1
|
Larsen J, Holland J, Kochhar P, Wolke D, Draper ES, Marlow N, Johnson S. Comparing the Prevalence of Psychiatric Disorders in Cohorts of Children Born Extremely Preterm in 1995 and 2006: The EPICure Studies. JAACAP OPEN 2024; 2:217-228. [PMID: 39239392 PMCID: PMC11372438 DOI: 10.1016/j.jaacop.2024.02.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 03/19/2024] [Indexed: 09/07/2024]
Abstract
Objective This study aimed to identify the prevalence of psychiatric disorders in 2 population-based cohorts of children born extremely preterm (EP) 11 years apart to ascertain whether psychiatric outcomes have changed over time following improved survival of EP children. Method In the EPICure2 study, 200 children born EP (22-26 weeks' gestation) in England in 2006 were assessed at 11 years of age alongside 143 term-born children. Children were assessed using the Developmental and Wellbeing Assessment (DAWBA). DSM-IV diagnoses were assigned by clinical psychiatrists for 145 EP and 98 term-born children. Outcomes were compared between a subsample of children from the EPICure2 cohort (2006, n = 76) and the earlier-born EPICure (1995, n = 161) cohort born at 22 to 25 weeks' gestation in England. Results EP children in EPICure2 were significantly more likely than term-born children to have any psychiatric disorder (39.3% vs 3.1%; adjusted odds ratio [OR] = 15.1, 95% CI = 4.4-51.1), emotional disorders (14.6% vs 2.0%; OR = 7.3, 95% CI = 1.6-32.7), conduct disorders (6.3% vs 0.0%, p = .01), attention-deficit/hyperactivity disorder (ADHD, 21.9% vs 2.6%; OR = 7.2; 95% CI = 1.5-33.6), and autism spectrum disorder (ASD, 18.9%; vs 0.0%, p < .001). There was no significant difference in the rates of any psychiatric disorder between EP children in the EPICure2 and EPICure cohorts. Conclusion EP children remain at increased risk for psychiatric disorders at 11 years of age compared with term-born peers. Increased survival has not translated into improved psychiatric outcomes. Health care professionals need to be aware of this ongoing risk when caring for children born preterm.
Collapse
Affiliation(s)
| | | | - Puja Kochhar
- University of Nottingham Nottingham, United Kingdom
| | | | | | - Neil Marlow
- University College London, London, United Kingdom
| | | |
Collapse
|
2
|
Trześniowska A, Wagner E, Ściseł A, Szymańska K, Szyprowski K, Kimber-Trojnar Ż. Did the COVID-19 Pandemic Affect the Stress Levels among the Mothers of Premature Infants? A Narrative Review of the Present State of Knowledge, Prevention Strategies, and Future Directions. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2024; 21:1095. [PMID: 39200705 PMCID: PMC11353938 DOI: 10.3390/ijerph21081095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/02/2024] [Revised: 08/16/2024] [Accepted: 08/18/2024] [Indexed: 09/02/2024]
Abstract
Understanding COVID-19's effects on susceptible populations remains essential for clinical implementations. Our review aimed to examine whether the pandemic significantly impacted the stress levels in the mothers of premature infants in NICUs. The review of the literature from Google Scholar and PubMed resulted in identifying specific stressors such as the disruption of healthcare systems, limited access to neonatal care, uncertainty due to frequent changes in restrictions, the risk of COVID-19 infection, social isolation, and financial stress. While some quantitative studies concerning this topic did not show a significant increase in the perception of stress in this population compared to the pre-pandemic group, various research has indicated that the COVID-19 pandemic may result in enduring impacts on the emotional and neurological development of children. This article demonstrates a correlation between the repercussions of the COVID-19 pandemic and an elevated incidence of depressive symptoms among the mothers of premature infants. Further studies are needed to assess the long-term impact of pandemic-induced stress.
Collapse
Affiliation(s)
| | - Emilia Wagner
- Chair and Department of Obstetrics and Perinatology, Medical University of Lublin, 20-090 Lublin, Poland; (A.T.); (A.Ś.); (K.S.); (K.S.)
| | | | | | | | - Żaneta Kimber-Trojnar
- Chair and Department of Obstetrics and Perinatology, Medical University of Lublin, 20-090 Lublin, Poland; (A.T.); (A.Ś.); (K.S.); (K.S.)
| |
Collapse
|
3
|
Trimarco E, Jafrasteh B, Jiménez-Luque N, Marín Almagro Y, Román Ruiz M, Lubián Gutiérrez M, Ruiz González E, Segado Arenas A, Lubián-López SP, Benavente-Fernández I. Thalamic volume in very preterm infants: associations with severe brain injury and neurodevelopmental outcome at two years. Front Neurol 2024; 15:1427273. [PMID: 39206295 PMCID: PMC11349527 DOI: 10.3389/fneur.2024.1427273] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2024] [Accepted: 07/24/2024] [Indexed: 09/04/2024] Open
Abstract
Introduction Several studies demonstrate the relationship between preterm birth and a reduced thalamus volume at term-equivalent age. In contrast, this study aims to investigate the link between the thalamic growth trajectory during the early postnatal period and neurodevelopment at two years of age. Methods Thalamic volume was extracted from 84 early MRI scans at postmenstrual age of 32.33 (± 2.63) weeks and 93 term-equivalent age MRI scans at postmenstrual age of 42.05 (± 3.33) weeks of 116 very preterm infants (56% male) with gestational age at birth of 29.32 (± 2.28) weeks and a birth weight of 1158.92 (± 348.59) grams. Cognitive, motor, and language outcomes at two years of age were assessed with Bayley Scales of Infant and Toddler Development Third Edition. Bivariate analysis was used to describe the clinical variables according to neurodevelopmental outcomes and multilevel linear regression models were used to examine the impact of these variables on thalamic volume and its relationship with neurodevelopmental outcomes. Results The results suggest an association between severe brain injury and thalamic growth trajectory (β coef = -0.611; p < 0.001). Moreover, thalamic growth trajectory during early postnatal life was associated with the three subscale scores of the neurodevelopmental assessment (cognitive: β coef = 6.297; p = 0.004; motor: β coef = 7.283; p = 0.001; language: β coeficient = 9.053; p = 0.002). Discussion These findings highlight (i) the impact of severe brain injury on thalamic growth trajectory during early extrauterine life after preterm birth and (ii) the relationship of thalamic growth trajectory with cognitive, motor, and language outcomes.
Collapse
Affiliation(s)
- Emiliano Trimarco
- Biomedical Research and Innovation Institute of Cádiz (INiBICA) Research Unit, Puerta del Mar University Hospital, Cádiz, Spain
| | - Bahram Jafrasteh
- Biomedical Research and Innovation Institute of Cádiz (INiBICA) Research Unit, Puerta del Mar University Hospital, Cádiz, Spain
| | - Natalia Jiménez-Luque
- Biomedical Research and Innovation Institute of Cádiz (INiBICA) Research Unit, Puerta del Mar University Hospital, Cádiz, Spain
| | - Yolanda Marín Almagro
- Biomedical Research and Innovation Institute of Cádiz (INiBICA) Research Unit, Puerta del Mar University Hospital, Cádiz, Spain
| | - Macarena Román Ruiz
- Biomedical Research and Innovation Institute of Cádiz (INiBICA) Research Unit, Puerta del Mar University Hospital, Cádiz, Spain
| | - Manuel Lubián Gutiérrez
- Biomedical Research and Innovation Institute of Cádiz (INiBICA) Research Unit, Puerta del Mar University Hospital, Cádiz, Spain
- Division of Neonatology, Department of Paediatrics, Puerta del Mar University Hospital, Cádiz, Spain
| | - Estefanía Ruiz González
- Biomedical Research and Innovation Institute of Cádiz (INiBICA) Research Unit, Puerta del Mar University Hospital, Cádiz, Spain
- Division of Neonatology, Department of Paediatrics, Puerta del Mar University Hospital, Cádiz, Spain
| | - Antonio Segado Arenas
- Biomedical Research and Innovation Institute of Cádiz (INiBICA) Research Unit, Puerta del Mar University Hospital, Cádiz, Spain
- Division of Neonatology, Department of Paediatrics, Puerta del Mar University Hospital, Cádiz, Spain
| | - Simón Pedro Lubián-López
- Biomedical Research and Innovation Institute of Cádiz (INiBICA) Research Unit, Puerta del Mar University Hospital, Cádiz, Spain
- Division of Neonatology, Department of Paediatrics, Puerta del Mar University Hospital, Cádiz, Spain
| | - Isabel Benavente-Fernández
- Biomedical Research and Innovation Institute of Cádiz (INiBICA) Research Unit, Puerta del Mar University Hospital, Cádiz, Spain
- Division of Neonatology, Department of Paediatrics, Puerta del Mar University Hospital, Cádiz, Spain
- Area of Paediatrics, Department of Child and Mother Health and Radiology, Medical School, University of Cádiz, Cádiz, Spain
| |
Collapse
|
4
|
Leppänen M, Korja R, Rautava P, Ahlqvist-Björkroth S. Early psychosocial parent-infant interventions and parent-infant relationships after preterm birth-a scoping review. Front Psychol 2024; 15:1380826. [PMID: 39171238 PMCID: PMC11335663 DOI: 10.3389/fpsyg.2024.1380826] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2024] [Accepted: 07/19/2024] [Indexed: 08/23/2024] Open
Abstract
Objective Early psychosocial interventions for preterm infants and their parents are diverse. This study aimed to structure the knowledge on psychosocial parent-infant interventions and to identify gaps in the intervention studies. Methods We included studies on early (during first year of life) psychosocial parent-infant interventions with parent-infant relationship outcomes after preterm birth (< 37 weeks). We excluded studies that did not focus on preterm infants, failed to indicate the studied intervention and outcomes, were not written in English, were not controlled or peer-reviewed studies, or did not provide essential information for eligibility. The search included studies published between January 2000 and March 2024 in PubMed and PsycINFO. Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed in reporting. Psychosocial parent-infant intervention studies were classified adapting the International Classification of Health Interventions (ICHI) and the Template for Intervention Description and Replication (TIDieR). Results The included 22 studies reported data from 18 different interventions with preterm infants (< 37 weeks). Studies excluded preterm infants with health risks (19/22, 86%), with very low gestational age and/or birth weight (7/22, 32%), and/or mothers with psychosocial risks (14/22, 64%). Of the 18 interventions, 12 (67%) were classified as counseling, 3 (17%) as emotional support, 2 (11%) as psychotherapeutic, and 1 (6%) as educational. The parent-child relationship was assessed using 30 different methods and varying time points up to 18 months of age. Most studies (17/22, 77%) reported positive changes in the parent-child relationship favoring the intervention group. Conclusion We identified four types of interventions to influence parenting behavior; the most used was counseling. All four intervention types showed positive effects on parent-infant relationships, although the preterm populations studied were selective, the effects were evaluated using different methods, and the follow-up periods were short. These findings indicate a need for studies with standardized methods, longer follow-up, and less-restricted preterm populations to develop guidelines for all families with preterm infants.
Collapse
Affiliation(s)
- Marika Leppänen
- Department of Psychiatry and Public Health, University of Turku and Turku University Hospital, Turku, Finland
| | - Riikka Korja
- Department of Psychology, University of Turku, Turku, Finland
| | - Päivi Rautava
- Department of Public Health, University of Turku, and Research Services, Turku University Hospital, Turku, Finland
| | | |
Collapse
|
5
|
Bodunde EO, Buckley D, O'Neill E, Al Khalaf S, Maher GM, O'Connor K, McCarthy FP, Kublickiene K, Matvienko-Sikar K, Khashan AS. Pregnancy and birth complications and long-term maternal mental health outcomes: A systematic review and meta-analysis. BJOG 2024. [PMID: 38887891 DOI: 10.1111/1471-0528.17889] [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: 11/27/2023] [Revised: 05/21/2024] [Accepted: 05/29/2024] [Indexed: 06/20/2024]
Abstract
BACKGROUND Few studies have examined the associations between pregnancy and birth complications and long-term (>12 months) maternal mental health outcomes. OBJECTIVES To review the published literature on pregnancy and birth complications and long-term maternal mental health outcomes. SEARCH STRATEGY Systematic search of Cumulative Index to Nursing and Allied Health Literature (CINAHL), Excerpta Medica Database (Embase), PsycInfo®, PubMed® and Web of Science from inception until August 2022. SELECTION CRITERIA Three reviewers independently reviewed titles, abstracts and full texts. DATA COLLECTION AND ANALYSIS Two reviewers independently extracted data and appraised study quality. Random-effects meta-analyses were used to calculate pooled estimates. The Meta-analyses of Observational Studies in Epidemiology (MOOSE) guidelines were followed. The protocol was prospectively registered on the International Prospective Register of Systematic Reviews (PROSPERO: CRD42022359017). MAIN RESULTS Of the 16 310 articles identified, 33 studies were included (3 973 631 participants). Termination of pregnancy was associated with depression (pooled adjusted odds ratio, aOR 1.49, 95% CI 1.20-1.83) and anxiety disorder (pooled aOR 1.43, 95% CI 1.20-1.71). Miscarriage was associated with depression (pooled aOR 1.97, 95% CI 1.38-2.82) and anxiety disorder (pooled aOR 1.24, 95% CI 1.11-1.39). Sensitivity analyses excluding early pregnancy loss and termination reported similar results. Preterm birth was associated with depression (pooled aOR 1.37, 95% CI 1.32-1.42), anxiety disorder (pooled aOR 0.97, 95% CI 0.41-2.27) and post-traumatic stress disorder (PTSD) (pooled aOR 1.75, 95% CI 0.52-5.89). Caesarean section was not significantly associated with PTSD (pooled aOR 2.51, 95% CI 0.75-8.37). There were few studies on other mental disorders and therefore it was not possible to perform meta-analyses. CONCLUSIONS Exposure to complications during pregnancy and birth increases the odds of long-term depression, anxiety disorder and PTSD.
