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Hernández-Santillán G, Gurpegui M, Alcamí-Pertejo M, Lahera G, Bravo-Ortiz MF. Factors associated with depressive symptoms among 1,502 couples in the immediate puerperium. Int J Soc Psychiatry 2025; 71:509-519. [PMID: 39540405 DOI: 10.1177/00207640241296047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2024]
Abstract
BACKGROUND Historically, perinatal depression has predominantly focussed on the mother-baby dyad, often neglecting the crucial role of fathers. AIM To determine the prevalence and associated factors of depressive symptoms in the immediate puerperium (PDS) in both mothers and fathers, individually and concurrently. METHOD This study employed a cross-sectional design. The presence of PDS was assessed using the Edinburgh Postnatal Depression Scale (EPDS), with a cut-off score of ⩾11 for mothers and ⩾9 for fathers. Logistic regression analyses were conducted to identify factors independently associated with PDS. Robustness of findings was verified through sensitivity analyses among participants without prior psychiatric conditions. RESULTS Among 1,502 partnered mothers and fathers aged ⩾18 years who met the inclusion criteria, PDS were present in 13.0% of mothers, 10.5% of fathers and 3.5% of both parents. Mother-baby skin-to-skin contact and the father's pregnancy planning were associated with a lower likelihood of PDS in mothers. For fathers, financial difficulties increased the likelihood of experiencing PDS threefold. The presence of PDS in mothers quadrupled the likelihood of PDS in fathers, and vice versa; their EPDS scores demonstrated a moderate correlation (rs = .38). Among participants without prior psychiatric conditions, the odds of co-occurring PDS nearly tripled if the mother had a history of abortion or miscarriage. Fathers who had increased potentially addictive behaviours showed a six-fold increase in the likelihood of experiencing PDS. CONCLUSIONS Identifying depressive symptoms in both parents and incorporating fathers into clinical practice, research and health policy could enhance mental health outcomes in vulnerable populations.
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Affiliation(s)
- Gina Hernández-Santillán
- PhD Program in Medicine and Surgery, Universidad Autónoma de Madrid (UAM), Madrid, Spain
- Psychiatry Service, La Paz University Hospital, Madrid, Spain
| | - Manuel Gurpegui
- Granada Centre for Psychiatric Studies, Av. Andaluces 2, Granada, Spain
- Multicentre CTS-549 Research Group (Psychiatry and Neurosciences), Junta de Andalucía, Granada, Spain
| | - Margarita Alcamí-Pertejo
- Psychiatry Service, La Paz University Hospital, Madrid, Spain
- Hospital La Paz Institute for Health Research (IdiPAZ), Madrid, Spain
| | - Guillermo Lahera
- Psychiatry Service, Príncipe de Asturias University Hospital, Alcalá de Henares, Madrid, Spain
- Faculty of Medicine and Health Sciences, University of Alcalá, Madrid, Spain
- CIBERSAM, Ramón y Cajal Institute of Sanitary Research (IRYCIS), Madrid, Spain
| | - María Fe Bravo-Ortiz
- Psychiatry Service, La Paz University Hospital, Madrid, Spain
- Hospital La Paz Institute for Health Research (IdiPAZ), Madrid, Spain
- Department of Psychiatry, Universidad Autónoma de Madrid (UAM), Madrid, Spain
- Centro de Investigación Biomédica en Red en Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain
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Xu J, Xiao Y, Li F, Cui Y, Shi C, Shi J, Yu C, Qi S, Lu C, Li G, Jiang F. Prevalence and impact of parental co-morbid anxiety and depression during the first 2 years postpartum in China. J Affect Disord 2025; 374:63-71. [PMID: 39800070 DOI: 10.1016/j.jad.2025.01.041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2024] [Revised: 11/28/2024] [Accepted: 01/09/2025] [Indexed: 01/15/2025]
Abstract
BACKGROUND Parental postpartum co-morbid anxiety and depression negatively impact personal well-being, family dynamics, and child developmental outcomes. This study investigates the prevalence of co-morbid anxiety and depression in both mothers and fathers during the first 2 years postpartum in China, and to explore its associations with parental family support, maternal health-related quality of life (HRQoL), and child development. METHODS This cross-sectional study was conducted in China, involving families with children aged 0-2 years who participated in community child health care. Data were collected via questionnaires administered to parents by pediatricians and nurses at community health service (CHS) centers. Path analysis was utilized to test the hypothesized model, which links parental co-morbid anxiety and depression to parental family support, maternal HRQoL, and child development. RESULTS A total of 2073 pairs of both parents who completed the survey were included in the final analyses. The prevalence of maternal and paternal co-morbid anxiety and depression, was 5.7 % and 4.4 %, respectively. Among mothers, the prevalence ranged from 4.3 % to 6.5 % within the first 6 months, and 7.9 % in the second year. After adjusting for covariates, severe family dysfunction was significantly associated with maternal and paternal co-morbid anxiety and depression. The path analysis showed that maternal co-morbid anxiety and depression were directly associated with child development and maternal HRQoL. CONCLUSIONS These findings highlight the importance of prioritizing family support, addressing both depression and anxiety, involving both parents and extending support beyond the first year postpartum.
