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Thamby A, Bajaj A, L M, G SK, Gr G, K T, Ts J. Impaired mother-infant bonding: a community study from India. J Reprod Infant Psychol 2024; 42:528-539. [PMID: 36138562 DOI: 10.1080/02646838.2022.2125938] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Accepted: 09/13/2022] [Indexed: 10/14/2022]
Abstract
PURPOSE Impaired mother-infant bonding (MIB) is associated with inadequate maternal skills and pose a higher risk for impaired learning, child abuse, and psychiatric disorders in children. There are approximately 24 million births annually in India; however, community data on MIB from India is lacking. METHODS The study reports the findings of a cross-sectional survey of 8189 mothers with children of age between 13 and 15 months from the state of Kerala, India. Bonding was assessed using the Mother-infant bonding scale (MIBS). Other correlates assessed include obstetric and birth history, chronic pain, postpartum depression and temperamental issues in the infant. RESULTS The prevalence of impaired MIB in our sample was 12.3%. Those in extended/joint family, experiencing postpartum complications, supplementary breastfeeding in the first 6 months, postpartum depression and temperamental issues in infant were found to be associated with increased MIBS scores in a multivariate mixed-effect zero-inflated poisson model. CONCLUSION Experience of impaired MIB is not uncommon among mothers in India. More needs to be done to explore these issues, especially among those with higher risk to ensure appropriate interventions to mitigate long-term consequences.
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Affiliation(s)
- Abel Thamby
- Department of Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, India
| | - Aakash Bajaj
- Department of Biostatistics, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, India
| | - Manoj L
- National Health Mission (Kerala), Thiruvananthapuram, India
| | - Sunil Kumar G
- National Health Mission (Kerala), Thiruvananthapuram, India
| | - Gokul Gr
- National Health Mission (Kerala), Thiruvananthapuram, India
| | - Thennarasu K
- Department of Biostatistics, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, India
| | - Jaisoorya Ts
- Department of Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, India
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Larose MP, Haeck C, Lefebvre P, Merrigan P. Examining the impact of a change in maternity leave policy in Canada on maternal mental health care visits to the physician. Arch Womens Ment Health 2024:10.1007/s00737-024-01448-y. [PMID: 38411866 DOI: 10.1007/s00737-024-01448-y] [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: 05/31/2023] [Accepted: 02/12/2024] [Indexed: 02/28/2024]
Abstract
PURPOSE Maternity leave is a critical employee benefit that allows mothers to recover from the stress of pregnancy and childbirth and bond with their new baby. We aimed to examine the association between the extension of a maternity leave policy and maternal use of mental health services and prescription drugs in a universal public healthcare system. METHODS This study uses administrative medical records from 18,000 randomly selected women who gave birth three months before and after an extension of the maternity leave policy. More specifically, mothers who gave birth after January 1st 2001, were entitled to 50 weeks of paid maternity leave, while mothers who gave birth before that date were entitled to only 26 weeks of paid maternity leave. Medical records were analyzed over a seven-year period (i.e., from October 1998 to March 2006). We examined the number and costs of mothers' medical visits for mental health care in the five years following delivery, as well as maternal use of prescribed medication for mental health problems. RESULTS We found that mothers with extended maternity leave had - 0.12 (95%CI=-0.21; -0.02) fewer medical visits than mothers without a more generous maternity leave and that the cost of mental health services was Can$5 less expensive per women. These differences were found specifically during the extended maternity leave period. CONCLUSIONS The extra time away from work may help mothers to balance new family dynamics which may result in less demand on the healthcare system.
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Affiliation(s)
- Marie-Pier Larose
- INVEST Flagship Research Center, Department of Psychology and Speech-Language Pathology, University of Turku, Turku, Finland.
| | - Catherine Haeck
- Département des sciences économiques, Université du Québec à Montréal, P.O. 8888, Box "A", Montreal, QC, Canada
| | - Pierre Lefebvre
- Département des sciences économiques, Université du Québec à Montréal, P.O. 8888, Box "A", Montreal, QC, Canada
| | - Philip Merrigan
- Département des sciences économiques, Université du Québec à Montréal, P.O. 8888, Box "A", Montreal, QC, Canada
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Gu Y, Waters TEA, Zhu V, Jamieson B, Lim D, Schmitt G, Atkinson L. Attachment expectations moderate links between social support and maternal adjustment from 6 to 18 months postpartum. Dev Psychopathol 2024:1-13. [PMID: 38273665 DOI: 10.1017/s0954579423001657] [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: 01/27/2024]
Abstract
Significant links exist between one's perception of available social support and mental health outcomes, including during the transition to motherhood. Yet, attachment theory posits that individuals do not benefit equally from social support. As such, we examined the influence of attachment representations (i.e., secure base script knowledge) as they potentially moderate links between social support and psychological distress in a 1-year longitudinal study of an ethnically diverse (56% White) sample of infant-mother dyads. We hypothesized that higher social support would predict lower maternal psychological distress and this relation would be strongest in those with higher secure base script knowledge. Results indicated that maternal perceptions of social support were significantly negatively correlated with psychological distress. Analyses revealed that secure base script scores significantly moderated these associations. Interestingly, for those high in script knowledge, low social support predicted greater psychological distress. For those low in script knowledge, social support was unrelated to psychological distress. This pattern suggested that those who expect care (i.e., high secure base script knowledge) but receive minimal support (i.e., low perceived social support) find motherhood uniquely dysregulating. Practitioners may do well to examine individuals' attachment expectations in relation to their current social support.
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Affiliation(s)
- Yufei Gu
- Department of Psychology, New York University Abu Dhabi, Abu Dhabi, United Arab Emirates
- Department of Applied Psychology, Steinhardt School of Culture, Education, and Human Development, New York University, New York, NY, USA
| | - Theodore E A Waters
- Department of Psychology, New York University Abu Dhabi, Abu Dhabi, United Arab Emirates
- Department of Applied Psychology, Steinhardt School of Culture, Education, and Human Development, New York University, New York, NY, USA
| | - Victoria Zhu
- Department of Psychology, New York University Abu Dhabi, Abu Dhabi, United Arab Emirates
| | - Brittany Jamieson
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada
| | - Danielle Lim
- Department of Psychology, Toronto Metropolitan University, Toronto, ON, Canada
| | - Gabrielle Schmitt
- Department of Psychology, Toronto Metropolitan University, Toronto, ON, Canada
| | - Leslie Atkinson
- Department of Psychology, Toronto Metropolitan University, Toronto, ON, Canada
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Childbirth, trauma and family relationships. Eur J Psychotraumatol 2023; 14:2157481. [PMID: 37052080 PMCID: PMC9848292 DOI: 10.1080/20008066.2022.2157481] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
Abstract
Background: Childbirth is a major life event with expected positive outcomes, yet for some women postnatal psychopathological symptoms may harm women's interpersonal relationships. We hypothesized that higher levels of postnatal depression, post-traumatic stress (PTSD) symptoms, and fear of childbirth would be associated with mother-baby bond disorders and relationship dissatisfaction in couples.Method: A cross-sectional self-report online questionnaire was used to survey partnered women who had delivered in the year prior to the study. We used a convenience sample of 228 women recruited through purposive and snowball sampling. Childbirth experience, PTSD symptoms, attachment style, depression, mother-baby bond disorders, and couple relationship dissatisfaction were measured.Results: Women with higher PTSD and postnatal depression scores reported higher levels of mother-baby bond disorders-a relationship fully mediated by postnatal depression symptoms. Women who perceived childbirth as fearful or anxiety provoking had higher levels of PTSD and postnatal depression symptoms. Fearful and anxious birth perception was positively associated with mother-baby bond disorders-an association partly mediated by PTSD symptoms. Insecure attachment style was not found to be significantly associated with fearful or anxious perceptions of childbirth.Limitations: Women who have postnatal PTSD/depression are less inclined to participate in a study of this nature. Also, online surveys prevented the use of clinical diagnoses of PTSD and depression.Discussion and conclusions: Our results suggest that PTSD and postnatal depression affect women's mental health and family bonding. Women should be assessed for negative traumatic birth experiences, PTSD, and depression, to allow targeted observation for psychopathologies and therapeutic interventions.
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DEMİRCİ Ö, INAN E. Postpartum Paternal Depression: Its Impact on Family and Child Development. PSIKIYATRIDE GUNCEL YAKLASIMLAR - CURRENT APPROACHES IN PSYCHIATRY 2023. [DOI: 10.18863/pgy.1153712] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/28/2023]
Abstract
The postpartum period is when parents undergo great changes and gain new responsibilities. Factors such as the changes that come with having a baby, not meeting the expectations about parenthood, having a child with a difficult temperament or health problems, or relational problems can be quite challenging in this period. These problems can deeply affect the psychological well-being of the parents. Although studies on depressive symptoms of mothers during pregnancy and postpartum are at an important level, studies aiming to examine the psychological state of fathers for the same period are still limited. However, perceptions that postpartum depression develops due to hormonal changes during pregnancy have been reshaped by the findings that this situation may also develop due to psychosocial factors. Relatedly, the number of studies on postpartum depression experienced by fathers has increased over time. Results of those studies show that fathers' psychological state also influences their parenting and the development of children. Fathers may experience paternal depression due to a lack of social support, economic conditions, relationship dynamics, and changing living conditions in the postpartum period. This situation may cause fathers to avoid parenting duties, spend less time with their children, be unable to cooperate with the mother, and have anger problems or deterioration in the relationship with the mother. The effects of depression on individuals' parenting styles negatively affect child-parent attachment and may cause children to develop emotional and behavioral problems. Therefore, it is very important to examine fathers' psychological state for children's development and the healthy progress of family dynamics. This review aims to address the effect of paternal depression on parenting and child development.
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Kalfon-Hakhmigari M, Segal H, Peled Y, Handelzalts JE. Hebrew validation of the postpartum bonding questionnaire: a study of mothers and fathers. J Reprod Infant Psychol 2023:1-13. [PMID: 37581452 DOI: 10.1080/02646838.2023.2247014] [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: 03/20/2023] [Accepted: 08/07/2023] [Indexed: 08/16/2023]
Abstract
OBJECTIVE The Postpartum Bonding Questionnaire (PBQ) is a self-report questionnaire designed to screen disorders of the mother-infant relationship. The PBQ was adapted to several countries, though there is no agreement on the accepted number of items and factors. This study aimed to assess the validity and reliability of the Hebrew version for both mothers and fathers. METHODS Participants (602 mothers and 144 fathers) from two separate samples were randomly recruited in the maternity ward of a large tertiary health centre. The mothers' samples were combined and redivided to form subsamples A and B. At T1 (1-4 days postpartum), the participants completed demographic questionnaire in person the PBQ and the Edinburgh Postpartum Depression Scale (EPDS) were administered online at T2 (8-12 weeks postpartum). The PBQ was also administrated at T3 (six-months). RESULTS EFA on subsample A resulted in a two-factor structure, which was tested using CFA on subsample B. The model's fit was very good; χ(35)2 = 83.68, p < .001, CFI = .97, TLI = .91, RMSEA = .07, SRMR = .03. Additional reliability and validity analyses showed a very good fit for mothers. Scalar measurement invariance across mothers and fathers yielded satisfactory results. CFA among fathers, revealed adequate goodness of fit; χ2/df = 87.65/46, p < .001, CFI = .95, TLI = .89, RMSEA = .08, SRMR = .05. CONCLUSIONS The Hebrew version of the PBQ demonstrated satisfactory validity for both mothers and fathers. The revised version, with 14 items, measures bonding as a continuum rather than measuring bonding disorders like the original version. These findings emphasise the importance of validating the scale in different cultural contexts.
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Affiliation(s)
| | - Hila Segal
- School of Behavioral Sciences, Academic College of Tel-Aviv-Yaffo, Tel-Aviv, Israel
| | - Yoav Peled
- The Helen Schneider Hospital for Women, Rabin Medical Center, Petach-Tikva, Israel
- Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - Jonathan E Handelzalts
- School of Behavioral Sciences, Academic College of Tel-Aviv-Yaffo, Tel-Aviv, Israel
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA
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Courtin E, Rieckmann A, Bengtsson J, Nafilyan V, Melchior M, Berkman L, Hulvej Rod N. The effect on women's health of extending parental leave: a quasi-experimental registry-based cohort study. Int J Epidemiol 2023; 52:993-1002. [PMID: 36240451 PMCID: PMC10396408 DOI: 10.1093/ije/dyac198] [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: 03/22/2021] [Accepted: 09/30/2022] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Parental leave policies have been hypothesized to benefit mothers' mental health. We assessed the impact of a 6-week extension of parental leave in Denmark on maternal mental health. METHODS We linked individual-level data from Danish national registries on maternal sociodemographic characteristics and psychiatric diagnoses. A regression discontinuity design was applied to study the increase in parental leave duration after 26 March 1984. We included women who had given birth between 1 January 1981 and 31 December 1987. Our outcome was a first psychiatric diagnosis following the child's birth, ascertained as the first day of inpatient hospital admission for any psychiatric disorder. We presented cumulative incidences for the 30-year follow-up period and reported absolute risk differences between women eligible for the reform vs not, in 5-year intervals. RESULTS In all, 291 152 women were followed up until 2017, death, emigration or date of first psychiatric diagnosis. The median follow-up time was 29.99 years, corresponding to 10 277 547 person-years at risk. The cumulative incidence of psychiatric diagnoses at 30 years of follow-up was 59.5 (95% CI: 57.4 to 61.6) per 1000 women in the ineligible group and 57.5 (95% CI: 55.6 to 59.4) in the eligible group. Eligible women took on average 32.85 additional days of parental leave (95% CI: 29.20 to 36.49) and had a lower probability of having a psychiatric diagnosis within 5 years [risk difference (RD): 2.4 fewer diagnoses per 1000 women, 95% CI: 1.5 to 3.2] and up to 20 years after the birth (RD: 2.3, 95% CI: 0.4 to 4.2). In subgroup analyses, the risk reduction was concentrated among low-educated, low-income and single women. CONCLUSIONS Longer parental leave may confer mental health benefits to women, in particular to those from disadvantaged backgrounds.
