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Devita S, Bozicevic L, Deforges C, Ciavarella L, Tolsa JF, Sandoz V, Horsch A. Early mother-infant interactions within the context of childbirth-related posttraumatic stress symptoms. J Affect Disord 2024; 365:24-31. [PMID: 39151764 DOI: 10.1016/j.jad.2024.08.025] [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: 03/13/2024] [Revised: 07/15/2024] [Accepted: 08/09/2024] [Indexed: 08/19/2024]
Abstract
BACKGROUND Childbirth may lead to perinatal mental health issues, such as childbirth-related posttraumatic stress symptoms (CB-PTSS), depression, and anxiety. Despite well explored mother-infant interactions in the context of maternal depression and anxiety, only limited studies investigated mother-infant interactions in the context of CB-PTSS, which is the aim of the present study. METHODS One-hundred mother-infant dyads in the French speaking part of Switzerland were classified into three groups: birth-related symptoms (BRS, i.e., symptoms of re-experiencing and avoidance) (n = 20), general symptoms (GS, i.e., symptoms of negative cognition and mood and hyperarousal) (n = 46), and non-symptomatic (NS) (n = 34) based on maternal report on PTSD Checklist for DSM-5 (PCL-5). At six months postpartum, mother-infant interactions were video-recorded and their quality was assessed using the Global Rating Scale. Data was analyzed using ordinal logistic and negative binomial regressions. RESULTS In the adjusted model, mothers in BRS group engaged in more frequent coercions compared to the NS group (B = -1.46, p = 0.01, 95%CI = -2.63, -0.36) and showed lower reciprocity in their interactions with their infants compared to the GS group (B = 1.21, p = 0.03, 95%CI = 0.05, 2.37). LIMITATIONS The use of a cross-sectional design limited the exploration of how consistent these findings are regarding mother-infant interactions between groups over time. CONCLUSIONS Mothers with higher BRS may need support to improve interactions with their infants. Future studies should consider longitudinal design to observe mother-infant interaction changes between CB-PTSS groups over time.
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Affiliation(s)
- Sella Devita
- Institute of Higher Education and Research in Healthcare (IUFRS), University of Lausanne and Lausanne University Hospital, Lausanne, Switzerland
| | - Laura Bozicevic
- Department of Primary Care and Mental Health, University of Liverpool, Liverpool, United Kingdom
| | - Camille Deforges
- Institute of Higher Education and Research in Healthcare (IUFRS), University of Lausanne and Lausanne University Hospital, Lausanne, Switzerland
| | - Laura Ciavarella
- Institute of Higher Education and Research in Healthcare (IUFRS), University of Lausanne and Lausanne University Hospital, Lausanne, Switzerland
| | - Jean-François Tolsa
- Department Woman-Mother-Child, Clinic of Neonatology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Vania Sandoz
- Institute of Higher Education and Research in Healthcare (IUFRS), University of Lausanne and Lausanne University Hospital, Lausanne, Switzerland; Department Woman-Mother-Child, Child Abuse and Neglect Team, Lausanne University Hospital, Lausanne, Switzerland
| | - Antje Horsch
- Institute of Higher Education and Research in Healthcare (IUFRS), University of Lausanne and Lausanne University Hospital, Lausanne, Switzerland; Department Woman-Mother-Child, Clinic of Neonatology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland.