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Affiliation(s)
- Jianing Xu
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China; China Hospital Development Institute, Shanghai Jiao Tong University, Shanghai, China
| | - Yuyin Xiao
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China; Freeman Spogli Institute for International Studies, Stanford University, Stanford, CA, USA
| | - Feifei Li
- China Hospital Development Institute, Shanghai Jiao Tong University, Shanghai, China
| | - Yujie Cui
- China Hospital Development Institute, Shanghai Jiao Tong University, Shanghai, China
| | - Chenshu Shi
- Institute of Healthy Yangtze River Delta, Shanghai Jiao Tong University, Shanghai, China
| | - Jiaqi Shi
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China; China Hospital Development Institute, Shanghai Jiao Tong University, Shanghai, China
| | - Chenhao Yu
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China; China Hospital Development Institute, Shanghai Jiao Tong University, Shanghai, China
| | - Shaofang Qi
- China Hospital Development Institute, Shanghai Jiao Tong University, Shanghai, China
| | - Chunling Lu
- Division of Global Health Equity, Brigham and Women's Hospital, Boston, MA, USA; Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA, USA
| | - Guohong Li
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China; China Hospital Development Institute, Shanghai Jiao Tong University, Shanghai, China; Institute of Healthy Yangtze River Delta, Shanghai Jiao Tong University, Shanghai, China; Department of Developmental and Behavioral Pediatrics and Pediatric Translational Medicine Institute and Shanghai Key Laboratory of Child Brain and Development, National Children's Medical Center, Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
| | - Fan Jiang
- Department of Developmental and Behavioral Pediatrics and Pediatric Translational Medicine Institute and Shanghai Key Laboratory of Child Brain and Development, National Children's Medical Center, Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China; MOE-Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China; Shanghai Center for Brain Science and Brain-Inspired Technology, Shanghai, China.
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Zindani S, Chartrand J, Hannan J, Phillips JC. First-Time Father's Risk Factors of Paternal Perinatal Psychological Distress: A Scoping Review. Am J Mens Health 2025; 19:15579883251320035. [PMID: 40077892 PMCID: PMC11905032 DOI: 10.1177/15579883251320035] [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: 03/14/2025] Open
Abstract
Fathers can experience psychological distress during the paternal perinatal period. The effects of paternal perinatal psychological distress (PPPD) are multileveled. Little research is available about PPPD in first-time fathers. The purpose of this review is to explore the literature on risk factors contributing to PPPD in first-time fathers. The Arksey & O'Malley framework was used to guide this scoping review. The Population, Concept, and Context (PCC) framework was used for answering the review question "What evidence is available about factors contributing to PPPD in first-time fathers?" Five databases (CINAHL, EMBASE, MEDLINE, PsycINFO, and PubMed) were used to retrieve relevant, full-text, English references from January 01, 2020, to January 04, 2023. A data extraction tool was developed to identify risk factors assessed in the included studies. The Socio-Ecological Model (SEM) was used for analyzing the extracted data according to the four socio-ecological levels, i.e., individual, relationship, community, and societal. A total of 18 references reporting on 16 studies were included in the review. Fifty-six tools were used for assessing the risk factors contributing to PPPD in first-time fathers. Limited understanding was established about risk factors because tools lacked gender sensitivity. Risk factors aligned with 12 domains (e.g., psychological, relationship, social, and physical). Most domains corresponded with the individual level of SEM. Only two domains corresponded with the societal level of SEM. The literature indicates there are few studies about PPPD experienced by first-time fathers. This scoping review adds to the literature on the mental health care gaps for this population. Further research on measuring PPPD may improve individual and family functioning during the perinatal period.
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Affiliation(s)
- Sadaf Zindani
- School of Nursing, University of Ottawa, Ottawa, Ontario, Canada
| | - Julie Chartrand
- School of Nursing, University of Ottawa, Ottawa, Ontario, Canada
| | - Jean Hannan
- Nicole Wertheim College of Nursing & Health Sciences, Florida International University, Miami, FL, USA
| | - J Craig Phillips
- School of Nursing, University of Ottawa, Ottawa, Ontario, Canada
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Clément M, Ahun MN, Orri M, Montreuil TC, St‐André M, Herba CM, Moullec G, Côté SM. The interplay of maternal and paternal postpartum depressive symptoms with children's internalizing and externalizing symptoms from childhood to adolescence: does socioeconomic status matter? A longitudinal cohort study. J Child Psychol Psychiatry 2025; 66:225-240. [PMID: 39255831 PMCID: PMC11754721 DOI: 10.1111/jcpp.14051] [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] [Accepted: 07/01/2024] [Indexed: 09/12/2024]
Abstract
BACKGROUND Maternal postpartum depression is an important risk factor for internalizing and externalizing problems in children. The role of concurrent paternal depression remains unclear, especially by socioeconomic status. This study examined independent and interactive associations of postpartum maternal and paternal depression with children's internalizing/externalizing symptoms throughout childhood and adolescence (ages 3.5-17 years). METHODS We used data from the Québec Longitudinal Study of Child Development, a representative birth cohort (1997-1998) in Canada. Data included self-reported maternal and paternal depressive symptoms at 5 months' postpartum using the Center for Epidemiologic Studies Depression Scale. Internalizing and externalizing symptoms in children were reported by parents, teachers and children/adolescents using the Social Behaviour Questionnaire (ages 3.5-13 years) and the Mental Health and Social Inadaptation Assessment for Adolescents (ages 15-17 years). We used three-level mixed effects modelling to test associations after adjusting for confounding factors. RESULTS With 168 single-parent families excluded, our sample consisted of 1,700 families with useable data. Of these, 275 (16.2%) families reported maternal depression (clinically elevated symptoms), 135 (7.9%) paternal depression and 39 (2.3%) both. In families with high socioeconomic status, maternal depression was associated with greater child internalizing (β = .34; p < .001) and externalizing symptoms (β = .22; p = .002), regardless of the presence/absence of paternal depression. In families with low socioeconomic status, associations with symptoms were stronger with concurrent paternal depression (internalizing, β = .84, p < .001; externalizing, β = .71, p = .003) than without (internalizing, β = .30, p < .001; externalizing, β = .24, p = .002). CONCLUSIONS Maternal depression increases the risk for children's internalizing/externalizing problems in all socioeconomic contexts. In families with low socioeconomic status, risks were exacerbated by concurrent paternal depression. Postpartum depression, especially in low socioeconomic environments, should be a primary focus to optimize mental health across generations.