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Affiliation(s)
- Emilie Courtin
- Department of Public Health, Environments and Society, London School of Hygiene and Tropical Medicine, London, UK
| | - Andreas Rieckmann
- Department of Public Health, Section of Epidemiology, University of Copenhagen, Copenhagen, Denmark
| | - Jessica Bengtsson
- Department of Public Health, Section of Epidemiology, University of Copenhagen, Copenhagen, Denmark
| | - Vahe Nafilyan
- Department of Public Health, Environments and Society, London School of Hygiene and Tropical Medicine, London, UK
- King’s Business School, King’s College London, London, UK
| | - Maria Melchior
- Institut Pierre Louis d'Epidémiologie et de Santé Publique, INSERM UMR S 1136, Sorbonne University, Paris, France
| | - Lisa Berkman
- Harvard Center for Population and Development Studies, Harvard University, Cambridge, MA, USA
| | - Naja Hulvej Rod
- Department of Public Health, Section of Epidemiology, University of Copenhagen, Copenhagen, Denmark
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Hauge C, Rohde C, Østergaard SD. Treatment of postpartum psychotic- or mood disorder requiring admission: A nationwide study from Denmark. Acta Psychiatr Scand 2023. [PMID: 37339779 DOI: 10.1111/acps.13585] [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: 01/26/2023] [Revised: 04/25/2023] [Accepted: 05/27/2023] [Indexed: 06/22/2023]
Abstract
BACKGROUND Postpartum psychotic- or mood disorders are psychiatric emergencies associated with risk of suicide and infanticide. Except from case reports, there are only few descriptions of its treatment. Therefore, we aimed to describe the treatment of women admitted with postpartum psychotic- or mood disorder in Denmark with emphasis on the use of electroconvulsive therapy (ECT). METHODS We conducted a register-based cohort study of all women with incident postpartum psychotic- or mood disorder (no prior diagnoses of psychotic- or mood disorder or treatment with ECT) requiring admission in the period from 2011 to 2018. For these patients, we described the treatment and the 6-month readmission risk. RESULTS We identified 91 women with postpartum psychotic- or mood disorder with a median admission length of 27 days (interquartile range: 10-45). Of those, 19% received ECT with a median time from admission to first ECT of 10 days (interquartile range: 5-16). The median number of ECT sessions was eight (interquartile range: 7-12). In the 6 months following discharge, 90% of the women received some form of psychopharmacological treatment (62% antipsychotics, 56% antidepressants, 36% anxiolytics/sedatives, 19% lithium, and 9% mood stabilizing antiepileptics), and 31% were readmitted. CONCLUSION Psychiatric admission for incident postpartum psychotic- or mood disorder is rare in Denmark. Among those admitted, ECT and psychopharmacological treatment is commonly used. The 6-month readmission risk is high, warranting close follow-up. The fact that there is no international consensus on the optimal treatment of postpartum psychotic- or mood disorder is problematic and calls for action.
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Affiliation(s)
- Charlotte Hauge
- Regional Psychiatry Midt, Viborg, Denmark
- Department of Affective Disorders, Aarhus University Hospital-Psychiatry, Aarhus, Denmark
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Christopher Rohde
- Department of Affective Disorders, Aarhus University Hospital-Psychiatry, Aarhus, Denmark
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Søren D Østergaard
- Department of Affective Disorders, Aarhus University Hospital-Psychiatry, Aarhus, Denmark
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
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O'Dea GA, Youssef GJ, Hagg LJ, Francis LM, Spry EA, Rossen L, Smith I, Teague SJ, Mansour K, Booth A, Davies S, Hutchinson D, Macdonald JA. Associations between maternal psychological distress and mother-infant bonding: a systematic review and meta-analysis. Arch Womens Ment Health 2023:10.1007/s00737-023-01332-1. [PMID: 37316760 DOI: 10.1007/s00737-023-01332-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Accepted: 05/20/2023] [Indexed: 06/16/2023]
Abstract
PURPOSE Maternal psychological distress and mother-infant bonding problems each predict poorer offspring outcomes. They are also related to each other, yet the extensive literature reporting their association has not been meta-analysed. METHODS We searched MEDLINE, PsycINFO, CINAHL, Embase, ProQuest DTG, and OATD for English-language peer-reviewed and grey literature reporting an association between mother-infant bonding, and multiple indicators of maternal psychological distress. RESULTS We included 133 studies representing 118 samples; 99 samples (110,968 mothers) were eligible for meta-analysis. Results showed concurrent associations across a range of timepoints during the first year postpartum, between bonding problems and depression (r = .27 [95% CI 0.20, 0.35] to r = .47 [95% CI 0.41, 0.53]), anxiety (r = .27 [95% CI 0.24, 0.31] to r = .39 [95% CI 0.15, 0.59]), and stress (r = .46 [95% CI 0.40, 0.52]). Associations between antenatal distress and subsequent postpartum bonding problems were mostly weaker and with wider confidence intervals: depression (r = .20 [95% CI 0.14, 0.50] to r = .25 [95% CI 0.64, 0.85]), anxiety (r = .16 [95% CI 0.10, 0.22]), and stress (r = .15 [95% CI - 0.67, 0.80]). Pre-conception depression and anxiety were associated with postpartum bonding problems (r = - 0.17 [95% CI - 0.22, - 0.11]). CONCLUSION Maternal psychological distress is associated with postpartum mother-infant bonding problems. Co-occurrence of psychological distress and bonding problems is common, but should not be assumed. There may be benefit in augmenting existing perinatal screening programs with well-validated mother-infant bonding measures.
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Affiliation(s)
- Gypsy A O'Dea
- School of Psychology, Centre for Social and Emotional Early Development, Deakin University, Geelong, Australia.
| | - George J Youssef
- School of Psychology, Centre for Social and Emotional Early Development, Deakin University, Geelong, Australia
- Centre for Adolescent Health, Murdoch Children's Research Institute, Melbourne, Australia
| | - Lauryn J Hagg
- School of Psychology, Centre for Social and Emotional Early Development, Deakin University, Geelong, Australia
| | - Lauren M Francis
- School of Psychology, Centre for Social and Emotional Early Development, Deakin University, Geelong, Australia
| | - Elizabeth A Spry
- School of Psychology, Centre for Social and Emotional Early Development, Deakin University, Geelong, Australia
- Centre for Adolescent Health, Murdoch Children's Research Institute, Melbourne, Australia
- Department of Paediatrics, University of Melbourne, Parkville, Australia
| | - Larissa Rossen
- Counselling Psychology Department, Trinity Western University, Langley Township, BC, Canada
| | - Imogene Smith
- School of Psychology, Centre for Social and Emotional Early Development, Deakin University, Geelong, Australia
| | - Samantha J Teague
- School of Psychology, Centre for Social and Emotional Early Development, Deakin University, Geelong, Australia
- Division of Tropical Health and Medicine, Department of Psychology, College of Healthcare Sciences, James Cook University, Townsville, Australia
| | - Kayla Mansour
- School of Psychology, Centre for Social and Emotional Early Development, Deakin University, Geelong, Australia
| | - Anna Booth
- La Trobe University, School of Psychology and Public Health, The Bouverie Centre, Brunswick, Australia
| | - Sasha Davies
- School of Psychology, Centre for Social and Emotional Early Development, Deakin University, Geelong, Australia
- Faculty of Psychology, Counselling, and Psychotherapy, The Cairnmillar Institute, Hawthorn East, Australia
| | - Delyse Hutchinson
- School of Psychology, Centre for Social and Emotional Early Development, Deakin University, Geelong, Australia
- Centre for Adolescent Health, Murdoch Children's Research Institute, Melbourne, Australia
- Department of Paediatrics, University of Melbourne, Parkville, Australia
- National Drug and Alcohol Research Centre, University of New South Wales, Sydney, Australia
| | - Jacqui A Macdonald
- School of Psychology, Centre for Social and Emotional Early Development, Deakin University, Geelong, Australia
- Centre for Adolescent Health, Murdoch Children's Research Institute, Melbourne, Australia
- Department of Paediatrics, University of Melbourne, Parkville, Australia
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Baba K, Kataoka Y, Kitamura T. Identifying Core Items of the Japanese Version of the Mother-to-Infant Bonding Scale for Diagnosing Postpartum Bonding Disorder. Healthcare (Basel) 2023; 11:1740. [PMID: 37372858 DOI: 10.3390/healthcare11121740] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Revised: 06/09/2023] [Accepted: 06/11/2023] [Indexed: 06/29/2023] Open
Abstract
The Japanese version of the mother-to-infant bonding scale (MIBS-J), a self-report of postpartum bonding disorder, is used in clinical settings for screening postpartum bonding disorder at various time points. However, its psychometric properties, particularly measurement invariance, have rarely been reported, and the validity of comparing scores across time points and sex is unclear. We aimed to select and validate the MIBS-J items suitable for parents at three time points. Postpartum mothers (n = 543) and fathers (n = 350) were surveyed at 5 days, 1 month, and 4 months postpartum. All participants were randomly divided into two subgroups, one for exploratory factor analyses (EFAs) and another for confirmatory factor analyses. Measurement invariance of the best model was tested using the entire sample, between fathers and mothers, and across the three observation periods. A three-item structure (items 1, 6, and 8) extracted through EFAs showed acceptable configural invariance. This model was accepted for scalar invariance between fathers and mothers and for metric invariance across the three time points. Our findings suggest that the three-item MIBS-J is sufficient for diagnosis of postpartum parental bonding disorder through continuous observation for at least 4 postpartum months, in order to detect the priority of parents who need support.
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Affiliation(s)
- Kaori Baba
- Research Center for Social Science & Medicine, Tokyo Metropolitan Institute of Medical Science, Tokyo 156-8506, Japan
| | - Yaeko Kataoka
- Graduate School of Nursing Science, St. Luke's International University, Tokyo 104-0044, Japan
| | - Toshinori Kitamura
- Kitamura Institute of Mental Health Tokyo, Tokyo 151-0063, Japan
- Kitamura KOKORO Clinic Mental Health, Tokyo 151-0063, Japan
- T. and F. Kitamura Foundation for Studies and Skill Advancement in Mental Health, Tokyo 151-0063, Japan
- Department of Psychiatry, Graduate School of Medicine, Nagoya University, Nagoya 466-8550, Japan
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Screening and Diagnosis of Mental Health Conditions During Pregnancy and Postpartum: ACOG Clinical Practice Guideline No. 4. Obstet Gynecol 2023; 141:1232-1261. [PMID: 37486660 DOI: 10.1097/aog.0000000000005200] [Citation(s) in RCA: 24] [Impact Index Per Article: 24.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/25/2023]
Abstract
PURPOSE To review evidence on the current understanding of mental health conditions in pregnancy and postpartum, with a focus on mood and anxiety disorders, and to outline guidelines for screening and diagnosis that are consistent with best available scientific evidence. The conditions or symptoms reviewed include depression, anxiety and anxiety-related disorders, bipolar disorder, suicidality, and postpartum psychosis. For information on psychopharmacologic treatment and management, refer to American College of Obstetricians and Gynecologists (ACOG) Clinical Practice Guideline Number 5, "Treatment and Management of Mental Health Conditions During Pregnancy and Postpartum" (1). TARGET POPULATION Pregnant or postpartum individuals with mental health conditions. Onset of these conditions may have predated the perinatal period or may have occurred for the first time in pregnancy or the first year postpartum or may have been exacerbated in that time. METHODS This guideline was developed using an a priori protocol in conjunction with a writing team consisting of one specialist in obstetrics and gynecology and one maternal-fetal medicine subspecialist appointed by the ACOG Committee on Clinical Practice Guidelines-Obstetrics and two external subject matter experts. ACOG medical librarians completed a comprehensive literature search for primary literature within Cochrane Library, Cochrane Collaboration Registry of Controlled Trials, EMBASE, PubMed, and MEDLINE. Studies that moved forward to the full-text screening stage were assessed by two authors from the writing team based on standardized inclusion and exclusion criteria. Included studies underwent quality assessment, and a modified GRADE (Grading of Recommendations Assessment, Development and Evaluation) evidence-to-decision framework was applied to interpret and translate the evidence into recommendation statements. RECOMMENDATIONS This Clinical Practice Guideline includes recommendations on the screening and diagnosis of perinatal mental health conditions including depression, anxiety, bipolar disorder, acute postpartum psychosis, and the symptom of suicidality. Recommendations are classified by strength and evidence quality. Ungraded Good Practice Points are included to provide guidance when a formal recommendation could not be made because of inadequate or nonexistent evidence.
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Hu Y, Huang S, Xiao M, Fu B, Tang G, Lommel L, Lei J. Barriers and facilitators of psychological help-seeking behaviors for perinatal women with depressive symptoms: A qualitative systematic review based on the Consolidated Framework for Implementation Research. Midwifery 2023; 122:103686. [PMID: 37119670 DOI: 10.1016/j.midw.2023.103686] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Revised: 03/22/2023] [Accepted: 04/08/2023] [Indexed: 05/01/2023]
Abstract
OBJECTIVE To identify barriers and facilitators related to psychological help-seeking behaviors of perinatal depression from all related stakeholders (e.g., perinatal women, family members, mental health care providers, and policymakers). DESIGN A literature search of six English-language databases (PubMed, Web of Science, Embase, PsycINFO, the Cochrane Library, CINAHL) and three Chinese-language databases (China National Knowledge Infrastructure, Wan Fang, Chinese Biomedical Literature Databases). Studies published in English or Chinese using qualitative or mixed methods to explore the psychological help-seeking behaviors of women with perinatal depression were included. Data extraction was synthesized for common themes based on the Consolidated Framework for Implementation Research. The Joanna Briggs Institute Qualitative Assessment and Review Instrument was used to appraise methodologic quality. PARTICIPANTS AND SETTINGS Perinatal women with depression, mental health care providers (e.g., pediatricians/nurses, social workers, nurse-midwives, perinatal psychiatrists, community health workers, and administrators), partners and informal caregivers (e.g., community birth attendants, elderly mothers, and men of reproductive age) based in high, middle and low income countries. FINDINGS Forty-three articles were included in this review and presented according to the Consolidated Framework for Implementation Research domains (in parentheses). The most common barriers to help seeking were stigma (individual characteristics), misconceptions (individual characteristics), cultural beliefs (inner setting), and lack of social support (outer setting). The most common facilitators were providing adequate support (outer setting) and perinatal health care professional training on how to detect, manage and discuss depression; establishing supportive relationships with mental health care providers; and eroding stigma (all three implementation processes). KEY CONCLUSIONS AND IMPLICATIONS FOR PRACTICE This systematic review could serve as a reference framework for health authorities to develop diverse strategies for improving the psychological help-seeking behaviors of women with perinatal depression. More high-quality studies focused on the Consolidated Framework for Implementation Research characteristics of available interventions, and implementation processes are needed in future research.
