum depression are reported to vary considerably in Japan. This study aimed to evaluate the risk factors for women with high Edinburgh Postnatal Depression Scale (EPDS) scores and to find women who may need our intervention to prevent postpartum depression. METHODS This was a retrospective observational study conducted at a single center. At the one-month check-up after birth, the EPDS test was performed in 1625 women who gave birth at our hospital from 2008 to 2016. We evaluated maternal, birth, neonatal and social factors and the breastfeeding status from medical records. Thereafter, we examined the factors that contributed to a high EPDS score. RESULTS There were 284 women in the high-score group with an EPDS of ≥ 9, and 1341 women in the low-score group with an EPDS score ≤ of 8. Maternal mental disorders and neonatal transport were significantly associated with high EPDS scores. Conversely, exclusive breastfeeding was significantly associated with the low-score EPDS group. CONCLUSIONS The principal factor for high EPDS scores was a mental disease. Based on this result, we suggest that early intervention in women at high risk for postpartum depression could prevent serious consequences such as abuse and suicide.
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Affiliation(s)
- Tomomi Shiga
- Department of Obstetrics and Gynecology, Gifu University Graduate School of Medicine, 1-1 Yanagido, 501-1194, Gifu-city, Gifu, Japan.
| | - Tatsuro Furui
- Department of Obstetrics and Gynecology, Gifu University Graduate School of Medicine, 1-1 Yanagido, 501-1194, Gifu-city, Gifu, Japan
| | - Ken-Ichirou Morishige
- Department of Obstetrics and Gynecology, Gifu University Graduate School of Medicine, 1-1 Yanagido, 501-1194, Gifu-city, Gifu, Japan
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Doyle FL, Dickson SJ, Eapen V, Frick PJ, Kimonis ER, Hawes DJ, Moul C, Richmond JL, Mehta D, Dadds MR. Towards Preventative Psychiatry: Concurrent and Longitudinal Predictors of Postnatal Maternal-Infant Bonding. Child Psychiatry Hum Dev 2023; 54:1723-1736. [PMID: 35616764 PMCID: PMC10582133 DOI: 10.1007/s10578-022-01365-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/06/2021] [Revised: 04/08/2022] [Accepted: 04/22/2022] [Indexed: 11/03/2022]
Abstract
Maternal-infant bonding is important for children's positive development. Poor maternal-infant bonding is a risk factor for negative mother and infant outcomes. Although researchers have examined individual predictors of maternal-infant bonding, studies typically do not examine several concurrent and longitudinal predictors within the same model. This study aimed to evaluate the unique and combined predictive power of cross-sectional and longitudinal predictors of maternal-infant bonding. Participants were 372 pregnant women recruited from an Australian hospital. Data were collected from mothers at antenatal appointments (T0), following their child's birth (T1), and at a laboratory assessment when their child was 5-11-months-old (T2). Poorer bonding at T2 was predicted at T0 by younger maternal age, higher education, and higher antenatal depressive symptoms. Poorer bonding at T2 was predicted at T1 by younger maternal age, higher education, and higher postnatal depressive symptoms. Poorer bonding at T2 was predicted at T2 by younger maternal age, higher education, higher postnatal depression symptoms, higher concurrent perceived social support, and more difficult infant temperament, when controlling for child age at T2. To promote positive maternal-infant bonding, global and targeted interventions in the perinatal period may benefit from targeting maternal psychopathology, perceived lack of social support, and coping with difficult infant temperament.
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Affiliation(s)
- Frances L. Doyle
- School of Psychology, Faculty of Science, University of Sydney, 2006 Sydney, NSW Australia
- School of Psychology; MARCS Institute for Brain Behaviour and Development; Transforming early Education And Child Health Research Centre, Translational Health Research Institute, Western Sydney University, 2750 Penrith, NSW Australia
| | - Sophie J. Dickson
- School of Psychology, Faculty of Science, University of Sydney, 2006 Sydney, NSW Australia
- Faculty of Medicine, Health, and Human Sciences, Macquarie University, 2109 Sydney, NSW Australia
| | - Valsamma Eapen
- School of Psychiatry, Faculty of Medicine, University of New South Wales, 2052 Kensington, NSW Australia
| | - Paul J. Frick
- Department of Psychology, Louisiana State University, 70803 Baton Rouge, LA USA
| | - Eva R. Kimonis
- School of Psychology, University of New South Wales, 2052 Kensington, NSW Australia
| | - David J. Hawes
- School of Psychology, Faculty of Science, University of Sydney, 2006 Sydney, NSW Australia
| | - Caroline Moul
- School of Psychology, Faculty of Science, University of Sydney, 2006 Sydney, NSW Australia
| | - Jenny L. Richmond
- School of Psychology, University of New South Wales, 2052 Kensington, NSW Australia
| | - Divya Mehta
- Centre for Genomics and Personalised Health, Faculty of Health, Institute of Health and Biomedical Innovation, Queensland University of Technology (QUT), Kelvin Grove, 4059 Brisbane, Queensland Australia
| | - Mark R. Dadds
- School of Psychology, Faculty of Science, University of Sydney, 2006 Sydney, NSW Australia
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Toivo J, Tulivuo N, Kanzaki M, Koivisto AM, Kylmä J, Paavilainen E. First-Time Parents' Bonding with Their Baby: A Longitudinal Study on Finnish Parents during the First Eight Months of Parenthood. CHILDREN (BASEL, SWITZERLAND) 2023; 10:1806. [PMID: 38002897 PMCID: PMC10670067 DOI: 10.3390/children10111806] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/13/2023] [Revised: 11/02/2023] [Accepted: 11/07/2023] [Indexed: 11/26/2023]
Abstract
Early positive bonding between parents and babies promotes the development of parenting skills and parents' sensitivity to their infant's needs. Positive bonding has been suggested to decrease the risk of maltreatment. There is less research into the differences between primiparae's and their spouses' bonding with their baby and changes in the parent-to-infant bonding during the first year of the baby's life. The aim of this study was to describe bonding with one's baby and related differences and changes within first-time parents. The data were collected from nine maternal health clinics in 2019-2021 in one city in Finland. The Mother-to-Infant Bonding Scale (MIBS) and the Edinburgh Postnatal Depression Scale (EPDS) were used. The data were collected during pregnancy (T1) and when the baby was aged 1-2 months (T2) and 6-8 months (T3). The questionnaire was completed separately by the primiparae (n = 81 at T1) and their spouses (n = 79 at T1). The findings demonstrated that both parents had positive feelings for their baby. The primiparae's and their spouses' MIBS scores were relatively low at T2 and T3. The change between time points or the difference in the parents' bonding was not statistically significant when examining MIBS total scores. The present study identified a positive weak-to-moderate correlation between the MIBS and EPDS. This association was highlighted in the group of primiparae. The results of this study can be used to develop maternity and child health clinic services, and to promote parents' equal growth in parenthood.
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Affiliation(s)
- Jessica Toivo
- Unit of Health Sciences, Nursing Science, Faculty of Social Sciences, Tampere University, 33014 Tampere, Finland; (J.T.); (N.T.)
| | - Noora Tulivuo
- Unit of Health Sciences, Nursing Science, Faculty of Social Sciences, Tampere University, 33014 Tampere, Finland; (J.T.); (N.T.)
| | - Mitsuko Kanzaki
- Faculty of Nursing, Kyoto Tachibana University, Kyoto 607-8175, Japan;
| | - Anna-Maija Koivisto
- Unit of Health Sciences, Faculty of Social Sciences, Tampere University, Kalevantie 4, 33014 Tampere, Finland;
| | - Jari Kylmä
- Unit of Health Sciences, Nursing Science, Faculty of Social Sciences, Tampere University, 33014 Tampere, Finland; (J.T.); (N.T.)
| | - Eija Paavilainen
- Unit of Health Sciences, Nursing Science, Faculty of Social Sciences, Tampere University, 33014 Tampere, Finland; (J.T.); (N.T.)
- Etelä-Pohjanmaa Welfare County, 60220 Seinäjoki, Finland
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Lutz BH, Santos IDSD, Domingues MR, Murray J, Silveira MFD, Miranda VIA, Silveira MPT, Mengue SS, Pizzol TDSD, Bertoldi AD. Folic acid supplementation during pregnancy and postpartum depressive symptoms. Rev Saude Publica 2023; 57:76. [PMID: 37937650 PMCID: PMC10609648 DOI: 10.11606/s1518-8787.2023057004962] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2022] [Accepted: 12/19/2022] [Indexed: 11/09/2023] Open
Abstract
OBJECTIVE To verify whether folic acid supplementation during pregnancy is associated with the occurrence of maternal depressive symptoms at three months postpartum, in the 2015 Pelotas Birth Cohort. METHODS This study included 4,046 women, who were classified into three groups: did not use folic acid supplementation during pregnancy; used during only one trimester of pregnancy; and used for two or three trimesters. Depressive symptoms were assessed at three months postpartum using the Edinburgh Postnatal Depression Scale (EPDS), at cutoff points ≥ 10 (mild symptoms) and ≥ 13 (moderate to severe intensity). RESULTS The overall prevalence of mild symptoms was of 20.2% (95%CI 19.0-21.5), and moderate and severe was 11% (95%CI 10.0-12.0). The prevalence of EPDS ≥ 10 was of 26.8% (95%CI 24.0-29.5) among women who did not use folic acid and 18.1% for both those who used it during one trimester of pregnancy (95%CI 16.1-20.1) and those who used it for two or three trimesters (95%CI 16.0-20.2). The prevalence of EPDS ≥ 13 was of 15.7% (95%CI 13.5-17.9) in those who did not use folic acid, 9.1% (95%CI 7.5-10.6) in those who used it for one trimester, and 9.4% (95%CI 7.8-11.0) in those who used it for two or three trimesters. In the adjusted analyses, there was no statistically significant association between the use of folic acid during pregnancy and the occurrence of depressive symptoms at three months postpartum. CONCLUSION There was no association between folic acid supplementation during pregnancy and postpartum depression at three months.
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Affiliation(s)
- Bárbara Heather Lutz
- Universidade Federal de Pelotas . Departamento de Medicina Social . Programa de Pós-Graduação em Epidemiologia . Pelotas , RS , Brasil
| | - Iná da Silva Dos Santos
- Universidade Federal de Pelotas . Departamento de Medicina Social . Programa de Pós-Graduação em Epidemiologia . Pelotas , RS , Brasil
| | - Marlos Rodrigues Domingues
- Universidade Federal de Pelotas . Departamento de Medicina Social . Programa de Pós-Graduação em Epidemiologia . Pelotas , RS , Brasil
- Universidade Federal de Pelotas . Programa de Pós-Graduação em Educação Física . Pelotas , RS , Brasil
| | - Joseph Murray
- Universidade Federal de Pelotas . Departamento de Medicina Social . Programa de Pós-Graduação em Epidemiologia . Pelotas , RS , Brasil
| | - Mariângela Freitas da Silveira
- Universidade Federal de Pelotas . Departamento de Medicina Social . Programa de Pós-Graduação em Epidemiologia . Pelotas , RS , Brasil
| | - Vanessa Irribarem Avena Miranda
- Universidade Federal de Pelotas . Departamento de Medicina Social . Programa de Pós-Graduação em Epidemiologia . Pelotas , RS , Brasil
- Universidade do Extremo Sul Catarinense . Programa de Pós-graduação em Saúde Coletiva . Criciúma , SC , Brasil
| | - Marysabel Pinto Telis Silveira
- Universidade Federal de Pelotas . Departamento de Fisiologia e Farmacologia . Programa de Pós-Graduação Multicêntrico em Ciências Fisiológicas . Pelotas , RS , Brasil
| | - Sotero Serrate Mengue
- Universidade Federal do Rio Grande do Sul . Faculdade de Medicina . Programa de Pós-Graduação em Epidemiologia . Porto Alegr e, RS , Brasil
| | - Tatiane da Silva Dal Pizzol
- Universidade Federal do Rio Grande do Sul . Faculdade de Medicina . Programa de Pós-Graduação em Epidemiologia . Porto Alegr e, RS , Brasil
| | - Andréa Dâmaso Bertoldi
- Universidade Federal de Pelotas . Departamento de Medicina Social . Programa de Pós-Graduação em Epidemiologia . Pelotas , RS , Brasil
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Yang G, Hisada A, Yamamoto M, Kawanami A, Mori C, Sakurai K. Effect of nausea and vomiting during pregnancy on mother-to-infant bonding and the mediation effect of postpartum depression: the Japan Environment and Children's Study. BMC Pregnancy Childbirth 2023; 23:704. [PMID: 37784021 PMCID: PMC10544486 DOI: 10.1186/s12884-023-06014-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2023] [Accepted: 09/20/2023] [Indexed: 10/04/2023] Open
Abstract
BACKGROUND Mother-to-infant bonding (MIB) is critical for the health and well-being of the mother and child. Furthermore, MIB has been shown to boost the social-emotional development of infants, while also giving mothers a sense of happiness in raising their children. Nausea and vomiting during pregnancy (NVP) is a normal complication of pregnancy, occurring in approximately 50-90% of pregnant women in the early stages of pregnancy. Despite widespread knowledge of MIB and postpartum depression, little research attention has been given to the effects of NVP on MIB. This study aimed to investigate the relationship between NVP and MIB and the mediating effects of postpartum depression. METHODS We analyzed the data of 88,424 infants and 87,658 mothers from the Japan Environment and Children's Study (JECS), which is a government-funded nationwide birth prospective cohort study. The Japanese version of the Mother-to-Infant Bonding Scale (MIBS-J) was used to assess MIB, and the Edinburgh Postpartum Depression Scale (EPDS) was utilized to assess postpartum depression. We divided participants into four groups according to a self-reported questionnaire assessing NVP (No NVP, Mild NVP, Moderate NVP, and Severe NVP). MIB disorder was defined as a MIBS-J score ≥ 5. Logistic analysis was performed to evaluate the effect of NVP on MIB disorder at one year after delivery. A mediation analysis was conducted to examine whether postpartum depression mediated the association between NVP and MIBS-J scores. RESULTS The logistic regression analysis results revealed reduced risks of MIB disorder among mothers with Moderate NVP (adjusted OR 0.93; 95% confidence interval, 0.86-0.99) and Severe NVP (adjusted OR 0.81; 95% confidence interval, 0.74-0.89), compared to those with No NVP. The mediation analysis revealed that NVP positively correlated with MIBS-J score in the indirect effect via postpartum depression, while NVP (Mild NVP, Moderate NVP, and Severe NVP) negatively correlated with MIBS-J score in the direct effect. CONCLUSION The risks of MIB disorder were reduced in the Moderate NVP and Severe NVP mothers, although NVP inhibited the development of MIB via postpartum depression. The development of effective interventions for postpartum depression is important to improve MIB among mothers with NVP.
