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Sacchi C, De Carli P, Gregorini C, Monk C, Simonelli A. In the pandemic from the womb. Prenatal exposure, maternal psychological stress and mental health in association with infant negative affect at 6 months of life. Dev Psychopathol 2024; 36:810-820. [PMID: 36794393 DOI: 10.1017/s0954579423000093] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/17/2023]
Abstract
For mother-infant health especially, the pandemic has brought multiple stressors inside a susceptible psychobiological system. We study the longitudinal associations between maternal prenatal and postpartum: (a) COVID-19 stressful events exposure, (b) pandemic psychological stress, and (c) mental health and infants' negative affect. A sample of 643 Italian pregnant women completed a web-based survey from April 8th to May 4th, 2020 and a follow-up at 6 months after delivery. Maternal assessment covered prenatal and postpartum measures for: COVID-19 stressful events exposure, pandemic psychological stress, mental health symptoms (i.e., depression, anxiety, posttraumatic stress disorder) and postpartum, social support and report of infants' negative affect. Maternal mental health symptoms during pregnancy, at the peak of pandemic, is longitudinally associated with infant negative affect, with postpartum mental health mediating this association. Also, maternal COVID-19 stressful events exposure in postpartum is associated with negative affect at 6 months mediated by postpartum mental health symptoms. Maternal pandemic psychological stress during pregnancy predicted mental health symptoms in postpartum. The study supports the association between pandemic-related maternal health across pregnancy and postpartum and offspring's development (i.e., negative affect). It also puts the spotlight on mental health risk in women experiencing lockdown during pregnancy, especially when feeling high psychological stress in pregnancy or when directly exposed to COVID-19 stressful events postpartum.
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Affiliation(s)
- Chiara Sacchi
- Department of Developmental and Social Psychology, University of Padova, Padua, Italy
| | - Pietro De Carli
- Department of Psychology, University of Milano Bicocca, Milano, Italy
| | - Camilla Gregorini
- Department of Psychology, University of Milano Bicocca, Milano, Italy
| | - Catherine Monk
- Departments of Obstetrics and Gynecology, Columbia University Irving Medical Center, New York, NY, USA
| | - Alessandra Simonelli
- Department of Developmental and Social Psychology, University of Padova, Padua, Italy
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Bain M, Park S, Zaidi A, Atif N, Rahman A, Malik A, Surkan PJ. Social Support and Spousal Relationship Quality Improves Responsiveness among Anxious Mothers. Child Psychiatry Hum Dev 2024:10.1007/s10578-024-01702-5. [PMID: 38609719 PMCID: PMC11470967 DOI: 10.1007/s10578-024-01702-5] [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] [Accepted: 04/05/2024] [Indexed: 04/14/2024]
Abstract
Maternal responsiveness, a mother's ability to consistently identify infant cues and then act on them, is critical for healthy child development. A woman's social support and spousal relationship may affect responsiveness to an infant, especially among mothers with anxiety. We assessed how social support and spousal relationship quality is associated with responsiveness among anxious mothers, and if postpartum depression (PPD) moderated these associations. Cross-sectional data were collected from 2019 to 2022 in a public hospital in Pakistan from 701 women at six-weeks postpartum. Eligible women had at least mild anxiety in early- to mid- pregnancy. Linear regression analyses assessed if spousal relationship quality and social support from family and friends were associated with maternal responsiveness, measured using the Maternal Infant Responsiveness Instrument. Interaction terms were used to examine if PPD moderated these associations. Spousal relationship quality (B = 2.49, 95% CI: 1.48, 3.50) and social support (B = 1.07, 95% CI: 0.31, 1.83) were positively related to maternal responsiveness to the infant. Emotional support from a spouse was positively associated with responsiveness (B = 1.08, 95% CI: 0.12, 2.03 depressed; B = 2.96, 95% CI: 1.34, 4.58 non-depressed), and conflict with the spouse was negatively associated with responsiveness (B=-1.02, 95% CI: -1.94, -0.09 depressed; B=-2.87, 95% CI: -4.36, -1.37 non-depressed). However, social support was related to responsiveness only in non-depressed women (B = 2.61, 95% CI: 1.14, 4.07). While spousal relationships and social support enhance maternal responsiveness, for depressed women, spousal relationships were particularly critical. In considering maternal-infant interventions to improve child development outcomes, our study indicates the importance of supportive relationships that foster effective responsiveness.