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Affiliation(s)
- Ying Hu
- Department of Nursing, The Third Xiangya Hospital of Central South University, 138 Tongzipo Road, Yuelu District, Changsha, Hunan 410013, China; Xiang Ya Nursing School of Central South University, 172 Tongzipo Road, Yuelu District, Changsha, Hunan 410013, China
| | - Sasa Huang
- Department of Nursing, The Third Xiangya Hospital of Central South University, 138 Tongzipo Road, Yuelu District, Changsha, Hunan 410013, China; Xiang Ya Nursing School of Central South University, 172 Tongzipo Road, Yuelu District, Changsha, Hunan 410013, China
| | - Meili Xiao
- Department of Nursing, The Third Xiangya Hospital of Central South University, 138 Tongzipo Road, Yuelu District, Changsha, Hunan 410013, China; Xiang Ya Nursing School of Central South University, 172 Tongzipo Road, Yuelu District, Changsha, Hunan 410013, China; Department of Nursing, Hunan Normal University School of Medicine, 371 Tongzipo Road, Yuelu District, Changsha, Hunan 410013, China.
| | - Bing Fu
- Department of Obstetrics and Gynecology, The Third Xiangya Hospital of Central South University, 138 Tongzipo Road, Yuelu District, Changsha, Hunan 410013, China
| | - Guanxiu Tang
- Department of Geriatrics, the Third Xiangya Hospital of Central South University, 138 Tongzipo Road, Yuelu District, Changsha, Hunan 410013, China
| | - Lisa Lommel
- University of California, San Francisco, 1001 Potrero Ave, San Francisco, San Francisco, California 94110, United States
| | - Jun Lei
- Department of Obstetrics and Gynecology, The Third Xiangya Hospital of Central South University, 138 Tongzipo Road, Yuelu District, Changsha, Hunan 410013, China.
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Murakami K, Ishikuro M, Obara T, Noda A, Ueno F, Onuma T, Matsuzaki F, Takahashi I, Kikuchi S, Kobayashi N, Hamada H, Iwama N, Metoki H, Kikuya M, Saito M, Sugawara J, Tomita H, Yaegashi N, Kuriyama S. Maternal postnatal bonding disorder and emotional/behavioral problems in preschool children: The Tohoku Medical Megabank Project Birth and Three-Generation Cohort Study. J Affect Disord 2023; 325:582-587. [PMID: 36642309 DOI: 10.1016/j.jad.2023.01.044] [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: 08/03/2022] [Revised: 01/06/2023] [Accepted: 01/09/2023] [Indexed: 01/15/2023]
Abstract
BACKGROUND Although there is evidence that maternal perinatal mental disorders are associated with emotional/behavioral problems in children, the long-term impacts of postnatal bonding disorder remain unclear. We aimed to examine the associations between maternal postnatal bonding disorder and emotional/behavioral problems in preschool children. METHODS We analyzed data from 7220 mother-child pairs who participated in the Tohoku Medical Megabank Project Birth and Three-Generation Cohort Study. Maternal bonding disorder was defined as Mother-to-Infant Bonding Scale score ≥5 at 1 month after delivery. The Child Behavior Checklist for Ages 1½-5 was used to assess emotional/behavioral problems, and its subscales were used to assess internalizing and externalizing problems in children at 4 years of age. Multiple logistic regression analyses were conducted to examine the associations of postnatal bonding disorder with emotional/behavioral, internalizing, and externalizing problems after adjustment for age, education, income, parity, prenatal psychological distress, postnatal depressive symptoms, child's sex, preterm birth, and birth defects. RESULTS The prevalence of postnatal bonding disorder was 14.8 %. Postnatal bonding disorder was associated with an increased risk of emotional/behavioral problems in children: the odds ratio (OR) was 2.06 (95 % confidence interval [CI], 1.72-2.46). Postnatal bonding disorder was also associated with increased risks of internalizing problems and externalizing problems in children: the ORs were 1.69 (95 % CI, 1.42-2.02) and 1.90 (95 % CI, 1.59-2.26), respectively. LIMITATIONS Bonding and problems were self-reported. CONCLUSIONS Bonding disorder at 1 month after delivery was associated with an increased risk of emotional/behavioral problems in children at 4 years of age.
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Affiliation(s)
- Keiko Murakami
- Tohoku Medical Megabank Organization, Tohoku University, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8573, Japan; Graduate School of Medicine, Tohoku University, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8575, Japan.
| | - Mami Ishikuro
- Tohoku Medical Megabank Organization, Tohoku University, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8573, Japan; Graduate School of Medicine, Tohoku University, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8575, Japan
| | - Taku Obara
- Tohoku Medical Megabank Organization, Tohoku University, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8573, Japan; Graduate School of Medicine, Tohoku University, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8575, Japan; Tohoku University Hospital, 1-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8574, Japan
| | - Aoi Noda
- Tohoku Medical Megabank Organization, Tohoku University, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8573, Japan; Graduate School of Medicine, Tohoku University, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8575, Japan; Tohoku University Hospital, 1-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8574, Japan
| | - Fumihiko Ueno
- Tohoku Medical Megabank Organization, Tohoku University, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8573, Japan; Graduate School of Medicine, Tohoku University, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8575, Japan
| | - Tomomi Onuma
- Tohoku Medical Megabank Organization, Tohoku University, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8573, Japan
| | - Fumiko Matsuzaki
- Tohoku Medical Megabank Organization, Tohoku University, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8573, Japan; Graduate School of Medicine, Tohoku University, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8575, Japan
| | - Ippei Takahashi
- Graduate School of Medicine, Tohoku University, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8575, Japan
| | - Saya Kikuchi
- Graduate School of Medicine, Tohoku University, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8575, Japan; Tohoku University Hospital, 1-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8574, Japan
| | - Natsuko Kobayashi
- Graduate School of Medicine, Tohoku University, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8575, Japan; Tohoku University Hospital, 1-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8574, Japan
| | - Hirotaka Hamada
- Graduate School of Medicine, Tohoku University, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8575, Japan; Tohoku University Hospital, 1-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8574, Japan
| | - Noriyuki Iwama
- Tohoku Medical Megabank Organization, Tohoku University, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8573, Japan; Graduate School of Medicine, Tohoku University, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8575, Japan; Tohoku University Hospital, 1-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8574, Japan
| | - Hirohito Metoki
- Tohoku Medical Megabank Organization, Tohoku University, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8573, Japan; Faculty of Medicine, Tohoku Medical and Pharmaceutical University, 1-15-1 Fukumuro, Miyagino-ku, Sendai, Miyagi 983-8536, Japan
| | - Masahiro Kikuya
- Tohoku Medical Megabank Organization, Tohoku University, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8573, Japan; Teikyo University School of Medicine, 2-11-1 Kaga, Itabashi-ku, Tokyo 173-8605, Japan
| | - Masatoshi Saito
- Graduate School of Medicine, Tohoku University, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8575, Japan; Tohoku University Hospital, 1-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8574, Japan
| | - Junichi Sugawara
- Tohoku Medical Megabank Organization, Tohoku University, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8573, Japan; Graduate School of Medicine, Tohoku University, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8575, Japan; Tohoku University Hospital, 1-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8574, Japan
| | - Hiroaki Tomita
- Tohoku Medical Megabank Organization, Tohoku University, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8573, Japan; Graduate School of Medicine, Tohoku University, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8575, Japan; Tohoku University Hospital, 1-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8574, Japan; International Research Institute of Disaster Science, Tohoku University, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8573, Japan
| | - Nobuo Yaegashi
- Tohoku Medical Megabank Organization, Tohoku University, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8573, Japan; Graduate School of Medicine, Tohoku University, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8575, Japan; Tohoku University Hospital, 1-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8574, Japan
| | - Shinichi Kuriyama
- Tohoku Medical Megabank Organization, Tohoku University, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8573, Japan; Graduate School of Medicine, Tohoku University, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8575, Japan; International Research Institute of Disaster Science, Tohoku University, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8573, Japan
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Hong SA, Buntup D. Maternal Depression during Pregnancy and Postpartum Period among the Association of Southeast Asian Nations (ASEAN) Countries: A Scoping Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:5023. [PMID: 36981932 PMCID: PMC10049420 DOI: 10.3390/ijerph20065023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/25/2023] [Revised: 03/02/2023] [Accepted: 03/07/2023] [Indexed: 06/18/2023]
Abstract
Identification of mothers with depression is important because untreated perinatal depression can have both short- and long-term consequences for the mother, the child, and the family. This review attempts to identify the prevalence of antenatal and postnatal depression (AD and PD, respectively) of mothers among the ASEAN member countries. A literature review was conducted using PubMed, Scopus, and the Asian Citation Index. The reviews covered publications in peer-reviewed journals written in the English language between January 2010 and December 2020. Of the 280 articles identified, a total of 37 peer-reviewed articles conducted in 8 out of 11 ASEAN member countries were included. The Edinburgh Postnatal Depression Scale (EPDS) was the most common instrument used to identify depression. This study showed the number of studies reporting the prevalence of AD was 18 in five countries. For PD, 24 studies in eight countries were included. The prevalence of AD ranged from 4.9% to 46.8%, and that of PD ranged from 4.4% to 57.7%. This first review among ASEAN countries showed very few studies conducted in lower-middle-income and substantial heterogeneity in prevalence among studies reviewed. Further research should be conducted to estimate the prevalence using a large representative sample with a validated assessment tool among the ASEAN countries.
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Ahmadpour P, Faroughi F, Mirghafourvand M. The relationship of childbirth experience with postpartum depression and anxiety: a cross-sectional study. BMC Psychol 2023; 11:58. [PMID: 36869373 PMCID: PMC9983514 DOI: 10.1186/s40359-023-01105-6] [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: 06/24/2022] [Accepted: 02/28/2023] [Indexed: 03/05/2023] Open
Abstract
BACKGROUND The childbirth experience is a personal life event that is influenced by physiologic and mental-psychological processes. Due to the prevalence of psychiatric problems after childbirth, it is important to recognize the factors affecting women's emotional reactions. This study was conducted to define the relationship of childbirth experience with postpartum anxiety and depression. METHODS This cross-sectional study was conducted on 399 women from 1 to 4 months after their childbirth who were referred to health centers in Tabriz-Iran from January 2021 to September 2021. Socio-demographic and obstetric characteristics questionnaire, Childbirth Experience Questionnaire (CEQ 2.0), Edinburgh Postpartum Depression Scale (EPDS), and Postpartum Specific Anxiety Scale (PSAS) were used to collect the data. The general linear modeling was used along with adjustment of socio-demographic characteristics to determine the relationship between the childbirth experience with depression and anxiety. RESULTS The mean (SD) of the overall score for childbirth experience, anxiety, and depression were 2.9 (0.2) (score range: 1 to 4), 91.6 (4.8) (score range: 0 to153), and 9.4 (0.7) (score range: 0 to 30), respectively. There was a significant inverse correlation between the overall score of childbirth experiences, the depression score (r= -0.36, p < 0.001), and the anxiety score (r= -0.12, p = 0.028) based on the Pearson correlation test. According to the general linear modeling and with adjustment of socio-demographic characteristics, with the increasing score of the childbirth experience, the depression score decreased (B= -0.2; 95%CI: -0.3 to -0.1). Moreover, the variable of control during pregnancy was a predictor for postpartum depression and anxiety, so in women with the control during pregnancy, the mean score of postpartum depression (B= -1.8; CI 95%: -3.0 to -0.5; P = 0.004) and anxiety (B=-6.0; CI 95%: -10.1 to -1.6; P = 0.007) was less. CONCLUSION Based on the study results, postpartum depression and anxiety are related to childbirth experiences, therefore considering the effects of mothers' mental health on other aspects of a woman and her family's life, the core role of health care providers and policymakers in creating positive childbirth experiences is determined.
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Affiliation(s)
- Parivash Ahmadpour
- Midwifery Department, Faculty of Nursing and Midwifery, Student Research Committee, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Farnaz Faroughi
- Midwifery Department, Faculty of Nursing and Midwifery, Maragheh Branch, Islamic azad University, Maragheh, Iran
| | - Mojgan Mirghafourvand
- Social Determinants of Health Research Center, Department of Midwifery, Faculty of Nursing & Midwifery, Tabriz University of Medical sciences, Tabriz, Iran. .,Menopause Andropause Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran. .,Social Determinants of Health Research Center, Tabriz University of Medical sciences, Tabriz, Iran.
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Stability of maternal postnatal bonding between 3 and 6 months: Associations with maternal mental health and infant temperament. Infant Behav Dev 2023. [PMID: 36863245 DOI: 10.1016/j.infbeh.2023.101826] [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: 03/04/2023]
Abstract
Maternal bonding is key for infant development and well-being. Research to date focused on prenatal bonding experience, with fewer studies looking at the postnatal period. Moreover, evidence suggests significant associations among maternal bonding, maternal mental health, and infant temperament. The joint impact of maternal mental health and infant temperament on maternal postnatal bonding remains unclear, with limited research reporting longitudinal data. Hence, the present study aims (1) to explore the impact of maternal mental health and infant temperament on postnatal bonding at both 3 and 6 months of age, (2) to explore postnatal bonding stability from 3 to 6 months, and (3) to determine which factors are linked with 3-to-6-month changes in bonding. At the infants' 3 months (n = 261) and 6 months of age (n = 217), mothers provided measures of bonding, depressive and anxious symptoms, and infant temperament via validated questionnaires. At 3 months, higher levels of maternal bonding were predicted by lower levels of anxiety and depression in the mothers and by higher infants' regulation scores. At 6 months, lower levels of anxiety and depression predicted higher levels of bonding. Moreover, mothers showing decreases in bonding were characterized by 3-to-6-month increases in depression and anxiety, as well as increased reported difficulties in regulation dimensions of infant temperament. This study highlights the impact of both maternal mental health and infant temperament on maternal postnatal bonding in a longitudinal sample and could offer useful information for early childhood prevention and care.