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Affiliation(s)
- Myriam Clément
- Department of Social and Preventive Medicine, School of Public HealthUniversity of MontréalMontréalQCCanada
- Department of NursingUniversity of Québec in OutaouaisSaint‐JérômeQCCanada
- Research Unit on Children's Psychosocial MaladjustmentMontréalQCCanada
| | - Marilyn N. Ahun
- Research Unit on Children's Psychosocial MaladjustmentMontréalQCCanada
- Department of Medicine, Faculty of Medicine and Health SciencesMcGill UniversityMontréalQCCanada
- Department of Global Health and PopulationHarvard T.H. Chan School of Public HealthBostonMAUSA
| | - Massimiliano Orri
- Research Unit on Children's Psychosocial MaladjustmentMontréalQCCanada
- McGill Group for Suicide Studies, Douglas Mental Health University Institute, Department of PsychiatryMcGill UniversityMontréalQCCanada
- Department of Epidemiology, Biostatistics, and Occupational Health, School of Population and Global HealthMcGill UniversityMontréalQCCanada
| | - Tina C. Montreuil
- Research Unit on Children's Psychosocial MaladjustmentMontréalQCCanada
- Department of Educational and Counselling PsychologyMcGill UniversityMontréalQCCanada
| | - Martin St‐André
- Research Unit on Children's Psychosocial MaladjustmentMontréalQCCanada
- Perinatal and Early Childhood Psychiatry ClinicSainte‐Justine University Hospital CenterMontréalQCCanada
| | - Catherine M. Herba
- Research Unit on Children's Psychosocial MaladjustmentMontréalQCCanada
- Department of PsychologyUniversity of Québec at MontréalMontréalQCCanada
| | - Gregory Moullec
- Department of Social and Preventive Medicine, School of Public HealthUniversity of MontréalMontréalQCCanada
- Public Health Research CenterUniversity of MontréalMontréalQCCanada
- Integrated University Health and Social Services Centre of the Centre‐Sud‐de‐l'Île‐de‐MontréalMontréalQCCanada
| | - Sylvana M Côté
- Department of Social and Preventive Medicine, School of Public HealthUniversity of MontréalMontréalQCCanada
- Research Unit on Children's Psychosocial MaladjustmentMontréalQCCanada
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Iwasa H, Yoshida Y, Ishii K. Association of Spousal Social Support in Child-Rearing and Marital Satisfaction with Subjective Well-Being among Fathers and Mothers. Behav Sci (Basel) 2024; 14:106. [PMID: 38392459 PMCID: PMC10885880 DOI: 10.3390/bs14020106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2023] [Revised: 01/25/2024] [Accepted: 01/28/2024] [Indexed: 02/24/2024] Open
Abstract
This study explored the association of spousal support and marital satisfaction with the subjective well-being of fathers and mothers using a mediation analysis. Data were gathered from 360 fathers and 338 mothers (aged 25-50 years). Subjective well-being was measured as an outcome using the Japanese version of the World Health Organization-Five Well-Being Index. Marital satisfaction was measured as a mediating variable using the Japanese version of the Marital Relationship Satisfaction Scale. Spousal social support (including instrumental, emotional, and appraisal support) was measured as an independent variable using four-point scales. Control variables were the father's and mother's ages, number of children, age of the youngest child, children going to nursery school or kindergarten, use of childcare services, self-evaluated low economic status, and weekday working hours. Among fathers, instrumental and emotional support had significant direct and indirect effects, with the latter mediated by the impact of marital satisfaction on subjective well-being; appraisal support had only significant indirect effects. Among mothers, instrumental support had significant direct and indirect effects; emotional and appraisal support had only significant indirect effects. Our findings indicate that social support from spouses has protective direct and indirect effects on subjective well-being among parents and suggest the need for mutual support between spouses to facilitate effective co-parenting.