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Affiliation(s)
- Gui Yang
- Department of Nutrition and Metabolic Medicine, Center for Preventive Medical Sciences, Chiba University, 1-33 Yayoicho, Inageku, Chiba, Japan
| | - Aya Hisada
- Department of Sustainable Health Science, Center for Preventive Medical Sciences, Chiba University, 1-33 Yayoicho, Inageku, Chiba, Japan
| | - Midori Yamamoto
- Department of Sustainable Health Science, Center for Preventive Medical Sciences, Chiba University, 1-33 Yayoicho, Inageku, Chiba, Japan
| | - Akiko Kawanami
- Department of Sustainable Health Science, Center for Preventive Medical Sciences, Chiba University, 1-33 Yayoicho, Inageku, Chiba, Japan
| | - Chisato Mori
- Department of Sustainable Health Science, Center for Preventive Medical Sciences, Chiba University, 1-33 Yayoicho, Inageku, Chiba, Japan
- Department of Bioenvironmental Medicine, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-Ku, Chiba, Japan
| | - Kenichi Sakurai
- Department of Nutrition and Metabolic Medicine, Center for Preventive Medical Sciences, Chiba University, 1-33 Yayoicho, Inageku, Chiba, Japan.
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12
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Okun ML, Lac A. Postpartum Insomnia and Poor Sleep Quality Are Longitudinally Predictive of Postpartum Mood Symptoms. Psychosom Med 2023; 85:736-743. [PMID: 37506301 DOI: 10.1097/psy.0000000000001234] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/30/2023]
Abstract
OBJECTIVE Insomnia and poor sleep quality are frequently reported by perinatal women. Both are noted to increase the risk of postpartum depression, with less known about their association with postpartum anxiety. This study sought to assess whether perinatal sleep disturbances predicted depression and anxiety symptoms across each month of the first 6 months postpartum in women with a history of depression. METHODS Pregnant women without active depression at enrollment ( N = 159), 18 to 45 years of age, were recruited. In late pregnancy and for up to 6 months postpartum, women completed monthly online questionnaires including the Insomnia Symptom Questionnaire, Pittsburgh Sleep Quality Index, Edinburgh Postnatal Depression Scale, and Generalized Anxiety Disorder-7. Repeated-measures multilevel models were used to predict depression and anxiety across the postpartum. RESULTS The prevalence of insomnia was 20.4%, and the prevalence of poor sleep quality was 67.8% across the first 6 months postpartum. Postpartum insomnia and poor sleep quality at the between-subject and within-subject levels tended to uniquely predict greater depressive and anxiety symptoms, even after controlling for demographic characteristics, prenatal insomnia, and prenatal poor sleep quality. CONCLUSIONS Most of the women in our sample had sleep disturbances across the perinatal period. Consistent with the extant literature, postpartum insomnia and poor sleep quality, but not prenatal measures of sleep, longitudinally predicted greater postpartum depression and anxiety symptoms. The chronic sleep deprivation of insomnia and the subjective experience of poor sleep quality are uniquely relevant risks of postpartum mood disorders. Evaluation and mitigation of perinatal sleep disturbance are ideal opportunities to reduce postpartum mood disorders and subsequent health outcomes.
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Affiliation(s)
- Michele L Okun
- From the Biofrontiers Center (Okun) and Department of Psychology (Lac), University of Colorado Colorado Springs, Colorado Springs, Colorado
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13
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McNicholas E, Boama-Nyarko E, Julce C, Nunes AP, Flahive J, Byatt N, Moore Simas TA. Understanding Perinatal Depression Care Gaps by Examining Care Access and Barriers in Perinatal Individuals With and Without Psychiatric History. J Womens Health (Larchmt) 2023; 32:1111-1119. [PMID: 37582274 PMCID: PMC10541927 DOI: 10.1089/jwh.2022.0306] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/17/2023] Open
Abstract
Background: Depression affects one in seven perinatal individuals and remains underdiagnosed and undertreated. Individuals with a psychiatric history are at an even greater risk of perinatal depression, but it is unclear how their experiences with the depression care pathway may differ from individuals without a psychiatric history. Methods: We conducted a secondary analysis evaluating care access and barriers to care in perinatal individuals who screened positive for depression using the Edinburgh Postnatal Depression Scale (N = 280). Data were analyzed from the PRogram in Support of Moms (PRISM) study, a cluster randomized controlled trial of two interventions for perinatal depression. Results: Individuals with no prepregnancy psychiatric history (N = 113), compared with those with a history (N = 167), were less likely to be screened for perinatal depression, and less likely to be offered a therapy referral, although equally likely to attend if referred. When examining how these differences affected outcomes, those without a psychiatric history had 46% lower odds of attending therapy (95% confidence interval [CI]: 0.19-1.55), 79% lower odds of taking medication (95% CI: 0.08-0.54), and 80% lower odds of receiving any depression care (95% CI: 0.08-0.47). Barriers were similar across groups, except for concerns regarding available treatments and beliefs about self-resolution of symptoms, which were more prevalent in individuals without a psychiatric history. Conclusions: Perinatal individuals without a prepregnancy psychiatric history were less likely to be screened, referred, and treated for depression. Differences in screening and referrals resulted in missed opportunities for care, reinforcing the urgent need for universal mental health screening and psychoeducation during the perinatal period. Clinical Trial Registration No.: NCT02935504.
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Affiliation(s)
- Eileen McNicholas
- Department of Obstetrics and Gynecology, T.H. Chan School of Medicine, University of Massachusetts Chan Medical School, Worcester, Massachusetts, USA
- Department of Population and Quantitative Health Sciences, Morningside Graduate School of Biomedical Sciences, University of Massachusetts Chan Medical School, Worcester, Massachusetts, USA
| | - Esther Boama-Nyarko
- Department of Obstetrics and Gynecology, T.H. Chan School of Medicine, University of Massachusetts Chan Medical School, Worcester, Massachusetts, USA
- Department of Population and Quantitative Health Sciences, Morningside Graduate School of Biomedical Sciences, University of Massachusetts Chan Medical School, Worcester, Massachusetts, USA
| | - Clevanne Julce
- Department of Obstetrics and Gynecology, T.H. Chan School of Medicine, University of Massachusetts Chan Medical School, Worcester, Massachusetts, USA
- Department of Population and Quantitative Health Sciences, Morningside Graduate School of Biomedical Sciences, University of Massachusetts Chan Medical School, Worcester, Massachusetts, USA
| | - Anthony P. Nunes
- Department of Obstetrics and Gynecology, T.H. Chan School of Medicine, University of Massachusetts Chan Medical School, Worcester, Massachusetts, USA
- Department of Population and Quantitative Health Sciences, Morningside Graduate School of Biomedical Sciences, University of Massachusetts Chan Medical School, Worcester, Massachusetts, USA
| | - Julie Flahive
- Department of Obstetrics and Gynecology, T.H. Chan School of Medicine, University of Massachusetts Chan Medical School, Worcester, Massachusetts, USA
- Department of Population and Quantitative Health Sciences, Morningside Graduate School of Biomedical Sciences, University of Massachusetts Chan Medical School, Worcester, Massachusetts, USA
| | - Nancy Byatt
- Department of Obstetrics and Gynecology, T.H. Chan School of Medicine, University of Massachusetts Chan Medical School, Worcester, Massachusetts, USA
- Department of Psychiatry, T.H. Chan School of Medicine, University of Massachusetts Chan Medical School, Worcester, Massachusetts, USA
- Department of Population and Quantitative Health Sciences, Morningside Graduate School of Biomedical Sciences, University of Massachusetts Chan Medical School, Worcester, Massachusetts, USA
| | - Tiffany A. Moore Simas
- Department of Obstetrics and Gynecology, T.H. Chan School of Medicine, University of Massachusetts Chan Medical School, Worcester, Massachusetts, USA
- Department of Psychiatry, T.H. Chan School of Medicine, University of Massachusetts Chan Medical School, Worcester, Massachusetts, USA
- Department of Population and Quantitative Health Sciences, Morningside Graduate School of Biomedical Sciences, University of Massachusetts Chan Medical School, Worcester, Massachusetts, USA
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14
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Sileo F, Osinga JAJ, Visser WE, Jansen TA, Bramer WM, Derakhshan A, Citterio V, Tiemeier H, Persani L, Korevaar TIM. Association of gestational thyroid function and thyroid peroxidase antibody positivity with postpartum depression: a prospective cohort study and systematic literature review with meta-analysis. Eur J Endocrinol 2023; 189:S26-S36. [PMID: 37486224 DOI: 10.1093/ejendo/lvad092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Revised: 04/26/2023] [Accepted: 05/24/2023] [Indexed: 07/25/2023]
Abstract
IMPORTANCE Postpartum depression (PPD) has a major impact on maternal and offspring well-being, with multiple possible risk factors: Studies on the association of thyroid peroxidase antibody (TPOAb) positivity and thyroid function with PPD provide heterogeneous results. OBJECTIVE To study the association of thyroid function and TPOAb positivity with PPD. DESIGN We assessed the association of TPOAb and thyroid function with PPD in a population-based prospective cohort study and performed a systematic literature review and meta-analysis. METHODS We measured thyroid stimulating hormone (TSH), free thyroxine (FT4), and TPOAb between 9- and 17-week gestation. Postpartum depression was assessed with Edinburgh Postpartum Depression Scale at 2-month postpartum and Brief Symptom Inventory at 2-, 6-, and 36-month postpartum. Additionally, we performed a systematic literature review and meta-analysis assessing this association. RESULTS In the present study, there was no association of thyroid function with PPD (TSH: odds ratio [OR] 0.83, 95% CI 0.58-1.19, P = .32; FT4: OR 0.99, 95% CI 0.95-1.05, P = .86) or TPOAb positivity with PPD (OR 0.79, 95% CI 0.47-1.33, P = .37). An impaired thyroidal response to human chorionic gonadotropin (hCG), a surrogate marker for TPOAb positivity, was associated with a lower risk of PPD (P for interaction TSH = 0.04; FT4 = 0.06). Our systematic review and meta-analysis included 3 articles that were combined with the present study. There was no statistically significant association of TPOAb positivity with PPD (OR 1.93, 95% CI 0.91-4.10, P = .08), but the results were heterogeneous (I2 = 79%). CONCLUSIONS AND RELEVANCE There was no significant association of TPOAb positivity, TSH, or FT4 with PPD. Our systematic review and meta-analysis revealed high heterogeneity of the current literature. Although TPOAb-positive women should be monitored for postpartum thyroiditis, our findings do not support routinely screening for PPD.
