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Ionio C, Ciuffo G, Christiansen P, Della Vedova AM, Fallon V, Figlino MF, Landoni M, Silverio SA, Smorti M, Bramante A. Postpartum-Specific Anxiety and Maternal-Infant Bonding: A Predictive Validity Study amongst Italian Women. Eur J Investig Health Psychol Educ 2024; 14:1614-1626. [PMID: 38921073 PMCID: PMC11202692 DOI: 10.3390/ejihpe14060107] [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: 04/30/2024] [Revised: 05/31/2024] [Accepted: 05/31/2024] [Indexed: 06/27/2024] Open
Abstract
The role of anxiety is unknown in relation to postpartum bonding, unlike the well-known detrimental effect that postpartum depression has on the relationship between a mother and child. This study investigates how anxiety affects mother-infant bonding after childbirth, comparing the Italian version of the Postpartum Specific Anxiety Scale (PSAS-IT) with generalized measures of anxiety. Examining 324 non-randomly-selected participants responding to various scales, including the Edinburgh postnatal depression scale (EPDS), generalized anxiety disorder (GAD), postpartum-specific anxiety scale (PSAS-IT), postpartum bonding questionnaire (PBQ), and baby care questionnaire (BCQ-2), initial results suggest a link between certain postpartum anxiety symptoms and attachment problems. Surprisingly, anxiety measured with the PSAS has no direct influence on attachment; however, it is a strong predictor of bonding, even when maternal age, general anxiety, and depression are taken into account, explaining 3% of the variance in scores (β = 0.26, p < 0.001). This emphasizes the importance of early identification and intervention of postpartum anxiety in promoting bonding between mother and child.
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Affiliation(s)
- Chiara Ionio
- CRIdee, Unità di Ricerca sul Trauma, Dipartimento di Psicologia, Facoltà di Psicologia, Università Cattolica del Sacro Cuore, 20123 Milan, Italy;
| | - Giulia Ciuffo
- CRIdee, Unità di Ricerca sul Trauma, Dipartimento di Psicologia, Facoltà di Psicologia, Università Cattolica del Sacro Cuore, 20123 Milan, Italy;
| | - Paul Christiansen
- Department of Psychology, Institute of Population Health, Faculty of Health and Life Sciences, University of Liverpool, Liverpool L69 3GF, UK; (P.C.); (V.F.); (S.A.S.)
| | - Anna Maria Della Vedova
- Dipartimento di Scienze Cliniche e Sperimentali, Facoltà di Medicina e Chirurgia, Università Degli Studi di Brescia, 25123 Brescia, Italy;
| | - Victoria Fallon
- Department of Psychology, Institute of Population Health, Faculty of Health and Life Sciences, University of Liverpool, Liverpool L69 3GF, UK; (P.C.); (V.F.); (S.A.S.)
| | - Maria Francesca Figlino
- Dipartimento di Psicologia, Facoltà di Psicologia, Università Cattolica del Sacro Cuore, 20123 Milan, Italy;
| | - Marta Landoni
- CRIdee, Dipartimento di Psicologia, Facoltà di Psicologia, Università Cattolica del Sacro Cuore, 20123 Milan, Italy;
| | - Sergio A. Silverio
- Department of Psychology, Institute of Population Health, Faculty of Health and Life Sciences, University of Liverpool, Liverpool L69 3GF, UK; (P.C.); (V.F.); (S.A.S.)
- Department of Women & Children’s Health, School of Life Course & Population Sciences, Faculty of Life Sciences & Medicine, King’s College London, London WC2R 2LS, UK
| | - Martina Smorti
- Dipartimento di Patologia Chirurgica, Medica, Molecolare e dell’Area Critica, Università di Pisa, 56126 Pisa, Italy;
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Diaz-Ogallar MA, Hernandez-Martinez A, Linares-Abad M, Martinez-Galiano JM. Factors related to a disturbance in the mother-child bond and attachment. J Pediatr Nurs 2024; 76:114-123. [PMID: 38377918 DOI: 10.1016/j.pedn.2024.02.009] [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: 09/12/2023] [Revised: 02/12/2024] [Accepted: 02/12/2024] [Indexed: 02/22/2024]
Abstract
INTRODUCTION Establishing an adequate bond and attachment between a mother and child is essential for preventing pathologies and developing this relationship in the future. PURPOSE To identify the factors related to a disturbance of the mother-child bond or attachment. METHODS A cross-sectional descriptive study was carried out with women with a biological child between 6 weeks and 18 months of age. The Mother-Child Bond-Attachment Questionnaire (VAMF, for its name in Spanish) was administered to measure the bond and postnatal attachment together with a questionnaire containing sociodemographic, psychosocial, and health variables referring to the mother and the newborn. RESULTS 1114 women participated. The multivariate analysis showed that skin-to-skin contact (aOR = 0.58; 95% CI: 0.37, 0.90) and breastfeeding (aOR = 0.55; 95% IC: 0.35, 0.86) reduce the probability of presenting a bond disturbance. Anxiety during pregnancy, childbirth, and the puerperium (aOR = 3.95; 95% CI: 2.57, 6.05) and postpartum complications (aOR = 1.60; 95% CI: 1.03, 2.48) increase the chance of having a bond disturbance. Skin-to-skin contact (aOR = 0.61; 95% CI: 0.38, 1.00), breastfeeding (aOR = 0.47; 95% CI: 0.27, 0.80,) and an older age of the infant (months) (aOR = 0.77: 95% CI: 0.72, 0.82) reduces the probability of presenting an attachment disturbance. CONCLUSIONS Skin-to-skin contact and breastfeeding are associated with a lower probability of impaired bonding and attachment. Anxiety states during pregnancy, childbirth, and the puerperium, and complications after childbirth increase the probability of developing a bond disorder. The older the age of the infant, the lower the frequency of having an impaired attachment. IMPLICATIONS TO PRACTICE Identifying the factors associated with the establishment of the mother-child bond and attachment is essential for the development of prevention strategies and early identification of cases that may present alterations and avoid their consequences on the health of the mother and child.
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Affiliation(s)
- Maria Antonia Diaz-Ogallar
- Unit of Clinical Management Jodar, Andalusian Health Service, 23500 Jodar, Spain; Nursing Department, University of Jaen, 23071 Jaen, Spain.
| | - Antonio Hernandez-Martinez
- Department of Nursing, Physiotherapy and Occupational Therapy, Ciudad Real Faculty of Nursing, University of Castilla-La Mancha, 13071 Ciudad Real, Spain
| | | | - Juan Miguel Martinez-Galiano
- Nursing Department, University of Jaen, 23071 Jaen, Spain; Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), 28029 Madrid, Spain
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Wang S, Cai Z, Gao G, Yan S. Correlation Between Maternal Anxiety During Mid-Pregnancy and Subsequent Infant Sleep Issues: A Cross-Sectional Study from 2015 to 2016. Int J Gen Med 2024; 17:623-633. [PMID: 38410242 PMCID: PMC10894751 DOI: 10.2147/ijgm.s445604] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2023] [Accepted: 01/25/2024] [Indexed: 02/28/2024] Open
Abstract
Purpose To explore the correlation between maternal anxiety during mid-pregnancy and infant sleep issues based on the anxiety status of mothers in mid-pregnancy. Patients and Methods A cohort of 2122 primigravida women from Ma'anshan City, Anhui Province, was followed from pregnancy until 6 months postpartum. The study analyzed the impact of maternal anxiety on infant sleep patterns, including primary caregivers, encompassing insufficient sleep duration, frequent nocturnal awakenings, prolonged nocturnal awakening durations, and elongated sleep latency. Results A total of 1891 mother-infant pairs were included in this analysis. After adjusting for confounding factors, a positive correlation was found between maternal anxiety during mid-pregnancy and insufficient sleep duration (OR=1.69, 95% CI:1.13-2.52), and elongated sleep latency (OR=2.26, 95% CI:1.61-3.18). Conclusion Maternal anxiety during mid-pregnancy is associated with sleep issues in infants. Addressing maternal mental health during pregnancy may enhance sleep quality for mothers and infants, promoting overall maternal-infant health.