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Affiliation(s)
- Hajime Iwasa
- Department of Public Health, School of Medicine, Fukushima Medical University, Fukushima 960-1295, Japan
- Tokyo Metropolitan Institute for Geriatrics and Gerontology, Tokyo 173-0015, Japan
| | - Yuko Yoshida
- Tokyo Metropolitan Institute for Geriatrics and Gerontology, Tokyo 173-0015, Japan
| | - Kayoko Ishii
- Department of Midwifery and Maternal Nursing, School of Nursing, Fukushima Medical University, Fukushima 960-1295, Japan
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Kasamatsu H, Tsuchida A, Matsumura K, Hamazaki K, Inoue M, Inadera H. Impact of longer working hours on fathers' parenting behavior when their infants are 6 months old: The Japan Environment and Children's Study. Front Public Health 2023; 11:1100923. [PMID: 37441647 PMCID: PMC10334997 DOI: 10.3389/fpubh.2023.1100923] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Accepted: 05/30/2023] [Indexed: 07/15/2023] Open
Abstract
Objective Long working hours have been suggested to affect fathers' parenting behavior, but previously reported findings have been inconsistent. This study examined the association between the working hours and parenting behavior of fathers while accounting for other factors related to their parenting behavior, using data from the Japan Environment and Children Study (JECS), a large cohort study in Japan. Methods Data from 43,159 father-mother pairs were analyzed. The mother assessed the father's frequency of seven parenting behaviors at 6 months after delivery. Then, each behavior was classified into a high-engagement group (always and sometimes) or a low-engagement group (rarely and never). The father's weekly working hours was obtained from his responses and was classified into six levels. Results Logistic regression analysis showed that after adjustment for covariates, fathers' weekly working hours was inversely associated with the frequency of all parenting behaviors examined in this study (p for trend <0.0001). Compared with fathers working ≥0 to ≤40 h per week, those working >65 h per week showed the following adjusted odds ratios (95% confidence intervals) for low engagement in parenting behaviors: playing at home, 2.38 (2.08-2.72); changing diapers, 2.04 (1.89-2.20); and bathing the child, 2.01 (1.84-2.18). Conclusion This study suggests that the greater time constraints imposed by longer working hours constitute a major factor that discourages fathers from engaging in childrearing behavior. Intervention targeting long working hours could contribute to measures aimed at promoting high-engagement parenting behaviors among fathers.
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Affiliation(s)
- Haruka Kasamatsu
- Toyama Regional Center for JECS, University of Toyama, Toyama, Japan
| | - Akiko Tsuchida
- Toyama Regional Center for JECS, University of Toyama, Toyama, Japan
- Department of Public Health, Faculty of Medicine, University of Toyama, Toyama, Japan
| | - Kenta Matsumura
- Toyama Regional Center for JECS, University of Toyama, Toyama, Japan
- Department of Public Health, Faculty of Medicine, University of Toyama, Toyama, Japan
| | - Kei Hamazaki
- Toyama Regional Center for JECS, University of Toyama, Toyama, Japan
- Department of Public Health, Faculty of Medicine, University of Toyama, Toyama, Japan
- Department of Public Health, Gunma University Graduate School of Medicine, Maebashi, Japan
| | - Mariko Inoue
- Department of Public Health, Faculty of Medicine, University of Toyama, Toyama, Japan
| | - Hidekuni Inadera
- Toyama Regional Center for JECS, University of Toyama, Toyama, Japan
- Department of Public Health, Faculty of Medicine, University of Toyama, Toyama, Japan
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Kawamura E, Asano M. Changes, differences, and factors of parenthood in high-risk pregnant women and their partners in Japan. BMC Pregnancy Childbirth 2023; 23:205. [PMID: 36964602 PMCID: PMC10037369 DOI: 10.1186/s12884-023-05519-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Accepted: 03/14/2023] [Indexed: 03/26/2023] Open
Abstract
BACKGROUND Various stressors exists for pregnant women worldwide, especially negative social and environmental influences that can increase the number of high-risk pregnant women. These may cause a difficult transition to parenthood for women and their partners. However, limited studies have focused on and examined parenthood. Therefore, this study aimed to identify the changes in parenthood from pregnancy to post-discharge after childbirth among high-risk pregnant women and their partners, as well as the presence or absence of gender differences and the factors associated with parenthood. METHODS This longitudinal quantitative study used a self-administered anonymous questionnaire distributed among 127 pregnant women and their partners who visited a high-risk pregnant outpatient clinic. The Scale of Early Childrearing Parenthood (SECP; three subareas, 33 items) was administered thrice: during pregnancy (T1), after childbirth (T2), and after discharge (T3). RESULTS The analysis included 85 T1 (37 fathers and 48 mothers), 36 T2 (13 fathers and 23 mothers), and 31 T3 (11 fathers and 20 mothers) responses. There was a significant increase in the SECP scores for both parents from T1 to T3. Mothers had a greater increase in the SECP scores from T1 to T2 than fathers. In addition, fathers' mean SECP scores at T1 and T2 were higher compared with those of the mothers. Mothers' and fathers' SECP scores at each time point showed no significant differences. At all time points, the SECP scores were commonly and significantly associated with infertility treatment, physical and mental condition, postpartum depression at T2, and parenting stress at T3. CONCLUSIONS Because parenthood in the infertility treatment group was significantly higher throughout the series, we need to support such couples so that childbirth does not become their main goal. We suggest interventions for factors that impede parenthood development, understand the various backgrounds of the parents, and support the couple individually while also considering them as a unit.
