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Nakagawa A, Matsuki T, Tomida M, Miyachi T, Ebara T, Kamijima M. Development of temperamental regulation of infants at 6 and 24 months: Associations with maternal soothing and distress. Health Sci Rep 2024; 7:e70036. [PMID: 39234187 PMCID: PMC11372086 DOI: 10.1002/hsr2.70036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2024] [Revised: 07/31/2024] [Accepted: 08/16/2024] [Indexed: 09/06/2024] Open
Abstract
Background and Aims In the neurobiological theory of attention, the orienting network mainly supports the temperamental regulatory function in infancy, with soothing methods such as visual attention distraction influencing its development. The attention distraction method chosen for soothing is thought to be influenced by maternal sensitivity, which has been found to decrease with poor maternal mental health. We hypothesize that the degree of maternal distress may affect the choice of attention distraction soothing method. Further, individual differences in being soothed by attention distraction will be associated with the temperamental regulation function in infancy/toddlerhood. Method Structural equation modeling (SEM) was conducted on longitudinal data at 6 and 24 months on a sample (N = 1892) drawn from the sub-cohort of the Japan Environment and Children's Study (JECS). Temperament was examined through the short Infant Behavior Questionnaire-Revised (Japanese version) and the Early Childhood Behavior Questionnaire (Japanese version). Distress in caregivers was measured through the Kessler Psychological Distress Scale (Japanese version) at prenatal and 1-year-postnatal stages. Individual differences in using visual distraction soothing methods were also measured using tailor-made items. Results Postnatal maternal distress at 12 months was negatively related to the tendency to use visual attention distraction as a soothing method (β = -0.06, p = 0.006) at 24 months. When we applied the subscale of the temperamental regulatory factor in SEM, the more the mothers chose the distraction method for soothing, i.e., the more the toddlers experienced it, the higher their attention shifting scores (β = 0.07, p = 0.002). Conclusion The findings support the view that caregivers' choice of method for distracting offspring's attention from distress may be associated with the development of self-regulation during infancy and toddlerhood.
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Affiliation(s)
- Atsuko Nakagawa
- Graduate School of Humanities and Social Sciences Nagoya City University Nagoya Japan
| | - Taro Matsuki
- Department of Psychology Faculty of Health and Wellness Sciences, Hiroshima International University Higashihiroshima Japan
| | - Makiko Tomida
- Graduate School of Humanities and Social Sciences Nagoya City University Nagoya Japan
| | - Taishi Miyachi
- Nagoya Western Care Center for Disabled Children Nagoya Japan
| | - Takeshi Ebara
- Department of Ergonomics, Institute of Industrial Ecological Sciences University of Occupational and Environmental Health Kitakyushu Japan
| | - Michihiro Kamijima
- Department of Occupational and Environmental Health Graduate School of Medical Sciences, Nagoya City University Nagoya Japan
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Nordin-Remberger C, Wells MB, Woodford J, Lindelöf KS, Johansson M. Preferences of support and barriers and facilitators to help-seeking in pregnant women with severe fear of childbirth in Sweden: a mixed-method study. BMC Pregnancy Childbirth 2024; 24:388. [PMID: 38796427 PMCID: PMC11127315 DOI: 10.1186/s12884-024-06580-2] [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: 07/15/2023] [Accepted: 05/13/2024] [Indexed: 05/28/2024] Open
Abstract
BACKGROUND There are few support interventions for women with fear of childbirth tailored towards type of fears and parity. To inform the future development of an acceptable and relevant intervention for women with severe fear of childbirth, primary objectives were to examine: (1) pregnant women's experiences of and preferences for support and (2) barriers and facilitators to help-seeking. Secondary objectives were to examine if there are any differences based on pregnant women's parity. METHODS Pregnant women with a severe fear of childbirth in Sweden completed an online cross-sectional survey between February and September 2022. Severe fear of childbirth was measured using the fear of childbirth scale. Quantitative data were analysed using descriptive and inferential statistics and free answers were analysed using manifest content analysis. A contiguous approach to integration was adopted with qualitative and quantitative findings reported separately. RESULTS In total, 609 participants, 364 nulliparous and 245 parous women, had severe fear of childbirth. The main category "A twisting road to walk towards receiving support for fear of childbirth" was explored and described by the generic categories: Longing for support, Struggling to ask for support, and Facilitating aspects of seeking support. Over half (63.5%), of pregnant women without planned or ongoing treatment, wanted support for fear of childbirth. Most (60.2%) pregnant women with ongoing or completed fear of childbirth treatment regarded the treatment as less helpful or not at all helpful. If fear of childbirth treatment was not planned, 35.8% of women would have liked to have received treatment. Barriers to help seeking included stigma surrounding fear of childbirth, previous negative experiences with healthcare contacts, fear of not being believed, fear of not being listened to, and discomfort of having to face their fears. Facilitators to help seeking included receiving respectful professional support that was easily available, flexible, and close to home. CONCLUSIONS Most pregnant women with severe fear of childbirth felt unsupported during pregnancy. Findings emphasise the need to develop individual and easily accessible psychological support for women with severe fear of childbirth, delivered by trained professionals with an empathetic and respectful attitude.
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Affiliation(s)
- Carita Nordin-Remberger
- Obstetric and Reproductive Health Research, Department of Women´s and Children´s Health, Uppsala University, Uppsala, 752 37, Sweden.
- Women's Mental Health during the Reproductive Lifespan - WOMHER, Uppsala University, Uppsala, Sweden.
| | - Michael B Wells
- Women's and Children's Health, Karolinska Institute, Solna, Sweden
| | - Joanne Woodford
- Healthcare Sciences and e-Health, Department of Women´s and Children´s Health, Uppsala University, Uppsala, Sweden
| | | | - Margareta Johansson
- Obstetric and Reproductive Health Research, Department of Women´s and Children´s Health, Uppsala University, Uppsala, 752 37, Sweden
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McGuinn LA, Klein DN, Gutiérrez-Avila I, Keil AP, Ortiz MT, Just A, Coull B, Torres-Calapiz M, Kloog I, Téllez-Rojo MM, Wright RJ, Wright RO. Individual and joint effects of prenatal PM 2.5 and maternal stress on child temperament. ENVIRONMENTAL RESEARCH 2024; 249:118432. [PMID: 38354885 PMCID: PMC11065570 DOI: 10.1016/j.envres.2024.118432] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/10/2023] [Revised: 01/28/2024] [Accepted: 02/04/2024] [Indexed: 02/16/2024]
Abstract
Prenatal fine particulate matter (PM2.5) and maternal psychological functioning have been associated with child cognitive outcomes, though their independent and joint impacts on earlier behavioral outcomes remains less studied. We used data from 382 mother-child pairs from a prospective birth cohort in Mexico City. Temperament was measured at 24 months using the Carey Toddler Temperament Scale (TTS). Exploratory factor analysis (EFA) was used to update the factor structure of the TTS. During pregnancy, mothers completed the Crisis in Family Systems-Revised, Edinburgh Depression Scale, pregnancy-specific anxiety scale, and the Perceived Stress Scale. Pregnancy PM2.5 was assessed using estimates from a satellite-based exposure model. We assessed the association between prenatal maternal stress and PM2.5 on temperament, in both independent and joint models. Quantile g-computation was used to estimate the joint associations. Models were adjusted for maternal age, SES, education, child sex, and child age. In EFA, we identified three temperament factors related to effortful control, extraversion, and negative affect. Our main results showed that higher levels of PM2.5 and several of the maternal psychological functioning measures were related to both effortful control and negative affect in the child, both individually and as a mixture. For instance, a one quartile increase in the prenatal mixture was associated with higher negative affect scores in the child (0.34, 95% CI: 0.16, 0.53). We observed modification of these associations by maternal SES, with associations seen only among lower SES participants for both effortful control (-0.45, 95% CI: -0.70, -0.20) and negative affect outcomes (0.60, 95% CI: 0.35, 0.85). Prenatal PM2.5 and maternal psychological functioning measures were associated with toddler temperament outcomes, providing evidence for impacts of chemical and non-chemical stressors on early child health.
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Affiliation(s)
- Laura A. McGuinn
- Institute for Population and Precision Health, University of Chicago, Chicago, IL, USA
- Department of Family Medicine, University of Chicago, Chicago, IL, USA
| | - Daniel N. Klein
- Department of Psychology, Stony Brook University, Stony Brook, NY, USA
| | - Iván Gutiérrez-Avila
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Alexander P. Keil
- Occupational and Environmental Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD, USA
| | - Marcela Tamayo Ortiz
- Occupational Health Research Unit, Mexican Institute of Social Security, Mexico City, Mexico
| | - Allan Just
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Brent Coull
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | | | - Itai Kloog
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Geography and Environmental Development, Ben-Gurion University of the Negev, Be’er Sheva, Israel
| | - Martha Maria Téllez-Rojo
- Center for Nutrition and Health Research, National Institute of Public Health, Cuernavaca, Morelos, Mexico
| | - Rosalind J. Wright
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Robert O. Wright
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA
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Lipschutz R, Kulesz PA, Elgbeili G, Biekman B, Laplante DP, Olson DM, King S, Bick J. Maternal mental health mediates the effect of prenatal stress on infant temperament: The Harvey Mom Study. Dev Psychopathol 2024; 36:893-907. [PMID: 37078447 DOI: 10.1017/s0954579423000160] [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] [Indexed: 04/21/2023]
Abstract
Prenatal maternal stress and mental health problems are known to increase risk for developmental psychopathology in offspring, yet pathways leading to risk or resiliency are poorly understood. In a quasi-experimental design, we prospectively examined associations between disaster-related prenatal stress, maternal mental health symptoms, and infant temperament outcomes. Mothers who were pregnant during Hurricane Harvey (N = 527) reported on objective hardships (e.g., loss of belongings or income, evacuation, home flooding) related to the storm and subsequent mental health symptoms (anxiety/depression, posttraumatic stress) across time. At a postpartum assessment, mothers reported on their infant's temperament (negative affect, positive affect, orienting/regulatory capacity). Greater objective hardship indirectly predicted higher levels of infant orienting/regulatory capacity through its association with increased maternal posttraumatic stress symptoms. Greater objective hardship also indirectly predicted higher levels of infant negative affect through its association with increased maternal anxiety/depression symptoms across time. Our findings suggest a psychological mechanism linking prenatal stress with specific temperamental characteristics via maternal mental health symptoms. Findings point to the importance of high-quality assessment and mental health services for vulnerable women and young children.