Collapse
Affiliation(s)
- Elizabeth O Bodunde
- School of Public Health, University College Cork, Cork, Ireland
- INFANT Research Centre, University College Cork, Cork, Ireland
| | - Daire Buckley
- INFANT Research Centre, University College Cork, Cork, Ireland
| | - Eimear O'Neill
- Perinatal Mental Health, Acute Mental Health Services (AMHS) and Child and Adolescent Mental Health Services (CAMHS), University College Cork, Cork, Ireland
| | | | - Gillian M Maher
- School of Public Health, University College Cork, Cork, Ireland
- INFANT Research Centre, University College Cork, Cork, Ireland
| | - Karen O'Connor
- RISE, Early Intervention in Psychosis Team, South Lee Mental Health Services, Cork, Ireland
- Department of Psychiatry and Neurobehavioral Science, University College Cork, Cork, Ireland
| | - Fergus P McCarthy
- INFANT Research Centre, University College Cork, Cork, Ireland
- Department of Obstetrics and Gynaecology, Cork University Maternity Hospital, Cork, Ireland
| | - Karolina Kublickiene
- Division of Renal Medicine, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden
| | | | - Ali S Khashan
- School of Public Health, University College Cork, Cork, Ireland
- INFANT Research Centre, University College Cork, Cork, Ireland
| |
Collapse
|
6
|
Sandnes R, Le Floch M, Riquin E, Nocus I, Müller JB, Bacro F. Parental stress and mental health outcomes following very preterm birth: A systematic review of recent findings. J Affect Disord 2024; 355:513-525. [PMID: 38556094 DOI: 10.1016/j.jad.2024.03.154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Revised: 03/06/2024] [Accepted: 03/25/2024] [Indexed: 04/02/2024]
Abstract
BACKGROUND In recent years, there has been a wide array of research studies published on parental mental health and stress following very preterm birth. This review aims at reviewing the prevalence and risk factors of long-term parental depression, anxiety, post-traumatic stress symptoms and parenting stress following very preterm birth. METHODS We searched PubMed, PsychINFO and Web of Science for descriptive, cross-sectional and longitudinal studies published between January 2013 and August 2022. RESULTS 45 studies met our inclusion criteria. In the first two years, depression, anxiety, post-traumatic stress symptoms and parenting stress were present in ∼20 % of mothers of extreme and very low birth weight (E/VLBW) infants. Long-term psychological distress symptoms could be observed, although few studies have focused on symptoms into school age and longer. Fathers of VLBW infants might experience more psychological distress as well, however, they were only included in ten studies. We found that parental distress is more common when the co-parent is struggling with mental health symptoms. Many risk factors were identified such as social risk, history of mental illness, interpersonal factors (i.e. social support) and child-related factors (i.e. intraventricular hemorrhage, disability, use of medical equipment at home). LIMITATIONS Several studies have methodological issues, such as a lack of control of known confounders and there is a large variety of measures employed. CONCLUSION Important risk factors for stress and mental health symptoms were identified. More evidence is needed to determine if long-term symptoms persist into school age. Research should focus on taking a family-based approach in order to identify preventive strategies and resilience factors in parents of VLBW infants.
Collapse
Affiliation(s)
- Ramona Sandnes
- Faculty of Psychology, Centre de Recherche en Education de Nantes (CREN - UR 2661), Nantes University, Nantes, France.
| | - Marine Le Floch
- Department of Child and Adolescent Psychiatry, University Hospital of Angers, France
| | - Elise Riquin
- Department of Child and Adolescent Psychiatry, University Hospital of Angers, France; Univ Angers, [CHU Angers], LPPL EA4638, F-49000 Angers, France; Fondation de Santé des Étudiants de France, clinique de Sablé sur Sarthe, Sablé sur Sarthe, France
| | - Isabelle Nocus
- Faculty of Psychology, Centre de Recherche en Education de Nantes (CREN - UR 2661), Nantes University, Nantes, France
| | - Jean Baptiste Müller
- Loire Infant Follow-Up Team (LIFT) Network, Pays de Loire, France; Department of Neonatal Medicine, Nantes University Hospital, Nantes, France
| | - Fabien Bacro
- Faculty of Psychology, Centre de Recherche en Education de Nantes (CREN - UR 2661), Nantes University, Nantes, France
| |
Collapse
|
7
|
Suonpera E, Gallagher K, Marlow N, Lanceley A. 'I don't want him to always be so far behind': Parental perceptions of child independence in the context of extreme prematurity; a qualitative study. J Child Health Care 2024:13674935241256545. [PMID: 38798176 DOI: 10.1177/13674935241256545] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/29/2024]
Abstract
This study addresses the paucity of research on parents of extremely preterm adolescents (born <27 weeks of gestation) and their experiences within the framework of parental determinism. We conducted semi-structured interviews with twenty-two mothers and one father. Data were analysed thematically, revealing three overarching themes and eight subthemes shaping parental accounts. These themes centred on parental ambitions for their children, their perceptions of their child's abilities, and the parenting behaviours employed to support parental aspirations. Parents' actions were influenced by their ambitions and the belief that they could impact their child's future independence. While some parents adopted 'trusting', non-intensive parenting behaviours, those anticipating challenges for their child's future independence resorted to intensive parenting practices. These findings align with the concept of parental determinism, emphasising the perceived causal link between present parental actions and future child outcomes. In the context of extreme prematurity, a nuanced understanding of parental perceptions regarding their child's future independence aligned with a delicate balance between hope and realistic aspiration is crucial for enhancing parental support and well-being.
Collapse
Affiliation(s)
- Emmi Suonpera
- UCL EGA Institute for Women's Health, University College London, London, UK
| | - Katie Gallagher
- UCL EGA Institute for Women's Health, University College London, London, UK
| | - Neil Marlow
- UCL EGA Institute for Women's Health, University College London, London, UK
| | - Anne Lanceley
- UCL EGA Institute for Women's Health, University College London, London, UK
| |
Collapse
|
8
|
Janssen LE, Laarman AR, van Dijk-Lokkart EM, Bröring-Starre T, Oudijk MA, de Groot CJ, de Boer MA. Long-Term Maternal Mental Health after Spontaneous Preterm Birth. Am J Perinatol 2024; 41:e2893-e2900. [PMID: 37758204 PMCID: PMC11150068 DOI: 10.1055/a-2182-4131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2022] [Accepted: 09/18/2023] [Indexed: 10/03/2023]
Abstract
OBJECTIVE The aim of this study is to investigate whether a history of spontaneous preterm birth (SPTB) is associated with maternal depressive and anxiety symptoms, or psychosocial distress in the fifth decade of life. STUDY DESIGN This is a secondary analysis of the PreCaris-study, a prospective observational study in which we included 350 women with a history of SPTB between 220/7 and 366/7 weeks of gestation and compared them to 115 women who had a term birth. Primary outcomes were the Depression and Anxiety scores measured using the Hospital Anxiety Depression Scale and Psychosocial distress assessed with the Distress Thermometer for Parents. Secondary outcomes were self-reported impact of the birth in daily life and psychosocial support after delivery. RESULTS After a median of 13 years after delivery, no significant differences were found in primary outcomes. Significantly more women with a history of SPTB reported that the birth still had impact in daily life; adjusted odds ratio: 2.46 (95% confidence interval: 1.35-4.48). A total of 57 (16.3%) women after SPTB reported to have needed professional psychosocial support after delivery but did not receive it. These women more often had a high Anxiety score (p = 0.030), psychosocial distress (p = 0.001), and influence of birth in daily life (p = 0.000). CONCLUSION There are no long-term effects on depressive and anxiety symptoms and psychosocial distress in women who experienced SPTB compared with women who had a full-term pregnancy. A significant part of the women who delivered preterm needed psychosocial support but did not receive it and were at higher risk of anxiety, psychosocial distress, and impact in daily life. We therefore recommend offering all women after SPTB psychosocial support after delivery. KEY POINTS · No long-term effects on depressive and anxiety symptoms and psychosocial distress after SPTB.. · A total of 16.3% of the cases needed professional psychosocial support after delivery but did not receive it.. · This subgroup was at higher risk of anxiety symptoms, psychosocial distress, and impact on daily life..
Collapse
Affiliation(s)
- Laura E. Janssen
- Department of Obstetrics, Reproduction and Development Research Institute, Amsterdam UMC, Vrije Universiteit Medical Center, Amsterdam, The Netherlands
| | - Aranka R.C. Laarman
- Department of Child and Adolescent Psychiatry and Psychosocial Care, Amsterdam UMC, Emma Childrens' Hospital, Vrije Universiteit Medical Center, Amsterdam, The Netherlands
- Department of Child and Adolescent Psychiatry and Psychosocial Care, Amsterdam UMC, Emma Childrens' Hospital, Amsterdam Medical Center, Amsterdam, The Netherlands
| | - Elisabeth M. van Dijk-Lokkart
- Department of Child and Adolescent Psychiatry and Psychosocial Care, Amsterdam UMC, Emma Childrens' Hospital, Vrije Universiteit Medical Center, Amsterdam, The Netherlands
- Department of Child and Adolescent Psychiatry and Psychosocial Care, Amsterdam UMC, Emma Childrens' Hospital, Amsterdam Medical Center, Amsterdam, The Netherlands
| | - Tinka Bröring-Starre
- Department of Child and Adolescent Psychiatry and Psychosocial Care, Amsterdam UMC, Emma Childrens' Hospital, Vrije Universiteit Medical Center, Amsterdam, The Netherlands
- Department of Child and Adolescent Psychiatry and Psychosocial Care, Amsterdam UMC, Emma Childrens' Hospital, Amsterdam Medical Center, Amsterdam, The Netherlands
| | - Martijn A. Oudijk
- Department of Obstetrics, Reproduction and Development Research Institute, Amsterdam UMC, Amsterdam Medical Centre, Amsterdam, The Netherlands
| | - Christianne J.M. de Groot
- Department of Obstetrics, Reproduction and Development Research Institute, Amsterdam UMC, Vrije Universiteit Medical Center, Amsterdam, The Netherlands
- Department of Obstetrics, Reproduction and Development Research Institute, Amsterdam UMC, Amsterdam Medical Centre, Amsterdam, The Netherlands
| | - Marjon A. de Boer
- Department of Obstetrics, Reproduction and Development Research Institute, Amsterdam UMC, Vrije Universiteit Medical Center, Amsterdam, The Netherlands
- Department of Obstetrics, Reproduction and Development Research Institute, Amsterdam UMC, Amsterdam Medical Centre, Amsterdam, The Netherlands
| |
Collapse
|
9
|
Fitzallen GC, Kirby JN, Taylor HG, Liley HG, Bora S. Evaluating multidimensional facets of the maternal experience after preterm birth. J Perinatol 2024; 44:635-642. [PMID: 38238445 PMCID: PMC11090785 DOI: 10.1038/s41372-024-01865-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2022] [Revised: 12/15/2023] [Accepted: 01/02/2024] [Indexed: 05/15/2024]
Abstract
OBJECTIVE Describe self-relating (self-criticism, self-compassion) and parenting competence (satisfaction, self-efficacy) in mothers of children born preterm, and their associations with child characteristics, maternal sociodemographics at childbirth, and maternal concurrent well-being. STUDY DESIGN The sample comprised 1926 biological mothers of 3- to18-year-old children born preterm with self-ratings on the standardized Forms of Self-Criticising/Attacking & Self-Reassuring Scale, Self-Compassion Scale, and Parenting Sense of Competence Scale. RESULTS Mothers of children in early childhood reported significantly (p < 0.05) lower self-compassion than in middle childhood and adolescence. They also reported significantly lower parenting satisfaction than mothers of adolescents and higher self-efficacy than their middle childhood counterparts. Maternal psychosocial well-being was most strongly associated with self-compassion, parenting satisfaction, and self-efficacy after accounting for maternal psychopathology, child gestation, and child age. CONCLUSION Longer-term associations of preterm birth with maternal self-relating and parenting competence emphasize broadening the scope of neonatal follow-up services, extending beyond child neurodevelopmental surveillance and postpartum psychopathology screening.
Collapse
Affiliation(s)
- Grace C Fitzallen
- School of Psychological Sciences, College of Health and Medicine, University of Tasmania, Launceston, TAS, Australia
- School of Psychology, Faculty of Health and Behavioural Sciences, The University of Queensland, Brisbane, QLD, Australia
- Mater Research Institute, Faculty of Medicine, The University of Queensland, Brisbane, QLD, Australia
| | - James N Kirby
- School of Psychology, Faculty of Health and Behavioural Sciences, The University of Queensland, Brisbane, QLD, Australia
| | - H Gerry Taylor
- Center for Biobehavioral Health, Abigail Wexner Research Institute at Nationwide Children's Hospital, and Department of Pediatrics, The Ohio State University, Columbus, OH, USA
| | - Helen G Liley
- Mater Research Institute, Faculty of Medicine, The University of Queensland, Brisbane, QLD, Australia
| | - Samudragupta Bora
- Mater Research Institute, Faculty of Medicine, The University of Queensland, Brisbane, QLD, Australia.
- Department of Pediatrics, University Hospitals Rainbow Babies & Children's Hospital, Case Western Reserve University School of Medicine, Cleveland, OH, USA.
| |
Collapse
|
10
|
Suonpera E, Lanceley A, Ni Y, Marlow N. Parenting stress and health-related quality of life among parents of extremely preterm born early adolescents in England: a cross-sectional study. Arch Dis Child Fetal Neonatal Ed 2024; 109:253-260. [PMID: 37879883 DOI: 10.1136/archdischild-2023-325429] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Accepted: 09/27/2023] [Indexed: 10/27/2023]
Abstract
OBJECTIVE To determine whether extremely preterm (EP) birth exerts persisting effects on parents in early adolescence. DESIGN Cross-sectional survey conducted between March 2017 and October 2018. SETTING Evaluation of a longitudinal population-based birth cohort in England at 11 years of age (EPICure2@11 Study). PARTICIPANTS Parents of EP (<27 weeks of gestation) adolescents and control parents of term born (≥37 weeks of gestation) classmates of similar age and sex. MAIN OUTCOME MEASURES The Parenting Stress Index Short Form (PSI-4-SF) and the Short Form Health Survey (SF-12v1). RESULTS The 163 EP and 125 comparison respondents were most commonly mothers in their mid-40s. EP parents reported higher total parenting stress scores compared with controls, overall (adjusted difference in means: 14 (95% CI 9 to 20)) and after exclusion of moderate and severe child disability and multiples (9 (95% CI 3 to 15). Average physical and mental health-related quality of life scores were similar in the two groups (adjusted difference in means physical health: -2 (95% CI -4 to 1) and mental health: -1 (95% CI -4 to 1)). Among EP parents, 12% (20/164) reported the combination of high parenting stress and low mental health scores. With increasing child age, parenting stress scores for preterm parents were lower in contrast to controls who reported increasing parenting stress. CONCLUSIONS In early adolescence, compared with parents of term-born children, EP parents experience increased levels of parenting stress that are particularly high among a proportion of parents and associated with lower mental health-related quality of life. Practitioner awareness of this continuing risk throughout childhood is important to support parental abilities and well-being.
