Factors associated with postpartum depression in women from low socioeconomic level in Argentina: A hierarchical model approach

Postpartum depression and risk factors among working women one year after delivery in Beijing, China: a cross-sectional study

Background

Postpartum depression (PPD) is the most common mental illness affecting women after childbirth, and working mothers may be faced with unique challenges. This study aimed to examine the depression status among working postpartum women in 1 year of childbirth and explore the relationship between occupational factors and PPD in urban Beijing, China.

Methods

A cross-sectional survey of 554 postpartum women was conducted among ten community health service centers in six urban districts of Beijing, China. Sociodemographic, occupational, childbirth and postpartum information were collected. Depression status was obtained using the Edinburgh Postnatal Depression Scale. Prevalence of postpartum depression (PPD) was assessed in relation to occupational characteristics, and influencing factors were analyzed through logistic regression.

Results

Of the postpartum women, 29.42% met the criteria for depression. PPD prevalence was significantly higher among women employed in commercial enterprises (39.81%). The analysis of influencing factors showed that age, family or personal monthly income, maternity leave, feeding methods, and postpartum care affected the psychological health of occupational women after childbirth.

Conclusion

PPD prevalence is notably elevated among women employed in commercial enterprises, and specific risk factors contribute to its occurrence. These findings highlight the need for targeted interventions to address these risk factors and prevent PPD in this population.

Beneficial Effects of Limosilactobacillus reuteri PBS072 and Bifidobacterium breve BB077 on Mood Imbalance, Self-Confidence, and Breastfeeding in Women during the First Trimester Postpartum

Background: The post-delivery period could be characterized by psychological distress (e.g., anxiety, sadness, and irritability), leading to postpartum depression (PPD). Objective: The present clinical study assesses the effect of probiotic supplementation containing Limosilactobacillus reuteri PBS072 and Bifidobacterium breve BB077 (4 × 109 CFU/day) on the mother's mood and breastfeeding quality during the first trimester after delivery. Methods: A Randomized, Double-Blind, Controlled (RDBPC) trial was carried out on 200 healthy new mothers divided into an active group taking a supplement containing Limosilactobacillus reuteri PBS072 and Bifidobacterium breve BB077 (4 × 109 CFU/day) plus multivitamins and a control group (multivitamin complex only) for 90 days. Symptoms related to maternal depression and breastfeeding quality were evaluated at days 45 and 90 using the Edinburgh Postnatal Depression Scale (EPDS) and the Breastfeeding Self-Efficacy Scale-Short Form (BSES-SF). Results: At days 45 and 90, the probiotic treatment significantly ameliorated the mothers' mood compared to the control treatment (p < 0.001). Likewise, the breastfeeding quality and the baby's cries significantly improved in the probiotic group (p < 0.001). Conclusions: Microbiota alterations could influence a post-delivery woman's mental state. According to our results, L. reuteri PBS072 and B. breve BB077 are potential candidates that are able to improve stress resilience in the postpartum period.

Levels and predictors of postpartum depression and anxiety during the first year of the COVID-19 pandemic in a confined cross-border city

Pregnancy and/or the puerperium involve social, physiological and psychological changes that make women more vulnerable to mental disorders such as anxiety and depression, even more so if these develop in stressful contexts such as the pandemic. The aim of this study is to identify factors associated with the risk of postpartum anxiety and depression during the COVID-19 pandemic. A cross-sectional study was conducted among postpartum women (n = 69) who gave birth between March 2020 and March 2021 in Melilla, a Spanish cross-border city with Morocco whose borders were closed, making it a confined city. The scales used were the State-Trait Anxiety Inventory and the Edinburgh Postnatal Depression Scale. Results reported an elevated risk of depression (85.5%) and anxiety (63.8%), with severe anxiety reaching 40.6% of cases. Predictors of postpartum depression comprised a personal history of mood disorders (β = 8.421; CI95% = 4.863/11.978) and having been diagnosed with COVID-19 during pregnancy or postpartum (β = 4.488; CI95% = 1.331/7.646). As regards anxiety, it is predicted on the basis of mood antecedents (β = 14.175; CI95% = 7.870/20.479), the fact of having been diagnosed with COVID-19 during pregnancy or postpartum (β = 8.781; CI95% = 2.970/14.592) and the fact of being a multipara (β = 5.513; CI95% = 0.706/10.321). In conclusion, special attention should be paid to women with a history of mood disorders and a positive diagnosis of COVID-19 during pregnancy or postpartum, even more so in the case of multiparous women, because of its impact on mental health during the postpartum period.