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Affiliation(s)
- Miranda Bain
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe St, Baltimore, MD, 21205, USA
| | - Soim Park
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe St, Baltimore, MD, 21205, USA
| | - Ahmed Zaidi
- Public Mental Health Department, Health Services Academy, PM Health Complex, Islamabad, Pakistan
| | - Najia Atif
- Human Development Research Foundation, Global Institute of Human Development, Shifa Tameer-e-Millat University, Gujar Khan Campus, Near Government Rural Health Center Mandra, Rawalpindi, Pakistan
| | - Atif Rahman
- Human Development Research Foundation, Global Institute of Human Development, Shifa Tameer-e-Millat University, Gujar Khan Campus, Near Government Rural Health Center Mandra, Rawalpindi, Pakistan
- Department of Primary Care and Mental Health, Institute of Population Health, University of Liverpool, 1-5 Dover Street, Liverpool, L69 3GL, UK
| | - Abid Malik
- Public Mental Health Department, Health Services Academy, PM Health Complex, Islamabad, Pakistan
| | - Pamela J Surkan
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe St, Baltimore, MD, 21205, USA.
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Rusanen E, Lahikainen AR, Vierikko E, Pölkki P, Paavonen EJ. A Longitudinal Study of Maternal Postnatal Bonding and Psychosocial Factors that Contribute to Social-Emotional Development. Child Psychiatry Hum Dev 2024; 55:274-286. [PMID: 35870058 PMCID: PMC10796530 DOI: 10.1007/s10578-022-01398-5] [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: 01/01/2022] [Revised: 05/23/2022] [Accepted: 06/21/2022] [Indexed: 11/25/2022]
Abstract
In this longitudinal study, we examined how maternal bonding and psycho-social factors are associated with social-emotional problems in two-year-old children. Our data came from a birth cohort from which data were collected at four timepoints: prenatally during the third trimester, and postnatally at 3, 8 and 24 months. The participants were 1,667 mothers, of which 943 (56.6%) returned the questionnaire at each timepoint of the longitudinal study. The Children's social-emotional problems were examined using the Brief Infant-Toddler Social and Emotional Assessment. According to linear regression analysis, maternal bonding difficulties at three and eight months, maternal expectations of the unborn baby during pregnancy, and maternal relationships within and outside the family were related to social-emotional problems in children of two years of age. The results highlight the importance of screening mothers who already prenatally have bonding problems or mothers who have bonding problems postnatally to provide effective and targeted intervention support.
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Affiliation(s)
- E Rusanen
- Faculty of Educational Sciences, University of Helsinki, P.O. Box 9, 00014, Helsinki, Finland.
- Public Health and Welfare, Finnish Institute for Health and Welfare, P.O. Box 30, 00271, Helsinki, Finland.
| | - A R Lahikainen
- Faculty of Social Sciences, University of Tampere, FI-33014, Tampere, Finland
| | - E Vierikko
- Faculty of Social Sciences, Tampere University, FI-33014, Tampere, Finland
| | - P Pölkki
- Department of Social Sciences, University of Eastern Finland, P.O. Box 1627, 70211, Kuopio, Finland
| | - E J Paavonen
- Public Health and Welfare, Finnish Institute for Health and Welfare, P.O. Box 30, 00271, Helsinki, Finland
- Pediatric Research Center, Child Psychiatry, University of Helsinki and Helsinki University Hospital, P.O. Box 400, 00029, HUS, Finland
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Branson Dame K, Jazz Harvey M, Aichele S, Kralewski Van Denburg A, Hoyer L, Joslin S, McKenna A, Lincoln M, Closson L, Flykt M, Salo S, Harvey A, Biringen Z. Movement through motherhood: Exploring mood, wellbeing, and prenatal emotional availability (EA) through EA-based dance intervention. Infant Ment Health J 2024; 45:22-39. [PMID: 38081788 DOI: 10.1002/imhj.22093] [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: 09/20/2022] [Revised: 11/09/2023] [Accepted: 11/10/2023] [Indexed: 12/23/2023]
Abstract
Emotional availability (EA) is a construct that describes the observed emotional connection in parent-child relationships. During pregnancy, EA is assessed only using caregiver sensitivity and nonhostility. We used the nonverbal aspects of these qualities to create a new dance/movement intervention ("EA-Based Dance Intervention"). Given the scarcity of pregnancy interventions, we provided training to participants on how to be emotionally engaged with their unborn babies through dance/movement. The EA-Based Dance Intervention alone comprised the first intervention arm (n = 12). A second intervention arm involved the combination of EA-Based Dance Intervention with brief psychoeducation (n = 10). The third arm was a control group, which received only the assessments (n = 7). Measures of self-reported symptoms of depression and anxiety, emotional expressivity, flourishing, and the (newly developed) self-reported prenatal EA were used at pre- and posttest. The measure of observed prenatal EA was used to compare intervention versus control at posttest only. In this pilot study, we found that participants receiving the EA-Based Dance Intervention alone or combined with psychoeducation, self-reported improved anxiety symptoms and self-reported higher prenatal EA. When compared with the control group, those experiencing EA-Based Dance Intervention reported fewer depressive symptoms from pre- to posttest.