Collapse
Affiliation(s)
- Emmi Suonpera
- EGA UCL Institute for Women's Health, University College London, London, UK
| | - Anne Lanceley
- EGA UCL Institute for Women's Health, University College London, London, UK
| | - Yanyan Ni
- School of Public Health, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong, Hong Kong
| | - Neil Marlow
- EGA UCL Institute for Women's Health, University College London, London, UK
| |
Collapse
|
11
|
LaManna S, Hatfield B, McCann E. Considering the Influence of Social Determinants of Health on Parent Feeding Practices: A Case Example. Adv Neonatal Care 2024; 24:110-118. [PMID: 38241685 DOI: 10.1097/anc.0000000000001138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2024]
Abstract
BACKGROUND Social determinants of health (SDOH) are the nonmedical factors that influence health outcomes. SDOH can be grouped into 5 domains: economic stability, education access and quality, healthcare access and quality, neighborhood and built environment, and social and community context. SDOH impact people's health and quality of life but may also contribute to disparities in access to food, education, and healthcare. SDOH uniquely influence parent feeding practices in the neonatal intensive care unit (NICU) in a variety of ways, ranging from logistical considerations for parent visitation to cultural beliefs such as family perception of human milk feeding. EVIDENCE ACQUISITION A hypothetical case example of a preterm infant with a feeding disorder in the NICU is used to connect SDOH that influence prenatal health, parental lived experience, and postnatal medical care to maternal and infant outcomes with implications for feeding practices. Barriers and facilitators to successful feeding practices in the NICU and at discharge are considered for each SDOH domain. RESULTS This case example increases awareness of SDOH and how they influence parent feeding practices in the NICU, focusing on the intersection of SDOH, parent stress, and oral feeding outcomes. Examples were provided for how to support applying findings into practice. IMPLICATIONS FOR PRACTICE AND RESEARCH By being creating a culture of SDOH awareness, NICU staff can assist families in overcoming barriers by putting supports in place to increase equitable participation in developmentally supportive feeding practices during the NICU stay.
Collapse
Affiliation(s)
- Stefanie LaManna
- Author Affiliation: American Speech-Language-Hearing Association, Rockville, Maryland (Mss LaManna and Hatfield); and Independent Researcher, Voorhees, New Jersey (Ms McCann)
| | | | | |
Collapse
|
12
|
Wohlers L, Maier RF, Cuttini M, Wilson E, Benhammou V, Lebeer J, Laroche S, Sarrechia I, Petrou S, Thiele N, Zeitlin J, Aubert AM. Maternal Wellbeing Five Years after a Very Preterm Delivery: Prevalence and Influencing Factors in a European Cohort. CHILDREN (BASEL, SWITZERLAND) 2023; 11:61. [PMID: 38255374 PMCID: PMC10814990 DOI: 10.3390/children11010061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/27/2023] [Revised: 12/22/2023] [Accepted: 12/27/2023] [Indexed: 01/24/2024]
Abstract
(1) Background: Mothers of very preterm (VPT) infants may experience psychological symptoms compromising long-term emotional wellbeing. This study describes the emotional wellbeing of mothers of five-year-old children born VPT. We assess the association between sociodemographic, perinatal and neonatal characteristics, and the child's health and development at five years old and maternal emotional wellbeing. (2) Methods: Data are from the prospective European "Effective Perinatal Intensive Care in Europe" (EPICE) and subsequent "Screening for Health In very Preterm infantS in Europe" (SHIPS) projects including births <32 weeks' gestational age in 11 countries in 2011/12. Data were abstracted from obstetric and neonatal records. At five years old, 2605 mothers answered a parental questionnaire including the Mental Health Inventory-5 (MHI-5). Associations between sociodemographic and health characteristics and the mother's MHI-5 score were investigated using multilevel multivariate linear regression analysis with the country modelled as a random effect and inverse probability weighting to correct for attrition bias. (3) Results: The mean MHI-5 score was 71.3 (SD 16.7) out of 100 (highest emotional wellbeing) with a variation among countries from 63.5 (SD 16.8; Poland) to 82.3 (SD 15.8; the Netherlands). MHI-5 scores were significantly lower for mothers whose child had a severe health problem, developmental, or speech delay, for multiparous and single mothers, and when at least one of the parents was unemployed. (4) Conclusions: The emotional wellbeing of mothers of VPT infants differs between European countries. Identifying sociodemographic characteristics and child's health and developmental conditions that affect maternal emotional wellbeing may help to identify groups of mothers who need special assistance to cope with consequences of the delivery of a VPT child.
Collapse
Affiliation(s)
- Lena Wohlers
- Physiotherapy School, University Hospital of the Universities of Giessen and Marburg (UKGM), 35392 Giessen, Germany;
| | - Rolf F. Maier
- Children’s Hospital, University Hospital, Philipps University Marburg, 35033 Marburg, Germany;
| | - Marina Cuttini
- 0-3 Center for the at-Risk Infant, Scientific Institute IRCCS “Eugenio Medea”, 23842 Lecco, Italy;
| | - Emilija Wilson
- Unit of Reproductive Health, Women’s and Children’s Health, Karolinska Institutet, 17177 Stockholm, Sweden;
| | - Valérie Benhammou
- Inserm, INRAE, Centre for Research in Epidemiology and Statistics (CRESS), Obstetrical Perinatal and Pediatric Epidemiology Research Team, EPOPé, Université Paris Cité, F-75004 Paris, France; (V.B.); (J.Z.)
| | - Jo Lebeer
- Department of Medicine & Population Health, Faculty of Medicine & Health Sciences, University of Antwerp, 2610 Antwerp, Belgium; (J.L.); (I.S.)
| | - Sabine Laroche
- Neonatal Intensive Care Unit, University Hospital Antwerp, 2610 Antwerp, Belgium;
- Center for Developmental Disabilities, University Hospital Antwerp, 2610 Antwerp, Belgium
| | - Iemke Sarrechia
- Department of Medicine & Population Health, Faculty of Medicine & Health Sciences, University of Antwerp, 2610 Antwerp, Belgium; (J.L.); (I.S.)
| | - Stavros Petrou
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford OX1 2JD, UK;
| | - Nicole Thiele
- European Foundation for the Care of Newborn Infants (EFCNI), 81379 Munich, Germany;
| | - Jennifer Zeitlin
- Inserm, INRAE, Centre for Research in Epidemiology and Statistics (CRESS), Obstetrical Perinatal and Pediatric Epidemiology Research Team, EPOPé, Université Paris Cité, F-75004 Paris, France; (V.B.); (J.Z.)
| | - Adrien M. Aubert
- Inserm, INRAE, Centre for Research in Epidemiology and Statistics (CRESS), Obstetrical Perinatal and Pediatric Epidemiology Research Team, EPOPé, Université Paris Cité, F-75004 Paris, France; (V.B.); (J.Z.)
| |
Collapse
|
13
|
Fetene SM, Haile TG, Dadi A. Effect of adverse perinatal outcomes on postpartum maternal mental health in low-income and middle-income countries: a protocol for systematic review. BMJ Open 2023; 13:e074447. [PMID: 38101849 PMCID: PMC10729045 DOI: 10.1136/bmjopen-2023-074447] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Accepted: 11/20/2023] [Indexed: 12/17/2023] Open
Abstract
INTRODUCTION More than three-fourths of adverse perinatal outcomes (preterm, small for gestational age, low birth weight, congenital anomalies, stillbirth and neonatal death) occur in low-income and middle-income countries. These adverse perinatal outcomes can have both short-term and long-term consequences on maternal mental health. Even though there are few empirical studies on the effect of perinatal loss on maternal mental illness, comprehensive information on the impact of adverse perinatal outcomes in resource-limited settings is scarce. Therefore, we aim to systematically review and synthesise evidence on the effect of adverse perinatal outcomes on maternal mental health. METHODS AND ANALYSIS The primary outcome of our review will be postpartum maternal mental illness (anxiety, depression, post-traumatic stress disorder and postpartum psychosis) following adverse perinatal outcomes. All peer-reviewed primary studies published in English will be retrieved from databases: PubMed, MEDLINE, CINAHL Ultimate (EBSCO), PsycINFO, Embase, Scopus and Global Health through the three main searching terms-adverse perinatal outcomes, maternal mental illness and settings, with a variant of subject headings and keywords. We will follow the Joanna Briggs Institute critical appraisal checklist to assess the quality of the studies we are including. The review findings will be reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020 statement. Estimate-based meta-analysis will be performed. We will assess heterogeneity between studies using the I2 statistics and publication bias will be checked using funnel plots and Egger's test. A subgroup analysis will be conducted to explore potential sources of heterogeneity (if available). Finally, the certainty of the evidence will be evaluated using the Grading of Recommendations, Assessment, Development and Evaluation approach. ETHICS AND DISSEMINATION Since this systematic review does not involve human participants, ethical approval is not required. The review will be submitted for publication in a peer-reviewed journal. PROSPERO REGISTRATION NUMBER CRD42023405980.
Collapse
Affiliation(s)
| | | | - Abel Dadi
- Menzies School of Health Research, Charles Darwin University, Casuarina, Northern Territory, Australia
- Addis Continental Institute of Public Health, Addis Ababa, Ethiopia
| |
Collapse
|
14
|
Benhammou V, Marchand-Martin L, Pierrat V, Charkaluk ML, Romito P, Kaminski M, Ancel PY, Saurel-Cubizolles MJ. Maternal health-related quality of life at 1 year after a preterm birth: role of socioeconomic status at birth. J Epidemiol Community Health 2023; 78:25-32. [PMID: 37752012 DOI: 10.1136/jech-2023-220591] [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: 03/16/2023] [Accepted: 09/01/2023] [Indexed: 09/28/2023]
Abstract
BACKGROUND Maternal problems in the postpartum period may lead to suboptimal long-term health for women and could affect mother-child attachment. Social disadvantage is a risk factor for preterm birth, which carries its own burden of health issues and stress. The main aim of this study was to investigate the role for social factors in mothers' physical and emotional health-related quality of life (HRQoL) at 1 year after a preterm birth. METHODS EPIPAGE-2 is a French nationwide, prospective, population-based cohort of preterm children born before 35 weeks' gestation (N=3614 women). At birth, detailed data on the family's social status were collected. At 1 year after birth, mothers completed a mailed questionnaire to report information on their HRQoL, assessed by the Medical Outcomes Study 12-item Short Form. We used multivariate linear regression models to assess the association between social factors and maternal HRQoL. RESULTS At 1 year after childbirth, the emotional HRQoL of mothers of preterm children was worse than their physical HRQoL, even in women without any previous signs of psychological distress at the infant's discharge from hospital. Baseline social characteristics were the most important factors influencing the physical component of HRQoL. None of the studied social factors had any clear association with the mental component of HRQoL. CONCLUSION Our study underlines the importance of social disadvantage during pregnancy as risk factors for poor physical HRQoL at 1 year after a preterm birth.
Collapse
Affiliation(s)
- Valerie Benhammou
- Université Paris Cité, CRESS, Obstetrical Perinatal and Pediatric Epidemiology Research Team, EPOPé, INSERM, Paris, France
| | - Laetitia Marchand-Martin
- Université Paris Cité, CRESS, Obstetrical Perinatal and Pediatric Epidemiology Research Team, EPOPé, INSERM, Paris, France
| | - Véronique Pierrat
- Université Paris Cité, CRESS, Obstetrical Perinatal and Pediatric Epidemiology Research Team, EPOPé, INSERM, Paris, France
- Department of Neonatal Medicine, CHI Créteil, Créteil, France
| | - Marie-Laure Charkaluk
- Université Paris Cité, CRESS, Obstetrical Perinatal and Pediatric Epidemiology Research Team, EPOPé, INSERM, Paris, France
- Department of Neonatal Medicine, Lille Catholic Institute Hospital Group, Lomme, France
| | - Patrizia Romito
- Department of Human Studies, University of Trieste, Trieste, Italy
| | - Monique Kaminski
- Université Paris Cité, CRESS, Obstetrical Perinatal and Pediatric Epidemiology Research Team, EPOPé, INSERM, Paris, France
| | - Pierre-Yves Ancel
- Université Paris Cité, CRESS, Obstetrical Perinatal and Pediatric Epidemiology Research Team, EPOPé, INSERM, Paris, France
- Center for Clinical Investigation P1419, APHP - Centre Université Paris-Cité, Paris, France
| | | |
Collapse
|
15
|
Eves R, Baumann N, Bilgin A, Schnitzlein D, Richter D, Wolke D, Lemola S. Parents' life satisfaction prior to and following preterm birth. Sci Rep 2023; 13:21233. [PMID: 38040950 PMCID: PMC10692203 DOI: 10.1038/s41598-023-48582-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Accepted: 11/28/2023] [Indexed: 12/03/2023] Open
Abstract
The current study tested whether the reported lower wellbeing of parents after preterm birth, relative to term birth, is a continuation of a pre-existing difference before pregnancy. Parents from Germany (the German Socio-Economic Panel Study, N = 10,649) and the United Kingdom (British Household Panel Study and Understanding Society, N = 11,012) reported their new-born's birthweight and gestational age, subsequently categorised as very preterm or very low birthweight (VP/VLBW, < 32 weeks or < 1500 g), moderately/late preterm or low birthweight (MLP/LBW, ≥ 32 weeks and < 37 weeks/≥ 1500 g and < 2500 g), or term-born (≥ 37 weeks and ≥ 2500 g). Mixed models were used to analyse life satisfaction, an aspect of wellbeing, at four assessments-two years and six months before birth and six months and two years afterwards. Two years before birth, satisfaction of prospective term-born, MLP/LBW, or VP/VLBW mothers did not significantly differ. However, mothers of VP/VLBWs had lower satisfaction relative to mothers of term-borns at both assessments post-birth. Among fathers, satisfaction levels were similarly equivalent two years before birth. Subsequently, fathers of VP/VLBWs temporarily differed in satisfaction six months post-birth relative to fathers of term-borns. Results indicate that parents' lower life satisfaction after VP/VLBW birth is not a continuation of pre-existing life satisfaction differences.
Collapse
Affiliation(s)
- Robert Eves
- Fakultät Für Psychologie Und Sportwissenschaft, Abteilung Für Psychologie, Universität Bielefeld, 10 01 31, Bielefeld, Germany.