Supplementary Information

The online version contains supplementary material available at 10.1007/s12144-023-04719-6.

Risk Factors for Postpartum Depression and Severe Distress among Mothers of Very Preterm Infants at NICU Discharge

OBJECTIVE

 To identify psychological, medical, and socioenvironmental risk factors for maternal postpartum depression (PPD) and severe psychological distress (SPD) at intensive care nursery discharge among mothers of very preterm infants.

STUDY DESIGN

 We studied 562 self-identified mothers of 641 infants born <30 weeks who were enrolled in the Neonatal Neurobehavior and Outcomes in Very Preterm Infants Study (NOVI) conducted in nine university-affiliated intensive care nurseries. Enrollment interviews collected socioenvironmental data, depression, and anxiety diagnoses prior to and during the study pregnancy. Standardized medical record reviews ascertained prenatal substance use, maternal and neonatal medical complications. The Edinburgh Postnatal Depression Scale and Brief Symptom Inventory were administered at nursery discharge to screen for PPD and SPD symptoms, respectively.

RESULTS

 Unadjusted analyses indicated mothers with positive screens for depression (n = 76, 13.5%) or severe distress (n = 102, 18.1%) had more prevalent prepregnancy/prenatal depression/anxiety, and their infants were born at younger gestational ages, with more prevalent bronchopulmonary dysplasia, and discharge after 40 weeks postmenstrual age. In multivariable analyses, prior depression or anxiety was associated with positive screens for PPD (risk ratio [RR]: 1.6, 95% confidence interval [CI]: 1.1-2.2) and severe distress (RR: 1.6, 95% CI: 1.1-2.2). Mothers of male infants had more prevalent depression risk (RR: 1.7, 95% CI: 1.1-2.4), and prenatal marijuana use was associated with severe distress risk (RR: 1.9, 95% CI: 1.1-2.9). Socioenvironmental and obstetric adversities were not significant after accounting for prior depression/anxiety, marijuana use, and infant medical complications.

CONCLUSION

 Among mothers of very preterm newborns, these multicenter findings extend others' previous work by identifying additional indicators of risk for PPD and SPD associated with a history of depression, anxiety, prenatal marijuana use, and severe neonatal illness. Findings could inform designs for continuous screening and targeted interventions for PPD and distress risk indicators from the preconception period onward.

KEY POINTS

· Preconceptional and prenatal screening for postpartum depression and severe distress may inform care.. · Prior depression, anxiety, and neonatal complications predicted severe distress and depression symptoms at NICU discharge.. · Readily identifiable risk factors warrant continuous NICU screening and targeted interventions to improve outcomes..

The relationship between body dissatisfaction and postpartum depressive symptoms: A cross-sectional study

BACKGROUND

Women are least satisfied with their bodies during the postpartum period. There is a potential correlation between body dissatisfaction and depressive symptoms post delivery.The aim of this study was to explore the relationship of appearance and body areas satisfaction with depressive symptoms and examine the risk factors of depressive symptoms at 4-6 weeks postpartum.

METHODS

A total of 330 postpartum women participated in the study. Body dissatisfaction was measured using the Appearance Evaluation (AE) scale and Body Areas Satisfaction Scale (BASS), while depressive symptoms were measured using the Edinburgh Postnatal Depression Scale (EPDS), 4-6 weeks postpartum.