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Schaming C, Wendland J. Postnatal mental health during the COVID-19 pandemic: Impact on mothers' postnatal sense of security and on mother-to-infant bonding. Midwifery 2023; 117:103557. [PMID: 36473335 PMCID: PMC9678387 DOI: 10.1016/j.midw.2022.103557] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2022] [Revised: 10/08/2022] [Accepted: 11/20/2022] [Indexed: 11/23/2022]
Abstract
BACKGROUND The unprecedented COVID-19 pandemic context imposed new living conditions which greatly modified women's experience of the postpartum period and brought significant changes to postnatal care. OBJECTIVE The main objective of this study was to evaluate the impact of the COVID-19 pandemic context on maternal sense of security and on mother-to-child bonding in the postpartum. DESIGN This study had a mixed research design. We compared levels of mother-child bonding disturbances and of maternal emotional security amongst two samples of postnatal women recruited before and during the pandemic. Postnatal depression was also evaluated. A qualitative analysis of the participants' comments on the impact of the COVID-19 pandemic was performed with an open-coding approach. PARTICIPANTS Two samples of French-speaking mothers in the first six months after their childbirth, recruited before the pandemic (N=874) and during the pandemic (N=721). FINDINGS Mother-child bonding disturbances measured with PBQ and levels of emotional security levels evaluated with PPSSi did not differ significantly between the samples. A high prevalence of women at risk of postnatal depression was found in both samples. However, participants' comments on their postnatal experience during the pandemic contrasted with their quantitative data. Fears of contamination, social isolation, and lack of support were the main factors of insecurity. Lack of closeness with relatives and friends, limited presence of the partner in the maternity ward, and early interactions with the newborn with a mask appear to have altered mother-child bonding during this pandemic period. CONCLUSIONS AND IMPLICATIONS FOR PRACTICE The findings highlight the importance of considering social and environmental factors and needs when evaluating postnatal mental health and providing postnatal care to new mothers during a health crisis. Health services and professionals should pay particular attention to mothers' mental health and well-being and guarantee continuity of care to avoid parents' isolation in the sensitive postpartum period.
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Affiliation(s)
- Céline Schaming
- Université Paris Cité, Laboratoire de Psychopathologie et Processus de Santé, F-92100 Boulogne-Billancourt, France,Maternity, René Dubos Hospital, F-95303 Pontoise, France
| | - Jaqueline Wendland
- Université Paris Cité, Laboratoire de Psychopathologie et Processus de Santé, F-92100 Boulogne-Billancourt, France,Corresponding author at: University of Paris, Institute of Psychology, Psychopathology and Health Processes Laboratory, 71 Avenue Edouard Vaillant, 92774 Boulogne Billancourt, France
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Roxburgh E, Morant N, Dolman C, Johnson S, Taylor BL. Experiences of Mental Health Care Among Women Treated for Postpartum Psychosis in England: A Qualitative Study. Community Ment Health J 2023; 59:243-252. [PMID: 35900686 PMCID: PMC9859833 DOI: 10.1007/s10597-022-01002-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2022] [Revised: 05/17/2022] [Accepted: 06/17/2022] [Indexed: 01/25/2023]
Abstract
Postpartum psychosis has been found to affect 0.89-2.6 per 1000 women. Onset is typically rapid and severe. Early recognition and appropriate treatment are crucial for a good prognosis. Our aim in this study was to understand women's experiences of mental health care and services for psychosis in the postnatal period. Semi-structured interviews were conducted with 12 women who reported being treated for postpartum psychosis. Findings were analysed thematically. Women reported that healthcare professionals across maternity and mental health services often lacked awareness and knowledge of postpartum psychosis and did not always keep them or their partners/families informed, supported, and involved. Women wanted better collaboration between and within services, and more efficient, appropriate, and timely care. They valued inpatient services that could meet their needs, favouring Mother and Baby Units over general psychiatric wards. Early Intervention in Psychosis services and specialist perinatal community mental health teams were also well liked.
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Affiliation(s)
- Emily Roxburgh
- Kingston iCope, Camden & Islington NHS Foundation Trust, London, UK
- Division of Psychiatry, University College London, London, UK
| | - Nicola Morant
- Division of Psychiatry, University College London, London, UK
| | - Clare Dolman
- Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Sonia Johnson
- Division of Psychiatry, University College London, London, UK.
| | - Billie Lever Taylor
- Division of Psychiatry, University College London, London, UK
- Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
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Nakić Radoš S, Brekalo M, Matijaš M. Measuring stress after childbirth: development and validation of the Maternal Postpartum Stress Scale. J Reprod Infant Psychol 2023; 41:65-77. [PMID: 34151659 DOI: 10.1080/02646838.2021.1940897] [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] [Indexed: 01/25/2023]
Abstract
BACKGROUND Due to a wide range of stressors during the first postpartum year, this study aimed to develop and validate a self-report measure of stress intensity specific for postpartum. METHOD Postpartum women (N= 603) completed the Maternal Postpartum Stress Scale in a cross-sectional online study. They also filled out questionnaires on general stress, depression, and anxiety . Factor analysis, reliability, and validity were examined. RESULTS Exploratory factor analyses revealed a three-factor structure: Personal needs and fatigue , Infant nurturing , and Body changes and sexuality. The reliability of the total scale and all subscales was good. Significant positive correlation with general stress indicated good convergent validity, and with depression and anxiety good divergent validity. Primiparous mothers had a higher score on the Infant nurturing subscale, and the mothers of infants with health problems had a higher score on the total scale, Personal needs and fatigue, and Infant nurturing. CONCLUSION Maternal Postpartum Stress Scale is a new, valid, and reliable 22-items scale that measures stress during the first postpartum year. The total scale and tree subscales can be calculated separately to provide detailed information about stressors that mothers struggle with. The scale can be used for research and practical purposes.
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Affiliation(s)
- Sandra Nakić Radoš
- Department of Psychology, Catholic University of Croatia, Zagreb, Croatia
| | - Maja Brekalo
- Department of Psychology, Catholic University of Croatia, Zagreb, Croatia
| | - Marijana Matijaš
- Department of Psychology, Catholic University of Croatia, Zagreb, Croatia
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Psychosocial work stress and parent-child bonding during the COVID-19 pandemic: clarifying the role of parental symptoms of depression and aggressiveness. BMC Public Health 2023; 23:113. [PMID: 36647046 PMCID: PMC9841494 DOI: 10.1186/s12889-022-14759-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2022] [Accepted: 11/28/2022] [Indexed: 01/18/2023] Open
Abstract
BACKGROUND Parental work stress and impaired mental health seem to have intensified during the current COVID-19 pandemic. Both can have a negative impact on parent-child bonding: psychosocial work stress in the course of a spillover effect from work to family and symptoms of impaired mental health as part of a crossover effect from parent to child. This potentially affects the child's development in the long term. METHOD This cross-sectional study examined the relationship between psychosocial work stress and parent-child bonding during the early COVID-19 pandemic (May-June 2020). Symptoms of depression and aggressiveness were considered as mediators of this relationship. The sample consisted of employees in Eastern Germany (n = 380; 42.9% mothers, 57.1% fathers), aged 24-55 years, with children aged 0-36 months. RESULTS In the total sample, an association was only found after adjusting for potential confounders, indicating that higher psychosocial work stress is associated with weaker bonding between the parent and child (β = 0.148, p = .017, 95% CI [0.566, 5.614]). The separate analyses for mothers and fathers did not reveal a statistically significant relationship between psychosocial work stress and parent-child bonding. In the total sample, the higher the psychosocial work stress was, the higher were the parental symptoms of depression (β = 0.372, p < .001, 95% CI [3.417, 5.696]) and aggressiveness β = 0.254, p < .001, 95% CI [1.008, 3.208]). The mental health symptoms in turn were related to weaker parent-child bonding (symptoms of depression β = 0.320, p < .001, 95% CI [0.345, 0.749]; symptoms of aggressiveness β = 0.394, p < .001, 95% CI [0.697, 1.287]). The results furthermore suggested that parental mental health symptoms mediate the association between psychosocial work stress and parent-child bonding (symptoms of depression, ab = 2.491, 95% CI [1.472, 3.577] and of aggressiveness, ab = 2.091, 95% CI [1.147, 3.279]). The mediation effect was also found in the separate analyses for the mothers and fathers. DISCUSSION The results of this study during the early COVID-19 pandemic in Germany highlight the importance of prevention as well as intervention measures in relation to psychosocial work stress that may play a debilitating role in the context of family relationships. In addition, the results suggest that both employers and employees should be made aware of the importance of psychosocial work stress, as it can have a negative impact on mental health, which in turn may have a major influence on family relationships.
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Giacchetti N, Lattanzi GM, Aceti F, Vanacore N, Williams R. States of Mind with Respect to Attachment: a comparative study between women who killed their children and mothers diagnosed with post-partum depression. Nord J Psychiatry 2023; 77:3-13. [PMID: 35200074 DOI: 10.1080/08039488.2022.2039760] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
INTRODUCTION Attachment theory has been linked with the caregiving system, acting as a drive for a mother's behavior towards her offspring. The most dramatic consequence of distress following maternity is filicide. Despite this, only few studies addressed the attachment models of women who committed filicide, and very little provided comparisons with mothers diagnosed with post-partum depression. OBJECTIVE We described the socio-demographic and psychopathological characteristics of mothers who committed filicide. Our aim was to detect differences in the attachment models between mothers who committed filicide, mothers with post-partum depression and control mothers. Participants and setting: We recruited 19 women who committed filicide (group F) along with 52 women with post-partum depression (group D), and 23 control mothers (group C). METHODS We administered a semi-structured interview on socio-demographic aspects and psychiatric history along with the Adult Attachment Interview. We performed an ANOVA, a post-hoc analysis and a logistic regression. RESULTS The logistic regression showed a higher prevalence of Dismissing and Disorganized attachments in women of group F compared with group C (p = 0.002, p = 0.007). Dismissing attachment was also overrepresented in group D vs group C (p = 0.012). Interestingly, women of group F showed a Preoccupied/entangled attachment to a lesser extent than those of group D, reaching a borderline significance (p = 0.056). CONCLUSIONS Disorganized and Dismissing models of attachment are prevalent in women who committed filicide compared with mothers with post-partum depression and controls, while other models of attachment are less frequent. Therefore, attachment could be taken into consideration to define the risk for committing filicide.
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Affiliation(s)
- Nicoletta Giacchetti
- Department of Human Neuroscience, Faculty of Medicine and Dentistry, Sapienza Università di Roma - Policlinico Umberto I, Roma, Italy
| | - Guido Maria Lattanzi
- Department of Human Neuroscience, Faculty of Medicine and Dentistry, Sapienza Università di Roma - Policlinico Umberto I, Roma, Italy
| | - Franca Aceti
- Department of Human Neuroscience, Faculty of Medicine and Dentistry, Sapienza Università di Roma - Policlinico Umberto I, Roma, Italy
| | | | - Riccardo Williams
- Department of Dynamic and Clinical Psychology and Health Studies, Faculty of Medicine and Psychology, Sapienza Università di Roma, Roma, Italy
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22
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Disparities in Emergency Department Utilization Among Women with Postpartum Mood Disorders (2006-2016). Matern Child Health J 2023; 27:158-167. [PMID: 36352280 DOI: 10.1007/s10995-022-03544-w] [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: 08/04/2021] [Revised: 08/17/2022] [Accepted: 09/09/2022] [Indexed: 11/10/2022]
Abstract
INTRODUCTION Postpartum mood disorders are associated with adverse outcomes for newborns and mothers and may require urgent evaluation. The emergency department is often a healthcare entry point, but factors associated with these emergency department visits are unknown. METHODS A longitudinal retrospective analysis using the Nationwide Emergency Department Sample to assess national estimates of emergency department visits by women ages 15-49 with primary diagnosis of a postpartum mood disorder between 2006 and 2016. Emergency department visit rates for postpartum mood disorders per 100,000 live births were calculated. RESULTS Emergency department visits related to postpartum mood disorders remained stable from 2006 to 2016 (5153 to 5390 respectively). Two-thirds of visits were by patients younger than 30. Approximately half of visits for postpartum mood disorders were funded by Medicaid (42.4-56.7%) compared to 27.4-41.2% funded by Medicaid for all other age-matched women. Of postpartum mood disorder visits 30.3% were by women from the lowest income quartile. The highest rate of emergency department visits occurred in the youngest patients (ages 15-19: 231 visits versus ages 35-49: 105 visits). Postpartum mood disorder admissions were higher than those for age-matched women with all other diagnoses (19.8% vs. 6.5%). DISCUSSION The high rate of women that are young and with public insurance visiting the emergency department for postpartum mood disorders demonstrates an increased risk for these disorders in these populations and an opportunity for targeted intervention by policymakers and providers. Higher admission rates for postpartum mood disorders compared to all other diagnoses reveals a chance to optimize outpatient screening and treatment.
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23
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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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24
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Alsabi RNS, Zaimi AF, Sivalingam T, Ishak NN, Alimuddin AS, Dasrilsyah RA, Basri NI, Jamil AAM. Improving knowledge, attitudes and beliefs: a cross-sectional study of postpartum depression awareness among social support networks during COVID-19 pandemic in Malaysia. BMC Womens Health 2022; 22:221. [PMID: 35690751 PMCID: PMC9187926 DOI: 10.1186/s12905-022-01795-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2021] [Accepted: 05/23/2022] [Indexed: 11/24/2022] Open
Abstract
Background Postpartum depression (PPD) is the most prevalent mental health disorder after childbirth, notably during the COVID-19 pandemic. In addition, PPD is known to have a long-term influence on the mother and the newborn, and the role of social support network is crucial in early illness recognition. This study aims to evaluate the social support networks’ level of knowledge, attitudes and beliefs regarding PPD and examine their sociodemographic variables and exposure to the public information relating to PPD during the COVID-19 pandemic in Malaysia. Methods A cross-sectional study was conducted via an online Google Form disseminated to people in Klang Valley through WhatsApp, Email, Facebook, Instagram and other available social media among postpartum women’s social support networks aged 18 years and living in the Klang Valley area (N = 394). Data were collected from 1 March to 5 July 2021 and analysed using the Mann–Whitney U-test and generalised linear mixed models. Results During the COVID-19 epidemic in Klang Valley, most participants had good knowledge, negative attitudes and awareness of PPD. Marital status, gender and parity all had significant correlations with the amount of awareness regarding PPD. Ethnicity, gender, parity and educational level showed significant association with attitude towards PPD. No significant relationship was noted between sociodemographic variables and PPD beliefs. Public awareness of PPD was also associated with knowledge and attitude towards it. Conclusions A significant positive knowledge, negative attitude and negative awareness level of PPD exist among social support networks for postnatal women. However, no significant effect of belief on PPD awareness level was noted. Implications Insight campaigns and public education about PPD should be conducted to enhance postnatal mothers’ awareness and knowledge. Postnatal care, mental check-ups and counselling sessions for the new mothers are recommended. In future studies, a closer assessment of postpartum social support, variances and similarities across women from diverse racial/ethnic origins is critical.
