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Lähdepuro A, Räikkönen K, Pham H, Thompson-Felix T, Eid RS, O'Connor TG, Glover V, Lahti J, Heinonen K, Wolford E, Lahti-Pulkkinen M, O'Donnell KJ. Maternal social support during and after pregnancy and child cognitive ability: examining timing effects in two cohorts. Psychol Med 2024; 54:1661-1670. [PMID: 38087866 DOI: 10.1017/s0033291723003550] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/22/2024]
Abstract
BACKGROUND Maternal anxiety, depression, and stress during and after pregnancy are negatively associated with child cognitive development. However, the contribution of positive maternal experiences, such as social support, to child cognitive development has received less attention. Furthermore, how maternal experience of social support during specific developmental periods impacts child cognitive development is largely unknown. METHODS Using data from the Avon Longitudinal Study of Parents and Children (ALSPAC; n = 5784) and the Prediction and Prevention of Preeclampsia and Intrauterine Growth Restriction study (PREDO; n = 420), we investigated the associations between maternal perceived social support during and after pregnancy and child's general cognitive ability at 8 years of age, assessed with the Wechsler Intelligence Scale for Children (WISC). Bayesian relevant life course modeling was used to investigate timing effects of maternal social support on child cognitive ability. RESULTS In both cohorts, higher maternal perceived social support during pregnancy was associated with higher performance on the WISC, independent of sociodemographic factors and concurrent maternal symptoms of depression and anxiety. In ALSPAC, pregnancy emerged as a sensitive period for the effects of perceived social support on child cognitive ability, with a stronger effect of social support during pregnancy than after pregnancy on child cognitive ability. CONCLUSIONS Our findings, supported from two prospective longitudinal cohorts, suggest a distinct role of maternal perceived social support during pregnancy for cognitive development in children. Our study suggests that interventions aimed at increasing maternal social support during pregnancy may be an important strategy for promoting maternal and child well-being.
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Affiliation(s)
- Anna Lähdepuro
- Department of Psychology and Logopedics, University of Helsinki, Helsinki, Finland
- Yale Child Study Center, Yale University, New Haven, CT, USA
| | - Katri Räikkönen
- Department of Psychology and Logopedics, University of Helsinki, Helsinki, Finland
- Department of Obstetrics and Gynecology, Helsinki University Hospital, University of Helsinki, Helsinki, Finland
| | - Hung Pham
- Yale Child Study Center, Yale University, New Haven, CT, USA
| | | | - Rand S Eid
- Department of Psychology, McGill University, Montreal, QC, Canada
| | - Thomas G O'Connor
- Departments of Psychiatry, Neuroscience, Obstetrics and Gynecology, and Wynne Center for Family Research, University of Rochester, Rochester, NY, USA
| | | | - Jari Lahti
- Department of Psychology and Logopedics, University of Helsinki, Helsinki, Finland
- Folkhälsan Research Center, Helsinki, Finland
| | - Kati Heinonen
- Department of Psychology and Logopedics, University of Helsinki, Helsinki, Finland
- Psychology/Welfare Sciences, Tampere University, Tampere, Finland
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, ON, Canada
- Population Health Unit, Finnish Institute for Health and Welfare, Helsinki and Oulu, Finland
| | - Elina Wolford
- Department of Psychology and Logopedics, University of Helsinki, Helsinki, Finland
| | - Marius Lahti-Pulkkinen
- Department of Psychology and Logopedics, University of Helsinki, Helsinki, Finland
- Population Health Unit, Finnish Institute for Health and Welfare, Helsinki and Oulu, Finland
- Centre for Cardiovascular Science, Queen's Medical Research Institute, University of Edinburgh, Edinburgh, UK
| | - Kieran J O'Donnell
- Yale Child Study Center, Yale University, New Haven, CT, USA
- Department of Obstetrics, Gynecology and Reproductive Sciences, Yale University, New Haven, CT, USA
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Becker E, Atkinson L, Gonzalez A, Khoury J. Social support buffers the impact of pregnancy stress on perceptions of parent-infant closeness during the COVID-19 pandemic. Infant Ment Health J 2024; 45:328-340. [PMID: 38196240 DOI: 10.1002/imhj.22096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Revised: 12/11/2023] [Accepted: 12/18/2023] [Indexed: 01/11/2024]
Abstract
Pregnant individuals and parents have experienced elevated mental health problems and stress during COVID-19. Stress during pregnancy can be harmful to the fetus and detrimental to the parent-child relationship. However, social support is known to act as a protective factor, buffering against the adverse effects of stress. The present study examined whether (1) prenatal stress during COVID-19 was associated with parent-infant closeness at 6 months postpartum, and (2) social support moderated the effect of prenatal stress on the parent-infant relationship. In total, 181 participants completed questionnaires during pregnancy and at 6 months postpartum. A hierarchical linear regression analysis was conducted to assess whether social support moderated the effect of stress during pregnancy on parent-infant closeness at 6 months postpartum. Results indicated a significant interaction between prenatal stress and social support on parents' perceptions of closeness with their infants at 6 months postpartum (β = .805, p = .029); parents who experienced high prenatal stress with high social support reported greater parent-infant closeness, compared to those who reported high levels of stress and low social support. Findings underscore the importance of social support in protecting the parent-infant relationship, particularly in times of high stress, such as during the COVID-19 pandemic.
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Affiliation(s)
- Emma Becker
- Department of Psychology, Mount Saint Vincent University, Halifax, Nova Scotia, Canada
| | - Leslie Atkinson
- Department of Psychology, Metropolitan Toronto University, Toronto, Ontario, Canada
| | - Andrea Gonzalez
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada
- Offord Centre for Child Studies, McMaster University, Hamilton, Ontario, Canada
| | - Jennifer Khoury
- Department of Psychology, Mount Saint Vincent University, Halifax, Nova Scotia, Canada
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Shiffman N, Gluska H, Margalit S, Mayer Y, Daher R, Elyasyan L, Elia N, Sharon Weiner M, Miremberg H, Kovo M, Biron-Shental T, Gabbay-Benziv R, Helpman L. Unfolding of maternal-infant bonding amidst the COVID-19 pandemic: Social support as a risk and protective factor. Dev Psychopathol 2024:1-9. [PMID: 38654408 DOI: 10.1017/s0954579424000853] [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: 04/25/2024]
Abstract
BACKGROUND Social, familial, and physiological stressors may put maternal-infant bonding at risk. Therefore, it is plausible that the stressful conditions brought on by COVID-19 could influence maternal-infant bonding. This study aimed to elucidate the contribution of COVID-19-related experience to variance in maternal-infant bonding, beyond that of established risk factors and as moderated by social support. METHODS This longitudinal, multicenter study examined the relationship of demographic and obstetric variables, social support, postpartum depression, as well as COVID-19-related fear, exposure, and subjective difficulty with mother-infant bonding six months following birth. Participants (N = 246) were women who delivered during the pandemics' strict lockdown period and were recruited 10 weeks after a liveborn delivery and followed up six months later. RESULTS Relationship between fear of COVID-19 and maternal-infant bonding was moderated by social support: Amongst mothers with high levels of social support, fear of COVID-19 negatively predicted bonding. DISCUSSION Results indicate that social support, while overall a protective factor for mother-infant bonding, may lose its buffering effect when fear of COVID-19 is high. This relationship was maintained even when early bonding experiences such as forced separation and the risk incurred by postpartum depression were accounted for. Implications for providers are discussed.