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Deforges C, Noël Y, Ayers S, Holmes EA, Sandoz V, Avignon V, Desseauve D, Bourdin J, Epiney M, Horsch A. There was no call for immediate implementation of "Tetris" in clinical practice: Response to the commentary by Halvorsen et al. (2024). Mol Psychiatry 2024:10.1038/s41380-024-02766-4. [PMID: 39367054 DOI: 10.1038/s41380-024-02766-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2024] [Revised: 09/19/2024] [Accepted: 09/23/2024] [Indexed: 10/06/2024]
Affiliation(s)
- Camille Deforges
- Institute of Higher Education and Research in Healthcare, University of Lausanne, Lausanne, Vaud, Switzerland
| | - Yvonnick Noël
- Department of Psychology, Rennes 2 University, Rennes, France
| | - Susan Ayers
- Centre for Maternal and Child Health Research, City, University of London, London, UK
| | - Emily A Holmes
- Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
| | - Vania Sandoz
- Department Woman-Mother-Child, Lausanne University Hospital, Lausanne, Vaud, Switzerland
| | - Valérie Avignon
- Institute of Higher Education and Research in Healthcare, University of Lausanne, Lausanne, Vaud, Switzerland
- Department Woman-Mother-Child, Lausanne University Hospital, Lausanne, Vaud, Switzerland
| | - David Desseauve
- Department of Obstetrics, Grenoble Alpes University Hospital, Grenoble, France
| | - Julie Bourdin
- Institute of Pedagogy and Applied Research, Limésy, France
| | - Manuella Epiney
- Department of Woman, Child and Teenager, Geneva University Hospitals, Geneva, Switzerland
| | - Antje Horsch
- Institute of Higher Education and Research in Healthcare, University of Lausanne, Lausanne, Vaud, Switzerland.
- Department Woman-Mother-Child, Lausanne University Hospital, Lausanne, Vaud, Switzerland.
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Halvorsen JØ, Wessel I, Cristea IA. Premature call for implementation of Tetris in clinical practice: a commentary on Deforges et al. (2023). Mol Psychiatry 2024:10.1038/s41380-024-02642-1. [PMID: 38937543 DOI: 10.1038/s41380-024-02642-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2023] [Revised: 06/18/2024] [Accepted: 06/20/2024] [Indexed: 06/29/2024]
Affiliation(s)
- Joar Øveraas Halvorsen
- Psychological outpatient clinic for adults, Department of Psychology, Norwegian University of Science and Technology (NTNU), N-7491, Trondheim, Norway.
- St. Olav's University Hospital, Trondheim, Norway.
| | - Ineke Wessel
- Department of Psychology, University of Groningen, Groningen, The Netherlands
| | - Ioana A Cristea
- Department of General Psychology, University of Padova, Padova, Italy
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Gilbert L, Sandoz V, Deforges C, Horsch A. A two-item screening of maternal or infant perceived life threat during childbirth prospectively associated with childbirth-related posttraumatic stress symptoms up to six months postpartum: two observational longitudinal studies. Front Psychiatry 2024; 15:1360189. [PMID: 38654730 PMCID: PMC11036539 DOI: 10.3389/fpsyt.2024.1360189] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2023] [Accepted: 03/18/2024] [Indexed: 04/26/2024] Open
Abstract
Objective This study investigated prospective relationships between the perception of threat to one's own life or to that of one's infant during childbirth and maternal childbirth-related posttraumatic stress symptoms (CB-PTSS) and probable childbirth-related posttraumatic stress disorder (CB-PTSD) in a community and a community and an emergency cesarean section (ECS) sample. Methods Study samples included 72 mothers from a community sample and 75 mothers after emergency cesarean section. Perceived maternal and infant life threat were assessed at ≤1 week postpartum. Maternal CB-PTSS and probable CB-PTSD were assessed with validated questionnaires up to 6 months postpartum. Covariates were extracted from hospital records. Secondary data analysis with logistic and linear regressions was performed. Results Globally, mothers were significantly more likely to perceive their infant's life to be threatened, rather than their own. Both types of perceived threat were prospectively but differentially associated with maternal CB-PTSS and probable CB-PTSD at 4-6 weeks and 6 months postpartum. Statistical significance was set at p<0.05. Conclusion The type of perceived threat differently influences maternal CB-PTSS and probable CB-PTSD up to 6 months postpartum. These results may be the basis for the development of a short screening instrument after traumatic childbirth in clinical settings. Future studies need to assess the psychometric properties and acceptability of such a brief screening tool.