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Affiliation(s)
- Katelyn Branson Dame
- Human Development and Family Studies and the Prevention Research Center, Colorado State University, Fort Collins, Colorado, USA
| | - Madeline Jazz Harvey
- School of Music, Theatre, and Dance, Colorado State University, Fort Collins, Colorado, USA
| | - Stephen Aichele
- Human Development and Family Studies and the Prevention Research Center, Colorado State University, Fort Collins, Colorado, USA
| | - Ann Kralewski Van Denburg
- Human Development and Family Studies and the Prevention Research Center, Colorado State University, Fort Collins, Colorado, USA
| | - Lillian Hoyer
- Human Development and Family Studies and the Prevention Research Center, Colorado State University, Fort Collins, Colorado, USA
| | - Steffany Joslin
- Human Development and Family Studies and the Prevention Research Center, Colorado State University, Fort Collins, Colorado, USA
| | - Alexandria McKenna
- Human Development and Family Studies and the Prevention Research Center, Colorado State University, Fort Collins, Colorado, USA
| | - Michael Lincoln
- Human Development and Family Studies and the Prevention Research Center, Colorado State University, Fort Collins, Colorado, USA
| | - Lia Closson
- Human Development and Family Studies and the Prevention Research Center, Colorado State University, Fort Collins, Colorado, USA
| | - Marjo Flykt
- Department of Psychology, University of Helsinki, Helsinki, Finland
- University of Tampere, Tampere, Pirkanmaa, Finland
| | - Saara Salo
- Department of Psychology, University of Helsinki, Helsinki, Finland
| | - Ashley Harvey
- Human Development and Family Studies and the Prevention Research Center, Colorado State University, Fort Collins, Colorado, USA
| | - Zeynep Biringen
- Human Development and Family Studies and the Prevention Research Center, Colorado State University, Fort Collins, Colorado, USA
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Moniri M, Rashidi F, Mirghafourvand M, Rezaei M, Ghanbari-Homaie S. The relationship between pregnancy and birth experience with maternal-fetal attachment and mother-child bonding: a descriptive-analytical study. BMC Psychol 2023; 11:426. [PMID: 38053200 DOI: 10.1186/s40359-023-01475-x] [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: 08/03/2023] [Accepted: 11/30/2023] [Indexed: 12/07/2023] Open
Abstract
BACKGROUND Pregnancy and childbirth experience can be important factors for a pleasant relationship between mother and baby. This study assessed the relationship between the pregnancy and birth experience with maternal-fetal attachment (MFA) and mother-child bonding. METHODS A descriptive-analytical study was conducted among 228 pregnant women in Tabriz, Iran February 2022 to March 2023. Using cluster random sampling method, we included 228 women with gestational age 28-36 weeks and followed them up until six weeks postpartum. Data were collected in two stages using the following questionnaires: Pregnancy Experience Scale (hassles and uplifts), Maternal-Fetal Attachment Questionnaire (during the third trimester of pregnancy), Postpartum Bonding Questionnaire, and Childbirth Experience Questionnaire (six weeks postpartum). Data were analyzed using Pearson's correlation test and general linear model. RESULTS The mean score of MFA was significantly higher among women with feelings of being uplifted during pregnancy [β (95% CI) = 1.14 (0.87 to 1.41); p < 0.001]. However, there was no statistically significant relationship between pregnancy hassles and MFA and mother-child bonding (p > 0.05). Also, there was no statistically significant relationship between childbirth experience and mother-child bonding (p > 0.05). CONCLUSION According to the results of this study, pregnancy uplifts have a positive role in improving MFA. Therefore, it is recommended to plan interventions to make pregnancy period a pleasant experience for mothers.
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Affiliation(s)
- Monireh Moniri
- Student Research Committee, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Fatemeh Rashidi
- Student Research Committee, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mojgan Mirghafourvand
- Social Determinants of Health Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mansour Rezaei
- Department of Anesthesiology, School of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Solmaz Ghanbari-Homaie
- Department of Midwifery, Faculty of Nursing and Midwifery, Tabriz University of Medical Sciences, Shariati Street, P.O. Box: 51745-347, 513897977, Tabriz, Iran.