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Affiliation(s)
- N Shiffman
- Psychiatry and Mental Health Division, Rambam Medical Center, Haifa, Israel
- The Ruth and Bruce Rappaport Faculty of Medicine, Haifa, Israel
| | - H Gluska
- Obstetrics and Gynecology, Meir Medical center, Kfar Saba, Israel
- Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - Shiri Margalit
- Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - Y Mayer
- Department of Counseling and Human Development, Faculty of Education, University of Haifa, Haifa, Israel
| | - R Daher
- The Ruth and Bruce Rappaport Faculty of Medicine, Haifa, Israel
- Obstetrics and Gynecology, Hillel Yaffe Medical Center, Hadera, Israel
| | - L Elyasyan
- The Ruth and Bruce Rappaport Faculty of Medicine, Haifa, Israel
- Obstetrics and Gynecology, Hillel Yaffe Medical Center, Hadera, Israel
| | - N Elia
- Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
- Obstetrics and Gynecology, Edith Wolfson Medical Center, Holon, Israel
| | - M Sharon Weiner
- Obstetrics and Gynecology, Meir Medical center, Kfar Saba, Israel
- Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - H Miremberg
- Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
- Obstetrics and Gynecology, Edith Wolfson Medical Center, Holon, Israel
| | - M Kovo
- Obstetrics and Gynecology, Meir Medical center, Kfar Saba, Israel
- Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - T Biron-Shental
- Obstetrics and Gynecology, Meir Medical center, Kfar Saba, Israel
- Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - R Gabbay-Benziv
- The Ruth and Bruce Rappaport Faculty of Medicine, Haifa, Israel
- Obstetrics and Gynecology, Hillel Yaffe Medical Center, Hadera, Israel
| | - L Helpman
- Department of Counseling and Human Development, Faculty of Education, University of Haifa, Haifa, Israel
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Kelmanson IA. Manifest anxiety and maternal-fetal attachment in pregnant women with previous fetal losses. J Reprod Infant Psychol 2024; 42:45-61. [PMID: 35412396 DOI: 10.1080/02646838.2022.2056882] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Accepted: 03/14/2022] [Indexed: 10/18/2022]
Abstract
AIM To explore associations between manifest anxiety (Taylor's Manifest Anxiety Scale, TMAS), major obstetric and demographic features and maternal-fetal attachment (MFA) (Maternal Antenatal Attachment Scale, MAAS) in women with previous miscarriages. SUBJECTS AND METHODS One hundred pregnant women with previous miscarriages, having uncomplicated singleton pregnancy, not receiving any medications, and conceived in a natural manner . Ages ranged between 19 and 47 years, gestational age between 4 and 35 weeks. Hierarchical multiple linear regression, Kruskal-Wallis test, and ANCOVA were used in data analysis. RESULTS Maternal age, gestational age, previous abortions, parity, maternal education, and marital status in combination contributed significantly to the regression model in prediction of the MAAS quality and intensity scores. Adding the TMAS score accounted for an additional 17% of variation in the MAAS quality score, and the change in R2 was significant. There was a negative relationship between the TMAS and the MAAS quality scores. The TMAS score did not contribute to prediction of the MAAS intensity. The highest TMAS values were in the women having anxious, ambivalent or affectless preoccupation. CONCLUSION Prevention of negative consequences of poor quality of MFA in women with previous miscarriages should include early screening for manifest anxiety.
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Affiliation(s)
- Igor A Kelmanson
- Department of Children's Diseases, Institute for Medical Education of the V.A. Almazov National Medical Research Centre, St Petersburg, Russia
- Department of Clinical Psychology, St. Petersburg State Institute for Psychology and Social Work, St Petersburg, Russia
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Gonzales AM, Barcelo TI. Quality of prenatal care and maternal fetal attachment among primigravid mothers in the Philippines: A cross sectional study. Midwifery 2023; 127:103842. [PMID: 37871420 DOI: 10.1016/j.midw.2023.103842] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2022] [Revised: 09/28/2023] [Accepted: 10/10/2023] [Indexed: 10/25/2023]
Abstract
BACKGROUND The prenatal period is a proper chance for evaluating maternal-fetal attachment. AIM To determine the relationship between quality of prenatal care and maternal-fetal attachment among primigravida mothers during late pregnancy period. METHODS The study conducted a survey using a 46-item Quality of Prenatal Care Questionnaire and 24-item Maternal-Fetal Attachment Scale among 343 primigravida mothers in village health stations. Pearson correlation was used to correlate maternal-fetal attachment scores and quality of prenatal scores. Linear regression was used to determine relationships between variables. RESULTS Maternal-fetal attachment scores is correlated with: age ≤19 years (4.10 [95 % CI 1.81-6.39]), companion during visits (2.76 [95 % CI 0.34-5.18]), education (3.45 [95 % CI 0.93-5.97]). On multivariate analysis, the following were significantly associated with maternal-fetal attachment scores: information sharing (8.67 [95 % CI 4.74 - 12.60]), sufficient time (-2.34 [95 % CI -3.45 - -1.24]), support and respect (8.49 [95 % CI 4.54 - 12.45]), maternal age < 19 years (-3.78 [-5.81 to -1.75]), and unmarried (2.55 [95 % CI 0.70 - 4.41]). CONCLUSION The quality of prenatal care is correlated significantly with maternal-fetal attachment. Women valued the care given when it was individualized and the health workers were approachable in their ways and addressed their own particular needs. Combination of prenatal education and counselling tailored to address own particular emotional and social concerns of pregnant mothers are interventions that should be integrated in maternal care services.
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Affiliation(s)
- Artemio M Gonzales
- College of Arts, Sciences, and Technology, Occidental Mindoro State College, Occidental Mindoro, San Jose 5100, Philippines; Faculty of Management and Development Studies, University of the Philippines, Los Baños, Laguna 4030, Philippines.
| | - Teresita I Barcelo
- Faculty of Management and Development Studies, University of the Philippines, Los Baños, Laguna 4030, Philippines
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Bischoff M, Schmidt S, Muehlan H, Ulbricht S, Heckmann M, Berg NVD, Grabe HJ, Tomczyk S. Ecological momentary assessment of parent-child attachment via technological devices: A systematic methodological review. Infant Behav Dev 2023; 73:101882. [PMID: 37633249 DOI: 10.1016/j.infbeh.2023.101882] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Revised: 07/21/2023] [Accepted: 08/16/2023] [Indexed: 08/28/2023]
Abstract
Despite extensive research about parent-child attachment using observational and self-report studies, complementary measures are needed to assess this construct objectively with ecological validity, as well as less obtrusiveness and reactivity than traditional measures. This systematic review describes existing technology-based ecologically momentary assessment (EMA) tools examining attachment-related emotions, cognition, and behaviors between the child and its parents. From the study's inception until March 2021, four databases were searched resulting in 11,910 screened citations. Finally, 18 records were included, characterized by a broad variety of assessment tools, sample characteristics, study designs, and attachment outcomes. Technology-based EMA methods comprised audio, video, diary, and sensory assessment modalities, each occuying its methodological niche. When reported, the psychometric properties of the EMA methods were evaluated as very good; however, the included studies' psychometric data was not completely examined. The main attachment outcomes assessed by EMA were emotional and cognitive reactions and actions of the children, the parents, and the dyad. Cognition was rarely assessed using EMA methods. Future research should focus on the complexity of attachment considering different ethnic backgrounds, multiple caregivers' viewpoints, gender aspects, as well as cognitive and dyadic contents in the naturalistic environment.
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Affiliation(s)
- Marie Bischoff
- Institute of Psychology, Department Health and Prevention, University Greifswald, Germany.
| | - Silke Schmidt
- Institute of Psychology, Department Health and Prevention, University Greifswald, Germany
| | - Holger Muehlan
- Institute of Psychology, Department Health and Prevention, University Greifswald, Germany
| | - Sabina Ulbricht
- Institute for Community Medicine, University Medicine Greifswald, Germany
| | - Matthias Heckmann
- Department of Neonatology and Paediatric Intensive Care, University Medicine Greifswald, Germany
| | | | - Hans J Grabe
- Department of Psychiatry and Psychotherapy, University Medicine Greifswald, Germany
| | - Samuel Tomczyk
- Institute of Psychology, Department Health and Prevention, University Greifswald, Germany
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Testouri F, Hamza M, Amor AB, Barhoumi M, Fakhfakh R, Triki A, Belhadj A. Anxiety and Depression Symptoms in At-Risk Pregnancy: Influence on Maternal-Fetal Attachment in Tunisia. Matern Child Health J 2023; 27:2008-2016. [PMID: 37326790 DOI: 10.1007/s10995-023-03736-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/26/2023] [Indexed: 06/17/2023]
Abstract
OBJECTIVES To investigate maternal prenatal anxiety and depression in high-risk pregnancies and examine their influence on maternal-fetal attachment. METHODS We included 95 hospitalized high-risk pregnant women. The Hospital Anxiety and Depression Scale (HADS) and the Prenatal Attachment Inventory (PAI) were used to assess the primary objective. Internal consistency and construct validity of the PAI were investigated. RESULTS The average age was 31 years and gestational age ranged from 26 to 41 weeks. Prevalence of depressive symptoms was 20% and anxiety symptoms 39%. Cronbach alpha coefficient of the PAI Tunisian version was 0.8 and the construct validity in favour of one factor model. PAI scores correlated negatively and significatively with the HADS total score (r = - 0.218, p = 0.034) and was attributed to the depression dimension only (r = - 0.205, p = 0.046). CONCLUSIONS FOR PRACTICE Emotional wellbeing of pregnant women especially in high-risk pregnancies should be explored in order to prevent consequences on women, their growing fetus, and prenatal attachment.
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Affiliation(s)
- Ferdaous Testouri
- Faculty of Medicine of Tunis, University of Tunis El Manar, Djebal Lakhdhar, 1007, Tunis, Tunisia
| | - Meriem Hamza
- Faculty of Medicine of Tunis, University of Tunis El Manar, Djebal Lakhdhar, 1007, Tunis, Tunisia.
- Child and Adolescent Psychiatry Department, Mongi Slim Hospital, 2046, Sidi Daoud, Tunisia.
