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Pazzagli C, Buratta L, Coletti E, Mazzeschi C. Mother-to-infant bonding mediates the effects of depressive and anxious postpartum symptoms on parenting stress. J Psychosom Obstet Gynaecol 2023; 44:2264487. [PMID: 37837341 DOI: 10.1080/0167482x.2023.2264487] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Accepted: 09/24/2023] [Indexed: 10/16/2023] Open
Abstract
A number of studies have suggested close associations between maternal postpartum mental health (depressive and anxious symptoms), mother-infant bonding, and parenting stress. However, the relationship between maternal bonding and parenting stresshas hardly been explored in published literature. This cross-sectional study explored whether maternal bonding could mediate the effect of postpartum maternal mental health on parenting stress. This study assessed maternal bonding (MPAS), depressive and anxious symptoms (EPDS; STAI), and parenting stress (PSI) at 3 months postpartum in a community sample of 105 women (M (SD) = 32.60 (4.18) years old). Spearman's correlation analyses showed moderate to high correlations between these factors. The three mediation models run showed that mother's MPAS partially mitigates the effects of EPDS (b = 0.71; SE = 0.217; 95% CI = 0.290/1.136) and STAI State (b = 0.39; SE = 0.113; 95% CI = 0.178/0.625) on PSI, and totally mediated the relationship between STAI Trait and PSI (b = 0.59; SE = 0.155; 95% CI = 0.303/0.912). Maternal bonding resulted to be a relevant factor in the association between maternal mental health and parenting stress. This highlights the importance of interventions focusing on mother-infant relationship to reduce parenting stress and prevent developmental difficulties in children.
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Affiliation(s)
- Chiara Pazzagli
- Department of Dynamic and Clinical Psychology, and Health Studies - Faculty of Medicine and Psychology, Sapienza University of Rome, Roma, Italy
| | - Livia Buratta
- Department of Philosophy, Social Sciences and Education, University of Perugia, Perugia, Italy
| | - Elena Coletti
- Department of Dynamic and Clinical Psychology, and Health Studies - Faculty of Medicine and Psychology, Sapienza University of Rome, Roma, Italy
| | - Claudia Mazzeschi
- Department of Philosophy, Social Sciences and Education, University of Perugia, Perugia, Italy
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Dickerson J, Bridges S, Willan K, Kelly B, Moss RH, Lister J, Netkitsing C, Atkinson AL, Bird PK, Uphoff EP, Mason D, Newsham A, Waiblinger D, Razaq R, Ahern S, Bryant M, Blower SL, Pickett KE, McEachan RM, Wright J. Born in Bradford's Better Start (BiBBS) interventional birth cohort study: Interim cohort profile. Wellcome Open Res 2023; 7:244. [PMID: 37830108 PMCID: PMC10565418 DOI: 10.12688/wellcomeopenres.18394.2] [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] [Accepted: 09/18/2023] [Indexed: 10/14/2023] Open
Abstract
Background: The Born in Bradford's Better Start (BiBBS) interventional birth cohort study was designed as an innovative cohort platform for efficient evaluation of early life interventions delivered through the Better Start Bradford programme. There are a growing number of interventional cohorts being implemented internationally. This paper provides an interim analysis of BiBBS in order to share learning about the feasibility and value of this method. Methods: Recruitment began in January 2016 and will complete in December 2023 with a target sample of 5,000 pregnancies. An interim analysis was completed for all pregnancies recruited between January 2016 and November 2019 with an expected due date between 1 st April 2016 and 8 th March 2020. Descriptive statistics were completed on the data. Results: Of 4,823 eligible pregnancies, 2,626 (54%) pregnancies were recruited, resulting in 2,392 mothers and 2,501 children. The sample are representative of the pregnant population (61% Pakistani heritage; 12% White British; 8% other South Asian and 6% Central and Eastern European ethnicity). The majority of participants (84%) live in the lowest decile of the Index of Multiple Deprivation, and many live in vulnerable circumstances. A high proportion (85%) of BiBBS families have engaged in one or more of the Better Start Bradford interventions. Levels of participation varied by the characteristics of the interventions, such as the requirement for active participation and the length of commitment to a programme. Conclusions: We have demonstrated the feasibility of recruiting an interventional cohort that includes seldom heard families from ethnic minority and deprived backgrounds. The high level of uptake of interventions is encouraging for the goal of evaluating the process and outcomes of multiple early life interventions using the innovative interventional cohort approach. BiBBS covers a period before, during and after the coronavirus disease 2019 (COVID-19) pandemic which adds scientific value to the cohort.