- Department of Psychology, Lifespan Health and Wellbeing Group, University of Warwick, Coventry, UK.
| | - Nicole Baumann
- Department of Health Sciences, University of Leicester, Leicester, UK
- Turner Institute for Brain and Mental Health, School of Psychology Sciences, Monash University, Melbourne, Australia
| | - Ayten Bilgin
- Department of Psychology, University of Essex, Colchester, Essex, UK
| | - Daniel Schnitzlein
- Leibniz University of Hannover, Hannover, Germany
- IZA Bonn, Bonn, Germany
| | - David Richter
- German Institute for Economic Research, (DIW Berlin, Deutsches Institut Für Wirtschaftsforschung E.V.), Berlin, Germany
| | - Dieter Wolke
- Department of Psychology, Lifespan Health and Wellbeing Group, University of Warwick, Coventry, UK
| | - Sakari Lemola
- Fakultät Für Psychologie Und Sportwissenschaft, Abteilung Für Psychologie, Universität Bielefeld, 10 01 31, Bielefeld, Germany
| |
Collapse
|
16
|
Njoroge WFM, Gerstein ED, Lean RE, Paul R, Smyser CD, Rogers CE. Neonatal Intensive Care Unit Latent Profiles of Maternal Distress: Associations With 5-Year Maternal and Child Mental Health Outcomes. J Am Acad Child Adolesc Psychiatry 2023; 62:1123-1133. [PMID: 37084882 PMCID: PMC10543383 DOI: 10.1016/j.jaac.2023.02.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Revised: 01/23/2023] [Accepted: 04/12/2023] [Indexed: 04/23/2023]
Abstract
OBJECTIVE To examine profiles of distress of mothers of preterm infants in the neonatal intensive care unit (NICU) and relate profiles to maternal and child outcomes at child age 5 years. METHOD A racially and economically diverse sample of mothers (n = 94; 39% African American, 52% White) of preterm infants (≤30 weeks of gestation) completed validated questionnaires assessing depression, anxiety (state and trait), NICU stress, and life stress at NICU discharge of their infant. Mothers reported on their own and their children's symptomatology at child age 5. A latent profile analysis was conducted to categorize maternal symptomatology. RESULTS Latent profile analysis yielded 4 distinct maternal profiles: low symptomatology, high NICU stress, high depression and anxiety, and high state anxiety. Social determinants of health factors including age, education, neighborhood deprivation, and infant clinical risk distinguished the profiles. Mothers in the high depression and anxiety profile reported more anxiety and life stress at follow-up and reported their children experienced more anxious/depressed symptoms. CONCLUSION Existing literature has gaps related to examining multiple dimensions of NICU distress and understanding how patterns of mood/affective symptoms, life stressors, and related social determinants of health factors vary across mothers. In this study, one specific profile of maternal NICU distress demonstrated enduring risks for poorer maternal and child mental health outcomes. This new knowledge underscores sources of disparate health outcomes for mothers of preterm infants and the infants themselves. Universal screening is needed to identify at-risk dyads for poor health outcomes in need of individualized interventions that address both maternal and child well-being. DIVERSITY & INCLUSION STATEMENT We worked to ensure sex and gender balance in the recruitment of human participants. We worked to ensure race, ethnic, and/or other types of diversity in the recruitment of human participants. One or more of the authors of this paper self-identifies as a member of one or more historically underrepresented racial and/or ethnic groups in science. One or more of the authors of this paper self-identifies as a member of one or more historically underrepresented sexual and/or gender groups in science. We actively worked to promote inclusion of historically underrepresented racial and/or ethnic groups in science in our author group. While citing references scientifically relevant for this work, we also actively worked to promote sex and gender balance in our reference list. While citing references scientifically relevant for this work, we also actively worked to promote inclusion of historically underrepresented racial and/or ethnic groups in science in our reference list.
Collapse
Affiliation(s)
- Wanjikũ F M Njoroge
- Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania; Children's Hospital of Philadelphia, Philadelphia, Pennsylvania; Policy Lab, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania; Lifespan Brain Institute, Children's Hospital of Philadelphia and Penn Medicine, Philadelphia, Pennsylvania.
| | | | - Rachel E Lean
- Washington University School of Medicine, St. Louis, Missouri
| | - Rachel Paul
- Washington University School of Medicine, St. Louis, Missouri
| | | | | |
Collapse
|
17
|
Votruba N, Praveen D, Mellers L, Rajan E, Thout SR, Arora V, Malik Y, Kashyap A, Majumdar S, Hirst J, Maulik PK. SMARThealth PRegnancy And Mental Health study: protocol for a situational analysis of perinatal mental health in women living in rural India. Front Glob Womens Health 2023; 4:1143880. [PMID: 37575961 PMCID: PMC10416114 DOI: 10.3389/fgwh.2023.1143880] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2023] [Accepted: 07/11/2023] [Indexed: 08/15/2023] Open
Abstract
Introduction The situation for women experiencing mental health problems during pregnancy and postpartum in rural India is critical: a high burden of disease, a high estimated number of women are undiagnosed and untreated with mental health problems, a substantial gap in research on women's perinatal health, and severe stigma and discrimination. The SMARThealth Pregnancy study is a cluster randomised trial using a digital intervention to identify and manage anaemia, hypertension, and diabetes in the first year after birth in rural India. Within this study, the SMARThealth Pregnancy and Mental Health (PRAMH) study is a situational analysis to understand mental health problems during pregnancy and in the first year following birth in this population. Methods/design This situational analysis aims to analyse and to assess the context of perinatal mental health, health services, barriers, facilitators, and gaps in Siddipet district of Telangana state in India, to develop an implementation framework for a future intervention. A tested, standardised situational analysis tool will be adapted and applied to perinatal mental health in rural India. A desktop and policy review will be conducted to identify and analyse relevant mental health and pregnancy care policies at the national and state levels. We will conduct in-depth interviews with policymakers, planners, mental health professionals and other experts in perinatal mental health (n = 10-15). We will also conduct focus group discussions with key stakeholders, including women with perinatal mental health problems, their families and carers, and community health workers (n = 24-40). A theory of change workshop with key stakeholders will be conducted which will also serve as a priority setting exercise, and will clarify challenges and opportunities, priorities, and objectives for a pilot intervention study. The analysis of qualitive data will be done using thematic analysis. Based on the data analysis and synthesis of the findings, an implementation framework will be developed to guide development, testing and scale up of a contextually relevant intervention for perinatal mental health. Discussion The situational analysis will help to establish relationships with all relevant stakeholders, clarify the context and hypotheses for the pilot intervention and implementation.
Collapse
Affiliation(s)
- Nicole Votruba
- Department of Women’s & Reproductive Health, University of Oxford, Oxford, United Kingdom
- The George Institute for Global Health, Imperial College London, London, United Kingdom
| | - Devarsetty Praveen
- The George Institute for Global Health India, New Delhi, India
- The George Institute for Global Health, University of New South Wales, Sydney, NSW, Australia
| | - Lucy Mellers
- Department of Women’s & Reproductive Health, University of Oxford, Oxford, United Kingdom
| | - Eldho Rajan
- The George Institute for Global Health India, New Delhi, India
| | | | - Varun Arora
- Post Graduate Institute of Medical Science, Rohtak, India
| | - Yogender Malik
- Department of Psychiatry, Institute of Mental Health (IMH), University of Health Sciences PGIMS, Rohtak, India
| | - Aditya Kashyap
- SVS Institute of Neurosciences, Government Medical College, Siddipet, India
| | - Sreya Majumdar
- The George Institute for Global Health India, New Delhi, India
| | - Jane Hirst
- Department of Women’s & Reproductive Health, University of Oxford, Oxford, United Kingdom
- The George Institute for Global Health, Imperial College London, London, United Kingdom
| | - Pallab K. Maulik
- The George Institute for Global Health India, New Delhi, India
- The George Institute for Global Health, University of New South Wales, Sydney, NSW, Australia
| |
Collapse
|
18
|
Jones L, Mariapun J, Tan AXQ, Kassim Z, Su TT. Maternal wellbeing of Malaysian mothers after the birth of a preterm infant. BMC Pregnancy Childbirth 2023; 23:510. [PMID: 37442958 DOI: 10.1186/s12884-023-05823-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2022] [Accepted: 06/29/2023] [Indexed: 07/15/2023] Open
Abstract
BACKGROUND In Malaysia approximately 7% of births result in a preterm birth (< 37 weeks). Research in many other countries has found that mothers of preterm infants experience poorer psychological wellbeing. However, there has been limited research in Malaysia. We examined wellbeing, using the WHO Quality of Life brief version questionnaire (WHOQOL-BREF), in mothers who have preterm and full-term infants. METHODS Data was collected as part of the South East Asian Community Observatory MISS-P project. A total of 3221 mothers (7.9% with a preterm and 92.1 with a full-term birth) completed a survey, with a range of measures, including the WHOQoL-BREF and sociodemographic questions. RESULTS For the physical health, psychological wellbeing and quality of their environment WHOQOL-BREF domains, a lower gestational age, a lower education level, and having had an emergency caesarean delivery were significantly associated (p < 0.05) with a lower quality of life, and there was a weak effect for ethnicity for some domains. The effects were strongest for mothers' education level. CONCLUSIONS There is a weak but significant relationship between the gestational age of an infant and the mother's quality of life. Mothers in Malaysia with a preterm infant or a lower level of education may benefit from additional support.
Collapse
Affiliation(s)
- Liz Jones
- Jeffrey Cheah School of Medicine and Health Sciences, Monash University (Malaysia), Jalan Lagoon Selatan, Bandar Sunway, Selangor, Malaysia.
| | - Jeevitha Mariapun
- Jeffrey Cheah School of Medicine and Health Sciences, Monash University (Malaysia), Jalan Lagoon Selatan, Bandar Sunway, Selangor, Malaysia
| | - Abbey Xiao Qian Tan
- Jeffrey Cheah School of Medicine and Health Sciences, Monash University (Malaysia), Jalan Lagoon Selatan, Bandar Sunway, Selangor, Malaysia
| | - Zaid Kassim
- 2Segamat District Public Health Office, Ministry of Health, 85000, Segamat, Johor, Malaysia
| | - Tin Tin Su
- Jeffrey Cheah School of Medicine and Health Sciences, Monash University (Malaysia), Jalan Lagoon Selatan, Bandar Sunway, Selangor, Malaysia
- South East Asia Community Observatory (SEACO), Monash University (Malaysia), Jalan Lagoon, Selatan, Bandar Sunway, Selangor State, Malaysia
| |
Collapse
|
19
|
Legge N, Popat H, Fitzgerald D. Examining the impact of premature birth on parental mental health and family functioning in the years following hospital discharge: A review. J Neonatal Perinatal Med 2023:NPM221107. [PMID: 37182844 DOI: 10.3233/npm-221107] [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: 05/16/2023]
Abstract
BACKGROUND This review provides an update of the current research related to the impact of extreme and very premature birth on parental mental health and family functioning following discharge from hospital. METHODS Full-text peer reviewed articles in English, describing parents' and families' health and wellbeing after the discharge from hospital of their baby using validated questionnaires, were evaluated. Results of included studies are presented in a summarized format. Embase, Medline and PsycINFO databases were accessed in January 2021. RESULTS 38 studies were included. Nine manuscripts reported on parental mental health and 13 on stress, which are a concern after the birth of a premature infant, especially in the first year. Depression, anxiety, and stress are known to measure higher compared to parents of infants born at term. Over several years, these measures of mental health decrease significantly. Four reported on quality of life for parents of premature infants, which is reduced immediately after discharge, but then improves over time. The impact of premature birth on the family functioning was described in ten included studies and was described to have positive and negative consequences. CONCLUSION The negative impact of the premature birth and hospital journey on parental mental health lessens significantly with time.
Collapse
Affiliation(s)
- Nele Legge
- Department of Neonatal Intensive Care, Liverpool Hospital, Liverpool, Australia
- Discipline of Child and Adolescent Health, Sydney Medical School, Faculty of Health Sciences, University of Sydney, Australia
| | - H Popat
- Discipline of Child and Adolescent Health, Sydney Medical School, Faculty of Health Sciences, University of Sydney, Australia
- The Children's Hospital at Westmead, Westmead, Australia
| | - D Fitzgerald
- Discipline of Child and Adolescent Health, Sydney Medical School, Faculty of Health Sciences, University of Sydney, Australia
- The Children's Hospital at Westmead, Westmead, Australia
| |
Collapse
|
20
|
Runkle JD, Risley K, Roy M, Sugg MM. Association Between Perinatal Mental Health and Pregnancy and Neonatal Complications: A Retrospective Birth Cohort Study. Womens Health Issues 2023; 33:289-299. [PMID: 36621340 PMCID: PMC10213085 DOI: 10.1016/j.whi.2022.12.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2022] [Revised: 11/30/2022] [Accepted: 12/09/2022] [Indexed: 01/09/2023]
Abstract
BACKGROUND Maternal mental health as an important precursor to reproductive and neonatal complications remains understudied in the United States, particularly in the Southeastern region, despite high medical costs, maternal morbidity, and infant burden. This study sought to estimate the incidence of perinatal mental health disorders and the associated increased risk of leading pregnancy and infant complications. METHODS A population-based retrospective birth cohort of childbirth hospitalizations and readmissions was constructed for women in South Carolina, 1999 to 2017. Prevalence rates were calculated for perinatal mood and anxiety disorders (PMAD), severe mental illness, and mental disorders of pregnancy (MDP). Poisson regression models using generalized estimating equations were used to estimate adjusted relative risks for the association between mental health conditions and severe maternal morbidity, hypertensive disorders of pregnancy, gestational diabetes, cesarean section, preterm birth, and low birthweight. RESULTS The most prevalent maternal mental condition was MDP (3.9%), followed by PMAD (2.7%) and severe mental illness (0.13%). PMAD was associated with a higher risk of severe maternal morbidity, hypertensive disorders of pregnancy, and cesarean section, as well as a higher risk of preterm birth and low birthweight infants. Severe mental illness was associated with low birthweight, hypertensive disorders of pregnancy, and cesarean section. Pregnant populations with MDP were more at risk for severe maternal morbidity, preterm birth, hypertensive disorders of pregnancy, low birthweight, and cesarean section. Each maternal mental health outcome was associated with an increased risk for hospital readmissions up to 45 days after childbirth. CONCLUSIONS Results demonstrate the escalating burden of PMAD and MDP for pregnant populations over time, with important consequences related to maternal and infant morbidity.