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Affiliation(s)
- Sumei Wang
- Ma’anshan Maternal and Child Health Center, Ma’anshan, Anhiu Province, 243011, People’s Republic of China
| | - Zhiling Cai
- Ma’anshan Maternal and Child Health Center, Ma’anshan, Anhiu Province, 243011, People’s Republic of China
| | - Guopeng Gao
- Ma’anshan Maternal and Child Health Center, Ma’anshan, Anhiu Province, 243011, People’s Republic of China
| | - Shuangqin Yan
- Ma’anshan Maternal and Child Health Center, Ma’anshan, Anhiu Province, 243011, People’s Republic of China
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Moniri M, Rashidi F, Mirghafourvand M, Rezaei M, Ghanbari-Homaie S. The relationship between pregnancy and birth experience with maternal-fetal attachment and mother-child bonding: a descriptive-analytical study. BMC Psychol 2023; 11:426. [PMID: 38053200 DOI: 10.1186/s40359-023-01475-x] [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: 08/03/2023] [Accepted: 11/30/2023] [Indexed: 12/07/2023] Open
Abstract
BACKGROUND Pregnancy and childbirth experience can be important factors for a pleasant relationship between mother and baby. This study assessed the relationship between the pregnancy and birth experience with maternal-fetal attachment (MFA) and mother-child bonding. METHODS A descriptive-analytical study was conducted among 228 pregnant women in Tabriz, Iran February 2022 to March 2023. Using cluster random sampling method, we included 228 women with gestational age 28-36 weeks and followed them up until six weeks postpartum. Data were collected in two stages using the following questionnaires: Pregnancy Experience Scale (hassles and uplifts), Maternal-Fetal Attachment Questionnaire (during the third trimester of pregnancy), Postpartum Bonding Questionnaire, and Childbirth Experience Questionnaire (six weeks postpartum). Data were analyzed using Pearson's correlation test and general linear model. RESULTS The mean score of MFA was significantly higher among women with feelings of being uplifted during pregnancy [β (95% CI) = 1.14 (0.87 to 1.41); p < 0.001]. However, there was no statistically significant relationship between pregnancy hassles and MFA and mother-child bonding (p > 0.05). Also, there was no statistically significant relationship between childbirth experience and mother-child bonding (p > 0.05). CONCLUSION According to the results of this study, pregnancy uplifts have a positive role in improving MFA. Therefore, it is recommended to plan interventions to make pregnancy period a pleasant experience for mothers.
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Affiliation(s)
- Monireh Moniri
- Student Research Committee, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Fatemeh Rashidi
- Student Research Committee, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mojgan Mirghafourvand
- Social Determinants of Health Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mansour Rezaei
- Department of Anesthesiology, School of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Solmaz Ghanbari-Homaie
- Department of Midwifery, Faculty of Nursing and Midwifery, Tabriz University of Medical Sciences, Shariati Street, P.O. Box: 51745-347, 513897977, Tabriz, Iran.
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Sari YP, Hsu YY, Nguyen TTB. The Effects of a Mindfulness-Based Intervention on Mental Health Outcomes in Pregnant Woman: A Systematic Review and Meta-Analysis. J Nurs Res 2023; 31:e306. [PMID: 38036493 DOI: 10.1097/jnr.0000000000000586] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2023] Open
Abstract
BACKGROUND Pregnancy stress, anxiety, and depression increase the risk of short-term and long-term health problems for the mother and fetus. Mindfulness-based intervention (MBI) is one of the most popular, nonpharmacological interventions used to treat mental health problems. The results of prior research indicate MBI has a less consistent effect on mental health problems in pregnant women. PURPOSE The purpose of this systematic review and meta-analysis was to clarify and determine the effect of MBI on mental health outcomes in pregnant women. METHODS Six databases, including Embase, Ovid MEDLINE, CINAHL, EBSCOhost, Cochrane Library, and ScienceDirect, were searched from their dates of inception to November 2021. Google Scholar was also used for the literature inquiry. The inclusion criteria followed the PICO (Patient/Problem, Intervention, Comparison, and Outcome) model in terms of only including studies that used mindfulness therapy, reported mental health outcomes, and applied randomized controlled trial and quasi-experimental approaches. The Cochrane risk of bias tool was applied to evaluate the quality of the studies. Review Manager 5 software with random effect with a standardized mean difference (SMD) was used to analyze level of effect. RESULTS Thirteen studies (10 randomized controlled trials and three quasi-experimental studies) were included. MBI was found to have a small effect on mental health outcomes in pregnant women (p < .0001, SMDs = -0.48, 95% CI [-0.74, -0.22], I2 = 87%). Specifically, MBI had moderate effects on stress and anxiety (SMDs = -0.59, 95% CI [-1.09, -0.09], and SMDs = -0.55, 95% CI [-1.00, -0.10], respectively) and no significant effect on depression (SMDs = -0.33, 95% CI [-0.74, 0.08]). CONCLUSIONS MBIs have a small but notable effect on mental health in pregnant women. The high heterogeneity found in this review may reflect the different types and durations of interventions used. Notably, none of the studies in the review examined intervention effects by trimester. Future research should use larger sample sizes and assess the effects of therapy for each trimester of pregnancy.
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Affiliation(s)
- Yanti Puspita Sari
- MSN, RN, Doctoral Candidate, Department of Nursing, College of Medicine, National Cheng Kung University, Taiwan; and Assistant Professor, Maternity and Child Health Nursing Department, Faculty of Nursing, Universitas Andalas, Padang, West Sumatra, Indonesia
| | - Yu-Yun Hsu
- PhD, RN, Professor, Department of Nursing, College of Medicine, National Cheng Kung University, Taiwan
| | - Tram Thi Bich Nguyen
- MS, RN, Doctoral Student, Department of Nursing, College of Medicine, National Cheng Kung University, Taiwan; and Lecturer, Medical Simulation Center, Duy Tan University, Vietnam
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Pazzagli C, Buratta L, Coletti E, Mazzeschi C. Mother-to-infant bonding mediates the effects of depressive and anxious postpartum symptoms on parenting stress. J Psychosom Obstet Gynaecol 2023; 44:2264487. [PMID: 37837341 DOI: 10.1080/0167482x.2023.2264487] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Accepted: 09/24/2023] [Indexed: 10/16/2023] Open
Abstract
A number of studies have suggested close associations between maternal postpartum mental health (depressive and anxious symptoms), mother-infant bonding, and parenting stress. However, the relationship between maternal bonding and parenting stresshas hardly been explored in published literature. This cross-sectional study explored whether maternal bonding could mediate the effect of postpartum maternal mental health on parenting stress. This study assessed maternal bonding (MPAS), depressive and anxious symptoms (EPDS; STAI), and parenting stress (PSI) at 3 months postpartum in a community sample of 105 women (M (SD) = 32.60 (4.18) years old). Spearman's correlation analyses showed moderate to high correlations between these factors. The three mediation models run showed that mother's MPAS partially mitigates the effects of EPDS (b = 0.71; SE = 0.217; 95% CI = 0.290/1.136) and STAI State (b = 0.39; SE = 0.113; 95% CI = 0.178/0.625) on PSI, and totally mediated the relationship between STAI Trait and PSI (b = 0.59; SE = 0.155; 95% CI = 0.303/0.912). Maternal bonding resulted to be a relevant factor in the association between maternal mental health and parenting stress. This highlights the importance of interventions focusing on mother-infant relationship to reduce parenting stress and prevent developmental difficulties in children.
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Affiliation(s)
- Chiara Pazzagli
- Department of Dynamic and Clinical Psychology, and Health Studies - Faculty of Medicine and Psychology, Sapienza University of Rome, Roma, Italy
| | - Livia Buratta
- Department of Philosophy, Social Sciences and Education, University of Perugia, Perugia, Italy
| | - Elena Coletti
- Department of Dynamic and Clinical Psychology, and Health Studies - Faculty of Medicine and Psychology, Sapienza University of Rome, Roma, Italy
| | - Claudia Mazzeschi
- Department of Philosophy, Social Sciences and Education, University of Perugia, Perugia, Italy
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Chen YJ, Strodl E, Hou XY, Wu CA, Chen JY, Huang LH, Yin XN, Wen GM, Sun DL, Xian DX, Yang GY, Chen WQ. Parent-child interactions in early life mediating association between prenatal maternal stress and autistic-like behaviors among preschoolers. PSYCHOL HEALTH MED 2023; 28:2156-2168. [PMID: 35477332 DOI: 10.1080/13548506.2022.2070226] [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: 11/02/2021] [Accepted: 04/20/2022] [Indexed: 10/18/2022]
Abstract
A range of studies have shown that prenatal maternal stress (PNMS) exposure is associated with offspring autistic-like behaviors, however the potential pathways remain unexplored. This study aimed to evaluate the mediating role of parent-child interactions in early life in the association between PNMS exposure and preschoolers' autistic-like behaviors. Data from 65,928 child-parent dyads were obtained via a primary caregiver-reported questionnaire administered as part of the Longhua Child Cohort Study. To strengthen confidence in the reliability of the results, the analyses were initially conducted on a random selection of 70% of the total sample, and then validated on the remaining 30% of the sample. Analysis of covariance and multiple linear models were employed to estimate the associations between PNMS exposure, parent-child interactions in early life, and children's autistic-like behaviors. The results showed that PNMS exposure was positively associated with the presence of autistic-like behaviors at preschool age. The total indirect effect of the frequency of positive parent-child interactions in early life accounted for 9.69% or 8.99% of the variance of the association. Our findings indicate that parent-child interactions in early life might function as potential mediators of the association between PNMS and the increased risk of offspring autistic-like behaviors.