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Affiliation(s)
- Josie Dickerson
- Born in Bradford, Bradford Teaching Hospitals National Health Service Foundation Trust, Bradford, BD9 6RJ, UK
| | - Sally Bridges
- Born in Bradford, Bradford Teaching Hospitals National Health Service Foundation Trust, Bradford, BD9 6RJ, UK
| | - Kathryn Willan
- Born in Bradford, Bradford Teaching Hospitals National Health Service Foundation Trust, Bradford, BD9 6RJ, UK
| | - Brian Kelly
- Born in Bradford, Bradford Teaching Hospitals National Health Service Foundation Trust, Bradford, BD9 6RJ, UK
| | - Rachael H. Moss
- Born in Bradford, Bradford Teaching Hospitals National Health Service Foundation Trust, Bradford, BD9 6RJ, UK
| | - Jennie Lister
- Health Sciences, University of York, York, YO10 5DD, UK
| | - Chandani Netkitsing
- Born in Bradford, Bradford Teaching Hospitals National Health Service Foundation Trust, Bradford, BD9 6RJ, UK
- Health Sciences, University of York, York, YO10 5DD, UK
| | - Amy L. Atkinson
- Born in Bradford, Bradford Teaching Hospitals National Health Service Foundation Trust, Bradford, BD9 6RJ, UK
| | - Philippa K. Bird
- Born in Bradford, Bradford Teaching Hospitals National Health Service Foundation Trust, Bradford, BD9 6RJ, UK
| | | | - Dan Mason
- Born in Bradford, Bradford Teaching Hospitals National Health Service Foundation Trust, Bradford, BD9 6RJ, UK
| | - Alex Newsham
- Born in Bradford, Bradford Teaching Hospitals National Health Service Foundation Trust, Bradford, BD9 6RJ, UK
| | - Dagmar Waiblinger
- Born in Bradford, Bradford Teaching Hospitals National Health Service Foundation Trust, Bradford, BD9 6RJ, UK
| | - Rifat Razaq
- Born in Bradford, Bradford Teaching Hospitals National Health Service Foundation Trust, Bradford, BD9 6RJ, UK
| | - Sara Ahern
- Born in Bradford, Bradford Teaching Hospitals National Health Service Foundation Trust, Bradford, BD9 6RJ, UK
| | - Maria Bryant
- Health Sciences, University of York, York, YO10 5DD, UK
- Hull York Medical School, University of York, York, YO10 5DD, UK
| | | | | | - Rosemary M. McEachan
- Born in Bradford, Bradford Teaching Hospitals National Health Service Foundation Trust, Bradford, BD9 6RJ, UK
| | - John Wright
- Born in Bradford, Bradford Teaching Hospitals National Health Service Foundation Trust, Bradford, BD9 6RJ, UK
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Dickerson J, Bridges S, Willan K, Kelly B, Moss RH, Lister J, Netkitsing C, Atkinson AL, Bird PK, Uphoff EP, Mason D, Newsham A, Waiblinger D, Razaq R, Ahern S, Bryant M, Blower SL, Pickett KE, McEachan RM, Wright J. Born in Bradford's Better Start (BiBBS) interventional birth cohort study: Interim cohort profile. Wellcome Open Res 2023; 7:244. [PMID: 37830108 PMCID: PMC10565418 DOI: 10.12688/wellcomeopenres.18394.1] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/18/2023] [Indexed: 06/08/2024] Open
Abstract
Background: The Born in Bradford's Better Start (BiBBS) interventional birth cohort study was designed as an innovative cohort platform for efficient evaluation of early life interventions delivered through the Better Start Bradford programme. There are a growing number of interventional cohorts being implemented internationally. This paper provides an interim analysis of BiBBS in order to share learning about the feasibility and value of this method. Methods: Recruitment began in January 2016 and will complete in December 2023 with a target sample of 5,000 pregnancies. An interim analysis was completed for all pregnancies recruited between January 2016 and November 2019 with an expected due date between 1 st April 2016 and 8 th March 2020. Descriptive statistics were completed on the data. Results: Of 4,823 eligible pregnancies, 2,626 (54%) pregnancies were recruited, resulting in 2,392 mothers and 2,501 children. The sample are representative of the pregnant population (61% Pakistani heritage; 12% White British; 8% other South Asian and 6% Central and Eastern European ethnicity). The majority of participants (84%) live in the lowest decile of the Index of Multiple Deprivation, and many live in vulnerable circumstances. A high proportion (85%) of BiBBS families have engaged in one or more of the Better Start Bradford interventions. Levels of participation varied by the characteristics of the interventions, such as the requirement for active participation and the length of commitment to a programme. Conclusions: We have demonstrated the feasibility of recruiting an interventional cohort that includes seldom heard families from ethnic minority and deprived backgrounds. The high level of uptake of interventions is encouraging for the goal of evaluating the process and outcomes of multiple early life interventions using the innovative interventional cohort approach. BiBBS covers a period before, during and after the coronavirus disease 2019 (COVID-19) pandemic which adds scientific value to the cohort.