Collapse
Affiliation(s)
- Jennifer D Runkle
- North Carolina Institute for Climate Studies, North Carolina State University, Asheville, North Carolina.
| | - Kendra Risley
- North Carolina Institute for Climate Studies, North Carolina State University, Asheville, North Carolina
| | - Manan Roy
- Department of Nutrition and Health Care Management, Appalachian State University, Boone, North Carolina
| | - Margaret M Sugg
- Department of Geography and Planning, Appalachian State University, Boone, North Carolina
| |
Collapse
|
21
|
Kapito EM, Chirwa EM, Chodzaza E, Norr KF, Patil C, Maluwa AO, White-Traut R. The H-HOPE behavioral intervention plus Kangaroo Mother Care increases mother-preterm infant responsivity in Malawi: a prospective cohort comparison. BMC Pediatr 2023; 23:187. [PMID: 37085764 PMCID: PMC10120231 DOI: 10.1186/s12887-023-04015-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/10/2022] [Accepted: 04/16/2023] [Indexed: 04/23/2023] Open
Abstract
BACKGROUND Early behavioral intervention to promote development is recommended as the standard of care for preterm infants, yet is not provided in Malawi. One such intervention is H-HOPE (Hospital to Home: Optimizing the Premature Infant's Environment). In US studies, H-HOPE increased mother-preterm infant responsivity at 6-weeks corrected age (CA). Kangaroo Mother Care (KMC) improves infant survival and is the standard of care for preterm infants in Malawi. This is the first study to examine whether H-HOPE is feasible and promotes mother-preterm infant responsivity in Malawi, and the first to examine the impact of H-HOPE when KMC is the standard of care. METHOD This pilot was conducted in a KMC unit using a prospective cohort comparison design. Because the unit is an open room without privacy, random assignment would have led to contamination of the control cohort. H-HOPE includes participatory guidance for mothers and Massage + , a 15 min multisensory session provided by mothers twice daily. H-HOPE began when infants were clinically stable and at least 32 weeks postmenstrual age. Mothers participated if they were physically stable and willing to return for follow-up. Mother-preterm infant dyads were video-recorded during a play session at 6-weeks CA. Responsivity was measured using the Dyadic Mutuality Code (DMC). RESULTS The final sample included 60 H-HOPE + KMC and 59 KMC only mother-preterm infant dyads. Controlling for significant maternal and infant characteristics, the H-HOPE + KMC dyads were over 11 times more likely to have higher responsivity than those in the KMC only dyads (AOR = 11.51, CI = 4.56, 29.04). The only other factor related to higher responsivity was vaginal vs. Caesarian delivery (AOR = 5.44, CI = .096, 30.96). CONCLUSION This study demonstrated that H-HOPE can be provided in Malawi. Mother-infant dyads receiving both H-HOPE and KMC had higher responsivity at 6-weeks CA than those receiving KMC only. H-HOPE was taught by nurses in this study, however the nursing shortage in Malawi makes H-HOPE delivery by nurses challenging. Training patient attendants in the KMC unit is a cost-effective alternative. H-HOPE as the standard of care offers benefits to preterm infants and mothers that KMC alone does not provide.
Collapse
Affiliation(s)
- Esnath M Kapito
- School of Maternal, Neonatal and Reproductive Health Studies, Kamuzu University of Health Sciences, Private Bag 360, Blantyre, Malawi.
| | - Ellen M Chirwa
- School of Maternal, Neonatal and Reproductive Health Studies, Kamuzu University of Health Sciences, Private Bag 360, Blantyre, Malawi
| | - Elizabeth Chodzaza
- School of Maternal, Neonatal and Reproductive Health Studies, Kamuzu University of Health Sciences, Private Bag 360, Blantyre, Malawi
| | - Kathleen F Norr
- Children's Hospital of Wisconsin, Children's Research Institute, 9000 Winsconsin Avenue, Milwaukee, Winsconsin, 53226, USA
- College of Nursing, University of Illinois Chicago, 845 S. Damen Avenue (M/C 806), Chicago, IL, 60612, USA
| | - Crystal Patil
- College of Nursing, University of Illinois Chicago, 845 S. Damen Avenue (M/C 806), Chicago, IL, 60612, USA
| | - Alfred O Maluwa
- Malawi University of Science and Technology, P. O Box 5196, Limbe, Malawi
| | - Rosemary White-Traut
- Children's Hospital of Wisconsin, Children's Research Institute, 9000 Winsconsin Avenue, Milwaukee, Winsconsin, 53226, USA
- College of Nursing, University of Illinois Chicago, 845 S. Damen Avenue (M/C 806), Chicago, IL, 60612, USA
| |
Collapse
|
22
|
McGowan EC, McGrath M, Law A, O’Shea TM, Aschner JL, Blackwell CK, Fry RC, Ganiban JM, Higgins R, Margolis A, Sathyanarayana S, Taylor G, Alshawabkeh AN, Cordero JF, Spillane NT, Hudak ML, Camargo CA, Dabelea D, Dunlop AL, Elliott AJ, Ferrara AM, Talavera-Barber M, Singh AM, Karagas MR, Karr C, O’Connor TG, Paneth N, Wright RJ, Wright RO, Cowell W, Stanford JB, Bendixsen C, Lester BM. Health Care Utilization During the COVID-19 Pandemic Among Individuals Born Preterm. JAMA Netw Open 2023; 6:e2310696. [PMID: 37115545 PMCID: PMC10148204 DOI: 10.1001/jamanetworkopen.2023.10696] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Accepted: 03/16/2023] [Indexed: 04/29/2023] Open
Abstract
Importance Limited data exist on pediatric health care utilization during the COVID-19 pandemic among children and young adults born preterm. Objective To investigate differences in health care use related to COVID-19 concerns during the pandemic among children and young adults born preterm vs those born at term. Design, Setting, and Participants In this cohort study, questionnaires regarding COVID-19 and health care utilization were completed by 1691 mother-offspring pairs from 42 pediatric cohorts in the National Institutes of Health Environmental Influences on Child Health Outcomes Program. Children and young adults (ages 1-18 years) in these analyses were born between 2003 and 2021. Data were recorded by the August 31, 2021, data-lock date and were analyzed between October 2021 and October 2022. Exposures Premature birth (<37 weeks' gestation). Main Outcomes and Measures The main outcome was health care utilization related to COVID-19 concerns (hospitalization, in-person clinic or emergency department visit, phone or telehealth evaluations). Individuals born preterm vs term (≥37 weeks' gestation) and differences among preterm subgroups of individuals (<28 weeks', 28-36 weeks' vs ≥37 weeks' gestation) were assessed. Generalized estimating equations assessed population odds for health care used and related symptoms, controlling for maternal age, education, and psychiatric disorder; offspring history of bronchopulmonary dysplasia (BPD) or asthma; and timing and age at COVID-19 questionnaire completion. Results Data from 1691 children and young adults were analyzed; among 270 individuals born preterm, the mean (SD) age at survey completion was 8.8 (4.4) years, 151 (55.9%) were male, and 193 (71.5%) had a history of BPD or asthma diagnosis. Among 1421 comparison individuals with term birth, the mean (SD) age at survey completion was 8.4 (2.4) years, 749 (52.7%) were male, and 233 (16.4%) had a history of BPD or asthma. Preterm subgroups included 159 individuals (58.5%) born at less than 28 weeks' gestation. In adjusted analyses, individuals born preterm had a significantly higher odds of health care utilization related to COVID-19 concerns (adjusted odds ratio [aOR], 1.70; 95% CI, 1.21-2.38) compared with term-born individuals; similar differences were also seen for the subgroup of individuals born at less than 28 weeks' gestation (aOR, 2.15; 95% CI, 1.40-3.29). Maternal history of a psychiatric disorder was a significant covariate associated with health care utilization for all individuals (aOR, 1.44; 95% CI, 1.17-1.78). Conclusions and Relevance These findings suggest that during the COVID-19 pandemic, children and young adults born preterm were more likely to have used health care related to COVID-19 concerns compared with their term-born peers, independent of a history of BPD or asthma. Further exploration of factors associated with COVID-19-related health care use may facilitate refinement of care models.
Collapse
Affiliation(s)
- Elisabeth C. McGowan
- The Warren Alpert School of Medicine, Brown University, Providence, Rhode Island
| | - Monica McGrath
- Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Andrew Law
- Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | | | - Judy L. Aschner
- Albert Einstein College of Medicine, New York, New York
- Hackensack University Medical Center and Hackensack Meridian School of Medicine, Hackensack, New Jersey
| | | | - Rebecca C. Fry
- The University of North Carolina at Chapel Hill, Chapel Hill
| | - Jody M. Ganiban
- George Washington University, Washington, District of Columbia
| | - Rosemary Higgins
- Department of Global and Community Health, College of Health and Human Sciences, George Mason University, Fort Myers, Florida
- Marieb College of Health and Human Services, Florida Gulf Coast University, Fort Myers
| | - Amy Margolis
- Columbia University Irving Medical Center, New York, New York
| | - Sheela Sathyanarayana
- University of Washington, Seattle
- Seattle Children’s Research Institute, Seattle, Washington
| | | | | | - José F. Cordero
- Department of Epidemiology and Biostatistics, University of Georgia, Athens
| | - Nicole T. Spillane
- Hackensack University Medical Center and Hackensack Meridian School of Medicine, Hackensack, New Jersey
| | - Mark L. Hudak
- Department of Pediatrics, University of Florida College of Medicine, Jacksonville
| | | | - Dana Dabelea
- Lifecourse Epidemiology of Adiposity and Diabetes Center, University of Colorado Anschutz Medical Campus, Aurora
| | | | | | | | - Maria Talavera-Barber
- Avera McKennan Hospital, Sioux Falls, South Dakota
- University Health Center, Avera Research Institute, Sioux Falls, South Dakota
| | - Anne Marie Singh
- Department of Pediatrics, University of Wisconsin School of Medicine and Public Health, Madison
| | | | - Catherine Karr
- Department of Environmental and Occupational Health Sciences, University of Washington, Seattle
| | | | - Nigel Paneth
- Department of Epidemiology and Biostatistics, College of Human Medicine, Michigan State University, East Lansing
- Department of Food Science and Human Nutrition, Michigan State University, East Lansing
| | - Rosalind J. Wright
- Institute for Exposomic Research, Icahn School of Medicine Mount Sinai, New York, New York
| | - Robert O. Wright
- Institute for Exposomic Research, Icahn School of Medicine Mount Sinai, New York, New York
| | - Whitney Cowell
- Department of Pediatrics, NYU Grossman School of Medicine, New York, New York
| | | | - Casper Bendixsen
- Marshfield Clinic Research Institute, Marshfield Clinic Health System, Marshfield, Wisconsin
| | - Barry M. Lester
- The Warren Alpert School of Medicine, Brown University, Providence, Rhode Island
| |
Collapse
|
23
|
Filippa M, Monaci MG, Spagnuolo C, Di Benedetto M, Serravalle P, Grandjean D. Oxytocin Levels Increase and Anxiety Decreases in Mothers Who Sing and Talk to Their Premature Infants during a Painful Procedure. CHILDREN (BASEL, SWITZERLAND) 2023; 10:334. [PMID: 36832462 PMCID: PMC9955880 DOI: 10.3390/children10020334] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/15/2022] [Revised: 02/05/2023] [Accepted: 02/08/2023] [Indexed: 02/12/2023]
Abstract
(1) Background: Preterm infants spend their first weeks of life in the hospital partially separated from their parents and subjected to frequent potentially painful clinical procedures. Previous research has found that early vocal contact reduces infant pain perception while simultaneously increasing oxytocin (OXT) levels. The current study aims to assess the effect of maternal singing and speaking on mothers. (2) Methods: During a painful procedure over two days, twenty preterm infants were randomly exposed to their mother's live voice (speaking or singing). Maternal OXT levels were measured twice: before and after singing, as well as before and after speaking. The anxiety and resilience responses of mothers were studied before and after the two-day interventions, regardless of the speaking/singing condition. OXT levels in mothers increased in response to both singing and speech. Concurrently, anxiety levels decreased, but no significant effects on maternal resilience were found. (3) Conclusions: OXT could be identified as a key mechanism for anxiety regulation in parents, even in sensitive care situations, such as when their infant is in pain. Active involvement of parents in the care of their preterm infants can have a positive effect on their anxiety as well as potential benefits to their sensitivity and care abilities through OXT.
Collapse
Affiliation(s)
- Manuela Filippa
- Swiss Center of Affective Sciences, Faculty of Psychology and Educational Sciences, University of Geneva, 1205 Geneva, Switzerland
- Department of Social Sciences, University of Valle D’Aosta, 11100 Aosta, Italy
| | - Maria Grazia Monaci
- Department of Social Sciences, University of Valle D’Aosta, 11100 Aosta, Italy
| | - Carmen Spagnuolo
- Maternal and Child Department, Parini Hospital, 11100 Aosta, Italy
| | | | - Paolo Serravalle
- Maternal and Child Department, Parini Hospital, 11100 Aosta, Italy
| | - Didier Grandjean
- Swiss Center of Affective Sciences, Faculty of Psychology and Educational Sciences, University of Geneva, 1205 Geneva, Switzerland
| |
Collapse
|
24
|
Cortisol reactivity and negative affect among preterm infants at 12 months during a mother-infant interaction task. Infant Behav Dev 2023; 70:101784. [PMID: 36401957 DOI: 10.1016/j.infbeh.2022.101784] [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: 05/05/2022] [Revised: 09/26/2022] [Accepted: 10/27/2022] [Indexed: 11/17/2022]
Abstract
The purpose of this study was to investigate correlates of preterm (PT) infant's cortisol reactivity and the association to infant negative affect, during a mother-infant interaction procedure. Participants included 48 infants born prematurely (gestational age < 37 weeks) and their mothers, assessed when infants were 12 months old corrected for prematurity. The examined variables comprised both neonatal and environmental dimensions including maternal interactive behavior. Infant negative affect and maternal interactive behavior were assessed with a standardized mother-infant interaction task. A baseline infant saliva sample was collected before the interaction began, and a second sample after the interaction episodes ended. Results revealed that decrease of infant's cortisol concentration was significantly associated with the exposure to more sensitive, and less intrusive maternal behaviors. However, once controlled for neonatal risk, family SES and maternal psychological distress, the associations were rendered non-significant. Although the association between cortisol reactivity and negative affect trended toward significance, maternal intrusiveness was the only significant predictor of observed infant negative affect. Findings suggest the importance of primary relational experiences on PT infants' early regulatory competencies.
Collapse
|
25
|
Parent Survey Identifies Low-Cost Emotional and Educational Supports in NICU and Beyond. Adv Neonatal Care 2023; 23:E14-E21. [PMID: 36191346 DOI: 10.1097/anc.0000000000001035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
BACKGROUND Families face significant mental health challenges after preterm birth. However, there are few low-cost and sustainable services to help with mental health challenges. PURPOSE To understand suggestions for low-cost and sustainable mental health supports to help families. METHODS This was an internet-based survey made available to preterm families through the Canadian Premature Babies Foundation social media (Facebook private parents' group). RESULTS Families reported that peer support, such as connecting with other parents and families who experience preterm birth, was most beneficial. Parents also reported ways to allow families to access the existing mental health services, such as providing child care options and improving advertisement of available resources. IMPLICATIONS Our results can help implement beneficial low-cost and sustainable mental health supports across many contexts (eg, hospitals and community organization) both in-person and online.