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Affiliation(s)
- Leah Gilbert
- Department Woman-mother-child, Lausanne University Hospital, Lausanne, Switzerland
- Charles Perkins Center, Nepean Clinical School, Faculty of Medicine and Health, University of Sydney, Penrith, NSW, Australia
| | - Vania Sandoz
- Child Abuse and Neglect Team, Department Woman-mother-child, Lausanne University Hospital, Lausanne, Switzerland
- Institute of Higher Education and Research in Healthcare, University of Lausanne, Lausanne, Switzerland
| | - Camille Deforges
- Institute of Higher Education and Research in Healthcare, University of Lausanne, Lausanne, Switzerland
| | - Antje Horsch
- Department Woman-mother-child, Lausanne University Hospital, Lausanne, Switzerland
- Institute of Higher Education and Research in Healthcare, University of Lausanne, Lausanne, Switzerland
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Devita S, Deforges C, Bickle-Graz M, Tolsa JF, Sandoz V, Horsch A. Maternal childbirth-related posttraumatic stress symptoms, bonding, and infant development: a prospective study. J Reprod Infant Psychol 2023:1-15. [PMID: 37740725 DOI: 10.1080/02646838.2023.2261057] [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: 05/09/2023] [Accepted: 09/15/2023] [Indexed: 09/25/2023]
Abstract
BACKGROUND Childbirth-related posttraumatic stress symptoms (CB-PTSS) including general symptoms (GS, i.e., mainly negative cognitions and mood and hyperarousal symptoms) and birth-related symptoms (BRS, i.e., mostly re-experiencing and avoidance symptoms) may disrupt mother-infant bonding and infant development. This study investigated prospective and cross-sectional associations between maternal CB-PTSS and mother-infant bonding or infant development (language, motor, and cognitive). METHOD We analysed secondary data of the control group of a randomised control trial (NCT03576586) with full-term French-speaking mother-infant dyads (n = 55). Maternal CB-PTSS and mother-infant bonding were assessed via questionnaires at six weeks (T1) and six months (T2) postpartum: PTSD Checklist for DSM-5 (PCL-5) and Mother-Infant Bonding Scale (MIBS). Infant development was assessed with the Bayley Scales of Infant Development at T2. Sociodemographic and medical data were collected from questionnaires and medical records. Bivariate and multivariate regression were used. RESULTS Maternal total CB-PTSS score at T1 was associated with poorer bonding at T2 in the unadjusted model (B = 0.064, p = 0.043). In the adjusted model, cross-sectional associations were found at T1 between a higher total CB-PTSS score and poorer bonding (B = 0.134, p = 0.017) and between higher GS and poorer bonding (B = 0.306, p = 0.002). Higher BRS at T1 was associated with better infant cognitive development at T2 in the unadjusted model (B = 0.748, p = 0.026). CONCLUSIONS Results suggest that CB-PTSS were associated with mother-infant bonding difficulties, while CB-PTSS were not significantly associated with infant development. Additional studies are needed to increase our understanding of the intergenerational consequences of perinatal trauma.
