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Lamsal R, Yeh EA, Pullenayegum E, Ungar WJ. A Systematic Review of Methods and Practice for Integrating Maternal, Fetal, and Child Health Outcomes, and Family Spillover Effects into Cost-Utility Analyses. PHARMACOECONOMICS 2024:10.1007/s40273-024-01397-5. [PMID: 38819718 DOI: 10.1007/s40273-024-01397-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 05/12/2024] [Indexed: 06/01/2024]
Abstract
BACKGROUND Maternal-perinatal interventions delivered during pregnancy or childbirth have unique characteristics that impact the health-related quality of life (HRQoL) of the mother, fetus, and newborn child. However, maternal-perinatal cost-utility analyses (CUAs) often only consider either maternal or child health outcomes. Challenges include, but are not limited to, measuring fetal, newborn, and infant health outcomes, and assessing their impact on maternal HRQoL. It is also important to recognize the impact of maternal-perinatal health on family members' HRQoL (i.e., family spillover effects) and to incorporate these effects in maternal-perinatal CUAs. OBJECTIVE The aim was to systematically review the methods used to include health outcomes of pregnant women, fetuses, and children and to incorporate family spillover effects in maternal-perinatal CUAs. METHODS A literature search was conducted in Medline, Embase, EconLit, Cochrane Collection, Cumulative Index to Nursing and Allied Health Literature (CINAHL), International Network of Agencies for Health Technology Assessment (INAHTA), and the Pediatric Economic Database Evaluation (PEDE) databases from inception to 2020 to identify maternal-perinatal CUAs that included health outcomes for pregnant women, fetuses, and/or children. The search was updated to December 2022 using PEDE. Data describing how the health outcomes of mothers, fetuses, and children were measured, incorporated, and reported along with the data on family spillover effects were extracted. RESULTS Out of 174 maternal-perinatal CUAs identified, 62 considered the health outcomes of pregnant women, and children. Among the 54 quality-adjusted life year (QALY)-based CUAs, 12 included fetal health outcomes, the impact of fetal loss on mothers' HRQoL, and the impact of neonatal demise on mothers' HRQoL. Four studies considered fetal health outcomes and the effects of fetal loss on mothers' HRQoL. One study included fetal health outcomes and the impact of neonatal demise on maternal HRQoL. Furthermore, six studies considered the impact of neonatal demise on maternal HRQoL, while four included fetal health outcomes. One study included the impact of fetal loss on maternal HRQoL. The remaining 26 only included the health outcomes of pregnant women and children. Among the eight disability-adjusted life year (DALY)-based CUAs, two measured fetal health outcomes. Out of 174 studies, only one study included family spillover effects. The most common measurement approach was to measure the health outcomes of pregnant women and children separately. Various approaches were used to assess fetal losses in terms of QALYs or DALYs and their impact on HRQoL of mothers. The most common integration approach was to sum the QALYs or DALYs for pregnant women and children. Most studies reported combined QALYs and incremental QALYs, or DALYs and incremental DALYs, at the family level for pregnant women and children. CONCLUSIONS Approximately one-third of maternal-perinatal CUAs included the health outcomes of pregnant women, fetuses, and/or children. Future CUAs of maternal-perinatal interventions, conducted from a societal perspective, should aim to incorporate health outcomes for mothers, fetuses, and children when appropriate. The various approaches used within these CUAs highlight the need for standardized measurement and integration methods, potentially leading to rigorous and standardized inclusion practices, providing higher-quality evidence to better inform decision-makers about the costs and benefits of maternal-perinatal interventions. Health Technology Assessment agencies may consider providing guidance for interventions affecting future lives in future updates.
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Affiliation(s)
- Ramesh Lamsal
- Child Health Evaluative Sciences, The Hospital for Sick Children, Toronto, ON, Canada
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada
| | - E Ann Yeh
- Division of Neurology, Department of Pediatrics, University of Toronto, Toronto, ON, Canada
- Neurosciences and Mental Health, SickKids Research Institute, Toronto, ON, Canada
| | - Eleanor Pullenayegum
- Child Health Evaluative Sciences, The Hospital for Sick Children, Toronto, ON, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - Wendy J Ungar
- Child Health Evaluative Sciences, The Hospital for Sick Children, Toronto, ON, Canada.
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada.
- The Hospital for Sick Children, Peter Gilgan Centre for Research and Learning, 686 Bay Street, 11th Floor, Toronto, ON, M5G 0A4, Canada.
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Goyal D, Dol J, Huynh J, Anand S, Dennis CL. Postpartum Mental Health and Perceptions of Discrimination Among Asian Fathers During the COVID-19 Pandemic. MCN Am J Matern Child Nurs 2024; 49:88-94. [PMID: 38108414 DOI: 10.1097/nmc.0000000000000984] [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: 12/19/2023]
Abstract
PURPOSE The purpose of this study was twofold: (1) to examine the prevalence of postpartum depression and anxiety symptomatology among fathers of Asian descent living in North America during the COVID-19 pandemic, and (2) to identify the occurrences of online racial discrimination. STUDY DESIGN AND METHODS Using a cross-sectional design and convenience sampling methods, we recruited fathers online via social media sites (Facebook, Instagram) between March 12 and July 31, 2022. The Edinburgh Postnatal Depression Scale, General Anxiety Scale, and the Online Victimization Scale assessed mental health well-being and discrimination outcomes. Data were analyzed using descriptive statistics, two sample t-test, chi-square test of independence, and Pearson's correlation analysis. RESULTS Our sample included 61 fathers within 6 months postpartum living in the United States and Canada. Participants were on average 34 years old, married, and represented 17 Asian ethnic groups, including Asian Indian (41%), Filipino (11.3%), and Korean (8.1%). One-third of our participants (31.1%, n = 19) were at high risk of developing postpartum depression and scores of three (4.9%) fathers indicated they had clinically significant anxiety. Overall, 26.3% reported experiencing direct online racial discrimination and 65% reported occurrences of indirect online racial discrimination. CLINICAL IMPLICATIONS There was a high rate of depressive symptoms and occurrences of online racial discrimination among fathers of Asian descent living in North America. These rates are higher than the general perinatal population and further research is warranted to examine risk factors and preventive strategies among this unique paternal ethnic group.
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Smith SVM, Darroch FE, Giles AR, Wykes D. Fatherhood and Elite Athletics: Sacrifice, Selfishness, and Gaining "Dad Strength". THE JOURNAL OF MEN'S STUDIES 2024; 32:152-177. [PMID: 38269335 PMCID: PMC10803200 DOI: 10.1177/10608265231204564] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/26/2024]
Abstract
This study contributes to a growing body of scholarly discussions around the many aspects and challenges of combining parenthood with elite-level sport, with a particular focus on the experiences of male elite athletes who are fathers. We used a caring masculinities theoretical framework, community-based participatory research, and semi-structured interviews to explore the experiences of 10 elite/international and world-class athletes (n = 9 fathers, n = 1 expectant father). Through reflexive thematic analysis, we identified three main themes: fatherhood can (1) improve and (2) impede elite athlete-fathers' athletic performance; and (3) athlete-fathers experience a trade-off between athletic performance and fatherhood responsibilities. Our findings underscore the ways in which male athletes' experiences with parenthood reflect the new era of involved fatherhood and are analogous to some of the identity tensions that have been reported with regard to the experiences of elite female athletes who are pregnant and/or mothers. Recognizing the impact of children on male athletes' athletic careers and the parallels between fatherhood, motherhood, and elite sport may lead to better support for athlete-fathers while also contributing to diminishing the expectation that women are primary caregivers to children.
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Affiliation(s)
- Sydney V. M. Smith
- School of Human Kinetics, Faculty of Health Sciences, University of Ottawa, Ottawa, ON, Canada
| | - Francine E. Darroch
- Department of Health Sciences, Faculty of Science, Carleton University, Ottawa, ON, Canada
| | - Audrey R. Giles
- School of Human Kinetics, Faculty of Health Sciences, University of Ottawa, Ottawa, ON, Canada
| | - Dylan Wykes
- Mile2Marathon Coaching Inc., Ottawa, ON, Canada
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Jeong J, McCann JK, Joachim D, Ahun MN, Kabati M, Kaaya S. Fathers' mental health and coping strategies: a qualitative study in Mwanza, Tanzania. BMJ Open 2024; 14:e080933. [PMID: 38417960 PMCID: PMC10900361 DOI: 10.1136/bmjopen-2023-080933] [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: 10/14/2023] [Accepted: 02/02/2024] [Indexed: 03/01/2024] Open
Abstract
OBJECTIVES To investigate the nature of paternal mental health problems, their causes and the coping strategies used by fathers of young children under the age of 2 years. DESIGN AND SETTING We conducted in-depth interviews with fathers, mothers, community leaders and community health workers as well as focus group discussions with fathers-only, mothers-only and mixed groups of fathers and mothers. Respondents provided their perspectives on the psychosocial challenges affecting fathers and how fathers responded to their mental health problems. Data were triangulated across stakeholders and analysed using thematic content analysis. SETTING The study was conducted in four communities in Mwanza, Tanzania. PARTICIPANTS The total sample included 56 fathers, 56 mothers and 8 community stakeholders that were equally distributed across the four communities. RESULTS Respondents highlighted a spectrum of mental health concerns affecting fathers, including elevated parenting stress, depressive symptoms, and anxiety. Causes of paternal mental health problems included poverty, child-related concerns, marital problems and family illness. When asked about paternal coping strategies, both fathers and mothers shared that fathers mostly turned to negative coping strategies to manage their distress, such as paternal alcohol use and poor conflict resolution strategies. However, respondents also shared how some fathers used positive coping strategies, such as seeking out social support from their family and friends, engaging in exercise and leisure activities and relying on their faith. CONCLUSIONS Overall, this study highlights the importance of supporting positive mental health among fathers. Our findings can inform the design of psychosocial programme components that can be integrated within parenting interventions to promote the well-being of specifically fathers and ultimately improve the family caregiving environment.
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Affiliation(s)
- Joshua Jeong
- Hubert Department of Global Health and Population, Emory University, Atlanta, Georgia, USA
| | - Juliet K McCann
- Hubert Department of Global Health and Population, Emory University, Atlanta, Georgia, USA
| | - Damas Joachim
- Tanzania Home Economics Organization, Mwanza, Tanzania, United Republic of
| | - Marilyn N Ahun
- Department of Global Health and Population, Harvard University T H Chan School of Public Health, Boston, Massachusetts, USA
- Department of Medicine, McGill University, Montréal, Québec, Canada
| | - Mary Kabati
- Tanzania Home Economics Organization, Mwanza, Tanzania, United Republic of
| | - Sylvia Kaaya
- Department of Psychiatry and Mental Health, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania, United Republic of
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Han RR, Xiang ZX, Zhang SH, Gao LL. Predictors of anxiety among pregnant women with gestational diabetes mellitus and their partners: The mediating role of marital satisfaction. Int J Nurs Pract 2024; 30:e13155. [PMID: 37056171 DOI: 10.1111/ijn.13155] [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: 08/28/2022] [Revised: 03/15/2023] [Accepted: 03/19/2023] [Indexed: 04/15/2023]
Abstract
AIMS This study aims to examine the prevalence of anxiety symptoms and identify predictors of anxiety among pregnant women with gestational diabetes mellitus and their partners and explore the mediating role of marital satisfaction between maternal and paternal anxiety. DESIGN A cross-sectional study was conducted in Guangzhou, China, from July 2021 to May 2022. METHODS A total of 306 dyads of pregnant women with gestational diabetes mellitus and their partners completed the State-Trait Anxiety Inventory, Locke-Wallace Marital Adjustment Test and the socio-demographic and clinical data sheet. RESULTS The prevalence of anxiety symptoms was 32.4% and 36.6% in pregnant women with gestational diabetes mellitus and their partners, respectively. The predictors of maternal anxiety were paternal anxiety, maternal marital satisfaction, maternal monthly salary, fasting glucose value and 1-h glucose value. By contrast, the predictors of paternal anxiety were maternal anxiety, paternal marital satisfaction and paternal monthly salary. Moreover, the relationship between maternal and paternal anxiety was mediated by marital satisfaction. CONCLUSIONS The anxiety symptoms of pregnant women with gestational diabetes mellitus and their partners influence each other, and this relationship was mediated by marital satisfaction. Every couple should be screened for anxiety symptoms and treated as a team rather than focusing solely on the pregnant woman.
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Affiliation(s)
- Rong-Rong Han
- School of Nursing, Sun Yat-Sen University, Guangzhou, China
| | - Zhi-Xuan Xiang
- School of Nursing, Sun Yat-Sen University, Guangzhou, China
| | - Shu-Han Zhang
- School of Nursing, Sun Yat-Sen University, Guangzhou, China
| | - Ling-Ling Gao
- School of Nursing, Sun Yat-Sen University, Guangzhou, China
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Lewkowitz AK, Rubin-Miller L, Jahnke HR, Clark MA, Zlotnick C, Miller ES, Henrich N. Demographic and Support Interest Differences Among Nonbirthing Parents Using a Digital Health Platform With Parenthood-Related Anxiety: Cross-Sectional Study. JMIR Pediatr Parent 2023; 6:e46152. [PMID: 37990826 PMCID: PMC10686614 DOI: 10.2196/46152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Revised: 10/11/2023] [Accepted: 10/16/2023] [Indexed: 11/23/2023] Open
Abstract
Background The transition to parenthood is a period of major stressors and increased risk of anxiety for all parents. Though rates of perinatal anxiety are similar among women (4%-25%) and men (3%-25%), perinatal anxiety research on nonbirthing partners remains limited. Objective We aimed to examine whether demographic characteristics or digital perinatal support preferences differed among nonbirthing partners with compared to without self-reported high parenthood-related anxiety. Methods In this large cross-sectional study of nonbirthing partners using a digital perinatal health platform during their partner's pregnancy, users reported their parenthood-related anxiety through a 5-item Likert scale in response to the prompt "On a scale of 1=None to 5=Extremely, how anxious are you feeling about parenthood?" High parenthood-related anxiety was defined as reporting being very or extremely anxious about parenthood. During the onboarding survey, in response to the question "Which areas are you most interested in receiving support in?" users selected as many support interests as they desired from a list of options. Chi-square and Fisher exact tests were used to compare demographic characteristics and support interests of nonbirthing partners with low versus high parenthood anxiety. Logistic regression models estimated the odds ratios (ORs), with 95% CIs, of high parenthood-related anxiety with each user characteristic or digital support interest. Results Among 2756 nonbirthing partners enrolled in the digital platform during their partner's pregnancy, 2483 (90.1%) were men, 1668 (71.9%) were first-time parents, 1159 (42.1%) were non-Hispanic White, and 1652 (50.9%) endorsed an annual household income of >US $100,000. Overall, 2505 (91.9%) reported some amount of parenthood-related anxiety, and 437 (15.9%) had high parenthood-related anxiety. High parenthood-related anxiety was more common among non-White nonbirthing partners: compared to those who identified as non-Hispanic White, those who identified as Asian, Black, or Hispanic had 2.39 (95% CI 1.85-3.08), 2.01 (95% CI 1.20-3.23), and 1.68 (95% CI 1.15-2.41) times the odds of high parenthood-related anxiety, respectively. Lower household income was associated with increased odds of reporting high parenthood anxiety, with the greatest effect among those with annual incomes of US $100,000 (OR 2.13, 95% CI 1.32-3.34). In general, nonbirthing partners were interested in receiving digital support during their partner's pregnancy, but those with high parenthood-related anxiety were more likely to desire digital support for all support interests compared to those without high parenthood anxiety. Those with high parenthood-related anxiety had more than 2 times higher odds of requesting digital education about their emotional health compared to those without high parenthood-related anxiety (OR 2.06, 95% CI 1.67-2.55). Conclusions These findings demonstrate the need for perinatal anxiety-related support for all nonbirthing partners and identify nonbirthing partners' demographic characteristics that increase the odds of endorsing high parenthood-related anxiety. Additionally, these findings suggest that most nonbirthing partners using a digital health platform with high parenthood-related anxiety desire to receive perinatal mental health support.