- Research Lab, LR22SP01 Mother-Child Health, Tunis, Tunisia.
| | - Anissa Ben Amor
- Faculty of Medicine of Tunis, University of Tunis El Manar, Djebal Lakhdhar, 1007, Tunis, Tunisia
- Gynecology-Obstetrics Department, Mongi Slim Hospital, 2046, Sidi Daoud, Tunisia
| | - Marwene Barhoumi
- Faculty of Medicine of Tunis, University of Tunis El Manar, Djebal Lakhdhar, 1007, Tunis, Tunisia
| | - Radhouane Fakhfakh
- Faculty of Medicine of Tunis, University of Tunis El Manar, Djebal Lakhdhar, 1007, Tunis, Tunisia
- Department of Epidemiology and Statistics, Abderrahmen Mami Hospital, 2080, Ariana, Tunisia
- Research Lab, LR22SP01 Mother-Child Health, Tunis, Tunisia
| | - Amel Triki
- Faculty of Medicine of Tunis, University of Tunis El Manar, Djebal Lakhdhar, 1007, Tunis, Tunisia
- Gynecology-Obstetrics Department, Mongi Slim Hospital, 2046, Sidi Daoud, Tunisia
- Research Lab, LR22SP01 Mother-Child Health, Tunis, Tunisia
| | - Ahlem Belhadj
- Faculty of Medicine of Tunis, University of Tunis El Manar, Djebal Lakhdhar, 1007, Tunis, Tunisia
- Child and Adolescent Psychiatry Department, Mongi Slim Hospital, 2046, Sidi Daoud, Tunisia
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Tekmen EK, Boztepe H, Akdağ Topal C. Does the immigration affect prenatal attachment levels? Women Health 2023; 63:637-647. [PMID: 37642344 DOI: 10.1080/03630242.2023.2250468] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Revised: 07/19/2023] [Accepted: 08/15/2023] [Indexed: 08/31/2023]
Abstract
Pregnancy is an important period in which mother-infant attachment begins, includes bio-psychological changes, and has physical and psychological effects on the future life of the fetus. This study aims to evaluate the prenatal attachment levels of Syrian refugee and Turkish mothers in Turkey and to determine the variables that affect these. This cross-sectional study conducted in the obstetric outpatient clinics with 397 pregnant women 197 Syrian and 200 native women. Inclusion criteria were a pregnancy of at least 20 weeks, no communication or mental disorders, no chronic diseases, no diagnosis of high-risk pregnancy, literacy in the pregnant Turkish women, Turkish language proficiency in the pregnant Syrian women, and residence in Turkey for at least three years. Data were collected using a Sociodemographic form and The Prenatal Attachment Inventory (PAI). The data were analyzed by conducting independent t-tests, and hierarchical multiple linear regression analysis. The mean prenatal attachment score of Turkish pregnant women (61.79 ± 8.55) was higher than Syrian women (48.38 ± 10.39) (p < .05). Education level, pre-pregnancy counseling, regular checkup, support from spouses, relatives, and friends, and being a refugee of pregnant women were determined as predictors of prenatal attachment. The results showed that 67 percent of the total variance in the prenatal attachment levels could be explained in model 2 (F = 35.524, R2 variation = .673, p = .001). The low prenatal attachment level of Syrian pregnant women was a result of the detrimental impacts of being a refugee on pregnancy. The integration of transcultural knowledge, culture-specific perspectives, and cross-cultural theories into clinical practices is essential for immigrant women.
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Affiliation(s)
| | - Handan Boztepe
- Nursing Department, Faculty of Health Sciences Atilim University, Ankara, Turkey
| | - Cansu Akdağ Topal
- Nursing Department, Faculty of Health Sciences Başkent University, Ankara, Turkey
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Volling BL, Tan L, Rosenberg L, Bader LR. Will I love my second baby as much as my first? Prevalence and psychosocial correlates of maternal-fetal relationship anxiety for second-time mothers. Infant Ment Health J 2023; 44:541-553. [PMID: 37149744 PMCID: PMC10524320 DOI: 10.1002/imhj.22060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Revised: 03/21/2023] [Accepted: 04/11/2023] [Indexed: 05/08/2023]
Abstract
Most mothers have more than one child. Second-time mothers may worry about whether they will love the second baby as much as their first child. The current study examined mothers' maternal-fetal relationship anxiety (MFRA) to their second baby, the prediction of mother-infant bonding (MIB) and infant-mother attachment security post-partum, and the psychosocial correlates of mothers' MFRA during pregnancy. Mothers (N = 241, 85.9% White, 5.4% Black, 2.9% Asian/American, 3.7% Latina) and their second-born infants (55% boys) living in the Midwestern United States participated in a longitudinal investigation starting in the last trimester of pregnancy, and 1, 4, 8, and 12 months postpartum. Most women reported little to no anxiety about forming an attachment to their second baby (89.1%). MFRA predicted less maternal warmth toward the baby at 1, 4, and 8 months postpartum, but did not predict security of the infant-mother attachment at 12 months. Prenatal MFRA was also related to maternal depressive symptoms, an insecure attachment with the first child, more marital distress, and more adult attachment avoidance and ambivalence prenatally. Mothers worrying about loving a second baby as much as their first child may be experiencing other psychosocial risks that have repercussions for the developing mother-infant relationship.
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Affiliation(s)
| | - Lin Tan
- Department of Health Behavior and Health Systems, University of North Texas, Health Science Center
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Skelton E, Smith A, Harrison G, Rutherford M, Ayers S, Malamateniou C. The effect of the COVID-19 pandemic on UK parent experiences of pregnancy ultrasound scans and parent-fetal bonding: A mixed methods analysis. PLoS One 2023; 18:e0286578. [PMID: 37267279 DOI: 10.1371/journal.pone.0286578] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2022] [Accepted: 05/18/2023] [Indexed: 06/04/2023] Open
Abstract
INTRODUCTION Companionship in antenatal care is important for facilitating positive parental experiences. During the COVID-19 pandemic, restrictions on partner attendance at fetal ultrasound scans were introduced nationally to minimise transmission of the virus. This study aimed to explore the effect of these restrictions on maternal and paternal experiences of pregnancy scans and evaluate their potential effect on parent-fetal bonding. METHODS A UK-wide, anonymous cross-sectional survey was completed by new and expectant parents (n = 714) who had, or were awaiting a pregnancy scan during the COVID-19 pandemic. The CORE-10 and an adapted version of the Prenatal Attachment Inventory were used to evaluate psychological distress and prenatal bonding. Additional survey questions captured parental experiences of scans. Separate statistical and thematic analyses of the data were undertaken. A joint display matrix was used to facilitate integration of quantitative and qualitative claims to generate a comprehensive interpretation of study findings. FINDINGS When fathers did not attend the scan, feelings of excitement and satisfaction were significantly reduced (p<0.001) and feelings of anxiety increased (p<0.001) in both parents. Mothers were concerned about receiving unexpected news alone and fathers felt excluded from the scan. Mean paternal bonding (38.22, SD 10.73) was significantly lower compared to mothers (47.01, SD 7.67) although no difference was demonstrated between those who had attended the scan and those who had not. CORE-10 scores suggested low-to-mild levels of psychological distress, although the mean difference between mothers and fathers was not significant. Key themes described both parents' sense of loss for their desired pregnancy scan experience and reflected on sonographers' central role in providing parent-centred care during scans. CONCLUSION Restrictions on partner attendance at scans during the COVID-19 pandemic had a negative effect on parental experiences of antenatal imaging. Provision of parent-centred care, which is inclusive of partners, is essential for improved parental experiences.
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Affiliation(s)
- Emily Skelton
- Division of Radiography and Midwifery, School of Health and Psychological Sciences, City, University of London, London, United Kingdom
| | - Alison Smith
- Guy's & St Thomas' NHS Foundation Trust, London, United Kingdom
| | - Gill Harrison
- Society and College of Radiographers, London, United Kingdom
| | - Mary Rutherford
- Perinatal Imaging and Health, King's College London, London, United Kingdom
| | - Susan Ayers
- Centre for Maternal and Child Health Research, School of Health and Psychological Sciences, City, University of London, London, United Kingdom
| | - Christina Malamateniou
- Division of Radiography and Midwifery, School of Health and Psychological Sciences, City, University of London, London, United Kingdom
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11
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Anxiety, stress, and depression in Australian pregnant women during the COVID-19 pandemic: A cross sectional study. Midwifery 2023; 119:103619. [PMID: 36812820 PMCID: PMC9933579 DOI: 10.1016/j.midw.2023.103619] [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: 01/29/2022] [Revised: 08/08/2022] [Accepted: 02/02/2023] [Indexed: 02/18/2023]
Abstract
BACKGROUND The COVID-19 pandemic necessitated rapid responses by health services to suppress transmission of the virus. AIM This study aimed to investigate predictors of anxiety, stress and depression in Australian pregnant women during the COVID-19 pandemic including continuity of carer and the role of social support. METHODS Women aged 18 years and over in their third trimester of pregnancy were invited to complete an online survey between July 2020 and January 2021. The survey included validated tools for anxiety, stress, and depression. Regression modelling was used to identify associations between a range of factors including continuity of carer, and mental health measures. FINDINGS 1668 women completed the survey. One quarter screened positive for depression, 19% for moderate or higher range anxiety, and 15.5% for stress. The most significant contribution to higher anxiety, stress, and depression scores was a pre-existing mental health condition, followed by financial strain and a current complex pregnancy. Protective factors included age, social support, and parity. DISCUSSION Maternity care strategies to reduce COVID-19 transmission restricted women's access to their customary pregnancy supports and increased their psychological morbidity. CONCLUSION Factors associated with anxiety, stress and depression scores during the COVID-19 pandemic were identified. Maternity care during the pandemic compromised pregnant women's support systems.