RESULTS

The prevalence of postpartum depressive symptoms among postpartum women was 40 % while 12.1 % of the women had thoughts of self-harm. Those with depressive symptoms or thoughts of self-harm had lower AE and BASS scores. Body dissatisfaction was significantly associated with factors such as postpartum weight retention of >5 kgs, no exercise, lower education level, and cesarean delivery. The three body areas that women were most dissatisfied with were weight, mid-torso, and lower torso. Education level, delivery method, and BASS score significantly predicted postpartum depressive symptoms.

LIMITATIONS

The selection bias might have occurred if those with depressive symptoms neglected routine postpartum care visits due to emotional distress.

CONCLUSIONS

The results indicate an association between body dissatisfaction and depressive symptoms at 4-6 weeks postpartum. Awareness of this relationship and focus on these risk factors will help healthcare providers plan peripartum programs to decrease the likelihood of postpartum depressive symptoms.

Postpartum Depression Prevalence and Associated Factors: An Observational Study in Saudi Arabia

Background and Objectives: Postpartum depression (PPD) is a psychological disorder in women who recently gave birth. It can present as mild to severe depression. Multiple studies across the globe have used the Edinburgh Postnatal Depression Scale to reveal the factors that affect the prevalence of PPD. Results from various published studies showed a high prevalence of PPD in Saudi Arabia. The objective of this study is to investigate the major factors that increase PPD and other associated factors. Materials and Methods: An observational cross-sectional study was carried out at primary healthcare centres and military hospitals in Al Kharj. The study measured the rate of PPD among Saudi women during the postpartum period. We studied 279 women aged 19-45 (mean age 31.91, SD ± 6.45) in their postpartum period and followed up to 2 months after delivery. Results: The prevalence of PPD in our cohort was 32.8%. Multivariate logistic regression analysis showed that previous depression diagnosis (p = 0.001), lower education status (p = 0.029), unemployment (p = 0.014), and delivery disposition of C-section (p = 0.002) remained associated with an increased risk of developing PPD. Conclusions: The increasing number of Saudi women with PPD demonstrates that it is a highly prevalent condition. PPD affects not only the health of the mother but also that of her baby and other family members. Our results showed that the history of diagnosed depression, lower education status, unemployment, and delivery disposition of C-sections were independent predictors of PPD development. Raising awareness and controlling the vulnerable factors could decrease the high risk of its effects.

Family History of Psychiatric Disorders as a Risk Factor for Maternal Postpartum Depression: A Systematic Review and Meta-analysis

Importance

Current evidence on the association between family history of psychiatric disorders and postpartum depression is inconsistent; family studies have identified familial risk of postpartum depression, whereas systematic reviews and umbrella reviews, compiling all risk factors for postpartum depression, often have not.

Objective

To investigate the association between family history of psychiatric disorders and risk of developing postpartum depression within 12 months post partum.

Data Sources

Literature searches were conducted in PubMed, Embase, and PsycINFO in September 2021 and updated in March 2022, accompanied by citation and reference search.

Study Selection

Studies eligible for inclusion comprised peer-reviewed cohort and case-control studies reporting an odds ratio (OR) or sufficient data to calculate one for the association between family history of any psychiatric disorder and postpartum depression. Study selection was made by 2 independent reviewers: title and abstract screening followed by full-text screening.

Data Extraction and Synthesis

Reporting was performed using the MOOSE checklist. Two reviewers independently extracted predefined information and assessed included studies for risk of bias using the Newcastle-Ottawa Scale. Data were pooled in a meta-analysis using a random-effects model. Heterogeneity was investigated with meta-regression, subgroup, and sensitivity analyses. Publication bias was investigated using a funnel plot, and GRADE (Grading of Recommendations Assessment, Development, and Evaluation) was used to evaluate the overall certainty of the findings.