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Affiliation(s)
| | - Paulina A Kulesz
- Department of Psychology, University of Houston, Houston, TX, USA
| | | | - Brian Biekman
- Department of Psychology, University of Houston, Houston, TX, USA
| | - David P Laplante
- Lady Davis Institute - Jewish General Hospital, Montreal, Canada
| | | | - Suzanne King
- Psychosocial Research Unit, Douglas Research Centre, Verdun, Canada
- Department of Psychiatry, McGill University, Montreal, Canada
| | - Johanna Bick
- Department of Psychology, University of Houston, Houston, TX, USA
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Sörensen F, Kimmel MC, Brenner V, Krägeloh-Mann I, Skalkidou A, Mahjani B, Fransson E. Interactions of perinatal depression versus anxiety and infants' early temperament trajectories. Child Dev 2024; 95:721-733. [PMID: 38010823 DOI: 10.1111/cdev.14041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2022] [Revised: 09/05/2023] [Accepted: 09/18/2023] [Indexed: 11/29/2023]
Abstract
This study examines the interplay between maternal depression/anxiety and infant temperament's developmental trajectory in 1687 Swedish-speaking mother-infant dyads from Uppsala County (2009-2019), Sweden. The sample includes a high proportion of university-educated individuals and a low share of foreign-born participants. Maternal depressive and anxiety symptoms were assessed using the Edinburgh Postnatal Depression Scale during gestational weeks 17 and 32 and postpartum at week 6. Multinomial regression explored associations between maternal variables and infant temperament trajectories at 6 weeks, 12 months, and 18 months. Prenatal anxiety is associated with the high-rising infant difficult temperament trajectory, while prenatal depression/anhedonia is associated with the stable-medium trajectory, attenuated postpartum. Associations between infant temperament and maternal mood depended on timing (pre/postpartum) and symptom type (depression/anhedonia vs. anxiety).
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Affiliation(s)
- Ferdinand Sörensen
- Pediatric Neurology & Developmental Medicine, University Children's Hospital Tübingen, Tübingen, Germany
- Department of Psychiatry and Psychotherapy, Innovative Neuroimaging, University Hospital Tübingen, Tübingen, Germany
| | - Mary C Kimmel
- Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
- Department of Psychiatry, Center for Women's Mood Disorders, University of North Carolina, Chapel Hill, North Carolina, USA
| | - Vera Brenner
- Department of Child and Adolescent Psychiatry and Psychotherapy, University Hospital Tübingen, Tübingen, Germany
| | - Ingeborg Krägeloh-Mann
- Pediatric Neurology & Developmental Medicine, University Children's Hospital Tübingen, Tübingen, Germany
| | - Alkistis Skalkidou
- Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
| | - Behrang Mahjani
- Department of Psychiatry, Seaver Autism Center for Research and Treatment, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Emma Fransson
- Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
- Department of Microbiology, Tumor and Cell Biology, Centre for Translational Microbiome Research, Karolinska Institutet, Stockholm, Sweden
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Mattera JA, Erickson NL, Barbosa-Leiker C, Gartstein MA. COVID-19 pandemic effects: Examining prenatal internalizing symptoms and infant temperament. INFANCY 2024; 29:386-411. [PMID: 38244202 DOI: 10.1111/infa.12583] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2023] [Revised: 11/06/2023] [Accepted: 01/02/2024] [Indexed: 01/22/2024]
Abstract
For pregnant women, the COVID-19 pandemic has resulted in unprecedented stressors, including uncertainty regarding prenatal care and the long-term consequences of perinatal infection. However, few studies have examined the role of this adverse event on maternal wellbeing and infant socioemotional development following the initial wave of the pandemic when less stringent public health restrictions were in place. The current study addressed these gaps in the literature by first comparing prenatal internalizing symptoms and infant temperament collected after the first wave of the pandemic to equivalent measures in a pre-pandemic sample. Second, associations between prenatal pandemic-related stress and infant temperament were examined. Women who were pregnant during the COVID-19 pandemic endorsed higher pregnancy-specific anxiety relative to the pre-pandemic sample. They also reported greater infant negative emotionality and lower positive affectivity and regulatory capacity at 2 months postpartum. Prenatal infection stress directly predicted infant negative affect. Both prenatal infection and preparedness stress were indirectly related to infant negative emotionality through depression symptoms during pregnancy and at 2 months postpartum. These results have implications for prenatal mental health screening procedures during the pandemic and the development of early intervention programs for infants born to mothers during this adverse event.
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Affiliation(s)
- Jennifer A Mattera
- Department of Psychology, Washington State University, Pullman, Washington, USA
| | - Nora L Erickson
- Department of Pediatrics, University of Minnesota, Minneapolis, Minnesota, USA
| | | | - Maria A Gartstein
- Department of Psychology, Washington State University, Pullman, Washington, USA
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Karaahmet AY, Dolgun G, Özen M. Effects of probiotics on gastrointestinal symptoms, anthropometric measurements, and breastfeeding duration in infants with colic: a randomized control trial. SAO PAULO MED J 2024; 142:e2023069. [PMID: 38655990 DOI: 10.1590/1516-3180.2023.0069.r1.31052023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2023] [Accepted: 05/23/2023] [Indexed: 04/26/2024] Open
Abstract
BACKGROUND Infantile colic has a multifactorial etiology. Recent studies have suggested that probiotics may be effective in its management. OBJECTIVE This study was carried out to evaluate the effect of the Actiregularis strain (5×106 cfu\ml) included in maternal nutrition on gastrointestinal problems, growth development, and breastfeeding outcomes in infantile colic. DESIGN AND SETTING The study was a randomized controlled trial conducted in the neonatal outpatient clinic of a training and research hospital in Turkey. METHODS A probiotic drink containing the Actiregularis (5×106 cfu\ml) strain was added to the diet of mothers in the probiotics group once daily for 15 consecutive days. Data were collected for each infant's 0th (birth), 1st, 4th, and 6th months. RESULTS Infants whose mothers were administered Actiregularis for 15 days had decreased crying intensity (P = 0.000). When the difference in breastfeeding rates between the groups was significant at the 4th and 6th months (P = 0.044; P = 0.035). There was no difference in anthropometric values except the babies' weights at the 6th month. (P < 0.001). CONCLUSION Infants treated with Actiregularis, which was added to their mothers' diet for 15 days, showed a decrease in the frequency of crying, and the difference in breastfeeding rates between the groups was significant at the 4th and 6th months. There was no difference in anthropometric values except the babies' weights at the 6th month. CLINICAL TRIALS REGISTRATION NCT04374955 (https://clinicaltrials.gov/ct2/show/).
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Affiliation(s)
- Aysu Yıldız Karaahmet
- PhD. Assistant Professor, Department of Midwifery, Faculty of Health Science, Halic University, Istanbul, Turkiye
| | - Gülümser Dolgun
- PhD. Professor, Department of Midwifery, Faculty of Health Science, Istanbul University-Cerrahpasa, Istanbul, Turkiye
| | - Metehan Özen
- MD. Professor, Department of Child Health and Diseases, Faculty of Medicine, Acıbadem University, Istanbul, Turkiye
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Campbell SA, Dys SP, Henderson JMT, Bradley HA, Rucklidge JJ. Exploring the impact of antenatal micronutrients used as a treatment for maternal depression on infant temperament in the first year of life. Front Nutr 2024; 11:1307701. [PMID: 38711532 PMCID: PMC11073451 DOI: 10.3389/fnut.2024.1307701] [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: 10/05/2023] [Accepted: 03/25/2024] [Indexed: 05/08/2024] Open
Abstract
Antenatal depression and maternal nutrition can influence infant temperament. Although broad-spectrum-micronutrients (BSM: vitamins and minerals) given above Recommended Dietary Allowances during pregnancy can mitigate symptoms of antenatal depression, their associated effects on infant temperament are unknown. One hundred and fourteen New Zealand mother-infant dyads (45 infants exposed to BSM during pregnancy (range of exposure during pregnancy: 12-182 days) to treat antenatal depressive symptoms (measured by Edinburgh Postnatal Depression Scale) and 69 non-exposed infants) were followed antenatally and for 12 months postpartum to determine the influence of in utero BSM exposure on infant temperament. The Infant Behavior Questionnaire-Revised: Very Short-Form assessed temperament at 4 (T1), 6 (T2) and 12 (T3) months postpartum via online questionnaire. Latent growth curve modeling showed BSM exposure, antenatal depression and infant sex did not statistically significantly predict initial levels or longitudinal changes in orienting/regulatory capacity (ORC), positive affectivity/surgency (PAS) or negative affectivity (NEG). Higher gestational age was positively associated with initial PAS, and smaller increases between T1 and T3. Breastfeeding occurrence was positively associated with initial NEG. Although not significant, BSM exposure exerted small, positive effects on initial NEG (β = -0.116) and longitudinal changes in ORC (β = 0.266) and NEG (β = -0.235). While BSM exposure did not significantly predict infant temperament, it may mitigate risks associated with antenatal depression. BSM-exposed infants displayed temperamental characteristics on par with typical pregnancies, supporting the safety of BSM treatment for antenatal depression.
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Affiliation(s)
- S. A. Campbell
- School of Psychology, Speech and Hearing, University of Canterbury, Christchurch, New Zealand
| | - S. P. Dys
- Department of Psychology, Simon Fraser University, Burnaby, BC, Canada
| | - J. M. T. Henderson
- School of Psychology, Speech and Hearing, University of Canterbury, Christchurch, New Zealand
| | - H. A. Bradley
- School of Psychology, Speech and Hearing, University of Canterbury, Christchurch, New Zealand
| | - J. J. Rucklidge
- School of Psychology, Speech and Hearing, University of Canterbury, Christchurch, New Zealand
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Fairbrother N, Stagg B, Scoten O, Keeney C, Cargnelli C. Perinatal anxiety disorders screening study: a study protocol. BMC Psychiatry 2024; 24:162. [PMID: 38395837 PMCID: PMC10893673 DOI: 10.1186/s12888-024-05575-9] [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: 12/22/2023] [Accepted: 01/31/2024] [Indexed: 02/25/2024] Open
Abstract
BACKGROUND The anxiety and their related disorders (AD) are the most common of all mental health conditions, and affect approximately 20% of pregnant and postpartum people. They are associated with significant distress and life interference for sufferers, as well as negative consequences for fetal and infant development. At present, little if any routine screening for prenatal AD is being conducted and data regarding the most effective tools to screen for these disorders is lacking. The majority of screening studies suffer from methodological difficulties which undermine the confidence needed to recommend measures for population distribution. The primary purpose of this research is to identify the most accurate self-report tool(s) to screen for perinatal AD. METHODS A large, prospective cohort of pregnant people (N = 1,000) is being recruited proportionally across health service delivery regions in British Columbia (BC). The screening accuracy of a broad range of perinatal AD self-report measures are being assessed using gold standard methodology. Consenting individuals are administered online questionnaires followed by a semi-structured diagnostic interview between 16- and 36-weeks' gestation, and again between 6 and 20 weeks postpartum. Questionnaires include all screening measures, measures of sleep and unpaid family work, and questions pertaining to demographic and reproductive history, COVID-19, gender role burden, and mental health treatment utilization. Interviews assess all current anxiety disorders, as well as obsessive-compulsive disorder, and posttraumatic stress disorder. DISCUSSION This research is in response to an urgent demand for accurate perinatal AD screening tools based on high quality evidence. AD among perinatal people often go unidentified and untreated, resulting in continued suffering and life impairment. Findings from this research will inform healthcare providers, policymakers, and scientists, about the most effective approach to screening for anxiety and related disorders in pregnancy in the postpartum period.