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Affiliation(s)
- Sella Devita
- Institute of Higher Education and Research in Healthcare (IUFRS), University of Lausanne and Lausanne University Hospital, Lausanne, Switzerland
| | - Camille Deforges
- Institute of Higher Education and Research in Healthcare (IUFRS), University of Lausanne and Lausanne University Hospital, Lausanne, Switzerland
| | - Myriam Bickle-Graz
- Department Woman-Mother-Child, Clinic of Neonatology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Jean-François Tolsa
- Department Woman-Mother-Child, Clinic of Neonatology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Vania Sandoz
- Institute of Higher Education and Research in Healthcare (IUFRS), University of Lausanne and Lausanne University Hospital, Lausanne, Switzerland
- Department Woman-Mother-Child, Child Abuse and Neglect Team, Lausanne University Hospital, Lausanne, Switzerland
| | - Antje Horsch
- Institute of Higher Education and Research in Healthcare (IUFRS), University of Lausanne and Lausanne University Hospital, Lausanne, Switzerland
- Department Woman-Mother-Child, Clinic of Neonatology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
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Deforges C, Sandoz V, Noël Y, Avignon V, Desseauve D, Bourdin J, Vial Y, Ayers S, Holmes EA, Epiney M, Horsch A. Single-session visuospatial task procedure to prevent childbirth-related posttraumatic stress disorder: a multicentre double-blind randomised controlled trial. Mol Psychiatry 2023; 28:3842-3850. [PMID: 37759037 PMCID: PMC10730415 DOI: 10.1038/s41380-023-02275-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2023] [Revised: 09/10/2023] [Accepted: 09/14/2023] [Indexed: 09/29/2023]
Abstract
Preventive evidence-based interventions for childbirth-related posttraumatic stress disorder (CB-PTSD) are lacking. Yet, 18.5% of women develop CB-PTSD symptoms following an unplanned caesarean section (UCS). This two-arm, multicentre, double-blind superiority trial tested the efficacy of an early single-session intervention including a visuospatial task on the prevention of maternal CB-PTSD symptoms. The intervention was delivered by trained maternity clinicians. Shortly after UCS, women were included if they gave birth to a live baby, provided consent, and perceived their childbirth as traumatic. Participants were randomly assigned to the intervention or attention-placebo group (allocation ratio 1:1). Assessments were done at birth, six weeks, and six months postpartum. Group differences in maternal CB-PTSD symptoms at six weeks (primary outcomes) and six months postpartum (secondary outcomes) were assessed with the self-report PTSD Checklist for DSM-5 (PCL-5) and by blinded research assessors with the Clinician-administered PTSD scale for DSM-5 (CAPS-5). Analysis was by intention-to-treat. The trial was prospectively registered (ClinicalTrials.gov, NCT03576586). Of the 2068 women assessed for eligibility, 166 were eligible and 146 were randomly assigned to the intervention (n = 74) or attention-placebo control group (n = 72). For the PCL-5, at six weeks, a marginally significant intervention effect was found on the total PCL-5 PTSD symptom count (β = -0.43, S.E. = 0.23, z = -1.88, p < 0.06), and on the intrusions (β = -0.73, S.E. = 0.38, z = -1.94, p < 0.0525) and arousal (β = -0.55, S.E. = 0.29, z = -1.92, p < 0.0552) clusters. At six months, a significant intervention effect on the total PCL-5 PTSD symptom count (β = -0.65, S.E. = 0.32, z = -2.04, p = 0.041, 95%CI[-1.27, -0.03]), on alterations in cognition and mood (β = -0.85, S.E. = 0.27, z = -3.15, p = 0.0016) and arousal (β = -0.56, S.E. = 0.26, z = -2.19, p < 0.0289, 95%CI[-1.07, -0.06]) clusters appeared. No group differences on the CAPS-5 emerged. Results provide evidence that this brief, single-session intervention carried out by trained clinicians can prevent the development of CB-PTSD symptoms up to six months postpartum.