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12
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Li X, Wang X, Zhou G. Heterogeneity of emotional distress in pregnancy during COVID-19 pandemic: a latent profile analysis. J Reprod Infant Psychol 2023:1-12. [PMID: 36941566 DOI: 10.1080/02646838.2023.2192748] [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: 03/23/2023]
Abstract
BACKGROUND Emotional distress, including depressive and anxiety symptoms, is a common concern among pregnant individuals and has negative impacts on maternal and offspring's health. Previous studies indicated the heterogeneity of perinatal emotional distress. Moreover, during the pandemic of COVID-19, expectant mothers are faced with more tough challenges, which could exacerbate their emotional distress. OBJECTIVE The aim of present study is to examine potential subgroups with distinct profiles on emotional distress and relationship resources during the pandemic. METHODS A total of 187 pregnant people in China were recruited from April 22 to May 16 in 2020. Latent profile analysis was applied based on prenatal depressive and anxiety symptoms, COVID-19-related negative emotions, prenatal attachment, marital satisfaction and family sense of coherence. RESULTS Four subgroups were identified. Group 1 and Group 2 shared with low levels of emotional distress and COVID-19-related negative emotions, among which Group 1 had plenty of relationship resources, while Group 2 had insufficient support. Group 3 had moderate levels of emotional distress but above-average prenatal attachment. Group 4 was a highly distressed subtype with severe emotional distress and poor states across all domains. CONCLUSION Our findings support that emotion distress among expecting mothers is heterogeneous, highlighting the need for tailed interventions to address the specific needs of subgroups during pregnancy.
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Affiliation(s)
- Xinyi Li
- School of Psychological and Cognitive Sciences and Beijing Key Laboratory of Behaviour and Mental Health, Peking University, Beijing, China
| | - Xi Wang
- School of Psychological and Cognitive Sciences and Beijing Key Laboratory of Behaviour and Mental Health, Peking University, Beijing, China
| | - Guangyu Zhou
- School of Psychological and Cognitive Sciences and Beijing Key Laboratory of Behaviour and Mental Health, Peking University, Beijing, China
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Abdominal examination during pregnancy may enhance relationships between midwife, mother and child: a qualitative study of pregnant women's experiences. BMC Pregnancy Childbirth 2023; 23:84. [PMID: 36721122 PMCID: PMC9887567 DOI: 10.1186/s12884-023-05392-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2022] [Accepted: 01/18/2023] [Indexed: 02/01/2023] Open
Abstract
BACKGROUND Abdominal examination is a routine procedure performed by midwives several times during pregnancy to monitor the growth and well-being of the baby. Literature and instructions regarding abdominal examination focus on the technical performance, with limited attention paid to the women's experience of the examination or the bonding-related aspects between the mother and baby. The aim of the study was to explore how pregnant women experience the abdominal examination and how the examination affects maternal-fetal attachment. METHODS Participant observation and semi-structured interviews with 10 pregnant women. We used thematic analysis to identify themes across the empirical material. RESULTS We identified the following four central themes: an essential examination, the baby becomes real, the importance of being involved and different senses provide different experiences. These themes describe how the women regarded the abdominal examination as an essential part of the midwifery consultation and considered it the occasion when the baby became real and tangible. Being prepared and involved before and during the examination were pivotal for how the examination was experienced by the women. The abdominal examination was crucial to the pregnant women because it provided them with important sensory aspects that were not obtained from ultrasound examination. CONCLUSION The abdominal examination is regarded as essential in midwifery consultations and has the potential for supporting a woman's bodily sensation of her baby, which is reinforced by the midwife's manual palpation. Touch can be a way for a pregnant woman to become acquainted with her unborn child, which provides midwives a profound potential to facilitate the process of maternal-fetal attachment.
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O'Reilly G, Cheung PS, McCaffrey T. A Pilot Study of Maternal Songwriting to Support Bonding During Pregnancy: "I Could Feel Her Rise and Fall With My Breath While Singing". J Midwifery Womens Health 2023; 68:205-209. [PMID: 36683203 DOI: 10.1111/jmwh.13463] [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: 07/26/2022] [Revised: 11/17/2022] [Accepted: 11/27/2022] [Indexed: 01/24/2023]
Abstract
INTRODUCTION Attachment is a lasting psychological and emotional bond that impacts a child's social, emotional, and cognitive development. Maternal-fetal attachment is a precursor to this bond that is regarded as a predictor for mother-infant relating postbirth. Although previous studies have investigated use of music interventions to support maternal-fetal attachment, no study to date has investigated the use of maternal songwriting to support this bond during pregnancy. METHODS Four pregnant women were recruited to this pilot study. Each woman participated in 2 songwriting workshops with the aim of writing an original song to their fetus. Following the workshops, experiences of using songwriting for the purposes of supporting bonding were investigated through individual semistructured interviews and analyzed using thematic content analysis. RESULTS Analysis of semistructured interviews with pregnant women revealed 3 main themes: song singing promotes physical connection with the fetus; songwriting encourages open communication with the fetus; and songwriting can create a musical legacy within families. DISCUSSION To the best of our knowledge, this study is the first of its kind that investigated maternal songwriting to support bonding during pregnancy. Findings indicated that songwriting has the potential to support such attachment due to its capacity to enhance physical connection and open communication with the fetus, while also creating a musical legacy that can be used and passed on among other family members. Overall, songwriting may support pregnant women to draw on their inner resources to create such a bespoke musical gift to their unborn child. Further research around this topic is warranted.
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Affiliation(s)
- Gemma O'Reilly
- Irish World Academy of Music and Dance, University of Limerick, Limerick, Ireland
| | - Pui Sze Cheung
- Irish World Academy of Music and Dance, University of Limerick, Limerick, Ireland
| | - Tríona McCaffrey
- Irish World Academy of Music and Dance, University of Limerick, Limerick, Ireland
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15
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Ağapınar Şahin S, Bekar M. The influence of laughter yoga on pregnancy symptoms, mental well-being, and prenatal attachment: A randomized controlled study. Health Care Women Int 2023; 44:782-801. [PMID: 36625775 DOI: 10.1080/07399332.2022.2164284] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
The researchers' aim was to evaluate the impact of laughter yoga on pregnancy symptoms, mental well-being, and prenatal attachment. They carried out this study on 85 pregnant women randomized in a maternity hospital in the Eastern Anatolia Region of Turkey. The researchers collected data using the Pregnant Introduction Form, Pregnancy Symptom Inventory (PSI), Warwick-Edinburgh Mental Well-being Scale (WEMWBS), and Prenatal Attachment Inventory (PAI). After applying the laughter yoga practice, they found that mental well-being and prenatal attachment levels were higher in pregnant women in the experimental group and the difference was statistically significant. Thus, they concluded that laughter yoga was an effective practice in reducing the frequency of pregnancy symptoms and limiting daily activities by pregnancy symptoms and increasing mental well-being and prenatal attachment levels.