Collapse
|
26
|
Côté-Corriveau G, Paradis G, Luu TM, Ayoub A, Bilodeau-Bertrand M, Auger N. Longitudinal risk of maternal hospitalization for mental illness following preterm birth. BMC Med 2022; 20:447. [PMID: 36397055 PMCID: PMC9670637 DOI: 10.1186/s12916-022-02659-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Accepted: 11/09/2022] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Preterm birth may affect maternal mental health, yet most studies focus on postpartum mental disorders only. We explored the relationship between preterm delivery and the long-term risk of maternal hospitalization for mental illness after pregnancy. METHODS We performed a longitudinal cohort study of 1,381,300 women who delivered between 1989 and 2021 in Quebec, Canada, and had no prior history of mental illness. The exposure was preterm birth, including extreme (<28 weeks), very (28-31 weeks), and moderate to late (32-36 weeks). The outcome was subsequent maternal hospitalization for depression, bipolar, psychotic, stress and anxiety, personality disorders, and self-harm up to 32 years later. We used adjusted Cox proportional hazards models to estimate hazard ratios (HR) and 95% confidence intervals (CI) for the association between preterm birth and mental illness hospitalization. RESULTS Compared with term, women who delivered preterm had a higher rate of mental illness hospitalization (3.81 vs. 3.01 per 1000 person-years). Preterm birth was associated with any mental illness (HR 1.38, 95% CI 1.35-1.41), including depression (HR 1.37, 95% CI 1.32-1.41), psychotic disorders (HR 1.35, 95% CI 1.25-1.44), and stress and anxiety disorders (HR 1.42, 95% CI 1.38-1.46). Delivery at any preterm gestational age was associated with the risk of mental hospitalization, but risks were greatest around 34 weeks of gestation. Preterm birth was strongly associated with mental illness hospitalization within 2 years of pregnancy, although associations persisted throughout follow-up. CONCLUSIONS Women who deliver preterm may be at risk of mental disorders in the short and long term.
Collapse
Affiliation(s)
- Gabriel Côté-Corriveau
- Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, Quebec, Canada.,Institut national de santé publique du Québec, 190 Cremazie Blvd E., Montreal, Quebec, H2P 1E2, Canada.,Department of Pediatrics, Sainte-Justine Hospital Research Centre, University of Montreal, Montreal, Quebec, Canada.,University of Montreal Hospital Research Centre, Montreal, Quebec, Canada
| | - Gilles Paradis
- Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, Quebec, Canada.,Institut national de santé publique du Québec, 190 Cremazie Blvd E., Montreal, Quebec, H2P 1E2, Canada
| | - Thuy Mai Luu
- Department of Pediatrics, Sainte-Justine Hospital Research Centre, University of Montreal, Montreal, Quebec, Canada
| | - Aimina Ayoub
- Institut national de santé publique du Québec, 190 Cremazie Blvd E., Montreal, Quebec, H2P 1E2, Canada.,University of Montreal Hospital Research Centre, Montreal, Quebec, Canada
| | | | - Nathalie Auger
- Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, Quebec, Canada. .,Institut national de santé publique du Québec, 190 Cremazie Blvd E., Montreal, Quebec, H2P 1E2, Canada. .,University of Montreal Hospital Research Centre, Montreal, Quebec, Canada. .,School of Public Health, University of Montreal, Montreal, Quebec, Canada.
| |
Collapse
|
27
|
Treyvaud K, Eeles AL, Spittle AJ, Lee KJ, Cheong JLY, Shah P, Doyle LW, Anderson PJ. Preterm Infant Outcomes at 24 Months After Clinician-Supported Web-Based Intervention. Pediatrics 2022; 150:189551. [PMID: 36130917 DOI: 10.1542/peds.2021-055398] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/12/2022] [Indexed: 11/24/2022] Open
Abstract
UNLABELLED The authors of this study evaluated infant and parent outcomes at 12 and 24 months after a clinician-supported, web-based early intervention for preterm infants. OBJECTIVE To examine the efficacy of a clinician-supported, web-based intervention delivered over the first year after birth compared with standard care in children born after <34 weeks' gestation, on child development at 24 months corrected age (CA), parental mental health, and the parent-child relationship at 24 months. METHODS We randomly allocated 103 preterm infants to clinician-supported, web-based intervention (n = 50) or standard care control (n = 53) groups. At 24 months CA, child cognitive, language, motor, social-emotional development, and the parent-child relationship were assessed. Parental mental health and quality of life were assessed at 12 and 24 months CA. RESULTS At 24 months, child development, maternal mental health, and maternal quality of life were similar for the intervention and control groups. There was some evidence that mothers in the intervention group had lower odds of being in the elevated category for depression at 12 months (odds ratio: 0.19; 95% confidence interval [CI]: 0.04-0.90; P = .04). Scores were higher in the intervention group for child responsiveness (mean difference: 0.57; 95% CI: 0.03-1.11; P = .04), child involvement (mean difference: 0.61; 95% CI: 0.09-1.13; P = .02), and maternal structuring (mean difference: 0.72; 95% CI: 0.22-1.21; P = .01) during the parent-infant interaction at 24 months. CONCLUSIONS This study provides preliminary evidence that a clinician-supported, web-based early intervention program for preterm infants had a positive effect on the parent-child relationship and maternal mental health immediately after the intervention but potentially little effect on child development.
Collapse
Affiliation(s)
- Karli Treyvaud
- La Trobe University, Victoria, Australia.,Murdoch Children's Research Institute, Victoria, Australia.,University of Melbourne, Victoria, Australia.,Royal Women's Hospital, Victoria, Australia
| | - Abbey L Eeles
- Murdoch Children's Research Institute, Victoria, Australia.,University of Melbourne, Victoria, Australia.,Turner Institute for Brain & Mental Health, School of Psychological Sciences, Monash University, Victoria, Australia
| | - Alicia J Spittle
- Murdoch Children's Research Institute, Victoria, Australia.,University of Melbourne, Victoria, Australia.,Royal Women's Hospital, Victoria, Australia
| | - Katherine J Lee
- Murdoch Children's Research Institute, Victoria, Australia.,University of Melbourne, Victoria, Australia
| | - Jeanie L Y Cheong
- Murdoch Children's Research Institute, Victoria, Australia.,University of Melbourne, Victoria, Australia.,Royal Women's Hospital, Victoria, Australia
| | - Parool Shah
- Life's Little Treasures Foundation, Ringwood, VIC, Australia
| | - Lex W Doyle
- Murdoch Children's Research Institute, Victoria, Australia.,University of Melbourne, Victoria, Australia.,Royal Women's Hospital, Victoria, Australia
| | - Peter J Anderson
- Murdoch Children's Research Institute, Victoria, Australia.,Turner Institute for Brain & Mental Health, School of Psychological Sciences, Monash University, Victoria, Australia
| |
Collapse
|
28
|
Twilhaar ES, Pierrat V, Marchand-Martin L, Benhammou V, Kaminski M, Ancel PY. Profiles of Functioning in 5.5-Year-Old Very Preterm Born Children in France: The EPIPAGE-2 Study. J Am Acad Child Adolesc Psychiatry 2022; 61:881-891. [PMID: 34508804 DOI: 10.1016/j.jaac.2021.09.001] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Revised: 08/05/2021] [Accepted: 09/01/2021] [Indexed: 11/29/2022]
Abstract
OBJECTIVE Very preterm born children are at risk for impairments in multiple neurodevelopmental domains, but outcomes vary between individuals. The present study aimed to distinguish subgroups with distinct profiles of functioning across motor, cognitive, behavioral, and psychosocial domains. These profiles were related to neonatal and social/environmental factors. METHOD The sample included 1977 children born very preterm (<32 weeks' gestation) in 2011 from the French population-based EPIPAGE-2 cohort. Using latent profile analysis, subgroups of children were distinguished based on their functioning at 5.5 years. The relation between outcome profiles and neonatal and social/environmental factors was tested using multivariable multinomial logistic regression analysis. RESULTS Four subgroups with distinct outcome profiles were distinguished: no deficit in any domain (45%); motor and cognitive deficits without behavioral/psychosocial deficits (31%); primarily behavioral and psychosocial deficits (16%); and deficits in multiple domains (8%). Male sex (odds ratio [OR] = 2.1-2.7), bronchopulmonary dysplasia (OR = 2.1-2.8), low parental education level (OR = 1.8-2.1), and parental non-European immigrant status (OR = 2.3-3.0) were independently associated with higher odds for all suboptimal outcome profiles compared to the favorable outcome profile. CONCLUSION Among 5.5-year-old very preterm born children, subgroups can be distinguished with distinct outcome profiles that vary in severity, type, and combinations of deficits. This information is important for the development of interventions that are tailored to the needs of large subgroups of children across multiple domains of functioning. General neonatal and social/environmental factors may be useful for early identification of very preterm born children at risk for general rather than domain-specific impairments.
Collapse
Affiliation(s)
- E Sabrina Twilhaar
- Université de Paris, Institut National de la Santé et de la Recherche Médicale (INSERM), Paris, France.
| | - Véronique Pierrat
- Université de Paris, Institut National de la Santé et de la Recherche Médicale (INSERM), Paris, France; CHU Lille, Jeanne de Flandre Hospital, Lille, France
| | - Laetitia Marchand-Martin
- Université de Paris, Institut National de la Santé et de la Recherche Médicale (INSERM), Paris, France
| | - Valérie Benhammou
- Université de Paris, Institut National de la Santé et de la Recherche Médicale (INSERM), Paris, France
| | - Monique Kaminski
- Université de Paris, Institut National de la Santé et de la Recherche Médicale (INSERM), Paris, France
| | - Pierre-Yves Ancel
- Université de Paris, Institut National de la Santé et de la Recherche Médicale (INSERM), Paris, France; Assistance Publique-Hôpitaux de Paris, Clinical Investigation Center P1419, Paris, France
| |
Collapse
|
29
|
Mclean MA, Scoten OC, Yu W, Ye XY, Petrie J, Church PT, Soraisham AS, Mirea LS, Weinberg J, Synnes AR, O'Brien K, Grunau RE. Lower Maternal Chronic Physiological Stress and Better Child Behavior at 18 Months: Follow-Up of a Cluster Randomized Trial of Neonatal Intensive Care Unit Family Integrated Care. J Pediatr 2022; 243:107-115.e4. [PMID: 34971651 DOI: 10.1016/j.jpeds.2021.12.055] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Revised: 12/15/2021] [Accepted: 12/22/2021] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To assess whether Family Integrated Care (FICare) in the neonatal intensive care unit improves maternal chronic physiological stress and child behavior at 18 months of corrected age for infants born preterm. STUDY DESIGN Follow-up of a multicenter, prospective cluster-randomized controlled trial comparing FICare and standard care of children born at <33 weeks of gestation and parents, stratified by tertiary neonatal intensive care units, across Canada. Primary outcomes at 18 months of corrected age were maternal stress hormones (cortisol, ie, hair cumulative cortisol [HCC], dehydroepiandrosterone [DHEA]) assayed from hair samples. Secondary outcomes included maternal reports of parenting stress, child behaviors (Internalizing, Externalizing, Dysregulation), and observer-rated caregiving behaviors. Outcomes were analyzed using multilevel modeling. RESULTS We included 126 mother-child dyads from 12 sites (6 FICare sites, n = 83; 6 standard care sites, n = 43). FICare intervention significantly lowered maternal physiological stress as indicated by HCC (B = -0.22 [-0.41, -0.04]) and cortisol/DHEA ratio (B = -0.25 [-0.48, -0.02]), but not DHEA (B = 0.01 [-0.11, 0.14]). Enrollment in FICare led to lower child Internalizing (B = -0.93 [-2.33, 0.02]) and Externalizing behavior T scores (B = -0.91 [-2.25, -0.01]) via improvements to maternal HCC (mediation). FICare buffered the negative effects of high maternal HCC on child Dysregulation T scores (B = -11.40 [-23.01, 0.21]; moderation). For mothers reporting high parenting stress at 18 months, FICare was related to lower Dysregulation T scores via maternal HCC; moderated mediation = -0.17 (-0.41, -0.01). CONCLUSIONS FICare has long-term beneficial effects for mother and child, attenuating maternal chronic physiological stress, and improving child behavior in toddlerhood. CLINICAL TRIAL REGISTRATION NCT01852695.
Collapse
Affiliation(s)
- Mia A Mclean
- Department of Pediatrics, University of British Columbia, Vancouver, British Columbia, Canada; BC Children's Hospital Research Institute, Vancouver, British Columbia, Canada
| | - Olivia C Scoten
- BC Children's Hospital Research Institute, Vancouver, British Columbia, Canada
| | - Wayne Yu
- Department of Cellular & Physiological Sciences, University of British Columbia, Vancouver, British Columbia, Canada
| | - Xiang Y Ye
- Maternal-Infant Care Research Centre, Mount Sinai Hospital, Toronto, Ontario, Canada
| | - Julie Petrie
- BC Women's Hospital, Vancouver, British Columbia, Canada
| | - Paige T Church
- Department of Pediatrics, University of Toronto, Toronto, Ontario, Canada
| | | | | | - Joanne Weinberg
- Department of Cellular & Physiological Sciences, University of British Columbia, Vancouver, British Columbia, Canada
| | - Anne R Synnes
- Department of Pediatrics, University of British Columbia, Vancouver, British Columbia, Canada; BC Children's Hospital Research Institute, Vancouver, British Columbia, Canada; BC Women's Hospital, Vancouver, British Columbia, Canada
| | - Karel O'Brien
- Maternal-Infant Care Research Centre, Mount Sinai Hospital, Toronto, Ontario, Canada; Department of Pediatrics, University of Toronto, Toronto, Ontario, Canada; Department of Pediatrics, Mount Sinai Hospital, Toronto, Ontario, Canada
| | - Ruth E Grunau
- Department of Pediatrics, University of British Columbia, Vancouver, British Columbia, Canada; BC Children's Hospital Research Institute, Vancouver, British Columbia, Canada; BC Women's Hospital, Vancouver, British Columbia, Canada.
| |
Collapse
|
30
|
Girchenko P, Robinson R, Rantalainen VJ, Lahti-Pulkkinen M, Heinonen-Tuomaala K, Lemola S, Wolke D, Schnitzlein D, Hämäläinen E, Laivuori H, Villa PM, Kajantie E, Räikkönen K. Maternal postpartum depressive symptoms partially mediate the association between preterm birth and mental and behavioral disorders in children. Sci Rep 2022; 12:947. [PMID: 35042942 PMCID: PMC8766431 DOI: 10.1038/s41598-022-04990-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2021] [Accepted: 01/03/2022] [Indexed: 01/10/2023] Open
Abstract
Preterm birth has been linked with postpartum depressive (PPD) disorders and high symptom levels, but evidence remains conflicting and limited in quality. It remains unclear whether PPD symptoms of mothers with preterm babies were already elevated before childbirth, and whether PPD symptoms mediate/aggravate the effect of preterm birth on child mental disorders. We examined whether preterm birth associated with maternal PPD symptoms, depressive symptoms trajectories from antenatal to postpartum stage, and whether PPD symptoms mediated/aggravated associations between preterm birth and child mental disorders. Mothers of preterm (n = 125) and term-born (n = 3033) children of the Prediction and Prevention of Preeclampsia and Intrauterine Growth Restriction study reported depressive symptoms four times within 8 weeks before and twice within 12 months after childbirth. Child mental and behavioral disorder diagnoses until age 8.4-12.8 years came from medical register. Preterm birth associated with higher PPD symptoms (mean difference = 0.19 SD, 95% CI 0.01, 0.37, p = 0.04), and higher odds (odds ratio = 2.23, 95% CI 1.22, 4.09, p = 0.009) of the mother to belong to a group that had consistently high depressive symptoms levels trajectory from antenatal to postpartum stage. PPD symptoms partially mediated and aggravated the association between preterm birth and child mental disorders. Preterm birth, maternal PPD symptoms and child mental disorders are associated, calling for timely prevention interventions.