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Affiliation(s)
- Adam K Lewkowitz
- Department of Obstetrics and Gynecology, Warren Alpert Medical School at Brown University, ProvidenceRI, United States
| | | | | | - Melissa A Clark
- Department of Obstetrics and Gynecology, Warren Alpert Medical School at Brown University, ProvidenceRI, United States
- Department of Health Services, Policy, & Practice, Brown School of Public Health, ProvidenceRI, United States
| | - Caron Zlotnick
- Department of Obstetrics and Gynecology, Warren Alpert Medical School at Brown University, ProvidenceRI, United States
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School at Brown University, ProvidenceRI, United States
| | - Emily S Miller
- Department of Obstetrics and Gynecology, Warren Alpert Medical School at Brown University, ProvidenceRI, United States
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Lewkowitz AK, Guille C, Rubin-Miller L, Jahnke HR, Ayala NK, Miller ES, Henrich N. Association between nonbirthing parent's perinatal education and mental health support desires and perinatal anxiety among either parent. Am J Obstet Gynecol MFM 2023; 5:101177. [PMID: 37806649 PMCID: PMC10842621 DOI: 10.1016/j.ajogmf.2023.101177] [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: 07/05/2023] [Revised: 09/19/2023] [Accepted: 10/03/2023] [Indexed: 10/10/2023]
Abstract
BACKGROUND Although perinatal anxiety is common in birthing and nonbirthing parents, little is known about the mental health or educational needs of nonbirthing parents during the perinatal period and whether perinatal anxiety in the birthing parent is associated with nonbirthing parent educational preferences. OBJECTIVE This study aimed to examine the desired digital perinatal educational preferences of nonbirthing parents and whether these preferences differed by (1) endorsement of high parenthood-related anxiety in the nonbirthing partner and (2) mental health of the birthing parent (including both identified mental health conditions and presence of pregnancy-related anxiety). STUDY DESIGN In this cross-sectional study, nonbirthing and birthing parents using Maven, a digital perinatal health platform, selected the areas in which they wanted education or support from a list of options. In addition, the participants reported their experience of parenthood or pregnancy-related anxiety through a 5-item Likert scale in response to the prompt, "On a scale of 1 (not at all) to 5 (extremely), how anxious are you feeling about parenthood or pregnancy?" High parenthood or pregnancy-related anxiety was defined as being very (scale: 4) or extremely (scale: 5) anxious. Furthermore, birthing parents reported whether they had a current or previous mood disorder, but this information was not reported by nonbirthing parents. Survey responses for birthing and nonbirthing parents were linked through the digital platform. Descriptive analyses were used to assess nonbirthing parent demographics and perinatal support interests, stratified by high parenthood-related anxiety, high pregnancy-related anxiety in their partner, and perinatal mood disorders or high pregnancy-related anxiety in their partner. RESULTS Among 382 nonbirthing parents, most (85.6%) desired to receive digital support during their partner's pregnancy: the most commonly endorsed support interests were infant care (327 [85.6%]) and understanding their partner's emotional (313 [81.9%]) or physical (294 [77.0%]) experience during pregnancy. Overall, 355 nonbirthing parents (93.9%) endorsed any parenthood-related anxiety, and 63 nonbirthing parents (16.5%) were categorized as having high parenthood-related anxiety. Those with high parenthood-related anxiety were more likely to desire digital support for each topic. Among birthing parents, 124 (32.4%) had a mental health condition, and 45 (11.8%) had high pregnancy-related anxiety. When nonbirthing parents were stratified by the presence of their partner having a mental health condition or high pregnancy-related anxiety alone, no difference in desired perinatal education was identified. Although nonbirthing parents had higher rates of high parenthood-related anxiety if the birthing parent reported high pregnancy anxiety (17 [27.0%] vs 28 [8.8%]; P<.001), no difference was found with other conditions within the mental health composite. CONCLUSION In this cross-sectional study, many nonbirthing parents who engaged with a perinatal digital platform desired education on their or their partner's emotional health during the perinatal period, and most endorsed parenthood-related anxiety. Our findings suggest that perinatal mental health support is needed for nearly all parents and that nonbirthing parents who use digital health platforms are amenable to receiving comprehensive perinatal education via these platforms.
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Affiliation(s)
- Adam K Lewkowitz
- Department of Obstetrics and Gynecology, Warren Alpert Medical School of Brown University, Providence, RI (Drs Lewkowitz, Ayala, and Miller); Center for Digital Health, Brown University School of Public Health, Providence, RI (Dr Lewkowitz).
| | - Constance Guille
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC (Dr Guille); Maven Clinic, New York, NY (Dr Guille, Ms Rubin-Miller, and Drs Jahnke and Henrich)
| | - Lily Rubin-Miller
- Maven Clinic, New York, NY (Dr Guille, Ms Rubin-Miller, and Drs Jahnke and Henrich)
| | - Hannah R Jahnke
- Maven Clinic, New York, NY (Dr Guille, Ms Rubin-Miller, and Drs Jahnke and Henrich)
| | - Nina K Ayala
- Department of Obstetrics and Gynecology, Warren Alpert Medical School of Brown University, Providence, RI (Drs Lewkowitz, Ayala, and Miller)
| | - Emily S Miller
- Department of Obstetrics and Gynecology, Warren Alpert Medical School of Brown University, Providence, RI (Drs Lewkowitz, Ayala, and Miller)
| | - Natalie Henrich
- Maven Clinic, New York, NY (Dr Guille, Ms Rubin-Miller, and Drs Jahnke and Henrich)
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Oftedal A, Tsotsi S, Kaasen A, Mayerhofer LJK, Røysamb E, Smajlagic D, Tanbo TG, Bekkhus M. Anxiety and depression in expectant parents: ART versus spontaneous conception. Hum Reprod 2023; 38:1755-1760. [PMID: 37354117 PMCID: PMC10477938 DOI: 10.1093/humrep/dead133] [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: 12/14/2022] [Revised: 06/05/2023] [Indexed: 06/26/2023] Open
Abstract
STUDY QUESTION Do expectant parents experience increased anxiety and depression during pregnancies conceived through ART compared to spontaneous conception? SUMMARY ANSWER Among all expectant parents in the sample, those who conceived through ART reported overall lower levels of anxiety and depression in pregnancy compared to expectant parents who conceived spontaneously, while in the subsample of parents who conceived both through ART and spontaneous conception, expectant mothers experienced increased anxiety and depression in early pregnancy following ART compared to spontaneous conception. WHAT IS KNOWN ALREADY Previous research on expectant parents' psychosocial adjustment in response to ART has found mixed results, with some studies suggesting ART is associated with increased anxiety and depression, and other studies suggesting improved mental health or no relationship. Mixed findings may relate to the use of cross-sectional designs that do not account for confounding differences between groups, or variability in the timing of assessment. STUDY DESIGN, SIZE, DURATION This prospective cohort study used data from the Norwegian Mother, Father and Child Cohort Study (MoBa), which includes 2960 pregnant women who underwent ART and 108 183 women who conceived spontaneously. Of these, a subsample of expectant parents had two consecutive pregnancies with one pregnancy resulting from ART and one conceived spontaneously (n = 286 women, n = 211 partners). Women self-reported their composite symptoms of anxiety and depression at two timepoints during each pregnancy (gestational weeks 17 and 30). Their partners self-reported composite symptoms of anxiety and depression at 17 weeks gestation during each pregnancy. Couples reported their relationship satisfaction at 17 weeks gestation. MAIN RESULTS AND THE ROLE OF CHANGE Using a conventional full-cohort analysis we found that ART was associated with less total anxiety and depression and greater relationship satisfaction, compared to spontaneous conception among both women and men. However, in the subsample of parents who experienced both ART and spontaneous pregnancies, ART was associated with increased levels of maternal anxiety and depression at gestational age 17 weeks (M = 1.19), compared to spontaneous pregnancies (M = 1.15), 95% CI of the mean difference 0.006, 0.074. At 30 weeks gestation, anxiety and depression were similar across both types of pregnancies. Expectant fathers reported similar levels of anxiety and depression at 17 weeks gestation during both pregnancies. Among women relationship satisfaction was higher following ART conception than spontaneous conception. LIMITATIONS, REASONS FOR CAUTION There is potential for selection effects in the sample, as women who have conceived through both ART and spontaneous conception in their first two pregnancies are rare. In addition, several factors that may be important predictors of mental health in this context, such as previous miscarriages and long-term infertility, were not assessed in the current study. WIDER IMPLICATIONS OF THE FINDINGS Our findings indicate that previous discrepancies in the literature may be related to inherent differences between the groups of parents receiving reproductive treatment and those who do not. This study addresses that limitation by prospectively comparing different types of pregnancies within the same expectant parents. Earlier inconsistencies may also relate to variations in gestational age when anxiety and depression were assessed. By examining symptoms at two timepoints in each pregnancy, we were able to examine the relation between gestational age and symptoms of anxiety and depression. STUDY FUNDING/COMPETING INTEREST(S) The MoBa is supported by the Norwegian Ministry of Health and the Norwegian Research Council/FUGE (grant number 151918/S10). This work was also supported by the Research Council of Norway grant number 288083 and 301004. The authors have no conflicts of interest to declare. TRIAL REGISTRATION NUMBER N/A.
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Affiliation(s)
- Aurora Oftedal
- Department of Children and Families, Division of Mental and Physical Health, Norwegian Institute of Public Health, Oslo, Norway
| | - Stella Tsotsi
- Promenta Research Center, Department of Psychology, University of Oslo, Oslo, Norway
| | - Anne Kaasen
- Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway
| | - Lilian J K Mayerhofer
- Promenta Research Center, Department of Psychology, University of Oslo, Oslo, Norway
| | - Espen Røysamb
- Department of Children and Families, Division of Mental and Physical Health, Norwegian Institute of Public Health, Oslo, Norway
- Promenta Research Center, Department of Psychology, University of Oslo, Oslo, Norway
| | - Dinka Smajlagic
- Promenta Research Center, Department of Psychology, University of Oslo, Oslo, Norway
| | - Tom G Tanbo
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Mona Bekkhus
- Promenta Research Center, Department of Psychology, University of Oslo, Oslo, Norway
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Garthus-Niegel S, Kittel-Schneider S. [Fathers and peripartum mental illness: the neglected parent?]. DER NERVENARZT 2023; 94:779-785. [PMID: 37389668 DOI: 10.1007/s00115-023-01508-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 05/11/2023] [Indexed: 07/01/2023]
Abstract
Fathers also play an important role during pregnancy and the postpartum period, both for the partner and for the child. With changes in society and increasing early involvement in the care of infants, the father-child relationship has become increasingly more important in recent years. There is growing evidence that fathers can also suffer from mental illnesses during their partner's pregnancy and especially after the birth of a child. As the transition to the role of a father is a major change in a man's life, the birth of a child can be a life event that contributes to a first time mental illness or triggers a new episode of an already existing illness. For example, birth complications can also traumatize the attendant fathers and result in trauma sequelae. Peripartum anxiety disorders and depression probably affect approximately 5% of all men and can among other things have a negative impact on the development of exposed children. Specific screening or even treatment services for affected men are still very rare and little research has been performed. Much less is known about the prevalence, risk factors, and treatment of other mental illnesses in fathers, and there is still a great need for research in this respect.
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Affiliation(s)
- Susan Garthus-Niegel
- Institut und Poliklinik für Arbeits- und Sozialmedizin, Technische Universität Dresden, Dresden, Deutschland
- Abteilung für Epidemiologie und Frauen- & Familiengesundheit, Medical School Hamburg, Hamburg, Deutschland
| | - Sarah Kittel-Schneider
- Department of Psychiatry and Neuobehavioural Science, Acute Mental Health Unit, Cork University Hospital, Wilton, University College Cork, Cork, Irland.
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Silverwood V, Bullock L, Jordan J, Turner K, Chew-Graham CA, Kingstone T, Dawson S. Non-pharmacological interventions for the management of perinatal anxiety in primary care: a meta-review of systematic reviews. BJGP Open 2023; 7:BJGPO.2023.0022. [PMID: 37217213 PMCID: PMC10646202 DOI: 10.3399/bjgpo.2023.0022] [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: 02/09/2023] [Revised: 05/12/2023] [Accepted: 05/19/2023] [Indexed: 05/24/2023] Open
Abstract
BACKGROUND Perinatal anxiety (PNA), anxiety that occurs during pregnancy and/or up to 12 months postpartum, is estimated to affect up to 21% of women, and may impact negatively on mothers, children, and their families. The National Institute for Health and Care Excellence (NICE) has called for further research around non-pharmacological interventions in primary care for PNA. AIM To summarise the available international evidence on non-pharmacological interventions for women with PNA in a primary care population. DESIGN & SETTING A meta-review of systematic reviews (SRs) with narrative synthesis was performed following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidance. METHOD Systematic literature searches were conducted in 11 health-related databases up to June 2022. Titles, abstracts, and full-text articles were dual-screened against pre-defined eligibility criteria. A variety of study designs were included. Data were extracted about study participants, intervention design, and context. Quality appraisal was performed using the AMSTAR 2 tool (A MeaSurement Tool to Assess systematic Reviews). A patient and public involvement group informed and contributed towards this meta-review. RESULTS Twenty-four SRs were included in the meta-review. Interventions were grouped into the following six categories for analysis purposes: psychological therapies; mind-body activities; emotional support from healthcare professionals (HCPs); peer support; educational activities; and alternative or complementary therapies. CONCLUSION In addition to pharmacological and psychological therapies, this meta-review has demonstrated that there are many more options available for women to choose from that might be effective to manage their PNA. Evidence gaps are present in several intervention categories. Primary care clinicians and commissioners should endeavour to provide patients with a choice of these management options, promoting individual choice and patient-centred care.
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Affiliation(s)
| | | | | | - Katrina Turner
- Centre of Academic Primary Health Care, Bristol Medical School, University of Bristol, Bristol, UK
| | - Carolyn A Chew-Graham
- School of Medicine, Keele University, Keele, UK
- Midlands Partnership NHS Foundation Trust,Trust Headquarters, St George's Hospital, Stafford, UK
- Applied Research Collaboration (ARC) West Midlands, Keele University, Keele, UK
| | - Tom Kingstone
- School of Medicine, Keele University, Keele, UK
- Midlands Partnership NHS Foundation Trust,Trust Headquarters, St George's Hospital, Stafford, UK
| | - Shoba Dawson
- Centre of Academic Primary Health Care, Bristol Medical School, University of Bristol, Bristol, UK
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11
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Martin AF, Maughan B, Konac D, Barker ED. Mother and father depression symptoms and child emotional difficulties: a network model. Br J Psychiatry 2023; 222:204-211. [PMID: 36942415 PMCID: PMC10895513 DOI: 10.1192/bjp.2023.8] [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: 05/18/2022] [Revised: 12/14/2022] [Accepted: 01/10/2023] [Indexed: 03/23/2023]
Abstract
BACKGROUND Mother and father depression symptoms often co-occur, and together can have a substantial impact on child emotional well-being. Little is understood about symptom-level mechanisms underlying the co-occurrence of depression symptoms within families. AIMS The objective was to use network analysis to examine depression symptoms in mothers and fathers after having a baby, and emotional symptoms in children in early adolescence. METHOD We examined data from 4492 mother-father-child trios taken from a prospective, population-based cohort in the UK. Symptoms were examined using two unregularised partial correlation network models. The initial model was used to examine the pattern of associations, i.e. the overall network structure, for mother and father depression symptoms, and then to identify bridge symptoms that reinforce depression symptoms between parents during offspring infancy. The second model examined associations between the parent symptom network, including bridge symptoms, with later child emotional difficulties. RESULTS The study included 4492 mother-father-child trios; 2204 (49.1%) children were female. Bridge symptoms reinforcing mother and father depression symptoms were feeling guilty and self-harm ideation. For mothers, the bridge symptom of feeling guilty, and symptoms of anhedonia, panic and sadness were highly connected with child emotional difficulties. For fathers, the symptom of feeling overwhelmed associated with child emotional difficulties. Guilt and anhedonia in fathers appeared to indirectly associate with child emotional difficulties through the same symptom in mothers. CONCLUSIONS Our findings suggest that specific symptom cascades are central for co-occurring depression in parents and increased vulnerability in children, providing potential therapeutic targets.