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Affiliation(s)
- Federica Sileo
- Department of Medical Biotechnology and Translational Medicine, University of Milan, Milan 20100, Italy
- Lab of Endocrine and Metabolic Research, Department of Endocrine and Metabolic Diseases, IRCCS Istituto Auxologico Italiano, Milan 20149, Italy
| | - Joris A J Osinga
- Department of Internal Medicine, Erasmus Medical Center, Rotterdam 3000 CA, The Netherlands
- Academic Center for Thyroid Diseases, Erasmus Medical Center, Rotterdam 3000 CA, The Netherlands
| | - W Edward Visser
- Department of Internal Medicine, Erasmus Medical Center, Rotterdam 3000 CA, The Netherlands
- Academic Center for Thyroid Diseases, Erasmus Medical Center, Rotterdam 3000 CA, The Netherlands
| | - Toyah A Jansen
- Department of Internal Medicine, Erasmus Medical Center, Rotterdam 3000 CA, The Netherlands
- Academic Center for Thyroid Diseases, Erasmus Medical Center, Rotterdam 3000 CA, The Netherlands
| | - Wichor M Bramer
- Medical Library, Erasmus MC-Erasmus University Medical Center, Rotterdam 3000 CA, The Netherlands
| | - Arash Derakhshan
- Department of Internal Medicine, Erasmus Medical Center, Rotterdam 3000 CA, The Netherlands
- Academic Center for Thyroid Diseases, Erasmus Medical Center, Rotterdam 3000 CA, The Netherlands
| | - Valeria Citterio
- Department of Medical Biotechnology and Translational Medicine, University of Milan, Milan 20100, Italy
- Lab of Endocrine and Metabolic Research, Department of Endocrine and Metabolic Diseases, IRCCS Istituto Auxologico Italiano, Milan 20149, Italy
| | - Henning Tiemeier
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus University Medical Center, Rotterdam 3000 CA, The Netherlands
- Department of Social and Behavioral Science, Harvard TH Chan School of Public Health, Boston, MA 02115, USA
| | - Luca Persani
- Department of Medical Biotechnology and Translational Medicine, University of Milan, Milan 20100, Italy
- Lab of Endocrine and Metabolic Research, Department of Endocrine and Metabolic Diseases, IRCCS Istituto Auxologico Italiano, Milan 20149, Italy
| | - Tim I M Korevaar
- Department of Internal Medicine, Erasmus Medical Center, Rotterdam 3000 CA, The Netherlands
- Academic Center for Thyroid Diseases, Erasmus Medical Center, Rotterdam 3000 CA, The Netherlands
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15
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Laifer LM, DiLillo D, Brock RL. Prenatal negative affectivity and trauma-related distress predict mindful parenting during toddler age: Examining parent-infant bonding as a mechanism. Dev Psychopathol 2023; 35:1036-1050. [PMID: 34649640 DOI: 10.1017/s0954579421000894] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Despite findings demonstrating the importance of parental present-centered awareness, factors undermining mindful parenting have received less attention. Increasingly, evidence points to parental psychopathology as a salient risk factor for parenting difficulties. Thus, the goal of the present study was to investigate specific dimensions of parental trauma-related distress and general negative affectivity during pregnancy as predictors of mindful parenting during toddler age. Parental psychopathology, parent-infant bonding, and mindful parenting were assessed in a sample of heterosexual couples (N = 159) across four waves of data collection spanning pregnancy to child age two. Data were analyzed using path analysis within a dyadic framework. Results demonstrated the unique impact of maternal trauma-related distress during pregnancy (e.g., intrusions and avoidance) on facets of mindful parenting more than two years later. Further, among both mothers and fathers, general negative affectivity common across internalizing disorders undermined mindful parenting through impaired parent-infant bonding. Findings highlight the need for early intervention efforts that incorporate mindfulness strategies to reduce subthreshold symptoms of prenatal psychopathology, promote healthy bonding, and improve parental awareness and self-regulation, thereby enhancing the overall parent-child relationship.
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16
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Benton M, Davies M, Ismail K, Lenzi J. Gestational diabetes mellitus and its impact on the mother-infant relationship: A cohort study in the postnatal period. Prev Med Rep 2023; 34:102270. [PMID: 37334211 PMCID: PMC10272488 DOI: 10.1016/j.pmedr.2023.102270] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Revised: 05/29/2023] [Accepted: 05/30/2023] [Indexed: 06/20/2023] Open
Abstract
Women with gestational diabetes mellitus (GDM) are at increased risk of poor perinatal mental health outcomes. However, the association between GDM and the mother-infant relationship is unclear. This study aimed to examine whether GDM itself impacts the mother-infant relationship and maternal mental health using a cohort study design. We used data from the Cohort of Newborns in Emilia-Romagna (CoNER) study, which included 642 women recruited in Bologna, Italy. Psychological data were collected at 6 and 15 months postnatally using a purpose designed measure to examine the mother-infant relationship. We used linear fixed effects and mixed-effects models to assess the effect of GDM on relationship scores at 6 and 15 months postpartum. Women with GDM had significantly lower relationship scores at 15 months postpartum [β - 1.75 95% CrI (-3.31; -0.21)] but not at 6 months [β - 0.27 95% CrI (-1.37; 0.81)]. Mother-infant relationship scores were significantly lower overall at 15 months compared to 6 months postpartum [β - 0.29 95% CrI (-0.56; -0.02)]. Our findings suggest that there may be a delayed effect on the mother-infant relationship in response to the experience of GDM. Future research using large birth cohorts should investigate this further to confirm these findings, and whether women with GDM would benefit from early interventions to improve relationships taking into account length of time postpartum.
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Affiliation(s)
- Madeleine Benton
- Department of Psychological Medicine, King’s College London, United Kingdom
| | - Megan Davies
- Section of Epidemiology, University Copenhagen, Denmark
| | - Khalida Ismail
- Department of Psychological Medicine, King’s College London, United Kingdom
| | - Jacopo Lenzi
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Italy
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17
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Dubner SE, Morales MC, Marchman VA, Shaw RJ, Travis KE, Scala M. Maternal mental health and engagement in developmental care activities with preterm infants in the NICU. J Perinatol 2023; 43:871-876. [PMID: 37046070 PMCID: PMC10096104 DOI: 10.1038/s41372-023-01661-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Revised: 03/16/2023] [Accepted: 03/21/2023] [Indexed: 04/14/2023]
Abstract
OBJECTIVE To examine associations between maternal mental health and involvement in developmental care in the NICU. STUDY DESIGN Mothers of infants born <32 weeks gestation (n = 135) were approached to complete mental health screening questionnaires at two weeks after admission. Mothers who completed screening (n = 55) were further classified as with (n = 19) and without (n = 36) elevated scores. Mothers' frequency, rate, and duration of developmental care activities were documented in the electronic health record. RESULTS 35% of screened mothers scored above the cutoff for clinical concern on ≥1 measure. No significant differences between the 3 groups were identified for rates, frequency, or amount of all developmental care, kangaroo care, and swaddled holding. CONCLUSION Elevated scores on maternal mental health questionnaires did not relate to developmental care. Maternal developmental care engagement may not indicate mental health status. Universal screening for psychological distress is required to accurately detect symptoms in mothers of hospitalized preterm infants.
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Affiliation(s)
- Sarah E Dubner
- Division of Developmental-Behavioral Pediatrics, Department of Pediatrics, Stanford University School of Medicine, Stanford, CA, USA
| | - Maya Chan Morales
- Division of Developmental-Behavioral Pediatrics, Department of Pediatrics, Stanford University School of Medicine, Stanford, CA, USA
| | - Virginia A Marchman
- Division of Developmental-Behavioral Pediatrics, Department of Pediatrics, Stanford University School of Medicine, Stanford, CA, USA
- Department of Psychology, Stanford University, Stanford, CA, USA
| | - Richard J Shaw
- Division of Child Psychiatry, Department of Psychiatry, Stanford University School of Medicine, Stanford, CA, USA
| | - Katherine E Travis
- Division of Developmental-Behavioral Pediatrics, Department of Pediatrics, Stanford University School of Medicine, Stanford, CA, USA
| | - Melissa Scala
- Division of Neonatal and Developmental Medicine, Department of Pediatrics, Stanford University School of Medicine, Stanford, CA, USA.
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18
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Ondrušová S. Breastfeeding and Bonding: A Surprising Role of Breastfeeding Difficulties. Breastfeed Med 2023. [PMID: 37219989 DOI: 10.1089/bfm.2023.0021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
Aims: To explore the role of breastfeeding difficulties in bonding. Background: Studies published to date yielded varying results regarding the relationship between breastfeeding and bonding. In qualitative studies, mothers often describe breastfeeding as a bonding experience and regard breastfeeding difficulties as challenging. Only one quantitative study explored the impact of breastfeeding difficulties on bonding. Methods: A cross-sectional method was used and a self-report questionnaire was administered to a convenience sample of mothers with infants aged 0-6 months. Results: We found that having problem-free breastfeeding versus breastfeeding associated with breastfeeding difficulties led to a difference in bonding quality. Experiencing any breastfeeding difficulties was associated with bonding impairment (p = 0.000, r = 0.174), especially in cases of breast engorgement (p = 0.016, r = 0.094), a nonlatching baby (p = 0.000, r = 0.179), perceived low milk supply (p = 0.004, r = 0.112), and fussing at the breast (p = 0.000, r = 0.215). We also found a difference in bonding impairment between exclusively breastfeeding and exclusively bottle-feeding mothers (p = 0.001), but only when taking into account breastfeeding difficulties. Conclusions: Breastfeeding is a complex interaction that can be associated with mother-infant bonding in various ways. We found that breastfeeding difficulties were linked to bonding impairment, whereas exclusive breastfeeding without the presence of breastfeeding difficulties was not. Strategies to help achieve exclusive breastfeeding and prevent and resolve breastfeeding difficulties may help mothers fulfill the bonding potential with their infant.
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Affiliation(s)
- Soňa Ondrušová
- Department of Psychology, Palacky University in Olomouc, Olomouc, Czech Republic
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Laifer LM, Maras OR, Sáez G, Gervais SJ, Brock RL. Self-objectification during the perinatal period: The role of body surveillance in maternal and infant wellbeing. SEX ROLES 2023; 88:459-473. [PMID: 37206990 PMCID: PMC10191413 DOI: 10.1007/s11199-023-01360-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/21/2023] [Indexed: 05/21/2023]
Abstract
Pregnancy represents a unique time during which women's bodies undergo significant physical changes (e.g., expanding belly, larger breasts, weight gain) that can elicit increased objectification. Experiences of objectification set the stage for women to view themselves as sexual objects (i.e., self-objectification) and is associated with adverse mental health outcomes. Although women may experience heightened self-objectification and behavioral consequences (such as body surveillance) due to the objectification of pregnant bodies in Western cultures, there are remarkably few studies examining objectification theory among women during the perinatal period. The present study investigated the impact of body surveillance, a consequence of self-objectification, on maternal mental health, mother-infant bonding, and infant socioemotional outcomes in a sample of 159 women navigating pregnancy and postpartum. Utilizing a serial mediation model, we found that mothers who endorsed higher levels of body surveillance during pregnancy reported more depressive symptoms and body dissatisfaction, which were associated with greater impairments in mother-infant bonding following childbirth and more infant socioemotional dysfunction at 1-year postpartum. Maternal prenatal depressive symptoms emerged as a unique mechanism through which body surveillance predicted bonding impairments and subsequent infant outcomes. Results highlight the critical need for early intervention efforts that not only target general depression, but also promote body functionality and acceptance over the Western "thin ideal" of attractiveness among expecting mothers.
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Affiliation(s)
- Lauren M. Laifer
- Department of Psychology, University of Nebraska-Lincoln, Lincoln, Nebraska, USA
| | - Olivia R. Maras
- Department of Psychology, Arizona State University, Tempe, Arizona, USA
| | - Gemma Sáez
- Department of Psychology and Anthropology, University of Extremadura, Badajoz, Spain
| | - Sarah J. Gervais
- Department of Psychology, University of Nebraska-Lincoln, Lincoln, Nebraska, USA
| | - Rebecca L. Brock
- Department of Psychology, University of Nebraska-Lincoln, Lincoln, Nebraska, USA
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20
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Döblin S, Seefeld L, Weise V, Kopp M, Knappe S, Asselmann E, Martini J, Garthus-Niegel S. The impact of mode of delivery on parent-infant-bonding and the mediating role of birth experience: a comparison of mothers and fathers within the longitudinal cohort study DREAM. BMC Pregnancy Childbirth 2023; 23:285. [PMID: 37098555 PMCID: PMC10127505 DOI: 10.1186/s12884-023-05611-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2022] [Accepted: 04/14/2023] [Indexed: 04/27/2023] Open
Abstract
BACKGROUND The association between mode of delivery (MOD) and parent-infant-bonding has only been studied in mothers and findings have been inconclusive. The aim of this study was to prospectively investigate how MOD relates to postpartum parent-infant-bonding in both mothers and fathers and whether these associations are mediated by birth experience. METHODS This study is part of the prospective cohort study "Dresden Study on Parenting, Work, and Mental Health" (DREAM). Our sample comprised N = 1,780 participants who completed quantitative questionnaires during pregnancy as well as 8 weeks and 14 months postpartum. MOD was dummy coded, contrasting spontaneous vaginal delivery against vaginal delivery induced by drugs, operative vaginal delivery, planned, and unplanned cesarean section. Parent-infant bonding and birth experience were assessed using validated scales. A moderated mediation analysis based on ordinary least square (OLS) regression and bootstrapped estimates was conducted, considering relevant confounding variables. RESULTS Compared to spontaneous vaginal delivery, all categories of MOD predicted more negative birth experiences in both parents. A more positive birth experience predicted stronger parent-infant-bonding at 8 weeks, but not at 14 months postpartum. Mothers who delivered via cesarean section (planned or unplanned) reported stronger parent-infant-bonding at 8 weeks and 14 months postpartum. In fathers, only unplanned cesarean section was associated with stronger parent-infant-bonding at 8 weeks postpartum. At 8 weeks postpartum, birth experience mediated the association between a vaginal delivery induced by drugs and a planned cesarean section and mother-infant-bonding and between a vaginal delivery induced by drugs, an operative vaginal delivery, and planned cesarean section and father-infant-bonding. At 14 months postpartum, birth experience mediated the association between a vaginal delivery induced by drugs, operative vaginal delivery, and planned cesarean section and parent-infant-bonding in both parents. CONCLUSIONS The results emphasize the importance of the birth experience for parent-infant-bonding in both mothers and fathers. Further research should address the mechanisms by which parents with an unplanned cesarean section establish stronger parent-infant-bonding compared to parents whose baby was delivered via spontaneous vaginal delivery, despite their overall more negative birth experiences.