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Affiliation(s)
- Safiye Ağapınar Şahin
- Department of Midwifery, Ataturk University Faculty of Health Science, Erzurum, Turkey
| | - Mine Bekar
- Faculty of Health Science, Department of Midwifery, Sivas Cumhuriyet University, Sivas, Turkey
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16
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Kang DI, Park E. Do taegyo practices, self-esteem, and social support affect maternal-fetal attachment in high-risk pregnant women? A cross-sectional survey. KOREAN JOURNAL OF WOMEN HEALTH NURSING 2022; 28:338-347. [PMID: 36617485 PMCID: PMC9830115 DOI: 10.4069/kjwhn.2022.12.16] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2022] [Accepted: 12/16/2022] [Indexed: 12/31/2022] Open
Abstract
PURPOSE The incidence of high-risk pregnancies is increasing in Korea as the birth age increasesdue to late marriage. Maternal-fetal attachment is an important factor that affects children even afterchildbirth, but it is difficult for high-risk pregnant women to form maternal-fetal attachment. Thecurrent study aimed to explore whether taegyo practice (i.e., pregnant women's efforts for fetal goodgrowth and development), self-esteem, and social support influenced the degree of maternal-fetalattachment in women with high-risk pregnancies. METHODS The participants included 226 pregnant Korean women at ≥20 gestational weeks, hospitalized with 15 high-risk pregnancy conditions as defined by the Ministry of Health and Welfare.Recruitment via convenience sampling was done at four sites in Busan, Korea. Surveys were distributed and collected from February 1 to 28, 2022. Data analysis was conducted using descriptive statistics, the t-test, one-factor analysis of variance, Pearson correlation coefficients, and hierarchicalmultiple regression. RESULTS On average, participants were 33.97±4.23 years of age and at 31.65±6.23 gestational weeks.Preterm labor (35.4%) and gestational diabetes (21.0%) were the most common high-risk conditions. Maternal-fetal attachment was positively correlated with taegyo practice (r=.70, p<.001),self-esteem (r=.53, p<.001), and social support (r=.53, p<.001), all with statistical significance. Taegyo practice (β=.50, p<.001) and social support (β=.17, p=.030) explained 53% of variance in maternal-fetal attachment in women with high-risk pregnancies. CONCLUSION Nurses caring for women with high-risk pregnancies during hospitalization can usethese findings by promoting taegyo practice and enhancing social support to increase maternal-fetalattachment.
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Affiliation(s)
- Da-In Kang
- Department of Nursing, Pukyong National University, Busan, Korea
| | - Euna Park
- Department of Nursing, Pukyong National University, Busan, Korea
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17
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Tohme P, Abi-Habib R, Nassar E, Hamed N, Abou-Ghannam G, Chalouhi GE. The Psychological Impact of the COVID-19 Outbreak on Pregnancy and Mother-infant Prenatal Bonding. Matern Child Health J 2022; 26:2221-2227. [PMID: 35972590 PMCID: PMC9379892 DOI: 10.1007/s10995-022-03464-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2021] [Revised: 07/14/2022] [Accepted: 07/18/2022] [Indexed: 11/25/2022]
Abstract
This study aimed to assess the impact of the COVID-19 stress and anxiety on prenatal attachment during the second trimester of gestation. Pregnancy is an important stage for mothers-to-be in creating representations of themselves as a “mother”, with the developing attachment relationship to the unborn child considered as a milestone in the future parent’s developmental trajectory. The outbreak of the COVID-19 pandemic and the national health measures installed can hence have consequences on these representations and on prenatal attachment. Our sample consisted of 95 mothers that were recruited from a prenatal ultrasound screening center. Results suggested that the COVID-19 pandemic significantly affected prenatal attachment (PAI) with significant correlations between PAI total score and age, anxiety (DASS) and stress (IES-R). When entered in one model looking for predictors of PAI total score, age and COVID-19 stress were the only variables found to significantly predict prenatal attachment. We argue for a cultural component in explaining these results, hypothesizing that stress could trigger defensive strategies, leading to more investment in the attachment relationship, potentially playing the role of a protective factor.
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Affiliation(s)
- Pia Tohme
- Department of Social And Education Sciences, School of Arts and Sciences, Lebanese American University, Beirut, Lebanon
| | - Rudy Abi-Habib
- Department of Social And Education Sciences, School of Arts and Sciences, Lebanese American University, Beirut, Lebanon.
| | - Elma Nassar
- Department of Social And Education Sciences, School of Arts and Sciences, Lebanese American University, Beirut, Lebanon
| | - Nouran Hamed
- Department of Obstetrics and Gynecology, American University of Beirut Medical Center, Beirut, Lebanon
| | - Gaël Abou-Ghannam
- Department of Obstetrics and Gynecology, Bellevue Medical Center, Beirut, Lebanon
| | - Gihad E Chalouhi
- Department of Obstetrics and Gynecology, American University of Beirut Medical Center, Beirut, Lebanon
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18
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The structure and correlates of the 20-item Maternal-Fetal Attachment Scale in a population-based sample of Hungarian expectant women. Midwifery 2022; 112:103422. [DOI: 10.1016/j.midw.2022.103422] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Revised: 06/27/2022] [Accepted: 07/01/2022] [Indexed: 10/17/2022]
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19
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McNamara J, Risi A, Bird AL, Townsend ML, Herbert JS. The role of pregnancy acceptability in maternal mental health and bonding during pregnancy. BMC Pregnancy Childbirth 2022; 22:267. [PMID: 35351015 PMCID: PMC8966290 DOI: 10.1186/s12884-022-04558-6] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2021] [Accepted: 03/08/2022] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND Pregnancy is an important time for women's mental health and marks the foundations of the emerging bond between mother and baby. This study aimed to investigate the role of pregnancy acceptability and intendedness in maternal mental health and bonding during pregnancy. METHODS Data were collected from a community sample of 116 Australian pregnant women (M = 29.54, SD = 5.31) through a series of self-report questionnaires pertaining to mental health and antenatal bonding. RESULTS Lower pregnancy acceptability was correlated with higher depression, anxiety and total distress, lower physical and environmental quality of life and lower antenatal bonding. Women who reported their pregnancy was intended reported higher physical quality of life than those who reported their pregnancy was unintended. The relationship between total distress and antenatal bonding was moderated by women's degree of pregnancy acceptability (low versus high). For women with low acceptability, higher distress was associated with lower bonding, but there was no such association for women with high pregnancy acceptability. The moderation model examining associations between distress and pregnancy acceptability explained 15% of the variance in antenatal bonding scores. CONCLUSION Consideration of women's appraisal of their pregnancy acceptability may provide a valuable framework for identifying individuals who may be at risk for mental health and bonding difficulties.
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Affiliation(s)
- Josephine McNamara
- School of Psychology, University of Wollongong, Wollongong, NSW, 2522, Australia.,Early Start, University of Wollongong, Wollongong, NSW, 2522, Australia
| | - Alixandra Risi
- School of Psychology, University of Wollongong, Wollongong, NSW, 2522, Australia.,Early Start, University of Wollongong, Wollongong, NSW, 2522, Australia
| | - Amy L Bird
- School of Psychology, University of Waikato, Hamilton, Waikato, 3240, New Zealand
| | - Michelle L Townsend
- School of Psychology, University of Wollongong, Wollongong, NSW, 2522, Australia.,Illawarra Health and Medical Research Institute, University of Wollongong, Wollongong, NSW, 2522, Australia
| | - Jane S Herbert
- School of Psychology, University of Wollongong, Wollongong, NSW, 2522, Australia. .,Early Start, University of Wollongong, Wollongong, NSW, 2522, Australia.
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20
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Infant Developmental Outcomes: Influence of Prenatal Maternal-Fetal Attachment, Adult Attachment, Maternal Well-Being, and Perinatal Loss. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19042433. [PMID: 35206621 PMCID: PMC8872269 DOI: 10.3390/ijerph19042433] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/24/2021] [Revised: 02/15/2022] [Accepted: 02/18/2022] [Indexed: 11/29/2022]
Abstract
Identification of prenatal characteristics that predict later infant development may afford opportunities for early intervention, potentially optimizing childhood development outcomes. The aim of the present study was to examine the effects of selected prenatal factors (maternal–fetal attachment, maternal adult attachment, maternal well-being, and previous perinatal loss) on later infant development. Pregnant women were recruited from two antenatal clinics at one tertiary hospital and asked to complete self-report questionnaires. The Bayley’s Scales of Infant and Toddler Development were then completed one to two years after their baby’s birth. Independent samples t-tests, correlational analyses, and multivariate linear regression models were conducted. Results from 40 dyads revealed that more favorable maternal–fetal attachment, more secure/less anxious maternal attachment, and higher maternal well-being predicted maternal reports of infant adaptive behavior regardless of previous perinatal loss. Infants of women without perinatal loss scored higher in external observer-rated cognitive development compared to infants of women with previous perinatal loss. While further research is required, findings indicate that a mother’s well-being and her relationship with her baby during pregnancy contributes to positive perceptions of her infant’s daily living skills. Supporting the parenting of women with perinatal loss is required to, in turn, promote optimal cognitive development in infants.