Main Outcomes and Measures

The primary outcome was the pooled association between family history of psychiatric disorders and postpartum depression.

Results

A total of 26 studies were included, containing information on 100 877 women. Meta-analysis showed an increased OR of developing postpartum depression when mothers had a family history of psychiatric disorders (OR, 2.08; 95% CI, 1.67-2.59; I2 = 57.14%) corresponding to a risk ratio of 1.79 (95% CI, 1.52-2.09), assuming a 15% postpartum depression prevalence in the general population. Subgroup, sensitivity, and meta-regression analyses were in line with the primary analysis. The overall certainty of evidence was deemed as moderate according to GRADE.

Conclusions and Relevance

In this study, there was moderate certainty of evidence for an almost 2-fold higher risk of developing postpartum depression among mothers who have a family history of any psychiatric disorder compared with mothers without.

Mode of Delivery Is Associated with Postpartum Depression: Do Women with and without Depression History Exhibit a Difference?

Whether the mode of birth delivery correlates with the incidence of postpartum depression (PPD) is still under debate. This study seeks to clarify such a correlation and to further investigate if there are any differences in the likelihood of PPD medical care use among women with and without a history of depression. A logistic regression at two assessment points (6-month and 12-month postpartum) on the National Health Insurance Database in Taiwan is performed. In total, 32,729 women were included who gave first birth from 2007 to 2011 via cesarean section (CS), elective CS, and vaginal delivery, of whom 3580 (10.9%) were diagnosed with a history of depression. Findings show that CS was associated with a higher likelihood of PPD doctor visits regardless of whether the women have a history of depression or not, but elective CS tended to have different impacts for these two groups of women. Mentally healthy women who experienced elective CS had 1.36- and 1.64-times higher risk of PDD medical care use than those who delivered vaginally, whereas previous depressive women undertaking an elective cesarean birth had no significant difference observed in incidences. A notably higher risk of elective CS delivery versus vaginal delivery for mentally healthy women suggests that elective CS is not clinically appropriate, yet it might be an alternative to vaginal delivery with careful counseling for pregnant women who experience a history of depression.

The peripartum period involvement in the development of post-partum depression. A prospective cohort study

PURPOSE

This study explores postpartum depression (PPD) in women who screened negative in mid-pregnancy to assess the impact of the peripartum period on the development of depressive symptoms.

METHODS

A prospective cohort study was carried out in two facilities in Argentina. The Edinburgh postnatal depression scale (EPDS) scale was applied to pregnant women between weeks 20-24 gestation, and those screening negative (<10) were included in the cohort. Participants were followed up until the 4th week postpartum, when the EPDS was repeated. If positive, a semi-structured clinical interview was applied (MINI) to define the diagnosis.

RESULTS

A total of 112 pregnant women were eligible for the follow-up. At the 4th week postpartum, 14 women (12.5%, CI 95% 7.0; 20.1) screened positive using a cutoff point of 10 or more in the EPDS. Of those screened positive in the EPDS, two participants (1.8%, CI 95% 0.2-6.3) had a Major Depressive Disorder. Newborn admission to the Intensive Care Unit, hospitalization of the newborn after discharge, abuse during childbirth, and lack of company during labor were identified as peripartum risk factors.

CONCLUSIONS

This study reinforces the relevance of women and newborn mental health care during the hospitalization process surrounding peripartum. The women and newborn hospitalization process should be better explored to understand the contribution to PPD and design and test strategies to alleviate the impact of maternal depression.

Triggering of postpartum depression and insomnia with cognitive impairment in Argentinian women during the pandemic COVID-19 social isolation in relation to reproductive and health factors

Objective

The 2019 coronavirus disease pandemic (COVID-19) required strict confinement measures that differentially impacted the individual's daily life. Thus, this work aimed to study postpartum women's mental health in Argentina during mandatory social isolation.