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Affiliation(s)
- Svenja Döblin
- Institute and Policlinic of Occupational and Social Medicine, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
| | - Lara Seefeld
- Institute and Policlinic of Occupational and Social Medicine, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
- Department of Psychotherapy and Psychosomatic Medicine, Faculty of Medicine TU Dresden, Dresden, Germany
| | - Victoria Weise
- Institute and Policlinic of Occupational and Social Medicine, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
| | - Marie Kopp
- Institute and Policlinic of Occupational and Social Medicine, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
| | - Susanne Knappe
- Evangelische Hochschule Dresden (Ehs), University of Applied Sciences for Social Work, Education and Nursing, Dresden, Germany
| | - Eva Asselmann
- Faculty of Health, HMU Health and Medical University, Potsdam, Germany
| | - Julia Martini
- Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany
- Department of Psychiatry & Psychotherapy, Faculty of Medicine, Carl Gustav Carus University Hospital, Technische Universität Dresden, Dresden, Germany
| | - Susan Garthus-Niegel
- Institute and Policlinic of Occupational and Social Medicine, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany.
- Institute for Systems Medicine (ISM), Faculty of Medicine, Medical School Hamburg, Hamburg, Germany.
- Department of Childhood and Families, Norwegian Institute of Public Health, Oslo, Norway.
- Institute and Outpatient Clinics of Occupational and Social Medicine, Faculty of Medicine of the Technische Universität Dresden, Fetscherstraße 74, 01307, Dresden, Germany.
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Koire A, Nong YH, Cain CM, Greeley CS, Puryear L, Van Horne BS. Prenatal depression screening with postpartum follow-up in an integrated healthcare system identifies risks for positive screens and persistent depressive symptoms. JOURNAL OF AFFECTIVE DISORDERS REPORTS 2023. [DOI: 10.1016/j.jadr.2023.100509] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/25/2023] Open
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22
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Laifer LM, Maras OR, Sáez G, Gervais SJ, Brock RL. Self-objectification during the perinatal period: The role of body surveillance in maternal and infant wellbeing. RESEARCH SQUARE 2023:rs.3.rs-2714781. [PMID: 36993503 PMCID: PMC10055659 DOI: 10.21203/rs.3.rs-2714781/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/31/2023]
Abstract
Pregnancy represents a unique time during which women's bodies undergo significant physical changes (e.g., expanding belly, larger breasts, weight gain) that can elicit increased objectification. Experiences of objectification set the stage for women to view themselves as sexual objects (i.e., self-objectification) and is associated with adverse mental health outcomes. Although women may experience heightened self-objectification and behavioral consequences (such as body surveillance) due to the objectification of pregnant bodies in Western cultures, there are remarkably few studies examining objectification theory among women during the perinatal period. The present study investigated the impact of body surveillance, a consequence of self-objectification, on maternal mental health, mother-infant bonding, and infant socioemotional outcomes in a sample of 159 women navigating pregnancy and postpartum. Utilizing a serial mediation model, we found that mothers who endorsed higher levels of body surveillance during pregnancy reported more depressive symptoms and body dissatisfaction, which were associated with greater impairments in mother-infant bonding following childbirth and more infant socioemotional dysfunction at 1-year postpartum. Maternal prenatal depressive symptoms emerged as a unique mechanism through which body surveillance predicted bonding impairments and subsequent infant outcomes. Results highlight the critical need for early intervention efforts that not only target general depression, but also promote body functionality and acceptance over the Western "thin ideal" of attractiveness among expecting mothers.
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Frankham LJ, Thorsteinsson EB, Bartik W. The Impact of COVID-19 Related Distress on Antenatal Depression in Australia. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:4783. [PMID: 36981691 PMCID: PMC10049555 DOI: 10.3390/ijerph20064783] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Revised: 02/25/2023] [Accepted: 03/03/2023] [Indexed: 06/18/2023]
Abstract
Globally, the impact of COVID-19 on mental health has been significant. Pregnant women are known to be a vulnerable population in relation to mental health. In Australia, there was an unprecedented demand during the pandemic for mental health services, including services for pregnant women. Maternal mental health has unique and enduring features that can significantly shape a child's overall development and poor maternal mental health can have considerable social and economic costs. This cross-sectional study evaluated symptoms of antenatal depression and COVID-19-related distress in a sample of two hundred and sixty-nine pregnant women residing in Australia aged between 20 and 43 (M = 31.79, SD = 4.58), as part of a larger study. Social media advertising was used to recruit participants between September 2020 and November 2021. Prevalence rates for antenatal depression were found to be higher in this study (16.4%) compared with previous Australian prevalence rates (7%). COVID-19 distress in relation to having a baby during a COVID-19 outbreak significantly predicted symptoms of antenatal depression, B = 1.46, p < 0.001. Results from this study suggest that mothers and families may have increased mental health vulnerabilities as a consequence of the pandemic for some time yet.
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Li H. Maternal-Infant Attachment and its Relationships with Postpartum Depression, Anxiety, Affective Instability, Stress, and Social Support in a Canadian Community Sample. Psychiatr Q 2023; 94:9-22. [PMID: 36469258 DOI: 10.1007/s11126-022-10011-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2022] [Revised: 11/20/2022] [Accepted: 11/20/2022] [Indexed: 12/07/2022]
Abstract
As a crucial component of child development, maternal-infant attachment influences a child's cognitive, psychological, and social development. Maternal depression, anxiety, stress, and social support have been identified as risk factors for poor maternal-infant attachment in some studies, while others did not find such relationships. The aim of this study was to examine the associations of maternal-infant attachment with depression, anxiety, affective instability, stress, social support, and other variables in a community sample of Canadian postpartum women. A total of 108 Canadian postpartum women participated in this cross-sectional study. The Depression, Anxiety, and Stress Scale-21 (DASS-21) assessed depression, anxiety, and stress, and the Affective lability Scale-18 measured affective instability (AI). Multiple linear regression was conducted to examine the association between maternal-infant attachment and other variables. The findings revealed a significant association of maternal-infant attachment with postpartum depression, and infant temperament, while anxiety, AI, stress, and social support were not identified as predictors for maternal-infant attachment. The results implicate the importance of addressing maternal depression and maternal-infant attachment, consequently decreasing the risk for childhood psychopathology.
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Affiliation(s)
- Hua Li
- College of Nursing, University of Saskatchewan, 104 Clinic Place, Saskatoon, S7N 2Z4, Canada.
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Schaming C, Wendland J. Postnatal mental health during the COVID-19 pandemic: Impact on mothers' postnatal sense of security and on mother-to-infant bonding. Midwifery 2023; 117:103557. [PMID: 36473335 PMCID: PMC9678387 DOI: 10.1016/j.midw.2022.103557] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2022] [Revised: 10/08/2022] [Accepted: 11/20/2022] [Indexed: 11/23/2022]
Abstract
BACKGROUND The unprecedented COVID-19 pandemic context imposed new living conditions which greatly modified women's experience of the postpartum period and brought significant changes to postnatal care. OBJECTIVE The main objective of this study was to evaluate the impact of the COVID-19 pandemic context on maternal sense of security and on mother-to-child bonding in the postpartum. DESIGN This study had a mixed research design. We compared levels of mother-child bonding disturbances and of maternal emotional security amongst two samples of postnatal women recruited before and during the pandemic. Postnatal depression was also evaluated. A qualitative analysis of the participants' comments on the impact of the COVID-19 pandemic was performed with an open-coding approach. PARTICIPANTS Two samples of French-speaking mothers in the first six months after their childbirth, recruited before the pandemic (N=874) and during the pandemic (N=721). FINDINGS Mother-child bonding disturbances measured with PBQ and levels of emotional security levels evaluated with PPSSi did not differ significantly between the samples. A high prevalence of women at risk of postnatal depression was found in both samples. However, participants' comments on their postnatal experience during the pandemic contrasted with their quantitative data. Fears of contamination, social isolation, and lack of support were the main factors of insecurity. Lack of closeness with relatives and friends, limited presence of the partner in the maternity ward, and early interactions with the newborn with a mask appear to have altered mother-child bonding during this pandemic period. CONCLUSIONS AND IMPLICATIONS FOR PRACTICE The findings highlight the importance of considering social and environmental factors and needs when evaluating postnatal mental health and providing postnatal care to new mothers during a health crisis. Health services and professionals should pay particular attention to mothers' mental health and well-being and guarantee continuity of care to avoid parents' isolation in the sensitive postpartum period.
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Affiliation(s)
- Céline Schaming
- Université Paris Cité, Laboratoire de Psychopathologie et Processus de Santé, F-92100 Boulogne-Billancourt, France,Maternity, René Dubos Hospital, F-95303 Pontoise, France
| | - Jaqueline Wendland
- Université Paris Cité, Laboratoire de Psychopathologie et Processus de Santé, F-92100 Boulogne-Billancourt, France,Corresponding author at: University of Paris, Institute of Psychology, Psychopathology and Health Processes Laboratory, 71 Avenue Edouard Vaillant, 92774 Boulogne Billancourt, France
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Domek GJ, Heller Szafran L, Jimenez-Zambrano A, Silveira L. Impact on Maternal Postpartum Depressive Symptoms of a Primary Care Intervention Promoting Early Language: A Pilot Study. Matern Child Health J 2023; 27:346-355. [PMID: 36525167 DOI: 10.1007/s10995-022-03550-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/09/2022] [Indexed: 12/23/2022]
Abstract
OBJECTIVES Maternal depressive symptoms are an important risk factor for adverse child outcomes, especially in the perinatal period. We studied whether introducing finger puppets in the primary care setting to promote infant language improves maternal postpartum depressive symptoms. METHODS An intervention cohort was enrolled and given a finger puppet at the 2-month infant well visit. Two usual care cohorts were enrolled at either the 6- or 12-month well visit as part of a larger study. Depressive symptoms were assessed using the Edinburgh Postnatal Depression Scale (EPDS), which was administered by clinic providers as part of routine screening done at both the 2- and 4-month well visits. EPDS scores were obtained retrospectively through the electronic medical record. RESULTS Included mothers (n = 127) completed the EPDS at 2 and 4 months postpartum. Most children (83%) were on government-sponsored insurance. Mean EPDS scores and scores classified as possible depression (≥ 10) did not differ between cohorts. However, the change in scores between visits was significantly different for intervention (n = 46) compared to usual care (n = 81) participants (-1.1 vs. +0.4, p = 0.001). More intervention scores improved (n = 17, 37%) compared to usual care (n = 14, 17%), while more usual care scores worsened (n = 28, 35%) compared to intervention (n = 6, 13%) (p = 0.008). CONCLUSION Finger puppets introduced during infant primary care visits to support language-rich maternal-infant interactions may provide a simple, low-cost way to improve maternal postpartum depressive symptoms. Larger studies with more diverse populations are needed to determine if effects are replicable, generalizable, and translate into better clinical outcomes.
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Affiliation(s)
- Gretchen J Domek
- Department of Pediatrics, University of Colorado Anschutz Medical Campus, Aurora, CO, USA. .,Center for Global Health, Colorado School of Public Health, Mail Stop A090, 13199 E Montview Blvd, Suite 310, 80045, Aurora, CO, USA.
| | - Lauren Heller Szafran
- Center for Global Health, Colorado School of Public Health, Mail Stop A090, 13199 E Montview Blvd, Suite 310, 80045, Aurora, CO, USA
| | - Andrea Jimenez-Zambrano
- Center for Global Health, Colorado School of Public Health, Mail Stop A090, 13199 E Montview Blvd, Suite 310, 80045, Aurora, CO, USA.,Adult & Child Center for Outcomes Research & Delivery Science , University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Lori Silveira
- Department of Pediatrics, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
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Federica G, Renata T, Marzilli E. Parental Postnatal Depression in the Time of the COVID-19 Pandemic: A Systematic Review of Its Effects on the Parent-Child Relationship and the Child's Developmental Outcomes. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:2018. [PMID: 36767385 PMCID: PMC9915850 DOI: 10.3390/ijerph20032018] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/29/2022] [Revised: 01/17/2023] [Accepted: 01/18/2023] [Indexed: 06/18/2023]
Abstract
The international literature has shown that maternal and paternal postnatal depression (PND) is one of the most common mental illnesses in the perinatal period, with significant consequences for parent-infant relationships and infant development. The COVID-19 pandemic has increased the rates of prevalence of PND, exacerbating the mental health risk for new families. This systematic review aims to examine the effect of maternal and paternal PND on parent-infant relationships and children's development in the first 36 months after childbirth during the COVID-19 outbreak. Eligible studies were identified using the following databases: Medline, CINAHL, SCOPUS, PsycINFO, PsycARTICLES, ScienceDirect, and Web of Science. Of the 1252 studies considered, 10 studies met the inclusion criteria. Results showed that maternal PND significantly affected the quality of the early mother-infant relationship and the infant's motor, self-regulation, and socio-emotional development. In addition, the detrimental impact of maternal PND on the quality of early mother-infant relationships seems to become stronger as COVID-19 concerns increase. No studies included fathers. These findings strengthened the importance of planning targeted prevention and treatment strategies to prevent PND and its short- and long-term consequences, especially in the case of stressful and traumatic events. They also suggested the urgent need for further exploration of fathers.