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Affiliation(s)
- Eriko Kawamura
- Nagoya University Graduate School of Medicine, 1-1-20 Daiko Minami, Higashi-Ku, Nagoya, Aichi, 461-8673, Japan.
| | - Midori Asano
- Nagoya University Graduate School of Medicine, 1-1-20 Daiko Minami, Higashi-Ku, Nagoya, Aichi, 461-8673, Japan
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Kestler-Peleg M, Stenger V, Lavenda O, Bendett H, Alhalel-Lederman S, Maayan-Metzger A, Strauss T. "I'll Be There": Informal and Formal Support Systems and Mothers' Psychological Distress during NICU Hospitalization. CHILDREN (BASEL, SWITZERLAND) 2022; 9:children9121958. [PMID: 36553401 PMCID: PMC9777094 DOI: 10.3390/children9121958] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Revised: 12/05/2022] [Accepted: 12/11/2022] [Indexed: 12/15/2022]
Abstract
Mothers of infants hospitalized in the Neonatal Intensive Care Unit (NICU) are at a high risk for psychological distress, which is of concern to health and social professionals due to the negative implications for mothers and infants. A model for explaining maternal psychological distress, consisting of intolerance to uncertainty and support from informal (spouse, family, and friends) and formal (medical staff) systems was examined. Data was collected from one of the largest NICUs in Israel; 129 mothers of 215 preterm infants completed self-report questionnaires regarding their background variables, intolerance to uncertainty, perceived informal support and perceived medical staff support. The NICU's medical staff provided indicators for the infants of participating mothers. A hierarchical multiple regression analysis was conducted. The examined model explained 29.2% of the variance in maternal psychological distress. Intolerance of uncertainty positively predicted psychological distress. Informal support, and in particular, spousal support negatively predicted psychological distress above and beyond intolerance of uncertainty. Medical staff support negatively predicted psychological distress above and beyond intolerance to uncertainty and informal support. Our findings suggest that maternal psychological distress is reduced through a family-centered care approach in NICUs. Medical professionals and social services should develop further solutions for addressing preterm mothers' need for certainty and support.
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Affiliation(s)
- Miri Kestler-Peleg
- School of Social Work, Ariel University, Ariel 40700, Israel
- Correspondence:
| | - Varda Stenger
- Department of Neonatology, Safra Children’s Hospital, Sheba Medical Center, Ramat Gan 52621, Israel
| | - Osnat Lavenda
- School of Social Work, Ariel University, Ariel 40700, Israel
| | - Haya Bendett
- Department of Neonatology, Safra Children’s Hospital, Sheba Medical Center, Ramat Gan 52621, Israel
| | - Shanee Alhalel-Lederman
- Department of Neonatology, Safra Children’s Hospital, Sheba Medical Center, Ramat Gan 52621, Israel
| | - Ayala Maayan-Metzger
- Department of Neonatology, Safra Children’s Hospital, Sheba Medical Center, Ramat Gan 52621, Israel
| | - Tzipora Strauss
- Department of Neonatology, Safra Children’s Hospital, Sheba Medical Center, Ramat Gan 52621, Israel
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Wendelboe KI, Nielsen JS, Stuart AC, Væver MS. The parental reflective functioning questionnaire: Infant version in fathers of infants and association with paternal postpartum mental health. Infant Ment Health J 2022; 43:921-937. [PMID: 36228620 PMCID: PMC9828265 DOI: 10.1002/imhj.22023] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Accepted: 06/27/2022] [Indexed: 01/12/2023]
Abstract
The parents' capacity to reflect upon the psychological processes in their child, termed parental reflective functioning (PRF) can be impaired by parental mental health problems. The present study aimed to investigate the factor structure of an infant version of the Parental Reflective Functioning Questionnaire (PRFQ-I) in a low-risk sample of 259 Danish fathers of 1-11-month-old infants to investigate measurement invariance of the PRFQ-I between fathers and mothers; and to examine the association between PRF and paternal depressive symptoms, psychological distress, and parenting stress. Confirmatory factor analysis supported a three-factor model of the PRFQ-I. Multi-group factor analysis indicated partial measurement invariance. Multiple linear regressions showed that paternal depressive symptoms were not associated with PRF. There was an interaction effect of paternal depressive symptoms and general psychological distress on paternal interest and curiosity in their infant's mental state and certainty of infant mental state. Increased parenting stress was associated with impaired PRF on all three subscales of the PRFQ-I. These results provide further evidence for a multidimensional, brief assessment of paternal reflective skills and insight into how variability in paternal psychological functioning relates to impaired PRF in the postpartum period.
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Affiliation(s)
- Katrine Isabella Wendelboe
- Center for Early Intervention and Family Studies, Department of PsychologyUniversity of CopenhagenCopenhagenDenmark
| | - Johanne Smith Nielsen
- Center for Early Intervention and Family Studies, Department of PsychologyUniversity of CopenhagenCopenhagenDenmark
| | - Anne Christine Stuart
- Center for Early Intervention and Family Studies, Department of PsychologyUniversity of CopenhagenCopenhagenDenmark
| | - Mette Skovgaard Væver
- Center for Early Intervention and Family Studies, Department of PsychologyUniversity of CopenhagenCopenhagenDenmark
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Abstract
Objectives The present study investigated the effectiveness of an 8-week mindfulness mobile phone app on women’s depression, anxiety, stress and mindful attention/awareness in the postnatal period. Methods The study enrolled 99 mothers of a child under 1 year old, and randomly assigned them to intervention (n = 49, mean age = 31.11, SD = 4.30, years) and control (n = 50, mean age = 31.35, SD = 5.29, years) groups. Multiple regression examined intervention effects on depression, anxiety, stress and mindful attention/awareness measured post-intervention and at 4-week follow-up, controlling for the baseline and post-intervention measurement of the specific outcome, respectively. Results The intervention group showed significant decreases in depression, anxiety and stress levels and an increase of mindful attention/awareness post-intervention compared to the control group, with medium to large effect sizes after controlling for effects of corresponding variables at baseline. The intervention group showed further decrease in depression and stress levels and an increase in mindful attention/awareness at 4 weeks post-intervention compared to the control group, with small to medium effect sizes, after controlling for effects of corresponding variables at post-intervention. Conclusions The outcomes of the study suggest that delivery of mindfulness via smartphones could be a viable and affordable resource for reducing postnatal depression, anxiety and stress.