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Wang X, Xu H, Liu X, Yan J, Chen C, Li Y. Evaluating the effect of psychoeducational interventions on prenatal attachment and anxiety/depression in pregnant women and partners: A systematic review and meta-analysis. J Affect Disord 2023; 342:33-44. [PMID: 37689313 DOI: 10.1016/j.jad.2023.08.131] [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: 05/23/2023] [Revised: 08/05/2023] [Accepted: 08/29/2023] [Indexed: 09/11/2023]
Abstract
BACKGROUND Evidence about effective psychoeducational interventions to improve prenatal attachment, anxiety and depression has been increasing, but it lacks a complete synthesis of the results. The aim of this study is to evaluate the effect of psychoeducational intervention on prenatal attachment and anxiety/depression in pregnant women and their partners. METHODS Ten databases were systematically searched to identify randomized controlled trials (RCTs) on the effectiveness of psychoeducational interventions on prenatal attachment from inception to March 2023, then manually screened to include studies of anxiety or depression. Two researchers assessed the methodological quality of the included studies using the Cochrane risk-of-bias tool and meta-analysis was performed using RevMan 5.4 software. RESULTS Ten RCTs with a total of 700 pregnant women and 399 partners were included. Prenatal attachment scores after the intervention (standardized mean difference = 1.10, 95 % CI 0.65 to 1.55, P <.00001) was significantly increased and anxiety scores (standardized mean difference = -0.99, 95 % CI -1.18 to -0.80, P <.00001) was significantly lower. The subgroup analysis showed that the different prenatal attachment assessment tools were the source of heterogeneity in the combined results. The sensitivity analysis results showed reliable pooled results except for the studies using the self-made anxiety scale. CONCLUSION This review suggests that psychoeducational interventions can effectively enhance prenatal attachment, reduce anxiety and depression, providing reference for the promotion of evidence-based practice of psychoeducational interventions in perinatal pregnant women and their partners.
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Affiliation(s)
- Xiaoying Wang
- College of Nursing, Anhui Medical University, Hefei, Anhui, China
| | - Han Xu
- College of Nursing, Anhui Medical University, Hefei, Anhui, China
| | - Xuejie Liu
- College of Nursing, Anhui Medical University, Hefei, Anhui, China
| | - Jingwen Yan
- College of Nursing, Anhui Medical University, Hefei, Anhui, China
| | - Caifeng Chen
- College of Nursing, Anhui Medical University, Hefei, Anhui, China
| | - Yuhong Li
- College of Nursing, Anhui Medical University, Hefei, Anhui, China.
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GHASEMI NASAB ZOHREH, MOTAGHI ZAHRA, NAZARI ALIMOHAMMAD, KERAMAT AFSANEH, HADIZADEH-TALASAZ FATEMEH. The effect of cognitive-behavioral counseling on maternal-fetal attachment among pregnant women with unwanted pregnancy in Iran: A randomized clinical Trial. JOURNAL OF PREVENTIVE MEDICINE AND HYGIENE 2023; 64:E316-E322. [PMID: 38125990 PMCID: PMC10730047 DOI: 10.15167/2421-4248/jpmh2023.64.3.2930] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Accepted: 09/15/2023] [Indexed: 12/23/2023]
Abstract
Background Unwanted pregnancy is an important public health concern that can have significant health, social, and economic effects on the mother, the baby and her family. The establishment and enhancement of maternal-fetal attachment (MFA) play a role in the promotion of emotional communication between the mother and the child in the future. This study aimed at investigating the effect of cognitive-behavioral counseling on maternal-fetal attachment among pregnant women with unwanted pregnancy. Methods In this randomized clinical trial, 60 eligible pregnant women with unwanted pregnancy and gestational age of 22-28 weeks who had referred to health centers in Mashhad, a city in the northeast of Iran, were selected and they were through random block assignment divided into two groups of counseling with the cognitive-behavioral approach (n = 30) and the control group (n = 30). In addition to the routine pregnancy care, the cognitive-behavioral counseling group received four group counseling sessions on a weekly basis, while the control group only received the routine pregnancy care from healthcare providers. Maternal-fetal attachment before and after intervention in the two groups was assessed through Cranley's Maternal-Fetal Attachment Scale. Comparison of mean scores within and between the two groups was performed using SPSS 21 through independent and paired t-tests. Results At the end of the study and after the intervention, the mean scores of maternal-fetal attachment in the intervention and control groups were 94.06 ± 11.73 and 80.16 ± 10.09, respectively, and the difference between the groups was significant. Although the difference between the mean scores of each group at the beginning and the end of the study was significant, this difference between the two groups was also noticeable (21.56 ± 12.16 vs 7.40 ± 12.39) and statistically significant. Conclusions Cognitive-behavioral counseling can be effective in enhancing the maternal-fetal attachment in unwanted pregnancies; therefore, it is recommended to be integrated into pregnant women's healthcare programs.