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Affiliation(s)
- Alex F Martin
- Department of Psychology, Institute of Psychiatry, Psychology & Neuroscience, King's College London, UK
| | - Barbara Maughan
- Social, Genetic & Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK
| | - Deniz Konac
- Department of Psychology, Institute of Psychiatry, Psychology & Neuroscience, King's College London, UK and Department of Psychology, Adana Alparslan Turkes Science and Technology University, Turkey
| | - Edward D Barker
- Department of Psychology, Institute of Psychiatry, Psychology & Neuroscience, King's College London, UK
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12
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Parental anxiety and offspring development: A systematic review. J Affect Disord 2023; 327:64-78. [PMID: 36740142 DOI: 10.1016/j.jad.2023.01.128] [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: 05/06/2022] [Revised: 01/24/2023] [Accepted: 01/30/2023] [Indexed: 02/05/2023]
Abstract
BACKGROUND Parental anxiety has been associated with increased risk of emotional and behavioural problems for offspring, yet the differing impact of each parent is unclear. As emotional disorders continue to present a significant challenge to the health system and with the role of mothers and fathers changing over the past two decades, we sought to systematically review the available literature for an association between parental anxiety and offspring suboptimal outcomes. METHODS A systematic review was conducted using the following databases: Ovid MEDLINE, Embase; PsycINFO and Google Scholar. Reference lists of the included papers were also searched. Data was analysed and grouped based on offspring age. RESULTS Eighteen studies were included in this review. Results suggest that both parents' mental health can impact negatively on the functioning of offspring, during infancy, childhood, and adolescence. This association is weak in infancy, with equivocal results, however the association in childhood appears robust for both mothers and fathers. In adolescence, the findings suggest that maternal anxiety may be more influential than paternal anxiety. LIMITATIONS As the methodology of the included studies was heterogenous, and the timing of assessment varied across the papers, drawing concrete conclusions from the existing research is somewhat impaired. CONCLUSIONS Both mothers' and fathers' anxiety have the propensity to negatively impact on their child's development. Implementing preventative interventions, which include both parents, as well as systemic interventions, which include the whole family, are essential in stemming the intergenerational transmission of mental health problems within families.
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13
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Isokääntä S, Koivula K, Kokki H, Palokangas S, Tavast K, Toivonen I, Kokki M. Psychiatric symptoms and couple satisfaction in parents of newborns before and during the COVID-19 pandemic-A comparison of two prospective studies. Nurs Open 2023; 10:2667-2677. [PMID: 36380141 PMCID: PMC10006651 DOI: 10.1002/nop2.1475] [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: 03/24/2022] [Revised: 10/21/2022] [Accepted: 10/29/2022] [Indexed: 11/17/2022] Open
Abstract
AIMS To assess anxiety, depression, perceived stress, couple satisfaction and life satisfaction of parents of healthy newborns in two cohorts in 2015 and in 2020 during the COVID-19 pandemic. DESIGN A prospective follow-up study. METHODS We enrolled 60 parents of healthy newborns (n = 30 dyads) in 2015 and 60 parents (n = 30 dyads) in 2020. Both parents completed six valid and reliable questionnaires independently 1-2 days and 12 months after delivery: Beck Anxiety Inventory, Beck Depression Inventory-II, Edinburgh Postnatal Depression Scale, Perceived Stress Scale, Couple Satisfaction Index and Life Satisfaction Scale-4. RESULTS Anxiety was more common but couple satisfaction better in both parents during the COVID-19 pandemic than in 2015. Depressive symptoms and perceived stress were similarly low, and life satisfaction was similarly high in both cohorts, indicating ample parental resilience. There was a moderate positive association between previous mental health disorders and parental anxiety after delivery during the COVID-19 pandemic.
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Affiliation(s)
- Siiri Isokääntä
- Department of Anesthesiology and Intensive Care, Kuopio University Hospital, Kuopio, Finland.,School of Medicine, Faculty of Health Sciences, University of Eastern Finland, Kuopio, Finland
| | - Krista Koivula
- Department of Pediatrics, Kuopio University Hospital, Kuopio, Finland
| | - Hannu Kokki
- Department of Anesthesiology and Intensive Care, Kuopio University Hospital, Kuopio, Finland
| | - Sinivaula Palokangas
- School of Medicine, Faculty of Health Sciences, University of Eastern Finland, Kuopio, Finland
| | - Kati Tavast
- School of Medicine, Faculty of Health Sciences, University of Eastern Finland, Kuopio, Finland
| | - Iines Toivonen
- School of Medicine, Faculty of Health Sciences, University of Eastern Finland, Kuopio, Finland
| | - Merja Kokki
- Department of Anesthesiology and Intensive Care, Kuopio University Hospital, Kuopio, Finland
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14
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Sutcliffe KL, Levett K, Dahlen HG, Newnham E, MacKay LM. How Do Anxiety and Relationship Factors Influence the Application of Childbirth Education Strategies During Labor and Birth: A Bowen Family Systems Perspective. Int J Womens Health 2023; 15:455-465. [PMID: 37033120 PMCID: PMC10075222 DOI: 10.2147/ijwh.s399588] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2022] [Accepted: 03/24/2023] [Indexed: 04/03/2023] Open
Abstract
The effectiveness of childbirth education (CBE) has long been debated with studies showing contradictory outcomes for mothers and babies. Understanding how what is learned in CBE is translated into practice during labor and birth is an area that requires investigation as this may be a mediating factor in its effectiveness. Bowen family system theory's concept of differentiation of self, the ability to be guided by and to act from one's beliefs and values, is an organizing principle that may affect how relational factors affect the use and application of CBE at the time of birth. The ability to act with emotional maturity when faced with a stressor, such as childbirth, depends on an individual's capability to separate thoughts from the more reactive feeling process. Recognizing how one's level of differentiation interacts with the anxious responses of others may assist pregnant women and birth partners to make decisions more objectively about how they want to manage the birthing process. For the health professional, understanding the interplay of relationship variables, physiological stress, anxiety and individual reactivity may allow for the provision of more thoughtful evidence-based practice, which may increase objectivity, and aid communication and decision-making for women during birth. Bowen theory, as a comprehensive systems-based approach to understanding human functioning under stress, offers a novel approach to exploring the application of CBE during birth.
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Affiliation(s)
- Kerry L Sutcliffe
- School of Medicine, University of Notre Dame Australia, Sydney, NSW, Australia
- Correspondence: Kerry L Sutcliffe, School of Medicine, University of Notre Dame Australia, Auburn Clinical School, 88-90 Water Street, Auburn, Sydney, NSW, 2144, Australia, Tel +61 451771723, Email
| | - Kate Levett
- School of Medicine, University of Notre Dame Australia, Sydney, NSW, Australia
- Adjunct Fellow, NICM Health Research Institute, and THRI, Western Sydney University, Sydney, NSW, Australia
- Honorary Fellow, Centre for Midwifery, Child and Family Health, University of Technology Sydney, Sydney, NSW, Australia
| | - Hannah G Dahlen
- School of Nursing & Midwifery, Western Sydney University, Sydney, NSW, Australia
| | - Elizabeth Newnham
- School of Nursing & Midwifery, University of Newcastle, Newcastle, NSW, Australia
| | - Linda M MacKay
- School of Arts & Sciences, University of Notre Dame Australia, Sydney, NSW, Australia
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15
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Solberg B, Glavin K, Berg RC, Olsvold N. "Opening up a well of emotions": A qualitative study of men's emotional experiences in the transition to fatherhood. Nurs Open 2023; 10:2282-2294. [PMID: 36403217 PMCID: PMC10006604 DOI: 10.1002/nop2.1482] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2022] [Revised: 11/01/2022] [Accepted: 11/03/2022] [Indexed: 11/21/2022] Open
Abstract
AIM To explore the emotional changes and reactions men experience in their transition to fatherhood. DESIGN This study used a qualitative design. METHODS Data were collected through in-depth interviews with 13 Norwegian fathers. RESULTS Through thematic analysis, three main themes were developed: (1) from self-focus to family perspective; (2) emotional vulnerability; and (3) from insecurity to self-assurance. The themes describe fathers' emotional process during the child's first year of life, ranging from positive feelings like affection and mastery, to challenging feelings like exclusion, jealousy and exhaustion. Many fathers describe taboos and shame over their own emotional reactions, although these can be considered a natural part of the postnatal period.
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Affiliation(s)
- Beate Solberg
- Faculty of Health, VID Specialized University, Oslo, Norway
| | - Kari Glavin
- Faculty of Health, VID Specialized University, Oslo, Norway
| | - Rigmor C Berg
- Norwegian Institute of Public Health, Oslo, Norway.,University of Tromsø, Tromsø, Norway
| | - Nina Olsvold
- Faculty of Health, VID Specialized University, Oslo, Norway
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16
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Shorey S, Chong YS, Shi L, Chua JS, Mathews J, Lim SH, Du R, Chan YH, Tan TC, Chee C, Law E. Evaluating the Effects of the Supportive Parenting App on Infant Developmental Outcomes: Longitudinal Study. JMIR Mhealth Uhealth 2023; 11:e43885. [PMID: 36811952 PMCID: PMC9996416 DOI: 10.2196/43885] [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: 10/28/2022] [Revised: 12/04/2022] [Accepted: 01/12/2023] [Indexed: 01/15/2023] Open
Abstract
BACKGROUND Previous studies have investigated the various effects of parenting on infant developmental outcomes. In particular, parental stress and social support have been found to significantly affect the growth of the newborn. Although many parents today use mobile apps to obtain more support in parenting and perinatal care, few studies have examined how these apps could affect infant development. OBJECTIVE This study aimed to examine the effectiveness of the Supportive Parenting App (SPA) in improving infant developmental outcomes during the perinatal period. METHODS This study adopted a 2-group parallel prospective longitudinal design and recruited 200 infants and their parents (N=400 mothers and fathers). The parents were recruited at 24 weeks of gestation for a randomized controlled trial conducted from February 2020 to July 2022. They were randomly allocated to either the intervention or control group. The infant outcome measures included cognition, language, motor skills, and social-emotional development. Data were collected from the infants when they were aged 2, 4, 6, 9, and 12 months. Linear and modified Poisson regressions were used to analyze the data to examine between- and within-group changes. RESULTS At 9 and 12 months post partum, the infants in the intervention group were found to have better communication and language skills than those in the control group. An analysis of motor development revealed that a larger proportion of the infants in the control group fell under the at-risk category, where they scored approximately 2 SDs below the normative scores. The control group infants scored higher on the problem solving domain at 6 months post partum. However, at 12 months postpartum, the infants in the intervention group performed better on cognitive tasks than those in the control group. Despite not being statistically significant, the intervention group infants were found to have consistently scored better on the social components of the questionnaires than the control group infants. CONCLUSIONS Overall, the infants whose parents had received the SPA intervention tended to fare better in most developmental outcome measures than those whose parents had received standard care only. The findings of this study suggest that the SPA intervention exerted positive effects on the communication, cognition, motor, and socioemotional development of the infants. Further research is needed to improve the content and support provided by the intervention to maximize the benefits gained by infants and their parents. TRIAL REGISTRATION ClinicalTrials.gov NCT04706442; https://clinicaltrials.gov/ct2/show/NCT04706442.
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Affiliation(s)
- Shefaly Shorey
- Alice Lee Centre for Nursing Studies, National University of Singapore, Singapore, Singapore
| | - Yap Seng Chong
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Luming Shi
- Singapore Clinical Research Institute, Singapore, Singapore
| | - Jing Shi Chua
- Alice Lee Centre for Nursing Studies, National University of Singapore, Singapore, Singapore
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- Division of Nursing, KK Women's and Children's Hospital, Singapore, Singapore
| | - Jancy Mathews
- National University Polyclinics, Singapore, Singapore
| | | | - Ruochen Du
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Yiong Huak Chan
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Thiam Chye Tan
- Mount Elizabeth Novena Specialist Centre, Singapore, Singapore
| | | | - Evelyn Law
- National University Hospital, Singapore, Singapore
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17
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Dabb C, Dryer R, Brunton RJ, Yap K, Roach VJ. Paternal pregnancy-related anxiety: Systematic review of men's concerns and experiences during their partners' pregnancies. J Affect Disord 2023; 323:640-658. [PMID: 36481231 DOI: 10.1016/j.jad.2022.11.092] [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: 10/17/2022] [Revised: 11/28/2022] [Accepted: 11/30/2022] [Indexed: 12/12/2022]
Abstract
BACKGROUND Up to 25 % of expectant parents experience anxiety symptoms. Pregnancy-related anxiety is characterised by concerns and worries specific to pregnancy, childbirth, and the transition to parenthood. While pregnancy-related anxiety is well-researched in women, the exact nature of this construct in men is unclear. The purpose of the current review was to examine men's concerns, worries, and fears during pregnancy and gain an understanding of their experiences during pregnancy. METHODS An integrative review design was adopted, using thematic content analysis to synthesise findings from quantitative and qualitative studies. Quality appraisal of the quantitative studies used the AXIS appraisal tool. The Critical Appraisal Skills Program (CASP) checklist was used for the qualitative studies. RESULTS A comprehensive search of nine databases led to inclusion of 14 quantitative and 41 qualitative studies. Ten dimensions of paternal pregnancy-related anxiety were identified: childbirth concerns, attitudes towards childbirth, baby concerns, acceptance of pregnancy, partner concerns, relationship concerns, worry about self, transition to parenthood, attitudes towards health care professionals, and practical and financial concerns. The pregnancy transition was characterised by mixed emotions and conflicted experiences for fathers. LIMITATIONS Generalizability of review findings was limited by poor reporting of demographic information by many included studies, exclusion of studies not published in English, and focus on heterosexual relationships. CONCLUSIONS Expectant fathers may experience anxiety symptoms characterised by excessive worry across multiple domains of pregnancy-related concerns. Clinicians play an important role in identifying and supporting fathers with pregnancy-related anxiety and addressing the sense of exclusion often experienced by them.
