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Thompson T, Tisher J, Davis S, Miller C, Kirk J, Tartaglia N, Howell S. The emotional journey of adapting to prenatally identified trisomy X. J Genet Couns 2024; 33:793-804. [PMID: 37691399 PMCID: PMC10924744 DOI: 10.1002/jgc4.1778] [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: 04/21/2023] [Revised: 07/14/2023] [Accepted: 08/19/2023] [Indexed: 09/12/2023]
Abstract
There is a paucity of research on the experiences of parents of children with trisomy X (47,XXX). Increased prenatal diagnoses associated with advances in noninvasive prenatal screening necessitate a better understanding of how trisomy X impacts family systems. This qualitative investigation aimed to describe the lived experience of parents of young daughters with prenatally identified trisomy X to guide genetic counseling. Semi-structured qualitative interviews were conducted via teleconferencing with parents (n = 11) of girls with trisomy X, ages 6-44 months. A descriptive phenomenological approach was used to code transcripts for significant statements and reduce data into themes describing the experience of receiving a diagnosis of trisomy X and the experience of early parenting in this population. Participants described an emotional journey of adapting to prenatally identified trisomy X. Four descriptive themes included two related, yet distinct, life stages: Negative Diagnostic Experience and a Hopeful Early Childhood, as well as two ongoing experiences: Persistent Ambiguity and Coping with and Adapting to Uncertainty. Results suggest providers should carefully consider word choice and timing in delivery of diagnosis, and genetic counseling should provide expectant parents with current research specific to trisomy X, facilitate connections with other parents of young girls with trisomy X, introduce developmental monitoring approaches, and be prepared to support families with a range of emotional responses to the diagnosis and decisions regarding disclosure.
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Affiliation(s)
- Talia Thompson
- Department of Pediatrics, University of Colorado School of Medicine, Aurora, Colorado
- eXtraordinarY Kids Program, Children’s Hospital Colorado, Aurora, Colorado
| | - Jessica Tisher
- Genetic Counseling Graduate Program, University of Colorado, Anschutz Medical Campus, Aurora, Colorado
- Avera Health, Sioux Falls, South Dakota
| | - Shanlee Davis
- Department of Pediatrics, University of Colorado School of Medicine, Aurora, Colorado
- eXtraordinarY Kids Program, Children’s Hospital Colorado, Aurora, Colorado
| | - Christina Miller
- Genetic Counseling Graduate Program, University of Colorado, Anschutz Medical Campus, Aurora, Colorado
| | - Jillian Kirk
- Genetic Counseling Graduate Program, University of Colorado, Anschutz Medical Campus, Aurora, Colorado
| | - Nicole Tartaglia
- Department of Pediatrics, University of Colorado School of Medicine, Aurora, Colorado
- eXtraordinarY Kids Program, Children’s Hospital Colorado, Aurora, Colorado
| | - Susan Howell
- Department of Pediatrics, University of Colorado School of Medicine, Aurora, Colorado
- eXtraordinarY Kids Program, Children’s Hospital Colorado, Aurora, Colorado
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Fuchs A, Resch F, Kaess M, Moehler E. Early Parenting Stress Links Obstetric Complications and Child Psychopathology in Middle Childhood in an At-Risk Sample. J Dev Behav Pediatr 2022; 43:e48-e55. [PMID: 33908374 DOI: 10.1097/dbp.0000000000000960] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2020] [Accepted: 03/03/2021] [Indexed: 11/26/2022]
Abstract
OBJECTIVE Obstetric complications (OCs) are adverse events during pregnancy, birth, or immediately after birth. Evidence on cumulative OC and longitudinal associations with child psychopathology is sparse. Prospective studies testing mediating pathways such as parenting stress are needed. This study aimed to investigate the impact of OC on child psychopathology in middle childhood and to highlight whether and which type of parenting stress specifically mediates this association. METHODS We investigated n = 54 mother-child dyads from 5 months to 8 years of age. Child psychopathology at 8 years and parenting stress at 12 months were assessed using the Child Behavior Checklist (CBCL) and the Parenting Stress Index. OCs were evaluated by the Steinhausen Questionnaire and through access to official pregnancy records at the 5-month visit. Half of the mothers had experienced early-life maltreatment (ELM), assessed with the Childhood Trauma Questionnaire. RESULTS There was a significant indirect effect of maternal parenting stress at 12 months mediating the association between OC and child psychopathology at 8 years (β = 0.26; p < 0.01; 95% [0.35-1.83]). A significant proportion of 35% of CBCL-variance was explained. The significant effect remained even when maternal ELM and maternal psychological distress were controlled for. On the subscale level, only the "Difficult Child" subscale was a significant mediator. CONCLUSION Our findings suggest that parenting stress should be targeted to prevent adverse effects of OC on child psychopathology. More research focusing on families subjected to OC is needed to highlight how maternal parenting stress and child regulatory functioning interact to affect child development longitudinally.