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Affiliation(s)
- ZOHREH GHASEMI NASAB
- Student Research Committee, School of Nursing and Midwifery, Shahroud University of Medical Sciences, Shahroud, Iran
| | - ZAHRA MOTAGHI
- Department of Reproductive Health, School of Nursing and Midwifery, Shahroud University of Medical Sciences, Shahroud, Iran
| | - ALI MOHAMMAD NAZARI
- Department of Reproductive Health, School of Nursing and Midwifery, Shahroud University of Medical Sciences, Shahroud, Iran
| | - AFSANEH KERAMAT
- Department of Reproductive Health, School of Nursing and Midwifery, Shahroud University of Medical Sciences, Shahroud, Iran
| | - FATEMEH HADIZADEH-TALASAZ
- Department of Midwifery, School of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran
- Nursing and Midwifery Care Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
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Lee KN, Kim HJ, Choe K, Cho A, Kim B, Seo J, Myung W, Park JY, Oh KJ. Effects of Fetal Images Produced in Virtual Reality on Maternal-Fetal Attachment: Randomized Controlled Trial. J Med Internet Res 2023; 25:e43634. [PMID: 36826976 PMCID: PMC10007014 DOI: 10.2196/43634] [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: 10/24/2022] [Revised: 12/07/2022] [Accepted: 01/19/2023] [Indexed: 01/20/2023] Open
Abstract
BACKGROUND Maternal-fetal attachment (MFA) has been reported to be associated with the postpartum mother-infant relationship. Seeing the fetus through ultrasound might influence MFA, and the effect could be increased by more realistic images, such as those generated in virtual reality (VR). OBJECTIVE The aim was to determine the effect of fetal images generated in VR on MFA and depressive symptoms through a prenatal-coaching mobile app. METHODS This 2-arm parallel randomized controlled trial involved a total of 80 pregnant women. Eligible women were randomly assigned to either a mobile app-only group (n=40) or an app plus VR group (n=40). The VR group experienced their own baby's images generated in VR based on images obtained from fetal ultrasonography. The prenatal-coaching mobile app recommended health behavior for the pregnant women according to gestational age, provided feedback on entered data for maternal weight, blood pressure, and glucose levels, and included a private diary service for fetal ultrasound images. Both groups received the same app, but the VR group also viewed fetal images produced in VR; these images were stored in the app. All participants filled out questionnaires to assess MFA, depressive symptoms, and other basic medical information. The questionnaires were filled out again after the interventions. RESULTS Basic demographic data were comparable between the 2 groups. Most of the assessments showed comparable results for the 2 groups, but the mean score to assess interaction with the fetus was significantly higher for the VR group than the control group (0.4 vs 0.1, P=.004). The proportion of participants with an increased score for this category after the intervention was significantly higher in the VR group than the control group (43% vs 13%, P=.005). The feedback questionnaire revealed that scores for the degree of perception of fetal appearance all increased after the intervention in the VR group. CONCLUSIONS The use of a mobile app with fetal images in VR significantly increased maternal interaction with the fetus. TRIAL REGISTRATION ClinicalTrials.gov NCT04942197; https://clinicaltrials.gov/ct2/show/NCT04942197.
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Affiliation(s)
- Kyong-No Lee
- Department of Obstetrics and Gynecology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam-si, Gyeonggi-do, Republic of Korea
| | - Hyeon Ji Kim
- Department of Obstetrics and Gynecology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam-si, Gyeonggi-do, Republic of Korea
| | - Kiroong Choe
- Department of Computer Science and Engineering, Seoul National University, Seoul, Republic of Korea
| | - Aeri Cho
- Department of Computer Science and Engineering, Seoul National University, Seoul, Republic of Korea
| | - Bohyoung Kim
- Division of Biomedical Engineering, Hankuk University of Foreign Studies, Gyeonggi-do, Republic of Korea
| | - Jinwook Seo
- Department of Computer Science and Engineering, Seoul National University, Seoul, Republic of Korea
| | - Woojae Myung
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam-si, Gyeonggi-do, Republic of Korea
| | - Jee Yoon Park
- Department of Obstetrics and Gynecology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam-si, Gyeonggi-do, Republic of Korea
| | - Kyung Joon Oh
- Department of Obstetrics and Gynecology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam-si, Gyeonggi-do, Republic of Korea
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Lovato I, Simonelli A, Visentin S, Priante E, Baraldi E, Sacchi C. Prenatal environment and developmental trajectories: the intrauterine growth restriction. Minerva Pediatr (Torino) 2023; 75:62-74. [PMID: 35708036 DOI: 10.23736/s2724-5276.22.06949-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
The prenatal environment is of fundamental importance for the fetus, as the fetus is particularly susceptible to environmental influences while in utero, and several prenatal adversities may constitute a risk factor for fetal growth and child development. Intrauterine growth restriction (IUGR) refers to a pregnancy complication involving the inadequate growth of the fetus in utero, with potential programming consequences on the children's brain-behavior development. In this narrative review we will discuss the most recent literature about IUGR children, including their development and their relationship with the prenatal and postnatal environment. In particular, as an attempt to an adaptive response to intrauterine changes, the brain development of IUGR fetuses follows abnormal developmental pathways, which likely has cascade effects on the future neurodevelopmental outcomes of the children. Cognitive and motor functions are in fact impaired, as well as IUGR children present, across studies, poor socio-emotional abilities and a greater risk for internalizing and externalizing behavior problems. The current work also highlights how the postnatal environment, and in particular parental care, has an important role in IUGR development, acting as a protective factor, or otherwise increasing their constitutional vulnerabilities. Overall, this narrative review has important implications for clinical practice, suggesting the need for long-term follow-up care with IUGR children and strategies supporting parent-child interactions as well.