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Affiliation(s)
- Ying-Jie Chen
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Esben Strodl
- School of Psychology and Counselling, Queensland University of Technology, Brisbane, QLD, Australia
| | - Xiang-Yu Hou
- School of Health and Wellbeing, University of Southern Queensland
| | - Chuan-An Wu
- Women's and Children's Hospital of Longhua District of Shenzhen, Shenzhen, Guangdong, China
| | - Jing-Yi Chen
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Li-Hua Huang
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Xiao-Na Yin
- Women's and Children's Hospital of Longhua District of Shenzhen, Shenzhen, Guangdong, China
| | - Guo-Min Wen
- Women's and Children's Hospital of Longhua District of Shenzhen, Shenzhen, Guangdong, China
| | - Deng-Li Sun
- Women's and Children's Hospital of Longhua District of Shenzhen, Shenzhen, Guangdong, China
| | - Dan-Xia Xian
- Women's and Children's Hospital of Longhua District of Shenzhen, Shenzhen, Guangdong, China
| | - Gui-You Yang
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Wei-Qing Chen
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong, China
- Department of Information Management, Xinhua College of Sun Yat-sen University, Guangzhou, Guangdong, China
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Hulsbosch LP, Potharst ES, Schwabe I, Boekhorst MGBM, Pop VJM, Nyklíček I. Online mindfulness-based intervention for women with pregnancy distress: A randomized controlled trial. J Affect Disord 2023; 332:262-272. [PMID: 37054897 DOI: 10.1016/j.jad.2023.04.009] [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: 07/13/2022] [Revised: 03/29/2023] [Accepted: 04/07/2023] [Indexed: 04/15/2023]
Abstract
BACKGROUND Pregnancy distress among childbearing women is common and can negatively affect both mother and infant. Mindfulness-based interventions (MBIs) may have a positive effect on pregnancy distress but randomized controlled trials with sufficient power are lacking. The current study examined the effectiveness of an online self-guided MBI in pregnant women with pregnancy distress. METHODS Pregnant women with elevated pregnancy distress levels at 12 weeks of pregnancy, measured with the Edinburgh Depression Scale (EDS) and Tilburg Pregnancy Distress Scale negative affect (TPDS-NA), were randomized into an intervention group (online MBI, N = 109) or control group (care as usual, N = 110). The primary outcome was the change in pregnancy distress post-intervention and at eight-weeks-follow-up. Secondary outcomes were mindfulness skills (Three Facet Mindfulness Questionnaire-Short Form), rumination (Rumination-Reflection Questionnaire), and self-compassion (Self-Compassion Scale-Short Form) at post-intervention and follow-up in the intervention group. RESULTS Significant improvements were found in pregnancy distress scores, but no significant differences between intervention and control group appeared. The MBI group showed improvements in mindfulness skills, rumination, and self-compassion. LIMITATIONS Low adherence to the intervention and assessment of secondary outcome measures in the intervention group only. CONCLUSIONS An intervention trial with one of the largest samples (N = 219) provided no evidence of a significant effect of an online self-guided MBI in distressed pregnant women. An online MBI may be associated with an improvement in mindfulness skills, rumination, and self-compassion. Future research should address the effectiveness of MBI's with different formats (online and group-based combined) and examine a possible delayed effect. TRIAL REGISTRATION ClinicalTrials.gov: NCT03917745, registered on 4 March 2019.
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Affiliation(s)
- Lianne P Hulsbosch
- Center of Research in Psychological and Somatic disorders (CoRPS), Department of Medical and Clinical Psychology, Tilburg University, Warandelaan 2, Tilburg, the Netherlands.
| | - Eva S Potharst
- UvA minds, academic outpatient (child and adolescent) treatment center of the University of Amsterdam, Amsterdam, the Netherlands; Research Institute of Child Development and Education, University of Amsterdam, Nieuwe Achtergracht 127, Amsterdam, the Netherlands
| | - Inga Schwabe
- Department of Methodology and Statistics, Tilburg University, Tilburg, the Netherlands
| | - Myrthe G B M Boekhorst
- Center of Research in Psychological and Somatic disorders (CoRPS), Department of Medical and Clinical Psychology, Tilburg University, Warandelaan 2, Tilburg, the Netherlands
| | - Victor J M Pop
- Center of Research in Psychological and Somatic disorders (CoRPS), Department of Medical and Clinical Psychology, Tilburg University, Warandelaan 2, Tilburg, the Netherlands
| | - Ivan Nyklíček
- Center of Research in Psychological and Somatic disorders (CoRPS), Department of Medical and Clinical Psychology, Tilburg University, Warandelaan 2, Tilburg, the Netherlands
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Klauser N, Müller M, Zietlow AL, Nonnenmacher N, Woll C, Becker-Stoll F, Rec C. Maternal postpartum anxiety and the development of infant attachment: The effect of body sensations on infant attachment. J Affect Disord 2023; 331:259-268. [PMID: 36958486 DOI: 10.1016/j.jad.2023.03.048] [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: 05/20/2022] [Revised: 03/04/2023] [Accepted: 03/16/2023] [Indexed: 03/25/2023]
Abstract
BACKGROUND Knowledge about the influences of maternal postpartum anxiety disorders (PAD) on infant development is limited. Aim of this present study is to evaluate the influence of PAD on infant attachment. METHODS In a longitudinal study, self-reported anxiety symptoms of N = 70 mothers (N = 28 with PAD diagnosed according to the DSM-IV, N = 42 controls) were examined in the postpartum period and one year later. Infants' attachment was observed in the Strange Situation Test (SST) at the age of 12-24 months. RESULTS Results indicate a strong relationship between PAD and infant attachment: infants of mothers with PAD were significantly more likely to be classified as insecure or disorganized than infants of control mothers. Logistic regression analysis led to a significant model with 76.8 % correct classification of infant attachment dependent on the maternal fear of anxiety associated body sensations (OR = 4.848) in the postpartum period. Including maternal sensitivity and interaction behavior, only maternal intrusiveness was additionally associated with infant attachment (ρ = 0.273, p < .05; OR = 45.021, p = .153). LIMITATIONS Participants were highly educated. Different anxiety disorders included led to a heterogenous sample. Generalization is diminished. Maternal sensitivity was measured on a global scale, and body tension was self-reported. CONCLUSIONS PAD plays a crucial role in the development of infant attachment. Interaction-focused interventions, helping mothers to decrease intrusiveness, and body-focused interventions, helping mothers to deal with their fear of anxiety symptoms, might be promising pathways to buffer the influence of PAD on infant attachment.