Strengths and limitations This cross-sectional study is one of the early studies on the area of PPD in the Malaysian region during COVID-19. Numerous data have been collected using low-cost approaches using self-administered surveys through Google Forms in this research.
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25
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Murakami K, Ishikuro M, Obara T, Ueno F, Noda A, Onuma T, Matsuzaki F, Kikuchi S, Kobayashi N, Hamada H, Iwama N, Metoki H, Kikuya M, Saito M, Sugawara J, Tomita H, Yaegashi N, Kuriyama S. Social isolation and postnatal bonding disorder in Japan: the Tohoku Medical Megabank Project Birth and Three-Generation Cohort Study. Arch Womens Ment Health 2022; 25:1079-1086. [PMID: 36114927 DOI: 10.1007/s00737-022-01266-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Accepted: 09/09/2022] [Indexed: 12/14/2022]
Abstract
Although there is substantial information about the effects of social relationships on mental health, their effects on postnatal bonding remain unclear. We aimed to examine the association between social isolation and postnatal bonding disorder. We analyzed data from 17,999 women who participated in the Tohoku Medical Megabank Project Birth and Three-Generation Cohort Study. An abbreviated version of the Lubben Social Network Scale was used to assess social isolation in the second trimester of pregnancy, and its subscales were used to assess marginal family ties and marginal friendship ties. Bonding disorder was defined as a Mother-to-Infant Bonding Scale score of ≥ 5 1 month after delivery. Multiple logistic regression analyses were conducted to examine the association between social isolation and postnatal bonding disorder after adjusting for age at delivery, parity, feelings towards pregnancy, psychological distress during pregnancy, and household income. Analyses stratified by postnatal depressive symptoms (PDS) were also conducted. Social isolation was associated with postnatal bonding disorder: the odds ratio (OR) was 1.55 (95% confidence interval [CI], 1.41-1.71). Marginal family ties and friendship ties were associated with postnatal bonding disorder: the ORs were 1.40 (95% CI, 1.23-1.60) and 1.44 (95% CI, 1.32-1.57), respectively. Marginal family ties were associated with postnatal bonding disorder only among women without PDS: the ORs were 1.30 (95% CI, 1.10-1.55) among women without PDS and 1.13 (95% CI, 0.91-1.40) among women with PDS. Social isolation during pregnancy was associated with an increased risk of postnatal bonding disorder.
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Affiliation(s)
- Keiko Murakami
- Tohoku Medical Megabank Organization, Tohoku University, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8573, Japan. .,Graduate School of Medicine, Tohoku University, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8575, Japan.
| | - Mami Ishikuro
- Tohoku Medical Megabank Organization, Tohoku University, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8573, Japan.,Graduate School of Medicine, Tohoku University, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8575, Japan
| | - Taku Obara
- Tohoku Medical Megabank Organization, Tohoku University, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8573, Japan.,Graduate School of Medicine, Tohoku University, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8575, Japan.,Tohoku University Hospital, 1-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8574, Japan
| | - Fumihiko Ueno
- Tohoku Medical Megabank Organization, Tohoku University, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8573, Japan.,Graduate School of Medicine, Tohoku University, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8575, Japan
| | - Aoi Noda
- Tohoku Medical Megabank Organization, Tohoku University, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8573, Japan.,Graduate School of Medicine, Tohoku University, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8575, Japan.,Tohoku University Hospital, 1-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8574, Japan
| | - Tomomi Onuma
- Tohoku Medical Megabank Organization, Tohoku University, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8573, Japan
| | - Fumiko Matsuzaki
- Tohoku Medical Megabank Organization, Tohoku University, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8573, Japan.,Graduate School of Medicine, Tohoku University, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8575, Japan
| | - Saya Kikuchi
- Graduate School of Medicine, Tohoku University, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8575, Japan.,Tohoku University Hospital, 1-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8574, Japan
| | - Natsuko Kobayashi
- Graduate School of Medicine, Tohoku University, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8575, Japan.,Tohoku University Hospital, 1-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8574, Japan
| | - Hirotaka Hamada
- Graduate School of Medicine, Tohoku University, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8575, Japan.,Tohoku University Hospital, 1-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8574, Japan
| | - Noriyuki Iwama
- Tohoku Medical Megabank Organization, Tohoku University, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8573, Japan.,Graduate School of Medicine, Tohoku University, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8575, Japan.,Tohoku University Hospital, 1-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8574, Japan
| | - Hirohito Metoki
- Tohoku Medical Megabank Organization, Tohoku University, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8573, Japan.,Faculty of Medicine, Tohoku Medical and Pharmaceutical University, 1-15-1 Fukumuro, Miyagino-ku, Sendai, Miyagi, 983-8536, Japan
| | - Masahiro Kikuya
- Tohoku Medical Megabank Organization, Tohoku University, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8573, Japan.,Teikyo University School of Medicine, 2-11-1 Kaga, Itabashi-ku, Tokyo, 173-8605, Japan
| | - Masatoshi Saito
- Graduate School of Medicine, Tohoku University, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8575, Japan.,Tohoku University Hospital, 1-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8574, Japan
| | - Junichi Sugawara
- Tohoku Medical Megabank Organization, Tohoku University, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8573, Japan.,Graduate School of Medicine, Tohoku University, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8575, Japan.,Tohoku University Hospital, 1-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8574, Japan
| | - Hiroaki Tomita
- Tohoku Medical Megabank Organization, Tohoku University, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8573, Japan.,Graduate School of Medicine, Tohoku University, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8575, Japan.,Tohoku University Hospital, 1-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8574, Japan.,International Research Institute of Disaster Science, Tohoku University, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8573, Japan
| | - Nobuo Yaegashi
- Tohoku Medical Megabank Organization, Tohoku University, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8573, Japan.,Graduate School of Medicine, Tohoku University, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8575, Japan.,Tohoku University Hospital, 1-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8574, Japan
| | - Shinichi Kuriyama
- Tohoku Medical Megabank Organization, Tohoku University, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8573, Japan.,Graduate School of Medicine, Tohoku University, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8575, Japan.,International Research Institute of Disaster Science, Tohoku University, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8573, Japan
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Suzuki D, Ohashi Y, Shinohara E, Usui Y, Yamada F, Yamaji N, Sasayama K, Suzuki H, Nieva RF, da Silva Lopes K, Miyazawa J, Hase M, Kabashima M, Ota E. The Current Concept of Paternal Bonding: A Systematic Scoping Review. Healthcare (Basel) 2022; 10:2265. [PMID: 36421589 PMCID: PMC9690989 DOI: 10.3390/healthcare10112265] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Revised: 11/04/2022] [Accepted: 11/08/2022] [Indexed: 07/30/2023] Open
Abstract
Bonding is crucial to perinatal mental health. Despite an extensive body of literature on maternal bonding, few studies have focused on paternal bonding. This scoping review aimed to clarify the current state of the concept of paternal-infant/fetus bonding. The eligibility criteria were drawn from the population concept and context elements to answer the following questions: "what is paternal bonding?" and "what are the constructs of the concept of paternal bonding?" The review comprised 39 studies. Paternal bonding was associated with both positive and negative paternal behavior and thought and may be determined based on fathers' beliefs and rearing history. Most studies showed that father-child interaction is one of the factors promoting paternal bonding. However, fathers generally felt more distant from their babies post-delivery than mothers. Only a few studies originally defined paternal bonding; most relied on the definitions of maternal bonding. We found different descriptions lacking consensus. Few studies examined the differences between paternal and maternal bonding. No consensus exists on the concept, constructs, and assessment of paternal bonding. The causal relationship between paternal bonding and other variables is unexplored. Future studies should explore fathers' perspectives and experiences, focusing on the unknown aspects of paternal bonding identified in this review.
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Affiliation(s)
- Daichi Suzuki
- Department of Nursing, Faculty of Health and Medical Sciences, Kanagawa Institute of Technology, Atsugi 243-0292, Japan
| | - Yukiko Ohashi
- Department of Nursing, Faculty of Nursing, Josai International University, Togane 283-8555, Japan
- Kitamura Institute of Mental Health Tokyo, Shibuya-ku, Tokyo 151-0063, Japan
- Research Institute of Imperial Gift Foundation Boshi-Aiiku-Kai, Minato-ku, Tokyo 106-8580, Japan
| | - Eriko Shinohara
- Department of Nursing, School of Medicine, Yokohama City University, Yokohama 236-0004, Japan
| | - Yuriko Usui
- Department of Midwifery and Women’s Health, Division of Health Sciences & Nursing, Graduate School of Medicine, The University of Tokyo, Bunkyo-ku, Tokyo 113-0033, Japan
| | - Fukiko Yamada
- Department of Midwifery, St. Luke’s International University, Chuo-ku, Tokyo 104-0044, Japan
| | - Noyuri Yamaji
- Global Health Nursing, Graduate School of Nursing Science, St. Luke’s International University, Chuo-ku, Tokyo 104-0044, Japan
| | - Kiriko Sasayama
- Department of Nursing, Global Health Nursing, International University of Health and Welfare, Narita 286-8686, Japan
| | - Hitomi Suzuki
- Global Health Nursing, Graduate School of Nursing Science, St. Luke’s International University, Chuo-ku, Tokyo 104-0044, Japan
| | - Romulo Fernandez Nieva
- Gender Studies and Criminology Programme, School of Sociology, University of Otago, P.O. Box 56, Dunedin 9054, New Zealand
| | - Katharina da Silva Lopes
- Graduate School of Public Health, St. Luke’s International University, Chuo-ku, Tokyo 104-0045, Japan
| | - Junko Miyazawa
- Department of Nursing, Faculty of Nursing, Josai International University, Togane 283-8555, Japan
| | - Michiko Hase
- Pediatric Nursing, Department of Nursing, Faculty of Nursing, Musashino University, Koto-ku, Tokyo 135-8181, Japan
| | - Minoru Kabashima
- Department of Nursing, Faculty of Nursing, Josai International University, Togane 283-8555, Japan
| | - Erika Ota
- Global Health Nursing, Graduate School of Nursing Science, St. Luke’s International University, Chuo-ku, Tokyo 104-0044, Japan
- Tokyo Foundation for Policy Research, Minato-ku, Tokyo 106-6234, Japan
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Association between maternal-infant bonding and depressive symptoms in Neonatal Intensive Care Unit mothers: A case-control study. ENFERMERIA INTENSIVA 2022; 33:165-172. [PMID: 36347799 DOI: 10.1016/j.enfie.2021.07.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2021] [Accepted: 07/20/2021] [Indexed: 11/07/2022]
Abstract
OBJECTIVES Maternal perinatal depression has been associated with impaired mother-infant bonding. The adverse effect of this impaired bonding has been reported. This study aimed to investigate and compare the posnatal depressive symptoms and the mother-infant bonding in a Neonatal Intensive Care Unit (NICU) and of mothers with healthy newborns respectively. Secondly, was to explore the association between depressive symptomatology and bonding in both groups. METHODS In this case study, mothers in the early pospartum period who gave birth in the same perinatal center of Greece were recruited to participate. The cases consisted of 88 mothers of neonates who were hospitalized in the NICU and controls were 100 mothers of full-term healthy neonates. For the collection of the data questionnaires including demographics and perinatal variables were used. For the bonding and posnatal assessment, the Mother to Infant Bonding Scale, the Postpartum Bonding Questionnaire, and the Hospital Anxiety and Depression Scale were used. RESULTS There was a significant difference between the mean of bonding scores of NICU mothers and the control group (t = -2.696, P = 0.008). NICU mothers presented lower scores in bonding with the newborn compared to the control group and presented higher depression scores compared to those of controls (χ2 = 28.588, P = 0.000). The depression scores were correlated with bonding scores in both groups. DISCUSSION A NICU admission has an impact on bonding and in some way interacts with maternal pospartum mental health, therefore more research is needed. CONCLUSIONS NICU mothers have been presented as more vulnerable than mothers of healthy infants since they expressed a lower mother-infant bonding and higher depression scores. The support of these vulnerable mothers and the facilitation of mother-infant bonding by the NICU staff is of utmost importance.
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28
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Perceived social support on postpartum mental health: An instrumental variable analysis. PLoS One 2022; 17:e0265941. [PMID: 35511885 PMCID: PMC9070871 DOI: 10.1371/journal.pone.0265941] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Accepted: 03/10/2022] [Indexed: 11/19/2022] Open
Abstract
The postpartum period is a challenging transition period with almost one in ten mothers experiencing depression after childbirth. Perceived social support is associated with mental health. Yet empirical evidence regarding the causal effects of social support on postpartum mental health remains scarce. In this paper, we used a nationally representative panel data of women to examine causality between perceived social support and postpartum mental health. We used fixed-effect method and included dependent variable lags to account for past mental health condition before birth (i.e., the pre-pregnancy and prenatal periods). The study also used an instrumental variable approach to address endogeneity. We find a declining trend in postpartum mental health between 2002 to 2018. Our study also showed that past mental health (i.e., before childbirth) is positively correlated with postpartum mental health. A universal routine mental health screening for expectant and new mothers should remain a key priority to ensure mental wellbeing for the mothers and their infants.