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Affiliation(s)
- Camille Deforges
- Institute of Higher Education and Research in Healthcare, University of Lausanne, Lausanne, Vaud, Switzerland
| | - Vania Sandoz
- Institute of Higher Education and Research in Healthcare, University of Lausanne, Lausanne, Vaud, Switzerland
- Department Woman-Mother-Child, Lausanne University Hospital, Lausanne, Vaud, Switzerland
| | - Yvonnick Noël
- Department of Psychology, Rennes 2 University, Rennes, France
| | - Valérie Avignon
- Institute of Higher Education and Research in Healthcare, University of Lausanne, Lausanne, Vaud, Switzerland
- Department Woman-Mother-Child, Lausanne University Hospital, Lausanne, Vaud, Switzerland
| | - David Desseauve
- Department Woman-Mother-Child, Lausanne University Hospital, Lausanne, Vaud, Switzerland
| | - Julie Bourdin
- Department Woman-Mother-Child, Lausanne University Hospital, Lausanne, Vaud, Switzerland
| | - Yvan Vial
- Department Woman-Mother-Child, Lausanne University Hospital, Lausanne, Vaud, Switzerland
| | - Susan Ayers
- Centre for Maternal and Child Health Research, City, University of London, London, UK
| | - Emily A Holmes
- Department of Psychology, Uppsala University, Uppsala, Sweden
| | - Manuella Epiney
- Department of Woman, Child and Teenager, Geneva University Hospitals, Geneva, Switzerland
| | - Antje Horsch
- Institute of Higher Education and Research in Healthcare, University of Lausanne, Lausanne, Vaud, Switzerland.
- Department Woman-Mother-Child, Lausanne University Hospital, Lausanne, Vaud, Switzerland.
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Corbaz F, Boussac E, Lepigeon K, Gomes Dias D, Marcadent S, Desseauve D, Horsch A. 'connEcted caesarean section': creating a virtual link between MOthers and their infanTs to ImprOve maternal childbirth experieNce - study protocol for a PILOT trial (e-motion-pilot). BMJ Open 2023; 13:e065830. [PMID: 37286319 DOI: 10.1136/bmjopen-2022-065830] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/09/2023] Open
Abstract
INTRODUCTION One-third of mothers rate their childbirth as traumatic. The prevalence of childbirth-related post-traumatic stress disorder (CB-PTSD) is 4.7%. Skin-to-skin contact is a protective factor against CB-PTSD. However, during a caesarean section (CS), skin-to-skin contact is not always feasible and mothers and infants are often separated. In those cases, there is no validated and available solution to substitute this unique protective factor. Based on the results of studies using virtual reality and head-mounted displays (HMDs) and studies on childbirth experience, we hypothesise that enabling the mother to have a visual and auditory contact with her baby could improve her childbirth experience while she and her baby are separated. To facilitate this connection, we will use a two-dimensional 360° camera filming the baby linked securely to an HMD that the mother can wear during the end of the surgery. METHODS AND ANALYSIS This study protocol describes a monocentric open-label controlled pilot trial with minimal risk testing the effects of a visual and auditory contact via an HMD worn by the mother airing a live video of her newborn compared with treatment-as-usual in 70 women after CS. The first 35 consecutive participants will be the control group and will receive the standard care. The next 35 consecutive participants will have the intervention. The primary outcome will be differences in maternal childbirth experience (Childbirth Experience Questionnaire 2) at 1-week postpartum between the intervention and control groups. Secondary outcomes will be CB-PTSD symptoms, birth satisfaction, mother-infant bonding, perceived pain and stress during childbirth, maternal anxiety and depression symptoms, anaesthesiological data and acceptability of the procedure. ETHICS AND DISSEMINATION Ethics approval was granted by the Human Research Ethics Committee of the Canton de Vaud (study number 2022-00215). Dissemination of results will occur via national and international conferences, peer-reviewed journals, public conferences and social media. TRIAL REGISTRATION NUMBER NCT05319665.