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Affiliation(s)
- Katie A Bear
- School of Psychology, University of Waikato, Hillcrest, Private Bag 3105, 3240 Hamilton, New Zealand
| | - Carol C Barber
- School of Psychology, University of Waikato, Hillcrest, Private Bag 3105, 3240 Hamilton, New Zealand
| | - Oleg N Medvedev
- School of Psychology, University of Waikato, Hillcrest, Private Bag 3105, 3240 Hamilton, New Zealand
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Fan P, Zhang Z, Liu Y, Xiong Y. Parent-Performed Infant Massage for Improving Parental Mental State Within 18 Months Postpartum: A Systematic Review. J Psychosoc Nurs Ment Health Serv 2022; 61:52-59. [PMID: 36099486 DOI: 10.3928/02793695-20220906-04] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
The aim of the current review was to assess whether parent-performed infant massage (PPIM) could effectively improve the mental state of parents during the postpartum period. Several international electronic databases were thoroughly searched for relevant articles. Included studies observed the influence of PPIM on the mental state of parents of healthy full-term infants within 18 months postpartum or medically stable preterm infants during hospitalization after birth. Nine studies were included, which observed one or more aspects of parental mental state, including depression, anxiety, parental stress, or general mood state. Characteristics of participants, massage protocols, and outcome measures were heterogenous; hence, results regarding the influence of PPIM on parental mental state were inconsistent. Upon further investigation, 10-minute, home-based PPIM for at least 4 weeks is advisable for maternal depression within 5 months postpartum. Moreover, PPIM in a neonatal intensive care unit is advisable for improving the general mood of mothers of preterm infants. Additional methodologically rigorous studies are needed to provide stronger evidence. [Journal of Psychosocial Nursing and Mental Health Services, 61(4), 52-59.].
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Ertekin Pinar S, Ozbek H. Paternal depression and attachment levels of first-time fathers in Turkey. Perspect Psychiatr Care 2022; 58:1082-1088. [PMID: 34216394 DOI: 10.1111/ppc.12905] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2020] [Revised: 05/07/2021] [Accepted: 06/19/2021] [Indexed: 11/29/2022] Open
Abstract
PURPOSE Paternal depression and inadequate attachment experienced in the postpartum period may be associated with future emotional and behavioural problems of children. This study aimed to investigate the paternal depression and attachment levels of first-time fathers. DESIGN AND METHODS The sample of this descriptive study consisted of 175 fathers with 3-6 months old babies whose wives applied to the polyclinic for check-up. FINDINGS When the cut-off point of the scale was evaluated at 13 and above in this study, the risk of depression was found to be 14.2%. The level of attachment decreases as fathers' risk of depression increases (p < 0.05). PRACTICE IMPLICATIONS There is a risk of depression in fathers in the postpartum period. The level of attachment decreases as fathers' risk of depression increases.
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Affiliation(s)
- Sukran Ertekin Pinar
- Midwifery Department, Faculty of Health Sciences, Sivas Cumhuriyet University, Sivas, Turkey
| | - Hilal Ozbek
- Midwifery Department, Faculty of Health Sciences, Sivas Cumhuriyet University, Sivas, Turkey
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Analysis of Emotional Stress of Teachers in Japanese Teaching Process Based on EEG Signal Analysis. Occup Ther Int 2022; 2022:2593338. [PMID: 35844240 PMCID: PMC9259334 DOI: 10.1155/2022/2593338] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2022] [Revised: 05/27/2022] [Accepted: 05/31/2022] [Indexed: 12/02/2022] Open
Abstract
The construction direction of Japanese teaching evaluation system based on hybrid teaching mode is to give full feedback to teaching process, diversify evaluation subjects and evaluation methods, and obtain comprehensive and objective evaluation results. Compared with most similar studies, more EEG data of teachers' emotional stress relief and healthy people in Japanese teaching process were collected, and a large number of features were extracted. An experiment of teachers' emotional stress relief recognition in Japanese teaching process based on EEG signal was designed. The feature selection algorithm was used to screen the EEG feature combinations of teachers' emotional stress relief and healthy subjects, and the classification experiment was carried out to verify the difference. Finally, this paper uses the feature selection algorithm of tree model and the random forest model classifier to establish the recognition model of teachers' emotional stress discharge in Japanese teaching process based on EEG signals and achieves the effect of more accurate recognition of teachers' emotional stress discharge in Japanese teaching process. First, the connotation, value, and influencing factors of teachers' emotion management ability are logically integrated and systematically expounded. Second, based on emotional psychology, emotional intelligence theory, psychotherapy theory, and management theory, teachers' emotional management ability is constructed according to the three-dimensional structure theory of intelligence and information processing theory. It is constructed from three dimensions: object dimension (teachers themselves, students, and students), content dimension (positive and negative emotions), and operational dimension (emotional perception, emotional understanding, emotional expression, and emotional regulation).