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Binyamin Y, Wainstock T, Sheiner E, Battat TL, Reuveni I, Leibson T, Pariente G. The association between epidural analgesia during labor and mother-infant bonding. J Clin Anesth 2022; 80:110795. [PMID: 35489303 DOI: 10.1016/j.jclinane.2022.110795] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Revised: 03/19/2022] [Accepted: 03/25/2022] [Indexed: 11/19/2022]
Abstract
STUDY OBJECTIVE This study was aimed to assess the association between the use of epidural analgesia during labor and mother-infant bonding. DESIGN A cross-sectional study. SETTING Maternity ward at Soroka University Medical Center during 2020. PATIENTS Women who delivered a singleton live-born infant vaginally in their immediate post-partum period. INTERVENTIONS Women completed questionnaires. 25 items post-partum bonding questionnaire (PBQ) to assess mother-infant bonding (A high score on the PBQ indicates impaired mother-infant bonding) and the Edinburgh postnatal depression scale (EPDS) questionnaire to assess risk for post-partum depression. MEASUREMENTS The study used PBQ questionnaire and four sub-scales to assess mother-infant bonding and the EPDS questionnaire to assess risk for post- partum depression. Generalized linear regression models (gamma) were constructed to examine the association between epidural analgesia and mother-infant bonding total score and impaired bonding sub- scale, while adjusting for confounders Additional information such as pregnancy complications and sociodemographic data was drawn from women's medical records. MAIN RESULTS A total of 234 women were included in the final analysis, of them 126 (53.8%) delivered with epidural analgesia. The total PBQ score was significantly lower among women who received epidural analgesia compared to women without epidural analgesia (7.6 vs. 10.2, p = 0.024), demonstrating a better mother -infant bonding. Using two multivariable linear regression models, controlling for confounders such as maternal age and educational status, epidural analgesia during labor was independently associated with a better mother -infant bonding total score and better impaired bonding sub-scale score (Beta coefficient-0.252, 95% CI -0.5; -0.006, p = 0.045 and Beta coefficient - 0.34, 95% CI -0.52; -0.08, p = 0.01 for mother-infant bonding total score and sub-scale score, respectively). No differences in post-partum depression risks were found between the groups (EDPS≥13, 5.7% vs. 13%, p = 0.058). CONCLUSION Our study demonstrated better mother -infant bonding among women delivering with epidural analgesia.
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Affiliation(s)
- Yair Binyamin
- Department of Anesthesiology, Soroka University Medical Center and the Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel.
| | - Tamar Wainstock
- Department of Public Health, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Eyal Sheiner
- Department of Obstetrics and Gynecology, Soroka University Medical Center, Ben Gurion University of the Negev, Beer-Sheva, Israel
| | - Talya Lanxner Battat
- Department of Obstetrics and Gynecology, Soroka University Medical Center, Ben Gurion University of the Negev, Beer-Sheva, Israel
| | - Inbal Reuveni
- Department of Psychiatry, Hadassah Medical Center and Faculty of Medicine, Hebrew University of Jerusalem, Israel
| | - Tom Leibson
- Department of Pediatrics, Mount Sinai Hospital, Toronto, ON, Canada; Division of Clinical Pharmacology and Toxicology, Hospital for Sick Children, Toronto, ON, Canada
| | - Gali Pariente
- Department of Obstetrics and Gynecology, Soroka University Medical Center, Ben Gurion University of the Negev, Beer-Sheva, Israel
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Murakami K, Ishikuro M, Obara T, Ueno F, Noda A, Onuma T, Matsuzaki F, Kikuchi S, Kobayashi N, Hamada H, Iwama N, Metoki H, Saito M, Sugawara J, Tomita H, Yaegashi N, Kuriyama S. Maternal personality and postpartum mental disorders in Japan: the Tohoku Medical Megabank Project Birth and Three-Generation Cohort Study. Sci Rep 2022; 12:6400. [PMID: 35430603 PMCID: PMC9013371 DOI: 10.1038/s41598-022-09944-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2021] [Accepted: 03/21/2022] [Indexed: 11/09/2022] Open
Abstract
AbstractPersonality has been shown to predict postpartum depressive symptoms (PDS) assessed by the Edinburgh Postnatal Depression Scale (EPDS). However, existing studies have not considered the underlying symptom dimensions in the EPDS. We analyzed data from 15,012 women who participated in the Tohoku Medical Megabank Project Birth and Three-Generation Cohort Study. Personality was assessed in middle pregnancy using the short-form Eysenck Personality Questionnaire-Revised. PDS were defined as EPDS score ≥ 9 at 1 month after delivery. The EPDS items were further divided into three dimensions: depressed mood, anxiety, and anhedonia. Multiple analyses were conducted to examine the associations of each personality scale with PDS and three dimensions in the EPDS, adjusting for age, parity, mode of delivery, education, income, and social isolation. The prevalence of PDS assessed by the EPDS at 1 month after delivery was 13.1%. Higher neuroticism scores were associated with PDS (odds ratio [OR], 2.63; 95% confidence interval [CI], 2.48 to 2.79) and all three dimensions (all p < 0.001). Lower extraversion scores were associated with PDS (OR, 0.74; 95% CI, 0.70 to 0.78) and all three dimensions (all p < 0.001). Lower psychoticism scores were associated with PDS (OR, 0.89; 95% CI, 0.85 to 0.94) and anxiety (p < 0.001), but not with depressed mood (p = 0.20) or anhedonia (p = 0.92). In conclusion, higher neuroticism and lower extraversion were associated with PDS and the three underlying dimensions in the EPDS, while lower psychoticism was associated with anxiety, but not with depressed mood or anhedonia.
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Nasreen HE, Pasi HB, Aris MAM, Rahman JA, Rus RM, Edhborg M. Impact of parental perinatal depressive and anxiety symptoms trajectories on early parent-infant impaired bonding: a cohort study in east and west coasts of Malaysia. Arch Womens Ment Health 2022; 25:377-387. [PMID: 34313824 DOI: 10.1007/s00737-021-01165-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2021] [Accepted: 07/18/2021] [Indexed: 10/20/2022]
Abstract
The association between maternal depressive and anxiety symptoms and impaired bonding with infants were widely studied, but not in fathers and none in Malaysia. We investigated the impact of different trajectories of perinatal depressive and anxiety symptoms on parent-infant impaired bonding during 2-3 months postpartum in both mothers and fathers in two areas of Malaysia. This study originated from a psychiatric morbidity cohort study carried out in health clinics in east and west Malaysia. Edinburgh Postnatal Depression Scale and anxiety subscale of Depression, Anxiety, and Stress Scale at late pregnancy and 2-3 months postpartum and Postpartum Bonding Questionnaire were completed by 566 mothers and 457 fathers. About 11.7% mothers and 16.1% fathers reported depressive symptoms during pregnancy, 6.5% mothers and 10.5% fathers during 2-3 months postpartum, and 3-4% mothers and fathers both depressive and anxiety symptoms 2-3 months postpartum. The mean impaired bonding score was highest in mothers and fathers who had both depressive and anxiety symptoms 2-3 months postpartum. Impaired bonding is associated with higher EPDS and DASS (anxiety subscale) scores 2-3 months postpartum in both parents. Physical partner violence and deteriorated marital relationship were associated with increased risk of impaired bonding in mothers. The association between depressive, anxiety, and comorbidity of depressive and anxiety symptoms in both mothers and fathers and parent-infant impaired bonding during 2-3 months postpartum urges for screening and treatment of depressive and anxiety symptoms in both parents during early parenthood.
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Affiliation(s)
- Hashima E Nasreen
- Department of Community Medicine, Faculty of Medicine, International Islamic University Malaysia, Jalan Sultan Ahmad Shah, 25200, Kuantan, Pahang, Malaysia.
| | - Hafizah Binti Pasi
- Department of Community Medicine, Faculty of Medicine, International Islamic University Malaysia, Jalan Sultan Ahmad Shah, 25200, Kuantan, Pahang, Malaysia
| | - Mohd Aznan Md Aris
- Department of Family Medicine, Faculty of Medicine, International Islamic University Malaysia, Jalan Sultan Ahmad Shah, 25200, Kuantan, Pahang, Malaysia
| | - Jamalludin Ab Rahman
- Department of Community Medicine, Faculty of Medicine, International Islamic University Malaysia, Jalan Sultan Ahmad Shah, 25200, Kuantan, Pahang, Malaysia
| | - Razman Mohd Rus
- Department of Community Medicine, Faculty of Medicine, International Islamic University Malaysia, Jalan Sultan Ahmad Shah, 25200, Kuantan, Pahang, Malaysia
| | - Maigun Edhborg
- Department of Neurobiology, Care Sciences and Society, Karolinska Institute, 141 83 Huddinge, Stockholm, Sweden
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Naghibi S, Barzegari A, Shariatzadeh M, Vatandoost M, Ahmadi M, Mahdinia E, Neghabi F, Rajabpour A, Sadat Aleahmad A, Sadat Balaghati F, Sadat Naserimanesh S, Saeedipour M, Sadeghi O, Yeganeh F, Salari AA. Voluntary physical activity increases maternal care and reduces anxiety- and depression-related behaviours during the postpartum period in mice. Brain Res 2022; 1784:147880. [DOI: 10.1016/j.brainres.2022.147880] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2021] [Revised: 02/22/2022] [Accepted: 03/08/2022] [Indexed: 01/21/2023]
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From adolescence to parenthood: a multi-decade study of preconception mental health problems and postpartum parent-infant bonds. Soc Psychiatry Psychiatr Epidemiol 2022; 57:601-610. [PMID: 33001248 DOI: 10.1007/s00127-020-01965-y] [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: 11/06/2019] [Accepted: 09/23/2020] [Indexed: 10/23/2022]
Abstract
PURPOSE To examine associations between anxiety and depressive symptoms across adolescence and young adulthood with subsequent maternal- and paternal-infant bonding at 1 year postpartum. METHODS The data were from a prospective, intergenerational cohort study. Participants (381 mothers of 648 infants; 277 fathers of 421 infants) self-reported depression and anxiety at three adolescent waves (ages 13, 15 and 17 years) and three young adult waves (ages 19, 23 and 27 years). Subsequent parent-infant bonds with infants were reported at 1 year postpartum (parent age 29-35 years). Generalised estimating equations (GEE) separately assessed associations for mothers and fathers. RESULTS Mean postpartum bonding scores were approximately half a standard deviation lower in parents with a history of persistent adolescent and young adult depressive symptoms (maternal βadj = - 0.45, 95% CI - 0.69, - 0.21; paternal βadj = - 0.55, 95% CI - 0.90, 0.20) or anxiety (maternal βadj = - 0.42, 95% CI - 0.66, - 0.18; paternal βadj = - 0.49, 95% CI - 0.95, 0.03). Associations were still mostly evident, but attenuated after further adjustment for postpartum mental health concurrent with measurement of bonding. CONCLUSIONS Persistent symptoms of depression or anxiety spanning adolescence and young adulthood predict poorer emotional bonding with infants 1-year postbirth for both mothers and fathers.
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Ionio C, Mascheroni E, Lista G, Colombo C, Ciuffo G, Landoni M, Daniele I, Gattis M. Monochorionic Twins and the Early Mother-Infant Relationship: An Exploratory Observational Study of Mother-Infant Interaction in the Post-Partum Period. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19052821. [PMID: 35270513 PMCID: PMC8910336 DOI: 10.3390/ijerph19052821] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/14/2022] [Revised: 02/25/2022] [Accepted: 02/26/2022] [Indexed: 12/10/2022]
Abstract
The extraordinary increase in twin rates and specifically monochorionic twin pregnancies represents a major public health issue due to the associated increased risks for the mother, the child and their relationship. The aim of the present study was to examine the quality of mothers’ behaviour during mother–infant interaction in the early postpartum period by comparing mothers of twins and mothers of singletons during face-to-face interaction with their infants. Demographic and clinical information was collected by trained research psychologists from the mothers’ and the childrens’ clinical records and from interviews with the mothers. At three months (corrected for prematurity), the interactions of the dyads (11 mother-twin infant dyads and 11 mother-singleton dyads) were filmed at participants’ homes in accordance with the procedure of the Global Rating Scales. Maternal behaviour during interactions was assessed and rated by two trained research psychologists. With regard to the mothers’ interaction with each twin, no differences were found between mothers’ scores in every GRS subscale, indicating that mothers did not interact differently with their twins. Comparisons between mothers of MC twins and mothers of singletons showed that the quality of maternal sensitive behaviour during the interactions were lower in mothers of twins (0.35) Mothers of twins were also more distant during interactions with their babies and more likely to experience depression symptoms than mothers of singletons (0.05). Future research should examine mother-infant relationships following twin birth with larger samples. Such research will be especially useful in evaluating the potential benefits of interventions to promote positive mother-infant interactions.
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Affiliation(s)
- Chiara Ionio
- CRIdee Unità di Ricerca sul Trauma, Psychology Department, Università Cattolica del Sacro Cuore, 20123 Milan, Italy
- Correspondence:
| | | | - Gianluca Lista
- Neonatologia Patologia e Terapia Intensiva Neonatale, Ospedale dei Bambini “Vittore Buzzi”, ASST Fatebenefratelli Sacco, 20154 Milan, Italy; (G.L.); (C.C.); (I.D.)
| | - Caterina Colombo
- Neonatologia Patologia e Terapia Intensiva Neonatale, Ospedale dei Bambini “Vittore Buzzi”, ASST Fatebenefratelli Sacco, 20154 Milan, Italy; (G.L.); (C.C.); (I.D.)
| | - Giulia Ciuffo
- CRIdee, Psychology Department, Università Cattolica del Sacro Cuore, 20123 Milan, Italy; (G.C.); (M.L.)
| | - Marta Landoni
- CRIdee, Psychology Department, Università Cattolica del Sacro Cuore, 20123 Milan, Italy; (G.C.); (M.L.)
| | - Irene Daniele
- Neonatologia Patologia e Terapia Intensiva Neonatale, Ospedale dei Bambini “Vittore Buzzi”, ASST Fatebenefratelli Sacco, 20154 Milan, Italy; (G.L.); (C.C.); (I.D.)
| | - Merideth Gattis
- School of Psychology, Cardiff University, Cardiff CF10 3AT, UK;
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Personality traits as a risk factor for postpartum depression: A systematic review and meta-analysis. J Affect Disord 2022; 298:577-589. [PMID: 34763034 DOI: 10.1016/j.jad.2021.11.010] [Citation(s) in RCA: 24] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Revised: 10/30/2021] [Accepted: 11/03/2021] [Indexed: 12/15/2022]
Abstract
BACKGROUND Certain personality traits increase vulnerability to depression, but the evidence linking personality and postpartum depression (PPD) is less robust. This systematic review aimed to identify personality traits that increase the risk of PPD. METHODS We systematically reviewed studies retrieved from PubMed/Medline, PsycINFO, Scopus, CINAHL, and Cochrane, following the PRISMA guidelines for reporting. We carried out a meta-analysis on the association between neuroticism and PPD. RESULTS A total of 34 studies were analyzed. Of these, 31 considered at least one trait associated with PPD; 10 studies considered at least one trait not associated with PPD. The meta-analysis included 13 studies, concluding that neuroticism was associated with PPD (OR: 1.37; 95%CI: 1.22-1.53; p<0.001). LIMITATIONS Study design and approach to personality assessment influence results. Prospective longitudinal studies of persons with no prior history of mood disorder would provide stronger evidence about whether particular personality traits predict PPD. Most studies reviewed used self-report measures to assess personality. Study design and approach to personality assessment influence results, and indications of publication bias were found. CONCLUSIONS Neuroticism is the personality trait most widely studied in relation to PPD. Our meta-analysis found this trait is strongly related with PPD. Moreover, vulnerable personality style and trait anxiety are also associated with PPD. Screening for these traits might help identify women at risk, improving prevention, early detection, and possibly treatment.