Design

A cross-sectional survey was conducted from May to July 2020, which included five validated questionnaires to assess postpartum depression (Postpartum Depression Screening Scale‐Short Form), insomnia (Insomnia Severity Index), memory complaints (Memory Complaint Scale), metacognition (Brief Metamemory and Metaconcentration Scale), and breastfeeding self-efficacy (Breastfeeding Self-Efficacy Scale-Short Form). Sociodemographic variables, social isolation characteristics, and breastfeeding practices were also collected. This study was conducted in accordance with the Declaration of Helsinki. Statistical analysis included zero-order correlations, multiple logistic regressions, and a set of structural equation models (SEM) to test direct and indirect effects. Goodness-of-fit indices were calculated for SEM.

Setting

Postpartum women were recruited from public hospitals, private health clinics, and online community recruitment in the Cordoba province (Argentina).

Participants

305 postpartum women from Argentina.

Measurements and findings

37% of women reported postpartum depression, 46% insomnia, 42% memory impairment, 60% low metaconcentration, 50% low metamemory, and 23% low breastfeeding efficacy. Also, significant associations were found demonstrating that social isolation promoted postpartum depression and insomnia were reciprocally related, which compromised female cognition and efficacy. This situation was aggravated in women during late postpartum, with previous children, and by low social support (e.g., family, health professionals), with non-exclusive breastfeeding being increased.

Key conclusions

This is the first study addressing postpartum women's mental status during social isolation in Argentina, which was a promoting factor for postpartum depression and insomnia that were reciprocally related. This situation was also aggravated by reproductive factors, such as late postpartum, multiparity, breastfeeding frequency, and non-exclusive breastfeeding. Additionally, breastfeeding self-efficacy depended on mental health status, and euthymia therefore favoured the practice of exclusive breastfeeding.

Risk factors for postpartum depression in Chinese women: A cross-sectional study at 6 weeks postpartum

OBJECTIVE

Postpartum depression (PPD) has received increasing attention due to its harmful impacts and high incidence. PPD is affected by physiological and psychological factors, but the conclusions are not uniform at present, so this study explored the risk factors of postpartum depressive symptoms (PPDS) in Chinese population.

METHODS

A total of 397 women attending the obstetric department of the First Affiliated Hospital of Wenzhou Medical University participated in the questionnaire survey, mainly through a cross sectional study. At 6 weeks postpartum, the Edinburgh Postpartum Depression Scale (EPDS) and Pittsburgh Sleep Quality Index (PSQI) were used to assess PPDS and sleep quality, respectively.

RESULTS

The incidence of probable PPDS in our study population was 14.6% at 6 weeks postpartum. Women with blood group A had an almost 3-fold greater risk of PPDS than those with blood group B (OR [95% CI], 2.99 [1.43-6.28], p = 0.004). After adjusting for potential confounding variables, the blood group A phenotype was significantly more prevalent in women with PPDS compared to blood group B (OR [95% CI], 2.65 [1.23-5.70], p = 0.01).

CONCLUSIONS

Compared to women with blood groups B, AB or O, women with blood group A had high odds of PPDS. If this result can be demonstrated and replicated in other populations, blood group A may be a useful predictor of risk for PPDS in Chinese postpartum women.

Gender of infant and risk of postpartum depression: a meta-analysis based on cohort and case-control studies

BACKGROUND

It is inconclusive nowadays for the association between infant's gender and their mothers' risk of developing postpartum depression (PPD). In addition, a complete overview is missing. A meta-analysis of cohort and case-control studies was performed to address the question of whether women who gave birth to a female infant were at an increased risk of developing PPD, compared with those giving birth to a male infant.

METHODS

Unrestricted searches were conducted, with an end date parameter of 31 January 2018, of PubMed, Embase, Google Scholar, Cochrane Libraries, and Chinese databases, to identify studies that met pre-stated inclusion criteria. Reference lists of retrieved articles were also reviewed. Either a fixed- or a random-effects model was used to calculate the overall combined risk estimates.