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Affiliation(s)
- Genova Federica
- Department of Psychology “Renzo Canestrari”, University of Bologna, 40127 Bologna, Italy
| | - Tambelli Renata
- Department of Dynamic, Clinical & Health Psychology, Sapienza University of Rome, 00185 Rome, Italy
| | - Eleonora Marzilli
- Department of Dynamic, Clinical & Health Psychology, Sapienza University of Rome, 00185 Rome, Italy
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Psychosocial work stress and parent-child bonding during the COVID-19 pandemic: clarifying the role of parental symptoms of depression and aggressiveness. BMC Public Health 2023; 23:113. [PMID: 36647046 PMCID: PMC9841494 DOI: 10.1186/s12889-022-14759-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2022] [Accepted: 11/28/2022] [Indexed: 01/18/2023] Open
Abstract
BACKGROUND Parental work stress and impaired mental health seem to have intensified during the current COVID-19 pandemic. Both can have a negative impact on parent-child bonding: psychosocial work stress in the course of a spillover effect from work to family and symptoms of impaired mental health as part of a crossover effect from parent to child. This potentially affects the child's development in the long term. METHOD This cross-sectional study examined the relationship between psychosocial work stress and parent-child bonding during the early COVID-19 pandemic (May-June 2020). Symptoms of depression and aggressiveness were considered as mediators of this relationship. The sample consisted of employees in Eastern Germany (n = 380; 42.9% mothers, 57.1% fathers), aged 24-55 years, with children aged 0-36 months. RESULTS In the total sample, an association was only found after adjusting for potential confounders, indicating that higher psychosocial work stress is associated with weaker bonding between the parent and child (β = 0.148, p = .017, 95% CI [0.566, 5.614]). The separate analyses for mothers and fathers did not reveal a statistically significant relationship between psychosocial work stress and parent-child bonding. In the total sample, the higher the psychosocial work stress was, the higher were the parental symptoms of depression (β = 0.372, p < .001, 95% CI [3.417, 5.696]) and aggressiveness β = 0.254, p < .001, 95% CI [1.008, 3.208]). The mental health symptoms in turn were related to weaker parent-child bonding (symptoms of depression β = 0.320, p < .001, 95% CI [0.345, 0.749]; symptoms of aggressiveness β = 0.394, p < .001, 95% CI [0.697, 1.287]). The results furthermore suggested that parental mental health symptoms mediate the association between psychosocial work stress and parent-child bonding (symptoms of depression, ab = 2.491, 95% CI [1.472, 3.577] and of aggressiveness, ab = 2.091, 95% CI [1.147, 3.279]). The mediation effect was also found in the separate analyses for the mothers and fathers. DISCUSSION The results of this study during the early COVID-19 pandemic in Germany highlight the importance of prevention as well as intervention measures in relation to psychosocial work stress that may play a debilitating role in the context of family relationships. In addition, the results suggest that both employers and employees should be made aware of the importance of psychosocial work stress, as it can have a negative impact on mental health, which in turn may have a major influence on family relationships.
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Donovan J, Chiatti BD, McKeever A, Bloch JR, Gonzales MS, Birati Y. "Yes, I can bond." Reflections of autistic women's mothering experiences in the early postpartum period. WOMEN'S HEALTH (LONDON, ENGLAND) 2023; 19:17455057231175312. [PMID: 37209090 DOI: 10.1177/17455057231175312] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
Abstract
BACKGROUND Autism is a neurodevelopmental condition affecting communication and social interaction. Much of the research regarding childbirth and motherhood is focused on non-autistic women. Autistic mothers may experience challenges communicating their needs to health care professionals and find aspects of the hospital environment distressing, indicating a need for more informed practice. OBJECTIVE To describe the experiences of autistic women bonding with their newborns after delivery in an acute care setting. DESIGN The study used a qualitative interpretative description design with data analysis using the method described by Knafl and Webster. The study explored the women's childbirth experiences in the early postpartum period. METHOD Interviews were conducted using a semi-structured interview guide. The women were interviewed in a setting of their choosing and included in person meetings, meetings over Skype, over the telephone, or via Facebook messenger. Twenty-four women ages 29-65 years participated in the study. The women were from the United States, the United Kingdom, and Australia. All women gave birth to a healthy term newborn in an acute care setting. RESULTS Three major themes emerged from the data: having difficulty communicating, feeling stressed in an uncertain environment, and being an autistic mother. CONCLUSION The autistic mothers in the study expressed love and concern for their babies. Some women described needing more time to recover physically and emotionally before assuming care of the newborn. The stress of childbirth left them exhausted and the demands of caring for a newborn could be overwhelming for some women. Miscommunication during labor affected some of the women's ability to trust the nurses caring for them and, in two cases, left the women feeling judged as mothers.
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Maternal symptoms of depression and anxiety during the postpartum period moderate infants' neural response to emotional faces of their mother and of female strangers. COGNITIVE, AFFECTIVE & BEHAVIORAL NEUROSCIENCE 2022; 22:1370-1389. [PMID: 35799031 DOI: 10.3758/s13415-022-01022-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 06/17/2022] [Indexed: 01/27/2023]
Abstract
Affective exchanges between mothers and infants are key to the intergenerational transmission of depression and anxiety, possibly via adaptations in neural systems that support infants' attention to facial affect. The current study examined associations between postnatal maternal symptoms of depression, panic and social anxiety, maternal parenting behaviours, and infants' neural responses to emotional facial expressions portrayed by their mother and by female strangers. The Negative Central (Nc), an event-related potential component that indexes attention to salient stimuli and is sensitive to emotional expression, was recorded from 30 infants. Maternal sensitivity, intrusiveness, and warmth, as well as infant's positive engagement with their mothers, were coded from unstructured interactions. Mothers reporting higher levels of postnatal depression symptoms were rated by coders as less sensitive and warm, and their infants exhibited decreased positive engagement with the mothers. In contrast, postnatal maternal symptoms of panic and social anxiety were not significantly associated with experimenter-rated parenting behaviours. Additionally, infants of mothers reporting greater postnatal depression symptoms showed a smaller Nc to their own mother's facial expressions, whereas infants of mothers endorsing greater postnatal symptoms of panic demonstrated a larger Nc to fearful facial expressions posed by both their mother and female strangers. Together, these results suggest that maternal symptoms of depression and anxiety during the postpartum period have distinct effects on infants' neural responses to parent and stranger displays of emotion.
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Chang LY, Chiang TL. Family environment characteristics and sleep duration in children: Maternal mental health as a mediator. Soc Sci Med 2022; 314:115450. [PMID: 36257089 DOI: 10.1016/j.socscimed.2022.115450] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Revised: 09/13/2022] [Accepted: 10/08/2022] [Indexed: 11/18/2022]
Abstract
BACKGROUND Family environment is a key factor affecting children's health. However, little is known about whether and how the family environment affects sleep duration in children. This study investigated the effects of both physical and social characteristics of the family environment on sleep duration in children and determined whether these associations were mediated by maternal mental health. METHODS Data were obtained from the Taiwan Birth Cohort Study. A total of 19,400 children who completed 6-month, 18-month, 3-year, 5.5-year, and 8-year surveys were analyzed. The physical family environment characteristics were household crowding and housing quality. Family functioning was used as an indicator of family social environment. Multiple linear regression and path analysis were performed to test the hypotheses. RESULTS The children living in crowded households had shorter sleep durations (β = -0.03, p < .001). Superior housing quality and family functioning were associated with longer sleep durations (β = 0.04 and 0.02, respectively, ps < .01). The effects of housing quality and family functioning on sleep duration were mediated by maternal mental health. CONCLUSIONS Both physical and social characteristics of the family environment are critical to sleep duration in children. The effects of family environment characteristics on sleep duration in children are in part mediated by maternal mental health. Interventions to improve sleep during childhood by targeting the family environment may be more effective when maternal mental health is considered.
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Affiliation(s)
- Ling-Yin Chang
- Institute of Health Behaviors and Community Sciences, College of Public Health, National Taiwan University, Taipei, Taiwan.
| | - Tung-Liang Chiang
- Institute of Health Policy and Management, College of Public Health, National Taiwan University, Taipei, Taiwan
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Weinberg A. Pathways to depression: Dynamic associations between neural responses to appetitive cues in the environment, stress, and the development of illness. Psychophysiology 2022; 60:e14193. [PMID: 36256483 DOI: 10.1111/psyp.14193] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2022] [Revised: 09/14/2022] [Accepted: 09/21/2022] [Indexed: 11/30/2022]
Abstract
This review focuses on research my colleagues and I have conducted on etiological pathways to depression. Much of this work has focused on the measurement of neural responses to appetitive cues, using two event-related brain potential (ERP) components, the Late Positive Potential (LPP) and the Reward Positivity (RewP). Reductions in each of these components have been associated with current symptoms of depression, and in some cases have been shown to differentiate anxious from depressive phenotypes. In this review, I will describe three broad and related approaches we have taken in our research to address a series of interdependent issuess. The first attempts to understand different sources of variation in the LPP and RewP, and how these sources interact with one another. The second tries to identify whether variation in the processes measured by these ERP components might reflect a latent vulnerability to depression and its symptoms, that is evident prior to illness onset. And the third examines the possibility that the processes reflected in the LPP and RewP might play a mechanistic role in the development of depression.
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Affiliation(s)
- Anna Weinberg
- Department of Psychology, McGill University, Montreal, Quebec, Canada
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Association between maternal-infant bonding and depressive symptoms in Neonatal Intensive Care Unit mothers: A case-control study. ENFERMERIA INTENSIVA 2022; 33:165-172. [PMID: 36347799 DOI: 10.1016/j.enfie.2021.07.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2021] [Accepted: 07/20/2021] [Indexed: 11/07/2022]
Abstract
OBJECTIVES Maternal perinatal depression has been associated with impaired mother-infant bonding. The adverse effect of this impaired bonding has been reported. This study aimed to investigate and compare the posnatal depressive symptoms and the mother-infant bonding in a Neonatal Intensive Care Unit (NICU) and of mothers with healthy newborns respectively. Secondly, was to explore the association between depressive symptomatology and bonding in both groups. METHODS In this case study, mothers in the early pospartum period who gave birth in the same perinatal center of Greece were recruited to participate. The cases consisted of 88 mothers of neonates who were hospitalized in the NICU and controls were 100 mothers of full-term healthy neonates. For the collection of the data questionnaires including demographics and perinatal variables were used. For the bonding and posnatal assessment, the Mother to Infant Bonding Scale, the Postpartum Bonding Questionnaire, and the Hospital Anxiety and Depression Scale were used. RESULTS There was a significant difference between the mean of bonding scores of NICU mothers and the control group (t = -2.696, P = 0.008). NICU mothers presented lower scores in bonding with the newborn compared to the control group and presented higher depression scores compared to those of controls (χ2 = 28.588, P = 0.000). The depression scores were correlated with bonding scores in both groups. DISCUSSION A NICU admission has an impact on bonding and in some way interacts with maternal pospartum mental health, therefore more research is needed. CONCLUSIONS NICU mothers have been presented as more vulnerable than mothers of healthy infants since they expressed a lower mother-infant bonding and higher depression scores. The support of these vulnerable mothers and the facilitation of mother-infant bonding by the NICU staff is of utmost importance.
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Capistrano CG, Grande LA, McRae K, Phan KL, Kim P. Maternal socioeconomic disadvantage, neural function during volitional emotion regulation, and parenting. Soc Neurosci 2022; 17:276-292. [PMID: 35620995 PMCID: PMC10829500 DOI: 10.1080/17470919.2022.2082521] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2018] [Revised: 03/27/2022] [Indexed: 10/18/2022]
Abstract
The transition to becoming a mother involves numerous emotional challenges, and the ability to effectively keep negative emotions in check is critical for parenting. Evidence suggests that experiencing socioeconomic disadvantage interferes with parenting adaptations and alters neural processes related to emotion regulation. The present study examined whether socioeconomic disadvantage is associated with diminished neural activation while mothers engaged in volitional (i.e., purposeful) emotion regulation. 59 mothers, at an average of 4 months postpartum, underwent fMRI scanning and completed the Emotion Regulation Task (ERT). When asked to regulate emotions using reappraisal (i.e., Reappraise condition; reframing stimuli in order to decrease negative emotion), mothers with lower income-to-needs ratio exhibited dampened neural activation in the dorsolateral and ventrolateral PFC, middle frontal and middle temporal gyrus, and caudate. Without explicit instructions to down-regulate (i.e., Maintain condition), mothers experiencing lower income also exhibited dampened response in regulatory areas, including the middle frontal and middle temporal gyrus and caudate. Blunted middle frontal gyrus activation across both Reappraise and Maintain conditions was associated with reduced maternal sensitivity during a mother-child interaction task. Results of the present study demonstrate the influence of socioeconomic disadvantage on prefrontal engagement during emotion regulation, which may have downstream consequences for maternal behaviors.