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21
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Filippetti ML, Clarke ADF, Rigato S. The mental health crisis of expectant women in the UK: effects of the COVID-19 pandemic on prenatal mental health, antenatal attachment and social support. BMC Pregnancy Childbirth 2022; 22:68. [PMID: 35081906 PMCID: PMC8790719 DOI: 10.1186/s12884-022-04387-7] [Citation(s) in RCA: 24] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2021] [Accepted: 01/04/2022] [Indexed: 12/14/2022] Open
Abstract
Background Pregnancy has been shown to be times in a woman’s life particularly prone to mental health issues, however a substantial percentage of mothers report subclinical perinatal mental health symptoms that go undetected. Experiences of prenatal trauma, such as the COVID-19 pandemic, may exacerbate vulnerability to negative health outcomes for pregnant women and their infants. We aimed to examine the role of: 1) anxiety, depression, and stress related to COVID-19 in predicting the quality of antenatal attachment; 2) perceived social support and COVID-19 appraisal in predicting maternal anxiety and depression. Methods A sample of 150 UK expectant women were surveyed during the COVID-19 pandemic. Questions included demographics, pregnancy details, and COVID-19 appraisal. Validated measures were used to collect self-reported maternal antenatal attachment (MAAS), symptoms of anxiety (STAI), depression (BDI-II), and stress related to the psychological impact of COVID-19 (IES-r). Results We found that the pandemic has affected UK expectant mothers’ mental health by increasing prevalence of depression (47%), anxiety (60%) and stress related to the psychological impact of COVID-19 (40%). Women for whom COVID-19 had a higher psychological impact were more likely to suffer from depressive (95% HDPI = [0.04, 0.39]) and anxiety symptoms (95% HPDI = [0.40, 0.69]). High depressive symptoms were associated with reduced attachment to the unborn baby (95% HPDI [-0.46, -0.1]). Whilst women who appraised the impact of COVID-19 to be more negative showed higher levels of anxiety (HPDI = [0.15, 0.46]), higher social support acted as a protective factor and was associated with lower anxiety (95% HPDI = [-0.52, -0.21]). Conclusions The current findings demonstrate that direct experience of prenatal trauma, such as the one experienced during the COVID-19 pandemic, significantly amplifies mothers’ vulnerability to mental health symptoms and impairs the formation of a positive relationship with their unborn baby. Health services should prioritise interventions strategies aimed at fostering support for pregnant women. Supplementary Information The online version contains supplementary material available at 10.1186/s12884-022-04387-7.
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Affiliation(s)
- Maria Laura Filippetti
- Centre for Brain Science, Department of Psychology, University of Essex, Colchester, UK.
| | - Alasdair D F Clarke
- Centre for Brain Science, Department of Psychology, University of Essex, Colchester, UK
| | - Silvia Rigato
- Centre for Brain Science, Department of Psychology, University of Essex, Colchester, UK
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22
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Craig F, Gioia MC, Muggeo V, Cajiao J, Aloi A, Martino I, Tenuta F, Cerasa A, Costabile A. Effects of maternal psychological distress and perception of COVID-19 on prenatal attachment in a large sample of Italian pregnant women. J Affect Disord 2021; 295:665-672. [PMID: 34509782 PMCID: PMC8428478 DOI: 10.1016/j.jad.2021.08.102] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2021] [Revised: 07/21/2021] [Accepted: 08/28/2021] [Indexed: 12/23/2022]
Abstract
BACKGROUND Evidence concerning the impact of COVID-19-related stress exposure on prenatal attachment in pregnant women is unknown. In this study we sought to assess the effect of psychological distress and risk perception of COVID-19 on prenatal attachment in a Italian sample of pregnant women. METHODS 1179 pregnant women completed an anonymous online survey and self-report questionnaires measuring socio-demographic and obstetric characteristics, psychological distress (STAI Form Y-1-2 and BDI-II), prenatal attachment (PAI) and risk perception of COVID-19. Data were collected from March 2020 to April 2020 referring to the national lockdown period. RESULTS After adjusting for the socio-demographic and obstetric factors in the multivariable analysis, we found out the state anxiety was shown to be a significant predictor (p < 0001) of prenatal attachment. Moreover, the COVID-19-risk perception positively moderate the relationship between trait anxiety and prenatal attachment (p=0008), indicating that when COVID-19-risk perception is high, the effects of trait anxiety on prenatal attachment is attenuated. The synergistic effect between STAI Form Y-1 and COVID-19-risk perception index on PAI is partially mediated by STAI Form Y-2 score. CONCLUSIONS Findings from this study showed that state anxiety related to COVID-19 outbreak in pregnant women may affect the prenatal attachment process of the expectant mother negatively. However, an adequate and functional perception of COVID-19 could enhance prenatal attachment. These results underline the importance of monitoring the prenatal attachment process and the mother's mental health during pandemics, to safeguard maternal and infant mental health.
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Affiliation(s)
- Francesco Craig
- Department of Cultures, Education and Society, University of Calabria, Cosenza, Italy
| | - Maria Cecilia Gioia
- iGreco Ospedali Riuniti - Sacro Cuore Corso Italia, 50, 87100 Cosenza CS; Associazione di Volontariato Mammachemamme, Cosenza, Italy.
| | - Vito Muggeo
- Department of Economics, Business and Statistics, University of Palermo, Palermo, Italy
| | - Juanita Cajiao
- Faculty of Medicine Universitat de Barcelona, Barcelona, Spain,Grupo de Investigación en Salud, Fundación Universitaria CAFAM, Colombia
| | - Alessia Aloi
- Associazione di Volontariato Mammachemamme, Cosenza, Italy
| | - Iolanda Martino
- Department of Medical and Surgical Sciences, Institutes of Neurology, Magna Græcia University of Catanzaro, Catanzaro, Italy
| | - Flaviana Tenuta
- Department of Cultures, Education and Society, University of Calabria, Cosenza, Italy
| | - Antonio Cerasa
- Institute for Biomedical Research and Innovation, National Research Council (IRIB-CNR), 98164, Messina, Italy,S’Anna Institute, 88900 Crotone, Italy
| | - Angela Costabile
- Department of Cultures, Education and Society, University of Calabria, Cosenza, Italy
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Oruç M, Kukulu K. The relationship between maternal function and maternal attachment of women during the postpartum period. J Reprod Infant Psychol 2021; 40:288-298. [PMID: 34348545 DOI: 10.1080/02646838.2021.1962824] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
OBJECTIVE The objective of this study was to investigate the relationship between maternal functions including self-care and adjustment and maternal attachment during the postpartum period. BACKGROUND Mothers adapt to their new role during the postpartum period by recognising both their baby and their physical, emotional, and social recovery. During this period, a mother's interaction with her baby supports attachment. METHOD The study design was planned as a descriptive-relational type. The study was performed in two Family Healthcare Centres located in Antalya city, Turkey country. The population of the study consisted of 250 mothers aged 18-45 years who had a postpartum period between 8 and 11 weeks. A simple sampling method was used. Data were collected using the mothers' identification forms, the Barkin Index of Maternal Function, and the Maternal Attachment Inventory. The forms were administered to mothers via the face-to-face interview method. Numerical, percental, and relational statistical methods as well as arithmetic means were used in the data analysis. RESULTS The mean score of the Barkin Index of the Maternal Function was 76.97 ± 10.19 and the mean score of the Maternal Attachment Inventory was 100.92 ± 3.17. There was a positive, low, and significant relationship between maternal function and maternal attachment (r = 0.22, p = 0.00). There was a positive, low, and significant relationship between maternal attachment and self-care, maternal psychology, infant care, social support, and maternal adjustment scores. CONCLUSION The maternal attachment level was found to be high in women with high maternal function. To develop the relationship between functional status and maternal attachment, mothers may provided with social support and, if necessary, psychological support.
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Affiliation(s)
- Mine Oruç
- Antalya Research and Education Hospital, Antalya Health Science University
| | - Kamile Kukulu
- Faculty of Nursing, Akdeniz University, Antalya, Turkey
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24
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Fu F, Yan P, You S, Mao X, Qiao T, Fu L, Wang Y, Dai Y, Maimaiti P. The pregnancy-related anxiety characteristics in women with gestational diabetes mellitus: why should we care? BMC Pregnancy Childbirth 2021; 21:424. [PMID: 34112107 PMCID: PMC8194142 DOI: 10.1186/s12884-021-03887-2] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2020] [Accepted: 05/20/2021] [Indexed: 12/24/2022] Open
Abstract
Background Gestational diabetes mellitus (GDM) is very commonly-seen in clinical settings, and GDM patients may have higher levels of anxiety. It’s necessary to evaluate the anxiety level and potentially influencing factors in patients with GDM, to provide insights for the management of anxiety of GDM patients. Methods Patients with GDM treated in our hospital from May, 2018 to May, 2020 were included. We evaluated the characteristics of patients and the scores of pregnancy-related anxiety scale for anxiety level, vulnerable personality style questionnaire (VPSQ) for personality, general self-efficacy scale (GSES) for self-efficacy, social support rating scale (SSRS) for social support level. Logistic regression analyses were conducted to identify the potential influencing factors of anxiety in GDM patients. Results A total of 386 GDM patients were included, the incidence of anxiety in patients with GDM was 59.07%. Anxiety was positively correlated with the susceptible personality (r = 0.604, p = 0.023), and it was negatively correlated with self-efficacy and social support (r = -0.586 and -0.598 respectively, all p < 0.05). The education level, monthly income, abnormal pregnancy (miscarriage, premature rupture of membranes) and cesarean section history and first pregnancy were the independent influencing factors for the anxiety in the patients with GDM (all p < 0.05). Conclusions The anxiety of GDM patients is very common, early care and interventions are warranted for those patients with abnormal pregnancy and cesarean section history, first pregnancy, lower education level, and less monthly income.