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Affiliation(s)
- Carol Dabb
- School of Behavioural and Health Sciences, Australian Catholic University, Strathfield Campus, NSW 2135, Australia.
| | - Rachel Dryer
- School of Behavioural and Health Sciences, Australian Catholic University, Strathfield Campus, NSW 2135, Australia
| | - Robyn J Brunton
- School of Psychology, Charles Sturt University, Bathurst Campus, NSW 2795, Australia
| | - Keong Yap
- School of Behavioural and Health Sciences, Australian Catholic University, Strathfield Campus, NSW 2135, Australia
| | - Vijay J Roach
- Past President, Royal Australian and New Zealand College of Obstetricians and Gynaecologists
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18
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Challacombe FL, Pietikäinen JT, Kiviruusu O, Saarenpää-Heikkilä O, Paunio T, Paavonen EJ. Paternal perinatal stress is associated with children's emotional problems at 2 years. J Child Psychol Psychiatry 2023; 64:277-288. [PMID: 36215991 PMCID: PMC10092317 DOI: 10.1111/jcpp.13695] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/28/2022] [Indexed: 01/17/2023]
Abstract
BACKGROUND Paternal mental health in pregnancy and postpartum has been increasingly highlighted as important both in its own right, but also as crucial for the development of children. Rates of help-seeking among fathers is low, possibly due to conceptualising their own difficulties as stress rather than problems with mood. The relationship between paternal stress and child outcomes has not been investigated. METHODS This study used data from the Finnish CHILD-SLEEP birth cohort. Data were available for 901 fathers and 939 mothers who completed questionnaires on demographics, stress, anxiety and depression at 32 weeks gestation, 3 months, 8 months and 24 months postpartum. Parental report of child emotional and behavioural problems was collected at 24 months. RESULTS Around 7% of fathers experienced high stress (over 90% percentile) at each timepoint measured in the perinatal period, rising to 10% at 2 years postpartum. Paternal stress measured antenatally, at 3 and 24 months was associated with child total problems at 24 months, while paternal depression and anxiety were not related to child outcomes when in the same model. After adjusting for concurrent maternal depression, anxiety and stress, an association remained between paternal stress at each timepoint and child total problem scores at 24 months. The strongest association was with paternal stress at 3 months (OR 3.17; 95% CI 1.63-6.16). There were stronger relationships between paternal stress and boys' rather than girls' total problem scores, although the interactions were not statistically significant. CONCLUSIONS Paternal stress is an important manifestation of perinatal distress and is related to child mental health, particularly when present in the early postpartum months. Paternal stress should therefore be assessed in the perinatal period, which presents opportunities for early intervention and prevention of difficulties for both father and child.
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Affiliation(s)
| | - Johanna T Pietikäinen
- Department of Public Health and Welfare, Finnish Institute for Health and Welfare, Helsinki, Finland.,Department of Psychiatry, University of Helsinki and Helsinki University Central Hospital, Helsinki, Finland
| | - Olli Kiviruusu
- Department of Public Health and Welfare, Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Outi Saarenpää-Heikkilä
- Pediatric Clinics, Tampere University Hospital, Tampere, Finland.,Tampere Centre for Child Health Research, University of Tampere and Tampere University Hospital, Tampere, Finland
| | - Tiina Paunio
- Department of Public Health and Welfare, Finnish Institute for Health and Welfare, Helsinki, Finland.,Department of Psychiatry and SleepWell Research Program, Faculty of Medicine, University of Helsinki and Helsinki University Central Hospital, Helsinki, Finland
| | - E Juulia Paavonen
- Department of Public Health and Welfare, Finnish Institute for Health and Welfare, Helsinki, Finland.,Pediatric Research Center, Child Psychiatry, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
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19
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Silverwood VA, Bullock L, Turner K, Chew-Graham CA, Kingstone T. The approach to managing perinatal anxiety: A mini-review. Front Psychiatry 2022; 13:1022459. [PMID: 36590629 PMCID: PMC9797985 DOI: 10.3389/fpsyt.2022.1022459] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2022] [Accepted: 11/23/2022] [Indexed: 12/23/2022] Open
Abstract
Perinatal Anxiety (PNA) is defined as anxiety occurring during pregnancy and up to 12 months post-partum and is estimated to affect up to 20% of women. Risk factors for PNA are multiple and can be classed as psychological, social and biological. PNA negatively impacts on the mother, child and family. PNA is not well-recognized and diagnosis of PNA can be challenging for clinicians. There is currently no validated case-finding or diagnostic test available for PNA. PNA has been less extensively researched than perinatal depression (PND). Clinical guidance currently recommends pharmacological and psychological therapies for the management of women with PNA, however the limited research available suggests that other intervention types may also be effective with some evidence on the effectiveness of non-pharmacological interventions in primary care for PNA. This article provides a mini-review of PNA, summarizing current evidence around PNA including risk factors, the impact of PNA, the process of diagnosis of PNA and focussing predominantly on available management options for PNA.
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Affiliation(s)
| | - Laurna Bullock
- School of Medicine, Keele University, Staffordshire, United Kingdom
| | - Katrina Turner
- Centre of Academic Primary Health Care, Bristol Medical School, University of Bristol, Bristol, United Kingdom
| | - Carolyn A. Chew-Graham
- School of Medicine, Keele University, Staffordshire, United Kingdom
- Midlands Partnership NHS Foundation Trust, Trust Headquarters, St George's Hospital, Stafford, United Kingdom
- Applied Research Collaboration (ARC) West Midlands, Keele University, Staffordshire, United Kingdom
| | - Tom Kingstone
- School of Medicine, Keele University, Staffordshire, United Kingdom
- Midlands Partnership NHS Foundation Trust, Trust Headquarters, St George's Hospital, Stafford, United Kingdom
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20
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Lowrie N, Le Bas G, Youssef G, Macdonald JA, Teague S, Rogers A, Sunderland M, Mattick R, Elliott EJ, Allsop S, Burns L, Najman J, Jacobs S, Olsson CA, Hutchinson D. Association of adolescent and young adult depression and anxiety with perinatal mental health in fathers: Findings from an Australian longitudinal study. J Psychiatr Res 2022; 156:206-213. [PMID: 36265257 DOI: 10.1016/j.jpsychires.2022.10.017] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Revised: 09/07/2022] [Accepted: 10/03/2022] [Indexed: 11/06/2022]
Abstract
The current study examined associations between preconception diagnoses of major depressive disorder (MDD) and anxiety disorders in adolescence and young adulthood and perinatal depression and anxiety symptoms in early fatherhood. In an Australian community cohort study of health and development, earlier history of MDD and anxiety disorders (extending back to adolescence) were assessed retrospectively in the third trimester of pregnancy via the Composite International Diagnostic Interview. Paternal perinatal depression and anxiety were then assessed prospectively over three timepoints (third trimester of pregnancy, 8 weeks and 12 months postpartum), using established cut-points on the Edinburgh Postnatal Depression Scale and the Depression Anxiety Stress Scales (anxiety subscale). Mixed-effects regression models examined risk associations between preconception diagnoses of MDD and anxiety disorders, and perinatal depression and anxiety symptoms at each timepoint, adjusting for socio-demographic factors and concurrent maternal mental health difficulties. The odds of clinically concerning levels of paternal perinatal depression and anxiety were 6-fold and 4-fold higher, respectively, in men with a preconception history of MDD. The odds of perinatal depression were 3-fold higher in men with a preconception history of an anxiety disorder. Less evidence was found for an association between preconception diagnoses of an anxiety disorder and perinatal anxiety in fathers. Interventions aimed at improving mental health in men during adolescence and young adulthood may promote continued psychological health in men during early fatherhood.
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Affiliation(s)
- Nele Lowrie
- Deakin University, Centre for Social and Early Emotional Development, School of Psychology, Faculty of Health, Geelong, Australia.
| | - Genevieve Le Bas
- Deakin University, Centre for Social and Early Emotional Development, School of Psychology, Faculty of Health, Geelong, Australia.
| | - George Youssef
- Deakin University, Centre for Social and Early Emotional Development, School of Psychology, Faculty of Health, Geelong, Australia; Murdoch Children's Research Institute, Centre for Adolescent Health, Royal Children's, Hospital, Melbourne, Australia; University of Melbourne, Department of Paediatrics, Royal Children's Hospital, Melbourne, Australia.
| | - Jacqui A Macdonald
- Deakin University, Centre for Social and Early Emotional Development, School of Psychology, Faculty of Health, Geelong, Australia; Murdoch Children's Research Institute, Centre for Adolescent Health, Royal Children's, Hospital, Melbourne, Australia; University of Melbourne, Department of Paediatrics, Royal Children's Hospital, Melbourne, Australia.
| | - Samantha Teague
- Deakin University, Centre for Social and Early Emotional Development, School of Psychology, Faculty of Health, Geelong, Australia; James Cook University, Department of Psychology, College of Healthcare Sciences, Townsville, Australia.
| | - Alana Rogers
- Deakin University, Centre for Social and Early Emotional Development, School of Psychology, Faculty of Health, Geelong, Australia.
| | - Matthew Sunderland
- The Matilda Centre for Research in Mental Health and Substance Use, University of Sydney, Sydney, Australia.
| | - Richard Mattick
- National Drug and Alcohol Research Centre, University of New South Wales, Sydney, Australia.
| | - Elizabeth J Elliott
- Discipline of Child and Adolescent Health, Faculty of Medicine and Health, University of Sydney, Sydney, Australia; The Sydney Children's Hospitals Network, Westmead, Sydney, Australia.
| | - Steve Allsop
- National Drug Research Institute, Curtin University, Perth, Australia.
| | - Lucinda Burns
- National Drug and Alcohol Research Centre, University of New South Wales, Sydney, Australia.
| | - Jake Najman
- School of Public Health, Faculty of Medicine, University of Queensland, Australia.
| | - Sue Jacobs
- Department of Obstetrics, Royal Prince Alfred Hospital, Sydney, NSW, Australia.
| | - Craig A Olsson
- Deakin University, Centre for Social and Early Emotional Development, School of Psychology, Faculty of Health, Geelong, Australia; Murdoch Children's Research Institute, Centre for Adolescent Health, Royal Children's, Hospital, Melbourne, Australia; University of Melbourne, Department of Paediatrics, Royal Children's Hospital, Melbourne, Australia.
| | - Delyse Hutchinson
- Deakin University, Centre for Social and Early Emotional Development, School of Psychology, Faculty of Health, Geelong, Australia; Murdoch Children's Research Institute, Centre for Adolescent Health, Royal Children's, Hospital, Melbourne, Australia; University of Melbourne, Department of Paediatrics, Royal Children's Hospital, Melbourne, Australia; National Drug and Alcohol Research Centre, University of New South Wales, Sydney, Australia.
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Lee P, Sanders D, Milgrom J, Kavanagh DJ, Scuffham PA. The economic evaluation of an Internet-based parental wellbeing intervention. J Telemed Telecare 2022:1357633X221137113. [PMID: 36398328 DOI: 10.1177/1357633x221137113] [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: 02/17/2024]
Abstract
BACKGROUND Internet-based parental programmes may improve parental wellbeing and mitigate the burden of mental health issues during the perinatal period. However, few studies have explored the cost and clinical impacts of such interventions. In the present study, we sought to evaluate the cost-effectiveness associated with an online cognitive behaviour therapy intervention (Baby Steps Wellbeing) to an information-only programme (Baby Care). METHODS An alongside-trial cost-effectiveness analysis was undertaken using data from a randomised clinical trial comparing the Baby Steps Wellbeing intervention to Baby Care. Direct healthcare costs, as well as indirect costs attributed to income loss, were considered. The Assessment of Quality of Life-8 Dimensions multi-attribute utility instrument was used to estimate participant utilities, and subsequently calculate quality-adjusted life years (QALYs). Incremental cost-effectiveness ratios were calculated to assess the cost-effectiveness of the intervention. The economic evaluation adopted a societal perspective. RESULTS In total, 496 parents were randomised to either the Baby Steps Wellbeing intervention or the Baby Care control arm. No significant differences in costs (-$27, 95% confidence interval (CI): -$1189-$1134) or QALYs (0.051, 95% CI: -0.097-0.200) were identified. Bootstrapped results showed that the Baby Steps Wellbeing programme was cost-saving and health improving in 38% of simulations and cost-effective in another 37% of simulations. CONCLUSIONS The Baby Steps Wellbeing programme was slightly cost-saving with slightly improved health outcomes compared with Baby Care. Bootstrapped results indicate the Baby Steps Wellbeing was cost-effective in 75% of simulations. Overall, the Baby Steps Wellbeing programme is an online programme that is cost-effective. TRIAL REGISTRATION Australian & New Zealand Clinical Trials Registry: ANZCTR12614001256662.
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Affiliation(s)
- Peter Lee
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
- Centre for Applied Health Economics, Menzies Health Institute Queensland, 5723Griffith University, Brisbane, Australia
| | - Davina Sanders
- Institute for Health and Behavioural Innovation, 1969Queensland University of Technology, Brisbane, Australia
| | - Jeannette Milgrom
- Parent-Infant Research Institute, Austin Health & Melbourne School of Psychological Sciences, University of Melbourne, Melbourne, Australia
| | - David J Kavanagh
- Institute for Health and Behavioural Innovation, 1969Queensland University of Technology, Brisbane, Australia
| | - Paul A Scuffham
- Centre for Applied Health Economics, Menzies Health Institute Queensland, 5723Griffith University, Brisbane, Australia
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Baldoni F, Giannotti M, Casu G, Agostini F, Mandolesi R, Peverieri S, Ambrogetti N, Spelzini F, Caretti V, Terrone G. The Perinatal Assessment of Paternal Affectivity (PAPA): Italian validation of a new tool for the screening of perinatal depression and affective disorders in fathers. J Affect Disord 2022; 317:123-130. [PMID: 36028014 DOI: 10.1016/j.jad.2022.08.049] [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: 01/19/2022] [Revised: 08/05/2022] [Accepted: 08/20/2022] [Indexed: 11/26/2022]
Abstract
BACKGROUND Questionnaires for the screening of paternal perinatal psychological distress are based on clinical manifestations expressed by women, showing limitations in capturing the wide array of signs and symptoms exhibited by men. The current study aimed to validate the Perinatal Assessment of Paternal Affectivity, a new self-report tool for the screening of paternal depressive and affective disorder. METHOD This study used a cross-sectional design with a 3-month test-retest, involving respectively 385 (T1) and a sub-sample of 111(T2) fathers. Confirmatory factor analysis (CFA) was performed to test structural validity and concurrent validity was assessed by Spearman correlations. We assessed reliability using McDonald's ω and ordinal alpha. Group differences in PAPA scores based on sociodemographic were also tested. RESULTS The CFA reported a one factor structure as the optimal solution. The PAPA also showed adequate reliability and internal consistency as well as acceptable test-retest indices. Concurrent validity was confirmed by significant correlations between PAPA total score and standardized test scores. Non-Italian fathers and fathers who experienced recent stressful life events reported higher PAPA scores. LIMITATIONS Our sample was not homogeneous in terms of nationality and most of the participants, were from Northern Italy. Some risk factors associated with paternal parental psychological distress (e.g., unplanned pregnancy) have not been considered. CONCLUSION This study provides initial evidence of validity and reliability of the PAPA as a brief and sensitive screening tool to detect signs and symptoms of paternal affective disorder during both prenatal and postnatal period.