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Affiliation(s)
| | - Leah A Grande
- Department of Psychology, University of Denver, Denver, CO, USA
| | - Kateri McRae
- Department of Psychology, University of Denver, Denver, CO, USA
| | - K Luan Phan
- Department of Psychiatry and Behavioral Health, The Ohio State University, Columbus, OH, USA
| | - Pilyoung Kim
- Department of Psychology, University of Denver, Denver, CO, USA
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35
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Koire A, Van Horne BS, Nong YH, Cain CM, Greeley CS, Puryear L. Patterns of peripartum depression screening and detection in a large, multi-site, integrated healthcare system. Arch Womens Ment Health 2022; 25:603-610. [PMID: 35332376 DOI: 10.1007/s00737-022-01223-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2021] [Accepted: 03/15/2022] [Indexed: 11/28/2022]
Abstract
The purpose of this study was to examine peripartum depression (PD) screening patterns within and across the prenatal and postpartum periods and assess the incidence of new positive screens during standard screening protocol timepoints to inform practice, particularly when limited screenings can be conducted.This is a retrospective observational study of women screened for PD through a large, integrated health system using the Edinburgh Postnatal Depression Scale (EPDS) within their obstetrics and pediatric practices. Pregnancies with an EPDS score for at least one obstetric and one pediatric appointment between November 2016 and October 2019 were included (n = 3240). The data were analyzed using chi-squared test, Student's t-test, and binary logistic regression analyses. An EPDS score of 10 or higher was considered a positive screen.The positive screening rate for this cohort was 18.5%, with a prenatal positive rate of 9.9% and a postpartum positive rate of 8.6%. Single relationship status showed a higher rate of PD overall. Two thirds of women were not screened until their third trimester, resulting in delayed detection for an estimated 28% of women who ultimately screened positive. Few new positive screens (1.3%) were detected after 9 weeks postpartum in women who had completed all recommended prior screens.Obstetric providers should screen for PD as early in pregnancy as possible and continue to screen as often as feasible regardless of previous negative EPDS scores. Prioritizing screening more often in pregnancy and before 9 weeks postpartum is optimal to avoid delays in detection and intervention.
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Affiliation(s)
- Amanda Koire
- Department of Psychiatry, Brigham and Women's Hospital, Boston, MA, USA.,Harvard Medical School, Boston, MA, USA
| | - Bethanie S Van Horne
- Department of Pediatrics, Baylor College of Medicine, 6621 Fannin Street, MC A2275, Houston, TX, 77030, USA. .,Division of Public Health Pediatrics, Texas Children's Hospital, 6621 Fannin Street, MC A2275, Houston, TX, USA.
| | - Yen H Nong
- Department of Pediatrics, Baylor College of Medicine, 6621 Fannin Street, MC A2275, Houston, TX, 77030, USA.,Division of Public Health Pediatrics, Texas Children's Hospital, 6621 Fannin Street, MC A2275, Houston, TX, USA
| | - Cary M Cain
- Department of Pediatrics, Baylor College of Medicine, 6621 Fannin Street, MC A2275, Houston, TX, 77030, USA.,Division of Public Health Pediatrics, Texas Children's Hospital, 6621 Fannin Street, MC A2275, Houston, TX, USA
| | - Christopher S Greeley
- Department of Pediatrics, Baylor College of Medicine, 6621 Fannin Street, MC A2275, Houston, TX, 77030, USA.,Division of Public Health Pediatrics, Texas Children's Hospital, 6621 Fannin Street, MC A2275, Houston, TX, USA
| | - Lucy Puryear
- Obstetrics and Gynecology, Menninger Department of Psychiatry, Baylor College of Medicine, 6651 Main Street, Houston, TX, USA
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Beato AF, Albuquerque S, Kömürcü Akik B, da Costa LP, Salvador Á. Do Maternal Self-Criticism and Symptoms of Postpartum Depression and Anxiety Mediate the Effect of History of Depression and Anxiety Symptoms on Mother-Infant Bonding? Parallel-Serial Mediation Models. Front Psychol 2022; 13:858356. [PMID: 35693484 PMCID: PMC9178241 DOI: 10.3389/fpsyg.2022.858356] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2022] [Accepted: 04/08/2022] [Indexed: 12/12/2022] Open
Abstract
Introduction History of depression symptoms, including before and during pregnancy, has been identified as an important risk factor for postpartum depression (PPD) symptoms. This condition has also been associated with diverse implications, namely, on the quality of mother-infant bonding. Moreover, the role of self-criticism on PPD has been recently found in several studies. However, the link between these factors has not been explored yet. Furthermore, anxiety symptoms in postpartum has been less studied. Methods This study analyzed whether the history of depression symptoms predicted mother-infant bonding, via self-criticism and PPD symptoms. The same model was repeated with a history of anxiety and postpartum anxiety symptoms. A total of 550 mothers of infants <24 months old participated in this cross-sectional study and answered an online survey. Results Through a parallel-serial mediation model, the results show that in a first step, self-criticism dimensions of inadequate-self, hated-self, and reassuring-self, and in a second step, PPD symptoms, mediate the relationship between the history of depression symptoms and mother-infant bonding. However, the relationship between the history of anxiety symptoms and bonding is not mediated by all the considered chain of mediators, being only mediated by one of the self-criticism dimensions, inadequate self. Conclusions The current study confirmed the association of history of both depression and anxiety with mother-infant bonding. While in the case of history of anxiety symptoms, the relation was only mediated by inadequate self-dimension of self-criticism, in the case of history of depression symptoms, the relation was mediated by self-criticism and postpartum depressive symptoms. The buffering effect of reassuring-self on bonding and negative affect was also evidenced. Psychological and preventive interventions should address this evidence to target interventions for mother-infant bonding problems in accordance with previous and actual current maternal risk factors.
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Affiliation(s)
- Ana Filipa Beato
- Digital Human-Environment Interaction Lab (HEI-Lab), Lusófona University, Lisbon, Portugal
| | - Sara Albuquerque
- Digital Human-Environment Interaction Lab (HEI-Lab), Lusófona University, Lisbon, Portugal
- Research Center in Neuropsychology and Cognitive Behavioral Intervention, Faculty of Psychology, University of Coimbra, Coimbra, Portugal
| | - Burcu Kömürcü Akik
- Department of Psychology, Faculty of Languages and History-Geography, Ankara University, Ankara, Turkey
| | | | - Ágata Salvador
- Digital Human-Environment Interaction Lab (HEI-Lab), Lusófona University, Lisbon, Portugal
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Armstrong VG, Ross J. The Experiences of Parents and Infants Using a Home-Based Art Intervention Aimed at Improving Wellbeing and Connectedness in Their Relationship. Front Psychol 2022; 13:732562. [PMID: 35664138 PMCID: PMC9161640 DOI: 10.3389/fpsyg.2022.732562] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Accepted: 04/25/2022] [Indexed: 11/16/2022] Open
Abstract
During the period of COVID-19 restrictions, we offered vulnerable families with 0 to 3 year old children boxes of art resources and guided creative activities to do together at home. This paper explores families' experiences of this intervention, highlighting their perceptions of change in wellbeing and attachment. There is a developing case for the social benefits of art, including the impact of arts on mental health and on the wellbeing of children. However, we know that social factors impact upon arts participation, and existing inequalities and mental health difficulties have been exacerbated in the context of the pandemic. This project aimed to adapt to restrictions, to provide a meaningful remote intervention, supporting parent-infant dyads to have positive interactions through art making. We sought to explore the benefits of this intervention for infants and parents with a view to understanding more about the psychological benefits of art participation and about ways to engage families into art making, as well as thinking about how best we can evidence these kinds of arts in health interventions. Preliminary findings showed promising outcomes from the art boxes and this paper brings together the full results, primarily based on interviews with sixteen parents and four referrers alongside collected feedback. We highlight potential mechanisms for change within the intervention and detail the perceived impact of the art boxes in supporting attachment. Parents felt that the art-boxes facilitated changes in their own wellbeing that would make them more available to connection, and recognised changes for babies that reflected their increased capacity to mentalise about their child. Importantly, there were also concrete changes for the dyad that represented improved connection, such as more playful time together and increased shared attention and eye contact. Our observations suggest that the quality of the parent-infant relationship benefited from home-based art intervention, and we speculate about the potential efficacy of this approach beyond the pandemic.
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38
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Huffhines L, Coe JL, Busuito A, Seifer R, Parade SH. Understanding links between maternal perinatal posttraumatic stress symptoms and infant socioemotional and physical health. Infant Ment Health J 2022; 43:474-492. [PMID: 35513001 PMCID: PMC9177799 DOI: 10.1002/imhj.21985] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2021] [Accepted: 02/02/2022] [Indexed: 11/10/2022]
Abstract
Maternal posttraumatic stress symptoms (PTSS) are associated with adverse consequences for older children, but very few studies have examined links between perinatal maternal PTSS and infant outcomes. Trauma exposure and psychopathology, including PTSS, is often heightened for women during pregnancy through 1 year postpartum. Therefore, the perinatal period may be a critical time for understanding the risk maternal PTSS and other mental health factors pose to the socioemotional and physical health of infants. The present study explored the relation between maternal PTSS and infant socioemotional and physical health problems in a sample of racially and ethnically diverse mother-infant dyads (N = 295) assessed prenatally and at 12 months postpartum. This study also examined whether there are: (1) moderating effects of maternal depressive symptoms and parenting stress on these associations and (2) indirect effects of PTSS on infant outcomes through observed maternal sensitivity. Results indicated that postpartum depressive symptoms and parenting stress, rather than PTSS, were associated with greater infant socioemotional health problems. However, prenatal PTSS were associated with greater infant physical health problems when mothers also reported clinically significant levels of postpartum depressive symptoms. Maternal sensitivity was not associated with maternal PTSS, depressive symptoms, or parenting stress, nor was it related to infant socioemotional and physical health; thus, maternal sensitivity was not tested as an intermediary mechanism linking maternal mental health with infant outcomes. Implications for promoting maternal mental health in the perinatal period to bolster socioemotional and physical health of infants are discussed.
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Affiliation(s)
- Lindsay Huffhines
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, Rhode Island, USA.,Bradley/Hasbro Children's Research Center, E.P. Bradley Hospital, East Providence, Rhode Island, USA
| | - Jesse L Coe
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, Rhode Island, USA.,Bradley/Hasbro Children's Research Center, E.P. Bradley Hospital, East Providence, Rhode Island, USA
| | - Alex Busuito
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, Rhode Island, USA
| | - Ronald Seifer
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, Rhode Island, USA.,Bradley/Hasbro Children's Research Center, E.P. Bradley Hospital, East Providence, Rhode Island, USA.,Frank Porter Graham Child Development Institute, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Stephanie H Parade
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, Rhode Island, USA.,Bradley/Hasbro Children's Research Center, E.P. Bradley Hospital, East Providence, Rhode Island, USA
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COVID-19 related worry moderates the association between postpartum depression and mother-infant bonding. J Psychiatr Res 2022; 149:83-86. [PMID: 35259664 PMCID: PMC8889491 DOI: 10.1016/j.jpsychires.2022.02.039] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2021] [Revised: 02/02/2022] [Accepted: 02/28/2022] [Indexed: 11/23/2022]
Abstract
The aim of this study was to ask whether a substantial external stressor, such as the COVID-19 pandemic, affects the association between postpartum depression (PPD) and mother-infant bonding. Specifically, we aimed to determine whether worry regarding such an external threat differentially affected PPD and bonding by analyzing a longitudinal sample of postpartum women assessed before and during the pandemic. One-hundred forty women responded to online questionnaires at (T1) Pre-COVID-19: Six months postpartum (February 2018 to December 2019), and (T2) During COVID-19: Twenty-one months postpartum (April 2020 to January 2021). The strength of correlation between mother-infant bonding and PPD significantly declined from before (T1: R = 0.64, p < 0.00) to during the pandemic (T2: R = 0.44, p < 0.001; Difference = 0.20, p = 0.05). Furthermore, only PPD correlated with the worry due to the pandemic; thus the PPD-bonding association was weaker among women who were less concerned about the pandemic (F(3, 136) = 15.4, R2 = 0.25). The study suggests that emotions and cognitions related to motherhood, such as mother-infant bonding, may be more resilient to external pressures such as a pandemic than affective states such as PPD. (174 words).
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40
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Nasreen HE, Pasi HB, Aris MAM, Rahman JA, Rus RM, Edhborg M. Impact of parental perinatal depressive and anxiety symptoms trajectories on early parent-infant impaired bonding: a cohort study in east and west coasts of Malaysia. Arch Womens Ment Health 2022; 25:377-387. [PMID: 34313824 DOI: 10.1007/s00737-021-01165-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2021] [Accepted: 07/18/2021] [Indexed: 10/20/2022]
Abstract
The association between maternal depressive and anxiety symptoms and impaired bonding with infants were widely studied, but not in fathers and none in Malaysia. We investigated the impact of different trajectories of perinatal depressive and anxiety symptoms on parent-infant impaired bonding during 2-3 months postpartum in both mothers and fathers in two areas of Malaysia. This study originated from a psychiatric morbidity cohort study carried out in health clinics in east and west Malaysia. Edinburgh Postnatal Depression Scale and anxiety subscale of Depression, Anxiety, and Stress Scale at late pregnancy and 2-3 months postpartum and Postpartum Bonding Questionnaire were completed by 566 mothers and 457 fathers. About 11.7% mothers and 16.1% fathers reported depressive symptoms during pregnancy, 6.5% mothers and 10.5% fathers during 2-3 months postpartum, and 3-4% mothers and fathers both depressive and anxiety symptoms 2-3 months postpartum. The mean impaired bonding score was highest in mothers and fathers who had both depressive and anxiety symptoms 2-3 months postpartum. Impaired bonding is associated with higher EPDS and DASS (anxiety subscale) scores 2-3 months postpartum in both parents. Physical partner violence and deteriorated marital relationship were associated with increased risk of impaired bonding in mothers. The association between depressive, anxiety, and comorbidity of depressive and anxiety symptoms in both mothers and fathers and parent-infant impaired bonding during 2-3 months postpartum urges for screening and treatment of depressive and anxiety symptoms in both parents during early parenthood.