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Affiliation(s)
- Anna Fuchs
- Centre for Psychosocial Medicine, Department of Child and Adolescent Psychiatry, University Hospital Heidelberg, Heidelberg, Germany
- Department of Psychology, Pennsylvania State University, University Park, PA
| | - Franz Resch
- Centre for Psychosocial Medicine, Department of Child and Adolescent Psychiatry, University Hospital Heidelberg, Heidelberg, Germany
| | - Michael Kaess
- Centre for Psychosocial Medicine, Department of Child and Adolescent Psychiatry, University Hospital Heidelberg, Heidelberg, Germany
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
| | - Eva Moehler
- Centre for Psychosocial Medicine, Department of Child and Adolescent Psychiatry, University Hospital Heidelberg, Heidelberg, Germany
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital Saarland, Homburg, Germany
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Schifsky K, Deavenport-Saman A, Mamey MR, Sheth N, Mirzaian CB, Schrager SM, Chmait RH, Vanderbilt DL. Risk Factors for Parenting Stress in Parents of Children Treated with Laser Surgery for Twin-Twin Transfusion Syndrome 2 Years Postpartum. Am J Perinatol 2021; 38:944-951. [PMID: 31986541 DOI: 10.1055/s-0040-1701194] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
OBJECTIVE Twin-twin transfusion syndrome (TTTS) is a rare but serious condition that can occur in monochorionic and diamniotic twin pregnancies. Research indicates almost half of postpartum mothers with TTTS may have clinically significant levels of stress. However, no studies have measured the levels of parenting stress at 2 years postpartum, and little research has been conducted on sources of stress. STUDY DESIGN A prospective cohort study was conducted. Data were collected from parents whose children were treated with laser ablation in utero and were 2 years old at the time of screening. The Parenting Stress Index - Short Form (PSI-SF) and its three subscales were used to collect data. Descriptive, bivariate, and multivariate analyses were conducted to determine significant predictors associated with each outcome. RESULTS A total of 99 children from 56 families were enrolled. Unmarried status (B = -22.8; p = 0.039) and lower maternal educational level (B = -7.8; p = 0.01) were both significantly associated with higher PSI-SF total score. CONCLUSION Subgroups of parents whose pregnancy required laser surgery for TTTS may continue to have clinically significant levels of stress at 2 years postpartum. It is important the health care team is aware of this and the sociodemographic risk factors to provide appropriate support for families.
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Affiliation(s)
- Kelly Schifsky
- Department of Pediatrics, USC University Center for Excellence in Developmental Disabilities, Children's Hospital Los Angeles, Los Angeles, California
| | - Alexis Deavenport-Saman
- Department of Pediatrics, USC University Center for Excellence in Developmental Disabilities, Children's Hospital Los Angeles, Los Angeles, California
| | - Mary Rose Mamey
- USC Suzanne Dworak-Peck School of Social Work, Los Angeles, California
| | - Nidhi Sheth
- College of Osteopathic Medicine of the Pacific, Western University of Health Sciences, Pomona, California
| | - Christine B Mirzaian
- Department of Pediatrics, USC University Center for Excellence in Developmental Disabilities, Children's Hospital Los Angeles, Los Angeles, California
| | - Sheree M Schrager
- Division of Hospital Medicine, Department of Pediatrics, Children's Hospital Los Angeles, Los Angeles, California
| | - Ramen H Chmait
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, USC Keck School of Medicine, Los Angeles, California
| | - Douglas L Vanderbilt
- Department of Pediatrics, USC University Center for Excellence in Developmental Disabilities, Children's Hospital Los Angeles, Los Angeles, California
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Chase T, Fusick A, Pauli JM. Couvade syndrome: more than a toothache. J Psychosom Obstet Gynaecol 2021; 42:168-172. [PMID: 31769327 DOI: 10.1080/0167482x.2019.1693539] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
Abstract
BACKGROUND Couvade Syndrome is best characterized as a somatic symptom disorder where the partner experiences somatic symptoms during their partner's pregnancy most often during the first and third trimesters. Several psychoanalytical theories have been proposed for this disorder. There are well studied mood changes that correspond to hormonal shifts that occur in response to anticipated parenthood which serve as a physiologic mechanism for this pathology. CASE The following is a case of Couvade syndrome in the setting of a high risk pregnancy complicated by pre-eclampsia with severe features necessitating a preterm delivery. CONCLUSION Expectant fathers should be screened for symptoms of Couvade Syndrome throughout the pregnancy in order to better support the familial unit.