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Affiliation(s)
- Feng Fu
- School of Nursing, Xinjiang Medical University, No. 567, Shangde North Road, Urumqi, 830000, Xinjiang, China
| | - Ping Yan
- School of Nursing, Xinjiang Medical University, No. 567, Shangde North Road, Urumqi, 830000, Xinjiang, China
| | - Shuping You
- School of Nursing, Xinjiang Medical University, No. 567, Shangde North Road, Urumqi, 830000, Xinjiang, China
| | - Xinmin Mao
- School of Nursing, Xinjiang Medical University, No. 567, Shangde North Road, Urumqi, 830000, Xinjiang, China
| | - Tingting Qiao
- Reproductive Medicine Center, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, China
| | - Li Fu
- Emergency Trauma Center, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, China
| | - Yanni Wang
- School of Nursing, Xinjiang Medical University, No. 567, Shangde North Road, Urumqi, 830000, Xinjiang, China
| | - Yali Dai
- School of Nursing, Xinjiang Medical University, No. 567, Shangde North Road, Urumqi, 830000, Xinjiang, China
| | - Palida Maimaiti
- School of Nursing, Xinjiang Medical University, No. 567, Shangde North Road, Urumqi, 830000, Xinjiang, China.
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25
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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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Maternal-fetal attachment and perceived parental bonds of pregnant women. Early Hum Dev 2021; 154:105310. [PMID: 33508560 PMCID: PMC7910275 DOI: 10.1016/j.earlhumdev.2021.105310] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2020] [Revised: 12/22/2020] [Accepted: 01/11/2021] [Indexed: 11/24/2022]
Abstract
BACKGROUND The parental bond is characterized by the perception of care and protection received by parental figures throughout human development. During the gestational period, the intensity in which the woman manifests behaviors and feelings for the fetus was denominated maternal-fetal attachment (MFA). In this perspective, the literature indicates that there is association between MFA and the pregnant woman's perception about the bond established with her parents. AIMS This study aimed to evaluate the association between MFA and perceived parental bonds of pregnant women in the city of Pelotas/RS (Brazil). STUDY DESIGN This is a cohort study with 839 women during their gestational period. All women answered to the Parental Bonding Instrument to investigate the perceived parental bonds, and the MFA was assessed through the Maternal-Fetal Attachment Scale. RESULTS The main results showed that perceived paternal overprotection was associated with a higher MFA after adjustment (B 2.00 CI95% 0.30; 3.70). Additionally, the pregnant women who were in the first trimester of pregnancy (p < 0.001), who did not live with a partner (p = 0.018), and who did not feel supported by the baby's father during pregnancy (p = 0.014) presented lower scores of MFA. CONCLUSION This study showed the importance of the paternal role in the women's life, considering the perception of the bond with their father during their development, an adequate support by the father of the baby, and the presence of a partner during pregnancy. As a result, the paternal role may influence the feelings and behaviors of greater affection, care, and concern regarding the fetus.
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Smith M, Mitchell AS, Townsend ML, Herbert JS. The relationship between digital media use during pregnancy, maternal psychological wellbeing, and maternal-fetal attachment. PLoS One 2020; 15:e0243898. [PMID: 33326465 PMCID: PMC7743947 DOI: 10.1371/journal.pone.0243898] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2020] [Accepted: 11/30/2020] [Indexed: 11/18/2022] Open
Abstract
The widespread accessibility and use of the internet provides numerous opportunities for women to independently seek out pregnancy-related information and social and emotional support during the antenatal period. Given the heightened psychological vulnerability of the pregnancy period there is a critical need to examine digital media use within the context of the feelings that women have about themselves and towards their fetus. The current study examined the relationship between digital media use during pregnancy, psychological wellbeing and their maternal-fetal attachment using an online survey. Forty-eight pregnant women completed a self-report questionnaire on their reasons for using digital media, and standardised measures of self-criticism, negative affect, social quality of life (QOL), and maternal-fetal attachment. The mean age of participants was 29.4 years (SD = 5.26), with a mean of 24.3 weeks gestation (SD = 9.95). Information seeking, emotional support and social support were highly endorsed reasons for digital media use (85.42%, 66.67%, 62.5% respectively). However, digital media use was positively correlated with negative affect (p = .003) and self-criticism (p < .001). Digital media use was also negatively correlated with QOL (p = .007). There was no evidence of a relationship between digital media use and maternal-fetal attachment (p = .330). Digital environments may be an important social context within which a pregnant woman develops her own maternal identity and knowledge. There are a number of benefits and limitations of this medium for providing information and support for women during pregnancy. Enhancing the opportunities to promote pregnant women's wellbeing in this context is an important avenue for further research and practice.
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Affiliation(s)
- Melissa Smith
- School of Psychology, University of Wollongong, Wollongong, New South Wales, Australia
| | - Annaleise S. Mitchell
- School of Psychology, University of Wollongong, Wollongong, New South Wales, Australia
- Early Start, University of Wollongong, Wollongong, New South Wales, Australia
| | - Michelle L. Townsend
- School of Psychology, University of Wollongong, Wollongong, New South Wales, Australia
- Illawarra Health and Medical Research Institute, University of Wollongong, Wollongong, Australia
| | - Jane S. Herbert
- School of Psychology, University of Wollongong, Wollongong, New South Wales, Australia
- Early Start, University of Wollongong, Wollongong, New South Wales, Australia
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Schaal NK, Marca-Ghaemmaghami PL, Preis H, Mahaffey B, Lobel M, Amiel Castro R. The German version of the pandemic-related pregnancy stress scale: A validation study. Eur J Obstet Gynecol Reprod Biol 2020; 256:40-45. [PMID: 33166796 DOI: 10.1016/j.ejogrb.2020.10.062] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2020] [Accepted: 10/23/2020] [Indexed: 10/23/2022]
Abstract
OBJECTIVE The consequences of the COVID-19 pandemic may lead to exceptional stress in pregnant women. In order to evaluate stress levels of pregnant woman in this difficult time, the Pandemic-Related Pregnancy Scale (PREPS) was introduced in the US. The present study introduces and validates the German version of the PREPS. STUDY DESIGN In total, 1364 German-speaking pregnant women from Germany and Switzerland took part in this online cohort study and completed the PREPS as well as gave information on sociodemographic, obstetric and other psychological factors. RESULTS A confirmatory factor analysis of the PREPS showed very good psychometric values and confirmed the structure of the original questionnaire. The PREPS comprises three dimensions: Infection Stress (5 items), Preparedness Stress (7 items) and Positive Appraisal (3 items). Furthermore, correlations between the PREPS and other psychological factors such as Pregnancy Specific Stress and Fear of Childbirth highlight convergent validity. The sensitivity of the questionnaire was demonstrated by its associations with several obstetric and COVID-19 related factors. CONCLUSION The German PREPS showed good psychometric properties and is a useful instrument for future studies which aim to investigate the impact of pandemic-related stress on birth outcomes and postpartum factors.
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Affiliation(s)
- Nora K Schaal
- Institute of Experimental Psychology, Heinrich-Heine-University, Duesseldorf, Germany.
| | - Pearl La Marca-Ghaemmaghami
- Psychology Research and Counselling Institute for Sexuality, Marriage, and Family, International Academy for Human Sciences and Culture, Walenstadt, Switzerland
| | - Heidi Preis
- Department of Psychology, Stony Brook University, Stony Brook, NY, USA; Department of Pediatrics, Renaissance School of Medicine, Stony Brook University, Stony Brook, NY, USA
| | - Brittain Mahaffey
- Department of Psychiatry and Behavioral Health, Renaissance School of Medicine, Stony Brook University, Stony Brook, NY, USA
| | - Marci Lobel
- Department of Psychology, Stony Brook University, Stony Brook, NY, USA
| | - Rita Amiel Castro
- Department of Clinical Psychology and Psychotherapy, University of Zurich, Zurich, Switzerland
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Kucharska M. Selected predictors of maternal-fetal attachment in pregnancies with congenital disorders, other complications, and in healthy pregnancies. HEALTH PSYCHOLOGY REPORT 2020; 9:193-206. [PMID: 38084226 PMCID: PMC10694702 DOI: 10.5114/hpr.2020.97295] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2020] [Revised: 06/13/2020] [Accepted: 06/15/2020] [Indexed: 03/19/2024] Open
Abstract
BACKGROUND The mother-infant attachment begins to form during pregnancy and is important for the future development of the child. Pregnancy complications can affect this relationship. The purpose of the study was to identify predictors of maternal-fetal attachment in physiological and high-risk pregnancies. PARTICIPANTS AND PROCEDURE The study group included women in pregnancies with congenital disorders (n = 65) or with other pregnancy complications (n = 65). A third group included women in healthy pregnancies (n = 65). Data were collected by: the Maternal-Fetal Attachment Scale, the Questionnaire of Attachment Styles, the Rosenberg Self-Esteem Scale, the State-Trait Anxiety Inventory, the Social Support Scale, a standardized interview, the Dependency on Intimate Partner Scale, and the Pregnancy Experiences Scale. RESULTS No significant differences in maternal-fetal attachment (MFA) were found between the groups. No predictors of MFA were observed for the women with a pregnancy with a congenital disorder. In the group of pregnancies with other complications, the only predictor of attachment intensity was pregnancy experience: a more negative attitude toward pregnancy was associated with lower MFA. In physiological pregnancies, MFA was found to be determined by pregnancy experience, gestational age, maternal age and dependency on one's intimate partner. MFA increased as pregnancy progressed. Younger mothers in physiological pregnancies, who have more positive pregnancy experiences and are less dependent on a partner, achieve higher levels of MFA. CONCLUSIONS The presence of high-risk pregnancy, or its absence, does not differentiate the intensity of the emotional bond between mother and fetus. However, women with healthy pregnancies demonstrate different predictors of MFA than those with high-risk pregnancies.