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Affiliation(s)
- Hashima E Nasreen
- Department of Community Medicine, Faculty of Medicine, International Islamic University Malaysia, Jalan Sultan Ahmad Shah, 25200, Kuantan, Pahang, Malaysia.
| | - Hafizah Binti Pasi
- Department of Community Medicine, Faculty of Medicine, International Islamic University Malaysia, Jalan Sultan Ahmad Shah, 25200, Kuantan, Pahang, Malaysia
| | - Mohd Aznan Md Aris
- Department of Family Medicine, Faculty of Medicine, International Islamic University Malaysia, Jalan Sultan Ahmad Shah, 25200, Kuantan, Pahang, Malaysia
| | - Jamalludin Ab Rahman
- Department of Community Medicine, Faculty of Medicine, International Islamic University Malaysia, Jalan Sultan Ahmad Shah, 25200, Kuantan, Pahang, Malaysia
| | - Razman Mohd Rus
- Department of Community Medicine, Faculty of Medicine, International Islamic University Malaysia, Jalan Sultan Ahmad Shah, 25200, Kuantan, Pahang, Malaysia
| | - Maigun Edhborg
- Department of Neurobiology, Care Sciences and Society, Karolinska Institute, 141 83 Huddinge, Stockholm, Sweden
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41
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Reid HE, Pratt D, Edge D, Wittkowski A. Maternal Suicide Ideation and Behaviour During Pregnancy and the First Postpartum Year: A Systematic Review of Psychological and Psychosocial Risk Factors. Front Psychiatry 2022; 13:765118. [PMID: 35401283 PMCID: PMC8987004 DOI: 10.3389/fpsyt.2022.765118] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2021] [Accepted: 02/14/2022] [Indexed: 11/13/2022] Open
Abstract
Suicide is a leading cause of maternal death during pregnancy and up to a year after birth (perinatal period). Many psychological and psychosocial risk factors for maternal suicidal ideation and behaviour have been investigated. Despite this, there have been no attempts to systematically search the literature on these risk factors. Additionally, few studies have described how the risk factors for suicidal ideation, attempted suicides and suicide deaths differ, which is essential for the development of tools to detect and target suicidal ideation and behaviour. Seven databases were searched up to June 2021 for studies that investigated the association between suicidal ideation and/or suicidal behaviour and psychological/psychosocial risk factors in pregnant and postpartum women. The search identified 17,338 records, of which 59 were included. These 59 studies sampled a total of 49,929 participants and investigated 32 different risk factors. Associations between abuse, experienced recently or during childhood, and maternal suicide ideation, attempted suicide and death were consistently reported. Social support was found to be less associated with suicide ideation but more so with suicide attempts. Identifying women who have experienced domestic violence or childhood abuse and ensuring all women have adequate emotional and practical support during the perinatal period may help to reduce the likelihood of suicidal behaviour.
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Affiliation(s)
- Holly E. Reid
- Division of Psychology and Mental Health, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, United Kingdom
- Manchester Academic Health Science Centre, Manchester, United Kingdom
| | - Daniel Pratt
- Division of Psychology and Mental Health, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, United Kingdom
- Manchester Academic Health Science Centre, Manchester, United Kingdom
- Greater Manchester Mental Health NHS Foundation Trust, Manchester, United Kingdom
| | - Dawn Edge
- Division of Psychology and Mental Health, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, United Kingdom
- Manchester Academic Health Science Centre, Manchester, United Kingdom
| | - Anja Wittkowski
- Division of Psychology and Mental Health, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, United Kingdom
- Manchester Academic Health Science Centre, Manchester, United Kingdom
- Greater Manchester Mental Health NHS Foundation Trust, Manchester, United Kingdom
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42
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Creech SK, Kroll‐Desrosiers A, Benzer JK, Pulverman CS, Mattocks K. The impact of military sexual trauma on parent-infant bonding in a sample of perinatal women veterans. Depress Anxiety 2022; 39:201-210. [PMID: 34633137 PMCID: PMC9044465 DOI: 10.1002/da.23218] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Revised: 08/23/2021] [Accepted: 09/25/2021] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND The experience of sexual assault and harassment during military service (military sexual trauma [MST]) is associated with increased risk for perinatal and reproductive health problems among women veterans. The objective of this study was to examine the associations between mothers' MST exposure and mother-infant bonding, as well as to examine whether there are any salient sociodemographic or military service characteristics among women veterans with greater impairment to mother-infant bonding, including stress during pregnancy and posttraumatic stress disorder (PTSD) diagnosis. METHODS This study was a secondary analysis of data collected from prospective, longitudinal study of women veterans using VHA maternity care benefits at 15 VHA medical centers across the US between January 2016 and February 2020. Participants were 697 pregnant veterans using VHA maternity care benefits. RESULTS MST was associated with higher maternal depression, and higher maternal depression was associated with poorer mother-infant bonding. The effect of MST on bonding was indirect through depression. PTSD diagnosis and life stressors during pregnancy also had significant indirect pathways with bonding through maternal depression. CONCLUSIONS Results underscore the need for access to high quality and trauma-informed perinatal mental health treatment for women veterans, for education on the unique risks conveyed by MST provided to civilian providers treating this population outside VA, and for further research to understand how to ameliorate the harmful effects of MST on perinatal women veterans and their children.
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Affiliation(s)
- Suzannah K. Creech
- VHA VISN 17 Center of Excellence for Research on Returning War Veterans and the Central Texas Veterans Health Care SystemWacoTexasUSA,Department of Psychiatry and Behavioral SciencesDell Medical School of the University of Texas at AustinAustinTexasUSA
| | - Aimee Kroll‐Desrosiers
- VA Central Western Massachusetts Healthcare SystemLeedsMassachusettsUSA,Departments of Population and Quantitative Health Sciences and PsychiatryUniversity of Massachusetts Medical SchoolWorcesterMassachusettsUSA
| | - Justin K. Benzer
- VHA VISN 17 Center of Excellence for Research on Returning War Veterans and the Central Texas Veterans Health Care SystemWacoTexasUSA,Department of Psychiatry and Behavioral SciencesDell Medical School of the University of Texas at AustinAustinTexasUSA
| | - Carey S. Pulverman
- VHA VISN 17 Center of Excellence for Research on Returning War Veterans and the Central Texas Veterans Health Care SystemWacoTexasUSA,Department of Psychiatry and Behavioral SciencesDell Medical School of the University of Texas at AustinAustinTexasUSA
| | - Kristin Mattocks
- VA Central Western Massachusetts Healthcare SystemLeedsMassachusettsUSA,Departments of Population and Quantitative Health Sciences and PsychiatryUniversity of Massachusetts Medical SchoolWorcesterMassachusettsUSA
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43
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Liu CH, Hyun S, Mittal L, Erdei C. Psychological risks to mother-infant bonding during the COVID-19 pandemic. Pediatr Res 2022; 91:853-861. [PMID: 34645943 PMCID: PMC9008072 DOI: 10.1038/s41390-021-01751-9] [Citation(s) in RCA: 22] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Revised: 03/09/2021] [Accepted: 04/20/2021] [Indexed: 11/13/2022]
Abstract
BACKGROUND The purpose of this study was to examine the association between mental health symptoms, along with psychological experiences and coronavirus disease 2019 (COVID-19) related concerns, and self-reported maternal-infant bonding experiences of postpartum women. METHODS Using data collected from May 19 to August 17, 2020, this cross-sectional online study assessed 429 women to better understand the impact of the COVID-19 pandemic on women during the postpartum period. Enrolled respondents were asked to participate in a 30-45-min online survey about COVID-19-related experiences, pregnancy, stress, and well-being. RESULTS Postpartum women's depressive symptoms were related to lower quality maternal-infant bonding, but the anxiety symptoms were not associated with bonding. Maternal self-efficacy, but not social support, was associated with mothers' higher quality of maternal-infant bonding. COVID-19-related grief was significantly associated with lower quality bonding. On the other hand, COVID-19-related health worries were associated with higher quality of maternal-infant bonding. CONCLUSIONS We describe potential psychological risk factors to maternal-infant bonding among postpartum women during the pandemic period. To best support the medical and psychological well-being of the mothers and infants, enhanced interdisciplinary partnerships among perinatal healthcare professionals involved in primary and/or specialty care is needed. IMPACT Unique COVID-19-related health and grief concerns exist, with implications for maternal-infant bonding. Depression but not anxiety is associated with lower maternal-infant bonding. Caregiving confidence, but not social support, is associated with higher maternal-infant bonding. It is critical to screen for postpartum depression and COVID-19-related grief during maternal follow-up and pediatric visits. Study findings inform and prioritize pediatric interventions toward enhancing maternal-infant bonding during the COVID-19 era.
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Affiliation(s)
- Cindy H. Liu
- Department of Newborn Medicine, Brigham and Women’s Hospital, Boston, MA,Department of Psychiatry, Brigham and Women’s Hospital, Boston, MA,Harvard Medical School, Boston, MA,Corresponding Author: Cindy H. Liu, PhD, Brigham and Women’s Hospital, Harvard Medical School, 221 Longwood Avenue, Boston, MA 02115, USA, Tel: 617-525-4131, Fax: 617-582-6026,
| | - Sunah Hyun
- Department of Newborn Medicine, Brigham and Women’s Hospital, Boston, MA,Harvard Medical School, Boston, MA
| | - Leena Mittal
- Department of Psychiatry, Brigham and Women’s Hospital, Boston, MA,Harvard Medical School, Boston, MA
| | - Carmina Erdei
- Department of Newborn Medicine, Brigham and Women’s Hospital, Boston, MA,Harvard Medical School, Boston, MA
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44
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Glenn Fowler M, Boivin MJ, Familiar I, Nyangoma B. Central Nervous System and Neurodevelopmental Outcomes of HIV+ and HIV exposed children: A Mini Review of Recent Findings and Lessons Learned from the Field. Neurosci Lett 2022; 775:136501. [PMID: 35122932 DOI: 10.1016/j.neulet.2022.136501] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Revised: 01/11/2022] [Accepted: 01/28/2022] [Indexed: 12/11/2022]
Affiliation(s)
- Mary Glenn Fowler
- Dept of Pathology, Johns Hopkins U. School of Medicine Baltimore MD, USA; Dept of PsychiatryMichigan State U. East Lansing, MI, USA; Makerere U. Johns Hopkins U. Research Collaboration, USA; Kampala Uganda
| | - Michael J Boivin
- Dept of Pathology, Johns Hopkins U. School of Medicine Baltimore MD, USA; Dept of PsychiatryMichigan State U. East Lansing, MI, USA; Makerere U. Johns Hopkins U. Research Collaboration, USA; Kampala Uganda
| | - Itziar Familiar
- Dept of Pathology, Johns Hopkins U. School of Medicine Baltimore MD, USA; Dept of PsychiatryMichigan State U. East Lansing, MI, USA; Makerere U. Johns Hopkins U. Research Collaboration, USA; Kampala Uganda
| | - Betty Nyangoma
- Dept of Pathology, Johns Hopkins U. School of Medicine Baltimore MD, USA; Dept of PsychiatryMichigan State U. East Lansing, MI, USA; Makerere U. Johns Hopkins U. Research Collaboration, USA; Kampala Uganda
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45
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Ahrnberg H, Pajulo M, Scheinin NM, Kajanoja J, Karlsson L, Karlsson H, Karukivi M. Alexithymic traits and parental postpartum bonding: Findings from the FinnBrain Birth Cohort Study. Scand J Psychol 2022; 63:100-108. [PMID: 35066882 DOI: 10.1111/sjop.12797] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Revised: 11/01/2021] [Accepted: 11/02/2021] [Indexed: 11/27/2022]
Abstract
In the postpartum period, some parents experience problems in bonding with the infant, which can lead to difficulties in adjusting to the parental caregiving role. Alexithymia, through deficits in emotional processing, could potentially be associated with problems in parental postpartum bonding. In the current study, this association has been explored in a large population-based sample of mothers and fathers, and to our knowledge, this is the first study to investigate this association. The study population (n = 2,671) was part of the FinnBrain Birth Cohort study and included 1,766 mothers and 905 fathers who returned The Postpartum Bonding Questionnaire (PBQ) at three months postpartum and the 20-item Toronto Alexithymia Scale (TAS-20) at six months postpartum. Correlation analyses and hierarchical regression modeling, adjusted for selected background factors, were performed separately for mothers and fathers. The alexithymia dimension "Difficulty Identifying Feelings" (DIF) in mothers and fathers, and additionally dimensions of "Difficulty Describing Feelings" (DDF) and "Externally Oriented Thinking" (EOT) in fathers were associated with weaker postpartum bonding, when related background factors were controlled for. To our knowledge this was the first study to investigate the relationship between parents' alexithymic traits and postpartum bonding within a large birth cohort study population. The main finding was that especially higher levels of maternal DIF and paternal EOT were associated with weaker postpartum bonding. Longitudinal studies are needed to establish the potential causality of this relationship.