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Affiliation(s)
- Nathania Klauser
- Ludwig-Maximilians University, Department of Psychology, Munich, Germany.
| | - Mitho Müller
- Ludwig-Maximilians University, Department of Psychology, Munich, Germany
| | - Anna-Lena Zietlow
- Technical University Dresden, Department of Psychology, Dresden, Germany
| | - Nora Nonnenmacher
- Heidelberg University Hospital, General Psychiatry, Heidelberg, Germany
| | - Christian Woll
- Ludwig-Maximilians University, Department of Psychology, Munich, Germany
| | - Fabienne Becker-Stoll
- Ludwig-Maximilians University, Department of Psychology, Munich, Germany; Staatsinstitut für Frühpädagogik Bayern, Munich, Germany
| | - Corinna Rec
- Ludwig-Maximilians University, Department of Psychology, Munich, Germany
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da Silva Moreira S, de Matos Manoel B, Inácio JPG, de Souza CG, Reis ACC, Jorge BC, de Aquino AM, Scarano WR, Cardoso CAL, Arena AC. Lactational exposure to venlafaxine provokes late repercussions on reproductive parameters in male rat offspring. J Appl Toxicol 2023; 43:387-401. [PMID: 36063371 DOI: 10.1002/jat.4389] [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: 05/10/2022] [Revised: 08/30/2022] [Accepted: 08/30/2022] [Indexed: 11/09/2022]
Abstract
Exposure to selective serotonin reuptake inhibitors can affect hormone-dependent processes, such as the brain sexual differentiation. Because the use of these antidepressants cause concern during lactation, we evaluated the possible effects of venlafaxine on lactational exposure and its late repercussions on reproductive parameters in male rats. Lactating rats were exposed to venlafaxine (3.85, 7.7, or 15.4 mg/kg/body weight; gavage), from lactational day 1 to 20. Venlafaxine and O-desmethylvenlafaxine residues were found in all milk samples of dams treated, demonstrating the lactational transfer of this antidepressant to the offspring. Although the maternal behavior was normal, the dams presented an increase in urea and uric acid levels in the groups treated with 7.7 and 15.4, respectively, as well as a spleen weight increased in the 3.85 and 15.4 groups. The male offspring showed a decrease in play behavior parameters in the intermediate dose group. Sperm analysis indicated a reduction in sperm motility in all treated groups. The androgen receptor expression in the hypothalamus was decreased in the highest dose group, although the sexual behavior had not been affected. In conclusion, venlafaxine was transferred through breast milk and promoted changes in play behavior, sperm quality, and hypothalamic androgen receptor (AR) content, which may indicate an incomplete masculinization of the brain of male offspring.
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Affiliation(s)
- Suyane da Silva Moreira
- Department of Structural and Functional Biology, Institute of Biosciences of Botucatu, UNESP - Univ. Estadual Paulista, Botucatu, São Paulo State, Brazil
| | - Beatriz de Matos Manoel
- School of Health Sciences, Federal University of Grande Dourados, UFGD, Dourados, Mato Grosso do Sul State, Brazil
| | - João Pedro Gaspar Inácio
- Department of Structural and Functional Biology, Institute of Biosciences of Botucatu, UNESP - Univ. Estadual Paulista, Botucatu, São Paulo State, Brazil
| | - Carolina Gabrielli de Souza
- Department of Structural and Functional Biology, Institute of Biosciences of Botucatu, UNESP - Univ. Estadual Paulista, Botucatu, São Paulo State, Brazil
| | - Ana Carolina Casali Reis
- Department of Structural and Functional Biology, Institute of Biosciences of Botucatu, UNESP - Univ. Estadual Paulista, Botucatu, São Paulo State, Brazil
| | - Bárbara Campos Jorge
- Department of Structural and Functional Biology, Institute of Biosciences of Botucatu, UNESP - Univ. Estadual Paulista, Botucatu, São Paulo State, Brazil
| | - Ariana Musa de Aquino
- Department of Structural and Functional Biology, Institute of Biosciences of Botucatu, UNESP - Univ. Estadual Paulista, Botucatu, São Paulo State, Brazil
| | - Wellerson Rodrigo Scarano
- Department of Structural and Functional Biology, Institute of Biosciences of Botucatu, UNESP - Univ. Estadual Paulista, Botucatu, São Paulo State, Brazil
| | | | - Arielle Cristina Arena
- Department of Structural and Functional Biology, Institute of Biosciences of Botucatu, UNESP - Univ. Estadual Paulista, Botucatu, São Paulo State, Brazil.,Center of Toxicological Assistance (CEATOX), Institute of Biosciences of Botucatu, Univ. Estadual Paulista - Botucatu (UNESP), São Paulo, Brazil
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11
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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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12
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Zeevenhooven J, de Bruin FE, Schappin R, Vlieger AM, van der Lee JH, Haverman L, van Sleuwen BE, L'Hoir MP, Benninga MA. Follow-up of infants with colic into childhood: Do they develop behavioural problems? J Paediatr Child Health 2022; 58:2076-2083. [PMID: 36054703 PMCID: PMC9804625 DOI: 10.1111/jpc.16174] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2022] [Revised: 06/28/2022] [Accepted: 08/07/2022] [Indexed: 01/07/2023]
Abstract
AIM To assess whether infants with colic (IC) demonstrate persisting developmental dysregulation into childhood, manifested as behavioural problems, and to determine if these behavioural problems are associated with parenting factors. METHODS Preschool children with a history of IC at the age of 0-3 months, as defined by the Wessel criteria, were invited to participate in an observational follow-up study, in which their caregivers completed the Child Behaviour Checklist (CBCL). Raw scores and clinical-range scores on the internalising, externalising and total behavioural problems scales were compared with a Dutch normative sample using independent t-tests and Chi-square tests. For the clinical-range scores, multivariable logistic regressions (odds ratios [99% confidence interval, CI]) were used to adjust for confounders and to identify variables associated with behavioural problems. RESULTS Two hundred and fifty-eight children with a history of IC (median age 5.1 (interquartile range, IQR 4.6-5.5) years, 51.9% boys) were included. The cases had a significantly higher adjusted risk (adjusted odds ratios (aORs) [99% CI]) of scoring in the clinical range of the emotionally reactive, internalising and total problems scale (2.96 [1.24-7.06]; 2.50 [1.35-4.62]; 2.98 [1.46-6.07], respectively). Internalising (P < 0.001), externalising (P < 0.001) and total (P < 0.001) behavioural problems in children with a history of IC were associated with higher parenting stress scores. CONCLUSIONS Children with a history of IC demonstrated significantly more internalising behavioural problems at preschool age compared to the norm sample. Specific advice and support need to be available for parents to understand and regulate the behaviour of their child, from infancy to childhood.
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Affiliation(s)
- Judith Zeevenhooven
- Department of Medical Psychology and Social Work, Wilhelmina Children's HospitalUniversity Medical Center UtrechtUtrechtthe Netherlands,Pediatric Gastroenterology, Hepatology and Nutrition, Emma Children's Hospital, Amsterdam UMCUniversity of AmsterdamAmsterdamthe Netherlands
| | - Françoise E de Bruin
- Faculty of Social and Behavioral SciencesUtrecht UniversityUtrechtthe Netherlands
| | - Renske Schappin
- Department of Medical Psychology and Social Work, Wilhelmina Children's HospitalUniversity Medical Center UtrechtUtrechtthe Netherlands
| | - Arine M Vlieger
- Department of PediatricsSt. Antonius HospitalNieuwegeinthe Netherlands
| | - Johanna H van der Lee
- Pediatric Clinical Research Office, Emma Children's Hospital, Amsterdam UMCUniversity of AmsterdamAmsterdamthe Netherlands
| | - Lotte Haverman
- Psychosocial Department, Emma Children's Hospital, Amsterdam UMCUniversity of AmsterdamAmsterdamthe Netherlands
| | | | - Monique P L'Hoir
- Nutrition and Health over the LifecourseWageningen University & ResearchWageningenthe Netherlands
| | - Marc A Benninga
- Pediatric Gastroenterology, Hepatology and Nutrition, Emma Children's Hospital, Amsterdam UMCUniversity of AmsterdamAmsterdamthe Netherlands
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13
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Cai Q, Wang H, Chen D, Xu W, Yang R, Xu X. Effect of family-centred care on parental mental health and parent-infant interactions for preterm infants: a systematic review protocol. BMJ Open 2022; 12:e062004. [PMID: 36198456 PMCID: PMC9535193 DOI: 10.1136/bmjopen-2022-062004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
INTRODUCTION Unexpected premature delivery and separation from preterm infants are common problems that parents of preterm infants must handle with. Parents of preterm infants may suffer from severe psychological distress. Family-centred care (FCC) can effectively ease parents' psychological distress and strengthen connections between parents and their preterm infants. The purpose of this systematic review will be to systematically review and evaluate the impacts of FCC interventions on the mental health of parents of preterm infants and the parent-infant relationship. METHODS AND ANALYSIS This protocol for this systematic review will be conducted in line with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis Protocol. We will search databases including PubMed, Embase, The Cochrane Library, CINAHL, Web of Science, PsycINFO, Scopus and ProQuest, CNKI, SinoMed and Wanfang Data from 1 July 2012 to 1 July 2022. An additional search of OpenGrey will be conducted to identify grey literature. Randomised controlled trials related to FCC inventions for preterm infants≤37 weeks' gestational age and their parents will be included, and the outcome measures will be parental mental health and parent-infant interaction. Two reviewers will independently conduct title and abstract screening, full-text screening, data extraction and study quality assessment. Risk of bias for the studies will be evaluated using the Cochrane Collaboration Risk of Bias V.2.0. Any disagreements will be solved by a third reviewer to reach a consensus. If appropriate, a meta-analysis will be conducted to assess the effect of FCC on parental mental health and parent-infant relationship. ETHICS AND DISSEMINATION Research ethics approval will not be required for this review since it will not involve the collection of primary data and will only use published literature. The results will be disseminated in a peer-reviewed journal through publication or by presentation at relevant academic conference. PROSPERO REGISTRATION NUMBER CRD42022299203.