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Affiliation(s)
- F Baldoni
- Department of Psychology, University of Bologna, Italy
| | - M Giannotti
- Department of Psychology and Cognitive Sciences, University of Trento, Rovereto, Italy.
| | - G Casu
- Department of Psychology, University of Bologna, Italy
| | - F Agostini
- Department of Psychology, University of Bologna, Italy
| | - R Mandolesi
- Department of Psychology, University of Bologna, Italy
| | - S Peverieri
- Department of Psychology, University of Bologna, Italy
| | - N Ambrogetti
- Department of Psychology, University of Bologna, Italy
| | - F Spelzini
- Operative Unit of Obstetrics and Gynecology, Rimini Hospital, AUSL Romagna, Rimini, Italy
| | | | - G Terrone
- University of Rome Tor Vergata, Rome, Italy
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23
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The Effectiveness of Interventions for the Prevention or Treatment of Paternal Perinatal Anxiety: A Systematic Review. J Clin Med 2022; 11:jcm11226617. [PMID: 36431094 PMCID: PMC9692859 DOI: 10.3390/jcm11226617] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Revised: 10/30/2022] [Accepted: 11/05/2022] [Indexed: 11/09/2022] Open
Abstract
Background: The worldwide prevalence of paternal perinatal anxiety (PPA) ranges between 3.4% and 25.0% antenatally, and 2.4% and 51.0% postnatally. Experiencing PPA can adversely impact the individual, partners, and infants. Research concerning PPA is lagging and fragmented compared to research for new mothers. Objectives: To establish the effectiveness of prevention or treatment interventions for PPA in adults identifying as male. Data sources: We completed searches of Medline, EMBASE, PsycINFO and Web of Science from inception to 2 December 2021, as well as hand searches of references from relevant papers. Search selection and data extraction: Randomised controlled trials delivering prevention or treatment interventions and reporting anxiety outcomes for new/expectant fathers in the perinatal mental health period were included. Our review follows the PRISMA reporting guidelines. One reviewer independently screened 5170 titles/abstracts; second reviewers screened 50%. Two reviewers independently screened full text, extracted data, and conducted risk of bias assessments. Synthesis: Cochrane's collaboration tool 2 was used to assess quality. Primarily results are synthesised narratively, a post-hoc sub-group analysis was completed on four studies using the same outcome measure. Main results: Twelve of the 5170 studies fulfilled the inclusion criteria. Studies used psychoeducational or practical skills interventions. Interventions mostly involved couple-dyads and three studies assessed PPA as a primary outcome. Included interventions were prevention-based; no treatment interventions were found. Father-only interventions consistently reported a significant reduction of PPA. Conclusions: Systematic searching yielded no treatment interventions, highlighting a substantial gap in the evidence base. Within a limited and heterogenous sample, no studies targeted diagnosed PPA. Evidence suggested father-focused interventions may be effective in preventing PPA, regardless of the intervention delivery mode or intervention content. However, consistency between study design and options within the field are lacking compared to interventions available for mothers.
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Kakaşçı ÇG, Potur DC, Abbasoğlu DE, Karabulut Ö, Merih YD, Demirci N. Is participation in antenatal classes associated with fathers' mental health? A quasi-experimental and prospective study. Infant Ment Health J 2022; 43:938-950. [PMID: 36260029 DOI: 10.1002/imhj.22015] [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: 06/11/2020] [Accepted: 08/20/2022] [Indexed: 11/11/2022]
Abstract
BACKGROUND In comparison to those conducted with women, studies about the transition of men to parenthood are limited in numbers, especially in developing countries. Moreover, in Turkey, along with gender roles and sociocultural changes, the roles of fathers are also changing. This change highlights the need to understand early parenthood for fathers. METHODS A quasi-experimental, non-randomized prospective study with a pre- and post-training model was conducted in a hospital in Istanbul, Turkey. Men in the antenatal education group (EG = 55) and their pregnant wives participated in 6 weeks of training during pregnancy (24th-28th weeks gestation). Men in the care-as-usual group (CG = 55) attended routine check-ups and follow-ups with their wives. GHQ-28 (General Health Questionnaire-28) was administered three times in total at study enrolment, immediately following the 6-week intervention period, and at the 6th postpartum week. RESULTS There was no significant difference between the groups' GHQ-28 scores before and after the training. In the 6th week of postpartum follow-up, the GHQ-28 scores were significantly higher for the fathers who participated in the educational intervention. CONCLUSIONS Antenatal education classes were found to be associated with the mental health of fathers. Further research evaluating family-centered parenting support programs is warranted to better understand how to support fathers in the transition to parenthood, particularly in countries in which fathers' roles in pregnancy and early parenthood are changing.
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Affiliation(s)
- Çiğdem Gün Kakaşçı
- Faculty of Health Sciences, Division of Midwifery, Suleyman Demirel University, Isparta, Turkey
| | - Dilek Coşkuner Potur
- Faculty of Health Sciences, Department of Obstetrics and Gynecology Nursing, Division of Nursing, Marmara University, Istanbul, Turkey
| | | | - Özlem Karabulut
- Zeynep Kamil Women and Child Disease Training and Research Hospital, Istanbul, Turkey
| | - Yeliz Doğan Merih
- Faculty of Hamidiye, Division on Nursing, Department of Obstetrics Gynecology Nursing, Sağlık Bilimleri University, Istanbul, Turkey
| | - Nurdan Demirci
- Faculty of Health Sciences, Department of Obstetrics and Gynecology Nursing, Division of Nursing, Marmara University, Istanbul, Turkey
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25
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Factors that influence father’s experiences of childbirth and their implications upon postnatal mental health: a narrative systematic review. Nurse Educ Pract 2022; 65:103460. [DOI: 10.1016/j.nepr.2022.103460] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2022] [Accepted: 09/23/2022] [Indexed: 11/20/2022]
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Daire C, de Tejada BM, Guittier MJ. Fathers' anxiety levels during early postpartum: A comparison study between first-time and multi-child fathers. J Affect Disord 2022; 312:303-309. [PMID: 35760186 DOI: 10.1016/j.jad.2022.06.052] [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: 01/20/2022] [Revised: 06/01/2022] [Accepted: 06/20/2022] [Indexed: 12/01/2022]
Abstract
BACKGROUND The postnatal period is considered the most challenging period in the adjustment to fatherhood. This study aimed to assess anxiety levels among fathers during this period. METHODS A comparative study assessing the anxiety levels of first-time and multi-child fathers before the mother and child returned home (0-7 days after birth) was conducted. We used the French validation of the State-Trait Anxiety Inventory (STAI). RESULTS Among 235 fathers who were met at the maternity ward, 182 (77 %) responded to the questionnaire. For most fathers in both groups, anxiety levels were low or very low for trait anxiety (166/182, 91.21 %) and state anxiety (177/182, 97.25 %). Levels of state anxiety were statistically higher for first-time fathers compared to multi-child fathers but were mainly at a low or very low level (70/83 [84 %] versus 71/99 [71 %], respectively, p = 0.029). The multiple linear regression showed that "feeling prepared at birth time" was the only significantly (p < 0.001) associated factor with state anxiety among first-time fathers only. LIMITATIONS The validity and reliability of the STAI have been widely proven for the general population but not specifically for men during the postpartum period. CONCLUSIONS Most fathers had low to very low anxiety levels during the early postpartum period, suggesting that developing new specific support interventions is not needed during early postnatal care. Further research focusing on when the family is back home is warranted.
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Affiliation(s)
- C Daire
- University of Applied Sciences and Arts Western Switzerland (HES-SO) and University of Lausanne (UNIL), Switzerland
| | - B Martinez de Tejada
- Department of Pediatrics, Gynecology and Obstetrics, University Hospitals of Geneva, Geneva, Switzerland; Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - M J Guittier
- Department of Pediatrics, Gynecology and Obstetrics, University Hospitals of Geneva, Geneva, Switzerland; School of Health Sciences Geneva HES-SO, University of Applied Sciences and Arts Western, Switzerland.
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Male partners’ experiences of early pregnancy ultrasound scans in Soweto, South Africa: The Healthy Pregnancy, Healthy Baby randomised trial. SOUTH AFRICAN JOURNAL OF CHILD HEALTH 2022. [DOI: 10.7196/sajch.2022.v16i2.1783] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
Background. Despite international evidence highlighting the benefits of male partners attending antenatal visits, including pregnancy ultrasound scans, it is unusual for South African (SA) men to attend such visits, and little is known about their experiences if they do.
Objectives. To explore the experiences and antenatal attachment among male partners who attend early pregnancy ultrasound examinations in Soweto, SA.
Methods. Pregnant women attending ultrasound examinations were invited to bring their partners with them. Both completed individual questionnaires, including the antenatal attachment scale. The results are based on a descriptive analysis of 102 mother-partner pairs.
Results. The mean age of partners was 35 years. Only 32% of men were living with their pregnant partner. Before the ultrasound scan, 64% of men reported feeling very anxious, while 54% also felt anxious after the procedure. The ultrasound examination had a positive effect on men and their thoughts regarding their developing baby, with 30% stating that they were ready or excited to be a father. Twenty-eight percent believed their relationship with the mother was stronger as a result of participating in antenatal care.
Conclusions. We found that prenatal ultrasound scans had a positive effect on male partners and their thoughts about the pregnancy, their forthcoming child and their relationship with and support for their partner. Health services in SA should accommodate partners/ fathers and encourage them to attend antenatal care, including pregnancy ultrasound scans. Interventions are needed to encourage more men to be involved – from conception – potentially addressing individual, familial, societal and structural barriers to involvement of the father in long-term maternal and child care.
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Ertekin Pinar S, Ozbek H. Paternal depression and attachment levels of first-time fathers in Turkey. Perspect Psychiatr Care 2022; 58:1082-1088. [PMID: 34216394 DOI: 10.1111/ppc.12905] [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: 12/08/2020] [Revised: 05/07/2021] [Accepted: 06/19/2021] [Indexed: 11/29/2022] Open
Abstract
PURPOSE Paternal depression and inadequate attachment experienced in the postpartum period may be associated with future emotional and behavioural problems of children. This study aimed to investigate the paternal depression and attachment levels of first-time fathers. DESIGN AND METHODS The sample of this descriptive study consisted of 175 fathers with 3-6 months old babies whose wives applied to the polyclinic for check-up. FINDINGS When the cut-off point of the scale was evaluated at 13 and above in this study, the risk of depression was found to be 14.2%. The level of attachment decreases as fathers' risk of depression increases (p < 0.05). PRACTICE IMPLICATIONS There is a risk of depression in fathers in the postpartum period. The level of attachment decreases as fathers' risk of depression increases.
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Affiliation(s)
- Sukran Ertekin Pinar
- Midwifery Department, Faculty of Health Sciences, Sivas Cumhuriyet University, Sivas, Turkey
| | - Hilal Ozbek
- Midwifery Department, Faculty of Health Sciences, Sivas Cumhuriyet University, Sivas, Turkey
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29
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Uphoff EP, Zamperoni V, Yap J, Simmonds R, Rodgers M, Dawson S, Seymour C, Kousoulis A, Churchill R. Mental health promotion and protection relating to key life events and transitions in adulthood: a rapid systematic review of systematic reviews. J Ment Health 2022:1-14. [PMID: 35658814 DOI: 10.1080/09638237.2022.2069724] [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: 12/06/2021] [Revised: 04/04/2022] [Accepted: 04/08/2022] [Indexed: 10/18/2022]
Abstract
BACKGROUND During the decades representing working-age adulthood, most people will experience one or several significant life events or transitions. These may present a challenge to mental health. AIM The primary aim of this rapid systematic review of systematic reviews was to summarise available evidence on the effectiveness of interventions to promote and protect mental health relating to four key life events and transitions: pregnancy and early parenthood, bereavement, unemployment, and housing problems. This review was conducted to inform UK national policy on mental health support. METHODS We searched key databases for systematic reviews of interventions for working-age adults (19 to 64 years old) who had experienced or were at risk of experiencing one of four key life events. Titles and abstracts were screened by two reviewers in duplicate, as were full-text manuscripts of relevant records. We assessed the quality of included reviews and extracted data on the characteristics of each literature review. We prioritised high quality, recent systematic reviews for more detailed data extraction and synthesis. RESULTS The search and screening of 3997 titles/abstracts and 239 full-text papers resulted in 134 relevant studies, 68 of which were included in a narrative synthesis. Evidence was strongest and of the highest quality for interventions to support women during pregnancy and after childbirth. For example, we found benefits of physical activity and psychological therapy for outcomes relating to mental health after birth. There was high quality evidence of positive effects of online bereavement interventions and psychological interventions on symptoms of grief, post-traumatic stress, and depression. Evidence was inconclusive and of lower quality for a range of other bereavement interventions, unemployment support interventions, and housing interventions. CONCLUSIONS Whilst evidence based mental health prevention and promotion is available during pregnancy and early parenthood and for bereavement, it is unclear how best to support adults experiencing job loss, unemployment, and housing problems.
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Affiliation(s)
| | | | - Jade Yap
- Mental Health Foundation, London, UK
| | | | - Mark Rodgers
- Centre for Reviews and Dissemination, University of York, York, UK
| | - Sarah Dawson
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | | | | | - Rachel Churchill
- Centre for Reviews and Dissemination, University of York, York, UK
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Moderating Effect of Changes in Perceived Social Support during Pregnancy on the Emotional Health of Mothers and Fathers and on Baby’s Anthropometric Parameters at Birth. CHILDREN 2022; 9:children9050648. [PMID: 35626825 PMCID: PMC9139256 DOI: 10.3390/children9050648] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/08/2022] [Revised: 04/25/2022] [Accepted: 04/27/2022] [Indexed: 11/16/2022]
Abstract
(1) Background: this study is based on a model of how changes in protective factors may affect the emotional health of mothers and fathers and thus influence the development of the baby. Our research goal is to determine whether variations in perceived social support moderate levels of stress and depression during pregnancy and/or the effect of parents’ emotional health on the baby’s anthropometric parameters. (2) Methods: to achieve these aims, a longitudinal study was made of 132 couples and babies, who were evaluated at weeks 12 and 32 of gestation and at birth. Separate analyses were performed for the mothers and fathers, focused on the role of social support in moderating their levels of depression and stress during pregnancy, and the consequent impact on the baby. (3) Results: the results obtained show the moderating effects of changes in social support on maternal and paternal stress and depression. Reduced social support during pregnancy is associated with higher levels of stress and depression in both parents and with a high cephalisation index in their babies. (4) Conclusions: special attention should be paid to social support, which can have a strong impact on the evolution of emotional health during pregnancy and concomitantly on the development of the baby.
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van Veenendaal NR, van Kempen AAMW, Broekman BFP, de Groof F, van Laerhoven H, van den Heuvel MEN, Rijnhart JJM, van Goudoever JB, van der Schoor SRD. Association of a Zero-Separation Neonatal Care Model With Stress in Mothers of Preterm Infants. JAMA Netw Open 2022; 5:e224514. [PMID: 35344044 PMCID: PMC8961319 DOI: 10.1001/jamanetworkopen.2022.4514] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
IMPORTANCE Active participation in care by parents and zero separation between parents and their newborns is highly recommended during infant hospitalization in the neonatal intensive care unit (NICU). OBJECTIVE To study the association of a family integrated care (FICare) model with maternal mental health at hospital discharge of their preterm newborn compared with standard neonatal care (SNC). DESIGN, SETTING, AND PARTICIPANTS This prospective, multicenter cohort study included mothers with infants born preterm treated in level-2 neonatal units in the Netherlands (1 unit with single family rooms [the FICare model] and 2 control sites with standard care in open bay units) between May 2017 and January 2020 as part of the AMICA study (fAMily Integrated CAre in the neonatal ward). Participants included mothers of preterm newborns admitted to participating units. Data analysis was performed from January to April 2021. EXPOSURES FICare model in single family rooms with complete couplet-care for the mother-newborn dyad during maternity and/or neonatal care. MAIN OUTCOMES AND MEASURES Maternal mental health, measured using the Parental Stress Scale: NICU (PSS-NICU). Secondary outcomes included survey scores on the Hospital Anxiety and Depression Scale, Postpartum Bonding Questionnaire, Perceived Maternal Parenting Self-efficacy Scale, and satisfaction with care (using EMPATHIC-N). Parent participation (using the CO-PARTNER tool) was assessed as a potential mediator of the association of the FICare model on outcomes with mediation analyses. RESULTS A total of 296 mothers were included; 124 of 141 mothers (87.9%) in the FICare model and 115 of 155 (74.2%) mothers in SNC responded to questionnaires (mean [SD] age: FICare, 33.3 [4.0] years; SNC, 33.3 [4.1] years). Mothers in the FICare model had lower total PSS-NICU stress scores at discharge (adjusted mean difference, -12.24; 95% CI, -18.44 to -6.04) than mothers in SNC, and specifically had lower scores for mother-newborn separation (adjusted mean difference, -1.273; 95% CI, -1.835 to -0.712). Mothers in the FICare model were present more (>8 hours per day: 105 of 125 [84.0%] mothers vs 42 of 115 [36.5%]; adjusted odds ratio, 19.35; 95% CI, 8.13 to 46.08) and participated more in neonatal care (mean [SD] score: 46.7 [6.9] vs 40.8 [6.7]; adjusted mean difference, 5.618; 95% CI, 3.705 to 7.532). Active parent participation was a significant mediator of the association between the FICare model and less maternal depression and anxiety (adjusted indirect effect, -0.133; 95% CI, -0.226 to -0.055), higher maternal self-efficacy (adjusted indirect effect, 1.855; 95% CI, 0.693 to 3.348), and better mother-newborn bonding (adjusted indirect effect, -0.169; 95% CI, -0.292 to -0.068). CONCLUSIONS AND RELEVANCE The FICare model in our study was associated with less maternal stress at discharge; mothers were more present and participated more in the care for their newborn than in SNC, which was associated with improved maternal mental health outcomes. Future intervention strategies should aim at reducing mother-newborn separation and intensifying active parent participation in neonatal care. TRIAL REGISTRATION Netherlands Trial Register identifier NL6175.