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Smythe KL, Petersen I, Schartau P. Prevalence of Perinatal Depression and Anxiety in Both Parents: A Systematic Review and Meta-analysis. JAMA Netw Open 2022; 5:e2218969. [PMID: 35749112 PMCID: PMC9233234 DOI: 10.1001/jamanetworkopen.2022.18969] [Citation(s) in RCA: 63] [Impact Index Per Article: 21.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
IMPORTANCE New and expectant parents experience perinatal mood disorders, with consequences to parenting ability, bonding with the neonate, interpersonal relationships, and health and well-being of parents. Research shows that maternal and paternal perinatal mood disorders are associated, but no recent systematic review has addressed the prevalence of perinatal mood disorders in both mothers and fathers (parental dyad). OBJECTIVE To examine the prevalence of perinatal mood disorders in parental dyads and identify factors associated with perinatal mood disorders in parental dyads. DATA SOURCES Ovid (MEDLINE, Embase, and PsycINFO) and Web of Science were searched from January 1, 1990, to June 8, 2021, for observational studies reporting on the prevalence of perinatal depression or anxiety in a parental dyad. STUDY SELECTION Studies reporting the prevalence of anxiety or depression in both members of a parental dyad were included, with diagnosis according to established criteria (Diagnostic and Statistical Manual of Mental Disorders [Fifth Edition], International Classification of Diseases, 11th Revision) or use of validated screening tools. DATA EXTRACTION AND SYNTHESIS Prevalence data were extracted in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Data were analyzed in subgroups: antenatal depression, early postnatal depression (0-12 weeks), late postnatal depression (3-12 months), and perinatal anxiety. Pooled prevalence was calculated using a random-effects meta-analysis model. Quality assessment was performed using Joanna Briggs Institute Appraisal Checklist for Studies Reporting Prevalence Data. Data were analyzed in June 2021. MAIN OUTCOMES AND MEASURES Prevalence of perinatal anxiety and perinatal depression in parental dyads. RESULTS Twenty-three studies were included, with data from 29 286 couples. The pooled prevalence of antenatal depression in both parents was 1.72% (95% CI, 0.96%-2.48%; P < .001). The prevalence of early postnatal depression (up to 12 weeks post partum) was 2.37% (95% CI, 1.66%-3.08%; P < .001) and the prevalence of late postnatal depression (3-12 months post partum) was 3.18% (95% CI, 2.3-4.05; P < .001). Only 3 studies reported on perinatal anxiety in both parents, precluding a quantitative analysis. CONCLUSIONS AND RELEVANCE In up to 3.18% of couples, both parents may concurrently experience perinatal depression. Perinatal health care must consider the mental health needs of parents, both as individuals and as a parental dyad. Further research is needed to examine outcomes in families where both parents experience perinatal mood disorders.
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Affiliation(s)
- Kara L Smythe
- Department of Primary Care and Population Health, Institute of Epidemiology and Health Care, University College London, London, United Kingdom
| | - Irene Petersen
- Department of Primary Care and Population Health, Institute of Epidemiology and Health Care, University College London, London, United Kingdom
| | - Patricia Schartau
- Department of Primary Care and Population Health, Institute of Epidemiology and Health Care, University College London, London, United Kingdom
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Mothers' interoceptive sensibility mediates affective interaction between mother and infant. Sci Rep 2022; 12:6273. [PMID: 35428844 PMCID: PMC9011379 DOI: 10.1038/s41598-022-09988-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2021] [Accepted: 03/31/2022] [Indexed: 12/01/2022] Open
Abstract
Interoceptive sensibility, which denotes the self-perceived sensitivity to inner-body sensations, has been associated with the emotional experiences and inferences of others’ emotional states. Focusing on the role of interoceptive sensibility in the emotional states and psychological well-being of mothers during caregiving, this study explores how physiological arousal and interoceptive sensibility mediate the association between mother–infant interaction and maternal well-being using an experience sampling method. Infant-directed-singing (IDS) with social touch was used to facilitate mother–infant interaction. Pairs of 2–8-month-old infants and their mothers participated. Mothers in an IDS group (N = 25) and a no-IDS group (N = 26) recorded their and the infant’s daily feelings and physiological states using a smartphone application for one month. All participants, including the control group (N = 78) who neither performed IDS nor used the application, answered the Multidimensional Assessment of Interoceptive Awareness questionnaire before and after the recording period. Results indicated that IDS improved mother–infant interactions and positive feelings, enhancing maternal physiological arousal. Increased interoceptive sensibility enhanced infants’ positive feelings in the IDS group, whereas in the no-IDS group, it weakened mother’s positive feelings, suggesting that maternal interoceptive sensibility mediated the effects of IDS on mother and infant well-being.
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Association between Mothers’ Attachment Styles and Parenting Stress among Japanese Mothers with Toddlers. PSYCHIATRY INTERNATIONAL 2022. [DOI: 10.3390/psychiatryint3020010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Parenting stress is affected by various factors, including maternal attachment; however, the number of studies focusing on Japanese samples is limited. As such, we explored the association between mothers’ attachment styles and parenting stress among Japanese mothers with 18-month-old toddlers. This cross-sectional study was conducted in Sasebo City, Japan between 2018 and 2019. Anonymous self-reported questionnaires were distributed to 1399 mothers who attended an infant health check-up. We categorized maternal attachment style as secure, anxious/ambivalent, or avoidant, and conducted a multiple logistic regression analysis to evaluate the associations between each attachment style and parenting stress. Of the 1399 mothers, 529 responded to the survey (37.8%). About 40% reported experienced parenting stress. Further, approximately two-thirds showed a secure attachment style, 20% had an anxious/ambivalent style, and 15% had an avoidant style. In the multiple logistic regression analysis, the ambivalently attached mothers had a significantly higher level of parenting stress than those with secure attachment (odds ratio = 2.4, 95% confidence interval (1.5, 3.9)), but avoidantly attached mothers did not have a significantly higher level of parenting stress than those with secure attachment (odds ratio = 0.9, 95% confidence interval (0.5, 1.6)). The findings demonstrate that an anxious/ambivalent attachment style is associated with a higher level of parenting stress than a secure style. Thus, it is important for experts to understand the mother’s attachment style when offering childrearing support.