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Affiliation(s)
- Nichole Fairbrother
- Department of Family Practice, University of British Columbia, Vancouver, Canada.
| | - Bryn Stagg
- Department of Obstetrics and Gynaecology, University of British Columbia, Vancouver, Canada
| | - Olivia Scoten
- Faculty of Medicine, University of British Columbia, Vancouver, Canada
| | - Cora Keeney
- Department of Family Practice, University of British Columbia, Vancouver, Canada
| | - Claudia Cargnelli
- Department of Obstetrics and Gynaecology, University of British Columbia, Vancouver, Canada
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10
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Buthmann JL, Miller JG, Gotlib IH. Maternal-prenatal stress and depression predict infant temperament during the COVID-19 pandemic. Dev Psychopathol 2024; 36:161-169. [PMID: 36345652 PMCID: PMC10164837 DOI: 10.1017/s0954579422001055] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
Researchers have begun to examine the psychological toll of the ongoing global COVID-19 pandemic. Data are now emerging indicating that there may be long-term adverse effects of the pandemic on new mothers and on children born during this period. In a longitudinal study of maternal mental health and child emotional development during the pandemic, we conducted online assessments of a cohort of women at two time points: when they were pregnant at the beginning of the surge of the pandemic in the United States (baseline, N = 725), and approximately 1 year postpartum (follow-up, N = 296), examining prenatal and postnatal maternal mental health, prenatal pandemic-related stress, and infant temperament. Pandemic-related stress at baseline was associated with concurrent depressive symptoms and infant negative affect at follow-up. Baseline maternal depressive symptoms were associated with follow-up depressive symptoms, which in turn were also associated with infant negative affect. Pandemic-related stress during pregnancy may have enduring effects on infant temperament. These findings have important implications for our understanding of the emotional development of children who were in utero during the COVID-19 pandemic.
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Affiliation(s)
| | - Jonas G Miller
- Department of Psychology, Stanford University, Stanford, CA, USA
| | - Ian H Gotlib
- Department of Psychology, Stanford University, Stanford, CA, USA
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11
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Mattera JA, Campagna AX, Goodman SH, Gartstein MA, Hancock GR, Stowe ZN, Newport DJ, Knight BT. Associations between mothers' and fathers' depression and anxiety prior to birth and infant temperament trajectories over the first year of life: Evidence from diagnoses and symptom severity. J Affect Disord 2023; 343:31-41. [PMID: 37741466 PMCID: PMC10672733 DOI: 10.1016/j.jad.2023.09.023] [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: 04/22/2023] [Revised: 09/11/2023] [Accepted: 09/17/2023] [Indexed: 09/25/2023]
Abstract
BACKGROUND Developmental shifts in infant temperament predict distal outcomes including emerging symptoms of psychopathology in childhood. Thus, it is critical to gain insight into factors that shape these developmental shifts. Although parental depression and anxiety represent strong predictors of infant temperament in cross-sectional research, few studies have examined how these factors influence temperament trajectories across infancy. METHODS We used latent growth curve modeling to examine whether mothers' and fathers' anxiety and depression, measured in two ways - as diagnostic status and symptom severity - serve as unique predictors of developmental shifts in infant temperament from 3 to 12 months. Participants included mothers (N = 234) and a subset of fathers (N = 142). Prior to or during pregnancy, both parents were assessed for lifetime diagnoses of depression and anxiety as well as current severity levels. Mothers rated their infants' temperament at 3, 6, and 12 months of age. RESULTS Mothers' depression and anxiety primarily predicted initial levels of temperament at 3 months. Controlling for mothers' symptoms, fathers' depression and anxiety largely related to temperament trajectories across infancy. Lifetime diagnoses and symptom severities were associated with distinct patterns. LIMITATIONS Infant temperament was assessed using a parent-report measure. Including an observational measure would provide a more comprehensive picture of the infants' functioning. CONCLUSIONS These results indicate that mothers' and fathers' mental health are uniquely associated with infant temperament development when measured using diagnostic status and/or symptom severity. Future studies should examine whether these temperament trajectories mediate intergenerational transmission of risk for depression and anxiety.
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Affiliation(s)
| | | | | | - Maria A Gartstein
- Department of Psychology, Washington State University, Pullman, WA, USA
| | - Gregory R Hancock
- Department of Human Development and Quantitative Methodology, University of Maryland, College Park, MD, USA
| | - Zachary N Stowe
- Department of Psychiatry and Behavioral Sciences, University of Wisconsin at Madison, Madison, WI, USA
| | - D Jeffrey Newport
- Departments of Psychiatry & Behavioral Sciences and Women's Health, University of Texas at Austin Dell Medical School, Austin, TX, USA
| | - Bettina T Knight
- Department of Psychiatry, University of Arkansas for Medical Sciences, Little Rock, AR, USA
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López-Morales H, Canet-Juric L, Del-Valle MV, Sosa JM, López MC, Urquijo S. Prenatal anxiety during the pandemic context is related to neurodevelopment of 6-month-old babies. Eur J Pediatr 2023; 182:4213-4226. [PMID: 37452845 DOI: 10.1007/s00431-023-05112-y] [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] [Received: 05/10/2023] [Revised: 06/27/2023] [Accepted: 07/08/2023] [Indexed: 07/18/2023]
Abstract
Prenatal anxiety and depression in pandemic context could introduce changes in the fetal developmental trajectories that, ultimately, could alter the adaptive behaviors of the offspring, potentially affecting, for example, general neurodevelopment. The sample consisted of 105 mother-child dyads, recruited between March and May 2020. The dyads were evaluated longitudinally, prenatally and postnatally (6 months). The Pandemic Impact Questionnaire, the State-Trait Anxiety Inventory, and the Beck-II Depression Inventory were used to assess indicators of maternal anxiety and depression, respectively. Regarding the babies, their mothers responded to Age and Stages: 3, which assesses different dimensions of early neurodevelopment, in addition to a closed questionnaire to identify sociodemographic and maternal and child health variables. A series of mediation models were tested to examine the association between prenatal psychopathology/negative experiences of the pandemic and neurodevelopment. The results indicated that the negative experiences of the pandemic were indirectly associated with the socio-individual and fine motor neurodevelopment of the offspring, through maternal anxiety symptoms, during the third trimester, which functioned as a mediator. Conclusions: This study provides evidence on the mediating effects of maternal anxiety on infant neurodevelopment in contexts of early adversity. It is important to point out the need to implement public health policies that allow a timely evaluation of neurodevelopmental variables during early childhood, which can implement early interventions to reduce the risks associated with these deficits. What is Known: • Effects of maternal mental health have been reported, effects on child neurodevelopment, in motor, cognitive, linguistic and socio-emotional dimensions. • Contexts of early adversity have been associated with maternal mental health and offspring development. What is New: • The context of pandemic adversity caused by COVID-19 is associated with motor and socio-individual neurodevelopment, mediated by maternal prenatal anxiety.
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Affiliation(s)
- Hernán López-Morales
- Instituto de Psicología Básica Aplicada y Tecnología (IPSIBAT), Mar del Plata, Argentina.
- Universidad Nacional de Mar del Plata (UNMDP), Mar del Plata, Argentina.
- Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Buenos Aires, Argentina.
- Escuela Superior de Medicina, Universidad Nacional de Mar del Plata, Mar del Plata, Argentina.
| | - Lorena Canet-Juric
- Instituto de Psicología Básica Aplicada y Tecnología (IPSIBAT), Mar del Plata, Argentina
- Universidad Nacional de Mar del Plata (UNMDP), Mar del Plata, Argentina
- Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Buenos Aires, Argentina
| | - Macarena Verónica Del-Valle
- Instituto de Psicología Básica Aplicada y Tecnología (IPSIBAT), Mar del Plata, Argentina
- Universidad Nacional de Mar del Plata (UNMDP), Mar del Plata, Argentina
- Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Buenos Aires, Argentina
| | - Julieta Mariel Sosa
- Instituto de Psicología Básica Aplicada y Tecnología (IPSIBAT), Mar del Plata, Argentina
- Universidad Nacional de Mar del Plata (UNMDP), Mar del Plata, Argentina
| | - Marcela Carolina López
- Instituto de Psicología Básica Aplicada y Tecnología (IPSIBAT), Mar del Plata, Argentina
- Universidad Nacional de Mar del Plata (UNMDP), Mar del Plata, Argentina
| | - Sebastián Urquijo
- Instituto de Psicología Básica Aplicada y Tecnología (IPSIBAT), Mar del Plata, Argentina
- Universidad Nacional de Mar del Plata (UNMDP), Mar del Plata, Argentina
- Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Buenos Aires, Argentina
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13
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Khoury JE, Atkinson L, Jack S, Bennett T, Raha S, Duku E, Gonzalez A. Protocol for the COVID-19 Wellbeing and Stress Study: a longitudinal study of parent distress, biological stress and child biopsychosocial development during the pandemic and beyond. BMJ Open 2023; 13:e071926. [PMID: 37580092 PMCID: PMC10432660 DOI: 10.1136/bmjopen-2023-071926] [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: 01/16/2023] [Accepted: 05/22/2023] [Indexed: 08/16/2023] Open
Abstract
INTRODUCTION The COVID-19 pandemic has had a unique impact on the mental health and well-being of pregnant individuals and parents of young children. However, the impact of COVID-19-related stress during pregnancy on early child biopsychosocial development, remains unclear. The COVID-19 Wellbeing and Stress Study will: (1) investigate the impact of different forms of prenatal stress experienced during the pandemic (including objective hardship, perceived psychological distress and biological stress) on child stress biology, (2) examine the association between child stress biology and child developmental outcomes, (3) determine whether child stress biology acts as a mechanism linking prenatal stress to adverse child developmental outcomes and (4) assess whether gestational age at the onset of the COVID-19 pandemic or child sex, moderate these associations. METHODS AND ANALYSES The COVID-19 Wellbeing and Stress Study is a prospective longitudinal study, consisting of six time points, spanning from pregnancy to 3 years postpartum. The study began in June 2020, consisting of 304 pregnant people from Ontario, Canada. This multimethod study is composed of questionnaires, biological samples, behavioural observations and developmental assessments ETHICS AND DISSEMINATION: This study was approved by the Hamilton Integrated Research Ethics Board (#11034) and the Mount Saint Vincent University Research Ethics Board (#2020-187, #2021-075, #2022-008). Findings will be disseminated through peer-reviewed presentations and publications, community presentations, and electronic forums (social media, newsletters and website postings).