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Affiliation(s)
- Josie Dickerson
- Born in Bradford, Bradford Teaching Hospitals National Health Service Foundation Trust, Bradford, BD9 6RJ, UK
| | - Sally Bridges
- Born in Bradford, Bradford Teaching Hospitals National Health Service Foundation Trust, Bradford, BD9 6RJ, UK
| | - Kathryn Willan
- Born in Bradford, Bradford Teaching Hospitals National Health Service Foundation Trust, Bradford, BD9 6RJ, UK
| | - Brian Kelly
- Born in Bradford, Bradford Teaching Hospitals National Health Service Foundation Trust, Bradford, BD9 6RJ, UK
| | - Rachael H. Moss
- Born in Bradford, Bradford Teaching Hospitals National Health Service Foundation Trust, Bradford, BD9 6RJ, UK
| | - Jennie Lister
- Health Sciences, University of York, York, YO10 5DD, UK
| | - Chandani Netkitsing
- Born in Bradford, Bradford Teaching Hospitals National Health Service Foundation Trust, Bradford, BD9 6RJ, UK
- Health Sciences, University of York, York, YO10 5DD, UK
| | - Amy L. Atkinson
- Born in Bradford, Bradford Teaching Hospitals National Health Service Foundation Trust, Bradford, BD9 6RJ, UK
| | - Philippa K. Bird
- Born in Bradford, Bradford Teaching Hospitals National Health Service Foundation Trust, Bradford, BD9 6RJ, UK
| | | | - Dan Mason
- Born in Bradford, Bradford Teaching Hospitals National Health Service Foundation Trust, Bradford, BD9 6RJ, UK
| | - Alex Newsham
- Born in Bradford, Bradford Teaching Hospitals National Health Service Foundation Trust, Bradford, BD9 6RJ, UK
| | - Dagmar Waiblinger
- Born in Bradford, Bradford Teaching Hospitals National Health Service Foundation Trust, Bradford, BD9 6RJ, UK
| | - Rifat Razaq
- Born in Bradford, Bradford Teaching Hospitals National Health Service Foundation Trust, Bradford, BD9 6RJ, UK
| | - Sara Ahern
- Born in Bradford, Bradford Teaching Hospitals National Health Service Foundation Trust, Bradford, BD9 6RJ, UK
| | - Maria Bryant
- Health Sciences, University of York, York, YO10 5DD, UK
- Hull York Medical School, University of York, York, YO10 5DD, UK
| | | | | | - Rosemary M. McEachan
- Born in Bradford, Bradford Teaching Hospitals National Health Service Foundation Trust, Bradford, BD9 6RJ, UK
| | - John Wright
- Born in Bradford, Bradford Teaching Hospitals National Health Service Foundation Trust, Bradford, BD9 6RJ, UK
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Bird PK, Hindson Z, Dunn A, Cronin de Chavez A, Dickerson J, Howes J, Bywater T. Implementing the Maternal Postnatal Attachment Scale (MPAS) in universal services: Qualitative interviews with health visitors. Wellcome Open Res 2022; 7:85. [PMID: 36874586 PMCID: PMC9975410 DOI: 10.12688/wellcomeopenres.17551.2] [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: 11/03/2022] [Indexed: 01/09/2023] Open
Abstract
Background: A secure parent-infant relationship lays the foundations for children's development, however there are currently no measurement tools recommended for clinical practice. We evaluated the clinical utility of a structured assessment of the parent-infant relationship (the Maternal Postnatal Attachment Scale, MPAS) in a deprived, multi-ethnic urban community in England. This paper answers the question: what are health visitors' views on the parent-infant relationship, and experiences of piloting the MPAS? It explores the barriers and facilitators to implementation, and complements the paper on psychometric properties and representativeness reported in Dunn et al (2022). Methods: Semi-structured interviews were conducted with 11 health visitors and data were analysed using thematic analysis. Results: Health visitors saw identification and support of the parent-infant relationship as an important part of their role, and reported benefits of the MPAS, including opening conversation and identifying and reporting concerns. Challenges included timing and workload, the appropriateness of language, perceived intrusiveness and understanding of the questions, and the length of the tool. Suggestions for improvements to the tool were put forward. Conclusions: The experiences, benefits and challenges identified help to explain results in Dunn et al, and the wide-ranging challenges identified would hinder assessment of the parent-infant relationship in routine practice. Further work with health professionals and parents has been undertaken to co-produce an acceptable, feasible and reliable tool for clinical practice.
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Affiliation(s)
- Philippa K Bird
- Bradford Institute for Health Research, Bradford, BD96RJ, UK.,Leeds Teaching Hospitals Trust, Great George Street, Leeds, LS1 3EX, UK
| | - Zoe Hindson
- Department of Health Sciences, University of York, York, UK.,Family Action, 34 Wharf Road, London, N1 7GR, UK
| | - Abigail Dunn
- Department of Health Sciences, University of York, York, UK.,Cordis Bright, 23-24 Smithfield Street, London, EC1A 9LF, UK
| | - Anna Cronin de Chavez
- Bradford Institute for Health Research, Bradford, BD96RJ, UK.,London School of Hygiene and Tropical Medicine, Keppel St, London, WC1E 7HT, UK
| | - Josie Dickerson
- Bradford Institute for Health Research, Bradford, BD96RJ, UK
| | - Joanna Howes
- Better Start Bradford, Bradford, UK.,Bradford Metropolitan District Council, Britannia House, Hall Ings, Bradford, BD1 1HX, UK
| | - Tracey Bywater
- Department of Health Sciences, University of York, York, UK
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