Collapse
Affiliation(s)
- Polina Girchenko
- Institute of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, (Haartmaninkatu 3), P.O BOX 21, 00014, Helsinki, Finland.
| | - Rachel Robinson
- Institute of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, (Haartmaninkatu 3), P.O BOX 21, 00014, Helsinki, Finland
| | - Ville Juhani Rantalainen
- Institute of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, (Haartmaninkatu 3), P.O BOX 21, 00014, Helsinki, Finland
| | - Marius Lahti-Pulkkinen
- Institute of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, (Haartmaninkatu 3), P.O BOX 21, 00014, Helsinki, Finland.,National Institute for Health and Welfare, Helsinki, Finland.,Queen's Medical Research Institute, University of Edinburgh, Edinburgh, UK
| | - Kati Heinonen-Tuomaala
- Institute of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, (Haartmaninkatu 3), P.O BOX 21, 00014, Helsinki, Finland.,Psychology/Welfare Sciences, Faculty of Social Sciences, Tampere University, Tampere, Finland
| | - Sakari Lemola
- Department of Psychology, University of Warwick, Coventry, UK.,Department of Psychology, Bielefeld University, Bielefeld, Germany
| | - Dieter Wolke
- Department of Psychology, University of Warwick, Coventry, UK
| | - Daniel Schnitzlein
- Leibniz University of Hannover, Hannover, Germany.,IZA Bonn, Bonn, Germany
| | - Esa Hämäläinen
- Department of Clinical Chemistry, University of Eastern Finland, Kuopio, Finland
| | - Hannele Laivuori
- Department of Obstetrics and Gynecology, Tampere University Hospital, Tampere, Finland.,Center for Child, Adolescent and Maternal Health Research, Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland.,Medical and Clinical Genetics, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.,Institute for Molecular Medicine Finland, Helsinki Institute of Life Science, University of Helsinki, Helsinki, Finland
| | - Pia M Villa
- Obstetrics and Gynaecology, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - Eero Kajantie
- National Institute for Health and Welfare, Public Health Promotion Unit, Helsinki, Finland.,University of Oulu, Oulu, Finland
| | - Katri Räikkönen
- Institute of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, (Haartmaninkatu 3), P.O BOX 21, 00014, Helsinki, Finland
| |
Collapse
|
31
|
Parents' Perception of Family-Centered Music Therapy with Stable Preterm Infants. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182312813. [PMID: 34886539 PMCID: PMC8657748 DOI: 10.3390/ijerph182312813] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/12/2021] [Revised: 11/23/2021] [Accepted: 12/03/2021] [Indexed: 11/18/2022]
Abstract
Premature birth places considerable demands on preterm infants and their families. Most of these infants are treated on a neonatal intensive care unit immediately after birth, leading to psychosocial stress for parents and making it more difficult to build a stable parent-child bond. We hypothesized that accompaniment with live music therapy by a music therapist supports the parents to get in contact with their child and to promote the parents’ wellbeing. Preterm infants born at less than 32 gestational weeks received creative music therapy twice a week until discharge. At the time of discharge, the parents were asked to complete a Likert-style questionnaire to evaluate the music therapy. Six items related to socio-demographic characteristics, 4 items to observations on the infant and 10 items to personal perception. Of 40 preterm infants receiving music therapy, 32 (80%) parents completed the questionnaires. Thirty (94%) of these parents were able to relax during the music therapy session. Relaxation in their infants was observed by 29 (91%) during and by 28 (88%) after music therapy. Parents perceived music therapy as a positive change and enrichment during their infant’s hospital stay. All parents were thankful for the music therapy they received. Music therapy supports the parents of preterm infants in the first time after birth until discharge from the hospital.
Collapse
|
32
|
Wu B, Arslanian KJ, Nyhan K, Taylor S, Shabanova V, Muasau-Howard B, Hawley NL. Preterm birth among Pacific Islander women and related perinatal outcomes: a scoping review protocol. BMJ Open 2021; 11:e050483. [PMID: 34728448 PMCID: PMC8565552 DOI: 10.1136/bmjopen-2021-050483] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Accepted: 09/10/2021] [Indexed: 11/25/2022] Open
Abstract
INTRODUCTION Infants born alive <37 weeks are classified as premature. The global estimate of preterm birth in 2014 was 10.6%, and it is the leading cause of death of children under the age of 5 years. Preterm birth disproportionately affects women of minority populations, yet knowledge about the incidence and associated outcomes among Pacific Islanders is limited. The objectives of this scoping review are to identify studies that describe risk factors, maternal-child health outcomes and existing interventions to prevent preterm birth among Pacific Islanders, and to summarise the barriers and facilitators to decrease the burden. METHODS AND ANALYSIS We will follow the Joanna Briggs Institute Manual for Evidence Synthesis for scoping reviews and the Preferred Reporting Items for Scoping Reviews (PRISMA-ScR) to conduct this scoping review. The Covidence web application will be used for data management and consensus review. We will search on MEDLINE ALL (Ovid), EMBASE (Ovid), Web of Science Core Collection (as licensed at Yale), the Cochrane Library, CINAHL (EBSCOhost) and two non-indexed regional journals (Pacific Journal of Reproductive Health and Pacific Health Dialog). Title-abstract and full-text screening of eligible studies will be performed by two authors, and data will be extracted by the first author. Outcomes extracted will be presented using evidence mapping. ETHICS AND DISSEMINATION Findings will drive suggestions for new data collection needed to fill knowledge gaps and improve future study designs to decrease the burden of preterm birth among Pacific Islanders. There are no ethical concerns. This protocol will be disseminated in related peer-reviewed journals.
Collapse
Affiliation(s)
- Bohao Wu
- Department of Chronic Disease Epidemiology, Yale University School of Public Health, New Haven, Connecticut, USA
| | - Kendall J Arslanian
- Department of Social and Behavioral Sciences, Yale University School of Public Health, New Haven, Connecticut, USA
| | - Kate Nyhan
- Harvey Cushing/John Hay Whitney Medical Library, Yale University, New Haven, Connecticut, USA
- Department of Environmental Health Sciences, Yale University School of Public Health, New Haven, Connecticut, USA
| | - Sarah Taylor
- Division of Neonatal-Perinatal Medicine, Yale School of Medicine, New Haven, Connecticut, USA
| | - Veronika Shabanova
- Department of Pediatrics, Yale School of Medicine, New Haven, Connecticut, USA
- Department of Biostatistics, Yale School of Medicine, New Haven, Connecticut, USA
| | - Bethel Muasau-Howard
- Department of Obstetrics and Gynecology, Lyndon B Johnson Tropical Medical Center, Pago Pago, American Samoa
| | - Nicola L Hawley
- Department of Chronic Disease Epidemiology, Yale University School of Public Health, New Haven, Connecticut, USA
| |
Collapse
|
33
|
Yates R, Anderson PJ, Lee KJ, Doyle LW, Cheong JLY, Pace CC, Spittle AJ, Spencer-Smith M, Treyvaud K. Maternal Mental Health Disorders Following Very Preterm Birth at 5 Years Post-Birth. J Pediatr Psychol 2021; 47:327-336. [PMID: 34664642 DOI: 10.1093/jpepsy/jsab101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2020] [Revised: 09/11/2021] [Accepted: 09/14/2021] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVE Mothers of children born very preterm (VP) are at increased risk of developing postnatal depression, anxiety, and post-traumatic stress symptoms. However, mental health disorder rates are rarely assessed in this population compared with full-term peers, and it is unclear if postnatal distress symptoms precede higher rates of maternal mental health disorders at 5 years post-birth in both birth groups. METHODS Mothers of children born VP (n = 65; mean [SD] age at birth, 33.9 [5.0]; 72.1% tertiary educated) and full-term (n = 90; mean [SD] age at birth, 33.4 [4.0]; 88.2% tertiary educated) completed questionnaires assessing symptoms of depression, anxiety, and trauma within 4 weeks of birth. At 5 years post-birth, they participated in a structured diagnostic interview assessing mood, anxiety, and trauma-related mental health disorders, both current and over the lifetime. RESULTS There was little evidence for differences between mothers in the VP and full-term groups in rates of any mental health disorder at 5 years (VP = 14%, full-term = 14%) or lifetime (VP = 41%, full-term = 37%). In mothers of children born VP, elevated postnatal post-traumatic stress symptoms were associated with higher rates of mental health disorders at 5 years (odds ratio = 21.5, 95% confidence interval = 1.35-342). CONCLUSIONS Findings suggest that preterm birth may not lead to increased odds of later developing maternal mental health disorders, despite known risks of elevated postnatal distress following a VP birth. However, those with post-traumatic stress symptoms following a VP birth could be more vulnerable, and assessment and monitoring is recommended.
Collapse
Affiliation(s)
- Rosemary Yates
- Turner Institute for Brain and Mental Health and School of Psychological Sciences, Monash University, Clayton, Vic, Australia.,Murdoch Children's Research Institute, Parkville, Vic, Australia
| | - Peter J Anderson
- Turner Institute for Brain and Mental Health and School of Psychological Sciences, Monash University, Clayton, Vic, Australia.,Murdoch Children's Research Institute, Parkville, Vic, Australia
| | - Katherine J Lee
- Murdoch Children's Research Institute, Parkville, Vic, Australia.,Department of Paediatrics, University of Melbourne, Parkville, Vic, Australia
| | - Lex W Doyle
- Murdoch Children's Research Institute, Parkville, Vic, Australia.,Department of Paediatrics, University of Melbourne, Parkville, Vic, Australia.,Neonatal Services, Royal Women's Hospital, Parkville, Vic, Australia.,Department of Obstetrics and Gynaecology, University of Melbourne, Parkville, Vic, Australia
| | - Jeanie L Y Cheong
- Murdoch Children's Research Institute, Parkville, Vic, Australia.,Neonatal Services, Royal Women's Hospital, Parkville, Vic, Australia.,Department of Obstetrics and Gynaecology, University of Melbourne, Parkville, Vic, Australia
| | - Carmen C Pace
- Murdoch Children's Research Institute, Parkville, Vic, Australia.,Department of Paediatrics, University of Melbourne, Parkville, Vic, Australia.,Department of Adolescent Medicine, Royal Children's Hospital, Parkville, Vic, Australia.,Mental Health, Royal Children's Hospital, Parkville, Vic, Australia
| | - Alicia J Spittle
- Murdoch Children's Research Institute, Parkville, Vic, Australia.,Neonatal Services, Royal Women's Hospital, Parkville, Vic, Australia.,Department of Physiotherapy, University of Melbourne, Parkville, Vic, Australia
| | - Megan Spencer-Smith
- Turner Institute for Brain and Mental Health and School of Psychological Sciences, Monash University, Clayton, Vic, Australia.,Murdoch Children's Research Institute, Parkville, Vic, Australia
| | - Karli Treyvaud
- Murdoch Children's Research Institute, Parkville, Vic, Australia.,Department of Paediatrics, University of Melbourne, Parkville, Vic, Australia.,Neonatal Services, Royal Women's Hospital, Parkville, Vic, Australia.,Department of Psychology and Counselling, La Trobe University, Bundoora, Vic, Australia
| |
Collapse
|
34
|
Ren L, Song C, Xia C, Wang N, Yang Y, Yin S. Pregnancy and parenting experiences of women with twin-to-twin transfusion syndrome: a qualitative study. BMC Pregnancy Childbirth 2021; 21:595. [PMID: 34479507 PMCID: PMC8417964 DOI: 10.1186/s12884-021-04057-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2020] [Accepted: 08/17/2021] [Indexed: 11/25/2022] Open
Abstract
Background Qualitative research can reflect the actual thoughts and experience of research subjects and can be used to explore the experiences of women presenting with twin-to-twin transfusion syndrome (TTTS) to facilitate the provision of targeted psychological support. Methods A semi-structured interview method was used to assess the pregnancy and parenting experiences of women with TTTS. Colaizzi method was used for data analysis. Results Eighteen women participated in the study. We found that women with TTTS during pregnancy experienced persistent worry about their children’s health from the disease diagnosis to the subsequent parenting processes, even in case of minor changes in their children’s health. The lack of an efficient referral process and health information increased their uncertainty about their children’s health. Conclusion In addition to the children’s health, other difficulties encountered during pregnancy and parenting may aggravate the pressure. Clinicians in the first-visit hospital and foetal medicine centre should improve the referral process and establish a follow-up system to provide women with health information and psychological support. Supplementary Information The online version contains supplementary material available at 10.1186/s12884-021-04057-0.