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Frohberg J, Bittner A, Steudte-Schmiedgen S, Junge-Hoffmeister J, Garthus-Niegel S, Weidner K. Early Abusive Relationships-Influence of Different Maltreatment Types on Postpartum Psychopathology and Mother-Infant Bonding in a Clinical Sample. Front Psychiatry 2022; 13:836368. [PMID: 35711603 PMCID: PMC9196898 DOI: 10.3389/fpsyt.2022.836368] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Accepted: 05/09/2022] [Indexed: 11/13/2022] Open
Abstract
Postpartum psychopathology is a well-documented risk factor for impaired mother-infant bonding and thus child development. Increasingly, the focus of research in this area lies on maternal adverse childhood experiences that mothers bring into the relationship with their own baby, especially regarding the possible intergenerational transmission of traumatic experiences. Several studies showed that there is no direct link between child maltreatment and mother-infant bonding as one part of mother-child relationship, but that this link is mediated by postpartum psychopathology. To date, few studies examined differential effects between sexual, physical, and emotional abuse, and physical and emotional neglect, especially in a clinical sample. The aim of this study is to investigate whether the relationship between child maltreatment, psychopathology, and mother-infant bonding can be found for different forms of child maltreatment in patients of a mother-baby unit. Our sample consisted of 330 mothers of a mother-baby-unit in a psychosomatic clinic, who filled out self-report measures at time of admission. Mothers reported on maternal child maltreatment history with the Childhood Trauma Questionnaire, on current psychopathology with the Brief Symptom Inventory, and on mother-infant bonding with the Postpartum Bonding Questionnaire. Mediation analyses were performed with psychopathology as mediator, child maltreatment history as independent, and mother-infant bonding as dependent variable. There was no total effect of child maltreatment on mother-infant bonding. However, there were significant indirect effects of child maltreatment in general (ab = 0.09) and of the various forms of child maltreatment on mother-infant bonding via psychopathology (0.16 ≤ ab ≤ 0.34). The strongest effect was found for emotional abuse. After controlling for psychopathology, the direct effect of physical abuse on mother-infant bonding presented as a negative significant effect. This indicates that the more severe the physical abuse experienced, the better the self-reported bonding. A similar, but non-significant trend was found for sexual abuse. Our findings highlight the importance of assessing neglect forms of child maltreatment as well as abuse in women during the perinatal period. It further supports initial findings that different forms of child maltreatment can have differential effects on mother-infant bonding as one aspect of the mother-child relationship. Further research should include observational data to compare with self-report measures.
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Affiliation(s)
- Julia Frohberg
- Department of Psychotherapy and Psychosomatic Medicine, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
| | - Antje Bittner
- Department of Psychotherapy and Psychosomatic Medicine, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
| | - Susann Steudte-Schmiedgen
- Department of Psychotherapy and Psychosomatic Medicine, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
| | - Juliane Junge-Hoffmeister
- Department of Psychotherapy and Psychosomatic Medicine, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
| | - Susan Garthus-Niegel
- Institute for Systems Medicine, Faculty of Human Medicine, Medical School Hamburg, Hamburg, Germany.,Institute and Policlinic of Occupational and Social Medicine, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany.,Department of Child Health and Development, Norwegian Institute of Public Health, Oslo, Norway
| | - Kerstin Weidner
- Department of Psychotherapy and Psychosomatic Medicine, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
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Ogawa S, Parhar IS. Functions of habenula in reproduction and socio-reproductive behaviours. Front Neuroendocrinol 2022; 64:100964. [PMID: 34793817 DOI: 10.1016/j.yfrne.2021.100964] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2021] [Revised: 10/11/2021] [Accepted: 11/02/2021] [Indexed: 12/19/2022]
Abstract
Habenula is an evolutionarily conserved structure in the brain of vertebrates. Recent reports have drawn attention to the habenula as a processing centre for emotional decision-making and its role in psychiatric disorders. Emotional decision-making process is also known to be closely associated with reproductive conditions. The habenula receives innervations from reproductive centres within the brain and signals from key reproductive neuroendocrine regulators such as gonadal sex steroids, gonadotropin-releasing hormone (GnRH), and kisspeptin. In this review, based on morphological, biochemical, physiological, and pharmacological evidence we discuss an emerging role of the habenula in reproduction. Further, we discuss the modulatory role of reproductive endocrine factors in the habenula and their association with socio-reproductive behaviours such as mating, anxiety and aggression.
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Affiliation(s)
- Satoshi Ogawa
- Brain Research Institute, Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, 47500 Bandar Sunway, Selangor, Malaysia
| | - Ishwar S Parhar
- Brain Research Institute, Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, 47500 Bandar Sunway, Selangor, Malaysia.
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Kalra H, Tran T, Romero L, Chandra P, Fisher J. Burden of severe maternal peripartum mental disorders in low- and middle-income countries: a systematic review. Arch Womens Ment Health 2022; 25:267-275. [PMID: 35061103 PMCID: PMC8921056 DOI: 10.1007/s00737-021-01201-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Accepted: 12/26/2021] [Indexed: 11/27/2022]
Abstract
Peripartum severe mental disorders (PSMDs) encompass schizophrenia, affective psychosis, and psychotic and non-psychotic forms of bipolar disorders. PSMDs are well documented in high-income countries. However, much less is known about the prevalence of PSMDs in low- and middle-income countries (LMICs). The aim was to review the available literature systematically and estimate the prevalence of PSMDs among women in LMICs. We searched the Ovid MEDLINE, Embase, PsycINFO, CINAHL and Maternity and Infant Care databases systematically from the date of inception to Dec 31, 2020, for English-language publications with data on the prevalence of PSMDs among women in World Bank-defined LMICs. Selection of studies, extraction of data and assessment of study quality were each undertaken independently by at least two of the investigators. A total of five studies (completed in three countries spanning two continents) met the inclusion criteria. Five studies reported cumulative incidence of postpartum psychosis (ranging from 1.1 to 16.7 per 1000 births). We found no studies on the prevalence of severe mental disorder during pregnancy in these settings. Marked heterogeneity in methodology precluded meta-analysis. These findings indicate that PSMDs occur at a similar prevalence in low- and middle-income to high-income countries. However overall, there is a paucity of high-quality evidence from these settings. There is a need for rigorous studies with standardized methods to increase knowledge of the nature, prevalence, and determinants of PSMDs among women in resource-constrained LMICs to inform policies, service development, program planning and health professional training.
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Affiliation(s)
- Harish Kalra
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia. .,Ballarat Rural Clinical School, University of Notre Dame Australia, Sydney, Australia. .,Grampians Area Mental Health Services, Ballarat, VIC, Australia.
| | - Thach Tran
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Lorena Romero
- The Ian Potter Library, The Alfred Hospital, Melbourne, VIC Australia
| | - Prabha Chandra
- Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bangalore, India
| | - Jane Fisher
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
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Faisal-Cury A, Matijasevich A. The Relationship Between Bonding Impairment and Maternal Postpartum Smoking. Matern Child Health J 2021; 26:1246-1254. [PMID: 34846606 DOI: 10.1007/s10995-021-03306-0] [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: 11/21/2021] [Indexed: 10/19/2022]
Abstract
OBJECTIVES Maternal postpartum smoking is associated with several negative outcomes for mother and child. The relationship between bonding impairment (BI) and maternal postpartum smoking is less known. The aim of the present study was to assess the relationship between BI and maternal postpartum smoking at 6 to 8 months after childbirth in a primary care sample of low-income mothers who had depression during the previous pregnancy. METHODS We performed a cross-sectional, secondary analysis from a community trial with 356 postpartum women from public primary care clinics in São Paulo, Brazil. The main outcome measure was maternal postpartum smoking. The main exposure variable was BI assessed with the Postpartum Bonding Questionnaire. A socio-demographic questionnaire evaluated maternal and obstetric characteristics. Postpartum depression was assessed with the Patient Health Questionnaire. Crude and adjusted prevalence ratios (PR) of the association between BI and maternal postpartum smoking, with 95% confidence intervals (CI), were calculated using Poisson regression. Multivariate analysis was performed using three models (Model 1 adjusted for randomization during pregnancy, Model 2 adjusted for Model 1 plus mother's socioeconomic and obstetric characteristics, and Model 3 adjusted for Model 2 plus postpartum depression). RESULTS Maternal postpartum smoking occurred in 16.7% of our sample. In the multivariable analysis, BI was associated with maternal postpartum smoking (PR:2.04; CI 95% 1.08:3.84). CONCLUSIONS FOR PRACTICE Women presenting bonding problems are at higher risk of smoking after childbirth. Intervention to enhance mother-child bonding may have the potential to decrease maternal postpartum smoking.
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Affiliation(s)
- Alexandre Faisal-Cury
- Departamento de Medicina Preventiva, Faculdade de Medicina FMUSP, Universidade de São Paulo, São Paulo, SP, Brazil. .,University of Sao Paulo, Av Dr Arnaldo 455, Room 2214, São Paulo, 01246-903, Brazil.
| | - Alicia Matijasevich
- Departamento de Medicina Preventiva, Faculdade de Medicina FMUSP, Universidade de São Paulo, São Paulo, SP, Brazil
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Asociación entre el vínculo madre-hijo y los síntomas depresivos en madres de la Unidad de Cuidados Intensivos Neonatales: estudio caso-control. ENFERMERÍA INTENSIVA 2021. [DOI: 10.1016/j.enfi.2021.07.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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Kornfield SL, White LK, Waller R, Njoroge W, Barzilay R, Chaiyachati BH, Himes MM, Rodriguez Y, Riis V, Simonette K, Elovitz MA, Gur RE. Risk And Resilience Factors Influencing Postpartum Depression And Mother-Infant Bonding During COVID-19. Health Aff (Millwood) 2021; 40:1566-1574. [PMID: 34606353 DOI: 10.1377/hlthaff.2021.00803] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Acute stress during pregnancy can have adverse effects on maternal health and increase the risk for postpartum depression and impaired mother-infant bonding. The COVID-19 pandemic represents an acute environmental stressor during which it is possible to explore risk and resilience factors that contribute to postpartum outcomes. To investigate prenatal risk and resilience factors as predictors of postpartum depression and impaired mother-infant bonding, this study recruited a diverse cohort of 833 pregnant women from an urban medical center in Philadelphia, Pennsylvania, and assessed them once during pregnancy in the early phase of the COVID-19 pandemic (April-July 2020) and again at approximately twelve weeks postpartum. Adverse childhood experiences, prenatal depression and anxiety, and COVID-19-related distress predicted a greater likelihood of postpartum depression. Prenatal depression was the only unique predictor of impaired maternal-infant bonding after postpartum depression was controlled for. Women reporting greater emotion regulation, self-reliance, and nonhostile relationships had healthier postpartum outcomes. Policies to increase the number of nonspecialty providers providing perinatal mental health services as well as reimbursement for integrated care and access to mental health screening and care are needed to improve lifelong outcomes for women and their children.
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Affiliation(s)
- Sara L Kornfield
- Sara L. Kornfield is an assistant professor in the Penn Center for Women's Behavioral Wellness, Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, in Philadelphia, Pennsylvania. Kornfield and Lauren K. White are co-first authors
| | - Lauren K White
- Lauren K. White is a research scientist in the Lifespan Brain Institute, Children's Hospital of Philadelphia and Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania. White and Sara L. Kornfield are co-first authors
| | - Rebecca Waller
- Rebecca Waller is an assistant professor in the Department of Psychology, University of Pennsylvania
| | - Wanjiku Njoroge
- Wanjiku Njoroge is an assistant professor in the Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania
| | - Ran Barzilay
- Ran Barzilay is an assistant professor in the Lifespan Brain Institute, Children's Hospital of Philadelphia and Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania
| | - Barbara H Chaiyachati
- Barbara H. Chaiyachati is an associate fellow in the Lifespan Brain Institute, Children's Hospital of Philadelphia and Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania
| | - Megan M Himes
- Megan M. Himes is a research assistant in the Lifespan Brain Institute, Children's Hospital of Philadelphia and Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania
| | - Yuheiry Rodriguez
- Yuheiry Rodriguez is a study coordinator in the Department of Psychology, University of Pennsylvania
| | - Valerie Riis
- Valerie Riis is the director of operations, Maternal and Child Health Research Center, Department of Obstetrics and Gynecology, Perelman School of Medicine, University of Pennsylvania
| | - Keri Simonette
- Keri Simonette is a clinical research coordinator at Jefferson Health, in Philadelphia, Pennsylania. She was a project manager with the Maternal Child Health Research Center, Department of Obstetrics and Gynecology, Perelman School of Medicine, University of Pennsylvania, when this work was performed
| | - Michal A Elovitz
- Michal A. Elovitz is a professor in the Department of Obstetrics and Gynecology, Perelman School of Medicine, University of Pennsylvania
| | - Raquel E Gur
- Raquel E. Gur is a professor in the Lifespan Brain Institute, Children's Hospital of Philadelphia and Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania
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Zacharia A, Taylor BL, Sweeney A, Morant N, Howard LM, Johnson S. Mental Health Support in the Perinatal Period for Women With a Personality Disorder Diagnosis: A Qualitative Study of Women's Experiences. J Pers Disord 2021; 35:589-604. [PMID: 32539620 DOI: 10.1521/pedi_2020_34_482] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Women who receive a diagnosis of personality disorder may face particular challenges in the context of having a baby. However, this area has received little attention. This study aimed to qualitatively explore experiences of mental health support during the perinatal period in a group of mothers who self-reported having a personality disorder diagnosis. Semistructured interviews were conducted with 12 women who received mental health support during the perinatal period. These data were analyzed thematically. Key themes related to women feeling judged to be unfit mothers; not feeling heard or understood by services; feeling that services struggled with the complexity of their needs; valuing specialist support to cope with their struggles in motherhood; and valuing professional relationships that resembled real-life friendships. Our findings raise questions about how best to provide support to this group of women and about the use and consequences of the diagnosis of personality disorder among new mothers.