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Affiliation(s)
- Jennifer E Khoury
- Department of Psychology, Mount Saint Vincent University, Halifax, Nova Scotia, Canada
| | - Leslie Atkinson
- Department of Psychology, Toronto Metropolitan University, Toronto, Ontario, Canada
| | - Susan Jack
- School of Nursing, McMaster University, Hamilton, Ontario, Canada
| | - Teresa Bennett
- Psychiatry and Behavioural Neuroscience, McMaster University, Hamilton, Ontario, Canada
- Offord Centre for Child Studies, McMaster University, Hamilton, Ontario, Canada
| | - Sandeep Raha
- Department of Biochemistry & Biomedical Sciences, McMaster University, Hamilton, Ontario, Canada
| | - Eric Duku
- Offord Centre for Child Studies, McMaster University, Hamilton, Ontario, Canada
| | - Andrea Gonzalez
- Psychiatry and Behavioural Neuroscience, McMaster University, Hamilton, Ontario, Canada
- Offord Centre for Child Studies, McMaster University, Hamilton, Ontario, Canada
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14
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López-Morales H, Del-Valle MV, López MC, Andrés ML, García MJ, Canet-Juric L, Urquijo S. Maternal anxiety, exposure to the COVID-19 pandemic and socioemotional development of offspring. JOURNAL OF APPLIED DEVELOPMENTAL PSYCHOLOGY 2023; 86:101517. [PMID: 36748034 PMCID: PMC9892320 DOI: 10.1016/j.appdev.2023.101517] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Revised: 01/20/2023] [Accepted: 01/30/2023] [Indexed: 02/05/2023]
Abstract
The COVID-19 pandemic context may predispose mothers to increased maternal psychopathology, which may be associated with offspring socioemotional development. The aim of this study is to analyze the relationships between prenatal anxiety and depression and exposure to the COVID-19 pandemic with offspring socioemotional development, controlling for postnatal anxiety and depression. A total of 105 mother-child dyads were assessed in pre- and postnatal periods. Questionnaires were used to assess the impact of the pandemic, indicators of psychopathology, and the socioemotional development of the offspring. Results suggest that negative pandemic experiences are indirectly associated with offspring socioemotional development via prenatal maternal anxiety symptomatology and after controlling for postnatal anxiety and depression. These indicators predispose to emotional deficits and increase the risks of psychopathological and neurodevelopmental disorders. It is important to adopt health policies that provide timely assessment of development in early childhood to reduce the risks associated with these deficits.
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Affiliation(s)
- Hernán López-Morales
- Instituto de Psicología Básica Aplicada y Tecnología (IPSIBAT), Mar del Plata, Argentina
- Universidad Nacional de Mar del Plata (UNMDP), Mar del Plata, Argentina
- Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Argentina
- Escuela Superior de Medicina, Universidad Nacional de Mar del Plata, Argentina
| | - Macarena Verónica Del-Valle
- Instituto de Psicología Básica Aplicada y Tecnología (IPSIBAT), Mar del Plata, Argentina
- Universidad Nacional de Mar del Plata (UNMDP), Mar del Plata, Argentina
- Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Argentina
| | - Marcela Carolina López
- Instituto de Psicología Básica Aplicada y Tecnología (IPSIBAT), Mar del Plata, Argentina
- Universidad Nacional de Mar del Plata (UNMDP), Mar del Plata, Argentina
- Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Argentina
| | - María Laura Andrés
- Instituto de Psicología Básica Aplicada y Tecnología (IPSIBAT), Mar del Plata, Argentina
- Universidad Nacional de Mar del Plata (UNMDP), Mar del Plata, Argentina
- Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Argentina
| | - Matías Jonás García
- Instituto de Psicología Básica Aplicada y Tecnología (IPSIBAT), Mar del Plata, Argentina
- Universidad Nacional de Mar del Plata (UNMDP), Mar del Plata, Argentina
- Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Argentina
| | - Lorena Canet-Juric
- Instituto de Psicología Básica Aplicada y Tecnología (IPSIBAT), Mar del Plata, Argentina
- Universidad Nacional de Mar del Plata (UNMDP), Mar del Plata, Argentina
- Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Argentina
| | - Sebastián Urquijo
- Instituto de Psicología Básica Aplicada y Tecnología (IPSIBAT), Mar del Plata, Argentina
- Universidad Nacional de Mar del Plata (UNMDP), Mar del Plata, Argentina
- Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Argentina
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15
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Swales DA, Davis EP, Mahrer NE, Guardino CM, Shalowitz MU, Ramey SL, Schetter CD. Preconception maternal posttraumatic stress and child negative affectivity: Prospectively evaluating the intergenerational impact of trauma. Dev Psychopathol 2023; 35:619-629. [PMID: 35074031 PMCID: PMC9309186 DOI: 10.1017/s0954579421001760] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
The developmental origins of psychopathology begin before birth and perhaps even prior to conception. Understanding the intergenerational transmission of psychopathological risk is critical to identify sensitive windows for prevention and early intervention. Prior research demonstrates that maternal trauma history, typically assessed retrospectively, has adverse consequences for child socioemotional development. However, very few prospective studies of preconception trauma exist, and the role of preconception symptoms of posttraumatic stress disorder (PTSD) remains unknown. The current study prospectively evaluates whether maternal preconception PTSD symptoms predict early childhood negative affectivity, a key dimension of temperament and predictor of later psychopathology. One hundred and eighteen women were recruited following a birth and prior to conception of the study child and were followed until the study child was 3-5 years old. Higher maternal PTSD symptoms prior to conception predicted greater child negative affectivity, adjusting for concurrent maternal depressive symptoms and sociodemographic covariates. In exploratory analyses, we found that neither maternal prenatal nor postpartum depressive symptoms or perceived stress mediated this association. These findings add to a limited prospective literature, highlighting the importance of assessing the mental health of women prior to conception and providing interventions that can disrupt the intergenerational sequelae of trauma.
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Affiliation(s)
| | - Elysia Poggi Davis
- Department of Psychology, University of Denver, Denver, CO
- Department of Psychiatry and Human Behavior, University of California, Irvine, Irvine, CA
| | | | | | - Madeleine U. Shalowitz
- Department of Pediatrics, NorthShore University HealthSystem Research Institute, Evanston, IL
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16
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Rúger-Navarrete A, Vázquez-Lara JM, Antúnez-Calvente I, Rodríguez-Díaz L, Riesco-González FJ, Palomo-Gómez R, Gómez-Salgado J, Fernández-Carrasco FJ. Antenatal Fear of Childbirth as a Risk Factor for a Bad Childbirth Experience. Healthcare (Basel) 2023; 11:healthcare11030297. [PMID: 36766873 PMCID: PMC9914781 DOI: 10.3390/healthcare11030297] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2022] [Revised: 01/12/2023] [Accepted: 01/16/2023] [Indexed: 01/20/2023] Open
Abstract
Giving birth is one of the most impressive experiences in life. However, many pregnant women suffer from fear of childbirth (FOC) and experience labour in very different ways, depending on their personality, previous life experiences, pregnancy, and birth circumstances. The aim of this study was to analyse how fear of childbirth affects the childbirth experience and to assess the related consequences. For this, a descriptive cross-sectional study was carried out in a sample of 414 women between 1 July 2021 and 30 June 2022. The Birth Anticipation Scale (BAS) was used to measure fear of childbirth and the Childbirth Experience Questionnaire (CEQ-E) was applied to measure satisfaction with the childbirth experience. Fear of childbirth negatively and significantly predicted the childbirth experience. In addition, women who were more fearful of childbirth were found to have worse obstetric outcomes and a higher likelihood of having a caesarean delivery (p = 0.008 C. I 95%). Fear behaved as a risk factor for the birth experience, so the greater the fear, the higher the risk of having a worse birth experience (OR 1.1). Encouraging active listening and support strategies may increase pregnant women's confidence, thus decreasing their fear of the process and improving their childbirth experience.
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Affiliation(s)
| | - Juana María Vázquez-Lara
- Nursing Department, Faculty of Health Sciences of Ceuta, University of Granada, 51001 Ceuta, Spain
- Correspondence: (J.M.V.-L.); (J.G.-S.); Tel.: +34-956526116 (J.M.V.-L.); +34-959219703 (J.G.-S.)
| | - Irene Antúnez-Calvente
- Department of Obstetrics, Hospital Universitario Punta de Europa, 11207 Algeciras, Spain
| | - Luciano Rodríguez-Díaz
- Nursing Department, Faculty of Health Sciences of Ceuta, University of Granada, 51001 Ceuta, Spain
| | | | - Rocío Palomo-Gómez
- Department of Obstetrics, La Linea de la Concepción Hospital, 11300 La Línea de la Concepción, Spain
| | - Juan Gómez-Salgado
- Department of Sociology, Social Work and Public Health, Faculty of Labour Sciences, University of Huelva, 21007 Huelva, Spain
- Safety and Health Postgraduate Programme, University of Espíritu Santo, Guayaquil 092301, Ecuador
- Correspondence: (J.M.V.-L.); (J.G.-S.); Tel.: +34-956526116 (J.M.V.-L.); +34-959219703 (J.G.-S.)
| | - Francisco Javier Fernández-Carrasco
- Department of Obstetrics, Hospital Universitario Punta de Europa, 11207 Algeciras, Spain
- Department of Nursing and Physiotherapy, Faculty of Nursing, University of Cádiz, 11207 Algeciras, Spain
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17
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Khoury JE, Giles L, Kaur H, Johnson D, Gonzalez A, Atkinson L. Associations between psychological distress and hair cortisol during pregnancy and the early postpartum: A meta-analysis. Psychoneuroendocrinology 2023; 147:105969. [PMID: 36335755 DOI: 10.1016/j.psyneuen.2022.105969] [Citation(s) in RCA: 13] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2022] [Revised: 09/26/2022] [Accepted: 10/26/2022] [Indexed: 11/06/2022]
Abstract
Pregnancy and the early postpartum signify a period of high stress. Perinatal stress can include psychological distress (PD), such as anxiety, depression, and stress, as well as neuroendocrine stress, indexed by activation of the hypothalamic-pituitary-adrenal (HPA) axis and the production of the hormone cortisol. Elevated PD and cortisol levels during the perinatal period can have long-term implications for the mother and child. Methodological advances have enabled the sampling of cortisol from hair, to provide a retrospective marker of HPA axis activity over several months. Despite knowing that maternal PD and HPA activity during the perinatal period independently impact health and development, research to date is unclear as to the association between maternal PD and hair cortisol. The present meta-analysis included 29 studies to assess the strength of the relation between maternal PD and hair cortisol levels during pregnancy and the early postpartum period. Several sample and methodological factors were assessed as moderators of this effect. Analyses were conducted using multilevel meta-analysis. Results of the multilevel meta-analysis indicated that the overall effect size between PD and HCC was small but not significant z = 0.039, 95% CI [- 0.001, 0.079]. Moderator analyses indicated that the strength of the association between PD and hair cortisol was moderated by pregnancy status (i.e., effects were stronger in pregnant compared to postpartum samples), timing of HCC and PD measurements (i.e., effects were larger when PD was measured before HCC) and geographic location (i.e., effects were larger in North American studies). The findings advance our understanding of the link between PD and HPA activity during the perinatal period, a time of critical impact to child development.
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Affiliation(s)
- Jennifer E Khoury
- Department of Psychology, Mount Saint Vincent University, Halifax, NS Canada.
| | - Lauren Giles
- Department of Psychology, Mount Saint Vincent University, Halifax, NS Canada
| | - Hargun Kaur
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON Canada
| | - Dylan Johnson
- Department of Applied Psychology and Human Development, University of Toronto, Toronto, ON Canada
| | - Andrea Gonzalez
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON Canada; Offord Centre for Child Studies, McMaster University, Hamilton, ON Canada
| | - Leslie Atkinson
- Department of Psychology, Toronto Metropolitan University, Toronto, ON Canada
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18
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López-Morales H, Gelpi Trudo R, del-Valle MV, Canet-Juric L, Biota M, Andrés ML, Urquijo S. The Pandemial babies: effects of maternal stress on temperament of babies gestated and born during the pandemic. CURRENT PSYCHOLOGY 2022:1-13. [PMID: 36437907 PMCID: PMC9676865 DOI: 10.1007/s12144-022-03976-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/30/2022] [Indexed: 11/21/2022]
Abstract
The COVID-19 pandemic may configure an adverse prenatal context for early development. The aim of this study was to analyze the effects of pandemic-related negative experiences, prenatal anxiety and depression on the temperament of six-month-old babies. The sample consisted of 105 mother-child dyads. A longitudinal evaluation was carried out using pre- and postnatal online surveys. Mothers completed the State-Trait Anxiety Inventory, the Beck Depression Inventory - II, the Pandemic Impact Questionnaire and the Infant Behavior Questionnaire Revised. Serial mediation models were tested, in which the pandemic-related negative experiences constituted the independent variable, the prenatal anxiety and depression were the mediators, and the children's temperament dimensions were the dependent variables. Pandemic-related negative experiences were indirectly associated with the offspring's negative affect and surgency through anxious symptomatology, which acted as a mediating variable. This was the first study to identify the effects of the COVID-19 pandemic on temperament. Such an adverse context implies risks for child development. Public health policies aiming to evaluate socioemotional variables during early childhood become necessary to allow on-time interventions for lessening these risks.
