Mother-to-infant bonding mediates the effects of depressive and anxious postpartum symptoms on parenting stress

Path analysis of the factors associated with postpartum depression symptoms in postpartum women

OBJECTIVES

Postpartum depression (PPD) is widely acknowledged as a significant mental health problem for postpartum women, and several factors have been associated with PPD. This study aimed to assess the prevalence of PPD and explore the factors and relationships associated with PPD symptoms in postpartum women using path analysis. Furthermore, a new framework for PPD modeling for postpartum women was introduced.

METHODS

A cross-sectional survey of 406 women at 42 days postpartum was conducted to collect the basic postpartum conditions and the factors associated with PPD. Linear regression was used to identify factors associated with PPD, and path analysis was used to explore the relationship between PPD and related factors.

RESULTS

The incidence of PPD symptoms was 18.5% (75/406). Multiple linear regression analysis showed that the independent risk factors associated with PPD symptoms in postpartum women included maternal postpartum stress, postpartum anxiety, social support, marital satisfaction, sleep quality, and maternal postnatal attachment (P < 0.05). The constructed path analysis model had good a fit (χ2/DF = 1.779, CFI = 0.998, GFI = 0.997, AGFI = 0.965, NFI = 0.995, IFI = 0.998, and RMSEA = 0.044). The path analysis revealed that postpartum anxiety exhibited only a direct effect on PPD (effect value: 0.243). Sleep quality was the factor that most affected PPD symptoms, followed by maternal postnatal attachment, postpartum stress, social support, postpartum anxiety, and marital satisfaction.

DISCUSSION

Our findings show that interventions targeting enhanced maternal postnatal attachment, improved sleep quality, strengthened social support, better marital relationships, as well as reduced postpartum stress and anxiety, can effectively alleviate PPD symptoms. The direct and indirect effects of these factors on PPD highlight its complexity and the significance of a multifaceted prevention and treatment approach. Our study deepens the understanding of the intricate relationships between psychosocial factors and PPD, providing insights for potential intervention targets.

Effect of pandemic-induced PTSD in pregnant women on infant physical growth: a prospective cohort study

BACKGROUND

The COVID-19 pandemic has had a profound impact on global mental health, particularly affecting vulnerable groups such as pregnant women. Post-traumatic stress disorder (PTSD) in this population may potentially hinder infant physical development, underscoring the necessity for specific interventions. This study seeks to explore the prevalence of PTSD among pregnant women during the pandemic and its implications for infant physical development, thereby providing evidence to mitigate the adverse effects of the pandemic on maternal and child health.

METHODS

A prospective cohort study was carried out involving 450 pregnant women from December 2022 to February 2023. Data included demographic details, PTSD evaluation using the PTSD Checklist-Civilian version (PCL-C) scale, coping mechanisms, and infant growth indicators at three months postpartum. Statistical methods included descriptive statistics, univariate analysis, and multivariate analysis of covariance (ANCOVA) to control for confounding factors.

RESULTS

The study enrolled a total of 450 pregnant women. Following exclusions and follow-up attrition, 422 pregnant women were analyzed. There were 72 pregnant women with PTSD and 350 without PTSD. There was no statistically significant difference in birth weight between the two groups of participants. Three months after birth, infants of PTSD-positive mothers exhibited significantly lower weight percentiles at three months (P < 0.001), adjusted for birth weight, feeding method, and coping strategies. Multivariate analysis affirmed a 9.44-point reduction in weight percentile among infants in the PTSD-positive group (95% CI: 4.01-14.87, P = 0.001).

CONCLUSION

Pregnant women suffering from PTSD during the pandemic are at risk of giving birth to infants with impaired physical growth. These findings highlight the critical need for mental health support for pregnant women to foster optimal infant development and to guide public health policies and clinical practices.

Does early skin-to-skin contact have a long-term effect on the emotional and behavioral development of very preterm infants?

Introduction

Premature birth may impair a sensitive, responsive, enjoyable, and regulating parenting style, potentially leading to behavioral, cognitive, and emotional deficits in children. Additionally, the emotional bond between the parent and infant may be disturbed due to the restrictions and difficulties at the neonatal intensive care unit (NICU), further negatively impacting child development. Skin-to-skin contact (SSC) directly after birth is strongly recommended also for preterm or low birth weight infants since there is high-certainty evidence that SSC has positive effects on neonatal and maternal health as well as on the quality of the parent-child relationship. The aim of this study was to examine the effect of skin-to-skin contact immediately after childbirth on the development of emotional and behavioral problems in children born preterm entering school.

Methods

This study is part of a randomized controlled delivery room skin-to-skin study (Deisy Study). A total of 33 children (aged 6-8 years) were assessed at school start. The German version of the CBCL/6-18R was used to evaluate the presence of behavior problems.

Results

The perceived parental stress 6 months after discharge was the variable that most contributed to the variance explanation. SSC immediately after childbirth was not significant in the prediction of emotional and behavioral problems at school start.

Limitations

The study was conducted in a small study group. Partners' variables were not included. Information regarding sociodemographic variables and bonding quality was collected 6 months (corrected age) after birth. The measurement of children's behavioral problems is not objective and corresponds to the parents' perception.

Clinical Trial Registration

https://clinicaltrials.gov, deisy study NCT01959737, deisy follow up NCT03366285.