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Affiliation(s)
- Nicole R. van Veenendaal
- Department of Pediatrics and Neonatology, OLVG, Amsterdam, the Netherlands
- Amsterdam UMC, University of Amsterdam, Vrije Universiteit, Emma Children’s Hospital, Amsterdam, the Netherlands
| | | | - Birit F. P. Broekman
- Department of Psychiatry, OLVG, Amsterdam, the Netherlands
- Department of Psychiatry, Amsterdam UMC, Vrije Universiteit, Amsterdam, the Netherlands
| | - Femke de Groof
- Department of Pediatrics and Neonatology, NoordWest ZiekenhuisGroep, Alkmaar, the Netherlands
| | | | | | - Judith J. M. Rijnhart
- Department of Epidemiology and Data Science, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit, Amsterdam, the Netherlands
| | - Johannes B. van Goudoever
- Amsterdam UMC, University of Amsterdam, Vrije Universiteit, Emma Children’s Hospital, Amsterdam, the Netherlands
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32
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Silang KA, Sohal PR, Bright KS, Leason J, Roos L, Lebel C, Giesbrecht GF, Tomfohr-Madsen LM. eHealth Interventions for Treatment and Prevention of Depression, Anxiety, and Insomnia During Pregnancy: Systematic Review and Meta-analysis. JMIR Ment Health 2022; 9:e31116. [PMID: 35188471 PMCID: PMC8902665 DOI: 10.2196/31116] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Revised: 10/08/2021] [Accepted: 11/05/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Pregnancy is associated with an increased risk for depression, anxiety, and insomnia. eHealth interventions provide a promising and accessible treatment alternative to face-to-face interventions. OBJECTIVE The objective of this systematic review and meta-analysis is to determine the effectiveness of eHealth interventions in preventing and treating depression, anxiety, and insomnia during pregnancy. Secondary aims are to identify demographic and intervention moderators of effectiveness. METHODS A total of 5 databases (PsycINFO, Medline, CINAHL, Embase, and Cochrane) were searched from inception to May 2021. Terms related to eHealth, pregnancy, randomized controlled trials (RCTs), depression, anxiety, and insomnia were included. RCTs and pilot RCTs were included if they reported an eHealth intervention for the prevention or treatment of depression, anxiety, or insomnia in pregnant women. Study screening, data extractions, and quality assessment were conducted independently by 2 reviewers from an 8-member research team (KAS, PRS, Hangsel Sanguino, Roshni Sohail, Jasleen Kaur, Songyang (Mark) Jin, Makayla Freeman, and Beatrice Valmana). Random-effects meta-analyses of pooled effect sizes were conducted to determine the effect of eHealth interventions on prenatal mental health. Meta-regression analyses were conducted to identify potential moderators. RESULTS In total, 17 studies were included in this review that assessed changes in depression (11/17, 65%), anxiety (10/17, 59%), and insomnia (3/17, 18%). Several studies included both depression and anxiety symptoms as outcomes (7/17, 41%). The results indicated that during pregnancy, eHealth interventions showed small effect sizes for preventing and treating symptoms of anxiety and depression and a moderate effect size for treating symptoms of insomnia. With the exception of intervention type for the outcome of depressive symptoms, where mindfulness interventions outperformed other intervention types, no significant moderators were detected. CONCLUSIONS eHealth interventions are an accessible and promising resource for treating symptoms of anxiety, depression, and insomnia during pregnancy. However, more research is necessary to identify ways to increase the efficacy of eHealth interventions for this population. TRIAL REGISTRATION PROSPERO (International Prospective Register of Systematic Reviews) CRD42020205954; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=205954.
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Affiliation(s)
| | - Pooja R Sohal
- Department of Psychology, University of Calgary, Calgary, AB, Canada
| | - Katherine S Bright
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.,Women's Mental Health Clinic, Foothills Medical Centre, Alberta Health Services, Calgary, AB, Canada
| | - Jennifer Leason
- Department of Anthropology and Archaeology, University of Calgary, Calgary, AB, Canada
| | - Leslie Roos
- Department of Psychology and Pediatrics, University of Manitoba, Winnipeg, MB, Canada.,Children's Hospital Research Institute of Manitoba, Winnipeg, MB, Canada
| | - Catherine Lebel
- Department of Radiology, Alberta Children's Hospital Research Institute, Hotchkiss Brain Institute, Calgary, AB, Canada
| | - Gerald F Giesbrecht
- Department of Psychology, University of Calgary, Calgary, AB, Canada.,Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.,Alberta Children's Hospital Research Institute, Calgary, AB, Canada.,Department of Pediatrics, University of Calgary, Calgary, AB, Canada
| | - Lianne M Tomfohr-Madsen
- Department of Psychology, University of Calgary, Calgary, AB, Canada.,Department of Radiology, Alberta Children's Hospital Research Institute, Hotchkiss Brain Institute, Calgary, AB, Canada.,Alberta Children's Hospital Research Institute, Calgary, AB, Canada
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Doi S, Isumi A, Fujiwara T. Association of Paternal Workplace and Community Social Capital With Paternal Postnatal Depression and Anxiety: A Prospective Study. Front Psychiatry 2022; 13:782939. [PMID: 35250659 PMCID: PMC8892241 DOI: 10.3389/fpsyt.2022.782939] [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: 09/25/2021] [Accepted: 01/24/2022] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE The aim of this study is to examine the association between workplace and community social capital and fathers' postpartum depression and anxiety at 3 months after delivery in Japan. METHODS Fathers who had babies delivered in two obstetric clinics in Tokyo, Japan were recruited to take part in the study (response rate = 76.2%). Participants completed questionnaires measuring workplace and community social capital, depression, and anxiety at 1 week and a follow-up at 3 months post-delivery (N = 398). Multiple linear regression analyses were performed with multiple imputation for missing data (at most, N = 60, 15.1%). RESULTS Community social capital was inversely associated with both depressive symptoms (β = -0.21, 95%CI = -0.33 to -0.08) and anxiety (β = -0.38, 95%CI = -0.66 to -0.11) at 3 months, after adjusting for covariates. No association was found between workplace social capital and depressive symptoms and anxiety. CONCLUSION Paternal community social capital, but not workplace social capital, was shown to be a preventive factor for paternal depression and anxiety up to 3 months post-delivery. To prevent paternal mental health problems during the postpartum period, an intervention to promote paternal community, rather than workplace, social capital may be warranted.
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Affiliation(s)
- Satomi Doi
- Department of Global Health Promotion, Tokyo Medical and Dental University (TMDU), Tokyo, Japan.,Japan Society for the Promotion of Science, Tokyo, Japan
| | - Aya Isumi
- Department of Global Health Promotion, Tokyo Medical and Dental University (TMDU), Tokyo, Japan.,Japan Society for the Promotion of Science, Tokyo, Japan
| | - Takeo Fujiwara
- Department of Global Health Promotion, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
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Prevalence and associated factors of paternal stress, anxiety, and depression symptoms in the early postnatal period. Glob Ment Health (Camb) 2022; 9:306-321. [PMID: 36561920 PMCID: PMC9768414 DOI: 10.1017/gmh.2022.33] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2022] [Revised: 05/26/2022] [Accepted: 06/07/2022] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND The changes experienced during the transition to first-time or subsequent fatherhood are mainly positive; however, fathers can also experience adverse mental health outcomes such as stress, anxiety, and depression. The aim of this study was to investigate the prevalence and associated factors of paternal stress, anxiety, and depression symptoms in the early postnatal period. METHODS A quantitative, descriptive correlational design was used. Data were collected using a self-administered questionnaire comprising of the Perceived Stress Scale, the State-Trait Anxiety Inventory, and the Edinburgh Postnatal Depression Scale. RESULTS A total of 336 fathers were included in the study. The prevalence rates were 41.1% (n = 138) for moderate/high stress symptoms, 20.8% (n = 70) for state anxiety symptoms, 25.9% (n = 87) for trait anxiety symptoms, and 13.4% (n = 45) for depression symptoms. In the multivariable analysis, several factors were associated with increased stress, anxiety, and depression symptoms including being a subsequent father (p = 0.009), not living in a house (p = 0.009), having a history of adverse mental health (p = 0.008), and having a partner with a history of anxiety (p = 0.040). CONCLUSION The findings suggest that fathers are at risk of adverse mental health in the early postnatal period which is a pivotal time for fathers in terms of bonding with their infant and redefining their relationship with their partner.
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Doi S, Isumi A, Fujiwara T. Association of adverse childhood experiences with postpartum depression and anxiety in fathers: A prospective study. Psychiatry Clin Neurosci 2022; 76:35-36. [PMID: 34726331 DOI: 10.1111/pcn.13312] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2021] [Revised: 10/21/2021] [Accepted: 10/27/2021] [Indexed: 11/27/2022]
Affiliation(s)
- Satomi Doi
- Department of Global Health Promotion, Tokyo Medical and Dental University, Tokyo, Japan.,Japan Society for the Promotion of Science, Tokyo, Japan
| | - Aya Isumi
- Department of Global Health Promotion, Tokyo Medical and Dental University, Tokyo, Japan.,Japan Society for the Promotion of Science, Tokyo, Japan
| | - Takeo Fujiwara
- Department of Global Health Promotion, Tokyo Medical and Dental University, Tokyo, Japan
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Reif A, Baune BT, Deckert J, Juckel G, Kittel-Schneider S, Kircher T, Kornhuber J, Rupprecht R, Bauer M. Rationale, Mission and Vision for a National Centre of Affective Disorders in Germany. PHARMACOPSYCHIATRY 2021; 55:65-72. [PMID: 34921380 DOI: 10.1055/a-1697-5854] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Affective disorders are common, complex disorders representing one of the major challenges to global health in the 21st century. To mitigate the burden of disease, substantial public health efforts need to be undertaken since research on the causes and adequate treatment requires multidisciplinary approaches. These should integrate translational, and clinical research, aided by technological advancements in collecting and analysing comprehensive data. Here we present the rationale, concept, mission and vision of the recently founded National Centre of Affective Disorders (NCAD) in Germany. NCAD founding partners build on their previous successful cooperation within the German Research Network for Mental Disorders funded by the Federal Ministry of Education and Research (BMBF). They form an internationally pre-eminent network of integrative excellence, leading in science and contributing significantly to the improved care of affective disorder patients. The partners will provide complementary structures and innovative methods across the entire translational continuum from bench to clinical and real-world settings. The vision of the NCAD is to foster cross-disciplinary research from basic neuroscience to public mental health by close translational collaboration between academia, non-university research institutions, and international partners, including industry, to deliver cutting-edge research, innovative clinical services and evidence-based training to young clinicians and scientists. The mission is to accomplish research in a highly translational manner, especially with respect to clinical studies in a trans-sectoral way. This approach aims to ensure continuous improvement in the treatment and care provided to patients and an interdisciplinary environment for high-level research and education in affective disorders.
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Affiliation(s)
- Andreas Reif
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital Frankfurt - Goethe University, Frankfurt am Main, Germany
| | - Bernhard T Baune
- Department of Psychiatry, University Hospital Münster, University of Münster, Münster, Germany
| | - Jürgen Deckert
- Department of Psychiatry, Psychosomatics and Psychotherapy, Center of Mental Health, University Hospital of Würzburg, Würzburg, Germany
| | - Georg Juckel
- Department of Psychiatry, Psychotherapy and Preventive Medicine, LWL University Hospital, Ruhr University Bochum, Germany
| | - Sarah Kittel-Schneider
- Department of Psychiatry, Psychosomatics and Psychotherapy, Center of Mental Health, University Hospital of Würzburg, Würzburg, Germany
| | - Tilo Kircher
- Department of Psychiatry and Psychotherapy, Philipps-University Marburg, Marburg, Germany
| | - Johannes Kornhuber
- Department of Psychiatry and Psychotherapy, University Hospital Erlangen, Friedrich-Alexander-University of Erlangen-Nuremberg, Germany
| | - Rainer Rupprecht
- Department of Psychiatry and Psychotherapy, University Regensburg, Regensburg, Germany
| | - Michael Bauer
- Department of Psychiatry and Psychotherapy, Medical Faculty, Carl Gustav Carus University Hospital, Technische Universität Dresden, Dresden, Germany
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Nawa N, Trude ACB, Black MM, Richiardi L, Surkan PJ. Associations between Paternal Anxiety and Infant Weight Gain. CHILDREN 2021; 8:children8110977. [PMID: 34828690 PMCID: PMC8618665 DOI: 10.3390/children8110977] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Revised: 10/22/2021] [Accepted: 10/25/2021] [Indexed: 11/16/2022]
Abstract
The aim of this study was to examine the relationship between parental anxiety (father-only, mother-only, or both) and infant weight change. We performed a secondary data analysis among 551 children in the Avon Longitudinal Study of Parents and Children, a birth cohort with weight measurements collected prospectively at 4, 8, and 12 months of age. Paternal and maternal anxiety symptoms were based on the eight-item anxiety subscale of the Crown-Crisp Experiential Index. Scores in the top 15% at 8 weeks postpartum were classified as high anxiety. Generalized Estimating Equations were employed to estimate the joint association between parental anxiety and change in child weight-for-age z-score. Children who had fathers, but not mothers, with anxiety showed a 0.15 (95% CI: 0.01, 0.29) greater increase in weight-for-age z-score than children with neither parent anxious. This result suggests that paternal anxiety, not maternal anxiety, was associated with increases in child weight gain in the first year of life. Public health practitioners and clinicians should consider the use of robust measures of both maternal and paternal anxiety in the postpartum period, in addition to the suggested screening for postpartum depression. Given the limitations of the study, this study should be considered preliminary and hypothesis generating.
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Affiliation(s)
- Nobutoshi Nawa
- Department of Global Health Promotion, Tokyo Medical and Dental University, Tokyo 113-8519, Japan
- Department of Medical Education Research and Development, Tokyo Medical and Dental University, Tokyo 113-8519, Japan
- Correspondence:
| | - Angela C. B. Trude
- Department of Pediatrics, School of Medicine, University of Maryland, Baltimore, MD 21201, USA; (A.C.B.T.); (M.M.B.)
| | - Maureen M. Black
- Department of Pediatrics, School of Medicine, University of Maryland, Baltimore, MD 21201, USA; (A.C.B.T.); (M.M.B.)