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Ponti L, Smorti M, Ghinassi S, Tani F. The relationship between romantic and prenatal maternal attachment: The moderating role of social support. INTERNATIONAL JOURNAL OF PSYCHOLOGY 2020; 56:143-150. [PMID: 32319679 DOI: 10.1002/ijop.12676] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2019] [Accepted: 04/01/2020] [Indexed: 11/11/2022]
Abstract
The aim of this study was to examine the relationships between three types of maternal attachment bonds: anxious romantic, avoidant romantic and prenatal. The moderating role of perceived social support is also analysed. Ninety-one pregnant women in or near their thirtieth week of gestation (M = 29.59; SD = 4.57) were recruited, all of whom completed a series of questionnaires to assess the quality of their romantic and prenatal attachment bonds and their levels of perceived social support. The results reveal that both anxious and avoidant romantic attachments were significantly associated with low levels of maternal prenatal attachment. Moreover, the level of social support perceived during pregnancy moderated the relationship between anxious and prenatal attachments but had no effect on avoidant romantic and prenatal attachments. Our discussion of these findings considers the emotional and behavioural characteristics of various forms of insecure romantic attachments. Overall, the data highlight the relevance of the quality of intimate close relationships on maternity experiences and women's caregiving abilities.
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Affiliation(s)
- Lucia Ponti
- Department of Health Sciences, University of Florence, Florence, Italy
| | - Martina Smorti
- Department of Surgical, Medical and Molecular Pathology and Critical Care Medicine, University of Pisa, Pisa, Italy
| | - Simon Ghinassi
- Department of Health Sciences, University of Florence, Florence, Italy
| | - Franca Tani
- Department of Health Sciences, University of Florence, Florence, Italy
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Prenatal Attachment and Perinatal Depression: A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17082644. [PMID: 32290590 PMCID: PMC7216181 DOI: 10.3390/ijerph17082644] [Citation(s) in RCA: 51] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/14/2020] [Revised: 04/05/2020] [Accepted: 04/08/2020] [Indexed: 11/17/2022]
Abstract
Pregnancy is a period of complex bio-psychological changes, during which the development of an attachment bond to the fetus takes on a central role. Depressive symptoms are common during this period. Both symptoms of depression and low levels of prenatal attachment are related to negative outcomes in caregivers and infants. Following the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) statement, this systematic review analyzes and systematizes 41 studies concerning the association between prenatal attachment and perinatal depression. The majority of the studies reported a significant association between the two. Specifically, prenatal depressive symptoms were found to be negatively associated with prenatal attachment. Furthermore, lower levels of prenatal attachment were related to higher postnatal depressive symptoms, although fewer studies assessed this association. While these results were found across different populations, conflicting findings emerged, suggesting they should be interpreted with caution, particularly in male samples and in non-normative pregnancies (e.g., high-risk pregnancies, medically assisted pregnancies, and pregnancies with previous perinatal losses). These results are clinically important for the perinatal screening process and for implementing preventive and treatment programs. However, future studies are needed to further confirm and generalize these results.
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Celik M, Ergin A. The effect on pregnant women's prenatal attachment of a nursing practice using the first and second Leopold's maneuvers. Jpn J Nurs Sci 2019; 17:e12297. [PMID: 31762185 DOI: 10.1111/jjns.12297] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2019] [Revised: 06/25/2019] [Accepted: 07/12/2019] [Indexed: 11/27/2022]
Abstract
OBJECTIVE This study aimed to determine the effect on pregnant women's prenatal attachment of a nursing practice using the first and second Leopold's maneuvers. METHOD This experimental, randomized and controlled study was conducted in a pregnancy class of a training and research hospital in Kocaeli, Turkey from September 2016 to September 2017. Its sample included 100 pregnant women, 50 in the experimental group and 50 in the control group (https://www.random.org, accessed: 09.20.2016). Data were collected using a personal information form, the Prenatal Attachment Inventory (PAI) and the Fetal Position Awareness Scale (FPAS). The study offered education that included fetal development, the first and second Leopold's maneuvers, and Leopold's maneuvers were administered in the 28th week of the women's pregnancy and re-administered in the 32nd and 36th weeks of pregnancy. No intervention was administered to the control group in these weeks, but the scales were administered. RESULTS The sociodemographic, obstetric, social support and baby-related characteristics of the groups were similar (p > .05). There were no statically significant differences between their mean PAI and FPAS scores in the 28th week of pregnancy (p > .05). The experimental group's mean PAI and the FPAS scores in the 32nd and 36th weeks of pregnancy were significantly higher than those of the control group (p < .01). CONCLUSION The study concluded that Leopold's maneuvers affected the pregnant women's prenatal attachment levels.
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Affiliation(s)
- Meryem Celik
- Faculty of Medicine Research, Teaching Hospital, MSN, Kocaeli University, Kocaeli, Turkey
| | - Ayla Ergin
- Faculty of Health Sciences, Midwifery Department, Kocaeli University, Kocaeli, Turkey
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O'Malley EG, Walsh MC, Reynolds CM, Kennelly M, Sheehan SR, Turner MJ. A cross-sectional study of maternal-fetal attachment and perceived stress at the first antenatal visit. J Reprod Infant Psychol 2019; 38:271-280. [PMID: 31271307 DOI: 10.1080/02646838.2019.1637516] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
BACKGROUND Maternal-fetal attachment (MFA) psychologically is well described. Suboptimal attachment may have negative consequences particularly if it is associated with unhealthy maternal behaviour that may potentially increase the risk of adverse pregnancy outcomes. The perception of stress or anxiety is also associated with potential adverse outcomes including preterm birth. OBJECTIVE This cross-sectional study examined MFA and perceived stress at the time of the first ultrasound examination in early pregnancy. METHODS Convenience sampling was used to recruit women after they presented to the Ultrasound Department for a routine dating ultrasound at their first antenatal visit. Informed consent was obtained and clinical and sociodemographic details were recorded. Women were invited to complete validated Cranley MFA and Perceived Stress Scale (PSS) questionnaires. RESULTS Of the 90 women recruited, 80 completed the questionnaires successfully. No association was found between the MFA score and maternal age, parity, education, marital status, previous pregnancy loss or smoking behaviour. An unplanned pregnancy was associated with a lower mean MFA score (p < 0.01) and a higher mean PSS score (p < 0.005). These relationships persisted in a multiple regression analysis controlling for maternal age and parity. CONCLUSION In early pregnancy, an unplanned pregnancy is associated with a lower MFA and higher PSS score. Additional research is required to assess if this persists as pregnancy advances. ABBREVIATIONS Maternal-Fetal Attachment (MFA), Maternal-Fetal Attachment Scale (MFAS), Perceived stress scale (PSS), Maternal Antenatal Attachment Scale (MAAS), Standard Deviation (SD), Central Statistics Office (CSO), Body Mass Index (BMI), Relative Risk (RR).
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Affiliation(s)
- Eimer G O'Malley
- Centre for Human Reproduction, University College Dublin (UCD) , Dublin, Ireland
| | - Mary Catherine Walsh
- Centre for Human Reproduction, University College Dublin (UCD) , Dublin, Ireland
| | - Ciara Me Reynolds
- Centre for Human Reproduction, University College Dublin (UCD) , Dublin, Ireland
| | - Mairead Kennelly
- Department of Obstetrics and Gynaecology, Coombe Women and Infants University Hospital , Dublin, Ireland
| | - Sharon R Sheehan
- Department of Obstetrics and Gynaecology, Coombe Women and Infants University Hospital , Dublin, Ireland
| | - Michael J Turner
- Centre for Human Reproduction, University College Dublin (UCD) , Dublin, Ireland
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