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Affiliation(s)
- Fiona Corbaz
- Woman-Mother-Child, Lausanne University Hospital, Lausanne, Switzerland
| | - Emilie Boussac
- Anesthesiology, Lausanne University Hospital, Lausanne, Switzerland
| | - Karine Lepigeon
- Woman-Mother-Child, Lausanne University Hospital, Lausanne, Switzerland
| | - Diana Gomes Dias
- Woman-Mother-Child, Lausanne University Hospital, Lausanne, Switzerland
| | | | - David Desseauve
- Woman-Mother-Child, Lausanne University Hospital, Lausanne, Switzerland
| | - Antje Horsch
- Woman-Mother-Child, Lausanne University Hospital, Lausanne, Switzerland
- Institute of Higher Education and Research in Healthcare, University of Lausanne, Lausanne, Switzerland
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Recognizing childbirth-related posttraumatic stress disorder. Nurse Pract 2022; 47:10-12. [PMID: 36006812 DOI: 10.1097/01.npr.0000841948.56723.09] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Deforges C, Fort D, Stuijfzand S, Holmes EA, Horsch A. Reducing childbirth-related intrusive memories and PTSD symptoms via a single-session behavioural intervention including a visuospatial task: A proof-of-principle study. J Affect Disord 2022; 303:64-73. [PMID: 35108604 DOI: 10.1016/j.jad.2022.01.108] [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: 08/03/2021] [Revised: 12/03/2021] [Accepted: 01/28/2022] [Indexed: 11/29/2022]
Abstract
BACKGROUND Intrusive memories (IMs) of traumatic events are a key symptom of posttraumatic stress disorder (PTSD), and contribute to its maintenance. This translational proof-of-principle study tested whether a single-session behavioural intervention reduced the number of childbirth-related IMs (CB-IMs) and childbirth-related PTSD (CB-PTSD) symptoms, in women traumatised by childbirth. The intervention was assumed to disrupt trauma memory reconsolidation. METHODS In this pre-post study, 18 participants, whose traumatic childbirth had occurred between seven months and 6.9 years before, received an intervention combining childbirth-related reminder cues (including the return to maternity unit) with a visuospatial task. They recorded their daily CB-IMs in the two weeks pre-intervention (diary 1), the two weeks post-intervention (diary 2; primary outcome), and in week 5 and 6 post-intervention (diary 3). CB-PTSD symptom severity was assessed five days pre-intervention and one month post-intervention. RESULTS Compared to diary 1, 15/18 participants had ≥ 50% fewer CB-IMs in diary 2. The median (IQR) reduction of the number of CB-IMs was 81.89% (39.58%) in diary 2, and persisted in diary 3 (n = 17). At one month post-intervention, CB-PTSD symptom severity was reduced by ≥ 50% in 10/18 participants. Of the 8 participants with a CB-PTSD diagnosis pre-intervention, none met diagnostic criteria post-intervention. The intervention was rated as highly acceptable. LIMITATIONS The design limits the causal interpretation of observed improvements. CONCLUSION This is the first time such a single-session behavioural intervention was tested for old and real-life single-event trauma. The promising results justify a randomized controlled trial, and may be a first step toward an innovative CB-PTSD treatment.
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Affiliation(s)
- Camille Deforges
- Institute of Higher Education and Research in Healthcare (IUFRS), University of Lausanne and Lausanne University Hospital, Lausanne, Switzerland
| | - Déborah Fort
- Institute of Higher Education and Research in Healthcare (IUFRS), University of Lausanne and Lausanne University Hospital, Lausanne, Switzerland
| | - Suzannah Stuijfzand
- Institute of Higher Education and Research in Healthcare (IUFRS), University of Lausanne and Lausanne University Hospital, Lausanne, Switzerland
| | - Emily A Holmes
- Department of Psychology, Uppsala University, Uppsala, Sweden
| | - Antje Horsch
- Institute of Higher Education and Research in Healthcare (IUFRS), University of Lausanne and Lausanne University Hospital, Lausanne, Switzerland; Woman-Mother-Child Department, Lausanne University Hospital, Lausanne, Switzerland.