- RTI International, Research Triangle Park, NC 27709, USA
| | - Lorenzo Richiardi
- Cancer Epidemiology Unit, Department of Medical Sciences, CPO-Piemonte, University of Turin, 10126 Turin, Italy;
| | - Pamela J. Surkan
- Department of International Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD 21205, USA;
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Fisher SD, Cobo J, Figueiredo B, Fletcher R, Garfield CF, Hanley J, Ramchandani P, Singley DB. Expanding the international conversation with fathers' mental health: toward an era of inclusion in perinatal research and practice. Arch Womens Ment Health 2021; 24:841-848. [PMID: 34431009 DOI: 10.1007/s00737-021-01171-y] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/16/2021] [Accepted: 08/02/2021] [Indexed: 10/20/2022]
Abstract
Paternal mental health is beginning to be recognized as an essential part of perinatal health. Historically, fathers were not recognized as being at risk for perinatal mental illnesses or relevant to maternal and infant health outcomes. The purpose of this paper is to provide an overview of paternal perinatal mental health, leading tools to assess paternal depression and anxiety, the impact of paternal mental health on mother and child health, and future directions for the field. An international team of paternal perinatal mental health experts summarized the key findings of the field. Fathers have an elevated risk of depression and anxiety disorders during the perinatal period that is associated with maternal depression and can impact their ability to support mothers. Paternal mental health is uniquely associated with child mental health and developmental outcomes starting from infancy and continuing through the child lifespan. Tailored screening approaches for paternal mental health are essential to support fathers early in the perinatal period, which would offset health risks for the family. Recommendations on paternal mental health are provided on four key areas to support father perinatal mental health: (1) intervention research, (2) clinical training, (3) national policy, and (4) the inclusion of fathers in the focus of the International Marcé Society for Perinatal Mental Health.
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Affiliation(s)
- Sheehan D Fisher
- Department of Psychiatry and Behavioral Sciences, Northwestern University, Chicago, IL, USA.
| | - Jesus Cobo
- Psychiatry Department, Corporació Sanitària Parc Taulí - CIBERSAM - I3PT - Universitat Autònoma de Barcelona (Sabadell, Barcelona), Barcelona, Spain
| | | | - Richard Fletcher
- College of Heath, Medicine and Wellbeing, The University of Newcastle, Callaghan, NSW, 2308, Australia
| | - Craig F Garfield
- Department of Pediatrics, Ann& Robert H. Lurie Children's Hospital of Chicago and Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Jane Hanley
- Perinatal MH Training CIC, Carmarthen, Wales, UK.,Swansea University, Swansea, Wales, UK
| | - Paul Ramchandani
- PEDAL Research Centre, Faculty of Education, University of Cambridge, Cambridge, UK
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Gün Kakaşçı Ç, Coşkuner Potur D, Karabulut Ö, Ertuğrul Abbasoğlu D, Demirci N, Doğan Merih Y. Does Antenatal Education Affect Level Of Empathy And Attachment Of Fathers? J Reprod Infant Psychol 2021; 40:366-383. [PMID: 34555950 DOI: 10.1080/02646838.2021.1979198] [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: 10/20/2022]
Abstract
OBJECTIVE The study aimed to determine the effects of antenatal education on the paternal bonding and empathic tendency levels of men who would become fathers for the first time. BACKGROUND There are a limited number of studies in the literature that have investigated the effects of antenatal education programmes on fathers. METHODS This prospective, controlled quasi-experimental study was conducted in a hospital in Istanbul. The men in the antenatal educational group (EG) and their wives participated in training in antenatal classes. The men in the control group (CG) came for routine prenatal follow-up examinations with their wives. The Empathic Tendency and Paternal Postnatal Attachment Scales were used to collect the data. RESULTS The Empathic Tendency Scale was applied before the education (1) - after the education (2) and at the 6th postpartum week (3), whilst the Paternal Postnatal Attachment Scale was used at the 6th postpartum month (4). EG had higher emphatic tendency levels in the 2nd and 3rd measurements and higher paternal bonding levels in the 4th measurement in comparison to CG (p < 0.05). CONCLUSION Antenatal education increased the emphatic tendency of the fathers and the effects of this education continued in the postpartum period and affected paternal bonding positively.
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Affiliation(s)
- Çiğdem Gün Kakaşçı
- Department of Obstetrics and Gynecology Nursing, Division of Nursing, Mehmet Akif Ersoy University, Burdur, Turkey
| | - Dilek Coşkuner Potur
- Department of Obstetrics and Gynecology Nursing, Division of Nursing, Marmara University, İstanbul, Turkey
| | - Özlem Karabulut
- Zeynep Kamil Women and Child Disease Training and Research Hospital, Istanbul, Turkey
| | | | - Nurdan Demirci
- Department of Obstetrics and Gynecology Nursing, Division of Nursing, Marmara University, İstanbul, Turkey
| | - Yeliz Doğan Merih
- Department of Obstetrics Gynecology Nursing, University of Health Sciences, İstanbul, Turkey
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Domínguez-Solís E, Lima-Serrano M, Lima-Rodríguez JS. Non-pharmacological interventions to reduce anxiety in pregnancy, labour and postpartum: A systematic review. Midwifery 2021; 102:103126. [PMID: 34464836 DOI: 10.1016/j.midw.2021.103126] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2020] [Revised: 06/01/2021] [Accepted: 08/06/2021] [Indexed: 11/18/2022]
Abstract
BACKGROUND The anxiety mothers experience during pregnancy is well known and may have negative consequences for the emotional, psychological, and social development of newborns. Anxiety must therefore be reduced using different strategies. OBJECTIVE To determine published non-pharmacological interventions to reduce anxiety during pregnancy, childbirth and postpartum. METHODS A systematic peer-review of experimental and quasi-experimental studies was conducted using the PubMed, Scopus, Web of Science (WOS), and CINAHL databases. The quality of the studies was assessed using the Spanish version of the PEDro scale. Two researchers participated independently in the data selection and extraction process. FINDINGS 587 articles were identified, of which 21 met the eligibility criteria. In eleven studies the intervention was performed during pregnancy, in three of them during labour, in four of them during the postpartum period, and in three of them during pregnancy and postpartum. During pregnancy, the most effective interventions were behavioural activation, cognitive behavioural therapy, yoga, music therapy, and relaxation; during childbirth: aromatherapy; during pregnancy and postpartum: antenatal training, massage by partners, and self-guided book reading with professional telephone assistance. CONCLUSION AND IMPLICATIONS The most effective interventions to reduce anxiety were performed either during pregnancy or during the postpartum period, not during labour. Most of the interventions were performed on the women, with few of them being performed on both partners. Non-pharmacological interventions may be applied by nurses and midwives to reduce anxiety during pregnancy, labour and postpartum.
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Affiliation(s)
- Esther Domínguez-Solís
- Nurse specialist in gynecology and obstetrics. PhD student of the University of Seville, Seville, Spain
| | - Marta Lima-Serrano
- Department of Nursing, Doctor from the University of Seville, Seville, Spain.
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Kruijff I, Veldhuis MS, Tromp E, Vlieger AM, Benninga M, Lambregtse‐van den Berg MP. Distress in fathers of babies with infant colic. Acta Paediatr 2021; 110:2455-2461. [PMID: 33840149 DOI: 10.1111/apa.15873] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2021] [Revised: 03/31/2021] [Accepted: 04/09/2021] [Indexed: 11/26/2022]
Abstract
AIM The aim of this case-control study was to compare parental stress, depression, anxiety and bonding problems between fathers and mothers of babies with infant colic and parents of control infants. METHODS Parents of 34 infants with infant colic and 67 control dyads were included. Parental feelings were assessed using validated questionnaires. RESULTS Fathers as well as mothers of infants with infant colic showed significantly higher mean scores compared with controls on stress (20.9 ± 5.8 and 25.5 ± 7.2 vs 16.4 ± 6.1 and 14.7 ± 7.0), depression (5.6 ± 4.0 and 9.1 ± 4.8 vs 2.9 ± 2.9 and 4.0 ± 3.1), anxiety (41.9 ± 9.2 and 46.0 ± 10.2 vs 32.4 ± 8.4 and 32.2 ± 9.3) and bonding problems (16.1 ± 8.1 and 13.7 ± 5.9 vs 8.7 ± 6.3 and 5.0 ± 4.4). In fathers, after adjustments for infant and parental confounders and maternal negative feelings, depression and anxiety were significantly increased in the infant colic group (difference of 2.7 (p = 0.017) and 8.6 (p = 0.002)). CONCLUSION In fathers of infants with infant colic, the experienced distress is strongly associated with maternal distress, except for depression and anxiety. Paediatricians should be aware of these paternal feelings as parental reassurance and support is one of the cornerstones in the treatment of infants with colic.
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Affiliation(s)
- Ineke Kruijff
- Department of Pediatrics St Antonius Hospital Nieuwegein The Netherlands
| | | | - Ellen Tromp
- Department of Epidemiology and Statistics St Antonius Hospital Nieuwegein The Netherlands
| | - Arine M. Vlieger
- Department of Pediatrics St Antonius Hospital Nieuwegein The Netherlands
| | - Marc.A. Benninga
- Department of Pediatric Gastroenterology and Nutrition Amsterdam University Medical Center Amsterdam the Netherlands
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Tandon SD, Hamil J, Gier EE, Garfield CF. Examining the Effectiveness of the Fathers and Babies Intervention: A Pilot Study. Front Psychol 2021; 12:668284. [PMID: 34335380 PMCID: PMC8319568 DOI: 10.3389/fpsyg.2021.668284] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2021] [Accepted: 06/21/2021] [Indexed: 01/21/2023] Open
Abstract
There is increasing recognition of the importance of addressing the mental health of fathers, including during the perinatal period. Fathers exhibiting mental health concerns during the perinatal period are at heightened risk for future negative mental health outcomes and are less likely to engage in nurturing relationships with their children, leading to a sequalae of negative child outcomes during infancy and into adolescence. Although interventions have been developed for perinatal fathers, they typically do not focus directly on addressing paternal mental health. To fill this gap, we developed the Fathers and Babies intervention to be delivered to perinatal fathers whose partners (mothers) were enrolled in home visiting programs. A pre-post longitudinal study was conducted in which 30 father-mother dyads were recruited from home visiting programs. Fathers received the 12-session Fathers and Babies intervention while the mother concurrently received the Mothers and Babies intervention delivered to her by a home visitor. Baseline, 3- and 6-month self-report surveys were conducted with both fathers and mothers. Fathers and mothers had statistically significant decreases in perceived stress between baseline and both follow-up time points, with moderate effect sizes generated for both sexes. No statistically significant differences were found for depressive symptoms, anxiety symptoms, or perceived partner support, although we found small effects for reductions in depressive symptoms among fathers, as well as increases in the percentage of fathers and mothers who reported high levels of emotional and instrumental support post-intervention. While preliminary, these findings suggest the potential for Fathers and Babies to positively impact the mental health of fathers in the perinatal period, and also signal the viability of home visiting as a setting for delivering this intervention. Future research should employ a comparison group to generate stronger evidence of intervention effectiveness and include measurement of dyadic relationships and paternal parenting practices.
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Affiliation(s)
- S Darius Tandon
- Center for Community Health, Northwestern Feinberg School of Medicine, Institute of Public Health and Medicine, Chicago, IL, United States.,Department of Medical Social Sciences, Northwestern Feinberg School of Medicine, Chicago, IL, United States
| | - Jaime Hamil
- Center for Community Health, Northwestern Feinberg School of Medicine, Institute of Public Health and Medicine, Chicago, IL, United States
| | - Emma E Gier
- Center for Community Health, Northwestern Feinberg School of Medicine, Institute of Public Health and Medicine, Chicago, IL, United States
| | - Craig F Garfield
- Department of Medical Social Sciences, Northwestern Feinberg School of Medicine, Chicago, IL, United States.,Family and Child Health Innovations Program, Department of Pediatrics, Lurie Children's Hospital of Chicago, Chicago, IL, United States
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Fathers' Experience of Perinatal Obsessive-Compulsive Symptoms: A Systematic Literature Review. Clin Child Fam Psychol Rev 2021; 24:529-541. [PMID: 34046813 DOI: 10.1007/s10567-021-00348-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/17/2021] [Indexed: 10/21/2022]
Abstract
Perinatal Obsessive-Compulsive Disorder (pOCD) refers to the onset/exacerbation of Obsessive-Compulsive Disorder (OCD) during the perinatal period. This disorder has been studied in mothers, with limited research conducted on fathers. The aim of the current study was to conduct the first systematic review of research investigating the experience of pOCD in fathers. A systematic review was conducted via electronic searches of Scopus, ProQuest, APA PsychNet, PubMed, and EBSCOhost. There were 523 articles identified and screened for eligibility, resulting in six eligible studies included in the final review. All studies reported the presence of subclinical obsessive-compulsive symptoms in fathers during the perinatal period, with the prevalence comparable to mothers. Compared to mothers, however, fathers were found to report less intrusion-related distress. Two studies reported a correlation between dysfunctional beliefs, negative appraisal of intrusions, and pOCD symptoms. Common categories of obsessive thoughts and compulsions experienced by fathers were also identified. Fathers appear susceptible to pOCD, which is consistent with the Cognitive-Behavioral Theory of OCD. Future research is recommended, therefore, to investigate clinical prevalence and severity of pOCD in fathers, particularly relative to mothers, and further investigate the role of dysfunctional beliefs in the development of pOCD.
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A Review of the Involvement of Partners and Family Members in Psychosocial Interventions for Supporting Women at Risk of or Experiencing Perinatal Depression and Anxiety. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18105396. [PMID: 34070148 PMCID: PMC8158393 DOI: 10.3390/ijerph18105396] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/13/2021] [Revised: 05/05/2021] [Accepted: 05/11/2021] [Indexed: 11/23/2022]
Abstract
A maternal experience of perinatal mental health conditions can have serious short- and long-term consequences for child development and family relationships. Women with perinatal depression and/or anxiety are primarily supported by their partner/spouse and family. The aim of this review was to synthesise data from studies that have examined the inclusion of partners or family members in psychosocial interventions for women at risk of or experiencing perinatal depression and/or anxiety. A systematic search of five databases was conducted to identify literature published between 2010 and 2020. Nine empirical studies met the eligibility criteria and were independently assessed by two authors using the National Heart, Lung and Blood Institute Quality Assessment Tools and data were extracted and narratively synthesised guided by TIDieR (Template for Intervention Description and Replication) checklist. Eligible studies detailed diverse interventions facilitated by a variety of programme facilitators, with no central model of intervention or study outcome measures evident across the studies. All studies except one reported a significant change in maternal depression and anxiety scores. The interventions had limited evaluation of the woman’s, partner’s or family member’s experiences of involvement in the intervention. Further research is required to firmly establish the effectiveness of co-designed interventions to support the sustainable integration of such interventions into routine perinatal mental health services.