RESULTS

Twenty-three studies involving 119,736 women were included for analysis. Overall, mothers who gave birth to a female infant experienced a significantly increased risk of developing PPD compared with the reference group (OR = 1.15, 95%CI: 1.01-1.31; p = .03). However, substantial heterogeneity (p < .00001; I² = 75%) was observed across studies. Relevant heterogeneity moderators have been identified by subgroup analysis. Sensitivity analysis yielded consistent results. No evidence of publication bias was observed.

CONCLUSIONS

Although the role of potential bias and evidence of heterogeneity should be carefully evaluated, the present study suggests women giving birth to a girl are associated with a higher risk of developing PPD when compared with those giving birth to a boy. Improving family and social communication and reducing gender preference should be important components of any such interventions.Statement of significanceProblem or issue Interestingly, the known risk factors leading to PPD are basically the same in different regions and cultures, but the gender of the infant seems to be an exception.What is already known Some studies conducted in traditional western countries indicated that there is a weak or null association between infant's gender and risk of PPD, while others suggested a positive association. In contrast, studies conducted in Nigeria, India, Turkey and China showed that mothers giving birth to a female infant were at a higher risk of developing PPD.What this paper adds Today, the association between infant's gender and risk of developing postpartum depression (PPD) is still uncertain; additionally, a complete overview is missing. Our study represents the first meta-analysis of risk of PPD associated with infant's gender.

Predictors of postpartum depression and the utilization of postpartum depression services in rural areas in the Philippines

PURPOSE

This study explored the prevalence and predictors of postpartum depression (PPD) as well as the utilization and evaluation of PPD services among postpartum women in rural areas of the Philippines.

DESIGN AND METHODS

A cross-sectional study was conducted. One hundred sixty-five women who visited maternal facilities in the rural areas of the Central Philippines completed the Edinburgh Postnatal Depression Scale (EPDS).

FINDINGS

The prevalence of PPD was 16.4% at the sixth postpartum week. Occupation and marital status had significant direct influences on PPD. PPD services were not routinely provided by doctors and nurses.

PRACTICE IMPLICATIONS

Our results highlight a greater need to intensify government programs relative to PPD services, specifically related to the early detection and screening of PPD among high-risk pregnancies.

The role of education in maternal depressive symptoms among different ethnic groups: A cross-sectional study in rural western China

OBJECTIVE

To estimate the maternal depressive symptoms (MDS) rates in different ethnic groups, and to explore possible reasons especially the role of education for its ethnic differences.

METHODS

A community-based cross-sectional survey was conducted in 20 rural counties of 8 provinces in western China. The possible influencing factors of MDS were collected. The Edinburgh Postpartum Depression Scale (EPDS) was used to assess MDS. Univariate and multivariate logistic regression models were used to analyze the risk factors of MDS. Two multivariate logistic regression models that separately containing and not containing the factor of educational level were used to explore the role of education in the ethnic differences of MDS.

RESULTS

A total of 3,163 mothers were included in the analysis, and the MDS rate was 15.6%. In multivariate analysis, educational level of primary school and below (adjOR1: 1.47, 95%CI: 1.07-2.03), delivery at home (adjOR1: 1.66, 95%CI: 1.11-2.47) and diarrhea of youngest child in the past two weeks (adjOR1: 1.31, 95%CI: 1.03-1.67) remained as independent predictors of MDS after adjusting all the factors significant in univariate analysis. If educational level was not adjusted in above multivariate model, women from Yi ethnic group (adjOR2: 1.39, 95%CI: 1.03-1.89) would additionally become significant.

LIMITATIONS

EPDS is a screening tool and some possible risk factors for MDS were not included.

CONCLUSION

The ethnic differences in MDS were largely due to the ethnic differences in educational level. To reduce the high risk of MDS among Yi mothers, further popularizing nine-year compulsory education could be effective.