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Affiliation(s)
- Tess Chase
- Department of Obstetrics and Gynecology, Penn State Milton S. Hershey Medical Center, Hershey, PA, USA
| | - Adam Fusick
- James A. Haley Veterans' Hospital, Mental Health and Behavioral Sciences Service, Tampa, FL, USA
| | - Jaimey M Pauli
- Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, Penn State Milton S. Hershey Medical Center, Hershey, PA, USA
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Chaharrahifard L, Jashni Motlagh A, Akbari-Kamrani M, Ataee M, Esmaelzadeh-Saeieh S. The Effect of Midwife-led Psycho-Education on Parental Stress, Postpartum Depression and Parental Competency in High Risk Pregnancy Women: A Randomized Controlled Trial. J Caring Sci 2021; 10:70-76. [PMID: 34222115 PMCID: PMC8242294 DOI: 10.34172/jcs.2021.014] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2019] [Accepted: 01/27/2020] [Indexed: 11/21/2022] Open
Abstract
Introduction: Women with high-risk pregnancy are at increased risk of depression and anxiety during pregnancy, as well as a less favorable parent-infant interaction. This study aimed to investigate the effect of midwife-led psycho-education intervention on parental stress, competency, and postpartum depression in nulliparous women hospitalized with high-risk pregnancy. Methods: This randomized controlled trial was carried out on 66 nulliparous women admitted to the high-risk pregnancy ward of Kamali Hospital, Karaj, Iran. Using convenient sampling method, the mothers were randomly assigned to control and intervention groups. In addition to routine care, the intervention group received four sessions of midwife-led psycho-education intervention in two group sessions in pregnancy and two individual sessions immediately after delivery. The parental stress, parental competency, and postpartum depression questionnaires were used for data collection before, after, and one month after the intervention. Data were analyzed using SPSS software ver. 13.0. Repeated-measures ANOVA test was used for comparing the mean scores of parenting stress, parental competency, and depression between and within both study groups before, after, and one month after delivery. Results: While postpartum depression and parental stress decreased in intervention group, parental competency increased. Conclusion: Our findings indicated that midwife-led psycho-education was effective on parental stress, competency, and postpartum depression in high-risk pregnancy mothers. Accordingly, prenatal distress in high-risk pregnancies should be assessed routinely.
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Affiliation(s)
- Leila Chaharrahifard
- Departement of Reproductive Health, Student Research Committee, Faculty of Medicine, Alborz University of Medical Sciences, Karaj, Iran
| | - Alireza Jashni Motlagh
- Department of Pediatrics, Neonatal-Perinatal Medicine, Faculty of Medicine, Alborz University of Medical Sciences, Karaj, Iran
| | - Mahnaz Akbari-Kamrani
- Department of Reproductive Health, Faculty of Medicine, Alborz University of Medical Sciences, Karaj, Iran
| | - Mina Ataee
- Department of Obstetrics and Gynecology, Faculty of Medicine, Alborz University of Medical Sciences, Karaj, Iran
| | - Sara Esmaelzadeh-Saeieh
- Department of Reproductive Health, Social Determinants of Health Research Center, Alborz University of Medical Sciences, Karaj, Iran
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Dollberg DG. Mothers' parental mentalization, attachment dimensions and mother-infant relational patterns. Attach Hum Dev 2021; 24:189-207. [PMID: 33729095 DOI: 10.1080/14616734.2021.1901297] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
We examined the links between mothers' prenatal attachment dimensions, parental mentalization and mother-infant relational patterns. The sample consisted of 68 mother-infant dyads. During pregnancy, mothers reported on attachment-related anxiety and avoidance. When the infants were three months old, the mothers' parental reflective functioning (PRF) was assessed via the PDI-R2-S interview. Mothers-infant free play interactions were coded for maternal sensitivity and dyadic reciprocity and mothers' utterances were coded for appropriate and non-attuned mind-mindedness (MM). Prenatal attachment anxiety was associated with less appropriate MM. Appropriate MM was associated with maternal sensitivity and mother-infant dyadic reciprocity. The models predicting maternal sensitivity and dyadic reciprocity from dimensions of the mothers' prenatal anxiety/avoidance attachment, mediated by their PRF, appropriate and non-attuned MM, were significant. Univariate analyses revealed a significant direct link only between appropriate MM and mother-infant dyadic reciprocity. We discuss these results as well as the differences between the PRF and MM constructs.