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Affiliation(s)
- Hernán López-Morales
- Instituto de Psicología Básica Aplicada Y Tecnología (IPSIBAT), Mar del Plata, Argentina
- Universidad Nacional de Mar del Plata (UNMDP), Mar del Plata, Argentina
- Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Buenos Aires, Argentina
- Escuela Superior de Medicina, Universidad Nacional de Mar del Plata, Mar del Plata, Argentina
| | - Rosario Gelpi Trudo
- Instituto de Psicología Básica Aplicada Y Tecnología (IPSIBAT), Mar del Plata, Argentina
- Universidad Nacional de Mar del Plata (UNMDP), Mar del Plata, Argentina
- Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Buenos Aires, Argentina
| | - Macarena Verónica del-Valle
- Instituto de Psicología Básica Aplicada Y Tecnología (IPSIBAT), Mar del Plata, Argentina
- Universidad Nacional de Mar del Plata (UNMDP), Mar del Plata, Argentina
- Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Buenos Aires, Argentina
| | - Lorena Canet-Juric
- Instituto de Psicología Básica Aplicada Y Tecnología (IPSIBAT), Mar del Plata, Argentina
- Universidad Nacional de Mar del Plata (UNMDP), Mar del Plata, Argentina
- Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Buenos Aires, Argentina
| | - Magdalena Biota
- Unidad Ejecutora de Estudios en Neurociencias Y Sistemas Complejos (CONICET - Hospital El Cruce - Universidad Nacional Arturo Jauretche), Buenos Aires, Argentina
| | - María Laura Andrés
- Instituto de Psicología Básica Aplicada Y Tecnología (IPSIBAT), Mar del Plata, Argentina
- Universidad Nacional de Mar del Plata (UNMDP), Mar del Plata, Argentina
- Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Buenos Aires, Argentina
| | - Sebastián Urquijo
- Instituto de Psicología Básica Aplicada Y Tecnología (IPSIBAT), Mar del Plata, Argentina
- Universidad Nacional de Mar del Plata (UNMDP), Mar del Plata, Argentina
- Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Buenos Aires, Argentina
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19
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Mudra S, Göbel A, Möhler E, Stuhrmann LY, Schulte-Markwort M, Arck P, Hecher K, Diemert A. Behavioral Inhibition in the Second Year of Life Is Predicted by Prenatal Maternal Anxiety, Overprotective Parenting and Infant Temperament in Early Infancy. Front Psychiatry 2022; 13:844291. [PMID: 35722567 PMCID: PMC9203734 DOI: 10.3389/fpsyt.2022.844291] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/27/2021] [Accepted: 05/16/2022] [Indexed: 11/22/2022] Open
Abstract
Background Behavioral inhibition, characterized by shyness, fear and avoidance of novel stimuli, has been linked with internalizing personality traits in childhood, adolescence and early adulthood, and particularly later social anxiety disorder. Little is known about the relevance of potential prenatal precursors and early predictors for the development of inhibited behavior, such as infant vulnerability and family risk factors like parental anxiety and overprotection. Pregnancy-related anxiety has been associated with both infant temperament and maternal overprotective parenting. Thus, the aim of this study was investigating the predictive relevance of prenatal pregnancy-related anxiety for behavioral inhibition in toddlerhood, by considering the mediating role of maternal overprotection and infant distress to novelty. Materials and Methods As part of a longitudinal pregnancy cohort, behavioral inhibition at 24 months postpartum was assessed in N = 170 mother-child pairs. Maternal pregnancy-related anxiety was examined in the third trimester of pregnancy, and maternal overprotection and infant distress to novelty at 12 months postpartum. Results Mediation analysis with two parallel mediators showed that the significant direct effect of pregnancy-related anxiety on child behavioral inhibition was fully mediated by infant distress to novelty p < 0.001 and maternal overprotection (p < 0.05). The included variables explained 26% of variance in behavioral inhibition. A subsequent explorative mediation analysis with serial mediators further showed a significant positive association between distress to novelty and maternal overprotective parenting (p < 0.05). Conclusion Results indicate a predictive relevance of both infant and maternal factors for the development of behavioral inhibition in toddlerhood. Mothers who perceived more pregnancy-related anxiety showed more overprotective parenting and had infants with more distress to novelty. Further, mothers being more overprotective reported their child to be more inhibited in toddlerhood. Our findings also indicate the stability of reported infant distress to novelty as one aspect of later behavioral inhibition. Addressing specific forms of parental anxiety from pregnancy on and in interaction with child-related variables seems to be a promising approach for future studies and clinical interventions.
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Affiliation(s)
- Susanne Mudra
- Department of Child and Adolescent Psychiatry, Psychotherapy, and Psychosomatics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Ariane Göbel
- Department of Child and Adolescent Psychiatry, Psychotherapy, and Psychosomatics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Eva Möhler
- Department of Child and Adolescent Psychiatry, Psychotherapy, and Psychosomatics, Saarland University Medical Center, Hamburg, Germany
| | - Lydia Yao Stuhrmann
- Department of Child and Adolescent Psychiatry, Psychotherapy, and Psychosomatics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Michael Schulte-Markwort
- Department of Child and Adolescent Psychiatry, Psychotherapy, and Psychosomatics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Petra Arck
- Division of Experimental Feto-Maternal Medicine, Department of Obstetrics and Fetal Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Kurt Hecher
- Department of Obstetrics and Fetal Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Anke Diemert
- Department of Obstetrics and Fetal Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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20
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Negative emotionality as a candidate mediating mechanism linking prenatal maternal mood problems and offspring internalizing behaviour. Dev Psychopathol 2022; 35:604-618. [PMID: 35440354 DOI: 10.1017/s0954579421001747] [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: 11/06/2022]
Abstract
Negative emotionality (NE) was evaluated as a candidate mechanism linking prenatal maternal affective symptoms and offspring internalizing problems during the preschool/early school age period. The participants were 335 mother-infant dyads from the Maternal Adversity, Vulnerability and Neurodevelopment project. A Confirmatory Bifactor Analysis (CFA) based on self-report measures of prenatal depression and pregnancy-specific anxiety generated a general factor representing overlapping symptoms of prenatal maternal psychopathology and four distinct symptom factors representing pregnancy-specific anxiety, negative affect, anhedonia and somatization. NE was rated by the mother at 18 and 36 months. CFA based on measures of father, mother, child-rated measures and a semistructured interview generated a general internalizing factor representing overlapping symptoms of child internalizing psychopathology accounting for the unique contribution of each informant. Path analyses revealed significant relationships among the general maternal affective psychopathology, the pregnancy- specific anxiety, and the child internalizing factors. Child NE mediated only the relationship between pregnancy-specific anxiety and the child internalizing factors. We highlighted the conditions in which prenatal maternal affective symptoms predicts child internalizing problems emerging early in development, including consideration of different mechanistic pathways for different maternal prenatal symptom presentations and child temperament.
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21
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Fairbrother N, Albert A, Collardeau F, Keeney C. The Childbirth Fear Questionnaire and the Wijma Delivery Expectancy Questionnaire as Screening Tools for Specific Phobia, Fear of Childbirth. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19084647. [PMID: 35457513 PMCID: PMC9028446 DOI: 10.3390/ijerph19084647] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/26/2022] [Revised: 03/14/2022] [Accepted: 04/02/2022] [Indexed: 12/04/2022]
Abstract
Background: Perinatal anxiety and related disorders are common (20%), distressing and impairing. Fear of childbirth (FoB) is a common type of perinatal anxiety associated with negative mental health, obstetrical, childbirth and child outcomes. Screening can facilitate treatment access for those most in need. Objectives: The purpose of this research was to evaluate the accuracy of the Childbirth Fear Questionnaire (CFQ) and the Wijma Delivery Expectations Questionnaire (W-DEQ) of FoB as screening tools for a specific phobia, FoB. Methods: A total of 659 English-speaking pregnant women living in Canada and over the age of 18 were recruited for the study. Participants completed an online survey of demographic, current pregnancy and reproductive history information, as well as the CFQ and the W-DEQ, and a telephone interview to assess specific phobia FoB. Results: Symptoms meeting full and subclinical diagnostic criteria for a specific phobia, FoB, were reported by 3.3% and 7.1% of participants, respectively. The W-DEQ met or exceeded the criteria for a “good enough” screening tool across several analyses, whereas the CFQ only met these criteria in one analysis and came close in three others. Conclusions: The W-DEQ demonstrated high performance as a screening tool for a specific phobia, FoB, with accuracy superior to that of the CFQ. Additional research to ensure the stability of these findings is needed.
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Affiliation(s)
- Nichole Fairbrother
- Department of Family Practice, University of British Columbia, Vancouver, BC V6T 1Z4, Canada;
- Correspondence: ; Tel.: +1-250-0519-5390 (ext. 36439)
| | - Arianne Albert
- Women’s Health Research Institute, Vancouver, BC V6H 2N9, Canada;
| | - Fanie Collardeau
- Department of Psychology, University of Victoria, Victoria, BC V8P 5C2, Canada;
| | - Cora Keeney
- Department of Family Practice, University of British Columbia, Vancouver, BC V6T 1Z4, Canada;
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22
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Veringa‐Skiba IK, de Bruin EI, van Steensel FJA, Bögels SM. Fear of childbirth, nonurgent obstetric interventions, and newborn outcomes: A randomized controlled trial comparing mindfulness-based childbirth and parenting with enhanced care as usual. Birth 2022; 49:40-51. [PMID: 34250636 PMCID: PMC9292241 DOI: 10.1111/birt.12571] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2020] [Accepted: 06/24/2021] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To investigate whether mindfulness-based childbirth and parenting (MBCP) or enhanced care as usual (ECAU) for expectant couples decreases fear of childbirth (FOC) and nonurgent obstetric interventions during labor and improves newborn outcomes. DESIGN Randomized controlled trial. SETTING Midwifery settings, the Netherlands, April 2014-July 2017. POPULATION Pregnant women with high FOC (n = 141) and partners. METHODS Allocation to MBCP or ECAU. Hierarchical multilevel and intention-to-treat (ITT) and per-protocol (PP) analyses. MAIN OUTCOME MEASURES Primary: pre-/postintervention FOC, labor anxiety disorder, labor pain (catastrophizing and acceptance), and preferences for nonurgent obstetric interventions. Secondary: rates of epidural analgesia (EA), self-requested cesarean birth (sCB), unmedicated childbirth, and 1- and 5-minute newborn's Apgar scores. RESULTS MBCP was significantly superior to ECAU in decreasing FOC, catastrophizing of labor pain, preference for nonurgent obstetric interventions, and increasing acceptance of labor pain. MBCP participants were 36% less likely to undergo EA (RR 0.64, 95% CI [0.43-0.96]), 51% less likely to undergo sCB (RR 0.49, 95% CI [0.36-0.67]), and twice as likely to have unmedicated childbirth relative to ECAU (RR 2.00, 95% CI [1.23-3.20]). Newborn's 1-minute Apgar scores were higher in MBCP (DM -0.39, 95% CI [-0.74 to -0.03]). After correction for multiple testing, results remained significant in ITT and PP analyses, except EA in ITT analyses and 1-minute Apgar. CONCLUSIONS MBCP for pregnant couples reduces mothers' fear of childbirth, nonurgent obstetric interventions during childbirth and may improve childbirth outcomes. MBCP adapted for pregnant women with high FOC and their partners appears an acceptable and effective intervention for midwifery care.