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Affiliation(s)
- Irene Lovato
- Department of Developmental Psychology and Socialization, University of Padua, Padua, Italy
| | - Alessandra Simonelli
- Department of Developmental Psychology and Socialization, University of Padua, Padua, Italy
| | - Silvia Visentin
- Department of Women's and Children's Health, University of Padua, Padua, Italy
| | - Elena Priante
- Department of Women's and Children's Health, University of Padua, Padua, Italy
| | - Eugenio Baraldi
- Department of Women's and Children's Health, University of Padua, Padua, Italy
| | - Chiara Sacchi
- Department of Developmental Psychology and Socialization, University of Padua, Padua, Italy -
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Gioia MC, Cerasa A, Muggeo VMR, Tonin P, Cajiao J, Aloi A, Martino I, Tenuta F, Costabile A, Craig F. The relationship between maternal-fetus attachment and perceived parental bonds in pregnant women: Considering a possible mediating role of psychological distress. Front Psychol 2023; 13:1095030. [PMID: 36726507 PMCID: PMC9885764 DOI: 10.3389/fpsyg.2022.1095030] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2022] [Accepted: 12/19/2022] [Indexed: 01/19/2023] Open
Abstract
Maternal-Fetal Attachment (MFA) delineates the emotional, cognitive, and behavioral aspects that mothers develop toward the unborn baby during pregnancy. The literature indicates that optimal attachment in pregnancy represents a protective factor for the mother-child attachment bond after birth and child development outcomes. To date, there are few studies that have investigated associated factors of MFA. This study sets out to explore the association between perceived parental bonds and maternal-fetal bonding in pregnant women, accounting for factors such as psychological distress, socio-demographic and obstetric characteristics. Methods In this cross-sectional study, 1,177 pregnant women answered the Parental Bonding Instrument, the Maternal-Fetal Attachment Scale, State-Trait Anxiety Inventory (STAI-Y), and Beck-Depression Inventory (BDI-II). Results We found out that perceived maternal and paternal care had significant direct effects on maternal-infant bonding during the pregnancy period when controlling for some confounders, including gestational age and mother age among others. Such maternal and paternal perceived care effects were not mediated by levels of psychological distress, which in turn resulted to be a "borderline" significant predictor of prenatal attachment. Interestingly, the gestational age and the mother age emerged to have a significant and synergic nonlinear effect, suggesting the influence on the MFAS of the gestational age depends on the values of the mother age, and likewise, the effect of mother age on MFAS depends on the gestational week. Conclusion This study expands our knowledge of the intergenerational transmission of attachment pointing out the effects of a woman's perceived bond in relation to her parental figures during the development of the prenatal attachment process. Findings also suggests that parenting support interventions may have benefits that are realized across generations.
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Affiliation(s)
- Maria C. Gioia
- iGreco Ospedali Riuniti, Cosenza, Italy,Associazione di Volontariato Mammachemamme, Cosenza, Italy
| | - Antonio Cerasa
- Institute for Biomedical Research and Innovation (IRIB), National Research Council of Italy (CNR), Messina, Italy,Pharmacotechnology Documentation and Transfer Unit, Preclinical and Translational Pharmacology, Department of Pharmacy, Health Science and Nutrition, University of Calabria, Rende, Italy,S’Anna Institute, Crotone, Italy,*Correspondence: Antonio Cerasa,
| | - Vito M. R. Muggeo
- Department of Economics, Business and Statistics, University of Palermo, Palermo, Italy
| | | | - Juanita Cajiao
- Faculty of Medicine Universitat de Barcelona, Barcelona, Spain
| | - Alessia Aloi
- Associazione di Volontariato Mammachemamme, Cosenza, Italy
| | - Iolanda Martino
- Department of Medical and Surgical Sciences, Institutes of Neurology, Magna Græcia University of Catanzaro, Catanzaro, Italy
| | - Flaviana Tenuta
- Department of Cultures, Education and Society, University of Calabria, Cosenza, Italy
| | - Angela Costabile
- Department of Cultures, Education and Society, University of Calabria, Cosenza, Italy
| | - Francesco Craig
- Department of Cultures, Education and Society, University of Calabria, Cosenza, Italy,Scientific Institute, IRCCS E. Medea—Unit for Severe Disabilities in Developmental Age and Young Adults, Brindisi, Italy
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Lindblom J, Pajulo M, Nolvi S, Tervahartiala K, Karlsson H, Karlsson L, Korja R. Early pathways of maternal mentalization: Associations with child development in the FinnBrain birth cohort study. Front Psychol 2022; 13:855190. [PMID: 36582339 PMCID: PMC9792295 DOI: 10.3389/fpsyg.2022.855190] [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: 01/14/2022] [Accepted: 11/09/2022] [Indexed: 12/12/2022] Open
Abstract