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Dhungel B, Tsuguhiko K, Ochi M, Gilmour S, Kachi Y, Takehara K. Association of child's disability status with father's health outcomes in Japan. SSM Popul Health 2021; 16:100951. [PMID: 34754897 PMCID: PMC8556528 DOI: 10.1016/j.ssmph.2021.100951] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2021] [Revised: 10/21/2021] [Accepted: 10/21/2021] [Indexed: 11/25/2022] Open
Abstract
Fathers' involvement in childcare has been increasing in recent years. However, very little is known about the health impact on fathers when they are caring for or living with a disabled child. This study aims to understand the psychological distress and subjective health outcomes among fathers living with a disabled child compared to fathers living without a disabled child. Data for this study were obtained from the Comprehensive Survey of the Living Conditions conducted by the Ministry of Health, Labour and Welfare in 2016. Multivariable logistic regression was used among 438 disabled-child and father dyads and 27,682 non-disabled-child and father dyads to analyse the association between a child's disability status with father's health outcomes. Fathers of disabled children had a higher prevalence of psychological distress (17% vs. 12%) and poor subjective health status (13% vs. 8%) than fathers of non-disabled children. A large proportion of disabled children were boys (70%) and had disability level 1 (47%). After adjusting for covariates, the odds ratio (OR) of having psychological distress (OR, 1.53; 95% CI, 1.19–1.97) and poor subjective health status (OR, 1.78; 95% CI, 1.34–2.36) among fathers of disabled children is significantly higher compared to fathers of non-disabled children. Unemployed fathers had a higher odds ratio of psychological distress (OR, 3.07; 95% CI, 2.49–3.79) and poor subjective health status (OR, 4.90; 95% CI, 3.95–6.09) compared to regular working fathers. Fathers of children with disabilities need greater physical and mental health and wellbeing support. They should be provided with additional support not just for their mental but also their subjective wellbeing. Fathers of disabled children have higher odds ratio of psychological distress. Fathers of disabled children have higher odds ratio of poor subjective health status. 70% of disabled children were boys and 47% had mildest severity of disability.
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Affiliation(s)
- Bibha Dhungel
- Department of Health Policy, National Centre for Child Health and Development, Tokyo, 157- 8535, Japan.,Graduate School of Public Health, St. Luke's International University, Tokyo, 104-0045, Japan
| | - Kato Tsuguhiko
- Graduate School of Public Health, St. Luke's International University, Tokyo, 104-0045, Japan.,Department of Social Medicine, National Centre for Child Health and Development, Tokyo, 157-8535, Japan
| | - Manami Ochi
- Department of Social Medicine, National Centre for Child Health and Development, Tokyo, 157-8535, Japan.,Department of Health and Welfare Services, National Institute of Public Health, Saitama, 351-0197, Japan
| | - Stuart Gilmour
- Graduate School of Public Health, St. Luke's International University, Tokyo, 104-0045, Japan
| | - Yuko Kachi
- Department of Public Health, Kitasato University School of Medicine, Kanagawa, 252-0374, Japan.,School of Humanities and Social Sciences, Tokyo Metropolitan University, Tokyo, 192-0397, Japan
| | - Kenji Takehara
- Department of Health Policy, National Centre for Child Health and Development, Tokyo, 157- 8535, Japan
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Associations between Coparenting Relationships and Maternal Depressive Symptoms and Negative Bonding to Infant. Healthcare (Basel) 2021; 9:healthcare9040375. [PMID: 33800683 PMCID: PMC8065466 DOI: 10.3390/healthcare9040375] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2021] [Accepted: 03/24/2021] [Indexed: 11/19/2022] Open
Abstract
Maternal mental illnesses during early postpartum may be caused by lack of the coparenting relationship parents share and cooperate regarding child-rearing. This study clarifies the association of the coparenting relationship and negative mental health of mothers at one and three months after childbirth. This study conducted a secondary analysis of data from an intervention study wherein 24 mothers rearing their first child with a cohabitant (husband/partner) participated. Maternal mental health was evaluated using the Edinburgh Postnatal Depression Scale to determine postpartum depressive symptoms and the Mother-to-Infant Bonding Scale to assess negative bonding. Mothers’ average age was 31.5 ± 4.2 years old. All mothers were not working during the research period. The prevalence of postpartum depression and bonding disorder were approximately 13% and 21%, respectively. A better coparenting relationship was associated with lower postpartum depressive symptoms at both one month (β = −0.617, p = 0.002) and three months (β = −0.709, p < 0.01) postpartum. In contrast, no association was found between a coparenting relationship and negative bonding. The results indicate that the coparenting relationship may possibly prevent maternal depression during the early postpartum period.
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