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Affiliation(s)
- Irena K. Veringa‐Skiba
- Research Institute of Child Development and Education (RICDE)Research Priority Area YieldUniversity of AmsterdamAmsterdamthe Netherlands
| | - Esther I. de Bruin
- Research Institute of Child Development and Education (RICDE)Research Priority Area YieldUniversity of AmsterdamAmsterdamthe Netherlands,UvA‐mindsAcademic Center of the University of AmsterdamAmsterdamthe Netherlands
| | - Francisca J. A. van Steensel
- Research Institute of Child Development and Education (RICDE)Research Priority Area YieldUniversity of AmsterdamAmsterdamthe Netherlands
| | - Susan M. Bögels
- Research Institute of Child Development and Education (RICDE)Research Priority Area YieldUniversity of AmsterdamAmsterdamthe Netherlands
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23
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Rodríguez-Soto NC, Buxó CJ, Morou-Bermudez E, Pérez-Edgar K, Ocasio-Quiñones IT, Surillo-González MB, Martinez KG. The impact of prenatal maternal stress due to potentially traumatic events on child temperament: A systematic review. Dev Psychobiol 2021; 63:e22195. [PMID: 34674245 PMCID: PMC8549868 DOI: 10.1002/dev.22195] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Revised: 07/21/2021] [Accepted: 08/18/2021] [Indexed: 12/11/2022]
Abstract
The objective of the current study was to complete a systematic review of the relationship between prenatal maternal stress due to potentially traumatic events (PTEs) and child temperament. Eligible studies through June 2020 were identified utilizing a search strategy in PubMed and PsycInfo. Included studies examined associations between prenatal maternal stress due to PTE and child temperament. Two independent coders extracted study characteristics and three coders assessed study quality. Of the 1969 identified studies, 20 met full inclusion criteria. Studies were classified on two dimensions: (1) disaster-related stress and (2) intimate partner violence during pregnancy. For disaster-related prenatal maternal stress, 75% (nine out of 12) of published reports found associations with increased child negative affectivity, 50% (five out of 10) also noted associations with lower effortful control/regulation, and 38% (three out of eight) found associations with lower positive affectivity. When considering prenatal intimate partner violence stress, 80% (four out of five) of published reports found associations with higher child negative affectivity, 67% (four out of six) found associations with lower effortful control/regulation, and 33% (one out of three) found associations with lower positive affectivity. Prenatal maternal stress due to PTEs may impact the offspring's temperament, especially negative affectivity. Mitigating the effects of maternal stress in pregnancy is needed in order to prevent adverse outcomes on the infant's socioemotional development.
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Affiliation(s)
- Nayra C. Rodríguez-Soto
- University of Puerto Rico, Medical Sciences Campus, San Juan, PR
- Carlos Albizu University, San Juan, PR
| | - Carmen J. Buxó
- University of Puerto Rico, Medical Sciences Campus, San Juan, PR
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24
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Staver MA, Moore TA, Hanna KM. An integrative review of maternal distress during neonatal intensive care hospitalization. Arch Womens Ment Health 2021; 24:217-229. [PMID: 32851469 DOI: 10.1007/s00737-020-01063-7] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Accepted: 08/21/2020] [Indexed: 11/26/2022]
Abstract
To synthesize literature addressing maternal distress and associated variables in response to infant hospitalization in the NICU. CINAHL, Medline, PubMed, PsychINFO, and Scopus were searched for studies addressing maternal distress during NICU hospitalization published between January 2009 and August 2019. The initial literature search yielded 862 articles. Articles were included for analysis if (a) they were peer-reviewed, (b) maternal distress was defined or measured, and (c) maternal distress occurred in the NICU. Ultimately, 33 articles were included for analysis. Distress symptoms were not consistently measured across the literature by one specific instrument. However, despite the variety of instruments, distress was prevalent in this population. Individual elements of maternal distress in the NICU include depression, anxiety, trauma, and post-traumatic stress symptoms. These elements often occur together and tend to follow a specific trajectory during hospitalization. This body of literature was inconsistent regarding the timing of distress measurement as well as the relationship between relevant associated variables (e.g., marital status or infant illness severity) and maternal distress. Additionally, researchers often excluded mothers of non-preterm infants and infants with congenital anomalies from investigation. Researchers and clinicians should carefully consider timing and instrumentation in their interpretations of maternal distress measurement during a NICU hospitalization. Future work should focus on developing a comprehensive, valid, and reliable screening tool for clinicians and researchers to use to identify maternal distress in the NICU. Additionally, future research should address gaps in the populations included in studies.
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Affiliation(s)
- Morgan A Staver
- University of Nebraska Medical Center College of Nursing, Omaha, NE, USA.
| | - Tiffany A Moore
- University of Nebraska Medical Center College of Nursing, Omaha, NE, USA
| | - Kathleen M Hanna
- University of Nebraska Medical Center College of Nursing, Omaha, NE, USA
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25
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Takegata M, Matsunaga A, Ohashi Y, Toizumi M, Yoshida LM, Kitamura T. Prenatal and Intrapartum Factors Associated With Infant Temperament: A Systematic Review. Front Psychiatry 2021; 12:609020. [PMID: 33897486 PMCID: PMC8060501 DOI: 10.3389/fpsyt.2021.609020] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2020] [Accepted: 03/08/2021] [Indexed: 11/23/2022] Open
Abstract
Background: Temperament involves individual variations in behavioural tendencies of emotional responses and reactions to stimuli after birth. Because 'foetal programming' is a strong hypothesis in developing temperament, prenatal and intrapartum factors may be significant determinants of infant temperament. This systematic literature review aims to elucidate the evidence of prenatal and intrapartum predictors, including genetic, biological, environmental, socio-demographic, psychological, and obstetric factors of parents and their child. Methods: Relevant articles were searched using MEDLINE, PubMed, and SCOPUS. The inclusion criteria were (a) original research article, (b) written in English, (c) assessed the temperament of infants 12 months old or younger as an outcome variable, and (d) investigated prenatal and intrapartum factorial variables of infant temperament. Following the PRISMA guideline, the articles found in the three databases were screened and selected according to the inclusion and exclusion criteria before the final review. Results: Finally, 35 articles were reviewed. This systematic review identified a variety of prenatal and intrapartum factors that were significantly associated with infant temperament: (1) genetic and biological factors: certain genotypes, maternal cortisol and ACTH, and CRHs, (2) environmental factors: substance use such as tobacco, alcohol, and illegal drugs, (3) socio-demographic factor: lower-income, (4) psychological factors: depression or anxiety, eating disorders, personality types of mothers, and domestic violence, and (5) obstetric factors: foetal growth (birth weight), hypertension in mothers, nausea (emesis), and preterm birth. Conclusion: The findings support gene-environment interaction and biological mechanisms for developing infant temperament, suggesting the importance of ensuring a safe and comfortable environment for pregnant mothers, unborn infants, and families during pregnancy and delivery.
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Affiliation(s)
- Mizuki Takegata
- Department of Pediatric Infectious Diseases, Institute of Tropical Medicine, Nagasaki University, Nagasaki, Japan.,Kitamura Institute of Mental Health Tokyo, Tokyo, Japan
| | - Asami Matsunaga
- Kitamura Institute of Mental Health Tokyo, Tokyo, Japan.,Kitamura KOKORO Clinic Mental Health, Tokyo, Japan.,Department of Community Mental Health and Law, National Institute of Mental Health, National Center of Neurology and Psychiatry, Kodaira, Japan
| | - Yukiko Ohashi
- Faculty of Nursing, Josai International University, Togane, Japan
| | - Michiko Toizumi
- Department of Pediatric Infectious Diseases, Institute of Tropical Medicine, Nagasaki University, Nagasaki, Japan
| | - Lay Myint Yoshida
- Department of Pediatric Infectious Diseases, Institute of Tropical Medicine, Nagasaki University, Nagasaki, Japan
| | - Toshinori Kitamura
- Kitamura Institute of Mental Health Tokyo, Tokyo, Japan.,Kitamura KOKORO Clinic Mental Health, Tokyo, Japan.,T. and F. Kitamura Foundation for Studies and Skill Advancement in Mental Health, Tokyo, Japan.,Department of Psychiatry, Graduate School of Medicine, Nagoya University, Nagoya, Japan
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26
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Spry EA, Aarsman SR, Youssef GJ, Patton GC, Macdonald JA, Sanson A, Thomson K, Hutchinson DM, Letcher P, Olsson CA. Maternal and paternal depression and anxiety and offspring infant negative affectivity: A systematic review and meta-analysis. DEVELOPMENTAL REVIEW 2020. [DOI: 10.1016/j.dr.2020.100934] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
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27
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Bang KS, Lee I, Kim S, Yi Y, Huh I, Jang SY, Kim D, Lee S. Relation between Mother's Taekyo, Prenatal and Postpartum Depression, and Infant's Temperament and Colic: A Longitudinal Prospective Approach. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E7691. [PMID: 33096813 PMCID: PMC7589274 DOI: 10.3390/ijerph17207691] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/08/2020] [Revised: 10/09/2020] [Accepted: 10/20/2020] [Indexed: 12/04/2022]
Abstract
This longitudinal cohort correlational study aimed to confirm the relation among taekyo or traditional prenatal practice, prenatal depression, postpartum depression, maternal-fetal interaction, and infant temperament and colic using a prospective design. We recruited 212 women 16-20 weeks pregnant from July 2017 to September 2018; they were followed up until six months postpartum. Data from 97 participants were used in the final analysis. We used the Edinburgh Postnatal Depression Scale, Cranley's Maternal-Fetal Attachment Scale, and What My Baby Is Like as measurement tools. We observed a significant correlation between prenatal maternal depression in the first to third trimesters and 6-8 weeks and six months postpartum. In addition, infant temperament at six months old showed a significant negative correlation with prenatal and postpartum depression: the higher the prenatal and postpartum depression level, the more difficult the infant's temperament. Taekyo practice was significantly related to maternal-fetal attachment (r = 0.45-0.68, p < 0.001). Difficult infants showed more colic episodes than any other type of infant (χ2 = 18.18, p < 0.001). Prenatal and postnatal maternal depression affected infants' temperament and colic episodes. The management of mothers' mental health before and after pregnancy is important for infants' and mothers' health.