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Affiliation(s)
- Alice Zacharia
- Division of Psychiatry, University College London, London, UK
| | | | - Angela Sweeney
- Population Health Research Institute, St. George's University of London, London, UK
| | - Nicola Morant
- Division of Psychiatry, University College London, London, UK
| | - Louise M Howard
- Section of Women's Mental Health, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, UK
| | - Sonia Johnson
- Division of Psychiatry, University College London, London, UK
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Assal-Zrike S, Marks K, Atzaba-Poria N. Maternal Emotional Distress Following the Birth of a Preterm Baby: The Case of Bedouin Mothers Living in Southern Israel. JOURNAL OF CROSS-CULTURAL PSYCHOLOGY 2021. [DOI: 10.1177/00220221211033991] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Mothers of preterm infants are at higher risk for postpartum emotional distress (PPED). In this study, we investigated PPED among Bedouin mothers, an ethnic minority group living in Israel. Our aim was to understand how maternal acculturation style and birth order were related to mothers’ PPED following a premature birth. Three hundred twenty-one Bedouin mothers and their babies (preterm: n = 66; full-term: n = 255) participated in the study. Data were collected in the maternity ward and the NICU (Neonatal Intensive Care Unit) of a large general hospital in Southern Israel providing medical care to all populations in the southern region. Mothers completed questionnaires on maternal postpartum depression and anxiety. Additionally, maternal acculturation style was assessed using the acculturation questionnaire and information on child birth order. Mothers of preterm infants indicated having more symptoms of PPED than mothers of full-term infants. Additionally, both maternal acculturation style as well as birth order (i.e., whether the preterm was first- or later-born) were found to act as moderators in the link between prematurity and PPED. Specifically, we found that among the preterm group, low levels of Westernized acculturation style and the birth of a preterm infant who was later-born predicted higher levels of PPED. Our findings indicate that ethnicity, acculturation, and birth order are important variables that need to be considered when studying PPED and premature birth. Results highlight the fact that mothers from an ethnic minority group who have had a premature birth are at higher risk for experiencing PPED. However, individual differences emerged when examining maternal acculturation style and birth order. Culturally—informed clinical implications are proposed.
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Affiliation(s)
| | - Kyla Marks
- Soroka University Medical Center and the Faculty of Health Sciences, Beer Sheva, Israel
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Iwanowicz-Palus G, Marcewicz A, Bień A. Analysis of determinants of postpartum emotional disorders. BMC Pregnancy Childbirth 2021; 21:517. [PMID: 34284727 PMCID: PMC8293488 DOI: 10.1186/s12884-021-03983-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2020] [Accepted: 07/07/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The birth of a child entails major changes in a woman's life. In the perinatal period, the woman is particularly susceptible to emotional problems. The objective of the present paper was to investigate the relationship between global orientation to life and its components on the one hand, and socio-demographic factors on the other, with regard to early postpartum emotional disorders. METHODS The study included 643 patients hospitalized in obstetric departments in Lublin, Poland, who had had a spontaneous vaginal delivery. Research instruments included: the Edinburgh Postnatal Depression Scale (EPDS), the Orientation to Life Questionnaire (SOC-29), and the authors' own survey questionnaire to record participants' characteristics. RESULTS The study findings indicate an association between lower levels of postpartum blues and higher levels of global sense of coherence, as well as a stronger sense of meaningfulness, manageability, and comprehensibility. More severe emotional disorders were found in patients who were single. Postpartum blues symptoms were more intense in less educated respondents. CONCLUSIONS Postpartum emotional disorders are associated with a global sense of coherence and its components. Higher levels of SOC reduce the risk of postpartum blues.
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Affiliation(s)
- Grażyna Iwanowicz-Palus
- Chair and Department of Development in Midwifery, Faculty of Health Sciences, Medical University of Lublin, Lublin, Poland
| | - Agnieszka Marcewicz
- Chair and Department of Development in Midwifery, Faculty of Health Sciences, Medical University of Lublin, Lublin, Poland.
| | - Agnieszka Bień
- Chair and Department of Development in Midwifery, Faculty of Health Sciences, Medical University of Lublin, Lublin, Poland
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Iturralde E, Hsiao CA, Nkemere L, Kubo A, Sterling SA, Flanagan T, Avalos LA. Engagement in perinatal depression treatment: a qualitative study of barriers across and within racial/ethnic groups. BMC Pregnancy Childbirth 2021; 21:512. [PMID: 34271852 PMCID: PMC8284181 DOI: 10.1186/s12884-021-03969-1] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2021] [Accepted: 06/08/2021] [Indexed: 12/02/2022] Open
Abstract
Background To better understand previously observed racial/ethnic disparities in perinatal depression treatment rates we examined care engagement factors across and within race/ethnicity. Methods Obstetric patients and women’s health clinician experts from a large healthcare system participated in this qualitative study. We conducted focus groups with 30 pregnant or postpartum women of Asian, Black, Latina, and White race/ethnicity with positive depression screens. Nine clinician experts in perinatal depression (obstetric, mental health, and primary care providers) were interviewed. A semi-structured format elicited treatment barriers, cultural factors, and helpful strategies. Discussion transcripts were coded using a general inductive approach with themes mapped to the Capability-Opportunity-Motivation-Behavior (COM-B) theoretical framework. Results Treatment barriers included social stigma, difficulties recognizing one’s own depression, low understanding of treatment options, and lack of time for treatment. Distinct factors emerged for non-White women including culturally specific messages discouraging treatment, low social support, trauma history, and difficulty taking time off from work for treatment. Clinician factors included knowledge and skill handling perinatal depression, cultural competencies, and language barriers. Participants recommended better integration of mental health treatment with obstetric care, greater treatment convenience (e.g., telemedicine), and programmatic attention to cultural factors and social determinants of health. Conclusions Women from diverse backgrounds with perinatal depression encounter individual-level, social, and clinician-related barriers to treatment engagement, necessitating care strategies that reduce stigma, offer convenience, and attend to cultural and economic factors. Our findings suggest the importance of intervention and policy approaches effecting change at multiple levels to increase perinatal depression treatment engagement.
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Affiliation(s)
- Esti Iturralde
- Division of Research, Kaiser Permanente Northern California, 2000 Broadway, Oakland, CA, 94612, USA.
| | - Crystal A Hsiao
- Division of Research, Kaiser Permanente Northern California, 2000 Broadway, Oakland, CA, 94612, USA
| | - Linda Nkemere
- Division of Research, Kaiser Permanente Northern California, 2000 Broadway, Oakland, CA, 94612, USA
| | - Ai Kubo
- Division of Research, Kaiser Permanente Northern California, 2000 Broadway, Oakland, CA, 94612, USA
| | - Stacy A Sterling
- Division of Research, Kaiser Permanente Northern California, 2000 Broadway, Oakland, CA, 94612, USA
| | | | - Lyndsay A Avalos
- Division of Research, Kaiser Permanente Northern California, 2000 Broadway, Oakland, CA, 94612, USA
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Abstract
This review summarizes recent evidences regarding the potential influences of epidural labor analgesia (ELA) on the outcomes of neonates and children. Terms and relevant words including “ELA,” “ELA and neonatal outcomes,” “ELA and children's development,” and “ELA and children's neurocognitive development” were used to search articles published in PubMed database up to October 2019. Original articles and reviews regarding potential influences of ELA on neonates and children were identified. Relevant references of the selected articles were also screened. The anesthetics used during ELA can be absorbed, enter the fetus, and produce neonatal depression; however, these effects are less severe than those during systematic opioid analgesia. The impact of anesthetic exposure during ELA on children's neurodevelopment has not been fully studied, but would be mild if any. ELA increases the risk of intrapartum maternal fever; the latter may be harmful to neonatal outcomes. The use of ELA may increase birth injury by increasing instrumental delivery, although long-term adverse events are rare. On the other hand, ELA may reduce maternal depression and, thus, produce favorable effects on neurocognitive development in childhood; but evidences are still lacking in this aspect. ELA may produce both favorable and unfavorable effects on neonates and children. These effects should be discussed with parturient women before making decisions. The potential harmful effects should be carefully managed. The overall impacts of ELA on neonatal and children's outcomes need to be studied further.
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Shreffler KM, Spierling TN, Jespersen JE, Tiemeyer S. Pregnancy intendedness, maternal-fetal bonding, and postnatal maternal-infant bonding. Infant Ment Health J 2021; 42:362-373. [PMID: 33860552 PMCID: PMC8175017 DOI: 10.1002/imhj.21919] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
This study models associations between pregnancy intendedness and prenatal maternal-fetal bonding with postnatal maternal-infant bonding. Unintended pregnancies are associated with disruptions in maternal-infant bonding, which has long-term adverse implications for maternal and child well-being. Given the high proportion of births that are unintended in the United States, identifying protective factors is critical. Pregnant women (ages 16-38) were recruited from two prenatal clinics in a metropolitan city in the South Central United States at their first prenatal visit and followed throughout pregnancy and postbirth. Multiple regression analyses examined associations, mediation, and moderation. Results indicate that the more unintended/unwanted women reported their pregnancies to be, the lower they reported their maternal-infant bonding postbirth, and higher maternal-fetal bonding scores are associated with higher postnatal maternal-infant bonding. An interaction revealed that a higher level of prenatal bonding is protective for postnatal bonding among those with unintended/unwanted pregnancies. Because prenatal bonding can be enhanced through intervention, it is a promising target to reduce the risks associated with unintended pregnancy.
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Affiliation(s)
- Karina M Shreffler
- Department of Human Development and Family Science, Oklahoma State University, Tulsa, Oklahoma, USA
| | - Tiffany N Spierling
- Department of Human Development and Family Science, Oklahoma State University, Stillwater, Oklahoma, USA
| | - Jens E Jespersen
- Department of Human Development and Family Science, Oklahoma State University, Stillwater, Oklahoma, USA
| | - Stacy Tiemeyer
- Center for Research on Childhood Adversity, Oklahoma State University Center for Health Sciences, Tulsa, Oklahoma, USA
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The impact of postpartum depression and bonding impairment on child development at 12 to 15 months after delivery. JOURNAL OF AFFECTIVE DISORDERS REPORTS 2021. [DOI: 10.1016/j.jadr.2021.100125] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Associations between Coparenting Relationships and Maternal Depressive Symptoms and Negative Bonding to Infant. Healthcare (Basel) 2021; 9:healthcare9040375. [PMID: 33800683 PMCID: PMC8065466 DOI: 10.3390/healthcare9040375] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2021] [Accepted: 03/24/2021] [Indexed: 11/19/2022] Open
Abstract
Maternal mental illnesses during early postpartum may be caused by lack of the coparenting relationship parents share and cooperate regarding child-rearing. This study clarifies the association of the coparenting relationship and negative mental health of mothers at one and three months after childbirth. This study conducted a secondary analysis of data from an intervention study wherein 24 mothers rearing their first child with a cohabitant (husband/partner) participated. Maternal mental health was evaluated using the Edinburgh Postnatal Depression Scale to determine postpartum depressive symptoms and the Mother-to-Infant Bonding Scale to assess negative bonding. Mothers’ average age was 31.5 ± 4.2 years old. All mothers were not working during the research period. The prevalence of postpartum depression and bonding disorder were approximately 13% and 21%, respectively. A better coparenting relationship was associated with lower postpartum depressive symptoms at both one month (β = −0.617, p = 0.002) and three months (β = −0.709, p < 0.01) postpartum. In contrast, no association was found between a coparenting relationship and negative bonding. The results indicate that the coparenting relationship may possibly prevent maternal depression during the early postpartum period.
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Bevilacqua F, Morini F, Ragni B, Braguglia A, Gentile S, Zaccara A, Bagolan P, Aite L. Pediatric medical traumatic stress (PMTS) in parents of newborns with a congenital anomaly requiring surgery at birth. J Pediatr Surg 2021; 56:471-475. [PMID: 32862997 DOI: 10.1016/j.jpedsurg.2020.07.030] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2020] [Revised: 07/09/2020] [Accepted: 07/16/2020] [Indexed: 11/18/2022]
Abstract
BACKGROUND Pediatric medical traumatic stress (PMTS) is a psychological and physiological response of children and their families to pain, serious illness, and invasive medical procedures. We aimed to apply the PMTS model to parents of newborns operated at birth for a congenital malformation and to identify clinical and sociodemographic risk factors associated with PMTS symptoms at 6 months. METHODS We designed a cross-sectional study to assess PMTS symptoms (avoidance, arousal, reexperiencing) in parents of six months children operated on for a congenital anomaly, with the Italian version of the Impact of Event Scale - Revised (IES-R). RESULTS One-hundred-seventy parents form the object of the study. Eighty-two parents (48.2%) fell over the clinical cut-off. Ventilatory time (p = 0.0001), length of hospital stay (p = 0.0001), associated anomalies (p = 0.0002), medical devices at discharge (p = 0.0001) and Bayley motor scale (p = 0.0002) were significantly correlated with IES-R Total and Subscale Scores. Multivariate linear regression showed length of hospital stay and number of associated anomalies as significant predictors of IES-R Scores. CONCLUSIONS Regardless the type of anomaly and sociodemographic factors, it is the clinical history of the child which seems to predict the severity of PMTS symptoms in this population of parents. PMTS represents a useful model to describe the psychological reactions of parents of newborns operated at birth for a congenital malformation. NICU and outpatient pediatric staff should be aware of risk factors to identify families who may request early multidisciplinary interventions since the first admission. LEVEL OF EVIDENCE Prognosis study, level II.
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Affiliation(s)
- Francesca Bevilacqua
- Unit of Clinical Psychology, Department of Neuroscience and Neurorehabilitation, Bambino Gesù Children's Hospital, Rome, Italy.
| | - Francesco Morini
- Department of Neonatal Medicine and Surgery, Bambino Gesù Children's Hospital, Rome, Italy
| | | | - Annabella Braguglia
- Department of Neonatal Medicine and Surgery, Bambino Gesù Children's Hospital, Rome, Italy
| | - Simonetta Gentile
- Unit of Clinical Psychology, Department of Neuroscience and Neurorehabilitation, Bambino Gesù Children's Hospital, Rome, Italy
| | - Antonio Zaccara
- Department of Pediatric Surgery, Bambino Gesù Children's Hospital, Rome, Italy
| | - Pietro Bagolan
- Department of Neonatal Medicine and Surgery, Bambino Gesù Children's Hospital, Rome, Italy
| | - Lucia Aite
- Unit of Clinical Psychology, Department of Neuroscience and Neurorehabilitation, Bambino Gesù Children's Hospital, Rome, Italy
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