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Affiliation(s)
- Qian Cai
- Faculty of Nursing, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
- Nursing Department, Women's Hospital School of Medicine Zhejiang University, Hangzhou, Zhejiang, China
| | - Hua Wang
- Nursing Department, Women's Hospital School of Medicine Zhejiang University, Hangzhou, Zhejiang, China
| | - Danqi Chen
- Faculty of Nursing, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
- Nursing Department, Women's Hospital School of Medicine Zhejiang University, Hangzhou, Zhejiang, China
| | - Wenli Xu
- Obstetrics Department, Haining Maternal and Child Health Hospital, Branch of Women's Hospital School of Medicine Zhejiang University, Haining, Zhejiang, China
| | - Rui Yang
- Faculty of Nursing, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
- Nursing Department, Women's Hospital School of Medicine Zhejiang University, Hangzhou, Zhejiang, China
| | - Xinfen Xu
- Nursing Department, Women's Hospital School of Medicine Zhejiang University, Hangzhou, Zhejiang, China
- Obstetrics Department, Haining Maternal and Child Health Hospital, Branch of Women's Hospital School of Medicine Zhejiang University, Haining, Zhejiang, China
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14
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Howard LM, Abel KM, Atmore KH, Bick D, Bye A, Byford S, Carson LE, Dolman C, Heslin M, Hunter M, Jennings S, Johnson S, Jones I, Taylor BL, McDonald R, Milgrom J, Morant N, Nath S, Pawlby S, Potts L, Powell C, Rose D, Ryan E, Seneviratne G, Shallcross R, Stanley N, Trevillion K, Wieck A, Pickles A. Perinatal mental health services in pregnancy and the year after birth: the ESMI research programme including RCT. PROGRAMME GRANTS FOR APPLIED RESEARCH 2022. [DOI: 10.3310/ccht9881] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Background
It is unclear how best to identify and treat women with mental disorders in pregnancy and the year after birth (i.e. the perinatal period).
Objectives
(1) To investigate how best to identify depression at antenatal booking [work package (WP) 1]. (2) To estimate the prevalence of mental disorders in early pregnancy (WP1). (3) To develop and examine the efficacy of a guided self-help intervention for mild to moderate antenatal depression delivered by psychological well-being practitioners (WP1). (4) To examine the psychometric properties of the perinatal VOICE (Views On Inpatient CarE) measure of service satisfaction (WP3). (5) To examine the clinical effectiveness and cost-effectiveness of services for women with acute severe postnatal mental disorders (WPs 1–3). (6) To investigate women’s and partners’/significant others’ experiences of different types of care (WP2).
Design
Objectives 1 and 2 – a cross-sectional survey stratified by response to Whooley depression screening questions. Objective 3 – an exploratory randomised controlled trial. Objective 4 – an exploratory factor analysis, including test–retest reliability and validity assessed by association with the Client Satisfaction Questionnaire contemporaneous satisfaction scores. Objective 5 – an observational cohort study using propensity scores for the main analysis and instrumental variable analysis using geographical distance to mother and baby unit. Objective 6 – a qualitative study.
Setting
English maternity services and generic and specialist mental health services for pregnant and postnatal women.
Participants
Staff and users of mental health and maternity services.
Interventions
Guided self-help, mother and baby units and generic care.
Main outcome measures
The following measures were evaluated in WP1(i) – specificity, sensitivity, positive predictive value, likelihood ratio, acceptability and population prevalence estimates. The following measures were evaluated in WP1(ii) – participant recruitment rate, attrition and adverse events. The following measure was evaluated in WP2 – experiences of care. The following measures were evaluated in WP3 – psychometric indices for perinatal VOICE and the proportion of participants readmitted to acute care in the year after discharge.
Results
WP1(i) – the population prevalence estimate was 11% (95% confidence interval 8% to 14%) for depression and 27% (95% confidence interval 22% to 32%) for any mental disorder in early pregnancy. The diagnostic accuracy of two depression screening questions was as follows: a weighted sensitivity of 0.41, a specificity of 0.95, a positive predictive value of 0.45, a negative predictive value of 0.93 and a likelihood ratio (positive) of 8.2. For the Edinburgh Postnatal Depression Scale, the diagnostic accuracy was as follows: a weighted sensitivity of 0.59, a specificity of 0.94, a positive predictive value of 0.52, a negative predictive value of 0.95 and a likelihood ratio (positive) of 9.8. Most women reported that asking about depression at the antenatal booking appointment was acceptable, although this was reported as being less acceptable for women with mental disorders and/or experiences of abuse. Cost-effectiveness analysis suggested that both the Whooley depression screening questions and the Edinburgh Postnatal Depression Scale were more cost-effective than with the Whooley depression screening questions followed by the Edinburgh Postnatal Depression Scale or no-screen option. WP1(ii) – 53 women with depression in pregnancy were randomised. Twenty-six women received modified guided self-help [with 18 (69%) women attending four or more sessions] and 27 women received usual care. Three women were lost to follow-up (follow-up for primary outcome: 92%). At 14 weeks post randomisation, women receiving guided self-help reported fewer depressive symptoms than women receiving usual care (adjusted effect size −0.64, 95% confidence interval −1.30 to 0.06). Costs and quality-adjusted life-years were similar, resulting in a 50% probability of guided self-help being cost-effective compared with usual care at National Institute for Health and Care Excellence cost per quality-adjusted life-year thresholds. The slow recruitment rate means that a future definitive larger trial is not feasible. WP2 – qualitative findings indicate that women valued clinicians with specialist perinatal expertise across all services, but for some women generic services were able to provide better continuity of care. Involvement of family members and care post discharge from acute services were perceived as poor across services, but there was also ambivalence among some women about increasing family involvement because of a complex range of factors. WP3(i) – for the perinatal VOICE, measures from exploratory factor analysis suggested that two factors gave an adequate fit (comparative fit index = 0.97). Items loading on these two dimensions were (1) those concerning aspects of the service relating to the care of the mother and (2) those relating to care of the baby. The factors were positively correlated (0.49; p < 0.0001). Total scores were strongly associated with service (with higher satisfaction for mother and baby units, 2 degrees of freedom; p < 0.0001) and with the ‘gold standard’ Client Service Questionnaire total score (test–retest intraclass correlation coefficient 0.784, 95% confidence interval 0.643 to 0.924; p < 0.0001). WP3(ii) – 263 of 279 women could be included in the primary analysis, which shows that the odds of being readmitted to acute care was 0.95 times higher for women who were admitted to a mother and baby unit than for those not admitted to a mother and baby unit (0.95, 95% confidence interval 0.86 to 1.04; p = 0.29). Sensitivity analysis using an instrumental variable found a markedly more significant effect of admission to mother and baby units (p < 0.001) than the primary analysis. Mother and baby units were not found to be cost-effective at 1 month post discharge because of the costs of care in a mother and baby unit. Cost-effectiveness advantages may exist if the cost of mother and baby units is offset by savings from reduced readmissions in the longer term.
Limitations
Policy and service changes had an impact on recruitment. In observational studies, residual confounding is likely.
Conclusions
Services adapted for the perinatal period are highly valued by women and may be more effective than generic services. Mother and baby units have a low probability of being cost-effective in the short term, although this may vary in the longer term.
Future work
Future work should include examination of how to reduce relapses, including in after-care following discharge, and how better to involve family members.