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Affiliation(s)
- Kyung-Sook Bang
- The Research Institute of Nursing Science, College of Nursing, Seoul National University, Seoul 03080, Korea; (K.-S.B.); (I.L.); (S.K.); (I.H.)
| | - Insook Lee
- The Research Institute of Nursing Science, College of Nursing, Seoul National University, Seoul 03080, Korea; (K.-S.B.); (I.L.); (S.K.); (I.H.)
| | - Sungjae Kim
- The Research Institute of Nursing Science, College of Nursing, Seoul National University, Seoul 03080, Korea; (K.-S.B.); (I.L.); (S.K.); (I.H.)
| | - Yunjeong Yi
- Department of Nursing, Kyung-In Women’s University, Incheon 21041, Korea;
| | - Iksoo Huh
- The Research Institute of Nursing Science, College of Nursing, Seoul National University, Seoul 03080, Korea; (K.-S.B.); (I.L.); (S.K.); (I.H.)
| | - Sang-Youn Jang
- College of Nursing, Seoul National University, Seoul 03080, Korea; (D.K.); (S.L.)
| | - Dasom Kim
- College of Nursing, Seoul National University, Seoul 03080, Korea; (D.K.); (S.L.)
| | - Sujin Lee
- College of Nursing, Seoul National University, Seoul 03080, Korea; (D.K.); (S.L.)
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28
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Chandra PS, Nanjundaswamy MH. Pregnancy specific anxiety: an under-recognized problem. World Psychiatry 2020; 19:336-337. [PMID: 32931120 PMCID: PMC7491640 DOI: 10.1002/wps.20781] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Affiliation(s)
- Prabha S Chandra
- Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bangalore, India
| | - Madhuri H Nanjundaswamy
- Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bangalore, India
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29
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Erickson NL, Neumann AA, Hancock GR, Gartstein MA. Baby preparation and worry scale (Baby-PAWS): Instrument development and psychometric evaluation. Early Hum Dev 2020; 147:105080. [PMID: 32485400 DOI: 10.1016/j.earlhumdev.2020.105080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2019] [Revised: 05/02/2020] [Accepted: 05/19/2020] [Indexed: 10/24/2022]
Abstract
BACKGROUND The Baby Preparation and Worry Scale (Baby-PAWS) addresses expectant mothers' anticipatory worries regarding the transition to parenthood, focusing on practical concerns (i.e., ability to care for the infant, securing childcare, personal wellbeing, and partner involvement). AIMS The present study describes measurement development, psychometric evaluation, and predictive and concurrent validity of Baby-PAWS, administered during pregnancy. STUDY DESIGN We used a repeated-measures design, with anonymous self-report obtained during the 3rd trimester of pregnancy and at 2 months postpartum. SUBJECTS Healthy pregnant women (N = 276) completed Baby-PAWS and measures of depression, general anxiety, and pregnancy-specific anxiety. Demographic, pregnancy, and birth-related information (e.g., complications, gestational age) was also obtained. At postpartum follow-up, the majority (n = 154) met inclusion criteria and provided data on themselves and their infants. OUTCOME MEASURES Prenatally, we examined correlations between Baby-PAWS and established measures of general anxiety, pregnancy-specific anxiety, and depression. Postnatally, Baby-PAWS scores were used to predict maternal depression, anxiety, and infant temperament. RESULTS AND CONCLUSIONS Two factor-analytic techniques indicated a three-factor structure, with internal consistency for all three components and the overall scale. We labeled the three factors: Self and Partner Worry, Non-parental Childcare Worry, and Baby Caregiving Worry, based on item content. Higher Baby-PAWS scores were associated with greater anxiety and depression in the third trimester. Predictive links with postpartum anxiety/depression symptoms and infant temperament were observed for the overall Baby-PAWS score and Self and Partner Worry factor. Although this instrument requires further evaluation, it offers promising utility in research and clinical settings.
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Affiliation(s)
- Nora L Erickson
- Hennepin Healthcare Research Institute, 701 Park Ave, Suite PP7.700, Minneapolis, MN 55415, United States of America.
| | - Alyssa A Neumann
- Washington State University, P.O. Box 644820, Pullman, WA 99164-4820, United States of America.
| | - Gregory R Hancock
- University of Maryland, 1230 Benjamin Building, 3942 Campus Drive, College Park, MD 20742-1115, United States of America.
| | - Maria A Gartstein
- Washington State University, P.O. Box 644820, Pullman, WA 99164-4820, United States of America.
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30
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Cena L, Palumbo G, Mirabella F, Gigantesco A, Stefana A, Trainini A, Tralli N, Imbasciati A. Perspectives on Early Screening and Prompt Intervention to Identify and Treat Maternal Perinatal Mental Health. Protocol for a Prospective Multicenter Study in Italy. Front Psychol 2020; 11:365. [PMID: 32218756 PMCID: PMC7079581 DOI: 10.3389/fpsyg.2020.00365] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2020] [Accepted: 02/17/2020] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND The most common mental disorders in women during the perinatal (antenatal and postnatal) period are depressive syndromes and anxiety syndromes. The global prevalence of maternal perinatal depression ranges from 10 to 20%, while the prevalence of perinatal anxiety ranges from 10 to 24%. The comorbidity of mood and anxiety disorders in perinatal women is common, reaching 40%. In Italy, a few studies have been undertaken to evaluate the prevalence of perinatal depression and anxiety, and there is still a scarcity of research and intervention programs regarding primary prevention. Three of the main aims of this study are: (1) to evaluate the prevalence of maternal perinatal depression and anxiety in a large sample of women attending healthcare centers in Italy; (2) to investigate the psychosocial risks and protective factors associated with maternal perinatal depression and anxiety; (3) to evaluate the effectiveness of a manualized psychological intervention (Milgrom et al., 1999) to treat perinatal depression; (4) to evaluate the psychometric properties of both the Edinburgh Postnatal Depression Scale and the Patient Health Questionnaire-9 in detecting perinatal depression; and (5) to evaluate the influence of maternal depression and anxiety on the development of infant temperament. METHODS This is a prospective cohort study, which merges an observational design and a pre-post intervention design. The study includes a 1-year recruitment period and a one-year follow-up period. The methodological strategy includes: (1) self-report questionnaires on maternal depression, anxiety, health status, quality of life and psychosocial risks; (2) a self-report questionnaire to measure the infant's temperament; (3) a clinical interview; (4) a structured diagnostic interview; and (5) a psychological intervention. DISCUSSION The results of this study may contribute to our knowledge about prevalence of antenatal and postnatal depression and anxiety (during both the trimesters of pregnancy and the first six trimesters after birth) and about the effectiveness of early psychological intervention in the perinatal health services.
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Affiliation(s)
- Loredana Cena
- Department of Clinical and Experimental Sciences, Section of Clinical Psychology, Observatory of Perinatal Clinical Psychology, University of Brescia, Brescia, Italy
| | - Gabriella Palumbo
- Center for Behavioural Sciences and Mental Health, National Institutes of Health, Rome, Italy
| | - Fiorino Mirabella
- Center for Behavioural Sciences and Mental Health, National Institutes of Health, Rome, Italy
| | - Antonella Gigantesco
- Center for Behavioural Sciences and Mental Health, National Institutes of Health, Rome, Italy
| | - Alberto Stefana
- Department of Clinical and Experimental Sciences, Section of Clinical Psychology, Observatory of Perinatal Clinical Psychology, University of Brescia, Brescia, Italy
| | - Alice Trainini
- Department of Clinical and Experimental Sciences, Section of Clinical Psychology, Observatory of Perinatal Clinical Psychology, University of Brescia, Brescia, Italy
| | - Nella Tralli
- Department of Clinical and Experimental Sciences, Section of Clinical Psychology, Observatory of Perinatal Clinical Psychology, University of Brescia, Brescia, Italy
| | - Antonio Imbasciati
- Department of Clinical and Experimental Sciences, Section of Clinical Psychology, Observatory of Perinatal Clinical Psychology, University of Brescia, Brescia, Italy
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31
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Kim Y, Bird A, Peterson E, Underwood L, Morton SMB, Grant CC. Maternal Antenatal Depression and Early Childhood Sleep: Potential Pathways Through Infant Temperament. J Pediatr Psychol 2020; 45:203-217. [DOI: 10.1093/jpepsy/jsaa001] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2019] [Revised: 12/10/2019] [Accepted: 01/10/2020] [Indexed: 11/13/2022] Open
Abstract
Abstract
Objective
Maternal depression is associated with infant and child sleep patterns, and with infant temperament. Here, we examine whether infant temperament mediated an association between maternal antenatal depression and toddler sleep.
Method
Within the prebirth longitudinal cohort Growing Up in New Zealand, symptoms of antenatal and postnatal depression were measured in 5,568 women using the Edinburgh Postnatal Depression Scale (EPDS). Infant temperament was measured at age 9 months using the Very Short Form of Infant Behavior Questionnaire-Revised (IBQ-R VSF). Sleep duration and nighttime awakenings were reported by parents when children were 2 years old.
Results
Independent associations of maternal depression with child sleep patterns at age 2 years, adjusted for maternal demographics, physical health, family relationships, and child health and feeding, were determined using multivariate logistic regression analysis. The odds of having ≥2 nighttime awakenings were increased for children whose mothers had antenatal (1.36, 1.07–1.73) but not postnatal (1.22, 0.88–1.68) or both antenatal and postnatal depression (0.89, 0.56–1.36). There was no association of maternal depression with shorter sleep duration. Two of five dimensions of infant temperament (fear and negative affect) were associated with both antenatal depression scores and increased nighttime awakenings. Mediation analyses controlling for postnatal depression and other predictors of child sleep supported an indirect pathway of antenatal depression to child sleep through infant temperamental negative affectivity.
Conclusion
Antenatal depression is independently associated with more frequent nighttime awakenings in early childhood. Findings support an indirect pathway through infant negative affect characteristics.