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McNeil MJ, Baker JN, Snyder I, Rosenberg AR, Kaye EC. Grief and Bereavement in Fathers After the Death of a Child: A Systematic Review. Pediatrics 2021; 147:peds.2020-040386. [PMID: 33648950 DOI: 10.1542/peds.2020-040386] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/22/2020] [Indexed: 11/24/2022] Open
Abstract
CONTEXT The death of a child is devastating, and complicated grief adversely impacts parental physical and psychosocial well-being. Most research currently is centered on bereaved mothers, and the experiences of fathers remains underexplored. OBJECTIVE We systematically reviewed the literature to characterize the grief and bereavement experiences of fathers after the death of a child. DATA SOURCES We searched Medline, PsycInfo, Embase, and Cumulative Index to Nursing and Allied Health Literature using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. STUDY SELECTION Inclusion criteria encompassed English language articles published between 2007 and 2019 that evaluated the grief and bereavement experiences of fathers after the death of their child. We excluded studies describing paternal bereavement after the death of a child aged older than 21 years, stillbirth, miscarriage, or studies that did not specify age of death. DATA EXTRACTION Extracted domains included study design, demographics, findings, and quality assessment. RESULTS We screened 1848 deduplicated titles and abstracts and 139 full articles, yielding 21 articles for inclusion in this analysis. Fathers often avoided discussing their grief with others, returned to work earlier, and used goal-oriented tasks as coping strategies. Intense grief reactions and posttraumatic psychological sequelae diminished over time in mothers yet persisted in fathers. LIMITATIONS Included studies were primarily descriptive in nature, without ability to ascertain causality. Limited paternal data exists in the literature compared with maternal data. CONCLUSIONS Despite evolving gender roles, many fathers navigate loss through stoicism, self-isolation, and hard work. For some fathers, these coping mechanisms may be inadequate for navigating grief.
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Affiliation(s)
- Michael J McNeil
- Division of Quality and Life and Palliative Care, Department of Oncology St. Jude Children's Research Hospital, Memphis, Tennessee;
| | - Justin N Baker
- Division of Quality and Life and Palliative Care, Department of Oncology St. Jude Children's Research Hospital, Memphis, Tennessee
| | - Ian Snyder
- University of Tennessee Health Science Center, Memphis, Tennessee
| | - Abby R Rosenberg
- Palliative Care and Resilience Laboratory, Seattle Children's Research Institute, Seattle, Washington; and.,Department of Pediatrics, School of Medicine, University of Washington, Seattle, Washington
| | - Erica C Kaye
- Division of Quality and Life and Palliative Care, Department of Oncology St. Jude Children's Research Hospital, Memphis, Tennessee
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Vahtel K, Eilmann K, Pühvel J, Kangasniemi M. Expectant fathers' experiences of family-centred births in Estonia: a qualitative study. Midwifery 2021; 96:102948. [PMID: 33631412 DOI: 10.1016/j.midw.2021.102948] [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: 03/15/2020] [Revised: 10/19/2020] [Accepted: 02/10/2021] [Indexed: 11/24/2022]
Abstract
OBJECTIVE One of the aims of family-centred care is to provide expectant fathers with positive experiences during childbirth, so they can support their partners and bond with their new baby. However, research in this area has been limited. This study described men´s experiences with family-centred births in Estonia, Northern Europe. DESIGN Qualitative study with open-ended interviews that were audio taped and analysed by inductive content analysis by Elo and Kyngäs (2008). SETTING Birth units at one central and one regional hospital in Estonia. PARTICIPANTS Twelve Estonian fathers aged 22-44, interviewed 4-12 weeks after their baby's birth. KEY CONCLUSIONS Fathers' experiences of family-centred care during their baby's birth focused on their transition to fatherhood, their experiences of birth as a multifactorial life event and the experiences they shared with other fathers. They discussed supporting their partners during the birth, their involvement in decision making, the attitudes of healthcare professionals and how their role in the family changed. The fathers said that the birth was a private and public event, where their own role, and the roles of healthcare professionals, were confusing. This made family-centred care difficult during the birth. Sharing experiences with other fathers decreased their fears and increased their understanding of becoming fathers. Some fathers were not ready for fatherhood and midwives needed to assess how involved fathers wanted to get during the birth. IMPLICATIONS FOR PRACTICE Family-centred care is important during birth, but more research is needed into how fathers see their role. The roles played by medical staff also need to be clearer. Better knowledge about what fathers expect and need, can help midwives to involve and support them at a level they feel comfortable with. Peer support can play a vital role in preparing fathers for birth and fatherhood.
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Affiliation(s)
- Käthlin Vahtel
- Health Education Centre, Midwife Curriculum, Tallinn Health Care College, Tallinn, Estonia.
| | | | - Janne Pühvel
- Institute of Family Medicine and Public Health, Faculty of Medicine, University of Tartu, Tartu, Estonia.
| | - Mari Kangasniemi
- Institute of Family Medicine and Public Health, Faculty of Medicine, University of Tartu, Tartu, Estonia; Department of Nursing Science, Faculty of Medicine, University of Turku, Finland.
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McMahon GE, Anderson PJ, Giallo R, Pace CC, Cheong JL, Doyle LW, Spittle AJ, Spencer-Smith MM, Treyvaud K. Mental Health Trajectories of Fathers Following Very Preterm Birth: Associations With Parenting. J Pediatr Psychol 2021; 45:725-735. [PMID: 32514578 DOI: 10.1093/jpepsy/jsaa041] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2019] [Revised: 05/05/2020] [Accepted: 05/14/2020] [Indexed: 12/19/2022] Open
Abstract
OBJECTIVE Mothers of infants born very preterm (VPT) are at high risk of mental health difficulties. However, less is known about the course of fathers' depressive and anxiety symptoms over time, and the implications this may have for early parenting behaviors. METHODS In total, 100 fathers of 125 infants born VPT (<30 weeks' gestation) completed questionnaires assessing depressive and anxiety symptoms shortly after their infant's birth, and when their infant reached term-equivalent age, 3 months, 6 months, and 12 months' corrected age. At 12 months' corrected age, fathers' parenting behaviors were assessed using the Emotional Availability Scales. Longitudinal latent class analysis was used to identify trajectories of fathers' depressive and anxiety symptoms, and linear regression equations examined relationships between these trajectories and fathers' parenting behaviors. RESULTS For both depressive and anxiety symptoms, two distinct trajectories were identified. For depression, most fathers were assigned to the persistently low symptom trajectory (82%), while the remainder were assigned to the persistently high symptom trajectory (18%). For anxiety, 49% of fathers were assigned to the persistently low symptom trajectory, while 51% were assigned to the trajectory characterized by moderate symptoms over the first postnatal year. There were no significant differences in parenting behaviors between fathers assigned to the different depressive and anxiety symptom trajectories. CONCLUSIONS Fathers of infants born VPT are at risk of chronic depressive and anxiety symptoms over the first postnatal year, highlighting the need for screening and ongoing support.
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Affiliation(s)
- Grace E McMahon
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University.,Murdoch Children's Research Institute
| | - Peter J Anderson
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University.,Murdoch Children's Research Institute
| | - Rebecca Giallo
- Murdoch Children's Research Institute.,Department of Paediatrics, University of Melbourne
| | - Carmen C Pace
- Murdoch Children's Research Institute.,Department of Paediatrics, University of Melbourne.,Department of Adolescent Medicine, Royal Children's Hospital
| | - Jeanie L Cheong
- Murdoch Children's Research Institute.,Neonatal Services, Royal Women's Hospital.,Department of Obstetrics and Gynaecology, University of Melbourne
| | - Lex W Doyle
- Murdoch Children's Research Institute.,Department of Paediatrics, University of Melbourne.,Neonatal Services, Royal Women's Hospital.,Department of Obstetrics and Gynaecology, University of Melbourne
| | - Alicia J Spittle
- Murdoch Children's Research Institute.,Neonatal Services, Royal Women's Hospital.,Department of Physiotherapy, University of Melbourne
| | - Megan M Spencer-Smith
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University.,Murdoch Children's Research Institute
| | - Karli Treyvaud
- Murdoch Children's Research Institute.,Department of Paediatrics, University of Melbourne.,Neonatal Services, Royal Women's Hospital.,Department of Psychology and Counselling, La Trobe University
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48
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Naurin E, Markstedt E, Stolle D, Enström D, Wallin A, Andreasson I, Attebo B, Eriksson O, Martinsson K, Elden H, Linden K, Sengpiel V. Pregnant under the pressure of a pandemic: a large-scale longitudinal survey before and during the COVID-19 outbreak. Eur J Public Health 2021; 31:7-13. [PMID: 33231625 PMCID: PMC7717243 DOI: 10.1093/eurpub/ckaa223] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND One of the groups that is most vulnerable to the COVID-19 pandemic is pregnant women. They cannot choose to refrain from care; they and their children are at risk of severe complications related to the virus; and they lose comfort and support as clinics prohibit their partners and as societal restrictions demand isolation from friends and relatives. It is urgent to study how this group is faring during the pandemic and we focus here on their health-related worries. METHODS A longitudinal survey at a Swedish hospital starting 6 months before (16 September 2019) and continuing during the COVID-19 outbreak (until 25 August 2020). A total of 6941 pregnant women and partners of diverse social backgrounds were recruited. Ninety-six percent of birth-giving women in the city take early ultrasounds where recruitment took place. Sixty-two percent of the women with an appointment and fifty-one percent of all partners gave consent to participate. RESULTS Pregnant women experienced dramatically increased worries for their own health, as well as for their partner's and their child's health in the beginning of the pandemic. The worries remained at higher than usual levels throughout the pandemic. Similar, but less dramatic changes were seen among partners. CONCLUSIONS There is a need for heightened awareness of pregnant women's and partners' health-related worries as a consequence of the COVID-19 pandemic. Related feelings, such as anxiety, have been linked to adverse pregnancy outcome and might have long-term effects. The healthcare system needs to prepare for follow-up visits with these families.
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Affiliation(s)
- Elin Naurin
- Department of Political Science, University of Gothenburg, Gothenburg, Sweden
| | - Elias Markstedt
- Department of Political Science, University of Gothenburg, Gothenburg, Sweden.,Society, Opinion and Media Institute, University of Gothenburg, Gothenburg, Sweden
| | - Dietlind Stolle
- Department of Political Science, McGill University, Montreal, Canada
| | - Daniel Enström
- Society, Opinion and Media Institute, University of Gothenburg, Gothenburg, Sweden
| | - Anton Wallin
- Department of Political Science, University of Gothenburg, Gothenburg, Sweden
| | - Ingrid Andreasson
- Department of Political Science, University of Gothenburg, Gothenburg, Sweden
| | - Birgitta Attebo
- Department of Political Science, University of Gothenburg, Gothenburg, Sweden
| | - Ottilia Eriksson
- Department of Political Science, University of Gothenburg, Gothenburg, Sweden
| | - Klara Martinsson
- Department of Political Science, University of Gothenburg, Gothenburg, Sweden
| | - Helen Elden
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Karolina Linden
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Verena Sengpiel
- Sahlgrenska University Hospital, Gothenburg, Sweden.,Department of Obstetrics and Gynecology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
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49
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Moran E, Bradshaw C, Tuohy T, Noonan M. The Paternal Experience of Fear of Childbirth: An Integrative Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:1231. [PMID: 33573071 PMCID: PMC7908162 DOI: 10.3390/ijerph18031231] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/29/2020] [Revised: 12/17/2020] [Accepted: 01/23/2021] [Indexed: 11/24/2022]
Abstract
BACKGROUND It is estimated that approximately 13% of expectant fathers experience a pathological and debilitating fear of childbirth. OBJECTIVE The aim of this integrative review was to examine and synthesise the current body of research relating to paternal experience of fear of childbirth. METHODS A systematic literature search of five databases-CINAHL, Cochrane Library, MEDLINE, PsycArticles and PsycInfo-identified seventeen papers. Methodological quality of studies was assessed using the Crowe Critical Appraisal Tool. RESULTS Thematic data analysis identified three themes: the focus of fathers' childbirth-related fears, the impact of fear of childbirth on health and wellbeing, and fear of childbirth as a private burden. DISCUSSION Fear of childbirth is a significant and distressing experience for expectant fathers who may benefit from an opportunity to express their childbirth-related fears in an environment where they feel validated and supported. Antenatal education is recommended to enhance fathers' childbirth-related self-efficacy to reduce fear of childbirth. CONCLUSIONS Fear of childbirth may negatively impact the lives of men and consequently their families. Further investigation into methods and models for identifying and supporting men at risk of or experiencing fear of childbirth is required to improve outcomes for this population of men.
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Affiliation(s)
- Emma Moran
- St. Patrick’s Mental Health Services, D08K7YW Dublin, Ireland
| | - Carmel Bradshaw
- Department of Nursing and Midwifery, University of Limerick, V94X5K6 Limerick, Ireland; (C.B.); (T.T.); (M.N.)
| | - Teresa Tuohy
- Department of Nursing and Midwifery, University of Limerick, V94X5K6 Limerick, Ireland; (C.B.); (T.T.); (M.N.)
| | - Maria Noonan
- Department of Nursing and Midwifery, University of Limerick, V94X5K6 Limerick, Ireland; (C.B.); (T.T.); (M.N.)
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50
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Gorman G, Toomey E, Flannery C, Redsell S, Hayes C, Huizink A, Kearney PM, Matvienko-Sikar K. Fidelity of Interventions to Reduce or Prevent Stress and/or Anxiety from Pregnancy up to Two Years Postpartum: A Systematic Review. Matern Child Health J 2020; 25:230-256. [PMID: 33237506 DOI: 10.1007/s10995-020-03093-0] [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: 11/07/2020] [Indexed: 10/22/2022]
Abstract
INTRODUCTION Intervention fidelity refers to whether an intervention is delivered as intended and can enhance interpretation of trial outcomes. Fidelity of interventions to reduce or prevent stress and anxiety during pregnancy and postpartum has yet to be examined despite inconsistent findings for intervention effects. This study systematically reviews use and/or reporting of intervention fidelity strategies in trials of interventions, delivered to (expectant) parents during pregnancy and postpartum, to reduce or prevent stress and/or anxiety. METHODS MEDLINE, Embase, CINAHL, PsychINFO, and Maternity and Infant Care were searched from inception to March 2019. Studies were included if they were randomised controlled trials including pregnant women, expectant fathers and/or partners during pregnancy, and/ or parents within the first two years postpartum. The National Institutes of Health Behavior Change Consortium checklist was used to assess fidelity across five domains (study design, provider training, delivery, receipt, enactment). RESULTS Sixteen papers (14 interventions) were identified. Average reported use of fidelity strategies was 'low' (45%), ranging from 17.5 to 76%. Fidelity ratings ranged from 22% for provider training to 54% for study design. CONCLUSIONS Low levels of intervention fidelity may explain previous inconsistent effects of stress and anxiety reduction interventions. Important methodological areas for improvement include intervention provider training, fidelity of comparator conditions, and consideration of non-specific treatment effects. Increased methodological rigour in fidelity enhancement and assessment will improve intervention implementation and enhance examination of stress and anxiety reduction and prevention interventions delivered during pregnancy and the postpartum.
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Affiliation(s)
- Gregory Gorman
- School of Public Health, University College Cork, Western Gateway Building, Western Road, Cork, Ireland
| | - Elaine Toomey
- School of Allied Health, University of Limerick, Limerick, Ireland
| | - Caragh Flannery
- School of Public Health, University College Cork, Western Gateway Building, Western Road, Cork, Ireland
| | - Sarah Redsell
- School of Medicine, University of Nottingham, Nottingham, England
| | | | - Anja Huizink
- Department of Clinical, Neuro- and Developmental Psychology, VU University Amsterdam, Amsterdam, The Netherlands
| | - Patricia M Kearney
- School of Public Health, University College Cork, Western Gateway Building, Western Road, Cork, Ireland
| | - Karen Matvienko-Sikar
- School of Public Health, University College Cork, Western Gateway Building, Western Road, Cork, Ireland. .,School of Public Health, University College Cork, 4th Floor, Western Gateway Building, Western Road, Cork, Ireland.
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