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Affiliation(s)
- Daphna G Dollberg
- School of Behavioral Sciences, Academic College of Tel Aviv-Yaffo, Tel Aviv-Yafo, Israel
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Hanko C, Bittner A, Junge-Hoffmeister J, Mogwitz S, Nitzsche K, Weidner K. Course of mental health and mother-infant bonding in hospitalized women with threatened preterm birth. Arch Gynecol Obstet 2019; 301:119-128. [PMID: 31828434 DOI: 10.1007/s00404-019-05406-3] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2019] [Accepted: 12/02/2019] [Indexed: 10/25/2022]
Abstract
PURPOSE Pregnancy complications (PC) with signs of threatened preterm birth are often associated with lengthy hospital stays, which have been shown to be accompanied by anxiety, depressive symptoms, and increased stress level. It remains unclear, whether the perinatal course of mental health of these women differs from women without PC and whether there may be differences in the postpartum mother-infant bonding. METHODS In a naturalistic longitudinal study with two measurements (24-36th weeks of gestation and 6 weeks postpartum), we investigated depression (EPDS), anxiety (STAI-T), stress (PSS), and postpartum mother-infant bonding (PBQ) in women with threatened preterm birth (N = 75) and women without PC (N = 70). For data evaluation, we used means of frequency analysis, analysis of variance with repeated measurements, and t-tests for independent samples. RESULTS The patient group showed significantly higher rates of depression, anxiety, and stress during inpatient treatment in pregnancy, as well as 6 weeks postpartum compared to the control group. While depression and anxiety decreased over time in both groups, stress remained at the same level 6 weeks postpartum as in pregnancy. We found no significant differences in mother-infant bonding between the two groups at all considered PBQ scales. CONCLUSION It is recommended to pay attention to the psychological burden of all obstetric patients as a routine to capture a psychosomatic treatment indication. A general bonding problem in women with threatened preterm birth was not found. Nevertheless, increased maternal stress, anxiety, and depressiveness levels during pregnancy may have a negative impact on the development of the fetus.
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Affiliation(s)
- Cornelia Hanko
- Department of Psychotherapy and Psychosomatic Medicine, University Hospital Carl Gustav Carus, Technische Universitaet Dresden, Fetscherstraße 74, 01307, Dresden, Germany.
| | - Antje Bittner
- Department of Psychotherapy and Psychosomatic Medicine, University Hospital Carl Gustav Carus, Technische Universitaet Dresden, Fetscherstraße 74, 01307, Dresden, Germany
| | - Juliane Junge-Hoffmeister
- Department of Psychotherapy and Psychosomatic Medicine, University Hospital Carl Gustav Carus, Technische Universitaet Dresden, Fetscherstraße 74, 01307, Dresden, Germany
| | - Sabine Mogwitz
- Department of Psychotherapy and Psychosomatic Medicine, University Hospital Carl Gustav Carus, Technische Universitaet Dresden, Fetscherstraße 74, 01307, Dresden, Germany
| | - Katharina Nitzsche
- Department of Gynecology and Obstetrics, University Hospital Carl Gustav Carus, Technische Universitaet Dresden, Fetscherstraße 74, 01307, Dresden, Germany
| | - Kerstin Weidner
- Department of Psychotherapy and Psychosomatic Medicine, University Hospital Carl Gustav Carus, Technische Universitaet Dresden, Fetscherstraße 74, 01307, Dresden, Germany
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Nakamura Y, Sato M, Watanabe I. Positive Emotion and its Changes during Pregnancy: Adjunct Study of Japan Environment and Children's Study in Miyagi Prefecture. TOHOKU J EXP MED 2018; 245:223-230. [PMID: 30058596 DOI: 10.1620/tjem.245.223] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
During pregnancy, women experience various emotional changes. Previous research has investigated positive emotion influenced childbirth outcomes positively. This study explored the extent of positive emotion which pregnant women aware of their own pregnancy life subjectively and variables related to the changes thereof. This was an adjunct study of the Japan Environment and Children's Study which is a nationwide epidemiological study to identify the impact of environmental factors on health and development of children in Miyagi Prefecture. Data were collected at 12 weeks (T1) and 24-28 weeks (T2) of gestation. Participants were 3,513 pregnant women. Women's degree of positive emotion was assessed through a numeric rating scale. We also measured related variables, including obstetric factors, physical health status, mental health status, and social situation, using the 8-Item Short Form Health Survey, Kessler-6, and family APGAR score, along with demographic data. Analyses included correlations among variables related to the change in positive emotion. The extent of positive emotion was significantly related with health-related quality of life and satisfaction with family relationships during pregnancy. The women whose positive emotion decreased from T1 to T2 tended to have lower morning sickness symptoms, be unemployed, lower physical and mental health status, and a higher risk of psychological distress in middle pregnancy. Importantly, even discomfort like morning sickness, physical symptoms that indicate being pregnant, might make women to confirm pregnancy. Moreover, employment and satisfaction with family relationships are especially crucial for pregnant women to spend comfortable maternity life.
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Affiliation(s)
- Yasuka Nakamura
- Nursing Course, Tohoku University Graduate School of Medicine
| | - Mari Sato
- Nursing Course, Tohoku University Graduate School of Medicine
| | - Ikue Watanabe
- Department of Nursing, Faculty of Health Sciences, Tohoku Fukushi University
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