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Affiliation(s)
| | - Amy Bird
- University of Waikato
- University of Auckland
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Göbel A, Arck P, Hecher K, Schulte-Markwort M, Diemert A, Mudra S. Manifestation and Associated Factors of Pregnancy-Related Worries in Expectant Fathers. Front Psychiatry 2020; 11:575845. [PMID: 33362598 PMCID: PMC7759496 DOI: 10.3389/fpsyt.2020.575845] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/24/2020] [Accepted: 11/09/2020] [Indexed: 12/15/2022] Open
Abstract
Background: During the last decades, fathers have increasingly participated in prenatal care, birth preparation classes, and childbirth. However, comparably little is known about the prenatal emotional well-being of fathers, particularly content and extent of broader paternal concerns that may arise during pregnancy beyond those focusing on childbirth. Thus, the aims of this study were to investigate the manifestation of paternal pregnancy-related worries in a population-based sample and to identify relevant associated factors. Materials and Methods: As part of a longitudinal pregnancy cohort at the University Medical Center Hamburg-Eppendorf, Germany, N = 129 expectant fathers were assessed once during pregnancy. Pregnancy-related worries centering around medical procedures, childbirth, health of the baby, as well as socioeconomic aspects were assessed with the Cambridge Worry Scale (CWS). Additionally, paternal socioeconomic background and maternal obstetrical history, symptoms of generalized anxiety and depression, and level of hostility were investigated, as well as perceived social support. The cross-sectional data were analyzed based on multiple regression analyses. Results: The level of reported worries was overall low. Some fathers reported major worries for individual aspects like the health of a significant other (10.9%) and the baby (10.1%), as well as the current financial (6.2%) and employment situation (8.5%). Pregnancy-related worries were negatively associated with household income and positively associated with anxious and depressive symptoms and low perceived social support. Associations varied for specific pregnancy-related worries. Limitations: Due to the cross-sectional data examined in this study, a causal interpretation of the results is not possible. The sample was rather homogeneous regarding its socioeconomic background. More research needs to be done in larger, more heterogeneous samples. Conclusion: Though overall worries were rather low in this sample, specific major worries could be identified. Hence, addressing those fathers reporting major worries regarding specific aspects already in prenatal care might support their psychosocial adjustment. Fathers with little income, those with elevated levels of general anxious and depressive symptoms, and those with less social support reported higher pregnancy-related worries. Our results indicate the relevance of concerns beyond health- and birth-related aspects that could be relevant for fathers. Measurements developed specifically for expectant fathers are needed to properly capture their perspective already during pregnancy.
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Affiliation(s)
- Ariane Göbel
- Department of Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Petra Arck
- Department of Obstetrics and Fetal Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Kurt Hecher
- Department of Obstetrics and Fetal Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Michael Schulte-Markwort
- Department of Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Anke Diemert
- Department of Obstetrics and Fetal Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Susanne Mudra
- Department of Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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Erickson NL, Hancock GR, Oberlander TF, Brain U, Grunau RE, Gartstein MA. Prenatal SSRI antidepressant use and maternal internalizing symptoms during pregnancy and postpartum: Exploring effects on infant temperament trajectories for boys and girls. J Affect Disord 2019; 258:179-194. [PMID: 31437600 DOI: 10.1016/j.jad.2019.08.003] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2019] [Revised: 07/30/2019] [Accepted: 08/02/2019] [Indexed: 01/03/2023]
Abstract
BACKGROUND The severity and treatment of depression/anxiety during pregnancy and postpartum has important implications for maternal and child well-being. Yet, little is known about prenatal SSRI use and early child socioemotional development. This study explores effects of prenatal SSRI exposure, and pre- and postnatal internalizing symptoms on trajectories of infant temperament, identifying potential differences for boys and girls. METHODS Using latent growth models, sex differences in infant temperament trajectories from 3- to 10-months were examined in relation to prenatal and postpartum internalizing symptoms and prenatal SSRI exposure among 185 mother-infant dyads. RESULTS For girls, prenatal internalizing symptoms were associated with greater initial distress to limitations, and lower duration of orienting, smiling/laughter, and soothability. Postnatal symptoms predicted slower decreases in girls' duration of orienting. SSRI exposure predicted decreases in distress to limitations and slower increases in smiling and laughter. For boys, maternal internalizing symptoms did not generally affect temperament profiles. SSRI exposure was associated with higher initial activity level and slower declines in distress to limitations. LIMITATIONS Only parent-report indicators of infant temperament across 10 months of infancy were provided. Maternal internalizing symptoms were measured at discrete times during pregnancy and postpartum, with no analysis of changes in symptoms across time. CONCLUSIONS Prenatal SSRI treatment, and both prenatal and postpartum internalizing symptoms, exert unique effects on infant temperament. Overall, the present study suggests sex-dependent fetal programming effects that should be further evaluated in future research. Results have implications for perinatal mental health treatment and perceived impacts on child socioemotional development.
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Affiliation(s)
- Nora L Erickson
- Department of Psychiatry, University of Michigan, 4250 Plymouth Road, Ann Arbor, MI 48109, United States.
| | - Gregory R Hancock
- Department of Measurement, Statistics & Evaluation, University of Maryland, College Park, MD, United States
| | - Tim F Oberlander
- Department of Pediatrics, University of British Columbia, Child and Family Research Institute, Vancouver, British Columbia, Canada
| | - Ursula Brain
- Department of Pediatrics, University of British Columbia, Child and Family Research Institute, Vancouver, British Columbia, Canada
| | - Ruth E Grunau
- Department of Pediatrics, University of British Columbia, Child and Family Research Institute, Vancouver, British Columbia, Canada
| | - Maria A Gartstein
- Department of Psychology, Washington State University, Pullman, WA, United States
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Nieto L, Lara MA, Navarrete L, Manzo G. Infant temperament and perinatal depressive and anxiety symptoms in Mexican women. SEXUAL & REPRODUCTIVE HEALTHCARE 2019; 21:39-45. [PMID: 31395232 DOI: 10.1016/j.srhc.2019.05.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2018] [Revised: 05/14/2019] [Accepted: 05/28/2019] [Indexed: 01/29/2023]
Abstract
AIM This study explores the association between infant temperament at six months postpartum and pre- and postpartum depressive and anxiety symptoms. The association between infant temperament and stressful life events is also evaluated. METHOD A total of 210 Mexican women were assessed during pregnancy (gestational age 32.39 ± 4.01) and at six months postpartum. The instruments used were: Patient Health Questionnaire (PHQ-9), the Anxiety Subscale of the Hopkins Symptoms Checklist (SCL-90R), a short form of Stressful Life Events and The Infant Characteristics Questionnaire, when infants were six months old. RESULTS Although a mother's emotional state during pregnancy (depressive and anxiety symptoms and stressful life events) was not associated with difficult infant temperament, it was associated with depressive and anxious symptomatology during the postpartum period. Mothers with prenatal depressive symptoms who remained depressed and mothers who only had depression symptoms during the postpartum period reported having more difficult infants. Likewise, mothers with prenatal anxiety symptoms who maintained anxiety symptoms postpartum and mothers with anxiety symptoms during the postpartum period alone reported having more difficult infants. Comorbidity was found between depressive and anxious postnatal symptomatology in its association with difficult infant temperament. CONCLUSION In this study, postpartum depressive and anxiety symptoms played an important role in shaping difficult infant temperament. Comorbidity between the two conditions warrants clinical attention and additional research, since it is related to maternal perception of difficult infant temperament. Psychological interventions are required, since these women may require assistance with emotional adaptation in the transition to motherhood.
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Affiliation(s)
- Lourdes Nieto
- Ramón de la Fuente Muñiz National Institute of Psychiatry, Calzada México-Xochimilco 101, San Lorenzo Huipulco, Tlalpan, México, D.F. 14370, Mexico
| | - Ma Asunción Lara
- Ramón de la Fuente Muñiz National Institute of Psychiatry, Calzada México-Xochimilco 101, San Lorenzo Huipulco, Tlalpan, México, D.F. 14370, Mexico.
| | - Laura Navarrete
- Ramón de la Fuente Muñiz National Institute of Psychiatry, Calzada México-Xochimilco 101, San Lorenzo Huipulco, Tlalpan, México, D.F. 14370, Mexico
| | - Gabriela Manzo
- University of California, Irvine, Irvine, CA 92697, United States
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Takács L, Smolík F, Putnam S. Assessing longitudinal pathways between maternal depressive symptoms, parenting self-esteem and infant temperament. PLoS One 2019; 14:e0220633. [PMID: 31381596 PMCID: PMC6681961 DOI: 10.1371/journal.pone.0220633] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2019] [Accepted: 07/19/2019] [Indexed: 01/17/2023] Open
Abstract
BACKGROUND Previous studies of relations between parenting self-concepts, parental adjustment and child temperament have been ambiguous regarding the direction of influence; and have rarely followed families from pregnancy through the first year of life. The current study examines change and stability in maternal depressive symptoms, parenting competences and child temperament through the perinatal period until nine months postpartum. METHODS Czech mothers (N = 282) participated at three time points: the third trimester of pregnancy (Time 1), six weeks (Time 2) and nine months postpartum (Time 3). Questionnaire data concerned depressive symptoms (T1, T2, T3), maternal parenting self-esteem (T1, T2) and sense of competence (T3), and child temperament (T2, T3). A path model was used to examine concurrent and longitudinal relations between these variables. RESULTS The analyses indicated longitudinal stability of all constructs, as well as concurrent relations between them. Longitudinal relations supported child-to-parent, rather than parent-to-child, effects: child difficult temperament predicted decreases in perceived maternal parenting competences, but maternal variables did not predict change in infant temperament. In addition, we observed weak mutual relations between maternal depression levels and parenting competences, such that maternal depression diminished perceived parenting competences that in turn contributed to higher levels of depression. CONCLUSION Mothers' confidence in their ability to parent is influenced by their experience with a difficult infant and by their depressive symptoms during the child's first year of life. Depressive symptoms are, in turn, aggravated by mothers' low perceived competences in the parenting role.
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Affiliation(s)
- Lea Takács
- Department of Psychology, Faculty of Arts, Charles University, Prague, Czech Republic
- * E-mail:
| | - Filip Smolík
- Institute of Psychology, Czech Academy of Sciences, Prague, Czech Republic
| | - Samuel Putnam
- Department of Psychology, Bowdoin College, Brunswick, Maine, United States of America
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Ornoy A, Koren G. Selective serotonin reuptake inhibitor use in pregnant women; pharmacogenetics, drug-drug interactions and adverse effects. Expert Opin Drug Metab Toxicol 2018; 14:247-259. [PMID: 29345153 DOI: 10.1080/17425255.2018.1430139] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
INTRODUCTION Possible negative effects of selective serotonin reuptake inhibitors (SSRIs) in pregnancy relate to congenital anomalies, negative perinatal events and neurodevelopmental outcome. Many studies are confounded by the underlying maternal disease and by pharmacogenetic and pharmacokinetic differences of these drugs. Areas covered: The possible interactions of SSRIs and serotonin and norepinephrine reuptake inhibitors with other drugs and the known effects of SSRIs on congenital anomalies, perinatal and neurodevelopmental outcome. Expert opinion: SSRIs should be given with caution when combined with other drugs that are metabolized by cytochrome P450 enzymes. SSRIs apparently increase the rate of severe cardiac malformations, induce neonatal adaptation problems in up to 30% of the offspring, increase the rate of persistent pulmonary hypertension of the newborn and possibly slightly increase the rate of prematurity and low birth weight. Most neurodevelopmental follow up studies did not find significant cognitive impairments except some transient gross motor delay, slight impairment of language abilities and possibly behavioral changes. The literature on the possible association of SSRIs with autism spectrum disorder is inconsistent; if an association exists, it is apparently throughout pregnancy. The risk associated with treatment discontinuation seems to outweigh the risk of treatment, as severe maternal depression may negatively affect the child's development. If needed, treatment should continue in pregnancy with the minimal effective dose.
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Affiliation(s)
- Asher Ornoy
- a Laboratory of Teratology, Department of Medical Neurobiology , Hebrew University Hadassah Medical School , Jerusalem , Israel
| | - Gideon Koren
- b Morris Kahn- Maccabi Institute of Research and Innovation, and Tel Aviv University , TEl - AVIV , Israel
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