Collapse
Affiliation(s)
- Lijie Ren
- Gynecology and Obstetrics Department, Shengjing Hospital of China Medical University, 36 Sanhao Road, Heping District, Shenyang City, CO 110004, Liaoning Province, China.,Nursing Department, Shengjing Hospital of China Medical University, 36 Sanhao Road, Heping District, Shenyang City, CO 110004, Liaoning Province, China
| | - Cancan Song
- Nursing Department, Shengjing Hospital of China Medical University, 36 Sanhao Road, Heping District, Shenyang City, CO 110004, Liaoning Province, China
| | - Chunling Xia
- Nursing Department, Shengjing Hospital of China Medical University, 36 Sanhao Road, Heping District, Shenyang City, CO 110004, Liaoning Province, China
| | - Nan Wang
- Nursing Department, Shengjing Hospital of China Medical University, 36 Sanhao Road, Heping District, Shenyang City, CO 110004, Liaoning Province, China
| | - Yan Yang
- Nursing Department, Shengjing Hospital of China Medical University, 36 Sanhao Road, Heping District, Shenyang City, CO 110004, Liaoning Province, China.
| | - Shaowei Yin
- Gynecology and Obstetrics Department, Shengjing Hospital of China Medical University, 36 Sanhao Road, Heping District, Shenyang City, CO 110004, Liaoning Province, China.
| |
Collapse
|
35
|
Morris AR, Bora S, Austin NC, Woodward LJ. Mental health, neurodevelopmental, and family psychosocial profiles of children born very preterm at risk of an early-onset anxiety disorder. Dev Med Child Neurol 2021; 63:954-962. [PMID: 33738794 DOI: 10.1111/dmcn.14859] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/25/2021] [Indexed: 01/30/2023]
Abstract
AIM To compare the mental health and neurodevelopmental profiles of school-age children born very preterm, with and without an anxiety disorder, and to identify neonatal medical, psychosocial, and concurrent neurodevelopmental correlates. METHOD A regional cohort of 102 (51 males, 51 females) children born very preterm (mean [SD] gestation at birth=28wks [2], range=23-31wks) was studied from birth to age 9 years alongside a comparison group of 109 (58 males, 51 females) children born at term (mean [SD] gestation at birth=40wks [1], range=38-41wks). At age 9 years, all children underwent a neurodevelopmental evaluation while parents were interviewed using the Development and Well-Being Assessment to diagnose a range of DSM-IV childhood psychiatric disorders. Detailed information was also available about the children's neonatal medical course and postnatal psychosocial environment, including maternal mental health and parenting. RESULTS At age 9 years, 21% (n=21) of very preterm and 13% (n=14) of term-born children met diagnostic criteria for an anxiety disorder. Clinically-anxious children born very preterm were characterized by higher rates of comorbid mental health (odds ratio [OR]=11.5, 95% confidence interval [CI]=3.8-34.7), social (OR=6.2, 95% CI=2.1-18.4), motor (OR=4.4, 95% CI=1.6-12.2), and cognitive (OR=2.6, 95% CI=1.0-7.0) problems than those without an anxiety disorder. Concurrent maternal mental health and child social difficulties were the strongest independent correlates of early-onset child anxiety disorders. INTERPRETATION Children born very preterm who developed an early-onset anxiety disorder were subject to high rates of comorbid problems. Findings highlight the importance of addressing both maternal and child mental health issues to optimize outcomes in this high-risk population. What this paper adds One out of five school-age children born very preterm are likely to meet DSM-IV diagnostic criteria for an anxiety disorder. Half of these children born very preterm with an early-onset anxiety disorder have comorbid attention-deficit/hyperactivity disorder. Other neurodevelopmental correlates of early-onset anxiety disorders include lower cognitive ability, motor problems, and peer social difficulties. Concurrent maternal mental health and child social adjustment problems were the strongest correlates of early-onset anxiety disorder risk among children born very preterm.
Collapse
Affiliation(s)
- Alyssa R Morris
- Department of Psychology, University of Southern California, Los Angeles, CA, USA
| | - Samudragupta Bora
- Mothers, Babies and Women's Health Program, Mater Research Institute, Faculty of Medicine, The University of Queensland, South Brisbane, QLD, Australia
| | - Nicola C Austin
- Department of Paediatrics, University of Otago, Christchurch, New Zealand
| | - Lianne J Woodward
- School of Health Sciences, University of Canterbury, Christchurch, New Zealand
| |
Collapse
|
36
|
Zengin Akkus P, Bahtiyar Saygan B, Ilter Bahadur E, Ozdemir G, Celik HT, Ozmert EN. Longitudinal changes in attachment patterns of preterm infants born in a non-Western country. Infant Ment Health J 2021; 42:517-528. [PMID: 33410526 DOI: 10.1002/imhj.21906] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
Unexpected early birth of an infant may affect the attachment formation of mother-child dyads. This longitudinal study aimed to explore mother-infant attachment patterns of very preterm (VPT) and preterm (PT) infants compared to their term-born peers in a non-Western country. Neurodevelopmental outcomes of infants, maternal anxiety and depressive symptoms, and sociodemographic features were evaluated to explore their effects on attachment. Eighteen VPT, 11 PT, 11 term infants and their mothers participated. Observations of attachment patterns and neurodevelopmental assessments were performed at 18 and 24 months of corrected age. This study identified a change in attachment patterns of VPT infants over time such that VPT infants tended to have less insecure attachment patterns with their mothers at the end of the infancy period. While motor and language development scores were associated with attachment patterns at 18 months, models predicting attachment patterns were no longer significant at 24 months. Therefore, change in VPT infants' developmental outcomes and attachment patterns over time suggests that preterm birth itself is not necessarily a risk factor for developing insecure attachment patterns; yet, developmental delays may account for insecure attachment patterns. It is suggested that efforts to promote developmental outcomes of preterm infants may improve mother-child attachment.
Collapse
Affiliation(s)
- P Zengin Akkus
- Division of Developmental Pediatrics, Department of Pediatrics, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | | | - E Ilter Bahadur
- Division of Developmental Pediatrics, Department of Pediatrics, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - G Ozdemir
- Division of Developmental Pediatrics, Department of Pediatrics, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - H T Celik
- Department of Pediatrics, Department of Neonatology, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - E N Ozmert
- Division of Developmental Pediatrics, Department of Pediatrics, Hacettepe University Faculty of Medicine, Ankara, Turkey
| |
Collapse
|
37
|
Mayoral K, Garin O, Caballero-Rabasco MA, Praena-Crespo M, Bercedo A, Hernandez G, Castillo J, Lizano Barrantes C, Pardo Y, Ferrer M. Smartphone App for monitoring Asthma in children and adolescents. Qual Life Res 2021; 30:3127-3144. [PMID: 33387290 DOI: 10.1007/s11136-020-02706-z] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/11/2020] [Indexed: 01/04/2023]
Abstract
PURPOSE The asthma stepwise treatment approach recommended is based on monitoring patients' symptoms. The Asthma Research in Children and Adolescents (ARCA) cohort was created to provide evidence about the evolution of persistent asthma. This manuscript describes the development of an electronic health tool, comprising a mobile health application for patients with asthma and its associated online platform for pediatricians to monitor them. METHODS The development process followed 7 phases: the first 5 (Conceptualization, Preparation, Assessment scheduling, Image and user interface, and Technical development) defined and designed the tool, followed by a testing phase (functionality assessment and pilot test with ARCA patients), and a last phase which evaluated usability. Since the target population was aged 6-16 years, three versions were designed within the same smartphone application: parents/proxy, children, and adolescents. The online platform for pediatricians provides real-time information from the application: patients' responses over time with color-coded charts (red/amber/green, as in traffic lights). RESULTS The pilot test through semi-structured phone interviews of the first 50 participants included in the ARCA study (n = 53) detected their misunderstandings. Pediatricians were trained to emphasize that the application is free of charge and requires monthly answers. Median of the System Usability Scale scores (n = 85), ranging 0 (negative)-100 (positive), was > 93 in the three age versions of the application. CONCLUSIONS Technology has the capability of transforming the use of patient-reported outcomes. Describing all the development phases of a mobile health application for monitoring children and adolescents with asthma may increase the knowledge on how to design applications for young patients.
Collapse
Affiliation(s)
- K Mayoral
- Health Services Research Group, IMIM-Hospital del Mar Medical Research Institute, Barcelona, Spain.,Department of Paediatrics, Obstetrics and Gynaecology and Preventive Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain.,Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública CIBERESP, Madrid, Spain
| | - O Garin
- Health Services Research Group, IMIM-Hospital del Mar Medical Research Institute, Barcelona, Spain. .,Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública CIBERESP, Madrid, Spain. .,Pompeu Fabra University UPF, Barcelona, Spain.
| | - M A Caballero-Rabasco
- Department of Paediatrics, Obstetrics and Gynaecology and Preventive Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain.,Pediatric Allergy and Pulmonology Unit, Pediatric Service, Hospital del Mar, Barcelona, Spain
| | - M Praena-Crespo
- Centro de Salud la Candelaria, Servicio Andaluz de Salud, Seville, Spain.,Grupo de Vías Respiratorias de la Asociación Española de Pediatras de Atención Primaria (AEPAP), Madrid, Spain
| | - A Bercedo
- Grupo de Vías Respiratorias de la Asociación Española de Pediatras de Atención Primaria (AEPAP), Madrid, Spain.,Centro de Salud Dobra, Servicio Cántabro de Salud, Cantabria, Spain
| | - G Hernandez
- Grupo de Vías Respiratorias de la Asociación Española de Pediatras de Atención Primaria (AEPAP), Madrid, Spain.,CAP Vila Olimpica, Parc Sanitari Pere Virgili, Barcelona, Spain
| | - J Castillo
- Grupo de Vías Respiratorias de la Asociación Española de Pediatras de Atención Primaria (AEPAP), Madrid, Spain.,Pediatric Pneumology Unit, Pediatric Service, Hospital Infantil Universitario Miguel Servet, Zaragoza, Spain
| | - C Lizano Barrantes
- Health Services Research Group, IMIM-Hospital del Mar Medical Research Institute, Barcelona, Spain.,Pompeu Fabra University UPF, Barcelona, Spain.,University of Costa Rica, San José, Costa Rica
| | - Y Pardo
- Health Services Research Group, IMIM-Hospital del Mar Medical Research Institute, Barcelona, Spain.,Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública CIBERESP, Madrid, Spain.,Department of Psychiatry and Legal Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - M Ferrer
- Health Services Research Group, IMIM-Hospital del Mar Medical Research Institute, Barcelona, Spain. .,Department of Paediatrics, Obstetrics and Gynaecology and Preventive Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain. .,Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública CIBERESP, Madrid, Spain.
| | | |
Collapse
|
38
|
Eeles AL, Gibbs D. Tool to Enhance Relationships Between Staff and Parents in the Neonatal Unit. J Obstet Gynecol Neonatal Nurs 2020; 49:593-604. [PMID: 32979323 DOI: 10.1016/j.jogn.2020.08.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/01/2020] [Indexed: 11/25/2022] Open
Abstract
OBJECTIVE To explore the experiences of neonatal nurses in the implementation of a tool to enhance relationships between staff and parents in the neonatal unit: the You and Your Baby Nursery Guide. DESIGN Qualitative descriptive design with focus groups. SETTING The study took place in a Level 4, 20-bed neonatal unit in Melbourne, Victoria, Australia. PARTICIPANTS Purposive sample of seven registered nurses who worked day or afternoon shifts. METHODS We conducted two semistructured focus groups after a 4-week implementation period of the You and Your Baby Nursery Guide. Participants completed a weekly reflective journal throughout the implementation period. We audiotaped and transcribed the focus groups and qualitatively analyzed the interview data with the use of thematic analysis. RESULTS Use of the guide helped transform the relationships between parents and staff. The use of the guide enhanced communication, promoted participants' personal reflection on their clinical skills and style/approach to parent engagement, and directly affected the care participants provided to infants and families. CONCLUSION The You and Your Baby Nursery Guide was a useful resource to facilitate the delivery of family-centered, developmentally supportive care.
Collapse
|
39
|
Qian J, Zhou X, Sun X, Wu M, Sun S, Yu X. Effects of expressive writing intervention for women's PTSD, depression, anxiety and stress related to pregnancy: A meta-analysis of randomized controlled trials. Psychiatry Res 2020; 288:112933. [PMID: 32315889 DOI: 10.1016/j.psychres.2020.112933] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2019] [Revised: 03/10/2020] [Accepted: 03/18/2020] [Indexed: 12/22/2022]
Abstract
Expressive writing (EW) is a common psychological intervention that aims to improve the mental health of traumatized individuals. Pregnancy is considered an anxious or traumatic experience for some women, and any crisis in relation to pregnancy is closely associated with their psychological well-being. Post-traumatic stress disorder (PTSD), depression, anxiety and stress are the most prominent emotional and psychological responses that may occur during the process. However, the effects of EW in mediating women's PTSD, depression, anxiety and stress related to pregnancy remain uncertain, and no qualified meta-analysis has assessed such effects. The aim of this study was to assess the effectiveness of EW as a psychological intervention for women. Five databases, including PubMed, EMBASE, Cochrane, Web of Science and PsycINFO, were searched from inception to September 2019 for eligible studies. Finally, a total of 929 participants from 8 randomized controlled trial (RCT) studies were included. A pooled analysis demonstrated that EW was an efficient therapy for decreasing PTSD. However, the results showed that the EW intervention was not associated with the expected effects on anxiety and stress symptoms. The efficacy of EW for depression was inconclusive. More RCTs are necessary to verify the effectiveness of EW for depression. Studies concentrating on EW's effects on physical symptoms are necessary, and researchers should create an EW intervention group, neutral writing group and no writing group to examine the true effects of EW. Future research should examine whether longer, more frequent, and more targeted writing interventions would result in different conclusions.
Collapse
Affiliation(s)
- Jialu Qian
- Zhejiang University School of Medicine, Hangzhou, China; Department of Obstetrics and Gynecology, Women's Hospital School of Medicine, Zhejiang University, Hangzhou, China.
| | - Xiaoli Zhou
- Zhejiang University School of Medicine, Hangzhou, China; Department of Obstetrics and Gynecology, Women's Hospital School of Medicine, Zhejiang University, Hangzhou, China.
| | - Xueshan Sun
- Zhejiang University School of Medicine, Hangzhou, China.
| | - Mengwei Wu
- Zhejiang University School of Medicine, Hangzhou, China; Department of Obstetrics and Gynecology, Women's Hospital School of Medicine, Zhejiang University, Hangzhou, China.
| | - Shiwen Sun
- Department of Obstetrics and Gynecology, Women's Hospital School of Medicine, Zhejiang University, Hangzhou, China.
| | - Xiaoyan Yu
- Department of Obstetrics and Gynecology, Women's Hospital School of Medicine, Zhejiang University, Hangzhou, China.
| |
Collapse
|
40
|
Transitioning Into the Role of Mother Following the Birth of a Very Low-Birth-Weight Infant: A Grounded Theory Pilot Study. J Perinat Neonatal Nurs 2020; 34:125-133. [PMID: 32332442 DOI: 10.1097/jpn.0000000000000466] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
This qualitative grounded theory pilot study investigated the concerns and coping mechanisms of mothers of very low-birth-weight (VLBW; <1500 g) infants following discharge from the neonatal intensive care unit in Alberta, Canada. In-depth, semistructured, face-to-face, audio-recorded interviews were conducted with women of VLBW infants. Interviews lasting 75 to 90 minutes were transcribed verbatim and coded using grounded theory methodology. Data saturation and theoretical redundancy were achieved in interviews with 6 mothers of VLBW infants. The core variable of "reconstructing normal" emerged from the interview data. Women indicated that mothering a VLBW infant is an unfolding experience that is continuously being revised, creating a new sense of normal. The construct consists of 4 categories; mother-infant relationship, maternal development, maternal caregiving and role-reclaiming strategies, and infant developmental milestones. Findings from this study suggest that women found the transition into motherhood following the birth of a VLBW infant as a multidimensional and dynamic process. Further research is warranted to confirm these results and to further explore mothering issues with VLBW infants.
Collapse
|