Trial registration
This trial is registered as ISRCTN83768230 and as study registration UKCRN ID 16403.
Funding
This project was funded by the National Institute for Health and Care Research (NIHR) Programme Grants for Applied Research programme and will be published in full in Programme Grants for Applied Research; Vol. 10, No. 5. See the NIHR Journals Library website for further project information.
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Affiliation(s)
- Louise M Howard
- Section of Women’s Mental Health, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
| | - Kathryn M Abel
- Centre for Women’s Mental Health, The University of Manchester, Manchester, UK
| | - Katie H Atmore
- Section of Women’s Mental Health, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
| | - Debra Bick
- Division of Women and Children’s Health, Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, King’s College London, London, UK
| | - Amanda Bye
- Section of Women’s Mental Health, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
| | - Sarah Byford
- King’s Health Economics, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
| | - Lauren E Carson
- Section of Women’s Mental Health, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
| | - Clare Dolman
- Section of Women’s Mental Health, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
| | - Margaret Heslin
- King’s Health Economics, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
| | - Myra Hunter
- Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
| | - Stacey Jennings
- Section of Women’s Mental Health, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
| | - Sonia Johnson
- Division of Psychiatry, University College London, London, UK
| | - Ian Jones
- Institute of Psychological Medicine and Clinical Neuroscience, Cardiff University, Cardiff, UK
| | | | - Rebecca McDonald
- Section of Women’s Mental Health, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
| | - Jeannette Milgrom
- Department of Clinical and Health Psychology, Parent–Infant Research Institute, University of Melbourne, Melbourne, VIC, Australia
| | - Nicola Morant
- Division of Psychiatry, University College London, London, UK
| | - Selina Nath
- Section of Women’s Mental Health, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
| | - Susan Pawlby
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
| | - Laura Potts
- Biostatistics and Health Informatics, King’s College London, London, UK
| | - Claire Powell
- Section of Women’s Mental Health, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
| | - Diana Rose
- Service User Research Enterprise, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
| | - Elizabeth Ryan
- Biostatistics and Health Informatics, King’s College London, London, UK
| | | | - Rebekah Shallcross
- Section of Women’s Mental Health, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
| | - Nicky Stanley
- School of Social Work, Care and Community, University of Central Lancashire, Harrington, UK
| | - Kylee Trevillion
- Section of Women’s Mental Health, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
| | - Angelika Wieck
- Greater Manchester Mental Health NHS Foundation Trust, Manchester, UK
| | - Andrew Pickles
- Biostatistics and Health Informatics, King’s College London, London, UK
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15
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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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16
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Fernandes DV, Canavarro MC, Moreira H. Self-compassion and mindful parenting among postpartum mothers during the COVID-19 pandemic: The role of depressive and anxious symptoms. CURRENT PSYCHOLOGY 2022; 42:1-13. [PMID: 35283611 PMCID: PMC8905028 DOI: 10.1007/s12144-022-02959-6] [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] [Accepted: 02/25/2022] [Indexed: 11/03/2022]
Abstract
Self-compassion is an important psychological skill that may facilitate the adoption of a mindful way of parenting, especially during the COVID-19 pandemic. However, the association between these constructs may be explained by several variables, such as maternal psychopathological symptoms, with a well-established interference in parenting. This study aimed to compare mothers who experienced and mothers who did not experience a negative emotional impact of the COVID-19 pandemic on self-compassion, mindful parenting, postpartum depressive symptoms (PPDS) and postpartum anxious symptoms (PPAS). We also explored whether mothers' self-compassion was associated with mindful parenting and whether this relationship may be mediated by PPDS and PPAS. A sample of 977 Portuguese mothers of infants aged between zero and six months completed an online survey between December 2020 and January 2021, a period of major pandemic-related restrictions. The survey included several self-report questionnaires that assessed sociodemographic, clinical, and COVID-19 information, self-compassion, mindful parenting, PPDS and PPAS. Mothers who reported having felt that the pandemic had a negative emotional impact during their postpartum period (79.5%) presented lower levels of self-compassion and mindful parenting, and higher levels of PPDS and PPAS. Regarding the mediation model, higher levels of self-compassion were related to higher levels of mindful parenting, and this association was mediated by lower levels of PPAS. These results highlight the relevance of mothers' self-compassion for helping them feel less anxious and to adopt a mindful way of parenting in the postpartum period, particularly during the pandemic. Compassion-based interventions may be particularly important in reducing PPAS and promoting mindful parenting and should be available to postpartum mothers, especially during, but also beyond the pandemic.
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Affiliation(s)
- Daniela Ventura Fernandes
- Centre for Research in Neuropsychology and Cognitive Behavioural Intervention (CINEICC), Faculty of Psychology and Educational Sciences, University of Coimbra, Rua Do Colégio Novo, 3030-115 Coimbra, Portugal
| | - Maria Cristina Canavarro
- Centre for Research in Neuropsychology and Cognitive Behavioural Intervention (CINEICC), Faculty of Psychology and Educational Sciences, University of Coimbra, Rua Do Colégio Novo, 3030-115 Coimbra, Portugal
| | - Helena Moreira
- Centre for Research in Neuropsychology and Cognitive Behavioural Intervention (CINEICC), Faculty of Psychology and Educational Sciences, University of Coimbra, Rua Do Colégio Novo, 3030-115 Coimbra, Portugal
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17
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Craig F, Gioia MC, Muggeo V, Cajiao J, Aloi A, Martino I, Tenuta F, Cerasa A, Costabile A. Effects of maternal psychological distress and perception of COVID-19 on prenatal attachment in a large sample of Italian pregnant women. J Affect Disord 2021; 295:665-672. [PMID: 34509782 PMCID: PMC8428478 DOI: 10.1016/j.jad.2021.08.102] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2021] [Revised: 07/21/2021] [Accepted: 08/28/2021] [Indexed: 12/23/2022]
Abstract
BACKGROUND Evidence concerning the impact of COVID-19-related stress exposure on prenatal attachment in pregnant women is unknown. In this study we sought to assess the effect of psychological distress and risk perception of COVID-19 on prenatal attachment in a Italian sample of pregnant women. METHODS 1179 pregnant women completed an anonymous online survey and self-report questionnaires measuring socio-demographic and obstetric characteristics, psychological distress (STAI Form Y-1-2 and BDI-II), prenatal attachment (PAI) and risk perception of COVID-19. Data were collected from March 2020 to April 2020 referring to the national lockdown period. RESULTS After adjusting for the socio-demographic and obstetric factors in the multivariable analysis, we found out the state anxiety was shown to be a significant predictor (p < 0001) of prenatal attachment. Moreover, the COVID-19-risk perception positively moderate the relationship between trait anxiety and prenatal attachment (p=0008), indicating that when COVID-19-risk perception is high, the effects of trait anxiety on prenatal attachment is attenuated. The synergistic effect between STAI Form Y-1 and COVID-19-risk perception index on PAI is partially mediated by STAI Form Y-2 score. CONCLUSIONS Findings from this study showed that state anxiety related to COVID-19 outbreak in pregnant women may affect the prenatal attachment process of the expectant mother negatively. However, an adequate and functional perception of COVID-19 could enhance prenatal attachment. These results underline the importance of monitoring the prenatal attachment process and the mother's mental health during pandemics, to safeguard maternal and infant mental health.