Parental mentalization refers to a parents' capacity and interest to consider the individual experience and mental state underlying the behaviors of the child. Higher mentalization is considered a key aspect for parental sensitivity in interaction, fostering child's socioemotional and self-regulatory development. Yet, previous studies have not examined the dynamic pathways through which the maternal mentalization may develop, nor their effects on child development. Thus, in the current person-oriented study, first, we identify distinct profiles and longitudinal trajectories of maternal mentalization from pregnancy to child's 2 years of age. Second, we test how the profiles and trajectories associate with children's internalizing and externalizing problems, social-emotional competence and effortful control at the age of 2 years. Third, we examine how the profiles and trajectories associate with contextual demographic and child related. The substudy was part of the FinnBrain Birth Cohort and included families from general population (n = 2,687). Mothers reported their parental reflective functioning (PRF) at late pregnancy, 6 months and 2 years of child's age. Both mothers (n = 1,437) and fathers (n = 715) reported the developmental child outcomes at the child's age of 2 years. Latent Profile Analysis and Latent Transition Analysis were used to identify PRF profiles and trajectories. The results showed decreasing heterogeneity in PRF from pregnancy to child's age of 6 months and 2 years (i.e., four, three and two latent classes, respectively). Most mothers progressed towards high PRF over time. Second, the profiles and trajectories depicting high PRF associated with child high social-emotional competence at the age of 2 years, yet no clear positive effects were found on child's problems and effortful control. The group of mixed PRF trajectories showed strongest association with child's internalizing and externalizing problems. Finally, there were theoretically meaningful associations between the PRF trajectories and both the contextual (e.g., parity) and child related (e.g., infant temperament) factors. This was the first study to explore the early unfolding of maternal mentalization. The results are discussed in relation with the potential mechanisms accounting for child development and with the nature and limitations of self-reported parental mentalization.
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Affiliation(s)
- J. Lindblom
- The FinnBrain Birth Cohort Study, Turku Brain and Mind Center, Department of Clinical Medicine, University of Turku, Turku, Finland,Faculty of Social Sciences, Tampere University, Tampere, Finland,*Correspondence: J. Lindblom,
| | - M. Pajulo
- The FinnBrain Birth Cohort Study, Turku Brain and Mind Center, Department of Clinical Medicine, University of Turku, Turku, Finland,Department of Child Psychiatry, University of Turku and Turku University Hospital, Turku, Finland
| | - S. Nolvi
- The FinnBrain Birth Cohort Study, Turku Brain and Mind Center, Department of Clinical Medicine, University of Turku, Turku, Finland,Turku Institute for Advanced Studies, University of Turku, Turku, Finland,Department of Psychology and Speech Language Pathology, University of Turku, Turku, Finland
| | - K. Tervahartiala
- The FinnBrain Birth Cohort Study, Turku Brain and Mind Center, Department of Clinical Medicine, University of Turku, Turku, Finland,Centre for Population Health Research, University of Turku and Turku University, Turku, Finland
| | - H. Karlsson
- The FinnBrain Birth Cohort Study, Turku Brain and Mind Center, Department of Clinical Medicine, University of Turku, Turku, Finland,Centre for Population Health Research, University of Turku and Turku University, Turku, Finland,Department of Psychiatry, Turku University Hospital and University of Turku, Turku, Finland
| | - L. Karlsson
- The FinnBrain Birth Cohort Study, Turku Brain and Mind Center, Department of Clinical Medicine, University of Turku, Turku, Finland,Centre for Population Health Research, University of Turku and Turku University, Turku, Finland,Department of Psychiatry, Turku University Hospital and University of Turku, Turku, Finland
| | - R. Korja
- The FinnBrain Birth Cohort Study, Turku Brain and Mind Center, Department of Clinical Medicine, University of Turku, Turku, Finland,Department of Psychology and Speech Language Pathology, University of Turku, Turku, Finland
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12
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de Castro MHM, Mendonça CR, Noll M, de Abreu Tacon FS, do Amaral WN. Psychosocial Aspects of Gestational Grief in Women Undergoing Infertility Treatment: A Systematic Review of Qualitative and Quantitative Evidence. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182413143. [PMID: 34948752 PMCID: PMC8701103 DOI: 10.3390/ijerph182413143] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Revised: 12/07/2021] [Accepted: 12/11/2021] [Indexed: 02/03/2023]
Abstract
Women undergoing assisted reproduction treatment without being able to become pregnant, and experiencing pregnancy loss after assisted reproduction, are triggering factors for prolonged grief and mourning. This review aims to investigate the psychosocial aspects of gestational grief among women who have undergone infertility treatment. We searched the databases of MEDLINE/PubMed, EMBASE, CINAHL, Scopus, ScienceDirect, and Lilacs for works published up to 5 March 2021. The outcomes analyzed were negative and positive psychosocial responses to gestational grief among women suffering from infertility and undergoing assisted human reproduction treatment. Eleven studies were included, which yielded 316 women experiencing infertility who were undergoing treatment. The most frequently reported negative psychosocial manifestations of grief response were depression (6/11, 54.5%), despair or loss of hope/guilt/anger (5/11, 45.5%), anxiety (4/11, 36.4%), frustration (3/11, 27.3%), and anguish/shock/suicidal thoughts/isolation (2/11, 18.2%). Positive psychosocial manifestations included the hope of becoming pregnant (4/6, 66.6%) and acceptance of infertility after attempting infertility treatment (2/6, 33.3%). We identified several negative and positive psychosocial responses to gestational grief in women experiencing infertility. Psychological support before, during, and after assisted human reproduction treatment is crucial for the management of psychosocial aspects that characterize the grief process of women experiencing infertility who become pregnant and who lose their pregnancy. Our results may help raise awareness of the area of grief among infertile women and promote policy development for the mental health of bereaved women.