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Affiliation(s)
- Hanna Ahrnberg
- Department of Psychiatry, University of Turku and Turku University Hospital, Turku, Finland.,FinnBrain Birth Cohort Study, Department of Clinical Medicine, Turku Brain and Mind Center, University of Turku, Turku, Finland.,Unit of Adolescent Psychiatry, Satakunta Hospital District, Pori, Finland
| | - Marjukka Pajulo
- FinnBrain Birth Cohort Study, Department of Clinical Medicine, Turku Brain and Mind Center, University of Turku, Turku, Finland.,Department of Child Psychiatry, University of Turku and Turku University Hospital, Turku, Finland
| | - Noora M Scheinin
- Department of Psychiatry, University of Turku and Turku University Hospital, Turku, Finland.,FinnBrain Birth Cohort Study, Department of Clinical Medicine, Turku Brain and Mind Center, University of Turku, Turku, Finland
| | - Jani Kajanoja
- Department of Psychiatry, University of Turku and Turku University Hospital, Turku, Finland.,FinnBrain Birth Cohort Study, Department of Clinical Medicine, Turku Brain and Mind Center, University of Turku, Turku, Finland
| | - Linnea Karlsson
- Department of Psychiatry, University of Turku and Turku University Hospital, Turku, Finland.,FinnBrain Birth Cohort Study, Department of Clinical Medicine, Turku Brain and Mind Center, University of Turku, Turku, Finland.,Centre for Population Health Research, University of Turku and Turku University Hospital, Turku, Finland
| | - Hasse Karlsson
- Department of Psychiatry, University of Turku and Turku University Hospital, Turku, Finland.,FinnBrain Birth Cohort Study, Department of Clinical Medicine, Turku Brain and Mind Center, University of Turku, Turku, Finland.,Centre for Population Health Research, University of Turku and Turku University Hospital, Turku, Finland
| | - Max Karukivi
- Department of Psychiatry, University of Turku and Turku University Hospital, Turku, Finland.,FinnBrain Birth Cohort Study, Department of Clinical Medicine, Turku Brain and Mind Center, University of Turku, Turku, Finland
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Frohberg J, Bittner A, Steudte-Schmiedgen S, Junge-Hoffmeister J, Garthus-Niegel S, Weidner K. Early Abusive Relationships-Influence of Different Maltreatment Types on Postpartum Psychopathology and Mother-Infant Bonding in a Clinical Sample. Front Psychiatry 2022; 13:836368. [PMID: 35711603 PMCID: PMC9196898 DOI: 10.3389/fpsyt.2022.836368] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Accepted: 05/09/2022] [Indexed: 11/13/2022] Open
Abstract
Postpartum psychopathology is a well-documented risk factor for impaired mother-infant bonding and thus child development. Increasingly, the focus of research in this area lies on maternal adverse childhood experiences that mothers bring into the relationship with their own baby, especially regarding the possible intergenerational transmission of traumatic experiences. Several studies showed that there is no direct link between child maltreatment and mother-infant bonding as one part of mother-child relationship, but that this link is mediated by postpartum psychopathology. To date, few studies examined differential effects between sexual, physical, and emotional abuse, and physical and emotional neglect, especially in a clinical sample. The aim of this study is to investigate whether the relationship between child maltreatment, psychopathology, and mother-infant bonding can be found for different forms of child maltreatment in patients of a mother-baby unit. Our sample consisted of 330 mothers of a mother-baby-unit in a psychosomatic clinic, who filled out self-report measures at time of admission. Mothers reported on maternal child maltreatment history with the Childhood Trauma Questionnaire, on current psychopathology with the Brief Symptom Inventory, and on mother-infant bonding with the Postpartum Bonding Questionnaire. Mediation analyses were performed with psychopathology as mediator, child maltreatment history as independent, and mother-infant bonding as dependent variable. There was no total effect of child maltreatment on mother-infant bonding. However, there were significant indirect effects of child maltreatment in general (ab = 0.09) and of the various forms of child maltreatment on mother-infant bonding via psychopathology (0.16 ≤ ab ≤ 0.34). The strongest effect was found for emotional abuse. After controlling for psychopathology, the direct effect of physical abuse on mother-infant bonding presented as a negative significant effect. This indicates that the more severe the physical abuse experienced, the better the self-reported bonding. A similar, but non-significant trend was found for sexual abuse. Our findings highlight the importance of assessing neglect forms of child maltreatment as well as abuse in women during the perinatal period. It further supports initial findings that different forms of child maltreatment can have differential effects on mother-infant bonding as one aspect of the mother-child relationship. Further research should include observational data to compare with self-report measures.
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Affiliation(s)
- Julia Frohberg
- Department of Psychotherapy and Psychosomatic Medicine, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
| | - Antje Bittner
- Department of Psychotherapy and Psychosomatic Medicine, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
| | - Susann Steudte-Schmiedgen
- Department of Psychotherapy and Psychosomatic Medicine, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
| | - Juliane Junge-Hoffmeister
- Department of Psychotherapy and Psychosomatic Medicine, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
| | - Susan Garthus-Niegel
- Institute for Systems Medicine, Faculty of Human Medicine, Medical School Hamburg, Hamburg, Germany.,Institute and Policlinic of Occupational and Social Medicine, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany.,Department of Child Health and Development, Norwegian Institute of Public Health, Oslo, Norway
| | - Kerstin Weidner
- Department of Psychotherapy and Psychosomatic Medicine, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
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Kossakowska K, Bielawska-Batorowicz E. Postpartum Depressive Symptoms and Their Selected Psychological Predictors in Breast-, Mixed and Formula-Feeding Mothers. Front Psychiatry 2022; 13:813469. [PMID: 35185655 PMCID: PMC8847159 DOI: 10.3389/fpsyt.2022.813469] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2021] [Accepted: 01/05/2022] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND Although breastfeeding is recommended by WHO and professionals as the most beneficial for newborn babies, many women find it challenging. Previous research yielded ambiguous results concerning the role of breastfeeding in the development of postpartum depression. The study aimed to identify the best predictors of depressive symptoms for each of these feeding method. METHODS The participants were 151 women (mean age 29.4 yrs; SD = 4.5) who gave birth within the last 6 months and included 82 women classified as breastfeeding, 38 classified as mixed-feeding (breast and bottle), and 31 as formula-feeding. The study had a cross-sectional design using a web-based survey for data collection. The following measures were administered: The Edinburgh Postnatal Depression Scale; Sense of Stress Questionnaire; The Postpartum Bonding Questionnaire; Parenting Sense of Competence Scale; Infant Feeding Questionnaire. RESULTS Women in study groups differed in stress, bonding difficulties, and beliefs related to feeding practices and infancy. There were no significant differences in the severity of depressive symptoms, but all mean EPDS scores were above 12. Maternal satisfaction, intrapsychic stress, and concerns about feeding on a schedule were the best predictors of EPDS scores for breastfeeding women. For mixed-feeding - emotional tension, concern about infant's hunger, overeating, and awareness of infant's hunger and satiety cues; while for the formula-feeding group, predictors included emotional tension, bonding difficulties, and such maternal feeding practices and beliefs as concern about undereating, awareness of infant's hunger and satiety cues, concerns about feeding on a schedule and social interaction with the infant during feeding. CONCLUSION Differences in predictors of postpartum depression for study groups suggest that breastfeeding itself may not be a risk for postpartum depression. However, the specificity of maternal experiences with the various types of feeding is related to difficulties promoting postpartum depression. Providing emotional and educational support appropriate for different types of feeding may be an essential protective factor for postnatal depression.
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Affiliation(s)
- Karolina Kossakowska
- Department of Clinical Psychology and Psychopathology, Faculty of Educational Sciences, Institute of Psychology, University of Lodz, Lodz, Poland
| | - Eleonora Bielawska-Batorowicz
- Department of Clinical Psychology and Psychopathology, Faculty of Educational Sciences, Institute of Psychology, University of Lodz, Lodz, Poland
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Eitenmüller P, Köhler S, Hirsch O, Christiansen H. The Impact of Prepartum Depression and Birth Experience on Postpartum Mother-Infant Bonding: A Longitudinal Path Analysis. Front Psychiatry 2022; 13:815822. [PMID: 35706472 PMCID: PMC9189288 DOI: 10.3389/fpsyt.2022.815822] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Accepted: 04/27/2022] [Indexed: 11/13/2022] Open
Abstract
INTRODUCTION Negative effects of impaired postpartum mother-infant-bonding on mental health of mothers, their newborn children and subsequent child development are well documented. Previous research demonstrated an association between a negative birth experience and postpartum mental health affecting postpartum mother-infant bonding. This study investigates the extent to which prepartum depression and birth experience influence the postpartum mental health of mothers and their bonding toward their newborns, and whether these influences differ according to parity and self-reported prior mental health problems. METHOD Three hundred and fifty-four women (18-43 years; M = 30.13, SD = 5.10) filled in the Edinburgh Postnatal Depression Scale (EPDS), the Maternal-Fetal Attachment Scale (MFAS), Salmon's Item List (SIL) assessing the birth experience, and the Postpartum Bonding Questionnaire (PBQ) at pre- and postpartum; they were also asked about birth complications and parity status. RESULTS Primipara reported significantly more birth complications (p = 0.048), with path analysis confirming this result (p < 0.001). Birth complications were associated with a more negative rating of the overall birth experience (p < 0.001). Mothers with self-reported prior mental health problems had higher prepartum depression scores (p < 0.001) but did not differ in other variables from mothers without prior self-reported mental health problems. Differences in depression scores between mothers with self-reported prior mental health problems and those without vanished at postpartum assessment (p > 0.05). Path-analysis highlighted the key role of postpartum depression, which was the only significant predictor of postpartum impairment in maternal-child bonding (p < 0.001). Birth experience and prepartum depression scores exerted an indirect effect on postpartum maternal-child bonding, mediated by postpartum depression. DISCUSSION The present study demonstrates the relevance of prepartum mental health of expectant mothers, especially of those who self-report prior mental health problems. The results support that reducing mental health problems of pregnant mothers might contribute to a more positive birth experience and potentially reduce postpartum depressive symptoms. As postpartum depression is associated with impaired parent-child bonding, such targeted interventions could promote child development. Group differences between primiparous and multiparous mothers suggest that the birth experience may be an influential factor for postpartum mental health.
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Affiliation(s)
- Pia Eitenmüller
- Department of Clinical Child and Adolescent Psychology, Philipps University Marburg, Marburg, Germany
| | - Siegmund Köhler
- Department of Obstetrics and Gynecology, University of Giessen-Marburg, Marburg, Germany
| | - Oliver Hirsch
- Department of Psychology, FOM University of Applied Sciences, Siegen, Germany
| | - Hanna Christiansen
- Department of Clinical Child and Adolescent Psychology, Philipps University Marburg, Marburg, Germany
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Muzard A, Olhaberry M, Immel N, Moran-Kneer J. Family dynamics. An exploration of parental sensitivity and depressive symptoms among mothers and fathers of toddlers. RESEARCH IN PSYCHOTHERAPY: PSYCHOPATHOLOGY, PROCESS AND OUTCOME 2021; 24:551. [PMID: 35047427 PMCID: PMC8715268 DOI: 10.4081/ripppo.2021.551] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/22/2021] [Accepted: 09/27/2021] [Indexed: 12/03/2022]
Abstract
In studies of maternal sensitivity, the influence of mothers’ depressive symptomatology has been consistently highlighted. Additionally, the relevance of both maternal and paternal sensitive responses to children’s development has been recognized. However, literature regarding the dynamics of the mother-father-toddler triad is scarce. This is particularly true when understanding how parental sensitivity may be bidirectionally shaped by both parents’ (i.e., mothers’ and fathers’ depressive symptomatology) and children’s characteristics (i.e., age). Hence, the present study aims to describe and analyse the associations between parental depression, paternal sensitivity and children’s socioemotional difficulties and age with mothers’ sensitive responses to highlight the appropriateness of considering fathers’ depressive symptoms and sensitivity to better understand the impact of maternal depressive symptomatology on mothers’ sensitivity. The participants included 80 Chilean mother-father-child triads in which all children were between 1 and 3 years of age and presented some degree of socioemotional difficulty. The results reveal no differences in maternal and paternal sensitivity or higher depressive symptomatology in mothers than in fathers. Additionally, while mothers’ depression was significantly associated with their sensitivity, this was not the case for fathers. Paternal depressive symptomatology was associated with the mother’s depression. Finally, paternal sensitivity emerged as a mediator between maternal depressive symptoms and sensitivity. This result calls attention to the use of paternal variables to understand how maternal depression impacts mothers’ sensitivity and to thus develop appropriate interventions that expand the scope of such impacts from the dyad to the triad.
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Schoppmann J, Teismann T, Holleck-Weithmann VA, Hundertmark E, Jandewerth K, Obereiner P, Rudolph D, Seehagen S. Infant carrying is associated with reduced maternal repetitive negative thinking and increased maternal mental health. J Reprod Infant Psychol 2021:1-14. [PMID: 34882494 DOI: 10.1080/02646838.2021.2012647] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
INTRODUCTION Mental disorders, such as postnatal depression, are common in mothers. Repetitive negative thinking has been identified as a cognitive factor underlying the resulting difficulties in mother-infant interactions. METHOD The present online survey investigated associations between infant carrying (baby-wearing) and maternal repetitive negative thinking and positive mental health. RESULTS Repetitive negative thinking was significantly lower, and positive mental health was significantly higher while carrying compared to overall levels. There were no relations between maternal mental health and frequency of carrying. Maternal activities during carrying are portrayed. CONCLUSION These results are the first indication that carrying could be a low threshold, easily administered intervention method for maternal mental health problems.
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Affiliation(s)
| | - Tobias Teismann
- Faculty of Psychology, Ruhr-Universität Bochum, Bochum, Germany
| | | | | | | | | | - Dinah Rudolph
- Faculty of Psychology, Ruhr-Universität Bochum, Bochum, Germany
| | - Sabine Seehagen
- Faculty of Psychology, Ruhr-Universität Bochum, Bochum, Germany
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