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Sandoz V, Stuijfzand S, Lacroix A, Deforges C, Quillet Diop M, Ehlert U, Rubo M, Messerli-Bürgy N, Horsch A. The Lausanne Infant Crying Stress Paradigm: Validation of an Early Postpartum Stress Paradigm with Women at Low vs. High Risk of Childbirth-Related Posttraumatic Stress Disorder. J Pers Med 2021; 11:472. [PMID: 34073240 PMCID: PMC8228424 DOI: 10.3390/jpm11060472] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Revised: 05/21/2021] [Accepted: 05/24/2021] [Indexed: 12/27/2022] Open
Abstract
Stress reactivity is typically investigated in laboratory settings, which is inadequate for mothers in maternity settings. This study aimed at validating the Lausanne Infant Crying Stress Paradigm (LICSP) as a new psychosocial stress paradigm eliciting psychophysiological stress reactivity in early postpartum mothers (n = 52) and to compare stress reactivity in women at low (n = 28) vs. high risk (n = 24) of childbirth-related posttraumatic stress disorder (CB-PTSD). Stress reactivity was assessed at pre-, peri-, and post-stress levels through salivary cortisol, heart rate variability (high-frequency (HF) power, low-frequency (LF) power, and LF/HF ratio), and perceived stress via a visual analog scale. Significant time effects were observed for all stress reactivity outcomes in the total sample (all p < 0.01). When adjusting for perceived life threat for the infant during childbirth, high-risk mothers reported higher perceived stress (p < 0.001, d = 0.91) and had lower salivary cortisol release (p = 0.023, d = 0.53), lower LF/HF ratio (p < 0.001, d = 0.93), and marginally higher HF power (p = 0.07, d = 0.53) than low-risk women. In conclusion, the LICSP induces subjective stress and autonomic nervous system (ANS) reactivity in maternity settings. High-risk mothers showed higher perceived stress and altered ANS and hypothalamic-pituitary-adrenal reactivity when adjusting for infant life threat. Ultimately, the LICSP could stimulate (CB-)PTSD research.
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Affiliation(s)
- Vania Sandoz
- Institute of Higher Education and Research in Healthcare (IUFRS), University of Lausanne, 1010 Lausanne, Switzerland; (V.S.); (S.S.); (A.L.); (C.D.); (M.Q.D.)
| | - Suzannah Stuijfzand
- Institute of Higher Education and Research in Healthcare (IUFRS), University of Lausanne, 1010 Lausanne, Switzerland; (V.S.); (S.S.); (A.L.); (C.D.); (M.Q.D.)
| | - Alain Lacroix
- Institute of Higher Education and Research in Healthcare (IUFRS), University of Lausanne, 1010 Lausanne, Switzerland; (V.S.); (S.S.); (A.L.); (C.D.); (M.Q.D.)
| | - Camille Deforges
- Institute of Higher Education and Research in Healthcare (IUFRS), University of Lausanne, 1010 Lausanne, Switzerland; (V.S.); (S.S.); (A.L.); (C.D.); (M.Q.D.)
| | - Magali Quillet Diop
- Institute of Higher Education and Research in Healthcare (IUFRS), University of Lausanne, 1010 Lausanne, Switzerland; (V.S.); (S.S.); (A.L.); (C.D.); (M.Q.D.)
| | - Ulrike Ehlert
- Department of Clinical Psychology and Psychotherapy, University of Zurich, 8050 Zurich, Switzerland;
| | - Marius Rubo
- Clinical Child Psychology & Biological Psychology, University of Fribourg, 1701 Fribourg, Switzerland; (M.R.); (N.M.-B.)
| | - Nadine Messerli-Bürgy
- Clinical Child Psychology & Biological Psychology, University of Fribourg, 1701 Fribourg, Switzerland; (M.R.); (N.M.-B.)
| | - Antje Horsch
- Institute of Higher Education and Research in Healthcare (IUFRS), University of Lausanne, 1010 Lausanne, Switzerland; (V.S.); (S.S.); (A.L.); (C.D.); (M.Q.D.)
- Neonatology Service, Department Woman-Mother-Child, Lausanne University Hospital and University of Lausanne, 1011 Lausanne, Switzerland
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