Contextual-relationship and stress-related factors of postpartum depression symptoms in nulliparas: a prospective study from Ljubljana, Slovenia

Background

For a significant proportion of women, postpartum depression (PPD) is the first mood episode in their lives, yet its aetiology still remains unclear. Insecure attachment in close adult relationships is considered to be a risk factor for depressive symptoms. This study aimed to gain further insight into the risk factors for postpartum depression symptoms (PPDS) of nulliparas in Slovenia and to examine vulnerability to developing depressive symptoms, with an emphasis on contextual and stress-related characteristics.

Methods

The sample consisted of 156 nulliparas in the third trimester of pregnancy enrolled in a childbirth preparation program. The following instruments were applied: Experiences in Close Relationships-Revised, the Edinburgh Postpartum Depression Scale (EPDS), the Zung Anxiety Scale and a question battery designed by the research team including questions about emotional support and work-related stress. Logistic regression was used to test the association between demographic, social, environmental, personality and attachment variables and PPD of nulliparas (EPDS ≥10), controlling for baseline (prepartum) depression score. A multivariable linear regression model was built with the postpartum EPDS continuous score as a dependent variable.

Results

28/156 (17,9%) were evaluated as being at risk for depression (EPDS≥10) in the last trimester and 25/156 (16%) at six weeks postpartum. The results of the logistic regression model controlled for prepartum depression score showed that increased risk for developing PPDS was associated with anxiety level postpartum, intimate-partner-attachment anxiety postpartum, and elevated stress due to loss of employment or an unsuccessful search for employment in the previous year. The results of the multivariable regression model, however, showed the association with education and postpartum anxiety with PPDS continuous score; EPDS after giving birth was higher for more educated and more anxious primiparas.

Conclusions

Our findings demonstrate the importance of anxiety symptoms and higher education level in assessments of nulliparas’ mental health. The results of our study show and confirm the results of previous research that anxiety symptoms in the immediate postpartum period are likely to be associated with depressive symptoms in nulliparas. The results also suggest that higher level of education of first-time mothers might not be a protective factor, especially for nulliparas with the university level of education. Further studies on larger samples should be considered.

Fathers for the first time: Validation of a questionnaire to asses father experiences of first childbirth in Latin America

The active incorporation of men in the process of childbirth is an increasingly common practice internationally. However, there are no validated instruments for Latin America.

OBJECTIVE

To validate an instrument to assess new fathers' experiences during childbirth in Latin America.

DESIGN

Prospective validation study.

SETTING

Talcahuano, Chile.

POPULATION

Fathers who participated in the birth of their first child (n = 220) between September 2015 to May 2016, in a public hospital in Chile.

METHODS

The Swedish questionnaire "First Time Fathers Questionnaire" was used. As a first step, the questionnaire was translated to Spanish, followed by expert judgment of such translation and validation. For content validity, a descriptive analysis of the expert judgment and combined Kappa evaluation was performed. Construct validity with Exploratory Factor Analysis was done. Reliability based on internal consistency, was tested using Cronbach's Alpha. Criteria validity was tested with Pearson correlation and Student t-test, and logistic regression.

MAIN OUTCOME MEASURES

Questionnaire in Spanish with adequate evidence of reliability and validity.

RESULTS

Two components were identified: "Support from the Health System" and "Father Worry", with 19 items and adequate internal reliability (0.84 and 0.79 respectively). There is a statistically significant inverse correlation between "Father Worry" and "Support from the Health System". There is a statistically significant association between "Father Worry" and the type of delivery, being higher in Caesarean sections. There is a statistically significant association between "Support of the Health System" and preparation for childbirth being higher in those who were prepared.

CONCLUSIONS

This study provides a validated instrument to assess the experience of fathers who participate in the birth of their first child in Latin America.

IMPLICATIONS FOR PRACTICE

The evaluation of the paternal experience during birth contributes to the knowledge of the male's emotional processes involved in this event. Midwifery is in a key position to promote a transcendent parental experience.