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Affiliation(s)
- Francesco Craig
- Department of Cultures, Education and Society, University of Calabria, Cosenza, Italy
| | - Maria Cecilia Gioia
- iGreco Ospedali Riuniti - Sacro Cuore Corso Italia, 50, 87100 Cosenza CS; Associazione di Volontariato Mammachemamme, Cosenza, Italy.
| | - Vito Muggeo
- Department of Economics, Business and Statistics, University of Palermo, Palermo, Italy
| | - Juanita Cajiao
- Faculty of Medicine Universitat de Barcelona, Barcelona, Spain,Grupo de Investigación en Salud, Fundación Universitaria CAFAM, Colombia
| | - Alessia Aloi
- Associazione di Volontariato Mammachemamme, Cosenza, Italy
| | - Iolanda Martino
- Department of Medical and Surgical Sciences, Institutes of Neurology, Magna Græcia University of Catanzaro, Catanzaro, Italy
| | - Flaviana Tenuta
- Department of Cultures, Education and Society, University of Calabria, Cosenza, Italy
| | - Antonio Cerasa
- Institute for Biomedical Research and Innovation, National Research Council (IRIB-CNR), 98164, Messina, Italy,S’Anna Institute, 88900 Crotone, Italy
| | - Angela Costabile
- Department of Cultures, Education and Society, University of Calabria, Cosenza, Italy
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18
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Kolk TA, Nath S, Howard LM, Pawlby S, Lockwood-Estrin G, Trevillion K. The association between maternal lifetime interpersonal trauma experience and perceived mother-infant bonding. J Affect Disord 2021; 294:117-127. [PMID: 34280788 PMCID: PMC8424749 DOI: 10.1016/j.jad.2021.06.069] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2020] [Revised: 06/19/2021] [Accepted: 06/27/2021] [Indexed: 01/17/2023]
Abstract
BACKGROUND Interpersonal traumas are common among expectant and new mothers and are found to have considerable impacts on women's mental health. These experiences may disrupt maternal perceptions of the mother-infant relationship, which is essential for healthy infant development, but findings are inconsistent. This study aims to explore associations between lifetime interpersonal traumas and their impact on self-reported mother-infant bonding. METHODS Secondary data analysis of a representative cohort of 453 women attending at a South London maternity service. Lifetime interpersonal trauma experience and its association with self-reported mother-infant bonding (Postpartum Bonding Questionnaire) was assessed in uni- and multivariable linear regressions, the latter adjusted to account for antenatal depressive and posttraumatic symptoms, measured using the Edinburgh Postnatal Depression Scale and Posttraumatic Stress Disorder Scale, and key sociodemographic risk factors. RESULTS Maternal lifetime trauma was not associated with perceived difficulties in mother-infant bonding at three months postnatal; however antenatal depressive symptoms, both with continuous EPDS score (0.33, 95% CI 0.17-0.50, p<0.001) and clinical cut-off ≥13 (4.26, 95% CI 2.02-6.49, p<0.001) were associated with self-reported bonding difficulties. LIMITATIONS The composite trauma measurement did not allow for a comprehensive assessment of individual trauma types. CONCLUSIONS There was no evidence for a link between maternal lifetime trauma experiences and self-reported bonding difficulties. However, an association between antenatal depressive symptoms and perceived postpartum bonding impairment was found. This highlights the importance of identification and treatment of depressive symptoms during pregnancy and offering women support in facilitating a positive mother-infant relationship.
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Affiliation(s)
- Tessel Annejo Kolk
- Section of Women's Mental Health, Institute of Psychiatry, Psychology and Neuroscience, King's College London, De Crespigny Park, London SE5 8AF, UK..
| | - Selina Nath
- Section of Women's Mental Health, Institute of Psychiatry, Psychology and Neuroscience, King's College London, De Crespigny Park, London SE5 8AF, UK
| | - Louise Michele Howard
- Section of Women's Mental Health, Institute of Psychiatry, Psychology and Neuroscience, King's College London, De Crespigny Park, London SE5 8AF, UK
| | - Susan Pawlby
- Division of Psychological Medicine, Institute of Psychiatry, Psychology & Neuroscience, King's College London, De Crespigny Park, London SE5 8AF, UK
| | - Georgia Lockwood-Estrin
- Henry Wellcome Building, Centre for Brain and Cognitive Development, Birkbeck College, 32 Torrington Square, London WC1E 7JL, UK
| | - Kylee Trevillion
- Section of Women's Mental Health, Institute of Psychiatry, Psychology and Neuroscience, King's College London, De Crespigny Park, London SE5 8AF, UK
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19
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Yatziv T, Vancor EA, Bunderson M, Rutherford HJV. Maternal perinatal anxiety and neural responding to infant affective signals: Insights, challenges, and a road map for neuroimaging research. Neurosci Biobehav Rev 2021; 131:387-399. [PMID: 34563563 DOI: 10.1016/j.neubiorev.2021.09.043] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Revised: 09/02/2021] [Accepted: 09/22/2021] [Indexed: 11/28/2022]
Abstract
Anxiety symptoms are common among women during pregnancy and the postpartum period, potentially having detrimental effects on both mother and child's well-being. Perinatal maternal anxiety interferes with a core facet of adaptive caregiving: mothers' sensitive responsiveness to infant affective communicative 'cues.' This review summarizes the current research on the neural correlates of maternal processing of infant cues in the presence of perinatal anxiety, outlines its limitations, and offers next steps to advance future research. Functional neuroimaging studies examining the neural circuitry involved in, and electrophysiological studies examining the temporal dynamics of, processing infant cues during pregnancy and postpartum are reviewed. Studies have generally indicated mixed findings, although emerging themes suggest that anxiety may be implicated in several stages of processing infant cues- detection, interpretation, and reaction- contingent upon cue valence. Limitations include inconsistent designs, lack of differentiation between anxiety and depression symptoms, and limited consideration of parenting-specific (versus domain-general) anxiety. Future studies should incorporate longitudinal investigation of multiple levels of analysis spanning neural, cognitive, and observed aspects of sensitive caregiving.
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20
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Bind RH, Biaggi A, Bairead A, Du Preez A, Hazelgrove K, Waites F, Conroy S, Dazzan P, Osborne S, Pawlby S, Sethna V, Pariante CM. Mother-infant interaction in women with depression in pregnancy and in women with a history of depression: the Psychiatry Research and Motherhood - Depression (PRAM-D) study. BJPsych Open 2021; 7:e100. [PMID: 34030765 PMCID: PMC8167851 DOI: 10.1192/bjo.2021.52] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND Little is known about the effects of depression before birth on the quality of the mother-infant interaction. AIMS To understand whether depression, either in pregnancy or in lifetime before pregnancy, disrupts postnatal mother-infant interactions. METHOD We recruited 131 pregnant women (51 healthy, 52 with major depressive disorder (MDD) in pregnancy, 28 with a history of MDD but healthy pregnancy), at 25 weeks' gestation. MDD was confirmed with the Structured Clinical Interview for DSM-IV Disorders. Neonatal behaviour was assessed at 6 days with the Neonatal Behavioural Assessment Scale, and mother-infant interaction was assessed at 8 weeks and 12 months with the Crittenden CARE-Index. RESULTS At 8 weeks and 12 months, dyads in the depression and history-only groups displayed a reduced quality of interaction compared with healthy dyads. Specifically, at 8 weeks, 62% in the depression group and 56% in the history-only group scored in the lowest category of dyadic synchrony (suggesting therapeutic interventions are needed), compared with 37% in the healthy group (P = 0.041); 48% and 32%, respectively, scored the same at 12 months, compared with 14% in the healthy group (P = 0.003). At 6 days, neonates in the depression and history-only groups exhibited decreased social-interactive behaviour, which, together with maternal socioeconomic difficulties, was also predictive of interaction quality, whereas postnatal depression was not. CONCLUSIONS Both antenatal depression and a lifetime history of depression are associated with a decreased quality of mother-infant interaction, irrespective of postnatal depression. Clinicians should be aware of this, as pregnancy provides an opportunity for identification and intervention to support the developing relationship.
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Affiliation(s)
- Rebecca H Bind
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK
| | - Alessandra Biaggi
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK
| | | | - Andrea Du Preez
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK; and The Maurice Wohl Clinical Neuroscience Institute, Department of Basic and Clinical Neuroscience, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK
| | - Katie Hazelgrove
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK
| | - Freddie Waites
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK
| | - Susan Conroy
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK
| | - Paola Dazzan
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK
| | - Sarah Osborne
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK
| | - Susan Pawlby
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK
| | - Vaheshta Sethna
- Sackler Institute for Translational Neurodevelopment, Department of Forensic & Neurodevelopmental Sciences, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK
| | - Carmine M Pariante
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK
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21
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Chasson M, Ben-Yaakov O, Taubman – Ben-Ari O. Meaning in Life among New Mothers before and during the COVID-19 Pandemic: The Role of Mothers' Marital Satisfaction and Perception of the Infant. JOURNAL OF HAPPINESS STUDIES 2021; 22:3499-3512. [PMID: 33776553 PMCID: PMC7986640 DOI: 10.1007/s10902-021-00378-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 03/14/2021] [Indexed: 06/12/2023]
Abstract
On the assumption that existential questions may arise in the face of the transition to motherhood in the shadow of a global crisis, we sought to compare the levels of presence of meaning and search for meaning in life between two samples of new mothers: one recruited before the outbreak of COVID-19, and the other during the pandemic. In addition, we examined the associations between mother's marital satisfaction and perception of the infant on the one hand, and the two aspects of meaning in life on the other, investigating whether these variables mediate the link between research group and meaning in life. The results indicate that mothers reported significantly higher perception of infant's warmth and presence of meaning before than during the pandemic. Furthermore, they displayed greater marital satisfaction and more search for meaning during the pandemic than prior to it. For the whole sample, higher marital satisfaction and perception of infant's warmth were related to higher presence of meaning, and lower marital satisfaction and perception of the infant's invasiveness were related to higher search for meaning. Finally, mother's marital satisfaction and perception of the infant fully mediated the relationship between the research group and the two aspects of meaning in life. These findings are significant in that they provide, for the first time, evidence of changes in meaning in life among new mothers in a crisis situation, along with the importance of their perceptions of their relationships with the infant and spouse under these circumstances.