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Affiliation(s)
- Michelle Herminia Mesquita de Castro
- Postgraduate Program in Health Sciences, Faculdade de Medicina, Universidade Federal de Goiás, Goiânia 74605-050, Brazil; (M.N.); (F.S.d.A.T.); (W.N.d.A.)
- Correspondence: (M.H.M.d.C.); (C.R.M.)
| | - Carolina Rodrigues Mendonça
- Postgraduate Program in Health Sciences, Faculdade de Medicina, Universidade Federal de Goiás, Goiânia 74605-050, Brazil; (M.N.); (F.S.d.A.T.); (W.N.d.A.)
- Correspondence: (M.H.M.d.C.); (C.R.M.)
| | - Matias Noll
- Postgraduate Program in Health Sciences, Faculdade de Medicina, Universidade Federal de Goiás, Goiânia 74605-050, Brazil; (M.N.); (F.S.d.A.T.); (W.N.d.A.)
- Campus Ceres, Instituto Federal Goiano, Ceres 76300-000, Brazil
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, 5230 Odense, Denmark
| | - Fernanda Sardinha de Abreu Tacon
- Postgraduate Program in Health Sciences, Faculdade de Medicina, Universidade Federal de Goiás, Goiânia 74605-050, Brazil; (M.N.); (F.S.d.A.T.); (W.N.d.A.)
| | - Waldemar Naves do Amaral
- Postgraduate Program in Health Sciences, Faculdade de Medicina, Universidade Federal de Goiás, Goiânia 74605-050, Brazil; (M.N.); (F.S.d.A.T.); (W.N.d.A.)
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Cataudella S, Lampis J, Busonera A, Congia F, Melis GB, Zavattini GC. From pregnancy to 3 months after birth:the beginning of mother-infant relationship from a maternal perspective. J Reprod Infant Psychol 2021; 40:266-287. [PMID: 34693840 DOI: 10.1080/02646838.2021.1995597] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
BACKGROUND An early positive mother-child relationship is a central factor in the development of a psychologically balanced personality. The study aims to identify risk and protective factors for the development of a balanced maternal-infant postnatal attachment. We explored the association between maternal-infant attachment and prenatal and postnatal variables potentially implicated in the development of this early bond: maternal-foetal prenatal attachment, social support, memories of parental care, romantic attachment, dyadic adjustment, parity, breastfeeding, planning pregnancy, woman's and infant's age, and difficulty of delivery. METHODS 123 pregnant women participated in the longitudinal study; they were assessed on the MAAS, PBI, ECR-R, MSPSS (t1: pregnancy), MPAS (t2: 3-months postnatally), DAS , and CES-D (t1, t2). RESULTS Four significant predictors of maternal-infant postnatal attachment (MPAS) emerged: maternal-foetal prenatal attachment (β = 0.379, p < .001), anxiety in the romantic relationships (β=-0.237, p=0.019), prenatal and postnatal dyadic adjustment (t1, β=-0.323, p=0.025 ;t2, β=0.329, p=0.014) in the couple's relationship. These variables explained 20.2% of variance in mother-infant attachment (R2adjusted=0.202). DISCUSSION The study highlights associations of maternal-infant postnatal attachment with prenatal and postnatal relational variables and with other variables related to the woman's reproductive and pregnancy history. Clinical attention to these factors could help protect the well-being of mother and child.
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Affiliation(s)
- Stefania Cataudella
- Department of Pedagogy, Psychology, Philosophy, University of Cagliari, Cagliari, Italy
| | - Jessica Lampis
- Department of Pedagogy, Psychology, Philosophy, University of Cagliari, Cagliari, Italy
| | - Alessandra Busonera
- Department of Dynamic and Clinical Psychology, Sapienza, University of Rome, Italy
| | - Francesca Congia
- Department of Obstetrics and Gynecology, University Hospital of Cagliari (AOUCA), Cagliari, Italy
| | - Gian Benedetto Melis
- Department of Obstetrics and Gynecology, University Hospital of Cagliari (AOUCA), Cagliari, Italy
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