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Affiliation(s)
- Miriam Chasson
- The Louis and Gabi Weisfeld School of Social Work, Bar-Ilan University, 52900 Ramat Gan, Israel
| | - Ofir Ben-Yaakov
- The Louis and Gabi Weisfeld School of Social Work, Bar-Ilan University, 52900 Ramat Gan, Israel
| | - Orit Taubman – Ben-Ari
- The Louis and Gabi Weisfeld School of Social Work, Bar-Ilan University, 52900 Ramat Gan, Israel
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22
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Oh S, Chew-Graham CA, Silverwood V, Shaheen SA, Walsh-House J, Sumathipala A, Kingstone T. Exploring women's experiences of identifying, negotiating and managing perinatal anxiety: a qualitative study. BMJ Open 2020; 10:e040731. [PMID: 33380483 PMCID: PMC7780520 DOI: 10.1136/bmjopen-2020-040731] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/20/2023] Open
Abstract
OBJECTIVES Anxiety affects around 15% of women during the perinatal period and can adversely impact both mother and child, with potential implications for long-term health; few studies have examined women's experiences of perinatal anxiety (PNA). In the context of the National Institute for Health and Care Excellence prioritising PNA, this study aimed to explore women's experiences of the identification and management of PNA and their engagement with healthcare professionals. DESIGN Qualitative study with semi-structured interviews and applying thematic analysis. SETTING Recruitment materials were shared widely through maternal support groups, children's centres, libraries, National Health Service (NHS) providers (primary and secondary care) operating in the West Midlands or North West of England and through social media. PARTICIPANTS Seventeen women (aged 25-42 years) with self-reported anxiety during pregnancy and/or up to 12 months postpartum. Interviews digitally recorded and transcribed with consent. RESULTS Three main themes and corresponding sub-themes are described around a central concept of PNA as an individualised experience: barriers to disclosing PNA; help-seeking for PNA and establishing and engaging support networks. Disclosing, help-seeking and accessing systems of support were interconnected and contextualised by individualised experiences of PNA and pervaded by stigma. CONCLUSIONS This research provides new insights into PNA and calls for awareness to be improved to achieve parity alongside depression and avoid missed opportunities in the provision of care for women and families. Future research should seek to develop novel PNA-specific interventions aimed at prevention, management and/or combatting stigma to support more women to disclose mental health concerns and seek help early.
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Affiliation(s)
- Soo Oh
- School of Medicine, Keele University, Keele, UK
| | - Carolyn A Chew-Graham
- School of Medicine, Keele University, Keele, UK
- St George's Hospital, Midlands Partnership NHS Foundation Trust, Stafford, UK
| | | | | | | | - Athula Sumathipala
- School of Medicine, Keele University, Keele, UK
- St George's Hospital, Midlands Partnership NHS Foundation Trust, Stafford, UK
| | - Tom Kingstone
- School of Medicine, Keele University, Keele, UK
- St George's Hospital, Midlands Partnership NHS Foundation Trust, Stafford, UK
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23
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Abstract
Perinatal mental health has become a significant focus of interest in recent years, with investment in new specialist mental health services in some high-income countries, and inpatient psychiatric mother and baby units in diverse settings. In this paper, we summarize and critically examine the epidemiology and impact of perinatal mental disorders, including emerging evidence of an increase of their prevalence in young pregnant women. Perinatal mental disorders are among the commonest morbidities of pregnancy, and make an important contribution to maternal mortality, as well as to adverse neonatal, infant and child outcomes. We then review the current evidence base on interventions, including individual level and public health ones, as well as service delivery models. Randomized controlled trials provide evidence on the effectiveness of psychological and psychosocial interventions at the individual level, though it is not yet clear which women with perinatal mental disorders also need additional support for parenting. The evidence base on psychotropic use in pregnancy is almost exclusively observational. There is little research on the full range of perinatal mental disorders, on how to improve access to treatment for women with psychosocial difficulties, and on the effectiveness of different service delivery models. We conclude with research and clinical implications, which, we argue, highlight the need for an extension of generic psychiatric services to include preconception care, and further investment into public health interventions, in addition to perinatal mental health services, potentially for women and men, to reduce maternal and child morbidity and mortality.
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Affiliation(s)
- Louise M. Howard
- Section of Women's Mental Health, Health Service and Population Research DepartmentInstitute of Psychiatry, Psychology and Neuroscience, King's College LondonLondonUK
| | - Hind Khalifeh
- Section of Women's Mental Health, Health Service and Population Research DepartmentInstitute of Psychiatry, Psychology and Neuroscience, King's College LondonLondonUK
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24
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Lutkiewicz K, Bieleninik Ł, Cieślak M, Bidzan M. Maternal-Infant Bonding and Its Relationships with Maternal Depressive Symptoms, Stress and Anxiety in the Early Postpartum Period in a Polish Sample. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E5427. [PMID: 32731490 PMCID: PMC7432717 DOI: 10.3390/ijerph17155427] [Citation(s) in RCA: 44] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/28/2020] [Revised: 07/24/2020] [Accepted: 07/27/2020] [Indexed: 01/01/2023]
Abstract
A large body of literature indicates that there is a relationship between maternal psychological well-being and the early maternal-infant bond. However, this relationship is not fully understood, due to the different theoretical frameworks of maternal-infant bonding and different data collections points. Thus, the aim of this study was to examine the relationship between the maternal bond and the maternal psychological state including anxiety, stress, and maternal depressive symptoms. In this cohort study, 150 women who gave birth after 37 weeks of pregnancy completed the following self-reports 1-3 days post-delivery: Socio-demographic questionnaire, Postpartum Bonding Questionnaire (PBQ), Edinburgh Postpartum Depression Scale (EPDS), Postpartum Depression Screening Scale (PDSS), Generalized Anxiety Disorder Assessment (GAD-7), and Parental Stress Scale (PSS). The obtained results showed that the maternal level of stress, anxiety and postnatal depressive symptoms are significantly correlated with the maternal-infant bond in Polish mothers. In addition, regression analysis shows that postpartum depressive symptoms and maternal stress are significantly associated with the maternal-infant bonding process in the early postpartum period. This finding emphasizes the importance of identifying maternal mental state difficulties in the early postpartum period in order to provide interventions to help build healthy maternal-infant bonding.
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Affiliation(s)
- Karolina Lutkiewicz
- Institute of Psychology, University of Gdansk, 80-309 Gdańsk, Poland; (Ł.B.); (M.C.); (M.B.)
| | - Łucja Bieleninik
- Institute of Psychology, University of Gdansk, 80-309 Gdańsk, Poland; (Ł.B.); (M.C.); (M.B.)
- GAMUT—The Grieg Academy Music Therapy Research Centre, NORCE Norwegian Research Centre AS, 5029 Bergen, Norway
| | - Mariusz Cieślak
- Institute of Psychology, University of Gdansk, 80-309 Gdańsk, Poland; (Ł.B.); (M.C.); (M.B.)
| | - Mariola Bidzan
- Institute of Psychology, University of Gdansk, 80-309 Gdańsk, Poland; (Ł.B.); (M.C.); (M.B.)
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The role of reproductive variables, anxiety, physical activity, on the sleep quality of lactating women referring to health care centers of Zanjan-Iran. PREVENTIVE CARE IN NURSING AND MIDWIFERY JOURNAL 2020. [DOI: 10.52547/pcnm.10.1.39] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
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